Does use of continuous or flash glucose monitors decrease hypoglycemia episodes in T2D?

NO. In adults with insulin-treated type 2 diabetes (T2D), continuous glucose monitoring (CGM) and flash glucose monitoring (FGM) do not decrease symptomatic hypoglycemia episodes (strength of recommendation [SOR], B) but do lower time in hypoglycemia (SOR, C; disease-oriented evidence).CGM, in which glucose levels are sent automatically in numeric and graphic format to a patient's smart device for their potential action, did not change the hypoglycemic event rate (SOR, B; 2 prospective studies).

Survey of clinical informatics fellows graduating 2016-2024: experiences before and during fellowship.

Objective: To describe experiences and activities of Clinical Informatics (CI) fellows since the first fellowships were accredited in 2014.

Materials And Methods: We performed a voluntary and anonymous survey of 394 alumni and current clinical informatics fellows from the graduating classes of 2016-2024 in the summer of 2022.

Results: We received 198 responses; 2% declined to participate.

Identifying Failure Modes in Telemedicine: An Instructional Needs Assessment.

Technology failures in telehealth are common, and clinicians need the skills to diagnose and manage them at the point of care. However, there are issues beyond technology failures mediating the effective use of telehealth. We must teach best-practice procedures for conducting telemedicine visits and include in instructional simulations commonly encountered failure modes so students can build their skills.

Differential Perceptions of What Constitutes a Medical Error Associated with Electronic Medical Records.

Perceptions of errors associated with healthcare information technology (HIT) often depend on the context and position of the viewer. HIT vendors posit very different causes of errors than clinicians, implementation teams, or IT staff. Even within the same hospital, members of departments and services often implicate other departments.

Consumers' Needs for Laboratory Results Portals: Questionnaire Study.

Background: Over the last decade, there has been an increase in the number of health care consumers (ie, patients, citizens, and laypeople) with access to their laboratory results through portals. However, many portals are not designed with the consumer in mind, which can limit communication effectiveness and consumer empowerment.

Objective: We aimed to study design facilitators and barriers affecting consumer use of a laboratory results portal.

Goal-Oriented Prevention: How to Fit a Square Peg into a Round Hole.

Prevention does not fit well within our problem-oriented medical paradigm in which the focus is on curing or ameliorating existing diseases. It is easier and more satisfying to solve existing problems than it is to advise and motivate patients to implement measures to prevent future problems that may or may not occur. Clinician motivation is further diminished by the time required to help people make lifestyle changes, the low reimbursement rate, and the fact that the benefits, if any, are often not apparent for years.

Medical student preparation for the operating room.

Background: This study examines student perceptions of preparedness for the operating room (OR), resources used, and time spent in preparation.

Methods: Third-year medical and second-year physician assistant students across two campuses at a single academic institution were surveyed to assess perceptions of preparedness, time spent in preparation, resources used, and perceived benefits of preparation.

Results: 95 responses (response rate 49%) were received.

Current state and practice variation in the use of Meningitis/Encephalitis (ME) FilmArray panel in children.

Background: The Meningitis/Encephalitis FilmArray® Panel (ME panel) was approved by the U.S. Food and Drug Administration in 2015 and provides rapid results when assessing patients with suspected meningitis or encephalitis.

Interprofessional survey on medication reconciliation activities in the US Department of Veterans' Affairs: development and validation of an Implementation Readiness Questionnaire.

Background: Medication reconciliation (MR) can detect medication history discrepancies at interfaces-in-care and help avoid downstream adverse drug events. However, organisations have struggled to implement high-quality MR programmes. The literature has identified systems barriers, including technology capabilities and data interoperability.

Unpacking determinants and consequences of food insecurity for insulin resistance among people living with HIV: Conceptual framework and protocol for the NOURISH-OK study.

Background: Over the past four decades, advances in HIV treatment have contributed to a longer life expectancy for people living with HIV (PLWH). With these gains, the prevention and management of chronic co-morbidities, such as diabetes, are now central medical care goals for this population. In the United States, food insecurity disproportionately impacts PLWH and may play a role in the development of insulin resistance through direct and indirect pathways.

What barriers delay treatment in patients with hepatitis C?

A Multiple patient-specific and provider-perceived factors delay initiation of treatment in patients with hepatitis C. Patient-specific barriers to initiation of treatment for hepatitis C virus (HCV) include age, race, gender, economic status, insurance status, and comorbidities such as HIV coinfection, psychiatric illness, and other psychosocial factors.Provider-perceived patient factors include substance abuse history, older age, psychiatric illness, medical comorbidities, treatment adverse effect risks, and factors that might limit adherence (eg, comprehension level).

Middle school start times and young adolescent sleep, behavioral health, and academic performance outcomes: a narrative review.

Study Objectives: This narrative review aims to synthesize peer-reviewed and gray literature research that associates middle school start times to adolescent sleep, health, and academic performance.

Methods: A systematic search of publications in PubMed, Scopus, ERIC, APA PsycInfo, CINAHL, ProceedingsFirst, and ProQuest Dissertations and Theses from 2002-2020 was conducted. Studies with middle school students that had either an empirical evaluation of the implementation of a change in school start time or a comparison of schools with different school start times, and which also reported outcomes related to sleep and health and quantitative academic measures were included.

Relationships between proximity to grocery stores and Oklahoma Early Care and Education classroom nutrition practices.

The study purpose was to determine associations between proximity to grocery stores and Early Care and Education programs' (i.e., ECEs) classroom nutrition practices and barriers, by ECE context (Head Start, community-based childcare [CBC], and family child care homes [FCCHs]).

Hidden in Plain Sight: Overlooked Results and Other Errors in Evaluating Online Laboratory Results.

People are increasingly accessing their own laboratory (lab) results online. However, Canadians may be expected to use different systems to access their results, depending upon where they are tested (e.g.

Teaching Teledermatology: A Simulation Pilot for Health Professional Students.

We developed a teledermatology simulation to give medical and physician assistant students practice with live videoconferencing and store-and-forward workflows. The simulation included (1) pre-session reading; (2) a brief teledermatology didactic; (3) a simulated encounter with a standardized patient; and (4) faculty-led debriefs. The faculty observed students during the simulation and distributed a post-session learner satisfaction survey.

Using Simulations to Train Medical Students for Unanticipated Technology Failures in Telemedicine.

Simulations offer a safe environment for health professional training and the opportunity to predictably and consistently introduce events or variables that may be rare or dangerous in a live setting. Exposing trainees to unanticipated events during simulations can improve their ability to adapt and improvise. The COVID-19 pandemic accelerated the adoption of telehealth worldwide and highlighted the need for better training in health professional schools.

Why Do People Use Online Lab Results and What Do They Look For: A Qualitative Study.

Laboratory (lab) test results are increasingly available online for patient review. However, there is a dearth of research with respect to users' information needs, goals, and information processing strategies. In this exploratory qualitative study, we interviewed a sample of (N = 25) online lab results users to understand their objectives and search targets.

When does 1 + 1 not equal 2? The relative advantage of public school-based pre-k versus head start for low-income children's kindergarten cognitive and self-regulatory skills.

Decades of research suggest that both Head Start and public pre-kindergarten (pre-k) programs boost low-income preschoolers' kindergarten skills. What is not yet well understood is whether there are relative advantages of transitioning from Head Start after 1 year into a school-based public pre-k program for the year immediately before kindergarten for children's developing cognitive and self-regulation skills. This is an important question, because in many communities Head Start and school-based pre-k programs provide competing early education options for low-income 4-year-olds, leaving policymakers, educators, and parents wondering which pathway best promotes the mix of skills predictive of success in elementary school.

Teaching Medical Students Health Care Failure Mode and Effect Analysis: A Case Study of Inpatient Pain Management Computerized Decision Support.

There is a pressing need to provide health professional leaners experiential learning opportunities in health systems science and quality improvement. Moreover, there are several published tools to diagnose and treat health system vulnerabilities and hazards. The Health Care Failure Mode and Effect AnalysisTM (HFMEA) is a systems-engineering tool that the military and aerospace industries developed to proactively identify potential errors.