scholarly journals Cohort differences in dementia recognition and treatment indicators among assisted living residents in Maryland: did a change in the resident assessment tool make a difference?

2013 ◽  
Vol 25 (12) ◽  
pp. 2047-2056 ◽  
Author(s):  
Quincy M. Samus ◽  
Amrita Vavilikolanu ◽  
Lawrence Mayer ◽  
Matthew McNabney ◽  
Jason Brandt ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Assisted Living ◽  
Behavioral Problems ◽  
Assessment Tool ◽  
Neuropsychiatric Symptoms ◽  
Care Quality ◽  
Dementia Care ◽  
Cross Sectional ◽  
Cohort Differences ◽  
The Impact

ABSTRACTBackground:There is a lack of empirical evidence about the impact of regulations on dementia care quality in assisted living (AL). We examined cohort differences in dementia recognition and treatment indicators between two cohorts of AL residents with dementia, evaluated prior to and following a dementia-related policy modification to more adequately assess memory and behavioral problems.Methods:Cross-sectional comparison of two AL resident cohorts was done (Cohort 1 [evaluated 2001–2003] and Cohort 2 [evaluated 2004–2006]) from the Maryland Assisted Living studies. Initial in-person evaluations of residents with dementia (n = 248) were performed from a random sample of 28 AL facilities in Maryland (physician examination, clinical characteristics, and staff and family recognition of dementia included). Adequacy of dementia workup and treatment was rated by an expert consensus panel.Results:Staff recognition of dementia was better in Cohort 1 than in Cohort 2 (77% vs. 63%, p = 0.011), with no significant differences in family recognition (86% vs. 85%, p = 0.680), or complete treatment ratings (52% vs. 64%, p = 0.060). In adjusted logistic regression, cognitive impairment and neuropsychiatric symptoms correlated with staff recognition; and cognitive impairment correlated with family recognition. Increased age and cognitive impairment reduced odds of having a complete dementia workup. Odds of having complete dementia treatment was reduced by age and having more depressive symptoms. Cohort was not predictive of dementia recognition or treatment indicators in adjusted models.Conclusions:We noted few cohort differences in dementia care indicators after accounting for covariates, and concluded that rates of dementia recognition and treatment did not appear to change much organically following the policy modifications.

Cost of Dementia and Its Correlation With Dependence

2016 ◽  
Vol 28 (8) ◽  
pp. 1448-1464 ◽  
Author(s):  
Örjan Åkerborg ◽  
Andrea Lang ◽  
Anders Wimo ◽  
Anders Sköldunger ◽  
Laura Fratiglioni ◽  
...  
Keyword(s):  
Cognitive Ability ◽  
Resource Utilization ◽  
Annual Cost ◽  
Neuropsychiatric Symptoms ◽  
Dementia Care ◽  
Cost Of Care ◽  
Path Model ◽  
National Study ◽  
Strong Impact ◽  
The Impact

Objective: To estimate the cost of dementia care and its relation to dependence. Method: Disease severity and health care resource utilization was retrieved from the Swedish National Study on Aging and Care. Informal care was assessed with the Resource Utilization in Dementia instrument. A path model investigates the relationship between annual cost of care and dependence, cognitive ability, functioning, neuropsychiatric symptoms, and comorbidities. Results: Average annual cost among patients diagnosed with dementia was €43,259, primarily incurred by accommodation. Resource use, that is, institutional care, community care, and accommodation, and corresponding costs increased significantly by increasing dependency. Path analysis showed that cognitive ability, functioning, and neuropsychiatric symptoms were significantly correlated with dependence, which in turn had a strong impact on annual cost. Discussion: This study confirms that cost of dementia care increases with dependence and that the impact of other disease indicators is mainly mediated by dependence.

scholarly journals The Impact of Vegan Diet in the Prevention and Treatment of Type 2 Diabetes: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2123
Author(s):  
Daniela Pollakova ◽  
Aikaterini Andreadi ◽  
Francesca Pacifici ◽  
David Della-Morte ◽  
Davide Lauro ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Assessment Tool ◽  
Vegan Diet ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Observational Cohort ◽  
Meta Analyses ◽  
The Impact

A protective effect of vegan diets on health outcomes has been observed in previous studies, but its impact on diabetes is still debated. The aim of this review is to assess the relationship between vegan diets and the risk for type 2 diabetes (T2D) along with its effect on glycemic control and diabetes-related complications. In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta–Analyses) guidelines, Pubmed and Cochrane library databases were systematically searched for all relevant studies. Seven observational and eight randomized controlled (RCTs) studies were included. The methodological quality of studies was assessed using the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies and the Cochrane Risk of Bias Tool for RCTs. We found that a vegan diet is associated with lower T2D prevalence or incidence and in T2D patients decreases high glucose values and improves glucose homeostasis, as reported from the majority of included studies. This approach seems to be comparable to other recommended healthful eating models, but as it may have potential adverse effects associated with the long-term exclusion of some nutrients, appropriate nutritional planning and surveillance are recommended, particularly in specific groups of diabetic patients such as frail elderly, adolescents, and pregnant or breastfeeding women.

scholarly journals Antenatal Care Quality by Midwives as A Stunting Prevention Effort in Malang, East Java: A Comparative Study

2020 ◽  
Author(s):  
Diadjeng Setya W ◽  
◽  
Miftahul Jannah ◽  
Rismaina Putri ◽  
◽  
...  
Keyword(s):  
Antenatal Care ◽  
Cross Sectional Study ◽  
Care Quality ◽  
Questionnaire Data ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact ◽  
Child's Brain ◽  
Dominant Influence

ABSTRACT Background: Fulfilment of nutrition in the first 1000 days of life greatly affects the development of a child’s brain and body. If the nutritional intake is not fulfilled, the impact on children’s development will be permanent, one of which is stunting. This study aimed to compare the quality of antenatal care (ANC) by midwives in the stunting locus and not the stunting locus village. Subjects and Method: This was a comparative analytic with cross-sectional study conducted in stunting locus and not stunting locus village in Malang Regency from August-December 2019. A total of 84 midwives were enrolled in this study by purposive sampling. The data were collected by questionnaire. Data were analyzed using a multiple linear regression. Results: Quality of ANC in stunting locus and not stunting locus village were not showing good results. The most dominant influence on the quality of ANC midwives in the stunting locus was the length of work of the midwives. Meanwhile, the most dominant influence on the quality of ANC midwives in non-stunting locus was the latest education. Conclusion: Quality of ANC in stunting locus and not stunting locus village are not yet showing good results. Keywords: stunting, quality, antenatal care, midwives Correspondence: Diadjeng Setya Wardani. Faculty of Medicine, Universitas Brawijaya. Jl. Veteran Malang, East Java, Indonesia. [email protected] DOI: https://doi.org/10.26911/the7thicph.03.06

scholarly journals Is there a correlation between cognition and the ability to remember how to use assistive devices?

2019 ◽  
Vol 47 (1) ◽  
pp. 58-72
Author(s):  
Gerard Mc Carroll ◽  
Mary Cooke
Keyword(s):  
Null Hypothesis ◽  
Assessment Tool ◽  
Mmse Score ◽  
Primary Objective ◽  
Assistive Devices ◽  
Assessment Instrument ◽  
Cross Sectional ◽  
Content Type ◽  
Objective Evidence ◽  
The Impact

Purpose This study aims to establish a correlation between a patient’s mini mental state examination (MMSE) score and their ability to remember how to use common assistive dressing devices. Design/methodology/approach The study was a prospective, cross-sectional and correlational study. A final sample of 63 patients formed the study. Patients’ cognition was measured using the MMSE, and a new assessment tool was developed to assess patients’ ability to use three assistive devices and piloted on 15 patients to address normality, reliability, validity and clinical usefulness. Pearson’s rank correlation coefficient was used to establish direct correlations between the MMSE score and the assessment tool score. Eta squared was used to calculate the effect size to achieve an indication of the difference between the groups. Ethical approval had been granted by the regional ethics committee. The null hypothesis states that patients with an MMSE score of 22 or less show no difference in their ability to safely and appropriately use assistive devices provided and demonstrated by an occupational therapist than patients with an MMSE score of 23 or higher. Findings The null hypothesis was rejected and patients with an MMSE score of 22 or less showed a significant difficulty in their ability to use the three devices. Correlation coefficients showed significant positive correlations between MMSE scores and assistive devices scoring tool results for all three devices: Helping hand (r = 6.677, n = 60, p = 0.01), shoe horn (r = 0.649, n = 54, p = 0.01) and sock aid (r = 0.877, n = 54, p = 0.01). Originality/value The study is in an Irish context and demonstrated primary, objective evidence of the impact of impaired cognition on functional ability. Patients with cognitive deficits pose a larger safety challenge but still should be afforded an opportunity to use and benefit from assistive devices. The assessment tool is a new and unique instrument and although requires further development, may conceivably act not just as an assessment instrument but also an effective treatment tool.

scholarly journals Development and validation of the Vietnamese Primary Care Assessment Tool – provider version

2019 ◽  
Vol 20 ◽  
Author(s):  
Nguyen Thi Hoa ◽  
Anselme Derese ◽  
Jeffrey F. Markuns ◽  
Nguyen Minha Tam ◽  
Wim Peersman
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Internal Consistency ◽  
Assessment Tool ◽  
Care Quality ◽  
Quality Of Primary Care ◽  
Care Assessment ◽  
The Impact ◽  
Primary Care Assessment Tool

Abstract Aim: To adapt the provider version of the Primary Care Assessment Tool (PCAT) for Vietnam and determine its internal consistency and validity. Background: There is a growing need to measure and explore the impact of various characteristics of health care systems on the quality of primary care. It would provide the best evidence for policy makers if these evaluations come from both the demand and supply sides of the health care sector. Comparatively more researchers have studied primary care quality from the consumer perspective than from the provider’s perspective. This study aims at the latter. Method: Our study translated and adapted the PCAT provider version (PCAT PE) into a Vietnamese version, after which a cross-sectional survey was conducted to examine the feasibility, internal consistency and validity of the Vietnamese PCAT provider version (VN PCAT PE). All general doctors working at 152 commune health centres in Thua Thien Hue province had been selected to participate in the survey. Findings: The VN PCAT PE is an instrument for evaluation of primary care in Vietnam with 116 items comprising six scales representing four core primary care domains, and three additional scales representing three derivative domains. From the translation and cultural adaptation stage, two items were combined, two items were removed and one item was added. Six other items were excluded due to problems in item-total correlations. All items have a low non-response or ‘don’t know/don’t remember’ response rate, and there were no floor or ceiling effects. All scales had a Cronbach’s alpha above 0.80, except for the Coordination scale, which still was above the minimum level of 0.70. Conclusion: The VN PCAT PE demonstrates adequate internal consistency and validity to be used as an effective tool for measuring the quality of primary care in Vietnam from the provider perspective.

Differential Effect of Recurrent Concussions on Symptom Clusters in Sport Concussion Assessment Tool

2019 ◽  
Vol 28 (7) ◽  
pp. 735-739
Author(s):  
Jian Chen ◽  
Bruce Oddson ◽  
Heather C. Gilbert
Keyword(s):  
Assessment Tool ◽  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Symptom Clusters ◽  
Cross Sectional ◽  
Sport Concussion ◽  
Comprehensive Survey ◽  
Using Data ◽  
Composite Scores ◽  
The Impact

Context: Symptom checklist in Sport Concussion Assessment Tool has been widely used in preseason assessment and in concussion diagnosis, but the impact of prior concussions on the graded symptoms after a new concussion has not been evaluated. Objective: This study was undertaken to examine reported symptoms associated with recurrent concussions using data of a comprehensive survey among athletes. Design: Retrospective survey and cross-sectional study. Setting: College athletes. Participants: Student athletes who sustained one or more concussions. Main Outcome Measures: Concussion history and graded symptoms of the most recent concussion at time of the survey were surveyed. The impact of prior concussions was examined over symptoms and aggregated symptoms. Results: Multiple concussions were associated with greater reporting of individual symptoms related to emotion and physical symptoms of sensitivity to light and noise: more emotional (z = 2.3, P = .02); sadness (z = 2.4, P = .02); nervousness (z = 2.4, P = .02); irritability (z = 3.6, P = .01); sensitivity to light (z = 2.6, P = .01); and sensitivity to noise (z = 2.4, P = .04). The composite scores of emotional symptom and sensitivity symptom clusters were significantly higher: t = 2.68 (P < .01) and t = 3.35 (P < .01), respectively. Conclusions: The significant rises in emotional and sensitivity symptoms may be an important additive effect of concussive injury. Closer attention should be given to these symptom clusters when evaluating concussion injury and recovery.

PP26  Knowledge, attitudes and practices of UK paramedics regarding pharmacology and the legal, management and administration aspects of medicines: a cross-sectional online quantitative survey

2020 ◽  
Vol 37 (10) ◽  
pp. e12.2-e12
Author(s):  
Samantha Laws ◽  
Mary Halter ◽  
Chao Wang
Keyword(s):  
Online Survey ◽  
Care Quality ◽  
Further Education ◽  
Medicines Management ◽  
Cross Sectional Survey ◽  
Perceived Knowledge ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
The Impact ◽  
Knowledge Attitudes And Practices

BackgroundChanges in the paramedic profession have seen an increased range of medicines available within UK ambulances services. However, poor practice in medicines management has been identified by the Care Quality Commission. Literature in this area is sparse. This study aimed to determine the perceived knowledge, attitudes and practices of paramedics regarding pharmacology and the legal and regulatory issues of medicines management and administration.MethodsThe study utilised a cross-sectional survey design, administering an anonymous online survey to all (approximately 1000) paramedics within one UK NHS ambulance trust. The survey focused on paramedic knowledge on pharmacology, legal supply and administration; self-assessment of knowledge and confidence related to medicine management and administration; and personal characteristics. The primary outcome was percentage of (pre-determined) correct answers.Results251 responses were received. The mean percentage of correct answers was 79.0% (SD 10.0), with variation by question observed, from 34.7 to 97.2% correct responses. A higher correct knowledge was associated with: higher self-rated confidence, lower self-reported knowledge, being less likely to report errors and higher education-based initial route into the paramedic profession.ConclusionThis single-site UK-based survey highlighted variation in medicines knowledge amongst self-selecting paramedic respondents. The results indicate a need for medicines-specific further education for all paramedics, particularly those who have not experienced longer formal education entry routes, integrating a focus on confidence and self-perceived knowledge, and enhancing and embedding integrated improvement strategies. Further research is required with larger, multi-site samples, and to evaluate the impact of education packages developed.

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