Category Archives: Internal Medicine

Should neonatal-perinatal medicine move to two-year fellowships? | Journal of Perinatology – Nature.com

Keller DM, Davis MM, Freed GL. Access to pediatric subspecialty care for children and youth: possible shortages and potential solutions. Pediatr Res. 2020;87:11512.

Article PubMed Google Scholar

Bethell CD, Read D, Blumberg SJ, Newacheck PW. What is the prevalence of children with special health care needs? Toward an understanding of variations in findings and methods across three national surveys. Matern Child Health J. 2008;12:114.

Article PubMed Google Scholar

Stoll BJ, Hansen NI, Bell EF, Walsh MC, Carlo WA, Shankaran S, et al. Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012. Jama. 2015;314:103951.

Article CAS PubMed PubMed Central Google Scholar

National Academies of Science, Engineering, and Medicine. The Future of Pediatric Subspecialty Physician Workforce: Meeting the Needs of Infants, Children and Adolescents. Consensus Study Report 2023. https://nap.nationalacademies.org/read/27207/chapter/1.

Shah S, Cheng TL. Optimizing the childrens hospitals graduate medical education payment program at a time of pediatric workforce challenges and health need. J pediatrics. 2022;245:46.e2.

Article Google Scholar

Rimsza ME, Ruch-Ross HS, Clemens CJ, Moskowitz WB, Mulvey HJ. Workforce trends and analysis of selected pediatric subspecialties in the United States. Acad Pediatr. 2018;18:80512.

Article PubMed Google Scholar

Catenaccio E, Rochlin JM, Simon HK. Differences in lifetime earning potential for pediatric subspecialists. Pediatrics 2021;147:e2020027771.

Article PubMed Google Scholar

Rochlin JM, Simon HK. Does fellowship pay: what is the long-term financial impact of subspecialty training in pediatrics? Pediatrics 2011;127:25460.

Article PubMed Google Scholar

Catenaccio E, Rochlin JM, Simon HK. Association of lifetime earning potential and workforce distribution among pediatric subspecialists. JAMA Pediatr. 2021;175:10539.

Article PubMed Google Scholar

Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Pediatric Hospital Medicine 2022. https://www.acgme.org/globalassets/pfassets/programrequirements/334_pediatrichospitalmedicine_2022v2.pdf.

Cleveland WW, Brownlee RC. Future training of pediatricians: summary report of a series of conferences sponsored by the American Board of Pediatrics. Pediatrics. 1987;80:4517.

Article CAS PubMed Google Scholar

Freed GL, Dunham KM, Switalski KE, Jones MD Jr, McGuinness GA. Pediatric fellows: perspectives on training and future scope of practice. Pediatrics. 2009;123:S317.

Article PubMed Google Scholar

Health Resources and Services Administration. Physician Workforce: Projections, 2020-2035; 2022. https://bhw.hrsa.gov/sites/default/files/bureau-healthworkforce/Physicians-Projections-Factsheet.pdf.

Keels EL, Goldsmith JP. Neonatal provider workforce. Pediatrics 2019;144:e20193147.

Article PubMed Google Scholar

American Board of Internal Medicine. Critical Care Medicine Policies 2023. https://www.abim.org/certification/policies/internal-medicine-subspecialty-policies/criticalcaremedicine/#:~:text=Candidates%20certified%20in%20internal%20medicine,the%20critical%20care%20medicine%20examination.

Cordero L, Hart BJ, Hardin R, Mahan JD, Giannone PJ, Nankervis CA. Pediatrics residents preparedness for neonatal resuscitation assessed using high-fidelity simulation. J graduate Med Educ. 2013;5:399404.

Article Google Scholar

Freed GL, Dunham KM, Loveland-Cherry C, Martyn KK, Moote MJ. Private practice rates among pediatric subspecialists. Pediatrics 2011;128:6736.

Article PubMed Google Scholar

Pineda R, Kati K, Breault CC, Rogers EE, Mack WJ, Fernandez-Fernandez A. NICUs in the US: levels of acuity, number of beds, and relationships to population factors. J Perinatol : Off J Calif Perinat Assoc. 2023;43:796805.

Article Google Scholar

The American Board of Pediatrics. Pediatric Subspecialists Ever Certified 2023. https://www.abp.org/dashboards/pediatric-subspecialists-ever-certified.

Gamber RA, Blonsky H, McDowell M, Lakshminrusimha S Declining birth rates, increasing maternal age and neonatal intensive care unit admissions. Journal of perinatology :official journal of the California Perinatal Association. (2023).

Orr CJ, Turner AL, Ritter VS, Gutierrez-Wu JC, Leslie LK. Educational debt and subspecialty fellowship type. Pediatrics 2023;152:e2023062318.

Article PubMed Google Scholar

National Resident Matching Program. Fellowship Match Data and Reports 2023. https://www.nrmp.org/match-data-analytics/fellowship-data-reports/.

Backes CH, Bonachea EM, Rivera BK, Reynolds MM, Kovalchin CE, Reber KM, et al. Preparedness of pediatric residents for fellowship: a survey of US neonatal-perinatal fellowship program directors. J Perinatol: Off J Calif Perinat Assoc. 2016;36:11327.

Article CAS Google Scholar

Dyess NF, Keels E, Myers P, French H, Reber K, LaTuga MS, et al. Optimizing clinical care and training in the neonatal intensive care unit: the relationship between front line providers and physician trainees. J Perinatol: Off J Calif Perinat Assoc. 2023;43:15139.

Article Google Scholar

Myers P, Gupta AG. Impact of the revised NRP meconium aspiration guidelines on term infant outcomes. Hosp Pediatr. 2020;10:2959.

Article PubMed Google Scholar

Marx AA, Horton C, Amon RL, Joseph K, Carlson N, Decreasing J. neonatl intubation rates: trends at a community hospital. J Neonatal Nurs. 2016;22:2315.

Article Google Scholar

NYU Grossman School of Medicine Accelerated Three-Year MD 2023. https://med.nyu.edu/education/md-degree/accelerated-three-year-md.

Campoamor D Idaho closes its maternity ward, citing the states political climate2023 Date Accessed: 12/12/23. https://www.today.com/parents/pregnancy/idahosbonner-general-hospital-closes-maternity-ward-rcna75776.

Machut KZ, Kushnir A, Oji-Mmuo CN, Kataria-Hale J, Lingappan K, Kwon S, et al. Effect of Coronavirus Disease-2019 on the workload of neonatologists.J Pediatr.2022;242:14551.e1.

Article CAS PubMed Google Scholar

Schell GJ, Lavieri MS, Jankovic F, Li X, Toriello A, Martyn KK, et al. Strategic modeling of the neonatal nurse practitioner workforce. Nurs Outlook. 2016;64:38594.

Article PubMed Google Scholar

Lakshminrusimha S, Olsen SL, Lubarsky DA. Behavioral economics in neonatology balancing provider wellness and departmental finances. J Perinatol: Off J Calif Perinat Assoc. 2022;42:6838.

Article Google Scholar

Mercurio MR. Neonatologys race to the bottom: RVUs, cFTEs, and physician time. J Perinatol: Off J Calif Perinat Assoc. 2021;41:25613.

Article Google Scholar

Omahen DA. The 10,000-hour rule and residency training. CMAJ. 2009;180:1272. 38.5 -7.7 -25%

Article PubMed PubMed Central Google Scholar

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Should neonatal-perinatal medicine move to two-year fellowships? | Journal of Perinatology - Nature.com

Vigorous exercise may preserve cognition in high-risk patients with hypertension – EurekAlert

image:

Richard Kazibwe, M.D., assistant professor of internal medicine at Wake Forest University School of Medicine

Credit: Wake Forest University School of Medicine

WINSTON-SALEM, N.C. June 6, 2024 People with high blood pressure have a higher risk of cognitive impairment, including dementia, but a new study from researchers at Wake Forest University School of Medicine suggests that engaging in vigorous physical activity more than once a week can lower that risk.

The findings appear online today in Alzheimers & Dementia: The Journal of the Alzheimers Association.

We know that physical exercise offers many benefits, including lowering blood pressure, improving heart health and potentially delaying cognitive decline, said Richard Kazibwe, M.D., assistant professor of internal medicine at Wake Forest University School of Medicine and lead author of the study. However, the amount and the intensity of exercise needed to preserve cognition is unknown.

In 2015, published findings from the landmark Systolic Blood Pressure Intervention Trial (SPRINT) showed that intensive blood pressure management reduced cardiovascular disease and lowered the risk of death.

SPRINT began in the fall of 2009 and included more than 9,300 participants with hypertension ages 50 and older, recruited from about 100 medical centers and clinical practices throughout the United States. Participants were randomly assigned to a systolic blood pressure goal of either less than 120 mm Hg (intensive treatment) or less than 140 mm Hg (standard treatment). The National Institutes of Health (NIH) stopped the blood pressure intervention earlier than originally planned to quickly disseminate the significant preliminary results, resulting in a new set of guidelines for controlling blood pressure.

In 2019, results of the ancillary SPRINT MIND trial, led by Wake Forest University School of Medicine, showed that intensive control of blood pressure in older people significantly reduced the risk of developing mild cognitive impairment, a precursor of early dementia.

In a secondary analysis of the SPRINT MIND study, Kazibwe and team examined the effect of self-reported sessions of vigorous physical activity (at least once a week) on the risk of mild cognitive impairment and dementia.

People who engaged in one or more sessions of vigorous physical activity per week had lower rates of mild cognitive impairment and dementia.

Kazibwe said that nearly 60% of study participants reported vigorous physical activity at least once a week, even among those aged 75 and up.

It is welcome news that a higher number of older adults are engaging in physical exercise. This also suggests that older adults who recognize the importance of exercise may be more inclined to exercise at higher intensity, Kazibwe said.

However, the research team found the protective impact of vigorous exercise was more pronounced for those under 75.

While this study provides evidence that vigorous exercise may preserve cognitive function in high-risk patients with hypertension, more research is needed to include device-based physical activity measurements and more diverse participant populations, Kazibwe said.

Alzheimer s & Dementia

People

Effect of vigorous-intensity physical activity on incident cognitive impairment in high-risk hypertension

6-Jun-2024

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Vigorous exercise may preserve cognition in high-risk patients with hypertension - EurekAlert