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  • 1
    Language: English
    In: Injury, December 2013, Vol.44(12), pp.1838-1842
    Description: There is a paucity of research into the outcomes and complications of cervical spine immobilisation (hard collar or halothoracic brace) in older people. To identify morbidity and mortality outcomes using geriatric medicine assessment techniques following cervical immobilisation in older people with isolated cervical spine fractures. We identified participants using an injury database. We completed a questionnaire measuring pre-admission medical co-morbidities and functional independence. We recorded the surgical plan and all complications. A further questionnaire was completed three months later recording complications and functional independence. Sixteen patients were recruited over a three month period. Eight were immobilised with halothoracic brace, 8 with external hard collar. Three deaths occurred during the study. Lower respiratory tract infection was the most common complication (7/16) followed by delirium (6/16). Most patients were unable to return home following the acute admission, requiring sub-acute care on discharge. The majority of patients were from home prior to a fall, 6/16 were residing there at 3 months. Most participants had an increase in their care needs at 3 months. There was no difference in the type or incidence of complications between the different modes of immobilisation. Geriatric medicine assessment techniques identified the morbidity and functional impairment associated with cervical spine immobilisation. This often results in a prolonged length of stay in supported care. This small pilot study recommends a larger study over a longer period using geriatric medicine assessment techniques to better define the issues.
    Keywords: Cervical Spine Fracture ; Older Adults
    ISSN: 0020-1383
    E-ISSN: 1879-0267
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  • 2
    In: Journal of the American Geriatrics Society, October 1995, Vol.43(10), pp.1088-1091
    Description: To determine whether patients with dementia have reduced bone mass, altered vitamin D, or parathyroid hormone status. Survey. University hospital outpatient department. Twenty women with DSM‐III‐R mild dementia living in the community were compared with 40 cognitively normal community‐dwelling women, matched for age, who had been recruited as part of studies in elderly twins. Bone density at the lumbar spine and neck of femur by dual‐energy X‐ray absorptiometry, intact serum PTH, and 25‐hydroxyvitamin D levels. There was no significant difference in bone density between the subjects with mild dementia and the age‐ and sex‐matched controls. The intact PTH (mean ± SD) in the demented subjects was 4.9 ± 2.1 pmol/L compared with 2.9 ± 1.7 pmol/L in the twin controls ( 〈 .01). The mean 25‐hydroxyvitamin D in the demented subjects was 61 ± 33 nmol/L, whereas it was 90 ± 38 nmol/L in the twin controls ( 〈 .01). We conclude that there were no significant differences in the bone density of community‐dwelling women with mild dementia compared with normals. However, there were significant differences in parathyroid hormone and vitamin D levels between the two groups, suggesting that there is a high prevalence of subclinical hypovitaminosis D in demented women in the community.
    Keywords: Bone Density ; Dementia -- Complications ; Hydroxycholecalciferols -- Blood ; Osteoporosis, Postmenopausal -- Etiology ; Parathyroid Hormone -- Blood;
    ISSN: 0002-8614
    E-ISSN: 1532-5415
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  • 3
    Language: English
    In: Journal of Alzheimer's disease : JAD, 2018, Vol.62(2), pp.867-876
    Description: Clinical practice guidelines for dementia highlight the importance of providing patient-centered care. This can be achieved by improving health professionals' attitudes and knowledge toward people with dementia. Quantitatively evaluate the impact of a virtual dementia experience on medical and pharmacy students' knowledge and attitudes toward people with dementia. A non-randomized controlled study from September-October 2016. The intervention group received a 1.5-hour multisensory, virtual simulation of light, sound, color, and visual content to experience the cognitive and perceptual difficulties faced by people with dementia. Controls participated in the standard curriculum only. All students were invited to complete the 20-item Dementia Attitudes Scale (DAS) pre- and post-intervention. A total of 278 students (n = 64 medical, n = 214 pharmacy) were analyzed (n = 80 intervention, n = 198 control). The majority of students were female (n = 184, 66.2%), with an average age of 22.5 years. The intervention improved the DAS total score and subdomains of comfort and knowledge (p 〈 0.001). The intervention had a positive impact on medical and pharmacy students' knowledge and attitudes toward people with dementia.
    Keywords: Alzheimer’s Disease ; Dementia ; Education ; Medicine ; Pharmacy
    ISSN: 13872877
    E-ISSN: 1875-8908
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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  • 4
    Language: English
    In: Dementia (London, England), 01 January 2018, pp.1471301218770270
    Description: Objectives It is important for healthcare professional students to understand the experience of people with dementia, their family, and their carers. Despite person-centred educational policies, current curriculums may not adequately prepare students to meet the needs of people with dementia. This study qualitatively evaluated the impact of a virtual dementia experience on medical and pharmacy students' self-reported knowledge and attitudes towards people with dementia. Methods Ten focus groups were conducted with 29 medical and 24 pharmacy students in September and October 2016. All students had undertaken a multisensory virtual dementia experience designed to simulate the cognitive and perceptual difficulties faced by people with dementia. Focus groups were used to evaluate the virtual dementia experience in terms of perceived usefulness, suggestions for improvement, and ability to inform students' understanding of dementia-friendly environments. Focus groups were audio-recorded and analysed via a thematic approach. Results The virtual dementia experience was described as useful and impactful, and students suggested how it could be more tailored towards their learning needs, such as via incorporating hospital, medical, and pharmacy-specific scenarios and opportunities for role play. Additionally, students explained how dementia-friendly communication techniques could be used in their future practice and provided strategies to optimise dementia-friendly characteristics of current work environments. Conclusion A virtual dementia experience improved student self-reported knowledge and attitudes towards people with dementia.
    Keywords: Alzheimer’s Disease ; Dementia ; Education ; Medicine ; Pharmacy
    ISSN: 14713012
    E-ISSN: 1741-2684
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  • 5
    Language: English
    In: BMJ Open, 24 May 2019, Vol.9(5)
    Description: The formative aspect of the mini-clinical evaluation exercise (mini-CEX) in postgraduate medical workplace-based assessment is intended to afford opportunities for active learning. Yet, there is little understanding of the perceived relationship between the mini-CEX and how trainees self-regulate their learning. Our objective was to explore trainees’ perceptions of their mini-CEX experiences from a learning perspective, using Zimmerman’s self-regulated learning theoretical framework as an interpretive lens.
    Keywords: Workplace Based Assessment ; Geriatric Medicine ; Mini-Cex
    ISSN: 2044-6055
    ISSN: 20446055
    E-ISSN: 2044-6055
    E-ISSN: 20446055
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  • 6
    Language: English
    In: ANZ journal of surgery, July 2006, Vol.76(7), pp.607-11
    Description: Level 3 evidence-based guidelines recommend first walk after hip fracture surgery within 48 h. Early mobilization is resource and effort intensive and needs rigorous investigation to justify implementation. This study uses a prospective randomized method to investigate the effect of early ambulation (EA) after hip fracture surgery on patient and hospital outcomes. Sixty patients (41 women and 19 men; mean age 79.4 years) admitted between March 2004 through December 2004 to The Alfred Hospital, Melbourne, for surgical management of a hip fracture were studied. Randomization was either EA (first walk postoperative day 1 or 2) or delayed ambulation (DA) (first walk postoperative day 3 or 4). Functional levels on day 7 post-surgery, acute hospital length of stay and destination at discharge were compared. At 1 week post-surgery, patients in the EA group walked further than those in the DA group (P = 0.03) and required less assistance to transfer (P = 0.009) and negotiate a step (P = 0.23). Patients in the EA group were more likely to be discharged directly home from the acute care than those in the DA group (26.3 compared with 2.4%) and less likely to need high-level care (36.8 compared with 56%). A failed early ambulation subgroup had significantly more postoperative cardiovascular instability and worse results for all outcome measures. EA after hip fracture surgery accelerates functional recovery and is associated with more discharges directly home and less to high-level care.
    Keywords: Physical Therapy Modalities ; Hip Fractures -- Rehabilitation ; Hip Joint -- Physiopathology ; Orthopedic Procedures -- Methods ; Recovery of Function -- Physiology ; Walking -- Physiology
    ISSN: 1445-1433
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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  • 7
    In: ANZ Journal of Surgery, July 2006, Vol.76(7), pp.607-611
    Description: Level 3 evidence‐based guidelines recommend first walk after hip fracture surgery within 48 h. Early mobilization is resource and effort intensive and needs rigorous investigation to justify implementation. This study uses a prospective randomized method to investigate the effect of early ambulation (EA) after hip fracture surgery on patient and hospital outcomes. Sixty patients (41 women and 19 men; mean age 79.4 years) admitted between March 2004 through December 2004 to The Alfred Hospital, Melbourne, for surgical management of a hip fracture were studied. Randomization was either EA (first walk postoperative day 1 or 2) or delayed ambulation (DA) (first walk postoperative day 3 or 4). Functional levels on day 7 post‐surgery, acute hospital length of stay and destination at discharge were compared. At 1 week post‐surgery, patients in the EA group walked further than those in the DA group ( = 0.03) and required less assistance to transfer ( = 0.009) and negotiate a step ( = 0.23). Patients in the EA group were more likely to be discharged directly home from the acute care than those in the DA group (26.3 compared with 2.4%) and less likely to need high‐level care (36.8 compared with 56%). A failed early ambulation subgroup had significantly more postoperative cardiovascular instability and worse results for all outcome measures. EA after hip fracture surgery accelerates functional recovery and is associated with more discharges directly home and less to high‐level care.
    Keywords: Early Ambulation ; Hip Fracture ; Recovery Outcome
    ISSN: 1445-1433
    E-ISSN: 1445-2197
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