J Am Board Fam Med
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Climate change is considered one of the greatest threats to humanity and the most significant global public health emergency of our lifetime. Millions of people from throughout the globe suffer and die each year from degraded air quality, extreme heat, water and vector-borne diseases as well as the mental health effects of climate change. ⋯ These include 1) meeting patients where they are, 2) providing patient education, and 3) telling authentic stories. Developing and delivering effective communication strategies to our patients to prevent and prepare for climate-related health issues are paramount- if we are to make meaningful progress.
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Climate change poses a threat to the health of people worldwide. Little is known about the awareness of primary care clinicians toward climate change and if they are open and prepared to address climate change issues with their patients. As pharmaceuticals are the main source of carbon emissions in primary care, avoiding the prescription of particular climate-harmful medications is a meaningful contribution to the reduction of greenhouse gases. ⋯ Although many primary care clinicians are open to addressing climate change in their working environment and with their patients, they lack knowledge and confidence to do so. In contrast, the majority of the US population is willing to do more to mitigate climate change. Although curricula on climate change topics are increasingly implemented in student education, programs to educate mid- and late-career clinicians are lacking.
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Due to the COVID-19 pandemic, a "state of emergency" was declared in North Carolina on March 10, 2020. Subsequent "stay-at-home" (SAH) orders restricted activities including use of fitness facilities, and teleworking was encouraged. This study investigates metabolic effects of these changes in activity level. ⋯ With the exception of DBP, findings reveal consistency in HbA1c, weight, and BP across time periods before, during, and after COVID-19 SAH orders in North Carolina.
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Clinical trials generally have not assessed efficacy of long-term opioid therapy (LTOT) beyond 6 months because of methodological barriers and ethical concerns. We aimed to measure the effectiveness of LTOT for up to 12 months. ⋯ Using LTOT for up to 12 months is not more effective in improving CLBP outcomes than treatment without opioids. Clinicians should consider tapering opioid dosage among LTOT users in accordance with clinical practice guidelines.
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A substantial number of opioid analgesics dispensed into communities will go unused and be susceptible to diversion for misuse. Convenient, efficient, and environmentally safe mechanisms for disposal are needed to prevent the diversion of unused opioid analgesics. ⋯ The distribution of drug deactivation pouches is feasible in a community setting and although community members expressed interest in using drug deactivation pouches to dispose of unused opioid analgesics and other drugs, the majority still disposed of their unused medications through other avenues. This, underscore the need to raise community members' awareness about the importance, benefits, and viability of these pouches as a tool for the primary prevention of opioid overdose because of their ease of use, safety, environmental considerations, and cost-effectiveness.