Factors Associated with Persisting Post-Concussion Symptoms Among Collegiate Athletes and Military Cadets: Findings from the NCAA-DoD CARE Consortium.

Background: Persisting post-concussion symptoms (PPCS) is a condition characterized by prolonged recovery from a mild traumatic brain injury (mTBI) and compromised quality of life. Previous literature, on the basis of small sample sizes, concludes that there are several risk factors for the development of PPCS.

Objective: We seek to identify protective and risk factors for developing slow recovery or persisting post-concussion symptoms (PPCS) by analyzing medical history, contact sport level, setting, and the Sport Concussion Assessment Tool (SCAT) and Brief Symptom Inventory (BSI-18) assessments at baseline and post-injury.

Hospital readmissions reduction program penalizes safety net hospital clinicians.

Objective: The Hospital Readmissions Reduction Program (HRRP), started under the Patient Protection and Affordable Care Act and administered by the Centers for Medicare and Medicaid Services, was created with the intention to improve healthcare quality and costs. However, research on disparities in healthcare demonstrates the HRRP's protocolized risk-adjustment calculations neglect social factors, which consequently harms disadvantaged patient populations and unfairly contributes to clinician and hospital penalties.

Methods: A PRISMA literature review was conducted using PubMed and Cochrane Library to explore the inclusion of social factors such as socioeconomic status on risk-adjustment calculations, and their relation to healthcare disparities, penalties, and outcomes.

Time to Publication in Medical Education Journals: An Analysis of Publication Timelines During COVID-19 (2019-2022).

Introduction: COVID-19 changed scholarly publishing. Yet, its impact on medical education publishing is unstudied. Because journal articles and their corresponding publication timelines can influence academic success, the field needs updated publication timelines to set evidence-based expectations for academic productivity.

The Next Era of Assessment Within Medical Education: Exploring Intersections of Context and Implementation.

In competency-based medical education (CBME), which is being embraced globally, the patient-learner-educator encounter occurs in a highly complex context which contributes to a wide range of assessment outcomes. Current and historical barriers to considering context in assessment include the existing post-positivist epistemological stance that values objectivity and validity evidence over the variability introduced by context. This is most evident in standardized testing.

Association of Sport Helmet Status on Concussion Presentation and Recovery in Male Collegiate Student-Athletes.

Sporting helmets contain force attenuating materials which reduce traumatic head injury risk and may influence sport-related concussion (SRC) sequelae. The purpose of this study was to examine the association of sport helmet status with SRC-clinical presentation and recovery trajectories in men's collegiate athletes. Sport helmet status was based on the nature of sports being either helmeted/non-helmeted.

How Should Therapists Treat Patients who are so Altruistic They Regularly Harm Themselves for the Sake of Others?

Mental health providers sometimes encounter patients who are exceptionally altruistic toward others and, at the same time, are willing to ignore their own needs and even significantly harm themselves to best achieve these ends for others. Traditionally, therapists have seen it to be their role to discern patients' negative symptoms, then seek to reduce them. This article reviews gains based on positive psychology that highlight the importance of therapists giving priority to supporting patients' strengths, particularly the sources of meaning they have in their lives.

Mechanisms of Injury Leading to Concussions in Collegiate Soccer Players: A CARE Consortium Study.

Background: Few previous studies have investigated how different injury mechanisms leading to sport-related concussion (SRC) in soccer may affect outcomes.

Purpose: To describe injury mechanisms and evaluate injury mechanisms as predictors of symptom severity, return to play (RTP) initiation, and unrestricted RTP (URTP) in a cohort of collegiate soccer players.

Study Design: Cohort study; Level of evidence, 2.

Centering Justice in Health Professions Education by Owning Limitations of Anti-Bias Checklists.

This article argues that, although efforts to integrate checklists for assessing bias in educational content represent a sincere effort to address or mitigate harm, such efforts will likely have limited (if any) impact on curricular reform or the actual lived experiences of minoritized students. This is because checklists are not designed for justice-oriented assessment and thus will not create the kind of change needed to transform health professions, especially medical education. What is needed is more attention to the ways whiteness is used to organize health professions education and a deep commitment to faculty development focused on raising educators' critical consciousness.

Why Competency Frameworks Are Insufficiently Nuanced for Health Equity Teaching and Assessment.

This article suggests how competency-based medical education should robustly integrate health equity by focusing on physicians' responsibilities to (1) know why and how underlying structural mechanisms contribute to health equity and then (2) take action to achieve health equity in their practice. This article first canvasses currently available frameworks for helping trainees cultivate these 2 specific skills of discernment and action. This article then offers strategies for teaching and assessing these skills in specific learning activities.

Twitter as a Mechanism of Knowledge Translation in Health Professions Education: An Exploratory Content Analysis.

Introduction: Social media may facilitate knowledge sharing within health professions education (HPE), but whether and how it is used as a mechanism of knowledge translation (KT) is not understood. This exploratory study aimed to ascertain what content has been shared on Twitter using #MedEd and how it is used as a mechanism of KT.

Methods: Symplur was used to identify all tweets tagged with #MedEd between March 2021 - March 2022.

What Should Students and Trainees Be Taught About and Where Patients Belong?

Turfing is a colloquialism that refers to what clinicians do to patients whose needs do not fit neatly and tidily into typical clinical placement protocols, especially during inpatient admissions from a hospital's emergency department. This term and this practice are both clinically and ethically problematic because a patient is rarely, if ever, "turfed" to their advantage. Ethically speaking, turfing constitutes deferral of responsibility for a patient's admission or care to colleagues.

and Questions Regarding Death Anxiety, Forgiveness, and Patient Self-disclosure.

This commentary examines three critical therapeutic questions that arise for all patients, particularly for patients with psychiatric illness. These questions involve fearing death, forgiving oneself for past acts, and disclosing medical and psychiatric conditions to others. These questions, which can be critical to providing optimal medical care in some contexts, are prompted by the movie , as it might provoke questions regarding death and self-disclosure in patients.

Expanding Interdisciplinarity: A Bibliometric Study of Medical Education Using the Medical Education Journal List-24 (MEJ-24).

Introduction: Interdisciplinary research, which integrates input (e.g., data, techniques, theories) from two or more disciplines, is critical for solving wicked problems.

Assessment of Veterans Affairs Case Management Leadership.

Purpose/objectives: The critical work of Veterans Affairs (VA) case managers is to assist and advocate for veterans navigating the VA and civilian health care systems, aligning services, developing integrated care plans, and supporting team-based care (Hunt & Burgo-Black, 2011). The article reviews publications regarding VA case management leadership because case managers who function as leaders are likely to better coordinate health care services for veterans.

Primary Practice Setting: VA case managers adhere to the Commission for Case Managers (CCM) scope of practice through patient advocacy, education, and resource management, while ensuring the care is safe, effective, and equitable.

Tool to improve patient-provider interactions in adult primary care: Randomized controlled pilot study.

Objective: To assess whether an intervention to help patients prioritize goals for their visit would improve patient-provider communication and clinical outcomes.

Design: Randomized controlled pilot study.

Setting: Primary care clinic.

Transparency in peer review: Exploring the content and tone of reviewers' confidential comments to editors.

Purpose: Recent calls to improve transparency in peer review have prompted examination of many aspects of the peer-review process. Peer-review systems often allow confidential comments to editors that could reduce transparency to authors, yet this option has escaped scrutiny. Our study explores 1) how reviewers use the confidential comments section and 2) alignment between comments to the editor and comments to authors with respect to content and tone.

Three Primary Cancers in a Veteran With Agent Orange and Agent Blue Exposures.

A Vietnam War veteran's exposures likely contributed to his cancer diagnoses, but these associations are confounded by his substance use, particularly cigarette smoking.

Knowledge syntheses in medical education: Meta-research examining author gender, geographic location, and institutional affiliation.

Introduction: Authors of knowledge syntheses make many subjective decisions during their review process. Those decisions, which are guided in part by author characteristics, can impact the conduct and conclusions of knowledge syntheses, which assimilate much of the evidence base in medical education. To better understand the evidence base, this study describes the characteristics of knowledge synthesis authors, focusing on gender, geography, and institution.

Albuterol, Acidosis, and Aneurysms.

A patient with a complicated medical history on admission for dyspnea was administered nebulizer therapy but after 72 hours developed asymptomatic acute kidney injury and anion-gap metabolic acidosis.

Gastrointestinal Symptoms and Lactic Acidosis in a Chronic Marijuana User.

A patient presented with diffuse abdominal pain and a history of frequent cannabis use, a diet lacking in meat and fish, and an increase in consumption of simple carbohydrates in the past year.

Ethical Challenges Posed by Big Data.

Big Data is a term that refers to tremendously large data sets intended for computational analysis that can be used to advance research through revealing trends and associations. Innovative research that leverages Big Data can dramatically advance the fields of medicine and public health but can also raise new ethical challenges. This paper explores these challenges, and how they might be addressed such that individuals are optimally protected.

"To Conserve Fighting Strength": The Role of Military Culture in the Delivery of Care.

Introduction: There are ongoing discussions about reorganizing the delivery of health care within the US Armed Forces. The military cultural context of care has beneficial qualities for patients with orthopedic and extremity trauma acquired during deployments to conflict zones.

Methods: The study included 35 participants with lower limb amputations who had been discharged from the Amputee Patient Care Program ≥ 12 months prior to the study.

Integrating Wikipedia editing into health professions education: a curricular inventory and review of the literature.

Introduction: Wikipedia is an online encyclopedia read by millions seeking medical information. To provide health professions students with skills to critically assess, edit, and improve Wikipedia's medical content, a skillset aligned with evidence-based medicine (EBM), Wikipedia courses have been integrated into health professions schools' curriculum. This literature review and curricular inventory of Wikipedia educational initiatives provides an overview of current approaches and identifies directions for future initiatives and research.

SimLEARN Musculoskeletal Training for VHA Primary Care Providers and Health Professions Educators.

A simulation-based training curricula applied to the primary care evaluation and management of shoulder and knee pain resulted in improved access to care for veterans and cost savings for the health care system.