Abstract:
OBJECTIVES:To document the prevalence of asymptomatic bacteriuria in patients in one large long-term care facility, and describe clinical outcomes in initially bacteriuric and nonbacteriuric residents during prospective observation encompassing one year. METHODS:Patients enrolled in the study were residents of the Haim-Shoham Geriatric Center, a long-term care institute with 800 inhabitants. Twenty patients were related randomly for study enrollment on each of the ten wards. A urine culture was obtained from the enrolled patients. A second culture was obtained within one week if the initial culture grew >or= 10(5) colony-forming units per milliliter (cfu/ml) of at least one uropathogen. Demographic data and comorbidities, as well as most recent laboratory results, were recorded for all patients enrolled. Subjects were followed prospectively for one year or until death. Clinical events and usage of antibiotics were recorded. In patients with asymptomatic bacteriuria, repeated urine cultures were obtained every two months. RESULTS:Eighty-five (43.3%) of a total of 196 elder residents screened presented asymptomatic bacteriuria. There were no differences between patients with and without asymptomatic bacteriuria in age, gender, and underlying diseases. Patients with asymptomatic bacteriuria were significantly more bed-ridden (91.7% vs. 82.1%, P = 0.05); demented (78.8% vs. 59.8%, P = 0.03); and incontinent of urine (93% vs. 71.4%, P < 0.0001) and bowel (85.8% vs. 59.3%). During one year of prospective observation, bacteriuric patients had a mortality rate of 25.9%, compared to 7.1% for nonbacteriuric (P < 0.0001). Mortality in the group with bacteriuria was higher due to both urinary infection and other causes. CONCLUSIONS:In our population, asymptomatic bacteriuria was associated with increased functional impairment and increased mortality over 12 months. The increased mortality, however, was not fully attributable to urinary infection.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Raz R,Gronich D,Ben-Israel Y,Nicolle LEkeywords:
subject
Has Abstractpub_date
2001-11-01 00:00:00pages
275-8issue
6eissn
1525-8610issn
1538-9375pii
S1525-8610(04)70221-2journal_volume
2pub_type
杂志文章abstract:BACKGROUND/OBJECTIVE:Falls are common in nursing homes and cause a high burden of injuries. The objective of this study was to analyze factors associated with serious consequences of falls in nursing home residents. DESIGN:Prospective observational study. SETTING:Falls were recorded over 1 year, covering all resident...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.03.015
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Although many older adults require skilled nursing facility (SNF) care after acute hospitalization, it is unclear whether internal medicine residents have sufficient knowledge of the care that can be provided at this site. METHODS:We developed a 10-item multiple choice pre-test that assessed knowledge of th...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.08.004
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Despite recommendations for annual vaccinations against influenza, many older African-Americans do not receive this vaccine. For 1 month in our private medical offices, we conducted a survey to estimate the vaccination rate for our practice, the reasons why older African-Americans declined to be vaccinated, ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVES:We sought to examine the associations of osteosarcopenia with physical performance, balance, and falls and fractures in community-dwelling older adults. Additionally, we aimed to determine which clinical outcomes are associated with specific components of osteosarcopenia. DESIGN:Cross-sectional study. SETT...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.09.005
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to evaluate the benefits of influenza vaccination against hospitalization and mortality on frail elderly people. DESIGN:The design was a population-based retrospective cohort study. SETTING:Taiwan's National Health Insurance claims data. PARTICIPANTS:Participants were 5063 ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2013.12.003
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:Little is known about the relationship between how medical care is organized and delivered in nursing homes. Taking a lead from the acute care arena, we hypothesize that nursing home medical staff organization (NHMSO) is an important predictor of clinical outcomes in the nursing home. METHODS:A total of 202...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.06.004
更新日期:2011-11-01 00:00:00
abstract:PURPOSE:To describe a feasible quality improvement system to manage feeding assistance care processes in an assisted living facility (ALF) that provides dementia care and the use of these data to maintain the quality of daily care provision and prevent unintentional weight loss. DESIGN AND METHODS:Supervisory ALF staf...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.12.012
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:The issue of subjects with mild cognitive impairment (MCI) reverting to normal cognition (NC) has to date been taken in limited consideration, and no conclusive data are available on the rate of reversion. We aimed at systematically reviewing available longitudinal studies on MCI and meta-analyzing data with...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jamda.2016.06.020
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings. DESIGN:Systematic review and meta-analysis. SETTING AND P...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2019.09.017
更新日期:2020-03-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.05.011
更新日期:2014-08-01 00:00:00
abstract::Pressure ulcers remain problematic across health care settings, with prevalence and incidence changing little over the past 2 decades. Because external pressure is viewed as the chief factor in the development of pressure ulcers, considerable research has focused on pressure relief. Because relief of external pressure...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2010.03.007
更新日期:2010-07-01 00:00:00
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
doi:
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:To compare the effects of care based on comprehensive geriatric assessment (CGA) as a complement to usual care in an outpatient setting with those of usual care alone. The assessment was performed 36 months after study inclusion. DESIGN:Randomized, controlled, assessor-blinded, single-center trial. SETTING:...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamda.2015.12.008
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:To determine the short- (4 weeks) and long-term (6 month) effectiveness of Tibetan medicated bathing therapy in patients with post-stroke limb spasticity. DESIGN:Prospective, blinded, randomized controlled trial. SUBJECTS:Post-stroke patients with limb spasticity were recruited between December 2013 and Feb...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.10.018
更新日期:2020-03-01 00:00:00
abstract:INTRODUCTION:Current guidelines recommend antithrombotic prophylaxis for venous thromboembolism (VTE) using risk assessment, factoring contraindications. This report represents a summary of current practice patterns to prevent VTE in long term care as Phase 1 of a 3-phase educational intervention study. PHASE 1 PARTIC...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2011.04.016
更新日期:2012-03-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.038
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVES:To describe current practices of incontinence care in nursing homes (NHs) provided by certified nurse assistants (CNAs), and to evaluate the feasibility and acceptability of an integrated incontinence care product, the One Step Incontinence System (OSIS) in the NH setting. While the ultimate purpose of OSIS ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jamda.2006.10.001
更新日期:2007-05-01 00:00:00
abstract::Up to 80% of nursing home residents are affected by pain. Pain assessment aims to determine pain intensity, quality, and course of pain to underpin diagnostic decision making. In the nursing home population, pain assessment is frequently compromised by cognitive impairment. Characteristics of the nursing home setting,...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.08.002
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:An estimated 1.5 million residents of nursing homes (NH) in the United States were prescribed an average of 7 to 8 medications each month. However, it is unknown which of these prescribed drugs and nutritional supplements have been tested for use among NH residents who often have distinct and complex needs c...
journal_title:Journal of the American Medical Directors Association
pub_type: 历史文章,杂志文章
doi:10.1016/j.jamda.2008.06.005
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:There is an increased demand for nursing homes (NHs) in middle-income countries such as Brazil. To monitor the quality of NHs, there is a need for reliable instruments to assess the extent to which the care provided meets the expectations and rights of residents and their families. PURPOSE:To evaluate the r...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.04.007
更新日期:2017-07-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.05.013
更新日期:2012-09-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.09.012
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVES:To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. METHODS:Qualitative, semistructu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.01.072
更新日期:2015-05-01 00:00:00
abstract::Nursing homes can be ideal clinical teaching and learning environments for acquiring geriatric specialty and interdisciplinary team skills, particularly those regarding assessment, care planning, management, monitoring, and collaborating in an interdisciplinary milieu. Little is known as to how geriatric specialty tra...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2008.11.002
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to measure the level of lighting in nursing homes in a variety of areas to determine its adequacy in meeting the visual needs of elderly residents. DESIGN:Observational study PARTICIPANTS:Eight nursing homes cooperating in an intervention study designed to prevent accidental...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2007.01.003
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:Older people who are admitted to inpatient rehabilitation settings often experience sleep disturbance or disorders. Both intrinsic and environmental factors may contribute to reduced sleep quality. Poor sleep quality has been reported to be associated with poorer rehabilitation outcomes. The aim of this revi...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2020.03.002
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:This study examined the association between intensive rehabilitation for subacute stroke patients and medical costs and readmission ratio during the year after discharge. DESIGN:This was a natural experiment study. SETTING AND PARTICIPANTS:We identified individuals with a diagnosis of cerebrovascular disor...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.12.015
更新日期:2021-01-18 00:00:00
abstract:BACKGROUND:Inappropriate antipsychotic prescribing is a key quality indicator by which clinical outcomes might be monitored and improved in long-term care (LTC), but limited evidence exists on the most effective strategies for reducing inappropriate antipsychotic use. OBJECTIVES:The objective of the study was to evalu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.07.025
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:Sex-specific impact of frailty on all-cause mortality in older age population remains controversial. This meta-analysis aimed to evaluate the association between frailty and all-cause mortality in older age women vs men from the general population. DESIGN:Meta-analysis. SETTING AND PARTICIPANTS:PubMed and E...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.05.059
更新日期:2020-07-15 00:00:00
abstract:BACKGROUND:Although traditional Chinese medicine (TCM) is known as an integrative part of China's health care system, little is known on the prevalence and determinants of using TCM among the middle-aged and older Chinese population, especially among those with chronic conditions. METHODS:The nationwide survey data of...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.07.011
更新日期:2015-11-01 00:00:00