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https://www.readbyqxmd.com/read/29691069/a-multidisciplinary-bootcamp-as-an-educational-launch-to-a-geriatric-emergency-department
#1
Allyson A Kreshak, Sean X Neath, Vaishal M Tolia, Edward M Castillo, Thoedore C Chan
BACKGROUND: Emergency department (ED) visits are increasing among patients ≥65 years of age. Geriatric EDs (GED) provide specialized emergency care for this older population. Interdisciplinary education of GED staff and providers is needed as part of the development of a GED. OBJECTIVES: We sought to describe the effective use of a GED bootcamp as an educational mechanism for the introduction of a GED to a health system. METHODS: An all-day, in-person GED bootcamp was held on the campus of our health system's medical school campus and was led by experts in geriatric emergency care...
April 21, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29683237/establishing-a-proactive-geriatrician-led-comprehensive-geriatric-assessment-in-older-emergency-surgery-patients-outcomes-of-a-pilot-study
#2
Matthew C Mason, Amy L Crees, Matthew R Dean, Nahida Bashir
INTRODUCTION: Increasing numbers of older adults are presenting with acute surgical disease to the unselected general surgical take. General surgeons have little training to manage these patients. We developed a pilot service of proactive geriatrician input into older emergency general surgical patients in a single institution. We wanted to demonstrate if geriatricians improve the management of these patients. METHODS: Patients aged 70 years or older admitted acutely under the general surgeons were assessed proactively by a geriatrician using comprehensive geriatric assessment (CGA)...
April 23, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29676874/-screening-of-frailty-in-the-emergency-unit-myth-or-reality
#3
A A Zulfiqar
At present, it is recognized that screening for frailty in the elderly is a major public health issue. Frailty screening in emergency unit is essential to optimize the management of elderly patients in hospital. Ideally, the role of a mobile geriatric team seems essential, taking over the frailty screening carried out in the emergency department, in order to optimize intra-hospital management and consequently reduce further intra-hospital visits and possible risks of decompensation of geriatric syndromes.
April 2018: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29676780/retrospective-evaluation-of-a-restrictive-transfusion-strategy-in-older-adults-with-hip-fracture
#4
Lorene Zerah, Lucile Dourthe, Judith Cohen-Bittan, Marc Verny, Mathieu Raux, Anthony Mézière, Frédéric Khiami, Cendrine Tourette, Christian Neri, Yannick Le Manach, Bruno Riou, Hélène Vallet, Jacques Boddaert
OBJECTIVES: To compare the association between a restrictive transfusion strategy and cardiovascular complications during hospitalization for hip fracture with the association between a liberal transfusion strategy and cardiovascular complications, accounting for all transfusions from the emergency department to postacute rehabilitation settings. DESIGN: Retrospective study. SETTING: Perioperative geriatric care unit. PARTICIPANTS: All individuals aged 70 and older admitted to the emergency department for hip fracture and hospitalized in our perioperative geriatric care unit (N=667; n=193 in the liberal transfusion group, n=474 in the restrictive transfusion group) from July 2009 to April 2016...
April 20, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#5
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29662881/the-continuum-of-aging-and-age-related-diseases-common-mechanisms-but-different-rates
#6
REVIEW
Claudio Franceschi, Paolo Garagnani, Cristina Morsiani, Maria Conte, Aurelia Santoro, Andrea Grignolio, Daniela Monti, Miriam Capri, Stefano Salvioli
Geroscience, the new interdisciplinary field that aims to understand the relationship between aging and chronic age-related diseases (ARDs) and geriatric syndromes (GSs), is based on epidemiological evidence and experimental data that aging is the major risk factor for such pathologies and assumes that aging and ARDs/GSs share a common set of basic biological mechanisms. A consequence is that the primary target of medicine is to combat aging instead of any single ARD/GSs one by one, as favored by the fragmentation into hundreds of specialties and sub-specialties...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29659475/frailty-screening-and-a-frailty-pathway-decrease-length-of-stay-loss-of-independence-and-30-day-readmission-rates-in-frail-geriatric-trauma-and-emergency-general-surgery-patients
#7
Kathryn E Engelhardt, Quentin Reuter, Jessica Liu, Jonathan F Bean, Joliette Barnum, Michael B Shapiro, Allison Ambre, Amanda Dunbar, Mara Markzon, Tara Reddy, Christine Schilling, Joseph Posluszny
BACKGROUND: Frail geriatric trauma and emergency general surgery (TEGS) patients have longer lengths of stay (LOS), more readmissions, and higher rates of post-discharge institutionalization than their non-frail counterparts. Despite calls to action by national trauma coalitions, there are few published reports of prospective interventions. The objective of this quality improvement (QI) project was to first develop a frailty screening program, and, then, if frail, implement a novel Frailty Pathway to reduce LOS, 30-day readmissions, and loss of independence (LOI)...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659009/state-of-the-science-interprofessional-approaches-to-aging-dementia-and-mental-health
#8
Timothy W Farrell, Marilyn K Luptak, Katherine P Supiano, James T Pacala, Rosalind De Lisser
Interprofessional education (IPE) is essential to develop the healthcare workforce of the future. Geriatrics healthcare professionals have long championed innovations in IPE and patient care, but there is increased urgency to address challenges in aging, dementia, and geriatric mental health in America. In 2010, the Partnership for Health in Aging multidisciplinary competencies and a related position statement in the Journal of the American Geriatrics Society addressed interdisciplinary team (IDT) training in geriatrics...
April 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29627192/why-do-the-very-old-self-harm-a-qualitative-study
#9
Anne P F Wand, Carmelle Peisah, Brian Draper, Henry Brodaty
OBJECTIVES: To examine the perspectives of people aged 80 years or older who self-harmed regarding their reasons for self-harm and its consequences, and their perceptions of care. DESIGN: A qualitative study using in-depth interviews. SETTING: Participants were recruited from two teaching hospitals and associated community services. PARTICIPANTS: People aged 80 years or older who had self-harmed within the previous month...
March 15, 2018: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29607245/future-of-health-findings-from-a-survey-of-stakeholders-on-the-future-of-health-and-healthcare-in-england
#10
Jennie Corbett, Camilla d'Angelo, Lorenzo Gangitano, Jon Freeman
This article presents findings from a survey conducted by RAND Europe at the request of the National Institute for Health Research (NIHR) to gather and synthesise stakeholder views on the future of health and healthcare in England in 20 to 30 years' time. The aim of the research was to generate an evidenced-based picture of the future health and healthcare needs, and how it might differ from today, in order to inform strategic discussions about the future priorities of the NIHR and the health and social care research communities more broadly...
April 2018: Rand Health Quarterly
https://www.readbyqxmd.com/read/29601378/is-anesthesia-technique-associated-with-a-higher-risk-of-mortality-or-complications-within-90-days-of-surgery-for-geriatric-patients-with-hip-fractures
#11
Vimal Desai, Priscilla H Chan, Heather A Prentice, Gary L Zohman, Glenn R Diekmann, Gregory B Maletis, Brian H Fasig, Diana Diaz, Elena Chung, Chunyuan Qiu
BACKGROUND: Postoperative mortality and complications after geriatric hip fracture surgery remain high despite efforts to improve perioperative care for these patients. One factor of particular interest is anesthetic technique, but prior studies on this are limited by sample selection, competing risks, and incomplete followup. QUESTIONS/PURPOSES: (1) Among older patients undergoing surgery for hip fracture, does 90-day mortality differ depending on the type of anesthesia received? (2) Do 90-day emergency department returns and hospital readmissions differ based on anesthetic technique after geriatric hip fracture repairs? (3) Do 90-day Agency for Healthcare Research and Quality (AHRQ) outcomes differ according to anesthetic techniques used during hip fracture surgery? METHODS: We conducted a retrospective study on geriatric patients (65 years or older) with hip fractures between 2009 and 2014 using the Kaiser Permanente Hip Fracture Registry...
March 28, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29582533/potentially-inappropriate-medications-with-polypharmacy-increase-the-risk-of-falls-in-older-japanese-patients-1-year-prospective-cohort-study
#12
Shoichi Masumoto, Mikiya Sato, Takami Maeno, Yumiko Ichinohe, Tetsuhiro Maeno
AIM: We aimed to evaluate whether potentially inappropriate medications (PIMs) increase the risk for adverse clinical outcomes including falls, emergency department (ED) visits and unplanned hospitalizations in older Japanese patients with chronic diseases, comparing the difference between patients with and without polypharmacy. METHODS: A prospective observational cohort study was carried out in a Japanese outpatient primary care clinic. Baseline data was collected from January to March 2016...
March 26, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29573893/health-care-providers-perceptions-of-family-caregivers-involvement-in-consultations-within-a-geriatric-hospital-setting
#13
Daniela Koren, Rebekah Laidsaar-Powell, Wendy Tilden, Mark Latt, Phyllis Butow
This study explored health professionals' (HPs') experiences of interacting with family care-givers (FCs), and the strategies they employ during these interactions. Qualitative methods involved audio-taped and transcribed in-depth semi-structured interviews with 21 HPs (doctors, nurses) from the geriatric wards of two tertiary hospitals. Framework methods were used to analyze data. Seven main themes emerged: Variation in family behaviours; FCs face many challenges; Psychosocial factors influence FCs' behaviours; Attitudes, competing responsibilities and lack of resources influencing HPs' strategies and behaviours; Strategies employed by HPs to improve communication; HPs' self-care strategies; Impact of interactions on HPs and the healthcare system...
March 21, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29565018/impact-of-frailty-on-outcomes-after-discharge-in-older-surgical-patients-a-prospective-cohort-study
#14
Yibo Li, Jenelle L Pederson, Thomas A Churchill, Adrian S Wagg, Jayna M Holroyd-Leduc, Kannayiram Alagiakrishnan, Raj S Padwal, Rachel G Khadaroo
BACKGROUND: Frailty is a state of vulnerability to diverse stressors. We assessed the impact of frailty on outcomes after discharge in older surgical patients. METHODS: We prospectively followed patients 65 years of age or older who underwent emergency abdominal surgery at either of 2 tertiary care centres and who needed assistance with fewer than 3 activities of daily living. Preadmission frailty was defined according to the Canadian Study of Health and Aging Clinical Frailty Scale as "well" (score 1 or 2), "vulnerable" (score 3 or 4) or "frail" (score 5 or 6)...
February 20, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29564853/-self-supporting-care-model-for-older-adults
#15
Yen-Chun Lin, Lian-Hua Huang
Self-supporting care is an emerging concept in the geriatric care system of Taiwan. The traditional care model tends to prioritize aspects such as "safety" and "convenient and effective". For older adult patients, this situation has led to excessive restrictions, enforced bedrest, and the use of adult diapers, which seriously deteriorate quality of life. The present article introduces the development and current status of self-supporting care and international empirical research results from the perspective of holistic care for older adults as well as describes the intervention strategies that are currently used in Taiwan...
April 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29560835/how-argentina-is-training-their-mental-health-residents-to-face-its-silver-tsunami
#16
Sergio A Strejilevich, Florencia Vallejos, Julian Bustin
In low- and middle-income countries, there is an increase in the percentage of aging population similar to or greater than that of high-income countries (World Population Ageing 1950-2050, UN, 2001). The emerging health and economical challenges due to these demographic changes will have to be addressed by their health systems. In this context, an adequate training of available human resources in geriatric psychiatry/psychogeriatrics (GP/PG) should be an essential step to meet those challenges.
March 21, 2018: International Psychogeriatrics
https://www.readbyqxmd.com/read/29549205/diagnostic-accuracy-of-the-ottawa-3dy-and-short-blessed-test-to-detect-cognitive-dysfunction-in-geriatric-patients-presenting-to-the-emergency-department
#17
David Barbic, Brian Kim, Qadeem Salehmohamed, Kate Kemplin, Christopher R Carpenter, Skye Pamela Barbic
OBJECTIVES: Cognitive dysfunction (CD) is a common finding in geriatric patients presenting to the emergency department (ED). Our primary objective was to determine the diagnostic accuracy of the Ottawa 3DY (O3DY) and Short Blessed Test (SBT) as screening tools for the detection of CD in the ED. Our secondary objective was to estimate the inter-rater reliability of these instruments. METHODS: We conducted a prospective cross-sectional comparative study at an inner-city academic medical centre (annual ED visit census 86 000)...
March 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29547361/statement-on-minimum-standards-for-the-care-of-older-people-in-emergency-departments-by-the-geriatric-emergency-medicine-special-interest-group-of-the-international-federation-for-emergency-medicine-erratum
#18
Brittany Ellis, Christopher R Carpenter, Judy A Lowthian, Simon P Mooijaart, Christian H Nickel, Don Melady
No abstract text is available yet for this article.
March 16, 2018: CJEM
https://www.readbyqxmd.com/read/29546287/degree-of-peripheral-thyroxin-deiodination-frailty-and-long-term-survival-in-hospitalized-older-patients
#19
Giuseppe Pasqualetti, Valeria Calsolaro, Sara Bernardini, Giuseppe Linsalata, Renato Bigazzi, Nadia Caraccio, Fabio Monzani
Introduction: Although the association between low FT3 and poor outcome has been extensively reported in literature, the degree of peripheral thyroxin deiodination and its relationship with frailty and survival in hospitalized older patients has not been fully established yet. The aim of the current study was to evaluate the possible correlation between FT3/FT4 ratio reduction, an indirect marker of thyroxin deiodination impairment, and frailty status and survival in hospitalized older patients...
March 12, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29539602/stroke-referrals-from-nursing-homes-high-rate-of-mimics-and-late-presentation
#20
Markus Kneihsl, Christian Enzinger, Kurt Niederkorn, Gerit Wünsch, Lisa Müller, Valeriu Culea, Andreas Lueger, Franz Fazekas, Thomas Gattringer
BACKGROUND: Stroke has become a treatable condition with increasing evidence of treatment benefits in older people. However, stroke mimics in geriatric patients are especially prevalent, causing incorrect suspicion and consecutive burden to patients and emergency room resources. We therefore examined the dimension of this problem by investigating emergency room admissions from nursing homes for suspected stroke. METHODS: We performed a retrospective cohort study of all nursing home residents who were admitted to the neurological emergency room of our primary and tertiary care university hospital between 2013 and 2015...
March 14, 2018: Cerebrovascular Diseases
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