Southern medical journal
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Anxiety and pain are common responses to surgery, and both can negatively affect patient outcomes. Music interventions have been suggested as a nonpharmacological intervention to alleviate pain and anxiety during surgical treatment. Although the data are somewhat mixed, the research suggests that music-based interventions are effective in reducing anxiety, pain perception, and sedative intake. ⋯ Most of the studies found in the literature involve passive music listening via headphones. The data suggest that researcher-selected music is most effective in reducing anxiety, primarily because it incorporates evidence-based parameters such as consistent tempo and dynamics, stable rhythms, and smooth melodic lines. Finally, the literature suggests that music therapists can serve as experts to help medical personnel identify effective implementation strategies.
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Undertriage is common in patients 55 years and older and is even worse for those 65 and older. In 1999, the Florida legislature implemented a statewide trauma system, including a new Florida trauma triage algorithm (FTTA). This study examines how the new system affected prehospital triage in younger versus older patients. ⋯ Whereas FTTA appropriately triaged patients 15 to 54 years old to the trauma center, those 55 years old and older were much less likely to be triaged correctly. The reasons for this finding remain unknown, and further studies are needed to investigate and improve elderly triage.
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Southern medical journal · Aug 2012
Comparative StudyFatal falls in an ethnically diverse urban community: the link between demographic factors and the circumstances surrounding fatal falls.
Fatal falls cause more than 15,000 deaths per year in the United States. Despite this, the circumstances surrounding fatal falls in elderly adults are poorly understood. It is unknown whether these circumstances differ across ethnicities, although Hispanic American individuals are at reduced risk for fatal falls. This study sought to describe fatal falls in an urban, predominantly Hispanic, and white non-Hispanic community and to determine the association of demographics with the circumstances surrounding these falls (proximate factors). ⋯ Fatal fall prevention is needed for elderly individuals living in the community and should target the oldest elderly adults living at home while helping to ensure that individuals who are living without family have the appropriate support. These data suggest that Hispanic individuals may benefit from prevention strategies developed in other populations.
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Life expectancy for Americans has increased dramatically since 1900, as have the available pharmacotherapeutic options. Unfortunately, pharmacotherapy mishaps occur commonly in the older adult population. ⋯ A thorough understanding of pharmacokinetics, pharmacodynamics, adverse drug reactions, drug interactions, and several other factors is necessary for practitioners to develop a safe and effective drug therapy plan for older adults. This review provides a general but comprehensive review of the issues pertaining to pharmacotherapy in elderly people and offers several suggestions for improving their pharmaceutical care.