Southern medical journal
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Southern medical journal · Mar 2022
Using an Implementation Research Framework to Identify Facilitators and Barriers to Physical Activity and Weight Loss in Appalachia.
West Virginia (WV) is the only state entirely located in Appalachia, a large, mostly rural area in the eastern United States. WV has the highest adult obesity rate in the United States, as well as one of the highest physical inactivity rates. Obesity has been found to be significantly higher in rural counties than in urban counties, and many rural communities do not have the resources to address this growing health concern. It is well documented that healthy eating and becoming more physically active can be successful in reducing weight and managing obesity-related illness. Despite this overwhelming evidence, obesity rates in WV continue to climb. The purpose of this study was to understand the factors associated with obesity in WV and identify what influences the behavior of people in regard to weight loss and exercise. ⋯ The results of this study identify how individuals living in rural Appalachian view lifestyle changes and what influences their ability to pursue physical activity and healthy eating. Future programs to encourage healthy lifestyles in Appalachia need to consider the characteristics of the given community to achieve the goal of a tailored lifestyle intervention program that is feasible and effective. In addition, the findings suggest that the CFIR can be used to implement and refine intervention strategies that can be used in the real world.
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Southern medical journal · Mar 2022
Ultrasound-Measured Urethral Length Does Not Change following Minimally Invasive Sacrocolpopexy for Pelvic Organ Prolapse.
To compare urethral length (UL), as measured by three-dimenstional transvaginal ultrasound, before and after minimally invasive sacrocolpopexy (SCP). ⋯ UL does not change following suspension of the anterior vaginal wall with SCP.
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Southern medical journal · Mar 2022
Characterization of Clinical Skills Remediation: A National Survey of Medical Schools.
Clinical skills instruction is a standard part of medical school curricula, but how institutions address learners who struggle in this area is less clear. Although recommendations for the remediation of clinical skills at an institutional level have been published, how these recommendations are being implemented on a national scale is unknown. In this descriptive study, we characterize current clinical skills remediation practices at US medical schools and US-accredited Caribbean medical schools. ⋯ Although most institutions are able to identify struggling students, they lack a standardized approach to intervene. Remediation effectiveness is limited by a lack of student buy-in and institutional time, expertise, and resources. These findings highlight the need for more formalized structure and standardization in remediation program design and implementation.
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Southern medical journal · Mar 2022
Observational StudyAnalysis of the Effects of a Texas State-Wide Mask Mandate (Executive Order GA-29) on Case Load, Hospitalizations, and Mortality.
The coronavirus disease 2019 (COVID-19) pandemic has resulted in unprecedented hospitalizations, ventilator use, and deaths. Because of concerns for resource utilization and surges in hospital capacity use, Texas Executive Order GA-29 required statewide mask wear beginning July 3, 2020. Our objective was to compare COVID-19 case load, hospital bed use, and deaths before and after implementation of this mask order. ⋯ In both adjusted and unadjusted analyses, we were unable to detect a reduction in case load, hospitalization rates, or mortality associated with the implementation of an executive order requiring a statewide mask order. These results suggest that during a period of rapid virus spread, additional public health measures may be necessary to mitigate transmission at the population level.
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Southern medical journal · Mar 2022
Analysis of Airway Management for Cesarean Delivery: Use of Risk and Proportion Differences.
Securing the parturient airway is essential during general anesthesia for cesarean delivery. The purpose of this study was to compare inferior airway views provided by the use of three commonly available laryngoscopy blades-Macintosh, Miller, or Glidescope Mac-Style-to the incidence of difficult orotracheal intubation. ⋯ Miller blade laryngoscopy provided the lowest proportion difference for difficult orotracheal intubation during general anesthesia for cesarean delivery. Miller blade laryngoscopy provides effective procurement of the parturient airway.