Interactions between persons-Knowledge, decision making, and the co-production of practice.

There is now broad agreement that ideas like person-centred care, patient expertise and shared decision-making are no longer peripheral to health discourse, fine ideals or merely desirable additions to sound, scientific clinical practice. Rather, their incorporation into our thinking and planning of health and social care is essential if we are to respond adequately to the problems that confront us: they need to be seen not as "ethical add-ons" but core components of any genuinely integrated, realistic and conceptually sound account of healthcare practice. This, the tenth philosophy thematic edition of the journal, presents papers conducting urgent research into the social context of scientific knowledge and the significance of viewing clinical knowledge not as something that "sits within the minds" of researchers and practitioners, but as a relational concept, the product of social interactions. It includes papers on the nature of reasoning and evidence, the on-going problems of how to 'integrate' different forms of scientific knowledge with broader, humanistic understandings of reasoning and judgement, patient and community perspectives. Discussions of the epistemological contribution of patient perspectives to the nature of care, and the crucial and still under-developed role of phenomenology in medical epistemology, are followed by a broad range of papers focussing on shared decision-making, analysing its proper meaning, its role in policy, methods for realising it and its limitations in real-world contexts.

Risk of bias assessment of clinical trials published in iberoamerican urological journals / Evaluación del riesgo de sesgo en los ensayos clínicos publicados en revistas urológicas iberoamericanas

OBJECTIVES: To assess the risk of bias of clinical trials published in iberoamerican indexed journals from January 1, 2008 to December 31, 2012. METHODS: We performed a descriptive study based on the clinical trials published from January 1st 2008 to December 31st 2012 in the iberoamerican urological journals. We assessed the risk of bias by the Cochrane tool. We used descriptive statistics in Stata 13 and Revman 5.2 to create the risk of bias graphs within and across studies. RESULTS: We identified 41 clinical trials: 21 trials in the International Brazilian Journal of Urology, seven trials in Actas Urológicas Españolas, six trials in Archivos Españoles de Urología, two trials in the Boletin Mexicano de Urología, four trials in Revista Mexicana de Urología and one trial in Revista Urología Colombiana. Most of these trials had unclear risk for the generation of the randomization (selection bias), the allocation concealment (selection bias) and the blinding (performance and detection). There was low risk of bias for incomplete results data (Attrition bias) and selective notification (notification bias). High risk of bias was found in other possible sources of bias, mainly because of low sample size. CONCLUSIONS: Based on the Cochrane risk of bias tool assessment, most of the published trials do not accomplish an adequate description of the methods. We should also be aware that most of the trials lack an adequate sample size calculation that limits the power of these trials. We recommend better description of the methods for randomization, and increasing the sample size to improve the quality of the trials published in urologic iberoamerican journals

OBJETIVO: Evaluar el riesgo de sesgo en los ensayos clínicos publicados en revistas iberoamericanas indexadas desde el 1 de enero del 2008 al 31 de Diciembre del 2012. MÉTODOS: Realizamos un estudio descriptivo basado en los ensayos clínicos publicados en las revistas urológicas iberoamericanas desde el 1 de Enero del 2008 y el 31 de diciembre del 2012. Evaluamos el riesgo de sesgo mediante la herramienta Cochrane. Utilizamos estadísticas descriptivas en Stata 13 y Revman 5.2 para crear gráficas del riesgo de sesgo dentro de los estudios y entre ellos. RESULTADOS: Identificamos 41 ensayos clínicos: 21 ensayos en el International Brazilian Journal of Urology, siete ensayos en Actas Urólogicas Españolas, seis ensayos en Archivos Españoles de Urología, dos en el Boletín Mexicano de Urología, cuatro en la Revista Mexicana de Urología y un ensayo en la Revista Urología colombiana. La mayoría de estos ensayos presentan un riesgo confuso para la generación de la aleatorización (sesgo de selección), la ocultación de la asignación (sesgo de selección) y el enmascaramiento (ejecución y detección). Había un bajo riesgo de sesgo para datos de resultados incompletos (sesgo de abandono) y de notificación selectiva (sesgo de notificación). El alto riesgo de sesgo se encontró en otras posibles fuentes de sesgo, principalmente debido a tamaño muestral bajo. CONCLUSIONES: Basándose en la herramienta Cochrane de evaluación del riesgo de sesgo, la mayoría de los ensayos publicados no llevan a cabo una adecuada descripción de los métodos. También debemos ser conscientes de que la mayoría de los ensayos carecen de un cálculo del tamaño muestral adecuado lo que limita su poder. Recomendamos una mejor descripción de los métodos de asignación aleatoria y aumentar el tamaño muestral para mejorar la calidad de los ensayos publicados en las revistas urológicas iberoamericanas

[Modern directions of scientific and practical research of the policy of active and healthy longevity: experience and perspectives].

Modern terminology on active and healthy aging used in scientific and project activities is discussed. There have been analyzed the WHO conception on active aging, which has no precise universally agreed definition, its main determinants. The directions of scientific expertise in the major European projects INNOVAGE - assessment of potentially profitable social innovations relating to the welfare and quality of life and health in old age; MOPACT - the interference between the demographic development and the main dimensions of economic and social contribution of older persons is defined. The approach to implement the policy of active and healthy longevity as a valuable asset of the modern society is underlined.

Implementación y adaptación en Colombia del sistema preventivo Communities That Care / Implementation and adaptation in Colombia of the Communities That Care

La Corporación Nuevos Rumbos (Colombia) viene implementando hace más de dos años en ocho comunidades de Colombia, el sistema preventivo Comunidades Que se Cuidan (CQC), adaptación de Communities That Care (CTC), creado en la Universidad de Washington en Seattle, que ha sido desarrollado por más de 25 años en los Estados Unidos y en ocho países de América, Oceanía y Europa. El sistema busca que, a través del empoderamiento comunitario y empleando el enfoque de la Salud Pública y en la estrategia de desarrollo social, las comunidades tomen las mejores decisiones basadas en los datos de prevalencias de consumo y en la identificación de los factores protectores y de riesgo (basada en la utilización de la encuesta original validada en Colombia) y puedan escoger las estrategias de intervención probadas que más se ajusten a sus necesidades. Este documento describe el proceso de implementación en Colombia, sus diferencias con CTC, la creación de puntos de corte propios para el país, las principales limitaciones en el proceso de adaptación y cómo se abordaron. CQC aparece como un sistema preventivo que puede tener amplia aplicabilidad en otros países de América Latin

For more than two years, Corporación Nuevos Rumbos (Colombia) has been carrying out, in eight Colombian communities, a preventive system called Comunidades Que se Cuidan (CQC), an adaptation of Communities That Care (CTC), created at the University of Washington (Seattle), developed for more than 25 years in the United States of America and implemented in eight countries of America, Oceania, and Europe. The system is based on the public health approach, and the social development strategy for community empowerment. The core idea is to teach communities how to make decisions based on data regarding drugs and alcohol consumption and the identification of protective and risk factors, on the basis of the original survey validated in Colombia: these will allow communities to choose the best preventive interventions, tailored for each of them according to their needs. This paper describes the process of implementation of CQC in Colombia, its differences with CTC, the creation of Colombian cutpoints, the main difficulties and how these were solved. CQC seems to be a preventive system with a wide potential applicability in other Latin American countries

Evidence for validity of the brief resilient coping scale in a young spanish sample

The aim of the present study was to provide evidence of validity of the Brief Resilient Coping Scale for use in Spanish young population. A total of 365 university students responded to the Spanish version of the BRCS as well as to other tools for measuring personal perceived competence, life satisfaction, depression, anxiety, negative and positive affect, and coping strategies. Confirmatory factor analysis confirmed the unidimensional structure of the scale. Internal consistency reliability and temporal stability through Cronbach’s alpha and test-retest correlations, respectively, were comparable to those found in the initial validation of the tool. The BRCS showed positive and significant correlations with personal perceived competence, optimism, life satisfaction, positive affect (p < .01), and some coping strategies (p < .05). Significant negative correlations were observed with depression, anxiety and negative affect. (p < .01). Multiple regression analysis with stepwise method showed that positive affect, negative affect, optimism and problem solving explained 41.8% of the variance of the BRCS (p < .001). The Spanish adaptation of the BRCS in a young population is satisfactory and comparable to those of the original version and with the Spanish version adapted in an elderly population. This supports its validity as a tool for the assessment of resilient coping tendencies in young people who speak Spanish and offers researchers and professionals interested in this area of study a simple tool for assessing it (AU)

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Word association norms in Mexican Spanish

The aim of this research is to present a Spanish Word Association Norms (WAN) database of concrete nouns. The database includes 234 stimulus words (SWs) and 67,622 response words (RWs) provided by 478 young Mexican adults. Eight different measures were calculated to quantitatively analyze word-word relationships: 1) Associative strength of the first associate, 2) Associative strength of the second associate, 3) Sum of associative strength of first two associates, 4) Difference in associative strength between first two associates, 5) Number of different associates, 6) Blank responses, 7) Idiosyncratic responses, and 8) Cue validity of the first associate. The resulting database is an important contribution given that there are no published word association norms for Mexican Spanish. The results of this study are an important resource for future research regarding lexical networks, priming effects, semantic memory, among others (AU)

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[PhD theses on gerontological topics in Russia 1995-2012: scientometric analysis].

The paper presents a scientometric analysis of PhD theses on gerontological topics in Russian humanities (excluding economics) for the period from 1995 to 2012. During this period, 253 PhD theses (238 of "candidate dissertations," and 15 of "doctoral dissertations") were defended in Russia. Almost half of them were defended during the boom years (2005-2006; 2009-2010). The number of theses defended in the 2000-s has increased significantly compared to the second half of 1990-s. However for gerontological PhD-s overall as a percentage of all theses defended in Russian humanities, the number hardly changed and remained small (less than 0.3%). The leading discipline in the study of aging (within the humanities) is sociology accounting for more than a third of all defended theses. Though the theses were defended in 48 cities, more than half of them were defended in 3 cities, which are Moscow, St. Petersburg and Saratov. Thematic analysis showed that the leading position was occupied by two topics: "the elderly and the state" (42%) and "(re)socialization/adaptation of the elderly" (25%). 14% of the works are devoted to intergenerational relations and social status of the elderly. Other topics (old man/woman's personality, self-perceptions of aging, violence and crime against the elderly, loneliness, discrimination, etc.) are presented by very few studies.

The current state of midwifery and development of midwifery research in four European countries.

OBJECTIVE: to describe the current state of midwifery and explore the development of midwifery research during the last two decades in four non-English speaking European countries in order to understand what factors influenced the course of establishing research as a professional activity. DESIGN: qualitative collective case study. SETTING: Germany, Austria, Switzerland and the Netherlands. FINDINGS: with the ICM Workshop in Germany in 1989 as a central starting point for midwifery research in all four countries, different courses, in timing as well as content, characterised its development in the individual countries. Major factors contributing to this development during the last decades involved the history and character of midwifery, initiatives of individual midwifery researchers, alliances with other professions and the transition of midwifery programmes into higher education. Whereas midwifery research is currently established as a professional role in all countries, future challenges involve the creation of its own profile and identity, while building up its own academic workforce and strengthening the role of midwifery in multidisciplinary alliances. KEY CONCLUSIONS AND IMPLICATIONS: although a common vision was shared between the four countries in 1989, midwifery research developed as a context-specific phenomenon related to the character of midwifery and education in each country. These factors have to be taken into account in the further development of midwifery as an academic discipline at a national as well as at an international level.