Journal of general internal medicine
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Randomized Controlled Trial Comparative Study
Financial incentives for extended weight loss: a randomized, controlled trial.
Previous efforts to use incentives for weight loss have resulted in substantial weight regain after 16 weeks. ⋯ Financial incentives produced significant weight loss over an 8-month intervention; however, participants regained weight post-intervention.
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Multicenter Study Comparative Study
Food insufficiency and health services utilization in a national sample of homeless adults.
Homeless people have high rates of hospitalization and emergency department (ED) use. Obtaining adequate food is a common concern among homeless people and may influence health care utilization. ⋯ One-fourth of homeless adults in this national survey were food insufficient, and this was associated with increased odds of acute health services utilization. Addressing the adverse health services utilization patterns of homeless adults will require attention to the social circumstances that may contribute to this issue.
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Patients are asked to assume greater responsibility for care, including use of medications, during transitions from hospital to home. Unfortunately, medications dispensed via respiratory inhalers to patients with asthma or chronic obstructive pulmonary disease (COPD) can be difficult to use. ⋯ Inhaler misuse is common, but correctable in hospitalized patients with COPD or asthma. Hospitals should implement a program to assess and teach appropriate inhaler technique that can overcome barriers to patient self-management, including insufficient vision, during transitions from hospital to home.
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Comparative Study
Why do patients agree to a "Do not resuscitate" or "Full code" order? Perspectives of medical inpatients.
The majority of patients who die in hospital have a "Do Not Resuscitate" (DNR) order in place at the time of their death, yet we know very little about why some patients request or agree to a DNR order, why others don't, and how they view discussions of resuscitation status. ⋯ Our study identified important differences and commonalities between the perspectives of DNR and FC patients. We hope that this information can be used to help physicians better understand the needs of their patients when discussing resuscitation.
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Comparative Study
A cohort study assessing difficult patient encounters in a walk-in primary care clinic, predictors and outcomes.
Previous studies have found that up to 15% of clinical encounters are experienced as difficult by clinicians. ⋯ Both patient and physician characteristics are associated with "difficult" encounters, and patients involved in such encounters have worse short-term outcomes.