Journal of general internal medicine
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Little is known about patients' experiences with benzodiazepine (BZD) discontinuation, which is thought to be challenging given the physiological and psychological dependence and accompanying potential for significant withdrawal symptoms. The marked decline in BZD prescribing over the past decade in the US Department of Veterans Affairs healthcare system presents an important opportunity to examine the experience of BZD discontinuation among long-term users. ⋯ BZD discontinuation after long-term use is relatively well tolerated, and participants appreciated reducing their medication exposure, particularly to one associated with physical dependence. These findings may help reduce both patient and clinician anxiety related to BZD discontinuation.
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Burnout is common among medical trainees. Whether brief periods of training on the internal medicine ward leads to resident burnout is unknown. ⋯ Seven in ten residents are in a state of burnout after completing internal medicine ward rotations. Interventions to mitigate burnout development during periods of high intensity clinical training are needed.
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Medical interpretation is an underutilized resource, despite its legal mandate and proven efficacy in improving health outcomes for populations with low English proficiency. This disconnect can often be attributed to the costs and wait-times associated with traditional means of interpretation, making the service inaccessible and burdensome. ⋯ The impetus to utilize this burgeoning tool for improved health equity must be combined with a critical view of the safety, privacy, and clinical decision-making risks involved. Physicians must be active participants and collaborators in both the mobilization of AI tools to improve clinical care and the development of regulations to mitigate harm.
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Observational Study
Continuation of Buprenorphine During Hospitalization and Subsequent Retention in Therapy: an Observational Study in Veterans Administration Hospitals.
Inpatient hospitalization has the potential to disrupt buprenorphine therapy. ⋯ Inpatient buprenorphine administrations near the time of discharge were highly predictive of continued outpatient therapy and a significant subset of patients did not continue or reinitiate buprenorphine therapy following discharge. As recommendations for perioperative and inpatient management of buprenorphine coalescence around continuation, efforts are needed to optimize hospital-based buprenorphine practices.
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Burnout is common and can lead to worse outcomes for both healthcare workers and patients. Our study purpose was to assess the structural relationship among factors that protect against or worsen burnout. ⋯ Burnout is common among Japanese ICU professionals. Resilience, teamwork, and safety are all correlated with reduced burnout. Those who had depression or anxiety or COVID fear had higher degrees of burnout, an effect that appears to be mediated by reduced resilience. These are potential targets for interventions to reduce burnout.