UNASSIGNED: Day Medical Care Home is a care and treatment institution providing day care services for people with disabilities (mainly older adults), implemented in Poland since 2015. This study aimed to analyze the impact of the new model of day care on the mental health status and cognitive functions of older adults with disabilities treated in Day Medical Care Homes in Poland, 2017-2023.
UNASSIGNED: Admission and discharge reports of 949 patients treated in Day Medical Care Homes between 2017 and 2023 were analyzed. Geriatric Depression Scale (GDS-15) and Hamilton Rating Scale for Depression (HAM-D) were used to assess mental health. Cognitive functions were assessed using Mini-Mental State Examination (MMSE).
UNASSIGNED: The mean age was 74.3 ± 8.5 years, 76.6% were women. and 62.6% lived in rural areas. The percentage of patients with moderate or severe depression measured with a GDS-15 score decreased from 58.3% on admission to 34.6% on discharge (p<0.001). The percentage of patients with depressive disorders measured with HAM-D score decreased from 48.3% on admission to 37.2% on discharge (p<0.001). The percentage of patients with dementia or cognitive disorders measured with the MMSE score decreased from 54.3% on admission to 40.5% on discharge (p<0.001). Improvement in mental health status and cognitive functions was observed in all sociodemographic groups.
UNASSIGNED: Day Medical Care Home is an effective model of day care that improves the mental health status and cognitive functions of older adults with disabilities.

OBJECTIVE: Isokinetic knee extensor strength is poorly evaluated in geriatric day hospitals (GDHs), despite its potential functional significance compared to grip strength. This study aimed to investigate age-related effects on absolute and relative isokinetic knee extensor peak torque (KEPT) data in community-dwelling older GDH patients.
METHODS: A total of 472 French GDH patients (179 men and 293 women, aged 75-94 years) participated in this study. Absolute and relative KEPT were measured at six distinct angular velocities between 0.52 and 3.14 rad/s. In addition, comfortable gait speed and grip strength were assessed. Participants were stratified by sex and age using 5-year intervals. One-way ANOVAs were used to examine age-related effects on KEPT values. Multiple linear regression models were employed to investigate the associations between gait speed and both mean KEPT values and grip strength, with separate models conducted on absolute and relative values.
RESULTS: The recruited GDH patients presented lower absolute and relative KEPT values in comparison with established reference values for healthy community-dwelling older individuals, with men being consistently stronger than women. Notably, there was a significant decline in both absolute and relative KEPT values beyond the age of 85 for both sexes. Importantly, the multiple linear regression analyses conducted revealed a significant positive relationship between gait speed and mean KEPT values, surpassing the association with grip strength.
CONCLUSIONS: These findings underscore the clinical importance of assessing isokinetic knee extensor strength in community-dwelling older GDH patients, particularly for tailoring personalized physical activity interventions.

With limited healthcare resources, it is important to provide the right level and form of care. The aim of this study was to determine whether selected single-jaw orthognathic surgery in outpatient care (OPC) generates lower healthcare costs than in inpatient care (IPC). The costs of surgically assisted rapid maxillary expansion (SARME), Le Fort I osteotomy (LFI), and bilateral sagittal split osteotomy (BSSO) were calculated for 165 patients, 107 treated in OPC and 58 in IPC. Additionally, costs for revisits, emergency visits, emergency phone calls, re-operations, and plate removal during the first 12 months postoperatively were recorded. The total mean costs of the different operations including revisits, emergency visits, and phone calls were 34.2-48.8% lower in OPC than in IPC at 12 months postoperatively. Operation costs were lower for LFI in OPC (P = 0.009) and for SARME in IPC (P = 0.007). Anaesthesia costs were lower for LFI (P < 0.001) and BSSO (P < 0.001) in OPC, and there were fewer revisits (P = 0.001) and lower costs (P = 0.002) after LFI in OPC compared to IPC. This study showed that selected single-jaw orthognathic surgeries in outpatient care are associated with lower healthcare costs compared to inpatient care.

Professional support for elderly people suffering from cognitive impairment needs to be comprehensive, and requires the active involvement of a wide range of professionals. Two clinical cases show how the combined support of a therapeutic day-care center and medical specialists can improve the quality of life of patients and their families, by helping to refine diagnoses or adjust treatment.

UNASSIGNED: To report our initial experience of day care percutaneous nephrolithotomy (PCNL) with early hospital discharge within less than 24 hours of the procedure.
UNASSIGNED: The files of patients treated with PCNL between 1st January 2020 till 31st December 2022 were retrospectively reviewed. Day care PCNL was defined as the discharge of patients either on the same day or within 24 hours after surgery. Patient age, ASA score, body mass index, stone diameter, laterality, stone burden, Hounsfield unit, and Guy\'s score were analyzed. Operative time, size of the access tract, method of lithotripsy, estimated blood loss, and length of hospital stay were also recorded. Postoperative complications were stratified according to the Dindo-Clavien classification. The primary outcome was to evaluate the feasibility and safety of early discharge within 24 hours after PCNL compared to the in-patients who were kept in hospital for at least 2 days after surgery.
UNASSIGNED: A total of 85 patients underwent PCNL at our center of whom 36 patients were discharged within 24 hours (day care PCNL) of the procedure and 49 patients were kept for at least 2 days (in-patient PCNL). In the day care group, median stone burden was 465 mm2 (360-980) and 18 patients (50%) had Guy\'s stone score ≥ III. The median tract size was 24 (13-30) and endoscopic combined intrarenal surgery (ECIRS) was performed in 7 cases in the day care group. Tubeless PCNL was carried out in 88.8% of the day care surgery group compared to 37.5% in the in-patient group (p < 0.0001). The postoperative complication rate was comparable between both groups (13.8% vs 22.4% for day care vs in-patient group, respectively, p = 0.08).
UNASSIGNED: Day care PCNL is feasible and safe for selected patients including those having large stone burden without increasing the risk of complications or readmission rate.

UNASSIGNED: Unprecedented ageing and growth of the global population of older people is predicted. Between independent and residential care, day care is an essential part of a population-based strategy to support ageing well in place.
UNASSIGNED: To describe experiences of older people attending day care services.
UNASSIGNED: Using the qualitative method, two focus groups were completed in 2018 in a region of Ireland with 12 participants. Interviews were audio-recorded and transcribed; grounded theory guided the subsequent analysis.
UNASSIGNED: Older people valued their participation in day care, describing the \'home from home\' experience positively. Community nurses from the local public health nursing service played a key role in fostering and sustaining participation.
UNASSIGNED: National commitment to population-based age friendly environments is required to facilitate the wellbeing of a growing older demographic.

BACKGROUND: Palliative day-care clinics (PDCCs) can complement inpatient and outpatient specialized palliative care. Some studies have shown improvements in the patients\'́ symptoms, functional level and psychological well-being, while others have not. This study aimed to document the experience of referring physicians with PDCCs.
METHODS: A postal questionnaire was sent to referring physicians between 11/2020 and 3/2021. The questionnaire included open and closed questions about professional background, symptom control, medical / psychosocial benefits for patients and challenges in the collaboration. Closed, 5-point scaled questions were analyzed descriptively with IBM SPSS Statistics 25®, open questions with a thematic content analysis using MAXQDA 2020®.
RESULTS: Of the 96 referring physicians contacted, 76 questionnaires were returned (79%), 73 of which could be analyzed. Most referring physicians were general practitioners (57%), followed by oncologists (28%). 12% had completed further training in palliative medicine and had been working with patients with palliative care needs for an average of almost 19 years. On average, they had referred 24 patients (range 1-200) to a PDCC. 93% said that inpatient stays were delayed or avoided by PDCCs. 97% were of the opinion that their patients achieved a (great or rather great) benefit from medical treatment, and 96% thought that they benefited (to a great or rather great degree) from psychosocial treatment. 58% said that their own time spent with patients treated at the PDCC had decreased. In addition, a total of 227 open comments on challenges in cooperation, suggestions for optimization, reasons for referring patients and general wishes for PDCCs were analyzed.
CONCLUSIONS: The high response rate to the questionnaires shows that PDCCs are of great importance to referring physicians. They consider the cooperation with PDCCs to be supportive and helpful for both themselves and their patients.
CONCLUSIONS: PDCCs make an important contribution to palliative care. Almost all respondents believe that treatment at a PDCC prevents or delays hospitalization.

Cancer often causes long-term physical and psychological impairments. Lifestyle modification and nature-based interventions (NBIs) can have a positive impact on patients\' quality of life (QOL). This participants-blinded, non-randomized controlled study assessed parameters at weeks 0, 12, and 24, including, as a primary endpoint, QOL in cancer patients on the Functional Assessment of Cancer Therapy-General (FACT-G) at week 12. QOL in breast cancer patients, fatigue, well-being, stress, anxiety/depression, socio-psychological well-being, benefits of nature interaction, insomnia, self-efficacy, mindfulness, and self-compassion were assessed as secondary endpoints. N = 107 cancer patients (96.3% women; 52.5 ± 9.3 years, 80.4% breast cancer) were assigned to either a 12-week nature-based (NDC; n = 56) or conventional (DC; n = 51) oncology day care clinic program, whereby the assignment group was not known to the participants. There was no significant group difference for the primary endpoint. At week 24, QOL, fatigue, mindfulness and self-compassion scores were significantly higher, and at weeks 12 and 24, the insomnia score was significantly lower in NDC compared to DC. In conclusion, this study indicates positive and clinically relevant effects of the program on QOL, fatigue, and psychological parameters. NBIs seem to have a more pronounced effect.

We examined the association between parental educational level (PEL) and children\'s food consumption and nutrient intake in a sample of Finnish 3- to 6-year-old preschoolers (n 811). The data were obtained from the cross-sectional DAGIS project, conducted in eight municipalities in Finland during 2015-2016. The food consumption and nutrient intake were assessed using food records. The highest educational level of the family was used as the indicator of socio-economic status. Differences in diet by PEL were analysed using a hierarchical linear model adjusted for energy intake. Compared with high PEL, low PEL was associated with a child\'s lower consumption of fresh vegetables and salads, vegetarian dishes, berries, white bread, blended spread, skimmed milk and ice cream but higher consumption of milk with 1-1·5 % fat content, dairy-based desserts and sugar-sweetened soft drinks. Food consumption was also examined after disaggregating dishes into their ingredients. Low PEL was associated with lower consumption of vegetables, nuts and seeds, berries and fish but higher consumption of red meat. Children in the low PEL, compared with the high PEL group, had a lower intake of protein, fibre, EPA, DHA, vitamin D, riboflavin, vitamin B6, folate, vitamin B12, vitamin C, potassium, phosphorous, Ca, Mg, Zn and iodine but a higher intake of fat and saturated, trans and MUFA. The observed diet-related disparities highlight the need for policy actions and interventions supporting healthy eating patterns such as high consumption of vegetables, nuts and berries in childhood, paying special attention to those with low PEL.

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