Jaapa-Journal of the American Academy of Physician Assistants最新文献

Abstract: Pelvic floor disorders are a wide-ranging group of conditions arising due to abnormalities of the musculature of the pelvic floor. These conditions can include constipation, pelvic pain, urinary incontinence, and dyspareunia. This article first provides an overview of key anatomy of the pelvic floor muscles before discussing pelvic floor physical therapy (PFPT), highlighting the goals of treatment and tactics used by physical therapists to achieve these goals. The article then explores the definition, diagnosis, and treatment of constipation, pelvic pain, and urinary incontinence caused by pelvic floor dysfunction. It is meant to help reduce the gap in this underdiagnosed and undertreated condition and identify key patient populations that may significantly benefit, including through improvements to quality of life, from PFPT.

Objective: This study aimed to measure the impact of adverse events (AEs) on advanced practice provider (APP) well-being and to describe symptoms of second victim syndrome (SVS) among this group of healthcare professionals.

Methods: A survey was designed to measure the incidence of AEs among APPs employed at a large healthcare system and AE impact on emotional, physical, and professional well-being. It also measured burnout, callousness, and the desire for peer support among APPs who had experienced AEs and those who had not.

Results: Of the 350 APPs who completed the survey, 55.4% had experienced an AE. APPs exposed to an AE had a higher rate of burnout ( p = .027) than those who had not. Following an AE, 97% of APPs experienced one or more symptoms of SVS; additionally, 87% sought peer support after an AE, with 96% finding it helpful.

Conclusion: Findings demonstrate that AEs have a negative emotional impact on APP well-being and are associated with burnout and callousness. Peer support is desired by APPs after AEs and may enhance recovery.

Abstract: Resistant hypertension (RH) is defined as blood pressure (BP) that remains above goal despite treatment with three first-line pharmacologic classes or BP that requires four or more medications to obtain control. After ruling out secondary causes and implementing nonpharmacologic treatments, clinicians may encounter the question of which pharmacologic treatment options should be used next. This article discusses evidence-based second-line medication options for RH.

Abstract: Physician associates (PAs) and nurse practitioners (NPs) are vital members of the healthcare team. Increasing opportunities for leadership roles have emerged for PAs and NPs in the past decade. PAs and NPs often utilize other health professions' frameworks for leadership, but no framework exists for PAs and NPs specifically. This article examines existing leadership structures and proposes a leadership framework specifically for PAs and NPs through the health systems science lens.

Abstract: Global health emergencies such as the COVID-19 pandemic have revealed the fragility of medical infrastructure in the US and elsewhere. Specifically, the pandemic insidiously targeted the relationship between public health and medicine by affecting the screening for and prevention of communicable diseases, such as HIV. This case report focuses on a patient with a problematic and late HIV diagnosis amid the pandemic and discusses HIV history, pathogenesis, epidemiology, and current screening guidelines. Although the negative implications of the pandemic are yet to be fully unraveled, health professionals can combat its ill effects on disease screening and prevention by proactively educating their patients on best health practices, including safe sex and sexually transmitted infection (STI) screening, as well as on when to seek care.

Abstract: Dental pain, infections, and abscesses are common concerns in primary care settings. Prompt diagnosis and targeted management are essential to prevent severe complications such as sepsis, bone or soft tissue loss, and airway compromise. This article provides physician associates and other clinicians with practical, evidence-based strategies to identify and manage odontogenic infections, distinguish between infectious and noninfectious dental pain, and select appropriate antibiotic regimens, with special attention to antibiotic resistance trends. It also highlights circumstances under which collaboration with dental specialists becomes necessary and emphasizes patient education to prevent recurrence. By bridging knowledge gaps in dental health management, this article empowers clinicians to address these conditions confidently in outpatient settings, improving patient outcomes, reducing unnecessary ED visits, and lowering healthcare costs.