scholarly journals The Effectiveness of a Board Game-Based Oral Hygiene Education Program on Oral Hygiene Knowledge and Plaque Index of Adults with Intellectual Disability: A Pilot Study

2021 ◽  
Vol 18 (3) ◽  
pp. 946
Author(s):  
Hsiu-Yueh Liu ◽  
Ping-Ho Chen ◽  
Wun-Jyun Chen ◽  
Shan-Shan Huang ◽  
Jen-Hao Chen ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Oral Hygiene ◽  
Care Facility ◽  
Plaque Index ◽  
Board Game ◽  
Term Care ◽  
Long Term Care Facility ◽  
Post Test ◽  
Health Related ◽  
Two Stages

An oral hygiene board game was designed as an intervention tool and applied to explore the effectiveness for the oral health related knowledge (OHK) score and plaque index (PI) of adults with intellectual disability (ID). This one-group pre/post-test design study was conducted in a residential long-term care facility for 42 participants. The study had one pre-test (baseline) and three post-tests evaluated in both control and intervention stages, respectively. The participants participated in a 60-min oral hygiene board game twice a week during the intervention stage. Total OHK score and PI of the participants were recorded to determine the effectiveness of intervention. There were no differences in OHK score and PI between the two stages at baseline. The results in intervention stage demonstrated a significant gradual increase and reduction in the OHK score when compared with the control stage. A statistically significant improvement in the OHK score and PI (42.29% and −33.28%, respectively) at the end of intervention between two stages was recorded. This study proved a board game is deemed an effective education method applicable to promote the OHK and skills of ID adults.

A Semi-Markov Multiple State Model for Reverse Mortgage Terminations

2012 ◽  
Vol 6 (2) ◽  
pp. 235-257 ◽  
Author(s):  
Min Ji ◽  
Mary Hardy ◽  
Johnny Siu-Hang Li
Keyword(s):  
Care Facility ◽  
State Model ◽  
Home Equity ◽  
Reverse Mortgage ◽  
Term Care ◽  
Long Term Care Facility ◽  
Health Related ◽  
The Usa ◽  
Multiple State ◽  
Multiple State Model

AbstractReverse mortgages provide a mechanism for seniors to release the equity that has been built up in their home. At termination, the mortgagors are usually guaranteed to owe no more than the value of their property. The value of the reverse mortgage guarantee is heavily dependent on the maturity or termination date, which is uncertain. In this paper, we model reverse mortgage terminations using a semi-Markov multiple state model which incorporates three different modes of exit: death, entrance into a long-term care facility, and voluntary prepayment. We apply the proposed model specifically to develop the valuation formulas for roll-up mortgages in the UK and Home Equity Conversion Mortgages (HECMs) in the USA. We examine the significance of each mode of termination by valuing the contracts allowing progressively for each mode. On the basis of our model and assumptions, we find that both health related terminations and voluntary (non-health related) terminations significantly impact the contract value. In addition we analyze the premium structure for US reverse mortgage insurance, and demonstrate that premiums appear to be too high for some borrowers, and substantial cross-subsidies may result.

scholarly journals Assessment of Oral Health-Related Photographs by Dentists and Professional Non-Dental Caregivers - A Quantitative Comparative Study

2019 ◽  
Author(s):  
Stefanie Krausch-Hofmann ◽  
Trung Dung Tran ◽  
Dominique Declerck ◽  
Johanna de Almeida Mello ◽  
Anja Declercq ◽  
...  
Keyword(s):  
Oral Health ◽  
Oral Hygiene ◽  
Care Facility ◽  
Mixed Effects ◽  
University Hospital ◽  
Mixed Effects Models ◽  
Term Care ◽  
Linear Mixed Effects Models ◽  
Linear Mixed Effects ◽  
Health Related

Abstract Background Photographs might aid professional non-dental caregivers to detect problems when inspecting the mouth of care-dependent older individuals. This study evaluated whether the assessment of oral health-related conditions presented on photographs systematically differed between dentists and professional non-dental caregivers. Methods Photographs were taken from long-term care facility residents and from patients at the Department of Dentistry of a University Hospital. The following oral health aspects were depicted: denture hygiene, oral hygiene, teeth, gums, tongue and palate/lips/cheeks. Collection continued until a pool of 20-35 photographs was available for each oral health aspect, including a variety of conditions from perfect health and hygiene to severe problems. The total pool consisted of 179 photographs. A segmented Visual Analogue Scale was applied to assess the conditions presented on the photographs. The benchmark was established by three dentists with academic-clinical expertise in gerodontology, special needs dentistry and periodontology. For each photograph they provided a collective score after reaching consensus. Photographs were assessed individually by 32 general dentists and by 164 professional non-dental caregivers. Linear mixed effects models and generalized linear mixed effects models were fitted and mean squared errors were computed to quantify differences between both groups related to the benchmark. Results For the different oral health aspects, absolute distances from the benchmark scores were 1.13 (95%CI:1.03-1.23) to 1.51 (95%CI:1.39-1.65) times higher for the caregivers than for the dentists. The odds to overestimate the condition were higher for the caregivers than the dentists for oral hygiene (OR=0.72, 95%CI=0.62-0.84) and teeth (OR=0.74; 95%CI=0.61-0.88). The odds to underestimate the condition were higher for the caregivers than the dentists for gums (OR=1.39; 95%CI:1.22-1.59) and palate/lips/cheeks (OR=1.22; 95%CI=1.07-1.40). Over all assessments, the variance in caregiver scores was 1.9 (95%CI:1.62-2.23) times higher than that for the dentists. Conclusion Small but significant systematic differences were found between dentists and non-dental caregivers regarding the assessment of oral health-related conditions presented on clinical photographs. When photographs are used to aid non-dental caregivers with the oral health assessment, these visualizations should be complemented with comments to facilitate accurate interpretation.

scholarly journals 178. Implementation of the Core Elements of Antibiotic Stewardship in Nursing Homes – National Healthcare Safety Network (NHSN), 2016–2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S96-S96
Author(s):  
Katryna A Gouin ◽  
Sarah Kabbani; Angela Anttila ◽  
Josephine Mak ◽  
Elisabeth Mungai ◽  
Ti Tanissha McCray ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Antibiotic Stewardship ◽  
Care Facility ◽  
Antibiotic Use ◽  
Infection Prevention And Control ◽  
Term Care ◽  
Long Term Care Facility ◽  
The Core ◽  
Use Of Resources ◽  
Core Elements

Abstract Background Since 2016, nursing homes (NHs) enrolled in the Centers for Disease Control and Prevention’s NHSN Long-term Care Facility (LTCF) Component have reported on their implementation of the core elements of antibiotic stewardship. In 2016, 42% of NHs reported implementing all seven core elements. Recent regulations require antibiotic stewardship programs in NHs. The objectives of this analysis were to track national progress in implementation of the core elements and evaluate how time dedicated to infection prevention and control (IPC) is associated with the implementation of the core elements. Methods We used the NHSN LTCF 2016–2018 Annual Surveys to assess NH characteristics and implementation of the core elements, defined as self-reported implementation of at least one corresponding stewardship activity. We reported absolute differences in percent implementation. We used log-binomial regression models to estimate the association between weekly IPC hours and the implementation of all seven core elements, while controlling for confounding by facility characteristics. Results We included 7,506 surveys from 2016–2018. In 2018, 71% of NHs reported implementation of all seven core elements, a 28% increase from 2016 (Fig. 1). The greatest increases in implementation from 2016–2018 were in Education (+19%), Reporting (+18%) and Drug Expertise (+15%) (Fig. 2). Ninety-eight percent of NHs had an individual responsible for antibiotic stewardship activities (Accountability), with 30% indicating that the role was fulfilled by an infection preventionist. Furthermore, 71% of NHs reported pharmacist involvement in improving antibiotic use, an increase of 27% since 2016. NHs that reported at least 20 hours of IPC activity per week were 14% more likely to implement all seven core elements, when controlling for facility ownership and affiliation, 95% CI: (1.07, 1.20). Conclusion NHs reported substantial progress in antibiotic stewardship implementation from 2016–2018. Improvements in accessing drug expertise, providing education and reporting antibiotic use may reflect increased stewardship awareness and use of resources among NH providers under new regulatory requirements. NHs with at least 20 hours dedicated to IPC per week may have greater capacity to implement all core elements. Disclosures All Authors: No reported disclosures

scholarly journals Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden: a nationwide study

2021 ◽  
Vol 36 (3) ◽  
pp. 287-298
Author(s):  
Jonathan Bergman ◽  
Marcel Ballin ◽  
Anna Nordström ◽  
Peter Nordström
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Long Term Care ◽  
Care Facility ◽  
Prescription Medication ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
All Cause Mortality

AbstractWe conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled general-population controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.

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