Prevalence of depression symptoms in outpatients with a complaint of headache.

PURPOSE: This case-control study was designed to determine whether adults who present to a primary care office with a chief complaint of headache have more reported symptoms of depression than adults presenting with other problems. METHODS: Adult, English-speaking patients who presented to a primary care office with a chief complaint of headache were matched to adult patients of the same age and sex who presented with problems other than headache. All participants completed the PRIME-MD 9-item Patient Health Questionnaire as a screen for depression. RESULTS: A total of 200 participants entered the study. The mean age of the participants was 43.8 years (range, 18-87 years). Women constituted 84% of the participants. Of those patients who presented with headache, 32% had a likelihood of possible major depressive disorder compared with 12% in the patients presenting without headache. CONCLUSIONS: Almost one-third of adult patients who present to a primary care office with a complaint of headache report moderate symptoms of depression when screened compared with approximately 10% of patients presenting with a complaint other than headache. Given such a high prevalence of these symptoms, primary care physicians should screen all adult patients who present with headache for depression.

Measuring awareness, interest, and involvement in the osteopathic community through board certification: a survey of DO residents in ACGME-accredited training programs.

Currently, close to 50% of osteopathic medical graduates receive residency training from programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) rather than those approved by the American Osteopathic Association (AOA). As a result, leaders within the osteopathic medical profession have expressed ongoing concerns about the viability of the profession's distinct osteopathic identity. Using a one-page, 12-item survey, the authors queried ACGME-trained family practice residents (N=1354) regarding their interest in formal membership, continuing medical education activities, and specialty board certification options within the osteopathic medical profession. Four hundred twenty-six completed surveys were returned and usable for analysis for an overall response rate of 31.4%. A majority of survey participants indicated an interest "in continuing [their] osteopathic skills and training during residency" (376 [88.5%]), membership in osteopathic organizations and participating in continuing medical education programs (325 [77.2%]), and completing the American Osteopathic Board of Family Physicians certification examination (267 [63.7%]). Unfortunately, actual involvement may be limited by lack of communication or understanding, as in the case of lack of awareness regarding eligibility criteria for AOA board certification (311 [74.2%]). A variety of recommendations are offered to osteopathic organizations to improve involvement in and commitment to the profession among ACGME-trained DOs.

The economic impact of acute sunburn.

OBJECTIVE: To estimate the economic impact of sunburn in a beachgoing population during the summer. DESIGN: Survey. SETTING: Galveston, Tex, beachfront. PARTICIPANTS: Convenience sample of 56 sunburned beachgoers. Intervention None. MAIN OUTCOME MEASURES: Days of work lost as a result of sunburn in the previous year. RESULTS: Thirty-eight respondents (68%) reported painful sunburn. Sunscreen use did not prevent painful sunburn (23/38 [60%]). Those consuming alcohol at the beach had more severe sunburns than nondrinkers and had a higher frequency of analgesic use after sunburn (69% vs 26%, P =.007). Five men (5/18 [28%]) and 4 women (4/38 [10%]) missed a total of 9 and 8 days of work, respectively, because of sunburn within the prior year. Based on these findings and attendant assumptions, it is estimated that sunburn may account for as many as 92 720 lost workdays by Galveston beachgoers each year. The annual economic impact for lost work and treatment may exceed $10 million. CONCLUSION: Sunburn is a costly and preventable skin injury.