Loneliness and isolation in the ederly

Treball Final de Grau en Psicologia. Codi: PS1048. Curs: 2022/2023Introducción. Durante la etapa del envejecimiento pueden suceder una serie de cambios y pérdidas que facilitan la aparición del sentimiento de soledad. La soledad se ha conceptualizado como el aislamiento social percibido y se le ha descrito como una condición que puede llegar a ser grave (Cacioppo y Cacioppo, 2012; Weiss. 1973). Esta experiencia subjetiva de soledad es un predictor de las disminuciones en la salud mental (Russell et. al, (1997). Objetivo. Evaluar el bienestar mental, la soledad y el apoyo social en una muestra de personas mayores de 50 años en la ciudad de Castellón. Método. El estudio base del cuál se han extraído los datos, utilizó como metodología una encuesta transversal, dónde se recogió la información a través de una encuesta telefónica, a una muestra de 243 personas (132 mujeres, 108 hombres y 3 se definieron de otro género) con un rango de edad de 50 a 99 años. Se elaboró un cuestionario de 30 ítems. Para la medición de la variables bienestar mental se utilizó la escala WHO-5; para la evaluación de soledad la escala UCLA y para la percepción del apoyo social, la escala LSNS-6 de Lubben. El procedimiento utilizado para la selección de la muestra fue el de muestreo por cuotas de edad y género. Resultados. La correlación de Pearson realizada entre los constructos soledad, bienestar mental y apoyo social obtenida mediante los resultados en las escalas WHO-5, UCLA y LSNS-6, respectivamente, expuso lo siguiente: ➔ r= - 0.41** para la relación soledad-bienestar mental. ➔ r= 0.351** para la relación bienestar mental-apoyo social. Conclusión. En línea con estudios previos, los resultados muestran una correlación negativa entre soledad-bienestar mental, lo cuál indica, que la presencia de sentimientos de soledad supone un menor bienestar mental (López et al., 2022). Por otro lado, la correlación entre bienestar mental-apoyo social muestra que ambas variables mantienen una relación positiva. De manera que, la percepción de apoyo social supone la presencia de un correcto bienestar mental, tal y como afirma la OMS.Introduction. During the aging stage, a number of changes and losses can occur that facilitate the emergence of feelings of loneliness. Loneliness has been conceptualized as perceived social isolation and has been described as a condition that can become severe (Cacioppo and Cacioppo, 2012; Weiss. 1973). This subjective experience of loneliness is a predictor of declines in mental health (Russell et. al, (1997). Objectives. To evaluate mental well-being, loneliness and social support in a sample of people over 50 years of age in the city of Castellón. Method. The base study from which the data was extracted used a cross-sectional survey methodology, where information was collected through a telephonic survey of a sample of 243 people (132 women, 108 men and 3 were defined as other genders) with an age range of 50 to 99 years. A 30-item questionnaire was developed. The WHO-5 scale was used to measure mental well-being; the UCLA scale was used to measure loneliness and the LSNS-6 Lubben scale was used to measure social support. The procedure used for sample selection was age and gender quota sampling. Results. Pearson's correlation between the constructs loneliness, mental well-being and social support obtained by the results on the WHO-5, UCLA and LSNS-6 scales, respectively, showed the following: ➔ r= - 0.41** for the loneliness-mental well-being relationship. ➔ r= 0.351** for the mental well-being-social support relationship. Conclusion. In line with previous studies, the results show a negative correlation between loneliness-mental well-being, which indicates that the presence of feelings of loneliness leads to lower mental well-being (López et al., 2022). On the other hand, the correlation between mental well-being and social support shows that both variables have a positive relationship. Thus, the perception of social support implies the presence of a correct mental well-being, as stated by the WHO

Generation and integrated analysis of advanced patient-derived orthoxenograft models (PDOX) for the rational assessment of targeted therapies in endometrial cancer

Clinical management of endometrial cancer (EC) is handicapped by the limited availability of second line treatments and bona fide molecular biomarkers to predict recurrence. These limitations have hampered the treatment of these patients, whose survival rates have not improved over the last four decades. The advent of coordinated studies such as The Cancer Genome Atlas Uterine Corpus Endometrial Carcinoma (TCGA_UCEC) has partially solved this issue, but the lack of proper experimental systems still represents a bottleneck that precludes translational studies from successful clinical testing in EC patients. Within this context, the first study reporting the generation of a collection of endometrioid-EC-patient-derived orthoxenograft (PDOX) mouse models is presented that is believed to overcome these experimental constraints and pave the way toward state-of-the-art precision medicine in EC. The collection of primary tumors and derived PDOXs is characterized through an integrative approach based on transcriptomics, mutational profiles, and morphological analysis; and it is demonstrated that EC tumors engrafted in the mouse uterus retain the main molecular and morphological features from analogous tumor donors. Finally, the molecular properties of these tumors are harnessed to assess the therapeutic potential of trastuzumab, a human epidermal growth factor receptor 2 (HER2) inhibitor with growing interest in EC, using patient-derived organotypic multicellular tumor spheroids and in vivo experiments

High frequency of low-count monoclonal B-cell lymphocytosis in hospitalized COVID-19 patients

Low-count monoclonal B-cell lymphocytosis (MBLlo, <500 clonal B-cells/μL) is a highly prevalent condition in the general population (4% to 16% of otherwise healthy adults), which increases significantly with age.1-7 In most cases, clonal B-cells share phenotypic and cytogenetic features with chronic lymphocytic leukemia (CLL), but only a small fraction (≈1.8%) progresses to high-count MBL (MBLhi; ≥500 and <5000 clonal B-cells/μL)3 in the medium-term.8 However, previous reports showed that MBLlo subjects had an increased risk of severe infections in association with a (predominantly) secondary antibody deficiency,8-10 suggesting that MBLlo might be a risk marker for developing more severe infections.This work was supported by the Instituto de Salud Carlos III (Ministerio de Ciencia e Innovación, Madrid, Spain, and FONDOS FEDER (a way to build Europe) grants CB16/12/00400 (CIBERONC), COV20/00386, and PI17/00399; the Consejería de Educación and the Gerencia Regional de Salud, Consejería de Sanidad from Junta de Castilla y León (Valladolid, Spain) grants SA109P20 and GRS-COVID-33/A/20; the European Regional Development Fund (INTERREG POCTEP Spain-Portugal) grant 0639-IDIAL-NET-3-3; and the CRUK (United Kingdom), Fundación AECC (Spain), and Associazione Italiana per la Ricerca Sul Cancro (Italy) “Early Cancer Research Initiative Network on MBL (ECRINM3)” ACCELERATOR award. G.O.-A. is supported by a grant from the Consejería de Educación, Junta de Castilla y León (Valladolid, Spain); B.F.-H. was supported by grant 0639-IDIAL-NET-3-3.Peer reviewe

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Derechos de imagen sobre los deportistas menores de edad

Dentro de un espectáculo deportivo, la imagen del deportista es uno de los bienes más preciados y sometido a diversidad de pactos. Por ello, cuando aparece la figura del menor de edad, es absolutamente necesario una regulación clara y exhaustiva que evite malas interpretaciones y abusos, donde el joven jugador tenga una significación elevada pero bajo la protección pública, ante sí mismo, y ante los diversos elementos que le rodean (clubes, Federaciones, padres, agentes, compañeros y autoridades públicas). Aportar luz a estas relaciones, así como algunas soluciones de lege ferenda es nuestra intención.Sin financiaciónNo data (2015)UE

La problemática sobre los deportistas retirados y post mortem en relación con los derechos de imagen

El derecho de imagen en el sector deportivo cada vez posee mayor contenido económico, ligado al profesionalismo. Pero la realidad es que su estudio sobre todo se ha centrado en el deportista en activo, y a través de este trabajo tratamos de profundizar en los diversos perfiles que nos ofrece el jugador ya retirado, e incluso cuál será su regulación una vez haya fallecido. Comprobaremos cómo ha ido evolucionando la regulación de los derechos de imagen de los deportistas en las últimas décadas, y cómo se ha dejado de lado un mayor hincapié sobre los deportistas profesionales retirados y/o post mortem. La normativa es demasiado abierta y debemos tratar de medirla con la experiencia estadounidense, lo que junto a la vieja doctrina española nos permite concretar los déficits y las necesidades respecto a una oportuna regulación de lege ferenda.Sin financiaciónNo data (2015)UE