Primary Care Provider HIV PrEP Knowledge, Attitudes, and Prescribing Habits: A Cross-Sectional Survey of Late Adopters in Rural and Suburban Practice.

Objective: Pre-exposure prophylaxis (PrEP) is a recommended strategy for HIV prevention, yet PrEP prescribing rates in primary care remain low. The aim of this study was to further describe the current knowledge, attitudes, and prescribing behaviors of HIV PrEP in primary care providers with a focus on the perceived barriers and facilitators to PrEP prescribing.

Methods: Cross-sectional survey of primary care providers at rural and suburban practices in a large academic institution.

Integrating Quality Improvement and Community Engagement Education: Curricular Evaluation of Resident Population Health Training.

Background And Objectives: The Accreditation Council for Graduate Medical Education requires all residents be trained in population health, but the most effective training strategies to impact care of patients and populations are not well established. The purpose of this study is to assess resident self-efficacy and expected application of population management skills through iterative experiential, longitudinal, team-based training in the office and community settings.

Methods: Using a prospective longitudinal curricular evaluation, we surveyed residents at a single institution from 2014-2020, evaluating self-efficacy in population health skills as well as perceived impact on patient care and future practice.

Parathyroid Disorders.

Parathyroid disorders are most often identified incidentally by abnormalities in serum calcium levels when screening for renal or bone disease or other conditions. Parathyroid hormone, which is released by the parathyroid glands primarily in response to low calcium levels, stimulates osteoclastic bone resorption and serum calcium elevation, reduces renal calcium clearance, and stimulates intestinal calcium absorption through synthesis of 1,25-dihydroxyvitamin D. Primary hyperparathyroidism, in which calcium levels are elevated without appropriate suppression of parathyroid hormone levels, is the most common cause of hypercalcemia and is often managed surgically.

Preparing for the future of medical education: A case series of traditional and virtual clinical rotations in addiction medicine spanning the COVID pandemic.

Substance use accounts for more than 400,000 deaths annually in the United States and overdose rates surged during the COVID pandemic. While the pandemic created increased pressure for better prepared providers, it simultaneously placed restrictions on medical training programs. The purpose of this educational case series is to assess the feasibility of a virtual addiction medicine training program and conduct a qualitative evaluation of medical student attitudes toward caring for people with substance use disorders, both before and after their addiction medicine training experience.

Area- and Individual-Level Correlates of Self-Rated Health: Implications for Geographic Health Disparities.

Background: Self-rated health (SRH) is a common measure of overall health. However, little is known about multilevel correlates of physical and mental SRH.

Methods: Patients attending primary care clinics completed a survey before their appointment, which we linked to community data from American Community Survey and other sources (n = 455).

Urethritis: Rapid Evidence Review.

Urethritis refers to inflammation of the urethra and is classified as gonococcal (caused by Neisseria gonorrhoeae) or nongonococcal in origin (most commonly caused by Chlamydia trachomatis, Mycoplasma genitalium, or Trichomonas vaginalis). The most common signs and symptoms include dysuria, mucopurulent urethral discharge, urethral discomfort, and erythema. Diagnostic criteria include typical signs, symptoms, or history of exposure in addition to mucopurulent discharge, Gram stain of urethral secretions showing at least two white blood cells per oil immersion field, first-void urinalysis showing at least 10 white blood cells per high-power field, or a positive leukocyte esterase result with first-void urine.

Harm Reduction: Assessing the Educational Needs of Family Medicine Residents in Care of Persons Who Inject Drugs.

Background And Objectives: Rates of injection drug use and associated medical complications have increased, yet engagement of persons who inject drugs (PWID) in primary care is limited, with significant barriers to care. Family physicians play an important role in caring for PWID, but residency training is limited. This study aimed to assess role responsibility, self-efficacy, and attitudes of family medicine residents in caring for PWID.

Primary Care for Persons Who Inject Drugs.

More than 750,000 persons in the United States inject opioids, methamphetamine, cocaine, or ketamine, and that number is increasing because of the current opioid epidemic. Persons who inject drugs (PWID) are at higher risk of infectious and noninfectious skin, pulmonary, cardiac, neurologic, and other causes of morbidity and mortality. Nonjudgmental inquiries about current drug use can uncover information about readiness for addiction treatment and identify modifiable risk factors for complications of injection drug use.

Common Gastrointestinal Infections.

Gastrointestinal infections account for a large burden of acute and chronic disease, with diarrhea being the most common manifestation. Most cases are due to viruses, with norovirus being the most common, whereas bacteria and parasites are also important contributors to acute and chronic gastrointestinal infections and their sequelae. Nontyphoidal Salmonella species cause the most hospitalizations and deaths in the United States.

A snap shot of patients' recall, attitudes, and perceptions of their pain contracts from a family medicine resident outpatient clinic.

Objective: Determine patient recall, attitudes, and perceptions of their pain contract in a family medicine resident out-patient clinic.

Design: A cross-sectional study design using a telephone survey to all eligible subjects who signed a hardcopy pain contract from August 29, 2014 to May 19, 2016 at a resident outpatient clinic.

Setting: Penn State Hershey Family and Community Medicine Residency clinic.

HIV: A Socioecological Case Study.

Introduction: New strategies are needed to lower health care costs and address the health care needs of communities, especially for marginalized persons and subpopulations. Improved education in health systems, which encompasses population, community, preventive, and public health, is one way to better train the future physician workforce to meet national and local health care needs. This resource was created as part of an 18-month science of health systems and navigation curriculum.

Management of human immunodeficiency virus in primary care.

This article presents an overview of current human immunodeficiency (HIV) management for primary care practitioners. Discussion is focused on appropriate screening, antiretroviral treatment, opportunistic infection prophylaxis, laboratory testing and prevention. Improved screening can identify the 20-25% of persons living with HIV in the United States who remain undiagnosed.