Journal of general internal medicine
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Multicenter Study Comparative Study
Persistent depression affects adherence to secondary prevention behaviors after acute coronary syndromes.
The persistence of depressive symptoms after hospitalization is a strong risk factor for mortality after acute coronary syndromes (ACS). Poor adherence to secondary prevention behaviors may be a mediator of the relationship between depression and increased mortality. ⋯ Persistently depressed patients were less likely to adhere to behaviors that reduce the risk of recurrent ACS. Differences in adherence to these behaviors may explain in part why depression predicts mortality after ACS.
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Comparative Study Controlled Clinical Trial
Medical comorbidity in women and men with schizophrenia: a population-based controlled study.
Persons with persistent mental illness are at risk for failure to receive medical services. In order to deliver appropriate preventive and primary care for this population, it is important to determine which chronic medical conditions are most common. ⋯ Schizophrenia is associated with substantial chronic medical burden. Familiarity with conditions affecting persons with schizophrenia may assist programs aimed at providing medical care for the mentally ill.
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Comparative Study
The effect of market reform on racial differences in hospital mortality.
To determine whether racial differences in hospital mortality worsened after implementation of a New Jersey law in 1993 that reduced subsidies for uninsured hospital care and changed hospital payment from rate regulation to price competition. ⋯ Market-based reform and reductions in subsidies for hospital care for the uninsured in New Jersey were associated with worsening racial disparities in in-hospital mortality for AMI but not for 6 other common conditions.
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Comparative Study
Prevalence of basic information technology use by U.S. physicians.
Information technology (IT) has been advocated as an important means to improve the practice of clinical medicine. ⋯ In early 2004, the majority of physicians did not regularly use basic, inexpensive, and widely available IT tools in clinical practice. Efforts to increase the use of IT in medicine should focus on practice-level barriers to adoption.
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A profound and moving spirituality provided emotional and psychological support for most terminally ill patients at Grady Memorial Hospital. The authors were able to trace the roots of these patients' spirituality to core beliefs described by African-American theologians. ⋯ Importantly, almost all patients were willing to share their beliefs with the authors in long bedside interviews. This willingness to share indicates that physicians can learn about and validate such patients' spiritual sources of support.