Implementation, Reach, and Effectiveness of the Direct Observation of Residents in Clinic Program.

Background: Direct observation is important, yet medical residents are rarely observed. We implemented and evaluated a direct observation program in resident clinics to increase the frequency of observation and feedback and improve perceptions about direct observation.

Methods: We assigned faculty as observers in our resident clinics between June 2019 and February 2020.

Postpartum Maternal Hypothermia in an Adolescent Patient Following Spontaneous Vaginal Delivery.

Postpartum hypothermia, though rare after spontaneous vaginal delivery, can be life-threatening, warranting efficient workup and intervention. A 14-year-old primigravida developed postpartum hypothermia following spontaneous vaginal delivery. No clear etiology was identified despite extensive workup.

Identifying and Addressing Language Needs in Primary Care: a Pilot Implementation Study.

Background: Medical interpreters improve care for patients with Limited English Proficiency but are underused. Protocols to improve interpreter use in primary care are needed.

Methods: Medical Assistants (MAs) screened patients for language needs and arranged for telephone interpreters during rooming in two pilot clinics (PCs).

Relationships Between English Language Proficiency, Health Literacy, and Health Outcomes in Somali Refugees.

Little is known about the impacts of health literacy and English proficiency on the health status of Somali refugees. Data came from interviews in 2009-2011 of 411 adult Somali refugees recently resettled in Massachusetts. English proficiency, health literacy, and physical and mental health were measured using the Basic English Skills Test Plus, the Short Test of Health Literacy in Adults, and the Physical and Mental Component Summaries of the Short Form-12.

Feasibility and Patient Perceptions of Video Declarations Regarding End-of-Life Decisions by Hospitalized Patients.

Background: A videotaped declaration by patients of their advance care planning preferences could be an opportunity to supplement advance directive forms and be a source of information for family, caregivers, and clinicians, yet research is needed to examine the content and acceptability of making declarations among patients.

Objective: To evaluate the content and acceptability of 'video declarations': the process of patients videotaping themselves describing their advance care planning preferences.

Design: We showed a brief video describing three approaches to end-of-life care and then invited participants to use an iPad to videotape themselves making a declaration about their wishes.

Persistent pneumocystis colonization leads to the development of chronic obstructive pulmonary disease in a nonhuman primate model of AIDS.

Human immunodeficiency virus (HIV)-infected patients are at increased risk for development of pulmonary complications, including chronic obstructive pulmonary disease (COPD). Inflammation associated with subclinical infection has been postulated to promote COPD. Persistence of Pneumocystis is associated with HIV infection and COPD, although a causal relationship has not been established.