Academic Detailing From Medical Students: Part of a Plan to Emphasize Feedback in One Clerkship.

Introduction: Medical schools have an enduring need to provide ongoing faculty development and to foster educational alliances between teachers and learners, so that feedback provided to learners is both frequent and of high quality. We hypothesized that medical students trained as academic detailers with a mission to increase the emphasis on feedback could serve in this role during our clerkship, while still being evaluated as students in our clerkship rotation.

Methods: The family medicine clerkship at Mayo Clinic School of Medicine launched a revised curriculum in 2016 in which students were taught how they might build an educational alliance with preceptors, were taught characteristics of high-quality feedback, and practiced requesting more useful feedback when initial quality was poor.

Vitamin D and the Breastfeeding Infant: Family Medicine Clinicians' Knowledge, Attitudes, and Practices.

Background: The American Academy of Pediatrics and the National Academy of Medicine recommend vitamin D supplementation for breastfeeding infants. However, compliance with this recommendation is poor. Maternal supplementation with vitamin D is a safe and effective alternative to achieving vitamin D sufficiency in breastfeeding infants, and mothers have indicated a preference for self-supplementation over infant supplementation.

Comparison of the effect of daily versus bolus dose maternal vitamin D supplementation on the 24,25-dihydroxyvitamin D to 25-hydroxyvitamin D ratio.

Objective: Supplementing lactating mothers with high doses of vitamin D can adequately meet vitamin D requirements of the breastfed infant. We compared the effect of bolus versus daily vitamin D dosing in lactating mothers on vitamin D catabolism. We hypothesized that catabolism of 25(OH)D to 24,25(OH)D would be greater in the bolus than in the daily dose group.

Maternal Preferences for Vitamin D Supplementation in Breastfed Infants.

Daily vitamin D supplementation is recommended for breastfed infants, but alternative methods include enriching breast milk with vitamin D through maternal supplementation or intermittent high-dose vitamin D. We determined maternal preferences for vitamin D supplementation in 140 mothers with exclusively breastfed infants, and 44 who used both breast and formula milk. Only 101 (55%) supplemented their infants with vitamin D.

Diabetes and obesity not associated with 6-month remission rates for primary care patients with depression.

Background: Complex interrelationships appear to exist among depression, diabetes, and obesity, and it has been proposed that both diabetes and obesity have an association with depression.

Objective: The purpose of our study was to explore the effect of obesity and diabetes on response to the treatment of depression. Our hypothesis was that obesity and the diagnosis of diabetes in primary care patients with depression would have no effects on depression remission rates 6 months after diagnosis.

Changing Incidence of Serum 25-Hydroxyvitamin D Values Above 50 ng/mL: A 10-Year Population-Based Study.

Objective: To determine the incidence trend of 25-hydroxyvitamin D (25(OH)D) values above 50 ng/mL and associated toxicity.

Patients And Methods: We conducted a retrospective population-based study in Olmsted County, Minnesota, in the 10-year period from January 1, 2002, through December 31, 2011, by using the Rochester Epidemiology Project. Individuals were eligible if they resided in Olmsted County during the study period and had a measured 25(OH)D value above 50 ng/mL.

Impact of symptom remission on outpatient visits in depressed primary care patients treated with collaborative care management and usual care.

Depression symptoms contribute to significant morbidity and health care utilization. The aim of this study was to determine the impact of symptom improvement (to remission) on outpatient clinical visits by depressed primary care patients. This study was a retrospective chart review analysis of 1733 primary care patients enrolled into collaborative care management (CCM) or usual care (UC) with 6-month follow-up data.

Future complexity of care tier affected by depression outcomes.

Background: The inclusion of mental health issues in the evaluation of multimorbidity generally has been as the presence or absence of the condition rather than severity, complexity, or stage. The hypothesis for this study was that clinical outcome of the depression 6 months after enrollment into collaborative care management would have a role in predicting future complexity of care tier.

Methods: This study was a retrospective chart review of 1894 primary care patients who were diagnosed with major depressive disorder or dysthymia as of December 2012.

Maternal vitamin D supplementation to improve the vitamin D status of breast-fed infants: a randomized controlled trial.

Objective: To determine whether a single monthly supplement is as effective as a daily maternal supplement in increasing breast milk vitamin D to achieve vitamin D sufficiency in their infants.

Patients And Methods: Forty mothers with exclusively breast-fed infants were randomized to receive oral cholecalciferol (vitamin D3) 5000 IU/d for 28 days or 150,000 IU once. Maternal serum, breast milk, and urine were collected on days 0, 1, 3, 7, 14, and 28; infant serum was obtained on days 0 and 28.

Timely response to secure messages from primary care patients.

Purpose: To assess delays in response to patient secure e-mail messages in primary care.

Background: Secure electronic messages are initiated by primary care patients. Timely response is necessary for patient safety and quality.