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OBJECTIVE To develop and evaluate a best practice model of general hospital acute medical care for older people with cognitive impairment. DESIGN Randomised controlled trial, adapted to take account of constraints imposed by a busy acute medical admission system. SETTING Large acute general hospital in the United Kingdom. PARTICIPANTS 600 patients(More)
OBJECTIVES To assess whether adding a novel computerised diagnostic tool, the MoleMate system (SIAscopy with primary care scoring algorithm), to current best practice results in more appropriate referrals of suspicious pigmented lesions to secondary care, and to assess its impact on clinicians and patients. DESIGN Randomised controlled trial. SETTING 15(More)
BACKGROUND tools are required to identify high-risk older people in acute emergency settings so that appropriate services can be directed towards them. OBJECTIVE to evaluate whether the Identification of Seniors At Risk (ISAR) predicts the clinical outcomes and health and social services costs of older people discharged from acute medical units. DESIGN(More)
BACKGROUND UK care home residents are often poorly served by existing healthcare arrangements. Published descriptions of residents' health status have been limited by lack of detail and use of data derived from surveys drawn from social, rather than health, care records. AIM to describe in detail the health status and healthcare resource use of UK care(More)
BACKGROUND Distal radius fracture is a common injury with a variety of operative and non-operative management options. There remains debate as to the optimal treatment for a given patient and fracture. Despite the popularity of volar locking plate fixation, there are few large cohort or long term follow up studies to justify this modality. Our aim was to(More)
BACKGROUND Frail older people with mental health problems including delirium, dementia and depression are often admitted to general hospitals. However, hospital admission may cause distress, and can be associated with complications. Some commentators suggest that their healthcare needs could be better met elsewhere. METHODS We studied consecutive patients(More)
BACKGROUND A high prevalence of co-morbid mental health problems is reported among older adults admitted to general hospitals. SETTING An 1,800 bed teaching hospital. DESIGN Consecutive general medical and trauma orthopaedic admissions aged 70 or older were screened for mental health problems. Those screening positive were invited to undergo further(More)
Background: older people are at an increased risk of adverse outcomes following attendance at acute hospitals. Screening tools may help identify those most at risk. The objective of this study was to compare the predictive properties of five frailty-rating scales. Method: this was a secondary analysis of a cohort study involving participants aged 70 years(More)
BACKGROUND The Cord Pilot Trial aimed to assess the feasibility of conducting a large UK randomised trial to compare the effects of alternative polices for timing of cord clamping (immediate within 20 seconds or deferred after at least 2 minutes) for very preterm birth before 32 weeks gestation. Initial recruitment was from March 2013 to February 2014,(More)
OBJECTIVE This analysis sought to describe the characteristics and well-being of carers of older people with mental health problems admitted to a general hospital. METHODS General medical and trauma orthopaedic patients aged 70 years or older admitted to an acute general teaching hospital were screened for mental health problems. Those screened positive,(More)