Journal of general internal medicine
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Because shared decision making has been recommended for screening mammography by women under age 50, we studied women's decision-making process regarding the procedure. ⋯ The women in this study demonstrated little ambivalence in their desire for mammography screening prior to age 50. They reported minimal communication with their medical providers about the risks and benefits of screening. Better information flow regarding mammography screening is necessary. Given the lack of uncertainty among women's perceptions regarding screening mammography, shared decision making in this area may be difficult to achieve.
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It is not known whether factors associated with primary care career choice affect trainees differently at different times or stages of medical education. ⋯ The effect of peer encouragement and role models on career choice differed for students and residents and, in the case of residents, by year of training, suggesting that interventions to increase the primary care workforce should be tailored to stage of training.
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To examine the association of physician nonverbal communication with standardized patient (SP) satisfaction in the context of the "quality" of the interview (i.e., information provided and collected, communication skills). ⋯ Better nonverbal communication skills are associated with significantly greater patient satisfaction in a variety of different types of clinical encounters with standardized patients. Formal instruction in nonverbal communication may be an important addition to residency.
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To examine if delayed transfer to the intensive care unit (ICU) after physiologic deterioration is associated with increased morbidity and mortality. ⋯ Slow transfer to the ICU of physiologically defined high-risk hospitalized patients was associated with increased risk of death. Slow response to physiologic deterioration may explain these findings.
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Randomized Controlled Trial Clinical Trial
Diabetes control improved when inner-city patients received graphic feedback about glycosylated hemoglobin levels.
To develop and test an inexpensive visual tool to help patients with diabetes improve glycemic control. ⋯ A graph linking GHb and self-care activities shows promise for improving glycemic control.