Journal of general internal medicine
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Despite the widespread availability of SARS-CoV-2 vaccines in the USA, vaccine hesitancy continues to represent a significant impediment to the attainment of herd immunity and the end of the COVID-19 pandemic. This survey analysis provides an update for clinical healthcare providers and public health officials regarding current trends in misinformation exposure, as well as common objections to COVID-19 vaccination. ⋯ The survey results add to previous research on misinformation and vaccine hesitancy by quantifying exposure to specific misinformation themes and identifying its relationship to vaccine hesitancy. Overcoming these impediments to vaccination will require strategic and targeted messaging on the part of public health professionals, which may be aided by collaboration with political thought leaders. Understanding the volume and nature of misinformation themes the public is exposed to regarding COVID-19 vaccines may aid public health officials in targeting this vaccine messaging to more directly address reasons for vaccine hesitancy.
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SARS-CoV-2 has infected over 200 million people worldwide, resulting in more than 4 million deaths. Randomized controlled trials are the single best tool to identify effective treatments against this novel pathogen. ⋯ A large number of randomized trials were launched early in the pandemic to evaluate treatments for COVID-19. However, many trials were underpowered for important clinical endpoints and substantial geographic disparities were observed, highlighting the importance of improving national clinical trial infrastructure.
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Physicians and patients report frustration after primary care visits for chronic pain. The need to shift between multiple clinical topics to address competing demands during visits may contribute to this frustration. ⋯ In primary care visits for patients with chronic pain taking opioids, more linear visits were associated with better physician and patient experience. Frequent topic shifts may be disruptive. If confirmed in future research, this finding implies that reducing shifts between topics could help decrease mutual frustration related to discussions about pain.
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The COVID-19 pandemic plunged hospital systems into resource-deprived conditions unprecedented since the 1918 flu pandemic. It brought forward concerns around ethical management of scarcity, racism and distributive justice, cross-disciplinary collaboration, provider wellness, and other difficult themes. ⋯ Support for global health educational activities is a valuable component of medical training, as they build skills and perspectives that are critical to responding to a pandemic or other health system cataclysm. We frame our argument as consideration of three questions that required rapid, effective responses in our home institutions during the pandemic: How can our health system function with new limitations on essential resources? How do we work at high intensity and volume, on a new disease, within new and evolving systems, while still providing high-quality, patient-centered care? And, how do we help personnel manage an unprecedented level of morbidity and mortality, disproportionately affecting the poor and marginalized, including moral difficulties of perceived care rationing?