Journal of general internal medicine
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Randomized Controlled Trial
Dissociation Between Long-term Weight Loss Intervention and Blood Pressure: an 18-month Randomized Controlled Trial.
Obesity is associated with elevated blood pressure (BP). In patients with obesity and hypertension, weight loss lowers BP, but the long-term effect of weight loss on BP is less clear. ⋯ ClinicalTrials.gov Identifier: NCT01530724.
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In 2020, roughly 25% of applicants who matched into internal medicine (IM) residencies were international medical graduates (IMGs). We examine 12-year trends in distribution of IMGs among IM training programs and explore differences in program perceptions towards IMG recruitment. ⋯ Our study was limited to exploring program factors in residency recruitment and did not assess applicant preferences. There is a large, longstanding difference in the recruitment of IMGs to US community-based and university residencies, beginning during the interview and ranking process. Further research in disparities in IMG recruitment is needed, including exploring pressures, preferences, and potential biases associated with the recruitment of IMGs.
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Stable, affordable housing is an established determinant of health. As affordable housing shortages across the USA threaten to displace people from their homes, it is important to understand the implications of cost-related residential moves for healthcare access. ⋯ People who have moved due to unaffordable housing represent a population at increased risk for unmet medical needs. Policy makers seeking to improve population health should consider strategies to limit cost-related moves and to mitigate their adverse effects on healthcare access.
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Patient-perpetrated sexual harassment adversely affects healthcare organizations, staff, and other patients, yet few institutions have clear policies to address it. Understanding the challenges to addressing patient-perpetrated harassment can inform development of institutional guidelines and interventions. ⋯ VA offers unique opportunities for studying patient-perpetrated harassment of women staff and patients due to its majority-male patient population, culture informed by military gender norms, and commitment to reducing harassment at its facilities. Our findings highlight the complexity of addressing patient-perpetrated harassment and underscore the need for systemic, multilevel interventions.
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Patients with disabilities often require healthcare accommodations in order to access high-quality, equitable healthcare services. While attention has been paid to accommodation needs in specific disability populations, limited research to date has explored healthcare accommodations that cross-cut diverse disability populations. ⋯ These identified themes represent specific opportunities for healthcare teams to effectively provide accessible care to patients with disabilities. Many of the accommodations require minimal financial investment, but did require behavioral changes by the healthcare team to ensure equitable healthcare.