Journal of general internal medicine
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An African American male to female transgender patient treated with estrogen detected a breast lump that was confirmed by her primary care provider. The patient refused mammography and 14 months later she was diagnosed with metastatic breast cancer with spinal cord compression. ⋯ Analysis suggests dissociation between the patient's social and biological identities, fear and fatalism around cancer screening, and legitimization of injectable hormones. This case emphasizes the importance of eliciting and interpreting a patient's conceptions of health and illness when discordant understandings develop between patient and physician.
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Multicenter Study Controlled Clinical Trial
Implementation of the Tobacco Tactics program in the Department of Veterans Affairs.
Smoking cessation services in the Department of Veterans Affairs (VA) are currently provided via outpatient groups, while inpatient cessation programs have not been widely implemented. ⋯ A large proportion of inpatient nursing staff can rapidly be trained to deliver tobacco cessation interventions to inpatients resulting in increased provision of services.
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Personal health records (PHRs) are designed to help people manage information about their health. Over the past decade, there has been a proliferation of PHRs, but research regarding their effects on clinical, behavioral, and financial outcomes remains limited. The potential for PHRs to facilitate patient-centered care and health system transformation underscores the importance of embracing a broader perspective on PHR research. ⋯ These lessons are applicable to other PHR systems and the conduct of PHR research across different organizational contexts.
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Comparative Study
The day-to-day impact of urogenital aging: perspectives from racially/ethnically diverse women.
Urogenital symptoms affect up to half of women after menopause, but their impact on women's day-to-day functioning and wellbeing is poorly understood. ⋯ Urogenital symptoms can have a marked impact on sexual functioning, everyday activities, emotional wellbeing, body image, and interpersonal relations after menopause. Clinicians may need to question women actively about these symptoms, as many are reluctant to seek help for this problem.