Prevalence and Impact of Inflammatory Bowel Disease–Irritable Bowel Syndrome on Patient-reported Outcomes in CCFA Partners

In this study, we aimed to evaluate the prevalence of IBD–IBS and investigate its impact on patient-reported outcomes. Method: We performed a cross-sectional analysis within the CCFA Partners Study. Bivariate analyses and logistic regression models were used to investigate associations between IBD–IBS and various demographic, disease factors, and patient-reported outcomes including anxiety, depression, sleep disturbances, pain interference, and social satisfaction. Results: Of the 6309 participants included, a total of 1279 (20%) reported a coexisting IBS diagnosis. The prevalence of IBD–IBS in this cohort was similar within disease subtypes. A diagnosis of IBD–IBS was associated with higher narcotic use compared with those with no IBS diagnosis for both Crohn's disease, 17% versus 11% (P
Source: Inflammatory Bowel Diseases - Category: Gastroenterology Tags: Original Clinical Article Source Type: research

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Atypical chest pain is of diverse origin. Typically, we initially consider cardiac etiology. When pain appears non-cardiac, there is a tendency to underestimate the illness, especially if the patient has neuropsychiatric illness. Our resident with dementia and anxiety disorder had chest pain; the diagnosis was unexpected.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
Chronic pain is common among older adults, as is the use of medications to treat these symptoms. Aging physiology, in combination with a higher likelihood of medication use and declining renal function, makes older adults more susceptible to adverse drug effects. As such, monitoring for side effects and changes in renal function is important to avoid drug toxicity, especially during acute illness when medication errors and acute changes in renal function are more likely to occur among older adults.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
Up to 38% of individuals with advanced dementia experience clinical depression. Although studies demonstrate lower rates of clinical depression as dementia advances, this may be attributed to the difficulty of assessment at this stage. Clinical interviews are thorough in assessing depression, though they are time- and resource-contingent. As such, healthcare providers often turn to screening tools or scales. However, conventional tools for assessing depression have problems with validity in this population.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
There has been a growing emphasis towards emotional well-being in the care of older adults. This is especially important with regards to residents in a nursing home, where they can often feel marginalized or depressed. The aim of this study is to evaluate the effectiveness of pet-therapy in improving the mood and well-being in this subset of the population.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
Many patients are discharged to post-acute care facilities (PACFs) following surgery. These patients have either had major surgery and require close monitoring and intensive rehabilitation, or have significant medical co-morbidities. Currently they are transported, sometimes at considerable cost, to the surgeon ’s office for post-surgery visits (PSVs). These trips can be painful and uncomfortable. A staff member from the PACF may need to accompany the patient. During PSVs surgeons observe the patient's incision(s), and assess potential complications following surgery, pain, and functional recovery.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
Nursing home (NH) residents are at increased risk for malnutrition compared to community-dwelling older adults. Poor nutrition is associated with depression, functional decline, and higher 1-year mortality. Communal dining environments create a social dining atmosphere that increases the amount of food being consumed.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
The geriatric population is at high risk of severe low blood glucose (LBG) events due to diminished homeostatic mechanisms, especially on hypoglycemic medications. Moderate to severe LBG events in these patients can contribute to behavior changes such as agitation, change in level of consciousness, disruption of sleep, instability and increased risk of myocardial infarction, stroke and falls. Rapid recognition and appropriate treatment and prevention of LBG and recurrences can reduce risk for hospitalization in the geriatric population.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
Parkinson ’s disease (PD) is a multifaceted condition that impacts a wide range of functions, including speech. The effect of loss of communication ability creates a cascade of effects which includes decreased participation in social events, social isolation, and potentially depression. If improvements in v oice occur, the cascade can be diverted. A physiological basis, as well as research evidence, supports use of singing to improve voice of those with PD. The implementation of a choir for those with PD has the potential to provide a socially engaging intervention, which is cost effective.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
Chronic pain is among the most common reasons for seeking medical attention. In the United States, 1 in 5 adults had chronic pain in 2016 and it is estimated to cost over $500 billion annually in direct medical costs and disability. It is a prevalent problem among residents in the nursing home. Non-pharmacologic therapies are the most preferred treatment for chronic pain as pharmacological therapies, such as opioids, have proven to be less effective and associated with numerous side effects among older adults.
Source: Journal of the American Medical Directors Association - Category: Health Management Authors: Source Type: research
This study investigated whether this risk varied across months and/or methods of suicide. METHODS: Time, date, method (eg, firearm, poisoning), and demographic information for 35,338 suicides were collected from the National Violent Death Reporting System for the years 2003-2010. Time of fatal injury was grouped into 1-hour bins and compared to the estimated hourly proportion of the population awake from the American Time Use Survey for 2003-2010. Negative binomial modeling then generated hourly incidence risk ratios (IRRs) of suicide. Risks were then aggregated into 4 categories: morning (6:00 am to 11:59 am), afterno...
Source: Journal of Clinical Psychiatry - Category: Psychiatry Tags: J Clin Psychiatry Source Type: research
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