Mclambwilhelmsen6201

Overall, 21% of providers referred their patients with prediabetes to LCPs, and 6.4% engaged in bi-directional referral. Provider practices that established clinical-community linkages (CCLs) with LCPs (AOR = 4.88), used electronic health records (EHRs) to manage patients (AOR = 2.94), or practiced within 10 miles of an in-person, public LCP class location (AOR = 1.49) were more likely to refer. Establishing CCLs with LCPs (AOR = 8.59) and using EHRs (AOR = 1.86) were also facilitators of bi-directional referral. This study highlights the importance of establishing CCLs between provider settings and organizations offering the National DPP LCP, increasing use of EHRs to manage patients, and increasing availability of in-person LCP class locations near provider practices.Community social networks positively affect older adults' dietary behavior, but the underlying mechanisms remain uncertain. This study investigated if the relationship between community social networks and dietary behavior is mediated by social participation, and whether the influence of community social networks differs across sociodemographic groups. We conducted a cross-lagged panel mediation analysis employing nonlinear structural equation modeling using panel data from the Japan Gerontological Evaluation Study (JAGES), a longitudinal study of Japanese older adults in 2010, 2013, and 2016, which included 11,347 men and 14,105 women aged over 65. Monodirectional relationships in community social networks, individual social participation, and fruit/vegetable intake were examined. Community social networks were associated with social participation regardless of sociodemographic conditions. Uprosertib Akt inhibitor Individual social participation was in turn, positively associated with fruit/vegetable intake, with this association being stronger among those living alone. Analyses further showed that individuals' social participation positively mediated the relationship between community social networks and fruit/vegetable intake. For both genders, the mediating effects were stronger among people living alone than in those living with someone. However, community networks could also directly and negatively affect fruit/vegetable intake among men who live alone unless they participated in community activities. Community social networks may promote social participation, thereby facilitating healthier dietary behavior regardless of sociodemographic status. Social participation in turn may positively contribute to the dietary health of people living alone. Community-based interventions to encourage people living alone to participate in social activities may help reduce inequality in dietary behavior related to cohabitation status.Use of prescription opioids 'beyond the bounds' of medical guidance can lead to opioid dependence. Yet recent efforts to predict extra-medical use of prescription pain relievers (EMPPR) have relied on electronic medical or pharmacy records. Because peak incidence of EMPPR occurs during adolescence- a time of relative health- administrative data may be inadequate. In this study, with data from a United States (US) population sample, we develop and internally validate an EMPPR prediction model. We analyzed data from 234,593 individuals aged 12-to-17-years, as sampled by the US National Survey of Drug Use and Health, 2004-2018, an annual cross-sectional survey. We encoded 14 predictors with onset prior to EMPPR initiation, including age, sex, and facets of drug and psychiatric history. We ranked these predictors by clinical utility before sequentially adding each to a regularized logistic regression model. On held-out test data (n = 23,685), the model performs well with 14 predictors, with an area under the precision recall curve (AUPRC) is 0.155. The area under the receiver operator curve (AUC) is 0.819, exceeding a recent benchmark on this dataset. Results are robust to survey redesign that occurred in 2015, and are not moderated by past-year use of medical services. In conclusion, while selection of predictors is limited to those with known timing prior to initiation of EMPPR rather than any cross-sectional variable, this model discriminates well. Good classification occurs even with a small set of clinically available predictors- age, a history of depression and alcohol, cigarette, and cannabis use.Accumulating research indicates robust associations between sense of control and salutary health and well-being outcomes. However, whether change in sense of control is associated with subsequent outcomes has been under-evaluated. Participants (N = 12,998) were from the Health and Retirement Study-a diverse, nationally representative, and longitudinal sample of U.S. adults aged >50 years. We examined how increase in sense of control (from t02006/2008 to t1 2010/2012) was associated with better outcomes on 35 indicators of physical-, behavioral-, and psychosocial-health (t22014/2016). We used multiple logistic-, linear-, and generalized-linear regression models and controlled for sociodemographic characteristics, personality traits, sense of control, and all outcomes in the pre-baseline wave (t02006/2008). During the 4-year follow-up, people in the highest (vs. lowest) quartile of sense of control, conditional on prior sense of control, had reduced risk of mortality and improved physical-health outcomes (lower risk of stroke, lung disease, physical limitations, cognitive impairment, chronic pain and higher self-rated health). Sense of control was related to better health-behaviors (increased physical activity, reduced sleep problems), higher psychological well-being (positive affect, life satisfaction, optimism, purpose, personal-, health-, financial-mastery), lower psychological distress (depression, hopelessness, negative affect, perceived constraints), decreased loneliness, and increased contact with friends. Sense of control was unrelated to other physical health indicators (diabetes, hypertension, heart disease, cancer, arthritis, overweight/obesity), health behaviors (binge drinking, smoking), and social factors (living with spouse/partner, frequency of contact with children and other family). These findings underscore the importance of sense of control as a potential intervention target for fostering physical-, behavioral-, and psychosocial-health.