Journal of general internal medicine
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"Code-switching"-the mixing of languages, dialects, tones, or lexicons within a single conversation-is a prevalent linguistic phenomenon that has been described thoroughly in the social science literature. However, it is relatively unknown to the medical community despite its clear implications for clinicians as they navigate their role in the physician-patient relationship. As multilingualism and other forms of mixed speech become increasingly common in the urban and globally minded populations of America's modern cities, physicians must be cognizant of how they use their language skills-such as code-switching-to communicate with their patients in an ethical, supportive, and non-offensive manner. Multidisciplinary literature, case studies, and thought experiments on the subject provide an actionable framework by which health professionals can work toward achieving this goal of cultural competence.
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Clusters of breast cancer with varied incidence or mortality are known to exist. No national scale of analysis of geographical variation in breast cancer incidence has been published before for the contiguous USA. ⋯ There exist several significant clusters in the contiguous USA, both for breast cancer incidence and for breast cancer mortality. Some of the clusters persisted even after adjusting for several key risk factors. These geographic areas warrant further investigation to potentially identify additional local concerns or needs to further address female breast cancer in those specific sites.
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