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Elderly care

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https://www.readbyqxmd.com/read/29149187/epidemiology-and-impact-on-all-cause-mortality-of-sepsis-in-norwegian-hospitals-a-national-retrospective-study
#1
Siri Tandberg Knoop, Steinar Skrede, Nina Langeland, Hans Kristian Flaatten
BACKGROUND: Although sepsis is the leading cause of death from infection, there are few population-level epidemiological sepsis reports. The impact of sepsis-related deaths on all-cause hospital mortality is insufficiently described, in particular in Europe where data are non-existent. The objective of this study was to provide nationwide epidemiological results on sepsis hospitalizations in Norway and to estimate sepsis' contribution to overall hospital mortality in a European setting...
2017: PloS One
https://www.readbyqxmd.com/read/29149045/self-organizing-peer-to-peer-middleware-for-healthcare-monitoring-in-real-time
#2
Hyun Ho Kim, Hyeong Gon Jo, Soon Ju Kang
As the number of elderly persons with chronic illnesses increases, a new public infrastructure for their care is becoming increasingly necessary. In particular, technologies that can monitoring bio-signals in real-time have been receiving significant attention. Currently, most healthcare monitoring services are implemented by wireless carrier through centralized servers. These services are vulnerable to data concentration because all data are sent to a remote server. To solve these problems, we propose self-organizing P2P middleware for healthcare monitoring that enables a real-time multi bio-signal streaming without any central server by connecting the caregiver and care recipient...
November 17, 2017: Sensors
https://www.readbyqxmd.com/read/29148657/a-comparison-of-heat-wave-response-plans-from-an-aged-care-facility-perspective
#3
Benjamin Okwuofu-Thomas, Paul J Beggs, Ross J MacKenzie
Heat waves result in significant excess mortality, particularly amongst elderly people. This article examines selected heat wave response plans at national, state/provincial, and municipal levels, with a particular focus on specific responses aimed at residents of aged care facilities. We sourced heat wave response plans from several countries that are experiencing a demographic transition that features a growing aging population. We collected a total of 23 heat wave response plans; most of those plans were from Australia, with only three plans each available from Canada and the UK, and only two available from the U...
April 2017: Journal of Environmental Health
https://www.readbyqxmd.com/read/29148311/for-which-clinical-rules-do-doctors-want-decision-support-and-why-a-survey-of-dutch-general-practitioners
#4
Stephanie Medlock, Saeid Eslami, Marjan Askari, Derk L Arts, Esther M van de Glind, Henk J Brouwer, Henk C van Weert, Sophia E de Rooij, Ameen Abu-Hanna
Despite the promise of decision support for improving care, alerts are often overridden or ignored. We evaluated Dutch general practitioners' intention to accept decision support in a proposed implementation based on clinical rules regarding care for elderly patients, and their reasons for wanting or not wanting support. We developed a survey based on literature and structured interviews and distributed it to all doctors who would receive support in the proposed implementation (n = 43), of which 65 percent responded...
November 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/29147805/can-clinical-practice-indicator-relating-to-long-acting-benzodiazepine-use-in-the-elderly-be-easily-generated-in-a-hospital-setting
#5
Badria Kadri, Antonio Teixeira, Christelle Duteil, Annabelle Tan, Hélène Barreteau, Christophe Segouin, Pénélope Troude
BACKGROUND: To improve the appropriate use of long-acting benzodiazepine (la.bzd) prescriptions in the elderly, the Haute Autorité de Santé (HAS) has developed clinical practice indicators (CPI). The alert indicator (AI) evaluates the prevalence of la.bzd prescription among older people. The mastering indicator (MI) corresponds to the prevalence of elderly with a justified, i.e., appropriate, la.bzd prescription among all the elderly with la.bzd prescriptions. OBJECTIVE: The objective of this study was to test the feasibility of routine generation of CPI regarding la...
November 16, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29147496/markov-chain-based-acute-effect-estimation-of-air-pollution-on-elder-asthma-hospitalization
#6
Li Luo, Fengyi Zhang, Wei Zhang, Lin Sun, Chunyang Li, Debin Huang, Gao Han, Bin Wang
Background: Asthma caused substantial economic and health care burden and is susceptible to air pollution. Particularly, when it comes to elder asthma patient (older than 65), the phenomenon is more significant. The aim of this study is to investigate the Markov-based acute effects of air pollution on elder asthma hospitalizations, in forms of transition probabilities. Methods: A retrospective, population-based study design was used to assess temporal patterns in hospitalizations for asthma in a region of Sichuan province, China...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29146536/analysis-of-an-integral-care-programme-for-hip-fracture-patients-aged-over-65-years
#7
J Franch Parella
OBJECTIVE: To analyse the results of a comprehensive care programme in elderly patients with hip fracture. METHODS: Non-randomised intervention study with patients undergoing hip fracture in Althaia Hospital (Manresa). The care model of the control group was the traditional, with the orthopaedist centralising decisions. By contrast, in the intervention group, a multidisciplinary model was used with the active collaboration, among other professionals, of orthopaedic surgeons and geriatricians...
November 13, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29144543/primary-thromboprophylaxis-in-individuals-without-cancer-admitted-to-a-geriatric-palliative-care-unit
#8
Adam J Gurau, Anna Berall, Jurgis Karuza, Giulia-Anna Perri
BACKGROUND/OBJECTIVES: The prevalence of individuals with advanced noncancer disease is increasing on palliative care units (PCUs), but there are no current guidelines to direct venous thromboembolism (VTE) prophylaxis decisions in these individuals. The aim of this study was to compare primary VTE prophylaxis in elderly adults with advanced noncancer diagnoses with that of those with advanced cancer on a dedicated geriatric PCU. DESIGN: Single-center retrospective chart review...
November 16, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29144382/treatment-approaches-to-moderate-to-severe-psoriasis
#9
REVIEW
Paolo Gisondi, Micol Del Giglio, Giampiero Girolomoni
Psoriasis is a common disease, which has a considerable impact on patients and the health care system. Treatment approaches to the disease may be various because some issues are not definitely addressed. Moreover, the therapeutic paradigms are continuously changing because of the recent approval of new treatments for psoriasis such as interleukin (IL)-17 inhibitors and apremilast. In this review, the factors influencing psoriasis severity, the indications for systemic treatments, the overall parameters to be considered in the treatment choice, life style interventions, and the recommendations for the use, screening, and monitoring of systemic therapies available including acitretin, cyclosporine, methotrexate, apremilast, adalimumab, etanercept, infliximab, secukinumab, ixekizumab, and ustekinumab are discussed...
November 16, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29142907/social-effects-of-health-care-reform-medicaid-expansion-under-the-affordable-care-act-and-changes-in-volunteering
#10
Heeju Sohn, Stefan Timmermans
Do public health policy interventions result in pro-social behaviors? The Affordable Care Act (ACA)'s Medicaid expansions were responsible for the largest gains in public insurance coverage since its inception in 1965. These gains were concentrated in states that opted to expand Medicaid eligibility and provide a unique opportunity to study not just medical but also social consequences of increased public health coverage. This article examines the association between Medicaid and volunteer work. Volunteerism is implicated in individuals' health and well-being yet it is highly correlated with a person's existing socioeconomic resources...
January 2017: Socius
https://www.readbyqxmd.com/read/29142628/perioperative-results-and-complications-after-posterior-lumbar-interbody-fusion-for-spinal-stenosis-in-geriatric-patients-over-than-70-years-old
#11
Jong Min Choi, Man Kyu Choi, Sung Bum Kim
Objective: As increasing the size of the geriatric population, the number of elderly patients, who need the surgery for painful degenerative spinal stenosis has been increasing. The geriatric population may be relatively high complications, because of age and age-associated medical conditions. However, there is a lack of studies addressing the perioperative complications and outcomes in elderly patients with posterior lumbar inter body fusion with screw augmentation (PLIF). Methods: We retrospectively reviewed the medical records and radiographic studies of geriatric patients who had spine surgery of PLIF due to spinal stenosis for 11 years...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29142496/precipitous-resolution-of-type-a-intramural-hematoma-with-medical-management-in-a-patient-with-metastatic-stage-4-renal-cell-carcinoma
#12
Camilo A Velasquez, Syed Usman Bin Mahmood, Mohammad A Zafar, Adam J Brownstein, Ayman Saeyeldin, Bulat A Ziganshin, John A Elefteriades
Intramural hematoma (IMH) is a variant form of aortic dissection characterized by involvement of the aortic media without the presence of an overt intimal flap. Surgical extirpation is the standard of care for type-A IMH in the Western world. However, a conservative approach with anti-impulse therapy has been advocated especially in Japan as a viable alternative. Here, we report a case of an elderly male patient with a history of metastatic stage 4 renal cell carcinoma who was treated with anti-impulse therapy for an acute type-A IMH...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29141681/patient-influence-in-home-based-reablement-for-older-persons-qualitative-research
#13
Aud Moe, Kari Ingstad, Hildfrid V Brataas
BACKGROUND: Reablement services are rehabilitation for older people living at home, being person-centered in information, mapping and the goal-setting conversation. The purpose of this study was to gain knowledge about conversation processes and patient influence in formulating the patients' goals. There are two research questions: How do conversation theme, structure and processes appear in interactions aiming to decide goals of home-based reablement rehabilitation for the elderly? How professionals' communication skills do influence on patients' participation in conversation about everyday life and goals of home-based reablement? METHODS: A qualitative field study explored eight cases of naturally occurring conversations between patients and healthcare professionals in a rehabilitation team...
November 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29140858/computerized-cognitive-testing-in-primary-care-a-qualitative-study
#14
Geneva Millett, Gary Naglie, Ross Upshur, Liisa Jaakkimainen, Jocelyn Charles, Mary C Tierney
Computerized cognitive assessment tools may facilitate early identification of dementia in the primary care setting. We investigated primary care physicians' (PCPs') views on advantages and disadvantages of computerized testing based on their experience with the Computer Assessment of Mild Cognitive Impairment (CAMCI). Over a 2-month period, 259 patients, 65 years and older, from the family practice of 13 PCPs completed the CAMCI. Twelve PCPs participated in an individual interview. Generally, PCPs felt that the relationship between them and their patients helped facilitate cognitive testing; however, they thought available paper tests were time consuming and not sufficiently informative...
November 14, 2017: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/29140737/older-americans-were-sicker-and-faced-more-financial-barriers-to-health-care-than-counterparts-in-other-countries
#15
Robin Osborn, Michelle M Doty, Donald Moulds, Dana O Sarnak, Arnav Shah
High-income countries are grappling with the challenge of caring for aging populations, many of whose members have chronic illnesses and declining capacity to manage activities of daily living. The 2017 Commonwealth Fund International Health Policy Survey of Older Adults in eleven countries showed that US seniors were sicker than their counterparts in other countries and, despite universal coverage under Medicare, faced more financial barriers to health care. The survey's findings also highlight economic hardship and mental health problems that may affect older adults' health, use of care, and outcomes...
November 15, 2017: Health Affairs
https://www.readbyqxmd.com/read/29140555/withdrawn-electrical-cardioversion-for-atrial-fibrillation-and-flutter
#16
REVIEW
Gillian E Mead, Andrew Elder, Andrew D Flapan, John Cordina
BACKGROUND: Atrial fibrillation increases stroke risk and adversely affects cardiovascular haemodynamics. Electrical cardioversion may, by restoring sinus rhythm, improve cardiovascular haemodynamics, reduce the risk of stroke, and obviate the need for long-term anticoagulation. OBJECTIVES: To assess the effects of electrical cardioversion of atrial fibrillation or flutter on the risk of thromboembolic events, strokes and mortality (primary outcomes), the rate of cognitive decline, quality of life, the use of anticoagulants and the risk of re-hospitalisation (secondary outcomes) in adults (>18 years)...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29139651/the-risk-for-fall-and-functional-dependence-in-polish-adults-60%C3%A2-87-years-old
#17
Jaroslaw Domaradzki, Slawomir Koziel, Zofia Ignasiak, Teresa Sławińska, Anna Skrzek, Małgorzata Kołodziej
The constantly rising percentage of the elderly (60+), who are particularly at risk of the dangerous consequence of falls, results not only in the loss of independence in daily life, but also in a serious threat to health and life. Therefore, many authors emphasize the necessity of conducting prophylaxis and prevention among senior citizens. The most important aspect of fall prophylaxis is care about the optimum level of agility. Exercise should focus on increasing muscular strength, balance and dexterity. The aim of the present study is to determine the relationship between functional fitness and the risk for falls of older people in the light of maintaining physical independence...
March 2017: Collegium Antropologicum
https://www.readbyqxmd.com/read/29139215/treatment-utilization-and-outcomes-in-elderly-patients-with-locally-advanced-esophageal-carcinoma-a-review-of-the-national-cancer-database
#18
Gregory Vlacich, Pamela P Samson, Stephanie M Perkins, Michael C Roach, Parag J Parikh, Jeffrey D Bradley, A Craig Lockhart, Varun Puri, Bryan F Meyers, Benjamin Kozower, Cliff G Robinson
For elderly patients with locally advanced esophageal cancer, therapeutic approaches and outcomes in a modern cohort are not well characterized. Patients ≥70 years old with clinical stage II and III esophageal cancer diagnosed between 1998 and 2012 were identified from the National Cancer Database and stratified based on treatment type. Variables associated with treatment utilization were evaluated using logistic regression and survival evaluated using Cox proportional hazards analysis. Propensity matching (1:1) was performed to help account for selection bias...
November 15, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/29138544/early-postoperative-delirium-after-hemiarthroplasty-in-elderly-patients-aged-over-70-years-with-displaced-femoral-neck-fracture
#19
Yi-Hwa Choi, Dae-Hwan Kim, Tae-Young Kim, Tae-Wan Lim, Seok-Woo Kim, Je-Hyun Yoo
Purpose: Postoperative delirium is a risk factor for worse outcome after hip fracture surgery in elderly patients. Postoperative delirium is associated with anesthesia, postoperative pain, and patient factors. We investigated the incidence, predictors, and prognostic implications of post-operative delirium after hemiarthroplasty (HA) in elderly patients with femoral neck fracture. Patients and methods: A total of 356 consecutive patients aged >70 years who underwent HA for femoral neck fracture were enrolled...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29137820/does-acute-care-for-the-elderly-ace-unit-decrease-the-incidence-of-falls
#20
Ahmed Abdalla, Mehul Adhaduk, Raad A Haddad, Yanal Alnimer, Carlos F Ríos-Bedoya, Ghassan Bachuwa
To determine whether acute care for the elderly (ACE) units decrease the incidence of patient falls compared to general medical and surgical (GMS) units, a non-concurrent prospective study included individuals aged 65 and older admitted to ACE or GMS units over a 2-year span was done. There were 7069 admissions corresponded to 28,401 patient-days. A total of 149 falls were reported for an overall incidence rate (IR) of 5.2 falls per 1000 patient-days, 95% CI, 4.4/1000-6.1/1000 patient-days. The falls IR ratio for patients in ACE unit compared to those in non-ACE units after adjusting for age, sex, prescribed psychotropics and hypnotics, and Morse Fall Score was 0...
November 11, 2017: Geriatric Nursing
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