scholarly journals Usefulness of the self‐reported Dementia Assessment Sheet for Community‐based Integrated Care System‐21 items (DASC‐21) in the community‐dwelling elderly

2020 ◽  
Vol 16 (S10) ◽  
Author(s):  
Rei Ono ◽  
Kazuaki Uchida ◽  
Rika Kawaharada ◽  
Yoshiaki Kido ◽  
Hisafumi Yasuda ◽  
...  
Keyword(s):  
Integrated Care ◽  
Community Dwelling ◽  
The Self ◽  
Community Based ◽  
Assessment Sheet ◽  
Care System

Development of the dementia assessment sheet for community-based integrated care system

2016 ◽  
Vol 16 ◽  
pp. 123-131 ◽  
Author(s):  
Shuichi Awata ◽  
Mika Sugiyama ◽  
Kae Ito ◽  
Chiaki Ura ◽  
Fumiko Miyamae ◽  
...  
Keyword(s):  
Integrated Care ◽  
Community Based ◽  
Assessment Sheet ◽  
Care System

scholarly journals Comparative Effects of Etelcalcetide and Maxacalcitol on Serum Calcification Propensity in Secondary Hyperparathyroidism

2021 ◽  
Vol 16 (4) ◽  
pp. 599-612
Author(s):  
Tetsuo Shoji ◽  
Shinya Nakatani ◽  
Daijiro Kabata ◽  
Katsuhito Mori ◽  
Ayumi Shintani ◽  
...  
Keyword(s):  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Integrated Care ◽  
Vitamin D Receptor ◽  
Handgrip Strength ◽  
Interquartile Range ◽  
Community Based ◽  
Link Type ◽  
Assessment Sheet ◽  
Care System

Background and objectivesVitamin D receptor activators and calcimimetics (calcium-sensing receptor agonists) are two major options for medical treatment of secondary hyperparathyroidism. A higher serum calcification propensity (a shorter T50 value) is a novel surrogate marker of calcification stress and mortality in patients with CKD. We tested a hypothesis that a calcimimetic agent etelcalcetide is more effective in increasing T50 value than a vitamin D receptor activator maxacalcitol.Design, setting, participants, & measurementsA randomized, multicenter, open-label, blinded end point trial with active control was conducted in patients with secondary hyperparathyroidism undergoing hemodialysis in Japan. Patients were randomly assigned to receive intravenous etelcalcetide 5 mg thrice weekly (etelcalcetide group) or intravenous maxacalcitol 5 or 10 µg thrice weekly (maxacalcitol group). The primary, secondary, and tertiary outcomes were changes in T50 value, handgrip strength, and score of the Dementia Assessment Sheet for Community-Based Integrated Care System from baseline to 12 months, respectively.ResultsIn total, 425 patients from 23 dialysis centers were screened for eligibility, 326 patients were randomized (etelcalcetide, n=167; control, n=159), and 321 were included in the intention-to-treat analysis (median age, 66 years; 113 women [35%]). The median (interquartile range) of T50 value was changed from 116 minutes (interquartile range, 90–151) to 131 minutes (interquartile range, 102–176) in the maxacalcitol group, whereas it was changed from 123 minutes (interquartile range, 98–174) to 166 minutes (interquartile range, 127–218) in the etelcalcetide group. The increase in T50 value was significantly greater in the etelcalcetide group (difference in change, 20 minutes; 95% confidence interval, 7 to 34 minutes; P=0.004). No significant between-group difference was found in the change in handgrip strength or in the Dementia Assessment Sheet for Community-Based Integrated Care System score.ConclusionsEtelcalcetide was more effective in increasing T50 value than maxacalcitol among patients on hemodialysis with secondary hyperparathyroidism. There was no difference in handgrip strength or cognition between the two drugs.Clinical Trial registry name and registration number:VICTORY; UMIN000030636 and jRCTs051180156

Models of home care services for persons with dementia: a narrative review

2015 ◽  
Vol 27 (10) ◽  
pp. 1593-1600 ◽  
Author(s):  
Lee-Fay Low ◽  
Jennifer Fletcher
Keyword(s):  
Case Management ◽  
Home Care ◽  
Integrated Care ◽  
Community Dwelling ◽  
Narrative Review ◽  
Nursing Home Admission ◽  
Community Based ◽  
People With Dementia ◽  
The Impact ◽  
Community Based Services

ABSTRACTBackground:Worldwide trends of increasing dementia prevalence, have put economic and workforce pressures to shifting care for persons with dementia from residential care to home care.Methods:We reviewed the effects of the four dominant models of home care delivery on outcomes for community-dwelling persons with dementia. These models are: case management, integrated care, consumer directed care, and restorative care. This narrative review describes benefits and possible drawbacks for persons with dementia outcomes and elements that comprise successful programs.Results:Case management for persons with dementia may increase use of community-based services and delay nursing home admission. Integrated care is associated with greater client satisfaction, increased use of community based services, and reduced hospital days however the clinical impacts on persons with dementia and their carers are not known. Consumer directed care increases satisfaction with care and service usage, but had little effect on clinical outcomes. Restorative models of home care have been shown to improve function and quality of life however these trials have excluded persons with dementia, with the exception of a pilot study.Conclusions:There has been a little research into models of home care for people with dementia, and no head-to-head comparison of the different models. Research to inform evidence-based policy and service delivery for people with dementia needs to evaluate both the impact of different models on outcomes, and investigate how to best deliver these models to maximize outcomes.

Geography over doctrine? Factors affecting the role of Buddhist priests in a community‐based integrated care system

2021 ◽  
Author(s):  
Yukan Ogawa ◽  
Akinori Takase ◽  
Masaya Shimmei ◽  
Chiaki Ura ◽  
Machiko Nakagawa ◽  
...  
Keyword(s):  
Integrated Care ◽  
Community Based ◽  
Factors Affecting ◽  
Care System
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