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A Cluster-Randomized Study of Technology-Assisted Health Coaching for Weight Management in Primary Care [Original Research]

PURPOSE

We undertook a trial to test the efficacy of a technology-assisted health coaching intervention for weight management, called Goals for Eating and Moving (GEM), within primary care.

METHODS

This cluster-randomized controlled trial enrolled 19 primary care teams with 63 clinicians; 9 teams were randomized to GEM and 10 to enhanced usual care (EUC). The GEM intervention included 1 in-person and up to 12 telephone-delivered coaching sessions. Coaches supported goal setting and engagement with weight management programs, facilitated by a software tool. Patients in the EUC arm received educational handouts. We enrolled patients who spoke English or Spanish, were aged 18 to 69 years, and either were overweight (body mass index 25-29 kg/m2) with a weight-related comorbidity or had obesity (body mass index ≥30 kg/m2). The primary outcome (weight change at 12 months) and exploratory outcomes (eg, program attendance, diet, physical activity) were analyzed according to intention to treat.

RESULTS

We enrolled 489 patients (220 in the GEM arm, 269 in the EUC arm). Their mean (SD) age was 49.8 (12.1) years; 44% were male, 41% Hispanic, and 44% non-Hispanic Black. At 12 months, the mean adjusted weight change (standard error) was –1.4 (0.8) kg in the GEM arm vs –0.8 (1.6) kg in the EUC arm, a nonsignificant difference (P = .48). There were no statistically significant differences in secondary outcomes. Exploratory analyses showed that the GEM arm had a greater change than the EUC arm in mean number of weekly minutes of moderate to vigorous physical activity other than walking, a finding that may warrant further exploration.

CONCLUSIONS

The GEM intervention did not achieve clinically important weight loss in primary care. Although this was a negative study possibly affected by health system resource limitations and disruptions, its findings can guide the development of similar interventions. Future studies could explore the efficacy of higher-intensity interventions and interventions that include medication and bariatric surgery options, in addition to lifestyle modification.




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[PERSPECTIVES] New Paradigms in the Clinical Management of Li-Fraumeni Syndrome

Approximately 8.5%–16.2% of childhood cancers are associated with a pathogenic/likely pathogenic germline variant—a prevalence that is likely to rise with improvements in phenotype recognition, sequencing, and variant validation. One highly informative, classical hereditary cancer predisposition syndrome is Li–Fraumeni syndrome (LFS), associated with germline variants in the TP53 tumor suppressor gene, and a >90% cumulative lifetime cancer risk. In seeking to improve outcomes for young LFS patients, we must improve the specificity and sensitivity of existing cancer surveillance programs and explore how to complement early detection strategies with pharmacology-based risk-reduction interventions. Here, we describe novel precision screening technologies and clinical strategies for cancer risk reduction. In particular, we summarize the biomarkers for early diagnosis and risk stratification of LFS patients from birth, noninvasive and machine learning–based cancer screening, and drugs that have shown the potential to be repurposed for cancer prevention.




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Management of opioid use disorder: 2024 update to the national clinical practice guideline [Guideline]

Background

In an evolving landscape of practices and policies, reviewing and incorporating the latest scientific evidence is necessary to ensure optimal clinical management for people with opioid use disorder. We provide a synopsis of the 2024 update of the 2018 National Guideline for the Clinical Management of Opioid Use Disorder, from the Canadian Research Initiative in Substance Matters.

Methods

For this update, we followed the United States Institute of Medicine’s Standards for Developing Trustworthy Clinical Practice Guidelines and used the Appraisal of Guidelines Research and Evaluation—Recommendation Excellence tool to ensure guideline quality. We carried out a comprehensive systematic literature review, capturing the relevant literature from Jan. 1, 2017, to Sept. 14, 2023. We drafted and graded recommendations according to the Grading of Recommendations, Assessments, Development and Evaluation approach. A multidisciplinary external national committee, which included people with living or lived experience of opioid use disorder, provided input that was incorporated into the guideline.

Recommendations

From the initial 11 recommendations in the 2018 guideline, 3 remained unchanged, and 8 were updated. Specifically, 4 recommendations were consolidated into a single revised recommendation; 1 recommendation was split into 2; another recommendation was moved to become a special consideration; and 2 recommendations were revised. Key changes have arisen from substantial evidence supporting that methadone and buprenorphine are similarly effective, particularly in reducing opioid use and adverse events, and both are now considered preferred first-line treatment options. Slow-release oral morphine is recommended as a second-line option. Psychosocial interventions can be offered as adjunctive treatment but should not be mandatory. The guideline reaffirms the importance of avoiding withdrawal management as a standalone intervention and of incorporating evidence-based harm reduction services along the continuum of care.

Interpretation

This guideline update presents new recommendations based on the latest literature for standardized management of opioid use disorder. The aim is to establish a robust foundation upon which provincial and territorial bodies can develop guidance for optimal care.




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Management of central sleep apnoea: a review of non-hypercapnic causes

Central sleep apnoea (CSA) is characterised by recurrent episodes of airway cessation or reduction in the absence of respiratory effort. Although CSA is less common than obstructive sleep apnoea, it shares similar symptoms. CSA can be secondary to various medical conditions, high altitude and medication exposure. CSA can also emerge during obstructive sleep apnoea therapy. There are a range of treatment options and selecting the right therapy requires an understanding of the pathophysiology of CSA. This review explores the aetiology, pathophysiology and clinical management of non-hypercapnic CSA.




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Controversies in the clinical management of chronic pulmonary aspergillosis

Chronic pulmonary aspergillosis has a range of manifestations from indolent nodules to semi-invasive infection. Patients may be asymptomatic or have chronic symptoms such as cough and weight loss or present with life-threatening haemoptysis. The physician can choose from a range of available therapies including medical therapy with antifungals, minimally invasive therapy with intracavitary antifungal therapy and surgery involving open thoracotomy or video-assisted thoracoscopic surgery. The patients with the most severe forms of pulmonary infection may not be surgical candidates due to their underlying pulmonary condition. The management of haemoptysis can include tranexamic acid, bronchial artery embolisation, antifungals or surgery. There are few controlled studies to inform clinicians managing complex cases, so a multidisciplinary approach may be helpful.




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Palliative care in lung cancer: tumour- and treatment-related complications in lung cancer and their management

Palliative care pertains to the holistic multidimensional concept of "patient-centred" care. It is an interprofessional specialty, primarily aiming to improve quality of care for cancer patients and their families, from the time of diagnosis of malignant disease, over the continuum of cancer care, and extending after the patient's death to the period of bereavement to support the patient's family. There are various complex and frequently unmet needs of lung cancer patients and their families/caregivers, not only physical but also psychological, social, spiritual and cultural. Systematic monitoring of patients’ symptoms using validated questionnaires and patient-reported outcomes (PROs), on a regular basis, is highly encouraged and recommended in recent guidelines on the role of PRO measures in the continuum of cancer clinical care. It improves patient–physician communication, physician awareness of symptoms, symptom control, patient satisfaction, health-related quality of life and cost-effectiveness. This implies that all treating physicians should improve their skills in communication with lung cancer patients/relatives and become more familiar with this multidimensional assessment, repeatedly screening patients for palliative care needs. Therefore, they should receive education and training to develop palliative care knowledge, skills and attitudes. This review is dedicated to lung cancer palliative care essentials that should be within the competences of treating physicians, i.e. pneumologists/thoracic oncologists.




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Optimizing Vendor Portfolio with Vendor Management Software

In today’s complex business environment, organizations rely heavily on external vendors for essential services and resources. Managing these relationships effectively is crucial for operational efficiency, cost control, and risk management. To achieve this, many companies turn to Vendor Management Software to streamline vendor interactions, ensuring that the right processes and tools are in place for […]

The post Optimizing Vendor Portfolio with Vendor Management Software appeared first on Chart Attack.




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How to Overcome Your Device Dependency and Manage a Successful Digital Detox

Getting outside – without your phone – is one way to disconnect.




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Alberta government fires AIMCo board, four top executives, in 'reset' for pension fund manager

The province says the move comes "after years of AIMCo consistently failing to meet its mandated benchmark returns." For now, Finance Minister Nate Horner has been appointed the AIMCo board's sole director and chair. Senior public servant Ray Gilmour has been appointed interim CEO.



  • News/Canada/Edmonton

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Let African Communities Manage Their Climate Adaptation Plans

Outside groups often offer their solutions for climate adaptation in Africa. But the best people to manage the climate crisis are the people in those communities themselves. For climate adaptation to succeed in Africa, let communities and local leaders show the way




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A Wearable to Manage Parkinson’s Motor Symptoms: Interview with Lucy Jung, CEO at Charco Neurotech

Charco Neurotech, a medtech company based in the United Kingdom, has developed CUE1, a non-invasive wearable that is intended to assist those with Parkinson’s disease to manage their motor symptoms. The device is typically affixed to the sternum, and provides vibratory action in a focused region of the body. The technology is based on the […]




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Hospitals Are Relying More on PBMs to Manage Manufacturers' 340B Contract Pharmacy Restrictions: DCI's 2024 Market Analysis (rerun)

This week, I’m rerunning some popular posts while we put the finishing touches on DCI’s new 2024-25 Economic Report on Pharmaceutical Wholesalers and Specialty Distributors.

Click here to see the original post from June 2024.



The 340B contract pharmacy market shows little sign of slowing down. Drug Channels Institute’s exclusive analysis of the 2024 market reveals that:
  • About 33,000 pharmacy locations—more than half of the entire U.S. pharmacy industry—act as contract pharmacies for the hospitals and federal grantees that participate in the 340B program. 
  • Five multi-billion-dollar, for-profit, publicly traded pharmacy chains and pharmacy benefit managers (PBMs)—Cigna (via Express Scripts), CVS Health, UnitedHealth Group (via OptumRx), and Walgreens, Walmart—continue to dominate the 340B contract pharmacy market.
  • Federal grantees are aligned primarily with the vertically intergated organizations' retail pharmacies, while hospitals rely on mail and specialty pharmacies.
Over the past four years, manufacturers’ restrictions on 340B contract pharmacies have led hospitals to deepen their relationships with the largest PBMs—even as those PBMs have simultaneously limited hospitals’ direct participation in specialty pharmacy networks.

For an updated look at what’s next for the 340B contract pharmacy market, join Adam J. Fein, Ph.D., on June 21 for his latest live video webinar: The 340B Drug Pricing Program: Trends, Controversies, and Outlook.
Read more »
       




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Pain Management in Crisis: Why Hospitals Are Limiting Pain Medications and What This Means for Patients

Hospitals across the U.S. have significantly restricted the use of pain medications containing narcotics. This shift comes amid […]

The post Pain Management in Crisis: Why Hospitals Are Limiting Pain Medications and What This Means for Patients appeared first on World of DTC Marketing.




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Institutional investors' shifting allocation strategies are driving hedge funds towards new products - EY�s Natalie Deak on how hedge fund managers are pursuing growth

EY�s Natalie Deak on how hedge fund managers are pursuing growth




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Rules are Changing for Corporate Reputation Management, According to Sodexo 2015 Workplace Trends Report - 2015 Sodexo Workplace Trends Overview

2015 Sodexo Workplace Trends Overview







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Danica Patrick All Smiles as Aspen Dental Management, Inc. Extends Partnership, Doubles Commitment - Danica�s Racecar Honors Veterans

Aspen Dental & Danica Patrick unveil a salute to more than 2,200 veterans at Chicagoland Speedway to honor their service and raise awareness about the need for oral health care.





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CA Intermediate Cost and Management Accounting Question Paper New Course September 2024

Download CA Intermediate Cost and Management Accounting Question Papers New Course Sep 2024 in PDF. For other question papers of CA Inter May 2024, Nov 2023, May 2023, Nov 2022, May 2022, Dec 2021, July 2021, Nov 2020, Nov 2019, May 2019, Nov 18, May 2018, Nov 2017, Nov 2016, May 2016, May 17, may 2016, CA IPC Nov 2015, CA IPC may 2015, CA IPC Nov 2014 check similar section. Previous years Taxation CA IPCC IPC question papers can also be downloaded using Search. You can also search and download may 2015 Final question papers here. We are providing ca final question papers of may 2016 for Financial Reporting FR, Advanced Financial Management AFM, Advanced Auditing and Professional Ethics, Taxation, Corporate & Allied Laws,Advanced & Management Accounting AMA, Direct Tax Laws DT, Indirect Tax Laws IDT and IPCC/IPC may 2015 question papers for Advanced Accounting , Business, Law, Ethics & Communications, Taxation, Advanced Accounting , Auditing & Assurance, Information Technology & Strategic Management ITSM.




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CA Intermediate Financial Management and Strategic Management Question Paper New Course September 2024

Download CA Intermediate Financial Management and Strategic Management Question Papers New Course Sep 2024 in PDF. For other question papers of CA Inter May 2024, Nov 2023, May 2023, Nov 2022, May 2022, Dec 2021, July 2021, Nov 2020, Nov 2019, May 2019, Nov 18, May 2018, Nov 2017, Nov 2016, May 2016, May 17, may 2016, CA IPC Nov 2015, CA IPC may 2015, CA IPC Nov 2014 check similar section. Previous years Taxation CA IPCC IPC question papers can also be downloaded using Search. You can also search and download may 2015 Final question papers here. We are providing ca final question papers of may 2016 for Financial Reporting FR, Advanced Financial Management AFM, Advanced Auditing and Professional Ethics, Taxation, Corporate & Allied Laws,Advanced & Management Accounting AMA, Direct Tax Laws DT, Indirect Tax Laws IDT and IPCC/IPC may 2015 question papers for Advanced Accounting , Business, Law, Ethics & Communications, Taxation, Advanced Accounting , Auditing & Assurance, Information Technology & Strategic Management ITSM.




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CA Final Advanced Financial Management (AFM) Paper New Course Nov 2024

Download CA Final Advanced Financial Management (AFM) Question Papers New Course Nov 2024 in PDF. For older question papers of CA final May 2024, Nov 2023, May 2023, Nov 2022, May 2022, Dec 2021, Nov 2020, May 2019, Nov 2018,CA final May 2018, Nov 2017, May 2017, CA final may 2016, CA final Nov 2016 check similar section. Previous years CA final Financial Reporting FR question papers can also be downloaded using Search. You can also search and download may 2015 IPCC & IPC question papers here. We are providing ca final question papers of may 2016 for Financial Reporting FR, Advanced Financial Management AFM, Advanced Auditing and Professional Ethics, Direct Tax Laws DT, Indirect Tax Laws IDT,Integrated Business Solutions (Multidisciplinary Case Study with Strategic Management) and IPCC/IPC Nov 2023 question papers for Accounting, Business, Law, Ethics & Communications , Cost Accounting & Financial Management CAFM, Taxation, Advanced Accounting , Auditing & Assurance, Information Technology & Strategic Management ITSM.




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Why Fans Think Chappell Roan Has Fired Her Manager Nick Bobetsky

Renowned singer Chappell Roan has stirred discussions among her fans after she commented on Billboard’s post that stated that she has parted ways with her management team and manager, Nick Bobetsky. She recently made headlines after her name was inducted into the list of candidates who are nominated in the big categories of next year’s […]

The post Why Fans Think Chappell Roan Has Fired Her Manager Nick Bobetsky appeared first on ComingSoon.net - Movie Trailers, TV & Streaming News, and More.




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Technical Consultancy for Project Development and Management Support Services to MJP are taxable under GST at the rate of 18%

The AAR Maharashtra, in the case of M/s. The Nisarga Consultancy, In Re [Order No. GST-ARA-21 of 2023-24/2024-25/B-55 dated July 31, 2024] ruled that no tax will be leviable on work allotted by Maharashtra Jeevan Pradhikar ("MJP") as per of Jal Jeevan Mission ("JJM") which is a mission of Government




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'The manager [said], "You really want to burn this bridge?" I said, "Yes"': 20+ Employees who quit their jobs as fast as possible

There's no need to double down on a bad bet, especially when your career is on the line. Although it can be a letdown to try and start a new job only to leave immediately, it's better than staying somewhere you hate for years only to regret it each day. 

 Some workplaces have working conditions that are completely unacceptable, and a lot of folks cited that as their reasons for leaving. For example, one person found themself working in a propane tank factory, but they realized they were working in the second-hottest room possible. They were stationed right next to a kiln room, and the room they were in was often at 130 degrees! They rightfully refused to return to that job. 

Other people were dealing with some really incompetent management situations. As one worker shared, their management at a small retail shop barely bothered to train them, and they spent their entire second day on the job alone. This was the deciding factor for that person, and they called it quits. At least some of the people who shared their stories moved onto way better jobs after learning from these bad ones. 

After that, read about this job candidate who chose the wrong interviewer to lie to, because at the job he claimed to work at, "Nobody knew him." 




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25-year-old employee requests off to attend a funeral, micromanager demands for proof of the service: 'After this, I want to quit'

The last thing anyone wants when they are going through a family emergency is to have to deal with your micromanaging boss simultaneously. Here, we have an employee who took one day off to attend the funeral service of a family member. He did not request any bereavement leave or anything more than just the one day of paid time off he was certainly entitled to based on his contract. 

However, upon his return to the office, his micromanaging supervisor demanded for proof that he did, in fact, take time off to attend a funeral service. Apparently, this was because he also had to dip out early one day due to a dentist appointment. The supervisor's own boss was skeptical about the whole thing and forced the supervisor to request for proof. Now, all the employee wants to do is leave the company with no notice instead.

Keep scrolling below for the full story and for the best reactions from folks in the comments section. For more, check out this post about a 40-year-old company man who was passed over for a promotion in favor of a much younger coworker.




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'[It] is just really tacky': Job candidate interviews with glowing recommendation, picky manager spots one flaw and refuses to hire her

This manager is being totally ridiculous, and he doesn't even realize the full scope of what he did. 

Sticking your neck out for a friend can be risky. In this person's case, they recommended their friend for an interview at their coffee shop job. They figured this friend would be a shoo-in for the role. To be a great barista, you need to be upbeat and positive when interacting with customers, be able to put drinks together quickly, and work well under pressure. U/BAAAUGH was completely exasperated by the way her boss treated that friend she recommended for the job

The only person who should be embarrassed by the way things went down is the boss. It almost seems like he's worried that his staffers will steal coffee or something. First of all, most baristas do drink coffee at their workplaces, but it's a cheap item, just let them have it! And secondly, if that's the boss's biggest concern about a potential employee, maybe he should spend some more time behind the counter, preparing orders, and learning what it actually takes to thrive in a cafe environment. 

Up next, read about this scorned ex who yanked a $600 gift card back from an ex just to get back at her. 




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Unleashing the Power of Curcumin: A Natural Approach to Weight Management

Highlights: Curcumin in turmeric aids weight loss and reduces inflammation It shows promise in managing o




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Smart water management can help avert climate-induced food shortages

Warsaw, Poland – November 15th 2013 – Climate change will have a “profound” impact on water resources that could have serious knock-on effects for agriculture, according to a new report published today. Download the full media release

The post Smart water management can help avert climate-induced food shortages first appeared on International Water Management Institute (IWMI).




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CEA partners with IWMI to improve Colombo’s municipal waste management and farmers’ access to organic fertilizers

Colombo, December 10, 2013. At the request of the Colombo Municipal Council (CMC), the Central Environmental Authority (CEA), in collaboration with the International Water Management Institute (IWMI), organized a stakeholder meeting to discuss improvements that can be made to the management of municipal waste in the City of Colombo. The meeting was held at the […]

The post CEA partners with IWMI to improve Colombo’s municipal waste management and farmers’ access to organic fertilizers first appeared on International Water Management Institute (IWMI).




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Press Release: Sustainable Development Goals Offer Unique Opportunity to Transform Management of Critical Water Resources

Targets that promote efficient, nationally and locally appropriate water use will be key to achieving the SDGs.

The post Press Release: Sustainable Development Goals Offer Unique Opportunity to Transform Management of Critical Water Resources first appeared on International Water Management Institute (IWMI).



  • Press releases
  • Sustainable Development Goals (SDG)
  • sustainable water resources development
  • water for food

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Press Release: Satellite imaging and disaster management experts gather in Colombo

Experts from across Asia gathered to discuss how the next generation of satellite based technologies could help improve disaster preparedness and response at a three-day meeting in Mount Lavinia.

The post Press Release: Satellite imaging and disaster management experts gather in Colombo first appeared on International Water Management Institute (IWMI).




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New project brings five African countries together to jointly manage region’s groundwater

The five Partner States of the Kavango Zambezi Transfrontier Conservation Area (KAZA TFCA) have joined forces with IWMI to manage groundwater resources spanning an area larger than Austria and Germany.

The post New project brings five African countries together to jointly manage region’s groundwater first appeared on International Water Management Institute (IWMI).




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IWMI’s new Board Chair and Sri Lanka’s Prime Minister reiterate commitment to sustainable water management

Climate change and water resilience a joint priority, as international research organization prepares to launch new strategy and mark 40-year anniversary.

The post IWMI’s new Board Chair and Sri Lanka’s Prime Minister reiterate commitment to sustainable water management first appeared on International Water Management Institute (IWMI).




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New Index for Ulcerative Colitis Management

Ulcerative colitis (UC) is an inflammatory bowel illness that affects the lining of the large intestine, causing irritation, inflammation, and medlinkulcers/medlink.




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IWMI awarded for second consecutive year by the Project Management Institute in Sri Lanka

The Climate Smart Governance (CSG) Dashboard is recognized for its contribution to national climate adaptation, planning and development.

The post IWMI awarded for second consecutive year by the Project Management Institute in Sri Lanka first appeared on International Water Management Institute (IWMI).





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A conversation with IWMI’s knowledge management team on enhancing agricultural research with FAO’s AGRIS and AGROVOC programs

AGRIS is a comprehensive bibliographic database focused on agriculture and nutrition, while AGROVOC is a multilingual thesaurus covering a wide range of agricultural terms.

The post A conversation with IWMI’s knowledge management team on enhancing agricultural research with FAO’s AGRIS and AGROVOC programs first appeared on International Water Management Institute (IWMI).




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Hope Vs. Mindfulness: Impact on Stress Management

Hope tends to be more helpful than mindfulness in assisting people in managing their stress and maintaining their professional engagement during extended




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Virtual Therapy Helps Manage Depression and Anxiety

Remote video consultations with medlinkmental health/medlink specialists lead to a small yet meaningful improvement in symptoms of depression and anxiety (!--ref1--).




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Decision Making On Scientific Data For Improved Water Resource Management Critical: IWMI

This training was conducted through the World Bank funded Balochistan Integrated Water Resources Management and Development Project (BIWRMDP).

The post Decision Making On Scientific Data For Improved Water Resource Management Critical: IWMI first appeared on International Water Management Institute (IWMI).




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ECOWAS, IWMI call for efficient water resources management

The Economic Community of West African States (ECOWAS) and IWMI seek to work together to address the challenges of water scarcity, climate change, and sustainable irrigational agriculture practices in the region.

The post ECOWAS, IWMI call for efficient water resources management first appeared on International Water Management Institute (IWMI).



  • In the media
  • water resource management

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Mainstreaming gender in participatory irrigation management: Why does empowerment matter?

Tanusree Paul and Naga Velpuri call for investing in interventions to strengthen women’s capabilities and participation in water governance.

The post Mainstreaming gender in participatory irrigation management: Why does empowerment matter? first appeared on International Water Management Institute (IWMI).





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Telehealth Nurse Case Managers Reduce Blood Pressure in Minority Stroke Survivors

Low-income Black and Hispanic stroke survivors with uncontrolled hypertension experienced a more than two-fold reduction in systolic medlinkblood pressure/medlink




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NCPA Applauds Rep. Weiner for Introducing Bill to Rein in Pharmacy Benefit Manager Practices That Hurt Patients, Plan Sponsors and Community Pharmacies

NCPA Applauds Rep. Weiner for Introducing Bill to Rein in Pharmacy Benefit Manager Practices That Hurt Patients, Plan Sp




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AI Driven Drug Discovery for Advanced Pain Management

Approximately one in five Americans experiences chronic pain, and existing medications aren't very promising. Feixiong Cheng, Ph.D, Director of the Genome




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Boosting Newborn Health: India's Initiative on Lactation Management

The Indian government has taken a significant step towards improving the health of medlinknewborn babies/medlink by establishing Comprehensive Lactation




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How Parents Influence Kids' Pain Management Ability

Parents and doctors shape how children manage pain later in life by the way they treat pain, whether it's a minor injury or medlinkfear of injections/medlink.