To study the health-related quality of life (HRQoL) of persons with opioid use disorder (OUD) initiating medication treatment. We conducted a secondary analysis of data collected from a clinical trial funded by the National Drug Abuse Treatment Clinical Trials Network, where participants (N=570) in residential treatment were randomized to initiating extended-release naltrexone (XR-NTX) or buprenorphine-naloxone (BUP-NX) for the prevention of opioid relapse. A generalized structural equation latent-class model was used to identify associations and describe HRQoL trajectories over the 24-week trial and subsequent 28- and 36-week follow-ups for all participants regardless of success initiating treatment. Two latent classes were identified and defined: HRQoL “pharmacotherapy responsive” (82.3%), and HRQoL “baseline sensitive” (17.7%). The pharmacotherapy responsive class was characterized by HRQoL that tended to increase over time and a significant positive association between HRQoL and whether BUP-NX or XR-NTX was received in the past 30 days. The baseline sensitive class was characterized by lower average receipt of pharmacotherapy, initial increase in HRQoL with gradual decrease over time, and no significant HRQoL response to pharmacotherapy. HRQoL changes over time among patients in this class were sensitive to age, race, marital status, and motivation at baseline. Compared to the pharmacotherapy responsive class, the baseline sensitive class included higher proportions of participants who were female, white, married, less educated, and less motivated at baseline. The pharmacotherapy responsive class participants had, on average, less severe medical, drug, legal, and psychiatric problems at baseline. The majority of persons with OUD enrolled in this trial experienced improvements in HRQoL that were associated with pharmacotherapy, while a smaller sub-group with lower average receipt of pharmacotherapy had HRQoL changes that were associated with baseline characteristics but not pharmacotherapy. Our analysis provides insights for improved person-centered care for OUD patients receiving pharmacotherapy who are not adherent to treatment.

For overweight patients with type 2 diabetes mellitus, a program of intensive lifestyle intervention is more effective in promoting weight loss, improving glycemic control, and reducing cardiovascular risk factors than standard diabetes education, according to 4-year results from the Look AHEAD: Action For Health in Diabetes trial [NCT00017953].

: Pennington Biomedical Research Center (PBRC) continues a 16 year collaborative effort with the Department of Defense (DoD) in this research effort. Objectives: To assess and evaluate novel ways to sustain warfighter performance during high intensity missions at home and abroad, under specially funded cooperative agreements between the US Army Medical Research and Materiel Command (USAMRMC) and PBRC, PBRC provides high quality analytical laboratory, nutrition database and metabolic unit support for military nical research protocols. . nutrition cliSpecific Aims: PBRC performs four research tasks as follows: Task 1: Clinical Laboratory for Human Samples; Task 2: Stable Isotope Laboratory; Task 3: Nutrient Database Laboratory; Task 4: Metabolic Unit Services. The four tasks supported 6 projects directed by USARIEM investigators. (1)The effect of fitness level, caloric intake, and protein intake on short-term nitrogen balance during a 1000-calorie increase in daily energy expenditure. (2)Nutritional Evaluation of the Meal, Cold Weather (MCW) as a Sole Source of Subsistence During an Extended Cold-Weather Operation (3)Effects of Caloric Deprivation and Meal Composition on Cognitive Performance and Glucose Levels (4) Effect of Tyrosine Supplementation on Cognitive Performance and Mood During Severe Cold Stress (5)Comparison of a PDA-based Method vs. Written Records for Assessing Energy Intake and Expenditure (6)Response of Biomarkers of Bone Remodeling to Military Recruit Training Study Design: In consultation with the Project Officer at US Army Research Institute of Environmental Medicine (USARIEM), PBRC Task Leaders for Tasks 1 and 2 determined the number, timing, type of sample and type of analysis. Analysis of relevant endpoints in the PBRC Clinical Laboratory and Stable Isotope Laboratory provided information useful for determination of energy expenditure, water turnover, body composition, clinical biochemistry and metabolism.

The rural Lower Mississippi Delta of Arkansas, Louisiana, and Mississippi has a large economically and socially disadvantaged population at high risk for health problems. Their health status is poorly understood as they are not well represented in national health surveys. A random-digit-dialing telephone survey was conducted in 2000, with 2,236 respondents representing residents of 36 counties along the Mississippi River. Self-reported chronic conditions, health status, and obesity (derived from weight and height) were compared with the nationally representative Continuing Survey of Food Intake of Individuals. High cholesterol, diabetes, and hypertension were significantly higher than in the national sample. Obesity was strikingly higher in Delta children (27.9% versus 16.2%) of all ages and in Delta adults (33.9% versus 17.3%). Controlling for age, income, and gender, African Americans were at particular risk for obesity, hypertension, and diabetes. A public health crisis appears to exist in the Delta given the high prevalence health problems.