A Pilot of a Randomized Control Trial of Melatonin and Vitamin C for Mild-to-Moderate COVID-19.

Unlabelled: This study aimed to help determine the effect of dietary supplements on symptom course and quality of life in patients with mild-to-moderate COVID-19 infection.

Design: We modified the Wisconsin Upper Respiratory Symptom Survey (WURSS) to conduct a 3 arm, parallel, randomized, double-blind, placebo-controlled trial, enrolling patients with mild-to-moderate symptoms of COVID-19 infection. Patients took placebo ( = 34), vitamin C 1000 mg ( = 32), or melatonin 10 mg (n = 32) orally for 14 days.

A Framework to Guide the Implementation of Best Practice Clinical Learning Environments in Community General Practice: Australia.

Clinical education/training is increasingly being expanded to community general practice settings (primary care clinics led by doctors). This plays an important role in developing a skilled "primary-care ready" workforce. However, there is limited information to guide the implementation of high-quality learning environments suitable for the range of general practices and clinical learners they oversee.

Novel team-based approach to quality improvement effectively engages staff and reduces adverse events in healthcare settings.

Background: Despite significant attention to safety and quality in healthcare over two decades, patient harm in hospitals remains a challenge. There is now growing emphasis on continuous quality improvement, with approaches that engage front-line staff. Our objective was to determine whether a novel approach to reviewing routine clinical practice through structured conversations-could improve engagement of front-line staff in quality improvement activities and drive improvements in indicators of patient harm.

Genetic Risk of Alzheimer's Disease: Three Wishes Now That the Genie is Out of the Bottle.

The availability and increasing popularity of direct-to-consumer genetic testing for the presence of an APOE4 allelle led the Alzheimer's Foundation of America Medical, Scientific and Memory Screening Advisory Board to identify three critical areas for attention: 1) ensure consumer understanding of test results; 2) address and limit potential negative consequences of acquiring this information; and 3) support linking results with positive health behaviors, including potential clinical trial participation. Improving access to appropriate sources of genetic counseling as part of the testing process is critical and requires action from clinicians and the genetic testing industry. Standardizing information and resources across the industry should start now, with the input of consumers and experts in genetic risk and health information disclosure.

The Relationship Between Family Caregiving and the Mental Health of Emerging Young Adult Caregivers.

Caring for dependent relatives has become a normative challenge for families in the USA and throughout the world. The study objective was to examine the relationship of family caregiving responsibilities and the mental health and well-being of individuals, ages 18-24 years, referred to as emerging young adults. It was hypothesized that young adult caregivers with past and present responsibilities would report significantly more symptoms of depression and anxiety, have lower self-esteem, and use less adaptive coping styles than non-caregiving peers.

Development of a productive research culture in emergency medicine: Report of the outcomes of a research forum.

In recent years, the Australasian College for Emergency Medicine (ACEM) has increasingly focused on the need for high-quality research in emergency medicine (EM). One important initiative was the establishment of the ACEM Foundation, which among other responsibilities, is required to support clinical research through the provision of research funding and other measures. In February 2015, the Foundation held a Research Forum that was attended by the leading EM researchers from Australasia.

Do physicians address other medical problems during preventive gynecologic visits?

Background: The patient-centered medical home model may be a strategic approach to improve delivery of women's health care and consistently provide women with accessible and comprehensive care. We examined whether primary care physicians (family medicine, internal medicine, and hospital general medicine clinics) and obstetrician-gynecologists differ in scope and the number of medical issues addressed during preventive gynecologic visits.

Methods: We analyzed data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey to characterize visits with a primary diagnosis of gynecological examination or routine cervical Papanicolaou test between 1999 and 2008.

State regulations for nursing home residents with serious mental illness.

To identify state regulations for nursing home residents with Serious Mental Illness (SMI). We reviewed state regulations for policies relating to nursing home residents with SMI, and conducted interviews with expert stakeholders. A framework for analyzing state regulations was generated by identifying four discrete categories: States with specific mental illness regulations, Alzheimer's or dementia regulations, minor mention of mental illness, and no mention of mental illness.

Impact of family caregiving by youth on their psychological well-being: a latent trait analysis.

Secondary data analyses were conducted on a survey dataset from 1,281 middle school students to analyze the impact of family caregiving on self-reports of psychological well-being using the Multiple Indicators, Multiple Causes (MIMIC) model. Factor analysis resulted in four latent factors underlying psychological functioning, and the MIMIC model revealed significant caregiver effects on three factors: anxiety/depression, engaged coping, and disengaged coping, but not life satisfaction. Youth caregivers, especially those living with the care recipient, reported significantly higher anxiety/depression and a greater use of both coping styles compared to non-caregivers.

State policies for the residency of offenders in long-term care facilities: balancing right to care with safety.

The presence of residents in long-term care facilities who are registered sex offenders, other predatory offenders, parolees, or inmates transferred by correctional authorities is controversial and has raised concerns about how to care for this potentially dangerous population who may jeopardize the safety of others. Although the present offender population appears to be small, it is likely that demographic and economic pressures will increase its size. Since 2004, 14 states have passed legislation about placement of sex and other offenders in facilities and 5 have implemented non-law policies.

Trends in the provision of preventive women's health services by family physicians.

Background And Objectives: Family medicine has experienced variations in scope and comprehensiveness of care in recent years. To investigate whether these changes in practice have impacted women's health services, we measured trends in the proportion of preventive women's health visits provided by family physicians nationally.

Methods: We analyzed the National Ambulatory Medical Care Survey to identify the trend in the proportion of preventive women's health visits to family physicians and obstetrician-gynecologists and others between 1995 to 2007.

Trends in well-child visits to family physicians by children younger than 2 years of age.

Purpose: Provision of prenatal visits by family physicians decreased by 50% from 1995 to 2004. To determine the impact of this trend on the provision of well-child visits by these professionals, we measured trends in and factors associated with well-child visits by children younger than 2 years of age to family physicians and pediatricians.

Methods: Using the National Ambulatory Medical Care Survey, we identified well-child visits made in the first 2 years of life to family physicians and pediatricians between 1995 and 2007.

Trends in prenatal cares settings: association with medical liability.

Background: Medical liability concerns centered around maternity care have widespread public health implications, as restrictions in physician scope of practice may threaten quality of and access to care in the current climate. The purpose of this study was to examine national trends in prenatal care settings based on medical liability climate.

Methods: Analysis of prenatal visits in the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 1997 to 2004 (N = 21,454).

Declining trends in the provision of prenatal care visits by family physicians.

Purpose: We wanted to measure trends in the proportion of prenatal visits provided by family physicians nationally for a 10-year period and determine characteristics of prenatal visits made to family physicians compared with visits made to obstetricians.

Methods: We analyzed the National Ambulatory Medical Care Survey to identify prenatal visits made to family physicians and obstetricians between 1995 and 2004. The primary outcome measure was the trend in proportion of prenatal visits seen by family physicians.

Vulvar cancer.

Vulvar cancer was reported in 3,200 women in 1998, resulting in 800 deaths. Recent evidence suggests that vulvar cancer comprises two separate diseases. The first type may develop from vulvar intraepithelial neoplasia caused by human papillomavirus infection and is increasing in prevalence among young women.