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PURPOSE The objective of this study was to characterize the Best Medical Canada microMOSFET detectors for their application in in vivo dosimetry for high-dose-rate brachytherapy (HDRBT) with 192 Ir. We also developed a mathematical model to correct dependencies under the measurement conditions of these detectors. METHODS We analyzed the linearity, reproducibility, and interdetector variability and studied the microMOSFET response dependence on temperature, source-detector distance, and angular orientation of the receptor with respect to the source. The correction model was applied to 19 measurements corresponding to five simulated treatments in a custom phantom specifically designed for this purpose. RESULTS The detectors (high bias applied in all measurements) showed excellent linearity up to 160 Gy. The response dependence on source-detector distance varied by (8.65 ± 0.06)% (k = 1) for distances between 1 and 7 cm, and the variation with temperature was (2.24 ± 0.05)% (k = 1) between 294 and 310 K. The response difference due to angular dependence can reach (10.3 ± 1.3)% (k = 1). For the set of measurements analyzed, regarding angular dependences, the mean difference between administered and measured doses was -4.17% (standard deviation of 3.4%); after application of the proposed correction model, the mean difference was -0.1% (standard deviation of 2.2%). For the treatments analyzed, the average difference between calculations and measures was 4.7% when only the calibration coefficient was used, but it is reduced to 0.9% when the correction model is applied. CONCLUSION Important response dependencies of microMOSFET detectors used for in vivo dosimetry in HDRBT treatments, especially the angular dependence, can be adequately characterized by a correction model that increases the accuracy of this system in clinical applications.

Old age represents a social group that is undergoing continuous expansion. The aging population will be prone to chronic diseases and falls, which is a marker of frailty and a public health problem. This study aims to examine the relationship between living conditions and the prevalence of the risk of falls in older adults within the community. As an observational cross-sectional study, intentional sampling was carried out on residents of the metropolitan area over 75 years of age. The socio-demographic data of the subjects and their history of falls were collected. Additionally, the subjects were evaluated on the risk of falling, basic activities of daily living, such as walking and balance, fragility, and their fear of falling. The statistical analyses used were based on the Shapiro–Wilk test for normality, statistics of central tendency with description, mean (M) and dispersion, standard deviation (SD), bivariate contingency tables for studying the relationships between the variables, and the analysis of Pearson’s relational statistics (χ2). The comparisons of means were resolved by parametric or non-parametric routes. We obtained the following results: 1. The socio-demographic profile of our sample consisted of adults over 75 years of age, the majority of whom were overweight or obese women living in an urban area, specifically in an apartment, and receiving care; 2. Older people in the studied community had mild dependency and frailty, and were also at severe risk of falls; 3. The prevalence of falls was higher in women than in men in this study. Through these results, we confirmed the relationship between living conditions and the prevalence of risk of falls in older adults within the community.

© The Author(s)., [Background]: The increase in the survival of oncology patients include multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. An implementation of the conventional clinical practice, developed through multimodal physical exercise and functional rehabilitation program intervention, may be useful in controlling dyspnoea. This study aims to evaluate the effects of a multimodal exercise and functional rehabilitation program on fatigue, pain, functional capacity, and quality of life in cancer patients with cancer-related asthenia. [Methods]: This is a protocol for an experimental, prospective, randomised study using a parallel, fixed assignment scheme, with an experimental group and a control group in patients from the oncology hospitalisation unit at the Salamanca University Hospital Complex in Spain, using consecutive sampling to select 50 participants with oncological asthenia who are hospitalised at the time of inclusion. After the baseline evaluation, the participants will be randomised into two groups. Both groups will receive standard clinical practice care and the normal health education program at discharge, but in addition, the participants assigned to the experimental group will also complete a multimodal exercise and functional rehabilitation program lasting one month. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of asthenia (FACT-An scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the attention and executive functions (Trail-Making Test), fear/avoidance of movement (TAMPA scale), pain (VAS scale), and body composition (waist, hip, brachial, thigh, wrist, and ankle circumferences). [Discussion]: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with asthenia. The current study addresses to improve the conventional clinical practice by proposing a multimodal physical exercise and functional rehabilitation program intervention, which will be implemented by an interdisciplinary team, to try to improve the autonomy of cancer patients with cancer-related asthenia., This study was funded by the Regional Health Management of Castile and León, Spain, with project file number 2181/A/2020, and has undergone peer-review by the funding body.

© The Author(s)., [Background]: Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea. [Methods]: This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale). [Discussion]: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life.

Background: Everyday cognition is the application of basic cognitive skills and knowledge of the specific domain for the resolution of problems that are integrated within the instrumental domains of functioning. The main objective to evaluate the effectiveness of a Training Programme in Everyday Cognition in order to improve the levels of everyday cognition and global cognitive performance in older adults.Methods: Experimental, randomised, stratified, prospective, longitudinal study using a fixed-assignment parallel scheme with an experimental group and a control group. The sample was composed of healthy older adults. The intervention of the experimental group consisted of an Everyday Cognition Training Programme, and the intervention of the control group consisted of a Conventional Cognitive Training Programme. The Rapid Assessment of Cognitive Functions test (ERFC, for its acronym in French) and the Everyday Cognition Battery test (ECB) were used for the assessment.Results: Total sample (n=237) composed of 44 men and 223 women, with a mean age of 73.45 years. Statistically significant differences (p Daily Cognition Training Programme presents greater benefits in terms of both global cognitive performance and everyday cognition than the use of a Traditional Conventional Cognitive Training Programme in elderly adults.Trial registration: ClinicalTrials.gov: NCT04041999 (https://clinicaltrials.gov/ct2/show/NCT04041999)Retrospectively registered.

Background: Everyday cognition is the application of basic cognitive skills and knowledge of the specific domain for the resolution of problems that are integrated within the instrumental domains of functioning. The main objective to evaluate the effectiveness of a Training Programme in Everyday Cognition in order to improve the levels of everyday cognition and global cognitive performance in older adults.Methods: Experimental, randomised, stratified, prospective, longitudinal study using a fixed-assignment parallel scheme with an experimental group and a control group. The sample was composed of healthy older adults. The intervention of the experimental group consisted of an Everyday Cognition Training Programme, and the intervention of the control group consisted of a Traditional Cognitive Psycho-stimulation Programme. The Rapid Assessment of Cognitive Functions test (ERFC, for its acronym in French) and the Everyday Cognition Battery test (ECB) were used for the assessment.Results: Total sample (n=237) composed of 44 men and 223 women, with a mean age of 73.45 years. Statistically significant differences (pDaily Cognition Training Programme presents greater benefits in terms of both global cognitive performance and everyday cognition than the use of a Traditional Cognitive Psycho-stimulation Programme in elderly adults.Trial registration: ClinicalTrials.gov: NCT04041999 (https://clinicaltrials.gov/ct2/show/NCT04041999)Retrospectively registered.

We aimed to determine the short- and medium-term effects of a multimodal physical exercise program (MPEP) on bone health status, fall risk, balance, and gait in patients with Alzheimer&rsquo, s disease. A single-blinded, controlled clinical trial was performed where 72 subjects were allocated in a 3:1 ratio to an intervention group (IG, n = 53) and control group (CG, n = 19), where the IG&rsquo, s subjects were admitted to live in a State Reference Center of Alzheimer&rsquo, s disease, which offers the targeted exercise program, while the CG&rsquo, s subjects resided in independent living. A multidisciplinary health team assessed all patients before allocation, and dependent outcomes were again assessed at one, three, and six months. During the study, falls were recorded, and in all evaluations, bone mineral density was measured using a calcaneal quantitative ultrasound densitometer, balance and gait were measured using the performance-oriented mobility assessment (POMA), the timed up and go test (TUG), the one-leg balance test (OLB), and the functional reach test (FR). There were no differences between groups at baseline for all outcome measures. The prevalence of falls was significantly lower in the IG (15.09%) than in the CG (42.11%) (&chi, 2 = 5.904, p = 0.015). We also found that there was a significant time*group interaction, with a post hoc &Scaron, id&aacute, k test finding significant differences of improved physical function, especially in gait, for the IG, as assessed by POMA-Total, POMA-Gait, and TUG with a large effect size (ƞ2p = 0.185&ndash, 0.201). In balance, we found significant differences between groups, regardless of time, and a medium effect size as assessed by POMA-Balance and the OLB (ƞ2p = 0.091&ndash, 0.104). Clinically relevant effects were observed, although without significant differences in bone health, with a slowing of bone loss. These results show that a multimodal physical exercise program reduces fall risk and produces an improvement in gait, balance, and bone mineral density in the short and medium term in institutionalized patients with Alzheimer&rsquo, s disease.

La incidencia del cáncer (Ca) en España está en aumento (247.771 nuevos diagnósticos). La Supervivencia de pacientes oncológicos a los 5 años es 53%. Principal problema, es la calidad de esa supervivencia. Un Importante factor condicionante son los niveles de dependencia de los pacientes en tratamiento activo. Objetivo principal: Evaluar el nivel de dependencia de los pacientes oncológicos con disnea. METODOLOGÍA: Estudio observacional prospectivo transversal con muestreo no probabilístico de asignación accidental. La muestra se reclutó del Servicio de Oncología Médica del Hospital Universitario de Salamanca. Se procedió a la derivación de los pacientes al programa de terapia ocupacional con la consiguiente inclusión de estos en el estudio. Posteriormente y tras obtener el consentimiento informado firmado, se procedió a evaluar. Se utilizó la escala de Lawton-Brody, y el índice de Barthel. Se diseñó una hoja de registro para datos sociodemográficos y clínicos. RESULTADOS: Muestra total de 180 individuos. Edad media de 68,48 (±10,513) años. El 52,8% varones, por un 47,2% mujeres. El 22,8% presentaban diagnóstico de Ca de mama, un 31,7% Ca pulmonar y un 45,6% Ca relacionado con el aparato digestivo. En cuanto a los niveles de dependencia, escala de Lawton-Brody, puntuación media de 4,31 (±1,832) puntos (niveles de dependencia moderados); índice de Barthel, puntuación media de 42,53 (±2,789) puntos (nivel de dependencia moderado). Peores puntuaciones en diagnóstico anatomopatológico pulmonar. Correlación fuerte y estadísticamente significativa entre ABVD y AIVD (r=0,803, para p

Resumen Justificación: La revisión de la literatura pone de manifiesto el impacto negativo que la astenia tumoral tiene sobre la calidad de vida y recomienda utilizar además del tratamiento farmacológico para controlar el síntoma, otras terapias centradas en aumentar la autonomía. Nuestro objetivo ha sido comprobar la eficacia del “Programa de entrenamiento en la realización de las actividades de la vida diaria”, en la mejora de la Calidad de Vida Relacionada con la Salud (CVRS) de los pacientes oncológicos con astenia. Metodología: Estudio experimental, prospectivo, longitudinal, aleatorizado mediante un esquema paralelo de asignación fija con grupo experimental y grupo control. El instrumento de evaluación para medir la variable dependiente fue el cuestionario SF-12 v2. El estudio se realizó con 180 sujetos reclutados entre diciembre de 2013 y septiembre de 2015. Resultados: Después de la intervención encontramos diferencias estadísticamente significativas (p< 0,01) en todos los ítems de calidad de vida en los pacientes incluidos en el grupo experimental, exceptuando el ítem “dolor corporal” (p> 0,05). Sin embargo no hemos encontrado relación entre la edad y la mejora de la calidad de vida. Conclusiones: La utilización sistemática y controlada del “Programa de entrenamiento en la realización de las actividades de la vida diaria” mejora todos los niveles de CVRS de los pacientes oncológicos por lo que después de estos resultados nuestro último objetivo será la implementación de este programa y su utilización en nuestra práctica clínica diaria. Abstract Background: The review of the literature show a negative impact of the fatigue on quality of life and recommend, in addition of the use of traditional drug treatment to control symptoms, other therapies focused into improve the autonomy. Our aim is to test the efficacy of improving the levels of quality of life related to health (HRQOL) of cancer patients using a” daily activity training program” to control fatigue reported by the oncological disease. Methods/design: experimental, prospective, longitudinal and randomized study using a parallel fixed allocation scheme with experimental and control group. We used the SF-12 v2 questionnaire to measure HRQL. The study was conducted in 180 subjects recruited between December 2013 and September 2015. Results: We found statistically significant differences after intervention (p < 0.001) in all items related to quality of life in the experimental group patients, except for the item “bodily pain”(p> 0, 05). However, we found no relationship between age and improving of the quality of life. In summary systematic and controlled use of our “daily activity training program” improve all levels of quality of life related to health (HRQOL) of cancer patients. Therefore after these results our ultimate goal will be the implementation of this program and its use in our daily practice.