IMPORTANCE Delirium is common among older emergency department (ED) patients, is associated with high morbidity and mortality, and frequently goes unrecognized. Anecdotal evidence has described atypical presentations of coronavirus disease 2019 (COVID-19) in older adults; however, the frequency of and outcomes associated with delirium in older ED patients with COVID-19 infection have not been well described. OBJECTIVE To determine how frequently older adults with COVID-19 present to the ED with delirium and their associated hospital outcomes.

Older adults are at greatest risk of severe disease and death due to coronavirus disease 2019 (COVID-19). Globally, persons older than 65 years comprise 9% of the population, 1 yet account for 30% to 40% of cases and more than 80% of deaths. 2 Unfortunately, there is a long history of exclusion of older adults from clinical trials. In response, the National Institutes of Health instituted the Inclusion Across the Lifespan policy, requiring the inclusion of older adults in clinical trials. 3 Thus, we reviewed all COVID-19 treatment and vaccine trials on http:// www.clinicaltrials.gov to evaluate their risk for exclusion of older adults (≥65 years).

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Background/Aims All agree that informed consent is a process, but past research has focused content analyses post-consent or in one conversation in the consent series. Our aim was to identify and describe the content of different types of consent conversations. Methods We conducted a secondary analysis of 38 adult oncology phase 1 consent conversations, which were audio-recorded, transcribed, coded, and qualitatively analyzed for type and content. Results Four types of consent conversations were identified: 1) priming; 2) patient-centered options; 3) trial-centered; and 4) decision made. The analysis provided a robust description of the content discussed in each type of conversation. Two themes, supportive care and prognosis, were rarely mentioned. Four themes clustered in the patient-centered (type 2) conversations: affirmation of honesty, comfort, progression and offer of supportive care. Conclusion We identified and described four types of consent conversations. Our novel findings include 1) four different types of conversations with one – priming – not mentioned before; 2) a change of focus from describing the content of one consent conversation to describing the content of different types. These in-depth descriptions provide the foundation for future research to determine if the four types of conversations occur in sequence, thus describing the structure of the consent process and providing the basis for coaching interventions to alert physicians to the appropriate content for each type of conversation. A switch from a focus on one conversation to the types of conversations in the process may better align the consent conversations with the iterative process of shared-decision making.

The relationship between processes of mental health recovery and lifelong learning is an area of increasing international interest. Experiences of transformation, positive effects on self-esteem, self-insight, and empowerment have been identified regarding both endeavors. Recognition of these benefits has stimulated collaborative development of educational programs in personal development, self-efficacy, and recovery principles. The importance of evaluating this educational provision has been emphasized; however, there has been little detailed exploration of students' experiences and perceptions of recovery and learning in the context of recovery education programs. In this article, we present a participatory arts-based inquiry with 14 women, including mental health service users, who undertook a recovery training program to support their roles as mental health support workers in Ireland. Participatory visual analysis revealed three recurring themes; the interrelatedness of learning and recovery journeys, knowledge as a source of stability and rescue and the need for resilience in learning and recovery.