The West Virginia medical journal最新文献_第5页

What Providers Know vs. What Providers Do: Barriers to Contraception in Adolescents 提供者知道什么vs.提供者做什么:青少年避孕的障碍

The West Virginia medical journal Pub Date : 2021-06-01 DOI: 10.21885/wvmj.2021.9

Andrya J. Durr, BS, Elizabeth A. Critch, MBA, M. P. Fitzgerald, PhD, Kylie A. Fuller, MD, Kelly M. Devlin, MD, Roberta I. Renzelli-Cain, DO, MHS, NCMP, FACOG, IF

{"title":"What Providers Know vs. What Providers Do: Barriers to Contraception in Adolescents","authors":"Andrya J. Durr, BS, Elizabeth A. Critch, MBA, M. P. Fitzgerald, PhD, Kylie A. Fuller, MD, Kelly M. Devlin, MD, Roberta I. Renzelli-Cain, DO, MHS, NCMP, FACOG, IF","doi":"10.21885/wvmj.2021.9","DOIUrl":"https://doi.org/10.21885/wvmj.2021.9","url":null,"abstract":"INTRODUCTION The teenage birth rate in West Virginia (WV) remains among the highest in the United States. The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) recommend long-acting reversible contraception (LARC) as first-line contraception. Because WV teenagers' LARC use is exceptionally low, the objective of this study was to gain insight into the current knowledge, practice, and beliefs of health care providers (HCP) in WV regarding LARC for adolescent patients. METHODS An electronic survey using Qualtrics.com was distributed to WV HCPs. Of the 2,196 HCPs contacted, 132 respondents returned the survey, and 109 completed usable data. RESULTS A majority of HCPs were aware that LARC (i.e., intrauterine devices and implantable devices) is the first line recommendation of the ACOG and AAP for adolescent birth control. However, HCPs most frequently prescribed combination oral contraceptives and injectables, which are not first-line recommendations. Notably, 59% of HCPs prescribing combination oral contraceptives believed they were prescribing according to COG and AAP recommendations. Forty-one percent of HCPs knew that combination oral contraceptives were not a first-line recommendation but prescribed them most often. The most frequently identified most important reason for not prescribing LARC was that the HCP did not know how to place them (16.5% of respondents), followed by litigious or malpractice action if there is a malfunction or complication (4.6% of respondents). DISCUSSION These results indicate a need to provide adequate LARC training to HCPs in WV.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84008392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Feasability of Utilizing a Rapid Screening Tool for Suicide and Major Depressive Disorder in Appalachian Acute Care Settings 在阿巴拉契亚急症护理机构中使用自杀和重度抑郁症快速筛查工具的可行性

The West Virginia medical journal Pub Date : 2021-06-01 DOI: 10.21885/wvmj.2021.8

Melinda J. Sharon, MPH, Erica Shaver, MD, FACEP, Carmen Burrell, DO, Joseph Minardi, MD, Christopher Kiefer, MD, FACEP, Stephen Davis, PhD, Elyce Biddle, PhD

{"title":"Feasability of Utilizing a Rapid Screening Tool for Suicide and Major Depressive Disorder in Appalachian Acute Care Settings","authors":"Melinda J. Sharon, MPH, Erica Shaver, MD, FACEP, Carmen Burrell, DO, Joseph Minardi, MD, Christopher Kiefer, MD, FACEP, Stephen Davis, PhD, Elyce Biddle, PhD","doi":"10.21885/wvmj.2021.8","DOIUrl":"https://doi.org/10.21885/wvmj.2021.8","url":null,"abstract":"INTRODUCTION Patients who commit suicide will often visit the emergency department (ED) shortly before death for reasons other than those related to the suicide. These visits may be a prime opportunity to identify patients with symptoms of major depressive disorder (MDD) that contribute to suicidal ideation. This pilot study investigated the feasibility of a recently developed tool, the CAD-MDD-S, a combination of the Computerized Adaptive Diagnostic Screening Tool for Major Depressive Disorder (CAD-MDD) and four screening questions from the Columbia-Suicide Severity Rating Scale (C-SSRS),to identify patients with suicidal thoughts, intent, plans, and behaviors, and/or MDD. METHOD CAD-MDD-S was administered to ambulatory adult patients (18+ years) who presented at an academic ED or student health services clinic for non-mental health concerns. The goal was to study the feasibility and efficiency of the screening tool, assessing the potential impact the tool may have in identifying at risk patients in these clinical settings. RESULTS From August 2015 to November 2016, 345 patients agreed to complete the screening tool (89% agree rate), with 76 screening positive for MDD, 13 for risk of suicide, and 7 for both. The median screening time to completion was six minutes, with 87% of patients taking less than 10 minutes. CONCLUSIONS This pilot study demonstrated that the ad- ministration of the CAD-MDD-S diagnostic screening tool was feasible and efficient in emergency settings, and the time to completion did not present a substantial burden to the patient. Future studies are needed to confirm these findings in other populations with larger samples.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89826268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

LGBT Medical Education Assessment in West Virginia 西弗吉尼亚州LGBT医学教育评估

The West Virginia medical journal Pub Date : 2021-03-01 DOI: 10.21885/wvmj.2021.5

Elizabeth Duarte, MD, Mahreen Hashmi, MD, Kylie A. Fuller, MD

{"title":"LGBT Medical Education Assessment in West Virginia","authors":"Elizabeth Duarte, MD, Mahreen Hashmi, MD, Kylie A. Fuller, MD","doi":"10.21885/wvmj.2021.5","DOIUrl":"https://doi.org/10.21885/wvmj.2021.5","url":null,"abstract":"BACKGROUND Lesbian, gay, bisexual and transgender (LGBT) individuals experience healthcare disparities related to their physical, mental, behavioral, and sexual health. Educating medical students about how to address this public health issue is a priority of the Association of American Medical Colleges and all medical schools across the country. Yet, the training to care for LGBT patients has been inconsistent, and it is unknown how comprehensively these competencies are being addressed at the two allopathic medical schools in West Virginia (WV). METHODS An online questionnaire was distributed to medical students at the two allopathic medical schools in WV to evaluate perceptions of the curricula with respect to care for LGBT patients. RESULTS Medical students (N-91) felt prepared to address 9 of 16 LGBT-specific subject areas. The majority of students felt prepared to discuss sexual orientation (64/91; 70.3%) and human immunodeficiency virus (60/91; 65.9%). Fewer students felt prepared to discuss sex-reassignment surgery (17/91; 18.7%) and transitioning (21/91; 23.1%). Overall, 82.4% of respondents reported feeling \"comfortable\" or \"somewhat comfortable\" with LGBT health issues. Medical school education helped 59.3% of respondents feel \"more comfortable\" and 65,9% of respondents feel \"more prepared\" to provide medical care to LGBT patients. CONCLUSION Our data suggests that medical school curricula in WV has increased student-rated comfort and preparedness in providing medical care to LGBT patients, but should be further developed and standardized to reduce the perceived knowledge gaps.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79557545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Appalachian Culture & History, An Important Lesson for Incoming Medical Students 阿巴拉契亚文化与历史:对即将入学的医学生的重要一课

The West Virginia medical journal Pub Date : 2021-03-01 DOI: 10.21885/wvmj.2021.3

Jason S. Hedrick, MA, Larry A. Rhodes, MD, Scott Cottrell, EdD, Norman D. Ferrari III, MD

{"title":"Appalachian Culture & History, An Important Lesson for Incoming Medical Students","authors":"Jason S. Hedrick, MA, Larry A. Rhodes, MD, Scott Cottrell, EdD, Norman D. Ferrari III, MD","doi":"10.21885/wvmj.2021.3","DOIUrl":"https://doi.org/10.21885/wvmj.2021.3","url":null,"abstract":"INTRODUCTION There is an expectation that medical students will be exposed to and gain cultural competence prior to graduation. It is prudent to ensure that cultural competence education starts early in the medical school curriculum. METHODS A 90-minute educational session (\"Appalachian Culture and History\") was created at the West Virginia University School of Medicine as a part of the cultural competency curriculum to better introduce and orient new medical school matriculates to the culture and history of both the state and Appalachia. Students anonymously completed on-line evaluations at the conclusion of the session to rate the quality of the presentation on a five-point scale which ranged from 1 (\" very dissatisfied \") to S (\"extremely satisfied \"). RESULTS Students rated the session at a mean of 4.52, 4.37, and 4,53 in 2018, 2019, and 2020 respectively. Positive comments were generated by in-state and out-of-state students. DISCUSSION Matriculating students have been overwhelmingly satisfied with the Appalachian Culture and History educational session based upon anonymous evaluations. CONCLUSIONS As the majority of medical students have positively appraised the Appalachian Culture and History educational session, there is reason to believe they will be better prepared to learn from and care for patients from Appalachia.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"42 10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76608528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rural Obesity Medical Education for Primary Care in West Virginia: A Needs Assessment 西弗吉尼亚州农村肥胖医学教育初级保健:需求评估

The West Virginia medical journal Pub Date : 2021-03-01 DOI: 10.21885/wvmj.2021.2

Laura Davisson, MD, MPH, FACP, Melissa A. Hernandez-Pachon, BS, Treah S. Haggerty, MD, MS

{"title":"Rural Obesity Medical Education for Primary Care in West Virginia: A Needs Assessment","authors":"Laura Davisson, MD, MPH, FACP, Melissa A. Hernandez-Pachon, BS, Treah S. Haggerty, MD, MS","doi":"10.21885/wvmj.2021.2","DOIUrl":"https://doi.org/10.21885/wvmj.2021.2","url":null,"abstract":"ABSTRACT INTRODUCTION Obesity is a serious disease associated with adverse health effects and costs, West Virgini(WV) has one of the highest obesity rates in the nation. Addressing obesity largely falls on primary care practitioners, but many feel ill -equipped to counsel patients on weight loss. It is critical for clinicians to be adequately trained to treat obesity, We conducted this study to assess the obesity medical education needs of WV primary care practices. METHODS Data was collected from 17 health systems through W/V Practice-Based Research Network's Collective Outreach and Research Engagement survey. Survey results were analyzed using descriptive statistics to summarize demographics; obesity treatment knowledge and confidence, topics of interest; and preferred educational delivery methods. RESULTS The majority of respondents agreed that medical training in obesity should be strengthened (96.4%). Relatively low confidence levels were reported for prescribing anti-obesity medications (49,4%), optimizing chronic medications for weight (61.0%), and counseling/managing patients before/after bariatric surgery (52,4%). Highest reported interest levels were in strategies for discussing weight with patients (87.2%), food and nutrition (85.7%), physical activity plans (84.4%), motivational interviewing (84.0%), and optimizing chronic medications for weight (79,2%). The highest rated educational delivery method was virtual Continuing Medical Education (91.5%) with lecture format (89.0%). CONCLUSIONS These results can be used to develop obesity medical education for primary care that can ultimately help to reduce health disparities in rural WV. An educational plan should ideally be delivered in virtual lecture format and should address lifestyle modifications, motivational interviewing, bariatric surgery, and obesity pharmacotherapy.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86890733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Editor's Letter: West Virginian Physicians: Role Models of Optimal Patient Care 编者信:西弗吉尼亚医生:最佳病人护理的榜样

The West Virginia medical journal Pub Date : 2021-03-01 DOI: 10.21885/wvmj.2021.1

引用次数: 0

Raising Awareness about Health Disparities with a Medical and Dental School Web-Based Collaboration 通过医学和牙科学校网络协作提高对健康差异的认识

The West Virginia medical journal Pub Date : 2021-03-01 DOI: 10.21885/wvmj.2021.4

Shelia S. Price DDS, EdD, Linda Nield, MD, Christa L. Lilly, PhD, Manuel C. Vallejo MD, DMD

{"title":"Raising Awareness about Health Disparities with a Medical and Dental School Web-Based Collaboration","authors":"Shelia S. Price DDS, EdD, Linda Nield, MD, Christa L. Lilly, PhD, Manuel C. Vallejo MD, DMD","doi":"10.21885/wvmj.2021.4","DOIUrl":"https://doi.org/10.21885/wvmj.2021.4","url":null,"abstract":"INTRODUCTION A collaborative web-based learning event for beginning medical and dental students was created to raise awareness about health disparities. METHODS Incoming medical and dental students completed an online assignment based upon real patient scenarios which addressed the following six topics: religion, sexual preference, socio-economic status, race, culture, and military veteran status, Students completed identical pre- and post- questionnaires approved by the West Virginia University Institutional Review Board. Questions were ranked on a 6-point Libert scale (1 = strongly disagree to 6 = strongly agree) or 5-point frequency scale (1 = never to 5= always). Data were analyzed using the Mann-Whitney test, with p < 0.05 as significant RESULTS The pre- and post-questionnaires were completed by 45 dental students (94% response rate) and 118 (pre-) and 116 (post-) medical students with 98% and 97% respective response rates. Both dental and medical students had a significant increase in their awareness of health disparities. Dental students had a significant increase in their appreciation of the frequency of health disparities in state and country, while medical students had a significant increase in their agreement that learning events about diversity and inclusion should be threaded throughout the curriculum, and disparities are influenced by the quality of interpersonal health care. CONCLUSIONS Bringing attention to diverse patient populations in a web-based format as part of new student orientation is effective in introducing and enhancing medical and dental students' awareness of health disparities and under essentiality of diversity topics in.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81397287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Spinal Flexion Distraction Injuries: Chance Fractures and Posterior Ligamentous Equivalents in Children and Adolescents 脊柱屈曲牵张损伤:儿童和青少年的偶发骨折和后韧带等效损伤

The West Virginia medical journal Pub Date : 2020-10-01 DOI: 10.21885/wvmj.2020.8

Tyler Calkin, Emily P. Ernest, J. Lubicky

{"title":"Spinal Flexion Distraction Injuries: Chance Fractures and Posterior Ligamentous Equivalents in Children and Adolescents","authors":"Tyler Calkin, Emily P. Ernest, J. Lubicky","doi":"10.21885/wvmj.2020.8","DOIUrl":"https://doi.org/10.21885/wvmj.2020.8","url":null,"abstract":"Flexion-distraction injuries (FDI) are uncommon and often serious due to the mechanism of injury. Although originally described as a bony lesion in the thoracolumbar spine, these injuries can be purely bony, purely ligamentous/soft tissue or a combination at all spinal levels. Because of the forces involved, associated non-spine injuries can occur. Data on patients age 0-18 years with spinal injuries over a ten-year period were retrospectively reviewed and patients were classified into two groups, those with FDI and those with a spinal fracture other than FDI. Cervical and thoracic FDI, Chance fractures and posterior ligamentous equivalents, all considered FDI in this study, occurred in 22/301 spinal injured patients. The highest incidence considering all spinal injured patients was in the under 10 years old group (31.6%; p=0.004). A motor vehicle collision was the most common mechanism of injury. Statistically significant differences between patients with FDI compared to those without were respectively: average age (13.7 vs. 15.6 years), length of stay (10.2 days vs. 4.0 days), follow-up (1.7 years vs. 0.5 years), spinal surgery (78.3% vs. 15.5%), intra-abdominal organ injury (26% vs. 11%) and neurological deficit at presentation (43% vs. 10.4%) and at final follow-up (22% vs. 4%). Five patients without neurologic deficit did not undergo surgery.Seventy-two percent (13/18) of FDI patients having surgery required instrumentation. There was no association between injury level and FDI incidence or neurological deficit. FDI are most common in younger children with high likelihood of associated injuries, including intra-abdominal and neurological. FDI patients most often require surgical treatment, have an increased length of hospital stay and require longer-term follow-up.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78468976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Concurrent Development of Septic Arthritis of the Acromioclavicular Joint and Osteomyelitis of the Acromion in a Pediatric Patient 一名儿科患者肩锁关节脓毒性关节炎和肩峰骨髓炎的并发发展

The West Virginia medical journal Pub Date : 2020-10-01 DOI: 10.21885/wvmj.2020.6

C. Vijay, Charles B. Chen

引用次数: 0

Preventing a Convergence of COVID-19 Pandemic and Influenza Epidemic on West Virginia’s Residents and Healthcare System 防止COVID-19大流行和流感大流行对西弗吉尼亚州居民和医疗保健系统的融合

The West Virginia medical journal Pub Date : 2020-10-01 DOI: 10.21885/wvmj.2020.5

Elaine Darling

引用次数: 0