Background: This study describes the epidemiology of COVID-19 outbreaks in four care homes in terms of spread, severity, presentation and interventions.
Methods: Participants were 100 residents and 102 staff from four co-located care homes in Wales. Data were collected from the homes and Public Health Wales, including demographics, presentations, test status and results, hospital admissions and deaths. Genomic sequencing of confirmed case samples was completed, where possible. Epi-curves, crude attack rates, a Kaplan-Meier survival curve and adjusted hazard ratios were calculated using R.
Results: About 14 confirmed and 43 possible resident cases, 23 confirmed and 47 possible staff cases occurred. Crude attack rates of possible and confirmed cases were 57% (residents) and 69% (staff). Genomic sequencing for 10 confirmed case PCR samples identified at least 5 different UK lineages of COVID-19.42 (42%) residents died, 23 (55%) with COVID-19 or suspected COVID-19 recorded on the death certificate. The hazard ratio for death amongst resident possible and confirmed cases compared to null cases, adjusting for age and sex, was 13.26 (95% CI 5.61-31.34).
Conclusions: There were extensive outbreaks of COVID-19 in these homes with high crude attack rates and deaths. Universal testing and early isolation of residents are recommended.
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http://dx.doi.org/10.1093/pubmed/fdab150 | DOI Listing |
BMC Palliat Care
January 2025
DEFACTUM, Central Region Denmark, Aarhus, Denmark.
Background: Despite growing research on the daily life of people with advanced cancer, more specific knowledge is needed about the specific strategies these people use to manage everyday activities.
Purpose: This study explores how people with advanced cancer manage their everyday activities and describe their specific strategies.
Methods: The qualitative study was designed with an explorative approach.
BMJ Open
January 2025
Department of Health Sciences, Brunel University of London, Uxbridge, UK
Objective: To investigate the safety, feasibility and acceptability of the Neurofenix platform for upper-limb rehabilitation in acute and subacute stroke.
Design: A feasibility randomised controlled trial with a parallel process evaluation.
Setting: Acute Stroke Unit and participants' homes (London, UK).
BMJ Open
January 2025
Centre for Health Services Studies, University of Kent, Canterbury, UK.
Background: Older adult care homes in England are required to develop care plans on behalf of each of their residents and to make these documents available to those who provide care. However, there is a lack of formal agreement around the key principles that should inform the development of care plans in care homes for older adults. Using a modified Delphi survey, we intend to generate consensus on a set of key principles that should inform the care planning process.
View Article and Find Full Text PDFBMJ Open
January 2025
Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
Objectives: To assess the feasibility of capturing older care home residents' quality of life (QoL) in digital social care records and the construct validity (hypothesis testing) and internal consistency (Cronbach's alpha) of four QoL measures.
Design: Cross-sectional data collected in wave 1 of the DACHA (eveloping resources nd minimum dataset for are omes' doption) study, a mixed-methods pilot of a prototype minimum dataset (MDS).
Setting: Care homes (with or without nursing) registered to provide care for older adults (>65 years) and/or those living with dementia.
Chest
January 2025
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany. Electronic address:
Background: There is limited knowledge about long-term mortality, care pathways and health-related quality of life (HrQoL) among intensive care unit (ICU) patients receiving prolonged mechanical ventilation (PMV).
Research Question: What are the long-term mortality, care pathways, and HrQoL of patients receiving invasive PMV, stratified by weaning success?
Study Design: and methods: We conducted a secondary analysis of patients from the cluster-randomised controlled Enhanced Recovery after Intensive Care trial who were treated in two ICU clusters and received invasive PMV (≥21 days via endotracheal tube/tracheostomy or ≥four days via tracheostomy). Data on weaning success, mortality, care place transitions, readmissions, and HrQoL were collected for six months after ICU discharge.
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