Learning about sites of care for older adults: a jigsaw educational session for medical students.

Choosing the appropriate site of care for patients is a vital clinical skill when caring for older adults. For better patient safety and smoother transitions of care, we need improved curricula to train clinicians about the system of sites and services where older adults receive care. Here we present an innovative introduction for medical trainees to the complexities of long-term and post-acute care for geriatric patients. Students participated in a team-based 'jigsaw' learning activity, in which each team researched a particular site of care and then taught a larger group of their peers about that site. It was subsequently converted to a virtual format due to COVID-19. The activity was assessed using students' written feedback and satisfaction scores. Students enjoyed the interactivity and hands-on approach, giving the activity an average score of 3.9 out of 5 (1 = 'poor'; 5 = 'excellent'). The jigsaw provided an engaging, case-based foundation for learning about sites of care and was well-received by students.

Chronic Effects of Different Types of Neuromuscular Training on Hemodynamic Responses Estimated VO2max, and Walking Performance in Older People.

This paper investigated the effects over time of different forms of neuromuscular training on hemodynamic responses, the estimated VO2max, and walking performance. 105 older adults were randomly organized into three groups: RGA, RGB, and the Control Group (CG). RGA and RGB did 4 weeks of adaptation phase training and 12 weeks of intervention with different loads: moderate loads for RGB. and higher loads for RGA. A pre- and post-evaluation of the resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), double product (DP), estimated VO2max, and walking performance were assessed. Significant differences were observed for SBP, DBP, HR, and DP. For SBP, a post-evaluation reduction was observed only in RGA (p = 0.007) and when comparing RGA with the Control Group (p < 0.000). For the absolute VO2max, a significant improvement was seen in RGB compared to RGA (p = 0.037) and CG (p < 0.000). For the relative VO2max, RGB scored significantly higher than RGA (p < 0.000) and CG (p < 0.000), post-intervention. For the walk test, a significant reduction in completion times was observed for RGA (p = 0.027) and RGB (p < 0.000), and for RGB compared to RGA (p = 0.000) and CG (p < 0.000). Resistance training can be an excellent strategy for hemodynamic and cardiorespiratory improvement in the elderly.

Suffering assessment: a review of available instruments for use in palliative care.

BACKGROUND: The prevention and relief of suffering in palliative care are critical to the well-being and quality of life of patients and families facing life-threatening diseases. Many tools to assess different issues in health care are available, but few are specifically designed to evaluate suffering, which is essential for its prevention, early management, and treatment. OBJECTIVE: The purpose of this review was to identify and describe existing instruments developed to assess suffering in palliative care, as well as to comment on their psychometric properties. METHODS: A review of articles indexed in MEDLINE, PsycINFO, and SciELO up to June 2011 was conducted. All articles reporting the development, description, or psychometric properties of instruments that assess suffering were included. An assessment of their psychometric quality was performed following a structured checklist. RESULTS: Ten instruments that assess suffering were identified. Their main features and psychometric properties are described in order to facilitate the selection of the appropriate one given each patient's context. CONCLUSION: By taking into consideration all features of the assessment instruments under review, the evaluation of suffering can be made easier. A wide and ever expanding range of approaches is now available, which facilitates the selection of the suffering-assessment instrument that is best suited to the needs of the specific patient. One of the challenges ahead will be to further analyze the psychometric properties of some existing instruments.