Age-Related Disparities in the Quality of Stroke Care and Outcomes in Rehabilitation Hospitals: The Australian National Audit

2021 ◽  
Vol 30 (5) ◽  
pp. 105707
Author(s):  
Tara Purvis ◽  
Isobel J Hubbard ◽  
Dominique A Cadilhac ◽  
Kelvin Hill ◽  
Justine Watkins ◽  
...  
Keyword(s):  
Stroke Care ◽  
National Audit ◽  
Age Related ◽  
Rehabilitation Hospitals

scholarly journals Temporal variations in quality of acute stroke care and outcomes in London hyperacute stroke units: a mixed-methods study

2020 ◽  
Vol 8 (34) ◽  
pp. 1-98
Author(s):  
Robert Simister ◽  
Georgia B Black ◽  
Mariya Melnychuk ◽  
Angus IG Ramsay ◽  
Abigail Baim-Lance ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Acute Stroke ◽  
Stroke Care ◽  
National Audit ◽  
Acute Stroke Care ◽  
Stroke Units ◽  
Hyperacute Stroke ◽  
Factors Influencing ◽  
Time Of Admission

Background Seven-day working in hospitals is a current priority of international health research and policy. Previous research has shown variability in delivering evidence-based clinical interventions across different times of the day and week. We aimed to identify factors influencing such variations in London hyperacute stroke units. Objectives To investigate variations in quality of acute stroke care and outcomes by day and time of admission in London hyperacute stroke units, and to identify factors influencing such variations. Design This was a prospective cohort study using anonymised patient-level data from the Sentinel Stroke National Audit Programme. Factors influencing variations in care and outcomes were studied through interview and observation data. Setting The setting was acute stroke services in London hyperacute stroke units. Participants A total of 7094 patients with a primary diagnosis of stroke took part. We interviewed hyperacute stroke unit staff (n = 76), including doctors, nurses, therapists and administrators, and 31 patients and carers. We also conducted non-participant observations of delivery of care at different times of the day and week (n = 45, ≈102 hours). Intervention Hub-and-spoke model for care of suspected acute stroke patients in London with performance standards was designed to deliver uniform access to high-quality hyperacute stroke unit care across the week. Main outcome measures Indicators of quality of acute stroke care, mortality at 3 days after admission, disability at the end of the inpatient spell and length of stay. Data sources Sentinel Stroke National Audit Programme data for all patients in London hyperacute stroke units with a primary diagnosis of stroke between 1 January and 31 December 2014, and nurse staffing data for all eight London hyperacute stroke units for the same period. Results We found no variation in quality of care by day and time of admission across the week in terms of stroke nursing assessment, brain scanning and thrombolysis in London hyperacute stroke units, nor in 3-day mortality nor disability at hospital discharge. Other quality-of-care measures significantly varied by day and time of admission. Quality of care was better if the nurse in charge was at a higher band and/or there were more nurses on duty. Staff deliver ‘front-door’ interventions consistently by taking on additional responsibilities out of hours, creating continuities between day and night, building trusting relationships and prioritising ‘front-door’ interventions. Limitations We were unable to measure long-term outcomes as our request to the Sentinel Stroke National Audit Programme, the Healthcare Quality Improvement Partnership and NHS Digital for Sentinel Stroke National Audit Programme data linked with patient mortality status was not fulfilled. Conclusions Organisational factors influence 24 hours a day, 7 days a week (24/7), provision of stroke care, creating temporal patterns of provision reflected in patient outcomes, including mortality, length of stay and functional independence. Future work Further research would help to explore 24/7 stroke systems in other contexts. We need a clearer understanding of variations by looking at absolute time intervals, rather than achievement of targets. Research is needed with longer-term mortality and modified Rankin Scale data, and a more meaningful range of outcomes. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 34. See the NIHR Journals Library website for further project information.

scholarly journals Challenges and Perspectives on Breast Cancer Survivorship: The Journey Continues

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 96-96
Author(s):  
Victoria Raveis ◽  
Simona Kwon
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivor ◽  
Breast Cancer Survivors ◽  
Cancer Survival ◽  
Survival Rates ◽  
Extended Period ◽  
Health Issues ◽  
Age Related

Abstract Women have a 1-in-8 lifetime risk of breast cancer. Earlier diagnosis and treatment advances have improved 15- and 20-year survival rates. Increased survival can mean coping with the effects of cancer and its treatment over an extended period of time, while experiencing age-related changes in functioning and the emergence of other health issues. To explore breast cancer survivors’ perspectives on their issues and concerns across the life-course, focus groups were conducted with a culturally diverse sample (N=18) of survivors (72% white, 28% Black, 11% Hispanic). Participants were 44-82 years old. Most, 83% were 50 and older, 56% were 60 and older. The majority (83%) were diagnosed in their 40’s and 50’s. Two were diagnosed in their early 30’s and one at age 68. Participants reaffirmed the necessity, as a breast cancer survivor, of being a life-long health advocate on their own behalf, and the importance of being self-informed. As one woman commented: “Knowledge is power”. Survivors shared that their emergent health issues were complicated by their cancer history, and, that, as a cancer survivor, “I never stop worrying”. A widespread concern was not knowing if the health issues and co-morbidities they experienced (such as joint pain, neuropathy, tendinitis, heart disease), were age-related, a consequence of their cancer, or a late treatment effect. An overriding sentiment expressed was that clinicians have not recognized the importance of quality of life in cancer survival. As a survivor succinctly stated: “We are living longer, but we need to live long with quality of life.”

scholarly journals Online Assessment of Cognitive Functioning: A Reliable Alternative to Laboratory Testing?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 576-577
Author(s):  
Maximilian Haas ◽  
Sascha Zuber ◽  
David Framorando ◽  
Elissa El Khawli ◽  
Susanne Scheibe ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Cognitive Abilities ◽  
Rapid Assessment ◽  
Cognitive Disorders ◽  
Assessment Tools ◽  
Adult Lifespan ◽  
Face To Face ◽  
Age Related ◽  
Online Tools

Abstract As the population ages, risks for cognitive decline threaten independence and quality of life for older adults. Classically, psychological assessment tools to evaluate cognitive functioning are administered in face-to-face laboratory sessions, which is time- and resource-consuming. With the aim of reducing such costs, the present study set out to develop and validate two new online tools, allowing a rapid assessment of general cognitive abilities and of prospective memory. We collected data from 250 participants equally spread across the adult lifespan (aged 18 – 86). Results suggest that performance assessed via these newly developed online tools is comparable to performance in face-to-face laboratory settings. Our findings thereby indicate that these online tools can reliably measure cognitive functioning across the lifespan at a reduced cost, which may help detect individuals at risk of developing age-related cognitive disorders.

scholarly journals Monitoring Health Parameters of Elders to Support Independent Living and Improve Their Quality of Life

Sensors ◽  
2021 ◽  
Vol 21 (2) ◽  
pp. 517
Author(s):  
Ilia Adami ◽  
Michalis Foukarakis ◽  
Stavroula Ntoa ◽  
Nikolaos Partarakis ◽  
Nikolaos Stefanakis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Independent Living ◽  
Elderly Population ◽  
Well Being ◽  
The Elderly ◽  
Chronic Illnesses ◽  
Age Related ◽  
Self Sufficiency ◽  
Health And Well Being

Improving the well-being and quality of life of the elderly population is closely related to assisting them to effectively manage age-related conditions such as chronic illnesses and anxiety, and to maintain their independence and self-sufficiency as much as possible. This paper presents the design, architecture and implementation structure of an adaptive system for monitoring the health and well-being of the elderly. The system was designed following best practices of the Human-Centred Design approach involving representative end-users from the early stages.

FP22-TU-01 Quality of acute stroke care in Thailand, a prospective multicenter countrywide study

2009 ◽  
Vol 285 ◽  
pp. S91
Author(s):  
Y. Nilanont ◽  
S. Nidhinandana ◽  
N. Suwanwela ◽  
N. Poungvarin
Keyword(s):  
Acute Stroke ◽  
Stroke Care ◽  
Acute Stroke Care

Anti-aging natural compounds and their role in the regulation of metabolic pathways leading to longevity

2021 ◽  
Vol 21 ◽  
Author(s):  
Aqsa Muzammil ◽  
Muhammad Waqas ◽  
Ahitsham Umar ◽  
Muhammad Sufyan ◽  
Abdur Rehman ◽  
...  
Keyword(s):  
Natural Products ◽  
Metabolic Pathways ◽  
Natural Compounds ◽  
Chronic Obstructive ◽  
Telomere Shortening ◽  
Age Related ◽  
Chronic Obstructive Pulmonary Diseases ◽  
Extended Lifespan ◽  
Ancient Times

: Aging is an unavoidable process, leads to cell senescence due to physiochemical changes in an organism. Anti-aging remedies have always been of great interest since ancient times. The purpose of anti-aging activities is to increase the life span and the quality of life. Anti-aging activities are primarily involved in the therapies of age-related disorders such as Parkinson's disease (PD), Alzheimer's disease (AD), cardiovascular diseases, cancer and chronic obstructive pulmonary diseases. These diseases are triggered by multiple factors that are involved in numerous molecular pathways including telomere shortening, NF-κB pathway, adiponectin receptor pathway, insulin and IGF signaling pathway, AMPK, mTOR and mitochondria dysfunction. Natural products are known as effective molecules to delay the aging process through influencing metabolic pathways and thus ensure an extended lifespan. These natural compounds are being utilized in drug design and development through computational and high throughput techniques for effective pro-longevity drugs. A comprehensive study of natural compounds demonstrated with their anti-aging activities along with databases of natural products for drug designing was executed and summarized in this review article.

AGE-RELATED ISSUES OF THE QUALITY OF LIFE IN HEARING IMPAIRED PATIENTS

2021 ◽  
pp. 885-892
Author(s):  
Л. Е. Голованова ◽  
Е. А. Огородникова ◽  
Е. С. Лаптева ◽  
М. Ю. Бобошко
Keyword(s):  
Quality Of Life ◽  
Hearing Loss ◽  
Hearing Aids ◽  
Pure Tone Audiometry ◽  
Hearing Impaired ◽  
Hearing Disorders ◽  
Age Related ◽  
Sf 36 ◽  
Significant Difference

Целью исследования было изучение качества жизни лиц с нарушениями слуха в разных возрастных группах. Обследованы 100 пациентов, обратившихся в городской сурдологический центр для взрослых в связи с нарушением слуха: 50 человек - 34-59 лет, 50 - 60 лет и старше, из которых 32 человека были пожилого возраста (60-74 года)и 18 - старческого (75-86 лет). Степень тугоухости оценивали на основании результатов тональной пороговой аудиометрии. Для исследования качества жизни все пациенты заполняли общий опросник MOS SF-36, отражающий физический и психологический компоненты здоровья, а также специальный опросник HHIА(E)-S для лиц с нарушениями слуха. Установлено, что шкала HHIА(E)-S демонстрирует высокую корреляцию со степенью тугоухости у пациентов моложе 60 лет ( R =0,98; достоверность различий на уровне p <0,05), которая снижается у пациентов 60 лет и старше ( R =0,94; различия в оценках при разной степени тугоухости недостоверны). Значительные трудности в старшей возрастной группе могут быть связаны с тем, что людям пожилого и, особенно, старческого возраста сложно пользоваться слуховыми аппаратами (или они для них неэффективны) и оценивать свои затруднения по шкалам опросника. Целесообразно использовать шкалу HHIА(Е)-S в качестве скринингового инструмента для раннего выявления тугоухости, направления пациентов к сурдологу и своевременного слухопротезирования. The aim of the research was to study the quality of life in hearing impaired patients of different age. 100 patients referred to the city audiology centre because of their hearing disorders were examined: 50 patients from 34 to 59 years old and 50 patients from 60 years and older, from which 32 patients were of older age (60 to 74 years old) and 18 of oldest age (75 to 86 years old). A degree of hearing loss was assessed according to results of pure tone audiometry. To study the quality of life all patients filled in the questionnaire MOS SF-36, which evaluates physical and psychological components of health, and the questionnaire HHIA(E)-S, designed specifically for patients with hearing disorders. The HHIA(E)-S scale was found to show high correlation with hearing loss degree in patients younger than 60 years old ( R =0,98 with statistically significant difference, p <0,05), with decreasing correlation in patients from 60 years and older ( R =0,98; no significant difference while assessing various hearing loss degrees). Considerable difficulties in this age group may be explained by the fact, that older and especially oldest patients have a challenge with hearing aids usage (or they are of low efficiency for them) and with assessing theirs difficulties on the questionnaire scales. The HHIA(E)-S scale is useful as a screening tool for early detection of hearing loss, referral of patients to an audiologist and prompt hearing aid fitting.

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