scholarly journals A Pilot Study of the Clinical Frailty Scale to Predict Frailty Transition and Readmission in Older Patients in Vietnam

2020 ◽  
Vol 17 (5) ◽  
pp. 1582
Author(s):  
Tan Van Nguyen ◽  
Thuy Thanh Ly ◽  
Tu Ngoc Nguyen
Keyword(s):  
Pilot Study ◽  
Older Patients ◽  
Rural And Remote ◽  
Clinical Frailty Scale ◽  
Frailty Status ◽  
Phone Calls ◽  
Increased Risk ◽  
Rural And Remote Areas ◽  
The Impact

Background. The Clinical Frailty Scale (CFS) is gaining increasing acceptance due to its simplicity and applicability. Aims. This pilot study aims to examine the role of CFS in identifying the prevalence of frailty, frailty transition, and the impact of frailty on readmission after discharge in older hospitalized patients. Methods. Patients aged ≥60 admitted to the geriatric ward of a hospital in Vietnam were recruited from 9/2018–3/2019 and followed for three months. Frailty was assessed before discharge and after three months, using the CFS (robust: score 1–2, pre-frail: 3–4, and frail: ≥5). Multivariate logistic regression was applied to investigate the associated factors of frailty transition and the impact of frailty on readmission. Results. There were 364 participants, mean age 74.9, 58.2% female. At discharge, 4 were robust, 160 pre-frail, 200 frail. Among the 160 pre-frail participants at discharge, 124 (77.5%) remained pre-frail, and 36 (22.5%) became frail after 3 months. Age (adjusted OR1.09, 95% CI 1.03–1.16), number of chronic diseases (adjusted OR 1.37, 95% CI 1.03–1.82), and polypharmacy at discharge (adjusted OR 3.68, 95% CI 1.15–11.76) were significant predictors for frailty after 3 months. A frailty status at discharge was significantly associated with increased risk of readmission (adjusted OR2.87, 95% CI 1.71–4.82). Conclusions. Frailty was present in half of the participants and associated with increased risk of readmission. This study suggests further studies to explore the use of the CFS via phone calls for monitoring patients’ frailty status after discharge, which may be helpful for older patients living in rural and remote areas.

scholarly journals Cancer and Aging: Two Tightly Interconnected Biological Processes

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1400
Author(s):  
Lieze Berben ◽  
Giuseppe Floris ◽  
Hans Wildiers ◽  
Sigrid Hatse
Keyword(s):  
Older Patients ◽  
Current Knowledge ◽  
Geriatric Oncology ◽  
Individual Treatment ◽  
Treatment Regimens ◽  
Patients With Cancer ◽  
Increased Risk ◽  
The Impact

Age is one of the main risk factors of cancer; several biological changes linked with the aging process can explain this. As our population is progressively aging, the proportion of older patients with cancer is increasing significantly. Due to the heterogeneity of general health and functional status amongst older persons, treatment of cancer is a major challenge in this vulnerable population. Older patients often experience more side effects of anticancer treatments. Over-treatment should be avoided to ensure an optimal quality of life. On the other hand, under-treatment due to fear of toxicity is a frequent problem and can lead to an increased risk of relapse and worse survival. There is a delicate balance between benefits of therapy and risk of toxicity. Robust biomarkers that reflect the body’s biological age may aid in outlining optimal individual treatment regimens for older patients with cancer. In particular, the impact of age on systemic immunity and the tumor immune infiltrate should be considered, given the expanding role of immunotherapy in cancer treatment. In this review, we summarize current knowledge concerning the mechanistic connections between aging and cancer, as well as aging biomarkers that could be helpful in the field of geriatric oncology.

Zinc Depletion Increases Readmission in Older Patients: An Example of Interactions Between Nutrition and Disease

2017 ◽  
Vol 87 (1-2) ◽  
pp. 10-16 ◽  
Author(s):  
Salah Gariballa ◽  
Awad Alessa
Keyword(s):  
Nutritional Status ◽  
Inductively Coupled Plasma ◽  
Older Patients ◽  
Controlled Trial ◽  
Prognostic Indicators ◽  
Hospitalised Patients ◽  
Increased Risk ◽  
Co Morbidity ◽  
The Impact ◽  
Poor Nutrition

Abstract. Background: ill health may lead to poor nutrition and poor nutrition to ill health, so identifying priorities for management still remains a challenge. The aim of this report is to present data on the impact of plasma zinc (Zn) depletion on important health outcomes after adjusting for other poor prognostic indicators in hospitalised patients. Methods: Hospitalised acutely ill older patients who were part of a large randomised controlled trial had their nutritional status assessed using anthropometric, hematological and biochemical data. Plasma Zn concentrations were measured at baseline, 6 weeks and at 6 months using inductively- coupled plasma spectroscopy method. Other clinical outcome measures of health were also measured. Results: A total of 345 patients assessed at baseline, 133 at 6 weeks and 163 at 6 months. At baseline 254 (74%) patients had a plasma Zn concentration below 10.71 μmol/L indicating biochemical depletion. The figures at 6 weeks and 6 months were 86 (65%) and 114 (70%) patients respectively. After adjusting for age, co-morbidity, nutritional status and tissue inflammation measured using CRP, only muscle mass and serum albumin showed significant and independent effects on plasma Zn concentrations. The risk of non-elective readmission in the 6-months follow up period was significantly lower in patients with normal Zn concentrations compared with those diagnosed with Zn depletion (adjusted hazard ratio 0.62 (95% CI: 0.38 to 0.99), p = 0.047. Conclusions: Zn depletion is common and associated with increased risk of readmission in acutely-ill older patients, however, the influence of underlying comorbidity on these results can not excluded.

The approach to patients with cognitive impairment and hip fracture: the role of orthogeriatric care

2014 ◽  
Vol 24 (3) ◽  
pp. 219-227 ◽  
Author(s):  
Francisco J Tarazona-Santabalbina ◽  
Juan R Doménech-Pascual ◽  
Ángel Belenguer-Varea A ◽  
Eduardo Rovira Daudi
Keyword(s):  
Cognitive Impairment ◽  
Hip Fracture ◽  
Functional Recovery ◽  
Functional Outcomes ◽  
Older Patients ◽  
Future Research ◽  
Research Perspectives ◽  
Increased Risk ◽  
Risk Of Falls

SummaryHip fracture is very common among older patients, who are characterized by increased co-morbidities, including cognitive impairment. These patients have an increased risk of falls and fractures, poorer functional recovery and lower survival both in hospital and 12 months after discharge. We review the survival and functional outcomes of older patients with cognitive impairment and hip fracture managed in orthogeriatric units, and highlight the gaps in our knowledge of the efficacy and efficiency of specific orthogeriatric programmes for such patients and the future research perspectives in this field.

IMPACT OF DIGITAL MARKETING: THE PRESENT SCENARIO IN TELANGANA STATE – AN EMPERICAL STUDY

2021 ◽  
Vol 8 (65) ◽  
pp. 15164-15172
Author(s):  
S. Pratap ◽  
Aziz Fatima
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Digital Marketing ◽  
Rural And Remote ◽  
Remote Areas ◽  
Wide Range ◽  
Rural And Remote Areas ◽  
Telangana State ◽  
The Impact ◽  
Made In

In present scenario of COVID-19, the effect of pandemic on Digital Marketing is visible not only in urban areas but also in rural areas. Customers are searching for various products and services through Google by which they can purchase wide range of products and services to fill their needs and desires at relatively low price. The freedom to select numerous products is available by browsing various websites. Hence this study focuses on Impact of digital marketing particularly in the selected rural areas of Telangana state. This state been formed recently but in the IT sector it is receiving much attention throughout the globe, as many MNC’s are establishing their operations in this state. Therefore, an attempt has been made in this study to find out how the Impact of digital marketing is trickling down in the rural and remote areas of newly formed Telangana state. Hence this study focuses the impact of digital marketing in the selected areas of Telangana state.

scholarly journals Emerging Role of Microbiome in the Prevention of Urinary Tract Infections in Children

2022 ◽  
Vol 23 (2) ◽  
pp. 870
Author(s):  
Anna Kawalec ◽  
Danuta Zwolińska
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Pediatric Population ◽  
Urologic Diseases ◽  
Increased Risk ◽  
Tract Infections ◽  
The Impact

The microbiome of the urinary tract plays a significant role in maintaining health through the impact on bladder homeostasis. Urobiome is of great importance in maintaining the urothelial integrity and preventing urinary tract infection (UTI), as well as promoting local immune function. Dysbiosis in this area has been linked to an increased risk of UTIs, nephrolithiasis, and dysfunction of the lower urinary tract. However, the number of studies in the pediatric population is limited, thus the characteristic of the urobiome in children, its role in a child’s health, and pediatric urologic diseases are not completely understood. This review aims to characterize the healthy urobiome in children, the role of dysbiosis in urinary tract infection, and to summarize the strategies to modification and reshape disease-prone microbiomes in pediatric patients with recurrent urinary tract infections.

Chlamydia—inside out

2002 ◽  
Vol 13 (6) ◽  
pp. 406-410 ◽  
Author(s):  
Andrea Dodd ◽  
Diane Lesley Comber ◽  
Mary Hernon
Keyword(s):  
Pilot Study ◽  
Sexual Health ◽  
Community Health ◽  
Health Care Professionals ◽  
Time Management ◽  
Partner Notification ◽  
Phone Calls ◽  
Complementary Role ◽  
Genitourinary Medicine

The aim was to inform other health care professionals within the field of sexual health about the expanding role of the health adviser in genitourinary medicine. It also highlights the complementary role of a community health adviser that may develop if the chlamydia pilot study became a national screening programme. An audit of time management and workload created by partner notification for the positive patients generated by the chlamydia pilot was undertaken. This was done prospectively over a two-month period and the data were collected by the health advisers in the genitourinary medicine department. The results showed that 164 people generated by the pilot study were treated for chlamydia (80 cases and 84 partners): 25 letters and 8 phone calls were required to achieve this. The national sexual health strategy now addresses the issue of integration of sexual health services. It may be suggested that the role of the health adviser could be fundamental to this strategy and development of a community health adviser may then evolve.

Rural Social Work in Australia

2016 ◽  
Author(s):  
Margaret Alston
Keyword(s):  
Social Work ◽  
Social Workers ◽  
Economic Status ◽  
Service Access ◽  
Rural And Remote ◽  
Remote Areas ◽  
Rural Social Work ◽  
Rural And Remote Areas ◽  
Sparse Population

This article examines the role of social workers in rural and remote areas of Australia. The uniqueness of Australia’s landscape, its vast distances, and sparse population base, create unique issues relating to service delivery in general and social work in particular. High levels of poverty, poorer health, lower socio-economic status, and an aging population base typify Australia’s remote areas. Despite these factors, inland regions of the country are subject to economic rationalist policies that make service access problematic. It is in these regions that rural and remote social workers practice. The article outlines the personal, practical, and professional challenges facing social workers and notes the unique opportunities available to workers who choose to live and work in these regions.

scholarly journals Frailty and Anticoagulant Therapy in Patients Aged 65 Years or Older with Atrial Fibrillation

2020 ◽  
Vol 4 (3) ◽  
pp. 153-161
Author(s):  
Jiapeng Liu ◽  
Xin Du ◽  
Mengmeng Li ◽  
Zhaoxu Jia ◽  
Shangxin Lu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Advanced Age ◽  
Elderly Adults ◽  
Clinical Frailty Scale ◽  
Cross Sectional ◽  
Factors Associated ◽  
Frailty Status ◽  
Increased Risk

Background: Elderly adults with atrial fibrillation (AF) are at increased risk of frailty and thromboembolic complications. However, studies on the prevalence of frailty in AF patients and data on the relationship between frailty and the use of anticoagulants are limited.Methods: We conducted a cross-sectional study involving 500 participants. Patients aged 65 years or older were consecutively selected from the Chinese Atrial Fibrillation Registry study. The patient’s frailty status was assessed with use of the Canadian Study of Health and Aging Clinical Frailty Scale. We assessed the prevalence of and factors associated with frailty, and how frailty affects anticoagulant therapy.Results: In 500 elderly adults with AF (age 75.2±6.7 years; 51.6% female), 201 patients (40.2%) were frail. The prevalence of frailty was higher in females (P=0.002) and increased with age and CHA2DS2-VASc score (P for trend less than 0.001 for both). The factors associated with frailty were a history of heart failure (odds ratio [OR] 2.40, 95% confidence interval [CI] 1.39‐4.14), female sex (OR 2.09, 95% CI 1.27‐3.43), and advanced age (OR 1.13, 95% CI 1.09‐1.17). Frail patients were significantly less likely to have ever been prescribed anticoagulants compared with nonfrail patients (81.7 vs. 54.9%, P<0.001).Conclusions: Frailty is prevalent in elderly adults with AF, especially in females, those of advanced age, and those with heart failure. Frailty status has a significant impact on prescription of anticoagulants for high-risk AF patients.

scholarly journals The Potential Role of Human Papillomavirus Infection in Bell's Palsy: A Hypothesis-Generating Study Based on a Nationwide Cohort

2021 ◽  
Vol 8 ◽  
Author(s):  
Kuan-Ying Li ◽  
Mei-Chia Chou ◽  
Renin Chang ◽  
Hei-Tung Yip ◽  
Yao-Min Hung ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Index Date ◽  
Hpv Infection ◽  
Bell’S Palsy ◽  
Sensitivity Analyses ◽  
Chronic Obstructive ◽  
Bell's Palsy ◽  
Increased Risk ◽  
The Impact

Objective: Our purpose was to investigate whether people with a previous human papillomavirus (HPV) infection were associated with an increased risk of Bell's palsy (BP).Methods: By using Taiwan population-based data, patients aged &gt; 18 years with HPV infection (n = 22,260) from 2000 to 2012 were enrolled and compared with control subjects who had never been diagnosed with an HPV infection at a 1:4 ratio matched by sex, age, index date, and co-morbidities (n = 89,040). The index date was the first date of HPV diagnosis. All the patients were tracked until the occurrence of BP. Cox proportional hazards regression was applied to estimate the hazard ratios (HRs) for the development of BP in both groups.Results: The HPV group had 1.25 [95% confidence interval (CI) = 1.03–1.51] times higher risk of BP compared with the non-HPV group after adjusting for sex, age, and co-morbidities. The association of HPV and BP was significant in the sensitivity analyses. In the subgroup analysis, the impact of HPV infection on the risk of BP was more pronounced in the elderly &gt; 50 years [adjusted hazard ratio (aHR) =1.86; 95% CI = 1.37–2.52], hypertension (aHR = 1.65; 95% CI = 1.17–2.31), and chronic obstructive pulmonary disease (aHR = 2.14, 95% CI 1.333.43) subgroups.Conclusions: Patients with HPV infection have a higher risk of subsequent BP compared with non-HPV patients. More rigorous studies are needed to confirm if and how specific HPV genotypes are associated with BP and the possible role of vaccines in disease prevention.

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