bluuebunny/crossref_metadata_2025_split huggingface dataset:
2882 Frail2Fit study: a feasibility and acceptability study of an intervention delivered by volunteers to improve frailty
Authors: Meredith SJ , Holt L , Grocott MPW , Jack S , Murphy J , Varkonyi-Sepp J , Bates A , Lim SER 
Published: January 2025

Abstract

Introduction
Physical activity (PA) and replete nutritional status are key to maintaining independence and improving frailty status among frail older adults. We aimed to evaluate the feasibility and acceptability of training volunteers to deliver a remote intervention, comprising exercise, behaviour change, and nutrition support, to older people with frailty after a hospital stay.

Methods
Volunteers were trained to deliver a 3-month, multimodal intervention to frail (Clinical Frailty Status ≥5) adults ≥65 years after hospital discharge, using telephone, or online support. Feasibility was assessed by determining the number of volunteers recruited, trained, and retained; participant recruitment; and intervention adherence. Interviews were conducted with 16 older adults, 1 carer, and 5 volunteers to explore intervention acceptability. Secondary outcomes included physical function, appetite, well-being, quality of life, anxiety and depression, self-efficacy, and PA. Outcomes were measured and compared at baseline, post-intervention, and follow-up (3-months). Interviews were transcribed verbatim and analysed using thematic analysis.

Results
Five volunteers (mean age 16, 3 female) completed training, and 3 (60%) were retained at the end of the study. Twenty-seven older adults (mean age 80 years, 15 female) signed up to the intervention (10 online; 13 telephone). Seventeen completed the intervention. Participants attended 75% (IQR 38–92) online sessions, and 80% (IQR 68.5–94.5) telephone support. Self-reported total PA (p = 0.006), quality of life (p = 0.04), and appetite (p = 0.03) improved significantly post-intervention, with a non-significant decrease at follow-up. The intervention was safe and acceptable to volunteers, and older adults with frailty. Key barriers were lack of social support, and exercise discomfort. The online group was a positive vicarious experience, and telephone calls provided reassurance and monitoring to socially isolated older adults.

Conclusion
Volunteers can safely deliver a remote multimodal intervention for frail older adults discharged from hospital with training and support from a health practitioner.
2768 Needs of people with dementia in the perioperative environment from the perspective of healthcare professionals
Authors: Diaz A , Kozlowska O , Pendlebury S 
Published: January 2025

Abstract

Introduction
The incidence of dementia among patients in perioperative settings is on the rise, presenting significant challenges for healthcare professionals in delivering adequate and appropriate care to this patient population. In order to gain a deeper understanding of the perioperative care needs of patients with dementia, thirty healthcare professionals were interviewed. The focus was on their experiences and perspectives regarding the fulfilment of these needs. Key factors influencing perioperative care were identified and categorised into three main themes: patient-related factors, healthcare professional-related factors, and healthcare environment-related factors.

Methods
Thirty interviews were conducted with a diverse group of healthcare professionals, including anaesthetists, surgeons, nurses, and other perioperative staff. Thematic analysis was employed to process and interpret the data, identifying recurring themes and sub-themes that reflect the complexities of perioperative care for patients with dementia.

Results
The analysis revealed three primary themes: 1) Factors related to the patient with dementia: Cognitive impairment and comorbidities uniquely challenge perioperative care. The unfamiliar hospital environment often exacerbates cognitive symptoms, and adherence to postoperative protocols can be problematic. Family involvement is crucial in supporting these patients. 2) Healthcare Professional Factors: Perceptions of dementia, communication issues, pain assessment, and the need for personalised care were highlighted. Training and education deficits among healthcare professionals were evident, impacting the quality of care. 3) Institutional Factors: Organisational policies and resource allocation significantly affect the provision of dementia care. Support for healthcare professionals through ongoing education and the development of dementia-specific guidelines were identified as essential needs.

Conclusion
Effective perioperative care for patients with dementia requires addressing multifaceted challenges. Improving communication, enhancing education and training for healthcare professionals, involving family members, and ensuring institutional support are critical steps. A comprehensive, empathetic approach can lead to better outcomes and experiences for patients with dementia in the perioperative setting.
2873 Post traumatic stress disorder in older adults after delirium: a systematic review
Authors: Narayanasamy S , Muchenje N , McColl A 
Published: January 2025

Abstract

Introduction
Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by frightening or traumatic events. Delirium is a state of acute confusion associated with acute illness, surgery, and hospitalisation. Delirium is known to be associated with a risk of PTSD in patients in the Intensive Care (ICU) setting. However, there is limited information on the prevalence of delirium in older adults outside of Intensive Care. We therefore undertook a systematic review to ascertain the prevalence of PTSD in elderly patients after an episode of delirium on a general ward.

Methods
The systematic review was conducted using MEDLINE (1946–10/01/2024), Embase (1974–10/01/2024), and PsycINFO (1806–10/01/2024) to identify studies. Studies were eligible if they included adults aged ≥65 years, admitted to an acute hospital, diagnosed with delirium using a validated screening tool, (e.g. 4AT, CAM-ICU) and subsequently screened for PTSD at any point following discharge with a validated screening tool (e.g. the PTSS-14). The exclusion criteria excluded ICU cohorts and terminal illness with &lt;3 months life expectancy. Two researchers (SM, NM) independently reviewed all studies with any disparities resolved through a 3rd researcher (AM).

Results
After removal of duplicates, the search identified 1042 titles from which only 3 eligible studies were identified. All 3 studies were in older patients after surgical procedures (n = 132 participants in total). Two of the studies reported no association between delirium and the subsequent risk of PTSD. However, the largest study (n = 77) reported a significant independent association between delirium and the 3-month risk of PTSD.

Conclusion
The current body of research on the prevalence of PTSD following episodes of in-patient delirium in older adults is limited. The findings of this review highlight the need for further research. A prospective cohort study on Geriatric Medicine wards is being planned.
2796 Improving physical health care in older people in mental health settings: the ImPreSs-care qualitative study
Authors: Hickey B , Desai B , Davies F , Chari D , Evley R , Clegg C , Donovan A , Rajkumar AP , Dening T , Subramaniam H , Mukaetova-Ladinska E , Robinson T , Tarrant C , Beishon L 
Published: January 2025

Abstract

Background
The overlap between physical and mental health is a common challenge for older adults, and many live with co-occurring physical and mental health disorders. Different service models have been adopted; however, the majority provide specialist mental health input to older adults with physical health needs in acute hospital trusts. Few service models are available providing comprehensive physical health input to older adults in secondary mental healthcare settings. Furthermore, little information is available regarding specific physical healthcare needs facing older people receiving specialist mental healthcare. The aim of this qualitative study was to determine the facilitators and barriers to delivering physical healthcare for older adult patients, their carers, and staff within specialist mental health settings (inpatients and community).

Methods
54 semi-structured interviews (REC:22/IEC08/0022) were conducted with different stakeholders (staff (n = 28), patients (n = 7), carers (n = 19)) across two mental health trusts (Leicester, Nottingham). Interviews explored the facilitators and barriers to delivering physical healthcare to older people (aged &gt;65 years) receiving secondary mental healthcare (dementia and functional disorders) with combined physical health needs. Interviews were audio recorded and transcribed verbatim. Data were analysed thematically, drawing on an underpinning framework of integrated care for individuals with multimorbidity (SELFIE).

Results
Three main themes were identified: 1) service delivery; focussing on care coordination and communication between services, 2) workforce; focussing on training and skills alongside support and availability of physical health expertise, 3) the individual with multimorbidity; focussing on mental-physical health interplay and patient experience.

Conclusions
The findings from this study can be used to inform service development to improve the provision of physical healthcare for older people receiving secondary mental healthcare in the UK, focussing on improving care coordination and communication between physical and mental health services, and upskilling and training mental health teams in physical health provision with appropriate support from physical health experts.
Coagulation abnormalities following brown recluse spider (Loxosceles reclusa) envenomation: A description of 2 cases and review of the literature
Authors: Hart Stephanie A , Gailani David , Bibb Lorin A , Zwerner Jeffrey P , Booth Garrett S , Jacobs Jeremy W 
Published: January 2025

Abstract

Objective
Hemostatic abnormalities, including disseminated intravascular coagulation (DIC), are often cited as a common finding in patients following Loxosceles spider envenomation (ie, loxoscelism). The prevalence and severity of coagulopathy, however, particularly following L reclusa (ie, brown recluse) envenomation, is not well described. This study aimed to characterize coagulation laboratory parameters and coagulopathy in patients following L reclusa envenomation.

Methods
We evaluated the coagulation laboratory parameters (eg, prothrombin time, partial thromboplastin time, coagulation factor activity levels, lupus anticoagulant [LA] testing) of 2 patients seen at our institution following brown recluse spider envenomation. We also comprehensively reviewed the literature for all reported cases of brown recluse spider envenomation and assessed patient demographics, clinical presentations, coagulation laboratory parameters, and outcomes.

Results
We identified 2 patients with loxoscelism (1 cutaneous only, 1 systemic with hemolysis) with prolonged partial thromboplastin times but with normal clotting factor levels following envenomation. Literature review identified 263 patients: 12 patients had at least 1 prolonged clotting time, 31 reported a platelet count below 150 × 109/L, and there was clinical concern for DIC in 12 cases. The odds of death were statistically significantly higher in patients with clinical concern for DIC than in cases without concern for DIC or coagulopathy (odds ratio, 82.9 [95% CI, 12.6-433.8]; P &lt; .001).

Conclusions
Following brown recluse spider envenomation, hemostatic perturbations are infrequent and clinical coagulopathy is uncommon, but the odds of death following a brown recluse spider bite are statistically significantly greater if DIC develops, even when compared to individuals with hemolysis without DIC.
Keynes and the Provincial investment problem
Authors: Woods J E 
Published: January 2025

Abstract
From early 1924 until his death in 1946, Keynes was actively involved in managing the assets of the Provincial Insurance Company, based in Kendal, Westmorland. From 1940, increasing responsibilities advising the UK Government meant a gradual reduction in day-to-day management activities, his replacement being Ian Macpherson, the senior partner of the London stock-broking firm, Buckmaster & Moore, who was well known to both Keynes and F. C. Scott, The Provincial’s managing director. The Provincial materials reproduced in Chapter 1 of Volume XII of The Collected Writings suggest increasing differences of opinion between them on investment policy from the late 1930s. A review of their correspondence in the Keynes Archive at King’s College, Cambridge, demonstrates that such differences were more serious than previously understood, with Scott imposing a significant change to Keynes’ policy in 1942 by creating the low-volatility Stable Fund accounting for 40% of total assets. Eventually, in mid-1944, this change presented Macpherson with a problem he described to Keynes as ‘most intractable’ and also involved him telling Keynes that Scott ‘does not understand the elementary principles and theory of investment’. In this article, we review Keynes’ relationship with The Provincial, tracing the development of this ‘most intractable problem’ by means of three Case Studies, which provide insights into not only his role at The Provincial but also the principles underlying the unconventional, oblique investment approach he practised in the 1930s and 1940s, as distinct from his credit cycling policy of the 1920s.
COVID-19 among Kidney Transplant Recipients: Evaluating Risk Factors During the Initial Phase of the Pandemic
Authors: Nowak Alexandra , Caldinelli Aurora , Segelmark Mårten , Rydell Helena , Artborg Angelica , Bellocco Rino , Stendahl Maria , Lindholm Bengt , Wijkström Julia , Evans Marie 
Published: January 2025

Abstract

Background
Current knowledge about risk factors for severe COVID-19 among kidney transplant recipients stem from meta-analyses of small or regional studies.

Methods
All kidney transplant recipients in Sweden as of January 1, 2020 (n = 5 824) were followed during the first two years of the pandemic. Data from the Swedish Renal Registry and linked health care registries were analysed by multivariable adjusted logistic regression to identify risk factors for severe COVID-19, defined as hospitalization or death due to COVID-19.

Results
Male sex increased the risk of severe COVID-19. While many comorbidities were associated with increased risk, their significance diminished after adjustment for other factors. Kidney transplant recipients of working age, 49–58 years adjusted odds ratio (aOR) 2.32 (95% CI 1.53–3.51) and 59–68 years aOR (1.92; 1.26–2.91) had the highest risk compared to the youngest age group (18–38 years). Compared to recently (&lt;1 year) transplanted patients, those transplanted more than 5 years ago had lower the risk of severe COVID-19 (aOR 0.52; 0.36–0.75 for 6–10 years; aOR 0.57; 0.41–0.79 for &gt; 10 years). Longer pre-transplant dialysis vintage (aOR1-year 1.04; 1.01–1.06) and deceased donor kidneys (aOR 1.41; 1.09–1.84) increased the risk. Immunosuppression with mycophenolate mofetil (aOR 1.47, 95% CI 1.08–1.99) and proton pump inhibitor use (aOR 1.58, 95% CI 1.24–2.01) was strongly associated with severe COVID-19.

Conclusions
While kidney transplant recipients share risk factors with the general population, working age groups were at the highest risk- unlike in the general population. These findings emphasize the need for targeted prevention and treatment strategies for kidney transplant recipients in future pandemics.
Prevalence and Correlates of Social Isolation Among Older Adults in Subsidized Housing
Authors: Wu Richard , Pomeroy Mary Louise , Prichett Laura , Duchen Jessica , Runge Katherine , Andes Laura , Williams Nicole , Thorpe Roland J , Latkin Carl , Boyd Cynthia , Cudjoe Thomas K M 
Published: January 2025

Abstract

Background and Objectives
Social isolation is an increasing public health concern. Older residents in subsidized housing may be susceptible to isolation given high rates of chronic illness/disabilities, low income, and living alone. This cross-sectional study examined correlates of social isolation among over 3,000 older adults from nearly 100 subsidized housing communities across the US.

Research Design and Methods
Respondent Lubben Social Network Scale-6 scores, demographic data, and health information were collected in 2019 by a non-profit housing organization and linked to the Neighborhood Atlas Area Deprivation Index. Associations between social isolation and other variables were assessed using logistic regression.

Results
The mean respondent age was 75.9 years; 67% were female, 33% were male, 38.8% were white, 15.5% were Black, 7.8% were Hispanic, and 27.5% were Asian. Among all respondents, 29.8% were isolated. Adjusting for demographics, multi-level logistic regressions demonstrated significant associations between isolation and poor self-rated health, functional impairment, mental health distress, and knowing/relying on fewer neighbors.

Discussion and Implications
This study sheds light on the prevalence and correlates of social isolation among older adults who live in subsidized housing managed by a large non-profit housing organization. The findings from this study suggest that contextual and structural factors must be further investigated to better understand social isolation among older subsidized housing residents. Ultimately, this work informs efforts to identify socially isolated older adults and evidence-based interventions to address this public health concern.
The association between oxidative stress and risk of sarcopaenia: a Mendelian randomisation study
Authors: Ma Yiqin , Yang Dan , Zhao Xiaoxuan , Wang Rongyun 
Published: January 2025

Abstract

Objective
This study aimed to evaluate the causal link between oxidative stress and sarcopaenia using Mendelian randomisation.

Methods
Instrumental variables (IVs) at the genome-wide significance level were gathered from a published summary database, and the inverse variance weighted approach and many other Mendelian randomisation (MR) methods were used to assess the causal relationship between oxidative stress and risk of sarcopaenia.

Results
Inverse variance weighting analysis showed absolute α-tocopherol levels and absolute circulating retinol levels had a direct causal effect on handgrip strength. In addition, walking pace was linked to genetically predicted circulating α-tocopherol and superoxide dismutase (SOD). However, genetically predicted oxidative stress-related characteristics did not exhibit any causal relationship with appendicular lean mass.

Conclusions
Our findings indicate that α-tocopherol and retinol boost grip strength and life quality in sarcopenia. Despite affecting walking pace, SOD's protection suggests gait speed can improve with antioxidant adjustments.
Direct economic costs related to antimicrobial resistance in bloodstream infections isolated from newborns in a perinatal hospital in Peru
Authors: Pons Maria J , Quispe Antonio M , Tirado Miguel , Soza Gabriela , Ruiz Joaquim 
Published: January 2025

Abstract

Background
Antimicrobial resistance (AMR) has emerged as a priority for both public health and the global economy. Moreover, information on AMR is scarce, particularly in low/middle-income countries. We evaluated the direct economic cost of microorganisms and AMR.

Methods
We performed a cross-sectional study to assess the economic costs of neonatal cases diagnosed with bacteremia at the Instituto Nacional Materno Perinatal in Lima, Peru, from January 2017 to June 2018. We used cost invoices calculated by the micro-costing bottom-up approach, as well as the strain identification and antimicrobial susceptibility data, to estimate the direct costs.

Results
The average costs of bacteremia were US$349 (SD 403) for multidrug-resistant (MDR) strains and US$276 (SD 349) for non-MDR strains. Costs were higher for microorganisms associated with late-onset sepsis (LOS). We found that LOS, multidrug resistance and age were significantly associated with bloodstream infection (BSI) costs. Also, all microorganism groups were associated with increased costs, with the highest average costs for Acinetobacter, followed by Pseudomonas.

Conclusions
In Peru, BSI costs are strongly associated with AMR. Furthermore, costs increase significantly with LOS, multidrug resistance and the patient's age. We urge health authorities to strengthen measures and strategies against the pressing threat of AMR.
A Reconception of Power in Competition Law with Its Application in the Digital Realm
Authors: Li Liang 
Published: January 2025

Abstract
As a fundamental concern of competition law, the concept of power remains inadequately understood. The limitations have become increasingly evident in the digital economy realm where new challenges have often not been addressed promptly, coherently, and effectively. Although new theories and analytical tools have been proposed, they frequently result in overlaps and gaps. There is a pressing need to establish a more coherent theoretical foundation that integrates traditional and emerging theories of power. Tapping into legal philosophy and global empirical evidence, this article proposes a reconceptualization of power as an overarching theoretical framework. This reconceptualization differentiates between power as capacity and its exercise, classifies the various forms of power exertion, and identifies several distinct types of power. The reconceptualization elucidates how different types of power—such as economic, political, informational, and technological—all contribute to power dynamics in markets. By broadening the dimensions of power analysis in competitive assessment, the proposed understanding of power frees legal discourse from the limitations of a purely economic perspective. The Facebook/WhatsApp merger is analysed as an illustration. However, the proposed conception is also relevant for assessing other competitive issues, such as the power interplay between economic and noneconomic factors like privacy and personal data protection, and democracy.
Group Cognitive Behavioral Therapy for PTSD
Authors: Beck J. Gayle 
Published: January 2025

Abstract
Group Cognitive Behavioral Therapy (CBT) for PTSD: Therapist Guide provides session by session guidance for clinicians to deliver Cognitive Behavior Therapy (CBT) in a group setting to clients with PTSD. It overviews best practices derived from group therapy literature, with evidence-based cognitive behavioral approaches targeting PTSD and frequently co-occurring conditions. The co-occurring conditions include depression, anxiety, and social isolation. Moreover, Group CBT has been tested and shown to reduce symptoms of PTSD and improve quality of life, overall functioning, and life satisfaction. The Therapist Guide also offers helpful notes and worksheets dedicated to each session based on the clinical experience working with people with PTSD.
Session 1: Education About PTSD and Group CBT
Authors: Beck J. Gayle 
Published: January 2025

Abstract
This chapter outlines the basic information that therapists should provide to clients who are beginning group cognitive behavioral therapy for posttraumatic stress disorder (PTSD). Group CBT is based on a structured approach to treatment, designed to help clients build skills for handling posttrauma problems and develop a better sense of control. Therapists should explain how trauma can develop into PTSD. This chapter provides an overview of the treatment program, introducing a series of skills designed to help clients cope with problems related to the trauma. The therapists should emphasize the importance of maintaining confidentiality so that clients can discuss their feelings openly.