Stress and burnout in nursing home and égida workers during COVID-19.

AIMS: Finding out whether there are differences in the levels of stress and burnout between workers providing care to dependent adults and those caring for independent older adults would provide comparative information about two different models of care. During the COVID-19 pandemic, workers caring for older adults were subjected to maladaptive situations that produced stress and burnout. DESIGN: A cross-sectional survey design using the STROBE checklist. METHODS: A total of 900 nursing home and égidas workers were assessed for stress and burnout. Data were collected online from October 2020 to February 2021, when Puerto Rico was experiencing the peak of the third wave of COVID-19. MANOVAs were performed to study the interactions between the workplace and having had COVID, the workplace and the size of institution and the workplace and position held. DATA SOURCES: October 2020 to February 2021. RESULTS: All interactions were significant. Nursing homes showed higher levels of stress and burnout when workers had undergone COVID, when the size of the institution was larger and for technical staff other services; in égidas, having undergone COVID did not influence stress or burnout, which increased when the institution was smaller and for executive staff. CONCLUSIONS: This study showed that the effects of the COVID-19 pandemic affected nursing home workers more significantly than those working in other types of residential models with independent older adults. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Applying preventive interventions aimed at reducing stress and burnout would facilitate the adaptation of workers caring for older adults and help to improve the quality of care. IMPACT: This study analysed the impact of COVID-19 on the stress and burnout of workers providing services to older adults. Nursing home workers who have had COVID-19 have higher stress and burnout. The size of the institution has a different effect depending on whether older adults are dependent or independent. Workers in institutions dedicated to the care of the older adults. REPORTING METHOD: This study has adhered to the relevant EQUATOR guidelines: STROBE. PATIENT OR PUBLIC CONTRIBUTION: During the different waves of the COVID-19 pandemic, it was difficult to establish direct contact with workers providing care to older adults; this reason made it necessary to apply online systems to obtain information. The workers appreciated the fact that the implications for stress and burnout of the situation experienced during this difficult process were investigated.

Coping and guilt in informal caregivers: a predictive model based on structural equations.

Caregivers experience great stress, and coping can be one of the factors, which determine the extent of stress. The aim of the present paper is to analyze the effects of coping strategies on distress of the older adult's caregiver, including guilt as a mediating factor in those maladaptive strategies. The sample consisted of 201 informal caregivers of institutionalized older adults. The three constructs measured were: stress, guilt, and coping strategies. Results showed that strategies that have a better ability to reduce stress are active, positive reframing and acceptance; on the contrary, behavioral disengagement, self-distraction, self-blame and venting positively predicted the feeling of guilt that facilitated the perception of stress. Given the important association obtained between the experience of guilt and psychological distress in caregivers, it could be relevant to develop psychoeducational interventions with caregivers including techniques to reduce this feeling of guilt and develop cognitive behavioral strategies that facilitate adaptation.

Factors associated with satisfaction and depressed mood among nursing home workers during the covid-19 pandemic.

AIMS AND OBJECTIVES: This paper aims to examine the satisfaction and depressed mood experienced by nursing home workers during the COVID-19 pandemic and associated variables. Specifically, to analyse the factors that may contribute to nursing home workers developing adaptive behaviours that promote satisfaction or, on the contrary, show characteristics associated with a negative mood. BACKGROUND: Nursing homes have faced unprecedented pressures to provide appropriately skills to meet the demands of the coronavirus outbreak. DESIGN: A cross-sectional survey design using the STROBE checklist. METHODS: Professionals working in nursing homes (n = 165) completed an online survey measuring sociodemographic and professional characteristics, burnout, resilience, experiential avoidance, satisfaction with life and depression. Data were collected online from April to July 2021, the time in which Spain was experiencing its fifth wave of COVID-19. Two multiple linear regression models were performed to identify salient variables associated with depressive mood and satisfaction. RESULTS: Resilience, personal accomplishment and satisfaction had a significant and negative relationship with depression and emotional exhaustion, depersonalisation and experiential avoidance had a positive relationship with depression. However, emotional exhaustion, depersonalisation and experiential avoidance had a negative and significant relationship with satisfaction and personal accomplishment, and resilience had a positive and significant relationship with satisfaction. In addition, it was found that accepting thoughts and emotions when they occur is beneficial for developing positive outcomes such as satisfaction. CONCLUSIONS: Experiential avoidance was an important predictor of the effects that the COVID-19 pandemic can have on nursing home workers. RELEVANCE TO CLINICAL PRACTICE: Interventions focusing on resources that represent personal strengths, such as acceptance, resilience and personal accomplishment, should be developed. NO PATIENT OR PUBLIC CONTRIBUTION: The complex and unpredictable circumstances of COVID's strict confinement in the nursing home prohibited access to the centres for external personnel and family members. Contact with the professionals involved could not be made in person but exclusively through online systems. However, professionals related to the work environment have subsequently valued this research positively as it analyses 'How they felt during this complicated process'.

Relationship Between Personality Traits, Generativity, and Life Satisfaction in Individuals Attending University Programs for Seniors.

Personality traits of older adults and their contribution to life satisfaction and generative interest were assessed. A total of 342 older participants (66% women), mean age = 67.89 years old ( SD = 6.52, range = 55-84 years old), who attended the University of the Experience in Salamanca (Spain), were evaluated. Information on sociodemographic data, perceived health and activity, personality traits, generativity, and life satisfaction was collected using self-reported questionnaires. Results confirmed a relation between personality traits, life satisfaction, and generativity. In addition, generative concern, neuroticism, extraversion, agreeableness, and conscientiousness predicted life satisfaction at this stage. Moreover, the role of personality on generativity was confirmed. Individuals with interest and agreeableness toward others, who are organized, persistent, and motivated, are more predisposed to generativity. These results open the way to develop intervention programs that enhance positive personality traits and generative interest to improve quality of life of older people.

Ten ways remote sensing can contribute to conservation.

In an effort to increase conservation effectiveness through the use of Earth observation technologies, a group of remote sensing scientists affiliated with government and academic institutions and conservation organizations identified 10 questions in conservation for which the potential to be answered would be greatly increased by use of remotely sensed data and analyses of those data. Our goals were to increase conservation practitioners' use of remote sensing to support their work, increase collaboration between the conservation science and remote sensing communities, identify and develop new and innovative uses of remote sensing for advancing conservation science, provide guidance to space agencies on how future satellite missions can support conservation science, and generate support from the public and private sector in the use of remote sensing data to address the 10 conservation questions. We identified a broad initial list of questions on the basis of an email chain-referral survey. We then used a workshop-based iterative and collaborative approach to whittle the list down to these final questions (which represent 10 major themes in conservation): How can global Earth observation data be used to model species distributions and abundances? How can remote sensing improve the understanding of animal movements? How can remotely sensed ecosystem variables be used to understand, monitor, and predict ecosystem response and resilience to multiple stressors? How can remote sensing be used to monitor the effects of climate on ecosystems? How can near real-time ecosystem monitoring catalyze threat reduction, governance and regulation compliance, and resource management decisions? How can remote sensing inform configuration of protected area networks at spatial extents relevant to populations of target species and ecosystem services? How can remote sensing-derived products be used to value and monitor changes in ecosystem services? How can remote sensing be used to monitor and evaluate the effectiveness of conservation efforts? How does the expansion and intensification of agriculture and aquaculture alter ecosystems and the services they provide? How can remote sensing be used to determine the degree to which ecosystems are being disturbed or degraded and the effects of these changes on species and ecosystem functions?

Pharmacokinetic behavior of enrofloxacin and its metabolite ciprofloxacin in urutu pit vipers (Bothrops alternatus) after intramuscular administration.

Enrofloxacin is widely used in veterinary medicine and is an important alternative to treating bacterial infections, which play an important role as causes of disease and death in captive snakes. Its extralabel use in nontraditional species has been related to its excellent pharmacokinetic and antimicrobial characteristics. This can be demonstrated by its activity against gram-negative organisms implicated in serious infectious diseases of reptile species with a rapid and concentration-dependent bactericidal effect and a large volume of distribution. Pharmacokinetic parameters for enrofloxacin were investigated in seven urutu pit vipers (Bothrops alternatus), following intramuscular injections of 10 mg/kg. The plasma concentrations of enrofloxacin and its metabolite, ciprofloxacin, were measured using high-performance liquid chromatography. Blood samples were collected from the ventral coccygeal veins at 0.5, 1, 2, 4, 8, 12, 24, 36, 48, 72, 96, 108, and 168 hr. The kinetic behavior was characterized by a relatively slow absorption (time of maximal plasma concentration = 4.50 +/- 3.45 hr) with peak plasma concentration of 4.81 +/- 1.12 microg/ml. The long half-life during the terminal elimination phase (t1/2 lambda = 27.91 +/- 7.55 hr) of enrofloxacin after intramuscular administration, calculated in the present study, could suggest that the antibiotic is eliminated relatively slowly and/or the presence of a slow absorption in urutu pit vipers. Ciprofloxacin reached a peak plasma concentration of 0.35 microg/ml at 13.45 hr, and the fraction of enrofloxacin metabolized to ciprofloxacin was 13.06%. If enrofloxacin's minimum inhibitory concentration (MIC90) values of 0.5 microg/ml were used, the ratios AUC(e+c): MIC90 (276 +/- 67 hr) and Cmax(e+c): MIC90 (10 +/- 2) reach the proposed threshold values (125 hr and 10, respectively) for optimized efficacy and minimized resistance development when treating infections caused by Pseudomonas. The administration of 10 mg/kg of enrofloxacin by the i.m. route should be considered to be a judicious choice in urutu pit vipers against infections caused by microorganisms with MIC values < or = 0.5 microg/ml. For less susceptible bacteria, a dose increase and/or an interval reduction should be evaluated.

Pharmacokinetic and pharmacodynamic properties of enrofloxacin in southern crested caracaras (Caracara plancus).

To determine the dosage of enrofloxacin in southern crested caracaras (Caracara plancus), plasma concentrations of enrofloxacin were measured by high-performance liquid chromatography after intravenous (IV) (5 mg/kg) and intramuscular (IM) (10 mg/kg) administration. This compound presented a relatively high volume of distribution (2.09 L/kg), a total body clearance of 0.24 L/kg x h, and a long permanence as shown by an elimination half-life of 7.81 hours after IV administration and a terminal half-life of 6.58 hours after IM administration. The areas under the concentration-time curves (AUC) were 21.92 and 34.38 microg x h/mL for IM and IV administration, respectively. Enrofloxacin was rapidly absorbed after IM administration with a time to reach maximum concentration of 0.72 hours and bioavailability of 78.76%. After IM administration, the peak drug concentration (C(max)) was 3.92 microg/mL. Values of minimum inhibitory concentration (MIC), C(max), and AUC have been used to predict the clinical efficacy of a drug in treating bacterial infections, with a C(max)/MIC value of 10 and an AUC/MIC ratio of 125-250 associated with optimal bactericidal effects. By using the study data and a MIC breakpoint of 0.25 microg/mL, values of C(max)/MIC were 13.74 and 15.94 and for AUC/MIC were 90.73 and 139.63, for the IV and IM routes respectively. For the treatment of infectious diseases caused by microorganisms with MIC < or = 0.25 microg/mL, the calculated optimal dosages were 7.5 and 9.5 mg/kg q24h by the IV and IM routes, respectively. For less susceptible bacteria, a dose increase should be evaluated. To treat caracara by the IV route against microorganisms with MIC < or = 0.25 microg/mL, the dose should be higher than the 5 mg/kg used in our study, but possible side effects derived from an increase in the IV dose and efficacy in sick birds should be assessed.

[Guilt and well-being in institutionalized family caregivers of dependent older adult people]. / Culpa y bienestar en cuidadores familiares de personas mayores dependientes institucionalizadas.

INTRODUCTION AND OBJECTIVE: The experience of family caregivers after nursing home admission has received much less attention, probably because many caregivers experience an initial sense of initial emotional relief. However, for some caregivers nursing home admission is a stressor despite the reduced physical burden of caregiving. Caregiver distress following institutionalization has been related to the new burdens and challenges encountered in the nursing home. Ambivalence and guilt related to the institutionalization decision have been identified as sources of stress. Therefore, this study examined the effect of guilt and well-being on the perceived stress of family caregivers of institutionalized dependent persons. MATERIALS AND METHODS: Two hundred and one family caregivers of institutionalized persons in a nursing home (La Rioja, Spain) participated. Perceived stress, caregiving guilt and subjective well-being, sociodemographic and caregiving-related variables were assessed. Linear regression analyses and correlations between variables were performed. RESULTS: Guilt and five dimensions of well-being (anxiety, vitality, self-control and depression, except general health) significantly predicted stress (R2adj=.552 (F (6, 198)=41.71, P<.001)). The effect size was large (95% CI=.461). CONCLUSIONS: Paying attention to family caregivers' feelings of guilt during institutionalization is important. This will enable the design and implementation of psychosocial interventions that improve caregiver adjustment immediately after institutionalization.

Transcranial Direct Current Stimulation Intervention in Alzheimer's Disease and Its Follow-Up.

BACKGROUND: Alzheimer's disease (AD) stands as the prevailing type of dementia, marked by gradual memory loss and cognitive decline. Transcranial direct current stimulation (tDCS) is a non-invasive method used to regulate cortical brain function and has been explored as a potential treatment for cognitive impairment. OBJECTIVE: This study aimed to compare the effects of daily home-based active or sham tDCS on cognitive function in patients with early-stage AD and its follow-up after one month. METHODS: The study involved a randomized, blinded, and controlled-placebo design, with 18 participants enrolled. The primary outcome measures were general cognitive function, immediate, and delayed recall, and executive function. Participants included in the study were randomly assigned to the anodal and sham tDCS groups. Participants were assessed before and after the intervention and one month after the end of treatment. The home-based intervention was applied for 5 consecutive days, daily. RESULTS: The results showed a significant interaction between the active and sham groups; in particular, improvements in MMSE scores, immediate memory and delayed recall were observed at one-month follow-up in the active group. CONCLUSIONS: The positive effects of tDCS on cognitive function in AD patients observed suggest that tDCS may induce long-term neuroplastic changes, leading to sustained improvements in cognitive abilities.

Sense of coherence and burnout in nursing home workers during the COVID-19 pandemic in Spain.

Care staff in nursing homes work in a challenging environment, and the COVID-19 pandemic has exacerbated those challenges in an unprecedented way. On the other hand, the sense of coherence (SOC) is a competence that could help these professionals perceive the situation as understandable, manageable and meaningful. This study aims to analyse the extent to which potential risk and protective factors against burnout have affected nursing home workers during the COVID-19 pandemic and to assess the contribution of these factors to their burnout. Three hundred forty professionals who worked in nursing homes in Spain completed a survey and reported on their sociodemographic characteristics and their organisational characteristics of the job related to COVID-19, SOC and burnout. Multiple linear regression analyses were performed. The results showed that the SOC is highly related to the dimensions of burnout and is a protective factor against this. In addition, the increase in hours has a negative effect, facilitating inadequate responses to stressful situations; and whereas perceived social support and availability of resources have a protective effect, the deterioration in mental and physical health is the most important risk factor. This study could help better understand the psychological consequences of the effort that nursing home workers and can also help design mental health prevention and care interventions for workers that provide them with resources and supports that foster their coping skills.

Augmenting the Standard Operating Procedures of Health and Air Quality Stakeholders With NASA Resources.

The combination of air quality (AQ) data from satellites and low-cost sensor systems, along with output from AQ models, have the potential to augment high-quality, regulatory-grade data in countries with in situ monitoring networks and provide much needed AQ information in countries without them, including Low and Moderate Income Countries (LMICs). We demonstrate the potential of free and publicly available USA National Aeronautics and Space Administration (NASA) resources, which include capacity building activities, satellite data, and global AQ forecasts, to provide cost-effective, and reliable AQ information to health and AQ professionals around the world. We provide illustrative case studies that highlight how global AQ forecasts along with satellite data may be used to characterize AQ on urban to regional scales, including to quantify pollution concentrations, identify pollution sources, and track the long-range transport of pollution. We also provide recommendations to data product developers to facilitate and broaden usage of NASA resources by health and AQ stakeholders.

Features and psychometric properties of the Montreal Cognitive Assessment: Review and proposal of a process-based approach version (MoCA-PA).

The current study presents a rapid review of the psychometric features of the standard Montreal Cognitive Assessment (MoCA), and the proposal for a modified version of the test, informed by the methodology of the Boston Process Approach to neuropsychological assessment. In order to aid the process of identification of the primary underlying neurocognitive mechanism responsible for defective test performance, the MoCA-Process-Based Approach (MoCA-PA) adds complementary or satellite test conditions in some of its subtests, includes "new" qualitative indices to capture the cognitive processes involved in each cognitive task, and incorporates new qualitative classifications of error subtypes. It provides concurrent assessment of multiple cognitive processes within each task, without significantly increasing administration time or placing significant additional burden upon the respondent. We present preliminary results obtained from an initial sample of 45 community-dwelling older adults attending a University program for seniors. Results suggest the usefulness of additional indices in providing additional information on cognitive deterioration that may be overlooked with the only consideration of quantitative scores. Future research will aim to collect normative data for different clinical populations using the newly developed indices in order to determine the validity and clinical utility of the relatively novel qualitative process-based methods used in the MoCA-PA.

An improved method for estimating surface fine particle concentrations using seasonally adjusted satellite aerosol optical depth.

Using satellite observations of aerosol optical depth (AOD) to estimate surface concentrations of fine particulate matter (PM2.5) is a well-established technique in the air quality community. In this study, the relationships between PM2.5 concentrations measured at five monitor locations in the Baltimore, MD/Washington, DC region and AOD from Moderate Resolution Imaging Spectroradiometer (MODIS), Multi-Angle Imaging Spectroradiometer (MISR), and Geostationary Operational Environmental Satellite (GOES) were calculated for the summer of 2004 and all of 2005. Linear regression methods were used to determine the direct quantitative relationships between the satellite AOD values and PM2.5 concentration measurements. Results show that correlations between AOD and surface PM2.5 concentrations range from 0.46 to 0.84 for the analyzed time period. Correlations with AOD from MODIS and MISR were higher than those from GOES, likely because of variations in the algorithms used by the different instruments. To determine the relative usefulness of platform- and season-specific AOD PM2.5 regression analysis, the results from this study were used to estimate surface PM2.5 concentrations for two representative case studies. This analysis of case studies demonstrates that it is necessary to include season and satellite platform information for more accurate estimates of surface PM2.5 concentrations from satellite AOD data. Consequently, tools that currently use a constant relationship to estimate surface PM2.5 concentrations from satellite AOD data, such as the Infusing satellite Data into Environmental Applications (IDEA) website, may need to be revised to include parameters that allow the relationships to vary with season and satellite platform to provide more accurate results.

Applications of the three-dimensional air quality system to western U.S. air quality: IDEA, smog blog, smog stories, airquest, and the remote sensing information gateway.

A system has been developed to combine remote sensing and ground-based measurements of aerosol concentration and aerosol light scattering parameters into a three-dimensional view of the atmosphere over the United States. Utilizing passive and active remote sensors from space and the ground, the system provides tools to visualize particulate air pollution in near real time and archive the results for retrospective analyses. The main components of the system (Infusing satellite Data into Environmental Applications [IDEA], the U.S. Air Quality Weblog [Smog Blog], Smog Stories, U.S. Environmental Protection Agency's AIRQuest decision support system, and the Remote Sensing Information Gateway [RSIG]) are described, and the relationship of how data move from one system to another is outlined. To provide examples of how the results can be used to analyze specific pollution episodes, three events (two fires and one wintertime low planetary boundary layer haze) are discussed. Not all tools are useful at all times, and the limitations, including the sparsity of some data, the interference caused by overlying clouds, etc., are shown. Nevertheless, multiple sources of data help a state, local, or regional air quality analyst construct a more thorough picture of a daily air pollution situation than what one would obtain with only surface-based sensors.

Evaluation of allometric scaling as a tool for extrapolation of the enrofloxacin dose in American black vultures (Coragyps atratus).

OBJECTIVE: To determine the pharmacokinetics of enrofloxacin after IV administration in American black vultures (Coragyps atratus), to compare clearance of enrofloxacin in American black vultures with clearance of this fluoroquinolone in other avian species, and to evaluate whether allometric scaling is an appropriate tool for dose extrapolation in avian species. ANIMALS: 6 healthy adult American black vultures. PROCEDURES: Enrofloxacin concentrations were quantified by use of high-performance liquid chromatography. Pharmacokinetics of enrofloxacin was determined in American black vultures after IV administration. Pharmacokinetic parameters for 12 avian species obtained from 24 pharmacokinetic studies were used. Allometric analysis of enrofloxacin pharmacokinetic parameters was performed. RESULTS: Volume of distribution at steady state for enrofloxacin was 3.47 L/kg, clearance was 0.147 L/h·kg, and elimination half-life was 18.3 hours. Comparisons among avian species revealed that American black vultures had the lowest extraction ratio for enrofloxacin (1.04%). Only the volume of distribution at steady state and clearance had a good allometric fit. Goodness of fit was improved when ratites were not included in the analysis. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the use of allometric scaling for the prediction of volume of distribution at steady state could provide a suitable method for extrapolation of enrofloxacin doses among avian species; however, allometric scaling could not be used to adequately predict the clearance of enrofloxacin.

Chronopharmacological study of cephalexin in dogs.

Recent studies have identified a 24 h rhythm in the expression and function of PEPT1 in rats, with significantly higher levels during the nighttime than daytime. Similarly, temporal variations have been described in glomerular filtration rate and renal blood flow, both being maximal during the activity phase and minimal during the rest phase in laboratory rodents. The aim of this study was to assess the hypothesis that the absorption of the first-generation cephalosporin antibiotic cephalexin by dogs would be less and the elimination would be slower after evening (rest span) compared to morning (activity span) administration, and whether such administration-time changes could impair the medication's predicted clinical efficacy. Six (3 male, 3 female; age 4.83+/-3.12 years) healthy beagle dogs were studied. Each dog received a single dose of 25 mg/kg of cephalexin monohydrate per os at 10:00 and 22:00 h, with a two-week interval of time between the two clock-time experiments. Plasma cephalexin concentrations were determined by microbiological assay. Cephalexin peak plasma concentration was significantly reduced to almost 77% of its value after the evening compared to morning (14.52+/-2.7 vs. 18.77+/-2.8 microg/mL) administration. The elimination half-life was prolonged 1.5-fold after the 22:00 h compared to the 10:00 h administration (2.69+/-0.9 vs. 1.79+/-0.2 h). The area under the curve and time to reach peak plasma concentration did not show significant administration-time differences. The duration of time that cephalexin concentrations remained above the minimal inhibitory concentrations (MIC) for staphylococci susceptiblity (MIC=0.5 microg/mL) was>70% of each of the 12 h dosing intervals (i.e., 10:00 and 22:00 h). It can be concluded that cephalexin pharmacokinetics vary with time of day administration. The findings of this acute single-dose study require confirmation by future steady-state, multiple-dose studies. If such studies are confirmatory, no administration-time dose adjustment is required to ensure drug efficacy in dogs receiving an oral suspension of cephalexin in a dosage of 25 mg/kg at 12 h intervals.

Pharmacokinetics of Immediate and Sustained Release Cephalexin Administered by Different Routes to Llamas (Lama glama).

We investigate the pharmacokinetics of two different cephalexin formulations administered to llamas by the intravenous (IV), intramuscular (IM), and subcutaneous (SC) routes, the minimum inhibitory concentration (MIC) of cephalexin against some Escherichia coli and staphylococci isolated from llamas, and we apply the PK/PD modelling approach, so that effective dosage recommendations for this species could be made. Six llamas received immediate (10 mg/kg, IV, IM, and SC) and sustained (8 mg/kg IM, SC) release cephalexin. Pharmacokinetic parameters were calculated by noncompartmental approach. Immediate release SC administration produced a significantly longer elimination half-life as compared with the IV and IM administration (1.3 ± 0.2 versus 0.6 ± 0.1 and 0.6 ± 0.1 h, resp.) and higher mean absorption time as compared with the IM administration (1.7 ± 0.5 versus 0.6 ± 0.4 h). Absolute bioavailability was in the range of 72-89% for both formulations and routes of administration. Cephalexin MIC90 values against staphylococci and E. coli were 1.0 and 8.0 µg/mL, respectively. Our results show that the immediate release formulation (10 mg/kg) would be effective for treating staphylococcal infections administered every 8 h (IM) or 12 h (SC), whereas the sustained release formulation (8 mg/kg) would require the IM or SC administration every 12 or 24 h, respectively.

Nitric Oxide And Hypoxia Response In Pluripotent Stem Cells.

The expansion of pluripotent cells (ESCs and iPSCs) under conditions that maintain their pluripotency is necessary to implement a cell therapy program. Previously, we have described that low nitric oxide (NO) donor diethylenetriamine/nitric oxide adduct (DETA-NO) added to the culture medium, promote the expansion of these cell types. The molecular mechanisms are not yet known. We present evidences that ESC and iPSCs in normoxia in presence of low NO triggers a similar response to hypoxia, thus maintaining the pluripotency. We have studied the stability of HIF-1α (Hypoxia Inducible Factor) in presence of low NO. Because of the close relationship between hypoxia, metabolism, mitochondrial function and pluripotency we have analyzed by q RT-PCR the expression of genes involved in the glucose metabolism such as: HK2, LDHA and PDK1; besides other HIF-1α target gene. We further analyzed the expression of genes involved in mitochondrial biogenesis such as PGC1α, TFAM and NRF1 and we have observed that low NO maintains the same pattern of expression that in hypoxia. The study of the mitochondrial membrane potential using Mito-Tracker dye showed that NO decrease the mitochondrial function. We will analyze other metabolic parameters, to determinate if low NO regulates mitochondrial function and mimics Hypoxia Response. The knowledge of the role of NO in the Hypoxia Response and the mechanism that helps to maintain self-renewal in pluripotent cells in normoxia, can help to the design of culture media where NO could be optimal for stem cell expansion in the performance of future cell therapies.

A population pharmacokinetic approach to describe cephalexin disposition in adult and aged dogs.

This study was conducted in order to characterize the pharmacokinetics of orally administered cephalexin to healthy adult and aged dogs, using a population pharmacokinetic approach. Two hundred and eighty-six cephalexin plasma concentrations obtained from previous pharmacokinetic studies were used. Sex, age, pharmaceutical formulation, and breed were evaluated as covariates. A one-compartment model with an absorption lag-time (Tlag) best described the data. The final model included age (adult; aged) on apparent volume of distribution (Vd/F), apparent elimination rate (ke/F), and Tlag; sex (female; male) on ke/F, and breed (Beagle; mixed-breed) on Vd/F. Addition of the covariates to the model explained 78% of the interindividal variability (IIV) in Vd/F, 36% in ke/F, and 24% in Tlag, respectively. Formulation did not affect the variability of any of the pharmacokinetic parameters. Tlag was longer, whereas Vd/F and ke/F were lower in aged compared to adult animals; in female aged dogs ke/F was lower than in male aged dogs; however, the differences were of low magnitude. Different disposition of cephalexin may be expected in aged dogs.

Culpa y bienestar en cuidadores familiares de personas mayores dependientes institucionalizadas / Guilt and well-being in institutionalized family caregivers of dependent older adult people

Antecedentes y objetivo: La experiencia de los cuidadores familiares tras el ingreso en una residencia de personas mayores ha recibido escasa atención, probablemente porque muchos cuidadores experimentan una sensación inicial de alivio emocional inicial. Sin embargo, para algunos cuidadores el ingreso en una residencia de mayores es un factor de estrés a pesar de la reducción de la carga física de los cuidados. La angustia del cuidador tras la institucionalización se ha relacionado con las nuevas cargas y retos que se encuentran en la residencia de mayores. La ambivalencia y la culpa relacionados con la decisión de institucionalización se han identificado como fuentes de estrés. Por eso, este estudio examinó el efecto de la culpa y el bienestar en el estrés percibido de cuidadores familiares de personas dependientes institucionalizadas. Materiales y métodos: Participaron 201 cuidadores familiares de personas institucionalizadas en una residencia de mayores (La Rioja, España). Se evalúo el estrés percibido, la culpa para el cuidado y el bienestar subjetivo, variables sociodemográficas y relacionadas con el cuidado. Se realizaron análisis de regresión lineal y correlaciones entre las variables. Resultados: La culpa y 5 dimensiones de bienestar (ansiedad, vitalidad, autocontrol y depresión, excepto salud general) predijeron significativamente el estrés (R2adj=0,552 [F (6, 198)=41,71; p<0,001]). El tamaño del efecto fue grande (IC del 95%: 0,461). Conclusiones: Prestar atención a los sentimientos de culpa de los cuidadores familiares durante la institucionalización es fundamental. Ello permitirá diseñar e implementar intervenciones psicosociales que mejoren la adaptación del cuidador inmediatamente después de la institucionalización. (AU)

Introduction and objective: The experience of family caregivers after nursing home admission has received much less attention, probably because many caregivers experience an initial sense of initial emotional relief. However, for some caregivers nursing home admission is a stressor despite the reduced physical burden of caregiving. Caregiver distress following institutionalization has been related to the new burdens and challenges encountered in the nursing home. Ambivalence and guilt related to the institutionalization decision have been identified as sources of stress. Therefore, this study examined the effect of guilt and well-being on the perceived stress of family caregivers of institutionalized dependent persons. Materials and methods: Two hundred and one family caregivers of institutionalized persons in a nursing home (La Rioja, Spain) participated. Perceived stress, caregiving guilt and subjective well-being, sociodemographic and caregiving-related variables were assessed. Linear regression analyses and correlations between variables were performed. Results: Guilt and five dimensions of well-being (anxiety, vitality, self-control and depression, except general health) significantly predicted stress (R2adj=.552 (F (6, 198)=41.71, P<.001)). The effect size was large (95% CI=.461). Conclusions: Paying attention to family caregivers’ feelings of guilt during institutionalization is important. This will enable the design and implementation of psychosocial interventions that improve caregiver adjustment immediately after institutionalization. (AU)