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Evaluation of pulmonary hypertension by echocardiogram in geriatrics patients with SARSCOV2 from a Latin American cohort.

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MC Gomez; JA Gomez; JA Gomez; SF Castillo; EC Blanco; LA Dulcey; MP Ciliberti; AP Lizcano; MJ Medina; MJ Estevez; CJ Hernandez; JC Martinez; DA Acevedo; Torres, H; AF Arias; EY Gutierrez; MC Amaya; GS Ramos
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Introduction : Pulmonary hypertension assessed by echocardiography in patients with COVID-19 has not been adequately studied and it is unknown precisely whether it is linked to worse outcomes. Materials and Methods : Retrospective study of 306 adults infected with COVID-19 by antigenic or molecular testing. The main objective was to evaluate the role of the probability of echocardiographic pulmonary hypertension and its relationship with morbidity and mortality according to the ROX index in patients with COVID-19 infection. In the inferential statistical analysis, the OR odds ratios with their

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Exploring the Experiences of Sedentary Behaviour in Older Adults Aged ≥75 Years

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R Tadrous 1; A Forster 1; A Farrin 2; P Coventry 3; A Clegg 1
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Introduction: Older adults are the fastest growing and most sedentary group in society. With sedentary behaviour associated with deleterious health outcomes, reducing sedentary time may improve overall well-being. Adults aged ≥75 years are underrepresented in sedentary behaviour research. This study aimed to qualitatively profile the sedentary behaviour of adults aged ≥75 years. This included ascertaining older adults’ understanding of sedentary behaviour; identifying the activities performed in sitting and standing and identifying the barriers and facilitators towards reducing sedentary time

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A Mixed-Method Feasibility Study of an Intervention to Reduce Sedentary Behaviour in Community-Dwelling Older Adults Aged ≥75

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R Tadrous 1; A Forster 1; A Farrin 2; P Coventry 3; A Clegg 1
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Introduction: Older adults are the fastest growing and most sedentary group in society. With sedentary behaviour associated with negative health outcomes, reducing sedentary time may improve overall wellbeing. This single-arm mixed-method feasibility study explored the acceptability of an intervention to reduce sedentary behaviour in community-dwelling older adults aged ≥75 years. Methods: Participants were recruited from the Community Ageing Research 75+ Study (CARE75+) cohort, with factors such as age, frailty status, living arrangements and levels of sedentariness being considered. The

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Experience of Family Caregivers for Older Patients with Delirium: A Qualitative Study

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A Mahmoud1 ; S Raghuraman1 ; E Richards2 ; L Allan1 ; R Anderson1 ; S M Trimmer 1 on behalf of the RECOVERED Study team
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Background Delirium is associated with psychological and cognitive complications that have impacts beyond the patients. Although family members and carers can play a significant role in the management and recognition of delirium, there is limited research on the experience of family caregivers in the context of delirium. This study aims to explore the needs and experiences of family caregivers for a person with delirium and offer suggestions to support them. Method A qualitative interview study with family caregivers of persons with delirium. Data were analysed using an abductive analysis

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Geriatric Medicine Competencies Required By All Hospital Doctors Caring For Older Adults: A Scoping Review

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Emily Buckley, Deirdre Bennett, Aileen Barrett, Colm O' Tuathaigh, John Cooke
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Introduction An ageing population globally has created an escalating demand for age-attuned healthcare services. There is however an insufficient number of geriatricians to meet this need. Most older adults will therefore continue to receive their medical care from doctors without specialised geriatric medicine training. It is important therefore that all doctors possess fundamental gerontological competencies. Which specific competencies and how they might best be integrated into medical education remain unclear. Our aim was to summarise the literature on the geriatric medical competencies

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Competencies Required By All Hospital Doctors Caring for Older Adults: A Group Concept Mapping Study

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Emily Buckley, Colm O’ Tuathaigh, Aileen Barrett, Deirdre Bennett, John Cooke
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Introduction The number of older adults accessing the healthcare service far exceeds the available geriatric specialist services. It is recognised that for the foreseeable future most hospital inpatient contacts with older adults will be completed by doctors not specifically trained in Geriatric Medicine. To ensure the provision of adequate healthcare, it is imperative that all hospital doctors are trained in the minimum Geriatric Medicine competencies. Allowing for the broad, complex, and multidisciplinary nature of Geriatric Medicine, we conducted a group concept mapping (GCM) study to

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Using poisons centre data to identify potential safety risks associated with the use of monitored dosage systems.

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H Price1; E Edwards2; C Thomas3; L Gray2
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Introduction Monitored dosage systems (MDS) encompass a wide range of devices to help management of medication. This research uses poison centre data to explore risks associated with their use. Method A search of accidental overdose enquiries to the UK National Poisons Information Service (NPIS) between 1/01/2017-31/12/22, classified as “therapeutic error/medical error” involving patients aged 65 or over was performed. Enquiries involving an MDS were identified. Data were analysed using descriptive statistics and chi-square test. Results There were 394 enquiries concerning 393 patients and

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NHS Staff Experiences of Racism from Patients and Carers: Survey from a London Older Persons Service

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CH Parker1,2; S Ali3; EL Sampson1,2; D Sivapathasuntharam4
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Introduction: There is growing awareness of the harms caused by racial abuse and discrimination from patients towards healthcare professionals, including anecdotal reports of patients ‘requesting a white doctor’ (Kline, BMJ Opinion, 2020); yet there is limited understanding of the impact in Geriatric settings. We conducted a survey in an inpatient Older Persons Service (OPS) on the prevalence, impact and actions taken in response to patient racism towards staff. Methods: A cross-sectional survey (Total N=47; Black and Minority Ethnic (BME) staff: N=32; White staff: N=15) of staff experiences

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Clinical assessment and documentation of delirium in older patients undergoing vascular surgery: a quality improvement project

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Dr Therese Mc Carthy, Dr Chandini Chand, Dr Rebecca Anthony
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Introduction: The Centre for Perioperative Care recommends the assessment and documentation of delirium using a validated tool such as the 4-AT in older people undergoing surgery. Aim: This quality improvement project (QIP) aimed to improve the assessment and documentation of delirium in patients aged 65 and above following vascular surgery in a tertiary centre. Methods: Patients aged ≥65 years who had undergone vascular surgery were identified and data was collected with access to the electronic patient record system. Analysis was carried out using Microsoft Excel and SPSS. Following baseline

The need for delirium education and psychosocial care after discharge: A realist analysis of interviews with key stakeholders

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S Raghuraman1; E Richards1,2; A Mahmoud1; S Morgan-Trimmer1; L Clare1,3; R Anderson1; V Goodwin1,3; L Allan1,3
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Introduction There is limited understanding of long-term delirium care after discharge from hospital for older people. A realist approach was used to investigate the contextual factors and mechanisms of care that influence recovery from delirium. Realist evaluation is fundamentally theory-driven. A preliminary programme theory was used as the foundation for theory testing and refinement, in order to develop the RecoverED intervention. Method Realist interviewing techniques were used to obtain real-world and lived experiences of delirium recovery and service use in the community for theory

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Improving communication and documentation in patients receiving End of Life care

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V Ahmad 1; K Hall 1; A Chatterjee 1
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Introduction Improvement project in response to several bereavement meetings with families reporting concerns with communication and care received during their loved ones’ end of life care (EOLC). Methods Retrospective review of 79 inpatients documentation who died between August 2021-March 2022 in comparison against the Royal College of Physicians National Care of the dying audit to identify targets for intervention. Survey of 22 members of ward staff between (January-March 23) including medical, nursing, and allied health professionals to understand confidence, clinical knowledge and

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Bone health after hip fracture; does introducing a 10 day vitamin D loading regime increase use of inpatient intravenous zoledronate?

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R Devlin1; Z Alio2; M Brown3; K Chalmers4; A Rashid5
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Background: Patients who experience a hip fracture have a high re-fracture risk. Prompt initiation of anti-osteoporosis treatment is therefore vital. Oral bisphosphonates are less well tolerated in some older people resulting in poor adherence. A single dose of IV zoledronate however, can be effective for up to 3 years and is shown to reduce fracture rate by 35% (Gregson, Age and Ageing, Vol 51, 2022). Aim: To increase use of IV zoledronate post hip fracture in Salford Royal Hospital Local barriers: a trust guideline advising a 7 week vitamin D loading regime means inpatient IV zoledronate

The British Geriatric Society's Training Programme Director survey 2023: A summary of our findings

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1.Dr Sarah True; 2.Dr Amanda Koh; 3. Dr Amit Arora
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Introduction: As we strive to generate more geriatricians we must understand the journey of the training programme. Whilst information is available from the RCP census and BGS workforce survey this study will compliment that data and obtain a broader picture. A similar survey was last undertaken by the BGS in 2019 and since that time much has changed, from a pandemic to the first published NHS Long term workforce plan. Method: TPDs were contacted directly by the BGS VP for workforce at the geriatric medicine specialty advisory committee and invited to complete an electronic survey. The survey

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Therapeutic use of film screenings for care home residents: A scoping review.

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Khalid Ali 1, 2; Andrew Hughes 2; Robert Abrams 3.
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Introduction Symptoms of depression and anxiety, with and without dementia, are common in older care home residents. It is postulated that that watching films can help residents to share emotions, enhance social connectedness and engage in reminiscence. As such, films can ameliorate depression and promote well-being. This scoping review summarises the evidence for the therapeutic benefits of film-based interventions in care homes. Methods Electronic databases MEDLINE, Embase, EMCare and CINAHL were searched for quantitative and qualitative studies in English including adults aged 65 years and

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Co-developing a qualitative study exploring the determinants of safe anti-coagulation in frail older adults.

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Khalid Ali 1,2, Ekow Mensah 2, Frances-Anne Kirkham 2, Chakravathi Rajkumar 1,2.
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Introduction Despite the knowledge that oral anti-coagulation (OAC) is effective in secondary prevention of stroke, prescribing rates are low in frail older patients with atrial fibrillation (AF), dementia, and high fall risks. A joint decision-making approach between clinicians, patients and carers is needed to negotiate the risk-benefit balance. The aim of this participatory study was to engage with a group of older adults, their carers and healthcare professionals to identify key themes that will inform a planned qualitative study exploring frail older patients’ acceptance of and adherence

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Doing nothing is NOT an option - Successful collaboration as part of wider quality improvement exercise in frailty services

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J Acharya, A Manzoor, R Lisk, R Mahmood
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Introduction: Population is growing old worldwide and UK is no exception. Health service models designed to cater the needs of service users are under immense pressure due to the aging phenomenon. With unprecedented demand, their often low acuity, hence low priority and delayed conveyance to hospital and unavailability of services to address their needs due to delayed arrival; frail older patients often have to wait longer in emergency department (ED) to receive care in ED. Innovation and news models of care are therefore need of the hour to address this challenging situation. Methods: Quality

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Emergency department attendance stratified by cause and frailty status: a national cohort study of over 155 million patients

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Balamrit Singh Sokhal1,2; Adrija Matetić2,3; Joanne Protheroe1; Toby Helliwell1; Phyo Kyaw Myint4,5; Timir Paul6; Christian Mallen7; Mamas Mamas2
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Background: Data are limited on whether the causes of Emergency Department (ED) attendance and clinical outcomes vary by frailty status. Methods: Using the Nationwide ED Sample, causes of attendance were stratified by Hospital Frailty Risk Score (HFRS). Logistic regression was used to determine adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) of ED and overall mortality. Results: A total of 155,497,048 ED attendances were included, of which 125,809,960 (80.9%) had a low HFRS (<5), 27,205,257 (17.5%) had an intermediate HFRS (5-15) and 2,481,831 (1.6%) had a high HFRS (>15). The

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Temporal Trends in Parkinson’s Disease-Related Mortality from 1999-2020: A Nationwide Cohort Study

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Balamrit Singh Sokhal1 | Sowmya Prasanna Kumar Menon1 | Thomas Shepherd1 | Sara Muller1 | Amit Arora1,2 | Christian D Mallen1
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Introduction Parkinson’s disease (PD) is the most common neurodegenerative movement disorder and is associated with significant disability. The prevalence of PD is rising and the literature demonstrates potential sex and race disparities in patient outcomes. There is a paucity of data about the demographic trends in PD-related mortality in the United States (US). This descriptive study aimed to report the national demographic trends in PD-related mortality over a 20-year period. Methods From January 1999 to December 2020, the US Centers for Disease Control and Prevention Wide-Ranging Online

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Establishing a national network of trainee representatives in geriatric medicine higher specialty training.

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1.Dr Sarah True; 2.Dr Victoria O'Brien
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Introduction : This study demonstrates how a network of geriatric medicine trainee representatives was established across the UK. The intention of the network was threefold: accurately represent the interests of trainees by gathering national feedback, develop a job description of deanery trainee representatives and create a community of practice between representatives. Method: Deanery trainee representatives were identified through TPDs then contacted to participate in an online questionnaire which also consented for whatsapp group invitation. Results: Deanery representatives were identified

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Geriatric overactive bladder & Botulinum toxin A: Feasibility and tolerability in the outpatient setting under local anaesthetic

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A Lavigne; S Foley; Katie Evans; B Yang
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Introduction Urinary incontinence significantly impacts the lives of older adults increasing their susceptibility to falls, social isolation and longterm care Intravesical Botulinum Toxin A (Botox) offers a well-established treatment for overactive bladders in women. In select centres, it can be administered under local anaesthetic, allowing access for frailer patients at higher risk from general anaesthetic and in whom anti-muscarinic therapies are best avoided. This project performed an analysis of geriatric patients who underwent intravesical Botox under local anaesthetic in an outpatient

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