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https://www.readbyqxmd.com/read/28094135/diabetes-prevention-program-translation-in-the-veterans-health-administration
#1
Tannaz Moin, Laura J Damschroder, Mona AuYoung, Matthew L Maciejewski, Santanu K Datta, Jane E Weinreb, Nanette I Steinle, Charles Billington, Maria Hughes, Fatima Makki, Robert G Holleman, H Myra Kim, Amy S Jeffreys, Linda S Kinsinger, Jennifer A Burns, Caroline R Richardson
INTRODUCTION: This clinical demonstration trial compared the effectiveness of the Veterans Affairs Diabetes Prevention Program (VA-DPP) with an evidence-based usual care weight management program (MOVE!(®)) in the Veterans Health Administration health system. DESIGN: Prospective, pragmatic, non-randomized comparative effectiveness study of two behavioral weight management interventions. SETTING/PARTICIPANTS: Obese/overweight Veterans with prediabetes were recruited from three geographically diverse VA sites between 2012 and 2014...
January 13, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28087180/a-comparison-of-hfref-vs-hfpef-s-clinical-workload-and-cost-in-the-first-year-following-hospitalization-and-enrollment-in-a-disease-management-program
#2
T M Murphy, D F Waterhouse, S James, C Casey, E Fitzgerald, E O'Connell, C Watson, J Gallagher, M Ledwidge, K McDonald
BACKGROUND: Admission with heart failure (HF) is a milestone in the progression of the disease, often resulting in higher intensity medical care and ensuing readmissions. Whilst there is evidence supporting enrolling patients in a heart failure disease management program (HF-DMP), not all reported HF-DMPs have systematically enrolled patients with HF with preserved ejection fraction (HFpEF) and there is a scarcity of literature differentiating costs based on HF-phenotype. METHODS: 1292 consenting, consecutive patients admitted with a primary diagnosis of HF were enrolled in a hospital based HF-DMP and categorized as HFpEF (EF≥45%) or HFrEF (EF<45%)...
December 23, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28029198/neural-responses-to-negative-outcomes-predict-success-in-community-based-substance-use-treatment
#3
Sarah E Forster, Peter R Finn, Joshua W Brown
BACKGROUND AND AIMS: Activation in some specific brain regions has demonstrated promise as prognostic indicators in substance dependent individuals (SDIs) but this issue has not yet been explored in SDIs attending typical of community-based treatment. We used a data-driven, exploratory approach to identify brain-based predictors of treatment outcome in a representative community sample of SDIs. The predictive utility of brain-based measures was evaluated against clinical indicators, cognitive-behavioral performance, and self-report assessments...
December 28, 2016: Addiction
https://www.readbyqxmd.com/read/28027338/effect-of-an-intensive-outpatient-program-to-augment-primary-care-for-high-need-veterans-affairs-patients-a-randomized-clinical-trial
#4
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
December 27, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27992624/association-of-perioperative-statin-use-with-mortality-and-morbidity-after-major-noncardiac-surgery
#5
Martin J London, Gregory G Schwartz, Kwan Hur, William G Henderson
Importance: The efficacy of statins in reducing perioperative cardiovascular and other organ system complications in patients undergoing noncardiac surgery remains controversial. Owing to a paucity of randomized clinical trials, analyses of large databases may facilitate informed hypothesis generation and more efficient trial design. Objective: To evaluate associations of early perioperative statin use with outcomes in a national cohort of veterans undergoing noncardiac surgery...
December 19, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27977854/effects-of-high-intensity-physical-training-on-muscle-fiber-characteristics-in-post-stroke-patients
#6
J L Andersen, J R Jørgensen, P Zeeman, D T Bech-Pedersen, J Sørensen, I Ara, L L Andersen
INTRODUCTION: Stroke is a leading cause of disability worldwide. High-intensity physical training can improve muscle strength and gait speed, but adaptive mechanisms at the muscle cellular level are largely unknown. METHODS: Outpatients with post-stroke hemiparesis participated in a 3-month rehabilitation program combining high-intensity strength and body-weight supported treadmill-training. Biopsies sampled bilaterally from vastus lateralis muscles, before, after, and at 1-year follow-up after intervention, were analyzed for fiber size, type, and capillarization...
December 15, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/27911566/pedometer-step-count-targets-during-pulmonary-rehabilitation-in-copd-a-randomized-controlled-trial
#7
Claire M Nolan, Matthew Maddocks, Jane L Canavan, Sarah E Jones, Veronica Delogu, Djeya Kaliaraju, Winston Banya, Samantha S C Kon, Michael I Polkey, William D-C Man
RATIONALE: Increasing physical activity is a key therapeutic aim in COPD. Pulmonary rehabilitation (PR) improves exercise capacity, but there is conflicting evidence regarding its ability to improve physical activity levels. OBJECTIVE: To determine whether using pedometers as an adjunct to PR can enhance time spent in at least moderate intensity physical activity (time ≥ 3METs) in people with COPD. METHODS: In this single-blinded randomized controlled trial, participants were assigned 1:1 to receive control (PR comprising 8 weeks, two supervised sessions/week) or intervention (PR plus pedometer-directed step targets, reviewed weekly for 8 weeks)...
December 2, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27891062/results-from-10-years-of-a-cbt-pain-self-management-outpatient-program-for-complex-chronic-conditions
#8
Kathryn A Boschen, Edward Robinson, Kent A Campbell, Sarah Muir, Elvina Oey, Kristen Janes, Samantha R Fashler, Joel Katz
Background. Traditional unimodal interventions may be insufficient for treating complex pain, as they do not address cognitive and behavioural contributors to pain. Cognitive Behavioural Therapy (CBT) and physical exercise (PE) are empirically supported treatments that can reduce pain and improve quality of life. Objectives. To examine the outcomes of a pain self-management outpatient program based on CBT and PE at a rehabilitation hospital in Toronto, Ontario. Methods. The pain management group (PMG) consisted of 20 sessions over 10 weeks...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27876616/the-starting-treatment-for-ethanol-in-primary-care-trials-step-trials-protocol-for-three-parallel-multi-site-stepped-care-effectiveness-studies-for-unhealthy-alcohol-use-in-hiv-positive-patients
#9
E Jennifer Edelman, Stephen A Maisto, Nathan B Hansen, Christopher J Cutter, James Dziura, Lynn E Fiellin, Patrick G O'Connor, Roger Bedimo, Cynthia Gibert, Vincent C Marconi, David Rimland, Maria C Rodriguez-Barradas, Michael S Simberkoff, Amy C Justice, Kendall J Bryant, David A Fiellin
Unhealthy alcohol use is common among HIV-positive patients, yet effective evidence-based treatments are rarely provided in clinical settings providing HIV care. Further, given patient variability in response to initial treatments, stepped care approaches may be beneficial. We describe the rationale, aims and study design for the current StartingTreatment forEthanol inPrimary care Trials (STEP Trials); three parallel randomized controlled effectiveness trials being conducted in five Infectious Disease Clinics...
January 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27858219/-the-impact-of-catastrophizing-on-the-effect-of-depression-on-pain-and-functional-ability-a%C3%A2-longitudinal-mediator-analysis
#10
J Briest, M Bethge
BACKGROUND: While the association between pain and depression is well proven, little is known about the mechanisms influencing this relationship. The cognitive distortion of catastrophizing plays a significant role in several concepts of both diseases. OBJECTIVE: The aim of the study was to analyze the role of catastrophizing on the effect of depression on pain and functional ability. MATERIAL AND METHODS: Participants were recruited from 11 outpatient rehabilitation centers in Germany at the beginning of orthopedic rehabilitation aftercare...
November 17, 2016: Der Schmerz
https://www.readbyqxmd.com/read/27854323/a-clinical-pilot-study-of-individual-and-group-treatment-for-adolescents-with-chronic-pain-and-their-parents-effects-of-acceptance-and-commitment-therapy-on-functioning
#11
Marie Kanstrup, Rikard K Wicksell, Mike Kemani, Camilla Wiwe Lipsker, Mats Lekander, Linda Holmström
Pediatric chronic pain is common and can result in substantial long-term disability. Previous studies on acceptance and commitment therapy (ACT) have shown promising results in improving functioning in affected children, but more research is still urgently needed. In the current clinical pilot study, we evaluated an ACT-based interdisciplinary outpatient intervention (14 sessions), including a parent support program (four sessions). Adolescents were referred to the clinic if they experienced disabling chronic pain...
November 16, 2016: Children
https://www.readbyqxmd.com/read/27825381/cornerstone-program-for-transition-age-youth-with-serious-mental-illness-study-protocol-for-a-randomized-controlled-trial
#12
Michelle R Munson, Andrea Cole, Victoria Stanhope, Steven C Marcus, Mary McKay, James Jaccard, Shelly Ben-David
BACKGROUND: Transition-age youth have elevated rates of mental disorders, and they often do not receive services. This is a serious public health concern, as mental health conditions persist into adulthood. Continuing to engage this population has been a pervasive challenge for the mental health care system worldwide. Few mental health interventions have been developed for transition-age youth, and even fewer have been found to be effective over the transition to adulthood. Cornerstone, a theoretically guided intervention has shown promise for addressing the mental health and psychosocial needs of this population as they emerge into adulthood...
November 8, 2016: Trials
https://www.readbyqxmd.com/read/27802253/do-patients-with-chronic-low-back-pain-benefit-from-early-intervention-regarding-absence-from-work-a-randomized-controlled-single-center-pilot-study
#13
Anja Davis Norbye, Aina Vedvik Omdal, Marit Eikrem Nygaard, Ulla Romild, Guttorm Eldøen, Rune Midgard
STUDY DESIGN: A randomized, controlled, single-center pilot study. OBJECTIVE: The aim of this study was to investigate the feasibility of running a trial to explore if early intervention in individuals with chronic low back pain (CLBP) would lead to an early return to work (RTW) and reduce sick leave during 12 months of follow-up compared with patients on a 3-month waiting list. SUMMARY OF BACKGROUND DATA: Back pain is the reason for numerous absent days from work...
November 1, 2016: Spine
https://www.readbyqxmd.com/read/27785478/outcome-of-intensive-outpatient-rehabilitation-and-bracing-in-an-adult-patient-with-scheuermann-s-disease-evaluated-by-radiologic-imaging-a-case-report
#14
Hagit Berdishevsky
BACKGROUND: No studies examine the efficacy of intensive specific physical therapy (PT) exercises along with brace for the adult with Scheuermann's kyphosis (SK). The aim of this study was to examine the effects of intensive PT based on the Barcelona Scoliosis Physical Therapy School (BSPTS) and SpinoMed brace on a 76-year-old female with SK. CASE DESCRIPTION: A 76-year-old female, diagnosed with SK as an adolescent, presented in October 2014 with thoracic hyperkyphosis T1 to T12 Cobb angle of 85° and lumbar hyper lordosis L1 to L5 Cobb angle of 70°...
2016: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/27745534/integrating-buprenorphine-into-an-opioid-treatment-program-tailoring-care-for-patients-with-opioid-use-disorders
#15
Soteri Polydorou, Stephen Ross, Peter Coleman, Laura Duncan, Nichole Roxas, Anil Thomas, Sonia Mendoza, Helena Hansen
OBJECTIVES: This report identifies the institutional barriers to, and benefits of, buprenorphine maintenance treatment (BMT) integration in an established hospital-based opioid treatment program (OTP). METHODS: This case study presents the authors' experiences at the clinic, hospital, and corporation levels during efforts to integrate BMT into a hospital-based OTP in New York City and a descriptive quantitative analysis of the characteristics of hospital outpatients treated with buprenorphine from 2006 to 2013 (N=735)...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27743470/long-term-rehabilitation-in-patients-with-acquired-brain-injury
#16
Andreas Bender, Christine Adrion, Luzia Fischer, Martin Huber, Kerstin Jawny, Andreas Straube, Ulrich Mansmann
BACKGROUND: Patients with acquired brain injury who have been discharged from inpatient neurological rehabilitation often continue to suffer from limited independence, participation, and quality of life. Participation-focused outpatient treatment (in German: teilhabeorientierte ambulan. METHODS: In a randomized, controlled trial, 53 patients who had sustained an acquired brain injury approximately four years earlier were allotted to two different sequences of treatment (26 TEAM/control, 27 control/TEAM)...
September 23, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/27733902/perception-of-primary-care-physicians-on-the-impact-of-comprehensive-geriatric-assessment-what-is-the-next-step
#17
Pei Chen, Michael A Steinman
Older adults are at high risk of developing multimorbidity, and the high levels of clinical and psychosocial complexity in this population pose special challenges for primary care physicians (PCPs). As a way to improve the care for the older adults, a number of health systems have developed programs to provide comprehensive geriatric assessment (CGA), which generally refers to an intensive interprofessional evaluation and management of geriatric syndromes with the goals of maximizing health in aging. Sternberg and Bentur examined the impact of CGA as perceived by PCPs, the PCPs attitude toward CGA, and their satisfaction with CGA...
2016: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/27692387/a-prospective-study-predicting-the-outcome-of-chronic-low-back-pain-and-physical-therapy-the-role-of-fear-avoidance-beliefs-and-extraspinal-pain
#18
Aloma S A Feitosa, Jaqueline Barros Lopes, Eloisa Bonfa, Ari S R Halpern
OBJECTIVE: To identify the prognostic factors for conventional physical therapy in patients with chronic low back pain (CLBP). METHODS: Prospective observational study. PARTICIPANTS: One hundred thirteen patients with CLBP selected at the Spinal Disease Outpatient Clinic. MAIN OUTCOME MEASURES: Pain intensity was scored using the Numeric Rating Scale (NRS), and function was measured using the Roland-Morris Disability Questionnaire (RMDQ)...
September 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/27676991/isokinetic-muscular-strengthening-of-upper-limb-versus-passive-movement-in-chronic-stroke-patients-randomised-controlled-trial
#19
Flavia Coroian, Jérôme Froger, H-Y Bonnin Koang, Claire Jourdan, Karima Bakhti, Marc Julia, Audrey Jaussent, Christian Hérisson, Isabelle Laffont
OBJECTIVE: The sensori-motor impairment of upper limb (UL) affects more than 50% of patients after stroke. The objective of this work was to study the efficiency of isokinetic muscle strengthening (IMS) in the chronic phase of stroke in this population. MATERIAL/PATIENTS AND METHODS: The patients underwent 6 weeks of outpatient rehabilitation, 3 days per week, combining physiotherapy (twice/day) and occupational therapy every day. The program was completed by 30 minutes elbow and wrist concentric slow speed IMS of flexor and extensor muscles, in the study group versus 30 minutes passive mobilisation of the joints carried out by the same isokinetic dynamometer in the control group...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27647061/referring-hospitalized-smokers-to-outpatient-quit-services-a-randomized-trial
#20
Jeffrey L Fellows, Richard A Mularski, Michael C Leo, Charles J Bentz, Lisa A Waiwaiole, Melanie C Francisco, Kimberly Funkhouser, Catherine M Stoney
INTRODUCTION: Linking outpatient cessation services to bedside counseling for hospitalized smokers can improve long-run quit rates. Adding an assisted referral (AR) offer to a tobacco treatment specialist consult service fits the team approach to care in U.S. hospitals. DESIGN: A two-arm patient-randomized trial tested the effectiveness of adding an AR offer to outpatient smoking-cessation services and interactive voice recognition (AR+IVR) follow-up to a usual care (UC) tobacco-cessation consult for hospitalized smokers...
October 2016: American Journal of Preventive Medicine
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