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  1. Article ; Online: Survival and critical care use among people with dementia in a large English cohort.

    Yorganci, Emel / Sleeman, Katherine E / Sampson, Elizabeth L / Stewart, Robert

    Age and ageing

    2023  Volume 52, Issue 9

    Abstract: Background: Admitting people with dementia to critical care units may not always lead to a clear survival benefit. Critical care admissions of people with dementia vary across countries. Little is known about the use and trends of critical care ... ...

    Abstract Background: Admitting people with dementia to critical care units may not always lead to a clear survival benefit. Critical care admissions of people with dementia vary across countries. Little is known about the use and trends of critical care admissions of people with dementia in England.
    Objective: To investigate critical care use and survival among people with dementia in a large London catchment area.
    Methods: A retrospective cohort study using data from dementia assessment services in south London, UK (2007-20) linked with national hospitalisation data to ascertain critical care admissions. Outcomes included age-sex-standardised critical care use and 1-year post-critical care admission survival by dementia severity (binary: mild versus moderate/severe). We used logistic regression and Kaplan-Meier survival plots for investigating 1-year survival following a critical care admission and linear regressions for time trends.
    Results: Of 19,787 people diagnosed with dementia, 726 (3.7%) had ≥1 critical care admission at any time after receiving their dementia diagnosis. The overall 1-year survival of people with dementia, who had a CCA, was 47.5% (n = 345). Dementia severity was not associated with 1-year survival following a critical care admission (mild dementia versus moderate-severe dementia odds of 1-year mortality OR: 0.90, 95% CI [0.66-1.22]). Over the 12-year period from 2008 to 2019, overall critical care use decreased (β = -0.05; 95% CI = -0.01, -0.0003; P = 0.03), while critical care admissions occurring during the last year of life increased (β = 0.11, 95% CI = 0.01, 0.20, P = 0.03).
    Conclusions: In this cohort, while critical care use among people with dementia declined overall, its use increased among those in their last year of life. Survival remains comparable to that observed in general older populations.
    MeSH term(s) Humans ; Retrospective Studies ; Critical Care ; Intensive Care Units ; Dementia/diagnosis ; Dementia/therapy ; England/epidemiology
    Language English
    Publishing date 2023-09-07
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 186788-x
    ISSN 1468-2834 ; 0002-0729
    ISSN (online) 1468-2834
    ISSN 0002-0729
    DOI 10.1093/ageing/afad157
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  2. Article: "You can't wash your hands in a house without running water": pandemic precautionary behaviors after Hurricane Laura.

    Girard, Cécile M F / Cherry, Katie E / Sampson, Laura

    Current psychology (New Brunswick, N.J.)

    2023  , Page(s) 1–12

    Abstract: Hurricane Laura made landfall in southwestern Louisiana in August 2020 while the world was several months into the COVID-19 pandemic. In the present research, we examined pandemic precautionary behaviors in a sample of adults who varied in exposure and ... ...

    Abstract Hurricane Laura made landfall in southwestern Louisiana in August 2020 while the world was several months into the COVID-19 pandemic. In the present research, we examined pandemic precautionary behaviors in a sample of adults who varied in exposure and damage due to Hurricane Laura, a destructive Category 4 hurricane. A total of 127 participants responded to an online survey that assessed pandemic worry and precautionary behaviors, hurricane exposure and damage, and health-related quality of life. We found that Hurricane Laura victims neglected pandemic precautionary behaviors at significantly higher levels in the weeks immediately following Hurricane Laura than did indirectly impacted control participants, although the two comparison groups did not differ in COVID-19 worry or adherence to precautionary pandemic behavior 14-22 months after Hurricane Laura made landfall. Older age was negatively correlated with COVID-19 worry prior to Hurricane Laura, which was unexpected given that older people in general were more vulnerable to COVID-19 by their membership in a high-risk group. Future directions for research on post-disaster vulnerabilities during a global pandemic are discussed.
    Language English
    Publishing date 2023-05-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2021598-8
    ISSN 1936-4733 ; 1046-1310
    ISSN (online) 1936-4733
    ISSN 1046-1310
    DOI 10.1007/s12144-023-04677-z
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  3. Article ; Online: Towards standardising retinal OCT angiography image analysis with open-source toolbox OCTAVA.

    Untracht, Gavrielle R / Durkee, Madeleine S / Zhao, Mei / Kwok-Cheung Lam, Andrew / Sikorski, Bartosz L / Sarunic, Marinko V / Andersen, Peter E / Sampson, David D / Chen, Fred K / Sampson, Danuta M

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 5979

    Abstract: Quantitative assessment of retinal microvasculature in optical coherence tomography angiography (OCTA) images is important for studying, diagnosing, monitoring, and guiding the treatment of ocular and systemic diseases. However, the OCTA user community ... ...

    Abstract Quantitative assessment of retinal microvasculature in optical coherence tomography angiography (OCTA) images is important for studying, diagnosing, monitoring, and guiding the treatment of ocular and systemic diseases. However, the OCTA user community lacks universal and transparent image analysis tools that can be applied to images from a range of OCTA instruments and provide reliable and consistent microvascular metrics from diverse datasets. We present a retinal extension to the OCTA Vascular Analyser (OCTAVA) that addresses the challenges of providing robust, easy-to-use, and transparent analysis of retinal OCTA images. OCTAVA is a user-friendly, open-source toolbox that can analyse retinal OCTA images from various instruments. The toolbox delivers seven microvascular metrics for the whole image or subregions and six metrics characterising the foveal avascular zone. We validate OCTAVA using images collected by four commercial OCTA instruments demonstrating robust performance across datasets from different instruments acquired at different sites from different study cohorts. We show that OCTAVA delivers values for retinal microvascular metrics comparable to the literature and reduces their variation between studies compared to their commercial equivalents. By making OCTAVA publicly available, we aim to expand standardised research and thereby improve the reproducibility of quantitative analysis of retinal microvascular imaging. Such improvements will help to better identify more reliable and sensitive biomarkers of ocular and systemic diseases.
    MeSH term(s) Retinal Vessels ; Reproducibility of Results ; Fluorescein Angiography/methods ; Macula Lutea ; Microvessels ; Tomography, Optical Coherence/methods
    Language English
    Publishing date 2024-03-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-53501-6
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  4. Article ; Online: Patterns of unplanned hospital admissions among people with dementia: from diagnosis to the end of life.

    Yorganci, Emel / Stewart, Robert / Sampson, Elizabeth L / Sleeman, Katherine E

    Age and ageing

    2022  Volume 51, Issue 5

    Abstract: Background: hospitalisations are sentinel events for people with dementia. How patterns of unplanned hospital admissions change among people with dementia after diagnosis is relatively unknown.: Objective: to describe patterns of unplanned hospital ... ...

    Abstract Background: hospitalisations are sentinel events for people with dementia. How patterns of unplanned hospital admissions change among people with dementia after diagnosis is relatively unknown.
    Objective: to describe patterns of unplanned hospital admissions of people with dementia from diagnosis until death/study end.
    Methods: retrospective cohort study using mental healthcare provider data of people diagnosed with dementia in London, UK (1995-2017), linked to mortality and hospital data. The primary outcome was the rate of unplanned hospital admissions after diagnosis until death/study end. We calculated the cumulative incidence of unplanned hospital admissions. The rates of unplanned hospital admissions and the percentage of time spent as an inpatient were stratified by time from first dementia diagnosis.
    Results: for 19,221 people with dementia (61.4% female, mean age at diagnosis 81.0 years (standard deviation, SD 8.5)), the cumulative incidence of unplanned hospital admissions (n = 14,759) was 76.8% (95% CI 76.3%-77.3%). Individuals remained in the study for mean 3.0 (SD 2.6) years, and 12,667 (65.9%) died. Rates and lengths of unplanned hospital admissions remained relatively low and short in the months after the dementia diagnosis, increasing only as people approached the end of life. Percentage of time spent as an inpatient was <3% for people who were alive at the study end but was on average 19.6 and 13.3% for the decedents in the last 6 and 12 months of life, respectively.
    Conclusions: the steep rise in hospitalisations before death highlights the need for improved community care and services for people with dementia who are approaching the end of life.
    MeSH term(s) Death ; Dementia/diagnosis ; Dementia/epidemiology ; Dementia/therapy ; Female ; Hospitalization ; Hospitals ; Humans ; Male ; Retrospective Studies
    Language English
    Publishing date 2022-06-14
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 186788-x
    ISSN 1468-2834 ; 0002-0729
    ISSN (online) 1468-2834
    ISSN 0002-0729
    DOI 10.1093/ageing/afac098
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  5. Article ; Online: Understanding the association between pain and delirium in older hospital inpatients: systematic review and meta-analysis.

    White, Nicola / Bazo-Alvarez, Juan Carlos / Koopmans, Michel / West, Emily / Sampson, Elizabeth L

    Age and ageing

    2024  Volume 53, Issue 4

    Abstract: Objective: Delirium and pain are common in older adults admitted to hospital. The relationship between these is unclear, but clinically important. We aimed to systematically review the association between pain (at rest, movement, pain severity) and ... ...

    Abstract Objective: Delirium and pain are common in older adults admitted to hospital. The relationship between these is unclear, but clinically important. We aimed to systematically review the association between pain (at rest, movement, pain severity) and delirium in this population.
    Methods: PubMed, EMBASE, CINAHL, PsycINFO, Cochrane and Web of Science were searched (January 1982-November 2022) for Medical Subject Heading terms and synonyms ('Pain', 'Analgesic', 'Delirium'). Study eligibility: (1) validated pain measure as exposure, (2) validated delirium tool as an outcome; participant eligibility: (1) medical or surgical (planned/unplanned) inpatients, (2) admission length ≥ 48 h and (3) median cohort age over 65 years. Study quality was assessed with the Newcastle Ottawa Scale. We collected/calculated odds ratios (ORs) for categorical data and standard mean differences (SMDs) for continuous data and conducted multi-level random-intercepts meta-regression models. This review was prospectively registered with PROSPERO [18/5/2020] (CRD42020181346).
    Results: Thirty studies were selected: 14 reported categorical data; 16 reported continuous data. Delirium prevalence ranged from 2.2 to 55%. In the multi-level analysis, pain at rest (OR 2.14; 95% confidence interval [CI] 1.39-3.30), movement (OR 1.30; 95% CI 0.66-2.56), pain categorised as 'severe' (OR 3.42; 95% CI 2.09-5.59) and increased pain severity when measured continuously (SMD 0.33; 95% CI 0.08-0.59) were associated with an increased delirium risk. There was substantial heterogeneity in both categorical (I2 = 0%-77%) and continuous analyses (I2 = 85%).
    Conclusion: An increase in pain was associated with a higher risk of developing delirium. Adequate pain management with appropriate analgesia may reduce incidence and severity of delirium.
    MeSH term(s) Humans ; Aged ; Inpatients ; Pain/diagnosis ; Pain/epidemiology ; Pain Management ; Hospitals ; Delirium/diagnosis ; Delirium/epidemiology
    Language English
    Publishing date 2024-04-12
    Publishing country England
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 186788-x
    ISSN 1468-2834 ; 0002-0729
    ISSN (online) 1468-2834
    ISSN 0002-0729
    DOI 10.1093/ageing/afae073
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  6. Article ; Online: Psychometric evaluation of the Pain Assessment in Advanced Dementia scale in an acute general hospital setting.

    Dunford, Emma / West, Emily / Sampson, Elizabeth L

    International journal of geriatric psychiatry

    2022  Volume 37, Issue 12

    Abstract: Background: People with dementia are at risk of unplanned hospital admissions and commonly have painful conditions. Identifying pain is challenging and may lead to undertreatment. The psychometric properties of the Pain Assessment in Advanced Dementia ( ... ...

    Abstract Background: People with dementia are at risk of unplanned hospital admissions and commonly have painful conditions. Identifying pain is challenging and may lead to undertreatment. The psychometric properties of the Pain Assessment in Advanced Dementia (PAINAD) scale, in medical inpatients with dementia have not been evaluated.
    Methods: A secondary data analysis from a longitudinal study of 230 people with dementia admitted to two acute general hospitals in London, UK. Internal consistency, inter-rater reliability, test-retest reliability, concurrent validity, construct validity and discriminant validity of PAINAD were tested at rest and in movement.
    Results: This predominantly female (65.7%) sample had a mean age of 87.2 (Standard Deviation; SD = 5.92) years. Inter-rater reliability showed an intra-class correlation (ICC) of 0.92 at rest and 0.98 in movement, test-retest reliability ICC was 0.54 at rest and 0.66 in movement. Internal consistency was 0.76 at rest and 0.80 in movement (Cronbach's α). Concurrent validity was weak between PAINAD and a self-rating level of pain (Kendall's Tau; τ = 0.29; p > 0.001). There was no correlation between PAINAD and a measure of behavioural and psychological symptoms of dementia, suggesting no evidence of convergent validity. PAINAD scores were higher during movement than rest, providing evidence of discriminant validity (z = -8.01, p < 0.001).
    Conclusions: We found good inter-rater reliability and internal consistency. The test-retest reliability was modest. This study raises concerns about the validity of the PAINAD in general acute hospitals. This provides an insight into pain assessment in general acute hospitals which may inform further refinements of the PAINAD.
    MeSH term(s) Female ; Humans ; Aged, 80 and over ; Male ; Pain Measurement ; Psychometrics ; Reproducibility of Results ; Hospitals, General ; Dementia/complications ; Dementia/diagnosis ; Dementia/psychology ; Longitudinal Studies ; Pain/etiology ; Pain/complications
    Language English
    Publishing date 2022-11-01
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 806736-3
    ISSN 1099-1166 ; 0885-6230
    ISSN (online) 1099-1166
    ISSN 0885-6230
    DOI 10.1002/gps.5830
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  7. Book ; Online: The State of Sustainable Markets 2023

    Kemper, L. / Sampson, G. / Larrea, C. / Schlatter, B. / Luna, E. / Dang, D. / Willer, H.

    Statistics and Emerging Trends

    2023  

    Abstract: This seventh global report provides new insights into the evolution of certified agriculture and forestry. The International Trade Centre has teamed up once again with the Research Institute of Organic Agriculture and the International Institute for ... ...

    Abstract This seventh global report provides new insights into the evolution of certified agriculture and forestry. The International Trade Centre has teamed up once again with the Research Institute of Organic Agriculture and the International Institute for Sustainable Development to provide data about 14 major sustainability standards for bananas, cocoa, coffee, cotton, oil palm, soybeans, sugarcane, tea and forestry products. This year’s report adds data from 2021 and finds that slow growth resumed after a dip in 2020. The publication helps shape decisions of policymakers, producers and businesses, working to address systemic labour and environmental challenges through certified sustainable production.
    Keywords Surveys and statistics
    Language English
    Publisher International Trade Centre (ITC)
    Publishing country dk
    Document type Book ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article: Psychiatric liaison service referral patterns during the UK COVID-19 pandemic: An observational study.

    Sampson, E L / Wright, J / Dove, J / Mukadam, N

    The European journal of psychiatry

    2021  Volume 36, Issue 1, Page(s) 35–42

    Abstract: Background and objectives: COVID-19 has had a profound effect on mental health. Liaison psychiatry teams assess and treat people in mental health crises in emergency departments (EDs) and on hospital wards. During the first pandemic wave, new Mental ... ...

    Abstract Background and objectives: COVID-19 has had a profound effect on mental health. Liaison psychiatry teams assess and treat people in mental health crises in emergency departments (EDs) and on hospital wards. During the first pandemic wave, new Mental Health Crisis Assessment Services (MHCAS) were created to divert people away from EDs. Our objective was to describe patterns in referrals to psychiatric liaison services across the North Central London care sector (NCL) and explore the impact of a new MHCAS.
    Methods: Retrospective study using routinely collected data (ED and ward referrals) from five liaison psychiatry services across NCL (total population 1.5 million people). We described referrals (per week and month) by individual liaison services and cross-sector, and patterns of activity (January 1st 2020 -September 31st 2020, weeks 1-39) compared with the same period in 2019. We calculated changes in the proportion of ED attendees (all-cause) referred to liaison psychiatry.
    Results: From 2019-2020, total referrals decreased by 16.5% (12,265 to 10,247), a 16.4% decrease in ED referrals (9528 to 7965) and 16.6% decrease in ward referrals (2737 to 2282). There was a marked decrease in referrals during the first pandemic wave (March/April 2020), which increased after lockdown ended. The proportion of ED attendees referred to liaison psychiatry services increased compared to 2019.
    Conclusions: People in mental health crisis continued to seek help via ED/MHCAS and a higher proportion of people attending ED were referred to liaison psychiatry services just after the first pandemic wave. MHCAS absorbed some sector ED activity during the pandemic.
    Language English
    Publishing date 2021-06-04
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 1038152-1
    ISSN 0213-6163
    ISSN 0213-6163
    DOI 10.1016/j.ejpsy.2021.05.003
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    Zs.A 2607: Show issues Location:
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  9. Article ; Online: Racial disparities in the development of comorbid conditions after preterm birth: A narrative review.

    Karvonen, Kayla L / Goronga, Faith / McKenzie-Sampson, Safyer / Rogers, Elizabeth E

    Seminars in perinatology

    2022  Volume 46, Issue 8, Page(s) 151657

    Abstract: Despite recognition and attempts to reduce racial disparities in perinatal outcomes, Black infants are still disproportionately represented among those who are born preterm. Postnatal investigations of racial disparities in comorbidities and outcomes ... ...

    Abstract Despite recognition and attempts to reduce racial disparities in perinatal outcomes, Black infants are still disproportionately represented among those who are born preterm. Postnatal investigations of racial disparities in comorbidities and outcomes after preterm birth are increasing, although their results and interpretations are conflicting. In the present review, we 1.) identify important methodological limitations of that literature 2.) summarize the conflicting literature investigating racial disparities, specifically Black-white differences, in postnatal comorbidities and outcomes after preterm birth 3.) describe mechanisms by which racism operates to contextualize our understanding to inform future work to actively reduce disparities in preterm birth and subsequently, its complications.
    MeSH term(s) Infant ; Pregnancy ; Female ; Infant, Newborn ; Humans ; Premature Birth/epidemiology ; Racial Groups ; Racism ; Black People ; Health Status Disparities
    Language English
    Publishing date 2022-08-28
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 752403-1
    ISSN 1558-075X ; 0146-0005
    ISSN (online) 1558-075X
    ISSN 0146-0005
    DOI 10.1016/j.semperi.2022.151657
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  10. Article ; Online: Multidisciplinary residential home intervention to improve outcomes for frail residents.

    Steel, Anna / Hopwood, Helen / Goodwin, Elizabeth / Sampson, Elizabeth L

    BMC health services research

    2022  Volume 22, Issue 1, Page(s) 58

    Abstract: Background: Residential homes provide accommodation and assistance with personal care only and are not required to have registered nurses on site. However, their residents often have a combination of comorbidity, polypharmacy, frailty and mental-health ... ...

    Abstract Background: Residential homes provide accommodation and assistance with personal care only and are not required to have registered nurses on site. However, their residents often have a combination of comorbidity, polypharmacy, frailty and mental-health conditions with poor access to healthcare to meet these needs. Integrated healthcare for older people is a key NHS priority in the Long-Term Plan and the Five-Year Forward View. We describe development and implementation of multi-disciplinary intervention to integrate healthcare and promote interprofessional education.
    Methods: A multi-disciplinary residential home quality improvement project in two cycles by a team comprising senior and trainee general practitioners, trainees in geriatrics, psychiatry, pharmacist and residential home senior staff. The intervention was underpinned by the framework for enhanced health in care homes including Comprehensive Geriatric Assessment (CGA) and mental-health review. Each intervention session included an educational presentation by a team member consideration of each resident in a pre-evaluation multi-disciplinary discussion followed by a structured clinical assessment and discussion of proposed management.
    Results: Three residential homes participated with a total 34 residents receiving intervention. In one residential home, there was a 75% reduction in admissions for those reviewed and a reduction in overall admission costs. Polypharmacy was reduced by an average of 2 medications per resident across the three sites. There was a 63% increase in cardio-pulmonary resuscitation decisions and 76% increase in advance care planning discussions.
    Conclusion: This was an effective model for multi-disciplinary trainees working with a perceived impact on physical and mental health, and valuable opportunities for sharing learning.
    MeSH term(s) Aged ; Delivery of Health Care ; Frail Elderly ; Geriatric Assessment ; Health Facilities ; Humans ; Quality Improvement
    Language English
    Publishing date 2022-01-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050434-2
    ISSN 1472-6963 ; 1472-6963
    ISSN (online) 1472-6963
    ISSN 1472-6963
    DOI 10.1186/s12913-021-07407-y
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