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2021 ◽  
Alice Pierobon ◽  
Alessandra Dal Zotto ◽  
Antonio Antico ◽  
Mario Ernesto De Antoni ◽  
Liviano Vianello ◽  

Objectives: Description of a SARS-CoV-2 B.1.617.2 (Delta) variant outbreak among residents (N = 69) and Health Workers (HWs: N = 69) of a small Nursing Home in Northern-East Italy, with full vaccination coverage of 91 and 82 %, respectively. Evaluation of the Anti-Spike IgG titers 28 weeks after the mRNA vaccine boosts against SARS-COV-2 infection and severe Covid-19. Materials and methods: A timely collection of sera within 48 h from the index case; anti-Spike IgG determination (expressed as Binding Antibody Units - BAU/mL) through a commercial quantitative assay; SARS-CoV-2 diagnostics via RT-PCR, and full-genome sequencing for lineage characterization. Residents were grouped according to anti-Spike IgG titers (≤50, 51-1000, and >1000 BAU/mL) and resulting protection against the infection and the severe disease was measured. Results: 0/20 HWs and 14/59 (24 %) residents fully vaccinated and without a previous SARS-CoV-2 infection showed anti-Spike IgG ≤50 BAU/mL (1-sided Fisher exact p=0.011). Among these residents, a level of anti-Spike IgG ≤50 BAU/mL resulted in a higher risk of SARS-CoV-2 infection (RR=1.55, CI 95% 1.17-2.05) and severe Covid-19 disease (RR=5.33, CI95% 1.83-15.57). Conclusion Low levels of SARS-CoV-2 neutralizing anti-Spike IgG in serum 28 weeks after the administration of the second dose parallels the waning of vaccine protection.

2021 ◽  
Vol 1 (2) ◽  
pp. 100-106
Bela Aprilia Nuraini ◽  
Latifa Aini Susumaningrum ◽  
Tantut Susanto ◽  
Hanny Rasni ◽  
Fahruddin Kurdi

COVID-19 pandemic has been restricting the physical and social interaction among elders. Furthermore, this pandemic has been limiting elders’ participation in their social environment. This research aimed to analyze the implementation of social interaction among elders during the COVID-19 pandemic at the Nursing Home of Jember. The method used in this study was descriptive research with a cross-sectional approach. The sample used in this study was 74 elders at the Nursing Home of Jember which matched with the criteria of research inclusion and exclusion. The data analyzed was the social interaction which was used to find out the adaptation of elders’ social interaction during the pandemic. The one-sample Kolmogorov-Smirnov's test was used to reach the aim of this study. The result showed that social interaction among elders underwent a significant change during the pandemic Md(P25-75)=11(9-14); Z=0,104; p-value 0,045. It can be concluded that there was a significant change in elders’ social interaction during the COVID-19 pandemic. Therefore, discussing and telling are activities that needed to implement for improving the social interaction among elders during the pandemic.

2021 ◽  
Vol 21 (1) ◽  
Ramona Backhaus ◽  
Hilde Verbeek ◽  
Bram de Boer ◽  
Judith H. J. Urlings ◽  
Debby L. Gerritsen ◽  

Abstract Background To protect nursing home residents, many governments around the world implemented blanket visitor bans in March and April 2020. As a consequence, family caregivers, friends, and volunteers were not allowed to enter nursing homes, while residents were not allowed to go out. Up until now, little is known on the long-term consequences and effects of visiting bans and re-opening of nursing homes. The aim of the study was to assess the long-term effects of the pandemic on residents, family members, and staff, and their preparedness for the next coronavirus wave. Methods A mixed-methods approach was used, consisting of a questionnaire and analyses of documentation (local visiting protocols). Of the 76 nursing home locations that participated in a Dutch national pilot on welcoming visitors back into nursing homes, 64 participated in this follow-up study. Data were collected in September/October 2020. For each nursing home, one contact person completed the questionnaire. Descriptive statistics were calculated for quantitative questionnaire data. Data on open-ended questions, as well as data from the documentation, were analyzed thematically. Results The study demonstrated that the consequences of strict visiting bans do not disappear at the moment the visiting ban is lifted. Although in October 2020, daily life in nursing homes was more “back to normal,” more than one-third of the respondents indicated that they still applied restrictions. Compared to the situation before the pandemic, fewer volunteers were working in the nursing homes, grandchildren visited their relative less often, and visits differed. Conclusions Five months after the visiting ban in Dutch nursing homes had been lifted, it still had an impact on residents, family members, and staff. It is questionable whether nursing homes feel prepared for welcoming visitors in the case of new COVID-19 infections. Nursing homes indicated that they felt prepared for the next wave, while at the same time, they were particularly concerned about staff well-being and vitality. It seems wise to invest in staff well-being. In addition, it seems desirable to think about how to support nursing homes in seeking a balance between infection prevention and well-being of residents, family members, and staff.

2021 ◽  
Vol 18 ◽  
Carina Wattmo ◽  
Kaj Blennow ◽  
Oskar Hansson

Background: Cerebrospinal fluid (CSF) biomarkers are associated with conversion from mild cognitive impairment to Alzheimer’s disease (AD), but their predictive value for later end-points has been less evaluated with inconsistent results. Objective: We investigated potential relationships between CSF amyloid-β1-42 (Aβ42), phosphorylat- ed tau (P-tau), and total tau (T-tau) with time to nursing home placement (NHP) and life expectan- cy after diagnosis. Methods: This prospective observational study included 129 outpatients clinically diagnosed with mild-to-moderate AD who underwent a lumbar puncture. The CSF biomarkers were analysed with xMAP technology. Dates of institutionalisation and death were recorded. Results : After 20 years of follow-up, 123 patients (95%) were deceased. The participants with ab- normal P-tau and T-tau (A+ T+ (N)+) died earlier than those with normal P-tau/abnormal T-tau (A+ T- (N)+) (mean, 80.5 vs. 85.4 years). Linear associations were demonstrated between lower Aβ42 and shorter time to NHP (p = 0.017), and higher P-tau and younger age at death (p = 0.016). No correlations were detected between survival after AD diagnosis and CSF biomarkers. In sex- and-age-adjusted Cox regression models, higher P-tau and T-tau were independent predictors of shorter lifespan after diagnosis. In multivariate Cox models, older age and lower baseline cognitive status, but not elevated tau, significantly precipitated both institutionalisation and death. Conclusion: These findings suggest that CSF biomarker levels plateau in the dementia phase of AD, which may limit their possible relationships with clinical end-points, such as NHP and survi- val time. However, the biomarkers reflect the central pathophysiologies of AD. In particular, patho- logic tau is associated with more advanced disease, younger age at onset, and earlier death.

Ulrike Junius-Walker ◽  
Olaf Krause ◽  
Petra Thürmann ◽  
Simone Bernhard ◽  
Angela Fuchs ◽  

Stavros Kyriakidis ◽  
Matthew Stevens ◽  
Kristina Karstad ◽  
Karen Søgaard ◽  
Andreas Holtermann

The purpose of our study was to investigate which organizational levels and factors determine the number of resident handlings in eldercare. We conducted a multi-level study, stratified on day and evening shifts, including information on four levels: nursing homes (n = 20), wards within nursing homes (day, n = 120; evening, n = 107), eldercare workers within wards (day, n = 619; evening, n = 382), and within eldercare workers (i.e., days within eldercare workers; day, n = 5572; evening, n = 2373). We evaluated the influence of each level on the number of resident handlings using variance components analysis and multivariate generalized linear mixed models. All four levels contributed to the total variance in resident handlings during day and evening shifts, with 13%/20% at “nursing homes”, 21%/33% at “wards within nursing homes”, 25%/31% at “elder-care workers within wards”, and 41%/16% “within eldercare workers”, respectively. The percentage of residents with a higher need for physical assistance, number of residents per shift, occupational position (only within day shifts), and working hours per week (only within day shifts) were significantly associated with the number of resident handlings performed per shift. Interventions aiming to modify number of resident handlings in eldercare ought to target all levels of the eldercare organization.

Deborah S. Lee ◽  
Andrew R. Zullo ◽  
Yoojin Lee ◽  
Lori A. Daiello ◽  
Dae Hyun Kim ◽  

2021 ◽  
Vol 12 ◽  
Peng Cui ◽  
Jun Zhang ◽  
Ting Ting Li

Nursing homes are the facilities where the elderly conduct their daily activities. This may lead to a complicated acoustic environment which would potentially affect the ability of the elderly to function. In this study, the main indoor public space of a nursing home in Harbin was taken as the research object, and the methods of field observation, sound measurement, and questionnaire survey were used to explore the sound perception and preference of the elderly. The results revealed that in terms of the temporal and spatial distribution of sound pressure level (SPL), the unit living space had the highest SPL, which was above 60 dB (A). The reverberation time (RT) of the unit living space, medical and health care center corridor, was 2.15 and 2.13 s, respectively, at a frequency of 1,000 Hz, which was within the discomfort range. The results also revealed that an acoustic environment had a strong correlation with humidity and a weak correlation with temperature. However, no significant correlation could be assessed with a luminous environment. The elderly people were generally willing to accept the natural sound sources. The factors of gender and offspring numbers had no significant impact on the evaluation of acoustic environment comfort, whereas marriage and income status affected the comfort. This study may help improve the quality of life of the elderly in the nursing home and provide a reference for the construction and design of pension facilities.

2021 ◽  
Vol 21 (1) ◽  
Bistra I. Veleva ◽  
Monique A. A. Caljouw ◽  
Astrid Muurman ◽  
Jenny T. van der Steen ◽  
Victor G. M. Chel ◽  

Abstract Background Observational studies have reported an inverse association between ultraviolet (UV) radiation and hypertension. The aim of this study was to assess differences in blood pressure changes between persons with dementia receiving UV light versus vitamin D (VD) supplementation. Methods Post-hoc analysis of randomized controlled trial data concerning nursing home residents with dementia (N = 61; 41 women, mean age 84.8 years). The participants received half-body UV irradiation, twice weekly over 6 months, at one standard erythema dose (UV group, n = 22) or 5600 international units of cholecalciferol once a week (VD group, n = 39). Short-term effects were evaluated after 1 month and long-term effects after 3 and 6 months. Differences in blood pressure changes were assessed using linear mixed models. Results With the VD group as a reference, the estimated difference in mean change of systolic blood pressure was − 26.0 mmHg [95% confidence interval (CI) -39.9, − 12.1, p = .000] at 1 month, 4.5 mmHg (95% CI -6.8, 15.9, p = 0.432) at 3 months, and 0.1 (95% CI -14.1, 14.3, p = 0.83) at 6 months. The estimated difference in diastolic blood pressure was − 10.0 mmHg (95% CI -19.2, − 0.7, p = 0.035) at 1 month, 3.6 mmHg (95% CI -4.1, 11.2, p = 0.358) at 3 months, and 2.7 (95% CI -6.8, 12.1, p = 0.580) at 6 months. Conclusions UV light had only a short-term effect but not a long-term effect on blood pressure reduction compared to VD use in this sample of normotensive to mild hypertensive nursing home residents with dementia. Future studies will be needed to determine the effect of UV light in different samples of the population and especially in a population with hypertension.

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