scholarly journals Hospital Caseload Demand in the Presence of Interventions during the COVID-19 Pandemic: A Modeling Study

2020 ◽  
Vol 9 (10) ◽  
pp. 3065
Author(s):  
Katsuma Hayashi ◽  
Taishi Kayano ◽  
Sumire Sorano ◽  
Hiroshi Nishiura

A surge in hospital admissions was observed in Japan in late March 2020, and the incidence of coronavirus disease (COVID-19) temporarily reduced from March to May as a result of the closure of host and hostess clubs, shortening the opening hours of bars and restaurants, and requesting a voluntary reduction of contact outside the household. To prepare for the second wave, it is vital to anticipate caseload demand, and thus, the number of required hospital beds for admitted cases and plan interventions through scenario analysis. In the present study, we analyzed the first wave data by age group so that the age-specific number of hospital admissions could be projected for the second wave. Because the age-specific patterns of the epidemic were different between urban and other areas, we analyzed datasets from two distinct cities: Osaka, where the cases were dominated by young adults, and Hokkaido, where the older adults accounted for the majority of hospitalized cases. By estimating the exponential growth rates of cases by age group and assuming probable reductions in those rates under interventions, we obtained projected epidemic curves of cases in addition to hospital admissions. We demonstrated that the longer our interventions were delayed, the higher the peak of hospital admissions. Although the approach relies on a simplistic model, the proposed framework can guide local government to secure the essential number of hospital beds for COVID-19 cases and formulate action plans.

2019 ◽  
Vol 121 (2) ◽  
pp. 690-700 ◽  
Author(s):  
Chesney E. Craig ◽  
Michail Doumas

We investigated whether postural aftereffects witnessed during transitions from a moving to a stable support are accompanied by a delayed perception of platform stabilization in older adults, in two experiments. In experiment 1, postural sway and muscle cocontraction were assessed in 11 healthy young, 11 healthy older, and 11 fall-prone older adults during blindfolded stance on a fixed platform, followed by a sway-referenced platform and then by a fixed platform again. The sway-referenced platform was more compliant for young adults, to induce similar levels of postural sway in both age groups. Participants were asked to press a button whenever they perceived that the platform had stopped moving. Both older groups showed significantly larger and longer postural sway aftereffects during platform stabilization compared with young adults, which were pronounced in fall-prone older adults. In both older groups elevated muscle cocontraction aftereffect was also witnessed. Importantly, these aftereffects were accompanied by an illusory perception of prolonged platform movement. After this, experiment 2 examined whether this illusory perception was a robust age effect or an experimental confound due to greater surface compliance in young adults, which could create a larger perceptual discrepancy between moving and stable conditions. Despite exposure to the same surface compliance levels during sway-reference, the perceptual illusion was maintained in experiment 2 in a new group of 14 healthy older adults compared with 11 young adults. In both studies, older adults took five times longer than young adults to perceive platform stabilization. This supports that sensory reweighting is inefficient in older adults. NEW & NOTEWORTHY This is the first paper to show that postural sway aftereffects witnessed in older adults after platform stabilization may be due to a perceptual illusion of platform movement. Surprisingly, in both experiments presented it took older adults five times longer than young adults to perceive platform stabilization. This supports a hypothesis of less efficient sensory reintegration in this age group, which may delay the formation of an accurate postural percept.


2019 ◽  
Author(s):  
Meaghan Elizabeth Spedden ◽  
Mikkel Malling Beck ◽  
Mark Schram Christensen ◽  
Martin Jensen Dietz ◽  
Anke Ninija Karabanov ◽  
...  

AbstractThe control of ankle muscle force is an integral component of walking and postural control. Aging impairs the ability to produce force steadily and accurately, which can compromise functional capacity and quality of life. Here, we hypothesized that reduced force control in older adults would be associated with altered cortico-cortical communication within a network comprising the primary motor area (M1), the premotor cortex (PMC), parietal, and prefrontal regions. We examined electroencephalographic (EEG) responses from fifteen younger (20-26 yr) and fifteen older (65-73 yr) participants during a unilateral dorsiflexion force-tracing task. Dynamic Causal Modelling (DCM) and Parametric Empirical Bayes (PEB) were used to investigate how directed connectivity between contralateral M1, PMC, parietal, and prefrontal regions was related to age group and precision in force production. DCM and PEB analyses revealed that the strength of connections between PMC and M1 were related to ankle force precision and differed by age group. For young adults, bidirectional PMC-M1 coupling was negatively related to task performance: stronger backward M1-PMC and forward PMC-M1 coupling was associated with worse force precision. The older group exhibited deviations from this pattern. For the PMC to M1 coupling, there were no age-group differences in coupling strength; however, within the older group, stronger coupling was associated with better performance. For the M1 to PMC coupling, older adults followed the same pattern as young adults - with stronger coupling accompanied by worse performance - but coupling strength was lower than in the young group. Our results suggest that bidirectional M1-PMC communication is related to precision in ankle force production and that this relationship changes with aging. We argue that the observed age-related differences reflect compensatory mechanisms whereby older adults maintain performance in the face of declines in the sensorimotor system.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S80-S81
Author(s):  
Grace Caskie ◽  
Anastasia E Canell ◽  
Hannah M Bashian

Abstract Attitudes towards aging include both positive and negative beliefs about older adults (Iverson et al., 2017; Palmore, 1999). Palmore’s (1998) Facts on Aging Quiz, a widely used assessment of knowledge about aging, also identifies common societal misconceptions about aging. Findings regarding age group differences in attitudes toward aging are mixed (Bodner et al., 2012; Cherry & Palmore, 2008; Rupp et al., 2005). The current study compared knowledge of aging, negative age bias, and positive age bias between young adults (18-35 years, n=268) and middle-aged adults (40-55 years; n=277). Middle-aged adults reported significantly greater average knowledge of aging than young adults (p=.019), although both groups had relatively low knowledge (MA: M=13.0, YA: M=12.2). Middle-aged adults also showed significantly less negative age bias (p<.001) and significantly more positive age bias than young adults (p=.026). Although the total sample was significantly more likely to be incorrect than correct on 23 of the 25 facts (p<.001), young adults were significantly more likely than middle-aged adults (p<.001) to respond incorrectly for only 2 of 25 facts. Both facts reflected greater negative age bias among young adults than middle-aged adults. These facts concerned older adults’ ability to work as effectively as young adults (fact 9) and frequency of depression in older adults (fact 13). Results demonstrate that age bias is not limited to young adults and may continue through midlife, though negative age bias in particular may be lower for individuals approaching older adulthood, which could have implications for their psychological and physical well-being.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S477-S477
Author(s):  
Phoebe E Bailey ◽  
Tarren Leon

Abstract This systematic review and meta-analysis quantifies the magnitude and breadth of age-related differences in trust. Thirty-eight independent data sets met criteria for inclusion. Overall, there was a moderate effect of age group on trust (g = 0.22), whereby older adults were more trusting than young adults. Three additional meta-analyses assessed age-related differences in trust in response to varying degrees of trustworthiness. This revealed that older adults were more trusting than young adults in response to neutral (g = 0.31) and negative (g = 0.33), but not positive (g = 0.15), indicators of trustworthiness. The effect of age group on trust in response to positive and neutral cues was moderated by type of trust (financial vs. non-financial) and type of responding (self-report vs. behavioral). Older adults were more trusting than young adults in response to positive and neutral indicators of trustworthiness when trust was expressed non-financially, but not financially. There was also an age-related increase in self-reported, but not behavioral, trust in response to neutral cues. Older adults were more trusting than young adults in response to negative indicators of trustworthiness regardless of the type of trust or type of responding. The reliability of information about trustworthiness (superficial vs. genuine cues) did not moderate any effects of age on trust. Implications of these findings and directions for future research are discussed.


2022 ◽  
Vol 12 ◽  
Author(s):  
Larry E. Humes ◽  
Gary R. Kidd ◽  
Jennifer J. Lentz

The Test of Basic Auditory Capabilities (TBAC) is a battery of auditory-discrimination tasks and speech-identification tasks that has been normed on several hundred young normal-hearing adults. Previous research with the TBAC suggested that cognitive function may impact the performance of older adults. Here, we examined differences in performance on several TBAC tasks between a group of 34 young adults with a mean age of 22.5 years (SD = 3.1 years) and a group of 115 older adults with a mean age of 69.2 years (SD = 6.2 years) recruited from the local community. Performance of the young adults was consistent with prior norms for this age group. Not surprisingly, the two groups differed significantly in hearing loss and working memory with the older adults having more hearing loss and poorer working memory than the young adults. The two age groups also differed significantly in performance on six of the nine measures extracted from the TBAC (eight test scores and one average test score) with the older adults consistently performing worse than the young adults. However, when these age-group comparisons were repeated with working memory and hearing loss as covariates, the groups differed in performance on only one of the nine auditory measures from the TBAC. For eight of the nine TBAC measures, working memory was a significant covariate and hearing loss never emerged as a significant factor. Thus, the age-group deficits observed initially on the TBAC most often appeared to be mediated by age-related differences in working memory rather than deficits in auditory processing. The results of these analyses of age-group differences were supported further by linear-regression analyses with each of the 9 TBAC scores serving as the dependent measure and age, hearing loss, and working memory as the predictors. Regression analyses were conducted for the full set of 149 adults and for just the 115 older adults. Working memory again emerged as the predominant factor impacting TBAC performance. It is concluded that working memory should be considered when comparing the performance of young and older adults on auditory tasks, including the TBAC.


2010 ◽  
Vol 21 (4) ◽  
pp. 247-258 ◽  
Author(s):  
Kai Lutz ◽  
Mike Martin ◽  
Lutz Jäncke

Using a continuous bimanual tracking task with three different movement speeds, we examined motor learning and transfer in older adults. Three groups of subjects within each age group learned only one particular trajectory during training of 40 trials, while the other two trajectories were not practiced during this period. Motor learning (measured as absolute and relative reduction in tracking error) was identified in all subjects. The most important finding was that motor learning was present even for the trajectories that were not practiced to almost the same degree as for practiced trajectories and motor skills for visuomotor tracking show the same amount of improvement and transfer in young and older adults.


1998 ◽  
Vol 4 (3) ◽  
pp. 222 ◽  
Author(s):  
Colette Browning ◽  
Keith Hill ◽  
Hal Kendig ◽  
Deborah Osborne

Falls are the leading cause of injury and hospitalisation for people aged 65 and over. It has been estimated that 20% of hospital admissions in this age group are a result of falls and Fildes (1994) reported that the costs of falls is about $2369 million annually in Victoria. The purpose of this paper is to present a profile of gender differences in the frequency and location of falls, fear of falling, and predictors of falls in community dwelling older adults.


2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
L Bishop ◽  
D Tiwari

Abstract Introduction NICE guidance recommends that during the COVID-19 pandemic all adults are assessed for frailty, suitability for resuscitation and escalation to critical care on admission to hospital. Risks, benefits and likely outcomes should be discussed with patients/relatives. Aim To investigate impact of intervention on treatment escalation plan (TEP) use during the first wave (W1) and second wave (W2) of pandemic. Intervention W1: An ethically approved TEP and a Critical Care Decision Aid (CCDA) was added to the admission booklet. W2: The TEP update included a ‘confirm discussed with patient/relatives’ section. Method W1: We conducted retrospective review of 62 case-notes of patients admitted through COVID-19 pathway and grouped into >80 and ≤ 80 years old. Resuscitation, TEP, CCDA and communication with patient/relatives were collected. W2: 60 further case-notes of patients with COVID-19 admitted in January 2021 were analysed. Results W1: 100% patients had resuscitation decisions and 95% had TEPs in both groups. Significantly higher proportions of Frailty scores were calculated in >80s (58% vs 35% p = 0.04). On average resuscitation and TEPs were made within 13.8 hours of admission (range 1–72 hours). 53.2% of resuscitation decisions and 30% TEPs were discussed with patients of whom higher proportions were discussed in younger age group, majority were discussed at the time of deterioration. W2: 98.3% patients had resuscitation decisions made and 96.7% had TEPs across both groups. On average resuscitation decisions were made within 14.9 hours of admission. In the >80s, 86.7% of resuscitation decisions were discussed and 63.3% of the TEPs were discussed with patient/relatives. In the <80s, 82.8% of resuscitation decisions were discussed and 71.4% of TEPs were discussed with the patient/relatives. Conclusion We significantly improved Treatment Escalation planning during W1 and W2 of pandemic by introducing the TEP in W1 and adding prompt to improve communication with patients/relatives in W2 (p = 0.02).


2021 ◽  
pp. 1-1
Author(s):  
Naveen Kumar

The second wave of Covid -19 in India has made us witness as to how negligence from the part of everyone of us, be it people, Government or policy makers of healthcare system might bring the unwanted disaster in the form of Covid Tsunami. This has made us to see never ending queues of patients , relatives standing for hours for the want of hospital beds, oxygen, essential medicines and lastly but unfortunate for their turn for the cremations of loved ones . But now we can see the number of active cases are declining across the country. Amidst this positive observation in regard of second wave ,there is speculation erupting about the Covid third wave. We can appreciate a similarity in the way that the noble corona virus behave with the Spanish flu that had shaken the world in 1918. It had resulted in three waves with second wave was most deadly and long lasting than the other two waves. During the first wave where the infection was mostly of mild severity we had seen the disease affecting the elderly and immune-compromised patients more. In contrast to this, second wave resulting from mutant strains affected the younger population more and it was of larger severity with high mortality rate. Scientists and experts are now anticipating the third wave , taking the lesson from the Spanish flu and we must be better prepare for it. In order to prepare ourselves from a expected third wave of Covid-19, we shouldn’t repeat mistakes that we made during previos waves. We should refrain ourselves from dismantling our enhanced healthcare facilities, there should not be any sorts of shortage of oxygen , hospital beds, and drug that we have already witnessed. We must have an aggressive containment measure comprising of a really strong and pro-active surveillance system. This can be achieved by increasing the capacity of the existing surveillance system by identifying active cases early. We must ensure that we should follow “social vaccine” of proper masking, avoid indoor gatherings, and proper sanitization. Our vaccination programme needs a boost. We should vaccinate a large section of people before any third wave hits us. The more we vaccinate, the better prepared we are. As medical professionals, it must be ensured that proper scientific protocol must be implemented while handling Covid-19 cases. And last but not the least efforts must be made to fill up vacancies seen in our public health system, especially for frontline healthcare workers. As it is anticipated that the young children are more vulnerable to the forthcoming third wave, efforts are to be sought in order to start vaccination of the younger children in our country. Trials for which has already been started in India and across the world. Till the time vaccine is made available, the resources are to be mobilized to build up healthcare facilities catering the vulnerable age group in this third wave such as building up of more paediatric wards, paediatric ICU’s , training of healthcare personals in handling the emergencies for expected third wave .In addition to these efforts , more and more paediatric covid care centers must be set up at various parts of the country. Equally important is making arrangements for rehabilitation centers for the orphans. Countries like US, Singapore and UAE have already started vaccinating the children in age group between 12 to 15 years with Pfizer-BioNTech Covid vaccine. It’s a high time that the government in India must consider for allowing “expedited approval pathway” to the companies like Pfizer for their Covid-19 vaccine for children. All these combined efforts from everyone may ensure that the country and world may remain well equipped against these subsequent waves of this deadly virus and pave the path of the triumph in the near future.


2021 ◽  
Author(s):  
Joram Soch ◽  
Anni Richter ◽  
Hartmut Schütze ◽  
Jasmin M. Kizilirmak ◽  
Anne Assmann ◽  
...  

AbstractOlder adults and particularly those at risk for developing dementia typically show a decline in episodic memory performance, which has been associated with altered memory network activity detectable via functional magnetic resonance imaging (fMRI). To quantify the degree of these alterations, a score has been developed as a putative imaging biomarker for successful aging in memory for older adults (Functional Activity Deviations during Encoding, FADE; Düzel et al., 2011). Here, we introduce and validate a more comprehensive version of the FADE score, termed FADE-SAME (Similarity of Activations during Memory Encoding), which differs from the original FADE score by considering not only activations but also deactivations in fMRI contrasts of stimulus novelty and successful encoding, and by taking into account the variance of young adults’ activations. We computed both scores for novelty and subsequent memory contrasts in a cohort of 217 healthy adults, including 106 young and 111 older participants, as well as a replication cohort of 117 young subjects. We further tested the stability and generalizability of both scores by controlling for different MR scanners and gender, as well as by using different data sets of young adults as reference samples. Both scores showed robust age-group-related differences for the subsequent memory contrast, and the FADE-SAME score additionally exhibited age-group-related differences for the novelty contrast. Furthermore, both scores correlate with behavioral measures of cognitive aging, namely memory performance. Taken together, our results suggest that single-value scores of memory-related fMRI responses may constitute promising biomarkers for quantifying neurocognitive aging.


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