Journal of general internal medicine
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Comparative Study
Personal characteristics associated with resident physicians' self perceptions of preparedness to deliver cross-cultural care.
Recent reports from the Institute of Medicine emphasize patient-centered care and cross-cultural training as a means of improving the quality of medical care and eliminating racial and ethnic disparities. ⋯ Cross-cultural care skills training is associated with increased self-perceived preparedness to care for diverse patient populations providing support for the importance of such training in graduate medical education. In addition, selected resident characteristics are associated with being more or less prepared for different aspects of cross-cultural care. This underscores the need to both include medical residents from diverse backgrounds in all training programs and tailor such programs to individual resident needs in order to maximize the chances that such training is likely to have an impact on the quality of care.
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Comparative Study
The increasing number of clinical items addressed during the time of adult primary care visits.
Primary care physicians report that there is insufficient time to meet patients' needs during clinical visits, but visit time has increased over the past decade. ⋯ The volume of work associated with primary care visits has increased to a greater extent than has visit duration, resulting in less available time to address individual items. These findings have important implications for reimbursing physician time and improving the quality of care.
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Review Meta Analysis
Periodontal disease and coronary heart disease incidence: a systematic review and meta-analysis.
Periodontal disease is common among adults in the US and is a potential source of chronic inflammation. Recent data have suggested an important role for chronic inflammation in the development of coronary heart disease (CHD). ⋯ Periodontal disease is a risk factor or marker for CHD that is independent of traditional CHD risk factors, including socioeconomic status. Further research in this important area of public health is warranted.
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Multicenter Study Comparative Study
Impact of patient race on patient experiences of access and communication in HIV care.
Patient-centered care--including the domains of access and communication--is an important determinant of positive clinical outcomes. ⋯ We observed racial disparities in patients' experience of access to care but not in patient-provider communication. Disparities were explained by poor access at minority-serving clinics. Efforts to make care more patient-centered for minority HIV-infected patients should focus more on improving access to HIV care in minority communities than on improving cross-cultural patient-provider interactions.
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Randomized Controlled Trial Comparative Study
Engaging homeless persons in end of life preparations.
There are no prospective studies that have investigated the effects of an intervention to improve end of life (EOL) care in an underserved population. ⋯ This study demonstrates that people living in dire economic and social situations will complete an AD when offered the opportunity. While offering guidance resulted in higher rates of completion; even a simple self-guided AD process can achieve completion of ADs in this population.