Using routine health care data to develop and validate a system dynamics simulation model of frailty trajectories in an ageing population.

Frailty is common in older adults and has a substantial impact on patient outcomes and service use. Information to support service planning, including prevalence in middle-aged adults and patterns of frailty progression at population level, is scarce. This paper presents a system dynamics model describing the dynamics of frailty and ageing within a population of patients aged ≥50, based on linked data for 2.

Correction: Clusters and associations of adverse neonatal events with adult risk of multimorbidity: A secondary analysis of birth cohort data.

[This corrects the article DOI: 10.1371/journal.pone.

The optical performance of a 3D printed, titanium dioxide painted, Ganzfeld bowl.

The emergence of three dimensional (3D) printing has inspired creative ways to enable clinicians to make their own medical devices at low cost, a process called distributed manufacture. Devices for light stimulation, such as for visual electrophysiology or pupillometry, require both physical and optical properties. Here we tested whether a 3D printed (fused deposition modelling, FDM) poly-lactic acid (PLA) surface can exhibit Lambertian reflectance, and tested the behaviour of a 3D printed Ganzfeld bowl as an integrating sphere.

Exploring the relationship between education and academic ability in childhood with healthcare utilization in adulthood: findings from the Aberdeen Children of the 1950s (ACONF).

We explored the association between education and academic ability in childhood and both outpatient appointments and hospital admissions in adulthood, accounting for adult factors, including long-term conditions. The analytical sample consisted of 7183 participants in the Aberdeen Children of the 1950s. Three outcomes were measured using routine Scottish medical records over a five-year period (2004-2008): (1) ≥5 outpatient appointments, (2) ≥2 hospital admissions, or (3) ≥3 outpatient appointments plus ≥1 hospital admission.

Cognitive impairment and health outcomes in non-dialysis chronic kidney disease: a systematic review and meta-analysis.

Background: Cognitive impairment is prevalent in individuals with chronic kidney disease (CKD), but its effects on health outcomes remain unclear. While cognitive impairment can affect self-management, its role in CKD has been insufficiently explored. This systematic review aimed to examine the association between cognitive impairment and health outcomes or self-management ability among persons with CKD.

Biomarkers of Kidney Failure and All-Cause Mortality in CKD.

Background: Chronic kidney disease (CKD) carries a variable risk for multiple adverse outcomes, highlighting the need for a personalised approach. This study evaluated several novel biomarkers linked to key disease mechanisms to predict the risk of kidney failure (first event of eGFR <15 ml/min/1.73m2 or kidney replacement therapy), all-cause mortality, and a composite of both.

Development of a complex multidisciplinary medication review and deprescribing intervention in primary care for older people living with frailty and polypharmacy.

Introduction: Reducing polypharmacy and overprescribing in older people living with frailty is challenging. Evidence suggests that this could be facilitated by structured medication review (SMR) and deprescribing processes involving the multidisciplinary team (MDT). This study aimed to develop an MDT SMR and deprescribing intervention in primary care for older people living with frailty.

Capturing the human impact of living with multiple long-term conditions in routine electronic health records - lost in translation?

Background: Living with multiple long-term conditions (MLTCs) involves 'work'. A recent qualitative synthesis identified eight patient-centred work themes: 'learning and adapting', 'accumulation and complexity', 'investigation and monitoring', 'health service and administration' and 'symptom', 'emotional', 'medication' and 'financial' work. These themes may be underrepresented in electronic health records (EHRs).

Clusters and associations of adverse neonatal events with adult risk of multimorbidity: A secondary analysis of birth cohort data.

Objective: To investigate associations between clustered adverse neonatal events and later-life multimorbidity.

Design: Secondary analysis of birth cohort data.

Setting: Prospective birth cohort study of individuals born in Britain in one week of 1970.

Medicine Optimisation and Deprescribing Intervention Outcomes for Older People with Dementia or Mild Cognitive Impairment: A Systematic Review.

Background: Polypharmacy is common amongst older people with dementia or mild cognitive impairment (MCI), increasing the risk of medication-related harm. Medicine optimisation and deprescribing to reduce polypharmacy is considered feasible, safe and can lead to improved health. However, for those living with dementia or MCI, this can be challenging.

Research recommendations from the 2024 Breakthrough T1D, Diabetes UK and Kidney Research UK, diabetes and kidney disease expert workshop.

Aims: To develop a position statement that identifies research priorities in diabetic kidney disease and provides recommendations to researchers and research funders on how best to address them.

Methods: A one-day research workshop was conducted, bringing together research experts in diabetes and kidney disease, healthcare professionals, and people living with diabetes, to identify and prioritise research recommendations.

Results: The following key areas were identified as needing increased focus: Understanding causal mechanisms in diabetic kidney disease Prevention of diabetic kidney disease Addressing health inequalities Improving diagnosis Improving care Supporting self-management CONCLUSIONS: This position statement outlines recommendations to address the urgent need to tackle diabetic kidney disease and calls on the diabetes and kidney research communities to act upon these recommendations to ensure future research works to eliminate unfair and avoidable disparities in health.

Cohort profile: creation of the SAIL MELD-B e-cohort (SMC) and SAIL MELD-B children and young adult e-cohort (SMYC) to investigate the lived experience of the 'burdensomeness' of multimorbidity.

Purpose: We have established the SAIL MELD-B electronic cohort (e-cohort SMC) and the SAIL MELD-B children and Young adults e-cohort (SMYC) as a part of the Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) project. Each cohort has been created to investigate and develop a deeper understanding of the lived experience of the 'burdensomeness' of multimorbidity by identifying new clusters of burdensomeness concepts, exploring early life risk factors of multimorbidity and modelling hypothetical prevention scenarios.

Participants: The SMC and SMYC are longitudinal e-cohorts created from routinely collected individual-level population-scale anonymised data sources available within the Secure Anonymised Information Linkage (SAIL) Databank.

The impact of living with multiple long-term conditions (multimorbidity) on everyday life - a qualitative evidence synthesis.

Background: Multiple long-term conditions (MLTCs), living with two or more long-term conditions (LTCs), often termed multimorbidity, has a high and increasing prevalence globally with earlier age of onset in people living in deprived communities. A holistic understanding of the patient's perspective of the work associated with living with MLTCs is needed. This study aimed to synthesise qualitative evidence describing the experiences of people living with MLTCs (multimorbidity) and to develop a greater understanding of the effect on people's lives and ways in which living with MLTCs is 'burdensome' for people.

Effects of Azithromycin on Blood Inflammatory Gene Expression and Cytokine Production in Sarcoidosis.

Introduction: In sarcoidosis granulomas, monocyte-derived macrophages are activated by pro-inflammatory cytokines including TNF and IL-6. Current drug treatment for sarcoidosis aims to suppress inflammation but disabling side effects can ensue. The macrolide azithromycin may be anti-inflammatory.

Individual and neighborhood-level social and deprivation factors impact kidney health in the GLOMMS-CORE study.

Prospective cohort studies of kidney equity are limited by a focus on advanced rather than early disease and selective recruitment. Whole population studies frequently rely on area-level measures of deprivation as opposed to individual measures of social disadvantage. Here, we linked kidney health and individual census records in the North of Scotland (Grampian area), 2011-2021 (GLOMMS-CORE) and identified incident kidney presentations at thresholds of estimated glomerular filtration rate (eGFR) under 60 (mild/early), under 45 (moderate), under 30 ml/min/1.

Quality of life in people with chronic kidney disease: focusing on modifiable risk factors.

Purpose Of Review: With ageing populations and rising prevalence of key risk factors, the prevalence of many long-term conditions including chronic kidney disease (CKD) is increasing globally. Health-related quality of life (HRQoL) is important to people living with CKD but not all HRQoL determinants are modifiable. This review summarizes recently identified potentially modifiable factors affecting HRQoL for people with CKD and recent trials incorporating HRQoL as an outcome.

Primary and secondary care service use and costs associated with frailty in an ageing population: longitudinal analysis of an English primary care cohort of adults aged 50 and over, 2006-2017.

Background: Frailty becomes more prevalent and healthcare needs increase with age. Information on the impact of frailty on population level use of health services and associated costs is needed to plan for ageing populations.

Aim: To describe primary and secondary care service use and associated costs by electronic Frailty Index (eFI) category.

Multidisciplinary ecosystem to study lifecourse determinants and prevention of early-onset burdensome multimorbidity (MELD-B) - protocol for a research collaboration.

Background: Most people living with multiple long-term condition multimorbidity (MLTC-M) are under 65 (defined as 'early onset'). Earlier and greater accrual of long-term conditions (LTCs) may be influenced by the timing and nature of exposure to key risk factors, wider determinants or other LTCs at different life stages. We have established a research collaboration titled 'MELD-B' to understand how wider determinants, sentinel conditions (the first LTC in the lifecourse) and LTC accrual sequence affect risk of early-onset, burdensome MLTC-M, and to inform prevention interventions.