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Add the result to your basketPain management: The combined patient and provider perspective / Resnick, Barbara in Geriatric Nursing, Vol.38 No.4 (Jul-Aug) 2017 ([10/09/2017])
Title : Pain management: The combined patient and provider perspective Material Type: printed text Authors: Resnick, Barbara, Author Publication Date: 2017 Article on page: p.274-275 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.274-275Keywords: Pain management.Patient.Provider perspective. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27335 [article] Pain management: The combined patient and provider perspective [printed text] / Resnick, Barbara, Author . - 2017 . - p.274-275.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.274-275Keywords: Pain management.Patient.Provider perspective. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27335
Title : Outbreak of G2P[4] rotavirus gastroenteritis in a retirement community, Brazil, 2015 Material Type: printed text Authors: Luchs, Adriana, Author ; Madalosso, Geraldine, Author ; Cilli, Audrey, Author Publication Date: 2017 Article on page: p.283-290 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.283-290Keywords: Gastroenteritis, Rotavirus, Elderly, Surveillance, Genptyping Abstract: The present study described a group A rotavirus (RVA) outbreak in an age-care facility in Brazil, using epidemiologic and molecular diagnostic methods. A descriptive clinical, epidemiological and environmental investigation was conducted. Stool samples were collected and screened for RVA, Norovirus (NoV), Enteric Adenovirus 40/41 (AdV 40/41) and Astrovirus (AstV) using ELISA, RT-PCR, qRT-PCR, electron microscopy and sequencing methods. Outbreak occurred during 26th–29th October, 2015; 28 individuals affected (22 residents; 6 staff). The attack rate was 25.9% and 8.5% among residents (median-age: 85.5 years) and staff (median-age: 28 years), respectively. Female staff was identified as the index case. RVA G2P[4] genotype was detected in 87.5% (7/8). Genetic analysis demonstrated that the outbreak involved one single strain, suggesting a common-source infection. RVA should be considered during outbreaks investigations in residential facilities, and raise the question if the current licensed RVA vaccines for children could also be helpful for the elderly. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27336 [article] Outbreak of G2P[4] rotavirus gastroenteritis in a retirement community, Brazil, 2015 [printed text] / Luchs, Adriana, Author ; Madalosso, Geraldine, Author ; Cilli, Audrey, Author . - 2017 . - p.283-290.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.283-290Keywords: Gastroenteritis, Rotavirus, Elderly, Surveillance, Genptyping Abstract: The present study described a group A rotavirus (RVA) outbreak in an age-care facility in Brazil, using epidemiologic and molecular diagnostic methods. A descriptive clinical, epidemiological and environmental investigation was conducted. Stool samples were collected and screened for RVA, Norovirus (NoV), Enteric Adenovirus 40/41 (AdV 40/41) and Astrovirus (AstV) using ELISA, RT-PCR, qRT-PCR, electron microscopy and sequencing methods. Outbreak occurred during 26th–29th October, 2015; 28 individuals affected (22 residents; 6 staff). The attack rate was 25.9% and 8.5% among residents (median-age: 85.5 years) and staff (median-age: 28 years), respectively. Female staff was identified as the index case. RVA G2P[4] genotype was detected in 87.5% (7/8). Genetic analysis demonstrated that the outbreak involved one single strain, suggesting a common-source infection. RVA should be considered during outbreaks investigations in residential facilities, and raise the question if the current licensed RVA vaccines for children could also be helpful for the elderly. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27336
Title : US and Dutch nurse experiences with fall prevention technology within nursing home environment and workflow : A qualitative study Material Type: printed text Authors: Vandenberg, Ann E., Author ; VanBeijnum, Bert-Jan, Author ; Overdevest, Vera G.P., Author Publication Date: 2017 Article on page: p.276-282 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.276-282Keywords: Fall prevention, Long-term care, Monitoring technology, Position monitors, Bed exit alarms, Pressure sensor mats, Alarm fatigue Abstract: Falls remain a major geriatric problem, and the search for new solutions continues. We investigated how existing fall prevention technology was experienced within nursing home nurses' environment and workflow. Our NIH-funded study in an American nursing home was followed by a cultural learning exchange with a Dutch nursing home. We constructed two case reports from interview and observational data and compared the magnitude of falls, safety cultures, and technology characteristics and effectiveness. Falls were a high-magnitude problem at the US site, with a collectively vigilant safety culture attending to non-directional audible alarms; falls were a low-magnitude problem at the NL site which employed customizable, infrared sensors that directed text alerts to assigned staff members' mobile devices in patient-centered care culture. Across cases, 1) a coordinated communication system was essential in facilitating effective fall prevention alert response, and 2) nursing home safety culture is tightly associated with the chosen technological system. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27337 [article] US and Dutch nurse experiences with fall prevention technology within nursing home environment and workflow : A qualitative study [printed text] / Vandenberg, Ann E., Author ; VanBeijnum, Bert-Jan, Author ; Overdevest, Vera G.P., Author . - 2017 . - p.276-282.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.276-282Keywords: Fall prevention, Long-term care, Monitoring technology, Position monitors, Bed exit alarms, Pressure sensor mats, Alarm fatigue Abstract: Falls remain a major geriatric problem, and the search for new solutions continues. We investigated how existing fall prevention technology was experienced within nursing home nurses' environment and workflow. Our NIH-funded study in an American nursing home was followed by a cultural learning exchange with a Dutch nursing home. We constructed two case reports from interview and observational data and compared the magnitude of falls, safety cultures, and technology characteristics and effectiveness. Falls were a high-magnitude problem at the US site, with a collectively vigilant safety culture attending to non-directional audible alarms; falls were a low-magnitude problem at the NL site which employed customizable, infrared sensors that directed text alerts to assigned staff members' mobile devices in patient-centered care culture. Across cases, 1) a coordinated communication system was essential in facilitating effective fall prevention alert response, and 2) nursing home safety culture is tightly associated with the chosen technological system. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27337
Title : Latent classes of caregiver relationships with patients : Workplace violence implications Material Type: printed text Authors: Byon, Ha Do, Author ; Storr, Carla L., Author ; Lipscomb, Jane, Author Publication Date: 2017 Article on page: p.291-295 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.291-295Keywords: Direct care worker, Home care worker, Caregiver, Home care, Latent class analysis, Patient–caregiver relationship, Workplace violence Abstract: The bonds and relationships that direct care workers in the home setting (DCWHs) develop with their elderly or disabled home care patients may put them at risk for patient violence. This study used a data-driven approach, latent class analysis, to identify distinct underlying patterns of DCWH–patient relationships and then assessed how DCWH–patient class membership was associated with patient violence. This study analyzed survey data obtained from 964 DCWHs working in two not-for-profit home care agencies. Four classes of DCWH–patient relationships emerged: Non-familial (40% of the sample), Overly Concerned (14%); Boundary-keeping (22%), and Overly Involved (24%). DCWHs in the Overly Involved class were more likely to experience physical violence from their patients relative to those in the Non-familial class (probability = 0.11 vs. 0.04, p = 0.01). Building a positive relationship with boundaries between caregivers and patients may have a potential to reduce patient violence toward the caregivers and ultimately improve the quality of care. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27338 [article] Latent classes of caregiver relationships with patients : Workplace violence implications [printed text] / Byon, Ha Do, Author ; Storr, Carla L., Author ; Lipscomb, Jane, Author . - 2017 . - p.291-295.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.291-295Keywords: Direct care worker, Home care worker, Caregiver, Home care, Latent class analysis, Patient–caregiver relationship, Workplace violence Abstract: The bonds and relationships that direct care workers in the home setting (DCWHs) develop with their elderly or disabled home care patients may put them at risk for patient violence. This study used a data-driven approach, latent class analysis, to identify distinct underlying patterns of DCWH–patient relationships and then assessed how DCWH–patient class membership was associated with patient violence. This study analyzed survey data obtained from 964 DCWHs working in two not-for-profit home care agencies. Four classes of DCWH–patient relationships emerged: Non-familial (40% of the sample), Overly Concerned (14%); Boundary-keeping (22%), and Overly Involved (24%). DCWHs in the Overly Involved class were more likely to experience physical violence from their patients relative to those in the Non-familial class (probability = 0.11 vs. 0.04, p = 0.01). Building a positive relationship with boundaries between caregivers and patients may have a potential to reduce patient violence toward the caregivers and ultimately improve the quality of care. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27338
Title : Dental care practices and oral health training for professional caregivers in long-term care facilities : An interdisciplinary approach to address oral health disparities Material Type: printed text Authors: Kohli, Richie, Author ; Nelson, Sandra S., Author ; Ulrich, Samantha, Author ; Finch, Tony, Author ; Karen, Hall, Author Publication Date: 2017 Article on page: p.296-301 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.296-301Keywords: Seniors, Oral health training, Caregivers, Long-term care facilities Abstract: The objectives of this study were to: 1) Assess and analyze the knowledge and attitudes of caregivers towards dental care for older adults in long-term care facilities; and 2) Train administrators, medical staff, and caregivers in the oral health competencies necessary to provide daily oral health care for residents of Assisted Living Communities in Oregon. Our results indicate that although the majority of caregivers felt comfortable with regard to their oral health background and daily activities, they expressed a need for additional training in several areas. Caregivers who participated in the training recognized the poor oral health of their residents and felt the training curriculum provided them with competencies needed to improve their daily oral health services. This innovative training demonstrates that oral health can be integrated into daily routines which could improve oral and systemic health and reduce inequities in oral health care for older adults. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27339 [article] Dental care practices and oral health training for professional caregivers in long-term care facilities : An interdisciplinary approach to address oral health disparities [printed text] / Kohli, Richie, Author ; Nelson, Sandra S., Author ; Ulrich, Samantha, Author ; Finch, Tony, Author ; Karen, Hall, Author . - 2017 . - p.296-301.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.296-301Keywords: Seniors, Oral health training, Caregivers, Long-term care facilities Abstract: The objectives of this study were to: 1) Assess and analyze the knowledge and attitudes of caregivers towards dental care for older adults in long-term care facilities; and 2) Train administrators, medical staff, and caregivers in the oral health competencies necessary to provide daily oral health care for residents of Assisted Living Communities in Oregon. Our results indicate that although the majority of caregivers felt comfortable with regard to their oral health background and daily activities, they expressed a need for additional training in several areas. Caregivers who participated in the training recognized the poor oral health of their residents and felt the training curriculum provided them with competencies needed to improve their daily oral health services. This innovative training demonstrates that oral health can be integrated into daily routines which could improve oral and systemic health and reduce inequities in oral health care for older adults. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27339
Title : The use of acupuncture in patients with Parkinson's disease Material Type: printed text Authors: Cheng, Fung Kei, Author Publication Date: 2017 Article on page: p.302-314 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.302-314Keywords: Chinese medicine, Complementary and alternative therapy, Literature review, Neuro-degeneration, Rehabilitation Abstract: Parkinson's disease, a progressive neuro-degeneration of multiple systems damaging motor and non-motor functions, affects individual and societal dimensions negatively. In addition to standard treatments, complementary and alternative medicine has been adopted, in which acupuncture, a traditional Chinese medical practice by needle penetration at specific stimulation points (acupoints) along the body, indicates positive outcomes in this illness. Apart from offering an overview of using acupuncture in Parkinson's disease, this literature review analyses the effects of acupuncture on Parkinson's-induced physical symptoms and mental problems such as slow movements, stiffness, constipation, and sleep disorders. In light of the 35 reviewed research projects in mainland China, Japan, Korea, Taiwan, and the United States of America, this study reveals the optimization of this approach through combined therapy and its preventive contribution using acupuncture alone. It also suggests research and practical implications that hint at enhancements in medical applications. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27340 [article] The use of acupuncture in patients with Parkinson's disease [printed text] / Cheng, Fung Kei, Author . - 2017 . - p.302-314.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.302-314Keywords: Chinese medicine, Complementary and alternative therapy, Literature review, Neuro-degeneration, Rehabilitation Abstract: Parkinson's disease, a progressive neuro-degeneration of multiple systems damaging motor and non-motor functions, affects individual and societal dimensions negatively. In addition to standard treatments, complementary and alternative medicine has been adopted, in which acupuncture, a traditional Chinese medical practice by needle penetration at specific stimulation points (acupoints) along the body, indicates positive outcomes in this illness. Apart from offering an overview of using acupuncture in Parkinson's disease, this literature review analyses the effects of acupuncture on Parkinson's-induced physical symptoms and mental problems such as slow movements, stiffness, constipation, and sleep disorders. In light of the 35 reviewed research projects in mainland China, Japan, Korea, Taiwan, and the United States of America, this study reveals the optimization of this approach through combined therapy and its preventive contribution using acupuncture alone. It also suggests research and practical implications that hint at enhancements in medical applications. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27340
Title : Experiences of health care for older people who need support to live at home : A systematic review of the qualitative literature Material Type: printed text Authors: Gregory, Anna, Author ; Mackintosh, Shylie, Author ; Kumar, Saravana, Author ; Grech, Carol, Author Publication Date: 2017 Article on page: p.315-324 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.315-324Keywords: Aged, Caregivers, Home care services, Quality of health care, Qualitative research Abstract: Perceived experiences of health care for older people who need support to live at home can illuminate areas needing improvement in quality of care, and guide towards better ways to support ageing populations to live at home. This systematic review synthesized findings from the qualitative literature about perceived experiences of health care for older people who need support to live at home, from the perceptions of older people, carers and health providers. Searches of electronic databases and eligibility screening produced 46 included studies for review. Thematic synthesis revealed how health care impacts on the older person's sense of autonomy, both in health care decisions and everyday life. Autonomy is empowered by the older person's own capacity and by respectful conduct of health providers. Engagement between older people, carers and health providers is a negotiated interaction, affected by multiple factors. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27341 [article] Experiences of health care for older people who need support to live at home : A systematic review of the qualitative literature [printed text] / Gregory, Anna, Author ; Mackintosh, Shylie, Author ; Kumar, Saravana, Author ; Grech, Carol, Author . - 2017 . - p.315-324.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.315-324Keywords: Aged, Caregivers, Home care services, Quality of health care, Qualitative research Abstract: Perceived experiences of health care for older people who need support to live at home can illuminate areas needing improvement in quality of care, and guide towards better ways to support ageing populations to live at home. This systematic review synthesized findings from the qualitative literature about perceived experiences of health care for older people who need support to live at home, from the perceptions of older people, carers and health providers. Searches of electronic databases and eligibility screening produced 46 included studies for review. Thematic synthesis revealed how health care impacts on the older person's sense of autonomy, both in health care decisions and everyday life. Autonomy is empowered by the older person's own capacity and by respectful conduct of health providers. Engagement between older people, carers and health providers is a negotiated interaction, affected by multiple factors. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27341
Title : Attitudes, perceptions and experiences of mealtimes among residents and staff in care homes for older adults : A systematic review of the qualitative literature Material Type: printed text Publication Date: 2017 Article on page: p.325-333 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.325-333Keywords: Residential care, Older adults, Mealtimes, Qualitative research Abstract: Addressing problems associated with malnutrition in care home residents has been prioritized by researchers and decision-makers. This review aimed to better understand factors that may contribute to malnutrition by examining the attitudes, perceptions and experiences of mealtimes among care home residents and staff. Five databases were searched from inception to November 2015: Medline, Embase, PsychINFO, AMED, and the Cochrane Database. Forward and backward citation checking of included articles was conducted. Titles, abstracts, and full texts were screened independently by two reviewers and quality was assessed using the Wallace criteria. Thematic analysis of extracted data was undertaken. Fifteen studies were included in the review, encompassing the views and opinions of a total of 580 participants set in nine different countries. Four main themes were identified: (1) organizational and staff support, (2) resident agency, (3) mealtime culture, and (4) meal quality and enjoyment. Organizational and staff support was an over-arching theme, impacting all aspects of the mealtime experience. Mealtimes are a pivotal part of care home life, providing structure to the day and generating opportunities for conversation and companionship. Enhancing the mealtime experience for care home residents needs to take account of the complex needs of residents while also creating an environment in which individual care can be provided in a communal setting. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27342 [article] Attitudes, perceptions and experiences of mealtimes among residents and staff in care homes for older adults : A systematic review of the qualitative literature [printed text] . - 2017 . - p.325-333.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.325-333Keywords: Residential care, Older adults, Mealtimes, Qualitative research Abstract: Addressing problems associated with malnutrition in care home residents has been prioritized by researchers and decision-makers. This review aimed to better understand factors that may contribute to malnutrition by examining the attitudes, perceptions and experiences of mealtimes among care home residents and staff. Five databases were searched from inception to November 2015: Medline, Embase, PsychINFO, AMED, and the Cochrane Database. Forward and backward citation checking of included articles was conducted. Titles, abstracts, and full texts were screened independently by two reviewers and quality was assessed using the Wallace criteria. Thematic analysis of extracted data was undertaken. Fifteen studies were included in the review, encompassing the views and opinions of a total of 580 participants set in nine different countries. Four main themes were identified: (1) organizational and staff support, (2) resident agency, (3) mealtime culture, and (4) meal quality and enjoyment. Organizational and staff support was an over-arching theme, impacting all aspects of the mealtime experience. Mealtimes are a pivotal part of care home life, providing structure to the day and generating opportunities for conversation and companionship. Enhancing the mealtime experience for care home residents needs to take account of the complex needs of residents while also creating an environment in which individual care can be provided in a communal setting. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27342
Title : The impact of inadequate health literacy on patient satisfaction, healthcare utilization, : and expenditures among older adults Material Type: printed text Authors: MacLeod, Stephnie, Author ; Musich, Shirley, Author ; Gulyas, Stephen, Author ; Cheng, Yan, Author Publication Date: 2017 Article on page: p.334-341 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.334-341Keywords: Health literacy, Older adults, Medicare, Medigap, Medicare supplement, Patient satisfaction Abstract: Inadequate health literacy (HL) is associated with impaired healthcare choices leading to poor quality-of-care. Our primary purpose was to estimate the prevalence of inadequate HL among two populations of AARP® Medicare Supplement insureds: sicker and healthier populations; to identify characteristics of inadequate HL; and to describe the impact on patient satisfaction, preventive services, healthcare utilization, and expenditures. Surveys were mailed to insureds in 10 states. Multivariate regression models were used to identify characteristics and adjust outcomes. Among respondents (N = 7334), 23% and 16% of sicker and healthier insureds, respectively, indicated inadequate HL. Characteristics of inadequate HL included male gender, older age, more comorbidities, and lower education. Inadequate HL was associated with lower patient satisfaction, lower preventive service compliance, higher healthcare utilization and expenditures. Inadequate HL is more common among older adults in poorer health, further compromising their health outcomes; thus they may benefit from expanded educational or additional care coordination interventions. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27343 [article] The impact of inadequate health literacy on patient satisfaction, healthcare utilization, : and expenditures among older adults [printed text] / MacLeod, Stephnie, Author ; Musich, Shirley, Author ; Gulyas, Stephen, Author ; Cheng, Yan, Author . - 2017 . - p.334-341.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.334-341Keywords: Health literacy, Older adults, Medicare, Medigap, Medicare supplement, Patient satisfaction Abstract: Inadequate health literacy (HL) is associated with impaired healthcare choices leading to poor quality-of-care. Our primary purpose was to estimate the prevalence of inadequate HL among two populations of AARP® Medicare Supplement insureds: sicker and healthier populations; to identify characteristics of inadequate HL; and to describe the impact on patient satisfaction, preventive services, healthcare utilization, and expenditures. Surveys were mailed to insureds in 10 states. Multivariate regression models were used to identify characteristics and adjust outcomes. Among respondents (N = 7334), 23% and 16% of sicker and healthier insureds, respectively, indicated inadequate HL. Characteristics of inadequate HL included male gender, older age, more comorbidities, and lower education. Inadequate HL was associated with lower patient satisfaction, lower preventive service compliance, higher healthcare utilization and expenditures. Inadequate HL is more common among older adults in poorer health, further compromising their health outcomes; thus they may benefit from expanded educational or additional care coordination interventions. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27343
Title : Engaging patients with heart failure into the design of health system interventions : Impact on research methods Material Type: printed text Authors: Newhouse, Robin P., Author ; ohantgen, Meg J, Author ; Thomas, Sue A., Author ; Trocky, Nina M., Author ; Dennison-Himmelfarb, Cheryl, Author Publication Date: 2017 Article on page: p.334-341 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.334-341Keywords: Heart failure, Patient engagement, Rural hospital, Research design. Abstract: The purpose of this study was to engage patients with heart failure (HF) to assess if changes are needed in a research study design, methods and outcomes when transferring interventions used in urban/community hospitals to rural hospital settings. A qualitative structured interview was conducted with eight patients with a diagnosis of HF admitted to two rural hospitals. Patients validated the study design, measures and outcomes, but identified one area that should be added to the study protocol, symptom experience. Results validated that the intervention, methods and outcomes for the planned study were important, but modifications to the study protocol resulted. Patient engagement in the conceptualization of research is essential to guide patient-centered studies. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27344 [article] Engaging patients with heart failure into the design of health system interventions : Impact on research methods [printed text] / Newhouse, Robin P., Author ; ohantgen, Meg J, Author ; Thomas, Sue A., Author ; Trocky, Nina M., Author ; Dennison-Himmelfarb, Cheryl, Author . - 2017 . - p.334-341.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.334-341Keywords: Heart failure, Patient engagement, Rural hospital, Research design. Abstract: The purpose of this study was to engage patients with heart failure (HF) to assess if changes are needed in a research study design, methods and outcomes when transferring interventions used in urban/community hospitals to rural hospital settings. A qualitative structured interview was conducted with eight patients with a diagnosis of HF admitted to two rural hospitals. Patients validated the study design, measures and outcomes, but identified one area that should be added to the study protocol, symptom experience. Results validated that the intervention, methods and outcomes for the planned study were important, but modifications to the study protocol resulted. Patient engagement in the conceptualization of research is essential to guide patient-centered studies. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27344
Title : Associations between socioeconomic status, aging and : functionality among older women Material Type: printed text Authors: Barrera, Gladys, Author ; Cases, Tania, Author ; Bunout, Daniel, Author Publication Date: 2017 Article on page: p.347-351 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.347-351Keywords: Education, Socioeconomic level, Functional capacity Abstract: To assess if there is an association between socioeconomic status and quality of life, functional status and markers of aging, we studied 86 women aged 73 ± 7 years, who answered the WHO Qol Bref quality of life survey. Mini mental state examination, timed up and go test, 12 minutes' walk, hand grip and quadriceps strength, dual X-ray absorptiometry (DEXA), carotid intima-media thickness and telomere length in peripheral leukocytes were measured. Successful aging was defined as a walking speed, handgrip strength, appendicular lean body mass, timed up and go and minimental values above cutoff points for disability. Participants with successful aging had a higher quality of life score and were more likely to live in rich municipalities. There was a positive correlation between telomere length, right handgrip strength and total fat free mass. Therefore, there is an association between socioeconomic status, successful aging and quality of life. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27345 [article] Associations between socioeconomic status, aging and : functionality among older women [printed text] / Barrera, Gladys, Author ; Cases, Tania, Author ; Bunout, Daniel, Author . - 2017 . - p.347-351.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.347-351Keywords: Education, Socioeconomic level, Functional capacity Abstract: To assess if there is an association between socioeconomic status and quality of life, functional status and markers of aging, we studied 86 women aged 73 ± 7 years, who answered the WHO Qol Bref quality of life survey. Mini mental state examination, timed up and go test, 12 minutes' walk, hand grip and quadriceps strength, dual X-ray absorptiometry (DEXA), carotid intima-media thickness and telomere length in peripheral leukocytes were measured. Successful aging was defined as a walking speed, handgrip strength, appendicular lean body mass, timed up and go and minimental values above cutoff points for disability. Participants with successful aging had a higher quality of life score and were more likely to live in rich municipalities. There was a positive correlation between telomere length, right handgrip strength and total fat free mass. Therefore, there is an association between socioeconomic status, successful aging and quality of life. Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27345
Title : Cranberry products for urinary tract infections Material Type: printed text Authors: Simonson, William, Author Publication Date: 2017 Article on page: p.352-353 Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.352-353Keywords: urinary tract infections. Abstract: With the advent of the Antibiotic Stewardship Program, signed into law by President Barak Obama in 2014, antibiotic use will fall under increasing scrutiny. The interdisciplinary health care team will increasingly collaborate to reduce, and ideally eliminate, irrational and unnecessary use of antibiotics. This includes incorrectly using antibiotics to treat viral infections, unnecessarily long courses of antibiotic therapy and use of potentially dangerous antibiotics when safer agents are available. With antibiotic use going under a microscope it is likely that caregivers and patients will also look for natural alternatives to commercially manufactured antibiotics.
Urinary tract infection (UTI) is one of the most common conditions for which antibiotics are routinely used in the older patient. Treatment regimens vary depending on a number of factors including the type and severity of infection and whether it is acute or recurrent. The approach to antibiotic treatment of UTI has improved over time. It has been demonstrated that rather than a prolonged 10–14 day course of therapy, which was commonly prescribed decades ago, an acute, uncomplicated UTI can be treated with a short course of an appropriate antibiotic including nitrofurantoin monohydrate macrocrystals, 100 mg twice daily for 5 days or TMP-SMZ, 160/800 mg twice daily for three days.1 This approach makes sense from a pharmacologic and bacteriologic perspective because these antibiotics are excreted unchanged by the kidneys and each of these medications is concentrated in urine at levels that are far greater than that needed to eradicate typical bacterial pathogens. These shorter courses of antibiotic therapy are likely to decrease the cost of therapy and the risk of adverse antibiotic-induced side effects and will also likely reduce possible complications including the development of antimicrobial resistance and the occurrence of major alterations in the intestinal microbiome which can have profound negative consequences including putting the patient at increased risk of developing clostridium difficile infection.2
Further improvement in therapy could be achieved through behavioral steps such as drinking sufficient amounts of water which helps cleanse the urinary tract of bacteria and/or the use of some natural compounds such as ascorbic acid (vitamin C) or cranberry products in place of actual antibiotics.1 This approach has stimulated considerable interest in cranberry juice for prevention, or perhaps even treatment of UTIs. This column will briefly discuss the use of cranberry products for UTI's and will review some recent scientific studies looking at the safety and efficacy of cranberry products.
Cranberries are rich in antioxidant compounds known as proanthocyanidins (PAC) which are responsible for the juice's vibrant color.3 Fokelore and several scientific studies suggest that PAC helps to prevent urinary tract infections, especially for women who have a history of recurrent infections. The proposed mechanism of action is that the PAC in cranberries alters E. coli bacteria, the most common pathogen causing UTIs, making the bacteria less able to adhere to cells lining the urinary tract and bladder so the bacteria are more likely to be washed out during urination.3
The two most common forms of cranberry that have been studied are juice and capsules/tablets containing concentrated amounts of PAC but there are some important nuances about cranberry juice that must first be understood. Commercially available cranberry beverages include a product that contains 100% pure cranberry juice with no additives or other ingredients. It has a natural dark cranberry color and a distinctly tart taste that may be unpalatable to some. A variety of other beverages labeled as containing cranberry juice contain a lower concentration of cranberry juice and may also contain other products such as sugar, high-fructose corn syrup, ascorbic acid and other juices to make the product more palatable. In addition, these products are typically less expensive than the 100% pure cranberry juice.
The type of juice used in an attempt to treat or prevent UTI is important because, while the products containing lesser concentrations of cranberry juice may provide hydration and possibly help to wash bacteria from the urinary tract, depending on the product they may contain insufficient amounts of PAC to offer any protection against UTI.4
The other form of cranberry that may be used to prevent UTI is non-prescription cranberry capsules/tablets, which contain concentrated PAC. Depending on the product one capsule may contain as much PAC as that contained in 16 ounces of pure cranberry juice.4
Previous studies indicated that cranberries reduce the occurrence of UTI in sexually active women with recurrent UTIs by 40%–50%.5 However, other studies, have found no difference between cranberry and placebo groups in treating or preventing UTIs. The most recent 2012 update of the Cochrane review on the use of cranberries for preventing UTIs concluded that, while there was a small trend towards fewer UTIs in people taking cranberry product compared to placebo or no treatment, it was not a statistically significant finding.6 However, the authors noted that a number of the studies had a high dropout and low compliance rate, possibly due to the palatability/acceptability of the products, primarily the cranberry juice, and that most of the studies of other cranberry products (tablets and capsules) did not report the amount of “active” ingredient in the product contained so the products may have not been potent enough. This points to the need for additional, well-designed clinical studies.
Three recent studies of the effect of cranberry on UTI have come to conflicting conclusions. One study published in 2017 involved ambulatory women, mean age 41 years, who had a recent history of urinary tract infection. The group was divided in half with one group drinking 240 ml of cranberry-containing beverage per day and the other group drinking the same amount of a placebo beverage containing no cranberry or PAC. After 24 weeks the group drinking the cranberry beverage experienced a 39% reduction in clinical UTI episodes and a 37% reduction of clinical UTI with pyuria.7
Another study of cranberry-containing beverage concluded that cranberry concentrate does not seem to effectively prevent UTIs in female patients over the age of 65 with hip fracture and indwelling urinary catheter.5 In my opinion, this study may have set the bar too high because women with indwelling catheters have a high likelihood of developing bacteriuria even if they are receiving antibiotics so one would not expect cranberry products to be more effective than antibiotics.
A third study, published in 2016 looked at two groups of female nursing home residents age 65 and older with or without pyuria at baseline.8 One-half received two cranberry capsules per day with the other half receiving placebo. The researchers concluded that administration of cranberry capsules resulted in no significant difference in presence of bacteriuria plus pyuria over 1 year but following publication of the study data there was significant pushback from urologists and cranberry researchers who cited significant flaws in the study design.9
While definitive research is lacking, some studies and considerable anecdotal reporting of the efficacy of cranberry products exists, especially in preventing recurrent UTIs. The focus on antibiotic stewardship will certainly continue to increase the interest in cranberry products as an alternative to antibiotics, at least in some clinical conditions. Considering little-to-no risk compared to potential considerable benefit, cranberry products, either in the form of juice or a capsule/tablet, may be a reasonable option for the prevention and possibly the treatment of UTIs but only if the product contains sufficient amount of PAC.
Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27346 [article] Cranberry products for urinary tract infections [printed text] / Simonson, William, Author . - 2017 . - p.352-353.
Languages : English (eng) Original Language : English (eng)
in Geriatric Nursing > Vol.38 No.4 (Jul-Aug) 2017 [10/09/2017] . - p.352-353Keywords: urinary tract infections. Abstract: With the advent of the Antibiotic Stewardship Program, signed into law by President Barak Obama in 2014, antibiotic use will fall under increasing scrutiny. The interdisciplinary health care team will increasingly collaborate to reduce, and ideally eliminate, irrational and unnecessary use of antibiotics. This includes incorrectly using antibiotics to treat viral infections, unnecessarily long courses of antibiotic therapy and use of potentially dangerous antibiotics when safer agents are available. With antibiotic use going under a microscope it is likely that caregivers and patients will also look for natural alternatives to commercially manufactured antibiotics.
Urinary tract infection (UTI) is one of the most common conditions for which antibiotics are routinely used in the older patient. Treatment regimens vary depending on a number of factors including the type and severity of infection and whether it is acute or recurrent. The approach to antibiotic treatment of UTI has improved over time. It has been demonstrated that rather than a prolonged 10–14 day course of therapy, which was commonly prescribed decades ago, an acute, uncomplicated UTI can be treated with a short course of an appropriate antibiotic including nitrofurantoin monohydrate macrocrystals, 100 mg twice daily for 5 days or TMP-SMZ, 160/800 mg twice daily for three days.1 This approach makes sense from a pharmacologic and bacteriologic perspective because these antibiotics are excreted unchanged by the kidneys and each of these medications is concentrated in urine at levels that are far greater than that needed to eradicate typical bacterial pathogens. These shorter courses of antibiotic therapy are likely to decrease the cost of therapy and the risk of adverse antibiotic-induced side effects and will also likely reduce possible complications including the development of antimicrobial resistance and the occurrence of major alterations in the intestinal microbiome which can have profound negative consequences including putting the patient at increased risk of developing clostridium difficile infection.2
Further improvement in therapy could be achieved through behavioral steps such as drinking sufficient amounts of water which helps cleanse the urinary tract of bacteria and/or the use of some natural compounds such as ascorbic acid (vitamin C) or cranberry products in place of actual antibiotics.1 This approach has stimulated considerable interest in cranberry juice for prevention, or perhaps even treatment of UTIs. This column will briefly discuss the use of cranberry products for UTI's and will review some recent scientific studies looking at the safety and efficacy of cranberry products.
Cranberries are rich in antioxidant compounds known as proanthocyanidins (PAC) which are responsible for the juice's vibrant color.3 Fokelore and several scientific studies suggest that PAC helps to prevent urinary tract infections, especially for women who have a history of recurrent infections. The proposed mechanism of action is that the PAC in cranberries alters E. coli bacteria, the most common pathogen causing UTIs, making the bacteria less able to adhere to cells lining the urinary tract and bladder so the bacteria are more likely to be washed out during urination.3
The two most common forms of cranberry that have been studied are juice and capsules/tablets containing concentrated amounts of PAC but there are some important nuances about cranberry juice that must first be understood. Commercially available cranberry beverages include a product that contains 100% pure cranberry juice with no additives or other ingredients. It has a natural dark cranberry color and a distinctly tart taste that may be unpalatable to some. A variety of other beverages labeled as containing cranberry juice contain a lower concentration of cranberry juice and may also contain other products such as sugar, high-fructose corn syrup, ascorbic acid and other juices to make the product more palatable. In addition, these products are typically less expensive than the 100% pure cranberry juice.
The type of juice used in an attempt to treat or prevent UTI is important because, while the products containing lesser concentrations of cranberry juice may provide hydration and possibly help to wash bacteria from the urinary tract, depending on the product they may contain insufficient amounts of PAC to offer any protection against UTI.4
The other form of cranberry that may be used to prevent UTI is non-prescription cranberry capsules/tablets, which contain concentrated PAC. Depending on the product one capsule may contain as much PAC as that contained in 16 ounces of pure cranberry juice.4
Previous studies indicated that cranberries reduce the occurrence of UTI in sexually active women with recurrent UTIs by 40%–50%.5 However, other studies, have found no difference between cranberry and placebo groups in treating or preventing UTIs. The most recent 2012 update of the Cochrane review on the use of cranberries for preventing UTIs concluded that, while there was a small trend towards fewer UTIs in people taking cranberry product compared to placebo or no treatment, it was not a statistically significant finding.6 However, the authors noted that a number of the studies had a high dropout and low compliance rate, possibly due to the palatability/acceptability of the products, primarily the cranberry juice, and that most of the studies of other cranberry products (tablets and capsules) did not report the amount of “active” ingredient in the product contained so the products may have not been potent enough. This points to the need for additional, well-designed clinical studies.
Three recent studies of the effect of cranberry on UTI have come to conflicting conclusions. One study published in 2017 involved ambulatory women, mean age 41 years, who had a recent history of urinary tract infection. The group was divided in half with one group drinking 240 ml of cranberry-containing beverage per day and the other group drinking the same amount of a placebo beverage containing no cranberry or PAC. After 24 weeks the group drinking the cranberry beverage experienced a 39% reduction in clinical UTI episodes and a 37% reduction of clinical UTI with pyuria.7
Another study of cranberry-containing beverage concluded that cranberry concentrate does not seem to effectively prevent UTIs in female patients over the age of 65 with hip fracture and indwelling urinary catheter.5 In my opinion, this study may have set the bar too high because women with indwelling catheters have a high likelihood of developing bacteriuria even if they are receiving antibiotics so one would not expect cranberry products to be more effective than antibiotics.
A third study, published in 2016 looked at two groups of female nursing home residents age 65 and older with or without pyuria at baseline.8 One-half received two cranberry capsules per day with the other half receiving placebo. The researchers concluded that administration of cranberry capsules resulted in no significant difference in presence of bacteriuria plus pyuria over 1 year but following publication of the study data there was significant pushback from urologists and cranberry researchers who cited significant flaws in the study design.9
While definitive research is lacking, some studies and considerable anecdotal reporting of the efficacy of cranberry products exists, especially in preventing recurrent UTIs. The focus on antibiotic stewardship will certainly continue to increase the interest in cranberry products as an alternative to antibiotics, at least in some clinical conditions. Considering little-to-no risk compared to potential considerable benefit, cranberry products, either in the form of juice or a capsule/tablet, may be a reasonable option for the prevention and possibly the treatment of UTIs but only if the product contains sufficient amount of PAC.
Link for e-copy: http://www.gnjournal.com/ Record link: http://libsearch.siu.ac.th/siu/opac_css/index.php?lvl=notice_display&id=27346
