Reshaping Care for Older People: Trends in emergency admissions to hospital during a period of simultaneous interventions in Glasgow City, April 2011-March 2015. | LitMetric
This study describes trends in emergency admissions (EAs) in Glasgow City during a period when interventions were designed and implemented, aimed at shifting the balance from institutional to community-based care. Standardised monthly rates of EAs between April 2011 and March 2015 were calculated, for residents of Glasgow City aged 65 years and over. Multilevel zero-inflated Negative Binomial models for EAs nested by datazone were created, adjusting for sex, 5-year age group, area-level deprivation (SIMD quintile), season, month and month squared. Models were also run for EAs by cause, for three causes: chronic obstructive pulmonary disease (COPD), falls and dementia. The rate of EAs first rose then fell during the study period. When modelled, RRs for month (RR for month 12 relative to month 1 and 95% CI=1.02 (0.99, 1.06)) and month squared (RR=0.999 (0.998, 0.999)) indicated a rise in admissions until February 2012, followed by a fall. Risk of admission was greater for males and increased with increasing age group. The risk of going into hospital for those from SIMD 5 (most affluent) was 0.58 (0.56, 0.59) relative to those from SIMD 1 (most deprived). Socioeconomic inequalities were particularly great for COPD-related admissions, where RR for SIMD 5 was 0.25 (0.23, 0.28) times that of SIMD 1. An interaction term between month and SIMD was not significant for any outcome. For dementia-related EAs there was a suggestion that inequalities may be reducing over time. EAs for those aged 65 years and more reduced during the Change Fund period, with similar relative reductions observed across all deprivation quintiles.
Little is known about the epidemiology of leptospirosis in the Dominican Republic, the second most populous country in the Caribbean. We report on findings from a multi-stage household survey across two regions in the country that reveals a previously under-estimated burden of human Leptospira infection. Our findings, based on the reference-standard microscopic agglutination test, indicate a complex picture of serogroup diversity, spatial heterogeneity in infection and risk, and a marked discrepancy between reported cases and serologically estimated infections.
The disadvantaged populations eGFR (estimated glomerular filtration rate) epidemiology (DEGREE) study was designed to gain insight into the burden of chronic kidney disease (CKD) of undetermined cause (CKDu) using standard protocols to estimate the general-population prevalence of low eGFR internationally. Therefore, we estimated the age-standardized prevalence of eGFR under 60 ml/min per 1.73m in adults aged 18-60, excluding participants with commonly known causes of CKD; an ACR (albumin/creatinine ratio) over 300 mg/g or equivalent, or self-reported or measured (HT) hypertension or (DM) diabetes mellitus, stratified by sex and location.
Background: Advanced breast cancer affects approximately 30 % of people diagnosed with breast cancer, leading to distressing symptoms and unmet needs. Despite the consensus on the need for specialist care, access remains inconsistent due to disparities in specialist cancer nurse education.
Objectives: The aim of this study was to evaluate the acceptability, usability, learning experience and perceived impact of the advanced breast cancer for nurses (ABC4Nurses) eLearning programme on learners' clinical practice.
Background: In the phase 3 JAVELIN Renal 101 trial (NCT02684006), first-line treatment with avelumab + axitinib resulted in significantly longer progression-free survival (PFS) and a higher objective response rate (ORR) vs sunitinib in patients with advanced renal cell carcinoma (aRCC). We report the final analysis, including the primary analysis of overall survival (OS).
Patients And Methods: Patients with untreated aRCC (any prognostic risk score) were enrolled.
