480 INFORMATION OVERKILL: IF THE WALLS ACROSS HOSPITALS WARDS COULD TALK

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
P Wijayasiri ◽  
H P Than ◽  
M Munir ◽  
O Sahota
Keyword(s):  
Older People ◽  
Older Patients ◽  
Information Needs ◽  
Hospital Management ◽  
Holistic Care ◽  
Essential Information ◽  
Information Media ◽  
Hospital Wards ◽  
Current List ◽  
A Current

Abstract Background The walls across hospital wards are cluttered with posters, which, in some places, are peeling and staining with the years. Hospital management and well intention ward users dictate these displays, however their effectiveness in delivering essential information is rarely measured. We undertook a survey to establish: a) Whether posters are effective, b) What information ward users want, c) How they want information to be delivered. Methods 100 participants (68 staff and 32 patients’ relatives) were surveyed across three 28 bedded wards for older people. They had to recall as many posters as possible then identify useful posters from a current list. They were asked about unmet information needs, other media that they would utilise and alternative uses for ward walls. Interventions were made on one ward based on initial findings: 1. An ‘Information for Relatives’ board was created, 2. A mural was installed. 20 relatives were asked to complete an anonymous form reviewing the board. Results Only 23% of participants were able to recall at least 3 posters. 34% could not find a single useful topic among the current posters. The most popular unmet information needs, among many, were ‘the discharge pathway’, ‘delirium’ and ‘falls’. Most participants said they would engage with alternative information media, suggesting leaflets, email and websites. A quarter felt walls should be for artwork, not posters. The ‘Information for Relatives’ board was well received. In the second survey, new unmet information needs were uncovered and, despite the new mural, 45% called for more paintings still. Conclusions Most people do not read the information on the walls on hospital wards. An appetite exists for alternative media. Paintings were earnestly called for at every point; a comforting ward environment should be part of the holistic care we aim to offer, especially for older patients.

Farmacogenetische tests in de Belgische zorg: (hoe) beginnen we eraan?

2021 ◽  
Author(s):  
A. DE PAUW ◽  
W. MARTINET ◽  
D. THEUNS ◽  
K. VANDEVEN ◽  
H. DE LOOF
Keyword(s):  
Drug Interactions ◽  
Information Needs ◽  
Scientific Evidence ◽  
Scientific Information ◽  
Implementation Process ◽  
Local Context ◽  
Pharmacogenetic Testing ◽  
Average Patient ◽  
Current List ◽  
A Current

Pharmacogenetic tests in Belgian care: (how) do we get started? Personalized medicine attempts to take all the information about an individual into account, and this also includes characteristics that differ from the presumed ‘average patient’. This approach includes pharmacogenetics, where the influence of genetic variation in various biomolecules on drug response is studied. By performing preemptive pharmacogenetic testing, drug therapies can be optimized, and serious side effects can be avoided. In order to implement pharmacogenetic testing in practice, some hurdles still need to be overcome. For example, scientific information needs to be translated into practical clinical guidelines that are applicable in the local context and reimbursement issues also need to be resolved. In this paper, a current list of gene-drug interactions is presented that could be prioritized during the implementation process in Belgium. The list only contains clinically relevant interactions for which there is sufficient scientific evidence. In addition, a tool is described that takes into account the drug consumption in a specific healthcare environment, to prioritize the most interesting gene-drug interactions. International implementation initiatives show that the obstacles are surmountable. It is therefore time to start a dialogue on accelerating the implementation of pharmacogenetic testing in Belgium. We hope that this prioritized list, together with a discussion of some hurdles that need to be overcome, can inform this debate.

scholarly journals Delirium: A Marker of Vulnerability in Older People

2021 ◽  
Vol 13 ◽  
Author(s):  
Giuseppe Bellelli ◽  
Justin S. Brathwaite ◽  
Paolo Mazzola
Keyword(s):  
Older People ◽  
Older Patients ◽  
Network Connectivity ◽  
Diagnostic Tools ◽  
Pathophysiological Mechanisms ◽  
Presenting Symptoms ◽  
Formidable Challenge ◽  
Increased Risk ◽  
Hospital Wards

Delirium is an acute neuropsychiatric syndrome and one of the most common presenting symptoms of acute medical illnesses in older people. Delirium can be triggered by a single cause, but in most cases, it is multifactorial as it depends on the interaction between predisposing and precipitating factors. Delirium is highly prevalent in older patients across various settings of care and correlates with an increased risk of adverse clinical outcomes. Several pathophysiological mechanisms may contribute to its onset, including neurotransmitter imbalance, neuroinflammation, altered brain metabolism, and impaired neuronal network connectivity. Several screening and diagnostic tools for delirium exist, but they are unfortunately underutilized. Additionally, the diagnosis of delirium superimposed on dementia poses a formidable challenge – especially if dementia is severe. Non-pharmacological approaches for the prevention and multidomain interventions for the treatment of delirium are recommended, given that there is currently no robust evidence of drugs that can prevent or resolve delirium. This article aims to review the current understanding about delirium in older people. To achieve this goal, we will describe the epidemiology and outcomes of the syndrome, the pathophysiological mechanisms that are supposed to be involved, the most commonly used tools for screening and diagnosis, and prevention strategies and treatments recommended. This review is intended as a brief guide for clinicians in hospital wards to improve their knowledge and practice. At the end of the article, we propose an approach to improve the quality of care provided to older patients throughout a systematic detection of delirium.

Older people's satisfaction with intermediate care: a systematic review

2007 ◽  
Vol 17 (3) ◽  
pp. 199-218 ◽  
Author(s):  
Andrew Wilson ◽  
Suzanne Richards ◽  
Janette Camosso-Stefinovic
Keyword(s):  
Systematic Review ◽  
Older People ◽  
Older Patients ◽  
Hospital Care ◽  
Patient Choice ◽  
Intermediate Care ◽  
Care Services ◽  
The Relationship

Although intermediate care takes a variety of different forms and has developed somewhat differently in different countries, we believe that intermediate-care schemes have enough in common to make it meaningful to examine the relationship between this method of care and the views of older patients receiving either it or its alternatives. This is particularly important as one of the underlying principles of intermediate care is to extend patient choice; furthermore, most intermediate-care services target older people. In this review we examine evidence about whether older people prefer intermediate or hospital care, and what they like and dislike about intermediate care.

Praktijkadvies rond de aanpak van anafylaxie bij (Covid-19-)vaccinatie bij kwetsbare ouderen (incl. e-learning)

2021 ◽  
Author(s):  
E. DUYVER ◽  
T. VAN DE VELDE ◽  
D. RAZOOQI ◽  
K. VERSLUYS ◽  
M. PETROVIC ◽  
...  
Keyword(s):  
Older People ◽  
Older Patients ◽  
Large Scale ◽  
Vaccination Campaign ◽  
Line Treatment ◽  
First Line ◽  
Practical Advice ◽  
E Learning ◽  
Treatment Education ◽  
First Line Treatment

Practical advice on the anaphylaxis policy for (COVID-19) vaccination in frail, older patients In view of the imminent start of the COVID-19 vaccination campaign, a practical advice based on the available literature on anaphylaxis in older people was drawn up for use in frail, older patients. The present practical advice provides guidance with regard to the diagnosis of anaphylaxis, the first-line treatment, education and necessary material with the purpose of making nursing homes and vaccination centres well prepared for the large-scale COVID-19 vaccination.

Why older people stop to drive? A cohort study of older patients admitted to a rehabilitation setting

2017 ◽  
Vol 30 (5) ◽  
pp. 543-546 ◽  
Author(s):  
Christian Pozzi ◽  
Elena Lucchi ◽  
Alessandro Lanzoni ◽  
Simona Gentile ◽  
Sara Morghen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Older People ◽  
Older Patients

scholarly journals Issues Associated With the Management and Governance of Sensor Data and Information to Assist Aging in Place: Focus Group Study With Health Care Professionals (Preprint)

2020 ◽  
Author(s):  
Inga Hunter ◽  
Phoebe Elers ◽  
Caroline Lockhart ◽  
Hans Guesgen ◽  
Amardeep Singh ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Information Needs ◽  
Sensor Data ◽  
Care Providers ◽  
Community Based ◽  
Age In Place

BACKGROUND Smart home and telemonitoring technologies have often been suggested to assist health care workers in supporting older people to age in place. However, there is limited research examining diverse information needs of different groups of health care workers and their access to appropriate information technologies. OBJECTIVE The aim of this study was to investigate the issues associated with using technologies that connect older people to their health care providers to support aging in place and enhance older people’s health and well-being. METHODS Seven focus group discussions were conducted comprising 44 health care professionals who provided clinic-based or in-home services to community-dwelling older people. Participants were asked about their information needs and how technology could help them support older people to age in place. The recordings of the sessions were transcribed and thematically analyzed. RESULTS The perspectives varied between the respondents who worked in primary care clinics and those who worked in community-based services. Three overarching themes were identified. The first theme was “access to technology and systems,” which examined the different levels of technology in use and the problems that various groups of health care professionals had in accessing information about their patients. Primary care professionals had access to good internal information systems but they experienced poor integration with other health care providers. The community-based teams had poor access to technology. The second theme was “collecting and sharing of information,” which focused on how technology might be used to provide them with more information about their patients. Primary care teams were interested in telemonitoring for specific clinical indicators but they wanted the information to be preprocessed. Community-based teams were more concerned about gaining information on the patients’ social environment. The third theme was that all respondents identified similar “barriers to uptake”: cost and funding issues, usability of systems by older people, and information security and privacy concerns. CONCLUSIONS The participants perceived the potential benefits of technologies, but they were concerned that the information they received should be preprocessed and integrated with current information systems and tailored to the older people’s unique and changing situations. Several management and governance issues were identified, which needed to be resolved to enable the widespread integration of these technologies into the health care system. The disconnected nature of the current information architecture means that there is no clear way for sensor data from telemonitoring and smart home devices to be integrated with other patient information. Furthermore, cost, privacy, security, and usability barriers also need to be resolved. This study highlights the importance and the complexity of management and governance of systems to collect and disseminate such information. Further research into the requirements of all stakeholder groups and how the information can be processed and disseminated is required.

scholarly journals The First-Class, the Familiar and the Forgettable: An analysis of Prime Ministerial performance in New Zealand

2021 ◽  
Author(s):  
◽  
Katherine Smith
Keyword(s):  
New Zealand ◽  
Political Leadership ◽  
The United States ◽  
Public Perceptions ◽  
Prime Ministers ◽  
Political Performance ◽  
Professional Interest ◽  
And Performance ◽  
Current List ◽  
A Current

<p>Within the literature associated with political leadership, scholarship directly focused upon political performance in office is thinly conducted, both in New Zealand and in other areas across the world. This thesis aims to greater understand political leadership and performance in New Zealand, and address the gaps in the literature correlated with Prime Ministerial performance. To do this, this thesis provides a current list of rankings of former Premiers and Prime Ministers in New Zealand and identifies the dimensions that one must fulfil to display exceptional performance in office. To undertake this research, this thesis uses a series of surveys – distributed to students at Victoria University of Wellington, and to other individuals with a professional interest in politics and history in New Zealand – to best assess public perceptions towards political performance. Building upon the path dependency created by former exercises of the same nature in New Zealand (conducted by Simon Sheppard in 1998, and by Jon Johansson and Stephen Levine in 2011), this thesis provides a snapshot of the current public perceptions of outstanding political performance. In a similar nature to the earlier studies, this thesis identifies the dimensions of longevity, death in office, and being a ‘big change’ or crisis Prime Minister as being directly correlated with elevated performance in office. Additionally, this thesis investigates whether a series of variables – namely time between exercises in New Zealand, and the appearance of a possible recency effect– provide any influence or change over results. Additionally, this thesis moves outside the scope of exercises conducted previously in New Zealand, by ranking Prime Ministerial performance using a series of different methodologies. In conjunction with a replication of the exercises already conducted in New Zealand, this survey also assesses Prime Ministerial performance by using a survey based upon the well-cited Schlesinger ranking studies in the United States, and a third survey aimed to assess political shifts and levels of knowledge and recall rates amongst university students. Regardless of such factors, the results of this thesis remain consistent with previous exercises, with Michael Savage, Richard Seddon, Helen Clark and Peter Fraser being regarded by the political and academic elite across all surveys as embodying the highest qualities of successful political leadership in New Zealand.</p>

scholarly journals Issues Associated With the Management and Governance of Sensor Data and Information to Assist Aging in Place: Focus Group Study With Health Care Professionals

10.2196/24157 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e24157
Author(s):  
Inga Hunter ◽  
Phoebe Elers ◽  
Caroline Lockhart ◽  
Hans Guesgen ◽  
Amardeep Singh ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Information Needs ◽  
Sensor Data ◽  
Care Providers ◽  
Community Based ◽  
Age In Place

Background Smart home and telemonitoring technologies have often been suggested to assist health care workers in supporting older people to age in place. However, there is limited research examining diverse information needs of different groups of health care workers and their access to appropriate information technologies. Objective The aim of this study was to investigate the issues associated with using technologies that connect older people to their health care providers to support aging in place and enhance older people’s health and well-being. Methods Seven focus group discussions were conducted comprising 44 health care professionals who provided clinic-based or in-home services to community-dwelling older people. Participants were asked about their information needs and how technology could help them support older people to age in place. The recordings of the sessions were transcribed and thematically analyzed. Results The perspectives varied between the respondents who worked in primary care clinics and those who worked in community-based services. Three overarching themes were identified. The first theme was “access to technology and systems,” which examined the different levels of technology in use and the problems that various groups of health care professionals had in accessing information about their patients. Primary care professionals had access to good internal information systems but they experienced poor integration with other health care providers. The community-based teams had poor access to technology. The second theme was “collecting and sharing of information,” which focused on how technology might be used to provide them with more information about their patients. Primary care teams were interested in telemonitoring for specific clinical indicators but they wanted the information to be preprocessed. Community-based teams were more concerned about gaining information on the patients’ social environment. The third theme was that all respondents identified similar “barriers to uptake”: cost and funding issues, usability of systems by older people, and information security and privacy concerns. Conclusions The participants perceived the potential benefits of technologies, but they were concerned that the information they received should be preprocessed and integrated with current information systems and tailored to the older people’s unique and changing situations. Several management and governance issues were identified, which needed to be resolved to enable the widespread integration of these technologies into the health care system. The disconnected nature of the current information architecture means that there is no clear way for sensor data from telemonitoring and smart home devices to be integrated with other patient information. Furthermore, cost, privacy, security, and usability barriers also need to be resolved. This study highlights the importance and the complexity of management and governance of systems to collect and disseminate such information. Further research into the requirements of all stakeholder groups and how the information can be processed and disseminated is required.

scholarly journals What happens to anxiety disorders in later life?

2002 ◽  
Vol 24 (suppl 1) ◽  
pp. 74-80 ◽  
Author(s):  
Gerard JA Byrne
Keyword(s):  
Anxiety Disorders ◽  
Older People ◽  
Older Patients ◽  
Depressive Disorders ◽  
Late Onset ◽  
Reliability And Validity ◽  
Later Life ◽  
Pharmacological Interventions ◽  
Measuring Change ◽  
Pathological Anxiety

Anxiety disorders decline in prevalence with advancing age but remain more common than depressive disorders. They are often of late-onset and there is frequent comorbidity with depressive disorders and physical illness. While anxiety disorders in older people are likely to respond to the same non-pharmacological interventions that have been shown to work in younger people, there is currently little formal evidence of this. Although there is some evidence that the non-benzodiazepine anxiolytic medication, buspirone, is effective against late life anxiety symptoms, clinical trials in older people with rigorously diagnosed anxiety disorders are needed. An anxiety scale with demonstrated reliability and validity in older people is needed for screening for pathological anxiety and for measuring change in older patients undergoing treatment for anxiety disorders.

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