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OBJECTIVES To determine what treatment decisions physicians will make when faced with an incompetent elderly patient with life-threatening gastrointestinal bleeding and to identify the factors that affect their decisions. DESIGN Survey. SETTING Family practice, medical and geriatrics rounds in academic medical centres and community hospitals in seven(More)
PURPOSE This study tests the validity of self-reported illicit substance use against biochemical testing among Emergency Department (ED) patients seeking treatment with narcotics for backache, headache, and toothache and to characterize patients who provide false reports. METHODS Retrospective chart review comparing the self-reported drug use history(More)
Physical restraint is commonly used in the management of elderly people in North American hospitals and nursing homes. Between December 1981 and March 1982 the Department of Geriatric Medicine, St. Boniface General Hospital, Winnipeg, changed its practice regarding the use of such restraints. In the fiscal year 1980-81 the rate of application of physical(More)
This study examined whether nurses who currently provide direct patient care would perceive and treat pain differently in patients whose pain resulted from activities involving different levels of socially acceptable behavior. Clinical vignettes (differing only with respect to information provided about the patient's behavior at the time of injury) were(More)
The cellular antioxidant system appears to protect cochlear hair cells from oxidative stress due to noise and aging. The role of individual metabolic variables remains poorly understood, however. We examined the role of a number of metabolic factors on human cochlear function in noise-exposed individuals. In 58 factory workers we measured audiometry and(More)
OBJECTIVE Acute gastroenteritis results in 220,000 hospitalizations yearly in the United States. The substantial geographic variation in gastroenteritis care, coupled with the evidence of effective treatment of dehydration in nonhospital settings, suggests that the majority of these hospitalizations are avoidable. We sought to decrease hospitalizations for(More)
PURPOSE To report the findings from a critical appraisal concerning the credibility of a meta-analysis (M-A) about the role of dietary soy intake in reducing breast cancer risk. The use of an evidence-based, advanced nursing practice framework was used to appraise the M-A. APPROACH The clinical question was developed from a problem that could be(More)
A threatened strike by non-professional hospital employees caused a teaching hospital to halve its in-patient numbers. This paper describes this unexpected, involuntary intervention in patient care in the Department of Geriatric Medicine. Fifty-three patients were discharged, 46 patients were transferred for 12 days to another hospital and 29 remained in(More)
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