Neurotoxicity prevention with a multimodal program (ATENTO) prior to cancer treatment versus throughout cancer treatment in women newly diagnosed for breast cancer: Protocol for a randomized clinical trial.

A current challenge in breast cancer (BC) patients is how to reduce the side effects of cancer and cancer treatments and prevent a decrease in quality of life (QoL). Neurotoxic side effects, especially from chemotherapy, are present in up to 75% of women with BC, which implies a large impact on QoL. There is a special interest in the preventive possibilities of therapeutic exercise (TE) for these neurological sequelae, and the benefits of TE could be improved when it is combined with vagal activation techniques (VATs). This superiority randomized controlled trial aims to examine the feasibility and efficacy of an 8-week multimodal intervention (ATENTO) based on moderate-vigorous intensity and individualized TE (aerobic and strength exercises) and VAT (myofascial and breathing exercises), on neurotoxicity prevention in women with BC before starting adjuvant chemotherapy (ATENTO-B) versus throughout adjuvant chemotherapy (ATENTO-T). A sample of 56 women newly diagnosed with BC, as calculated with a power of 85%, will be randomly allocated into these two groups. This study could provide an impetus for the introduction of early multimodal intervention methods to prevent neurotoxicity and consequently avoid the QoL deterioration that BC patients presently suffer throughout their treatments.

[Features of elder abuse and mistreatment in Puerto Rico]. / Características del abuso y maltrato de personas ancianas en Puerto Rico.

PURPOSE OF THE STUDY: This descriptive study seeks to understand the prevalence and the phenomenon of abuse and mistreatment among the elderly (60+) in Puerto Rico. The various forms of elder abuse are defined, including socio demographic characteristics, recurrence of abuse, characteristics of perpetrators (abusers), risk factors, and history of health conditions, among others. METHODS: A random sample group was selected among the cases filed with the Protective Services Unit of the Family Department Adults Services during 1999 throughout 2000 (fiscal year). The study included the regions of Aguadilla, Arecibo, Bayamón, Caguas, Carolina, Guayama, Humacao, Mayagüez, Ponce and San Juan. A total of 255 cases were evaluated of which 246 fulfilled the pre-established criteria. The procedures followed were in accordance with privacy and ethical standards. FINDINGS: The most common type of abuse identified is neglect, followed by emotional or psychological abuse, physical abuse, financial exploitation and sexual abuse. Cognitive and social impairment and the need for assistance are important risk factors for elder abuse. Most abusers are family members (especially the elders' offspring). Mitigating factors that explain or increase the risk of elderly abuse are physical or psychological illness of family members or caregiver and/or lack of access to resources. RECOMMENDATIONS: A systematic approach to appropriately report and document patient abuse is recommended. It is necessary to educate the public about the rights of the elderly. Educating professionals, caregivers, and the public on abuse is critical to prevention. The lack of awareness about elder abuse can lead to the public not being able to detect and/or denounce the elderly abuse and may result in death of the victim or aggressors.

Femenización de la vejez en Puerto Rico / Feminization of old age in Puerto Rico

As a result of the inequality of gender in life expectancy, there is a higher proportion of women than men in old age. The problems and changes that take place in this stage of life are basically women' problems so it can be stated that aging is a women's issue. Women face prejudices nor only for being women but also for being old, sexist and ageist prejudices. This article discusses areas in which women are affected as they aged such as: discrimination and ageism, poverty and loneliness, physical and social losses and changes. It will also present the positive aspects of being old and female

Política pública y mujer de edad avanzada / Public policy and elderly woman

Hablar de edad avanzada es hablar de mujer envejeciente. Los datos censales en Puerto Rico reflejan un aumento considerable del sector poblacional de las mujeres de edad avanzada. Esta aumento representa un reto de prestación de servicios y un reto al diseño e implantación de políticas públicas en torno a este grupo poblacional. Esta política pública debe ir encaminada a poner fin a la desigualdad existente entre géneros, a reconocer y a manejar apropiadamente las necesidades particulares de este grupo. Tres áreas de la política pública que son primordiales particularmente a la mujer de edad avanzada son: la seguridad económica, el cuidado de la salud y los servicios sociales