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EFFECTIVENESS OF PROBIOTICS IN PREVENTING ANTIBIOTIC ASSOCIATED DIARRHEA AND CLOSTRIDIUM DIFFICILE IN LONG TERM CARE
Title
EFFECTIVENESS OF PROBIOTICS IN PREVENTING ANTIBIOTIC ASSOCIATED DIARRHEA AND CLOSTRIDIUM DIFFICILE IN LONG TERM CARE.
Creator
Edwards-Marshall, Marva, Wink, Dianne, University of Central Florida
Abstract / Description
Purpose: Antibiotic associated diarrhea (AAD) and clostridium-difficile diarrhea (CDAD) are the most common forms of infectious diarrhea in long term care facilities. The purpose of this study is to determine the effectiveness of probiotics in preventing AAD and CDAD in the long term care geriatric population, and to identify interventions which can be used to improve clinical practice. Methods: This was a retrospective cohort study. The study population consisted of residents of a LTC...
Show morePurpose: Antibiotic associated diarrhea (AAD) and clostridium-difficile diarrhea (CDAD) are the most common forms of infectious diarrhea in long term care facilities. The purpose of this study is to determine the effectiveness of probiotics in preventing AAD and CDAD in the long term care geriatric population, and to identify interventions which can be used to improve clinical practice. Methods: This was a retrospective cohort study. The study population consisted of residents of a LTC facility who were sixty-five years of age and older who were administered antibiotic therapies with or without co-administration of probiotics. A data collection instrument which was created for this study was piloted prior to its use in the study. Chi-square test of independence and CochranÂÂ's Q were the proposed statistical analysis procedures used to determine relationships between variables. Results: Eighty-three residents received antibiotics. In the forty-four residents who were administered probiotic with antibiotic, five cases of diarrhea were reported. In the thirty-nine residents who received antibiotics without probiotics, two cases of diarrhea were reported. Analysis with chi-square test of independence comparing the relationship between antibiotic administration with and without probiotic and AAD prevention, was (X²(1) =1.041, p=0.308). No cases of CDAD were found in the group who received antibiotic (s) and a probiotic. One case of CDAD was found in the group which received no probiotic with the antibiotic. Analysis with chi-square test of independence comparing the relationship between antibiotic administration with or without probiotic and CDAD prevention was (X²(1) =1.142, p=0.285). Discussion/Implication: The results of this study showed no statistically significant evidence to support the effectiveness of probiotic use in the prevention of AAD or CDAD in this population. The incidence of AAD was higher in the group who received a probiotic at the time of antibiotic administration.
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Date Issued
2010
Identifier
CFE0003281, ucf:48532
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0003281
VOICE ONSET TIME PRODUCTION IN INDIVIDUALS WTH ALZHEIMER'S DISEASE
Title
VOICE ONSET TIME PRODUCTION IN INDIVIDUALS WTH ALZHEIMER'S DISEASE.
Creator
Baker, Julie Baker, Ryalls, Jack, University of Central Florida
Abstract / Description
In the present study, voice onset time (VOT) measurements were compared between a group of individuals with moderate Alzheimer's disease (AD) and a group of healthy age- and gender-matched peers. Participants read a list of consonant-vowel-consonant (CVC) words, which included the six stop consonants. Recordings were gathered and digitized. The VOT measurements were made from oscillographic displays obtained from the Brown Laboratory Interactive Speech System (BLISS) implemented on an IBM...
Show moreIn the present study, voice onset time (VOT) measurements were compared between a group of individuals with moderate Alzheimer's disease (AD) and a group of healthy age- and gender-matched peers. Participants read a list of consonant-vowel-consonant (CVC) words, which included the six stop consonants. Recordings were gathered and digitized. The VOT measurements were made from oscillographic displays obtained from the Brown Laboratory Interactive Speech System (BLISS) implemented on an IBM-compatible computer. VOT measures for the participants' six stop consonant productions were subjected to statistical analysis. The results of the study indicated that differences in VOT values were not statistically significant in the speakers with Alzheimer's disease from the normal control speakers.
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Date Issued
2006
Identifier
CFE0001269, ucf:46918
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0001269
A SYSTEMIC LITERATURE REVIEW EXPLORING THE EFFECTS OF OCCUPATIONAL THERAPY REHABILITATION AND MOTIVATION ON GERIATRIC PATIENTS
Title
A SYSTEMIC LITERATURE REVIEW EXPLORING THE EFFECTS OF OCCUPATIONAL THERAPY REHABILITATION AND MOTIVATION ON GERIATRIC PATIENTS.
Creator
Buckman, Melissa A, Biddle, Jeffrey, University of Central Florida
Abstract / Description
The purpose of this thesis was to examine the effects of occupational therapy rehabilitation on geriatric patients by reviewing studies conducted on motivation in occupational therapy. In occupational therapy it is important that you set goals for your patients (Creek & Lougher, 2008). It is also important to understand what motivates a patient to achieve those goals because goals and valued activities are intimately connected to motivation. Motivation deals with why we perform certain...
Show moreThe purpose of this thesis was to examine the effects of occupational therapy rehabilitation on geriatric patients by reviewing studies conducted on motivation in occupational therapy. In occupational therapy it is important that you set goals for your patients (Creek & Lougher, 2008). It is also important to understand what motivates a patient to achieve those goals because goals and valued activities are intimately connected to motivation. Motivation deals with why we perform certain behaviors. It can predict physical performance and how well a person might recover from an illness and has been suggested to be predictive for rehabilitation success (Carlson, 1997). Because the geriatric population has more longevity, it is important to ensure that they receive the appropriate care necessary to improve and maintain their quality of life (Mason, 1994). After reviewing multiple studies the results reinforced the importance of motivation in occupational therapy treatment. Self-efficacy was found to highly influence a person�s motivation and was a recurring theme throughout this review (Peralta-Catipon & Hwang, 2011). One key to understanding and studying motivation in older adults was to identify what occupations matter to them (Teitelman, Raber, & Watts, 2010). It is important that occupational therapists understand how occupations become meaningful for the geriatric population as participation in those occupations plays an important role in promoting productive aging. When the occupational therapist was able to understand how occupations became meaningful to the patient, they were more equipped to help motivate the patient to participate in their rehabilitation (Janssen & Stube, 2013).
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Date Issued
2016
Identifier
CFH2000007, ucf:45575
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFH2000007
COHORT STUDY OF PAIN BEHAVIORS IN THE ELDERLY RESIDING IN SKILLED NURSING CARE
Title
COHORT STUDY OF PAIN BEHAVIORS IN THE ELDERLY RESIDING IN SKILLED NURSING CARE.
Creator
Burfield, Allison, Sole, Mary Lou, University of Central Florida
Abstract / Description
An integral concern across care settings is the prompt intervention for patients suffering with pain. Long-term care (LTC) settings present with unique challenges to assess and manage pain in resident populations. Pain assessment is especially challenging, because residents have varying degrees of cognition to communicate their pain, and clinician/staff knowledge of pain symptoms may be lacking. The purpose of this research was to improve the measurement of pain and outcomes of care for the...
Show moreAn integral concern across care settings is the prompt intervention for patients suffering with pain. Long-term care (LTC) settings present with unique challenges to assess and manage pain in resident populations. Pain assessment is especially challenging, because residents have varying degrees of cognition to communicate their pain, and clinician/staff knowledge of pain symptoms may be lacking. The purpose of this research was to improve the measurement of pain and outcomes of care for the elderly residing in skilled nursing care, especially those with cognitive-impairment. The specific aims of this study were to: 1) Determine the magnitude of the relationship between pain behaviors and a measurement model hypothesized for pain; 2) Test the construct validity of a pain measurement model; 3) Examine the concomitance of pain and cognition in a three-year longitudinal analysis. The research questions answered: 1) Is there a difference in the prevalence of pain in cognitively intact versus cognitively-impaired residents; 2) Can a theoretically derived model of pain aid in detecting pain across all cognitive levels; and 3) Do pain and cognitive status concomitantly correlate? The goal was to examine the covariance model of concomitance of pain and cognition to more accurately construct theoretical models of pain to then include additional resident care factors in future research. Traditional self-reports of pain are often under-assessed and under-treated in the cognitively-impaired (CI) elderly resident. Having additional measures to detect pain beyond self-reports of pain intensity and frequency increases the likelihood of detecting pain in populations with complex symptom presentation. Data collected from skilled nursing facilities offer exceptional opportunities to study resident demographics, characteristics, symptoms, medication use, quality indicators, and care outcomes. The Minimum Data Set-Resident Assessment Instrument (MDS-RAI) 2.0, a nationally required resident assessment tool, must be completed on every resident in a Medicare LTC facility within 14 days of admission, quarterly, annually and with significant changes in resident status. Because the MDS is widely used and recognized in LTC settings, core items from MDS [i.e., pain frequency (J2a) and pain intensity (J2b)] along with additional MDS items hypothesized to signify pain were analyzed in the pilot measurement model. Ten core items from MDS were used: 1) Inappropriate behavior frequency (E4da); 2) Repetitive physical movements; 3) Repetitive verbalizations (E1c); 4) Sad facial expressions (E1l); 5) Crying (E1m); 6) Change in mood (E3); 7) Negative statements (E1a); 8) Pain frequency (J2a); 9) Pain intensity (J2b); and 10) Cumulative pain sites scores. All indicators of pain were significant at the p<.01 level. A longitudinal cohort design was used to answer if a concomitance exists between pain and cognition. Data were collected from MDS annual assessments from 2001, 2002 and 2003 for residents across the United States. The sample consisted of 56,494 residents age 65 years and older with an average age of 83 ±8.2 years. Descriptive statistics, ANOVA and a covariance model were used to evaluate cognition and pain at the three time intervals. ANOVA indicated a significant effect (p<.01) for pain and cognition with protected t-tests indicating scores decreased significantly over time with resident measures of pain and cognition. Results from this study suggest that: 1) Using only pain intensity and frequency, pain prevalence was found in 30% of the pilot population, while 47.7% of cognitively intact residents had documented pain and only 18.2% of the severely CI had documented pain, supporting previous research that pain is potentially under-reported in the CI; 2) Parsimonious measurements models of pain should include dimensions beyond self-reports of pain (i.e., cognitive, affective, behavioral and inferred pain indicators); 3) Model fit was improved by using specific MDS items in the pain construct; 4) Longitudinal analysis revealed relative stability for pain and cognition measures over time (e.g., larger stability or consistency was found in cognitive measures than the measures of pain over the three-year period); 5) Crossed-legged effects between pain and cognition were not consistent; 6) A concomitant relationship was not found between pain and cognition. The relationship was significant (p<.01), but associations were weak (r=0.03 to 0. 08). Pain or cognition should not be used as a predictor of the other in theoretical models for similar populations. The MDS is a reliable instrument to follow resident attributes, quality of care, and patient outcomes over time. The development of more accurate assessments of pain may improve resident care outcomes. Ineffectively intervening on the pain cycle is posited to cause secondary unmet needs that affect the resident's quality of life. Findings support the importance of improving clinical outcomes in the management of pain in the elderly residing in long-term care. Deficits in the treatment of pain highlight the impetus to support health policy change that includes pain treatment as a top health priority and a quality indicator for federally funded programs supporting eldercare.
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Date Issued
2009
Identifier
CFE0002533, ucf:47660
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0002533
PERCEPTIONS OF SENIOR CITIZENS IN CENTRAL FLORIDA REGARDING QUALITY OF CARE UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA)
Title
PERCEPTIONS OF SENIOR CITIZENS IN CENTRAL FLORIDA REGARDING QUALITY OF CARE UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA).
Creator
Nieves , Rafael, Sumner, Jennifer, University of Central Florida
Abstract / Description
On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. This reform, it is argued, is projected to increase insurance coverage of pre-existing conditions, to expand access to insurance for more than 30 million Americans, and to increase estimated National medical spending while lowering projected Medicare spending. This thesis sought to investigate and analyze the perceptions of senior citizens in Central Florida about PPACA and their...
Show moreOn March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. This reform, it is argued, is projected to increase insurance coverage of pre-existing conditions, to expand access to insurance for more than 30 million Americans, and to increase estimated National medical spending while lowering projected Medicare spending. This thesis sought to investigate and analyze the perceptions of senior citizens in Central Florida about PPACA and their perceived effects on the healthcare quality provided to them under this law. Four sections of PPACA bill, thought to specifically pertain to the elderly, were selected for this study; respondents were asked their opinions regarding PPACA's aspects of: (1) the reform on preventive healthcare services; (2) Medicare Part D [prescription drugs]; (3) Medicare; and (4) Medicaid. This thesis employed both qualitative and quantitative methodologies; data were collected and analyzed with findings presented and discussed.
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Date Issued
2013
Identifier
CFH0004468, ucf:45112
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFH0004468