Delirium upon admission to Swiss nursing homes

QUESTIONS UNDER STUDY: We wished to investigate the prevalence of delirium in patients upon admission to nursing homes and whether or not the previous place of residence predicts delirium. METHODS: The Resident Assessment Instrument Minimum Data Set (RAI-MDS) and the Nursing Home Confusion Assessment Method (NHCAM) were used to determine whether the previous place of residence (community, nursing home, acute care, psychiatric, rehabilitation hospital) predicted the prevalence of sub-syndromal or full delirium in nursing home residents in three Swiss cantons (n = 11745). RESULTS: 39.7% had sub-syndromal and 6.5% had full delirium. Lower cognitive performance and increased depressive symptoms were significant predictors of higher NHCAM values independent of previous residence. Age, civil status, continence, newly introduced drugs, and basic activities of daily living were predictors in some resident groups. The variance of NHCAM scores explained varied between 25.1% and 32.3% depending on previous residence. CONCLUSIONS: Sub-syndromal and full delirium are common upon nursing home admission. Increased dependence and depression are consistently associated with higher NHCAM scores. Patients from psychiatric settings have an increased risk of delirium. Although factors associated with delirium depend on a patient's previous residence, all patients must be carefully screened for sub-syndromal and full delirium.

From Craton to Rift: Empirically Based Ground-Truth Criteria for Local Events Recorded on Regional Networks

Region-specific empirically based ground-truth (EBGT) criteria used to estimate the epicentral-location accuracy of seismic events have been developed for the Main Ethiopian Rift and the Tibetan plateau. Explosions recorded during the Ethiopia-Afar Geoscientific Lithospheric Experiment (EAGLE), the International Deep Profiling of Tibet, and the Himalaya (INDEPTH III) experiment provided the necessary GT0 reference events. In each case, the local crustal structure is well known and handpicked arrival times were available, facilitating the establishment of the location accuracy criteria through the stochastic forward modeling of arrival times for epicentral locations. In the vicinity of the Main Ethiopian Rift, a seismic event is required to be recorded on at least 8 stations within the local Pg/Pn crossover distance and to yield a network-quality metric of less than 0.43 in order to be classified as EBGT5(95%) (GT5 with 95% confidence). These criteria were subsequently used to identify 10 new GT5 events with magnitudes greater than 2.1 recorded on the Ethiopian Broadband Seismic Experiment (EBSE) network and 24 events with magnitudes greater than 2.4 recorded on the EAGLE broadband network. The criteria for the Tibetan plateau are similar to the Ethiopia criteria, yet slightly less restrictive as the network-quality metric needs to be less than 0.45. Twenty-seven seismic events with magnitudes greater than 2.5 recorded on the INDEPTH III network were identified as GT5 based on the derived criteria. When considered in conjunction with criteria developed previously for the Kaapvaal craton in southern Africa, it is apparent that increasing restrictions on the network-quality metric mirror increases in the complexity of geologic structure from craton to plateau to rift. Accession Number: WOS:000322569200012

Psychotropic medication use in Swiss nursing homes

Psychotropic medication is commonly used in nursing homes, to treat behavioural and psychological symptoms of dementia (BPSD) for example. Treatment with antipsychotics may improve BPSD in some residents but can be associated with serious side effects, such as higher mortality, faster disease progression and cerebrovascular events. In the current study, psychotropic medication use was analysed in a representative sample of nursing home residents in the German-speaking part of Switzerland, at entry and during follow-up.