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Jonnalagadda VG. Geriatric Medicine as a Profession. JAMA 2024; 331:164-165. [PMID: 38193969 DOI: 10.1001/jama.2023.22471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
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Kokorelias KM, Grosse A, Zhabokritsky A, Walmsley SL, Sirisegaram L. Exploring implementation considerations for geriatric-HIV clinics: A secondary analysis from a scoping review on HIV models of geriatric care. HIV Med 2024; 25:38-59. [PMID: 37794607 DOI: 10.1111/hiv.13549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVES This review aimed to map the current state of knowledge regarding the implementation considerations of existing geriatric-HIV models of care, to identify areas of further research and to inform the implementation of future geriatric-HIV interventions that support older adults living with HIV. METHODS We conducted a scoping review that was methodologically informed by the Arskey and O'Malley's 5 step framework and theoretically informed by the Consolidated Framework for Implementation Research (CFIR). A systematic search of six databases was conducted for peer-reviewed literature. The grey literature was also searched. Article screening was performed in duplicate. Data was extracted for the purpose of this secondary analysis using a data extraction template informed by the CFIR. Data was inductively and deductively analyzed. RESULTS In total, 11 articles met the inclusion criteria. The models of care described varied in terms of their location and setting, the number and type of care providers involved, the mechanism of patient referral, the type of assessments and interventions performed and the methods of longitudinal patient follow-up. Four key categories emerged to describe factors that influenced their implementation: care provider buy-in, patient engagement, mechanisms of communication and collaboration, and available resources. CONCLUSIONS The findings from this scoping review provide an initial understanding of the key factors to consider when implementing geriatric-HIV models of care. We recommend health system planners consider mechanisms of communication and collaboration, opportunities for care provider buy-in, patient engagement and available resources. Future research should explore implementation in more diverse settings to understand the nuances that influence implementation and care delivery.
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Affiliation(s)
- Kristina Marie Kokorelias
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Anna Grosse
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alice Zhabokritsky
- Department of Medicine, The University of Toronto, Toronto, Ontario, Canada
- Infectious Diseases, Department of Medicine, University Health Network, Toronto, Ontario, Canada
- CIHR Canadian HIV Trails Network, Vancouver, British Columbia, Canada
| | - Sharon L Walmsley
- Department of Medicine, The University of Toronto, Toronto, Ontario, Canada
- Infectious Diseases, Department of Medicine, University Health Network, Toronto, Ontario, Canada
- CIHR Canadian HIV Trails Network, Vancouver, British Columbia, Canada
| | - Luxey Sirisegaram
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Sari-ol Qadam Z, Alivandi Vafa M, Hashemi T, Panah Ali A. Aging Enjoyment: A Grounded Theory Study. IRANIAN JOURNAL OF PSYCHIATRY 2024; 19:45-56. [PMID: 38420279 PMCID: PMC10896754 DOI: 10.18502/ijps.v19i1.14338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 03/02/2024]
Abstract
Objective: The aim of this study was to investigate the factors contributing to enjoyment in old age. Method : To this end, this research used a qualitative exploratory research design known as grounded-theory research. Seventeen elderly participants (aged 65-85 years), comprising 11 men and 6 women, were selected using purposive sampling. A semi-structured interview was used as the data collection instrument. The method proposed by Corbin and Strauss was employed to design the interview questions. In this study, data analysis was interpretive using phenomenological analysis, which was done through open, axial, and selective coding. Results: The results indicated that the new emergent construct - ageing enjoyment - consisted of five categories and 19 subcategories. These categories include present moment awareness, liberating past, psychosocial safety, ultimate purpose for being, and self-peace. Subcategories include: Vitality, Family solidarity and intimacy, Occupational Adequacy, Economic wisdom, Social Acceptability, Healthy society, Talent flourish, productive experiences, Physical well-being, Willingness to develop, Mindfulness, satisfaction, Moralization, Adaptability, Benevolence, Acceptance, Desire to live, Meaningfulness, Religiosity. Conclusion: These categories suggest that present moment awareness, liberating past, as well as having psychosocial safety help the elderly experience ageing enjoyment. Hence, they are likely to reach self-peace through an ultimate purpose for being as they deal with challenging life issues. Practical implications of the findings are further discussed.
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Affiliation(s)
- Zahra Sari-ol Qadam
- Department of Psychology, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | | | - Touraj Hashemi
- Department of Psychology, Tabriz University, Tabriz, Iran
| | - Amir Panah Ali
- Department of Counseling, Tabriz Branch, Islamic Azad University, Tabriz, Iran
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Er AT, Sng LH. Overcoming ageism: Ensuring quality geriatric care during radiology examinations. J Med Imaging Radiat Sci 2023; 54:S32-S37. [PMID: 37741709 DOI: 10.1016/j.jmir.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/19/2023] [Accepted: 08/31/2023] [Indexed: 09/25/2023]
Affiliation(s)
- Amanda Tw Er
- Department of Radiology, Changi General Hospital, Singapore; Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, VIC 3800, Australia.
| | - Li Hoon Sng
- Department of Radiology, Sengkang General Hospital, Singapore; Health and Social Sciences, Singapore Institute of Technology (SIT), Singapore
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Prins LAP, Gamble CJ, van Dam van Isselt EF, Stammen RAI, Ettaibi A, Creemers IAM, van Haastregt JCM. An Exploratory Study Investigating Factors Influencing the Outpatient Delivery of Geriatric Rehabilitation. J Clin Med 2023; 12:5045. [PMID: 37568449 PMCID: PMC10420316 DOI: 10.3390/jcm12155045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/12/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Outpatient delivery of geriatric rehabilitation (GR) might contribute to preserving the accessibility and quality of GR, whilst dealing with an increasing demand for healthcare in an aging population. However, the application of outpatient GR differs between GR facilities. This study aimed to gain insight into factors influencing outpatient GR utilization. METHODS In this case study, 24 semi-structured interviews were conducted with physicians, physiotherapists, nurse practitioners, occupational therapists, and managers in GR. Interviews were transcribed and analyzed using summative content analysis. RESULTS Various patient-related barriers for using outpatient GR were mentioned including lacking social support and limited capacities and self-management skills. Additionally, professional-related barriers included a lack of awareness and consensus among care professionals regarding the possibilities and potential advantages of outpatient GR. Yet, most perceived barriers were related to efficiency and organization of outpatient GR (e.g., reimbursement system, lacking practical guidance). Still, most participants were in favor of increasing outpatient GR because of expected advantages for patients, GR organizations, and society. CONCLUSIONS Despite experienced barriers, there seems to be agreement on the need to increase outpatient GR application. It is recommended to use the present findings to develop and evaluate new ways of organizing and reimbursing outpatient GR.
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Affiliation(s)
- Lidy A. P. Prins
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, 6229 ER Maastricht, The Netherlands; (L.A.P.P.); (C.J.G.)
| | - Chris J. Gamble
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, 6229 ER Maastricht, The Netherlands; (L.A.P.P.); (C.J.G.)
- Stichting Valkenhof, 5555 KL Valkenswaard, The Netherlands
| | | | - Romy A. I. Stammen
- Faculty of Health Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands; (R.A.I.S.); (A.E.); (I.A.M.C.)
| | - Ahlam Ettaibi
- Faculty of Health Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands; (R.A.I.S.); (A.E.); (I.A.M.C.)
| | - Ilse A. M. Creemers
- Faculty of Health Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands; (R.A.I.S.); (A.E.); (I.A.M.C.)
| | - Jolanda C. M. van Haastregt
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, 6229 ER Maastricht, The Netherlands; (L.A.P.P.); (C.J.G.)
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Bermudez H, Faye AS, Kochar B. Managing the older adult with inflammatory bowel disease: is age just a number? Curr Opin Gastroenterol 2023; 39:268-273. [PMID: 37265181 PMCID: PMC10275506 DOI: 10.1097/mog.0000000000000943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE OF REVIEW This review summarizes the most recent literature on older adults with inflammatory bowel diseases (IBD). Additionally, we review geriatric syndromes that may be pertinent to the management of older adults with IBD. RECENT FINDINGS Traditionally chronological age has been used to risk stratify older adults with IBD, however physiologic status, including comorbidities, frailty, and sarcopenia, are more closely associated with clinical outcomes for older adults. Delaying care for and undertreating older adults with IBD based upon advanced chronologic age alone is associated with worse outcomes, including increased mortality. Treatment decisions should be made considering physiologic status, with an understanding of the differential risks associated with both ongoing disease and treatment. As such, there is an increasing recognition of the impact geriatric syndromes have on older adults with IBD, which need to be further explored. SUMMARY Older adults with IBD are less likely to receive advanced therapies and timely surgery. They are also more likely to have adverse outcomes despite having similar disease courses to younger adults with IBD. Focusing on biological age as opposed to chronological age can shift this trajectory and improve quality of care for this growing population of patients with IBD.
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Affiliation(s)
- Helen Bermudez
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Adam S. Faye
- Division of Gastroenterology, Department of Medicine NYU Grossman School of Medicine, New York, NY
- Department of Population Health, NYU Grossman School of Medicine, New York, NY
| | - Bharati Kochar
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA
- The Mongan Institute, Boston, MA
- Harvard Medical School, Boston, MA
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Leinert C, Fotteler M, Kocar TD, Dallmeier D, Kestler HA, Wolf D, Gebhard F, Uihlein A, Steger F, Kilian R, Mueller-Stierlin AS, Michalski CW, Mihaljevic A, Bolenz C, Zengerling F, Leinert E, Schütze S, Hoffmann TK, Onder G, Andersen-Ranberg K, O’Neill D, Wehling M, Schobel J, Swoboda W, Denkinger M. Supporting SURgery with GEriatric Co-Management and AI (SURGE-Ahead): A study protocol for the development of a digital geriatrician. PLoS One 2023; 18:e0287230. [PMID: 37327245 PMCID: PMC10275448 DOI: 10.1371/journal.pone.0287230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 06/18/2023] Open
Abstract
INTRODUCTION Geriatric co-management is known to improve treatment of older adults in various clinical settings, however, widespread application of the concept is limited due to restricted resources. Digitalization may offer options to overcome these shortages by providing structured, relevant information and decision support tools for medical professionals. We present the SURGE-Ahead project (Supporting SURgery with GEriatric co-management and Artificial Intelligence) addressing this challenge. METHODS A digital application with a dashboard-style user interface will be developed, displaying 1) evidence-based recommendations for geriatric co-management and 2) artificial intelligence-enhanced suggestions for continuity of care (COC) decisions. The development and implementation of the SURGE-Ahead application (SAA) will follow the Medical research council framework for complex medical interventions. In the development phase a minimum geriatric data set (MGDS) will be defined that combines parametrized information from the hospital information system with a concise assessment battery and sensor data. Two literature reviews will be conducted to create an evidence base for co-management and COC suggestions that will be used to display guideline-compliant recommendations. Principles of machine learning will be used for further data processing and COC proposals for the postoperative course. In an observational and AI-development study, data will be collected in three surgical departments of a University Hospital (trauma surgery, general and visceral surgery, urology) for AI-training, feasibility testing of the MGDS and identification of co-management needs. Usability will be tested in a workshop with potential users. During a subsequent project phase, the SAA will be tested and evaluated in clinical routine, allowing its further improvement through an iterative process. DISCUSSION The outline offers insights into a novel and comprehensive project that combines geriatric co-management with digital support tools to improve inpatient surgical care and continuity of care of older adults. TRIAL REGISTRATION German clinical trials registry (Deutsches Register für klinische Studien, DRKS00030684), registered on 21st November 2022.
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Affiliation(s)
- Christoph Leinert
- Institute for Geriatric Research at AGAPLESION Bethesda Ulm, Ulm University Medical Center, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
| | - Marina Fotteler
- Institute for Geriatric Research at AGAPLESION Bethesda Ulm, Ulm University Medical Center, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Thomas Derya Kocar
- Institute for Geriatric Research at AGAPLESION Bethesda Ulm, Ulm University Medical Center, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
| | - Dhayana Dallmeier
- Institute for Geriatric Research at AGAPLESION Bethesda Ulm, Ulm University Medical Center, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States of America
| | - Hans A. Kestler
- Institute for Medical Systems Biology, Ulm University, Ulm, Germany
| | - Dennis Wolf
- Institute for Medical Systems Biology, Ulm University, Ulm, Germany
| | - Florian Gebhard
- Department for Orthopedic Trauma, Ulm University Medical Center, Ulm, Germany
| | - Adriane Uihlein
- Department for Orthopedic Trauma, Ulm University Medical Center, Ulm, Germany
| | - Florian Steger
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Reinhold Kilian
- Department of Psychiatry and Psychiatry II, Section of Health Economics and Health Services Research, Ulm University, Guenzburg, Germany
| | - Annabel S. Mueller-Stierlin
- Department of Psychiatry and Psychiatry II, Section of Health Economics and Health Services Research, Ulm University, Guenzburg, Germany
- Institute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | - André Mihaljevic
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
| | | | | | - Elena Leinert
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Sabine Schütze
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Thomas K. Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Hospital, Ulm, Germany
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Instituto Superiore di Sanità, Rome, Italy
| | - Karen Andersen-Ranberg
- Geriatric Research Unit, Department of Clinical Research, Faculty of Health, University of Southern Denmark, Odense, Denmark
| | - Desmond O’Neill
- Centre for Ageing, Neuroscience and the Humanities, Trinity College Dublin, Dublin, Ireland
| | - Martin Wehling
- Working Group FORTA, Faculty of Medicine Mannheim, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany
| | - Johannes Schobel
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Walter Swoboda
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Michael Denkinger
- Institute for Geriatric Research at AGAPLESION Bethesda Ulm, Ulm University Medical Center, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
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García Navarro JA. [Geriatrics can save medicine]. Rev Esp Geriatr Gerontol 2023; 58:1-2. [PMID: 36805294 DOI: 10.1016/j.regg.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 02/19/2023]
Affiliation(s)
- José Augusto García Navarro
- Presidente de la Sociedad Española de Geriatría y Gerontología, Director General del Consorcio de Salud y Social de Cataluña, Barcelona, España.
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