Rapid emergency department intervention for older people reduces risk of functional decline: results of a multicenter randomized trial.

Objectives: To determine the effectiveness of a two-stage (screening and nursing assessment) intervention for older patients in the emergency department (ED) who are at increased risk of functional decline and other adverse outcomes.

Design: Controlled trial, randomized by day of ED visit, with follow-up at 1 and 4 months.

Setting: Four university-affiliated hospitals in Montreal.

Stress and residents' lifestyle. Survey of family medicine residents at McGill University.

To study the effects of training on quality of life and work satisfaction, we distributed questionnaires to all McGill family medicine residents. Residents lacked leisure time and were concerned that the heavy workload would affect subsequent quality of care. However, they adapted well to the stress of training.

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Because we are concerned with the teaching of preventive medicine to residents in family medicine, we decided to implement a vaccination study to evaluate residents' efficacy in preventing infectious diseases. After collecting each patient's past history of infectious diseases and vaccination the residents completed the necessary vaccination according to protocol, over one year. We used the one-tail hypothesis test of proportion to verify significant differences in the proportion of patients not well immunized at the end of the study, compared with the beginning, for each vaccine studied.

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The Speech and Hearing Department of the University of Montréal, in conjunction with ‘l'Unité de médecine familiale de Verdun’ set up a pilot project grouping family doctors, audiologists and speech pathologists. Information was exchanged on speech and language problems in children, stuttering, voice disorders, aphasia and hearing problems in children and adults. We emphasized the importance of early detection of these problems, of adequate information to the patient and his family and referral to the speech pathologist or to the audiologist.