Variations and value improvement in back pain care in one area of England.

The pursuit of value and equity have been put on a legal footing in the NHS with the arrival of the legal duty for all in the NHS to improve health and well-being of the population served, to provide fair access to high quality healthcare, and to use resources sustainably and efficiently. Recognising this we used analysis of variation to help us understand the degree to which we were fulfilling our new duty for people with back pain in Mid-Nottinghamshire and where there might be opportunities for value improvement.MSK Together is a group of clinical and managerial representatives from providers, purchasers, local government, and patients who work collectively to optimise the use of resources for people with MSK conditions in Mid-Nottinghamshire.

Introducing Quin: The Design and Development of a Prototype Chatbot to Support Smoking Cessation.

Introduction: Chatbots emulate human-like interactions and may usefully provide on-demand access to tailored smoking cessation support. We have developed a prototype smartphone application-based smoking cessation chatbot, named Quin, grounded in real-world, evidence-, and theory-based smoking cessation counseling sessions.

Methods: Conversation topics and interactions in Quitline counseling sessions (N = 30; 18 h) were characterized using thematic, content, and proponent analyses of transcripts.

Reactive knee stiffening strategies between various conditioning histories.

Optimizing joint stiffness through appropriate muscular activation is crucial for maintaining stability and preventing injury. Conditioning techniques may affect joint stability by increasing joint stiffness and altering neuromuscular control; however no studies have assessed this in a controlled setting. Fifteen endurance athletes, 12 power athletes, and 15 control subjects sat on a stiffness device that generated a rapid knee flexion perturbation and were instructed to react to the perturbation.

Process-oriented dynamic group psychotherapy for depression as a teaching modality in a family medicine residency program- A pilot study.

Background and Objectives This pilot study provides a description and evaluation of process-oriented dynamic group psychotherapy for depression as a teaching modality for family medicine residents. The main purpose of using this modality was to teach family medicine residents a variety of psychological clinical skills. A secondary benefit of this modality was to provide in-house, primary care treatment to depressed patients, although the efficacy of this was not evaluated in the present study.

Rehospitalization of older adults discharged to home hospice care.

Background: Acute hospital readmission of older adults receiving hospice care is not aligned with hospice goals.

Objective: To identify factors associated with 30-day readmission among older adults newly discharged to hospice.

Design/subjects: Medical record review of 59 patients, 19 readmitted within 30 days and 40 randomly selected controls not readmitted, from 206 patients newly discharged to home hospice care between February 1, 2005 and January 31, 2010.