Coaching has been shown to improve resident well-being; however, not all benefit equally. Assess predictors of changes in resident physician well-being and burnout in a multisite implementation of a Professional Development Coaching Program. Pre- and post-implementation surveys administered to participant cohorts at implementation sites in their intern year. Effect size was calculated comparing pre- and post-intervention paired data. In total, 272 residents in their intern year at five internal medicine residency programs (Boston Medical Center, University Hospitals Cleveland Medical Center, Duke University, Emory University, Massachusetts General Hospital). Analyses included 129 residents with paired data. Interns were paired with a faculty coach trained in positive psychology and coaching skills and asked to meet quarterly with coaches. Primary outcomes included Maslach Burnout Inventory depersonalization (DP) and emotional exhaustion (EE) subscales, and thePERMA well-being scale. Key predictorsce, and who have higher intolerance of uncertainty and lower resilience at baseline. Coaching skills of goal setting and reflection may positively affect interns and teach coping skills. In primary care risk stratification, automated algorithms do not consider the same factors as providers. The process of adjudication, in which providers review and adjust algorithm-derived risk scores, may improve the prediction of adverse outcomes. We assessed the patient factors that influenced provider adjudication behavior and evaluated the performance of an adjudicated risk model against a commercial algorithm. (1) Structured interviews with primary care providers (PCP) and multivariable regression analysis and (2) receiver operating characteristic curves (ROC) with sensitivity analyses. Primary care patients aged 18years and older with an adjudicated risk score. https://www.selleckchem.com/products/vy-3-135.html APPROACH AND MAIN MEASURES (1) Themes from structured interviews and discrete variables associated with provider adjudication behavior; (2) comparison of concordance statistics and sensitivities between risk models. 47,940 patients were adjudicated by PCPs in 2018. Interviews revealed that, in adjudication, providers consider disease sare able to apply their training to clinical decision-making.Provider adjudication of risk stratification improves model performance because providers have a personal understanding of their patients and are able to apply their training to clinical decision-making. New bone-directed therapies, including denosumab, abaloparatide, and romosozumab, emerged during the past decade, and recent trends in use of these therapies are unknown. To examine temporal trends in bone-directed therapies. An open cohort study in a US commercial insurance database, January 2009 to March 2020. All-users of bone-directed therapies age >50 years, users with osteoporosis, users with malignancies, and patients with recent (within 180 days) fractures at key osteoporotic sites. The percentage of each cohort with prescription dispensing or medication administration claims for each bone-directed therapy during each quarter of the study period. We analyzed 15.48 million prescription dispensings or medication administration claims from 1.46 million unique individuals (89% women, mean age 69 years). Among all users of bone-directed therapies, alendronate, and zoledronic acid use increased modestly (49 to 63% and 2 to 4%, respectively, during the study period). In contrast, denosumab use increased rapidly after approval in 2010, overtaking use of all other medications except alendronate by 2017 and reaching 16% of users by March 2020. Similar trends were seen in cohorts of osteoporosis, malignancy, and recent fractures. Importantly, use of any bone-directed therapy after fractures was low and declined from 15 to 8%. Rates of denosumab use outpaced growth of all other bone-directed therapies over the past decade. Treatment rates after osteoporotic fractures were low and declined over time, highlighting major failings in osteoporosis treatment in the US.Rates of denosumab use outpaced growth of all other bone-directed therapies over the past decade. Treatment rates after osteoporotic fractures were low and declined over time, highlighting major failings in osteoporosis treatment in the US. By 2030, the number of US adults age ≥65 will exceed 70 million. Their quality of life has been declared a national priority by the US government. Assess effects of an eHealth intervention for older adults on quality of life, independence, and related outcomes. Multi-site, 2-arm (11), non-blinded randomized clinical trial. Recruitment November 2013 to May 2015; data collection through November 2016. Three Wisconsin communities (urban, suburban, and rural). Purposive community-based sample, 390 adults age ≥65 with health challenges. long-term care, inability to get out of bed/chair unassisted. Access (vs. no access) to interactive website (ElderTree?) designed to improve quality of life, social connection, and independence. Primary outcome quality of life (PROMIS Global Health). Secondary independence (Instrumental Activities of Daily Living); social support (MOS Social Support); depression (Patient Health Questionnaire-8); falls prevention (Falls Behavioral Scale). Moderation healthcare use (Me.gov ; registration ID number NCT02128789.ClinicalTrials.gov ; registration ID number NCT02128789. While there is a prevailing perception that coronary artery disease (CAD) is a "man's disease," little is known about the factors which influence cardiac risk assessment and whether it varies by gender. 1)Qualitatively capture the complexity of cardiac risk assessment from a patient-centered perspective. 2)Explore how risk assessment may vary by gender. 3)Quantitatively validate qualitative findings among a new sample. This study was conducted in two parts (1) semi-structured in-depth interviews were audio-recorded, transcribed verbatim, and analyzed using modified grounded theory; (2) emergent themes were surveyed in a separate sample to validate findings quantitatively. Differences were estimated using 2-tailed t-tests and kappa. Participants who were referred for their first elective coronary angiogram for suspected CAD with at least1 prior abnormal test were recruited from a tertiary care hospital. Patient-centered themes were derived from part one. In part two, patients estimated the probability that their symptoms were heart-related at multiple time points. |