scholarly journals Behavioral, Environmental and Pharmacotherapy Challenges in Dementia during COVID-19 Pandemic: Solutions and Management Issues

2021 ◽  
Author(s):  
Fatemeh Mohammadian ◽  
Marjan Moghadamnia ◽  
Ali Talebi ◽  
Niayesh Mohebbi
Keyword(s):  
Health Care Providers ◽  
Elderly Population ◽  
Cognitive Disorders ◽  
Behavioral Symptoms ◽  
Care Providers ◽  
Medical Centers ◽  
Dementia Patients ◽  
Age Related ◽  
Cognitive Disorders And Dementia ◽  
Management Issues

With the increase in the world's elderly population, age-related disorders such as cognitive disorders and dementia have increased in this group, and with the onset of the COVID-19 pandemic in 2019, many of the world's rules and regulations have changed, and personal protection recommendations against infection have been recommended by various medical centers, which is very challenging for patients with dementia and can even lead to the development or exacerbation of behavioral symptoms in their everyday life. On the other hand, caregivers of dementia patients are exposed to the burden of disease caused by the stress of transmitting infection along with the usual care needed for dementia patients, which has definitely increased this time during the pandemic. Therefore, caregivers of dementia patients, both at home and in care centers, need the advice to care for patients and prevent pandemic physical and psychological complications on themselves and their patients. Regarding the administration of drugs effective on COVID-19 infection and the possibility of their interaction with drugs prescribed in patients with dementia or cognitive complications, delirium, and exacerbation of dementia, there is a need for solutions that are briefly reviewed in this report. It is hoped to provide assistance and support in providing services and care to dementia patients, health care providers, and physicians.

scholarly journals Identifying and describing a model region to evaluate the impact of telemedicine

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Harst ◽  
S Oswald ◽  
P Timpel
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Focus Groups ◽  
Health Care Providers ◽  
Rural Areas ◽  
Demographic Data ◽  
Care Providers ◽  
Age Related ◽  
Model Region ◽  
The Impact

Abstract Background Telemedicine solutions providing patient-centered care over distance need to be integrated into the regional setting. The acceptance by both providers and patients hat to be continuously evaluated using methods of participatory implementation research. In controlled trials, often taking place in laboratory settings, these methods cannot be applied. In the following, research in progress is presented. Methods Based on socio-demographic data, epidemiology prevalence of age-related chronic diseases and data on the value of health care provision in Saxony, Germany a model region was chosen. Then, a focus group (n = 6) was conducted to differentiate the results and analyze the health networks of patients. For this, network maps putting the individual in the middle and his/her sources of information and support in case of illness in concentric circles around it, were used. The focus group was audiotaped, transcribed and analyzed by two researchers using MaxQDA. Results With a mean age of 47.8 years (n = 17,431), high prevalence of diabetes (>15.85 %) and hypertension (>39.1%) and an expected shortage of primary physicians in 2030, the town of Kamenz is a mirror image of the current health care challenges in rural areas of Saxony. Participants of the focus groups also stated problems in finding a primary physician or a dentist. Compensatory behavior, such as traveling large distances, relying on self-researched online diagnoses and immediately going to the emergency room for medical support was described. According to the network maps, primary sources of support in case of illness are partners and relatives, yet there is little connection between those and health care providers, as well as between different medical specialists. Conclusions The results will lead to potential use cases of telemedicine to be included into a standardized questionnaire for the assessment of telemedicine readiness in the model region. Key messages Telemedicine implementation in a rural area can be studied using a participatory approach. Focus groups and network maps are useful qualitative methods for participatory research and can inform the design of quantitative measurements.

scholarly journals Adapting to Health Change: Aging Bias, Sensitivity, and Interprofessionalism in an Aging Sensitivity Training

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 882-883
Author(s):  
Keith Kleszynski ◽  
Lee Jennings ◽  
Thomas Teasdale ◽  
Carrie Ciro ◽  
Carol Rogers ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Interprofessional Education ◽  
Vision Loss ◽  
Medication Management ◽  
Care Providers ◽  
Age Related ◽  
High Satisfaction ◽  
Small Change ◽  
Aging Attitudes ◽  
Age Related Changes

Abstract Adapting to Health Change, a 2-hour aging sensitivity simulation to increase student sensitivity to age-related changes, was delivered to 148 health professions students in March 2020. Five small group stations (hearing loss, neuropathy and dexterity, vision loss and medication management, language and cognitive impairment, and mobility and balance) were facilitated by older adult volunteers and interdisciplinary faculty. Students completed (pre-post) Aging IQ Quiz, Aging Attitudes Assessment, Inter-professional Attitudes Scale (IPAS) Teamwork, Roles, and Responsibilities and Interprofessional Biases subscales, and an overall satisfaction rating. There was a statistically significant but small change in perceived knowledge of aging (mean Aging IQ score changed -0.025 points, p = 0.03). We also found a post-training increase in negative bias (mean Aging Attitudes Assessment score changed +2.68 points, p = 0.0001). While there was no change in attitudes about interprofessional education, this wasattributed to high baseline scores, suggesting students already valued interprofessional interactions. Multiple high satisfaction scores were encouraging. Ninety-four percent agreed that the simulation increased their understanding of age-related changes, while 97% indicated facilitators provided useful insights into the experiences of aging. A high majority (89%) felt they would be better health care providers for older patients than they would have been without the experience. This exercise to increase student empathy about age-related disabilities was well received, but did not achieve the usual intended aims. Simulation content should “re-aim” beyond empathy to teach new knowledge, highlight positive aspects of aging and professional care provision, and reinforce interprofessional roles toward wellness for older adults.

Searching for lymphoma: An analysis of internet and social network activity and engagement.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18102-e18102
Author(s):  
John Patrick Galvin ◽  
Anne Catherine Meier ◽  
David J. Peace
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Health Care Providers ◽  
Network Activity ◽  
Care Providers ◽  
Daily Lives ◽  
Specific Content ◽  
Medical Centers ◽  
The Social ◽  
Analytical Research

e18102 Background: Online search engines, forums and social networks can offer an important space to ask questions and share experiences. Online searches, forums and social networks have become one of the most common ways patients learn about their lymphoma. However, not much is known about which sites and online sources engage people on the topic of lymphoma and which social networks are used to learn and/or share experiences. Methods: Our objective was to analyze the sites with the most engagement online on the topic of lymphoma. We used an online analytical research program (BuzzSumo), which can assess specific content and identify sites that generate the greatest frequency of engagement across social platforms. Our analysis covered activity from 2/2014-2/2019. Results: From the analysis of 9,141 online articles on the topic of lymphoma and 662,690 engagements, we found that the social network that was used the most was Facebook and to a much lesser extent Twitter. The Pinterest and Reddit platforms were not engaged on this topic. Most engagements were with “List” and “What you should know” articles on lymphoma for both Facebook and Twitter with a significantly lesser amount of engagement for video content. Articles on lymphoma less than 2000 words had the most engagement. A number of different types of sites generated the most engagements -- ranging from media outlets, lymphoma foundations and large medical centers. An analysis of 28,863 Facebook posts on lymphoma with 4,765,956 total engagements revealed that video posts generated the most engagements and that posts that were > 300 characters generated more engagement. An analysis of questions asked online mentioning lymphoma revealed that the most common topics were that of “diagnosis” and associated emotions – “worried” or “scared.” Conclusions: Online articles and social networks have become integrated into our daily lives. It is important that we start to understand how these information sources are being used by patients, caregivers and health care providers. Our analysis of online engagement on the topic of lymphoma is an example of how analytical programs can be used to help understand where and how people are engaging to learn and share their experiences with lymphoma.

scholarly journals A resident boot camp for reducing door-to-needle times at academic medical centers

2017 ◽  
Vol 7 (3) ◽  
pp. 237-245 ◽  
Author(s):  
Ilana M. Ruff ◽  
Ava L. Liberman ◽  
Fan Z. Caprio ◽  
Matthew B. Maas ◽  
Scott J. Mendelson ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Boot Camp ◽  
Adverse Outcomes ◽  
Care Providers ◽  
Process Measures ◽  
Medical Centers ◽  
Academic Medical ◽  
Tissue Plasminogen ◽  
Concomitant Reduction ◽  
Prospective Database

AbstractBackground:We sought to determine if a structured educational program for neurology residents can lower door-to-needle (DTN) times at an academic institution.Methods:A neurology resident educational stroke boot camp was developed and implemented in April 2013. Using a prospective database of 170 consecutive acute ischemic stroke (AIS) patients treated with IV tissue plasminogen activator (tPA) in our emergency department (ED), we evaluated the effect of the intervention on DTN times. We compared DTN times and other process measures preintervention and postintervention. p Values < 0.05 were considered significant.Results:The proportion of AIS patients treated with tPA within 60 minutes of arrival to our ED tripled from 18.1% preintervention to 61.2% postintervention (p < 0.001) with concomitant reduction in DTN time (median 79 minutes vs 58 minutes, p < 0.001). The resident-delegated task (stroke code to tPA) was reduced (75 minutes vs 44 minutes, p < 0.001), while there was no difference in ED-delegated tasks (door to stroke code [7 minutes vs 6 minutes, p = 0.631], door to CT [18 minutes in both groups, p = 0.547]). There was an increase in stroke mimics treated (6.9% vs 18.4%, p = 0.031), which did not lead to an increase in adverse outcomes.Conclusions:DTN times were reduced after the implementation of a stroke boot camp and were driven primarily by efficient resident stroke code management. Educational programs should be developed for health care providers involved in acute stroke patient care to improve rapid access to IV tPA at academic institutions.

scholarly journals The needs of Pacific families affected by age-related cognitive impairment in New Zealand: interviews with providers from health-care organisations

2021 ◽  
Vol 13 (4) ◽  
pp. 317
Author(s):  
Vanda Symon ◽  
Rosalina Richards ◽  
Pauline Norris ◽  
Talai Mapusua ◽  
Leigh Hale
Keyword(s):  
Health Care ◽  
Cognitive Impairment ◽  
New Zealand ◽  
Cognitive Decline ◽  
Health Care Providers ◽  
Service Providers ◽  
Care Providers ◽  
Access To Services ◽  
Age Related ◽  
Poor Access

ABSTRACTINTRODUCTIONPacific populations in New Zealand are aging, but little is known in the health-care environment about their experiences with cognitive impairment.AIMThe aim was to explore the needs of Pacific peoples affected by age-related cognitive decline from the perspectives of health-care providers.METHODSSix health-care service providers from organisations focused on Pacific patients were interviewed to determine services available to aged Pacific peoples, access, and whether they met Pacific people’s needs.RESULTSThree areas of concern were identified by all participants: access to services; getting a diagnosis; and communication and language. Many experienced a lack of information and poor access to services. Diagnosis of cognitive impairment was frequently made difficult by inconsistent access to general practitioners in lower socio-economic areas. Communication was hindered by poor access to information in Pacific languages.DISCUSSIONCommon themes noted by all participating health-care providers indicated the needs of aged Pacific people experiencing cognitive decline were often not being met.

scholarly journals Frailty in Preclinical Models: Impact of Healthspan on Disease Expression Over the Life Course

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 33-33
Author(s):  
Susan Howlett
Keyword(s):  
Health Care Providers ◽  
Frailty Index ◽  
Scale Up ◽  
Care Providers ◽  
Deficit Accumulation ◽  
Adverse Health Outcomes ◽  
Frail Patients ◽  
Age Related ◽  
And Function ◽  
The Life Course

Abstract People age at different rates. This heterogeneity in aging has led to the concept of “frailty”, a state of heightened vulnerability to adverse health outcomes at any age. Frailty challenges health care providers, as frail patients are more likely than non-frail patients to experience diseases, hospitalization, and death. We showed that frailty occurs not only in humans, but also in aging rodents. It can be measured with a “frailty index” (FI) based on age-related health deficit accumulation as originally established in humans. We found that maladaptive changes in heart structure and function in late life are correlated more so with frailty than age and are closely graded by FI score, especially in male mice. Adverse effects of frailty originate at cellular/subcellular levels and scale up to organ and system levels, predisposing towards cardiovascular disease. Poor overall health, quantified with an FI, may drive maladaptive cardiac remodeling, especially in older males.

Aging, Genetic Variations, and Ethnopharmacology

2016 ◽  
Vol 28 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Diana Lynn Woods ◽  
Janet C. Mentes ◽  
Mary Cadogan ◽  
Linda R. Phillips
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Genetic Variations ◽  
Healthcare Research ◽  
Genetic Differences ◽  
Care Providers ◽  
Drug Responses ◽  
Age Related ◽  
Age Related Changes

Unique drug responses that may result in adverse events are among the ethnocultural differences described by the Agency for Healthcare Research and Quality. These differences, often attributed to a lack of adherence on the part of the older adult, may be linked to genetic variations that influence drug responses in different ethnic groups. The paucity of research coupled with a lack of knowledge among health care providers compound the problem, contributing to further disparities, especially in this era of personalized medicine and pharmacogenomics. This article examines how age-related changes and genetic differences influence variations in drug responses among older adults in unique ethnocultural groups. The article starts with an overview of age-related changes and ethnopharmacology, moves to describing genetic differences that affect drug responses, with a focus on medications commonly prescribed for older adults, and ends with application of these issues to culturally congruent health care.

scholarly journals Behavioral Factors Related to the Incidence of Frailty in Older Adults

2020 ◽  
Vol 9 (10) ◽  
pp. 3074
Author(s):  
Hiroyuki Shimada ◽  
Takehiko Doi ◽  
Kota Tsutsumimoto ◽  
Sangyoon Lee ◽  
Seongryu Bae ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care Providers ◽  
Social Activity ◽  
Cognitive Activity ◽  
Total Activity ◽  
Productive Activity ◽  
Care Providers ◽  
Behavioral Factors ◽  
Physical Frailty ◽  
Age Related

Frailty is a widely prevalent geriatric condition whereby individuals experience age-related functional declines. This study aimed to identify behavioral factors related to the incidence of frailty in older adults. Participants were 2631 older adults (average age: 71) without physical frailty at a baseline assessment in 2011–2012 who took part in a second-wave assessment in 2015–2016. Physical frailty was defined as having limitations in at least three of the following domains: weight loss, low physical activity, exhaustion, slow walking speed, and muscle weakness. Participants completed a 16-item questionnaire examining cognitive, social, and productive activity as well as instrumental activities of daily living (IADL) as varying dimensions of lifestyle activity. During the follow-up period, 172 participants (6.5%) converted from nonfrail to frail. Logistic regression showed that the odds ratios (ORs) for conversion were significantly lower in the participants who had high IADL scores (OR: 0.78; 95% confidence interval (CI): 0.64–0.96), cognitive activity (OR: 0.74; 95% CI: 0.62–0.89), social activity (OR: 0.52; 95% CI: 0.43–0.63), and total activity (OR: 0.81; 95% CI: 0.75–0.87). There was no significant association between frailty and productive activity. Health care providers should recommend an active lifestyle to prevent frailty in older adults.

scholarly journals The emerging issue of cognitive disorders and dementia among migrants

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Canevelli ◽  
E Lacorte ◽  
I Cova ◽  
S Cascini ◽  
A M Bargagli ◽  
...  
Keyword(s):  
Public Health ◽  
Population Aging ◽  
Cognitive Disorders ◽  
Population Data ◽  
Assessment Tools ◽  
Migrant Population ◽  
Age Related ◽  
Cultural Mediators ◽  
Cognitive Disorders And Dementia

Abstract Background Due to population aging, people with a migration background are (and will be) increasingly exposed to the burden of chronic, age-related diseases. Specifically, the occurrence of dementia and cognitive disorders in this population of individuals can assume special clinical and public health relevance. The ImmiDem project (GR-2016-02364975) is aimed at characterizing the emerging phenomenon of cognitive disorders in migrants in Italy. Methods The number of dementia and mild cognitive impairment (MCI) cases among migrants living in the extended European Union was calculated by applying the age- and gender-specific prevalence rates of these conditions to the population data of international migrants provided by Eurostat. A pilot survey was addressed to a representative sample of Italian centers for cognitive disorders and dementia (CCDDs) with the aim of collecting information on the number of migrants attending these services, the adopted diagnostic, and the possible barriers and resources in the provision of care. Results Nearly 700,000 cases of dementia and 680,000 cases of MCI can be estimated in the migrant population living in Europe in 2018. Nevertheless, the number of migrants referred to the surveyed CCDDs was very low and was considered as stable over the last 5 years. Most of CCDDs reported the possibility of contacting cultural mediators and/or interpreters, while only a few reported the availability and regular use of translated and/or cross-cultural cognitive assessment tools. Conclusions The data produced by the ImmiDem project allow a preliminary characterization of the emerging phenomenon of cognitive disturbances in the migrant population. The survey will be extended to all Italian dementia services (CDCD, day centers, residential structures). Activities aimed at identifying and promoting dedicated care pathways or good practices will also be conducted. Key messages The clinical and epidemiological characterization of cognitive disorders occurring in migrants represent an emerging public health matter for Western countries. The onset of dementia in migrants can result in important clinical-diagnostic and healthcare complexities.

scholarly journals An Academic Medical Center’s Learners’ Perceptions of Health Disparities

PRiMER ◽  
2018 ◽  
Vol 2 ◽  
Author(s):  
Joyce E. Balls-Berry ◽  
Eddie Greene ◽  
Jennifer McCormick ◽  
Onelis Quirindongo-Cedeno ◽  
Karen Weavers ◽  
...  
Keyword(s):  
Health Disparities ◽  
Health Care Providers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Care Providers ◽  
Unequal Treatment ◽  
Medical Centers ◽  
Academic Medical ◽  
Significant Difference ◽  
Patient Groups

Introduction: Lack of health equity ultimately leads to unequal treatment of diverse patients and contributes to the growing disparities seen in national health. Academic medical centers should consider providing health care providers and biomedical researchers training on how to identify and address health disparities. Methods: The authors led an introductory health disparities course for graduate students and research and clinical fellows at an academic medical center in the Midwest. We compared pre/postcourse assessments to determine changes in learners’ perceptions and knowledge of health disparities using an unpaired analysis to permit inclusion of responses provided only at baseline. Results: Sixty-two learners completed preassessment, with 56 completing the postassessment (90%). In the postcourse assessment, learners reported an increase in knowledge of disparities and had changes in their perceptions of health disparities linked to treatment of different patient groups based on demographic characteristics. There was a statistically significant difference in learners’ perceptions of how patients are treated based on gender identity (P=0.02) and sexual orientation (P=0.04). Conclusions: The results detail how an academic medical center can provide training on health disparities for diverse learners. This study underscores the influence of health disparities from the perspective of learners who conduct biomedical research and patient care. This course serves a model for introductory-level health disparities courses.

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