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8 results

  • Utilization of Alternate Care Sites During the COVID-19 Surge and Mass Care: California, 2020–2021

  • Kate Christensen, Mitch Metzner, LeAnne Lovett-Floom, Carol Lindsay, Colin A. Meghoo, Kathy Staats, Asha Devereaux, Erin Noste, Howard Backer
  • Journal:
    Disaster Medicine and Public Health Preparedness / Volume 17 / 2023
    Published online by Cambridge University Press:
    01 April 2022, e155
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  • The coronavirus disease (COVID-19) pandemic caused critical hospital bed and staffing shortages in parts of California for most of 2020 and 2021. Alternate Care Sites (ACS) were established in several regions to alleviate the hospital patient surge and to maximize staffed bed capacity. Over 1900 patients were successfully provided medical care (with physician, nursing, respiratory therapy, oxygen, and pharmacy services) in relatively austere settings. This paper examines the challenges faced at these ACS facilities and how adaptations were incorporated according to the changing dynamics of the COVID-19 pandemic to successfully manage higher acuity patients. ACS facilities were 1 approach to California’s surge of COVID-19 patients, despite limited medical supplies and staffing.

  • Frailty and neuropathology in relation to dementia status: the Cambridge City over-75s Cohort study

  • Lindsay Wallace, Sally Hunter, Olga Theou, Jane Fleming, Kenneth Rockwood, Carol Brayne
  • Journal:
    International Psychogeriatrics / Volume 33 / Issue 10 / October 2021
    Published online by Cambridge University Press:
    15 February 2021, pp. 1035-1043
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  • Objective:

    To examine the relative contributions of frailty and neuropathology to dementia expression in a population-based cohort study.

    Design:

    Cross-sectional analysis of observational data.

    Setting:

    Population-representative clinicopathological cohort study.

    Participants:

    Adults aged 75+ recruited from general practice registries in Cambridge, UK, in 1985.

    Measurements:

    A 39-item frailty index and 15-item neuropathological index were used to operationalize frailty and neuropathology, respectively. Dementia status was ascertained by clinical consensus at time of death. Relationships were evaluated using logistic regression models in participants with autopsy records (n = 183). Model fit was assessed using change in deviance. Population attributable fraction for frailty was evaluated in relation to dementia incidence in a representative sample of the survey participants (n = 542).

    Results:

    Participants with autopsy were 92.3 ± 4.6 years at time of death, and mostly women (70%). Average frailty index value at last survey before death was 0.34 ± 0.16. People with dementia (63% of the sample) were frailer, had lower MMSE scores, and a higher burden of neuropathology. Frailty and neuropathological burden were significantly and independently associated with dementia status, without interaction; frailty explained an additional 3% of the variance in the model. Assuming a causal relationship and based on population-attributable fraction analyses, preventing severe frailty (Frailty Index ≥ 0.40) could have avoided 14.2% of dementia cases in this population-based cohort.

    Conclusions:

    In the very old, frailty contributes to the risk for dementia beyond its relationship with the burden of traditional dementia neuropathologies. Reducing frailty could have important implications for controlling the burden of dementia. Future research on frailty interventions should include dementia risk as a key outcome, public health interventions and policy decisions should consider frailty as a key risk factor for dementia, and biomedical research should focus on elucidating shared mechanisms of frailty and dementia development.

  • The effect of mothers' communication mode on language development in preschool deaf children

  • Carol Reich Musselman, Peter H. Lindsay, Anne Keeton Wilson
  • Journal:
    Applied Psycholinguistics / Volume 9 / Issue 2 / June 1988
    Published online by Cambridge University Press:
    28 November 2008, pp. 185-204

  • A longitudinal study was conducted of the effect of mothers' communication mode on the language development of 149 children with severe and profound hearing losses. The relationship of several subject and family characteristics to mode selection was also investigated. The children were between 3 and 5 years of age at the commencement of the 4-year study. Mothers' mode was coded from videotapes of structured and semistructured interactions. Findings indicated that children whose mothers used oral communication had higher scores on measures of spoken language, whereas children whose mothers used manual communication had higher scores on measures of receptive language and mother-child communication. Within the oral group, children whose mothers made extensive use of gestures had lower scores than children whose mothers did not. Within the manual group, children receiving limited sign input had lower scores on most measures than children receiving extensive input.