Journal of general internal medicine
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The presence of angiotensin receptor blockers (ARBs) on the formularies of Medicare Part D prescription drug plans (PDPs) is vitally important to the health of seniors who cannot tolerate angiotensin-converting enzyme (ACE) inhibitors. ⋯ Whereas ARBs are present on all Part D formularies, many seniors will pay more for these drugs under Part D. Any savings in copayments under Part D may be erased by the monthly premium and by more expensive cost-sharing when seniors reach the 'donut hole'.
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Clinical performance examinations (CPX) with standardized patients (SPs) have become a preferred method to assess communication skills in US medical schools. Little is known about how trainees' backgrounds impact CPX performance. ⋯ Even after controlling for English language knowledge as measured in MCAT verbal scores, speaking a primary childhood language other than English is associated with lower CPX communication scores for Asian students. While poorer communication skills cannot be ruled out, SP exams may contain measurement bias associated with differences in childhood language or culture. Caution is indicated when interpreting CPX communication scores among diverse examinees.
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Vitamin D deficiency, an important risk factor for osteoporosis and other chronic medical conditions, is epidemic in the United States. Uninsured women may be at an even higher risk for vitamin D deficiency than others owing to low intake of dietary and supplemental vitamin D and limited sun exposure. ⋯ These results demonstrate a high prevalence of vitamin D deficiency in an uninsured, medically underserved female population. Uninsured women should be strongly encouraged to increase their vitamin D intake.
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The objective of the study is to understand patient factors contributing to the chronicity of benzodiazepine use by older adults as a first step in the development of acceptable intervention strategies for taper/discontinuation or prevention of chronic use. ⋯ The reluctance of older chronic benzodiazepine users to taper or discontinue use highlights the importance of prevention and early intervention strategies to avoid the development of chronic use. Suggestions for curbing chronic use are presented.
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Complementary degree programs and research training are important alternative tracks in medical school that typically interrupt the traditional MD curriculum. ⋯ Delays of > or = 3 years between the second and third years of medical school are associated with lower grades and scores on clinical knowledge tests. Further research is needed to determine the optimal timing of research training and develop effective interventions to facilitate reentry into the medical school curriculum.