Impact of a community-based lifestyle intervention with initial sedentary reduction or physical activity increasing goals on self-reported health-related quality of life.

Background: In previous efforts, health-related quality of life (HRQoL) improved for individuals at high risk of type 2 diabetes and cardiovascular disease after participation in community-based lifestyle interventions (LI) with a moderate-to-vigorous physical activity (MVPA) movement goal.

Purpose: It is unknown whether HRQoL improves with LI when the primary movement goal is to reduce sedentary behavior. HRQoL changes were examined among adults with overweight and prediabetes and/or metabolic syndrome randomized to a 12-month Diabetes Prevention Program-based Group Lifestyle Balance (DPP-GLB) community LI work with goals of weight-loss and either increasing MVPA (DPP-GLB) or reducing sedentary time (GLB-SED).

Implementing brief behavioral treatment for insomnia in Department of Veterans Affairs Primary Care Mental Health Integration clinics: Reach outcomes from a hybrid type 3 effectiveness-implementation trial.

Chronic insomnia is one of the most common health problems among veterans and can significantly impact health, function, and quality of life. Brief behavioral treatment for insomnia (BBTI), an adaptation of cognitive behavioral therapy for insomnia (CBT-I), was developed to help increase access to care outside of specialty settings. However, training providers alone is rarely sufficient, and implementation strategies are needed for successful uptake, adoption, and sustainable delivery of care.

Outcomes of Women Undergoing Noncardiac Surgery in Veterans Affairs Compared With Non-Veterans Affairs Care Settings.

Importance: Recent legislation facilitates veterans' ability to receive non-Veterans Affairs (VA) surgical care. Although veterans are predominantly male, the number of women receiving care within the VA has nearly doubled to 10% over the past decade and recent data comparing the surgical care of women in VA and non-VA care settings are lacking.

Objective: To compare postoperative outcomes among women treated in VA hospitals vs private-sector hospitals.

A Retrospective Cohort Study to Evaluate Adding Biomarkers to the Risk Analysis Index of Frailty.

Introduction: The Risk Analysis Index (RAI) is a frailty assessment tool associated with adverse postoperative outcomes including 180 and 365-d mortality. However, the RAI has been criticized for only containing subjective inputs rather than including more objective components such as biomarkers.

Methods: We conducted a retrospective cohort study to assess the benefit of adding common biomarkers to the RAI using the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database.

Interpreting the risk analysis index of frailty in the context of surgical oncology.

Background And Objectives: The Risk Analysis Index (RAI) accurately predicts adverse postoperative outcomes but the inclusion of cancer status in the RAI has raised two key concerns about its suitability for use in surgical oncology: (1) the potential over classification of cancer patients as frail, and (2) the potential overestimation of postoperative mortality for patients with surgically curable cancers.

Methods: We performed a retrospective cohort analysis to assess the RAI's power to appropriately identify frailty and predict postoperative mortality in cancer patients. We assessed discrimination for mortality and calibration across five RAI models-the complete RAI and four variants that removed different cancer-related variables.

Effectiveness of a Health Coaching Intervention for Patient-Family Dyads to Improve Outcomes Among Adults With Diabetes: A Randomized Clinical Trial.

Importance: More than 75% of US adults with diabetes do not meet treatment goals. More effective support from family and friends ("supporters") may improve diabetes management and outcomes.

Objective: To determine if the Caring Others Increasing Engagement in Patient Aligned Care Teams (CO-IMPACT) intervention improves patient activation, diabetes management, and outcomes compared with standard care.

Effects of an integrated mindfulness intervention for veterans with diabetes distress: a randomized controlled trial.

Introduction: US military veterans have disproportionately high rates of diabetes and diabetes-related morbidity in addition to being at risk of comorbid stress-related conditions. This study aimed to examine the effects of a technology-supported mindfulness intervention integrated into usual diabetes care and education on psychological and biobehavioral outcomes.

Research Design And Methods: Veterans (N=132) with type 1 or 2 diabetes participated in this two-arm randomized controlled efficacy trial.

Patient and supporter factors affecting engagement with diabetes telehealth.

Objectives: To assess what patient, family supporter, and call characteristics predicted whether patients completed automated and coach-provided calls in a telehealth diabetes intervention.

Study Design: A total of 123 adults with type 2 diabetes and high glycated hemoglobin A1c (HbA1c) or blood pressure, enrolled with a family supporter, received automated interactive voice response (IVR) and coach-provided visit preparation calls over 12 months.

Methods: Data from baseline surveys and diabetes-related clinical information from patient medical records were entered into multilevel, multivariate regression models of associations between participant and call characteristics with call completion.

Serum Biomarkers of Iron Status and Risk of Hepatocellular Carcinoma Development in Patients with Nonalcoholic Fatty Liver Disease.

Background: Nonalcoholic fatty liver disease (NAFLD) has become a major contributor to the rising incidence of hepatocellular carcinoma (HCC) in the United States and other developed countries. Iron, an essential metal primarily stored in hepatocytes, may play a role in the development of NAFLD-related HCC. Epidemiologic data on iron overload without hemochromatosis in relation to HCC are sparse.

Use of Complementary and Alternative Therapy for Knee Osteoarthritis: Race and Gender Variations.

Objective: To evaluate race and gender variations in complementary and alternative medicine (CAM) use for knee osteoarthritis (OA) (unadjusted and adjusted for demographic and clinical factors).

Methods: A secondary analysis of cross-sectional data was conducted. The sample included Veterans Affairs patients 50 years of age or older with symptomatic knee OA.

Preinjury Health Status of Adults With Traumatic Brain Injury: A Preliminary Matched Case-Control Study.

Objective: To discern whether there is evidence that individuals who sustained a traumatic brain injury (TBI) had the greater odds of preexisting health conditions and/or poorer health behaviors than matched controls without TBI.

Setting: Brain Injury Inpatient Rehabilitation Unit at Mount Sinai Hospital. Midlife in the United States (MIDUS) control data were collected via random-digit-dialing phone survey.

Rates of New Human Papillomavirus Detection and Loss of Detection in Middle-aged Women by Recent and Past Sexual Behavior.

Background: Understanding the source of newly detected human papillomavirus (HPV) in middle-aged women is important to inform preventive strategies, such as screening and HPV vaccination.

Methods: We conducted a prospective cohort study in Baltimore, Maryland. Women aged 35-60 years underwent HPV testing and completed health and sexual behavior questionnaires every 6 months over a 2-year period.

Brief Behavioral Treatment for Insomnia vs. Cognitive Behavioral Therapy for Insomnia: Results of a Randomized Noninferiority Clinical Trial Among Veterans.

The goal of this study was to compare a brief behavioral treatment for insomnia (BBTI), which has fewer sessions (4), shorter duration (<30-45 minutes), and delivers treatment in-person plus phone calls to cognitive behavioral therapy for insomnia (CBTI), which has 5 in-person sessions. The hypothesis was BBTI would be noninferior to CBTI. The Reliable Change Index was used to establish a noninferiority margin (NIM) of 3.

Outcomes for dogs with functional thyroid tumors treated by surgical excision alone.

Objective: To describe clinical findings and survival times for dogs with functional thyroid tumors treated with surgery alone and investigate potential prognostic factors for outcome in these patients.

Animals: 27 client-owned dogs.

Procedures: Medical records of 9 institutions were reviewed to identify dogs with hyperthyroidism secondary to thyroid neoplasia that were treated with surgery alone between 2005 and 2015.

Continuing education for systematic reviews: a prospective longitudinal assessment of a workshop for librarians.

Objective: This prospective, longitudinal study explored the impact of a continuing education class on librarians' knowledge levels about and professional involvement with systematic reviews. Barriers to systematic review participation and the presence of formal systematic review services in libraries were also measured.

Methods: Participants completed web-based surveys at three points in time: pre-class, post-class, and six-months' follow-up.

Modified cranial closing wedge ostectomy in 25 dogs.

Objective: To describe the planning of a modified cranial closing wedge ostectomy (mCCWO) and determine the accuracy of execution without intraoperative jigs or alignment guides.

Study Design: Retrospective study.

Animals: Twenty-five client-owned dogs (32 stifles) with cranial cruciate ligament disease.

Dementia and motor vehicle crash hospitalizations: Role of physician reporting laws.

Objective: To determine the effect of physician reporting laws and state licensing requirements on crash hospitalizations among drivers with dementia.

Methods: A study of drivers hospitalized because of vehicle crashes, identified from the State Inpatient Databases of the Agency for Healthcare Research and Quality. Multivariable logistic regression was used to examine the effect of mandatory physician reporting of at-risk drivers and state licensing requirement on the prevalence of dementia among hospitalized drivers.

A hybrid type I trial to increase Veterans' access to insomnia care: study protocol for a randomized controlled trial.

Background: Chronic insomnia is among the most reported complaints of Veterans and military personnel referred for mental health services. It is highly comorbid with medical and psychiatric disorders, and is associated with significantly increased healthcare utilization and costs. Evidence-based psychotherapy, namely Cognitive Behavioral Therapy for Insomnia (CBTI), is an effective treatment and recommended over prescription sleep medications.

Muscle Attenuation Is Associated With Newly Developed Hypertension in Men of African Ancestry.

Increased ectopic adipose tissue infiltration in skeletal muscle is associated with insulin resistance and diabetes mellitus. We evaluated whether change in skeletal muscle adiposity predicts subsequent development of hypertension in men of African ancestry, a population sample understudied in previous studies. In the Tobago Health Study, a prospective longitudinal study among men of African ancestry (age range 40-91 years), calf intermuscular adipose tissue, and skeletal muscle attenuation were measured with computed tomography.

Mandatory Physician Reporting of At-Risk Drivers: The Older Driver Example.

Purpose Of The Study: In a number of states, physicians are mandated by state law to report at-risk drivers to licensing authorities. Often these patients are older adult drivers who may exhibit unsafe driving behaviors, have functional/cognitive impairments, or are diagnosed with conditions such as Alzheimer's disease and/or seizure disorders. The hypothesis that mandatory physician reporting laws reduce the rate of crash-related hospitalizations among older adult drivers was tested.

A three-step estimation procedure using local polynomial smoothing for inconsistently sampled longitudinal data.

Parametric mixed-effects models are useful in longitudinal data analysis when the sampling frequencies of a response variable and the associated covariates are the same. We propose a three-step estimation procedure using local polynomial smoothing and demonstrate with data where the variables to be assessed are repeatedly sampled with different frequencies within the same time frame. We first insert pseudo data for the less frequently sampled variable based on the observed measurements to create a new dataset.

Greater skeletal muscle fat infiltration is associated with higher all-cause mortality among men of African ancestry.

Background: fat infiltration within and around skeletal muscle (i.e. myosteatosis) increases with ageing, is greater in African versus European ancestry men and is associated with poor health.

Impact of Coal Mining on Self-Rated Health among Appalachian Residents.

Objective: To determine the impact of coal mining, measured as the number of coal mining-related facilities nearby one's residence or employment in an occupation directly related to coal mining, on self-rated health in Appalachia.

Methods: Unadjusted and adjusted ordinal logistic regression models calculated odds ratio estimates and associated 95% confidence intervals for the probability of having an excellent self-rated health response versus another response. Covariates considered in the analyses included number of coal mining-related facilities nearby one's residence and employment in an occupation directly related to coal mining, as well as potential confounders age, sex, BMI, smoking status, income, and education.

Alcohol brief intervention for hospitalized veterans with hazardous drinking: protocol for a 3-arm randomized controlled efficacy trial.

Background: Various hospital accreditation and quality assurance entities in the United States have approved and endorsed performance measures promoting alcohol brief intervention (BI) for hospitalized individuals who screen positive for unhealthy alcohol use, the spectrum of use ranging from hazardous use to alcohol use disorders. These performance measures have been controversial due to the limited and equivocal evidence for the efficacy of BI among hospitalized individuals. The few BI trials conducted with hospital inpatients vary widely in methodological quality.