Journal of general internal medicine
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Smoking starts in early adulthood and persists throughout the life course, but the association between these trajectories and midlife cognition remains unclear. ⋯ The association between early to midlife smoking trajectories and midlife cognition was dose-dependent. Results underscore the cognitive health risk of moderate and heavy smoking and the potential benefits of quitting on cognition, even in midlife.
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Randomized Controlled Trial
Computerized Intervention in Primary Care for Women Veterans with Sexual Assault Histories and Psychosocial Health Risks: a Randomized Clinical Trial.
Sexual assault is a public health concern for women and is associated with subsequent psychosocial health risks of posttraumatic stress disorder (PTSD), hazardous drinking, and intimate partner violence (IPV). Sexual assault is associated with social stigma and other barriers shown to inhibit one from seeking mental health care. Digital health technologies may overcome these barriers. ⋯ SHE was effective in improving mental health treatment initiation and utilization compared to a control group. Computer-based interventions to address sexual trauma and its consequences are acceptable, are highly scalable, and can add value to primary care with little cost or increase in provider time.
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Stakeholder advisory boards are recognized as an essential and useful part of patient-centered research. However, such engagement can involve exchanges of diverse individual experiences, multiple opinions, and strong feelings in the face of researchers' limitations, deadlines, and agendas. Yet, little work examines how these potential tensions occur and are resolved in actual advisory board meetings. ⋯ Our analysis focused on two short excerpts from the first PAC meeting to demonstrate members' navigation of advice-giving and advice-receiving-one in which advice was ultimately implemented by the study team and another in which it was deemed unfeasible. Although advice is inherent to the work of all PACs, it often emerges unannounced as negotiated moments, made up of seemingly minor conversation moves. As a recurring event, advice can and should be analyzed and discussed within PACs to improve communication and team dynamics.
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Editorial
Embracing Social Engagement in Academic Medicine: Ongoing Challenges and How to Move Forward.
Academic medical centers have historically been defined by scientific discovery for health advancement. However, the mounting challenges of modern medicine are fueled by the social, economic, and political determinants of health that predict vulnerability and accelerate poor outcomes. To surmount looming threats to health, the academic medical mindset must equally prioritize social engagement-work that directly addresses the systemic social causes of health and illness-alongside the traditional pedagogy of laboratory-based, translational, and clinical research. ⋯ Academic medicine has the agency to support elements of restructuring to help prioritize research, education, and training to more prominently include social engagement. Crucial steps to ensure the success of this process include prioritizing financial commitments to community-engaged scholarship and programmatic work and rigorous recognition of faculty who work on socially engaged scholarship within promotion schemes. The COVID pandemic presents an unprecedented opportunity for academic medicine to reflect on the breadth of the work we promote and encourage, work that reflects all the complex elements of health-those that can be documented in a lab notebook and those rooted in social systems and structures that we have neglected for too long.