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Covid-19: Guidance for managing staff and residents with COVID-19 infection in aged residential care facilities COVID-19: Guidance for managing staff/residents with COVID-19 infection in aged residential care facilities 26 April 2020 This document outlines guidance on managing staff and residents with potential COVID-19 infection in aged residential care (ARC) facilities. District health boards (DHBs) are expected to work closely with ARC facilities to ensure there are adequate supplies (...) of personal protective equipment (PPE) to meet requirements. These guidelines are interim and may be amended as the COVID-19 outbreak evolves. Aged care facilities are residents’ homes where they are cared for by staff. There are multiple contact points between residents and staff daily, which increases the risk of transmission of COVID-19. If a staff member or resident is suspected of having COVID-19, the person has likely had contacts with multiple staff, residents and visitors. Management of staff
JAMA Intern Med Actions . 2020 Apr 20;e200440. doi: 10.1001/jamainternmed.2020.0440. Online ahead of print. Effect of a Mammography Screening Decision Aid for Women 75 Years and Older: A Cluster Randomized Clinical Trial , , , , , , , , , , , , , , Affiliations Expand Affiliations 1 Division of General Medicine, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts. 2 Division of Geriatric Medicine, Department of Medicine, The University (...) aid (DA) for women 75 years and older on their screening decisions. Design, setting, and participants: A cluster randomized clinical trial with clinician as the unit of randomization. All analyses were completed on an intent-to-treat basis. The setting was 11 primary care practices in Massachusetts or North Carolina. Of 1247 eligible women reached, 546 aged 75 to 89 years without breast cancer or dementia who had a mammogram within 24 months but not within 6 months and saw 1 of 137 clinicians
Institute of Evidence-Based Medicine in OldAge, Leiden, The Netherlands. PMID: 32246476 DOI: Item in Clipboard Geriatric Screening, Triage Urgency, and 30-Day Mortality in Older Emergency Department Patients Laura C Blomaard et al. J Am Geriatr Soc . 2020 . Show details J Am Geriatr Soc Actions . 2020 Apr 4. doi: 10.1111/jgs.16427. Online ahead of print. Authors , , , , , , , , , Affiliations 1 Department of Internal Medicine, Section Geriatrics, Leiden University Medical Center, Leiden (...) , in older patients, urgency triage systems could be improved by taking geriatric vulnerability into account. We investigated the association of geriatric vulnerability screening in addition to triage urgency levels with 30-day mortality in older ED patients. Design: Secondary analysis of the observational multicenter Acutely Presenting Older Patient (APOP) study. Setting: EDs within four Dutch hospitals. Participants: Consecutive patients, aged 70 years or older, who were prospectively included
prevalence of pre-frailty was 33% (95% CI: 26-40%) in elderly patients with ACS. Pooled analyses showed that frailty was associated with significantly higher risk of all-cause mortality and readmission (hazard ratios [HRs] = 2.43 and 2.32, respectively). Pre-frailty was also associated with significantly higher risk of all-cause mortality and readmission, respectively (HRs = 1.55 and 1.34, respectively).Both frailty and pre-frailty are risk factors for all-cause mortality and readmission in older (...) Frailty as aÂ predictor of all-cause mortality and readmission in older patients with acute coronary syndrome : AÂ systematic review and meta-analysis. Evidence from longitudinal studies linking frailty and outcome after acute coronary syndrome (ACS) is mixed. This systematic review and meta-analysis aimed to examine whether frailty is a predictor of all-cause mortality and hospital readmission in older patients with ACS.A systematic search was carried out in PubMed, EMBASE and Web of Science
Lipid-based nutrient supplements and all-cause mortality in children 6-24 months of age: a meta-analysis of randomized controlled trials. Undernutrition is associated with an elevated risk of mortality among children in low- and middle-income countries. Small-quantity lipid-based nutrient supplements (LNS) have been evaluated as a method to prevent undernutrition and improve infant development, but the effects on mortality are unknown.Our objective was to evaluate the effect of LNS on all-cause (...) mortality among children 6-24 mo old.We conducted a systematic review and meta-analysis of randomized controlled trials of LNS designed to prevent undernutrition, with or without other interventions. Literature was searched in May 2019 and trials were included if they enrolled children between 6 and 24 mo old and the period of supplementation lasted ≥6 mo. We extracted data from participant flow diagrams and contacted study investigators to request data. We conducted a meta-analysis to produce summary
is emerging, there is currently a lack of utilization of the concept in pathological and at-risk populations.Clinical implications: The current research of cognition in SA provides several valid options to evaluate if a person is aging successfully. The emerging research indicates that people from at-risk and pathological populations can age successfully. (...) Cognition in Successful Aging: Systematic Review and Future Directions. Objectives: To characterize the inclusion of cognition in definitions of successful aging (SA) according to empirical studies published in peer-reviewed journals.Methods: A systematic review across ISI Web of Knowledge.Results: Of the 74 included studies, there were 65 studies (87.8%) analyzing cognition as one component of multicomponent SA model (cognitive component studies), and 9 studies (12.2%) focusing solely
20-Year Comparative Survival and Mortality of Cancer of the Stomach by Age, Sex, Race, Stage, Grade, Cohort Entry Time-Period, Disease Duration & Selected ICD-O-3 Oncologic Phenotypes: Background and Importance.-Globally, almost one million new cases of stomach cancer were estimated to have occurred in 2012 (952,000 cases, 6.8% of the total), making it the fifth most common malignancy in the world, after lung, breast, colorectal, and prostate. Gastric cancer was the world's third leading cause (...) the statistical database of SEER*Stat 8.3.4 for diagnosis years 1973-2014 employing multiple case selection variables. Methods.-A retrospective, population-based study using nationally representative data from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program to evaluate 157,258 cases for diagnosis years 1973-2014 comparing multiple variables of age, sex, race, stage, grade, cohort entry time-period, disease duration and histologic oncotype: Relative survival
What implies registered nurses' leadership close to older adults in municipal home health care? A systematic review. Registered nurses are key figures in municipal home health care for older adults. Thus, registered nurses' leadership is crucial to a successful and preventive care process as well as a supportive organization in order to achieve safe care. However, there is limited research on what registered nurses' leadership implies close to older adults in municipal home health care. Thus (...) , the aim is to compile and critically evaluate how international research results describe registered nurses' leadership close to older adults in municipal home health care.A systematic literature review was performed in accordance with a qualitative research study. The main search was conducted on 20 April 2018. The review was reported according to the PRISMA guidelines and is registered in the PROSPERO database (ID# CRD42019109206). Nine articles from PubMed and CINAHL meet the quality criteria
Accuracy of Biomarker Testing for Neuropathologically Defined Alzheimer Disease in Older Adults With Dementia: A Systematic Review. Biomarker accuracy for Alzheimer disease (AD) is uncertain.To summarize evidence on biomarker accuracy for classifying AD in older adults with dementia.Electronic bibliographic databases (searched from January 2012 to November 2019 for brain imaging and cerebrospinal fluid [CSF] tests and from inception to November 2019 for blood tests), ClinicalTrials.gov (...) (to November 2019), and systematic review bibliographies.English-language studies evaluating the accuracy of brain imaging, CSF testing, or blood tests for distinguishing neuropathologically defined AD from non-AD among older adults with dementia. Studies with low or medium risk of bias were analyzed.Two reviewers rated risk of bias. One extracted data; the other verified accuracy.Fifteen brain imaging studies and 9 CSF studies met analysis criteria. Median sensitivity and specificity, respectively, were
Brief Cognitive Tests for Distinguishing Clinical Alzheimer-Type Dementia From Mild Cognitive Impairment or Normal Cognition in Older Adults With Suspected Cognitive Impairment: A Systematic Review. The accuracy and harms of brief cognitive tests for identifying clinical Alzheimer-type dementia (CATD) are uncertain.To summarize evidence on accuracy and harms of brief cognitive tests for CATD in older adults with suspected cognitive impairment.Electronic bibliographic databases (from inception (...) to November 2019) and systematic review bibliographies.English-language, controlled observational studies in older adults that evaluated the accuracy of brief cognitive tests (standalone tests; memory, executive function, and language tests; and brief multidomain batteries) for distinguishing CATD from mild cognitive impairment (MCI) or normal cognition as defined by established diagnostic criteria. Studies with low or medium risk of bias (ROB) were analyzed.Two reviewers rated ROB. One reviewer extracted
Is dietary fat associated with the risk of age-related macular degeneration? Protocol for a systematic review and meta-analysis. Previous studies evaluating the association of dietary fat and risk of age-related macular degeneration (AMD) yield discrepant results. The objective of this systematic review (SR) and meta-analysis is to establish whether an association exists between dietary fat and AMD. This protocol was developed in line with the quality requirements of the Preferred Reporting
Maternal age and the risk of gestational diabetes mellitus: A systematic review and meta-analysis of over 120 million participants. The objective of the present analysis was to evaluate and quantify the risk for gestational diabetes mellitus (GDM) according to maternal age.Three electronic databases were searched for publications from inception to July 2018. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated. A dose-response analsis was performed using generalised least (...) squares regression. Subgroup and meta-regression analyses were conducted to explore the source of identified heterogeneity among studies.Twenty-four studies were included in the present meta-analysis. The ORs and 95% CIs for women aged <20 years vs 25-29 years, 30-34 years, 35-39 years and ≥40 years were 0.60 (95% CI = 0.50-0.72), 1.69 (95% CI = 1.49-1.93), 2.73 (95% CI = 2.28-3.27), 3.54 (95% CI = 2.88-4.34) and 4.86 (95% CI = 3.78-6.24), respectively. Dose-response analysis showed that GDM risk
Pain as a risk factor for suicidal behavior in older adults: A systematic review. The objective of this systematic review was to examine whether pain is a risk factor for suicidal behavior (suicide ideation, suicide attempts or suicide) in older adults.An extensive search was conducted on the following databases: MEDLINE, ISI Web of Knowledge, Scopus and PsycARTICLES. Search terms used were "pain", "suicid*" and "elderly". Studies that assessed the relation between pain and suicidal behavior (...) among peopleaged ≥60 years were included. Two reviewers independently screened the abstracts and applied selection criteria in the full-text of all included articles.Results from 38 original research articles were included and reviewed. Moderate/severe pain increased the risk of suicide ideation from OR = 1.13 (95 %CI = 1.02-1.25) to OR = 2.7 (95 %CI = 1.1-7.0). The influence in suicide attempts ranged between OR = 1.92 (95 %CI 1.17-3.15) and 3.63-fold for extreme pain; and one article reported
Epigenome-wide meta-analysis of blood DNA methylation in newborns and children identifies numerous loci related to gestational age. Preterm birth and shorter duration of pregnancy are associated with increased morbidity in neonatal and later life. As the epigenome is known to have an important role during fetal development, we investigated associations between gestational age and blood DNA methylation in children.We performed meta-analysis of Illumina's HumanMethylation450-array associations (...) between gestational age and cord blood DNA methylation in 3648 newborns from 17 cohorts without common pregnancy complications, induced delivery or caesarean section. We also explored associations of gestational age with DNA methylation measured at 4-18 years in additional pediatric cohorts. Follow-up analyses of DNA methylation and gene expression correlations were performed in cord blood. DNA methylation profiles were also explored in tissues relevant for gestational age health effects: fetal brain
Investigating associations between personality and the efficacy of interventions for cognitive ageing: A systematic review. The personal and societal impact of age-related cognitive decline supports the development of effective interventions. While some strategies, such as cognitive training, exercise or socio-intellectual engagement, appear beneficial, few studies have examined the association between personality and intervention efficacy. A systematic review was therefore conducted (...) to summarise and synthesise the literature regarding the influence of personality traits on the effectiveness of non-pharmacological interventions for cognitive ageing. A systematic search of PubMed, PsycINFO and Web of Science was carried out. Of the 2100 papers identified by the search strategy, 10 studies were retained that met the relevant criteria (e.g., intervention studies with one or more cognitive outcomes and a measure of personality). Of these, two studies reported that higher levels of Openness