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Objectives: This study examines healthcare resource use (hospitalizations, emergency department [ED] visits, and home health episodes) among adults 65 and older diagnosed with hearing, vision, or dual sensory loss (SL) seen in the primary care setting of an academic health system. Methods: Multivariable logistic regression models were used to examine the relationship between SL (identified using ICD-10 codes) and healthcare resource use for 45,000 primary care patients. Results: The sample included 5.5% (N = 2479) with hearing loss, 10.4% (N = 4697) with vision loss, and 1.0% with dual SL (N = 469). Hearing loss increased the likelihood of having an ED visit (OR = 1.22, CI: 1.07–1.39), and home health services (OR = 1.27, CI: 1.07–1.51) compared to older adults without any SL. Vision loss reduced the likelihood of having a hospitalization (OR =.81, CI:.73–.91). Discussion: Findings support research into the drivers of healthcare use among older adults with sensory loss. [ABSTRACT FROM AUTHOR]

To address the pending public health crisis due to Alzheimer's disease (AD) and related neurodegenerative disorders, the Marian S. Ware Alzheimer Program at the University of Pennsylvania held a meeting entitled "State of the Science Conference on the Advancement of Alzheimer's Diagnosis, Treatment and Care," on June 21-22, 2012. The meeting comprised four workgroups focusing on Biomarkers; Clinical Care and Health Services Research; Drug Development; and Health Economics, Policy, and Ethics. The workgroups shared, discussed, and compiled an integrated set of priorities, recommendations, and action plans, which are presented in this article.

Background: Within the next 30 years, the number of visits older adults will make to emergency departments (EDs) is expected to double from 16 million, or 14% of all visits, to 34 million and comprise nearly a quarter of all visits.Objective: The objectives of this study were to determine prevalence rates of cognitive impairment among older adults in the ED and to identify associations, if any, between environmental factors unique to the ED and rates of cognitive impairment.Methods: A cross-sectional observational study of adults 65 and older admitted to the ED of a large, urban, tertiary academic health center was conducted between September 2007 and May 2008. Patients were screened for cognitive impairment in orientation, recall and executive function using the Six-Item Screen (SIS) and the CLOX1, clock drawing task. Cognitive impairment among this ED population was assessed and both patient demographics and ED characteristics (crowding, triage time, location of assessment, triage class) were compared through adjusted generalized linear models.Results: Forty-two percent (350/829) of elderly patients presented with deficits in orientation and recall as assessed by the SIS. An additional 36% of elderly patients with no impairment in orientation or recall had deficits in executive function as assessed by the CLOX1. In full model adjusted analyses patients were more likely to screen deficits in orientation and recall (SIS) if they were 85 years or older (Relative Risk [RR]=1.63, 95% Confidence Interval [95% CI]=1.3-2.07), black (RR=1.85, 95% CI=1.5-2.4) and male (RR=1.42, 95% CI=1.2-1.7). Only age was significantly associated with executive functioning deficits in the ED screened using the clock drawing task (CLOX1) (75-84 years: RR=1.35, 95% CI= 1.2-1.6; 85+ years: RR=1.69, 95% CI= 1.5-2.0).Conclusion: These findings have several implications for patients seen in the ED. The SIS coupled with a clock drawing task (CLOX1) provide a rapid and simple method for assessing and documenting cognition when lengthier assessment tools are not feasible and add to the literature on the use of these tools in the ED. Further research on provider use of these tools and potential implication for quality improvement is needed. [West J Emerg Med. 2011; 12(1):56-62.]

An innovative approach to teaching psychiatric nursing incorporates students' knowledge and experience as subject matter for inquiry. It includes an artistic genre project in order to develop empathy through aesthetic experience. (SK)

The University of Pennsylvania School of Nursing has established a community-based practice based on a model of socially responsible care and designed to meet the complex care needs of frail elders. The LIFE program is culturally relevant, involves the community in governance, and includes a research agenda and health-information network. (JOW)

Describes a fundamental revision of an undergraduate psychiatric-mental health nursing program that was undertaken to maintain its humanistic focus while rising to the marketplace challenges that confront nurses in constantly changing environments. Includes a chart of core content, psychiatric mental health content, and competencies. (Author/JOW)

Alliances for academic home care offer a new approach to advance the knowledge base related to home care, to improve quality and cost effectiveness of home care services, to prepare the next generation of providers to manage and deliver care in a restructured practice paradigm, and to influence health and social policy. (JOW)