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Among nursing home residents with an ED visit in the past 90 days, 40 percent had a potentially preventable ED visit. Injuries from falls were the most common conditions accounting for potentially preventable ED visits by nursing home residents. Nursing home residents who had a potentially preventable ED visit in the past 90 days had shorter lengths of stay and more medications.
Eight percent of nursing home residents in 2004 had at least one ED visit in the past 90 days, representing 123,600 residents nationally (Figure 1). Among nursing home residents with an ED visit in the past 90 days, 40 percent had potentially preventable ED visits (Figure 2). Injuries related to falls accounted for over one-third of the potentially preventable ED visits (Figure 3).
Among residents with potentially preventable ED visits in the past 90 days, 64 percent had a length of stay more than 6 months compared with 70 percent of all other nursing home residents; and 56 percent had nine or more medications compared with 50 percent of all other nursing home residents (see table).
Overall, 8 percent of nursing home residents in 2004 had visited an ED in the past 90 days.
Reason for Potentially Preventable Emergency Department Visits: defined by a response to the following question, a€?What was the primary reason for the visit(s)?a€? It should be noted that the Reason for Visit Classification system was used to code these data rather than the International Classification of Diseases, Ninth Revision codes (11). Christine Caffrey is with the Centers for Disease Control and Preventiona€™s National Center for Health Statistics, Division of Health Care Statistics, Long-Term Care Statistics Branch. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated. The continuous advancement in medical tests has been a major contributing factor to the increased life expectancy of our generation. Drunk driving is a worldwide problem, here in the United States we have seen far too many lives impacted by this preventable issue. In the past 20 years, considerable progress has been made in reducing alcohol impaired driving in  many developed countries.
On average someone dies due to a drunk driver every 51 minutes in the United States, every 90 seconds someone is injured; these are scary drunk driving statistics. Most of these accidents are occurring at night time for obvious reasons, most of these accidents occur between 9pm-6am. Someone with a BAC (blood alcohol content) over the legal limit as compared to someone with a BAC of zero is 385 times more likely to be involved in an accident. With drunk driving statistics like this why do millions of Americans choose to get behind the wheel and drive when the chances of the hurting and killing someone are so high? She is a ‘ministering angel’ without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor, every poor fellow’s face softens with gratitude at the sight of her.
Nightingale is less known for her managerial and statistical acumen, and her pivotal role in medical statistics. Here is an interesting critique of the Nightingale Rose Charts which is presented at Dynamic Diagrams.  It appears that by placing the preventable diseases wedge-section in the outer section of the wedge, the blue  received a proportionally larger area, an artifact of this radial plot.
You can read more about the Mathematical affiliation of  Nightingale in this excerpt form the Newsletter of the Association for Women in Mathematics.
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Coronary heart disease (CHD) was the biggest cause of death in England, accounting for nearly 60,000 of the total 466,800 deaths in 2012 (about one in seven deaths in men and one in ten deaths in women). The good news is that the death rate from heart disease has fallen dramatically since the 1980s, and in England, in the under-75s, it's down by 40% over the past decade.
But for more recent falls in CHD mortality, other things seem to have had more of an impact: medical therapies, for instance, with the increased uptake of drugs such as statins and ACE inhibitors, as well as improved blood pressure in the general population - thought to be linked to falling intakes of salt. The history matters because it can help us to understand how we can focus our actions to save the most lives in the future.
The earlier we start, the better, because it's easier to protect our hearts in later life if we develop healthy lifestyles that reduce the risks of cardiovascular disease - the family of diseases that affect the heart and blood vessels that make up our circulatory system.
That's one of the reasons why preventing, and tackling, obesity in childhood is so important. One of the worrying things about childhood obesity is the way it can persist into adulthood. We also have to get more kids moving, more often and for longer, especially girls, who are less likely than boys to be active.
As our children grow into teenagers, there are some new challenges to add to the existing ones of diet and exercise. And when these teenagers become adults, how can we do an even better job of protecting them from cardiovascular disease? But there's also an extra challenge: many people - millions in fact - may be at increased risk for cardiovascular disease and not even know it, let alone be in a position to do something about it. That's why PHE is leading the NHS Health Check programme, which flags up risks such as high blood pressure and cholesterol as well as lifestyle risks - such as alcohol, poor diet, obesity - in a systematic and co-ordinated way for 15m adults between the ages of 40 and 74. Programmes need good intelligence, and PHE's national cardiovascular intelligence network provides the resources - from data to emerging evidence - that help local public health leaders to understand the health profile of their communities and target their efforts accordingly. These are ambitious programmes; not just because they are aiming to improve the country's record on preventable diseases but because they're also targeting inequalities. Senior Report: In its fourth year, this report uses 35 measures to track the state-by-state health of our senior population.
The next generation of seniors is expected to have a higher prevalence of diabetes and obesity. Builds on our America's Health Rankings platform to measure the impact of multiple unhealthy behaviors on health status.

See how your state stacks up on each health measure in the Annual Report and compares with other states. See how your state stacks up on each health measure in the Spotlight Report and compares with other states. The infographic highlights the prevalence of 3 or more unhealthy behaviors and the gap that exists in this measure by education level. See how the states rank for each of the health measures on this year's Annual health report. Sign up for the America's Health Rankings email newsletter to keep current with population health news.
Connect with America's Health Rankings and discuss how health in your state is changing. Older adults, particularly nursing home residents, comprise a large and growing percentage of those visiting the ED (2,3). Of those nursing home residents with an ED visit in the past 90 days, 15 percent had two or more ED visits in that time period, representing 18,400 residents nationally. Symptoms of heart conditions (mainly chest pain, pressure, burning, and heart failure) accounted for almost 20 percent and pneumonia for 12 percent of the potentially preventable ED visits. A substantial percentage of those with an ED visit in the past 90 days had conditions that have been linked to potentially preventable visits.
The question included the following probe, a€?Please include visits that occurred after the selected residenta€™s most recent admission to the nursing home.a€? Up to five visits were documented. The first stage was the selection of facilities and the second stage was the selection of residents.
Vulnerable populations at risk of potentially avoidable hospitalizations: The case of nursing home residents with Alzheimera€™s disease. Nursing home characteristics and potentially preventable hospitalizations of long-stay residents. Inappropriate hospitalization of nursing facility residents: A symptom of a sick system of care for frail older people. Mobility and other predictors of hospitalization for urinary tract infection: A retrospective cohort study.
Potentially preventable emergency department visits by nursing home residents: United States, 2004.
What is astonishing is that another 850,000 people are thought to have type 2 diabetes but they don't know it! Every single one of these crashes effects more than just the people involved in the accident. If you read at the average speed by the time you finish this sentence one person has been physically injured by a drunk driver.
Many people understand the risks behind drunk driving but once alcohol has become part of their system it will lower one’s ability to make smart choices.
Nationwide education isn’t the answer, most people understand the risks of drunk driving but think they can successfully do it anyway. Today nursing is a skilled degree-earning profession, requiring extensive training, with professional rights and responsibilities. Nightingale kept meticulous notes of mortality rates at the Scutari hospital in Istanbul which declined dramatically during her administration. This does not detract at all from her achievements, and, as shown in the corrected charts, not even from her case for improving hospital sanitation to reduce preventable diseases as the leading cause of death, regardless of presentation format.
One interesting factoid: she was the first woman to be nominated a fellow of the Royal Statistical Society. A little group of us from web publishing at Nature were invited behind the scenes and we saw a collection of her beautiful charts.
There are a number of reasons why we think this has happened, but it's a complex picture, which shifts over time. Even more recent evidence suggests that England's 2007 smoking ban has also had an impact on reducing heart attacks.
But there are things that can be done about the rise in diabetes and the high rates of obesity and excess weight, which experts warn could erode the health gains we're aiming for in heart disease.
In England, 18.9% of 10 to 11-year-olds were classified as obese in 2012-13, according to data from the National Child Measurement Programme. We need to support children to eat a healthier, balanced diet (currently less than one in five in the UK eats the recommended portions of fruit and vegetables every day), both in and out of school. The good news is there's been a fall in the percentage of teenagers who say they've consumed alcohol in the previous week. Health campaigns can help people to change unhealthy lifestyles, and now there's the potential to harness the power of social media and technologies, from smartphones to apps, to make change both fun and relevant. That's why PHE argues that these broad influences also have to be addressed, from how we plan our towns and our transport system, to how employers promote staff health and how our national diet can be improved - by reducing salt in the manufacture of foods, for example. For example, there are over 5m people in England who it's thought have undiagnosed hypertension - around 40% of the total expected number. Early estimates suggest the programme could detect at least 20,000 cases of diabetes or kidney disease earlier and could prevent 1,600 heart attacks and strokes, on average per year.
As the chart below shows, the death rate from cardiovascular disease is higher the more deprived you are, especially if you're a man. What if you look at the laundry list of behaviours and medical conditions and wonder what you can still do, in your 70s and beyond, to improve your chances of overall health - including cardiovascular health?
The next generation of seniors, now aged 50 to 64, have a higher prevalence of obesity and diabetes.
Prior research has identified conditions that may lead to potentially preventable visits to an ED among nursing home residents (4a€“11).

The remaining one-third included mental status changes, urinary tract infections, gastrointestinal bleeding symptoms, fever, metabolic disturbances, and skin diseases.
Number of ED visits was missing for two cases, representing 286 residents missing nationally.
The primary sampling strata of facilities were defined by sampling bed size category and metropolitan area status. They affect the families, the friends, the towns and the schools in which these preventable accidents occurred. More restrictions need to put in place to help reduce the number of people who are being affected. That was not the case less than 120 years ago, when normally only  the military and religious orders offered semi-skilled assistance to physicians.  Nightingale changed all that, and revolutionizing the way medicine is practiced. Upon her return to London, she compiled the records into a new polar diagram, known as Nightingale Rose Chart. February marks national heart month, so it's a good time to reflect on what the research can tell us about how to stay "heart healthy". Most of the risk of heart attack is down to a few risk factors that are potentially modifiable: in other words, we can do something about them - as individuals and as a population. So for example, it's been calculated that the biggest single contribution to the reduction in heart deaths during the 1980s and 1990s was the fall in smoking (other important influences were improved management of cholesterol and blood pressure as well as improved cardiological treatments).
There's added pressure to act because there are trends underway now that risk undermining future improvements in heart disease.
We need to encourage families to make those small improvements to their diets, which add up over time. Last year's Stoptober (Public Health England's smoking cessation campaign) was a big success with 250,000 registrations and almost 50,000 new fans on social media.
It's estimated there are more than 3m adults with Type 2 diabetes in England, of which around 500,000 have not been diagnosed. It's also why PHE, together with partners, will publish an action plan for preventing, detecting and controlling high blood pressure, and is developing a new health campaign.
The evidence is still emerging, but a recent study has found that being physically active, for example, is associated with improved healthy ageing.
Fever, chest pain, heart disease (mainly heart failure), mental status changes, gastrointestinal bleeding, urinary tract infections, metabolic disturbances, pneumonia, diseases of the skin, and injuries due to falls have been identified as reasons for potentially preventable visits to an ED. It is designed to provide descriptive information on nursing homes, their services, their staff members, and the residents they serve.
For the 2004 NNHS, 1,500 nursing homes were selected using systematic statistical sampling with probability proportional to their bed sizes. When you realize the amount of lives destroyed by this problem, those drunk driving statistics become heart breaking. These factors include smoking, obesity, a poor diet, high cholesterol and blood pressure, as well as physical inactivity. Second, it also increases the risks of high blood pressure, raised cholesterol and diabetes, which are also, in themselves, risk factors for cardiovascular disease.
It's hard to overstate how crucial this is: about two thirds of adult smokers report they took up smoking before the age of 18. Researchers argue that some of these conditions, such as urinary tract infections, could be more appropriately treated in the nursing home. This report identifies conditions and resident characteristics that nursing homes and policymakers might target to reduce preventable ED visits. The second stage sampling of current residents was carried out by the interviewers at the time of their visits to the facilities.
Analysis of these trends provides information regarding the strategies that have been most effective in bringing about progress and the problems that have impeded progress. Usually coverage of an accident is just a blip on the afternoon news, but for far too many people these accidents will change their lives forever. This professional approach included keeping medical records and using them to improve health care.
Other conditions prompting ED visits, such as those related to falls or pneumonia, may have been avoided by preventing the adverse health event itself.
The sampling frame for current residents was the total number of residents on the register of the facility as of midnight the day before the survey interview. Even those who have not been directly touched help pay the $132 billion yearly price tag of drunk driving. Decreasing potentially preventable visits to EDs may reduce health care costs, lessen trauma or complications resulting from medical treatment for nursing home residents, and improve quality of care.
A sample of up to 12 current residents per facility was selected, resulting in a total of 14,017 residents. This report presents the only national information on potentially preventable ED use among U.S. The 2004 NNHS was administered using a computer-assisted personal interviewing (CAPI) system.
Data were collected on facility characteristics and characteristics of the sampled residents. To learn more about our services and make a booking with an Exercise Physiologist, call us on (03) 9857 3007.

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