The usual challenges of conducting primary care research, including randomized trials, have been exacerbated, and new ones identified, during the COVID-19 pandemic. HOMER (Home versus Office for Medication Enhanced Recovery; subsequently, Comparing Home, Office, and Telehealth Induction for Medication Enhanced Recovery) is a pragmatic, comparative-effectiveness research trial that aims to answer a key question from patients and clinicians: What is the best setting in which to start treatment with buprenorphine for opioid use disorder for this patient at this time? In this article, we describe the difficult journey to find the answer. The HOMER study began as a randomized trial comparing treatment outcomes in patients starting treatment with buprenorphine via induction at home (unobserved) vs in the office (observed, synchronous). The study aimed to enroll 1,000 participants from 100 diverse primary care practices associated with the State Networks of Colorado Ambulatory Practices and Partners and the American Academy of Family Physicians National Research Network. The research team faced unexpected challenges related to the COVID-19 pandemic and dramatic changes in the opioid epidemic. These challenges required changes to the study design, protocol, recruitment intensity, and funding conversations, as well as patience. As this is a participatory research study, we sought, documented, and responded to practice and patient requests for adaptations. Changes included adding a third study arm using telehealth induction (observed via telephone or video, synchronous) and switching to a comprehensive cohort design to answer meaningful patient-centered research questions. Using a narrative approach based on the Greek myth of Homer, we describe here the challenges and adaptations that have provided the opportunity for HOMER to thrive and find the way home. These clinical trial strategies may apply to other studies faced with similar cultural and extreme circumstances.

PURPOSE

Meeting scholarly activity requirements continues to be a challenge in many family medicine (FM) residency programs. Studies comprehensively describing FM resident scholarship have been limited. We sought to identify institutional factors associated with increased scholarly output and meeting requirements of the Accreditation Council for Graduate Medical Education (ACGME).

PURPOSE

Despite being key to better health outcomes for patients from racial and ethnic minority groups, the proportion of underrepresented in medicine (URiM) physicians remains low in the US health care system. This study linked a nationally representative sample of family physicians (FPs) with Medicaid claims data to explore the relative contributions to care of Medicaid populations by FP race and ethnicity.

PURPOSE

Currently, 40% of counties in the United States do not have an obstetrician or midwife, and in rural areas the likelihood of childbirth being attended to by a family medicine (FM) physician is increasing. We sought to characterize the effect of the FM presence on unit culture and a key perinatal quality metric in Iowa hospital intrapartum units.

The respiratory literature, both written and in online formats, is growing exponentially. Capturing quality content, to meet the learning needs of those working in all fields of respiratory medicine and delivering it in a palatable, accessible format is challenging but paramount. In this article we discuss ways to determine the information content and review different methods of delivering this content to those who need it.

Stephen Flynn has been criticised by SNP colleagues after saying he would stay on at Westminster, even if elected to Holyrood.

Nintendo today hosted a Super Nintendo World Direct livestream that featured Shigeru Miyamoto giving a deep dive look into the Donkey Kong Country-themed land.

The new land will feature a family roller coaster, called Mine-Cart Madness, congas you can hit to a rhythm, letters that can found throughout the land that can be scanned on the new Donkey Kong Power-Up Band, character meet and greets, and new food options.

Donkey Kong Country will open at Universal Studios Japan on December 11, 2024, and will also be a part of Super Nintendo World at Epic Universe in Florida when the theme park opens in May 2025.

View the Direct below:

A life-long and avid gamer, William D'Angelo was first introduced to VGChartz in 2007. After years of supporting the site, he was brought on in 2010 as a junior analyst, working his way up to lead analyst in 2012 and taking over the hardware estimates in 2017. He has expanded his involvement in the gaming community by producing content on his own YouTube channel and Twitch channel. You can contact the author on Twitter @TrunksWD.

Full Article - https://www.vgchartz.com/article/463038/super-nintendo-world-direct-dives-into-the-donkey-kong-country-themed-land/

Remedy's Alan Wake 2 has now "recouped most of its development and marketing expenses", CEO Tero Virtala has announced in a business review for January-September 2024. Speaking as somebody who would quite like there to be more Alan Wake games - or at least, moderately weird and pretty decent blockbuster singleplayer horror games - I am both pleased by this news and a little troubled that Remedy's eldritch forest fable (which came out in October 2023) has yet to break even.

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"A lot of puzzle games can leave you staring at the same static screen for ages, but here, I’m always pushing you forward," says Mark Brown of Game Maker’s Toolkit. For a decade now, Brown has been releasing accessible deep dives on game design for his popular YouTube channel, like "How Game Designers Protect Players From Themselves" and "The Two Types of Random in Game Design." This week, he’s releasing his own for the first time.

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Medically evacuating an astronaut from space is difficult and expensive, and a new model predicts that one in three long-duration moon missions may require it

AlphaProof, an AI from Google DeepMind, came close to matching the top participants in a prestigious competition for young mathematicians

Between 2005 and 2021, Facebook, Twitter and YouTube were more likely to make policy changes in the weeks after negative stories in the media

Match of the Day presenter Gary Lineker has sealed a new agreement with the BBC just hours after his exit was confirmed.

Stay up to date on the latest AI technology advancements and learn about the challenges and opportunities AI presents

… Junior Asia/ Oceania Davis Cup and Fed Cup final qualifying event. The … players selected for the Junior Davis Cup include Dev V. Javia, Sandeep … Gogoi (reserve). The Junior Fed Cup team includes Anisha Kashyap, Bhakti … Junior Asia/ Oceania Junior Davis Cup will begin in Kuching, Malaysia ….

A stadium-sized asteroid is passing relatively close to Earth on Tuesday, NASA announced. Its distance from Earth and its massive size makes it a "potentially hazardous object."

Police are hunting laughing yobs who filmed themselves hurling a cat off a bridge and posted the video on Snapchat.

A mum-of-four was tragically found dead at her home following a fire.

However, the comparative Win 11 AMD tests were on an unpatched (L3 cache, CPPC2) PC.

The standard model predicted that the NASA/ESA/CSA James Webb Space Telescope would see dim signals from small, primitive galaxies.

The post New Research Questions Standard Theory of How Galaxies Formed in Early Universe appeared first on Sci.News: Breaking Science News.

Narratives around addiction often reduce it to a series of poor choices, lack of values and weakness. This has real-world consequences, warns Anna Wolfe

The 2024 Nobel prize in physiology or medicine has gone to Victor Ambros and Gary Ruvkun for their discovery that tiny pieces of RNA called microRNAs play a key role in controlling genes

People who went from using social media for at least 2 hours a day to just 30 minutes a day reported no improvement to their sleep or emotional well-being

Social media commentators claimed Jill Biden refused to look at Vice President Harris as they were seated together at Arlington Cemetery for a Veterans' Day Remembrance.

Dallas Mavericks minority owner Mark Cuban returned to the Bluesky social media platform with a post after weeks of contentious X posts.

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Brianna Ghey's mother, Esther Ghey, is now campaigning to raise awareness about the dangers of social media and the "toxic" online world which her daughter came to inhabit. She wants tighter regulation on internet access and more parental controls.

We’ve all been there. You’ve gone to the store or scrolled through countless online sites, desperately searching for a graduation gift that’s unique, funny, and something your friend won’t toss in a drawer and forget about. Well, it turns out there’s a new trend catching fire, and it’s a fake college diploma. Yes, you heard […]

The post Why Fake College Diplomas Are the Latest Comedy Trend in Graduation Gifts appeared first on Chart Attack.

Dropbox also laid off 500 last year but still had "excess layers of management."

If the legislation is passed, social media platforms including X, TikTok, Instagram and Facebook would have one year to work out how to exclude Australian children.