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8% of Area-CG (p = 0.02). In girls 3 to 12 years of age, 75% of participants reduced or maintained BMI, compared with 42% of Ref-CG (p < 0.001) and 59.8% of Area-CG (p = 0.07). On average, the difference in BMI change over the 6-month follow-up period was -0.85 kg/m² (95% confidence interval = -1.25 to -0.46 kg/m²) compared with Ref-CG and -0.28 kg/m² (95% confidence interval = -0.63 to 0.08 kg/m²) and Area-CG.

Low- to moderate-intensity family-based weight management intervention in primary care can be successful after only 6 months compared with a referred control group.

Low- to moderate-intensity family-based weight management intervention in primary care can be successful after only 6 months compared with a referred control group.

Patient, provider, and system factors can contribute to chronic care management and outcomes. Few studies have examined these multilevel associations with osteoporosis care and outcomes. We examined how key process and structural factors at the patient, primary care physician (PCP), and primary care clinic (PCC) levels were associated with guideline concordant osteoporosis pharmacotherapy, daily calcium intake, vitamin D supplementation, and weekly exercise sessions at 52 weeks following enrollment in a cluster randomized controlled trial.

We conducted a secondary analysis of observational data from 1 site of the trial. The study sample included 1996 men and women ≥ 50 years of age at the time of recruitment following completion of a dual-energy x-ray absorptiometry (DXA) scan and who had complete data at baseline and 52 weeks. Our primary independent variable was "relationship continuity" the DXA-ordering provider was the patient's PCP. Hierarchical linear and logistic regression accounted for patient, provider, and primary care clinic characteristics.

In multivariable regression analyses, relationship continuity (ie, the PCP ordered the study DXA) was associated with higher average daily calcium intake and likelihood of vitamin D supplementation at 52 weeks. No PCP or primary care clinic factors were associated with osteoporosis care.

The relationship continuity, in which the provider ordering a DXA is the patient's PCP and therefore also presents the results of a DXA, may help to promote patient behaviors associated with good bone health.

The relationship continuity, in which the provider ordering a DXA is the patient's PCP and therefore also presents the results of a DXA, may help to promote patient behaviors associated with good bone health.

NUT carcinoma is an extremely rare disease and yet extremely aggressive with 2-year survival of only approximately 19% and median survival of 6 to 9 months.

We report here 2 successfully treated patients with durable complete remission (CR) after concurrent chemotherapy and radiation using 2 completely different chemotherapy regimens. One patient had extremely high tumor burden and obtained CR with ifosfamide and etoposide concurrently with radiation. One patient with low tumor burden obtained CR with carboplatin and paclitaxel concurrently with radiation. Interestingly, both patients had high PD-L1 expression in the tumor that may be associated with the favorable outcome.

Our experiences with these 2 successfully treated patients offer insight for the management of NUT carcinoma.

Our experiences with these 2 successfully treated patients offer insight for the management of NUT carcinoma.

E-cigarette/vaping use in adolescents has increased 77.8% among high schoolers and 48.5% among middle schoolers in 2017-2018. As such, there is need for an effective workflow for screening for vaping. We aimed to increase screening rates of e-cigarette/vaping users from less than 1% to at least 50% in 6 months.

Screening for vaping in youth was implemented in a pediatric clinic in Northern California beginning in the summer of 2019 for 6 months. Depending on comorbidity, severity, and readiness to quit, patients were referred to treatment. Outcomes included screening rates, process measure included positive screening rates, and balancing measure was provider time.

The clinic completed 1414 physicals with an average screening rate of 76% and a positive rate of 7.9%. learn more The average age of patients was 15 (standard deviation = 1.3), 48% were female and 29% were Asian/Pacific Islander, 23% Hispanic, and 23% White. After 6 months, we met our goal in all but 1 plan-do-study-act (PDSA) cycle.

We created a standardized workflow that identified teens who vaped. When compared to other studies, the positive rate for this study was low which is likely due to misinterpretation by staff of screening questions as well as the fact that data were collected during a clinic visit.

It is important to find ways in which providers can mitigate this epidemic given the alarming increase in e-cigarette/vaping use among adolescents. This study furthers the effort to develop a screening method that is simple and brief, allowing physicians to intervene if necessary.

It is important to find ways in which providers can mitigate this epidemic given the alarming increase in e-cigarette/vaping use among adolescents. This study furthers the effort to develop a screening method that is simple and brief, allowing physicians to intervene if necessary.

Community health centers (CHCs) in British Columbia, Canada, are using a data-driven approach to enable functions related to the design, organization, management, delivery, and evaluation of primary health care services for complex populations.

Descriptive study leveraging case studies from 4 CHCs in Vancouver, Canada, to provide an overview and examples of the functions and outputs of the Vancouver Community Analytics Tool (VCAT). Quantitative data were derived from electronic medical record data and regional emergency department data. Data were analyzed and reported by the VCAT software.

VCAT is a health system modeling, analytics, and reporting application suite that enables operationalization of the Ten Building Blocks of High-Performing Primary Care framework via 1) creation of a virtual patient record, 2) modeling and measurement of epidemiological profiles, 3) population management and quality improvement, 4) measurement and assessment of biopsychosocial complexity, 5) empanelment, and 6) design and optimization of team-based care.