Evolving Prehospital, Emergency Department, and “Inpatient” Management Models for Geriatric Emergencies

Alternative management methods are essential to ensure high quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols for case-finding and rapid diagnosis to support early condition-specific treatment for older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to look beyond the diagnosis to address the influence of other factors on the patient's health: isolation and depression; finances and transportation; and chronic medical conditions and polypharmacy. This review article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care

Diagnosis of Elder Abuse in U.S. Emergency Departments

To estimate the proportion of visits to United States emergency departments (EDs) receiving a diagnosis of elder abuse using two nationally representative datasets

Discrepancies between ClinicalTrials.gov recruitment status and actual trial status: a cross-sectional analysis

To determine the accuracy of the recruitment status listed on ClinicalTrials.gov as compared with the actual trial status

A Modern-Day Purgatory: Older Emergency Department Patients with Non-Operative Injuries

Older adults frequently present to the emergency department (ED) with injuries that do not require operative treatment but are sufficiently severe to make it unsafe for them to return home. These patients typically do not meet criteria for an ‘inpatient’ hospital admission. However, because of the limited reimbursement for observation patients, admitting physicians are often reluctant to accept these patients in to observation. Admission to a skilled nursing or assisted living facility from the ED or rapid access to additional in-home care is also often difficult or impossible. As a result, older patients with non-operative injuries often spend a long time in the ED waiting for an appropriate disposition. We describe the challenges of identifying an appropriate disposition for these patients, the consequences for patients, and some potential solutions to this commonly encountered problem

Systematic Reviews Published in Emergency Medicine Journals Do Not Routinely Search Clinical Trials Registries: A Cross-Sectional Analysis

Publication bias compromises the validity of systematic reviews. This problem can be addressed in part through searching clinical trials registries to identify unpublished studies. This study aims to determine how often systematic reviews published in emergency medicine journals include clinical trials registry searches

Plato on Well-Being

Plato's dialogues use several terms for the concept of well-being, which concept plays a central ethical role as the ultimate goal for action and a central political role as the proper aim for states. But the dialogues also reveal sharp debate about what human well-being is. I argue that they endorse a Socratic conception of well-being as virtuous activity, by considering and rejecting several alternatives, including an ordinary conception that lists a variety of goods, a Protagorean conception that identifies one's well-being with what appears one to be one's well-being, and hedonistic conceptions

Cross-sectional assessment of patient attitudes towards participation in clinical trials: does making results publicly available matter?

Previous studies have shown that a majority of patients cite altruistic motives, such as contributing to generalisable medical knowledge, as factors motivating clinical trial participation. We sought to examine the impact of making trial results publicly available on patients' willingness to participate in clinical research

Self-Reported Versus Performance-Based Assessments of a Simple Mobility Task Among Older Adults in the Emergency Department

Accurate information about the mobility of independently-living older adults is essential in determining whether they may be safely discharged home from the emergency department (ED). We assessed the accuracy of self-reported ability to complete a simple mobility task among older ED patients

Randomized trials in emergency medicine journals, 2008 to 2011

Knowledge of current areas of activity in emergency medicine research may improve collaboration among investigators and may help inform decisions about future research priorities. Randomized controlled trials are a key component of research activity and an essential tool for improving care. We investigated the characteristics of randomized trials recently published in emergency medicine journals

Malnutrition Among Cognitively Intact, Noncritically Ill Older Adults in the Emergency Department

We estimate the prevalence of malnutrition among older patients presenting to an emergency department (ED) in the southeastern United States and identify subgroups at increased risk