Christina Bell

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OBJECTIVE To examine the effect of intervention by geriatric medicine fellows and a geriatrician on medication cost among long term care residents with polypharmacy. DESIGN Interventional study. SETTING A single hospital-affiliated long term care facility. PARTICIPANTS Long term care residents with polypharmacy, defined as being on 9 or more(More)
BACKGROUND Weight loss and poor nutrition are important quality measures in long term care. Long term care professionals need to identify factors associated with weight loss and poor nutrition to target high-risk patients. METHODS The authors systematically searched Medline and CINAHL databases and included English language studies with more than 100(More)
Congruence between preferred and actual place of death may be an essential component in terminal care. Most patients prefer a home death, but many patients do not die in their preferred location. Specialized (physician, hospice, and palliative) home care visits may increase home deaths, but factors associated with congruence have not been systematically(More)
Congruence between preferred and actual place of death is an important palliative care outcome reported in the literature. We examined methods of measuring and reporting congruence to highlight variations impairing cross-study comparisons. Medline, PsychInfo, CINAHL, and Web of Science were systematically searched for clinical research studies examining(More)
OBJECTIVES To identify potentially modifiable late-life biological, lifestyle, and sociodemographic factors associated with overall and healthy survival to age 85. DESIGN Prospective longitudinal cohort study with 21 years of follow-up (1991-2012). SETTING Hawaii Lifespan Study. PARTICIPANTS American men of Japanese ancestry (mean age 75.7, range(More)
PURPOSE OF REVIEW Malnutrition in the nursing home is increasingly recognized as a major international research priority, given the expanding geriatric populations, serious consequences, and challenges conducting research in nursing homes. This review examines the recent literature and suggests implications for research and practice. RECENT FINDINGS(More)
BACKGROUND AND PURPOSE Vitamin D deficiency has been reported to contribute to the risk of cardiovascular disease, especially stroke. We examined the relationship between dietary vitamin D intake and 34-year incident stroke. METHODS The Honolulu Heart Program is a prospective population-based cohort study of 8006 Japanese-American men in Hawaii who were(More)
This article provides a comprehensive review of the outcomes of polypharmacy in nursing homes. Our review had some limitations. First, we only included studies beginning in 1990, and significant earlier studies are not included. Only English language articles were included. We only researched studies from MEDLINE, and may have missed studies based on our(More)
The stress status of the apoptotic cell can promote phenotypic changes that have important consequences on the immunogenicity of the dying cell. Autophagy is one of the biological processes activated in response to a stressful condition. It is an important mediator of intercellular communications, both by regulating the unconventional secretion of(More)
OBJECTIVE To examine the effects of a medication review project by geriatricians and geriatric medicine fellows on polypharmacy in a teaching nursing home. DESIGN Quality improvement intervention study SETTING Long-term care facility in Honolulu, HI PARTICIPANTS: Seventy-four patients with the Minimum Data Set quality indicator criteria of polypharmacy(More)