Conscientious Objection: Understanding When and Why Primary Care Physicians Object to Providing Health Care to Transgender and Gender-Diverse Patients in an Appalachian Medical Center.

Introduction: Transgender and gender-diverse (TGD) individuals face barriers to accessing primary and gender-affirming care, especially in rural regions where a national shortage of medical providers with skills in caring for TGD people is further magnified. This care may also be impacted by individual providers' strongly held personal or faith beliefs and associated conscientious objection to care.

Purpose: This study assesses the prevalence of conscientious objection to providing care and gender-affirming hormone (GAH) therapy to TGD individuals among physicians in an Appalachian academic medical center.

Navigating coverage: A qualitative study exploring the perceived impact of an insurance company policy to discontinue coverage of antiobesity medication.

Introduction: Obesity rates continue to rise in the United States. Treatment includes modification of diet, exercise, behavioral modification and medical consideration including anti-obesity medications. However, multiple highly effective anti-obesity medications are expensive and with that we see insurers opting out of coverage of these medications.

Surveying the Knowledge and Practices of Primary Care Residents in Managing Adult Patients with Obesity.

Background: The prevalence of obesity is increasing worldwide at an alarming rate, yet obesity remains under-addressed during clinic encounters. A lack of training in how to treat obesity is one crucial factor contributing to this deficiency.

Objective: This study explored resident physicians' perceptions of their education on obesity and its relationship with confidence and practice behaviors when caring for patients with obesity.

Significant symptom resolution of spinal lipomatosis with weight loss.

71-year-old male with epidural spinal lipomatosis and spondylolisthesis. Conservative treatment failed, and a spinal fusion and laminectomy were performed. Postoperatively, the patient reported a reduction in pain; however, the pain recurred soon after surgery.

Twitter and Communicating Stigma about Medications to Treat Obesity.

In North America, stigma remains a significant barrier to treating obesity. Many candidates for medical weight management do not seek treatment, possibly related to anticipated and internalized stigma and weight bias. Pharmacologic treatment of obesity remains highly stigmatized, despite advances in drug development and medical weight management programs.

Apixaban and rivaroxaban use for atrial fibrillation in patients with obesity and BMI ≥50 kg/m.

Background: Apixaban and rivaroxaban are increasingly used for thromboembolism prophylaxis in patients with non-valvular atrial fibrillation (NVAF) and commonly in patients with obesity and body mass index (BMI) ≥50 kg/m despite the limited data.

Objectives: This study aimed to establish the effectiveness and safety of apixaban and rivaroxaban in patients with NVAF and BMI ≥50 kg/m .

Methods: A single health-system, retrospective cohort study evaluated the effectiveness and safety of apixaban and rivaroxaban initiated in adult patients (≥18 years of age) with BMI ≥50 kg/m and NVAF.

Universal Well-Being Assessment Associated With Increased Resident Utilization of Mental Health Resources and Decrease in Professionalism Breaches.

Background: A previous study showed that residents felt a universal well-being visit to a Faculty Staff Assistance Program (FSAP) would increase self-initiated visits. It is unknown whether such program is associated with more self-initiated visits, improved professionalism, or positive well-being measures.

Objective: We measured internal medicine (IM) resident-initiated visits before and after the universal well-being FSAP intervention to assess for increased utilization of FSAP services and effect on professionalism and well-being measures.

"Cleanse" detoxification diet program in Appalachia: Participant characteristics and perceived health effects.

Introduction Numerous detoxification or "detox" diets purport to eliminate toxins from the body, help with weight loss, and improve health. Despite the claims of proponents, few of these programs have evidence of effectiveness. They often have significant associated costs and may have potential for harm, but they seem to be quite popular.

Bariatric Surgery Outcomes in Appalachia Influenced by Surgery Type, Diabetes, and Depression.

Background: Most effective treatment for morbid obesity and its comorbidities is bariatric surgery. However, research is limited on weight loss and associated outcomes among patients in Appalachia. The objective of this study was to examine demographic and comorbidity influence on surgical outcomes of this population including age, sex, race, state of residence, education, marital status, body mass index (BMI kg/m), excess body weight (EBW), percent excess weight loss (%EWL), blood pressure, diagnosed depression, diagnosed type 2 diabetes (T2D), Beck Depression Inventory-II (BDI-II), and laboratory values (i.

Implementing a Universal Well-Being Assessment to Mitigate Barriers to Resident Utilization of Mental Health Resources.

Background: Physician utilization of well-being resources remains low despite efforts to promote use of these resources.

Objective: We implemented a well-being assessment for internal medicine residents to improve access and use of mental health services.

Methods: We scheduled all postgraduate year 1 (PGY-1) and PGY-2 residents at West Virginia University for the assessment at our faculty and staff assistance program (FSAP).

Rational care or rationing care? Updates and controversies in women's prevention.

Prevention has potential benefits, but the majority of people undergoing disease screening will receive no benefit and may actually be exposed to health risks. Public opinion is generally very favorable toward prevention. However, many recent guidelines recommend fewer preventive services in women than previously suggested.

Women's Health Curriculum for Internal Medicine Residents: Development, Implementation, and Evaluation.

Objective: Women's health knowledge and skills are important for physicians, but training is often inadequate. The objective of this project was to develop, implement, and evaluate a women's health curriculum for an internal medicine residency program.

Methods: After assessing institutional factors, we developed a curriculum for a multidisciplinary clinical rotation with a web-based tutorial.

Rational care or rationing care? Updates and controversies in women's prevention.

Prevention has potential benefits, but the majority of people undergoing disease screening will receive no benefit and may actually be exposed to health risks. Public opinion is generally very favorable toward prevention. However, many recent guidelines recommend fewer preventive services in women than previously suggested.

Osteoporosis screening: factors associated with bone mineral density testing of older women.

Background: Osteoporosis is a major public health problem. Guidelines recommend osteoporosis screening, primarily with bone mineral density (BMD) testing, of all women aged > or =65 and younger women at increased risk. However, BMD testing is underused, and osteoporosis screening practices are not in compliance with guidelines.

The rectovaginal examination: physician attitudes and practice patterns.

Background: The value of screening with the rectovaginal examination (RVE) has not been validated. This study describes physician attitudes and practice patterns regarding the RVE.

Methods: Cross-sectional survey of residents and faculty in general internal medicine and obstetrics/gynecology (OB/GYN) at a university hospital.