Journal of general internal medicine
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The development of rigorous, high-quality clinical guidelines increases the need for resources and skilled personnel within guideline-producing organizations. While collaboration between organizations provides a unique opportunity to pool resources and save time and effort, the collaboration presents its own unique challenges. ⋯ The survey identified organizational challenges in supporting rigorous guideline development, including the time, resources, and personnel required. Connecting guideline developers to existing databases of high-quality systematic reviews and the use of freely available online platforms may facilitate guideline development. Guideline-producing organizations may also consider allocating resources to hiring or training personnel with expertise in systematic review methodologies or utilizing resources more effectively by establishing collaborations with other organizations.
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While hate crimes rose during the COVID-19 pandemic, few studies examined whether this pandemic-time racial discrimination has led to negative health consequences at the population level. ⋯ Racial discrimination may be associated with higher likelihood of distress, and cigarette smoking among racial and ethnic minorities. Addressing racial discrimination is important for mitigating negative mental and behavioral health ramifications of the pandemic.
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The emotional stress of caring for someone with Alzheimer's disease and related dementias is high and results in adverse effects on caregivers and the persons living with disease. In preliminary work, caregiver reports of regularly feeling "completely overwhelmed" were associated with lack of measurable clinical benefit from a comprehensive dementia care program. ⋯ A single question about whether a caregiver is overwhelmed might indicate caregivers who have considerable current and future symptom burden and who may benefit from increased support and resources.
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The American Board of Internal Medicine Foundation's Choosing Wisely campaign has resulted in a vast number of recommendations to reduce low-value care. Implementation of these recommendations, in conjunction with patient input, remains challenging. ⋯ Specific voting categories, along with the use of patient-friendly language, allowed for the successful co-creation of recommendations.