Objectives: This article describes the implementation of the Care for Seniors model of care, an innovative approach to improving care coordination and integration, and provides preliminary evidence of effective use of specialist resources and acute care services.
Design: Retrospective.
Setting: Primary care; cross-sector.
Participants: Older adults living in a rural area in southwestern Ontario, Canada.
Measurements: Number of new geriatrician referrals and follow-up visits before and after the launch of the Care for Seniors program, number of Nurse Practitioner visits in a primary care setting, in-home, retirement home and hospital, number of discharges home from hospital and length of hospital stay between.
Results: In the 2 years before the launch of the program, the total number of visits to the geriatrician for individuals from this FHT was relatively low, 21 and 15, respectively for 2005-06 and 2006-07, increasing to 73 for the 2011-12 year. Although the absolute number of individuals supported by the NP-Geri has remained relatively the same, the numbers seen in the primary care office or in the senior's clinic has declined over time, and the number of home visits has increased, as have visits in the retirement homes. The percentage of individuals discharged home increased from 19% in 2008-09 to 31% in 2009-10 and 26% in 2011-12 and the average length of stay decreased over time.
Conclusions: This model of care represents a promising collaboration between primary care and specialist care for improving care to frail older adults living in rural communities, potentially improving timely access to health care and crisis intervention.
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http://dx.doi.org/10.1111/jgs.12982 | DOI Listing |
Obes Surg
January 2025
Division of Upper Gastrointestinal and General Surgery, Department of Surgery, Keck Medical Center of University of Southern California, Los Angeles, USA.
Background: Bariatric surgery is the most effective intervention for severe pediatric obesity, but a subset of youth experience suboptimal weight loss and/or recurrent weight gain. Early re-initiation of obesity pharmacotherapy postoperatively may improve outcomes, though this has not been evaluated in pediatric populations.
Methods: A retrospective cohort study at a tertiary care children's hospital evaluated the safety and efficacy of reintroducing obesity pharmacotherapy within six weeks after laparoscopic sleeve gastrectomy (LSG).
Clin Drug Investig
January 2025
Department of Medicine, Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Perelman School of Medicine, 423 Guardian Drive, Philadelphia, PA, 19104, USA.
Purpose: The REDUCE-IT randomized trial demonstrated a cardiovascular benefit of icosapent ethyl (IPE) but also raised potential safety signals for atrial fibrillation (AF) and serious bleeding. We aimed to evaluate the real-world safety of IPE versus mixed omega-3 polyunsaturated fatty acid (OM-3) formulations.
Methods: This retrospective active comparator new-user cohort study compared rates of new-onset AF and major bleeding (MB) among adult new users of IPE versus OM-3 in 2020-2024 US Veterans Affairs data.
J Infect Dis
January 2025
College of Mathematical Sciences, College of Science, Rochester Institute of Technology, Rochester, NY.
Introduction: We sought to explore the variability of antibody responses to multiple vaccines during early life in individual children, assess the trajectory of each child longitudinally, determine the associations of demographic variables and antibiotic exposures with vaccine-induced immunity, and link vaccine responsiveness to infection proneness.
Methods: In 357 prospectively-recruited children, age six through 36 months, antibody levels to 13 routine vaccine antigens were measured in sera at multiple time points and normalized to their respective protective thresholds to categorize children into four groups: very low, low, normal, and high vaccine responder. Demographic variables and frequency of antibiotic exposure data were collected.
Introduction: Pediatric anxiety is rapidly increasing, and in 2022, the US Preventive Services Task Force recommended universal anxiety screening using a validated tool for children 8-18 years.
Method: This evidence-based practice quality improvement initiative integrated an educational process, a validated anxiety screening tool, and a Caregiver Satisfaction Survey into all primary care wellness visits for patients aged 8-18 years.
Results: Significant increases in screening and referrals for mental healthcare were observed postinitiative implementation, especially in ages 8-11 years.
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