Journal of General Internal Medicine

http://link.springer.com/journal/11606

List of Papers (Total 1,853)

Hypoglycemia is More Common Among Type 2 Diabetes Patients with Limited Health Literacy: The Diabetes Study of Northern California (DISTANCE)

BACKGROUNDLittle is known about the frequency of significant hypoglycemic events in actual practice. Limited health literacy (HL) is common among patients with type 2 diabetes, may impede diabetes self-management, and thus HL could increase the risk of hypoglycemia.OBJECTIVETo determine the proportion of ambulatory, pharmacologically-treated patients with type 2 diabetes...

An Uncommon Cause of Headache

Legend:A healthy 46-year-old Caucasian woman complained of a 4-week history of progressive left-sided headache, nausea and vomiting. One week after symptom onset, computed tomography (CT) of head was normal. Three weeks later, she presented with blurry vision, left otalgia, tinnitus, and hearing loss. Physical examination demonstrated bilateral papilledema, exquisite tenderness...

Antihypertensive Medication Adherence, Stroke and Death

The Authors' Reply. We appreciate Dr. Lapane’s analysis of the practical implications raised by our recent article documenting the adverse effect of antihypertensive medication non-adherence on risk of stroke and death.1 We agree with both Dr. Lapane and Fischer et al.2 that there is great potential for well-designed interventions using health information technology to improve...

Procedures Performed by the Hospitalist and Non-hospitalist

To the Editors:— Thakkar et al. present results from a cross-sectional survey comparing the number of bedside procedures performed by hospitalist and non-hospitalist physicians.1 This article is a reanalysis of 2004 survey data. The authors studied the performance of nine procedures designated “core competencies” by the Society of Hospital Medicine (SHM) in 2006. Although only 11...

A 43-Year-Old Woman with Abdominal Pain and Fever

In this series, a clinician extemporaneously discusses the diagnostic approach (regular text) to sequentially presented clinical information (bold). Additional commentary on the diagnostic reasoning process (italics) is integrated throughout the discussion.Clinical Information: A 43-year-old Mexican woman presented to the emergency department with abdominal pain. Her illness had...

Assessing Patient-centered Care: One Approach to Health Disparities Education

BACKGROUND Patient-centered care has been described as one approach to cultural competency education that could reduce racial and ethnic health disparities by preparing providers to deliver care that is respectful and responsive to the preferences of each patient. In order to evaluate the effectiveness of a curriculum in teaching patient-centered care (PCC) behaviors to medical...

Teaching About Health Care Disparities in the Clinical Setting

Clinical teachers often observe interactions that may contribute to health care disparities, yet may hesitate to teach about them. A pedagogical model could help faculty structure teaching about health care disparities in the clinical setting, but to our knowledge, none have been adapted for this purpose. In this paper, we adapt an established model, Time-Effective Strategies for...

Cardiac Procedures among American Indians and Alaska Natives compared to Non-Hispanic Whites Hospitalized with Ischemic Heart Disease in California

Background American Indians/Alaska Natives (AIAN) experience a high burden of cardiovascular disease with rates for fatal and nonfatal heart disease approximately twofold higher than the U.S. population. Objective To determine if disparities exist in cardiac procedure rates among AIAN compared to non-Hispanic whites hospitalized in California for ischemic heart disease defined as...

Racial/Ethnic Discrimination in Health Care: Impact on Perceived Quality of Care

Background Racial/ethnic minorities are more likely to report receipt of lower quality of health care; however, the mediators of such patient reports are not known. Objectives To determine (1) whether racial disparities in perceptions of quality of health care are mediated by perceptions of being discriminated against while receiving medical care and (2) whether this association...

A Model for Interprofessional Health Disparities Education: Student-Led Curriculum on Chronic Hepatitis B Infection

BACKGROUND Although health disparities are commonly addressed in preclinical didactic curricula, direct patient care activities with affected communities are more limited. PURPOSE To address this problem, health professional students designed a preclinical service-learning curriculum on hepatitis B viral (HBV) infection, a major health disparity affecting the Asian/Pacific...

One Day Later

It was fitting that I was barraged with the oversized memories of my cardiac intensive care rotation while shopping at Costco only 1 day after the rotation ended. I had just finished a month as the senior resident in the CCU and had experienced many things. Room after room of patients on mechanical ventilation. Residents probing and prodding, placing needles in veins and tubes in...

Do Health Educator Telephone Calls Reduce At-risk Drinking Among Older Adults in Primary Care?

Background Alcohol screening and brief intervention for unhealthy alcohol use has not been consistently delivered in primary care as part of preventive healthcare. Objective To explore whether telephone-based intervention delivered by a health educator is efficacious in reducing at-risk drinking among older adults in primary care settings. Design Secondary analyses of data from a...