J Am Board Fam Med
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The Colorado Asthma Toolkit Program (CATP) has been shown to improve processes of care with less evidence demonstrating improved outcomes. ⋯ Implementation of the CATP in a primary care setting led to some improved processes of asthma care, but no changes in measured outcomes. Recommendations for future work include supplemental follow-up training including case review.
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Clinical Trial
Awareness of Prediabetes Status and Subsequent Health Behavior, Body Weight, and Blood Glucose Levels.
Lifestyle intervention decreases diabetes risk in prediabetic subjects, but the impact of passive notification of prediabetes status on glycemia or health behavior is unclear. ⋯ Communication of prediabetes status is associated with improvements in glucose tolerance, glycemia, and adiposity, probably via self-directed lifestyle modification.
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Dermoscopy aids family physicians (FPs) in skin cancer detection. The triage amalgamated dermoscopic algorithm (TADA) was created to simplify the dermoscopic evaluation of a skin growth. The purpose of this image-based study was to evaluate the effect of teaching the clinical and dermoscopic features of benign skin lesions on the diagnostic accuracy of skin cancer identification using TADA. We also sought to determine the best method to teach benign neoplasms. ⋯ Short dermoscopy training sessions with dedicated time for benign growths followed by TADA training for malignant growths are an effective means of teaching FPs dermoscopy and result in a high sensitivity and specificity for the identification of benign and malignant skin neoplasms.
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Discussions about racism, ethnicity, sexism, discrimination, and diversity have increased within medicine, and their impact on the physician workforce, advancement, hiring, wage inequities, mistreatment, and scholarly output, to name a few. Most medical organizations have created policies and initiatives on diversity and inclusion, focusing on supporting underrepresented minorities. Similar discussions are taking place online, including on Twitter, via specific hashtags, such as #BlackMenInMedicine, #ILookLikeASurgeon. News reports suggested some of these hashtags were "trending." We set out to assess selected hashtags and analyze their spread, as well as whether or how health professional organizations publicized or amplified this emerging discourse on Twitter. ⋯ Strengthening, deepening and, ultimately, expanding the conversation on diversity and inclusion in medicine on Twitter requires an intentional and strategic use of hashtags, photographs and links; Engaging "influencers" such as mainstream media and medical organizations is also critical to more widespread dissemination.
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Latino health deserves intense focus in promoting a just health care system. Despite the surprisingly positive health outcomes associated with the "Hispanic Paradox" phenomenon, the trend of Latino immigrants tending to have better health outcomes than other minorities, linguistic issues persist. The following essay is a combination of actual patient encounters through my experiences serving Spanish-speaking patients, as a medical student and Spanish speaker, and a reflection on the clash between impersonal interpretation services and Hispanic cultural values. I then present potential initiatives to improve rapport in patient encounters while maintaining the standard of care across foreign language barriers.