Background/Objectives Delirium is common and under-diagnosed in elderly Emergency Department (ED) patients. The primary aim of this study is to create a risk prediction rule for ED delirium. The secondary aim is to compare the mortality rates and resource utilization of delirious versus non-delirious elderly ED patients. Design Prospective observational study. Setting An urban tertiary care emergency department. Participants 700 patients 65 years of age or older and presenting for ED care. Measurements A trained research assistant performed a structured mental status assessment and attention tests, after which delirium was determined using the Confusion Assessment Method. We collected data on patient demographics, comorbidities, medications and ED course, hospital and Intensive Care Unit (ICU) admission, length of stay, hospital charges, and 30-day re-hospitalization and mortality. Results Nine percent of elderly study participants were delirious. Using logistic regression, we created a delirium prediction rule consisting of older age, prior stroke or transient ischemic attack, dementia, suspected infection and acute intracranial hemorrhage with good predictive accuracy (AUC=0.77). Among admitted patients, those with ED delirium had longer median lengths of stay (4 versus 2 days), and were more likely to require ICU admission (13% versus 6%) and to be discharged to a new long-term care facility (37% versus 9%). Among all patients, ED delirium was associated with higher 30-day mortality (6% vs. 1%) and 30-day readmissions (27% vs. 13%). Conclusion Our risk prediction rule may help identify a group of high risk ED patients that should undergo screening for delirium, but requires external validation. Identification of delirium in the ED may enable physicians to implement strategies to decrease delirium duration and avoid inappropriate discharge of acutely delirious patients, thereby improving patient outcomes.

Individuals' attachment styles have been traced throughout the life span, informing our understanding of long-standing interpersonal patterns and self-care habits. Recent scholarship has identified direct and indirect mechanisms through which attachment theory may impact individuals' health outcomes, with specific emphasis on endocrine and behavioral responses to stress. This article reviews extant literature on medical patients' attachment styles and also proposes a new line of research: an investigation of the interaction between patients' and providers' attachment styles. As medical establishments place more emphasis on effective patient-provider communication, attachment theory serves as an apt framework for clarifying, measuring, and training medical personnel in the advancement of patient-centered care.From birth, we are genetically wired to attach to our caregivers for survival. These first relationships not only shape expectations for the self and for future relationships, but they also shape the organization of the brain, nervous system, and endocrine system. In other words, how we attach to others in early childhood can affect how we develop interpersonally and biologically throughout the life

Neurocysticercosis results from the infestation of the central nervous system with invading tapeworm larvae. Though uncommon in the US prior to 1965, new cases are currently being diagnosed at an unprecedented rate. Drawing on environmental health, intervention and risk data retrieved from standard/alternative databases and in-country sources, we present an update and summary of modifiable risk factors and field-tested primary prevention measures. While points of intervention, subpopulations at risk and overall magnitude of the problem are addressed, particular attention is paid to defining risk reduction measures that can be adopted by individuals and high risk groups in the near-term to interrupt or eliminate pathways of exposure leading to disease transmission. Though global eradication is not attainable in the near future, effective preventative measures exist and should be taken now by international travellers and workers, US/foreign government agencies, and individuals living in endemic regions to reduce human suffering.