Care in the Community: A COVID-19 initiative to reduce hospital re-presentations among community-dwelling people.

Objective: The COVID-19 pandemic has had a substantial impact on the utilisation of hospital and emergency department (ED) services. We examined the effect of a rapid response service on hospital re-presentations among people discharged from the ED and short-stay wards at a tertiary referral hospital.

Methods: This retrospective cohort study compared 112 patients who completed the Care in the Community program with 112 randomly selected controls.

Strategies adopted by informal carers to enhance participation in daily activities for persons with dementia.

Objective: Carers for people with dementia commonly experience difficulty assisting the care-recipients with their daily activities and may adopt specific strategies to decrease the difficulties experienced. The objective of this qualitative study was to explore and understand the strategies used by carers to assist with daily activities for persons living with dementia.

Methods: Individual semi-structured interviews via face-to-face or telephone mode were conducted with 62 carers of persons living with dementia in Australia.

In-hospital outcomes among older medical inpatients admitted to aged care wards after activation of a 2-tier rapid response system.

Background: The outcomes of rapid response systems (RRS) are poorly established in older people. We examined the outcomes in older inpatients at a tertiary hospital that uses a 2-tier RRS, including the outcomes of each tier.

Methods: The 2-tier RRS comprised the clinical review call (CRC) (tier one) and the medical emergency team call (MET) (tier two).

Assistance provided in daily tasks and difficulty experienced by caregivers for people living with dementia.

Introduction: There is a growing body of research that addresses caregivers for people living with dementia. However, there is limited research looking at the perceptions of caregivers in specific daily tasks. To address this gap, this study investigated the assistance caregivers provided and the difficulty they faced when completing daily tasks for people with dementia and, additionally, how these experiences might relate to their perceived burden.

Twice-Weekly Structured Interdisciplinary Bedside Rounds and Falls among Older Adult Inpatients.

Background/objective: Ineffective interdisciplinary communication has negative impacts on patient outcomes. The use of regular structured interdisciplinary bedside rounds (SIBR), where each patient interaction lasts 3-5 minutes, is a model of care that improves interdisciplinary communication. We evaluated the impact of SIBR on in-hospital falls.

Structured interdisciplinary bedside rounds, in-hospital deaths, and new nursing home placements among older inpatients.

Purpose: Ineffective interdisciplinary communication is linked to many adverse consequences of hospitalization. This study evaluated the effect of SIBR, a model of care that encourages interdisciplinary communication and patient and family participations, on in-hospital deaths and new nursing home (NH) placements.

Materials And Methods: This before-after study included 3,673 consecutive inpatients of mean age 83.

Functional deterioration in the month before hospitalisation is associated with in-hospital functional decline: an observational study.

Introduction: Functional deterioration preceding acute hospital admission may be associated with poorer in-hospital outcomes. We sought to investigate the association between functional decline in the month preceding admission and in-hospital outcomes.

Materials And Methods: Consecutive patients admitted under geriatric medicine over 5 years were prospectively included.

Predictors on admission of functional decline among older patients hospitalised for acute care: A prospective observational study.

Objective: We sought to investigate the incidence of, and factors associated with, in-hospital functional decline among older acute hospital patients.

Methods: We conducted a prospective observational study of consecutive patients admitted under geriatric medicine over 5 years. The primary outcome measure was functional decline between admission and discharge, representing deterioration in any of the following: Modified Barthel Index (MBI), independence in Timed Up and Go test or walking, and/or need for walking aid.

The Impact of Being a Migrant from a Non-English-Speaking Country on Healthcare Outcomes in Frail Older Inpatients: an Australian Study.

The purpose of this prospective study of 2180 consecutive index admissions to an acute geriatric service was to compare in-hospital outcomes of frail older inpatients born in non-English-speaking counties, referred to as culturally and linguistically diverse (CALD) countries in Australia, with those born in English-speaking countries. Multivariate logistic regression was used to model in-hospital mortality and new nursing home placement. Multivariate Cox proportional hazards regression was used to model length of stay.

Structured interdisciplinary bedside rounds do not reduce length of hospital stay and 28-day re-admission rate among older people hospitalised with acute illness: an Australian study.

Objective Structured interdisciplinary bedside rounds (SIBR) are being implemented across many hospitals in Australia despite limited evidence of their effectiveness. This study evaluated the effect of SIBR on two interconnected outcomes, namely length of stay (LOS) and 28-day re-admission. Methods In the present before-after study of 3644 patients, twice-weekly SIBR were implemented on two aged care wards.

Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness.

Purpose: To examine the association between falls in hospital and new placement in a nursing home among older people hospitalized with acute illness.

Materials And Methods: This prospective cohort study of 2,945 consecutive patients discharged alive from an acute geriatric medicine service used multivariate logistic regression to model the association between one or more falls and nursing home placement (primary analysis). Secondary analyses stratified falls by injury and occurrence of multiple falls.

New medical diagnoses and length of stay of acutely unwell older patients: Implications for funding models.

Aim: To examine the relationship between newly made medical diagnoses and length of stay (LOS) of acutely unwell older patients.

Methods: Consecutive patients admitted under the care of four geriatricians were randomly allocated to a model development sample (n = 937) or a model validation sample (n = 855). Cox regression was used to model LOS.

Frailty in an older inpatient population: using the clinical frailty scale to predict patient outcomes.

Objective: To evaluate the impact of frailty, measured using the Canadian Study of Health and Aging Clinical Frailty Scale, on outcomes of older people hospitalized with acute illness.

Method: Consecutive patients were randomly allocated to a model development sample or a model validation sample. Multivariate analyses were used to model in-hospital mortality, new nursing home placement, and length of stay.

Antigen unmasking induced by superheating.

This paper is dedicated to the description of superheating as a method for antigen retrieval. In our investigation, this antigen retrieval method was used on thermal plate, heating tissue sections at temperature 120° C for 90 minutes. In the research we conducted the superheating method was applied to formalin-fixed paraffin-embedded tissue sections of breast tumors.

Admission variables predicting short lengths of stay of acutely unwell older patients: relevance to emergency and medical short-stay units.

Objective: To help develop criteria to identify older patients suitable for admission to medical short-stay units, by determining predictors of length of stay (LOS) of 3 days or less.

Methods: The data were prospectively collected from consecutive older patients admitted from the emergency department of a university hospital to an acute geriatric medicine service. Data included active medical diagnoses, the Modified Barthel Index (MBI), the Timed Up and Go (TUG) test, and demographic information.

The validity of the Rowland Universal Dementia Assessment Scale (RUDAS) in a multicultural cohort of community-dwelling older persons with early dementia.

The 6-item Rowland Universal Dementia Assessment Scale (RUDAS) is a simple, portable multicultural scale for detecting dementia. Items address executive function, praxis, gnosis, recent memory, and category fluency. It can be directly translated to other languages, without the need to change the structure or the format of any item.

Using the timed up and go test to stratify elderly inpatients at risk of falls.

Objective: To determine whether the Timed Up and Go Test is useful at stratifying acutely unwell elderly inpatients according to their risk for subsequent falls.

Design: Prospective cohort study.

Setting: Multidisciplinary acute care unit for the elderly at Liverpool Hospital, in Sydney, Australia.

The Timed Up and Go Test does not predict length of stay on an acute geriatric ward.

This study aimed to determine whether the admission Timed Up and Go Test (TUG) predicted the length of stay of patients in an acute geriatric ward. Consecutive patients were quasi-randomly allocated to either a model development sample or a model validation sample. Multivariate Cox proportional hazards regression was used to model length of stay.

The Rowland Universal Dementia Assessment Scale (RUDAS) and the Folstein MMSE in a multicultural cohort of elderly persons.

Objective: To compare the accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) and the Folstein Mini-mental State Examination (MMSE) for diagnosis of dementia in a multicultural cohort of elderly persons.

Methods: A total of 129 community-dwelling persons were selected at random from a database of referrals to an aged-care team. Subjects were stratified according to language background and cognitive diagnosis, and matched for age and gender.

A prospective, randomised controlled trial of an aged care nurse intervention within the Emergency Department.

The aim of this randomised controlled trial involving 224 elderly patients was to determine whether early geriatric assessment (in the form of an aged care nurse intervention based in the emergency department) reduced admission to the hospital, length of inpatient stay (LOS), or functional decline during the hospitalisation. Baseline geriatric assessments were recorded in the medical files of intervention patients (n = 114). The nurse also liaised with the patients' carers and health care providers, organised referrals for out-of-hospital assessment and support services, and assisted in the care of those admitted as inpatients by documenting suggestions for assessment and referral.

The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale.

Objective: To develop and validate a simple method for detecting dementia that is valid across cultures, portable and easily administered by primary health care clinicians.

Design: Culture and Health Advisory Groups were used in Stage 1 to develop culturally fair cognitive items. In Stage 2, clinical testing of 42 items was conducted in a multicultural sample of consecutive new referrals to the geriatric medicine outpatient clinic at Liverpool Hospital, Sydney, Australia (n = 166).

Accuracy of the clock drawing test for detecting dementia in a multicultural sample of elderly Australian patients.

Objective: To assess the accuracy of clock drawing for detecting dementia in a multicultural, non-English-speaking-background population.

Design: A prospective cohort study.

Setting: A general geriatric medical outpatient clinic in southwest Sydney, Australia.

Standardised assessment of older patients by a nurse in an emergency department.

The primary aim of this study was to evaluate the ability of a nurse practitioner in geriatrics, working in the emergency department of a tertiary referral hospital, to assess high-risk elderly patients comprehensively. A secondary aim was to explore patient characteristics associated with referral to community aged care services. Of 469 patients assessed by the nurse, 327 (70%) were admitted to the hospital.

Rate and amplitude of adaptation to intermittent and continuous exercise in older men.

Purpose: This study determined the amplitude and rate of adaptation to 10 wk of continuous (CEx) and intermittent exercise (IEx) in a group of older men when the training intensity and total amount of work completed by each exercise group were the same.

Methods: Ten healthy men were assigned to either a CEx (63 +/- 1 yr) or IEx (65 +/- 1 yr) group while a further five subjects (65 +/- 1 yr) acted as nonexercising controls (CON). The three groups (CEx, IEx, and CON) were matched for age, peak oxygen uptake (VO2peak), and cardiac output (Qpeak) before commencing training.