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or fortified foods as well continued electrolyte and micronutrient management. Following recovery, caregivers are given appropriate nutritional training to avoid similar recurrences and instructed on the importance of sensory stimulation in children for continued emotional and physical development (Ashworth, ). SAM among children under 6 months of age is increasingly being associated with higher mortality than in older infants and children (WHO, ). The WHO guideline suggests that in infants who are under 6 (...) months of age with SAM should receive the same general medical care as infants with SAM who are 6 months of age or older with increased focus on establishing, or re‐establishing, effective exclusive breastfeeding by the mother or other caregiver (WHO, ). In this review, we will assess the effectiveness of various community‐based and facility‐based strategies to identify and manage MAM and SAM; including the community‐based screening, identification management of SAM and MAM, relative effectiveness
Clopidogrel versus ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome (POPular AGE): the randomised, open-label, non-inferiority trial. Current guidelines recommend potent platelet inhibition with ticagrelor or prasugrel in patients after an acute coronary syndrome. However, data about optimal platelet inhibition in older patients are scarce. We aimed to investigate the safety and efficacy of clopidogrel compared with ticagrelor or prasugrel (...) in older patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).We did the open-label, randomised controlled POPular AGE trial in 12 sites (ten hospitals and two university hospitals) in the Netherlands. Patients aged 70 years or older with NSTE-ACS were enrolled and randomly assigned in a 1:1 ratio using an internet-based randomisation procedure with block sizes of six to receive a loading dose of clopidogrel 300 mg or 600 mg, or ticagrelor 180 mg or prasugrel 60 mg, and then a maintenance
the efficacy and safety of levetiracetam, fosphenytoin, and valproate in established status epilepticus, and here we describe our results after extending enrolment in children to compare outcomes in three age groups.In this multicentre, double-blind, response-adaptive, randomised controlled trial, we recruited patients from 58 hospital emergency departments across the USA. Patients were eligible for inclusion if they were aged 2 years or older, had been treated for a generalised convulsive seizure (...) included: 225 children (aged <18 years), 186 adults (18-65 years), and 51 older adults (>65 years). 175 (38%) patients were randomly assigned to levetiracetam, 142 (31%) to fosphenyltoin, and 145 (31%) were to valproate. Baseline characteristics were balanced across treatments within age groups. The primary efficacy outcome was met in those treated with levetiracetam for 52% (95% credible interval 41-62) of children, 44% (33-55) of adults, and 37% (19-59) of older adults; with fosphenytoin in 49% (38
Zinc supplementation for the promotion of growth and prevention of infections in infants less than six months of age. Zinc is a vital micronutrient for humans and is essential for protein synthesis, cell growth, and differentiation. Severe zinc deficiency can lead to slower physical, cognitive and sexual growth, cause skin disorders, decrease immunity, increase incidence of acute illnesses in infants and children and contribute to childhood stunting. By estimation, 17.3% of the world population (...) is at risk of inadequate zinc intake. Such nutritional impairment increases the risk of diarrhoea and pneumonia by 20%, as well as leads to a global loss of more than 16 million disability-adjusted life years in children less than five years of age. Not only does zinc deficiency affect lives, it adds to the considerable financial burden on depleted resources in countries that are most affected. By preventing or curing this deficiency, we can improve childhood mortality, morbidity and growth.To assess
and confounding in observational data.To determine the effectiveness of the influenza vaccine in reducing hospitalizations and mortality among elderly persons by using an observational research design that reduces the possibility of bias and confounding.A regression discontinuity design was applied to the sharp change in vaccination rate at age 65 years that resulted from an age-based vaccination policy in the United Kingdom. In this design, comparisons were limited to individuals who were near the age-65 (...) reduced hospitalizations or mortality among elderly persons. The estimates were precise enough to rule out results from many previous studies.The study relied on observational data, and its focus was limited to individuals near age 65 years.Current vaccination strategies prioritizing elderly persons may be less effective than believed at reducing serious morbidity and mortality in this population, which suggests that supplementary strategies may be necessary.National Institute on Aging.
Canadian guidelines on cannabis use disorder among older adults 135 CANADIAN GERIATRICS JOURNAL, VOLUME 23, ISSUE 1, MARCH 2020 ABSTRACT Background Cannabis Use Disorder (CUD) is an emerging and diverse challenge among older adults. Methods The Canadian Coalition for Seniors’ Mental Health, with financial support from Health Canada, has produced evidence- based guidelines on the prevention, identification, assessment, and treatment of this form of substance use disorder. Conclusions Older (...) and distribution, provided the original work is properly cited.BERTRAM: CANNABIS USE DISORDER GUIDELINES 136 CANADIAN GERIATRICS JOURNAL, VOLUME 23, ISSUE 1, MARCH 2020 among older adults. The pace and scope of cannabis research may require clinical recommendations, and recommenda- tions such as those below, to be updated and modified more frequently than other clinical guidelines. The Canadian Coalition for Seniors’ Mental Health (CC- SMH), with financial support from the Substance Use and Addictions Program
Checklist for Residential Aged Care Facility (RACF) preparation for COVID-19 prevention and outbreak management Version 1.4 Issued 17/3/2020 Checklist for Residential Aged Care Facility (RACF) preparation for COVID-19 prevention and outbreak management Please note that this checklist for preparation is presented as a guide only and is not an exhaustive list of requirements for RACF pandemic preparation. It should be used in conjunction with the CDNA National Guidelines for the Prevention (...) in the Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019). RACFs are also required to operate under the Aged Care Act 1997 and comply with Aged Care Quality Standards. Checklist ???? Review and update RACF outbreak management plan including, but not limited to, consideration of: - single point of entry and risk assessment for all staff, visitors, contractors, delivery drivers - business continuity planning in setting of potential staff sick leave - roster adjustments
A school intervention for 13- to 15-year-olds to prevent dating and relationship violence: the Project Respect pilot cluster RCT A school intervention for 13- to 15-year-olds to prevent dating and relationship violence: the Project Respect pilot cluster RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website
trauma already accounts for 33% of trauma care expenditures in the United States, or US $9 billion per year,  while trauma ranks as the seventh-highest cause of death for those 65 years and older.  Among elderly trauma patients, ground-level fall (GLF) is the most common traumatic mechanism, occurring nearly 10 times more often than motor vehicle crashes.  Nearly one in three geriatric persons will have a GLF each year.  These GLFs are not benign in this population, as 6% will sustain (...) TJ, Kammerlander-Knauer U, Krappinger D, Blauth M. Ortho-geriatric service—a literature review comparing different models. Osteoporos Int . 2010;21(Suppl 4):S637–S646. Handoll HH, Cameron ID, Mak JC, Finnegan TP. Multidisciplinary rehabilitation for olderpeople with hip fractures . Cochrane Bone, Joint and Muscle Trauma Group, editor. Cochrane Database Syst Rev . 2009;15(1):29. Cameron ID, Handoll HH, Finnegan TP, Madhok R, Langhorne P. Co-ordinated multidisciplinary approaches for inpatient
practical and timely clinical recom- mendations on the prevention, assessment, and treatment of OUD in older adults within the Canadian context. Key words: opioids, opioid dependence, opioid use disorder, substance use disorder, substance abuse, older adult, geriatric, systematic review, guideline INTRODUCTION According to the World Health Organization (WHO), people over the age of 50 accounted for 39% of deaths from drug use worldwide by 2015, and of those deaths in older adults (age = 65 (...) opioid therapy (24.8%) than any other age group. (14) From 2007 to 2015, hospitalizations for opioid overdose (referred to as poisonings) in Canada were con- sistently higher in older adults than in any other age cohort: At over 20 per 100,000, older-adult admissions are almost double that of 15 to 24-year-olds, and represent 30% of all admissions to hospital for opioid poisoning. (15) Only recently by 2017 have younger adults in Canada started to equal and just surpass older adults
: Prospective cohort study with long-term follow-up. Setting: International and multicenter locations. Participants: Patients aged 70 years or older undergoing elective surgery for a malignant solid tumor at five centers (n = 229). Measurements: We assessed long-term survival and institutionalization using the Preoperative Risk Estimation for Onco-geriatric Patients (PREOP) score, developed to predict the 30-day risk of major complications. The PREOP score collected data about sex, type of surgery (...) REFERENCES Kinsella K, Philips DR. Global aging: the challenge of success. Popul Bull. 2005;60(1):3-40. Korc-Grodzicki B, Downey RJ, Shahrokni A, Kingham TP, Patel SG, Audisio RA. Surgical considerations in older adults with cancer. J Clin Oncol. 2014;32(24):2647-2653. Mohanty S, Rosenthal RA, Russell MM, Neuman MD, Ko CY, Esnaola NF. Optimal perioperative management of the geriatric patient: a best practices guideline from the American College of Surgeons NSQIP and the American Geriatrics Society. J Am
-targeted database (2016-2017). Outcomes were analyzed between adult (age <65), older-adult (age ≥65 and <80), and oldest-old (age ≥80) patients. Five-factor modified frailty index (mFI-5) was calculated based on functional status, diabetes, COPD, CHF, and hypertension, and used in comparative analyses. Results: A total of 2189 adult, 635 older-adult, and 59 oldest-old patients were included. Compared to adult patients, older-adult and oldest-old patients had higher mFI-5 ≥0.4 rates (14% vs. 22% vs. 31 (...) %, respectively, p < 0.001). The overall complication rate was 17.0% and similar between groups; however, oldest-old patients had higher rates of surgical site infection (3.4% vs. 0.3% vs. 0.4%), pneumonia (5.1% vs. 0.3% vs. 0.2%), and readmission (10.2% vs. 2.4% vs. 2.6%) compared to older-adult and adult patients, respectively (p < 0.05). On multivariable analyses of thyroidectomy-specific complications, mFI-5 ≥0.4 (OR 2.5, 95%-CI 1.4-4.4) and bleeding disorder (OR 4.6, 95%-CI 1.3-16.3) were predictive
Share Permalink Copy Page navigation J Am Geriatr Soc Actions . 2020 Feb 25. doi: 10.1111/jgs.16357. Online ahead of print. Self-Administered Acupressure for Caregivers of Older Family Members: A Randomized Controlled Trial , , , , , , , , , , , Affiliations Expand Affiliations 1 School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. 2 School of Nursing, Hong Kong Sanatorium and Hospital, Hong Kong, China. 3 School of Nursing, The Hong Kong Polytechnic (...) Faculty of Medicine, The University of Hong Kong, Hong Kong, China. 9 Virginia University of Integrative Medicine, Fairfax, Virginia. PMID: 32096884 DOI: Item in Clipboard Self-Administered Acupressure for Caregivers of Older Family Members: A Randomized Controlled Trial Denise Shuk Ting Cheung et al. J Am Geriatr Soc . 2020 . Show details J Am Geriatr Soc Actions . 2020 Feb 25. doi: 10.1111/jgs.16357. Online ahead of print. Authors , , , , , , , , , , , Affiliations 1 School of Nursing, Li Ka Shing
care” or high care) residents had this diagnosis. The prevalence of “cognitive impairment” (which in this setting usually indicates delirium or dementia) was much higher at 54% in low care settings and 90% in high care settings. People with dementia in residential care tend to be older than those with dementia living in private households, and have more severe dementia (91% of those with moderate or severe dementia were in residential aged care) . In 2008, people living with dementia made up (...) of the nursing home population suffers from urinary incontinence .Falls, often recurrent, affect 30% of nursing home residents. . Osteoporosis is almost universal in the nursing home . Long term care residents in New Zealand have a 10.5 fold increase in risk of hip fracture compared with age-matched people living in private homes , and 38% of the 15,000 hip fractures in Australia in 1996, occurred among olderpeople living in hostels and nursing homes . Annual hip fracture risk
Continuation of Annual Screening Mammography and Breast Cancer Mortality in Women Older Than 70 Years. Randomized trials have shown that initiating breast cancer screening between ages 50 and 69 years and continuing it for 10 years decreases breast cancer mortality. However, no trials have studied whether or when women can safely stop screening mammography. An estimated 52% of women aged 75 years or older undergo screening mammography in the United States.To estimate the effect of breast cancer (...) screening on breast cancer mortality in Medicare beneficiaries aged 70 to 84 years.Large-scale, population-based, observational study of 2 screening strategies: continuing annual mammography, and stopping screening.U.S. Medicare program, 2000 to 2008.1 058 013 beneficiaries aged 70 to 84 years who had a life expectancy of at least 10 years, had no previous breast cancer diagnosis, and underwent screening mammography.Eight-year breast cancer mortality, incidence, and treatments, plus the positive