Although it is known that the social determinants of health have a larger influence on health outcomes than health care, there currently is no structured way for primary care providers to identify and address nonmedical social needs experienced by patients seen in a clinic setting. We developed and piloted WellRx, an 11-question instrument used to screen 3048 patients for social determinants in 3 family medicine clinics over a 90-day period. Results showed that 46% of patients screened positive for at least 1 area of social need, and 63% of those had multiple needs. Most of these needs were previously unknown to the clinicians. Medical assistants and community health workers then offered to connect patients with appropriate services and resources to address the identified needs. The WellRx pilot demonstrated that it is feasible for a clinic to implement such an assessment system, that the assessment can reveal important information, and that having information about patients' social needs improves provider ease of practice. Demonstrated feasibility and favorable outcomes led to institutionalization of the WellRx process at a university teaching hospital and influenced the state department of health to require managed care organizations to have community health workers available to care for Medicaid patients.

Effects of short versus long bouts of aerobic exercise in sedentary women with fibromyalgia: A randomized controlled trial. Physical Therapy, 83, 340 -358. Senay, I., Albarracín, D., & Noguchi, K. (2010). Motivating goal-directed behavior through introspective self-talk: The role of the interrogative form of simple future tense.

Purpose Training of health professionals requires development of interprofessional competencies and assessment of these competencies. No validated tools exist to assess all four competency domains described in the 2011 Core Competencies for Interprofessional Collaborative Practice (the IPEC Report). The purpose of this study was to develop and validate a scale based on the IPEC competency domains that assesses interprofessional attitudes of students in the health professions. Method In 2012, a survey tool was developed and administered to 1,549 students from the University of Utah Health Science Center, an academic health center composed of four schools and colleges (Health, Medicine, Nursing, and Pharmacy). Exploratory and confirmatory factor analyses (EFA and CFA) were performed to validate the assessment tool, eliminate redundant questions, and to identify subscales. Results The EFA and CFA focused on aligning subscales with IPEC core competencies, and demonstrating good construct validity and internal consistency reliability. A response rate of 45% (n = 701) was obtained. Responses with complete data (n=678) were randomly split into two datasets which were independently analyzed using EFA and CFA. The EFA produced a 27-item scale, with five subscales (Cronbach’s alpha coefficients: 0.62 to 0.92). CFA indicated the content of the five subscales was consistent with the EFA model. Conclusions The Interprofessional Attitudes Scale (IPAS) is a novel tool that, compared to previous tools, better reflects current trends in interprofessional competencies. The IPAS should be useful to health sciences educational institutions and others training people to work collaboratively in interprofessional teams.

During April-August 2020, a preemptive testing strategy combined with accessible isolation and symptom screening among people experiencing homelessness in congregant living settings in San Diego contributed to a low incidence proportion of COVID-19: 0.9%. Proactively addressing challenges specific to a vulnerable population may significantly prevent spread and community outbreaks.

Please cite this paper as: Kennedy et al. for the 2009 Pandemic H1N1 Influenza‐Associated Lower Respiratory Tract Hemorrhage Working Group. (2012) Lower respiratory tract hemorrhage associated with 2009 pandemic influenza A (H1N1) virus infection. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12022. Background  Influenza‐associated lower respiratory tract hemorrhage (LRTH) has been reported in previous pandemics and is a rare complication of seasonal influenza virus infection. We describe patients with LRTH associated with 2009 pandemic influenza A (H1N1) (pH1N1) virus infection identified from April 2009 to April 2010 in the United States. Methods  We ascertained patients with pH1N1‐associated LRTH through state and local surveillance, the Emerging Infections Program, and CDCs Infectious Diseases Pathology Branch. All patients had influenza A, evidence of pneumonia, and evidence of LRTH. Results  We identified 44 cases; the median number of days from illness onset to clinical signs of LRTH was one. Hemoptysis or respiratory tract bleeding was documented in 40% of pH1N1‐associated LRTH cases, often present early during the course of illness. Twenty‐one (48%) patients with LRTH had no other hemorrhagic diatheses. Seven (23%) patients with LRTH received antiviral treatment within two days of illness onset. Conclusions  During influenza season, clinicians should consider influenza infection in the differential diagnosis for patients presenting with hemoptysis or other signs or symptoms of LRTH. While the impact of timing of antiviral therapy on this complication has not been studied, the rapid progression of LRTH may support use of early empiric therapy. Continued investigation is necessary to betterdefine the clinical spectrum of both seasonal influenza‐ and pH1N1‐associated LRTH.

Among patients from a socioeconomically disadvantaged background living in a Hispanic-majority area, being Hispanic is associated with higher odds of 30-day hospital re-admission after adjusting for demographic, clinical and socioeconomic covariates. Our findings show that further research is needed to understand disparities in Hispanic's heart failure-related outcomes.

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