Persons with AD do not incur higher costs than persons with other types of dementia or age-matched persons without dementia in a mature health maintenance organization during the last few years of life, when utilization is likely to be highest.

No abstract

The results add further support to guidelines that suggest that CT scans of the brain for confused elderly patients should only be performed for those with acute neurological findings, head trauma or a fall.

Polypharmacy and adverse drug reactions are common with ageing. Deprescribing or ceasing unnecessary or harmful medications is an important component of aged care practice, especially in the final year of life. Changes in pharmacokinetics and pharmacodynamics with ageing can affect decisions about deprescribing. Similarly, the balance between risk and benefit for medications is often altered in patients in their final year of life and needs to be taken into account. There is evidence for medicines that can be safely ceased abruptly and medicines that need to be weaned. An individualised approach is required to assess prognosis, trajectory of decline and therapeutic goals for each patient. An algorithm is provided in this review to guide safe, rational deprescribing for patients who are believed to be in their last year of life.

No abstract

Our intervention resulted in better protocol adherence in intervention stroke units, which explains our main trial findings of improved patient 90-day outcomes. Although monitoring practices significantly improved, there was no difference between the groups in the treatment of fever and hyperglycemia following acute stroke. A significant link between improved treatment practices and improved outcomes would have explained further the success of our intervention, and we are still unable to explain definitively the large improvements in death and dependency found in the main trial results. One potential explanation is that improved monitoring may have led to better overall surveillance of deteriorating patients and faster initiation of treatments not measured as part of the main trial.

The discovery and development of the Thermal DeNO, process are described. One important aspect of that development was the continuation of the basic research in order to develop the computer model of the NO reduction chemistry. This model proved useful in optimizing the application of the Thermal DeNO, process to boilers and furnaces, in understanding other potential applications, e.g., gas turbines, automobiles, fluid bed combustors, and low-Btu gas, and in understanding problems in the chemistry such as the self-inhibition effect and the lack of an effect from addition of sulfur oxides.

HIRAID should be considered for integration into clinical practice to provide nurses with a systematic approach to patient assessment and potentially improve the delivery of safe patient care.