PA scope of practice reform: History informing the future.

State-level physician associate/assistant (PA) practice regulations have evolved since the profession's inception. The conditions that influence states' adoption of PA regulatory reforms are not fully understood. As some states begin to adopt components of optimal team practice, PAs in other states continue to face significant legal and regulatory practice restrictions.

Why We Must Prevent and Appropriately Manage Delirium.

Delirium is common and increases in prevalence with age and medical complexity. A form of acute brain dysfunction, its presence is associated with significant morbidity, such as cognitive impairment, decreased mobility, depression, and institutionalization, as well as mortality. Many organizations have developed clinical protocols to prevent and treat delirium and what are called "cognitive-friendly" policies to care for elderly patients.

Does It Matter Whether a Psychiatric Intervention Is "Palliative"?

Palliative interventions are intended to alleviate suffering and improve quality, not quantity, of life and are not intended to cure illness. In psychiatry, uncertainty about which interventions count as palliative stems from the fact that psychiatry generally prioritizes symptom management irrespective of diagnosis or specific pathophysiology of illness. This commentary on a case considers how distinctions between palliative and other psychiatric interventions might not be all that helpful in resolving clinical and ethical questions about which interventions are-and when they are-appropriate.

Atopic Dermatitis: A Qualitative Study on the Burdens of Living with Itchiness.

Objective: We sought to understand the consequences itchiness has on daily life that may not be immediately obvious in clinical assessments for patients with atopic dermatitis (AD).

Methods: Focus groups and interviews involving 21 patients with AD and 12 family members examined aspects of the effects of itchiness on health-related quality of life (HRQL). Investigators conducted a thematic analysis where two researchers independently coded the narratives and arrived at a consensus on major themes.

Methods Reporting Quality and its Association with Methods Section Length: A Cross-sectional Assessment of STROBE and CONSORT Reporting Adherence in Top-cited Dermatology Journals.

Background: Adequate methods reporting in observational and trial literature is critical to interpretation and implementation.

Objective: Evaluate methodology reporting adherence in the dermatology literature and compare this to internal medicine (IM) literature.

Methods: We performed a cross-sectional review of randomly-selected dermatology and IM manuscripts published between 2014-2018.

Hospice Nurse Ethics and Institutional Policies Toward Medical Aid in Dying.

A significant number of hospices in U.S. jurisdictions where medical aid in dying is legal have implemented policies that require nurses to leave the room when a patient ingests aid-in-dying medication.

Rent-a-MEDEX: An early PA prototype.

In the 1970s, busy physicians knew little about the capabilities of a new member of the healthcare team-the physician associate/assistant (PA). Internal studies by the University of Utah and University of Washington educational programs demonstrated that the MEDEX/PA could increase access to care by providing quality, cost-effective care in rural primary care practices. Marketing this concept was essential, and in the early 1970s, the Utah program devised an innovative plan, partially funded through a grant from the federal Bureau of Health Resources Development, called Rent-a-MEDEX.

Science and Ethics of "Curing" Misinformation.

A growing chorus of academicians, public health officials, and other science communicators have warned of what they see as an ill-informed public making poor personal or electoral decisions. Misinformation is often seen as an urgent new problem, so some members of these communities have pushed for quick but untested solutions without carefully diagnosing ethical pitfalls of rushed interventions. This article argues that attempts to "cure" public opinion that are inconsistent with best available social science evidence not only leave the scientific community vulnerable to long-term reputational damage but also raise significant ethical questions.

An update on expanding HIV preexposure prophylaxis.

HIV continues to affect certain populations disproportionately, including sexual and gender minorities, racial/ethnic minorities, and populations with limited resources in southern US states. New CDC guidelines include a recommendation to discuss HIV preexposure prophylaxis (PrEP) with all sexually active patients, which is likely to expand use. The guidelines also include important changes in PrEP monitoring and address PrEP telehealth.

State of Science in Alarm System Safety: Implications for Researchers, Vendors, and Clinical Leaders.

Alarm fatigue is a complex phenomenon that needs to be assessed within the context of the clinical setting. Considering that complexity, the available information on how to address alarm fatigue and improve alarm system safety is relatively scarce. This article summarizes the state of science in alarm system safety based on the eight dimensions of a sociotechnical model for studying health information technology in complex adaptive healthcare systems.