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Menopause is associated with a marked reduction in endogenous estrogen production. Lower levels of circulating blood estrogen have various deleterious effects, including those on the lower urinary tract. The vaginal epithelium becomes atrophied and dry, which can cause vaginal discomfort, itching, and dyspareunia. The epithelium may become inflamed and(More)
The purpose of this report is to summarize data from a sample of 230 residents in eight nursing homes (NHs) that are relevant to the development of environmental and behavioral interventions for sleep. Four conclusions can be drawn: (1) there is strong evidence that the nighttime sleep of these residents was adversely affected by environmental noise and(More)
N Engl J Med 2004;350:786-99. Copyright © 2004 Massachusetts Medical Society. veractive bladder is a symptom complex that includes urinary urgency with or without urge incontinence, urinary frequency (voiding eight or more times in a 24-hour period), and nocturia (awakening two or more times at night to void). 1-3 The International Continence Society(More)
With increasing age, the competence of the immune system to fight infections and tumors declines. Age-dependent changes have been mostly described for human CD8 T cells, raising the question of whether the response patterns for CD4 T cells are different. Gene expression arrays of memory CD4 T cells yielded a similar age-induced fingerprint as has been(More)
OBJECTIVES To determine if two physical activity programs of varying intensity would result in improved sleep among incontinent and physically restrained nursing home residents. DESIGN Controlled trials of two physical activity programs. SETTING Seven community nursing homes in the Los Angeles area. PARTICIPANTS Residents were included if they had(More)
Increasing attention is being paid to inappropriate medication use in nursing homes. However, criteria defining the appropriate or inappropriate use of medication in this setting are not readily available and are not uniform. We used a two-round survey, based on Delphi methods, with 13 nationally recognized experts to reach consensus on explicit criteria(More)
OBJECTIVES To examine the frequency and reasons for potentially avoidable hospitalizations of nursing home (NH) residents. DESIGN Medical records were reviewed as a component of a project designed to develop and pilot test clinical practice tools for reducing potentially avoidable hospitalization. SETTING NHs in Georgia. PARTICIPANTS In 10 NHs with(More)
OBJECTIVE To quantify the appropriateness of medication prescriptions in nursing home residents. DESIGN Prospective, cohort study. SETTING Twelve nursing homes in the greater Los Angeles area. PARTICIPANTS A total of 1106 nursing home residents. MAIN OUTCOME MEASURES The appropriateness of medication prescriptions was evaluated using explicit(More)
OBJECTIVES To examine clinical outcomes and describe the staffing requirements of an incontinence and exercise intervention. DESIGN Randomized controlled trial with blinded assessments of outcomes at three points over 8 months. SETTING Four nursing homes. PARTICIPANTS Two hundred fifty-six incontinent residents. INTERVENTION Research staff provided(More)
OBJECTIVE To develop a simple, noninvasive assessment strategy that will enable nursing home staff to identify incontinent residents who respond well to prompted voiding. DESIGN Incontinent nursing home residents underwent an extensive clinical and functional assessment and then 7 days of prompted voiding. Data from the assessment and the first 3 days of(More)