bluuebunny/crossref_metadata_2025_split huggingface dataset:
2787 Supporting older ethnic minority groups in Brighton and hove to engage with research through digital means
Authors: Coleman L , Mensah E , Mukhopadhyay R , Ali K 
Published: January 2025

Abstract

Introduction
People from ethnic minorities are 1.5 times less likely to use digital technology. Within Brighton and Hove, 2021 Census reports that 26.1% described themselves as non-White-British categorised as other White (11.5%), Mixed Race (4.8%), Asian (3.7%), Black (2.0%), Chinese (1.1%), Arab (1.1%), and Other (2.0%). The aim of the project was to understand the lived experience of older ethnic minority adults in Brighton and Hove with digital technology, and how this experience affects their potential engagement with research.

Methods
Older people from ethnic minorities were identified through Brighton and Hove Health Watch, Bridging Change, Sussex Interpreting Services, and Black and Minority Ethnic Partnership. Using a mixed-methods approach, focus group and one-to-one meetings were held with 22 people, exploring their digital literacy, using a Likert scale, and preferences for research engagement using digital means. Meetings were transcribed and thematic analysis was undertaken.

Results
The group average age was 71.6 years. Six identified as male, 16 as female, and confidence with digital technology averaged 3/5 (5 representing high confidence). Variation of digital skills was observed, with older age and language barriers limiting digital access. Digital technology was used for social, transactional and health purposes (booking GP appointments, receiving test results, and GP consultations). Trust and confidence in the research team enhanced the group’s likelihood to engage digitally. Explaining the research in their own language would be an incentive. Younger family members can help explain digital elements. Offering choice of digital alongside traditional methods was important. There was a preference for initial research conversations to be in person. Willingness to engage is higher when the research topic is common in their community or they are personally affected.

Conclusions
Older people from ethnic minorities in Brighton and Hove are willing to engage in research using digital means if tailored to their social circumstances.
2793 Virtual wards for people with frailty—evidence to think anew?
Authors: Westby M , Ijaz S , Savović J , McLeod H , Dawson S , Welsh  , Le Roux H , Walsh N , Bradley N 
Published: January 2025

Abstract

Introduction
Increasing prevalence of people living with frailty is a key challenge to healthcare providers. One solution may be virtual wards (VWs). Our research sought to: examine different frailty VW models; and determine how, why and under what circumstances VWs may work effectively. During our early research, NHS England (NHSE) started roll-out of short-term VWs intended to treat acute patients with frailty crises at home instead of hospital. We expected our work to inform NHSE policy, especially how to ‘do’ VWs better.

Methods
We conducted a rapid realist review of frailty VWs, searching published and grey literature for evidence on multidisciplinary VWs based in the UK, using a literature-based definition of VWs. Information on how and why VWs might ‘work’ was extracted and synthesised iteratively into context-mechanism-outcome configurations (CMOCs). Throughout we engaged closely with clinicians and patient/public contributors. The iterative nature of the realist review led to emerging understanding.

Results
From 28 documents, we identified two VW models: longer-term, proactive care wards admitting patients at high risk of a frailty crisis; and short-term reactive care wards for people experiencing a frailty crisis. Using evidence from both models, we generated 12 CMOCs, under three themes. First, building blocks for effective VW operation (e.g. common standards agreements, information sharing, a multidisciplinary team planning patient care remotely). Second, how the VW delivers the frailty pathway (e.g. patient selection, assessment, proactive care). Third, Patient/Caregiver empowerment. Mechanisms included motivating professionals (e.g. a ‘team-of-teams’); buy-in; building relationships: professionals, patients and caregivers. VWs should be set within frailty management guidance, and a whole-system approach to care is needed. For sustainability of VWs, proactive care for people at high risk of a frailty crisis should be provided.

Conclusions
This review has implications for optimal implementation and sustainability of frailty VWs, through proactive care and a whole system approach.
2886 Video-based patient Records for Supporting Care Delivery for older adults with frailty: the Isla for frailty feasibility study
Authors: Averill P , Lear R , Odedra R , Long S , Taylor A , Charville P-J , Fernandes J , Nwobilo U , Ollivierre-Harris T , Ellis S , Mayer EK 
Published: January 2025

Abstract

Introduction
Written documentation and verbal handovers can be ineffective at communicating the specifics of frail, older patients’ complex functional abilities and support needs. Video-recordings of individual patients may help to convey a patient’s condition in a more nuanced, objective way, potentially improving safety at care transitions. The Isla platform interfaces with electronic health record systems, allowing care providers to capture video-recordings during patient care. We evaluated the acceptability, feasibility, and potential effectiveness of video-based patient records (the Isla platform) for supporting the care of older frail inpatients within the acute hospital setting and at care transitions.

Method
Over a three-month pilot period, a non-randomised, mixed-methods feasibility study of video-based patient records (alongside usual care) was conducted within three elderly medicine wards of a large acute hospital in England. Patient and public involvement and engagement (PPIE) was central to study design and implementation. Participant enrolment figures; semi-structured interview data; and video capture and view metrics were examined within an embedded process evaluation, appraising intervention acceptability among patients, carers, and ward staff; barriers and facilitators to intervention implementation; and perceived intervention impacts.

Results
The study enrolled 57 ward staff and 29 patients (56.9%); one patient withdrew. Enrolment figures and early interview analyses indicate apparent acceptability of video-based patient records to patients and carers. Intervention barriers (e.g. patient pain), facilitators (e.g. staff-patient rapport) and potential intervention impacts (e.g. improved person-centred care, team communication) were identified. Modal use-cases for video-recordings were to document patients’ transfers (n = 16), mobility (n = 13), and eating/drinking supports (n = 3); however, view metrics suggested limited engagement with videos once captured.

Conclusion(s)
Preliminary findings indicate the acceptability and feasibility of video-based patient records, although several implementation considerations warrant address. Perceived intervention impacts (e.g. improved person-centred care) were promising; although greater engagement with videos is a probable precondition to demonstrating efficacy in future research.
2788 Exercise trainers as key enablers in the remote delivery of dementia prevention interventions in the homes of older adults
Authors: Tranchant CC , Gallibois M , Handrigan G , Omar H , Yetman L , Haché J , Faig K , Jarrett P , Bohnsack A , McGibbon CA 
Published: January 2025

Abstract

Introduction
Social support for physical activity is important for engaging older adults in physically active lifestyles. Few studies examined the impact of individual exercise trainers (IETs) in the context of dementia prevention interventions with physical activity. We aimed to assess the contributions of IETs in the remote delivery of a home-based dementia prevention program combining physical exercise and cognitive training targeting older adults at risk for dementia.

Methods
Convergent mixed-method analysis was conducted using data from SYNERGIC@Home, a feasibility study of a 16-week intervention that included one-on-one supervised physical exercise (3 sessions/week) fully delivered through Zoom. Quantitative data consisted of descriptive statistics, measures of adherence, participants’ preference and satisfaction. Qualitative interviews centred on participants’ experience and motivation were conducted post-intervention.

Results
Of the 60 participants randomised to one of four intervention arms (mean age 68.9, 76.7% female), 52 completed the interventions with high overall adherence (87.5%). Pre-intervention, participants expressed a clear preference for cognitive interventions, but post-intervention preference shifted to exercise. IETs (n = 21) were part-time research assistants, each assigned to one participant after completing CSEP Certified Personal Trainer® or Clinical Exercise Physiologist™ certification as part of their training. One full-time Lead IET coordinated and supervised the other trainers. IETs worked the closest with study participants, also working closely with study coordinator and with study physician for adverse event monitoring. Interviewed participants (n = 15) often described the positive relationships that developed with their IET. Trainers were instrumental in participants’ motivation and enjoyment, personalising the sessions and addressing technological issues. Satisfaction rates with IETs (n = 54 exit survey respondents) were high.

Conclusions
Exercise trainers played crucial roles that extended beyond the supervision of exercise sessions and contributed to participant engagement in the interventions. Access to these allied health professionals should be featured more prominently in strategies/programs promoting active lifestyles among older adults.
2830 A systematic review of the association between ethnicity and frailty prevalence, incidence, trajectories and risks
Authors: Khan M , Nicholl B , Macdonald S , Hanlon P 
Published: January 2025

Abstract

Background
Ethnic variations in frailty are poorly understood. This systematic review examined ethnic variations in frailty prevalence, incidence and trajectories; associations between frailty and sociodemographic/lifestyle risk-factors; and health-related outcomes of pre-frailty and frailty.

Methods
We searched four electronic databases from 2000 to April 2023 using terms for ethnicity and frailty. Inclusion criteria: observational studies assessing frailty in adults ≥18 years from community-based settings, including care homes; ethnicity defined by race, country of birth, language, ancestry, or culture. We supplemented searches with manual citation and reference list searches. Primary outcomes: prevalence, incidence, and transitions of frailty. Secondary outcomes: factors associated with frailty and health-related outcomes (e.g. falls, hospital admissions, mortality). Two reviewers independently screened all articles; conflicts were resolved by a third reviewer.

Results
We included 80 studies, representing data from 13 countries plus two multi-national samples from 15 European and 10 Asian countries, respectively. Across settings, frailty prevalence was higher in minority groups (including Black or Hispanic people in USA, South Asian or Black people in UK, Moroccan or Surinamese in the Netherlands, ‘non-white’ groups in South America, Māori in New Zealand, and non-Han groups in China) compared to majority groups (White in most settings, or Han in studies in China). Ethnic differences appear sensitive to methods used to measure frailty. Two US-based studies found that ethnic differences were independent of sociodemographic differences. Six studies from USA or UK showed that Black and South-Asian people, respectively, had higher frailty incidence or more rapid frailty progression. There were no significant differences in mortality risk of frailty between ethnic groups.

Conclusion
Ethnic variation in frailty prevalence and dynamics persist across multiple settings, with minority groups adversely impacted. Future research should seek to explain ethnic differences in frailty measurement. Interventions targeting frailty need to take account of structural inequalities faced by minority groups.
2844 ‘You are as frail as your arteries’—exploring the correlation between frailty, and chronological and vascular age parameters
Authors: Mukhopadhyay R , Mensah E , Kirkham F-A , Shwe PS , Ali K , Rajkumar C 
Published: January 2025

Abstract

Introduction
Thomas Sydenham, English physician stated, ‘a man is as old as his arteries’. Chronological age has been noted to correlate strongly with vascular/biological age. However, little is known about how chronological and vascular parameters of ageing, correlate with frailty. In this study, we sought to study the correlations between frailty, chronological age and parameters of vascular ageing.

Methods
Data from two studies with participants aged ≥60 years investigating the associations between Cytomegalovirus infection and frailty indices and vascular parameters were included. Two hundred and sixty community dwelling adults were enrolled in both studies. Vascular parameters were measured by cardio-ankle vascular index (CAVI) using VaSera VS-2000® and pulse wave velocity-PWV (carotid-femoral and carotid-radial) using COMPLIOR®. Hand grip strength (HGS) and Charlson co-morbidity index (CCI) were measured for clinical frailty data. Patients were excluded if they had malignancy, were on active treatment for cancer or were unable to give consent.

Results
There were 260 study participants, (mean age ± SD; 72 ± 8 years), with gender distribution M:F (50:50). Chronological age strongly correlated positively with vascular ageing parameters such as CAVI (r = 0.6, p &lt; 0.001) and cf-PWV (r = 0.5, p &lt; 0.01). Similarly, chronological age correlated positively with CCI (r = 0.7, p˂0.001) and negatively with HGS (r = − 0.3, p˂0.001). Vascular ageing as measured by CAVI (estimated CAVI age) correlated positively with CCI (r = 0.5, p &lt; 0.01) and negatively with HGS (r = −0.2, p = 0.01). Other measures of vascular ageing such as cf-PWV positively correlated with CCI (r = 0.4, p &lt; 0.01) and negatively with HGS (r = − 0.1, p = 0.09).

Conclusion
Clinical frailty parameters correlate strongly with measures of vascular ageing and chronological age. Vascular ageing is a strong independent predictor of frailty.
2660 Drug classes associated with geriatric readmissions: the canary in a coal mine
Authors: Loh KY , Tay L 
Published: January 2025

Abstract

Introduction
Older adults are at increased risks of drug-related problems, contributed by increasing incidence of multimorbidity with age, and the consequent polypharmacy. We aim to investigate the drug classes associated with 30-day readmissions in hospitalised older adults.

Method
We prospectively studied patients aged 65 years and above admitted to a general medical department in Sengkang General Hospital, Singapore, between October 2018 and January 2020. Medication lists were obtained from electronic medical records at admission. Unplanned readmission within 30 days of discharge was tracked through the hospital’s electronic health records. Medications were classified according to the World Health Organisation’s Anatomical Therapeutic Chemical classification system. Univariate logistic regression was performed for the association of drug classes with 30-day readmission.

Results
We recruited 1507 consecutive admissions with follow-up data. 30-day readmission occurred in 331 patients (22.0%). Greater length of stay, higher comorbidity burden, hospitalisation in the year preceding index admission, frailty and polypharmacy were more commonly observed among patients who were readmitted within 30 days of discharge. Admission diagnoses associated with 30-day readmission include infections, fluid overload, acute coronary events and constipation. Drg classes associated with a higher risk of 30-day readmission include drugs for acid-related disorder (OR = 1.62, 95%CI 1.27–2.07), drugs for constipation (OR = 1.96, 95%CI 1.41–2.73), antithrombotic agents (OR = 1.40, 95%CI 1.09–1.79), antianaemic preparations (OR = 2.22, 95%CI 1.68–2.91), cardiac therapy (OR = 1.70, 95%CI 1.23–2.34), diuretics (OR = 1.41, 95%CI 1.04–1.90), beta-blocking agents (OR = 1.55, 95%CI 1.21–1.99) and analgesics (OR = 1.56, 95%CI 1.02–2.39).

Conclusion
Drg classes associated with 30-day geriatric readmissions include drugs for acid-related disorder, constipation, antithrombotic agents, antianaemic preparations, cardiac therapy, diuretics, beta-blocking agents and analgesics. Patients on the above drug classes should herald a higher index of scrutiny during admissions and necessitate closer follow-up upon discharge.
2855 Dementia in elderly individuals with depression: a systematic review and Meta-analysis of longitudinal studies (2013–2024)
Authors: da Costa Galvão PE , de Sousa Romeiro AM , de Souza GLC Branco , Prudente TP , Dias EMV , Nogueira TE , Silveira EA 
Published: January 2025

Abstract

Introduction
With population ageing comes challenges like dementia, prompting the urgent identification of risk factors and its associations with other psychiatric disorders. This review aims to explore the connection between depression and the onset of mild cognitive impairment (MCI) or dementia through recent literature analysis.

Methods
Systematic review and meta-analysis, following PRISMA recommendations, with studies from 2013 onwards. The search strategy ‘Depression’ AND ‘Dementia’ AND ‘Aged’ was employed in the Cochrane, Embase, LILACS, PubMed, Scopus, and Scielo databases. Cohort studies in Portuguese, English, or Spanish were included, while reviews or clinical trials were excluded. The meta-analysis was conducted using RevMan software, employing unadjusted OR effect measures for exposure in the Forest Plot graph. Study heterogeneity was calculated using the I2 statistic, with a cutoff point of &gt;75% indicating high heterogeneity.

Results
The search strategy identified 3394 articles, screened by title and abstract. Of these, 187 were fully read, and 26 were included in the review. The most used tool for assessing depressive symptoms was the Geriatric Depression Scale (38.4%), while the Mini-Mental State Examination was the most frequently used tool for assessing symptoms of MCI and dementia (26.9%). The quantitative analysis included 14 studies evaluating dementia and 8 studies evaluating MCI. The likelihood of older adults with depression developing dementia was 1.75 times higher than in the non-depressed population (OR = 1.75; 95% CI 1.46–2.11). Additionally, a twofold increase in the likelihood of developing MCI was found in depressed older adults (OR = 2.03; 95% CI 1.44–2.88). All analyses revealed high heterogeneity.

Conclusion
Depression was found to be associated with higher likelihood of developing MCI or dementia in older adults. Understanding this complex relationship with new studies and reviews is crucial for developing targeted interventions and improving the prognosis for individuals affected by both conditions.
2763 Process evaluation of the BASIL+ trial: addressing low mood among older people
Authors: Bosanquet K , Newbronner E , Coventry P , Shearsmith L , Littlewood E , Bailey D , Henry A , Burke L , Ryde E , McMillan D , Ekers D , Gilbody S , Chew-Graham CA 
Published: January 2025

Abstract

Introduction
During the COVID-19 pandemic, older adults were at risk of being socially isolated or experiencing loneliness, increasing the risk of depression. We adapted the delivery of Behavioural Activation (BA), an effective evidence-based intervention for depression in older adults and people with multiple long-term conditions (LTCs), so it could be delivered remotely under COVID-19 restrictions.

Method
The qualitative study was nested within the BASIL+ definitive randomised controlled trial (https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(23)00238-6/fulltext). Semi-structured telephone interviews were conducted with 24 older adults, two caregivers and 16 BASIL Support Workers (BSWs). They were digitally recorded and transcribed professionally. Data were analysed thematically using constant comparison.

Results

Conclusion
Findings suggest a BASIL+ style intervention should become more widely available for older adults with LTCs and low mood, given its positive impact on most participants and its remote delivery by non-specialist practitioners.
Improving care in elderly neurosurgery initiative guideline on management of chronic subdural haematoma in older people-relevance for the geriatrician
Authors: Rickard Frances , Cox Anthony , Willliams Adam , Mortimer Alex , Wigfield Crispin , Shipway David 
Published: January 2025

Abstract
Chronic subdural haematoma (cSDH) is a common subtype of traumatic brain injury, typically affecting older people living with frailty and multimorbidity. Until now, no published guideline has existed internationally to guide management, perhaps explaining why the care of the older cSDH patient varies between neurosurgical centres.
The Improving Care in Elderly Neurosurgery Initiative guideline is the first guideline dedicated to the care of patients with cSDH across the entire patient pathway, from initial presentation through to rehabilitation and discharge after surgery. It includes specific recommendations for those patients not requiring surgery who, in the UK, are mostly managed in satellite hospitals away from the tertiary neurosurgical centre. It therefore has relevance to clinicians across the entire UK and also potentially to a broader international audience.
In this guideline commentary we summarise the key points for geriatricians and those allied specialties such as acute medicine who deliver care to a large proportion of patients with cSDH.
We discuss issues and limitations relating to guideline development, in particular in the rapidly evolving field of Middle Meningeal Artery Embolisation. We also comment on factors which may influence guideline implementation and future service development. Finally we call for some form of national registry in older people sustaining SDH, which may need to be supported by financial incentives to drive investment in services for this historically neglected patient group.
Comparison of trends in CPS reports of child maltreatment and child maltreatment-related mortality across time, place and race/ethnicity
Authors: Goitom Saron , Neumann Krista , Veazie Stephanie , Farkas Kriszta , Ahern Jennifer , Mason Susan M , Riddell Corinne A 
Published: January 2025

Abstract
Background: Child maltreatment is a persistent public health problem in the United States. Child Protective Services (CPS) data are the de facto data source for child maltreatment surveillance, despite these data’s established limitations. Maltreatment-related mortality could be a complementary source of child maltreatment surveillance data.
Methods: We calculated trends over time, and patterns across state and by race/ethnicity, comparing child maltreatment report rates to child maltreatment-related mortality rates, between 2005 and 2020.
Results: These two measures of maltreatment show different time trends and patterns by state and race/ethnicity. Time trends in maltreatment-related mortality decreased slightly across the study period for all racial/ethnic groups, while maltreatment report rates increased, particularly for Non-Hispanic Black children. Reports and mortality data revealed very different pictures of which states had the highest and lowest maltreatment rates, overall and by race/ethnicity. Only 14 states had report and mortality rates in the same tertile, with less alignment when stratified by race/ethnicity.
Discussion: Patterns in child maltreatment report rates and death rates do not align. Future work should consider additional sources of data to improve maltreatment surveillance. These findings highlight the need to identify a valid and consistent approach to capture patterns of maltreatment in the United States.