The Link - August 2024

Sharing serious news, or information that may change a patient’s (or parent’s) perception of the future in a negative way, is among the most challenging tasks of being a clinician. Often in these conversations, physicians and parents must grapple with uncertainty and high-stakes decisions. Consequences of poor communication can decrease trust, create conflict, and even impact health outcomes. Studies have shown that physicians experience stress in these encounters,1 and fear both their patients’ and their own emotional reactions.2 Many clinicians are uncomfortable in serious news situations and feel they have not received training in how to communicate effectively in these circumstances. 

Since the onset of the COVID-19 pandemic, the recommendations for COVID-19 vaccines have evolved and changed. The upcoming fall season is no exception. On June 27, the Centers for Disease Control and Prevention (CDC) announced the recommendation that everyone 6 months of age and older should receive an updated 2024-2025 COVID-19 vaccine. This recommendation does not depend on previous vaccination status. Vaccination remains the best tool to protect against severe outcomes from COVID-19 illness. The SARS-CoV-2 virus continues to evolve, and coupled with declining protection over time, an updated vaccine is necessary to provide protection from severe disease and to reduce the chance of suffering from long COVID. Moderna, Novavax and Pfizer will all have updated vaccines available this fall. Pfizer and Moderna vaccines are mRNA vaccines that have historically been for those aged 6 months and older. Novavax is a protein sub-unit vaccine for those aged 12 years and older. It is suggested that those eligible should receive one of the vaccines as soon as they become available. These vaccines can be given concurrently with influenza vaccine. More specific information will become available as the vaccines are made available. 

As I write this article, Kansas City is entering the hottest week of the year with a heat index value ranging from 105 to 110 degrees. While we may never get used to the shock of each heat wave, unfortunately these extremely hot summer days are not foreign to us. Over the past 10 years, the United States has experienced record-setting high temperatures, with 2023 being the hottest year to date. Since the 1970s, average temperatures have increased rapidly ranging from 0.32 to 0.51 F per decade.2 Globally, climate change is a major concern as it significantly impacts humans, plants and wildlife. Increased global temperatures have led to erratic weather patterns, more natural disasters (e.g., hurricanes, wildfires, floods, droughts), reduced water supply, rising ocean water levels, seasonal disruption, and significant negative impacts on ocean life.

A brief resolved unexplained event (BRUE) is a term used to describe a sudden, brief episode in an infant that involves a change in breathing, color, muscle tone or responsiveness that resolves on its own and cannot be explained after a thorough medical evaluation. Primary care providers need to understand BRUE in order to effectively manage it and, when appropriate, reassure concerned families.