Associations between Social Support and Cognitive Performance among Persons with MS
Background: Social support is a protective factor against cognitive decline in the general population. However, the relationship between social support and cognitive functioning among persons with multiple sclerosis (MS) is not well understood…
Overview of global real-world data sources for pediatric pharmacoepidemiologic research
Purpose: Given limited information available on real-world data (RWD) sources with pediatric populations, this study describes features of globally available RWD sources for pediatric pharmacoepidemiologic research…
In what settings and social contexts do young adults vape or smoke cannabis? Findings from a web-based diary pilot study
Background: Vaping is an increasingly common mode of cannabis use among young adults. Despite potential to inform targeted prevention, settings and social contexts where young adults vape and/or smoke cannabis have rarely been investigated. We addressed this question in a diverse young adult sample…
Use of high- and low-value care among US adults by education levels
Background: Healthcare reform in the United States has focused on improving the value of health care, but there are some concerns about the inequitable delivery of value-based care…
Addressing racial inequality and its effects on vaccination rate: A trial comparing a pharmacist and peer educational program (MOTIVATE) in diverse older adults
BACKGROUND: The mortality, morbidity, health care utilization, and cost attributable to vaccine-preventable diseases are substantial for those aged 50 years and older. Although vaccination is the most cost-effective strategy to prevent common infectious diseases in older adults, vaccination rates remain below US Centers for Disease Control and Prevention benchmarks, especially among racial minorities. Historical mistrust, structural racism within the US medical system, and misinformation contributed to lower immunization rates among minorities, especially Black Americans. To address the critical need to increase knowledge and trust in vaccination, 2 community-based educational interventions were tested: a pharmacist-led didactic session (PHARM) and a peer-led educational workshop (PEER).
Genomic approaches to identify and investigate genes associated with atrial fibrillation and heart failure susceptibility
Atrial fibrillation (AF) and heart failure (HF) contribute to about 45% of all cardiovascular disease (CVD) deaths in the USA and around the globe. Due to the complex nature, progression, inherent genetic makeup, and heterogeneity of CVDs, personalized treatments are believed to be critical. To improve the deciphering of CVD mechanisms, we need to deeply investigate well-known and identify novel genes that are responsible for CVD development. With the advancements in sequencing technologies, genomic data have been generated at an unprecedented pace to foster translational research. Correct application of bioinformatics using genomic data holds the potential to reveal the genetic underpinnings of various health conditions…
Knowledge Gaps in End-Of-Life Family Caregiving for Persons Living With Dementia: A Study of Hospice Clinician Perspectives
Introduction: More than 35% of hospice care recipients 65 and older have a dementia diagnosis. Yet family care partners of persons living with dementia report feeling unprepared to address their hospice recipient’s changing needs nearing end of life. Hospice clinicians may have unique insight into the knowledge needs of family care partners and strategies for end-of-life dementia caregiving.
Air Pollution and Cardiovascular and Thromboembolic Events in Older Adults With High-Risk Conditions
Abstract: Little epidemiologic research has focused on pollution-related risks in medically vulnerable or marginalized groups. Using a nationwide 50% random sample of 2008–2016 Medicare Part D–eligible fee-for-service participants in the United States, we identified a cohort with high-risk conditions for cardiovascular and thromboembolic events (CTEs) and linked individuals with seasonal average zip-code–level concentrations of fine particulate matter (particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5)).
Naloxone expansion is not associated with increases in adolescent heroin use and injection drug use: Evidence from 44 US states
Naloxone distribution is central to ongoing efforts to address the opioid overdose crisis. Some critics contend that naloxone expansion may inadvertently promote high-risk substance use behaviors among adolescents, but this question has not been directly investigated…
Childhood asthma diagnoses declined during the COVID-19 pandemic in the United States
Background: Prior studies have documented declines in pediatric asthma exacerbations and asthma-related health care utilization during the COVID-19 pandemic, but less is known about the incidence of asthma during the pandemic…
Geographic Trends in Pediatric Psychotropic Medication Dispensing Before and After the Start of the COVID-19 Pandemic
Objective: This study examined trends and geographic variability in dispensing of prescription psychotropic medications to U.S. youths before and after the start of the COVID-19 pandemic…
Psychological Determinants of Physician Variation in End-of-Life Treatment Intensity: A Systematic Review and Meta-Synthesis
Background: Physicians treating similar patients in similar care-delivery contexts vary in the intensity of life-extending care provided to their patients at the end-of-life. Physician psychological propensities are an important potential determinant of this variability, but the pertinent literature has yet to be synthesized…
How COVID-19 Emergency Practitioner Licensure Impacted Access to Care: Perceptions of Local and National Stakeholders
ABSTRACT: The COVID-19 public health emergency required US states to respond rapidly on regulatory issues, including the process for licensing healthcare practitioners. At least 45 states enacted some form of a licensure waiver, enabling practitioners to temporarily work across state lines. We conducted 22 interviews with national and local (New Jersey) licensure stakeholders in September and October 2021 to capture perceptions of how emergency licensure impacted access to care…
Revising ruling discourses: The griefwork evidence-to-practice gap and the mental health workforce
Elisabeth Kübler-Ross’ pioneering work focused on dying, yet some clinicians persist in prescribing it as a path through grief. We surveyed 964 mental health clinicians who completed a five-section mixed methods survey: two sections assessed knowledge with multiple choice questions and a case study to assess clinicians’ knowledge-base and approach to grief/loss in practice. Analysis of four items related to Kübler-Ross’ model and 66/962 case studies indicates ongoing use of “stages” and Kübler-Ross’ model. Only 330 (34.2%) of the clinicians were deemed knowledgeable; 462 (47.9%) were questionable; and 172 (17.9%) were misinformed, continuing to use Kübler-Ross’ stage theory for grief…
Hydroxychloroquine lowers Alzheimer’s disease and related dementias risk and rescues molecular phenotypes related to Alzheimer’s disease
Abstract: We recently nominated cytokine signaling through the Janus-kinase–signal transducer and activator of transcription (JAK/STAT) pathway as a potential AD drug target. As hydroxychloroquine (HCQ) has recently been shown to inactivate STAT3, we hypothesized that it may impact AD pathogenesis and risk. Among 109,124 rheumatoid arthritis patients from routine clinical care, HCQ initiation was associated with a lower risk of incident AD compared to methotrexate initiation across 4 alternative analyses schemes addressing specific types of biases including informative censoring, reverse causality, and outcome misclassification (hazard ratio [95% confidence interval] of 0.92 [0.83–1.00], 0.87 [0.81–0.93], 0.84 [0.76–0.93], and 0.87 [0.75–1.01]). We additionally show that HCQ exerts dose-dependent effects on late long-term potentiation (LTP) and rescues impaired hippocampal synaptic plasticity prior to significant accumulation of amyloid plaques and neurodegeneration in APP/PS1 mice. Additionally, HCQ treatment enhances microglial clearance of Aβ1-42, lowers neuroinflammation, and reduces tau phosphorylation in cell culture-based phenotypic assays. Finally, we show that HCQ inactivates STAT3 in microglia, neurons, and astrocytes suggesting a plausible mechanism associated with its observed effects on AD pathogenesis…
Organizational Factors Associated with Guideline Concordance of Chronic Disease Care and Management Practices
Background: Guidelines for managing and preventing chronic disease tend to be well-known. Yet, translation of this evidence into practice is inconsistent. We identify a combination of factors that are connected to guideline concordant delivery of evidence-informed chronic disease care in primary care…
The Associations of Racial Discrimination and Neighborhood Disadvantage With World Assumptions Among Black, Latine, and Asian Young Adults
Abstract: The theory of shattered assumptions proposes that experiencing traumatic events can change how people view themselves and the world. Most adults experience a traumatic event during their lifetime, and some subsequently develop post-traumatic stress disorder (PTSD). However, the current conceptualization of trauma (i.e., Criterion A PTSD) may be too narrow to adequately capture the range of potentially traumatizing events that People of Color experience, including racial discrimination and neighborhood disadvantage. This study investigated the association of racial discrimination and neighborhood disadvantage with core beliefs about the world being safe and predictable (i.e., world assumptions) among a sample of Black, Latine, and Asian young adults. Multi-step analyses of covariance tested associations between racial discrimination and neighborhood disadvantage with world assumptions and whether these held in the context of other traumatic exposures. Results indicated that racial discrimination negatively impacted world assumptions among Asian young adults only and this effect remained in the context of trauma. In addition, low neighborhood support negatively impacted world assumptions across all racial groups and neighborhood violence negatively impacted world assumptions among Latine young adults only; however, this effect did not remain in the context of trauma. This study indicates it is worthwhile to consider other adverse events in the conceptualization of trauma, such as racial discrimination and neighborhood disadvantage, that may impact world assumptions and contribute to subsequent post-trauma psychopathology…
Person-centered patterns of substance use during the COVID-19 pandemic and their associations with COVID-related impacts on health and personal finances in young Black and White women
Abstract: Population-level statistics on pandemic-related change in substance use can obscure patterns of use (e.g., polysubstance use) within individuals. This longitudinal study used a person-centered approach to identify subgroups with respect to patterns of substance use prior to and during the COVID-19 pandemic, and to examine profile correlates (e.g., socio-demographic characteristics), which can inform tailored intervention…
The ethical case for placebo control in HIV-cure-related studies with ART interruption
Abstract: Many studies that seek to cure HIV must ask participants to interrupt their antiretroviral treatment. In such circumstances, is it permissible to include a placebo group in the study? We explain why doing so is a scientific and an ethical necessity, and more benign than imagined…
Trends in Prescribing Preferences for Antidiabetic Medications Among Patients With Type 2 Diabetes in the U.K. With and Without Chronic Kidney Disease, 2006–2020
OBJECTIVE: To evaluate trends in antidiabetic medication initiation patterns among patients with type 2 diabetes mellitus (T2DM) with and without chronic kidney disease (CKD)…