Negative health outcomes and adverse events in older people attending emergency departments: A systematic review

2011 ◽  
Vol 14 (3) ◽  
pp. 141-162 ◽  
Author(s):  
Linda Schnitker ◽  
Melinda Martin-Khan ◽  
Elizabeth Beattie ◽  
Len Gray
2018 ◽  
Author(s):  
Daniel Jose Arenas ◽  
Sara Zhou ◽  
Arthur Thomas ◽  
Jici Wang ◽  
Gilberto Vila Arroyo ◽  
...  

Introduction: Social determinants of health, such as food security, are an important target for health providers, particularly in the care of patients from underserved populations, including the uninsured and socially marginalized. Preliminary research has shown that food insecurity status (FIS) is associated with negative health outcomes.Objective: We aim to present a concise, yet comprehensive resource that lists the health outcomes associated with FIS. This guide is meant to provide innovative health providers with the tools needed to justify the importance of using FIS screening and treatment as a preventive medicine intervention.Methods: We conducted a systematic review of peer-reviewed manuscripts that studied FIS in the United States of America (USA) and at least one health outcome. We searched PubMed, Embase, Web of Science, and Scopus and had multiple reviewers examine each abstract and manuscript. We only retained peer-reviewed studies that contained USA data, directly measured FIS, and directly compared FIS to a health outcome.Results: The initial search yielded 1,817 manuscripts. After screening abstracts for duplicates and inclusion criteria, a total of 117 manuscripts were retained and fully examined. Several manuscripts showed significant association between FIS and neurologic, cardiac, endocrine, and pulmonary health outcomes. Studies in the USA population show robust associations between FIS and poor mental health (including depression, anxiety, sleep disorders, impaired cognitive functioning, and epilepsy), metabolic syndrome, hyperlipidemia, greater risk for bone fracture in children, higher risk of end-stage renal disease in patients with chronic kidney disease, self-reported poor health, and higher mortality in patients with the human immunodeficiency virus. Though other literature reviews show positive associations between FIS and health outcomes such as diabetes, body mass index, and hypertension, our systematic review showed mixed results.Conclusions: FIS leaves underserved populations at risk for negative health outcomes. More research should be done to examine the effects of FIS alleviation as a preventative medicine intervention.


2017 ◽  
Vol 73 (7) ◽  
pp. 914-924 ◽  
Author(s):  
Julian Alcazar ◽  
Amelia Guadalupe-Grau ◽  
Francisco J García-García ◽  
Ignacio Ara ◽  
Luis M Alegre

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Christina Sul ◽  
Sherif M. Badawy

In-flight medical emergencies (IMEs) are acute onboard events of illnesses or injuries with potential immediate risk to a passenger’s short- or long-term health, or life. IMEs are significant events that are related to public safety concerns. With the increasing amount of annual air travel every year, it is expected that the number of encountered IMEs will continue to grow. Thus, it will be critical to develop and implement appropriate measures to manage IMEs with the best possible outcome. Despite the fact that most IMEs are self-limited with no serious adverse events, serious IME can lead to death, disability, or other unfavorable health outcomes, particularly as a result of suboptimal medical care. In this article, we systematically reviewed the published up-to-date evidence on the subject of in-flight emergencies with a specific focus on pediatric population.


Author(s):  
Renata Cunha Carvalho ◽  
Fernanda Ayache Nishi ◽  
Tatiane Bomfim Ribeiro ◽  
Gustavo Galvão França ◽  
Patricia Melo Aguiar

Background: Many people are still affected by uncontrolled glycemic events during hospital admission, what encompasses hypoglycemia, hyperglycemia, and high glycemic variability. Introduction: Primary studies have shown association of glycemic dysregulation with increased length of hospital stay and with mortality among overall patients, however, there is no systematic review of current evidence on the association between uncontrolled in-hospital glycemia in patients with diabetes and health outcomes. This study aimed to systematic review the current evidence on the association between uncontrolled in-hospital glycemia in patients with diabetes and health outcomes. Methods: The association between glycemic dysregulation and health outcomes for inpatients with diabetes was systematically reviewed. PubMed, Embase, and LILACS databases were searched. Two independent reviewers were involved in each of the following steps: screening titles, abstracts, and full-texts; assessing the methodological quality; and extracting data from included reviews. Descriptive analysis method was used. Results: Seven cohort studies were included, and only two had a prospective design, consisting of 7,174 hospitalized patients with diabetes. In-hospital occurrence of hypoglycemia, hyperglycemia, and glycemic variability were assessed, and outcomes were mortality, infections, renal complications, and adverse events. Among the exposure and outcomes, an association was observed between severe hypoglycemia and mortality, hyperglycemia and infection, and hyperglycemia and adverse events. Conclusion: In-hospital uncontrolled glycemia in patients with diabetes is associated with poor health outcomes. More studies should be conducted for better investigation because diabetes is a complex condition. Effects of glycemic dysregulation should be investigated according to overall health instead of the organ target perspective, which makes the investigation difficult.


2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i30-i32
Author(s):  
S E R Lim ◽  
N J Cox ◽  
H C Roberts

Abstract Introduction Physical activity (PA) is important for older people to maintain functional independence and healthy ageing. PA interventions for community-dwelling older adults are often delivered by healthcare professionals, fitness instructors or trained members of a research team. Innovative approaches are needed to ensure that these interventions are practical and sustainable. This systematic review explores the effectiveness of volunteer-led PA interventions in improving health outcomes for community-dwelling older people. Methods Following PRISMA recommendations, five databases (MEDLINE, Embase, CINAHL, PEDro, Cochrane library) were systematically searched until May 2019, for studies using trained volunteers to deliver PA interventions for community-dwelling older people aged ≥ 65 years, reporting on participant outcomes. Meta-analysis was not conducted due to included study heterogeneity. Results Twelve papers (eight studies including three randomised controlled trials (RCTs)) were included in the review; five papers reported different outcomes from the same RCT. Intervention settings included community exercise groups (n=4), home (n=2) and care homes (n=2). All eight studies included strength and balance exercises and frequency of PA ranged from once daily to weekly sessions. The three RCTs showed improvement in grip strength, nutritional and frailty status, and reduction in fear of falling, among 39 older adults (mean age 83 years) who received a physical training and nutritional intervention; improvement in grip strength and activity of daily living scores among 56 nursing home older adults (mean age 78 years) who received resistance exercise training; and a significantly higher proportion of older adults (n = 193, 9% improvement vs 0.5% in the control group) achieved the recommended target of 150 minutes of moderate vigorous PA per week using the Falls Management Exercise intervention. Two studies compared volunteer and health professional-delivered PA interventions and reported that both interventions were equally effective in reducing fear of falls and improving quality of life. Two quasi-experimental studies reported improvement in functional outcomes including functional reach, timed up and go test, and chair stand. A large prospective cohort study (n = 1620) reported a reduction in disability among older adults who received volunteer-led exercise compared to control, with a hazard ratio of 0.73 (95% CI 0.62-0.86) for development of disability. Conclusions Trained volunteers can lead PA interventions among community-dwelling older adults with some evidence of improved health outcomes including nutritional, functional and frailty status.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 240-241
Author(s):  
Carolina Freiria ◽  
Graziele Silva ◽  
Larissa Hara ◽  
André Fattori ◽  
Flavia Borim ◽  
...  

Abstract Food security can be defined as when the individual has access to food consumption in adequate quality and quantity, respecting aspects such as age, physiological condition and cultural habits. While international studies showed the association of Food Insecurity (FI) and many negative health outcomes, like depressive symptoms, less is known about food insecurity among older people in Brazil, especially about its association with health. The aim of this study is to analyze the relationship between FI and Depressive Symptoms (DS) among community older Brazilian adults. Were included in this study 493 community older people with 60+. Geriatric Depression Scale were used to measure DS and for assessment of FI was used the short version of the Brazilian Food Insecurity Scale, added with one question involving functional limitations to buy food. Logistic regression was used to estimate the odds ratio (OR) adjusted for covariates (e.g., sex, education, age and familiar income). The prevalence of FI were 42.4% and the prevalence of DS were 71.5% of population. The prevalence of DS was higher in the group with FI than among those without F (78.9% vs 65.8% respectively; p=0.001). In the adjusted regression analysis, the chance of presenting positive symptomatology for depression was 1.87 times higher among the older people with FI (CI 1.18 –2.91; p=0.007). The findings demonstrate high prevalence of FI and DS indicating the importance of FI screening among community-based older people in order to avoid possible negative health outcomes in this population, such as the development of depressive symptoms.


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