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Frailty test predicts outcomes in older patients
Living Talmudic principles Background.—The Rabbis of the Talmud involved in the business of their times were scholars and teachers who trained others in a tradition and a system of behavior and belief. The role of the dentist might be viewed as similar to that of the Rabbis of the Talmud. The Rabbis of the Talmud.—Although the Rabbis were scholars and trained students to carry on their scholarship and leadership, they were also artisans, blacksmiths, potters, farmers, and were engaged in other businesses of the time. They were entrusted with the sacred system of beliefs and actions and were expected to embody the values they taught. They also led the expansion and understanding of the traditional teachings. Policies and actions were greatly influenced by these men of affairs. They were leaders in social consciousness efforts, teaching others to serve and embodying the spirit of serving those who were less fortunate. Dentists.—The Latin word for doctor means teacher, and dentists are indeed teachers in many settings. They teach patients about better dental and overall health. They teach dental students about the various aspects of dentistry. They teach disadvantaged groups and clinic patients about dental health matters. They also mentor predental and dental students, often through the sponsorship of Alpha Omega chapters. In addition, dentists take part in political action groups, shaping public policies regarding health care. Philanthropic efforts include donating time, expertise, and resources to various causes throughout the
world. The Board of Directors of Alpha Omega could be viewed as similar to Rabbis of the Talmud as they train successors in leadership roles. Discussion.—When looking at the role of the Rabbis of the Talmud in their society, it is easy to note parallels in the role played by the modern dentist. Teaching is a vital part of what dentists do, whether it is the one-on-one in a dental practice, the mentoring of persons studying to follow in our footsteps, or the modeling and teaching of healthy behaviors to audiences of various types—disadvantaged groups, elderly, children, and so on. Dentists also serve as business leaders, change leaders, and philanthropists in today’s society. It is interesting to note the similarities of these roles to those of the leaders in past times.
Clinical Significance.—Dentists wear many hats and have numerous opportunities to have an effect on the society. It is important to become involved in these activities for the betterment of those around us.
Margolis FS: How similar are dentists to the Rabbis of the Talmud? Alpha Omegan 103:48, 2010 Reprints not available
EXTRACTS FRAILTY TEST PREDICTS OUTCOMES IN OLDER PATIENTS Researchers at Johns Hopkins University School of Medicine have developed a simple, 10-minute frailty test for older patients to take before undergoing surgery. The result can predict with great certainty the patient’s risk for complications, length of hospital stay, and need for care in a nursing home after surgery. The measure uses a 5-point scale and issues 1 point for each of five problems, specifically, loss of 10 pounds or more in the previous year, weakness measured by a handheld dynamometer, exhaustion, low physical activity level, and slowed walking. Scores of 4 or 5 indicate the patient is frail, whereas scores of 2 or 3 indicate intermediate frailty. Results of using the test in 594 patients over age 65 years who were having elective surgery, show frail patients are 2.5 times more likely than nonfrail ones to suffer a postoperative complication, 1.5 times as likely to have an extended hospital stay, and 20 times as likely to be discharged to a nursing home or assisted living facility. Frailty has been linked in previous studies to mortality, morbidity, falls, and increased hospitalization. Dr Martin A Makary, the study’s leader, says, ‘‘A good frailty test can help patients and surgeons make more informed decisions.’’ Having the information up front may help providers lower the risk of complications in frail patients by increasing monitoring efforts and attention to hydration, nutrition, and mobilization. [Level of Frailty Predicts Surgical Outcomes in Older Patients. Medical News Today, May 13, 2010.]
Volume 55
Issue 6
2010
287
world. The Board of Directors of Alpha Omega could be viewed as similar to Rabbis of the Talmud as they train successors in leadership roles. Discussion.—When looking at the role of the Rabbis of the Talmud in their society, it is easy to note parallels in the role played by the modern dentist. Teaching is a vital part of what dentists do, whether it is the one-on-one in a dental practice, the mentoring of persons studying to follow in our footsteps, or the modeling and teaching of healthy behaviors to audiences of various types—disadvantaged groups, elderly, children, and so on. Dentists also serve as business leaders, change leaders, and philanthropists in today’s society. It is interesting to note the similarities of these roles to those of the leaders in past times.
Clinical Significance.—Dentists wear many hats and have numerous opportunities to have an effect on the society. It is important to become involved in these activities for the betterment of those around us.
Margolis FS: How similar are dentists to the Rabbis of the Talmud? Alpha Omegan 103:48, 2010 Reprints not available
EXTRACTS FRAILTY TEST PREDICTS OUTCOMES IN OLDER PATIENTS Researchers at Johns Hopkins University School of Medicine have developed a simple, 10-minute frailty test for older patients to take before undergoing surgery. The result can predict with great certainty the patient’s risk for complications, length of hospital stay, and need for care in a nursing home after surgery. The measure uses a 5-point scale and issues 1 point for each of five problems, specifically, loss of 10 pounds or more in the previous year, weakness measured by a handheld dynamometer, exhaustion, low physical activity level, and slowed walking. Scores of 4 or 5 indicate the patient is frail, whereas scores of 2 or 3 indicate intermediate frailty. Results of using the test in 594 patients over age 65 years who were having elective surgery, show frail patients are 2.5 times more likely than nonfrail ones to suffer a postoperative complication, 1.5 times as likely to have an extended hospital stay, and 20 times as likely to be discharged to a nursing home or assisted living facility. Frailty has been linked in previous studies to mortality, morbidity, falls, and increased hospitalization. Dr Martin A Makary, the study’s leader, says, ‘‘A good frailty test can help patients and surgeons make more informed decisions.’’ Having the information up front may help providers lower the risk of complications in frail patients by increasing monitoring efforts and attention to hydration, nutrition, and mobilization. [Level of Frailty Predicts Surgical Outcomes in Older Patients. Medical News Today, May 13, 2010.]
Volume 55
Issue 6
2010
287