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Geriatric emergency medicine

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https://www.readbyqxmd.com/read/27761112/hospitalizations-due-to-adverse-drug-events-in-the-elderly-a-retrospective-register-study
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/27476988/geriatric-cardiology-an-emerging-discipline
#6
REVIEW
John A Dodson, Daniel D Matlock, Daniel E Forman
Given changing demographics, patients with cardiovascular (CV) disease in developed countries are now older and more complex than even a decade ago. This trend is expected to continue into the foreseeable future; accordingly, cardiologists are encountering patients with a greater number of comorbid illnesses as well as "geriatric conditions," such as cognitive impairment and frailty, which complicate management and influence outcomes. Simultaneously, technological advances have widened the therapeutic options available for patients, including those with the most advanced CV disease...
September 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27476983/assessment-and-utility-of-frailty-measures-in-critical-illness-cardiology-and-cardiac-surgery
#7
REVIEW
Naheed Rajabali, Darryl Rolfson, Sean M Bagshaw
Frailty is a clearly emerging theme in acute care medicine, with obvious prognostic and health resource implications. "Frailty" is a term used to describe a multidimensional syndrome of loss of homeostatic reserves that gives rise to a vulnerability to adverse outcomes after relatively minor stressor events. This is conceptually simple, yet there has been little consensus on the operational definition. The gold standard method to diagnose frailty remains a comprehensive geriatric assessment; however, a variety of validated physical performance measures, judgement-based tools, and multidimensional scales are being applied in critical care, cardiology, and cardiac surgery settings, including open cardiac surgery and transcatheter aortic value replacement...
September 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27475022/geriatric-emergency-medicine
#8
EDITORIAL
Amal Mattu
No abstract text is available yet for this article.
August 2016: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27475008/current-trends-in-geriatric-emergency-medicine
#9
REVIEW
Joseph H Kahn, Brendan G Magauran, Jonathan S Olshaker, Kalpana N Shankar
The number of geriatric visits to United States emergency departments continues to rise. This article reviews demographics, statistics, and future projections in geriatric emergency medicine. Included are discussions of US health care spending, geriatric emergency departments, prehospital care, frailty of geriatric patients, delirium, geriatric trauma, geriatric screening and prediction tools, medication safety, long-term care, and palliative care.
August 2016: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27372433/the-patient-participation-culture-tool-for-healthcare-workers-pact-hcw-on-general-hospital-wards-a-development-and-psychometric-validation-study
#10
S Malfait, K Eeckloo, J Van Daele, A Van Hecke
BACKGROUND: Patient participation is an important subject for modern healthcare. In order to improve patient participation on a ward, the ward's culture regarding patient participation should first be measured. In this study a measurement tool for patient participation culture from the healthcare worker's perspective, the Patient Participation Culture Tool for healthcare workers (PaCT-HCW), was developed and psychometrically evaluated. OBJECTIVES: The aim of this study was to develop and validate a tool that measures the healthcare worker-related factors of patient participation and information sharing and dialogue in patient participation from the healthcare worker's perspective in order to represent the patient participation culture on general and university hospital wards...
September 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27269239/surgery-in-the-older-person-training-needs-for-the-provision-of-multidisciplinary-care
#11
L Pearce, J Bunni, K McCarthy, J Hewitt
Introduction Many older surgical patients are exposed to high risks of morbidity and mortality when undergoing both elective and emergency surgery. Methods We provide an overview of perioperative care teams and the educational opportunities available to surgeons who undertake surgery in the older person. Findings The number of older people undergoing surgery is increasing at a rate faster than the proportion of older people in the overall population. Management of the older surgical patient throughout the surgical pathway forms part of the Specialty Training Curriculum for Geriatric Medicine...
July 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27242109/knowledge-of-the-law-about-withholding-or-withdrawing-life-sustaining-treatment-by-intensivists-and-other-specialists
#12
Ben White, Lindy Willmott, Colleen Cartwright, Malcolm H Parker, Gail Williams
OBJECTIVE: Decisions about withholding or withdrawing life-sustaining treatment (WWLST) from adults who lack capacity are an integral part of intensive care (IC) practice. We compare the knowledge, attitudes and practice of intensivists in relation to the law about WWLST with six other specialties most often involved in end-of-life care. DESIGN, SETTING AND PARTICIPANTS: We used a cross-sectional postal survey of medical specialists in the three most populous Australian states, and analysed responses from 867 medical specialists from the seven specialties most likely to be involved in WWLST decisions in the acute-care setting (emergency, geriatric, palliative, renal and respiratory medicine, medical oncology and IC)...
June 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27188227/reasons-doctors-provide-futile-treatment-at-the-end-of-life-a-qualitative-study
#13
Lindy Willmott, Benjamin White, Cindy Gallois, Malcolm Parker, Nicholas Graves, Sarah Winch, Leonie Kaye Callaway, Nicole Shepherd, Eliana Close
OBJECTIVE: Futile treatment, which by definition cannot benefit a patient, is undesirable. This research investigated why doctors believe that treatment that they consider to be futile is sometimes provided at the end of a patient's life. DESIGN: Semistructured in-depth interviews. SETTING: Three large tertiary public hospitals in Brisbane, Australia. PARTICIPANTS: 96 doctors from emergency, intensive care, palliative care, oncology, renal medicine, internal medicine, respiratory medicine, surgery, cardiology, geriatric medicine and medical administration departments...
August 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27167854/evaluation-and-establishment-of-a-ward-based-geriatric-liaison-service-for-older-urological-surgical-patients-pops-urology-proactive-care-of-older-people-undergoing-surgery
#14
Philip Braude, Anna Goodman, Tania Elias, Gordana Babic-Illman, Ben Challacombe, Danielle Harari, Jugdeep K Dhesi
OBJECTIVE: To assess the impact of introducing and embedding a structured geriatric liaison service, POPS-Urology, using comprehensive geriatric assessment methodology, on an inpatient urology ward. PATIENTS AND METHODS: A phased quality improvement project was undertaken using stepwise interventions. Phase 1 - A before-and-after study with initiation of a daily board round, weekly multidisciplinary meeting, and targeted geriatrician-led ward rounds for elective and emergency urology patients ≥65 years admitted over two one-month periods...
May 11, 2016: BJU International
https://www.readbyqxmd.com/read/27104873/frailty-in-pulmonary-and-critical-care-medicine
#15
Jonathan P Singer, David J Lederer, Matthew R Baldwin
Conceptualized first in the field of geriatrics, frailty is a syndrome characterized by a generalized vulnerability to stressors resulting from an accumulation of physiologic deficits across multiple interrelated systems. This accumulation of deficits results in poorer functional status and disability. Frailty is a "state of risk" for subsequent disproportionate declines in health status following new exposure to a physiologic stressor. Two predominant models have emerged to operationalize the measurement of frailty...
August 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27086864/a-national-survey-of-canadian-emergency-medicine-residents-comfort-with-geriatric-emergency-medicine
#16
Tristan Snider, Don Melady, Andrew P Costa
BACKGROUND: Geriatric patients represent a large and complex subgroup seen in emergency departments (EDs). Competencies in geriatric emergency medicine (EM) training have been established. Our objectives were to examine Canadian postgraduate year (PGY)-5 EM residents' comfort with the geriatric EM competency domains, assess whether Canadian EM residents become more comfortable through residency, and determine whether geriatric educational exposures are correlated with resident comfort with geriatric EM...
April 18, 2016: CJEM
https://www.readbyqxmd.com/read/27084420/hot-off-the-press-use-of-shared-decision-making-for-management-of-acute-musculoskeletal-pain-in-older-adults-discharged-from-the-emergency-department
#17
Kevin Cullison, Christopher R Carpenter, William K Milne
No abstract text is available yet for this article.
August 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27076860/characteristics-of-older-adults-admitted-to-hospital-versus-those-discharged-home-in-emergency-department-patients-referred-to-internal-medicine
#18
Kathryn Hominick, Victoria McLeod, Kenneth Rockwood
BACKGROUND: Frail older adults present to the Emergency Department (ED) with complex medical, functional, and social needs. When these needs can be addressed promptly, discharge is possible, and when they cannot, hospital admission is required. We evaluated the care needs of frail older adults in the ED who were consulted to internal medicine and seen by a geriatrician to determine, under current practices, which factors were associated with hospitalization and which allowed discharge...
March 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27035632/depressive-symptoms-following-stroke-and-transient-ischemic-attack-is-it-time-for-a-more-intensive-treatment-approach-results-from-the-tabasco-cohort-study
#19
Oren Tene, Shani Shenhar-Tsarfaty, Amos D Korczyn, Efrat Kliper, Hen Hallevi, Ludmila Shopin, Eitan Auriel, Anat Mike, Natan M Bornstein, Einor Ben Assayag
OBJECTIVE: To examine whether depressive symptoms after a stroke or a transient ischemic attack (TIA) increase the risk of cognitive impairment and functional deterioration at 2-year follow-up. METHODS: Participants were survivors of first-ever, mild-to-moderate ischemic stroke or TIA from the TABASCO prospective cohort study who underwent 3T magnetic resonance imaging and were examined by a multiprofessional team 6, 12, and 24 months after the event using direct interviews, depression scales, and neurologic, neuropsychological, and functional evaluations...
May 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/26932497/photographing-injuries-in-the-acute-care-setting-development-and-evaluation-of-a-standardized-protocol-for-research-forensics-and-clinical-practice
#20
Elizabeth M Bloemen, Tony Rosen, Justina A Cline Schiroo, Sunday Clark, Mary R Mulcare, Michael E Stern, Regina Mysliwiec, Neal E Flomenbaum, Mark S Lachs, Stephen Hargarten
BACKGROUND: Photographing injuries in the acute setting allows for improved documentation as well as assessment by clinicians and others who have not personally examined a patient. This tool is important, particularly for telemedicine, tracking of wound healing, the evaluation of potential abuse, and injury research. Despite this, protocols to ensure standardization of photography in clinical practice, forensics, or research have not been published. In preparation for a study of injury patterns in elder abuse and geriatric falls, our goal was to develop and evaluate a protocol for standardized photography of injuries that may be broadly applied...
May 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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