Current trends in health care delivery and management such as predictive and personalized health care incorporating information and communication technologies, home-based care, health prevention and promotion through patients’ empowerment, care coordination, community health networks and governance represent exciting possibilities to dramatically improve health care. However, as a whole, current health care trends involve a fragmented and scattered array of practices and uncoordinated pilot projects. The present paper describes an innovative and integrated model incorporating and “assembling” best practices and projects of new innovations into an overarching health care system that can effectively address the multidimensional health care challenges related to aging patient especially with chronic health issues. The main goal of the proposed model is to address the emerging health care challenges of an aging population and stimulate improved cost-efficiency, effectiveness, and patients’ well-being. The proposed home-based and community-centered Integrated Healthcare Management System may facilitate reaching the persons in their natural context, improving early detection, and preventing illnesses. The system allows simplifying the health care institutional structures through interorganizational coordination, increasing inclusiveness and extensiveness of health care delivery. As a consequence of such coordination and integration, future merging efforts of current health care approaches may provide feasible solutions that result in improved cost-efficiency of health care services and simultaneously increase the quality of life, in particular, by switching the center of gravity of health delivery to a close relationship of individuals in their communities, making best use of their personal and social resources, especially effective in health delivery for aging persons with complex chronic illnesses.

Introduction: A substantial body of research indicates an increasing prevalence of mental health issues among university students in a range of countries. A number of psychosocial factors have been put forward in the research literature as possible explanations for this persistent decline in psychological wellbeing in higher education. The present study focused on the role of family factors and the use of digital technologies by students.Methods: A replication study was conducted at the University of the Americas (Chile) based on a previous study on psychosocial factors of academic learning patterns and mental health of university students at the Complutense University of Madrid (UCM), Spain. A cross-sectional design was employed, using the same questionnaire, plus indicators of most frequently used digital technologies by the students. The questionnaire was administered online at the same time to all incoming students, gathering a sample of 4,523 students. A series of multiple regressions and ANOVAs was conducted to ascertain the extent to which family and digital factors could be identified as predictors of mental health indicators.Results: The most significant findings indicate that high levels of parental protection and control/discipline, and especially the high use of social media and smartphones, are particularly salient factors contributing to mental health problems in the learning process of higher education students.Discussion: The results suggest strategies to promote wellbeing, with a focus on the psychosocial diversity within an inclusive university community. Social and digital innovation, collective entrepreneurship, and participatory place-building may facilitate networks of artistic, cultural, ecological, and sports spaces to promote the sense of university community. A longitudinal follow-up on the same sample across academic years will reveal the extent to which these wellbeing initiatives are fruitful.

Background: There is a large literature on the significant impact of rearing factors in the psychological development of different child’s learning patterns and wellbeing in elementary and secondary schools, but there is a scarcity of studies on to what extent those influences remain stable up to higher education. Objective: In this study, parenting practices and family status were analyzed as predictors of the different learning styles, psychological difficulties, mental health factors, and academic performance, comprising the psychosocial diversity in learning (DinL) at the university classroom. Methods: Using a cross-sectional design, a questionnaire was administered to a sample of 2522 students at the Complutense University of Madrid (Spain). It included a DinL scale measuring five psychological learning dimensions (coping with difficulties, effort, autonomy, Social/Physical Context, and understanding/career interest), plus several items on retrospective parenting practices, family, and sociodemographic variables. Multiple regressions and analyses of variance were conducted with the family factors as independent variables and the learning factors as dependent variables. Results: Results showed parenting variables, parents’ education, and family economy as having a significant impact on psychological learning dimensions, academic performance, and especially on the students’ wellbeing and mental health status, being an important contributors to explain the DinL in the university classroom. Conclusion: The results bring interesting conclusions for developmental and health psychologists when working with parents aimed at fostering wellbeing and learning strategies related to academic inclusion and achievement.

This study analyzed variability in cerebral blood flow velocity (CBFV) and its association with emotional, clinical and functional variables and medication use in fibromyalgia syndrome (FMS). Using transcranial Doppler sonography, CBFV were bilaterally recorded in the anterior (ACA) and middle (MCA) cerebral arteries of 44 FMS patients and 31 healthy individuals during a 5-min resting period. Participants also completed questionnaires assessing pain, fatigue, insomnia, anxiety, depression and health-related quality of life (HRQoL). Fast Fourier transformation revealed a spectral profile with four components: (1) a first very low frequency (VLF) component with the highest amplitude at 0.0024 Hz; (2) a second VLF component around 0.01-to-0.025 Hz; (3) a low frequency (LF) component from 0.075-to-0.11 Hz; and (4) a high frequency (HF) component with the lowest amplitude from 0.25-to-0.35 Hz. Compared to controls, FMS patients exhibited lower LF and HF CBFV variability in the MCAs (p < .005) and right ACA (p = .03), but higher variability at the first right MCA (p = .04) and left ACA (p = .005) VLF components. Emotional, clinical and functional variables were inversely related to LF and HF CBFV variability (r≥-.24, p≤.05). However, associations for the first VLF component were positive (r≥.28, p≤.05). While patients´ medication use was associated with lower CBFV variability, comorbid depression and anxiety disorders were unrelated to variability. Lower CBFV variability in the LF and HF ranges were observed in FMS, suggesting impaired coordination of cerebral regulatory systems. CBFV variability was differentially associated with clinical variables as a function of time-scale, with short-term variability being related to better clinical outcomes. CBFV variability analysis may be a promising tool to characterize FMS pathology and it impact on facets of HRQoL.

Purpose: This work critiques the situation of the ecological and cultural heritage in many coastal territories and analyses how current land planning methodologies are responding to it. The study builds a new integrated approach founded on ecocultural values and local knowledge as resources for an effective territorial planning and sustainable development.Design/methodology/approach: The proposed framework was developed through: (1) analysing coastal planning needs and problems in European coastal areas; (2) identifying ecocultural values, including local knowledge, in such areas; (3) selecting best approaches and tools in spatial planning; (4) applying the selected planning approaches to use ecocultural values as resources for spatial planning and sustainable development; and (5) validating the final methodology.Findings: A dynamic approach for maritime-land planning was developed projecting coastal waters and river basins as strategic drivers for sustainable development, based on the natural capacity of water to shape and integrate the ecological and cultural territory. A participatory governance planning methodology supports the new articulations of space based on ecocultural value chains and networks as synergistic vectors, focusing on local knowledge as psychosocial capital for a collective mapping of cultural, historical, social, economic and ecological values into ecocultural littoral plans.Originality/value: The results show the potentials of combining new approaches applying cultural and ecological heritage into an effective strategy of integration between society and territory as a powerful driver for effective sustainable planning and development.

A hipertensão arterial tem sido estudada sob vários enfoques. As pesquisas demonstram a conexão entre os determinantes sociais e as manifestações da doença. Este estudo trata dos estressores sociais de hipertensão na Vila Nossa Senhora de Fátima, Porto Alegre, Brasil. Relata e discute os resultados do trabalho realizado junto a esta população, no qual se examinam variáveis constitucionais, sociais e fisiológicas. O exame da literatura sobre o tema e a comparação com um grupo controle, advindo de estudo semelhante com população de outro contexto social, mostrou a influência dos estressores sociais no processo de desenvolvimento da hipertensão. As conclusões alcançadas permitem algumas recomendações de ação no sentido da construção da cidadania como instrumento de participação e promoção de saúde. The origins of systemic high blood pressure has been studied from a wide array of different approaches. Researches suggests a very close connection between social environment stressors and all the manifestations of the disease itself. The present study deals with relevant social stressors that might be related to the high rates of high blood pressure found among the inhabitants of Vila Nossa Senhora de Fátima, a poor neighborhood in Porto Alegre, Brasil. Results, when compared to those comming from samples from different contexts of the same city, suggest an important relationship between certain social circunstances and the evolution of the hypertension desease. The discussion points to the importance of building up ciitzenship as a tool for health participation and promotion