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Full-Text Articles in Medicine and Health Sciences
The Rbans Effort Index: Base Rates In Geriatric Samples, K. Duff, C. Spering, S. O'Bryant, L. Beglinger, D. Moser, J. Bayless, Kennith Culp, J. Mold, R. Adams, J. Scott
The Rbans Effort Index: Base Rates In Geriatric Samples, K. Duff, C. Spering, S. O'Bryant, L. Beglinger, D. Moser, J. Bayless, Kennith Culp, J. Mold, R. Adams, J. Scott
Kennith R. Culp
The Effort Index (EI) of the RBANS was developed to assist clinicians in discriminating patients who demonstrate good effort from those with poor effort. However, there are concerns that older adults might be unfairly penalized by this index, which uses uncorrected raw scores. Using five independent samples of geriatric patients with a broad range of cognitive functioning (e.g., cognitively intact, nursing home residents, probable Alzheimer's disease), base rates of failure on the EI were calculated. In cognitively intact and mildly impaired samples, few older individuals were classified as demonstrating poor effort (e.g., 3% in cognitively intact). However, in the more …
Twelve-Month Mortality Among Delirium Subtypes, S. Decrane, Kennith Culp, B. Wakefield
Twelve-Month Mortality Among Delirium Subtypes, S. Decrane, Kennith Culp, B. Wakefield
Kennith R. Culp
This study used data from the Delirium Among the Elderly in Rural Long-Term Care Facilities Study and data from the National Death Index (NDI) to examine mortality among 320 individuals. Individuals were grouped into noncases, subsyndromal cases, hypoactive delirium, hyperactive delirium, and mixed delirium on the basis of scoring using the Confusion Assessment Method (CAM), NEECHAM Scale, Mini-Mental State Examination (MMSE), Clinical Assessment of Confusion-A (CAC-A), and Vigilance A instruments. Risk ratios of mortality using "days of survival" did not reach statistical significance (alpha = .05) for any subgroup. Underlying cause of death (UCD) using International Classification of Disease, 10th …
Risk For Acute Confusion In Sensory-Impaired, Rural, Long-Term-Care Elders, P. Cacchione, Kennith Culp, M. Dyck, J. Laing
Risk For Acute Confusion In Sensory-Impaired, Rural, Long-Term-Care Elders, P. Cacchione, Kennith Culp, M. Dyck, J. Laing
Kennith R. Culp
Acute confusion is a common geriatric syndrome in long-term care (LTC) elders with prevalence rates of 10% to 39%. Sensory impairment, specifically vision and hearing impairment, is even more common in LTC, with prevalence rates of 40% to 90%. The purpose of this study was to investigate the risk relationship between sensory impairment and the development of acute confusion in LTC elders. Each resident (N = 114) underwent sensory screening and then was followed for 28 days to monitor for the onset of acute confusion. Twenty residents (17.5%) developed acute confusion, 60 residents (52.6%) were found to be visually impaired, …
Hydration And Acute Confusion In Long-Term Care Residents... Including Commentary By Lindgren Cl And Mills Em With Author Response, Kennith Culp, J. Mentes, B. Wakefield
Hydration And Acute Confusion In Long-Term Care Residents... Including Commentary By Lindgren Cl And Mills Em With Author Response, Kennith Culp, J. Mentes, B. Wakefield
Kennith R. Culp
Although it is generally appropriate for a healthy adult to consume 2000 to 2500 ml per day, the literature does not address evaluating any standard. The objective here was to develop a weight-based hydration management intervention and evaluate the impact of this on the incidence of acute confusion (AC) using an N = 98. The intervention consisted of a fluid intake goal based on 100 ml per kg for the first 10 kg, 50 ml/kg for the next 10 kg, and 15 ml for the remaining body weight. The treatment group received instruction and assistance on the fluid goal and …
Geriatric Hemodialysis Patients: A Comparative Study Of Vascular Access... Including Commentary By Courts Nf And Mathers T, Kennith Culp, L. Taylor, P. Hulme
Geriatric Hemodialysis Patients: A Comparative Study Of Vascular Access... Including Commentary By Courts Nf And Mathers T, Kennith Culp, L. Taylor, P. Hulme
Kennith R. Culp
OBJECTIVES: To compare vascular access in hemodialysis patients >/= 65 years of age with those /= 65 years). DESIGN: A descriptive, longitudinal study with a 1-year follow-up period. METHODS: Following the placement of a permanent vascular access, information was collected by the dialysis nursing staff about the configuration of the access, needle gauge used for cannulation, dialysis prescriptions, diabetic status, and other comorbid disease conditions. Odds ratios (OR) for vascular access thrombosis (VAT) risk were calculate between the two age groups. RESULTS: Comparisons between the two age groups suggest a higher frequency of polytetrafluorethylene (PTFE) grafts in the >/= 65-year-old …
Risk Factors And Outcomes Associated With Hospital Admission For Dehydration, B. Wakefield, J. Mentes, J. Holman, Kennith Culp
Risk Factors And Outcomes Associated With Hospital Admission For Dehydration, B. Wakefield, J. Mentes, J. Holman, Kennith Culp
Kennith R. Culp
The hospital admission rate for dehydration is one of the Agency for Healthcare Research and Quality Prevention's Quality Indicators, which are considered screening tools for potential quality issues. Thus, admission for dehydration may reflect the quality of care provided in community settings. Using a case-control design, this study estimated the incidence, risk factors, and outcomes of dehydration in adults admitted to the hospital. The overall prevalence rate for three International Classification of Diseases codes for dehydration at admission was 0.55%. Cases and controls differed significantly on a number of clinical variables at admission, including weight, body mass index, pulse, blood …
Delirium In Elderly Patients: An Overview Of The State Of The Science, M. Foreman, B. Wakefield, Kennith Culp, K. Milisen
Delirium In Elderly Patients: An Overview Of The State Of The Science, M. Foreman, B. Wakefield, Kennith Culp, K. Milisen
Kennith R. Culp
Delirium is a common and potentially preventable and reversible cause of functional disability, morbidity, mortality, and increased health care use among elderly individuals. Much has been learned about delirium in the past decade. Highlighted in this article are recent advances in the diagnosis of delirium, delirium in long-term care, use of health care resources, outcomes of delirium, etiologies, and interventions to prevent and treat delirium. Suggestions for future research also are proposed.
Studying Acute Confusion In Long-Term Care: Clinical Investigation Or Secondary Data Analysis Using The Minimum Data Set?, Kennith Culp, J. Mentes, E. Mcconnell
Studying Acute Confusion In Long-Term Care: Clinical Investigation Or Secondary Data Analysis Using The Minimum Data Set?, Kennith Culp, J. Mentes, E. Mcconnell
Kennith R. Culp
Incidence and prevalence rates between hospital settings and longterm care settings may be significantly different because of diagnostic challenges imposed by the higher prevalence of dementia in the nursing home population, the notion that dementia is a risk factor for acute confusion, and that individuals who are acutely confused may not want to be identified.
Civic Engagement As A Retirement Role For Aging Americans, B. Kaskie, S. Imhof, J. Cavanaugh, Kennith Culp
Civic Engagement As A Retirement Role For Aging Americans, B. Kaskie, S. Imhof, J. Cavanaugh, Kennith Culp
Kennith R. Culp
No abstract provided.
Pesticide Handling And Exposures Among Cotton Farmers In The Gambia, R. Kuye, K. Donham, S. Marquez, W. Sanderson, L. Fuortes, R. Rautiainen, M. Jones, Kennith Culp
Pesticide Handling And Exposures Among Cotton Farmers In The Gambia, R. Kuye, K. Donham, S. Marquez, W. Sanderson, L. Fuortes, R. Rautiainen, M. Jones, Kennith Culp
Kennith R. Culp
Objectives: There are substantial health hazards to farmers and the environment associated with pesticide use in developing countries. Based on observations by the authors and previous reports, most previous studies in Africa are descriptive in nature. The aim of this study was to investigate how cotton farmers are exposed to pesticides in The Gambia and quantify their pesticide exposures and provide information for the formulation of a policy on pesticide safety for the country. Methods: A representative sample of 20 cotton farmers in the Central and Upper River Divisions (CRD and URD) of The Gambia were surveyed by questionnaires. Dermal …
Comparing The Geriatric Depression Scale, Minimum Data Set, And Primary Care Provider Diagnosis For Depression In Rural Nursing Home Residents, C. Kerber, M. Dyck, Kennith Culp, Kathleen Buckwalter
Comparing The Geriatric Depression Scale, Minimum Data Set, And Primary Care Provider Diagnosis For Depression In Rural Nursing Home Residents, C. Kerber, M. Dyck, Kennith Culp, Kathleen Buckwalter
Kennith R. Culp
BACKGROUND: Depression has a substantial negative impact on quality of life. Underdiagnosis and undertreatment of depression are major problems in nursing home residents. OBJECTIVES: This study sought to determine the prevalence of depression among older adults in nursing homes in rural Iowa using the Geriatric Depression Scale (GDS), Minimum Data Set (MDS), and primary care provider (PCP) depression diagnosis. DESIGN: This is a secondary analysis of data collected from 279 randomly selected residents of nursing homes in rural Iowa. RESULTS: The prevalence of depression based on the GDS (score of 6 or greater) was 37.3%, the MDS was 21.3%, and …
Reducing Hydration-Linked Events In Nursing Home Residents... Including Commentary By Godkin D, J. Mentes, Kennith Culp
Reducing Hydration-Linked Events In Nursing Home Residents... Including Commentary By Godkin D, J. Mentes, Kennith Culp
Kennith R. Culp
The authors used a quasi-experimental treatment and control group design with 49 participants from four nursing homes to test the effectiveness of an 8-week hydration intervention in reducing hydration-linked events (HLEs). A Kaplan Meier survival curve with log rank test was calculated to determine incidence and time to occurrence of a HLE. Incidence of and time to a HLE did not differ between the treatment and control groups over an 8-week period (p > .05). However, treatment group participants were found to be more frail, more cognitively impaired and more at risk for acute confusion than the control group participants. Although …
Renal Osteodystrophy In Older Adults With End-Stage Renal Disease, C. Roth, Kennith Culp
Renal Osteodystrophy In Older Adults With End-Stage Renal Disease, C. Roth, Kennith Culp
Kennith R. Culp
No abstract provided.
Acute Confusion Indicators: Risk Factors And Prevalence Using Mds Data, J. Mentes, Kennith Culp, Meridean Maas, M. Rantz
Acute Confusion Indicators: Risk Factors And Prevalence Using Mds Data, J. Mentes, Kennith Culp, Meridean Maas, M. Rantz
Kennith R. Culp
OBJECTIVE: The purpose of this study was to use Minimum Data Set (MDS) data from LTC (long-term care) in one Midwestern state to test whether risk variables derived from a conceptual model developed from findings in acute care predicted acute confusion in long-term care residents. DESIGN: Cross-sectional. SETTING: MDS nursing home records. POPULATION: The sample was composed predominantly of women (n = 1,775). INTERVENTIONS: The 1995 MIS annual reviews of nursing home residents from a Midwestern state provided the data for analysis; however missing data, on the average about 10% for the acute confusion/delirium indicators, reduced the sample to 2,318. …
Use Of A Urine Color Chart To Monitor Hydration Status In Nursing Home Residents, J. Mentes, B. Wakefield, Kennith Culp
Use Of A Urine Color Chart To Monitor Hydration Status In Nursing Home Residents, J. Mentes, B. Wakefield, Kennith Culp
Kennith R. Culp
To determine whether urine color, as measured by a color chart, might be a valid indicator of hydration status in frail nursing home residents, this study tested the associations between urine color and urine specific gravity. This is a descriptive correlational study set in seven nursing homes in eastern Iowa. Ninety-eight nursing home residents > or =65 years of age participated. Exclusion criteria for the study included: unstable congestive heart failure or diabetes, documented renal disease, hyponatremia (serum sodium or =50 ml/min) had significant associations between average urine color and average Usg. Females with mild renal impairment (CrCl between 30 and …
Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega
Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega
Kennith R. Culp
Acute confusion (AC), also referred to as delirium (AC/delirium), is a common problem seen by health professionals who work in a variety of care settings. This is an evaluative report on the clinical usability of instruments to assess AC/delirium as a part of nursing practice. Specifically, five instruments [the Confusion Assessment Method (CAM), Delirium Rating Scale (DRS), Delirium Symptom Inventory (DSI), Mini-Mental State Examination (MMSE), and Neelon/Champagne (NEECHAM) Confusion Scale] are discussed. The work demonstrates how the cooperation of nurses in practice, education, and research can improve both patient and staff outcomes.
Screening For Acute Confusion In Elderly Long-Term Care Residents, Kennith Culp, Toni Tripp-Reimer, K. Wadle, B. Wakefield, J. Akins, Paula Mobily, M. Kundradt
Screening For Acute Confusion In Elderly Long-Term Care Residents, Kennith Culp, Toni Tripp-Reimer, K. Wadle, B. Wakefield, J. Akins, Paula Mobily, M. Kundradt
Kennith R. Culp
While acute confusion (AC) is frequently studied in the hospitalized elderly population, this phenomena has been largely ignored in elders who are residents in long-term care (LTC) facilities. The purpose of this study was to estimate the prevalence of AC in older LTC residents, the antecedent conditions present at the time of the AC event and the recognition rate of AC when assessed by staff nurses in two LTC facilities. This is a descriptive, longitudinal study with a 14 day follow-up period which incorporates a screening algorithm using AC instruments with established psychometric properties. A behavioral symptom instrument was also …
Antidepressant Treatment Of Depression In Rural Nursing Home Residents, C. Kerber, M. Dyck, Kennith Culp, Kathleen Buckwalter
Antidepressant Treatment Of Depression In Rural Nursing Home Residents, C. Kerber, M. Dyck, Kennith Culp, Kathleen Buckwalter
Kennith R. Culp
Under-diagnosis and under-treatment of depression are major problems in nursing home residents. The purpose of this study was to determine antidepressant use among nursing home residents who were diagnosed with depression using three different methods: (1) the Geriatric Depression Scale, (2) Minimum Data Set, and (3) primary care provider assessments. As one would expect, the odds of being treated with an antidepressant were about eight times higher for those diagnosed as depressed by the primary care provider compared to the Geriatric Depression Scale or the Minimum Data Set. Men were less likely to be diagnosed and treated with antidepressants by …
Clinical Methods. Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega
Clinical Methods. Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega
Kennith R. Culp
Acute confusion (AC), also referred to as delirium (AC/delirium), is a common problem seen by health professionals who work in a variety of care settings. This is an evaluative report on the clinical usability of instruments to assess AC/delirium as a part of nursing practice. Specifically, five instruments [the Confusion Assessment Method (CAM), Delirium Rating Scale (DRS), Delirium Symptom Inventory (DSI), Mini-Mental State Examination (MMSE), and Neelon/Champagne (NEECHAM) Confusion Scale] are discussed. The work demonstrates how the cooperation of nurses in practice, education, and research can improve both patient and staff outcomes.
Postadmission Dehydration: Risk Factors, Indicators, And Outcomes, B. Wakefield, J. Mentes, J. Holman, Kennith Culp
Postadmission Dehydration: Risk Factors, Indicators, And Outcomes, B. Wakefield, J. Mentes, J. Holman, Kennith Culp
Kennith R. Culp
Detecting and treating dehydration in hospitalized patients is critical because of the adverse outcomes associated with this condition. Using a case-control design, this study estimated the incidence, risk factors, and outcomes of dehydration in hospitalized adults. The overall incidence rate for developing one of three ICD-9 codes for dehydration during a hospital stay was 3.5%. Cases and controls differed significantly on a number of clinical variables on admission; a large percentage of patients may have had dehydration on admission to the hospital. Mortality rates at 30 and 180 days postdischarge were significantly higher when dehydration was present. Patients may be …
Clinical Profile Of Acute Confusion In The Long-Term Care Setting, P. Cacchione, Kennith Culp, J. Laing, Toni Tripp-Reimer
Clinical Profile Of Acute Confusion In The Long-Term Care Setting, P. Cacchione, Kennith Culp, J. Laing, Toni Tripp-Reimer
Kennith R. Culp
Aspects of acute confusion (AC) including risk factors, behavior patterns, and outcomes are not well documented in long-term care (LTC) residents. The purpose of this prospective study was to describe the clinical profile of AC in LTC including risk factors, behavior patterns, etiologies, and 3-month outcomes. Seventy-four elderly LTC residents were assessed for AC, depression, and global cognitive impairment. Risk factors associated with AC included hearing deficits, depression, pulmonary disorders, and abnormal serum sodium or potassium levels. Behavior patterns of acutely confused residents included hyperactive (n = 9, 31%), hypoactive (n = 8, 28%), and mixed (n = 7, 24%). …
Monitoring Hydration Status In Elderly Veterans, B. Wakefield, J. Mentes, L. Diggelmann, Kennith Culp
Monitoring Hydration Status In Elderly Veterans, B. Wakefield, J. Mentes, L. Diggelmann, Kennith Culp
Kennith R. Culp
Dehydration is a common water and electrolyte disorder in long-term care residents. Practical methods to detect and monitor dehydration are needed. This study determined whether urine color measured by a urine color chart reflects hydration status. The study employed a repeated measures design with two observations during a 10-hour period. Urine color was compared to the criterion standard of urine specific gravity and osmolality. The sample included 89 participants from two Veterans' Affairs facilities. Urine color was graded on an eight-level color chart. Urine specific gravity and osmolality, serum sodium and osmolality, hematocrit, blood urea nitrogen (BUN), and creatinine were …