Comparing Social Isolation in Older Adults With and Without Physical Health Challenges During COVID-19: Church and Church Friends Matter.

Older adults were disproportionately affected by COVID-19. The purpose of this study was to explore experiences of sudden-onset social isolation and factors that influenced it among social isolation in two groups of older adults. A qualitative thematic study with a survey component was conducted comparing 18 older adults in two groups: 12 reporting physical health challenges and 6 reporting no physical health challenges.

Effect of a dementia friends information session on health professional students' attitudes and knowledge related to dementia.

Despite the growing prevalence of dementia, few models of training for health professional students on this topic have been formally evaluated or widely disseminated. The Dementia Friends (DF) initiative is part of a global movement to improve the way people think, act, and talk about dementia. The impact of these sessions on the dementia-related knowledge and attitudes of health professional trainees has not been adequately assessed.

An evaluation of a sustained senior mentor program for medical students.

Background/Objective Medical student geriatrics education using community-based volunteer older persons, known as a Senior Mentor Program (SMP), began decades ago. Though these programs have been described and evaluated against curriculum objectives, the full breadth of students' learning from SMPs has not been reported. Methods We conducted a qualitative study using content analysis of reflections of Year 2 medical students submitted during a single visit home-based SMP.

What the VA can teach us about geriatric care.

The innovation now being demanded by Medicare is creating new opportunities for health care organizations to redesign how they deliver care for elderly people. For many years, the VA Health System has experimented with ways to deliver care more effectively and efficiently. Hospital-based postacute and palliative care and home-based primary care are two examples of successful approaches that non-VA providers should be looking at as they move away from fee-for-service reimbursement and invent new care-delivery models.

Perception, satisfaction and utilization of the VALUE home telehealth service.

We conducted a randomized controlled trial to evaluate the perception, satisfaction and utilization of a home telehealth service for frail elderly people living independently in their home communities. Control group subjects continued with their usual care and intervention group subjects were able to supplement their usual care with the use of a web portal. The web portal allowed videoconferencing and electronic messaging between home care nurses and clients, ordering health-related and home care services, access to health-related information and general access to the Internet.

Effect of an End-of-Life Planning Intervention on the completion of advance directives in homeless persons: a randomized trial.

Background: Few interventions have focused on improving end-of-life care for underserved populations, such as homeless persons.

Objective: To determine whether homeless persons will complete a counseling session on advance care planning and fill out a legal advance directive designed to assess care preferences and preserve the dignity of marginalized persons.

Design: Prospective, single-blind, randomized trial comparing self-guided completion of an advance directive with professionally assisted advance care planning.

The altruistic unbalanced paired kidney exchange: proof of concept and survey of potential donor and recipient attitudes.

Background: Altruistic unbalanced paired kidney exchanges (AUPKE) use compatible live donor/recipient pairs to facilitate transplants for individuals with incompatible live donors. We report a three donor/recipient pair complex AUPKE. Little is known of the circumstances under which individuals are likely to trade away a compatible live donor or the overall impact that AUPKE could have on the organ supply.

Engaging homeless persons in end of life preparations.

Background: There are no prospective studies that have investigated the effects of an intervention to improve end of life (EOL) care in an underserved population.

Objective: To determine whether homeless persons will complete an advance directive (AD).

Design: Randomized trial comparing two modes of providing an opportunity for homeless persons to complete an AD.

Altruistic unbalanced paired kidney exchange at Columbia University/New York-Presbyterian hospital: rationale and practical considerations.

Paired kidney exchanges are being used with increasing frequency to overcome humoral immunologic incompatibilities between patients in need of renal transplantation and their potential live donors. Altruistic unbalanced exchanges utilize compatible donor/recipient pairs in order to facilitate the transplantation of a patient with an incompatible donor. We have now performed several altruistic unbalanced paired kidney exchanges at our institution.

Dying on the streets: homeless persons' concerns and desires about end of life care.

Background: There is little understanding about the experiences and preferences at the end of life (EOL) for people from unique cultural and socioeconomic backgrounds. Homeless individuals are extreme examples of these overlooked populations; they have the greatest risk of death, encounter barriers to health care, and lack the resources and relationships assumed necessary for appropriate EOL care. Exploring their desires and concerns will provide insight for the care of this vulnerable and disenfranchised population, as well as others who are underserved.

Experiences with and attitudes toward death and dying among homeless persons.

Background: Homeless persons face many barriers to health care, have few resources, and experience high death rates. They live lives of disenfranchisement and neglect. Few studies have explored their experiences and attitudes toward death and dying.

A novel way of distributing medical practice guidelines using Personal Digital Assistants (PDA).

With the rapid growth in medical knowledge, physicians' ability to keep up to date has become increasingly difficult. Although the Internet brought significant improvements in access to medical knowledge, there are still problems remaining, particularly for the mobile physician who is unable to perform time-consuming on-line searches, even with wireless access to the Internet. The goal of this project was to develop a novel way of distributing medical knowledge from the Internet to health professionals' Personal Digital Assistants (PDAs).

Percutaneous lumbar sympathetic plexus catheter placement for short- and long-term pain relief: CT technique and results.

Purpose: The purpose of this work was to evaluate the use of percutaneously placed lumbar sympathetic plexus catheter placement under CT guidance in patients with complex regional pain syndrome (CRPS) or nonspecified neuropathic pain (NP) of the lower extremity.

Method: Sixteen lumbar sympathetic plexus catheter placements were performed in seven patients with CRPS and seven patients with NP. A 19 gauge epidural catheter was placed anterior to the psoas muscle at the L2-3 level.

Smoking and idiopathic congestive cardiomyopathy.

Two case control studies were performed to evaluate whether smoking may affect myocardial function. Cardiomyopathy subjects had a greater pack year smoking history than 52 control subjects with no CAD (p < 0.02) and were more likely to have diabetes (p < 0.

Differences between nursing home admissions and residents.

The use of a cross-sectional sample of nursing home residents rather than a sample of admissions to estimate admission characteristics carries a potential bias. The purpose of this study was to fill this void by comparing abstracted records data for an admissions cohort (n = 1,118) and a residents cohort (n = 830) residing in the same nursing homes. Compared to residents, admissions were significantly more dependent in their ability to get around and to dress themselves, received more clinical services, and had a higher rate of medication use.

Longitudinal study of psychotropic drug use by elderly nursing home residents.

In this longitudinal study of patterns of use of psychotropic drugs by a cohort of elderly nursing home residents (N = 5,752), drug use was examined upon admission, 3 months later, and at discharge/end of study. At each time point, 17% of the cohort used neuroleptics. Half of the subjects discontinued neuroleptics at each time point; however, a similar number were initiated on the drug.

Evaluation of neuroleptic drug use by nursing home elderly under proposed Medicare and Medicaid regulations.

Federal regulations for use of neuroleptic drugs in Medicare- and Medicaid-certified nursing homes throughout the United States were implemented October 1, 1990. These regulations constitute the first time that prescription drugs are required, by law, to be justified by indications documented in the medical chart. This study used extant data to estimate ineligible neuroleptic use at the individual and nursing home levels had these regulations been in effect in 1976 through 1985.

Influenza and pneumococcal immunization in medical clinics, 1978-1980.

In 1978 to 1979, the General Medicine Clinic (GMC) immunization program at the University of Chicago immunized 54% of 1,543 high-risk patients with influenza vaccine. In 1979 to 1980, 45% of 1,462 high-risk patients were immunized, including 72% of the patients who had been immunized the year before. Many patients who were immunized were initially undecided or did not want the vaccine.