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https://www.readbyqxmd.com/read/29219905/systems-addressing-frail-elder-care-description-of-a-successful-model
#1
Lianna Zaven Ansryan, Harriet Udin Aronow, Jeff Edward Borenstein, Viola Mena, Flora Haus, Katherine Palmer, Ellen Chan, Jane W Swanson, Sharon Mass, Bradley Rosen, Glenn David Braunstein, Linda Burnes Bolton
OBJECTIVE: The aim of this article is to describe the Systems Addressing Frail Elder (SAFE) Care model, features of the interprofessional team and reengineered workflow, and details of the intervention. BACKGROUND: Older inpatients are vulnerable to adverse events related to frailty. SAFE Care, an interprofessional team-based program, was developed and evaluated in a cluster randomized controlled trial (C-RCT). Results found reduced length of stay and complications...
January 2018: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29219876/effectiveness-of-patient-centered-interventions-on-falls-in-the-acute-care-setting-compared-to-usual-care-a-systematic-review
#2
Donna Avanecean, Dawn Calliste, Teresita Contreras, Yeogyeong Lim, Aileen Fitzpatrick
BACKGROUND: Unintentional falls during hospitalization remain a concern for healthcare institutions globally despite implementation of various improvement strategies. Although the incidence of falls has been of heightened focus for many years and numerous studies have been done evaluating different approaches for fall prevention, fall rates remain high in acute care settings. Patient fall risk scales tend to address only particular intrinsic and extrinsic factors but do not adequately assess a patient's current fall risk status, subsequently warranting more patient-centered risk assessments and interventions...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29219799/-characteristics-and-healthcare-utilization-of-patients-with-highest-costs-of-care
#3
J J G Wammes, M Tanke, W Jonkers, G P Westert, P J van der Wees, P P T Jeurissen
OBJECTIVE: To determine characteristics and healthcare utilization of high-cost patients in the Netherlands. DESIGN: Cross-sectional study, using claim data for 2013 from one Dutch health insurer. Analyses were limited to the curative health system (care that falls under the Health Insurance Act), including voluntary supplementary insurance. METHOD: We established total healthcare costs per beneficiary by summing all claims with a starting date in 2013...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29217023/visual-impairment-as-an-independent-risk-factor-for-falls-in-hospitalized-patients
#4
Toshimitsu Kasuga, Fumiko Aruga, Koichi Ono, Yoshimune Hiratsuka, Akira Murakami
OBJECTIVE: To investigate the association between visual impairment and the risk of falls in hospitalized patients. DESIGN: Individually matched case-control study. METHODS: The medical records of patients who fell while hospitalized at Juntendo Tokyo Koto Geriatric Medical Center (JTKGMC) from January to December 2014 were reviewed retrospectively. Among them, 36 patients who were recorded as visiting the Ophthalmology Outpatient Clinic from 1 year before to 1 year after the fall were included as cases...
December 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/29216838/a-prediction-model-to-identify-hospitalised-older-adults-with-reduced-physical-performance
#5
Inge H Bruun, Thomas Maribo, Birgitte Nørgaard, Berit Schiøttz-Christensen, Christian B Mogensen
BACKGROUND: Identifying older adults with reduced physical performance at the time of hospital admission can significantly affect patient management and trajectory. For example, such patients could receive targeted hospital interventions such as routine mobilisation. Furthermore, at the time of discharge, health systems could offer these patients additional therapy to maintain or improve health and prevent institutionalisation or readmission. The principle aim of this study was to identify predictors for persisting, reduced physical performance in older adults following acute hospitalisation...
December 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29214512/anticholinergic-prescribing-in-medicare-part-d-beneficiaries-residing-in-nursing-homes-results-from-a-retrospective-cross-sectional-analysis-of-medicare-data
#6
Joshua Niznik, Xinhua Zhao, Tao Jiang, Joseph T Hanlon, Sherrie L Aspinall, Joshua Thorpe, Carolyn Thorpe
BACKGROUND: Prescribing of medications with anticholinergic properties in older nursing home residents is relatively common, despite an association with an increased risk for falls, delirium, and other outcomes. Few studies have investigated what factors influence different levels of prescribing of these agents. OBJECTIVES: The primary objective was to identify factors associated with low- and high-level anticholinergic burden in nursing home residents. A secondary objective was to examine in detail the contribution of different medications to low versus high burden to aid in determining which drugs to target in interventions...
December 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29212996/-a-comparison-of-the-associations-of-dynapenia-and-sarcopenia-with-fear-of-falling-in-elderly-diabetic-patients
#7
Satoshi Ida, Kazuya Murata, Yuki Ishihara, Kanako Imataka, Ryutaro Kaneko, Ryoko Fujiwara, Hiroka Takahashi
AIM: To comparatively investigate whether dynapenia and sarcopenia, as defined by the Asian Working Group for Sarcopenia (AWGS), are associated with fear of falling in elderly patients with diabetes. METHODS: The subjects were outpatients with diabetes who were at least 65 years of age when they visited our hospital. Sarcopenia was evaluated based on the AWGS definition. The cutoff values for the appendicular skeletal mass index (multi-frequency bioelectrical impedance method), grip strength, and walking speed were, respectively, 7...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/29210809/evaluation-and-refinement-of-a-handheld-health-information-technology-tool-to-support-the-timely-update-of-bedside-visual-cues-to-prevent-falls-in-hospitals
#8
Ruth C-A Teh, Renuka Visvanathan, Damith Ranasinghe, Anne Wilson
AIM: To evaluate clinicians' perspectives, before and after clinical implementation (i.e. trial) of a handheld health information technology (HIT) tool, incorporating an iPad device and automatically generated visual cues for bedside display, for falls risk assessment and prevention in hospital. METHODS: This pilot study utilized mixed-methods research with focus group discussions and Likert-scale surveys to elicit clinicians' attitudes. The study was conducted across three phases within two medical wards of the Queen Elizabeth Hospital...
November 27, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29209550/rare-case-of-large-bowel-injury-due-to-direct-blunt-trauma-to-a-preexisting-femoral-hernia
#9
C Tinner, M Odermatt, P Villiger
We report a case of an 85-year-old man with a known asymptomatic left femoral hernia who was admitted to the emergency ward a few hours after falling from a bicycle and suffering from blunt trauma of the handlebar to the left inguinal region. The clinical findings and a computed tomography (CT) scan detecting free air in the femoral hernia sac suggested bowel perforation. Emergency laparotomy 6 hours after the incident confirmed a tear of the sigmoid colon accompanied by free blood and faeces in the left inguinal region of the abdomen...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29206823/-thoracic-and-lumbar-fractures-in-adolescents-an-eight-year-study
#10
Félix Adolfo Sánchez-Chávez, Jorge Arturo Cabrera-Escamilla
METHODS: In order to know the characteristics of these lesions in our environment and compare with those the adults, a transversal and descriptive study of adolescents between 12 and 18 years who were hospitalized for thoracic and lumbar fracture in two centers of high level trauma in our country for 8 years was performed. The variables studied were applied statistical analysis descriptive and correlation. RESULTS: They were found significant date by associating the causes of damage with associated lesions (p = 0...
November 2017: Gaceta Médica de México
https://www.readbyqxmd.com/read/29205846/use-and-clinical-efficacy-of-standard-and-health-information-technology-fall-risk-assessment-tools
#11
Ruth C Teh, Anne Wilson, Damith Ranasinghe, Renuka Visvanathan
OBJECTIVE: To evaluate the health information technology (HIT) compared to Fall Risk for Older Persons (FROP) tool in fall risk screening. METHODS: A HIT tool trial was conducted on the geriatric evaluation and management (GEM, n = 111) and acute medical units (AMU, n = 424). RESULTS: Health information technology and FROP scores were higher on GEM versus AMU, with no differences between people who fell and people who did not fall. Both score completion rates were similar, and their values correlated marginally (Spearman's correlation coefficient 0...
December 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29204686/weather-conditions-influence-the-number-of-psychiatric-emergency-room-patients
#12
Eva Janina Brandl, Tristram A Lett, George Bakanidze, Andreas Heinz, Felix Bermpohl, Meryam Schouler-Ocak
The specific impact of weather factors on psychiatric disorders has been investigated only in few studies with inconsistent results. We hypothesized that meteorological conditions influence the number of cases presenting in a psychiatric emergency room as a measure of mental health conditions. We analyzed the number of patients consulting the emergency room (ER) of a psychiatric hospital in Berlin, Germany, between January 1, 2008, and December 31, 2014. A total of N = 22,672 cases were treated in the ER over the study period...
December 4, 2017: International Journal of Biometeorology
https://www.readbyqxmd.com/read/29204497/decreased-risk-of-knee-buckling-with-adductor-canal-block-versus-femoral-nerve-block-in-total-knee-arthroplasty-a-retrospective-cohort-study
#13
Ryan R Thacher, Thomas R Hickernell, Matthew J Grosso, Roshan Shah, Herbert J Cooper, Robert Maniker, Anthony Robin Brown, Jeffrey Geller
Background: Femoral nerve (FNB) and adductor canal blocks (ACB) are used in the setting of total knee arthroplasty (TKA), but neither has been demonstrated to be clearly superior. Although dynamometer studies have shown ACBs spare perioperative quadriceps function when compared to FNBs, ACBs have been widely adopted in orthopaedic surgery without significant evidence that they decrease the risk of perioperative falls. Methods: All patients who received single-shot FNB (129 patients) or ACB (150 patients) at our institution for unilateral primary TKA from April 2014 to September 2015 were retrospectively reviewed for perioperative falls or near-falls during physical therapy and inpatient care...
December 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/29204193/management-and-outcome-analysis-of-pediatric-unstable-thoracolumbar-spine-injury-large-surgical-series-with-literature-review
#14
REVIEW
Guru Dutta Satyarthee, M Sangani, Sumit Sinha, Deepak Agrawal
Pediatric thoracolumbar spine fractures are considered rare injuries with paucity of publication across the globe. Further, spine injuries in children are comparatively rarer, and pediatric spine differs from adults, both biomechanically and anatomically; so, adult spine management strategy cannot be applied to pediatric cases, and exact guidelines for management of pediatric spinal injury is lacking. The current study is undertaken to study epidemiology, surgical management, and outcome of pediatric dorsolumbar unstable spine injury...
July 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29203597/perspectives-on-innovations-in-oral-health-care
#15
R Gary Rozier
A downward trend in dental caries in permanent teeth of children that began in the 1970s has leveled out at historic lows. Severe periodontal disease affects a small percentage of people, and tooth loss has plummeted so that complete tooth loss, once a common occurrence, now is almost non-existent in upper socioeconomic groups. But not all people have benefited equally from these positive trends. Dental problems continue to affect the disadvantaged in society at unacceptable rates, and their disease burden is likely to increase because of trends in social determinants of oral diseases...
November 2017: North Carolina Medical Journal
https://www.readbyqxmd.com/read/29203200/traumatic-skull-fractures-in-children-and-adolescents-a-retrospective-observational-study
#16
Hongwei Wang, Yue Zhou, Jun Liu, Lan Ou, Jianda Han, Liangbi Xiang
OBJECTIVE: To investigate the epidemiological features of child and adolescent (≤18 years old) patients managed for traumatic skull fractures (TSKFs) and associated traumatic brain injury (TBI). DESIGN: 393 Patients who were children and adolescent who had TSKFs admitted to our university affiliated hospitals between January 2003 and December 2010. The incidence and patterns were summarized with respect to different age group, admission time and etiology. SETTING: Two university-affiliated hospitals from January 2003 to May 2010...
November 29, 2017: Injury
https://www.readbyqxmd.com/read/29202811/high-prevalence-of-prescription-of-psychotropic-drugs-for-older-patients-in-a-general-hospital
#17
Inken Arnold, Kati Straube, Wolfgang Himmel, Stephanie Heinemann, Vivien Weiss, Laura Heyden, Eva Hummers-Pradier, Roland Nau
BACKGROUND: Many elderly patients receive psychotropic drugs. Treatment with psychotropic agents is associated with serious side effects including an increased risk of falls and fractures. Several psychotropic drugs are considered potentially inappropriate for treatment of the elderly. METHODS: A retrospective chart review was conducted covering all patients aged ≥ 65 years who were admitted to Evangelisches Krankenhaus Göttingen-Weende between 01/01/2013 and 03/31/2013...
December 4, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29202254/incidence-correlates-and-outcomes-associated-with-falls-in-the-intensive-care-unit-a-retrospective-cohort-study
#18
Drayton Trumble, Michael A Meier, Maryellen Doody, Xiaoming Wang, Sean M Bagshaw
BACKGROUND: Falls among hospitalised patients contribute to avoidable morbidity and prolonged hospital stay. We aimed to describe the incidence, circumstances and outcomes associated with patient falls occurring in intensive care units. METHODS: Retrospective cohort study of adult admissions to an academic, tertiary ICU in Edmonton, Canada between 1 January 2013 and 30 April 2016. Fall events were ascertained by interrogation of an electronic health record. Each fall was independently adjudicated by two intensivists to confirm that a fall did occur, and to determine if the fall was potentially avoidable...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29201960/demographics-of-fall-related-trauma-among-the-elderly-presenting-to-emergency-department-a-cross-sectional-study
#19
Hamid Reza Morteza Bagi, Sajjad Ahmadi, Maryam Hosseini
Introduction: Falling is reported to be the most common cause of mortality due to trauma in individuals over the age of 75 years. The present study is designed with the aim of determining the demographics of fall-related trauma among the elderly presenting to emergency department (ED). Methods: The present prospective cross-sectional study was carried out on all elderly patients ≥ 60 years old presenting to ED of a major referral trauma center in North West of Iran during 1 year...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/29201839/trauma-patterns-of-drowning-after-falling-from-bridges-over-han-river
#20
Jung Hwan Lee, Chung Kee Chough, Jae Il Lee
Objective: Recently, the number of patients who fell or jumped from bridges over Han River has rapidly increased. However, the injury patterns and outcomes of these patients have been poorly characterized. The aim of this study was to determine the injury characteristics of these patients. Methods: We reviewed the medical records of all patients who were transferred to the Emergency Room due to jumping or falling from bridges over Han River between 2011 and 2015...
October 2017: Korean Journal of Neurotrauma
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