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https://www.readbyqxmd.com/read/28642002/development-of-geriatric-mental-health-learning-objectives-for-medical-students-a-response-to-the-institute-of-medicine-2012-report
#1
Susan W Lehmann, William B Brooks, Dennis Popeo, Kirsten M Wilkins, Mary C Blazek
America is aging as the population of older adults increases. The shortage of geriatric mental health specialists means that most geriatric mental healthcare will be provided by physicians who do not have specialty training in geriatrics. The Institute of Medicine Report of 2012 highlighted the urgent need for development of national competencies and curricula in geriatric mental health for all clinicians. Virtually all physicians can expect to treat older patients with mental health symptoms, yet currently there are no widely accepted learning objectives in geriatric mental health specific for medical students...
May 12, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28622606/dementia-correlates-with-anticoagulation-underuse-in-older-patients-with-atrial-fibrillation
#2
Giovanni Viscogliosi, Evaristo Ettorre, Iulia Maria Chiriac
OBJECTIVES: Stroke prevention in older atrial fibrillation (AF) patients remains a challenge. This study aimed to investigate whether a dementia diagnosis is an independent correlate of lower prescription rate of oral anticoagulant treatment (OAT) in a sample of older AF patients. METHODS: Cross-sectional retrospective study. Consecutive older community-dwelling AF patients referred for a comprehensive geriatric assessment, were considered. Evaluation of physical, social and mental health, and administration of the Cumulative Illness Rating Scale (CIRS) and Barthel Index were performed...
June 8, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28559128/performance-of-the-modified-richmond-agitation-sedation-scale-in-identifying-delirium-in-older-emergency-department-patients
#3
Florian F Grossmann, Wolfgang Hasemann, Reto W Kressig, Roland Bingisser, Christian H Nickel
BACKGROUND: Delirium in older emergency department (ED) patients is associated with severe negative patient outcomes and its detection is challenging for ED clinicians. ED clinicians need easy tools for delirium detection. We aimed to test the performance criteria of the modified Richmond Agitation Sedation Scale (mRASS) in identifying delirium in older ED patients. METHODS: The mRASS was applied to a sample of consecutive ED patients aged 65 or older by specially trained nurses during an 11-day period in November 2015...
May 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28540113/comparison-of-3-different-perioperative-care-models-for-patients-with-hip-fractures-within-1-health-service
#4
Lillian Sarah Coventry, Austin Nguyen, Amalia Karahalios, Sasha Roshan-Zamir, Phong Tran
INTRODUCTION: Orthogeriatric care models have been introduced within many health-care facilities to improve outcomes for hip fracture patients. This study aims to evaluate differences in care between 3 models, an orthopedic model, a geriatric model, and a comanaged model. MATERIALS AND METHODS: A retrospective analysis was conducted for hip fracture patients treated at Western Health between November 2012 and March 2014. All patients aged 65 years or older were included in the analysis...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28532688/progress-in-the-contemporary-management-of-hemophilia-the-new-issue-of-patient-aging
#5
REVIEW
Pier Mannuccio Mannucci, Massimo Iacobelli
The management of inherited coagulation disorders such as hemophilia A and B has witnessed dramatic progresses since the last few decades of the last century. Accordingly, persons with hemophilia (PWH) now enjoy a life expectancy at birth not different from that of males in the general population, at least in high income countries. Nowadays, a substantial proportion of PWH are aging, like their peers in the general population. This outstanding progress is accompanied by problems that are in part similar to those of any old person (multiple concomitant diseases and the resulting intake of multiple drugs other than those specific for hemophilia treatment)...
May 20, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28513887/geriatrics-for-specialists-initiative-an-eleven-specialty-collaboration-to-improve-care-of-older-adults
#6
Andrew G Lee, John A Burton, Nancy E Lundebjerg
In the early 1990s, visionary leaders at the American Geriatrics Society and The John A. Hartford Foundation recognized that the marked and growing shortage of geriatrics healthcare professionals would lead to a U.S. healthcare system ill prepared to provide optimal care for the ever-increasing number of older Americans. Led by the late Dennis W. Jahnigen, MD, they set forth a plan to address this shortage by collaborating with surgical and related medical specialists to create a series of programs to foster the highest quality care of older adults...
May 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28500499/-anesthesiological-care-of-trauma-patients-in-orthogeriatric-co-management
#7
Markus F Luger, Thomas J Luger
Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification...
May 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28499724/cardio-oncology-in-the-older-adult
#8
REVIEW
Prajwal Reddy, Chetan Shenoy, Anne H Blaes
Heart disease and cancer are the leading causes of death in older adults. Many first-line cancer treatments have the potential for cardiotoxicity. Age-related risk factors, pre-existing cardiac disease, and a high prevalence of comorbidities are reasons for increased cardiotoxicity in older adults. Concerns regarding cardiotoxicity may lead to frailty bias and undertreatment, resulting in suboptimal outcomes. There is an urgent need for geriatric-specific evidence and guidelines to help tailor care for this vulnerable group...
May 9, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28471943/clinical-implications-of-aging-with-hiv-infection-perspectives-and-the-future-medical-care-agenda
#9
Giovanni Guaraldi, Frank J Palella
: The increasing number of aging HIV-infected (HIV+) persons comprises a unique population at risk for illnesses and syndromes traditionally associated with the elderly. As a result, similar to the current need for primary care providers to manage chronic noninfectious comorbidities among aging persons with well controlled HIV infection, HIV clinical care will need to routinely involve geriatric medicine in a new HIV-geriatric discipline. The objective of this article is to provide a conceptual framework in which HIV and geriatric management considerations for healthcare professionals caring for HIV+ persons are integrated...
June 1, 2017: AIDS
https://www.readbyqxmd.com/read/28469902/reducing-returns-to-theatre-for-neck-of-femur-fracture-patients
#10
Selina Graham, Mark Dahill, Derek Robinson
The Royal United Hospital, Bath, admits approximately 550 patients with neck of femur fractures per year. The risks from returning to theatre for this patient group are often life-threatening. Post-operative wound ooze was noted to cause a significant rate of return to theatre, with increased lengths of stay and patient morbidity. A wound closure protocol was agreed by the consultant body. This information was disseminated by email and teaching sessions to all members of the multidisciplinary team, including surgeons, theatre staff and ortho-geriatricians...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28459304/how-can-we-best-screen-for-cognitive-impairment-in-malaysia-a-pilot-of-the-idea-cognitive-screen-and-picture-based-memory-impairment-scale-and-comparison-of-criterion-validity-with-the-mini-mental-state-examination
#11
Roshaslina Rosli, Maw Pin Tan, William K Gray, Pathmawathi Subramanian, Noran Naqiah Mohd Hairi, Ai-Vyrn Chin
OBJECTIVES: To pilot two new cognitive screening tools for use in an urban Malaysian population and to compare their criterion validity against a gold standard, the well-established Mini-Mental State Examination (MMSE). METHODS: The IDEA cognitive screen, Picture-based Memory Impairment Scale (PMIS), and MMSE were administered to a convenience sample of elderly (≥ 65 years) from the community and outpatient clinics at an urban teaching hospital. Consensus diagnosis was performed by two geriatricians blinded to PMIS and IDEA cognitive screen scores using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) clinical criteria...
March 29, 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/28451380/which-factors-affect-the-implementation-of-geriatric-recommendations-by-primary-care-physicians
#12
Yan Press, Boris Punchik, Ella Kagan, Alex Barzak, Tamar Freud
BACKGROUND: The overall implementation rate for outpatient comprehensive geriatric assessment (OCGAU) recommendations ranges from 48.6 to 71%. The purpose of the study was to identify factors that reduce the implementation rate of geriatric recommendations. METHODS: The medical records of patients who were assessed in the comprehensive geriatric assessment unit over an 8 year study period were surveyed. Data collected included patient's characteristics (socio-demographic, functional, cognitive, and affective condition, co-morbidity), number of recommendations, the identity of the geriatrician, and data related to the primary physician (age, sex, seniority, number of patients referred for geriatric assessment)...
2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28432823/-gerimedjc-the-twitter-complement-to-the-traditional-format-geriatric-medicine-journal-club
#13
Amanda I Gardhouse, Laura Budd, Seu Y C Yang, Camilla L Wong
Twitter is a public microblogging platform that overcomes physical limitations and allows unrestricted participation beyond academic silos, enabling interactive discussions. Twitter-based journal clubs have demonstrated growth, sustainability, and worldwide communication, using a hashtag (#) to follow participation. This article describes the first year of #GeriMedJC, a monthly 1-hour live, 23-hour asynchronous Twitter-based complement to the traditional-format geriatric medicine journal club. The Twitter moderator tweets from the handle @GeriMedJC; encourages use of #GeriMedJC; and invites content experts, study authors, and followers to participate in critical appraisal of medical literature...
April 22, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28400963/psychiatry-and-the-geriatric-syndromes-creating-constructive-interfaces
#14
EDITORIAL
Simon Thacker, Mike Skelton, Rowan Harwood
Integrating mental and physical healthcare is difficult to achieve because of professional and organisational barriers. Psychiatrists recognise the problems resulting from fragmentation of services and want continuity of care for patients, but commissioning and service structures perpetuate these problems. One way forward may be to follow the syndromic model employed by geriatricians as a means of avoiding over-emphasis on diagnosis above the pragmatics of implementing multi-component, coordinated care. Commissioners need to be made aware of the overlap and complementarity of skills possessed by old age psychiatry and geriatric medicine to create joint services for people vulnerable to dementia and delirium...
April 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28387803/from-one-syndrome-to-many-incorporating-geriatric-consultation-into-hiv-care
#15
Harjot K Singh, Tessa Del Carmen, Ryann Freeman, Marshall J Glesby, Siegler Eugenia L
Antiretroviral therapy has enabled people to live long lives with HIV. As a result, most HIV-infected adults in the US are over 50. In light of this changing epidemiology, HIV providers must recognize and manage multiple comorbidities and aging-related syndromes. Geriatric principles can help meet this new challenge, as preservation of function and optimization of social and psychological health are relevant to the care of aging HIV-infected adults, even those who are not yet old. Nonetheless, the field is still in its infancy...
April 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28384148/provision-of-stroke-thrombolysis-services-in-new-zealand-changes-between-2011-and-2016
#16
Qiliang Liu, Annemarei Anna Ranta, Ginny Abernethy, P Alan Barber
AIMS: To obtain an overall picture of the organisation of stroke thrombolysis provision in New Zealand hospitals and compare changes between 2011 and 2016. METHODS: Surveys were distributed to all New Zealand district health boards (DHBs) in 2011 and 2016, and included questions about the infrastructure, staffing, training, guidelines and audit provided for stroke thrombolysis. RESULTS: Responses were received from all DHBs, with 86% offering stroke thrombolysis in 2011 and 100% in 2016...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28372591/cooperation-between-geriatricians-and-general-practitioners-for-improved-pharmacotherapy-in-home-dwelling-elderly-people-receiving-polypharmacy-the-coop-study-study-protocol-for-a-cluster-randomised-controlled-trial
#17
Rita Romskaug, Espen Molden, Jørund Straand, Hege Kersten, Eva Skovlund, Kaisu H Pitkala, Torgeir Bruun Wyller
BACKGROUND: Polypharmacy and inappropriate drug use is associated with negative health outcomes among older people. Various interventions for improving drug treatment have been evaluated, but the majority of studies are limited by the use of surrogate outcomes or suboptimal design. Thus, the potential for clinically significant improvements from different interventions is still unclear. The main objective of this study is therefore to evaluate the effect upon patient-relevant endpoints of a cooperation between geriatricians and general practitioners on complex drug regimens in home-dwelling elderly people...
April 4, 2017: Trials
https://www.readbyqxmd.com/read/28367005/a-multidisciplinary-approach-to-improve-the-quality-of-care-for-patients-with-fragility-fractures
#18
Laura C Lamb, Stephanie C Montgomery, Brian Wong Won, Siobhan Harder, Jeffrey Meter, James M Feeney
BACKGROUND: Fragility fractures have become a worldwide epidemic associated with significant morbidity and mortality. As the world population ages, the number of patients that experience these fractures is also expected to rise. A multidisciplinary team was assembled that was coordinated by the Acute Inpatient Medical Service and included orthopedic surgeons, geriatricians, anesthesiologists, cardiologists, nurses, trauma surgeons, emergency medicine physicians, physiatrists, and physical therapists...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28340600/an-evaluation-of-the-comparative-effectiveness-of-geriatrician-led-comprehensive-geriatric-assessment-for-improving-patient-and-healthcare-system-outcomes-for-older-adults-a-protocol-for-a-systematic-review-and-network-meta-analysis
#19
Charlene Soobiah, Caitlin Daly, Erik Blondal, Joycelyne Ewusie, Joanne Ho, Meghan J Elliott, Rossini Yue, Jayna Holroyd-Leduc, Barbara Liu, Sharon Marr, Jenny Basran, Andrea C Tricco, Jemila Hamid, Sharon E Straus
BACKGROUND: Comprehensive geriatric assessment (CGA) is an integrated model of care involving a geriatrician and an interdisciplinary team and can prioritize and manage complex health needs of older adults with multimorbidity. CGAs differ across healthcare settings, ranging from shared care conducted in primary care settings to specialized inpatient units in acute care. Models of care involving geriatricians vary across healthcare settings, and it is unclear which CGA model is most effective...
March 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28338866/the-growing-challenge-of-major-trauma-in-older-people-a-role-for-comprehensive-geriatric-assessment
#20
James Michael Fisher, Charlotte Bates, Jay Banerjee
In this commentary article, we describe the impact that an ageing population is having on the nature of major trauma seen in emergency departments. The proportion of major trauma victims who are older people is rapidly increasing and a fall from standing is now the most common mechanism of injury in major trauma. Potential barriers to effective care of this patient group are highlighted, including: a lack of consensus regarding triage criteria; potentially misleading physiological parameters within triage criteria; non-linear patient presentations and diagnostic nihilism...
March 10, 2017: Age and Ageing
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