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1

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

PubMed Central

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

2013-01-01

2

Responses of Fourth-Year Medical Students to a Required Clerkship in Geriatrics.  

ERIC Educational Resources Information Center

Students at the Mount Sinai School of Medicine of the City University of New York taking a required clinical clerkship in geriatrics were surveyed before and after the clerkship on their knowledge of geriatrics, attitudes toward the elderly, and evaluation of the rotation. (Author/MLW)

Murden, Robert A.; And Others

1986-01-01

3

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

Microsoft Academic Search

A clinical geriatric pharmacy clerkship in which the student is guided through three separate practice areas (long term, acute and ambulatory care) is described. In each setting the student participates in treatment teams under the direction of geriatric trained attending physicians. Unlike other geriatric clerkships in South Florida, this clerkship closely models the philosophy and protocol of medical education by

Isabel Polo; John W. Triplett

1994-01-01

4

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.

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

2014-01-01

5

Teaching Prevention in Internal Medicine Clerkships.  

ERIC Educational Resources Information Center

Reviews the rationale for including prevention in the clinical medicine clerkship. Summarizes current guidelines, presents examples of curricula in several medical schools, and proposes a future direction that stresses integrating teaching preventive medicine into internal medicine clerkships and across the entire four-year medical curriculum. (DB)

Kinsinger, Linda

2000-01-01

6

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

ERIC Educational Resources Information Center

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

Polo, Isabel; And Others

1994-01-01

7

Clinical Skills Acquired during a Clerkship in Family Medicine.  

ERIC Educational Resources Information Center

A study of the preceived acquisition of clinical skills by second-year medical students in six required clerkships is reported. The students completed self-assessments of their clinical skills when taking the family medicine clerkship. The principal contributions of the family medicine clerkship were in the management of common problems.…

Michener, J. Lloyd; And Others

1986-01-01

8

A Multidisciplinary Clerkship in Emergency Medicine.  

ERIC Educational Resources Information Center

At the New Jersey Medical School, an obligatory, multidisciplinary, fourth-year emergency medicine clerkship requires ambulance duty, emergency room rotation, medical specialty lectures, and a cardiac life support providers course. Particular problems associated with multidisciplinary courses are discussed. (Author/JMD)

And Others; Marshall, Carter L.

1979-01-01

9

Handheld Computer Use in a Family Medicine Clerkship  

Microsoft Academic Search

Purpose. The objectives of this study were to track students' use of medical and nonmedical personal digital assistant (PDA) software and to obtain students' ratings of the usefulness of PDAs in a family medicine clerkship. Method. During the academic year 2001- 02, third-year clerkship students at the Northeastern Ohio Universities College of Medicine were loaned PDAs equipped with company-installed software,

John Sutton; LuAnne Stockton; Gary McCord; Valerie J. Gilchrist; Dinah Fedyna

2004-01-01

10

Model Geriatric Clerkship for Physician Assistant Students: The Continuum of Elder Care. Executive Summary.  

National Technical Information Service (NTIS)

The purpose of the Project was to develop, field test, and suggest strategies for implementing a four-to-six week Model Geriatric Clerkship for PA students using a variety of clinical settings. With the assistance of consultants and an active seven-member...

G. Yeo D. Tully

1987-01-01

11

Model Geriatric Clerkship for Physician Assistant Students: The Continuum of Elder Care. Final Report.  

National Technical Information Service (NTIS)

The purpose of the Project was to develop, field test, and suggest strategies for implementing a four-to-six week Model Geriatric Clerkship for PA students using a variety of clinical settings. With the assistance of consultants and an active seven-member...

G. Yeo D. Tully

1987-01-01

12

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

13

Development and Modification of a Required Family Medicine Clerkship.  

ERIC Educational Resources Information Center

A new required clinical clerkship in family medicine at Duke University School of Medicine is described in terms of planning, implementation, and modification in response to students' evaluations. The data demonstrate that family medicine can be taught effectively as a core clinical rotation. (Author/MLW)

Michener, J. Lloyd; And Others

1985-01-01

14

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

ERIC Educational Resources Information Center

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

Parkerson, George R., Jr.; And Others

1984-01-01

15

Community Medicine Clerkships in an Applied Research Setting  

ERIC Educational Resources Information Center

A four-week clerkship in community medicine is a requirement for all third-year students at the Mount Sinai School of Medicine. An important feature of the program is the wide variety of settings available to students, including the City Hospital Center at Elmhurst, which is described. (LBH)

Stewart, Michael M.; And Others

1977-01-01

16

National Curricular Guidelines for Third-Year Family Medicine Clerkships.  

ERIC Educational Resources Information Center

The process used by the Society of Teachers of Family Medicine to develop core curriculum guidelines for third-year family medicine clerkships is described, the guidelines are presented, and dissemination, implementation, and further development activities are outlined. The work was supported by a Department of Health and Human Services grant.…

Academic Medicine, 1991

1991-01-01

17

ENT Experience in a Family Medicine Clerkship: Is There Enough?  

ERIC Educational Resources Information Center

Used patient encounter records completed by 445 medical students to determine whether a family medicine clerkship offered enough experience in ear, nose, and throat (ENT) conditions. Results, which were used for curriculum development, suggest that these students were receiving sufficient opportunities for some areas of ENT practice, but not for…

O'Hara, Brenda S.; Saywell, Robert M., Jr.; Zollinger, Terrell W.; Smith, Christopher P.; Burba, Jennifer L.; Stopperich, David M.

2000-01-01

18

A national survey of grading systems used in medicine clerkships.  

PubMed

To better understand the variety in U.S. medicine clerkship grading terminology, the number of grading levels, and the distribution of grades within each level, the authors surveyed medicine clerkship directors in the United States and Puerto Rico in 1986 and 1987. Completed questionnaires were returned from 101 of the 124 medical schools (81%). Descriptor grades were the most commonly used form of grading of medicine clerks, used in 68 of the 101 responding schools; letter grades were used by another 28 of the schools; and four schools used a numerical grading system. Although descriptor grades were most commonly used for grading medicine clerks, there was lack of consistency in their use between schools. The authors discuss the data related to letter grades and descriptor grades across this representative sample of U.S. medical schools. PMID:2261039

Magarian, G J; Mazur, D J

1990-10-01

19

Model Geriatric Clerkship for Physician Assistant Students: The Continuum of Elder Care. Manual for Physician Assistant Programs.  

National Technical Information Service (NTIS)

The purpose of the Project was to develop, field test, and suggest strategies for implementing a four-to-six week Model Geriatric Clerkship for PA students using a variety of clinical settings. With the assistance of consultants and an active seven-member...

G. Yeo D. Tully

1987-01-01

20

Perspectives on the future of geriatric medicine.  

PubMed

The following comments were presented to the 20th anniversary celebration of the geriatric medicine fellowship training program at the Baylor College of Medicine in the Texas Medical Center, Houston, Texas, on June 24, 2005. The author, who was the first graduate of the geriatric medicine training program at Baylor, proposes that geriatrics is at a critical juncture and that the voice and identity of geriatric medicine should be that of advocacy for our patients, and that in such a role geriatric medicine is well suited to become the "soul of medicine." She encourages all geriatricians to read the report of the Task Force on the Future of Geriatric Medicine and to look for opportunities to personally be involved in implementing the recommendations. She suggests that since our visions of the future are often only caricatures of our past, we must be creative and dream big dreams of what the future may hold. She challenges each of us to get involved in actively creating the future of geriatric medicine. PMID:16503314

Elon, Rebecca D

2006-03-01

21

Improving medical students' understanding of prehospital care through a fourth year emergency medicine clerkship  

Microsoft Academic Search

ObjectivesThe objective of this study was to survey medical students for a measurable opinion or knowledge increase in prehospital care after a fourth-year clerkship in emergency medicine (EM). The goal of the mandatory prehospital care aspect of the clerkship was twofold: to diminish the prehospital knowledge gap in medical school by teaching students about prehospital protocols and disaster medicine and

Mark A Merlin; Jeffery Moon; Jessica Krimmel; Junfeng Liu; Andreia Marques-Baptista

2010-01-01

22

Student Performance in Internal Medicine: The Effect of Previous Clerkship Experience.  

ERIC Educational Resources Information Center

Groups of medical students were compared with respect to ward-performance scores and scores on identical examinations to determine whether students with previous clerkships are likely to perform better in their internal medicine clerkships. It is concluded that previous experience apparently does not have a beneficial effect on student performance…

And Others; Smiley, R. Kennedy

1979-01-01

23

Using Bedside Rounds to Teach Communication Skills in the Internal Medicine Clerkship  

Microsoft Academic Search

Background: Physicians' communication skills, which are linked to important patient outcomes, are rarely explicitly taught during the clinical years of medical school. This paper describes the development, implementation, and evaluation of a communication skills curriculum during the third-year Internal Medicine Clerkship. Methods: In four two-hour structured bedside rounds with trained Internal Medicine faculty facilitators, students learned core communication skills in

Regina Janicik; Adina L. Kalet; Mark D. Schwartz; Sondra Zabar; Mack Lipkin

2007-01-01

24

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

25

Medical students' perceptions of an emergency medicine clerkship: an analysis of self-assessment surveys  

PubMed Central

Background No studies have been performed that evaluate the perceptions of medical students completing an emergency medicine (EM) clerkship. Given the variability of exposure to EM in medical schools nationwide, assessment of the student rotation may inform the structure and content of new and existing clerkships, particularly in relation to student’s acquisition of the core competencies. Objectives To investigate whether undergraduate medical students rotating through an EM clerkship improved their understanding and abilities in core content areas and common procedural skills; to evaluate whether improvement was affected by rotation length. Methods All students participating in an EM clerkship over a 12-month period were asked to complete an anonymous voluntary pre- and post-rotation survey. Confidence with patient assessment, diagnosis, and management plans; trauma and medical resuscitations; formal and informal presentations; basic procedure skills and understanding of the modern practice of EM were self assessed using a Likert scale. Group mean scores on each question on the pre- and post-clerkship surveys were calculated and compared. The mean scores on each survey item, both pre- and post-clerkship, were compared between 2- and 4-week clerkship rotation groups. Results Two hundred thirty-nine students participated in the rotation during the 12 months of the study. One hundred sixty-one (161), or 67.4%, completed the pre-rotation survey, and 96 (40.2%) completed the post-rotation survey. Overall, students showed significant mean gains in confidence with initial patient assessment, diagnosis, and management plans (p?clerkship participants were significantly less confident in all procedures except EKG interpretation, splinting, and venipuncture (p?=?0.28, 0.22, 0.05). Regardless of rotation length, students generally felt they had sufficient exposure to patients and opportunities for hands-on learning and practice, and overwhelmingly would recommend the EM clerkship to a fellow student, regardless of their chosen specialty. Conclusions Medical students show significant gains in confidence with acute care knowledge, disease management, and procedure skills after completion of an EM clerkship. Although a 4-week clerkship may be preferable to expose students to the widest variety of patients and procedures, all students can benefit and improve in core competencies after an EM undergraduate experience.

2012-01-01

26

Simulation in Medical Student Education: Survey of Clerkship Directors in Emergency Medicine  

PubMed Central

Introduction The objective of this study is to identify (1) the current role of simulation in medical student emergency medicine (EM) education; (2) the challenges to initiating and sustaining simulation-based programs; and (3) educational advances to meet these challenges. Methods We solicited members of the Clerkship Directors in Emergency Medicine (CDEM) e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey elements addressed the nature of the undergraduate EM clerkship and utilization of simulation, types of technology, and barriers to increased use in each setting. Results CDEM members representing 60 EM programs on the list (80%) responded. Sixty-seven percent of EM clerkships are in the fourth year of medical school only and 45% are required. Fewer than 25% of clerkship core curriculum hours incorporate simulation. The simulation modalities used most frequently were high-fidelity models (79%), task trainers (55%), and low-fidelity models (30%). Respondents identified limited faculty time (88.7%) and clerkship hours (47.2%) as the main barriers to implementing simulation training in EM clerkships. Financial resources, faculty time, and the volume of students were the main barriers to additional simulation in preclinical years. Conclusion A focused, stepwise application of simulation to medical student EM curricula can help optimize the ratio of student benefit to faculty time. Limited time in the curriculum can be addressed by replacing existing material with simulation-based modules for those subjects better suited to simulation. Faculty can use hybrid approaches in the preclinical years to combine simulation with classroom settings for either small or large groups to more actively engage learners while minimizing identified barriers.

Heitz, Corey; Eyck, Raymond Ten; Smith, Michael; Fitch, Michael

2011-01-01

27

Creating a geriatric medicine fellowship program in 10 "easy" steps.  

PubMed

The aging of the U.S. population poses one of the greatest future challenges for family medicine and internal medicine residency training. One important barrier to providing quality education and training in geriatric medicine to residents is a serious and growing shortage of practicing geriatricians and geriatrics faculty. The Accreditation Council for Graduate Medical Education currently accredits 45 family medicine-based and 107 internal medicine-based geriatric medicine fellowships in the United States. There are 13 American Osteopathic Association-certified geriatric medicine fellowship programs. In this article, the authors examine the rationale for the development of additional geriatric medicine fellowship programs and offer some practical suggestions and pointers for those interested in developing their own geriatric medicine fellowships. The authors write from the perspective of their own recent experiences with the development and accreditation of a family medicine residency-affiliated fellowship in geriatrics. Other residencies may find this article useful in determining the feasibility of developing a geriatric medicine fellowship for their programs and communities and will find practical guidance for beginning the process. PMID:21824121

English, Shannon Keane; vanSchagen, John E

2011-10-01

28

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.

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

2013-01-01

29

A Third-Year Family Medicine Clerkship Based in an Academic Family Practice Center.  

ERIC Educational Resources Information Center

A 5-week family medicine clerkship is described that uses several innovative techniques: problem-based learning focusing on patient management tutorials; consultation with specialists; supervised patient care and a nursing home inpatient teaching service; and workshops on topics such as office-surgical techniques, practice management, and…

Taylor, Robert B; And Others

1984-01-01

30

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

31

Improving the National Board of Medical Examiners Internal Medicine Subject Exam for Use in Clerkship Evaluation  

PubMed Central

OBJECTIVE To provide a consensus opinion on modifying the National Board of Medical Examiners (NBME) Medicine Subject Exam (Shelf) to: 1) reflect the internal medicine clerkship curriculum, developed by the Society of General Internal Medicine (SGIM) and the Clerkship Directors in Internal Medicine (CDIM); 2) emphasize knowledge important for a clerkship student; and 3) obtain feedback about students' performances on the Shelf. DESIGN Two-round Delphi technique. PARTICIPANTS The CDIM Research and Evaluation Committee and CDIM members on NBME Step 2 Committees. MEASUREMENTS Using 1–5 Likert scales (5 = highest ratings), the group rated test question content for relevance to the SGIM–CDIM Curriculum Guide and importance for clerkship students' knowledge. The Shelf content is organized into 4 physician tasks and into 11 sections that are generally organ system based. Each iteration of the Shelf has 100 questions. Participants indicated a desired distribution of questions by physician task and section, topics critical for inclusion on each exam, and new topics to include. They specified the types of feedback clerkship directors desired on students' performances. Following the first round, participants viewed pooled results prior to submitting their second-round responses. RESULTS Of 15 individuals contacted, 12 (80%) participated in each round. The desired distribution by physician task was: diagnosis (43), treatment (23), mechanism of disease (20), and health maintenance (15). The sections with the most questions requested were the cardiovascular (17), respiratory (15), and gastroenterology (12) sections. The fewest were requested in aging/ethics (4) and neurology, dermatology, and immunology (5 each). Examples of low-rated content were Wilson's Disease, chancroid and tracheal rupture (all <2.0). Health maintenance in type 2 diabetes, hypertension, and cardiovascular disease all received 5.0 ratings. Participants desired feedback by: section (4.6) and physician task (3.9), on performances of the entire class (4.0), and for individual students (3.8). CONCLUSION Clerkship directors identified test content that was relevant to the curricular content and important for clerkship students to know, and they indicated a desired question distribution. They would most like feedback on their students' performance by organ system–based sections for the complete academic year. This collaborative effort could serve as a model for aligning national exams with course goals.

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

2002-01-01

32

Geriatric medicine workforce planning: a giant geriatric problem or has the tide turned?  

PubMed

The UK's population is ageing and an adequately staffed geriatric medicine workforce is essential for high quality care. We evaluated the current and future geriatric medicine workforce, drawing on data relating to the UK population, current geriatric medicine consultants and trainees, recruitment into the specialty and trainee career progression. Data were derived from various sources, including the British Geriatrics Society Education and Training Committee biannual survey of training posts. The demographic of consultant geriatricians is changing and so too are their job plans, with more opting to work less than full time. The number of applicants to geriatric medicine training is increasing, yet increasing numbers of posts remain unfilled (4.7% in November 2010 and 14.1% in May 2013). The majority of geriatric medicine trainees secure a substantive consultant post within 6 months of obtaining their certificate of completion of training This work highlights challenges for the future: potential barriers to trainee recruitment, unfilled training posts and an ageing population and workforce. PMID:24715117

Fisher, James M; Garside, Mark; Hunt, Kelly; Lo, Nelson

2014-04-01

33

Geriatrics.  

National Technical Information Service (NTIS)

Developments in the practice of geriatric medicine in Great Britain are reviewed in a discussion opening with a quote concerning 'the importance of a special study of the diseases of old age' from a book written in 1881. The discussion touches on the orga...

M. R. Hall

1976-01-01

34

Factors affecting the reliability of ratings of students’ clinical skills in a medicine clerkship  

Microsoft Academic Search

Objective:To determine the overall reliability and factors that might affect the reliability of ratings of students’ clinical skills\\u000a in a medicine clerkship.\\u000a \\u000a Design:A nine-item instrument was used to evaluate students’ clinical skills. Raters were also asked to provide a grade of each student’s\\u000a overall clinical performance. Generalizability studies were performed to estimate the reliability of the ratings. The effects\\u000a of

Jan D. Carline; Douglas S. Paauw; Keith W. Thiede; Paul G. Ramsey

1992-01-01

35

Undergraduate teaching in geriatric medicine: mapping the British Geriatrics Society undergraduate curriculum to Tomorrow's Doctors 2009.  

PubMed

Introduction: in 2008, the British Geriatrics Society (BGS) developed the Recommended Undergraduate Curriculum in Geriatric Medicine. This was subsequently mapped to the second edition of Tomorrows' Doctors (TD2, 2003). Following the publication of the third edition of Tomorrow's Doctors in 2009 (TD3), the mapping exercise was repeated to verify the extent to which the updated General Medical Council recommendations supported teaching in ageing and geriatric medicine. Method: we analysed TD3 and identified 48 aspects of its general guidance that were relevant to the teaching of medicine for older people. We then mapped these to the 2009 BGS curriculum. Results: the BGS curriculum was supported in full by TD3. However, learning outcomes relating to the interpretation and conduct of research in TD3 had no corresponding outcomes in the BGS curriculum. Conclusion: the BGS curriculum for medical undergraduates continues to provide a specific and complete list of learning objectives, all of which could help to operationalise the general statements made in TD3 with relation to ageing and geriatric medicine. Learning outcomes in research in frail older patients have been added following this mapping exercise. PMID:24610864

Forrester-Paton, Calum; Forrester-Paton, Jayne; Gordon, Adam Lee; Mitchell, Hannah K; Bracewell, Nicola; Mjojo, Jocelyn; Masud, Tahir; Gladman, John R F; Blundell, Adrian

2014-05-01

36

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

37

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

38

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.

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

2014-01-01

39

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

Microsoft Academic Search

Purpose: This study examined medical students' interest in geriatrics: Are knowledge, positive atti- tudes, and prior experience with older adults associated with an interest in geriatric medicine? Design and Methods: Entering University of Michigan medical students completed three surveys: the Revised Facts on Aging Quiz, the University of California at Los Angeles Geriatric Attitudes Scale, and the Maxwell-Sullivan Attitudes Scale.

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

40

[Geriatric surgery or geriatrisation of surgical medicine].  

PubMed

In the western industrial nations the proportion of old people (according to WHO definition people over 75 years) has been rising for many years and with it the amount of surgical treatment on this group of the population. High age does not automatically mean a risk too high for surgical treatment. Very often the reasons for this age group being high-risk patients are hospital admission in an advanced stage of illness or complications due to the illness. Old people are biologically younger than they were years ago. Often they express their perfectly understandable wish for suitable treatment. New treatments and strategies in surgery such as minimal-invasive surgery, endoluminal techniques for heart and vascular surgery, fast-track-concepts, anaesthetising techniques like spinal anaesthesia or the use of better controllable narcotics, improves alleviation of pain, quick mobilisation and early oral nutrition contribute to a minimisation of the risk. Age-related multimorbidity defines the risks of major operations and requires an individual weighing up of benefit and risk. The decision for or against an operation must take the elderly patient's wishes into account. The most important aspect is not only to help the people survive but to enable them to participate in life. In this paper we try to give an overview of geriatric surgery with all its aspects relevant to insurance. PMID:21488383

Slany, E; Abel, M; Reuter, W

2011-03-01

41

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

42

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

PubMed

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

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

2014-06-01

43

Medicine in the 21st Century: Recommended Essential Geriatrics Competencies for Internal Medicine and Family Medicine Residents  

PubMed Central

Background Physician workforce projections by the Institute of Medicine require enhanced training in geriatrics for all primary care and subspecialty physicians. Defining essential geriatrics competencies for internal medicine and family medicine residents would improve training for primary care and subspecialty physicians. The objectives of this study were to (1) define essential geriatrics competencies common to internal medicine and family medicine residents that build on established national geriatrics competencies for medical students, are feasible within current residency programs, are assessable, and address the Accreditation Council for Graduate Medical Education competencies; and (2) involve key stakeholder organizations in their development and implementation. Methods Initial candidate competencies were defined through small group meetings and a survey of more than 100 experts, followed by detailed item review by 26 program directors and residency clinical educators from key professional organizations. Throughout, an 8-member working group made revisions to maintain consistency and compatibility among the competencies. Support and participation by key stakeholder organizations were secured throughout the project. Results The process identified 26 competencies in 7 domains: Medication Management; Cognitive, Affective, and Behavioral Health; Complex or Chronic Illness(es) in Older Adults; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care. The competencies map directly onto the medical student geriatric competencies and the 6 Accreditation Council for Graduate Medical Education Competencies. Conclusions Through a consensus-building process that included leadership and members of key stakeholder organizations, a concise set of essential geriatrics competencies for internal medicine and family medicine residencies has been developed. These competencies are well aligned with concerns for residency training raised in a recent Medicare Payment Advisory Commission report to Congress. Work is underway through stakeholder organizations to disseminate and assess the competencies among internal medicine and family medicine residency programs.

Williams, Brent C.; Warshaw, Gregg; Fabiny, Anne Rebecca; Lundebjerg, MPA, Nancy; Medina-Walpole, Annette; Sauvigne, Karen; Schwartzberg, Joanne G.; Leipzig, Rosanne M.

2010-01-01

44

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

45

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

46

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

ERIC Educational Resources Information Center

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

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

2003-01-01

47

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

48

Building a Learning Experience: The Implementation of a Clerkship in Geriatric Medicine.  

ERIC Educational Resources Information Center

In a mandatory 4-week program, medical students assessed and managed the care of frail elderly with acute medical problems and disabilities. Web-based lectures with pre/posttests and electronic portfolio assessment were included. The experience was intended to promote reflection, interactive learning, and feedback. (Contains 24 references.) (SK)

Duque, Gustavo; Bonnycastle, Michael; Nazerali, Najmi; Bailey, Robert; Ferrier, Catherine; Heilpern, Paul; Gold, Susan

2003-01-01

49

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

50

Clerkship pathway  

PubMed Central

Abstract Objective To identify factors that help predict success for international medical graduates (IMGs) who train in Canadian residency programs and pass the Canadian certification examinations. Design A retrospective analysis of 58 variables in the files of IMGs who applied to the Collège des médecins du Québec between 2000 and 2008. Setting Quebec. Participants Eight hundred ten IMGs who applied to the Collège des médecins du Québec through either the “equivalency pathway” (ie, starting training at a residency level) or the “clerkship pathway” (ie, relearning at the level of a medical student in the last 2 years of the MD diploma). Main outcome measures Success factors in achieving certification. Data were analyzed using descriptive statistics and ANOVA (analysis of variance). Results International medical graduates who chose the “clerkship pathway” had greater success on certification examinations than those who started at the residency level did. Conclusion There are several factors that influence IMGs’ success on certification examinations, including integration issues, the acquisition of clinical decision-making skills, and the varied educational backgrounds. These factors perhaps can be better addressed by a regular clerkship pathway, in which IMGs benefit from learner-centred teaching and have more time for reflection on and understanding of the North American approach to medical education. The clerkship pathway is a useful strategy for assuring the integration of IMGs in the North American health care system. A 2-year relearning period in medical school at a clinical clerkship level deserves careful consideration.

MacLellan, Anne-Marie; Brailovsky, Carlos; Miller, Francois; Leboeuf, Sylvie

2012-01-01

51

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

PubMed Central

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

Cefalu, Charles A.; Schwartz, Robert S.

2007-01-01

52

The Senior Mentor Program at Duke University School of Medicine  

Microsoft Academic Search

The Duke University School of Medicine has a unique curriculum in which students complete basic sciences in year 1 and clinical clerkships in year 2, making way for an entire year of independent study in year 3. Into this compact curriculum, education in geriatrics has been successfully introduced through focused exercises and activities strategically integrated in all four years. The

Mitchell T. Heflin

2006-01-01

53

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

54

Geriatric Core Competencies for Family Medicine Curriculum and Enhanced Skills: Care of Elderly  

PubMed Central

Background There is a growing mandate for Family Medicine residency programs to directly assess residents’ clinical competence in Care of the Elderly (COE). The objectives of this paper are to describe the development and implementation of incremental core competencies for Postgraduate Year (PGY)-I Integrated Geriatrics Family Medicine, PGY-II Geriatrics Rotation Family Medicine, and PGY-III Enhanced Skills COE for COE Diploma residents at a Canadian University. Methods Iterative expert panel process for the development of the core competencies, with a pre-defined process for implementation of the core competencies. Results Eighty-five core competencies were selected overall by the Working Group, with 57 core competencies selected for the PGY-I/II Family Medicine residents and an additional 28 selected for the PGY-III COE residents. The core competencies follow the CanMEDS Family Medicine roles. Both sets of core competencies are based on consensus. Conclusions Due to demographic changes, it is essential that Family Physicians have the required skills and knowledge to care for the frail elderly. The core competencies described were developed for PGY-I/II Family Medicine residents and PGY-III Enhanced Skills COE, with a focus on the development of geriatric expertise for those patients that would most benefit.

Charles, Lesley; Triscott, Jean A.C.; Dobbs, Bonnie M.; McKay, Rhianne

2014-01-01

55

Aging Q3: an initiative to improve internal medicine residents' geriatrics knowledge, skills, and clinical performance.  

PubMed

A growing number of older adults coupled with a limited number of physicians trained in geriatrics presents a major challenge to ensuring quality medical care for this population. Innovations to incorporate geriatrics education into internal medicine residency programs are needed. To meet this need, in 2009, faculty at the Medical University of South Carolina developed Aging Q(3)-Quality Education, Quality Care, and Quality of Life. This multicomponent initiative recognizes the need for improved geriatrics educational tools and faculty development as well as systems changes to improve the knowledge and clinical performance of residents. To achieve these goals, faculty employ multiple intervention strategies, including lectures, rounds, academic detailing, visual cues, and electronic medical record prompts and decision support. The authors present examples from specific projects, based on care areas including vision screening, fall prevention, and caring for patients with dementia, all of which are based on the Assessing Care of Vulnerable Elders quality indicators. The authors describe the principles driving the design, implementation, and evaluation of the Aging Q(3) program. They present data from multiple sources that illustrate the effectiveness of the interventions to meet the knowledge, skill level, and behavior goals. The authors also address major challenges, including the maintenance of the teaching and modeling interventions over time within the context of demanding primary care and inpatient settings. This organized, evidence-based approach to quality improvement in resident education, as well as faculty leadership development, holds promise for successfully incorporating geriatrics education into internal medicine residencies. PMID:22450181

Moran, William P; Zapka, Jane; Iverson, Patty J; Zhao, Yumin; Wiley, M Kathleen; Pride, Pamela; Davis, Kimberly S

2012-05-01

56

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

57

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

58

Ethical Issues in Geriatric Medicine: A Unique Problematic?  

Microsoft Academic Search

It is commonly believed thatgeriatric medicine generates a distinctive setof ethical problems. Implicated are such issuesas resource allocation, competence and consent,advance directives, medical futility anddeliberate death. It is also argued that itwould be unjust to allow the elderly to competewith younger populations for expensive andscarce health care resources because theelderly “have already lived,” and that treatingthem the same as these

Eike-Henner W. Kluge

2002-01-01

59

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

60

The Wisconsin Approach to Faculty Development in Geriatric Dentistry and the Duke Approach to Faculty Development in Geriatric Medicine.  

ERIC Educational Resources Information Center

Shay, Simpson, and Biernat describe geriatric dentistry training that included mentorship and shared experiences with physician trainees. Cohen and Lyles describe a fellowship program in which physicians care for older patients in unique settings and conduct research projects. (SK)

Shay, Kenneth; And Others

1996-01-01

61

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

62

Effect of clinical teaching on student performance during a medicine clerkship 1 1 The opinions contained in this article solely represent the views of the authors and are not to be construed as representing the views of the Department of Defense or the Department of the Army  

Microsoft Academic Search

PURPOSE: To measure what proportion of student clerkship performance can be attributed to teachers’ educational skills as reported by students.SUBJECTS AND METHODS: From August 1992 to June 1994, we collected critiques of teacher skills from 314 third-year students at the end of a 12-week medicine clerkship. Interns, residents, attending physicians, and student preceptors were rated (on a 1 to 5

Stuart A Roop; Louis Pangaro

2001-01-01

63

Student Learning on a Pediatric Clerkship.  

ERIC Educational Resources Information Center

Students from the George Washington University School of Medicine and Health Sciences and faculty members and pediatric residents from the Children's Hospital National Medical Center developed a new curriculum for the third-year pediatric clerkship. Students were asked to complete a log and check the appropriate learning activity. (MLW)

Greenberg, Larrie W.; Jewett, Leslie S.

1983-01-01

64

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.

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

2013-01-01

65

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

66

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

67

Availability of selected Institute of Medicine recommendations for geriatric care in hospitals providing care to injured older adults.  

PubMed

This study evaluated the presence of eight geriatric care Institute of Medicine (IOM) recommendations in a representative sample of hospitals (N = 128) that provide care to injured older adults. Four data sources were utilized to form a dataset. Descriptive statistics were conducted and Chi-square analyses were used to examine differences among trauma center levels and non-trauma centers. Six IOM recommendations were present in less than 50% of hospitals. Recommendations related to computerized support for risk assessment of two geriatric-specific conditions (CAUTI, pressure ulcers) were present in more than 70% of hospitals. Level I and II trauma centers had greater adoption of recommendations than level III/IV trauma centers and non-trauma centers. Continued efforts are needed to promote and support the advancement of IOM recommendations throughout U.S. hospitals. PMID:24702716

Maxwell, Cathy A

2014-01-01

68

Clinical Nuclear Pharmacy Clerkship  

ERIC Educational Resources Information Center

The School of Pharmacy, University of the Pacific, and the Pharmacy Service, Letterman Army Medical Center, initiated a 15-week clinical nuclear pharmacy clerkship in 1975. It includes basic nuclear medical science, technical competency, professional competency, and special interest emphasis. (LBH)

Dunson, George L.; Christopherson, William J., Jr.

1977-01-01

69

Advances in research, education and practice in geriatric medicine, 1982-2012.  

PubMed

Over the last 30 years, major advances in the provision of services for frail older people in Australasia have taken place. This has been spurred on by the accumulation of the evidence for benefits of the multidisciplinary team model of comprehensive geriatric assessment and management. Current research is now uncovering mechanisms of frailty associated with the ageing process and will lead to further interventions in the management of the health problems of older people. These interventions will almost certainly include both medical and lifestyle strategies. Although there have been major improvements in the education of health professionals in aspects of geriatrics, more concerted efforts are required for the ageing population. PMID:24164983

Flicker, Leon

2013-10-01

70

Pharmacotherapy, clinical pharmacology and biomarker research in geriatric patients  

Microsoft Academic Search

Evaluation of pharmacotherapy and diagnosis and treatment of dementia are important subjects within geriatric medicine. Geriatric patients are more vulnerable for adverse events and pharmacokinetic interactions. Polypharmacy should be reduced, however, undertreatment of conditions or illnesses is also recognised in geriatric populations. Pharmacotherapy was evaluated in geriatric patients attending the diagnostic day-clinic and the geriatric ward of a general hospital.

S. V. Frankfort

2007-01-01

71

[Geriatrics for internists in primary care].  

PubMed

Internal medicine specialists involved in primary care will have a leading part in the treatment of geriatric patients with complex healthcare needs in the future. Approved models like specialized geriatric practices, ambulant or mobile geriatric rehabilitation and special geriatric services for nursing homes are available. Essential is a geriatric qualification that fits with the tasks of an internist in primary care. An incentive payment system has to be created for this purpose to improve the treatment of elderly patients. PMID:21750935

Swoboda, W; Hermens, T

2011-08-01

72

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

73

Students' Educational Activities During Clerkship.  

ERIC Educational Resources Information Center

Logs completed by 201 medical students in third-year clerkships at nine community-based hospitals indicated students received 6.5 hours of teaching with an instructor daily, spending 4.9 more hours in clerkship-related learning. Most teaching was by full-time faculty and residents. In half their educational activities, students participated with…

O'Sullivan, Patricia S.; And Others

1997-01-01

74

Importance of Radiology Clerkships in Teaching Medical Students Life-Threatening Abnormalities on Conventional Chest Radiographs  

Microsoft Academic Search

Rationale and ObjectivesThe purpose of this study was to investigate the ability of medical students who had already completed medicine and surgery clerkships to identify life-threatening abnormalities on conventional chest radiographs.

Jac D. Scheiner; Richard B. Noto; Kathleen M. McCarten

2002-01-01

75

The Nonphysician “Medical Student Educator”: A Formal Addition to the Clerkships and Key Programs at an Academic Medical Center  

Microsoft Academic Search

Background: Medical school faculty members face increased clinical and academic demands, leaving less time for teaching, curriculum development, and assessment of learners.Description: The Keck School of Medicine has hired a dedicated medical student educator for each required clerkship. The medical student educator assists the clerkship director with clinical teaching, curriculum development, student and program evaluation, and administrative functions.Evaluation: The program

Donna Elliott; Sarah Ingersoll; Maura Sullivan; Madeleine Bruning; Moreen Logan; Clive R. Taylor

2007-01-01

76

The Development of a Medical Student Interest Group in Geriatrics.  

ERIC Educational Resources Information Center

Since 1988, a special interest group in geriatrics has provided students at Mount Sinai School of Medicine a forum for pursuing research interests, networking, and interacting with faculty. Such groups foster interest in careers in geriatric medicine. (SK)

Paris, Barbara E. Cammer

1998-01-01

77

UK medical teaching about ageing is improving but there is still work to be done: the Second National Survey of Undergraduate Teaching in Ageing and Geriatric Medicine  

PubMed Central

Introduction: in 2008, a UK national survey of undergraduate teaching about ageing and geriatric medicine identified deficiencies, including failure to adequately teach about elder abuse, pressure ulcers and bio- and social gerontology. We repeated the survey in 2013 to consider whether the situation had improved. Method: the deans of all 31 UK medical schools were invited to nominate a respondent with an overview of their undergraduate curriculum. Nominees were invited by email and letter to complete an online questionnaire quantifying topics taught, type of teaching and assessment undertaken, and the amount of time spent on teaching. Results: one school only taught pre-clinical medicine and declined to participate. Of the 30 remaining schools, 20 responded and 19 provided analysable data. The majority of the schools (95–100%) provided teaching in delirium, dementia, stroke, falls, osteoporosis, extra-pyramidal disorders, polypharmacy, incontinence, ethics and mental capacity. Only 68% of the schools taught about elder abuse. Thirty-seven per cent taught a recognised classification of the domains of health used in Comprehensive Geriatric Assessment (CGA). The median (range) total time spent on teaching in ageing and geriatric medicine was 55.5 (26–192) h. There was less reliance on informal teaching and improved assessment:teaching ratios compared with the 2008 survey. Conclusions: there was an improvement in teaching and assessment of learning outcomes in ageing and geriatric medicine for UK undergraduates between 2008 and 2013. However, further work is needed to increase the amount of teaching time devoted to ageing and to improve teaching around elder abuse and the domains of health used in CGA.

Gordon, Adam Lee; Blundell, Adrian; Dhesi, Jugdeep K.; Forrester-Paton, Calum; Forrester-Paton, Jayne; Mitchell, Hannah K.; Bracewell, Nicola; Mjojo, Jocelyn; Masud, Tahir; Gladman, John R. F.

2014-01-01

78

Using In-Clerkship Tests To Identify Students with Insufficient Knowledge and Assessing the Effect of Counseling on Final Examination Performance.  

ERIC Educational Resources Information Center

Analysis of students' mean scores on two internal medicine clerkship tests at Wright State University investigated test sensitivity and specificity for identifying students with insufficient knowledge, and compared final examination pass rates of counseled and noncounseled students. Results indicate that in-clerkship tests can identify at-risk…

Hemmer, Paul A.; Markert, Ronald J.; Wood, Virginia

1999-01-01

79

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

80

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

81

Student evaluation of a primary care clerkship: quality assurance and identification of potential for improvement  

PubMed Central

Background In Germany, like many other countries, general practice clerkships have only recently become mandatory during medical education. The biggest challenges for the organisation of such clerkships are achieving a minimum level of standardisation, and developing and maintaining a system of quality assurance. The aim of this study is to assess the instructional quality in teaching practices using a benchmark system. Methods Before commencing, students anonymously assessed the importance of core aspects of the mandatory primary care clerkship. After the clerkship, they evaluated learning opportunities and teaching performance. Based on this data, a benchmark system was developed to identify areas of strength and weakness for all practices as well as individual teaching practices. Results A total of 695 students evaluated 97 general practices belonging to a teaching network. Prior to the clerkship, most students considered recognition of frequent diseases (85%) and communication skills (65%) the most important learning goals. After the clerkship, nearly 90% of students confirmed that the general practitioner (GP) was good or excellent at teaching these two goals but only two-thirds thought the GP's teaching performance good or excellent in preventive medicine and screening. In an exemplary analysis, we identified the 2 best and the 2 worst practices that consistently received scores far above or below average, respectively. Conclusion We were able to identify areas of weakness in teaching and identified specific GPs who did not meet the students' needs and expectations. This evaluation seems to be a useful quality assurance tool to identify the potential for improvement and faculty development.

Chenot, Jean-Francois; Kochen, Michael M; Himmel, Wolfgang

2009-01-01

82

The "Shrinking" Clerkship: Characteristics and Length of Clerkships in Psychiatry Undergraduate Education  

ERIC Educational Resources Information Center

OBJECTIVE: The authors explored the time that is currently devoted to psychiatry clerkships to determine whether "shortened" clerkships differ in course director satisfaction and evaluation strategies. METHOD: An 18-item questionnaire was sent to 150 U.S. and Canadian clerkship directors. RESULTS: The return rate was 74% (111 questionnaires).…

Rosenthal, Renate H.; Levine, Ruth E.; Carlson, David L.; Clegg, Kathleen A.; Crosby, Ross D.

2005-01-01

83

Iatrogenic Disease and Geriatric Medicine: Issues for Research. Summary of Proceedings Held at Denver, Colorado on May 16, 1984.  

National Technical Information Service (NTIS)

A one-day conference was held May 16, 1984, in association with the joint annual meeting of the American Geriatric Society and the American Federation for Aging Research. A summary of the proceedings covers the speakers' presentations in the morning: 'Ove...

K. Steel C. Crescenzi

1984-01-01

84

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

85

Geriatrics (Geriatrician)  

MedlinePLUS

... Join our e-newsletter! Aging & Health A to Z Geriatrics Basic Facts & Information Printer-Friendly PDF What ... older adults. Search by city, state, or zip code! Or call 800-563-4916 to have a ...

86

An Interviewing Course for a Psychiatry Clerkship  

ERIC Educational Resources Information Center

Objective: Taking a psychiatric history is a key educational objective in the psychiatry clerkship. Medical students arrive on psychiatry clerkships unprepared for the unique challenges of psychiatric interviewing. This paper describes an interviewing course for psychiatry clerks that combines practice, observation, and feedback in a small group…

Nuzzarello, Angela; Birndorf, Catherine

2004-01-01

87

An Evaluation of a Clerkship In Cardiology  

ERIC Educational Resources Information Center

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

Edson, John N.; and others

1969-01-01

88

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.

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

2014-01-01

89

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

90

Geriatric nephrology and the `nephrogeriatric giants'  

Microsoft Academic Search

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

Carlos G. Musso

2002-01-01

91

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.

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

2013-01-01

92

Guidelines for Graduate Medical Education in Geriatrics.  

ERIC Educational Resources Information Center

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

Robbins, Alan S.; Beck, John C.

1982-01-01

93

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

94

Tracking Reflective Practice-Based Learning by Medical Students during an Ambulatory Clerkship  

PubMed Central

Objective To explore the use of web and palm digital assistant (PDA)-based patient logs to facilitate reflective learning in an ambulatory medicine clerkship. Design Thematic analysis of convenience sample of three successive rotations of medical students’ patient log entries. Setting Johns Hopkins University School of Medicine. Participants MS3 and MS4 students rotating through a required block ambulatory medicine clerkship. Interventions Students are required to enter patient encounters into a web-based log system during the clerkship. Patient-linked entries included an open text field entitled, “Learning Need.” Students were encouraged to use this field to enter goals for future study or teaching points related to the encounter. Measurement and Main Results The logs of 59 students were examined. These students entered 3,051 patient encounters, and 51 students entered 1,347 learning need entries (44.1% of encounters). The use of the “Learning Need” field was not correlated with MS year, gender or end-of-clerkship knowledge test performance. There were strong correlations between the use of diagnostic thinking comments and observations of therapeutic relationships (Pearson’s r=.42, p<0.001), and between diagnostic thinking and primary interpretation skills (Pearson’s r=.60, p<0.001), but not between diagnostic thinking and factual knowledge (Pearson’s r =.10, p=.46). CONCLUSIONS We found that when clerkship students were cued to reflect on each patient encounter with the electronic log system, student entries grouped into categories that suggested different levels of reflective thinking. Future efforts should explore the use of such entries to encourage and track habits of reflective practice in the clinical curriculum.

Goldberg, Harry

2007-01-01

95

Palliative care for the geriatric patient in Europe  

Microsoft Academic Search

Background  Knowledge about the quality of end-of-life care in the elderly patient in Europe is fragmented. The European Union Geriatric\\u000a Medicine Society (EUGMS) Geriatric Palliative Medicine (GPM) Interest Group set as one of its goals to better characterize\\u000a geriatric palliative care in Europe.\\u000a \\u000a \\u000a \\u000a \\u000a Objective  The goal of the current study was to map the existing palliative care structures for geriatric patients, the

R. Piers; S. Pautex; V. Curale; M. Pfisterer; M.-C. Van Nes; L. Rexach; M. Ribbe; N. Van Den Noortgate

2010-01-01

96

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.

97

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

98

The Loss of Student Idealism in the 3rd-Year Clinical Clerkships  

Microsoft Academic Search

The purpose of this study was to specify how student attitudes toward different types of patients and the profession change during clinical rotations. A questionnaire was given to all medical students prior to 3rd-year rotations regarding their attitudes toward the medical profession and patient types. It was given again after students completed their l6-week medicine-surgery clerkship. Eighty-eight of 96 students

Charles H. Griffith; John F. Wilson

2001-01-01

99

Geriatric Curriculum Resource Package.  

National Technical Information Service (NTIS)

The materials included in the Geriatric Curriculum Resource Package (CRP) were written and selected to assist Physician Assistant faculty members to develop and implement geriatric curricula. The contract for the GEPAF project specified that the topics co...

G. Yeo D. Tully V. Fowkes M. Goldstein

1985-01-01

100

CORRELATES OF ENTERING MEDICAL STUDENTS' ATTITUDES TOWARD GERIATRICS  

Microsoft Academic Search

Six successive entering classes at a medical school were surveyed concerning their attitudes toward geriatrics. Responding students' general attitudes toward the elderly were not negative. Despite this, only 3% of all students showed interest in specializing in geriatric medicine. Path analysis revealed that preference for treating older patients, prior volunteer work with the elderly, and a positive attitude toward the

Celeste P. M. Wilderom; Jacob A. Tebes; Linda Nichols; Evan Calkins; Arthur G. Cryns; Frank Schimpfhauser

1990-01-01

101

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

102

Training Students in Community Health: A Novel Required Fourth-Year Clerkship at the University of Rochester  

PubMed Central

In 2004, community health became the 4th mission of the University of Rochester Medical Center, along with education, clinical care, and research. In that same year, a novel clerkship was added to the 4th-year curriculum that focuses on the “practice” of community health and preventive medicine. The goal is to offer intensive experiential training to develop skills in community health improvement by partnering with community agencies involved in health promotion and disease prevention. The learning objectives addressed include: community health assessment, risk behavior change, assurance of personal health services, advocacy and policy change, environmental interventions, community organization and partnership-building, and program evaluation. The clerkship involves 3 full days of didactic instruction, followed by 4 weeks of program development and implementation. Each student chooses a project that focuses on a specific target population, then designs it and incorporates public health knowledge, skills, and attitudes learned during the didactic component. Course directors then mentor students during project implementation. Students can begin “longitudinal” experiences in their first or second years to fold into the required clerkship. Innovations include a novel “Advocacy and Policy Change” module and a highly rated “Cultural Determinants of Health” lecture, and a resource-based course website. The clerkship was initially offered as an elective, and has since become a required course. In the clerkship to date, three hundred and forty students have launched hundreds of community-level interventions within various settings locally, nationally, and internationally. Evaluation efforts to date indicate the clerkship has been received favorably by both faculty and students.

McIntosh, Scott; Block, Robert C.; Kapsak, Gabrielle; Pearson, Thomas A.

2012-01-01

103

Medical Student Experiences during Psychiatric Clerkships? Fantasies and Reality.  

ERIC Educational Resources Information Center

The psychiatric clerkship for medical students is examined with regard to the accompanying educational process of reconciliation of fantasy to clinical reality. Commonly encountered student fantasies are detailed, and questions are raised concerning the suitability of psychiatric clerkships. (Author/DS)

Babineau, Raymond

1978-01-01

104

American Association for Geriatric Psychiatry  

MedlinePLUS

... Partnership for Grassroots Advocacy. More>> TRAINEES / STUDENTS Geriatric psychiatry offers rich opportunities for researchers and clinicians in ... many opportunities for medical students, residents, and geriatric psychiatry fellows. More>> The American Association for Geriatric Psychiatry ( ...

105

[Review in geriatric medicine 2012].  

PubMed

2012 brought additional evidence regarding the benefits of exercise in older persons in showing morbidity compression in those most active. Several studies invite to revise therapeutic targets in older diabetics, especially those with cognitive impairment or dementia where a value of 8 to 9% for HbAlc might be a good compromise. On the dementia side, a study suggests that biological and structural abnormalities associated with Alzheimer's disease might occur as early as 25 years before its first clinical manifestations. On the therapeutic side, ginkgo and the double therapy with memantine and donepezil did not make it in RCTs, and two studies about treatments for behavioral symptoms of dementia showed that interruption could be deleterious. PMID:23367702

Major, K; Saiah, L; Rubli, E; Rochat, S; Monod, S; Büla, C

2013-01-01

106

Interdisciplinary training for medical and nursing students: learning to collaborate in the care of geriatric patients.  

PubMed

A medicine clerkship for students at the Albert Einstein College of Medicine provided the setting for a pilot program in interdisciplinary geriatric training with nursing students from the College of Mount Saint Vincent. The program's objectives were to provide opportunities for interdisciplinary collaboration and to increase appreciation for the role of each discipline in caring for the aged. Additionally, it sought to foster a holistic approach to the aging and a recognition of the psychosocial influences on their lives. Teams of one medical and two nursing students conducted patient work-ups and presented cases to an interdisciplinary group of health care professionals. Analysis of pretest-posttest responses of ten medical and ten nursing students to a Role Assessment Questionnaire (RAQ) found that the program significantly increased medical students' perceptions of the nurse's role in caring for hospitalized elderly patients (P less than 0.05). Despite this gain, however, there continued to be substantial discrepancies between medical and nursing students' perceptions of the extent to which nurses are "essential" in caring for the elderly. In evaluating the program, all participants concurred that working with students in another health profession was a valuable learning experience. While nursing students felt that the program achieved all its goals, responses of medical students were more variable, with volunteers having more positive perceptions of program impact than those who were assigned. The program demonstrated both the need for and the effect of interdisciplinary training, and that teaching and clinical experiences centering around the hospitalized older person can provide a natural setting for such training. PMID:6690578

Croen, L G; Hamerman, D; Goetzel, R Z

1984-01-01

107

Lean business model and implementation of a geriatric fracture center.  

PubMed

Geriatric hip fracture is a common event associated with high costs of care and often with suboptimal outcomes for the patients. Ideally, a new care model to manage geriatric hip fractures would address both quality and safety of patient care as well as the need for reduced costs of care. The geriatric fracture center model of care is one such model reported to improve both outcomes and quality of care. It is a lean business model applied to medicine. This article describes basic lean business concepts applied to geriatric fracture care and information needed to successfully implement a geriatric fracture center. It is written to assist physicians and surgeons in their efforts to implement an improved care model for their patients. PMID:24721360

Kates, Stephen L

2014-05-01

108

Integrating Prevention Education into the Medical School Curriculum: The Role of Departments of Family Medicine.  

ERIC Educational Resources Information Center

Discusses the role of departments of family medicine in teaching preventive medicine through required clinical experiences, required nonclinical courses, electives, collaborative interdisciplinary clerkships, and interdisciplinary nonclinical courses. Offers examples of innovative programs at the Universities of Michigan, Wisconsin, Vermont,…

Stine, Curtis; Kohrs, Francis P.; Little, David N.; Kaprielian, Victoria; Gatipon, Betty B.; Haq, Cynthia

2000-01-01

109

A Required Internal Medicine Preceptorship.  

ERIC Educational Resources Information Center

A preceptorship in an internal medicine clerkship at Southern Illinois University School of Medicine is discussed and evaluated. The results of a telephone survey indicate that the preceptorship had an important impact on the students, who learned time management, office management, and management of chronic clinical problems. (MLW)

Anderson, M. Brownell; And Others

1982-01-01

110

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

ERIC Educational Resources Information Center

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

Bauer, Richard L.; And Others

1997-01-01

111

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

112

ELI Lilly and Company Global Medical Information: Pharmacy Student Clerkships in Industry  

Microsoft Academic Search

With the growing need for clinical clerkship sites, Eli Lilly and Company continues to expand opportunities available to PharmD students. This paper presents the drug information clinical clerkship program for Eli Lilly and Company in Global Medical Information within the regulatory component. Goals for the drug information clerkship program include: providing the student with experience in drug information, exposing the

Jennifer L. Riggins; Jeffrey L. Winn

1998-01-01

113

Geriatric Anesthesia Q&A  

MedlinePLUS

Geriatric Anesthesia Q & A Share PRINT Print Home > Anesthesia Topics > Detail Page Q: As an older patient, ... your procedure. It is important to consult a geriatric specialist before your surgery to help you understand ...

114

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

115

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

116

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

117

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

118

The geriatric floating interdisciplinary transition team.  

PubMed

Older adults often receive suboptimal care during hospitalizations and transitions to postacute settings. Inpatient geriatric services have been shown to increase care quality but have not improved patient outcomes consistently. Acute Care for the Elderly units improve patient outcomes but are resource intensive. Transitional care has been shown to reduce hospital readmissions and healthcare costs. This article describes the Geriatric Floating Interdisciplinary Transition Team (Geri-FITT), a model that combines the strengths of inpatient geriatric evaluation and comanagement and transitional care models by creating an inpatient comanagement service that also delivers transitional care. The Geri-FITT model is designed to improve the hospital care of older adults and their transitions to postacute settings. In Geri-FITT, a geriatrician-geriatric nurse practitioner team assesses patients, comanages geriatric syndromes, provides staff education, encourages patient self-management, communicates with primary care providers, and follows up with patients soon after discharge. This pilot cohort study of Geri-FITT included hospitalized patients aged 70 and older on four general medicine services (two Geri-FITT, two usual care) at an academic medical center (N=717). The study assessed the effect of Geri-FITT on patients' care transition quality (Care Transitions Measure) and their satisfaction with hospital care (four questions). The results indicate that Geri-FITT is associated with slightly higher, though not statistically significantly so, quality care transitions and greater patient satisfaction with inpatient care. Geri-FITT may be a feasible approach to enhancing inpatient management and transitional care for older adults. Further study of its effect on these and other outcomes in other healthcare settings seems warranted. PMID:20370860

Arbaje, Alicia I; Maron, David D; Yu, Qilu; Wendel, V Inez; Tanner, Elizabeth; Boult, Chad; Eubank, Kathryn J; Durso, Samuel C

2010-02-01

119

Geriatric bipolar disorder.  

PubMed

Because the elderly are the fastest growing segment of the population, the number of older adults with bipolar disorder is increasing. Geriatric bipolar disorder is relatively rare, with an estimated lifetime prevalence of 0.5% to 1%, although approximately 4% to 17% of older patients in clinical psychiatric settings have bipolar disorder. Bipolar elders are disproportionately affected by medical burden. Given the complex nature of this disorder, comorbidity, and behavioral disturbances, various interventions may be indicated, including pharmacotherapies, electroconvulsive therapy, psychotherapies, and integrated care models. Additional research is needed to better understand the epidemiology, phenomenology, and treatment of geriatric bipolar disorder. PMID:21536161

Sajatovic, Martha; Chen, Peijun

2011-06-01

120

Geriatric education: a system approach.  

PubMed

This article describes an institutionwide geriatric educational initiative (called Geriatrics Awareness Month) that provided didactic and formal experiential learning designed for health professionals. From an educational perspective, to learn geriatrics requires systems thinking, and, to learn systems thinking, geriatrics provides an excellent clinical context. The authors evaluated the didactic and experiential aspects of Geriatric Awareness Month. For attendees of didactic sessions, the availability of pocket-sized educational materials was deemed most valuable. Despite busy schedules, house staff were able to make a change in their practice and study the effect of this change. PMID:10181846

Splaine, M; Brooks, W B; Patterson, J A; von Reyn, L; Wasson, J H

1998-07-01

121

A process evaluation of a required primary care clerkship.  

PubMed

A process evaluation was implemented to guide faculty in developing a new required primary care clerkship. During the first eight months of the clerkship, 23 medical students were observed in a time and motion analysis and a study of the verbal content of the precepting interactions as students presented their patients to a preceptor. Students spent an average of 44% of their clinic time in examination rooms with patients, 21% interacting with preceptors and 13% waiting without interaction. The verbal behaviors accounting for 80% of the student-preceptor interaction time were case presentations (50%), direct or indirect questioning (16%), and making recommendations for management (13%). PMID:1936739

Walter, L L; Zweig, S C; Hosokawa, M C

1991-01-01

122

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

123

Geriatric assessment tools.  

PubMed

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

Rosen, Sonja L; Reuben, David B

2011-01-01

124

Integrating Communication Training into a Required Family Medicine Clerkship  

Microsoft Academic Search

Persistent evidence suggests that the communication skills of practicing physicians do not achieve desired goals of enhancing patient satisfaction, strengthening health outcomes and decreasing malpractice litigation. Stronger communication skills training during the clinical years of medical education might make use of an underutilized window of opportunity—students' clinical years—to in- still basic and important skills. The authors describe the implementation of

Thomas R. Egnew; Larry B. Mauksch; Thomas Greer; Stuart J. Farber

2004-01-01

125

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.

2014-01-01

126

Psychiatric Day Treatment Clerkship for Undergraduate Pharmacy Students.  

ERIC Educational Resources Information Center

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

Cardoni, Alex A.; Gunning, Jacqueline

1981-01-01

127

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

128

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

129

Geriatric Models of Care  

Microsoft Academic Search

\\u000a Although patients aged 65 and over represent about 13% of the US population, they account for 40% of those undergoing surgical\\u000a procedures in American hospitals. Due to the increased likelihood of comorbidities, older patients also represent a higher\\u000a rate of postoperative complications that influence morbidity and mortality following major surgery. These problems have led\\u000a to the development of several geriatric

Elizabeth A. Capezuti; Patricia Ursomanno; Marie Boltz; Hongsoo Kim

130

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

131

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

132

28 CFR 2.78 - Geriatric parole.  

Code of Federal Regulations, 2010 CFR

...Prisoners and Parolees] [Sec. 2.78 - Geriatric parole.] 28 JUDICIAL ADMINISTRATION...Prisoners and Parolees Sec. 2.78 Geriatric parole. (a) Upon receipt of a report...whether or not to release the prisoner on geriatric parole. Release on geriatric...

2009-07-01

133

28 CFR 2.78 - Geriatric parole.  

Code of Federal Regulations, 2010 CFR

...2010-07-01 2010-07-01 false Geriatric parole. 2.78 Section 2.78 ...Prisoners and Parolees § 2.78 Geriatric parole. (a) Upon receipt of...whether or not to release the prisoner on geriatric parole. Release on geriatric...

2010-07-01

134

The geriatric dental patient.  

PubMed

The life expectancy of our citizens has increased due to better living conditions and medical care. This poses new challenges to dental surgeons because geriatric dental patients have different needs brought on by ageing. Tooth loss, periodontal disease, alveolar bone resorption, mucosal changes, edentulism are just some of the problems faced by the elderly. Recognition of the dental needs of this special category of the population compels us to bear the responsibility of treating them now and in the future. We require a gerodontology programme that emphasizes prevention, maintenance of the oral health and understanding of their psychological status. PMID:3592599

Loh, F C; Neo, J; Tan, P H

1987-01-01

135

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

Microsoft Academic Search

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

Vicki L. Martin; David S. Bennett

2004-01-01

136

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.

2013-01-01

137

Factors Determining Students' Global Satisfaction with Clerkships: An Analysis of a Two Year Students' Ratings Database  

ERIC Educational Resources Information Center

Clerkships would benefit from teachers' improved understanding of the didactic aspects of their task. The purpose of this study is to identify factors that determine the teaching quality of clerkships and to examine the predictive value of these factors for students' global satisfaction. Thus, results would be further reflected to clinical…

Durak, Halil Ibrahim; Vatansever, Kevser; van Dalen, Jan; van der Vleuten, Cees

2008-01-01

138

The Design and Evaluation of a Clinical Clerkship for Hospital Pharmacists.  

ERIC Educational Resources Information Center

Forty hospital pharmacists participated in a 2 week pilot of a postgraduate clinical pharmacy clerkship, using different hospital services as teaching sites at the University of Illinois and Cook County hospitals in Chicago. The clerkship experience broadened participants' conceptions of the depth and scope of the clinical pharmacist's role.…

Belsheim, David J.; And Others

1986-01-01

139

Learning Activities and Third-Year Medical Student Ratings of High Quality Teaching Across Different Clerkships  

Microsoft Academic Search

Objective: To identify and compare learning activities that students associate with high quality teaching across clerkships. Methods: For six months, 110 third year medical students recorded data on learning activities and teaching quality using personal digital assistants (PDAs) during five different required clinical clerkships. Univariate and multivariate analyses were performed to assess the association between learning activities and student ratings

Dario M. Torre; Deborah Simpson; D. Bower; P. Redlich; P. Palma-Sisto; Michael R. Lund; James L. Sebastian

140

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

141

An Innovative Method for Teaching Epidemiology, Public Health, and Preventive Medicine.  

ERIC Educational Resources Information Center

The Department of Community Health and Family Medicine at the University of Florida College of Medicine developed a curriculum component integrating epidemiologic concepts into a third year family medicine clerkship through a small-group project on a specific condition likely to be encountered by primary care physicians in community practice. (MSE)

Duerson, Margaret C.; And Others

1990-01-01

142

Obstetrics and gynecology clerkship for males and females: similar curriculum, different outcomes?  

PubMed Central

Objective To determine if performance differences exist between male and female students on a 6-week obstetrics and gynecology (Ob/Gyn) clerkship and to evaluate potential variables that might underlie any observed variations. Study Design Final clerkship grades and component scores (clinical evaluations, objective structured clinical examination [OSCE], oral examination, and National Board of Medical Examiners [NBME] subject examination) from July 2007 to June 2010 were matched by student and analyzed by gender. Basic science grade point average (GPA) and initial United States Medical Licensing Exam (USMLE) Step 1 scores were used to establish students’ baseline medical knowledge. On a post-clerkship questionnaire, a subset of students reported the numbers of procedures they performed during the clerkship; students also completed online pre- and post-clerkship questionnaires reflecting their self-assessed confidence in women's health clinical skills. Results Scores were analyzed for 136 women and 220 men. Final clerkship grades were significantly higher for females than for males (89.05 vs. 87.34, p=0.0004, ? 2=0.08). Specifically, females outscored males on the OSCE, oral, and NBME subject examination portions of the clerkship but not clinical evaluations. Males reported completing fewer breast examinations (p=0.001, ? 2=0.14). Pre-clerkship, males were significantly less confident than females in women's health clinical skills (p<0.01) but reached similar levels upon completion of the clerkship. No gender differences were detected for basic science GPA and USMLE Step 1 scores. Conclusion Student gender is associated with final grades on an Ob/Gyn clerkship. Further research regarding these differences should be explored.

Craig, LaTasha B.; Smith, Chad; Crow, Sheila M.; Driver, Whitney; Wallace, Michelle; Thompson, Britta M.

2013-01-01

143

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

144

Strengthening Training in Geriatrics for Physicians.  

National Technical Information Service (NTIS)

This report reviews the range of public and private programs, mostly operational within the past decade, that have been directed at recruiting and training physicians in geriatrics. Efforts have included undergraduate medical education, geriatrics fellows...

1993-01-01

145

A Compendium of Objectives for Geriatric Dentistry.  

ERIC Educational Resources Information Center

Results of a survey of geriatric dentistry specialists concerning the competencies required of geriatric dentists and the relative importance of those skills in five settings (dental school, general practice residency, prosthodontic specialty programs, geriatric fellowship programs, and continuing education) are reported. (MSE)

Kress, Gerard C. Jr.; Vidmar, Gordon C.

1985-01-01

146

Geriatric Dentistry in the Predoctoral Curriculum.  

ERIC Educational Resources Information Center

A survey of U.S. dental schools to determine the status of geriatric dentistry in the curriculum is discussed. Evidence of growing commitment is shown by deans who plan to give geriatric dentistry increasing priority in the future and by the fact that all schools now teach geriatric dentistry in some way. (MLW)

Moshman, Jack; And Others

1985-01-01

147

Family Medicine Curriculum Resource Project: Overview  

Microsoft Academic Search

In 2000, the Health Resources and Services Administration, in the interest of fostering curriculum reform in medical schools, awarded a 4-year contract to the Society of Teachers of Family Medicine to develop a curricular resource. The contract directed development of a multi-part resource aimed at (1) preclerkship prerequisites for third-year clerkships in collaboration with internal medicine and pediatrics, (2) the

Ardis K. Davis; Jeffrey A. Stearns; Alexander W. Chessman; Paul M. Paulman; David J. Steele; Roger A. Sherwood

148

Oral examinations: actual and perceived contributions to surgery clerkship performance.  

PubMed

Controversy persists regarding the validity, utility, and practicality of oral examinations. This study of a recent 3-year experience at the University of Michigan Medical School was undertaken to determine the value of the oral examination in the required junior year surgery clerkship. Multiple regression analysis of the relationship between the oral examination and ward grades, written examination grades, and the final grades for the clerkship years 1980 to 1981 (n = 198), 1981 to 1982 (n = 234), and 1982 to 1983 (n = 215) (classes of 1982, 1983, and 1984) revealed significant correlation between the oral examination and other evaluation parameters. Stepwise regression analysis revealed that the oral examination contributed unique information to final grade determination. Two surveys identified faculty and student opinion regarding the oral examination. The results were consistent during the 3-year period of study. Faculty and student opinion regarding the examination as an evaluation process and motivational device were positive, as was opinion regarding the breadth and depth of knowledge tested and the examination as a learning experience and an accurate reflection of students' performance. Both faculty and students agreed that the examination was worth the time and effort invested by faculty, was an appropriate evaluation process, and was a source of worthwhile faculty and student interaction. PMID:4002121

Zelenock, G B; Calhoun, J G; Hockman, E M; Youmans, L C; Erlandson, E E; Davis, W K; Turcotte, J G

1985-06-01

149

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

150

[Hearing in a geriatric perspective].  

PubMed

To assess whether hearing rehabilitation of older people can be improved by co-operation between the audiology and geriatric departments and the home service, 139 old and frail audiological patients were allocated to three groups with three different fitting procedures: 1) conventional fitting including verification of acoustical gain in the patient's ear; 2) home-fitting by hearing therapists, and 3) home-fitting by a specially trained geriatric nursing assistant, the home help also being present. Outcome was assessed by the ordinary questionnaire mailed to hearing aids users three to four months after fitting and by a geriatric evaluation procedure. The response rate in the conventionally fitted group was highly unsatisfactory (36%) and too small for further data-analysis. In the educational group a tendency was found towards better manipulation skills and significantly higher hearing aid use. However, the response rate was lower than in the geriatric group (71% compared to 81%), and no knowledge of hearing aid use was registered in the home service by this procedure. In the geriatric group a correlation was found between practical ability and use and satisfaction with the hearing aid. However, two thirds of the group were dependent on lasting help for the handling of the aid. Most patients in this group were already known by the hospital and home service, and the individual home help showed an interest in learning about hearing aid use. Home fitting by a joint audiological and geriatric effort in collaboration with the home help has proven feasible and valuable to both patient and home help. Extended co-operation is recommended between the health care and the social sector concerning hearing aid use. PMID:9411959

Boisen, G; Lindemann, L; Lange, K; Horwitz, N; Parving, A

1997-10-20

151

Effect of Early Exposure to Family Medicine on Students' Attitudes Toward the Specialty.  

ERIC Educational Resources Information Center

A study of the influence of clinical experiences on one medical school's students' choice of specialty found that neither early exposure to role models in family medicine nor the order in which specialty clerkships were taken significantly affected students' choice of family medicine. (MSE)

Allen, Sharon S.; And Others

1987-01-01

152

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

153

Psychiatry and Emergency Medicine: Medical Student and Physician Attitudes toward Homeless Persons  

ERIC Educational Resources Information Center

Objective: The purpose of the study was to explore changes in medical students' attitudes toward homeless persons during the Psychiatry and Emergency Medicine clerkships. Simultaneously, this study explored attitudes toward homeless persons held by Psychiatry and Emergency Medicine residents and faculty in an attempt to uncover the "hidden…

Morrison, Ann; Roman, Brenda; Borges, Nicole

2012-01-01

154

Virtual patients in geriatric education.  

PubMed

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 have spurred the development of virtual patient programs to teach geriatrics at the medical undergraduate, graduate, and postgraduate levels. As an instructional tool, the Virtual Patient must be placed in the correct educational context to help educators identify opportunities for its proper use in the curriculum. In this review, the experiences of three medical schools in the development and application of geriatric virtual patients are described as case studies. In each case study, the challenges encountered and solutions developed are presented. Areas of future research in the use of virtual patients in geriatrics education include the determination of the optimal combination of features, the settings of use of virtual patient programs, the underlying pedagogy, and the limitations in its application in clinical instruction. PMID:20509062

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

2010-01-01

155

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

156

Screening Tests for Geriatric Depression  

Microsoft Academic Search

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

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

1982-01-01

157

Hiking on the Geriatrics Rotation  

Microsoft Academic Search

Objectives: Most geriatrics training emphasizes chronically ill, dying, demented, or institutionalized patients. While some programs link trainees to healthy older adults in interview settings, we developed an experience that exposes trainees to vigorously active seniors with the objective of demonstrat- ing the physical capabilities of older adults. Methods: We sent residents with a senior group (age 60s-80s) from a hiking

Barry D. Weiss; Lynne Tomasa

158

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

159

A Brief, Intensive, Clinically-focused Geriatrics Course during the Third Year of Medical School  

PubMed Central

During the next several decades the aging of the “baby boom” generation in the United States will result in a dramatic increase in the number of patients over the age of 65 years seeking medical care. However, current projections suggest that the shortage of Geriatric trained specialists will only worsen during this time period. As a result, the care of elderly patients will largely fall to other types of physicians. Consequently, it is imperative that medical school training include exposure to the basic skills needed to safely care for older adults. This goal is challenging as the number of Geriatric Medicine faculty in most academic medical centers is small, and multiple other medical specialties are also vying for time in a busy medical school curriculum. We explored whether a brief three day course conducted during the third year of medical school could teach basic principles of Geriatric Medicine in a time and manpower effective manner. We found that even this brief exposure to Geriatrics could have meaningful impacts on student knowledge of and comfort with Geriatrics.

Fisher, Alfred L.; O'Keefe, Elizabeth A.; Hanlon, Joseph T.; Studenski, Stephanie A.; Hennon, John G.; Resnick, Neil M.

2009-01-01

160

Geriatric Obesity: Evaluating the Evidence for the Use of Flavonoids to Promote Weight Loss  

Microsoft Academic Search

Obesity is a rapidly growing epidemic that now affects approximately 30% of the adult population in the United States. The prevalence of obesity in the geriatric population makes it one of the fastest growing groups due to aging baby boomers. Because of the limited number of available treatments for obese adults, they often turn to supplements and alternative medicine sources

Ryan T. Hurt; Ted Wilson

2012-01-01

161

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

162

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.

2014-01-01

163

State of the Art in Geriatric Rehabilitation. Part I: Review of Frailty and Comprehensive Geriatric Assessment  

Microsoft Academic Search

Wells JL, Seabrook JA, Stolee P, Borrie MJ, Knoefel F. State of the art in geriatric rehabilitation. Part I: Review of frailty and comprehensive geriatric assessment. Arch Phys Med Rehabil 2003;84:890-7. Objectives: To increase recognition of geriatric rehabilita- tion and to provide recommendations for practice and future research. Data Sources: A CINAHL and 2 MEDLINE searches were conducted for 1980

Jennie L. Wells; Jamie A. Seabrook; Paul Stolee; Michael J. Borrie; Frank Knoefel

164

Family medicine curriculum resource project: overview.  

PubMed

In 2000, the Health Resources and Services Administration, in the interest of fostering curriculum reform in medical schools, awarded a 4-year contract to the Society of Teachers of Family Medicine to develop a curricular resource. The contract directed development of a multi-part resource aimed at (1) preclerkship prerequisites for third-year clerkships in collaboration with internal medicine and pediatrics, (2) the family medicine clerkship, (3) post-clerkship preparation for residency training, and (4) specific special topic areas of importance to the government. The Family Medicine Curriculum Resource (FMCR) was produced by primary care educators, with day-to-day direction from an executive committee and overall oversight by an advisory committee. The FMCR was built around a theoretical framework to link medical student competencies with the Accreditation Council for Graduate Medical Education (ACGME) competencies for residency training. Considerable energy throughout development of the FMCR was devoted to obtaining input from potential end-user audiences through an active dissemination effort. PMID:17186443

Davis, Ardis K; Stearns, Jeffrey A; Chessman, Alexander W; Paulman, Paul M; Steele, David J; Sherwood, Roger A

2007-01-01

165

Geriatric Depression in Primary Care  

PubMed Central

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

Park, Mijung; Unutzer, Jurgen

2011-01-01

166

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

167

Optimizing perioperative management of geriatric patients with head and neck cancer.  

PubMed

Given emerging demographic trends, many more elderly patients are being diagnosed with head and neck cancers. The surgical care paradigm for this cohort of patients must take into account specific challenges inherent to geriatric perioperative management. This article attempts to summarize the existing body of literature relevant to the geriatric head and neck cancer population, and to extrapolate relevant data from geriatric perioperative medicine in order to better understand and guide management decisions. The involvement of geriatricians and of patients' primary care providers may be invaluable in assisting in complex perioperative decision-making and in participating in longitudinal management. Preoperative risk stratification and assessment of medical, social, and functional variables are critical for appropriate decision-making in this challenging patient population. © 2013 Wiley Periodicals, Inc. Head Neck 36: 743-749, 2014. PMID:23596001

Shuman, Andrew G; Patel, Snehal G; Shah, Jatin P; Korc-Grodzicki, Beatriz

2014-05-01

168

The Visiting Medical Student Clerkship Program at Mayo Clinic  

PubMed Central

OBJECTIVE: To describe the history, objectives, statistics, and initiatives used to address challenges associated with the Mayo Clinic Visiting Medical Student (VMS) Clerkship Program. MATERIALS AND METHODS: Mayo Clinic administrative records were reviewed for calendar years 1995 through 2008 to determine the effect of interventions to increase the numbers of appropriately qualified international VMSs and underrepresented minority VMSs. For numerical data, descriptive statistics were used; for comparisons, ?2 tests were performed. RESULTS: During the specified period, 4908 VMSs participated in the Mayo VMS Program (yearly mean [SD], 351 [24]). Most students were from US medical schools (3247 [66%]) and were male (3084 [63%]). Overall, 3101 VMSs (63%) applied for and 935 (30%) were appointed to Mayo Clinic residency program positions. Interventions to address the challenge of large numbers of international students who participated in our VMS program but did not apply for Mayo residency positions resulted in significantly fewer international students participating in our VMS program (P<.001), applying for Mayo residency program positions (P<.001), and being appointed to residency positions (P=.001). Interventions to address the challenge of low numbers of underrepresented minority students resulted in significantly more of these students participating in our VMS program (P=.005), applying for Mayo residency positions (P=.008), and being appointed to residency positions (P=.04). CONCLUSION: Our findings suggest that specific interventions can affect the characteristics of students who participate in VMS programs and who apply for and are appointed to residency program positions.

Mueller, Paul S.; McConahey, Linda L.; Orvidas, Laura J.; Jenkins, Sarah M.; Kasten, Mary J.

2010-01-01

169

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

170

Building Psychosocial Programming in Geriatrics Fellowships: A Consortium Model  

ERIC Educational Resources Information Center

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

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

2011-01-01

171

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

172

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

ERIC Educational Resources Information Center

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

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

2012-01-01

173

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

ERIC Educational Resources Information Center

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

Campbell, R. Keith

1975-01-01

174

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.

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

175

A Survey of Evaluation Instruments Used in Clinical Clerkships in American Medical Schools.  

ERIC Educational Resources Information Center

An analysis of the evaluation instruments of clinical clerkships from 54 medical schools was made. Instruments were classified as to purpose, format, and skills measured. Thirty-nine schools used a modified Likert format; a few schools also had a check list of adjectives or short answer questions. Nearly all instruments had some space for general…

Reid, J. C.

176

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

177

A Pilot Survey of Patient-Initiated Assaults on Medical Students during Clinical Clerkship  

ERIC Educational Resources Information Center

Objectives: To assess the incidents of patient-initiated assault (PIA) against clinical clerks during the first six months of clinical clerkship. To characterise the assaults with respect to service, location, clerk gender, patient gender. To examine the students' perceptions of the reporting process for PIA. Methods: A brief email survey was sent…

Waddell, Andrea E.; Katz, Mark R.; Lofchy, Jodi; Bradley, John

2005-01-01

178

Do Student Evaluations Influence the Teaching Skills of Clerkship Clinical Faculty?  

ERIC Educational Resources Information Center

Web-based student evaluations of clinical faculty were collected over an 8-year period. There were 19,881 medical student evaluations over the 8-year period for all clinical clerkships, representing a total of 952 faculty. Students used a 5-point Likert scale to rate the teaching effectiveness of faculty. Criterion-based methods and standard…

Chandrasekhar, Arcot J.; Durazo-Arvizu, Ramon; Hoyt, Amy; McNulty, John A.

2013-01-01

179

Do Clinical Evaluations in a Psychiatry Clerkship Favor Students with Positive Personality Characteristics?  

ERIC Educational Resources Information Center

Objective: The authors examine associations of personality characteristics, National Board of Medical Examiners subject examination performance, and Objective Structured Clinical Examination performance with clinical evaluations of third-year medical students in a psychiatry clerkship. Methods: Students completed the Revised NEO Personality…

Chibnall, John T.; Blaskiewicz, Robert J.

2008-01-01

180

Influence of Clerkship on Attitudes of Medical Students toward Psychiatry across Cultures: United States and Qatar  

ERIC Educational Resources Information Center

Objective: To assure adequate treatment for patients with mental illness worldwide, medical schools must impart positive attitudes toward psychiatry. The authors examined the effect of culture on changes in attitudes toward psychiatry among medical students receiving the same psychiatry clerkship curriculum in two different countries. Methods: A…

Burgut, F. Tuna; Polan, H. Jonathan

2013-01-01

181

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

182

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

183

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

184

The Performance of Female Medical Students in an Obstetrics and Gynecology Clerkship.  

ERIC Educational Resources Information Center

A study showed that although female medical students had slightly lower National Board examination scores on part one and lower grade point averages, they performed significantly better in the obstetrics and gynecology clerkship. Possible factors include women students' interest in women's health care and female representation on the house staff.…

Miller, Joseph M.; Smith, Imogene K.

1982-01-01

185

An objective structured clinical exam in a multisite obstetrics and gynecology clerkship  

Microsoft Academic Search

An Objective Structured Clinical Exam (OSCE) was developed to test students completing a multiple site clinical clerkship. Common ambulatory problems were emphasized. The exam was given in the outpatient department where 60 students rotated through approximately 10 short problem stations. Gynecologic teaching associates, clinical staff, and others served as simulated patients. The specific stations, exam logistics, and expenses are explained.

William W. Young; Joan C. Barthold; Debra Birenbaum; Phyllis Long; Michele Dion; Lewis A. Hamilton

1995-01-01

186

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

PubMed Central

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

2010-01-01

187

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

188

Maintenance Therapy for the Geriatric Patient.  

National Technical Information Service (NTIS)

The concept of maintenance therapy and its application in the prolonged treatment of geriatric patients are examined. Maintenance therapy encompasses therapeutic measures that retard deterioration in patients who are chronically ill either by slowing the ...

J. L. Rudd R. J. Margolin

1968-01-01

189

Cultural competency training for third-year clerkship students: effects of an interactive workshop on student attitudes.  

PubMed Central

With an increasing awareness of health disparities, medical schools are challenged to develop training in cultural competency for their students. We developed and evaluated the effectiveness of an interactive workshop designed to improve third-year students' attitudes, beliefs and cross-cultural communication skills. METHODS: At the start of a six-week required family medicine clerkship, 196 medical students participated in small group (20-24 students) workshops. Didactics included facts about health disparities and a model of cultural competency. During a skill-building component, students were exposed to live vignettes portraying ineffective and effective cross-cultural doctor-patient interactions. Impact on students' attitudes, perceived bias and knowledge of techniques was assessed by comparing pre- and postworkshop scores. RESULTS: Participants increased their cultural awareness on most items of a cultural awareness scale. Fifty-five-, 71- and 66% of the sample agreed or strongly agreed the program was valuable, appropriate and effective, respectively. Conversely, only 17-, 6- and 9% of the sample disagreed or strongly disagreed, respectively. CONCLUSIONS: A workshop for third-year students led to an increase in cultural awareness and was considered appropriate and valuable. Further study, including longitudinal training and evaluation, is needed regarding effective methods to increase cultural competence in clinical practice.

Carter, Michele M.; Lewis, Evelyn L.; Sbrocco, Tracy; Tanenbaum, Richard; Oswald, Jennifer C.; Sykora, William; Williams, Pamela; Hill, Lauren D.

2006-01-01

190

The Merck Manual of Geriatrics  

NSDL National Science Digital Library

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

2005-11-30

191

The Merck Manual of Geriatrics  

NSDL National Science Digital Library

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

1995-01-01

192

Acute medical unit comprehensive geriatric assessment intervention study (AMIGOS)  

PubMed Central

Background Many older people presenting to Acute Medical Units (AMU) are discharged after only a short stay (< 72 hours), yet many re-present to hospital or die within 1 year. Comprehensive Geriatric Assessment may improve patient outcomes for this group. Method Participants Patients aged > 70 years and scoring positive on a risk screening tool ('Identification of Seniors At Risk') who are discharged within 72 hours of attending an AMU with a medical crisis, recruited prior to discharge. Sample size is 400. Carers of participants will also be recruited. Intervention Assessment on the AMU and further out-patient management by a specialist physician in geriatric medicine. Assessment and further management will follow the principles of Comprehensive Geriatric Assessment, providing advice and support to primary care services. Design Multi-centre, individual patient randomised controlled trial comparing intervention with usual care. Outcome measurement Follow up is by postal questionnaire 90 days after randomisation, and data will be entered into the study database by a researcher blind to allocation. The primary outcome is 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). Secondary outcomes include mortality, institutionalisation, health and social care resource use, and scaled outcome measures, including quality of life, disability, mental well-being. Carer strain and well being will also be measured at 90 days. Analyses Comparisons of outcomes and costs, and a cost utility analysis between the intervention and control groups will be carried out. Trial Registration ISRCTN: ISRCTN21800480

2011-01-01

193

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

194

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

195

CONSTRUCTION AND PRACTICE OF MEDICAL RESPONSIBILITY: DILEMMAS AND NARRATIVES FROM GERIATRICS  

Microsoft Academic Search

A narrative approach is employed in this article about dilemmasand physician reasoning in geriatric medicine in order toexplore the moral-medical worlds of urban American physicians.Reconstructed dilemmas, in the form of stories told by 51doctors, are analyzed as cultural documents of both clinical-moralknowledge and practice and the physician as moral actor. Discussionfocuses on ways in which responsibility is constituted and enactedthrough

SHARON R. KAUFMAN

1997-01-01

196

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.

Bang, Jae-Beum

2013-01-01

197

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

PubMed

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

Zerzan, Judy T; Rich, Eugene C

2014-06-01

198

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

199

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

200

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

201

Pharmaceutical Care Preceptor Training and Assessment in Community Pharmacy Clerkship Sites1  

Microsoft Academic Search

This training model used self-study, home-based therapeutics instruction and a clerkship strategy to train rural community pharmacy preceptors in pharmaceutical care (PC). Specific aims were to: (i) provide intensive instruction in clinical and managerial aspects of setting up a PC model in a rural community phar- macy setting, and (ii) assess effectiveness of the instruction through post-training assessment of PC

David M. Scott; Warren A. Narducci; Paul W. Jungnickel; Lucinda G. Miller; Anthony E. Ranno; Pierre A. Maloley

1999-01-01

202

Research Ethics Issues in Geriatric Psychiatry  

PubMed Central

Synopsis With an aging population, and the prevalence of psychiatric illness in the older population expected to rise dramatically in coming decades, advances in geriatric psychiatry research are urgently needed. Ethical issues in the design, conduct, and monitoring of research involving older adults parallel these same issues related to human subjects research generally. Yet a number of special issues relevant to geriatric psychiatry research merit further discussion. These special issues include the assessment of capacity in populations where cognitive disorders are more prevalent, the role of surrogate decision makers, the legal status of surrogate consent, the use of advanced directives for research participation, and research involving suicidal individuals.

Dunn, Laura B.; Misra, Sahana

2009-01-01

203

Development of an Evaluative Procedure for Clinical Clerkships.  

ERIC Educational Resources Information Center

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

And Others; Pancorbo, Salvador

1980-01-01

204

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

PubMed Central

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 provides a contemporary update on the status of geriatric education and explores how geriatric coverage is valued, how geriatric competence is defined, and how students are evaluated for geriatric competencies. Design and Methods: Semi-structured interviews were conducted with curriculum representatives from 7 health profession disciplines in a case study of one academic medical center. Findings: Geriatric training varies across health professions’ disciplines. Although participants recognized the unique needs of older patients and valued geriatric coverage, they identified shortage of time in packed curricula, lack of geriatrics-trained educators, absence of financial incentive, and low student demand (resulting from limited exposure to older adults and gerontological stereotyping) as barriers to improving geriatric training. Implications: Progress in including geriatric training within curricula across the health professions continues to lag behind need as a result of the continuing presence of barriers identified several decades ago. There remains an urgent need for institutional commitment to enhance geriatric education as a component of health professions curricula.

Bardach, Shoshana H.; Rowles, Graham D.

2012-01-01

205

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.

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

2014-01-01

206

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

207

Geriatric dentistry--meet the need.  

PubMed

Geriatric dentistry or gerodontics is the delivery of dental care to older adults involving the diagnosis, prevention, and treatment of problems associated with normal ageing and age-related diseases as part of an inter-disciplinary team with other health care professionals. Geriatric health is an ignored and under-explored area worldwide. Oral health reflects overall well being for the elderly population. Conversely, elderly patients are more predisposed to oral conditions due to age-related systemic diseases and functional changes. The major barriers to practising geriatric dentistry are the lack of trained faculty members, a crowded curriculum and monetary concerns. For successful treatment, the practitioner must adopt a humanitarian approach and develop a better understanding of the feelings and attitudes of the elderly. Prevention and early intervention strategies must be formulated to reduce the risk of oral diseases in this population. In future, dental professionals must have a proper understanding of the magnitude of the services to be provided to the elderly. This could only be realised through an education programme in geriatric dentistry, which should be started without further delay. This article hence sets out the objectives, needs, present scenario, strategies and types of dental treatment required by the elderly population. PMID:22612827

Issrani, Rakhi; Ammanagi, Renuka; Keluskar, Vaishali

2012-06-01

208

Diagnostic Tests, Drugs, and the Geriatric Patient.  

National Technical Information Service (NTIS)

The physiologic processes that accompany aging are examined in terms of the considerations involved in the use of drugs and diagnostic agents for the geriatric patient. The tissue changes of aging -- a decrease in the aggregate cell population of the meta...

B. J. Means P. P. Lamy

1974-01-01

209

Geriatric Dentistry in the Predoctoral Curriculum.  

ERIC Educational Resources Information Center

To treat the elderly more competently and to provide clinical training to undergraduates simultaneously, a geriatric dental program was initiated in 1976 at the University of Illinois College of Dentistry. The program's current status and operation are described. (Author/MLW)

Freedman, Kenneth A.; And Others

1985-01-01

210

Geriatric rehabilitation nursing: developing a model.  

PubMed

In this paper, we describe a geriatric rehabilitation nursing model developed on the basis of the nursing and rehabilitation literature. That literature comprised some 120 articles addressing the rehabilitation of elderly patients and the work done by nurses in that process, various philosophical questions and the results of geriatric rehabilitation. One-third of these articles has been evaluated on the strength of the articles' evidence, and these are discussed in this paper. The findings show that the main factors in geriatric rehabilitation nursing are the patient with health or functional problems and the nurse with professional values, knowledge and skills. The patient is part of a family and the nurse works as part of a multidisciplinary team. In the geriatric rehabilitation process, the patient and the nurse work in close interaction. The aims of rehabilitation depend upon the patient's commitment to the objective and upon the nurse's commitment to help the patient achieve that objective. A health orientation, goal-oriented work, nursing decision-making and a rehabilitative approach to work are all central to this effort. Work is organized in multidisciplinary teams where nurses have equal responsibilities with other professional staff. Testing and development of the model is ongoing. PMID:15461690

Routasalo, Pirkko; Arve, Seija; Lauri, Sirkka

2004-10-01

211

Simulation in Medical School Education: Review for Emergency Medicine  

PubMed Central

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.

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

2011-01-01

212

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

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee...C. App. 2, that a meeting of the Geriatrics and Gerontology Advisory Committee will...Health on all matters pertaining to geriatrics and gerontology. The Committee...

2013-09-11

213

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

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee...C. App. 2, that a meeting of the Geriatrics and Gerontology Advisory Committee will...Health on all matters pertaining to geriatrics and gerontology. The Committee...

2013-01-30

214

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

Federal Register 2010, 2011, 2012, 2013

...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...

2012-03-13

215

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

Federal Register 2010, 2011, 2012, 2013

...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...

2010-03-11

216

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

Federal Register 2010, 2011, 2012, 2013

...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

217

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

Federal Register 2010, 2011, 2012, 2013

...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...

2010-09-03

218

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

Federal Register 2010, 2011, 2012, 2013

...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...

2011-03-31

219

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

Federal Register 2010, 2011, 2012, 2013

...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...

2011-09-01

220

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

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee...C. App. 2, that a meeting of the Geriatrics and Gerontology Advisory Committee has...Health on all matters pertaining to geriatrics and gerontology. The Committee...

2013-02-25

221

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.

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

2013-01-01

222

Geriatric Medicine: A Self-Instructional Text for Clinicians.  

National Technical Information Service (NTIS)

While this volume was designed mainly as an update and review for practicing, primary care physicians, it will also be valuable for physicians-in-training, some medical specialists and other health care providers. The volume brings together the most curre...

R. D. T. Cape R. M. Coe I. Rossman J. Tobin R. W. Besdine

1981-01-01

223

Developing Leadership in Geriatric Education: An Annual Faculty Institute. Proceedings of the Summer Geriatric Institute (4th, Lexington, Kentucky, July 24-27, 1989).  

ERIC Educational Resources Information Center

This document presents the proceedings of a conference on geriatric education. These papers are included: Promoting Healthy Aging: A Leadership Role for Geriatric Education; National Research Priorities in Aging; Aging with a Disability; Recent Advances in Clinical Strategies in Geriatric Education: The Role of the Geriatric Nurse in the Acute…

Gardner, Davis L., Ed.; Hoekelman, Margaret C., Ed.

224

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

225

Factors Associated with Geriatric Syndromes in Older Homeless Adults  

PubMed Central

Although older homeless adults have high rates of geriatric syndromes, risk factors for these syndromes are not known. We used multivariable regression 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 ADLs. 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.

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

2013-01-01

226

Recognition of geriatric popular song repertoire: a comparison of geriatric clients and music therapy students.  

PubMed

The purposes of the current study were to determine geriatric clients' recognition of 32 popular songs and songs from musicals by asking whether they: (a) had heard the songs before; (b) could "name the tune" of each song; and (c) list the decade that each song was composed. Additionally, comparisons were made between the geriatric clients' recognition of these songs and by music therapy students' recognition of the same, songs, based on data from an earlier study (VanWeelden, Juchniewicz, & Cevasco, 2008). Results found 90% or more of the geriatric clients had heard 28 of the 32 songs, 80% or more of the graduate students had heard 20 songs, and 80% of the undergraduates had heard 18 songs. The geriatric clients correctly identified 3 songs with 80% or more accuracy, which the graduate students also correctly identified, while the undergraduates identified 2 of the 3 same songs. Geriatric clients identified the decades of 3 songs with 50% or greater accuracy. Neither the undergraduate nor graduate students identified any songs by the correct decade with over 50% accuracy. Further results are discussed. PMID:20635525

VanWeelden, Kimberly; Cevasco, Andrea M

2010-01-01

227

Using Facebook Within a Geriatric Pharmacotherapy Course  

PubMed Central

Objective To evaluate using an Internet-based social networking site within an elective geriatric pharmacotherapy course. Design Thirty pharmacy students enrolled in a geriatric pharmacotherapy elective course were invited to join a closed Facebook (Facebook Inc, Palo Alto, CA) group to enhance communication among students and faculty members within the course. Creating a discussion board was the primary activity in the course. Each week, 3 students were assigned to post a healthy aging topic, and other students in the class were expected to post their comments and reactions. The healthy aging topics also were discussed during class. Assessment Students wrote reflections about their experiences using Facebook for the activities within this course. A survey instrument also measured students' opinions about using Facebook for educational purposes. Conclusion Using Facebook allowed students to discuss topics more openly and encouraged classroom discussions of healthy aging topics.

2010-01-01

228

Setting performance goals in geriatric nursing.  

PubMed

Behavioural techniques are increasingly being applied in the geriatric field as part of a broader emphasis on psychological and social treatments in the care of the elderly. The nurse is in the best position to analyse a patient's performance and manage an intervention programme; however, some nurses have had little experience of autonomously diagnosing problems and setting performance goals. The authors argue that it is important to set such goals and give examples of how performance may be objectively specified, prerequisites made explicit, criteria for success defined and the consequences of goal attainment or non-attainment discussed with those most concerned. A complex situation drawn from the geriatric setting which was used as part of a teaching workshop to help nurses define suitable targets for intervention is described in the Appendix. PMID:6902731

Davies, A D; Crisp, A G

1980-07-01

229

[Geriatric assessment prior to oncological therapy].  

PubMed

Ageing is the single most important risk factor for cancer. This is also true for most cancer diseases of the genitourinary tract. In combination with the demographic changes in Germany and most other countries, the consequence is a substantial increase in the number of elderly patients with cancer. Most therapies in oncology have a high risk for toxic side effects. Ageing is a very heterogeneous process. The chronological age of a patient insufficiently reflects the individual resources, deficits and risk factors but this can be assessed by a structured geriatric assessment. Integration of geriatric assessment into oncological treatment decisions is still low and is one of the major tasks in cancer care in the future. PMID:23708006

Wedding, U

2013-06-01

230

Geriatric surgery is about disease, not age  

PubMed Central

Summary Maintaining life span and quality of life remains a valid aim of surgery in elderly people. Surgery can be an effective way of restoring both length and quality of life to older people. Minimally invasive techniques and surgery under local anaesthesia make fewer demands on geriatric physiology; given that co-morbidity is a stronger predictor of outcome from surgery than age, this is a significant consideration.

Preston, Stephen D; Southall, Ashley RD; Nel, Mark; Das, Saroj K

2008-01-01

231

[Patient education in geriatrics: which specificities?].  

PubMed

The prevalence of chronic diseases strongly increases with age, and the treatment of these diseases is complex in very old persons due to multiple comorbidities, loss of independence and/or frailty. In addition, cognitive troubles, dementia, sensorial disturbances are common. Patient education is becoming an important component of chronic disease management. Patients education programs aim to provide to the patient information and skill to help him/her live with his/her chronic condition. By applying patient education to geriatric patients, we described several specific aspects. Programs should involve family caregivers and must have specific objectives and use special materials which are adapted to very old persons. The model of Alzheimer disease includes caregivers and is a success. We have identified 30 patient education programs in France which are specifically devoted to geriatric patients. Most deal with Alzheimer disease, falls, drugs and multiple comorbidities management. Works have to be done to developed specials programs in other chronic diseases, with the relevant adaptation for the geriatric patient and his/her caregiver. PMID:23317631

Pariel, Sylvie; Boissières, Amélie; Delamare, Delphyne; Belmin, Joël

2013-02-01

232

Comparability of Clerkship Sites in a Community-Based Medical School: Evaluation of Undergraduate and Postgraduate Measures.  

ERIC Educational Resources Information Center

This report discusses results of a study that sought to determine if medical students perform equally on undergraduate and postgraduate academic measures regardless of the clinical site of their clerkship. A review of the literature revealed that accreditation requirements and sound education practices require that clinical sites be comparable…

Markert, Ronald J.; And Others

233

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

ERIC Educational Resources Information Center

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

Ramchandani, Dilip

2011-01-01

234

Toward a Core Curriculum for Interdisciplinary Geriatric Care  

Microsoft Academic Search

This paper describes a core curriculum for interdisciplinary geriatric care that was developed by the faculty of the Hunter\\/Mount Sinai Geriatric Education Center (GEC). The core curriculum encompasses the knowledge, attitudes and skills held in common by the nine health care disciplines that the GEC faculty represent. Each discipline can use the core as a unified base upon which to

Catherine A. Bevil; Suzanne D. Fields; D. Karl Davis

1988-01-01

235

Dental Students' Self-Assessed Competence in Geriatric Dentistry.  

ERIC Educational Resources Information Center

A study of four classes of dental students (n=172) exposed to both didactic and clinical geriatric dental training found that the students perceived significant improvements in their abilities to manage geriatric patients in all areas assessed, notably treatment planning, preventive dentistry, referrals, and providing care in alternative settings.…

Kiyak, H. Asuman; Brudvik, James

1992-01-01

236

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

237

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

238

Neuropsychological Predictors of Adaptive Kitchen Behavior in Geriatric Psychiatry Inpatients  

Microsoft Academic Search

This study examined the degree to which demographic variables, psychiatric diagnosis, depression rating, and neuropsychological test performance predict adaptive kitchen behavior in geriatric psychiatry patients and normal elderly volunteers. A mixed group of 27 participants including 8 normal volunteers and 19 geriatric psychiatry inpatients underwent psychiatric evaluation, neuropsychological testing, and a kitchen skills assessment conducted in a natural setting. Both

Ralph H. B. Benedict; Marion Zucker Goldstein; Melissa Dobraski; Judith Tannenhaus

1997-01-01

239

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

240

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

2004-01-01

241

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

242

Pharmacists' Perceptions of Major Difficulties in Geriatric Pharmacy Practice.  

ERIC Educational Resources Information Center

Pharmacists (N=233) responded to the question "What is the most difficult aspect of geriatric pharmacy practice?" Most commonly cited problems were (1) inadequate professional skills or knowledge in geriatrics; (2) patient compliance; (3) physician functioning (including overprescribing of medications); (4) communication with the elderly; (5) lack…

Pratt, Clara Collette; And Others

1982-01-01

243

Social learning: medical student perceptions of geriatric house calls.  

PubMed

Bandura's social learning theory provides a useful conceptual framework to understand medical students' perceptions of a house calls experience at Virginia Commonwealth University School of Medicine. Social learning and role modeling reflect Liaison Committee on Medical Education guidelines for "Medical schools (to) ensure that the learning environment for medical students promotes the development of explicit and appropriate professional attributes (attitudes, behaviors, and identity) in their medical students." This qualitative study reports findings from open-ended survey questions from 123 medical students who observed a preceptor during house calls to elderly homebound patients. Their comments included reflections on the medical treatment as well as interactions with family and professional care providers. Student insights about the social learning process they experienced during house calls to geriatric patients characterized physician role models as dedicated, compassionate, and communicative. They also described patient care in the home environment as comprehensive, personalized, more relaxed, and comfortable. Student perceptions reflect an appreciation of the richness and complexity of details learned from home visits and social interaction with patients, families, and caregivers. PMID:20509061

Abbey, Linda; Willett, Rita; Selby-Penczak, Rachel; McKnight, Roberta

2010-01-01

244

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

245

Renal function in geriatric psychiatry patients compared to non-psychiatric older adults: effects of lithium use and other factors.  

PubMed

Objectives: Chronic renal failure is very common, affecting 30%-40% of community-dwelling elderly. We wished to verify whether geriatric psychiatry patients are at increased risk of renal dysfunction compared to elderly controls, as well as whether lithium exposure and other factors are important predictors of risk.Method: This is a four-year retrospective cohort and nested case-control study at a Canadian tertiary-care hospital using data from March 2007 to March 2011. We compared 82 geriatric psychiatry outpatients and 200 psychotropic-naïve family medicine controls aged ?65. Our main continuous measure of renal outcome was change in estimated glomerular filtration rate (eGFR). Multivariate analyses were performed to determine potential risk factors for renal dysfunction in geriatric psychiatry patients, including age, hypertension, diabetes mellitus, diuretics, and lithium duration.Results: Clinically important decreases in eGFR (>8 mL/min/1.73 m(2)) were found in 40.2% of geriatric psychiatry patients compared to 29.5% of controls (p = 0.040). Multivariate analyses found that lithium duration was independently associated with adverse renal outcome in patients with eGFR < 60 mL/min/1.73 m(2). In this sub-population, lithium users had clinically important decreases in eGFR when compared to non-lithium users: 10.3 vs. 0.40 mL/min/1.73 m(2) (p = 0.017).Conclusion: Geriatric psychiatry patients are at a greater risk for clinically important decreases of renal function than similarly aged controls. Lithium appears to be an important risk factor for renal dysfunction when eGFR is <60 mL/min/1.73 m(2). However, in the majority of older adults who have normal kidney function, lithium use appears to be safe. PMID:24533667

Rej, Soham; Li, Brian Weixi; Looper, Karl; Segal, Marilyn

2014-09-01

246

[Progress in geriatric care through telemedicine].  

PubMed

A constantly aging population leads to an increasing number of elderly patients. As a result, the treatment of chronic illnesses becomes a significant part of daily routine. Today's concepts in social services and healthcare require time consuming and barely cost-effective efforts for the special needs of geriatric care. The use of telemedicine offers a possible solution, because telemedical methods may help to realize improved monitoring systems for optimized and effective patient management. This report provides an overview of the scenarios and advantages of telemedicine in general. In addition, we provide information on practical experiences in a project on telemedical glaucoma management in Mecklenburg-Vorpommern. PMID:16924448

Jürgens, C; Tost, F

2006-09-01

247

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.

2014-01-01

248

Geriatric dyspnea: doing worse, feeling better.  

PubMed

Older age is associated with a decline in physical fitness and reduced efficiency of the respiratory system. Paradoxically, it is also related to reduced report of dyspnea, that is, the experience of difficult and uncomfortable breathing. Reduced symptom reporting contributes to misdiagnosis or late diagnosis of underlying disease, suboptimal treatment, faster disease progression, shorter life expectancy, lower quality of life for patients, and considerably increased costs for the health care system in an aging society. However, pathways in the complex relationship between dyspnea and age are not well explored yet. We propose a model on geriatric dyspnea that integrates physiological, neurological, psychological and social pathways which link older age with dyspnea perception and expression. We suggest that the seemingly paradox of reduction of dyspnea in older age, despite physiological decline, can be solved by taking age-related changes on these multiple levels into account. In identifying these variables, the Geriatric Dyspnea Model highlights risk factors for reduced dyspnea perception and report in older age and pathways for intervention. PMID:24675044

Petersen, Sibylle; von Leupoldt, Andreas; Van den Bergh, Omer

2014-05-01

249

Pharmacological treatment of geriatric cachexia: evidence and safety in perspective.  

PubMed

Anticachexic or antisarcopenic medications are prescribed worldwide for geriatric patients with poor appetite and associated weight loss. They represent a valuable treatment option for managing cachexia. However, the well-publicized adverse reports about these medications in acquired immunodeficiency syndrome (AIDS) and in the cancer population has led to some concern and much subsequent discussion over the safety of these medications being used in geriatric population. This review looks at the evidence in relation to the benefits and risks of these medications and discusses what we know about their use in the geriatric population. PMID:17619035

Yeh, Shing-Shing; Lovitt, Sherri; Schuster, Michael W

2007-07-01

250

Differences between "geriatric" and "medical" patients aged 75 and over.  

PubMed Central

We analysed the characteristics of patients aged 75 and over admitted to the geriatric and general medical wards over a three month period in a teaching hospital. Patients admitted to the geriatric wards were slightly older, were more often female, more likely to be admitted during the day and during a week day, more likely to have been seen by their own general practitioner, had more chronic and multiple illness with non-specific presentations, and stayed longer in hospital. Referring doctors seem to discriminate between patients needing geriatric care and those more suitable for general medical care, but there is an overlap in the characteristics of the two groups.

Todd, M.; Crawford, V.; Stout, R. W.

1993-01-01

251

A Course Outline in Geriatric Care: A Trainee Project.  

National Technical Information Service (NTIS)

A course outline on geriatric care was developed to assist professional nurses in caring for the elderly patient in the general hospital setting. The course outline was developed through an extensive review of literature and through the development and di...

E. Woodcock

1972-01-01

252

The Physician Assistant in Geriatric Long-Term Care  

ERIC Educational Resources Information Center

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

Becker, Robert G.

1976-01-01

253

Aging (Physiology) (Includes Geriatrics, GeronTOLOGY, Longevity).  

National Technical Information Service (NTIS)

Lists 116 domestic and foreign references on physiological and psychological aspects of aging. Includes reports on: geriatrics; gerontology; longevity; age and behavior; personality development; age morphology; biochemistry of aging; physical and mental i...

1964-01-01

254

Rehabilitation in Long-Term and Geriatric Care.  

National Technical Information Service (NTIS)

A working group on rehabilitation in long-term and geriatric care convened by the World Health Organization met in 1974 and was attended by representatives from Norway, Bulgaria, Denmark, France, the German Democratic Republic, Italy, and the Netherlands....

1974-01-01

255

Research Priorities in Geriatric Palliative Care: Multimorbidity  

PubMed Central

Abstract With global aging and scientific advances extending survival, the number of adults experiencing multiple chronic conditions has grown substantially and is projected to increase by another third between 2000 and 2030. Among the many challenges posed by multimorbidity, some of the most pressing include how to characterize and measure comorbid conditions, understand symptoms and illness burden, and provide person-centered care in the context of competing health care priorities and increasing complexity. In this white paper emanating from a National Institute on Aging supported conference to discuss research gaps at the geriatrics–palliative care interface, the authors review common definitions of multimorbidity; describe the association between multimorbidity and quality of life, functional status, quality of care, and health care utilization; note content and methodological gaps in multimorbidity evidence; and make recommendations regarding research priorities in this area of expanding public health impact.

Zulman, Donna M.

2013-01-01

256

[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

257

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

258

Clinical Conundrums in Management of Hypothyroidism in Critically Ill Geriatric Patients  

PubMed Central

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

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

2014-01-01

259

A New Model of Delirium Care in the Acute Geriatric Setting: Geriatric Monitoring Unit  

PubMed Central

Background Delirium is a common and serious condition, which affects many of our older hospitalised patients. It is an indicator of severe underlying illness and requires early diagnosis and prompt treatment, associated with poor survival, functional outcomes with increased risk of institutionalisation following the delirium episode in the acute care setting. We describe a new model of delirium care in the acute care setting, titled Geriatric Monitoring Unit (GMU) where the important concepts of delirium prevention and management are integrated. We hypothesize that patients with delirium admitted to the GMU would have better clinical outcomes with less need for physical and psychotropic restraints compared to usual care. Methods/Design GMU models after the Delirium Room with adoption of core interventions from Hospital Elder Life Program and use of evening bright light therapy to consolidate circadian rhythm and improve sleep in the elderly patients. The novelty of this approach lies in the amalgamation of these interventions in a multi-faceted approach in acute delirium management. GMU development thus consists of key considerations for room design and resource planning, program specific interventions and daily core interventions. Assessments undertaken include baseline demographics, comorbidity scoring, duration and severity of delirium, cognitive, functional measures at baseline, 6 months and 12 months later. Additionally we also analysed the pre and post-GMU implementation knowledge and attitude on delirium care among staff members in the geriatric wards (nurses, doctors) and undertook satisfaction surveys for caregivers of patients treated in GMU. Discussion This study protocol describes the conceptualization and implementation of a specialized unit for delirium management. We hypothesize that such a model of care will not only result in better clinical outcomes for the elderly patient with delirium compared to usual geriatric care, but also improved staff knowledge and satisfaction. The model may then be transposed across various locations and disciplines in the acute hospital where delirious patients could be sited. Trial Registration Current Controlled Trials ISRCTN52323811

2011-01-01

260

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

PubMed Central

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

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

2014-01-01

261

Current Status of Geriatric Dentistry Educational Activities in U.S. Dental Schools.  

ERIC Educational Resources Information Center

Data on dental faculty involvement in geriatric programs, didactic and clinical academic curricula, and other aspects of ongoing geriatric educational activities in dental schools are reported and the prospects for future activities are discussed. (Author/MSE)

Mann, Jonathan; And Others

1987-01-01

262

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

PubMed

Given the American Geriatrics Society's (AGS) commitment to improving health care for older adults by, among other means, educating older people and their caregivers about their health and healthcare choices, the AGS was delighted when, in late 2011, the American Board of Internal Medicine Foundation invited the Society to join its "Choosing Wisely(®) " campaign. Choosing Wisely is designed to engage patients, healthcare professionals, and family caregivers in discussions about the safety and appropriateness of medical tests, medications, and procedures. Ideally, these discussions should examine whether the tests and procedures are evidence-based, whether any risks they pose might overshadow their potential benefits, whether they are redundant, and whether they are truly necessary. In addition to improving the quality of care, the initiative aims to rein in unneeded healthcare spending. According to a 2008 Congressional Budget Office report, as much as 30% of healthcare spending in the United States may be unnecessary. PMID:23469880

2013-04-01

263

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

PubMed

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

2014-05-01

264

Geriatric day hospital: who improves the most?  

PubMed

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 day hospital (GDH). The study also evaluated whether or not improvements, if any, were maintained 3 months after discharge. One-hundred-and-fifty-one people, categorized by primary reason for admission, were assessed at the GDH with reliable and valid tools, at admission and at discharge. Three months after discharge, they were reassessed with the same tools. Overall, two categories of clients, stroke / neurological diseases and musculoskeletal disorders / amputations, improved the most. For the gait disorders and falls group, only the functional independence score improved, but not at a clinically significant level. Finally, clients in the cognitive function disorders / psychopathologies group improved the most on their well-being scores and caregivers' burden decreased the most. All gains were maintained up to 3 months after discharge, except for leisure satisfaction. With the exception of clients who attended the GDH because of gait disorders and falls, the improvements and maintenance achieved in each category occurred in the domains where improvement had been hoped for, because of the particular disabilities in question and because of the nature of the GDH services offered. PMID:15660296

Desrosiers, Johanne; Hébert, Réjean; Payette, Hélène; Roy, Pierre-Michel; Tousignant, Michel; Côté, Sylvie; Trottier, Lise

2004-01-01

265

Advances in rehabilitation medicine.  

PubMed

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

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

2013-10-01

266

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

Microsoft Academic Search

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

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

2010-01-01

267

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

268

Geriatric-Focused Educational Offerings in the Department of Veterans Affairs From 1999 to 2009  

Microsoft Academic Search

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

Stephen Thielke; Nina Tumosa; Rivkah Lindenfeld; Kenneth Shay

2011-01-01

269

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

270

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

271

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

ERIC Educational Resources Information Center

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

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

2011-01-01

272

[Zinc deficiency in geriatric patients. A study on a geriatric department's wheeling and dealing].  

PubMed

We studied the prevalence of zinc deficiency in patients who were hospitalised in a geriatric ward and its association with risk factors for this deficiency and the possible symptoms. The serum zinc level was measured from 45 consecutive admissions to a geriatric ward and patient characteristics were collected. A peer group of healthy subjects originating from a population survey was used as a control group. The serum zinc measured in the admitted patients was significantly lower than the reference value for adults (65.8% had a lowered zinc level) and the serum zinc for healthy elderly. There was no association found with possible causes of zinc deficiency. In an univariate analysis lethargy was the only significant association to zinc deficiency. There was a reverse relationship between the sum of the number of present symptoms and the zinc proportion A lower zinc level is associated with symptoms of zinc deficiency. As more symptoms appear the probability of zinc deficiency is greater. The importance for the clinical practice based on present knowledge is discussed. PMID:12012944

Hegge, H H M; Wielders, J P M; Slaets, J P J

2002-04-01

273

Impact of the Foundations of Clinical Medicine Course on USMLE Scores  

PubMed Central

BACKGROUND The synthesis of basic and clinical science knowledge during the clerkship years has failed to meet educational expectations. OBJECTIVES We hypothesized that a small-group course emphasizing the basic science underpinnings of disease, Foundations of Clinical Medicine (FCM), could be integrated into third year clerkships and would not negatively impact the United States Medical Licensure Examination (USMLE) step 2 scores. DESIGN In 2001–2002, all third year students met weekly in groups of 8–12 clustered within clerkships to discuss the clinical and basic science aspects of prescribed, discipline-specific cases. PARTICIPANTS Students completing USMLE step 2 between 1999 and 2004 (n?=?743). MEASUREMENTS Course evaluations were compared with the overall institutional average. Bivariate analyses compared the mean USMLE steps 1 and 2 scores across pre- and post-FCM student cohorts. We used multiple linear regression to assess the association between USMLE step 2 scores and FCM cohort controlling for potential confounders. RESULTS Students’ average course evaluation score rose from 66 to 77 (2001–2004) compared to an institutional average of 73. The unadjusted mean USMLE step 1 score was higher for the post-FCM cohort (212.9 vs 207.5, respectively, p?clerkships is feasible and associated with improvement in standardized testing. Electronic supplementary material The online version of this article (doi: 10.1007/s11606-008-0631-z) contains supplementary material, which is available to authorized users.

Blue, Amy V.; Powell, Caroline K.; Geesey, Mark E.; Moran, William P.

2008-01-01

274

Multi-institutional development and utilization of a computer-assisted learning program for the pediatrics clerkship: the CLIPP Project.  

PubMed

Computer-assisted instruction (CAI) holds significant promise for meeting the current challenges of medical education by providing consistent and quality teaching materials regardless of training site. The Computer-assisted Learning in Pediatrics Project (CLIPP) was created over three years (2000-2003) to meet this potential through multi-institutional development of interactive Internet-based patient simulations that comprehensively teach the North American core pediatrics clerkship curriculum. Project development adhered to four objectives: (1) comprehensive coverage of the core curriculum; (2) uniform approach to CAI pedagogy; (3) multi-institutional development by educators; and (4) extensive evaluation by users. Pediatrics clerkship directors from 30 institutions worked in teams to develop a series of 31 patient case simulations. An iterative process of case content and pedagogy development, case authoring, peer review, and pilot-testing ensured that the needs of clerkship directors and medical students were met. Fifty medical schools in the United States and Canada are presently using CLIPP. More than 8,000 students have completed over 98,000 case sessions, with an average of 2,000 case sessions completed per week at this time. Each CLIPP case has been completed by more than 3,000 students. The current cost of CLIPP development is approximately $70 per student user, or $6 per case session. The project's success demonstrates that multi-institutional development and implementation of a peer-reviewed comprehensive CAI learning program by medical educators is feasible and provides a useful model for other organizations to develop similar programs. Although CAI development is both time-consuming and costly, the initial investment decreases significantly with broad use over time. PMID:16123465

Fall, Leslie H; Berman, Norman B; Smith, Sherilyn; White, Christopher B; Woodhead, Jerold C; Olson, Ardis L

2005-09-01

275

Medical humanities at New York University School of Medicine: an array of rich programs in diverse settings.  

PubMed

The New York University School of Medicine has a rich tradition of cultivating programs in medical humanities and professionalism. They are drawn from the departments, centers, students, and faculty in the School of Medicine, have linkages throughout the university, and are interwoven into the fabric and culture of the institution. Some are centrally based in the School of Medicine's deans' office, and others are located in individual departments and receive support from the dean's office. This article describes representative programs for medical students and faculty. Curricular initiatives, the fundamental components of medical students' learning, include a course entitled "The Physician, Patient, and Society," a clerkship essay in the Medicine Clerkship, an opportunity for reflection during the medicine clerkship, and a medical humanities elective. In 2002, the Professionalism Initiative was launched to enhance and reflect the values of the medical profession. Its curriculum consists of a series of events that coordinate, particularly, with existing elements of the first-year curriculum (e.g., orientation week, a session during anatomy, a self-assessment workshop, and a peer-assessment workshop). The Master Scholars Program is a group of five, theme-based master societies consisting of faculty and students who share common interests around the society's themes. Programs developed for the societies include colloquia, faculty-led seminars, a mandatory student-mentoring program, and visiting scholars. Finally, the authors describe three high-quality literary publications created at New York University School of Medicine. Each of the initiatives undergoes regular critical examination and reflection that drive future planning. PMID:14534091

Krackov, Sharon K; Levin, Richard I; Catanesé, Veronica; Rey, Mariano; Aull, Felice; Blagev, Denitza; Dreyer, Benard; Grieco, Anthony J; Hebert, Cristy; Kalet, Adina; Lipkin, Mack; Lowenstein, Jerome; Ofri, Danielle; Stevens, David

2003-10-01

276

Nuclear Medicine  

MedlinePLUS

Nuclear Medicine What is nuclear medicine? What are radioactive tracers? What is Single Photon Emission Computed Tomography (SPECT)? What ... funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that uses ...

277

Vitamin B12 deficit and development of geriatric syndromes  

PubMed Central

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

2013-01-01

278

Geriatric Conditions Develop in Middle-Aged Adults with Diabetes  

Microsoft Academic Search

BACKGROUND  Geriatric conditions, collections of symptoms common in older adults and not necessarily associated with a specific disease,\\u000a increase in prevalence with advancing age. These conditions are important contributors to the complex health status of older\\u000a adults. Diabetes mellitus is known to co-occur with geriatric conditions in older adults and has been implicated in the pathogenesis\\u000a of some conditions.\\u000a \\u000a \\u000a \\u000a \\u000a OBJECTIVE  To investigate

Christine T. Cigolle; Pearl G. Lee; Kenneth M. Langa; Yuo-Yu Lee; Zhiyi Tian; Caroline S. Blaum

2011-01-01

279

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.

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

2014-01-01

280

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

281

Geriatric Educational Program for Nurses: Facilitator Manual Volume 2.  

National Technical Information Service (NTIS)

The purpose of Module I is to increase the geriatric/gerontological nurse's skills in training and educating health care personnel to provide quality care to the aged. The goals of the module are to: increase participant understanding of adult learning pr...

1983-01-01

282

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

283

Development of the Geriatric Oral Health Assessment Index.  

ERIC Educational Resources Information Center

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

Atchison, Kathryn A.; Dolan, Teresa A.

1990-01-01

284

Geriatric Education for Physician Assistant Faculty. Executive Summary.  

National Technical Information Service (NTIS)

The purposes of the project were: (A) To design, implement, and assess a short-term individualized geriatric educational program for physician assistant (PA) teachers in which they have both didactic and clinical experience in the care of well and ill eld...

1986-01-01

285

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

286

Evaluation of a Distance Learning Course in Geriatric Interdisciplinary Teaming.  

ERIC Educational Resources Information Center

Pre/post course evaluations by 35 students in an interdisciplinary geriatric training program delivered via distance methods indicated an increase in interdisciplinary team skills. Students working with older clients had better attitudes about teams and were motivated to seek additional training. Distance delivery enabled outreach to underserved…

Coogle, Constance L.; Parham, Iris A.; Welleford, E. Ayn; Netting, F. Ellen

2002-01-01

287

Evaluation of an Interdisciplinary Faculty Development Program in Geriatrics.  

ERIC Educational Resources Information Center

The first four years of a summer faculty development program were evaluated through participant surveys, quarterly trainee logs, and reports of participant projects. The program received consistently high ratings; number of courses with gerontology/geriatrics content increased; and trainees went on to train peers, students, and laypersons. (SK)

Wood, Joan B.; Parham, Iris A.

1996-01-01

288

Geriatric Knowledge and Educational Needs among Rural Health Care Professionals.  

ERIC Educational Resources Information Center

In a needs assessment of 84 rural health care professionals (44.1% physicians, 15.5% pharmacists, 14.3% nurses, 26.1% other), 39% considered their geriatrics knowledge above average. They were interested in learning more about Alzheimer's/dementia, medication use, and adverse effects. Preferred methods were videotapes, CD-ROM, and an…

Goins, R. Turner; Gainor, Sara Jane; Pollard, Cecil; Spencer, S. Melinda

2003-01-01

289

Development of a Geriatric Nurse Practitioner Program in Arizona.  

National Technical Information Service (NTIS)

The feasibility of educating nurses in Arizona to become geriatric nurse practitioners is explored. In a survey of 2,250 registered nurses, 386 women and 9 men responded and stated that they were interested in expanding their professional knowledge and sk...

1975-01-01

290

Geriatric Health Teams: Classifying Models of Professional and Team Functioning.  

ERIC Educational Resources Information Center

Examines geriatric health teams, discussing four dimensions of models for professional functioning (logic of assessment, focus of efforts, locus of responsibility, and pace of action) and three dimensions of models for team functioning (focus of attention, decision-making style, and beliefs about interprofessional dependence). (Author/NB)

Qualls, Sara Honn; Czirr, Ruth

1988-01-01

291

Cultural perspectives of meals expressed by patients in geriatric care  

Microsoft Academic Search

The aim of this study was to investigate cultural values and ideas concerning table manners and food habits expressed by patients in geriatric care. The research approach was ethnographic. The findings exposed conflicts related to three themes. The first, “Mind your manners”, demonstrated problems in managing food and objects, keeping clean, and conduct at table. The second, “Appetite for food”,

Anna-Christina Ek

1996-01-01

292

Conceptualizing a Geriatric Core Curriculum for the Health Professions  

Microsoft Academic Search

As representatives of different health professions encompassing a variety of concerns and disciplines, the authors conceptualize a skills-based geriatric core curriculum for the health professions. Their approach defines areas of commonality and focuses primarily on skills. The attention in this approach is centered on what health providers need to do when serving the elderly, although it also encompasses the underlying

Paula Fishman; Annette B. Ramirez de Arellano; Carol I. Waslien

1988-01-01

293

Integrating Geriatric Dentistry into General Practice Residency Programs.  

ERIC Educational Resources Information Center

The predoctoral dental curriculum cannot provide the depth of experience and knowledge needed for the increasing representation of geriatric patients in family dental practices. A curriculum model designed to enhance knowledge and refine clinical skills in caring for the elderly is proposed. (MSE)

Lloyd, Patrick M.; Shay, Kenneth

1989-01-01

294

Current Status of Geriatric Education in American Dental Schools.  

ERIC Educational Resources Information Center

A survey of the 60 American dental schools was conducted to determine the extent of existing and planned programs in geriatric dentistry. All respondents indicated that they either conduct a gerontology program or plan to conduct one in the future; various educational approaches were reported. (MLW)

Thomas, Annette M.; Ship, Irwin I.

1981-01-01

295

Using Principles of Human Development in Teaching Geriatric Dentistry.  

ERIC Educational Resources Information Center

An approach to curriculum design for geriatric dentistry that incorporates an understanding of the students' own developmental stages into instructional activities is outlined, and the University of Mississippi's experience with this strategy is evaluated. An important element is to help students crystallize their value systems with regard to the…

Mahan, J. Maurice; And Others

1983-01-01

296

Interpretive Accuracy of Two MMPI Short Forms with Geriatric Patients.  

ERIC Educational Resources Information Center

Assessed and compared the interpretive accuracy of the standard Minnesota Multiphasic Personality Inventory (MMPI) and two MMPI short forms with a sample of geriatric psychiatric inpatients. Psychiatric teams evaluated the accuracy of the interpretation. Standard form interpretations were rated significantly greater than the interpretations…

Newmark, Charles S.; And Others

1982-01-01

297

Validation of Geriatric Care Environment Scale in Portuguese Nurses  

PubMed Central

The number of hospitalized older adults in Portugal necessitates a better understanding of the acute care environment for older adults. This study translated and examined the psychometric qualities of the Geriatric Care Environment Scale (GCES) among 1,068 Portuguese registered nurses (RNs). Four factors emerged from the exploratory factor analyses: resource availability, aging-sensitive care delivery, institutional values regarding older adults and staff, and continuity of care. The internal consistency of the GCES was ? = .919. The GCES was significantly associated with the variables of region, hospital type, unit type, and RNs perception of hospital educational, staff knowledge, difficulty, rewarding, and burdensome in caring for older adults. Nurses who worked in hospitals centers in the northern region and medical and surgery units had more positive perceptions of the geriatric care environment. More positive perception was also found among RNs that reported more educational support, had more knowledge, and felt more rewarding and less difficulty and burden in caring older adults. This process resulted in a valid and reliable measurement of the geriatric care environment Portuguese version which provides hospital leadership with an instrument to evaluate organizational support for geriatric nursing practice and target specific areas that support or hinder care delivery.

Paulo de Almeida Tavares, Joao; Leite da Silva, Alcione; Sa-Couto, Pedro; Boltz, Marie

2013-01-01

298

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

299

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

300

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

301

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

302

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

303

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

304

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

305

Maximizing the Potential of Internships in Gerontology and Geriatrics  

Microsoft Academic Search

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 attention to a variety of concerns. Using examples and illustrations from an ongoing gerontology internship component (undergraduate

Rona J. Karasik

2009-01-01

306

[Uro-gynecologic disorders in female geriatric patients].  

PubMed

As geriatric patients those above 60 years of age are described. Incontinence is not necessarily an associated symptom of old age. In women above 60 years 15-30% suffer from urinary incontinence. With advancing age the prevalence rises to more than 40%. The cause of miction trouble must not be sought only in the urogenital tract, where with advancing age under the influence of atrophic processes typical functional and anatomical changes take place, but also in the sphere of the CNS where in geriatric patients may be the cause of impaired continence. A preliminary classification of urinary incontinence may be made already on the basis of a detailed case-history. Data provided by the patient are usually not sufficient and it is necessary to obtain the required information on the character of incontinence by aimed questions. Furthermore it is of interest what sort of medication the patient is taking at the time, incl. medication she take spontaneously. Sometimes after mere discontinuation of certain drug groups complaints can be markedly reduced or completely eliminated. In the case-history we must always focus attention on risk factors associated with incontinence and questions on the abuse of alcohol are also justified. Somatic examination comprises gynaecological examination for evaluation of the anatomical characteristics at rest and during elevated intraabdominal pressure. Functional geriatric examination is the starting point for optimal care of old people. There is a number of functional geriatric tests. For clinical practice due to its straightforward character Barthel's test of basic everyday activities is useful. Urodynamic examination is not essential in geriatric patients. Information obtained in diagnostic processes may serve as a basis for rational therapy of incontinence. Different urodynamic methods are used in case therapy fails or when the anamnestic data are obscure. PMID:9600132

Krofta, L

1997-09-17

307

The effects of firocoxib (Previcox) in geriatric dogs over a period of 90 days.  

PubMed

The long-term use of non-steroidal anti-inflammatory agents in geriatric dogs with osteoarthritis has not been well studied in veterinary medicine. This study evaluated the effects of firocoxib administered to dogs over 7 years of age for 90 days. Pain and lameness scores were evaluated by the owner weekly for the 1st month and then biweekly through to the end of the study, the veterinarian evaluated the dogs monthly. Serum chemistry, including urea, creatinine, alanine transferase, aspartate transaminase, bile acids and bilirubin, urine specific gravity and a urine dipstick, were performed at monthly intervals. Forty-five dogs were enrolled into the treatment group and 9 into the control group. A total of 33 dogs completed the trial in the treatment group and 8 in the control group. Lameness and pain scores were found to be significantly lower in the treated group from day 30 for most parameters evaluated. Bile acids (although not comparable to controls, with higher mean value and a high standard deviation in the control group; in addition the control group had increased bile acids at day 0) and urea (within normal reference range provided (WNL)) were significantly different in the treatment group between days 0 and 90. Urea (WNL) on days 30 and 90 and creatinine (WNL) on day 90 were significantly different between the control group and the treatment group. The most common adverse events reported were diarrhoea, vomition, dark faeces and anorexia. This study showed that firocoxib was effective in managing pain associated with osteoarthritis for 90 days. Despite the geriatric high-risk population used for this study, minimal biochemical changes were seen and adverse drug events seen were in agreement with those previously reported. PMID:20169752

Joubert, K E

2009-09-01

308

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

309

Isolation followed by integration: a model for development of a separate geriatric course.  

PubMed

Because of the growing population of older adults in America, nursing faculty throughout the United States have been consistently challenged during the past decade to use the most appropriate methods to strengthen geriatric content in baccalaureate nursing programs. The question of whether to integrate content throughout the curriculum or offer a stand-alone geriatric nursing course has been explored extensively, but no ultimate conclusion has been found. With the support of a grant for geriatric curriculum integration from the John A. Hartford Foundation, one university began the journey to integrate geriatric nursing curriculum throughout all baccalaureate nursing courses. However, at a curriculum evaluation meeting held halfway through the grant period, faculty expressed the need to have concentrated content earlier in the program that could serve as a foundation on which to build geriatric knowledge. Faculty unanimously voted to create a geriatric nursing course to be offered to students during their second year of baccalaureate study. PMID:16021801

Wallace, Meredith; Lange, Jean; Grossman, Sheila

2005-06-01

310

Insomnia symptoms and their correlates among the elderly in geriatric homes in Alexandria, Egypt  

Microsoft Academic Search

The prevalence of sleep complaints increases steadily with age. Studies investigating insomnia among elderly people living\\u000a in geriatric homes, especially among Egyptians, are scarce. This study aimed to determine the prevalence of insomnia symptoms\\u000a among the elderly living in geriatric homes in Alexandria and their correlates. A cross-sectional survey of a representative\\u000a sample of elderly population of geriatric homes in

Mohamed M. Makhlouf; Abla I. Ayoub; Moataz M. Abdel-Fattah

2007-01-01

311

The effects of percutaneous nephrolithotomy on renal function in geriatric patients in the early postoperative period  

Microsoft Academic Search

Since percutaneous nephrolithotomy (PNL) is a surgical intervention, it may show deteriorative effects on renal function in\\u000a the early postoperative period. In this study, the deteriorative effects of PNL on renal function were investigated in the\\u000a geriatric population, and it was compared to the non-geriatric population.\\u000a \\u000a A total of 711 patients [64 in the geriatric group (female\\/male ratio: 33\\/31, mean

Adem Tok; Savas Ozturk; Abdulkadir Tepeler; Ahmet Hamdi Tefekli; Rumeyza Kazancioglu; Ahmet Yaser Muslumanoglu

2009-01-01

312

Novel oral anticoagulants for stroke prevention in the geriatric population.  

PubMed

Prior to the availability of several newer anticoagulant medications, there had been no new advances in anticoagulation management for stroke prevention since the advent of warfarin in the 1950s. The availability of the novel oral anticoagulants (NOACs) dabigatran, rivaroxaban,and apixaban represent improvements over warfarin in many respects, including the elimination of the need for therapeutic drug monitoring, fewer drug and food interactions,and favorable efficacy; however, these agents are not without risk. Specifically, the use of the NOACs in the geriatric population, who are more likely to have an increased risk of stroke due to atrial fibrillation and other medical comorbidities, is not without risk. The objective of this review is to update the clinician on the use of the NOACs in the geriatric population and introduce the controversies and risks surrounding these newer therapies. PMID:24234513

Kim, Daniel; Barna, Richard; Bridgeman, Mary Barna; Brunetti, Luigi

2014-02-01

313

[Subcutaneous perfusion of hypodermoclysis: a useful rehydration method in geriatrics].  

PubMed

A USEFUL TECHNIQUE IN GERIATRICS: Older people are at high risk of dehydration. In common practice, oral intakes are often inadequate. Intravenous infusion may be difficult and may generate complications. Hypodermoclysis or subcutaneous infusion is a useful technique for the prevention or cure of moderate dehydration in the older subjects. MANY ADVANTAGES AND FEW RISKS: When it is used correctly (i.e. volume and type of solutions, aseptic conditions) and when its contraindications are respected (i.e. emergency situations), hypodermoclysis is a simple technique that is safe, effective and comfortable. It does not need intensive surveillance and can be used both at home or in an institution, thus avoiding hospitalization of older subjects. A TECHNIQUE THAT SHOULD BE DEVELOPED: The numerous advantages of hypodermoclysis in older patients should encourage its wider use in geriatrics. PMID:10636020

Dardaine, V; Ferry, M; Constans, T

314

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.

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

2014-01-01

315

Passive therapeutic gardens. A study on an inpatient geriatric ward.  

PubMed

A brief history of the link between horticultural activities and care of patients, particularly psychiatric patients, is reviewed in this article. Past research on both passive and active garden activities is examined in terms of physical and psychological benefits to patients. A passive garden intervention on an inpatient geriatric ward is described. Participants in this study were patients on a geriatric inpatient ward in a mid-sized regional hospital in New Zealand. Behavioral observations of patient movement on the ward were used to demonstrate the effects on patient behavior in response to the presence of the conservatory garden. Results showed a positive reaction to the conservatory, which was maintained 6 months after the initial plants were installed. The benefits of such garden installations are discussed, and areas for further research are outlined. Procedures, ethical concerns, and practical considerations of setting up such a conservatory on an inpatient ward are discussed. PMID:12765006

Pachana, Nancy A; McWha, J Lindsay; Arathoon, Maureen

2003-05-01

316

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

317

Characteristics of persons utilizing a geriatric psychiatry outpatient clinic.  

PubMed

Mental-health service utilization among elderly people has been shown to be low relative to younger age groups. This study was done to determine the current proportion of elderly persons served in a university-affiliated psychiatry outpatient clinic, and to better characterize elderly patients who receive specialized mental-health care in this setting. The proportion of visits from elderly patients (aged 60 and over) was found to be 16%. Demographic and clinical characteristics of a sample of 140 consecutive geriatric patients evaluated at the clinic were obtained. The data revealed that the patients had a mean age of 74.7+/-7.5 (SD) years, and were mostly female (72.1%) and white (78.6%). Surprisingly, the age distribution was found to be bell shaped, with a small upper tail. The three most prevalent psychiatric diagnoses were depression (56.4%), dementia (35.7%), and substance use disorder (20%). Overall, 59.3% of geriatric patients had a history of prior psychiatric treatment. Females were significantly more likely than males to have a psychiatric history (69.3% vs. 33.3%, P = .0001). Among patients with a psychiatric history, females were more likely to have a current diagnosis of major depression (P = .0006), while males were more likely to have a current substance use disorder (P = .03). The prevalence of dementia increased with each successive decade above 60, while the occurrence of bipolar and adjustment disorders was confined to younger geriatric patients. Elderly patients receiving psychiatric treatment in the clinic thus formed a heterogeneous group. Gender, age, and presence of a psychiatric history were all associated with differences in prevalence and distribution of various mental disorders in this geriatric psychiatry outpatient clinic. PMID:9453678

Holroyd, S; Duryee, J J

1997-10-01

318

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

319

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

320

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

321

Reliability of drug histories in a specialized geriatric outpatient clinic  

Microsoft Academic Search

To examine the reliability of drug histories of elderly outpatients, records of 122 frail elderly patients in a geriatric\\u000a outpatient evaluation clinic were reviewed. Drug histories were taken by an internist during an initial clinical evaluation\\u000a and by a nurse practitioner during a home visit. Home and office drug lists disagreed in 39 cases (32%). Roughly equal numbers\\u000a of “extra”

J. Edward Jackson; Joe W. Ramsdell; Marian Renvall; Joanne Swart; Harold Ward

1989-01-01

322

Geriatric hip fracture clinical pathway: the Hong Kong experience  

PubMed Central

Geriatric hip fracture is one of the commonest fractures in orthopaedic trauma. There is a trend of further increase in its incidence in the coming decades. Besides the development of techniques and implants to overcome the difficulties in fixation of osteoporosis bone, the general management of the hip fracture is also very challenging in terms of the preparation of the generally poorer pre-morbid state and complicate social problems associated with this group of patients. In order to cope with the increasing demand, our hospital started a geriatric hip fracture clinical pathway in 2007. The aim of this pathway is to provide better care for this group of patients through multidisciplinary approach. From year 2007 to 2009, we had managed 964 hip fracture patients. After the implementation of the pathway, the pre-operative and the total length of stay in acute hospital were shortened by over 5 days. Other clinical outcomes including surgical site infection, 30 days mortality and also incidence of pressure sore improved when compared to the data before the pathway. The rate of surgical site infection was 0.98%, and the 30 days mortality was 1.67% in 2009. The active participation of physiotherapists, occupational therapists as well as medical social workers also helped to formulate the discharge plan as early as the patient is admitted. In conclusion, a well-planned and executed clinical pathway for hip fracture can improve the clinical outcomes of the geriatric hip fractures.

Leung, F.; Siu, D.; Wong, G.; Luk, K. D. K.

2010-01-01

323

Cadaver treasure hunt: introducing geriatrics concepts in the anatomy class.  

PubMed

The objective of this study was to develop an educational program introducing geriatrics to medical students during anatomy. Observational study of an educational intervention in medical school was the design utilized. First-year medical students in an anatomy laboratory were participants. The program consists of a lecture and a workshop. First, a geriatrics lecture early in the course presents demographic data on the cadavers, followed by comparison with national data on leading causes of death. Second, there is a "treasure hunt" in the anatomy laboratory conducted by geriatricians. Each geriatrician spends 45 minutes with one-four-student cadaver group at a time, reviewing anatomical findings and facilitating a discussion of clinical correlations and implications. A list of common anatomical findings, aging- and disease-related, is distributed to the students as an aid in identifying findings of interest. Students have been surprised to learn that the mean age of the 24 cadavers exceeded 80 years (mean 81, median 85 for 2 years), and that causes of death mirrored national data. The students begin understanding aging and appreciate the valuable resource of cadavers. The students acquire a new holistic perspective regarding their cadavers that is not apparent during the dissections. Students and faculty find the experience valuable in understanding the interplay of disease and aging. Evaluations have been mostly positive (82-87% positive responses). The anatomy lecture and "treasure hunt" experience are unique strategies for using cadavers to introduce geriatrics principles into the medical school. PMID:22568595

McNicoll, Lynn; Fulton, Ana Tuya; Ritter, Dale; Besdine, Richard W

2012-05-01

324

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.

Kessler, Elizabeth R.

2014-01-01

325

An Etiologic Profile of Anemia in 405 Geriatric Patients  

PubMed Central

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.

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

2014-01-01

326

Geriatric palliative care: do medical students' narrative reflections after a hospice clinical experience link to geriatric competencies?  

PubMed

Since the Association of American Medical Colleges geriatric competencies were released, educators are striving to incorporate them into medical student curricula. The purpose of this study is to examine medical students' reflections after an interdisciplinary, hospice staff-precepted clinical experience, and whether these reflections relate to the geriatric competencies which focus on palliative care. From July 2010 to June 2011, 155 2nd- and 3rd-year medical students participated in a required, half-day hospice experience, with 120 (77%) submitting narrative reflections for analysis. The narratives were analyzed using the constant comparative method associated with grounded theory, followed by consensus-building in an iterative process, to identify themes. Six themes were identified from the analysis of student narratives: demonstrating a new or expanded knowledge of hospice care (79%, 95/120), developing new insights about self and others (74%, 89/120), changing attitudes toward hospice care (63%, 76/120), linking patient needs with appropriate team members (43%, 52/120), understanding patient goals of care (43%, 51/120), and discussing palliative care as a treatment option (27%, 32/120). The authors conclude that a brief, interdisciplinary, hospice staff-precepted clinical experience is an effective model to inspire medical students to reflect on geriatric palliative care. Students clearly reflected on the geriatric palliative care competencies of symptom assessment and management, and gained insight into the role of the hospice team members and how hospice care can be a positive treatment option. Future educators should think about building on this type of high impact learning experience, and developing items to measure application of knowledge gained. PMID:23972213

Corcoran, Amy M; True, Gala; Charles, Natasha; Margo, Katherine L

2013-01-01

327

A Multidisciplinary Allied Health Faculty Team: Formation and First Year Production of Problem-Based Learning in Gerontology/Geriatrics.  

ERIC Educational Resources Information Center

Describes how a multidisciplinary team developed problem-based cases related to older adults for allied health students to explore gerontology/geriatrics issues in the Mid-Atlantic Allied Health Geriatric Education Center. (SK)

Silver, Sylvia

1998-01-01

328

Diabetes Medicines  

MedlinePLUS

... choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends on your type of diabetes, ... pills. Combination pills contain two kinds of diabetes medicine in one tablet. Some people take pills and ...

329

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

330

COPD Medicine  

MedlinePLUS

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

331

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.

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

2012-01-01

332

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

333

A Structured Curriculum for an Undergraduate Elective Clerkship in Pediatric Nephrology  

ERIC Educational Resources Information Center

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

Rauch, Jerome S.; Schwartz, M. William

1977-01-01

334

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

ERIC Educational Resources Information Center

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

Vu, Nu V.; And Others

1981-01-01

335

Is Dental Education in Step with Current Geriatric Health Promotion Initiatives?  

ERIC Educational Resources Information Center

Several recent national initiatives by both professional associations and public agencies provide measurable health objectives and suggestions for educational activities in geriatric oral health promotion. These can be used to evaluate current educational programs in geriatric dentistry and to plan programs and health promotion activities to meet…

Dolan, Teresa A.

1992-01-01

336

Outcomes of Continuous Process Improvement of Nutritional Care Program Among Geriatric Units  

Microsoft Academic Search

Background. Up to 65% of elderly patients are protein-calorie undernourished at admission or acquire nutritional def- icits while hospitalized. The aims of this project were: (a) to assess the quality of care concerning nutrition among Belgian geriatric units, (b) to include more routinely nutritional assessments and interventions in comprehensive geriatric assess- ment, and (c) to assess the impact of nutritional

Thierry Pepersack

2005-01-01

337

Corrected QT Intervals in Newly Admitted Geriatric Psychiatric Patients: An Examination of Risk Factors  

Microsoft Academic Search

Objectives: The primary objective of this study was to determine the incidence of prolonged corrected QT (QTc) intervals in a population of geriatric psychiatry inpatients. Our secondary objective was to examine the associations between prolonged QTc intervals and risk factors identified as determinants in prolonging the QTc interval. Methods: We identified all geriatric patients (aged 60 years and older) who

Jane Dumontet; Rhonda Malyuk; Gary Kiang; Ric M Procyshyn

338

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

339

The Effect of Dental Geriatric Curricula on Attitudes toward the Elderly.  

ERIC Educational Resources Information Center

A study of recent dental school graduates' attitudes toward the elderly suggests that those attitudes may have little to do with formal dental curriculum elements in geriatric dentistry, and that newly trained professionals' attitudes do not differ greatly from those of professionals trained before geriatric dental curriculum was widespread. (MSE)

Mann, Jonathan; And Others

1988-01-01

340

The Development of Geriatric Curricula in U.S. Dental Schools, 1979-1984.  

ERIC Educational Resources Information Center

A 1984 survey of dental schools was compared with a 1979 survey showing an increase in the teaching of geriatric dentistry. Factors associated with the establishment of a course were that the school was located in a state with a large geriatric population and financial assistance for patients was available. (Author/MLW)

Beck, James D.; Ettinger, Ronald L.

1987-01-01

341

9 CFR 381.157 - Canned boned poultry and baby or geriatric food.  

Code of Federal Regulations, 2010 CFR

...2000-01-01 2000-01-01 false Canned boned poultry and baby or geriatric food. 381.157 Section 381.157 Animals...Identity or Composition § 381.157 Canned boned poultry and baby or geriatric food. (a) Canned boned poultry shall,...

2000-01-01

342

9 CFR 381.157 - Canned boned poultry and baby or geriatric food.  

Code of Federal Regulations, 2010 CFR

...1998-01-01 1998-01-01 false Canned boned poultry and baby or geriatric food. 381.157 Section 381.157 MANDATORY...Identity or Composition § 381.157 Canned boned poultry and baby or geriatric food. (a) Canned boned poultry...

1998-01-01

343

9 CFR 381.157 - Canned boned poultry and baby or geriatric food.  

Code of Federal Regulations, 2010 CFR

...1999-01-01 1999-01-01 false Canned boned poultry and baby or geriatric food. 381.157 Section 381.157 FOOD...Identity or Composition § 381.157 Canned boned poultry and baby or geriatric food. (a) Canned boned poultry shall,...

1999-01-01

344

9 CFR 381.157 - Canned boned poultry and baby or geriatric food.  

Code of Federal Regulations, 2010 CFR

...1997-01-01 1997-01-01 false Canned boned poultry and baby or geriatric food. 381.157 Section 381.157 MANDATORY...Identity or Composition § 381.157 Canned boned poultry and baby or geriatric food. (a) Canned boned poultry...

1997-01-01

345

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

346

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

347

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

348

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

349

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

350

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

351

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

352

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

353

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

354

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

355

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

356

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

357

Yogic practice and diabetes mellitus in geriatric patients  

PubMed Central

Background: Stress has negative effect on health and type 2 diabetes patients may be at an increased risk. Abnormally high levels of free radicals and the simultaneous decline of antioxidant defense mechanisms can increase lipid peroxidation and insulin resistance. The objective of the present study was to demonstrate the efficacy of yogic practice in geriatric patients with type 2 diabetes mellitus and also to compare the efficacy with the state of glycaemic control. Materials and Methods: Seventy three (73) healthy elderly patients of type 2 diabetes mellitus in the age group of 60 to 70 years with a history of diabetes for 5 to 10 years and with poor glycaemic control (HbA1c >8 %) residing in Kozhikode district were recruited for the study. The subjects were divided into three groups according to their glycaemic control. Group I with HbA1c 8.6–9.7 %, group II with HbA1c 9.8–10.7 % and group III with HbA1c 10.8–12.7 %. Participants did yogic practice under the supervision of experienced trainer, daily 90 minutes and for three months. Biochemical estimation of HbA1c, glucose, lipid profile, cortisol, ferritin, malondialdehyde (MDA) and catalase activity were carried out on 0 day and 90th day. Seventy patients participated in a comparable control session. Results: The participants in the test group showed statistically significant (P < 0.001) decrease in glucose, HbA1c, lipids, cortisol, ferritin, MDA and significant increase in catalase activity after yogic practice. Conclusions: Yoga may improve risk profiles induced by stress in geriatric patients with type 2 diabetes and may have promise for the prevention or delay in diabetes complications. And at all stages of the disease a significant improvement can be achieved by yogic practice in geriatric diabetes.

Beena, Rani K; Sreekumaran, E

2013-01-01

358

[Estimating length of stay of geriatric rehabilitation patients].  

PubMed

The aim of the study was to identify the most influential predictors of length of stay (LOS) among data, which are usually available on admission in geriatric rehabilitation units, such as diagnosis, functional limitations, age, gender, or marital status. Datasets of 6740 consecutive patients of a geriatric rehabilitation clinic have been retained for the analysis. As the density distribution of the LOS was grouped in intervals of 0-4, 4-6, 6-8 and 8 weeks and more, separate multivariate logistic regression models have been tested for the four intervals of LOS as well as for each of the four intervals separately. Some functional limitations on admission are significantly associated with longer LOS: limitations in dressing are associated with LOS of 6-8 weeks (OR = 1.47; CI = 1.32-1.65), and limitations in using the toilet are associated with LOS of 8 weeks and more (OR = 3.50; CI = 2.98-4.10). Shorter LOS of 0 to 4 weeks are significantly predicted by being respectively married (OR = 1.52; CI = 1.37-1.68), 75 years old and alder (OR = 1.29; CI = 1.16-1.43) or having a femur fracture (OR = 1.45; CI = 1.22-1.73). Single ADL-limitations such as in using the toilet or in dressing have a high predictivity of the LOS. Married patients and older patients are discharged earlier. Social characteristics like those subsumated under age or marital status seem to play a more important role as expected in determining the LOS in geriatric rehabilitation patients. PMID:12219708

Lalu, R E; Schmitz-Scherzer, R

2002-06-01

359

[Practical guideline for nutritional care in geriatric institutions].  

PubMed

Malnutrition is widespread in geriatric patients, but often unrecognized and untreated. The main barriers against implementation of adequate nutritional care are seen in low nutritional awareness, lack of knowledge, interest and responsibilities but also in established procedures and lack of standard protocols for nutritional screening and therapy. It is, thus, the aim of the present publication to provide a comprehensive, practice oriented guideline for quality assurance of nutritional care of elderly people in geriatric institutions. The guideline includes routine assessment of individual nutritional status as well as the planning and implementation of appropriate interventions and measurement of results. The guideline is aimed at the prevention and adequate treatment of weight loss and malnutrition and is composed of the following sections: 1) screening, 2) assessment, 3) definition of aims, 4) intervention, 5) monitoring with adaptation of aims and interventions, 6) planning of nutritional care after discharge. Appropriate interventions aim, on the one hand, at the elimination of underlying causes of malnutrition and, on the other hand, at adequate and sufficient dietary intake to meet the requirements. Dietetic, nursing and medical actions should be implemented in a coordinated manner in order to use all options to achieve the best nutritional care for each patient. As a prerequisite for high quality individual nutritional care, several basic conditions have to be established, e.g. appropriate supply of food and beverages to meet patient needs, well-organized caring processes during meals, willingness of all involved persons for interdisciplinary teamwork, and well-regulated responsibilities. This general guideline has to be adapted to the local conditions of each institution and consistently put into practice. For implementation of the guideline, a nutrition team with members of all relevant professions should be organized with regular meetings. In the long run, increasing nutritional awareness and established routines for adequate nutritional screening and therapy will enable high quality nutritional care of geriatric patients with manageable charges. PMID:18398632

Volkert, D

2009-04-01

360

Interdisciplinary collaboration in geriatrics: advancing health for older adults.  

PubMed

The call for interdisciplinary research, education, and practice is heightened by the recognition of the potential it holds in generating creative solutions to complex problems in health care and to improving quality and effectiveness of care. With the aging of the population and the complex issues in caring for older adults, interdisciplinary collaboration is particularly salient to the field of geriatrics. However, despite interest in this approach for several decades, adoption has been slow and dissemination is not widespread. This article provides examples of recent initiatives and presents driving and restraining forces involved in adoption of interdisciplinary approaches. PMID:21757083

Young, Heather M; Siegel, Elena O; McCormick, Wayne C; Fulmer, Terry; Harootyan, Linda K; Dorr, David A

2011-01-01

361

[Geriatric patients with chronic kidney insufficiency: which antalgia?].  

PubMed

Pain is a leading cause of office visits. In the geriatric population, it is known that the prevalence of renal failure increases exponentially with age, modifing the elimination of drugs and of their metabolites. What analgesia should be offered to these patients? The holy grail would be a medication without renal elimination, without toxic metabolites and without nephrotoxicity. Based on the literature we try to propose a specific approach to analgesia in older patients with kidney insufficiency, in order to help practitioners to better prescribe for this group of patients. PMID:24791426

Ionescu, M; Hemett, O M; Descombes, E; Blondel, N; Hayoz, D

2014-04-01

362

Cultural perspectives of meals expressed by patients in geriatric care.  

PubMed

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

Sidenvall, B; Fjellström, C; Ek, A C

1996-04-01

363

Investigations into geriatric psychiatry challenges: AAGP Senior Investigator Award 2000.  

PubMed

The author summarizes the American Association for Geriatric Psychiatry Senior Investigator Award presentation delivered at the 13th Annual Meeting March 12-15, 2000, in Miami Beach, Florida, and reviews his research studies that define a trajectory leading to investigations of early detection and prevention of Alzheimer's disease (AD). Themes and critical transitions that fostered the research are emphasized, and effective collaboration, mentoring, and timing are discussed. These studies have combined neuroimaging and genetic methods to identify subjects before they develop AD, so that interventions might delay dementia onset. The eventual goal is to translate the clinical research discoveries into modern clinical practice. PMID:11069266

Small, G W

2000-01-01

364

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

365

Accidental Falls Among Geriatric Patients: Can More Be Prevented?  

PubMed Central

The potential for accidental falls among geriatric patients is of mounting concern. Two hundred forty-one accidental falls over a 12-month period at the VA Medical Center were analyzed retrospectively and the literature reviewed in order to highlight factors that have bearing on the incidence and severity of falls. If a patient's potential for falling could be identified through a grading system based on these premonitory features, preventive measures might be more clearly focused where needed to reduce this frequent hazard in our hospital population.

Johnson, Edwin T.

1985-01-01

366

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

PubMed

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

Grünberg, Jose

2010-03-01

367

Rationale and methods of the multicenter randomised trial of a heart failure management programme among geriatric patients (HF-Geriatrics)  

PubMed Central

Background Disease management programmes (DMPs) have been shown to reduce hospital readmissions and mortality in adults with heart failure (HF), but their effectiveness in elderly patients or in those with major comorbidity is unknown. The Multicenter Randomised Trial of a Heart Failure Management Programme among Geriatric Patients (HF-Geriatrics) assesses the effectiveness of a DMP in elderly patients with HF and major comorbidity. Methods/Design Clinical trial in 700 patients aged ? 75 years admitted with a primary diagnosis of HF in the acute care unit of eight geriatric services in Spain. Each patient should meet at least one of the following comorbidty criteria: Charlson index ? 3, dependence in ? 2 activities of daily living, treatment with ? 5 drugs, active treatment for ? 3 diseases, recent emergency hospitalization, severe visual or hearing loss, cognitive impairment, Parkinson's disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), anaemia, or constitutional syndrome. Half of the patients will be randomly assigned to a 1-year DMP led by a case manager and the other half to usual care. The DMP consists of an educational programme for patients and caregivers on the management of HF, COPD (knowledge of the disease, smoking cessation, immunizations, use of inhaled medication, recognition of exacerbations), diabetes (knowledge of the disease, symptoms of hyperglycaemia and hypoglycaemia, self-adjustment of insulin, foot care) and depression (knowledge of the disease, diagnosis and treatment). It also includes close monitoring of the symptoms of decompensation and optimisation of treatment compliance. The main outcome variables are quality of life, hospital readmissions, and overall mortality during a 12-month follow-up. Discussion The physiological changes, lower life expectancy, comorbidity and low health literacy associated with aging may influence the effectiveness of DMPs in HF. The HF-Geriatrics study will provide direct evidence on the effect of a DMP in elderly patients with HF and high comorbidty, and will reduce the need to extrapolate the results of clinical trials in adults to elderly patients. Trial registration (ClinicalTrials.gov number, NCT01076465).

2011-01-01

368

Chronic Diseases in Captive Geriatric Female Chimpanzees (Pan troglodytes)  

PubMed Central

The current aging population of captive chimpanzees is expected to develop age-related diseases and present new challenges to providing their veterinary care. Spontaneous heart disease and sudden cardiac death are the main causes of death in chimpanzees (especially of male animals), but little is known about the relative frequency of other chronic diseases. Furthermore, female chimpanzees appear to outlive the males and scant literature addresses clinical conditions that affect female chimpanzees. Here we characterize the types and prevalence of chronic disease seen in geriatric (older than 35 y) female chimpanzees in the colony at Alamogordo Primate Facility. Of the 16 female chimpanzees that fit the age category, 87.5% had some form of chronic age-related disease. Cardiovascular-related disease was the most common (81.25%) followed by metabolic syndrome (43.75%) and renal disease (31.25%). These data show the incidence of disease in geriatric female chimpanzees and predict likely medical management challenges associated with maintaining an aging chimpanzee population.

Nunamaker, Elizabeth A; Lee, D Rick; Lammey, Michael L

2012-01-01

369

[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

370

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

371

Where does research occur in geriatrics and gerontology?  

PubMed

The International Plan of Action on Aging 2002 emphasized the need to promote and develop research on aging, especially in underdeveloped countries. This article aims at describing the current situation with regard to the international scientific production in the field of geriatrics and gerontology. All articles published in journals included in the categories "Geriatrics and Gerontology" of the Science Citation Index or "Gerontology" of the Social Science Citation Index in 2002 were analyzed. There is unquestionable predomination by the United States, which participates in 53.8% of the articles analyzed, followed by the United Kingdom (9.66%) and Canada (6.66%). The production of the 15 European Union countries together is 31.2%. When adjustments are made for economic or population factors, other countries show their importance: Israel and Sweden, for example. Authors from richer countries participate in more than 95% of the articles, whereas those in less-developed countries tend to publish less, and when they do so, it is through collaboration with more-developed countries. In general, only 10.5% of the articles are written in collaboration with institutions from different countries. One of the keys to stimulating research in less wealthy countries would seem to be precisely through collaboration. This would aid the transfer of knowledge and experience, allowing researchers in these countries to obtain autonomy to perform their own studies independently and to provide them with the ability to gain access for their publications at the international level. PMID:15935034

Navarro, Albert; Lynd, Frances E

2005-06-01

372

Geriatric Workforce Capacity: A Pending Crisis for Nursing Home Residents  

PubMed Central

Introduction: The nursing home (NH) population in the US has grown to 1.6 million people and is expected to double by 2030. While 88.3% of NH residents are over 65, the elders aged 85 and more have become the principal group. This demographic change has increased the already high rates of chronic diseases and functional disabilities in NH residents. Methods: This study reviewed the supply of geriatricians in addressing the growing healthcare needs of NH residents. Results: English-written articles between 1989 and 2012 were reviewed. Trend data demonstrate that the geriatrician workforce has decreased from 10,270 in 2000 to 8,502 in 2010. Further, the pipeline analysis of physicians projected to receive board certification in geriatrics (and maintain this certification) indicates a worsening of the already insufficient supply of geriatricians for this vulnerable population. Conclusion: Strategies to attract and maintain a geriatrician workforce are imperative to avert a mounting crisis in the geriatric care in NH and, by extension, other living settings.

Lee, Wei-Chen; Sumaya, Ciro V.

2013-01-01

373

[Diagnosis of osteoporosis in geriatric patients - possibilities and limitations].  

PubMed

Osteoporosis with its increased risk of low-trauma fractures has to be regarded as a disorder with significant influence on quality of life, increased morbidity and mortality in the elderly. Therapies of osteoporosis, in particular drug therapies aiming to reduce the fracture risk, are in general only initiated after diagnostic procedures prior to the start of osteoporosis therapy. Consequently, diagnosis of osteoporosis plays a key role in optimized patient care and management. Medical history, physical examination, planar X-ray, osteodensitometry and a range of laboratory parameters make up the key steps in the diagnostic work up of osteoporosis. In some clinical settings such as the investigation of possible occult fractures after falls, additional imaging methods including computed tomography, magnetic resonance imaging, and bone scintigraphy may be necessary to make up adequate diagnosis. However, it has to be questioned in which way all these diagnostic investigations can be effectively used in the diagnostic work up of geriatric patients. The article will give an overview of the different diagnostic methods with their possibilities and limitations and will present possible diagnostic work flows based on frequent clinical settings seen in geriatric patients. PMID:21956551

Mikosch, Peter

2012-03-01

374

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

PubMed Central

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

Epstein, Nancy E.

2011-01-01

375

[Community aspects of geriatric dentistry--a literature review: 1975-2000].  

PubMed

The world's population is in transition, but there is an inevitable move in all societies towards an aging population. There is an agreement that the ability of the geriatric population to adjust to the "third age" depends on the will of the society and the community to provide services and to support this vulnerable and dependent population. The preponderance of oral health issues and their impact upon general health and quality of life have prompted a variety of geriatric related efforts over the last 20 years. Predoctoral and postdoctoral education and training efforts have been initiated, geriatric research agendas have started to yield important findings, and a few service programs have marginally helped improve dental care access for the geriatric population. Past discoveries have enabled large portions of the world's population to enjoy far better oral health than their forebears a century ago. Although different patterns of dental needs emerge throughout the world, the "silent epidemic" of oral diseases is affecting the most vulnerable parts of the population: the poor children, the elderly and many members of racial and ethnic minority groups. The review of the literature of community aspects of geriatric dentistry in the past twenty-five years will be introduced in two articles. The first article summarizes the important issues of demography, oral health condition, changes in attitude towards oral health of the geriatric population, oral health services given in geriatric institutions and mobile dentistry. The issues of law and ethics, development of public and community oral health programs for the geriatric population and plans as well as trends for the future will be discussed in the second article. Setting goals and presenting data are steps in the right direction but are not enough; the success will be measured by the ability to make things happen. The continuing anticipated growth of the geriatric population will, hopefully, be translated into a rising political power and to fruitful and practical health outcomes. PMID:16323405

Vered, Y; Adut, R

2005-07-01

376

[Community aspects of geriatric dentistry--a literature review: 1975 - 2000].  

PubMed

The world's population is in transition, but there is an inevitable move in all societies towards an aging population. There is an agreement that the ability of the geriatric population to adjust to the "third age" depends on the will of the society and the community to provide services and to support this vulnerable and dependent population. The preponderance of oral health issues and their impact upon general health and quality of life have prompted a variety of geriatric related efforts over the last 20 years. Predoctoral and postdoctoral education and training efforts have been initiated, geriatric research agendas have started to yield important findings, and a few service programs have marginally helped improve dental care access for the geriatric population. Past discoveries have enabled large portions of the world's population to enjoy far better oral health than their forebears a century ago. Although different patterns of dental needs emerge throughout the world, the" silent epidemic" of oral diseases is affecting the most vulnerable parts of the population: the poor children, the elderly and many members of racial and ethnic minority groups. The review of the literature of community aspects of geriatric dentistry in the past twenty five years will be introduced in two articles. The first article summarizes the important issues of demography, oral health condition, changes in attitude towards oral health of the geriatric population, oral health services given in geriatric institutions and mobile dentistry. The issues of law and ethics, development of public and community oral health programs for the geriatric population and plans as well as trends for the future will be discussed in the second article. Setting goals and presenting data are steps in the right direction but are not enough; the success will be measured by the ability to make things happen. The continuing anticipated growth of the geriatric population will, hopefully, be translated into a rising political power and to fruitful and practical health outcomes. PMID:16599325

Vered, Y; Adut, R

2005-10-01

377

Geriatric pharmacology and pharmacotherapy education for health professionals and students: a systematic review  

PubMed Central

AIMS Given the reported high rates of medication errors, especially in elderly patients, we hypothesized that current curricula do not devote enough time to the teaching of geriatric pharmacology. This review explores the quantity and nature of geriatric pharmacology education in undergraduate and postgraduate curricula for health professionals. METHODS Pubmed, Embase and PsycINFO databases were searched (from 1 January 2000 to 11 January 2011), using the terms ‘pharmacology’ and ‘education’ in combination. Articles describing content or evaluation of pharmacology education for health professionals were included. Education in general and geriatric pharmacology was compared. RESULTS Articles on general pharmacology education (252) and geriatric pharmacology education (39) were included. The number of publications on education in general pharmacology, but not geriatric pharmacology, has increased over the last 10 years. Articles on undergraduate and postgraduate education for 12 different health disciplines were identified. A median of 24 h (from 15 min to 4956 h) devoted to pharmacology education and 2 h (1–935 h) devoted to geriatric pharmacology were reported. Of the articles on education in geriatric pharmacology, 61.5% evaluated the teaching provided, mostly student satisfaction with the course. The strength of findings was low. Similar educational interventions were not identified, and evaluation studies were not replicated. CONCLUSIONS Recently, interest in pharmacology education has increased, possibly because of the high rate of medication errors and the recognized importance of evidence-based medical education. Nevertheless, courses on geriatric pharmacology have not been evaluated thoroughly and none can be recommended for use in training programmes. Suggestions for improvements in education in general and geriatric pharmacology are given.

Keijsers, Carolina J P W; van Hensbergen, Larissa; Jacobs, Lotte; Brouwers, Jacobus R B J; de Wildt, Dick J; ten Cate, Olle Th J; Jansen, Paul A F

2012-01-01

378

Family Medicine.  

National Technical Information Service (NTIS)

The role, functions, and potential of family medicine are examined in a discussion drawing on observations of the University of Rochester Family Medicine Program at Highland Hospital, Rochester, New York. The discussion opens with a review of the factors ...

P. S. Warren

1970-01-01

379

Alternative Medicine  

MedlinePLUS

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

380

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.

381

Osteopathic Medicine: About Osteopathic Medicine  

MedlinePLUS

... Advancing the distinctive philosophy and practice of osteopathic medicine Inside the AOA About the AOA AOA Membership ... DOs Licensed? How Are DOs Certified? About Osteopathic Medicine Page Content You are more than just the ...

382

[Evolutionary medicine].  

PubMed

Evolutionary medicine allows new insights into long standing medical problems. Are we "really stoneagers on the fast lane"? This insight might have enormous consequences and will allow new answers that could never been provided by traditional anthropology. Only now this is made possible using data from molecular medicine and systems biology. Thereby evolutionary medicine takes a leap from a merely theoretical discipline to practical fields - reproductive, nutritional and preventive medicine, as well as microbiology, immunology and psychiatry. Evolutionary medicine is not another "just so story" but a serious candidate for the medical curriculum providing a universal understanding of health and disease based on our biological origin. PMID:24343183

Wjst, M

2013-12-01

383

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

384

Pelvic radiation therapy for gynecologic malignancy in geriatric patients  

SciTech Connect

Thirty-one patients, aged 75 years or older, who received pelvic radiation therapy as part of primary treatment for a gynecologic malignancy, were reviewed. Ten patients (32%) failed to complete their treatment and 4 patients (13%) died of treatment-related complications. The treatment-related complications were independent of increasing age, but did correlate closely with the patients' pretreatment ECOG performance status. Ten patients with performance levels of 2 or higher had a mortality rate of 30%, while 70% failed to complete treatment. Treatment fractions of greater than 220 cGy per day also resulted in unacceptably high complication rates. Alternative treatment formats should be considered in geriatric patients with poor initial performance levels.

Grant, P.T.; Jeffrey, J.F.; Fraser, R.C.; Tompkins, M.G.; Filbee, J.F.; Wong, O.S.

1989-05-01

385

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

386

The use and characteristics of elderspeak in Swedish geriatric institutions.  

PubMed

The aim of this study is to investigate the occurrence of elderspeak in a Swedish context and to describe its characteristics. Elderspeak refers to adjustments made in communication with elderly people; adjustments similar to those made in interaction with infants. Previous findings show that adjustments of communication are made within several linguistic domains, and are a part of the communicative environment of elderly people. Five people working in different forms of geriatric institutions participated in this study, and data consist of recordings of interactions between caregivers and residents (without dementia) and interactions between caregivers and colleagues. The recordings were transcribed and analyzed by means of perceptual, semantic and acoustic analyses. The findings demonstrate that caregivers, to a varying extent, adjusted their communication within several linguistic domains. The adjustments were mainly made within the prosodic domain, but there were also adjustments made within other language domains. PMID:23806132

Samuelsson, Christina; Adolfsson, Elin; Persson, Hanna

2013-08-01

387

Geriatric education centers address medication issues affecting older adults.  

PubMed Central

Serious problems have been identified in the prescribing of medications for elderly patients and use of prescription and nonprescription drugs by older persons. Overuse, underuse, and inappropriate use of drugs by the elderly have been widely documented, and the harmful consequences have been described. This paper reviews information concerning the need for action to improve health professionals' knowledge and skills with respect to drugs and the elderly and activities being undertaken by geriatric education centers (GECs) to enhance these capacities. Grant support for the centers from the Health Resources and Services Administration, a Public Health Service component agency, began in 1983. In fiscal year 1992 there are 31 centers operating in 26 States. The centers are multi-institutional and conduct four types of educational activities. These include review of pharmacological issues for multidisciplinary groups, specialized training for pharmacists, discipline-specific programs focusing on medication issues, and activities aimed at educating the public. Examples of the GECs' educational activities are given.

Kahl, A; Blandford, D H; Krueger, K; Zwick, D I

1992-01-01

388

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.

389

Recent Advances in Neuroimaging Biomarkers in Geriatric Psychiatry  

PubMed Central

Neuroimaging, both structural and functional, serve as useful adjuncts to clinical assessment, and can provide objective, reliable means of assessing disease presence and process in the aging population. In the following review we briefly explain current imaging methodologies. Then, we analyze recent developments in developing neuroimaging biomarkers for two highly prevalent disorders in the elderly population- Alzheimer's disease (AD) and late-life depression (LLD). In AD, efforts are focused on early diagnosis through in vivo visualization of disease pathophysiology. In LLD, recent imaging evidence supports the role of white matter ischemic changes in the pathogenesis of depression in the elderly, the “vascular hypothesis.” Finally, we discuss potential roles for neuroimaging biomarkers in geriatric psychiatry in the future.

Khandai, Abhisek C.; Aizenstein, Howard J.

2013-01-01

390

Adherence to recommendations of community-based comprehensive geriatric assessment programmes  

Microsoft Academic Search

Background: non-adherence to the recommendations of short-term community-based consultative comprehen- sive geriatric assessment programmes is a threat to the effectiveness of these programmes. Objective: to synthesize the literature on patient and physician adherence to recommendations of community- based comprehensive geriatric assessment programmes. Method: I identified papers cited by an English language literature search of MEDLINE, Health Star and CINAHL databases

FARANAK AMINZADEH

2000-01-01

391

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

392

[Medicine and humanism: clinical ethics and the community dimension of geriatrics].  

PubMed

Clinical ethics is generally related to the clinical bedside activity. Clinical ethics constitutes one aspect of bioethics. In particular, its aim consists in facilitating the solving of conflicts of values in practical care. By encouraging effective communication and discussion within the interdisciplinary team, geriatricians will be able to make adequate diagnostic and therapeutic interventions, in accordance with the fundamental desire of the patient and her or his family. PMID:9894427

Forest, M I; Olmari-Ebbing, M; Bizon, M; Malacrida, R; Loew, F; Rapin, C H

1998-12-01

393

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

PubMed Central

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 community geriatrics clinic. We made our assessments by using two manual muscle tests, a timed-gait test, a modified Physical Performance Test (mPPT), and the Kohlman Evaluation of Living Skills (KELS). Results Participants in the self-neglect group had impaired mPPT (p < .077) and KELS (p < .001) scores compared with community-controls. Using analysis of covariance models, we found that self-neglect referral explained a significant proportion of the variance in KELS scores (32%; p < .001) but not in mPPT scores (22%; p = .49). Implications The geriatric syndrome of self-neglect is associated with increased morbidity and mortality and appears to be independently associated with impairments in instrumental activities of daily living. The evaluation and treatment of geriatric self-neglect should be consistent with that of other geriatric syndromes.

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

2010-01-01

394

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

395

Management of the elderly patient with gynecologic cancer: report of the 2011 workshop in geriatric gynecologic oncology.  

PubMed

Reflecting the worldwide aging trend and close association of aging with cancer, geriatric oncology is now growing beyond its pioneer years. Nevertheless, geriatric oncology in the gynecologic field is in the beginning stage; indeed, there is no geriatric specialist who is trained in this particular field of gynecologic oncology. Therefore, we held the first workshop in geriatric gynecologic oncology. In this review, we summarize what we discussed at the workshop and provide evidence-based recommendations for the diagnosis and treatment of gynecologic cancer in elderly individuals. PMID:22080887

Suh, Dong Hoon; Kang, Sokbom; Lim, Myong Cheol; Lee, Taek Sang; Park, Jeong-Yeol; Kim, Tae-Joong; Kim, Jee Hyun; Lee, Kwang-Beom; Park, Dong Choon; Chung, Hyun Hoon; Kim, Kidong; Seo, Sang-Soo; Kim, Hak Jae; Kim, Mi-Kyung; Ju, Woong; Kim, Jae Weon; Lichtman, Stuart M; Park, Sang-Yoon

2012-01-01

396

Cough Medicines  

NSDL National Science Digital Library

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

Science Update;

2004-08-16

397

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

398

Aerospace Medicine  

NASA Technical Reports Server (NTRS)

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

Davis, Jeffrey R.

2006-01-01

399

Managing constipation: implementing a protocol in a geriatric rehabilitation setting.  

PubMed

HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at https://villanova.gosignmeup.com/dev_students.asp?action=browse&main=Nursing+Journals&misc=564. To obtain contact hours you must: 1. Read the article, "Managing Constipation: Implementing a Protocol in a Geriatric Rehabilitation Setting" found on pages 18-27, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until July 31, 2016. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Identify common reasons for high constipation rates among hospitalized older adults. 2. Describe outcomes of implementing a Constipation Management Protocol (CMP) within a hospital setting. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. This study examined the effect of implementing a constipation management protocol (CMP) within a geriatric rehabilitation setting. A convergent mixed-methods research design was used. Quantitative data on bowel activity, laxative use, opiate drug use, and nursing documentation regarding bowel care were gathered through a review of health records for 305 patients admitted to three geriatric rehabilitation units before (n = 137) and after (n = 168) protocol implementation over two 3-month periods. Focus groups were conducted examining nursing staff's experiences with such a protocol. Findings revealed that although implementation of the CMP did not reduce constipation rates among older patients, the average number of incidences of constipation per patient was reduced after implementation of the protocol. More importantly, it resulted in more due diligence by staff regarding patients' bowel patterns as well as improved bowel care documentation. Findings and recommendations extend current literature and have practical implications for nurses interested in improving management of patients' bowel care. [Journal of Gerontological Nursing, 40(8), 18-27.]. PMID:24804648

Klein, Jennifer; Holowaty, Sandra

2014-08-01

400

Bioenergetic medicine.  

PubMed

Here we discuss a specific therapeutic strategy we call 'bioenergetic medicine'. Bioenergetic medicine refers to the manipulation of bioenergetic fluxes to positively affect health. Bioenergetic medicine approaches rely heavily on the law of mass action, and impact systems that monitor and respond to the manipulated flux. Since classically defined energy metabolism pathways intersect and intertwine, targeting one flux also tends to change other fluxes, which complicates treatment design. Such indirect effects, fortunately, are to some extent predictable, and from a therapeutic perspective may also be desirable. Bioenergetic medicine-based interventions already exist for some diseases, and because bioenergetic medicine interventions are presently feasible, new approaches to treat certain conditions, including some neurodegenerative conditions and cancers, are beginning to transition from the laboratory to the clinic. PMID:24004341

Swerdlow, Russell H

2014-04-01

401

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.

402

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.

Spiegel, D; Stroud, P; Fyfe, A

1998-01-01

403

How Much is Geriatric Caregivers Burnout Caring-Specific? Questions from a Questionnaire Survey  

PubMed Central

Summary: Background and Aims: Research dealing with occupational strain and burnout in geriatric care is generally focused on the behavioral problems of the patient and/or the psychological traits or attitudes of the carers rather than on organizational functionality. This paper describes data from a survey of all geriatric professions, using the Stressful Events Questionnaire (SEQ), a tool that takes into account multiple dimensions that can affect the genesis of burnout, including the patient, the geriatric health care professional, and the health care organization. The aim of this study is to compare patterns of answers among different roles in geriatric care. Method: Patterns of SEQ answers are described for the entire sample as well as for workers experiencing burnout and for each caring profession investigated: certified nursing assistants (CNAs), registered nurses and physicians/psychologists. Results; In general, carers refer more often as stressful the facility-related events; the only exception is that CNAs working in general hospital geriatric wards refer most often as stressful the patient-related events. The self-related events area seems to have a great importance for all professions. Discussion: The specificity of gerontological burnout has to be discussed, to better define the role played by caring problems, including psychological attitudes of carers versus the role played by the institution and by the social situation of each worker. For CNAs, the interaction between educational background and the length of time spent as a CNA seems to be a critical topic.

Cocco, Ennio

2010-01-01

404

Fractionated laser resurfacing corrects the inappropriate UVB response in geriatric skin  

PubMed Central

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

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

2012-01-01

405

Teaching, learning, and assessment in geriatric dentistry: researching models of practice.  

PubMed

Changing demography due to the increasing population of elderly persons the world over has raised new challenges in every sphere of life. The greatest challenge is to provide affordable, accessible, and equitable health care to this population. Oral health is an integral part of general health and affects physical and mental well-being and quality of life of elderly persons. To provide quality oral health care to the elderly, it is important to focus on education in geriatric dentistry, since it is known that education is closely linked to health care provision. It has been found that education in geriatric dentistry has wide variations in different parts of the world. Also, it is being taught at different levels: the predoctoral curriculum, postdoctoral certificate/diploma courses of varying duration by direct or distance mode using computer-assisted learning, degree courses of three years' duration, or continuing education programs. This article attempts to study geriatric dentistry education in global perspective. It is discussed in three sections: 1) varying concepts and methods of teaching, learning, and assessment in dental education; 2) status of geriatric dental education in developed and developing countries with emphasis on the Indian scenario; and 3) challenges and opportunities in developing geriatric dental education. PMID:20061526

Shah, Naseem

2010-01-01

406

A geriatric rehabilitation and assessment unit in a community hospital.  

PubMed

This report describes functional status at admission, discharge, and six months later for 100 elderly persons treated at a community hospital assessment and rehabilitation unit. The goal of the unit is to prevent institutionalization of frail elderly persons considered at risk for nursing home placement. Characteristics of the first 100 admissions include the following: average age, 79 years; female, 77 per cent; length of stay, 23 days; average number of admitting diagnoses, 3.4. Ninety-one new diagnoses of treatable conditions were made. On admission, 81 per cent of patients were confined to bed or chair or needed assistance with ambulation, compared with 27 per cent at discharge and 22 per cent at six months. Activities showing significant improvement include dressing, housekeeping, use of toilet, and ambulation. At six months, 15 per cent had died, 67 per cent were living in the community, and 19 per cent were institutionalized. It is concluded that care at the geriatric unit probably resulted in improved function and decreased nursing home placement. PMID:6833696

Applegate, W B; Akins, D; Vander Zwaag, R; Thoni, K; Baker, M G

1983-04-01

407

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

408

[Travel medicine].  

PubMed

Travel Medicine was inherited from Tropical Medicine and was organised around the development of intercontinental travels. It concerns all types of travellers, especially tourists, migrants and expatriates. It must be universal, scientific, but first of all preventive. Its aims to the information of all professionals concerned by health and tourism. Its goal is also the training of physicians and the education of travellers regarding their own responsibilities. PMID:7819786

Armengaud, M

1993-01-01

409

Filling the void in geriatric mental health: the Geropsychiatric Nursing Collaborative as a model for change.  

PubMed

Mental health for older adults is a looming public health problem. Yet, geriatric mental health specialists are a scarce commodity, and few generalists have had formal education in either geriatrics or mental health. A multilevel collaboration using a diffusion of innovation model served to achieve change nationally in preparing entry-and advanced practice-level nurses to improve the mental health of older Americans. The John A. Hartford Foundation Geropsychiatric Nursing Collaborative at the American Academy of Nursing is the exemplar described here. The Geropsychiatric Nursing Collaborative developed and infused mental health competency enhancements for generalist and specialist nurses; identified and disseminated teaching-learning strategies to convey related key concepts using the POGOe (Portal of Geriatric Online Education) website; raised awareness through multiple presentations and publications; and notified deans of every school of nursing about these new resources. Fully embracing diffusion of innovation principles, the Geropsychiatric Nursing Collaborative is achieving change in this critical area of nursing practice. PMID:21757081

Beck, Cornelia; Buckwalter, Kathleen C; Dudzik, Pamela M; Evans, Lois K

2011-01-01

410

Understanding dental students' knowledge and perceptions of older people: toward a new model of geriatric dental education.  

PubMed

Increasing numbers of older people and the decreasing rates of edentulism highlight the importance of dental education that focuses on oral health and aging. This evaluation study assessed dental students' knowledge and beliefs about older people as well as their awareness of the biopsychosocial concerns that are potential barriers to oral health care. Dental students' (N=202) knowledge and perceptions of older people were evaluated before and after the first year of a new educational program. Students completed the Palmore Facts on Aging Quiz II (FAQ II) and answered questions about health problems and social concerns that may influence patient care. The intervention was twofold: 1) the CARES (Counseling, Advocacy, Referral, Education, and Service) Program, a clinical collaboration between the schools of Dental Medicine and Social Work, was initiated; and 2) all students were exposed to geriatric educational interventions. FAQ II scores did not significantly change, but dental students' awareness of mental health, independence, and social concerns increased between Times 1 and 2. The results of the study suggest that positive interactions with older adults by health care providers may depend more on positive perceptions toward older people than increased knowledge about aging. Future research will focus on positive experiences with older adults and attitudes of dental students toward the elderly. PMID:15800255

Fabiano, Jude A; Waldrop, Deborah P; Nochajski, Thomas H; Davis, Elaine L; Goldberg, Louis J

2005-04-01

411

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

412

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.

Zou, Dan

2014-01-01

413

High-Energy Proximal Femur Fractures in Geriatric Patients  

PubMed Central

Background: There is limited information in the literature on the outcomes and complications in elderly patients who sustain high-energy hip fractures. As the population ages, the incidence of high-energy geriatric hip fractures is expected to increase. The purpose of this study was to analyze the outcomes and complications in patients aged 65 years or older, who sustained a high-energy proximal femur fracture. Methods: Retrospective review of a prospective trauma database from January 2000 to April 2011 at a single US academic level-1 trauma center. Inclusion criteria consisted of all patients of age 65 years or older, who sustained a proximal femur fracture related to a high-energy trauma mechanism. Details concerning injury, acute treatment, and clinical course and outcome were obtained from medical records and radiographs. Results: We identified 509 proximal femur fractures in patients older than 65 years of age, of which 32 (6.3%) were related to a high-energy trauma mechanism. The mean age in the study group was 72.2 years (range 65-87), with a mean injury severity score of 20 points (range 9-57). Three patients died before discharge (9.4%), and 22 of 32 patients sustained at least one complication (68.8%). Blunt chest trauma represented the most frequently associated injury, and the main root cause of pulmonary complications. The patients' age and comorbidities did not significantly correlate with the rate of complications and the 1-year mortality. Conclusions: High-energy proximal femur fractures in elderly patients are not very common and are associated with a low in-hospital mortality rate of less than 10%, despite high rate of complications of nearly 70%. This selective cohort of patients requires a particular attention to respiratory management due to the high incidence of associated chest trauma.

Hahnhaussen, Jens; Hak, David J; Weckbach, Sebastian; Ertel, Wolfgang; Stahel, Philip F

2011-01-01

414

Defining geriatric trauma: When does age make a difference?  

PubMed Central

Background Injured elderly patients experience high rates of undertriage to trauma centers (TCs) while debate continues regarding the age defining a geriatric trauma patient. We sought to identify when mortality risk increases in injured patients due to age alone, to determine whether TC care was associated with improved outcomes for these patients, and to estimate the added admissions burden to TCs using an age threshold for triage. Methods We performed a retrospective cohort study of injured patients treated at TCs and non-TCs in Pennsylvania from April 1, 2001, to March 31, 2005. Patients were included if they were between ages 19 to 100 years and had sustained minimal injury (ISS<9). The primary outcome was in-hospital mortality. We analyzed age as a predictor of mortality using the fractional polynomial method. Results A total of 104,015 patients were included. Mortality risk significantly increased at 57 years (OR: 5.58; 95% CI: 1.07-29.0; p=0.04) relative to 19-year-old patients. TC care was associated with a decreased mortality risk compared to non-TC care (OR: 0.83; 95% CI: 0.69-0.99; p=0.04). Using an age of 70 as a threshold for mandatory triage, we estimated TCs could expect an annual increase of approximately one additional admission per day. Conclusions Age is a significant risk factor for mortality in trauma patients, and TC care improves outcomes even in older, minimally injured patients. An age threshold should be considered as a criterion for TC triage. Using the clinically relevant age of 70 as this threshold would not impose a substantial increase on annual TC admissions.

Goodmanson, Nicholas W.; Rosengart, Matthew R.; Barnato, Amber E.; Sperry, Jason L.; Peitzman, Andrew B.; Marshall, Gary T.

2014-01-01

415

Mesopotamian medicine.  

PubMed

Although the Mesopotamian civilisation is as old as that of Egypt and might even have predated it, we know much less about Mesopotamian medicine, mainly because the cuneiform source material is less well researched. Medical healers existed from the middle of the 3rd millennium. In line with the strong theocratic state culture, healers were closely integrated with the powerful priestly fraternity, and were essentially of three main kinds: barû (seers) who were experts in divination, âshipu (exorcists), and asû (healing priests) who tended directly to the sick. All illness was accepted as sent by gods, demons and other evil spirits, either as retribution for sins or as malevolent visitations. Treatment revolved around identification of the offending supernatural power, appeasement of the angry gods, for example by offering amulets or incantations, exorcism of evil spirits, as well as a measure of empirical therapy aimed against certain recognised symptom complexes. Medical practice was rigidly codified, starting with Hammurabi's Code in the 18th century BC and persisting to the late 1st millennium BC. Works like the so-called Diagnostic Handbook, the Assyrian Herbal and Prescription Texts describe the rationale of Mesopotamian medicine, based predominantly on supernatural concepts, although rudimentary traces of empirical medicine are discernible. There is evidence that Egyptian medicine might have been influenced by Mesopotamian practices, but Greek rational medicine as it evolved in the 5th/4th centuries BC almost certainly had no significant Mesopotamian roots. PMID:17378276

Retief, F P; Cilliers, L

2007-01-01

416

State of the art in geriatric rehabilitation. Part I: Review of frailty and comprehensive geriatric assessment 1 1 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated  

Microsoft Academic Search

Wells JL, Seabrook JA, Stolee P, Borrie MJ, Knoefel F. State of the art in geriatric rehabilitation. Part I: Review of frailty and comprehensive geriatric assessment. Arch Phys Med Rehabil 2003;84:890-7.

Jennie L Wells; Jamie A Seabrook; Paul Stolee; Michael J Borrie; Frank Knoefel

2003-01-01

417

Social Learning: Medical Student Perceptions of Geriatric House Calls  

ERIC Educational Resources Information Center

Bandura's social learning theory provides a useful conceptual framework to understand medical students' perceptions of a house calls experience at Virginia Commonwealth University School of Medicine. Social learning and role modeling reflect Liaison Committee on Medical Education guidelines for "Medical schools (to) ensure that the learning…

Abbey, Linda; Willett, Rita; Selby-Penczak, Rachel; McKnight, Roberta

2010-01-01

418

Clinical medicine  

PubMed Central

With the December issue of the Journal of Clinical Investigation, I announce the launch of a new category of manuscript called “Clinical Medicine,” along with new editorial board members to adjudicate the peer-review process. With this initiative, the journal aims to publish the highest quality human research that reports early-stage, effective new therapies that impact disease outcomes.

Rockman, Howard A.

2012-01-01

419

Nuclear medicine  

SciTech Connect

In 1985 and 1986 nuclear medicine became more and more oriented toward in vov chemistry, chiefly as a result of advances in positron emission tomography (PET). The most important trend was the extension of PET technology into the care of patients with brain tumors, epilepsy, and heart disease. A second trend was the increasing use of single-photon emission computed tomography (SPECT).

Wagner, H.N. Jr.

1986-10-17

420

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

421

Maritime Medicine.  

ERIC Educational Resources Information Center

Presents a fascinating look at the practice of medicine aboard commercial and military ships in the 18th and early 19th centuries. Contemporary medical practice believed all diseases were created by one of four "humors." In spite of this, and the constant presence of disease, most seamen led relatively healthy lives. (MJP)

Estes, J. Worth

1996-01-01

422

USING A BALINT?LIKE GROUP FOR GERIATRIC EDUCATION IN A NURSING HOME SETTING  

Microsoft Academic Search

The authors describe how a weekly patient care conference evolved into a multidisciplinary round?table educational and support program, for nursing home staff and for family practice residents as part of a geriatric rotation. Like a Balint group, in which physicians discuss their relationships with their patients and the illnesses, the Roundtable offers a mechanism to share responses to patient care,

Mary F. Smith; Warren C. Litts; Lisa Robbiano; James J. Hoin; Ronald G. Nathan; Eugene M. Bont

1993-01-01

423

Evaluation of PHS (Public Health Service) Funded Geriatric Education Centers: Executive Summary.  

National Technical Information Service (NTIS)

The primary purpose of the study was to derive lessons of a programmatic nature from the four original Geriatric Education Centers (GECs). Drawing on their experieces over the past three years, the study explored what kinds of efforts were most fruitful i...

J. A. Todd J. Solon

1986-01-01

424

Impact of a Geriatric Consultation Team on Discharge Placement and Repeat Hospitalization.  

ERIC Educational Resources Information Center

Examined use of Geriatric Consultation Team in acute care hospital among 185 older veterans. Intervention patients were more likely than controls to have recommendations concerning discharge planning and long-term care. Groups had similar discharge placements. Preadmission location, functional status, mental status, occurrence of hospital-acquired…

Saltz, Constance Corley; And Others

1988-01-01

425

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

ERIC Educational Resources Information Center

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

Dolan, Teresa A.

1997-01-01

426

Geriatric Foot Care: A Model Educational Program for Mid-Level Practitioners.  

ERIC Educational Resources Information Center

An educational program on geriatric foot care was completed by 59 nurse practitioners, 12 physicians' assistants, and 1 physician. The 3 1/2 day program included interactive sessions, observation, and hands-on patient care. Posttest results and 6-month follow-up showed significant knowledge increases and incorporation of learning into practice.…

Suggs, Patricia K.; Krissak, Ruth; Caruso, Frank; Teasdall, Robert

2002-01-01

427

AGE ESTIMATION IN THE ELDERLY: RELEVANCE TO GERIATRIC RESEARCH IN DEVELOPING COUNTRIES  

PubMed Central

SUMMARY The accurate estimation of age is an important area in geriatric research. The lack of suitable records in developing countries coupled with illiteracy makes this process difficult. Fifty patients were studied in order to assess their age by means of a checklist which contained significant personal and historical events. The average patient was found to under-report his age by three years.

Srinivasan, T.N.; Suresh, T.R.; Rajkumar, S.

1993-01-01

428

Behind-the-Scenes: Designing a Long-Distance Course on Geriatric Interdisciplinary Teaming  

ERIC Educational Resources Information Center

In this paper, the design and development of a long-distance course on geriatric interdisciplinary teaming are presented. The focus is on the conceptualization of the course, followed by details surrounding developing a design team; designing curricular content; deciding delivery methods; scripting; overseeing and editing videos; and determining…

Welleford, E. Ayn; Parham, Iris A.; Coogle, Constance L.; Netting, F. Ellen

2004-01-01

429

Distance Learning: Videoconferences as Vehicles for Faculty Development in Gerontology/Geriatrics.  

ERIC Educational Resources Information Center

From 1985-1992 the Virginia Geriatric Education Center broadcast via satellite 22 videoconferences involving over 22,000 health professionals in the United States, Canada, and Bermuda. The program required substantial marketing to attract sufficiently large audiences to be cost effective, was labor intensive, and necessitated technical expertise.…

Wood, Joan B.; Parham, Iris A.

1996-01-01

430

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

Microsoft Academic Search

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

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

2001-01-01

431

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

432

The Severe Impairment Battery Predicts Functional Abilities in an Inpatient Geriatric Population  

Microsoft Academic Search

There is limited research examining the relationship between cognition in severe dementia and functional skills. The aim of the present study was to examine the relationship between the Severe Impairment Battery (SIB) and functional abilities as measured by the Assessment of Instrumental Function (AIF) in an acute inpatient geriatric psychiatry setting. Analyses showed significant correlation between the SIB and the

Paul Malloy; Nicole C. R. McLaughlin; Gary Epstein-Lubow; Anne Doughty; Louis Marino; Marnee Milner

2010-01-01

433

Defining Best Practices for Specialty Geriatric Mental Health Outreach Services: Lessons for Implementing Mental Health Reform  

Microsoft Academic Search

Objective: This paper reviews fundamental areas that inform best practices for outreach services as they relate to shared care, education, and program and systems development and illustrates a framework for defining best practices. Method: We examined literature that addresses the needs and characteristics of older persons with mental illness, studies that investigate geriatric mental health outreach services, and relevant theoretical

Mary Pat Sullivan; Linda Kessler; J Kenneth; Le Clair; Paul Stolee; Whitney Berta

2004-01-01

434

A Geriatric Evaluation Unit's Use of a Microcomputer for Patient Care and Research.  

ERIC Educational Resources Information Center

A microcomputer with off-the-shelf software is successfully used to track Geriatric Evaluation Unit patients. The system satisfies four requirements: low cost, software exportability, management of several hundred variables, and decentralized access. Highly sophisticated computer expertise was not necessary for development, and demand on the…

Teasdale, Thomas A.; And Others

1986-01-01

435

Implementation of geriatric acute care best practices: initial results of the NICHE SITE self-evaluation.  

PubMed

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

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

2013-12-01

436

Comprehensive Geriatric Assessment: Applications for Community-Residing, Elderly People with Mental Retardation/Developmental Disabilities.  

ERIC Educational Resources Information Center

The effects of using comprehensive geriatric assessment with 24 community-based elderly individuals with mental retardation/developmental disabilities were evaluated. The evaluation found significantly greater numbers of medical and dental diagnoses than were found by the subjects' previous medical evaluations. (Author/DB)

Carlsen, Wayne R.; And Others

1994-01-01

437

Effect of a Geriatric Educational Experience on Graduates Activities and Attitudes.  

ERIC Educational Resources Information Center

The 1975 to 1985 graduates of the University of Iowa College of Dentistry were surveyed to evaluate the influence on dental practice of a comprehensive geriatric dental curriculum introduced in 1980. Those who graduated before 1980 were more likely to be consultants in nursing homes than carrying out comprehensive care for this population.…

Ettinger, R. L.; And Others

1990-01-01

438

A Controlled Evaluation of Computer Assisted Training Simulations in Geriatric Dentistry.  

ERIC Educational Resources Information Center

A study compared effects of two methods of teaching geriatric dentistry: traditional approach based on readings, and computer-assisted simulation of patient interaction and clinical decision making. Although subjects (n=20) showed no significant differences by treatment, computer-trained students had statistically nonsignificant higher performance…

Mulligan, Roseann; Wood, Gary J.

1993-01-01

439

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

440

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

441

Transforming Social Work Education: The First Decade of the Hartford Geriatric Social Work Initiative  

ERIC Educational Resources Information Center

This book, celebrating the Geriatric Social Work Initiative's 10th Anniversary, documents the effect that its educational programs have had on shaping gerontological social work education as a whole. Each chapter highlights various aspects of this John A. Hartford Foundation-funded initiative--its competency-based education, model for curricular…

Hooyman, Nancy R.

2009-01-01

442

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

ERIC Educational Resources Information Center

Onsite workplace education was provided for employees of the Geriatric Authority of Holyoke (GAH), Massachusetts. Instructional programs in English as a Second Language, adult basic education, and General Educational Development (GED) preparation were offered. The union and supervisors assisted in a broad recruitment effort. Individualized…

Massachusetts Career Development Inst., Springfield.

443

Factors Associated With Functional Decline of Hospitalised Older Persons Following Discharge From an Acute Geriatric Unit  

Microsoft Academic Search

Introduction: Older persons are likely to develop functional impairment following hospitalisation. Several studies in the West have examined the factors associated with functional decline following the older person's discharge from hospital but there are little data on Asian populations. This study aims to look at the associated risk factors in our local population, following admission to an acute geriatric unit.

Wu Huei; Jalan Tan; Tock Seng

444

Factors Associated With Functional Decline of Hospitalised Older Persons Following Discharge From an Acute Geriatric Unit  

Microsoft Academic Search

Abstract Introduction: Older persons are likely to develop functional impairment following hospitalisation. Several studies in the West have examined the factors associated with functional decline following the older person’s discharge from hospital but there are little data on Asian populations. This study aims to look at the associated risk factors in our local population, following admission to an acute geriatric

HY Wu; S Sahadevan; YY Ding

445

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

446

Status of Geriatric Dentistry in the Undergraduate Curriculum of the Nation's Dental Schools - Final Report.  

National Technical Information Service (NTIS)

A survey was conducted among all U.S. Dental schools, of whom 93 percent participated, to elicit factual information about the magnitude, content, importance and other characteristics of the status of geriatric dentistry in the curriculum for the dental u...

1984-01-01

447

[Community health for aged persons: the activities of the geriatric polyclinic in Geneva].  

PubMed

In addition to its mainly home-based clinical activity, the Geriatric Polyclinic has chosen to develop tree programmes with a specific activity. Their common objectives being promoting heath and maintaining home-based treatment in the best conditions and for as long as possible. This article describes these programmes. PMID:10967646

Olmari-Ebbing, M; Bizon, M; Naef, J J; Forest, M I; Rapin, C H

2000-07-01

448

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

449

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

450

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

451

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

452

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

453

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

454

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

455

The Prevalence of Undiagnosed Geriatric Health Conditions among Adult Protective Service Clients  

ERIC Educational Resources Information Center

Purpose: We sought to determine the prevalence of remediable health conditions from in-home geriatric assessments of referred adult protective service (APS) clients suffering elder mistreatment. Design and Methods: We used a retrospective cohort study of 211 APS clients (74% female; age, M = 77 years) in two central New Jersey counties. Results:…

Heath, John M.; Brown, Merle; Kobylarz, Fred A.; Castano, Susan

2005-01-01

456

Overview of Geriatric Distance Education for Academic Courses and Continuing Education  

ERIC Educational Resources Information Center

Distance education technologies may be applied to academic settings, continuing education/continuing medical education settings or in combination to both. This article provides an overview of what we have learned about academic and continuing education/continuing medical education in geriatrics and gerontology. It includes information on the scope…

Johnson, Helen Arleen

2004-01-01

457

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

458

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

459

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

PubMed Central

Background Geriatric patients are typically underrepresented in studies on the functional outcome of rehabilitation after stroke. Moreover, most geriatric stroke patients do probably not participate in intensive rehabilitation programs as offered by rehabilitation centers. As a result, very few studies have described the successfulness of geriatric stroke rehabilitation in nursing home patients, although it appears that the majority of these patients are being discharged back to the community, rather than being transferred to residential care. Nevertheless, factors associated with the successfulness of stroke rehabilitation in nursing homes or skilled nursing facilities are largely unknown. The primary goal of this study is, therefore, to assess the factors that uniquely contribute to the successfulness of rehabilitation in geriatric stroke patients that undergo rehabilitation in nursing homes. A secondary goal is to investigate whether these factors are similar to those associated with the outcome of stroke rehabilitation in the literature. Methods/Design This study is part of the Geriatric Rehabilitation in AMPutation and Stroke (GRAMPS) study in the Netherlands. It is a longitudinal, observational, multicenter study in 15 nursing homes in the Southern part of the Netherlands that aims to include at least 200 patients. All participating nursing homes are selected based on the existence of a specialized rehabilitation unit and the provision of dedicated multidisciplinary care. Patient characteristics, disease characteristics, functional status, cognition, behavior, and caregiver information, are collected within two weeks after admission to the nursing home. The first follow-up is at discharge from the nursing home or one year after inclusion, and focuses on functional status and behavior. Successful rehabilitation is defined as discharge from the nursing home to an independent living situation within one year after admission. The second follow-up is three months after discharge in patients who rehabilitated successfully, and assesses functional status, behavior, and quality of life. All instruments used in this study have shown to be valid and reliable in rehabilitation research or are recommended by the Netherlands Heart Foundation guidelines for stroke rehabilitation. Data will be analyzed using SPSS 16.0. Besides descriptive analyses, both univariate and multivariate analyses will be performed with the purpose of identifying associated factors as well as their unique contribution to determining successful rehabilitation. Discussion This study will provide more information about geriatric stroke rehabilitation in Dutch nursing homes. To our knowledge, this is the first large study that focuses on the determinants of success of geriatric stroke rehabilitation in nursing home patients.

2010-01-01

460

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

PubMed

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

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

2011-01-01

461

Impact of geriatric comorbidity and polypharmacy on cholinesterase inhibitors prescribing in dementia  

PubMed Central

Background Although most guidelines recommend the use of cholinesterase inhibitors (ChEIs) for mild to moderate Alzheimer's Disease, only a small proportion of affected patients receive these drugs. We aimed to study if geriatric comorbidity and polypharmacy influence the prescription of ChEIs in patients with dementia in Germany. Methods We used claims data of 1,848 incident patients with dementia aged 65 years and older. Inclusion criteria were first outpatient diagnoses for dementia in at least three of four consecutive quarters (incidence year). Our dependent variable was the prescription of at least one ChEI in the incidence year. Main independent variables were polypharmacy (defined as the number of prescribed medications categorized into quartiles) and measures of geriatric comorbidity (levels of care dependency and 14 symptom complexes characterizing geriatric patients). Data were analyzed by multivariate logistic regression. Results On average, patients were 78.7 years old (47.6% female) and received 9.7 different medications (interquartile range: 6-13). 44.4% were assigned to one of three care levels and virtually all patients (92.0%) had at least one symptom complex characterizing geriatric patients. 13.0% received at least one ChEI within the incidence year. Patients not assigned to the highest care level were more likely to receive a prescription (e.g., no level of care dependency vs. level 3: adjusted Odds Ratio [OR]: 5.35; 95% CI: 1.61-17.81). The chance decreased with increasing numbers of symptoms characterizing geriatric patients (e.g., 0 vs. 5+ geriatric complexes: OR: 4.23; 95% CI: 2.06-8.69). The overall number of prescribed medications had no influence on ChEI prescription and a significant effect of age could only be found in the univariate analysis. Living in a rural compared to an urban environment and contacts to neurologists or psychiatrists were associated with a significant increase in the likelihood of receiving ChEIs in the multivariate analysis. Conclusions It seems that not age as such but the overall clinical condition of a patient including care dependency and geriatric comorbidities influences the process of decision making on prescription of ChEIs.

2011-01-01

462

A legislative history of federal assistance for health professions training in primary care medicine and dentistry in the United States, 1963-2008.  

PubMed

This article reviews the legislative history of Title VII of the United States Public Health Service Act. It describes three periods of federal support for health professions training in medicine and dentistry. During the first era, 1963 to 1975, federal support led to an increase in the overall production of physicians and dentists, primarily through grants for construction, renovation, and expansion of schools. The second period, 1976 to 1991, witnessed a shift in federal support to train physicians, dentists, and physician assistants in the fields of primary care defined as family medicine, general internal medicine, and general pediatrics. During this era, divisions of general internal medicine and general pediatrics, and departments of family medicine, were established in nearly every medical and osteopathic medical school. All three disciplines conducted primary care residencies, medical student clerkships, and faculty development programs. The third period, 1992 to present, emphasized the policy goals of caring for vulnerable populations, greater diversity in the health professions, and curricula innovations to prepare trainees for the future practice of medicine and dentistry. Again, Title VII grantees met these policy goals by designing curricula and creating clinical experiences to teach care of the homeless, persons with HIV, the elderly, and other vulnerable populations. Many grantees recruited underrepresented minorities into their programs as trainees and as faculty, and all of them designed and implemented new curricula to address emerging health priorities.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs. PMID:18971650

Reynolds, P Preston

2008-11-01

463

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

PubMed Central

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

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

2004-01-01

464

A randomised clinical trial on a comprehensive geriatric assessment and intensive home follow-up after hospital discharge: the Transitional Care Bridge  

PubMed Central

Background Older patients are at high risk for poor outcomes after acute hospital admission. The mortality rate in these patients is approximately 20%, whereas 30% of the survivors decline in their level of activities of daily living (ADL) functioning three months after hospital discharge. Most diseases and geriatric conditions that contribute to poor outcomes could be subject to pro-active intervention; not only during hospitalization, but also after discharge. This paper presents the design of a randomised controlled clinical trial concerning the effect of a pro-active, multi-component, nurse-led transitional care program following patients for six months after hospital admission. Methods/Design Three hospitals in the Netherlands will participate in the multi-centre, double-blind, randomised clinical trial comparing a pro-active multi-component nurse-led transitional care program to usual care after discharge. All patients acutely admitted to the Department of Internal Medicine who are 65 years and older, hospitalised for at least 48 hours and are at risk for functional decline are invited to participate in the study. All patients will receive integrated geriatric care by a geriatric consultation team during hospital admission. Randomization, which will be stratified by study site and cognitive impairment, will be conducted during admission. The intervention group will receive the transitional care bridge program, consisting of a handover moment with a community care Care Nurse (CN) during hospital admission and five home visits after discharge. The control group will receive 'care as usual' after discharge. The main outcome is the level of ADL functioning six months after discharge compared to premorbid functioning measured with the Katz ADL index. Secondary outcomes include; survival, cognitive functioning, quality of life, and health care utilization, satisfaction of the patient and primary care giver with the transitional care bridge program. All outcomes will be measured at three, six and twelve months after discharge. Approximately 674 patients will be enrolled to either the intervention or control group. Discussion The study will provide new knowledge on a combined intervention of integrated care during hospital admission, a proactive handover moment before discharge and intensive home visits after discharge. Trial registration Trial registration number: NTR 2384

2010-01-01

465

Medicine safety and children  

MedlinePLUS

... medicine is made to look and taste like candy. Children are curious and attracted to medicine. Most ... like you. Do not call medicine or vitamins candy. Children like candy and will get into medicine ...

466

Using Medicines Wisely  

MedlinePLUS

... of Medicine Sepa cómo tomar sus medicamentos Use Medicines Wisely Print and Share (PDF 2.43MB) Medicines ... or foods should I avoid? 2. Keep a Medicine List Write down the important facts about each ...

467

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 ...

468

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

469

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

470

Effect of Nicotinic Acid Combined with a Tranquillizer (Hydroxyzine) on Serum Lipid Levels and Urinary Catecholamine Excretion in Geriatric Patients.  

National Technical Information Service (NTIS)

The purpose of this study was to follow plasma lipids, urinary catecholamine excretion and the clinical response to treatment with a tranquilizer (hydroxyzine) and an antilipolytic drug (nicotinic acid) in truly geriatric patients and to investigate wheth...

L. A. Carlson L. Levi E. Ryd Tord

1970-01-01

471

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

472

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

473

Increased Basal and Alum-Induced Interleukin-6 Levels in Geriatric Patients Are Associated with Cardiovascular Morbidity  

PubMed Central

Background/Aim of the study Low-grade systemic inflammation was suggested to participate to the decline of physiological functions and increased vulnerability encountered in older patients. Geriatric syndromes encompass various features such as functional dependence, polymorbidity, depression and malnutrition. There is a strong prevalence of cardiovascular diseases and related risk factors and chronic cytomegalovirus infections in the geriatric population. As these underlying conditions were proposed to influence the inflammatory state, the aim of this study was to assess their potential contribution to the association of geriatric syndromes with inflammatory parameters. Methodology We recruited 100 subjects in the general population or hospitalized for chronic medical conditions (age, 23-96 years). We collected information on clinical status (medical history, ongoing comorbidities, treatments and geriatric scales), biological parameters (hematological tests, cytomegalovirus serology) and cytokines production (basal and alum-induced interleukin (IL)-1? and IL-6 levels). Using stepwise backward multivariate analyses, we defined which set of clinical and biological variables could be predictive for increased inflammatory markers. Principal Findings We confirmed the age-associated increase of circulating IL-6 levels. In contrast to geriatric scales, we found history of cardiovascular diseases to be strongly associated for this parameter as for high IL-6 production upon ex vivo stimulation with alum. Conclusions Association between low-grade inflammation and geriatric conditions could be linked to underlying cardiovascular diseases.

Compte, Nathalie; Boudjeltia, Karim Zouaoui; Vanhaeverbeek, Michel; De Breucker, Sandra; Pepersack, Thierry; Tassignon, Joel; Trelcat, Anne; Goriely, Stanislas

2013-01-01

474

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.

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