The generative naming ability (verbal fluency) of 88 idiopathic Parkinson disease (PD) patients was evaluated and compared to that of 21 Alzheimer disease (AD) patients and 43 normal age- and education-matched normal control subjects. The PD patients were classified according to whether they scored within the normal range on the Mini-Mental State Examination (MMSE), a score of 27 or higher, or in the abnormal range, a score of 26 or lower. Semantic and letter generative naming tasks were administered to assess verbal fluency. Results of the study provide evidence that letter category naming is inherently more difficult than semantic category naming; that age significantly affects generative naming; that PD patients with normal MMSE scores were significantly inferior to normal control subjects in generative naming even after the effects of age and mental status are controlled; that PD patients with non-normal MMSE scores performed like AD patients after controlling for the effects of age and mental status; and, that ideational perseveration is the most common type of error response for all subject groups.

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Study objectives Older adults who sustain hip fractures are susceptible to high rates of morbidity and mortality. The systemic administration of opioids is associated with side effects disproportionately affecting the elderly. The ultrasound-guided fascia iliaca compartment block procedure (FICB) is associated with a reduced patient need for oral and parenteral opioids and with improved functional outcomes. We designed a multi-disciplinary quality improvement initiative to train emergency physicians (EPs) to perform the ultrasound-guided FICB procedure for geriatric hip fracture patients. We examined the lessons derived from the EPs' resistance to implementing a practice-changing behavior. Methods This study was a prospective observational cohort study. We included all emergency department (ED) patients > 65 years with X-ray confirmation of isolated hip fractures. We also enrolled the treating EPs. Patients were enrolled from March 2016 to January 2017 in an urban, academic ED with 100,000 annual visits. The ED ultrasound faculty trained ED faculty and residents in the FICB procedure. Seventeen of 50 attending EPs completed the training: classroom lecture and online narrated video instruction. The hands-on sessions consisted of three stations: scan a human model volunteer to review the sonoanatomy, practice the needle technique using a Blue Phantom TM Regional Anesthesia Ultrasound Training Block Model (Simulaids, Inc., NY, US), and practice the needle technique using a static simulator. We created a multi-disciplinary geriatric hip fracture order set for the electronic medical record. The attending EPs, caring for eligible patients, were asked to complete a Research Electronic Data Capture (REDCap) survey, and we analyzed the data using descriptive statistics. Results We enrolled 77 geriatric hip fracture patients. Two of the 77 patients received FICB. Thirty-two EPs participated as providers for these patients while 97% of these providers completed the post-intervention survey. Providers used the geriatric hip fracture order set in 10 of 77 encounters. Most EPs did not perform the block because they were not trained or did not feel comfortable performing it. Conclusion Despite the efficacy supported by the literature and training sessions offered, the EPs in this study did not adopt the FICB procedure. Future efforts could include developing a FICB on-call team, increasing the proportion of trained EPs through initial supervised hands-on practice, and partnering financial or education incentives with getting trained.

We have created a low-cost and easy to make phantom for abscess identification using point-of-care ultrasound. The phantom also allows needle tracking and abscess aspiration using ultrasound guidance.