The Role of the Family Physician in Rural Maternity Care.

Of the 28 million rural women of reproductive age in the United States, ∼7 million of them live in areas of limited access to maternity care. While only 6.7% of Family Physicians currently provide maternity care, they are the only delivering physicians in 27% of rural hospitals.

Fever of Unknown Origin in Adults.

Fever of unknown origin is defined as a clinically documented temperature of 101°F or higher on several occasions, coupled with an unrevealing diagnostic workup. The differential diagnosis is broad but is typically categorized as infection, malignancy, noninfectious inflammatory disease, or miscellaneous. Most cases in adults occur because of uncommon presentations of common diseases, and up to 75% of cases will resolve spontaneously without reaching a definitive diagnosis.

Risk-based guidelines: Redefining management of abnormal cervical cancer screening results.

In making the 2019 guidelines for risk-based management of patients with abnormal cervical cancer screening tests and cancer precursors, the guidelines committee shifted from results-based to risk-based management recommendations, based on the patient's immediate and 5-year risks of grade 3 or higher cervical intraepithelial neoplasia (CIN 3+). The risk is determined by current and prior screening results (human papillomavirus infection, cytology testing) and the clinical history including age. An immediate 4% or higher risk of CIN 3+ was established as the dividing line between higher and lower risks, and the corresponding management recommendations.

Care of the College Student.

Approximately 19 million students attend college in the United States. Although they are generally healthy, about 20% of youth have special health care needs, including asthma, diabetes mellitus, and learning, mental health, and substance use disorders. Physicians can facilitate the transition of a youth to an adult model of health care by using structured processes to orient the youth to self-care before entry into college.

Out-of-Hospital Birth.

Since the 1970s, most births in the United States have been planned to occur in a hospital. However, a small percentage of Americans choose to give birth outside of a hospital. The number of out-of-hospital births has increased, with one in every 61 U.

Interventions to Improve Sexual and Reproductive Health in US Active Duty Military Service Members: A Systematic Review.

Objective: To identify and describe behavioral interventions to promote sexual and reproductive health among US active duty military service members.

Data Sources: Systematic searches of PubMed, CINAHL, and PsychINFO (N = 1609 records).

Inclusion Criteria: English-language articles published between 1991 and 2018 and retrieved using search terms related to military service, interventions, and sexual and reproductive health.

Primary Care Behavioral Health Training in Family Medicine Residencies: A Qualitative Study From a Large Health Care System.

Background And Objectives: Primary care behavioral health (PCBH) is a service delivery model of integrated care linked to a wide variety of positive patient and system outcomes. However, considerable challenges with provider training and attrition exist. While training for nonphysician behavioral scientists is well established, little is known about how to train physicians to work efficiently within integrated teams.

Women's Health and the Military.

Approximately 1.8 million American women are veterans of the Armed Services, and an additional 200,000 women are currently serving on active duty. With the increasing number of women in the military, there has been an increase in the number of women who have faced prolonged deployment in combat environments.

Training the Doctors: A Scoping Review of Interprofessional Education in Primary Care Behavioral Health (PCBH).

Primary care behavioral health (PCBH) is a model of integrated healthcare service delivery that has been well established in the field of psychology and continues to grow. PCBH has been associated with positive patient satisfaction and health outcomes, reduced healthcare expenditures, and improved population health. However, much of the education and training on PCBH has focused on developing behavioral health providers to practice in this medical setting.

Recurrent UTIs in women: How you can refine your care.

Which risk factors are (really) associated with recurrence? Which prophylactic and nonpharmacologic strategies are useful? This guide provides the answers.

Cesarean delivery: counseling issues and complication management.

Nearly one-third of all deliveries in the United States are cesarean deliveries. Compared with spontaneous vaginal delivery, cesarean delivery is associated with increased maternal and neonatal morbidity and mortality. Interventions that decrease the chance of a cesarean delivery include avoiding non-medically indicated induction of labor, avoiding amniotomy, and having a doula present.

Trauma in pregnancy: assessment, management, and prevention.

Trauma complicates one in 12 pregnancies, and is the leading nonobstetric cause of death among pregnant women. The most common traumatic injuries are motor vehicle crashes, assaults, falls, and intimate partner violence. Nine out of 10 traumatic injuries during pregnancy are classified as minor, yet 60% to 70% of fetal losses after trauma are a result of minor injuries.

Acute pancreatitis.

Acute pancreatitis is most commonly caused by gallstones or chronic alcohol use, and accounts for more than 200,000 hospital admissions annually. Using the Atlanta criteria, acute pancreatitis is diagnosed when a patient presents with two of three findings, including abdominal pain suggestive of pancreatitis, serum amylase and/or lipase levels at least three times the normal level, and characteristic findings on imaging. It is important to distinguish mild from severe disease because severe pancreatitis has a mortality rate of up to 30%.

Care of the returning veteran.

Of the 23.8 million military veterans living in the United States, approximately 3 million have served in Operation Enduring Freedom or Operation Iraqi Freedom. The injuries and illnesses that affect veterans returning from combat are predictable.

Blueprint for action: steps toward a high-quality, high-value maternity care system.

Childbirth Connection hosted a 90th Anniversary national policy symposium, Transforming Maternity Care: A High Value Proposition, on April 3, 2009, in Washington, DC. Over 100 leaders from across the range of stakeholder perspectives were actively engaged in the symposium work to improve the quality and value of U.S.