Journal of general internal medicine
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Randomized Controlled Trial Comparative Study
Financial incentives for extended weight loss: a randomized, controlled trial.
Previous efforts to use incentives for weight loss have resulted in substantial weight regain after 16 weeks. ⋯ Financial incentives produced significant weight loss over an 8-month intervention; however, participants regained weight post-intervention.
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Multicenter Study Comparative Study
Ethnic differences in the self-recognition of obesity and obesity-related comorbidities: a cross-sectional analysis.
Obesity and its related co-morbidities place a huge burden on the health care system. Patients who know they are obese may better control their weight or seek medical attention. Self-recognition may be affected by race/ethnicity, but little is known about racial/ethnic differences in knowledge of obesity's health risks. ⋯ African-Americans and Hispanics are significantly less likely to self report obesity and associated health risks. Educational efforts may be necessary, especially for patients with BMIs between 30 and 35.
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While evidence-based medicine (EBM) has advanced medical practice, the health care system has been inconsistent in translating EBM into improvements in health. Disparities in health and health care play out through patients' limited ability to incorporate the advances of EBM into their daily lives. Assisting patients to self-manage their chronic conditions and paying attention to unhealthy community factors could be added to EBM to create a broader paradigm of evidence-based health. A perspective of evidence-based health may encourage physicians to consider their role in upstream efforts to combat socially patterned chronic disease.
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Multicenter Study Comparative Study
Food insufficiency and health services utilization in a national sample of homeless adults.
Homeless people have high rates of hospitalization and emergency department (ED) use. Obtaining adequate food is a common concern among homeless people and may influence health care utilization. ⋯ One-fourth of homeless adults in this national survey were food insufficient, and this was associated with increased odds of acute health services utilization. Addressing the adverse health services utilization patterns of homeless adults will require attention to the social circumstances that may contribute to this issue.
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Comparative Study
Why do patients agree to a "Do not resuscitate" or "Full code" order? Perspectives of medical inpatients.
The majority of patients who die in hospital have a "Do Not Resuscitate" (DNR) order in place at the time of their death, yet we know very little about why some patients request or agree to a DNR order, why others don't, and how they view discussions of resuscitation status. ⋯ Our study identified important differences and commonalities between the perspectives of DNR and FC patients. We hope that this information can be used to help physicians better understand the needs of their patients when discussing resuscitation.