Pulmonary vest therapy in pediatric long-term care.


OBJECTIVES:Pulmonary infections are common in children with quadriplegic cerebral palsy. High frequency chest wall oscillation with the vest therapy (VT) is used to promote pulmonary clearance and to prevent pneumonias in cystic fibrosis patients. The purpose of this study was to ascertain the effectiveness of VT in patients with quadriplegic cerebral palsy who reside in pediatric skilled nursing facilities. METHODS:Seven individuals with quadriplegic cerebral palsy, who had frequent pulmonary infections were identified (age range: 7-28 years; median 19 years; 2 females and 5 males). Five had a tracheostomy and three an active seizure disorder. Clinical data was collected for 12 months before starting VT and during 12 months of VT. RESULTS:The total number of pneumonias that required antibiotics decreased from 36 per year before VT, to 18 during the year of VT (P < 0.05). The number of hospitalizations due to pneumonia decreased from 9 to 3. With VT, the frequency of effective suctioning of pulmonary secretions was significantly increased (P < 0.01). In the patients with epilepsy, with VT, the average monthly frequency of seizures decreased from 4 to 1, from 9 to 2, and from 9 to 1. CONCLUSION:VT resulted in more effective suctioning of pulmonary secretions, reduced incidence of pneumonia, and reduced number of hospitalizations for pneumonia. In patients with epilepsy, VT resulted in reduced seizure frequency. VT was tolerated well, without complications or side effects. Further clinical investigations of the use of VT in cerebral palsy are indicated.


J Am Med Dir Assoc


Plioplys AV,Lewis S,Kasnicka I





Has Abstract


2002-09-01 00:00:00














  • Nontraditional Small House Nursing Homes Have Fewer COVID-19 Cases and Deaths.

    abstract:OBJECTIVES:Green House and other small nursing home (NH) models are considered "nontraditional" due to their size (10-12 beds), universal caregivers, and other home-like features. They have garnered great interest regarding their potential benefit to limit Coronavirus Disease 2019 (COVID-19) infections due to fewer peo...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Zimmerman S,Dumond-Stryker C,Tandan M,Preisser JS,Wretman CJ,Howell A,Ryan S

    更新日期:2021-01-26 00:00:00

  • Protein redistribution from skeletal muscle to splanchnic tissue on fasting and refeeding in young and older healthy individuals.

    abstract:BACKGROUND:During aging, a shift of protein metabolism from muscle to splanchnic tissue contributes to increased muscle protein loss after a period of metabolic stress (eg, fasting). OBJECTIVE:To study the adaptation of protein metabolism in the whole body and tissue (ie, skeletal muscle and splanchnic area) to metabo...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Moreau K,Walrand S,Boirie Y

    更新日期:2013-09-01 00:00:00

  • Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group.

    abstract::New evidence shows that older adults need more dietary protein than do younger adults to support good health, promote recovery from illness, and maintain functionality. Older people need to make up for age-related changes in protein metabolism, such as high splanchnic extraction and declining anabolic responses to ing...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 共识发展会议,杂志文章,评审


    authors: Bauer J,Biolo G,Cederholm T,Cesari M,Cruz-Jentoft AJ,Morley JE,Phillips S,Sieber C,Stehle P,Teta D,Visvanathan R,Volpi E,Boirie Y

    更新日期:2013-08-01 00:00:00

  • Do Exercises Prevent Falls Among Older Adults: Where Are We Now? A Systematic Review.

    abstract:OBJECTIVE:To determine whether single interventions (SI), multifactorial interventions (MI), or multiple component interventions (MCI) including vitamin D supplementation prevent the incidence of falls and fall risk factors among older adults who are community-dwelling or living in long-term care facilities. DESIGN:Sy...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章,评审


    authors: Senderovich H,Tsai PM

    更新日期:2020-09-01 00:00:00

  • Effects of an Integrated Palliative Care Pathway: More Proactive GPs, Well Timed, and Less Acute Care: A Clustered, Partially Controlled Before-After Study.

    abstract:OBJECTIVES:This study presents the design of an integrated, proactive palliative care pathway covering the full care cycle and evaluates its effects using 3 types of outcomes: (1) physician-reported outcomes, (2) outcomes reported by family, and (3) (utilization of) health care outcomes. DESIGN:A clustered, partially ...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Groenewoud AS,Wichmann AB,Dijkstra L,Knapen E,Warmerdam F,De Weerdt-Spaetgens C,Dominicus W,Akkermans R,Meijers J

    更新日期:2020-11-19 00:00:00

  • Interventions for the Treatment of Pain in Nursing Home Residents: A Systematic Review and Meta-Analysis.

    abstract:BACKGROUND:More than one-half of nursing home residents experience a complex mix of pain. Despite this, assessment and treatment of pain remain inadequate. METHODS:Using techniques of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we assessed effi...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章,meta分析,评审


    authors: Knopp-Sihota JA,Patel P,Estabrooks CA

    更新日期:2016-12-01 00:00:00

  • Diabetes risk factors, diabetes risk algorithms, and the prediction of future frailty: the Whitehall II prospective cohort study.

    abstract:OBJECTIVE:To examine whether established diabetes risk factors and diabetes risk algorithms are associated with future frailty. DESIGN:Prospective cohort study. Risk algorithms at baseline (1997-1999) were the Framingham Offspring, Cambridge, and Finnish diabetes risk scores. SETTING:Civil service departments in Lond...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Bouillon K,Kivimäki M,Hamer M,Shipley MJ,Akbaraly TN,Tabak A,Singh-Manoux A,Batty GD

    更新日期:2013-11-01 00:00:00

  • Zopiclone Use and Risk of Fractures in Older People: Population-Based Study.

    abstract:OBJECTIVES:The primary objective was to evaluate the risk of fractures associated with use of zopiclone, a new Z-hypnotic, in a population-based cohort of older people in New Zealand (NZ) in a real-world setting. The secondary objective was to examine a nonlinear relationship with age and risk for fractures in zopiclon...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Nishtala PS,Chyou TY

    更新日期:2017-04-01 00:00:00

  • Antibiotic Stewardship Programs in Nursing Homes: A Systematic Review.

    abstract:INTRODUCTION:Antibiotic stewardship programs (ASPs) are coordinated interventions promoting the appropriate use of antibiotics to improve patient outcomes and reduce microbial resistance. These programs are now mandated in nursing homes (NHs) but it is unclear if these programs improve resident outcomes. This systemati...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Feldstein D,Sloane PD,Feltner C

    更新日期:2018-02-01 00:00:00

  • Predictors of Disease Progression in Early-Onset Alzheimer's Dementia: A Retrospective Cohort Study.

    abstract:OBJECTIVES:Early-onset Alzheimer's disease (EOAD), defined as onset of AD before the age of 65 years, is less common than the late-onset type, and little is known about the factors affecting disease progression. The aim of the study was to investigate factors influencing disease progression in people with EOAD. DESIGN...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Velayudhan L,Baillon S,Daby L,Suntharamoorthy P,Kablan A,Tromans S,Lindesay J

    更新日期:2020-11-01 00:00:00

  • Evidence-based recommendations for addressing malnutrition in health care: an updated strategy from the feedM.E. Global Study Group.

    abstract::The prevalence of malnutrition ranges up to 50% among patients in hospitals worldwide, and disease-related malnutrition is all too common in long-term and other health care settings as well. Regrettably, the numbers have not improved over the past decade. The consequences of malnutrition are serious, including increas...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Correia MI,Hegazi RA,Higashiguchi T,Michel JP,Reddy BR,Tappenden KA,Uyar M,Muscaritoli M

    更新日期:2014-08-01 00:00:00

  • Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Oldest Adults: Predictors of In-Hospital Mortality and Need for Post-acute Care.

    abstract:OBJECTIVES:Older age is associated with higher risk of death during acute exacerbations of chronic obstructive pulmonary disease (AE-COPD). Older patients hospitalized for AE-COPD often require post-acute care after acute phase. The aim of this study was to evaluate components of a comprehensive geriatric assessment an...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Spannella F,Giulietti F,Cocci G,Landi L,Lombardi FE,Borioni E,Cenci A,Giordano P,Sarzani R

    更新日期:2019-07-01 00:00:00

  • Optimizing Quality of Life With Cognitive Impairment: A Study of End-of-Life Care in Assisted Living.

    abstract:OBJECTIVES:Assisted living (AL) is an expanding site of end-of-life (EOL) care in the United States. Understanding determinants of quality of life (QoL) for AL residents near EOL is vital to optimize care for this growing population, most of whom have some degree of cognitive impairment (CI). This analysis aimed to ide...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Arneson L,Bender AA,Robert MN,Perkins MM

    更新日期:2020-05-01 00:00:00

  • Are standing order programs associated with influenza vaccination? - NNHS, 2004.

    abstract:BACKGROUND:Influenza vaccination coverage among nursing home residents has consistently been reported well below the Healthy People goals. We sought to determine if standing order programs (SOPs) in long-term care facilities are associated with greater influenza vaccination coverage among residents. METHODS:The Nation...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Bardenheier BH,Shefer AM,Lu PJ,Remsburg RE,Marsteller JA

    更新日期:2010-11-01 00:00:00

  • Predicting outcomes from 6-minute walk distance in chronic obstructive pulmonary disease.

    abstract:BACKGROUND:Exercise tolerance is an important clinical aspect of chronic obstructive pulmonary disease that can be easily and reliably measured with the 6-minute walking test (6MWT). To improve the utility of the 6MWT for patient and health care system management, the interpretation of the functional status measure in ...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章,多中心研究


    authors: Spruit MA,Polkey MI,Celli B,Edwards LD,Watkins ML,Pinto-Plata V,Vestbo J,Calverley PM,Tal-Singer R,Agusti A,Coxson HO,Lomas DA,MacNee W,Rennard S,Silverman EK,Crim CC,Yates J,Wouters EF,Evaluation of COPD Longitudinal

    更新日期:2012-03-01 00:00:00

  • Motoric Cognitive Risk Syndrome and Risk for Falls, Their Recurrence, and Postfall Fractures: Results From a Prospective Observational Population-Based Cohort Study.

    abstract:OBJECTIVE:Motoric cognitive risk syndrome (MCR) is a predementia stage associated with increased risk for falls. There are conflicting results regarding its association with recurrent falls and no information about its association with postfall fractures. The aim of the study was to examine the association of MCR and i...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Beauchet O,Sekhon H,Schott AM,Rolland Y,Muir-Hunter S,Markle-Reid M,Gagne H,Allali G

    更新日期:2019-10-01 00:00:00

  • Validation of a Delirium Risk Assessment Using Electronic Medical Record Information.

    abstract:OBJECTIVE:Identifying patients at risk for delirium allows prompt application of prevention, diagnostic, and treatment strategies; but is rarely done. Once delirium develops, patients are more likely to need posthospitalization skilled care. This study developed an a priori electronic prediction rule using independent ...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Rudolph JL,Doherty K,Kelly B,Driver JA,Archambault E

    更新日期:2016-03-01 00:00:00

  • Obesity among Nursing Home Residents: Association with Potentially Avoidable Hospitalizations.

    abstract:BACKGROUND/OBJECTIVES:Studies show that in nursing homes (NHs), the prevalence of moderate-to-severe obesity has doubled in the last decade and continues to increase. Obese residents are often complex and costly, and this increase in prevalence has come at a time when NHs struggle to decrease hospitalizations, particul...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Temkin-Greener H,Wang S,Caprio T,Mukamel DB,Cai S

    更新日期:2020-09-01 00:00:00

  • Improving safety and operational efficiency in residential care settings with WiFi-based localization.

    abstract:OBJECTIVES:To assess the effectiveness of a wireless network (WiFi-based) localization system (devices mounted on resident wheelchairs) in decreasing caretaker time spent searching for residents and providing alerts of residents going outdoors in a skilled nursing facility. DESIGN:A controlled study over two 2-month p...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Doshi-Velez F,Li W,Battat Y,Charrow B,Curtis D,Park JG,Hemachandra S,Velez J,Walsh C,Fredette D,Reimer B,Roy N,Teller S

    更新日期:2012-07-01 00:00:00

  • Twenty-year trends in dependency in residential aged care in Auckland, New Zealand: a descriptive study.

    abstract:OBJECTIVE:To describe changes in aged care residents' dependency over a 20-year period. DESIGN:All residents in 1988, 1993, 1998, and 2008 were assessed using the same 23-item functional ability survey. SETTING:Residential aged care facilities in Auckland, New Zealand. PARTICIPANTS:In 1988 there were 7516 participan...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Boyd M,Broad JB,Kerse N,Foster S,von Randow M,Lay-Yee R,Chelimo C,Whitehead N,Connolly MJ

    更新日期:2011-09-01 00:00:00

  • Clinical update on nursing home medicine: 2013.

    abstract::This is the seventh article in the series of Clinical Updates on Nursing Home Care. The topics covered are antiresorptive drugs, hip fracture, hypertension, orthostatic hypotension, depression, undernutrition, anorexia, cachexia, sarcopenia, exercise, pain, and behavioral and psychological symptoms of dementia. ...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章,评审


    authors: Messinger-Rapport BJ,Gammack JK,Thomas DR,Morley JE

    更新日期:2013-12-01 00:00:00

  • The effects of estrogen on short-term memory in genetic men.

    abstract:BACKGROUND:The subject of estrogen in regard to short-term memory is controversial. There is support in the medical literature for estrogen improving short-term memory in women, but there are few data on this subject pertaining to genetic men. OBJECTIVE:To examine the effects of supplemental estrogen on short-term mem...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Friedman G

    更新日期:2000-01-01 00:00:00

  • Advance care planning in nursing homes and assisted living communities.

    abstract:OBJECTIVES:To determine the prevalence and characteristics of advance care planning (ACP) among persons dying in long-term care (LTC) facilities, and to examine the relationship between respondent, facility, decedent, and family characteristics and ACP. DESIGN:After-death interviews of family members of decedents and ...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Daaleman TP,Williams CS,Preisser JS,Sloane PD,Biola H,Zimmerman S

    更新日期:2009-05-01 00:00:00

  • Implementation of an Algorithm of Cohort Classification to Prevent the Spread of COVID-19 in Nursing Homes.

    abstract::Older adults living in nursing homes are the most vulnerable group of the COVID-19 pandemic. There are many difficulties in isolating residents and limiting the spread in this setting. We have developed a simple algorithm with a traffic light format for resident classification and sectorization within nursing homes, b...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: González de Villaumbrosia C,Martínez Peromingo J,Ortiz Imedio J,Álvarez de Espejo Montiel T,García-Puente Suárez L,Navas Clemente I,Morales Cubo S,Cotano Abad LE,Suárez Sánchez Y,Torras Cortada S,Oñoro Algar C,Palicio Martínez C,

    更新日期:2020-12-01 00:00:00

  • Texas certified volunteer Long-Term Care Ombudsmen: perspectives of role and effectiveness.

    abstract:BACKGROUND:Under the federally mandated Long-Term Care Ombudsman Program (LTCOP), certified volunteer ombudsmen (CVO) advocate for the welfare and rights of residents in nursing facilities. In Texas, the Department on Aging contracts with 28 agencies to deliver the LTCOP in respective regions. Regional ombudsman staff ...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Ostwald SK,Runge A,Lees EJ,Patterson GD

    更新日期:2003-11-01 00:00:00

  • Psychotropic Drug Prescription and the Risk of Falls in Nursing Home Residents.

    abstract:BACKGROUND:Falling is a common and serious problem in the elderly. Previous studies suggest that the use of psychotropic drugs increases the risk of falling. However, the contribution of these drugs on fall risk has not been quantified on a daily basis among the general population of nursing homes until now. OBJECTIVE...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Cox CA,van Jaarsveld HJ,Houterman S,van der Stegen JC,Wasylewicz AT,Grouls RJ,van der Linden CM

    更新日期:2016-12-01 00:00:00

  • Elderly residents at risk for being victims or offenders.

    abstract::The phenomenon of elderly sexual offenders is poorly catalogued, and is especially complex. In institutions, elderly people are often unrecognized victims of sexual abuse but are also at great risk for doing abuse toward vulnerable victims like children. The lack of attention to an elder's basic needs can endanger or ...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Corbi G,Grattagliano I,Catanesi R,Ferrara N,Yorston G,Campobasso CP

    更新日期:2012-09-01 00:00:00

  • To What Extent Do Physician Orders for Life-Sustaining Treatment (POLST) Reflect Patients' Preferences for Care at the End of Life?

    abstract:OBJECTIVE:To assess whether medical orders within Physician Orders for Life-Sustaining Treatment (POLST) forms reflect patients' preferences for care at the end of life. DESIGN:This cross-sectional study assessed the agreement between medical orders in POLST forms and the free-form text documentation of an advance car...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Lovadini GB,Fukushima FB,Schoueri JFL,Reis RD,Fonseca CGF,Rodriguez JJC,Coelho CS,Neves AF,Rodrigues AM,Marques MA,Bassett R,Steinberg KE,Moss AH,Vidal EIO

    更新日期:2020-11-13 00:00:00

  • Parkinson's disease without expected neuropathologic abnormality.

    abstract::A case is reported of an initially 78-year-old man whose presentation and course, closely followed over 10 years by an academic neurologist, were consistent with classic idiopathic Parkinson's disease (PD), including unilateral onset, obvious cogwheeling, and a very good prolonged response to levodopa/carbidopa (LD/CD...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Velickovic M,Lesser G,Purohit D,Neufeld RR,Tarshish CY,Libow LS

    更新日期:2004-11-01 00:00:00

  • Adoption of Health Information Technology Among US Nursing Facilities.

    abstract:OBJECTIVES:Nursing facilities have lagged behind in the adoption of interoperable health information technology (ie technologies that allow the sharing and use of electronic patient information between different information systems). The objective of this study was to estimate the nationwide prevalence of electronic he...

    journal_title:Journal of the American Medical Directors Association

    pub_type: 杂志文章


    authors: Vest JR,Jung HY,Wiley K Jr,Kooreman H,Pettit L,Unruh MA

    更新日期:2019-08-01 00:00:00