Loneliness, ageism and mental wellbeing in nursing homes during the COVID-19 pandemic

16th European Public Health Conference 2023 Our Food, Our Health, Our Earth: A Sustainable Future for Humanity Dublin, Ireland 8-11 November 2023.Background: The measures imposed during the COVID-19 pandemic, especially social distancing, had important effects on feelings of loneliness. The objective of this work is to assess the perception of loneliness in older adults living in nursing homes during the pandemic, how it has changed during the pandemic and its explanatory factors. Methods: The data come from the cross-sectional project "Protective environments of the elderly in health crises", carried out in the Community of Madrid (Spain) in 2021. The variables used were the frequency of feelings of loneliness and its change during the pandemic, as well as socio-demographic, health, emotional and contextual characteristics. Descriptive statistics and logistic regression analysis were calculated. Results: The sample consisted of 447 people; mean age was 83.8; 63.1% were women; half of the sample were widowed; 40% had an educative level lower than primary. Almost 3 out of 10 residents stated that they often or always/almost always felt alone. In the regression model, loneliness was negatively associated with age, number of medications, emotional balance, coping ability, self-perception of aging, and engaging in rewarding activities; while having a low assessment of mobility in the residential environment was positively associated. In addition, 28% of the participants who declared loneliness, also felt lonelier than before the pandemic. The variables associated with change in feelings of loneliness were age, self-perception of aging and a low assessment of the residential environment. Conclusions: The restrictions on mobility and social relationships during the COVID-19 epidemic have affected older people who were living in residences, with an increase in the feeling of loneliness related to demographic, emotional and contextual variables. Interventions on the design of residential spaces can mitigate the effects of isolation and loneliness related to health crises such as COVID-19 pandemic.S

Association with litter size of new polymorphisms on ESR1 and ESR2 genes in a Chinese-European pig line

The objective of this study was to search for polymorphisms in the coding region of the estrogen receptors 1 and 2 (ESR1 and ESR2 )and to analyze the effects of these variants and the well known intronic ESR1 Pvu II polymorphism on litter size in a Chinese-European pig line. We identified five silent single nucleotide polymorphisms (SNP) in the ESR1 cDNA: c.669T > C (exon 3), c.1227C > T (exon 5), c.1452C > T (exon 7), c.1665T > C and c.1755A > G (exon 8). One pair of these SNP (c.1665T > C and c.1755A > G) co-segregated in the analyzed line, and the SNP c.669T > C showed the same segregation pattern as the Pvu II polymorphism. These polymorphisms were tested in this study, although the c.1452C > T SNP within exon 7 was not analyzed due to its low informativeness. In the ESR2 cDNA, one missense SNP was found within exon 5, which caused an amino acid substitution in the coded protein: "c.949G > A (p.Val317Met)" and was tested on sow litter size. Information on 1622 litter records from 408 genotyped sows was analyzed to determine whether these SNP influenced the total number of piglets born (TNB) or the number of born alive (NBA). The polymorphisms ESR1: [Pvu II; c.669T > C], ESR1: [c.1665T > C; c.1755A > G] and ESR2: c.949G > A showed no statistically significant association with litter size. However, the ESR1: c.1227T allele was significantly associated with TNB. The additive substitution effect was estimated to be 0.40 piglets born per litter (P < 0.03), and no dominance effects were observed. This SNP could be useful in assisted selection for litter size in some pig lines, as a new genetic marker in linkage disequilibrium with the causative mutation

Effectiveness of Oral Sensory-Motor Stimulation in Premature Infants in the Neonatal Intensive Care Unit (NICU) Systematic Review

[EN] The aim of this study was to identify and to assess the best evidence currently available on the effectiveness of oral sensory-motor stimulation in preterm infants in the neonatal intensive care unit. We performed a systematic review following the Preferred Reporting Items for Systematic Reviews (PRISMA) statements. The search was conducted using the Pubmed, Web of Science (WOS), PEDro and Scopus databases. Clinical trials were reviewed and PEDro rating scale was used to assess the methodological quality of these studies. Results: 1267 studies were found and 11 were relevant and included in this review. Improvements were obtained in achieving independent feeding, maturation of the sucking pattern, transition to full feeding, motor function and length of hospital stay in most studies. Conclusions: there is evidence to support the benefits of the use of oral sensorimotor stimulation to achieve independent oral feeding in preterm infants, thereby reducing their stay in the Neonatal Intensive Care UnitS

Change and predictors of quality of life in institutionalized older adults with dementia

PURPOSE: This study aims to assess the change in and predictive factors of the quality of life (QoL) of institutionalized older adults with dementia over a 20-month period. METHODS: Information was used from a follow-up study conducted over an average period of 19.61 ± 1.93 months on a sample of 274 institutionalized older adults aged 60 or over, diagnosed with dementia. Two linear regression models were built to predict change in the EQ-5D index and the quality of life in Alzheimer's disease (QOL-AD) scale, taking as independent variables: sociodemographic characteristics and measures of functional ability (Barthel Index), depression in dementia (Cornell Scale), number of chronic health problems, cognitive level (MEC, the Spanish Mini-Mental State Examination) and severity of dementia (Clinical Dementia Rating) at baseline. RESULTS: The majority of the participants were women (81.75 %) with an average age of 84.70 ± 6.51 years, single (78.15 %), with severe dementia and moderate functional dependence. There was a significant decrease on the EQ-5D, EQ-VAS and QOL-AD between baseline and follow-up scores. The main predictors of QoL of the institutionalized older adults with dementia were the number of chronic problems and baseline scores of the QoL measures. CONCLUSIONS: A significant decrease in the QoL of institutionalized older adults was observed over a 20-month period. Results suggest that interventions aimed at reducing the number of chronic medical conditions may have a beneficial effect on older adults' QoL.This study was funded by the CIEN Foundation, Carlos III Institute of Health (Ref. PI 017/09). We would like to thank the help provided by V Blaya-Novakova in language editing. The Spanish Research Group on Quality of Life and Aging is formed by: M. J. Forjaz, ENS-ISCIII; P. Martinez-Martin, CNE-ISCIII; F. Rojo-Perez, CCHS-CSIC; G. Fernandez-Mayoralas, CCHS-CSIC; B. Frades, Fundación CIEN-ISCIII; B. Leon-Salas, Fundación CIEN-ISCIII; Marina Avila, Fundación CIEN-ISCIII; M. E. Prieto-Flores, UNED; S. Martin, EULEN; I. Martinez, EULEN; C. Rodriguez-Blazquez, CNE-ISCIII; A. Ayala, ENS-ISCIII

Measurement properties of the Community Wellbeing Index in older adults

PURPOSE: The international wellbeing index (IWI) consists of two scales, the personal (PWI) and national (NWI) wellbeing indices. The community wellbeing index (CWI) is a new measure of the individual's level of satisfaction with the local place of residence. The main goal of this paper is to validate the CWI in a sample of older adults. METHODS: The IWI was satisfactorily applied to survey the global quality of life of a community sample of 1,106 people aged 60 years and over residing in Spain. The CWI psychometric properties were studied using Rasch analysis. Classic psychometric parameters were also analyzed. RESULTS: Tests of unidimensionality, and exploratory and confirmatory factor analyses, revealed the presence of three subscales: community services, community attachment, and physical and social environment. To achieve adequate model fit of the three subscales to the Rasch model, one item (distribution of wealth) of the initial 11 was removed and item response categories were rescored. The person separation index was 0.82-0.85, indicating a good reliability. All items were free from gender bias. The three subscales displayed satisfactory convergent validity with the PWI and NWI and were able to discriminate between groups with high and low satisfaction with local place of residence. CONCLUSION: The CWI, made up of three subscales, is a valid and reliable measure of subjective wellbeing related to the community as assessed by older adults. Further research with this promising measure should focus on cross-national comparisons.This research was supported by the Spanish Ministry of Science and Innovation (National R&D&I Plan: ref. SEJ2006-15122-C02-00). Prieto-Flores’ position is supported by the Juan de la Cierva program for postdoctoral research, of the Spanish Ministry of Science and Innovation. The Carlos III Institute of Health team is a member of the Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas—CIBERNED). The Spanish Research Group on Quality of Life and Aging is made up as follows: (1) at the Carlos III Institute of Health by M. Joao Forjaz, Pablo Martinez-Martin, Maria-Eugenia Prieto-Flores, Belen Frades-Payo, Carmen Rodriguez-Blazquez and Concepcion Delgado-Sanz; and, (2) at the Spanish National Research Council by Gloria Fernandez-Mayoralas, Fermina Rojo-Perez, Karim Ahmed-Mohamed and Raul Lardies-Bosque

Validation of living with chronic illness scale in a type 2 diabetes mellitus population

Background: Worldwide, type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic diseases and one of those producing greatest impact on patients’ day-to-day quality of life. Our study aim is to validate the “Living with Chronic Illness Scale” for a Spanish-speaking T2DM population. Methods: In this observational, international, cross-sectional study, 582 persons with T2DM were recruited in primary care and outpatient hospital consultations, in Spain and Colombia, during the period from May 2018 to June 2019. The properties analysed were feasibility/acceptability, internal consistency, reliability, precision and (structural) content-construct validity including confrmatory factor analysis. The COSMIN checklist was used to assess the methodological/psychometric quality of the instrument. Results: The scale had an adequate internal consistency and test retest reliability (Cronbach’s alpha=0.90; intraclass correlation coefcient=0.96, respectively). In addition, the instrument is precise (standard error of measurement=3.34, with values<½SD=8.52) and correlates positively with social support (DUFSS) (rs=0.56), quality of life (WHOQOL-BREF) (rs=0.51–0.30) and ssatisfaction with life (SLS-6) (rs=0.50–0.38). The original 26-items version of the scale did not support totally the confrmatory factor analysis. The COSMIN checklist is favourable for all the properties analysed, although weaknesses are detected for structural validity. Conclusions: The LW-CI-T2DM is a valid, reliable and accurate instrument for use in clinical practice to determine how a person’s life is afected by the presence of diabetes. This instrument correlates well with the associated constructs of social support, quality of life and satisfaction. Additional research is needed to determine how well the questionnaire structure performs when robust factor analysis methods are applied.This study has been funded by the Ministry of Science, Innovation and University of the Spanish Government (FEDER/Ministerio de Ciencia, Innovación y Universidades-Agencia Estatal de Investigación/ Proyecto (CSO2017-82691-R)).S

The Personal Wellbeing among Community-Dwelling Older Adults in Spain and Associated Factors

Objective: The conceptual framework of Quality of Life (QoL) allows approaching the knowledge of the living conditions of people in order to help establishing policies for QoL improvement. This study is aimed at examining the assessment made by older adults on their personal wellbeing and the satisfaction with life and the associated factors. A summary of the psychometric properties of the measurement instrument was also presented. Method: The data came from the Ageing in Spain Longitudinal Study, Pilot Survey (ELES-PS), carried out in 2011 among people 50 years old or more living in family housing in Spain. The Personal Wellbeing Index (PWI), as a multidimensional measure of QoL, was used to evaluate the subjective wellbeing. Personal, social and residential characteristics were considered as independent variables. Descriptive statistical analysis, ANOVA, correlation, factor and regression analyses were applied. Results and conclusions: The PWI had good psychometric properties and showed the convergent validity with satisfaction with life as a whole (SWLW). Unidimensional structure of the scale was also demonstrated. PWI and SWLW total scores reached 74.5%SM and 77.1%SM, respectively. The best rated life domains were the satisfaction with relationships, safety and feeling part of the community. The SWLW observed significant differences in gender categories while PWI within age and social status. Both scales were associated with marital status, educational level, household size, current activity status and social status. The regression model of the PWI explained 34.2% of the variance through factors on socio-demographic and economic resources, psychosocial, health/functioning, family and social networks, leisure and residential environment. Based on these results, it would be desirable to deepen on this line from a longitudinal perspective to detect the influence of the changing conditions of the aged people in their personal well-being and life satisfaction.This research was funded by the Spanish Ministry of Science and Innovation (National R&D&I Plan: ref. CSO2009-08645-E/SOCI, CSO2009-06638-E/SOCI, CSO2009-06637-E/SOCI), by the Fundación Obra Social Cajamadrid and by the Basque Government, and supported by the Ageing Process Research Unit INGEMA-CSIC, for carrying out the ELES Project Pilot Survey. Another grant from the Spanish Ministry of Science and Innovation (National R&D&I Plan: ref. CSO2011-30210-C02-01) was endorsed for the analysis. Authors would like to thank the editor and the anonymous reviewer/s for their helpful comments during the development of this paper

NKG2D-CAR memory T cells target pediatric T-cell acute lymphoblastic leukemia in vitro and n vivo but fail to eliminate leukemiai nitiating cells

[Introduction]: Refractory/relapsed pediatric acute leukemia are still clinically challenging and new therapeutic strategies are needed. Interactions between Natural Killer Group 2D (NKG2D) receptor, expressed in cytotoxic immune cells, and its ligands (NKG2DL), which are upregulated in leukemic blasts, are important for anti-leukemia immunosurveillance. Nevertheless, leukemia cells may develop immunoescape strategies as NKG2DL shedding and/or downregulation. [Methods]: In this report, we analyzed the anti-leukemia activity of NKG2D chimeric antigen receptor (CAR) redirected memory (CD45RA-) T cells in vitro and in a murine model of T-cell acute lymphoblastic leukemia (T-ALL). We also explored in vitro how soluble NKG2DL (sNKG2DL) affected NKG2D-CAR T cells’ cytotoxicity and the impact of NKG2D-CAR T cells on Jurkat cells gene expression and in vivo functionality. [Results]: In vitro, we found NKG2D-CAR T cells targeted leukemia cells and showed resistance to the immunosuppressive effects exerted by sNKG2DL. In vivo, NKG2D-CAR T cells controlled T cell leukemia burden and increased survival of the treated mice but failed to cure the animals. After CAR T cell treatment, Jurkat cells upregulated genes related to proliferation, survival and stemness, and in vivo, they exhibited functional properties of leukemia initiating cells. [Discussion]: The data here presented suggest, that, in combination with other therapeutic approaches, NKG2D-CAR T cells could be a novel treatment for pediatric T-ALL.This work was supported by a grant from the Instituto de Salud Carlos III to LF PI21/01049, the II and V awards from UNOENTRECIENMIL Foundation, and a grant from CRIS FOUNDATION to Beat Cancer as part of the projects “Cell therapy based on NKG2D-CAR for pediatric leukemia” and “NKG2D-CAR as treatment for pediatric patients suffering from acute leukemia and juvenile myelomonocytic leukemia”. AF, MI-N, AN-Z and CF have been supported by Personnel research grants from CRIS Foundation to beat cancer. CM has been supported by Personnel PhD student grants from the Instituto de Salud Carlos III (ISCIII), PFIS (FI19/00176). MVG is funded by grant PID2021-123795OB-I00 from the Spanish Ministry of Science and Innovation [Ministerio de Ciencia e Innovación (MCIN)/Agencia Estatal de Investigación (AEI) / 10.13039/501100011033 and European Regional Development Fund (ERDF)-A way of making Europe] and belongs to cancer-Hub CSIC. MI lab is funded by grant PID2020-114148RB-I00 from the Spanish Ministry of Science and Innovation MCIN/AEI/10.13039/501100011033,which was in part granted with FEDER funding (EC)

International psychometric validation of the Living with Chronic Illness Scale in Spanish-speaking patients with chronic obstructive pulmonary disease

Objectives To validate the Living with Chronic Illness (LW-CI) Scale in patients with chronic obstructive pulmonary disease (COPD). Design Observational, cross-sectional validation study with retest. Acceptability, reliability, precision and construct validity were tested. Setting The study took place in primary and secondary specialised units of public and private hospitals of Spain and Colombia. Participants The study included 612 patients with COPD assessed from May 2018 to May 2019. A consecutive cases sampling was done. Inclusion criteria included: (A) patients with a diagnosis of COPD; (B) native Spanish speaking; (C) able to read and understand questionnaires; and (D) able to provide informed consent. Exclusion criteria included: (A) cognitive deterioration and (B) pharmacological effect or disorder that could disrupt the assessment. Results The LW-CI-COPD presented satisfactory data quality, with no missing data or floor/ceiling effects, showing high internal consistency for all the domains (Cronbach's alpha for the total score 0.92). Test-retest reliability was satisfactory (intraclass correlation coefficient=0.92). The LW-CI-COPD correlated 0.52-0.64 with quality of life and social support measures. The scale demonstrated satisfactory known-groups validity, yielding signifi cantly different scores in patients grouped according to COPD severity levels. Conclusions This has been the first validation study of the LW-CI-COPD. It is a feasible, reliable, valid and precise self-reported scale to measure living with COPD in the Spanish-speaking population. Therefore, it could be recommended for research and clinical practice to measure this concept and evaluate the impact of centred-care interdisciplinary interventions based on the patients' perspective, focused on providing holistic and comprehensive care to patients with COPDMinistry of Science, Innovation and University (FEDER/Ministerio de Ciencia, Innovacion y Universidades -Agencia Estatal de Investigacion)||Universidad de la Saban

Real-life disease monitoring in follicular lymphoma patients using liquid biopsy ultra-deep sequencing and PET/CT

In the present study, we screened 84 Follicular Lymphoma patients for somatic mutations suitable as liquid biopsy MRD biomarkers using a targeted next-generation sequencing (NGS) panel. We found trackable mutations in 95% of the lymph node samples and 80% of the liquid biopsy baseline samples. Then, we used an ultra-deep sequencing approach with 2 · 10−4 sensitivity (LiqBio-MRD) to track those mutations on 151 follow-up liquid biopsy samples from 54 treated patients. Positive LiqBio-MRD at first-line therapy correlated with a higher risk of progression both at the interim evaluation (HRINT 11.0, 95% CI 2.10–57.7, p = 0.005) and at the end of treatment (HREOT, HR 19.1, 95% CI 4.10–89.4, p < 0.001). Similar results were observed by PET/CT Deauville score, with a median PFS of 19 months vs. NR (p < 0.001) at the interim and 13 months vs. NR (p < 0.001) at EOT. LiqBio-MRD and PET/CT combined identified the patients that progressed in less than two years with 88% sensitivity and 100% specificity. Our results demonstrate that LiqBio-MRD is a robust and non-invasive approach, complementary to metabolic imaging, for identifying FL patients at high risk of failure during the treatment and should be considered in future response-adapted clinical trials.This study has been funded by Instituto de Salud Carlos III (ISCIII) and co-funded by the European Union through the projects PI21/00314, PI19/01430, PI19/01518 and PI18/00295, PTQ2020-011372, CP19/00140, CP22/00082, Doctorado industrial CAM IND2020/TIC-17402 and CRIS cancer foundation