Journal of general internal medicine
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In January 2003, people covered by Oregon's Medically Needy program lost benefits owing to state budget shortfalls. The Medically Needy program is a federally matched optional Medicaid program. In Oregon, this program mainly provided prescription drug benefits. ⋯ The Medically Needy program provided coverage for a low-income, chronically ill population. Since its termination, enrollees have decreased prescription drug use and increased financial burden. As states make program changes and Medicare Part D evolves, effects on vulnerable populations must be considered.
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Very little is known about complementary and alternative medicine (CAM) use in Asian Americans (AA), especially on a national level. To compare CAM use, reasons for use, and disclosure rates between Asian and non-Hispanic white Americans (NHW), and examine ethnic variations among AA. Data on CAM use in the past year (excluding prayer) were used from the 2002 National Health Interview Survey for 917 AA and 20,442 NHW. ⋯ Among AA, CAM use was associated with being female, having higher education, and having a chronic medical condition; foreign-birth was not associated with CAM use. Complementary and alternative medicine use is common among AA, and there are important ethnic variations in use. Asian Americans are less likely than NHW to disclose CAM use to conventional healthcare providers, suggesting that it is particularly important that physicians query AA patients about CAM use.
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Increasing numbers of medicines increase nonadherence. Little is known about how older adults manage multiple medicines for multiple illnesses. ⋯ Prescribing a new medicine, a change in provider or copayment can provoke new choices about both new and existing medications in older adults with multiple morbidities.
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Comparative Study
A ten-month program in curriculum development for medical educators: 16 years of experience.
Despite increased demand for new curricula in medical education, most academic medical centers have few faculty with training in curriculum development. ⋯ This model for training in curriculum development has long-term sustainability and is associated with participant satisfaction, improvement in self-rated skills, and implementation of curricula on important topics.
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Kawasaki Disease is a small-to-medium-vessel vasculitis that preferentially affects children. Kawasaki Disease can occur in adults, but the presentation may differ from that observed in children. Typical findings in both adults and children include fever, conjunctivitis, pharyngitis, and skin erythema progressing to a desquamating rash on the palms and soles. ⋯ We report a case of acute Kawasaki Disease in a 24-year-old man who presented with rash, fever, and arthritis. He was successfully treated with high-dose aspirin and intravenous immunoglobulin (IVIG). Our case highlights the importance of considering Kawasaki Disease in adults presenting with symptoms commonly encountered in a general medical practice.