Articles: aged.
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To assess the clinical impact on generally healthy older Australians of changing from the 2009 CKD-EPI (CKD-EPI2009) to the 2021 CKD-EPI (CKD-EPI2021) equation for calculating the estimated glomerular filtration rate (eGFR). ⋯ Using CKD-EPI2021 would yield higher eGFR values than the CKD-EPI2009, substantially reducing the proportion of older Australian adults classified as having CKD, without any overall difference in long term health outcomes for people reclassified to less advanced CKD stages. Using the CKD-EPI2021 could markedly reduce the number of referrals of generally healthy older adults to specialist nephrology services.
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Emerg Med Australas · Feb 2025
A pilot trial exploring the use of music in the emergency department and its association with delirium and other clinical outcomes.
To assess potential feasibility of a targeted music intervention trial in older ED patients and association with clinical outcomes. ⋯ Self-selected use of a targeted music intervention was feasible in a cohort of older ED patients. While we were likely underpowered to detect associations between intervention and outcome, collection of selected outcome measures proved feasible; these may be helpful in larger scale studies. Exploration of barriers and facilitators to use, as well as preferred delivery methods, are likely to be helpful in wider investigations of music therapy in this high-risk cohort.
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Older adults with multimorbidity are underrepresented in clinical trials, with enrollment of Asians particularly low. ⋯ Chinese older adults perceived obstacles to clinical trial participation that could be mitigated by involving trusted physicians in recruitment, using language and culturally concordant materials/staff, and educating patients and community-based physicians. Recognition of differences in attitudes among US- and non-US-born Chinese people may be important to tailoring recruitment strategies.
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Transfer of patients between hospitals is common, costly, and over 20 % are estimated to be avoidable, meaning patients do not receive specialized interventions once transferred. Older adults are more likely to be transferred and may be at increased risk for developing delirium or other complications due to transfer. We aimed to determine the frequency of potentially avoidable transfer (PAT) among older adults; identify conditions most likely to involve a PAT; and describe factors associated with PAT. ⋯ PATs were common in transfers of older adults, particularly among a subset of neurologic, cardiovascular, and injury-related conditions. These conditions may represent ideal targets for intervention to decrease rates of avoidable transfer. Research exploring hospital variation in transfer practices and the impact of PAT on older adults' health outcomes are also needed.
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Explore factors influencing pain management among female breast cancer survivors aged 65+ years with moderate to severe pain based on a score of 4 or greater on the 0-10 numeric rating scale. ⋯ Providing contact information for care team members during and after clinic hours facilitates open communication, including timely reporting of new and undertreated pain. Collaborating with the patient and care team on a clear pain management plan and establishing parameters for when to notify the care team empower patients to optimize management of their pain. Verifying patients' understanding of prescribed analgesia and management of side effects and providing education as needed may reduce negative perceptions of opioid analgesia.