Objectively measured daily activity was not associated with one-year symptom improvements among community-dwelling adults with knee osteoarthritis. In those with advanced disease (Kellgren–Lawrence grade 4), greater daily minutes in physical activity were associated with worsening symptoms. How best to implement exercise regimens in persons with advanced knee osteoarthritis to reduce the deleterious impact on symptoms needs to be explored.
New Free Metastatic Melanoma CME from Elsevier! This CME activity will focus on the clinical data presented at the European Cancer Congress 2015 annual meeting pertaining to metastatic melanoma and the role of PD-1 therapies. Upon completion, you may receive a maximum of 1.0 AMA PRA Category 1 Credits™. Click here to begin this activity.
In this prospective study of healthy infants, the authors found that breastfeeding reduced respiratory symptoms mainly in the first six months of life, with a stronger protective effect in girls. Breastfeeding mitigated the effects of maternal smoking on respiratory symptoms during pregnancy, gestational age, and cesarean delivery. The authors found no interaction between breastfeeding and maternal atopy, number of older siblings, child care attendance, or environmental particulate matter.
The current clinical practice guidelines advocate for motivational interviewing (MI) for smokers not ready to quit. This randomized controlled trial assigned 255 smokers with low motivation to quit to MI, health education, or brief advice groups to evaluate the efficacy of MI for inducing cessation-related behaviors. MI was generally more efficacious than brief advice, and health education appeared the most efficacious in inducing cessation behaviors. These results highlight the need to identify the contexts in which MI may be most efficacious and question recommendations to use MI rather than other interventions. (Available for CME credit.)
This pragmatic controlled trial enrolled 495 patients in parallel arms for 12 months to study the effectiveness of the Propeller Health Asthma Platform, which uses an inhaler sensor, mobile apps, and feedback to improve asthma control. The daily mean number of SABA uses per person decreased by 0.41 for the Propeller group (PG) and by 0.31 for the routine care group (RC) (p<0.001)). Asthma Control Test (ACT) scores were not significantly different between arms in the entire study population, but adults with initially uncontrolled ACT scores showed a significantly larger improvement in the proportion with controlled asthma in PG vs. RC (63% vs. 49%, p<0.05). The Propeller system showed effectiveness in this sample and warrants further study.
This study highlights the lack of sexually transmitted infection (STI) testing and barriers to such testing among adolescents and young adults, nationally. Confidentiality concerns, missed opportunities for STI testing, and costs were found to be important barriers to testing. Understanding these barriers at a national level is critical given the high risk of STIs in this group.
Which nursing home characteristics lead to higher adoption of health information technologies (HIT)? It is becoming recognized that better continuity and coordination of care correlates with higher technology practices in nursing homes. Some nursing homes have been quicker to adopt HIT. Information gleaned from two US-based databases (OSCAR and HIMSS) demonstrated nursing homes with higher levels of licensed nursing staff were 20% more likely to adopt HIT. Nursing homes with higher numbers of Medicare-paid vs Medicaid-paid residents also adopted more HIT.
Elsevier ECFS Cystic Fibrosis Symposium Registration Open Register today for this live lunch satellite symposium, "Current Strategies for the Long-term Assessment, Monitoring, and Management of Patients Treated With CFTR Modulator Therapy," in conjunction with the 39th European Cystic Fibrosis Society Conference. The emergence of novel targeted agents, that directly correct CFTR loss function alleles, has created new treatment opportunities for patients with cystic fibrosis with advanced disease. European Accreditation has been granted for this symposium by the EACCME. Click here to register for this live activity.
Continuing Medical Education
Elsevier ECFS Cystic Fibrosis Symposium Registration Open
Register today for this live lunch satellite symposium, “Current Strategies for the Long-term Assessment, Monitoring, and Management of Patients Treated With CFTR Modulator Therapy,” in conjunction with the 39th European Cystic Fibrosis Society Conference. The emergence of novel targeted agents, that directly correct CFTR loss function alleles, has created new treatment opportunities for patients with cystic fibrosis with advanced disease. European Accreditation has been granted for this symposium by the EACCME. Register for this live activity.
A study in the New England Journal of Medicine found that current or former smokers who did not meet criteria for a formal diagnosis of chronic obstructive pulmonary disease had rates of disease symptoms similar to patients diagnosed with mild to moderate COPD. The findings, based on data for 2,736 current or former smokers and controls who never smoked, also showed that symptomatic smokers without a COPD diagnosis performed worse in lung function assessments and timed walking tests compared with asymptomatic smokers.
Researchers looked at 4,373 adults who were followed for 20 years and found those with higher cardiorespiratory fitness had a lower risk of developing prediabetes or type 2 diabetes, according to a study in Diabetologia. A second study in the Journal of Applied Physiology showed that the risk of developing prediabetes or type 2 diabetes was reduced by 0.1% among people with an 8% to 11% improved fitness level.
Adults with high blood pressure but no other cardiac trouble may be more likely to develop heart problems if they consume alcohol, according to a study scheduled for discussion at a meeting of the American Society of Hypertension. Researchers found that even moderate drinking can disrupt the function of the lower left chamber of the heart, with adults who drank the most alcohol showing signs of thicker left ventricular walls, which results in a less flexible chamber and less efficient movement of blood.
Only one patient safety indicator developed by the CMS and the Agency for Healthcare Research and Quality to assess hospital quality clearly reflects patient safety, according to a Johns Hopkins University study published in Medical Care. The 21 metrics are used by numerous organizations to evaluate and rank hospitals, but 16 measures lacked adequate data for inclusion in the analysis. Of the remaining five, only PSI 15, which tracks intraoperative accidental punctures or lacerations, can be considered valid, the researchers reported. Health care providers, payers and policymakers should collaborate on developing robust safety and quality measures, lead author Dr. Bradford Winters said.
A report found that about 73% of responding independent physicians said they did not want to sell their practice, although 44% said they were likely to do so. The "Physician Migratory Patterns: Threats to Independents and Implications for the Future" report found 49% of physicians said the most attractive practice model was collaborating in independent practice associations with like-minded specialists.
Nearly 50% of parents said that they kept their children's leftover prescription opioids such as Oxycontin and Percocet at home, while 30% disposed of leftover pills in the trash or toilet, and only 8% returned them to the doctor or pharmacy, according to the C.S. Mott Children's Hospital National Poll on Children's Health. Researchers surveyed nearly 1,200 parents with at least one child, aged 5 to 17, and found that only one-third said that their child's doctor told them what to do with excess medication.