The Portal of Geriatrics Online Education: A 21st‐Century Resource for Teaching Geriatrics

The way students are taught and evaluated is changing, with greater emphasis on flexible, individualized, learner‐centered education, including the use of technology. The goal of assessment is also shifting from what students know to how they perform in practice settings. Developing educational materials for teaching in these ways is time‐consuming and can be expensive. The Portal of Geriatrics Online Education (POGOe) was developed to aid educators in meeting these needs and become quicker, better‐prepared teachers of geriatrics. POGOe contains more than 950 geriatrics educational materials that faculty at 45% of allopathic and 7% of osteopathic U.S. medical schools and the Centers for Geriatric Nursing Excellence have created. These materials include various instructional and assessment methodologies, including virtual and standardized patients, games, tutorials, case‐based teaching, self‐directed learning, and traditional lectures. Materials with common goals and resource types are available as selected educational series. Learner assessments comprise approximately 10% of the educational materials. POGOe also includes libraries of videos, images, and questions extracted from its educational materials to encourage educators to repurpose content components to create new resources and to align their teaching better with their learners' needs. Web‐Geriatric Education Modules, a peer‐reviewed online modular curriculum for medical students, is a prime example of this repurposing. The existence of a robust compendium of instructional and assessment materials allows educators to concentrate more on improving learner performance in practice and not simply on knowledge acquisition. It also makes it easier for nongeriatricians to teach the care of older adults in their respective disciplines.     

A.S.P.E.N. Clinical Guidelines

Background: Children with severe intestinal failure and prolonged dependence on parenteral nutrition are susceptible to the development of parenteral nutrition–associated liver disease (PNALD). The purpose of this clinical guideline is to develop recommendations for the care of children with PN‐dependent intestinal failure that have the potential to prevent PNALD or improve its treatment. Method: A systematic review of the best available evidence to answer a series of questions regarding clinical management of children with intestinal failure receiving parenteral or enteral nutrition was undertaken and evaluated using concepts adopted from the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group. A consensus process was used to develop the clinical guideline recommendations prior to external and internal review and approval by the American Society for Parenteral and Enteral Nutrition Board of Directors. Questions: (1) Is ethanol lock effective in preventing bloodstream infection and catheter removal in children at risk of PNALD? (2) What fat emulsion strategies can be used in pediatric patients with intestinal failure to reduce the risk of or treat PNALD? (3) Can enteral ursodeoxycholic acid improve the treatment of PNALD in pediatric patients with intestinal failure? (4) Are PNALD outcomes improved when patients are managed by a multidisciplinary intestinal rehabilitation team?     

Applied information quality: A framework for thinking about the quality of specific information

Information quality, considered abstractly, may seem to be a relatively straightforward matter. Information should be accurate, up to date, useful, and attributable to reputable sources. However, determining the quality of a specific piece of information for a specific use is a more complicated process. The concept ofapplied information quality is defined in this paper as a judgment of information quality (1) made by a specific person or persons, (2) in a specific situational context for use of that information, and (3) based on the characteristics of the information. Each of the three elements of the judgment influences its outcome. Information judgments are made by individuals in the context of their discipline and community of practice. The situational context includes the specifics of the context for use of the information, the questions that the information must address, the strategy for locating potentially relevant information, and the body of information that is retrieved and is available for judgment and use. The paper focuses on the third element of a judgment of information quality—the characteristics of the information on which the judgment is based. These characteristics are grouped for discussion under six metaquestions: What is the information item of interest? How was the focal information created and when? Who is involved with the focal information? From what perspective was the information created and why? What relationships does the focal information have to other information—its antecedents, sources, and other related information? What approval, review, or other filtering processes, if any, has the information gone through? Approaches to improving quality judgments can focus on improving the information itself, improving the channels that organize and deliver information, or improving the individual''s ability to judge the quality of information for a specific purpose. These are not mutually exclusive and, probably, all should be pursued. Applied judgments of information quality are ultimately the responsibility of the individuals using information; they need to be supported in this professional activity as they are in the other responsibilities of their professional practice.     

An association between dentate status and hearing acuity

Hearing improvement following dental treatment has been reported in case studies, yet few objective studies of this phenomenon have been conducted. To determine if a relationship exists between dentate status and hearing acuity, we conducted a retrospective study of elderly subjects enrolled in a health promotion clinical trial. Air-conduction pure tone average thresholds (PTA) administered to left and right ears at 500 Hz, 1000 Hz, 2000 Hz, 3000 Hz, 4000 Hz, and 6000 Hz were used to create six hearing outcome variables, and were compared between groups of subjects who either had 25 or more teeth (n = 182) or were edentulous (n = 43). Mean PTA thresholds were significantly greater (p < 0.05) in edentulous subjects for each hearing outcome variable, and differences between unadjusted group means ranged from 4.9 dB to 8.6 dB. Mean PTA thresholds adjusted for clinical factors known to affect hearing also Indicated worse hearing acuity In the edentulous group. These pilot findings suggest an association between dentate status and hearing acuity .