Rhode Island medical journal (2013)
-
Delirium is a highly prevalent and complex neuro- psychiatric disorder marked by attentional dysfunction, disturbances in multiple cognitive domains, and changes in motor behavior, perception, sleep, and thought process. Delirium results from diverse toxic, metabolic, infectious, and structural etiologies and is associated with a number of adverse outcomes. Delirium pathophysiology involves perturbation of multiple neurotransmitter systems. ⋯ Diagnostic assessment of delirium includes thorough physical examination, careful cognitive testing, appropriate metabolic and infectious studies, review of medications, and structural brain imaging and electroencephalography as indicated. Pharmacologic and non-pharmacologic interventions have been documented to reduce the incidence and severity of delirium. Anti- psychotics are the treatment of choice for delirium-related agitation and psychosis.
-
Compassion and compassion fatigue are discussed in the medical literature. However, few studies address physicians and none examine physicians' spiritual beliefs related to their provision of compassionate care. ⋯ Physicians value compassion, linking it to spiritual values and self-care, but identify challenges in daily practice. Further study is needed to explore how to support physicians' provision of compassionate care and prevent burnout.
-
Level I trauma centers are required to provide screening and brief interventions for alcohol abuse. The World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is a validated screening measure for all substances of abuse. This study is the first to use the ASSIST to screen a trauma population. ⋯ The ability of the ASSIST to identify misuse of multiple substances makes it a good candidate for the screening measure used by trauma centers.