"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

The Distribution, Composition, and Management of Drifting Fish Aggregating Devices (dFADs) in the North Atlantic Ocean

Drifting Fish Aggregating Devices (dFADs) are a gear accessory utilized on a global scale by commercial fishers to increase catch size and efficiency of target pelagic fishes such as tuna and dolphinfish. Despite their widespread use, there are few scientific estimates of the total number of abandoned or beached dFADs in the Atlantic Ocean and Caribbean Basin or the compliance of dFAD use with t-RFMO recommendations. Previous studies have utilized the modeled drift trajectories of dFADs to predict beaching probability and location, but this study is the first of its kind, analyzing true beaching events. This study identifies the beaching location, composition, and ICCAT Rec. 19-02 compliance of stranded dFADs in the western North Atlantic and Caribbean Sea using citizen science data reported over social media. Abandoned, lost, or otherwise discarded (ALDFG) dFADs were reported on the shores of the Gulf of Mexico, along the Atlantic coast of the United States and 17 Caribbean island nations, with reports as distant as Scotland, Ireland, and Brazil. Sixty-one (22.8%) dFADs were reported as having beached in United States National or State Parks, MPAs (both domestic and foreign), as well as foreign conservation areas. Furthermore, a total of 119 (61.03%) of photo-documented dFADs were non-compliant. It is my recommendation that the distribution of abandoned lost, and otherwise discarded dFADs be surveyed in the North Atlantic Ocean to gain better understanding of the scope of dispersal and construction. Additional research is necessary to determine best practices of identification marking schemes and ALDFG recovery incentives

Caribbean FAD Tracking Project Dataset

This dataset encompasses crowd-sourced reports of abandoned, lost or otherwise discarded fishing gear (ALDFG), particularly drifting Fish Aggregating Devices (dFADs) from citizen scientists around the North Atlantic Ocean and greater Caribbean region. Data collection did not involve survey efforts, but rather keyword searches of affiliated terms such as bamboo raft and satellite buoy , as well as collection of reports via email and Facebook. Although this dataset is incomplete and an under representation of the total number of ALDFG dFADs as a result of widespread nature of stranding locations, it provides a minimum estimate of the numbers of FADs stranding in coastal Caribbean regions and insight into the lack of sufficient ALDFG management and mitigation