Volume 117, Issue 10

Background Nutrition is often overlooked in everyday health care despite the definitive connection between diet and health. Many practicing physicians and medical students feel unqualified to discuss specific dietary recommendations with patients, which may be attributed to inadequate nutrition education during medical school. Objective To assess the nutrition knowledge of osteopathic medical students and their attitudes regarding the importance of nutrition counseling in their future role as practicing physicians. Methods Using a descriptive, cross-sectional study design, the authors evaluated first- and second-year osteopathic medical students’ nutrition knowledge and attitudes toward nutrition counseling. A questionnaire that assessed attitudes toward nutrition counseling and a quiz that tested nutrition knowledge were used. Results A total of 257 first-year (n=139) and second-year (n=118) medical students (mean [SD] age, 24.8 [3.4] years; 52.8% female and 78.2% white) completed the quiz and survey. The average score of the nutrition knowledge quiz was 69.5%, with 130 participants (50.6%) scoring below the school's passing rate of 72.5%. Second-year students performed better than first-year students on the quiz (mean, 74.2% vs 65.9%; t =−5.17; P <.001). The majority of participants (143 [55.6%]) felt comfortable counseling patients on nutrition recommendations; however, only 30 (11.9%) were aware of the current dietary reference intakes. Qualitatively, most participants acknowledged the importance of providing patient education, promoting overall health and wellness, and preventing and treating disease. Conclusion The majority of participants felt comfortable counseling future patients on nutrition recommendations; however, most participants lacked knowledge of dietary reference intakes and medical nutrition therapy. Because half of osteopathic medical students typically enter primary care, students and their future paitents would benefit from the integration of more nutrition education in medical school.

Background Concussion is one of the most common injuries in athletes. Current concussion consensus statements propose that female sex may be a modifying factor in concussion management and recovery. Objective To determine whether female athletes in middle school and high school with a first-time, sports-related concussion remained symptomatic longer than their male counterparts. Methods A retrospective medical record analysis was performed among athletes who sustained a concussion between 2011 and 2013. Inclusion criteria consisted of age between 11 and 18 years and diagnosis of first-time concussion sustained while playing organized sports. Using the documented notes in the medical record, length of time that each athlete was symptomatic from his or her concussion was calculated. Results A total of 110 male and 102 female athletes (N=212) met the eligibility criteria for the study. A significant difference was found in the median number of days female athletes remained symptomatic (28 days) when compared with male athletes (11 days) ( P <.001). No statistically significant difference was found in symptom duration between age groups. When matched for sex, no statistically significant differences were found in symptom duration between the type of sports played. Conclusion Female athletes aged 11 to 18 years with first-time, sports-related concussions remained symptomatic for a longer period when compared with male athletes of similar age, regardless of sport played. The mechanism behind this difference needs to be further elucidated.

The importance of increasing scholarly activity has been highlighted among residency programs currently accredited by the American Osteopathic Association (AOA) to ensure a smooth transition to the single accreditation system. The Scholar 7 program, a series of seven 2-hour sessions, was created to aid faculty and residents in the pursuit of scholarly work and to facilitate change in an entire community hospital system's environment by creating a self-replicating scholarly culture in a timely and cost-efficient manner. Skills were taught by means of preparation and submission of a research protocol to the institutional review board (IRB) along with grant proposals. The authors tracked scholarly work, IRB submissions, and grants awarded to participants during the 2015-2016 academic year. The results were compared in a post-hoc fashion with previous classes since 2007-2008 within the same hospitals system. The Scholar 7 program successfully aided faculty in achieving their required pursuit of scholarly work in 8 months. This program has the potential to help AOA-focused residency programs meet the scholarly requirements of the Accreditation Council for Graduate Medical Education.

Context As graduate medical education evolves under the single accreditation system, osteopathic residency programs and consortia strive for sustainable ways to achieve and support the Osteopathic Recognition (OR) designation. Objective To determine whether differences existed in perceived importance of OR from 3 cohorts of osteopathic stakeholders: students, residents, and faculty. Methods A nonexperimental quantitative cross-sectional online survey was administered during February and March 2016 to osteopathic medical students at Michigan State University College of Osteopathic Medicine and residents and faculty from the affiliated Statewide Campus System. After examining final working dataset patterns, a series of Kruskal-Wallis tests were conducted to identify statistically significant differences in perceived OR importance response categories across sample subgroups, including program specialty and primary vs non–primary care specialty. Results The final analytic sample comprised 278 osteopathic medical students, 359 residents, and 94 faculty members. Of 728 respondents, 497 (67.9%) indicated that OR was “somewhat important,” “important,” or “very important.” The overall perceived importance category patterns varied significantly across students, residents, and faculty cohort respondents (, P <.001) and program specialty (, P <.001), as well as between primary care and non–primary care residents and faculty (, P <.001). Conclusion Based on these initial results, OR is generally valued across osteopathic stakeholder groups, but significant differences may exist between different types of students, residents, and faculty. Pre- and postgraduate educational support structures designed to reduce barriers to OR implementation may help to sustain osteopathic principles and practice in the single accreditation system.

Leiomyoma can be found concomitant with pregnancy and can cause complications during labor, delivery, and postpartum management. In the present case, a 26-year-old nulliparous patient at 39.4 weeks gestational age with a 12×9-cm retroplacental leiomyoma underwent a spontaneous vaginal delivery. Nine weeks after delivery, the patient presented with acute pain and vaginal bleeding. Immediate manual removal of the bulk of the leiomyoma tissue via vaginal approach was performed. Four weeks later, the patient returned for removal of the remaining tissue via hysteroscopic excision. This case demonstrates that a large retroplacental leiomyoma can be associated with both immediate and delayed postpartum complications, and it can be managed in a minimally invasive way.