Journal of general internal medicine
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Graduate medical education is a critical period for fostering self-directed learning (SDL). This study introduced an academic coaching program to support SDL among internal medicine (IM) residents, leveraging Gallimore and Tharp's four-stage model as a scaffolding framework. ⋯ Sustained coaching, defined as two or more coaching meetings, is associated with improved IM-ITE performance. Qualitative findings underscore the program's role in enhancing residents' SDL.
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Millions of Americans remain infected with hepatitis C (HCV). Innovation in care delivery is required to achieve the goal of national elimination. ⋯ It is possible to both diagnose HCV and complete the entire pre-treatment evaluation in a single encounter and initiate treatment within 1 month, even for predominantly uninsured populations in rural areas.
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Long-acting injectable cabotegravir (CAB-LA), approved in 2021, is a more effective HIV prevention method than daily oral PrEP. CAB-LA expansion addresses key HIV prevention gaps, especially in the Southern United States (U.S.), to support national Ending the HIV Epidemic (EHE) goals. However, complex implementation requirements hinder CAB-LA expansion, highlighting the need for real-world data to guide effective and equitable scale-up. ⋯ We successfully implemented a CAB-LA PrEP program in a safety-net primary care center in the U.S. South, using an approach designed to address structural barriers to PrEP uptake and persistence.
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Criminal legal involvement (CLI) has been associated with increased burden of disease, worse health outcomes, and high healthcare utilization. The health needs of women with CLI are often overlooked despite the rising proportion of women in the US legal system. ⋯ Women with lifetime CLI experience a different profile of diseases compared to men with increased prevalence of any mental illness and chronic disease, especially respiratory diseases. They also had higher rates of healthcare utilization. Additional research should focus on interventions tailored to the unique needs of this population.