Articles: pandemics.
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This issue highlights changes in medical care delivery since the start of the COVID-19 pandemic and features research to advance the delivery of primary care. Several articles report on the effectiveness of telehealth, including its use for hospital follow-up, medication abortion, management of diabetes, and as a potential tool for reducing health disparities. ⋯ One article addresses the wage gap between early-career female and male family physicians. Several articles report on inappropriate testing for common health problems; are you following recommendations for ordering Pulmonary Function Tests, mt-sDNA for colon cancer screening, and HIV testing?
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Physical inactivity and obesity crises persist in the United States despite substantial mitigation efforts. The primary goal of this analysis is to determine whether the geographic concentration of religious institutions overlaps with geographic patterns for physical inactivity and obesity prevalence. ⋯ Approaches to addressing the pandemics of unhealthy lifestyle-related health factors of physical inactivity and obesity in the United States have, in large part, been unsuccessful. Church-based healthy lifestyle programs, particularly in areas where a high concentration of congregations align with high physical inactivity and obesity, may offer a novel and effective approach to addressing this issue.
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The COVID-19 pandemic began interrupting family medicine residency training in spring 2020. While a decline in scores on the American Board of Family Medicine In-Training Examination (ITE) has been observed, whether this decline has translated into the high-stakes Family Medicine Certification Examination (FMCE) is unclear. The goal of this study was to systematically assess the magnitude of COVID-19 impact on medical knowledge acquisition during residency, as measured by the ITE and FMCE. ⋯ This study found nonsubstantive COVID-19 impact on FMCE scores, but a considerable knowledge acquisition decline during residency, especially during the PGY-2 to PGY-3 period. While COVID-19 impacted learning, our findings indicated that residencies were largely able to remediate knowledge deficits before residents took the FMCE.
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The COVID-19 pandemic disrupted how primary care patients with chronic pain received care. Our study sought to understand how long-term opioid therapy (LtOT) for chronic pain changed over the course of the pandemic overall and for different demographic subgroups. ⋯ The use of LtOT for chronic pain in primary care has increased from before to after the COVID-19 pandemic with racial/ethnic and geographic disparities. Future research is needed to understand these disparities in LtOT and their effect on patient outcomes.
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As the coronavirus disease 2019 pandemic continued into 2021 and beyond, unrelenting work pressures continued to mount on the emergency nursing workforce. In the second year of this longitudinal study on emergency nurse lived experiences, staff outlined the continued strain of the profession, highlighting their increasing levels of burnout and identifying early stages of trauma response. ⋯ Deep engagement with participant emergency nurses across 2 years of the coronavirus disease 2019 pandemic has revealed a need for greater emphasis on staff well-being for future maintenance of a resilient and healthy workforce. Without this, lack of support for subsequent nursing cohorts may affect the quality and reliability of care being provided in acute care centers.