The challenge of home and community older adult care in China: a survey of the capability of primary care physicians in providing geriatric healthcare services.

Introduction: In the context of ageing at home and in the community, healthcare services for older adult people in China are mainly provided by primary care physicians (PCPs). This study aimed to understand the level of geriatric healthcare service capability of PCPs in China and to give recommendations for improving care.

Methods: We surveyed PCPs in the eastern, central, and western regions of China, using a combination of multi-stage stratified cluster sampling and typical sampling.

Nurses' Reports of Inhaler Use Errors in Patients with Chronic Obstructive Pulmonary Disease in Hong Kong.

Background: Persistently high rates of inhaler errors and poor adherence among Chronic Obstructive Pulmonary Disease (COPD) patients contribute to ineffective symptomatic control, high care burdens, and increased healthcare resource utilization.

Objective: This study aimed to report (i) nurses-identified common problems and errors of inhaler use in COPD patients, (ii) nurses' attitudes, practices, training needs and required support in inhaler education.

Methods: An online questionnaire survey was conducted with nurses working in Hong Kong from May to June 2023 using an exponential, non-discriminative snowball sampling strategy.

Effectiveness of Primary Caregiver Training Programmes in Community Health Centres on Quality of Life and Mental Health in Older Patients with Urinary Tract Tumours.

Objective: Patients with urological tumours frequently experience compromised quality of life and mental health issues. This study aimed to evaluate the impact of a primary caregiver training programme conducted by a community health service centre on these patients.

Methods: This retrospective study assessed a primary caregiver training programme for patients with urological tumours conducted across ten community health centres in China over 6 weeks from March 2020 to March 2024.

Marital satisfaction and its impact on frailty in Korean older adults: a longitudinal analysis.

Background: Despite a wealth of literature on marital dissatisfaction and adverse health outcomes, little is known about the relationship between marital dissatisfaction and frailty in older adults.

Methods: This longitudinal study utilised the data of 11 174 individuals who participated in the biennial Korean Longitudinal Study of Ageing survey from 2006 to 2020 and were aged ≥45 during the initial wave. Frailty was measured using a frailty instrument, which utilised exhaustion, social isolation, and handgrip strength weakness.

Depressive symptoms in older adults are associated with changes in stress-related markers, functional connectivity and brain volume.

Background: Subclinical depressive symptoms increase the risk of developing Alzheimer's disease (AD). The neurobiological mechanisms underlying this link may involve stress system dysfunction, notably related to the hippocampus which is particularly sensitive to AD. We aimed to investigate the links between blood stress markers and changes in brain regions involved in the stress response in older adults with or without subclinical depressive symptoms.

Factors associated with phenoconversion of idiopathic rapid eye movement sleep behavior disorder: a prospective study.

This study explores the effect of risk factors on the progression of idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) to α-synucleinopathies in a Chinese cohort. Patients with iRBD were enrolled and assessed for environmental factors and lifestyle using standardized structured questionnaires at baseline. All patients were prospectively followed for phenoconversion monitoring.

Adipose ZFP36 protects against diet-induced obesity and insulin resistance.

Aims: Obesity, as a worldwide healthcare problem, has become more prevalent. ZFP36 is a well-known RNA-binding protein and involved in the posttranscriptional regulation of many physiological processes. Whether the adipose ZFP36 plays a role in obesity and insulin resistance remains unclear.

The association between frailty and falls among individuals aged 60 years and older residing in community settings and experiencing hip fractures in China: a cross-sectional study.

Objectives: Previous studies have established a correlation between frailty and an increased risk of falls among middle-aged and elderly individuals within community settings. The frailty status of hospitalized and community-dwelling adults aged 60 or older with hip fractures is poorly investigated. This study aims to examine the relationship between frailty status and falls in China among community-dwelling and hospitalized individuals with hip fractures aged 60 and older.

Cardiovascular Safety of Anti-CGRP Monoclonal Antibodies in Older Adults or Adults With Disability With Migraine.

Importance: Monoclonal antibodies (mAbs) targeting calcitonin gene-related peptide (CGRP) or its receptor (anti-CGRP mAbs) offer effective migraine-specific preventive treatment. However, concerns exist about their potential cardiovascular risks due to CGRP blockade.

Objective: To compare the incidence of cardiovascular disease (CVD) between Medicare beneficiaries with migraine who initiated anti-CGRP-mAbs vs onabotulinumtoxinA in the US.

Priority Clinical Actions for Outpatient Management of Nonhospitalized Traumatic Brain Injury.

Outpatient care following nonhospitalized traumatic brain injury (TBI) is variable, and often sparse. The National Academies of Sciences, Engineering, and Medicine's 2022 report on highlighted the need to improve the consistency and quality of TBI care in the community. In response, the present study aimed to identify existing evidence-based guidance and specific clinical actions over the days to months following nonhospitalized TBI that should be prioritized for implementation in primary care.

The ability of the prognostic nutritional index to predict short-term mortality in geriatric acute heart failure.

Background: Heart failure is a critical cardiovascular condition, necessitating comprehensive treatment approaches and contributing to elevated mortality rates. This study aimed to evaluate the effect of the prognostic nutritional index (PNI) on the prognosis of geriatric patients diagnosed with acute heart failure.

Results: A total of 104 patients were included and evaluated retrospectively in this study; 57.

Expression and clinical significance of 25-hydroxyvitamin D, insulin-like growth factor 1, and beta-2 microglobulin in cognitive dysfunction after ischemic stroke in the elderly.

We aimed to unveil the clinical significance of serum 25-hydroxyvitamin D (25-OH-VD), insulin-like growth factor 1 (IGF-1), and beta-2 microglobulin (β2-MG) levels in cognitive dysfunction after ischemic stroke (IS) in the elderly. A total of 160 geriatric IS patients admitted to our hospital were retrospectively collected. The patients' serum 25-OH-VD, IGF-1, and β2-MG levels were detected, and the correlation between the three levels and the patients' National Institutes of Health Stroke Scale (NIHSS) and Montreal Cognitive Assessment (MoCA) scores was tested by the Pearson test.

Epidemiology of pulmonary embolism in China, 2021: a nationwide hospital-based study.

Background: Pulmonary embolism (PE) as a preventable and potentially fatal noncommunicable disease was believed to have a lower incidence in Asian populations compared to Western populations. However, the incidence and mortality rates of PE in China and the impact of venous thromboembolism (VTE) prevention system constructions on PE still lack nationwide evidence.

Methods: For this nationwide hospital-based observational study, we used data from the National Hospital Quality Monitoring System (HQMS) and public database in China.

Single nucleotide polymorphisms: Implications in the early diagnosis and targeted intervention of coronary microvascular dysfunction.

Coronary microvascular dysfunction (CMD) is a clinical syndrome of myocardial ischemia caused by structural and/or functional abnormalities of pre-coronary arterioles and arterioles. While genetics and other factors play a role in CMD etiology, the key pathogenic mechanism remains unclear. Currently, the diagnostic procedure for CMD is still cumbersome, and there is a lack of effective targeted interventions.

Using Contemplative Medicine to Harness Compassion in the Palliative Care Setting: Lessons Learned.

Background: Burnout is common among palliative care clinicians caring for patients with a serious illness. Contemplative medicine is an emerging approach that aims to utilize Buddhist concepts of mindfulness, insight, and compassion to address unspoken suffering in clinicians.

Objectives: To introduce and share contemplative medicine practices with Hospice Palliative Medicine (HPM) fellows participating in two academic programs in New York.

Understanding Loneliness in an Aging Population of San Vito de Coto Brus, Costa Rica.

As trends in life expectancy continue to improve, the burden of loneliness in geriatric populations on a global scale is increasing. With advancing age comes an increase in the number of life events that can perpetuate a state of loneliness such as losing a life partner, dwindling social networks, and deteriorating health conditions. This burden can manifest in a variety of mental and physical consequences.

Feasibility of a Low-Intensity Intervention to Influence Antibiotic Prescribing Rates Use in Outpatient Settings: A Cluster Randomized Controlled Clinical Trial.

Background: Primary care providers (PCPs) may modify their antibiotic prescription practices if aware of their potentially damaging impact.

Methods: We conducted a cluster randomized controlled trial at 12 Veterans Affairs community-based outpatient clinics. PCPs at clinics randomized to the intervention group received quarterly antibiotic use reports with feedback about antibiotics prescribed for acute respiratory infections and adverse event letters alerting about infection or antibiotic-resistant gram-negative bacteria among their patients.

Long-term Outcomes of Geriatric Medicine Teaching Strategies: Comparing no Content, Traditional Lecture, and Flipped Classroom 2 Years Postintervention.

Background: The long-term effects of use of the flipped classroom to teach geriatric medicine are still underexplored.

Objective: To investigate whether different educational interventions on geriatrics (i.e.

Association of Pretreatment Albumin-bilirubin Grade With Hepatotoxicity and Efficacy in EGFR-TKIs Therapy for NSCLC.

Background/aim: The albumin-bilirubin (ALBI) grade is an assessment tool for hepatic function and prognosis in patients with hepatocellular carcinoma (HCC). However, its significance in patients with non-small cell lung cancer (NSCLC) treated with an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) remains unclear. We retrospectively investigated the relationship between pre-treatment ALBI grade and hepatotoxicity and treatment efficacy in patients with NSCLC receiving EGFR-TKIs.

Scale-based screening and assessment of age-related frailty.

As the population ages, the prevalence of age-related frailty increases sharply, which increases the risk of poor health status of older adults, such as disability, falls, hospitalization, and death. Across the globe, frailty is moving toward the forefront of health and medical research. Currently, frailty is believed to be preventable and reversible, so the early identification of frailty is critical.

A Novel Integrated Geriatric Services Hub for Frailty Identification and Comprehensive Management of Community-Dwelling Older Adults in Singapore: Impact on Health Service Utilization.

Background: Healthcare systems need to address the high healthcare use of frail older adults. The Geriatric Services Hub (GSH) is a novel program in Singapore that delivers frailty screening, comprehensive geriatric assessment and coordinated care for community-dwelling older persons with bio-psycho-social needs. We aimed to evaluate the effects of the GSH on healthcare use.

The impact of inflammatory response on psychological status of medical staff during COVID-19 pandemic.

Background: Limited research has been conducted on the relationship between inflammatory markers and psychological status in medical staff fighting COVID-19.

Objective: This article examines the psychological and inflammatory conditions of medical personnel working on the front lines of the battle against COVID-19.

Methods: A total of 102 clinical staff members were included in this study.