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Wright Butcher posted an update 1 month, 3 weeks ago
Second, during prosaccade in the gap and overlap conditions, patients with ADD had significantly longer latencies than patients with MCI, and the trend was similar during antisaccade in the gap condition as patients with ADD had significantly more errors than patients with MCI. The anti-effect magnitude was similar between controls and patients, and the magnitude of the latency of the gap effect varied among healthy controls and MCI and ADD subjects, but the effect size of the latency remained large in both patients. These findings suggest that, using gap effect, anti-effect, and specific choices of saccade paradigms and conditions, distinctions could be made between MCI and ADD patients as well as between patients and controls.In Sweden, palliative care has, over the past decades, been object to policies and guidelines with focus on how to achieve “good palliative care”. The aim of this study has been to analyse how experts make sense of the development and the current state of palliative care. Departing from this aim, focus has been on identifying how personal experiences of ‘the self’ are intertwined with culturally available meta-level concepts and how experts contribute to construct new scripts on palliative care. Twelve qualitative interviews were conducted. Four scripts were identified after analysing the empirical material 1. script of paths towards working within palliative care; 2. script of desirable and deterrent reference points; 3. script of tensions between improvement and bureaucracy; and 4. script of low status and uncertain definitions. The findings of this study illustrate how experts in complex ways intertwine experiences of ‘the self’ with meta-levels concepts in order to make sense of the field of palliative care. The participants did not endorse one “right way” of “good” deaths. Instead, palliative care was considered to be located in a complex state where the historical development, consisting of both desirable ideals, death denials and lack of guidelines, and more recent developments of strives towards universal concepts, “improvement” and increased bureaucracy altogether played a significant role for how palliative care has developed and is organised and conducted today.
Long-acting reversible contraceptives (LARCs) such as intrauterine devices (IUDs) and implants are highly effective and increasingly popular. Internal Medicine (IM) clinics and residency curricula do not routinely include LARCs, which can limit patient access to these methods. In response, internists are integrating LARCs into IM practices and residency training.
This study examines the approaches, facilitators, and barriers reported by IM faculty to incorporating LARCs into IM clinics and resident education.
We interviewed faculty who were prior or current LARC providers and/or teachers in 15 IM departments nationally. L(+)-Monosodium glutamate monohydrate Each had implemented or attempted to implement LARC training for residents in their IM practice. Semi-structured interviews were used.
Eligible participants were a convenience sample of clinicians identified as key informants at each institution.
We used inductive thematic coding analysis to identify themes in the transcribed interviews.
Fourteen respondents currently offered LARCsces, patient needs, stakeholder support, and educational goals of the program.
The model for integration of LARCs into IM clinics and resident education depends upon the clinical resources, patient needs, stakeholder support, and educational goals of the program.
Despite public perception, most of the nearly 20 million US veterans have health coverage outside the Veterans Health Administration (VHA), and VHA eligibility and utilization vary across veterans. Out-of-pocket healthcare spending thus remains a potential source of financial hardship for veterans. The Affordable Care Act (ACA) aimed to expand health insurance access, but its effect on veterans’ financial risk protection has not been explored.
To evaluate whether ACA implementation was associated with changes in veterans’ risk of catastrophic health expenditures, and to characterize drivers of catastrophic health spending among veterans post-ACA.
Using multivariable linear probability regression, we examined changes in likelihood of catastrophic health spending after ACA implementation, stratifying by age (18-64 vs 65+), household income tercile, and payer (VHA vs non-VHA). Among veterans with catastrophic spending post-ACA, we evaluated sources of out-of-pocket spending.
Nationally representative samngs highlight gaps in veterans’ financial protection and areas amenable to policy intervention.
ACA implementation was associated with reduced household catastrophic health expenditures for younger but not older veterans. These findings highlight gaps in veterans’ financial protection and areas amenable to policy intervention.
Good medication adherence is associated with decreased healthcare expenditure; however, adherence is usually assessed for single medication. We aim to explore the associations of adherence levels to 23 chronic medications with emergency room (ER) visits and hospitalizations. The primary endpoints are ER visits and hospitalizations in internal medicine and surgical wards.
Individuals aged 50-74 years, with a diagnosis of diabetes mellitus or hypertension, treated with at least one antihypertensive or antidiabetic medication during 2017 were included. We determined personal adherence rates by calculating the mean adherence rates of the medications prescribed to each individual. Adherence rates were stratified into categories. We retrieved information about all the ER visits, and hospitalizations in internal medicine and surgical wards during 2016-2018.
Of 268,792 persons included in the study, 50.6% were men. The mean age was 63.7 years. Hypertension was recorded for 217,953 (81.1%), diabetes for 160,082 g medication adherence may reduce health costs and improve patients’ health.
Some gender-based disparities in medicine may relate to pregnancy and parenthood. An understanding of the challenges faced by pregnant physicians and physician parents is needed to design policies and interventions to reduce these disparities.
Our objective was to characterize work-related barriers related to pregnancy and parenthood described by physicians.
We performed framework analysis of qualitative data collected through individual, semi-structured interviews between May and October 2018. Data related to pregnancy or parenthood were organized chronologically to understand barriers throughout the process of pregnancy, planning a parental leave, taking a parental leave, returning from parental leave, and parenting as a physician.
Physician faculty members of all genders, including parents and non-parents, from a single department at a large academic medical school in Canada were invited to participate in a department-wide study broadly exploring gender equity.
Thematic analysis guided by constructivism.