scholarly journals 112 A Critical Evaluation of the VIP Tool in Identifying Frailty in the Older Adult in a Kerry Hospital

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Amanda Brolly ◽  
Liza Bergin ◽  
Paudie McQuinn ◽  
Shinann Buckley O’Sullivan ◽  
Corina Naughton
Keyword(s):  
Older Adult ◽  
Screening Tool ◽  
Critical Evaluation ◽  
Implementation Process ◽  
Adverse Health Outcomes ◽  
Increased Risk ◽  
Acute Confusion ◽  
Reduced Mobility ◽  
Therapy Team ◽  
Selection Of

Abstract Background The Variable Indicative of Placement risk (VIP) is a tool that was developed in Belgium to identify older people at risk of adverse health outcomes at the time of hospital admission (Vandewoude et al 2008). VIP is a simple 3-item screening tool for the selection of hospitalized patients aged 70 and older who are at increased risk of problems at discharge. It asks three simple questions about frailty factors already existing before admission. This tool has been validated to select patients who would benefit from a geriatric assessment (Vandewoude et al 2008). As part of the implementation process, it is important to critically review VIP as a frailty screening and selection tool for the Frailty Intervention Therapy Team (FITT) service compared to age criteria alone. There is a risk that patients screening negative on VIP could be inappropriately excluded from the FITT review. Methods All patients over 75 were screened using the VIP tool over a 6 week period by nursing staff in triage The “Think Frail” tool was also used to screen all patients reviewed by FITT- both positive & negative VIP Data was retrospectively gathered and VIP positive/negative patients reviewed by FITT were analysed Results 55% were VIP positive 45% were VIP negative 16.5% of VIP negative patients were screened positive for frailty using the “Think Frail” tool We found VIP under-recognised patients presenting with reduced mobility (5.5%, n=20), acute confusion (2.7%, n=10) and polypharmacy (8.1%, n=29), all potentially modifiable frailty Conclusion The VIP tool is not sensitive to identifying the presence of pre-frailty markers including falls, polypharmacy and acute confusion. Further research is needed into the use of the VIP tool in Ireland. It is recommended that this tool is not used independently to identify frailty in the ED.

scholarly journals ‘I AM NOT A MONSTER': THE LINGUISTIC STIGMA OF BORDERLINE PERSONALITY DISORDER.

2021 ◽  
Author(s):  
Kaja Widuch ◽  
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Public Involvement ◽  
Borderline Personality ◽  
Increased Risk ◽  
Social Media Platforms ◽  
User Friendly ◽  
Chronic Suicidality ◽  
Therapy Team ◽  
Selection Of

"Borderline Personality Disorder is arguably the most distressing disorder amongst the DSM diagnoses for all involved. Although psychiatric labelling can be validating it is often stigmatising. Due to the nature of BPD, people living with the disorder (PBPD) tend to be marginalized and discriminated against. A quick and random review of the World Wide Web (including a selection of popular social media platforms) reveals a common linguistic theme in describing BPD. PBPD are ‘toxic’, ‘difficult’ and ‘manipulative. Other labels, more diagnostically - oriented see PBPD as the ‘PDs’ or ‘the borderlines’. These also carry negative connotations of the inner and outer groups - ‘us’ vs ‘them’. Given the nature of the labels, recovery for PBPD is often dubious. One might think - ‘I am a monster anyway’, a classic example of cognitive dissonance. The language used in clinical practice as well as out of it is a powerful weapon. Some might poetically describe BPD as a lethal cocktail of blended psychopathologies with the ingredients including chronic suicidality, abandonment and intermittent lucidity to name a few. Of note, externalising such pathologies in an adaptive way is almost a fantasy for the therapy team. A more user friendly descriptive diagnosis is ‘difficulty in emotion regulation’. However, probably the most accurate ‘label’ of BPD for PBPD is ‘living in acute pain’. The current climate and the uncertainty surrounded the ongoing COVID-19 pandemic has meant a significantly increased risk not only in symptoms remission but also in the increase in cyber-bullying and suicidality rate. The pandemic has also put a halt to the Participant and Public Involvement in the evidence based practice. Linguistic shift in reducing stigma is essential and of immediate need."

Detection of Older People at Increased Risk of Adverse Health Outcomes After an Emergency Visit: The ISAR Screening Tool

1999 ◽  
Vol 47 (10) ◽  
pp. 1229-1237 ◽  
Author(s):  
Jane McCusker ◽  
Francois Bellavance ◽  
Sylvie Cardin ◽  
Sylvain Trepanier ◽  
Josee Verdon ◽  
...  
Keyword(s):  
Older People ◽  
Health Outcomes ◽  
Screening Tool ◽  
Emergency Visit ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Increased Risk

scholarly journals Age is just a number: Is frailty being ignored in vascular access planning for dialysis?

2021 ◽  
pp. 112972982198990
Author(s):  
Kulli Kuningas ◽  
Nicholas Inston
Keyword(s):  
Decision Making ◽  
Kidney Disease ◽  
Vascular Access ◽  
Clinical Condition ◽  
The Elderly ◽  
Dialysis Access ◽  
Adverse Health Outcomes ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
First Choice

Current international guidelines advocate fistula creation as first choice for vascular access in haemodialysis patients, however, there have been suggestions that in certain groups of patients, in particular the elderly, a more tailored approach is needed. The prevalence of more senior individuals receiving renal replacement therapy has increased in recent years and therefore including patient age in decision making regarding choice of vascular access for dialysis has gained more relevance. However, it seems that age is being used as a surrogate for overall clinical condition and it can be proposed that frailty may be a better basis to considering when advising and counselling patients with regard to vascular access for dialysis. Frailty is a clinical condition in which the person is in a vulnerable state with reduced functional capacity and has a higher risk of adverse health outcomes when exposed to stress inducing events. Prevalence of frailty increases with age and has been associated with an increased risk of mortality, hospitalisation, disability and falls. Chronic kidney disease is associated with premature ageing and therefore patients with kidney disease are prone to be frailer irrespective of age and the risk increases further with declining kidney function. Limited data exists on the relationship between frailty and vascular access, but it appears that frailty may have an association with poorer outcomes from vascular access. However, further research is warranted. Due to complexity in decision making in dialysis access, frailty assessment could be a key element in providing patient-centred approach in planning and maintaining vascular access for dialysis.

scholarly journals Genomic Analysis, Progress and Future Perspectives in Dairy Cattle Selection: A Review

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 599
Author(s):  
Miguel A. Gutierrez-Reinoso ◽  
Pedro M. Aponte ◽  
Manuel Garcia-Herreros
Keyword(s):  
Dairy Cattle ◽  
Production Efficiency ◽  
Association Studies ◽  
Phenotypic Traits ◽  
Progeny Testing ◽  
Genome Wide Association Studies ◽  
Genetic Progress ◽  
Breeding Programs ◽  
Increased Risk ◽  
Selection Of

Genomics comprises a set of current and valuable technologies implemented as selection tools in dairy cattle commercial breeding programs. The intensive progeny testing for production and reproductive traits based on genomic breeding values (GEBVs) has been crucial to increasing dairy cattle productivity. The knowledge of key genes and haplotypes, including their regulation mechanisms, as markers for productivity traits, may improve the strategies on the present and future for dairy cattle selection. Genome-wide association studies (GWAS) such as quantitative trait loci (QTL), single nucleotide polymorphisms (SNPs), or single-step genomic best linear unbiased prediction (ssGBLUP) methods have already been included in global dairy programs for the estimation of marker-assisted selection-derived effects. The increase in genetic progress based on genomic predicting accuracy has also contributed to the understanding of genetic effects in dairy cattle offspring. However, the crossing within inbred-lines critically increased homozygosis with accumulated negative effects of inbreeding like a decline in reproductive performance. Thus, inaccurate-biased estimations based on empirical-conventional models of dairy production systems face an increased risk of providing suboptimal results derived from errors in the selection of candidates of high genetic merit-based just on low-heritability phenotypic traits. This extends the generation intervals and increases costs due to the significant reduction of genetic gains. The remarkable progress of genomic prediction increases the accurate selection of superior candidates. The scope of the present review is to summarize and discuss the advances and challenges of genomic tools for dairy cattle selection for optimizing breeding programs and controlling negative inbreeding depression effects on productivity and consequently, achieving economic-effective advances in food production efficiency. Particular attention is given to the potential genomic selection-derived results to facilitate precision management on modern dairy farms, including an overview of novel genome editing methodologies as perspectives toward the future.

scholarly journals A Multidisciplinary Perspective of Ultra-Processed Foods and Associated Food Processing Technologies: A View of the Sustainable Road Ahead

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3948
Author(s):  
Francesco Capozzi ◽  
Faidon Magkos ◽  
Fabio Fava ◽  
Gregorio Paolo Milani ◽  
Carlo Agostoni ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Food Processing ◽  
Low Cost ◽  
Classification Systems ◽  
Processed Foods ◽  
Processing Technologies ◽  
Adverse Health Outcomes ◽  
Increased Risk ◽  
Multidisciplinary Perspective ◽  
By Products

Ultra-processed foods (UPFs) are negatively perceived by part of the scientific community, the public, and policymakers alike, to the extent they are sometimes referred to as not “real food”. Many observational surveys have linked consumption of UPFs to adverse health outcomes. This narrative synthesis and scientific reappraisal of available evidence aims to: (i) critically evaluate UPF-related scientific literature on diet and disease and identify possible research gaps or biases in the interpretation of data; (ii) emphasize the innovative potential of various processing technologies that can lead to modifications of the food matrix with beneficial health effects; (iii) highlight the possible links between processing, sustainability and circular economy through the valorisation of by-products; and (iv) delineate the conceptual parameters of new paradigms in food evaluation and classification systems. Although greater consumption of UPFs has been associated with obesity, unfavorable cardiometabolic risk factor profiles, and increased risk for non-communicable diseases, whether specific food processing techniques leading to ultra-processed formulations are responsible for the observed links between UPFs and various health outcomes remains elusive and far from being understood. Evolving technologies can be used in the context of sustainable valorisation of food processing by-products to create novel, low-cost UPFs with improved nutritional value and health potential. New paradigms of food evaluation and assessment should be funded and developed on several novel pillars—enginomics, signalling, and precision nutrition—taking advantage of available digital technologies and artificial intelligence. Research is needed to generate required scientific knowledge to either expand the current or create new food evaluation and classification systems, incorporating processing aspects that may have a significant impact on health and wellness, together with factors related to the personalization of foods and diets, while not neglecting recycling and sustainability aspects. The complexity and the predicted immense size of these tasks calls for open innovation mentality and a new mindset promoting multidisciplinary collaborations and partnerships between academia and industry.

Symptoms of dementia or post-traumatic stress disorder? Under-recognised behaviours in veterans with dementia

2021 ◽  
Vol 17 (4) ◽  
pp. 140-146 ◽  
Author(s):  
Deborah Hutchinson ◽  
Martin Isaacs ◽  
Lucy Chamberlain ◽  
Karen Harrison Dening
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Screening Tool ◽  
Stress Disorder ◽  
Psychological Symptoms ◽  
Poor Mental Health ◽  
Post Traumatic Stress ◽  
People With Dementia ◽  
Increased Risk ◽  
Post Traumatic

Background: The veteran community are at increased risk of poor mental health and developing dementia as a result of their miliary service, with the potential to lead to delayed onset post-traumatic stress disorder (DOPTSD). The manifestation of DOPTSD may be misinterpreted as behavioural and psychological symptoms of dementia (BPSD), which create difficulties in caring for the person experiencing these distressing symptoms. Aims: This paper details the development of a screening tool for people with dementia, which aims to reframe and contextualise some of the behaviours under the lens of historic traumatic events. Methods: The utility of the screening tool is demonstrated through the presentation and an analysis of an anonymised case study to support nurse practice development. Conclusions: A trauma history tool offers a more comprehensive and interpretive view of the possible historic, trauma-related causes of current behaviours and can aid informal carers' understanding of the stress and distress reactions of their family members.

Translation and adaption of short version of IQCODE into Hausa and its psychometric evaluation among outpatients older adults

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Tolulope Adeniji ◽  
Adetoyeje Y. Oyeyemi
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Internal Consistency ◽  
Screening Tool ◽  
Receiver Operating Curve ◽  
Cognitive Screening ◽  
Cronbach’S Alpha ◽  
Cognitive Changes ◽  
Content Type ◽  
Cronbach's Alpha

Purpose This study aims at translating and adapting a common and widely used proxy rated cognitive screening tool – Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) into Hausa language and also to evaluate the instrument’s psychometric properties. Design/methodology/approach IQCODE was translated and adapted using a qualitative process involving experts and the adapted version was then evaluated against a gold standard (Diagnostic and Statistical Manual of Mental Disorder V criteria for neurocognitive disorders) with older adults subjects (N = 100), while its reliability (internal consistency) was also evaluated. Descriptive statistics of mean and frequencies, and inferential statistic of receiver operating curve analysis and Cronbach’s alpha coefficient were used for data analysis at an alpha level set at 0.05. Findings The Hausa IQCODE has a sensitivity value of 73.3%, specificity value of 71.8% and optimal cut-off values of between 3.2 and 3.3. For his adapted instrument the area under the Curve (AUC) curve is 0.79 (95% CI: 0.663–0.919; std. err: 0.066; P = 0.000), and Cronbach’s alpha value of 0.819 was obtained indicating that the adapted instrument has good internal consistency. Research limitations/implications The adapted IQCODE is a valid and reliable proxy based cognitive screening tool for the older adult Hausa speakers in Maiduguri. However, clinician and researcher might want to consider different optimal cut-off points when using this tool to screen or to monitor cognitive changes among older adults. Originality/value This research paper translated and adapted Hausa IQCODE into Hausa language. And it gives information on the validity and reliability of the adapted tool alongside with new optimal cut-off for cognitive screening by proxy among older adult patients in Nigeria.

Recycling Oriented Fasteners: A Critical Evaluation of VDI 2243’s Selection Table

1994 ◽  
Author(s):  
Zachary VerGow ◽  
Bert Bras
Keyword(s):  
Critical Evaluation ◽  
Critical Issue ◽  
Environmentally Benign ◽  
Material Recycling ◽  
Life Cycle Design ◽  
German Standard ◽  
Product Recycling ◽  
Technical Products ◽  
Non Destructive ◽  
Selection Of

Abstract A growing concern about the environment, and especially about waste and landfill, has spurred research into the design of more environmentally benign products. A dramatic reduction in environmental impact can be made by recycling. A critical issue in recycling is the separation of joints in the disassembly process. In product recycling (also referred to as reuse) non-destructive disassembly is desired, whereas in material recycling destructive disassembly is allowed (e.g., shredding). This has an impact on the selection of fasteners. In this paper, we provide an overview of the issues involved and specifically we evaluate the selection of fasteners in the context of product recycling, material recycling, and technical aspects as documented in the new German standard VDI 2243, “Designing Technical Products for Ease of Recycling – Fundamentals and Rules for Design”. The results of this evaluation provide insight in future areas of research and fastener selection models for life cycle design.

Neurostrategy

2021 ◽  
pp. 1876-1893
Author(s):  
César Camisón
Keyword(s):  
Decision Making ◽  
Critical Evaluation ◽  
Managerial Decision ◽  
Mental Processes ◽  
Organization Studies ◽  
Managerial Decision Making ◽  
Economic Decisions ◽  
Behavioural Strategy ◽  
Problem Solving Process ◽  
Selection Of

The key premise of economics, which views people as utilitarian individuals who make completely rational economic decisions, has influenced other disciplines as Strategy. However, the developments in behavioural neuroscience have opened a major understanding of the mental processes that explain managers's behaviour and effectiveness.This article presents a review of the contributions from behavioural neuroscience to the study of managerial decision-making and offers a critical evaluation of its implications for management and organization studies, especially in the field of strategy. The paper reviews the most recent literature on neurostrategy and maps out the main strands of the debate and their implications for understanding the behaviour of strategy-makers. The study of neuronal and psicological foundations for strategy-makers behaviours and decision-making has identified the problems of the general model of the rational problem-solving process in information, perception, and selection of strategies, and how behavioural strategy can help us to identify them and prevent them.

The Neurobiology of Aggression

2013 ◽  
pp. 1103-1111
Author(s):  
R. James ◽  
R. Blair
Keyword(s):  
Decision Making ◽  
Motor Behavior ◽  
Neural Systems ◽  
Emotional Modulation ◽  
Good Decision ◽  
Norm Violations ◽  
Instrumental Aggression ◽  
Increased Risk ◽  
The Individual ◽  
Selection Of

This chapter considers the neurobiology of aggression both the neural systems mediating this behavior as well as how these systems can become perturbed such that the aggression is maladaptive to the individual. A distinction will be drawn between planned, goal directed instrumental aggression and threat/ frustration based reactive aggression. Instrumental aggression implicates the neural systems involved in instrumental motor behavior generally as well as emotional learning and decision making systems that allow the selection of one action over another. Conditions decreasing the responsiveness of neural systems allowing good decision making (amygdala, striatum, ventromedial prefrontal cortex) are associated with an increased risk for maladaptive instrumental aggression. Reactive aggression implicates sub cortical systems involved in the basic response to threat as well as cortical systems involved in emotional modulation and the response to norm violations.

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