Meningitis in the Guise of Dementia: Lyme-Induced Normal Pressure Hydrocephalus.

While the cause of altered mentation in the elderly may be multifactorial, infectious etiologies may be missed. This case report aims to detail an account of a patient with dementia, found to have Lyme meningitis in the setting of a normal pressure hydrocephalus (NPH). The patient smelled of urine and presented with ambulatory dysfunction, fitting the "wet, wacky, and wobbly" triad of NPH while also having subjective chills and leukocytosis.

Assessing the risk of COVID-19 reinfection and severe outcomes among individuals with substance use disorders: a retrospective study using real-world electronic health records.

Objective: Despite advancement in vaccines and treatments for COVID-19 over the past 2 years, many concerns remain about reinfection and waning immunity against COVID-19 and its variants, especially among people with substance use disorder (SUD). The study assessed the risk of COVID-19 reinfection and severe illness among adults with SUD and their vaccination status to inform management in this vulnerable population as the pandemic continues.

Design: Retrospective cohort study.

Opioid dose risk, clinician and patient characteristics, and adherence to opioid prescribing recommendations in chronic non-cancer pain.

Objective: This study aims to assess associations between morphine-equivalent daily dose (MEDD) of opioids, clinician and patient characteristics, and prescriber adherence to guidelines for long-term opioid therapy (LTOT) in chronic noncancer pain (CNCP) and to elucidate potential relationships associated with increased-risk opioid prescribing.

Design: Retrospective cross-sectional study.

Setting: Academic health system's 33 primary care clinics.

Adoption and Discontinuance of Innovation Packages: A Longitudinal Study of Transitions in COVID-19 Mitigation.

The past decades have seen growing interest and application of interventions targeting the change of multiple behaviors at once. We advance this work by using the diffusion of innovations theory (DOI) to consider constellations of behaviors as : multiple innovations that are logically related, interdependent in their use or effects, and often promoted as a set (Rogers, 2003). In addition, we embraced DOI's focus on behavioral decisions as a continual process that can include adoption and discontinuance over time, especially as new innovations (e.

Shifting quality chronic pain treatment measures from processes to outcomes.

Objective: Misapplication of the 2016 Centers for Disease Control (CDC) opioid prescribing guidelines has led to overem-phasis of morphineequivalent daily dose (MEDD) as a "metric of success" in chronic noncancer pain (CNCP), resulting in unintentional harms to patients. This article reviews CNCP-related guidelines and patient preferences in order to identify pragmatic, patient-centered metrics to assess treatment response and safety in opioid-treated CNCP.

Methods: We reviewed the clinical (CDC), research (Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials), and implementability-related guidelines (GuideLine Implementability Appraisal), along with relevant patient-identified treatment goals.

Experiences of adults with opioid-treated chronic low back pain during the COVID-19 pandemic: A cross-sectional survey study.

This study aimed to evaluate the impact of the COVID-19 pandemic on adults with opioid-treated chronic low back pain (CLBP), an understudied area. Participants in a "parent" clinical trial of non-pharmacologic treatments for CLBP were invited to complete a one-time survey on the perceived pandemic impact across several CLBP- and opioid therapy-related domains. Participant clinical and other characteristics were derived from the parent study's data.

Risk Factors for Self-Harm Ideation Among Persons Treated With Opioids for Chronic Low Back Pain.

Objectives: Chronic pain is a significant health concern that adversely affects all aspects of life, including emotional well-being. Opioids are prescribed for the management of refractory, severe chronic pain, although they have been associated with adverse effects, including addiction and overdose. The aim of this study was to examine factors that predict thoughts of self-harm among adults with chronic pain who are prescribed opioids.

We are all in this together: Rurality, Social cohesion, and COVID-19 prevention behaviors.

Background: Social cohesion refers to an individual's sense of belonging to their community and correlates with health outcomes. Rural communities tend to have higher social cohesion than urban communities. Social cohesion is relatively understudied as a factor impacting COVID-19 prevention behaviors.

Preferred Information Source Correlates to COVID-19 Risk Misperception.

Inaccurate perceptions of COVID-19 (coronavirus disease 2019) risk may decrease compliance with public health mitigation practices, in turn increasing disease burden. The extent to which public perceptions of COVID-19 risk are inaccurate is not well studied. This study investigates the relationship between preferred information sources and inaccurate COVID-19 risk perception.

To be aware, or to accept, that is the question: Differential roles of awareness of automaticity and pain acceptance in opioid misuse.

Background: Individuals with chronic low back pain (CLBP) are commonly prescribed long-term opioid therapy (LTOT) for analgesia, placing this population at increased risk for opioid misuse and opioid use disorder. Acceptance of aversive experiences (e.g.

Virtual Recruitment Effects on Matched Residents in Family Medicine: Experiences From Central Pennsylvania.

Background And Objectives: As a result of the COVID-19 pandemic, interviews during the 2021 US residency match were conducted virtually, a practice again recommended and repeated by many programs in 2022. The impact of virtual interviews on recruitment and match outcomes has recently been of interest, with results showing the virtual format to be mostly well received by applicants due to cost, travel, and scheduling benefits. Few studies have looked at pre/posttransition comparisons of applicant geographic and demographic data.

Race, employment, and the pandemic: An exploration of covariate explanations of COVID-19 case fatality rate variance.

We derive a simple asymptotic approximation for the long-run case fatality rate of COVID-19 (alpha and delta variants) and show that these estimations are highly correlated to the interaction between US State median age and projected US unemployment rate (Adj. r2 = 60%). We contrast this to the high level of correlation between point (instantaneous) estimates of per state case fatality rates and the interaction of median age, population density and current unemployment rates (Adj.

Extending the Theory of Normative Social Behavior: Collective Norms, Opinion Leadership, and Masking During the COVID-19 Pandemic.

Novel, public behaviors, such as masking, should be susceptible to normative influence. This paper advances the theory of normative social behavior by considering a new set of moderators of normative influence - superdiffuser traits - and by clarifying the antecedents and consequences of exposure to collective norms. We use data from a two-wave survey of a cohort living in one U.

External Validation of the COVID-NoLab and COVID-SimpleLab Prognostic Tools.

Our objective was to externally validate 2 simple risk scores for mortality among a mostly inpatient population with COVID-19 in Canada (588 patients for COVID-NoLab and 479 patients for COVID-SimpleLab). The mortality rates in the low-, moderate-, and high-risk groups for COVID-NoLab were 1.1%, 9.

A General Framework for Exploring Ethical and Legal Issues in Sports Medicine.

Background: Medicolegal dilemmas faced by Sports Medicine providers differ from those of other primary care physicians in type and frequency. Exotic, high-profile challenges are widely covered in the literature and offer guidance on how to navigate challenging situations. However, there is a gap in the literature on how to approach more mundane, but nevertheless common, medicolegal dilemmas.

Provider and patient sex disparities in opioid prescribing and patient outcomes.

Objective: To assess sex disparities in opioid prescribing practices and patient outcomes.

Design: A retrospective cross-sectional study.

Setting: Thirty-three primary care clinics in an academic health system.

Mixed-methods Analysis of Adults Likely versus Unlikely to Get a COVID-19 Vaccination.

This mixed-methods study compared perspectives of those 'very likely' versus 'very unlikely' to receive a hypothetical COVID-19 vaccine. We used an explanatory, sequential, mixed- methods design to analyze quantitative data from a rural Pennsylvania sample. Of the 976 participants, 67 selected 'very unlikely' to get the COVID-19 vaccine.

Risks of Severe COVID-19 Outcomes Among Patients With Diabetic Polyneuropathy in the United States.

Context: Diabetic neuropathy (DN) affects more than 50% of diabetic patients who are also likely to have compromised immune system and respiratory function, both of which can make them susceptible to the SARS-CoV-2 virus.

Objective: To assess the risk of severe COVID-19 illness among adults with DN, compared with those with no DN and those with no diabetes.

Setting: The analysis utilized electronic health records from 55 US health care organizations in the TriNetX research database.

Support for HPV vaccine school-entry requirements in the United States: The role of exemption policies.

In the United States (U.S.), only five states or territories require human papillomavirus (HPV) vaccination for school attendance, even though almost all U.

Skeptical Health Mavens May Limit COVID-19 Vaccine Diffusion: Using the Innovation Diffusion Cycle to Interpret Results of a Cross-sectional Survey among People Who are Socially Vulnerable.

We sought to identify barriers to COVID-19 vaccine uptake among persons who are socially vulnerable in light of the natural cycle of innovation diffusion. Widespread adoption of a health innovation requires a cadre of opinion leaders to build on successes experienced by early adopters. One type of opinion leader in healthcare are health mavens: members of a community who maintain up-to-date health knowledge and share their knowledge others.

Perceptions and knowledge regarding the COVID-19 pandemic between U.S. and China: a mixed methods study.

Background: SARS-CoV-2, a new coronavirus first reported by China on December 31st, 2019, has led to a global health crisis that continues to challenge governments and public health organizations. Understanding COVID-19 knowledge, attitudes, and practices (KAP) is key for informing messaging strategies to contain the pandemic. Cross-national studies (e.

Essential and non-essential US workers' health behaviors during the COVID-19 pandemic.

We seek to quantify the relationship between health behaviors and work-related experiences during the COVID-19 pandemic by predicting health behaviors as a function of essential worker status, job loss, change in work hours, and COVID-19 experiences. We use multivariate models and survey data from 913 employed adults in a semi-rural mid-Atlantic US county, and test whether essential worker results vary by gender, parenthood, and/or university employment. Multivariate models indicate that essential workers used tobacco on more days (4.

Latent class analysis of health, social, and behavioral profiles associated with psychological distress among pregnant and postpartum women during the COVID-19 pandemic in the United States.

Background: There is a growing body of literature documenting negative mental health impacts from the COVID-19 pandemic. The purpose of this study was to identify risk and protective factors associated with mental health and well-being among pregnant and postpartum women during the pandemic.

Methods: This was a cross-sectional, anonymous online survey study distributed to pregnant and postpartum (within 6 months) women identified through electronic health records from two large healthcare systems in the Northeastern and Midwestern United States.

Adjunctive osteopathic therapy for hospitalized COVID-19 patients: A feasibility-oriented chart review study with matched controls.

Background: Osteopathic manipulative treatment (OMT) may improve outcomes during COVID-related respiratory distress - the most common cause of death from novel coronavirus (SARS-CoV-2). Outcomes from OMT treatments of respiratory distress during the COVID-19 pandemic have not been reported.

Objective: Assess adjunctive OMT in hospitalized patients with SARS-CoV-2 and respiratory distress.