Annals of internal medicine
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Identification of hepatitis C virus (HCV)-infected persons through screening could lead to interventions that improve clinical outcomes. ⋯ Agency for Healthcare Research and Quality.
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Despite recent guidelines promoting online professionalism, consequences for specific violations by physicians have not been explored. In this article, the authors gauged consensus among state medical boards in the United States (response rate, 71%) about the likelihood of investigations for violations of online professionalism by using 10 hypothetical vignettes. High consensus was defined as more than 75% of respondents indicating that investigation was "likely" or "very likely," moderate consensus as 50% to 75% indicating this, and low consensus as fewer than 50% indicating this. ⋯ Three demonstrated moderate consensus for investigation: depicting alcohol intoxication (73%; 35/48), violating patient confidentiality (65%; 31/48), and using discriminatory speech (60%; 29/48). Three demonstrated low consensus: using derogatory speech toward patients (46%; 22/48), showing alcohol use without intoxication (40%; 19/48), and providing clinical narratives without violation of confidentiality (16%; 7/48). Areas of high consensus suggest "online behaviors" that physicians should never engage in, whereas moderate- and low-consensus areas provide useful contextual information about "gray areas." Increased awareness of these specific behaviors may reduce investigations and improve online professionalism for physicians.
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U.S. HIV treatment guidelines recommend branded once-daily, 1-pill efavirenz-emtricitabine-tenofovir as first-line antiretroviral therapy (ART). With the anticipated approval of generic efavirenz in the United States, a once-daily, 3-pill alternative (generic efavirenz, generic lamivudine, and tenofovir) will decrease cost but may reduce adherence and virologic suppression. ⋯ National Institute of Allergy and Infectious Diseases.
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Randomized Controlled Trial
Improved immunogenicity with high-dose seasonal influenza vaccine in HIV-infected persons: a single-center, parallel, randomized trial.
HIV-infected persons have less robust antibody responses to influenza vaccines. ⋯ National Institute of Allergy and Infectious Diseases and Center for AIDS Research of the University of Pennsylvania.
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Although there is broad policy consensus that both cost containment and quality improvement are critical, the association between costs and quality is poorly understood. ⋯ Robert Wood Johnson Foundation.