scholarly journals Glycemic Control and Use of High-risk Antihyperglycemic Agents Among Nursing Home Residents With Diabetes in Ontario, Canada

Author(s):  
Iliana C. Lega ◽  
Michael A. Campitelli ◽  
Jeremy Matlow ◽  
Yingbo Na ◽  
Nathan M. Stall ◽  
...  
Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 1035-P
Author(s):  
ALEXANDRA K. LEE ◽  
SEI J. LEE ◽  
BOCHENG JING ◽  
MEDHA MUNSHI ◽  
ANDREW J. KARTER

2020 ◽  
Vol 21 (3) ◽  
pp. B31
Author(s):  
Matthew Griffith ◽  
Matthew Griffith ◽  
Cari Levy ◽  
Toral Parikh ◽  
Pedro Gozalo ◽  
...  

2020 ◽  
Vol 1 (1) ◽  
pp. 10-13
Author(s):  
Hassan A. Khan ◽  
Nader Hanna ◽  
Michael J. Chaskes ◽  
Gregory D. Gudleski ◽  
Piotr Karmilowicz ◽  
...  

2017 ◽  
Vol 177 (1) ◽  
pp. 130 ◽  
Author(s):  
Amy Hsu ◽  
Siqi Gan ◽  
Irena Cenzer-Stijacic ◽  
Sei J. Lee

JAMA ◽  
2011 ◽  
Vol 306 (2) ◽  
Author(s):  
Yue Li ◽  
Jun Yin ◽  
Xueya Cai ◽  
Helena Temkin-Greener ◽  
Dana B. Mukamel

2017 ◽  
Vol 61 (10) ◽  
Author(s):  
Natalia Blanco ◽  
Lisa Pineles ◽  
Alison D. Lydecker ◽  
J. Kristie Johnson ◽  
John D. Sorkin ◽  
...  

ABSTRACT The objectives of the study were to estimate the risk of transmission of antibiotic-resistant Gram-negative bacteria (RGNB) to gowns and gloves (G&G) worn by health care workers (HCWs) when providing care to nursing home residents and to identify the types of care and resident characteristics associated with transmission. A multicenter, prospective observational study was conducted with residents and HCWs from Veterans Affairs (VA) nursing homes. Perianal swabs to detect RGNB were collected from residents. HCWs wore G&G during usual care activities, and the G&G were swabbed at the end of the interaction in a standardized manner. Transmission of RGNB from a colonized resident to G&G by type of care was measured. Odds ratios (ORs) associated with type of care or resident characteristics were estimated. Fifty-seven (31%) of 185 enrolled residents were colonized with ≥1 RGNB. RGNB transmission to HCW gloves or gowns occurred during 9% of the interactions (n = 905): 7% to only gloves and 2% to only gowns. Bathing the resident and providing hygiene and toilet assistance were associated with a high risk of transmission. Glucose monitoring and assistance with feeding or medication were associated with a low risk of transmission. In addition, antibiotic use by the resident was strongly associated with greater transmission (OR, 2.51; P < 0.01). RGNB were transferred to HCWs during ∼9% of visits. High-risk types of care were identified for which use of G&G may be prioritized. Antibiotic use was associated with 2.5 times greater risk of transmission, emphasizing the importance of antibiotic stewardship. (This study has been registered at ClinicalTrials.gov under registration no. NCT01350479.)


2015 ◽  
Vol 36 (10) ◽  
pp. 1155-1162 ◽  
Author(s):  
Lona Mody ◽  
Kristen E. Gibson ◽  
Amanda Horcher ◽  
Katherine Prenovost ◽  
Sara E. McNamara ◽  
...  

OBJECTIVETo characterize the epidemiology of multidrug-resistant (MDR)Acinetobacter baumanniicolonization in high-risk nursing home (NH) residents.DESIGNNested case-control study within a multicenter prospective intervention trial.SETTINGFour NHs in Southeast Michigan.PARTICIPANTSCase patients and control subjects were NH residents with an indwelling device (urinary catheter and/or feeding tube) selected from the control arm of the Targeted Infection Prevention study. Cases were residents colonized with MDR (resistant to ≥3 classes of antibiotics)A. baumannii; controls were never colonized with MDRA. baumannii.METHODSFor active surveillance cultures, specimens from the nares, oropharynx, groin, perianal area, wounds, and device insertion site(s) were collected upon study enrollment, day 14, and monthly thereafter.A. baumanniistrains and their susceptibilities were identified using standard microbiologic methods.RESULTSOf 168 NH residents, 25 (15%) were colonized with MDRA. baumannii. Compared with the 143 controls, cases were more functionally disabled (Physical Self-Maintenance Score >24; odds ratio, 5.1 [95% CI, 1.8–14.9];P<.004), colonized withProteus mirabilis(5.8 [1.9–17.9];P<.003), and diabetic (3.4 [1.2–9.9];P<.03). Most cases (22 [88%]) were colonized with multiple antibiotic-resistant organisms and 16 (64%) exhibited co-colonization with at least one other resistant gram-negative bacteria.CONCLUSIONFunctional disability,P. mirabiliscolonization, and diabetes mellitus are important risk factors for colonization with MDRA. baumanniiin high-risk NH residents.A. baumanniiexhibits widespread antibiotic resistance and a preference to colonize with other antibiotic-resistant organisms, meriting enhanced attention and improved infection control practices in these residents.Infect Control Hosp Epidemiol 2015;36(10):1155–1162


2016 ◽  
Vol 64 (10) ◽  
pp. 1975-1980 ◽  
Author(s):  
Angela C. Eke-Usim ◽  
Mary A.M. Rogers ◽  
Kristen E. Gibson ◽  
Christopher Crnich ◽  
Lona Mody ◽  
...  

Author(s):  
Gabriel Torbahn ◽  
Isabella Sulz ◽  
Franz Großhauser ◽  
Michael J. Hiesmayr ◽  
Eva Kiesswetter ◽  
...  

Abstract Background/Objectives Malnutrition (MN) in nursing home (NH) residents is associated with poor outcome. In order to identify those with a high risk of incident MN, the knowledge of predictors is crucial. Therefore, we investigated predictors of incident MN in older NH-residents. Subjects/Methods NH-residents participating in the nutritionDay-project (nD) between 2007 and 2018, aged ≥65 years, with complete data on nutritional status at nD and after 6 months and without MN at nD. The association of 17 variables (general characteristics (n = 3), function (n = 4), nutrition (n = 1), diseases (n = 5) and medication (n = 4)) with incident MN (weight loss ≥ 10% between nD and follow-up (FU) or BMI (kg/m2) < 20 at FU) was analyzed in univariate generalized estimated equation (GEE) models. Significant (p < 0.1) variables were selected for multivariate GEE-analyses. Effect estimates are presented as odds ratios and their respective 99.5%-confidence intervals. Results Of 11,923 non-malnourished residents, 10.5% developed MN at FU. No intake at lunch (OR 2.79 [1.56–4.98]), a quarter (2.15 [1.56–2.97]) or half of the meal eaten (1.72 [1.40–2.11]) (vs. three-quarter to complete intake), the lowest BMI-quartile (20.0–23.0) (1.86 [1.44–2.40]) (vs. highest (≥29.1)), being between the ages of 85 and 94 years (1.46 [1.05; 2.03]) (vs. the youngest age-group 65–74 years)), severe cognitive impairment (1.38 [1.04; 1.84]) (vs. none) and being immobile (1.28 [1.00–1.62]) (vs. mobile) predicted incident MN in the final model. Conclusion 10.5% of non-malnourished NH-residents develop MN within 6 months. Attention should be paid to high-risk groups, namely residents with poor meal intake, low BMI, severe cognitive impairment, immobility, and older age.


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