Older Adult Misuse of Over-the-Counter Medications: Effectiveness of a Novel Pharmacy-Based Intervention to Improve Patient Safety.

Objectives: Older adults' (ages ≥65) inappropriate over-the-counter medications (OTC) use is prevalent, comprising Drug-Age, Drug-Drug, Drug-Disease, and Drug-Label types. Given that pharmacies sell many OTCs, structurally redesigning pharmacy aisles for improving patient safety (Senior Safe) was conceived to mitigate older adult OTC misuse, using Stop Signs and Behind-the-Counter Signs for high-risk OTCs. This study determined whether Senior Safe reduced high-risk OTCs misuse, while secondarily evaluating misuse changes for all OTCs.

MindScape Study: Integrating LLM and Behavioral Sensing for Personalized AI-Driven Journaling Experiences.

Mental health concerns are prevalent among college students, highlighting the need for effective interventions that promote self-awareness and holistic well-being. MindScape explores a novel approach to AI-powered journaling by integrating passively collected behavioral patterns such as conversational engagement, sleep, and location with Large Language Models (LLMs). This integration creates a highly personalized and context-aware journaling experience, enhancing self-awareness and well-being by embedding behavioral intelligence into AI.

Virtual reality anatomy trainer turns teaching endobronchial ultrasound inside-out.

Background: Traditional approaches for learning anatomy for curvilinear endobronchial ultrasound (EBUS) require learners to mentally visualize structures relative to the position of the bronchoscope. Virtual reality (VR) can demonstrate anatomy from the perspective of bronchoscopic tools.

Research Question: Does the use of a VR anatomy trainer for teaching EBUS-associated anatomy improve procedural performance compared to traditional methods?

Study Design And Methods: In this randomized, cross-over study design, subjects studied EBUS-related anatomy during two sequential sessions using a VR trainer and a traditional modality (two-dimensional pictures (2D) or a three-dimensional model (3D)).

Is Attention All You Need For Actigraphy? Foundation Models of Wearable Accelerometer Data for Mental Health Research.

Wearable accelerometry (actigraphy) has provided valuable data for clinical insights since the 1970s and is increasingly important as wearable devices continue to become widespread. The effectiveness of actigraphy in research and clinical contexts is heavily dependent on the modeling architecture utilized. To address this, we developed the Pretrained Actigraphy Transformer (PAT)-the first pretrained and fully attention-based model designed specifically to handle actigraphy.

Beyond Detection: Towards Actionable Sensing Research in Clinical Mental Healthcare.

Researchers in ubiquitous computing have long promised that passive sensing will revolutionize mental health measurement by detecting individuals in a population experiencing a mental health disorder or specific symptoms. Recent work suggests that detection tools do not generalize well when trained and tested in more heterogeneous samples. In this work, we contribute a narrative review and findings from two studies with 41 mental health clinicians to understand these generalization challenges.

Improving Patient Understanding of Emergency Department Discharge Instructions.

Introduction: Previous studies have shown that patients in the emergency department (ED) are frequently given incomplete discharge instructions that are written at least four grade levels above the recommended sixth-grade reading level, leading to poor understanding. Our aims in this study were to implement standardized discharge instructions containing six key components written at a more appropriate reading level for common emergency department (ED) diagnoses to improve patient understanding.

Methods: We conducted this study in a 20-bed ED at an urban Veteran's Administration hospital.

Anhedonia in flux: Understanding the associations of emotion regulation and anxiety with anhedonia dynamics in a sample with major depressive disorder.

Negative rumination and emotion regulation difficulties have been consistently linked with depression. Despite anhedonia-the lack of interest in pleasurable experiences-being a cardinal symptom of depression, emotion regulation of positive emotions, including dampening, are considered far less in the literature. Given that anhedonia may manifest through blunted responses to previously positive or enjoyable experiences, it is vital to understand how different positive emotion regulation strategies impact anhedonia symptom severity and how it can vary or change over time.

An Anatomic Reconstruction of Both the Anterior Cruciate Ligament and Fibular Collateral Ligament Using Autografts.

Fibular collateral ligament (FCL) tears rarely occur in isolation and are typically injured in conjunction with another ligament, including the anterior cruciate ligament (ACL). Reconstruction of both ACL and the FCL is critical to restore proper knee biomechanics and stability. This technique describes an anatomic reconstruction of both the ACL using a bone-patellar tendon-bone autograft and the FCL using a semitendinosus hamstring autograft.

Detecting Longitudinal Trends between Passively Collected Phone Use and Anxiety among College Students.

Introduction: Existing theories and empirical works link phone use with anxiety; however, most leverage subjective self-reports of phone use (e.g., validated questionnaires) that may not correspond well with true behavior.

When Things Go Right: Safety II in an Academic Emergency Department.

Objectives Historically, "safety" has been defined as an absence of error. Practice variability of any kind has been viewed as a threat. This is termed Safety I.

Use of passively collected actigraphy data to detect individual depressive symptoms in a clinical subpopulation and a general population.

The presentation of major depressive disorder (MDD) can vary widely due to its heterogeneity, including inter- and intraindividual symptom variability, making MDD difficult to diagnose with standard measures in clinical settings. Prior work has demonstrated that passively collected actigraphy can be used to detect MDD at a disorder level; however, given the heterogeneous nature of MDD, comprising multiple distinct symptoms, it is important to measure the degree to which various MDD symptoms may be captured by such passive data. The current study investigated whether individual depressive symptoms could be detected from passively collected actigraphy data in a (a) clinical subpopulation (i.

Identifying potential outcomes of patient engagement in primary care quality improvement: a modified Delphi study.

Rationale: A barrier to dedicating resources towards patient engagement in primary care quality improvement is the lack of clearly identified outcomes that might result from these initiatives.

Aims And Objectives: We sought to identify these potential outcomes at three healthcare levels as defined by the Institute of Medicine: 1) Micro/Direct Care; 2) Meso/Microsystem; and 3) Macro/Clinic/System using a Modified Delphi technique.

Method: Two focus groups of patients and primary care clinician leaders generated a first set of outcomes.

Strategies to Deimplement Opioid Prescribing in Primary Care: A Cluster Randomized Clinical Trial.

Importance: Centers for Disease Control and Prevention guidelines advocate reduced opioid prescribing for chronic pain, yet research on their implementation remains limited.

Objective: To compare 4 deimplementation strategies to promote guideline-concordant opioid prescribing.

Design, Setting, And Participants: This cluster randomized clinical trial was performed at 32 primary care clinics from 2 US health care systems from February 2020 to March 2022, using a hybrid type 3 sequential multiple-assignment design focused on patient outcomes.

Inclusion of Individuals With Lived Experiences in the Development of a Digital Intervention for Co-Occurring Depression and Cannabis Use: Mixed Methods Investigation.

Background: Existing interventions for co-occurring depression and cannabis use often do not treat both disorders simultaneously and can result in higher rates of symptom relapse. Traditional in-person interventions are often difficult to obtain due to financial and time limitations, which may further prevent individuals with co-occurring depression and cannabis use from receiving adequate treatment. Digital interventions can increase the scalability and accessibility for these individuals, but few digital interventions exist to treat both disorders simultaneously.

Evaluating a mobile app's effects on depression and anxiety in medication-treated opioid use disorder.

Depression and anxiety frequently co-occur with opioid use disorder (OUD) yet are often overlooked in standard OUD treatments. This study evaluated the feasibility, acceptability, and preliminary effectiveness of a mobile application designed to address these symptoms in individuals receiving medications for OUD (MOUD). A randomized controlled trial recruited N = 63 adults with OUD who received MOUD and screened positive for moderate depression or generalized anxiety.

Role of the Surgeon in De-Escalating Emotion During a Breast Cancer Surgery Consultation: A Qualitative Study of Patients' Experiences in Alliance A231701CD.

Background: Patient engagement in decision making can improve satisfaction with care. Studies demonstrate that patients' emotional states can be significant barriers to engaging in shared decision making.

Objective: We sought to examine how emotion associated with a breast cancer diagnosis impacts patient experiences during the surgical consultation, and explore opportunities for surgeons to mitigate the impact of emotion.

A large-scale observational comparison of antidepressants and their effects.

Background: Selective Serotonin Reuptake Inhibitors (SSRIs) represent a diverse class of medications widely prescribed for depression and anxiety. Despite their common use, there is an absence of large-scale, real-world evidence capturing the heterogeneity in their effects on individuals. This study addresses this gap by utilizing naturalistic search data to explore the varied impact of six different SSRIs on user behavior.

A template and tutorial for preregistering studies using passive smartphone measures.

Passive smartphone measures hold significant potential and are increasingly employed in psychological and biomedical research to capture an individual's behavior. These measures involve the near-continuous and unobtrusive collection of data from smartphones without requiring active input from participants. For example, GPS sensors are used to determine the (social) context of a person, and accelerometers to measure movement.

Barriers to Adherence to Overactive Bladder Treatment for Hispanic Women.

Importance: Adherence to overactive bladder (OAB) therapy is low among the general population. Prior studies suggest that OAB is more prevalent among Hispanic women compared with other ethnicities.

Objectives: The aims of this study were to analyze nonadherence to OAB therapy among Hispanic compared with non-Hispanic women and identify potential barriers to treatment to reduce disparities in care.

MoodCapture: Depression Detection Using In-the-Wild Smartphone Images.

MoodCapture presents a novel approach that assesses depression based on images automatically captured from the front-facing camera of smartphones as people go about their daily lives. We collect over 125,000 photos in the wild from N=177 participants diagnosed with major depressive disorder for 90 days. Images are captured naturalistically while participants respond to the PHQ-8 depression survey question: .

Systems Forces Leading to Feeding Tube Placement in Patients with Advanced Dementia: A Qualitative Exploration of Clinical Momentum.

Older adults with serious illness near the end-of-life often receive invasive treatments. We developed a conceptual model called clinical momentum that describes system-level forces producing a trajectory of care that is difficult to modify and contributes to overtreatment. We sought to evaluate the empirical fit of our model by examining an event with clear guidelines against intervention: permanent feeding tube placement in patients with advanced dementia.

From mood to use: Using ecological momentary assessments to examine how anhedonia and depressed mood impact cannabis use in a depressed sample.

Anhedonia and depressed mood are two cardinal symptoms of major depressive disorder (MDD). Prior work has demonstrated that cannabis consumers often endorse anhedonia and depressed mood, which may contribute to greater cannabis use (CU) over time. However, it is unclear (1) how the unique influence of anhedonia and depressed mood affect CU and (2) how these symptoms predict CU over more proximal periods of time, including the next day or week (rather than proceeding weeks or months).