Importance: Chronic pain is common among individuals with dialysis-dependent kidney failure.
Objective: To evaluate the effectiveness of pain coping skills training (PCST), a cognitive behavioral intervention, on pain interference.
Design, Setting, And Participants: This multicenter randomized clinical trial of PCST vs usual care was conducted across 16 academic centers and 103 outpatient dialysis facilities in the US.
Background: Cognitive impairment constitutes a prevailing issue in the schizophrenia spectrum, severely impacting patients' functional outcomes. A global cognitive score, sensitive to the stages of the spectrum, would benefit the exploration of potential factors involved in the cognitive decline.
Methods: First, we performed principal component analysis on cognitive scores from 768 individuals across the schizophrenia spectrum, including first-degree relatives of patients, individuals at ultra-high risk, who had a first-episode psychosis, and chronic schizophrenia patients, alongside 124 healthy controls.
Background: Despite the increased availability of evidence-based treatments for chronic pain, many patients in rural areas experience poor access to services. Patients receiving care through the VA may also need to navigate multiple systems of care.
Objective: To examine the effectiveness of a remotely delivered collaborative care intervention for improving pain interference among veterans with high-impact chronic pain living in rural areas.
The standard modality for diagnosis of smoke inhalational injury in burn patients is bronchoscopy with or without bronchoalveolar lavage (BAL). However, the risks associated with these procedures are poorly described in established literature. We sought to investigate the association between diagnostic BAL at admission and the development of pneumonia in burn patients.
View Article and Find Full Text PDFBackground: Treatment resistance is a major challenge in psychiatric disorders. Early detection of potential future resistance would improve prognosis by reducing the delay to appropriate treatment adjustment and recovery. Here, we sought to determine whether neurodevelopmental markers can predict therapeutic response.
View Article and Find Full Text PDFObjective: To compare theoretical strengths and limitations of common immortal time adjustment methods, propose a new approach using multiple imputation (MI), and provide practical guidance for using MI in precision medicine evaluations centered on a real-world case study.
Study Setting And Design: Methods comparison, guidance, and real-world case study based on previous literature. We compared landmark analysis, time-distribution matching, time-dependent analysis, and our proposed MI application.
Purpose: In Canada, health data are siloed, slowing bioinnovation and evidence generation for personalized cancer care. Secured data-sharing platforms (SDSPs) can enable data analysis across silos through rapid concatenation across trial and real-world settings and timely researcher access. To motivate patient participation and trust in research, it is critical to ensure that SDSP design and oversight align with patients' values and address their concerns.
View Article and Find Full Text PDFIntroduction: Meaningful engagement of patients in the research process has increased over the past 20 years. Few accounts are available of engagement infrastructure and processes used by large research organizations. The Pain/Opioid Consortium of Research (Consortium) is a U.
View Article and Find Full Text PDFPurpose: To develop and administer an assessment tool for facilitating patient-clinician discussions regarding amputation-related pain and sensation.
Materials And Methods: An assessment tool was developed to measure the impact of different types of amputation-related pain and sensation on a patient's life. The tool first provides patients with written descriptions and images of three common types of amputation-related pain or sensations: residual limb pain, phantom limb sensation, and phantom limb pain.
In September 2022, CDC funded a nationwide program, Together TakeMeHome (TTMH), to expand distribution of HIV self-tests (HIVSTs) directly to consumers by mail through an online ordering portal. To publicize the availability of HIVSTs to priority audiences, particularly those disproportionately affected by HIV, CDC promoted this program through established partnerships and tailored resources from its Let's Stop HIV Together social marketing campaign. The online portal launched March 14, 2023, and through March 13, 2024, distributed 443,813 tests to 219,360 persons.
View Article and Find Full Text PDFPurpose: Self-collected testing for human papillomavirus (HPV) is poised to transform cervical cancer screening. Self-tests demonstrate similar accuracy to clinician-collected tests, but for the half a million women served by the Veterans Health Administration (VA) and their clinicians, self-collected cervical cancer screening would be a new practice. We examined VA patient and staff perspectives to inform future implementation.
View Article and Find Full Text PDFObjectives: Daily, approximately 3,400 traffic-related deaths occur globally, with over 90% concentrated in low and middle-income countries (LMICs). Notably, Rwanda has one of the highest road traffic death rates in the world (29.7 per 100,000 people) and is the first low-income country to implement a national Automated Speed Enforcement (ASE) policy.
View Article and Find Full Text PDFPurpose: Phantom limb pain (PLP) is treated with medications and non-drug treatments. Best clinical practices for measuring treatment outcomes have not been defined. The objective of this study was to evaluate the internal consistency of patient-reported outcomes measures (PROMs) in a sample of Veterans with lower limb amputation.
View Article and Find Full Text PDFBackground: The Veterans Health Administration tracks urine drug tests (UDTs) among patients on long-term opioid therapy (LTOT) and recommends discussing the health effects of cannabis use.
Objective: To determine the occurrence of cannabis-related discussions between providers and patients on LTOT during six months following UDT positive for cannabis, and examine factors associated with documenting cannabis use.
Design: We identified patients prescribed LTOT with a UDT positive for cannabis in 2019.
Introduction: LatinX youth in the U.S. are disproportionately affected by HIV and STIs, commonly attributed to a lack of diagnostic testing and regular physician consultations to address sexual health.
View Article and Find Full Text PDFBackground: Despite significant progress in HIV treatment and prevention, the US remains far from its goal of 'Ending the HIV Epidemic' by 2030. Economic models using local data can synthesise the evidence to help policymakers allocate HIV resources efficiently, but persistent research-to-practice gaps remain. Little is known about how to facilitate the use of economic modelling data among local public health policymakers in real-world settings.
View Article and Find Full Text PDFObjective: To determine the effect of opioid and stimulant Risk Mitigation Guidance (RMG) dispensations on mortality and acute care visits during the dual public health emergencies of overdose and covid-19.
Design: Population based retrospective cohort study.
Setting: British Columbia, Canada.
Objective: The purpose of this study was to explore self-reported Veterans Affairs (VA) amputation clinician perspectives and clinical practices regarding the measurement and treatment for amputation-related pain.
Study Design: Cross-sectional survey with 73 VA rehabilitation clinicians within the VA Health Care System.
Results: The most frequent clinical backgrounds of respondents included physical therapists (36%), prosthetists (32%), and physical medicine and rehabilitation specialist (21%).