caregivers

IMPORTANCE: Intimate partner violence (IPV) affects millions of US residents across the lifespan and is often unrecognized. Abuse of older or vulnerable adults by a caregiver or someone else they may trust is common and can result in significant injury, death, and long-term adverse health consequences.
OBJECTIVE: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for IPV, abuse of older adults, and abuse of vulnerable adults.
POPULATION: The recommendation on screening for IPV applies to adolescents and adults who are pregnant or postpartum, and women of reproductive age. The recommendation on screening in older and vulnerable adults applies to persons without recognized signs and symptoms of abuse or neglect.
EVIDENCE ASSESSMENT: The USPSTF concludes that screening for IPV in women of reproductive age, including those who are pregnant and postpartum, and providing or referring those who screen positive to multicomponent interventions has a moderate net benefit. The USPSTF concludes that the benefits and harms of screening for caregiver abuse and neglect in older or vulnerable adults are uncertain and that the balance of benefits and harms cannot be determined.
RECOMMENDATION: The USPSTF recommends that clinicians screen for IPV in women of reproductive age, including those who are pregnant and postpartum. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for caregiver abuse and neglect in older or vulnerable adults.

Author/s:

US Preventive Services Task Force Recommendation Statement, Michael Silverstein, John B Wong, Esa M Davis, David Chelmow, Tumaini Rucker Coker, Alicia Fernandez, Ericka Gibson, Carlos Roberto Jaén, Marie Krousel-Wood, Sei Lee, Wanda K Nicholson, Goutham Rao, John M Ruiz, James Stevermer, Joel Tsevat, Sandra Millon Underwood, Sarah Wiehe

Clinician's Guide to Assessing and Counseling Older Drivers, 4th Edition

Erin Blanchette — Mon, 09 Dec 2024 15:14:17 +0000

Date Added:

December 9, 2024

Publisher:

American Geriatrics Society

Pages:

1-282

URL:

Clinician's Guide to Assessing and Counseling Older Drivers, 4th Edition

Type:

Clinical Decision Aids

Format:

Web Page

Keywords

MeSH

Guidance for how to assess a person's capacity to drive safely. James W. Mold, MD, MPH

Free full text

View

The Clinician’s Guide to Assessing and Counseling Older Drivers, 4th Edition is published by the American Geriatrics Society (AGS) as a service to healthcare providers involved in the care of older adults. This 4th edition is an update of the 3rd edition to the current state of the literature, with a continued focus on the interprofessional nature of the team caring for an older adult driver. This edition is the result of a cooperative agreement between AGS and the U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA).

The Clinician’s Guide is available in two formats, a digital text accessed through your browser and a downloadable PDF.

NIAAA for Middle School

Erin Blanchette — Mon, 19 Feb 2024 16:29:17 +0000

Date Added:

February 19, 2024

Publisher:

National Institute of Health

URL:

NIAAA for Middle School

Type:

Patient Education Materials

Format:

Web Page

Keywords

MeSH

national institute on alcohol abuse and alcoholism (U.S.)

alcoholism

Parents

caregivers

Guidance for families with middle school children regarding prevention of alcohol use and abuse. James W. Mold, MD, MPH

Free full text

View

Underage drinking is a significant public health problem in the United States.

This webpage contains interactive activities to help parents, caregivers, and teachers introduce and reinforce key messages about peer pressure, resistance skills, and other important topics related to underage drinking.

These engaging activities are designed for middle schoolers ages 11 to 13. They can be used at home, in classrooms, or in after-school programs.

The content is based on a curriculum for grades 6–8 developed by the University of Michigan. The curriculum was created for the Alcohol Misuse Prevention Study (AMPS), a large-scale project supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

One goal of AMPS was to give students a clearer picture about alcohol use among their peers. Many middle schoolers tend to overestimate how much other students their age really drink. When they learn more accurate information, some of the pressure to drink can subside. Other goals of AMPS were to help students learn skills to resist pressure to drink and to give them reasons not to drink. This site incorporates AMPS goals in these and other features.

This website contains three sections focused on different aspects of alcohol, peer pressure, and resistance skills, followed by a resource list in section 4. The first three sections contain an overview, handouts, and role-playing exercises. The overviews provide background information to help you prepare to discuss alcohol and peer pressure with middle schoolers. The handouts are designed to be given to middle schoolers. The role-playing exercises are designed to be led by an adult and consist of two parts—a guide for the adult leader and a script for the middle schooler to read aloud.

Button battery ingestions in children

Bethie Seay — Tue, 28 Sep 2021 05:00:00 +0000

Date Added:

September 28, 2021

Journal/Publication:

CMAJ

Publication Date:

September 27, 2021

Issue:

Volume:

193

Pages:

E1498

Type:

Meta-analyses, Reviews, and Guidelines

DOI (1):

10.1503/cmaj.210572

MeSH

Constriction, Pathologic

caregivers

outpatients

Poisons

Electric Power Supplies

Esophageal Fistula

Abdomen

Gastrointestinal Hemorrhage

vomiting

hospitals

Eating

A concise review of button battery ingestions in children and what to do about them.

View

1. Injuries in children from ingesting button batteries are
increasing
2. The type and size of the ingested battery influence the
likelihood of complications
3. Urgency of management depends on the location of the battery
4. Honey or sucralfate should be administered after battery
ingestion
5. Children should be monitored for long-term complications

Author/s:

Zipursky, A. R., Ratnapalan, S.

Cleaning and Disinfecting Your Home

Devin Evans — Wed, 07 Apr 2021 05:00:00 +0000

Date Added:

April 7, 2021

Publisher:

Center for Disease Control and Prevention

Publication Date:

April 5, 2021

URL:

Cleaning and Disinfecting Your Home

Type:

Patient Education Materials

Format:

Web Page

Keywords

MeSH

Coronavirus Infections

Disinfection

SARS-CoV-2

Reasonable advice from the CDC regarding when and how to disinfect your home. James W. Mold, MD, MPH

Free full text

View

Cleaning with a household cleaner that contains soap or detergent reduces the amount of germs on surfaces and decreases risk of infection from surfaces. In most situations, cleaning alone removes most virus particles on surfaces. Disinfection to reduce transmission of COVID-19 at home is likely not needed unless someone in your home is sick or if someone who is positive for COVID-19 has been in your home within the last 24 hours.

Author/s:

Centers for Disease Control and Prevention (CDC)

Best Practices for COVID-19–Positive or Exposed Mothers—Breastfeeding and Pumping Milk

Brian Desmarais — Tue, 03 Nov 2020 14:12:52 +0000

Date Added:

November 3, 2020

Journal/Publication:

JAMA Pediatrics

Publication Date:

October 26, 2020

URL:

Best Practices for COVID-19–Positive or Exposed Mothers—Breastfeeding and Pumping Milk

Type:

Patient Education Materials

Format:

Web Page

MeSH

Emergency Responders

pandemics

Coronavirus Infections

severe acute respiratory syndrome coronavirus 2

Advise to breastfeeding mothers exposed to COVID-19. James W. Mold, MD, MPH

Free full text

View

Not available.

Author/s:

Sullivan, S.E., Thompson, L.A.

Effectiveness of a Mouth Care Program Provided by Nursing Home Staff vs Standard Care on Reducing Pneumonia Incidence: A Cluster Randomized Trial

Brian Desmarais — Mon, 22 Jun 2020 15:39:47 +0000

Date Added:

June 22, 2020

Journal/Publication:

JAMA Network Open

Publisher:

American Medical Association

Publication Date:

June 1, 2020

Issue:

Volume:

URL:

Effectiveness of a Mouth Care Program Provided by Nursing Home Staff vs Standard Care on Reducing Pneumonia Incidence: A Cluster Randomized Trial

Type:

Clinical Research Results

Format:

Article

DOI (1):

https://doi.org/10.1001/jamanetworkopen.2020.4321

Keywords

MeSH

The organisms responsible for pneumonia live in the mouth. Technically, nearly all pneumonias are due to aspiration. At least one RCT in Japan showed that excellent oral hygiene (by dental hygienists) in NHs can reduce the incidence of pneumonia. This study showed that enhanced oral hygiene performed by nurses reduced pneumonia episodes for the first year, and then the effect waned. James W. Mold, MD, MPH

Free full text

View

Abstract

Importance: Pneumonia affects more than 250 000 nursing home (NH) residents annually. A strategy to reduce pneumonia is to provide daily mouth care, especially to residents with dementia.

Objective: To evaluate the effectiveness of Mouth Care Without a Battle, a program that increases staff knowledge and attitudes regarding oral hygiene, changes mouth care, and improves oral hygiene, in reducing the incidence of pneumonia among NH residents.

Design, setting, and participants: This pragmatic cluster randomized trial observing 2152 NH residents for up to 2 years was conducted from September 2014 to May 2017. Data collectors were masked to study group. The study included 14 NHs from regions of North Carolina that evidenced proportionately high rehospitalization rates for pneumonia and long-term care residents. Nursing homes were pair matched and randomly assigned to intervention or control groups.

Intervention: Mouth Care Without a Battle is a standardized program that teaches that mouth care is health care, provides instruction on individualized techniques and products for mouth care, and trains caregivers to provide care to residents who are resistant and in special situations. The control condition was standard mouth care.

Main outcomes and measures: Pneumonia incidence (primary) and hospitalization and mortality (secondary), obtained from medical records.

Results: Overall, the study enrolled 2152 residents (mean [SD] age, 79.4 [12.4] years; 1281 [66.2%] women; 1180 [62.2%] white residents). Participants included 1219 residents (56.6%) in 7 intervention NHs and 933 residents (43.4%) in 7 control NHs. During the 2-year study period, the incidence rate of pneumonia per 1000 resident-days was 0.67 and 0.72 in the intervention and control NHs, respectively. Neither the primary (unadjusted) nor secondary (covariate-adjusted) analyses found a significant reduction in pneumonia due to Mouth Care Without a Battle during 2 years (unadjusted incidence rate ratio, 0.90; upper bound of 1-sided 95% CI, 1.24; P = .27; adjusted incidence rate ratio, 0.92; upper bound of 1-sided 95% CI, 1.27; P = .30). In the second year, the rate of pneumonia was nonsignificantly higher in intervention NHs. Adjusted post hoc analyses limited to the first year found a significant reduction in pneumonia incidence in intervention NHs (IRR, 0.69; upper bound of 1-sided 95% CI, 0.94; P = .03).

Conclusions and relevance: This matched-pairs cluster randomized trial of a mouth care program compared with standard care was not effective in reducing pneumonia incidence at 2 years, although reduction was found during the first year. The lack of significant results in the second year may be associated with sustainability. Improving mouth care in US NHs may require the presence and support of dedicated oral care aides.

Author/s:

Zimmerman, S., Sloane, P.D., Ward, K., Wretman, C.J., Stearns, S.C., Poole, P., Preisser, J.S.

Canadian guideline for Parkinson disease

Brian Desmarais — Mon, 03 Feb 2020 17:28:55 +0000

Date Added:

February 3, 2020

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

September 9, 2019

Issue:

Volume:

191

Pages:

E989-E1004

URL:

Canadian guideline for Parkinson disease

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.181504

MeSH

Hospice and Palliative Care Nursing

Parkinsonian Disorders

decision making

communication

Canada

Updated Canadian guidelines for management of Parkinson’s Disease. James W. Mold, MD, MPH

Free full text

View

KEY POINTS

This guideline update reflects substantial changes in the literature on diagnosis and treatment of Parkinson disease, and adds information on palliative care.
Impulse control disorders can develop in a person with Parkinson disease who is on any dopaminergic therapy at any stage in the disease course, especially for those taking dopamine agonists.
Advanced therapies like deep brain stimulation and intrajejunal levodopa-carbidopa gel infusion are now routinely used in Parkinson disease to manage motor symptoms and fluctuations.
Evidence exists to support early institution of exercise at the time of diagnosis of Parkinson disease, in addition to the clear benefit now shown in those with well-established disease.
Palliative care requirements of people with Parkinson disease should be considered throughout all phases of the disease, which includes an option of medical assistance in dying.

Author/s:

Grimes,D., Fitzpatrick, M., Gordon, J., Miyasaki, J., Fon, E.A., Schlossmacher, M., Suchowersky, O., Rajput, A., Lafontaine, A.L, Mestre, T., Appel-Cresswell, S., Kalia, S., Schoffer, K., Zurowski, M., Postuma, R.B., Udow, S., Fox, S., Barbeau, P., Hutton, B.

Parents' Guide to Childhood Immunizations

Tracy Ashby — Wed, 13 Feb 2019 06:00:00 +0000

Date Added:

February 13, 2019

Publisher:

U.S. Department of Health & Human Services

URL:

Parents' Guide to Childhood Immunizations

Type:

Patient Education Materials

Format:

Article

Keywords

MeSH

education of patients

caregivers

Information for parents about immunization effectiveness and safety from the CDC.

Free full text

View

The CDC childhood immunizations frequently asked questions.

Author/s:

Centers for Disease Control and Prevention (CDC)

Patient Education Resources Pertaining to Children

Tracy Ashby — Fri, 01 Feb 2019 06:00:00 +0000

Date Added:

February 1, 2019

Publisher:

The Hospital for Sick Children

URL:

Patient Education Resources Pertaining to Children

Type:

Patient Education Materials

Format:

Web Page

Keywords

MeSH

education of patients

child

caregivers

A good resource for patient education materials pertaining to children.

Free full text

View

AboutKidsHealth is a health education website for children, youth and their caregivers.

Pharmacotherapy for Adults With Alcohol Use Disorder (AUD) in Outpatient Settings

Tracy Ashby — Fri, 07 Dec 2018 06:00:00 +0000

Date Added:

December 7, 2018

Journal/Publication:

AHRQ Comparative Effectiveness Reviews

Publisher:

Agency for Healthcare Research and Quality

Publication Date:

February 16, 2016

URL:

Pharmacotherapy for Adults With Alcohol Use Disorder (AUD) in Outpatient Settings

Type:

Meta-analyses, Reviews, and Guidelines, Meta-analyses, Reviews, and Guidelines

Format:

Article

Keywords

alcohol use disorder

pharmacotherapy

patient care

PMID (1):

26937549

MeSH

alcoholism

caregivers

decision making

This is a summary of the current evidence on medication-assisted treatment of alcohol use disorder.

Free full text

Focus of This Summary

This is a summary of a systematic review evaluating the evidence regarding the efficacy, comparative effectiveness, and adverse effects of medications in adults with alcohol use disorder (AUD). The systematic review included 167 articles reporting on 135 eligible studies published from January 1, 1970, to October 11, 2013. This summary is provided to inform discussions with patients and/or caregivers of treatment options and to assist in decisionmaking along with consideration of a patient's values and preferences. However, reviews of evidence should not be construed to represent clinical recommendations or guidelines.

Author/s:

John M. Eisenberg Center for Clinical Decisions and Communications Science