Tom D. Thacher
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View article: “It’s only the money: The hospital is always stronger”— a qualitative study of fracture care pathways in Mamou, Guinea
“It’s only the money: The hospital is always stronger”— a qualitative study of fracture care pathways in Mamou, Guinea Open
Background Despite the availability of modern orthopedic care, traditional bone-setters (TBS) still play a large role in managing fractures in Guinea. Delayed surgical care for complex fractures where surgery is indicated leads to worse ou…
View article: The Association Between Patient-Reported Social Risks and the HOUSES Index: A Rural-Urban Comparison
The Association Between Patient-Reported Social Risks and the HOUSES Index: A Rural-Urban Comparison Open
Introduction/Objectives: Little is known about the prevalence of patient-reported social risk factors and the use of the HOUSES Index, a simple, reliable method of assessing socioeconomic status (SES) based on publicly available housing da…
View article: Intralesional Injection of Vitamin D3 for Treatment of Cutaneous Warts: A Randomized, Double-Blind, Placebo-Controlled Trial
Intralesional Injection of Vitamin D3 for Treatment of Cutaneous Warts: A Randomized, Double-Blind, Placebo-Controlled Trial Open
Introduction: Treatment of cutaneous warts with intralesional vitamin D3 has demonstrated promising results in over 35 studies with methodological limitations. Methods: We conducted a randomized, double-blind, placebo-controlled trial in o…
View article: Reported Behavioral Patterns and Concern Surrounding Well Water Testing for Arsenic in Midwestern Homeowners with Children
Reported Behavioral Patterns and Concern Surrounding Well Water Testing for Arsenic in Midwestern Homeowners with Children Open
Toxins from ingested water can significantly affect overall physical health in children and adults. In the United States, domestic water wells are not commonly tested for any heavy metal contaminants. It is well-known that chronic arsenic …
View article: Intralesional Injections of Vitamin D Are Ineffective for the Treatment of Cutaneous Warts
Intralesional Injections of Vitamin D Are Ineffective for the Treatment of Cutaneous Warts Open
CONTEXT: Cutaneous warts are a common manifestation of human papillomavirus (HPV) infection of skin epithelium. Vitamin D has immunomodulatory properties that may augment the immune response to cutaneous HPV, and the skin has vitamin D rec…
View article: Relationship between Social Risks and Diabetes Metrics in a Large US Health System
Relationship between Social Risks and Diabetes Metrics in a Large US Health System Open
CONTEXT: Type 2 diabetes impacts 11.3% of the US population and disproportionately affects racial and ethnic minorities and low-income adults. Primary care settings may be an appropriate environment to address social risk factors, however …
View article: Relationship Between Social Risks and Diabetes Metrics in a US Health System
Relationship Between Social Risks and Diabetes Metrics in a US Health System Open
This data reinforces the important clinical impact social risk factors have for primary care patients and highlights the need for more interventional studies.
View article: Sulfated vitamin D metabolites represent prominent roles in serum and in breastmilk of lactating women
Sulfated vitamin D metabolites represent prominent roles in serum and in breastmilk of lactating women Open
Sulfated vitamin D metabolites have prominent roles for women during lactation with 25OHD3-S highly abundant in serum and VitD3-S distinctly abundant in breastmilk. These data support the notion that 25OHD3-S and VitD3-S may have physiolog…
View article: Serum 25-hydroxyvitamin D threshold and risk of rickets in young children: a systematic review and individual participant data meta-analysis to inform the development of dietary requirements for vitamin D
Serum 25-hydroxyvitamin D threshold and risk of rickets in young children: a systematic review and individual participant data meta-analysis to inform the development of dietary requirements for vitamin D Open
Purpose The objective of this systematic review was to determine a minimum serum 25-hydroxyvitamin D (25OHD) threshold based on the risk of having rickets in young children. This work was commissioned by the WHO and FAO within the framewor…
View article: Arsenic Exposure in Well Water From the Perspective of Patients and Providers
Arsenic Exposure in Well Water From the Perspective of Patients and Providers Open
Background: Arsenic is a well-known toxin which may contaminate household water. It is harmful when ingested over prolonged periods of time. As a result, public health experts recommend that water should be screened and treated to prevent …
View article: Engaging the EHR to Address Health Related Social Needs: Primary Care Learning Experiences in a Health System
Engaging the EHR to Address Health Related Social Needs: Primary Care Learning Experiences in a Health System Open
CONTEXT: Identifying patients with health-related social needs and connecting them with appropriate resources in an effective, efficient, and timely way can prove challenging. The EHR should serve as a tool that facilitates Primary care cl…
View article: Disparities in Diabetes Care: Differences Between Rural and Urban Patients Within a Large Health System
Disparities in Diabetes Care: Differences Between Rural and Urban Patients Within a Large Health System Open
Rural patients had worse diabetes quality outcomes than their urban counterparts, even after adjustment for other contributing factors and despite being part of the same integrated health system. Lower visit frequency and less specialty in…
View article: Ranking of Practice Recommendations by Primary Care Clinicians in a Health System
Ranking of Practice Recommendations by Primary Care Clinicians in a Health System Open
CONTEXT: Primary care clinicians are tasked with reviewing and adopting new practice recommendations. The USPSTF alone had 23 new recommendations in 2020-2021. Our primary care learning collaborative (PCLC) in a large health system, update…
View article: The Association of Birth Weight and Early Childhood Weight Trajectories with the incidence of Type II Diabetes
The Association of Birth Weight and Early Childhood Weight Trajectories with the incidence of Type II Diabetes Open
BACKGROUND: Perinatal factors, including gestational age, birthweight, size-for-gestational age, delivery route, maternal parity, maternal age, and socioeconomic status, have been linked to the long-term incidence of chronic comorbidities.…
View article: Diabetic Disparity: Rural/Urban Differences in Quality Outcomes within a Large Health System
Diabetic Disparity: Rural/Urban Differences in Quality Outcomes within a Large Health System Open
CONTEXT: Type 2 diabetes mellitus continues to grow as a national health priority that disproportionately affects rural patients. OBJECTIVE: To compare patient level quality outcome data between rural and urban patients across a large inte…
View article: Correlation between Social Determinants of Health and Attainment of Quality Metrics in a Rural Wisconsin Clinic
Correlation between Social Determinants of Health and Attainment of Quality Metrics in a Rural Wisconsin Clinic Open
CONTEXT: Social Determinants of Health (SDOH) contribute significantly to health outcomes such as chronic disease management and screening test completion. Electronic medical record (EMR) data can provide insight into individual-level SDOH…
View article: Primary Care Workload Experience
Primary Care Workload Experience Open
BACKGROUND: In spring 2021, outbreaks of new variants of SARS-CoV-2 and vaccine resistance disrupted hopes that the pandemic was waning. New cases overwhelmed inpatient services, often shifting care of very ill patients to outpatient servi…
View article: Infant and Maternal Vitamin D Supplementation: Clinician Perspectives and Practices
Infant and Maternal Vitamin D Supplementation: Clinician Perspectives and Practices Open
MIC are more likely than IC to embrace high-dose maternal vitamin D supplementation to provide adequate vitamin D for infants. This highlights an opportunity for further education of clinicians about this option.
View article: Clinician Adoption of an Artificial Intelligence Algorithm to Detect Left Ventricular Systolic Dysfunction in Primary Care.
Clinician Adoption of an Artificial Intelligence Algorithm to Detect Left Ventricular Systolic Dysfunction in Primary Care. Open
Clinicaltrials.gov Identifier: NCT04000087.
View article: Use of the EHR to address the social determinants of health – primary care learning experiences in a health system
Use of the EHR to address the social determinants of health – primary care learning experiences in a health system Open
CONTEXT: Identifying patients with needs related to Social Determinants of Health (SDOH) and connecting them with appropriate resources in an effective, efficient, and timely way can prove challenging. Primary care clinicians (PCC’s) inter…
View article: Primary care clinical experience during a pandemic: A model for medical crisis planning
Primary care clinical experience during a pandemic: A model for medical crisis planning Open
CONTEXT: In the aftermath of large disasters such as hurricanes and earthquakes which result in mass casualties and infrastructure disruption, within days primary care becomes an essential element in the recovery of health care services. B…
View article: One year of COVID: Primary care learning experiences in a health system
One year of COVID: Primary care learning experiences in a health system Open
Context: Patients and communities consider their primary care clinicians (PCC's) to be their most trusted source of information. During the first 12 months of the COVID pandemic, initially reliable, accurate information was scare, evolving…
View article: Evaluating the Evidence in Clinical Studies of Vitamin D in COVID-19
Evaluating the Evidence in Clinical Studies of Vitamin D in COVID-19 Open
Laboratory evidence provides a biological rationale for the benefits of vitamin D in COVID-19, and vitamin D supplementation is associated with reduced risk of respiratory infections. Most of the clinical studies of vitamin D in COVID-19 h…
View article: Association of Perinatal Factors With Severe Obesity and Dyslipidemia in Adulthood
Association of Perinatal Factors With Severe Obesity and Dyslipidemia in Adulthood Open
Background: Perinatal factors including gestational age, birthweight, size for gestational age, delivery route, maternal parity, maternal age, maternal education, socioeconomic status, race, and sex, are associated with the future risk of …