Publications

Take a deeper look into all the publications produced by researchers at The Dartmouth Institute.

Weeks WB, Jain N, Weinstein JN

2020 Oct 1;45(19):1382doi: 10.1097/BRS.0000000000003601

Spine (Phila Pa 1976)|2020 Oct 1

Fraze TK, Briggs ADM, Whitcomb EK, Peck KA, Meara E

2020 Oct;58(10):853-860doi: 10.1097/MLR.0000000000001364

The objective of this study was to estimate trends in the percentage of Medicare beneficiaries cared for by nurse practitioners from 2012 to 2017, to characterize beneficiaries cared for by nurse practitioners in 2017, and to examine how the percentage of beneficiaries cared for by nurse practitioners varies by practice characteristics.

Med Care|2020 Oct

Wang ME, Leyenaar JK, Leykum L

2020 Sep;15(9):576doi: 10.12788/jhm.3496

J Hosp Med|2020 Sep

Stahl JE, Belisle SS, Zhao W

2020;7:422doi: 10.3389/fmed.2020.00422

Physical inactivity, sedentary lifestyle, and impaired neuromuscular function increases fall risk and fractures in our aging population. Mind-body modalities, improve strength, balance and coordination, mitigating these risks. This study examined whether a manualized Medical Qigong protocol measurably improves balance, gait, and health self-confidence among older adults. Randomized prospective cohort pre-post study with wait time control. Two martial arts centers in Massachusetts and Arizona. Ninety-five adults age ≥ 50 (mean age 68.6 y.o., range 51-96) were randomly assigned to an immediate start group (N = 53) or 4-week delayed start group ( = 43). A 10 form qigong protocol taught over 12 weekly classes. Primary outcome measures were the Community Balance and Mobility Scale (CBMS) and Activities-Specific Balance Confidence (ABC) Scale. Data was collected at baseline, 1-month and 4-months. Both groups at both sites demonstrated improved balance and gait (CBMS + 11.9 points, < 0.001). This effect was strongest in patients in their 60 s (CBMS +12.9 < 0.01) and 70 s (CBMS + 14.3, < 0.001), was equal across genders and socioeconomic status. Balance self-confidence did not significantly change (ABC + 0.9, = 0.48), though several elements within ABC trended toward improvement [e.g., walk up/down ramp ( = 0.07), bend over/pick up ( = 0.09)]. Falls in the past year was inversely correlated with balance self-confidence ( = 0.01). A 12-week manualized Medical Qigong protocol significantly improved balance and gait and modestly improved balance self-confidence among older adults. Medical Qigong may be a useful clinical intervention for older adults at heightened risk for falls and related injuries. www.ClinicalTrials.gov, identifier: NCT04430751.

Front Med (Lausanne)|2020

Batsis JA, Petersen CL, Cook SB, Al-Nimr RI, Pidgeon D, Mackenzie TA, Bartels SJ

2020 Sep 9;:1-13doi: 10.1080/21551197.2020.1817226

This study was a 12-week feasibility weight-loss intervention consisting of caloric restriction and aerobic/resistance exercise in older adults with obesity (body mass index ≥ 30 kg/m) in a geographically isolated area. Primary outcomes assessed weight and physical function. Mean age was 71.0 ± 5.1 years (67% female). Individuals completed 100% of all assessments, attended 88% of the physical therapy classes and 89% of the nutrition sessions. Level of satisfaction (5-point Likert) was high (5.0, 1 - low; 5 - high). Weight decreased from 93.7 ± 9.7 to 89.4 ± 4.0 kg ( < 0.001). Mean BMI and waist circumference decreased, respectively, from 35.4 ± 3.4 to 33.6 ± 3.7 ( < 0.001), and 116.3 ± 7.5 to 108.7 ± 9.2 cm ( = 0.002). Grip strength, gait speed, and 5-times sit-to-stand time all improved from 29.2 ± 7.5 to 35.2 ± 6.7 kg ( = 0.006), 1.16 ± 0.21 to 1.35 ± 0.23 m/s ( = 0.004), and 12.5 ± 4.0 to 9.6 ± 1.7s ( = 0.02). The intervention was feasible and acceptable, and holds promise in promoting weight loss with a concomitant improvement in physical function in older adults.

J Nutr Gerontol Geriatr|2020 Sep 9

Colla CH, Ajayi T, Bitton A

2020 Sep 8;324(10):948-950doi: 10.1001/jama.2020.13093

JAMA|2020 Sep 8

Soneji S, Knutzen KE, Gravely S, Elton-Marshall T, Sargent J, Lambert E, Hilmi N, Sharma E, Jackson KJ, Wang B, Robinson J, Driezen P, Bover-Manderski M, Bansal-Travers M, Hyland A, Travers M, Yang DH, Dang R, Fong GT

2020 Sep 7;doi: 10.1111/add.15250

The prevalence of hookah smoking has increased in the United States since at least 2010, especially among youth and young adults. This study assessed self-reported reasons for hookah smoking cessation and transition to or maintenance of high-frequency hookah smoking among current hookah smokers.

Addiction|2020 Sep 7

Schwedhelm TM, Rees JR, Onega T, Zipkin RJ, Schaefer A, Celaya MO, Moen EL

2020 Sep 3;20(1):847doi: 10.1186/s12885-020-07355-6

Oncotype DX® (ODX) is used to assess risk of disease recurrence in hormone receptor positive, HER2-negative breast cancer and to guide decisions regarding adjuvant chemotherapy. Little is known about how physician factors impact treatment decisions. The purpose of this study was to examine patient and physician factors associated with ODX testing and adjuvant chemotherapy for breast cancer patients in New Hampshire.

BMC Cancer|2020 Sep 3

Check DK, Zullig LL, Davis MM, Davies L, Chambers D, Fleisher L, Kaplan SJ, Proctor E, Ramanadhan S, Schroeck FR, Stover AM, Koczwara B

2020 Aug 31;doi: 10.1007/s11606-020-06138-w

Efforts to improve cancer care primarily come from two fields: improvement science and implementation science. The two fields have developed independently, yet they have potential for synergy. Leveraging that synergy to enhance alignment could both reduce duplication and, more importantly, enhance the potential of both fields to improve care. To better understand potential for alignment, we examined 20 highly cited cancer-related improvement science and implementation science studies published in the past 5 years, characterizing and comparing their objectives, methods, and approaches to practice change. We categorized studies as improvement science or implementation science based on authors' descriptions when possible; otherwise, we categorized studies as improvement science if they evaluated efforts to improve the quality, value, or safety of care, or implementation science if they evaluated efforts to promote the implementation of evidence-based interventions into practice. All implementation studies (10/10) and most improvement science studies (6/10) sought to improve uptake of evidence-based interventions. Improvement science and implementation science studies employed similar approaches to change practice. For example, training was employed in 8/10 implementation science studies and 4/10 improvement science studies. However, improvement science and implementation science studies used different terminology to describe similar concepts and emphasized different methodological aspects in reporting. Only 4/20 studies (2 from each category) described using a formal theory or conceptual framework to guide program development. Most studies were multi-site (10/10 implementation science and 6/10 improvement science) and a minority (2 from each category) used a randomized design. Based on our review, cancer-related improvement science and implementation science studies use different terminology and emphasize different methodological aspects in reporting but share similarities in purpose, scope, and methods, and are at similar levels of scientific development. The fields are well-positioned for alignment. We propose that next steps include harmonizing language and cross-fertilizing methods of program development and evaluation.

J Gen Intern Med|2020 Aug 31

Perez TA, Castillo EG, Ancochea J, Pastor Sanz MT, Almagro P, Martínez-Camblor P, Miravitlles M, Rodríguez-Carballeira M, Navarro A, Lamprecht B, Ramírez-García Luna AS, Kaiser B, Alfageme I, Casanova C, Esteban C, Soler-Cataluña JJ, De-Torres JP, Celli BR, Marin JM, Lopez-Campos JL, Riet GT, S...

2020 Sep;171:106105doi: 10.1016/j.rmed.2020.106105

There is partial evidence that COPD is expressed differently in women than in men, namely on symptoms, pulmonary function, exacerbations, comorbidities or prognosis. There is a need to improve the characterization of COPD in females.

Respir Med|2020 Sep

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