Family medicine
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Although smoking and smokeless tobacco use are recognized as major problems among school-age youth, few studies report on tobacco use in rural areas, especially remote rural areas. ⋯ The high rate of female smokers and male chewers in senior high is consistent with other studies. The rate of female chewing tobacco use is unusually high. Isolated rural communities have significant adolescent tobacco abuse, and prevention and treatment strategies need to be developed for this special population.
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Comparative Study
Resident attrition from family practice residencies: United States versus international medical graduates.
Attrition of residents from family practice residency programs may cause significant problems for faculty, residents, and patients. The objective of this study was to determine international medical graduates' attrition rate from family practice residencies, compared with US medical school graduates. ⋯ Attrition rates from family practice residency programs are higher for international medical graduates than for US graduates. International graduates enrolled outside of the NRMP were most likely to leave a program.
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Family practice, especially when applied to the Community-oriented Primary Care model, needs to incorporate the epidemiological profile and health care needs of a particular community. The rapidly growing Latino population is creating a great number of largely Latino communities. While they tend to have high poverty rates and low education rates, their family and health profiles contradict many assumptions made about poor, underserved minority groups. ⋯ Latinos do, however, have higher death rates due to motor vehicle accidents and cirrhosis than Anglos, blacks, or Asians and a diabetes death rate higher than Anglos or Asians. Surprisingly, Latinos have lower age-adjusted death rates due to drug-related causes and weapons-related causes than Anglos or blacks, but substantially higher than Asians. It is suggested that, much against the stereotype, Latinos should be considered a high-level wellness population for whom family practice, based on prevention and primary care, would be an ideal match.