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Jeri A Logemann - One of the best experts on this subject based on the ideXlab platform.
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comparison of 2 interventions for Liquid Aspiration on pneumonia incidence
Annals of Internal Medicine, 2008Co-Authors: Joanne Robbins, Diane Brandt, Jacqueline A Hind, Anne S Lindblad, Gary Gensler, David Lilienfeld, Jeri A Logemann, Herbert M Baum, Steven Kosek, Donna S LundyAbstract:To test strategies for avoiding Aspiration pneumonia in cognitively impaired elderly patients, Robbins and colleagues randomly assigned 515 patients age 50 years or older with dementia or Parkinson...
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comparison of 2 interventions for Liquid Aspiration on pneumonia incidence a randomized trial
Annals of Internal Medicine, 2008Co-Authors: Joanne Robbins, Diane Brandt, Jacqueline A Hind, Anne S Lindblad, Gary Gensler, David Lilienfeld, Jeri A Logemann, Herbert M Baum, Steven Kosek, Donna S LundyAbstract:Swallowing disorders are associated with increased morbidity and mortality. An estimated 18 million adults will require care for dysphagia-related malnutrition, dehydration, pneumonia, and reductions in quality of life by 2010 (1-3). Patients with dysphasia have an increased incidence of Aspiration pneumonia because the aspirated material is heavily colonized with bacteria. Pneumonia is the most common cause of infectious death in the United States among persons age 65 years or older and the third leading cause of death for persons age 85 years or older (4). One hospital admission for pneumonia is estimated to cost $7166 (5). Rates of hospital discharge for Medicare beneficiaries with pneumonia as a primary diagnosis have increased by 93.5% in the past decade (6), along with length of stay and death rates (4). Liquid Aspiration is the most common type of Aspiration in elderly persons (1). Relative risk for pneumonia is highest in patients with dementia, followed by those who are institutionalized (7). As many as 50% of patients with parkinsonism are estimated to have dysphagia (8), and one third aspirate silently---that is, with no external sign (such as coughing) to eject material or alert caregivers (9). Many short- and long-term care facilities use thickened Liquid diets to treat of Aspiration (10). In these diets, thin Liquids (for example, water, tea, coffee) are eliminated, even in the absence of efficacy data, at a substantial cost in financial and quality-of-life terms. It costs approximately $200 per month for an individual to drink thickened Liquids (11,12). A common alternative to thickened Liquids is use of a chin-down posture (13-17). Welch and coworkers (13) noted that posterior shift of anterior pharyngeal structures with the chin-down posture improved airway protection. Whereas previous studies have provided a basis for the widespread clinical use of chin-down posture, none has provided long-term health outcome data. Results from a previously reported portion of this study demonstrated short-term elimination of Aspiration during the videofluorographic swallowing evaluation most often with honey-thick Liquids, followed by nectar-thick Liquids, and finally chin-down position (18). We sought to compare the effectiveness of chin-down posture and thickened Liquids (nectar thick and honey thick) on the incidence of pneumonia in participants with dementia or Parkinson disease during 3 months of treatment.
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challenges in the design and conduct of a randomized study of two interventions for Liquid Aspiration
Clinical Trials, 2006Co-Authors: Diane Brandt, Jacqueline A Hind, Joanne Robbins, Anne S Lindblad, Gary Gensler, Gary Gill, Herb Baum, David Lilienfeld, Jeri A LogemannAbstract:Background Liquid Aspiration during swallowing has been linked to pneumonia, the most common cause of infectious death in the elderly. This paper examines the key issues in the design and implementation of the first multisite, randomized behavioral trial in dysphagia in an aging population. The study evaluated two commonly used treatments with respect to short-term and long-term management of Liquid Aspiration and subsequent pneumonia in dysphagic geriatric participants with dementia and/or Parkinson's disease.Methods Discussed are lessons learned during the conduct of this trial and include (1) ethical and methodological design issues, (2) pragmatic implementation of procedures and forms, (3) importance of multiple communication and monitoring strategies, (4) response to funding issues, and (5) changes in staff and facilities.Results In order to complete this trial the researchers were required to provide more support than anticipated in tasks such as completion of regulatory requirements by sites, suppl...
Joanne Robbins - One of the best experts on this subject based on the ideXlab platform.
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comparison of 2 interventions for Liquid Aspiration on pneumonia incidence
Annals of Internal Medicine, 2008Co-Authors: Joanne Robbins, Diane Brandt, Jacqueline A Hind, Anne S Lindblad, Gary Gensler, David Lilienfeld, Jeri A Logemann, Herbert M Baum, Steven Kosek, Donna S LundyAbstract:To test strategies for avoiding Aspiration pneumonia in cognitively impaired elderly patients, Robbins and colleagues randomly assigned 515 patients age 50 years or older with dementia or Parkinson...
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comparison of 2 interventions for Liquid Aspiration on pneumonia incidence a randomized trial
Annals of Internal Medicine, 2008Co-Authors: Joanne Robbins, Diane Brandt, Jacqueline A Hind, Anne S Lindblad, Gary Gensler, David Lilienfeld, Jeri A Logemann, Herbert M Baum, Steven Kosek, Donna S LundyAbstract:Swallowing disorders are associated with increased morbidity and mortality. An estimated 18 million adults will require care for dysphagia-related malnutrition, dehydration, pneumonia, and reductions in quality of life by 2010 (1-3). Patients with dysphasia have an increased incidence of Aspiration pneumonia because the aspirated material is heavily colonized with bacteria. Pneumonia is the most common cause of infectious death in the United States among persons age 65 years or older and the third leading cause of death for persons age 85 years or older (4). One hospital admission for pneumonia is estimated to cost $7166 (5). Rates of hospital discharge for Medicare beneficiaries with pneumonia as a primary diagnosis have increased by 93.5% in the past decade (6), along with length of stay and death rates (4). Liquid Aspiration is the most common type of Aspiration in elderly persons (1). Relative risk for pneumonia is highest in patients with dementia, followed by those who are institutionalized (7). As many as 50% of patients with parkinsonism are estimated to have dysphagia (8), and one third aspirate silently---that is, with no external sign (such as coughing) to eject material or alert caregivers (9). Many short- and long-term care facilities use thickened Liquid diets to treat of Aspiration (10). In these diets, thin Liquids (for example, water, tea, coffee) are eliminated, even in the absence of efficacy data, at a substantial cost in financial and quality-of-life terms. It costs approximately $200 per month for an individual to drink thickened Liquids (11,12). A common alternative to thickened Liquids is use of a chin-down posture (13-17). Welch and coworkers (13) noted that posterior shift of anterior pharyngeal structures with the chin-down posture improved airway protection. Whereas previous studies have provided a basis for the widespread clinical use of chin-down posture, none has provided long-term health outcome data. Results from a previously reported portion of this study demonstrated short-term elimination of Aspiration during the videofluorographic swallowing evaluation most often with honey-thick Liquids, followed by nectar-thick Liquids, and finally chin-down position (18). We sought to compare the effectiveness of chin-down posture and thickened Liquids (nectar thick and honey thick) on the incidence of pneumonia in participants with dementia or Parkinson disease during 3 months of treatment.
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challenges in the design and conduct of a randomized study of two interventions for Liquid Aspiration
Clinical Trials, 2006Co-Authors: Diane Brandt, Jacqueline A Hind, Joanne Robbins, Anne S Lindblad, Gary Gensler, Gary Gill, Herb Baum, David Lilienfeld, Jeri A LogemannAbstract:Background Liquid Aspiration during swallowing has been linked to pneumonia, the most common cause of infectious death in the elderly. This paper examines the key issues in the design and implementation of the first multisite, randomized behavioral trial in dysphagia in an aging population. The study evaluated two commonly used treatments with respect to short-term and long-term management of Liquid Aspiration and subsequent pneumonia in dysphagic geriatric participants with dementia and/or Parkinson's disease.Methods Discussed are lessons learned during the conduct of this trial and include (1) ethical and methodological design issues, (2) pragmatic implementation of procedures and forms, (3) importance of multiple communication and monitoring strategies, (4) response to funding issues, and (5) changes in staff and facilities.Results In order to complete this trial the researchers were required to provide more support than anticipated in tasks such as completion of regulatory requirements by sites, suppl...
Donna S Lundy - One of the best experts on this subject based on the ideXlab platform.
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comparison of 2 interventions for Liquid Aspiration on pneumonia incidence a randomized trial
Annals of Internal Medicine, 2008Co-Authors: Joanne Robbins, Diane Brandt, Jacqueline A Hind, Anne S Lindblad, Gary Gensler, David Lilienfeld, Jeri A Logemann, Herbert M Baum, Steven Kosek, Donna S LundyAbstract:Swallowing disorders are associated with increased morbidity and mortality. An estimated 18 million adults will require care for dysphagia-related malnutrition, dehydration, pneumonia, and reductions in quality of life by 2010 (1-3). Patients with dysphasia have an increased incidence of Aspiration pneumonia because the aspirated material is heavily colonized with bacteria. Pneumonia is the most common cause of infectious death in the United States among persons age 65 years or older and the third leading cause of death for persons age 85 years or older (4). One hospital admission for pneumonia is estimated to cost $7166 (5). Rates of hospital discharge for Medicare beneficiaries with pneumonia as a primary diagnosis have increased by 93.5% in the past decade (6), along with length of stay and death rates (4). Liquid Aspiration is the most common type of Aspiration in elderly persons (1). Relative risk for pneumonia is highest in patients with dementia, followed by those who are institutionalized (7). As many as 50% of patients with parkinsonism are estimated to have dysphagia (8), and one third aspirate silently---that is, with no external sign (such as coughing) to eject material or alert caregivers (9). Many short- and long-term care facilities use thickened Liquid diets to treat of Aspiration (10). In these diets, thin Liquids (for example, water, tea, coffee) are eliminated, even in the absence of efficacy data, at a substantial cost in financial and quality-of-life terms. It costs approximately $200 per month for an individual to drink thickened Liquids (11,12). A common alternative to thickened Liquids is use of a chin-down posture (13-17). Welch and coworkers (13) noted that posterior shift of anterior pharyngeal structures with the chin-down posture improved airway protection. Whereas previous studies have provided a basis for the widespread clinical use of chin-down posture, none has provided long-term health outcome data. Results from a previously reported portion of this study demonstrated short-term elimination of Aspiration during the videofluorographic swallowing evaluation most often with honey-thick Liquids, followed by nectar-thick Liquids, and finally chin-down position (18). We sought to compare the effectiveness of chin-down posture and thickened Liquids (nectar thick and honey thick) on the incidence of pneumonia in participants with dementia or Parkinson disease during 3 months of treatment.
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comparison of 2 interventions for Liquid Aspiration on pneumonia incidence
Annals of Internal Medicine, 2008Co-Authors: Joanne Robbins, Diane Brandt, Jacqueline A Hind, Anne S Lindblad, Gary Gensler, David Lilienfeld, Jeri A Logemann, Herbert M Baum, Steven Kosek, Donna S LundyAbstract:To test strategies for avoiding Aspiration pneumonia in cognitively impaired elderly patients, Robbins and colleagues randomly assigned 515 patients age 50 years or older with dementia or Parkinson...
Diane Brandt - One of the best experts on this subject based on the ideXlab platform.
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comparison of 2 interventions for Liquid Aspiration on pneumonia incidence
Annals of Internal Medicine, 2008Co-Authors: Joanne Robbins, Diane Brandt, Jacqueline A Hind, Anne S Lindblad, Gary Gensler, David Lilienfeld, Jeri A Logemann, Herbert M Baum, Steven Kosek, Donna S LundyAbstract:To test strategies for avoiding Aspiration pneumonia in cognitively impaired elderly patients, Robbins and colleagues randomly assigned 515 patients age 50 years or older with dementia or Parkinson...
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comparison of 2 interventions for Liquid Aspiration on pneumonia incidence a randomized trial
Annals of Internal Medicine, 2008Co-Authors: Joanne Robbins, Diane Brandt, Jacqueline A Hind, Anne S Lindblad, Gary Gensler, David Lilienfeld, Jeri A Logemann, Herbert M Baum, Steven Kosek, Donna S LundyAbstract:Swallowing disorders are associated with increased morbidity and mortality. An estimated 18 million adults will require care for dysphagia-related malnutrition, dehydration, pneumonia, and reductions in quality of life by 2010 (1-3). Patients with dysphasia have an increased incidence of Aspiration pneumonia because the aspirated material is heavily colonized with bacteria. Pneumonia is the most common cause of infectious death in the United States among persons age 65 years or older and the third leading cause of death for persons age 85 years or older (4). One hospital admission for pneumonia is estimated to cost $7166 (5). Rates of hospital discharge for Medicare beneficiaries with pneumonia as a primary diagnosis have increased by 93.5% in the past decade (6), along with length of stay and death rates (4). Liquid Aspiration is the most common type of Aspiration in elderly persons (1). Relative risk for pneumonia is highest in patients with dementia, followed by those who are institutionalized (7). As many as 50% of patients with parkinsonism are estimated to have dysphagia (8), and one third aspirate silently---that is, with no external sign (such as coughing) to eject material or alert caregivers (9). Many short- and long-term care facilities use thickened Liquid diets to treat of Aspiration (10). In these diets, thin Liquids (for example, water, tea, coffee) are eliminated, even in the absence of efficacy data, at a substantial cost in financial and quality-of-life terms. It costs approximately $200 per month for an individual to drink thickened Liquids (11,12). A common alternative to thickened Liquids is use of a chin-down posture (13-17). Welch and coworkers (13) noted that posterior shift of anterior pharyngeal structures with the chin-down posture improved airway protection. Whereas previous studies have provided a basis for the widespread clinical use of chin-down posture, none has provided long-term health outcome data. Results from a previously reported portion of this study demonstrated short-term elimination of Aspiration during the videofluorographic swallowing evaluation most often with honey-thick Liquids, followed by nectar-thick Liquids, and finally chin-down position (18). We sought to compare the effectiveness of chin-down posture and thickened Liquids (nectar thick and honey thick) on the incidence of pneumonia in participants with dementia or Parkinson disease during 3 months of treatment.
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challenges in the design and conduct of a randomized study of two interventions for Liquid Aspiration
Clinical Trials, 2006Co-Authors: Diane Brandt, Jacqueline A Hind, Joanne Robbins, Anne S Lindblad, Gary Gensler, Gary Gill, Herb Baum, David Lilienfeld, Jeri A LogemannAbstract:Background Liquid Aspiration during swallowing has been linked to pneumonia, the most common cause of infectious death in the elderly. This paper examines the key issues in the design and implementation of the first multisite, randomized behavioral trial in dysphagia in an aging population. The study evaluated two commonly used treatments with respect to short-term and long-term management of Liquid Aspiration and subsequent pneumonia in dysphagic geriatric participants with dementia and/or Parkinson's disease.Methods Discussed are lessons learned during the conduct of this trial and include (1) ethical and methodological design issues, (2) pragmatic implementation of procedures and forms, (3) importance of multiple communication and monitoring strategies, (4) response to funding issues, and (5) changes in staff and facilities.Results In order to complete this trial the researchers were required to provide more support than anticipated in tasks such as completion of regulatory requirements by sites, suppl...
Anne S Lindblad - One of the best experts on this subject based on the ideXlab platform.
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comparison of 2 interventions for Liquid Aspiration on pneumonia incidence
Annals of Internal Medicine, 2008Co-Authors: Joanne Robbins, Diane Brandt, Jacqueline A Hind, Anne S Lindblad, Gary Gensler, David Lilienfeld, Jeri A Logemann, Herbert M Baum, Steven Kosek, Donna S LundyAbstract:To test strategies for avoiding Aspiration pneumonia in cognitively impaired elderly patients, Robbins and colleagues randomly assigned 515 patients age 50 years or older with dementia or Parkinson...
-
comparison of 2 interventions for Liquid Aspiration on pneumonia incidence a randomized trial
Annals of Internal Medicine, 2008Co-Authors: Joanne Robbins, Diane Brandt, Jacqueline A Hind, Anne S Lindblad, Gary Gensler, David Lilienfeld, Jeri A Logemann, Herbert M Baum, Steven Kosek, Donna S LundyAbstract:Swallowing disorders are associated with increased morbidity and mortality. An estimated 18 million adults will require care for dysphagia-related malnutrition, dehydration, pneumonia, and reductions in quality of life by 2010 (1-3). Patients with dysphasia have an increased incidence of Aspiration pneumonia because the aspirated material is heavily colonized with bacteria. Pneumonia is the most common cause of infectious death in the United States among persons age 65 years or older and the third leading cause of death for persons age 85 years or older (4). One hospital admission for pneumonia is estimated to cost $7166 (5). Rates of hospital discharge for Medicare beneficiaries with pneumonia as a primary diagnosis have increased by 93.5% in the past decade (6), along with length of stay and death rates (4). Liquid Aspiration is the most common type of Aspiration in elderly persons (1). Relative risk for pneumonia is highest in patients with dementia, followed by those who are institutionalized (7). As many as 50% of patients with parkinsonism are estimated to have dysphagia (8), and one third aspirate silently---that is, with no external sign (such as coughing) to eject material or alert caregivers (9). Many short- and long-term care facilities use thickened Liquid diets to treat of Aspiration (10). In these diets, thin Liquids (for example, water, tea, coffee) are eliminated, even in the absence of efficacy data, at a substantial cost in financial and quality-of-life terms. It costs approximately $200 per month for an individual to drink thickened Liquids (11,12). A common alternative to thickened Liquids is use of a chin-down posture (13-17). Welch and coworkers (13) noted that posterior shift of anterior pharyngeal structures with the chin-down posture improved airway protection. Whereas previous studies have provided a basis for the widespread clinical use of chin-down posture, none has provided long-term health outcome data. Results from a previously reported portion of this study demonstrated short-term elimination of Aspiration during the videofluorographic swallowing evaluation most often with honey-thick Liquids, followed by nectar-thick Liquids, and finally chin-down position (18). We sought to compare the effectiveness of chin-down posture and thickened Liquids (nectar thick and honey thick) on the incidence of pneumonia in participants with dementia or Parkinson disease during 3 months of treatment.
-
challenges in the design and conduct of a randomized study of two interventions for Liquid Aspiration
Clinical Trials, 2006Co-Authors: Diane Brandt, Jacqueline A Hind, Joanne Robbins, Anne S Lindblad, Gary Gensler, Gary Gill, Herb Baum, David Lilienfeld, Jeri A LogemannAbstract:Background Liquid Aspiration during swallowing has been linked to pneumonia, the most common cause of infectious death in the elderly. This paper examines the key issues in the design and implementation of the first multisite, randomized behavioral trial in dysphagia in an aging population. The study evaluated two commonly used treatments with respect to short-term and long-term management of Liquid Aspiration and subsequent pneumonia in dysphagic geriatric participants with dementia and/or Parkinson's disease.Methods Discussed are lessons learned during the conduct of this trial and include (1) ethical and methodological design issues, (2) pragmatic implementation of procedures and forms, (3) importance of multiple communication and monitoring strategies, (4) response to funding issues, and (5) changes in staff and facilities.Results In order to complete this trial the researchers were required to provide more support than anticipated in tasks such as completion of regulatory requirements by sites, suppl...