Journal of general internal medicine
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Depression management can be challenging for primary care (PC) settings. While several evidence-based models exist for depression care, little is known about the relationships between PC practice characteristics, model characteristics, and the practice's choices regarding model adoption. ⋯ Both readiness factors and characteristics of depression care models influence model adoption. Greater model simplicity may make collocation attractive within local quality improvement efforts. Dissemination through regional networks may be effective for more complex models such as TIDES.
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Primary Care-Mental Health Integration (PC-MHI) may improve mental health services access and continuity of care. ⋯ Receipt of same-day PC-MHI may facilitate timely receipt of depression treatment.
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Readmission and mortality after hospitalization for community-acquired pneumonia (CAP) and heart failure (HF) are publically reported. This systematic review assessed the impact of social factors on risk of readmission or mortality after hospitalization for CAP and HF-variables outside a hospital's control. ⋯ A broad range of social factors affect the risk of post-discharge readmission and mortality in CAP and HF. Future research on adverse events after discharge should study social determinants of health.
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Physicians and patients increasingly use social media technologies, such as Facebook, Twitter, and weblogs (blogs), both professionally and personally. Amidst recent reports of physician misbehavior online, as well as concerns about social media's potential negative effect on trust in the medical profession, several national-level physician organizations have created professional guidelines on social media use by physicians. Missing from these guidelines is adequate attention to conflict of interest. ⋯ Moreover, in emphasizing disclosure alone, current guidelines are inconsistent with medicine's general trend toward management or elimination, not just disclosure, of potential conflicts. Because social media sites typically rely on physicians' voluntary compliance with professional norms, physicians necessarily play a major role in shaping these norms' content and scope. To achieve the benefits of social media and ensure the veracity of social media content while preserving trust in the profession, physicians must reaffirm their commitment to disclose potential conflicts; advocate for better electronic disclosure mechanisms; and develop concrete management strategies-including, where necessary, the elimination of conflicts altogether.
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Energized and productive faculty are critical to academic medicine, yet studies indicate a lack of advancement and senior roles for women. ⋯ Faculty men and women are equally engaged in their work and share similar leadership aspirations. However, medical schools have failed to create and sustain an environment where women feel fully accepted and supported to succeed; how can we ensure that medical schools are fully using the talent pool of a third of its faculty?