Robert D. Kaplan is a contributing editor at The Atlantic, a senior fellow at the Center for a New American Security in Washington and the author, most recently, of Asia's Cauldron: The South . The comparison intervention consisted of weekly education meetings for 24 weeks, and then monthly for 6 months. Free delivery worldwide on over 20 million titles. We examined 4 different methods of estimating the effect of health care on health outcomes.METHODS: We reviewed the contributions of medical care to health outcomes using 4 methods: (1) analyses by McGinnis and Schroeder, (2) Wennberg and colleagues' studies of small area variation, (3) Park and colleagues' analysis of County Health Rankings and Roadmaps, and (4) the RAND Health Insurance Experiment.RESULTS: The 4 methods, using different data sets, produced estimates ranging from 0% to 17% of premature mortality attributable to deficiencies in health care access or delivery. The PA program consisted of 50-minute center-based exercise 2 weekly, augmented with home-based activity to achieve a goal of 150min/wk of PA. Health education consisted of weekly workshops for 26 weeks, and monthly sessions thereafter. 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. Surprisingly, however, mobility was a stronger correlate of HRQOL than an index of comorbidity, suggesting that interventions addressing mobility limitations may provide significant health benefits to this population. Baseline data (collected in April-December 2004, analyzed in 2006) included demographics, medical history, the Quality of Well-Being Scale (QWB-SA), a timed 400-m walk, and the Short Physical Performance Battery (SPPB). Sleep-wake disturbances were evaluated using the Insomnia Severity Index (ISI) (range 0-28; 8 defined insomnia), Epworth Sleepiness Scale (ESS) (range 0-24; 10 defined daytime drowsiness), Pittsburgh Sleep Quality Index (PSQI) (range 0-21; >5 defined poor sleep quality), and Berlin Questionnaire (high risk of sleep apnea).Prevalence rates were 43.5% for slow gait speed and 44.7% for moderate to severe mobility impairment, with 77.0% of accelerometry wear time spent as sedentary time. Early diagnosis does not assure application of an intervention that alters the pathway toward demise. The incremental cost-effectiveness ratios were US$42,376/major mobility disability prevented and US$49,167/QALY. View details for DOI 10.1377/hlthaff.2018.0443, View details for Web of Science ID 000463962900016. Groessl, E. J., Kaplan, R. M., Rejeski, W. J., Katula, J. INTRODUCTION: Older adults are a rapidly growing segment of the U.S.POPULATION: Mobility problems that lead to further disability can be addressed through physical activity interventions. Quality of life outcome results are reported from a large trial of physical activity for sedentary older adults at risk for mobility disability.METHODS: Data were from the Lifestyle Interventions and Independence for Elders study. Effect of structured physical activity on prevention of serious fall injuries in adults aged 70-89: randomized clinical trial (LIFE Study). Rather than reading a good book with a cup of coffee in the afternoon, instead they cope with some infectious bugs inside their desktop computer. B., Studenski, S. A., Goodpaster, B. H., Glynn, N. W., Lopez, O., Nadkarni, N. K., Williams, K., Newman, M. A., Grove, G., Bonk, J. T., Rushing, J., Kost, P., Ives, D. G., 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., Wu, K. C., Shepard, D. M., Fennelly, B., Iannone, L. P., Mautner, R., Sweeney Barnett, T., Halpin, S. N., Brennan, M. J., Bugaj, J. Losing the ability to walk safely and independently is a major concern for many older adults. The physical activity and exercise intervention resulted in statistically significantly lower decline in eGFRCysC over 2 years compared with the health education arm (mean difference, 0.96 mL/min/1.73 m2; 95% CI, 0.02-1.91 mL/min/1.73 m2) and lower odds of rapid eGFRCysC decline (odds ratio, 0.79; 95% CI, 0.65-0.97).Conclusions and Relevance: Results of this ancillary analysis of a randomized clinical trial showed that when compared with health education, a physical activity and exercise intervention slowed the rate of decline in eGFRCysC among community-dwelling sedentary older adults. OBJECTIVES: Our aim was to examine the impacts of baseline fatigue on the effectiveness of a physical activity (PA) intervention to prevent major mobility disability (MMD) and persistent major mobility disability (PMMD) in participants from the Lifestyle Interventions and Independence for Elders (LIFE) study.DESIGN: Prospective cohort of individuals aged 65years or older undergoing structured PA intervention or health education (HE) for a mean of 2.6years.SETTING: LIFE was a multicenter eight-site randomized trial that compared the efficacy of a structured PA intervention with an HE program in reducing the incidence of MMD.PARTICIPANTS: Study participants (N=1591) at baseline were 78.95.2years of age, with low PA and at risk for mobility impairment.MEASUREMENTS: Self-reported fatigue was assessed using the modified trait version of the Exercise-Induced Feelings Inventory, a six-question scale rating energy levels in the past week. A., Goodpaster, B. H., McDermott, M. M., Nicklas, B. J., Yank, V., Johnson, 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. You can email or call Law Offices of Robert M. Kaplan to arrange a meeting with a lawyer in one of their offices at 1535 W Schaumburg Rd. in terms of outcomes that are meaningful to patients. All cognitive measures loaded onto the first principal component (global cognitive function), which accounted for 40% of the overall variance.Our results support the use of computer-based tools for assessing cognitive function in multicenter clinical trials of older individuals. Jobs People Learning Dismiss Dismiss. The objective of this study was to evaluate cross-sectional and longitudinal associations between ankle-brachial index (ABI) and indicators of cognitive function.Randomized clinical trial (Lifestyle Interventions and Independence for Elders Trial).Eight US academic centers.A total of 1601 adults ages 70-89 years, sedentary, without dementia, and with functional limitations.Baseline ABI and interviewer- and computer-administered cognitive function assessments were obtained. Robert S. Kaplan is Senior Fellow and Marvin Bower Professor of Leadership Development, Emeritus at the Harvard Business School. Behavioral interventions often use measures that are not generally applied in other areas of health outcomes research. 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. Jacobsen, P. B., Prasad, R., Villani, J., Lee, C., Rochlin, D., Scheuter, C., Kaplan, R. M., Freedland, K. E., Manber, R., Kanaan, J., Wilson, D. K. Economic analysis in behavioral health: Toward application of standardized methodologies. My wife, Jackie, and I were briefly in South Africa just last month, mainly to visit my 98-year-old mother who is barely hanging on in Knysna. Our results indicate that mindfulness meditation and physical exercise function in part by different mechanisms, with PE increasing physical fitness and IBMT inducing plasticity in the central nervous systems. 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. Baseline characteristics including younger age, fewer comorbid conditions, non-white ethnicity, and faster 400-meter walk times were also associated with higher health-related quality of life over time.CONCLUSIONS: Declining mobility measured by physical performance is associated with lower quality of life in sedentary older adults. These differing services compete for the same resources and it is difficult to compare their value. Tang, Y., Fan, Y., Lu, Q., Tan, L., Tang, R., Kaplan, R. M., Pinho, M. C., Thomas, B. P., Chen, K., Friston, K. J., Reiman, E. M. Health Care Is Failing the Most Vulnerable Patients: Three Underused Solutions. These findings suggest mobility benefit from such a program in vulnerable older adults.clinicaltrials.gov Identifier: NCT01072500. Background. OBJECTIVE: Incidence rates of ankylosing spondylitis (AS) among males versus females are poorly understood. Outcomes were assessed every six months for up to 42 months by staff masked to intervention assignment. View details for PubMedCentralID PMC3989438, View details for Web of Science ID 000334289900004, View details for PubMedCentralID PMC3989438. Robert M. Kaplan is a forensic psychiatrist, speaker and writer based in Wollongong, Australia. Kaplan is the author or co-author of more than 15 books and approximately 450 articles or chapters. Outcome estimates were determined at year 2, accounting for implementation and steady-state intervention costs.RESULTS: After accounting for implementation and recurring operating costs of approximately $9.5 billion, estimated net cost savings of between $13 and $41 billion can be accomplished concurrently with improvements in quality and experience of coordinated chronic care ($0.01-$6.8 billion), cognitively protective acute care ($8.7-$26.6 billion), timely caregiver support ($4.3-$7.5 billion), and caregiver efficiency ($4.1-$7.2 billion).CONCLUSION: A high-value care model for AD may improve the experience of patients with AD while significantly lowering costs. These mixed results might reflect heterogeneity in response to physical activity, with some subgroups of individuals responding positively, but not others.1) To examine the impact of genetic variation and sex on changes in depressive symptoms in older adults after a physical activity (PA) intervention, and 2) to determine if PA differentially improves particular symptom dimensions of depression.Randomized controlled trial.Four field centers (Cooper Institute, Stanford University, University of Pittsburgh, and Wake Forest University).396 community-dwelling adults aged 70-89 years who participated in the Lifestyle Interventions and Independence for Elders Pilot Study (LIFE-P).12-month PA intervention compared to an education control.Polymorphisms in the serotonin transporter (5-HTT), brain-derived neurotrophic factor (BDNF), and apolipoprotein E (APOE) genes; 12-month change in the Center for Epidemiologic Studies Depression Scale total score, as well as scores on the depressed affect, somatic symptoms, and lack of positive affect subscales.Men randomized to the PA arm showed the greatest decreases in somatic symptoms, with a preferential benefit in male carriers of the BDNF Met allele. Accelerometry data collected during PA training revealed that the average intensity - 1,555 counts/minute for men and 1,237 counts/minute for women - was well below the cutoff point used to classify exercise as being of moderate intensity or higher for adults. In this report, we offer three examples of how economic data could promote greater adoption of behavioral and psychosocial interventions in clinical settings where primary or specialty medical care is delivered to patients. 12. Previous studies have shown that physical exercise and mindfulness meditation can both lead to improvement in physical and mental health. These data illustrate that it is not feasible to have a single exercise prescription for older adults with compromised function. These include the EQ-5D, the Health Utilities Index (HUI), the self-administered Quality of Well-being Scale (QWB-SA), and the Health and Activities Limitation Index (HALex). Associated persons: . View details for DOI 10.1080/21642850.2021.1979407, View details for PubMedCentralID PMC8462930. Lee, C., Scheuter, C., Rochlin, D., Platchek, T., Kaplan, R. M. Effects of Mental Health on the Costs of Care for Chronic Illnesses. Glynn, N. W., Gmelin, T., Santanasto, A. J., Lovato, L. C., Lange-Maia, B. S., Nicklas, B. J., Fielding, R. A., Manini, T. M., Myers, V. H., de Rekeneire, N., Spring, B. J., Pahor, M., King, A. C., Rejeski, W. J., Newman, A. The lack of distinguishable characteristics suggests that variably applied terminology may hinder efforts to narrow the gap between research and practice. Wilson, D. K., Kaplan, R. M., Jacobsen, P., Riley, W. Effect of Physical Activity on Frailty Secondary Analysis of a Randomized Controlled Trial, Trombetti, A., Hars, M., Hsu, F., Reid, K. F., Church, T. S., Gill, T. M., King, A. C., Liu, C. K., Manini, T. M., McDermott, M. M., Newman, A. Biography ID: 12846404 . Robert M Kaplan South African Journal of Psychiatry | Vol 9, No 2 | a137 | DOI: https://doi.org/10.4102/sajpsychiatry.v9i2.137 | 2003 Robert M Kaplan | This work is licensed under CC Attribution 4.0 Submitted: 11 August 2008 | Published: 01 September 2003 About the author (s) Robert M Kaplan, HMPG, South Africa However, evidence is inconclusive regarding the influence of this polymorphism on older adults' functional responses to exercise. View Details. (PsycINFO Database Record, View details for Web of Science ID 000402052300010. To date, physical exercise is the only intervention consistently demonstrated to attenuate age-related declines in physical function. Rating scales were rated as easiest to use and respondents were more satisfied with rating scales and conjoint in comparison to time tradeoffs. Accelerometer patterns were characterized as bouts of sedentary (<100 counts/min; 1, 10, 30, 60 minute lengths) and activity (100 counts/min; 1, 2, 5, 10 minute lengths) time. This polymorphism is known to influence a variety of physiological adaptions to exercise. Discover Book Depository's huge selection of Robert M Kaplan books online. Lawyer Robert M. Kaplan, graduated from Rutgers University, B.A., 1977 Rutgers University Law School, J.D., 1980, is now employed by Margolis Edelstein at 100 Century Parkway, Suite 200 Mount Laurel, NJ 08054. Gender, age, and scores on a short physical performance battery did not moderate these effects. Robert Kaplan mbchb FRANZCP MA [Journ] Forensic Psychiatrist Clinical Associate Professor Graduate School of Medicine Wollongong University NSW Australia 332 Crown Street Wollongong and 16 Vernon Street Bondi Junction Phone (02) 4268 3949 Fax (02) 4210 7326 MOB 0408 363 383 E-Mail : info@rmkaplan.com.au DATE OF BIRTH: 13/04/50 Although the Enhancing Recovery in Coronary Heart Disease (ENRICHD) treatment was designed to include individual therapy and cognitive behavioral group training for patients with depression and/or low perceived social support, only 31% of treated participants received group training. Dr. Kaplan is expected to join the NIH in early 2011. View details for DOI 10.1016/j.jamda.2015.03.010, View details for Web of Science ID 000358423400010, View details for PubMedCentralID PMC4516564. Med Decis Making 2019 10 26;39(7):816-826. Hierarchical linear regression models were used to examine correlates of HRQOL.The mean QWB-SA score for the sample was 0.630 on an interval scale ranging from 0.0 (death) to 1.0 (asymptomatic, optimal functioning). Assuming a diversion rate of 50% based on previous studies, national savings range from $230 million to $1.0 billion annually. 2018 o 8:00 UTC na Court 2, Stellenbosch, South Africa. In adjusted models, measures of mobility and physical inactivity were generally not associated with sleep-wake disturbances, using continuous or categorical variables.In a large sample of sedentary community-dwelling elderly adults with functional limitations, sleep-wake disturbances were prevalent but only mildly severe and were generally not associated with mobility impairment or physical inactivity. Schaumburg, IL 60194. A., Brubaker, P. H., Mihalko, S. L., Jennings, J. M., Chen, S., Pierce, J. J., Chen, H., Hadley, E. C., Romashkan, S., Patel, K. V., Bethesda, Bonds, D., McDermott, M. M., Spring, B., Hauser, J., Kerwin, D., Domanchuk, K., Graff, R., Rego, A., Church, T. S., Blair, S. N., Myers, V. H., Monce, R., Britt, N. E., Harris, M. N., McGucken, A. P., Rodarte, R., Millet, H. K., Tudor-Locke, C., Butitta, B. P., Donatto, S. G., Cocreham, S. H., King, A. C., Castro, C. M., Haskell, W. L., Stafford, R. S., Pruitt, L. A., Yank, V., Berra, K., Bell, C., Thiessen, R. M., Youngman, K. P., Virgen, S. B., Maldonado, E., Tarin, K. N., Klaftenegger, H., Prosak, C. A., Campero, I., Garcia, D. M., Soto, J., Chio, L., Hoskins, D., Fielding, R. A., Nelson, M. E., Folta, S. C., Phillips, E. M., Liu, C. K., McDavitt, E. C., Reid, K. F., Kirn, D. R., Pasha, E. P., Kim, W. S., Krol, J. M., Beard, V. E., Tsiroyannis, E. X., Hau, C., Manini, T. M., Pahor, M., Anton, S. D., Buford, T. W., Marsiske, M., Nayfield, S. G., Sandesara, B. D., Black, M. L., Burk, W. L., Hoover, B. M., Knaggs, J. D., Marena, W. C., Korytov, I., Curtis, S. D., Lorow, M. S., Goswami, C. S., Lewis, M. A., Kamen, M., Bitz, J. N., Stanton, B. K., Hicks, T. T., Gay, C. W., Xie, C., Morris, H. L., Singletary, F. F., Causer, J., Yonce, S., Radcliff, K. A., Smith, M. P., Scott, J. S., Rodriguez, M. M., Fitch, M. S., Dunn, M. C., Schllesinger, J. Q., Newman, A. 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. How scarcity, crime, overpopulation, tribalism, and disease are rapidly destroying the social fabric of our planet. with Honors and Academic Distinction Psychology Department Special Award for graduation with highest academic View PDF In February of 2011,Robert M. Kaplan, Ph.D. joined the National Institutes of Health (NIH) Office of the Director as Associate Director for Behavioral and Social . We randomized a volunteer sample of 1635 sedentary men and women aged 70 to 89 years who had physical limitations, defined as a score on the Short Physical Performance Battery of 9 or below, but were able to walk 400 m.Participants were randomized to a structured, moderate-intensity physical activity program (n=818) conducted in a center (twice/wk) and at home (3-4 times/wk) that included aerobic, resistance, and flexibility training activities or to a health education program (n=817) consisting of workshops on topics relevant to older adults and upper extremity stretching exercises.The primary outcome was major mobility disability objectively defined by loss of ability to walk 400 m.Incident major mobility disability occurred in 30.1% (246 participants) of the physical activity group and 35.5% (290 participants) of the health education group (hazard ratio [HR], 0.82 [95% CI, 0.69-0.98], P=.03).Persistent mobility disability was experienced by 120 participants (14.7%) in the physical activity group and 162 participants (19.8%) in the health education group (HR, 0.72 [95% CI, 0.57-0.91]; P=.006).

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