Impact of the first COVID-19 shutdown on traumatological patient volumes in Switzerland.

Background: The coronavirus has caused a worldwide pandemic with serious impacts on our healthcare systems. Many countries experienced a decline in traumatological patient volume. The aim of this study is to evaluate the impact of the first lockdown on traumatological patient volume in Switzerland.

Top Ten Tips Palliative Care Clinicians Should Know About Prognostication in Children.

Pediatric palliative care (PPC) is different from palliative care (PC) for adults. However, conceptualizing PPC remains cumbersome due to the high heterogeneity of often rare diseases, the high diversity of disease trajectories, and the particular difficulty to predict the future of an individual, severely ill child. This article aims to provide an overview and critical reflection of different aspects of prognostication in children with PC needs.

Top Ten Tips Palliative Care Clinicians Should Know About Prognostication in Critical Illness and Heart, Kidney, and Liver Diseases.

Specialty palliative care (PC) clinicians are frequently asked to discuss prognosis with patients and their families. When conveying information about prognosis, PC clinicians need also to discuss the likelihood of prolonged hospitalization, cognitive and functional disabilities, and death. As PC moves further and further upstream, it is crucial that PC providers have a broad understanding of curative and palliative treatments for serious diseases and can collaborate in prognostication with specialists.

Teaching geriatric medicine through gamification: a tool for enhancing postgraduate education in geriatric medicine.

Background: Polypharmacy is becoming increasingly common and all doctors must be prepared to manage it competently.

Aims: The aim of this project is to evaluate the feasibility and use of a novel gamification-based teaching intervention on polypharmacy among doctors undergoing advanced geriatric training. Among others, one of the learning goals for the students was to be able to describe the adherence to medication.

Top Ten Tips Palliative Care Clinicians Should Know About Prognostication in Oncology, Dementia, Frailty, and Pulmonary Diseases.

Prognostication has been described as "Medicine's Lost Art." Taken with diagnosis and treatment, prognostication is the third leg on which medical care rests. As research leads to additional beneficial treatments for vexing conditions like cancer, dementia, and lung disease, prognostication becomes even more difficult.

Top Ten Tips Palliative Care Clinicians Should Know About Trauma and Emergency Surgery.

There is growing interest in, and need for, integrating palliative care (PC) into the care of patients undergoing emergency surgery and those with traumatic injury. Thus, PC consults for these populations will likely grow in the coming years. Understanding the nuances and unique characteristics of these two acutely ill populations will improve the care that PC clinicians can provide.

Top Ten Tips Palliative Care Clinicians Should Know About Cognitive Impairment and Institutional Care.

Most long-term care (LTC) residents are of age >65 years and have multiple chronic health conditions affecting their cognitive and physical functioning. Although some individuals in nursing homes return home after receiving therapy services, most will remain in a LTC facility until their deaths. This article seeks to provide guidance on how to assess and effectively select treatment for delirium, behavioral and psychological symptoms for patients with dementia, and address other common challenges such as advanced care planning, decision-making capacity, and artificial hydration at the end of life.

Playing a musical instrument is associated with slower cognitive decline in community-dwelling older adults.

Background: Elucidating behavioral protective factors for cognitive decline and dementia can have a far-reaching impact.

Aims: To describe the association of present and past musical instrument playing with cognitive function in cognitively intact older adults.

Method: A post hoc observational analysis of the Zurich Disability Prevention Trial.

Continuing, Withdrawing, and Withholding Medical Treatment at the End of Life and Associated Characteristics: a Mortality Follow-back Study.

Background: Studies on forgoing treatment often ignore treatments that are continued until death.

Objective: To investigate how often specific treatments are withdrawn or withheld before death and to describe the associated patient, physician, and care characteristics.

Design: National mortality follow-back study in Switzerland in 2013/2014 using a standardized survey to collect information on the patient's end of life and demographics on the physician.

Total Serum Testosterone and Western Ontario and McMaster Universities Osteoarthritis Index Pain and Function Among Older Men and Women With Severe Knee Osteoarthritis.

Objective: To investigate whether serum total testosterone level is associated with knee pain and function in men and women with severe knee osteoarthritis (OA).

Methods: We enrolled 272 adults age ≥60 years (mean ± SD age 70.4 ± 4.

Timeline of functional recovery after hip fracture in seniors aged 65 and older: a prospective observational analysis.

Unlabelled: We investigated the timeline of functional recovery after hip fracture over 12 months in adults age ≥ 65 years using objective lower extremity function tests and subjective physical functioning. Objective functional recovery was largely complete in the first 6 months, whereas subjective recovery improved up to 9 months after hip fracture.

Introduction: Hip fractures are a major cause of loss of function among seniors.

Effects of a simple home exercise program and vitamin D supplementation on health-related quality of life after a hip fracture: a randomized controlled trial.

Purpose: To test the effects of vitamin D intervention and a simple home exercise program (HE) on health-related quality of life (HRQL) in the first 12 months after hip fracture.

Methods: HRQL was reported in 173 acute hip fracture patients (mean age 84 years, 79% females, 77% community dwelling) who were enrolled in the 12-month 2 × 2 factorial Zurich Hip Fracture Trial. Pre-fracture HRQL was assessed at baseline (4.

Effect of Monthly High-Dose Vitamin D on Mental Health in Older Adults: Secondary Analysis of a RCT.

Objectives: To test the effect of monthly high-dose vitamin D supplementation on mental health in pre-frail older adults.

Design: Ancillary study of a 1-year double-blind randomized clinical trial conducted in Zurich, Switzerland.

Setting And Participants: A total of 200 community-dwelling adults 70 years and older with a prior fall event in the last year.

Effect of 800 IU Versus 2000 IU Vitamin D3 With or Without a Simple Home Exercise Program on Functional Recovery After Hip Fracture: A Randomized Controlled Trial.

Objectives: To evaluate 2 simple strategies, vitamin D and a home exercise program, in functional recovery during the first year after hip fracture.

Design: Secondary analysis of a factorial clinical trial. Patients were randomly allocated to 800 IU (standard of care) or 2000 IU vitamin D and a daily instruction of a simple home exercise program (SHEP) or standard physiotherapy alone during acute care.

Physician-related determinants of medical end-of-life decisions - A mortality follow-back study in Switzerland.

Background: Medical end-of-life decisions (MELD) and shared decision-making are increasingly important issues for a majority of persons at the end of life. Little is known, however, about the impact of physician characteristics on these practices. We aimed at investigating whether MELDs depend on physician characteristics when controlling for patient characteristics and place of death.

Continuous deep sedation until death in patients admitted to palliative care specialists and internists: a focus group study on conceptual understanding and administration in German-speaking Switzerland.

Background: Continuous deep sedation until death is increasingly used to treat intolerable suffering of terminally ill patients. One of the highest incidences and strongest increases has been observed in Switzerland. Variation in prevalence estimates indicates a potential effect of differences in sedation practice between care settings and professionals.

Prospective Associations between Single Foods, Alzheimer's Dementia and Memory Decline in the Elderly.

: Evidence whether single “cognitive health” foods could prevent cognitive decline is limited. We investigated whether dietary intake of red wine, white wine, coffee, green tea, olive oil, fresh fish, fruits and vegetables, red meat and sausages, assessed by a single-food-questionnaire, would be associated with either incident Alzheimer’s dementia (AD) or verbal memory decline. Participants aged 75+ of the German Study on Aging, Cognition and Dementia in Primary Care Patients (AgeCoDe) cohort were regularly followed over 10 years ( = 2622; = 418 incident AD cases).

Issues of trial selection and subgroup considerations in the recent meta-analysis of Zhao and colleagues on fracture reduction by calcium and vitamin D supplementation in community-dwelling older adults.

Unlabelled: Zhao and colleagues are addressing an important question about the efficacy of calcium and vitamin D on fracture risk reduction among community-dwelling adults age 50+. However, we are concerned about four aspects of their approach, which may affect the validity of their conclusions and implications for public health.

Introduction: We discuss the recent meta-analysis by Zhao and colleagues on the primary prevention of fractures of calcium and vitamin D as well as their combination among community-dwelling adults age 50+.

Which Method of Fall Ascertainment Captures the Most Falls in Prefrail and Frail Seniors?

There is no consensus on the most reliable method of ascertaining falls among the elderly. Therefore, we investigated which method captured the most falls among prefrail and frail seniors from 2 randomized controlled trials conducted in Zurich, Switzerland: an 18-month trial (2009-2010) including 200 community-dwelling prefrail seniors with a prior fall and a 12-month trial (2005-2008) including 173 frail seniors with acute hip fracture. Both trials included the same methods of fall ascertainment: monthly active asking, daily self-report diary entries, and a call-in hotline.

Association between Caregiver Role and Short- and Long-Term Functional Recovery after Hip Fracture: A Prospective Study.

Objectives: After a hip fracture, 50% of senior patients are left with permanent functional decline and 30% lose their autonomy. The aim of this prospective study was to evaluate whether seniors who are in a caregiver role have better functional recovery after hip fracture compared with noncaregivers.

Design: Prospective observational study.

Gender-specific association between dietary acid load and total lean body mass and its dependency on protein intake in seniors.

Unlabelled: Diet-related mild metabolic acidosis may play a role in the development of sarcopenia. We investigated the relationship between dietary acid load and total lean body mass in male and female seniors age ≥ 60 years. We found that a more alkaline diet was associated with a higher %TLM only among senior women.