Margaret Pelli: A Geriatric Standardized Patient Case

Denis Pelli

appeared, predator-prey interactions resulted in more selection pressure. Exceptionally preserved fossil occurrences reveal an increase in ecological complexity over time. Escalation in the number of different modes of life includes the exploitation of a greater range of levels above and below the sediment surface (tiering), as well as diversification of feeding mechanisms and modes of locomoti...

Margaret McCartney: Passing the patient

Epilepsy services managed by nurses. Heart failure services run by pharmacists. General practices staffed by nurses who do almost everything, save for a GP here and there. Have expensive doctors outlived our usefulness in some (or many) quarters? What happens to a patient who gets intermittent mild breathlessness and chest ache sometimes, but not always, on exertion? History, examination: a lit...

Margaret McCartney: Trust the patient.

Each year surveys tell us that doctors are the most trusted UK professionals, well above journalists and politicians. Trust can be quick or slow to grow, conditional, and tentative. But trust is best when it’s experiential, laid down in aliquots of conversation, gesture, and thinking silence, and built up through repeated contact over time. A trusting relationship doesn’t mean perfection. Rathe...

Operationalizing a frailty index from a standardized comprehensive geriatric assessment.

OBJECTIVES To construct and validate a frailty index (FI) that is clinically sensible and practical for geriatricians by basing it on a routinely used comprehensive geriatric assessment (CGA) instrument. DESIGN Secondary analysis of a 3-month randomized, controlled trial of a specialized mobile geriatric assessment team. SETTING Rural Nova Scotia. Participants were seen in their homes. PA...

Reframing the geriatric patient.