PRiMER (Leawood, Kan.)最新文献

{"title":"Methods for Studying Bias in Graduate Medical Education.","authors":"Danielle L Terry, Jessica Graham, Christopher P Terry, Mayanthi Telge","doi":"10.22454/PRiMER.2025.759472","DOIUrl":"10.22454/PRiMER.2025.759472","url":null,"abstract":"<p><p>Consistent with patterns seen in the larger population, bias in medical settings has been well established and negatively impacts outcomes, quality of care, and patient-clinician interactions. The purpose of this article is to provide a brief and introductory review of research methods for studying bias in graduate medical education, including (a) specific designs to consider and (b) considerations for overcoming barriers to implementation. While there are a variety of ways in which bias and inequity can be studied in medical settings, the unique limitations of graduate medical education may pose numerous challenges that researchers may need to overcome. Limited research addresses bias and inequity in graduate medical settings; future research might explore these topics in ways that are tailored to this educational setting.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"9 ","pages":"34"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Trends in Vitamin D Research From 1985 to 2024.","authors":"Mudasir Umer, Syed Mustafa Ali Shah, Camille Moeckel, Erum Azhar, Faisal Aziz, Abdul Waheed","doi":"10.22454/PRiMER.2025.538113","DOIUrl":"10.22454/PRiMER.2025.538113","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the importance of vitamin D, the number of vitamin D-related research publications has declined since 2020. This study examines trends in vitamin D-related research and National Institutes of Health (NIH) funding over 4 decades.</p><p><strong>Methods: </strong>We conducted a PubMed search using medical subject headings terms to identify vitamin D-related papers published between 1985 and 2024. NIH funding data were from NIH Reporter; statistical significance was determined using negative binomial regression.</p><p><strong>Results: </strong>Vitamin D-related publications rose steadily from 1985 to 2000, surged from 2008 to 2021, peaked at 6,019 in 2021, and then declined. A similar trend was seen in research on vitamin D-associated diseases. NIH funding for vitamin D research peaked at $52.4 million in 2013 but decreased to $10.5 million by 2024. A negative binomial regression showed a significant difference in publication rates (<i>P</i><.001) in Vitamin D-related publications with \"year\" being a significant predictor across all models (<i>P</i><.05). Negative binomial regression across 4 decades showed an annual publication growth of Vitamin D-related papers of 1.44% (<i>P</i>=.002) from 1985 to 1994, 4.78% (<i>P</i><.001) from 1995 to 2004, and 12.88% (<i>P</i><.001) from 2005 to 2014. In contrast, during the years 2015 to 2024, the annual increase dropped to 0.63% (<i>P</i>=.389), indicating a decline in publication activity.</p><p><strong>Conclusions: </strong>Vitamin D research output surged through 2014 but has since lost momentum, declining from its 2021 peak and showing no significant annual growth from 2015 to 2024 (<i>P</i>=.389). These findings regarding vitamin D-related research raise important questions that remain unanswered.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"9 ","pages":"33"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"Artificial Intelligence-Prompted Explanations of Common Primary Care Diagnoses\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.22454/PRiMER.2025.412803","DOIUrl":"10.22454/PRiMER.2025.412803","url":null,"abstract":"","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"9 ","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Cognitive Behavioral Therapy on Body Mass Index in Patients Treated Exclusively for Depression.","authors":"Shawn Y Sunu, Jason R Woloski","doi":"10.22454/PRiMER.2025.921088","DOIUrl":"10.22454/PRiMER.2025.921088","url":null,"abstract":"<p><strong>Introduction: </strong>Mood can affect an individual's weight and eating habits, making cognitive behavioral therapy (CBT) a potential approach to improving body mass index (BMI). Nevertheless, analyzing weight change is complex due to other factors, such as exercise and medications. This retrospective study examines BMI changes in depressed patients undergoing CBT exclusively for depression, not weight management.</p><p><strong>Methods: </strong>A retrospective study compared BMI changes between a CBT group and a no CBT group of depressed patients at an academic medical center in central Pennsylvania. To minimize variability, participants were matched one-to-one for gender, age at diagnosis, and BMI at diagnosis. Both groups were followed from the initial psychology visit to the completion of CBT in the experimental group.</p><p><strong>Results: </strong>From 2009 to 2019, 1,659 people were diagnosed with depression, but only 231 underwent CBT for depression. The CBT group had a slightly higher BMI at baseline (BMI=35.7 vs BMI=34.6). Among controls (no CBT), 9.2% were on Medicaid compared to only 1.3% in the experimental group. Overall, neither group showed a median difference in BMI during the study period.</p><p><strong>Conclusions: </strong>CBT alone did not significantly impact BMI when used exclusively for depression without additional weight-loss interventions. A secondary finding was the apparent underutilization of CBT among those with depression. Future research should explore barriers to CBT access in the depressed population.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"9 ","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Presence of Doulas on Perceived Racism for Black Mothers During the COVID-19 Pandemic.","authors":"Belainesh Nigeda, Kiara Patton, Gisselle Pichardo, Sarah E Rubin, Sharon Casapulla","doi":"10.22454/PRiMER.2025.813796","DOIUrl":"10.22454/PRiMER.2025.813796","url":null,"abstract":"<p><strong>Introduction: </strong>Few studies have explored the impact of doulas on Black births in the United States during the COVID-19 pandemic. The goal of this pilot study was to explore the birth experiences of Black mothers in the United States who used doulas and gave birth during the pandemic. More specifically, we aimed to compare the experiences of Black mothers who used doulas with those who did not; and explore differences between the physical presence of doulas, virtual doulas, and absence of doulas.</p><p><strong>Methods: </strong>We used a cross-sectional descriptive study that utilized an electronic survey administered to participants who gave birth during the COVID-19 pandemic. Participants completed the online survey between March 2021 and August 2021.</p><p><strong>Results: </strong>Sixty-two survey recipients participated in the study. Many of the participants-both with and without doulas-reported being afraid of enduring pregnancy-related complications (70.9%) or death due to the color of their skin (54.8%). Five of 13 participants with a doula present in the delivery room agreed that their doula decreased their experience with racism during pregnancy (<i>P</i>=.03). Eighty percent of participants with a doula present in the delivery room reported an improved birth experience.</p><p><strong>Conclusion: </strong>Results of our pilot study suggest that having a doula physically present (not including virtually present) in the delivery room could make a positive difference in Black women's birth experiences, especially with regards to racism. Our study had a small sample size and further research is needed to draw more generalizable conclusions.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"9 ","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel, Open-Access Family Medicine Residency Global Health Toolkit.","authors":"Chase Ballard, Weyinshet Gossa, Lauren Bull, Kathy Z Chang, Ann Evensen, Sommer Aldulaimi","doi":"10.22454/PRiMER.2025.268571","DOIUrl":"10.22454/PRiMER.2025.268571","url":null,"abstract":"<p><strong>Introduction: </strong>There are no established family medicine (FM) residency-level global health objectives or curricula for program directors who want to offer ethical and meaningful global health experiences to residents. We sought to develop and evaluate a toolkit of resources that family medicine educators can use to improve residents' knowledge of this important aspect of family practice.</p><p><strong>Methods: </strong>We reviewed and categorized peer-reviewed and grey literature publications and global health curricula from FM and non-FM residency programs related to clinical topics, standards of global health practice and partnerships, decolonization, and others. The toolkit uses six standard Accreditation Council for Graduate Medical Education (ACGME) competencies to organize learning objectives, content areas, and resources. Resources were further categorized based on complexity, cost, and time. We developed the toolkit with a focus on patient safety and ethical engagement with global partners. We evaluated the toolkit using an online survey of global health educators from inside and outside the United States.</p><p><strong>Results: </strong>The toolkit was vetted by the Society of Teachers of Family Medicine Board of Directors and published as an open-access resource on the STFM website (https://stfm.org/teachingresources/curriculum/globalhealthtoolkit/overview/).The toolkit had 1,446 unique views in the 18 months after it was published. Most global health educators surveyed found the toolkit to be appropriate for resident-level education and ethically sound. Respondents indicated that they would most likely use the toolkit to improve an existing global health experience or track.</p><p><strong>Conclusion: </strong>A novel toolkit provides resources curated and presented by topic, complexity, and estimated cost that residency programs can use to create or augment global health offerings. Educators can use resources and associated learning objectives presented using standard ACGME competencies to connect knowledge, skills, and attitudes gained through global health education to their residents' overall learning needs.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"9 ","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Rural Patients' Perspectives on Patient Care Teams.","authors":"Amy Tite, Brynn Magner, Emily Pierce, Mindy Ann Smith","doi":"10.22454/PRiMER.2025.315637","DOIUrl":"10.22454/PRiMER.2025.315637","url":null,"abstract":"<p><strong>Introduction: </strong>With a critical primary care clinician shortage, team-based care (TBC) is under development to enhance access, especially in rural regions. However, there has been limited discussion about TBC from the patient's perspective. We explored rural patient preferences for composition of their current and ideal primary health care team.</p><p><strong>Methods: </strong>An anonymous online survey of rural residents was conducted within the Kootenay-Boundary region of British Columbia. The survey included demographic information and current and ideal health care team composition. Descriptive statistics were used.</p><p><strong>Results: </strong>Four hundred ninety individuals responded to the survey. Most respondents self-identified as female, were over age 40 years, White, and had a postsecondary school diploma. Those with a health care provider (n=362, 74%) included a primary care doctor (86.5%), alternative medicine practitioner (52.2%), allied health professional (35.4%), friends/family/support people (35.1%), specialist physician (30.1%) and nurse practitioner (18.5%) on their team. Ideal health care teams included a primary care physician (92.2%) followed by an alternative medicine practitioner (64.1%), allied health professionals (61.2%), specialist physician (59.8%), and nurse practitioner (54.8%). Almost half of all respondents (46.6%) chose five or more categories of team members and 43.7% chose 3-4 categories of members. Respondents (81.1%) were highly likely (49.6%) or likely (31.6%) to affiliate with a primary health care team clinic.</p><p><strong>Conclusion: </strong>Both current and ideal health care team membership included many types of caregivers, with most respondents including three or more team-member categories. As many people in rural BC are without primary care providers, incorporating alternative medical practitioners and allied health professions into clinical teams within multidisciplinary settings could improve health care access.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"9 ","pages":"29"},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications Associated With Circumcision in a Community-Based Hospital.","authors":"Khushwant Dhaliwal, Kathleen Dor, Monique George, Xing Wei","doi":"10.22454/PRiMER.2025.923856","DOIUrl":"10.22454/PRiMER.2025.923856","url":null,"abstract":"<p><strong>Introduction: </strong>Infant male circumcision is a common elective procedure in the United States. Complications include bleeding, glans injury, insufficient or excessive skin removal, and adhesions. We assessed percentages and factors associated with complications of circumcisions at our community-based hospital from 2010 to 2020.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of male infant patients who had circumcisions performed in the Kaiser Permanente Woodland Hills (KPWH) Medical Center from January 1, 2010, to January 1, 2020. Complications were measured through emergency room visits up to 24 hours postcircumcision, complication codes, and referral appointments to urology within 2 years of age.</p><p><strong>Results: </strong>Of the total patients (N=2,715), 1.4% were referred to urology for potential complications, and 0.3% required revision surgery. Weight and age at the time of the circumcision and the location of the circumcision (hospital vs clinic) did not have a significant effect on the complication rate. Infants who had a circumcision with a Mogen clamp had an increased percentage of complications compared to the Gomco clamp (2% compared to 0.9%). The number of complications requiring surgery decreased (from 0.4% to 0.17%) when our hospital limited those physicians performing circumcisions by requiring 20 circumcisions per year to maintain privileges.</p><p><strong>Conclusions: </strong>Infant male circumcision is a safe procedure whether performed in the hospital or clinic. Complications likely can be reduced if circumcisions are completed by physicians who perform them regularly. Further studies are needed to investigate the difference between Mogen and Gomco clamp outcomes.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"9 ","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulatory Curriculum Enhancing Education for Modern Resident Learners.","authors":"Selda Ishkin, Adam Halpern, Janelle Singh, Anna Cornish, Seleshi Demissie, Eleny Romanos-Sirakis","doi":"10.22454/PRiMER.2025.929936","DOIUrl":"10.22454/PRiMER.2025.929936","url":null,"abstract":"<p><strong>Introduction: </strong>Data on the implementation of successful pediatric ambulatory curricula in residency are limited. Although most pediatric residents pursue careers in primary care, the educational focus in residency training sways toward inpatient medicine. Barriers exist to standardized, consistent teaching in the outpatient clinic. We aimed to create a novel longitudinal ambulatory curriculum focusing on high-yield topics geared toward modern learners that would be well-received and result in retained knowledge.</p><p><strong>Methods: </strong>Thirty-two pediatric residents were exposed to an 18-month curriculum consisting of 62 high-yield ambulatory topics. Standardized topic guides were taught in brief sessions weekly. Pre- and posttests, midcurriculum cumulative exams, and a 1-year follow-up exam assessed baseline knowledge and long-term retention. We used a Likert scale (1=not at all, 5=very much) to assess satisfaction and use of the curriculum in clinical practice.</p><p><strong>Results: </strong>Mean weekly scores increased from pretest to posttest and from pretest to final exam for each half curriculum. The mean test score 1 year later was sustained at over 85%. Mean satisfaction and effectiveness scores were 4.6 and 4.5, respectively. When asked how much the curriculum was used in clinical practice, the average score was 4.45.</p><p><strong>Conclusions: </strong>Ambulatory education in residency is often inconsistent, with gaps in published data. We created an approach geared toward modern learners that provided consistent pediatric outpatient education of high-yield topics, was well received, and led to a sustained increase in knowledge. This type of curriculum can be used in other ambulatory settings to improve resident knowledge with minimal interruption to clinical sessions.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"9 ","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Identified Barriers to Hepatitis C Treatment.","authors":"Joey Buytendorp, Serena Xiong, Darin Brink, David V Power","doi":"10.22454/PRiMER.2025.634340","DOIUrl":"10.22454/PRiMER.2025.634340","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatitis C virus (HCV) remains a public health concern in the United States. We developed a quality improvement project to address persistent challenges to HCV treatment at one primary care clinic. Challenges addressed included barriers to accessing specialist care to receive antiviral treatment and lack of patient resources, education, and awareness. Recognizing the potential for primary care providers to bridge treatment gaps, our initiative at an urban family medicine residency clinic in a large Midwest city targeted a patient population diagnosed with HCV but who remained untreated.</p><p><strong>Methods: </strong>Searching the medical record, we identified 40 eligible patients who had not received treatment despite a positive HCV diagnosis. Enrolled participants were asked to report their awareness, perceived barriers, and willingness to receive treatment in a primary care setting via a phone-assisted survey.</p><p><strong>Results: </strong>A total of 16 patients completed the survey (response rate 40%). Eighty-two percent were aware of their diagnosis, and 68.8% had not completed treatment. Only seven (43.8%) understood what an HCV infection is, while eight (50.0%) were aware that untreated HCV can lead to liver damage and cancer. Six (37.5%) claimed not to understand what an HCV infection is, and five reported that a medical professional had never explained it to them. Most respondents (81.2%) expressed a desire to initiate a treatment regimen and preferred to receive treatment at their primary care clinic.</p><p><strong>Conclusion: </strong>In an urban primary care residency clinic, HCV treatment is both possible and desired by patients.</p>","PeriodicalId":74494,"journal":{"name":"PRiMER (Leawood, Kan.)","volume":"9 ","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}