Menopause Decoded: What's Happening and How to Manage It.

Menopause marks a significant transition in a woman's life, typically occurring between the ages of 46 and 55 years, characterized by the cessation of menstruation and a decline in ovarian function. This article provides a comprehensive overview of menopause, examining its physiological, psychological, and social dimensions. It explores the hormonal changes, including decreased levels of estrogen and progesterone, and how these changes contribute to common symptoms such as hot flashes, sleep disturbances, and mood fluctuations.

Impact of Dermoscopy Training on Diagnostic Accuracy, and Its Association With Biopsy and Referral Patterns Among Primary Care Providers: A Retrospective and Prospective Educational Intervention Study.

Background: Proper diagnosis in primary care is crucial due to the large number of skin cancer diagnoses each year and its associated growing economic burden. Understanding how primary care providers can be best trained in dermoscopy is instrumental in helping primary care providers differentiate benign and malignant cutaneous lesions so that appropriate action can be taken (eg, biopsy/referral to dermatology or reassurance).

Objective: To assess the success of concise dermoscopy training among primary care providers.

Improving access to cervical cancer screening: The impact of a Saturday pap smear clinic.

Introduction: The implementation of cervical cancer screening and human papillomavirus (HPV) vaccination has significantly reduced cervical cancer rates. However, it remains the fourth most common cancer among women globally. Barriers to screening include personal, health system, and insurance factors.

Closing the gap: improving the percentage of Annual Wellness Visits among Medicare patients.

Background: The Medicare Annual Wellness Visit (AWV) allows providers to acquire critical information about patients' health through a review of vitals, environmental risks, and medical and family history. These visits are free to those enrolled in Medicare and prioritize patient-provider relationship building and preventative care. Despite this, AWV completion rates are suboptimal.

Identifying Discrepancies in Gestational Diabetes Mellitus Postpartum Follow-Up During Care Transitions.

Background: Gestational diabetes mellitus (GDM) is a common complication of pregnancy that carries lasting risks. For women who have a history of GDM, the risk of developing type 2 diabetes mellitus (T2DM) increases by 50 to 60%. To monitor and prevent the development of T2DM, guidelines suggest screening those with a history of GDM at 6-weeks and 3-years post-delivery.

Utility of Dermoscopy Training in Improving Diagnostic Accuracy of Skin Lesions Among Physician Assistant Students.

Introduction: Patients often first present to their primary care provider for skin lesion concerns, and dermoscopy is a tool that enhances diagnostic acumen of both malignant and benign skin lesions. Physician assistants (PAs) frequently serve as primary care and dermatology providers, but to our knowledge, no current research on dermoscopy expertise with PAs exists. We hypothesize that PA students could be taught dermoscopy based on the triage amalgamated dermoscopic algorithm (TADA) to increase their diagnostic skill, as previously shown with medical students.

Stats on the desats: alarm fatigue and the implications for patient safety.

Background: Physiological monitoring systems, like Masimo, used during inpatient hospitalisation, offer a non-invasive approach to capture critical vital signs data. These systems trigger alarms when measurements deviate from preset parameters. However, often non-urgent or potentially false alarms contribute to 'alarm fatigue,' a form of sensory overload that can have adverse effects on both patients and healthcare staff.

Saturday Pap Smear Clinic: addressing barriers to cervical cancer screening.

Background: The incidence of cervical cancer has decreased by 70% since the 1950s. Preventative measures include vaccination against HPV strains and Papanicolaou tests. Early identification of cervical cancer through routine screening can significantly improve patient outcomes.

Papanicolaou test collection with the Papette brush or the spatula with cytobrush: A pragmatic study.

Background: Cotesting with the Papanicolaou (Pap) and human papillomavirus tests detects most precancerous and cancerous lesions and increases the sensitivity for detecting high-grade precancerous and invasive cervical cancers compared with human papillomavirus testing alone.

Objective: To compare the use of the Papette brush (hereafter Papette) to the traditional spatula with endocervical brush (cytobrush) for cervical cancer screening.

Design: Pragmatic observational study.

Clicks away from reduced healthcare expenditures: leveraging the electronic health record to reinforce education efforts.

Objectives: Lupron 11.25 mg has both a narrow indication and a high cost compared to other Lupron presentations. Prior to our study initiation there was no clear distinction between presentations when ordering within the health-system's Electronic Health Record (EHR).

Understanding attributes and characteristics of the PA leader-physician relationship.

Purpose: This study sought to evaluate the attributes and characteristics of physician mentors, dual-roled physician assistant (PA) leaders, and how this relationship affects PA leaders and the PA leader-physician relationship. Dual-role PA leaders may possess additional formal job titles and duties as well as having direct reports.

Method: We surveyed PA leaders at a single large academic medical center and its associated health system.

Bleeding Complications Associated With Intrauterine Contraception in Women Receiving Anticoagulation Therapy.

Objective: To determine whether anticoagulation therapy is associated with an increased risk of complications after initiation of intrauterine contraception (IUC).

Patients And Methods: We retrospectively reviewed records of women receiving anticoagulation therapy at the time of IUC placement from 2000 to 2017 and records of controls (no anticoagulation), matched by race, age, and body mass index. The primary outcome was the cumulative incidence of bleeding (more than spotting [World Health Organization bleeding grades 2 to 4]), IUC expulsion, and IUC removal.

Barriers to cervical cancer screening among immigrants.

For women ages 21 to 65 years who have not had a hysterectomy, the US Preventive Services Task Force (USPSTF) recommends cervical cancer screening with cytology (Pap smear) every 3 years or a combination of cytology and human papillomavirus (HPV) testing every 5 years. However, foreign-born women were less likely to have received a Pap smear compared with US-born women. This article reviews barriers to cervical cancer screening for foreign-born women.

PA job satisfaction and career plans.

Objective: To understand the relationships between burnout, job satisfaction, and career plans among physician assistants in the United States.

Methods: The authors surveyed PAs in 2016. The survey included the Maslach Burnout Inventory and items on job satisfaction and career plans.

Addressing Anxiety and Fear during the Female Pelvic Examination.

Methods: We reviewed the literature pertaining to anxiety and fear surrounding the pelvic examination to help guide health care providers' on available screening options and to review options for individualized patient management.

Results: Anxiety and fear are common before and during the pelvic examination. In fact, the pelvic exam is one of the most common anxiety-provoking medical procedures.

Pregnancy Reasonably Excluded Guide (PREG) Evaluation of Pregnancy Status Before Contraceptive Procedures: Improved Availability of Same-Day Insertion.

Objective: To determine whether implementation of the Pregnancy Reasonably Excluded Guide (PREG) in a primary care gynecology clinic improves access to contraceptive procedures and affects the number of urine human chorionic gonadotropin (hCG) tests.

Patients And Methods: PREG was administered to 981 women aged 18 to 50 years (1012 visits) who were seen in a primary care gynecology clinic for contraceptive procedures from September 30, 2015, through April 30, 2018. Contraceptive procedures included insertion of an intrauterine contraceptive (IUC) or subdermal contraceptive implant.

Burnout and satisfaction with work-life integration among PAs relative to other workers.

Objective: To evaluate burnout and satisfaction with work-life integration among physician assistants (PAs) compared with other US workers.

Methods: We surveyed PAs and a probability-based sample of US workers. The survey included the Maslach Burnout Inventory and an item on satisfaction with work-life integration.

Professional Satisfaction of Advanced Practice Providers in Primary Care Specialties.

This prospective study focuses on professional satisfaction among advanced practice providers (APPs) in primary care. We aimed to determine whether incorporating specialty care clinics within primary care practices increases professional satisfaction. We administered the validated Misener Nurse Practitioner Job Satisfaction Scale and a self-developed demographic questionnaire to all primary care APPs before and one year after implementation of a gynecology practice within the primary care setting.