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About the cover
ORIGINAL ARTICLES
2007 James A Vohs Award for Quality First-Place Selection
A Multidisciplinary Approach to Transition Care: A Patient Safety Innovation Study.
This article describes a description of a systematic and comprehensive program for dealing with the problems inherent in a complex health system necessitating frequent transfers of responsibility among providers. There is concentration on avoidance of medication errors and coordination of outpatient care.
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Penicilloyl-Polylysine Stability and Clinical Use Over Time.
Because of unavailability of a commercial product, outdated material was used to test for penicillin allergy. Results were satisfactory and comparable to those with materials previously used before the stated expiration date.
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Introducing Narrative Practices in a Locked, Inpatient Psychiatric Unit.
A trial program of innovative, daily one-hour group therapy sessions emphasizes storytelling as a technique for obtaining emotional rapport with involuntarily confined psychiatric patients. The interesting positive results are potentially useful. Expressing your current story, then constructing a new one, is powerful self-treatment.
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Fetal Heart Rate Pattern Notification Guidelines and Suggested Management Algorithm for Intrapartum Electronic Fetal Heart Rate Monitoring.
Variability in the use of FHR guidelines may account for past trials showing lack of efficacy. The proof of effectiveness of a practice guideline is day-to-day use through a management algorithm.
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A Decade of Experience with a Multiday Residential Communication Skills Intensive: Has the Outcome Been Worth the Investment?
This study of videotaped, role-play practice with actors for 525 physicians cites significant effects: change in habits, patient satisfaction, and physician satisfaction--all sustained over time.
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Whole Person Health for the Whole Population: One-Year Evaluation of Health Coaching.
This article reports on the positive impact of personal health coaching on quality outcomes --improved glycemic control-- and overall patient satisfaction.
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Clostridium difficile Colitis: Reduced Time to Diagnosis in a Community-Based Outpatient Setting Between 1997 and 2004.
A study of two time periods about 7-8 years apart showed that there was substantial shortening of time to diagnosis of Clostridium difficile colitis in outpatients. The major risk factor is antecedent antibiotic use, including metronidazole.
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Which Chronic Obstructive Pulmonary Disease Patients Will Be Likely to Attend Consistently a Pulmonary Rehabilitation Program?
With a view of optimizing use of limited resources, this study examines a variety of traits potentially predictive of good attendance at specialized pulmonary rehabilitation classes. Several are identified. Continued smoking is the greatest predictor of low attendance.
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BOOK REVIEWS
Family and Friends' Guide to Domestic Violence: How to Listen, Talk and Take Action When Someone You Care About is Being Abused
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Clinical Problem-Solving
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CLINICAL MEDICINE
Corridor Consult
Anal Fissure: A Common Cause of Anal Pain.
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REVIEW ARTICLE
The Argument for Use of Epidural Steroid Injections in Management of Acute Radicular Pain.
Studies fail to show that epidural steroid injections reduce long-term pain. Their role is simply to facilitate earlier pain relief and return to full function.
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CASE STUDIES
Finding the Words: Literacy and Traditional Vietnamese Medicine.
Through an ethnographic interview, a medical student understands the issues facing a Vietnamese patient and states her resolve for her future in medicine.
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EDITORIALS
The Importance of Graduate Medical Education for Permanente Physicians, Kaiser Permanente, and American Medicine.
KP GME leaders highlight a six-decade experience and its future impact on American medicine through training in an integrated system, with a comprehensive electronic patient database, and preventive care.
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Social Science Interventions in Medicine Produce Medical Science Outcomes.
Scientific disciplines like psychology, sociology, and anthropology contribute significantly to medical practice and to the objective outcomes sought through medical science.
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COMMENTARIES
Katrina: Health Care System Recovery, Reform, and Renaissance.
Two years after Katrina a disturbing portrait of Louisiana health care emerges. After a review of the current health system, the primary recommendation is to promote primary and preventive care delivery.
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Continuing Medical Education and Maintenance of Certification: Essential Links.
Leaders of the American Board of Internal Medicine explain that physicians’ active self-assessment, and evaluation of their daily clincial behaviors, are required learning to improve their practice.
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Story-Based Health Policy: An Interview with Fitzhugh Mullan, MD.
Dr Mullan’s story of the death of his father in a system of uncoordinated care exemplifies the power of personal narrative to strongly influence health policy.
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ABSTRACTS
Abstracts from the HMO Research Network
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SOUL OF THE HEALER
Original Visual Art
“Tulip Study”
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“Carefree Days”
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“Central Park in Spanish Harlem”
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“Early Fall Maples”
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Original Literary Art
TapTap.
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LETTERS TO THE EDITOR
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