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October 2022

Screening for Anxiety in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

JAMA

US Preventive Services Task Force; Carol M Mangione, Michael J Barry, Wanda K Nicholson, Michael Cabana, Tumaini Rucker Coker, Karina W Davidson, Esa M Davis, Katrina E Donahue, Carlos Roberto Jaén, Martha Kubik, Li Li, Gbenga Ogedegbe, Lori Pbert, John M Ruiz, Michael Silverstein, James Stevermer, John B Wong

Anxiety disorder, a common mental health condition in the US, comprises a group of related conditions characterized by excessive fear or worry that present as emotional and physical symptoms. The 2018-2019 National Survey of Children’s Health found that 7.8% of children and adolescents aged 3 to 17 years had a current anxiety disorder. Anxiety disorders in childhood and adolescence are associated with an increased likelihood of a future anxiety disorder or depression. Read more >>


Screening for Depression and Suicide Risk in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

JAMA

US Preventive Services Task Force; Carol M Mangione, Michael J Barry, Wanda K Nicholson, Michael Cabana, David Chelmow, Tumaini Rucker Coker, Karina W Davidson, Esa M Davis, Katrina E Donahue, Carlos Roberto Jaén, Martha Kubik, Li Li, Gbenga Ogedegbe, Lori Pbert, John M Ruiz, Michael Silverstein, James Stevermer, John B Wong

Depression is a leading cause of disability in the US. Children and adolescents with depression typically have functional impairments in their performance at school or work as well as in their interactions with their families and peers. Depression can also negatively affect the developmental trajectories of affected youth. Major depressive disorder (MDD) in children and adolescents is strongly associated with recurrent depression in adulthood; other mental disorders; and increased risk for suicidal ideation, suicide attempts, and suicide completion. Read more >>


Outcome Insights: Applying an NPG Lens to Examine a Capacity Building Initiative Among the Government and its Partner

International Journal of Public Administration

Sapna Varkey, Kara Lawrence, Leila Chelbi, Amanda J. Stewart & Richard M. Clerkin

Providing services for a diverse population requires a shift in paradigms and mechanisms. New Public Governance (NPG) provides insights on the need for collaborative actions between organizations from all sectors. This study applies an NPG lens to investigate a state’s effort to enhance mental health and substance use recovery through building capacity in peer-support service providing organizations (SPOs). Read more >>


An Individualized Approach to Kidney Disease Screening in Children With a History of Preterm Birth

Clinical Pediatrics

Keia Sanderson, T Michael O’Shea, Christine E Kistler 

Well-child Bright Futures screenings provide considerable benefits for child health and disease prevention; however, the benchmarks and screening for the many children with medical comorbidities are less well defined. With advancements in pediatric medicine, more children are living well with chronic diseases such as asthma, obesity, and hypertension. For these children, a more individualized approach to screening for comorbidities is needed. Read more >>


Treatment Intensity, Prescribing Patterns, and Blood Pressure Control in Rural Black Patients with Uncontrolled Hypertension

Journal of Racial and Ethnic Health Disparities

Doyle M Cummings, Alyssa Adams, Shivajirao Patil, Andrea Cherrington, Jacqueline R Halladay, Suzanne Oparil, Orysya Soroka, Joanna Bryan Ringel, Monika M Safford

Because racial disparities in hypertension treatment persist, the objective of the present study was to examine patient vs. practice characteristics that influence antihypertensive selection and treatment intensity for non-Hispanic Black (hereafter “Black”) patients with uncontrolled hypertension in the rural southeastern USA. Read more >>


Association between breastfeeding, host genetic factors, and calicivirus gastroenteritis in a Nicaraguan birth cohort

PLoS One

Vielot NA, François R, Huseynova E, González F, Reyes Y, Gutierrez L, Nordgren J, Toval-Ruiz C, Vilchez S, Vinjé J, Becker-Dreps S, Bucardo F.

Norovirus and sapovirus are important causes of childhood acute gastroenteritis (AGE). Breastfeeding prevents AGE generally; however, it is unknown if breastfeeding prevents AGE caused specifically by norovirus and sapovirus. We investigated the association between breastfeeding and norovirus or sapovirus AGE episodes in a birth cohort.  Read more >>


Removing the Financial Barriers to Home-Based Medical Care for Frail Older Persons

Journal of the American Medical Directors Association

Sloane PD, Eleazer GP, Phillips SL, Batchelor F.

Approximately 7.5 million adults in the United States (US) have difficulty making office visits to physicians, either because they are homebound (2 million) or need transport and other assistance (5.5 million).

Although many would qualify for care in a nursing home, these individuals and their families often prefer home-based care, which includes (1) home-based medical services (ie, medical and mental health providers and therapeutics) and (2) home health care (ie, nursing, allied health, rehabilitation, social services, and personal care).  Read more >>

Geriatric Care in the Community Setting: When Older Adults Can No Longer Live Alone at Home

Family Physician Essentials

Kistler CE.

Older adults living alone at home are at risk of many adverse outcomes, including injuries from falls, firearms, and driving; adverse drug events due to drug errors; and self-neglect or elder abuse. An estimated 4.5 million Medicare beneficiaries became homebound between 2012 and 2018. Becoming homebound increases the risk of harm for older adults. Clinicians should evaluate the home safety of older adult patients, which requires assessing their medical conditions, home physical environment, and social circumstances. Identified problems should be addressed with interventions that allow patients to live safely in the least restrictive environment possible. Read more >>


Journal of the Pediatric Infectious Diseases Society
Vielot NA, Brinkman A, DeMaso C, Vilchez S, Lindesmith LC, Bucardo F, Reyes Y, Baric RS, Ryan EP, Braun R, Becker-Dreps S.
We measured antibody binding to diverse norovirus virus-like particles over 12 months in 16 children. All had maternal antibodies at 2 months, with estimated lowest levels at 5 months of age. Antibody increases after 3 months suggested natural infections. This information could guide the timing of future norovirus vaccines. Read more >>

Journal of the Pediatric Infectious Diseases Society
Becker-Dreps S, Brewer-Jensen PD, González F, Reyes Y, Mallory ML, Gutiérrez L, Vielot NA, Diez-Valcarce M, Vinjé J, Baric RS, Lindesmith LC, Bucardo F.
A birth cohort design was used to understand whether heterotypic ligand-blocking norovirus antibodies provide cross-protection within the GII genogroup. We found that almost one-half of children who experienced a norovirus GII episode had preexisting antibodies heterotypic to the infecting genotype; therefore, these antibodies did not provide cross-protection. Read more >>

Sexually Transmitted Diseases
Grabert BK, Islam JY, Kabare E, Vielot NA, Waweru W, Mandaliya K, Shafi J, Adala L, McClelland RS, Smith JS.
We compared detection of Chlamydia trachomatis , Neisseria gonorrhoeae , and Trichomonas vaginalis using dry and wet self-collected samples using brushes among females who engage in sex work in Mombasa, Kenya. Detection of T. vaginalis and N. gonorrhoeae in dry and wet samples was similar, but C. trachomatis detection in dry samples appeared lower. Read more >>

Family Physician Essentials
Halpert KD.
Falls are the leading cause of injury among patients 65 years and older in the United States. Many falls are preventable, and clinicians can help patients reduce the risk of falls. This involves screening for fall risk, assessing for modifiable risk factors, and implementing evidence-based interventions for prevention. Screening for fall risk is required as part of the Welcome to Medicare visit and Annual Wellness Visits. Screening involves asking patients if they have had 2 or more falls in the past 12 months, if they are presenting because of an acute fall, and if they have difficulty with walking or balance. Read more >>
Family Physician Essentials
McClester Brown M.
By 2030, 1 in 5 Americans will be older than 65 years, and the health care system will need to prioritize disease prevention in these patients to help them maintain their health. The Welcome to Medicare visit and Annual Wellness Visits (AWVs) were established to provide the opportunity for clinicians to screen older adult patients for geriatric conditions, review and implement preventive health recommendations, and create an individualized plan for health promotion for the next 5 to 10 years. Any patient enrolled in Medicare Part B is eligible for these visits. Read more >>

Academic Medicine
Price DW, Wang T, O’Neill TR, Newton WP.
Spaced repeated testing over time results in better long-term knowledge retention than repeated study of the same material. It is particularly effective when feedback is provided, initial repetitions occur early, and answering questions requires application of knowledge through use of short-answer or context-rich multiple-choice questions. 1–4 American Board of Medical Specialties boards incorporate longitudinal knowledge assessments in their continuing certification programs, 5 but most have not yet systematically incorporated spaced repetition. Read more >>

September 2022

Residency Learning Networks: Why and How

Annals of Family Medicine

Warren Newton, Gerald Fetter, Grant S. Hoekzema, Lauren Hughes and Michael Magill

One of the most important features of the draft Accreditation Council for Graduate Medical Education (ACGME) family medicine residency requirements is a call for residencies to participate in learning networks. The American Board of Family Medicine (ABFM) believes that such networks are vital to residency redesign. Read more >>


The Face of God Revealed

Annals of Family Medicine

Timothy P Daaleman

Many years have passed since I visited Donny in the hospital, where he was admitted with a newly diagnosed and terminal lung cancer. Despite years of separation, his wife Rose took him back into her home and cared for Donny at the end of his life. In the months after his death, I learned more about their relationship; Donny’s drinking and infidelities, the emotional and verbal abuse that Rose put up with. At the end of one office visit, I was incredulous in silent amazement and asked her, “Why did you do it?” Rose looked at me and simply said, “Because he was one of us; because he was family.” Read more>>


Recommendations for Medical and Mental Health Care in Assisted Living Based on an Expert Delphi Consensus Panel: A Consensus Statement

JAMA Network Open

Sheryl Zimmerman, PhD, Philip D. Sloane, MD, MPH, Christopher J. Wretman, PhD, Kevin Cao, Johanna Silbersack, MSW, Paula Carder, PhD, Kali S. Thomas, PhD, Josh Allen, RN, Kim Butrum, RN, MS, Tony Chicotel, JD, MPP, Pat Giorgio, MPS, Mauro Hernandez, PhD, Helen Kales, MD, Paul Katz, MD, Juliet Holt Klinger, MA, Margo Kunze, RN, Christopher Laxton, CAE, Vicki McNealley, PhD, MN, RN, Suzanne Meeks, PhD, Kevin O’Neil, MD, Douglas Pace, NHA, Barbara Resnick, PhD, RN, Lindsay Schwartz, PhD, Dallas Seitz, MD, PhD, Lori Smetanka, JD, Kimberly Van Haitsma, PhD

Assisted living (AL) is the largest provider of residential long-term care in the US, and the morbidity of AL residents has been rising. However, AL is not a health care setting, and concern has been growing about residents’ medical and mental health needs. No guidance exists to inform this care. Read more >>


The first 20 months of the COVID-19 pandemic: Mortality, intubation and ICU rates among 104,590 patients hospitalized at 21 United States health systems

PLoS One

Michael C. Fiore , Stevens S. Smith, Robert T. Adsit, Daniel M. Bolt, Karen L. Conner, Steven L. Bernstein, Oliver D. Eng, David Lazuk, Alec Gonzalez, Douglas E. Jorenby, Heather D’Angelo, Julie A. Kirsch, Brian Williams, Margaret B. Nolan, Todd Hayes-Birchler, Sean Kent, Hanna Kim, Thomas M. Piasecki, Wendy S. Slutske, Stan Lubanski, Menggang Yu, Youmi Suk, Yuxin Cai, Nitu Kashyap, Jomol P. Mathew, Gabriel McMahan, Betsy Rolland, Hilary A. Tindle, Graham W. Warren, Lawrence C. An, Andrew D. Boyd, Darlene H. Brunzell, Victor Carrillo, Li-Shiun Chen, James M. Davis, Deepika Dilip, Edward F. Ellerbeck, Eduardo Iturrate, Thulasee Jose, Niharika Khanna, Andrea King, Elizabeth Klass, Michael Newman, Kimberly A. Shoenbill, Elisa Tong, Janice Y. Tsoh, Karen M. Wilson, Wendy E. Theobald, Timothy B. Baker

There is limited information on how patient outcomes have changed during the COVID-19 pandemic. This study characterizes changes in mortality, intubation, and ICU admission rates during the first 20 months of the pandemic. Read more >>


Norovirus Infection in Young Nicaraguan Children Induces Durable and Genotype-Specific Antibody Immunity

Viruses

Paul D Brewer-Jensen, Yaoska Reyes, Sylvia Becker-Dreps, Fredman González, Michael L Mallory, Lester Gutiérrez, Omar Zepeda, Edwing Centeno, Nadja Vielot, Marta Diez-Valcarce, Jan Vinjé, Ralph Baric, Lisa C Lindesmith, Filemon Bucardo

There are significant challenges to the development of a pediatric norovirus vaccine, mainly due to the antigenic diversity among strains infecting young children. Characterizing human norovirus serotypes and understanding norovirus immunity in naïve children would provide key information for designing rational vaccine platforms. Read more >>


Outcomes of States’ Loan Repayment and Forgiveness Programs From the Perspective of Safety Net Practice Administrators

Journal of the American Board of Family Medicine

Donald E Pathman, Robert G Sewell, Thomas Rauner, Marc Overbeck, Jackie Fannell, John Resendes

Nearly every state offers loan repayment (LRP) and some offer loan forgiveness to clinicians who commit to work in safety net practices. The effectiveness of these programs from the perspective of safety net practices is largely unknown. OBJECTIVES: To assess safety net practice administrators’ assessments of key outcomes for the 3 principal types of state service programs: LRPs funded by states, LRPs funded jointly by states and National Health Service Corps, and loan forgiveness programs. Read more >>


Immune Imprinting Drives Human Norovirus Potential for Global Spread

mBio

Lisa C Lindesmith, Florencia A T Boshier, Paul D Brewer-Jensen, Sunando Roy, Veronica Costantini, Michael L Mallory, Mark Zweigart, Samantha R May, Helen Conrad, Kathleen M O’Reilly, Daniel Kelly, Cristina C Celma, Stuart Beard, Rachel Williams, Helena J Tutill, Sylvia Becker Dreps, Filemón Bucardo, David J Allen, Jan Vinjé, Richard A Goldstein, Judith Breuer, Ralph S Baric

Understanding the complex interactions between virus and host that drive new strain evolution is key to predicting the emergence potential of variants and informing vaccine development. Under our hypothesis, future dominant human norovirus GII.4 variants with critical antigenic properties that allow them to spread are currently circulating undetected, having diverged years earlier. Read more >>


The Supreme Court of the United States, Disability Rights, and Implications for Mental Health Parity

Family Medicine

Linda Myerholtz, Elizabeth Myerholtz
It was the evening of Monday, May 2, 2022, at the Society of Teachers of Family Medicine (STFM) Annual Spring Conference. Attendees were learning to dance the tango and watching a Backstreet Boys routine at the MediPalooza fundraising event for the STFM Foundation. Then the text messages started flying. Leaked information from the Supreme Court of the United States (SCOTUS) indicated that Roe v Wade was likely to be overturned. Many of us were stunned and experienced strong emotions. Many of our members immediately began to consider actions to take in response. Then, on June 24, 2022, the Supreme Court did overturn Roe v Wade, undoing nearly 50 years of legalized abortion in the United States. Read more >>

The Impact of Self-directed Learning on the Future of Family Medicine Education

Family Medicine

Fareedat Oluyadi, D Jason Frasca

The landscape of health care delivery has changed dramatically in the past 2 years. For better or worse, the COVID pandemic and surges in police brutality resulting in the killings of innocent Black individuals have undoubtedly been catalysts for this evolution in health care systems. As we stand on the frontlines of care with our core focus on reducing health care disparities through a biopsychosocial perspective, family physicians are uniquely poised to rise to meet this evolving scope of care. Read more >>


Patient-level information underlying overdiagnosis of urinary tract infections in nursing homes: A discrete choice experiment

Infection Control and Hospital Epidemiology

Christopher J Wretman, Marcella H Boynton, John S Preisser, Sheryl Zimmerman, Christine E Kistler

The overdiagnosis of urinary tract infections (UTIs) in nursing home residents is a significant public health threat. Using a discrete choice experiment and a diagnostic guideline, we examined which patient-level information was associated with the overdiagnosis of UTIs and found that urinalysis results and lower urinary tract status were most associated. Read more >>


Smoking Status, Nicotine Medication, Vaccination, and COVID-19 Hospital Outcomes: Findings from the COVID EHR Cohort at the University of Wisconsin (CEC-UW) Study

Nicotine & Tobacco Research

Thomas M Piasecki, Stevens S Smith, Timothy B Baker, Wendy S Slutske, Robert T Adsit, Daniel M Bolt, Karen L Conner, Steven L Bernstein, Oliver D Eng, David Lazuk, Alec Gonzalez, Douglas E Jorenby, Heather D’Angelo, Julie A Kirsch, Brian S Williams, Margaret B Nolan, Todd Hayes-Birchler, Sean Kent, Hanna Kim, Stan Lubanski, Menggang Yu, Youmi Suk, Yuxin Cai, Nitu Kashyap, Jomol P Mathew, Gabriel McMahan, Betsy Rolland, Hilary A Tindle, Graham W Warren, Lawrence C An, Andrew D Boyd, Darlene H Brunzell, Victor Carrillo, Li-Shiun Chen, James M Davis, Vikrant G Deshmukh, Deepika Dilip, Edward F Ellerbeck, Adam O Goldstein, Eduardo Iturrate, Thulasee Jose, Niharika Khanna, Andrea King, Elizabeth Klass, Robin J Mermelstein, Elisa Tong, Janice Y Tsoh, Karen M Wilson, Wendy E Theobald, Michael C Fiore

Available evidence is mixed concerning associations between smoking status and COVID-19 clinical outcomes. Effects of nicotine replacement therapy (NRT) and vaccination status on COVID-19 outcomes in smokers are unknown. Electronic health record data from 104 590 COVID-19 patients hospitalized February 1, 2020 to September 30, 2021 in 21 U.S. health systems were analyzed to assess associations of smoking status, in-hospital NRT prescription, and vaccination status with in-hospital death and ICU admission. Read more >>


Creating a Lactation Research Community Through Use and Reuse of Survey Instruments and Scales

Journal of Human Lactation

Ellen Chetwynd

The Journal of Human Lactation contributes to the science that defines the work of lactating people’s bodies. Around the world, from all the places that our researchers, writers, and readers call home, we collectively study human breasts and the process by which that organ is used to feed and nurture human children. Across history and the political milieu, breasts and the process of breastfeeding have been fodder for cultural eccentricities and power dynamics. As scientists, writers, clinicians, and advocates in this field of study and work, our goal is to be unbiased and true to the data that we present. We work hard to speak about the bodies we study—the people we study—in a way that is respectful, transparent, clear, and concise. Read more >>


Being in the room where it happens: Leveraging behavioral scientists’ strengths in leadership

International Journal of Psychiatry in Medicine

Lauren Penwell-Waines, Linda Myerholtz

Studies of leadership have identified several key traits and skills among successful leaders, including honesty, emotional intelligence, setting a vision, effective communication, and interest in providing feedback and developing others. These attributes, in addition to specific knowledge and skills related to health care systems, medical education, and effective team dynamics can propel behavioral scientists to success in graduate medical education. Read more >>


Impact of pharmacist participation in the patient care team on value-based health measures

American Journal of Health System Pharmacy

Michael Patti, Evan W Colmenares, Anna Abrahamson, Sarah Weddle, Jamie Cavanaugh, Zack Deyo, Mary-Haston Vest

To evaluate whether pharmacist engagement on the interdisciplinary team leads to improved performance on diabetes-related quality measures. This was a retrospective observational study of patients seen in primary care and specialty clinics from October 2014 to October 2020. Read more >>


August 2022

Adaptation of a workshop for Japanese primary care professionals on dementia-specific advance care planning communication

Journal of the American Geriatrics Society

Le Donne M, Kistler CE, Hanson L, Kiyota A, Matsui T, Abe M, Inoue M.

Despite having the world’s oldest population and highest prevalence of persons living with dementia, Japan lags behind Western nations in rates of advance care planning.12 Advance care planning (ACP) is defined as discussions and documentation of patients’ preferences for future medical treatment.3 The purpose of this letter is to describe the translation and cultural adaptation of a toolkit to increase its relevance to the Japanese primary care clinician. Read more >>


Moral distress among clinicians working in US safety net practices during the COVID-19 pandemic: a mixed methods study

British Medical Journal

Pathman DE, Sonis J, Rauner TE, Alton K, Headlee AS, Harrison JN.

To explore the causes and levels of moral distress experienced by clinicians caring for the low-income patients of safety net practices in the USA during the COVID-19 pandemic. A cross-sectional survey in late 2020, employing quantitative and qualitative analyses. Read more >>


The impact of the real cost vaping and smoking ads across tobacco products

Nicotine & Tobacco Research

Kowitt SD, Sheldon JM, Vereen RN, Kurtzman RT, Gottfredson NC, Hall MG, Brewer NT, Noar SM.

Introduction: Little research has examined the spillover effects of tobacco communication campaigns, such as how anti-smoking ads affect vaping. Methods: Participants were a national sample of 623 US adolescents (ages 13-17) from a probability-based panel. In a between-subjects experiment, we randomly assigned adolescents to view one of four videos online: 1) a smoking prevention video ad from the Food and Drug Administration’s (FDA) The Real Cost campaign, 2) a neutral control video about smoking, 3) a vaping prevention video ad from The Real Cost campaign, or 4) a neutral control video about vaping. We present effect sizes as Cohen’s d, standardized mean differences, with 95% confidence intervals (CIs). Read more >>


Systematic review of smoking relapse rates among cancer survivors who quit at the time of cancer diagnosis

Cancer Epidemiology

Feuer Z, Michael J, Morton E, Matulewicz RS, Sheeran P, Shoenbill KGoldstein A, Sherman S, Bjurlin MA.

Tobacco cessation, at the time of cancer diagnosis, has been associated with better oncologic outcomes. Cancer diagnosis has been shown to serves as a “teachable moment,” inspiring tobacco cessation. However, the sustainability of abstinence from smoking is understudied. Similarly, there is a paucity of data regarding the utility of behavioral/pharmacologic intervention to support continued smoking cessation. A systematic literature review was conducted in August 2021 with no date limits. Relevant studies that reported tobacco smoking relapse rates for patients who quit at the time of cancer diagnosis were included. Our literature search identified 1620 articles and 29 met inclusion criteria. Read more >>


History of the relationship between smoking and bladder cancer: A public health perspective

Urology

Weiss KG, Matulewicz RS, Moreton E, Shoenbill KA, Milowsky MI, Rose TL, Kim WY, Goldstein AO, Bjurlin MA.

Cigarette smoking is the leading preventable cause of cancer worldwide and associated with substantial morbidity. Here, we chronicle how the relationship between smoking and the development of bladder cancer came to be understood. We describe the evidence that established the causal effect of smoking cigarettes on bladder cancer and highlight the scientists involved in these discoveries. Using Surgeon General’s Reports, from the mid-1900’s to 2020, we provide a historical narrative of the discovery of the link between cigarette smoking and bladder cancer. Read more >>


Intravenous iron vs. oral iron in iron deficiency anemia

American Family Physician

Mounsey A, Peacock E, Magnusson L.

Is intravenous iron infusion superior to oral iron for avoiding blood transfusion in adults with iron deficiency anemia? No, intravenous iron administration does not reduce the need for blood transfusion compared with oral iron supplementation. (Strength of Recommendation [SOR]: A, multiple meta-analyses of randomized controlled trials [RCTs].) Compared with oral iron, intravenous iron has no effect on mortality. (SOR: B, multiple meta-analyses of RCTs.) Intravenous iron may increase the risk of infection compared with oral iron. (SOR: B, inconsistent evidence from meta-analyses of RCTs.).  Read more >>


Rural-urban outcome differences associated with COVID-19 hospitalizations in North Carolina

PLoS One

Denslow S, Wingert JR, Hanchate AD, Rote A, Westreich D, Sexton L, Cheng K, Curtis J, Jones WS, Lanou AJ, Halladay JR.

People living in rural regions in the United States face more health challenges than their non-rural counterparts which could put them at additional risks during the COVID-19 pandemic. Few studies have examined if rurality is associated with additional mortality risk among those hospitalized for COVID-19. We studied a retrospective cohort of 3,991 people hospitalized with SARS-CoV-2 infections discharged between March 1 and September 30, 2020 in one of 17 hospitals in North Carolina that collaborate as a clinical data research network. Patient demographics, comorbidities, symptoms and laboratory data were examined. Logistic regression was used to evaluate associations of rurality with a composite outcome of death/hospice discharge. Comorbidities were more common in the rural patient population as were the number of comorbidities per patient. Read more >>


Disability as diversity: educational opportunities for family medicine

International Journal of Psychiatry in Medicine

Young KM, Newell KG.

Disability is an aspect of diversity that often receives less attention in healthcare and medical education than other aspects of diversity, such as gender or race. Approximately one in four Americans has some type of disability, and individuals with disabilities have less access to healthcare, greater dissatisfaction with their healthcare, and report being in poorer health than individuals without a disability. Although many factors likely contribute to these disparities, physician perception and understanding of disability have been examined as potential pathways that influence health inequity. Read more >>


The geriatric-focused emergency department: opportunities and challenges

Journal of the American Medical Directors Association

Sloane PD.

Emergency departments are an important site of medical care for older persons and serve as a gateway to hospital entry. In the United States, persons aged 65 years and older comprise 18% of emergency department visits and a whopping 40% of emergency department-to-hospital admissions. The primary focus of emergency departments is acute, potentially life-threatening conditions, which has led these settings to be characterized by a restive staff mindset, limited history taking, extensive use of laboratory and radiologic tests, and a focus on rapid decision making and patient disposition. This approach is in many ways antithetical to care of older persons, for which the key elements of quality include concern for comfort and homeostasis, understanding of the patient’s complex medical and psychosocial history, avoidance of unnecessary interventions, and observation over time. Read more >>


Relationship between anterior pituitary volume and IGF-1 serum levels in soldiers with mild traumatic brain injury history

Medicine & Science in Sports & Exercise

Castellano AK, Powell JR, Cools MJ, Walton SR, Barnett RR, Delellis SM, Goldberg RL, Kane SF, Means GE, Zamora CA, Depenbrock PJ, Mihalik JP.

A high mild traumatic brain injury (mTBI) incidence rate exists in military and sport. Hypopituitarism is an mTBI sequela; however, few studies have examined this phenomenon in those with an mTBI history. This cross-sectional study of Special Operations Forces combat soldiers aimed 1) to relate anterior pituitary gland volumes (actual and normalized) to insulin-like growth factor 1 (IGF-1) concentrations, 2) to examine the effect of mTBI history on anterior pituitary gland volumes (actual and normalized) and IGF-1 concentrations, and 3) to measure the odds of demonstrating lower anterior pituitary gland volumes (actual and normalized) or IGF-1 concentrations if self-reporting mTBI history. Read more >>


The pharmacogenetics of opiates and its impact on delirium in mechanically ventilated adults: A pilot study

The Journal of Pharmacy Technology

Austin CA, Szeto A, Gupta A, Wiltshire T, Crona DJ, Kistler C.J Pharm Technol.

Background: Pharmacogenetics may explain a substantial proportion of the variation seen in the efficacy and risk profile of analgesosedative drugs and the incidence of delirium in critically ill adults. Objectives: Conduct a feasibility study to demonstrate the reliability of collecting and analyzing pharmacogenetic information from critically ill patients and to assess the impact of pharmacogenetics on intensive care unit (ICU) outcomes. Read more >>


Critical analysis of reliability and validity in literature reviews

Journal of Human Lactation

Chetwynd E.J.

Literature reviews can take many forms depending on the field of specialty and the specific purpose of the review. The evidence base for lactation integrates research that cuts across multiple specialties (Dodgson, 2019) but the most common literature reviews accepted in the Journal of Human Lactation include scoping reviews, systematic reviews, and meta-analyses. Read more >>


Developing a toolkit to improve resident and family engagement in the safety of assisted living: Engage-A stakeholder-engaged research protocol

Research in Nursing & Health

Beeber AS, Hoben M, Leeman J, Palmertree S, Kistler CE, Ottosen T, Moreton E, Vogelsmeier A, Dardess P, Anderson RA.

Assisted living (AL) communities are experiencing rising levels of resident acuity, challenging efforts to balance person-centered care-which prioritizes personhood, autonomy, and relationship-based care practices-with efforts to keep residents safe. Safety is a broad-scale problem in AL that encompasses care concerns (e.g., abuse/neglect, medication errors, inadequate staffing, and infection management) as well as resident issues (e.g., falls, elopement, and medical emergencies). Person and family engagement (PFE) is one approach to achieving a balance between person-centered care and safety. In other settings, PFE interventions have improved patient care processes, outcomes, and experiences. In this paper, we describe the protocol for a multiple methods AHRQ-funded study (Engage) to develop a toolkit for increasing resident and family engagement in AL safety. Read more >>


July 2022

When less Is more: identifying patients with Type 2 Diabetes engaging in unnecessary blood glucose monitoring

Clinical Diabetes

Marcella H. Boynton; Katrina E. Donahue; Erica Richman; Asia Johnson; Jennifer Leeman; Maihan B. Vu; Jennifer Rees; Laura A. Young

This study examined whether certain patient characteristics are associated with the prescribing of self-monitoring of blood glucose for patients with type 2 diabetes who are not using insulin and have well-controlled blood glucose. Read more >>


Progesterone and preterm birth: using empirical research to explore structural racism within midwifery-led care

The Journal of Perinatal and Neonatal Nursing

Venus Standard, Kimberly Jones-Beatty, Lodz Joseph-Lemon, Ebony Marcelle, Charlotte E Morris, Trinisha Williams, Tracie Brown, Haley Shizuka Oura, Susan Stapleton, Diana R Jolles

Progesterone has been the standard of practice for the prevention of preterm birth for decades. The drug received expedited Food and Drug Administration approval, prior to the robust demonstration of scientific efficacy.

Methods: Prospective research from the American Association of Birth Centers Perinatal Data Registry, 2007-2020. Two-tailed t tests, logistic regression, and propensity score matching were used.

Results: Midwifery-led care was underutilized by groups most at risk for preterm birth and was shown to be effective at maintaining low preterm birth rates. The model did not demonstrate reliable access to progesterone. Read more >>


Physicians’ perceptions of race and engagement in race-based clinical practice: a mixed-methods systematic review and narrative synthesis

Journal of General Internal Medicine

Ebiere Okah, LáShauntá Glover, Katrina E Donahue, Giselle Corbie-Smith, Gaurav Dave

Using race-a socially assigned identity that does not adequately capture human genetic variation-to guide clinical care can result in poor outcomes for racially minoritized patients. This study assessed (1) how physicians conceptualize and use race in their clinical care (race-based care) and (2) physician characteristics associated with race-based care. Read more >>


Factors leading to successful performance on U.S. national licensure exams for medical students: a scoping review

Academic Medicine

Maniraj Jeyaraju , Henry Linford, Thiago Bosco Mendes, Christine Caufield-Noll, Sean Tackett

To synthesize the evidence of the factors leading to successful performance on knowledge-based national licensure exams (NLEs) for medical students. The authors conducted a scoping review to summarize the peer-reviewed empiric literature that used United States Medical Licensing Examination (USMLE) Step 1 or Step 2 Clinical Knowledge or Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level 1 or Level 2 Cognitive Evaluation scores as outcomes. The authors searched PubMed and Scopus without date restrictions through April 30, 2021. Two reviewers independently screened and selected studies for inclusion. Data were summarized narratively and with descriptive statistics. Read more >>


Behavioral counseling interventions to promote a healthy diet and physical activity for cardiovascular disease prevention in adults without cardiovascular disease risk factors: US Preventive Services Task Force Recommendation Statement

JAMA

Mangione CM, Barry MJ, Nicholson WK, Cabana MD, Coker TR, Davidson KW, Davis EM, Donahue KE, Jaén CR, Kubik M, Li L, Ogedegbe G, Pbert L, Ruiz JM, Stevermer J, Wong JB.

Cardiovascular disease (CVD), which includes heart disease, myocardial infarction, and stroke, is the leading cause of death in the US. A large proportion of CVD cases can be prevented by addressing modifiable risk factors, including smoking, obesity, diabetes, elevated blood pressure or hypertension, dyslipidemia, lack of physical activity, and unhealthy diet. Adults who adhere to national guidelines for a healthy diet and physical activity have lower rates of cardiovascular morbidity and mortality than those who do not; however, most US adults do not consume healthy diets or engage in physical activity at recommended levels. Read more >>


The association between primary care use and potentially-preventable hospitalization among dual eligibles age 65 and over

BMC Health Services Research

Oh NL, Potter AJ, Sabik LM, Trivedi AN, Wolinsky F, Wright B.

Individuals dually-enrolled in Medicare and Medicaid (dual eligibles) are disproportionately sicker, have higher health care costs, and are hospitalized more often for ambulatory care sensitive conditions (ACSCs) than other Medicare beneficiaries. Primary care may reduce ACSC hospitalizations, but this has not been well studied among dual eligibles. We examined the relationship between primary care and ACSC hospitalization among dual eligibles age 65 and older. Read more >>


Breadth and dynamics of Human Norovirus-specific antibodies in the first year of life

Journal of the Pediatric Infectious Diseases Society

Vielot NA, Brinkman A, DeMaso C, Vilchez S, Lindesmith LC, Bucardo F, Reyes Y, Baric RS, Ryan EP, Braun R, Becker-Dreps S.

We measured antibody binding to diverse norovirus virus-like particles over 12 months in 16 children. All had maternal antibodies at 2 months, with estimated lowest levels at 5 months of age. Read more >>


Preexisting heterotypic ligand-blocking antibody does not protect against genogroup II Norovirus episodes in young children

Journal of the Pediatric Infectious Diseases Society

Becker-Dreps S, Brewer-Jensen PD, González F, Reyes Y, Mallory ML, Gutiérrez L, Vielot NA, Diez-Valcarce M, Vinjé J, Baric RS, Lindesmith LC, Bucardo F.J.

A birth cohort design was used to understand whether heterotypic ligand-blocking norovirus antibodies provide cross-protection within the GII genogroup. Read more >>


Frontline, essential, and invisible: the needs of low-wage workers in hospital settings during COVID-19

Workplace Health & Safety

Zerden LS, Richman EL, Lombardi B, Forte AB.

Frontline health care workers are particularly vulnerable to burnout and diminished well-being as they endure COVID-19 pandemic-related stressors. While physicians and nurses are the public face of those experiencing burnout in hospitals, these stressors also affect low-wage workers such as food and housekeeping/janitorial service workers whose roles largely remain “invisible” when conceptualizing the essential health workforce and understanding their needs. This study sought to understand the experiences of frontline essential workers to better support them and prevent burnout. Read more >>


The Impact of Cannabis Packaging Characteristics on Perceptions and Intentions

American Journal of Preventative Medicine

Kowitt SD, Yockey RA, Lee JGL, Jarman KL, Gourdet CK, Ranney LM.

As cannabis increasingly becomes a consumer product in the U.S., its product packaging has become critically important to regulators. This study examined the influence of recreational cannabis packaging characteristics. Read more >>


Reducing misperceptions about very low nicotine content cigarettes: insights from adults who smoke

Nicotine & Tobacco Research

Ranney LM, Jarman KL, Clark S, Baler G, Gourlay M, Brewer NT, Goldstein AOByron MJ.

Many people incorrectly think that very low nicotine content (VLNC) cigarettes are less carcinogenic than current cigarettes. This risk misperception by people who smoke could reduce motivation to quit under a nicotine reduction policy. We qualitatively examined perspectives of campaign messages designed to reduce misperceptions. Read more >>


The impact of the COVID-19 pandemic on tobacco treatment program implementation at NCI-Designated Cancer Centers

Nicotine & Tobacco Research

Hohl SD, Shoenbill KA, Taylor KL, Minion M, Bates-Pappas GE, Hayes RB, Nolan MB, Simmons VN, Steinberg MB, Park ER, Ashing K, Beneventi D, Cox LS, Goldstein AO, King A, Kotsen C, Presant CA, Sherman SE, Sheffer CE, Warren GW, Adsit RT, Bird JE, D’Angelo H, Fiore MC, Nguyen CVT, Pauk D, Rolland B, Rigotti NA.

The COVID-19 pandemic disrupted cancer screening and treatment delivery, but COVID-19’s impact on tobacco cessation treatment for cancer patients who smoke has not been widely explored. Read more >>


Enriched marine oil supplement increases specific plasma specialized pro-resolving mediators in adults with obesity

The Journal of Nutrition

Al-Shaer AE, Regan J, Buddenbaum N, Tharwani S, Drawdy C, Behee M, Sergin S, Fenton JI, Maddipati KR, Kane S, Butler E, Shaikh SR.

Specialized pro-resolving mediators (SPMs), synthesized from PUFAs, resolve inflammation and return damaged tissue to homeostasis. Thus, increasing metabolites of the SPM biosynthetic pathway may have potential health benefits for select clinical populations, such as subjects with obesity who display dysregulation of SPM metabolism. However, the concentrations of SPMs and their metabolic intermediates in humans with obesity remains unclear. Read more >>


Progesterone and preterm birth: using empirical research to explore structural racism within midwifery-led care

The Journal of Perinatal & Neonatal Nursing

Standard V, Jones-Beatty K, Joseph-Lemon L, Marcelle E, Morris CE, Williams T, Brown T, Oura HS, Stapleton S, Jolles DR.

Progesterone has been the standard of practice for the prevention of preterm birth for decades. The drug received expedited Food and Drug Administration approval, prior to the robust demonstration of scientific efficacy. Prospective research from the American Association of Birth Centers Perinatal Data Registry, 2007-2020. Two-tailed t tests, logistic regression, and propensity score matching were used. Midwifery-led care was underutilized by groups most at risk for preterm birth and was shown to be effective at maintaining low preterm birth rates. The model did not demonstrate reliable access to progesterone. Read more >>


Factors leading to successful performance on U.S. National Licensure exams for medical students: a scoping review

Academic Medicine

Jeyaraju M, Linford H, Mendes TB, Caufield-Noll C, Tackett S.

To synthesize the evidence of the factors leading to successful performance on knowledge-based national licensure exams (NLEs) for medical students. The authors conducted a scoping review to summarize the peer-reviewed empiric literature that used United States Medical Licensing Examination (USMLE) Step 1 or Step 2 Clinical Knowledge or Comprehensive Osteopathic Medical Licensing Examination (COMLEX) Level 1 or Level 2 Cognitive Evaluation scores as outcomes. The authors searched PubMed and Scopus without date restrictions through April 30, 2021. Two reviewers independently screened and selected studies for inclusion. Data were summarized narratively and with descriptive statistics. Read more >>


June 2022

New Opportunities for Expanding Rural Graduate Medical Education to Improve Rural Health Outcomes: Implications of the Consolidated Appropriations Act of 2021

Academic Medicine

Emily M Hawes, Mark Holmes, Erin P Fraher, Alyssa Zamierowski, Judith Pauwels, Louis A Sanner, Jacob Rains, Cristen P Page

Evidence shows that those living in rural communities experience consistently worse health outcomes than their urban and suburban counterparts. One proven strategy to address this disparity is to increase the physician supply in rural areas through graduate medical education (GME) training. However, rural hospitals have faced challenges developing training programs in these underserved areas, largely due to inadequate federal funding for rural GME. Read more >>


Improving the Health of Rural Communities Through Academic-Community Partnerships and Interprofessional Health Care and Training Models

Academic Medicine

Erin P Fraher, Brianna Lombardi, Barbara Brandt, Emily Hawes 

Health disparities between rural and urban areas are widening at a time when urban health care systems are increasingly buying rural hospitals to gain market share. New payment models, shifting from fee-for-service to value-based care, are gaining traction, creating incentives for health care systems to manage the social risk factors that increase health care utilization and costs. Read more >>


Reduction and persistence of co-circulating respiratory viruses during the SARS-CoV-2 pandemic

American Journal of Infection Control

Jason R Smedberg, Lauren M DiBiase, Shawn E Hawken, Anika Allen, Suniti Mohan, Courtney Santos, Tandy Smedberg, Amir H Barzin, David A Wohl, Melissa B Miller

To evaluate the co-circulation of respiratory viruses during the SARS-CoV-2 Alpha surge, we performed a molecular respiratory panel on 1,783 nasopharyngeal swabs collected between January 15 and April 15, 2021, from symptomatic outpatients that tested negative for SARS-CoV-2 in North Carolina. Read more >>


First Episodes of Norovirus and Sapovirus Gastroenteritis Protect Against Subsequent Episodes in a Nicaraguan Birth Cohort

Epidemiology

Nadja A Vielot, Yaoska Reyes, Bryan Blette, Fredman González, Christian Toval-Ruiz, Lester Gutiérrez, Samuel Vilchez, Marta Diez-Valcarce, Jan Vinjé, Sylvia Becker-Dreps, Filemón Bucardo

Norovirus and sapovirus cause a large burden of acute gastroenteritis (AGE) in young children. We assessed protection conferred by norovirus and sapovirus AGE episodes against future episodes. Read more >>


Dementia and COVID-19 infection control in assisted living in seven states

Journal of American Geriatrics Society

Sheryl Zimmerman, Philip D Sloane, Johanna Silbersack Hickey, Christopher J Wretman, Selen P Gizlice, Kali S Thomas, Paula Carder, John S Preisser

ssisted living (AL) is the largest residential long-term care provider in the United States, including for persons with Alzheimer’s disease and related dementias. Despite recognizing the challenge of infection control for persons with dementia, this study of 119 AL communities is the first to describe dementia-relevant COVID-19 infection control across different types of AL communities, and to discuss implications for the future. Read more >>


May 2022

A national study of moral distress among U.S. internal medicine physicians during the COVID-19 pandemic

PLoS ONE

Sonis J, Pathman DE, Read S, Gaynes BN.

There have been no studies to date of moral distress during the COVID-19 pandemic in national samples of U.S. health workers. The purpose of this study was to determine, in a national sample of internal medicine physicians (internists) in the U.S.: 1) the intensity of moral distress; 2) the predictors of moral distress; 3) the outcomes of moral distress. Read more >>


Staff Attitudes Related to Antipsychotic Prescribing in Assisted Living

Journal of the American Medical Directors Association

Christopher J Wretman, Sheryl Zimmerman, Philip D Sloane, John S Preisser

Assisted living (AL) provides the majority of residential long-term care in the United States. 1 Almost 40% of AL residents display behaviors such as aggression and refusing care, 57% of whom receive medications for these behaviors. 2 In nursing homes, concerns about inappropriate antipsychotic prescribing led to initiatives to reduce prescribing, 2 and although there has been concern regarding similar prescribing in AL, 3 there has been no such action to date. Read more >>


Effects of Healthcare Organization Actions and Policies Related to COVID-19 on Perceived Organizational Support Among U.S. Internists: A National Study

Journal of Healthcare Management

Jeffrey Sonis, Donald E Pathman, Susan Read, Bradley N Gaynes, Courtney Canter, Patrick Curran, Cheryl B Jones, Thomas Miller

Perceived organizational support (POS) may promote healthcare worker mental health, but organizational factors that foster POS during the COVID-19 pandemic are unknown. The goals of this study were to identify actions and policies regarding COVID-19 that healthcare organizations can implement to promote POS and to evaluate the impact of POS on physicians’ mental health, burnout, and intention to leave patient care. Read more >>

 


April 2022


March 2022

Preferences for different features of ENDS products by tobacco product use: a latent class analysis

Chineme Enyioha, Marcella H Boynton, Leah M Ranney, M Justin Byron, Adam O Goldstein, Christine E Kistler

From a public health perspective, electronic nicotine delivery devices (ENDS) use may be beneficial for some populations (e.g., smokers who fully switch to ENDS) but detrimental for others (e.g., nonsmokers). Understanding the importance placed on different ENDS product features by user groups can guide interventions and regulations. Read more >>

 


February 2022

Effectiveness of Mobile Phone and Web-Based Interventions for Diabetes and Obesity Among African American and Hispanic Adults in the United States: Systematic Review.

JMIR Public Health and Surveillance

Chineme Enyioha, Matthew Hall, Christiane Voisin, Daniel Jonas

Mobile health (mHealth) and web-based technological advances allow for new approaches to deliver behavioral interventions for chronic diseases such as obesity and diabetes. African American and Hispanic adults experience a disproportionate burden of major chronic diseases. This paper reviews the evidence for mHealth and web-based interventions for diabetes and obesity in African American and Hispanic adults. Read more >>

 


January 2022

Prevalence and Characteristics of Providers’ Care Coordination Communication With Schools

Academic Pediatrics

Krissy Moehling Geffel, Brianna M Lombardi, Justin A Yu, Debra Bogen

Care coordination between schools and medical providers promotes child health, particularly for children with physical, emotional, and behavioral challenges. The purpose of this study was to assess caregivers’ reports of provider-school communication for their children. Further, the study assessed if communication rates varied by child demographic or health conditions. Read more >>


Overdiagnosis of urinary tract infections by nursing home clinicians versus a clinical guideline

Journal of American Geriatrics Society

Christine E Kistler, Christopher J Wretman, Sheryl Zimmerman, Chineme Enyioha, Kimberly Ward, Claire E Farel, Philip D Sloane, Marcella H Boynton, Anna S Beeber, John S Preisser

To inform overprescribing and antibiotic stewardship in nursing homes (NHs), we examined the concordance between clinicians’ (NH primary care providers and registered nurses) diagnosis of suspected UTI with a clinical guideline treated as the gold standard, and whether clinician characteristics were associated with diagnostic classification. Read more >>




2021 Publications

2020 Publications

2019 Publications

2017 Publications

2015 Publications

2013 Publications