Objectives To evaluate the effect of inhaler education programs on clinical outcomes and exacerbation rates in older adults with asthma or chronic obstructive pulmonary disease (COPD). Design Systematic review and meta‐analysis. Setting and Participants Older adults with asthma or COPD, either in primary or secondary health care and pharmacy setting. Measurements We searched the Medline, Embase, and Central databases according to the main eligibility criteria for inclusion: systematic reviews, meta‐analysis, clinical trials and quasi‐experimental studies; participants aged 65 and older; education on inhaler technique and reporting of disease control and exacerbation rates. We used the Grading of Recommendations, Assessment, Development and Evaluations scale for quality assessment and used a random‐effect model with Mantel–Haenszel adjustment to perform a meta‐analysis. Results We included 8 studies (4 randomized, 4 quasi‐experimental) with a total of 1,812 participants. The most frequent type of intervention was physical demonstration of inhaler technique, training with placebo devices. Five studies showed significant reduction in exacerbation rates (pooled risk ratio=0.71, 95% confidence interval=0.59–0.86; p < .001), although effect on disease control and quality of life showed high discrepancy in the reported results, and all randomized studies revealed uncertainty in their risk of bias assessment. Conclusion All interventions seemed to improve inhaler performance and clinically relevant outcomes, but a placebo device could be the most effective. There is evidence that interventions reduce exacerbation risk in older adults, although to an overall moderate degree. J Am Geriatr Soc 67:57–66, 2019.

In this large clinical series of Brazilian children and adolescents, autoimmune hepatitis-1 was more frequent, and patients with autoimmune hepatitis-2 exhibited higher disease remission rates with earlier response to treatment. Patients with autoimmune hepatitis-1 had a higher risk of death.

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A surge of research has been conducted to examine memory editing mechanisms that help distinguish accurate from inaccurate memories. In the present experiment, the authors examined the ability of participants to use novelty detection, recollection rejection, and plausibility judgments to reject lures presented on a recognition memory test. Participants studied a list of word pairs that were arranged in a category relationship (both words from the same category) or an unrelated relationship (both words from different categories) under full or divided attention. At test, participants were given a yes/no recognition test in which they were to respond after seeing the test items for 400 ms or 2,800 ms. Some of the test items were rearranged word pairs that were consistent with the study relationship, whereas others were inconsistent with the study relationship. The results demonstrate that the participants required full attention at study to use novelty detection, recollection rejection, and plausibility judgments to reject lures. Moreover, the results indicate that a long response deadline at test was needed for participants to use both recollection rejection and plausibility judgments to reject lures.