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CONTEXT Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce. OBJECTIVE To determine whether an intensive educational program in mindfulness, communication, and self-awareness is(More)
anyone injured by research; and provisions must be made to engage communities throughout the course of research. Routine preexposure prophylaxis in military personnel has resulted in observational studies of AVA in young adults, but additional data from adult populations — from dose-sparing studies, for example — are needed before pediatric testing can be(More)
A core curriculum for teaching medical interviewing is presented that enhances the internist's skills in a broad range of interactions with patients. Learning these skills is now left to chance and is often deficient. Four objectives are developed: patient-centered interviewing and treatment; an integrated (biopsychosocial) approach to clinical reasoning(More)
The narrative from a real patient encounter is used to illustrate the powerful effect that delivering bad news can have on both patient and physician. The meaning of bad news to the patient may be quite different than the medical or the personal meaning to the physician. Differences in perception must be explored and understood before the common ground(More)
BACKGROUND Patients with advanced heart failure (HF) have high rates of pain and other symptoms that diminish quality of life. We know little about the characteristics and correlates of pain in patients with advanced HF. METHODS AND RESULTS We identified pain prevalence, location, character, severity, frequency, and correlates in 347 outpatients with(More)
Although regulation of voltage-dependent calcium current (ICa,V) by neurotransmitters is a ubiquitous mechanism among nerve cells, the signaling pathways involved are not well understood. We have determined previously that in a neuroblastoma-glioma hybrid cell line (NG108-15), the heterotrimeric G-protein G13 mediates the inhibition of ICa,V produced by(More)
BACKGROUND Although there have been many studies of physician-assisted suicide and euthanasia in the United States, national data are lacking. METHODS In 1996, we mailed questionnaires to a stratified probability sample of 3102 physicians in the 10 specialties in which doctors are most likely to receive requests from patients for assistance with suicide(More)
OBJECTIVE The purpose of this study was to examine the effect of proactive palliative care consultation on length of stay for high-risk patients in the medical intensive care unit (MICU). DESIGN A prospective pre/post nonequivalent control group design was used for this performance improvement study. SETTING Seventeen-bed adult MICU. PATIENTS Of(More)