Journal of general internal medicine
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Traditional residency training may not promote competencies in patient-centered care. ⋯ A patient-centered inpatient curriculum was associated with higher satisfaction ratings in patient-centered domains by internal medicine residents and with higher satisfaction ratings of their physicians by patients. Future research will explore the intervention's impact on clinical outcomes.
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Early provider-patient communication about future care is critical for patients with heart failure (HF); however, advance care planning (ACP) discussions are often avoided or occur too late to usefully inform care over the course of the disease. ⋯ Physicians often missed the opportunity to engage in ACP despite openers patients provided that could have prompted such discussions. Communication training efforts should focus on helping physicians identify patient openers and providing a toolbox to encourage appropriate physician responses; in order to successfully leverage opportunities to engage in ACP discussions.
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Multicenter Study Comparative Study
Evaluation of the PHQ-9 Item 3 as a screen for sleep disturbance in primary care.
Sleep disturbance is a significant problem for adults presenting to primary care. Though it is recommended that primary care providers screen for sleep problems, a brief, effective screening tool is not available. ⋯ Item 3 of the PHQ-9 shows promise as a screener for sleep problems in primary care. Using this one-item of a popular screening measure for depression in primary care allows providers to easily screen for two important issues without unnecessarily adding significant burden.
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Review Meta Analysis
The relationship between distal and proximal colonic neoplasia: a meta-analysis.
To investigate the association between proximal colonic neoplasia and distal lesions as a function of the lesion type. The extent to which health, demographic, and study characteristics moderate this association was also examined. ⋯ All types of distal lesions are predictive of PN. All types of distal neoplasia are predictive of PAN. The association between distal lesions and proximal neoplasia increases with the severity of the distal lesion. The association between distal lesions and proximal advanced neoplasia is stronger in low-risk groups as compared to high-risk groups.
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Editorial Comment
From the editors' desk: it's the social determinants, stupid.