Missouri medicine
-
Comprehensive geriatric assessment (CGA) consists of medical history taking, medication review, physical examination with special attention to sensory and neurological evaluation, and use of assessment instruments to measure cognitive, affective, functional, social, and economic status. CGA is most often beneficial when applied to frail elders at risk of functional decline. Beneficial outcomes may include decreased risks of falls, cognitive decline, and nursing home placement--in addition to improved sense of well-being and satisfaction with care.
-
Despite the widespread knowledge that tobacco use causes death and debilitating disease, tobacco control efforts in Missouri remain inadequate. No other health issue combines the prevalence, lethality, and neglect of tobacco addiction. ⋯ Successful tobacco control efforts change society by creating an environment in which nonsmoking is the norm and quitting smoking is supported. This paper concludes that it is time for medicine and public health professionals to communicate, collaborate, and assume leadership in reducing the health burden of tobacco use in Missouri.
-
Patients with advanced heart and lung disease experience exacerbations resulting in hospitalizations and interventions the patient may not desire. Strategies are needed that address end of life issues, honor preferences, and improve care without increasing cost. This study examines the impact on hospitalization and care cost of an integrated system of end of life care and interdisciplinary home care for mid-Missouri veterans with advanced congestive heart failure or chronic obstructive pulmonary disease.