Subjective and objectives measures of frailty among adults with advanced chronic kidney disease: a cross-sectional analysis of clinician misclassification.

Background: Frailty is a recognisable clinical measure of impaired physiological reserve and vulnerability to adverse outcomes that is validated among patients with kidney disease. Practice patterns reveal inconsistent use of objective frailty measures by nephrologists, with clinicians prioritising subjective clinical impressions, possibly risking misclassification and discrimination.

Aims: The aim of this study was to examine correlations between subjective and objective measures of frailty in a cohort of patients attending routine nephrologist review.

UK Foot and Ankle Thromboembolism (UK-FATE).

Aims: Venous thromboembolism (VTE) is a potential complication of foot and ankle surgery. There is a lack of agreement on contributing risk factors and chemical prophylaxis requirements. The primary outcome of this study was to analyze the 90-day incidence of symptomatic VTE and VTE-related mortality in patients undergoing foot and ankle surgery and Achilles tendon (TA) rupture.

Patient perspectives and preferences for rehabilitation among people living with frailty and chronic kidney disease: a qualitative evaluation.

Background: Understanding the patient perspective of frailty is critical to offering holistic patient-centred care. Rehabilitation strategies for patients with advanced chronic kidney disease (CKD) and frailty are limited in their ability to overcome patient-perceived barriers to participation, resulting in high rates of drop-out and non-adherence. The aim of this study was to explore patient perspectives and preferences regarding experiences with rehabilitation to inform a CKD/Frailty rehabilitation model.

Support needs of Australians bereaved during the COVID-19 pandemic: A cross-sectional survey study.

Background: COVID-19 disrupted access to bereavement support. The objective of this study was to identify the bereavement supports used by Australians during the COVID-19 pandemic, perceived helpfulness of supports used, prevalence and areas of unmet support need, and characteristics of those with unmet support needs.

Methods: A convenience sample of bereaved adults completed an online questionnaire (April 2021-April 2022) about their bereavement experiences including support use and perceived helpfulness, unmet support needs and mental health.

Narrative Review: Clinical Implications and Assessment of Frailty in Patients With Advanced CKD.

Frailty is a multidimensional clinical syndrome characterized by low physical activity, reduced strength, accumulation of multiorgan deficits, decreased physiological reserve, and vulnerability to stressors. Frailty has key social, psychological, and cognitive implications. Frailty is accelerated by uremia, leading to a high prevalence of frailty in patients with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) as well as contributing to adverse outcomes in this patient population.

The mental health of Australians bereaved during the first two years of the COVID-19 pandemic: a latent class analysis.

Background: The COVID-19 pandemic disrupted many areas of life, including culturally accepted practices at end-of-life care, funeral rites, and access to social, community, and professional support. This survey investigated the mental health outcomes of Australians bereaved during this time to determine how these factors might have impacted bereavement outcomes.

Methods: An online survey indexing pandemic and bereavement experiences, levels of grief, depression, anxiety, and health, work, and social impairment.

The COVID-19 Pandemic: Bereavement Experiences Between Hospital and Home Deaths in Palliative Care.

Background: Australian COVID-19 public health measures reduced opportunities for people to communicate with healthcare professionals and be present at the death of family members/friends.

Aim: To understand if pandemic-specific challenges and public health measures during the COVID-19 pandemic impacted end-of-life and bereavement experiences differently if the death, supported by palliative care, occurred in a hospital or at home.

Design: A cross-sectional online survey was completed by bereaved adults during 2020-2022.

Use of frailty assessment instruments in nephrology populations: a scoping review.

Background: Frailty is a clinical syndrome of accelerated aging associated with adverse outcomes. Frailty is prevalent among patients with chronic kidney disease but is infrequently assessed in clinical settings, due to lack of consensus regarding frailty definitions and diagnostic tools. This study aimed to review the practice of frailty assessment in nephrology populations and evaluate the context and timing of frailty assessment.

A biophysical and statistical modeling paradigm for connecting neural physiology and function.

To understand single neuron computation, it is necessary to know how specific physiological parameters affect neural spiking patterns that emerge in response to specific stimuli. Here we present a computational pipeline combining biophysical and statistical models that provides a link between variation in functional ion channel expression and changes in single neuron stimulus encoding. More specifically, we create a mapping from biophysical model parameters to stimulus encoding statistical model parameters.

Inhibition of NMDA receptors through a membrane-to-channel path.

N-methyl-D-aspartate receptors (NMDARs) are transmembrane proteins that are activated by the neurotransmitter glutamate and are found at most excitatory vertebrate synapses. NMDAR channel blockers, an antagonist class of broad pharmacological and clinical significance, inhibit by occluding the NMDAR ion channel. A vast literature demonstrates that NMDAR channel blockers, including MK-801, phencyclidine, ketamine, and the Alzheimer's disease drug memantine, can bind and unbind only when the NMDAR channel is open.

ACT Transition from Hospital to Home Orthopaedic Survey: a cross-sectional survey of unplanned 30-day readmissions for patients having total hip arthroplasty.

Objectives: The aim of this study was to identify patient, hospital and transitional factors associated with unplanned 30-day readmissions in patients who had a total hip arthroplasty (THA).

Design: A cross-sectional survey was performed. All patients attending a 6-week follow-up after a THA in the Australian Capital Territory (ACT) at four public and private clinics in the ACT from 1 February 2018 to 31 January 2019, were invited to complete an .

Understanding factors affecting 30-day unplanned readmissions for patients undergoing total knee arthroplasty (TKA): the ACT Transition from Hospital to Home Orthopaedics Survey.

Objectives: The aim of this study was to investigate factors associated with unplanned 30-day readmissions following a total knee arthroplasty (TKA), including association with post-hospital syndrome, patient enablement and transition from hospital to home.

Design, Setting And Participants: A cross-sectional written survey of public and private patients attending a 6-week follow-up appointment after TKA at one of four clinical services in the Australian Capital Territory (ACT) between 1 February 2018 and 31 January 2019. Multiple logistic regression analyses were used to measure associations between patient, hospital and transitional care factors with unplanned 30-day readmissions, while controlling for known confounders.

Frailty in chronic kidney disease: challenges in nephrology practice. A review of current literature.

Frailty is a multidimensional clinical syndrome characterised by low physical activity, reduced strength, accumulation of multi-organ deficits, decreased physiological reserve and vulnerability to stressors. Frailty pathogenesis and 'inflammageing' is augmented by uraemia, leading to a high prevalence of frailty potentially contributing to adverse outcomes in patients with advanced chronic kidney disease (CKD), including end-stage kidney disease (ESKD). The presence of frailty is a stronger predictor of CKD outcomes than estimated glomerular filtration rate and more aligned with dialysis outcomes than age.

Choice of Statistical Tools for Outlier Removal Causes Substantial Changes in Analyte Reference Intervals in Healthy Populations.

Background: Reference intervals are an important aid in medical practice as they provide clinicians a guide as to whether a patient is healthy or diseased.Outlier results in population studies are removed by any of a variety of statistical measures. We have compared several methods of outlier removal and applied them to a large body of analytes from a large population of healthy persons.

'Traversing difficult terrain'. Advance care planning in residential aged care through multidisciplinary case conferences: A qualitative interview study exploring the experiences of families, staff and health professionals.

Background: Advance care planning improves the quality of end-of-life care for older persons in residential aged care; however, its uptake is low. Case conferencing facilitates advance care planning.

Aim: To explore the experience of participating in advance care planning discussions facilitated through multidisciplinary case conferences from the perspectives of families, staff and health professionals.

The impact of introducing Palliative Care Needs Rounds into rural residential aged care: A quasi-experimental study.

Objective: This study examined the impact of introducing Palliative Care Needs Rounds (hereafter Needs Rounds) into residential aged care on hospitalisations (emergency department presentations, admissions and length of stay) and documentation of advance care plans.

Design: A quasi-experimental study.

Setting: Two residential aged care facilities in one rural town in the Snowy Monaro region of New South Wales, Australia.

Postoperative Delirium Following Joint Replacement in Patients With Dementia in New South Wales, Australia: A State-Wide Retrospective Cohort Study.

The objective of the current study was to investigate the variation in postoperative delirium in patients with dementia undergoing joint replacement in New South Wales (NSW) Australia public hospitals, identify factors related to its occurrence, and explore the volume-outcome relationship. The NSW Admitted Patient Data (July 2001 to June 2014) were used in this study and included patients with dementia undergoing joint replacement who were 65 or older with minor to severe comorbidities. Mixed-effect logistic models were applied to investigate hospital-level variation and factors associated with postoperative delirium.

Identifying hotspots of type 2 diabetes risk using general practice data and geospatial analysis: an approach to inform policy and practice.

The prevalence of type 2 diabetes (T2D) is increasing worldwide and there is a need to identify communities with a high-risk profile and to develop appropriate primary care interventions. This study aimed to predict future T2D risk and identify community-level geographic variations using general practices data. The Australian T2D risk assessment (AUSDRISK) tool was used to calculate the individual T2D risk scores using 55693 clinical records from 16 general practices in west Adelaide, South Australia, Australia.

Relative importance of clinical and sociodemographic factors in association with post-operative in-hospital deaths in colorectal cancer patients in New South Wales: An artificial neural network approach.

Rationale, Aims And Objectives: Co-morbidities in colorectal cancer patients complicate hospital care, and their relative importance to post-operative deaths is largely unknown. This study was conducted to examine a range of clinical and sociodemographic factors in relation to post-operative in-hospital deaths in colorectal cancer patients and identify whether these contributions would vary by severity of co-morbidities.

Methods: In this multicentre retrospective cohort study, we used the complete census of New South Wales inpatient data to select colorectal cancer patients admitted to public hospitals for acute surgical care, who underwent procedures on the digestive system during the period of July 2001 to June 2014.

Adverse drug reactions due to opioid analgesic use in New South Wales, Australia: a spatial-temporal analysis.

Background: Pharmaceutical opioid analgesic use continues to rise and is associated with potentially preventable harm including hospitalisation for adverse drug reactions (ADRs). Spatial detection of opioid-related ADRs can inform future intervention strategies. We aimed to investigate the geographical disparity in hospitalised ADRs related to opioid analgesic use, and to evaluate the difference in patient characteristics between areas inside and outside the geographic clusters.

Patterns of comorbidities in hospitalised cancer survivors for palliative care and associated in-hospital mortality risk: A latent class analysis of a statewide all-inclusive inpatient data.

Background: At the end of life, cancer survivors often experience exacerbations of complex comorbidities requiring acute hospital care. Few studies consider comorbidity patterns in cancer survivors receiving palliative care.

Aim: To identify patterns of comorbidities in cancer patients receiving palliative care and factors associated with in-hospital mortality risk.

Hospital psychosocial interventions for patients with brain functional impairment: A retrospective cohort study.

Psychosocial interventions could improve health and care outcomes, however, little is known about their use for patients with complex needs in the acute hospital care setting. This study aimed to evaluate factors associated with psychosocial intervention use when treating patients with brain functional impairment during their hospital care. The all-inclusive New South Wales (NSW) Admitted Patient Data were employed to identify patients with neurodevelopment disorders, brain degenerative disorders, or traumatic brain injuries admitted to NSW public hospitals for acute care from July 2001 to June 2014.

Adverse drug event-related hospitalisation in persons with neurodevelopmental disorders: a state-wide retrospective cohort study.

Background: Little is known about the sociodemographic and clinical characteristics of adverse drug events (ADEs) in patients with neurodevelopmental disorders (NDD).

Objective: The objective of this study was to describe and compare the demographic details of people with and without NDD hospitalised due to ADEs.

Methods: The all-inclusive New South Wales Admitted Patient Data Collection from 2001 to 2014 was employed to identify ADE-related hospitalisations in patients with NDD using the International Classification of Diseases 10th revision Australian modification codes.