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Hospitalized older adults

Amy Witkoski Stimpfel, Mattia J Gilmartin
BACKGROUND: Registered nurses are often underprepared with the knowledge and skills to care for hospitalized older adult patients. One strategy to bridge this gap is for hospitals to adopt the Nurses Improving Care for Healthsystem Elders (NICHE) program: A nurse-led interdisciplinary organizational intervention to improve care of hospitalized older adults. OBJECTIVES: This study aimed to identify the market, organizational and managerial, and sociotechnical factors associated with the adoption of NICHE among U...
January 2019: Nursing Research
Yohei Nomura, Mitsunori Nakano, Brian Bush, Jing Tian, Atsushi Yamaguchi, Jeremy Walston, Rani Hasan, Kenton Zehr, Kaushik Mandal, Andrew LaFlam, Karin J Neufeld, Vidyulata Kamath, Charles W Hogue, Charles H Brown
BACKGROUND: Frailty is a geriatric syndrome thought to identify the most vulnerable older adults, and morbidity and mortality has been reported to be higher for frail patients after cardiac surgery compared to nonfrail patients. However, the cognitive consequences of frailty after cardiac surgery have not been well described. In this study, we examined the hypothesis that baseline frailty would be associated with postoperative delirium and cognitive change at 1 and 12 months after cardiac surgery...
December 11, 2018: Anesthesia and Analgesia
Maria Cristina Zanchim, Vanessa Ramos Kirsten, Ana Carolina Bertoletti De Marchi
The aim of this study was to assess the consumption of dietary intake markers in patients with diabetes using a mobile application. A cross-sectional study was conducted with 100 younger and older adult type 2 diabetes patients in treatment in a hospital in the State of Rio Grande do Sul, Brazil. Data was collected using the Diabetes Food Control app. The chi-squared test was used to measure the association between adequate consumption of healthy and unhealthy markers and the variables investigated by the study adopting a 5% significance level...
December 2018: Ciência & Saúde Coletiva
Efraim Jaul, Jeremy Barron, Joshua P Rosenzweig, Jacob Menczel
BACKGROUND: The prevalence of pressure ulcers particularly in the frail older adult population continues to be high and very costly especially in those suffering from chronic diseases and has brought a higher awareness to comprehensive, preventive and therapeutic measures for treatment of pressure ulcers. Internal risk factors highlighted by comorbidities play a crucial role in the pathogenesis of pressure ulcers. MAIN BODY: Focusing on the impact of common chronic diseases (comorbidities) in aging on pressure ulcers (e...
December 11, 2018: BMC Geriatrics
Shiv K Sah, Ambuj Karn, Aarati Shah, Bishnu D Paudel, Kajiram Adhikari, Bibek Acharya, Sandhya Chapagain
BACKGROUND: Myelosuppression remains a major toxicity in cancer patients receiving chemotherapy, and is associated with considerable morbidity, mortality and cost. OBJECTIVE: The present study aims to investigate the prevalence and incidence of myelotoxicity, anemia and neutropenia in the adult cancer population, and further to determine the factors influencing them. METHODS: This was a cross-sectional observational study conducted at National Academy of Medical Sciences, Bir Hospital, Kathmandu...
December 11, 2018: Journal of Oncology Pharmacy Practice
Pauline Joyce, Zena Eh Moore, Janice Christie
BACKGROUND: Pressure ulcers, which are a localised injury to the skin, or underlying tissue, or both, occur when people are unable to reposition themselves to relieve pressure on bony prominences. Pressure ulcers are often difficult to heal, painful, expensive to manage and have a negative impact on quality of life. While individual patient safety and quality care stem largely from direct healthcare practitioner-patient interactions, each practitioner-patient wound-care contact may be constrained or enhanced by healthcare organisation of services...
December 9, 2018: Cochrane Database of Systematic Reviews
Johanna E Bellon, Andrew Bilderback, Namita S Ahuja-Yende, Cindy Wilson, Stefanie C Altieri Dunn, Deborah Brodine, Michael L Boninger
OBJECTIVES: To compare rates of 30- and 90-day hospital readmissions and observation or emergency department (ED) returns of older adults using the University of Pittsburgh Medical Center (UPMC) Health Plan Home Transitions (HT) with those of Medicare fee-for-service (FFS) controls without HT. DESIGN: Retrospective cohort study. SETTING: Analysis of home health and hospital records from 8 UPMC hospitals in Allegheny County, Pennsylvania, from July 1, 2015, to April 30, 2017...
December 8, 2018: Journal of the American Geriatrics Society
Kah P Lau, Adeleke D Adewumi
Background Ageing is associated with changes in physiology, functional ability, declined in cognition and multiple co-morbidities. Alterations in pharmacodynamic and pharmacokinetic aspects also occur. Medications can improve the quality of life in people with multiple co-morbidities; polypharmacy and ageing could increase risks of medication misadventures and adverse events leading to hospital admissions. Medication management services (MedsCheck, Diabetes MedsCheck and Home Medication Review) were implemented in Australia to: increase patients' knowledge about their medicines, increase patients' confidence in using their medicines, and reduce avoidable hospital admissions...
December 11, 2018: International Journal of Clinical Pharmacy
Babawale Taslim Bello, Olalekan Ezekiel Ojo, Olapeju Funke Oguntunde, Adedotun Ademola Adegboye
Introduction: Late presentation, usually to the emergency centre (EC), is frequently reported among patients with chronic kidney disease (CKD) in resource-limited settings, and is known to be associated with poor outcomes. This study aims to describe the pattern of EC presentation of adults with CKD in Southwest Nigeria. Methods: This was a prospective observational study of 158 consecutively presenting CKD patients at the EC of two tertiary hospitals in Southwest Nigeria...
December 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Dominika Seblova, Maria Lopez Quiroga, Stefan Fors, Kristina Johnell, Martin Lövdén, Antonio Ponce de Leon, Anna Christina Svensson, Susanne Wicks, Anton Lager
Background: The continuous growth of the current dementia epidemic is contingent on the stability of age- and sex-specific trends over time. However, recent evidence suggests declining or stable trends. The aim of this study was to evaluate the real-world changes in the burden of dementia in older adults in Sweden from 1987 to 2016 by estimating age- and sex-specific incidence of dementia diagnosis in hospital inpatient records (dementia incidence). Differences in trends by sex, age, and educational levels were also examined...
2018: Clinical Epidemiology
Sarah H Gordon, Benjamin D Sommers, Ira B Wilson, Omar Galarraga, Amal N Trivedi
BACKGROUND: Midyear disenrollment from Marketplace coverage may have detrimental effects on continuity of care and risk pool stability of individual health insurance markets. OBJECTIVE: The main objective of this study was to assess associations between insurance plan characteristics, individual and area-level demographics, and disenrollment from Marketplace coverage. DATA: All payer claims data from individual market enrollees, 2014-2016...
January 2019: Medical Care
Annika B Kay, Emily L Wilson, Thomas W White, David S Morris, Sarah Majercik
BACKGROUND: We aimed to describe elderly engagement in recreational activities, their injury patterns, preinjury risks and outcomes. METHODS: A 16-year retrospective trauma registry review. All trauma patients ≥65 years admitted after injury sustained during sport were evaluated, and compared to a non-sport cohort of elderly trauma patients. RESULTS: During the study period, 9697 admissions age ≥65 were identified. 526 (5%) were sport-related...
December 3, 2018: American Journal of Surgery
Rajesh Ramanathan, Amr I Al Abbas, Travis Mason, Luke G Wolfe, Brian J Kaplan
BACKGROUND: Distal pancreatic neuroendocrine tumors (PNET) and pancreatic cystic neoplasms (PCN) are often incidentally found in older adults, requiring careful consideration between operative management and watchful waiting. This study analyzes the short-term complications associated with distal pancreatectomy (DP) for PNET and PCN in older adults to inform clinical decision-making. METHODS: Patients undergoing DP for PNET and PCN were analyzed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database and the pancreatectomy procedure-targeted dataset...
December 7, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Ling-Shan Syue, Hung-Jen Tang, Yuan-Pin Hung, Po-Lin Chen, Chia-Wen Li, Ming-Chi Li, Pei-Fang Tsai, Ching-Chuan Liu, Nan-Yao Lee, Wen-Chien Ko
BACKGROUND: Dengue is an important mosquito-borne tropical viral disease and dual infection, though rare, has been regarded as a risk factor for severe disease and mortality. However, few studies focused on bloodstream infections (BSIs) and empirical antibiotic therapy rarely addressed. METHODS: Dengue patients with concurrent or subsequent BSIs between July 1 and December 31, 2015 were included. Clinical information, laboratory data, and drug susceptibility data were collected...
November 23, 2018: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Nurit Gur-Yaish, Orly Tonkikh, Efrat Shadmi, Anna Zisberg
Processes related to daily care of older adults during hospitalization, such as mobility and nutrition, have long-term consequences for their health and functioning. Although instrumental support provided by family members during hospitalization is highly prevalent, its relationship to older adults' actual walking and eating is unknown. Data on walking level (walking outside vs. inside the room) and nutritional intake were collected from 493 independent older adults admitted to internal medicine wards through up to three daily interviews using validated questionnaires...
December 5, 2018: Geriatric Nursing
Ashley S Mogul, David M Cline, Jennifer Gabbard, Casey Bryant
BACKGROUND: Early integration of palliative care from the emergency department (ED) is an underutilized care modality with potential benefits, but few studies have identified who is appropriate for such care. OBJECTIVE: Our hypothesis is that patients aged 65 years or older who present to the ED as level I Emergency Severity Index from a long-term care (LTC) facility have high resource utilization and mortality and may benefit from early palliative care involvement...
December 6, 2018: Journal of Emergency Medicine
Derrick Y Tam, Jiming Fang, Andrew Tran, Jack V Tu, Dennis T Ko, Saswata Deb, Stephen E Fremes
BACKGROUND: Reducing readmission after cardiac surgery remains a quality improvement priority yet most readmission risk models examine only coronary artery bypass grafting (CABG). Our objective was to develop a predictive risk score for readmission after discharge in cardiac surgery. METHODS: All adults > 18 years undergoing isolated CABG, isolated/multiple valve, or combined CABG/valve surgery from 2008 to 2016 in Ontario were eligible. Risk factors for 30-day readmission after discharge were obtained through linkages of the CorHealth Ontario Cardiac Registry to other administrative health databases...
December 2018: Canadian Journal of Cardiology
Jennifer K Burton, Bruce Guthrie, Simona M Hapca, Vera Cvoro, Peter T Donnan, Emma L Reynish
BACKGROUND: Cognitive spectrum disorders (CSDs) are common in hospitalised older adults and associated with adverse outcomes. Their association with the maintenance of independent living has not been established. The aim was to establish the role of CSDs on the likelihood of living at home 30 days after discharge or being newly admitted to a care home. METHODS: A prospective cohort study with routine data linkage was conducted based on admissions data from the acute medical unit of a district general hospital in Scotland...
December 11, 2018: BMC Medicine
Beth Fields, Rose L Turner, Maharsi Naidu, Richard Schulz, Everette James, Juleen Rodakowski
A systematic review was conducted to characterize assessments for caregivers of hospitalized older adults. Electronic literature searches of Medline, PsycINFO, and CINAHL of articles on caregiver assessments published in English between 2006 and present were completed. Thirty-three articles underwent full-text review; four included assessments designed to capture caregiver needs in hospital settings. Original articles on the development of these assessments were reviewed for quality appraisal. Four findings emerged from our review...
December 10, 2018: Clinical Nursing Research
(no author information available yet)
This award is intended to recognize outstanding practitioners in psychology. Nominations are considered for psychologists working in a wide variety of institutional practice settings (e.g., schools, military, state hospital, Department of Veterans Affairs). Services provided to diverse client groups or patient populations, including but not limited to children/adolescents/adults/older adults, urban/rural/ frontier populations, minority populations, and persons with serious mental illness, are considered. Contributions are judged distinguished by virtue of peer recognition, advancement of the public's recognition of psychology as a profession, relevant professional association honors, or other meritorious accomplishments denoting excellence as a practitioner, including improvement of institutional service delivery systems or development of psychologically informed public policy...
December 2018: American Psychologist
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