Managing neonatal hyperbilirubinemia: An updated guideline.

More than 80% of newborn infants experience jaundice as a result of elevated bilirubin during the first few weeks after birth. In most cases, hyperbilirubinemia is physiologic, but persistent and extreme elevations can lead to serious long-term complications, such as kernicterus. To avoid these complications and help clinicians in the successful assessment, evaluation, and treatment of hyperbilirubinemia, the American Academy of Pediatrics updated its clinical practice guideline for neonatal hyperbilirubinemia.

The role of primary care in improving health outcomes in young foster children.

Children removed from their biological families because of abuse, neglect, and/or violence have increased healthcare needs and are susceptible to poor health outcomes compared with children who are not in the child welfare system. Developmental delays occur in about 75% of children in foster care. Up to 80% of children entering out-of-home care have at least one physical health problem and more than 40% experience educational challenges.

Improving access to care for underserved communities through telemedicine.

Telemedicine use expanded rapidly during the COVID-19 pandemic, giving patients access to quality care while reducing the spread of infection. Although beneficial changes were made to reimbursement and privacy guidelines to increase the ease of telemedicine for clinicians, the lack of digital devices, Internet, digital knowledge, and trust in this method of delivery are potential barriers to telemedicine for healthcare visits, and may have widened the care gap for underserved patients. To ensure that patients of all socioeconomic levels have access to telemedicine requires education, expanding broadband Internet access across the United States, and offering free or reduced Internet services to patients in need.

A practical guide to managing genitourinary syndrome of menopause in primary care.

Females spend a third to half of their life in menopause, and the number of US females in menopause is growing. A high percentage of postmenopausal females experience bothersome, sometimes debilitating genitourinary symptoms, which can affect quality of life. The genitourinary syndrome of menopause (GSM) describes the condition previously referred to as vulvovaginal atrophy, atrophic vaginitis, or urogenital atrophy.

Foundational Skill-Building in a Novel Well-being Curriculum.

Introduction: Mental illness and decreased well-being are pervasive throughout physician assistant (PA) training, and the accreditation standards require a wellness curriculum. The purpose of this study was to determine if a mandatory, multifaceted virtual wellness curriculum can mitigate the decline in well-being experienced by first-year PA students.

Methods: First-year PA students from 5 programs (n = 259) participated in a 16-week asynchronous virtual course.

Developing a Genital Training Associate Program.

Genitourinary training associates (GTAs) are individuals educated to teach medical learners invasive exams and procedures using their own body. Through specified protocols, the GTA teaches exam techniques to students in a supportive environment while giving feedback to the learner to optimize skill acquisition. Additionally, this experience can teach best practices for future provider-patient communication.

Meeting the Accreditation Standard for Diversity.

While increasing diversity has been an ongoing concern in physician assistant (PA) education, there is now a concentrated focus on diversity, equity, inclusion, and social justice, elevating these to top priorities. To achieve the goal of diversifying the PA workforce, PA programs, with their institution's support, must systematically inculcate strategies for overcoming and dismantling barriers against students of color and students underrepresented in medicine (URiM). These strategies should disrupt the status quo and expand structural processes that ensure successful diversification of students, especially URiM students, LGBTQ students, students from medically underserved areas, and first-generation college students.

An Examination of Predictors of Attrition in Physician Assistant Programs.

Introduction: The purpose of this study was to explore the relationship between program characteristics and attrition rates.

Methods: Program graduation rates, attrition rates, and Physician Assistant National Certifying Examination (PANCE) pass rates were extracted from program websites from February-March 2021 and summarized for 2018, 2019, and 2020. Means were compared across categories of independent variables.

Course Prerequisites: Here, There, and Everywhere. Time to Standardize?

Introduction: This study's aim was to examine prerequisite course requirements and compare them to previous studies with a secondary aim to examine potential differences relative to program characteristics.

Methods: Data were extracted from the websites of 265 entry-level physician assistant (PA) programs from October 2020 until December 2020. Course prerequisites as well as number of courses and semester hours required were described and examined according to program location, phase, Carnegie Classification, association with a medical school, and the public/private status of the sponsoring institution.

Pipeline to the Physician Assistant Profession: A Look to the Future.

The current pipeline of physician assistant (PA) school applicants reflects the future workforce of the profession, which is why the admissions process with all its components and variables is so important. Many studies have shown that a workforce that represents the patients it cares for leads to improved health outcomes, especially among underrepresented minority populations. Yet, PA programs have made little progress over the past 2 decades in increasing the diversity of matriculants and graduates.

Attitudes Towards Mental Health Among Physician Assistant Students with Shared Living Experiences Through Synchronous Videoconferencing.

Purpose: We tested the hypothesis that physician assistant (PA) students can benefit from exposure to senior PAs who share their living experiences with mental illness.

Methods: First-year students from 5 PA programs were asked to participate in this mixed methods study. After completing a pre-activity survey, students from 3 programs participated in an intervention consisting of senior PA faculty sharing their mental health experiences, including treatment and recovery.

PA licensure questions, the Americans with Disabilities Act, and seeking medical care.

Objective: This study built on a recent publication to explore physician assistant (PA) licensure renewal applications, as well as PA likelihood to seek help for physical or mental health conditions.

Methods: We were able to obtain licensure renewal applications from 47 states. A national survey was then conducted to explore the connection between licensure questions and help-seeking behavior.

Physician Assistant Education Community Assumptions About an Entry-level Doctoral Degree.

Purpose: This study described the assumptions that PA educators hold regarding the option and/or transition to a doctoral entry-level degree for PA graduates.

Methods: A cross-sectional electronic survey of all members of accredited PA programs was administered. The survey comprised 32 Likert-type statements that measured respondents' level of agreement ranging from strongly disagree to strongly agree and general demographic information.

Do PA licensure questions violate the Americans with Disabilities Act?

Objective: Negative stigma related to mental health diagnoses is common in both clinicians and the public. Questions about physical and mental conditions on licensure applications often are overly broad and may violate the Americans with Disabilities Act (ADA). This study investigated state physician assistant (PA) licensing applications relating to physical and mental health, and their consistency with the ADA.

Accreditation 101: Develop, Assess, and Report Program Goals.

The aim of this article is to highlight the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) accreditation requirements for PA program goals, describe methods for writing effective goals, provide examples and analysis of hypothetical goals, and encourage the use of effective reporting strategies. Programs are encouraged to use one of 3 mnemonic conventions with each providing a useful framework for identifying key elements of goals: FAST, SMART, and Objectives and Key Results. These 3 acronyms are easy to remember and will yield goals that are consistent with the requirements of ARC-PA.

Recognizing and responding to sex-trafficked minors in the healthcare setting.

Nearly 6,100 reports of sex trafficking were made to the United States Human Trafficking Hotline in 2017; 29% of those reports involved minors. Physician assistants (PAs), especially those working in emergency medicine and primary care, are among the few frequently accessed healthcare providers who have the opportunity for a private conversation with a sex trafficking victim or survivor. PAs must be able to recognize the risk factors and signs of trafficking and respond in a trauma-informed, survivor-centered manner.

Infectious disease considerations in immunocompromised patients.

Immunocompromised patients account for about 3% of the US population. Complications arising from infection are common in these patients and can present diagnostic and therapeutic challenges. This article describes the pathophysiology of immunosuppression in five common immunocompromised states-asplenia, HIV infection, solid organ transplant, biologic use, and cancer-as well as specific infectious risks and considerations for affected patients and how to manage them.

Advances in chronic traumatic encephalopathy.

Over the past decade, concern for negative outcomes associated with concussive brain trauma has grown immensely. These neuropathologic changes, termed chronic traumatic encephalopathy (CTE), have been linked to patients who exhibit neuropsychiatric symptoms and have experienced repetitive brain trauma. Recent publicity has brought about renewed interest in this progressive neurodegenerative disorder.

Deprescribing at the end of life in older patients.

In the United States, the adult population that will need hospice and palliative care is expected to double in the next 40 years. In primary care, providers are often faced with tough decisions on how to manage patients' medications at the end of life. This article describes how to deprescribe in the last year of life.