Fatalistic beliefs, self-care, and HbA1c in Mexican men with type 2 diabetes mellitus: A cross-sectional study.

The aim of this study is to examine the relationship between fatalistic beliefs, self-care, and glycemic control among Mexican men with type 2 diabetes mellitus. This is a cross-sectional study in men diagnosed with type 2 diabetes mellitus from 18 to 59 years of age from the Northeast of Mexico. Fatalistic beliefs, self-care, medication adherence, and HbA1C were evaluated. Patients were divided into glycemic control (<7% HbA1c) and without glycemic control (>7% HbA1c). Tests were performed to compare 2 independent groups, Student's t and U Mann Whitney. Correlation tests and multiple linear regression models were also performed. For statistical analysis, the SPSS v27 program was used. Forty-nine percent of the men had glycemic control (<7% HbA1c). Fatalistic beliefs were negatively correlated with self-care and medication adherence, but not with HbA1c. In multiple linear regression models, fatalistic beliefs were a negative predictor of self-care and medication adherence. In the model for HbA1c, the pessimism subdimension and self-care were the predictors. Fatalistic beliefs negatively affect self-care compliance and medication adherence, while the pessimism subdimension was related to the increase in HbA1c.

Feasibility of a Physical Training Intervention With Music in Community-Dwelling Older Women: A Quasi-Experimental Study.

Physical activity performed with music activates important brain areas associated with cognition, emotions, and motor skills. Limited information is available on the feasibility and acceptability of physical activity and music interventions. The current study aimed to (a) determine the feasibility of a physical training intervention with music in older women, and (b) describe the differences between pretest and posttest variables (i.e., cognitive state, immediate memory, executive function, gait parameters [cadence and gait speed], muscle strength, flexibility, and symptoms of depression). Results suggest that the intervention with physical training and music was feasible, given the high acceptability and retention rates, high level of attendance at the sessions, and absence of adverse events. Significant improvements were observed in immediate memory (p ≤ 0.01), executive function (p ≤ 0.05), cadence (p ≤ 0.01), leg strength (p ≤ 0.01), right arm strength (p ≤ 0.01), left arm strength (p ≤ 0.05), symptoms of depression (p ≤ 0.01), and left lower body flexibility (p ≤ 0.05). Therefore, a randomized clinical trial with a larger sample could confirm the effects of this intervention on memory, executive function, cadence, leg strength, arm strength, symptoms of depression, and left lower body flexibility. [Journal of Gerontological Nursing, 48(11), 37-43.].

Uso de la Realidad Virtual Inmersiva en la salud del adulto mayor, revisión sistemática / Use of Immersive Virtual Reality on the elderly health, systematic review

Introducción: El aumento del número de adultos mayores trae consigo un incremento de la prevalencia de enfermedades crónicas, que en conjunto con el deterioro asociado al envejecimiento conducen a una disminución temprana de las capacidades físicas y cognitivas. Dentro de esta problemática, la evidencia científica muestra que el uso de herramientas tecnológicas como la realidad virtual inmersiva tiene efectos positivos en la salud física y cognitiva en diversas poblaciones. Objetivo: Recopilar, revisar y analizar las intervenciones que utilizan sistemas de realidad virtual totalmente inmersivos en adultos mayores. Método: Por medio de los lineamientos del checklist PRISMA se realizó una búsqueda sistemática en las bases de datos: PubMed, Wiley Online Library, Science Direct y Google académico. La plataforma Web 3.0: Ficheros de Lectura Crítica se utilizó para analizar la calidad de los estudios. Resultados: Se incluyeron catorce estudios los cuales aportaron evidencia del uso, aceptación y tolerancia de la realidad virtual inmersiva, así como su efecto sobre la salud física y cognitiva. Conclusiones: Los estudios analizados revelan que la realidad virtual inmersiva es bien aceptada y tolerada por los adultos mayores, además de ser una herramienta prometedora para revertir o retrasar el deterioro físico y cognitivo. Sin embargo, los resultados no son consistentes debido a que existe una gran diversidad entre los sistemas de realidad virtual y contenido utilizado, así como estudios con muestras pequeñas y diseños no controlados. (AU)

Introduction: Due to the increase in the number of older adults, there is an increase in the prevalence of chronic diseases, which, together with the deterioration associated to aging, lead to an early decline in physical and cognitive abilities. Within this problem, scientific evidence shows that the use of technological tools such as immersive virtual reality has positive effects on physical and cognitive health in various population groups. Objective: Collect, review and assess interventions using fully immersive virtual reality systems in older adults. Method: Using the PRISMA checklist guidelines, a systematic search was carried out in the following databases: PubMed, Wiley Online Library, Science Direct and Google Scholar. The FLC 3.0 platform called “Ficheros de Lectura Crítica” (Critical Appraisal Tool) was used to assess the quality of the studies. Results: Fourteen studies were included, which provided evidence of the use, acceptance and tolerance of immersive virtual reality, as well as its effect on physical and cognitive health. Conclusions: The studies analyzed reveal that immersive virtual reality is well accepted and tolerated by older adults, as well as being a promising tool for reversing or delaying physical and cognitive decline. However, the results are not consistent due to the great diversity among virtual reality systems and content used, as well as studies with small samples and uncontrolled designs. (AU)

Riesgo de diabetes mellitus tipo 2 y sus determinantes / Risk of type 2 diabetes mellitus and its determinants

Objetivo: Describir la relación de los determinantes sociales de salud con el riesgo de DMT2 enpoblación mexicana.Métodos: Estudio descriptivo correlacional transversal, con una muestra de 256 individuos de unacomunidad rural de Sinaloa, México. La recolección de datos se realizó durante octubre de 2020 yfebrero de 2021. El muestreo fue no probabilístico por bola de nieve. Los instrumentos utilizados fueronel cuestionario internacional de actividad física (IPAQ) versión corta, IPAQ-A, IPAQ-C y una hoja deregistro datos sociodemográficos, antropométricos y clínicos.Resultados: Los indicadores de riesgo de DMT2 con mayor frecuencia para adultos fue padecerhipertensión arterial (81.7%) y SP/OB (68.6%) y para menores de edad fue tener SP/OB (34.9%).Resultó que el riesgo de DMT2 se acrecentaba según lo hacía la edad (r = .560, p < .01) perodisminuía al aumentar la escolaridad de las personas (r = -.127, p < .05).Conclusiones: El abordaje de factores de riesgo de DMT2 bajo la perspectiva de los DSS brinda laoportunidad de plantear estrategias de salud que contemplen factores contextuales simultáneos alestilo de vida que refuercen las acciones del personal de salud para contribuir a la reducción de losíndices de morbimortalidad causados por la DMT2 (AU)

Objective: Describe the relationship between social determinants of health and risk of type 2 diabetesmellitus in Mexican population.Methods: This was a cross-sectional descriptive correlational study of a sample of 256 individuals froma rural community in Sinaloa, Mexico. Data collection was carried out from October 2020 to February2021. A snowball non-probability sampling method was used. The Instruments used were theInternational Physical Activity Questionnaire (IPAQ), short version, the IPAQ-A for adults, the IPAQ-Cfor children, and a sociodemographic, anthropometric, and clinical data sheet.Results: The most frequent risk indicators for T2DM for adults are hypertension (81.7%) andoverweight/obesity (68.6%); in children, it was overweight/obesity (34.9%). The risk of T2DM increasedaccording to age (r = .560, p < .01) but decreased as education level increased (r = −.127, p < .05) (AU)

Replication of Integrative Data Analysis for Adipose Tissue Dysfunction, Low-Grade Inflammation, Postprandial Responses and OMICs Signatures in Symptom-Free Adults.

We previously reported preliminary characterization of adipose tissue (AT) dysfunction through the adiponectin/leptin ratio (ALR) and fasting/postprandial (F/P) gene expression in subcutaneous (SQ) adipose tissue (AT) biopsies obtained from participants in the GEMM study, a precision medicine research project. Here we present integrative data replication of previous findings from an increased number of GEMM symptom-free (SF) adults (N = 124) to improve characterization of early biomarkers for cardiovascular (CV)/immunometabolic risk in SF adults with AT dysfunction. We achieved this goal by taking advantage of the rich set of GEMM F/P 5 h time course data and three tissue samples collected at the same time and frequency on each adult participant (F/P blood, biopsies of SQAT and skeletal muscle (SKM)). We classified them with the presence/absence of AT dysfunction: low (<1) or high (>1) ALR. We also examined the presence of metabolically healthy (MH)/unhealthy (MUH) individuals through low-grade chronic subclinical inflammation (high sensitivity C-reactive protein (hsCRP)), whole body insulin sensitivity (Matsuda Index) and Metabolic Syndrome criteria in people with/without AT dysfunction. Molecular data directly measured from three tissues in a subset of participants allowed fine-scale multi-OMIC profiling of individual postprandial responses (RNA-seq in SKM and SQAT, miRNA from plasma exosomes and shotgun lipidomics in blood). Dynamic postprandial immunometabolic molecular endophenotypes were obtained to move towards a personalized, patient-defined medicine. This study offers an example of integrative translational research, which applies bench-to-bedside research to clinical medicine. Our F/P study design has the potential to characterize CV/immunometabolic early risk detection in support of precision medicine and discovery in SF individuals.

Determinantes individuales y contexto socioeconómico en el reporte de diabetes mellitus tipo 2 / Individual determinants and socioeconomic context in the report of type 2 diabetes mellitus / Determinantes individuais e contexto socioeconômico no relato de diabetes mellitus tipo 2

Objetivo: analizar la influencia de determinantes intermediarios individuales y estructurales del contexto socioeconómico del lugar de residencia en el reporte de DMT2 en adultos mayores colombianos. Método: diseño descriptivo correlacional transversal con datos de la Encuesta Nacional de Demografía y Salud, Colombia. La muestra representativa fueron 17,113 adultos mayores de 59 años. Se realizaron modelos logísticos multinivel con dos niveles: 1.determinantes individuales, 2.determinantes del contexto (departamentos: primera división administrativa del país). Resultados: la diabetes es mayor en mujeres, personas con educación superior, con dificultad para el ejercicio, con síntomas depresivos y ansiedad, pensionados e incapacitados. El nivel de riqueza fue positivo y significativamente asociado con el reporte de diabetes. Personas en departamentos con mayores promedios de riqueza fueron más propensos a tener auto reportes de diabetes. En contraste, el reporte de diabetes disminuyó después de los 80 años y a mejores niveles de percepción de salud. Personas en departamentos con mayores niveles de educación tuvieron menos auto reportes de diabetes. Conclusión: intervenciones efectivas de prevención y detección temprana de riesgo de diabetes, deben incluir factores sociales y económicos del contexto departamental, de modo que logren mejorar el estado de salud de los adultos mayores colombianos.

Objective: to analyze the influence of individual and structural intermediary determinants of the socioeconomic context of the place of residence in the DMT2 report in Colombian elderly. Method: transversal correlational design with data from the National Survey of Demography and Health, Colombia. The representative sample was 17,113 adults older than 59 years old. Multilevel logistic models were made with two levels: 1. individual determinants, 2. context determinants (departments: first administrative division of the country). Results: diabetes is higher in women, people with higher education, with difficulty in exercise, with depressive and anxiety symptoms, pensioners and disabled. The level of wealth was positive and significantly associated with the diabetes report. People in departments with higher average wealth were more likely to have autodiabetes reports. In contrast, the report of diabetes decreased after 80 years and to better levels of perception of health. People in departments with higher levels of education had fewer self-reports of diabetes. Conclusion: effective prevention interventions and early detection of diabetes risk must include social and economic factors of the departmental context, so that they can improve the health status of Colombian elderly.

Objetivo: analisar a influência dos determinantes intermediários individuais e estruturais do contexto socioeconômico do local de residência no relato de DMT2 em idosos colombianos. Método: desenho correlacional transversal com dados da Pesquisa Nacional de Demografia e Saúde, Colômbia. A amostra representativa foi de 17.113 idosos de 59 anos. Modelos logísticos multiníveis foram feitos com dois níveis: 1. determinantes individuais e 2. determinantes do contexto (departamentos: primeira divisão administrativa do país). Resultados: diabetes é maior em mulheres, pessoas com maior escolaridade, com dificuldade para o exercício, com sintomas depressivos e ansiosos, aposentados e deficientes. O nível de riqueza foi positivo e significativamente associado ao relato de diabetes. Pessoas em departamentos com maior riqueza média foram mais propensos a auto relato de diabetes. Em contraste, o registro de diabetes diminuiu após 80 anos e para melhores níveis de percepção de saúde. Pessoas em departamentos com níveis mais altos de educação tiveram menos relatos de diabetes. Conclusão: intervenções efetivas de prevenção e detecção precoce do risco de diabetes devem incluir fatores sociais e econômicos do contexto departamental, para que possam melhorar o estado de saúde dos idosos colombianos.

Riesgo ecológico para desarrollar Diabetes Mellitus tipo 2: derivación de una teoría de rango medio / Ecological risk to develop Diabetes Mellitus type 2: derivation of a mid-range theory

OBJETIVO: Describir la teoría de rango medio (TRM) "Riesgo ecológico para desarrollar Diabetes Mellitus Tipo 2". METODOLOGÍA: Se aplicó la estrategia "derivación teórica" por Walker y Avant a partir del Modelo Ecológico para la Promoción de la Salud. RESULTADOS: La teoría explica los factores individuales y del entorno involucrados en el riesgo de desarrollar Diabetes Mellitus tipo 2 (DMT2). CONCLUSIÓN: Existen en la literatura factores más allá del ámbito individual que influyen en las conductas de riesgo para desarrollar DMT2. Estos factores se pueden estructurar por medio del desarrollo de una TRM para facilitar la comprensión teórica del fenómeno. En este caso, la TRM se derivó del Modelo Ecológico para la Promoción de la Salud y permitió abordar el riesgo de desarrollar DMT2 desde una perspectiva ecológica

AIM: To describe the theory of mid-range (TRM) "Ecological risk to develop Type 2 Diabetes Mellitus". METHODOLOGY: The "theoretical derivation" strategy proposed by Walker y Avant was applied starting from the Ecological Model for the Promotion of Health. RESULTS: The theory explains the individual and environmental factors involved in the risk of developing Type 2 Diabetes Mellitus (DMT2). CONCLUSION: There are factors in the literature beyond the individual scope that influence risk behaviors to develop DMT2. These factors can be structured through the development of a TRM to facilitate the theoretical understanding of the phenomenon. In this case, the TRM was derived from the Ecological Model for Health Promotion and allowed addressing the risk of developing DMT2 from an ecological perspective

Teoría de rango medio: procesos familiares que predicen el descontrol glucémico en diabetes mellitus 2 / Middle range theory: family processes predicting glycemic uncontrolled in diabetes mellitus 2 / Teoria de médio alcance: processos familiares que predizem o descontrole glicêmico no diabetes mellitus 2

Objetivo: describir el desarrollo de una teoría de rango medio que contribuya en el abordaje de las perspectivas tanto del individuo como de los integrantes de la familia considerando las relaciones e interacciones que surgen en la dinámica de la vida diaria al experimentar una situación de cronicidad. Método: la teoría fue desarrollada deductivamente del modelo de la organización sistémica, un modelo empleado en la investigación y en la disciplina de enfermería para el abordaje del sistema familiar e individual. Los vínculos entre los conceptos de la teoría se desarrollan bajo los niveles de abstracción planteados por Smith y Liehr. Resultados: el desarrollo de la teoría procesos familiares e individuales y descontrol glucémico en adultos con diabetes mellitus 2 sirve para construir la ciencia de enfermería mediante la integración de la teoría de enfermería existente y el conocimiento empírico. Conclusión: esta teoría ayuda a comprender de mejor forma como se percibe y otorga el apoyo al interior de la familia y la influencia con el automanejo del integrante con diabetes mellitus 2 reflejado en el control glucémico.(AU)

Objective: to describe the development of a mid-range theory that contributes to the approach of the perspectives of both the individual and the members of the family considering the relationships and interactions that arise in the dynamics of daily life when experiencing a situation of chronicity. Method: the theory was developed deductively from the model of the systemic organization, a model used in research and in the discipline of nursing for the approach of the family and individual system. The links between the concepts of the theory are developed under the levels of abstraction proposed by Smith and Liehr. Results: the development of the theory: Family and Individual Processes and Glycemic Decontrol in adults with diabetes mellitus 2 serves to build nursing science through the integration of existing nursing theory and empirical knowledge. Conclusion: this theory helps to better understand how it is perceived and gives support to the interior of the family and the influence with the self-management of the member with diabetes mellitus 2 reflected in glycemic control.(AU)

Objetivo: descrever o desenvolvimento de uma teoria de médio alcance que contribua para abordagem das perspectivas tanto do indivíduo quanto dos membros da familia, considerando as relações e interações que surgem na dinâmica da vida diária ao experimentar uma situação de cronicidade. Método: teoria desenvolvida dedutivamente a partir do modelo de organização sistêmica, um modelo usado na investigação e disciplina de enfermagem para abordar a família e sistema individual. As ligações entre os conceitos da teoria são desenvolvidas sob os níveis de abstração levantados por Smith e Liehr. Resultados: o desenvolvimento da teoria processos familiares e individuais, e descontrole glicémico em adultos com diabetes mellitus 2 serve para construir a ciência de enfermagem mediante a integração da teoría de enfermagem existente e o conhecimento empírico. Conclusão: esta teoria ajuda a compreender de melhor forma como se percebe e fornece o apoio no interior da familia e a influência com o automanejo do integrante com diabetes mellitus 2 refletido no controle glicémico.(AU)

Social Factors Contributing to the Development of Allostatic Load in Older Adults: A Correlational-Predictive Study / Factores sociales que contribuyen al desarrollo de la carga alostática en adultos mayores: un estudio correlacional-predictivo / Fatores sociais que contribuem para o desenvolvimento da carga alostática em idosos: um estudo preditivo correlacional

ABSTRACT Objective: To determine if social factors, such as housing conditions, satisfaction with one's house, neighborhood characteristics, social support, family relations and church attendance affect allostatic load in older adults. Materials and method: A correlational-predictive, cross-sectional study was conducted. The instruments used were sociodemographic data, the perceived family relationships instrument, the Medical Outcomes Study-Social Support Survey and the abbreviated version of the Neighborhood Environment Walkability Scale. The allostatic load biomarkers used were: systolic and diastolic blood pressure, body mass index, waist circumference, waist-hip ratio, total cholesterol, high density lipoprotein, glycated hemoglobin, fibrinogen, and C-reactive protein. Sample size was estimated to contrast the no relation (R2= 0) hypotheis in a multiple lineal regression model with 11 covariables, with a significance level of .05, power of 90% (.90), when coefficient of determination (R2) is .15, resulting in a sample of 131 older adults. The statistical analysis included descriptive measures and generalized linear models. Results: The participants had either medium- or high-risk allostatic load. Multivariate linear regression model analysis showed that better housing conditions, satisfaction with own house, presence of dead-end streets, and church attendance reduce allostatic load, while dangerous traffic increases allostatic load. Conclusions: There are several social factors contributing to the development of allostatic load in older adults. It is necessary to create nursing care strategies toward the social environment to decrease allostatic load in older adults.

RESUMEN Objetivo: determinar si factores sociales como las condiciones de vivienda, la satisfacción con la casa, las características del vecindario, el apoyo social, las relaciones familiares y la asistencia a la iglesia contribuyen al desarrollo de la carga alostática en los adultos mayores. Materiales y método: se realizó un estudio correlacional y predictivo de corte transversal. Los instrumentos utilizados fueron una hoja de datos sociodemográficos, el instrumento de relaciones familiares percibidas, el cuestionario de Apoyo Social y la Escala de Movilidad Activa en el Entorno Comunitario, versión corta. Los biomarcadores de carga alostática utilizados fueron: presión arterial sistólica y diastólica, índice de masa corporal, circunferencia de la cintura, relación cintura-cadera, colesterol total, lipoproteína de alta densidad, hemoglobina glicosilada, fibrinógeno y proteína C-Reactiva. La muestra se calculó para para el contraste de la hipótesis de no relación (R2= 0), en un modelo de regresión lineal múltiple con 11 covariables, con un nivel de significancia del .05 y una potencia del 90 % (.90), cuando el coeficinete de determinación poblacional (R2) es .15, tamaño de muestra que resultó en 131 adultos mayores. El análisis estadístico incluyó medidas descriptivas y modelos lineales generalizados. Resultados: los participantes tenían un riesgo medio o alto de carga alostática. El análisis del modelo de regresión lineal multivariante mostró que las mejores condiciones de vivienda, la satisfacción con la propia casa, la presencia de calles sin salida y la asistencia a la iglesia reducen la carga alostática y que el tráfico peligroso aumenta la carga alostática. Conclusiones: existen varios factores sociales que contribuyen al desarrollo de la carga alostática en adultos mayores. Es necesario crear estrategias de cuidado de enfermería hacia el entorno social para disminuir la carga alostática en el adulto mayor.

RESUMO Objetivo: determinar se fatores sociais, como as condições de moradia, a satisfação com a casa, as características do bairro, o apoio social, as relações familiares e a freqüência à igreja afetam a carga alostática em idosos. Materiais e método: um estudo de correlação transversal e preditivo foi realizado. Os instrumentos utilizados foram dados sociodemográficos, o instrumento de relações familiares percebido, o Medical Outcomes Study-Social Support Survey e a Abbreviated Neighborhood Environment Walkability Scale. Os biomarcadores de carga alostática utilizados foram: pressão arterial sistólica e diastólica, índice de massa corporal, circunferência da cintura, relação cintura-quadril, colesterol total, lipoproteína de alta densidade, hemoglobina glicada, fibrinogênio e proteína C-reativa. A amostra foi calculada para o contraste do hipóseo de nenhuma relação (R2 = 0), em um modelo de regresión múltiple linear con 11 covariáveis, com um nível de significância de 0.05 e uma potencia de 90% (0.90), quando o coeficiente de determinação populacional (R2) es .15, o tamanho da amostra resultou em 131 idosos. A análise estatística incluiu medidas descritivas e modelos lineares generalizados. Resultados: os participantes tinham risco médio ou alto de carga alostática. A análise multivariada do modelo de regressão linear mostrou que melhores condições de moradia, satisfação com a casa própria, presença de ruas sem saída e freqüência à igreja reduzem a carga alostática e o tráfego perigoso aumenta a carga alostática. Conclusões: existem vários fatores sociais que contribuem para o desenvolvimento da carga alostática em idosos. É necessário criar estratégias de cuidados de enfermagem em direção ao ambiente social para diminuir a carga alostática no idoso.

Factors Contributing to Active Aging in Older Adults, from the Framework of Roy's Adaptation Model.

OBJECTIVES: To determine the variables contributing to the explanation of active aging according to Roy's adaptation model. METHODS: Descriptive correlational study, with convenience and snowball sampling. Two hundred older adults with chronic disease, were included. The instruments used were: a) Yesavage's Geriatric depression scale, b) Pheiffer's mental state questionnaire, c) basic activities of daily living, d) instrumental activities of daily living, e) Hope scale, f) coping mechanism items from the Successful Aging Inventory (coping with aging), g) hours of volunteer work, and h) The Duke-UNC Functional Social Support Questionnaire. Coping with aging was composed of independence in basic and instrumental activities of daily living, free from symptoms of depression, good mental state, and perception of health as good. Data were analyzed by using descriptive and inferential statistics, and simple and multiple linear regression models. RESULTS: Fifty one percent of the participants showed active aging (42% men, and 56% women). Of the proposed variables, the variables showing effect on the variables of active aging, in the generalized linear model, were years of suffering the disease (Λ=0.922; p=0.008), coping with aging (Λ=0.582; p=0.001), and perceived social support (Λ=0.885; p=0.001). These three variables explained 5% of basic activities of daily living, 41% of the instrumental activities, 12.5% of health perception, 26% of mental state, and 21% of depression. Hope, and volunteer work were not significant. When the variables of active aging were dichotomized, age showed negative effect on global active aging and coping with aging positive effect. CONCLUSIONS: Although, proposed variables explained individually active aging, only coping with aging explained global active aging.

Autocuidado del hombre con diabetes mellitus tipo 2: impacto del machismo / Self-care of man with type 2 diabetes mellitus: impact of machismo

Objetivo: Determinar si el machismo, apoyo familiar, la percepción de salud y la autoeficacia influyen en las actividades de autocuidado del hombre con diabetes mellitus tipo 2. Metodología: El diseño del estudio fue descriptivo correlacional, con una muestra de 126 participantes de 14 centros de atención primaria. Resultados: El machismo se correlacionó de manera negativa con el apoyo familiar y la autoeficacia. Mientras que el autocuidado se explicó el 30.5% de la varianza, las variables predictores fueron las conductas familiares, la autoeficacia, las sub-escalas del machismo; primacía del trabajo, ser independiente y violento. Conclusiones: El machismo puede influir de manera directa al autocuidado y de manera indirecta, por medio del apoyo familiar y la autoeficacia

Objective: To determine if machismo, family support, health perception and self-efficacy influence in the self-care activities of the man with type 2 diabetes mellitus. Methodology: The design of the study was correlational descriptive, with a sample of 14 primary attention centers. Results: Machismo correlated negatively with family support and self-efficacy. While self-care was explained the 30.5% of the variance, the predictor variables were the family conducts, the self-efficacy, the sub-scales of machismo, work supremacy, being independent and violent. Conclusions: Machismo may influence directly to self-care and indirectly, through family support and self-efficacy

Factores que contribuyen al Envejecimiento Activo en los adultos mayores, desde el marco del Modelo de Adaptación de Roy / Fatores que contribuem ao Envelhecimento Ativo nos adultos maiores, desde o marco do Modelo de Adaptação de Roy / Factors Contributing to Active Aging in Older Adults, from the Framework of Roy's Adaptation Model

Objective. To determine the variables contributing to the explanation of active aging according to Roy's adaptation model. Methods. Descriptive correlational study, with convenience and snowball sampling. Two hundred older adults with chronic disease, were included. The instruments used were: a) Yesavage's Geriatric depression scale, b) Pheiffer's mental state questionnaire, c) basic activities of daily living, d) instrumental activities of daily living, e) Hope scale, f) coping mechanism items from the Successful Aging Inventory (coping with aging), g) hours of volunteer work, and h) The Duke-UNC Functional Social Support Questionnaire. Coping with aging was composed of independence in basic and instrumental activities of daily living, free from symptoms of depression, good mental state, and perception of health as good. Data were analyzed by using descriptive and inferential statistics, and simple and multiple linear regression models. Results. Fifty one percent of the participants showed active aging (42% men, and 56% women). Of the proposed variables, the variables showing effect on the variables of active aging, in the generalized linear model, were years of suffering the disease (Λ=0.922; p=0.008), coping with aging (Λ=0.582; p=0.001), and perceived social support (Λ=0.885; p=0.001). These three variables explained 5% of basic activities of daily living, 41% of the instrumental activities, 12.5% of health perception, 26% of mental state, and 21% of depression. Hope, and volunteer work were not significant. When the variables of active aging were dichotomized, age showed negative effect on global active aging and coping with aging positive effect. Conclusion. Although, proposed variables explained individually active aging, only coping with aging explained global active aging. (AU)

Objetivo. Determinar las variables que contribuyen a la explicación del envejecimiento activo de acuerdo con el modelo de adaptacion de Roy. Métodos. Estudio descriptivo correlacional; se hizo muestreo por conveniencia y bola de nieve. Se incluyeron 200 adultos mayores. Se utilizaron los instrumentos: a) escala geriátrica de depresión de Yesavage, b) cuestionario de estado mental de Pfeiffer, c) Actividades básicas de la vida diaria, d) Actividades instrumentales de la vida diaria, e) escala de esperanza, f) reactivos de mecanismos de afrontamiento del inventario de Envejecimiento exitoso (afrontamiento al envejecimiento), y g) el cuestionario de apoyo social Duke-UNC-11. El envejecimiento activo se conformó por independencia en las actividades básicas e instrumentales de la vida diaria, libre de síntomas de depresión, buen estado mental y percepción de salud buena. Los datos se analizaron a partir de estadística descriptiva e inferencial, y modelos de regresión lineal y múltiple. Resultados. El 51% de los participantes mostró envejecimiento activo (42% en hombres y 56% en mujeres). De las variables propuestas, el modelo lineal generalizado mostró que los años de padecer la enfermedad, (Λ=0.922; p=0.008), el afrontamiento al envejecimiento (Λ=0.582; p=0.001), y el apoyo social percibido (Λ=0.885; p= 0.001), presentaron efecto sobre las variables que conformaron el envejecimiento activo. Estas tres variables explicaron el 5% de las actividades de la vida diaria, 41% de las instrumentales, 12.5% de la percepción de salud, 26% del estado mental y el 21% de la depresión. La esperanza y trabajo voluntario no fueron significativas. Al dicotomizar las variables del envejecimiento activo se encontraron efectos negativos de la edad y positivos del afrontamiento al envejecimiento. Conclusión. Aunque en este estudio se encontró que las variables propuestas explican en forma individual las variables del envejecimiento activo, solamente el afrontamiento al envejecimiento explicó la varianza del envejecimiento activo en forma global. (AU)

Objetivo. Determinar as variáveis que contribuem à explicação do envelhecimento ativo de acordo ao modelo de adaptação de Roy. Métodos. Estudo descritivo de correlação, se fez amostragem por conveniência e bola de neve. Se incluíram 200 adultos maiores. Se utilizaram os instrumentos: a) escala geriátrica de depressão de Yesavage, b) questionário de estado mental de Pfeiffer, c) Atividades básicas da vida diária, d) Atividades instrumentais da vida diária, e) escala de esperança, f) reativos de mecanismos de afrontamento do inventário de Envelhecimento de sucesso (afrontamento ao envelhecimento), e g) o questionário de apoio social Duke-UNC-11. O envelhecimento ativo se conformou por independência nas atividades básicas e instrumentais da vida diária, livre de sintomas de depressão, bom estado mental e percepção de boa saúde. Os dados se analisaram através de estatística descritiva e inferencial, e modelos de regressão lineal e múltipla. Resultados. 51% dos participantes mostrou envelhecimento ativo (42% em homens e 56% em mulheres). Das variáveis propostas o modelo lineal generalizado mostrou que os anos de padecer a doença, (Λ=0.922; p=0.008), o afrontamento ao envelhecimento (Λ=0.582; p=0.001), e o apoio social percebido (Λ=0.885; p=0.001), apresentaram efeito sobre as variáveis que conformaram o envelhecimento ativo. Estas três variáveis explicaram 5% das atividades da vida diária, 41% dos instrumentais, 12.5% da percepção de saúde, 26% do estado mental e 21% da depressão. A esperança, e trabalho voluntário não foram significativas. Ao classificar as variáveis do envelhecimento ativo se encontrou efeito negativo da idade e positivo do afrontamento ao envelhecimento sobre o envelhecimento ativo global. Conclusão. Embora neste estudo se encontrou que as variáveis propostas explicam em forma individual as variáveis do envelhecimento ativo, somente o afrontamento ao envelhecimento explicou a variável do envelhecimento ativo em forma global. (AU)

Factors associated with glycemic status and ability to adapt to changing demands in people with and without type 2 diabetes mellitus: A cross-sectional study.

OBJECTIVES: Type 2 diabetes mellitus studies focus on metabolic indicators and different self-reported lifestyle or care behaviors. Self-reported instruments involve conscious process therefore responses might not reflect reality. Meanwhile implicit responses involve automatic, unconscious processes underlying social judgments and behavior. No studies have explored the combined influence of both metabolic indicators and implicit responses on lifestyle practices in type 2 diabetes mellitus patients. The purpose was to investigate the explained variance of socio-demographic, metabolic, anthropometric, clinical, psychosocial, cognitive, and lifestyle variables on glycemic status and on the ability to adapt to changing demands in people with and without type 2 diabetes mellitus in Monterrey, Mexico. METHODS: Adults with (n = 30, mean age 46.90 years old, 33.33% male) and without (n = 32, mean age: 41.69 years old, 21.87% male) type 2 diabetes mellitus were studied. Glycemic status was assessed using Bio-Rad D-10 Hemoglobin A1c Program, which uses ion-exchange high-performance chromatography. Stroop 2 test was used to assess the ability to changing demands. RESULTS: In participants with type 2 diabetes mellitus, less years of education, negative self-actualization, and higher levels of cholesterol and triglycerides explained more than 50% of the variance in glycemic status. In participants without type 2 diabetes mellitus, the variance (38.7%) was explained by total cholesterol, metabolic syndrome, high-density lipoprotein, and self-actualization scores; the latter in opposite direction. The ability to adapt to changing demands was explained by total cholesterol, malondialdehyde, insulin resistance, and triglycerides. In participants without type 2 diabetes mellitus, the contributing variables were metabolic syndrome and nutrition scores. CONCLUSION: Results showed significant effect on at least one of the following variables (socio-demographic, metabolic, or lifestyle subscale) on glycemic status in people with and without type 2 diabetes mellitus. The ability to adapt to changing demands was explained by metabolic variables but only in participants without type 2 diabetes mellitus. Preference for unhealthy behaviors (implicit or automatic responses) outweighs healthy lifestyle practices in people with and without type 2 diabetes mellitus.

Middle-Range Theory: Coping and Adaptation with Active Aging.

Various disciplines focus on a multiplicity of aspects of aging: lifestyles, personal biological factors, psychological conditions, health conditions, physical environment, and social and economic factors. The aforementioned are all related to the determinants of active aging. The aim is to describe the development of a middle-range theory based on coping and adaptation with active aging. Concepts and relationships derived from Roy's model of adaptation are included. The proposed concepts are hope, health habits, coping with aging, social relations, and active aging.

Mini-Review: The Contribution of Intermediate Phenotypes to GxE Effects on Disorders of Body Composition in the New OMICS Era.

Studies of gene-environment (GxE) interactions describe how genetic and environmental factors influence the risk of developing disease. Intermediate (molecular or clinical) phenotypes (IPs) are traits or metabolic biomarkers that mediate the effects of gene-environment influences on risk behaviors. Functional systems genomics discovery offers mechanistic insights into how DNA variations affect IPs in order to detect genetic causality for a given disease. Disorders of body composition include obesity (OB), Type 2 diabetes (T2D), and osteoporosis (OSTP). These pathologies are examples of how a GxE interaction contributes to their development. IPs as surrogates for inherited genotypes play a key role in models of genetic and environmental interactions in health outcomes. Such predictive models may unravel relevant genomic and molecular pathways for preventive and therapeutic interventions for OB, T2D, and OSTP. Annotation strategies for genomes, in contrast to phenomes, are well advanced. They generally do not measure specific aspects of the environment. Therefore, the concepts of deep phenotyping and the exposome generate new avenues to exploit with high-resolution technologies for analyzing this sophisticated phenome. With the successful characterization of phenomes, exposomes, and genomes, environmental and genetic determinants of chronic diseases can be united with multi-OMICS studies that better examine GxE interactions.

Autopsia verbal en hombres adultos con diabetes tipo 2: estudio cualitativo / Verbal autopsy of adult men with diabetes type 2: qualitative study / Autópsia verbal em homens adultos com diabetes tipo 2: estudo qualitativo

INTRODUCCIÓN: La diabetes mellitus tipo 2 (DMT2) es un padecimiento crónico cuya incidencia se incrementa en forma alarmante. El objetivo fue identificar los factores asociados al no autocuidado en hombres con muerte prematura y diagnóstico de DMT2. MATERIALES Y MÉTODOS: Se realizaron seis entrevistas cualitativas a familiares de hombres con DMT2 que fallecieron por complicaciones de su enfermedad, utilizando la metodología de la autopsia verbal. Los resultados se analizaron mediante el análisis de contenido. RESULTADOS: Dentro de los factores que surgieron como limitantes para el autocuidado fueron: la negación de la DMT2, el trabajo, el machismo, preferencia en los alimentos, apoyo familiar, el consumo de alcohol, el consumo de tabaco y la depresión. DISCUSIÓN: Los hombres con DMT2 se ven influenciados por diversas circunstancias que limitan cuidarse, atenderse y por consiguiente presentar desventajas de salud, complicaciones e incluso una muerte temprana. CONCLUSIONES: Desde la perspectiva de enfermería los resultados ayudan a comprender el comportamiento de los hombres ante esta enfermedad en donde se requiere cuidado constante, a la par que una conciencia legítima de que no se deja de ser hombre por cuidarse.

INTRODUCTION: Diabetes mellitus type 2 (DMT2) is a chronic disease whose incidence increases in alarming manner. The objective was to identify the factors associated to no self-care in men with premature death and diagnosis of DMT2. MATERIALS AND METHODS: Six qualitative interviews, using the verbal autopsy methodology, were conducted with relatives of men with DMT2 who died due to complications of their disease. The results were analyzed through content analysis. RESULTS: Denial of the DMT2, work, male chauvinism, food preference, family support, alcohol consumption, smoking, and depression were among the factors the participants suggested as limiting self-care. DISCUSSION: Men with DMT2 are influenced by diverse circumstances that limit caring for themselves and, consequently, presenting health disadvantages, complications, and even an early death. CONCLUSIONS: From the nursing perspective, the results help to understand the behavior of the men regarding this disease, which requires constant care, while gaining a legitimate awareness that self-care does not threaten their manhood.

INTRODUÇÃO: Diabetes mellitus tipo 2 (DMT2) é uma condição crônica, cuja incidência aumenta de uma forma alarmante. O objetivo foi identificar os fatores associados ao não autocuidado em homens com morte prematura e diagnóstico de DMT2. MATERIAIS E MÉTODOS: Foram realizadas seis entrevistas qualitativas aos familiares de homens com DMT2 que morreram por complicações da sua doença, utilizando a metodologia de autópsia verbal. Os resultados foram analisados pela análise de conteúdo. RESULTADOS: Dentro dos fatores que surgiram como limitações para o autocuidado foram: negação da DMT2, trabalho, machismo, preferência alimentar, apoio familiar, consumo de álcool, consumo de tabaco e depressão. DISCUSSÃO: Os homens com DMT2 são influenciados por diversas circunstâncias que limitam cuidarem de si mesmo, prestar atenção e, portanto, têm desvantagens de saúde, complicações e até mesmo a morte precoce. CONCLUSÕES: Da perspectiva de enfermagem, os resultados ajudam a compreender o comportamento dos homens diante desta doença, quando necessário cuidado constante, ao mesmo tempo, uma consciência legítima que não se deixa de ser homem por se cuidar.

Genetic variants in KCNJ11, TCF7L2 and HNF4A are associated with type 2 diabetes, BMI and dyslipidemia in families of Northeastern Mexico: A pilot study.

The aim of the present study was to investigate whether genetic markers considered risk factors for metabolic syndromes, including dyslipidemia, obesity and type 2 diabetes mellitus (T2DM), can be applied to a Northeastern Mexican population. A total of 37 families were analyzed for 63 single nucleotide polymorphisms (SNPs), and the age, body mass index (BMI), glucose tolerance values and blood lipid levels, including those of cholesterol, low-density lipoprotein (LDL), very LDL (VLDL), high-density lipoprotein (HDL) and triglycerides were evaluated. Three genetic markers previously associated with metabolic syndromes were identified in the sample population, including KCNJ11, TCF7L2 and HNF4A. The KCNJ11 SNP rs5210 was associated with T2DM, the TCF7L2 SNP rs11196175 was associated with BMI and cholesterol and LDL levels, the TCF7L2 SNP rs12255372 was associated with BMI and HDL, VLDL and triglyceride levels, and the HNF4A SNP rs1885088 was associated with LDL levels (P<0.05).

Connection between competence, usability, environment and risk of falls in elderly adults.

OBJECTIVE: To determine connections between competence, usability, environment and risk of falls in elderly adults. METHOD: Correlational descriptive study, 123 elderly adults, both male and female, aged 70 years and older were included. Data was collected via the Tinetti Scale, CESD-7 Scale, Montreal Cognitive Assessment, Usability Questionnaire on Housing and Housing Enabler; and sociodemographic and health background certificate data. For data analysis, descriptive and inferential statistics were used, multivariate linear and logistic regression models were adjusted. RESULTS: 42.0% of the elderly adults had presented with falls, with a higher prevalence in women, and in the group of 70-75 years. The physical environment of the house, gait, and usability were set as risk factors for falls. A negative relationship between usability and depressive symptoms, cognitive health, balance, gait, the social and physical environment was found, p <0.05; and a strong positive correlation between walking and balance, p <0.05. CONCLUSION: This study helps to better understand the phenomenon of falling, to find a connection between usability with the risk of falls, and other variables.

Connection between competence, usability, environment and risk of falls in elderly adults / Relação entre competência, usabilidade, ambiente e risco de quedas em idosos / Relación entre competencia, usabilidad, entorno y riesgo de caídas en el adulto mayor

Objective: to determine connections between competence, usability, environment and risk of falls in elderly adults. Method: correlational descriptive study, 123 elderly adults, both male and female, aged 70 years and older were included. Data was collected via the Tinetti Scale, CESD-7 Scale, Montreal Cognitive Assessment, Usability Questionnaire on Housing and Housing Enabler; and sociodemographic and health background certificate data. For data analysis, descriptive and inferential statistics were used, multivariate linear and logistic regression models were adjusted. Results: 42.0% of the elderly adults had presented with falls, with a higher prevalence in women, and in the group of 70-75 years. The physical environment of the house, gait, and usability were set as risk factors for falls. A negative relationship between usability and depressive symptoms, cognitive health, balance, gait, the social and physical environment was found, p <0.05; and a strong positive correlation between walking and balance, p <0.05. Conclusion: this study helps to better understand the phenomenon of falling, to find a connection between usability with the risk of falls, and other variables.

Objetivo: determinar a relação entre competência, usabilidade e ambiente com risco de quedas em idosos. Método: estudo descritivo correlacional, incluindo 123 homens e mulheres idosos de 70 anos para mais. Os dados foram coletados com os instrumentos Escala de Tinetti, Escala CESD-7, Avaliação Cognitiva Montreal, Questionário de Usabilidade na Moradia e Housing Enabler; e um instrumento de coleta de dados para antecedentes sociodemográficos e de saúde. Para a análise dos dados, foi utilizada estatística descritiva e inferencial, em que foram ajustados modelos lineares multivariados e de regressão logística. Resultados: 42,0% dos idosos apresentaram quedas, sendo maior a prevalência nas mulheres e no grupo de 70-75 anos. Como risco de quedas, foram encontrados o ambiente físico da moradia, caminhada e usabilidade. Encontrou-se relação negativa entre usabilidade com sintomas depressivos, saúde cognitiva, equilíbrio, caminhada, ambiente social e físico p<0,05; e forte correlação positiva entre caminhada e equilíbrio p<0,05. Conclusão: o estudo contribui para melhor compreensão formal do fenômeno das quedas ao encontrar relação entre a usabilidade com o risco de quedas, e com outras variáveis que se relacionam com as quedas.

Objetivo: determinar la relación de la competencia, usabilidad y del entorno con el riesgo de caídas en el adulto mayor. Método: estudio descriptivo correlacional, se incluyeron 123 adultos mayores hombres y mujeres de 70 años y más. Los datos fueron recolectados con los instrumentos Escala de Tinetti, Escala CESD-7, Evaluación Cognitiva Montreal, Cuestionario de Usabilidad en la Vivienda y Housing Enabler; y una cédula de datos para antecedentes sociodemográficos y de salud. Para el análisis de datos se utilizó una estadística descriptiva e inferencial, en donde se ajustaron modelos lineales multivariados y de regresión logística. Resultados: el 42,0% de los adultos mayores había presentado caídas, con una mayor prevalencia en las mujeres y en el grupo de 70-75 años. El entorno físico de la vivienda, marcha y usabilidad se establecieron como riesgos de caída. Se encontró una relación negativa entre la usabilidad y los síntomas depresivos, la salud cognitiva, el equilibrio, la marcha, el entorno social y físico p<0,05; y una fuerte correlación positiva entre la marcha y el equilibrio p<0,05. Conclusión: el estudio contribuye a comprender mejor el fenómeno de las caídas al encontrar relación entre la usabilidad con el riesgo de caída, y con otras variables.

[Bone mineral density and its association with body composition and metabolic biomarkers of insulin-glucose axis, bone and adipose tissue in women]. / Densidad mineral ósea y su asociación con la composición corporal y biomarcadores metabólicos del eje insulino-glucosa, hueso y tejido adiposo en mujeres.

INTRODUCTION: There are few studies integrating the common causes of osteoporosis and obesity (disorders of body composition). A first step is to investigate correlations between their biological phenotypes to determine their common integrative physiology. OBJECTIVE: To correlate the variation of bone mineral density with phenotypes of body composition and biomarkers of bone physiology, insulin-glucose axis, and adipose tissue. METHODS: Cross-sectional study of 75 women (aged 18-45 years). MEASUREMENTS: Body mass index, waist, fat mass, lean mass (dual-energy X-ray absorptiometry), glucose, insulin, osteocalcin, leptin, tumor necrosis factor alpha. STATISTICAL ANALYSIS: multivariate general linear model, SPSS v.22, p<0.05. RESULTS: Age: 32.08±7.33. Bone mineral content multivariate general linear model 1 with two phenotypes excluded (glucose, insulin): osteocalcin (ß=-0.228, p=0.011), lean mass (ß=0.606, p=0.001) and fat mass (ß=1.237, p=0.001) in 62.0%. The bone mineral density multivariate general linear model 2 with three phenotypes excluded (body mass index, glucose, tumor necrosis factor alpha): insulin (ß=0.250, p=0.024), osteocalcin (ß=-0.362, p=0.001), lean mass (ß=0.512, p=0.001) and fat mass (ß=0.701, p=0.001) in 46.3%. CONCLUSIONS: Results show that body composition with an increased lean mass is beneficial to bone. This study reaffirms the importance of performing regular exercise to prevent muscle loss.