Implementing a Test-and-Treat Program for Lymphatic Filiriasis (LF) in a Public Health Clinic Setting

Objective. To develop a program to screen and treat patients from endemic areas for Lymphatic Filiriasis (LF) in a community setting. This required a partnership between the Centers for Disease Control (CDC) and the Palm Beach County Health Department. Background. Lymphatic filariasis (LF), the disease caused by infection with Wuchereria bancrofti, can lead to extreme limb, scrotal, and breast enlargement. An estimated 10,000 immigrants enter the US harboring this mosquito-borne parasite each year and based on the 2000 census, more than 4 million immigrants from LF-endemic countries reside in the U.S. Neither the test nor medication used for LF have FDA approval, making screening and treatment limited in the US. Method. Following a three year process to obtain all necessary IRB approval, the CDC and Riviera Beach Health Center began to educate and offer patients screening for the disease within the clinic. The NOW® rapid filariasis immunochromatographic card test is used to diagnose cases of LF. Those testing positive who do not have contraindications will be offered DEC treatment. Results. Between April and December of 2009, 175 clients from LF-endemic countries were screened under this research protocol. 11 patients (6%) tested positive for the parasite, and all of these individuals were treated for the disease. Conclusion. New immigrants from LF-endemic areas may harbor the disease, and may not have access to screening or treatment while in the US. It is possible to implement a test-and-treat program for research, however it is time consuming and has limited scope. Grants. PB-CHD supporte

Faculty development advancements: lessons learned in a time of change

Faculty development (FD) activities at colleges of medicine shifted to virtual in March 2020 as the coronavirus pandemic limited in-person engagement. Medical schools delivered quality virtual faculty development (VFD) through accessing national and international experts virtually, improving faculty access to FD through recorded sessions, collaborating across institutions, and building on previous success as comfort with virtual platforms grew. Disruptive innovation and Keller’s ARCS model, highlighting motivational concepts of attention, relevance, confidence, and satisfaction, guided nine faculty developers’ reflections towards continuous quality improvement of VFD offerings. The convenience and low-cost availability of virtual activities mean this format will likely persist

Effect of osteopathy in the Cranial Field on Visual Function--A pilot study

CONTEXT: The effects of osteopathy in the cranial field on visual function-particularly on changes in the visual field and on the binocular alignment of the eyes-have been poorly characterized in the literature. The authors examined whether osteopathy in the cranial field resulted in an immediate, measurable change in visual function among a sample of adults with cranial asymmetry. STUDY DESIGN: Randomized controlled double-blinded pilot clinical trial. SUBJECTS: Adult volunteers between ages 18 and 35 years who were free of strabismus or active ocular or systemic disease were recruited. Inclusion criteria were refractive error ranging between six diopters of myopia and five diopters of hyperopia, regular astigmatism of any amount, and cranial somatic dysfunction. INTERVENTION: All subjects were randomly assigned to the treatment or control group. The treatment group received a single intervention of osteopathy in the cranial field to correct cranial dysfunction. The control group received light pressure of a few ounces of force applied to the cranium without osteopathic manipulative treatment. MEASUREMENTS: Preintervention and postintervention optometric examinations consisted of distant visual acuity testing, Donder push-up (ie, accommodative system) testing, local stereoacuity testing, pupillary size measurements, and vergence system (ie, cover test with prism neutralization, near point of convergence) testing. Global stereoacuity testing and retinoscopy were performed only in preintervention to determine whether subjects met inclusion criteria. Analysis of variance (ANOVA) was performed for all ocular measures. RESULTS: Twenty-nine subjects completed the trial-15 in the treatment group and 14 in the control group. A hierarchical ANOVA revealed statistically significant effects within the treatment group and within the control group (P \u3c.05) in distance visual acuity of the right eye (OD) and left eye (OS), local stereoacuity, pupillary size measured under dim illumination OD and OS, and near point of convergence break and recovery. For the treatment group vs the control group, a statistically significant effect was observed in pupillary size measured under bright illumination OS (P \u3c.05). CONCLUSIONS: The present study suggests that osteopathy in the cranial field may result in beneficial effects on visual function in adults with cranial asymmetry. However, this finding requires additional investigation with a larger sample size and longer intervention and follow-up periods