Journal of the American Geriatrics Society
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Comparative Study
Comparison of brain natriuretic peptide and probrain natriuretic peptide in the diagnosis of cardiogenic pulmonary edema in patients aged 65 and older.
Differentiating cardiogenic pulmonary edema (CPE) from respiratory causes of dyspnea is difficult in elderly patients. The aim of this study was to compare the usefulness of B-type natriuretic peptide (BNP) and amino-terminal fragment BNP (proBNP), to diagnose CPE in patients aged 65 and older. ⋯ BNP assay is a more useful diagnostic indicator for CPE than proBNP in patients aged 65 and older.
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Clinical Trial Controlled Clinical Trial
A multifactorial intervention program reduces the duration of delirium, length of hospitalization, and mortality in delirious patients.
To investigate whether an education program and a reorganization of nursing and medical care improved the outcome for older delirious patients. ⋯ This study shows that a multifactorial intervention program reduces the duration of delirium, length of hospital stay, and mortality in delirious patients.
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Multicenter Study Comparative Study
Purchasing or providing nursing home care: can quality of care data provide guidance.
To examine whether quality of care differed for veterans in Department of Veterans Affairs (VA) nursing homes and those on contract in community nursing homes, and whether the VA was contracting with nursing homes providing better quality of care than other nursing homes. ⋯ Large purchasers and providers of nursing home care such as the VA are unlikely to find information on quality of care useful in making decisions on whether they should "make" or "buy" care. Nursing homes performing well on one quality measure may perform poorly on another, and it is difficult to identify nursing homes that are consistently among the best or worst. Other consumers may encounter similar difficulties when using data on nursing home quality.
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To assess the status of geriatric medicine (GM) fellows' training experiences in end-of-life care via self-report. ⋯ GM fellows feel their end-of-life care education is excellent and feel prepared to take care of dying patients. It is critical that geriatricians in training have access to and take advantage of palliative and end-of-life care rotations.