scholarly journals 102 - IPA Guidelines on Dementia and Agitation: From Provisional to Final

2021 ◽  
Vol 33 (S1) ◽  
pp. 3-3
Author(s):  
Jeffrey Cummings ◽  
Mary Sano ◽  
Jacobo Mintzer ◽  
Paul Rosenberg ◽  
Michael Splaine
Keyword(s):  
Hospice Care ◽  
Cognitive Disorders ◽  
Hospital Emergency ◽  
Special Circumstance ◽  
Consensus Definition ◽  
New Findings ◽  
Definition Of ◽  
Special Circumstances ◽  
Hospital Emergency Departments

Agitation is common across neuropsychiatric disorders and contributes to disability, institutionalization, and diminished quality of life for patients and their caregivers. In 2015 IPA convened a transparent process to build a consensus definition of agitation and agreement on what elements should be included in the syndrome that resulted in publication of provisional guidelines. (Cummings et al, 2015) In the 2020-2021 year, the two co-chairs of this symposium have led a new workgroup to make the provisional consensus definition of agitation in patients with cognitive disorders that can be applied in epidemiologic, non-interventional clinical, pharmacologic, non-pharmacologic interventional, and neurobiological studies and guide treatment final.Co-Chairs will discuss methods used in updating and findings and compare changes made to the provisional guidelines. Dr. Sano will present new findings on the biological basis of agitation in dementia and Dr. Mintzer will present on application of guidelines in the special circumstances of persons in palliative and hospice care. Dr. Rosenberg will discuss the special circumstance of agitation care in hospital emergency departments. Mr. Splaine will present findings about the utilization of the 2015 guidelines in the peer reviewed literature, professional and government dementia care guidance, and clinical trials.Cummings, J., Mintzer, J., Brodaty, H., Sano, M., Banerjee, S., Devanand, D., … Zhong, K. (2015). Agitation in cognitive disorders: International Psychogeriatric Association provisional consensus clinical and research definition. International Psychogeriatrics, 27(1), 7-17. doi:10.1017/S1041610214001963

Functional regression-based monitoring of quality of service in hospital emergency departments

2019 ◽  
Vol 51 (9) ◽  
pp. 1012-1024
Author(s):  
Devashish Das ◽  
Kalyan S. Pasupathy ◽  
Curtis B. Storlie ◽  
Mustafa Y. Sir
Keyword(s):  
Quality Of Service ◽  
Emergency Departments ◽  
Functional Regression ◽  
Hospital Emergency ◽  
Hospital Emergency Departments

scholarly journals Geographical data for the definition of theoretical STEMI patient base for hospital emergency departments in the Lazio region, Italy

2014 ◽  
Vol 14 (S2) ◽  
Author(s):  
Francesca Mataloni ◽  
Mariangela D’Ovidio ◽  
Mirko Di Martino ◽  
Paolo Sciattella ◽  
Marina Davoli ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Stemi Patient ◽  
Hospital Emergency ◽  
Lazio Region ◽  
Geographical Data ◽  
Definition Of ◽  
Hospital Emergency Departments

scholarly journals PREDICTORS OF PRESSURE ULCER DEVELOPMENT AMONG SENIORS DURING EMERGENCY TRANSFERS TO HOSPITAL EMERGENCY DEPARTMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S449-S449
Author(s):  
Colin Reid ◽  
Hannah Jiwani ◽  
Kaitlyn C Tate ◽  
Greta G Cummings
Keyword(s):  
Pressure Ulcer ◽  
Binary Logistic Regression ◽  
Skin Wounds ◽  
Hospital Emergency ◽  
Term Care ◽  
Pressure Ulcer Development ◽  
Canadian Provinces ◽  
Transition Times ◽  
Hospital Emergency Departments

Abstract Emergency transfers of seniors in long-term care facilities (LTCF) aged >65 to hospital emergency departments (ED) are common and carry with them risks that can lead to less-than-optimal quality of care and quality of life. Pressure ulcers are one such risk. We used data from the Older Persons Transitions in Care (OPTIC; N=637) study, conducted in two Canadian provinces in 2011 and 2012, to assess potential predictors of pressure ulcer development between the time that a resident is transported to the ED until the time they return to their original nursing home. Step-wise binary logistic regression was employed to identify predictors of pressure ulcer development during the transition. Potential predictors included length of transition, inpatient status, demographic, health variables (including incontinence). Among the 335 residents for whom we were able to gather new pressure ulcer data, 56 (16.7%) were identified as having developed new skin wounds upon return to the LTCF. Transitions from ED admission to return to LTCF averaged 106.7 hours (sd=143.6) with a median of 50.0 hours. Length of transition and whether the resident spent time as an inpatient emerged as the only predictors: longer transition times and spending time as an inpatient predict development of bed sores. These results speak to the need for improved monitoring and treatment of skin wounds during emergency transitions of older adults from LTCF.

scholarly journals Agitation in cognitive disorders: International Psychogeriatric Association provisional consensus clinical and research definition

2014 ◽  
Vol 27 (1) ◽  
pp. 7-17 ◽  
Author(s):  
Jeffrey Cummings ◽  
Jacobo Mintzer ◽  
Henry Brodaty ◽  
Mary Sano ◽  
Sube Banerjee ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Work Group ◽  
Cognitive Disorders ◽  
Development Programs ◽  
Consensus Definition ◽  
Face To Face ◽  
Dementia Syndrome ◽  
Widespread Agreement ◽  
Definition Of ◽  
Strongly Agree

ABSTRACTBackground:Agitation is common across neuropsychiatric disorders and contributes to disability, institutionalization, and diminished quality of life for patients and their caregivers. There is no consensus definition of agitation and no widespread agreement on what elements should be included in the syndrome. The International Psychogeriatric Association formed an Agitation Definition Work Group (ADWG) to develop a provisional consensus definition of agitation in patients with cognitive disorders that can be applied in epidemiologic, non-interventional clinical, pharmacologic, non-pharmacologic interventional, and neurobiological studies. A consensus definition will facilitate communication and cross-study comparison and may have regulatory applications in drug development programs.Methods:The ADWG developed a transparent process using a combination of electronic, face-to-face, and survey-based strategies to develop a consensus based on agreement of a majority of participants. Nine-hundred twenty-eight respondents participated in the different phases of the process.Results:Agitation was defined broadly as: (1) occurring in patients with a cognitive impairment or dementia syndrome; (2) exhibiting behavior consistent with emotional distress; (3) manifesting excessive motor activity, verbal aggression, or physical aggression; and (4) evidencing behaviors that cause excess disability and are not solely attributable to another disorder (psychiatric, medical, or substance-related). A majority of the respondents rated all surveyed elements of the definition as “strongly agree” or “somewhat agree” (68–88% across elements). A majority of the respondents agreed that the definition is appropriate for clinical and research applications.Conclusions:A provisional consensus definition of agitation has been developed. This definition can be used to advance interventional and non-interventional research of agitation in patients with cognitive impairment.

scholarly journals A critical review of the definition of ‘wellbeing’ for doctors and their patients in a post Covid-19 era

2021 ◽  
pp. 002076402110322
Author(s):  
Gemma Simons ◽  
David S Baldwin
Keyword(s):  
Operational Definition ◽  
Full Potential ◽  
International Consensus ◽  
Consensus Definition ◽  
Global Challenges ◽  
The World ◽  
The Face ◽  
Positive Feelings ◽  
Definition Of

Background: There is no international consensus definition of ‘wellbeing’. This has led to wellbeing being captured in many different ways. Aims: To construct an inclusive, global operational definition of wellbeing. Methods: The differences between wellbeing components and determinants and the terms used interchangeably with wellbeing, such as health, are considered from the perspective of a doctor. The philosophies underpinning wellbeing and modern wellbeing research theories are discussed in terms of their appropriateness in an inclusive definition. Results: An operational definition is proposed that is not limited to doctors, but universal, and inclusive: ‘Wellbeing is a state of positive feelings and meeting full potential in the world. It can be measured subjectively and objectively, using a salutogenic approach’. Conclusions: This operational definition allows the differentiation of wellbeing from terms such as quality of life and emphasises that in the face of global challenges people should still consider wellbeing as more than the absence of pathology.

scholarly journals Remission in schizophrenia: validity, frequency, predictors, and patients' perspective 5 years later

2010 ◽  
Vol 12 (3) ◽  
pp. 393-407 ◽  
Keyword(s):  
Quality Of Life ◽  
Significant Proportion ◽  
Future Research ◽  
Consensus Definition ◽  
Remission Criteria ◽  
Adequate Quality ◽  
Symptomatic Remission ◽  
Operational Criteria ◽  
Definition Of

In March 2005, the Remission in Schizophrenia Working Group (RSWG) proposed a consensus definition of symptomatic remission in schizophrenia and developed specific operational criteria for its assessment. They pointed out, however, that the validity and the relationship to other outcome dimensions required further examination. This article reviews studies on the validity, frequency, and predictors of symptomatic remission in schizophrenia and studies on patients' perspectives. These studies have demonstrated that the RSWG remission criteria appear achievable and sustainable for a significant proportion of patients, and are related to a better overall symptomatic status and functional outcome and, to a less clear extent, to a better quality of life and cognitive performance. However, achieving symptomatic remission is not automatically concurrent with an adequate status in other outcome dimensions. The results of the present review suggest that the RSWG remission criteria are valid and useful. As such, they should be consistently applied in clinical trials. However the lack of consensus definitions of functional remission and adequate quality of life hampers research on their predictive validity on these outcome dimensions. Future research should therefore search for criteria of these dimensions and test whether the RSWG remission criteria consistently predict a "good" outcome with respect to functioning and quality of life.

Palliative care and quality of life for people with dementia: medical and psychosocial interventions

2015 ◽  
Vol 27 (10) ◽  
pp. 1623-1634 ◽  
Author(s):  
Ladislav Volicer ◽  
Joyce Simard
Keyword(s):  
Palliative Care ◽  
Hospice Care ◽  
Psychosocial Interventions ◽  
Course Of Illness ◽  
Medical Interventions ◽  
People With Dementia ◽  
Dementing Illness ◽  
Definition Of ◽  
Severity Of Dementia

ABSTRACTBackground:Despite mounting evidence that principles of palliative care are appropriate in care for individuals with dementia they are often not applied. As a result, patients with dementia are often exposed to burdensome interventions that have little or no benefit and are not provided with psychosocial treatments.Methods:Recommendations for applying palliative care principles in caring for people with dementia are provided, based on the WHO definition of palliative care, our clinical experience and some key literature reports.Results:People with a diagnosis of an irreversible dementia such as Alzheimer's disease (AD) and their families are rarely informed that this is a terminal disease and palliative care principles are not discussed with them. They are applicable early in the course of illness when the person can still make end-of-life decisions. Palliative care can be used in conjunction with other therapies and services, such as hospice care that provide relief from pain and other distressing symptoms. The care should include keeping people with dementia involved in meaningful activities which decrease or eliminate behavioral symptoms of dementia.Conclusions:Educating families and professionals about palliative care is important as many professionals and non-professionals believe that this approach intends to hasten death, instead of affirming life and regarding dying as a normal process. Living, not just existing, with a dementing illness involves encouraging the person to continue to be involved in meaningful activities. Medical interventions should be compatible with goals of care and balance benefits and burdens for each intervention taking into consideration severity of dementia.

scholarly journals Real-time tracking and documentation in trauma management

2019 ◽  
Vol 26 (1) ◽  
pp. 328-341 ◽  
Author(s):  
Sara Montagna ◽  
Angelo Croatti ◽  
Alessandro Ricci ◽  
Vanni Agnoletti ◽  
Vittorio Albarello ◽  
...  
Keyword(s):  
Care Hospital ◽  
Trauma Management ◽  
Trauma Resuscitation ◽  
Hospital Emergency ◽  
Quality Of Trauma Care ◽  
Computer Based ◽  
Real Time Tracking ◽  
Paper Documentation ◽  
Hospital Emergency Departments

In trauma resuscitation, an accurate documentation is crucial to improve the quality of trauma care. Hospital emergency departments typically adopt handwritten paper records and flow sheets for acquiring data, which are often inaccurate. In this article, we describe TraumaTracker, a computer-based system for trauma tracking and documentation. Results demonstrate that completeness and accuracy of trauma documentation significantly improved using TraumaTracker, since it enables to add data and information that were not recorded in paper documentation – especially precise times and locations of events.

scholarly journals Evaluation of the Levels and Quality of Microbial Contamination in Medical Emergency Departments in Comparison to Other Workplaces

2016 ◽  
Vol 65 (4) ◽  
pp. 465-469
Author(s):  
Agata Bielawska-Drózd ◽  
Bożena Wlizło-Skowronek ◽  
Piotr Cieślik ◽  
Izabela Winnicka ◽  
Ewa Skopińska-Różewska ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Pathogenic Bacteria ◽  
Microbial Contamination ◽  
Sampling Method ◽  
Medical Emergency ◽  
Ward Staff ◽  
Hospital Emergency ◽  
Emergency Ward ◽  
Hospital Emergency Departments

Work in Hospital Emergency Departments (HEDs) exposes both the emergency ward staff and patients to infectious and in other way harmful biological agents. The results of this study shows the presence of pathogenic bacteria isolated by three different methods. It revealed 9.8% of pathogens detected by imprint method, 10.5% of pathogens by swabbing method, 17.6% and 22% in HEDs corridors and rooms, respectively, by air sampling method. In control workplaces (offices) pathogenic bacteria reached the level of 6.5% and 14.7% by imprint method and swabbing, respectively. The relatively low level of contamination by bacteria in HEDs may depend on the effectiveness of Standard Protective Precautions in the studied hospitals.

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