Sample records for geriatric medicine clerkship

  1. Learning while evaluating: the use of an electronic evaluation portfolio in a geriatric medicine clerkship

    Microsoft Academic Search

    Gustavo Duque; Adam Finkelstein; Ayanna Roberts; Diana Tabatabai; Susan L Gold; Laura R Winer

    2006-01-01

    BACKGROUND: Electronic evaluation portfolios may play a role in learning and evaluation in clinical settings and may complement other traditional evaluation methods (bedside evaluations, written exams and tutor-led evaluations). METHODS: 133 third-year medical students used the McGill Electronic Evaluation Portfolio (MEEP) during their one-month clerkship rotation in Geriatric Medicine between September 2002 and September 2003. Students were divided into two

  2. Learning while evaluating: the use of an electronic evaluation portfolio in a geriatric medicine clerkship

    PubMed Central

    Duque, Gustavo; Finkelstein, Adam; Roberts, Ayanna; Tabatabai, Diana; Gold, Susan L; Winer, Laura R

    2006-01-01

    Background Electronic evaluation portfolios may play a role in learning and evaluation in clinical settings and may complement other traditional evaluation methods (bedside evaluations, written exams and tutor-led evaluations). Methods 133 third-year medical students used the McGill Electronic Evaluation Portfolio (MEEP) during their one-month clerkship rotation in Geriatric Medicine between September 2002 and September 2003. Students were divided into two groups, one who received an introductory hands-on session about the electronic evaluation portfolio and one who did not. Students' marks in their portfolios were compared between both groups. Additionally, students self-evaluated their performance and received feedback using the electronic portfolio during their mandatory clerkship rotation. Students were surveyed immediately after the rotation and at the end of the clerkship year. Tutors' opinions about this method were surveyed once. Finally, the number of evaluations/month was quantified. In all surveys, Likert scales were used and were analyzed using Chi-square tests and t-tests to assess significant differences in the responses from surveyed subjects. Results The introductory session had a significant effect on students' portfolio marks as well as on their comfort using the system. Both tutors and students reported positive notions about the method. Remarkably, an average (± SD) of 520 (± 70) evaluations/month was recorded with 30 (± 5) evaluations per student/month. Conclusion The MEEP showed a significant and positive effect on both students' self-evaluations and tutors' evaluations involving an important amount of self-reflection and feedback which may complement the more traditional evaluation methods. PMID:16409640

  3. Impact of a mandatory geriatric medicine clerkship on the care of older acute medical patients: a retrospective cohort study

    PubMed Central

    2013-01-01

    Background The impact of geriatric medicine educational programs on patient level outcomes, as opposed to educational measures, is not well studied. We aimed to determine whether completion of a mandatory geriatrics rotation changed the clinical behaviors of clerks caring for older patients admitted to a medical clinical teaching unit. Methods We reviewed the charts of 132 older (>70y) patients, admitted to one medical clinical teaching unit (CTU) during 2005, and cared for by a clinical clerk, for documented functional assessment, cognitive assessment, recognition of medications that cause confusion, and early removal of indwelling urinary catheters. Performance of these outcomes was compared between clerks who had completed a mandatory 2-week geriatrics rotation immediately before the medical CTU rotation (n?=?62) and those who completed geriatrics immediately after (n?=?74). Patient outcomes were also measured and compared between groups. Results Compared to clerks without prior geriatric exposure, clerks with geriatrics exposure were almost 3 times as likely to assess function of their older patients within two days of assuming care (27% vs. 12%, OR: 2.73, 95% CI: 1.12 to 6.66). There were no significant differences in the other clinical behaviors. Patients cared for by geriatrics-exposed clerks were less likely to die or be institutionalized (10% vs. 31%, OR: 0.24, 95% CI: 0.09 to 0.63), and they had shorter lengths of stay by an average of -7.14 days (95% CI: -12.2 to -2.07). Adjustment for baseline differences in age and cognitive impairment did not alter the results. Conclusions Clinical clerks who had completed a mandatory geriatrics rotation were more likely to document functional status upon assuming care of their older medical CTU patients, and there was also an association with better clinical outcomes. This highlights the value of including a geriatric medicine rotation as part of the core clerkship curriculum. PMID:24341470

  4. Positioning Medical Students for the Geriatric Imperative: Using Geriatrics to Effectively Teach Medicine

    ERIC Educational Resources Information Center

    Nguyen, Annie L.; Duthie, Elizabeth A.; Denson, Kathryn M.; Franco, Jose; Duthie, Edmund H.

    2013-01-01

    Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on…

  5. Integrated Clinical Geriatric Pharmacy Clerkship in Long Term, Acute and Ambulatory Care.

    ERIC Educational Resources Information Center

    Polo, Isabel; And Others

    1994-01-01

    A clinical geriatric pharmacy clerkship containing three separate practice areas (long-term, acute, and ambulatory care) is described. The program follows the medical education clerkship protocol, with a clinical pharmacy specialist, pharmacy practice resident, and student. Participation in medical rounds, interdisciplinary conferences, and…

  6. Inpatient Medicine Clerkship Action Plan 1) Objectives

    E-print Network

    Myers, Lawrence C.

    conditions stressed in inpatient medicine and are able to ensure alternative learning opportunitiesInpatient Medicine Clerkship Action Plan 1) Objectives a. We fully support plans to alter course objectives to better represent conditions stressed in inpatient medicine 2) Essential Diagnoses a. We fully

  7. 25th Anniversary Geriatric Medicine Refresher Day

    E-print Network

    Sinnamon, Gordon J.

    25th Anniversary Geriatric Medicine Refresher Day Back to the Future: 25 Years of Geriatric Care Geriatric Medicine Refresher Day Back to the Future: 25 Years of Geriatric Care Wednesday, May 4, 2011 7 address is important. Without it, you will not receive the 2012 Geriatric Medicine Refresher Day Flyer

  8. Development and Evaluation of a Longitudinal Case-Based Learning (CBL) Experience for a Geriatric Medicine Rotation

    ERIC Educational Resources Information Center

    Struck, Bryan D.; Teasdale, Thomas A.

    2008-01-01

    The DWR Department of Geriatric Medicine at OUHSC and the OKC VA Medical Center began a mandatory third-year geriatric medicine clerkship in 2003. As part of the didactic sessions, the Department created a longitudinal Case-Based Learning (CBL) experience. The purpose of this paper is to describe the CBL experience, report student satisfaction…

  9. Feedback in the Emergency Medicine Clerkship

    PubMed Central

    Bernard, Aaron W; Kman, Nicholas E; Khandelwal, Sorabh

    2011-01-01

    Objective Feedback is a technique used in medical education to help develop and improve clinical skills. A comprehensive review article specifically intended for the emergency medicine (EM) educator is lacking, and it is the intent of this article to provide the reader with an in-depth, up-to-date, and evidence-based review of feedback in the context of the EM clerkship. Methods The review article is organized in a progressive manner, beginning with the definition of feedback, the importance of feedback in medical education, the obstacles limiting the effective delivery of feedback, and the techniques to overcome these obstacles then follows. The article concludes with practical recommendations to implement feedback in the EM clerkship. To advance the literature on feedback, the concept of receiving feedback is introduced. Results The published literature regarding feedback is limited but generally supportive of its importance and effectiveness. Obstacles in the way of feedback include time constraints, lack of direct observation, and fear of negative emotional responses from students. Feedback should be timely, expected, focused, based on first-hand data, and limited to behaviors that are remediable. Faculty development and course structure can improve feedback in the EM clerkship. Teaching students to receive feedback is a novel educational technique that can improve the feedback process. Conclusion Feedback is an important educational technique necessary to improve clinical skills. Feedback can be delivered effectively in the EM clerkship. PMID:22224156

  10. A Comparison of Students' Clinical Experience in Family Medicine and Traditional Clerkships.

    ERIC Educational Resources Information Center

    Parkerson, George R., Jr.; And Others

    1984-01-01

    Experience on the traditional internal medicine, surgery, pediatrics, obstetrics-gynecology, and psychiatry clerkships was compared with the experience on a family medicine clerkship. The family medicine clerkship offered the most experience with circulatory, respiratory, digestive, neurological, musculoskeletal, and skin problems and with…

  11. Improving the national board of medical examiners internal medicine subject exam for use in clerkship evaluation

    Microsoft Academic Search

    D. Michael Elnicki; Dianne A. Lescisin; Susan Case

    2002-01-01

    OBJECTIVE: To provide a consensus opinion on modifying the National Board of Medical Examiners (NBME) Medicine Subject Exam (Shelf)\\u000a to: 1) reflect the internal medicine clerkship curriculum, developed by the Society of General Internal Medicine (SGIM) and\\u000a the Clerkship Directors in Internal Medicine (CDIM); 2) emphasize knowledge important for a clerkship student; and 3) obtain\\u000a feedback about students’ performances on

  12. Section of Geriatrics, Yale University School of Medicine The Section of Geriatrics, Department of Internal Medicine, Yale University School of Medicine,

    E-print Network

    Lee, Daeyeol

    Section of Geriatrics, Yale University School of Medicine The Section of Geriatrics, Department investigation as well as evidence of excellent potential for an outstanding career in Geriatric clinical investigation. Geriatric clinical fellowship training is preferred but not required. Yale University

  13. ETHICS IN GERIATRIC MEDICINE RESEARCH

    PubMed Central

    ?lgili, Önder; Arda, Berna; Munir, Kerim

    2014-01-01

    This article aims to evaluate the research process in geriatrics from the ethical point of view. The elderly population is increasing rapidly, but there is no parallel in the amount of research concerning this demographic. On the other hand, in the light of research ethics, this group mainly represents vulnerable people and requires more sensitivity. Taking into account all these features, fundamental principles in research ethics are first considered: the soundness of the scientific project, qualifications of the investigators, ethics committee approval, informed consent, confidentiality and privacy, beneficence/nonmaleficence, and justice are evaluated. Special ethical issues in geriatric research such as ageism and research inclusion, paucity of research involving elderly people, vulnerability of elderly subjects, and cognitive impairments are discussed separately. PMID:25489272

  14. Evaluation of Students in Medicine Clerkships.

    ERIC Educational Resources Information Center

    Magarian, Gregory J.; Mazur, Dennis J.

    1990-01-01

    The authors report their findings concerning the process used to evaluate medicine clerks, specifically identifying the importance given to subjective evaluations, made by attending physicians, compared with the importance given to clerks' performances on objective means of evaluation based on written or oral examinations, whether national or…

  15. r. Charles Cefalu, Chief Dof Geriatric Medicine, is

    E-print Network

    r. Charles Cefalu, Chief Dof Geriatric Medicine, is one of three finalists in the Geria- trician agencies, as well as individual practitioners across a range of disciplines like geriatric care m a n a g e

  16. Re-demonstration without remediation – a missed opportunity? A national survey of internal medicine clerkship directors

    PubMed Central

    Hawthorne, Mary R.; Chretien, Katherine C.; Torre, Dario; Chheda, Shobhina G.

    2014-01-01

    Background Many different components factor into the final grade assigned for the internal medicine clerkship. Failure of one or more of these requires consideration of remedial measures. Purpose To determine which assessment components are used to assign students a passing grade for the clerkship and what remediation measures are required when students do not pass a component. Methods A national cross-sectional survey of Clerkship Directors in Internal Medicine (CDIM) institutional members was conducted in April 2011. The survey included sections on remediation, grading practices, and demographics. The authors analyzed responses using descriptive and comparative statistics. Results Response rate was 73% (86/113). Medicine clerkships required students to pass the following components: clinical evaluations 83 (97%), NBME subject exam 76 (88%), written assignments 40 (46%), OSCE 35 (41%), in-house written exam 23 (27%), and mini-CEX 19 (22%). When students failed a component of the clerkship for the first time, 55 schools (64%) simply allowed students to make up the component, while only 16 (18%) allowed a simple make-up for a second failure. Additional ward time was required by 24 schools (28%) for a first-time failure of one component of the clerkship and by 49 (57%) for a second failure. The presence or absence of true remedial measures in a school was not associated with clerkship director academic rank, grading scheme, or percent of students who failed the clerkship in the previous year. Conclusions Most schools required passing clinical evaluations and NBME subject exam components to pass the medicine clerkship, but there was variability in other requirements. Most schools allowed students to simply re-take the component for a first-time failure. This study raises the question of whether true remediation is being undertaken before students are asked to re-demonstrate competence in a failed area of the clerkship to be ready for the subinternship level. PMID:25500150

  17. Clerkship directors in emergency medicine: statement of purpose.

    PubMed

    Wald, David A; Manthey, David E; Lin, Michelle; Ander, Douglas S; Fisher, Jonathan

    2008-09-01

    The Academy of Clerkship Directors in Emergency Medicine (CDEM) provides a forum for the collaborative exchange of ideas among emergency medicine (EM) medical student educators, a platform for the advancement of education, research, and faculty development, and establishes for the first time a national voice for undergraduate medical education within our specialty. CDEM plans to take a leading role in providing medical student educators with additional educational resources and opportunities for faculty development and networking. CDEM will work to foster the professional growth and development of undergraduate medical educators within our specialty. The advancement of undergraduate education within our specialty and beyond will come primarily from the support, hard work, and dedication of the educators. To accomplish our goals, at the departmental, medical school, and national level, we must come together to further promote our specialty across the spectrum of undergraduate medical education. The first step has already been taken with the formation of the Academy of CDEM. PMID:19244637

  18. Undergraduate Teaching in Geriatric Medicine: The Role of National Curricula

    ERIC Educational Resources Information Center

    Blundell, Adrian; Gordon, Adam; Gladman, John; Masud, Tahir

    2009-01-01

    There has been recent international concern that the teaching of geriatrics may be in decline. Research has suggested that support for geriatrics in national undergraduate curricula is the key to effective delivery of teaching in the specialty. We set out to determine the geriatric medicine content in the U.K. generic curriculum, reviewing this in…

  19. SUBJECT EXAM TESTING DATES BY CLERKSHIP -2012-2013 FAMILY MEDICINE NEUROLOGY PEDIATRICS PSYCHIATRY SURGERY INTERNAL MED. OB/GYN

    E-print Network

    Berdichevsky, Victor

    SUBJECT EXAM TESTING DATES BY CLERKSHIP -2012-2013 FAMILY MEDICINE NEUROLOGY PEDIATRICS PSYCHIATRY SUBJECT EXAM SCHEDULE 8:00 AM ­ Pediatrics, Family Medicine, Psychiatry and Surgery 11:00 AM ­ Medicine

  20. A Reflection on Aging: A Portfolio of Change in Attitudes toward Geriatric Patients during a Clerkship Rotation

    ERIC Educational Resources Information Center

    Del Duca, Danny; Duque, Gustavo

    2006-01-01

    The process of students' evaluation in medical schools has changed from a tutor-led evaluation system based on students' performance to a student-based evaluation that involves self-reflection and their level of change in skills and attitudes. At the McGill University Division of Geriatric Medicine, we developed an innovative system of evaluation…

  1. The Effect of a Required Third-Year Family Medicine Clerkship on Medical Students' Attitudes: Value Indoctrination and Value Clarification.

    ERIC Educational Resources Information Center

    Senf, Janet H.; Campos-Outcalt, Douglas

    1995-01-01

    Data on 997 medical students' attitudes before and after a required 6-week clerkship in family medicine, compared with specialty match data, found that the clerkship had the effects of both value indoctrination and value clarification for students. This effect appeared to persist throughout the third and fourth years. (Author/MSE)

  2. Evaluation of Medical Students During a Clinical Clerkship in Internal Medicine

    ERIC Educational Resources Information Center

    O'Donohue, W. J., Jr.; Wergin, Jon F.

    1978-01-01

    During a three-month clinical clerkship in medicine 175 medical students were evaluated. A proficiency assessment process was developed that included preceptor evaluation of on-the-job performance as well as oral and written examinations. Data analysis showed small correlations among the three measurements of competence. (Author/LBH)

  3. Improving recruitment into geriatric medicine in Canada: Findings and recommendations from the geriatric recruitment issues study.

    PubMed

    Torrible, Susan J; Diachun, Laura L; Rolfson, Darryl B; Dumbrell, Andrea C; Hogan, David B

    2006-09-01

    As the number of Canadians aged 65 and older continues to increase, declining recruitment into geriatric medicine (GM) raises concerns about the future viability of this medical subspecialty. To develop effective strategies to attract more GM trainees into the field, it is necessary to understand how medical students, residents, GM trainees, and specialists make career choices. The Geriatric Recruitment Issues Study (GRIST) was designed to assess specific methods that could be used to improve recruitment into geriatrics in Canada. Between November 2002 and January 2003, 530 participants were invited to complete the GRIST survey (117 Canadian geriatricians, 12 GM trainees, 96 internal medicine residents, and 305 senior medical students). Two hundred fifty-three surveys (47.7%) were completed and returned (from 54 participating geriatricians, 9 GM trainees, 50 internal medicine residents, and 140 senior medical students). The survey asked respondents to rate factors influencing their choice of medical career, the attractiveness of GM, and the anticipated effectiveness of potential recruitment strategies. Although feedback varied across the four groups on these issues, consistencies were observed between medical students and residents and between GM trainees and geriatricians. All groups agreed that role modeling was effective and that summer student research programs were an ineffective recruitment strategy. Based on the GRIST findings, this article proposes six recommendations for improving recruitment into Canadian geriatric medicine training programs. PMID:16970658

  4. [The challenge of geriatric medicine in the twenty-first century].

    PubMed

    Berner, Yitshal N

    2012-09-01

    During the last generation the population in Israel has doubled and the number of hospital beds per capita has declined to the lowest number in the OECD. This has implications on the number of physicians and nurses, as well as the nation's capacity to educate medical staff, while there are no increases in the infrastructure. Shortening the length of stay for acute medical conditions to an average of about three to four days is the main consequence of this situation. About 800,000 elderly people over 65 years of age are now living in Israel. Many of them suffer from acute conditions with complicating chronic morbidities. Currently, they are the main victims of the present crisis in medical services in Israel. Aging is accompanied by a decline in the physiological reserves leading to increased morbidity, decreases in function and a prolonged period for returning to normal function after trauma or acute disease. During the twentieth century, the science of medicine progressed rapidly. The pathogenesis of many conditions, either chronic or acute, was recognized, as well as the structure of the human genome and many pharmaceutical, as well as other technologies, were developed for the cure and care of diseases. Nevertheless, understanding the aging process remains a challenge. Geriatric medicine is a medical specialty that deals with a process--the process of aging, which is like pediatrics, and unlike other specialties that concentrate on systems (cardiovascular, gastroenterology, blood, immune system etc.). The added value of the geriatrician in medical practice is in the knowledge of the scientific background of aging, as well as the practical implications concerning physical and cognitive decline of function with aging and its accompanying morbidity. The practice of Geriatric Medicine is the art of connecting the biological and medical sciences to the function and the environment of the individual aging person. It requires dedicating a lot of time and patience on the part of the physician, to retrieve the information, to build confidence in the relationship with the patient and to lead the patient to continue living with an optimal quality of life in his remaining years. During the last decades, the number of geriatricians in Israel has doubled, obligatory clerkship in Geriatric Medicine is part of the medical schools' curriculum and Geriatric Medicine is part of the board curriculum in Internal Medicine and Family Medicine. Thus, Geriatric Medicine maintains the art of medical practice, using the recent knowledge in biology and medical sciences, and dealing with the population with the highest level of morbidity and lowest function. The Geriatric Medicine approach to the old person who needs medical help has to lead medical practice in the near future, so that we can preserve the great achievements of medicine during the twentieth century. PMID:23367743

  5. Meeting the challenge of evidence-based medicine in the family medicine clerkship: closing the loop from academics to office.

    PubMed

    Cavanaugh, Susan K; Calabretta, Nancy

    2013-01-01

    An EBM Seminar and POEM® project was developed to teach evidence-based medicine in a family medicine clerkship. The seminar focused on the application of preclinical coursework in biostatistics and epidemiology to the clinical third year. POEM projects involved answering clinical questions, derived from patient cases in the family medicine offices, with best available evidence. These questions and answers were archived in a wiki which was made available to the institution's family medicine physicians. Selected POEMs were also published in the in-house family medicine newsletter. The POEM projects evolved from an educational exercise for medical students to a valuable repository of evidence for clinicians. PMID:23607466

  6. Assessing Knowledge Base on Geriatric Competencies for Emergency Medicine Residents

    PubMed Central

    Hogan, Teresita M.; Hansoti, Bhakti; Chan, Shu B.

    2014-01-01

    Introduction Emergency care of older adults requires specialized knowledge of their unique physiology, atypical presentations, and care transitions. Older adults often require distinctive assessment, treatment and disposition. Emergency medicine (EM) residents should develop expertise and efficiency in geriatric care. Older adults represent over 25% of most emergency department (ED) volumes. Yet many EM residencies lack curricula or assessment tools for competent geriatric care. Fully educating residents in emergency geriatric care can demand large amounts of limited conference time. The Geriatric Emergency Medicine Competencies (GEMC) are high-impact geriatric topics developed to help residencies efficiently and effectively meet this training demand. This study examines if a 2-hour didactic intervention can significantly improve resident knowledge in 7 key domains as identified by the GEMC across multiple programs. Methods A validated 29-question didactic test was administered at six EM residencies before and after a GEMC-focused lecture delivered in summer and fall of 2009. We analyzed scores as individual questions and in defined topic domains using a paired student t test. Results A total of 301 exams were administered; 86 to PGY1, 88 to PGY2, 86 to PGY3, and 41 to PGY4 residents. The testing of didactic knowledge before and after the GEMC educational intervention had high internal reliability (87.9%). The intervention significantly improved scores in all 7 GEMC domains (improvement 13.5% to 34.6%; p<0.001). For all questions, the improvement was 23% (37.8% pre, 60.8% post; P<0.001) Graded increase in geriatric knowledge occurred by PGY year with the greatest improvement post intervention seen at the PGY 3 level (PGY1 19.1% versus PGY3 27.1%). Conclusion A brief GEMC intervention had a significant impact on EM resident knowledge of critical geriatric topics. Lectures based on the GEMC can be a high-yield tool to enhance resident knowledge of geriatric emergency care. Formal GEMC curriculum should be considered in training EM residents for the demands of an aging population. PMID:25035745

  7. Ethical issues in geriatric medicine: a unique problematic?

    PubMed

    Kluge, Eike-Henner W

    2002-01-01

    It is commonly believed that geriatric medicine generates a distinctive set of ethical problems. Implicated are such issues as resource allocation, competence and consent, advance directives, medical futility and deliberate death. It is also argued that it would be unjust to allow the elderly to compete with younger populations for expensive and scarce healthcare resources because the elderly "have already lived," and that treating them the same as these other populations would diminish the available resources unfairly, prolong a life of inevitably failing health and result in increased health care expenditures. In fact, however, this perception of ethical uniqueness is mistaken. Differences in medical conditions, demographics and aetiology should not be allowed to obscure the fact that ethical issues in geriatric medicine are essentially the same as those faced in any other area of health care, and that the solutions that are adopted in the geriatric context must be consistent with the ethical principles that are followed elsewhere. The paper argues that the root of the mistaken perception lies in the abandonment of the Hippocratic mandate of medicine and in an unreflective adherence to the belief that medical advances are inevitably beneficial. It is suggested that a return to patient-centred medicine and the use of ethics impact analyses before introducing medical advances may be ethically appropriate. PMID:12814285

  8. Smoking Assessment and Cessation Skills in the Inpatient Medicine Clerkship.

    ERIC Educational Resources Information Center

    Hull, Alan L.; Kleinhenz, Mary Ellen

    1990-01-01

    Analysis of 61 inpatient medical writeups by 23 third year medicine clerks found smoking history notations in 74 percent but quantification of exposure much less commonly. None detailed patient addiction or willingness to quit, or included smoking cessation in the patient plan. Students' smoking assessment and cessation skills are seen as poorly…

  9. An Assessment of the Mastery of Entry-Level Practice Competencies Using a Primary Care Clerkship Training Model.

    ERIC Educational Resources Information Center

    Nelson, Arthur A., Jr.; Maddox, Ray R.

    1992-01-01

    A study investigated the effectiveness on entry-level skills of training six pharmacy graduate students in a primary care facility. Required clerkships in medicine, ambulatory care, and geriatrics were combined into a single rotation in a family practice ambulatory care clinic. Results were positive and have implications for improving some…

  10. Structured Communication: Teaching Delivery of Difficult News with Simulated Resuscitations in an Emergency Medicine Clerkship

    PubMed Central

    Lamba, Sangeeta; Nagurka, Roxanne; Offin, Michael; Scott, Sandra R.

    2015-01-01

    Introduction The objective is to describe the implementation and outcomes of a structured communication module used to supplement case-based simulated resuscitation training in an emergency medicine (EM) clerkship. Methods We supplemented two case-based simulated resuscitation scenarios (cardiac arrest and blunt trauma) with role-play in order to teach medical students how to deliver news of death and poor prognosis to family of the critically ill or injured simulated patient. Quantitative outcomes were assessed with pre and post-clerkship surveys. Secondarily, students completed a written self-reflection (things that went well and why; things that did not go well and why) to further explore learner experiences with communication around resuscitation. Qualitative analysis identified themes from written self-reflections. Results A total of 120 medical students completed the pre and post-clerkship surveys. Majority of respondents reported that they had witnessed or role-played the delivery of difficult news, but only few had real-life experience of delivering news of death (20/120, 17%) and poor prognosis (34/120, 29%). This communication module led to statistically significant increased scores for comfort, confidence, and knowledge with communicating difficult news of death and poor prognosis. Pre-post scores increased for those agreeing with statements (somewhat/very much) for delivery of news of poor prognosis: comfort 69% to 81%, confidence 66% to 81% and knowledge 76% to 90% as well as for statements regarding delivery of news of death: comfort 52% to 68%, confidence 57% to 76% and knowledge 76% to 90%. Respondents report that patient resuscitations (simulated and/or real) generated a variety of strong emotional responses such as anxiety, stress, grief and feelings of loss and failure. Conclusion A structured communication module supplements simulated resuscitation training in an EM clerkship and leads to a self-reported increase in knowledge, comfort, and competence in communicating difficult news of death and poor prognosis to family. Educators may need to seek ways to address the strong emotions generated in learners with real and simulated patient resuscitations. PMID:25834685

  11. The Glass Is Half Full: Geriatric Precepting Encounters in Family Medicine

    ERIC Educational Resources Information Center

    Rollins, Lisa K.; Martirosian, Tovia; Gazewood, John D.

    2009-01-01

    Approximately 19% to 20% of all family medicine office visits involve care to patients older than age 65, yet limited research addresses family medicine geriatric education in the outpatient setting. This study explored how geriatric content is incorporated into resident/attending precepting encounters, using direct observation. An observer…

  12. Complexity in graduate medical education: a collaborative education agenda for internal medicine and geriatric medicine.

    PubMed

    Chang, Anna; Fernandez, Helen; Cayea, Danelle; Chheda, Shobhina; Paniagua, Miguel; Eckstrom, Elizabeth; Day, Hollis

    2014-06-01

    Internal medicine residents today face significant challenges in caring for an increasingly complex patient population within ever-changing education and health care environments. As a result, medical educators, health care system leaders, payers, and patients are demanding change and accountability in graduate medical education (GME). A 2012 Society of General Internal Medicine (SGIM) retreat identified medical education as an area for collaboration between internal medicine and geriatric medicine. The authors first determined a short-term research agenda for resident education by mapping selected internal medicine reporting milestones to geriatrics competencies, and listing available sample learner assessment tools. Next, the authors proposed a strategy for long-term collaboration in three priority areas in clinical medicine that are challenging for residents today: (1) team-based care, (2) transitions and readmissions, and (3) multi-morbidity. The short-term agenda focuses on learner assessment, while the long-term agenda allows for program evaluation and improvement. This model of collaboration in medical education combines the resources and expertise of internal medicine and geriatric medicine educators with the goal of increasing innovation and improving outcomes in GME targeting the needs of our residents and their patients. PMID:24557513

  13. Geriatric Medicine Training for Family Practice Residents in the 21st Century: A Report from the Residency Assistance Program/Hartford Geriatrics Initiative.

    ERIC Educational Resources Information Center

    Warshaw, Gregg; Murphy, John; Buehler, James; Singleton, Stacy

    2003-01-01

    Summarizes the initial results of the regional geriatric medicine curriculum retreats for family practice residency directors provided as part of the American Academy of Family Physicians multi-part project to improve the amount and quality of geriatric medicine education received by family practice residents. (EV)

  14. Geriatric Medicine Fellows' Experiences and Attitudes toward an Objective Structured Clinical Examination (OSCE)

    ERIC Educational Resources Information Center

    Bagri, Anita S.; Zaw, Khin M.; Milanez, Marcos N.; Palacios, Juan J.; Qadri, Syeda S.; Bliss, Linda A.; Roos, Bernard A.; Ruiz, Jorge G.

    2009-01-01

    A total of 8 geriatric medicine fellows participated in an objective structured clinical examination (OSCE) assessing communication skills and clinical reasoning in common geriatric syndromes. To determine their perceptions about the experience, we conducted surveys and semistructured interviews. We analyzed the survey data using descriptive…

  15. Relating Medical Students' Knowledge, Attitudes, and Experience to an Interest in Geriatric Medicine

    ERIC Educational Resources Information Center

    Fitzgerald, James T.; Wray, Linda A.; Halter, Jeffrey B.; Williams, Brent C.; Supiano, Mark A.

    2003-01-01

    Purpose: This study examined medical students' interest in geriatrics: Are knowledge, positive attitudes, and prior experience with older adults associated with an interest in geriatric medicine? Design and Methods: Entering University of Michigan medical students completed three surveys: the Revised Facts on Aging Quiz, the University of…

  16. National survey of geriatric medicine fellowship programs: comparing findings in 2006/07 and 2001/02 from the American Geriatrics Society and Association of Directors of Geriatric Academic Programs Geriatrics Workforce Policy Studies Center.

    PubMed

    Bragg, Elizabeth J; Warshaw, Gregg A; Meganathan, Karthikeyan; Brewer, David E

    2010-11-01

    This article documents the development of geriatric medicine fellowship training in the United States through 2009. Results from a national cross-sectional survey of all geriatric medicine fellowship training programs conducted in 2007 is compared with results from a similar survey in 2002. Secondary data sources were used to supplement the survey results. The 2007 survey response rate was 71%. Sixty-seven percent of responding programs directors have completed formal geriatric medicine fellowship training and are board certified in geriatrics, and 29% are board certified through the practice pathway. The number of Accreditation Council for Graduate Medical Education-accredited fellowship programs has slowly increased, from 120 (23 family medicine (FM) and 97 internal medicine (IM)) in 2001/02 to 145 in 2008/09 (40 FM and 105 IM), resulting in a 21% increase in fellowship programs and a 13% increase in the number of first-year fellows (259 to 293). In 2008/09, the growth in programs and first-year slots, combined with the weak demand for geriatrics training, resulted in more than one-third of first-year fellow positions being unfilled. The number of advanced fellows decreased slightly from 72 in 2001/00 to 65 in 2006/07. In 2006/07, 55% of the advanced fellows were enrolled at four training programs. In 2008/09, 66% of fellows were international medical school graduates. The small numbers of graduating geriatric medicine fellows are insufficient to care for the expanding population of older frail patients, train other disciples in the care of complex older adults, conduct research in aging, and be leaders in the field. PMID:21039369

  17. Report of the Geriatrics-Hospice and Palliative Medicine Work Group: American Geriatrics Society and American Academy of Hospice and Palliative Medicine leadership collaboration.

    PubMed

    2012-03-01

    Although the fields of hospice and palliative medicine and geriatrics have developed from separate origins, they share much in common. They share concerns for optimizing care of older adults with advanced illness. They both seek to address the common problem of care fragmentation for those with chronic illness. Both subspecialties see the patient and their loved ones as a unit requiring thoughtful, integrated care, rather than seeing the patient as a cluster of organ systems and conditions. The fields also share many core principles, including an emphasis on interdisciplinary care and care coordination. As increasing emphasis is placed on the medical home, chronic and advanced illness care, and systems changes to decrease care fragmentation, geriatrics and hospice and palliative medicine stand to benefit by blending efforts and common interests to improve care for patients and their loved ones. In 2009, a collaborative effort was begun involving the leadership of the American Geriatrics Society, the American Academy of Hospice and Palliative Medicine, and the John A. Hartford Foundation. The goal of the collaboration was to convene leaders in geriatrics and hospice and palliative medicine to identify areas of potential synergy between the two subspecialties and to design a plan for exploring and developing these areas of common interest. This article describes the progress of the collaborative effort to date. PMID:22329491

  18. Stanford University School of Medicine Pre-Clerkship Curriculum 2013-14 Q1 Autumn Quarter (16 weeks) Q2 Winter Quarter (11 weeks) Q3 Spring Quarter (11 weeks)

    E-print Network

    Puglisi, Joseph

    Stanford University School of Medicine Pre-Clerkship Curriculum 2013-14 YEAR ONE Q1 Autumn Quarter Cardiovascular 10:00 11:00 Immunology Immunology 12:00 1:15 Gross Anatomy Practice of Medicine Anatomy Nervous System Practice of Medicine Practice of Medicine Practice of Medicine 2:15 3:15 Practice of Medicine 4

  19. Stanford University School of Medicine Pre-Clerkship Curriculum 2012-13 Q1 Autumn Quarter (16 weeks) Q2 Winter Quarter (11 weeks) Q3 Spring Quarter (11 weeks)

    E-print Network

    Puglisi, Joseph

    Stanford University School of Medicine Pre-Clerkship Curriculum 2012-13 YEAR ONE Q1 Autumn Quarter of Medicine Anatomy Nervous System Practice of Medicine Practice of Medicine Practice of Medicine 2:15 3:15 · Practice of Medicine 4:15 YEAR TWO Q4 Autumn Quarter (16 weeks) Q5 Winter Quarter (11 weeks) Q6 Spring

  20. Medical oncology and geriatric medicine: is it time for fellowship integration?

    PubMed

    Bennett, J M; Sahasrabudhe, D M; Hall, W J

    1997-10-01

    Although training programs exist in both medical oncology and geriatrics (approved by the American Board of Internal Medicine), neither is adequate to ensure an appropriate supply of physicians to assume a leadership role in the treatment of the increasing number of geriatric patients who have or will develop a malignancy. A proposal for offering a 3-4 year program leading to dual certification is under consideration. A careful review of both the medical oncology training program and added qualifications in geriatrics has identified key components of each that can serve as a basis for a combined program. Such a program can encourage research into behavior modification of existing biases in referring geriatric oncology patients for treatment as well as a better understanding of the biology of aging, addressing in particular the pharmacology of anticancer agents in this unique population. It is anticipated that pilot projects will be undertaken to develop common pathways for developing combined programs in medical oncology and geriatrics. The second phase will include recruitment of selected candidates who are interested in an academic career in geriatric oncology. A need for additional academic-based geriatric oncologists has been identified that can address the anticipated increase in the incidence and presence of cancer in an aging population. Such a cadre of specialists will be in an excellent position to recommend changes in the current (mostly negative) approach to the management of cancer in patients age > 65 years. PMID:9317190

  1. Salvaging a geriatric medicine academic program in disaster mode-the LSU training program post-Katrina.

    PubMed Central

    Cefalu, Charles A.; Schwartz, Robert S.

    2007-01-01

    Formal training in geriatric medicine in Louisiana is in its infancy. This article portrays the struggle of the sole functioning geriatric medicine training program and its trials and tribulations in a survival mode, opportunities that come with disaster as well as lessons learned post-Katrina. PMID:17534025

  2. FM Clerkship Update Helping Students do well

    E-print Network

    Maxwell, Bruce D.

    References #12;Key Teaching Points #12;+ Student log data # cases completed # cards within case completed Honors Family Medicine Pediatrics Internal Medicine Psychiatry #12;+ FM Clerkship Final Grade Mid-clerkship and annual basis. · All statistical analyses were conducted with SPSS (v19, 2010). ACKNOWLEDGEMENTS

  3. Fellows' Perceptions of a Mandatory Reflective Electronic Portfolio in a Geriatric Medicine Fellowship Program

    ERIC Educational Resources Information Center

    Ruiz, Jorge G.; Qadri, Syeda S.; Karides, Marina; Castillo, Carmen; Milanez, Marcos; Roos, Bernard A.

    2009-01-01

    Electronic portfolios (ePortfolios) can be useful for evaluating and documenting mastery of competencies. We investigated geriatric medicine fellows' perceptions of an ePortfolio. We conducted surveys and focus groups followed by quantitative and qualitative data analysis. Our study revealed that fellows considered the ePortfolio acceptable and…

  4. TRANSITIONING TO CLERKSHIPS: 2 Seniors share their strategy

    E-print Network

    Acton, Scott

    is not required to do away rotations or to take Step 2 but it is helpful. Acute care/geriatrics is not necessary: Many people seem to start back on the Acute Care/Geriatrics block. Those two clerkships do not have

  5. Effective Teaching Methods for Geriatric Competencies

    ERIC Educational Resources Information Center

    Strano-Paul, Lisa

    2011-01-01

    This study assesses how effective classroom sessions are at teaching geriatric competencies to medical students. At Stony Brook Medical School, most geriatric competencies are taught in the Ambulatory Care Clerkship during small-group educational sessions. Clinical exposure to reinforce these specialized skills varies with preceptor assignment. A…

  6. Using a Computerized Database to Manage a Decentralized Ambulatory Care Clerkship.

    ERIC Educational Resources Information Center

    Ruane, Thomas J.; Smith, Blake W. H.

    1990-01-01

    The ambulatory care clerkship at the College of Human Medicine of Michigan State University has an extensive database of clerkship experiences including a catalog of students' clinical experiences, assessment of students' performances by the faculty, and students' evaluation of various aspects of the clerkship. (MLW)

  7. MEC Subcommittee Summary and Recommendations for Change GAM Clerkship

    E-print Network

    Myers, Lawrence C.

    Psychiatry (year II), Family Medicine Clerkship, Clinical Pharmacology and the GAM the following: Dr. John Dick ­ Associate Dean for Clinical Education, Dr. Hilary Ryder" and "Elderly" was covered in On Doctoring, Biostats, Pharmacology, Hematology, SBM

  8. A National Survey on the Current Status of Family Practice Residency Education in Geriatric Medicine.

    ERIC Educational Resources Information Center

    Li, Ina; Arenson, Christine; Warshaw, Gregg; Bragg, Elizabeth; Shaull, Ruth; Counsell, Steven R.

    2003-01-01

    A survey of family practice residency directors found that 92 percent have a required geriatrics curriculum; nursing homes, assisted living facilities, and home care are the predominant training sites; the mean number of geriatrics faculty is 2.6 per program; and conflicting time demands with other curricula was ranked as the most significant…

  9. Clerkship in primary care: a cross-sectional study about expectations and experiences of undergraduates in medicine

    PubMed Central

    Fuchs, Stephan; Klement, Andreas; Lichte, Thomas; Abendroth, Jens

    2014-01-01

    Introduction: With the amendment of the medical licensure act (Approbationsordnung) in 2012, a four-week clerkship in primary care (FHV) became mandatory. We investigated the expectations with which students begin the FHV, which criteria are relevant in selecting the location for the FHV, and the experiences the students had during the FHV. Method: In a cross-sectional study, all third-year students at both medical schools in Saxony-Anhalt were surveyed in 2013 about their expectations and experiences regarding the FHV. This is the last cohort for which the FHV is optional. Questions were asked about 29 items addressing six topics (personal information, selection of FHV location, selection of FHV medical practice, expectations, experiences, and specialty selection). Results: Out of a student body of 446, responses were received from N=424 (response rate 95.1%; of which 61.8% female). Of these students, 71 (16.7%) had completed the FHV and 70 (16.5%) were planning to; another 267 students (63%) had not (yet) planned to participate in an FHV. Where a student’s parents lived, personal recommendations of a particular medical practice and the attractiveness of the region were the most important criteria for selecting the clerkship site. After completing the FHV, the learning objectives reflected themselves in the experiences of the students in a similar order and significance as in the expectations of students who planned or had not (as of yet) planned to complete the FHV. A relevant influence of the FHV confirming the choice to specialize in general practice or outpatient care was not indicated by those who had completed the FHV. Conclusion: After location and practice, the FHV is selected according to personal criteria and in connection with prioritized learning objectives. From the students’ perspective, the most frequently named learning objectives are also identified as acquired experience after completing the FHV. However, the FHV does not have a reinforcing effect on the selection of general practice as a specialty. PMID:25489344

  10. "Making the grade:" noncognitive predictors of medical students' clinical clerkship grades.

    PubMed Central

    Lee, Katherine B.; Vaishnavi, Sanjeev N.; Lau, Steven K. M.; Andriole, Dorothy A.; Jeffe, Donna B.

    2007-01-01

    OBJECTIVES: Because clinical clerkship grades are associated with resident selection and performance and are largely based on residents'/attendings' subjective ratings, it is important to identify variables associated with clinical clerkship grades. METHODS: U.S. medical students who completed > or =1 of the following required clinical clerkships--internal medicine, surgery, obstetrics/gynecology, pediatrics, neurology and psychiatry--were invited to participate in an anonymous online survey, which inquired about demographics, degree program, perceived quality of clerkship experiences, assertiveness, reticence and clerkship grades. RESULTS: A total of 2395 medical students (55% women; 57% whites) from 105 schools responded. Multivariable logistic regression models identified factors independently associated with receiving lower clerkship grades (high pass/pass or B/C) compared with the highest grade (honors or A). Students reporting higher quality of clerkship experiences were less likely to report lower grades in all clerkships. Older students more likely reported lower grades in internal medicine (P = 0.02) and neurology (P < 0.001). Underrepresented minorities more likely reported lower grades in all clerkships (P < 0.001); Asians more likely reported lower grades in obstetrics/gynecology (P = 0.007), pediatrics (P = 0.01) and neurology (P = 0.01). Men more likely reported lower grades in obstetrics/gynecology (P < 0.001) and psychiatry (P = 0.004). Students reporting greater reticence more likely reported lower grades in internal medicine (P = 0.02), pediatrics (P = 0.02) and psychiatry (P < 0.05). Students reporting greater assertiveness less likely reported lower grades in all clerkships (P < 0.03) except IM. CONCLUSIONS: The independent associations between lower clerkship grades and nonwhite race, male gender, older age, lower quality of clerkship experiences, and being less assertive and more reticent are concerning and merit further investigation. PMID:17987918

  11. Integrating Geriatrics into Medical School: Student Journaling as an Innovative Strategy for Evaluating Curriculum

    ERIC Educational Resources Information Center

    Shield, Renee R.; Farrell, Timothy W.; Nanda, Aman; Campbell, Susan E.; Wetle, Terrie

    2012-01-01

    Purpose of the study: The Alpert Medical School of Brown University began to integrate geriatrics content into all preclerkship courses and key clerkship cases as part of a major medical school curriculum redesign in 2006. This study evaluates students' responses to geriatrics integration within the curriculum using journals kept by volunteer…

  12. UConn Center on Aging Summer Geriatrics Conferences 28th

    E-print Network

    Kim, Duck O.

    UConn Center on Aging Summer Geriatrics Conferences ­ 28th Year UPDATE IN GERIATRIC MEDICINE Chief, or research geriatric issues No registration required; any questions: Helen-Mary Schwartz 860/8 9:00 Kristina Zdanys, MD Depression in Late Life 10:15 Kevin Chamberlin, PharmD Update in Geriatric

  13. Description of Clerkships FAMILY MEDICINE

    E-print Network

    Shihadeh, Alan

    General objectives 1. Provide a learning experience in ambulatory care. 2. Help students identify teaching, provide supervised patient care in different ambulatory settings, conduct case discussions and manage common, undifferentiated problems in ambulatory and community settings. 2. Approach the patient

  14. Effects and feasibility of an Integrative Medicine program for geriatric patients–a cluster-randomized pilot study

    PubMed Central

    Teut, Michael; Schnabel, Katharina; Baur, Roland; Kerckhoff, Annette; Reese, Frauke; Pilgram, Niels; Berger, Franziska; Luedtke, Rainer; Witt, Claudia M

    2013-01-01

    Background Older adults often use complementary medicine; however, very few interventional studies have focused on them. The aim of this study was to evaluate the feasibility and to obtain preliminary data on effectiveness of an Integrative Medicine (IM) program compared to usual medical care. Methods The study consisted of older adults living in shared apartment communities including caregiving. The shared apartments were cluster-randomized to the IM program or Usual Care (UC). IM consisted of additional lifestyle modification (exercise and diet), external naturopathic applications, homeopathic treatment, and modification of conventional drug therapy for 12 months. The UC group received conventional care alone. The following outcomes were used: Nurses Observation Scale for Geriatric Patients (NOSGER); Assessment of Motor and Process Skills; Barthel Index; Qualidem; Profile of Wellbeing; and Mini-mental State Examination. Exploratory effect sizes (Cohen’s d, means adjusted for differences of baseline values) were calculated to analyze group differences. Results A total of eight shared apartment communities were included; four were allocated to IM (29 patients, median seven patients; [mean ± standard deviation] 82.7 ± 8.6 years) and four to UC (29 patients, median eight patients; 76.0 ± 12.8 years of age). After 12 months, effect sizes ?0.3 were observed for activities of daily living on the NOSGER-Activities of Daily Living subscale (0.53), Barthel Index (0.30), Qualidem total sum score (0.39), Profile of Wellbeing (0.36), NOSGER-Impaired Social Behavior (0.47), and NOSGER-Depressed Mood subscales (0.40). Smaller or no effects were observed for all other outcomes. The intervention itself was found to be feasible, but elaborate and time consuming. Discussion This exploratory pilot study showed that for a full-scale trial, the outcomes of Activities of Daily Living and Quality of Life seem to be the most promising. The results have to be interpreted with care; larger confirmatory trials are necessary to validate the effects. PMID:23901266

  15. Nutraceuticals for geriatrics

    PubMed Central

    Gupta, Charu; Prakash, Dhan

    2014-01-01

    Geriatrics is a medical practice that addresses the complex needs of older patients and emphasizes maintaining functional independence even in the presence of chronic disease. Treatment of geriatric patients requires a different strategy and is very complex. Geriatric medicines aim to promote health by preventing and treating diseases and disabilities in older adults. Development of effective dietary interventions for promoting healthy aging is an active but challenging area of research because aging is associated with an increased risk of chronic disease, disability, and death. Aging populations are a global phenomenon. The most widespread conditions affecting older people are hypertension, congestive heart failure, dementia, osteoporosis, breathing problems, cataract, and diabetes to name a few. Decreased immunity is also partially responsible for the increased morbidity and mortality resulting from infectious agents in the elderly. Nutritional status is one of the chief variables that explains differences in both the incidence and pathology of infection. Elderly people are at increased risk for micronutrient deficiencies due to a variety of factors including social, physical, economic, and emotional obstacles to eating. Thus there is an urgent need to shift priorities to increase our attention on ways to prevent chronic illnesses associated with aging. Individually, people must put increased efforts into establishing healthy lifestyle practices, including consuming a more healthful diet. The present review thus focuses on the phytochemicals of nutraceutical importance for the geriatric population.

  16. Clerkship description by Roshini Pinto-Powell, MD Summary of Student Comments by Tom Finn (DMS 4)

    E-print Network

    Myers, Lawrence C.

    the skills necessary to competently and efficiently take care of complex geriatric and ambulatory medical patients in a busy clinic setting. These skills include specific knowledge of core geriatric and ambulatory medicine topics as well as augmentation

  17. Geriatric nephrology and the `nephrogeriatric giants'

    Microsoft Academic Search

    Carlos G. Musso

    2002-01-01

    As a branch of Internal Medicine, geriatric nephrology combines knowledge in gerontology, geriatrics and nephrology in order to obtain a better evaluation and treatment of renal disease in the elderly. Also, this specialty aims at a greater understanding of the process of renal senescence. This new specialty has been formed by combining various elements from each of its mother sciences:

  18. Regardless of age: Incorporating principles from geriatric medicine to improve care transitions for patients with complex needs.

    PubMed

    Arbaje, Alicia I; Kansagara, Devan L; Salanitro, Amanda H; Englander, Honora L; Kripalani, Sunil; Jencks, Stephen F; Lindquist, Lee A

    2014-06-01

    With its focus on holistic approaches to patient care, caregiver support, and delivery system redesign, geriatrics has advanced our understanding of optimal care during transitions. This article provides a framework for incorporating geriatrics principles into care transition activities by discussing the following elements: (1) identifying factors that make transitions more complex, (2) engaging care "receivers" and tailoring home care to meet patient needs, (3) building "recovery plans" into transitional care, (4) predicting and avoiding preventable readmissions, and (5) adopting a palliative approach, when appropriate, that optimizes patient and family goals of care. The article concludes with a discussion of practical aspects of designing, implementing, and evaluating care transitions programs for those with complex care needs, as well as implications for public policy. PMID:24557511

  19. Guidelines for Graduate Medical Education in Geriatrics.

    ERIC Educational Resources Information Center

    Robbins, Alan S.; Beck, John C.

    1982-01-01

    Performance objectives, core content, training experiences, and clinical exposure and program evaluations are described for geriatric fellows and house staff members in internal medicine, family practice, neurology, and psychiatry. A modified Delphi study was used. (Author/MLW)

  20. Efficacy and safety of the Chinese herbal medicine shuganjieyu with and without adjunctive repetitive transcranial magnetic stimulation (rTMS) for geriatric depression: a randomized controlled trial

    PubMed Central

    XIE, Minmin; JIANG, Wenhai; YANG, Haibo

    2015-01-01

    Background Pharmacological treatment of geriatric depression is often ineffective because patients cannot tolerate adequate doses of antidepressant medications. Aim Examine the efficacy and safety of shuganjieyu – the first Chinese herbal medicine approved for the treatment of depression by China’s drug regulatory agency -- with and without adjunctive treatment with repetitive transcranial magnetic stimulation (rTMS) in the treatment of geriatric depression. Methods Sixty-five inpatients 60 or older who met ICD-10 criteria for depression were randomly assigned to an experimental group (shuganjieyu + rTMS) (n=36) or a control group (shuganjieyu + sham rTMS)(n=29). All participants received 4 capsules of shuganjieyu daily for 6 weeks. rTMS (or sham rTMS) was administered 20 minutes daily, five days a week for 4 weeks. Blinded raters used the Hamilton Rating Scale for Depression (HAMD-17) and the Treatment Emergent Symptom Scale to assess clinical efficacy and safety at baseline and 1, 2, 4, and 6 weeks after starting treatment. Over the six-week trial, there was only one dropout from the experimental group and two dropouts from the control group. Results None of the patients had serious side effects, but 40% in the experimental group and 50% in the control group experienced minor side effects that all resolved spontaneously. Both groups showed substantial stepwise improvement in depressive symptoms over the 6 weeks. Repeated measures ANOVA found no differences between the two groups. After 6 weeks, 97% of the experimental group had experienced a 25% or greater drop in the level of depression, but only 20% had experience a 50% or greater drop in the level of depression; the corresponding values in the control group were 96% and 19%. There were some minor, non-significant differences in the onset of the treatment effect between the different types of depressive symptoms, but by the second week of treatment all five HAMD-17 subscale scores had improved significantly in both groups Conclusion The Chinese herbal medicine shuganjieyu is effective and safe in the treatment of geriatric depression, but only a minority of patients have greater than 50% improvement in their depressive symptoms after 6 weeks of treatment. Adjunctive use of rTMS with shuganjieyu does not improve the overall outcome and does not significantly speed up the onset of action of shuganjieyu.

  1. Academic Detailing to Teach Aging and Geriatrics.

    PubMed

    Duckett, Ashley; Cuoco, Theresa; Pride, Pamela; Wiley, Kathy; Iverson, Patty J; Marsden, Justin; Moran, William; Caton, Cathryn

    2015-01-01

    Geriatric education is a required component of internal medicine training. Work hour rules and hectic schedules have challenged residency training programs to develop and utilize innovative teaching methods. In this study, the authors examined the use of academic detailing as a teaching intervention in their residents' clinic and on the general medicine inpatient wards to improve clinical knowledge and skills in geriatric care. The authors found that this teaching method enables efficient, directed education without disrupting patient care. We were able to show improvements in medical knowledge as well as self-efficacy across multiple geriatric topics. PMID:24794649

  2. Impact of an Ambulatory Care Clerkship on the Attitudes of Students from Five Classes (1985-1989) toward Primary Care.

    ERIC Educational Resources Information Center

    Rucker, Lisa; And Others

    1991-01-01

    A study evaluated the effects of a required ambulatory care clerkship on students' (n=776) knowledge of primary care medicine and subsequent career choices. Results suggest that exposure to outpatient medicine during medical school facilitates student knowledge of primary care medicine and influences career choice. (Author/MSE)

  3. Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system.

    PubMed

    Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

    2014-01-01

    The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills.Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment.Success factors include continued support and investment from both organizations' leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers. PMID:24867551

  4. An Evaluation of a Clerkship In Cardiology

    ERIC Educational Resources Information Center

    Edson, John N.; and others

    1969-01-01

    Evaluation of the clinical clerkship in Cardiology for general practitioners proves there is an urgent need for continuing post graduate medical education for general practitioners. Clerkship was offered jointly by the Long Island College Hospital and the State University of New York Downstate Medical Center, Brooklyn, New York. (IR)

  5. A Medical Student Logbook for Streamlining Collection of Clerkship Evaluation Data.

    ERIC Educational Resources Information Center

    DaRosa, Debra A.; Folse, Roland

    A medical student logbook that was developed by the Department of Surgery at Southern Illinois University School of Medicine to improve the clerkship is described. Specific objectives of the logbook were: (1) to reinforce student habits to systematically record relevant data concerning patients for purposes of future recall and reference; (2) to…

  6. Skills Inventory/Biography University of Rochester School of Medicine & Dentistry

    E-print Network

    Goldman, Steven A.

    Boston University Geriatrics Medical or Scientific Specialty Geriatric Medicine, Internal Medicine society meetings (i.e. American Geriatrics Society Annual Meetings) What is the best way to contact you

  7. Specialist Physicians in Geriatrics—Report of the Canadian Geriatrics Society Physician Resource Work Group*

    PubMed Central

    Hogan, David B.; Borrie, Michael; Basran, Jenny F.S.; Chung, A. Maria; Jarrett, Pamela G.; Morais, José A.; Peters, Eileen; Rockwood, Kenneth J.; St. John, Philip D.; Sclater, Anne L.; Stultz, Timothy; Woolmore-Goodwin, Sarah

    2012-01-01

    Background At the 2011 Annual Business Meeting of the Canadian Geriatrics Society (CGS), an ad hoc Work Group was struck to submit a report providing an estimate of the number of physicians and full-time equivalents (FTEs) currently working in the field of geriatrics, an estimate of the number required (if possible), and a clearer understanding of what has to be done to move physician resource planning in geriatrics forward in Canada. Methods It was decided to focus on specialist physicians in geriatrics (defined as those who have completed advanced clinical training or have equivalent work experience in geriatrics and who limit a significant portion of their work-related activities to the duties of a consultant). Results In 2012, there are 230–242 certified specialists in geriatric medicine and approximately 326.15 FTE functional specialists in geriatrics. While this is less than the number required, no precise estimate of present and future need could be provided, as no attempts at a national physician resource plan in geriatrics based on utilization and demand forecasting, needs-based planning, and/or benchmarking have taken place. Conclusions This would be an opportune time for the CGS to become more involved in physician resource planning. In addition to this being critical for the future health of our field of practice, there is increasing interest in aligning specialty training with societal needs (n = 216). PMID:23259019

  8. Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care

    ERIC Educational Resources Information Center

    McCann-Stone, Nancy; Robinson, Sherry B.; Rull, Gary; Rosher, Richard B.

    2009-01-01

    This paper describes an Elder Specialist Program developed by one school of medicine to sensitize medical students to geriatric psychosocial issues. Elder Specialists participate in panel discussions as part of each geriatric session. As an alternative to traditional senior mentoring programs, the Elder Specialist Program provides all students a…

  9. Emergency Medicine Clerkship MID-ROTATION EVALUATION

    E-print Network

    Issa, Naoum

    and openness to feedback, self-improvement, and self-directed learning. 11. Establishes caring and trusting reasoning/problem solving: Clinical Skills: Leadership and teamwork: Self-directed learning: Other unique

  10. Family Medicine Clerkship MID-ROTATION EVALUATION

    E-print Network

    Issa, Naoum

    and openness to feedback, self-improvement, and self-directed learning. 11. Establishes caring and trusting Skills: Leadership and teamwork: Self-directed learning: Other unique characteristics: 2059540319 #12;

  11. Family Practice Clerkships in California and Nevada: A Manual and Guide for Medical Students.

    ERIC Educational Resources Information Center

    California Univ., San Francisco. Div. of Family and Community Medicine.

    Information is provided on family practice clerkships (25 available at the time of publication in California and 1 in Nevada) to assist students in choosing a clerkship. For each clerkship, information is presented on the following: school/course, residency affiliation, site, address and phone number, clerkship director, clerkship coordinator,…

  12. The Harvard Medical School-Cambridge Integrated Clerkship: An Innovative Model of Clinical Education

    Microsoft Academic Search

    Barbara Ogur; David Hirsh; Edward Krupat; David Bor

    2007-01-01

    The Harvard Medical School-Cambridge Integrated Clerkship (HMS-CIC) is a redesign of the principal clinical year to foster students' learning from close and continuous contact with cohorts of patients in the disciplines of internal medicine, neurology, obstetrics- gynecology, pediatrics, and psychiatry. With year-long mentoring, students follow their patients through major venues of care. Surgery and radiology also are taught longitudinally, grounded

  13. Gerontological education in Japan--geriatric education and training.

    PubMed

    Fukuchi, Y

    1992-05-01

    There are 13 academic geriatric departments among 80 medical schools in Japan as of November 1991. The first independent department was established in 1962 at Tokyo University. The undergraduate education program includes lectures in geriatrics (20 hours/year in 11/12 medical schools), bedside teaching at geriatric ward (6/12 medical schools, 66 hours on average per year). The theme of lectures are diverse and incorporate all the three major fields in gerontology: biology of aging, clinical geriatrics and socio-economical aspects of aging society. The postgraduate geriatric education is carried out mainly at university setting and most of the medical schools (83%) accept graduate students who are trained at independent geriatric ward (92%) as well as at outpatient clinics. In 1989, Japan Geriatrics Society started a new certification system by which 687 MDs have been temporarily certified in geriatrics. The first examination will be given by the society in 1992 and the eligibility to sit in the examination requires three years geriatrics fellowship after certification in medicine or general surgery. The curriculum proposed by the society shares many items of training in common with those found in north American and in Europe. Some points of suggestions and recommendations were presented for future improvement in the education of gerontology in Japan. PMID:1507505

  14. Skills Inventory/Biography University of Rochester School of Medicine & Dentistry

    E-print Network

    Goldman, Steven A.

    Program Director Boston University Geriatrics Medical or Scientific Specialty Geriatric Medicine, Internal and national medical society meetings (i.e. American Geriatrics Society Annual Meetings) What is the best way

  15. Academic career development in geriatric fellowship training.

    PubMed

    Medina-Walpole, Annette; Fonzi, Judith; Katz, Paul R

    2007-12-01

    Career development is rarely formalized in the curricula of geriatric fellowship programs, and the training of new generations of academic leaders is challenging in the 1 year of fellowship training. To effectively prepare fellows for academic leadership, the University of Rochester's Division of Geriatrics, in collaboration with the Warner School of Graduate Education, created a yearlong course to achieve excellence in teaching and career development during the 1-year geriatric fellowship. Nine interdisciplinary geriatric medicine, dentistry, and psychiatry fellows completed the course in its initial year (2005/06). As participants, fellows gained the knowledge and experience to successfully develop and implement educational initiatives in various formats. Fellows acquired teaching and leadership skills necessary to succeed as clinician-educators in an academic setting and to communicate effectively with patients, families, and colleagues. Fellows completed a series of individual and group education projects, including academic portfolio development, curriculum vitae revision, abstract submission and poster presentation at national meetings, lay lecture series development, and geriatric grand rounds presentation. One hundred percent of fellows reported that the course positively affected their career development, with six of nine fellows choosing academic careers. The course provided opportunities to teach and assess all six of the Accreditation Council of Graduate Medical Education core competencies. This academic career development course was intended to prepare geriatric fellows as the next generation of academic leaders as clinician-teacher-scholars. It could set a new standard for academic development during fellowship training and provide a model for national dissemination in other geriatric and subspecialty fellowship programs. PMID:17971139

  16. Transforming a Clinical Clerkship with Team Learning

    Microsoft Academic Search

    Ruth E. Levine; Michael O'Boyle; Paul Haidet; David J. Lynn; Michael M. Stone; Dwight V. Wolf; Freddy A. Paniagua

    2004-01-01

    Background: Team learning, an innovative educational method combining interac- tive small group learning with expert-based content delivery, was introduced into our psychiatry clerkship in 2002. The main goal was to increase classroom engagement and improve educational outcomes. Description: Eight of 16 lectures were replaced with team learning activities, includ- ing prerequisite readings, readiness assurance tests, and application exercises. Data on

  17. Accuracy of Surgery Clerkship Performance Raters.

    ERIC Educational Resources Information Center

    Littlefield, John H.; And Others

    1991-01-01

    Interrater reliability in numerical ratings of clerkship performance (n=1,482 students) in five surgery programs was studied. Raters were classified as accurate or moderately or significantly stringent or lenient. Results indicate that increasing the proportion of accurate raters would substantially improve the precision of class rankings. (MSE)

  18. Subcutaneously administered antibiotics: a national survey of current practice from the French Infectious Diseases (SPILF) and Geriatric Medicine (SFGG) society networks.

    PubMed

    Forestier, E; Paccalin, M; Roubaud-Baudron, C; Fraisse, T; Gavazzi, G; Gaillat, J

    2015-04-01

    A national survey was performed to explore antibiotic prescription by the subcutaneous (sc) route among French infectious diseases and geriatric practitioners. Among the participating physicians, 367 (96.1%) declared administering sc antibiotics at some point. Ceftriaxone was prescribed sc by all but one, and ertapenem, teicoplanin, aminoglycosides and amoxicillin by 33.2%, 39.2%, 35.1% and 15.3%, respectively. The sc route was resorted to mainly in case of unavailable oral, intravenous or intramuscular routes, especially during palliative care. Pain, skin necrosis and lack of efficacy were the main adverse effects, reported by 70.8%, 12.8% and 19.9% of practitioners, respectively. Further studies are needed to precise the indications, modalities and tolerance of sc antibiotic use. PMID:25658521

  19. The Effect of an Ambulatory Internal Medicine Rotation on Students' Career Choices.

    ERIC Educational Resources Information Center

    Bauer, Richard L.; And Others

    1997-01-01

    A study of 184 third-year medical students randomly assigned to ambulatory care and traditional inpatient curricula in an internal medicine clerkship found those with the ambulatory care experience were somewhat more likely to choose an ambulatory care career than those in the traditional curriculum. However, the clerkship experience did not…

  20. Geriatric Medical Education in Israel

    ERIC Educational Resources Information Center

    Leibovitz, Arthur; Baumoehl, Yehuda; Habot, Beni

    2004-01-01

    In this article we will focus on geriatric medical education in Israel and will review our experience in this field. A coordinated effort of the Ministry of Health and the Israeli Medical Association led to the establishment of a modern geriatric system and to the recognition of geriatrics as a medical specialty in the early 1980s. All four…

  1. [Drawn towards a career in elderly care medicine, but not till after medical school. Elderly care medicine as a career choice].

    PubMed

    Meiboom, A A; de Vries, H; Hesselink, B A M; Hertogh, C M P M; Scheele, F

    2014-01-01

    In order to develop strategies for raising the interest of medical students in a career in elderly care medicine (a specialty in The Netherlands) we should start by gaining more insight into the process influencing career choices among medical students and graduates. In this qualitative study we conducted three focus group discussions with trainees in elderly care medicine and two focus group discussions with obstetrics and gynaecology trainees. We found that all trainees made their career choice after clinical exposure in the field. The elderly care medicine trainees did not make their choice until after graduation, working in temporary employment in a nursing home. The obstetrics and gynaecology trainees made their specialty choice during medical school after their clerkship. Almost all focus group participants had a very negative perception during medical school about geriatrics and elderly care medicine. Once they were employed in a nursing home they changed their minds. They came to realize the work was more interesting, more difficult, more intensive and more meaningful than they had initially thought. PMID:24399288

  2. The CyberDoc project: using portable computing to enhance a community-based primary care clerkship.

    PubMed

    Maulitz, R C; Ohles, J A; Schnuth, R L; Lipsky, M S; Grealish, R J

    1996-12-01

    In July 1995, MCP-Hahnemann School of Medicine of the Allegheny University of the Health Sciences introduced its first-ever required clerkship in family medicine. It was decided that computer skills and applications would be an integral part of this rotation, and a special program, CyberDoc, was developed for the clerkship by some of the university's informatics professionals and family medicine faculty. CyberDoc is a suite of laptop-computer applications, based almost exclusively on "off-the-shelf" database and connectivity programs and designed expressly for students at community-based training sites. CyberDoc allows faculty members to track students' progress at off-site clerkships, and allows the students to access pharmaceutical and drug-interaction databases, the university's online academic information system (including MEDLINE), all basic Internet functions, e-mail, and an array of other applications. The authors briefly describe the background, goals, and structure of the CyberDoc project, as well as the preliminary outcomes of CyberDoc's pilot year. PMID:9114890

  3. Physician Assistant Attitude and Expressed Intent to Work with Geriatric Patients

    ERIC Educational Resources Information Center

    Woolsey, Lisa J.

    2007-01-01

    This study evaluated the attitudes of physician assistant students (PAS) and practicing physician assistants (PA) toward geriatric patients and the expressed intent of PAS and practicing PAs toward practicing in the specialized field of geriatric medicine using a cross-sectional study design. The 233 participants each completed a questionnaire…

  4. Occupational health for an ageing workforce: do we need a geriatric perspective?

    Microsoft Academic Search

    Gerald Choon-Huat Koh; David Koh

    2006-01-01

    Extending retirement ages and anti-age discrimination policies will increase the numbers of older workers in the future. Occupational health physicians may have to draw upon the principles and experience of geriatric medicine to manage these older workers. Examples of common geriatric syndromes that will have an impact on occupational health are mild cognitive impairment and falls at the workplace. Shifts

  5. Geriatric assessment tools.

    PubMed

    Rosen, Sonja L; Reuben, David B

    2011-01-01

    In addition to medical diseases, psychological, social, cognitive, and functional issues influence the health of older persons. Therefore, the traditional medical assessment alone is often not enough to evaluate the older population with multiple comorbidities. Out of this recognized need, the geriatric assessment has been developed, which emphasizes a broader approach to evaluating contributors to health in older persons. Geriatric assessment uses specific tools to help determine patient's status across several different dimensions, including assessment of medical, cognitive, affective, social, economic, environmental, spiritual, and functional status. This article reviews specific tools that practitioners can use in their screening for the following geriatric syndromes: hearing impairment, vision impairment, functional decline, falls, urinary incontinence, cognitive impairment, depression, and malnutrition. This article also reviews spiritual, economic, and social assessment. By identifying conditions that are common in the elderly, geriatric assessment can provide substantial insight into the comprehensive care of older persons, from those who are healthy and high-functioning to those with significant impairments and multiple comorbidities. PMID:21748738

  6. The need for geriatric dental education in India: the geriatric health challenges of the millennium.

    PubMed

    Thomas, Susan

    2013-06-01

    The rapid growth in the elderly population in a developing country such as India poses social and financial challenges by causing a shift towards non-communicable diseases and increases in chronic diseases. The economic impact of the burden of chronic diseases such as cardiovascular disease, hypertension, diabetes and cancer are high. The link between oral health and general health are particularly pronounced in older populations and impairs their quality of life. This paper reveals that in order to address the increasing health challenges and demands of a growing geriatric population, undergraduates and graduate students in dental schools should be given comprehensive or holistic health assessment training. Cost-effective modern educational strategies and educational tools such as problem-based learning will help to overcome the dearth of trained faculty in geriatric dentistry. Multidisciplinary health-care approaches and extended health-care team work are of vital importance to older patients who could benefit physically and psychologically from more efficient dental treatment. With often more than one chronic disease affecting individuals and use of polypharmacy, there is a need to increase overall knowledge of geriatric pharmacy and geriatric medicine. Measures to help older people remain healthy and active are a necessity in developing countries such as India for effective social and economic development. PMID:23691957

  7. [Specificities of pneumonia in geriatrics].

    PubMed

    Pepersack, T

    2014-09-01

    Pneumonia is a major cause of morbidity and mortality leading to a high rate of hospitalization especially in theelderly. It is often a sign of frailty and is associated with a poor prognosis. However, taking into account the geriatric specificities (risk factors, atypical clinical presentations with "geriatric syndromes", ethical debate) using an interdisciplinary and a comprehensive geriatric approach remains an important responsibility of the general practitionner. This article summarizes these specificities and offers interventions targeted on the characteristics of elderly patients. PMID:25675645

  8. [Validation of a screening tool toward a geriatric comprehensive assessment during a non geriatric consultation: the geriatric warning test].

    PubMed

    Sonnic, Anne; Pistorius, Marc-Antoine; Delamarre-Damier, Florence; De Decker, Laure; Planchon, Bernard; Berrut, Gilles

    2011-12-01

    Comprehensive geriatric assessment (CGA) is a validated method but is time consuming and must be performed by several professional. It is useful to elaborate a screening tool, which allows the elderly to CGA. The aim of this study is to validate the Geriatric Warning Test (GWT), a 6-questions form: 1) Did your patient consult or did hospitalize for a fall in the last 3 months? 2) Did your patient lose weight or did he loose the appetite? 3) Has your patient difficulties to see or listen? 4) Does your patient need help in the everyday life? 5) Has your patient a change of the cognitive functions? 6) Does your patient need a geriatric evaluation for one or several any reason that those cited previously? During a prospective observational study, a doctor non-geriatrician practitioner informed the GWT during a consultation of vascular medicine. All the patients aged 70 or more years old had an EGS after the consultation. An EGS was considered as necessary if 2 propositions and essential if 3 propositions were present from a 10 propositions list. The relevance of the TAG was analysed when one then 2 questions were informed during the consultation. The CGA was judged as necessary with a positive predictive value (PPV) of 81,8% and a negative predictive value (NPV) of 87,5%, when a single question is sufficient to indicate the CGA, and respectively of 76,5 and 53,9% when 2 questions of the GWT are taken into account. For an essential CGA (3 propositions), the PPV and NPV are 40,9 and 100%, by taking a single question of the GWT and 47,1 and 92,3% with 2 questions. A single positive question of the GWT must be used to propose an EGS during a non geriatric consultation. PMID:22182819

  9. Evaluation of Evidence-Based Medicine Search Skills in the Clinical Years

    Microsoft Academic Search

    Anne Linton; Patricia Wilson; Alexandra Gomes; Matthew Mintz

    2003-01-01

    Using a collaborative approach, the librarians of the Himmelfarb Health Sciences Library worked with the director of the Primary Care Clerkship and senior residents in informatics training for evidence-based medicine case studies.

  10. Do Geriatricians Stay in Geriatrics?

    ERIC Educational Resources Information Center

    Shah, Uday; Aung, Myo; Chan, Susanna; Wolfklein, Gisele

    2006-01-01

    To evaluate whether formally trained geriatricians remain in the field of Geriatrics, and to determine their job satisfaction and perceived quality of life, we surveyed the 107 fellows trained over the last 25 years in one accredited geriatric program. Of the 88 physicians who consented to participate, 75% devoted at least half of their practice…

  11. Hippocampal volume in geriatric depression

    Microsoft Academic Search

    David C Steffens; Christopher E Byrum; Douglas R McQuoid; Daniel L Greenberg; Martha E Payne; Timothy F Blitchington; James R MacFall; K. Ranga Rama Krishnan

    2000-01-01

    Background: There is a growing literature on the importance of hippocampal volume in geriatric depression.Methods: We examined hippocampal volume in a group of elderly depressed patients and a group of elderly control subjects (N = 66 geriatric depressed patients and 18 elderly nondepressed control subjects) recruited through Duke’s Mental Health Clinical Research Center for the Study of Depression in the

  12. Age and Ageing 2008; 18 C The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.orgdoi: 10.1093/ageing/afn227

    E-print Network

    Wisconsin at Madison, University of

    of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals. RIES1 , SANJAY ASTHANA1,2 1 Section of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin, Madison, WI 53705, USA 2 Geriatric Research, Education and Clinical Center (GRECC), William S

  13. Occupational health for an ageing workforce: do we need a geriatric perspective?

    PubMed

    Koh, Gerald Choon-Huat; Koh, David

    2006-01-01

    Extending retirement ages and anti-age discrimination policies will increase the numbers of older workers in the future. Occupational health physicians may have to draw upon the principles and experience of geriatric medicine to manage these older workers. Examples of common geriatric syndromes that will have an impact on occupational health are mild cognitive impairment and falls at the workplace. Shifts in paradigms and further research into the occupational health problems of an ageing workforce will be needed. PMID:16722617

  14. Geriatric Nursing Teaching Resources

    NSDL National Science Digital Library

    2012-02-17

    Developed by the University of Minnesota's Hartford Center of Geriatric Nursing Excellence, these resources are designed to assist nursing students in their quest to become effective health care providers to older adults. After reading a brief introduction to the site, visitors can use the table of contents to find the materials that will be most useful to them. Here they will find a listing of over 40 topic areas, including Biology of Aging, Depression, and Oral Health. Most areas contain at least a dozen links, complete with brief descriptions of the resources and how they might be used in practice or in an educational setting. Finally, visitors can sign up to receive updates when new materials are posted to the site.

  15. IMMUNITY, AGING, AND GERIATRIC DEPRESSION

    PubMed Central

    Morimoto, S. Shizuko; Alexopoulos, George S.

    2011-01-01

    Despite pioneering findings on immune functions in various depressive syndromes, few recent studies focus on the role of inflammation and its potential in generating novel antidepressant therapies. We suggest that geriatric depression is the behavioral syndrome par excellence in which inflammatory processes are likely to play an etiological role. We base this assertion on the following observations: Geriatric depression occurs in the context of medical and neurological illnesses in which inflammatory processes are part of their pathogenesis. Both aging and depression are associated with pronounced and prolonged immune responses. Brain areas related to mood processing, have increased inflammatory responses during aging. Moreover, the connectivity among mood regulating structures may be modulated by inflammatory responses. Geriatric depression exacerbates the pathology of its comorbid medical and neurological disorders raising the question whether depression-related inflammatory changes mediate the worsening of their outcomes. Finally, geriatric depression often occurs in persons exposed to chronic stress, a state precipitating geriatric depression and triggering pro-inflammatory responses. The clinical lesson derived from the available information is that depressed older adults should be examined for inflammatory disorders or risk factors of inflammation. It is premature to use anti-inflammatory agents in the treatment of geriatric depression. However, treatment of co-morbid conditions increasing CNS inflammatory responses can have general health benefits and should be part of clinical practice. Neuroimaging may identify microstructural abnormalities and dysfunction of neural networks associated with inflammatory processes accompanying geriatric depression. Transgenic animal models may help to identify candidate anti-inflammatory agents that later may be tested in clinical trials of geriatric depression. PMID:21536167

  16. A Year-Long Clerkship in Ambulatory Care.

    ERIC Educational Resources Information Center

    Ruane, Thomas J.

    1988-01-01

    A third-year medical clerkship in ambulatory care combining a long-term structure, defined curriculum, and many clinical encounters addresses the problem of limited numbers of patients, a changing clinical environment, and the need for specific skills in ambulatory care. (MSE)

  17. Comparative Evaluation of a Revised Clerkship in Basic Clinical Psychiatry.

    ERIC Educational Resources Information Center

    And Others; Bleier, Henry R.

    1981-01-01

    Evaluation data on Basic Clinical Psychiatry, a four week required clerkship of the University of Pennsylvania, are presented. The results of the evaluation suggest that, in spite of negative attitudes, student ratings of psychiatry courses can be consistent with measures of cognitive growth and sensitive to educational methods and design.…

  18. Psychiatric Day Treatment Clerkship for Undergraduate Pharmacy Students.

    ERIC Educational Resources Information Center

    Cardoni, Alex A.; Gunning, Jacqueline

    1981-01-01

    A psychiatric day treatment clerkship for undergraduate pharmacy students at the University of Connecticut is described. Students participate in client interviewing, medication history taking, client medication counseling, medication counseling, medication clinic, medication group, and health care group. Evaluation of performance is based on both…

  19. A National Radiation Oncology Medical Student Clerkship Survey: Didactic Curricular Components Increase Confidence in Clinical Competency

    SciTech Connect

    Jagadeesan, Vikrant S. [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States); Raleigh, David R. [Department of Radiation Oncology, School of Medicine, University of California–San Francisco, San Francisco, California (United States); Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J. [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States); Golden, Daniel W., E-mail: dgolden@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois (United States)

    2014-01-01

    Purpose: Students applying to radiation oncology residency programs complete 1 or more radiation oncology clerkships. This study assesses student experiences and perspectives during radiation oncology clerkships. The impact of didactic components and number of clerkship experiences in relation to confidence in clinical competency and preparation to function as a first-year radiation oncology resident are evaluated. Methods and Materials: An anonymous, Internet-based survey was sent via direct e-mail to all applicants to a single radiation oncology residency program during the 2012-2013 academic year. The survey was composed of 3 main sections including questions regarding baseline demographic information and prior radiation oncology experience, rotation experiences, and ideal clerkship curriculum content. Results: The survey response rate was 37% (70 of 188). Respondents reported 191 unique clerkship experiences. Of the respondents, 27% (19 of 70) completed at least 1 clerkship with a didactic component geared towards their level of training. Completing a clerkship with a didactic component was significantly associated with a respondent's confidence to function as a first-year radiation oncology resident (Wilcoxon rank–sum P=.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman ? P=.48) or confidence to function as a first year resident (Spearman ? P=.43). Conclusions: Based on responses to this survey, rotating students perceive that the majority of radiation oncology clerkships do not have formal didactic curricula. Survey respondents who completed a clerkship with a didactic curriculum reported feeling more prepared to function as a radiation oncology resident. However, completing an increasing number of clerkships does not appear to improve confidence in the decision to pursue radiation oncology as a career or to function as a radiation oncology resident. These results support further development of structured didactic curricula for the radiation oncology clerkship.

  20. Models of Care in Geriatric Oncology

    PubMed Central

    Magnuson, A.; Dale, W.; Mohile, S.

    2014-01-01

    Cancer is common in older adults and the approach to cancer treatment and supportive measures in this age group is continuously evolving. Incorporating geriatric assessment (GA) into the care of the older patient with cancer has been shown to be feasible and predictive of outcomes, and there are unique aspects of the traditional geriatric domains that can be considered in this population. Geriatric assessment-guided interventions can also be developed to support patients during their treatment course. There are several existing models of incorporating geriatrics into oncology care, including a consultative geriatric assessment, geriatrician “embedded” within an oncology clinic and primary management by a dual-trained geriatric oncologist. Although a geriatrician or geriatric oncologist leads the geriatric assessment, is it truly a multidisciplinary assessment, and often includes evaluation by a physical therapist, occupational therapist, pharmacist, social worker and nutritionist. PMID:25587518

  1. Expert Consensus Panel Guidelines on Geriatric Assessment in Oncology

    PubMed Central

    O'Donovan, A.; Mohile, S.G.; Leech, M.

    2015-01-01

    Introduction Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. Methods A four round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations in order to gain consensus on a given topic Results Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cutoff for assessment represented a higher degree of disagreement. Discussion The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients. PMID:25757457

  2. Expert consensus panel guidelines on geriatric assessment in oncology.

    PubMed

    O'Donovan, A; Mohile, S G; Leech, M

    2015-07-01

    Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. A four-round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations to gain consensus on a given topic. Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cut-off for assessment, represented a higher degree of disagreement. The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients. PMID:25757457

  3. GERIATRIC MEDICINE CAPITAL HEALTH RESEARCH Page 1

    E-print Network

    Brownstone, Rob

    in health care planning. This is critical in Canada, where 20 per cent of the population will be elderly healthy aging and how an aging population impacts the health care system. "With increasing pressure on our, efficient and effective care." As Dr. Mallery notes, proactive health management-- before a person becomes

  4. Homocysteine and Cognitive Function in Geriatric Depression

    Microsoft Academic Search

    P. Alexopoulos; S. Topalidis; G. Irmisch; K. Prehn; S. U. Jung; K. Poppe; H. Sebb; R. Perneczky; A. Kurz; S. Bleich; S. C. Herpertz

    2010-01-01

    Background\\/Objectives: Cognitive dysfunction is a common aspect of the spectrum of symptoms of geriatric depression. High homocysteine levels have been linked to cognitive decline in neuropsychiatric disorders. The present study investigated possible associations between cognitive impairment observed in geriatric depression and homocysteine levels. Methods: The performance of 25 mentally healthy individuals and 40 patients with geriatric depression in terms of

  5. Neuromodulation therapies for geriatric depression.

    PubMed

    Gálvez, Verňnica; Ho, Kerrie-Anne; Alonzo, Angelo; Martin, Donel; George, Duncan; Loo, Colleen K

    2015-07-01

    Depression is frequent in old age and its prognosis is poorer than in younger populations. The use of pharmacological treatments in geriatric depression is limited by specific pharmacodynamic age-related factors that can diminish tolerability and increase the risk of drug interactions. The possibility of modulating cerebral activity using brain stimulation techniques could result in treating geriatric depression more effectively while reducing systemic side effects and medication interactions. This may subsequently improve treatment adherence and overall prognosis in the older patient. Among clinically available neuromodulatory techniques, electroconvulsive therapy (ECT) remains the gold standard for the treatment of severe depression in the elderly. Studies have proven that ECT is more effective and has a faster onset of action than antidepressants in the treatment of severe, unipolar, geriatric depression and that older age is a predictor of rapid ECT response and remission. The application of novel and more tolerable forms of ECT for geriatric depression is currently being examined. Preliminary results suggest that right unilateral ultrabrief ECT (RUL-UB ECT) is a promising intervention, with similar efficacy to brief-pulse ECT and fewer adverse cognitive effects. Overall findings in repetitive transcranial magnetic stimulation (rTMS) suggest that it is a safe intervention in geriatric depression. Higher rTMS stimulation intensity and more treatments may need to be given in the elderly to achieve optimal results. There is no specific data on vagus nerve stimulation in the elderly. Transcranial direct current stimulation, magnetic seizure therapy and deep brain stimulation are currently experimental, and more data from geriatric samples is needed. PMID:25995098

  6. Geriatric Anxiety and Anxiety Disorders

    Microsoft Academic Search

    James D. Helsley; Sandra K. Vanin

    In 1965, the federal government passed the Older Americans Act (OAA) and the Administration on Aging (AoA) was created. By that act, older Americans were considered to be persons 60 years of age or older. There are many terms used to define this population of individuals, including geriatric, senior, seasoned, and aged. This chapter uses these terms interchangeably. From a

  7. Geriatric Suicide: The Arizona Study.

    ERIC Educational Resources Information Center

    Miller, Marv

    1978-01-01

    The consistently high suicide rates of older White males provide a strong rationale for increased study of the geriatric suicide problem. Data related to White males aged 60 and older who killed themselves in Arizona during 1970 through 1975 are presented. (Author)

  8. Screening Tests for Geriatric Depression

    Microsoft Academic Search

    T. L. Brink; Jerome A. Yesavage; Owen Lum; Philip H. Heersema; Michael Adey; Terrence L. Rose

    1982-01-01

    Contends that the diagnosis of depression in aged patients is the responsibility of both psychologists, and non-psychologists, for it is the latter that is most likely to make initial contact with an elder in need of help. Describes problems in the use of psychometric tests to identify geriatric depression. Reviews the advantages and disadvantages and limitations of scales currently employed.

  9. Virtual Patients in Geriatric Education

    ERIC Educational Resources Information Center

    Tan, Zaldy S.; Mulhausen, Paul L.; Smith, Stephen R.; Ruiz, Jorge G.

    2010-01-01

    The virtual patient is a case-based computer program that combines textual information with multimedia elements such as audio, graphics, and animation. It is increasingly being utilized as a teaching modality by medical educators in various fields of instruction. The inherent complexity of older patients and the shortage of geriatrics educators…

  10. Shorter Psychiatry Clerkship Length Is Associated with Lower NBME Psychiatry Shelf Exam Performance

    ERIC Educational Resources Information Center

    Bostwick, J. Michael; Alexander, Cara

    2012-01-01

    Objective: The goal of this study was to evaluate a recent medical school curriculum change at our institution 3 years ago; specifically: shortening the Psychiatry core clerkship from 4 to 3 weeks and adding an optional 6-week core/elective combination rotation in lieu of the 3-week core. The authors aimed to determine whether clerkship length was…

  11. Effect of Curriculum Change on Exam Performance in a 4-Week Psychiatry Clerkship

    ERIC Educational Resources Information Center

    Niedermier, Julie; Way, David; Kasick, David; Kuperschmidt, Rada

    2010-01-01

    Objective: The authors investigated whether curriculum change could produce improved performance, despite a reduction in clerkship length from 8 to 4 weeks. Methods: The exam performance of medical students completing a 4-week clerkship in psychiatry was compared to national data from the National Board of Medical Examiners' Psychiatry Subject…

  12. Psychiatric OSCE Performance of Students with and without a Previous Core Psychiatry Clerkship

    ERIC Educational Resources Information Center

    Goisman, Robert M.; Levin, Robert M.; Krupat, Edward; Pelletier, Stephen R.; Alpert, Jonathan E.

    2010-01-01

    Objective: The OSCE has been demonstrated to be a reliable and valid method by which to assess students' clinical skills. An OSCE station was used to determine whether or not students who had completed a core psychiatry clerkship demonstrated skills that were superior to those who had not taken the clerkship and which areas discriminated between…

  13. What Students Value: Learning Outcomes in a Required Third-Year Ambulatory Primary Care Clerkship.

    ERIC Educational Resources Information Center

    Lawrence, Stephen L.; Lindemann, Janet C.; Gottlieb, Mark

    1999-01-01

    Over 18 months, Medical College of Wisconsin students identified what they had learned during their clerkships in each of seven learning settings; the 3,030 outcomes were divided into 48 categories, and the ten most-frequent learning outcomes are reported. No significant differences by time of year or rural vs. urban clerkships were found.…

  14. Geriatric emergency department innovations: preliminary data for the geriatric nurse liaison model.

    PubMed

    Aldeen, Amer Z; Courtney, D Mark; Lindquist, Lee A; Dresden, Scott M; Gravenor, Stephanie J

    2014-09-01

    Older adults account for a large and growing segment of the emergency department (ED) population. They are often admitted to the hospital for nonurgent conditions such as dementia, impaired functional status, and gait instability. The aims of this geriatric ED innovations (GEDI) project were to develop GEDI nurse liaisons by training ED nurses in geriatric assessment and care coordination skills, describe characteristics of patients that these GEDI nurse liaisons see, and measure the admission rate of these patients. Four ED nurses participated in the GEDI training program, which consisted of 82 hours of clinical rotations in geriatrics and palliative medicine, 82 hours of didactics, and a pilot phase for refinement of the GEDI consultation process. Individuals were eligible for GEDI consultation if they had an Identification of Seniors At Risk (ISAR) score greater than 2 or at ED clinician request. GEDI consultation was available Monday through Friday from 9:00 a.m. to 8:00 p.m. An extensive database was set up to collect clinical outcomes data for all older adults in the ED before and after GEDI implementation. The liaisons underwent training from January through March 2013. From April through August 2013, 408 GEDI consultations were performed in 7,213 total older adults in the ED (5.7%, 95% confidence interval (CI) = 5.2-6.2%), 2,124 of whom were eligible for GEDI consultation (19.2%, 95% CI = 17.6-20.9%); 34.6% (95% CI = 30.1-39.3%) received social work consultation, 43.9% (95% CI = 39.1-48.7) received pharmacy consultation, and more than 90% received telephone follow-up. The admission rate for GEDI patients was 44.9% (95% CI = 40.1-49.7), compared with 60.0% (95% CI = 58.8-61.2) non-GEDI. ED nurses undergoing a 3-month training program can develop geriatric-specific assessment skills. Implementation of these skills in the ED may be associated with fewer admissions of older adults. PMID:25112656

  15. Comprehensive geriatric assessment in the emergency department.

    PubMed

    Ellis, Graham; Marshall, Trudi; Ritchie, Claire

    2014-01-01

    Changing global demography is resulting in older people presenting to emergency departments (EDs) in greater numbers than ever before. They present with greater urgency and are more likely to be admitted to hospital or re-attend and utilize greater resources. They experience longer waits for care and are less likely to be satisfied with their experiences. Not only that, but older people suffer poorer health outcomes after ED attendance, with higher mortality rates and greater dependence in activities of daily living or rates of admission to nursing homes. Older people's assessment and management in the ED can be complex, time consuming, and require specialist skills. The interplay of multiple comorbidities and functional decline result in the complex state of frailty that can predispose to poor health outcomes and greater care needs. Older people with frailty may present to services in an atypical fashion requiring detailed, multidimensional, and increasingly multidisciplinary care to provide the correct diagnosis and management as well as appropriate placement for ongoing care or admission avoidance. Specific challenges such as delirium, functional decline, or carer strain need to be screened for and managed appropriately. Identifying patients with specific frailty syndromes can be critical to identifying those at highest risk of poor outcomes and most likely to benefit from further specialist interventions. Models of care are evolving that aim to deliver multidimensional assessment and management by multidisciplinary specialist care teams (comprehensive geriatric assessment). Increasingly, these models are demonstrating improved outcomes, including admission avoidance or reduced death and dependence. Delivering this in the ED is an evolving area of practice that adapts the principles of geriatric medicine for the urgent-care environment. PMID:25473275

  16. Family Medicine Training in the Care of Older Adults--Has the Retreat Been Sounded?

    ERIC Educational Resources Information Center

    Mouton, Charles P.; Parker, Robert W.

    2003-01-01

    Discusses the trend away from geriatrics training in family medicine residency despite the growing need in society. Asserts that family medicine is failing to seize an opportunity to advance the care of older adults and discusses what would constitute acceptable training in geriatrics and how it should fit into the family medicine curriculum. (EV)

  17. Geriatric Depression in Primary Care

    PubMed Central

    Park, Mijung; Unützer, Jürgen

    2011-01-01

    Primary care settings present important opportunities for the detection and management of depression in older adults. As many as 10 % of older adults presenting in primary care have clinically significant depression, but only about half are recognized and only one in five depressed older adults receive effective treatment in primary care. We review common barriers to effective treatment such as atypical clinical presentations and comorbid medical conditions that are common in older adults. We identify treatment strategies such as measurement-based stepped care and collaborative care that can substantially improve the effectiveness of treatment in this setting and we highlight opportunities for addressing health disparities in geriatric depression care. We also point out the importance of engaging and supporting family caregivers of depressed older adults. We conclude by identifying three strategic areas to improve the treatment of geriatric depression in primary care: activation and engagement of patients and family members, health care provider training, and broader system changes. PMID:21536169

  18. Rhinitis in the geriatric population

    PubMed Central

    2010-01-01

    The current geriatric population in the United States accounts for approximately 12% of the total population and is projected to reach nearly 20% (71.5 million people) by 2030[1]. With this expansion of the number of older adults, physicians will face the common complaint of rhinitis with increasing frequency. Nasal symptoms pose a significant burden on the health of older people and require attention to improve quality of life. Several mechanisms likely underlie the pathogenesis of rhinitis in these patients, including inflammatory conditions and the influence of aging on nasal physiology, with the potential for interaction between the two. Various treatments have been proposed to manage this condition; however, more work is needed to enhance our understanding of the pathophysiology of the various forms of geriatric rhinitis and to develop more effective therapies for this important patient population. PMID:20465792

  19. The use of clinical decision-support tools to facilitate geriatric education.

    PubMed

    Litvin, Cara B; Davis, Kimberly S; Moran, William P; Iverson, Patty J; Zhao, Yumin; Zapka, Jane

    2012-06-01

    Innovative methods are needed to incorporate effective geriatric education into internal medicine residency programs. The purpose of this report is to describe the development and use of clinical decision-support (CDS) tools to facilitate geriatric education and improve the care delivered to older adults in an academic internal medicine residency ambulatory care clinic. Starting in 2009, CDS tools were implemented as a major strategy of an initiative to improve resident physician clinical competencies in geriatrics and improve the quality of care and quality of life of older adults. These tools, designed to improve resident assessment and action for each of three educational modules (falls, vision, and dementia) were embedded within the ambulatory electronic medical record (EMR) and provided a method of point-of-care training to residents caring for older adults. One hundred internal medicine residents supervised by 17 general internal medicine faculty members participated. Data regarding CDS use and associated outcomes were recorded and extracted from the ambulatory clinic EMR. Residents screened between 67% and 88% of eligible patients using CDS algorithms; rates of additional assessment and referral or further examination reflected the prevalence of the condition in the patient population. Although further development may be necessary, CDS tools are a promising modality to supplement geriatric postgraduate education while simultaneously improving patient care. PMID:22642270

  20. Profile of Your Geriatric Patient

    PubMed Central

    Longhurst, Mark F.; Slade, Debra

    1990-01-01

    The family doctor cares for many geriatric patients. Many of these patients enter the family practice for the first time, having either recently moved to the area or to a nearby long-term care facility. Obtaining a meaningful patient profile is essential to the physicians' care, allowing future medical decisions to be made in the best interest of that person. Patients' beliefs motivate their functioning in a system. Any system has its own history, structure, and function. PMID:21234029

  1. [Geriatrics on the internet].

    PubMed

    Hager, K

    1997-12-01

    National and international data networks for data transfer and communication are playing an increasingly important role in science and medicine. These networks already exist on a regional, national and international scale. The biggest international network, the Internet, offers more than 300 sites referring to "aging", which lead to a great number of other related pages. The access to the Internet and some examples of the information on aging available are presented here. This is to give the reader an impression of the present state of this worldwide data network, which may be useful for his professional use. At this stage, the author has the impression that conventional media such as journals, books and especially personal contacts are still sufficient to satisfy the need for professional information, and opinion that may well have to be reconsidered soon. In view of the future, however, it seems useful for medical societies to be represented on the Internet as soon as possible. PMID:9499490

  2. FORMAL AND INFORMAL FRAMEWORKS FOR TEACHING GERIATRICS

    Microsoft Academic Search

    Arnold J. Rosin; Leah Abramovitz

    1997-01-01

    Geriatrics has developed as a discipline mainly because of the increasing health care needs of the growing older population. This has resulted in a burgeoning of interest in and research on aging and older persons in medical, nursing and paramedical professions. Education in geriatrics, however, has been slow to develop in some professional areas because of attitudes of “agism,” unclear

  3. Geriatrician Clinician-Educator The Division of Hospital Medicine and Division of General Internal Medicine &

    E-print Network

    Chapman, Michael S.

    Geriatrician Clinician-Educator The Division of Hospital Medicine and Division of General Internal Medicine & Geriatrics within the Department of Medicine at Oregon Health & Science University seek to an academic career. This position will be a joint appointment in the Divisions of Hospital Medicine

  4. What can I do with this degree? Corporate office summer clerkships and entry level

    E-print Network

    Escher, Christine

    to contracts. GENERAL INFORMATIONAREAS EMPLOYERS CORPORATE PRACTICE FEDERAL GOVERNMENT LAW JUDICIAL CLERKSHIPS Federal, state & local government Private groups contract Gain supervised work experience in an area. Developtoleranceforbureaucraticprocedure. Any corporation (largest number of attorneys are at corporate headquarters) Most government

  5. Building Psychosocial Programming in Geriatrics Fellowships: A Consortium Model

    ERIC Educational Resources Information Center

    Adelman, Ronald D.; Ansell, Pamela; Breckman, Risa; Snow, Caitlin E.; Ehrlich, Amy R.; Greene, Michele G.; Greenberg, Debra F.; Raik, Barrie L.; Raymond, Joshua J.; Clabby, John F.; Fields, Suzanne D.; Breznay, Jennifer B.

    2011-01-01

    Geriatric psychosocial problems are prevalent and significantly affect the physical health and overall well-being of older adults. Geriatrics fellows require psychosocial education, and yet to date, geriatrics fellowship programs have not developed a comprehensive geriatric psychosocial curriculum. Fellowship programs in the New York tristate area…

  6. Medicines

    MedlinePLUS

    ... better. In the United States, the Food and Drug Administration is in charge of assuring the safety ... prescription and over-the-counter medicines. Even safe drugs can cause unwanted side effects or interactions with ...

  7. Curricular and Financial Implications of PharmD Clerkship Placements1

    Microsoft Academic Search

    JoLaine R. Draugalis; Jean T. Carter; Marion K. Slack

    1996-01-01

    The purpose of this study was to reassess curricular and financial aspects of PharmD clerkship programs. Questionnaires were mailed to clerkship coordinators at the 64 U.S. colleges of pharmacy offering PharmD degree programs during academic year 1994-95. The response rate was 91 percent. Increased numbers of schools reported difficulty in maintaining training sites, with required ambulatory care rotation sites the

  8. Hypernatremia in the geriatric population

    PubMed Central

    Shah, Maulin K; Workeneh, Biruh; Taffet, George E

    2014-01-01

    Hypernatremia in the geriatric population is a common disorder associated with significant morbidity and mortality. Older people are predisposed to developing hypernatremia because of age-related physiologic changes such as decreased thirst drive, impaired urinary concentrating ability, and reduced total body water. Medications may exacerbate this predisposition. Hypernatremia and dehydration occurring in nursing homes are considered indicators of neglect that warrant reporting, but there are other nonavoidable causes of hypernatremia, and consideration at time of presentation is essential to prevent delay in diagnosis and management. We describe a case illustrating the importance of the consideration of alternate explanations for hypernatremia in a nursing home resident, followed by a review of hypernatremia in the elderly population, to underscore that neglect is the etiology of exclusion after alternatives have been considered. PMID:25429210

  9. The Merck Manual of Geriatrics

    NSDL National Science Digital Library

    Merck and Co., Inc., publisher of the standard medical text The Merck Manual of Diagnosis and Therapy (described in the July 19, 1996 Scout Report but no longer available in an Internet version), has placed online the full text of another of its publications, The Merck Manual of Geriatrics. The Manual focuses on the medical problems and care of the elderly and is directed at healthcare professionals, but many older users and those caring for elderly relatives may find it useful. Divided into five sections and 114 chapters, the Manual offers a comprehensive review of the medical, social, psychological, and ethical issues involved in elder healthcare. Sample topics include nutrition, sleep disorders, pharmacology, organ system disorders, sexuality, psychiatric disorders, legal issues, and health insurance, among many others. The entire publication is searchable, and a guide for readers of the online version is provided.

  10. The Merck Manual of Geriatrics

    NSDL National Science Digital Library

    1995-01-01

    Merck and Co., Inc., publisher of the standard medical text The Merck Manual of Diagnosis and Therapy (described in the July 19, 1996 Scout Report but no longer available in an Internet version), has placed online the full text of another of its publications, The Merck Manual of Geriatrics. The Manual focuses on the medical problems and care of the elderly and is directed at healthcare professionals, but many older users and those caring for elderly relatives may find it useful. Divided into five sections and 114 chapters, the Manual offers a comprehensive review of the medical, social, psychological, and ethical issues involved in elder healthcare. Sample topics include nutrition, sleep disorders, pharmacology, organ system disorders, sexuality, psychiatric disorders, legal issues, and health insurance, among many others. The entire publication is searchable, and a guide for readers of the online version is provided.

  11. Effectiveness of geriatric rehabilitative care after fractures of the proximal femur in elderly women: a randomised clinical trial

    Microsoft Academic Search

    D. C. Kennie; J. Reid; I. R. Richardson; A. A. Kiamari; C. Kelt

    1988-01-01

    OBJECTIVE--To compare postoperative collaborative care between orthopaedic surgeons and physicians in geriatric medicine with routine orthopaedic care in elderly women with proximal femoral fracture. DESIGN--Exclusion of patients dying before fit enough to enter trial, those with pathological fractures, those likely to be discharged within seven days of entering the trial, and those remaining unfit for transfer to a peripheral hospital.

  12. THE INFLAMMATION HYPOTHESIS IN GERIATRIC DEPRESSION

    PubMed Central

    Alexopoulos, George S.; Morimoto, Sarah Shizuko

    2011-01-01

    Background A large body of research has focused on “mediating mechanisms” and predisposing brain abnormalities to geriatric depression, but little is known about its etiology. This paper examines whether age-related and comorbid disease-related immune deregulation is an etiologic contributor to geriatric depression. Methods This article reviews findings on neuroinflammation during the aging process and depression as well as studies of anti-inflammatory actions of classical antidepressants and antidepressant actions of anti-inflammatory agents. Results Aging results in increased peripheral immune responses, impaired peripheral-CNS immune communication, and a shift of the CNS into a pro-inflammatory state. These exaggerated and prolonged immune responses may lead to changes in the function of emotional and cognitive networks pertinent to geriatric depression and to behavioral changes reminiscent of the depressive and cognitive symptoms of geriatric depression. Some antidepressants may reduce the expression of inflammation markers. Limited data suggest that some anti-inflammatory agents may have antidepressant properties. Conclusions A synthesis of available findings suggests that aging-related and comorbid disease-related inflammatory processes may promote changes in the neural systems predisposing to geriatric depression or facilitating metabolic changes that mediate depressive syndromes. The “inflammation hypothesis” in geriatric depression cannot be tested in its entirety, but it can lead to testable hypotheses and data on mechanisms by which inflammatory processes promote geriatric depression. The significance of such an effort is that it may lead to a novel treatment development model bringing to bear recent advances of anti-inflammatory pharmacology to the treatment of depressed elderly patients. PMID:21370276

  13. An Interactive Web-based Curriculum on Evidence based Medicine: Design and Effectiveness

    Microsoft Academic Search

    Katherine Schilling; John Wiecha; Deepika Polineni; Souad Khalil

    2006-01-01

    Background and Objectives: Medical education experts have called for improved training in evidence- based medicine (EBM) and the increased use of e-learning technologies in medical education. In re- sponse, we developed an interactive, Web-based curriculum on key aspects of EBM in family medicine. Methods: Students participating in a 6-week family medicine clerkship (n=238) were randomly assigned to intervention (n=134) or

  14. 24th Annual Student Mentoring Conference in Gerontology and Geriatrics

    E-print Network

    Arnold, Jonathan

    24th Annual Student Mentoring Conference in Gerontology and Geriatrics Key Note Address and Paper in Gerontology and Geriatrics Armstrong Atlantic State University College of Health Professions Health Sciences

  15. The Clinical Education of Medical Students: A Perspective from Internal Medicine.

    ERIC Educational Resources Information Center

    Tierney, Lawrence M., Jr.

    1986-01-01

    A summary of what is generally thought to be taught well in internal medicine and what is taught less effectively is presented. The roles of medical students are considered in that context. Teaching contributions, evaluation of teaching, problems on clerkships, and opportunities for change are discussed. (MLW)

  16. Evaluation of Evidence-Based Medicine Search Skills in the Clinical Years

    Microsoft Academic Search

    Anne M. Linton; Patricia H. Wilson; Alexandra Gomes; Laura Abate; Matthew Mintz

    2004-01-01

    The librarians of the Health Sciences Library worked with the director of the Primary Care Clerkship to reinforce the principles of Evidence-Based Medicine (EBM) searching, taught during the first two years of medical school, through an intensive workshop. The purpose of the program was to ensure that students apply EBM principles in a timely and effective manner in clinical situations.

  17. Advancing geriatrics research, education, and practice: policy challenges after the great recession.

    PubMed

    Zerzan, Judy T; Rich, Eugene C

    2014-06-01

    The series of articles in this JGIM issue provides a number of policy-relevant recommendations for advancing geriatrics research, education and practice. Despite the unprecedented pressure to reduce state and federal spending, policymakers must concurrently address the challenges of a growing population of older individuals with increasingly complex health care problems. Thus, there may be opportunities to advance this agenda in creative ways. For example, without new spending, federal research agencies can make changes to encourage needed new directions in aging research, and the ACA provides new funding opportunities such as the Patient Centered Outcomes Research Institute. States and the federal government have an increasing need for the health professions workforce to have collaborative care skills and geriatrics clinical competencies, and are finding ways to invest in relevant initiatives. On the clinical program side, state and federal governments are initiating programs to promote delivery system changes that improve the care of older adults. Nonetheless, in the face of the policy challenges that have persisted after the "great recession," academic geriatrics and general internal medicine will need to join forces with public and private interests to secure the resources needed to advance this ambitious agenda for geriatrics research, education and practice. PMID:24557514

  18. Geriatrics Educational Outreach: A Tale of Three GRECCs

    ERIC Educational Resources Information Center

    Clark, Elizabeth; Fitzgerald, James T.; Griffith, Jennifer; Weir, Charlene

    2011-01-01

    Current geriatrics workforce projections indicate that clinicians who care for adults will need basic geriatrics knowledge and skills to address the geriatric syndromes and issues that limit functional independence and complicate medical management. This is most evident for the clinicians caring for veterans in the Department of Veterans Affairs…

  19. Anal function in geriatric patients with faecal incontinence

    Microsoft Academic Search

    J A Barrett; J C Brocklehurst; E S Kiff; G Ferguson; E B Faragher

    1989-01-01

    The association of faecal incontinence with constipation and confusion in the elderly is well recognised but the anal function of faecally incontinent geriatric patients is poorly understood. Anal studies were therefore performed on 99 geriatric patients (49 with faecal incontinence, 19 continent patients with faecal impaction and 31 geriatric control patients with normal bowel habit) and 57 younger healthy control

  20. When Patients Teach Their Doctors: A Curriculum for Geriatric Education

    ERIC Educational Resources Information Center

    Tomkowiak, John; Gunderson, Anne

    2004-01-01

    In response to aging patient demographics and a call for increased formal geriatric training in medical schools, a community volunteer geriatric mentor program, Bridging Generations, was developed to shape attitudes of medical students caring for the elderly. The geriatric mentor experience provided students with unique insight into the challenges…

  1. Automated Video and Sensor Analysis for Geriatric Care

    E-print Network

    CareMedia: Automated Video and Sensor Analysis for Geriatric Care NSF Cooperative Agreement No. IISMedia Carnegie Mellon University 2 CareMedia: Automated Video and Sensor Analysis for Geriatric Care March 2003, and (iii) secure, efficient visual information access will let geriatric care specialists obtain greater

  2. Summer 4th Year Elective Clerkships Elective Disciplines

    E-print Network

    Alford, Simon

    603 20757 Research-Dermatology CELE 603 20759 Special Topics-Dermatology Emergency Medicine CELE 604 15276 Clinical Toxicology CELE 604 15277 Emergency Medicine CELE 604 20218 Emergency Ultrasound CELE 604 20762 Special Topics-Emergency Medicine CELE 604 20764 Research-Emergency Medicine CELE 604 20767

  3. Development and validation of a questionnaire for evaluation of students' attitudes towards family medicine.

    PubMed

    Šter, Marija Petek; Švab, Igor; Klemenc-Ketiš, Zalika; Kersnik, Janko

    2015-03-01

    The development of the EURACT (European Academy of Teachers in General Practice) Educational Agenda helped many family medicine departments in development of clerkship and the aims and objectives of family medicine teaching. Our aims were to develop and validate a tool for assessment of students' attitudes towards family medicine and to evaluate the impact of the clerkship on students' attitudes regarding the competences of family doctor. In the pilot study, experienced family doctors were asked to describe their attitudes towards family medicine by using the Educational Agenda as a template for brainstorming. The statements were paraphrased and developed into a 164-items questionnaire, which was administered to 176 final-year students in academic year 2007/08. The third phase consisted of development of a final tool using statistical analysis, which resulted in the 60-items questionnaire in six domains which was used for the evaluation of students' attitudes. At the beginning of the clerkship, person-centred care and holistic approach scored lower than the other competences. Students' attitudes regarding the competences at the end of 7 weeks clerkship in family medicine were more positive, with exception of the competence regarding primary care management. The students who named family medicine as his or her future career choice, found holistic approach as more important than the students who did not name it as their future career. With the decision tree, which included students' attitudes to the competences of family medicine, we can successfully predict the future career choice in family medicine in 93.5% of the students. This study reports on the first attempt to develop a valid and reliable tool for measuring attitudes towards family medicine based on EURACT Educational Agenda. The questionnaire could be used for evaluating changes of students' attitudes in undergraduate curricula and for prediction of students' preferences regarding their future professional career in family medicine. PMID:26040061

  4. Research Priorities for High Quality Geriatric Emergency Care: Medication Management, Screening and Prevention and Functional Assessment

    PubMed Central

    Carpenter, Christopher R.; Heard, Kennon; Wilber, Scott; Ginde, Adit A.; Stiffler, Kirk; Gerson, Lowell W.; Wenger, Neal S.; Miller, Douglas K.

    2011-01-01

    Background Geriatric adults represent an increasing proportion of emergency department (ED) users, and can be particularly vulnerable to acute illnesses. Health care providers have recently begun to focus upon the development of quality indicators to define a minimal standard of care. Objectives The original objective of this project was to develop additional ED-specific quality indicators for older patients within the domains of medication management, screening and prevention, and functional assessment, but the quantity and quality of evidence was insufficient to justify unequivocal minimal standards of care for these three domains. Accordingly, the authors modified the project objectives to identify key research opportunities within these three domains that can be used to develop quality indicators in the future. Methods Each domain was assigned one or two content experts who created potential quality indicators (QI) based on a systematic review of the literature, supplemented by expert opinion. Candidate quality indicators were then reviewed by four groups: the Society for Academic Emergency Medicine (SAEM) Geriatric Task Force, the SAEM Geriatric Interest Group, and audiences at the 2008 SAEM Annual Meeting and the 2009 American Geriatrics Society Annual Meeting, using anonymous audience response system technology as well as verbal and written feedback. Results High-quality evidence based on patient-oriented outcomes was insufficient or non-existent for all three domains. The participatory audiences did not reach a consensus on any of the proposed QIs. Key research questions for medication management (3), screening and prevention (2), and functional assessment (3) are presented based upon proposed QIs that the majority of participants accepted. Conclusions In assessing a minimal standard of care by which to systematically derive geriatric QIs for medication management, screening and prevention, and functional assessment, compelling clinical research evidence is lacking. Patient-oriented research questions that are essential to justify and characterize future quality indicators within these domains are described. PMID:21676064

  5. A Self-Study of Clinical Evaluation in the McMaster Clerkship.

    ERIC Educational Resources Information Center

    Cohen, Gerald S.; And Others

    1991-01-01

    The McMaster University (Canada) undergraduate medical program participated in a nine-school self-study of clinical evaluation. Comparison of top-ranked problems found lack of transmission of evaluative information from one clerkship unit to subsequent ones to be a common problem. Faculty unwillingness to record negative evaluations was exclusive…

  6. Effect of Student and Preceptor Gender on Clinical Grades in an Ambulatory Care Clerkship.

    ERIC Educational Resources Information Center

    Wang-Cheng, Rebekah M.; And Others

    1995-01-01

    A study of grading of 375 third-year medical students and their 121 preceptors after a required 1-month ambulatory care clerkship examined patterns in student gender, preceptor gender, and student-preceptor gender pairs. Results indicate female students received higher clinical grades, especially when the preceptor was male. (Author/MSE)

  7. South Dakota's Third-Year Program of Integrated Clerkships in Ambulatory-Care Settings.

    ERIC Educational Resources Information Center

    Hansen, Lori A.; Talley, Robert C.

    1992-01-01

    In the University of South Dakota's medical school clerkship program, students may choose one of three ambulatory-care settings. In one, the curriculum is problem based and student centered to enhance student interest in primary care. The new program has been successful and well received and is being further developed. (MSE)

  8. The Effect of an End-of-Clerkship Review Session on NBME Psychiatry Subject Exam Scores

    ERIC Educational Resources Information Center

    Sidhu, Shawn S.; Chandra, Rohit M.; Wang, Lei; Gollan, Jacqueline K.; Rasminsky, Sonya; Brar, Simerjeet K.; Anzia, Joan M.

    2012-01-01

    Objective: The NBME Psychiatry Subject Examination (PSE) is used throughout North America to test MS-III end-of-clerkship knowledge; yet, literature on PSE preparatory methods remains sparse. This study assesses the effect of a curriculum intervention on NBME PSE scores. Method: An optional 1.5-hour review session and accompanying…

  9. INTERNSHIPS POLICY An internship (including externships, clerkships, student teaching or similar work experience) is

    E-print Network

    Hart, Gus

    1 INTERNSHIPS POLICY April 2007 An internship (including externships, clerkships, student teaching of the student or the internship provider under policy established by the department/school internship oversight committee. INTERNSHIP ENROLLMENT AND EXPERIENCE The course numbers designated by the University Curriculum

  10. Effect of a Clerkship on Students' Attitudes Toward Practice Problems and Preventive Care.

    ERIC Educational Resources Information Center

    Linn, Bernard S.; Zeppa, Robert

    1987-01-01

    A study compared the attitudes of men and women junior medical students at one medical school before and after a surgery clerkship concerning their confidence in dealing with problems in the doctor-patient relationship, concerns about future practice, and the value of preventive care. (MSE)

  11. How and What Do Medical Students Learn in Clerkships? Experience Based Learning (ExBL)

    ERIC Educational Resources Information Center

    Dornan, Tim; Tan, Naomi; Boshuizen, Henny; Gick, Rachel; Isba, Rachel; Mann, Karen; Scherpbier, Albert; Spencer, John; Timmins, Elizabeth

    2014-01-01

    Clerkship education has been called a "black box" because so little is known about what, how, and under which conditions students learn. Our aim was to develop a blueprint for education in ambulatory and inpatient settings, and in single encounters, traditional rotations, or longitudinal experiences. We identified 548 causal links…

  12. Using Multiple Assessments to Evaluate Medical Students' Clinical Ability in Psychiatric Clerkships

    ERIC Educational Resources Information Center

    Wang, Peng-Wei; Cheng, Cheng-Chung; Chou, Frank Huang-Chih; Tsang, Hin-Yeung; Chang, Yu-San; Huang, Mei-Feng; Yen, Cheng-Fang

    2011-01-01

    Background: No single assessment method can successfully evaluate the clinical ability of medical students in psychiatric clerkships; however, few studies have examined the efficacy of multiple assessments, especially in psychiatry. The aim of this study was to examine the relationship among different types of assessments of medical students'…

  13. How and what do medical students learn in clerkships? Experience based learning (ExBL).

    PubMed

    Dornan, Tim; Tan, Naomi; Boshuizen, Henny; Gick, Rachel; Isba, Rachel; Mann, Karen; Scherpbier, Albert; Spencer, John; Timmins, Elizabeth

    2014-12-01

    Clerkship education has been called a 'black box' because so little is known about what, how, and under which conditions students learn. Our aim was to develop a blueprint for education in ambulatory and inpatient settings, and in single encounters, traditional rotations, or longitudinal experiences. We identified 548 causal links between conditions, processes, and outcomes of clerkship education in 168 empirical papers published over 7 years and synthesised a theory of how students learn. They do so when they are given affective, pedagogic, and organisational support. Affective support comes from doctors' and many other health workers' interactions with students. Pedagogic support comes from informal interactions and modelling as well as doctors' teaching, supervision, and precepting. Organisational support comes from every tier of a curriculum. Core learning processes of observing, rehearsing, and contributing to authentic clinical activities take place within triadic relationships between students, patients, and practitioners. The phrase 'supported participation in practice' best describes the educational process. Much of the learning that results is too tacit, complex, contextualised, and individual to be defined as a set of competencies. We conclude that clerkship education takes place within relationships between students, patients, and doctors, supported by informal, individual, contextualised, and affective elements of the learned curriculum, alongside formal, standardised elements of the taught and assessed curriculum. This research provides a blueprint for designing and evaluating clerkship curricula as well as helping patients, students, and practitioners collaborate in educating tomorrow's doctors. PMID:24638146

  14. Student Pre- and Post-Evaluation of an Off-Campus Clinical Clerkship

    ERIC Educational Resources Information Center

    Campbell, R. Keith

    1975-01-01

    Describes the development and use of standardized forms found to be effective for evaluating clinical clerkship experiences of pharmacy students. Copies of the Preliminary Questionnaire and the Post-Evaluation Form are included along with the goals of the Washington State University College of Pharmacy Clinical Pharmacy Program. (JT)

  15. Creation of a Web-Based Lecture Series for Psychiatry Clerkship Students: Initial Findings

    ERIC Educational Resources Information Center

    Martin, Vicki L.; Bennett, David S.

    2004-01-01

    Objective: In recent years, the trend in medical education has been to utilize clerkship settings outside the medical school. Subsequently, students rotate at distant sites from the main campus and have lectures of varying quantity and quality. The objective of the present study was to standardize the core didactic experience for students in the…

  16. David K Brown Geriatrics Scholar Program

    E-print Network

    Mohaghegh, Shahab

    care of older adults in West Virginia by enhancing geriatrics training and competency of our state's health professionals that care for our older citizens. Our mission includes creating a sustainable policy and aging, community based care, managed and long term care, and health care service delivery

  17. Geriatric obesity: evaluating the evidence for the use of flavonoids to promote weight loss.

    PubMed

    Hurt, Ryan T; Wilson, Ted

    2012-01-01

    Obesity is a rapidly growing epidemic that now affects approximately 30% of the adult population in the United States. The prevalence of obesity in the geriatric population makes it one of the fastest growing groups due to aging baby boomers. Because of the limited number of available treatments for obese adults, they often turn to supplements and alternative medicine sources to help them lose weight. One such group of supplements contains plant metabolites flavonoids, which includes catechins from tea, quercetin from fruits and vegetables, and isoflavones from soy products. Some flavonoids such as catechins and soy isoflavones can modestly reduce weight. This review examined the clinical evidence for catechins, quercetin, and soy isoflavones for the treatment of obesity and explored the mechanisms of action as related to obesity. Furthermore, flavonoids were evaluated for the treatment of obesity in geriatric populations as well as for safety concerns. PMID:22888842

  18. Natural products and supplements for geriatric depression and cognitive disorders: an evaluation of the research.

    PubMed

    Varteresian, Taya; Lavretsky, Helen

    2014-08-01

    Numerous geriatric patients are using Complementary and Alternative Medicine (CAM) for late-life mood and cognitive disorders. Natural products and supplements are a common CAM intervention which have risks and benefits of which patients should be appropriately advised. The data for omega-3 fatty acids, ginkgo biloba, SAMe, St John's wort, B vitamins and vitamin D, huperzine, caprylidene, and coconut oil will be evaluated. Since the evidence basis for natural products and supplements is limited, especially for the geriatric population, studies involving the general adult population are included to infer effects in the aging population. Despite the data available, more rigorous studies with larger sample sizes over longer periods of time are still needed. Regardless of a physician's preference to recommend various natural supplements and products, a physician could protect their patients by having an understanding of the side effects and indications for various natural products. PMID:24912606

  19. Impact of clerkship attachments on students’ attitude toward pharmaceutical care in Ethiopia

    PubMed Central

    Tsega, Bayew; Bhagavathula, Akshaya Srikanth; Sarkar, Barun Ranjan; Melaku, Tadesse; Shewamene, Zewdneh

    2015-01-01

    Objective The study objective is to investigate the impact of mandatory clinical clerkship courses on 5th-year pharmacy students’ attitudes and perceived barriers toward providing pharmaceutical care (PC). Methods A cross-sectional survey was conducted among 5th-year pharmacy students undertaking mandatory clinical clerkship in the University of Gondar, Ethiopia. A pharmaceutical care attitudes survey (PCAS) questionnaire was used to assess the attitude (14 items), commonly identified drug-related problem/s (1 item) during clerkships, and perceived barriers (12 items) toward the provision of PC. Statistical analysis was conducted on the retrieved data. Results Out of the total of 69 clerkship students, 65 participated and completed the survey (94.2% response rate). Overall, 74.45% of participants opinioned a positive attitude toward PC provision. Almost all respondents agreed that the primary responsibility of pharmacists in the healthcare setting was to prevent and solve medication-related problems (98.5%), practice of PC was valuable (89.3%), and the PC movement will improve patient health (95.4%), respectively. Unnecessary drug therapy (43%), drug–drug interactions (33%), and non-adherence to medications (33%) were the most common drug-related problems identified in wards. Highly perceived barriers for PC provision included lack of a workplace for counseling in the pharmacy (75.4%), a poor image of pharmacist’s role in wards (67.7%), and inadequate technology in the pharmacy (64.6%). Lack of access to a patient’s medical record in the pharmacy had significant association (P<0.05) with PC practice, performance of PC during clerkship, provision of PC as clinical pharmacists, and Ethiopian pharmacists benefiting by PC. Conclusion Ethiopian clinical pharmacy students have a good attitude toward PC. Efforts should be targeted toward reducing these drug therapy issues, and aiding the integration of PC provision with pharmacy practice.

  20. Impact of clerkship in the attitudes toward psychiatry among Portuguese medical students

    PubMed Central

    2010-01-01

    Background Given the shortage of human resources and the launching of a new Mental Health Plan, recruitment of psychiatrists is currently a major concern in Portugal, as well as in several other countries. Medical students' attitude toward psychiatry has been pointed as a predictor of recruitment. This study aims to evaluate the medical students' perception of psychiatry before and after a clerkship, and the impact on their intention to pursue psychiatry as a future specialty option. Methods Two self-report questionnaires were administered to all 6th year students in a medical school in Lisbon, before and after a 4-weeks full-time psychiatric clerkship, in order to evaluate attitudes toward psychiatry and intention to follow psychiatry in the future. Statistical analysis included Wilcoxon and Chi-square tests. Results 153 students (60.8% female) filled in both questionnaires (no dropouts). After the clerkship, there was a significant improvement regarding the overall merits of psychiatry, efficacy, role definition and functioning of psychiatrists, use of legal powers to hospitalize patients and specific medical school factors. There was also a significant increase of students decided or considering the possibility to take a residency in psychiatry. However, perceptions of low prestige and negative pressure from family and peers regarding a future choice of psychiatry remained unchanged in about one-third of the students. Conclusions The results indicate clearly that the clerkship had a favorable overall impact on the student attitude towards psychiatry, as well as in the number of students considering a future career in psychiatry. Attitudes toward psychiatry seems a promising outcome indicator of the clerkship's quality, but further research is needed in order to assess its reliability as a sound predictor of recruitment. PMID:20678213

  1. Factors associated with geriatric syndromes in older homeless adults.

    PubMed

    Brown, Rebecca T; Kiely, Dan K; Bharel, Monica; Mitchell, Susan L

    2013-05-01

    Although older homeless adults have high rates of geriatric syndromes, risk factors for these syndromes are not known. We used multivariable regression models to estimate the association of subject characteristics with the total number of geriatric syndromes in 250 homeless adults aged 50 years and older. Geriatric syndromes included falls, cognitive impairment, frailty, major depression, sensory impairment, and urinary incontinence. A higher total number of geriatric syndromes was associated with having less than a high school education, medical comorbidities (diabetes and arthritis), alcohol and drug use problems, and difficulty performing one or more activities of daily living. Clinicians who care for older homeless patients with these characteristics should consider screening them for geriatric syndromes. Moreover, this study identifies potentially modifiable risk factors associated with the total number of geriatric syndromes in older homeless adults. This knowledge may provide targets for clinical interventions to improve the health of older homeless patients. PMID:23728022

  2. Advancing Geriatric Education: Development of an Interprofessional Program for Health Care Faculty.

    PubMed

    Ford, Channing R; Brown, Cynthia J; Sawyer, Patricia; Rothrock, Angela G; Ritchie, Christine S

    2015-01-01

    To improve the health care of older adults, a faculty development program was created to enhance geriatric knowledge. The University of Alabama at Birmingham (UAB) Geriatric Education Center leadership instituted a one-year, 36-hour curriculum focusing on older adults with complex health care needs. Content areas were chosen from the Institute of Medicine Transforming Health Care Quality report and a local needs assessment. Potential preceptors were identified and participant recruitment efforts began by contacting UAB department chairs of health care disciplines. This article describes the development of the program and its implementation over three cohorts of faculty scholars (n = 41) representing 13 disciplines, from nine institutions of higher learning. Formative and summative evaluation showed program success in terms of positive faculty reports of the program, information gained, and expressed intent by each scholar to apply learned content to teaching and/or clinical practice. This article describes the initial framework and strategies guiding the development of a thriving interprofessional geriatric education program. PMID:24884900

  3. Patient-reported geriatric symptoms as risk factors for hospitalization and emergency department visits.

    PubMed

    Chandra, Anupam; Crane, Sarah J; Tung, Ericka E; Hanson, Gregory J; North, Frederick; Cha, Stephen S; Takahashi, Paul Y

    2015-06-01

    There is an urgent need to identify predictors of adverse outcomes and increased health care utilization in the elderly. The Mayo Ambulatory Geriatric Evaluation (MAGE) is a symptom questionnaire that was completed by patients aged 65 years and older during office visits to Primary Care Internal Medicine at Mayo Clinic in Rochester, MN. It was introduced to improve screening for geriatric conditions. We conducted this study to explore the relationship between self-reported geriatric symptoms and hospitalization and emergency department (ED) visits within 1 year of completing the survey. This was a retrospective cohort study of patients who completed the MAGE from April 2008 to December 2010. The primary outcome was an ED visit or hospitalization within 1 year. Predictors included responses to individual questions in the MAGE. Data were obtained from the electronic medical record and administrative records. Logistic regression analyses were performed from significant univariate factors to determine predictors in a multivariable setting. A weighted scoring system was created based upon the odds ratios derived from a bootstrap process. The sensitivity, specificity, and AUC were calculated using this scoring system. The MAGE survey was completed by 7738 patients. The average age was 76.2 ± 7.68 years and 57% were women. Advanced age, a self-report of worse health, history of 2 or more falls, weight loss, and depressed mood were significantly associated with hospitalization or ED visits within 1 year. A score equal to or greater than 2 had a sensitivity of 0.74 and specificity of 0.45. The calculated AUC was 0.60. The MAGE questionnaire, which was completed by patients at an outpatient visit to screen for common geriatric issues, could also be used to assess risk for ED visits and hospitalization within 1 year. PMID:26029477

  4. Patient-Reported Geriatric Symptoms as Risk Factors for Hospitalization and Emergency Department Visits

    PubMed Central

    Chandra, Anupam; Crane, Sarah J; Tung, Ericka E; Hanson, Gregory J; North, Frederick; Cha, Stephen S; Takahashi, Paul Y

    2015-01-01

    There is an urgent need to identify predictors of adverse outcomes and increased health care utilization in the elderly. The Mayo Ambulatory Geriatric Evaluation (MAGE) is a symptom questionnaire that was completed by patients aged 65 years and older during office visits to Primary Care Internal Medicine at Mayo Clinic in Rochester, MN. It was introduced to improve screening for geriatric conditions. We conducted this study to explore the relationship between self-reported geriatric symptoms and hospitalization and emergency department (ED) visits within 1 year of completing the survey. This was a retrospective cohort study of patients who completed the MAGE from April 2008 to December 2010. The primary outcome was an ED visit or hospitalization within 1 year. Predictors included responses to individual questions in the MAGE. Data were obtained from the electronic medical record and administrative records. Logistic regression analyses were performed from significant univariate factors to determine predictors in a multivariable setting. A weighted scoring system was created based upon the odds ratios derived from a bootstrap process. The sensitivity, specificity, and AUC were calculated using this scoring system. The MAGE survey was completed by 7738 patients. The average age was 76.2 ± 7.68 years and 57% were women. Advanced age, a self-report of worse health, history of 2 or more falls, weight loss, and depressed mood were significantly associated with hospitalization or ED visits within 1 year. A score equal to or greater than 2 had a sensitivity of 0.74 and specificity of 0.45. The calculated AUC was 0.60. The MAGE questionnaire, which was completed by patients at an outpatient visit to screen for common geriatric issues, could also be used to assess risk for ED visits and hospitalization within 1 year. PMID:26029477

  5. Teaching methods in community health nursing clerkships: experiences of healthcare staff in Iran

    PubMed Central

    2014-01-01

    Purpose: Healthcare staff educate nursing students during their clerkships at community health nursing programs. Their teaching methods play an important role in nursing students’ acquisition of competencies; however, these methods have not been studied thoroughly. Thus, this study aims to describe, interpret, and understand the experiences of healthcare staff’s teaching methods in clerkships at a community health nursing program. Methods: This study was conducted using purposeful sampling and semi-structured interviews with 13 members of the staff of three urban healthcare centers in Iran. The data were analyzed through qualitative content analysis and thematic analysis. Results: Multiplicity of teaching was identified as the main category of teaching method, and the five subcategories were teaching through lecture, demonstration, doing, visits and field trips, and readiness. The most common method used by the healthcare staff was lecturing. Conclusion: The healthcare staff used multiple methods to teach students in the nursing clerkship of the community health program, which was the strength of the course. However, they should be familiar with, and utilize additional methods, such as discussion rather than lecture. PMID:25273853

  6. Creating stories to live by: caring and professional identity formation in a longitudinal integrated clerkship.

    PubMed

    Konkin, Jill; Suddards, Carol

    2012-10-01

    Building on other models of longitudinal integrated clerkships (LIC), the University of Alberta developed its Integrated Community Clerkship with guiding principles of continuity of care, preceptor and learning environment. Professionalism is an important theme in medical education. Caring is important in professional identity formation and an ethic of caring is a moral framework for caring. This study explored the development of an ethic of caring in an LIC using empathy, compassion and taking responsibility as descriptors of caring. Through a hermeneutic phenomenological study, the authors focused on students' accounts of being with patients. Following an iterative process of successive analyses and explorations of the relevant literature, sensitizing concepts related to physician identity, and an ethic of caring were used to make sense of these accounts following the principles of constructivist grounded theory methodology. Continuity afforded by the LIC results in a safe environment in which students can meaningfully engage with patients and take responsibility for their care under the supervision of a physician teacher. Together these attributes foster an emerging physician identity born at the site of patient-student interaction and grounded in an ethic of caring. A medical student's evolving professional identity in the clerkship includes the emergence of an ethic of caring. Student accounts of being with patients demonstrate that the LIC at the University of Alberta affords opportunities for students be receptive to and responsible for their patients. This ethic of caring is part of an emerging physician identity for the study participants. PMID:22052211

  7. Geriatric Psychiatry: A Subspecialty Whose Time Has Come

    Microsoft Academic Search

    Nathan Herrmann

    hat is geriatric psychiatry? Simply put, it is the subspecialty dealing with the assessment and manage- ment of mental disorders occurring in late life—a period occa- sionally and somewhat arbitrarily defined as aged 65 years and over (1). This definition falsely simplifies what we do as geriatric psychiatrists and does not acknowledge the scope of practice and the specific skills

  8. Geriatric-Focused CPE as a Tool in Seminary Training

    Microsoft Academic Search

    Mary Martha Thiel

    2011-01-01

    Clinical Pastoral Education in a geriatric setting enhances seminarians' classroom education and prepares them for pastoral care with the growing numbers of elders they will serve in congregational, health care, and residential settings. Strengths of a geriatric setting for CPE include demographic congruence with most ministry settings, breaking stereotypes of aging, longevity of pastoral relationships, opportunities for multifaceted care, decreasing

  9. Validation of the Geriatric Depression Scale Among Nursing Home Residents

    Microsoft Academic Search

    Emerson Lesher

    1986-01-01

    The Geriatric Depression Scale has been found to be a helpful screening instrument for depression among psychiatric and community elderly, but has never been validated among elderly nursing home residents. The reliability and validity of the Geriatric Depression Scale was examined among 51 nursing home residents. Reliability was assessed using several methods and was found to be acceptable. Validity was

  10. Designing a Multi-Disciplinary Geriatrics Health Professional Mentoring Program

    ERIC Educational Resources Information Center

    Cotter, James J.; Coogle, Constance L.; Parham, Iris A.; Head, Colleen; Fulton, LaQuana; Watson, Kathleen; Curtis, Angela

    2004-01-01

    This paper describes a Geriatric Health Professionals Mentoring Program designed to address recruitment and retention of health professionals in geriatrics and gerontology. The training provided information on the mentoring process, negotiating mentoring agreements, and coaching mentees. The evaluative framework described examines: (a) the effects…

  11. Geriatrics in Family Practice Residency Education: An Unmet Challenge.

    ERIC Educational Resources Information Center

    Gazewood, John D.; Vanderhoff, Bruce; Ackermann, Richard; Cefalu, Charles

    2003-01-01

    Offers a position statement on geriatric education in family practice residency, asserting that limited progress has been made despite an increasing need for such education. Offers seven recommendations, such as: every family practice residency should integrate a variety of training sites into a comprehensive curriculum of geriatric education that…

  12. The Filipino Nursing Students' Dilemmas in Geriatric Care

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Cruz, Andrei Angelo R.; Cruz, Angela Laurice G.; Cruz, Robert Edward D.; Cuarto, Jose Mari Nino L.

    2009-01-01

    The continually rising percentage of the elderly population and the demand for geriatric nursing care are dramatically related. While it is true that most undergraduate programs prepare nurses for the care of geriatric patients, most receive limited academic preparation in the nursing curriculum (Williams & Mezey, 2000). This is particularly true…

  13. Operationalizing a Frailty Index from a Standardized Comprehensive Geriatric Assessment

    Microsoft Academic Search

    David M. Jones; Xiaowei Song; Kenneth Rockwood

    2004-01-01

    OBJECTIVES: To construct and validate a frailty index (FI) that is clinically sensible and practical for geriatricians by basing it on a routinely used comprehensive geriatric assessment (CGA) instrument. DESIGN: Secondary analysis of a 3-month randomized, controlled trial of a specialized mobile geriatric assessment team. SETTING: Rural Nova Scotia. Participants were seen in their homes. PARTICIPANTS: Frail older adults, of

  14. Intention of nursing students to work in geriatrics.

    PubMed

    Ben Natan, Merav; Danino, Sharon; Freundlich, Nelli; Barda, Ayelet; Yosef, Racheli Mor

    2015-01-01

    The current study examined factors related to nursing students' intention to work in geriatrics upon graduation. A cross-sectional, descriptive design was used. A random sample of 200 nursing students completed a questionnaire based on the Theory of Planned Behavior and Kogan's Attitudes Toward Old People Scale. Participants expressed low intention to work in geriatrics upon graduation. Results of a multiple linear regression indicated that students' attitudes toward working in geriatrics and normative and control beliefs were found to be predictors of this intention. Additionally, male and religious students were more inclined to work in geriatrics. The current study indicated that nursing students' attitudes toward working in geriatrics were significantly predictive of their intention to work in this field upon graduation. [Res Gerontol Nurs. 2015; 8(3):140-147.]. PMID:25707032

  15. Predictors in geriatric psychiatry hospital length of stay.

    PubMed

    DiNapoli, Elizabeth A; Regier, Natalie; McPherron, Jesse; Mundy, Michael J; Sabastian, Sabin; Doss, Jerry; Parmelee, Patricia A

    2015-06-01

    This paper examined predictors of length of stay in a freestanding geriatric psychiatry hospital. Data on patient and treatment characteristics of geriatric inpatients (N = 1,593) were extracted from an archival administrative tracking database from Mary Starke Geriatric Harper Center. Five independent variables (length of time between last discharge and most recent admission, number of previous admissions, number of assaults, co-morbid medical condition, and admitting psychiatric diagnosis) were entered into a hierarchical regression model as potential predictors of length of stay in a geriatric psychiatry hospital. Number of assaults committed by the patient was the only significant predictor of length of stay, such that patients that had a greater number of assaults were more likely to have longer lengths of stay than those with fewer assaults. These findings highlight the importance of identifying patients at risk for assaultive behavior and developing effective interventions for aggression in geriatric psychiatry hospitals. PMID:25355603

  16. Geriatrics educational outreach: A tale of three GRECCS.

    PubMed

    Clark, Elizabeth; Fitzgerald, James T; Griffith, Jennifer; Weir, Charlene

    2011-01-01

    Current geriatrics workforce projections indicate that clinicians who care for adults will need basic geriatrics knowledge and skills to address the geriatric syndromes and issues that limit functional independence and complicate medical management. This is most evident for the clinicians caring for veterans in the Department of Veterans Affairs hospitals and clinics nationwide. Geriatric Research, Education and Clinical Centers (GRECCs), whose staff are geriatric-content experts, have developed a number of programs to tackle this daunting educational task. This article introduces three different programs designed and implemented by GRECCs to train currently practicing health care providers in the Veterans Health Administration medical clinics. It also describes the successes and lessons learned from these three programs. PMID:21347933

  17. The portal of geriatrics online education: a 21st-century resource for teaching geriatrics.

    PubMed

    Ramaswamy, Ravishankar; Leipzig, Rosanne M; Howe, Carol L; Sauvigne, Karen; Usiak, Craig; Soriano, Rainier P

    2015-02-01

    The way students are taught and evaluated is changing, with greater emphasis on flexible, individualized, learner-centered education, including the use of technology. The goal of assessment is also shifting from what students know to how they perform in practice settings. Developing educational materials for teaching in these ways is time-consuming and can be expensive. The Portal of Geriatrics Online Education (POGOe) was developed to aid educators in meeting these needs and become quicker, better-prepared teachers of geriatrics. POGOe contains more than 950 geriatrics educational materials that faculty at 45% of allopathic and 7% of osteopathic U.S. medical schools and the Centers for Geriatric Nursing Excellence have created. These materials include various instructional and assessment methodologies, including virtual and standardized patients, games, tutorials, case-based teaching, self-directed learning, and traditional lectures. Materials with common goals and resource types are available as selected educational series. Learner assessments comprise approximately 10% of the educational materials. POGOe also includes libraries of videos, images, and questions extracted from its educational materials to encourage educators to repurpose content components to create new resources and to align their teaching better with their learners' needs. Web-Geriatric Education Modules, a peer-reviewed online modular curriculum for medical students, is a prime example of this repurposing. The existence of a robust compendium of instructional and assessment materials allows educators to concentrate more on improving learner performance in practice and not simply on knowledge acquisition. It also makes it easier for nongeriatricians to teach the care of older adults in their respective disciplines. PMID:25644187

  18. The Use of the Internet in Geriatrics Education: Results of a National Survey of Medical Geriatrics Academic Programs

    ERIC Educational Resources Information Center

    Hajjar, Ihab M.; Ruiz, Jorge G.; Teasdale, Thomas A.; Mintzer, Michael J.

    2007-01-01

    In order to characterize use of the Internet in medical geriatrics education programs, 130 medical education programs in the U.S. that train medical students, interns, residents, fellows and practicing physicians were asked to complete a survey developed by the Consortium of E-Learning in Geriatrics Instruction (CELGI). Sixty-eight programs…

  19. The Geriatric Population and Psychiatric Medication

    PubMed Central

    Varma, Sannidhya; Sareen, Himanshu; Trivedi, J.K.

    2010-01-01

    With improvement in medical services in the last few years, there has been a constant rise in the geriatric population throughout the world, more so in the developing countries. The elderly are highly prone to develop psychiatric disorders, probably because of age related changes in the brain, concomitant physical disorders, as well as increased stress in later life. Psychiatric disorders in this population may have a different presentation than in other groups and some of psychopathologies might be mistaken for normal age related changes by an unwary clinician. Therefore the need of the day is to train psychiatrists and physicians to better recognize and manage mental disorders in this age group. PMID:21327169

  20. Development of an Evaluative Procedure for Clinical Clerkships.

    ERIC Educational Resources Information Center

    And Others; Pancorbo, Salvador

    1980-01-01

    In order to evaluate the clinical competencies of graduate pharmacy students upon the completion of a medicine rotation, an oral examination has been developed that requires students to present data and defend decisions. Objectives, responsibilities, and competencies required by the rotation and nine sample exam questions are appended. (JMD)

  1. Current publications in Gerontology and Geriatrics.

    PubMed

    Shock, N W

    1978-07-01

    The subject categories are those in A Classified Bibliography of Gerontology and Geriatrics by Nathan W. Shock, published by Stanford University Press, Stanford, California (1951). Only major headings are used and the Roman numerals correspond to those given in the bibliography. Insofar as possible, references are classified according to organ systems. Thus, most of the material on Geriatrics will be found under the organ system involved in the disease. Cross references are indicated by numbers at the end of each section. When available, abstract references are given (B.A.-Biological Abstracts. P.A.-Psychological Abstracts, and P.I.-Population Index). Abbreviations for journals are those in A World List of Scientific Periodicals Published in the years 1900-1933, 2nd Edition. For journals not listed, abbreviations were devised to the general rules used in the above source. It is impossible to cover all journals and list all papers concerned with aging and the aged. Authors and publishers are requested to call attention to publications or to send reprints to the Gerontology Research Center, Baltimore City Hospitals, Baltimore, Maryland 21224. PMID:376580

  2. Current publications in gerontology and geriatrics.

    PubMed

    Shock, N W

    1977-07-01

    THE SUBJECT categories are those in A Classified Bibliography of Gerontology and Geriatrics by Nathan W; Shock, published by Stanford University Press, Stanford, California (1951). Only major headings are used and the Roman numerals correspond to those given in the bibliography. Insofar as possible, references are classified according to organ systems. Thus, most of the material on Geriatrics will be found under the organ system involved in the disease. Cross references are indicated by numbers at the end of each section. When available, abstract references are given (B.A.--Biological Abstracts. P.A.--Psychological Abstracts, and P.I.-Population Index). Abbreviations for journals are those in A World List of Scientific Periodicals Published in the years 1900-1933; 2nd Edition. For journals not listed, abbreviations were devised to the general rules used in the above source. It is impossible to cover all journals and list all papers concerned with aging and the aged. Authors and publishers are requested to call attention to publications or to send reprints to the Gerontology Research Center, Baltimore City Hospitals, Baltimore, Maryland 21224. PMID:325062

  3. [Chartered specialist training in gerontology and geriatrics. Dissertation Council no. 601.001.01 working practice].

    PubMed

    Kozina, L S

    2014-01-01

    The article highlights basic facts about the foundation and activity of the Gerontology and Geriatrics Dissertation Council of St. Petersburg Institute of Bioregulation and Gerontology, which took invaluable part in chartered specialist training in this field of science that has actively developed in Russia in recent decades. Over the period from June, 2001 to December, 2013, a total of 41 doctoral dissertations were defended, of which 32 dissertations were on Medicine and 9 on Biological Sciences. Likewise, over the same period, a total of 186 candidate's dissertations were defended, of which 152 dissertations were on Medicine and 34 on Biological Sciences, the defenders coming from various regions of Russia and other countries. The defence-representative trend data acquired over the period of the Dissertation Council activities shows that the number of defended doctoral dissertations was relatively small within the period from 2002 to 2008, but it increased significantly in the years 2009 to 2013. The number of defended candidate's dissertations increased significantly over the same period, too. Among many others considered by the Dissertation Council, there were dissertations dedicated to basic research in the field of gerontology and geriatrics. The priority topics of a large number of dissertations performed in St. Petersburg and other Russian towns are age pathology mechanisms, geroprotective effects of regulatory peptides and effectiveness of their use in clinic. PMID:25306671

  4. Improving the quality of geriatric nursing care: enduring outcomes from the geriatric nursing education consortium.

    PubMed

    Gray-Miceli, Deanna; Wilson, Laurie Dodge; Stanley, Joan; Watman, Rachael; Shire, Amy; Sofaer, Shoshanna; Mezey, Mathy

    2014-01-01

    The nation's aging demography, few nursing faculty with gerontological nursing expertise, and insufficient geriatric content in nursing programs have created a national imperative to increase the supply of nurses qualified to provide care for older adults. Geriatric Nursing Education Consortium (GNEC), a collaborative program of the John A. Hartford Foundation, the American Association of Colleges of Nursing, and the New York University (NYU) Nursing Hartford Institute for Geriatric Nursing, was initiated to provide faculty with the necessary skills, knowledge, and competency to implement sustainable curricular innovations in care of older adults. This article describes the background, step-by-step process approach to the development of GNEC evidence-based curricular materials, and the dissemination of these materials through 6-, 2-, and a half-day national Faculty Development Institutes (FDIs). Eight hundred eight faculty, representing 418 schools of nursing, attended. A total of 479 individuals responded to an evaluation conducted by Baruch College that showed faculty feasibility to incorporate GNEC content into courses, confidence in teaching and incorporating content, and overall high rating of the GNEC materials. The impact of GNEC is discussed along with effects on faculty participants over 2 years. Administrative- and faculty-level recommendations to sustain and expand GNEC are highlighted. PMID:25455325

  5. The Physician Assistant in Geriatric Long-Term Care

    ERIC Educational Resources Information Center

    Becker, Robert G.

    1976-01-01

    The Physician Assistant (PA) is a new health-care professional who is trained to function as a "physician extender." The author's experience with 71 PA students and graduate PA's at the Jewish Institute for Geriatric Care is described. (Author)

  6. J Am Geriatr Soc . Author manuscript Disability and incident coronary heart disease in older community-dwelling

    E-print Network

    J Am Geriatr Soc . Author manuscript Page /1 11 Disability and incident coronary heart disease & numerical data ; Female ; France ; epidemiology ; Geriatric Assessment ; Hospitalization ; statistics in the elderly J Am Geriatr Soc . Author

  7. Anal function in geriatric patients with faecal incontinence.

    PubMed

    Barrett, J A; Brocklehurst, J C; Kiff, E S; Ferguson, G; Faragher, E B

    1989-09-01

    The association of faecal incontinence with constipation and confusion in the elderly is well recognised but the anal function of faecally incontinent geriatric patients is poorly understood. Anal studies were therefore performed on 99 geriatric patients (49 with faecal incontinence, 19 continent patients with faecal impaction and 31 geriatric control patients with normal bowel habit) and 57 younger healthy control patients. An age related reduction in anal squeeze pressure but not resting pressure was identified. A reduction in anal resting pressure was detected in the faecally incontinent geriatric patients but squeeze pressure did not differ significantly from that found in the other geriatric patients. Anal sensation was impaired in the faecally incontinent patients. No difference was found between the groups as measured by pudendal nerve terminal motor latency. Gross neuropathy of the distal part of the pudendal nerve does not account for the observed external anal sphincter weakness in geriatric patients or for their faecal incontinence. Internal anal sphincter dysfunction is an important factor in faecal incontinence in the elderly. PMID:2806992

  8. The Influence on Students' Specialty Selections of Faculty Evaluations and Mini-Board Scores during Third-Year Clerkships.

    ERIC Educational Resources Information Center

    Pamies, Rubens J.; And Others

    1992-01-01

    Analysis of data from 53 medical students found a gender-specific correlation between faculty evaluations of clinical clerkships and eventual female student choice of that rotation's specialty and between high mini-Board scores by male students and male selection of that specialty. Substantially more women chose pediatrics residencies than…

  9. Grading Medical Students in a Psychiatry Clerkship: Correlation with the NBME Subject Examination Scores and Its Implications

    ERIC Educational Resources Information Center

    Ramchandani, Dilip

    2011-01-01

    Background/Objective: The author analyzed and compared various assessment methods for assessment of medical students; these methods included clinical assessment and the standardized National Board of Medical Education (NBME) subject examination. Method: Students were evaluated on their 6-week clerkship in psychiatry by both their clinical…

  10. Clinical Conundrums in Management of Hypothyroidism in Critically Ill Geriatric Patients

    PubMed Central

    Sehgal, Vishal; Bajwa, Sukhminder Jit Singh; Sehgal, Rinku; Bajaj, Anurag

    2014-01-01

    Context: Articles in various international and national bibliographic indices were extensively searched with an emphasis on thyroid and hypothyroid disorders, hypothyroidism in elderly hospitalized patients, hypothyroidism in critically ill geriatric population, thyroxine in elderly hypothyroid, drug interactions and thyroid hormones, and thyroid functions in elderly. Evidence acquisition: Entrez (including PubMed), NIH.gov, Medscape.com, WebMD.com, MedHelp.org, Search Medica, MD consult, yahoo.com, and google.com were searched. Manual search was performed on various textbooks of medicine, critical care, pharmacology, and endocrinology. Results: Thyroid function tests in elderly hospitalized patients must be interpreted with circumspection. The elderly are often exposed to high iodide content and critical care settings. This may occur because of either decreased iodine excretion or very high intake of iodine. This is especially true for elderly population with underlying acute or chronic kidney diseases or both. Amiodarone, with a very high iodine content, is also often used in this set of population. Moreover, other medications including iodinated contrast are often used in the critical care settings. These may affect different steps of thyroid hormone metabolism, and thereby complicate the interpretation of thyroid function tests. Conclusions: The current review is aimed at analyzing and managing various clinical aspects of hypothyroidism in hospitalized elderly, and critically ill geriatric patients. PMID:24719636

  11. Creation of a novel, interdisciplinary, multisite clerkship: "understanding lupus".

    PubMed

    Nambudiri, Vinod E; Newman, Lori R; Haynes, Harley A; Schur, Peter; Vleugels, Ruth Ann

    2014-03-01

    Few medical school electives include longitudinal patient care across clinical specialties and environments. Systemic lupus erythematosus represents a disease process with complex pathophysiology for students to learn from providers across medical fields, including dermatology, rheumatology, nephrology, and cardiology, in both pediatric and adult patients. Diagnosis, understanding, and management of lupus also rely heavily on basic science and clinical immunology, providing a link to the preclinical curriculum. In 2009, Harvard Medical School introduced a one-month elective course "Understanding Lupus: A Multidisciplinary Approach to Systemic Disease," designed to provide students with both outpatient and inpatient care experiences in dermatology, rheumatology, and multidisciplinary clinics at Brigham and Women's Hospital and Boston Children's Hospital. Core components of the elective include a continuity experience that allows students to attend one patient's multiple specialist visits; didactics from dermatology, rheumatology, and immunology covering evidence-based medicine and basic sciences; and clinical immunology laboratory exposure to teach serologic and auto-antibody testing methods. The authors provide lessons learned in the development of this interdisciplinary, multi-institution elective rotation, which may serve as a model at other medical schools for incorporating basic sciences into the clinical curriculum and using multidisciplinary care and varied educational settings. PMID:24448033

  12. 76 FR 54536 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-01

    ...planning activities in geriatrics and extended care, recent VHA efforts regarding dementia and program advances in palliative care, and performance and oversight of VA Geriatric Research, Education, and Clinical Centers. No time will be...

  13. 77 FR 49865 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-17

    ...planning activities in geriatrics and extended care, recent VHA efforts regarding dementia and program advances in palliative care, and performance and oversight of VA Geriatric Research, Education, and Clinical Centers. No time will be...

  14. 75 FR 54232 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-03

    ...planning activities in geriatrics and extended care, recent VHA efforts regarding dementia and program advances in palliative care, and performance and oversight of the VA Geriatric Research, Education, and Clinical Centers. No time will...

  15. 78 FR 6406 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ...planning activities in geriatrics and extended care, recent VHA efforts regarding dementia and program advances in palliative care, and performance and oversight of VA Geriatric Research, Education, and Clinical Centers. No time will be...

  16. 76 FR 17999 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ...planning activities in geriatrics and extended care, recent VHA efforts regarding dementia and program advances in palliative care, and performance and oversight of the VA Geriatric Research, Education, and Clinical Centers. No time will...

  17. 78 FR 55778 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ...planning activities in geriatrics and extended care; recent VHA efforts regarding dementia and program advances in palliative care; and performance and oversight of VA Geriatric Research, Education, and Clinical Centers. No time will be...

  18. 77 FR 14860 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-13

    ...planning activities in geriatrics and extended care, recent VHA efforts regarding dementia and program advances in palliative care, and performance and oversight of VA Geriatric Research, Education, and Clinical Centers. No time will be...

  19. 78 FR 12831 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ...planning activities in geriatrics and extended care, recent VHA efforts regarding dementia and program advances in palliative care, and performance and oversight of VA Geriatric Research, Education, and Clinical Centers. No time will be...

  20. 75 FR 11638 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-11

    ...planning activities in geriatrics and extended care, recent VHA efforts regarding dementia and program advances in palliative care, and performance and oversight of the VA Geriatric Research, Education, and Clinical Centers. No time will...

  1. Baycrest Centre for Geriatric Care Patients with Severe Memory Loss Given Brighter Future with

    E-print Network

    Toronto, University of

    Baycrest Centre for Geriatric Care Patients with Severe Memory Loss Given Brighter Future with palmOne Handhelds Since 1918, Baycrest Centre for Geriatric Care has been devoted to enriching the quality of life

  2. 1. Exit the main Hospital through the Cancer Geriatrics Center Building on the 2nd floor.

    E-print Network

    Shyy, Wei

    1. Exit the main Hospital through the Cancer Geriatrics Center Building on the 2nd floor. 2. Follow the connector ramp between the Cancer Geriatric Center and Med Sci I. Turn left at the sign reading, "To

  3. Mapping geriatric nursing competencies to the 2001 NCLEX-RN test plan

    Microsoft Academic Search

    Anne Wendt

    2003-01-01

    The National Council Licensure Examination for Registered Nurses (NCLEX-RN©) identifies competencies that are important in providing nursing care for the geriatric client. Geriatric nursing competencies are mapped to specific areas of the 2001 NCLEX-RN Test Plan.

  4. What caring means to geriatric nurses.

    PubMed

    Shwu-Jiuan, Liu

    2004-06-01

    Caring is the major concept in nursing. The purpose of this study was to describe the meaning of caring for nurses caring for elderly patients. Parse' s phenomenology was addressed in the research design, which included four steps: participant selection, dialogical engagement, extraction-synthesis, and heuristic interpretation. By stratified sampling, 30 nurses who worked in medical-surgical wards in a general teaching hospital were selected as participants. Dialogical engagement was completed through in-depth, tape-recorded interviews on the open question, " What is the meaning of caring for you as a provider of care to the elderly? ". Data were interpreted by process of Parse' s phenomenology, which included extracting the essence, synthesizing the essence, formulating a proposition, extracting concepts, and structuring the meaning. The meaning of caring for nurses engaged in caring for the elderly was: " Through the initiative deliberation from sincerity, the nurse is to dedication by the empathy and tolerance". The core concepts of caring were: deliberation, initiative, sincerity, tolerance, empathy, and dedication. It should develop and apply the caring concept and theory actively to geriatric nursing care. PMID:15208778

  5. [Measuring the handgrip strength of geriatric patients].

    PubMed

    Kerckhofs, A G M; Vandewoude, M F J; Mudde, A N

    2014-09-01

    The handgrip strength of geriatric patients can be measured when the patient is hospitalized. This article elaborates on the intrinsic and extrinsic factors which have a direct or indirect influence on handgrip strength. For the best results the tests need to be taken in the best circumstances with attention to individual differences and the age of the patient. Handgrip strength as determination of biological vitality is a key concept. Besides the physical characteristics there are many psychological factors (cognition, psyching-up, test attitude…) influencing the results. These are barely mentioned or not mentioned at all in the usual procedures. Research of handgrip strength testing theories is mostly focused on young, healthy adults and less on elderly patients. The main goal of this article is stimulating experimental research on the measurement of handgrip strength with elderly people and involving them more actively with the procedure. It is not enough to acquire insight in function and predicting characteristics of handgrip strength. Next to the aiming for the best test performance is 'working interactively with elderly patients' a goal on itself in the modern vision of health care. PMID:24827615

  6. Pharmacokinetics of triazolam in geriatric patients.

    PubMed

    Dehlin, O; Björnson, G; Börjesson, L; Abrahamsson, L; Smith, R B

    1983-01-01

    Serum triazolam levels were determined in eight geriatric patients (average age 80 years) on Days 1 and 7 of administration of triazolam 0.25 mg once daily, 1 h after a standard breakfast. Triazolam was rapidly absorbed reaching average peak concentrations of 2.0 and 2.04 ng/ml, 1.5 and 1.38 h after administration on Days 1 and 7, respectively. The mean apparent elimination half-life was 1.41 h (range 0.73-4.13 h) on Day 1 and 1.37 h (range 0.69-3.36 h) on Day 7. There was no significant difference between mean serum triazolam concentrations or pharmacokinetic parameters on Days 1 and 7 of the treatment. Serum samples were also assayed for alpha-hydroxytriazolam, an active metabolite of triazolam, but none could be detected in any of the samples from Days 1 or 7, assay sensitivity 0.09 ng/2 ml serum. The range of half-lives of triazolam in the patients in the present study is in close agreement with that previously reported in elderly subjects. The study provides further evidence of the lack of change in pharmacokinetic parameters on multiple dosing and that drug accumulation did not occur. PMID:6137388

  7. An Introprofessional Geriatric Medication Activity Within a Senior Mentor Program

    PubMed Central

    Hummel, Heather; Byrd, Lauren; Wiley, Kathy

    2013-01-01

    Objective. To determine whether a required interprofessional geriatric medication activity within a senior mentor program changed pharmacy and medical students’ attitudes regarding interprofessional collaboration. Design. Interprofessional teams, consisting of 1 third-year pharmacy student and 2 second-year medical students, conducted an in-home interview and medication history with a senior mentor (geriatric patient). The team members then collaboratively analyzed and discussed the patient’s medication use and wrote an essay in which they identified the patient’s medication problems and reflected on the interprofessional experience. Assessment. Students completed a validated survey instrument to measure pharmacist-physician attitudes about interprofessional collaboration before and after the experience. Pharmacy and medical students’ already generally positive attitudes regarding interprofessional relationships were maintained and, in some instances, significantly improved. Students found the activity enhanced their geriatric training and increased their understanding of an interprofessional team. Conclusion. Incorporation of a geriatric medication activity within a senior mentor program maintained or improved pharmacy and medical students’ positive attitudes about interprofessional collaboration and enhanced geriatric training within the curriculum. PMID:23459269

  8. Geriatric-Focused Educational Offerings in the Department of Veterans Affairs from 1999 to 2009

    ERIC Educational Resources Information Center

    Thielke, Stephen; Tumosa, Nina; Lindenfeld, Rivkah; Shay, Kenneth

    2011-01-01

    The scope of geriatrics-related educational offerings in large health care systems, in either the target audiences or topics covered, has not previously been analyzed or reported in the professional literature. The authors reviewed the geriatrics-related educational sessions that were provided between 1999 and 2009 by the Geriatrics Research,…

  9. AMERICAN GERIATRICS SOCIETY CONSENSUS STATEMENT Vitamin D for Prevention of Falls and

    E-print Network

    Oliver, Douglas L.

    AMERICAN GERIATRICS SOCIETY CONSENSUS STATEMENT Vitamin D for Prevention of Falls Geriatrics Society Consensus Statement onVitamin D for Prevention of Falls and their Consequences,'' is published in the Journal of the American Geriatrics Society and is available online at www

  10. Three Strategies for Delivering Continuing Medical Education in Geriatrics to General Practitioners

    ERIC Educational Resources Information Center

    Rikkert, Marcel G. M.; Rigaud, Anne-Sophie

    2004-01-01

    General practitioners (GPs) need advanced skills in geriatric assessment to be competent to treat the increasing number of elderly patients. Continuing medical education in geriatrics for GPs is heterogeneous, and not assessed for effectiveness. In this study we compared the educational effects of three geriatric post-graduate training methods on…

  11. 22nd Anniversary Celebration of the Student Mentoring Conference in Gerontology and Geriatrics

    E-print Network

    Arnold, Jonathan

    22nd Anniversary Celebration of the Student Mentoring Conference in Gerontology and Geriatrics Student Mentoring Conference on Gerontology and Geriatrics. We hope you will be able to take full and geriatrics across different institutions are on hand to provide the nurturing. Two, a student

  12. http://jgp.sagepub.com Journal of Geriatric Psychiatry and Neurology

    E-print Network

    Gluck, Mark

    http://jgp.sagepub.com Journal of Geriatric Psychiatry and Neurology DOI: 10.1177/0891988708316858 2008; 21; 93J Geriatr Psychiatry Neurol Catherine E. Myers, Alan Kluger, James Golomb, Mark A. Gluck be found at: Published by: http://www.sagepublications.com can be found at:Journal of Geriatric Psychiatry

  13. SHORT REPORT Open Access Geriatric study in Europe on health effects of air

    E-print Network

    Paris-Sud XI, Université de

    SHORT REPORT Open Access Geriatric study in Europe on health effects of air quality in nursing, evidence existing on the effects of IAP in elderly is scanty. The Geriatric study in Europe on health Geriatric study in Europe on health effects of air quality in nursing homes (GERIE study) aiming

  14. PRESENTED BY Finger Lakes Geriatric Education Center of Upstate New York (FLGEC-UNY)

    E-print Network

    Goldman, Steven A.

    PRESENTED BY Finger Lakes Geriatric Education Center of Upstate New York (FLGEC-UNY) Division of Geriatrics / Aging, University of Rochester SMD Center for Clinical Research on Aging, University at the first stoplight. FINGER LAKES GERIATRIC EDUCATION CENTER OF UPSTATE NEW YORK (FLGEC-UNY) Prsrt Std. US

  15. RESEARCH (T32) FELLOWSHIP IN GERIATRIC MENTAL HEALTH RESPONSIBILITIES AND REQUIREMENTS

    E-print Network

    Squire, Larry R.

    RESEARCH (T32) FELLOWSHIP IN GERIATRIC MENTAL HEALTH RESPONSIBILITIES AND REQUIREMENTS Didactic and write articles, write a grant, etc. * Geriatric Psychiatry Didactic Seminar: In conjunction with the Geriatric Psychiatry Clinical Fellowship Program, we sponsor a weekly (Wednesday 2-3 PM) seminar

  16. Fieldwork Rotation: A Model for Educating Social Work Students for Geriatric Social Work Practice

    ERIC Educational Resources Information Center

    Ivry, Joann; Lawrance, Frances P.; Damron-Rodriguez, JoAnn; Robbins, Virginia Cooke

    2005-01-01

    The Geriatric Social Work Practicum Partnership Program was funded to attract graduate students to the field of aging and to strengthen field education in geriatric social work. Rotation was selected to achieve the program's goals to provide students with exposure to the spectrum of care in geriatric social work services. This paper describes the…

  17. Undernutrition in geriatric institutions in South-West France: policies and risk factors.

    E-print Network

    Paris-Sud XI, Université de

    1 Undernutrition in geriatric institutions in South-West France: policies and risk factors risk in geriatric institutions Abstract Objective: This study aimed to describe the nutritional status of geriatric home residents according to their place of dwelling and to identify institutional factors

  18. Health Care Workforce Development in Rural America: When Geriatrics Expertise Is 100 Miles Away

    ERIC Educational Resources Information Center

    Tumosa, Nina; Horvath, Kathy J.; Huh, Terri; Livote, Elayne E.; Howe, Judith L.; Jones, Lauren Ila; Kramer, B. Josea

    2012-01-01

    The Geriatric Scholar Program (GSP) is a Department of Veterans Affairs' (VA) workforce development program to infuse geriatrics competencies in primary care. This multimodal educational program is targeted to primary care providers and ancillary staff who work in VA's rural clinics. GSP consists of didactic education and training in geriatrics

  19. Geriatric rehabilitation of stroke patients in nursing homes: a study protocol

    Microsoft Academic Search

    Monica Spruit-van Eijk; Bianca I Buijck; Sytse U Zuidema; Frans LM Voncken; Alexander CH Geurts; Raymond TCM Koopmans

    2010-01-01

    BACKGROUND: Geriatric patients are typically underrepresented in studies on the functional outcome of rehabilitation after stroke. Moreover, most geriatric stroke patients do probably not participate in intensive rehabilitation programs as offered by rehabilitation centers. As a result, very few studies have described the successfulness of geriatric stroke rehabilitation in nursing home patients, although it appears that the majority of these

  20. American Geriatrics Society identifies another five things that healthcare providers and patients should question.

    PubMed

    2014-05-01

    Since 2012, the American Geriatrics Society (AGS) has also been collaborating with the American Board of Internal Medicine (ABIM) Foundation, joining its "Choosing Wisely" campaign on two separate lists of Five Things Healthcare Providers and Patients Should Question. The campaign is designed to engage healthcare organizations and professionals, individuals, and family caregivers in discussions about the safety and appropriateness of medical tests, medications, and procedures. Participating healthcare providers are asked to identify five things-tests, medications, or procedures-that appear to harm rather than help. Providers then share this information in a published article about these things on the ABIM campaign's website (www.choosingwisely.org). The first AGS list was published in February 2013. PMID:24575770

  1. Inter-professional clinical placements as a recruitment strategy in geriatrics: survey of students' perceptions.

    PubMed

    Grymonpre, Ruby; van Ineveld, Cornelia; Nelson, Michelle

    2013-01-01

    Inter-professional (IP) education and clinical placements have been identified as educational recruitment strategies to address the health workforce shortage. The research question in this secondary analysis study was, "What are students' attitudes toward working in geriatric environments and as part of inter-professional collaborative teams?" A five-item survey was administered to 47 pre-licensure learners from five different health professional programs (medicine, nursing, pharmacy, occupational therapy and physical therapy). Findings suggest that students want to practise on IP teams, which may influence their graduate first choice of employment. Although stronger evidence is required, offering IP clinical placements may be an important recruitment strategy, especially for those sites traditionally deemed less desirable. PMID:24034778

  2. Creating a surgery clerkship in a changing environment: reality, simulation, and the rules of engagement.

    PubMed

    Evans, Leigh V; Gusberg, Richard J

    2012-03-01

    This review describes the current challenges associated with creating a successful surgical clerkship and the ways in which teacher-focused and curriculum-focused initiatives can address these challenges. The challenges are both systemic (reflected by changes in our health care system and training programs) and institutional (reflected by factors that affect curriculum design and faculty advancement). Particular attention is paid to residents as teachers, faculty as mentors, the educational impact of the operating room, and the role of simulation. Strategies for engaging students, residents, and faculty are explored. The premise and impact of a comprehensive simulation course on the clinical education of medical students is detailed. Emphasis is placed on the educational validity of accountability and engagement of both the teachers and the learners. PMID:22461753

  3. Radiation Oncology Medical Student Clerkship: Implementation and Evaluation of a Bi-institutional Pilot Curriculum

    SciTech Connect

    Golden, Daniel W., E-mail: dgolden@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States); Spektor, Alexander [Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Rudra, Sonali; Ranck, Mark C. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States); Krishnan, Monica S.; Jimenez, Rachel B.; Viswanathan, Akila N. [Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J. [Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, Illinois (United States)

    2014-01-01

    Purpose: To develop and evaluate a structured didactic curriculum to complement clinical experiences during radiation oncology clerkships at 2 academic medical centers. Methods and Materials: A structured didactic curriculum was developed to teach fundamentals of radiation oncology and improve confidence in clinical competence. Curriculum lectures included: (1) an overview of radiation oncology (history, types of treatments, and basic clinic flow); (2) fundamentals of radiation biology and physics; and (3) practical aspects of radiation treatment simulation and planning. In addition, a hands-on dosimetry session taught students fundamentals of treatment planning. The curriculum was implemented at 2 academic departments in 2012. Students completed anonymous evaluations using a Likert scale to rate the usefulness of curriculum components (1 = not at all, 5 = extremely). Likert scores are reported as (median [interquartile range]). Results: Eighteen students completed the curriculum during their 4-week rotation (University of Chicago n=13, Harvard Longwood Campus n=5). All curriculum components were rated as extremely useful: introduction to radiation oncology (5 [4-5]); radiation biology and physics (5 [5-5]); practical aspects of radiation oncology (5 [4-5]); and the treatment planning session (5 [5-5]). Students rated the curriculum as “quite useful” to “extremely useful” (1) to help students understand radiation oncology as a specialty; (2) to increase student comfort with their specialty decision; and (3) to help students with their future transition to a radiation oncology residency. Conclusions: A standardized curriculum for medical students completing a 4-week radiation oncology clerkship was successfully implemented at 2 institutions. The curriculum was favorably reviewed. As a result of completing the curriculum, medical students felt more comfortable with their specialty decision and better prepared to begin radiation oncology residency.

  4. Economic viability of geriatric hip fracture centers.

    PubMed

    Clement, R Carter; Ahn, Jaimo; Mehta, Samir; Bernstein, Joseph

    2013-12-01

    Management of geriatric hip fractures in a protocol-driven center can improve outcomes and reduce costs. Nonetheless, this approach has not spread as broadly as the effectiveness data would imply. One possible explanation is that operating such a center is not perceived as financially worthwhile. To assess the economic viability of dedicated hip fracture centers, the authors built a financial model to estimate profit as a function of costs, reimbursement, and patient volume in 3 settings: an average US hip fracture program, a highly efficient center, and an academic hospital without a specific hip fracture program. Results were tested with sensitivity analysis. A local market analysis was conducted to assess the feasibility of supporting profitable hip fracture centers. The results demonstrate that hip fracture treatment only becomes profitable when the annual caseload exceeds approximately 72, assuming costs characteristic of a typical US hip fracture program. The threshold of profitability is 49 cases per year for high-efficiency hip fracture centers and 151 for the urban academic hospital under review. The largest determinant of profit is reimbursement, followed by costs and volume. In the authors’ home market, 168 hospitals offer hip fracture care, yet 85% fall below the 72-case threshold. Hip fracture centers can be highly profitable through low costs and, especially, high revenues. However, most hospitals likely lose money by offering hip fracture care due to inadequate volume. Thus, both large and small facilities would benefit financially from the consolidation of hip fracture care at dedicated hip fracture centers. Typical US cities have adequate volume to support several such centers. PMID:24579222

  5. Vitamin B12 deficit and development of geriatric syndromes.

    PubMed

    Ocampo Chaparro, José Mauricio

    2013-01-01

    Vitamin B12 deficiency or cyanocobalamin is a common condition in the elderly. It is repeatedly overlooked due to multiple clinical manifestations that can affect the blood, neurological, gastrointestinal, and cardiovascular systems, skin and mucous membranes. The various presentations of vitamin B12 deficiency are related to the development of geriatric syndromes like frailty, falls, cognitive impairment, and geriatric nutritional syndromes like protein-energy malnutrition and failure to thrive, in addition to enhancing aging anorexia and cachexia. Therefore, interventions must be developed to include their screening and diagnosis to make early and appropriate treatment to prevent its complications before they become irreversible. PMID:24892321

  6. Mature, Senior and Geriatric Horses: Management, Care and Use 

    E-print Network

    Martin, M. T.; Scrutchfield, W. L.; Gibbs, Pete G.; Potter, Gary D.

    2005-04-18

    .J. Valberg, J.H. Jones, B.L. Smith and B. Sommerville. 1995. ?Limitations to performance caused by skeletal muscle enzyme deficiencies.? Equine Veterinary Journal Supplement 18:205. ? S.J. Valberg, J.M. MacLeay and J.R. Mickel- son. 1997. ?Exertional... into geriatric status has been hastened by an injury. Chronically foundered horses, severely arthritic horses and those with special conditions of the kid- neys, liver or other organs may be classed as geriat- ric (see Table 2). Special conditions of geriatric...

  7. Measuring anxiety in late life: a psychometric examination of the geriatric anxiety inventory and geriatric anxiety scale.

    PubMed

    Gould, Christine E; Segal, Daniel L; Yochim, Brian P; Pachana, Nancy A; Byrne, Gerard J; Beaudreau, Sherry A

    2014-12-01

    We examined the psychometric properties, internal scale reliability and validity, of two geriatric anxiety measures: the Geriatric Anxiety Inventory (GAI) and Geriatric Anxiety Scale (GAS). We also determined the extent to which memory ability influenced the psychometric properties of these measures. Older adult participants (N=110; M age=75 years) completed self-report, clinician-rated and diagnostic psychiatric measures and a neuropsychiatric battery. GAI and GAS scores had good internal consistency, adequate reliability, and strong convergent validity. GAI scores had better discriminant validity than GAS scores relative to a health rating. Both measures had strong associations with depression scores. Psychometric properties were decreased in participants with average delayed memory recall compared with those with superior recall. Both measures had good psychometric support, particularly in those with strong memory abilities. Psychometric performance characteristics indicate that the GAI and GAS may be good alternatives to anxiety measures not designed specifically for older adults. PMID:25271176

  8. Geriatric pain competencies and knowledge assessment for nurses in long term care settings

    PubMed Central

    Swafford, Kristen L.; Miller, Lois L.; Herr, Keela; Forcucci, Chris; Kelly, Anne Marie L.; Bakerjian, Debra

    2015-01-01

    Pain in older adults is a prevalent problem that affects quality of life and challenges nurses, particularly those caring for older adults living in long term care settings. Despite the national priority of pain management, insufficient knowledge of nurses about geriatric pain is a documented barrier to effective geriatric pain management in all long term care settings. To address this knowledge gap, a website (GeriatricPain.org) was developed by the National Geriatric Pain Collaborative with a grant from the MayDay Fund to provide a single site for evidenced-based, easy-to-use, downloadable resources on pain management. This paper describes the development of the most recent addition to the website, a set of evidence-based core geriatric pain management competencies and a geriatric pain knowledge assessment, and discusses their potential uses in improving pain care for older adults. Geriatric Pain Competencies and Knowledge Assessment for Nurses in Long Term Care Settings. PMID:25037079

  9. Evidence-Based Geriatric Psychiatry: An Overview

    Microsoft Academic Search

    Stephen J. Bartels; Robert E. Drake

    2005-01-01

    Despite unparalleled developments in medical science and a health care budget that spends more on health care for each person than any other coun- try in the world, the American health care system is failing. As determined by the 2001 landmark study by the Institute of Medicine ''Crossing the Quality Chasm,'' the American health care system is plagued by high

  10. An Interdisciplinary Teaching Program in Geriatrics for Physician's Assistants.

    ERIC Educational Resources Information Center

    Stark, Ruth; And Others

    1984-01-01

    Describes a beginning course in clinical geriatrics for medical students and student physician's assistants, physical therapists and nurse practitioners. The course will increase students' ability to identify basic physical, psychological, and social characteristics of the normal aging process; and to recognize prevalent myths and negative…

  11. Residual Geriatric Depression Symptoms: A Place for Psychotherapy

    Microsoft Academic Search

    Forrest Scogin; Jodie Shackelford; Noelle Rohen; Jamie Stump; Mark Floyd; Nancy McKendree-Smith; Christine Jamison

    2001-01-01

    Geriatric depression is a relatively commonly occurring mental disorder. A subpopulation of depressed older adults are those who have engaged in or completed pharmacotherapy, yet continue to experience depressive symptoms. We review the prevalence, psychosocial effects, and treatment of residual symptoms of depression in older adults. Data from previous studies conducted by our group are presented to support our contention

  12. Health Promotion/Disease Prevention: New Directions for Geriatric Education.

    ERIC Educational Resources Information Center

    Levkoff, Sue; And Others

    1996-01-01

    Describes 10 modules for primary care practitioners on health promotion/disease prevention for the elderly on these topics: Alzheimer's disease in minorities, dehydration, diabetes, elder abuse, geriatric nutrition, oncology, oral health in long-term care, incontinence, injury prevention, and physical activity. These areas are significant for…

  13. Use of a geriatric formulary in long-term care.

    PubMed

    Babington, M A

    1997-01-01

    The use of drug formularies in nursing facilities (NFs) is a fairly new idea. A large long-term care pharmacy provider prepared a formulary specific to a geriatric population. This open formulary is contained within a handbook of clinical monographs, complete with dosing information, cost comparisons, and references to NF regulations affecting the use of particular drugs. PMID:10164509

  14. 1 | P a g e David K Brown Geriatrics

    E-print Network

    Mohaghegh, Shahab

    and health care of older adults in West Virginia by enhancing geriatrics training and competency of our state's health professionals that care for our older citizens. Our mission includes creating a sustainable's Center on Aging, was a beloved professor specializing in public policy and aging, community based care

  15. Objective Structured Video Examinations (OSVEs) for Geriatrics Education

    ERIC Educational Resources Information Center

    Simpson, Deborah; Gehl, Suzanne; Helm, Robin; Kerwin, Diana; Drewniak, Theresa; Bragg, Dawn St. A.; Ziebert, Monica M.; Denson, Steven; Brown, Diane; Heffron, Mary Gleason; Mitchell, Julie; Harsch, Harold H.; Havas, Nancy; Duthie, Edmund, Jr.; Denson, Kathryn

    2006-01-01

    The Medical College of Wisconsin (MCW) and the Wisconsin Geriatric Education Center (WGEC) are committed to developing educational materials for primary care physicians in training. In response to the opportunity created by the Accreditation Council for Graduate Medical Education (ACGME) competency mandate, an MCW-led interdisciplinary working…

  16. A Geriatric Day Hospital: Who Improves the Most?

    ERIC Educational Resources Information Center

    Desrosiers, Johanne; Hebert, Rejean; Payette, Helene; Roy, Pierre-Michel; Tousignant, Michel; Cote, Sylvie; Trottier, Lise

    2004-01-01

    This study compared the changes in some bio-psychosocial variables (functional independence, nutritional risk, pain, balance and walking, grip strength, general well-being, psychiatric profile, perception of social support, leisure satisfaction, and caregivers' feeling of burden) in four categories of clients during their program at a geriatric

  17. Geriatric medical oncology in the care of elderly cancer patients

    Microsoft Academic Search

    Gilbert B. Zulian

    2002-01-01

    Most cancers are diagnosed after 70 years of age but standard management and treatment for elderly cancer patients remain to be established. To determine whether the availability and recognition of medical oncology may influence cancer care in this population, five successive periods were studied. The number of formal written consultations given at the geriatric hospital and at the center for

  18. Geriatric Assessment Units and Rural Health System Viability.

    ERIC Educational Resources Information Center

    Lassey, William R.; Lassey, Marie L.

    The Geriatric Assessment Unit (GAU), which has proven successful in urban areas, may be a viable system for providing health care to the elderly in rural areas. GAUs engage in assessment, follow-up response to findings, education, and research. The assessment component includes, at minimum, physical health, functional ability in activities of…

  19. Neuroplasticity-Based Computerized Cognitive Remediation for Geriatric Depression

    PubMed Central

    Morimoto, Sarah Shizuko; Wexler, Bruce E.; Alexopoulos, George S.

    2012-01-01

    Objective This article describes a novel treatment model designed to target specific neurocognitive deficits in geriatric depression with neuroplasticity-based computerized cognitive remediation (NBCCR). Method The recent National Institute of Mental Health (NIMH) report “From Discovery to Cure” calls for studies focusing on mechanisms of treatment response with the goal of arriving at new interventions for those who do not respond to existing treatments. We describe the process that led to the identification of specific executive deficits and their underlying neurobiology, as well as the rationale for targeting these symptoms as a part of a strategy intended to improve both executive dysfunction and depression. We then propose a strategy for further research in this emerging area Results and Conclusions Despite significant developments, conventional antidepressant treatments leave many older adults still depressed and suffering (Thase, Entsuah et al. 2001). Psychotherapy may be effective in some depressed elders, although a recent review concluded that none of the available treatment studies meets stringent criteria for efficacy in the acute treatment of geriatric depression(Kiosses, Leon et al.). Appropriately developed and targeted NBCCR, has the potential to serve as a novel treatment intervention for geriatric depression. Pathophysiological changes associated with executive dysfunction may be an appropriate target for NBCCR. Examining both behavioral changes and indices of structural integrity and functional change of networks related to cognitive and emotional regulation may lead to a novel treatment and elucidate the role of specific cerebral networks in geriatric depression. PMID:22451346

  20. Automated Video and Sensor Analysis for Geriatric Care

    E-print Network

    , and data protection concerns associated with placing surveillance audio and video equipment in the nursing have continued to experiment on preliminary "surveillance-type" video, gathered at a nursing careCareMedia: Automated Video and Sensor Analysis for Geriatric Care NSF Cooperative Agreement No. IIS

  1. Automated Video and Sensor Analysis for Geriatric Care

    E-print Network

    , and data protection concerns associated with placing surveillance audio and video equipment in the nursing "surveillance-type" video, gathered during a pilot study at a nursing care facility, Longwood at OakmontCareMedia: Automated Video and Sensor Analysis for Geriatric Care NSF Cooperative Agreement No. IIS

  2. Development of the Geriatric Oral Health Assessment Index.

    ERIC Educational Resources Information Center

    Atchison, Kathryn A.; Dolan, Teresa A.

    1990-01-01

    This paper describes the rationale for and the development of the Geriatric Oral Health Assessment Index (GOHAI). The GOHAI has demonstrated a high level of internal consistency and reliability. Poor GOHAI scores were significantly correlated to having fewer teeth, wearing a removable denture, and perceiving the need for dental treatment.…

  3. Geriatric Foster Care: A Prototype Design and Implementation Issues.

    ERIC Educational Resources Information Center

    Steinhauer, Marcia B.

    1982-01-01

    Suggests geriatric foster care is among the least restrictive alternatives to institutional placement. Outlines the basic prototype principles, including broadly defined client population, maximum accessibility in referral sources, flexible use of existing local services, and uniform statewide quality guidelines. Discusses indicators of success…

  4. Maximizing the Potential of Internships in Gerontology and Geriatrics

    ERIC Educational Resources Information Center

    Karasik, Rona J.

    2009-01-01

    Internships and similar applied opportunities have long been valued for providing students with opportunities for practical experience, career preparation, and personal growth. The need for applied experiences in gerontology and geriatrics is particularly salient. Creating and sustaining effective internship experiences, however, requires careful…

  5. E-Learning Virtual Patients for Geriatric Education

    ERIC Educational Resources Information Center

    Orton, Eric; Mulhausen, Paul

    2008-01-01

    Computer-based virtual patients (VPs) are an emerging medium for medical education that addresses barriers faced by geriatrics educators. Research has shown VPs to be as effective in changing knowledge and behavior as more traditional forms of teaching. This paper presents a descriptive study of the development of the University of Iowa's…

  6. Geriatric Education in the Health Professions: Are We Making Progress?

    ERIC Educational Resources Information Center

    Bardach, Shoshana H.; Rowles, Graham D.

    2012-01-01

    Purpose: Relative to the overall population, older adults consume a disproportionally large percentage of health care resources. Despite advocacy and efforts initiated more than 30 years ago, the number of providers with specialized training in geriatrics is still not commensurate with the growing population of older adults. This contribution…

  7. A Web-Based Framework for Improving Geriatric Education

    ERIC Educational Resources Information Center

    Hirth, Victor A.; Hajjar, Ihab

    2004-01-01

    Despite the growth in the elderly population, physicians with special geriatric training and certification number only 9,000 out of 650,000 doctors in the United States. The flexibility and increasing availability of the Internet makes it an ideal avenue for addressing the educational needs of health care providers to improve the health and care…

  8. Clinical conundrums and challenges during geriatric orthopedic emergency surgeries

    PubMed Central

    Bajwa, Sukhminder Jit Singh

    2015-01-01

    Despite so many advancements and innovations in anesthetic techniques, expectations and challenges have also grown in plenty. Cardiac, pediatric, obstetric and neuro-anesthesia have perfectly developed to fulfill the desired needs of respective patient population. However, geriatric anesthesia has been shown a lesser interest in teaching and clinical practices over the years as compared with other anesthetic sub-specialties. The large growing geriatric population globally is also associated with an increase number of elderly patients presenting for orthopedic emergency surgeries. Orthopedic emergency surgery in geriatric population is not only a daunting clinical challenge but also has numerous socio-behavioral and economic ramifications. Decision making in anesthesia is largely influenced by the presence of co-morbidities, neuro-cognitive functions and the current socio-behavioral status. Pre-anesthetic evaluation and optimization are extremely important for a better surgical outcome but is limited by time constraints during emergency surgery. The current review aims to highlight comprehensively the various clinical, social, behavioral and psychological aspects during pre-anesthetic evaluation associated with emergency orthopedic surgery in geriatric population. PMID:25810963

  9. Geriatric muscle stem cells switch reversible quiescence into senescence.

    PubMed

    Sousa-Victor, Pedro; Gutarra, Susana; García-Prat, Laura; Rodriguez-Ubreva, Javier; Ortet, Laura; Ruiz-Bonilla, Vanessa; Jardí, Mercč; Ballestar, Esteban; González, Susana; Serrano, Antonio L; Perdiguero, Eusebio; Muńoz-Cánoves, Pura

    2014-02-20

    Regeneration of skeletal muscle depends on a population of adult stem cells (satellite cells) that remain quiescent throughout life. Satellite cell regenerative functions decline with ageing. Here we report that geriatric satellite cells are incapable of maintaining their normal quiescent state in muscle homeostatic conditions, and that this irreversibly affects their intrinsic regenerative and self-renewal capacities. In geriatric mice, resting satellite cells lose reversible quiescence by switching to an irreversible pre-senescence state, caused by derepression of p16(INK4a) (also called Cdkn2a). On injury, these cells fail to activate and expand, undergoing accelerated entry into a full senescence state (geroconversion), even in a youthful environment. p16(INK4a) silencing in geriatric satellite cells restores quiescence and muscle regenerative functions. Our results demonstrate that maintenance of quiescence in adult life depends on the active repression of senescence pathways. As p16(INK4a) is dysregulated in human geriatric satellite cells, these findings provide the basis for stem-cell rejuvenation in sarcopenic muscles. PMID:24522534

  10. The Geriatric Nurse Practitioner in the Community Mental Health Center.

    ERIC Educational Resources Information Center

    Trail, Ira D.

    A Federal mandate to provide comprehensive care for the aged population in this country has stimulated program planning in gerontology by mental health professionals. Introduction of the geriatric nurse practitioner into the mental health care system is viewed as one means of attempting to increase both the availability and quality of primary…

  11. Use of Geriatric Assessment for Older Adults in the Oncology Setting: A Systematic Review

    PubMed Central

    2012-01-01

    Background Geriatric assessment is a multidisciplinary diagnostic process that evaluates the older adult’s medical, psychological, social, and functional capacity. No systematic review of the use of geriatric assessment in oncology has been conducted. The goals of this systematic review were: 1) to provide an overview of all geriatric assessment instruments used in the oncology setting; 2) to examine the feasibility and psychometric properties of those instruments; and 3) to systematically evaluate the effectiveness of geriatric assessment in predicting or modifying outcomes (including the impact on treatment decision making, toxicity of treatment, and mortality). Methods We searched Medline, Embase, Psychinfo, Cinahl, and the Cochrane Library for articles published in English, French, Dutch, or German between January 1, 1996, and November 16, 2010, reporting on cross-sectional, longitudinal, interventional, or observational studies that assessed the feasibility or effectiveness of geriatric assessment instruments. The quality of articles was evaluated using relevant quality assessment frameworks. Results We identified 83 articles that reported on 73 studies. The quality of most studies was poor to moderate. Eleven studies examined psychometric properties or diagnostic accuracy of the geriatric assessment instruments used. The assessment generally took 10–45min. Geriatric assessment was most often completed to describe a patient’s health and functional status. Specific domains of geriatric assessment were associated with treatment toxicity in 6 of 9 studies and with mortality in 8 of 16 studies. Of the four studies that examined the impact of geriatric assessment on the cancer treatment decision, two found that geriatric assessment impacted 40%–50% of treatment decisions. Conclusion Geriatric assessment in the oncology setting is feasible, and some domains are associated with adverse outcomes. However, there is limited evidence that geriatric assessment impacted treatment decision making. Further research examining the effectiveness of geriatric assessment on treatment decisions and outcomes is needed. PMID:22851269

  12. Advances in rehabilitation medicine.

    PubMed

    Ng, Yee Sien; Chew, Effie; Samuel, Geoffrey S; Tan, Yeow Leng; Kong, Keng He

    2013-10-01

    Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation. PMID:24154577

  13. Using tablets to support self-regulated learning in a longitudinal integrated clerkship

    PubMed Central

    Alegría, Dylan Archbold Hufty; Boscardin, Christy; Poncelet, Ann; Mayfield, Chandler; Wamsley, Maria

    2014-01-01

    Introduction The need to train physicians committed to learning throughout their careers has prompted medical schools to encourage the development and practice of self-regulated learning by students. Longitudinal integrated clerkships (LICs) require students to exercise self-regulated learning skills. As mobile tools, tablets can potentially support self-regulation among LIC students. Methods We provided 15 LIC students with tablet computers with access to the electronic health record (EHR), to track their patient cohort, and a multiplatform online notebook, to support documentation and retrieval of self-identified clinical learning issues. Students received a 1-hour workshop on the relevant features of the tablet and online notebook. Two focus groups with the students were used to evaluate the program, one early and one late in the year and were coded by two raters. Results Students used the tablet to support their self-regulated learning in ways that were unique to their learning styles and increased access to resources and utilization of down-time. Students who used the tablet to self-monitor and target learning demonstrated the utility of tablets as learning tools. Conclusions LICs are environments rich in opportunity for self-regulated learning. Tablets can enhance students’ ability to develop and employ self-regulatory skills in a clinical context. PMID:24646438

  14. Geriatric Rehabilitation Patients’ Perceptions of Unit Dining Locations

    PubMed Central

    Baptiste, Françoise; Egan, Mary; Dubouloz-Wilner, Claire-Jehanne

    2014-01-01

    Background Eating together is promoted among hospitalized seniors to improve their nutrition. This study aimed to understand geriatric patients’ perceptions regarding meals in a common dining area versus at the bedside. Methods An exploratory qualitative study was conducted. Open-ended questions were asked of eight patients recruited from a geriatric rehabilitation unit where patients had a choice of meal location. Results Eating location was influenced by compliance with the perceived rules of the unit, physical and emotional well-being, and quarantine orders. Certain participants preferred eating in the common dining room where they had more assistance from hospital staff, a more attractive physical environment, and the opportunity to socialize. However, other participants preferred eating at their bedsides, feeling the quality of social interaction was poor in the dining room. Conclusions Participants’ experiences of, and preferences for, communal dining differed. If the benefits of communal dining are to be maximized, different experiences of this practice must be considered. PMID:24883161

  15. [Intermediate geriatric care in Geneva: experience of ten years].

    PubMed

    Weiss, Lucien; Graf, Christophe; Herrmann, François; Salomon, Raymonde; Perrenoud, Jean-Jacques

    2012-11-01

    Population aging has generated an increased demand for acute healthcare services in persons aged over 65, who may represent up to half of all patients treated in intensive care units (ICU). However, the number of available ICU beds is limited. Intermediate care units (IntCU) require less human and technical resources, and may represent an interesting alternative to intensive care in the geriatric population. This article describes a 10-year, single centre experience at a geriatrics IntCU in Geneva. We observed a significant reduction in in-hospital mortality after the creation of the IntCU (2000-2001) compared to the 2 years immediately preceding its inception (1998-1999). PMID:23173350

  16. Perceptions, attitudes, and experiences of hematology/oncology fellows toward incorporating geriatrics in their training.

    PubMed

    Maggiore, Ronald J; Gorawara-Bhat, Rita; Levine, Stacie K; Dale, William

    2014-01-01

    The aging of the U.S. population continues to highlight emerging issues in providing care generally for older adults and specifically for older adults with cancer. The majority of patients with cancer in the U.S. are currently 65 years of age or older; therefore, training and research in geriatrics and geriatric oncology are viewed to be integral in meeting the needs of this vulnerable population. Yet, the ways to develop and integrate best geriatrics training within the context of hematology/oncology fellowship remain unclear. Toward this end, the current study seeks to evaluate the prior and current geriatric experiences and perspectives of hematology/oncology fellows. To gain insight into these experiences, focus groups of hematology/oncology fellows were conducted. Emergent themes included: 1) perceived lack of formal geriatric oncology didactics among fellows; 2) a considerable amount of variability exists in pre-fellowship geriatric experiences; 3) shared desire to participate in a geriatric oncology-based clinic; 4) differences across training levels in confidence in managing older adults with cancer; and 5) identification of specific criteria on how best to approach older adults with cancer in a particular clinical scenario. The present findings will help guide future studies in evaluating geriatrics among hematology/oncology fellows across institutions. They will also have implications in the development of geriatrics curricula and competencies specific to hematology/oncology training. PMID:24484724

  17. Two faller risk functions for geriatric assessment unit patients

    Microsoft Academic Search

    Jacqueline McClaran roDirector; Francoise Forette; Jean-Louis Golmard; Marie-Pierre Hérvy; Patrice Bouchacourt

    1991-01-01

    This study was done in order to construct a simple clinical failer predictor model, which quantifies risk for the individual\\u000a elderly patient. Fifty patients sequentially admitted to a geriatric assessment unit were assessed systematically at admission\\u000a for six potential failer risk factors: age, gait, speed, gait quality, gender, symptoms of urinary urgency, and symptoms of\\u000a dizziness. Falls were systematically recorded

  18. How to optimize patients for geriatric fracture surgery

    Microsoft Academic Search

    D. Marsland; P. L. Colvin; S. C. Mears; S. L. Kates

    2010-01-01

    Low-energy fragility fractures account for >80% of fractures in elderly patients, and with aging populations, geriatric fracture\\u000a surgery makes up a substantial proportion of the orthopedic workload. Elderly patients have markedly less physiologic reserve\\u000a than do younger patients, and comorbidity is common. Even with optimal care, the risk of mortality and morbidity remains high.\\u000a Multidisciplinary care, including early orthogeriatric input,

  19. Prevalence and Causes of Anaemia in a Geriatric Hospitalized Population

    Microsoft Academic Search

    E. Joosten; W. Pelemans; M. Hiele; J. Noyen; R. Verhaeghe; M. A. Boogaerts

    1992-01-01

    Of 732 consecutive patients admitted to an acute geriatric ward, 178 (24%) were found to be anaemic (haemoglobin of 115 g\\/l or below). An appropriate cause responsible for anaemia was identified in 83 %. The anaemia of chronic disorders (ACD) (35%) and iron deficiency anaemia (15%) were the commonest causes. The spectrum of disorders associated with ACD is much broader

  20. Executive Dysfunction and Long-term Outcomes of Geriatric Depression

    Microsoft Academic Search

    George S. Alexopoulos; Barnett S. Meyers; Robert C. Young; Balu Kalayam; Tatsuyuki Kakuma; Michelle Gabrielle; Jo Anne Sirey; James Hull

    2000-01-01

    Background: This study investigated the relationship of executive and memory impairment to relapse, recur- rence, and course of residual depressive symptoms and signs after remission of geriatric major depression. Methods: Fifty-eight elderly subjects remitted from ma- jor depression received continuation nortriptyline treat- ment (plasma levels 60-150 ng\\/mL) for 16 weeks and then were randomly assigned to either nortriptyline mainte- nance

  1. Objective Structured Video Examinations (OSVEs) for geriatrics education.

    PubMed

    Simpson, Deborah; Helm, Robin; Drewniak, Theresa; Ziebert, Monica M; Brown, Diane; Mitchell, Julie; Havas, Nancy; Denson, Kathryn; Gehl, Suzanne; Kerwin, Diana; Bragg, Dawn St A; Denson, Steven; Gleason Heffron, Mary; Harsch, Harold H; Duthie, Edmund H

    2006-01-01

    The Medical College of Wisconsin (MCW) and the Wisconsin Geriatric Education Center (WGEC) are committed to developing educational materials for primary care physicians in training. In response to the opportunity created by the Accreditation Council for Graduate Medical Education (ACGME) competency mandate, an MCW-led interdisciplinary working group has developed competency-linked video-based assessment tools for use in primary care residency training programs. Modeled after the Objective Structured Clinical Examinations (OSCE), used as part of the medical licensing examination process, we created geriatric-focused Objective Structured Video Examinations (OSVEs) as a strategy to infuse geriatrics into residency training. Each OSVE tool contains a 1-3 minute video trigger that is associated with a series of multiple choice and/or constructed response questions (e.g., fill in the blank). These questions assess residents' understanding of video-demonstrated ACGME competencies including professionalism, systems-based practice, communication, and practice-based learning. An instructor's guide and scoring key are provided for each tool. Response to the OSVEs has been overwhelmingly enthusiastic including greater than 90% commitment by statewide faculty to use the tools in residency training. PMID:16537305

  2. Research priorities in geriatric oncology for 2013 and beyond

    PubMed Central

    Mohile, Supriya; Dale, William; Magnuson, Allison; Kamath, Nayana; Hurria, Arti

    2014-01-01

    The incidence of cancer increases with advanced age. Unfortunately, there is a significant lack of evidence regarding the safety and efficacy of treatments. The oncology community also lacks information regarding which older patients are most likely to benefit from treatment without undue toxicities. Interventions to lower symptoms and reduce long-term complications from cancer and cancer treatment in older patients are urgently needed. Establishing research priorities in geriatric oncology could help guide researchers and focus efforts on interventions that have the highest likelihood of improving outcomes. The Cancer and Aging Research Group, in partnership with the National Institute on Aging and National Cancer Institute, held linked conferences as part of a U13 grant in September of 2010 and November of 2012, summarising the gaps in knowledge in geriatric oncology and recommending ways to close these gaps. The overall purpose of this review is to highlight the important research priorities in geriatric oncology from the literature and from the previous U13 meetings. More evidence regarding the treatment of older cancer patients is urgently needed given the rapid aging of the population. PMID:25346565

  3. Geriatric Assessment Intervention in Reducing Chemotherapy Toxicity in Older Patients With Advanced Cancer | Division of Cancer Prevention

    Cancer.gov

    This randomized clinical trial compares geriatric assessment intervention in reducing chemotherapy toxicity in older patients with advanced cancer. A geriatric assessment may identify risk factors for chemotherapy toxicity and may improve treatment for older patients with advanced cancer.

  4. SUMMER 2013 MINNESOTA CHAIR IN LONG-TERM CARE AND AGING CENTER ON AGING MINNESOTA AREA GERIATRIC EDUCATION CENTER

    E-print Network

    Blanchette, Robert A.

    GERIATRIC EDUCATION CENTER OldNews Center on Aging Summer Institute 2013 Dementia: The Disease of Our GERIATRIC EDUCATION CENTER The obvious motivation for and benefit of early diagnosis would be preventing

  5. Nurses Improving Care for Healthsystem Elders – a model for optimising the geriatric nursing practice environment

    PubMed Central

    Capezuti, Elizabeth; Boltz, Marie; Cline, Daniel; Dickson, Victoria Vaughn; Rosenberg, Marie-Claire; Wagner, Laura; Shuluk, Joseph; Nigolian, Cindy

    2012-01-01

    Aims and objectives To explain the relationship between a positive nurse practice environment (NPE) and implementation of evidence-based practices. To describe the components of NICHE (Nurses Improving Care for Healthsystem Elders) programmes that contribute to a positive geriatric nursing practice environment. Background The NPE is a system-level intervention for promoting quality and patient safety; however, there are population-specific factors that influence the nurses’ perception of their practice and its’ relationship with patient outcomes. Favourable perceptions of the geriatric-specific NPE are associated with better perceptions of geriatric care quality. Designs Discursive paper. Method In this selective critical analysis of the descriptive and empirical literature, we present the implementation of geriatric models in relation to the NPE and components of the NICHE programme that support hospitals’ systemic capacity to effectively integrate and sustain evidence-based geriatric knowledge into practice. Results Although there are several geriatric models and chronic care models available, NICHE has been the most successful in recruiting hospital membership as well as contributing to the depth of geriatric hospital programming. Conclusions Although all geriatric care models require significant nursing input, only NICHE focuses on the nursing staff’s perception of the care environment for geriatric practice. Studies in NICHE hospitals demonstrate that quality geriatric care requires a NPE in which the structure and processes of hospital services focus on specific patient care needs. Relevance to clinical practice The implementation of evidence-based models addressing the unique needs of hospitalised older adults requires programmes such as NICHE that serve as technical resources centre and a catalyst for networking among facilities committed to quality geriatric care. Unprecedented international growth in the ageing population compels us to examine how to adapt the successful components of NICHE to the distinctive needs of health systems throughout the world that serve older adults. PMID:23083387

  6. Standardization of Course Plan and Design of Objective Structured Field Examination (OSFE) for the Assessment of Pharm.D. Student’s Community Pharmacy Clerkship Skills

    PubMed Central

    Monajjemzadeh, Farnaz; Shokri, Javad; Mohajel Nayebi, Ali Reza; Nemati, Mahboob; Azarmi, Yadollah; Charkhpour, Mohammad; Najafi, Moslem

    2014-01-01

    Purpose: This study was aimed to design Objective Structured Field Examination (OSFE) and also standardize the course plan of community pharmacy clerkship at Pharmacy Faculty of Tabriz University of Medical Sciences (Iran). Methods: The study was composed of several stages including; evaluation of the old program, standardization and implementation of the new course plan, design and implementation of OSFE, and finally results evaluation. Results: Lack of a fair final assessment protocol and proper organized educating system in various fields of community pharmacy clerkship skills were assigned as the main weaknesses of the old program. Educational priorities were determined and student’s feedback was assessed to design the new curriculum consisting of sessions to fulfill a 60-hour training course. More than 70% of the students were satisfied and successfulness and efficiency of the new clerkship program was significantly greater than the old program (P<0.05). In addition, they believed that OSFE was a suitable testing method. Conclusion: The defined course plan was successfully improved different skills of the students and OSFE was concluded as a proper performance based assessment method. This is easily adoptable by pharmacy faculties to improve the educational outcomes of the clerkship course. PMID:24511477

  7. How Many Sides Does a Coin Have? A Phenomenology of Filipino Nurses' Motivation and Attitudes toward Geriatric Care

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Dangoy, Reena-Jane D.; David, Kathleen Christian V.; Dayo, Ken Jarrett H.; de Claro, Keisha A.; de Guzman, Giorgio von Gerri G.; de Jesus, Gerald Ian D.

    2009-01-01

    Nurses play a significant role in geriatric care. However, as the aging population and demand for geriatric nurses increase worldwide, shortages of nurses seem to arise. This creates the need to assess and address the motivation and attitudes of nurses toward geriatric care. The intent of this qualitative study is to surface the essence or the…

  8. Injured geriatric patients are at increased risk of death and disability following traumatic injury.1,2,3

    E-print Network

    · Injured geriatric patients are at increased risk of death and disability following traumatic the documentation of these care discussions. · Protocol developed from the EAST recommendations for geriatric trauma of care, and HCPOA. · Retrospective, case-control study using historical cohort of injured geriatric

  9. Student Senior Partnership Program: University of California Irvine School of Medicine

    ERIC Educational Resources Information Center

    Fitzpatrick, Camille; Musser, Anne; Mosqueda, Laura; Boker, John; Prislin, Michael

    2006-01-01

    The Student Senior Partner Program (SSPP) forms the core of the required medical student geriatrics curriculum at the University of California-Irvine School of Medicine (UCISOM). The program utilizes a longitudinal modular format that extends over the first three years of medical school. Instruction is presented in didactic, patient interactive,…

  10. The Success and Struggles of Filipino Geriatric Nurses in Nursing Homes

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Coronel, Rona Denise V.; Chua, Kannerin O.; Constantino, Mariz G.; Cordova, Ericsann James C.

    2009-01-01

    Geriatric nursing is a physically and emotionally demanding job in healthcare. It is a neglected field despite the growing population of the elderly, and the experiences of geriatric nurses are one of the unrecognized aspects of this field. This qualitative study purports to explore the successes and struggles of the lived experiences of a select…

  11. An Interdisciplinary Service Learning Experience in Geriatrics for Occupational and Physical Therapy Students

    Microsoft Academic Search

    K. Jackson Thomas; Elizabeth B. Reigart; Becki A. Trickey

    1998-01-01

    An interdisciplinary service learning experience in geriatrics was provided for occupational and physical therapy students and supported by an Allied Health Project Grant. The service learning experience, which was developed by faculty from the Occupational Therapy, Physical Therapy, and Communication Sciences Disorders Programs at the Medical University of South Carolina, functioned as the clinical component of an interdisciplinary geriatrics course.

  12. Challenges for acute care geriatric inpatient units under the present Medicare prospective payment system.

    PubMed

    Fillit, H

    1994-05-01

    The Mount Sinai Medical Center's Geriatric Evaluation and Treatment Unit (GETU) is a 16-bed acute care geriatric unit that operates under the Medicare Prospective Payment System (PPS) in an academic medical center environment. The Medicare PPS and the needs of our local health care system have played a considerable role in the development and operation of our inpatient acute care geriatric unit. The GETU provides acute geriatric care and geriatric assessment and is a site for education and clinical research. The GETU serves a targeted group of acutely ill, hospitalized frail elderly with complex, interdisciplinary needs. The multidisciplinary GETU team was financed from generally available and justifiable hospital resources. Geriatric assessment is conducted under the Medicare PPS during the process of acute care without prolonging hospital length of stay. In fact, during the past 6 years, the introduction of geriatric care and assessment programs has been associated with a significant reduction in hospital length of stay and hospital costs for this complex and difficult population. It is our experience that an acute care geriatric unit functioning under traditional Medical Prospective Payment can have the dual effect of enhancing care and reducing hospital costs for the hospitalized frail elderly. PMID:8176152

  13. Hazards of Hospitalization: Hospitalists and Geriatricians Educating Medical Students about Delirium and Falls in Geriatric Inpatients

    ERIC Educational Resources Information Center

    Lang, Valerie J.; Clark, Nancy S.; Medina-Walpole, Annette; McCann, Robert

    2008-01-01

    Geriatric patients are at increased risk for complications from delirium or falls during hospitalization. Medical education, however, generally places little emphasis on the hazards of hospitalization for older inpatients. Geriatricians conducted a faculty development workshop for hospitalists about the hazards of hospitalization for geriatric

  14. The Brave New World of GEC Evaluation: The Experience of the Rhode Island Geriatric Education Center

    ERIC Educational Resources Information Center

    Filinson, Rachel; Clark, Phillip G.; Evans, Joann; Padula, Cynthia; Willey, Cynthia

    2012-01-01

    In 2007, the Health Resources Services Administration introduced new mandates that raised the standards on program evaluation for Geriatric Education Centers. Described in this article are the primary and secondary evaluation efforts undertaken for one program within the Rhode Island Geriatric Education Center (RIGEC), the findings from these…

  15. California Geriatric Education Center Logic Model: An Evaluation and Communication Tool

    ERIC Educational Resources Information Center

    Price, Rachel M.; Alkema, Gretchen E.; Frank, Janet C.

    2009-01-01

    A logic model is a communications tool that graphically represents a program's resources, activities, priority target audiences for change, and the anticipated outcomes. This article describes the logic model development process undertaken by the California Geriatric Education Center in spring 2008. The CGEC is one of 48 Geriatric Education…

  16. Mortality of Geriatric and Younger Patients with Schizophrenia in the Community

    ERIC Educational Resources Information Center

    Ran, Mao-Sheng; Chan, Cecilia Lai-Wan; Chen, Eric Yu-Hai; Tang, Cui-Ping; Lin, Fu-Rong; Li, Li; Li, Si-Gan; Mao, Wen-Jun; Hu, Shi-Hui; Schwab, Gerhard; Conwell, Yeates

    2008-01-01

    Little is known about the differences in mortality among non-institutionalized geriatric and younger patients with schizophrenia. In this study long-term mortality and suicidal behavior of all the geriatric (age greater than or equal to 65 years), middle-age (age 41-64 years), and young (age 15-40 years) subjects with schizophrenia living in a…

  17. Successful Implementation of a Faculty Development Program in Geriatrics for Non-Primary Care Physician Educators

    ERIC Educational Resources Information Center

    Williams, Brent C.; Schigelone, Amy R.; Fitzgerald, James T.; Halter, Jeffrey B.

    2008-01-01

    A four-year faculty development program to enhance geriatrics learning among house officers in seven surgical and related disciplines and five medical subspecialties at a large academic institution resulted in changes in attitudes and knowledge of faculty participants, expanded curricula and teaching activities in geriatrics, and enhanced and…

  18. Geriatric Expertise among Medical School Faculty: Preparing for the Challenges of an Aging Population

    ERIC Educational Resources Information Center

    Laditka, Sarah B.; Jenkins, Carol L.; Eleazer, G. Paul; Kelsey, Susan G.

    2007-01-01

    This study examined non-geriatrician physicians' experiences in a geriatrics-focused faculty development program, and effects of the program on their geriatrics knowledge and their teaching and practice. In-depth interviews were conducted with all physicians (n = 26) participating in the Dean's Faculty Scholars in Aging program. Most participants…

  19. Community Psychiatrists Who See Geriatric Patients: What's Training Got to Do with It?

    ERIC Educational Resources Information Center

    Lieff, Susan; Andrew, Melissa; Tiberius, Richard

    2004-01-01

    Objective: This study examines the issues influencing psychiatrists' decisions to provide care to the under-served geriatric population. Methods: Community-based psychiatrists who see geriatric patients participated in focus group discussions exploring factors that influence the characteristics of their current practices. Results: Personal themes,…

  20. Impairment in Instrumental Activities of Daily Living and the Geriatric Syndrome of Self-Neglect

    ERIC Educational Resources Information Center

    Naik, Aanand D.; Burnett, Jason; Pickens-Pace, Sabrina; Dyer, Carmel B.

    2008-01-01

    Purpose: We sought to characterize self-neglect definitively as a geriatric syndrome by identifying an association with functional impairment. Design and Methods: We performed a cross-sectional home evaluation of 100 community-living older adults referred by Adult Protective Services for geriatric self-neglect and 100 matched adults from a…

  1. Exploring Strategies to Advance Public-Sector Funding in Geriatric Social Work Education

    ERIC Educational Resources Information Center

    Behrman, Gary; Mancini, Michael; Briar-Lawson, Katharine; Rizzo, Victoria M.; Baskind, Frank; Valentine, Carl

    2006-01-01

    Changing U.S. demographics and family composition are challenging social work education programs to reposition and reconsider how to prepare students for practice in the field of geriatrics. Implications for future social service and health care needs include ongoing training and education of students with competencies in serving geriatric

  2. Health care: economic impact of caring for geriatric patients.

    PubMed

    Rich, Preston B; Adams, Sasha D

    2015-02-01

    National health care expenditures constitute a continuously expanding component of the US economy. Health care resources are distributed unequally among the population, and geriatric patients are disproportionately represented. Characterizing this group of individuals that accounts for the largest percentage of US health spending may facilitate the introduction of targeted interventions in key high-impact areas. Changing demographics, an increasing incidence of chronic disease and progressive disability, rapid technological advances, and systemic market failures in the health care sector combine to drive cost. A multidisciplinary approach will become increasingly necessary to balance the delicate relationship between our constrained supply and increasing demand. PMID:25459539

  3. Psychosocial work load and stress in the geriatric care

    PubMed Central

    2010-01-01

    Background Due to the decrease in informal care by family members and the demographic development, the importance of professional geriatric care will rise considerably. Aim of this study was to investigate the psychosocial workplace situation for employees in this profession. Methods The German version of the COPSOQ (Copenhagen Psychosocial Questionnaire) was used for the assessment of psychosocial factors at work. The instrument includes 22 scales and 3 single items concerning demands, control, stress, support, and strain. Results between two study groups of geriatric care were compared to each other as well as to employees in general hospital care and a general population mean (COPSOQ database). Statistical analysis included t-tests, ANOVA and multiple comparisons of means. Statistical significance (p < 0.01, two-tailed) and a difference of at least 5 points in mean values were defined as the relevant threshold. Results In total 889 respondents from 36 institutions took part in the study. 412 worked in Home Care (HC), 313 in Geriatric Nursing Homes (GNH), 164 in other professions (e.g. administration). Comparison between HC and GNH showed more favourable values for the first group for the most scales, e.g. lower quantitative and emotional demands and less work-privacy conflict, better possibilities for development etc. Compared to external values from the German COPSOQ database for general hospital care (N = 1.195) and the total mean across all professions, COPSOQ-total (N = 11.168), the results are again positive for HC workers on most of the scales concerning demands and social support. The only negative finding is the very low amount of social relations at work due to the obligation to work alone most of the time. Employees in GNH rate predictability, quality of leadership and feedback higher when compared to general hospital care and show some further favourable mean values compared to the COPSOQ mean value for all professions. A disadvantage for GNH is the high rating for job insecurity. A supplementary subgroup analysis showed that the degree of negative evaluation of psychosocial factors concerning demands was related to the amount of working hours per week and the number of on-call duties. Conclusions Compared to employees in general hospital care and the COPSOQ overall mean value across all professions, geriatric care employees and especially home care workers evaluate their psychosocial working situation more positive for most aspects. However, this seems partly due to the very high proportion of part-time workers. Critical results for the two study groups are the relatively high job insecurity in nursing homes and the lack of social relations for the HCrs. PMID:20663137

  4. Cultural perspectives of meals expressed by patients in geriatric care.

    PubMed

    Sidenvall, B; Fjellström, C; Ek, A C

    1996-04-01

    The aim of this study was to investigate cultural values and ideas concerning table manners and food habits expressed by patients in geriatric care. The research approach was ethnographic. The findings exposed conflicts related to three themes. The first, "Mind your manners", demonstrated problems in managing food and objects, keeping clean, and conduct at table. The second, "Appetite for food", was connected to tradition and taste, healthy food and the need not to waste food. The third, "Be contented and do not complain", illustrated the elderly patients' socialized manners in talking about meals and food. PMID:8675381

  5. Systemic pharmacologic postoperative pain management in the geriatric orthopaedic patient.

    PubMed

    Karani, Reena; Meier, Diane E

    2004-08-01

    Although older adults have surgical procedures more frequently than any other group, they also experience the worst postoperative pain management. Among patients with orthopaedic disorders, this undertreatment of pain impacts postsurgical functional recovery and clinical outcomes. Recently adopted evidence-based pain management guidelines have improved care, but there still is significant room for improvement. We review standards for pain assessment in cognitively intact and impaired older adults, provide detailed guidelines for the pharmacologic treatment of postoperative pain in the orthopaedic geriatric patient, and review the stepwise approach to effective side-effect management in this population. PMID:15292784

  6. Family Physicians and Geriatrics: Practice Experience, Age and Attitudes

    PubMed Central

    Williams, Glenys O.; Clements, William M.

    1980-01-01

    A study of 180 family physicians and residents was conducted to identify their experience and attitudes towards the elderly. Older physicians had more patients over 65 than younger physicians. Geriatric patients were found dissatisfying by more residents than family physicians. The most frequently mentioned problems in treating the aged were: communication, inadequate medical education, insufficient time. Residents perceived a need for a geriatrician more often than did family physicians. The data do not support the theory that physician pessimism is related to age or experience. Improved educational experience at all levels of training should prevent therapeutic pessimism. PMID:21293598

  7. Structures and geriatrics from a failure analysis experience viewpoint

    SciTech Connect

    Hopper, D.M. (Hopper and Associates Engineers, Redondo Beach, CA (United States))

    1993-05-01

    In a failure analysis consulting engineering practice one sees a variety of structural failures from which observations may be made concerning geriatric structures. Representative experience with power plants, refineries, offshore structures, and forensic investigations is summarized and generic observations are made regarding the maintenance of fitness for purpose of structures. Although it is important to optimize the engineering design for a range of operational and environmental variables, it is essential that fabrication and inspection controls exist along with common sense based ongoing monitoring and operations procedures. 18 figs.

  8. Absence of Streptococcus pneumoniae in pharyngeal swabs of geriatric inpatients.

    PubMed

    Jomrich, Nina; Kellner, Silvia; Djukic, Marija; Eiffert, Helmut; Nau, Roland

    2015-07-01

    Colonization of the pharynx by Streptococcus pneumoniae was studied in 185 in-hospital geriatric patients (median age 81 years) from 29 March 2011 to 22 June 2011. Swabs were plated on blood agar plates. Colonies with a morphology suggesting S. pneumoniae were further analyzed. Surprisingly, pneumococci were not found in any of the samples. Pneumococci chronically colonizing the pharynx of elderly people may be much rarer than previously thought and probably are not the source of pneumococcal pneumonia in old age. PMID:25746605

  9. [Effects of family medicine education on medical students' attitudes].

    PubMed

    Chou, M C; Lee, M C

    1991-07-01

    Undergraduate education is considered to be one of the main contributory factors for the development of family medicine through increasing the number of medical graduates opting for a career in family practice. To evaluate the effects of family medicine education on student's attitudes, 140 fifth year medical students were asked in 1989 to fill in a questionnaire both before and after their curricula. The average age of the 123 students who completed the questionnaire on both occasions was 24.9 years; 106 were males; 17 were tuition free and 26 took additional family medicine clerkships. On aggregate, the students' disposition toward family medicine before their curricula appeared to be uncertain. Mean scores on the attitude scale did not significantly differ between socioeconomic subgroups before the curricula. After the curricula, students' attitudes were significantly altered, especially toward the future development of family medicine in Taiwan. However, their disposition toward family practice as a career changed the least. The degree of alteration in students' attitude toward family medicine before and after the curricula was related to the intensity of the course and to their socioeconomic backgrounds. PMID:1875456

  10. "Pedogeriatrics": a pediatric nephrologist's outlook on common challenges facing pediatric and geriatric nephrologists.

    PubMed

    Grünberg, Jose

    2010-03-01

    Dramatic demographic changes longevity and medical progress helped create a new population made up of the survivors of previously fatal diseases. These trends pose new major social and economic challenges that should be accounted for in health policy making. This paper discusses the similarities between the specialties of pediatrics and geriatrics, especially in the realm of patient care. Children and the elderly share a limited autonomy and dependence on the human environment (i.e., willing and able caregiving persons) due to age or disease. The long-term care of dependent patients (DP) requires caregiving persons who share with dependent persons the risk of losing autonomy, facing burnout, family disruption, and interference with work and educational activities. Families with DPs may face potential losses of income because both patients and caregivers are partially or completely unable to work, the former for medical reasons and the latter due to the new demands on their time and energy. Additionally, new expenses have to be met because while direct medical expenses might be covered by insurance or the State, other expenses have to be financed by the family, such as co-payments for medicines, new water or electricity home installations, and transport and eventual hotel costs if they have to stay overnight near a hospital outside of their town. The main objectives of long-term care should be to maximize patients' independence and prevent their physical and psychological deterioration while minimizing the social, economic and personal costs to caregivers. To achieve these goals, one needs a holistic approach, a multidisciplinary professional team (doctors, nurses, social workers, nutritionists and psychologists) and auxiliary staff (secretaries, electricians, administrators, messengers, cleaning staff, doormen, nursing aids and coordinators of medical appointments and medical procedures). Optimal management of DPs on chronic treatments such as chronic dialysis requires adequate communication skills, respectful attitudes toward patients and caregivers and effective use of communication and information technologies. Auxiliary personnel require specific training to contribute effectively to the DP attention processes. This paper postulates that pediatric and geriatric teams and their patients would benefit from closer training and sharing of experiences and systems. PMID:19517264

  11. American Geriatrics Society care of lesbian, gay, bisexual, and transgender older adults position statement: American Geriatrics Society Ethics Committee.

    PubMed

    2015-03-01

    There is ample evidence that lesbian, gay, bisexual, and transgender (LGBT) individuals face discrimination in the healthcare setting. Providing high-quality health care for older LGBT adults will require active steps by organizations, institutions, advocacy groups, and health professionals that create an environment that is free from discrimination. This position statement that the American Geriatrics Society (AGS) Ethics Committee developed addresses the vision of the AGS for the care of LGBT older adults and specific steps that can be taken to ensure that they receive the care that they need. PMID:25803784

  12. The meal situation in geriatric care--intentions and experiences.

    PubMed

    Sidenvall, B; Fjellström, C; Ek, A C

    1994-10-01

    Meals in geriatric institutions are often served in a dining room. The elderly patients--endowed with their socialized table manners and diet habits--who enter this milieu are affected by diseases and handicaps, reducing their ability to eat. In the present study individual patients' meals in geriatric care institutions were studied with respect both to nursing staffs' intentions and assessments of patients, as well as to those patients' experiences and the amount of influence they expected to have. The research approach was ethnographic. Eighteen newly admitted, mentally orientated patients and their primary enrolled nurses were allocated. The results indicated that the idea of both the nurses and the elderly patients was to reach a meal situation that was as natural and independent as possible. Compared with the elderly patients, the nursing staff had broader standards for acceptable table manners, and carried out collective dining of all 18. The elderly patients strove to behave in accordance with their standards and suffered because of their own limited eating competence and the experience of other patients' problems. The elderly patients avoided expressing their needs, and some enrolled nurses thought they were prying if they asked questions about such issues. These different, culturally dependent, perceptions resulted in care that was not congruent with the needs of the elderly patients. PMID:7822594

  13. Oral diagnostics: an integral component to geriatric health care.

    PubMed

    Kishore, Mallika; Panat, Sunil R; Choudhary, Ananda; Aggarwal, Ashish; Upadhyay, Nitin; Agarwal, Nupur; Alok, Abhijeet

    2013-12-01

    Aging is inevitable, every day we live we age. The mouth is referred to as a mirror of overall health, reinforcing that oral health is an integral part of general health. Oral health reflects overall well being for the elderly population. Compromised oral health may be a risk factor for systemic diseases commonly occurring in age. Diagnosis and proper treatment is essential for healthy aging. Timely diagnosis, appropriate treatment and regular follow-up of both oral and systemic diseases are a prerequisite for active aging. Oral diagnostics is a revolutionary development with high potential to replace other investigative modalities. Changing demographics, including the increase in life expectancy and the growing numbers of elderly, has focused attention on the need for dental research activities to be expanded for geriatric dentistry. This paper is aimed to shed light on the growing elderly population and their ailments. It also aims to create awareness among health care providers about oral diagnostics and their application in geriatrics. PMID:23617577

  14. [Geriatric nursing staff retention. Opportunities, potentials, and strategies].

    PubMed

    Joost, A

    2013-08-01

    Retaining geriatric nurses in their line of work could be an important strategy to prevent the shortage of skilled staff in the future. A prerequisite for this is detailed knowledge of the length and structure of professional careers. The IWAK ( Institut für Wirtschaft, Arbeit und Kultur) evaluated data from the German Social Insurance and carried out a structural analysis of the professional careers of geriatric nurses. Results showed that the average duration of professional careers is 20 years, of which 11.7 years constitute the period of employment and 7.8 years account for periods of inactivity. According to these findings, there is a considerable potential in extending professional careers and reducing the periods of inactivity to make better use of the existing skilled staff and to reduce staff shortage in this area. Concrete measures could involve improvement of working conditions (with the aim of avoiding long periods of inactivity and illness-related premature career endings as well as of increasing job satisfaction), creating better conditions for a good balance between work and family life, as well as setting up individual strategies to expand weekly working hours. Key players are businesses but also local authorities and politicians. PMID:23884527

  15. Spine surgery in geriatric patients: Sometimes unnecessary, too much, or too little

    PubMed Central

    Epstein, Nancy E.

    2011-01-01

    Background: Although the frequency of spinal surgical procedures has been increasing, particularly in patients of age 65 and over (geriatric), multiple overlapping comorbidities increase their risk/complication rates. Nevertheless, sometimes these high-risk geriatric patients are considered for “unnecessary”, too much (instrumented fusions), or too little [minimally invasive surgery (MIS)] spine surgery. Methods: In a review of the literature and reanalysis of data from prior studies, attention was focused on the increasing number of operations offered to geriatric patients, their increased comorbidities, and the offers for “unnecessary” spine fusions, including both major open and MIS procedures. Results: In the literature, the frequency of spine operations, particularly instrumented fusions, has markedly increased in patients of age 65 and older. Specifically, in a 2010 report, a 28-fold increase in anterior discectomy and fusion was observed for geriatric patients. Geriatric patients with more comorbid factors, including diabetes, hypertension, coronary artery disease (prior procedures), depression, and obesity, experience higher postoperative complication rates and costs. Sometimes “unnecessary”, too much (instrumented fusions), and too little (MIS spine) surgeries were offered to geriatric patients, which increased the morbidity. One study observed a 10% complication rate for decompression alone (average age 76.4), a 40% complication rate for decompression/limited fusion (average age 70.4), and a 56% complication rate for full curve fusions (average age 62.5). Conclusions: Increasingly, spine operations in geriatric patients with multiple comorbidities are sometimes “unnecessary”, offer too much surgery (instrumentation), or too little surgery (MIS). PMID:22276241

  16. Geriatric oncology: comparing health related quality of life in head and neck cancer patients

    PubMed Central

    2011-01-01

    Background Population ageing is increasing the number of people annually diagnosed with cancer worldwide, once most types of tumours are age-dependent. High-quality healthcare in geriatric oncology requires a multimodal approach and should take into account stratified patient outcomes based on factors other than chronological age in order to develop interventions able to optimize oncology care. This study aims to evaluate the Health Related Quality of Life in head and neck cancer patients and compare the scores in geriatric and younger patients. Methods Two hundred and eighty nine head and neck cancer patients from the Oncology Portuguese Institute participated in the Health Related Quality of Life assessment. Two patient groups were considered: the geriatric (? 65 years old, n = 115) and the younger (45-60 years old, n= 174). The EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaires were used. Results Head and neck cancer patients were mostly males, 77.4% within geriatric group and 91.4% among younger patients group. The most frequent tumour locations were similar in both groups: larynx, oral cavity and oropharynx - base of the tongue. At the time of diagnosis, most of younger male patients were at disease stage III/IV (55.9%) whereas the majority of younger female patients were at disease stage I/II (83.4%). The geriatric patient distribution was found to be similar in any of the four disease stages and no gender differences were observed. We found that age (geriatrics scored generally worse), gender (females scored generally worse), and tumour site (larynx tumours denounce more significant problems between age groups) clearly influences Health Related Quality of Life perceptions. Conclusions Geriatric oncology assessments signalize age-independent indicators that might guide oncologic geriatric care optimization. Decision-making in geriatric oncology must be based on tumour characteristics and chronological age but also on performance status evaluation, co-morbidity, and patient reported outcomes assessment. PMID:21232097

  17. Innovations in geriatric trauma and resident research education: bridging the gap.

    PubMed

    Mangram, Alicia

    2013-12-01

    The recent history of changes in the geriatric population in the US, the unique vulnerability to different mechanisms of trauma and the need for innovative management strategies to address them are discussed using the Geriatric "G-60" service as an illustration. The issue is not whether geriatric trauma "G-60" is coming; G-60 is here. A short detour into my own research experience is presented not as prescription but guidance for the development of futures cadres of surgeons. Resident research is not a luxury but key to transforming knowledge from benchside to bedside and back. PMID:24296094

  18. Report on the 14th Conference of the International Society of Geriatric Oncology.

    PubMed

    Wedding, Ulrich

    2015-03-01

    14th Conference of the International Society of Geriatric Oncology, Lisbon, Portugal, 23-25 October 2014 The annual international conference of the International Society of Geriatric Oncology gathered about 400 scientists in Lisbon in October 2014. Arti Hurria, President of the Society, opened the meeting and presented recent Globocan data on the development of the number of people newly diagnosed with cancer. From 2012 to the expected figures of 2035 the number of people aged 65 years and older diagnosed with cancer will increase by 108%. All areas of the world are concerned, not only the so called western Countries. Five major tracts covered important areas in the field of Geriatric Oncology: solid tumors; hematological malignancies; new therapies and basic science; nursing, supportive care and geriatric assessment; advocacy and social-economical issues. PMID:25760969

  19. Using collaboration to maximize outcomes for a John A. Hartford Foundation geriatric enrichment project.

    PubMed

    Fromm Faria, Debra; David, Virginia V; Dauenhauer, Jason; Dwyer, Diane

    2007-01-01

    Two institutions representing two BSW and one MSW program and a geriatric education center collaborated in a John A. Hartford geriatric enrichment project. Sharing the risks and benefits of a collaborative model, 75 percent of faculty participated in mini faculty fellowships, and bi-monthly dinner meetings with colleagues from each of the three programs, and actively engaged in the curricula revisions. Faculty report pervasive geriatric enrichment in each program's foundation content areas, and increases in students placed in geriatric enriched field practicum settings, from pre-project levels of 8.1 percent to a high of 24 percent. The features of the collaborative project include: respecting each program's autonomy while actively sharing ideas, resources and partnering with community's aging experts; and strengthening mutually reciprocal relationships among faculty and the gerontologic practice community. This model of shared risks and benefits also provides opportunities for innovation, diverse thinking, and shared decision making. PMID:17210538

  20. Preparing Social Work Students for Interprofessional Practice in Geriatric Health Care: Insights from Two Approaches

    ERIC Educational Resources Information Center

    Bonifas, Robin P.; Gray, Amanda K.

    2013-01-01

    Although several interprofessional education projects have addressed training allied health students for effective teamwork in geriatrics, few curriculum evaluation studies have examined differences in learning outcomes between interprofessional and traditional uniprofessional approaches, especially for social work students. This paper compares…

  1. Methodological Considerations for Geriatric Drug Testing (Phase 1 and 2 Trials)

    Microsoft Academic Search

    Robert E. Vestal

    1985-01-01

    Methodological considerations for research in geriatric clinical pharmacology that have pertinence for Phase 1 and 2 drug testing in elderly subjects and patients are discussed. Such considerations include study design, subject recruitment, feasibility, data analysis, and reporting.

  2. Actualizing a mobile integrated system for geriatric care.

    PubMed

    Chew, Han Ei; Faber, Johannes; Liu, Zhiming; Madera, Vanessa; Qamar, Nafees

    2013-01-01

    Population aging looms over countries all over the world. The social and economic implications of this phenomenon extend beyond the individual person and the immediate family, affecting broader society and the global community in profound ways. Aging populations increase pressure on already over-burdened public health care services and expenditures. To address this impending predicament, many health care providers and countries have turned to technological solutions. The near-ubiquity of mobile devices entails that mHealth will rapidly become a key component of technologically-enabled health care delivery services. This poster presents research and engineering challenges for a sustainable ICT solution that supports information exchange for mobile geriatric care. PMID:23920883

  3. Geriatric Nursing Resources for Care of Older Adults: Assessment Tools

    NSDL National Science Digital Library

    For nurses interested in keeping up to date with developments in geriatric treatment, this set of resources created by expert practitioners will be quite a find. The entire site was developed as part of the Nurse Competence in Aging initiative created by the American Nurses Association. Here, visitors can read over twenty-five two-page assessment tools that include such helpful titles as â??Assessing Nutrition in Older Adultsâ?ť, â??Predicting Pressure Ulcer Riskâ?ť, and â??Immunizations for the Older Adultâ?ť. Written in clear and direct language, these resources will also be of assistance for nursing educators and those who are responsible for professional development workshops. It is also worth mentioning that these short tools are designed as screening tools, and are not for diagnosis.

  4. Rectal motility studies in faecally incontinent geriatric patients.

    PubMed

    Barrett, J A; Brocklehurst, J C; Kiff, E S; Ferguson, G; Faragher, E B

    1990-09-01

    Rectal motility was assessed in three groups of geriatric patients (faecally incontinent, continent faecally impacted and control patients) to determine whether 'uninhibited' rectal contractions are a cause of faecal incontinence. The incidence of rectal contractions in response to rectal distension did not differ between the three study groups. Two-thirds of the incontinent patients were unable to retain a condom distended with water (soft-stool model) during a proctometrogram. Involuntary expulsion of this device was correlated with the presence of rectal contractions and low anal resting pressure. Involuntary expulsion of an airfilled balloon (firm-stool model) from the rectum occurred less frequently and was correlated with low resting pressure but not with rectal contractions. The contribution of 'uninhibited' rectal contractions to faecal incontinence is insignificant except for a minor role in the expulsion of liquid stool. PMID:2251964

  5. Subtle ethical dilemmas in geriatric management and clinical research

    PubMed Central

    Rosin, A; van Dijk, Y

    2005-01-01

    Routine management of geriatric problems often raises ethical problems, particularly regarding autonomy of the old person. The carers or children may be unaware of the sensitivity of role reversal in dealing with the financial affairs; the need for a residential carer may compromise the old person's privacy. Attending a day centre confers much benefit, but one must understand the old person's resistance to change in the proposal of a new daily regimen. Similarly his or her autonomy must be the priority in planning for admittance to an old age home, and not the assumption that the family knows best. A common dilemma is the assessment of an old person's competency in decision making, either about management of his affairs, or regarding consent to treatment, or participation in research. Because cognitive capacity is not always identical with competency, meaningful tools have recently been developed in which the emphasis is on the specific situation to be investigated. PMID:15923486

  6. Multidisciplinary teams in geriatric wards: myth or reality?

    PubMed

    Evers, H K

    1981-05-01

    This paper argues that the rhetoric of multidisciplinary teamwork is central to the provision of health care generally and geriatric care in particular. Yet the notion of teamwork is poorly defined, and the supposed benefits for patients are not always readily apparent. Looking at teamwork in practice, examples from research are used to illustrate how multidisciplinary decision making and work with patients can, under particular circumstances, take on the appearance of collaboration amongst a team of expert colleagues, which co-opts patients and relatives to the status of team members. But very often, multidisciplinary work with patients is coordinated not by mutual collaboration amongst a team of equals, but by means of established work routines which are broadly applied to whole categories of patients, and by the operation of the traditional hierarchy of social relations in health care. For long stay patients, the pervasiveness of the teamwork mythology and the frequent concurrent withdrawal of other professionals can, at worst, leave the nurses in the invidious position of having responsibility, but no formal or legal authority for caring for their patients: work which no other professional is anxious to do. This leads to negative outcomes for patients as well as for nurses. Finally, it is stressed that analysis of multidisciplinary teamwork both in theory and in practice is vital if we are to understand the conditions under which multidisciplinary teamwork both flourishes, and can be demonstrated to be a necessary condition for the creation of positive care outcomes for geriatric patients in hospital. This paper seeks to raise some of the issues which must be confronted in the endeavour. PMID:6787102

  7. Taking Medicines

    MedlinePLUS

    ... of this page please turn Javascript on. Taking Medicines Drugs in the Body Medicines can enter the body in many different ways, ... many steps happen along the way. Understanding how medicines work in your body can help you learn ...

  8. COPD Medicine

    MedlinePLUS

    ... You are here: Health Information > Medications > COPD COPD Medicine Your doctor may prescribe medicine to control the ... Learn how to manage your medications . Signs the Medicine Is Helping How can you work with your ...

  9. ADHD Medicines

    MedlinePLUS

    ... System How the Body Works Main Page ADHD Medicines KidsHealth > Kids > Health Problems > Learning & Emotional Problems > ADHD ... doctor can decide if ADHD medicine is needed. Medicine and the Mind There are a lot of ...

  10. Nuclear Medicine.

    ERIC Educational Resources Information Center

    Badawi, Ramsey D.

    2001-01-01

    Describes the use of nuclear medicine techniques in diagnosis and therapy. Describes instrumentation in diagnostic nuclear medicine and predicts future trends in nuclear medicine imaging technology. (Author/MM)

  11. Engineering the fitness of older patients for chemotherapy: an exploration of Comprehensive Geriatric Assessment in practice.

    PubMed

    McCarthy, Alexandra L; Cook, Peta S; Yates, Patsy

    2014-03-01

    Clinicians often report that currently available methods to assess older patients, including standard clinical consultations, do not elicit the information necessary to make an appropriate cancer treatment recommendation for older cancer patients. An increasingly popular way of assessing the potential of older patients to cope with chemotherapy is a Comprehensive Geriatric Assessment. What constitutes Comprehensive Geriatric Assessment, however, is open to interpretation and varies from one setting to another. Furthermore, Comprehensive Geriatric Assessment's usefulness as a predictor of fitness for chemotherapy and as a determinant of actual treatment is not well understood. In this article, we analyse how Comprehensive Geriatric Assessment was developed for use in a large cancer service in an Australian capital city. Drawing upon Actor-Network Theory, our findings reveal how, during its development, Comprehensive Geriatric Assessment was made both a tool and a science. Furthermore, we briefly explore the tensions that we experienced as scholars who analyse medico-scientific practices and as practitioner-designers charged with improving the very tools we critique. Our study contributes towards geriatric oncology by scrutinising the medicalisation of ageing, unravelling the practices of standardisation and illuminating the multiplicity of 'fitness for chemotherapy'. PMID:23703221

  12. Kenneth L. Minaker, MD, FRCP(C), CSC(GM) Chief, Geriatric Medicine Unit

    E-print Network

    Mootha, Vamsi K.

    hormone (the less the better) 6. Caloric restriction (slows aging- soon to be demonstrated in Rhesus restriction pathways 8. Brain insulin (longevity regulated by insulin signaling in particular neurons in brain that mimic caloric restriction · Opposes all bad effects of high calorie intake · Caloric restriction (not

  13. Oral Examination: A Model for Its Use within a Clinical Clerkship.

    ERIC Educational Resources Information Center

    Vu, Nu V.; And Others

    1981-01-01

    The Department of Obstetrics and Gynecology at the Southern Illinois University School of Medicine has devised an evaluation system that not only provides the advantages of oral examination but also attempts to alleviate some of its disadvantages. The system uses oral examination to assess students' content knowledge. (MLW)

  14. A Structured Curriculum for an Undergraduate Elective Clerkship in Pediatric Nephrology

    ERIC Educational Resources Information Center

    Rauch, Jerome S.; Schwartz, M. William

    1977-01-01

    An organizational structure was developed at the University of Pennsylvania School of Medicine for a pediatric nephrology elective. A study guide and format ensure that students have a common knowledge base--the lack of which has been a problem in electives--and allows them to participate in patient problems. (LBH)

  15. A Comparison of Depressive Mood of Older Adults in a Community, Nursing Homes, and a Geriatric Hospital: Factor Analysis of Geriatric Depression Scale

    Microsoft Academic Search

    Joji Onishi; Yusuke Suzuki; Hiroyuki Umegaki; Hidetoshi Endo; Takashi Kawamura; Akihisa Iguchi

    2006-01-01

    The Geriatric Depression Scale (GDS)-15 was used in 607 adults aged 65+ years living in a community, nursing homes, and a general hospital to explore characteristics of depressive mood in different care settings. Factor analysis of GDS-15 extracted 4 factors labeled unhappiness, apathy and anxiety, loss of hope and morale, and energy loss. The scale scores labeled unhappiness, apathy and

  16. Transcriptomic biomarkers of the response of hospitalized geriatric patients admitted with heart failure. Comparison to hospitalized geriatric patients with infectious diseases or hip fracture.

    PubMed

    Vo, Thi Kim Duy; de Saint-Hubert, Marie; Morrhaye, Gabriel; Godard, Patrice; Geenen, Vincent; Martens, Henri J; Debacq-Chainiaux, Florence; Swine, Christian; Toussaint, Olivier

    2011-03-01

    The abundance of a preselection of transcripts involved in inflammation, immunosenescence and stress response was compared between PBMC of healthy aged donors and aged patients in acute phase of heart failure and at recovery. This study identified 22 transcripts differentially abundant in acute phase of heart failure versus healthy aged subjects. Transcripts involved in inflammation and oxidative stress were more abundant. Those associated with T-cell functions were less abundant. The results were compared to two other major acute geriatric issues: infectious diseases and hip fracture. In acute phase, compared to healthy aged subjects, the abundance of 15/22 transcripts was also altered in both geriatric infectious diseases and hip fracture. Many variations had not vanished at the recovery phase. The abundance of CD28, CD69, LCK, HMOX1, TNFRSF1A transcripts, known to be altered in healthy aged versus healthy young subjects, was further affected in acute phase of the three geriatric diseases considered. The transcript levels of BCL2, CASP8, CCL5, DDIT3, EGR3, IL10RB, IL1R2, SERPINB2 and TIMP1 were affected in all three pathological conditions compared to healthy aged, but not versus healthy young subjects. In conclusion, this work provides critical targets for therapeutic research on geriatric heart failure, infectious diseases and hip fracture. PMID:21335025

  17. The URI Office of the Provost, the College of Human Science and Services, the Program in Gerontology, and the Rhode Island Geriatric Education Center

    E-print Network

    Rhode Island, University of

    in Gerontology, and the Rhode Island Geriatric Education Center invite you to attend The URI Distinguished Visiting International Scholar and Malford Thewlis Lecture on Gerontology and Geriatrics GROWING OLDERWHAT

  18. [Analgesics in geriatric patients : Adverse side effects and interactions].

    PubMed

    Gosch, Markus

    2015-07-01

    Pain is a widespread symptom in clinical practice. Older adults and chronically ill patients are particularly affected. In multimorbid geriatric patients, pharmacological pain treatment is an extension of a previously existing multimedication. Besides the efficacy of pain treatment, drug side effects and drug-drug interactions have to be taken into account to minimize the health risk for these patients. Apart from the number of prescriptions, the age-related pharmacokinetic and pharmacodynamic changes significantly increase the risk among older adults. The use of non-steroidal anti-inflammatory drugs (NSAID) is widespread but NSAIDs have the highest risk of adverse drug reactions and drug interactions. In particular, the gastrointestinal, cardiovascular, renal and coagulation systems are affected. Apart from the known toxic effect on the liver (in high doses), paracetamol (acetaminophen) has similar risks although to a lesser degree. According to current data, metamizol is actually better than its reputation suggests. The risk of potential drug interactions seems to be low. Apart from the risk of sedation in combination with other drugs, tramadol and other opioids can induce the serotonin syndrome. Among older adults, especially in the case of polypharmacy, an individualized approach should be considered instead of sticking to the pain management recommended by the World Health Organization (WHO) in order to minimize drug-drug interactions and adverse drug reactions. PMID:26152872

  19. Approach to Helicobacter pylori infection in geriatric population

    PubMed Central

    Cizginer, Sevdenur; Ordulu, Zehra; Kadayifci, Abdurrahman

    2014-01-01

    The prevalence of Helicobacter pylori (H. pylori) infection and its complications increase with age. The majority of infected individuals remain asymptomatic throughout the life but 10%-20% develops peptic ulcer disease and 1% gastric malignancies. The incidence of ulcers and their complications are more common in the older population resulting in higher hospitalization and mortality rates. The increased use of medications causing gastric mucosal damage and the decreased secretion of protective prostaglandins in elderly are major factors increasing gastric mucosal sensitivity to the destructive effects of H. pylori. Due to higher prevalence of gastrointestinal (GI) malignancies, upper GI endoscopy is mostly preferred in elderly for the diagnosis of infection. Therefore, “endoscopy and treat” strategy may be more appropriate instead of “test and treat” strategy for dyspeptic patients in older age. Urea breath test and stool antigen test can be used for control of eradication, except for special cases requiring follow-up with endoscopy. The indications for treatment and suggested eradication regimens are similar with other age groups; however, the eradication failure may be a more significant problem due to high antibiotic resistance and low compliance rate in elderly. Multidrug usage and drug interactions should always be considered before starting the treatment. This paper reviews briefly the epidemiology, diagnosis, disease manifestations, and treatment options of H. pylori in the geriatric population. PMID:25133042

  20. Transcranial magnetic stimulation for geriatric depression: Promises and pitfalls

    PubMed Central

    Sabesan, Priyadharshini; Lankappa, Sudheer; Khalifa, Najat; Krishnan, Vasudevan; Gandhi, Rahul; Palaniyappan, Lena

    2015-01-01

    As the global population gets older, depression in the elderly is emerging as an important health issue. A major challenge in treating geriatric depression is the lack of robust efficacy for many treatments that are of significant benefit to depressed working age adults. Repetitive transcranial magnetic stimulation (rTMS) is a novel physical treatment approach used mostly in working age adults with depression. Many TMS trials and clinics continue to exclude the elderly from treatment citing lack of evidence in this age group. In this review, we appraise the evidence regarding the safety and efficacy of rTMS in the elderly. A consistent observation supporting a high degree of tolerability and safety among the elderly patients emerged across the Randomised Controlled Trials and the uncontrolled trials. Further, there is no reliable evidence negating the utility of rTMS in the elderly with depression. We also identified several factors other than age that moderate the observed variations in the efficacy of rTMS in the elderly. These factors include but not limited to: (1) brain atrophy; (2) intensity and number of pulses (dose-response relationship); and (3) clinical profile of patients. On the basis of the current evidence, the practice of excluding elderly patients from TMS clinics and trials cannot be supported. PMID:26110119

  1. Modeling the health care costs of geriatric inpatients.

    PubMed

    Shaw, Barry; Marshall, Adele H

    2006-07-01

    This paper extends a method for modeling the survival of patients in hospitals to allow the expected cost to be estimated for the patients' accumulated duration of time in care. An extension of Bayesian network (BN) theory has previously been developed to model patients' survival time in hospitals with respect to the graphical and probabilistic representation of the interrelationships between the patients' clinical variables. Unlike previous BN techniques, this extended model can accommodate continuous times that are skewed in nature. This paper presents the theory behind such an approach and extends it by attaching a cost variable to the survival times, enabling the costing and efficient management of groups of patients in hospitals. An application of the model is illustrated by considering a group of 4260 patients admitted into the geriatric department of a U.K. hospital between 1994-1997. Results are derived for the distribution for their length of stay in the hospital and associated costs. The model's practical use is highlighted by illustrating how hospital managers could benefit using such a method for investigating the influence of future decisions and policy changes on the hospital's expenditure. PMID:16871721

  2. Implementation of Geriatric Acute Care Best Practices:Initial Results of The NICHE SITE Self -Evaluation

    PubMed Central

    Boltz, Marie; Capezuti, Elizabeth; Shuluk, Joseph; Brouwer, Julianna; Carolan, Deirdre; Conway, Shirley; DeRosa, Sue; LaReau, Rita; Lyons, Denise; Nickoley, Sue; Smith, Tyleen; Galvin, James E.

    2013-01-01

    Nurses Improving Care of Healthsystem Elders (NICHE) provides hospitals with tools and resources to implement a geriatric initiative to improve health outcomes and experiences for older adults and their families. Beginning in 2011, members have engaged in a process of program self-evaluation, designed to evaluate internal progress toward developing, sustaining and disseminating NICHE. This manuscript describes the NICHE Site Self -evaluation and reports the inaugural self-evaluation data in 180 North American hospitals. NICHE members evaluate their program utilizing the following dimensions of a geriatric acute care program: guiding principles, organizational structures, leadership, geriatric staff competence, interdisciplinary resources and processes, patient- and family-centered approaches, environment of care, and quality metrics. The majority of NICHE sites were at the progressive implementation level (n= 100, 55.6%), having implemented interdisciplinary geriatric education and the geriatric resource nurse (GRN) model on at least one unit; 29% have implemented the GRN model on multiple units, including specialty areas. Bed size, teaching status, and Magnet® status were not associated with level of implementation, suggesting that NICHE implementation can be successful in a variety of settings and communities. PMID:23656606

  3. Professional development and exposure to geriatrics: medical student perspectives from narrative journals.

    PubMed

    Shield, Renée R; Farrell, Timothy W; Campbell, Susan E; Nanda, Aman; Wetle, Terrie

    2015-01-01

    Teaching professionalism is an important goal in American medical education. With the aging of the U.S. population, it is critical to understand how medical students develop professional behaviors when caring for older adults. Exposure to geriatrics and older patients can enhance students' professional development with patients of all ages and across different specialties. Medical students learn explicit and implicit messages during their education. In addition to helping to evaluate curricula, reflective journaling encourages individual development and helps in revealing how medical students become professionals. In this study, medical student volunteers described their responses to new geriatrics content in their curriculum, encounters with older patients in clinical settings, and their evolving physician identities. Multidisciplinary team analysis elicited 10 themes regarding: evaluation of geriatrics within the curriculum, recognition of geriatrics principles, and attitudes regarding aging and professional development over time. This article focuses on the impact of geriatrics exposure on students' professional development, revealing ways that students think about professionalism and older patients. Medical educators should consider journaling to help foster and gauge students' professional development. PMID:25152977

  4. Geriatric assessment to predict survival in older allogeneic hematopoietic cell transplantation recipients

    PubMed Central

    Muffly, Lori S.; Kocherginsky, Masha; Stock, Wendy; Chu, Quynh; Bishop, Michael R.; Godley, Lucy A.; Kline, Justin; Liu, Hongtao; Odenike, Olatoyosi M.; Larson, Richard A.; van Besien, Koen; Artz, Andrew S.

    2014-01-01

    Allogeneic hematopoietic cell transplantation is increasingly utilized in older adults. This study prospectively evaluated the prognostic utility of geriatric assessment domains prior to allogeneic transplantation in recipients aged 50 years and over. Geriatric assessment was performed prior to transplant, and included validated measures across domains of function and disability, comorbidity, frailty, mental health, nutritional status, and systemic inflammation. A total of 203 patients completed geriatric assessment and underwent transplant. Median age was 58 years (range 50–73). After adjusting for established prognostic factors, limitations in instrumental activities of daily living (HR 2.38, 95%CI: 1.59–3.56; P<0.001), slow walk speed (HR 1.80, 95%CI: 1.14–2.83; P=0.01), high comorbidity by hematopoietic cell transplantation-specific comorbidity index (HR 1.56, 95%CI: 1.07–2.28; P=0.02), low mental health by short-form-36 mental component summary (HR 1.67, 95%CI: 1.13–2.48; P=0.01), and elevated serum C-reactive protein (HR 2.51, 95%CI: 1.54–4.09; P<0.001) were significantly associated with inferior overall survival. These associations were more pronounced in the cohort 60 years and over. Geriatric assessment measures confer independent prognostic utility in older allogeneic transplant recipients. Implementation of geriatric assessment prior to allogeneic transplantation may aid appropriate selection of older adults. PMID:24816237

  5. Fractionated laser resurfacing corrects the inappropriate UVB response in geriatric skin.

    PubMed

    Spandau, Dan F; Lewis, Davina A; Somani, Ally-Khan; Travers, Jeffrey B

    2012-06-01

    Non-melanoma skin cancer is a disease primarily afflicting geriatric patients as evidenced by the fact that 80% of all non-melanoma skin cancers are diagnosed in patients over the age of 60 years. As such, geriatric skin responds to cancer-inducing UVB irradiation in a manner that allows the establishment of tumor cells. Currently, the only effective treatment for non-melanoma skin cancer is the removal of the tumors after they appear, indicating the need for a more cost-effective prophylactic therapy. Geriatric volunteers were treated with fractionated laser resurfacing therapy on either sun-protected (upper buttocks) or chronically sun-exposed (dorsal forearm) skin. Fractionated laser resurfacing therapy was shown to decrease the occurrence of senescent fibroblasts in geriatric dermis, increase the dermal expression of IGF-1, and correct the inappropriate UVB response observed in untreated geriatric skin. These responses to fractionated laser resurfacing were equal to the effects seen previously using the more aggressive wounding following dermabrasion. Furthermore, fractionated laser resurfacing was equally effective in both sun-protected and sun-exposed skin. The ability of fractionated laser resurfacing treatment to protect against the occurrence of UVB-damaged proliferating keratinocytes indicates the potential of fractionated laser resurfacing to reduce or prevent aging-associated non-melanoma skin cancer. PMID:22377757

  6. SILBERMAN SCHOOL OF SOCIAL WAS DESIGNATED AS ONE OF FIVE ACADEMIC CENTERS OF EXCELLENCE IN GERIATRIC SOCIAL WORK IN THE NATION

    E-print Network

    Qiu, Weigang

    IN GERIATRIC SOCIAL WORK IN THE NATION October, 2013--New York, NY-- The Hartford/GSA National Center as one of just three schools selected nationally to be a Center of Excellence in Geriatric Social Work) will be led by Dr. Carmen Morano, the Co-Director of the AGESW Geriatric Pre-Dissertation Initiative

  7. Minnesota Chair in Long-terM Care and aging Center on aging Minnesota area geriatriC eduCation Center The View from Here

    E-print Network

    Blanchette, Robert A.

    1 fall 2013 Minnesota Chair in Long-terM Care and aging · Center on aging · Minnesota area geriatriC 11 Geriatric Education Modules 12 School of Nursing Going National 13 U of M/Va to Educate More Minnesota Chair in Long-terM Care and aging · Center on aging · Minnesota area geriatriC eduCation Center

  8. Emergency medicine in the medical school curriculum.

    PubMed

    Wald, David A; Lin, Michelle; Manthey, David E; Rogers, Rob L; Zun, Leslie S; Christopher, Theodore

    2010-10-01

    Emergency medicine (EM) is a dynamic specialty that continues to define itself as a fertile training ground for medical students. Throughout the years, a number of U.S. medical schools have incorporated topics germane to EM training (basic cardiac life support, principles of wound care, splinting, basic procedural skills training, etc.) into the medical school curriculum. By virtue of their broad-based training and the unique patient care environment that they practice in, EM specialists can serve a multitude of educational roles in the medical school. Whether serving as a problem-based learning facilitator, collaborating with basic scientists, or teaching medical history-taking and physical examination skills in the emergency department (ED), EM faculty can effectively teach future physicians in training. Although opportunities for teaching will vary by institution, often all it takes to get involved is asking. Teaching can take place in the ED, classroom, or simulation center, both in the preclinical and in the clinical curriculum. EM faculty may be well suited to help teach procedural skills to students as they enter their clinical clerkships. A formal rotation in EM can also assist the medical school in achieving their institutional objectives or in identifying ways to satisfy the Liaison Committee on Medical Education's objectives. Patients presenting to the ED span the entire spectrum: young and old, sick and not sick. It is this variety of cases that makes the ED a truly valuable setting for educating students. PMID:21199080

  9. Learner-Centered Online Courses/Programs in Gerontology and Geriatrics: New Responses to Changing Needs of Health Professionals

    ERIC Educational Resources Information Center

    Cotter, J. James; Welleford, E. Ayn; Drain, Cecil B.

    2008-01-01

    This article describes recent trends that have led to an emphasis on a learner-centered approach to gerontology and geriatrics education especially in distance-based education. A learner-centered approach to education has combined with technological advances to stimulate distance-enhanced education for students in geriatric and gerontology…

  10. Effects of Polypharmacy on Adverse Drug Reactions among Geriatric Outpatients at a Tertiary Care Hospital in Karachi: A Prospective Cohort Study

    PubMed Central

    Mujeeb, Rakshinda; Patel, Muhammad Junaid

    2014-01-01

    Background Adverse drug reactions (ADRs) present a challenging and expensive public health problem. Polypharmacy is defined according to the WHO criteria as the, “concurrent use of five or more different prescription medication”. Elderly are more prone to adverse reactions due to comorbid conditions, longer lists of medications and sensitivity to drug effects. The aim of the study is to estimate the incidence and strength of association of ADRs due to polypharmacy among the geriatric cohort attending outpatient clinics at a tertiary care center. Methods A hospital based prospective cohort study was conducted at ambulatory care clinics of Aga Khan University Hospital April 2012 to March 2013. One thousand geriatrics patients (age ?65 years) visiting ambulatory clinics were identified. They were divided on the basis of exposure (polypharmacy vs. no polypharmacy). We followed them from the time of their enrollment (day zero) to six weeks, checking up on them once a week. Incidence was calculated and Cox Proportional Hazard Model estimates were used. Results The final analysis was performed on 1000 elderly patients. The occurrence of polypharmacy was 70% and the incidence of ADRs was 10.5% among the study cohort. The majority (30%) of patients were unable to read or write. The use of herbal medicine was reported by 3.2% of the patients and homeopathic by 3%. Our Cox adjusted model shows that polypharmacy was 2.3 times more associated with ADRs, con-current complementary and alternative medicine (CAM) was 7.4 times and those who cannot read and write were 1.5 times more associated with ADRs. Conclusion The incidence of ADRs due to poly pharmacy is alarmingly high. The factors associated with ADRs are modifiable. Policies are needed to design and strengthen the prescription pattern. PMID:25402452

  11. Alternative Medicine

    MedlinePLUS

    Alternative Medicine en Espańol email Send this article to a friend by filling out the fields below: Your name: ... Send Thanks for emailing that article! Tweet Alternative medicine may be defined as non-standard, unconventional treatments ...

  12. Diabetes Medicines

    MedlinePLUS

    Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...

  13. Geriatric nutritional risk index: a mortality predictor in hemodialysis patients.

    PubMed

    Edalat-Nejad, Mahnaz; Zameni, Fatemeh; Qlich-Khani, Mahdi; Salehi, Fatemeh

    2015-03-01

    Recently, the Geriatric Nutritional Risk Index (GNRI) has been introduced as a valuable tool to assess the nutritional status of hemodialysis (HD) patients. To determine the predictive value of the GNRI score for death in HD, we studied 145 chronic HD patients (%53 men, mean age 60 ± 16 years). The GNRI score was estimated by an equation involving serum albumin and individual's weight and height. According to the highest positive likelihood and risk ratios, the cut-off value of the GNRI for mortality was set at 100. The survival of patients on HD was examined with the Cox proportional hazards model. Mortality was monitored prospectively over an 18-month period, during which 35 patients died. The GNRI (mean 102.6 ± 5.5) was significantly positively correlated with lean body mass, hematocrit, serum lipids and presence of metabolic syndrome. Multivariate Cox proportional hazards analysis demonstrated that the GNRI <100, serum ferritin ? 500 ? g/L and age 65 years or older were significant predictors for mortality (hazard ratio 3.691, 95% CI 1.751-7.779, P = 0.001; hazard ratio 3.105, 95% CI 1.536-6.277, P = 0.002; and hazard ratio 2.806, 95% CI 1.297-6.073, P = 0.009, respectively), after adjustment to gender and vintage time. It can be concluded that, in addition to old age, malnutrition (low GNRI) and inflammation (high ferritin) are identified as significant independent risk factors that predict all-cause mortality in HD patients. PMID:25758879

  14. Visual manifestations of occipital lobe infarction in three patients on a geriatric psychiatry unit.

    PubMed

    La Mancusa, J C; Cole, A R

    1988-01-01

    The authors present three cases of hospitalized patients on a geriatric psychiatry floor who were found to have previously undiagnosed occipital lobe infarctions associated with visual manifestations. The manifestations discussed are visual field defects, visual hallucinations, and color anomia. The incidence of undiagnosed occipital lobe infarctions and the contribution of these infarctions to visual perception changes in this patient population are unknown. The authors suggest that for patients who present with visual perception changes, a high index of suspicion for occipital lobe infarction should be maintained. Careful visual field testing is an essential part of the admitting work-up for hospitalized geriatric patients. PMID:3252891

  15. Geriatrics: Profiles in Geriatrics

    MedlinePLUS

    ... natural fit. more info Moussa Sissoko, MD Boston University Medical Center "My experiences with my grandparents and ... more info Terry Fulmer, PhD, RN New York University College of Nursing "I have the same passion ...

  16. SCHOOL OF MEDICINE SCHOOL OF MEDICINE

    E-print Network

    Schladow, S. Geoffrey

    SCHOOL OF MEDICINE SCHOOL OF MEDICINE #12;School of Medicine 127 SCHOOL OF MEDICINE School of Medicine http://www.ucdmc.ucdavis.edu/medschool/ The Doctor of Medicine degree requires the satisfactory OF MEDICINE When you apply to the School of Medicine, you must submit the results from the Medical College

  17. Assessing the Value of an Optional Radiation Oncology Clinical Rotation During the Core Clerkships in Medical School

    SciTech Connect

    Zaorsky, Nicholas G.; Malatesta, Theresa M.; Den, Robert B.; Wuthrick, Evan; Ahn, Peter H.; Werner-Wasik, Maria; Shi, Wenyin; Dicker, Adam P.; Anne, P. Rani; Bar-Ad, Voichita [Department of Radiation Oncology, Jefferson Medical College, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States); Showalter, Timothy N., E-mail: timothy.showalter@jeffersonhospital.org [Department of Radiation Oncology, Jefferson Medical College, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States)

    2012-07-15

    Purpose: Few medical students are given proper clinical training in oncology, much less radiation oncology. We attempted to assess the value of adding a radiation oncology clinical rotation to the medical school curriculum. Methods and Materials: In July 2010, Jefferson Medical College began to offer a 3-week radiation oncology rotation as an elective course for third-year medical students during the core surgical clerkship. During 2010 to 2012, 52 medical students chose to enroll in this rotation. The rotation included outpatient clinics, inpatient consults, didactic sessions, and case-based presentations by the students. Tests of students' knowledge of radiation oncology were administered anonymously before and after the rotation to evaluate the educational effectiveness of the rotation. Students and radiation oncology faculty were given surveys to assess feedback about the rotation. Results: The students' prerotation test scores had an average of 64% (95% confidence interval [CI], 61-66%). The postrotation test scores improved to an average of 82% (95% CI, 80-83%; 18% absolute improvement). In examination question analysis, scores improved in clinical oncology from 63% to 79%, in radiobiology from 70% to 77%, and in medical physics from 62% to 88%. Improvements in all sections but radiobiology were statistically significant. Students rated the usefulness of the rotation as 8.1 (scale 1-9; 95% CI, 7.3-9.0), their understanding of radiation oncology as a result of the rotation as 8.8 (95% CI, 8.5-9.1), and their recommendation of the rotation to a classmate as 8.2 (95% CI, 7.6-9.0). Conclusions: Integrating a radiation oncology clinical rotation into the medical school curriculum improves student knowledge of radiation oncology, including aspects of clinical oncology, radiobiology, and medical physics. The rotation is appreciated by both students and faculty.

  18. Massachusetts Career Development Institute in Partnership with the Geriatric Authority of Holyoke, Massachusetts. Final Report.

    ERIC Educational Resources Information Center

    Massachusetts Career Development Inst., Springfield.

    The Massachusetts Career Development Institute (MCDI) refined and expanded the existing program of Workplace Education at the Geriatric Authority of Holyoke (GAH), Massachusetts. The 18-month program provided educational and support services on site to 60 employees at the GAH. Classes were held in English as a second language, adult basic…

  19. Efficacy of a geriatric oral health CD as a learning tool.

    PubMed

    Teasdale, Thomas A; Shaikh, Mehtab

    2006-12-01

    To better prepare professionals to meet the needs of older patients, a self-instructional computer module on geriatric oral health was previously developed. A follow-up study reported here tested the efficacy of this educational tool for improving student knowledge of geriatric oral care. A convenience sampling procedure was used. Sample size calculation revealed that fifty-six subjects were required to meet clinical and statistical criteria. Paired t-test addressed our hypothesis that use of the educational tool is associated with improvement in knowledge. Fifty-eight first-year dental students and nine third-year medical students completed the pre-intervention test and were given the CD-based educational tool. After seven days, all participants completed the post-intervention test. Knowledge of geriatric oral health improved among the sixty-seven students included in this study (p=0.019). When stratified on the basis of viewing the CD-ROM, the subgroup of thirty-eight students who reported not actually reviewing the CD-ROM had no change in their knowledge scores, while the subgroup of twenty-nine students who reported reviewing the CD had a significant improvement in test scores (p<0.001). Use of a self-instructional e-learning tool in geriatric oral health is effective among those students who choose to employ such tools. PMID:17170329

  20. Geriatric Conditions in Acutely Hospitalized Older Patients: Prevalence and One-Year Survival and Functional Decline

    PubMed Central

    Buurman, Bianca M.; Hoogerduijn, Jita G.; de Haan, Rob J.; Abu-Hanna, Ameen; Lagaay, A. Margot; Verhaar, Harald J.; Schuurmans, Marieke J.; Levi, Marcel; de Rooij, Sophia E.

    2011-01-01

    Background To study the prevalence of eighteen geriatric conditions in older patients at admission, their reporting rate in discharge summaries and the impact of these conditions on mortality and functional decline one year after admission. Method A prospective multicenter cohort study conducted between 2006 and 2008 in two tertiary university teaching hospitals and one regional teaching hospital in the Netherlands. Patients of 65 years and older, acutely admitted and hospitalized for at least 48 hours, were invited to participate. Eighteen geriatric conditions were assessed at hospital admission, and outcomes (mortality, functional decline) were assessed one year after admission. Results 639 patients were included, with a mean age of 78 years. IADL impairment (83%), polypharmacy (61%), mobility difficulty (59%), high levels of primary caregiver burden (53%), and malnutrition (52%) were most prevalent. Except for polypharmacy and cognitive impairment, the reporting rate of the geriatric conditions in discharge summaries was less than 50%. One year after admission, 35% had died and 33% suffered from functional decline. A high Charlson comorbidity index score, presence of malnutrition, high fall risk, presence of delirium and premorbid IADL impairment were associated with mortality and overall poor outcome (mortality or functional decline). Obesity lowered the risk for mortality. Conclusion Geriatric conditions were highly prevalent and associated with poor health outcomes after admission. Early recognition of these conditions in acutely hospitalized older patients and improving the handover to the general practitioner could lead to better health outcomes and reduce the burden of hospital admission for older patients. PMID:22110598

  1. Evaluation of physiological work demands and low back neuromuscular fatigue on nurses working in geriatric wards

    Microsoft Academic Search

    Ling Hui; Gabriel Y. F. Ng; Simon S. M. Yeung; Christina W. Y. Hui-Chan

    2001-01-01

    This study evaluated the physiological demands and low back neuromuscular fatigue patterns following a daytime work shift of 21 female nurses working in geriatric wards. Subjects’ heart rate (HR) at work was monitored for 8h and surface electromyogram (EMG) of their back muscle was recorded during a 1-minute horizontal trunk holding test before and after work. Results showed that the

  2. Can the Geriatric Depression Scale detect poststroke depression in Chinese elderly?

    Microsoft Academic Search

    Wai Kwong Tang; Sandra S. M Chan; Helen F. K Chiu; Ka Sing Wong; Timothy C. Y Kwok; Vincent Mok; Gabor S Ungvari

    2004-01-01

    Background: Little is known about the performance of the Geriatric Depression Scale (GDS) in the screening of post-stroke depression (PSD) among Chinese elderly. Methods: Three months after the index stroke, a research assistant administered the 15-item GDS to 127 Chinese elderly patients with acute stroke who were consecutively admitted to a general hospital. A psychiatrist, who was blind to the

  3. Factor Structure of the Geriatric Depression Scale in Cognitively Impaired Older Adults

    Microsoft Academic Search

    James R. Hall; Tommy E. Davis

    2009-01-01

    This study explores the factor structure of the 30-item Geriatric Depression Scale (GDS) obtained from a sample of elderly adults who were diagnosed with some level of cognitive impairment. Principle components analysis obtained a four-factor solution utilizing all 30 GDS items. The derived factors were labeled Dysphoria, Meaninglessness, Apathy, and Cognitive Impairment. Although differences in factor structure were noted, some

  4. Task Analysis for Health Occupations. Cluster: Nursing. Occupation: Geriatric Aide. Education for Employment Task Lists.

    ERIC Educational Resources Information Center

    Lake County Area Vocational Center, Grayslake, IL.

    This task analysis for nursing education provides performance standards, steps to be followed, knowledge required, attitudes to be developed, safety procedures, and equipment and supplies needed for 13 tasks performed by geriatric aides in the duty area of performing diagnostic measures and for 30 tasks in the duty area of providing therapeutic…

  5. Interdisciplinary Collaboration in Gerontology and Geriatrics in Latin America: Conceptual Approaches and Health Care Teams

    ERIC Educational Resources Information Center

    Gomez, Fernando; Curcio, Carmen Lucia

    2013-01-01

    The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a…

  6. Growing Old is Mandatory But Growing Up is Optional: An Explanation to Geriatrics.

    PubMed

    Priyadarshini, Smita R; Sahoo, Pradyumna Ku; Bhuyan, Sanat Ku; Misra, Satya Ranjan; Pati, Abhishek Rajan

    2014-12-01

    Growing old is an inevitable process and aging graciously requires a healthy body where oral cavity occupies an important place. Geriatric dentistry is a specialized multidisciplinary branch of general dentistry designed to provide dental services to elderly patients. The rise in life expectancy has attributed to the substantial reduction in mortality which brought about by improved health care facilities, sanitation, environmental and public health reforms coupled with better hygiene and living conditions. The goal of geriatric treatment is to achieve optimal oral health, thus enhancing overall health. This begins with a concerted effort between the patient and the healthcare and dental teams. When medical problems exist, the physician and other involved healthcare professionals should be consulted, as these diseases can affect the safety and efficacy of various dental treatments. Thus a unified approach should be followed to assist geriatric patients to maintain optimal oral health and a high quality of life. Here in, this article we have reviewed the categories geriatric patients are divided to, various aging theories, changes occurring in various systems with their effects on system along with the various dental effects and age changes in them and treatment needs and strategies' concerning the elderly population. PMID:25654057

  7. Developing and Using Interdisciplinary Case Studies in Teaching Geriatrics to Practicing Health Care Professionals.

    ERIC Educational Resources Information Center

    Owens, Norma J.; Padula, Cynthia A.; Hume, Anne L.

    2002-01-01

    Interdisciplinary clinical case studies in geriatrics were developed using active and problem-based learning approaches that simulate clinical environments. Feedback from their use in continuing education indicated that facilitators need interdisciplinary group skills, well-written discussion questions enhanced learning, and the presence of all…

  8. Dependency in the Institutional Setting: A Behavioral Training Program for Geriatric Staff.

    ERIC Educational Resources Information Center

    Sperbeck, David J.; Whitbourne, Susan Krauss

    1981-01-01

    Examined the effects of a training program for geriatric staff designed to reduce the functional dependency of targeted health-related facility residents. Results indicate dependency was reduced and independence increased by training staff in the principles of behavior analysis focusing on cognitive and attitudinal restructuring. (Author/RC)

  9. The Impact of VA's Geriatric Research, Education and Clinical Centers on Academic Affiliates

    ERIC Educational Resources Information Center

    Bragg, Elizabeth J.; Meganathan, Karthikeyan; Shay, Kenneth; Gilman, Stuart C.; Zeiss, Robert A.; Hettler, Debbie L.

    2011-01-01

    The education mission of the Department of Veterans Affairs (VA) is to train health professionals to benefit VA and the United States. One approach for achieving that mission, along with VA's research and clinical missions, was the establishment of Geriatric Research, Education and Clinical Centers (GRECCs) in 1975. These were developed at VA…

  10. Using a Geriatric Mentoring Narrative Program to Improve Medical Student Attitudes towards the Elderly

    ERIC Educational Resources Information Center

    Duke, Pamela; Cohen, Diane; Novack, Dennis

    2009-01-01

    This study examined first-year medical student attitudes concerning the elderly before and after instituting a geriatric mentoring program. The program began and ended with a survey designed to assess students' attitudes toward the elderly. During the mentoring program, students visited the same senior for four visits throughout the academic year.…

  11. The Impact of Curricular Changes on the Geriatrics Knowledge, Attitudes and Skills of Medical Students

    ERIC Educational Resources Information Center

    Nagoshi, Michael H.; Tanabe, Marianne K. G.; Sakai, Damon H.; Masaki, Kamal H.; Kasuya, Richard T.; Blanchette, Patricia L.

    2008-01-01

    We redesigned our medical school's Problem-Based Learning (PBL) curriculum to include a substantial increase in required geriatrics content. Innovations included new PBL health care problems and standardized patients (SPs) throughout the first three years and a new required four-week, fourth-year rotation. We used data from the AAMC Medical School…

  12. Geriatric Index of Comorbidity: validation and comparison with other measures of comorbidity

    Microsoft Academic Search

    RENZO ROZZINI; B. FRISONI; L UIGI FERRUCCI; P IERA BARBISONI; T ONI SABATINI; PIERA RANIERI; J ACK M. GURALNIK; M ARCO TRABUCCHI

    2002-01-01

    Background: the debate about measures of chronic comorbidity in the elderly is mainly due to the lack of consensus on pathogenetic models. Objective: the aim of the present study was to compare the concurrent validity of a number of measures of chronic comorbidity assuming different pathogenic models, versus disability in elderly patients. Setting: the Geriatric Evaluation and Rehabilitation Unit for

  13. The Short Form of the Geriatric Depression Scale: A Comparison With the 30Item Form

    Microsoft Academic Search

    William J. Burke; William H. Roccaforte; Steven P. Wengel

    1991-01-01

    The Geriatric Depression Scale (GDS) exists in both short and long forms. The original 30-item form of the GDS has been shown to be an effective screening test for depression in a variety of settings. However, its utility in patients with demen tia of the Alzheimer type (DAT) is questionable. The short, 15-item version of the GDS was developed primarily

  14. Simulating Geriatric Home Safety Assessments in a Three-Dimensional Virtual World

    ERIC Educational Resources Information Center

    Andrade, Allen D.; Cifuentes, Pedro; Mintzer, Michael J.; Roos, Bernard A.; Anam, Ramanakumar; Ruiz, Jorge G.

    2012-01-01

    Virtual worlds could offer inexpensive and safe three-dimensional environments in which medical trainees can learn to identify home safety hazards. Our aim was to evaluate the feasibility, usability, and acceptability of virtual worlds for geriatric home safety assessments and to correlate performance efficiency in hazard identification with…

  15. The Sensitivity of the Geriatric Oral Health Assessment Index to Dental Care.

    ERIC Educational Resources Information Center

    Dolan, Teresa A.

    1997-01-01

    A 24-month study of 96 patients in a community-based oral health promotion project found the Geriatric Oral Health Assessment Index (GOHAI), a self-report measure of oral health, to be sensitive to provision of dental care. Some further development of measures is needed. Potential applications of this and similar self-report measures in dental…

  16. Filipino Nursing Students' Behavioral Intentions toward Geriatric Care: A Structural Equation Model (SEM)

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Jimenez, Benito Christian B.; Jocson, Kathlyn P.; Junio, Aileen R.; Junio, Drazen E.; Jurado, Jasper Benjamin N.; Justiniano, Angela Bianca F.

    2013-01-01

    Anchored on the key constucts of Ajzen's Theory of Planned Behavior (1985), this paper seeks to test a model that explores the influence of knowledge, attitude, and caring behavior on nursing students' behavioral intention toward geriatric care. A five-part survey-questionnaire was administered to 839 third and fourth year nursing students from a…

  17. Time and motion study for pharmacists' activities in a geriatric hospital

    Microsoft Academic Search

    Francesca Wirth; Lilian M. Azzopardi; Marise Gauci; Maurice Zarb Adami; Anthony Serracino-Inglott

    2009-01-01

    Objectives To identify and quantify activities undertaken by pharmacists in a geriatric hospital. Methods A data-collection form was developed, validated and tested for applicability and practicality. Pharmacist activities were organised into three categories: Clinical, Administration and Others. Clinical activities incorporated patient discharge, patient admission, checking the ward controlled-drugs record book, emergency trolley and patient medication trolley, prescription monitoring, ward round,

  18. Implementation of discharge management for geriatric patients at risk of readmission or institutionalization

    Microsoft Academic Search

    ELS STEEMAN; PHILIP MOONS; KOEN MILISEN; NELE DE BAL; SABINA DE GEEST; CÉCILE DE FROIDMONT; VÉRONIQUE TELLIER; CHRISTIANE GOSSET; IVO ABRAHAM

    2006-01-01

    Objective. To evaluate whether implementation of discharge management by trained social workers or nurses reduces hospital readmissions and institutionalizations of geriatric patients in a real-world setting. Design. Quasi-experimental design. Setting. Six general hospitals in Belgium. Participants. A representative sample of 824 patients, 355 of whom were assigned to the experimental group receiving compre- hensive discharge management and 469 to the

  19. Burden and Correlates of Geriatric Depression in the Uyghur Elderly Population, Observation from Xinjiang, China

    PubMed Central

    Lu, Chen; Tang, Weiming; Mahapatra, Tanmay; Wang, Yu; Wang, Xihua; Ma, Ying; Ben, Yanli; Cao, Xiaolin; Mahapatra, Sanchita; Ling, Min; Gou, Anshuan; Wang, Yanmei; Xiao, Jiangqin; Hou, Ming; Wang, Xiuli; Lin, Bo; Chen, Ruoling; Wang, Faxing; Hu, Zhi

    2014-01-01

    Background With the gradual aging of the population, geriatric depression has become a major public health issue in China owing to its overall upward trend and associated negative socio-economic impact. Dearth of information regarding the burden and correlates of geriatric depression among Uyghur minority population in Xinjiang Autonomous Region, called for a comprehensive survey involving representative sample for designing efficient targeted intervention to control this disabling disease. Methods A cross-sectional study was conducted among 1329 consenting Uyghur elderly in 2011 in six randomly selected communities/villages in Xinjiang. Information about socio-demographics, behavior, negative life-events, satisfaction regarding income/quality of life and other chronic diseases were collected while assessment of geriatric depression was done using Geriatric Mental State Schedule (GMS). Results Among these participants, majority were currently married, had attended elementary school or less, had an average annual family income of less than 3000 Yuan/person, had strong religious beliefs while 10.61% (2.77% in urban and 23.60% in rural area) had geriatric depression (5.91% among male and 14.58% among females). 61.83% were suffering from other chronic diseases, 96.16% could take care of themselves and 39.28% had experienced negative events during last two years. Religious belief (AOR?=?3.92, 95% CI 1.18–13.03), satisfaction regarding quality of life (AOR?=?0.53, 95% CI 0.37–0.84) and income (AOR?=?0.75, 95% CI 0.35–1.60), suffering from more chronic diseases (AOR?=?1.70, 95% CI 1.42–2.04), experiencing three or more negative events (AOR?=?1.72, 95% CI 0.92–3.22) and lack of ability to take self-care (AOR?=?2.20, 95% CI 1.09–4.48) were all associated with having geriatric depression with or without adjustment for gender, education and occupation. Conclusion High prevalence of geriatric depression among Uyghur elderly in Xinjiang seemed to call for urgent interventions, specifically targeting rural residents, who experienced more negative life-events, were suffering from chronic diseases and were dissatisfied with their income and quality of life. PMID:25437860

  20. Geriatric-focused educational offerings in the Department of Veterans Affairs from 1999 to 2009.

    PubMed

    Thielke, Stephen; Tumosa, Nina; Lindenfeld, Rivkah; Shay, Kenneth

    2011-01-01

    The scope of geriatrics-related educational offerings in large health care systems, in either the target audiences or topics covered, has not previously been analyzed or reported in the professional literature. The authors reviewed the geriatrics-related educational sessions that were provided between 1999 and 2009 by the Geriatrics Research, Education, and Clinical Centers (GRECCs) and the Employee Education System (EES) of the United States' largest integrated health care system, the Veterans Health Administration (VHA). Using records of attendance and content at local training events and regional and national conferences, the authors estimated the number of attendees in different health disciplines and the number and types of lectures. During the past 11 years, GRECCs and EES provided geriatric-related educational sessions to about one third of a million attendees, most of them nurses and physicians, in about 15,000 lectures. About three-fourths of the educational events occurred through local, rather than regional or national, events. Lectures covered a wide variety of topics, with a particular emphasis on dementia and other mental health topics. A comparison of the number of potential learners in VHA with the number of geriatric-related educational presentations over this time period yields an average of one offering per VHA provider every 3 years; most providers likely never received any. Since 1999 the GRECCs have been the dominant source for geriatrics-related education for VHA health professionals, but given that about one half of VHA patients are older than age 65, there is still a large unmet need to provide geriatric education to VHA providers. Examination of the GRECC resources that have been put to use in the past to develop and deliver the face-to-face education experiences described sheds light on the magnitude of resources that might be required to address remaining unmet need in the future, and supports the prediction that there will need to be increasing reliance on distance learning and other alternatives to face-to-face educational modalities. PMID:21347930

  1. Medication Errors Among Geriatrics at the Outpatient Pharmacy in a Teaching Hospital in Kelantan

    PubMed Central

    Abdullah, Dellemin Che; Ibrahim, Noor Shufiza; Ibrahim, Mohamed Izham Mohamed

    2004-01-01

    The main aim of this study was to determine the medication errors among geriatrics at the outpatient pharmacy in a teaching hospital in Kelantan and the strategies to minimize the prevalence. A retrospective study was conducted that involved screening of prescription for a one-month period (March 2001). Only 15.35% (1601 prescription) of a total 10,429 prescriptions were for geriatrics. The prescriptions that were found to have medication errors was 403. Therefore, the prevalence of medication errors per day was approximately 20 cases. Generally, the errors between both genders were found to be comparable and to be the highest for Malays and at the age of 60–64 years old. Administrative errors was recorded to be the highest which included patient’s particulars and validity of the prescriptions (70.22%) and drugs that available in HUSM (16.13%). Whereas the total of prescribing errors were low. Under prescribing errors were pharmaceutical error (0.99%) and clinical error (8.68%). Sixteen cases or 3.98% had more than 1 error. The highest prevalence went to geriatrics who received more than nine drugs (32.16%), geriatrics with more than 3 clinical diagnosis (10.06%), geriatrics who visited specialist clinics (37.52%) and treated by the specialists (31.07%). The estimated cost for the 403 medication errors in March was RM9,327 or RM301 per day that included the cost of drugs and humanistic cost. The projected cost of medication errors per year was RM 111,924. In conclusion, it is very clear that the role of pharmacist is very great in preventing and minimizing the medication errors beside the needs of correct prescription writing and other strategies by all of the heath care components. PMID:22973127

  2. [Ambulatory geriatric rehabilitation--concepts, chances and responsibilities of participating physicians].

    PubMed

    Stamm, T; Rittgerodt, K; Gehrke, A

    1995-12-01

    The third stage of the bill of the health structure (GSG) still focuses on the tremendous increase of costs in hospitals. Hospitals are accused that the care of the older patients involves too much money and staff. Experts complain that geriatric-rehabilitative thinking and acting does hardly influence the daily work on the wards. Competent geriatric rehabilitation should diminish or prevent the need for nursing, should support the patients ability for self-sufficiency, and decrease hospitalization time. Since the expenses for the hospital care of older patients have increased during the last couple of years and show the greatest dynamic of increase together with the supply of aids, health politicians and health economists, physicians, health insurances, and social insurances set more and more medical and economic hope on the geriatric rehabilitation. Especially models of out of hospital programs in connection with panel doctors are discussed to relieve the hospitals and are favoured by legal institutions and health politicians. Despite the documented success of geriatric rehabilitation, it is surprising the only a few areas realize differentiated out of hospital concepts. This article summarizes the most important models of out of hospital geriatric rehabilitation as they are tested in different areas in Germany. Advantages and disadvantages are discussed and the demands of the participating physicians are demonstrated. The goal of this paper is to describe the medical role in these models to win more physicians for this task. The urgently necessary development of a country-wide out of hospital rehabilitation, introduces new important medical fields of activity. PMID:8850116

  3. Prevalence and Risk Factors of Depression in Geriatric Patients with Dermatological Diseases

    PubMed Central

    Kim, Eun Kyung; Kim, Hyung Ok; Park, Young Min; Park, Chul Jong; Yu, Dong Su

    2013-01-01

    Background Although rarely life threatening, dermatological diseases may have a considerable influence on a patient's quality of life and psychological well-being. As with morbidity and mental distress from other chronic diseases, a skin disorder can be the one of the main causes of depression in the geriatric population. Objective To determine the prevalence of depression in elderly patients with dermatological disease in Korea and to identify factors associated with depression. Methods Patients over the age of 60 years with dermatologic diseases were solicited for a questionnaire survey. The Geriatric Depression Scale (GDS) was used to obtain a patient-based measurement of depression. Additionally, demographic information and medical history were collected. Results The questionnaire was completed by 313 patients (39.94% men, mean age 69.04 years, mean disease duration 3.23 years). Dermatological disease overall had a significant effect on patients' depression (?2=177.13, p<0.0001), with a mean GDS score of 12.35 (out of 30). The patients who had a GDS score greater than 10 was 62.3% which indicated increased prevalence of mild to severe depression when compared to the general population among whom only 22.22% percent have GDS score greater than 10. In the univariate analysis, physical health, education level, and the presence of concurrent diseases were risk factors for geriatric depression. However, we did not find any demographic or disease related variables that were independent predictors of depression. Conclusion Geriatric patients with dermatological disease experience an increase burden of depression. Thus, it is important for clinicians to evaluate geriatric patients with dermatologic diseases for depression. PMID:24003268

  4. Complementary and alternative medicine in US medical schools

    PubMed Central

    Cowen, Virginia S; Cyr, Vicki

    2015-01-01

    An analysis of complementary and alternative medicine (CAM) in US medical school curriculum was undertaken. Websites for 130 US medical schools were systematically analyzed for course listings and content. Half of the schools (50.8%) offered at least one CAM course or clerkship. A total of 127 different course listings were identified, embracing a range of topics and methods of instruction. The most frequently listed topics were traditional medicine, acupuncture, spirituality, and herbs, along with the general topic of CAM. Nearly 25.0% of the courses referenced personal growth or self-care through CAM practices, while only 11.0% referenced inter-professional education activities involving interaction with CAM providers. The most frequently reported instructional methods were lectures, readings, and observation of, or receiving a CAM treatment. The findings of this analysis indicated fewer medical schools offered instruction in CAM than previously reported and a wide range of approaches to the topic across the schools where CAM is taught. PMID:25709517

  5. Faculty of Medicine Graduate School of Medicine

    E-print Network

    Miyashita, Yasushi

    2007--2008 Faculty of Medicine Graduate School of Medicine PROSPECTUS The University of Tokyo #12;#12;Welcome to Faculty of Medicine, Graduate School of Medicine The University of Tokyo Takao Shimizu Dean, Faculty of Medicine, Graduate School of Medicine The University of Tokyo The Faculty of Medicine

  6. Aerospace Medicine

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.

    2006-01-01

    This abstract describes the content of a presentation for ground rounds at Mt. Sinai School of Medicine. The presentation contains three sections. The first describes the history of aerospace medicine beginning with early flights with animals. The second section of the presentation describes current programs and planning for future missions. The third section describes the medical challenges of exploration missions.

  7. Vulnerable Medicine

    ERIC Educational Resources Information Center

    Bochner, Arthur P.

    2009-01-01

    In "Narrative Medicine: Honoring the Stories of Illness," Rita Charon paints an original and humane portrait of what it can mean to be a doctor, to live a life immersed in sickness and dedicated to wellness. Charon drops the veil, inviting readers to look at the secret, subjective, emotional face of medicine, a zone of self-censored feelings and…

  8. Cough Medicines

    NSDL National Science Digital Library

    Science Update

    2004-08-16

    A recent report in the journal Pediatrics questioned the effectiveness of over-the-counter children's cough medicines. In this Science Update, you'll hear more about the study, and why some medicines may have escaped this sort of rigorous testing.

  9. Behavioral Medicine.

    ERIC Educational Resources Information Center

    Garfield, Sol L., Ed.

    1982-01-01

    Contains 18 articles discussing the uses of behavioral medicine in such areas as obesity, smoking, hypertension, and headache. Reviews include discussions of behavioral medicine and insomnia, chronic pain, asthma, peripheral vascular disease, and coronary-prone behavior. Newly emerging topics include gastrointestinal disorders, arthritis,…

  10. Randomised active programs on healthcare workers’ flu vaccination in geriatric health care settings in France: The vesta study

    Microsoft Academic Search

    M. Rothan-Tondeur; Y. Filali-Zegzouti; J.-L. Golmard; B. De Wazieres; F. Piette; F. Carrat; B. Lejeune; Gaëtan Gavazzi

    Background  Because of a lack of efficacy of influenza vaccination in elderly population, there are still numerous outbreaks in geriatric\\u000a health care settings. The health care workers (HCW) flu vaccination is known to get herd immunity and decrease the impact\\u000a of influenza in elderly population living in geriatric health care settings. However, the rates of vaccinated HCWs are still\\u000a low in

  11. Significant Reduction of Nosocomial Pneumonia after Introduction of Disinfection of Upper Airways Using PovidoneIodine in Geriatric Wards

    Microsoft Academic Search

    Hironori Masaki; Tsuyoshi Nagatake; Norichika Asoh; Hiroyuki Yoshimine; Kiwao Watanabe; Hiroshi Watanabe; Kazunori Oishi; Naoto Rikitomi; Keizo Matsumoto

    2006-01-01

    We investigated the efficacy of disinfection of the upper airway using povidone-iodine against nosocomial pneumonia in geriatric wards. Cases of nosocomial pneumonia were retrospectively analyzed between January 1991 and March 1995 in geriatric wards (190 beds). Moreover, the relationship concerning methicillin-resistant Staphylococcus aureus (MRSA) isolates between patient and environment was investigated using pulsed-field gel electrophoresis (PFGE) with the SmaI restriction

  12. COLLEGE OF MEDICINE & VETERINARY MEDICINE MEDICAL ELECTIVES

    E-print Network

    Maizels, Rick

    COLLEGE OF MEDICINE & VETERINARY MEDICINE MEDICAL ELECTIVES 1. INITIAL APPLICATION All applications for elective attachments within for General Medicine, General Surgery, Paediatrics and Emergency Medicine should give 12­24 months

  13. Medicines management.

    PubMed

    Pegram, Anne; Bloomfield, Jacqueline

    2015-04-15

    All newly registered graduate nurses are required to have the appropriate knowledge and understanding to perform the skills required for patient care, specifically the competencies identified in the Nursing and Midwifery Council's essential skills clusters. This article focuses on the fifth essential skills cluster - medicines management. Nursing students should work to attain the knowledge and skills required for effective medicines management throughout their pre-registration education. The roles and responsibilities of the newly registered graduate nurse in the area of medicines management are discussed in this the final article of the essential skills cluster series. PMID:25872850

  14. Effectiveness of geriatric rehabilitative care after fractures of the proximal femur in elderly women: a randomised clinical trial.

    PubMed Central

    Kennie, D. C.; Reid, J.; Richardson, I. R.; Kiamari, A. A.; Kelt, C.

    1988-01-01

    OBJECTIVE--To compare postoperative collaborative care between orthopaedic surgeons and physicians in geriatric medicine with routine orthopaedic care in elderly women with proximal femoral fracture. DESIGN--Exclusion of patients dying before fit enough to enter trial, those with pathological fractures, those likely to be discharged within seven days of entering the trial, and those remaining unfit for transfer to a peripheral hospital. Remainder allocated to two groups: treatment group and control group. SETTING--District hospital acute admission ward and rehabilitation ward. PATIENTS--144 sequentially admitted elderly women with proximal fracture of the femur; 36 excluded on above criteria and remainder entered into trial. INTERVENTION--Both treatment and control groups (n = 54 in each) received physiotherapy and other services. The treatment group also received thrice weekly supervision by a geriatrician. END POINTS--Physical independence, residence after discharge, and length of hospital stay. MEASUREMENTS AND MAIN RESULTS--At discharge significantly more patients in treatment group were independent in terms of activities of daily living than controls (41 v 25) and their median stay was 24 days (range 8-197) compared with 41 (9-365) (95% confidence intervals for difference 2 to 25). Significantly fewer treatment patients were discharged to institutional care (10% v 32%; 95% confidence interval for difference 6% to 37%) and more to their own homes (63% v 38%; 95% confidence interval for difference 6% to 44%). These beneficial effects were consistent across a range of ages and mental state. CONCLUSIONS--Both hospital and patient benefited when postoperative rehabilitation was provided in a setting specialising in such care for elderly patients with trauma. PMID:3143436

  15. Faculty of Medicine Graduate School of Medicine

    E-print Network

    Miyashita, Yasushi

    2005--2006 Faculty of Medicine Graduate School of Medicine PROSPECTUS The University of Tokyo #12;#12;Welcome to Faculty of Medicine, Graduate School of Medicine The University of Tokyo Nobutaka Hirokawa Dean, Faculty of Medicine, Graduate School of Medicine The University of Tokyo The University of Tokyo Graduate

  16. SCHOOL OF MEDICINE School of Medicine 127

    E-print Network

    Ferrara, Katherine W.

    SCHOOL OF MEDICINE #12;School of Medicine 127 SCHOOL OF MEDICINE School of Medicine http://www.ucdmc.ucdavis.edu/medschool/ The Doctor of Medicine degree requires the satisfactory comple- tion of a four-year course of study composed Center and in nearby affiliated hospitals. PREPARING FOR THE STUDY OF MEDICINE When you apply

  17. Management of diabetes mellitus type-2 in the geriatric population: Current perspectives

    PubMed Central

    Bajwa, Sukhminder Jit Singh; Sehgal, Vishal; Kalra, Sanjay; Baruah, Manash Pratim

    2014-01-01

    The prevalence of diabetes mellitus (DM) has increased exponentially throughout the world and there is rapid increase in elderly diabetics. DM is associated with increased mortality and considerable morbidity including stroke, heart disease, and diminished quality of life in the elderly. However, the unique features of geriatric diabetes have not been given due a prominence in medical literature. Hypoglycemia remains the biggest complicating factor and needs to be avoided in the elderly. Most people in the geriatric age group have some degree of renal insufficiency and medications need to be adjusted wisely with changing renal profile. Because safer and more effective pharmacological therapy is available, an individual approach to DM in the elderly is essential. PMID:25035634

  18. Tools for decision-making in older cancer patients. Role of the comprehensive geriatric assessment.

    PubMed

    Molina-Garrido, M J; Guillen-Ponce, C; Castellano, C Sanchez; Errasquin, B Montero; Mora-Rufete, A; Cruz-Jentoft, A J

    2014-06-01

    Approximately 60% of cancer incidence and 70% of cancer mortality occurs in individuals older than 65 years. The optimal approach to cancer therapy in older adults is often unclear. Historically, advanced age has been an exclusion criterion in clinical cancer trials, and older adults have been consistently underrepresented. As a result, there is a lack of information about treatment efficacy and tolerability in this population. Comprehensive Geriatric Assessment (CGA) is one of the most useful tools for the oncologist to make decisions related to older patients diagnosed with cancer. This tool has proved to be very useful to detect many deficits, tolerance to chemotherapy and survival in such patients. In this review, we analyze the role of CGA in decision making in geriatric oncology. PMID:23438845

  19. Management of diabetes mellitus type-2 in the geriatric population: Current perspectives.

    PubMed

    Bajwa, Sukhminder Jit Singh; Sehgal, Vishal; Kalra, Sanjay; Baruah, Manash Pratim

    2014-07-01

    The prevalence of diabetes mellitus (DM) has increased exponentially throughout the world and there is rapid increase in elderly diabetics. DM is associated with increased mortality and considerable morbidity including stroke, heart disease, and diminished quality of life in the elderly. However, the unique features of geriatric diabetes have not been given due a prominence in medical literature. Hypoglycemia remains the biggest complicating factor and needs to be avoided in the elderly. Most people in the geriatric age group have some degree of renal insufficiency and medications need to be adjusted wisely with changing renal profile. Because safer and more effective pharmacological therapy is available, an individual approach to DM in the elderly is essential. PMID:25035634

  20. Medicinal Herbman

    E-print Network

    Hacker, Randi

    2010-07-21

    Broadcast Transcript: Japanese gardens are admired for their understated elegance, their meditation/movement fusion, their precise placement of essential elements such as water and stone. In this last way at least, Medicinal Herbman is typically...

  1. Progressive medicine.

    PubMed

    Martin, W John

    2005-06-01

    The term Progressive Medicine combines the evidence-based foundation of orthodox medicine with the growing understanding that life comprises much more than a series of biochemical reactions. Recent studies have identified an alternative cellular energy (ACE) pathway as an auxiliary defense mechanism against various diseases, including both conventional and stealth-adapted virus infections. This pathway can be activated through non-pharmaceutical methods that work through biophysical rather than biochemical reactions. Validation of these methods requires well-documented and successful clinical outcome studies. The methods also need to be fully disclosed to regulatory agencies such as the Food and Drug Administration (FDA). These requirements have been largely ignored by many practitioners of complimentary and alternative medicine. They are essential elements of Progressive Medicine. PMID:15924875

  2. Personalized Medicines

    MedlinePLUS Videos and Cool Tools

    ... our genes, our heredity, influences our responses to drugs. When different people take medications, they respond differently. ... the reasons people process medicines differently. Rochelle Long: Drugs act differently in people for a variety of ...

  3. GERIATRICS IN PRIMARY CARE LITERATURE CATEGORIES [To search by category, insert numeric category label into `label' field of EndNote's dialog box.

    E-print Network

    Ford, James

    . Assessment and Management Tools for Select Geriatric Syndromes (cognitive impairment, gait and balance, diagnosis and management of chronic pain, use and types of community resources) 7. Addressing Difficult

  4. French healthcare workers in geriatric healthcare settings staunchly opposed to influenza vaccination: The VESTA study

    Microsoft Academic Search

    Gaëtan Gavazzi; Younčs Filali-Zegzouti; Anne-Céline Guyon; Benoît De Wazieres; Benoist Lejeune; Jean-Louis Golmard; Joël Belmin; François Piette; Monique Rothan-Tondeur

    2011-01-01

    The observational diagnosis phase of the VESTA study was aimed to determine the composite profiles of vaccinated\\/non-vaccinated HCWs by analyzing reasons to accept\\/decline influenza vaccination. Between June and September 2005, 2485 HCWs (female: 82.9%; nursing auxiliaries: 42.1%; vaccination coverage: 23.4%) from 53 French geriatric HCSs were included in the study. Cluster analysis determined 3 composite profiles: HCWs for whom information

  5. YouTube and intergenerational communication: the case of Geriatric1927

    Microsoft Academic Search

    Dave Harley; Geraldine Fitzpatrick

    2009-01-01

    This paper presents a case study of a 79 year old video blogger called ‘Geriatric1927’, and his use of the video sharing website,\\u000a YouTube. Analysis of his first eight video blogs, and the subsequent text responses, reveals opportunities of this medium\\u000a for intergenerational contact, reminiscence, reciprocal learning and co-creation of content, suggesting that older people\\u000a can be highly motivated to use

  6. [The speech therapist in geriatrics: caregiver, technician-researcher, or both?].

    PubMed

    Orellana, Blandine

    2015-01-01

    Geriatric care mostly consists not in curingthe patient, but supportingthem to the end of their life, giving meaning to care procedures and actions through speech, touch or look and maintaining a connection.The helping relationship is omnipresent and the role of the speech therapist is therefore essential in helping to maintain or re-establish elderly patients' abilityto communicate. However, todaythis role is struggling to define itself between that of the technician-researcher and that of caregiver. PMID:25966525

  7. Norwalk Viral Gastroenteritis Outbreak Affecting Patients and Staff on a Geriatric Psychiatry Unit

    Microsoft Academic Search

    M. Sanikop; K. Agnes; M-C Roghmann

    2004-01-01

    BACKGROUND: Norwalk-like viral (NLV) gastroenteritis is a frequent cause of outbreaks in extended-care facilities (ECFs); however, outbreaks in geriatric psychiatry units (GPUs) present unique containment challenges and are disruptive to patient treatment plans that include group and social activities. GPU patients have difficulty in adhering to restrictions on movement and good personal hygiene practices due to their illnesses. The 40-bed

  8. [Optimization of geriatric help for urban and rural residents of the Ulianovsk region].

    PubMed

    Kabakova, T A; Katikova, O Iu; Balandin, A N; Kamaev, I A; Gorbunov, V I

    2003-01-01

    The problem of ageing of the population presupposes the necessity of essential in medico-social services activity and the creations of some uniform coordinated help system for the slderly within the framwork of public health sevices anf social protection. On the basis of the carried out analysis of demographic, social, economic and medical parameters we have developed the plan of geriatric service in Ulyanovsk area. Ulyanovsk Regional Clinical Hospital of War Veterans took the leading part in this work. For the period of 1993-1997 there have been created three regional geriatric centres with branches of day-time departments for 75 places each as structural division of Ukyanovsk regional clinic hospital. In 1999 on the basis of local hospitals in rural areas we opened two interdistrict geriatric centres for 50 and 40 places as divisions of URCHWV. In their structure there are round-the-clock and day-time places, rooms of nurse care, rooms and services for rendering medical, pyschological and social rehabilitation. One-place cost in 2001 has made 210 roubles, that is 1.5-2 times lower, than in city hospitals. As a result of the carried out treatment 88.3% of patients left the hospital with improvement, 9.6% of them--without changes and 1.7%--with deterioration. This form of specialized medical geriatric help to the person living in the countryside, which includes stationary help, stationary-substituted technologies, rooms of a nurse care, social and labour rehabilitation, proves its solvency and expediency in medical and pharma-economic aspects and may be recommended to introduction in practical public health services. PMID:12820534

  9. The pre-travel medical evaluation: the traveler with chronic illness and the geriatric traveler.

    PubMed Central

    Patterson, J. E.

    1992-01-01

    The pre-travel medical evaluation of elderly patients and patients with chronic illness requires special assessment and advice. Screening and special precautions are reviewed for traveling patients with respiratory disease, cardiac disease, sinusitis, diabetes mellitus, HIV infection, and other chronic medical conditions. Current guidelines for empiric therapy and prophylaxis of travelers' diarrhea are reviewed, with emphasis on concerns in geriatric or chronically ill travelers. Special considerations such as potential drug-drug interactions and insurance coverage are also discussed. PMID:1290273

  10. “Pedogeriatrics”: a pediatric nephrologist’s outlook on common challenges facing pediatric and geriatric nephrologists

    Microsoft Academic Search

    Jose Grünberg

    2010-01-01

    Dramatic demographic changes longevity and medical progress helped create a new population made up of the survivors of previously\\u000a fatal diseases. These trends pose new major social and economic challenges that should be accounted for in health policy making.\\u000a This paper discusses the similarities between the specialties of pediatrics and geriatrics, especially in the realm of patient\\u000a care. Children and

  11. Cardiorespiratory function, flexibility, and body composition among geriatric Tai Chi Chuan practitioners

    Microsoft Academic Search

    Ching Lan; Jin-Shin Lai; May-Kuen Wong; Mei-Li Yu

    1996-01-01

    Objective: To evaluate the health-related fitness of geriatric Tai Chi Chuan (TCC) practitioners.Design: Case-control study of a TCC group and a group of sedentary controls.Setting: Research project at a hospital-based exercise physiology laboratory.Participants: Seventy-six community-dwelling senior persons (mean age 69.3 ± 3.9yr), a TCC group that included 22 men and 19 women and a control group of sedentary subjects that

  12. Cognitive decline in late-life schizophrenia: a longitudinal study of geriatric chronically hospitalized patients

    Microsoft Academic Search

    Philip D Harvey; Jeremy M Silverman; Richard C Mohs; Michael Parrella; Leonard White; Peter Powchik; Michael Davidson; Kenneth L Davis

    1999-01-01

    Background: Geriatric schizophrenic patients with a chronic course of institutionalization manifest cognitive and functional impairments that implicate decline at some time point after the onset of illness. The rate of change in cognitive and functional status in these patients has not yet been identified with a longitudinal study.Methods: Three hundred and twenty-six schizophrenic patients entered a 30-month follow-up study with

  13. Malnutrition in Geriatric Patients: Diagnostic and Prognostic Significance of Nutritional Parameters

    Microsoft Academic Search

    Dorothee Volkert; Wolfgang Kruse; Peter Oster; Günter Schlierf

    1992-01-01

    Nutritional status was assessed in 300 geriatric patients aged 75 years or more using clinical, anthropometric, biochemical and immunologic methods. Relations between different assessment methods and their prognostic significance with regard to 18-month mortality were examined. For biochemical variables 10% (prealbumin, vitamin B6) to 37% (vitamins A and C) were below conventional limits. In 44% of the patients lymphocytes were

  14. Preoperative assessment of the older surgical patient: honing in on geriatric syndromes.

    PubMed

    Kim, Sunghye; Brooks, Amber K; Groban, Leanne

    2015-01-01

    Nearly 50% of Americans will have an operation after the age of 65 years. Traditional preoperative anesthesia consultations capture only some of the information needed to identify older patients (defined as ?65 years of age) undergoing elective surgery who are at increased risk for postoperative complications, prolonged hospital stays, and delayed or hampered functional recovery. As a catalyst to this review, we compared traditional risk scores (eg, cardiac-focused) to geriatric-specific risk measures from two older female patients seen in our preoperative clinic who were scheduled for elective, robotic-assisted hysterectomies. Despite having a lower cardiac risk index and Charlson comorbidity score, the younger of the two patients presented with more subtle negative geriatric-specific risk predictors - including intermediate or pre-frail status, borderline malnutrition, and reduced functional/mobility - which may have contributed to her 1-day-longer length of stay and need for readmission. Adequate screening of physiologic and cognitive reserves in older patients scheduled for surgery could identify at-risk, vulnerable elders and enable proactive perioperative management strategies (eg, strength, balance, and mobility prehabilitation) to reduce adverse postoperative outcomes and readmissions. Here, we describe our initial two cases and review the stress response to surgery and the impact of advanced age on this response as well as preoperative geriatric assessments, including frailty, nutrition, physical function, cognition, and mood state tests that may better predict postoperative outcomes in older adults. A brief overview of the literature on anesthetic techniques that may influence geriatric-related syndromes is also presented. PMID:25565783

  15. Integrative Medicine

    Microsoft Academic Search

    Joseph Mosquera

    Presently the expansive growth of Integrative medicine has been fueled in part by a public discontent with conventional medicine\\u000a and increasing consumer demand for medical advice on the subjects of lifestyle, nutrition, exercise, and natural therapies.\\u000a Patients want more emphasis on health, healing and prevention of chronic illness rather than just diagnosis and treatment.\\u000a Numerous peer-reviewed, published studies in the

  16. [Sport medicine].

    PubMed

    Epstein, Yoram

    2012-02-01

    It is only since the late 20th century that Sport and Exercise Medicine has emerged as a distinct entity in health care. In Israel, sports medicine is regulated by a State Law and a sport physician is certified after graduating a structured program. In the past, sports medicine was related to the diagnosis and treatment of injuries encountered by top athletes. In recent years, the scope of sport medicine has broadened to reflect the awareness of modern society of the dangers of physical inactivity. In this perspective the American College of Sport Medicine (ACSM) recently launched a program--"Exercise is Medicine", to promote physical activity in order to improve health and well-being and prevention of diseases through physical activity prescriptions. This program is from doctors and healthcare providers, adjusted to the patient or trainee. The sport physician does not replace a medical specialist, but having a thorough understanding about the etiology of a sport-related injury enables him to better focus on treatment and prevention. Therefore, Team Physicians in Elite Sport often play a role regarding not only the medical care of athletes, but also in the physiological monitoring of the athlete and correcting aberrations, to achieve peak physical performance. The broad spectrum of issues in sport and exercise medicine cannot be completely covered in one issue of the Journal. Therefore, the few reports that are presented to enhance interest and understanding in the broad spectrum of issues in sports and exercise medicine are only the tip of the iceberg. PMID:22741210

  17. Management of geriatric patient with epulis fissuratum using liquid nitrogen cryosurgery: a case report.

    PubMed

    Vyasarayani, Prasad; Madhumietha, A; Gundlapalle, Pratheeth

    2014-03-01

    The aim of this report is to present a case showing the treatment of Epulis fissuratum in relation to an ill fitting denture, in a debilitated geriatric patient with a novel technique using liquid nitrogen cryosurgery. Management of geriatric patients can be quite challenging due to the presence of various diseases. Epulis fissuratum associated with an ill fitting denture greatly hinders mastication and produces discomfort and pain to the patient. The liquid nitrogen cryosurgery can be used effectively in its management, due to its excellent haemorrhage control and postoperative healing. A 71-year-old male reported with Epulis fissuratum in the vestibular sulcus, which was associated with an ill- fitting denture. The patient was a known hypertensive and diabetic, presently on anti-coagulant therapy with previous history of myocardial infarction. Liquid nitrogen cryosurgery was used for the treatment of the lesion. During the procedure, nil haemorrhage was achieved and the postoperative healing was satisfactory. Liquid nitrogen cryosurgery hence can be used effectively in debilitated geriatric patients as it has the boon of achieving excellent haemostasis, good healing with minimal postoperative oedema and pain, maintaining an aseptic environment. This novel technique can be effectively used by dentists in the treatment of Epulis fissuratum besides it can also be used in treatment of other oral soft tissue pathologies achieving a plethora of benefits. PMID:24605008

  18. Working group recommendations: targeting criteria for geriatric evaluation and management research.

    PubMed

    Rubenstein, L Z; Goodwin, M; Hadley, E; Patten, S K; Rempusheski, V F; Reuben, D; Winograd, C H

    1991-09-01

    To maximize the cost effectiveness of geriatric evaluation and management (GEM) programs, criteria need to be established for selecting patients most likely to benefit. A working group was convened to define appropriate patient selection (targeting) criteria for each type of GEM program and to consider research questions for future targeting studies. The group outlined targeting criteria for the spectrum of GEM program types and locations. GEM program types included: inpatient GEM units; hospital geriatric consultation service; GEM programs in nursing homes; outpatient GEM programs for functionally impaired persons; and geriatric community outreach/screening programs for functionally independent elders. For each program type, the group outlined targeting criteria based on current literature and experience. Because research has not yet established the effectiveness of many of these patient targeting strategies, the group drafted a set of research questions, pertinent to targeting, that require attention: (1) For each identifiable population of elderly people, who are most likely to benefit from GEM? (2) How should these people best be identified/targeted? (3) What criteria should be used for targeting? (4) How and how often should population screening be performed to identify persons in need of GEM? PMID:1885876

  19. Treatment of colorectal cancer in older patients: International Society of Geriatric Oncology (SIOG) consensus recommendations 2013.

    PubMed

    Papamichael, D; Audisio, R A; Glimelius, B; de Gramont, A; Glynne-Jones, R; Haller, D; Köhne, C-H; Rostoft, S; Lemmens, V; Mitry, E; Rutten, H; Sargent, D; Sastre, J; Seymour, M; Starling, N; Van Cutsem, E; Aapro, M

    2015-03-01

    Colorectal cancer (CRC) is one of the most commonly diagnosed cancers in Europe and worldwide, with the peak incidence in patients >70 years of age. However, as the treatment algorithms for the treatment of patients with CRC become ever more complex, it is clear that a significant percentage of older CRC patients (>70 years) are being less than optimally treated. This document provides a summary of an International Society of Geriatric Oncology (SIOG) task force meeting convened in Paris in 2013 to update the existing expert recommendations for the treatment of older (geriatric) CRC patients published in 2009 and includes overviews of the recent data on epidemiology, geriatric assessment as it relates to surgery and oncology, and the ability of older CRC patients to tolerate surgery, adjuvant chemotherapy, treatment of their metastatic disease including palliative chemotherapy with and without the use of the biologics, and finally the use of adjuvant and palliative radiotherapy in the treatment of older rectal cancer patients. An overview of each area was presented by one of the task force experts and comments invited from other task force members. PMID:25015334

  20. [Good clinical practices in therapeutic trials in geriatrics especially in Alzheimer type senile dementia].

    PubMed

    Piette, F

    1991-01-01

    The rules of "Good clinical practices" 1987 and the law of December 20, 1988 concerning biomedical research give guidelines that are difficult to apply in Geriatrics. Pragmatic solutions have to be proposed if we want to avoid delay in clinical research especially in degenerative diseases and in the evaluation of therapeutics in old age. We can focus the problems on the chapter "Responsibilities of the investigator": 1) His professional qualification whereas gerontology in not yet considered as a specialty; 2) Obtention of informed consent in general, especially written informed consent and leaflet informations given to patients; 3) Constitution of staff according to low motivation of nurses to research and low methodological knowledge; investigators' disponibility considering low density of nurses and physicians in geriatric units. Among specific points of "Good clinical practices" for home trials we need a careful selection of general practitioners interested in both geriatrics and therapeutic trials. Finally obtaining pharmacokinetic data in elderly needs probably a clear distinction between two ways: classical pharmacokinetic studies with samples of old healthy paid volunteers and pharmacokinetic study of a population in therapeutic trials. PMID:2020932

  1. Striking Denervation of Neuromuscular Junctions without Lumbar Motoneuron Loss in Geriatric Mouse Muscle

    PubMed Central

    Chai, Ruth Jinfen; Vukovic, Jana; Dunlop, Sarah; Grounds, Miranda D.; Shavlakadze, Thea

    2011-01-01

    Reasons for the progressive age-related loss of skeletal muscle mass and function, namely sarcopenia, are complex. Few studies describe sarcopenia in mice, although this species is the mammalian model of choice for genetic intervention and development of pharmaceutical interventions for muscle degeneration. One factor, important to sarcopenia-associated neuromuscular change, is myofibre denervation. Here we describe the morphology of the neuromuscular compartment in young (3 month) compared to geriatric (29 month) old female C57Bl/6J mice. There was no significant difference in the size or number of motoneuron cell bodies at the lumbar level (L1–L5) of the spinal cord at 3 and 29 months. However, in geriatric mice, there was a striking increase (by ?2.5 fold) in the percentage of fully denervated neuromuscular junctions (NMJs) and associated deterioration of Schwann cells in fast extensor digitorum longus (EDL), but not in slow soleus muscles. There were also distinct changes in myofibre composition of lower limb muscles (tibialis anterior (TA) and soleus) with a shift at 29 months to a faster phenotype in fast TA muscle and to a slower phenotype in slow soleus muscle. Overall, we demonstrate complex changes at the NMJ and muscle levels in geriatric mice that occur despite the maintenance of motoneuron cell bodies in the spinal cord. The challenge is to identify which components of the neuromuscular system are primarily responsible for the marked changes within the NMJ and muscle, in order to selectively target future interventions to reduce sarcopenia. PMID:22164231

  2. 'I don't want to burden my family': handling communication challenges in geriatric oncology.

    PubMed

    Delgado-Guay, M O; De La Cruz, M G; Epner, D E

    2013-10-01

    Oncologists need excellent communication skills to effectively handle challenging conversations regarding prognosis, transition to palliative care, code status, and other sensitive topics. Foundational skills include: 1) posing open-ended, exploratory questions, 2) allowing for appropriate silence in the conversation, 3) listening actively, 4) recognizing emotions, 5) responding to emotions with empathy rather than biomedical information, and 6) speaking with clarity by avoiding technical jargon and offering small chunks of information. Conversations about sensitive topics can be particularly challenging with geriatric patients, who experience functional and sensory limitations. The risk-benefit ratio of diagnostic and therapeutic interventions tips precariously in older patients as many develop geriatric syndromes. Older cancer patients have the unique perspective of looking back on a long life and looking forward to impending death. Higher order skills can be very powerful in helping geriatric cancer patients find meaning and dignity at the end of life. These skills include exploring spirituality and coping strategies and engaging the patient in conversation and reflection about their legacy. PMID:24001760

  3. Factors Influencing RNs' Perceptions of Quality Geriatric Care in Rural Hospitals.

    PubMed

    Cline, Daniel D; Dickson, Victoria Vaughan; Kovner, Christine; Boltz, Marie; Kolanowski, Ann; Capezuti, Elizabeth

    2013-12-01

    The rapidly aging population and their frequent use of hospital services will create substantial quality challenges in the near future. Redesigning rural hospital work environments is the key to improving the quality of care for older adults. This study explored how the work environment influences registered nurses' (RNs') perceived quality of geriatric care in rural hospitals. We used an exploratory mixed-methods research design emphasizing the qualitative data (in-depth, semi-structured interviews). Quantitative data (questionnaire) measuring the RN work environment were also collected to augment qualitative data. Four themes emerged: (a) collegial RN relationships, (b) poor staffing/utilization, (c) technology benefits/challenges, and (d) RN-physician interactions, which were identified as key factors influencing the quality of geriatric care. We concluded that rural hospital work environments may not be optimized to facilitate the delivery of quality geriatric care. Targeted interventions are needed to improve overall quality of care for hospitalized older adults in rural settings. PMID:24319004

  4. Osteopathic Medicine: About Osteopathic Medicine

    MedlinePLUS

    ... Easy: Video Series for OGME Directors Single Accreditation System Webinar Series Professional Development Continuing Medical Education DO Jobs Online AOA Board Certification Practice Management Quality and Research International Osteopathic Medicine test3 test4 DO ...

  5. Bioenergetic medicine

    PubMed Central

    Swerdlow, Russell H

    2014-01-01

    Here we discuss a specific therapeutic strategy we call ‘bioenergetic medicine’. Bioenergetic medicine refers to the manipulation of bioenergetic fluxes to positively affect health. Bioenergetic medicine approaches rely heavily on the law of mass action, and impact systems that monitor and respond to the manipulated flux. Since classically defined energy metabolism pathways intersect and intertwine, targeting one flux also tends to change other fluxes, which complicates treatment design. Such indirect effects, fortunately, are to some extent predictable, and from a therapeutic perspective may also be desirable. Bioenergetic medicine-based interventions already exist for some diseases, and because bioenergetic medicine interventions are presently feasible, new approaches to treat certain conditions, including some neurodegenerative conditions and cancers, are beginning to transition from the laboratory to the clinic. Linked Articles This article is part of a themed issue on Mitochondrial Pharmacology: Energy, Injury & Beyond. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2014.171.issue-8 PMID:24004341

  6. Travel medicine

    PubMed Central

    Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

    2014-01-01

    Abstract Objective To define the practice of travel medicine, provide the basics of a comprehensive pretravel consultation for international travelers, and assist in identifying patients who might require referral to travel medicine professionals. Sources of information Guidelines and recommendations on travel medicine and travel-related illnesses by national and international travel health authorities were reviewed. MEDLINE and EMBASE searches for related literature were also performed. Main message Travel medicine is a highly dynamic specialty that focuses on pretravel preventive care. A comprehensive risk assessment for each individual traveler is essential in order to accurately evaluate traveler-, itinerary-, and destination-specific risks, and to advise on the most appropriate risk management interventions to promote health and prevent adverse health outcomes during travel. Vaccinations might also be required and should be personalized according to the individual traveler’s immunization history, travel itinerary, and the amount of time available before departure. Conclusion A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required. Those who advise travelers are encouraged to be aware of the extent of this responsibility and to refer all high-risk travelers to travel medicine professionals whenever possible. PMID:25500599

  7. Internal Medicine

    PubMed Central

    Bouland, Daniel L.; Doram, Keith

    1994-01-01

    The Council on Scientific Affairs of the California Medical Association presents the following inventory of items of progress in internal medicine. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome, and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, researchers, and scholars to stay abreast of these items of progress in internal medicine that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another. The items of progress listed below were selected by the Advisory Panel to the Section on Internal Medicine of the California Medical Association, and the summaries were prepared under its direction. PMID:8191758

  8. school of medicine school of medicine

    E-print Network

    Almor, Amit

    school of medicine #12;school of medicine Dr. Richard Hoppmann, Dean "The School of Medicine has, compassionate health care throughout the state and world." #12;the promise of medicine: to students, to society "Wherever the art of medicine is loved, there is also love of humanity." - Hippocrates It is a place where

  9. PROFESSIONALISM IN MEDICINE PROFESSIONALISM IN MEDICINE

    E-print Network

    PROFESSIONALISM IN MEDICINE Part I PROFESSIONALISM IN MEDICINE Part I LSU HEALTH SCIENCES CENTER DEPARTMENT OF MEDICINE Dayton W. Daberkow II, M.D. Associate Professor of Clinical Medicine Section of Comprehensive Medicine #12;ACGME General CompetenciesACGME General Competencies 1. Patient Care - compassionate

  10. PROFESSIONALISM IN MEDICINE PROFESSIONALISM IN MEDICINE

    E-print Network

    PROFESSIONALISM IN MEDICINE Part II PROFESSIONALISM IN MEDICINE Part II LSU HEALTH SCIENCES CENTER DEPARTMENT OF MEDICINE Dayton W. Daberkow II, M.D. Associate Professor of Clinical Medicine Section of Comprehensive Medicine #12;Challenges to the Elements of Professionalism Challenges to the Elements

  11. Microbial diversity and evidence of novel homoacetogens in the gut of both geriatric and adult giant pandas (Ailuropoda melanoleuca).

    PubMed

    Tun, Hein Min; Mauroo, Nathalie France; Yuen, Chan San; Ho, John Chi Wang; Wong, Mabel Ting; Leung, Frederick Chi-Ching

    2014-01-01

    Recent studies have described the bacterial community residing in the guts of giant pandas, together with the presence of lignocellulolytic enzymes. However, a more comprehensive understanding of the intestinal microbial composition and its functional capacity in giant pandas remains a major goal. Here, we conducted a comparison of bacterial, fungal and homoacetogenic microbial communities from fecal samples taken from two geriatric and two adult captive giant pandas. 16S rDNA amplicon pyrosequencing revealed that Firmicutes and Proteobacteria are the most abundant microbiota in both geriatric and adult giant pandas. However, members of phylum Actinobacteria found in adult giant pandas were absent in their geriatric counterparts. Similarly, ITS1 amplicon pyrosequencing identified developmental changes in the most abundant fungal classes from Sordariomycetes in adult pandas to Saccharomycetes in geriatric pandas. Geriatric pandas exhibited significantly higher abundance of a potential probiotic fungus (Candida tropicalis) as compared to adult pandas, indicating their importance in the normal digestive physiology of aged pandas. Our study also reported the presence of a lignocellulolytic white-rot fungus, Perenniporia medulla-panis, and the evidence of novel homoacetogens residing in the guts of giant pandas. PMID:24475017

  12. Depressive symptoms, cognitive impairment and functional impairment in a rural elderly population in India: a Hindi version of the geriatric depression scale (GDS?H)

    Microsoft Academic Search

    Mary Ganguli; Sanjay Dube; Janet M. Johnston; Rajesh Pandav; Vijay Chandra; Hiroko H. Dodge

    1999-01-01

    Objective. To measure depressive symptomatology in a largely illiterate elderly population in India, using a new Hindi version of the Geriatric Depression Scale (GDS-H), and to examine its distribution and associations with age, gender, literacy, cognitive impairment and functional impairment. Design. A Hindi version of the Geriatric Depression Scale was developed and administered to participants along with measures of demographic

  13. Medicinal Plants.

    ERIC Educational Resources Information Center

    Phillipson, J. David

    1997-01-01

    Highlights the demand for medicinal plants as pharmaceuticals and the demand for health care treatments worldwide and the issues that arise from this. Discusses new drugs from plants, anticancer drugs, antiviral drugs, antimalarial drugs, herbal remedies, quality, safety, efficacy, and conservation of plants. Contains 30 references. (JRH)

  14. Nuclear medicine

    SciTech Connect

    Wagner, H.N. Jr.

    1986-10-17

    In 1985 and 1986 nuclear medicine became more and more oriented toward in vov chemistry, chiefly as a result of advances in positron emission tomography (PET). The most important trend was the extension of PET technology into the care of patients with brain tumors, epilepsy, and heart disease. A second trend was the increasing use of single-photon emission computed tomography (SPECT).

  15. Medicine Handbook.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    A reference guide to laws, rules, and regulations that govern medical practice in New York State is presented. After an overview of professional regulation in the state, licensing requirements/procedures for medicine are described including education and postgraduate training requirements, state licensing examinations, and application…

  16. Medicine Handbook.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    New York State education law, rules, and regulations concerning the practice of medicine are presented, along with requirements and procedures for obtaining licensure and first registration as a physician. State statutory provisions cover: duration and registration of a license, practice and regulation of the profession, supervision by the Board…

  17. [Osteopathic medicine].

    PubMed

    Klein, P; Lepers, Y; Salem, W

    2011-09-01

    Osteopathy is originated in the 19th century in the United States. Andrew Taylor Still seek for an alternative medical system to the orthodox medicine largely empirical and advocating bloodletting, calomel, etc., all of which was resumed with terms like" heroic medicine". Osteopathy as other alternative medical practices (homeopathy, eclecticism, etc.) based on rational and metaphysical postulates as vitalism or the fact that man is a divinely ordained machine. Still's approach was essentially manual and based on manipulation of the joints. Today osteopaths challenge these dogmas and seek to agree their practice within scientific biomedical standards. Even if strong randomized clinical trials are lacking, several surveys report how osteopathy gained public notoriety. Several recent meta-analyses pinpoint the benefit of the spinal manipulative treatment and even if there is no evidence that such an approach is superior to other advocated therapies there is no evidence that these therapies are more effective than the first one. The major indications for such a treatment are cervical and low back pain, either chronic or acute. The quality of the relationship between the practitioner and patient together with the placebo effect are important components of a treatment effect. Osteopathic education is an important aspect and only higher education institutions, i.e. universities can achieve and maintain adequate standards. Materia medica and surgery represent the two major therapeutic mainstreams in medicine; osteopathy considered as manual medicine could be the third one. PMID:22034767

  18. Significant reduction of nosocomial pneumonia after introduction of disinfection of upper airways using povidone-iodine in geriatric wards.

    PubMed

    Masaki, Hironori; Nagatake, Tsuyoshi; Asoh, Norichika; Yoshimine, Hiroyuki; Watanabe, Kiwao; Watanabe, Hiroshi; Oishi, Kazunori; Rikitomi, Naoto; Matsumoto, Keizo

    2006-01-01

    We investigated the efficacy of disinfection of the upper airway using povidone-iodine against nosocomial pneumonia in geriatric wards. Cases of nosocomial pneumonia were retrospectively analyzed between January 1991 and March 1995 in geriatric wards (190 beds). Moreover, the relationship concerning methicillin-resistant Staphylococcus aureus (MRSA) isolates between patient and environment was investigated using pulsed-field gel electrophoresis (PFGE) with the SmaI restriction enzyme. The incidence of nosocomial pneumonia decreased significantly (p < 0.05). Major causative organisms of nosocomial pneumonia were MRSA and Pseudomonas aeruginosa, which significantly decreased. PFGE studies showed that the patterns of MRSA isolates show a strong association between patient and environment. Our study indicates that disinfection of the upper airways by povidone-iodine is very important in the prevention of nosocomial pneumonia in geriatric wards. PMID:16490984

  19. Managing Your Medicines

    MedlinePLUS

    Managing Your Medicines Updated:May 27,2015 If you have heart disease , medicine along with lifestyle changes may be part of ... Yourself • Tools & Resources Heart Insight Supplement: Know Your Medicines Keeping track of your medicines can be overwhelming. ...

  20. Buying & Using Medicine Safely

    MedlinePLUS

    ... Index to Drug-Specific Information Protecting Yourself Safe Disposal of Medicines Contact FDA Toll Free (855) 543- ... Medicine Driving When You Are Using Medicine Safe Disposal of Medicines Understanding Generic Drugs Facts about Generic ...

  1. Pregnancy and Medicines

    MedlinePLUS

    ... Our ePublications > Pregnancy and medicines fact sheet ePublications Pregnancy and medicines fact sheet Print this fact sheet ... and nurses find out about using medicines during pregnancy? Doctors and nurses get information from medicine labels ...

  2. Geriatric Conditions, Medication Use, and Risk of Adverse Drug Events in a Predominantly Male, Older Veteran Population

    PubMed Central

    Steinman, Michael A.; Lund, Brian C.; Miao, Yinghui; Boscardin, W. John; Kaboli, Peter J.

    2011-01-01

    Background To determine whether geriatric conditions and functional impairment are independent risk factors for adverse drug events (ADEs). Design Prospective cohort study. Setting and Participants 377 veterans from a Veterans Affairs medical center age 65 years or older and taking 5 or more medications. Measurements Geriatric conditions and functional status were assessed using patient interviews and structured assessments at study baseline. ADEs were elicited during patient interviews at 3 and 12 months after study enrollment using validated methods. Results The strong majority (97%) of participants were male, mean age was 74 +/? 5 years, and 123 (33%) had one or more dependencies in instrumental activities of daily living (IADLs). Over the one-year study period, 126 patients (33%) developed 167 ADEs. On multivariable analysis, risk of ADEs was not associated with any of the geriatric conditions we had sufficient power to evaluate, including IADL function, cognitive impairment, depression, visual impairment, incontinence, constipation, and a summative measure of geriatric burden comprising the above and history of falls or gait instability. In exploratory analyses, the strongest factor associated with ADES was the number of drugs added to a patient’s medication regimen during the 1 year study period (incidence rate ratio 1.11 per each added drug, 95% CI 1.03–1.19). Conclusion Common geriatric conditions and IADL function were not associated with ADEs in a predominantly male, older veteran population. While it is important to consider the unique circumstances of each patient, excessive caution in prescribing to elders with these geriatric conditions may not be warranted. PMID:21410446

  3. Impact of recommendations on crushing medications in geriatrics: from prescription to administration.

    PubMed

    Bourdenet, Gwladys; Giraud, Sophie; Artur, Marion; Dutertre, Sophie; Dufour, Marie; Lefčbvre-Caussin, Marie; Proux, Alice; Philippe, Sandrine; Capet, Corinne; Fontaine-Adam, Magali; Kadri, Karine; Landrin, Isabelle; Gréboval, Emmanuelle; Touflet, Myriam; Nanfack, Jules; Tharasse, Christine; Varin, Rémi; Rémy, Elise; Daouphars, Mikaël; Doucet, Jean

    2015-06-01

    The practice of crushing drugs is very common in geriatric units. In 2009 a first study, performed in all geriatric units of a university hospital, showed that numerous errors were made during prescription, preparation and administration. The aim of this second prospective study was to assess the impact of regional and national recommendations in the same geriatric units. A survey of 719 patients (85.3 ± 6.7 years) was performed in 2013. For each patient who received crushed drugs, we recorded the reason the drugs were crushed, pharmacological classes, galenic presentations and the technique used for preparation and administration. Results were compared to the previous study. The number of patients receiving drugs after crushing was significantly lower than in the previous study (22.9% vs. 32.3%, P < 0.001). The number of crushed drugs was lower too (594 per 165 patients vs. 966 per 224 patients (P < 0.01). The main indication for crushing drugs remained swallowing disorders. The dosage form prevented crushing in 24.9% of drugs (vs. 42.0% in 2009, P < 0.001), but the drugs generally remained crushed all together. A mortar was used less often (38.6% vs. 92.6%, P < 0.001), with preference for individual-specific cups (56.1%). Mortars were more often cleaned between each patient (56.0% vs. 11.6%). The vehicle was more often neutral (water 88.5% vs. 5.7%, P < 0.001). This second study shows that regional and national recommendations have led to an overall improvement of practices for crushing drugs. Technical improvements are still possible, in association with appropriate pharmacological studies. PMID:25789404

  4. Geriatric fractures about the hip: divergent patterns in the proximal femur, acetabulum, and pelvis.

    PubMed

    Sullivan, Matthew P; Baldwin, Keith D; Donegan, Derek J; Mehta, Samir; Ahn, Jaimo

    2014-03-01

    Geriatric acetabular, pelvis, and subtrochanteric femur fractures are poorly understood and rapidly growing clinical problems. The purpose of this study was to describe the epidemiologic trends of these injuries as compared with traditional fragility fractures about the hip. From 1993 to 2010, the Nationwide Inpatient Sample (NIS) recorded more than 600 million Medicare-paid hospital discharges. This retrospective study used the NIS to compare patients with acetabular fractures (n=87,771), pelvic fractures (n=522,831), and subtrochanteric fractures (n=170,872) with patients with traditional hip fractures (intertrochanteric and femoral neck, n=3,495,742) with regard to annual trends over an 18-year period in incidence, length of hospital stay, hospital mortality, transfers from acute care institutions, and hospital charges. Traditional hip fractures peaked in 1996 and declined by 25.7% by 2010. During the same 18-year period, geriatric acetabular fractures increased by 67%, subtrochanteric femur fractures increased by 42%, and pelvic fractures increased by 24%. Hospital charges, when controlling for inflation, increased roughly 50% for all fracture types. Furthermore, transfers from outside acute care hospitals for definitive management stayed elevated for acetabular fractures as compared with traditional hip fractures, suggesting a greater need for tertiary care of acetabular fractures. Geriatric acetabular fractures are rapidly increasing, whereas traditional hip fractures continue to decline. Patients with these injuries are more likely to be transferred from their hospital of presentation to another acute care institution, possibly increasing costs and complications. This is likely related to their complexity and the lack of consensus regarding optimal management. PMID:24762143

  5. The Effect of Nurse Practitioner Co-Management on the Care of Geriatric Conditions

    PubMed Central

    Reuben, David B.; Ganz, David A.; Roth, Carol P.; McCreath, Heather E.; Ramirez, Karina D.; Wenger, Neil S.

    2013-01-01

    Background/Objectives The quality of care for geriatric conditions remains poor. The Assessing Care of Vulnerable Elders (ACOVE)-2 model (case finding, delegation of data collection, structured visit notes, physician and patient education, and linkage to community resources) improves the quality of care for geriatric conditions when implemented by primary care physicians (PCPs) or by nurse practitioners (NPs) co-managing care with an academic geriatrician. However, it is unclear whether community-based PCP-NP co-management can achieve similar results. Design Case study. Setting Two community-based primary care practices. Participants Patients > 75 years who screened positive for at least one condition: falls, urinary incontinence (UI), dementia, and depression. Intervention The ACOVE-2 model augmented by NP co-management of conditions. Measurements Quality of care by medical record review using ACOVE-3 quality indicators (QIs). Patients receiving co-management were compared with those who received PCP care alone in the same practices. Results Of 1084 screened patients, 658 (61%) screened positive for > 1 condition; 485 of these patients were randomly selected for chart review and triggered a mean of 7 QIs. A NP saw approximately half (49%) for co-management. Overall, patients received 57% of recommended care. Quality scores for all conditions (falls: 80% versus 34%; UI: 66% versus 19%; dementia: 59% versus 38%) except depression (63% versus 60%) were higher for patients seen by a NP. In analyses adjusted for gender, age of patient, number of conditions, site, and a NP estimate of medical management style, NP co-management remained significantly associated with receiving recommended care (p<0.001), as did the NP estimate of medical management style (p=0.02). Conclusion Compared to usual care using the ACOVE-2 model, NP co-management is associated with better quality of care for geriatric conditions in community-based primary care. PMID:23772723

  6. Resident selection for a physical medicine and rehabilitation program: feasibility and reliability of the multiple mini-interview.

    PubMed

    Finlayson, Heather C; Townson, Andrea F

    2011-04-01

    The development of a process to select the best residents for training programs is challenging. There is a paucity of literature to support the implementation of an evidence-based approach or even best practice for program directors and selection committees. Although assessment of traditional academic markers such as clerkship grades and licensing examination scores can be helpful, these measures typically fail to capture performance in the noncognitive domains of medicine. In the specialty of physical medicine and rehabilitation, physician competencies such as communication, health advocacy, and managerial and collaborative skills are of particular importance, but these are often difficult to evaluate in admission interviews. Recent research on admission processes for medical schools has demonstrated reliability and validity of the "multiple mini-interview." The objective of our project was to develop and evaluate the multiple mini-interview for a physical medicine and rehabilitation residency training program, with a focus on assessment of the noncognitive physician competencies. We found that the process was feasible, time efficient, and cost-efficient and that there was good interrater reliability. The multiple mini-interview may be applied to other physical medicine and rehabilitation residency programs. Further research is needed to confirm reliability and determine validity. PMID:21765249

  7. Remote medicine

    SciTech Connect

    NONE

    1996-04-29

    The international oil industry, catalyzed by a surge in exploration and production projects in remote regions, is giving health care for its travelers and expatriates a high priority. L.R. Aalund, the Journal`s Managing Editor--Technology, reports on why and how this is happening now. He covers this in articles on: health care in Russia, air ambulance evacuations, and the deployment of remote paramedics. Aalund gathered the information during trips to Finland and Russia and interviews with oil industry personnel, physicians, and other medical professionals in North America, Europe, and Siberia. Titles of the four topics presented in this special section on remote medicine are as follows: Oil companies focus on emergency care for expats in Russia; Air ambulance plan can be critical; Remote paramedics have high level of training; and Other facets of remote medicine.

  8. Transfusion medicine

    SciTech Connect

    Murawski, K.; Peetoom, F.

    1986-01-01

    These proceedings contain 24 selections, including papers presented at the conference of American Red Cross held in May 1985, on the Subject of transfusion medicine. Some of the titles are: Fluosol/sup R/-DA in Radiation Therapy; Expression of Cloned Human Factor VIII and the Molecular Basis of Gene Defects that Cause Hemophilia; DNA-Probing Assay in the Detection of Hepatitis B Virus Genome in Human Peripheral Blood Cells; and Monoclonal Antibodies: Convergence of Technology and Application.

  9. [Anti-aging medicine: notes on a socio-technical controversy.

    PubMed

    Leităo, Antônio Nogueira; Pedro, Rosa Maria Leite Ribeiro

    2014-11-01

    After some decades of struggle, geriatrics and gerontology have become the legitimate sciences of aging. Today, their status is being questioned. In its short history, anti-aging medicine has taken root as a medical practice that questions how to address biological aging. In so doing, all medicine is questioned. Here, we explore in particular how this controversy is structured around the founding principles of the sciences of aging. Is there any basis for these questionings? How have they been treated by those who have received them? Taking a socio-technical viewpoint, it is worth considering that for geriatricians and gerontologists, the need to criticize anti-aging medicine also raises some important reflections about how the sciences of aging address their subject. PMID:25388446

  10. [Anti-aging medicine: notes on a socio-technical controversy].

    PubMed

    Leităo, Antônio Nogueira; Pedro, Rosa Maria Leite Ribeiro

    2014-01-01

    After some decades of struggle, geriatrics and gerontology have become the legitimate sciences of aging. Today, their status is being questioned. In its short history, anti-aging medicine has taken root as a medical practice that questions how to address biological aging. In so doing, all medicine is questioned. Here, we explore in particular how this controversy is structured around the founding principles of the sciences of aging. Is there any basis for these questionings? How have they been treated by those who have received them? Taking a socio-technical viewpoint, it is worth considering that for geriatricians and gerontologists, the need to criticize anti-aging medicine also raises some important reflections about how the sciences of aging address their subject. PMID:25606732

  11. UniversityofCentralFlorida CollegeofMedicine

    E-print Network

    Van Stryland, Eric

    week clerkships PEDS or OB/GYN PSYCH or NEURO PEDS or OB/GYN PSYCH or NEURO Block/GYN PSYCH or NEURO PEDS or OB/GYN PSYCH or NEURO Block (3) August 13, 2012 ­ September 21, 2012 ­ November 2, 2012 PEDS or OB/GYN PSYCH or NEURO Block (5) November 5, 2012 ­ December 14, 2012

  12. Development and Evaluation of a Palliative Medicine Curriculum for Third-Year Medical Students

    PubMed Central

    Mullan, Patricia; Nelesen, Richard A.; Soskins, Matt; Savoia, Maria; Buckholz, Gary; Weissman, David E.

    2012-01-01

    Abstract Objective To assess the impact, retention, and magnitude of effect of a required didactic and experiential palliative care curriculum on third-year medical students' knowledge, confidence, and concerns about end-of-life care, over time and in comparison to benchmark data from a national study of internal medicine residents and faculty. Design Prospective study of third-year medical students prior to and immediately after course completion, with a follow-up assessment in the fourth year, and in comparison to benchmark data from a large national study. Setting Internal Medicine Clerkship in a public accredited medical school. Participants Five hundred ninety-three third-year medical students, from July 2002 to December 2007. Main outcome measures Pre- and postinstruction performance on: knowledge, confidence (self-assessed competence), and concerns (attitudes) about end-of-life care measures, validated in a national study of internal medicine residents and faculty. Medical student's reflective written comments were qualitatively assessed. Intervention Required 32-hour didactic and experiential curriculum, including home hospice visits and inpatient hospice care, with content drawn from the AMA-sponsored Education for Physicians on End-of-life Care (EPEC) Project. Results Analysis of 487 paired t tests shows significant improvements, with 23% improvement in knowledge (F1,486=881, p<0.001), 56% improvement in self-reported competence (F1,486=2,804, p<0.001), and 29% decrease in self-reported concern (F1,486=208, p<0.001). Retesting medical students in the fourth year showed a further 5% increase in confidence (p<0.0002), 13% increase in allaying concerns (p<0.0001), but a 6% drop in knowledge. The curriculum's effect size on M3 students' knowledge (0.56) exceeded that of a national cross-sectional study comparing residents at progressive training levels (0.18) Themes identified in students' reflective comments included perceived relevance, humanism, and effectiveness of methods used to teach and assess palliative care education. Conclusions We conclude that required structured didactic and experiential palliative care during the clinical clerkship year of medical student education shows significant and largely sustained effects indicating students are better prepared than a national sample of residents and attending physicians. PMID:22845026

  13. Emergency Medicine Grand Rounds Emergency Medicine Classroom

    E-print Network

    Emergency Medicine Grand Rounds Emergency Medicine Classroom Tuesday, September 3, 2013 8 am ­ 9 am Department Presented by: Azeem Tajani, MD PGY-3, ECU Emergency Medicine Objectives: 1. Discuss the State in the suicidal Patient. Accreditation: The Brody School of Medicine of East Carolina University is accredited

  14. College of Medicine RM Radiation Medicine

    E-print Network

    MacAdam, Keith

    College of Medicine RM Radiation Medicine KEY: # = new course * = course changed = course dropped and advanced topics in nuclear medicine imaging physics, including positron emission tomographic procedures IN RADIATION MEDICINE. (1-6) Applied field work at the graduate level in the sciences relating to radiation

  15. College of Medicine MED Internal Medicine

    E-print Network

    MacAdam, Keith

    College of Medicine MED Internal Medicine KEY: # = new course * = course changed = course dropped. (Same as MI/PHA 616.) MED 815 FIRST-YEAR ELECTIVE, MEDICINE. (1-3) With the advice and approval of his of Medicine. The intent is to provide the student an opportunity for exploration and study in an area which

  16. College of Medicine ER Emergency Medicine

    E-print Network

    MacAdam, Keith

    College of Medicine ER Emergency Medicine KEY: # = new course * = course changed = course dropped University of Kentucky 2013-2014 Undergraduate Bulletin 1 ER 815 FIRST-YEAR ELECTIVE, EMERGENCY MEDICINE. (1 offered by the Department of Emergency Medicine. The intent is to provide the student an opportunity

  17. UW MEDICINE Referral Request UW Medicine

    E-print Network

    Borenstein, Elhanan

    UW MEDICINE Referral Request PT.NO NAME DOB UW Medicine Harborview Medical Center ­ UW Medical MEDICINE REFERRAL REQUEST *U2394* *U2394* WHITE ­ MEDICAL RECORD UH2394 REV NOV 11 Thank you for referring your patient to UW Medicine. This form is to be completed by the outside referring provider or designee

  18. Master in Molecular Medicine Faculty of Medicine

    E-print Network

    Pfeifer, Holger

    Master in Molecular Medicine Faculty of Medicine February 2010 #12;University of Ulm There are many of the Master program The English Master course of studies combines the disciplines Biology and Medicine of research, development and application in the field of molecular medicine especially in universities

  19. Complementary medicine use is not associated with non-adherence to conventional medication in the elderly: a retrospective study.

    PubMed

    Cherniack, E Paul

    2011-11-01

    Lack of adherence to medications is a potential cause of hospitalizations, morbidity, and mortality in the elderly. Medication adherence decreases with polypharmacy. Older persons commonly use complementary medicine, therefore complementary medicine use might pose an increase risk of loss of medication adherence with conventional medications, but this has not been previously investigated. A chart review was conducted of 300 patients at least sixty-five years of age who used at least three medications each who attended a university geriatrics clinic in Florida, USA to obtain information about medication adherence and complementary medicine use. However, no association was found between use of at least one complementary medicine and adherence to conventional medications. PMID:21982134

  20. Nature and frequency of medication errors in a geriatric ward: an Indonesian experience

    PubMed Central

    Ernawati, Desak Ketut; Lee, Ya Ping; Hughes, Jeffery David

    2014-01-01

    Purpose To determine the nature and frequency of medication errors during medication delivery processes in a public teaching hospital geriatric ward in Bali, Indonesia. Methods A 20-week prospective study on medication errors occurring during the medication delivery process was conducted in a geriatric ward in a public teaching hospital in Bali, Indonesia. Participants selected were inpatients aged more than 60 years. Patients were excluded if they had a malignancy, were undergoing surgery, or receiving chemotherapy treatment. The occurrence of medication errors in prescribing, transcribing, dispensing, and administration were detected by the investigator providing in-hospital clinical pharmacy services. Results Seven hundred and seventy drug orders and 7,662 drug doses were reviewed as part of the study. There were 1,563 medication errors detected among the 7,662 drug doses reviewed, representing an error rate of 20.4%. Administration errors were the most frequent medication errors identified (59%), followed by transcription errors (15%), dispensing errors (14%), and prescribing errors (7%). Errors in documentation were the most common form of administration errors. Of these errors, 2.4% were classified as potentially serious and 10.3% as potentially significant. Conclusion Medication errors occurred in every stage of the medication delivery process, with administration errors being the most frequent. The majority of errors identified in the administration stage were related to documentation. Provision of in-hospital clinical pharmacy services could potentially play a significant role in detecting and preventing medication errors. PMID:24940067

  1. Analysis of failure following anterior screw fixation of Type II odontoid fractures in geriatric patients.

    PubMed

    Osti, Michael; Philipp, Helmut; Meusburger, Berthold; Benedetto, Karl Peter

    2011-11-01

    Anterior screw fixation of Type II odontoid fractures has been recommended. Only few publications analyse the mechanism of failure in geriatric patients. We reviewed 18 male and 15 female patients aged 65 and above for parameters that influence the development of postoperative loss of correction, delayed union or non-union. Patients were stratified in two groups: 21 cases in Group A (union) and 12 patients in Group B (loss of correction, delayed union, non-union, revision surgery). Statistically significant correlation (p < 0.05) could be detected between failure to heal and: (1) degenerative changes in the atlanto-odontoid joint, (2) severity of osteoporosis in the odontoid process, (3) posterior oblique fracture type, (4) suboptimal fracture reduction, (5) suboptimal position of implant following demanding intraoperative conditions, (6) quality of fracture compression and (7) severity of fracture comminution. The overall morbidity and mortality rates were 29.0 and 8.6%, respectively. Our results indicate that these factors should be addressed regarding the selection of the operative treatment method in the geriatric patient. PMID:21728075

  2. Addressing geriatric oral health concerns through national oral health policy in India

    PubMed Central

    Singh, Abhinav; Purohit, Bharathi M

    2015-01-01

    There is an escalating demand for geriatric oral healthcare in all developed and developing countries including India. Two-thirds of the world’s elderly live in developing countries. This is a huge population that must receive attention from policy-makers who will be challenged by the changing demands for social and health services including oral health services. Resources are limited thus rather than being aspirational in wanting to provide all treatment needed for everybody, this critique presents a road map of how we might answer the present and future geriatric oral health concerns in a most efficient manner in a developing country. Viewing the recent Indian demographic profile and the trends in oral health, pertinent policy subjects have been discussed concerning the oral health needs of the elderly and also the associated challenges which include strategies to improve quality of life, strategies to train and educate the dental workforce and above all the role of healthcare systems towards realization of better aged society in India and other developing countries. PMID:25584351

  3. Systematic Review of the Use of Online Questionnaires among the Geriatric Population

    PubMed Central

    Remillard, Meegan L.; Mazor, Kathleen M.; Cutrona, Sarah L.; Gurwitz, Jerry H.; Tjia, Jennifer

    2014-01-01

    Background/Objectives The use of internet-based questionnaires to collect information from older adults is not well established. This systematic literature review of studies using online questionnaires in older adult populations aims to 1. describe methodologic approaches to population targeting and sampling and 2. summarize limitations of Internet-based questionnaires in geriatric populations. Design, Setting, Participants We identified English language articles using search terms for geriatric, age 65 and over, Internet survey, online survey, Internet questionnaire, and online questionnaire in PubMed and EBSCO host between 1984 and July 2012. Inclusion criteria were: study population mean age ?65 years old and use of an online questionnaire for research. Review of 336 abstracts yielded 14 articles for full review by 2 investigators; 11 articles met inclusion criteria. Measurements Articles were extracted for study design and setting, patient characteristics, recruitment strategy, country, and study limitations. Results Eleven (11) articles were published after 2001. Studies had populations with a mean age of 65 to 78 years, included descriptive and analytical designs, and were conducted in the United States, Australia, and Japan. Recruiting methods varied widely from paper fliers and personal emails to use of consumer marketing panels. Investigator-reported study limitations included the use of small convenience samples and limited generalizability. Conclusion Online questionnaires are a feasible method of surveying older adults in some geographic regions and for some subsets of older adults, but limited Internet access constrains recruiting methods and often limits study generalizability. PMID:24635138

  4. Evaluation of Oxidative Stress Parameters and Urinary Deoxypyridinoline Levels in Geriatric Patients with Osteoporosis

    PubMed Central

    Demir, Mehmet; Ulas, Turgay; Tutoglu, Ahmet; Boyaci, Ahmet; Karakas, Emel Yigit; Sezen, Hatice; Ustunel, Murat; Bilinc, Hasan; Gencer, Mehmet; Buyukhatipoglu, Hakan

    2014-01-01

    [Purpose] To evaluate the oxidative stress parameters and urinary deoxypyridinoline levels in geriatric patients with osteoporosis. [Subjects and Methods] Eighty geriatric patients aged over 65?years were recruited. Patients were divided into two groups: Group 1 (n=40) consisted of patients with osteoporosis, and Group 2 (n=40) consisted of patients without osteoporosis. Bone mineral density measurements were performed for all patients using DEXA. Oxidative stress parameters were analyzed in blood samples, and deoxypyridinoline levels were analyzed in 24-hour urinary samples. [Results] Compared to Group 2, the total antioxidant status and oxidative stress index levels of Group 1 were not significantly different; however, total oxidant status and 24-hour urinary deoxypyridinoline levels were significantly higher. Pearson correlation coefficients indicated that OSI and urinary deoxypyridinoline levels were not correlated with any biochemical parameters. ROC-curve analysis revealed that urinary deoxypyridinoline levels over 30.80?mg/ml predicted osteoporosis with 67% sensitivity and 68% specificity (area under the curve = 0.734; %95 CI: 0.624–0.844). [Conclusion] Our results indicate that oxidative stress would play a role in the pathogenesis of osteoporosis, and that urinary deoxypyridinoline levels may be a useful screening test for osteoporosis. PMID:25276024

  5. The structure of the geriatric depressed brain and response to electroconvulsive therapy.

    PubMed

    Oudega, Mardien L; van Exel, Eric; Stek, Max L; Wattjes, Mike P; van der Flier, Wiesje M; Comijs, Hannie C; Dols, Annemieke; Scheltens, Philip; Barkhof, Frederik; Eikelenboom, Piet; van den Heuvel, Odile A

    2014-04-30

    Electroconvulsive therapy (ECT) is the treatment of choice in severe geriatric depression. High remission rates may be influenced by specific brain morphology characteristic of geriatric depression. Our objective was to identify the relationship between brain structure, symptom profile, and ECT response. In a naturalistic cohort of 55 patients with a major depressive disorder, structural magnetic resonance imaging (MRI) was performed before ECT. Voxel-based morphometry was applied to determine regional differences in gray matter (GM) volume between patients and 23 matched healthy controls. Depressed patients with psychotic symptoms showed significantly higher remission rates and smaller regional GM volume of the left inferior frontal gyrus (IFG). Patients with late onset depression showed smaller regional GM volume of the bilateral lateral temporal cortex. Larger size of response in the whole patient group was related to smaller pretreatment regional GM volume of the right lateral temporal cortex, whereas faster speed of response was related to smaller pretreatment regional GM volume of the right IFG. ECT is most effective in depressed patients with psychotic symptoms. In this study the presence of psychotic symptoms was related to pretreatment smaller GM volume of the left IFG and bilateral temporal cortex. Smaller volume of the IFG pretreatment was related to faster treatment response, and smaller volume of the right lateral temporal cortex pretreatment was related to larger response to ECT. These results are possibly explained by the connectivity between these brain regions and an interconnected network that is particularly activated by the ECT-induced seizures. PMID:24686000

  6. Systemic hypoperfusion is associated with executive dysfunction in geriatric cardiac patients

    PubMed Central

    Jefferson, Angela L.; Poppas, Athena; Paul, Robert H.; Cohen, Ronald A.

    2009-01-01

    The present study examines the relationship between systemic hypoperfusion via cardiac output (CO) and neuropsychological performances emphasizing executive function in an aging cohort. Geriatric outpatients with treated, stable cardiovascular disease (CVD) and no history of neurological illness (n = 72, ages 56-85) were administered cognitive measures with an emphasis on executive functioning. Echocardiogram findings were used to stratify participants into two groups: low CO (<4.0 L/min) and normal CO (?4.0 L/min). Between-group comparisons were made using ANCOVAs adjusting for systolic blood pressure. The low CO group performed significantly worse than the normal CO group on DKEFS Tower Test and DKEFS Trail Making Test. No significant between-group differences were noted for any of the other cognitive indices. Findings suggest that reduced CO is associated with poorer executive functioning among geriatric outpatients with stable CVD, as the cognitive profile emphasizes a relationship between systemic hypoperfusion and problems with sequencing and planning. The executive dysfunction profile may be secondary to reduced blood flow to vulnerable subcortical structures implicated in frontal-subcortical circuitry. PMID:16469418

  7. Clinical practice with antidementia and antipsychotic drugs: Audit from a geriatric clinic in India

    PubMed Central

    Prasad, Krishna; Gupta, Himanshu; Bharath, Srikala; Prakash, Om; Sivakumar, P. T.; Kumar, C. Naveen; Varghese, Mathew

    2009-01-01

    Background: Dementia is one of the most disabling disorders afflicting the elderly, with a staggering emotional and economic impact. Antidementia agents have been used for delaying cognitive decline. Antipsychotics are commonly prescribed for behavioral symptoms associated with dementia. Objectives: To explore the use of anti-dementing agents and antipsychotics used in patients with a diagnosis of dementia Materials and Methods: A retrospective chart review method; geriatric clinic of tertiary care setting. Results: The study sample included 51 consecutive patients with a diagnosis of dementia. The commonest subtype of dementia that was diagnosed was Alzheimer's disease (45%), followed by Frontotemporal dementia (25%).The commonest antidementia drug that was used was donepezil, which alone was prescribed in 27 patients (52%). The commonest antipsychotic used was quetiapine, which was used in 24 patients (47%). Conclusions: The study found donepezil to be the most commonly prescribed antidementia drug and quetiapine to be the most commonly used antipsychotic in a tertiary care geriatric clinic, in a developing country. There is a need to study the cost-effectiveness of antidementia and antipsychotic drugs in patients with dementia, in developing countries. PMID:20048452

  8. A System Design for Studying Geriatric Patients with Dementia and Hypertension Based on Daily Living Information

    NASA Astrophysics Data System (ADS)

    Xu, Weifeng; Betz, Willian R.; Frezza, Stephen T.; Liu, Yunkai

    2011-08-01

    Geriatric patients with dementia and hypertension (DAH) suffer both physically and financially. The needs of these patients mainly include improving the quality of daily living and reducing the cost of long-term care. Traditional treatment approaches are strained to meet these needs. The goal of the paper is to design an innovative system to provide cost-effective quality treatments for geriatric patients with DAH by collecting and analyzing the multi-dimensional personal information, such as observations in daily living (ODL) from a non-clinical environment. The proposed ODLs in paper include activities, cleanliness, blood pressure, medication compliance and mood changes. To complete the system design, an incremental user-centered strategy is exploited to assemble needs of patients, caregivers, and clinicians. A service-oriented architecture (SOA) is employed to make full use of existing devices, software systems, and platforms. This health-related knowledge can be interpreted and utilized to help patients with DAH remain in their homes safely and improve their life quality while reducing medical expenditures.

  9. Complementary Use of Tai Chi Chih Augments Escitalopram Treatment of Geriatric Depression: A Randomized Controlled Trial

    PubMed Central

    Lavretsky, Helen; Altstein, L.; Olmstead, R.E.; Ercoli, L.; Riparetti-Brown, M.; St. Cyr, N.; Irwin, M. R.

    2011-01-01

    Background Nearly two-thirds of elderly patients treated for depression fail to achieve symptomatic remission and functional recovery with first-line pharmacotherapy. In this study, we ask whether a mind–body exercise, Tai Chi Chih (TCC), added to escitalopram will augment the treatment of geriatric depression designed to achieve symptomatic remission and improvements in health functioning and cognitive performance. Methods One hundred twelve older adults with major depression age 60 years and older were recruited and treated with escitalopram for approximately 4 weeks. Seventy-three partial responders to escitalopram continued to receive escitalopram daily and were randomly assigned to 10 weeks of adjunct use of either 1) TCC for 2 hours per week or 2) health education (HE) for 2 hours per week. All participants underwent evaluations of depression, anxiety, resilience, health-related quality of life, cognition, and inflammation at baseline and during 14-week follow-up. Results Subjects in the escitalopram and TCC condition were more likely to show greater reduction of depressive symptoms and to achieve a depression remission as compared with those receiving escitalopram and HE. Subjects in the escitalopram and TCC condition also showed significantly greater improvements in 36-Item Short Form Health Survey physical functioning and cognitive tests and a decline in the inflammatory marker, C-reactive protein, compared with the control group. Conclusion Complementary use of a mind–body exercise, such as TCC, may provide additional improvements of clinical outcomes in the pharmacologic treatment of geriatric depression. PMID:21358389

  10. Systemic hypoperfusion is associated with executive dysfunction in geriatric cardiac patients.

    PubMed

    Jefferson, Angela L; Poppas, Athena; Paul, Robert H; Cohen, Ronald A

    2007-03-01

    The present study examines the relationship between systemic hypoperfusion via cardiac output (CO) and neuropsychological performances emphasizing executive function in an aging cohort. Geriatric outpatients with treated, stable cardiovascular disease (CVD) and no history of neurological illness (n=72, ages 56-85) were administered cognitive measures with an emphasis on executive functioning. Echocardiogram findings were used to stratify participants into two groups: low CO (<4.0 L/min) and normal CO (> o r=4.0 L/min). Between-group comparisons were made using ANCOVAs adjusting for systolic blood pressure. The low CO group performed significantly worse than the normal CO group on DKEFS Tower Test and DKEFS Trail Making Test. No significant between-group differences were noted for any of the other cognitive indices. Findings suggest that reduced CO is associated with poorer executive functioning among geriatric outpatients with stable CVD, as the cognitive profile emphasizes a relationship between systemic hypoperfusion and problems with sequencing and planning. The executive dysfunction profile may be secondary to reduced blood flow to vulnerable subcortical structures implicated in frontal-subcortical circuitry. PMID:16469418

  11. Neuroplasticity-based computerized cognitive remediation for treatment-resistant geriatric depression.

    PubMed

    Morimoto, Sarah Shizuko; Wexler, Bruce E; Liu, Jiacheng; Hu, Willie; Seirup, Joanna; Alexopoulos, George S

    2014-01-01

    Executive dysfunction (ED) in geriatric depression (GD) is common, predicts poor clinical outcomes and often persists despite remission of symptoms. Here we develop a neuroplasticity-based computerized cognitive remediation-geriatric depression treatment (nCCR-GD) to target ED in GD. Our assumption is that remediation of these deficits may modulate the underlying brain network abnormalities shared by ED and depression. We compare nCCR-GD to a gold-standard treatment (escitalopram: 20?mg per 12 weeks) in 11 treatment-resistant older adults with major depression; and 33 matched historical controls. We find that 91% of participants complete nCCR-GD. nCCR-GD is equally as effective at reducing depressive symptoms as escitalopram but does so in 4 weeks instead of 12. In addition, nCCR-GD improves measures of executive function more than the escitalopram. We conclude that nCCR-GD may be equally effective as escitalopram in treating GD. In addition, nCCR-GD participants showed greater improvement in executive functions than historical controls treated with escitalopram. PMID:25093396

  12. Catheter-Related Bloodstream Infections (CR-BSI) in Geriatric Patients in Intensive Care Units.

    PubMed

    Chernecky, Cynthia; Macklin, Denise; Blackburn, Paul

    2015-01-01

    Catheter-related bloodstream infections (CR-BSIs) are bloodstream infections that, through specific laboratory testing, identify the intravascular catheter as the source of the bloodstream infection. By 2015, the rate of elderly patients 80 years of age and older admitted to the intensive care unit (ICU) will represent 1 in 4 admissions. Approximately 80 000 CR-BSIs occur in ICUs annually, potentially resulting in as many as 56 000 CR-BSIs occurring in the geriatric ICU patient, with 20% of these cases resulting in death. To minimize the occurrence of CR-BSIs in these patients, specific knowledge about the geriatric patient will have to be factored into the ICU health care professional's practice, including the development of a vascular access plan, which includes selection of the correct device and proper insertion of that device along with an evidence-based care and maintenance program. Intensive care unit health care professionals may be at a loss when it comes to navigating the vast array of vascular access medical devices available today. The Healthcare and Technology Synergy framework can assist the ICU health care professional to logically review each vascular access device and select those devices that best meet patient needs. PMID:26039650

  13. Automated Assessment of Medical Students' Clinical Exposures according to AAMC Geriatric Competencies.

    PubMed

    Chen, Yukun; Wrenn, Jesse; Xu, Hua; Spickard, Anderson; Habermann, Ralf; Powers, James; Denny, Joshua C

    2014-01-01

    Competence is essential for health care professionals. Current methods to assess competency, however, do not efficiently capture medical students' experience. In this preliminary study, we used machine learning and natural language processing (NLP) to identify geriatric competency exposures from students' clinical notes. The system applied NLP to generate the concepts and related features from notes. We extracted a refined list of concepts associated with corresponding competencies. This system was evaluated through 10-fold cross validation for six geriatric competency domains: "medication management (MedMgmt)", "cognitive and behavioral disorders (CBD)", "falls, balance, gait disorders (Falls)", "self-care capacity (SCC)", "palliative care (PC)", "hospital care for elders (HCE)" - each an American Association of Medical Colleges competency for medical students. The systems could accurately assess MedMgmt, SCC, HCE, and Falls competencies with F-measures of 0.94, 0.86, 0.85, and 0.84, respectively, but did not attain good performance for PC and CBD (0.69 and 0.62 in F-measure, respectively). PMID:25954341

  14. Comminuted pelvic fracture with retroperitoneal bleed in a geriatric patient: a case study.

    PubMed

    Johnson-Vaught, L Denise

    2013-01-01

    The case study presented involved an 87-year-old Hispanic man who was transferred to the emergency department (ED) of an acute care hospital. The patient was complaining of left hip pain and hitting his head. The patient had fallen backward upon standing from a wheelchair, lost his balance, and suffered an occipital laceration with hematoma. There was a brief loss of consciousness after hitting his head. An external pelvic stabilizer was placed on the patient's pelvis in an attempt to stabilize the comminuted pelvic fractures. Because of the patient's comorbidities and unstable condition, the consulting physician specialists determined that the patient was not a surgical or interventional candidate. Self-tamponed of retroperitoneal bleeding occurred without intervention of angiogram with embolization or laparotomy. A decision was made among the patient, the patient's stepchildren, and the attending physicians for a do-not-resuscitate order. The patient was then transferred to a palliative care unit outside the hospital. This case discusses the physiological changes in geriatric patients and the management of geriatric patients with pelvic trauma and retroperitoneal bleeding. PMID:23797615

  15. Interdisciplinary collaboration in gerontology and geriatrics in Latin America: conceptual approaches and health care teams.

    PubMed

    Gomez, Fernando; Curcio, Carmen Lucia

    2013-01-01

    The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a theoretical knowledge basis with well-justified priorities, functions, and long-term goals, in Latin America teams are arranged according to subjective interests on solving their problems. Three distinct approaches of interdisciplinary collaboration in gerontology are proposed. The first approach is grounded in the scientific rationalism of European origin. Denominated "logical-rational approach," its core is to identify the significance of knowledge. The second approach is grounded in pragmatism and is more associated with a North American tradition. The core of this approach consists in enhancing the skills and competences of each participant; denominated "logical-instrumental approach." The third approach denominated "logical-subjective approach" has a Latin America origin. Its core consists in taking into account the internal and emotional dimensions of the team. These conceptual frameworks based in geographical contexts will permit establishing the differences and shared characteristics of interdisciplinary collaboration in geriatrics and gerontology to look for operational answers to solve the "complex problems" of older adults. PMID:23384004

  16. American Geriatrics Society abstracted clinical practice guideline for postoperative delirium in older adults.

    PubMed

    2015-01-01

    The abstracted set of recommendations presented here provides essential guidance both on the prevention of postoperative delirium in older patients at risk of delirium and on the treatment of older surgical patients with delirium, and is based on the 2014 American Geriatrics Society (AGS) Guideline. The full version of the guideline, American Geriatrics Society Clinical Practice Guideline for Postoperative Delirium in Older Adults is available at the website of the AGS. The overall aims of the study were twofold: first, to present nonpharmacologic and pharmacologic interventions that should be implemented perioperatively for the prevention of postoperative delirium in older adults; and second, to present nonpharmacologic and pharmacologic interventions that should be implemented perioperatively for the treatment of postoperative delirium in older adults. Prevention recommendations focused on primary prevention (i.e., preventing delirium before it occurs) in patients who are at risk for postoperative delirium (e.g., those identified as moderate-to-high risk based on previous risk stratification models such as the National Institute for Health and Care Excellence (NICE) guidelines, Delirium: Diagnosis, Prevention and Management. Clinical Guideline 103; London (UK): 2010 July 29). For management of delirium, the goals of this guideline are to decrease delirium severity and duration, ensure patient safety and improve outcomes. PMID:25495432

  17. Demographical, sociomedical and physical characteristics in relation to malnutrition in geriatric patients.

    PubMed

    Unosson, M; Ek, A C; Bjurulf, P; Larsson, J

    1991-12-01

    The purpose of this study was to describe and compare demographical, sociomedical and physical characteristics between protein-energy malnourished and non-malnourished geriatric patients on admission. According to the International Statistical Classification of Diseases, 104 malnourished patients were age-, gender- and diagnosis-matched with 104 non-malnourished patients. Data were collected from patients' medical records. The patient's condition was assessed by a modified Norton scale on admission. No differences were seen in marital status, type of dwelling, previous need for help service, residence before admission, and dependence on assistance with ADL function. The malnourished patients had a greater consumption of diuretics (47%; P less than 0.05) and a lower consumption of analgesics (29%; P less than 0.05) than the non-malnourished patients (33% and 42% respectively). In the malnourished group, impaired conditions in activity (83%; P less than 0.05), and general physical condition (78%; P less than 0.01) were observed compared to the non-malnourished group (69% and 60% respectively). The malnourished patients had less sufficient food intake (41% vs 21%; P less than 0.01) and fluid intake (25% vs 10%; P less than 0.01) than non-malnourished patients. This study indicates that demographical characteristics and primary ADL-functions are of minor importance for the development of protein-energy malnutrition in geriatric patients. Observation of the patients' physical condition and drug consumption seemed more important on admission. PMID:1791250

  18. The Open Geriatric Medicine Journal, 2010, 3, 1-10 1 1874-8279/10 2010 Bentham Open

    E-print Network

    Chapman, Robert M.

    structures underlying neuropsychological test performance of elders belonging to three clinical groups of neuropsychological tests to 214 elderly participants in the groups. First, the underlying cognitive structure 17 neuropsychological test measures into 6 interpretable factors, accounting for 78% of the variance

  19. Why sports medicine is not medicine.

    PubMed

    Edwards, Steven D; McNamee, Mike

    2006-06-01

    Sports Medicine as an apparent sub-class of medicine has developed apace over the past 30 years. Its recent trajectory has been evidenced by the emergence of specialist international research journals, standard texts, annual conferences, academic appointments and postgraduate courses. Although this field of enquiry and practice lays claim to the title 'sports medicine' this paper queries the legitimacy of that claim. Depending upon how 'sports medicine' and 'medicine' are defined, a plausible-sounding case can be made to show that sports medicine is not in fact a branch of medicine. Rather, it is sometimes closer to practices such as non-therapeutic cosmetic surgery. The argument of the paper is as follows. It begins with a brief statement concerning methodology. We then identify and subscribe to a plausible defining goal of medicine taken from a recognised authority in the field. Then two representative, authoritative, definitions of sports medicine are discussed. It is then shown that acceptance of these definitions of sports medicine generates a problem in that if they are accepted, no necessary commitment to the defining goal of medicine is present within sports medicine. It seems to follow that sports medicine is not medicine. In the final part of the paper a critical response to that conclusion is presented and rebutted. The response is one which rejects the identification of the defining goal of medicine upon which our argument rests. PMID:17195578

  20. Int J Geriatr Psychiatry . Author manuscript Neurological signs and late-life depressive symptoms in a community

    E-print Network

    Paris-Sud XI, Université de

    Int J Geriatr Psychiatry . Author manuscript Page /1 8 Neurological signs and late-life depressive associations between neurological signs as markers of underlying brain dysfunction and caseness for depression in an elderly community sample, controlling for physical health and comorbid/past neurological disorders. Method

  1. New Paradigms for Treating Elderly Patients With Cancer: The Comprehensive Geriatric Assessment and Guidelines for Supportive Care

    Microsoft Academic Search

    Lodovico Balducci

    Strategies for treating cancer are evolving to address the grow- ing number of elderly patients with cancer. Older patients have highly variable physiologic ages, and their treatment should be individualized for optimal outcomes. Treatment paradigms should also take into account the diversity of patients' life expectancy, functional reserve, social sup- port, and personal preference. A Comprehensive Geriatric Assessment (CGA) is

  2. Recurrent Mandibular Dislocation in Geriatric Patients: Treatment and Prevention by a Simple and Non-invasive Technique.

    PubMed

    Chhabra, Shruti; Chhabra, Naveen; Gupta, Prachi

    2015-03-01

    Dislocation is defined as the complete loss of articular relationship between the articular fossa of the temporal bone and the condyle-disk complex. Most common aetiology of dislocation is wide mouth opening, trauma and use of certain drugs. It is classified as acute, chronic and recurrent. Chronic recurrent dislocation of mandible is a distressing condition especially for geriatric patients. Various non-surgical methods of reduction include Hippocratic method, Awang's gag reflex method, wrist-pivot technique, combined ipsilateral staggering technique, recumbent approach, intermaxillary fixation, injection of a sclerosing solution, autologus blood transfusion and botulinum toxin. In geriatric population, the ridges become atrophic with time and use of any method of reduction which exerts force on mandible increases chances of fracture of mandible. Awang's gag reflex method is a non invasive technique which helps in treatment of chronic recurrent dislocation in geriatric patients. Along with this technique the use of a cervical collar has been reported in this article, which not only acts as a restrainer but also is helpful for cervical spondylosis, a common condition encountered in geriatric population. PMID:25838702

  3. Boston University Family Medicine

    E-print Network

    Spence, Harlan Ernest

    Boston University Family Medicine Global Health CollaborativeFamily Medicine As part of the Department of Family Medicine at Boston University, the Collaborative is committed to introducing and improving Family Medicine programs around the world. Family Medicine is a holistic specialty that attends

  4. Safe Medicine Disposal Locations

    E-print Network

    Yamamoto, Keith

    Safe Medicine Disposal Locations Central Drug Store 4494 Mission St. SF, CA 94112 Charlie drop-off sites accept these non-controlled substances: prescription medicines, over-the-counter medicines, vitamins, liquid medicines, empty inhaler cartridges, pet medicines and medicated ointments. #12

  5. [Physical and pharmacological restraints in geriatric and gerontology services and centers].

    PubMed

    Ramos Cordero, Primitivo; López Trigo, José Antonio; Maíllo Pedraz, Herminio; Paz Rubio, José María

    2015-01-01

    Physical and pharmacological restraints are a controversial issue in the context of geriatric care due to their moral, ethical, social and legal repercussions and, despite this fact, no specific legislation exists at a national level. The use of restraints is being questioned with growing frequency, as there are studies that demonstrate that restraints do not reduce the number of falls or their consequences, but rather can increase them, cause complications, injuries and potentially fatal accidents. Restraints are not always used rationally, despite compromising a fundamental human right, that is, freedom, protected in the Constitution, as well as values and principles, such as dignity and personal self-esteem. There are centers where restraints are applied to more than 50% of patients, and in some cases without the consent of their legal representatives. On some occasions, restraints are used for attaining organizational or environmental objectives, such as complying with tight schedules, and for reducing or avoiding the supervision of patients who walk erratically and, at times, are used indefinitely. Even greater confusion exists with respect to the emerging concept of chemical or pharmacological restraints, since no conceptual framework exists based on scientific evidence, and with sufficient consensus for guiding healthcare workers. In this context, the Sociedad Espańola de Geriatría y Gerontología (SEGG--Spanish Geriatrics and Gerontology Society), aware of the significance and transcendence of the issue, and in an attempt to preserve and guarantee maximum freedom, dignity and self-esteem, on the one hand, and to ensure the maximum integrity and legal certainty of the persons cared for in geriatric and gerontology services and centers, on the other, decided to create an "Interdisciplinary Committee on Restraints" made up by members from different disciplines and members of SEGG Working Groups or Committees, external health care workers, groups, organizations, and associations, who are experts in restraints, as well as the main "anti-restraint" movements. An outcome of this decision is the Consensus document on physical and pharmacological restraints, together with the Consensus on physical and pharmacological restraints, published by the SEGG, which should signify a qualitative leap forward in care for the elderly, and serving as a best practice guide for healthcare workers. PMID:25443785

  6. Preventing HIV with Medicine

    MedlinePLUS

    ... information in Spanish ( en espańol ) Preventing HIV with medicine Get medicine right after you are exposed to ... to top More information on Preventing HIV with medicine Explore other publications and websites National HIV and ...

  7. National Farm Medicine Center

    MedlinePLUS

    Farm Medicine, Rural Health & Safety National Farm Medicine Center Established in 1981 in response to occupational health problems seen in farm patients coming to Marshfield Clinic, the National Farm Medicine Center ...

  8. Feinberg School of Medicine

    E-print Network

    Chisholm, Rex L.

    1.25.2012 SENIOR ELECTIVE CATALOG 2012-2013 Feinberg School of Medicine #12;2 TABLE OF CONTENTS_____________________________________ 18 Dermatology ________________________________________________ 19 Family Medicine _____________________________________________ 24 Internal Medicine_____________________________________________ 29 Neurology

  9. Urogynaecology Faculty Medicine

    E-print Network

    Utrecht, Universiteit

    Name: Profile Teaching commitment Urogynaecology Faculty Medicine Department Department of reproductive medicine and gynaecology Contact details Telephone +31887551041 E-mail address c innovation - Regenerative medicine External recognition COBRA award Dutch Pelvic Surgeons Publications List

  10. Nuclear Medicine Imaging

    MedlinePLUS

    Nuclear Medicine Imaging What you need to know about… A nuclear medicine procedure is sometimes described as ... nuclear medicine scan. Estudios de Imagen de Medicina Nuclear Lo que usted necesita saber acerca de... Un ...

  11. Complementary and Integrative Medicine

    MedlinePLUS

    ... medical treatments that are not part of mainstream medicine. When you are using these types of care, it may be called complementary, integrative, or alternative medicine. Complementary medicine is used together with mainstream medical ...

  12. Blood Pressure Medicines

    MedlinePLUS

    ... reducing sodium in your diet, you may need medicines. Blood pressure medicines work in different ways to lower blood pressure. ... and widen blood vessels. Often, two or more medicines work better than one. NIH: National Heart, Lung, ...

  13. Plasma Medicine

    NASA Astrophysics Data System (ADS)

    Laroussi, M.; Kong, M. G.; Morfill, G.; Stolz, W.

    2012-05-01

    Foreword R. Satava and R. J. Barker; Part I. Introduction to Non-equilibrium Plasma, Cell Biology, and Contamination: 1. Introduction M. Laroussi; 2. Fundamentals of non-equilibrium plasmas M. Kushner and M. Kong; 3. Non-equilibrium plasma sources M. Laroussi and M. Kong; 4. Basic cell biology L. Greene and G. Shama; 5. Contamination G. Shama and B. Ahlfeld; Part II. Plasma Biology and Plasma Medicine: 6. Common healthcare challenges G. Isbary and W. Stolz; 7. Plasma decontamination of surfaces M. Kong and M. Laroussi; 8. Plasma decontamination of gases and liquids A. Fridman; 9. Plasma-cell interaction: prokaryotes M. Laroussi and M. Kong; 10. Plasma-cell interaction: eukaryotes G. Isbary, G. Morfill and W. Stolz; 11. Plasma based wound healing G. Isbary, G. Morfill and W. Stolz; 12. Plasma ablation, surgery, and dental applications K. Stalder, J. Woloszko, S. Kalghatgi, G. McCombs, M. Darby and M. Laroussi; Index.

  14. HIV Medicine

    NSDL National Science Digital Library

    From Flying Publisher, _HIV Medicine 2005_ is a free, online "medical textbook that provides a comprehensive and up-to-date overview of the treatment of HIV Infection." This edition is an update of the 2003 version of the textbook (reported on in the June 13, 2003 NSDL Scout Report for Life Sciences). Chapter titles in the textbook include HIV Testing, HIV and Pulmonary Diseases, Mitochondrial Toxicity, HIV and HBV Coinfections, and Traveling with HIV, to name a few. The textbook is available in both German and English. Please note that while certain sections of the 2005 edition are currently available, many sections are still in the process of being published on the site. Sections from the 2003 edition are standing in for some of the forthcoming 2005 sections. The entire 352-page 2003 edition is available for download at this site as well.

  15. Medicine partnerships

    PubMed Central

    Cramer, J

    2003-01-01

    Partial medication compliance, where patients do not take enough of their prescribed medicine to achieve adequate outcomes, is common. Research using electronic monitoring to assess compliance has shown that people take approximately 75% of doses as prescribed, irrespective of the condition being treated or its severity. Erratic compliance often leads to discontinuation of therapy, as treatment is perceived to be ineffective. Compliance decreases as frequency of dosing increases. Inadequate compliance and treatment persistence results in poor outcomes, despite the best efforts of the medical team. It is important to develop and implement a strategy to improve compliance. Simple steps that can be taken include helping patients to select "cues" to remind them to take their tablets, use of dose reminder boxes, and visual feedback of compliance data from electronic monitors. PMID:12695430

  16. Medicine partnerships.

    PubMed

    Cramer, J

    2003-05-01

    Partial medication compliance, where patients do not take enough of their prescribed medicine to achieve adequate outcomes, is common. Research using electronic monitoring to assess compliance has shown that people take approximately 75% of doses as prescribed, irrespective of the condition being treated or its severity. Erratic compliance often leads to discontinuation of therapy, as treatment is perceived to be ineffective. Compliance decreases as frequency of dosing increases. Inadequate compliance and treatment persistence results in poor outcomes, despite the best efforts of the medical team. It is important to develop and implement a strategy to improve compliance. Simple steps that can be taken include helping patients to select "cues" to remind them to take their tablets, use of dose reminder boxes, and visual feedback of compliance data from electronic monitors. PMID:12695430

  17. Research Article in Medicine

    E-print Network

    Small, Dylan

    Research Article Statistics in Medicine Received XXXX (www.interscience.wiley.com) DOI: 10.1002/sim in medicine. Unfortunately, randomized controlled studies cannot answer many comparative effectiveness

  18. Health & Medicine Heart Disease

    E-print Network

    Rogers, John A.

    See Also: Health & Medicine Heart Disease· Medical Imaging· Vioxx· Matter & Energy Electronics Translational Medicine. The emerging technology holds promise for a new generation of flexible, implantable

  19. Medicines for osteoporosis

    MedlinePLUS

    ... Teriparatide (Forteo); Denosumab (Prolia); Low bone density - medicines; Osteoporosis - medicines ... Osteoporosis is a disease that causes bones to become brittle and more likely to fracture (break). With ...

  20. Does psychological resilience mediate the impact of social support on geriatric depression? An exploratory study among Chinese older adults in Singapore.

    PubMed

    Li, Jinhui; Theng, Yin-Leng; Foo, Schubert

    2015-04-01

    Social support and resilience were considered to be two significant influential factors for depression in late life. The study aims to present a mediation model for understanding the interrelations among social support, resilience, and geriatric depression. A cross-sectional survey study was conducted among 162 community-dwelling Chinese older adults in Singapore. Findings indicated a significant indirect effect of social support on geriatric depression through the mediation of resilience, by controlling demographic variables. Further, an identical influencing pattern between problem-solving resilience and emotion regulation resilience were found in the two individual models, suggesting a similar mediation role in linking social support and geriatric depression. These results extended and integrated earlier findings on the relationship of psychosocial factors and geriatric depression, and pointed out practical implications for future work on depression interventions. PMID:25703041

  1. Screening of patients admitted to a geriatric hospital with supposed organic dementia.

    PubMed

    Hedner, K; Gustafson, L; Steen, G; Steen, B

    1987-06-01

    75 patients, aged 69 to 97 (mean 84) years, admitted to a geriatric clinic with symptoms or signs of organic brain failure, were examined with a wide test battery including chemical analyses, electroencephalogram (EEG), regional cerebral blood flow (rCBF) measurement, and psychometric tests. There was a prevalence of 89% organic dementia, 3% treatable dementia, and 8% non-dementia conditions. Thus the prevalence of treatable conditions was rather low (11%). Multi-infarct dementia was more prevalent (52%) than dementia of Alzheimer type (31%). All but one of the non-dementia conditions were due to confusional reaction. In no case was depression, drug intoxication, or deafness the only cause of symptoms. After a follow-up period of 6 months, 33% of the patients had died. An autopsy was performed in 80% of these cases, and the clinical diagnosis was confirmed in all but four cases. PMID:3453285

  2. Respect your elders. Special considerations for EMS response to geriatric patients.

    PubMed

    Widmeier, Keith

    2013-08-01

    A variety of chronic pathologies often come along with the aging process and are experienced by many patients in late adulthood. EMS providers must be aware of the various challenges of transporting the geriatric population. And although an emphasis is often placed on the physical and medical issues associated with this population, it's also imperative to look at the whole picture to help prevent issues before they become an emegent problem. This includes being vigilant for elder abuse and neglect, as well as potential home hazards-including fall potentials and maintaining colder home temperatures-and dangerous cost-cutting measures, such as sharing medications. Prevention is key to helping older patients avoid potentially devastating situations, such as falls, medication errors and urban hyperthermia. But when those situations happen and providers are called to care for an older patient, compassion and demeanor are necessary to make this more vulnerable patient population comfortable and safe. PMID:24319883

  3. Geriatric research.

    PubMed

    Murphy, Susan L

    2010-01-01

    The American Occupational Therapy Association's Centennial Vision articulates the need for occupational therapy to be science driven and evidence based in major practice areas. This article provides a review on the state of the occupational therapy research published in the American Journal of Occupational Therapy (AJOT) in the area of productive aging in the past 2 years (2008-2009). The article identifies the types of research published, assesses how well the journal is meeting the Centennial Vision in productive aging research, and discusses implications for utilization of the evidence by occupational therapy practitioners. Although many basic research articles provide a foundation for future intervention development and further define practice roles, the AJOT articles addressing productive aging represent diverse research questions and have produced a body of knowledge that is not easily translated to practice. More effectiveness studies are needed to provide adequate evidence for occupational therapy intervention with older adults. PMID:20131577

  4. Proton geriatrics

    NASA Astrophysics Data System (ADS)

    Kephart, Thomas W.; Nakagawa, Norio

    1984-07-01

    An SO(10) model with particle spectrum and low energy gauge group identical to that of minimal SU (5) below MX but with a nonstandard charge assignment is shown to agree with the experimental best value of sin2?w(Mw) and the lower bound on the proton lifetime.

  5. Effect of in-hospital comprehensive geriatric assessment (CGA) in older people with hip fracture. The protocol of the Trondheim Hip Fracture Trial

    Microsoft Academic Search

    Olav Sletvold; Jorunn L Helbostad; Pernille Thingstad; Kristin Taraldsen; Anders Prestmo; Sarah E Lamb; Arild Aamodt; Roar Johnsen; Jon Magnussen; Ingvild Saltvedt

    2011-01-01

    Background  Hip fractures in older people are associated with high morbidity, mortality, disability and reduction in quality of life.\\u000a Traditionally people with hip fracture are cared for in orthopaedic departments without additional geriatric assessment. However,\\u000a studies of postoperative rehabilitation indicate improved efficiency of multidisciplinary geriatric rehabilitation as compared\\u000a to traditional care. This randomized controlled trial (RCT) aims to investigate whether an

  6. Development of a 5 year life expectancy index in older adults using predictive mining of electronic

    E-print Network

    and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA 2 Department Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, 210 E Huron, Suite 12

  7. Use of an Objective Structured Clinical Examination in Evaluating Student Performance

    Microsoft Academic Search

    Michael D. Prislin; Camille F. Fitzpatrick; Désirée Lie; Mark Giglio; Stephen Radecki; Ellen Lewis

    Background and Objectives: The objective structured clinical exam (OSCE) is increasingly being used to evaluate student clinical performance. However, scant literature exists pertinent to this approach in evaluating family medicine clerkship performance. In this study, we assess 8 years' experience with a family medicine clerkship OSCE. Methods: Eight annual clerkship OSCEs and the performance of 696 students are described. Comparisons

  8. [Disaster medicine].

    PubMed

    Carli, Pierre; Telionri, Caroline

    2015-01-01

    For over 30 years, the French hospital and pre-hospital medical teams are trained in disaster medicine. In fact, they are regularly confronted with the management of multiple casualties in accidents or even terrorist attacks, and more rarely to large-scale disasters. The intervention of physicians of the EMS system (SAMU-SMUR) in the field allows an original healthcare organization: in an advanced medical post, the victims are triaged according to their severity and benefit if needed of initial resuscitation. SAMU medical regulating center then organize their transport and repartition in several hospitals put on alert. To cope with a mass casualty situation, the hospital also has a specific organization, the White Plan. This plan, initiated by the director, assisted by a medico-administrative cell crisis can mobilize all the resources of the institution. Personnel are recalled and the ability of emergency units is increased. Care, less urgent, other patients are postponed. There are many plans for responding to disasters. ORSEC plans of the ministry of Interior articulate with the ORSAN plans of the ministry of Health. This complementarity allows a global mobilization of public services in disasters or exceptional medical situations. PMID:25842432

  9. Medicine organizer

    NASA Astrophysics Data System (ADS)

    Martins, Ricardo; Belchior, Ismael

    2015-04-01

    In the last year of secondary school, students studying physics and chemistry are incentivized to do a project where they must put in practice their improvement of scientific knowledge and skills, like observation of phenomena and analysis of data with scientific knowledge. In this project a group of students, tutored by the teacher, wanted to build an instrument that helps people to take their medical drugs at the right time. This instrument must have some compartments with an alarm and an LED light where the people can put their medical drugs. The instrument must be easily programed using an android program that also registers if the medicine has been taken. The students needed to simulate the hardware and software, draw the electronic system and build the final product. At the end of the school year, a public oral presentation was prepared by each group of students and presented to the school community. They are also encouraged to participate in national and international scientific shows and competitions.

  10. INSTITUTES AT NORTHWESTERN MEDICINE

    E-print Network

    Engman, David M.

    THE CANCER INSTITUTES AT NORTHWESTERN MEDICINE CANCER SURVIVORSHIP INSTITUTE THE INSTITUTES AT NORTHWESTERN MEDICINE #12;THE INSTITUTES AT NORTHWESTERN MEDICINE Today more than ever, cancer survivors Survivorship Institute at Northwestern Medicine is exceptionally well-positioned to integrate the best medical

  11. Advancing MEDICINE Through TECHNOLOGY

    E-print Network

    Vajda, Sandor

    Advancing MEDICINE Through TECHNOLOGY Annual Report 2010 -2011 BME #12;2 ADVANCING MEDICINE THROUGH, please visit our website at: bu.edu/bme #12;ADVANCING MEDICINE THROUGH TECHNOLOGY BME 2010-2011 ANNUAL the past year, the Biomedical Engineering Department furthered its goal of advancing medicine through

  12. FAMILY MEDICINE* Definition Of

    E-print Network

    Finley Jr., Russell L.

    FAMILY MEDICINE* Definition Of Family medicine is the medical specialty which provides continuing the biological, clinical and behavioral sciences. The scope of family medicine encompasses all ages, both sexes, each organ system and every disease entity. (1986) (2003) Quality Healthcare In Family Medicine Quality

  13. Medicine and Medical Center

    E-print Network

    Faculty of Medicine and Medical Center (FM/AUBMC) #12;400 Faculty of Medicine and Medical Center (FM/AUBMC) Graduate Catalogue 2014­15 Faculty of Medicine and Medical Center (FM/AUBMC) Officers Vice President for Medical Affairs and the Raja N. Khuri Dean of the Faculty of Medicine Ziyad Ghazzal

  14. Medicine and Medical Center

    E-print Network

    Shihadeh, Alan

    Faculty of Medicine and Medical Center (FM/AUBMC) #12;370 Faculty of Medicine and Medical Center (FM/AUBMC) Graduate Catalogue 2013­14 Faculty of Medicine and Medical Center (FM/AUBMC) Officers Vice President for Medical Affairs and the Raja N. Khuri Dean of the Faculty of Medicine Ziyad Ghazzal

  15. Genome Medicine 2009, 11

    E-print Network

    Genome Medicine 2009, 11::88 Correspondence BBrriiddggiinngg tthhee ggaapp bbeettwweeeenn Care Medicine and CRISMA laboratory, University of Pittsburgh School of Medicine, Scaife 602, 3550 Biotechnology Center, University of Torino, Via Nizza 52, I, 10126 Torino, Italy; 10Institutionen för Medicin

  16. Undergraduate Faculty of Medicine

    E-print Network

    Bristol, University of

    Undergraduate Medicine Faculty of Medicine and Dentistry #12;bristol.ac.uk/study A medical degree direction in medicine. At Bristol your medical education will start with a thorough scientific understanding, multicultural and forward-thinking; a fantastic environment in which to learn and practise medicine. The Medical

  17. Personality Characteristics Determine Health-Related Quality of Life as an Outcome Indicator of Geriatric Inpatient Rehabilitation

    PubMed Central

    Richter, Jörg; Schwarz, Martina; Bauer, Barbara

    2008-01-01

    Background. The aim of the present study was to investigate the relationships between personality and quality of life during the course of geriatric rehabilitation, against the background of Cloninger's biosocial theory of personality. Methods. All consecutive patients of a geriatric rehabilitation clinic during one year were evaluated at admission and discharge (N = 687) by means of the ‘‘Vienna List’’ (a newly developed questionnaire for the assessment of quality of life in patients with severe dementia), and two variants of the Temperament and Character Inventory. Results. Self-directedness showed the most general and highest impact on quality of life and successful rehabilitation. Conclusions. It is probable in old and very old individuals who are on their highest level of maturity that the character represents the most important regulatory system in the encounter with challenges of daily life, which necessitates rehabilitation. PMID:19415144

  18. Specific features of medicines safety and pharmacovigilance in Africa

    PubMed Central

    Pal, Shanthi N.; Olsson, Sten; Dodoo, Alexander; Bencheikh, Rachida Soulayami

    2012-01-01

    The thalidomide tragedy in the late 1950s and early 1960s served as a wakeup call and raised questions about the safety of medicinal products. The developed countries rose to the challenge putting in place systems to ensure the safety of medicines. However, this was not the case for low-resource settings because of prevailing factors inherent in them. This paper reviews some of these features and the current status of pharmacovigilance in Africa. The health systems in most of the 54 countries of Africa are essentially weak, lacking in basic infrastructure, personnel, equipment and facilities. The recent mass deployment of medicines to address diseases of public health significance in Africa poses additional challenges to the health system with notable safety concerns. Other safety issues of note include substandard and counterfeit medicines, medication errors and quality of medicinal products. The first national pharmacovigilance centres established in Africa with membership of the World Health Organization (WHO) international drug monitoring programme were in Morocco and South Africa in 1992. Of the 104 full member countries in the programme, there are now 24 African countries with a further nine countries as associate members. The pharmacovigilance systems operational in African countries are based essentially on spontaneous reporting facilitated by the introduction of the new tool Vigiflow. The individual case safety reports committed to the WHO global database (Vigibase) attest to the growth of pharmacovigilance in Africa with the number of reports rising from 2695 in 2000 to over 25,000 in 2010. There is need to engage the various identified challenges of the weak pharmacovigilance systems in the African setting and to focus efforts on how to provide resources, infrastructure and expertise. Raising the level of awareness among healthcare providers, developing training curricula for healthcare professionals, provisions for paediatric and geriatric pharmacovigilance, engaging the pharmaceutical industries as well as those for herbal remedies are of primary concern. PMID:25083223

  19. The stress response and anesthetic potency of unilateral spinal anesthesia for total Hip Replacement in geriatric patients.

    PubMed

    Zhu, Li; Tian, Chun; Li, Min; Peng, Ming-Qing; Ma, Kun-Long; Wang, Zhong-Lin; Ding, Jia-Hui; Cai, Yi

    2014-11-01

    Recently, some scholars suggested that it is important to keep a stablehemodynamic state and prevent the stress responses in geriatric patients undergoing total hip replacement (THR). We conducted this randomized prospective study to observe anesthetic potency of unilateral spinal anesthesia and stress response to it in geriatric patients during THR. We compared the effect of unilateral spinal and bilateral spinal on inhibition of stress response through measuring Norepinephrine (NE), epinephrine (E) and cortisol (CORT). Plasma concentrations of NE, E and CORT were determined in blood samples using ELISA (enzyme-linked immunosorbent assays) at three time points: To (prior to anesthesia) T1 (at the time point of skin closure), T2 (twenty-four hours after the operation). Sixty patients were randomly divided into two groups: group A (unilateral spinal anesthesia) and group B (conventional bilateral spinal anesthesia). 7.5tymg of hypobaric bupivacaine were injected into subarachnoid cavity at group A and 12mg hypobaric bupivacaine were given at group B. The onset time of sensory and motor block, loss of pinprick sensation, degree of motor block, regression of sensory and motor blocks and hemodynamic changes were also recorded. These data were used to evaluate anesthetic potency of spinal anesthesia. The results of this experiment show that unilateral spinal anesthesia can provide restriction of sensory and motor block, minimize the incidence of hypotension and prevent the stress responses undergoing THR. It is optimal anesthesia procedure for geriatric patients by rapid subarachnoid injection of small doses of bupivacaine. PMID:25410068

  20. A curricular model for the training of physician scientists: the evolution of the Duke University School of Medicine curriculum.

    PubMed

    O'Connor Grochowski, Colleen; Halperin, Edward Charles; Buckley, Edward George

    2007-04-01

    Duke University School of Medicine offers an unusual doctor of medicine educational program. The core basic sciences are taught in year one, core clinical clerkships are completed in the second year, the entire third year is devoted to scholarly investigation, and elective rotations are fulfilled in the fourth year. The creation of this unique structure presented many challenges and is the product of a desire of key faculty 40 years ago to change radically the way medical education was taught. Over the years, improvements have been made, but the underlying principles of these visionary leaders have been retained: inquire not just acquire, flexibility of choice, and in-depth exploration. In the spirit of innovation that was established 40 years ago, leaders and faculty at Duke developed a new curricular model in 2004, called Foundation for Excellence, which is anchored in integrated, interdisciplinary innovation. The authors describe the process of curricular reform and provide a detailed overview of this unique approach to medical education. In keeping with Duke's mission to graduate clinician-researchers and clinician-educators, reducing the basic science curriculum to one year created a year saved, which students are now required to devote to scholarly pursuits. The authors argue that adopting a similar one-year basic science curriculum would make instructional time available for other schools to achieve their own institutional goals. PMID:17414195