Penicillin allergy reassessment for treatment improvement: A dental office tool to support appropriate penicillin allergy labeling.

Background: Dental appointments offer an opportunity to evaluate a documented penicillin (PCN) allergy and determine whether the patient might be a candidate for medical reassessment of their allergy. The authors gathered feedback on the Penicillin Allergy Reassessment for Treatment Improvement (PARTI) tool, designed to enhance dentist-patient communications regarding PCN allergies.

Methods: From January 2022 through May 2023, the authors conducted a mixed-methods study, collecting focus group data from patients with PCN allergies and surveying health care workers (HCWs) regarding the PARTI tool.

Incorporating verbal defense into problem-based learning.

Introduction: The objective of this project was to evaluate the effect of adjusting the solution reporting phase of problem-based learning (PBL) while keeping core components of the pedagogy constant.

Methods: A PBL course for third year pharmacy students changed delivery of the problem solution from a written format to a verbal defense. Comparisons were made between the written format and verbal defense groups.

Future Directions for Practice-Based Research Networks (PBRNs): A CERA Survey.

Background: Thought leaders from family medicine and practice-based research networks (PBRNs) have put forth definitions and goals recommending future directions for PBRNs. Evidence demonstrating that PBRNs are acting in accordance with these trends supports future investment in PBRN infrastructure, funding, and training of clinician researchers. Our objective was to explore the alignment of PBRN research efforts with thought leader recommendations.

"I Never Would Have Caught That Before": Pharmacist Perceptions of Using Clinical Decision Support for Antimicrobial Stewardship in the United States.

To systematically improve the appropriateness of antibiotic prescribing, antimicrobial stewardship programs have been developed. There is a paucity of literature examining how pharmacists perform antimicrobial stewardship using a clinical decision support system in a hospital setting. The purpose of this qualitative study was to develop a model exploring how pharmacists perform antimicrobial stewardship to identify areas for programmatic improvement.

CERA: Clerkships Need National Curricula on Care Delivery, Awareness of Their NCC Gaps.

Background And Objectives: The Society of Teachers of Family Medicine's (STFM) National Clerkship Curriculum (NCC) was created to standardize and improve teaching of a minimum core curriculum in family medicine clerkships, promoting the Triple Aim of better care and population health at lower cost. It includes competencies all clerkships should teach and tools to support clerkship directors (CDs). This 2014 CERA survey of clerkship directors is one of several needs assessments that guide STFM's NCC Editorial Board in targeting improvements and peer-review processes.

Clinical skills development in student-run free clinic volunteers: a multi-trait, multi-measure study.

Background: At Wayne State University School of Medicine (WSU SOM), the Robert R. Frank Student Run Free Clinic (SRFC) is one place preclinical students can gain clinical experience. There have been no published studies to date measuring the impact of student-run free clinic (SRFC) volunteerism on clinical skills development in preclinical medical students.

Depression screening and treatment in uninsured urban patients.

Background: Depression has been widely studied in primary care settings, yet studies of medically uninsured populations are lacking. We sought to determine whether depression screening and treatment improved depression scores of a medically uninsured, mostly African American primary care population.

Methods: The study was a prospective repeated-measures design that recruited uninsured patients.

A practical method for surveillance of novel H1N1 influenza using automated hospital data.

We report a surveillance method for influenza that is based on automated hospital laboratory and pharmacy data. During the 2009 H1N1 influenza pandemic, this method was objective, easy to perform, and utilized readily available automated hospital data. This surveillance method produced results that correlated strongly with influenza-like illness surveillance data.

Predictors, barriers, and facilitators of lipid-lowering medication use among African Americans in a primary care clinic.

Introduction: Hypercholesterolemic African Americans are less likely than white Americans to be taking lipid-lowering medications, yet they suffer disproportionately from coronary heart disease (CHD).

Methods: Through medical record abstraction and focus groups with patients and physicians, we sought a better understanding of the predictors, barriers, and facilitators to lipid-lowering medication use in a Detroit primary care clinic. Stepwise regression analysis included 634 African American patients with abnormal cholesterol values (n = 575) or currently prescribed a lipid-lowering medication (n = 59).

Depressive personality disorder, dysthymia, and their relationship to perfectionism.

This paper reports the results of two studies in a nonclinical (n=105) and primary care outpatient sample (n=110), in which Depressive Personality Disorder (DPD), Dysthymia, and depression were assessed for their distinctive relationship with perfectionism. Results from both studies found that self-reported DPD, Dysthymia, and depressive symptoms were all intercorrelated, and that DPD, Dysthymia, and depressive symptoms were correlated with three dimensions of perfectionism-Concern over Mistakes, Doubts about Actions, and Parental Criticism. In the nonclinical sample, variance in measures of DPD was predicted by measures of perfectionism after controlling for depression and Dysthymia symptoms.

Challenges in making therapeutic lifestyle changes among hypercholesterolemic African-American patients and their physicians.

Objective: We explored challenges faced by hypercholesterolemic African-American primary care patients and their physicians regarding therapeutic lifestyle changes (TLC) and provide patient-influenced recommendations to physicians.

Methods: In this qualitative study, 23 urban family medicine patients and their physicians (N=12) participated in separate focus groups, where they were asked semistructured, open-ended questions about knowledge and barriers to lifestyle treatment of high cholesterol.

Results: During the focus groups, barriers mentioned by physicians were: lack of time for TLC counseling, inadequate knowledge about counseling patients, and patient readiness and responsibility to change.

Object representations and their relationship to psychopathology and physical health status in African-American women in primary care.

Object relations theories hypothesize a relationship between self/other representations and level of psychopathology. Research has lent support to this hypothesis. This study was conducted to examine the link between object representation and psychopathology, stress, physical health status, and alcohol abuse in 110 African-American women in primary care.

Physical and psychological symptoms in emotionally abused and non-abused women.

Background: This brief report compares emotionally abused and non-abused female family practice patients on physical and emotional symptoms, alcohol use problems, and social support problems.

Methods: We conducted a secondary analysis of data from a cross-sectional, multicenter study of victimization of family practice patients. Forty-seven adult women meeting criteria for emotional abuse (within the past year) and no physical abuse were matched demographically with 47 non-abused women.

Functional health status and its relationship to depressive personality disorder, dysthymia, and major depression: preliminary findings.

Controversy continues on the extent to which depressive personality disorder (DPD) and dysthymic disorder (DYST) may be differentiated. Although affective disorders often are accompanied by changes in functional health status, to date no study has examined how functional health associated with affective disorders may assist in differentiating the two disorders. In this study, we hypothesized that measures of DPD would have fewer correlations with functional health status than would measures of DYST and major depressive disorder (MDD).