Of 836 medical admissions evaluated over a 1-month period, 89 (10.7%) had a urinary catheter placed within 24 hours; 34 placements (38%) had no justifiable indication. Risk for inappropriate catheterization was independent of age, gender, functional status, and mental status at admission. Preventive measures should focus on increasing awareness among healthcare providers.
This study notes the differences between trust and distrust perceptions by the elderly as compared with younger populations. Given the importance of trust and distrust in compliance, changing behaviors, and forming partnerships for both health and disease management, it is necessary to be able to measure patient–doctor trust and distrust (PDTD). Following recent conceptualizations on trust and distrust as coexistent states, this study hypothesizes predictors of PDTD. We are proposing that these predictors form the basis for designing, developing and validating a PDTD scale (PDTDS). It is important to capture the trust–distrust perceptions of older patients as they confront the complexities and vulnerabilities of the modern healthcare delivery system. This is necessary if we are to design interventions to change behaviors of both the healthcare provider and the older patient.
In this report the literature on all cases of documented measles with hepatobiliary disease was reviewed to describe the characteristics of measles associated hepatitis. We found 27 patients described. Their age ranged from 9 to 59 years. Male to female ratio excluding military facilities was 1:1. The clinical and laboratory presentation appeared to follow one of two patterns. The first was suggestive of hepatocellular dysfunction characterized by aminotransferase elevation. It was encountered in 24/27 cases, seven of them with atypical measles. This form of liver disease tended to be asymptomatic. It appeared early and resolved in a few days. The second pattern was characterized by cholestasis and jaundice. It was described in three cases. This type of hepatitis became apparent when measles began to recede and persisted for two weeks or longer. The variation in time of appearance of the two types of liver disease may imply distinct pathogenetic mechanisms.
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