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

Abstract: The increasing use of antidepressants, escalating rates of unintended pregnancy, and disproportionately high rate of maternal suicide in the United States, as compared with other high-income countries, all highlight the urgent need for more clarity on available treatment options for perinatal depression. Misrepresentative data obtained from animal experiments and observational human studies, many of which do not account for underlying mental illness as a confounder, largely overestimate the teratogenicity of antidepressants. These outdated data-coupled with a lack of clear guidance from leading agencies-have created a healthcare scenario rife with decisional conflict. As general practitioners frequently serve as patients' first point of contact within the US healthcare system, primary care is central to preconception and mental health management. This article educates primary care providers on the risks of untreated perinatal depression and the realities of antidepressant teratogenicity. Doubling as a narrative review, the article also synthesizes available evidence to provide a risk-based guide for treatment with antidepressants that emphasizes a shared decision-making approach.

Abstract: Malaysia's healthcare system features a dual-tier structure with government and private sectors rooted in its colonial history. Assistant medical officers (AMOs) play a crucial role within this system, constituting the third largest group of healthcare professionals. The profession has evolved over 230 years, originating with the introduction of medical assistants to Malaysia by the British East India Company in 1786. Initially known as apothecaries or dressers, the role's responsibilities have transformed over the years in response to the nation's healthcare demands, as have its associated titles, with professionals becoming known as hospital assistants, medical assistants, and, finally, AMOs. Engaged in clinical duties in emergency and prehospital care, primary healthcare, medical and surgical care, management, and administrative functions, AMOs are linchpins in ensuring comprehensive healthcare services. Their training has progressed from apprenticeships to certificate, diploma, and bachelor's degree programs, ensuring they are well-equipped for diverse healthcare challenges. The profession will continue to evolve through further educational development, strengthening organizational structures, AMO role reinforcement, career advancement, human resource development, and international collaboration. AMOs have emerged as indispensable contributors to Malaysia's healthcare landscape, embodying adaptability and dedication in the pursuit of enhanced health outcomes.

Abstract: Popliteal artery entrapment syndrome (PAES) is a form of vascular compromise that is characterized by compression of the popliteal artery by the muscular structures of the popliteal fossa. The underlying etiology of this condition stems from both congenital and functional mechanisms. This case report describes a patient with an insidious onset of bilateral leg pain, who was initially diagnosed with chronic exertional compartment syndrome and later found to have PAES.

Abstract: Hospital-acquired pressure injuries (HAPIs) constitute a major concern for acute care facilities. These injuries can negatively impact a patient's health and create significant financial burdens for hospitals. Early detection of pressure injuries and implementation of prevention strategies are crucial to avoiding complications, extended hospital stays, and poor outcomes for the patient as well as added costs for the facility. This article explores the pathophysiology, risk factors, staging guidelines, prevention methods, financial implications, and impact of HAPIs in patients who are hospitalized, emphasizing the importance of early detection and preventive strategies.

Abstract: The healthcare industry is in the midst of unprecedented change as hospitals and health systems nationwide balance the need to increase patient access to services with managing costs. Nurse practitioners and physician associates are well-positioned, and often overlooked, members of the healthcare team who can serve as resources for organizations to improve care access. Using an intentional and data-driven process, one academic medical center both improved patient access and increased revenue through a holistic care model redesign in three specialty areas, as described in this organizational case report.