Older Adult and Primary Care Practitioner Perspectives on Using, Prescribing, and Deprescribing Opioids for Chronic Pain.

Importance: Guidelines recommend deprescribing opioids in older adults due to risk of adverse effects, yet little is known about patient-clinician opioid deprescribing conversations.

Objective: To understand the experiences of older adults and primary care practitioners (PCPs) with using opioids for chronic pain and discussing opioid deprescribing.

Design, Setting, And Participants: This qualitative study conducted semistructured individual qualitative interviews with 18 PCPs and 29 adults 65 years or older prescribed opioids between September 15, 2022, and April 26, 2023, at a Boston-based academic medical center.

Polygenic early-onset colorectal cancer in pediatric patients.

Colorectal cancer in the pediatric population is a rare but transpirable phenomenon. The occurrence should prompt suspicion for underlying genetic mutations in the setting of a hereditary cancer predisposition syndrome. In this series, we outline three pediatric patients with colonic adenocarcinoma who were found to have one or more germline mutations.

PEEDS-RAPEL: A case conceptualization model for evaluating pediatric cases with acquired brain injury.

Background: The needs of a child with an acquired brain injury (ABI) are not a scaled down version of those required by an adult with a brain injury who has impairments that impact their cognitive and physical or functional abilities, capacity for work, and/or independence in performing activities of daily living.

Purpose: The purpose of this article is to provide a standardized methodology for analysis of pediatric ABI cases when evaluating vocational potential as part of the child's future rehabilitation or life care planning. PEEDS-RAPEL, a case conceptualization model for rehabilitation professionals, is defined in the context of a tool or methodology for the evaluation of pediatric clients with ABI.

Fine-scale spatial genetic dynamics over the life cycle of the tropical tree Prunus africana.

Studying fine-scale spatial genetic patterns across life stages is a powerful approach to identify ecological processes acting within tree populations. We investigated spatial genetic dynamics across five life stages in the insect-pollinated and vertebrate-dispersed tropical tree Prunus africana in Kakamega Forest, Kenya. Using six highly polymorphic microsatellite loci, we assessed genetic diversity and spatial genetic structure (SGS) from seed rain and seedlings, and different sapling stages to adult trees.