ABSTRACT
Physicians must integrate care of populations with the care of individual patients to function optimally in today's health care environment. With this understanding, medical school curricula are increasingly addressing the skills and knowledge of public health along with those of clinical medicine. The University of Utah School of Medicine in 1997 revised its four-year curriculum to increase the teaching of topics needed by future physicians, including public health. This report describes one course in the curriculum, the Primary Care Preceptorship (PCP), a fourth-year, six-week required rotation that assists students in learning about the health needs of a community along with providing primary care for its individual residents. Students in the PCP spend approximately 60% of their time in clinical primary care and 40% completing a community health project. In the first year of the PCP, 32 students completed projects on clinical problems, 27 on community health needs assessment, 26 on patient education, and 15 on epidemiology.
Subject(s)
Community Health Services , Education, Medical , Preceptorship , Primary Health Care , Public Health/education , UtahABSTRACT
Numerous research studies have documented the inability of many health care providers to identify nutritional deficit vulnerability and early and advanced malnutrition states in the elderly. This article provides a clinical evaluation guide for identifying risks and diagnosing incipient and advanced malnutrition. Diagnosis and intervention can prevent loss of function and independence and decrease morbidity and mortality in the elderly.
Subject(s)
Geriatric Assessment , Nutrition Assessment , Protein-Energy Malnutrition/diagnosis , Activities of Daily Living , Aged , Anthropometry/methods , Depression/complications , Depression/diagnosis , Humans , Mass Screening/methods , Medical History Taking , Mental Status Schedule , Morbidity , Nursing Assessment/methods , Nutritional Requirements , Physical Examination , Prevalence , Protein-Energy Malnutrition/epidemiology , Protein-Energy Malnutrition/etiology , Psychiatric Status Rating Scales , Risk Factors , United States/epidemiologyABSTRACT
Identifying nutritional deficit vulnerability and early and advanced malnutrition states in the elderly can be challenging. This article provides a clinical evaluation guide for identifying risks and diagnosing incipient and advanced malnutrition. Diagnosis and intervention can prevent loss of function and independence and decrease morbidity and mortality in the elderly.
Subject(s)
Geriatric Assessment/methods , Malnutrition/prevention & control , Mass Screening/nursing , Nutrition Assessment , Aged , Humans , Malnutrition/epidemiology , Malnutrition/nursing , Risk Assessment , Risk Factors , United States/epidemiologyABSTRACT
In response to the Nutrition Screening Initiative, we have outlined a new role for the registered dietitian (RD) in effectively providing comprehensive nutrition case management using a functional approach to nutritional status assessment of the elderly. Recommendations are provided for coordinating access to resources. We propose that through this method RDs will be seen as essential members of the health care team who will provide intervention through direct assistance with the patients. Practical steps and assessment instruments specifically designed for RDs are provided that may be incorporated into routine nutrition screening, assessment, and case management within the health care delivery practice.
