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Geriatric emergency medicine

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https://www.readbyqxmd.com/read/28913934/the-incidence-of-sarcopenia-among-hospitalized-older-patients-results-from-the-glisten-study
#1
Anna Maria Martone, Lara Bianchi, Pasquale Abete, Giuseppe Bellelli, Mario Bo, Antonio Cherubini, Francesco Corica, Mauro Di Bari, Marcello Maggio, Giovanna Maria Manca, Emanuele Marzetti, Maria Rosaria Rizzo, Andrea Rossi, Stefano Volpato, Francesco Landi
BACKGROUND: New evidence is emerging on the importance of lean body mass during periods of illness and recovery. The preservation of lean body mass during such periods of intense stress impacts both patient and treatment outcomes. However, data concerning the incidence of sarcopenia among older people during hospitalization are scarce. The objective of this study was to evaluate the development of sarcopenia in a sample of hospitalized older subjects. METHODS: We used data of 394 participants from the multicentre Italian Study conducted by the Gruppo Lavoro Italiano Sarcopenia-Trattamento e Nutrizione (GLISTEN) in 12 Acute Care Wards (Internal Medicine and Geriatrics) of University Hospitals across Italy...
September 14, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28874007/new-horizons-in-comprehensive-geriatric-assessment
#2
S G Parker, A McLeod, P McCue, K Phelps, M Bardsley, H C Roberts, S P Conroy
In this article, we discuss the emergence of new models for delivery of comprehensive geriatric assessment (CGA) in the acute hospital setting. CGA is the core technology of Geriatric Medicine and for hospital inpatients it improves key outcomes such as survival, time spent at home and institutionalisation. Traditionally It is delivered by specialised multidisciplinary teams, often in dedicated wards, but in recent years has begun to be taken up and developed quite early in the admission process (at the 'front door'), across traditional ward boundaries and in specialty settings such as surgical and pre-operative care, and oncology...
September 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28776066/-management-of-an-elderly-patient-in-the-emergency-room-at-the-end-of-life-a%C3%A2-medical-ethics-challenge
#3
G Michels, R Nies, S Ortmann, R Pfister, F Salomon
A 94-year-old patient with cardiogenic shock due to myocardial infarction was admitted via the emergency room. A coronary angiography and intensive care were requested. The need for care due to dementia was known. After case discussion in the interdisciplinary and multiprofessional treatment team, the decision for a palliative care concept in the form of symptom control was made in the emergency room, taking into account the patient's medical history, the current situation, and the presumed patient consent...
August 3, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28610755/epistemological-erasure-the-subject-of-abuse-in-the-problematization-of-elder-abuse
#4
Bridget Garnham, Lia Bryant
The academic field of literature pertaining to elder abuse emerges largely from gerontology with contributions from a variety of disciplines including geriatric medicine, nursing, public health, law, psychology, sociology and social work. This paper presents a critical review of articles drawn from this literature to identify current directions leading the development of empirical research in this field. The objective measurement of prevalence, the identification and correlation of psycho-social risk factors and practice-based research oriented to intervention and prevention are identified as privileged sites for scientific investigation...
April 2017: Journal of Aging Studies
https://www.readbyqxmd.com/read/28586939/-urgent-visits-to-nursing-homes-a-general-practitioner-s-perspective
#5
Markus Bleckwenn, David Ashrafnia, Rieke Schnakenberg, Klaus Weckbecker
Aim of the study Due to demographic changes, home visits to nursing care facilities are increasing. Urgent home visits represent a challenge for general practitioners. There are no recommendations for the implementation of urgent home visits. Therefore, in this study, we investigated how GP practices deal with urgent home visits and what improvements can be made to the medical emergency care. Methods A total of 15 teaching doctors of the Department of Family Medicine at the University of Bonn were interviewed using semi-structured interviews on the subject...
June 6, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28513843/meeting-the-need-for-training-in-geriatrics-the-geriatrics-education-for-specialty-residents-program
#6
Myron Miller, Ronnie A Rosenthal
The imperative created by increasing numbers of aging Americans coupled with increasing longevity has generated recognition and acceptance within american medicine that education, from medical school through postgraduate training through continuing medical education, must include appropriate knowledge and skills in aging and geriatrics to provide for effective care of older adults. Such education and training is necessary not only for traditional primary care providers, but also for specialty physicians, including those in most surgical specialties and in related fields such as anesthesiology, emergency medicine and physical medicine and rehabilitation...
May 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28367005/a-multidisciplinary-approach-to-improve-the-quality-of-care-for-patients-with-fragility-fractures
#7
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/28338866/the-growing-challenge-of-major-trauma-in-older-people-a-role-for-comprehensive-geriatric-assessment
#8
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...
September 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28196947/cohort-profile-the-welsh-geriatric-registrar-led-research-network-wegen-rationale-design-and-description
#9
Benjamin Jelley, Sara Long, John Butler, Jonathan Hewitt
PURPOSE: Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28182802/the-association-of-geriatric-syndromes-with-hospital-outcomes
#10
Roman Romero-Ortuno, Duncan R Forsyth, Kathryn Jane Wilson, Ewen Cameron, Stephen Wallis, Richard Biram, Victoria Keevil
BACKGROUND: Frailty, history of dementia (HoD), and acute confusional states (ACS) are common in older patients admitted to hospital. OBJECTIVE: To study the association of frailty (≥6 points in the Clinical Frailty Scale [CFS]), HoD, and ACS with hospital outcomes, controlling for age, gender, acute illness severity (measured by a Modified Early Warning Score in the emergency department), comorbidity (Charlson Comorbidity Index), and discharging specialty (general medicine, geriatric medicine, surgery)...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28143449/cancers-of-unknown-primary-diagnosed-during-hospitalization-a-population-based-study
#11
William Jones, Gwen Allardice, Iona Scott, Karin Oien, David Brewster, David S Morrison
BACKGROUND: Cancers of Unknown Primary (CUP) are the 3-4(th) most common causes of cancer death and recent clinical guidelines recommend that patients should be directed to a team dedicated to their care. Our aim was to inform the care of patients diagnosed with CUP during hospital admission. METHODS: Descriptive study using hospital admissions (Scottish Morbidity Record 01) linked to cancer registrations (ICD-10 C77-80) and death records from 1998 to 2011 in West of Scotland, UK (population 2...
January 31, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28120773/medication-reconciliation-a-tool-to-prevent-adverse-drug-events-in-geriatrics-medicine
#12
Anaïs Berthe, Clémentine Fronteau, Éloïse Le Fur, Caroline Morin, Jean-François Huon, Isabelle Rouiller-Furic, Marielle Berlioz-Thibal, Gilles Berrut, Aline Lepelletier
Iatrogenic effects represent a large part of emergency admissions among elderly people. Throughout the care pathway of a patient, whether he is at home or hospitalized, many different health professionals are involved regarding the patient's medication. Medication reconciliation is one way to prevent adverse drug events at all care transitions for every patient by eliminating undocumented intentional discrepancies and unintentional discrepancies in the patient's medication. The aim of this article is to present the different activities of clinical pharmacy developed since 2011 in a follow up and rehabilitation geriatric care service, including medication reconciliation activity...
March 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28077927/utility-of-self-competency-ratings-during-residency-training-in-family-medicine-education-emerging-countries-findings-from-japan
#13
Michael D Fetters, Satoko Motohara, Lauren Ivey, Keiichiro Narumoto, Kiyoshi Sano, Masahiko Terada, Tsukasa Tsuda, Machiko Inoue
BACKGROUND: Family medicine education-emerging countries face challenges in demonstrating a new program's ability to train residents in womb-to-tomb care and resident ability to provide such care competently. We illustrate the experience of a new Japanese family medicine program with resident self-competency assessments. METHODS: In this longitudinal cross-sectional study, residents completed self-competency assessment surveys online during 2011-2015. Each year of training, residents self-ranked their competence using a 100-point visual analog scale for 142 conditions: acute (30 conditions), chronic (28 conditions) women's health (eight conditions), and geriatrics/home (12 conditions) care; procedures (38 types); health promotion (21 conditions)...
2017: Asia Pacific Family Medicine
https://www.readbyqxmd.com/read/28003385/evidence-for-greater-forensic-education-of-all-psychiatry-residents
#14
Howard L Forman, David W Preven
Booth and his colleagues have made an important contribution to the emerging evidence base that shows education in forensic psychiatry topics can improve attitudes toward the field. Given the desinstitutionalization of those with severe mental illness from state psychiatric facilities and the incarceration of many individuals with severe mental illness in correctional facilities, the need to train many more psychiatrists with competence in correctional settings is clear. Simply training more forensic psychiatrists will not both meet the psychiatric needs of incarcerated patients and fulfill the essential roles forensic psychiatrists play in the justice system...
December 2016: Journal of the American Academy of Psychiatry and the Law
https://www.readbyqxmd.com/read/27959354/delivering-comprehensive-geriatric-assessment-in-new-settings-advice-for-frontline-clinicians
#15
J R Gladman
Over the decades, as the principles of comprehensive geriatric assessment have been established, there have been attempts to apply its principles to settings other than acute hospital medical wards or the general communitydwelling older population, for example, to other settings where older people with infirmity are found. The purpose of this paper is to describe and reflect upon the application of and evidence for comprehensive geriatric assessment in these new settings and give some advice to clinicians about how to optimise their contributions to these processes...
September 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27761112/hospitalizations-due-to-adverse-drug-events-in-the-elderly-a-retrospective-register-study
#16
Outi Laatikainen, Sami Sneck, Risto Bloigu, Minna Lahtinen, Timo Lauri, Miia Turpeinen
Adverse drug events (ADEs) are more likely to affect geriatric patients due to physiological changes occurring with aging. Even though this is an internationally recognized problem, similar research data in Finland is still lacking. The aim of this study was to determine the number of geriatric medication-related hospitalizations in the Finnish patient population and to discover the potential means of recognizing patients particularly at risk of ADEs. The study was conducted retrospectively from the 2014 emergency department patient records in Oulu University Hospital...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27757231/emergency-department-crowding-in-singapore-insights-from-a-systems-thinking-approach
#17
Lukas K Schoenenberger, Steffen Bayer, John P Ansah, David B Matchar, Rajagopal L Mohanavalli, Sean Sw Lam, Marcus Eh Ong
OBJECTIVES: Emergency Department crowding is a serious and international health care problem that seems to be resistant to most well intended but often reductionist policy approaches. In this study, we examine Emergency Department crowding in Singapore from a systems thinking perspective using causal loop diagramming to visualize the systemic structure underlying this complex phenomenon. Furthermore, we evaluate the relative impact of three different policies in reducing Emergency Department crowding in Singapore: introduction of geriatric emergency medicine, expansion of emergency medicine training, and implementation of enhanced primary care...
2016: SAGE Open Medicine
https://www.readbyqxmd.com/read/27706002/the-european-curriculum-for-geriatric-emergency-medicine
#18
EDITORIAL
Abdelouahab Bellou, Simon P Conroy, Colin A Graham
No abstract text is available yet for this article.
August 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27699744/-factors-related-to-the-unplanned-90-day-readmission-rate-among-elderly-at-a-geriatric-medicine-center
#19
Chun-Fang Chiu, Miaw-I Lin, I Lee, Shiow-Rong Jeang, Yan-Choiu Ku
BACKGROUND: Unplanned readmissions increase healthcare utilization rates and healthcare costs. The Taiwan Healthcare Indicator Series regards the rate of hospital readmission as an important indicator of inpatient-care quality. The elderly face a higher risk of unplanned readmission due to elderly-specific health and disease characteristics such as deteriorating body functions and the relatively high incidence of complications after the treatment of acute diseases. PURPOSE: To explore the factors that relate to the unplanned readmission of elderly within 90 days of discharge at a geriatric medical center...
October 2016: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/27552616/association-of-integrated-team-based-care-with-health-care-quality-utilization-and-cost
#20
COMPARATIVE STUDY
Brenda Reiss-Brennan, Kimberly D Brunisholz, Carter Dredge, Pascal Briot, Kyle Grazier, Adam Wilcox, Lucy Savitz, Brent James
IMPORTANCE: The value of integrated team delivery models is not firmly established. OBJECTIVE: To evaluate the association of receiving primary care in integrated team-based care (TBC) practices vs traditional practice management (TPM) practices (usual care) with patient outcomes, health care utilization, and costs. DESIGN: A retrospective, longitudinal, cohort study to assess the association of integrating physical and mental health over time in TBC practices with patient outcomes and costs...
August 23, 2016: JAMA: the Journal of the American Medical Association
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