scholarly journals Reduction of inappropriate prescriptions in older adults through the support of Asynchronous Geriatric Counseling Online (AGAlink): Implemented in primary care

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258414
Author(s):  
Annia Marisol Avalos-Mejia ◽  
Juan Carlos García-Cruz ◽  
Jorge Escobedo de la Peña ◽  
Osvaldo Garrido-Acosta ◽  
Teresa Juárez-Cedillo
Keyword(s):  
Therapeutic Option ◽  
Geriatric Medicine ◽  
Daily Practice ◽  
The Elderly ◽  
Relevant Information ◽  
Level Of Care ◽  
Process Of Care ◽  
Family Doctors ◽  
Medication Prescription ◽  
Positive Effects

Background/Aim Medication prescription is a fundamental component in the care of the elderly. Several characteristics of aging and geriatric medicine affect prescriptions for these people and make the selection of drug therapy a difficult and complex process. The objective of this study is to develop a geriatric portal for asynchronous online counseling (AGAlink) for use by physicians specializing in family medicine to reduce medication problems among older adult patients in the first level of care. Method A qualitative study was carried out in the first level of care at the Mexican Institute of Social Security (IMSS), 31 family doctors were interviewed to identify attitudes, preferences about the use of the AGAlink geriatric portal, as well as their recommendations for the implementation of this tool in their daily practice. For the analysis of the data obtained, a qualitative thematic content analysis was used. Results 90% of the physicians used the geriatric portal outside office hours without the need for the patient to be present. The perception of the physician towards the use of the AGAlink geriatric portal was favorable, provided relevant information and had several positive effects on the process of care for medical prescription. The barriers identified to accept the change in medication were not having the proposed therapeutic option, lack of any laboratory analysis, continuing to consider their experience for the prescription of the medication. Conclusions The AGAlink geriatric portal was a tool that was well received by physicians who expressed a positive attitude, considered an investment of a short time that allowed them to update and learn about strategies to reduce the prescription problems presented among the elderly population. However, the main barrier was the use of technology, especially in the doctors with more seniority in the service.

Effects of a Group Program to Increase Cognitive Performance Through Cognitively Stimulating Leisure Activities in Healthy Older Subjects

GeroPsych ◽  
2011 ◽  
Vol 24 (2) ◽  
pp. 83-92 ◽  
Author(s):  
Valentina A. Tesky ◽  
Christian Thiel ◽  
Winfried Banzer ◽  
Johannes Pantel
Keyword(s):  
Cognitive Function ◽  
Cognitive Performance ◽  
Older Persons ◽  
Intervention Program ◽  
Leisure Activities ◽  
The Elderly ◽  
Cognitive Stimulation ◽  
Group Program ◽  
Positive Effects ◽  
Older Subjects

To investigate the effects of leisure activities on cognitive performance of healthy older subjects, an innovative intervention program was developed. Frequent participation in cognitively stimulating activities (i.e., reading, playing chess, or playing music) is associated with reduced risk of dementia. AKTIVA (active cognitive stimulation – prevention in the elderly) is an intervention program designed to enhance cognitive stimulation in everyday life by increasing cognitive stimulating leisure activities. The present study determines the effects of AKTIVA on cognitive function, mood and attitude toward aging in a sample of older participants from the general population. Several measurement instruments were used including the Alzheimer’s Disease Assessment Scale (ADAS-Cog), the Trail-Making Test (TMT), and the Memory Complaint Questionnaire (MAC-Q). Initially, the sample consisted of 307 older persons (170 female, 72 ± 7 years). The intervention was evaluated with a randomized, controlled pre-post follow-up design. Participants were randomly assigned to one of three conditions: AKTIVA intervention (n = 126), AKTIVA intervention plus nutrition and exercise counseling (n = 84), no-intervention control group (n = 97). The AKTIVA intervention consisted of 8 weekly sessions and two booster sessions after a break of 4 months. Participation in the group program resulted in positive effects on cognitive function and attitude toward aging for subassembly groups. Older persons (≥ 75 years) showed enhanced speed of information processing (by TMT Version A) (F = 4.17*, p < .05); younger participants (< 75 years) showed an improvement in subjective memory decline (by MAC-Q) (F = 2.55*, p < .05). Additionally, AKTIVA enhanced the frequency of activities for leisure activities for subassembly groups. The results of this study suggest that the AKTIVA program can be used to increase cognitively stimulating leisure activities in the elderly. Further research is necessary to identify the long-term effects of this intervention particularly with respect to the prevention of dementia.

Infections caused by medical products at longterm nursing care

2020 ◽  
pp. 7-10
Author(s):  
Hardy Thorsten Panknin
Keyword(s):  
Nursing Care ◽  
Nursing Staff ◽  
Nosocomial Infections ◽  
The Elderly ◽  
Relevant Information ◽  
Medical Products ◽  
The Disabled ◽  
The Usa ◽  
Therapeutic Measures

Nosocomial infections in the elderly, often suffering from many ailments, patients in homes for the disabled and the old are among the problematic diseases that specialized nursing staff and doctors have to deal with more often in such institutions. Review work from the USA introduces relevant information about infectious risks, as well as possible preventive and therapeutic measures.

Intergenerational Education for the Psychological, Social and Educational Improvement of the Elderly

2019 ◽  
Vol 15 (1) ◽  
pp. 22-26
Author(s):  
Nazaret Martínez-Heredia
Keyword(s):  
Educational Level ◽  
Mixed Type ◽  
Healthy Aging ◽  
Social Role ◽  
Intergenerational Relationships ◽  
Daily Practice ◽  
The Elderly ◽  
Educational Improvement ◽  
Intergenerational Education

Introduction: Intergenerational education encourages cooperation and interaction between two or more generations through experiences, knowledge, skills, attitudes and values. Objective: The main objective of our research was to know the benefits at the psychological, social and educational level of intergenerational education. Methods: This is mixed-type research establishing relationships between young and old. The sample consists of a total of 94 people, 47 young people (aged between 21 and 40 years old) and 47 older (aged between 65 and 85 years). We promote the development of a mixed methodology to know if after the implementation of an intergenerational program we have obtained benefits in the elderly participants. Results: Considering the results we can say that the benefits at the psychological, social and educational level have been very remarkable of our elders. Conclusions: We must bet on intergenerational relationships as an ideal within our daily practice achieving a healthy aging, benefiting continuity in an active social role of our elders.

Application of mobile health to support the elderly during the COVID-19 outbreak: A systematic literature review (Preprint)

2021 ◽  
Author(s):  
Saeedeh Fehresti ◽  
Elham Monaghesh
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Mobile Health ◽  
The Elderly ◽  
Mental Health Consultation ◽  
Inclusion Criteria ◽  
Physical And Mental Health ◽  
Current Crisis ◽  
Health Service Provision ◽  
Positive Effects

BACKGROUND The COVID-19 outbreak has affected the elderly's physical and mental health. The application of information and communication technology, such as mobile health (m-health), can play a significant role in combating this pandemic by changing the behavior and lifestyle of the elderly during this time of crisis. OBJECTIVE This systematic review aimed to synthesize m-health capabilities in providing health services to the elderly during the COVID-19 pandemic, and to identify the factors associated with the success of these tools. METHODS To find the relevant studies, a search was conducted in PubMed, Web of Science, Scopus, ProQuest, and Google Scholar. The inclusion criteria were: studies in English that used m-health intervention in all aspects of elderly healthcare during the COVID-19 outbreak, published in peer-reviewed journals from 31 December 2019, and had any research design and methodology. Two authors independently took all the steps of this review, and finally performed narrative synthesis to report the findings. RESULTS Our initial search identified 421 studies, of which 10 met the inclusion criteria. The data analysis showed that all the m-health interventions had positive effects on the health of the elderly. The m-health services for the elderly during the current pandemic were used for therapy, information provision, self-help, monitoring, and mental health consultation purposes. The results also indicated that various factors affected the elderly's use of m-health tools. CONCLUSIONS The application of m-health keeps the elderly and healthcare providers safe, accelerates health service provision, reduces the costs of service delivery, and decreases the risk of morbidity and mortality during the COVID-19 outbreak. The successful use of m-health tools for the elderly in health programs during the current crisis greatly depends on supporting the elderly and overcoming the barriers.

scholarly journals Monitoring New Long-Lasting Intravitreal Formulation for Glaucoma with Vitreous Images Using Optical Coherence Tomography

Pharmaceutics ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 217
Author(s):  
Maria Jesus Rodrigo ◽  
Amaya Pérez del Palomar ◽  
Alberto Montolío ◽  
Silvia Mendez-Martinez ◽  
Manuel Subias ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Relative Intensity ◽  
Therapeutic Option ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Aggregate Size ◽  
Daily Practice ◽  
Optical Coherence ◽  
Non Invasive ◽  
Invasive Method

Intravitreal injection is the gold standard therapeutic option for posterior segment pathologies, and long-lasting release is necessary to avoid reinjections. There is no effective intravitreal treatment for glaucoma or other optic neuropathies in daily practice, nor is there a non-invasive method to monitor drug levels in the vitreous. Here we show that a glaucoma treatment combining a hypotensive and neuroprotective intravitreal formulation (IF) of brimonidine–Laponite (BRI/LAP) can be monitored non-invasively using vitreoretinal interface imaging captured with optical coherence tomography (OCT) over 24 weeks of follow-up. Qualitative and quantitative characterisation was achieved by analysing the changes in vitreous (VIT) signal intensity, expressed as a ratio of retinal pigment epithelium (RPE) intensity. Vitreous hyperreflective aggregates mixed in the vitreous and tended to settle on the retinal surface. Relative intensity and aggregate size progressively decreased over 24 weeks in treated rat eyes as the BRI/LAP IF degraded. VIT/RPE relative intensity and total aggregate area correlated with brimonidine levels measured in the eye. The OCT-derived VIT/RPE relative intensity may be a useful and objective marker for non-invasive monitoring of BRI/LAP IF.

scholarly journals Effects of Vitamin A Supplementation on Immune Responses and Correlation with Clinical Outcomes

2005 ◽  
Vol 18 (3) ◽  
pp. 446-464 ◽  
Author(s):  
Eduardo Villamor ◽  
Wafaie W. Fawzi
Keyword(s):  
Vitamin A ◽  
Clinical Outcomes ◽  
Age Groups ◽  
Lymphocyte Activation ◽  
The Elderly ◽  
Conclusive Evidence ◽  
Vitamin A Supplementation ◽  
Mortality And Morbidity ◽  
Severe Diarrhea ◽  
Positive Effects

SUMMARY Vitamin A supplementation to preschool children is known to decrease the risks of mortality and morbidity from some forms of diarrhea, measles, human immunodeficiency virus (HIV) infection, and malaria. These effects are likely to be the result of the actions of vitamin A on immunity. Some of the immunomodulatory mechanisms of vitamin A have been described in clinical trials and can be correlated with clinical outcomes of supplementation. The effects on morbidity from measles are related to enhanced antibody production and lymphocyte proliferation. Benefits for severe diarrhea could be attributable to the functions of vitamin A in sustaining the integrity of mucosal epithelia in the gut, whereas positive effects among HIV-infected children could also be related to increased T-cell lymphopoiesis. There is no conclusive evidence for a direct effect of vitamin A supplementation on cytokine production or lymphocyte activation. Under certain circumstances, vitamin A supplementation to infants has the potential to improve the antibody response to some vaccines, including tetanus and diphtheria toxoids and measles. There is limited research on the effects of vitamin A supplementation to adults and the elderly on their immune function; currently available data provide no consistent evidence for beneficial effects. Additional studies with these age groups are needed.

Mourning and Reminiscence: Parallel Psychotherapeutic Processes for Elderly People

1989 ◽  
Vol 28 (4) ◽  
pp. 239-249 ◽  
Author(s):  
Linda L. Viney ◽  
Yvonne N. Benjamin ◽  
Carol Preston
Keyword(s):  
Elderly People ◽  
The Elderly ◽  
Relevant Information ◽  
Theoretical Explanation ◽  
Personal Construct ◽  
Elderly Persons ◽  
Personal Construct Theory ◽  
Psychotherapeutic Processes ◽  
Construct Theory ◽  
The Relationship

Mourning and reminiscence are therapeutic processes common in therapeutic work with the elderly. However, a theoretical explanation of why they are effective has been lacking. Personal construct theory accounts for both in terms of the search of elderly persons for validation of their construct systems. In this article, this explanation of the parallel psychotherapeutic processes is explored, together with relevant information from the literature on mourning and reminiscence. Therapeutic case studies illustrate the characteristics of the two processes and the relationship between them.

scholarly journals Physical activity and stress coping in the elderly

2010 ◽  
Vol 8 (4) ◽  
pp. 419-422 ◽  
Author(s):  
Fernando de Andréa ◽  
Fernanda Varkala Lanuez ◽  
Adriana Nunes Machado ◽  
Wilson Jacob Filho
Keyword(s):  
Physical Activity ◽  
Exercise Program ◽  
The Elderly ◽  
Physical Activity Program ◽  
Daily Activities ◽  
Stress Coping ◽  
Coping Capacity ◽  
Positive Effects ◽  
Supervised Exercise ◽  
Activity Program

ABSTRACT Objective: To analyze the value of a physical activity program on stress coping of the elderly. Methods: Intervention study with a group of 18 elderly people referred by the Geriatric Service of the Hospital das Clinicas of the Universidade de Sao Paulo, who attended a supervised exercise program, evaluated by the human activity profile and the coping questionnaire. Results: In the coping and functional performance scales, increased stress coping capacity and improvement of daily activities were found after exposure to a physical activity program. Conclusions: The practice of supervised and regular physical activity, combining aerobic, resistance, stretching, and respiratory exercises, yields positive effects in the coping capacity and in the accomplishment of the daily activities.

scholarly journals Identification and Ranking of Core Values in Family Medicine: A Mixed Methods Study From Ukraine

2021 ◽  
Vol 8 ◽  
Author(s):  
Pavlo Kolesnyk ◽  
Sabine Bayen ◽  
Ivanna Shushman ◽  
Andrew Kolesnyk ◽  
George Kuodza ◽  
...  
Keyword(s):  
Soviet Union ◽  
Family Medicine ◽  
Low Income ◽  
Core Competencies ◽  
Daily Practice ◽  
Integrated Approach ◽  
Successful Implementation ◽  
Family Doctors ◽  
Quantitative Survey ◽  
Delphi Round

Introduction/Context: The term core value (CV) can be defined as fundamental beliefs or principles, guiding one's behavior in a social context. Though core competencies of family medicine (FM) have been clearly defined by WONCA, there has been an ongoing debate on what the CVs are for family doctors (FDs). Ukraine is a developing country in the middle of Europe with a population of 43 million inhabitants, gained independence from the Soviet Union in 1991. Ukraine is a low-income country, developing a modern European healthcare system, especially regarding FM. To implement WONCA standards, it is mandatory to assess the ongoing understanding of CVs in clinical daily practice among active FDs, working in different countries of Europe including Ukraine.Research questions: How do Ukrainian FDs (Delphi group experts) define the CVs of FM in Ukraine and how important are these CVs to a wider population of Ukrainian FDs in their everyday practice?Methods: A mixed method study was conducted in two steps during August and September 2020 in Ukraine. The first part was a qualitative Delphi round (three rounds) design among 20 Ukrainian FDs who were familiar with teaching and terms like CV. A consensus list of six CVs has emerged from the Delphi round study. The second part was a quantitative survey among Ukrainian FDs, who were not specially used to discussing CVs. The consensus list of those six CVs was then submitted to 2000 FDs (randomly selected) who were not involved in the Delphi team, to rank those values from one to nine, according to the importance from their personal point of view. Demographic characteristics have been assessed for all the participants of the Delphi round and quantitative survey.Results: Twenty FDs were involved as experts in the first Delphi round, whereas only five experts continued their participation in the second and the third rounds of the survey. The following six CVs emerged from the Delphi round: comprehensive approach, care coordination, first recourse, continuity of care, integrated approach, and patient and family centered care. The final sample consisted of 375 FDs (19% response rate). There were 323 (88.7%) female and 34 (9.3%) male FDs in the sample. The mean age of the participants was 44.6±13.5 years.Discussion/Conclusion: Defining CVs for FM by Ukrainian FDs in a given socio-economical and historical-cultural setting is crucial to optimize primary medical care and to guarantee an appropriate and successful implementation of WONCA standards as well as CVs in different countries including those where reformation of the health system is ongoing.

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