Attention deficit hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder in children and is increasing in prevalence. There has also been a related increase in prescribing stimulant medication despite some controversy whether ADHD medication makes a lasting difference in school performance or achievement. Families who are apprehensive about side effects and with concerns for efficacy of medication pursue integrative medicine as an alternative or adjunct to pharmacologic and cognitive behavioral treatment approaches. Integrative medicine incorporates evidence-based medicine, both conventional and complementary and alternative therapies, to deliver personalized care to the patient, emphasizing diet, nutrients, gut health, and environmental influences as a means to decrease symptoms associated with chronic disorders. Pediatric integrative medicine practitioners are increasing in number throughout the United States because of improvement in patient health outcomes. However, limited funding and poor research design interfere with generalizable treatment approaches utilizing integrative medicine. The use of research designs originally intended for drugs and procedures are not suitable for many integrative medicine approaches. This article serves to highlight integrative medicine approaches in use today for children with ADHD, including dietary therapies, nutritional supplements, environmental hygiene, and neurofeedback.

Background: An adequate health workforce is an essential building block of effective health systems. In South Africa, medical officers (MOs) are a key component of service delivery in district health services. The Stellenbosch University Family Physician Research Network in the Western Cape identified that retention of MOs was a key issue. The aim of this study was to explore the factors that influence the retention of MOs in public sector district health services in the Western Cape, South Africa.Methods: This is a descriptive exploratory qualitative study. Medical officers were purposefully selected in terms of districts, facility types, gender, seniority and perceived likelihood of leaving in the next four years. Semi-structured interviews were performed by family physicians, and the qualitative data were analysed using the framework method.Results: Fourteen MOs were interviewed, and four major themes were identified: career intentions; experience of clinical work; experience of the organisation; and personal, family and community issues. Key issues that influenced retention were: ensure that the foundational elements are in place (e.g. adequate salary and good infrastructure), nurture cohesive team dynamics and relationships, have a family physician, continue the shift towards more collaborative and appreciative management styles, create stronger career pathways and opportunities for professional development in the district health services, be open to flexible working hours and overtime, and ensure workload is manageable.Conclusion: A number of important factors influencing retention were identified. Leaders and managers of the healthcare services could intervene across these multiple factors to enhance the conditions needed to retain MOs.

BackgroundDespite the high prevalence of burnout among doctors, studies have shown that some doctors who choose to remain in primary healthcare (PHC) survive, even thrive, despite stressful working conditions. The ability to be resilient may assist family physicians (FPs) to adapt successfully to the relatively new challenges they are faced with. This research seeks to explore resilience through reflection on the lived experiences of FPs who have been working in PHC.AimTo explore the resilience of FPs working in PHC in the Cape Metropole.SettingThe study was conducted among FPs in PHC in the Cape Town metropole, Western Cape province, South Africa.MethodsA phenomenological qualitative study involved interviewing 13 purposefully selected FPs working in the public sector PHC in the Cape Metropole. Data were analysed using the framework method.ResultsThe mean resilience scale was moderate. Six key aspects of resilience were identified: having a sense of purpose, ‘silver lining’ thinking, having several roles with autonomy, skilful leadership, having a support network and self-care.ConclusionThe aspects that contribute to FP resilience are multi-faceted. It entails having a sense of purpose, ‘silver lining’ thinking, having several roles with autonomy, skilful leadership, having a support network and valuing self-care. Our exploration of resilience in FPs in the Cape Metropole corroborates the findings of previous studies. To ensure physician wellness and improved patient outcomes, we recommend that individual and organisational strategies should be implemented in the absence of long-term policy changes.

The COVID-19 Community Research Partnership (CCRP) is a multisite surveillance platform designed to characterize the epidemiology of the SARS-CoV-2 pandemic. This manuscript describes the CCRP study design and methodology. The CCRP includes two prospective cohorts, one with six health systems in the mid-Atlantic and southern United States, and the other with six health systems in North Carolina. With enrollment beginning April 2020, sites invited persons within their healthcare systems as well as community members to participate in daily surveillance for symptoms of COVID-like illnesses, testing and risk behaviors. Participants with electronic health records were also asked to volunteer data access. Subsets of participants, representative of the general population and including oversampling of populations of interest, were selected for repeated at home serology testing. By October 2021, 65,739 participants (62,261 adult and 3,478 pediatric) were enrolled, with 89% providing syndromic data, 74% providing EHR data, and 70% participating in one of two serology sub-studies. An average of 62% of participants completed a daily survey at least once a week, and 55% of serology kits were returned. The CCRP provides rich regional epidemiologic data and the opportunity to more fully characterize the risks and sequelae of SARS-CoV-2 infection.

Integrative medicine is a quickly expanding field of health care that emphasizes nutrition as a key component. Dietitians and nutritionists have an opportunity to meet workforce demands by practicing dietetics and integrative medicine (DIM). The purpose of this article is to describe a DIM education program and practicum. We report the results of an interprofessional nutrition education and practicum program between the University of Kansas Medical Center (KUMC) Department of Dietetics and Nutrition and KU Integrative Medicine. This partnered program provides training that builds on the strong foundation of the Nutrition Care Process and adds graduate-level educational and practicum experiences in foundational integrative medicine knowledge, including nutritional approaches from a systems biology perspective, nutrigenomics, and biochemistry as the core knowledge to understand the root cause of a chronic disorder and to choose appropriate nutritional tools for interventions. This interprofessional KUMC program provides a dietetic internship, master's degree, and graduate certificate in DIM and fulfills a need for dietitians and nutritionists who seek careers practicing in an integrative medicine setting. The program fulfills expanding workforce needs to provide quality health care for patients with chronic illnesses.