Journal of general internal medicine
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Comparative Study
Correlates of use of antifracture therapy in older women with low bone mineral density.
Guidelines exist for treatment of low bone mineral density (BMD). Little is known about patient characteristics associated with use of treatment. ⋯ Even when physicians of study participants were provided with DXA scan results, 70% of older high-functioning women with an indication for therapy did not start or remain on an antifracture therapy. Substantial room for improvement exists in fracture prevention following a diagnosis of low BMD-especially among women with a history of falls, prior fractures, and among black women.
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During clinical training, house officers frequently encounter intense experiences that may affect their personal growth. The purpose of this study was to explore processes related to personal growth during internship. ⋯ Efforts to support personal growth during residency training include fostering supportive relationships, encouraging reflection, and recognizing interns' core values especially in association with powerful triggers.
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Editorial Comparative Study
Race, ethnicity, culture, and disparities in health care.
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Little is known about the relation between perceptions of health care discrimination and use of health services. ⋯ Persons who report discrimination may be less likely to receive some preventive health services. However, perceived discrimination is unlikely to account for a large portion of observed disparities in receipt of preventive care.
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Comparative Study
Osteoporosis risk assessment and ethnicity: validation and comparison of 2 clinical risk stratification instruments.
Dual energy x-ray absorptiometry (DXA), coupled with early treatment, may reduce morbidity and mortality associated with osteoporosis. Clinical tools to enhance selection of women for DXA screening have not been developed or validated in an ethnically diverse population. ⋯ The performance of the ORAI and SCORE instrument differed significantly from previous reports. Although both can reduce the use of DXA scans for screening for osteoporosis, lower sensitivities resulted in underrecognition of osteoporosis and may limit their clinical usefulness in an ethnically diverse population.