Journal of general internal medicine
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To evaluate the prevalence of and factors associated with depression among HIV-infected homeless and marginally housed men. ⋯ Depression is a major comorbidity among the HIV-infected urban poor. Given that missed medical appointments and alcohol use are likely indicators of depression and contributors to continued depression, alternate points of contact are necessary with many homeless individuals. Providers may consider partnering with payees to improve follow-up with individuals who are HIV-positive, homeless, and depressed.
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Postgraduate training involves intensive clinical education characterized by long work hours with minimal flexibility. Time demands may be a barrier to obtaining preventive care for housestaff during postgraduate training. ⋯ Housestaff accurately perceived their need for cervical cancer screening and were generally adherent to USPSTF recommendations, even though lack of time during postgraduate training was frequently reported as a barrier to obtaining preventive care. However, we found lower adherence among a small subgroup of housestaff at a slightly greater risk for cervical disease and most likely to benefit from screening.
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Homelessness and hunger are associated with poor health outcomes. Housing instability and food insecurity describe less severe problems securing housing and food. ⋯ Housing instability and food insecurity are associated with poor access to ambulatory care and high rates of acute care. These competing life demands may lead to delays in seeking care and predispose to acute care.
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To use qualitative methods to explore audiotape evidence of unanticipated confusion between benign prostatic hyperplasia (BPH) and prostate cancer in using a videotape BPH treatment decision aid (DA). ⋯ Overall knowledge increases with DA use may mask incorrect theories of disease process. Further research should identify decision support designs and clinical counseling strategies to address persistence of beliefs contrary to new information presented in evidence-based DAs.