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Mark S. Lachs, MD, MPH; Jeanne A. Teresi, EdD, PhD; Mildred Ramirez, PhD; Kimberly van Haitsma, PhD; Stephanie Silver, MPH; Joseph P. Eimicke, MS; Gabriel Boratgis, MPH; Gail Sukha, BA; Jian Kong, MS; Alexandra M. Besas, RN; Maria Reyes Luna, AS; and Karl A. Pillemer, PhD

Mistreatment of nursing home residents by staff is a well-known phenomenon, and policies and initiatives have been developed to detect, prevent, and prosecute such abuse. In an observational study, mistreatment committed by other residents, including threats and physical, verbal, and sexual actions, was determined and compared with that committed by staff.

Topics: internship and residency, nursing homes, medical residencies, elder abuse

This study tested the idea that nurse practitioners and physician assistants might provide relatively lower-value care than physicians in the primary care setting. The study was limited to patients with upper respiratory infections, back pain, and headache; outcome measures included the use of guideline-discordant antibiotics, radiography, computed tomography or magnetic resonance imaging, and referrals to other physicians.

Topics: antibiotics, primary care physicians, atrial premature complexes, hospitals, primary health care, low-value ...
Phillip O. Coffin, MD, MIA; Emily Behar, MA; Christopher Rowe, MPH; Glenn-Milo Santos, PhD, MPH; Diana Coffa, MD; Matthew Bald, MD; and Eric Vittinghoff, PhD

Unintentional overdose involving opioid analgesics is a leading cause of death in the United States. This study evaluates the feasibility and impact of prescribing naloxone prescription to patients receiving opioids for chronic pain in 6 safety net primary care clinics in San Francisco.

Topics: opioid analgesics, naloxone, opioids, pain
Nick van Es, MD; Tom van der Hulle, MD; Josien van Es, MD, PhD; Paul L. den Exter, MD; Renée A. Douma, MD, PhD; Robbert J. Goekoop, MD; Inge C.M. Mos, MD, PhD; Javier Galipienzo, MD, PhD; Pieter W. Kamphuisen, MD, PhD; Menno V. Huisman, MD, PhD; Frederikus A. Klok, MD, PhD; Harry R. Büller, MD, PhD; and Patrick M. Bossuyt, PhD

This review contributes new information on use of the Wells rule with D-dimer testing to make decisions about imaging in patients with suspected pulmonary embolism.

Topics: pulmonary embolism, fibrin d-dimer assay, dimers, wells dvt score, diagnostic imaging, laboratory ...
Cynthia Feltner, MD, MPH; Kristina Peterson, PhD; Rachel Palmieri Weber, PhD; Laurie Cluff, PhD; Emmanuel Coker-Schwimmer, MPH; Meera Viswanathan, PhD; and Kathleen N. Lohr, PhD

The Total Worker Health program was created in 2011 to focus attention on integrated approaches to worker health and safety. This review evaluates evidence about the benefits of integrated health programs for workers.

Topics: smoking cessation, fruit, united states national institutes of health, safety, vegetables, workplace, ...

New designs for precision medicine in oncology clinical trials are being developed to utilize our greater understanding of the molecular heterogeneity of human cancer types. The author describes some of the newer trial designs, cites examples of such trials, and presents detailed schematics to highlight their important features.

Topics: genome, medical oncology, neoplasms, basket studies, heterogeneity, mutation

This position paper from the National Institutes of Health Pathways to Prevention program highlights 8 recommendations critical for advancing the science of integrated interventions to improve the total health of workers.

Topics: united states national institutes of health, safety, occupational, safety

Highlighting recent findings of a National Academies of Sciences, Engineering, and Medicine report, this commentary addresses the feasibility of eliminating hepatitis B and C viruses in the United States.

Topics: hepatitis b, rare diseases

Concerns have been raised over possible expansion of the Zika virus epidemic by infected travelers returning from the 2016 Olympics in Brazil. A modeling study was performed to assess this risk, and the authors present its findings.

Topics: brazil, zika virus, olympics, traveler

Lachs and colleagues examined the prevalence and correlates of resident-to-resident elder mistreatment. The editorialist discusses the study results and calls for strategies to better prevent, screen for, monitor, and manage elder abuse in nursing homes.

Topics: elder abuse, nursing homes, medical residencies, internship and residency

Mafi and colleagues examined the role of nurse practitioners and physician assistants in the delivery of high-quality, cost-effective primary care. The editorialist discusses the findings and believes that questions remain on how to ensure ready availability of the deep clinical competencies required for diagnosis and management of medically complex patients.

Topics: primary health care, atrial premature complexes

Coffin and colleagues evaluated the implementation of overdose education and naloxone rescue kit prescriptions among patients in safety net community health centers treated with opioid therapy for chronic pain. The editorialists describe why this study is a critical step forward in integrating interventions to reduce opioid overdose in primary care settings.

Topics: mainstreaming (education), naloxone, chronic pain, opioids

Two articles present perspectives on the current science of the effectiveness of Total Worker Health interventions—employer-based interventions to promote health; disease management; control costs; and maintain a healthy, productive workforce. The editorialist discusses potential advantages and disadvantages.

Topics: workforce, employer
John Howard, MD; Chia-Chia Chang, MPH, MBA; Anita L. Schill, PhD, MPH, MA; and L. Casey Chosewood, MD, MPH

This editorial discusses the National Institute for Occupational Safety and Health response to the National Institutes of Health Pathways to Prevention workshop, “Total Worker Health—What's Work Got to Do With It?”

Topics: national institute for occupational safety and health (u.s.), united states national institutes ...
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Rickey E. Carter, PhD; David O. Hodge, MS; and Francisco Lopez-Jimenez, MD, MS
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Wataru Nagahori, MD; Hiromasa Takenoshita, MD; Kataoka Yuki, MD, MPH; and Miho Kimachi, MD, PhD
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Erica P. Gunderson, PhD, MPH, MS, and On behalf of the Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy Investigators
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Caroline M. Lee, MD, PhD; Jason D. Lee, MD, PhD; Lisa D. Hobson-Webb, MD; Richard S. Bedlack, MD, PhD; and Joseph K. Salama, MD
Topics: myasthenia gravis, thymoma, stereotactic body radiation therapy
Daniel S. Chertow, MD, MPH; Avindra Nath, MD; Anthony F. Suffredini, MD; Robert L. Danner, MD; Daniel S. Reich, MD, PhD; Rachel J. Bishop, MD; Richard W. Childs, MD; Andrew E. Arai, MD; Tara N. Palmore, MD; H. Clifford Lane, MD; Anthony S. Fauci, MD; and Richard T. Davey, MD
Topics: ebola virus disease, meningoencephalitis
Topics: hypertension, follow-up, cardiovascular event
Topics: coronary artery bypass surgery, ventricular dysfunction, left, medical management, mortality, follow-up
Topics: aspirin, colorectal cancer, mortality
Topics: aspirin, primary prevention, intracranial hemorrhages, cardiovascular diseases, gastrointestinal bleeding
Topics: acute cerebrovascular accidents, aspirin, transient ischemic attack, cerebrovascular accident, ischemic stroke, ticagrelor ...
Topics: antiplatelet agents, platelet transfusion
Topics: hypoglycemia, diabetes mellitus, type 2, dipeptidyl-peptidase iv inhibitors
Topics: aortic valve stenosis, cerebrovascular accident, ischemic stroke, laparotomy, transcatheter aortic-valve implantation, follow-up ...
Topics: depressive disorders, psychotherapy, interpersonal
Topics: transient ischemic attack, ischemic stroke, abcd score

The Consult Guys bring a new perspective to the art and science of medicine with lively discussion and analysis of real-world cases and situations.

Topics: myocardial infarction, consultation
Topics: myocardial infarction, systemic infection, opioid analgesics, hospitalists, naloxone, septicemia, opioids, tramadol, medical ...
David H. Wesorick, MD; and Vineet Chopra, MD, MSc
Topics: hospitalists, inpatient, heart failure, incretin, hospitalization
Topics: systemic infection, systemic inflammatory response syndrome, hospitalists, inpatient, septicemia
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