Health care has modest effects on the extension of US life expectancy, while behavioral and social determinants may have larger effects. American science produces the bestand most expensivemedical treatments in the world. Catalogues live online from 5th March. View details for DOI 10.1136/bmjebm-2020-111641. However, the PE group showed lower basal heart rate and greater chest respiratory amplitude. View details for DOI 10.1377/hlthaff.2018.0443, View details for Web of Science ID 000463962900016. By Robert D. Kaplan. A., King, A. C., Frierson, G., Hsu, F., Walkup, M., Pahor, M. Health-related quality of life in older adults at risk for disability. B., Pellegrini, C. A., Chen, S., Allore, H. G., Miller, M. E. Cost-effectiveness of the LIFE Physical Activity Intervention for Older Adults at Increased Risk for Mobility Disability. The racial/ethnic distribution was 84.1% non-Hispanic white, 9.2% non-Hispanic black, 4.1% Hispanic, and 2.6% Asian. . Robert Kaplan brings together extensive data to make the case that health care priorities in the United States are sorely misplaced. View details for Web of Science ID 000311424100024, View details for PubMedCentralID PMC3476929. One In Five Fewer Heart Attacks: Impact, Savings, And Sustainability In San Diego County Collaborative. Ninety-five percent confidence intervals (CI) were estimated using Monte Carlo modeling with random variation for three variables (cost of an emergency department visit, cost of a sobering center visit, and start-up costs per sobering center visit) and the percentage of cases diverted from emergency departments to sobering centers. However, a significant interaction was observed between sex and count frequency (P=0.036) for those without CVD, as counts per minute was related to HCHD risk in women (=-0.94, -1.48 to -0.41; P<0.001) but not in men (=-0.14, -0.59 to 0.88; P=0.704).Daily time spent being sedentary is positively associated with predicted 10-year HCHD risk among mobility-limited older adults. Espeland, M. A., Newman, A. Conclusions. The assessment of mobility is essential to both aging research and clinical geriatric practice. Genealogy for Robert Roman Kaplan (1908 - 1978) family tree on Geni, with over 240 million profiles of ancestors and living relatives. His funeral. Finally, a large number of published studies were not registered in ClinicalTrials.gov, but many of these were published before ClinicalTrials.gov's inception date of 2000.Improved prospective registration of trials and consistent reporting of results in ClinicalTrials.gov would help make ClinicalTrials.gov records more useful in finding unpublished information and identifying potential biases. View details for Web of Science ID 000391236900011. Medical tests - whether true or false - generate strong psychological messages. Outcomes were assessed every six months for up to 42 months by staff masked to intervention assignment. This shift also aims to motivate other large government and private payors to accelerate the adoption of value-based care through TRICARE's example. Comparison of Rating Scale, Time Tradeoff, and Conjoint Analysis Methods for Assessment of Preferences in Prostate Cancer. These findings suggest mobility benefit from such a program in vulnerable older adults.clinicaltrials.gov Identifier: NCT01072500. The mean number of counts per minute of daily PA was not significantly associated with HCHD risk in any model (P>0.05). The U.S. Military Health System spends about $50 billion annually to provide care to 9.6 million active duty service members, retirees, and their families through its TRICARE health plans. Contributions of Health Care to Longevity: A Review of 4 Estimation Methods. View details for PubMedCentralID PMC4772786. Looking for books by Robert M. Kaplan? Kaplan, R. M., Glassman, J. R., Milstein, A. A., Glynn, N. W., King, A. C., Anton, S. D., Walkup, M., Lu, C., Reid, K., Spring, B., Pahor, M. METHODS FOR QUANTIFYING EFFICACY-EFFECTIVENESS GAP OF RANDOMIZED CONTROLLED TRIALS: EXAMPLES IN ARDS. Cost estimates were derived from medical literature and national databases, including both public and private U.S. payers. Rochlin, D. H., Lee, C., Scheuter, C., Milstein, A., Kaplan, R. M. Systems Delivery Innovation for Alzheimer Disease. Bondoc, I., Cochrane, S. K., Church, T. S., Dahinden, P., Hettwer, S., Hsu, F., Stafford, R. S., Pahor, M., Buford, T. W. Effect of a 24-Month Physical Activity Intervention vs Health Education on Cognitive Outcomes in Sedentary Older Adults The LIFE Randomized Trial. Clinicians should consider targeted recommendation of physical activity and moderate-intensity exercise for older adults as a treatment to slow decline in eGFRCysC.Trial Registration: ClinicalTrials.gov Identifier: NCT01072500. Epidemiological evidence suggests that physical activity benefits cognition, but results from randomized trials are limited and mixed.To determine whether a 24-month physical activity program results in better cognitive function, lower risk of mild cognitive impairment (MCI) or dementia, or both, compared with a health education program.A randomized clinical trial, the Lifestyle Interventions and Independence for Elders (LIFE) study, enrolled 1635 community-living participants at 8 US centers from February 2010 until December 2011. The outcome was respondents' reported likelihood of receiving a vaccine for the coronavirus. Associations between these exposures and measured BMI and grip strength were evaluated using linear regression.Greater time spent in light intensity activity and lower sedentary times were both associated with lower BMI. Limited evidence suggests that physical activity may help prevent mobility disability; however, there are no definitive clinical trials examining whether physical activity prevents or delays mobility disability.To test the hypothesis that a long-term structured physical activity program is more effective than a health education program (also referred to as a successful aging program) in reducing the risk of major mobility disability.The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, randomized trial that enrolled participants between February 2010 and December 2011, who participated for an average of 2.6 years. Collaborative care has been widely studied from an economic perspective, with most studies demonstrating its relative cost-effectiveness per quality-adjusted life year (QALY) and some studies demonstrating its potential for cost neutrality or cost savings. Last updated 4 months ago. A., Gill, T. M., Marsh, A. P., Hsu, F., Yaghjyan, L., Woods, A. J., Glynn, N. W., King, A. C., Newton, R. L., Fielding, R. A., Pahor, M., Manini, T. M., Lifestyles Intervention and Independence for Elders Study Investigators. View Details. Before 2011 rates of hospitalization for heart attacks were about the same in San Diego County as they were in the rest of California. Waist circumference also was significantly higher in obese groups (DYN-O=114.012.9 and NDYN-O=111.213.1) than in nonobese (NDYN-NO=93.110.7 and DYN-NO=92.211.2, P.01); and higher in NDYN-O compared with DYN-O (P=.008). The methods are general and can be used to estimate the cost-effectiveness of social and environmental interventions in addition to traditional medical and surgical treatments. The purpose of this paper is to review standardized approaches to cost-effectiveness analysis and to encourage their use for the evaluation of behavioral intervention programs. Patient-reported outcomes are recognized as essential for the evaluation of medical and public health interventions. Dr Robert M Kaplan is a company that operates in the Hospital & Health Care industry. Application of standardized methods of cost-effectiveness analysis will allow direct comparisons between investing in behavioral interventions programs in comparison to a wide range of other alternatives. Pending further verification, the results may help to inform subsequent targeting of such subgroups for further investigation.Clinicaltrials.gov Identifier= NCT01072500. A., Goodpaster, B. H., McDermott, M. M., Nicklas, B. J., Yank, V., Johnson, J. Dismiss. Physical activity was measured by step count and minutes of moderate-intensity activity using accelerometers.Main Outcomes and Measures: The primary outcome was change in eGFRCysC. Buford, T. W., Hsu, F., Brinkley, T. E., Carter, C. S., Church, T. S., Dodson, J. To advance the field, we need a greater emphasis on evaluations that ask 'Does the treatment work under real-world conditions? Greater time spent in higher but not lower intensities of light activity (assessed objectively) was associated with greater grip strength in men but not women, while neither objectively assessed nor self-reported sedentary time was associated with grip strength.In this cross-sectional study, greater time spent in light intensity activity and lower sedentary times were associated with lower BMI. Costs for this PA program for older adults are comparable to those of other PA interventions. Schmaling, K., Kaplan, R. M., Porzsolt, F. Questioning the Benefit of Statins for Low-Risk Populations-Medical Misinformation or Scientific Evidence?-Reply. The subgroups with the lowest obesity prevalence (45.5-59.4%) consisted of participants who reported living in neighborhoods with higher residential density. This pilot work examined associations of brain grey matter volumes (GMV) with perceived fatigability in older adults to elucidate disablement mechanisms. Competing interests: None declared Competing interests: No competing interests 20 February 2004 Robert M Kaplan psychiatrist 2500 However, statistical test results were not included in 230 studies (55.3%). The Coming Anarchy. Fitzgerald, J. D., Johnson, L., Hire, D. G., Ambrosius, W. T., Anton, S. D., Dodson, J. Wilson, D. K., Christensen, A., Jacobsen, P. B., Kaplan, R. M. Cost impact of sobering centers on national health care spending in the United States. View details for DOI 10.1093/milmed/usab271. After checking Hardy-Weinberg equilibrium, we used using linear regression to evaluate the genotype*treatment interaction for each outcome. Robert Kaplan is Managing Director of Cape Gate Fence & Wire Works, and is a past president of the Cape Chamber of Industries. Rating scales were rated as easiest to use and respondents were more satisfied with rating scales and conjoint in comparison to time tradeoffs. In 1990, the Senate Appropriations Committee, recognizing that behavior may contribute to about half of all premature deaths, recommended that funding for behavioral and social sciences research should be about 10% of the NIH budget. Among participants aged 79-89 years, the subgroup (of three distinct subgroups identified) with the lowest obesity prevalence (19.4%) consisted of non-African American/Black participants who reported living in neighborhoods with friends or acquaintances similar in demographic characteristics to themselves. View details for DOI 10.1146/annurev-publhealth-052120-012811. A newly developed self-report measure of mobility, the mobility assessment tool-short form (MAT-sf), uses video animations as an innovative method to improve measurement accuracy/precision. The relationship between race/ethnicity, other potential risk factors, and the risk of incident diabetes was estimated using Cox proportional hazards models from which hazard ratios (HRs) and 95% CIs were computed.Participants were aged 63 years on average at baseline. Compared with studies without results, studies with any results were more likely to have hypotheses, include drug treatment conditions, and to have publications related to the study.CONCLUSIONS: Required study registration does not always result in transparent outcome reporting. B., Tudor-Locke, C., Gill, T. M. Light Intensity Physical Activity and Sedentary Behavior in Relation to Body Mass Index and Grip Strength in Older Adults: Cross-Sectional Findings from the Lifestyle Interventions and Independence for Elders (LIFE) Study. Each team then evaluated the impact of the evidence found in ClinicalTrials.gov on the conclusions in the review.Across the five reviews, the number of studies that had both a registry record and a publication varied widely, from none in one review to 43% of all studies identified in another. The ability of our field to communicate cost-effectiveness data to policy makers, employers, and insurers that incorporates implementation costs is central to the likelihood of our interventions being adopted by practitioners and reimbursed by payers. avoids the terminology problem and its misleading consequences. Groessl, E. J., Kaplan, R. M., Castro Sweet, C. M., Church, T., Espeland, M. A., Gill, T. M., Glynn, N. W., King, A. C., Kritchevsky, S., Manini, T., McDermott, M. M., Reid, K. F., Rushing, J., Pahor, M. Cost-effectiveness of the LIFE Physical Activity Intervention for Older Adults at Increased Risk for Mobility Disability. Implementing the intervention in non-research settings may reduce costs further. B., Studenski, S. A., Goodpaster, B. H., Lopez, O., Nadkarni, N. K., Ives, D. G., Newman, M. A., Grove, G., Williams, K., Bonk, J. T., Rush, J., Kost, P., Vincent, P., Gerger, A., Romeo, J. R., Monheim, L. C., Kritchevsky, S. B., Marsh, A. P., Brinkley, T. E., Demons, J. S., Sink, K. M., Kennedy, K., Shertzer-Skinner, R., Wrights, A., Fries, R., Barr, D., Gill, T. M., Axtell, R. S., Kashaf, S. S., de Rekeneire, N., McGloin, J. M., Mautner, R., Huie-White, S. M., Bianco, L., Zocher, J., Wu, K. C., Shepard, D. M., Fennelly, B., Castro, R., Halpin, S., Brennan, M., Barnett, T., Iannone, L. P., Zenoni, M. A., Bugaj, J. A serious adverse reaction rate of 1/100,000 was more likely to discourage vaccine use in comparison to rates of 1/million or 1/100 million. He serves as Chair of United Jewish Appeal (UIA) South Africa and as Chair of the Keren Hayesod Budget Committee. Outcome assessors were blinded to the intervention assignment. Kaplan was elected to the National Academy of Medicine (formerly the Institute of Medicine) in 2005. The main effects and interactions in the model remained unchanged. View details for DOI 10.1176/appi.ps.201900098. Rapid eGFRCysC decline was defined by the high tertile threshold of 6.7%/y.Results: Among the 1199 participants in the analysis, the mean (SD) age was 78.9 (5.2) years, and 800 (66.7%) were women. Standardized cost-effectiveness methodologies are now commonly used in the evaluation of medical therapies and new technologies. Robert M Kaplan Catherine M Crespi Ely Dahan Josemanuel D Saucedo Casey Pagan Christopher S Saigal. A consequence of neglecting to employ standardized cost-effectiveness analysis is that behavioral, psychological, and environmental interventions may be left out of resource allocation discussions. Partitioning the MAT-sf into four groups revealed that persons with scores <40, 40-49, 50-59, and 60+ had failure rates across 42 months of follow-up of 66%, 52%, 35%, and 22%, respectively.The MAT-sf is a quick and efficient way of identifying older adults at risk for MMD. B., Rejeski, W. J., Sink, K. M., Williamson, J. D. Sleep-Wake Disturbances in Sedentary Community-Dwelling Elderly Adults with Functional Limitations. B., Studenski, S. A., Goodpaster, B. H., Lopez, O., Glynn, N. W., Nadkarni, N. K., Ives, D. G., Newman, M. A., Grove, G., Williams, K., Bonk, J. T., Rush, J., Kost, P., Vincent, P., Gerger, A., Romeo, J. R., Monheim, L. C., Kritchevsky, S. B., Marsh, A. P., Brinkley, T. E., Demons, J. S., Sink, K. M., Kennedy, K., Shertzer-Skinner, R., Wrights, A., Fries, R., Barr, D., Gill, T. M., Axtell, R. S., Kashaf, S. S., de Rekeneire, N., McGloin, J. M., Mautner, R., Huie-White, S. M., Bianco, L., Zocher, J., Wu, K. C., Shepard, D. M., Fennelly, B., Castro, R., Halpin, S., Brennan, M., Barnett, T., Iannone, L. P., Zenoni, M. A., Bugaj, J. Secondary analyses classified intervention participants into two subgroups, (1) individual therapy only or (2) group training (i.e., coping skills training) plus individual therapy, to determine whether medical outcomes differed in participants who received the combination of group training and individual therapy compared to participants who received individual therapy only or usual care.Secondary analyses of 1243 usual care, 781 individual therapy only, and 356 group plus individual therapy myocardial infarction (MI) patients were performed. Multivariate regression analysis suggested that adjustment for age, race, poverty status and marital status explained part, but not nearly all, of the relationship between education and health. Data are presented on participants' motives and self-perceptions at the onset of the trial along with accelerometry data on patterns of PA during exercise training. Our findings show that the majority of diabetes cases are preventable, and risk reduction strategies can be effectively applied to all racial/ethnic groups. Geopolitics. Fremont, A., Kim, A. Y., Bailey, K., Hanley, H. R., Thorne, C., Dudl, R. J., Kaplan, R. M., Shortell, S. M., DeMaria, A. N. Educational Attainment and Health Outcomes: Data From the Medical Expenditures Panel Survey, Dynapenia and Metabolic Health in Obese and Nonobese Adults Aged 70 Years and Older: The LIFE Study. Those with less education were also more likely to be uninsured throughout the year. (PsycINFO Database Record, View details for Web of Science ID 000402052300010. Yet U.S. citizens lag behind their global peers in life expectancy and quality of life. To determine the effect of a one-year PA intervention on changes in CAF concentrations and to evaluate baseline and longitudinal associations between CAF concentrations and indices of physical function.Ancillary study to the Lifestyle Interventions and Independence for Elders Pilot (LIFE-P), a multi-site randomized clinical trial designed to evaluate the effects of chronic exercise on the physical function of older adults at risk for mobility disability.Four academic research centers within the U.S.Three hundred thirty three older adults aged 70 to 89 with mild to moderate impairments in physical function.A 12-month intervention of either structured physical activity (PA) or health education promoting successful aging (SA).Serum CAF concentrations and objectives measures of physical function - i.e. Optional sessions were offered during maintenance weeks (25-52). Baseline gait speed was significantly correlated with baseline CAF level (r = -0.151, p= 0.006), however the association between CAF and SPPB was not significant. Systematic standardized methodologies for valuing outcomes are available and are being applied by economists and health services researchers, but are not widely used in our field. After an average of 10.4 years of follow-up, compared with whites and adjusting for potential confounders, the HRs for incident diabetes were 1.55 for blacks (95% CI 1.47-1.63), 1.67 for Hispanics (1.54-1.81), and 1.86 for Asians (1.68-2.06). View details for DOI 10.1016/j.jpsychores.2009.01.015, View details for Web of Science ID 000267625300008. He has served as Chief Science Officer at the US Agency for Health Care Research and Quality (AHRQ) and Associate Director of the National Institutes of Health, where he led the behavioral and social sciences programs. A., Zenoni, M. A., Mignosa, B. M., Williamson, J., Hendrie, H. C., Rapp, S. R., Verghese, J., Woolard, N., Espeland, M., Jennings, J., Wilson, V. K., Pepine, C. J., Ariet, M., Handberg, E., Deluca, D., Hill, J., Szady, A., Chupp, G. L., Flynn, G. M., Hankinson, J. L., Vaz Fragoso, C. A., Groessl, E. J., Kaplan, R. M. THE NEED FOR ADAPTION: A CALL FOR PROMOTING THE VALUE OF BEHAVIORAL SCIENTISTS IN PUBLIC HEALTH CHALLENGES AND POLICIES.
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