Development of Written Materials for Participants in an Alzheimer's Disease and Related Dementias Screening Trial.

Given that participants' experiences in clinical trials include a variety of communication touchpoints with clinical trial staff, these communications should be designed in a way that enhances the participant experience by paying attention to the self-determination theoretical concepts of competence, autonomy, and relatedness. In this feature, we argue that clinical trial teams need to consider the importance of how they design their written participant communication materials, and we explain in detail the process our multidisciplinary team took to design written materials for the patient and family caregiver participants in our Alzheimer's disease and related dementias (ADRD) screening trial. This article concludes with suggested guidance and steps for other clinical trial teams.

The Impact of Health Information Technology for Early Detection of Patient Deterioration on Mortality and Length of Stay in the Hospital Acute Care Setting: Systematic Review and Meta-Analysis.

Objective: To evaluate the impact of health information technology (HIT) for early detection of patient deterioration on patient mortality and length of stay (LOS) in acute care hospital settings.

Data Sources: We searched MEDLINE and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus from 1990 to January 19, 2021.

Study Selection: We included studies that enrolled patients hospitalized on the floor, in the ICU, or admitted through the emergency department.

Impaired Lymphatic Drainage and Interstitial Inflammatory Stasis in Chronic Musculoskeletal and Idiopathic Pain Syndromes: Exploring a Novel Mechanism.

A normal functioning lymphatic pump mechanism and unimpaired venous drainage are required for the body to remove inflammatory mediators from the extracellular compartment. Impaired vascular perfusion and/or lymphatic drainage may result in the accumulation of inflammatory substances in the interstitium, creating continuous nociceptor activation and related pathophysiological states including central sensitization and neuroinflammation. We hypothesize that following trauma and/or immune responses, inflammatory mediators may become entrapped in the recently discovered interstitial, pre-lymphatic pathways and/or initial lymphatic vessels.

Keys to Driving Implementation of the New Kidney Care Models.

Contemporary nephrology practice is heavily weighted toward in-center hemodialysis, reflective of decisions on infrastructure and personnel in response to decades of policy. The Advancing American Kidney Health initiative seeks to transform care for patients and providers. Under the initiative's framework, the Center for Medicare and Medicaid Innovation has launched two new care models that align patient choice with provider incentives.

Healthy Aging Brain Care Monitor, Caregiver Version: Screening for Post-Intensive Care Syndrome.

Background: Cognitive impairment is common in intensive care unit survivors, pointing to the potential utility of a caregiver-based tool to screen for post-intensive care syndrome.

Objective: To validate the Healthy Aging Brain Care Monitor, Caregiver Version (HABC-M CG), as a caregiver-based tool to screen for post-intensive care syndrome.

Methods: A total of 116 patients who survived a stay in the intensive care unit completed standardized assessments of cognition, psychological symptoms, and physical functioning, and their caregivers completed the HABC-M CG.

Postoperative delirium and its relationship with biomarkers for dementia: a meta-analysis.

Objectives: This study seeks to identify Alzheimer's and related dementias (ADRD) biomarkers associated with postoperative delirium (POD) via meta-analysis.

Design: A comprehensive search was conducted. Studies met the following inclusion criteria: >18 years of age, identified POD with standardized assessment, and biomarker measured in the AT(N)-X (A = amyloid, T = tau, (N)=neurodegeneration, X-Other) framework.

Primary prevention recommendations to reduce the risk of cognitive decline.

Introduction: Few resources address steps clinicians can take to help patients reduce their risk of dementia, despite growing recognition that brain health can be optimized and that risk reduction for cognitive decline can be accomplished by lifestyle modifications.

Methods: To address this gap, UsAgainstAlzheimer's convened a risk reduction workgroup (RRWG) to review existing evidence and develop recommendations for primary care clinicians discussing cognitive decline and risk reduction with their patients.  RESULTS: The RRWG produced 11 consensus-based recommendations and implementation strategies across six topics: neurovascular risk management, physical activity, sleep, nutrition, social isolation, and cognitive stimulation.

Pharmacists-physicians collaborative intervention to reduce vaccine hesitancy and resistance: A randomized controlled trial.

Purpose: Given their negative influence on community health, vaccine hesitancy and resistance are emerging challenges that require healthcare intervention. Therefore, this study aimed to assess the impact of physician-pharmacist collaborative health coaching on rates of hesitancy and resistance for a COVID-19 vaccine.

Methods: After an initial assessment of rates of hesitancy and resistance for a COVID-19 vaccine was conducted, hesitant and resistant participants were approached, recruited, and randomized into an active and control group.

Predicting Video Game Addiction Through the Dimensions of Consumer Video Game Engagement: Quantitative and Cross-sectional Study.

Background: Video games are expanding exponentially with their increased popularity among users. However, this popularity has also led to an increase in reported video game addiction. There may be consumer engagement-related factors that may influence video game addiction.

Inclusion of Patient-Reported Outcomes in Adolescent and Young Adult Phase III Therapeutic Trials: An Analysis of Cancer Clinical Trials Registered on ClinicalTrials.gov.

Objectives: There is a paucity of research on the impact of cancer treatment on the health-related quality of life (HRQOL) of adolescent and young adult (AYA) patients with cancer. Patient-reported outcomes (PROs) are self-report measures used to assess HRQOL and symptom burden. The extent to which PROs have been included in trials that include common AYA cancer types has not been previously assessed.

Comparative Implementation of a Brief App-Directed Protocol for Delirium Identification by Hospitalists, Nurses, and Nursing Assistants : A Cohort Study.

Background: Systematic screening improves delirium identification among hospitalized older adults. Little data exist on how to implement such screening.

Objective: To test implementation of a brief app-directed protocol for delirium identification by physicians, nurses, and certified nursing assistants (CNAs) in real-world practice relative to a research reference standard delirium assessment (RSDA).

Major Surgery and Long Term Cognitive Outcomes: The Effect of Postoperative Delirium on Dementia in the Year Following Discharge.

Background: Delirium is among the most common complications following major surgery. Delirium following medical illness is associated with the development of chronic cognitive decline. The objective of this study was to determine the association of postoperative delirium with dementia in the year following surgery.

Usability-In-Place-Remote Usability Testing Methods for Homebound Older Adults: Rapid Literature Review.

Background: Technology can benefit older adults in many ways, including by facilitating remote access to services, communication, and socialization for convenience or out of necessity when individuals are homebound. As people, especially older adults, self-quarantined and sheltered in place during the COVID-19 pandemic, the importance of usability-in-place became clear. To understand the remote use of technology in an ecologically valid manner, researchers and others must be able to test usability remotely.

Dynamic Delirium Severity Trajectories and Their Association With 2-Year Healthcare Utilization and Mortality Outcomes.

Unlabelled: Delirium severity has been associated with a higher risk of mortality and an increasing morbidity burden. Recently defined delirium severity trajectories were predictive of 30-day mortality in a critically ill patient population. No studies to date have examined associations between delirium severity trajectories and 2-year mortality and healthcare utilization outcomes.

Coping Through COVID-19: A Mixed Method Approach to Understand How Palliative Care Teams Managed the COVID-19 Pandemic.

Objective: While previous work documented a substantial increase in patient mortality consultations and workload for palliative teams, little is known about how these team members managed their mental and physical health during the COVID-19 pandemic. We investigated how job resources (coworker and supervisor support) and personal resources (coping strategies) reduced perceptions of burnout and increased perceptions of well-being.

Method: An anonymous electronic survey was sent to all members ( = 64) of the palliative medical team among 14 hospitals of a New York State health system.

Survival outcomes for cancer types with the highest death rates for adolescents and young adults, 1975-2016.

Background: Five-year relative survival for adolescent and young adult (AYA) patients with cancer diagnosed at the ages of 15 to 39 years is 85%. Survival rates vary considerably according to the cancer type. The purpose of this study was to analyze long-term survival trends for cancer types with the highest mortality among AYAs to determine where the greatest burden is and to identify areas for future research.

Design, implement, and diffuse scalable and sustainable solutions for dementia care.

Most innovations developed to reduce the burden of Alzheimer disease and other related dementias (ADRD) are difficult to implement, diffuse, and scale. The consequences of such challenges in design, implementation, and diffusion are suboptimal care and resulting harm for people living with ADRD and their caregivers. National experts identified four factors that contribute to our limited ability to implement and diffuse of evidence-based services and interventions for people living with ADRD: (1) limited market demand for the implementation and diffusion of effective ADRD interventions; (2) insufficient engagement of persons living with ADRD and those caring for them in the development of potential ADRD services and interventions; (3) limited evidence and experience regarding scalability and sustainability of evidence-based ADRD care services; and (4) difficulties in taking innovations that work in one context and successfully implementing them in other contexts.

Meta-analysis of ICU Delirium Biomarkers and Their Alignment With the NIA-AA Research Framework.

Background: Between 30% and 80% of survivors of critical illness experience cognitive impairment, but the underlying mechanisms remain unknown.

Objective: To determine whether intensive care unit (ICU) delirium biomarkers align with the National Institute on Aging-Alzheimer's Association (NIA-AA) research framework for diagnostic biomarkers for Alzheimer disease and other related dementias (ADRD).

Methods: Ovid MEDLINE, PsycInfo, Embase, and the Cochrane Library were systematically searched for articles published between January 1, 2000, and February 20, 2020, on the relationship between delirium and biomarkers listed in the NIA-AA framework.

Improving Management of Type 2 Diabetes Using Home-Based Telemonitoring: Cohort Study.

Background: Diabetes is present in 10.5% of the US population and accounts for 14.3% of all office-based physician visits made by adults.

Barriers and Facilitators to Adolescent and Young Adult Cancer Trial Enrollment: NCORP Site Perspectives.

Background: Although it is well documented that adolescents and young adults (AYAs) with cancer have low participation in cancer clinical trials (CCTs), the underlying reasons are not well understood. We used the National Cancer Institute Community Oncology Research Program (NCORP) network to identify barriers and facilitators to AYA CCT enrollment, and strategies to improve enrollment at community-based and minority and/or underserved sites.

Methods: We performed one-on-one semistructured qualitative interviews with stakeholders (NCORP site principle investigators, NCORP administrators, physicians involved in enrollment, lead clinical research associates or clinical research nurses, nurse navigators, regulatory research associates, patient advocates) in the AYA CCT enrollment process.

Human factors and ergonomics methods for pharmacy research and clinical practice.

Background: Human factors and ergonomics (HFE) is a scientific and practical human-centered discipline that studies and improves human performance in sociotechnical systems. HFE in pharmacy promotes the human-centered design of systems to support individuals and teams performing medication-related work.

Objective: To review select HFE methods well suited to address pharmacy challenges, with examples of their application in pharmacy.

Motivational Mechanisms Underlying Physicians' Occupational Health: A Self-Determination Theory Perspective.

Numerous studies have documented deteriorating occupational health among practicing physicians. This trend poses a serious risk not only for physicians but also for the many patients under their care. Past research finds that one protective factor involves the quality of physicians' motivation.

Relationships between preoperative cortical thickness, postoperative electroencephalogram slowing, and postoperative delirium.

Background: It is unclear how preoperative neurodegeneration and postoperative changes in EEG delta power relate to postoperative delirium severity. We sought to understand the relative relationships between neurodegeneration and delta power as predictors of delirium severity.

Methods: We undertook a prospective cohort study of high-risk surgical patients (>65 yr old) to identify predictors of peak delirium severity (Delirium Rating Scale-98) with twice-daily delirium assessments (NCT03124303).

Reducing anticholinergic medication exposure among older adults using consumer technology: Protocol for a randomized clinical trial.

Introduction: A growing body of scientific evidence points to the potentially harmful cognitive effects of anticholinergic medications among older adults. Most interventions designed to promote deprescribing of anticholinergics have directly targeted healthcare professionals and have had mixed results. Consumer-facing technologies may provide a unique benefit by empowering patients and can complement existing healthcare professional-centric efforts.