A5034385321- Health Systems, Economic Evaluations, Quality of Life
- Nutrition and Health in Aging
- Blood Pressure and Hypertension Studies
- Cerebral Palsy and Movement Disorders
- Lipoproteins and Cardiovascular Health
- Primary Care and Health Outcomes
- Economic and Financial Impacts of Cancer
- Balance, Gait, and Falls Prevention
- COVID-19 and healthcare impacts
- Electronic Health Records Systems
- Ethics in Clinical Research
- Health Policy Implementation Science
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Obesity, Physical Activity, Diet
- Healthcare cost, quality, practices
- SARS-CoV-2 and COVID-19 Research
- Clinical practice guidelines implementation
- COVID-19 Clinical Research Studies
- Sodium Intake and Health
- Physical Activity and Health
- Stroke Rehabilitation and Recovery
- Frailty in Older Adults
- Advanced Causal Inference Techniques
- Cardiovascular Health and Risk Factors
- Global Public Health Policies and Epidemiology
VA Boston Healthcare System
2018-2024
Boston University
2024
Program Support Center
2023
Veterans Health Administration
2022
United States Department of Veterans Affairs
2022
National Institutes of Health
2022
National Heart Lung and Blood Institute
2022
Intellia Therapeutics (United States)
2022
St. Michael's Hospital
2022
Amarin (United States)
2019-2020
Whether chlorthalidone is superior to hydrochlorothiazide for preventing major adverse cardiovascular events in patients with hypertension unclear.In a pragmatic trial, we randomly assigned adults 65 years of age or older who were the Department Veterans Affairs health system and had been receiving at daily dose 25 50 mg continue therapy switch 12.5 mg. The primary outcome was composite nonfatal myocardial infarction, stroke, heart failure resulting hospitalization, urgent coronary...
Background.Whey protein supplementation may augment resistance exercise-induced increases in muscle strength and mass. Further studies are required to determine whether this effect extends mobility-limited older adults. The objectives of the study were compare effects whey concentrate (WPC) an isocaloric control on changes whole-body lean mass, mid-thigh cross-sectional area, strength, stair-climbing performance adults response 6 months training (RT).
We compared the effects of two uniquely different lower extremity power training interventions on changes in muscle power, physical performance, neuromuscular activation, and cross sectional area mobility-limited older adults.Fifty-two subjects (78±5 years, short performance battery score: 8.1±1) were randomized to either 16 weeks progressive high velocity resistance performed at low external (40% 1-repetition maximum [1-RM] [LO]) or (70% 1RM [HI]). Both groups completed three sets leg knee...
Observational evidence suggests that higher physical activity is associated with slower kidney function decline; however, to our knowledge, no large trial has evaluated whether and exercise can ameliorate decline in older adults.
This study examined the relationships between leg muscle strength, power, and perceived disease severity in subjects with knee osteoarthritis (OA) order to determine whether dynamic extensor power would be associated pain quality of life OA.Baseline data on 190 OA (mean ± SD age 60.2 10.4 years, body mass index 32.7 7.2 kg/m(2) ) were obtained from a randomized controlled trial. Knee was measured using Western Ontario McMaster Universities Osteoarthritis Index, health-related assessed Short...
Age-associated loss of muscular strength and power is a critical determinant physical function progression to disability in older adults. In this study, we examined the association systemic vascular measures muscle Measures endothelial included brachial artery flow-mediated dilation (FMD) pulse wave amplitude reactive hyperemia index (PWA-RHI). Augmentation (AIx) was taken as measure related arterial stiffness reflection. one repetition maximum (1RM) for bilateral leg press. Peak measured...
Background:Muscle power is a key predictor of physical function in older adults; however, clinically meaningful improvements leg-extensor muscle have yet to be identified. The purpose this study establish the minimal important improvement (MCII) and substantial (SI) for contraction velocity mobility-limited adults.
Importance and objective The aim of this pragmatic, embedded, adaptive trial was to measure the effectiveness subcutaneous anti-IL-6R antibody sarilumab, when added an evolving standard care (SOC), for clinical management inpatients with moderate severe COVID-19 disease. Design Two-arm, randomized, open-label controlled comparing SOC alone plus sarilumab. used a randomized play-the-winner design fully embedded within electronic health record (EHR) system. Setting 5 VA Medical Centers....
Pragmatic clinical trials (PCTs) have an established presence in research and yet only recently garnered attention within the landscape of genomic medicine. Using PRagmatic-Explanatory Continuum Indicator Summary 2 (PRECIS-2) as a framework, this paper illustrates application PCT principles to The Integrating Pharmacogenetics In Clinical Care (I-PICC) Study, trial pharmacogenetic testing prior statin initiation for cardiovascular disease prevention primary care. achieved high engagement with...
Importance Patients with prior myocardial infarction (MI) or stroke have a greater risk of recurrent cardiovascular (CV) events. Objective To evaluate the association chlorthalidone (CTD) vs hydrochlorothiazide (HCTZ) CV outcomes and noncancer deaths in participants without MI stroke. Design, Setting, Participants This was prespecified secondary analysis Diuretic Comparison Project (DCP), pragmatic randomized clinical trial conducted within 72 participating Veterans Affairs health care...
There is a growing demand to reduce ethnic health disparities. The Healthy Habits Program (HHP) was implemented provide community-based physical activity and education intervention for Chinese older adults living in Boston, Massachusetts. This study evaluated the HHP by assessing outcomes that are critical maintaining independence of persons.
Background/Aims: The US Department of Veterans Affairs Point Care Clinical Trial Program conducts studies that utilize informatics infrastructure to integrate clinical trial protocols into routine care delivery. Diuretic Comparison Project compared hydrochlorothiazide chlorthalidone in reduction major cardiovascular events subjects with hypertension. Here we describe the cultural, technical, regulatory, and logistical challenges solutions enabled successful implementation this large...
Recent studies have demonstrated a causal role for elevated triglycerides (TG) in incident cardiovascular (CV) events patients with established coronary heart disease (CHD) and those CV risk factors alone, particularly diabetes. Using large cohort of U.S. veterans statin-controlled LDL-C levels (40-100 mg/dL), we explored residual among baseline TG (150-499 mg/dL) vs. normal (<150 mg/dL). We identified receiving statin but not TG-lowering agent from the VA electronic health records database,...
Hypertension is a risk factor for the development and progression of chronic kidney disease (CKD). It unclear whether different thiazide diuretics have differential impact on outcomes.