Risk factors for inpatient facility admission among home health care patients with diabetes

BACKGROUND

Home health care (HHC) patients with diabetes are at high risk for inpatient admissions.

PURPOSE

To identify variables associated with inpatient admissions among adults age ≥50 with diabetes receiving HHC in the community and in assisted living (AL).

METHODS

Retrospective HHC data (collected October 2021 to March 2022 in the Southern United States) from the Outcome and Assessment Information Set D were analyzed with logistic regression (n = 5,308 patients).

DISCUSSION

The inpatient admission rate was 29.5%. For community-dwelling patients, multiple hospitalizations, depression, limited cognitive function, decreased activities of daily living (ADL) performance, and unhealed pressure ulcer or injury ≥stage 2 were significantly associated with inpatient admission. For those in AL, multiple prior hospitalizations and decreased ability to perform ADLs were associated with inpatient admission.

CONCLUSION

Understanding risk factors for inpatient admissions among patients with diabetes can support the identification of at-risk patients and inform interventions.

Effect of ethanol on the excitability of the inferior olive in decerebrate ferret

Climbing fibers, which originate in the inferior olive and project to Purkinje cells and Golgi cells in the cerebral cortex, were activated at low (0.4-Hz) and high (4-Hz) frequencies by periorbital stimulation in decerebrate ferrets. Climbing fiber responses were recorded as field potentials from the c3 zone of the cerebellar surface. When periorbital stimulation was applied at high frequency, the climbing fiber responses became strongly depressed within a few seconds. It has previously been shown that this high frequency depression (HFD) of climbing fiber responses is due to a cerebellar inhibition of the inferior olive, probably via the nucleo-olivary pathway. Acute administration of ethanol had small and variable effects on the amplitude of climbing fiber responses evoked by low-frequency stimulation. In contrast, medium concentrations (0.44-2.90 g/l) of ethanol led to a marked reduction of the HFD. Low ( < 0.44 g/l) systemic concentrations had no measurable effects on the HFD, whereas high concentrations ( > 2.90 g/l) caused either an increased HFD or a nonseptic reduction in olivary excitability. Because HFD has previously been shown to involve cerebello-olivary inhibition, the possibility of an interaction between ethanol and GABA-ergic responses in the interposito-olivary pathway is discussed.

Why doctors and nurses must not kill patients

Euthanasia continues to be a subject of lively interest to many groups in society. It is often discussed in terms which appeal to those who believe there is no other way to relieve the sufferings of the dying, but which fail to explore its important ethical, professional and legal aspects. When these are examined, it is seen that the legalization of euthanasia would create major problems in medicine and nursing, chiefly centred on the likelihood of abuse and the difficulty or impossibility of its detection. It is now known from official sources that in Holland, the only place where euthanasia is widely practised though in defiance of the law, the authorities have no control over it, and it is indeed associated with many abuses, including the frequent killing of persons without their consent.

Teaching employees breast self examination. Factors that may influence practice

Breast self examination is a widely known technique used for detection of breast lumps. Many women do not practice monthly breast self examination, although it has been proven that with early detection the prognosis of breast cancer can be improved greatly. When tend to be taught, or learn about, breast self examination at an early age. The educational techniques used during the instruction can influence the practice of BSE later on. Health professionals can make a difference in the practice of BSE by communicating the value of this detection technique. BSE is a viable breast cancer detection technique that employees can be taught easily in employee wellness programs by health professionals.