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Context: Aging increases fracture risk through bone loss and microarchitecture deterioration due to an age-related imbalance in bone resorption and formation during bone remodeling., Objective: We examined the associations between levels of phosphate, calcium (Ca), and alkaline phosphatase (ALP), and fracture risk in initially healthy older individuals., Methods: A post hoc analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial recruited 16 703 Australian participants aged 70 years and older and 2411 US participants aged 65 years and older. Analyses were conducted on ASPREE-Fracture substudy participants from Australia with serum calcium, phosphate, and ALP measurement. Fracture data were collected post randomization. Cox regression was used to calculate hazard ratios (HRs) and 95% CIs. Phosphate, Ca, and ALP were analyzed in deciles (D1-D10), with deciles 4 to 7 (31%-70%) as the reference category. Restricted cubic spline curves were used to identify nonlinear associations., Results: Of the 9915 participants, 907 (9.2%) individuals had incident fractures recorded over 3.9 (SD 1.4) years. In the fully adjusted model, men in the top decile (D10) of phosphate had a 78% higher risk of incident fracture (HR 1.78; 95% CI, 1.25-2.54). No such association was observed for women (HR 1.09; 95% CI, 0.83-1.44). The population attributable fraction in men within the D10 phosphate category is 6.9%., Conclusion: This result confirms that high-normal serum phosphate levels are associated with increased fracture risk in older men., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)

Background: Percutaneous coronary intervention (PCI) is a common cardiac procedure used to treat obstructive coronary artery disease. Patient-centred care is a priority in cardiovascular health having been shown to increase patient satisfaction, engagement with rehabilitation activities and reduce anxiety. Evidence indicates that patient-centred care is best achieved by routine collection of patient-reported outcomes (PROs). However, existing patient-reported outcome measures (PROMs) have limited the patient involvement in their development., Aims: To identify and explore outcomes, patients perceive as important following PCI., Methods: A qualitative design was adopted. Eight focus groups and five semi-structured interviews were conducted with 32 patients who had undergone PCI in the previous 6 months. Outcomes were identified and mapped under the U.S. Food and Drug Administration (FDA) patient-reported outcome (PROs) domains of feeling (physical and psychological outcomes), function and evaluation. Inductive and deductive analysis methods were used with open, axial and thematic coding., Results: Consistent with prior studies, patients identified feeling and function outcomes such as reductions in physical and psychological symptoms and the ability to perform usual activities as important. Participants also identified a range of new outcomes, including confidence to return to usual activities and evaluation domains such as adverse effects of medications and the importance of patient communication., Conclusion: The findings of this research should be considered in the design of a cardiac PROM for PCI patients. A PROM which adequately assesses these outcomes can provide clinicians and hospital staff with a foundation in which to address these concerns or symptoms., (© 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.)

Study Objective: To determine the social networking practices of directors of anesthesiology residency programs., Design: Cross-sectional survey., Setting: Online and paper survey tool., Subjects: 132 anesthesiology residency program directors in the United States., Measurements: A 13-item survey including dichotomous and multiple choice responses was administered using an online survey tool and a paper survey. Data analysis was conducted by descriptive and analytical statistics (chi-square test). A P-value < 0.05 indicated statistical significance., Main Results: 50% of anesthesiology program directors responded to the survey (66/132). Policies governing social networking practices were in place for 30.3% (n=20) of the programs' hospitals. The majority of program directors (81.8%, 54) reported never having had an incident involving reprimand of a resident or fellow for inappropriate social networking practices. The majority (66.7%, n=44) of responding programs reported that departments did not provide lectures or educational activities related to appropriate social networking practices. Monitoring of social networking habits of residents/fellows by program directors mainly occurs if they are alerted to a problem (54.5%, n=36). Frequent use of the Internet for conducting searches on a resident applicant was reported by 12.1% (n=8) of program directors, 30.3% (n=20) reported use a few times, and 57.6% (n=38) reported never using the Internet in this capacity., Conclusion: Residency programs should have a written policy related to social media use. Residency program directors should be encouraged to become familiar with the professionalism issues related to social media use in order to serve as adequate resident mentors within this new and problematic aspect of medical ethics and professionalism., (Copyright © 2012 Elsevier Inc. All rights reserved.)