Efficacy of intrauterine device procedural analgesics.

Nearly half of all pregnancies worldwide are unintended. Intrauterine devices are an effective, long-acting form of pregnancy prevention that require minimal maintenance, and also can be used in patients with menorrhagia. However, they are underused because of pain associated with their insertion.

On Health and Loneliness.

This essay connects loneliness with health problems and argues that both are comorbid with authoritarian politics. Although an old idea from Plato and Aristotle, this problem takes an acute shape in the contemporary world, as argued by Hegel, Hannah Arendt, and Kate Manne, and has a gendered dimension, as men are lonelier than women. This article also attends, briefly, to empirical material about loneliness in the contemporary world.

Solidarity in Mortal Time.

The concept of mortal time is useful in exploring what the hospice care framework might offer nonhospice clinicians. While hospice patients seem distinct from those in other settings, life-threatening serious illness brings with it profound vulnerability that permeates the atmosphere of caregiving. Hospice clinicians lean into this vulnerability, seeking to make meaning for patients and families in the critical present.

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.

Imprints of "Scanxiety".

The days leading up to and waiting for the results of magnetic resonance imaging (MRI) sessions are anxiety inducing, and this anxiety has earned the moniker . MRI images of the author's son's brain are used to track the progression and formation of tumors related to his neurofibromatosis (NF), a genetic disorder that occurs in 1 in 3000 births. NF can cause tumors to grow anywhere in or on the body.

Identifying pediatric malnutrition using STRONGkids: A quality improvement initiative.

Pediatric malnutrition can impact a patient's length of hospital stay, rates of infection and complications, cognitive development, and overall quality of life. This article compares nutritional screening tools to determine their efficiency and reliability in identifying patients with increased malnutrition risk at the time of hospital admission.

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.

Bringing Dying Out of the Hospital's Closet.

Why is the transition from "living" to "dying" not socially marked in the same way that death is marked? This question is addressed using classical anthropological theory, which highlights the significance of liminality, the transitional period during a rite of passage. Seriously ill and dying patients are subject to social vulnerabilities as they approach the end of life. Clinicians' awareness of these factors may improve their patients' care.

Neurofibromatosis and a Portrait of 1 in 3000.

Neurofibromatosis, a genetic disorder that occurs in 1 in 3000 births, can cause tumors to grow anywhere on or in the body. The first author (RM), an artist-researcher and mother of a son living with neurofibromatosis, has painted and exhibited more than 200 portraits of people living with neurofibromatosis to raise awareness of and resources for this little-known disorder. Among many stories shared through RM's works is the story of Ashok, a Nepali man who has undergone 3 surgeries to remove facially disfiguring tumors that developed as a result of neurofibromatosis.

Five Things Students and Clinicians Should Know About "Biocontainment".

was one way that Western, affluent, allopathic cultures tended to respond and make meaning during the 2013-2015 Ebola virus disease (EVD) pandemic. It became a pathway to restore trust in biomedicine itself, which had been shaken by unease across the globe when the EVD threat was at its height. Yet biocontaining barely qualifies as a public health measure.

Does a Patient's Trauma History Ethically Justify a Discriminatory Clinical Referral?

This article analyzes a child psychiatrist's referral approach when the patient's care must be transferred to an adult psychiatrist and the otherwise best adult psychiatrist has "accented" language, which is associated with the patient's prior trauma. The analysis considers the value of simplicity and a related "simplicity strategy," revealing that many ethical factors lay behind the simplicity approach. The inquiry then addresses simplicity regarding practical wisdom and context.

Inadequate Clinical Indications in Computed Tomography Chest and Abdomen/Pelvis Scans.

Context: As the use of computed tomography (CT) scans, which are expensive and result in considerable radiation exposure to the patient, continues to increase, communication between physicians and radiologists remains vital to explain the clinical context for the examination. However, the clinical information provided to the radiologist is often lacking.

Objective: To determine whether the clinical information provided in CT scan requests meets minimum criteria for requesting the examination.

Clinical Momentum as One Reason Dying Patients Are Underserved in Acute Care Settings.

"Clinical momentum" refers to the curious expansion of interventions applied to patients in the intensive care unit (ICU) without pause or design, leading to extensions of care that can violate patient wishes and distress clinicians. In this article, clinical momentum is placed in a wider context that includes ritual, reimbursement patterns, and actor network theory. These contextual features help motivate understanding of one way in which dying patients are underserved in intensive care settings.

Cultivating Humility and Diagnostic Openness in Clinical Judgment.

In this case, a physician rejects a patient's concerns that tainted water is harming the patient and her community. Stereotypes and biases regarding socioeconomic class and race/ethnicity, constraining diagnostic frameworks, and fixed first impressions could skew the physician's judgment. This paper narratively illustrates how cultivating humility could help the physician truly hear the patient's suggestions.

Strategies for Building Trust with the Caregiver of a Patient with End-Stage Dementia.

This case describes a patient with advanced dementia and an unrealistic spouse, presenting an apparent dilemma about nutrition for physicians. By eliciting the perspective of the caregiver, the physicians can gain insight and rebuild trust that protects the interests of both the patient and the spouse. Their goal needs to shift from resolving the professional ethical dilemma to affirming the immeasurable contribution of the caregiver, acknowledging her journey, asking for her advice, and enabling the work of making meaning in the time available.

Assessment of Clinical Alarms Influencing Nurses' Perceptions of Alarm Fatigue.

Background: Excessive clinical alarms have inundated health care for years. Multiple governing bodies, organizations, and facilities have deemed alarm management a priority. Alarm management is a multifaceted problem that affects all health care organizations and clinical staff, especially those in critical care units.

Colorectal Carcinoma and Emerging Targeted Therapies.

Targeted therapies for specific mutations in colorectal cancer have led to an increase in patient overall survival.