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https://www.readbyqxmd.com/read/29473945/home-based-primary-care-beyond-extension-of-the-independence-at-home-demonstration
#1
James Rotenberg, Bruce Kinosian, Peter Boling, George Taler
The Independence at Home (IAH) Demonstration Year 2 results confirmed that the first-year savings were 10 times as great as those of the pioneer accountable care organizations during their initial 2 years. We update projected savings from nationwide conversion of the IAH demonstration, incorporating Year 2 results and improving attribution of IAH-qualified (IAH-Q) Medicare beneficiaries to home-based primary care (HBPC) practices. Applying IAH qualifying criteria to beneficiaries in the Medicare 5% claims file, the effect of expanding HBPC to the 2...
February 23, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29473396/-objective-to-present-the-process-and-challenges-of-developing-an-online-competency-based-course-on-public-health-policy-using-a-collaborative-international-approach-methods-five-public-health-experts-supported-by-an-expert-in-educational-technology-adopted
#2
Réjean Hébert, Yves Coppieters, Christian Pradier, Bryn Williams-Jones, Cora Brahimi, Céline Farley
OBJECTIVE: To present the process and challenges of developing an online competency-based course on public health policy using a collaborative international approach. METHODS: Five public health experts, supported by an expert in educational technology, adopted a rigorous approach to the development of the course: a needs analysis, identification of objectives and competencies, development of a pedagogical scenario for each module and target, choice of teaching methods and learning activities, material to be identified or developed, and the responsibilities and tasks involved...
January 30, 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
https://www.readbyqxmd.com/read/29468076/capromorelin-a-ghrelin-receptor-agonist-and-novel-therapy-for-stimulation-of-appetite-in-dogs
#3
REVIEW
Linda Rhodes, Bill Zollers, Jessica A Wofford, Ernst Heinen
Ghrelin is a hormone, secreted from cells in the stomach, which is important in the regulation of appetite and food intake in mammals. It exerts its action by binding to a specific G-protein-coupled receptor, the growth hormone secretagogue receptor 1a (GHS-R1a) which is found in areas of the brain associated with the regulation of food intake. Ghrelin causes a release of growth hormone (GH) through binding to GHS-R1a in the hypothalamus and pituitary gland. A class of compounds known as growth hormone secretagogues, or ghrelin receptor agonists, were developed for therapeutic use in humans for the stimulation of GH in the frail elderly, and have subsequently been studied for their effects on increasing appetite and food intake, increasing body weight, building lean muscle mass, and treating cachexia...
February 2018: Veterinary Medicine and Science
https://www.readbyqxmd.com/read/29467186/a-pilot-study-of-a-medication-rationalization-mera-intervention
#4
Rachel Whitty, Sandra Porter, Kiran Battu, Pranjal Bhatt, Ellen Koo, Csilla Kalocsai, Peter Wu, Kendra Delicaet, Isaac I Bogoch, Robert Wu, James Downar
BACKGROUND: Many seriously ill and frail inpatients receive potentially inappropriate or harmful medications and do not receive medications for symptoms of advanced illness. We developed and piloted an interprofessional Medication Rationalization (MERA) approach to deprescribing inappropriate medications and prescribing appropriate comfort medications. METHODS: We conducted a single-centre pilot study of inpatients at risk of 6-month mortality from advanced age or morbidity...
February 16, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29445266/are-frail-elderly-patients-treated-in-a-cga-unit-more-satisfied-with-their-hospital-care-than-those-treated-in-conventional-acute-medical-care
#5
Niklas Ekerstad, Göran Östberg, Maria Johansson, Björn W Karlson
Objectives: Our aim was to study whether the acute care of frail elderly patients directly admitted to a comprehensive geriatric assessment (CGA) unit is superior to the care in a conventional acute medical care unit in terms of patient satisfaction. Design: TREEE (Is the TReatment of frail Elderly patients Effective in an Elderly care unit?) is a clinical, prospective, controlled, one-center intervention trial comparing acute treatment in CGA units and in conventional wards...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29416326/developing-an-assessment-based-on-physical-fitness-age-to-evaluate-motor-function-in-frail-and-healthy-elderly-women
#6
Masaki Nakagaichi, Yuya Anan, Yuto Hikiji, Sou Uratani
Objectives: The purpose of this study was to identify a method for assessing physical fitness age that is easy to use with both frail and healthy elderly women and to examine its validity. Methods: Principal component analysis was used to develop a formula of physical fitness age from four motor function variables. The subjects comprised 688 (75.7±6.0 years) elderly women, in order to develop a physical fitness scale. The formula for calculating physical fitness age was expressed as physical fitness age =-0...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29412293/non-frail-elderly-people-and-their-license-to-drive-motor-vehicles
#7
Maria Helena Lenardt, Ana Carolina Kozlowski Cordeiro Garcia, Maria Angélica Binotto, Nathalia Hammerschmidt Kolb Carneiro, Tânia Maria Lourenço, Clovis Cechinel
OBJECTIVE: to analyse the link between the non-frailty condition and the results of driving license for elderly people to drive motor vehicles. METHOD: cross-sectional study with data collection in the sample period from August 2015 to March 2016. Study performed with 347 elderlies (≥60 years). RESULTS: 180 (51.9%) of the participants were classified as non-frail. 48 (26.7%) of them were considered capable to drive, 121 (67.2%) capable to drive with restrictions and 11 (6...
March 2018: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29411319/-the-conversation-with-the-patient-is-essential-for-good-pharmacotherapeutic-care
#8
Lidwien C Lemmens, Gepke O Delwel, Renske J Hoefman, Judith D de Jong, Marjolein Weda
Frail elderly with polypharmacy are at greater risk of preventable medication-related health damage. To improve medication safety, the healthcare field prepared, in consultation with the Dutch Health Care Inspectorate, a number of guidelines and standards containing conditions for safe prescribing. According to these standards the active involvement of patients by health care professionals is essential for good pharmacotherapeutic care. However, two studies with patients show that there is still room for improvement...
February 6, 2018: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/29408342/increasing-use-of-cognitive-measures-in-the-operational-definition-of-frailty-a-systematic-review
#9
REVIEW
R Vella Azzopardi, I Beyer, S Vermeiren, M Petrovic, N Van Den Noortgate, I Bautmans, E Gorus
Ageing is associated both with frailty and cognitive decline. The quest for a unifying approach has led to a new concept: cognitive frailty. This systematic review explores the contribution of cognitive assessment in frailty operationalization. PubMed, Web of Knowledge and PsycINFO were searched until December 2016 using the keywords aged; frail elderly; aged, 80 and over; frailty; diagnosis; risk assessment and classification, yielding 2,863 hits. Seventy-nine articles were included, describing 94 frailty instruments...
February 2, 2018: Ageing Research Reviews
https://www.readbyqxmd.com/read/29406844/an-insight-into-the-effect-of-exercises-on-the-prevention-of-osteoporosis-and-associated-fractures-in-high-risk-individuals
#10
REVIEW
Helen Senderovich, Andrew Kosmopoulos
The purpose of this review was to investigate what type of exercises can potentially prevent osteoporosis (OP) and its associated fractures in high-risk populations. MEDLINE was searched for work relevant to various types of exercises used to prevent osteoporotic fractures in high-risk population, from the year 1995 onwards. Twelve articles were identified, and, from them, four were deemed suitable to the objective. The studies reviewed show that various types of exercise are effective and safe in preventing the onset of OP...
January 29, 2018: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29394588/-laparoscopic-lymphadenectomy-without-gastrectomy-for-lymph-nodes-recurrence-after-endoscopic-submucosal-dissection-esd
#11
Takashi Ajiki, Junichiro Yamauchi, Shota Fujita, Mamoru Sato, Kento Miyazaki, Tomoya Ikeda, Keiichi Shirasaki, Katsuo Tsuchihara, Noriko Kondo, Shuichi Ishiyama
A case oflaparoscopic lymphadenectomy in a patient with lymph node recurrence after endoscopic submucosal dissection (ESD)is presented. A 77-year-old man underwent ESD for gastric cancer. After 2 years, the patient was referred to our hospital with the diagnosis of lymph node recurrence. We offered radical surgery, including gastrectomy and lymphadenectomy; however, this suggestion was denied by the patient because ofstrong anxiety for gastrectomy. As an alternative therapy, laparoscopic lymphadenectomy for the limited area of high recurrence, without gastrectomy, was performed...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29390961/fractures-among-patients-with-dizziness-a-ten-year-follow-up
#12
Eva Ekvall Hansson, Anders Beckman
BACKGROUND: The number of elderly people persons suffering from dizziness is substantial, and dizziness is a risk factor for falls and fractures. Fall-related fractures represent a major public health issue. Longitudinal studies can help find ways of predicting fall-related fractures among frail elderly persons with multisensory dizziness. The aim of the present study was therefore to investigate whether different measures of balance, being male/female or admission to hospital, could predict fracture at a ten-year follow-up in patients suffering from multisensory dizziness...
February 2, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29390380/significant-efficacy-and-well-safety-of-apatinib-combined-with-radiotherapy-in-nsclc-case-report
#13
Chunbo Zhao, Qian Zhang, Wenbo Qiao
RATIONALE: The outcomes of locally advanced non-small cell lung cancer (NSCLC) remain poor, in particular, the frail elderly patients cannot tolerate chemotherapy. The new efficient, safe, and more specific treatments are needed. Radiation combined with targeted therapy is the focus of research in recent years. Apatinib is highly selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor-2, studies have revealed that apatinib inhibit the growth of solid tumors including NSCLC...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29385984/effects-of-low-intensity-bodyweight-training-with-slow-movement-on-motor-function-in-frail-elderly-patients-a-prospective-observational-study
#14
Kanae Kanda, Takeshi Yoda, Hiromi Suzuki, Yugo Okabe, Yutaka Mori, Kunihisa Yamasaki, Hiroko Kitano, Aya Kanda, Tomohiro Hirao
BACKGROUND: Slow-motion training, an exercise marked by extremely slow movements, yields a training effect like that of a highly intense training, even when the applied load is small. This study evaluated the effects of low-intensity bodyweight training with slow movement on motor function in frail, elderly patients. METHODS: Ninety-seven elderly men and women aged 65 years or older, whose level of nursing care was classified as either support required (1 and 2) or long-term care required (care level 1 and 2), volunteered to participate...
January 31, 2018: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29385011/early-predictors-for-long-term-functional-outcome-after-mild-traumatic-brain-injury-in-frail-elderly-patients
#15
Amaal Eman Abdulle, Myrthe E de Koning, Harm J van der Horn, Myrthe E Scheenen, Gerwin Roks, Gerard Hageman, Jacoba M Spikman, Joukje van der Naalt
OBJECTIVE: To identify the effect of frailty and early postinjury measures on the long-term outcome after mild traumatic brain injury in elderly patients. SETTING: Patients admitted to 3 Dutch hospitals designated as level 1 trauma centers. PARTICIPANTS: The elderly (≥60 years) with mild traumatic brain injury (N = 161). DESIGN: A prospective observational cohort study. MAIN MEASURES: Posttraumatic complaints and the Hospital Anxiety and Depression Scale determined 2 weeks postinjury; the Glasgow Outcome Scale Extended and Groningen frailty indicator determined 1 to 3 years postinjury...
January 30, 2018: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/29380857/the-impact-of-dietary-factors-on-indices-of-chronic-disease-in-older-people-a-systematic-review
#16
C A Nowson, C Service, J Appleton, J A Grieger
OBJECTIVES: There has been little evaluation of the evidence relating dietary factors to functional capacity in older adults. The aims were to i) conduct a systematic review of studies assessing dietary factors in relation to six key functional indicators which impact on quality of life in adults ≥65 yrs: non-fatal cardiovascular events, cognition, mental health, falls and fractures, physical health (muscle mass, strength) and frailty; and ii) assess if there was sufficient evidence to devise food-based dietary recommendations...
2018: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29351770/-i-struggle-to-count-my-blessings-recovery-after-hip-fracture-from-the-patients-perspective
#17
Vigdis Bruun-Olsen, Astrid Bergland, Kristi Elisabeth Heiberg
BACKGROUND: Recovery outlooks of physical functioning and quality of life after hip fracture have not changed significantly over the past 25 years. Previous research has mainly dealt with causalities and acute treatment, while the recovery process from the patients' perspective has been less comprehensively described. Expanded knowledge of what the patients consider important in their recovery process may have important consequences for how these patients are treated in the future and thereby on future patient outcomes...
January 19, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29346524/-effects-of-a-primary-care-based-multifactorial-intervention-on-physical-and-cognitive-function-in-frail-elderly-individuals-a-randomized-controlled-trial
#18
Laura Romera-Liebana, Francesc Orfila, Josep Maria Segura, Jordi Real, Maria Lluïsa Fabra, Mercedes Möller, Santiago Lancho, Anna Ramirez, Nuria Marti, Montserrat Cullell, Nuria Bastida, Dolors Martinez, Maria Giné, Patricia Cendrós, Anna Bistuer, Elena Perez, Maria Assumpta Fabregat, Gonçal Foz
Background: Detecting and managing frailty at early stages can prevent disability and other adverse outcomes. The study aim was to evaluate whether a multifactorial intervention program could modify physical and cognitive frailty parameters in elderly individuals. Methods: We conducted a multicenter, randomized, single-blind, parallel-group trial in community-living pre-frail/frail elderly individuals in Barcelona. A total of 352 patients, aged ≥65 years old with positive frailty screening, was randomized into two groups to receive a 12-week multidisciplinary intervention or usual care, with concealed allocation...
January 16, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29323208/composition-of-salivary-microbiota-in-elderly-subjects
#19
Taiji Ogawa, Yujiro Hirose, Mariko Honda-Ogawa, Minami Sugimoto, Satoshi Sasaki, Masahito Kibi, Shigetada Kawabata, Kazunori Ikebe, Yoshinobu Maeda
Frailty is gaining attention worldwide with the aging of society. Despite the potential lethality and multiple signs and symptoms in affected individuals, preclinical detection of early manifestations leading to frailty syndrome have not been established. We speculated that the composition of the oral microbiota is associated with general frailty, as well as a relationship between gut microbiota and general health condition. In the present study, we investigated the salivary microbiota composition in samples from healthy and frail elderly individuals using 16S rRNA sequencing analysis for characterization...
January 11, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29320602/when-metformin-is-not-enough-pros-and-cons-of-sglt2-and-dpp-4-inhibitors-as-a-second-line-therapy
#20
REVIEW
Angelo Avogaro, Elías Delgado, Ildiko Lingvay
The newer oral therapies for type 2 diabetes mellitus, dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium glucose cotransporter 2 (SGLT2) inhibitors, have advantages over older agents. Dipeptidyl peptidase-4 inhibitors are weight neutral and have few adverse effects. Sodium glucose cotransporter 2 inhibitors have additional benefits: weight loss, blood pressure reduction, cardiovascular risk reduction, and renoprotective effects. Sodium glucose cotransporter 2 inhibitors have increased risk of urogenital infections and possible risk of "euglycaemic" diabetic ketoacidosis...
January 10, 2018: Diabetes/metabolism Research and Reviews
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