JAMA : the journal of the American Medical Association
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To determine risk factors for delirium in elderly hospitalized patients. ⋯ Delirium in hospitalized patients is most closely associated with factors already present on admission such as prior cognitive impairment, advanced age, and fracture. In the hospital, use of neuroleptics and narcotics and the presence of infection are less strongly associated with this syndrome.
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To describe the patient care and staffing patterns of the 157 clinics that receive federal funding to provide health care to the homeless. ⋯ Current financial constraints may be impeding the ability of clinics serving the homeless to ensure adequate access to high quality care. Additional research should evaluate the impact various staffing patterns have on access and quality of care and develop methods to improve physician recruitment.
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Randomized Controlled Trial Clinical Trial
The quality of mercy. Caring for patients with 'do not resuscitate' orders.
To assess (1) the effect of an ethics education intervention for medical house officers on practices surrounding "Do Not Resuscitate" (DNR) orders and (2) the association of DNR care with patient diagnosis and demographic variables. ⋯ (1) An extensive ethics education intervention can improve care for DNR patients, especially with respect to CCCs. (2) In this setting, quality of care for DNR patients varied systematically with diagnosis. These results have implications for the design and implementation of ethics education programs.