UNASSIGNED: Poor access to lymphoedema specialists and communication between them and patients prevents appropriate lymphoedema management. Therefore, development and dissemination of remote systems is necessary to improve care in rural areas with limited medical personnel or access to medical coordination.
UNASSIGNED: The authors evaluated the elements required for providing patient education on conservative therapy for lymphoedema, to determine the feasibility of remote management.
UNASSIGNED: The study involved connecting a health professional in a local clinic (point A) treating a patient with lymphoedema, who was present alongside the clinician, with a specialist certified lymphoedema therapist (CLT) located remotely in a university (point B).
UNASSIGNED: The CLT was able to greet, interview and provide guidance to the patient on conservative therapy. Direct contact with the patient was not possible, which limited visualisation, palpation, leg circumference measurement, and lymphatic drainage management.
UNASSIGNED: The findings suggest that remote a lymphoedema management approach involving conservative therapy benefits both patients and health professionals, particularly in rural regions. Future studies are needed to confirm the effectiveness of this approach to confirm adequate treatment.

Since its first use just over a century ago, insulin treatment has evolved dramatically, such that the molecules are physiologic in nature, and treatment can now closely resemble the natural hormone response over 24 hours. Newer, longer-acting basal insulin analogs have provided insulin therapies with improved characteristics and, therefore, ease of use, and can readily be incorporated as part of routine treatment for type 2 diabetes (T2D), but evidence suggests that insulin remains underused in people with T2D. We review the barriers to initiation of basal insulin and the education needed to address these barriers, and we provide practical pointers, supported by evidence, for primary care physicians and advanced practice providers to facilitate timely initiation of basal insulin in the people with T2D who will benefit from such treatment.
Type 2 diabetes is a complex disease. It causes increased amounts of sugar in the blood, which can cause damage to the body. Medications are given to people with type 2 diabetes to keep their blood sugar at normal levels. Unfortunately, type 2 diabetes worsens over time, so regular adjustments to medications are needed to keep blood sugar levels controlled.Basal insulin, which is a type of insulin that works over the entire day, is a key treatment for type 2 diabetes. It works best if it is started as soon as other medications (tablets or non-insulin injections) are not working to control blood sugar levels. Unfortunately, delays in starting basal insulin are common. Some healthcare professionals and people with type 2 diabetes believe insulin is difficult to use. False information on insulin is common; for example, some people with diabetes believe that their symptoms are caused by insulin treatment rather than high blood sugar.This review summarizes key information to encourage effective conversations between healthcare professionals and people with type 2 diabetes about starting basal insulin. Proactive, positive, early discussion of the benefits of basal insulin can help to: 1) address concerns, 2) set appropriate, individual treatment targets, and 3) provide practical information and training to help with injecting insulin. This will give people living with type 2 diabetes the knowledge and confidence to take an active part in managing their diabetes and overcome any barriers to using basal insulin.

OBJECTIVE: This study examined campus and clinic factors that may influence likelihood of implementing sexual violence (SV) prevention for college students seeking care in campus health and counseling centers.
METHODS: Campus-, clinic-, and student-level data were collected from both intervention and control campuses as part of a 28-campus cluster randomized controlled trial. A case series exploratory data analysis assessed differences in the implementation of an SV prevention intervention by campus characteristics.
RESULTS: All large schools were in the top quartile for reporting positive prevention policies regarding SV. At the clinic level, the presence of SV protocols and procedures varied widely with no clear correlation with school size. Students at intervention schools where providers received instruction and tools to facilitate these discussions reported more discussions with providers about SV. Only school size appeared to be associated with positive SV policies on campus and student-reported receipt of SV prevention intervention. Large schools performed well on campus-level policies, yet students reported some of the lowest levels of intervention receipt in the clinics at these larger schools.
CONCLUSIONS: Consistency between campus and clinic environments and implementation of the intervention was not observed. Our findings suggest that high performance regarding SV policy and prevention on a campus do not necessarily translate to implementation of appropriate SV prevention and care for students seeking care on campus, including assessments, resources, referrals, and services.
BACKGROUND: NCT registration: NCT02355470.

Over the past few decades, prescription opioids have greatly impacted our society, providing much needed relief for those in severe pain while simultaneously leading many to develop opioid use disorder. Although the scientific community has made great progress in combating this epidemic, there is still much work to be done. Physicians play a crucial role in this fight, as they are the ones in direct contact with patients. Proper and thorough communication is absolutely necessary when treating patients who are prescribed opioids. In this piece, we describe the case of a 62-year-old woman who experienced debilitating, cyclic opioid withdrawals after years of inappropriate prescription opioid use and how much of her suffering could have been avoided. Her case highlights the importance of patient-provider communication and the willingness of many patients to discontinue opioids.