Age and ageing
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Geriatricians are often asked to make decisions about withholding cardiopulmonary resuscitation. This seems to be becoming more difficult and more controversial. There has been increased public concern about this subject recently and a recognition within the profession of the need for more openness and transparency in decision making. The implementation of The Human Rights Act led to updated guidelines from professional bodies, but these are likely to need careful interpretation in light of local circumstances before they can become a practical tool for decision making.
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Clinical Trial Controlled Clinical Trial
Proximal femur fracture in older patients--rehabilitation and clinical outcome.
hip fracture is a major cause of morbidity and mortality in older people; optimal post-surgical treatment is a matter of controversy. ⋯ based on our measured outcome variables institutional rehabilitation after surgical treatment of hip fracture apparently had no significant impact on mortality and morbidity in older patients of normal mental status.
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Randomized Controlled Trial Comparative Study Clinical Trial
Hospital re-admissions in relation to acute stroke unit care versus conventional care in elderly patients the first year after stroke: the Göteborg 70+ Stroke study.
re-hospitalisation after discharge following index stroke varies over time and with age and comorbidity. There is little knowledge about whether stroke unit care reduces the need of re-admissions. ⋯ re-admissions for conditions judged to be secondary to acute stroke were equal in the two groups in this prospective study.
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Evidence-based practice, the linking of research evidence with clinical decision-making, has been a major recent development. However there are many challenges to the development of evidence-based stroke rehabilitation. Before it can become a reality we need to establish a reliable evidence-base providing information which is relevant, reliable, accessible and understandable. This article describes some steps taken to develop such information based on common questions generated by clinicians. ⋯ Stroke rehabilitation needs to establish and apply a solid evidence-base even though the challenges are formidable.