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Geriatrics Critical Care

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https://www.readbyqxmd.com/read/28498197/overuse-of-health-care-services-in-the-management-of-cancer-a-systematic-review
#1
Shrujal S Baxi, Minal Kale, Salomeh Keyhani, Benjamin R Roman, Annie Yang, Antonio P Derosa, Deborah Korenstein
BACKGROUND: Overuse, the provision of health services for which harms outweigh the benefits, results in suboptimal patient care and may contribute to the rising costs of cancer care. We performed a systematic review of the evidence on overuse in oncology. METHODS: We searched Medline, EMBASE, the Cochrane Library, Web of Science, SCOPUS databases, and 2 grey literature sources, for articles published between December 1, 2011 and March 10, 2017. We included publications from December 2011 to evaluate the literature since the inception of the ABIM Foundation's Choosing Wisely initiative in 2012...
May 11, 2017: Medical Care
https://www.readbyqxmd.com/read/28493647/the-liminality-of-the-patient-with-dementia-in-geriatric-rehabilitation-hospitals
#2
Robin Digby, Susan Lee, Allison Williams
AIM: The aim was to explore the experiences of people with dementia in sub-acute geriatric rehabilitation hospitals to critically evaluate the care received by such patients. BACKGROUND: Globally the number of people with dementia is growing and is expected to impact progressively more on health systems. People with dementia can become deconditioned and deteriorate in cognitive function while in hospital. The unfamiliar environment and people can cause the person to become disorientated which then leads to behavioural symptoms which complicate care...
May 11, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28471238/clinician-perceptions-about-inpatient-occupational-therapy-groups-in-traumatic-brain-injury-rehabilitation
#3
Freyr Patterson, Jennifer Fleming, Emmah Doig
PRIMARY OBJECTIVE: The aim of the study was to explore the experiences and perceptions of clinicians about the benefits, challenges and processes of facilitating inpatient occupational therapy groups in traumatic brain injury (TBI) rehabilitation including peer-to-peer interactions and use of goals. DESIGN AND METHOD: A qualitative methodology, guided by a phenomenological approach was utilized with data collected from focus groups comprising 26 clinicians working in occupational therapy in three inpatient rehabilitation settings: brain injury, spinal injury and geriatric rehabilitation in order to identify aspects unique to brain injury rehabilitation...
May 4, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28432547/health-related-quality-of-life-and-diabetes-self-care-activity-in-elderly-patients-with-diabetes-in-korea
#4
Hacksun Kim, Kisook Kim
A critical goal in the management of elderly patients with diabetes is to improve their health-related quality of life (HRQOL). This study aimed to identify the factors affecting HRQOL in elderly Korean patients with diabetes. Participants were 365 elderly patients with diabetes who were treated in a general hospital in Korea. The data were analysed using independent t-tests, Pearson correlations, and stepwise multiple regression. The mean total HRQOL score was 74.77, and HRQOL showed positive correlations with activities of daily living (ADL), instrumental activities of daily living (IADL), and the Summary of Diabetes Self-care Activities (SDSA)...
April 21, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28419042/geriatric-fracture-care-future-trajectories-a-2015-aoa-critical-issues-symposium
#5
Julie A Switzer, Kevin J Bozic, Stephen L Kates
The population of the United States and the world is aging rapidly. Musculoskeletal care for older adults will be impacted by the manner in which health care is financed and the ability of the orthopaedic community to provide evidence-based integrated care for this population. We review the financial aspects of health-care reform and the implications for musculoskeletal care in the elderly. We discuss the establishment of quality measures for hip fracture care in the elderly, team building to accomplish this, and an innovative program designed to provide orthopaedic care to the frail elderly outside of the usual office setting...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28418066/a-national-survey-on-the-effect-of-the-geriatric-academic-career-award-in-advancing-academic-geriatric-medicine
#6
Kevin T Foley, Clare C Luz, Katherine V Hanson, Yuning Hao, Elisia M Ray
A workforce that understands principles of geriatric medicine is critical to addressing the care needs of the growing elderly population. This will be impossible without a substantial increase in academicians engaged in education and aging research. Limited support of early-career clinician-educators is a major barrier to attaining this goal. The Geriatric Academic Career Award (GACA) was a vital resource that benefitted 222 junior faculty members. GACA availability was interrupted in 2006, followed by permanent discontinuation after the Geriatrics Workforce Education Program (GWEP) subsumed it in 2015, leaving aspiring clinician-educators with no similar alternatives...
April 18, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28398987/predicting-risk-and-outcomes-for-frail-older-adults-an-umbrella-review-of-frailty-screening-tools
#7
João Apóstolo, Richard Cooke, Elzbieta Bobrowicz-Campos, Silvina Santana, Maura Marcucci, Antonio Cano, Miriam Vollenbroek-Hutten, Federico Germini, Carol Holland
BACKGROUND: A scoping search identified systematic reviews on diagnostic accuracy and predictive ability of frailty measures in older adults. In most cases, research was confined to specific assessment measures related to a specific clinical model. OBJECTIVES: To summarize the best available evidence from systematic reviews in relation to reliability, validity, diagnostic accuracy and predictive ability of frailty measures in older adults. INCLUSION CRITERIA POPULATION: Older adults aged 60 years or older recruited from community, primary care, long-term residential care and hospitals...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28364991/polypharmacy-and-delirium-in-critically-ill-older-adults-recognition-and-prevention
#8
REVIEW
Erik Garpestad, John W Devlin
Among older adults, polypharmacy is a sequelae of admission to the intensive care unit and is associated with increased medication-associated adverse events, drug interactions, and health care costs. Delirium is prevalent in critically ill geriatric patients and medications remain an underappreciated modifiable risk for delirium in this setting. This article reviews the literature on polypharmacy and delirium, with a focus on highlighting the relationships between polypharmacy and delirium in critically ill, older adults...
May 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28302750/the-clinical-frailty-scale-upgrade-your-eyeball-test
#9
Jonathan Afilalo
With the emergence of transcatheter aortic valve replacement (TAVR) as a therapeutic option to treat high-risk older adults suffering from aortic stenosis, the geriatric concept of frailty has assumed mainstream relevance for cardiovascular practitioners. We have eagerly adopted tools to objectify the definition of frailty and accordingly discern good and bad candidates among a pool of complex octogenarians with multiple chronic conditions - a daunting yet mission-critical task. Initial studies published during the first half of this decade revealed that frailty status was one of the top predictors of mid-term mortality and incident disability after TAVR1, leading to its integration in clinical care pathways and predictive risk models...
March 16, 2017: Circulation
https://www.readbyqxmd.com/read/28292313/relationship-between-family-caregiver-burden-and-physical-frailty-in-older-adults-without-dementia-a-systematic-review
#10
Thom Ringer, Afeez Abiola Hazzan, Arnav Agarwal, Adam Mutsaers, Alexandra Papaioannou
BACKGROUND: Physical frailty is a prevalent syndrome in older adults that increases vulnerability for a range of adverse outcomes including increased dependency and death. Caregivers of older adults experience significant physical, emotional, and financial burden, which is associated with poor physical and mental health. While it is known that care recipients' dementia is associated with burden, the literature regarding the impact of physical frailty on burden has yet to be synthesized...
March 14, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28279073/end-of-life-care-and-discussions-in-japanese-geriatric-health-service-facilities
#11
Asako Kanoh, Yoshiyuki Kizawa, Satoru Tsuneto, Shoji Yokoya
BACKGROUND: Geriatric health service facilities (GHSFs) play important roles as intermediate care facilities for elderly individuals temporarily when they need rehabilitation before returning home. However, the number of residents spending their end-of-life (EOL) period in such facilities is increasing. To improve the quality of EOL care, end-of-life discussions (EOLDs) are recommended by some guidelines and studies. AIM: This study aimed to clarify the current practice of EOL care and EOLDs in GHSFs in Japan...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28276179/effect-of-caregiving-relationship-and-formal-long-term-care-service-use-on-caregiver-well-being
#12
Kirsten Eom, Michael J Penkunas, Angelique W M Chan
AIM: Despite efforts to revise the traditional long-term care (LTC) model, informal caregivers continue to provide a substantial amount of support to older adults as front-line care providers. The present study aimed to understand the effect of informal caregiving on caregivers' well-being in Singapore with respect to different types of patient-caregiver relationships. Second, this study examined the association between formal LTC service use and caregivers' well-being. METHODS: Two waves of data for 781 dyads of patients with LTC needs and their caregivers from a longitudinal study were analyzed...
March 9, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28243074/delirium-in-405-articles-of-medical-non-surgical-or-icu-inpatients-unproven-speed-of-onset-and-recovery
#13
Paul Jay Regal
PURPOSE: There is agreement in the medical literature that delirium is of sudden or rapid onset. Although the speed of recovery cannot be used for initial diagnosis, recovery speed provides a test of diagnostic criteria. The aim of this study was to determine whether articles on delirium among medical inpatients proved sudden onset and rapid recovery. METHODS: The literature was searched for studies with at least 50 patients on medical or geriatric wards. Excluded were postoperative, critical care, and nursing home studies...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28231631/commentary-response-frailty-not-just-about-old-people-reply-to-smith-gd-kydd-a-2017-getting-care-of-older-people-right-the-need-for-appropriate-frailty-assessment
#14
Sunita R Jha, Julee Mcdonagh, Caleb Ferguson, Peter S Macdonald, Phillip J Newton
As highlighted in a recent editorial, the ageing population and burden of frailty amongst those aged 60 years and older represents an impending challenge for individuals and health care systems globally (Smith & Kydd 2017). As frailty is largely considered a geriatric syndrome, research has primarily occurred within elderly community dwelling populations (Fried et al. 2001). However, it is important to highlight that not all older people are frail; and conversely not all younger people are non-frail. With frailty research expanding its scope beyond geriatrics over the last 2 decades, our understanding of this syndrome and its complexities has progressed...
February 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28196637/an-outbreak-of-acute-gii-17-norovirus-gastroenteritis-in-a-long-term-care-facility-in-china-the-role-of-nursing-assistants
#15
Chang Cui, Lifeng Pan, Yuanping Wang, Caoyi Xue, Weiping Zhu, Linying Zhu, Chuchu Ye, Xianghua Lu, Haihong Song, Yifei Fu, Qiao Sun
More than 30 residents and nursing assistants in a geriatric nursing hospital developed acute gastroenteritis from December 7th to December 18th, 2014 in Shanghai, China. An immediate epidemiological investigation was conducted to identify the etiological agent of the outbreak, mode of transmission and the risk factors. Cases were investigated according to an epidemiological questionnaire. Samples from cases, highly transmissible environmental surfaces and drinking water were collected for pathogens detection...
February 9, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28183274/disability-in-long-term-care-residents-explained-by-prevalent-geriatric-syndromes-not-long-term-care-home-characteristics-a-cross-sectional-study
#16
Natasha E Lane, Walter P Wodchis, Cynthia M Boyd, Thérèse A Stukel
BACKGROUND: Self-care disability is dependence on others to conduct activities of daily living, such as bathing, eating and dressing. Among long-term care residents, self-care disability lowers quality of life and increases health care costs. Understanding the correlates of self-care disability in this population is critical to guide clinical care and ongoing research in Geriatrics. This study examines which resident geriatric syndromes and chronic conditions are associated with residents' self-care disability and whether these relationships vary across strata of age, sex and cognitive status...
February 10, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28178398/delphi-survey-of-clinical-nursing-and-midwifery-research-priorities-in-the-eastern-mediterranean-region
#17
Carolyn Sun, Jennifer Dohrn, Arwa Oweis, Huda Abu-Saad Huijer, Fathieh Abu-Moghli, Hania Dawani, Cheherezade Ghazi, Elaine Larson
PURPOSE: As the shortage of nurses and midwives is expected to worsen in the Eastern Mediterranean region concomitantly with a growing focus on achievement of universal health coverage, nurses and midwives are expected to fill major gaps in health care. Hence, the need for a solid evidence base for nursing practice and a clear direction for clinical nursing research are paramount. Therefore, a Delphi survey was conducted to determine clinical (research focused on patient outcomes) nursing and midwifery priorities for research within this region...
March 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28138915/evaluation-of-internet-based-patient-education-materials-from-internal-medicine-subspecialty-organizations-will-patients-understand-them
#18
David R Hansberry, Nitin Agarwal, Elizabeth S John, Ann M John, Prateek Agarwal, James C Reynolds, Stephen R Baker
The majority of Americans use the Internet daily, if not more often, and many search online for health information to better understand a diagnosis they have been given or to research treatment options. The average American reads at an eighth-grade level. The purpose of this study is to evaluate the readability of online patient education materials on the websites of 14 professional organizations representing the major internal medicine subspecialties. We used ten well-established quantitative readability scales to assess written text from patient education materials published on the websites of the major professional organizations representing the following subspecialty groups: allergy and immunology, cardiology, endocrinology, gastroenterology, geriatrics, hematology, hospice and palliative care, infectious disease, nephrology, oncology, pulmonology and critical care, rheumatology, sleep medicine, and sports medicine...
January 30, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28124100/-treatment-with-psychotropic-agents-in-patients-with-dementia-and-delirium-gap-between-guideline-recommendations-and-treatment-practice
#19
Walter Hewer, Christine Thomas
BACKGROUND AND OBJECTIVES: Psychiatric symptoms in dementia and delirium are associated with a substantially reduced quality of life of patients and their families and often challenging for professionals. Pharmacoepidemiological surveys have shown that, in particular, patients living in nursing homes receive prescriptions of psychotropic agents in significant higher frequency than recommended by current guidelines. This article focuses on a critical appraisal of this gap from the point of view of German healthcare services...
February 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28119313/the-association-between-cognitive-impairment-and-functional-outcome-in-hospitalised-older-patients-a-systematic-review-and-meta-analysis
#20
Peter Hartley, Nathalie Gibbins, Amanda Saunders, Kerry Alexander, Eimear Conroy, Rebecca Dixon, Joseph Lang, Jasmine Luckett, Tim Luddington, Roman Romero-Ortuno
BACKGROUND: in hospitalised older adults, cognitive impairments are common and may be associated with functional outcomes. Our aim was to systematically review this association. METHOD: we systematically searched MEDLINE, CINAHL, AMED and PsycINFO from inception to April 2016. Non-English language studies were filtered out at search stage. All types of studies were considered for inclusion except reviews, conference abstracts, dissertations and case studies. POPULATION: community-dwelling or institutionalised older adults aged 65 years or more, who are acutely hospitalised and have information on history of dementia and/or cognitive scores on admission...
January 23, 2017: Age and Ageing
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