Melatonin decreases delirium in elderly patients: a randomized, placebo-controlled trial.

Background: Disturbance in the metabolism of tryptophan and tryptophan-derived compounds (e.g., melatonin) may have a role in the pathogenesis of delirium.

Pain assessment in a geriatric psychiatry program.

Background: The assessment of pain in older persons with psychiatric illness is particularly challenging for health care professionals. There are few well-tested pain assessment tools for this population.

Objectives: A study was conducted to explore pain assessment and management issues in geriatric psychiatry.

Examining the nurse practitioner role in long-term care: evaluation of a pilot project in Canada.

This study examined the nurse practitioner (NP) role in three long-term care facilities in Ontario, Canada, to identify factors that facilitate or impede the implementation of this role. Facility staff were surveyed about their perceptions of the NP role, and the NP assigned to the facilities was interviewed. Findings indicated the NP had a positive impact on practice activities and staff assessment skills.

. . . But does it stick? Evaluating the durability of improved knowledge following an undergraduate experiential geriatrics learning session.

Canada's aging population, fewer medical students training in geriatric medicine, and inadequate geriatric curricula require that medical schools immediately address how future physicians will be able to care for older people effectively. The medical literature suggests that experiential learning strategies improve undergraduate medical students' knowledge of and interest in less-popular subjects, but the durability of improvements resulting from these resource-intensive learning approaches remains unclear. In October 2001, a convenience sample of all University of Western Ontario medical students attending the geriatric component of their first year was randomized to attend one 3-hour didactic lecture or 3-hour experiential learning session.

Factors associated with the effectiveness of continuing education in long-term care.

Purpose: This article examines factors within the long-term-care work environment that impact the effectiveness of continuing education.

Design And Methods: In Study 1, focus group interviews were conducted with staff and management from urban and rural long-term-care facilities in southwestern Ontario to identify their perceptions of the workplace factors that affect transfer of learning into practice. Thirty-five people were interviewed across six focus groups.

Instruments for the assessment of pain in older persons with cognitive impairment.

Pain in older persons with cognitive impairment is often unrecognized and inadequately treated. A major problem associated with this undertreatment is the challenging nature of pain assessment and in particular the selection of accurate and useful assessment instruments. The purpose of this study was to review pain measurement instruments for acute and chronic pain suggested for use with cognitively impaired older persons and to summarize available evidence on their reliability and validity.