Predicting incident dementia in community-dwelling older adults using primary and secondary care data from electronic health records.

Predicting risk of future dementia is essential for primary prevention strategies, particularly in the era of novel immunotherapies. However, few studies have developed population-level prediction models using existing routine healthcare data. In this longitudinal retrospective cohort study, we predicted incident dementia using primary and secondary care health records at 5, 10 and 13 years in 144 113 Scottish older adults who were dementia-free prior to 1st April 2009.

Patient and family member experience of hospital readmission following critical illness.

Background: Hospital readmission following critical illness is common. There is limited data which examines the patient and family perspective of hospital readmission. Understanding the impact of readmissions from a patient perspective can potentially help design meaningful clinical pathways to support improvements in care.

Mechanisms underlying neurocognitive dysfunction following critical illness: a systematic review.

Introduction: Cognitive impairment is a significant healthcare problem globally and its prevalence is projected to affect over 150 million people worldwide. Survivors of critical illness are impacted frequently by long-term neurocognitive dysfunction regardless of presenting illness, but the mechanisms are poorly understood. The goal of this review was to synthesise the existing evidence regarding potential mechanisms underlying neurocognitive dysfunction following critical illness in order to guide potential avenues for future research.

Systematic Review of Evidence for Conservative Management of Pelvic Organ Prolapse in Younger Women.

Introduction: Treatment of pelvic organ prolapse (POP) is poorly understood in younger women as the majority of prolapse research is conducted in the older population. There is an urgent need to evaluate conservative POP treatments for management in younger women due to high surgical complications and reoperation rates.

Methods: Systematic review of the literature following PRISMA guidelines and registered in PROSPERO.

Rate of non-metastatic solid tumor progression following critical illness: a prospective cohort study of UK Biobank participants.

Objective: To determine whether admission to critical care is associated with subsequent disease progression in patients with non-metastatic solid tumors.

Methods: This observational cohort study of UK Biobank participants identified those diagnosed with solid tumors and survived hospitalization. Two cohorts were identified based on critical care admission and new metastatic disease as reported at UK Biobank follow-up visits, or primary or secondary care records were compared.

Patient-psychologist telemedicine interactions in an intensive care unit recovery clinic: Qualitative secondary analysis.

Objectives: We aimed to describe the content of patient-psychologist mental health related dialogues during a telemedicine intensive care unit recovery clinic visit.

Research Methodology/design: Qualitative descriptive study nested within a randomized controlled pilot trial to assess a telemedicine intensive care unit recovery clinic feasibility and preliminary efficacy. Participants included adults hospitalized with sepsis and/or respiratory failure.

Influences on the physical activity behaviour of inpatients after stroke outside of staff-led rehabilitation sessions: a systematic review.

Objective: To use behavioural science frameworks to synthesise evidence on the factors influencing physical activity of patients hospitalised after stroke outside of staff-led rehabilitation sessions.

Data Sources: A systematic review of qualitative and mixed-methods studies. MEDLINE, PsycINFO, CINAHL, and AMED were searched from inception to October 2024 for studies that explored influences on the physical activity of patients hospitalised after stroke.

Investigating In Vivo Tumor Biomolecular Changes Following Radiation Therapy Using Raman Spectroscopy.

Treatment resistance is a major bottleneck in the success of cancer therapy. Early identification of the treatment response or lack thereof in patients can enable an earlier switch to alternative treatment strategies that can enhance response rates. Here, Raman spectroscopy was applied to monitor early tumor biomolecular changes in sensitive (UM-SCC-22B) and resistant (UM-SCC-47) head and neck tumor xenografts for the first time in in vivo murine tumor models in response to radiation therapy.

Exploring the experience of cardiothoracic ICU clinicians during the COVID-19 pandemic: A grounded theory study.

Background: Prior to the COVID-19 pandemic a flexible approach to visiting was adopted by many Intensive Care Units in the United Kingdom. Due to the rapid spread globally of COVID-19, significant policy changes were put in place, including the restriction on visitors to patients in hospital. Evidence has emerged demonstrating the negative impact of these restrictions on patients with COVID-19, their families and the staff caring for them.

Understanding hospital rehabilitation using electronic health records in patients with and without COVID-19.

Background: Many hospitalised patients require rehabilitation during recovery from acute illness. We use routine data from Electronic Health Records (EHR) to report the quantity and intensity of rehabilitation required to achieve hospital discharge, comparing patients with and without COVID-19.

Methods: We performed a retrospective cohort study of consecutive adults in whom COVID-19 testing was undertaken between March 2020 and August 2021 across three acute hospitals in Scotland.

Understanding attendance patterns and determinants in cardiac, pulmonary, and ICU rehabilitation/recovery programs: A systematic review and meta-analysis.

Background: Cardiac, pulmonary, and intensive care unit (ICU) rehabilitation/recovery programs are health promotion interventions designed to improve physical recovery, psychological well-being, and quality of life after acute illness while reducing the risk of adverse events.

Objective: Identify the difference in attendance rates for patients invited to a cardiac rehabilitation, pulmonary rehabilitation, or ICU recovery program and factors influencing attendance.

Methods: We conducted a systematic review and meta-analysis by searching PubMed, EMBASE, CINAHL, Web of Science, and manual reference lists from inception to June 3, 2024.

Anxiety and depression following critical illness: A comparison of the recovery trajectories of patients and caregivers.

Background: Following critical illness, family members are often required to adopt caregiving responsibilities. Anxiety and depression are common long term problems for both patients and caregivers. However, at present, it is not known how the trajectories of these symptoms compare between patients and caregivers.

Characterizing Cardiac Function in ICU Survivors of Sepsis: A Pilot Study Protocol.

Background: Sepsis is one of the most common reasons for ICU admission and a leading cause of mortality worldwide. More than one-half of survivors experience significant physical, psychological, or cognitive impairments, often termed post-intensive care syndrome (PICS). Sepsis is recognized increasingly as being associated with a risk of adverse cardiovascular events that is comparable with other major cardiovascular risk factors.

Association between inflammation and post-intensive care syndrome: a systematic review.

Post-intensive care syndrome describes the physical, cognitive and emotional symptoms which persist following critical illness. At present there is limited understanding of the pathological mechanisms contributing to the development of post-intensive care syndrome. The aim of this systematic review was to synthesise current evidence exploring the association between inflammation and features of post-intensive care syndrome in survivors of critical illness.

Could an integrated model of health and social care after critical illness reduce socioeconomic disparities in outcomes? A Bayesian analysis.

Background: There is limited evidence to understand what impact, if any, recovery services might have for patients across the socioeconomic spectrum after critical illness. We analysed data from a multicentre critical care recovery programme to understand the impact of this programme across the socioeconomic spectrum.

Methods: The setting for this pre-planned secondary analysis was a critical care rehabilitation programme-Intensive Care Syndrome: Promoting Independence and Return to Employment.

Factors Associated With New Analgesic Requirements Following Critical Illness.

Background: Chronic opioid use represents a significant burden to global healthcare with adverse long-term outcomes. Elevated patient reported pain levels and analgesic prescriptions have been reported following discharge from critical care. We describe analgesic requirements following discharge from hospital and identify if a critical care admission is a significant factor for stronger analgesic prescriptions.

Do critical illness survivors with multimorbidity need a different model of care?

There is currently a lack of evidence on the optimal strategy to support patient recovery after critical illness. Previous research has largely focussed on rehabilitation interventions which aimed to address physical, psychological, and cognitive functional sequelae, the majority of which have failed to demonstrate benefit for the selected outcomes in clinical trials. It is increasingly recognised that a person's existing health status, and in particular multimorbidity (usually defined as two or more medical conditions) and frailty, are strongly associated with their long-term outcomes after critical illness.

Cardiac dysfunction in survivors of sepsis: a scoping review.

Background: Sepsis is associated with an increased risk of adverse cardiovascular events in a magnitude comparable to other major cardiovascular risk factors. Sepsis is one of the most common reasons for intensive care admission and survivors often have significant functional limitations following discharge. However, it is not clear to what extent chronic cardiovascular dysfunction might mediate these functional impairments, or how we might screen and manage these patients at risk of chronic cardiovascular disease.

Understanding and Managing Anxiety Sensitivity During Critical Illness and Long-Term Recovery.

Anxiety sensitivity is a fear of symptoms associated with anxiety (eg, rapid respiration and heart rate, perspiration), also known as "fear of fear." This fear is a misinterpretation of nonthreatening symptoms as threatening across 3 domains: physical ("When my heart rate increases, I'm afraid I may have a heart attack"), social ("If people see me perspire, I fear they will negatively evaluate me"), and cognitive ("When I feel these symptoms, I fear it means I'm going crazy or will lose control and do something dangerous like disconnect my IV"). These thoughts stimulate the sympathetic nervous system, resulting in stronger sensations and further catastrophic misinterpretations, which may spiral into a panic attack.