Alex Smith, MD
@alexsmithmd.bsky.social
📤 410
📥 278
📝 13
Professor of medicine UCSF, GeriPal podcast, ePrognosis, JAGS, dad, husband, Ironman, Go Blue!
Palliative care clinicians and
#ALS
specialists have slightly different views of the unmet palliative needs of patients living with
#ALS
, great paper by Kara Bischoff
onlinelibrary.wiley.com/doi/10.1002/...
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Strengths and Opportunities: Clinicians' Perspectives on Palliative Care for Amyotrophic Lateral Sclerosis (ALS) in the United States
Introduction/Aims Little is known about the state of palliative care (PC) for people with ALS (pALS) in the U.S. We aimed to examine current practice regarding PC for pALS and how it can be improved...
https://onlinelibrary.wiley.com/doi/10.1002/mus.28458
3 months ago
1
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1
reposted by
Alex Smith, MD
Miriam Ní Challaráin
4 months ago
podcasts.apple.com/ie/podcast/g...
Keri Brenner: “it’s not about perfection, it’s about connection” Superb episode
@ewidera.bsky.social
@alexsmithmd.bsky.social
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Death Anxiety: Dani Chammas & Keri Brenner
Podcast Episode · GeriPal - A Geriatrics and Palliative Medicine Podcast · 17/07/2025 · 1h
https://podcasts.apple.com/ie/podcast/geripal-a-geriatrics-and-palliative-medicine-podcast/id1164272877?i=1000717637805
0
2
1
reposted by
Alex Smith, MD
GeriPal Podcast
4 months ago
Guest Victor Montori's book, "Why We Revolt," decries the Industrialization of
#healthcare
. Clinicians become busier & patients are tasked with more work to self manage.
#medsky
👉 Full episode at
bit.ly/GeriPalEp367
😀 Hosts
@alexsmithmd.bsky.social
|
@ewidera.bsky.social
😀 Guest: Victor Montori
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5
reposted by
Alex Smith, MD
GeriPal Podcast
3 months ago
Art in Medical Education: How art museums can enhance empathy & awareness, and create deeper team bonds for health care professionals.
#medsky
👉 Full episode:
bit.ly/GeriPalEp368
😀 Hosts
@alexsmithmd.bsky.social
|
@ewidera.bsky.social
😀 Guests: Amy Klein, Laura Morrison, and Gordon Wood
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5
2
reposted by
Alex Smith, MD
Journal of the American Geriatrics Society (JAGS)
4 months ago
JAGS Remains Committed to Scientific Principles That Support Better Health and Function for All Older Adults: Disparities, Diversity in Research, and Respectful Discourse.
#geriatrics
@alexsmithmd.bsky.social
agsjournals.onlinelibrary.wiley.com/doi/10.1111/...
0
6
3
reposted by
Alex Smith, MD
GeriPal Podcast
4 months ago
How can we best manage
#DeathAnxiety
? While some don't worry about it, others, including patients and clinicians, grapple with its impact.
#medsky
👉 Full episode at
geripal.org/death-anxiet...
😀 Hosts
@alexsmithmd.bsky.social
|
@ewidera.bsky.social
😀 Guests: Dani Chammas & Keri Brenner
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Many thanks to contributions from all authors and others who provided valuable feedback on drafts.
@amergeriatrics.bsky.social
#geriatrics
#DEImatters
add a skeleton here at some point
4 months ago
0
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Renn and friend Evan on hike to Stubai glacier in Tyrollean alps, Austria. (Look closely
@geripal.bsky.social
)
4 months ago
1
9
2
reposted by
Alex Smith, MD
GeriPal Podcast
5 months ago
Should
#PalliativeCare
be in the business of caring for
#CancerSurvivors
? It’s more complicated than it seems. We talk with Laura Petrillo and Laura Shoemaker about this topic.
#medsky
#cancersurvivor
👉 Full episode at
bit.ly/GeriPalEp363
😀 hosts
@alexsmithmd.bsky.social
|
@ewidera.bsky.social
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reposted by
Alex Smith, MD
GeriPal Podcast
6 months ago
#Dementia
patients having Lucid Episodes can be impactful for family, loved ones,
#caregivers
, and others. We discuss this impact with nurse researcher Andrea Gilmore-Bykovskyi & philosopher Andrew Peterson.
#medsky
bit.ly/GeriPalEp358
- hosts
@alexsmithmd.bsky.social
|
@ewidera.bsky.social
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4
reposted by
Alex Smith, MD
Thiago J. Avelino-Silva
6 months ago
My great-grandmother was born 150 years ago. In this special article
@agsjournal.bsky.social
, we tell a little about her story and reflect on resilience and aging.
agsjournals.onlinelibrary.wiley.com/doi/10.1111/...
@ucsfgeriatrics.bsky.social
@alexsmithmd.bsky.social
@kencovinsky.bsky.social
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Cocota's Story: Life Lessons in Aging, Resilience, and End‐of‐Life Agency From a Brazilian Matriarch
Resilience, cultivated across physical, cognitive, psychosocial, and spiritual domains, shapes how older adults navigate late-life challenges yet remains unfamiliar to many clinicians. Drawing on the...
https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.19566
0
9
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reposted by
Alex Smith, MD
GeriPal Podcast
6 months ago
Can music play an important role for those at the end of life? What about for dementia patients and caregivers? We examine the role of Music as Medicine with 3 guests: Jenny Chen, Tyler Jorgensen, and Theresa Allison.
#medsky
bit.ly/GeriPalEp357
-
@alexsmithmd.bsky.social
|
@ewidera.bsky.social
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reposted by
Alex Smith, MD
UCSF Geriatrics
6 months ago
Lauren Hunt, PhD, RN, FNP-BC, received the 2025 Terrie Fox Wetle Rising Star Award from @AFARorg for her impactful, multidisciplinary research in health services and aging. Congrats, Dr. Hunt! 👏
0
3
2
reposted by
Alex Smith, MD
Krista Harrison, PhD
6 months ago
Sing-along state of the science at
#AGS2025
by
@alexsmithmd.bsky.social
@kencovinsky.bsky.social
@ewidera.bsky.social
complete with light sticks at 8:45 am
#WeAreGeriatrics
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reposted by
Alex Smith, MD
Jen Woodard, MD
6 months ago
#ags25
#agslitreview
@amergeriatrics.bsky.social
@ewidera.bsky.social
@alexsmithmd.bsky.social
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2
reposted by
Alex Smith, MD
Lingsheng Li, MD MHS
6 months ago
Spotted at
#AGS25
. In this issue of "Stars - They're just like us!"
@alexsmithmd.bsky.social
@geripal.bsky.social
@ucsfgeriatrics.bsky.social
@amergeriatrics.bsky.social
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14
5
reposted by
Alex Smith, MD
Lingsheng Li, MD MHS
6 months ago
#AGS25
Geri Lit Review
@amergeriatrics.bsky.social
Thank you
@kencovinsky.bsky.social
@alexsmithmd.bsky.social
@ewidera.bsky.social
for an incredibly fun and memorable learning+sing-along experience about all things
#Geriatrics
!
@ucsfgeriatrics.bsky.social
0
13
5
reposted by
Alex Smith, MD
GeriPal Podcast
7 months ago
Today, people with
#HIV
are living into advanced ages with nearly half over age 55. So what are the implications for clinical care? for Loneliness? Stigma? Screening? Guests Peter Selwyn and
@geri4life.bsky.social
bit.ly/GeriPalEp354
- hosted by
@alexsmithmd.bsky.social
and
@ewidera.bsky.social
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reposted by
Alex Smith, MD
Meredith Greene MD (she/her)
7 months ago
Thank you
@geripal.bsky.social
@alexsmithmd.bsky.social
@ewidera.bsky.social
at the end we talk about how YOU can advocate for HIV service and research cuts. Situation only worse since March when this was recorded.
#silence=death
1
6
2
reposted by
Alex Smith, MD
GeriPal Podcast
7 months ago
Beware of PULET: Potentially Unsafe Low-Evidence Treatments endorsed by influencers & self-identified experts. We discuss risky therapies like
#ivermectin
for cancer. Guests Adam Marks, Laura Taylor, & Jill Schneiderhan.
#medsky
bit.ly/GeriPalEp353
-
@alexsmithmd.bsky.social
|
@ewidera.bsky.social
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reposted by
Alex Smith, MD
GeriPal Podcast
7 months ago
Loss of DEI Hurts Everyone. Pulitzer winner Farah Stockman & healthcare leader Ali Thomas discuss why DEI attacks harm healthcare & society, and how diversity & excellence are aligned. Ken Covinsky ties it to Jackie Robinson’s legacy.
bit.ly/GeriPalEp352
- hosted by Drs. Alex Smith and Eric Widera
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6
reposted by
Alex Smith, MD
CAPC
7 months ago
🎤 It’s the thrill of the CAPC Seminar, rising up to the top! The hosts of
@geripal.bsky.social
,
@alexsmithmd.bsky.social
&
@ewidera.bsky.social
, are bringing their energy (+ vocals!) to
#CAPCSeminar25
! Catch their keynote as they break down the latest in palliative care research.
ow.ly/JIJY50VeMqf
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Bitter end, NYC, guerrilla marketing. Amazing talent on singer songwriter night!
bitterend.com/history/
7 months ago
0
1
0
reposted by
Alex Smith, MD
GeriPal Podcast
8 months ago
Nancy Lundebjerg & Annie Medina-Walpole interview Alex Smith, Eric Widera, & Ken Covinsky about their final AGS literature review plenary session & discuss favorite articles, parody songs, & memories from AGS meetings past.
bit.ly/GeriPalEp350
- hosts
@alexsmithmd.bsky.social
|
@ewidera.bsky.social
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3
reposted by
Alex Smith, MD
Krista Harrison, PhD
8 months ago
Another great paper led by Dr. Lauren Hunt came out this week about
#hospice
&
#dementia
, this time regarding "Continued Use of Cholinesterase Inhibitors and Memantine", published in JAMA IM
@jama.com
.
pubmed.ncbi.nlm.nih.gov/40126467/
1/
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Continued Use of Cholinesterase Inhibitors and Memantine in Hospice - PubMed
Continued Use of Cholinesterase Inhibitors and Memantine in Hospice
https://pubmed.ncbi.nlm.nih.gov/40126467/
1
13
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So honored to have the inimitable Dr. Mike Malone give his last lecture, and last slide of his academic career with us at
@ucsfgeriatrics.bsky.social
8 months ago
0
6
1
reposted by
Alex Smith, MD
UCSF Geriatrics
8 months ago
Drs.
@kristalynharrison.bsky.social
,
@alexsmithmd.bsky.social
, John Boscardin, Lauren Hunt & team publish a *JAMA Network Open* study on hospice use among Medicare beneficiaries with Parkinson’s & Lewy Body Dementia.
#HospiceCare
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Hospice Use Among Medicare Beneficiaries With Parkinson Disease and Dementia With Lewy Bodies - PubMed
In this cohort study of Medicare beneficiaries, hospice use patterns differed by dementia subtype. Higher likelihood of hospice revocation in PD raises important questions about unmet needs and…
https://pubmed.ncbi.nlm.nih.gov/40036035/
0
6
3
reposted by
Alex Smith, MD
Journal of the American Geriatrics Society (JAGS)
8 months ago
Pulling Back the Curtain on Deprescribing Interventions.
#geriatrics
#deprescribing
agsjournals.onlinelibrary.wiley.com/doi/10.1111/...
0
6
6
reposted by
Alex Smith, MD
Eric Widera, MD
8 months ago
1 in 7 Medicaid beneficiaries received care at a nursing home following a new cancer diagnosis, with more than half of these individuals using one for the first time. Lung, breast, and hematological were most prevalent.
#gerisky
#medsky
agsjournals.onlinelibrary.wiley.com/doi/10.1111/...
0
13
10
reposted by
Alex Smith, MD
GeriPal Podcast
8 months ago
It's been 50 years since the first Palliative Care unit was opened in Quebec. But have we lost something along the way?
#medsky
Guests Sue Britton (1st nurse hired at that 1st PC unit), Michael Kearney, & Justin Sanders.
bit.ly/GeriPalEp347
- hosts
@alexsmithmd.bsky.social
|
@ewidera.bsky.social
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12
4
reposted by
Alex Smith, MD
Eric Widera, MD
9 months ago
I’m excited to give a keynote talk at the
@capcpalliative.bsky.social
#CAPCSeminar25
! Join
@alexsmithmd.bsky.social
and me in Philadelphia, Sept 15-17, for our session highlighting key papers in
#palliativecare
published in the last year. Register:
capc.org/seminar/
#hpm
#hapc
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CAPC National Seminar 2025 - About
Join us for the CAPC National Seminar 2025 to network, connect, and attend sessions to advance high-quality, equitable palliative care.
https://capc.org/seminar/
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Had the pleasure of being a guest on someone else’s Podcast! Check out My Medical Mixtape - music and palliative care - host Tyler Jorgensen EM/palliative doc in Austin.
open.spotify.com/episode/1HpR...
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Track 2, Side 2: Our Thick Candy Shells
https://open.spotify.com/episode/1HpRHTV1gzgUcLkzxz237S?si=9KMxxy00S3mVKBkc9l-FkA
9 months ago
0
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Congratulations Ab Brody on the HPNA distinguished researcher award!!!
#hapc2025
9 months ago
0
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If at
#hapc25
and you want to do 1 good thing today, go up to someone standing alone by their poster and ask for a 1 minute version. If you do 2 good things ask that poster presenter to join you at the GeriPal pub crawl starting at 8pm at the Celtic.
9 months ago
0
12
5
reposted by
Alex Smith, MD
Thiago J. Avelino-Silva
10 months ago
Agora o ePrognosis conta com uma calculadora atualizada para a versão em português do Walter Index, incorporando as estimativas de risco mais recentes do Brasil e incluindo
#delirium
como fator de risco!
eprognosis.ucsf.edu/walter.php?l...
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ePrognosis - Walter Index
https://eprognosis.ucsf.edu/walter.php?language=Portuguese
0
3
2
reposted by
Alex Smith, MD
UCSF Geriatrics
10 months ago
Dr. Richard Parenteau and his mentor, Dr. Thea Mauro, published "Epidermal Penetration Increases with Age and May Contribute to Systemic Inflammation" in the Journal of Investigative Dermatology.
https://buff.ly/3WYKNmn
#Dermatology
#Research
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Epidermal Penetration Increases with Age and May Contribute to Systemic Inflammation - PubMed
Epidermal Penetration Increases with Age and May Contribute to Systemic Inflammation
https://buff.ly/3WYKNmn
0
6
2
reposted by
Alex Smith, MD
Thanh Neville, MD, MSHS
10 months ago
As doctors and nurses, it is our moral duty to care for every person who walks through the door & needs medical help. Allowing ICE to raid hospitals & clinics is immoral and will lead to needless suffering & death. Reading this made me cry...what nation have we become?
#medsky
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Allowing ICE in hospitals is a public health catastrophe in the making
Allowing ICE to conduct raids in hospitals and medical clinics is not only cruel; it is a public health catastrophe in the making, writes Eric Reinhart.
https://www.statnews.com/2025/01/23/ice-hospitals-citizenship-status-undocumented-workers-health-care/
37
822
268
reposted by
Alex Smith, MD
Journal of the American Geriatrics Society (JAGS)
10 months ago
Comorbidities among older persons living with dementia do not appear to cluster into distinct groups or patterns highlighting the importance of taking an individualized approach for chronic disease management.
#geriatrics
#dementia
agsjournals.onlinelibrary.wiley.com/doi/10.1111/...
0
18
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reposted by
Alex Smith, MD
Rachel Schwartz
10 months ago
Interesting upcoming panel on MAiD on 2/11/25- with attention to how vulnerable groups without access to robust health care and treatment may be affected by
#MAiD
#hpm
#hapc
my.wlu.edu/mudd-center/...
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How We Die: A Panel Investigating the Ethics of Medical Aid in Dying (MAID) : Washington and Lee University
Terri Laws, Thaddeus Mason Pope, and Mara Buchbinder<br /><br /><strong>How We Die: A Panel Investigating the Ethics of Medical Aid in Dying (MAID)</strong><br /><strong>Tuesday, February 11, 2025 at ...
https://my.wlu.edu/mudd-center/programs-and-events/2024-2025-how-we-live-and-die/panel
0
3
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reposted by
Alex Smith, MD
Krista Harrison, PhD
10 months ago
This was a fun collaboration of researchers working on palliative care research across the lifespan, led by Komal Murali:
pubmed.ncbi.nlm.nih.gov/39773597/
#hapc
#palcare
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Palliative Nursing in Home Health Care Across the Lifespan - PubMed
Primary palliative nursing in home health care (HHC) can be delivered to medically complex patients across the lifespan. Primary palliative nursing provides patient- and family-centered care for serio...
https://pubmed.ncbi.nlm.nih.gov/39773597/
0
1
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Lauren Hunt demonstrated that slow inexorable functional decline in people with dementia can be punctuated by disruptive events such as hip fracture and hospitalization for pneumonia, leading to big drops in function.
#geriatrics
#hapc
agsjournals.onlinelibrary.wiley.com/doi/10.1111/...
10 months ago
0
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In this study, geriatrician-researcher Thiago Da Silva
@geritjas.bsky.social
shows that the Louise Walter
@lwaltermd.bsky.social
prognostic index for hospitalized older adults validates in Brazil, and delirium adds to prognostic accuracy.
#geriatrics
#hapc
jamanetwork.com/journals/jam...
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Validation of the Walter Index for Posthospitalization Mortality Prediction
This prognostic study investigates whether the Walter Index, developed to assess 12-month mortality risk in US older adults after hospitalization, has comparable predictive accuracy among older adults...
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829452
10 months ago
2
14
7
reposted by
Alex Smith, MD
Eric Widera, MD
10 months ago
What other departments or divisions are doing faculty sessions on teaching how to get on BlueSky?
@ucsfgeriatrics.bsky.social
is! Thanks
@lwaltermd.bsky.social
for setting this up!
#geriatrics
#gerisky
1
44
19
reposted by
Alex Smith, MD
Eric Widera, MD
10 months ago
Tamiflu (Oseltamivir), the most commonly prescribed influenza treatment, causes more adverse effects (nausea and vomiting) but has little to no effect on clinical outcomes compared with placebo (i.e.mortality, hospitalization, time to alleviation of symptoms).
#medsky
jamanetwork.com/journals/jam...
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Antiviral Medications for Treatment of Nonsevere Influenza
This systematic review and network meta-analysis evaluates the effectiveness and safety of antiviral treatment for patients with nonsevere influenza and thus support an update of World Health Organiza...
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2829156
0
23
10
reposted by
Alex Smith, MD
Eric Widera, MD
10 months ago
This paper argues that it's unethical to put a DNR order in for those who have a unilateral DNR as it "obscures the unilateral decision-making by the clinician", but misses the point that an order doesn't ever show reasoning; that's what a note is for.
#medsky
jamanetwork.com/journals/jam...
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Addressing Inadequate Documentation of Unilateral Do-Not-Resuscitate Orders
This Viewpoint discusses addressing inadequate documentation of unilateral do-not-resuscitate orders in the electronic health record.
https://jamanetwork.com/journals/jama/fullarticle/2829203
0
7
2
reposted by
Alex Smith, MD
Ken Covinsky
10 months ago
Important to remember that efforts to help people stop smoking will do FAR more to prevent to prevent lung cancer that screening CTs. To offer screening without addressing smoking is absurd
jamanetwork.com/journals/jam...
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Smoking Cessation Interventions in the Lung Cancer Screening Setting
This randomized clinical trial evaluates the effectiveness of smoking cessation interventions of varying intensities in the lung cancer screening setting.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2829155
0
4
2
reposted by
Alex Smith, MD
Ken Covinsky
10 months ago
Fascinating perspective on "Pressure ulcers"--Is skin injury always the result of pressure? Authors argue that like any organ, the skin can fail towards the end of life--and this is sometimes not preventable
jamanetwork.com/journals/jam...
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The Evolving Case for Skin Failure—Beyond Pressure Injury
This Viewpoint discusses the concept of skin failure, the breakdown of skin in aging and critically ill patients; how it differs from pressure injury; and future areas of research regarding the proces...
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2829154?utm_source=twitter&utm_campaign=content-shareicons&utm_content=article_engagement&utm_medium=social&utm_term=011325
0
9
4
reposted by
Alex Smith, MD
Thiago J. Avelino-Silva
10 months ago
“Delirium is inherently multifactorial; thus, effective treatments will require a multifactorial approach to target multiple vulnerability and precipitating factors.”
@nidus-delirium.bsky.social
@ucsfgeriatrics.bsky.social
@alexsmithmd.bsky.social
journals.lww.com/ccmjournal/f...
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Advancing Delirium Treatment Trials in Older Adults:... : Critical Care Medicine
ans, nurses, and pharmacists) and nonclinicians (biostatisticians, epidemiologists, and trial methodologists) was convened. Four expert panels were assembled to explore key subtopics (pharmacological/...
https://journals.lww.com/ccmjournal/fulltext/2025/01000/advancing_delirium_treatment_trials_in_older.3.aspx
0
3
2
reposted by
Alex Smith, MD
Eric Widera, MD
11 months ago
Our most listened-to podcast of 2024: The Nature of Suffering with BJ Miller and Naomi Saks. BJ and Naomi discuss topics like how to respond to someone suffering and the trap in comparing one person’s suffering to another person’s suffering.
#medsky
geripal.org/the-nature-o...
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The Nature of Suffering: BJ Miller and Naomi Saks
On this week's podcast, we are joined by BJ Miller, a palliative care doctor, and Naomi Sacks, a palliative care chaplain, to discuss the nature of suffering.
https://geripal.org/the-nature-of-suffering-bj-miller-and-naomi-saks/
0
23
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reposted by
Alex Smith, MD
Ken Covinsky
10 months ago
Provision of hearing aids to older persons with hearing impairment leads to profound improvements in day to day communication function. Important RCT Isn't it outrageous the Medicare does not pay for hearing aids?
agsjournals.onlinelibrary.wiley.com/doi/10.1111/...
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Effect of hearing intervention on communicative function: A secondary analysis of the ACHIEVE randomized controlled trial
Background The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) Study was designed to determine the effects of a best-practice hearing intervention on cognitive decline among community-dwel...
https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.19185
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