Topographical Features of Pediatric Electroencephalography during High Initial Concentration Sevoflurane for Inhalational Induction of Anesthesia.

Background: High-density electroencephalographic (EEG) monitoring remains underutilized in clinical anesthesia, despite its obvious utility in unraveling the profound physiologic impact of these agents on central nervous system functioning. In school-aged children, the routine practice of rapid induction with high concentrations of inspiratory sevoflurane is commonplace, given its favorable efficacy and tolerance profile. However, few studies investigate topographic EEG during the critical timepoint coinciding with loss of responsiveness-a key moment for anesthesiologists in their everyday practice.

In-person and telehealth treatment of veterans with insomnia disorder using cognitive behavioral therapy for insomnia during the COVID-19 pandemic.

Study Objectives: Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for insomnia disorder. The goal of this study was to evaluate clinical benefits of CBT-I to veterans with insomnia disorder during the early months of the COVID-19 pandemic using an uncontrolled observational design.

Methods: A cohort of 63 Veterans Affairs (VA) mental health providers delivered CBT-I to 180 veterans as part of an evidence-based psychotherapy training program and captured de-identified treatment outcome data through a data portal.

Repeated Measures of Modified Rankin Scale Scores to Assess Functional Recovery From Stroke: AFFINITY Study Findings.

Background Function after acute stroke using the modified Rankin Scale (mRS) is usually assessed at a point in time. The analytical implications of serial mRS measurements to evaluate functional recovery over time is not completely understood. We compare repeated-measures and single-measure analyses of the mRS from a randomized clinical trial.

e-ageing: development and evaluation of a flexible online geriatric medicine educational resource for diverse learners.

Aims: To determine preferred content and format for online education modules in aged care among inter-professional learners; to develop resources that meet user preferences.

Methods: Stakeholders were interviewed. A survey was administered to all health/medical students and teachers at The University of Western Australia.

Use of Potentially Harmful Medications and Health-Related Quality of Life among People with Dementia Living in Residential Aged Care Facilities.

Background: Use of potentially harmful medications (PHMs) is common in people with dementia living in Residential Aged Care Facilities (RACFs) and increases the risk of adverse health outcomes. Debate persists as to how PHM use and its association with quality of life should be measured. We designed this study to determine the association of exposure to PHM, operationalized by three different measures, with self-reported Health-Related Quality of Life among people with dementia residing in RACFs.

Dietary patterns are associated with cognition among older people with mild cognitive impairment.

There has been increasing interest in the influence of diet on cognition in the elderly. This study examined the cross-sectional association between dietary patterns and cognition in a sample of 249 people aged 65-90 years with mild cognitive impairment (MCI). Two dietary patterns; whole and processed food; were identified using factor analysis from a 107-item; self-completed Food Frequency Questionnaire.

Perception of worsening health predicts mortality in older men: the Health in Men Study (HIMS).

The main purpose of this study was to determine the most robust predictor of mortality among global self-rated health (SRH), time-comparative SRH or a combination of both measures. We also sought to determine factors associated with global SRH and time-comparative SRH measures. A prospective cohort study of 5583 community-dwelling older men aged 70 years or over living in Perth, Western Australia, was used.

Homocysteine, grey matter and cognitive function in adults with cardiovascular disease.

Background: Elevated total plasma homocysteine (tHcy) has been associated with cognitive impairment, vascular disease and brain atrophy.

Methods: We investigated 150 volunteers to determine if the association between high tHcy and cerebral grey matter volume and cognitive function is independent of cardiovascular disease.

Results: Participants with high tHcy (≥15 µmol/L) showed a widespread relative loss of grey matter compared with people with normal tHcy, although differences between the groups were minimal once the analyses were adjusted for age, gender, diabetes, hypertension, smoking and prevalent cardiovascular disease.

Memory loss.

Most older people with memory loss do not have dementia. Those with mild cognitive impairment are at increased risk of progressing to dementia, but no tests have been shown to enhance the accuracy of assessing this risk. Although no intervention has been convincingly shown to prevent dementia, data from cohort studies and randomised controlled trials are compelling in indicating that physical activity and treatment of hypertension decrease the risk of dementia.

Cognitive and brain changes associated with ischaemic heart disease and heart failure.

Aims: It is unclear whether the cognitive dysfunction associated with heart failure (HF) is due to HF or comorbid conditions such as ischaemic heart disease (IHD). This study aimed to determine whether, compared with controls with and without IHD, adults with systolic HF show evidence of cognitive impairment and cerebral grey matter (GM) loss.

Methods And Results: Cross-sectional study of 35 participants with HF, 56 with IHD, and 64 controls without either HF or IHD.

Systemic arterial inflammation, measured with 18FDG-PET, is common amongst subjects with both recent and prior cerebrovascular disease.

Objective: To compare systemic arterial inflammation in subjects with recent ischaemic stroke or TIA and controls with prior cerebrovascular disease.

Methods: Systemic arterial inflammation was prospectively measured by (18)F-fluorodeoxygluose positron emission tomography in 11 cases with recent ischaemic stroke or TIA, and 11 sex matched controls with prior cerebrovascular disease.

Results: Hot spots (both carotid and non-carotid) of localised (18)FDG uptake were found in more than half of all patients with either recent (n = 6) or prior (n = 8) cerebrovascular disease.

A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: the DIRECT study.

Background: The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care.

Methodology/principal Findings: This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤ 24, their GPs and facility staff participated.

Two-year course of cognitive function and mood in adults with congestive heart failure and coronary artery disease: the Heart-Mind Study.

Background: Congestive heart failure (CHF) has been associated with impaired cognitive function, but it is unclear if these changes are specific to CHF and if they get worse with time. We designed this study to determine if adults with CHF show evidence of cognitive decline compared with adults with and without coronary artery disease (CAD).

Methods: A longitudinal study was carried out of 77 adults with CHF (ejection fraction, EF < 0.

A randomized placebo controlled trial of early treatment of acute ischemic stroke with atorvastatin and irbesartan.

Background: Cholesterol and blood pressure lowering therapies are effective in the secondary prevention of ischemic stroke.

Aim: To determine whether 30 days of treatment with atorvastatin, or irbesartan, initiated within 96 h of symptom onset improves recovery from acute ischemic stroke.

Methods: Eighty-one patients with acute ischemic stroke participated in this double-blind, placebo-controlled, randomized trial of atorvastatin (80 mg) vs.

Factors associated with older patients' engagement in exercise after hospital discharge.

Objectives: To identify factors that are associated with older patients' engagement in exercise in the 6 months after hospital discharge.

Design: A prospective observational study using qualitative and quantitative evaluation.

Setting: Follow-up of hospital patients in their home setting after discharge from a metropolitan general hospital.

Association of clinical and aetiologic subtype of acute ischaemic stroke with inflammation, oxidative stress and vascular function: a cross-sectional observational study.

Background: The role of inflammation, vascular dysfunction and oxidative stress in the pathophysiology of different stroke subtypes is not well understood. We aimed to determine if the clinical and aetiologic subtype of acute ischaemic stroke influences systemic markers of vascular function, inflammation and oxidative stress.

Material/methods: 129 men and women were recruited within 10 days of acute ischaemic stroke or TIA at two tertiary hospitals in this cross-sectional observational study.

Students and teachers' preferences for undergraduate dementia education in Western Australia.

Medical graduates require positive attitudes toward older people with cognitive impairment, in addition to knowledge and skills in the diagnosis and management of dementia. The Student Training Project in Dementia (STriDE) project was conducted to ensure that these needs are met through curricula in Western Australian medical schools. Two medical schools in Perth, Western Australia, participated.

Evaluation of the sustained effect of inpatient falls prevention education and predictors of falls after hospital discharge--follow-up to a randomized controlled trial.

Background: This study aimed to determine (i) risk factors for postdischarge falls and (ii) the effect of inpatient falls prevention education on rates of falls after discharge.

Methods: Participants (n = 343) were a prospective cohort nested within a randomized controlled trial (n = 1,206) of falls prevention patient education in hospital compared with usual care. Participants were followed up for 6 months after discharge and falls recorded via a falls diary and monthly telephone calls.

Cytochrome P450 metabolites of arachidonic acid are elevated in stroke patients compared with healthy controls.

CYP450AAM [arachidonic acid metabolites of the CYP450 (cytochrome P450) enzyme system] have a range of biological functions. CYP450AAM are involved in the pathogenesis of hypertension, renal function and vascular function, yet their role in stroke has not been clarified. We aimed at determining the levels of circulating CYP450 metabolites in patients with acute ischaemic stroke (<96 h) compared with healthy age- and gender-matched controls.

Falls after discharge from hospital: is there a gap between older peoples' knowledge about falls prevention strategies and the research evidence?

Purpose: The aim of this study was to examine whether older people are prepared to engage in appropriate falls prevention strategies after discharge from hospital.

Design And Methods: We used a semi-structured interview to survey older patients about to be discharged from hospital and examined their knowledge regarding falls prevention strategies to utilize in the post-discharge period. The study was part of a prospective cohort study, nested within a larger, randomized controlled trial.

A pilot randomized controlled trial of deprescribing.

Objective: Polypharmacy and adverse drug reactions are frequent and important among older people. Few clinical trials have evaluated systematic withdrawal of medications among older people. This small, open, study was conducted to determine the feasibility of a randomized controlled deprescribing trial.

Quality use of medicines and health outcomes among a cohort of community dwelling older men: an observational study.

Aim: To determine the prevalence of potentially suboptimal medication use and association with adverse outcomes.

Methods: A prospective, observational cohort study of 4260 community-dwelling older men from Perth, Western Australia (mean age of 77 ± 3.6 years) was conducted.

Traditional risk factors for incident cardiovascular events have limited importance in later life compared with the health in men study cardiovascular risk score.

Background And Purpose: This study aimed to determine, among older men, the risk and independent significant baseline prognostic factors for first-ever stroke and MI.

Methods: We performed a prospective cohort study of 4382 community-dwelling older men (mean age, 75.4±4.

Factors associated with self and informant ratings of the quality of life of people with dementia living in care facilities: a cross sectional study.

Background: There is no consensus regarding the optimal approach to assessment of the quality of life of people with dementia. We undertook the present study to describe and determine the factors associated with ratings of the quality of life of a cohort of people with dementia living in a residential care facility.

Methodology/principal Findings: 351 people with dementia living in residential care facilities, and their staff and family informants participated in this cross sectional observational study.