Journal of general internal medicine
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Millions of Americans have medical debt and/or defer care due to cost. Few studies have examined the association of such health-related financial problems with sexual orientation or gender identity, and whether state-level policies protecting sexual and gender minority (SGM) people affect disparities in such problems. ⋯ Lesbian/gay/bisexual, female, and transgender adults experience more health-related financial problems, especially in states lacking SGM protections, underlining the importance of universal, comprehensive insurance coverage (including for services unique to SGM people), ending bans on gender-affirming care, and closing the male-female pay gap.
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To assess the influence of neighborhood socioeconomic deprivation on the effectiveness of an intensive lifestyle intervention (ILI) in the Look AHEAD trial. ⋯ In this clinical trial population, an intensive lifestyle intervention was equally effective across levels of neighborhood socioeconomic deprivation. However, these findings may not extend to individuals with the lowest income and educational attainment who are not typically represented in clinical trials and for whom more research is needed.
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Many medical schools have incorporated clinical reasoning (CR) courses into their pre-clinical curricula to address the quality and safety issue of diagnostic error. It is unknown how students use concepts and practices from pre-clinical CR courses once in clerkships. ⋯ Concepts taught in a pre-clinical CR course influenced how students prepared for and navigated clinical encounters. Contextual factors both enhanced and inhibited the utilization of CR concepts. Our findings align with social learning theories including social cognitive theory and ecological psychology. This contextual view-taking into account interactions between personal, social, and environmental factors-can help educators integrate CR education from the classroom to the clinical setting.