Proportional Trends in Pediatric Opioid Prescribing Between 2005 and 2016 by Age Group, Sex, Ethnicity, Race, Language, and Payer Status from a Large Children's Hospital in the Southwest United States.

Background/objectives: Prescription opioid use before adulthood is typically effective for acute pain control and is also associated with adverse short- and long-term consequences.

Methods: This study examined pediatric opioid prescribing trends over time across different age groups (early childhood, school age, adolescence, young adult) and sociodemographic subgroups (sex, ethnicity, race, language, payer type) from 2005 to 2016.

Results: Utilizing 42,020 first outpatient opioid prescriptions for youth aged 0-21 years from a large US children's hospital, this research found notable trends and disparities.

Challenges of perioperative pain control in opioid use disorder patients following intramedullary nail fixation.

Background: Outcomes of patients with opioid use disorder undergoing elective procedures have been well studied, but research is lacking in the orthopaedic trauma population.

Aim: The aim was to compare perioperative pain and morphine equivalents required by patients with versus without opioid use disorder following intramedullary nail fixation of femoral or tibial fractures.

Methods: We conducted a retrospective review of all patients with isolated femoral or tibial diaphyseal fractures treated with intramedullary nail fixation.

Motivational Interviewing Education and Utilization in US Physical Therapy.

Introduction: In physical rehabilitation, motivational interviewing (MI) can improve treatment adherence and therapeutic outcomes. The objective of this study was to investigate the relationship between MI education and use of MI skills in physical therapy practice in the United States.

Review Of Literature: Motivational interviewing is an empirically supported technique for facilitating behavior change.

The Pain Anxiety Symptom Scale: Initial Development and Evaluation of 4 and 8 Item Short Forms.

Elevated levels of anxiety in relation to chronic pain have been consistently associated with greater distress and disability. Thus, accurate measurement of pain-related anxiety is an important requirement in modern pain services. The Pain Anxiety Symptom Scale (PASS) was introduced over 30 years ago, with a shortened 20-item version introduced 10 years later.

Predicting Kidney Transplant Evaluation Non-attendance.

Non-attendance to kidney transplant evaluation (KTE) appointments is a barrier to optimal care for those with kidney failure. We examined the medical and socio-cultural factors that predict KTE non-attendance to identify opportunities for integrated medical teams to intervene. Patients scheduled for KTE between May, 2015 and June, 2018 completed an interview before their initial KTE appointment.

Teacher's Corner: An R Shiny App for Sensitivity Analysis for Latent Growth Curve Mediation.

Mechanisms of behavior change are the processes through which interventions are hypothesized to cause changes in outcomes. Latent growth curve mediation models (LGCMM) are recommended for investigating the mechanisms of behavior change because LGCMM models establish temporal precedence of change from the mediator to the outcome variable. The Correlated Augmented Mediation Sensitivity Analyses (CAMSA) App implements sensitivity analysis for LGCMM models to evaluate if a mediating path (mechanism) is robust to potential confounding variables.

Profiles of Pain Acceptance and Values-Based Action in the Assessment and Treatment of Chronic Pain.

Pain acceptance and values-based action are relevant to treatment outcomes in those with chronic pain. It is unclear if patterns of responding in these 2 behavioral processes can be used to classify patients into distinct classes at treatment onset and used to predict treatment response. This observational cohort study had 2 distinct goals.

Genotypic variation rather than ploidy level determines functional trait expression in a foundation tree species in the presence and absence of environmental stress.

Background And Aims: At the population level, genetic diversity is a key determinant of a tree species' capacity to cope with stress. However, little is known about the relative importance of the different components of genetic diversity for tree stress responses. We compared how two sources of genetic diversity, genotype and cytotype (i.

Leaf spectroscopy reveals divergent inter- and intra-species foliar trait covariation and trait-environment relationships across NEON domains.

Concurrent measurement of multiple foliar traits to assess the full range of trade-offs among and within taxa and across broad environmental gradients is limited. Leaf spectroscopy can quantify a wide range of foliar functional traits, enabling assessment of interrelationships among traits and with the environment. We analyzed leaf trait measurements from 32 sites along the wide eco-climatic gradient encompassed by the US National Ecological Observatory Network (NEON).

Physical therapists should play a greater role in managing patients with opioid use and opioid misuse.

The U.S. opioid crisis necessitates that health care providers of all types work collaboratively to manage patients taking prescription opioid medications and manage those who may be misusing prescription opioids.

Integrative data analysis of self-efficacy in 4 clinical trials for alcohol use disorder.

Background: Self-efficacy has been proposed as a key predictor of alcohol treatment outcomes and a potential mechanism of success in achieving abstinence or drinking reductions following alcohol treatment. Integrative data analysis, where data from multiple studies are combined for analyses, can be used to synthesize analyses across multiple alcohol treatment trials by creating a commensurate measure and controlling for differential item functioning (DIF) to determine whether alcohol treatments improve self-efficacy.

Method: The current study used moderated nonlinear factor analysis (MNLFA) to examine the effect of treatment on self-efficacy across four different treatment studies (N = 3720; 72.

Growth-defense trade-offs shape population genetic composition in an iconic forest tree species.

All organisms experience fundamental conflicts between divergent metabolic processes. In plants, a pivotal conflict occurs between allocation to growth, which accelerates resource acquisition, and to defense, which protects existing tissue against herbivory. Trade-offs between growth and defense traits are not universally observed, and a central prediction of plant evolutionary ecology is that context-dependence of these trade-offs contributes to the maintenance of intraspecific variation in defense [Züst and Agrawal, , 68, 513-534 (2017)].

Trait plasticity and trade-offs shape intra-specific variation in competitive response in a foundation tree species.

The ability to tolerate neighboring plants (i.e. degree of competitive response) is a key determinant of plant success in high-competition environments.

Initial evaluation of the Chronic Pain Acceptance Questionnaire - 2.

Greater acceptance of chronic pain is associated with lesser levels of pain-related distress and disability and better overall functioning. Pain acceptance is most often assessed using the Chronic Pain Acceptance Questionnaire (CPAQ), which includes both an eight-item short form (CPAQ-8) and a twenty item parent measure (CPAQ-20). This study derived a two-item CPAQ for use in busy clinical settings and for repeated measurement during treatment, the CPAQ-2.

Latent Class Mediation: A Comparison of Six Approaches.

Latent class mediation modeling is designed to estimate the mediation effect when both the mediator and the outcome are latent class variables. We suggest using an adjusted one-step approach in which the latent class models for the mediator and the outcome are estimated first to decide on the number of classes, then the latent class models and the mediation model are jointly estimated. We present both an empirical demonstration and a simulation study to compare the performance of this one-step approach to a standard three-step approach with modal assignment (modal) and four different modern three-step approaches.

Foliar functional traits from imaging spectroscopy across biomes in eastern North America.

Foliar functional traits are widely used to characterize leaf and canopy properties that drive ecosystem processes and to infer physiological processes in Earth system models. Imaging spectroscopy provides great potential to map foliar traits to characterize continuous functional variation and diversity, but few studies have demonstrated consistent methods for mapping multiple traits across biomes. With airborne imaging spectroscopy data and field data from 19 sites, we developed trait models using partial least squares regression, and mapped 26 foliar traits in seven NEON (National Ecological Observatory Network) ecoregions (domains) including temperate and subtropical forests and grasslands of eastern North America.

Receipt of multiple outpatient opioid prescriptions is associated with increased risk of adverse outcomes in youth: opioid prescribing trends, individual characteristics, and outcomes from 2005 to 2016.

Data on all outpatient opioid prescriptions (N = 71,647) to youth below age 21 (N = 42,020) from 2005 to 2016 were extracted from electronic medical records within a university hospital system in New Mexico (NM) as were demographic details and markers of morbidity/mortality. Relative risk was calculated for markers of morbidity/mortality based on sociodemographic characteristics. The sample was primarily male (55.

From the Arctic to the tropics: multibiome prediction of leaf mass per area using leaf reflectance.

Leaf mass per area (LMA) is a key plant trait, reflecting tradeoffs between leaf photosynthetic function, longevity, and structural investment. Capturing spatial and temporal variability in LMA has been a long-standing goal of ecological research and is an essential component for advancing Earth system models. Despite the substantial variation in LMA within and across Earth's biomes, an efficient, globally generalizable approach to predict LMA is still lacking.

Sensitivity Analysis of the No-Omitted Confounder Assumption in Latent Growth Curve Mediation Models.

Latent growth curve mediation models are increasingly used to assess mechanisms of behavior change. For latent growth mediation model, like any another mediation model, even with random treatment assignment, a critical but untestable assumption for valid and unbiased estimates of the indirect effects is that there should be no omitted variable that confounds indirect effects. One way to address this untestable assumption is to conduct sensitivity analysis to assess whether the inference about an indirect effect would change under varying degrees of confounding bias.

The (Lack of) Replication of Self-Reported Mindfulness as a Mechanism of Change in Mindfulness-Based Relapse Prevention for Substance Use Disorders.

The development and evaluation of mindfulness-based interventions for a variety of psychological and medical disorders has grown exponentially over the past 20 years. Yet, calls for increasing the rigor of mindfulness research and recognition of the difficulties of conducting research on the topic of mindfulness have also increased. One of the major difficulties is the measurement of mindfulness, with varying definitions across studies and ambiguity with respect to the meaning of mindfulness.

Consumption outcomes in clinical trials of alcohol use disorder treatment: Consideration of standard drink misestimation.

. The Food and Drug Administration recently added a new clinical endpoint for evaluating the efficacy of alcohol use disorder (AUD) treatment that is more inclusive of treatment goals besides abstinence: no heavy drinking days (NHDD). However, numerous critiques have been noted for such binary models of treatment outcome.

Global photosynthetic capacity is optimized to the environment.

Earth system models (ESMs) use photosynthetic capacity, indexed by the maximum Rubisco carboxylation rate (V ), to simulate carbon assimilation and typically rely on empirical estimates, including an assumed dependence on leaf nitrogen determined from soil fertility. In contrast, new theory, based on biochemical coordination and co-optimization of carboxylation and water costs for photosynthesis, suggests that optimal V can be predicted from climate alone, irrespective of soil fertility. Here, we develop this theory and find it captures 64% of observed variability in a global, field-measured V dataset for C plants.

Acclimation and adaptation components of the temperature dependence of plant photosynthesis at the global scale.

The temperature response of photosynthesis is one of the key factors determining predicted responses to warming in global vegetation models (GVMs). The response may vary geographically, owing to genetic adaptation to climate, and temporally, as a result of acclimation to changes in ambient temperature. Our goal was to develop a robust quantitative global model representing acclimation and adaptation of photosynthetic temperature responses.