This study provides empirical evidence on whether polypharmacy and potentially inappropriate prescription medications (PIRx, as defined by the 2003 Beers criteria) increase the likelihood of functional decline among community-dwelling older adults with dementia. Data were from the National Alzheimer's Coordinating Center, Uniform Data Set (9/2005-9/2009). Study sample included 1994 community-dwelling ...

The association of antihypertensive medication use with cognitive decline (including mild cognitive impairment) or dementia (including Alzheimer's disease (AD), vascular dementia (VD) and any dementia) has still been an area of controversy. This study examined the association of antihypertensive medication use with cognitive decline or dementia using a quantitative meta-analysis ...

BACKGROUND: Anticholinergic medications, although frequently used in elderly populations, are associated with cognitive impairment and constitute significant concern for patients with dementia. OBJECTIVE: The purpose of our study was to examine patterns and predictors of prescribing anticholinergic agents for elderly outpatients with dementia. METHODS: We combined data from the 2006-2007 ...

ABSTRACT: BACKGROUND: The objective of this study was to determine the sedative load and use of sedative and psychotropic medications among older people with dementia living in (residential) care homes. METHODS: Medication data were collected at baseline and at two further time-points for eligible residents of six care homes participating ...

OBJECTIVES: To estimate the proportion of community-dwelling older adults with dementia being prescribed a psychotropic and to identify patient and caregiver factors associated with antipsychotic use. METHODS: Retrospective cohort study of the Aging, Demographics, and Memory Study (ADAMS) from 2002 to 2004 designed to assess dementia severity and service use ...

PURPOSE:  This study identified how unlicensed staff members decide to administer medications prescribed pro re nata (PRN) to residents of assisted living (AL) settings designated for persons with dementia. Theories of knowledge, including explicit and implicit knowledge, discretion, and judgment, guided the analysis.  DESIGN AND METHODS:  Data were collected and ...

BACKGROUND: diagnosis of mild cognitive impairment (MCI) typically excludes individuals with medical co-morbidity. Interest in MCI screening raises the questions of what are the best criteria to identify a representative sample and what factors are associated with MCI progression to dementia. OBJECTIVES: to compare the pattern of disease co-morbidity across ...

ABSTRACTBackground: There is no valid instrument currently in use at acute-care hospitals in Hong Kong to aid the detection of cognitive impairment. The objectives of this study were to (1) validate the Digit Span Test (DST) in the identification and differentiation of dementia and delirium; and (2) determine the prevalence ...

There is no dedicated therapy for frontotemporal dementia (FTD). In order to treat the often devastating behavioral disturbances that interfere with both normal social functioning and the ability of caregivers to provide needed support, off-label medication usage is frequent. In addition to antidepressant and antipsychotic medications, which afford some benefits, ...

The ongoing 'enhancement' debate pits critics of new self-shaping technologies against enthusiasts. One important thread of that debate concerns medicalization, the process whereby 'non-medical' problems become framed as 'medical' problems. In this paper I consider the charge of medicalization, which critics often level at new forms of technological self-shaping, and ...

Education about physicians' disruptive behavior is relevant for practicing physicians, who must demonstrate competence in professionalism for maintenance of certification. In addition, physicians need to know about newer regulatory standards that define disruptive behavior and mandated processes for dealing with such behavior, as health care organizations are now charged with ...

Abraham Flexner's 1910 exposé on medical education recommended that only two of the seven extant medical schools for blacks be preserved and that they should train their students to "serve their people humbly" as "sanitarians." Addressing charges of racism, this article traces the roots of the recommendation that blacks serve ...

Adequate reliability of algorithms and computations of modern medical systems software is a matter of concern because the system software is in charge of satisfying safety requirements of the system environment, i.e., the patient. This chapter aims to present a framework for specifying the behavior of the Continuous Infusion Insulin ...

Editor's Note: The following is the commentary of a young psychiatrist about the evolution of his thinking during training. He offers a provocative and fresh view of a complicated illness which affects more and more of us as we grow older. In a psychiatry residency outpatient clinic, an elderly woman ...

There are more than 1 billion credit and debit cards used each day to make purchases. Many of these purchases happen in medical offices nationwide. Understanding whether to take a debit or credit charge from a patient could translate into great savings over time for a medial practice. The article ...

This article forms part of our 'Paperwork' series for 2011, providing information about a range of paperwork that general practitioners complete regularly. The aim of the series is to provide information on the purpose of the paperwork, and hints on how to complete it accurately. This will allow the GP ...

Clinical dilemma: In the Emergency Room you are asked to examine a patient diagnosed with dementia. You diagnose active psychosis, and contemplate whether to prescribe antipsychotic (AP) medication?

Errors involving medication administration can be costly, both in financial and in human terms. Indeed, there is much potential for errors due to the complexity of the medication administration process. Nurses are often singled out as the only responsible of these errors because they are in charge of drug administration. ...

This article presents strategies for advertising the medical practice. The emphasis is on breaking out of the old rules of how one should advertise and delves into asking questions that lead to a true strategy unique to one's medical practice and offerings. The article discusses the myriad ways to think ...

This paper principally concerns the examination of four English midwifery treatises written by midwives between 1671 and 1795. It focuses on their responses to the medicalisation of childbirth and, in particular, their concerns about medical negligence and their views on the value of anatomical knowledge to the development and defence ...

Due to an issue in manufacturing, downstream occlusion (DSO) sensors in some Smiths Medical CADD-Solis infusion pumps may drift out of calibration, potentially resulting in erroneous alarms that disable the units. Hospitals experiencing the problem should return affected units to Smiths Medical for recalibration (free of charge) and should consider ...

To describe current prehospital airway management practices for adults and children and barriers to adoption of evidence-based airway management practices in California. We surveyed local medical directors of California's 31 emergency medical services (EMS) agencies regarding prehospital airway management, including provider scope of practice, continuous quality improvement practices, and perceptions ...

What happens when you find yourself working in your medical practice every day with co-workers who are the ages of your parents or children? Do you find yourself reverting to age-related roles? Do you become exasperated with or bewildered by the values and behaviors of older or younger colleagues? This ...

We compared observed and reported practice among children with special health care needs transported in wheelchairs with the recommendations from the American National Standards Institute/Rehabilitation Engineering and Assistive Technology Society of North America Committee on Wheelchairs and Transportation voluntary standards for best practice for using wheelchairs in vehicles. A convenience ...

Since their introduction in 1980s, medical guidelines have become a milestone in the modern medical practice and science. Being a key feature of modern evidence-based medicine, guidelines offer the opportunity for unification and standardization of diagnostic procedures, their use guarantees the equal access of patients to medical service, and they ...

Doctors will soon be facing pressures to make their practices green, i.e., environmentally and ecologically friendly. Being a good doctor means caring for patients, and now we have to care for the planet as well. This article will discuss why doctors need to be conscious of the environment and offer ...

The new professionalism movement in medical education takes seriously the old medical virtues. Perhaps the most difficult virtue to understand and practice is humility, which seems out of place in a medical culture characterized by arrogance, assertiveness, and a sense of entitlement. Countercultural though it is, humility need not suggest ...

Faced with mounting losses associated with owned medical practices, leaders of integrated systems can be tempted to allow their concerns about the situation to goad them to act too hastily to remedy it. IDS leaders require a process for examining the causes of medical practice underperformance that focuses simply on ...

In this article I show that the argument in John Harris's famous "Survival Lottery" paper cannot be right. Even if we grant Harris's assumptions--of the justifiability of such a lottery, the correctness of maximizing consequentialism, the indistinguishability between killing and letting die, the practical and political feasibility of such a ...

Medical practice workplace etiquette is slowly being modified and fine-tuned. New workplace etiquette rules have become necessary because of advances in communications technology, shifting norms, and expectations of what constitutes good manners. Today's medical practice employees must concern themselves with traditional workplace manners but also the manners that come into ...

The ancient practice of the sweat lodge is increasingly common as part of healing practice in substance abuse and other programs for American Indians. It is popular outside Indian culture as well. Reported deaths of four whites in sweat-type ceremonies, however, suggest a need for medical caution. This review of ...

This study examined whether environmental factors and practice characteristics influence the existence of patient-centered medical home elements in family practices in Virginia. The study used multiple secondary data sets to measure the external environment and a survey of family practices to enumerate and describe medical home elements and practice environment. ...

Branding is the process of differentiating your medical practice from all other practices in the industry. Branding takes into account the "look and feel" of your office, you and your staff your materials, and every other detail that gives your patients clues as to who you are and what you ...

Medical practice redesign refers to the intentional efforts to improve practice processes and outcomes. Efforts to redesign office-based medical care go back some forty years. We divide the history of practice redesign into three overlapping phases: basic investigation, model development, and dissemination. The "medical home" movement in primary care has ...

Much research in France or abroad has highlighted the medical practice variation (MPV) phenomenon. There is no consensus on the origin of MPV between preference-centered approaches versus opportunities and constraints approaches. This study's main purpose is to assess the relevance of hypotheses which assume that physicians adopt a uniform practice ...

This article explores the initial set of epidemiological investigations in Victorian Britain that linked typhoid fever to milk from dairy cattle. Because Victorian epidemiologists first recognized the milk-borne route in outbreaks of typhoid fever, these investigations served as a model for later studies of milk-borne scarlet fever, diphtheria, and perhaps ...

Meditation practice in the medical setting is proving to be an excellent adjunctive therapy for many illnesses and an essential and primary means of maintaining holistic health and wellness. Rather than being a fringe or marginal concept, meditation is now widely known and accepted as a beneficial mind-body practice by ...

Is there a gap between your productivity and profitability? Look inside your organization and you may find hundreds of thousands of dollars that were stolen by someone associated with your practice. This article offers examples of stealing that occurred in hundreds of medical practices and hospitals nationwide and outlines six ...

Nonsurgical cosmetic procedures have become increasingly common and important to plastic surgery practices. Many physicians have either opened a medical spa or have thought about integrating a medical spa into their aesthetic practices. The authors (plastic surgeon and marketing professional) have shared their views on opening a medical spa and ...

This paper assesses the reputation of British military medical staff in the 18th century, focusing on the character and professionalism of regimental surgeons and mates who served at the time of the American Revolutionary War (1775-1783). Examining the careers and contributions of men such as Thomas Dickson Reide, Robert Jackson, ...

Burning sensation at the site of application is the most common side effect of topical calcineurin inhibitors and is considered the most common reasons for premature discontinuation. Here, we analyze the possible mechanism(s) and offer a simple practical tip to mitigate this adverse effect. Simple cooling of the tube, immediately ...

The medical professionalism movement, bolstered by many influential medical organizations and institutions, has in the last decade produced a number of conceptual definitions of professionalism and a number of concrete proposals for its measurement and teaching. These projects, however laudable, are misguided when they treat professionalism as a unitary descriptive ...

It may seem to you that there is little or nothing that you can do about the stressors you face in your medical practice. There is always so much to do. Working with patients who are anxious or frightened, short-staffing, emergencies, a crowded appointment schedule-all of this can make for ...

A report of the 3rd joint European Science Foundation and University of Barcelona Conference in Biomedicine, San Feliu de Guixols, Catalonia, Spain, 6-11 June 2010.

Quality medical records are the cornerstone of successful equine veterinary practice. The scope and integrity of the information contained in a practice's medical records influence the quality of patient care and client service and affect liability risk, practice productivity, and overall practice value.

Drawing on ethnographic data collected over 13 months of fieldwork in family doctor clinics in Havana from 2004 to 2005, I examine the shifting moral and material economies of Cuban socialist medical practice. In both official ideology and in daily practice, the moral economy of ideal socialist medicine is based ...

Despite widespread endorsement of competency-based assessment of medical trainees and practicing physicians, methods for identifying those who are not competent and strategies for remediation of their deficits are not standardized. This literature review describes the published studies of deficit remediation at the undergraduate, graduate, and continuing medical education levels. Thirteen ...

Experts agree that the recession exposes all types of businesses, including medical practices, to a greater risk of employee fraud and embezzlement. There are many cases of employee embezzlement that can remain undetected for long periods of time, costing practices thousands of dollars from their top and bottom lines. In ...

Oocyte cryopreservation has great promise for applications in oocyte donation and fertility preservation and for decreasing the number of unused cryopreserved embryos. The Practice Committee has and will continue to review the published medical literature relating to oocyte cryopreservation at regular intervals and is prepared to reconsider its position when ...

BACKGROUND: Despite the growing use of information technology (IT) in medical practices, little is known about the relationship between IT and physician satisfaction. PURPOSE: The objective of this study was to examine the relationship between physician IT adoption (of various applications) and overall practice satisfaction, as well as satisfaction with ...