Poor sleep quality and sleep disorders are the most common problems in people, affecting health-related quality of life. Various studies show an association between sleep disorders and altered levels of stress hormones and inflammatory cytokines measured in saliva. The main objective of this article is to provide an analysis of the current evidence related to changes in inflammatory markers in the saliva and their associations with sleep quality measurement (both objective and subjective methods) in healthy subjects and in sleep-related disorders. To that end, a scoping review was carried out, following the PRISMA criteria in the bibliographic search in several databases: PubMed, EBSCO, and SCOPUS. Eleven of the articles are from the adult population and two from the child-youth population. They mainly measure the relationship between sleep and interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNFα) alpha, as well as other inflammatory markers such as myeloperoxidase (MPO) and prostaglandin-endoperoxide synthase 2. An analysis shows the relationship between these salivary biomarkers and sleep quality, especially in the case of IL-6 in both healthy subjects and several pathologies associated with sleep-disorders. The results for TNFα and IL-1β measurements are still inconclusive and the difference with IL-6 was assessed. Two studies reported interventions that result in sleep improvement and are accompanied by the normalization of inflammatory changes detected in the saliva. As it is an easy-to-apply and non-invasive method, the measurement of salivary cytokines can be very useful in chronobiology studies. Further studies are required to determine the sensitivity of salivary inflammatory markers in monitoring biological rhythms and acting as biomarkers in the detection of sleep disorders and sleep interventions.
The reflective practice journal is a teaching methodology that facilitates the acquisition of professional, attitudinal values and skills, affording comprehensive training by reflecting on experiences that have been lived and showing feelings that, a priori, would be hidden. Our aim was to implement it in the international practicum in impoverished environments as a facilitating instrument of meaningful learning and the acquisition of professional skills, integrating affective and self-critical aspects. The project was developed with Nursing students at Catholic University of Valencia, in an impoverished environment. Qualitative reflections increased, highlighting humanity, closeness and attention focused on health promotion. The quality of the experience was 9.46/10. The mean score in self-criticism and expression was 4.57/5, and the self-evaluation of the acquisition of skills was 9.55/10. The double-blind peer evaluation of the performance of their practices in the international context was 9.68/10. The trust of the students with the teachers was evaluated as 10/10. The reflective practice journal facilitated the progression of learning, self-criticism, and the acquisition of values such as hospitality, the quality of care offered, and respect for customs and beliefs, as well as responsibility in the distribution of available resources and interventions.
Aging affects sleep and sleep problems are common in older individuals. However, the relationship between objective and subjective tools for analysing sleep and psycho-geriatric variables have not been tested in institutionalised older individuals. This work analyses sleep quality by using actigraphy as an objective tool and validates the Athens and Oviedo sleep questionnaires in octogenarian elderly individuals as subjective scales of sleep perception. All patients wore an actigraph device for one week and then completed the Athens and Oviedo clinical sleep-evaluation questionnaires. Morning cortisol levels in blood plasma and saliva samples were also measured to assess the association between objective and reported sleep patterns. Age, gender, and psycho-geriatric evaluations, including Barthel, Tinetti, and Mini-Mental scale measurements were analysed as variables with the potential to confound the strength of any such associations. There was a significant inverse correlation between the number of awakenings and the time spent awake during night assessed by actigraphy and the total Oviedo questionnaire score, but no significant associations for the other parameters. The blood cortisol concentration appears to be a marker of insomnia related to sleep times of less than four hours and diagnosis of insomnia based on Athens scale and thus, represents a potential marker for sleep interventions.
Background: Social determinants have a major influence on individuals’ health, and among them, loneliness has an important impact on the health of the elderly. Objectives: The aims were to determine loneliness and its social and emotional components in a sample of elderly people and to assess its prevalence and associations with sociodemographic variables. Methods: Analytical, cross-sectional, observational research was carried out based on a population over 60 years of age in Valencia (Spain). Loneliness was assessed with the De Jong-Gierveld Loneliness Scale. Results: Five-hundred and thirty community-dwelling individuals participated. The mean age of the sample was 72.7 years (84.2% women); 36.2% suffered from moderate loneliness and 6.6% suffered from extreme loneliness. The sociodemographic variables most significantly related to loneliness were being single, separated, or divorced (p < 0.01). Among widowers, loneliness was inversely associated with years of widowhood (p < 0.01). Having sons/daughters was a significant protective factor (p < 0.05), while having grandchildren or siblings did not have a significant influence. The ability to walk and smartphone and video call use were not associated with loneliness. Conclusions: There is a high prevalence of unwanted loneliness in community-dwelling individuals, and some social factors play an important role. Interventions against loneliness among older people are a priority for welfare and public health.
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