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1

Geriatrics and Ambulatory Medicine (GAM) Clerkship Review 7/3/14 MEC subcommittee: Dr. John Dick, Dr. Hilary Ryder, Dr. Pinto-Powell, Dr. Marybeth Durkin  

E-print Network

Geriatrics and Ambulatory Medicine (GAM) Clerkship Review ­ 7/3/14 MEC to diagnosis and treatment questions in ambulatory and geriatric patient care. Performance Evaluations and geriatric patient care. Performance Evaluations Clinic 1e 3 Apply current knowledge

Myers, Lawrence C.

2

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

PubMed Central

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

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

2006-01-01

3

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

ERIC Educational Resources Information Center

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…

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

2013-01-01

4

Description and students' perceptions of a required geriatric clerkship in postacute rehabilitative care.  

PubMed

This article describes medical students' evaluation of a geriatric clerkship in postacute rehabilitative care settings. This was a cross-sectional study of fourth-year medical students who completed a mandatory 2-week rotation at a postacute care facility. Students were provided with three instructional methods: Web-based interactive learning modules; small-group sessions with geriatric faculty; and Geriatric Interdisciplinary Care Summary (GICS), a grid that students used to formulate comprehensive interdisciplinary care plans for their own patients. After the rotation, students evaluated the overall clerkship, patient care activities, and usefulness of the three instructional methods using a 5-point Likert scale (1=poor to 5=excellent) and listed their area of future specialty. Of 156 students who completed the rotation, 117 (75%) completed the evaluation. Thirty (26%) chose specialties providing chronic disease management such as family, internal medicine, and psychiatry; 34 (29%) chose specialties providing primarily procedural services such as surgery, radiology, anesthesiology, pathology, and radiation oncology. Students rated the usefulness of the GICS as good to very good (mean+/-standard deviation 3.3+/-1.0). Similarly, they rated overall clerkship as good to excellent (3.8+/-1.0). Analysis of variance revealed no significant group difference in any of the responses from students with the overall clerkship (F(112, 4)=1.7, P=.20). Students rated the geriatric clerkship favorably and found the multimodal instruction to be useful. Even for students whose career choice was not primary care, geriatrics was a good model for interdisciplinary care training and could serve as a model for other disciplines. PMID:19682134

Bautista, Miho K; Meuleman, John R; Shorr, Ron I; Beyth, Rebecca J

2009-09-01

5

Emergency Medicine Clerkship Directors: Current Workforce  

PubMed Central

Introduction The emergency medicine clerkship director serves an important role in the education of medical students. The authors sought to update the demographic and academic profile of the emergency medicine clerkship director. Methods We developed and implemented a comprehensive questionnaire, and used it to survey all emergency medicine clerkship directors at United States allopathic medical schools accredited by the Liaison Committee on Medical Education. We analyzed and interpreted data using descriptive statistics. Results One hundred seven of 133 (80.4%) emergency medicine clerkship directors completed the survey. Clerkship Director’s mean age was 39.7 years (SD-7.2), they were more commonly male 68.2%, of Caucasian racial backgrounds and at the instructor or assistant professor (71.3%) level. The mean number of years of experience as clerkship director was 5.5 (SD-4.5). The mean amount of protected time for clerkship administration reported by respondents was 7.3 hours weekly (SD-5.1), with the majority (53.8%) reporting 6 or more hours of protected time per week. However, 32.7% of emergency medicine clerkship directors reported not having any protected time for clerkship administration. Most clerkship directors (91.6%) held additional teaching responsibilities beyond their clerkship and many were involved in educational research (49.5%). The majority (79.8%), reported being somewhat or very satisfied with their job as clerkship director. Conclusion Most clerkship directors were junior faculty at the instructor or assistant professor rank and were involved with a variety of educational endeavors beyond the clerkship. PMID:25035743

Wald, David A.; Khandelwal, Sorabh; Manthey, David E.; Way, David P.; Ander, Douglas S.; Thibodeau, Lorraine

2014-01-01

6

Geriatrics and internal medicine.  

PubMed

If medical education is to respond adequately to the growing number of citizens encompassed by the field of geriatric medicine, it must intensify its commitment to the special health and health-related problems of the elderly at every level, from student to certified specialist. This paper discusses the various intellectual, epidemiologic, economic, and attitudinal factors related to the teaching and practice of geriatric medicine. The emergence of a positive philosophy emphasizing coping and possible reversibility of disease is vital. The recent report of the Institute of Medicine on Aging and Medical Education is also reviewed, as well as graduate training opportunities and ways in which the American Board of Internal Medicine could play a leading role in this process by providing increased emphasis on geriatrics in its training programs and certifying examinations. The medical profession must continue its self-evaluation to ascertain how it can most effectively contribute to improving the lives of the elderly, perhaps our greatest national resource. PMID:517892

Butler, R N

1979-12-01

7

Perioperative Medicine and Pain Therapy Clerkship MID-ROTATION EVALUATION  

E-print Network

Perioperative Medicine and Pain Therapy Clerkship MID-ROTATION EVALUATION The University of Chicago in Perioperative Medicine and Pain Therapy clerkship. On the next page, please provide written comments to explain your scores. 0 1 2 3 4 5 Diagnosis and Management in Perioperative Medicine and Pain Therapy 1

Issa, Naoum

8

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

ERIC Educational Resources Information Center

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…

Struck, Bryan D.; Teasdale, Thomas A.

2008-01-01

9

25th Anniversary Geriatric Medicine Refresher Day  

E-print Network

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

Sinnamon, Gordon J.

10

GERIATRIC MEDICINE CAPITAL HEALTH RESEARCH Page 1  

E-print Network

GERIATRIC MEDICINE CAPITAL HEALTH RESEARCH Page 1 CAPITAL HEALTH -- RESEARCH FOCUS ON Many people are working to better understand and care for the complex needs of geriatric patients. Geriatric medicine by 2020. China is keenly interested as well. In fact, the Capital Health geriatric medicine team has

Brownstone, Rob

11

Expectations of and for the medicine clerkship director.  

PubMed

Maintaining quality in curriculum and evaluation in core clerkship rotations requires the supervision of a dedicated individual, who is not only expert in the subject matter of internal medicine but skilled in educational practice and in administration. This CDIM commentary aims to facilitate the mentoring of the clerkship director by listing expectations of and for the position. The clerkship director should have resources commensurate with the tasks to be performed. On average, clerkship directors report spending 28% of their time on clerkship administration (CDIM Evaluation Task Force Survey, 1996; unpublished data). CDIM recommends that 25% should be considered a minimum estimate of time for the "essential" administrative aspects of running a clerkship, not including time spent teaching students in seminars and lectures or in patient care activities. If scholarly activity in the clerkship is to be a principal measure of productivity towards academic promotion, then additional time will have to part of the clerkship director's week. Since a personal role in teaching is usual and scholarly productivity desirable, a minimum of 50% of a full-time equivalent should be expected. PMID:9831418

Pangaro, L N

1998-11-01

12

Consensus Development of a Pediatric Emergency Medicine Clerkship Curriculum  

PubMed Central

Introduction As emergency medicine (EM) has become a more prominent feature in the clinical years of medical school training, national EM clerkship curricula have been published to address the need to standardize students’ experiences in the field. However, current national student curricula in EM do not include core pediatric emergency medicine (PEM) concepts. Methods A workgroup was formed by the Clerkship Directors in Emergency Medicine and the Pediatric Interest Group of the Society of Academic Emergency Medicine to develop a consensus on the content to be covered in EM and PEM student courses. Results The consensus is presented with the goal of outlining principles of pediatric emergency care and prioritizing students’ exposure to the most common and life-threatening illnesses and injuries. Conclusion This consensus curriculum can serve as a guide to directors of PEM and EM courses to optimize PEM knowledge and skills education. PMID:25247034

Askew, Kim L.; Weiner, Debra; Murphy, Charles; Duong, Myto; Fox, James; Fox, Sean; O’Neill, James C.; Nadkarni, Milan

2014-01-01

13

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

E-print Network

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

Lee, Daeyeol

14

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

PubMed Central

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

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

2014-01-01

15

Ambulatory Education in the Internal Medicine Clerkship at Southern Illinois University School of Medicine.  

ERIC Educational Resources Information Center

The ambulatory care segment of the Southern Illinois University internal medicine clerkship provides extensive clinical exposure in a variety of settings and includes formal educational activities in seminars and workshops. Despite problems, educational quality has improved. Planned expansion includes a longitudinal experience for students.…

Kovach, Regina

1993-01-01

16

ETHICS IN GERIATRIC MEDICINE RESEARCH.  

PubMed

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

Ilgili, Onder; Arda, Berna; Munir, Kerim

2014-01-01

17

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

18

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

E-print Network

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

Berdichevsky, Victor

19

Undergraduate Teaching in Geriatric Medicine: The Role of National Curricula  

ERIC Educational Resources Information Center

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…

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

2009-01-01

20

Reshaping pre-clerkship years in reproductive medicine education.  

PubMed

The educational program of the Paul L. Foster School of Medicine in El Paso, Texas integrates the basic and clinical sciences and organizes them according to the organ-system based units. The reproduction unit focuses on human reproduction, pregnancy and illnesses associated with the female genital tract and breast. The sequence of 13 clinical presentations is structured so that the concepts developed during the study of one topic lays down a foundation for subsequent topics. Students are provided with a brief definition and a statement of clinical significance for each clinical presentation, which serves as the foundation for presentations of both clinical and basic science information. In the Medical Skills Course, students practice skills and behaviors associated with obstetrics and gynecology (Ob Gyn) history taking, culturally sensitive communication skills, conducting and recording of physical and pelvic examinations as they relate to clinical presentations. The Society, Community and Individual Course focuses on real life experience in a local community clinic setting and improves the understanding of the social determinants of female reproductive health. We believe that our pedagogical approach enhances knowledge comprehension, improves knowledge retention of the basic science and promotes the development of clinical reasoning, enabling easier transition to the clerkship years. PMID:21801034

Patham, Bhargavi; Plavsic, Sanja Kupesic

2011-11-01

21

Teaching About Racial\\/Ethnic Health Disparities: A National Survey of Clerkship Directors in Internal Medicine  

Microsoft Academic Search

Background: The Institute of Medicine and the Liaison Committee on Medical Education (LCME) have both identified the importance of integrating teaching regarding health disparities into medical education. Thus far most of the limited teaching in this area occurs in the first two years of medical school. Purpose: The purpose of this study is to evaluate education in internal medicine clerkships

Shobhina Chheda; Paul A. Hemmer; Steven Durning

2009-01-01

22

Geriatric management in medieval Persian medicine  

PubMed Central

In Iran, a large group of patients are elderly people and they intend to have natural remedies as treatment. These remedies are rooted in historical of Persian and humoral medicine with a backbone of more than 1000 years. The current study was conducted to draw together medieval pharmacological information related to geriatric medicine from some of the most often manuscripts of traditional Persian medicine. Moreover, we investigated the efficacy of medicinal plants through a search of the PubMed, Scopus and Google Scholar databases. In the medieval Persian documents, digestible and a small amount of food such as chicken broth, honey, fig and plum at frequent intervals as well as body massage and morning unctioning are highly recommended. In the field of pharmacotherapy, 35 herbs related to 25 families were identified. Plants were classified as tonic, anti-aging, appetizer, memory and mood enhancer, topical analgesic and laxative as well as health improvement agents. Other than historical elucidation, this paper presents medical and pharmacological approaches that medieval Persian practitioners applied to deal with geriatric complications. PMID:24381461

Emami, Morteza; Sadeghpour, Omid; Zarshenas, Mohammad M.

2013-01-01

23

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

ERIC Educational Resources Information Center

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…

Del Duca, Danny; Duque, Gustavo

2006-01-01

24

Drug Abuse Training as Part of a Family Medicine Clerkship.  

ERIC Educational Resources Information Center

A program incorporating experiential and didactic experience in identification and treatment of drug abuse into third-year clerkship curriculum is described. Experiential training is in a methadone maintenance clinic. Students are evaluated on their knowledge, attitudes, and level of participation in the drug abuse treatment. (MSE)

Confusione, Michael; And Others

1982-01-01

25

Caring for older Americans: the future of geriatric medicine.  

PubMed

In response to the needs and demands of an aging population, geriatric medicine has grown rapidly during the past 3 decades. The discipline has defined its core values as well as the knowledge base and clinical skills needed to improve the health, functioning, and well-being of older persons and to provide appropriate palliative care. Geriatric medicine has developed new models of care, advanced the treatment of common geriatric conditions, and advocated for the health and health care of older persons. Nevertheless, at the beginning of the 21st century, the health care of older persons is at a crossroads. Despite the substantial progress that geriatric medicine has made, much more remains to be done to meet the healthcare needs of our aging population. The clinical, educational, and research approaches of the 20th century are unable to keep pace and require major revisions. Maintaining the status quo will mean falling further and further behind. The healthcare delivery and financing systems need fundamental redesign to improve quality and eliminate waste. The American Geriatrics Society (AGS) Task Force on the Future of Geriatric Medicine has identified five goals aimed at optimizing the health of older persons: To ensure that every older person receives high-quality, patient-centered health care; To expand the geriatrics knowledge base; To increase the number of healthcare professionals who employ the principles of geriatric medicine in caring for older persons; To recruit physicians and other healthcare professionals into careers in geriatric medicine; To unite professional and lay groups in the effort to influence public policy to continually improve the health and health care of seniors. Geriatric medicine cannot accomplish these goals alone. Accordingly, the Task Force has articulated a set of recommendations primarily aimed at the government, organizations, agencies, foundations, and other partners whose collaboration will be essential in accomplishing these goals. The vision described in this document and the accompanying recommendations are only the broad outline of an agenda for the future. Geriatric medicine, through its professional organizations and its partners, will need to mobilize resources to identify and implement the specific steps that will make the vision a reality. Doing so will require broad participation, consensus building, creativity, and perseverance. The consequences of inaction will be profound. The combination of a burgeoning number of older persons and an inadequately prepared, poorly organized physician workforce is a recipe for expensive, fragmented health care that does not meet the needs of our older population. By virtue of their unique skills and advocacy for the health of older persons, geriatricians can be key leaders of change to achieve the goals of geriatric medicine and optimize the health of our aging population. Nevertheless, the goals of geriatric medicine will be accomplished only if geriatricians and their partners work in a system that is designed to provide high-quality, efficient care and recognizes the value of geriatrics. PMID:15963180

Besdine, Richard; Boult, Chad; Brangman, Sharon; Coleman, Eric A; Fried, Linda P; Gerety, Meghan; Johnson, Jerry C; Katz, Paul R; Potter, Jane F; Reuben, David B; Sloane, Philip D; Studenski, Stephanie; Warshaw, Gregg

2005-06-01

26

Geriatric fellowships in family medicine: status and directions.  

PubMed

The American Board of Medical Specialties recently approved the concept of certificates of added qualifications in geriatrics within both internal medicine and family practice. Certification requirements have been worked out for each training model, and questions have quite naturally arisen addressing whether the developing family practice model is substantially different from the longer established internal medicine model. A survey was made of 12 family practice based geriatric fellowship programs. Program directors were asked how they felt family practice geriatrics differed from internal medicine geriatrics in approaches to patient care and training and in areas of research interests. Information was also gathered about program size, length of training, and operational status. Eight fellowship programs were found to be active at the time of the survey, but only two for more than six months. Of the eight functioning programs, four were currently without fellows--a forewarning, perhaps, of potential recruitment problems for additional programs under development. Survey responses indicated a universal feeling among directors of family practice geriatric programs that their model does serve a unique function. Within the "distinguishing characteristics" most frequently noted, an emphasis on psychosocial and family issues can be identified. This emphasis can also be seen in the suggestions for distinctive research, with an indication of special interest in the delivery of health care. PMID:3342958

Koenig, H G; Kvale, J N; Hector, M

1988-01-01

27

Culture Competence in the Training of Geriatric Medicine Fellows  

ERIC Educational Resources Information Center

With the aging and diversifying of the elder population in the United States, there is a pressing need for an organized and effective curriculum in cultural competence. The Accreditation Council for Graduate Medical Education (ACGME) requires that the curriculum for Geriatric Medicine Fellowship training include cultural competency training.…

Tanabe, Marianne K. G.

2007-01-01

28

Smoking Assessment and Cessation Skills in the Inpatient Medicine Clerkship.  

ERIC Educational Resources Information Center

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…

Hull, Alan L.; Kleinhenz, Mary Ellen

1990-01-01

29

Analysis and Publication Rates of Clerkship Directors in Internal Medicine (CDIM) Annual Meeting Abstracts 1995–2005  

Microsoft Academic Search

Background: Abstracts presented at meetings may be a reflection of the meeting's quality. Summary: The goal is to determine purpose, content areas, research design, and subsequent publication rates of abstracts presented at Clerkship Directors in Internal Medicine's annual meetings. Abstracts presented in 1995–2005 were analyzed. A total of 201 abstracts were analyzed and coded. The purpose of the majority of

Klara K. Papp; Elizabeth A. Baker; Liselotte N. Dyrbye; D. Michael Elnicki; Paul A. Hemmer; Alex J. Mechaber; Matthew Mintz; Steven J. Durning

2011-01-01

30

The current status of family medicine geriatric fellowships.  

PubMed

A questionnaire was sent to directors of all family medicine-affiliated geriatric fellowship programs to characterize trends and changes since institution of ACGME accreditation of fellowships. The number of fellowships has more than doubled since 1986, but few fellows graduate from these programs. There is currently a surplus of fellowship positions; over half of all programs did not recruit a first-year fellow for the 1989 academic year. In 1986, most family medicine-affiliated programs had independent administration. Almost half of the programs are now jointly sponsored with an internal medicine department. These programs are over six times more likely to train internists than family physicians. Although there has been a growth in geriatric training programs over the past three years, the number of family physicians seeking such training remains negligible. PMID:2099748

Reed, R L; Weiss, B D; Senf, J H

1990-01-01

31

History of geriatric medicine: from Hippocrates to Marjory Warren.  

PubMed

It is widely assumed that geriatric medicine was an invention of the twentieth century. However, from the time of Hippocrates, there has been interest in the prolongation of the lifespan, the maintenance of health in old age and agerelated disease patterns. The debate about whether old age was a natural phenomenon or a disease state was not resolved until the nineteenth century. Calls for medicine relating to old age to be recognised as a discrete entity at the time when medical specialisation was developing were disregarded until the second half of the twentieth century. This review discusses the history of the theories of ageing and of disease and the practice of medicine for older people from the classical period up to Marjory Warren's initiative in London in 1935 and the development of geriatrics as a medical specialty. PMID:23240126

Ritch, A

2012-01-01

32

Assessing Knowledge Base on Geriatric Competencies for Emergency Medicine Residents  

PubMed Central

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

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

2014-01-01

33

Use of Non-Physician Professionals in Teaching Geriatrics to Internal Medicine and Family Practice Residents  

Microsoft Academic Search

Clinical training in geriatrics emphasizes the use of an interdisciplinary team in caring for the elderly patient. To examine how residency programs use non-physician professionals to teach geriatrics, a random sample consisting of one-third of all 420 internal medicine and 378 family practice training programs in the United States was surveyed. Thirty four percent of internal medicine programs and 68%

David B. Reuben; Arlene Fink; Susan Vivell; Susan H. Hirsch; John C. Beck

1992-01-01

34

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

ERIC Educational Resources Information Center

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…

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

2009-01-01

35

Art-making in a family medicine clerkship: how does it affect medical student empathy?  

PubMed

BackgroundTo provide patient-centred holistic care, doctors must possess good interpersonal and empathic skills. Medical schools traditionally adopt a skills-based approach to such training but creative engagement with the arts has also been effective. A novel arts-based approach may help medical students develop empathic understanding of patients and thus contribute to medical students¿ transformative process into compassionate doctors. This study aimed to evaluate the impact of an arts-making workshop on medical student empathy.MethodsThis was a mixed-method quantitative-qualitative study. In the 2011¿12 academic year, all 161 third year medical students at the University of Hong Kong were randomly allocated into either an arts-making workshop or a problem-solving workshop during the Family Medicine clerkship according to a centrally-set timetable. Students in the arts-making workshop wrote a poem, created artwork and completed a reflective essay while students in the conventional workshop problem-solved clinical cases and wrote a case commentary. All students who agreed to participate in the study completed a measure of empathy for medical students, the Jefferson Scale of Empathy (JSE) (student version), at the start and end of the clerkship. Quantitative data analysis: Paired t-test and repeated measures ANOVA was used to compare the change within and between groups respectively. Qualitative data analysis: Two researchers independently chose representational narratives based on criteria adapted from art therapy. The final 20 works were agreed upon by consensus and thematically analysed using a grounded theory approach.ResultsThe level of empathy declined in both groups over time, but with no statistically significant differences between groups. For JSE items relating to emotional influence on medical decision making, participants in the arts-making workshop changed more than those in the problem-solving workshop. From the qualitative data, students perceived benefits in arts-making, and gained understanding in relation to self, patients, pain and suffering, and the role of the doctor.ConclusionsThough quantitative findings showed little difference in empathy between groups, arts-making workshop participants gained empathic understanding in four different thematic areas. This workshop also seemed to promote greater self-awareness which may help medical students recognize the potential for emotions to sway judgment. Future art workshops should focus on emotional awareness and regulation. PMID:25431323

Potash, Jordan S; Chen, Julie Y; Lam, Cindy; Chau, Vivian

2014-11-28

36

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

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)

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

2003-01-01

37

First Year Medical Students' Knowledge, Attitudes, and Interest in Geriatric Medicine  

ERIC Educational Resources Information Center

The purpose of this study was to examine the impact of an extracurricular geriatric program on medical students' knowledge of, and attitudes toward, the elderly and their interest in studying geriatric medicine. The participants were first-year medical students (n = 137) who joined the Senior Teacher Education Partnership (STEP) program that…

Lu, Wei-Hsin; Hoffman, Kimberly G.; Hosokawa, Michael C.; Gray, M. Peggy; Zweig, Steven C.

2010-01-01

38

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

ERIC Educational Resources Information Center

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…

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

39

Construct Validity of Three Clerkship Performance Assessments  

ERIC Educational Resources Information Center

This study examined construct validity of three commonly used clerkship performance assessments: preceptors' evaluations, OSCE-type clinical performance measures, and the NBME [National Board of Medical Examiners] medicine subject examination. Six hundred and eighty-six students taking the inpatient medicine clerkship from 2003 to 2007…

Lee, Ming; Wimmers, Paul F.

2010-01-01

40

Specialty experience in geriatric medicine is associated with a small increase in knowledge of delirium  

PubMed Central

Background: delirium is underdiagnosed and undertreated. Understanding of delirium among doctors in medical and ICU settings has previously been shown to be low. We hypothesised that junior doctors who had gained experience in geriatrics, neurology or psychiatry may have an increased knowledge of delirium. Methods: we used data from a large multi-centre study of junior doctors conducted between December 2006 and January 2007 which is, to date, the largest survey of understanding of delirium among junior doctors. The original survey used a questionnaire within which certain key items led to a correct or incorrect answer. Total correct answers were recorded giving a maximum total knowledge score of 17 for each participant. The relationship between total knowledge score achieved on the questionnaire and time since qualification; specialty experience in geriatric medicine, psychiatry and/or neurology and self-reported experience with the Confusion Assessment Method (independent variables) were modelled using linear regression. Results: around half (53.2%; 399 of 750) of those surveyed stated that they had experience in geriatric medicine. In contrast only 4.1 and 8.0% of respondents had experience in psychiatry and neurology, respectively. Experience in geriatric medicine was significantly associated with a modest increase in correct answers (4.7 versus 4.3 points, P = 0.020). No other variables were significantly associated with better scores. Conclusion: experience in geriatric medicine leads to a small improvement in understanding of delirium among junior doctors. PMID:24132853

Jenkin, Rodric Peter Llewelyn; Musonda, Patrick; MacLullich, Alasdair M. J.; Myint, Phyo Kyaw; Davis, Daniel H. J.

2014-01-01

41

European undergraduate curriculum in geriatric medicine developed using an international modified Delphi technique  

PubMed Central

Introduction: the rise in the number of older, frail adults necessitates that future doctors are adequately trained in the skills of geriatric medicine. Few countries have dedicated curricula in geriatric medicine at the undergraduate level. The aim of this project was to develop a consensus among geriatricians on a curriculum with the minimal requirements that a medical student should achieve by the end of medical school. Methods: a modified Delphi process was used. First, educational experts and geriatricians proposed a set of learning objectives based on a literature review. Second, three Delphi rounds involving a panel with 49 experts representing 29 countries affiliated to the European Union of Medical Specialists (UEMS) was used to gain consensus for a final curriculum. Results: the number of disagreements following Delphi Rounds 1 and 2 were 81 and 53, respectively. Complete agreement was reached following the third round. The final curriculum consisted of detailed objectives grouped under 10 overarching learning outcomes. Discussion: a consensus on the minimum requirements of geriatric learning objectives for medical students has been agreed by European geriatricians. Major efforts will be needed to implement these requirements, given the large variation in the quality of geriatric teaching in medical schools. This curriculum is a first step to help improve teaching of geriatrics in medical schools, and will also serve as a basis for advancing postgraduate training in geriatrics across Europe. PMID:24603283

Masud, Tahir; Blundell, Adrian; Gordon, Adam Lee; Mulpeter, Ken; Roller, Regina; Singler, Katrin; Goeldlin, Adrian; Stuck, Andreas

2014-01-01

42

Effects of an inpatient geriatrics rotation on internal medicine residents’ knowledge and attitudes  

Microsoft Academic Search

OBJECTIVE: The purpose of this study is to assess the effect of a geriatrics-focused acute medicine inpatient rotation and the presence\\u000a or absence of a geriatrician as attending physician on knowledge about and attitudes toward older patients and the field of\\u000a geriatrics.\\u000a \\u000a \\u000a DESIGN: Randomized trial.\\u000a \\u000a \\u000a \\u000a \\u000a INTERVENTION: A 4-week acute care inpatient internal medicine rotation at a university-affiliated Veterans Affairs Medical

Michael C. Lindberg; Gail M. Sullivan

1996-01-01

43

TRANSITIONING TO CLERKSHIPS: 2 Seniors share their strategy  

E-print Network

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

Acton, Scott

44

The Roots of Geriatric Medicine: Care of the Aged in Byzantine Times (324–1453 AD)  

Microsoft Academic Search

Background: The search for the roots of geriatric medicine, which has been considered a relatively new branch. Objective: The purpose of the study is the research of the original Byzantine medical texts and the contemporary historical sources so as to bring to light knowledge about ancient medical care. Methods: The medical texts of Byzantine physicians were studied and analysed, as

J. Lascaratos; Effie Poulacou-Rebelacou

2000-01-01

45

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

ERIC Educational Resources Information Center

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…

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

2009-01-01

46

Optimal older adult emergency care: introducing multidisciplinary geriatric emergency department guidelines from the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine.  

PubMed

In the United States and around the world, effective, efficient, and reliable strategies to provide emergency care to aging adults is challenging crowded emergency departments (EDs) and strained healthcare systems. In response, geriatric emergency medicine clinicians, educators, and researchers collaborated with the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine to develop guidelines intended to improve ED geriatric care by enhancing expertise, educational, and quality improvement expectations, equipment, policies, and protocols. These Geriatric Emergency Department Guidelines represent the first formal society-led attempt to characterize the essential attributes of the geriatric ED and received formal approval from the boards of directors of each of the four societies in 2013 and 2014. This article is intended to introduce emergency medicine and geriatric healthcare providers to the guidelines while providing recommendations for continued refinement of these proposals through educational dissemination, formal effectiveness evaluations, cost-effectiveness studies, and eventually institutional credentialing. PMID:24890806

Carpenter, Christopher R; Bromley, Marilyn; Caterino, Jeffrey M; Chun, Audrey; Gerson, Lowell W; Greenspan, Jason; Hwang, Ula; John, David P; Lyons, William L; Platts-Mills, Timothy F; Mortensen, Betty; Ragsdale, Luna; Rosenberg, Mark; Wilber, Scott

2014-07-01

47

Medical readers' theater: relevance to geriatrics medical education.  

PubMed

Medical Readers' Theater (MRT) is an innovative and simple way of helping medical students to reflect on difficult-to-discuss topics in geriatrics medical education, such as aging stereotypes, disability and loss of independence, sexuality, assisted living, relationships with adult children, and end-of-life issues. The authors describe a required MRT experience involving third-year medical students on their Family Medicine clerkship and volunteer residents from a nearby continuing care retirement community. Evaluation of the program shows positive benefits to student and senior participants in terms of greater awareness of each other's perspectives and improved communication. PMID:22087781

Shapiro, Johanna; Cho, Beverly

2011-01-01

48

Effective Teaching Methods for Geriatric Competencies  

ERIC Educational Resources Information Center

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…

Strano-Paul, Lisa

2011-01-01

49

The Subinternship Curriculum in Internal Medicine: A National Survey of Clerkship Directors  

Microsoft Academic Search

Background: The 4th-year internal medicine subinternship (subI), with its strong emphasis on experience-based learning and increased patient responsibilities, is an important component of undergraduate medical education. Discussions have begun amongst educational leaders on the importance of standardizing curriculum and evaluation tools utilized during the subinternship. Purpose: The objective of this survey was to describe the current state of educational practices

Meenakshy K. Aiyer; T. Robert Vu; Cynthia Ledford; Melissa Fischer; Steven J. Durning

2008-01-01

50

Axioms, osteopathic culture, and a perspective from geriatric medicine.  

PubMed

Osteopathic medicine is a rapidly growing discipline in health care that has much to offer the wider biomedical community. A distinction of the osteopathic medical profession is the importance of an overall guiding philosophy. Despite the osteopathic medical profession's success, there remains concern about the profession's ability to maintain its unique identity. Among many factors that have contributed to the profession's success, certain axioms from its earliest days are pertinent to the profession's identity. Maintaining a knowledge and appreciation of osteopathic axioms can play an important role in safeguarding the profession's identity. These axioms encapsulate osteopathic philosophy and, moreover, are universally useful for patient care. As osteopathic geriatricians, the authors explore the value and meaning of these axioms for anyone who treats patients, but especially for the care of the elderly. The authors also propose a new axiom, derived from the experience of 2 of the authors: "First try to blame it on the medications." PMID:24285033

Noll, Donald R; Sthole, Havilah Julia; Cavalieri, Thomas A

2013-12-01

51

Using a queueing model to help plan bed allocation in a department of geriatric medicine.  

PubMed

By integrating queuing theory and compartmental models of flow we demonstrate how changing admission rates, length of stay and bed allocation influence bed occupancy, emptiness and rejection in departments of geriatric medicine. By extending the model to include waiting beds, we show how the provision of extra, emergency use, unstaffed, back up beds could improve performance while controlling costs. The model is applicable to all lengths of stay, admission rates and bed allocations. The results show why 10-15% bed emptiness is necessary to maintain service efficiency and demonstrate how unstaffed beds can serve to provide a more responsive and cost effective service. Further work is needed to test the validity and applicability of the model. PMID:12437280

Gorunescu, Florin; McClean, Sally I; Millard, Peter H

2002-11-01

52

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

ERIC Educational Resources Information Center

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…

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

2003-01-01

53

Death is not always a failure: outcomes from implementing an online virtual patient clinical case in palliative care for family medicine clerkship  

PubMed Central

Background The dying patient is a reality of medicine. Medical students, however, feel unprepared to effectively manage the complex end-of-life (EOL) management issues of the dying patient and want increased experiential learning in Palliative Care. Aims To address the need for more formal curriculum in EOL care, we developed and implemented an online virtual patient (VP) clinical case in Palliative Care into the 2010–2011 Year Three Family Medicine Clerkship rotation curriculum. Methods A mixed-method design was used to measure the change in knowledge and perceived preparedness level in EOL care before and after completing the online VP case. A survey collected qualitative descriptions of the students’ educational experience of using this case. Results Ninety five percent (130/137) of the students voluntarily consented to have their results analyzed. The group knowledge score (n=127) increased significantly from a pre-course average of 7.69/16±2.27, to a post-course average of 10.02/16±2.39 (p<0.001). The students’ self-assessed comfort level increased significantly with all aspects of EOL management from pre-course to post-course (p<0.001). Nearly, 91.1% of the students rated the VP realism as ‘Good to Excellent’, 86% rated the case as educationally beneficial. Nearly 59.3% of students felt emotionally engaged with the VP. Qualitative feedback found that the case content was very useful and realistic, but that the interface was sometimes awkward to navigate. Conclusions The online VP case in Palliative Care is a useful teaching tool that may help to address the need for increased formal Palliative Care experience in medical school training programs. PMID:24267774

Tan, Amy; Ross, Shelley Paige; Duerksen, Kimberley

2013-01-01

54

Road map to a patient-centered research agenda at the intersection of hospital medicine and geriatric medicine.  

PubMed

As the United States ages, the patient population in acute care hospitals is increasingly older and more medically complex. Despite evidence of a high burden of disease, high costs, and often poor outcomes of care, there is limited understanding of the presentation, diagnostic strategies, and management of acute illness in older adults. In this paper, we present a strategy for the development of a research agenda at the intersection of hospital and geriatric medicine. This approach is informed by the Patient-Centered Outcomes Research Institute (PCORI) framework for identification and prioritization of research areas, emphasizing input from patients and caregivers. The framework's four components are: 1) Topic generation, 2) Gap Analysis in Systematic Review, 3) Value of information (VOI) analysis, and 4) Peer Review. An inclusive process for topic generation requiring the systematic engagement of multiple stakeholders, especially patients, is emphasized. In subsequent steps, researchers and stakeholders prioritize research topics in order to identify areas that optimize patient-centeredness, population impact, impact on clinical decision making, ease of implementation, and durability. Finally, next steps for dissemination of the research agenda and evaluation of the impact of the patient-centered research prioritization process are described. PMID:24557516

Wald, Heidi L; Leykum, Luci K; Mattison, Melissa L P; Vasilevskis, Eduard E; Meltzer, David O

2014-06-01

55

University of Wisconsin School of Medicine and Public Health Course Title: Extramural Elective Clerkship in International Health  

E-print Network

University of Wisconsin School of Medicine and Public Health Course Title: Extramural Elective may include public health, prevention, and health education activities. Placements will be approved diagnosis and management, epidemiological, public health and prevention aspects of acute and/or chronic

Sheridan, Jennifer

56

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

ERIC Educational Resources Information Center

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…

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

2012-01-01

57

YEARS 3 and 4 REQUIREMENTS Starting class of 2011  

E-print Network

/Clerkships Family Medicine Clerkship 7 weeks Medicine (Inpatient) Clerkship 7 weeks Pediatrics Clerkship 7 weeks Psychiatry Clerkship 7 weeks Surgery Clerkship 7 weeks OB/GYN & Women's Health 7 weeks Geriatric & Ambulatory Medicine (GAM) 4 weeks Neurology 4 weeks Electives 16 weeks minimum 32 weeks maximum - Of these electives

Lotko, William

58

UConn Center on Aging Summer Geriatrics Conferences 28th  

E-print Network

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

Kim, Duck O.

59

Geriatrics (Geriatrician)  

MedlinePLUS

... all of the following professionals: Geriatrician Nurse Physician assistant Social worker Consultant pharmacist Nutritionist Physical therapist Occupational therapist Speech and hearing specialist Geriatric psychiatrist ...

60

Department of Medicine Annual Report 2014 Chairman's Message 1  

E-print Network

Medicine 34 Geriatrics & Palliative Medicine 36 Hematology/Oncology 38 Hospital Medicine 40 Infectious, MD) and geriatrics/palliative (Tia Kostas, MD) · Significant improvement in clinical efficiency

Scherer, Norbert F.

61

Geriatric pain  

Microsoft Academic Search

Geriatric pain will be a significant health care problem in the next millennium. Pain can be acute due to trauma or surgery,\\u000a and chronic due to medical illnesses and their sequels. In this article, management of geriatric chronic pain is discussed.

Daniel Lynch

1999-01-01

62

American Geriatrics Society/Association of Directors of Geriatric Academic Programs curricular milestones for graduating geriatric fellows.  

PubMed

This article describes the curricular milestones for geriatric fellows and the process used to develop them. The curricular milestones were developed to determine what every graduating geriatric fellow should be able to demonstrate to ensure that they will be able to practice effectively and safely in all care settings and with different older adult populations. Three major domains were identified: Caring for the Elderly Patient, Systems-Based Care for Elder Patients, and Geriatric Syndromes. Six hundred thirty-five geriatricians each reviewed and commented on one domain. These geriatricians represented important stakeholder groups: geriatric fellowship program directors; Association of Directors of Geriatric Academic Programs (ADGAP) members, who are primarily geriatric program and fellowship directors; the American Geriatrics Society (AGS) and ADGAP Education Committee; the AGS Teacher's Section; Geriatric Academic Career Award awardees; and through the American Board of Internal Medicine and the American Board of Family Medicine, board-certified geriatricians who spend more than 50% of their time in clinical practice. The AGS and ADGAP boards approved the final set of 76 Geriatric Curricular Milestones, which were posted on the Portal of Geriatric Online Education in December 2012. These curricular milestones are intended to assist geriatric fellowship directors as they develop curricula and assessments to inform program director reporting to the Accreditation Council for Graduate Medical Education in the Next Accreditation System, which begins in July 2014. PMID:24749808

Parks, Susan M; Harper, G Michael; Fernandez, Helen; Sauvigne, Karen; Leipzig, Rosanne M

2014-05-01

63

Attitude adjustment: shaping medical students' perceptions of older patients with a geriatrics curriculum.  

PubMed

For more than half a century, scientific research has documented widespread avoidance and even denial of aging. Though nothing new, aversive reactions to the elderly are not only unfortunate but dangerous today, as increasing life expectancy and consequent demand for specialized geriatric medical care vastly outpace the supply of qualified clinicians equipped to provide it. This discrepancy has led to a crisis that is not easily resolved. At the same time, geriatrics reports the highest level of physician satisfaction among medical specialties. How can this apparent disconnect be explained, and what can be done about it? Citing evidence from medicine and other health care disciplines, the authors address these questions by emphasizing the role of aging-related attitudes, a complex but theoretically modifiable construct. Successful educational interventions are described, including the authors' experience at the helm of a monthlong geriatrics clerkship for fourth-year medical students. Novel suggestions are provided to combat the daunting challenges to achieving a workforce that is sufficient both in number and training to effectively meet the needs of the fastest-growing segment of the U.S. population. As patients continue to age across most medical specialties, the importance of geriatric curricula, particularly those sensitizing learners to the need for a systems-based, biopsychosocial (i.e., interdisciplinary) model of care, cannot be overemphasized. Such training, it is argued, should be a standard component of medical education, and future research should focus on identifying specific curricular content and teaching methods that most effectively achieve this end. PMID:24072114

Bensadon, Benjamin A; Teasdale, Thomas A; Odenheimer, Germaine L

2013-11-01

64

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

PubMed Central

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

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

2013-01-01

65

The Making of Careers, the Making of a Discipline: Luck and Chance in Migrant Careers in Geriatric Medicine  

ERIC Educational Resources Information Center

The geriatric specialty, unpopular among most UK born and trained medical graduates, provided an opportunity for career development and achievement for those doctors whose training had been non-standard for a variety of reasons. Migrant doctors who have played a substantive role in the UK National Health Service since its inception made an…

Bornat, Joanna; Henry, Leroi; Raghuram, Parvati

2011-01-01

66

Molly Carnes, MD, MS Professor, Depts of Medicine,  

E-print Network

(N=0) 0 Dept Medicine Chairs at top 25: #12;What about geriatrics? Year med school graduation 1980 % women chiefs or heads of geriatrics (N=3) 19% % women MD geriatric fellows 1980 35% Discrete Geriatrics

Sheridan, Jennifer

67

Creating a Longitudinal Integrated Clerkship with Mutual Benefits for an Academic Medical Center and a Community Health System  

PubMed Central

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

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

2014-01-01

68

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

PubMed

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

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

2014-01-01

69

Prejudices and elderly patients’ personality – the problem of quality of care and quality of life in geriatric medicine  

PubMed Central

Background The article discusses the position of elderly patients in the context of medical intervention. The phenomenon of a “greying” population has changed the attitude towards the elderly but common observations prove that the quality of geriatric care is still unsatisfactory. This is a comparative study of personality among people at different ages, designed to improve specialists’ understanding of ageing. The results are discussed in relation to the elderly patient-centered paradigm to counterbalance ageist practices. Material/Methods This study involved 164 persons in early and late adulthood. Among the old, there were the young old (ages 65–74) and the older old (ages 75+). All participants were asked to fill-out the NEO-FFI [11]. Results The results demonstrate age-related differences in personality. In late adulthood, in comparison to early adulthood, there is decreased openness to new experiences. Two traits – agreeableness and conscientiousness – increase significantly. Age did not differentiate significantly the level of neuroticism or extraversion. The results of cluster analyses show differences in taxonomies of personality traits at different periods of life. Conclusions The results challenge the stereotypes that present older people as neurotic and aggressive. Age did not significantly influence the level of neuroticism or extraversion. In general, the obtained results prove that the ageist assumption that geriatric patients are troublesome is false. This article builds support for effective change in geriatric professional practices and improvement in elderly patients’ quality of life. PMID:23949099

B?achnio, Aleksandra; Buli?ski, Leszek

2013-01-01

70

Geriatric Technician.  

ERIC Educational Resources Information Center

This curriculum for training geriatric technicians is geared toward developing an understanding of, as well as the skills to assist with, the visually or hearing impaired older adult. The curriculum is organized in four modules. Each module is assigned a time frame and a credit unit base. The modules are divided into four major areas: knowledge,…

Seton Hill Coll., Greensburg, PA.

71

Near-Peer Teaching in a Required Third-Year Clerkship  

PubMed Central

Students who teach less experienced students within the same educational program are known as near-peer teachers. A number of studies have shown that near-peers are effective teachers in preclinical courses such as anatomy and physical examination. We hypothesized that near-peers could also be effective teachers in a clinical clerkship. We report on a pilot study in which near-peers participated in a training session and then taught a brief problem-focused skills curriculum to third-year students during a required ambulatory medicine rotation. The clerkship students assigned high ratings to the near-peer teachers, both on an absolute scale and relative to faculty. The results suggest that including near-peers as teachers in a clinical clerkship may be appropriate and that this concept deserves further investigation. PMID:24348221

Meller, Stephanie M.; Chen, Michelle; Chen, Ruijun; Haeseler, Frederick D.

2013-01-01

72

Georgia Geriatric Education Center  

E-print Network

Georgia Geriatric Education Center © Photography courtesy of the U.S. Administration on Aging. Georgia Geriatric Education Center Latestresourcesandtrainingforbestpracticesingerontologyandgeriatrics. The Georgia Geriatric Education Center (GGEC) is a statewide effort designed to help you access the latest

Arnold, Jonathan

73

Geriatric Disorders  

Microsoft Academic Search

At one time, the psychiatry of old age was believed to be “the darkest area of psychiatry.” The often confounding nature of\\u000a psychiatric disorder in the elderly is illustrated by the large number of terms used over the years to address the diversity\\u000a among geriatric psychiatric patients, including “late paraphrenia,” “vascular depression,” “pseudodementia,” and “masked depression.”\\u000a Many of these labels

Colin A. Depp; Jody Corey-Bloom

74

[Required competence in geriatrics in the view of the Competence Center for Geriatrics].  

PubMed

The geriatric patient is defined by a high specific risk that is taken into account by the special geriatric treatment concept. This risk relates to suffering from the permanent and significant loss of earlier functional independence caused by relatively trivial accessory conditions or other changes to the personal situation or falling in need of or increasing the need for care. It results from the geriatric patient's limited reserve capacities that are caused by physiological age-related limitations of organ and organ system reserves and/or manifested or at least latent functional impairments. A rather narrow definition of the geriatric patient based on this specific risk is a key criterion for the future systematic integration of geriatric care into the health service. In such a definition, use of the age component alone is adequate only from a very old age on. The high-risk group of geriatric patients narrowly defined in such a way also calls for primary medical geriatric case management: from commencement of a treatment throughout its entire course, from therapy to rehabilitation to longterm and outpatient care. This comprises first and foremost an comprehensive geriatric assessment and a treatment oriented primarily towards achieving quality of life and independence, medical treatment control including a systematic risk management system, continuous patient support, even in case of other temporary, specific treatments, the individual use of early rehabilitative treatments and the coordination of secondary treatment initiatives. Positioning geriatrics in the health care system in such a way means that the required skills extend beyond a general knowledge of geriatric medicine. Above all, high generic treatment expertise and experience in geriatric rehabilitation are also needed. Additionally, the guide and support function of the geriatrician demands a willingness to take special medical and ethical responsibility and an abundant ability to integrate and communicate. The education, training and development initiatives for attaining geriatric qualifications must satisfy these requirements. Lasting efficient geriatric care concepts also call for the appropriate skills in primary medical outpatient care. PMID:16189736

Lübke, N

2005-09-01

75

Patient-centred pharmaceutical design to improve acceptability of medicines: similarities and differences in paediatric and geriatric populations.  

PubMed

Patient acceptability of a medicinal product is a key aspect in the development and prescribing of medicines. Children and older adults differ in many aspects from the other age subsets of population and require particular considerations in medication acceptability. This review highlights the similarities and differences in these two age groups in relation to factors affecting acceptability of medicines. New and conventional formulations of medicines are considered regarding their appropriateness for use in children and older people. Aspects of a formulation that impact acceptability in these patient groups are discussed, including, for example, taste/smell/viscosity of a liquid and size/shape of a tablet. A better understanding of the acceptability of existing formulations highlights opportunities for the development of new and more acceptable medicines and facilitates safe and effective prescribing for the young and older populations. PMID:25274536

Liu, Fang; Ranmal, Sejal; Batchelor, Hannah K; Orlu-Gul, Mine; Ernest, Terry B; Thomas, Iwan W; Flanagan, Talia; Tuleu, Catherine

2014-10-01

76

Multiple variables influence the educational value of surgical clerkship sites  

Microsoft Academic Search

BackgroundStudents’ satisfaction with the educational quality of a surgical clerkship is influenced by their experiences at assigned clinical sites. We sought to identify key variables perceived by students to be associated with educationally valued clerkship sites.

Philip N. Redlich; Tracy Milkowski; Dawn Bragg; Kathy Biernat; Andrea Winthrop; Deborah Simpson

2006-01-01

77

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

E-print Network

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

Goldman, Steven A.

78

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

ERIC Educational Resources Information Center

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,…

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

79

Progress in Geriatrics: A Clinical Care Update.  

ERIC Educational Resources Information Center

This issue includes 18 theme articles that examine clinical care, conditions, and practice as they relate to older adults. It contains articles on the following: men's and women's health, depression, dementia, hypertension, incontinence, bone pain, infections, preventive medicine, geriatric medicine, health care delivery, managed care, long-term…

Blanchette, Patricia Lanoie; And Others

1997-01-01

80

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

PubMed Central

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

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

81

Annual Rocky Mountain Geriatrics Conference Unlocking Doors across the Long-Term Services and  

E-print Network

12th Annual Rocky Mountain Geriatrics Conference Unlocking Doors across the Long-Term Services and Support Spectrum September 15-16, 2014 Presented By: Division of Geriatrics, University of Utah School of Medicine In Affiliation With: Center on Aging, University of Utah Geriatric Research, Education

Tipple, Brett

82

Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care  

ERIC Educational Resources Information Center

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…

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

2009-01-01

83

Implementation of an Undergraduate Nutritional Support Clerkship.  

ERIC Educational Resources Information Center

A 10-week, full-time elective nutritional support clerkship designed for fifth-year pharmacy students is described. The course refines the student's communication skills and develops the student's ability to properly prepare and adjust a nutritional therapy plan. A weekly student activity plan and student evaluation form are appended. (MSE)

Stennett, Douglass J.; And Others

1983-01-01

84

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

E-print Network

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

Goldman, Steven A.

85

MEC Subcommittee Summary and Recommendations for Change GAM Clerkship  

E-print Network

. Topic of concern for integration across 4 years: · Geriatrics: The subcommittee the Geisel curriculum. o Review of the curriculum database using the terms "Geriatrics the Geriatrics Theme director for the new curriculum and will be following up

Myers, Lawrence C.

86

American Geriatrics Society  

MedlinePLUS

AGS State Affiliates | Find a Geriatrics Health Care Provider Join AGS Today | Member Login Press/In The News Membership ... Resources Program Schedule Hotel Information Travel Information New: AGS Clinical Practice Guideline for Postoperative Delirium in Older ...

87

Family Medicine Curriculum Resource Project: the future.  

PubMed

Under contract to the Health Resources and Services Administration (HRSA), the Society of Teachers of Family Medicine (STFM) created an undergraduate medical education curricular resource designed to train physicians to practice in the 21st century. An interdisciplinary group of more than 35 educators worked for 4 years to create the Family Medicine Curriculum Resource (FMCR). By consensus, the Accreditation Council for Graduate Medical Education (ACGME) competencies were adopted as the theoretical framework for this project. The FMCR provides materials for the preclerkship years, the third-year family medicine clerkship, the postclerkship year, and faculty development, as well as guidance for integrating topics of special interest to the federal government (such as, geriatrics, Healthy People 2010, genetics, informatics) into a 4-year continuum of medical education. There are challenges inherent in implementing each component of the FMCR. For example, can the ACGME competency-based approach be adapted to undergraduate medical education? Can the densely packed preclerkship years be adapted to include more focused effort on developing these competencies, and whose job is it anyway? What is "core" to being a competent clinician, and what information can be obtained when needed from medical informatics sources? Will family medicine educators embrace the FMCR recommendations for their third-year clerkships? Will exit assessment of the competency levels of graduating medical students be achieved, and can it make them more capable residents? Can faculty in different clinical and educational settings integrate the teaching of "how to learn" into their repertoire? How will faculty development innovation progress in a time of increasing emphasis on clinical productivity? Developing a common language and adoption of core competencies for all levels of medical education is imperative in a society that is focusing on improving health care quality and outcomes. The FMCR Project has developed a curricular resource to assist medical educators in this task. The challenge for the future is to measure how the FMCR is used and to ascertain if it has an influence on better patient and system outcomes. PMID:17186449

Stearns, Jeffrey A; Stearns, Marjorie A; Paulman, Paul M; Chessman, Alexander W; Davis, Ardis K; Sherwood, Roger A; Sheets, Kent J; Steele, David J; Matson, Christine C

2007-01-01

88

Clerkship maturity: Does the idea of training clinical skills work?  

PubMed Central

Background: With the reformed curriculum “4C”, the Medical Faculty of the University of Cologne has started to systematically plan practical skills training, for which Clerkship Maturity is the first step. The key guidelines along which the curriculum was development were developed by experts. This approach has now been validated. Materials and methods: Both students and teachers were asked to fill in a questionnaire regarding preclinical practical skills training to confirm the concept of Clerkship Maturity. Results and discussion: The Cologne training program Clerkship Maturity can be validated empirically overall through the activities of the students awaiting the clerkship framework and through the evaluation by the medical staff providing the training. The subjective ratings of the advantages of the training by the students leave room for improvement. Apart from minor improvements to the program, the most likely solution providing sustainable results will involve an over-regional strategy for establishing skills training planned as part of the curriculum. PMID:21866243

Stosch, Christoph; Joachim, Alexander; Ascher, Johannes

2011-01-01

89

Geriatric Medical Education in Israel  

ERIC Educational Resources Information Center

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…

Leibovitz, Arthur; Baumoehl, Yehuda; Habot, Beni

2004-01-01

90

Physician Assistant Attitude and Expressed Intent to Work with Geriatric Patients  

ERIC Educational Resources Information Center

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…

Woolsey, Lisa J.

2007-01-01

91

Some of My Best Friends Are Old: A Qualitative Exploration of Medical Students' Interest in Geriatrics  

ERIC Educational Resources Information Center

This paper provides insight into the reasons underlying medical students' interest in geriatrics. Semi-structured interviews, informed by attitude theory, were conducted with first-year medical students who indicated that they were not interested in geriatric medicine and those who indicated that they were moderately to very interested in…

Schigelone, Amy Schiller; Ingersoll-Dayton, Berit

2004-01-01

92

Some of My Best Friends Are Old: A Qualitative Exploration of Medical Students' Interest in Geriatrics  

ERIC Educational Resources Information Center

This paper provides insight into the reasons underlying medical students' interest in geriatrics. Semi-structured interviews, informed by attitude theory, were conducted with first-year medical students who indicated that they were not interested in geriatric medicine ( n =10) and those who indicated that they were moderately to very interested in…

Schigelone, Amy Schiller; Ingersoll-Dayton, Berit

2004-01-01

93

Geriatric Service Worker.  

ERIC Educational Resources Information Center

This curriculum for training geriatric service workers is designed to incorporate additional communication and group skills along with the basic knowledge and skills necessary to work with older adults. The curriculum is organized in four modules. Each module is assigned a time frame and a credit unit base. The modules are divided into four major…

Seton Hill Coll., Greensburg, PA.

94

Geriatric Live Interactive Teleconferencing.  

ERIC Educational Resources Information Center

This document includes a successful model for implementing educational teleconferencing, the Geriatric Live Interactive Teleconferencing program at Virginia Commonwealth University (VCU). As a vehicle for continuing professional education, teleconferencing can transmit the latest information to large numbers of health professionals in a variety of…

Parham, Iris A.; Wood, Joan

1985-01-01

95

Workplace learning through peer groups in medical school clerkships  

PubMed Central

Purpose When medical students move from the classroom into clinical practice environments, their roles and learning challenges shift dramatically from a formal curricular approach to a workplace learning model. Continuity among peers during clinical clerkships may play an important role in this different mode of learning. We explored students’ perceptions about how they achieved workplace learning in the context of intentionally formed or ad hoc peer groups. Method We invited students in clerkship program models with continuity (CMCs) and in traditional block clerkships (BCs) to complete a survey about peer relationships with open-ended questions based on a workplace learning framework, including themes of workplace-based relationships, the nature of work practices, and selection of tasks and activities. We conducted qualitative content analysis to characterize students’ experiences. Results In both BCs and CMCs, peer groups provided rich resources, including anticipatory guidance about clinical expectations of students, best practices in interacting with patients and supervisors, helpful advice in transitioning between rotations, and information about implicit rules of clerkships. Students also used each other as benchmarks for gauging strengths and deficits in their own knowledge and skills. Conclusions Students achieve many aspects of workplace learning in clerkships through formal or informal workplace-based peer groups. In these groups, peers provide accessible, real-time, and relevant resources to help each other navigate transitions, clarify roles and tasks, manage interpersonal challenges, and decrease isolation. Medical schools can support effective workplace learning for medical students by incorporating continuity with peers in the main clinical clerkship year. PMID:25427851

Chou, Calvin L.; Teherani, Arianne; Masters, Dylan E.; Vener, Margo; Wamsley, Maria; Poncelet, Ann

2014-01-01

96

[Specificities of pneumonia in geriatrics].  

PubMed

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

Pepersack, T

2014-09-01

97

Evaluating team-based, lecture-based, and hybrid learning methods for neurology clerkship in China: a method-comparison study  

PubMed Central

Background Neurology is complex, abstract, and difficult for students to learn. However, a good learning method for neurology clerkship training is required to help students quickly develop strong clinical thinking as well as problem-solving skills. Both the traditional lecture-based learning (LBL) and the relatively new team-based learning (TBL) methods have inherent strengths and weaknesses when applied to neurology clerkship education. However, the strengths of each method may complement the weaknesses of the other. Combining TBL with LBL may produce better learning outcomes than TBL or LBL alone. We propose a hybrid method (TBL?+?LBL) and designed an experiment to compare the learning outcomes with those of pure LBL and pure TBL. Methods One hundred twenty-seven fourth-year medical students attended a two-week neurology clerkship program organized by the Department of Neurology, Sun Yat-Sen Memorial Hospital. All of the students were from Grade 2007, Department of Clinical Medicine, Zhongshan School of Medicine, Sun Yat-Sen University. These students were assigned to one of three groups randomly: Group A (TBL?+?LBL, with 41 students), Group B (LBL, with 43 students), and Group C (TBL, with 43 students). The learning outcomes were evaluated by a questionnaire and two tests covering basic knowledge of neurology and clinical practice. Results The practice test scores of Group A were similar to those of Group B, but significantly higher than those of Group C. The theoretical test scores and the total scores of Group A were significantly higher than those of Groups B and C. In addition, 100% of the students in Group A were satisfied with the combination of TBL?+?LBL. Conclusions Our results support our proposal that the combination of TBL?+?LBL is acceptable to students and produces better learning outcomes than either method alone in neurology clerkships. In addition, the proposed hybrid method may also be suited for other medical clerkships that require students to absorb a large amount of abstract and complex course materials in a short period, such as pediatrics and internal medicine clerkships. PMID:24884854

2014-01-01

98

Student Experiences with Competency Domains during a Psychiatry Clerkship  

ERIC Educational Resources Information Center

Objectives: The authors reviewed medical student encounters during 3 years of a required psychiatry clerkship that were recorded on a web-based system of six broad competency domains (similar to ACGME-recommended domains). These were used to determine diagnoses of patients seen, clinical skills practiced, and experiences in interpersonal and…

West, Donald A.; Nierenberg, David W.

2009-01-01

99

Medical Students' Interest in Child Psychiatry: A Clerkship Intervention  

ERIC Educational Resources Information Center

Objective: The authors examine the efficacy of a brief presentation to enhance clerkship student interest in child and adolescent psychiatry as a career choice. Method: Attitudes of students attending a brief presentation on the positive aspects of child psychiatry were compared with those of non-attenders. Results: Students who attended the…

Martin, Vicki L.; Bennett, David S.; Pitale, Maria

2007-01-01

100

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

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

Wisconsin at Madison, University of

101

Do Geriatricians Stay in Geriatrics?  

ERIC Educational Resources Information Center

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…

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

2006-01-01

102

Hippocampal volume in geriatric depression  

Microsoft Academic Search

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

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

103

Standpoints of traditional Persian physicians on geriatric nutrition.  

PubMed

The present article aimed to compile information on the nutritional management for geriatric people. Popular textbooks of Persian medicine from 10th to 18th century were studied to derive relative viewpoints and considerations. The temperament, which is defined as the combination of 4 main elements (fire, air, water, and soil) and 4 humors made subsequently (black bile, yellow bile, phlegm, and blood), changes during age periods. Imbalance in proportional amounts of humors in elderly should be corrected with food and medicaments having opposite nature to the current condition. Traditional foods included mostly well-cooked soups, pottages, and porridges containing fresh sheep or chicken meat. Mono-ingredient foods were also administered according to their medical properties. Nutritional recommendations were also concerned with geriatrics' physiological conditions such as constipation, sleep disorders, and memory deficits. Many of traditional geriatric nutritional requirements are relevant in the present day. However, there are still notes that may be beneficial for consideration. PMID:25053755

Emami, Morteza; Nazarinia, Mohammad Ali; Rezaeizadeh, Hussein; Zarshenas, Mohammad M

2014-10-01

104

Increasing Interest in Child and Adolescent Psychiatry in the Third-Year Clerkship: Results from a Post-Clerkship Survey  

ERIC Educational Resources Information Center

Objective: The authors aimed to determine whether a structured clinical experience in child and adolescent psychiatry (CAP) during the third-year psychiatry clerkship would impact interest in pursuing careers in psychiatry and CAP. Methods: The authors constructed and administered a post-rotation survey, the Child and Adolescent Psychiatry…

Malloy, Erin; Hollar, David; Lindsey, Anthony

2008-01-01

105

Teaching geriatric fellows how to teach: a needs assessment targeting geriatrics fellowship program directors.  

PubMed

The entire healthcare workforce needs to be educated to better care for older adults. The purpose of this study was to determine whether fellows are being trained to teach, to assess the attitudes of fellowship directors toward training fellows to be teachers, and to understand how to facilitate this type of training for fellows. A nine-question survey adapted from a 2001 survey issued to residency program directors inquiring about residents-as-teachers curricula was developed and administered. The survey was issued electronically and sent out three times over a 6-week period. Of 144 ACGME-accredited geriatric fellowship directors from geriatric, internal medicine, and family medicine departments who were e-mailed the survey, 101 (70%) responded; 75% had an academic affiliation, 15% had a community affiliation, and 10% did not report. Academic and community programs required their fellows to teach, but just 55% of academic and 29% of community programs offered teaching skills instruction as part of their fellowship curriculum; 67% of academic programs and 79% of community programs felt that their fellows would benefit from more teaching skill instruction. Program directors listed fellow (39%) and faculty (46%) time constraints as obstacles to creation and implementation of a teaching curriculum. The majority of fellowship directors believe that it is important for geriatric fellows to become competent educators, but only approximately half of programs currently provide formal instruction in teaching skills. A reproducible, accessible curriculum on teaching to teach that includes a rigorous evaluation component should be created for geriatrics fellowship programs. PMID:25516033

Rivera, Veronica; Yukawa, Michi; Aronson, Louise; Widera, Eric

2014-12-01

106

A national radiation oncology medical student clerkship survey: Didactic curricular components increase confidence in clinical competency  

PubMed Central

Purpose/Objectives Students applying to radiation oncology residency programs complete one 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 three 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% (70/188). Respondents reported 191 unique clerkship experiences. 27% of respondents (19/70) completed at least one 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 = 0.03). However, the total number of clerkships completed did not correlate with confidence to pursue radiation oncology as a specialty (Spearman’s rho p = 0.48) or confidence to function as a first year resident (Spearman’s rho p = 0.43). 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. PMID:24331651

Jagadeesan, Vikrant S.; Raleigh, David R.; Koshy, Matthew; Howard, Andrew R.; Chmura, Steven J.; Golden, Daniel W.

2014-01-01

107

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

SciTech Connect

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.

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

108

Geriatric psychiatry and managed care.  

PubMed

A wide gap exists in the American health care system between what we know good geriatric mental health care services should look like and the types of services generally available. Cost effective treatment requires a continuum of care in which geriatric psychiatry and primary care geriatric services are integrated in an aggressively case managed model. MCOs have the infrastructure and tools at their disposal to make this work, but they must incorporate into their programs and approaches expert knowledge of the unique clinical problems of the frail elderly. PMID:10909119

Moak, G S

2000-06-01

109

Geriatric Fever Score: A New Decision Rule for Geriatric Care  

PubMed Central

Background Evaluating geriatric patients with fever is time-consuming and challenging. We investigated independent mortality predictors of geriatric patients with fever and developed a prediction rule for emergency care, critical care, and geriatric care physicians to classify patients into mortality risk and disposition groups. Materials and Methods Consecutive geriatric patients (?65 years old) visiting the emergency department (ED) of a university-affiliated medical center between June 1 and July 21, 2010, were enrolled when they met the criteria of fever: a tympanic temperature ?37.2°C or a baseline temperature elevated ?1.3°C. Thirty-day mortality was the primary endpoint. Internal validation with bootstrap re-sampling was done. Results Three hundred thirty geriatric patients were enrolled. We found three independent mortality predictors: Leukocytosis (WBC >12,000 cells/mm3), Severe coma (GCS ? 8), and Thrombocytopenia (platelets <150 103/mm3) (LST). After assigning weights to each predictor, we developed a Geriatric Fever Score that stratifies patients into two mortality-risk and disposition groups: low (4.0%) (95% CI: 2.3–6.9%): a general ward or treatment in the ED then discharge and high (30.3%) (95% CI: 17.4–47.3%): consider the intensive care unit. The area under the curve for the rule was 0.73. Conclusions We found that the Geriatric Fever Score is a simple and rapid rule for predicting 30-day mortality and classifying mortality risk and disposition in geriatric patients with fever, although external validation should be performed to confirm its usefulness in other clinical settings. It might help preserve medical resources for patients in greater need. PMID:25340811

Vong, Si-Chon; Yang, Tzu-Meng; Chen, Kuo-Tai; Lin, Hung-Jung; Chen, Jiann-Hwa; Su, Shih-Bin; Guo, How-Ran; Hsu, Chien-Chin

2014-01-01

110

Teaching Programs in Geriatric Optometry.  

ERIC Educational Resources Information Center

Results of a survey of U.S. and Canadian optometry programs concerning curriculum design, clinical and residency training programs, continuing education, and research projects planned or under way in geriatric optometry are presented and discussed. (MSE)

Rosenbloom, Albert A.

1985-01-01

111

Geriatric Nursing Teaching Resources  

NSDL National Science Digital Library

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.

2012-02-17

112

SONIA ANCOLI-ISRAEL, Ph.D Department of Psychiatry and Medicine  

E-print Network

SONIA ANCOLI-ISRAEL, Ph.D Department of Psychiatry and Medicine University of California, San Diego Diego, 1979. Staff Psychologist, Department of Psychiatry, School of Medicine, University of California, 1981-1992. Lecturer, Medical Student Clerkship, Department of Psychiatry, School of Medicine

Squire, Larry R.

113

Creating Stories to Live By: Caring and Professional Identity Formation in a Longitudinal Integrated Clerkship  

ERIC Educational Resources Information Center

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…

Konkin, Jill; Suddards, Carol

2012-01-01

114

A Pilot Family Practice Clerkship for Third and Fourth Year Students.  

ERIC Educational Resources Information Center

A clinical clerkship that provides medical students the opportunity to learn side by side with family practice residents is described. Clerkship objectives are to expose the student to: a variety of health care settings with the individual and family as the primary focus; ambulatory care of patients with conditions commonly seen by family…

Moseley, James L.

115

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

ERIC Educational Resources Information Center

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…

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

2010-01-01

116

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

ERIC Educational Resources Information Center

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…

Bostwick, J. Michael; Alexander, Cara

2012-01-01

117

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

ERIC Educational Resources Information Center

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…

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

2010-01-01

118

Canadian Otolaryngology - Head and Neck Surgery clerkship curricula: evolving toward tomorrow’s learners  

PubMed Central

Background Increasing focus is being placed on Clerkship curriculum design and implementation in light of new undergraduate medical education research and accreditation standards. Canadian Otolaryngology-Head and Neck Surgery (OTOHNS) Clerkship programs are continually but independently evolving towards a common goal of improving Clerkship curriculum. Methods An electronic survey was sent to undergraduate OTOHNS directors at all Canadian medical schools (n?=?17) examining their Clerkship curricula. Themes included Clerkship format, teaching methods, faculty support and development, program strengths, and barriers. Results Survey response rate was 76%. All responding schools had OTOHNS Clerkship programs ranging in type (mandatory, selective or elective) and length (<1 to 4 weeks). Learning modalities varied. Electronic learning tools were identified as increasingly important to curriculum delivery. Common strengths included wide clinical exposure and one-on-one mentoring. Multiple challenges were identified in curriculum implementation and evaluation. All schools expressed interest in developing national standards, objectives and e-learning resources. Conclusions Significant variation exists in OTOHNS Clerkship experiences between Canadian medical schools. Many schools perceive barriers of insufficient time, space and curriculum standardization. Interested Canadian OTOHNS educators are eager to collaborate to improve the collective OTOHNS Clerkship experience. PMID:23663703

2013-01-01

119

Models of Care in Geriatric Oncology  

PubMed Central

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.

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

2014-01-01

120

[Multidimensional geriatric assessment as clinical approach to the multimorbid patient in acute care].  

PubMed

The multidimensional geriatric assessment is an interdisciplinary diagnostic process, taking into account several health dimensions. The resulting know-ledge is used to establish a treatment plan. The multidimensional geriatric assessment has shown its efficacy in the acute care treatment of multidimensionally ill and polymorbid patients in acute geriatric structures. The multidimensional geriatric assessment plays a central role in questions regarding the allocation of resources and is becoming more important because of the demographic development and the rapidly changing framework in our health system. It ensures that older patients don't slip through the net in a more fragmented clinical medicine. Growing evidence allows using this assessment approach in polymorbid patients being treated in specialised fields as traumatology, cardiology, oncology and nephrology. PMID:23233101

Beck, S; Geser, C; Grob, D

2012-12-12

121

Geriatric Optometry Programs of Promise.  

ERIC Educational Resources Information Center

The curriculum design, philosophy, and innovation of four programs in geriatric optometry are described: the Pennsylvania College of Optometry and the colleges of Optometry at the State University of New York, University of Alabama at Birmingham, and University of Houston. (MSE)

Verma, Satya B.

1985-01-01

122

Geriatric Anxiety and Anxiety Disorders  

Microsoft Academic Search

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

James D. Helsley; Sandra K. Vanin

123

Virtual Patients in Geriatric Education  

ERIC Educational Resources Information Center

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…

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

2010-01-01

124

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

ERIC Educational Resources Information Center

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)

Mouton, Charles P.; Parker, Robert W.

2003-01-01

125

Integration of Women's Health into an Internal Medicine Core Curriculum for Medical Students.  

ERIC Educational Resources Information Center

Describes a collaboration to analyze and integrate elements of women's health into the core curriculum in internal medicine for a medical school's third year clerkship. Illustrates the new curriculum by describing the new module in pulmonary medicine and discusses the use of the process to integrate curricula in other interdisciplinary fields.…

Nicolette, JoDean; Jacobs, Michael D.

2000-01-01

126

Comprehensive geriatric assessment in the emergency department  

PubMed Central

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

Ellis, Graham; Marshall, Trudi; Ritchie, Claire

2014-01-01

127

Effects of a Geriatrics Interdisciplinary Experience on Learners' Knowledge and Attitudes  

ERIC Educational Resources Information Center

This study examines the impact of an interdisciplinary training program on knowledge and attitudes of learners from four health care programs: medicine, pharmacy, social work, and nursing. Sixty-two learners participated in a 4-day educational program (one day each week for 4 weeks) focusing on interdisciplinary geriatric care. After completing…

Fitzgerald, James T.; Williams, Brent C.; Halter, Jeffrey B.; Remington, Tami L.; Foulk, Mariko A.; Persky, Neal W.; Shay, Barbara R.

2006-01-01

128

Research advances in geriatric depression  

PubMed Central

Technical advances have facilitated the exploration of factors related to geriatric depression and have helped generate novel biological and psychosocial treatment approaches. This review summarizes the main advancements in epidemiology, clinical presentation and course, genetics, and other areas of biological research. Treatment interventions outlined in this paper include electroconvulsive therapy, repetitive transcranial magnetic stimulation, magnetic seizure therapy, vagus nerve stimulation, deep brain stimulatn, depression prophylaxis, multidisciplinary approaches to depression treatment, and psychotherapy. Forms of psychotherapy for geriatric depression summarized include interpersonal psychotherapy, supportive psychotherapy, cognitive-behavioral therapy, problem-solving therapy, and ecosystem-focused therapy. Neuroimaging techniques based on magnetic resonance imaging are discussed briefly, including volumetric brain studies, diffusion tensor imaging, fractional anisotropy, fiber tractography, magnetization transfer imaging, and blood-oxygenation-level-dependent functional magnetic resonance imaging. Finally, treatment effectiveness is addressed in a discussion of new models to improve access to and quality of care offered in the community. PMID:19812743

ALEXOPOULOS, GEORGE S.; KELLY JR., ROBERT E.

2009-01-01

129

An interdisciplinary teaching program in geriatrics for physician's assistants.  

PubMed

An interdisciplinary curriculum committee within the Division of Family Medicine, Stanford University Medical Center, developed and taught a beginning course in clinical geriatrics for medical students and student physician's assistants, physical therapists, and nurse practitioners. Through a series of Saturday classes held in community facilities serving seniors, physician's assistant students had the opportunity to learn clinical geriatrics from a faculty team including a physician's assistant, physician, nurse, physical therapist, social worker, gerontologist, and health educator. Local seniors served as consumer consultants and models of health and vigor. This interdisciplinary approach was modeled by the faculty to demonstrate the need for a team approach to deliver quality care to seniors. In this well-received course, the role of the physician's assistant in health care was made evident to their future physician employers and physical therapy co-workers through faculty modeling as well as through informal contacts and patient conferences. Older people constitute a growing and increasingly medically underserved population. Team training may serve to stimulate physician's assistant students to include geriatrics in their career plans while educating their future physician employers about their role. PMID:6150927

Stark, R; Yeo, G; Fordyce, M; Grudzen, M; Hopkins, J; McGann, L; Shepard, K

1984-11-01

130

Geriatric assessment in oncology practice.  

PubMed

There is no standard tool for assessing the "functional age" of an older adult with cancer, although it is widely recognized that chronological age does not capture the heterogeneous physiological and functional status of older adults. Integrating a "geriatric assessment" into oncology research and clinical practice would help fill this void. Geriatric assessment covers factors that predict morbidity and mortality in older adults, including functional status, comorbidity, cognition, psychological state, nutritional status, and social support. This assessment provides a broader overall understanding of individual characteristics that affect life expectancy. In addition, this assessment identifies areas of vulnerability in older adults for which further evaluation or intervention is indicated. This article will address the utility of a geriatric assessment in oncology practice, review data that attest to the benefits of the assessment, and issue a call for further research into how this assessment can be integrated into oncology care. Doing so will help develop targeted interventions and optimize cancer outcomes in this rapidly growing population. PMID:20122022

Hurria, Arti

2009-11-01

131

Position statement on interdisciplinary team training in geriatrics: an essential component of quality health care for older adults.  

PubMed

Interdisciplinary team training (IDT) is an important component of ensuring quality geriatric care delivery, which can be complex and time intensive, requiring coordination of many medical, psychosocial, and therapeutic interventions and professionals. The Partnership for Health in Aging (PHA), a loose coalition of more than 30 organizations representing healthcare professionals who care for older adults supported by the American Geriatrics Society, identified IDT training in geriatrics as a priority area in addressing the geriatrics workforce shortage described in the 2008 Institute of Medicine report, Retooling for An Aging America: Building the Health Care Workforce. A PHA Workgroup on Interdisciplinary Team Training in Geriatrics was convened to review the literature focused on geriatrics IDT training and to develop a position statement that would inform and influence groups involved in the development and expansion of academic and continuing education programs in IDT training, including professional associations, credentialing and licensing bodies, accreditation organizations, and university administrators. There are significant challenges to expanding the development and implementation of geriatrics IDT training for health professionals, and such training will be successful only with substantial and sustained advocacy from the above professional groups. PMID:24738753

2014-05-01

132

Voluntary undergraduate technical skills training course to prepare students for clerkship assignment: tutees’ and tutors’ perspectives  

PubMed Central

Background Skills lab training has become a widespread tool in medical education, and nowadays, skills labs are ubiquitous among medical faculties across the world. An increasingly prevalent didactic approach in skills lab teaching is peer-assisted learning (PAL), which has been shown to be not only effective, but can be considered to be on a par with faculty staff-led training. The aim of the study is to determine whether voluntary preclinical skills teaching by peer tutors is a feasible method for preparing medical students for effective workplace learning in clerkships and to investigate both tutees’ and tutors’ attitudes towards such an intervention. Methods A voluntary clerkship preparation skills course was designed and delivered. N?=?135 pre-clinical medical students visited the training sessions. N?=?10 tutors were trained as skills-lab peer tutors. Voluntary clerkship preparation skills courses as well as tutor training were evaluated by acceptance ratings and pre-post self-assessment ratings. Furthermore, qualitative analyses of skills lab tutors’ attitudes towards the course were conducted following principles of grounded theory. Results Results show that a voluntary clerkship preparation skills course is in high demand, is highly accepted and leads to significant changes in self-assessment ratings. Regarding qualitative analysis of tutor statements, clerkship preparation skills courses were considered to be a helpful and necessary asset to preclinical medical education, which benefits from the tutors’ own clerkship experiences and a high standardization of training. Tutor training is also highly accepted and regarded as an indispensable tool for peer tutors. Conclusions Our study shows that the demand for voluntary competence-oriented clerkship preparation is high, and a peer tutor-led skills course as well as tutor training is well accepted. The focused didactic approach for tutor training is perceived to be effective in preparing tutors for their teaching activity in this context. A prospective study design would be needed to substantiate the results objectively and confirm the effectiveness. PMID:24708782

2014-01-01

133

Depression in Geriatric and Adult Medical Inpatients.  

ERIC Educational Resources Information Center

Administered two scales for the evaluation of depression to two groups of medical inpatients: adults (N=201) and geriatric subjects (N=178). Results confirmed a high presence of depressive symptoms among patients with medical problems, particularly among geriatric subjects. Factors most predictive of depressive symptoms are identified. (JAC)

Magni, Guido; And Others

1985-01-01

134

28 CFR 2.78 - Geriatric parole.  

Code of Federal Regulations, 2014 CFR

...prisoner is confined that a prisoner who is at least 65 years of age has a chronic infirmity, illness, or disease related to aging, the Commission shall determine whether or not to release the prisoner on geriatric parole. Release on geriatric...

2014-07-01

135

THE FUTURE OF GERIATRIC AND INTERDISCIPLINARY EDUCATION  

Microsoft Academic Search

Support for geriatric and interdisciplinary education has increased recently for philosophical, clinical, and economic reasons. In medical education programs, trainees, and funding (mostly federal and university) has increased. However, programs are largely elective, reach few medical trainees, are carried by few and junior faculty, and are peripheral because of their novelty and unstable funding. The range of geriatric education is

David G. Satin

1986-01-01

136

Trends in Predoctoral Education in Geriatric Dentistry.  

ERIC Educational Resources Information Center

A survey of 46 United States and Canadian dental schools examined curriculum trends and assessed the effectiveness of educational initiatives and the value of American Association of Dental Schools and Administration on Aging geriatric dental curricular materials. An increasing number reported geriatric didactic courses, clinical rotations, and…

Saunders, Ralph H.; Yellowitz, Janet A.; Dolan, Teresa A.; Smith, Barbara J.

1998-01-01

137

Terror medicine as part of the medical school curriculum.  

PubMed

Terror medicine, a field related to emergency and disaster medicine, focuses on medical issues ranging from preparedness to psychological manifestations specifically associated with terrorist attacks. Calls to teach aspects of the subject in American medical schools surged after the 2001 jetliner and anthrax attacks. Although the threat of terrorism persists, terror medicine is still addressed erratically if at all in most medical schools. This paper suggests a template for incorporating the subject throughout a 4-year medical curriculum. The instructional framework culminates in a short course for fourth year students, such as one recently introduced at Rutgers New Jersey Medical School, Newark, NJ, USA. The proposed 4-year Rutgers curriculum serves as a model that could assist other medical schools contemplating the inclusion of terror medicine in pre-clerkship and clerkship training. PMID:25309891

Cole, Leonard A; Wagner, Katherine; Scott, Sandra; Connell, Nancy D; Cooper, Arthur; Kennedy, Cheryl Ann; Natal, Brenda; Lamba, Sangeeta

2014-01-01

138

[Geriatric assessment. Development, status quo and perspectives].  

PubMed

Multimorbidity is typical for geriatric patients. Problems not identified in time may lead to increased hospitalisation or prolonged hospital stay. Problems of multimorbidity are not covered by most guidelines or clinical pathways. The geriatric assessment supports standard clinical and technical assessment. Geriatric identification screening is basic for general practitioners and in emergency rooms to filter those patients bearing a special risk. Geriatric basic assessment covers most of the problems relevant for people in old age, revealing even problems that had so far been hidden. It permits to structure a comprehensive and holistic therapeutic approach and to evaluate the targets of treatment relevant for independent living and well-being. This results in reduction of morbidity and mortality. Assessment tools focusing on pain, nutrition and frailty should be added to the standardized geriatric basic assessment in Germany. PMID:21750936

Lüttje, D; Varwig, D; Teigel, B; Gilhaus, B

2011-08-01

139

Comprehensive geriatric assessment in the older cancer patient: coming of age in clinical cancer care  

PubMed Central

Cancer care at the extremes of life, in the young and the old, is characterized by unique issues associated with pediatrics and geriatric medicine, accentuated by the special vulnerabilities of these groups. In response to these needs, the field of pediatric oncology has been well honed to deal with the special problems associated with juvenile cancer patients. While most adult oncologists consider themselves well prepared to deal with older cancer patients, the current expansion of the geriatric population – their variable levels of fitness, frailty and vulnerability, the fact that cancer is primarily a disease of older adults, the significant expansion of agents and approaches to treat cancer, as well as their resultant toxicities and complications – has led to the development of specialized geriatric oncologists. Moreover, the special characteristics and needs of these patients have led to the evolution of new guidelines for evaluation, management and the conduct of research in older patients with cancer.

Owusu, Cynthia; Berger, Nathan A

2015-01-01

140

Summer 4th Year Elective Clerkships Elective Disciplines  

E-print Network

Family Medicine CELE 605 15280 Primary Care Sports Medicine CELE 605 19068 Interprofess. Reflect. Prac-Ophthalmology Orthopaedics CELE 611 15311 Orthopaedics CELE 611 15312 Orthopaedic Surgery CELE 611 15313 Sports Medicine CELE

Alford, Simon

141

Comprehensive geriatric assessment in oncology.  

PubMed

The incidence of cancer increases with advanced age and the majority of cancer deaths are in patients aged ? 65. The geriatric population is a heterogeneous group and a patient's chronologic age does not always correlate with underlying physiologic status. Oncologists need to be able to obtain information on physiologic and functional capacity in older patients in order to provide safe and effective treatment recommendations. The Comprehensive Geriatric Assessment (CGA) is a compilation of validated tools that predict morbidity and mortality in community-dwelling older adults. The various components of the CGA have also been shown to influence clinical decision-making and predict outcomes in older cancer patients. The combined data from the CGA can be used to stratify patients into risk categories to better predict their tolerance to treatment and risk for chemotherapy toxicity. However, the CGA is a comprehensive tool requiring significant time and training to perform. A variety of screening tools have been developed which may be useful in the general oncology practice setting to identify patients that may benefit from further testing and intervention. This chapter will review the components and predictive value of CGA in older cancer patients, with emphasis on how CGA can practically be incorporated into clinical practice. PMID:23503518

Mohile, Supriya G; Magnuson, Allison

2013-01-01

142

SCHOOL OF MEDICINE YEAR III CURRICULUM GUIDE  

E-print Network

Curricular Themes ........................................................... 16 Clinical Competencies............................................................... 17 EVALUATION, GRADING AND PROMOTION POLICIES FOR CLERKSHIP AND ELECTIVES .............................................................................................. 22 Mid-Clerkship Evaluations................................................................... 22

Cinabro, David

143

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

Microsoft Academic Search

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

Katherine Schilling; John Wiecha; Deepika Polineni; Souad Khalil

2006-01-01

144

Pharmacology for the geriatric surgical patient.  

PubMed

Alterations in pharmacokinetics and pharmacodynamics place geriatric patients at an increased risk of experiencing an adverse drug event. The incidence of medication-related adverse events can be decreased with careful selection of agents and appropriate dosage adjustments. PMID:25459548

Then, Janine; Tisherman, Samuel A

2015-02-01

145

Hypernatremia in the geriatric population  

PubMed Central

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

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

2014-01-01

146

An international model for geriatrics program development in China: the Johns Hopkins-Peking Union Medical College experience.  

PubMed

China has the world's largest and most rapidly growing older adult population. Recent dramatic socioeconomic changes, including a large number of migrating workers leaving their elderly parents and grandparents behind and the 4:2:1 family structure caused by the one-child policy, have greatly compromised the traditional Chinese family support for older adults. These demographic and socioeconomic factors, the improved living standards, and the quest for higher quality of life are creating human economic pressures. The plight of senior citizens is leading to an unprecedented need for geriatrics expertise in China. To begin to address this need, the Johns Hopkins University School of Medicine (JHU) and Peking Union Medical College (PUMC) have developed a joint international project aimed at establishing a leadership program at the PUMC Hospital that will promote quality geriatrics care, education, and aging research for China. Important components of this initiative include geriatrics competency training for PUMC physicians and nurses in the Division of Geriatric Medicine and Gerontology at JHU, establishing a geriatrics demonstration ward at the PUMC Hospital, faculty exchange between JHU and PUMC, and on-site consultation by JHU geriatrics faculty. This article describes the context and history of this ongoing collaboration and important components, progress, challenges, and future prospects, focusing on the JHU experience. Specific and practical recommendations are made for those who plan such international joint ventures. With such unique experiences, it is hoped that this will serve as a useful model for international geriatrics program development for colleagues in the United States and abroad. PMID:20533962

Leng, Sean X; Tian, Xinping; Liu, Xiaohong; Lazarus, Gerald; Bellantoni, Michele; Greenough, William; Fried, Linda P; Shen, Ti; Durso, Samuel C

2010-07-01

147

From Aging...to Saging--The Ohio State Senior Partners Program: Longitudinal and Experiential Geriatrics Education  

ERIC Educational Resources Information Center

The Ohio State College of Medicine began its Senior Partners Program (SPP) in 2001 as part of its commitment to integrate geriatric education throughout all four years of the medical curriculum. For participating senior partners and medical students, the SPP has signified a journey through a continuum of aging. Initial evaluations suggest that…

Kantor, Bonnie S.; Myers, Michelle R.

2006-01-01

148

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

Microsoft Academic Search

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.

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

1988-01-01

149

Filling in the Gaps of Clerkship with a Comprehensive Clinical Skills Curriculum  

ERIC Educational Resources Information Center

Although the clinical clerkship model is based upon sound pedagogy, including theories of social learning and situated learning, studies evaluating clinical performance of residents suggests that this model may not fully meet the learning needs of students. Here our objective was to design a curriculum to bridge the learning gaps of the existing…

Veale, Pamela; Carson, Julie; Coderre, Sylvain; Woloschuk, Wayne; Wright, Bruce; McLaughlin, Kevin

2014-01-01

150

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

ERIC Educational Resources Information Center

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…

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

2014-01-01

151

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

PubMed

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

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

2014-12-01

152

Reflective practice and palliative care education: a clerkship responds to the informal and hidden curricula.  

PubMed

The authors discuss the damaging influence of informal and hidden curricula on medical students and describe a two-week clerkship in palliative care and clinical ethics at their school (Weill Medical College of Cornell University). This required clerkship, begun in 1999, uses reflective practice and a special pedagogic technique, participant observation, to counteract the influences of the informal and hidden curricula. This technique seeks to immerse the participant observer in the context of care. In their role as participant observers, students are relieved of any direct clinical responsibilities for two weeks so they have time for the careful observation and reflection required and also can consider the humanistic dimensions of practice, which are often displaced by the need to master diagnostic and therapeutic skills. Course objectives include identifying psychosocial and contextual factors that influence care, principles of pain and symptom management, and ethical and legal issues at the end of life. Students are expected to learn how to apply ethical norms to patient care, describe methods of pain and symptom management, communicate in an effective and humanistic manner, and articulate models of patient-centered advocacy. The clerkship fosters professionalism in patient care, appreciation of cultural diversity, and the student's ability to assume responsibility for developing competency in these areas. Although it is too early to know whether this clerkship will ultimately affect the practice patterns of students who experience it, short-term evaluation has been very favorable. PMID:12634214

Fins, Joseph J; Gentilesco, Bethany J; Carver, Alan; Lister, Philip; Acres, Cathleen A; Payne, Richard; Storey-Johnson, Carol

2003-03-01

153

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

E-print Network

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

Hart, Gus

154

Academic Performance in the Context of a "Three Excused Absences" Psychiatry Clerkship Policy  

ERIC Educational Resources Information Center

Objective: In order to better manage medical student absences during the psychiatry clerkship, a policy allowing students to miss up to 3 days without penalty was developed. The purpose of this study was to describe absence patterns and compare academic performance between students with and without absences. Method: Authors reviewed the academic…

Schillerstrom, Jason E.; Lutz, Mary

2013-01-01

155

Psychiatry in the Harvard Medical School-Cambridge Integrated Clerkship: An Innovative, Year-Long Program  

ERIC Educational Resources Information Center

Objective: The authors present what is to their knowledge the first description of a model for longitudinal third-year medical student psychiatry education. Method: A longitudinal, integrated psychiatric curriculum was developed, implemented, and sustained within the Harvard Medical School-Cambridge Integrated Clerkship. Curriculum elements…

Griswold, Todd; Bullock, Christopher; Gaufberg, Elizabeth; Albanese, Mark; Bonilla, Pedro; Dvorak, Ramona; Epelbaum, Claudia; Givon, Lior; Kueppenbender, Karsten; Joseph, Robert; Boyd, J. Wesley; Shtasel, Derri

2012-01-01

156

Subspecialty Exposure in a Psychiatry Clerkship Does Not Improve Student Performance in the Subject Examination  

ERIC Educational Resources Information Center

Objective: The authors compared the NBME subject examination scores and subspecialty profiles of 3rd-year medical students who were assigned to psychiatry subspecialties during their clerkship with those who were not. Method: The authors collated and analyzed the shelf examination scores, the clinical grades, and the child psychiatry and emergency…

Retamero, Carolina; Ramchandani, Dilip

2013-01-01

157

Incorporating Active Learning into a Psychiatry Clerkship: Does It Make a Difference?  

ERIC Educational Resources Information Center

Objective: Medical students' satisfaction with the psychiatry clerkship, sense of preparedness for an institutional Objective Structured Clinical Exam (OSCE), expressed likelihood of choosing psychiatry as a specialty, and National Board of Medical Examiners (NBME) psychiatry shelf-examination scores were compared after a curriculum based on…

Morreale, Mary; Arfken, Cynthia; Bridge, Patrick; Balon, Richard

2012-01-01

158

Effect of a Year-Long Primary Care Clerkship on Graduates' Selection of Family Practice Residencies.  

ERIC Educational Resources Information Center

Selection of family practice residencies in 1981-89 was compared for graduates of State University of New York campuses and all United States medical schools. Compared to other groups, more of the students who had been trained during their third year in a Binghamton primary care clerkship selected family practice residencies. (MSE)

Erney, Stanley L.; And Others

1991-01-01

159

Development of a longitudinal integrated clerkship at an academic medical center.  

PubMed

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center. PMID:21475642

Poncelet, Ann; Bokser, Seth; Calton, Brook; Hauer, Karen E; Kirsch, Heidi; Jones, Tracey; Lai, Cindy J; Mazotti, Lindsay; Shore, William; Teherani, Arianne; Tong, Lowell; Wamsley, Maria; Robertson, Patricia

2011-01-01

160

Medical Student Psychiatry Examination Performance at VA and Non-VA Clerkship Sites  

ERIC Educational Resources Information Center

Objective: The authors examined the effects of medical student assignment to U.S. Department of Veterans Affairs (VA) Medical Center inpatient and outpatient psychiatry clerkship sites versus other university and community sites on the performance outcome measure of National Board of Medical Examiners (NBME) subject examination scores. Methods:…

Tucker, Phebe; von Schlageter, Margo Shultes; Park, EunMi; Rosenberg, Emily; Benjamin, Ashley B.; Nawar, Ola

2009-01-01

161

Development of a longitudinal integrated clerkship at an academic medical center  

PubMed Central

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center. PMID:21475642

Poncelet, Ann; Bokser, Seth; Calton, Brook; Hauer, Karen E.; Kirsch, Heidi; Jones, Tracey; Lai, Cindy J.; Mazotti, Lindsay; Shore, William; Teherani, Arianne; Tong, Lowell; Wamsley, Maria; Robertson, Patricia

2011-01-01

162

24th Annual Student Mentoring Conference in Gerontology and Geriatrics  

E-print Network

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

Arnold, Jonathan

163

Innovative Community Programs 12th Annual Rocky Mountain Geriatrics Conference  

E-print Network

Innovative Community Programs 12th Annual Rocky Mountain Geriatrics Conference September 15th ­ Engagement Activities #12;Clinical Staff · Full Time Medical Director and Attending MD · Full Time Geriatric

van den Berg, Jur

164

Correlation between clinical clerkship achievement and objective structured clinical examination (OSCE) scores of graduating dental students on conservative dentistry  

PubMed Central

Objectives This study aimed to investigate the effect of clinical clerkship-associated achievements, such as performance of procedures at the student clinic, observation, and attitude towards a clerkship, on the objective structured clinical examination (OSCE) scores of dental students graduating in restorative dentistry. Materials and Methods The OSCEs consisted of two stations designed to assess students' clinical skills regarding cavity preparation for a class II gold inlay and a class IV composite restoration. The clerkship achievements, consisting of the number of student clinical procedures performed, observation-related OSCE, and scores of their attitudes towards a conservative dentistry clerkship, were assessed. Correlation and multiple regression analyses were conducted. Results The correlation coefficient between the OSCE scores for cavity preparation for a class II gold restoration and clerkship attitude scores was 0.241 (p < 0.05). Regarding a class IV composite restoration, OSCE scores showed statistically significant correlations with the observation (r = 0.344, p < 0.01) and attitude (r = 0.303, p < 0.01) scores. In a multiple regression analysis, attitudes towards a clerkship (p = 0.033) was associated with the cavity preparation for a class II gold inlay OSCE scores, while the number of procedure observations (p = 0.002) was associated with the class IV composite restoration OSCE scores. Conclusions The number of clinical procedures performed by students, which is an important requirement for graduation, showed no correlation with either of the OSCEs scores. PMID:23741710

Bang, Jae-Beum

2013-01-01

165

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 April 2006, and (iii) secure, efficient visual information access will let geriatric care specialists obtain greater

166

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 2005, and (iii) secure, efficient visual information access will let geriatric care specialists obtain greater

167

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

168

Geriatrics Educational Outreach: A Tale of Three GRECCs  

ERIC Educational Resources Information Center

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…

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

2011-01-01

169

When Patients Teach Their Doctors: A Curriculum for Geriatric Education  

ERIC Educational Resources Information Center

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…

Tomkowiak, John; Gunderson, Anne

2004-01-01

170

Anal function in geriatric patients with faecal incontinence  

Microsoft Academic Search

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

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

1989-01-01

171

Preparing to care for an aging population: medical student reflections on their clinical mentors within a new geriatrics curriculum.  

PubMed

Reflective writing techniques such as journaling help provide insights into the process by which medical students are mentored and develop into practicing physicians. The authors sought to analyze medical students' journals regarding their mentored experiences within a new geriatrics curriculum at a U.S. medical school. Thirty preclinical and clinical medical student journalers participated in this project. The authors employed qualitative analytic techniques using an interdisciplinary team process. Three major themes emerged: (a) exposure to clinical mentors challenged medical students' preconceptions regarding older adults and geriatric medicine; (b) students learned new medical knowledge and techniques from observing their mentors; and (c) students provided positive and negative assessments of their mentors. Reflective journaling provides important insights into the process by which medical students draw upon mentored clinical experiences during their training. Such mentorship may be particularly relevant to promoting their interest in geriatrics. PMID:24138182

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

2013-01-01

172

A web-based system for students to document their experiences within six core competency domains during all clinical clerkships.  

PubMed

The authors describe the design and implementation of a new Web-based system that allows students to record important features of their clinical encounters during all 10 required clinical clerkships, document their learning experiences in six major competency domains, and generate detailed real-time reports for themselves and their clerkship directors. A new Web-based system, DMEDS (Dartmouth Medical Encounter Documentation System), accepts input from computers and PDAs. Its design permits students to describe their patients, learning sites, interactions with preceptors, and important aspects of their clinical encounters in all of our medical school's competency domains. Using a common format for all required clerkships, clerkship directors select specific items most relevant to their clerkships from a common menu and set learning targets for specific diagnoses and clinical skills. This new system was designed in the fall of 2003, tested in the spring of 2004, and implemented in all clerkships for the 2004 to 2005 academic year. During the first full academic year that DMEDS was used, students documented nearly 32,000 discrete student-patient-preceptor encounters, an average of between 21 and 120 clinical encounters per Year 3 clerkship. Highlights of the analysis of these initial data include the following: (1) insights into how educational targets are set, (2) the extent of site-to-site variation in clerkship experiences, (3) the epidemiology of patients' declining student involvement, and (4) student experiences in and understanding of the newer competency domains.DMEDS can be used in all clinical clerkships and can address student experiences in all competency domains. It provides substantial value to students, clerkship directors, preceptors, and medical school administrators. As secondary benefits, the authors found that DMEDS facilitates educational research and is readily adapted for use in residency and fellowship programs as well. Student feedback highlights the need to pay close attention to the time invested by students documenting their clinical encounters. Course directors must ensure that the benefits to students (such as knowledge of meeting learning targets and preceptors providing direct feedback to students) are transparent. Finally, for other schools contemplating the change to a competency-based curriculum with the use of a clinical encounter documentation system, the time required for both students and faculty to adopt and fully engage these major educational culture shifts seems to be at least several years. PMID:17198293

Nierenberg, David W; Eliassen, M Scottie; McAllister, Stephen B; Reid, Brian P; Pipas, Catherine Florio; Young, William W; Ogrinc, Greg S

2007-01-01

173

Geriatric Syndromes: Clinical, Research and Policy Implications of a Core Geriatric Concept  

PubMed Central

Geriatricians have embraced the term “geriatric syndrome”, using it extensively to highlight the unique features of common health conditions in the elderly. Geriatric syndromes, such as delirium, falls, incontinence and frailty, are highly prevalent, multifactorial, and associated with substantial morbidity and poor outcomes. Nevertheless, this central geriatric concept has remained poorly defined. This article reviews criteria for defining geriatric syndromes, and proposes a balanced approach of developing preliminary criteria based on peer-reviewed evidence. Based on a review of the literature, four shared risk factors—older age, baseline cognitive impairment, baseline functional impairment, and impaired mobility—were identified across five common geriatric syndromes (pressure ulcers, incontinence, falls, functional decline, and delirium). Understanding basic mechanisms involved in geriatric syndromes will be critical to advancing research and developing targeted therapeutic options. However, given the complexity of these multifactorial conditions, attempts to define relevant mechanisms will need to incorporate more complex models, including a focus on synergistic interactions between different risk factors. Finally, major barriers have been identified in translating research advances, such as preventive strategies of proven effectiveness for delirium and falls, into clinical practice and policy initiatives. National strategic initiatives are required to overcome barriers and to achieve clinical, research, and policy advances that will improve quality of life for older persons. PMID:17493201

Inouye, Sharon K.; Studenski, Stephanie; Tinetti, Mary E.; Kuchel, George A.

2008-01-01

174

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

PubMed

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

Konkin, Jill; Suddards, Carol

2012-10-01

175

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

PubMed Central

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

2014-01-01

176

David K Brown Geriatrics Scholar Program  

E-print Network

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

Mohaghegh, Shahab

177

Geriatric alcohol abuse: A national epidemic  

Microsoft Academic Search

Substance abuse is a widely identified problem in our society. Alcohol abuse is the most problematic, yet most undertreated. Primary care practitioners often do not screen the geriatric population appropriately for at-risk drinking, so the condition goes undiagnosed. This oversight is complicated by the fact that many manifestations of alcohol abuse do not present themselves until well into the disease

Christina Knauer

2003-01-01

178

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

PubMed

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

Varteresian, Taya; Lavretsky, Helen

2014-08-01

179

Comanagement of Geriatric Patients With Hip Fractures  

PubMed Central

The objective of this 3-year retrospective, controlled, cohort study is to characterize an interdisciplinary method of managing geriatric patients with hip fracture. All patients aged 65 years or older admitted to a single academic level I trauma center during a 3-year period with an isolated hip fracture were included as participants for this study. Thirty-one geriatric patients with hip fracture were treated with historical methods of care (cohort 1). The comparison group of 115 similar patients was treated under a newly developed, institutional comanagement hip fracture protocol (cohort 2). There were no differences in age, sex distribution, or comorbidity distribution between the 2 cohorts. Patients requiring intensive care unit (ICU) admission decreased significantly from 48% in cohort 1 to 23% in cohort 2 (P = .0091). Length of ICU stay for patients requiring ICU admission also decreased significantly, from a mean of 8.1 days in cohort 1 to 1.8 days in cohort 2 (P = .024). Total hospital stay decreased significantly, from a mean of 9.9 days in cohort 1 to 7.1 days in cohort 2 (P = .021). Although no decrease in in-hospital mortality rates was noted from cohort 1 to cohort 2, a trend toward decreased 1-year mortality rates was seen after implementation of the hip fracture protocol. Hospital charges decreased significantly, from US$52 323 per patient in cohort 1 to US$38 586 in cohort 2 (P = .0183). Implementation of a comanagement protocol for care of geriatric patients with hip fracture, consisting of admission to a geriatric primary care service, standardized perioperative assessment regimens, expeditious surgical treatment, and continued primary geriatric care postoperatively, resulted in reductions in lengths of stay, ICU admissions, and hospital costs per patient. On an annualized basis, this represented a savings of over US$700 000 for our institution. PMID:23936734

Rocca, Gregory J. Della; Moylan, Kyle C.; Crist, Brett D.; Volgas, David A.; Stannard, James P.; Mehr, David R.

2013-01-01

180

Simulation in medical school education: review for emergency medicine.  

PubMed

Medical education is rapidly evolving. With the paradigm shift to small-group didactic sessions and focus on clinically oriented case-based scenarios, simulation training has provided educators a novel way to deliver medical education in the 21st century. The field continues to expand in scope and practice and is being incorporated into medical school clerkship education, and specifically in emergency medicine (EM). The use of medical simulation in graduate medical education is well documented. Our aim in this article is to perform a retrospective review of the current literature, studying simulation use in EM medical student clerkships. Studies have demonstrated the effectiveness of simulation in teaching basic science, clinical knowledge, procedural skills, teamwork, and communication skills. As simulation becomes increasingly prevalent in medical school curricula, more studies are needed to assess whether simulation training improves patient-related outcomes. PMID:22224138

Chakravarthy, Bharath; Ter Haar, Elizabeth; Bhat, Srinidhi Subraya; McCoy, Christopher Eric; Denmark, T Kent; Lotfipour, Shahram

2011-11-01

181

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

Federal Register 2010, 2011, 2012, 2013, 2014

...DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee...Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee will...Health on all matters pertaining to geriatrics and gerontology. The Committee...

2012-08-17

182

Factors associated with geriatric syndromes in older homeless adults.  

PubMed

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

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

2013-05-01

183

Early exposure to geriatric nursing through an externship program.  

PubMed

The Summer Geriatric Extern Program was developed in 2004 to provide nursing students between the junior and senior year an opportunity to learn more about careers in geriatric nursing.This full-time, eight-week commitment provides students with a stipend and a faculty mentor in their area of interest. Of the 24 externs since the inception of the program, seven have enrolled in graduate programs. The findings suggest that the summer geriatric externship program is effective in developing interest in a geriatric nursing career and providing exposure to nursing research and other aspects of the faculty role. PMID:22860479

Souder, Elaine; Beverly, Claudia J; Kitch, Stephanie; Lubin, Sandie A

2012-01-01

184

Normal Pressure Hydrocephalus in Geriatric Medicine: A Challenge  

Microsoft Academic Search

Normal pressure hydrocephalus (NPH) in elderly patients is reviewed. Since the clinical signs that characterize NPH—in— continence, difficulty walking, and dementia—occur frequently in the elderly in association with a wide variety of disorders, attention is paid to the differential diagnosis of NPH on the basis of both clinical findings and laboratory tests. Success rates for treatment of NPH using surgical

Maurice St-Laurent

1988-01-01

185

Effect of a workshop in rational pharmacotherapy for interns during family medicine clerkship in Samsun- Turkey  

PubMed Central

Objective: We aimed to investigate the effect of rational pharmacotherapy workshop for interns on the rationality, cost and number of drugs prescribed. Methods: The participants were asked to prescribe a medication for acute noninflammatory osteoarthritis (ANOA), acute bacterial rhinosinusitis (ARS), acute otitis media (AOM), acute uncomplicated cystitis (AC), and acute bacterial tonsillopharyngitis (ABT) before and after workshop. Total 3000 prescriptions were scored regarding rationality of the drug choice (0-10), format (0-5), instructions (0-4), legibility (0-1) and total (0-20 points). The mean number of drug(s) and total costs per prescription were calculated. Paired samples t-test was used to compare the pre- and post score means. Results: Total pre- and post-prescribing scores (0-20) were significantly different (p=0.00 for each): ANOA (13.59±0.27, 18.33±0.18), ARS (13.26 ±0.18, 15.15 ±0.17), AOM (12.58 ± 0.26, 14.66±0.27), AC (13.53±0.17, 15.76±0.20), ABT (13.54±0.24, 15.49 ±0.28). Mean number of drugs per prescription for the indications in the pre-test and post-test were: ANOA (1.24 ±0.29, 1.02±0.01, p=0.00), ARS (2.08±0.04, 2.00±0.04, p=0.16), AOM (1.66±0.04 and 1.69±0.03, p=0.54), AC (1.55±0.04, 1.39±0.03, p=0.00) and ABT (2.10±0.05, 1.81±0.05, p=0.00). Mean costs per prescription in Turkish Liras: ANOA (6.31±0.29, 4.60±0.05, p=0.00), ARS (13.80±0.38, 4.63±0.04, p=0.00), AOM (10.18±0.28, 4.41±0.07, p=0.00), AC (11.33±0.21, 10.68±0.18, p=0.01) and ABT (12.03±0.34 and 10.41±0.35, p=0.00). Conclusion: Training produced a significant improvement in rational prescribing. PMID:24772132

Fevzi Dikici, Mustafa; Yaris, Fusun; Artiran Igde, Fusun; Yarar, Fulya; Altuntas, Oznur; Alper Gurz, Aysenur

2014-01-01

186

Psychometric Properties of the Geriatric Anxiety Scale: Comparison to the Beck Anxiety Inventory and Geriatric Anxiety Inventory  

Microsoft Academic Search

This study explored the convergent and discriminant validity of the Geriatric Anxiety Scale (GAS), a new measure of anxiety symptoms for older adults. The GAS, Beck Anxiety Inventory (BAI), Geriatric Anxiety Inventory (GAI), Beck Depression Inventory, Second Edition (BDI-II), and Geriatric Depression Scale (GDS) were administered to 117 community-dwelling, predominantly White, older adults (62% female; M age = 74.75 years,

Brian P. Yochim; Anne E. Mueller; Andrea June; Daniel L. Segal

2010-01-01

187

The process of community health nursing clinical clerkship: A grounded theory  

PubMed Central

Background: The performance of the community health nurse depends on a combination of scientific and practical competencies acquired by educational experiences during the nursing course. Curriculum planners of nursing education need to understand nursing education to train professional and community-oriented nurses. The aim of this article is to explore the experiences of nursing students during their community health nursing clinical clerkship courses. Materials and Methods: A grounded theory approach was used to conduct this study. Twelve nursing students, 13 health-care staff members, and 10 nursing instructors were interviewed individually in 2011-2012. The interviews were tape-recorded and later transcribed verbatim. The transcriptions were analyzed using the method of Strauss and Corbin. Results: Ambivalence of motivation was the main category and included five subcategories: Professional identity, educational atmosphere, educational management, motivation-based approaches, and inadequate productivity. This paper presents the aspects of the community health nursing clerkship course from the viewpoint of students in areas such as the role of the community health nurse, attitude toward the course, medical orientation, prerequisite skills/knowledge, poor administrative planning, rotation of students, insufficient activity for students, passiveness, providing service to clients, responsibility, and inproductivity. These categories could explain the nature of the community health nursing clerkship of the Mashhad Faculty of Nursing and probably others in Iran. Conclusions: The findings revealed inadequate productivity of the community health nursing education; so, it is suggested to define a position for nurses in this setting and remove barriers and provide conditions for them to play more important roles in the promotion of community health. PMID:24554943

Ildarabadi, Eshagh; Moonaghi, Hossein Karimi; Heydari, Abbas; Taghipour, Ali

2013-01-01

188

DISCOVERIES/INVENTIONS School of Medicine in primary care, family  

E-print Network

pollution Innovative ways to eradicate disease -- from developing cancer vaccines to stem cell research medicine and #6 in research, internal medicine and geriatrics ­ U.S. News & World Report School of NursingASL, which offers sign language by cell phone for deaf and hard-of-hearing people WebAnywhere, a web

Yetisgen-Yildiz, Meliha

189

Geriatric Medical Education and Training in the United States  

Microsoft Academic Search

Medical education in geriatrics is an important requirement to ready the profession to provide comprehensive health care to the world's and also Taiwan's aging population. The predoctoral curricula and postdoctoral training programs in the United States were developed and supported by government agencies and professional education societies. Geriatric medical education in American medical schools has improved in the past 20

Michéle J. Saunders; Chih-Ko Yeh; Lein-Tuan Hou; Michael S. Katz

2005-01-01

190

Pica in the Geriatric Mentally Ill: Unrelenting and Potentially Fatal  

Microsoft Academic Search

Pica has rarely been reported in patients with geriatric mental illness. The authors describe 3 male patients with pica in the geriatric unit of a state mental hospital. Two of these patients had a diagnosis of developmental delay with concomitant diagnoses of schizophrenia and schizoaffective disorder, respectively. The third patient was diagnosed with paranoid schizophrenia. In all 3 cases, pica

Noel I. Dumaguing; Indra Singh; Mohammad Sethi; D. P. Devanand

2003-01-01

191

Development of an Interview-Based Geriatric Depression Rating Scale.  

ERIC Educational Resources Information Center

Developed interview-based Geriatric Depression Rating Scale (GDRS) and administered 35-item GDRS to 68 older adults with range of affective disturbance. Found scale to have internal consistency and split-half reliability comparable to those of Hamilton Rating Scale for Depression and Geriatric Depression Scale. Concurrent validity, construct…

Jamison, Christine; Scogin, Forrest

1992-01-01

192

Implications for Fitness Programming---The Geriatric Population.  

ERIC Educational Resources Information Center

This article discusses the relevance of fitness programing for an aging population and provides parameters for a geriatric fitness program. Emphasized are physical activity as a preventive measure against age-related illness and management of a geriatric fitness program. (IAH)

Brown, Stanley P.; And Others

1989-01-01

193

The Filipino Nursing Students' Dilemmas in Geriatric Care  

ERIC Educational Resources Information Center

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…

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

2009-01-01

194

Geriatric Interdisciplinary Team Training ProgramEvaluation Results  

Microsoft Academic Search

Geriatric interdisciplinary team training has long been a goal in health education with little progress. In 1997, the John A. Hartford Foundation funded eight programs nationally to create Geriatric Interdisciplinary Team Training (GITT) programs. Faculty trained 1,341 health professions students. The results of the evaluation, including presentation of new measures developed to assess interdisciplinary knowledge, are presented, and the implications

Terry Fulmer; Kathryn Hyer; Ellen Flaherty; Mathy Mezey; Nancy Whitelaw; M. Orry Jacobs; Robert Luchi; Jennie Chin Hansen; Denis A. Evans; Christine Cassel; Ernestine Kotthoff-Burrell; Robert Kane; Eric Pfeiffer

2005-01-01

195

Operationalizing a Frailty Index from a Standardized Comprehensive Geriatric Assessment  

Microsoft Academic Search

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

David M. Jones; Xiaowei Song; Kenneth Rockwood

2004-01-01

196

Designing a Multi-Disciplinary Geriatrics Health Professional Mentoring Program  

ERIC Educational Resources Information Center

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…

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

2004-01-01

197

Validation of the Geriatric Depression Scale Among Nursing Home Residents  

Microsoft Academic Search

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

Emerson Lesher

1986-01-01

198

Geriatrics in Family Practice Residency Education: An Unmet Challenge.  

ERIC Educational Resources Information Center

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…

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

2003-01-01

199

Multiresistant pathogens in geriatric nursing – infection control in residential facilities for geriatric nursing in Germany  

PubMed Central

Background: The increase of multidrug-resistant organisms (MDROs) causes problems in geriatric nursing homes. Older people are at increased a growing risk of infection due to multimorbidity and frequent stays in hospital. A high proportion of the elderly require residential care in geriatric nursing facilities, where hygiene requirements in nursing homes are similar to those in hospitals. For this reason we examined how well nursing homes are prepared for MDROs and how effectively protect their infection control residents and staff. Methods: A cross-sectional study was performed on infection control in residential geriatric nursing facilities in Germany 2012. The questionnaire recorded important parameters of hygiene, resident and staff protection and actions in case of existing MDROs. Results: The response was 54% in Hamburg and 27% in the rest of Germany. Nursing homes were generally well equipped for dealing with infection control: There were standards for MDROs and regular hygiene training for staff. The facilities provided adequate protective clothing, affected residents are usually isolated and hygienic laundry processing conducted. There are deficits in the communication of information on infected residents with hospitals and general practitioners. 54% of nursing homes performed risk assessments for staff infection precaution. Conclusion: There is a growing interest in MDROs and infection control will be a challenge in for residential geriatric nursing facilities in the future. This issue has also drawn increasing attention. Improvements could be achieved by improving communication between different participants in the health service, together with specific measures for staff protection at work. PMID:25285266

Peters, Claudia; Schablon, Anja; Bollongino, Kirsten; Maaß, Monika; Kaß, Dietmar; Dulon, Madeleine; Diel, Roland; Nienhaus, Albert

2014-01-01

200

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

PubMed

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

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

2015-02-01

201

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

ERIC Educational Resources Information Center

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…

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

2007-01-01

202

What is empathy, and how can it be promoted during clinical clerkships?  

PubMed

The ability of medical students to empathize often declines as they progress through the curriculum. This suggests that there is a need to promote empathy toward patients during the clinical clerkships. In this article, the authors attempt to identify the patient interviewing style that facilitates empathy and some practice habits that interfere with it. The authors maintain that (1) empathy is a multistep process whereby the doctor's awareness of the patient's concerns produces a sequence of emotional engagement, compassion, and an urge to help the patient; and (2) the first step in this process--the detection of the patient's concerns--is a teachable skill. The authors suggest that this step is facilitated by (1) conducting a "patient-centered" interview, thereby creating an atmosphere that encourages patients to share their concerns, (2) enquiring further into these concerns, and (3) recording them in the section traditionally reserved for the patient's "chief complaint." Some practice habits may discourage patients from sharing their concerns, such as (1) writing up the history during patient interviewing, (2) focusing too early on the chief complaint, and (3) performing a complete system review. The authors conclude that sustaining empathy and promoting medical professionalism among medical students may necessitate a change in the prevailing interviewing style in all clinical teaching settings, and a relocation of a larger proportion of clinical clerkships from the hospital setting to primary care clinics and chronic care, home care, and hospice facilities, where students can establish a continuing relationship with patients. PMID:15326005

Benbassat, Jochanan; Baumal, Reuben

2004-09-01

203

Survival after trauma in geriatric patients.  

PubMed Central

In contrast to other studies, a recent report from the authors' institution has shown a good prognosis for functional recovery in geriatric patients that survive trauma. Because most survivors regained their pre-injury function, the authors examined factors related to nonsurvival in this population of 82 consecutive blunt trauma victims older than the age of 65. Seventeen patients died (21%). Compared with survivors, nonsurvivors were older, had more severe overall injury, and had more severe head and neck trauma but did not differ in severity of trauma that did not involve the head and neck, number of body regions injured, mechanism of injury, or incidence of surgery after injury. Nonsurvivors experienced more frequent complications (82% vs. 33%, p less than 0.05), including a higher incidence of cardiac complications (53% vs. 15%, p less than 0.05) and ventilator dependence for 5 or more days (41% vs. 14%, p less than 0.05). Mortality rates were increased in patients who were 80 years of age or older compared with those ages 65-79 (46% vs. 10%, p less than 0.01), despite injury of similar severity. More frequent complications may contribute to an increased mortality rate in the older group, including an increased incidence of prolonged mechanical ventilation (36% vs. 12%, p less than 0.025), cardiac complications (54% vs. 10%, p less than 0.01), and pneumonia (36% vs. 16%, p less than 0.06). Severely injured patients (Injury Severity Score [ISS] greater than or equal to 25) older than 80 years old had a mortality rate of 80%, and the survivors required permanent nursing home care. Discriminant analysis yielded a reliable method of differentiating survivors from nonsurvivors based on age, ISS, and the presence of cardiac and septic complications. To assess the accuracy of the discriminant function, 61 consecutive patients admitted during 1985 were reviewed prospectively. Discriminant scoring predicted outcome correctly in 92% of these patients. A Geriatric Trauma Survival Score (GTSS) based on the discriminant function was calculated for each of the 143 patients studied and was highly correlated with mortality rate (r = 0.99, p less than 0.001). Thus, the GTSS may serve as a valuable tool for evaluating death in geriatric trauma victims. Furthermore, because complications are potentially avoidable and contribute to increased mortality rates, routine aggressive care for geriatric patients with moderate overall injury is indicated. PMID:3689009

DeMaria, E J; Kenney, P R; Merriam, M A; Casanova, L A; Gann, D S

1987-01-01

204

The Geriatric Population and Psychiatric Medication  

PubMed Central

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

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

2010-01-01

205

Geriatrics in medical students’ curricula: questionnaire-based analysis  

PubMed Central

Background Demographic development is accompanied by an increasingly aging society. Concerning medical education, the treatment of older people as well as the scientific research and exploration of ageing aspects in the coming years need to be considered. Aim of the study was to ascertain medical students’ knowledge, interest, and attitudes regarding older patients and geriatric medicine. Methods Each participant completed a self-designed questionnaire. This questionnaire was based on three validated internationally recognised questionnaires (“Facts on Aging Quiz – FAQ”, “Expectations Regarding Aging – ERA” and the “Aging Semantic Differential – ASD”). The inquiry and survey were performed at the beginning of the summer term in 2012 at the University of Regensburg Medical School. Results A total of n?=?184/253 (72.7%) students participated in this survey. The results of the FAQ 25+ showed that respondents were able to answer an average of M?=?20.4 of 36 questions (56.7%) correctly (Median, Md?=?21; SD ±6.1). The personal attitudes and expectations of ageing averaged M?=?41.2 points on the Likert-scale that ranged from 0 to 100 (Md?=?40.4; SD ±13.7). Respondents’ attitudes towards the elderly (ASD 24) averaged M?=?3.5 points on the Likert-scale (range 1–7, Md 3.6, SD ±0.8). Conclusions In our investigation, medical students’ knowledge of ageing was comparable to previous surveys. Attitudes and expectations of ageing were more positive compared to previous studies. Overall, medical students expect markedly high cognitive capacities towards older people that can actively prevent cognitive impairment. However, medical students’ personal interest in medicine of ageing and older people seems to be rather slight. PMID:25062568

2014-01-01

206

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

PubMed

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

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

2014-03-01

207

Current publications in Gerontology and Geriatrics.  

PubMed

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

Shock, N W

1978-07-01

208

Current publications in gerontology and geriatrics.  

PubMed

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

Shock, N W

1977-07-01

209

Ethical issues in end-of-life geriatric care: the approach of three monotheistic religions-Judaism, Catholicism, and Islam.  

PubMed

Ethical dilemmas pervade modern geriatric medicine. What is considered right or wrong will differ depending on, among other things, the patient's religion. The three Abrahamic monotheistic religions, Judaism, Christianity (its Catholic variant), and Islam all have carefully considered positions on medical ethics. Although much is held in common, there are significant differences. The authors present three clinical cases, each of which presents ethical dilemmas typical of geriatric care, especially at the end of life. On the basis of these scenarios, the normative ethical position of each religion is compared and contrasted. It is hoped that this approach will offer the geriatrician a useful approach to treating patients in an increasingly multicultural society. PMID:12890081

Clarfield, A Mark; Gordon, Michael; Markwell, Hazel; Alibhai, Shabbir M H

2003-08-01

210

Research agenda-setting program for geriatric ophthalmology.  

PubMed

The healthcare needs of an aging population of "baby boomers" (persons born between 1946 and 1964) will disproportionately affect ophthalmology. To meet this emerging need, the American Geriatrics Society and the John A. Hartford Foundation developed a research agenda-setting process for geriatric ophthalmology. A systematic literature search was performed using Medline from the years 1990 to 2000. The literature review (168 papers) was performed to determine the current state of information regarding selected issues in geriatric ophthalmology. A needs assessment for each of the identified topics was performed, gaps in the existing knowledge base were identified, and key questions for future research were proposed. A research agenda-setting process for geriatric ophthalmology might provide a structural framework for future research efforts in the field. PMID:14962164

Lee, Andrew G; Coleman, Anne L

2004-03-01

211

Geriatric education in undergraduate and graduate levels in latin america.  

PubMed

A recent dramatic increase in the elderly population has not been accompanied by a parallel increase in specialized health care professionals in Latin America. The main purpose of this work was to determine the stage of geriatrics teaching for undergraduate and graduate medical levels in Latin America. Using a questionnaire given in person and online, the authors surveyed geriatricians from 16 countries: eight from South America and eight from Central America. Among 308 medical schools, 35% taught undergraduate geriatrics, ranging from none in Uruguay, Venezuela, and Guatemala to 82% in Mexico. The authors identified 36 programs in 12 countries with graduate medical education in geriatrics, ranging from 2 to 5 years of training. The authors conclude that although the population is aging rapidly in Latin American countries, there has been a slow development of geriatrics teaching at undergraduate and postgraduate levels in the region. PMID:24717013

López, Jorge H; Reyes-Ortiz, Carlos A

2015-01-01

212

[Contribution of psychoanalysis to geriatric care for institutionalized patients].  

PubMed

The contribution of psychoanalysis to geriatric care in nursing home is discussed in three directions: its conception of care, specially on its negative sides; its implication in geriatric units, in their conception and in the analysis of their management of care; the holding of care-givers and nurses by making clear what we call transference and conter-transference and their reflection on their function. PMID:24939406

Charazac, Pierre-Marie

2014-06-01

213

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

214

Specialist geriatric medical assessment for patients discharged from hospital acute assessment units: randomised controlled trial  

PubMed Central

Objective To evaluate the effect of specialist geriatric medical management on the outcomes of at risk older people discharged from acute medical assessment units. Design Individual patient randomised controlled trial comparing intervention with usual care. Setting Two hospitals in Nottingham and Leicester, UK. Participants 433 patients aged 70 or over who were discharged within 72 hours of attending an acute medical assessment unit and at risk of decline as indicated by a score of at least 2 on the Identification of Seniors At Risk tool. Intervention Assessment made on the acute medical assessment unit and further outpatient management by specialist physicians in geriatric medicine, including advice and support to primary care services. Main outcome measures The primary outcome was the number of days spent at home (for those admitted from home) or days spent in the same care home (if admitted from a care home) in the 90 days after randomisation. Secondary outcomes were determined at 90 days and included mortality, institutionalisation, dependency, mental wellbeing, quality of life, and health and social care resource use. Results The two groups were well matched for baseline characteristics, and withdrawal rates were similar in both groups (5%). Mean days at home over 90 days’ follow-up were 80.2 days in the control group and 79.7 in the intervention group. The 95% confidence interval for the difference in means was ?4.6 to 3.6 days (P=0.31). No significant differences were found for any of the secondary outcomes. Conclusions This specialist geriatric medical intervention applied to an at risk population of older people attending and being discharged from acute medical units had no effect on patients’ outcomes or subsequent use of secondary care or long term care. PMID:24103444

2013-01-01

215

Geriatrics in relation to the social and behavioural sciences.  

PubMed

Social and behavioural gerontology is the scientific study of how men and women adapt to their environment as they grow older. It is a multidisciplinary area, comprising subjects each of which asserts an existence in its own right, as a scientific enterprise, apart from other subjects in the area, and apart from geriatrics. Social and behavioural gerontology, however, forms part of the total context within which geriatrics gets its meaning and value. Geriatrics, in turn, affects these other adjacent disciplines. Social and behavioural gerontology could help in a general way by putting geriatrics into this wide perspective and thus demonstrating the wider issues that might otherwise be neglected in the busy round of geriatric care. Social and behavioural gerontology could also help in numerous particular ways such as: the collection of normative data; improved conceptual analysis; better methods of observation, experimentation, measurement and data analysis; the integration of social and behavioural case-work with clinical geriatrics for both treatment and training purposes; improved techniques of social and behavioural assessment; improvements in communication; better social attitldes; increased self-help and understanding of the role of the elderly in society; more effective consumer behaviour; and more effective social policies incorporating long-range, broad-spectrum preventive measures. PMID:1008006

Bromley, D B

1976-11-01

216

[Management and therapy of atrial fibrillation in geriatric patients].  

PubMed

Among geriatric patients, atrial fibrillation is the most common cardiac arrhythmia. In patients over 80 years of age, the prevalence rises to approximately 10%. Atrial fibrillation is associated with serious health implications, including a 2-fold increase in mortality risk and a 5-fold increase in stroke risk. In contrast to these facts, the current guidelines on the management of atrial fibrillation of the European Society of Cardiology (ESC) contain only a short paragraph on these patients. Many relevant clinical aspects go without any comment. Thus, the purpose of our paper is to discuss those special needs of geriatric patients and their physicians which are not mentioned in the guidelines of the ESC. In our review, we discuss rhythm versus rate control, oral anticoagulation, outcome, prevention, falls, adherence, polypharmacy, dementia, nursing home patients, frailty, and geriatric assessment in consideration of geriatric patients. An extended search of the literature on Pubmed served as the basis for this review. Individual aspects of each geriatric patient should be considered when managing these complex patients; however, the complexity of each case must not lead to an individualized therapy that is not in accordance with current guidelines and the literature. A large number of papers which help us to answer most of the clinical questions regarding the management of trial fibrillation in geriatric patients have already been published. PMID:22278008

Gosch, M; Roller, R E; Böhmdorfer, B; Benvenuti-Falger, U; Iglseder, B; Lechleitner, M; Sommeregger, U; Dovjak, P

2012-01-01

217

An Assisted Living Facility Curriculum to Introduce Geriatrics to First-Year Medical Students.  

PubMed

Many U.S. medical schools have developed curricula in geriatric medicine to address the growing older adult population. At our university, the authors have integrated an assisted living facility (ALF) program into a required first-year clinical skills course. During the 2011 to 2012 academic year, an electronic survey was distributed to 109 first-year medical students prior to and after the program. Eighty-eight percent and 85% of students completed the pre- and postintervention survey, respectively. Students reported a positive attitude toward caring for older adults (92.5% post- vs. 80.2% preintervention), an understanding of the medical and social needs of older adults (89.2% post- vs. 38.5% preintervention), an acquisition of the skills to assess the health of older adults (71% post- vs. 14.5% preintervention), and an understanding of ALFs as nonmedical supportive housing (92.5% post- vs. 70.8% preintervention). The authors' curriculum offers an innovative method to integrate geriatrics education early in medical education and to involve medical students in their community. PMID:25203100

Tong, Iris L; Dodd, Kimberly A; Warrier, Sarita S; Pugliese, Louis J; McMackin, Naomi Y; Taylor, Julie Scott

2014-09-01

218

Vestibular impairment in older people frequently contributes to dizziness as part of a geriatric syndrome.  

PubMed

Research to identify whether dizziness is a geriatric syndrome has largely overlooked often treatable vestibular causes. To ascertain the degree to which vestibular and other causes of dizziness interact in older people, an eight-month retrospective case-note review was undertaken in patients aged ?: 65 years referred with dizziness or imbalance to an audiovestibular medicine clinic. Of 41 patients aged 65-93 years old, 15 (37%) had multiple symptom triggers, 23 (56%) had recent dizziness-related falls, 24 (59%) and 10 (24%) had peripheral and central vestibular causes for dizziness respectively, whereas 6 (15%) had both. Sixteen (39%) had benign paroxysmal positional vertigo, of which 13 (32%) had an additional peripheral vestibular impairment. Twenty-six (63%) had other (general medical/cardiac) causes; of these 13 (50%) also had vestibular causes. Polypharmacy, orthostatic hypotension, psychotropic drug use and anxiety were common contributory factors. Vestibular causes of dizziness contribute to a multifactorial geriatric syndrome. All patients with dizziness and falls should have a vestibular assessment (especially peripheral) to improve quality of life and reduce falls. PMID:25650194

Ahearn, David J; Umapathy, Dolores

2015-02-01

219

Drug utilization pattern and pharmacoeconomic analysis in geriatric medical in-patients of a tertiary care hospital of India  

PubMed Central

Objective: To evaluate drug utilization pattern in terms of defined daily dose along with pharmacoeconomic analysis in geriatric patients admitted in medical ward of a tertiary care hospital. Materials and Methods: Retrospective medical record analysis was performed for indoor cases of the geriatric patients (age ?65 years) admitted in medicine ward from January 2010 to December 2010 were analyzed for demographics, indications for admission, various systems involved, duration of hospital stay, various drugs prescribed, and adverse drug reaction. The drugs were categorized by anatomical therapeutic classification and defined daily dose was calculated. The World Health Organization prescribing indicators were assessed. Cost of the drugs was calculated to assess the economic burden. Results: Cardiovascular diseases were the common cause for admission. Antiplatelet drugs-B01AC (93%), H2 blockers-A02BA (77.22%), antiemetics-A03FA (67.6%), vasodilators-C01D (55%), and hypolipidemic drugs-C10AA (52%) were commonly utilized groups. Average number of drugs per patient was 9.37 (95% CI: 9.09-9.64). Average number of antimicrobials prescribed per patient was 0.91 (95% CI: 0.82-0.99). Cefotaxime was the commonly prescribed antimicrobial drug. Average cost of treatment was ?540.5 (95% CI: ?458.0-623.0). Patients shared 45% of the economic burden for prescribed medicines. The average economic burden for drugs was significantly higher in expired than survived patients (?749.49 vs. 457.59). Conclusion: Polypharmacy and irrational use of medicines are common problems in geriatric prescription. Prescription guidelines should be formatted for them. PMID:24554905

Jhaveri, Binit N.; Patel, Tejas K.; Barvaliya, Manish J.; Tripathi, C. B.

2014-01-01

220

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

Federal Register 2010, 2011, 2012, 2013, 2014

...Health Administration (VHA) strategic 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...

2013-09-11

221

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

Federal Register 2010, 2011, 2012, 2013, 2014

...Health Administration (VHA) strategic 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...

2012-03-13

222

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

Federal Register 2010, 2011, 2012, 2013, 2014

...Health Administration (VHA) strategic 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...

2011-03-31

223

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

Federal Register 2010, 2011, 2012, 2013, 2014

...Health Administration (VHA) strategic 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...

2013-02-25

224

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

Federal Register 2010, 2011, 2012, 2013, 2014

...Health Administration (VHA) strategic 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...

2013-01-30

225

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

Federal Register 2010, 2011, 2012, 2013, 2014

...Health Administration (VHA) strategic 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...

2010-09-03

226

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

E-print Network

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

Shyy, Wei

227

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

E-print Network

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

Toronto, University of

228

Guide to Geriatric Syndromes: Common and Often Related Medical Conditions in Older Adults  

MedlinePLUS

... Urinary Incontinence Related Documents PDF A Guide to Geriatric Syndromes Download Join our e-newsletter! Resources A Guide to Geriatric Syndromes: Common and Often Related Medical Conditions in ...

229

[Measuring the handgrip strength of geriatric patients].  

PubMed

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

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

2014-09-01

230

[Geriatric outpatient healthcare: hierarchical demand structuring].  

PubMed

In Brazil, the rapid growth of the elderly population has been causing a great impact on the healthcare system, with increased costs and service utilization. The inefficiency of traditional models for geriatric healthcare has made it essential to change the healthcare concepts for this population. This can take place through the development of new healthcare models that include the means to identify, assess and treat elderly patients with a variety of morbid and functional conditions, and which can be applied diverse healthcare scenarios. An outpatient model is proposed, with two stages that differ in the depth and coverage of their actions. These stages are organized as increasing levels of complexity and are capable of selecting subgroups of individuals that, because of their risk characteristics, should follow different paths through the healthcare structure. This paper discusses the first stage of this model, which involves risk identification among large groups of elderly people, by means of structuring a hierarchical flow of actions and using assessment tools of adequate sensitivity and specificity. Individuals aged 65 years or over who are detected through walk-in outpatient consultation, home visits or telephone interview are classified using a rapid screening risk evaluation instrument composed of eight items. Depending upon the level of risk presented, the individual will either be referred to another level of functional evaluation (medium-high and high risk levels), or to normal clinical care and old people's community centers (low and medium risk levels). The second stage will be the subject of a subsequent paper. PMID:15895154

Lourenço, Roberto Alves; Martins, Cláudia de Souza Ferreira; Sanchez, Maria Angélica S; Veras, Renato Peixoto

2005-04-01

231

[The specificities of orthopedic trauma in the geriatric patient].  

PubMed

Aging of the population represents an ubiquitous and ever-growing phenomenon in the developed countries. Geriatric traumatology is a constant-developping sub-speciality of orthopedics and traumatology; it deals with the specific medical problems developed by older patients when affected by muskuloskeletal trauma. The optimal treatment of this pathology as well as the age threshold used to define the "geriatric" patient are still subjects of debate. Chronological age cannot be used as the sole inclusion criteria; physiological age as defined by comorbidities seems to be more appropriate. The aim of this article is to provide a general overview of the problems that the orthopedic surgeons faces when dealing with geriatric trauma: timing of surgery and anesthesia, technical aspects of surgery and fractures, complications and problems with the postoperative management of geriatric patients. Geriatric trauma is already today an important problem; it will certainly become a great challenge in coming years. The solution must reside in a multidisciplinary approach backed up by a solid infra-structure and good management decisions. PMID:25065248

Valcu, C A; Kurth, W; Remy, B; Gillet, P

2014-01-01

232

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

ERIC Educational Resources Information Center

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

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

2012-01-01

233

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

E-print Network

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

Oliver, Douglas L.

234

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

ERIC Educational Resources Information Center

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…

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

2004-01-01

235

Empirical Analysis on the Geriatric Care Data Set Using Rough Sets Theory  

E-print Network

Empirical Analysis on the Geriatric Care Data Set Using Rough Sets Theory Jiye Li1 and Nick Cercone the experiments on a Geriatric Care data set. 1 Motivation An association rules algorithm helps to find patterns method to large data sets, we perform the experi- ments on a geriatric care data set for reduct and core

Waterloo, University of

236

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

E-print Network

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

Goldman, Steven A.

237

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

E-print Network

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

Squire, Larry R.

238

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

E-print Network

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

Arnold, Jonathan

239

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

E-print Network

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

Gluck, Mark

240

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

E-print Network

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

Paris-Sud XI, Université de

241

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

ERIC Educational Resources Information Center

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…

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

2005-01-01

242

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

E-print Network

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

Paris-Sud XI, Université de

243

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

PubMed

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

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

2013-01-01

244

Increasing geriatric social work content through university/community partnerships.  

PubMed

Since their inception, social work education programs have operated in partnership with community agencies, as both field sites and foci for research. However, surprisingly little has been written on models of university/community partnerships in social work or the role of agencies in shaping curricula. This study analyzed the outcome reports of 67 Council on Social Work Education Geriatric Enrichment Projects (Gero Rich), funded by the Hartford Foundation, that sought to infuse geriatric content throughout the foundation curricula of B.S.W. and M.S.W. programs. Using both quantitative and qualitative analyses, the structures and functions of the programs' university/community partnerships were examined along with their association with the sustainability of curriculum change efforts. Findings suggest that these partnerships were a critical component in increasing and sustaining geriatric curricular content and were beneficial for faculty, students, and agencies. PMID:19042224

McCaslin, Rosemary; Barnstable, Cherie Lynn

2008-01-01

245

[Depression in frail geriatric patients. Diagnostics and treatment].  

PubMed

Frailty is associated with an increased risk of depressive syndromes. This review aims to summarize data on coincidence, clinical presentation, and diagnostic and therapeutic work-up of depression in frail patients. Depressive syndromes in geriatric patients are characterized by increased frequency and intensity of somatic symptoms. There is considerable overlap with symptoms of frailty. Both syndromes indicate an increased risk for subsequent somatic morbidity, worsening depression functional deterioration, admission to a nursing home and mortality. Diagnosis of subthreshold depressive syndromes allows preventive measures to be initiated. Barrier-free access to preventive and therapeutic interventions is essential. Concomitant somatic symptoms in subthreshold depression increase risk of progression to major depression. They must be addressed in an interdisciplinary approach involving geriatric teams and geriatric psychiatry. PMID:23250310

Kopf, D; Hummel, J

2013-02-01

246

596 Am J Geriatr Psychiatry 12:6, November-December 2004 Altered PET Functional Brain Responses  

E-print Network

596 Am J Geriatr Psychiatry 12:6, November-December 2004 Altered PET Functional Brain Responses-related neu- rophysiologic heterogeneity. (Am J Geriatr Psychiatry 2004; 12:596­605) Received August 20, 2003 for Geriatric Psychiatry #12;Scarmeas et al. Am J Geriatr Psychiatry 12:6, November-December 2004 597 In resting

247

Economic viability of geriatric hip fracture centers.  

PubMed

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

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

2013-12-01

248

Research Priorities in Geriatric Palliative Care: Policy Initiatives  

PubMed Central

Abstract Coordinated palliative care matched to patient needs improves quality of care for vulnerable patients with serious illness and reduces costly use of hospitals and emergency departments. Unfortunately, there is a disconnect in translating geriatric palliative care models and principles into policy and widespread practice. Gaps in policy-relevant research are addressed, including implementation strategies to scale up existing care models, the role of palliative care and geriatrics in health care payment reform efforts, development of quality measures for complex patients, strategies to address workforce shortages, and an approach to hospice reform. PMID:24147877

Unroe, Kathleen T.

2013-01-01

249

Geriatric veterinary dentistry: medical and client relations and challenges.  

PubMed

Quality of life is an important issue for geriatric patients. Allowing periodontal disease, fractured teeth, and neoplasia to remain untreated decreases this quality of life. Age itself should be recognized; however, it should not be a deterrent to successful veterinary dental care. PMID:15833566

Holmstrom, Steven E

2005-05-01

250

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

ERIC Educational Resources Information Center

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…

Stark, Ruth; And Others

1984-01-01

251

A Geriatric Day Hospital: Who Improves the Most?  

ERIC Educational Resources Information Center

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

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

2004-01-01

252

Rasch Analysis of the Geriatric Depression Scale--Short Form  

ERIC Educational Resources Information Center

Purpose: The purpose of this study was to examine scale dimensionality, reliability, invariance, targeting, continuity, cutoff scores, and diagnostic use of the Geriatric Depression Scale-Short Form (GDS-SF) over time with a sample of 177 English-speaking U.S. elders. Design and Methods: An item response theory, Rasch analysis, was conducted with…

Chiang, Karl S.; Green, Kathy E.; Cox, Enid O.

2009-01-01

253

A Reliability Generalization Study of the Geriatric Depression Scale.  

ERIC Educational Resources Information Center

Conducted a reliability generalization study of the Geriatric Depression Scale (T. Brink and others, 1982). Results from this investigation of 338 studies shows that the average score reliability across studies was 0.8482 and identifies the most important predictors of score reliability. (SLD)

Kieffer, Kevin M.; Reese, Robert J.

2002-01-01

254

Confirmatory Factor Analysis of the Geriatric Depression Scale  

ERIC Educational Resources Information Center

Purpose: The Geriatric Depression Scale (GDS) is widely used in clinical and research settings to screen older adults for depressive symptoms. Although several exploratory factor analytic structures have been proposed for the scale, no independent confirmation has been made available that would enable investigators to confidently identify scores…

Adams, Kathryn Betts; Matto, Holly C.; Sanders, Sara

2004-01-01

255

1 | P a g e David K Brown Geriatrics  

E-print Network

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

Mohaghegh, Shahab

256

Geriatric Training Needs of Nursing-Home Physicians  

ERIC Educational Resources Information Center

Medical care in nursing homes is not provided by board-licensed geriatricians; it mainly comes from physicians in need of educational programs in the field of geriatrics. Such programs, based on curriculum guidelines, should be developed. The purpose of this study was to seek input from nursing home physicians on their perceived needs for training…

Lubart, Emily; Segal, Refael; Rosenfeld, Vera; Madjar, Jack; Kakuriev, Michael; Leibovitz, Arthur

2009-01-01

257

Objective Structured Video Examinations (OSVEs) for Geriatrics Education  

ERIC Educational Resources Information Center

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…

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

258

Comprehensive geriatric assessment in elderly outpatients with dementia  

Microsoft Academic Search

Dementia is a common disabling disease in the elderly. In such patients, general health conditions may worsen the functional decline and loss of autonomy. The Comprehensive Geriatric Assessment (CGA) is a validated and recommended instrument for multidimensional evaluation of the aged. Nonetheless, it has yet to be assessed in demented patients. Objectives: To analyze the functional, emotional and clinical status

Márlon Juliano Romero Aliberti; Elina Lika Kikuchi; Regina Miksian Magaldi; Sérgio Márcio; Pacheco Paschoal; Wilson Jacob Filho

2007-01-01

259

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

ERIC Educational Resources Information Center

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…

Levkoff, Sue; And Others

1996-01-01

260

Lessons From Geriatric Psychiatry in the Long Term Care Setting  

Microsoft Academic Search

Of all long term care settings, the nursing home has served as the most productive laboratory for the study of the mental health problems of late life. Lessons from geriatric psychiatry research and practice in the nursing home have relevance to general psychiatry and to other health care settings, informing us about (a) psychiatric disorders in medically ill and disabled

Joel E. Streim; David Oslin; Ira R. Katz; Patricia A. Parmelee

1997-01-01

261

[Geriatric treatment in hospitals?--medical, legal, and economic aspects].  

PubMed

Multimorbidity and functional impairment in geriatric patients regularly necessitate a combination of acute medical care and functional therapy. In Germany, comprehensive geriatric care is usually provided in hospitals, but also in clinical rehabilitation units. Different payment systems (diagnosis related groups in hospitals, day-to-day charges in rehabilitation centers) have precipitated a discussion on the separation of the acute phase from the rehabilitative phase of the disease with medical issues prevailing in the former and functional training in the latter. In geriatric patients, however, medical treatment of acute and chronic diseases should be continuously combined with functional therapy from the beginning of the hospital stay (i. e. early rehabilitation). Thus, acute hospital treatment followed by rehabilitation in a different institution, a method frequently used with younger patients with single defined diagnoses, has shown to be disadvantageous in geriatric patients. Some federal states in Germany favor the concept of one-step comprehensive hospital care including rehabilitation. As discussed in the article in detail, this procedure is in full accordance with the German social law. PMID:18074086

Plute, G; Vogel, W

2007-12-01

262

Maximizing the Potential of Internships in Gerontology and Geriatrics  

ERIC Educational Resources Information Center

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…

Karasik, Rona J.

2009-01-01

263

E-Learning Virtual Patients for Geriatric Education  

ERIC Educational Resources Information Center

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…

Orton, Eric; Mulhausen, Paul

2008-01-01

264

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

ERIC Educational Resources Information Center

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…

Bardach, Shoshana H.; Rowles, Graham D.

2012-01-01

265

A Web-Based Framework for Improving Geriatric Education  

ERIC Educational Resources Information Center

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…

Hirth, Victor A.; Hajjar, Ihab

2004-01-01

266

Use of Readers Theater to Enhance Interdisciplinary Geriatric Education  

ERIC Educational Resources Information Center

This article focuses on the design and implementation of an interdisciplinary geriatric educational project at a small New England University. A novel, affective teaching approach of Readers Theater is highlighted as a beginning classroom instructional strategy for interdisciplinary students. The physical and psychosocial considerations for health…

MacRae, Nancy; Pardue, Karen T.

2007-01-01

267

Medical Readers' Theater: Relevance to Geriatrics Medical Education  

ERIC Educational Resources Information Center

Medical Readers' Theater (MRT) is an innovative and simple way of helping medical students to reflect on difficult-to-discuss topics in geriatrics medical education, such as aging stereotypes, disability and loss of independence, sexuality, assisted living, relationships with adult children, and end-of-life issues. The authors describe a required…

Shapiro, Johanna; Cho, Beverly

2011-01-01

268

The Differential Impact of Clerk Interest and Participation in a Child and Adolescent Psychiatry Clerkship Rotation upon Psychiatry and Pediatrics Residency Matches  

ERIC Educational Resources Information Center

Objective: The authors evaluated the differential impact of clerk interest and participation in a Child and Adolescent Psychiatry (CAP) clerkship rotation upon psychiatry and pediatrics residency matches. Method: Authors studied clerks from the McMaster University M.D. program graduating years of 2005-2007. Participants were categorized as 1)…

Hanson, Mark D.; Szatmari, Peter; Eva, Kevin W.

2011-01-01

269

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

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

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

2014-01-01

270

Changing attitudes about end-of-life decision making of medical students during third-year clinical clerkships.  

PubMed

To better define the learning objectives of ethics curricula and evaluate changes in medical students' attitudes about end-of-life decision making, enrolled students (N = 96) of a pilot medical ethics program were surveyed at the beginning and end of their third-year clinical clerkship about their experiences and attitudes about end-of-life decision making. At the end of their clinical clerkship year, the majority of students had participated in end-of-life decisions, prioritized patient autonomy and quality-of-life issues, were concerned about legal liability, were polarized over issues such as physician-assisted suicide, and gained confidence in their ethical decision-making ability. To train future physicians such that clinical practice is consistent with ethical guidelines and legislation on end-of-life care, medical ethics curricula should focus on symptom relief, clarification of legal issues, and resolution of conflicts between personal beliefs and public opinion about such issues as physician-assisted suicide. Appropriate role-modeling and mentoring by residents and attending physicians should also be emphasized. PMID:10341532

Hayes, R P; Stoudemire, A S; Kinlaw, K; Dell, M L; Loomis, A

1999-01-01

271

Integrating Structured Learning and Scholarly Activities into Clerkship Rotations: A Win–Win for Students and Preceptors  

PubMed Central

Objective: To merge scholarly activity into the curriculum developed for medical students electing a rotation in wound care and/or dermatology. Approach: The authors adapted the unique wound care curriculum developed for medical student rotators and residents to incorporate structured scholarly projects, opportunities for mentorship, and feedback for continued improvement. Results: Benefits have been observed to both students and to the clinic, as reflected by online survey results, increased productivity in the form of posters and manuscripts, and opportunities for professional networking. Discussion: Rotations and clerkships can be transformed from haphazard, bystander observational experiences to active participation that enhances comprehension and retention, while also providing benefits to preceptors. Innovation: Integration between research, education, and clinical activities in a structured way can provide opportunity for enhanced learning experiences and promote the concept of evidence-based practice. Conclusion: With observed benefits to students, researchers, and staff in this clinical setting, other clerkship rotation settings should consider an integrated and structured approach to learning, which includes scholarly activities. Further rigorous program evaluation is necessary to further quantify preliminary positive feedback regarding this approach. PMID:24804160

Miller, Stephannie; Fulton, Judith; Mostow, Eliot

2014-01-01

272

American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults  

PubMed Central

Potentially inappropriate medications (PIMs) continue to be prescribed and used as first-line treatment for the most vulnerable of older adults, despite evidence of poor outcomes from the use of PIMs in older adults. PIMs now form an integral part of policy and practice and are incorporated into several quality measures. The specific aim of this project was to update the previous Beers Criteria using a comprehensive, systematic review and grading of the evidence on drug-related problems and adverse drug events (ADEs) in older adults. This was accomplished through the support of The American Geriatrics Society (AGS) and the work of an interdisciplinary panel of 11 experts in geriatric care and pharmacotherapy who applied a modified Delphi method to the systematic review and grading to reach consensus on the updated 2012 AGS Beers Criteria. Fifty-three medications or medication classes encompass the final updated Criteria, which are divided into three categories: potentially inappropriate medications and classes to avoid in older adults, potentially inappropriate medications and classes to avoid in older adults with certain diseases and syndromes that the drugs listed can exacerbate, and finally medications to be used with caution in older adults. This update has much strength, including the use of an evidence-based approach using the Institute of Medicine standards and the development of a partnership to regularly update the Criteria. Thoughtful application of the Criteria will allow for (a) closer monitoring of drug use, (b) application of real-time e-prescribing and interventions to decrease ADEs in older adults, and (c) better patient outcomes. PMID:22376048

Campanelli, Christine M.

2013-01-01

273

Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education  

PubMed Central

Background There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM) focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Methods Fifth year medical students (academic year of 2010) at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. Results During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74%) were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value <0.001). The top three highest average satisfaction scores in the new EM curriculum group were trauma workshop, bedside teaching, and emergency medical services workshop. The mean (standard deviation) satisfaction scores of those three teaching methods were 4.70 (0.50), 4.63 (0.58), and 4.60 (0.55), respectively. Conclusion Teaching EM with workshops improved student satisfaction in EM education for medical students. PMID:25674034

Sricharoen, Pungkava; Yuksen, Chaiyaporn; Sittichanbuncha, Yuwares; Sawanyawisuth, Kittisak

2015-01-01

274

competency Course Objective 1 1a Apply evidence based knowledge to diagnosis and treatment questions in ambulatory and geriatric patient care.  

E-print Network

knowledge to diagnosis and treatment questions in ambulatory and geriatric patient and treatment question in ambulatory and geriatric patient care. 3 1e Apply current knowledge to clinical problems in ambulatory and geriatric patient care. 4 1f Apply knowledge

Myers, Lawrence C.

275

Comparing a Script Concordance Examination to a Multiple-Choice Examination on a Core Internal Medicine Clerkship  

Microsoft Academic Search

Background: Script concordance (SC) questions, in which a learner is given a brief clinical scenario then asked if additional information makes one hypothesis more or less likely, with answers compared to a panel of experts, are designed to reflect a learner's clinical reasoning. Purpose: The purpose is to compare reliability, validity, and learner satisfaction between a three-option modified SC examination

William Kelly; Steven Durning; Gerald Denton

2012-01-01

276

Integrating and Evaluating Geriatrics in Medical School: A Novel Approach for the Challenge  

ERIC Educational Resources Information Center

Brown Medical School developed a comprehensive curriculum in which enriched aging content increased from 22 to 80 hours in preclerkship courses and was also added for clerkships, residencies, and nongeriatrician physicians. Innovative evaluation strategies are also described. Highlights include "treasure hunts" in the anatomy laboratory, a…

Besdine, Richard W.; Shield, Renee R.; McNicoll, Lynn; Campbell, Susan E.; Wetle, Terrie

2011-01-01

277

COMMUNITY?BASED OUTREACH MULTIDIMENSIONAL GERIATRIC ASSESSMENT: A CLINICAL AND EDUCATIONAL MODEL  

Microsoft Academic Search

The shifting emphasis from institutionalto community?based care for the elderly in Canada necessitates a new approach to geriatric assessment and education. Geriatric assessment outreach teams using a multidimensional clinical and educational model are described in the context of a regionally based geriatric program in Ottawa. This community?based multidimensional model is compared to the traditional institutional?based multidisciplinary team model, particularly in

William B. Dalziel; Cheryl A. Susinski; Linda M. Dalziel

1992-01-01

278

Management of the Gastrointestinal Tract and Nutrition in the Geriatric Surgical Patient.  

PubMed

Aging is associated with physiological changes in the gut and with physical and psychosocial risk factors that predispose to malnutrition, particularly in the presence of disease states. The geriatric faction of the surgical population is increasing, and malnourished, critically ill geriatric surgical patients have worse outcomes. The authors discuss the assessment of nutritional risk, recognition of risk factors, statement of dietary goals, and appropriate nutritional interventions in critically ill geriatric surgical patients. PMID:25459544

Nohra, Eden; Bochicchio, Grant V

2015-02-01

279

Outcome in geriatric fracture patients and how it can be improved  

Microsoft Academic Search

Geriatric fractures are an increasing medical problem worldwide. This article wants to give an overview on the literature\\u000a concerning the outcome to be expected in geriatric fracture patients and what can be done to improve it. In literature, excess\\u000a mortality rates vary from 12% to 35% in the first year after a hip fracture, and also, other geriatric fractures seem

T. Roth; C. Kammerlander; M. Gosch; T. J. Luger; M. Blauth

2010-01-01

280

Geriatric Rehabilitation Patients’ Perceptions of Unit Dining Locations  

PubMed Central

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

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

2014-01-01

281

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

PubMed

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

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

2014-01-01

282

Repressive coping in geriatric patients' reports - impact on fear of falling.  

PubMed

We investigated the influence of repressive coping, depression, cognition, education and age on geriatric patients' reports on health-related status in 80 geriatric patients with a history of injurious falls. For patient reports, subjective statements on activity avoidance, perception of terminal decline, falls, and fear of falling were assessed. Co-morbidity and number of medications were documented based on patient charts. Repressive coping was significantly associated with underreporting in geriatric patients in all items documented and predicted most variables of patients' reports. Because of underreporting significant health problems geriatric patients with repressive coping may therefore be at risk for inadequate medical treatment. PMID:18560787

Hauer, K; Tremmel, A-D; Ramroth, H; Pfisterer, M; Todd, C; Oster, P; Schuler, M

2009-04-01

283

Occupational airborne contact allergy to tetrazepam in a geriatric nurse.  

PubMed

A 52-year-old geriatric nurse presented with recurrent eczema localized in uncovered skin areas. Patch testing produced an eczematous skin reaction with type IV sensitization totetrazepam. A relapse of contact dermatitis was successfully prevented by using occupational skin protection measures and organizational measures.Our case indicates that a sensitization to drugs should be considered when allergic contact dermatitisis suspected in nursing personnel. PMID:19453384

Breuer, Kristine; Worm, Margitta; Skudlik, Christoph; Schröder, Claudia; John, Swen Malte

2009-10-01

284

Undiagnosed malnutrition and nutrition-related problems in geriatric patients  

Microsoft Academic Search

Background & aims  Malnutrition is common in geriatric patients and associated with poor outcome. If recognised, effective treatment is possible.\\u000a In recent years, low nutritional awareness among health care professionals (HCPs) has been deplored with respect to the general\\u000a hospital population. The aim of the present cross-sectional study was to assess to which extent malnutrition and nutrition-related\\u000a problems are documented by

Dorothee Volkert; C. Saeglitz; H. Gueldenzoph; C. C. Sieber; P. Stehle

285

Undiagnosed malnutrition and nutrition-related problems in geriatric patients  

Microsoft Academic Search

Background & aims  Malnutrition is common in geriatric patients and associated with poor outcome. If recognised, effective treatment is possible.\\u000a In recent years, low nutritional awareness among health care professionals (HCPs) has been deplored with respect to the general\\u000a hospital population. The aim of the present cross-sectional study was to assess to which extent malnutrition and nutrition-related\\u000a problems are documented by

Dorothee Volkert; C. Saeglitz; H. Gueldenzoph; C. C. Sieber; P. Stehle

2010-01-01

286

How to optimize patients for geriatric fracture surgery  

Microsoft Academic Search

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,

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

2010-01-01

287

Bacterial Resistance to Trimethoprim in Geriatric Medical Wards  

Microsoft Academic Search

Urinary tract infections (UTI) caused by organisms resistant to trimethoprim (TMP), as well as their faecal carriage were studied in two geriatric wards. TMP-resistant UTI was common (26 and 50% of admission and ward-acquired infections, respectively) and was associated with male sex, recurrent and transferred admissions and length of stay. There was a strong relationship between faecal carriage and isolation

M. J. Bendall; S. Ebrahim; R. G. Finch; R. C. B. Slack; K. J. Towner

1989-01-01

288

Improving medication management competency of clinical trainees in geriatrics.  

PubMed

The authors hypothesized that an interprofessional workshop would improve geriatrics trainees' medication management. The workshop was based on a needs assessment and comprised an interactive session with pharmacists on managing medications in elderly adults. Participants were trainees in their geriatrics rotation at a tertiary care medical center. Trainees completed a medication appropriateness survey for three patients, one of which was their own. After the workshop, trainees reviewed medications of the three patients. Trainees completed online surveys after their rotation and 3 months later. Of 95 trainees rotating through geriatrics, 76 (80%) attended the workshop and completed the worksheet. Trainees' scores on reviewing medication lists improved significantly, from 6.7±2.3 to 7.7±2.0 out of 11 for standardized patient 1 (P<.001) and from 5.7±1.8 to 6.4±1.5 out of 11 for standardized patient 2 (P=.009). Trainees' scores on their own patients' lists also improved significantly, from 5.6±1.5 to 6.6±1.5 out of 10 (P<.001). After the workshop, 95% (71/75) planned to change the medication regimen of the patient they presented, and 93% (68/73) planned to change other patients' medications based on information learned during the workshop. Three months later, 35% (12/34) had made changes to the regimen of the patient they discussed during the workshop, and 71% (15/21) had made changes to other patients' regimens. Seventy-eight percent (18/23) rated the workshop as the top nonclinical experience of their geriatrics rotation. In conclusion, this interprofessional medication management workshop improved trainees' ability to perform medication reviews accurately and led to change in self-reported prescribing behavior. PMID:25040361

Kostas, Tia; Zimmerman, Kristin; Salow, Marci; Simone, Mark; Whitmire, Natalie; Rudolph, James L; McMahon, Graham T

2014-08-01

289

Executive Dysfunction and Long-term Outcomes of Geriatric Depression  

Microsoft Academic Search

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

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

2000-01-01

290

Prevalence and Causes of Anaemia in a Geriatric Hospitalized Population  

Microsoft Academic Search

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

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

1992-01-01

291

End-of-Life Care of the Geriatric Surgical Patient.  

PubMed

Providing end-of-life care is a necessity for nearly all health care providers and especially those in surgical fields. Most surgical practices will involve caring for geriatric patients and those with life-threatening or terminal illnesses where discussions about end-of-life decision making and goals of care are essential. Understanding the differences between do not resuscitate (DNR), palliative care, hospice care, and symptom management in patients at the end of life is a critical skill set. PMID:25459551

Peschman, Jacob; Brasel, Karen J

2015-02-01

292

Venlafaxine-Induced Orthostatic Hypotension in a Geriatric Patient  

PubMed Central

Venlafaxine is not usually associated with risk of orthostatic hypotension. A 65-year-old US Caucasian female taking 225?mg/day of venlafaxine extended-release developed symptomatic orthostatic hypotension. The systolic and diastolic blood pressure dropped by 25 and 18?mm Hg, respectively, from supine position to standing position within 3 minutes. The patient was otherwise healthy and the orthostatic hypotension resolved with venlafaxine discontinuation. This was a probable venlafaxine adverse drug reaction according to the Naranjo scale. This case contributes to the scarce literature that indicates that clinicians need to be aware that occasionally venlafaxine can induce clinically significant orthostatic hypotension, particularly in geriatric patients. Our patient did not have orthostatic hypotension when she was taking venlafaxine at 60 years of age in higher venlafaxine doses (300?mg/day) but developed this adverse drug reaction when venlafaxine was restarted at the geriatric age. This case indicates that a history of prior tolerance to venlafaxine does not guarantee tolerance after 65 years of age. If a clinician decides to use venlafaxine in geriatric patients, the clinician should warn the patient about the risk of orthostatic hypotension and consider very slow titration and low doses. PMID:23984153

Chikkaramanjegowda, Vidyashree; de Leon, Jose

2013-01-01

293

An etiologic profile of anemia in 405 geriatric patients.  

PubMed

Background. Anemia is a common condition in the elderly and a significant risk factor for increased morbidity and mortality, reducing not only functional capacity and mobility but also quality of life. Currently, few data are available regarding anemia in hospitalized geriatric patients. Our retrospective study investigated epidemiology and causes of anemia in 405 hospitalized geriatric patients. Methods. Data analysis was performed using laboratory parameters determined during routine hospital admission procedures (hemoglobin, ferritin, transferrin saturation, C-reactive protein, vitamin B12, folic acid, and creatinine) in addition to medical history and demographics. Results. Anemia affected approximately two-thirds of subjects. Of 386 patients with recorded hemoglobin values, 66.3% were anemic according to WHO criteria, mostly (85.1%) in a mild form. Anemia was primarily due to iron deficiency (65%), frequently due to underlying chronic infection (62.1%), or of mixed etiology involving a combination of chronic disease and iron deficiency, with absolute iron deficiency playing a comparatively minor role. Conclusion. Greater awareness of anemia in the elderly is warranted due to its high prevalence and negative effect on outcomes, hospitalization duration, and mortality. Geriatric patients should be routinely screened for anemia and etiological causes of anemia individually assessed to allow timely initiation of appropriate therapy. PMID:24707396

Geisel, Tabea; Martin, Julia; Schulze, Bettina; Schaefer, Roland; Bach, Matthias; Virgin, Garth; Stein, Jürgen

2014-01-01

294

Geriatric considerations in the treatment of advanced prostate cancer  

PubMed Central

Prostate cancer is the most common non-cutaneous cancer in US men and mainly affects elderly patients, with most new diagnoses occurring in those over 65. As the geriatric population in the US continues to grow, the incidence of this disease is likewise expected to rise. Many older patients are diagnosed with advanced disease or are treated only when their disease becomes symptomatic or metastatic. The treatment options for advanced prostate cancer have increased dramatically in the last decade. It is important to understand the nuances of caring for an elderly cancer patient in order to optimally treat prostate cancer, such as the importance of using a geriatric assessment to uncover overlooked or under-reported vulnerabilities. In addition, many of the newly approved agents for the treatment of advanced prostate cancer have a unique mechanism of action and toxicities that warrant consideration when choosing therapies for older patients. This review focuses on the importance of a geriatric assessment as well as the considerations of treating elderly patients with the newer agents approved for prostate cancer. PMID:24860655

Kessler, Elizabeth R.

2014-01-01

295

Multidimensional geriatric assessment in treatment decision in elderly cancer patients: 6-year experience in an outpatient geriatric oncology service  

Microsoft Academic Search

This prospective cohort study of consecutive elderly cancer patients was undertaken to evaluate the role of the multidimensional geriatric assessment (MGA) as an aid in treatment decision-making.A total of 571 cancer patients (aged ?70) were enrolled during 6-year (1999–2005). All underwent MGA as part of the first evaluation. In multivariate analysis, the probability of receiving active, instead of palliative, treatment

D. Marenco; R. Marinello; A. Berruti; F. Gaspari; M. F. Stasi; R. Rosato; O. Bertetto; M. Molaschi; G. Ciccone

2008-01-01

296

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

ERIC Educational Resources Information Center

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,…

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

2006-01-01

297

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

E-print Network

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

Blanchette, Robert A.

298

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

PubMed Central

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

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

2012-01-01

299

Translating Fall Incidence Data into Fall-Preventive Measures in Geriatric Wards – A Survey in Belgian Hospitals  

Microsoft Academic Search

Background: Fall incidents and their negative outcomes represent a considerable problem in hospitals, especially in geriatric wards, and require implementation of strategies to prevent these undesirable events. For this reason, the College of Geriatrics, a body funded by the Belgian Government to set up quality improvement initiatives in geriatric wards, selected ‘Fall prevention in Belgian hospitals’ as a quality project

Joke Coussement; Eddy Dejaeger; Margareta Lambert; Nele Van Den Noortgate; Leen De Paepe; Steven Boonen; Didier Schoevaerdts; Koen Milisen

2009-01-01

300

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

ERIC Educational Resources Information Center

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…

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

301

160 Am J Geriatr Psychiatry 9:2, Spring 2001 Longitudinal Study of Quality of Life in  

E-print Network

160 Am J Geriatr Psychiatry 9:2, Spring 2001 Longitudinal Study of Quality of Life in People, and they are likely to be useful for studying treatment in advanced AD. (Am J Geriatr Psychiatry 2001; 9, NY 10032. e-mail: sma10@columbia.edu Copyright 2001 American Association for Geriatric Psychiatry

302

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

303

Geriatric Oncology: How Far Have We Gone and What Are the Next Steps?  

Microsoft Academic Search

Geriatric oncology is increasingly developing in Western countries as it is established that cancer peaks after 60 years of age, and the populations are inexorably aging. Aging is associated with a decrease in the use of chemotherapy, and some patients are therefore exposed to undertreatment. Comprehensive geriatric assessment is a composite of several scores that target the multidimensional aspects of

Jean-Emmanuel Kurtz; Damien Heitz; Valérie Kurtz-Illig; Patrick Dufour

2009-01-01

304

An Innovative Continuing Nursing Education Program Targeting Key Geriatric Conditions for Hospitalized Older People in China  

ERIC Educational Resources Information Center

A lack of knowledge in registered nurses about geriatric conditions is one of the major factors that contribute to these conditions being overlooked in hospitalized older people. In China, an innovative geriatric continuing nursing education program aimed at developing registered nurses' understanding of the complex care needs of hospitalized…

Xiao, Lily Dongxia; Shen, Jun; Wu, Haifeng; Ding, Fu; He, Xizhen; Zhu, Yueping

2013-01-01

305

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

ERIC Educational Resources Information Center

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…

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

2009-01-01

306

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

ERIC Educational Resources Information Center

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…

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

2012-01-01

307

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

ERIC Educational Resources Information Center

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,…

Lieff, Susan; Andrew, Melissa; Tiberius, Richard

2004-01-01

308

The Success and Struggles of Filipino Geriatric Nurses in Nursing Homes  

ERIC Educational Resources Information Center

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…

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

2009-01-01

309

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

ERIC Educational Resources Information Center

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…

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

2007-01-01

310

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

ERIC Educational Resources Information Center

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

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

2008-01-01

311

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

ERIC Educational Resources Information Center

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…

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

2008-01-01

312

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

ERIC Educational Resources Information Center

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…

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

2008-01-01

313

Mortality of Geriatric and Younger Patients with Schizophrenia in the Community  

ERIC Educational Resources Information Center

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…

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

314

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

ERIC Educational Resources Information Center

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

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

2006-01-01

315

A Community-Based Approach for Integrating Geriatrics and Gerontology into Undergraduate Medical Education  

ERIC Educational Resources Information Center

Medical school accreditation requirements require educational opportunities in geriatrics. Twenty-six minimum graduating competencies in geriatrics have recently been identified for medical students. The authors describe how these competencies are being integrated into a new medical curriculum through coursework and community-based experiences.…

Martinez, Iveris L.; Mora, Jorge Camilo

2012-01-01

316

Long-term functional outcome in geriatric hip fracture patients  

Microsoft Academic Search

Background  Fragility fractures are a major health care problem worldwide. The proportion of the geriatric population and the overall\\u000a life expectancy will increase. Hip fractures are the most common fragility fractures needing surgery and nowadays treatment\\u000a concepts are changing. We studied the long-term functional outcome and their influencing factors in patients treated without\\u000a any interdisciplinary aspects.\\u000a \\u000a \\u000a \\u000a \\u000a Design and setting  A retrospective cohort

Christian Kammerlander; Markus Gosch; Ursula Kammerlander-Knauer; Thomas J. Luger; Michael Blauth; Tobias Roth

317

Structures and geriatrics from a failure analysis experience viewpoint  

SciTech Connect

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.

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

1993-05-01

318

Abstracts from the 32nd Annual Scientific Meeting of the Canadian Geriatrics Society Quebec City, April 2012  

PubMed Central

The opinions expressed in the abstracts are those of the authors and are not to be construed as the opinion of the publisher (Canadian Geriatrics Society) or the organizers of the 32nd Annual Scientific Meeting of the Canadian Geriatrics Society. Although the publisher (Canadian Geriatrics Society) has made every effort to accurately reproduce the abstracts, the Canadian Geriatrics Society and the 32nd Annual Scientific Meeting of the Canadian Geriatrics Society assumes no responsibility and/or liability for any errors and/or omissions in any abstract as published.

2012-01-01

319

[Burn out of formal carers in geriatric facilities].  

PubMed

From a person-centered perspective, this study investigates the relationship between burn out and anxiety-depression, among geriatric caregivers, according to the helplessness-hopelessness theory. The population studied consists of 150 caregivers, drawn from different geriatric facilities throughout France. Data was collected from three self-administered questionnaires: the Maslach Burnout Inventory (MBI) measures burn out, whereas the STAI measures anxiety and the CES-D assesses symptoms of depression. These tools have been used to analyze the effects of several potential vulnerability factors. Three distinct groups have been identified by cluster analysis on the MBI's dimensions. Subjects from the first cluster (n = 88) did not suffer from burn out, whereas subjects from group 2 (n = 46) and group 3 (n = 16) have been rated "at risk" and "at high risk" of developing burn out. The three groups have significantly different levels of anxiety and depression. Age, profession and type of facility appeared as vulnerability factors for professional burn out. PMID:15689336

Courty, Bénédicte; Bouisson, Jean; Compagnone, Philippe

2004-09-01

320

Clinical preference for factors in treatment of geriatric depression.  

PubMed

Little is known about symptom preferences of clinical psychiatrists in the treatment of geriatric depression and preferences for avoiding adverse drug effects. Participants (board-certified psychiatrists) were recruited prior to a lecture on geriatric depression during a continuing education program. An analytic hierarchy process was performed and participants were asked for pairwise comparison of criteria guiding them in appraising therapeutic efficacy, and in avoiding toxicity and adverse events. Of the 61 participants from the continuing education program, 42 (69%) returned their data sheet. Avoidance of cardiotoxicity was regarded as more important than avoidance of hepatotoxicity or hematotoxicity. Concerning adverse events, highest preference was given to avoidance of falls and drug interactions, followed by avoidance of sedation, weight change, and impairment of sexual function. The most important preferences for appraisal of therapeutic efficacy were suicidality over ability to concentrate and sleep. Clinical psychiatrists have a hierarchy of preferences for treatment goals and avoidance of adverse events and toxicity. This raises the question for future research whether these preferences cause differences in prescription patterns in clinical practice even though a multitude of antidepressants are similarly effective when judged with instruments used in clinical trials. PMID:25565848

Riepe, Matthias W

2015-01-01

321

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

PubMed

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

Joost, A

2013-08-01

322

Clinical preference for factors in treatment of geriatric depression  

PubMed Central

Little is known about symptom preferences of clinical psychiatrists in the treatment of geriatric depression and preferences for avoiding adverse drug effects. Participants (board-certified psychiatrists) were recruited prior to a lecture on geriatric depression during a continuing education program. An analytic hierarchy process was performed and participants were asked for pairwise comparison of criteria guiding them in appraising therapeutic efficacy, and in avoiding toxicity and adverse events. Of the 61 participants from the continuing education program, 42 (69%) returned their data sheet. Avoidance of cardiotoxicity was regarded as more important than avoidance of hepatotoxicity or hematotoxicity. Concerning adverse events, highest preference was given to avoidance of falls and drug interactions, followed by avoidance of sedation, weight change, and impairment of sexual function. The most important preferences for appraisal of therapeutic efficacy were suicidality over ability to concentrate and sleep. Clinical psychiatrists have a hierarchy of preferences for treatment goals and avoidance of adverse events and toxicity. This raises the question for future research whether these preferences cause differences in prescription patterns in clinical practice even though a multitude of antidepressants are similarly effective when judged with instruments used in clinical trials.

Riepe, Matthias W

2015-01-01

323

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

PubMed

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

Sidenvall, B; Fjellström, C; Ek, A C

1994-10-01

324

Poor oral health, a potential new geriatric syndrome.  

PubMed

This article presents a brief introduction to the medical aspects of ageing and age-related diseases, and to some geriatric syndromes, followed by a discussion on their impact on general and oral healthcare provision to community-dwelling older people. Recent investigations suggest that inflammation constitutes a biological foundation of ageing and the onset of age-related diseases. Multimorbidity and polypharmacy, together with alterations in pharmacokinetics and pharmacodynamics, make older people at risk of adverse medication reactions. A side effect of several medications is causing xerostomia and hyposalivation, and both the type and number of medications used are relevant. New options of general healthcare provision to community-dwelling older people are the use of mobility aids and assistive technology devices, domiciliary health care, respite care and telecare. Their oral health status may be jeopardised by frailty, disability, care dependency and limited access to professional oral health care. Recommendations for improvement are the following: better integrating oral health care into general health care, developing and implementing an oral healthcare guideline, providing customised oral hygiene care aids, domiciliary oral healthcare provision, visiting dental hygienists and/or nurses, oral hygiene telecare, easily and safely accessible dental offices, transforming dentistry into medical oral health care and upgrading dentists to oral physicians. In case oral healthcare providers do not take the responsibility of persuading society of the importance of adequate oral health, weakened oral health of community-dwelling older people will become a potential new geriatric syndrome. PMID:24446975

van der Putten, Gert-Jan; de Baat, Cees; De Visschere, Luc; Schols, Jos

2014-02-01

325

Nuclear Medicine.  

ERIC Educational Resources Information Center

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)

Badawi, Ramsey D.

2001-01-01

326

The brave new world of GEC evaluation: the experience of the Rhode Island Geriatric Education Center.  

PubMed

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 efforts, and the modifications to assessment that ensued in response to the increased accountability requirements. The evaluation focused on RIGEC's series of continuing education, day-long workshops for health and social service professionals, the completion of all seven of which leads to a Certificate in Interdisciplinary Practice in Geriatrics. PMID:22816974

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

2012-01-01

327

Nursing home research: the first International Association of Gerontology and Geriatrics (IAGG) research conference.  

PubMed

The International Association of Gerontology and Geriatrics held its first conference on nursing home research in St Louis, MO, in November 2013. This article provides a summary of the presentations. PMID:24767432

Rolland, Yves; Resnick, Barbara; Katz, Paul R; Little, Milta O; Ouslander, Joseph G; Bonner, Alice; Geary, Carol R; Schumacher, Karen L; Thompson, Sarah; Martin, Finbarr C; Wilbers, Joachim; Zúñiga, Franziska; Ausserhofer, D; Schwendimann, R; Schüssler, S; Dassen, Theo; Lohrmann, Christa; Levy, Cari; Whitfield, Emily; de Souto Barreto, Philipe; Etherton-Beer, Christopher; Dilles, Tinne; Azermai, Majda; Bourgeois, Jolyce; Orrell, Martin; Grossberg, George T; Kergoat, Hélène; Thomas, David R; Visschedijk, Jan; Taylor, Stephanie J C; Handajani, Yvonne S; Widjaja, Nelly T; Turana, Yuda; Rantz, Marilyn J; Skubic, Marjorie; Morley, John E

2014-05-01

328

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

ERIC Educational Resources Information Center

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…

Bonifas, Robin P.; Gray, Amanda K.

2013-01-01

329

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 âÂÂAssessing Nutrition in Older AdultsâÂÂ, âÂÂPredicting Pressure Ulcer RiskâÂÂ, and âÂÂImmunizations for the Older AdultâÂÂ. 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.

330

Actualizing a mobile integrated system for geriatric care.  

PubMed

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

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

2013-01-01

331

[Intuitive work. Influencing feelings of residents and patients in inpatient and ambulatory geriatric nursing].  

PubMed

The concept of sentimental work by Strauss and collaborators is presented and investigated empirically within the fields of home and out-patient geriatric care by means of questionnaires. The results illustrate that sentimental work is an important component of nursing work. Differences in the use of distinct types of sentimental work are shown. A comparison between sentimental work in home and out-patient geriatric care reveals similarities as well as typical differences. PMID:14964135

Büssing, André; Giesenbauer, Björn; Glaser, Jürgen

2003-12-01

332

Advanced Topics in Emergency Medicine: Curriculum Development and Initial Evaluation  

PubMed Central

Background Emergency medicine (EM) is a young specialty and only recently has a recommended medical student curriculum been developed. Currently, many schools do not require students to complete a mandatory clerkship in EM, and if one is required, it is typically an overview of the specialty. Objectives We developed a 10-month longitudinal elective to teach subject matter and skills in EM to fourth-year medical students interested in the specialty. Our goal was producing EM residents with the knowledge and skills to excel at the onset of their residency. We hoped to prove that students participating in this rigorous 10-month longitudinal EM elective would feel well prepared for residency. Methods We studied the program with an end-of-the-year, Internet-based, comprehensive course evaluation completed by each participant of the first 2 years of the course. Graduates rated each of the course components by using a 5-point Likert format from “strongly disagree” to “strongly agree,” either in terms of whether the component was beneficial to them or whether the course expectations were appropriate, or their perceptions related to the course. Results Graduates of this elective have reported feeling well prepared to start residency. The resident-led teaching shifts, Advanced Pediatric Life Support certification, Grand Rounds presentations, Advanced Cardiovascular Life Support proficiency testing, and ultrasound component, were found to be beneficial by all students. Conclusions Our faculty believes that participating students will be better prepared for an EM residency than those students just completing a 1-month clerkship. Our data, although limited, lead us to believe that a longitudinal, immersion-type experience assists fourth-year medical students in preparation for residency. PMID:22224157

Kman, Nicholas E; Bernard, Aaron W; Martin, Daniel R; Bahner, David; Gorgas, Diane; Nagel, Rollin; Khandelwal, Sorabh

2011-01-01

333

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

PubMed

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

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

2014-03-01

334

Mindfulness: Reconnecting the Body and Mind in Geriatric Medicine and Gerontology  

ERIC Educational Resources Information Center

Derived from Buddhism, mindfulness is a unique approach for understanding human suffering and happiness that has attracted rapidly growing interest among health care professionals. In this article I describe current thinking about the concept of mindfulness and elaborate on why and how mindfulness-based interventions have potential within the…

Rejeski, W. Jack

2008-01-01

335

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

E-print Network

Laboratory Tests Preoperative Assessment of the Elderly Patient #12;Hypertension Diastolic Risk Assessment of the Elderly Risk from Physiologic Changes Risk from Psychosocial Changes Risk from% of postoperative deaths occur in the elderly #12;ASA Classification for Elderly Patients -Emergency OperationE 100

Mootha, Vamsi K.

336

High yield research opportunities in geriatric emergency medicine: prehospital care, delirium, adverse drug events, and falls.  

PubMed

Emergency services constitute crucial and frequently used safety nets for older persons, an emergency visit by a senior very often indicates high vulnerability for functional decline and death, and interventions via the emergency system have significant opportunities to change the clinical course of older patients who require its services. However, the evidence base for widespread employment of emergency system-based interventions is lacking. In this article, we review the evidence and offer crucial research questions to capitalize on the opportunity to optimize health trajectories of older persons seeking emergency care in four areas: prehospital care, delirium, adverse drug events, and falls. PMID:21498881

Carpenter, Christopher R; Shah, Manish N; Hustey, Fredric M; Heard, Kennon; Gerson, Lowell W; Miller, Douglas K

2011-07-01

337

COPD Medicine  

MedlinePLUS

... 5654 ) You are here: Health Information > Medications > COPD COPD Medicine Your doctor may prescribe medicine to control ... Calendar Read the News View Daily Pollen Count COPD Program This program offers comprehensive, individualized care for ...

338

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 ...

339

Developing Leadership in Geriatric Education. Proceedings of the Annual Summer Geriatric Institute (5th, Lexington, Kentucky, July 23-25, 1990).  

ERIC Educational Resources Information Center

Papers in these proceedings are organized into four sections: (1) Research Studies in Aging; (2) Innovative Approaches in Geriatric Education; (3) Faculty Development Models; and (4) "The Publication Process: Perils and Pearls" (Workshop). Clinical Experiences: Design Not Chance" (Matzo); "The Development of a Collaborative Gerontological Research…

Gardner, Davis L., Ed.; Patzwald, Gari-Anne, Ed.

340

Medicine Women.  

ERIC Educational Resources Information Center

Described as a survival manual for Indian women in medicine, this collected work contains diverse pieces offering inspiration and practical advice for Indian women pursuing or considering careers in medicine. Introductory material includes two legends symbolizing the Medicine or Spirit Woman's role in Indian culture and an overview of Indians Into…

Beiswenger, James N., Ed.; Jeanotte, Holly, Ed.

341

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

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

Rhode Island, University of

342

Osteopathic Medicine: About Osteopathic Medicine  

MedlinePLUS

... Contact Us A A A Advancing the distinctive philosophy and practice of osteopathic medicine Inside the AOA ... of four years of academic study. Reflecting osteopathic philosophy, the curriculum emphasizes preventive medicine and comprehensive patient ...

343

Ritualized practices among caregivers at meals in geriatric care.  

PubMed

The aim of this study was to examine the procedures of the caregivers in their daily work with meals in geriatric care, emphasizing ritualized practices, praxis and norms. An ethnographic approach was used. Registered nurses, enrolled nurses and nurse's assistants observed in the study responded to a questionnaire and, finally, were interviewed. The findings indicated that the meals mainly took the form of ritualized practices, and praxis depended on the ability and needs of the patients as well as on the working conditions. The guiding norms identified were 'to provide a home-like situation with fellowship for training purposes', 'to ensure each patient gets what he/she needs/wants by means of a fair method of serving', and 'to keep things in order and to be responsible'. These norms were transferred from the traditional family in the society, giving the caregivers the role of the parent when training patients. The enrolled nurses, responsible for the meal performance, strove to keep the eating milieu in order, and the meal as a whole was performed as a ritual. Its static form made it difficult to individualize the meal in accordance with the different needs of the patients. PMID:8715786

Sidenvall, B; Fjellström, C; Ek, A C

1996-01-01

344

Provocative dietary factors in geriatric hypertension: A surveillance study  

PubMed Central

Hypertension is the most common psychosomatic disorder affecting 972 million people worldwide being more prevalent in old age. The present survey of hypertensive patients fulfilling the standard diagnostic criteria of WHO/ISH (2004) is carried out in geriatric age group from the Saurashtra region of Gujarat in India to observe the dietary pattern and provocative factors. Total 120 patients of 50 to 80 years of age having systolic blood pressure >140 mm Hg and ?180 mm Hg and diastolic blood pressure >90 mm Hg and ?110 mm Hg irrespective of gender and religion were selected for the present study. They were interviewed for list of provocative factors enlisted in Ayurveda. As observed, the study supported the facts described in Ayurveda that dietary etiological factors, such as excess intake of Lavana (salty), Amla (sour), Katu (pungent), Tikshna, Ushna (hot), Vidahi (producing burning sensation), Viruddha (incompatible), Snigdha (unctuous), Abhishyandi (leading to obstruction), Madhura (sweet), Guru (heavy to digest) dietary articles, Ajirnashana (taking diet before complete digestion of previous meal), Adhyashana (repeated eating at short intervals), will vitiate Rakta dhatu as well as Pitta dosha in the body leading to disorders like hypertension. Hypertension in old age is found to be a disease of Vata-Pitta dominant vitiation with the involvement of Rasa, Rakta, Meda as main Dushya (vitiated factors) and dietary factors can contribute to worsening of the disease. The etiological factors having role in the pathogenesis can also be applied for preventive guidelines for the management of hypertension. PMID:23723671

Jagtap, Madhavi V.; Deole, Yogesh S.; Chandola, Harimohan; Ravishankar, B.

2012-01-01

345

Provocative dietary factors in geriatric hypertension: A surveillance study.  

PubMed

Hypertension is the most common psychosomatic disorder affecting 972 million people worldwide being more prevalent in old age. The present survey of hypertensive patients fulfilling the standard diagnostic criteria of WHO/ISH (2004) is carried out in geriatric age group from the Saurashtra region of Gujarat in India to observe the dietary pattern and provocative factors. Total 120 patients of 50 to 80 years of age having systolic blood pressure >140 mm Hg and ?180 mm Hg and diastolic blood pressure >90 mm Hg and ?110 mm Hg irrespective of gender and religion were selected for the present study. They were interviewed for list of provocative factors enlisted in Ayurveda. As observed, the study supported the facts described in Ayurveda that dietary etiological factors, such as excess intake of Lavana (salty), Amla (sour), Katu (pungent), Tikshna, Ushna (hot), Vidahi (producing burning sensation), Viruddha (incompatible), Snigdha (unctuous), Abhishyandi (leading to obstruction), Madhura (sweet), Guru (heavy to digest) dietary articles, Ajirnashana (taking diet before complete digestion of previous meal), Adhyashana (repeated eating at short intervals), will vitiate Rakta dhatu as well as Pitta dosha in the body leading to disorders like hypertension. Hypertension in old age is found to be a disease of Vata-Pitta dominant vitiation with the involvement of Rasa, Rakta, Meda as main Dushya (vitiated factors) and dietary factors can contribute to worsening of the disease. The etiological factors having role in the pathogenesis can also be applied for preventive guidelines for the management of hypertension. PMID:23723671

Jagtap, Madhavi V; Deole, Yogesh S; Chandola, Harimohan; Ravishankar, B

2012-10-01

346

Approach to Helicobacter pylori infection in geriatric population  

PubMed Central

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

Cizginer, Sevdenur; Ordulu, Zehra; Kadayifci, Abdurrahman

2014-01-01

347

Geriatric screening in first opinion practice – results from 45 dogs  

PubMed Central

Objectives To evaluate and report the results of screening geriatric dogs in a first opinion practice. Methods A prospective health screen of dogs over nine-years-old involving history taking, physical examination and urinalysis. Results At least one previously unrecognised problem was identified in 80% of 45 dogs and 353 findings (mean 7·8 per dog) were recorded. Owners often failed to recognise and report serious signs of age-related disease. However, they most often reported increased sleeping (31%), loss of hearing (29%) or sight (20%), stiffness or lameness (22%) and “slowing down” (20%). Increased lens opacity (64%), increased thirst (58%), pain (24%), increased frequency of urination (24%), signs of osteoarthritis (24%) and dental disease (22%) were most frequently identified at the time of consultation. Potentially, life-threatening findings included respiratory distress, palpable abdominal masses and metastatic lung disease. Screening resulted in 29 further diagnostic procedures, including 10 dental procedures, seven medical treatments, two surgical procedures and euthanasia of two dogs. Clinical Significance Screening elderly dogs identified unrecognised and unreported health risk factors resulting in lifestyle modification and ongoing monitoring, as well as signs of age-related diseases resulting in diagnostic investigations, early diagnoses and surgical and medical interventions to improve quality of life. PMID:22835038

Davies, M

2012-01-01

348

Career paths of geriatric nurse practitioners employed in nursing homes.  

PubMed Central

The career paths of geriatric nurse practitioners (GNPs) trained with support from the W. K. Kellogg Foundation through the Mountain States Health Corporation (MSHC) were studied. Under this program, GNPs were recruited from sponsoring nursing homes and returned to GNP positions in the sponsoring facilities following training. Training was carried out under a continuing education model offered through six university-based schools of nursing. Questionnaires were sent to the 111 GNPs trained. Of the 102 respondents, 97 provided complete information about past and present education, work experience, and job functions. The GNPs were women with a median age of 45 years, and they were employed in rural settings in the western United States. More than 45 percent of the nurses had at least a baccalaureate degree at the time of GNP training. The GNPs remained employed in long-term care positions that implemented the practitioner role. The median length of GNP employment in their first jobs after training was more than 4.5 years. The resignation rate from this first position was 1.66 resignations for each 10 years of GNP employment. Job changes were likely to be attributed to organizational changes with subsequent positions shifting toward a diversification of the GNP role. The study demonstrates the success of the MSHC program in introducing and retaining GNPs in nursing homes. PMID:2106706

Radosevich, D M; Kane, R L; Garrard, J; Skay, C L; McDermott, S; Kepferle, L; Buchanan, J; Arnold, S

1990-01-01

349

[Unit dose systems prepared for geriatric patients. I].  

PubMed

The project was carried out to facilitate and improve the quality of the use of drugs by geriatric patients aiming at the observation of the therapeutic regimen and the improvement of their compliance. The group under study comprised 15 clients living in a selected old people's home in the city of Brno, for whom the pharmacist prepared drugs into one-week blister dispensers on the basis of their health dossiers for a period of 6 months (February - July 2002). Polypharmacy occured in all patients included into a unit-dose preparation for drugs; they took on average 16 drugs in a week. The most frequently administered drugs belonged to the ATC groups of psycholeptics, anti-inflammatory and antirheumatic agents, peripheral vasodilators, antianaemic agents, cardiac therapy, diuretics, and vasoprotectives and venopharmaceuticals. The dimensions of the dispensers used and the size of individual blisters in them proved to be sufficient with an average number of 11 drugs dispensed weekly. The preparation of one-week drug dispensers was also evaluated from the standpoint of time consumption. The average time of preperation of dispensers by the pharmacist was 16 minutes 20 seconds. Time consumption was connected not only with the total number of drugs dispensed, but also with the frequency of drug dosing, splitting (halving, quartering) of drugs, and frequent changes in medication. PMID:15506707

Mazánková, D; Kolár, J

2004-09-01

350

Modeling the health care costs of geriatric inpatients.  

PubMed

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

Shaw, Barry; Marshall, Adele H

2006-07-01

351

Validity and reliability of the geriatric sexuality inventory.  

PubMed

Effective health care for older adults requires that providers assess and manage sexual health needs with high priority. This assessment begins with an effective sexuality assessment tool. A two-step, research approach was undertaken to develop and test the Geriatric Sexuality Inventory (GSI). Literature and expert review resulted in a 34-item instrument that was initially completed by 34 older adults ages 60 to 91 (mean age = 75). The testing was repeated in 19 of the original participants. The sample was 75% women, and 88% Caucasian with 9% single, 27% married, 18% divorced, and 46% widowed participants. Internal consistency reliability was run on all 53 responses and revealed adequate reliability (alpha = 0.74). Test-retest analysis also revealed good initial instrument reliability (r = 0.78; p < 0.001). Responses to open-ended questions regarding sexual information and care needs supported evidence gathered from the literature. Initial testing of the GSI revealed content validity and good internal consistency and test-retest reliability. PMID:24066785

Kazer, Meredith Wallace; Grossman, Sheila; Kerins, Gerard; Kris, Alison; Tocchi, Christine

2013-11-01

352

Energy cost of fat-fuel mobilization in geriatric trauma.  

PubMed

Age-related changes in body composition may result in varied responses to acute accidental injury. Gaining fat as age advances is common and therefore the mobilization of fat fuel resources in traumatized geriatric patients needs closer examination. We have measured in six elderly (age, 60 to 74 years) and seven young (age, 18 to 46) traumatized, hypermetabolic, and highly catabolic patients, in the "flow phase" of the metabolic response to injury, the rates of whole-body lipolysis and net fat oxidation. This enabled us to calculate the rate of triglyceride/free fatty acid (TG/FFA) cycling in the whole body and to assess its contribution to energy expenditure. Energy metabolism in general and the fat metabolism in particular were found to be somewhat slowed in elderly trauma patients compared with equally injured young individuals, although the aged patients had more total body fat. The energy cost of TG/FFA cycling is significantly (P less than .025) lower in elderly trauma victims (0.28 +/- 0.06 kcal/kg/d) compared with young patients (0.63 +/- 0.1 kcal/kg/d). This can account for approximately 3% to 4% of the elevation in metabolic rate over that predicted in the uninjured state. PMID:2299986

Jeevanandam, M; Young, D H; Schiller, W R

1990-02-01

353

Tele-ICU: the way forward in geriatric care?  

PubMed

Aging population is set to increase in the near future, and will need specialized care when admitted to ICUs. The elderly are beset with chronic conditions, such as cardiovascular, COPD, diabetes, renal complications and depression. Specialist opinions can now be made available through telemedicine facilities. Tele-ICU is a specialized hub consisting of highly skilled staff trained in critical care able to deliver timely, quality care service to patients admitted to ICUs in remote areas using highly advanced information technology services. These specialists in the tele-ICU hub are able to analyze and gather data arriving at timely interventional management decisions and provide this vital feedback to the nursing staff and doctors manning remote ICU locations where specialized intensivist may not be available. Known clinical benefits of such a system include better patient outcomes, reduced medical errors, mortality and reduced hospital length of stay. The main disadvantage in implementation could be the upfront high cost involved, for which low-cost models are being explored. In the face of delivering such remote care, it is up to the local health policy to make legislative changes to include associated legal and ethical issues. Considering the burgeoning aging population, tele-ICU could become the way forward in delivering geriatric critical care. PMID:24803284

Hao, Jun-Feng; Cui, Han-Min; Han, Jing-Ming; Bai, Jiu-Xu; Song, Xiaohua; Cao, Ning

2014-12-01

354

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

PubMed Central

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

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

355

Influenza-Induced Production of Interferon-Alpha is Defective in Geriatric Individuals  

PubMed Central

Background The majority of deaths (90%) attributed to influenza are in person’s age 65 or older. Little is known about whether defects in innate immune responses in geriatric individuals contribute to their susceptibility to influenza. Objective Our aim was to analyze interferon-alpha (IFN-alpha) production in peripheral blood mononuclear cells (PBMCs) isolated from young and geriatric adult donors, stimulated with influenza A or Toll-like receptor (TLR) ligands. IFN-alpha is a signature anti-viral cytokine that also shapes humoral and cell-mediated immune responses. Results Geriatric PBMCs produced significantly less IFN-alpha in response to live or inactivated influenza (a TLR7 ligand) but responded normally to CpG ODN (TLR9 ligand) and Guardiquimod (TLR7 ligand). All three ligands activate plasmacytoid dendritic cells (pDCs). While there was a modest decline in pDC frequency in older individuals, there was no defect in uptake of influenza by geriatric pDCs. Discussion and Conclusion Influenza-induced production of IFN-alpha was defective in geriatric PBMCs by a mechanism that was independent of reduced pDC frequency or viability, defects in uptake of influenza, inability to secrete IFN-alpha, or defects in TLR7 signaling. PMID:20182777

Canaday, David H.; Amponsah, Naa Ayele; Jones, Leola; Tisch, Daniel J.; Hornick, Thomas R.

2010-01-01

356

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

E-print Network

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

Qiu, Weigang

357

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

GERIATRICS IN PRIMARY CARE · LITERATURE CATEGORIES [To search by category, insert numeric category. Assessment and Management Tools for Select Geriatric Syndromes (cognitive impairment, gait and balance (prevalence, risk factors, overlap, treatment options, and clinical course of these geriatric syndromes) 6

Ford, James

358

Treating Older Persons with Severe Mental Illness in the Community: Impact of an Interdisciplinary Geriatric Mental Health Team  

Microsoft Academic Search

Little information is available concerning community-based interventions to treat the growing number older persons with severe mental illness. This study examined treatment efficacy of a specialized interdisciplinary geriatric mental health team (mental health geriatric interdisciplinary teams or MHGITs) for 69 older clients with severe mental disorders. Depression, life satisfaction, health, and psychiatric and medical hospitalization data were gathered. A decrease

Sherry M. Cummings

2008-01-01

359

INTERNATIONAL REPORTS Implementation of Ward-Based Clinical Pharmacy Services in Belgium—Description of the Impact on a Geriatric Unit  

E-print Network

BACKGROUND: Patient-centered clinical pharmacy services are still poorly developed in Europe, despite their demonstrated advantages in North America and the UK. Reporting European pilot experiences is, therefore, important to assess the usefulness of clinical pharmacy services in this specific context. OBJECTIVE: To report the results of the first implementation of Belgian clinical pharmacy services targeting patients at high risk of drug-related problems. METHODS: An intervention study was conducted by a trained clinical pharmacist providing pharmaceutical care to 101 patients (mean age 82.2 y; mean ± SD number of prescribed drugs 7.8 ± 3.5) admitted to an acute geriatric unit, over a 7 month period. All interventions to optimize prescribing, and their acceptance, were recorded. An external panel (2 geriatricians, 1 clinical pharmacist) assessed the interventions ’ clinical significance. Persistence of interventions after discharge was assessed through telephone calls. RESULTS: A total of 1066 interventions were made over the 7 month period. The most frequent drug-related problems underlying interventions were: underuse (15.9%), wrong dose (11.9%), inappropriate duration of therapy (9.7%), and inappropriate choice of medicine (9.6%). The most prevalent consequences were to discontinue a drug (24.5%), add a drug (18.6%), and change dosage (13.7%). Acceptance rate by physicians was 87.8%. Among interventions with clinical impact, 68.3 % and 28.6 % had moderate and major clinical significance, respectively. Persistence of chronic treatment changes 3 months after discharge was 84%. CONCLUSIONS: Involving a trained clinical pharmacist in a geriatric team led to clinically relevant and well-accepted optimization of medicine use. This initiative may be a springboard for further development of clinical pharmacy services. KEY WORDS: Belgium; clinical pharmacy; drug-related problems; frail elderly; pharmaceutical care.

Anne Spinewine; Soraya Dhillon; Louise Mallet; Paul M Tulkens; Léon Wilmotte; Christian Swine

360

Nursing students and geriatric care: the influence of specific knowledge on evolving values, attitudes, and actions.  

PubMed

This descriptive study explored the influence of specific geriatric knowledge on second and third year nursing students in their provision of care to older adults. Nineteen student participants provided qualitative data on their values and beliefs about nursing older adults prior to their attendance at a 1-h session teaching about two assessment tools: SPICES (Sleep disorders, Problems with feeding, Incontinence, Confusion, Evidence of falls, Skin breakdown) and BPI-SF (Brief Pain Inventory-Short Form). Data were again collected following a 6-week practice experience in which the same students had the opportunity to implement the tools. Four emerging themes, beliefs, knowledge, attitudes, and application, suggested how the students' geriatric knowledge and attitudes evolved and took on personal meaning in their intermediate practice experiences. Their realization of the hegemony associated with devaluing of the care of older adults warrants further examination into how geriatric knowledge is conveyed and assimilated. PMID:23465846

Potter, Gail; Clarke, Tammie; Hackett, Susan; Little, Maureen

2013-09-01

361

[Nosocomial urinary tract infections in the geriatric hospital - pathogen spectrum and resistancies].  

PubMed

We examined 834 isolates of urinary cultures (26 fungi and 808 isolates from 28 bacteria) in an academic geriatric teaching hospital for microbial spectrum and resistance analysis. Of the bacteria, 90% were associated to ten species. Detection rate of MRSA and ESBL was 1%, detection rate for pseudomonas aeruginosa, proteus species, coagulase negative staphylococci and klebsiella species were higher than in an university clinic (p < 0.001). Resistency rates were high for the 10 most frequent bacteria: 53.3% of cross-tabulations between bacterium and antibiotic agent (sulfamethoxazol-trimethoprim, amoxicillin-clavulanate, ciprofloxacin, moxifloxacin, cefuroxim, imipenem) showed resistency rate higher than 10%. We assume that specific factors of geriatric sample taking have an impact to our 2-year resistogram results. It is necessary to combine data analysis from comprehensive geriatric assessment and microbiological methods. PMID:18327687

Thiesemann, R; Walter, E-U; Füsgen, I

2009-04-01

362

Educational needs, practice patterns and quality indicators to improve geriatric pharmacy care  

PubMed Central

Background: As the population ages and pressure increases to reduce adverse drug reactions and drug-related hospitalizations in the elderly, there will be a growing demand for pharmacists to competently take on shared responsibility for effective and safe prescribing in older adults. Methods: A cross-sectional postal survey was distributed to 3927 hospital and community pharmacists across Québec about their educational needs and practice patterns in geriatric care. Perceptions of different quality performance indicators were sought. Modifiable factors associated with higher performance were determined using univariate logistic regression. Results: Seven hundred six pharmacists (18%) completed the survey. Less than 50% were aware of the prevalence of polypharmacy, inappropriate prescribing, drug-related hospitalizations or falls in the geriatric population. Forty-one percent of community pharmacists and 74% of hospital pharmacists acknowledged familiarity with the Beers criteria of drugs to avoid in the elderly. The likelihood of screening for inappropriate prescriptions was 2.96 (95% confidence interval = 1.97-4.47) among pharmacists familiar with the Beers criteria and 2.24 (95% confidence interval = 1.50-3.34) among those who received continuing geriatric education in the workplace. On average, pharmacists reported having time to conduct detailed medication reviews in 30% of their older patients. The 2 quality indicators of geriatric care that were ranked most pertinent were being able to track the number of patients requiring hospitalization for drug-related problems and monitoring rates of inappropriate prescriptions. Ninety-six percent of respondents desired continuing education about geriatric care. Conclusion: Exposure to continuing education in geriatric pharmacotherapy in the workplace is the most consistent determinant of professional performance to improve drug outcomes in the elderly. PMID:24660011

Zou, Dan

2014-01-01

363

Thoracolumbar Spine Fractures in the Geriatric Fracture Center  

PubMed Central

Introduction: Thoracolumbar spine fractures are common osteoporotic fractures among elderly patients. Several studies suggest that these fractures can be treated successfully with a nonoperative management. The aim of this study is to evaluate the conservative treatment of elderly patients with a vertebral fracture. Methods: This study is a retrospective cohort study, which included all patients with an age of 65 years and older, who were diagnosed with a vertebral fracture and where therefore admitted to the Geriatric Fracture Center over a period of 2 years. Primary outcome was the level of functioning 6 weeks and 3 months after admission. Results: We included 106 patients with 143 vertebral fractures, of which 61 patients were evaluated after 3 months. In our population, 53% of the patients had a fracture involving both middle and anterior columns. The majority of the patients functioned sufficiently 6 weeks and 3 months after admission. Analysis showed that age <80 years is an independent predictor of a sufficient level of functioning after 6 weeks. Discussion: The nonoperative treatment of elderly patients with a vertebral fracture leads to a sufficient level of functioning 6 weeks and 3 months after admission. In our population, only age <80 years is an independent predictor for a sufficient level of functioning 6 weeks after admission. The level of functioning at 6 weeks predicts the level of functioning 3 months after admission. On comparison, the level of functioning after early ambulation is equal to the level of functioning after immobilization. Where immobilization may lead to complications, early ambulation was not associated with new complications or neurological damage. Based on these advantages, the treatment of elderly patients with a fracture involving both middle and anterior columns may be altered from immobilization to mobilization in the future. PMID:25360330

Folbert, E. C.; Kraai, M.; Smit, R. S.; Hegeman, J. H.; van der Velde, D.

2014-01-01

364

[Hospitalization of elderly in an acute-care geriatric department].  

PubMed

Hospital admissions following emergency visits of elderly people are frequent. This admission modality is often problematic both for the patients and the emergency healthcare professionals. Direct admission from home (or nursing home) in acute geriatric units (AGU) has been developed but has never been prospectively assessed. We conducted a 6-month prospective observational study to compare the 97 patients admitted through the emergency room (ER) in the AGU of Bichat's hospital to the 76 patients admitted directly. Collected data included socio-demographic and medical baseline data, clinical severity score at admission, cause of hospitalization, final diagnosis, in-hospital occurrence of urinary retention and of pressure ulcer, length of stay, discharge disposition and mortality. No significant differences between the groups were found for most baseline characteristics, clinical severity score, occurrence of pressure ulcers, length of stay and mortality. However ER patients were significantly older (88±6 vs 86±7 years, p=0.04) and had more often history of arrhythmia (29% vs 15%, p=0.02) and protein-energy malnutrition preceding admission (63% vs 46%, p=0.03). Falls as admission cause was more common in ER patients while unexplained health status or functional decline were most common in those admitted directly. Clinical outcomes were less favourable in ER patients with significantly more urinary retentions (25% vs 4%, p=0.0002) and transfers to rehabilitation units (48% vs 31%, p=0.04). The patients admitted directly returned more often at home without additional social support (53% vs 30%, p=0.001). Direct admission in AGU is feasible, medically effective and provides an alternative to attending an emergency room. This admission modality could be specially suitable for elder people suffering from an unexplained functional or health status declines. Further studies are necessary to support the hypothesis that quality gains and cost-effective measures may be achieved by dissemination of such an admission modality at the hospital. PMID:22713842

Neouze, Angèle; Dechartres, Agnès; Legrain, Sylvie; Raynaud-Simon, Agathe; Gaubert-Dahan, Marie-Line; Bonnet-Zamponi, Dominique

2012-06-01

365

Management of the Skin and Soft Tissue in the Geriatric Surgical Patient.  

PubMed

Aging has significant effects on the healing ability of the geriatric population. When the elderly suffer injuries, they have a decreased metabolic reserve to handle the stress required to recover. Diseases of the elderly, such as malnutrition, diabetes mellitus, treatment of malignancies, and vascular disease, all impair tissue repair. The geriatric population is more prone to pressure ulcers, venous stasis ulcers, and other chronic wounds. This review discusses how changes in the elderly lead to impaired healing or chronic wounds. Prevention of these problems and their treatment are also discussed. PMID:25459545

Greenhalgh, David G

2015-02-01

366

[Identification of acute geriatric patients in the city of Hamburg ("direct data collection")].  

PubMed

In the past the calculation for an in-patient special offer (quantity of beds needed) was mainly carried out by diagnosis-based statistics of hospital cases. The decision for an in-patient care within a geriatric unit is however influenced by factors as "status of self-help abilities", "social situation" and "co-morbidity". Those factors are investigated either directly by the help of the patient himself or by questioning the nurses and/or the medical staff. A new way of measuring will be introduced for this questioning. The crucial element is the Barthel-Index (BI). Supporting measures are done by the inclusion of main data concerning the social situation as well as recording the modified screening according Lachs. From the 6th of September until 14th of December 1997 the three-part measuring technique was used at seven hospitals in Hamburg (amongst them one University hospital and one hospital with a geriatric unit) within the framework of a representative sample survey. These collected data register 18 admission days of all patients of sixty or over who at the time of questioning stayed for five days in one of those acute hospitals. In some hospitals some additional data were collected at the third or 6th day after admission. Altogether a whole "virtual day-admission" of the 60 years old or older patients was collected for the City of Hamburg at the 5th day after admission. Out of 425 patients 137 were moved or exmitted before questioning, 4 had already died. Out of the rest of 284 patients two of them refused the questioning, whilst the data of 6 patients were not feasible for evaluating. Finally 276 patients were questioned. Out of them 231 patients are "not potential candidates for a geriatric hospital or a geriatric day-care unit", 8 are "candidates for a geriatric day-care unit directly after discharge of primary care" and 37 are "candidates for an in-patient geriatric hospital". The presented three-part question-sheet shows a sensitivity of 89.2% and a specification of 92.2%. This measuring technique in the hands of a trained examiner appears to be a valid and manageable tool in the framework of geriatric consultation as well as for the investigation of own directly ascertained statistic datas for "potential candidates for an in-patient geriatric hospital". PMID:9782585

Willkomm, M; Jansen, G; Thode, R; Renz, J C; Rüschmann, H H

1998-08-01

367

Vulnerable Medicine  

ERIC Educational Resources Information Center

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…

Bochner, Arthur P.

2009-01-01

368

Behavioral Medicine.  

ERIC Educational Resources Information Center

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,…

Garfield, Sol L., Ed.

1982-01-01

369

Teaching geriatrics using an innovative, individual-centered educational game: students and educators win. A proof-of-concept study.  

PubMed

Given the increasingly aging population, nearly every doctor will encounter elderly adults who present with multiple complex comorbidities that can challenge even experienced physicians. This may explain why many medical students do not have a positive attitude toward elderly adults and find the complexity of their problems overwhelming. It was hypothesized that a recently developed medical school geriatrics course, based on the game GeriatriX and designed specifically to address the complexities associated with decision-making in geriatrics, can have a positive effect on attitudes toward geriatrics and on perceived knowledge of geriatrics. The effects of this game-based course were evaluated as a proof of concept. The assessment was based on the Aging Semantic Differential (ASD) and a validated self-perceived knowledge scale of geriatric topics. The usability of (and satisfaction with) GeriatriX was also assessed using a 5-point Likert scale. After completion of the course, the ASD changed significantly in the geriatrics course group (n = 29; P = .02) but not in a control group that took a neuroscience course (n = 24; P = .30). Moreover, the geriatrics course group had a significant increase in self-perceived knowledge for 12 of the 18 topics (P = .002), whereas in the control group self-perceived knowledge increased significantly for one topic only (sensory impairment) (P = .04). Finally, the geriatrics students reported enjoying GeriatriX. This proof-of-concept study clearly supports the hypothesis that a 4-week course using a modern educational approach such as GeriatriX can improve students' self-perceived knowledge of geriatrics and their attitudes toward elderly adults. PMID:25283695

van de Pol, Marjolein H J; Lagro, Joep; Fluit, Lia R M G; Lagro-Janssen, Toine L M; Olde Rikkert, Marcel G M

2014-10-01

370

South Winnipeg Integrated Geriatric Program (SWING): A Rapid Community-Response Program for the Frail Elderly  

ERIC Educational Resources Information Center

The objective of this study was to compare enhanced access to geriatric assessment and case management to usual home care service provision for the frail elderly. This was a demonstration project, with randomized allocation to control or intervention groups of frail elderly persons who had been referred to the Home Care service in Winnipeg. Of the…

Montgomery, Patrick R.; Fallis, Wendy M.

2003-01-01

371

An Active-Learning Course Model to Teach Pharmacotherapy in Geriatrics  

PubMed Central

Objective To describe the development, implementation, and assessment of a geriatric pharmacotherapy elective course emphasizing a patient-centered approach and active, self-directed learning strategies. Design The course content included fundamental concepts in aging, geriatric syndromes, activities involving assessment of medically complex older adults, presentation of controversies in clinical geriatrics, book and film clubs, an Adopt-a-Patient project, and scientific and reflective writing. Students participated in site visits to interview and interact with older adults. Assessment Student evaluation of the course was assessed with the teaching evaluation tool, an end-of-semester survey, a follow-up P4 survey, and reflective writings. Students strongly agreed that course goals were achieved. Learning how to communicate with older adults and assess complex medication regimens were the areas of highest importance to students. P4 students strongly agreed that skills learned in the course were important to their success in advanced pharmacy practice experiences (APPEs). Conclusion A pharmacotherapy course emphasizing active and self-directed learning in geriatrics through innovative teaching was adaptable to doctor of pharmacy (PharmD) students at various stages of their training and improved students' perceptions of aging. PMID:20498731

Hume, Anne L.; Owens, Norma J.

2010-01-01

372

Influence of Yoga & Ayurveda on self-rated sleep in a geriatric population  

Microsoft Academic Search

Background & objectives: Sleep in older persons is characterized by decreased ability to stay asleep, resulting in fragmented sleep and reduced daytime alertness. Pharmacological treatment of insomnia in older persons is associated with hazardous side effects. Hence, the present study was designed to compare the effects of Yoga and Ayurveda on the self rated sleep in a geriatric population. Methods:

N. K. Manjunath; Shirley Telles

2005-01-01

373

Study design and methods of the Ansan Geriatric Study (AGE study)  

PubMed Central

Background The overall objective of the Ansan Geriatric Study (AGE study) was to describe the prevalence, incidence, and related risk factors for geriatric diseases in elderly Koreans. Methods/Design The AGE study was designed as a population-based prospective cohort study on health, aging, and common geriatric diseases of elderly Koreans aged 60 to 84 years. The inception cohort was recruited in May 2002. The first-wave and second-wave studies were performed using uniform and structured procedures. At the screening study, 2,767 participants were enrolled. Participants (1391 in the first wave study and 841 in the second wave study) were recruited and completed the evaluation. The prevalence of geriatric disease and related factors in elderly Koreans were estimated. Discussion Here, we report the design and sampling participants, measurement tools, and characteristics of the AGE study. This cohort study will allow a detailed study of the longitudinal comprehensive data on health information of elderly Koreans, thereby contributing to policy formulation and planning of health, welfare management, and other social services in Korea. PMID:19236723

Han, Changsu; Jo, Sangmee Ahn; Kim, Nan Hee; Jo, Inho; Park, Moon Ho

2009-01-01

374

Gender Bias in the Diagnosis of a Geriatric Standardized Patient: A Potential Confounding Variable  

ERIC Educational Resources Information Center

Background: Gender bias has been reported in the diagnosis and treatment of patients with a variety of illnesses. In the context of our 10-station fourth year Objective Structured Clinical Evaluation, we queried whether this could influence diagnosis in a geriatric case. Case writers hypothesized that, due to this bias, the female standardized…

Lewis, Roya; Lamdan, Ruth M.; Wald, David; Curtis, Michael

2006-01-01

375

Development of a Geriatric Scale of Hopelessness: Implications for Counseling and Intervention with the Depressed Elderly.  

ERIC Educational Resources Information Center

Evaluated hopelessness, depression, and self-esteem among depressed elderly people (N=78) and developed a Geriatric Hopelessness Scale (GHS). As predicted, elderly subjects who scored high on the GHS showed significantly higher depression and lower self-esteem scores. (JAC)

Fry, P. S.

1984-01-01

376

Cognitive-Behavioral and Psychodynamic Group Psychotherapy in Treatment of Geriatric Depression.  

ERIC Educational Resources Information Center

Assessed whether depressed geriatric patients (N=33) would respond to group psychotherapy and, if they would respond differently to cognitive-behavioral and psychodynamic modes. Results indicated that patients showed statistically and clinically significant reductions on observer-rated measures of depression and anxiety, as well as on self-report…

Steuer, Joanne L.; And Others

1984-01-01

377

A Brief Version of the Geriatric Depression Scale for the Chinese  

ERIC Educational Resources Information Center

Elderly persons (N=310) attending outpatient psychiatric clinics were given an interview on the 30-item Geriatric Depression Scale (T. L. Brink et al., 1982; J. A. Yesavage et al., 1983) and received an independent psychiatric evaluation. A 3-step binary logistic regression showed that 2 items measuring positive affect and 2 others measuring…

Cheng, Sheung-Tak; Chan, Alfred C. M.

2004-01-01

378

Validation of Geriatric Depression Scale--5 Scores among Sedentary Older Adults  

ERIC Educational Resources Information Center

This study examined the validity of Geriatric Depression Scale--5 (GDS-5) scores among older sedentary adults based on its structural properties and relationship with external criteria. Participants from two samples (Ns = 185 and 93; M ages = 66 and 67 years) completed baseline assessments as part of randomized controlled exercise trials.…

Marquez, David X.; McAuley, Edward; Motl, Robert W.; Elavsky, Steriani; Konopack, James F.; Jerome, Gerald J.; Kramer, Arthur F.

2006-01-01

379

Team Assessment of Geriatric Mental Patients: The Care of Functional Dementia Produced by Hysterical Behavior.  

ERIC Educational Resources Information Center

Multidisciplinary team identified hysterical behavior, rather than depression, as one form of pseudodementia in many cases of cognitive impairment observed in geriatric patients. Seven cases required thorough medical and neuropsychological assessment and careful functional analysis of patients' behavior patterns to determine the adaptive utility…

Kirby, Henry B.; Harper, Robert G.

1987-01-01

380

Quality Assurance in Gerontological and Geriatric Training Programs: The European Case  

ERIC Educational Resources Information Center

Quality assurance (QA) in gerontological and geriatric education programs is regarded as essential to maintain standards, strengthen accountability, improve readability of qualifications, and facilitate professional mobility. In this article the authors present a summary of international developments in QA and elaborate four international trends,…

Politynska, Barbara; van Rijsselt, Rene J. T.; Lewko, Jolanta; Philp, Ian; Figueiredo, Daniella; De Sousa, Lilliana

2012-01-01

381

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

ERIC Educational Resources Information Center

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…

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

382

Geriatric Education across 94 Million Acres: Adapting Conference Programming in a Rural State  

ERIC Educational Resources Information Center

Montana, a predominantly rural state, with a unique blend of geography and history, low population density, and cultural diversity represents the challenges for program development and implementation across remote areas. The paper discusses two statewide multidisciplinary geriatric education programs for health professionals offered by the…

Murphy-Southwick, Colleen; McBride, Melen

2006-01-01

383

Determinants of Length of Stay in Stroke Patients: A Geriatric Rehabilitation Unit Experience  

ERIC Educational Resources Information Center

The objective was to identify the predictors of length of stay--the impact of age, comorbidity, and stroke subtype--on the outcome of geriatric stroke patients. One hundred and seventy stroke patients (129 first-ever ischemic, 25 hemorrhagic, and 16 ischemic second strokes) were included in the study. The Oxfordshire Community Stroke Project…

Atalay, Ayce; Turhan, Nur

2009-01-01

384

The 1- ?g `low dose' ACTH test for assessment of adrenal function in geriatric patients  

Microsoft Academic Search

A commonly utilized dynamic test for evaluation of the hypothalamic-pituitary-adrenal (HPA) axis in the geriatric patient is the standard 250-?g ACTH stimulation test. However, there are significant potential drawbacks associated with this study. In contrast, administration of 1 ?g of ACTH has been shown to be very sensitive for detecting abnormalities in the HPA axis. We therefore assessed the responses

Jacob Feldman; Menachem S Shapiro; Marrk Niven; Eli Weiss; Abraham Yaretsky

1998-01-01

385

Cerebral White Matter Changes and Geriatric Syndromes: Is There a Link?  

Microsoft Academic Search

Cerebral white matter lesions (WMLs), also called ''leukoaraiosis,'' are common neuroradiological findings in elderly people. WMLs are often located at periventricular and subcortical areas and manifest as hyperintensities in magnetic resonance imaging. Recent studies suggest that cardiovascular risk factors are associated with the development of WMLs. These lesions are associated with different geriatric syndromes such as falls, executive cognitive impairment,

Hsu-Ko Kuo; Lewis A. Lipsitz

2004-01-01

386

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

PubMed Central

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

Sahoo, Pradyumna KU; Bhuyan, Sanat KU; Misra, Satya Ranjan; Pati, Abhishek Rajan

2014-01-01

387

Geriatric Education in a Family Practice Residency Program--An Interdisciplinary Health-Care Team Approach.  

ERIC Educational Resources Information Center

A program was designed to extend experience of residents and medical students rotating through Family Practice Center in the care of older patients. This educational experience was based on a group of representative geriatric cases at a nursing home and included paramedical personnel in service and educational elements. (Author)

Jelly, Eric C.; Hawkinson, William P.

1980-01-01

388

Interdisciplinary Educational Approaches to Promote Team-Based Geriatrics and Palliative Care  

Microsoft Academic Search

Despite the increasing public demand for enhanced care of older patients and those with life-threatening illness, health professionals have had limited formal education in geriatrics and palliative care. Furthermore, formal education in interdisciplinary team training is limited. In order to remedy this situation, proactive interventions are being undertaken so that education and training in palliative care is being embedded within

Judith L. Howe; Deborah Witt Sherman

2006-01-01

389

Sexuality Training for Caretakers of Geriatric Residents in Long Term Care Facilities  

Microsoft Academic Search

A training program on sexuality of geriatric residents for caretakers and administrators in a long term care facility was quite effective in eliciting interest and participation. The workshop's training focused on (1) Attitudes toward sexuality and the elderly; (2) Terminology and communication; (3) Residents' rights and abilities to make decisions about their sexuality; (4) Information sharing and handouts: information to

Kathleen S. Mayers; Dennis McBride

1998-01-01

390

Systemic hypoperfusion is associated with executive dysfunction in geriatric cardiac patients  

Microsoft Academic Search

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

Angela L. Jefferson; Athena Poppas; Robert H. Paul; Ronald A. Cohen

2006-01-01

391

The geriatrics excellence in teaching series: an integrated educational skills curriculum for faculty and fellows development.  

PubMed

Geriatricians need to acquire skills in teaching and curriculum development to educate physicians caring for the growing population of adults aged 65 and older. To meet this challenge, educators in the Duke University Center for the Study of Aging and Human Development introduced a monthly seminar series to promote the development of geriatrics faculty and fellows as clinician educators. Ten educational skills development seminars were incorporated into geriatrics grand rounds in the first year of the program. These sessions were implemented using a variety of active learning strategies to expose participants to innovative adult learning-centered approaches for enhancing learning and instruction in medical education. Participants assessed all sessions using a feedback form and were surveyed at the end of the series to measure their overall satisfaction with the program and ascertain its effect on their roles as educators. Participants rated individual sessions highly, and respondents to the survey at the end of the course agreed that the Geriatrics Excellence in Teaching Series provided them with resources for use in their teaching practices and attested to having already applied knowledge and skills learned in the series in their teaching practices. Key elements for the program's success included an upfront needs assessment to prioritize topics, interactive sessions promoting skill development through actual practice of various strategies, open discussions to identify challenges and solutions, and a convenient and customary time slot. This format can be replicated with other geriatrics programs, providing a needed opportunity for faculty and fellows to learn about education principles. PMID:18312312

Pinheiro, Sandro O; Heflin, Mitchell T

2008-04-01

392

Structural Basis of Geriatric Voiding Dysfunction. VII. Prospective Ultrastructural\\/Urodynamic Evaluation of Its Natural Evolution  

Microsoft Academic Search

PurposeIn cross-sectional studies ultrastructure of geriatric detrusors consistently correlates with their urodynamic behavior. This study was conducted to determine whether the ultrastructural observations were stable with time, changed in concert with urodynamic change and predicted or preceded such change.

Ahmad Elbadawi; Seife Hailemariam; Subbarao V. Yalla; Neil M. Resnick

1997-01-01

393

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

ERIC Educational Resources Information Center

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…

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

2008-01-01

394

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

ERIC Educational Resources Information Center

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…

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

2012-01-01

395

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

ERIC Educational Resources Information Center

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…

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

2011-01-01

396

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

ERIC Educational Resources Information Center

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.…

Duke, Pamela; Cohen, Diane; Novack, Dennis

2009-01-01

397

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

Microsoft Academic Search

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

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

398

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

Microsoft Academic Search

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

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

1991-01-01

399

Geriatrics Education in Psychiatric Residencies: A National Survey of Program Directors  

ERIC Educational Resources Information Center

Objective: The authors describe the current characteristics of geriatrics training within general psychiatry training programs. Methods: In the fall of 2006, a survey was mailed and made available online to all U.S. psychiatric residency program directors (N=181). Results: The response rate was 54% (n=97). Of the responding psychiatry programs,…

Warshaw, Gregg A.; Bragg, Elizabeth J.; Layde, Joseph B.; Meganathan, Karthikeyan; Brewer, David E.

2010-01-01

400

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

ERIC Educational Resources Information Center

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…

Gomez, Fernando; Curcio, Carmen Lucia

2013-01-01

401

The Geriatric Hand: Correlation of Hand-Muscle Function and Activity Restriction in Elderly  

ERIC Educational Resources Information Center

On the basis of the importance of hand manipulation in activities of daily living (ADL), deterioration of hand function because of various factors reduces quality and independence of life of the geriatric population. The aim of this study was to identify age-induced changes in manual function and to quantify the correlations between hand-muscle…

Incel, Nurgul Arinci; Sezgin, Melek; As, Ismet; Cimen, Ozlem Bolgen; Sahin, Gunsah

2009-01-01

402

Wilderness medicine  

PubMed Central

BACKGROUND: Human activity in wilderness areas has increased globally in recent decades, leading to increased risk of injury and illness. Wilderness medicine has developed in response to both need and interest. METHODS: The field of wilderness medicine encompasses many areas of interest. Some focus on special circumstances (such as avalanches) while others have a broader scope (such as trauma care). Several core areas of key interest within wilderness medicine are discussed in this study. RESULTS: Wilderness medicine is characterized by remote and improvised care of patients with routine or exotic illnesses or trauma, limited resources and manpower, and delayed evacuation to definitive care. Wilderness medicine is developing rapidly and draws from the breadth of medical and surgical subspecialties as well as the technical fields of mountaineering, climbing, and diving. Research, epidemiology, and evidence-based guidelines are evolving. A hallmark of this field is injury prevention and risk mitigation. The range of topics encompasses high-altitude cerebral edema, decompression sickness, snake envenomation, lightning injury, extremity trauma, and gastroenteritis. Several professional societies, academic fellowships, and training organizations offer education and resources for laypeople and health care professionals. CONCLUSIONS: The future of wilderness medicine is unfolding on multiple fronts: education, research, training, technology, communications, and environment. Although wilderness medicine research is technically difficult to perform, it is essential to deepening our understanding of the contribution of specific techniques in achieving improvements in clinical outcomes. PMID:25215140

Sward, Douglas G.; Bennett, Brad L.

2014-01-01

403

Complementary medicine.  

PubMed Central

The widespread use of complementary and alternative medicine techniques, often explored by patients without discussion with their primary care physician, is seen as a request from patients for care as well as cure. In this article, we discuss the reasons for the growth of and interest in complementary and alternative medicine in an era of rapidly advancing medical technology. There is, for instance, evidence of the efficacy of supportive techniques such as group psychotherapy in improving adjustment and increasing survival time of cancer patients. We describe current and developing complementary medicine programs as well as opportunities for integration of some complementary techniques into standard medical care. PMID:9584661

Spiegel, D; Stroud, P; Fyfe, A

1998-01-01

404

Clinical significance of chemotherapy for geriatric patients with advanced or recurrent gastric cancer  

PubMed Central

Recent clinical trials, such as JCOG9912 and SPIRITS, excluded geriatric patients aged ?75 years. The clinical significance of intensive chemotherapy for geriatric patients with advanced or recurrent gastric cancer remains unclear. Between 2002 and 2010, 54 consecutive advanced or recurrent gastric cancer patients aged ?75 years were enrolled in this study. We analyzed the predictors of chemotherapy administration and evaluated the survival benefit of chemotherapy for geriatric patients with advanced or recurrent gastric cancer. A total of 23 geriatric patients received no chemotherapy (GP), whereas the remaining 31 patients were administered chemotherapy (GPC). Of the 54 patients, 20 had severe concomitant illnesses, such as cardiorespiratory disease. Lymph node involvement (P=0.044) and the absence of cardiorespiratory disease (P<0.001) were found to be independently associated with chemotherapy administration. The GPC group exhibited a significantly better prognosis compared to the GP group (median survival time, 19.4 vs. 13.6 months, respectively; P=0.043). GPC patients without cardiorespiratory disease tended to have a better prognosis compared to GP patients without cardiorespiratory disease (P=0.106), whereas there were no significant differences between GP and GPC patients with cardiorespiratory disease. However, administration of chemotherapy was identified as an independent prognostic factor by the Cox proportional hazards model (hazard ratio = 2.609; 95% confidence interval: 1.173–5.761; P=0.019). Therefore, chemotherapy appears to provide a survival benefit in geriatric patients with advanced or recurrent gastric cancer, particularly those without concomitant cardiorespiratory disease. PMID:25469275

KAWAGUCHI, TSUTOMU; KOMATSU, SHUHEI; ICHIKAWA, DAISUKE; KUBOTA, TAKESHI; OKAMOTO, KAZUMA; KONISHI, HIROTAKA; SHIOZAKI, ATSUSHI; FUJIWARA, HITOSHI; OTSUJI, EIGO

2015-01-01

405

Inadequate analgesia in emergency medicine.  

PubMed

Review of emergency department pain management practices demonstrates pain treatment inconsistency and inadequacy that extends across all demographic groups. This inconsistency and inadequacy appears to stem from a multitude of potentially remediable practical and attitudinal barriers that include (1) a lack of educational emphasis on pain management practices in nursing and medical school curricula and postgraduate training programs; (2) inadequate or nonexistent clinical quality management programs that evaluate pain management; (3) a paucity of rigorous studies of populations with special needs that improve pain management in the emergency department, particularly in geriatric and pediatric patients; (4) clinicians' attitudes toward opioid analgesics that result in inappropriate diagnosis of drug-seeking behavior and inappropriate concern about addiction, even in patients who have obvious acutely painful conditions and request pain relief; (5) inappropriate concerns about the safety of opioids compared with nonsteroidal anti-inflammatory drugs that result in their underuse (opiophobia); (6) unappreciated cultural and sex differences in pain reporting by patients and interpretation of pain reporting by providers; and (7) bias and disbelief of pain reporting according to racial and ethnic stereotyping. This article reviews the literature that describes the prevalence and roots of oligoanalgesia in emergency medicine. It also discusses the regulatory efforts to address the problem and their effect on attitudes within the legal community. PMID:15039693

Rupp, Timothy; Delaney, Kathleen A

2004-04-01

406

ADHD Medicines  

MedlinePLUS

... Body Works Main Page The Pink Locker Society ADHD Medicines KidsHealth > Kids > Health Problems > Learning & Emotional Problems > ... and the Mind How Therapy Can Help About ADHD Have you ever been so bored that you ...

407

Major diagnosis and content areas of the 40 online cases that constitute the formal curriculum of the UWSOM Family Medicine Clerkship  

E-print Network

: Depression Content areas: 1. Insomnia in the elderly 2. Major Depressive Disorder (MDD): differential diagnosis, workup, community impact, treatment 3. Elder abuse 4 pressure - Mr. Martin Major diagnosis: Hypertension Content areas: 1. Hypertension

Maxwell, Bruce D.

408

Plasma medicine  

Microsoft Academic Search

Different aspects of plasma medicine, the new branch interdisciplinary between plasma chemistry and medicine, are considered.\\u000a It was shown that complex biological processes in living tissues and bodies can be controlled, stimulated, catalyzed, and\\u000a diagnosed with the use of low-temperature, atmospheric-pressure air plasma. It was found that discharge plasma can produce\\u000a the desired therapeutic effect in wound sterilization and healing,

V. N. Vasilets; A. Gutsol; A. B. Shekhter; A. Fridman

2009-01-01

409

Senior dental student's attitudes toward older adults and knowledge of geriatric dental care in the Islamic Republic of Iran.  

PubMed

Dental students should have knowledge of geriatric dental care and positive attitudes toward elderly patients. This study assessed senior dental students' knowledge of geriatric dental care and their attitude towards elderly patients. A descriptive cross-sectional questionnaire survey was conducted on volunteer senior students in all dental schools (n = 512) in the Islamic Republic of Iran. The completed questionnaires (n = 464) were analysed. The mean scores of respondents' knowledge and attitudes were 12.7 (SD 2.9) and 48 (SD 6.1) respectively. Female and male students' knowledge did not differ significantly but their attitudes score was different. The majority of dental students had low to moderate levels of knowledge of geriatric dental care and attitudes toward elderly people; therefore, an intervention programme is indicated. We conducted the study to use the findings to incorporate geriatric dental care programmes into dental school curricula in the Islamic Republic of Iran. PMID:24995742

Hatami, B; Ahmady, A Ebn; Khoshnevisan, M H; Lando, H A

2014-01-01

410

Effect of a long-term care geriatrics rotation on physician assistant students' knowledge and attitudes towards the elderly.  

PubMed

Physician assistants (PAs) have the opportunity to contribute to the high demand of providing health care to the growing older adult population. It is essential they have the knowledge to meet this need. The purpose of this study was to determine the difference in knowledge of and attitudes towards the elderly among a group of PA students before and after a required four-week geriatric rotation. PA students' knowledge of geriatrics was significantly improved following the long-term care rotation. Attitude did not change following the rotation but reflected a positive attitude at baseline. It is recommended that PA programs incorporate a rotation in geriatrics/long-term care to help increase PA students' geriatrics-specific knowledge and to better prepare them to provide care to their elderly patients. PMID:24765808

Bell-Dzide, Dodzi; Gokula, Murthy; Gaspar, Phyllis

2014-01-01

411

Objective Structured Clinical Examinations Provide Valid Clinical Skills Assessment in Emergency Medicine Education  

PubMed Central

Introduction Evaluation of emergency medicine (EM) learners based on observed performance in the emergency department (ED) is limited by factors such as reproducibility and patient safety. EM educators depend on standardized and reproducible assessments such as the objective structured clinical examination (OSCE). The validity of the OSCE as an evaluation tool in EM education has not been previously studied. The objective was to assess the validity of a novel management-focused OSCE as an evaluation instrument in EM education through demonstration of performance correlation with established assessment methods and case item analysis. Methods We conducted a prospective cohort study of fourth-year medical students enrolled in a required EM clerkship. Students enrolled in the clerkship completed a five-station EM OSCE. We used Pearson’s coefficient to correlate OSCE performance with performance in the ED based on completed faculty evaluations. Indices of difficulty and discrimination were computed for each scoring item. Results We found a moderate and statistically-significant correlation between OSCE score and ED performance score [r(239) =0.40, p<0.001]. Of the 34 OSCE testing items the mean index of difficulty was 63.0 (SD =23.0) and the mean index of discrimination was 0.52 (SD =0.21). Conclusion Student performance on the OSCE correlated with their observed performance in the ED, and indices of difficulty and differentiation demonstrated alignment with published best-practice testing standards. This evidence, along with other attributes of the OSCE, attest to its validity. Our OSCE can be further improved by modifying testing items that performed poorly and by examining and maximizing the inter-rater reliability of our evaluation instrument.

Wallenstein, Joshua; Ander, Douglas

2015-01-01

412

Randomised active programs on healthcareworkers’ flu vaccination in geriatric health care settings in France: The VESTA study  

Microsoft Academic Search

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

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

2011-01-01

413

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

Microsoft Academic Search

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

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

414

End points and trial design in geriatric oncology research: a joint European organisation for research and treatment of cancer--Alliance for Clinical Trials in Oncology--International Society Of Geriatric Oncology position article.  

PubMed

Selecting the most appropriate end points for clinical trials is important to assess the value of new treatment strategies. Well-established end points for clinical research exist in oncology but may not be as relevant to the older cancer population because of competing risks of death and potentially increased impact of therapy on global functioning and quality of life. This article discusses specific clinical end points and their advantages and disadvantages for older individuals. Randomized or single-arm phase II trials can provide insight into the range of efficacy and toxicity in older populations but ideally need to be confirmed in phase III trials, which are unfortunately often hindered by the severe heterogeneity of the older cancer population, difficulties with selection bias depending on inclusion criteria, physician perception, and barriers in willingness to participate. All clinical trials in oncology should be without an upper age limit to allow entry of eligible older adults. In settings where so-called standard therapy is not feasible, specific trials for older patients with cancer might be required, integrating meaningful measures of outcome. Not all questions can be answered in randomized clinical trials, and large observational cohort studies or registries within the community setting should be established (preferably in parallel to randomized trials) so that treatment patterns across different settings can be compared with impact on outcome. Obligatory integration of a comparable form of geriatric assessment is recommended in future studies, and regulatory organizations such as the European Medicines Agency and US Food and Drug Administration should require adequate collection of data on efficacy and toxicity of new drugs in fit and frail elderly subpopulations. PMID:24019549

Wildiers, Hans; Mauer, Murielle; Pallis, Athanasios; Hurria, Arti; Mohile, Supriya G; Luciani, Andrea; Curigliano, Giuseppe; Extermann, Martine; Lichtman, Stuart M; Ballman, Karla; Cohen, Harvey Jay; Muss, Hyman; Wedding, Ulrich

2013-10-10

415

Travel medicine  

PubMed Central

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

Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

2014-01-01

416

Brain Lithium Levels and Effects on Cognition and Mood in Geriatric Bipolar Disorder: A Lithium-7 Magnetic Resonance Spectroscopy Study  

PubMed Central

Objectives The authors investigated the relationship between brain lithium, serum lithium and age in adult subjects treated with lithium. In addition, the authors investigated the association between brain lithium and serum lithium with frontal lobe functioning and mood in a subgroup of older subjects. Design Cross-sectional assessment. Setting McLean Hospital’s Geriatric Psychiatry Research Program and Brain Imaging Center; The Division of Psychiatry, Boston University School of Medicine. Participants Twenty-six subjects, 20 to 85 years, with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition–TR bipolar disorder (BD), currently treated with lithium. Measurements All subjects had measurements of mood (Hamilton Depression Rating Scale [HDRS] and Young Mania Rating Scale) and serum and brain lithium levels. Brain lithium levels were assessed using lithium Magnetic Resonance Spectroscopy. Ten subjects older than 50 years also had assessments of frontal lobe functioning (Stroop, Trails A and B, Wis. Card Sorting Task). Results Brain lithium levels correlated with serum lithium levels for the group as a whole. However, this relationship was not present for the group of subjects older than 50. For these older subjects elevations in brain (but not serum) lithium levels were associated with frontal lobe dysfunction and higher HDRS scores. The higher HDRS were associated with increased somatic symptoms. Conclusion Frontal lobe dysfunction and elevated depression symptoms correlating with higher brain lithium levels supports conservative dosing recommendations in bipolar older adults. The absence of a predictable relationship between serum and brain lithium makes specific individual predictions about the “ideal” lithium serum level in an older adult with BD difficult. PMID:18626002

Forester, Brent P.; Streeter, Chris C.; Berlow, Yosef A.; Tian, Hua; Wardrop, Megan; Finn, Chelsea T.; Harper, David; Renshaw, Perry F.; Moore, Constance M.

2014-01-01

417

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

E-print Network

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

Blanchette, Robert A.

418

B complex vitamin patterns in geriatric and young adult inpatients with major depression.  

PubMed

This study compared the B complex vitamin status at time of admission of 20 geriatric and 16 young adult non-alcoholic inpatients with major depression. Twenty-eight percent of all subjects were deficient in B2 (riboflavin), B6 (pyridoxine), and/or B12 (cobalamin), but none in B1 (thiamine) or folate. The geriatric sample had significantly higher serum folate levels. Psychotic depressives had lower B12 than did non-psychotic depressives. Poorer blood vitamin status was not associated with higher scores on the Hamilton Depression Rating Scale or lower scores on the Mini-Mental State Examination in either age group. The data support the hypothesis that poorer status in certain B vitamins is present in major depression, but blood measures may not reflect central nervous system vitamin function or severity of affective syndromes as measured by the assays and scales in the present study. PMID:2005338

Bell, I R; Edman, J S; Morrow, F D; Marby, D W; Mirages, S; Perrone, G; Kayne, H L; Cole, J O

1991-03-01

419

Management of diabetes mellitus type-2 in the geriatric population: Current perspectives  

PubMed Central

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

Bajwa, Sukhminder Jit Singh; Sehgal, Vishal; Kalra, Sanjay; Baruah, Manash Pratim

2014-01-01

420

Dietary antioxidants and behavioral enrichment enhance neutrophil phagocytosis in geriatric Beagles  

Microsoft Academic Search

The study objective was to determine the effects of feeding food enriched in antioxidants and a program of environmental\\/cognitive enrichment on selected ex vivo assays of inflammatory and immune cells in healthy geriatric Beagle dogs (n=21). Four groups of dogs were tested using a 2×2 factorial design. The 2-year longitudinal study included both nutritional (control food or antioxidant-fortified food) and

Jean A. Hall; Rebecca A. Picton; Phyllis S. Finneran; Karyn E. Bird; Monica M. Skinner; Dennis E. Jewell; Steven Zicker

2006-01-01

421

Medical Problems Referred to a Care of the Elderly Physician: Insight for Future Geriatrics CME  

PubMed Central

Purpose Family physicians provide the majority of elderly patient care in Canada. Many experience significant challenges in serving this cohort. This study aimed to examine the medical problems of patients referred to a care of the elderly physician, to better understand the geriatric continuing medical education (CME) needs of family doctors. Methods A retrospective chart review of patients assessed at an urban outpatient seniors’ clinic between 2003 and 2008 was conducted. Data from 104 charts were analyzed and survey follow-up with 28 of the referring family physicians was undertaken. Main outcomes include the type and frequency of medical problems actually referred to a care of the elderly physician. Clarification of future geriatric CME topics of need was also assessed. Results Preventive care issues were addressed with 67 patients. Twenty-four required discussion of advance directives. The most common medical problems encountered were osteoarthritis (42), hypertension (34), osteoporosis (32), and depression or anxiety (23). Other common problems encountered that have not been highly cited as being a target of CME included musculoskeletal and joint pain (41), diabetes (23), neck and back pain (20), obesity (11), insomnia (11), and neuropathic, fibromyalgia and “leg cramps” pain (10). The referring family physicians surveyed agreed that these were topics of need for future CME. Conclusions The findings support geriatric CME for the common medical problems encountered. Chronic pain, diabetes, obesity and insomnia continue to be important unresolved issues previously unacknowledged by physicians as CME topics of need. Future CME focusing more on process of geriatric care may also be relevant. PMID:23983827

Lam, Robert; Gallinaro, Anna; Adleman, Jenna

2013-01-01

422

Preoperative assessment of the older surgical patient: honing in on geriatric syndromes  

PubMed Central

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

Kim, Sunghye; Brooks, Amber K; Groban, Leanne

2015-01-01

423

YouTube and intergenerational communication: the case of Geriatric1927  

Microsoft Academic Search

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

Dave Harley; Geraldine Fitzpatrick

2009-01-01

424

Cognitive decline in late-life schizophrenia: a longitudinal study of geriatric chronically hospitalized patients  

Microsoft Academic Search

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

Philip D Harvey; Jeremy M Silverman; Richard C Mohs; Michael Parrella; Leonard White; Peter Powchik; Michael Davidson; Kenneth L Davis

1999-01-01

425

Malnutrition in Geriatric Patients: Diagnostic and Prognostic Significance of Nutritional Parameters  

Microsoft Academic Search

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

Dorothee Volkert; Wolfgang Kruse; Peter Oster; Günter Schlierf

1992-01-01

426

Cardiorespiratory function, flexibility, and body composition among geriatric Tai Chi Chuan practitioners  

Microsoft Academic Search

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

Ching Lan; Jin-Shin Lai; May-Kuen Wong; Mei-Li Yu

1996-01-01

427

Medicine Handbook.  

ERIC Educational Resources Information Center

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…

New York State Education Dept., Albany. Office of the Professions.

428

Medicine Handbook.  

ERIC Educational Resources Information Center

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…

New York State Education Dept., Albany. Office of the Professions.

429

[Osteopathic medicine].  

PubMed

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

Klein, P; Lepers, Y; Salem, W

2011-09-01

430

Medicinal Plants.  

ERIC Educational Resources Information Center

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)

Phillipson, J. David

1997-01-01

431

Outcomes of Geriatric Hip Fractures Treated with AFFIXUS Hip Fracture Nail  

PubMed Central

Geriatric hip fractures are one of the commonest fractures worldwide. The purpose of this study was to report the outcomes of a series of unstable geriatric hip fractures treated with AFFIXUS hip fracture nail. A retrospective study of 100 unstable geriatric hip fractures treated with AFFIXUS hip fracture nail is presented. The mean follow-up duration was 8 months (range 3–32). Of the patients 83% were female. The average age was 85 years. The fracture was treated by closed reduction and intramedullary fixation. The mean acute hospital stay was 17.6 days. Systemic complications occurred in 29 patients (29%) and local complications in 3 patients (3%) including lag screw cutout in one patient (1%), lag screw backout in one patient (1%), and deep infection in one patient (1%). Mechanical failures and periprosthetic fractures were not observed in our series. Fractures united in all patients. Preinjury activity level was recovered in 78% of the patients. The results of AFFIXUS hip fracture nail were satisfactory in most elderly patients. The unique design of the lag screw and its thread spacing had effectively reduced cut-out rate. PMID:25580303

Mabrouk, Ahmed; Madhusudan, Mysore; Waseem, Mohammed; Kershaw, Steven

2014-01-01

432

Effect of a steam foot spa on geriatric inpatients with cognitive impairment: a pilot study  

PubMed Central

Purpose To investigate whether a steam foot spa improves cognitive impairment in geriatric inpatients. Methods Geriatric inpatients with cognitive impairment were given a steam foot spa treatment at 42°C for 20 minutes for 2 weeks (5 days/week). Physiological indicators such as blood pressure, percutaneous oxygen saturation, pulse, tympanic temperature, and sleep time and efficiency were assessed. Cognitive function and behavioral and psychological symptoms of dementia were assessed using the Mini-Mental State Examination, Dementia Mood Assessment Scale, and Dementia Behavior Disturbance scale. Results Significant decreases in systolic (P < 0.01) and diastolic blood pressure (P < 0.05) along with a significant increase in tympanic temperature (P < 0.01) were observed after the steam foot spas. A significant improvement was seen in the Mini-Mental State Examination score (P < 0.01) and the overall dementia severity items in Dementia Mood Assessment Scale (P < 0.05). Limitations Japanese people are very fond of foot baths. However, it is difficult to understand why inpatients cannot receive steam foot baths. In this study, a control group was not used. Raters and enforcers were not blinded. Conclusion The results of this pilot study suggest that steam foot spas mitigate cognitive impairment in geriatric inpatients. PMID:23717038

Koike, Yoshihisa; Kondo, Hideki; Kondo, Satoshi; Takagi, Masayuki; Kano, Yoshio

2013-01-01

433

Development of a conceptual framework for the assessment of geriatric rehabilitation outcomes.  

PubMed

The objective of the study was to develop a conceptual framework of key assessment areas for the evaluation of rehabilitation outcomes in older persons. The study was designed in four stages. First, a review of the literature generated a list of 84 potential outcome variables. Second, semi-structured interviews were conducted with older adults informants (n = 19) to record their thoughts about important rehabilitation outcomes. From the analyses of the transcripts, 20 recurrent themes became apparent. Third, relevant assessment areas were determined based on the merged data from the literature and the interviews. Fourth, a focus group was held with a panel of eight interdisciplinary experts with strong involvement in geriatric rehabilitation to evaluate, improve, and validate the preliminary work. As a result of the study, the conceptual framework for the assessment of geriatric rehabilitation outcomes (FAGRO) is composed of four primary outcome domains related to important activities for community-living older persons: mobility activities, basic activities of daily living, activities of independent living, and leisure activities. The models also allows for four brief evaluations of underlying functioning components, including: physical functioning, psychological functioning, social functioning, and factors related to the caregiver status and available resources. The model has the potential to become a valuable additional tool for outcome assessment, researched and developed specifically for geriatric rehabilitation. PMID:15066309

Demers, Louise; Ska, Bernadette; Desrosiers, Johanne; Alix, Caroline; Wolfson, Christina

2004-01-01

434

Pregnancy and Medicines  

MedlinePLUS

Not all medicines are safe to take when you are pregnant. Some medicines can harm your baby. That includes over-the- ... care provider before you start or stop any medicine. Not using medicine that you need may be ...

435

Risk stratification and rapid geriatric screening in an emergency department – a quasi-randomised controlled trial  

PubMed Central

Background To determine if risk stratification followed by rapid geriatric screening in an emergency department (ED) reduced functional decline, ED reattendance and hospitalisation. Method This was a quasi-randomised controlled trial. Patients were randomised by the last digit of their national registration identity card (NRIC). Odd number controls received standard ED care; even number patients received geriatric screening, followed by intervention and/or onward referrals. Patients were followed up for 12 months. Results There were 500 and 280 patients in the control and intervention groups. The intervention group had higher Triage Risk Screening Tool (TRST) scores (34.3% vs 25.4% TRST ?3, p?=?0.01) and lower baseline Instrumental Activity of Daily Living (IADL) scores (22.84 vs 24.18, p?geriatric clinic and 11.8% were admitted. 425 (85.0%) controls and 234 (83.6%) in the intervention group completed their follow-up. After adjusting for TRST and baseline IADL, the intervention group had significant preservation in function (Basic ADL -0.99 vs -0.24, p?geriatric screening at the request of the ED doctor. A major limitation was that a large proportion of patients who were randomized to the intervention group either refused (18.8%) or left the ED before being approached (32.0%). These two groups were not followed up, and hence were excluded in our analysis. Conclusion Risk stratification and focused geriatric screening in ED resulted in significant preservation of patients’ function at 12 months. Trial registration National Healthcare Group (NHG) Domain Specific Review Board (DSRB) C/09/023. Registered 5th March 2009. PMID:25178312

2014-01-01

436

Wilderness medicine.  

PubMed

Wilderness medicine is not a single entity. It encompasses clinical practice, instruction, and research as they pertain to wilderness settings. Clinical practice often takes place in removed settings far from traditional medical resources and facilities. Many of the conditions treated are unique to wilderness medicine. Decisions commonly are based on limited information. Practitioners of wilderness medicine must combine specialized training, resourcefulness, and improvisation. Instruction and research in wilderness medicine often are directed at clinical practice, with the focus on maximizing patient outcome. Preparation and planning are the best methods of reducing illness and injury; these involve conditioning and choosing clothing and equipment, including the medical kit. Conditioning should mimic the type of trip or activity, because choice will depend on the type, complexity, and duration of the trip, the anticipated environmental conditions, and specific needs of the group. Equipment should be designed for the type of activity, in good working condition, and familiar to the members of the group. The medical kit should include basic medical supplies, with additional supplies and equipment depending on the specific trip, the anticipated needs of the group, and their level of medical training and expertise. Once in the wilderness, the focus shifts from preparation and planning to prevention of illness and injury. This includes the use of safety equipment, appropriate shelter, water treatment, and location knowledge. The most common methods of water treatment are mechanical filters, chemicals, and heat. When an injury or illness does occur in the wilderness, proper assessment of the patient is essential to determine both the appropriate treatment and the need for evacuation to definitive care. This is best accomplished with an organized, systematic approach. The decision of what treatment should be initiated and if the patient requires evacuation to definitive care often is difficult. There are four phases of an SAR event: location, access, stabilization, and evacuation. Evacuation may require the assistance of organized search and rescue services. PMID:12687905

Townes, David Andrew

2002-12-01

437

Transfusion medicine  

SciTech Connect

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.

Murawski, K.; Peetoom, F.

1986-01-01

438

Space Medicine  

NASA Technical Reports Server (NTRS)

The National Academy of Sciences Committee on Space Biology and Medicine points out that space medicine is unique among space sciences, because in addition to addressing questions of fundamental scientific interest, it must address clinical or human health and safety issues as well. Efforts to identify how microgravity affects human physiology began in earnest by the United States in 1960 with the establishment of the National Aeronautics and Space Administration (NASA's) Life Sciences program. Before the first human space missions, prediction about the physiological effects of microgravity in space ranged from extremely severe to none at all. The understanding that has developed from our experiences in space to date allows us to be guardedly optimistic about the ultimate accommodations of humans to space flight. Only by our travels into the microgravity environment of space have we begun to unravel the mysteries associated with gravity's role in shaping human physiology. Space medicine is still at its very earliest stages. Development of this field has been slow for several reasons, including the limited number of space flights, the small number of research subjects, and the competition within the life sciences community and other disciplines for flight opportunities. The physiological changes incurred during space flight may have a dramatic effect on the course of an injury or illness. These physiological changes present an exciting challenge for the field of space medicine: how to best preserve human health and safety while simultaneously deciphering the effects of microgravity on human performance. As the United States considers the future of humans in long-term space travel, it is essential that the many mysteries as to how microgravity affects human systems be addressed with vigor. Based on the current state of our knowledge, the justification is excellent indeed compelling- for NASA to develop a sophisticated capability in space medicine. Teams of physicians and scientists should be actively engaged in fundamental and applied research designed to ensure that it is safe for humans to routinely and repeatedly stay and work in the microgravity environment of space.

Pool, Sam L.

2000-01-01

439

Microbial Diversity and Evidence of Novel Homoacetogens in the Gut of Both Geriatric and Adult Giant Pandas (Ailuropoda melanoleuca)  

PubMed Central

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

Tun, Hein Min; Mauroo, Nathalie France; Yuen, Chan San; Ho, John Chi Wang; Wong, Mabel Ting; Leung, Frederick Chi-Ching

2014-01-01

440

Herbal Medicines  

NSDL National Science Digital Library

In this open-ended multicultural lab activity, learners investigate the effectiveness of herbal remedies. Learners prepare extracts from plants that are used in a variety of herbal medicines; they test the antibiotic effects of the herbs on gram positive and gram negative bacteria, and look for antifungal effects using common molds. The effectiveness of the herbal extracts is compared with traditional antibiotic and antifungal preparations. Each group is in charge of their experimental design; variables include types of herbs chosen, methods of preparing extracts, microbes tested, and type of exposure of microorganisms to the extract (applied to agar surface, on sensitivity disks, in agar itself, heated, cooled, etc.). Adult supervision recommended.

Powers, Cheryl

2009-01-01

441

Impact of oral health status on oral health-related quality of life in Chinese hospitalised geriatric patients  

Microsoft Academic Search

Objectives  To examine the oral health status of Chinese hospitalised geriatric patients and identify its impacts on their oral health-related\\u000a quality of life (OHRQoL).\\u000a \\u000a \\u000a \\u000a Design  Cross-sectional correlational study.\\u000a \\u000a \\u000a \\u000a Setting  Geriatric wards of a regional hospital in Hong Kong.\\u000a \\u000a \\u000a \\u000a Subjects  A consecutive sample of Chinese hospitalised geriatric patients (N = 155) aged ? 65 years who were communicable.\\u000a \\u000a \\u000a \\u000a Measurements  The Brief Oral Health Status Examination (BOHSE) was used to evaluate

Doris S. F. Yu; Diana T. F. Lee; Athena W. L. Hong; Tak Yin Lau; Edward M. F. Leung

2008-01-01

442

Impact of a collaborative interprofessional learning experience upon medical and social work students in geriatric health care.  

PubMed

Abstract Interprofessional collaborative practice is increasingly recognized as an essential model in health care. This study lends preliminary support to the notion that medical students (including residents) and social work students develop a broader understanding of one another's roles and contributions to enhancing community-dwelling geriatric patients' health, and develop a more thorough understanding of the inherent complexities and unique aspects of geriatric health care. Wilcoxon Signed Rank Tests of participants' scores on the Index of Interdisciplinary Collaboration (IIC) indicated the training made significant changes to the students' perception of interprofessional collaboration. Qualitative analysis of participants' statements illustrated (1) benefits of the IPE experience, including complementary roles in holistic interventions; and (2) challenges to collaboration. The findings suggest that interprofessional educational experiences have a positive impact upon students' learning and strategies for enhanced care of geriatric patients. PMID:25268507

Gould, Paul Robert; Lee, Youjung; Berkowitz, Shawn; Bronstein, Laura

2014-09-30

443

Findings regarding the relationships between sociodemographic, psychological, comorbidity factors, and functional status, in geriatric inpatients.  

PubMed

Objective To assess the impact of socio-demographic and comorbidity factors, and quantified depressive symptoms on disability in inpatients. Methods Observational cross-sectional study, including a number of 80 elderly (16 men, 64 women; mean age 72.48 years; standard deviation 9.95 years) admitted in the Geriatrics Clinic of "St. Luca" Hospital, Bucharest, between May-July, 2012. We used the Functional Independence Measure, Geriatric Depression Scale and an array of socio-demographic and poly-pathology parameters. Statistical analysis included Wilcoxon and Kruskal-Wallis tests for ordinal variables, linear bivariate correlations, general linear model analysis, ANOVA. Results FIM scores were negatively correlated with age (R?=?-0.301; 95%CI?=?-0.439 -0.163; p?=?0.007); GDS scores had a statistically significant negative correlation (R?=?-0.322; 95% CI?=?-0.324 -0.052; p?=?0.004) with FIM scores. A general linear model, including other variables (gender, age, provenance, matrimonial state, living conditions, education, respectively number of chronic illnesses) as factors, found living conditions (p?=?0.027) and the combination of matrimonial state and gender (p?=?0.004) to significantly influence FIM scores. ANOVA showed significant differences in FIM scores stratified by the number of chronic diseases (p?=?0.035). Discussion and conclusions Our study objectified the negative impact of depression on functional status; interestingly, education had no influence on FIM scores; living conditions and a combination of matrimonial state and gender had an important impact: patients with living spouses showed better functional scores than divorced/widowers; the number of chronic diseases also affected the FIM scores: lower in patients with significant polypathology. These findings should be considered when designing geriatric rehabilitation programs, especially for home - including skilled - cares. PMID:25416109

Capisizu, Ana; Aurelian, Sorina; Zamfirescu, Andreea; Omer, Ioana; Haras, Monica; Ciobotaru, Camelia; Onose, Liliana; Spircu, Tiberiu; Onose, Gelu

2015-01-01

444

The Effect of Nurse Practitioner Co-Management on the Care of Geriatric Conditions  

PubMed Central

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

Reuben, David B.; Ganz, David A.; Roth, Carol P.; McCreath, Heather E.; Ramirez, Karina D.; Wenger, Neil S.

2013-01-01

445

Screening for geriatric depression in residential care facilities: a systematic narrative review.  

PubMed

Studies in residential care facilities suggest that routine screening can assist in the early detection of geriatric depression. However, the effectiveness of screening instruments in residential care in the US and Canada has not been adequately evaluated. We conducted a systematic narrative review of the English-language literature published between 2000 and 2010 on screening instruments used for depression detection in older adults living in residential care facilities. The review yielded nine scales and their modifications tested in residential care, which we evaluated. We provide specific recommendations for the use of effective scales and discuss implications for practice, policy and research. PMID:24926811

Azulai, Anna; Walsh, Christine A

2015-01-01

446

Advancing nursing home practice: the International Association of Geriatrics and Gerontology Recommendations.  

PubMed

Recognition of the urgent need to improve the provision of long-term care, as well as the known variations in standards of nursing home care around the world, prompted the International Association of Geriatrics and Gerontology (IAGG), in association with the World Health Organization (WHO), to form a task force. This task force was charged with the identification of the key concerns, research priorities, and actions that would enhance the care provided to older people in nursing homes. Nurses are equipped with the knowledge to take a leadership role in the IAGG/WHO initiative, and the task force eagerly seeks their input. PMID:21501902

Tolson, Debbie; Morley, John E; Rolland, Yves; Vellas, Bruno

2011-01-01

447

Rehabilitation of the Geriatric Surgical Patient: Predicting Needs and Optimizing Outcomes.  

PubMed

Geriatric surgical and trauma patients often require institutionalization following acute hospitalization, generally related to frailty. The potential need for rehabilitation can be assessed using various tools. Once the likelihood of rehabilitation needs is established, early involvement of the rehabilitation team is warranted. Rehabilitation interventions can be initiated during acute hospitalization, and even in the intensive care unit. The rehabilitation team addresses a tremendous spectrum of issues, and targeted interventions are carried out by various team members. There are many gaps in current knowledge of the benefits of rehabilitation interventions. Understanding common standardized assessment tools is important to assess the literature and advance the field. PMID:25459550

Biffl, Walter L; Biffl, Susan E

2015-02-01

448

Interpretive Medicine  

PubMed Central

Patient-centredness is a core value of general practice; it is defined as the interpersonal processes that support the holistic care of individuals. To date, efforts to demonstrate their relationship to patient outcomes have been disappointing, whilst some studies suggest values may be more rhetoric than reality. Contextual issues influence the quality of patient-centred consultations, impacting on outcomes. The legitimate use of knowledge, or evidence, is a defining aspect of modern practice, and has implications for patient-centredness. Based on a critical review of the literature, on my own empirical research, and on reflections from my clinical practice, I critique current models of the use of knowledge in supporting individualised care. Evidence-Based Medicine (EBM), and its implementation within health policy as Scientific Bureaucratic Medicine (SBM), define best evidence in terms of an epistemological emphasis on scientific knowledge over clinical experience. It provides objective knowledge of disease, including quantitative estimates of the certainty of that knowledge. Whilst arguably appropriate for secondary care, involving episodic care of selected populations referred in for specialist diagnosis and treatment of disease, application to general practice can be questioned given the complex, dynamic and uncertain nature of much of the illness that is treated. I propose that general practice is better described by a model of Interpretive Medicine (IM): the critical, thoughtful, professional use of an appropriate range of knowledges in the dynamic, shared exploration and interpretation of individual illness experience, in order to support the creative capacity of individuals in maintaining their daily lives. Whilst the generation of interpreted knowledge is an essential part of daily general practice, the profession does not have an adequate framework by which this activity can be externally judged to have been done well. Drawing on theory related to the recognition of quality in interpretation and knowledge generation within the qualitative research field, I propose a framework by which to evaluate the quality of knowledge generated within generalist, interpretive clinical practice. I describe three priorities for research in developing this model further, which will strengthen and preserve core elements of the discipline of general practice, and thus promote and support the health needs of the public. PMID:21805819

Reeve, Joanne

2010-01-01

449

Paralympic medicine.  

PubMed

Paralympic medicine describes the health-care issues of those 4500 or so athletes who gather every 4 years to compete in 20 sports at the Summer Paralympic Games and in five sports at the Winter Paralympic Games. Paralympic athletes compete within six impairment groups: amputation or limb deficiencies, cerebral palsy, spinal cord-related disability, visual impairment, intellectual impairment, or a range of physically impairing disorders that do not fall into the other classification categories, known as les autres. The variety of impairments, many of which are severe, fluctuating, or progressive disorders (and are sometimes rare), makes maintenance of health in thousands of Paralympians while they undertake elite competition an unusual demand on health-care resources. The increased physical fitness of athletes with disabilities has important implications for cardiovascular risk reduction in a population for whom the prevalence of risk factors can be high. PMID:22770458

Webborn, Nick; Van de Vliet, Peter

2012-07-01

450

Plasma Medicine  

NASA Astrophysics Data System (ADS)

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.

Laroussi, M.; Kong, M. G.; Morfill, G.; Stolz, W.

2012-05-01

451

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 ...

452

Preventing HIV with Medicine  

MedlinePLUS

... information in Spanish ( en español ) 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 ...

453

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 ...

454

Managing Your Medicines  

MedlinePLUS

... Blood Pressure Tools & Resources Stroke More Managing Your Medicines Updated:Apr 22,2014 If you have heart ... Tools & Resources NEW from Heart Insight: Know Your Medicines Keeping track of your medicines can be overwhelming. ...

455

Storing medicine safely  

MedlinePLUS

Medicine storage ... actually one of the worst places to keep medicine. Bathroom cabinets tend to be warm and humid, ... Being exposed to heat and moisture can make medicines less potent before their expiration date. For example, ...

456

Nonpharmacological therapeutic techniques to decrease agitation in geriatric psychiatric patients with dementia.  

PubMed

Agitation is not only a frequent and disturbing behavior for many patients with dementia, but it also troubles their caregivers and families. Many serious problems and side effects are associated with the use of medications to treat agitation; therefore, alternative approaches to treating agitation must be assessed. The current article presents results from a quality improvement pilot project that examined the usefulness of a specially designed, multisensory room intervention for geriatric psychiatric inpatients with mild to moderate agitation. Thirty-two visits to the sensory room were made by 13 inpatients with dementia. A significant decrease occurred in the Pittsburgh Agitation Scale (PAS) total scores over time from pre-room to post-room intervention, as well as 1-hour post-room intervention (F = 95.3, p < 0.001). Significant effects were found for all PAS subscales (i.e., aberrant vocalizations, motor agitation, and resistance to care), with the exception of the aggression subscale. The multisensory room intervention was effective in decreasing some symptoms of agitation in the geriatric psychiatric patient, thus contributing to positive patient, family, and nursing outcomes. [Journal of Gerontological Nursing, 41(2), 53-59.]. PMID:25347866

Mitchell, Ann M; Chiappetta, Laurel; Boucek, Lynn; Cain, Michelle; Patterson, Georgia; Owens, Kim; Herisko, Camellia; Stark, Kirsti Hetager

2015-02-01

457

Study of the Effect of Stress on Skeletal Muscle Function in Geriatrics  

PubMed Central

Background: Old age is associated with weakness of skeletal muscles and decrease in muscle functions. Usually in old-age, people undergo wasting of muscles, so they are more prone for fall and fracture. It has been stated that stress and cognition has an impact on muscle functions. This study was intended to demonstrate the effect of stress in muscle function in geriatrics. Methods: This was a cross sectional study done at a charitable home in Chennai sub urban. The geriatric males and females in the old age home were included in this study. Sixty-four subjects were included and the persons with previous history of musculo skeletal and neurological disorders were excluded. Anthropometric parameters were recorded Maximum Voluntary Contraction (MVC) and Endurance Time (ET) were measured by hand grip dynamometer. Perceived stress score was measured by perceived stress scale questionnaire. Muscle function parameters and stress score was compared. Results: Sixty-four subjects were included in this study and it was found out that there is a negative correlation between MVC & stress which was statistically significant. (r = -0.0675, P = 0.000). Age with MVC & ET showed a mild negative correlation but it was not significant. Conclusion: Hormones released during stress have a negative metabolic effect in skeletal muscle. Stress can induce earlier decline in muscle strength which will eventually lead to fall and fracture. Therefore, stress should be viewed as an independent risk factor for disability and other co morbid conditions. PMID:24596710

Poornima, K.N.; Karthick, N.; Sitalakshmi, R.

2014-01-01

458

American geriatrics society abstracted clinical practice guideline for postoperative delirium in older adults.  

PubMed

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

2015-01-01

459

Addressing geriatric oral health concerns through national oral health policy in India  

PubMed Central

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.

Singh, Abhinav; Purohit, Bharathi M

2015-01-01

460

The impact of a geriatric assessment unit on a psychiatric consultation service in a general hospital.  

PubMed

The opening of a geriatric assessment unit (GAU) in a large general hospital has affected the number of elderly patients referred for psychiatric consultation, the type of psychopathology seen, and the training provided for psychiatric residents and interns on the consultation-liaison service. To examine these changes, the six months prior to the opening of the GAU are compared to the six months immediately following its opening. The number of patients age 65 or older referred and diagnoses made by the consulting psychiatrists were studied. The opening of the GAU significantly increased the number of elderly patients referred for psychiatric consultation. It was found that the GAU offered unique advantages in the assessment and treatment of elderly patients with certain psychiatric problems, and the advantages and limitations of different facilities within the general hospital for the psychiatric assessment and treatment of elderly patients are discussed. A case is presented which illustrates the interplay between the consultation-liaison psychiatrist and the geriatric service in the management of an elderly patient referred for consultation. The experience of this hospital in providing psychogeriatric training for residents and interns on the psychiatric consultation service is reviewed. PMID:10279533

Swenson, J R; Perez, E L

1986-01-01

461

Clinical efficacy of Coleus forskohlii (Willd.) Briq. (Makandi) in hypertension of geriatric population  

PubMed Central

Hypertension is the most common psychosomatic disorder affecting 972 million people worldwide. The present clinical study deals with the effect of Makandi (Coleus forskohlii (Willd.) Briq.) Ghana vati and tablets of its powder in hypertension found in the geriatric age group (50-80 years). A total of 49 hypertensive patients fulfilling the diagnostic criteria were registered in two groups-Group I (Ghana vati) and Group II (Churna tablet). Out of 27 enrolled patients of group I, 21 patients completed the treatment. In Group II, out of 22 registered patients, a total of 20 patients completed the treatment. The effect of the therapy was assessed on the basis of changes in the systolic and diastolic blood pressures, in both sitting and supine positions; with Manasa Bhava Pariksha, Manasa Vibhrama Pariksha, symptomatology, geriatric signs and symptoms, and a brief psychiatric rating scale. Analysis of the results showed that the treatment in both the groups had been found to be good. It can be stated that Makandi, either in Ghana vati form or in churna tablet form, is an effective remedy for the treatment of hypertension. On analyzing the overall effect, 76.19% patients in Group I and 75.00% patients in Group II were mildly improved. Comparatively the overall treatment with group I was found to be better. PMID:22131759

Jagtap, Madhavi; Chandola, H. M.; Ravishankar, B.

2011-01-01

462

Could Some Geriatric Characteristics Hinder the Prescription of Anticoagulants in Atrial Fibrillation in the Elderly?  

PubMed Central

Several studies have reported underprescription of anticoagulants in atrial fibrillation (AF). We conducted an observational study on 142 out of a total of 995 consecutive ?75 years old patients presenting AF (14%) when admitted in an emergency unit of a general hospital, in search of geriatric characteristics that might be associated with the underprescription of anticoagulation therapy (mostly antivitamin K at the time of the study). The following data was collected from patients presenting AF: medical history including treatment and comorbidities, CHADS2 score, ISAR scale (frailty), Lawton's scale (ADL), GDS scale (mood status), MUST (nutrition), and blood analysis (INR, kidney function, and albumin). Among those patients for who anticoagulation treatment was recommended (73%), only 61% were treated with it. In the group with anticoagulation therapy, the following characteristics were observed more often than in the group without such therapy: a recent (?6 months) hospitalization and medical treatment including digoxin or based on >3 different drugs. Neither the value of the CHADS2 score, nor the geriatric characteristics could be correlated with the presence or the absence of an anticoagulation therapy. More research is thus required to identify and clarify the relative importance of patient-, physician-, and health care system-related hurdles for the prescription of oral anticoagulation therapy in older patients with AF. PMID:25295192

Vanderstraeten, Jacques

2014-01-01

463

Interdisciplinary collaboration in gerontology and geriatrics in Latin America: conceptual approaches and health care teams.  

PubMed

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

Gomez, Fernando; Curcio, Carmen Lucia

2013-01-01

464

A System Design for Studying Geriatric Patients with Dementia and Hypertension Based on Daily Living Information  

NASA Astrophysics Data System (ADS)

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.

Xu, Weifeng; Betz, Willian R.; Frezza, Stephen T.; Liu, Yunkai

2011-08-01

465

Evaluation of Oxidative Stress Parameters and Urinary Deoxypyridinoline Levels in Geriatric Patients with Osteoporosis  

PubMed Central

[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

Demir, Mehmet; Ulas, Turgay; Tutoglu, Ahmet; Boyaci, Ahmet; Karakas, Emel Yigit; Sezen, Hatice; Ustunel, Murat; Bilinc, Hasan; Gencer, Mehmet; Buyukhatipoglu, Hakan

2014-01-01

466

Hematopoietic Stem Cell Transplantation for Hematologic Malignancies in Older Adults: Geriatric Principles in the Transplant Clinic  

PubMed Central

Hematopoietic cell transplantation (HCT) provides a life-prolonging or potentially curative treatment option for patients with hematologic malignancies. Given the high transplant-related morbidity, these treatment strategies were initially restricted to younger patients, but are increasingly being used in older adults. The incidence of most hematologic malignancies increases with age; with the aging of the population, the number of potential older candidates for HCT increases. Autologous HCT (auto-HCT) in older patients may confer a slightly increased risk of specific toxicities (such as cardiac toxicities and mucositis) and have modestly lower effectiveness (in the case of lymphoma). However, auto-HCT remains a feasible, safe, and effective therapy for selected older adults with multiple myeloma and lymphoma. Similarly, allogeneic transplant (allo-HCT) is a potential therapeutic option for selected older adults, although fewer data exist on allo-HCT in older patients. Based on currently available data, age alone is not the best predictor of toxicity and outcomes; rather, the comorbidities and functional status of the older patient are likely better predictors of toxicity than chronologic age in both the autologous and allogeneic setting. A comprehensive geriatric assessment (CGA) in older adults being considered for either an auto-HCT or allo-HCT may identify additional problems or geriatric syndromes, which may not be detected during the standard pretransplant evaluation. Further research is needed to establish the utility of CGA in predicting toxicity and to evaluate the quality of survival in older adults undergoing HCT. PMID:24453296

Wildes, Tanya M.; Stirewalt, Derek L.; Medeiros, Bruno; Hurria, Arti

2014-01-01

467

Analysis of failure following anterior screw fixation of Type II odontoid fractures in geriatric patients.  

PubMed

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

Osti, Michael; Philipp, Helmut; Meusburger, Berthold; Benedetto, Karl Peter

2011-11-01

468

Chagas disease in 2 geriatric rhesus macaques (Macaca mulatta) housed in the Pacific Northwest.  

PubMed

Chagas disease (American trypanosomiasis) is caused by the protozoan parasite Trypanosoma cruzi. It is endemic in Latin America but also is found in the southern United States, particularly Texas and along the Gulf Coast. Typical clinical manifestations of Chagas disease are not well-characterized in rhesus macaques, but conduction abnormalities, myocarditis, and encephalitis and megaesophagus have been described. Here we report 2 cases of Chagas disease in rhesus macaques housed in the northwestern United States. The first case involved a geriatric male macaque with cardiomegaly, diagnosed as dilated cardiomyopathy on ultrasonographic examination. Postmortem findings included myocarditis as well as ganglioneuritis in the esophagus, stomach, and colon. The second case affected a geriatric female macaque experimentally infected with SIV. She was euthanized for a protocol-related time point. Microscopic examination revealed chronic myocarditis with amastigotes present in the cardiomyocytes, ganglioneuritis, and opportunistic infections attributed to her immunocompromised status. Banked serum samples from both macaques had positive titers for T. cruzi. T. cruzi DNA was amplified by conventional PCR from multiple tissues from both animals. Review of their histories revealed that both animals had been obtained from facilities in South Texas more than 12 y earlier. Given the long period of clinical latency, Chagas disease may be more prevalent in rhesus macaques than typically has been reported. T. cruzi infection should be considered for animals with unexplained cardiac or gastrointestinal pathology and that originated from areas known to have a high risk for disease transmission. PMID:25296019

Dickerson, Mary F; Astorga, Nestor Gerardo; Astorga, Nestor Rodrigo; Lewis, Anne D

2014-08-01

469

Addressing geriatric oral health concerns through national oral health policy in India.  

PubMed

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

Singh, Abhinav; Purohit, Bharathi M

2015-01-01

470

school of medicine school of medicine  

E-print Network

model in medical education. #12;school of medicine "Ultrasound technology is changing the future of medicine. The School of Medicine is a global leader in introducing ultrasound training into the medical in the nation to incorporate ultrasound training into all four years of medical education. Our partnership

Almor, Amit

471

Addictions Services: Follow-Up to the Statewide Model Detection and Prevention Program for Geriatric Alcoholism and Alcohol Abuse  

Microsoft Academic Search

A follow-up study was conducted to investigate the long term consequences of a statewide geriatric alcoholism detection and prevention effort in Virginia. High levels of knowledge had been retained seven years after the initial training. Quantitative and qualitative data provided by 64 of the volunteers, who were trained to conduct workshops in their communities, verified the program's ability to: 1)

Constance L. Coogle; Nancy J. Osgood; Iris A. Parham

2001-01-01

472

The Feasibility of Six-Minute and Two-Minute Walk Tests in In-patient Geriatric Rehabilitation  

ERIC Educational Resources Information Center

Objective: To evaluate the feasibility of the 6-minute and 2-minute walk tests in frail older persons. Design: Pre/post-design with measures at admission and discharge to in-patient geriatric rehabilitation. Participants: Fifty-two subjects (35 women, 17 men; age 80 plus or minus 8 years). Results: Only 1 of the first 8 subjects could complete a…

Brooks, Dina; Davis, Aileen M.; Naglie, Gary

2007-01-01

473

Long-Term Effects of Outpatient Geriatric Evaluation and Management on Health Care Utilization, Cost, and Survival  

ERIC Educational Resources Information Center

Purpose: The long-term effectiveness and efficiency of an outpatient geriatric evaluation and management (GEM) program was compared to usual primary care (UPC). Design and Method: A randomized controlled group design was used. Health care utilization, cost of care, and survival were assessed during a 48-month period among a sample of 160 male…

Engelhardt, Joseph B.; Toseland, Ronald W.; Gao, Jian; Banks, Steven

2006-01-01

474

Depressive Symptoms, Depletion, or Developmental Change? Withdrawal, Apathy, and Lack of Vigor in the Geriatric Depressive Scale.  

ERIC Educational Resources Information Center

This study has dual goals of confirming the existence of a "Withdrawal/Apathy/[Lack of] Vigor" (WAV) dimension of the Geriatric Depression Scale (GDS) and determining if it is descriptive of either depletion or disengagement-related change in older adults. High endorsement rates suggest WAV may be congruent with disengagement or depletion and may…

Adams, Kathryn Betts

2001-01-01

475

Is Geriatric Depression Scale15 a suitable instrument for measuring depression in Brazil? Results of a Rasch analysis  

Microsoft Academic Search

Depressive symptoms are the most prevalent mental health condition in older adults. Since it cannot be measured directly, the use of instruments is mandatory. The 15-item Geriatric Depression Scale (GDS) is one of the most widely used scales to measure depression in the elderly. It is recognized that the cultural context is a major determinant of the instrument's psychometric performance.

Eduardo Chachamovich; Marcelo P. Fleck; Mick Power

2010-01-01

476

Relationship of Normal Serum Vitamin B12 and Folate Levels to Cognitive Test Performance in Subtypes of Geriatric Major Depression  

Microsoft Academic Search

This retrospective study evaluated the relationships between normal serum vitamin B12 and folate levels and neuropsy chologic measures in a sample of 60 geriatric inpatients with psychotic depression, nonpsychotic depression, bipolar dis order, and dementia—all consecutively referred for cognitive testing. The psychotic depression subgroup demonstrated numerous significant positive correlations between B12 and cognitive subtests not seen in other diagnostic subgroups,

Iris R. Bell; Joel S. Edman; Joshua Miller; Nancy Hebben; Richard T. Linn; Diane Ray; Herbert L. Kayne

1990-01-01

477

Examination of the Philadelphia Geriatric Morale Scale as a Subjective Quality-of-Life Measure in Elderly Hong Kong Chinese  

ERIC Educational Resources Information Center

Purpose: We examine the psychometric properties of the Philadelphia Geriatric Morale Scale (PGMS) in an elderly Chinese population in Hong Kong. Design and Methods: The study consisted of two cohorts: (a) 759 participants aged 70 years and older living in the community who were recruited as part of a territory-wide health survey and interviewed in…

Wong, Eric; Woo, Jean; Hui, Elsie; Ho, Suzanne C.

2004-01-01

478

Developing a Multisite Project in Geriatric and/or Gerontological Education with Emphases in Interdisciplinary Practice and Cultural Competence.  

ERIC Educational Resources Information Center

Describes a two-year, multisite, curriculum-development project aimed to increase the pool of professionals trained in geriatric and/or gerontological social work. Methods included providing advanced training in aging, cultural competence, and interdisciplinary practice; developing, implementing, and testing an innovative student curriculum based…

Browne, Colette V.; Braun, Kathryn L.; Mokuau, Noreen; McLaughlin, Linda

2002-01-01

479

Structural Basis of Geriatric Voiding Dysfunction. VI. Validation and Update of Diagnostic Criteria In 71 Detrusor Biopsies  

Microsoft Academic Search

PurposeRefined criteria of distinctive patterns of detrusor ultrastructure in geriatric voiding dysfunctions have been developed as standard protocols for pathological evaluation of detrusor biopsies. This study was performed to test completeness and routine applicability of these protocols, corroborate our original ultrastructural\\/urodynamic correlations in larger material and identify subtle correlations that may have been elusive in our original study of 35

Ahmad Elbadawi; Seife Hailemariam; Subbarao V. Yalla; Neil M. Resnick

1997-01-01

480

Harnessing the hidden curriculum: a four-step approach to developing and reinforcing reflective competencies in medical clinical clerkship.  

PubMed

Changing the culture of medicine through the education of medical students has been proposed as a solution to the intractable problems of our profession. Yet few have explored the issues associated with making students partners in this change. There is a powerful hidden curriculum that perpetuates not only desired attitudes and behaviors but also those that are less than desirable. So, how do we educate medical students to resist adopting unprofessional practices they see modeled by supervisors and mentors in the clinical environment? This paper explores these issues and, informed by the literature, we propose a specific set of reflective competencies for medical students as they transition from classroom curricula to clinical practice in a four-step approach: (1) Priming-students about hidden curriculum in their clinical environment and their motivations to conform or comply with external pressures; (2) Noticing-educating students to be aware of their motivations and actions in situations where they experience pressures to conform to practices that they may view as unprofessional; (3) Processing-guiding students to analyze their experiences in collaborative reflective exercises and finally; (4) Choosing-supporting students in selecting behaviors that validate and reinforce their aspirations to develop their best professional identity. PMID:25319835

Holmes, Cheryl L; Harris, Ilene B; Schwartz, Alan J; Regehr, Glenn

2014-10-16