Syndromic Antibiograms and Nursing Home Clinicians' Antibiotic Choices for Urinary Tract Infections.

Importance: Empirical antibiotic prescribing in nursing homes (NHs) is often suboptimal. The potential for antibiograms to improve empirical antibiotic decision-making in NHs remains poorly understood.

Objective: To determine whether providing NH clinicians with a urinary antibiogram improves empirical antibiotic treatment of urinary tract infections (UTIs).

Characteristics of telemedicine workflows in nursing homes during the COVID-19 pandemic.

Background: The use of telemedicine increased dramatically in nursing homes (NHs) during the COVID-19 pandemic. However, little is known about the actual process of conducting a telemedicine encounter in NHs. The objective of this study was to identify and document the work processes associated with different types of telemedicine encounters conducted in NHs during the COVID-19 pandemic.

Antibiotic postprescribing modification opportunities among nursing home residents treated for urinary tract infection.

Objective: To characterize opportunities to postprescriptively modify antibiotic prescriptions initiated for treatment of suspected urinary tract infection (UTI) in nursing homes.

Design: Cross-sectional cohort study.

Methods: Data from the health records of residents treated for UTI between 2013 and 2014 in 5 Wisconsin nursing homes were abstracted using a structured approach.

There and back again: the shape of telemedicine in U.S. nursing homes following COVID-19.

Introduction: Telemedicine use in nursing homes (NHs) expanded during the COVID-19 pandemic. The objectives of this study were to characterize plans to continue telemedicine among newly adopting NHs and identify factors limiting its use after COVID-19.

Methods: Key informants from 9 Wisconsin NHs that adopted telemedicine during COVID-19 were recruited.

Comparison of criteria for determining appropriateness of antibiotic prescribing in nursing homes.

Background: Measuring the appropriateness of antibiotic prescribing in nursing homes remains a challenge. The revised McGeer criteria, which are widely used to conduct infection surveillance in nursing homes, were not designed to assess antibiotic appropriateness. The Loeb criteria were explicitly designed for this purpose but are infrequently used outside investigational studies.

A Qualitative Study of the System-level Barriers to Bariatric Surgery Within the Veterans Health Administration.

Objective: To characterize system-level barriers to bariatric surgery from the perspectives of Veterans with severe obesity and obesity care providers.

Summary Of Background Data: Bariatric surgery is the most effective weight loss option for Veterans with severe obesity, but fewer than 0.1% of Veterans with severe obesity undergo it.

Long-term dysphagia resolution following POEM versus Heller myotomy for achalasia patients.

Background: Heller myotomy (HM) has historically been considered the gold standard treatment for achalasia. Peroral endoscopic myotomy (POEM) is a less-invasive procedure and offers a quicker recovery. Although some studies have compared short-term outcomes of HM and POEM, predictors of long-term dysphagia resolution remain unclear.

Motivations of Males with Severe Obesity, Who Pursue Medical Weight Management or Bariatric Surgery.

Both medical weight management (MWM) and bariatric surgery are significantly underutilized by patients with severe obesity, particularly males. Less than 30% of participants in MWM programs are male, and only 20% of patients undergoing bariatric surgery are men. To identify motivations of males who pursue either MWM or bariatric surgery.

A structured, extended training program to facilitate adoption of new techniques for practicing surgeons.

Introduction: Laparoscopic inguinal hernia repair has been shown to have significant benefits when compared to open inguinal hernia repair, yet remains underutilized in the United States. The traditional model of short, hands-on, cognitive courses to enhance the adoption of new techniques fails to lead to significant levels of practice implementation for most surgeons. We hypothesized that a comprehensive program would facilitate the adoption of laparoscopic inguinal hernia repair (TEP) for practicing surgeons.

Trends in the Prevalence of Severe Obesity and Bariatric Surgery Access: A State-Level Analysis from 2011 to 2014.

Background: Understanding what proportion of the eligible population is undergoing bariatric surgery at the state level provides critical insight into characterizing bariatric surgery access. We sought to describe statewide trends in severe obesity demographics and report bariatric surgery volume in Wisconsin from 2011 to 2014.

Methods: Self-reported data from the Behavioral Risk Factor Surveillance System (BRFSS) were used to calculate prevalence rates of severe obesity (class II and III) in Wisconsin.

Psychosocial Factors Are Associated with Quality of Life After Laparoscopic Antireflux Surgery.

Background: Laparoscopic antireflux surgery (LARS) is the gold standard treatment for refractory gastroesophageal reflux disease (GERD). Traditional surgical outcomes following LARS are well described, but limited data exist regarding patient-reported outcomes. We aimed to identify preoperative characteristics that were independently associated with a high GERD health-related quality of life (GERD-HRQL) following LARS.

Obesity as a disease: has the AMA resolution had an impact on how physicians view obesity?

Background: In 2013, the American Medical Association (AMA) passed a resolution characterizing obesity as a disease. It is unclear whether primary care physicians (PCPs) agree with this characterization and how their agreement or lack thereof affects their treatment of patients with obesity.

Objectives: We sought to understand PCP opinions about the AMA obesity resolution and how it has affected management of patients with obesity.

Weight loss after bariatric surgery: a propensity score analysis.

Background: Laparoscopic vertical sleeve gastrectomy (LSG) has replaced laparoscopic Roux-en-Y gastric bypass (LRYGB) as the most commonly performed bariatric surgical procedure in the US for more than the past several years. Identifying which patients will achieve optimal outcomes remains challenging. We compared 90-d and 1-y outcomes between LSG and LRYGB patients and identified predictors of surgery type and excess body weight loss (EBWL).

Primary care physician decision making regarding severe obesity treatment and bariatric surgery: a qualitative study.

Background: Less than 1% of severely obese US adults undergo bariatric surgery annually. It is critical to understand the factors that contribute to its utilization.

Objectives: To understand how primary care physicians (PCPs) make decisions regarding severe obesity treatment and bariatric surgery referral.

Patient and Referring Practitioner Characteristics Associated With the Likelihood of Undergoing Bariatric Surgery: A Systematic Review.

Importance: Although bariatric surgery is the most cost-effective treatment for severe obesity, less than 1% of severely obese patients undergo it. Reasons for this low use are unclear.

Objectives: To identify patient and referring practitioner characteristics associated with the likelihood of undergoing bariatric surgery.

Dietary and psych predictors of weight loss after gastric bypass.

Background: Identifying severely obese patients who will succeed after bariatric surgery remains challenging. Although numerous studies have attempted to identify preoperative patient characteristics associated with weight loss, the roles of many dietary and psychological characteristics are unclear. The purpose of this study was to examine preoperative dietary and psychological predictors of successful weight loss after bariatric surgery.