Hospitalists' lack of knowledge of the Confusion Assessment Method: a barrier to systematic validated delirium surveillance.

Introduction: Delirium is frequently missed by inpatient health care providers despite the existence of a highly sensitive and specific assessment for delirium, the Confusion Assessment Method (CAM). The CAM, due to its test characteristics and ease of use, is an ideal physician instrument for systematic inpatient delirium screening; however, little is known about hospitalists' knowledge of the CAM.

Methods: A short survey with items assessing respondents' perceptions of delirium detection, familiarity and proficiency with the CAM, and knowledge of the CAM algorithm was administered at a regional hospital medicine conference.

Does lower-extremity arterial disease predict future falling among older men and women?

The purpose of this study was to determine whether lower-extremity peripheral arterial disease (PAD) is an independent risk factor for falls among older persons. Men and women 55 years old and older participated. Subjects with PAD (n = 86) were identified from a noninvasive vascular laboratory and a general medicine practice.

Literacy, race, and PSA level among low-income men newly diagnosed with prostate cancer.

Objectives: Among men with newly diagnosed prostate cancer, prostate-specific antigen (PSA) levels are higher and the cancer stage more advanced for African Americans than for whites. An earlier study found that after adjustment for literacy, race was no longer a significant predictor of advanced stage at presentation. We investigated whether, after adjusting for literacy, race was a significant independent predictor of greater PSA levels among men with newly diagnosed prostate cancer.

Opportunities for disease state management in prostate cancer.

In this paper, we examine how the management of prostate cancer lends itself to a disease state management (DSM)-based approach, and propose a framework that emphasizes the patient-provider-caregiver triad in managing the long-term implications of the condition. There is often no clearly superior approach to the management of patients with prostate cancer (eg, watchful waiting and hormonal therapy), and each option entails different trade-offs in quality of life. Ideally, the physician and patient discuss the options, issues, and patient preferences for treatment through the shared decision-making process.

Assessment instruments.

Assessment is the undergirding of palliative care and of geriatrics care. Both disciplines insist on a comprehensive assessment that includes personal and social aspects of the patient's illness experience. At the same time, both face challenges due to the amount of time and skill needed to encompass such a broad scope and the often heavy illness burden of the patients, which makes interaction stressful or difficult.

Depressive symptoms and lower extremity functioning in men and women with peripheral arterial disease.

Objective: Factors associated with impaired functioning in patients with lower extremity peripheral arterial disease (PAD) are not fully understood. The purpose of this study was to determine the relationship between depressive symptoms and objective measures of lower extremity functioning in persons with PAD.

Design: Cross-sectional.