Journal of general internal medicine
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An African American male to female transgender patient treated with estrogen detected a breast lump that was confirmed by her primary care provider. The patient refused mammography and 14 months later she was diagnosed with metastatic breast cancer with spinal cord compression. ⋯ Analysis suggests dissociation between the patient's social and biological identities, fear and fatalism around cancer screening, and legitimization of injectable hormones. This case emphasizes the importance of eliciting and interpreting a patient's conceptions of health and illness when discordant understandings develop between patient and physician.
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Teaching effectiveness is an important criterion for promoting clinician-educators. However, the relationship between residents' psychological characteristics and their assessments of faculty physicians is unknown. ⋯ This study demonstrates that residents' well-being does not influence their assessments of faculty physicians, thus supporting the trustworthiness of these assessments as a criterion for promoting clinician-educators. However, the association between residents' empathy and resident-of-faculty assessments suggests that faculty assessments may be modestly influenced by residents' intrinsic characteristics.
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Multicenter Study Controlled Clinical Trial
Implementation of the Tobacco Tactics program in the Department of Veterans Affairs.
Smoking cessation services in the Department of Veterans Affairs (VA) are currently provided via outpatient groups, while inpatient cessation programs have not been widely implemented. ⋯ A large proportion of inpatient nursing staff can rapidly be trained to deliver tobacco cessation interventions to inpatients resulting in increased provision of services.
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Comparative Study
The day-to-day impact of urogenital aging: perspectives from racially/ethnically diverse women.
Urogenital symptoms affect up to half of women after menopause, but their impact on women's day-to-day functioning and wellbeing is poorly understood. ⋯ Urogenital symptoms can have a marked impact on sexual functioning, everyday activities, emotional wellbeing, body image, and interpersonal relations after menopause. Clinicians may need to question women actively about these symptoms, as many are reluctant to seek help for this problem.