Let's keep the momentum going for optimal team practice: Become a champion for PAs No abstract available

Are PAs and NPs interchangeable? No abstract available

Which patients should receive the herpes zoster vaccine? The recombinant adjuvanted zoster vaccine (RZV, trade name Shingrix) is preferentially recommended by the Advisory Committee on Immunization Practices to prevent herpes zoster and related complications in immunocompetent adults age 50 years and older. This article reviews efficacy and safety of the vaccine, its use in special populations, and how to prevent administration errors to answer the question “Which patients should receive the herpes zoster vaccine?”

Managing gestational diabetes Gestational diabetes is diabetes diagnosed in the second or third trimester of pregnancy in a patient who was not diagnosed with diabetes before pregnancy. Timely identification and management of gestational diabetes is important to prevent fetal, infant, and maternal complications. Physical activity and dietary changes remain the hallmark of treatment, with insulin becoming the medication of choice if further intervention is needed. This article reviews the steps clinicians can take to screen for patients with gestational diabetes, recommendations for future type 2 diabetes screening, and how to manage gestational diabetes during the course of a patient's pregnancy based on the American Diabetes Association's current standards of care.

HPV-associated oropharyngeal cancer Exposure of the oral cavity and oropharynx to human papillomavirus (HPV) often results in an asymptomatic, transient oral infection that is cleared by the body's immune system; however, a small percentage of these oral infections can persist in a dormant state. Depending on the HPV genotype, a persistent oral infection may lead to benign or malignant disease. High-risk HPV types 16 and 18, which cause most cervical and anal cancers, also are the cause of the rising rate of oropharyngeal squamous cell carcinoma (SCC) in the United States. This article focuses on the epidemiology, transmission, risk factors, and clinical presentation of HPV-associated oropharyngeal SCC, and provides an update on HPV vaccination in the context of the new head and neck cancer epidemic.

CME POST-TEST No abstract available

Hypothenar hammer syndrome: An uncommon cause of secondary syndrome and digital ischemia Hypothenar hammer syndrome affects less than 1% of the population, but if the diagnosis is delayed, digital gangrene and critical ischemia can ensue. The condition is caused by injury to the ulnar artery at the level of the hook of hamate when the palm of the hand is repetitively used as a hammer. Injury includes segmental occlusion of the ulnar artery and aneurysmal formation with or without occlusion. Patients with hypothenar hammer syndrome often present with symptoms of secondary Raynaud syndrome; if Raynaud is unilateral, a vascular origin should be suspected and ruled out. Treatment options for hypothenar hammer syndrome include conservative treatment measures, fibrinolysis, or surgical resection and repair, and depend on the specific injury and timing of diagnosis.

Immunotherapy for non-small cell lung cancer Immunotherapy is a new genre of treatment for patients with advanced cancer. Initially approved for use in metastatic melanoma, immunotherapy has found a significant place in treating non-small cell lung cancer (NSCLC). Clinical trials using several combinations of immunotherapy are underway to help to determine the best treatment for specific patient groups. This article reviews approved uses of immunotherapy for NSCLC, immune-related toxicities, and explores the future direction of this treatment.

Measuring the effect of a competency-based education conference for PAs and NPs Objective: To evaluate the effectiveness of a competency-based continuing medical education (CME) conference model for physician assistants (PAs) and NPs. Methods: This mixed-method research included a pretest/post-test assessment of knowledge and procedural assessment for six clinical skills, along with an open-ended survey to assess the value of an educational conference for PAs and NPs (N = 48) in an urban academic healthcare facility. Results: Significant increases in knowledge scores and all six clinical skill procedures were noted from pre- to post-test. Participants said they acquired new techniques and knowledge (55%) or improved current knowledge and skills (40%). Conclusions: The competency-based conference model could serve as a viable method for providing evidence-based learning and informed practice as well as instilling reflective practice and a commitment to personal growth.

Reading between the lines for a solution to burnout Physician assistants (PAs) have historically reported high levels of professional satisfaction, but emerging research indicates increasing levels of professional burnout. This article explores burnout interventions in the literature and their usefulness to PAs. We propose that PAs and leaders of the profession must acknowledge and assess the phenomenon of burnout through standardized measurement at the population level, be mindful of personal boundaries in order to maintain a healthy work life balance, and commit to creating an organizational culture that sustains overall clinician well-being and fosters PA engagement.