A contribution to the French validation of the clinical anxiety scale amongst health care workers in Switzerland.

BACKGROUND: Anxiety disorders are frequent but remain often underdiagnosed and undertreated. Hence, valid screening instruments are needed to enhance the diagnostic process. The Clinical Anxiety Scale (CAS) is a 25-item anxiety screening tool derived from the Hamilton Anxiety Scale (HAM-A). However, this scale is not available in French. The General anxiety disorder - 7 (GAD-7) scale, which has been validated in French, is a 7-item instrument with good psychometric properties. This study contributes to the validation of an adapted French version of the CAS, using the GAD-7 as the reference. METHODS: A forward-backward English-French-English translation of the CAS was performed according to standard practice. The French versions of the CAS and GAD-7 were completed by 127 French speaking healthcare professionals. CAS internal consistency was assessed using Crohnbach's alpha, and test-retest reliability was tested after 15 days in a subsample of 30 subjects. Convergent validity with GAD-7 was assessed using Pearson's correlation coefficient. Test-retest reliability was explored using one-way random effects model to calculate the intra-class correlation coefficient (ICC). RESULTS: French CAS showed excellent internal consistency (Cronbach's alpha 0.97), high convergent validity with GAD-7 (Pearson's R 0.81, p < 0.001), and very good test-retest reliability (ICC = 0.97, 95% CI 0.93-0.98). CONCLUSION: The proposed French version of the CAS showed high reliability and validity that need to be further investigated in different populations.

[Estimating renal function in older patients : which is the best formula?] / Estimation de la fonction rénale chez la personne âgée : quelle formule utiliser ?

An accurate assessment of renal function is crucial for the diagnosis and follow up of kidney diseases. However, there is currently no clear consensus on the optimal method on how to measure renal function in older individuals (>65 years of age). The Cockcroft-Gault formula, the MDRD equation, and the CKD-EPI equation are among the most used equations. However, they have several limitations when applied to the older population. Other formulas specifically developed for the older, such as the Berlin Initiative Study (BIS) and the Full Age Spectrum (FAS) equation, demonstrated conflicting results and require more external validation. This article provides an overview of the currently available methods to assess renal function in the older persons and summarizes their shortcomings.

Une évaluation correcte de la fonction rénale est essentielle pour diagnostiquer et prendre des décisions cliniques importantes. Cependant, il n'y a pas de consensus clair sur la meilleure méthode pour mesurer la fonction rénale chez les personnes âgées. Les équations les plus couramment utilisées sont la formule de Cockcroft-Gault et les équations MDRD et CKD-EPI, mais elles présentent des limitations dans cette population. D'autres formules spécifiquement développées pour les aînés, telles que l'étude de l'initiative de Berlin (BIS) et l'équation du spectre complet de l'âge (FAS), ont montré des résultats contradictoires et nécessitent des études de validation externe. En conclusion, les médecins doivent être conscients des différentes options disponibles et des limitations de chaque méthode pour prendre des décisions cliniques éclairées.

Risk Factors for Early Hospital Readmission in Geriatric Patients: A Systematic Review.

The number of older patients is constantly growing, and early hospital readmissions in this population represent a major problem from a health, social and economic point of view. Furthermore, the early readmission rate is often used as an indicator of the quality of care. We performed a systematic review of the literature to better understand the risk factors of early readmission (30 and 90 days) in the geriatric population and to update the existing evidence on this subject. The search was carried out on the MEDLINE, EMBASE and PsycINFO databases. Three independent reviewers assessed the potential inclusion of the studies, and then each study was independently assessed by two reviewers using Joanna Briggs Institute critical appraisal tools; any discrepancies were resolved by the third reviewer. Studies that included inpatients in surgical wards were excluded. Twenty-nine studies were included in the review. Risk factors of early readmission can be classified into socio-economic factors, factors relating to the patient's health characteristics, factors related to the use of the healthcare system and clinical factors. Among these risk factors, those linked to patient frailty play an important role, in particular malnutrition, reduced mobility, risk of falls, fatigue and functional dependence. The early identification of patients at higher risk of early readmission may allow for targeted interventions in view of discharge.