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Strategies For Risk Reduction and Management of Older Adults With Cardiovascular Disease During the COVID-19 Pandemic Strategies For Risk Reduction and Management of Older Adults With Cardiovascular Disease During the COVID-19 Pandemic - American College of Cardiology ') Search All Types Search or Menu . This article was authored by Nicole M. Orr, MD, FACC , and the Geriatric Cardiology Council. Share via: Clinical Topics: Keywords: Aged, SARS Virus, Angiotensin Receptor Antagonists (...) , Hydroxychloroquine, Mineralocorticoid Receptor Antagonists, Caregivers, Angiotensin-Converting Enzyme Inhibitors, COVID-19, Coronavirus, Coronavirus Infections, Neprilysin, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Neprilysin, Chloroquine, Subacute Care, Social Isolation, Skilled Nursing Facilities, Cardiovascular Diseases > > Strategies For Risk Reduction and Management of Older Adults With Cardiovascular Disease During the COVID-19 Pandemic Heart House 2400 N Street NW Washington, DC 20037 Phone: , ext
and outcomes for peopleaged over 60 years? 13 Grey Literature 24 Gaps in the evidence 25 Discussion 26 Applicability 28 References 31 Appendix A 35 Appendix B 36 Appendix C 45 Appendix D 46 COMMUNITY-BASED HEALTH PROMOTION FOR OLDER ADULTS APRIL 2019 | SAX INSTITUTE 5 Executive summary Background Older adults who are physically active maintain better health and cognitive function than adults who are not. Evidence-based strategies to increase health and wellbeing among olderpeople are needed (...) Question 1: What community-based programs, that combine physical activity, with other activities addressing key health risk factors, have shown to be effective in improving the health behaviours and outcomes for peopleaged over 60 years? The evidence check identified 26 papers reporting on 23 different community-based programs for older adults (60+ years) that met the criteria for inclusion in this rapid review. Programs were developed in the United States, Canada, Brazil, several European countries
from a bank or post office. Consider action to ensure that olderpeople are not concerned about being able to pay their telephone/broadband bills. Telephone communication providers should consider whether they are able to cap call and internet charges and provide unlimited use for elderlypeople during this period. What the evidence says We based these suggestions on the following research findings On quality of life olderpeople report value in: ? Being able to manage on their own retaining (...) to meet basic needs o Having material resources to feel comfortable and independent 2 This review looked at qualitative research, in peopleaged 65 or over who were still living independently, that investigated their views about occupations that enhanced their wellbeing. Authors found that: Solitary occupations are described as positive and highly important to olderpeople’s wellbeing. ? Olderpeople described the need for autonomy in deciding what to do and when to do it; occupations needed
Estimating excess 1-year mortality associated with the COVID-19 pandemic according to underlying conditions and age: a population-based cohort study. The medical, societal, and economic impact of the coronavirus disease 2019 (COVID-19) pandemic has unknown effects on overall population mortality. Previous models of population mortality are based on death over days among infected people, nearly all of whom thus far have underlying conditions. Models have not incorporated information on high-risk (...) by Public Health England guidelines (from March 16, 2020) in individuals aged 30 years or older registered with a practice between 1997 and 2017, using validated, openly available phenotypes for each condition. We estimated 1-year mortality in each condition, developing simple models (and a tool for calculation) of excess COVID-19-related deaths, assuming relative impact (as relative risks [RRs]) of the COVID-19 pandemic (compared with background mortality) of 1·5, 2·0, and 3·0 at differing infection
in systolic blood pressure control or adverse events during 12-week follow-up.The Optimising Treatment for Mild Systolic Hypertension in the Elderly (OPTIMISE) study was a randomized, unblinded, noninferiority trial conducted in 69 primary care sites in England. Participants, whose primary care physician considered them appropriate for medication reduction, were aged 80 years and older, had systolic blood pressure lower than 150 mm Hg, and were receiving at least 2 antihypertensive medications were (...) Effect of Antihypertensive Medication Reduction vs Usual Care on Short-term Blood Pressure Control in Patients With Hypertension Aged 80 Years and Older: The OPTIMISE Randomized Clinical Trial. Deprescribing of antihypertensive medications is recommended for some older patients with polypharmacy and multimorbidity when the benefits of continued treatment may not outweigh the harms.This study aimed to establish whether antihypertensive medication reduction is possible without significant changes
In older adults with acute ischemic stroke, the Clinical Frailty Scale predicted mortality at 28 days. Evans NR, Wall J, To B, et al. Clinical frailty independently predicts early mortality after ischaemic stroke. AgeAgeing. 2020. [Epub ahead of print]. 31951248.
In older patients in the ED, higher ERA scores were associated with increased risk for mortality and return visits. Espinoza Suarez NR, Walker LE, Jeffery MM, et al. Validation of the Elderly Risk Assessment index in the emergency department. Am J Emerg Med. 2019. [Epub ahead of print]. 31839521.
Efficacy of a tetravalent dengue vaccine in healthy children aged 4-16 years: a randomised, placebo-controlled, phase 3 trial. A substantial unmet need remains for safe and effective vaccines against dengue virus disease, particularly for individuals who are dengue-naive and those younger than 9 years. We aimed to assess the efficacy, safety, and immunogenicity of a live attenuated tetravalent dengue vaccine (TAK-003) in healthy children aged 4-16 years.We present data up to 18 months post (...) -vaccination from an ongoing phase 3, randomised, double-blind trial of TAK-003 in endemic regions of Asia and Latin America (26 medical and research centres across Brazil, Colombia, Dominican Republic, Nicaragua, Panama, Philippines, Sri Lanka, and Thailand). Healthy children aged 4-16 years were randomly assigned 2:1 (stratified by age and region) to receive two doses of TAK-003 or two doses of placebo, 3 months apart. Investigators, participants and their parents or guardians, and sponsor
Safety and immunogenicity of a tetravalent dengue vaccine in children aged 2-17 years: a randomised, placebo-controlled, phase 2 trial. An unmet clinical need remains for an effective tetravalent dengue vaccine suitable for all age groups, regardless of serostatus. We assessed the immunogenicity and safety of three different dose schedules of a tetravalent dengue vaccine (TAK-003) over a 48-month period in children living in dengue-endemic countries.We did a large, phase 2, double-blind (...) , placebo-controlled trial at three sites in the Dominican Republic, Panama, and the Philippines. Healthy participants aged 2-17 years were randomly assigned 1:2:5:1 using an interactive web response system with stratification by age to receive either a two-dose primary series (days 1 and 91), one primary dose (day 1), one primary dose plus booster (days 1 and 365), or placebo. Participants and relevant study personnel were masked to the random assignment until completion of the study at month 48
BSPED Interim Guideline for the Management of Children and Young People under the age of 18 years with Diabetic Ketoacidosis BSPED Interim Guideline for the Management of Children and Young People under the age of 18 years with Diabetic Ketoacidosis The previous guideline for the management of DKA has been revised by the BSPED special interest group in diabetic ketoacidosis following a series of meetings. The relatively limited evidence regarding the management of DKA has been reviewed. Where (...) young peopleaged 16-18 years are managed by adult medical teams because of local arrangements, it is considered appropriate for them to be managed using local adult guidelines that the teams are familiar with rather than using potentially unfamiliar paediatric guidelines. Where individuals aged 16-18 are managed by Paediatric teams the Paediatric guidelines should be followed. 2) The ISPAD definition for DKA with acidosis and a bicarbonate of 3.0 mmol per litre has been adopted. The previous BSPED
the review as the impact of the intervention on only the ASD sample would be impossible to isolate. To be included in the review, either all participants in a study had to be of mainstream school age or a majority of participants had to be of mainstream school age. This meant that while most studies involved young peopleaged 6–16 years, one study (Piravej_2009) included some younger children (minimum 3 years old) and six studies included slightly older participants (MacKinnon_2014, Pryor_2016 (...) of anxiety for those with ASD varies widely (e.g., from 13% to 84%), the majority of studies suggest that a realistic estimate is between 40% and 50% (van Steensel, Bögels, & Perrin, ). The majority of studies undertaken exploring anxiety and ASD have focused on very young children, or older adolescents and adults. Fewer studies have been undertaken with school‐aged children, but those studies that have been conducted suggest a high co‐occurrence of anxiety in ASD populations of this age group (Ashburner
in nAMD and occurs in response to abnormally high levels of vascular endothelial growth factor (VEGF). Left untreated, AMD can lead to rapid, irreversible vision loss. nAMD is the leading cause of severe vision loss and legal blindness among individuals aged >65 years in Europe, North America, Australia and Asia (2, 3). Prevalence estimates suggest that nAMD affects approximately 1.7 million people in Europe (4, 5). The estimated incidence of late AMD in Europe in 2013 was between 2.9 and 3.7 per 1000 (...) , 8.1 6.4, 8.8 LSMD (SE) ?0.2 (1.00) ?0.7 (0.86) 95% CI for LSMD ?2.1, 1.8 ?2.4, 1.0 p-value for treatment difference (2-sided) 0.8695 0.4199 p-value for noninferiority (4- letter margin; 1-sided) 65 years in Europe, North America, Australia and Asia, and impacts an estimated 20–25 million people worldwide (2, 3). Prevalence reports have estimated that nAMD affects approximately 1.7 million people in Europe (4, 5). In developed nations, the estimated increase in population ageing is a contributing
Nuchal Translucency Evaluation at 11 to 14 Weeks Gestational Age New 2020 ACR Appropriateness Criteria ® 1 Nuchal Translucency Evaluation American College of Radiology ACR Appropriateness Criteria ® Nuchal Translucency Evaluation at 11 to 14 Weeks Gestational Age Variant 1: Routine nuchal translucency measurement at 11 to 14 weeks of gestation for single or twin gestations. Initial imaging. Procedure Appropriateness Category Relative Radiation Level US pregnant uterus transabdominal Usually (...) at the back of the fetal neck is a normal ultrasound (US) finding at 11 to 14 weeks of gestation; above this threshold, the fetus is considered to have an increased nuchal translucency, which is a marker for fetal aneuploidy, genetic syndromes, structural anomalies, and intrauterine demise . Fetal nuchal translucency increases with crown-rump length, so gestational age must be taken into account when determining whether a given nuchal translucency thickness is increased. It is customary to quantify
PMCID: DOI: Item in Clipboard Full-text links Cite Abstract Background: Digitally enabled rehabilitation may lead to better outcomes but has not been tested in large pragmatic trials. We aimed to evaluate a tailored prescription of affordable digital devices in addition to usual care for people with mobility limitations admitted to aged care and neurological rehabilitation. Methods and findings: We conducted a pragmatic, outcome-assessor-blinded, parallel-group randomised trial in 3 Australian (...) hospitals in Sydney and Adelaide recruiting adults 18 to 101 years old with mobility limitations undertaking aged care and neurological inpatient rehabilitation. Both the intervention and control groups received usual multidisciplinary inpatient and post-hospital rehabilitation care as determined by the treating rehabilitation clinicians. In addition to usual care, the intervention group used devices to target mobility and physical activity problems, individually prescribed by a physiotherapist
or fortified foods as well continued electrolyte and micronutrient management. Following recovery, caregivers are given appropriate nutritional training to avoid similar recurrences and instructed on the importance of sensory stimulation in children for continued emotional and physical development (Ashworth, ). SAM among children under 6 months of age is increasingly being associated with higher mortality than in older infants and children (WHO, ). The WHO guideline suggests that in infants who are under 6 (...) months of age with SAM should receive the same general medical care as infants with SAM who are 6 months of age or older with increased focus on establishing, or re‐establishing, effective exclusive breastfeeding by the mother or other caregiver (WHO, ). In this review, we will assess the effectiveness of various community‐based and facility‐based strategies to identify and manage MAM and SAM; including the community‐based screening, identification management of SAM and MAM, relative effectiveness
Covid-19: Guidance for admissions into aged residential care facilities COVID-19 Guidance for admissions into aged residential care facilities 27 APRIL 2020 Aged residential care (ARC) services, excluding deferrable respite, are essential services. This means they continue to operate, accepting referrals from both the community and from hospital. It is essential to ensure that people who do not need to be in hospital do not remain there unnecessarily. Admissions from the community ARC can (...) accept admissions from the community if the person has not had contact with anyone who has been overseas in the last 14 days or been overseas themselves, has not been in contact with anyone with confirmed, suspect or probable COVID-19 and does not have any acute respiratory symptoms (cough, fever, sore throat, or running nose). All people, prior to admission, must be screened by a General Practitioner/Nurse Practitioner or Community Based Assessment service for COVID-19 to determine