Journal of general internal medicine
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Case conferences, specifically those in which an unknown case is presented and discussed, are widely utilized in the delivery of medical education. However, the format of case conferences is not always optimized to engage and challenge audience members' clinical reasoning (CR). Based on the current conception of CR and our experience, we provide recommendations on how to better engineer case conferences to maximize CR education for learners at all levels through case selection, conference format, and intentional case construction.
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Most patients with mild or moderate COVID infection did not require hospital admission, but depending on their personal history, they needed medical supervision. In monitoring these patients in primary care, the design of specific surveillance programs was of great help. Between February 2021 and March 2022, EDCO program was designed in Tenerife, Spain, to telemonitor patients with COVID infection who had at least one vulnerability factor to reduce hospital admissions and mortality. ⋯ Vulnerable patients followed by a primary care programme had admission rates of 7.2% and mortality rates of 0.7%. Supervision of vulnerable patients by a Primary Care team was effective in the follow-up of these patients with complete resolution of symptoms in 91.7% of the cases.
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Champions of AI-facilitated clinical documentation have suggested that the emergent technology may decrease the administrative loads of physicians, thereby reducing cognitive burden and forestalling burnout. Explorations of physicians' experiences with automated documentation are critical in evaluating these claims. ⋯ According to physician interviewees, automated AI-driven clinical documentation has the potential to significantly reduce the administrative burden associated with particular types of provider-patient encounters. Addressing the growing pains of the incipient technology, identified here, may allow for a broader applicability for clinical practice.
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Although a well-established component of bone metabolism, the efficacy and safety of vitamin D supplementation for the prevention of fractures in elderly healthy individuals is still unclear. ⋯ Vitamin D supplementation does not reduce the total fracture development rate in the elderly healthy population, and it may increase the incidence of hip fractures among elderly healthy women. This finding suggests refraining from prescribing high intermittent doses of vitamin D, without calcium, to individuals aged 60 or older with unknown vitamin D serum concentration or osteoporosis status and inadequate calcium intake.
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In 2023, approximately 650,000 people experienced homelessness (PEH) nightly in the United States, the highest number recorded in the country's history. This alarming statistic has made homelessness a key issue in the 2024 elections, especially with the White House's goal to reduce homelessness by 25% by 2025. Despite efforts and investments, homelessness remains a persistent public health challenge. ⋯ However, challenges remain in establishing adequate fee schedules and integrating care management. Despite these obstacles, the integration of healthcare and housing services is crucial for addressing homelessness effectively, promoting stability, and improving health outcomes for PEH. This manuscript explores the history, practical guidance, and potential impacts of these developments on homelessness and public health.