Journal of general internal medicine
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Randomized Controlled Trial
Predictors of quitting among African American light smokers enrolled in a randomized, placebo-controlled trial.
To examine the predictors of quitting among African American (AA) light smokers (<10 cigarettes per day) enrolled in a smoking cessation trial. ⋯ Individual characteristics may decrease the likelihood of quitting; however, the provision of directive, advice-oriented counseling focused on the addictive nature of nicotine, health consequences of smoking, benefits of quitting, and development of a concrete quit plan may be an important and effective facilitator of quitting among AA light smokers.
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Many scholars have written about the historical underpinnings and likely consequences of African Americans distrust in health care, yet little research has been done to understand if and how this distrust affects African Americans' current views of the trustworthiness of physicians. ⋯ Unique factors contribute to trust and distrust in physicians among African-American patients. These factors should be considered in clinical practice to facilitate trust building and improve health care provided to African Americans.
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Multicenter Study
How do providers assess antihypertensive medication adherence in medical encounters?
Poor adherence to antihypertensives has been shown to be a significant factor in poor blood pressure (BP) control. Providers' communication with patients about their medication-taking behavior may be central to improving adherence. ⋯ Providers often do not ask about medication-taking behavior, and may not use the most effective communication strategies when they do. Focusing on the ways in which providers ask about patients' adherence to medications may improve BP control.
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Multicenter Study
Lack of adherence with preoperative B-blocker recommendations in a multicenter study.
Clinical guidelines support the use of preoperative B-blocker in select patients. Patient safety groups have sought to measure the level of adherence to these recommendations. ⋯ Preoperative B-blocker was significantly underutilized when compared with the current guideline recommendations. Target heart rate goals were not achieved in clinical practice, and few hospitalized patients had preoperative B-blockade initiated. The lack of adherence to preoperative B-blocker recommendations in practice may be impacted by ongoing clinical questions regarding the appropriate selection of candidates for this therapy. Further efforts toward achieving guideline recommendations for preoperative B-blocker use should be focused on the subset of patients that are uniformly agreed upon to be at high risk for cardiac events.
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As educators seek confirmation of successful trainee achievement, medical education must move toward a more evidence-based approach to teaching and evaluation. Although medical training often provides physicians with a general background in biostatistics, many are not prepared to apply these skills. ⋯ This paper is intended to be a concise educational tool and guide for choosing and interpreting statistical tests aimed toward medical education assessment. It includes guidelines and examples that clinician-educators can use when analyzing and interpreting studies and when writing methods and results sections of reports.