Primary care physicians, especially in family medicine, are more prone to use osteopathic manipulative treatment (OMT) than other specialists; however, barriers to OMT use exist. The purpose of this study is to evaluate if the frequency of OMT use in a family medicine outpatient setting is influenced by having posters promoting OMT in exam rooms and waiting rooms.
Methods: OMT posters were placed in two of four offices in an academic family medicine practice. Offices without posters served as the control group. Billing patterns were examined for the five months prior to and after poster placement. Report parameters included: age, gender, ethnicity, CPT code for OMT and somatic dysfunction ICD-10 codes.
Results: Data before and after poster placement were compared. Results showed a positive correlation between posters advertising OMT and OMT use. There was a 6.5% increase in OMT use in the offices that had posters advertising OMT.
Conclusion: This research showed that placing OMT posters in select family medicine offices resulted in an increase in OMT use. Possibilities for this increase include patients becoming more aware of the benefits of OMT and/or simply reminding osteopathic physicians of the benefits of OMT. Increased OMT utilization could lead to a decrease in pain medication prescribing and an increase in functionality through conservative measures.
Objective: There is much ambiguity regarding Eating Disorder (ED) diagnosis, including when a patient actually develops the disease. Many studies have focused on behaviors during late adolescence as a crucial time for ED development, but few have focused on menarche. This study seeks to identify possible behavioral traits during menarche, including emotion toward the first period, which can be used as a warning sign for future ED development. Method: An anonymous online survey was distributed to approximately 1000 female students and faculty at Rowan University School of Osteopathic Medicine and 100 females on an ED Recovery Facebook group. The survey was created and responses were recorded using Rowan Qualtrics system in order to protect patient responses and ensure anonymity. Data was analyzed using SPSS. Results: There were many significant differences found in this study; feelings of fear (p = 0.009), sadness (p = 0.021) and disgust (p = 0.026) toward menarche were significantly higher in those who have been diagnosed with an ED. Additionally, ED patients felt significantly less prepared (p = 0.015) for the body changes that occurred during puberty. Those with an ED also experienced significantly increased focus on weight both prior to and during menarche, and reported an increased incidence of self-criticizing their weight to others (p < 0.001). Conclusion: The results of this study give insight into behavioral attributes, fear, sadness and disgust, toward a concrete event (menarche) which parents, pediatricians and even school teachers can use to detect early signs of ED behaviors. This provides insight into the development of future diagnostic criteria that caretakers can use to establish early intervention with young, at-risk females to prevent a future ED.
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BSTRACT
Kearns–Sayre syndrome (KSS) is a mitochondrial encephalopathic disorder. Because mitochondria are ubiquitous organelles that are present in almost every human tissue, their dysfunction can affect nearly any organ system and give rise to a wide range of clinical characteristics. 1: As is the case with most diseases associated with mitochondrial DNA (mtDNA) mutations, the clinical features of KSS were defined before modern molecular genetic classifications emerged. 2: The exact prevalence of KSS is unknown; however, estimates place it at about 1:100,000 people. Although it is a rather rare syndrome, the ability to recognize or consider KSS as part of a differential diagnosis is crucial. Reported here are two case reports: 1) a 30-year-old Caucasian female patient who presented for evaluation to her primary care physician’s office and, and 2) A 57-year-old Caucasian female patient long-term C care resident. Guidelines are listed for management as a primary care physician as well as signs and symptoms that are often associated with Kearns–Sayre syndrome and other mitochondrial disorders.
Context: This study was conducted to gain a better understanding of patients’ understanding of homebound criteria and house call eligibility. Objective: To date, little empirical data exists assessing patient knowledge of home health care services. This study is designed to examine patients’ understanding of home health care services, eligibility criteria, costs, and interest in house calls. Methods: This study used an anonymous survey developed by the researchers and provided to patients in four separate office locations at a large academic Family Medicine practice. Questions about homebound criteria, eligibility, out of pocket cost, and patient interest were asked. Results: In total 393 surveys were collected. Approximately 47 percent of all respondents in the survey showed interest in having a home care visit by a healthcare professional, while only 59.6 percent were able to accurately identify the definition of homebound status. Approximately 60 percent of all respondents believe that they will have to pay more out of pocket for home visits, and the subgroup of respondents who have an interest in home visits showed that 63.4 percent of that group think that they will have to pay more out of pocket for such visits. Conclusion: These data have the potential to inform medical providers of a lack of understanding among patients regarding homebound criteria and home health care in general. While further studies could examine more specific details of this potential knowledge gap, the information provided by this study could prompt providers to begin educating patients on the possibility of home care.
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