J Am Board Fam Med
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Rural adolescent vaccination rates lag behind urban. We sought to assess rural-urban differences in barriers to adolescent vaccination, perceived parental vaccine attitudes, and immunization delivery practices among public health nursing (PHN), pediatric (Peds), and family medicine (FM) clinicians. ⋯ Rural barriers to adolescent vaccination include logistic issues and parental vaccine attitudes. Efforts to improve rural adolescent vaccination should include public health departments and address vaccine confidence and access barriers.
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COVID-19 affects multiple organ systems causing substantial long-term morbidity. The implications of the Post-Acute Sequelae of SARS-CoV-2 infection, particularly for primary care, remain unknown. This cross-sectional study examines new symptoms reported at primary care encounters during three post-acute follow-up intervals after initial SARS-CoV-2 infection. ⋯ This cross-sectional study provides support of a post-acute COVID syndrome, demonstrating that patients continue to experience symptoms after the acute infection period. Extensive follow-up data allowed for examining new symptoms up to 9 months after initial SARS-CoV-2 infection. Understanding of the course of multi-organ post-acute sequelae is restricted by cross-sectional study design limitations. Standardized, sequelae-related ICD-10-CM codes to specify the type and duration of post-acute COVID-related symptoms would enable better monitoring of the growing number of SARS-CoV-2 infection survivors.
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Substance use disorders (SUDs) are complex interactions between various genetic, environmental, developmental, and social factors. Yoga is recommended as a nonmainstream treatment for many health conditions, including SUDs. ⋯ Six out of 8 studies showed low concerns, while 2 studies showed some concerns about the risk of bias judgment. Although the results look encouraging, RCTs with larger sample size are needed to better evaluate the effectiveness of yoga as a treatment modality for substance use.
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Skin cancer is the most common type of cancer worldwide. Family physicians (FPs) need to differentiate between nonmalignant and malignant skin conditions, but the diagnostic accuracy of FPs has never been studied in primary care. ⋯ The calculated diagnostic accuracy of FPs is high and shows that FPs are especially accurate in excluding malignancy. This research shows the variety of skin problems in primary care and shows that the FP can deliver safe and effective dermatologic care.
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Measurements of C-reactive protein (CRP) concentration and erythrocyte sedimentation rate (ESR) are frequently ordered jointly in clinical practice. ⋯ In this general adult population with no overt inflammatory disease, the discordant pattern of high ESR and normal CRP was associated with greater age, whereas the pattern of high CRP and normal ESR was associated with higher BMI.