A5083780051- Geriatric Care and Nursing Homes
- Intensive Care Unit Cognitive Disorders
- Emergency and Acute Care Studies
- Dementia and Cognitive Impairment Research
- Chronic Disease Management Strategies
- Mental Health Treatment and Access
- Anesthesia and Sedative Agents
- Substance Abuse Treatment and Outcomes
- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- Frailty in Older Adults
- Cardiac Health and Mental Health
- Homelessness and Social Issues
- Adolescent Sexual and Reproductive Health
- Diabetes Management and Education
- Healthcare Decision-Making and Restraints
- Primary Care and Health Outcomes
- Anesthesia and Neurotoxicity Research
- Digital Mental Health Interventions
- Palliative Care and End-of-Life Issues
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare Policy and Management
- Schizophrenia research and treatment
- Aging and Gerontology Research
- Patient Satisfaction in Healthcare
McGill University
2016-2025
Centres Intégré Universitaires de Santé et de Services Sociaux
2022-2023
St Mary's Hospital
2011-2021
McGill University Health Centre
2005-2021
Montreal Heart Institute
2007-2012
Hôpital Charles-Le Moyne
2007-2012
Institut National de Santé Publique du Québec
2003-2012
Université de Sherbrooke
2012
St. Mary’s Hospital
1998-2009
Domus Medica
2007
<h3>Background</h3> Delirium has not been found to be a significant predictor of postdischarge mortality, but previous research methodologic limitations including small sample sizes and inadequate control confounding. This study aimed determine the independent effects presence delirium, type delirium (incident vs prevalent), severity symptoms on 12-month mortality among older medical inpatients. <h3>Methods</h3> A prospective, observational 2 cohorts inpatients was conducted with patients 65...
OBJECTIVES: To develop a self‐report screening tool to identify older people in the emergency department (ED) of hospital at increased risk adverse health outcomes, including: death, admission nursing home or long‐term hospitalization, clinically significant decrease functional status. DESIGN: Prospective (6‐month) follow‐up study cohort ED patients aged 65 and older. SETTING: The EDs four acute‐care hospitals Montreal, Quebec, Canada. PARTICIPANTS: Community‐dwelling who came during weekday...
<h3>Background</h3> Use of anticholinergic (ACH) medications is a biologically plausible and potentially modifiable risk factor delirium, but research findings are conflicting regarding its association with delirium. <h3>Objectives</h3> To evaluate the longitudinal between use ACH severity delirium symptoms to determine whether this modified by presence dementia. <h3>Patients Methods</h3> A total 278 medical inpatients 65 years older diagnosed incident or prevalent were followed up repeated...
Objectives: To determine the effects of prevalent and incident delirium on length hospital stay. Design: Prospective cohort study, comparing (1) stay after admission in cases versus controls without with (2) diagnosis matched by day diagnosis. Setting: The medical services a primary, acute care hospital. Participants: Medical admissions patients aged 65 older from emergency department diagnosed during first week Patients admitted to intensive or oncology those primary stroke were excluded. A...
Abstract Objectives: 1) To describe the pattern of return visits to emergency department (ED) among elders over six months following an index visit; 2) identify predictors early (within 30 days) and frequent (three or more in months); 3) evaluate a newly developed screening tool for functional decline, Identification Seniors At Risk (ISAR), with regard its ability predict visits. Methods: Subjects were patients aged 65 years who visited EDs four Canadian hospitals during weekday shift...
OBJECTIVES: To determine the prognostic significance of subsyndromal delirium (SSD) presentations. DESIGN: Cohort study. SETTING: University‐affiliated primary acute care hospital. PARTICIPANTS: One hundred sixty‐four elderly medical inpatients who did not meet Diagnostic and Statistical Manual Mental Disorders, Third Edition, Revised (DSM‐III‐R) criteria for during first week after admission were classified into three mutually exclusive groups. The group, prevalent SSD, included those had...
<b>Background:</b> People aged 65 years or more represent a growing group of emergency department users. We investigated whether characteristics primary care (accessibility and continuity) are associated with use by elderly people in both urban rural areas. <b>Methods:</b> conducted cross-sectional study using information for random sample 95 173 drawn from provincial administrative databases Quebec 2000 2001. obtained data on the patients9 age, sex, comorbidity, rate (number days which...
OBJECTIVES: To determine the effectiveness of a two‐stage (screening and nursing assessment) intervention for older patients in emergency department (ED) who are at increased risk functional decline other adverse outcomes. DESIGN: Controlled trial, randomized by day ED visit, with follow‐up 1 4 months. SETTING: Four university‐affiliated hospitals Montreal. PARTICIPANTS: Patients age 65 expected to be released from community score 2 or more on Identification Seniors At Risk (ISAR) screening...
This report describes the findings of a randomized study new team approach to home care for homebound chronically or terminally ill elderly. The includes physician, nurse practitioner, and social worker delivering primary health in patient's home, including physician house calls. Weekly conferences assure coordination patient care. is available emergency consultation through 24-hour telephone service. attends during necessary hospitalizations. was evaluated experimental design measuring its...
This study assesses the effects of HIV (human immunodeficiency virus) antibody testing on subsequent (one year) sexual behavior among 270 homosexual men at a Boston community health center, 21 per cent whom were unaware their test result. Except for number steady partners, levels all activities groups participants declined over time. No awareness status found protective receptive anogenital contact. Elimination unprotected insertive contact (by elimination practice or by condom use) was...
ABSTRACT Background Self‐directed interventions are cost‐effective for patients with cancer and their family caregivers, but barriers to use can compromise adherence efficacy. Aim Pilot a Sequential Multiple Assignment Randomized Trial (SMART) develop time‐varying dyadic self‐management intervention that follows stepped‐care approach in providing different types of guidance optimize the delivery Coping‐Together, self‐directed intervention. Methods 48 caregivers were randomized Stage 1 to:...
To evaluate the relationship of environmental risk factors in hospitals to changes over time delirium symptom severity scores.Observational prospective clinical study with repeated measurements, several times during first week hospitalization and then weekly hospitalization.University-affiliated general community hospital.Four hundred forty-four patients age 65 older admitted medical wards: 326 118 without delirium. Patients prior cognitive impairment were oversampled.The symptoms was...
ABSTRACT Objective: To determine which characteristics of older patients who use a hospital ED are associated with repeat visits during the 90 days following index visit. Methods: The study was conducted in 400‐bed university‐affiliated acute care community Montreal. Patients aged ≥75 years visited between 08:00 and 16:00 on convenience sample over an 8‐week period (July August 1994) were assessed using questionnaire, physical cognitive status instruments, functional problem checklist....
Objectives: To evaluate the validity of Identification Seniors at Risk (ISAR) screening tool for detecting severe functional impairment and depression predicting increased depressive symptoms utilization health services. Setting: Four university‐affiliated hospitals in Montreal. Design: Data from two previous studies were available: Study 1, which ISAR scale was developed (n=1,122), 2, it used to identify patients a randomized trial nursing intervention (n=1,889 with administrative data, 520...
Objectives: To assess the reliability, validity, and responsiveness of an instrument for measuring severity delirium, Delirium Index (DI). Design: Prospective cohort study, with repeated patient assessments at multiple points in hospital, 8 weeks after discharge, 6 12 months admission. Setting: The medical services a primary acute‐care hospital. Participants: Medical admissions aged 65 older: 165 delirium dementia, 57 only, 55 dementia 41 neither. Measurements: Severity symptoms was measured...