"It's Like Making Reflective Practice More of the Heart of Who We Are": An Exploration of Facilitators and Barriers to Implementing Reflective Supervision in State Pre-K.

High-quality supervision for teachers in early care and education (ECE) is essential for building positive teacher-child relationships and enhancing ECE program quality, which in turn promotes healthy social-emotional and academic development in young children. Reflective supervision (RS) is a process-oriented and relationship-centered supervisory approach that has growing empirical evidence supporting its use. As the evidence base for RS continues to expand, and early childhood-serving settings-including ECE-increasingly consider this approach, understanding whether RS is likely to be routinely used in ECE settings and what helps or hinders use of this approach is critically important.

A New Process Model for Relationship-Centred Shared Decision-Making in Physical Medicine and Rehabilitation Settings.

Introduction: We present a relationship-centred shared-decision-making (RCSDM) process model to explicate factors that shape decision-making processes during physical medicine and rehabilitation (PMR) encounters among patients, their care partners and practitioners. Existing shared decision-making (SDM) models fall short in addressing the everyday decisions routinely made regarding persons with chronic disabilities who require high levels of support, their care partners and rehabilitation practitioners. In PMR, these everyday decisions are small scale, immediate and in service to a larger therapeutic goal.

Acylcarnitines are associated with lower depressive symptomatology in a mainland puerto rican cohort.

Introduction: Recent studies have implicated acetyl-L-carnitine as well as other acylcarnitines in depression. To our knowledge, no untargeted metabolomics studies have been conducted among US mainland Puerto Ricans.

Objectives: We conducted untargeted metabolomic profiling on plasma from 736 participants of the Boston Puerto Rican Health Study.

Implementing Montessori approaches after training: A mixed methods study to examine staff understanding and movement toward action.

This paper uses Normalization Process Theory (NPT) to examine staff impressions of Montessori-based program training and implementation at Veterans Affairs Community Living Centers (VA CLCs; nursing homes). We conducted a mixed-methods evaluation of Montessori Approaches to Person-Centered Care (MAP-VA) at eight VA CLCs. Trainings were conducted as either a live virtual course or a pre-recorded asynchronous class.

Prediction-Augmented Shared Decision-Making and Lung Cancer Screening Uptake.

Importance: Addressing poor uptake of low-dose computed tomography lung cancer screening (LCS) is critical, especially for those having the most to gain-high-benefit persons with high lung cancer risk and life expectancy more than 10 years.

Objective: To assess the association between LCS uptake and implementing a prediction-augmented shared decision-making (SDM) tool, which enables clinicians to identify persons predicted to be at high benefit and encourage LCS more strongly for these persons.

Design, Setting, And Participants: Quality improvement interrupted time series study at 6 Veterans Affairs sites that used a standard set of clinical reminders to prompt primary care clinicians and screening coordinators to engage in SDM for LCS-eligible persons.

Metabolites and Cognitive Decline in a Puerto Rican Cohort.

Background: Recent studies have identified plasma metabolites associated with cognitive decline and Alzheimer's disease; however, little research on this topic has been conducted in Latinos, especially Puerto Ricans.

Objective: This study aims to add to the growing body of metabolomics research in Latinos to better understand and improve the health of this population.

Methods: We assessed the association between plasma metabolites and global cognition over 12 years of follow-up in 736 participants of the Boston Puerto Rican Health Study (BPRHS).

What Matters Most: The Documented Goals, Values and Motivators of Advanced Cancer Patients.

Background: Goals of care conversations are essential to delivery of goal concordant care. Infrequent and inconsistent goals of care documentation potentially limit delivery of goal concordant care.

Methods: At Kaiser Permanente San Francisco Cancer Center, a standardized documentation template was designed and implemented to increase goals of care documentation by oncologists.

Metabolomics and Self-Reported Depression, Anxiety, and Phobic Symptoms in the VA Normative Aging Study.

Traditional approaches to understanding metabolomics in mental illness have focused on investigating a single disorder or comparisons between diagnoses, but a growing body of evidence suggests substantial mechanistic overlap in mental disorders that could be reflected by the metabolome. In this study, we investigated associations between global plasma metabolites and abnormal scores on the depression, anxiety, and phobic anxiety subscales of the Brief Symptom Inventory (BSI) among 405 older males who participated in the Normative Aging Study (NAS). Our analysis revealed overlapping and distinct metabolites associated with each mental health dimension subscale and four metabolites belonging to xenobiotic, carbohydrate, and amino acid classes that were consistently associated across all three symptom dimension subscales.

Gaps in evidence on treatment of male osteoporosis: a Research Agenda.

Objective: To identify key research gaps regarding medication therapy to prevent osteoporotic fractures in men.

Data Sources: Articles from the peer-reviewed literature containing empirical studies of the use of medication therapy for fracture prevention in men, either in clinical trials or observational studies.

Study Selection And Data Extraction: We searched PubMed with search terms including "osteoporosis AND medication therapy management".

A systematic review with meta-analysis of cognitive bias modification interventions for anger and aggression.

Aggression and anger are associated with interpretation and attention biases. Such biases have become treatment targets for anger and aggressive behavior in cognitive bias modification (CBM) interventions. Several studies have evaluated the efficacy of CBM for the treatment of anger and aggressive behavior, with inconsistent results.

Association between Acid-Lowering Agents, Metformin, and Vitamin B12 among Boston-Area Puerto Ricans.

Background: Vitamin B12 involves several physiological functions, and malabsorption is reported with medication use.

Objectives: Studies have reported an inverse association between the use of metformin or acid-lowering agents (ALAs), such as proton pump inhibitors, histamine 2 receptor antagonists, and blood vitamin B12 concentration, because of malabsorption. The concomitant use of these medications is underreported.

Perceived benefits and barriers to implementing precision preventive care: Results of a national physician survey.

Polygenic risk scores (PRS) may improve risk-stratification in preventive care. Their clinical implementation will depend on primary care physicians' (PCPs) uptake. We surveyed PCPs in a national physician database about the perceived clinical utility, benefits, and barriers to the use of PRS in preventive care.

Different risk factors distinguish myalgic encephalomyelitis/chronic fatigue syndrome from severe fatigue.

Fatigue is a common reason that patients seek medical care. Only a fraction of these patients meet criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). To determine if ME/CFS is just a more extreme form of fatigue, or a qualitatively different condition, we assessed whether risk factors for ME/CFS and for Severe Fatigue were similar.

Two mental models of integrated care for advanced liver disease: qualitative study of multidisciplinary health professionals.

Objectives: The purpose of this paper is to present two divergent mental models of integrated advanced liver disease (AdvLD) care among 26 providers who treat patients with AdvLD.

Setting: 3 geographically dispersed United States Veterans Health Administration health systems.

Participants: 26 professionals (20 women and 6 men) participated, including 9 (34.

Yoga Versus Education for Veterans with Chronic Low Back Pain: a Randomized Controlled Trial.

Background: Yoga is effective for chronic low back pain (cLBP) in civilians but understudied among Veterans.

Objective: Determine whether yoga is more effective than an educational book for improving disability and pain among Veterans with cLBP.

Design, Setting, And Participants: Veterans diagnosed with cLBP at a VA medical center enrolled in a randomized controlled trial from March to December of 2015.

A qualitative approach to examining antimicrobial prescribing in the outpatient dental setting.

Objective: To understand barriers and facilitators to evidence-based prescribing of antibiotics in the outpatient dental setting.

Design: Semistructured interviews.

Setting: Outpatient dental setting.

Educating students while recruiting underrepresented populations for Alzheimer's disease research: the Student Ambassador Program.

Background: Increasing numbers of patients with Alzheimer's Disease and related disorders (ADRD) necessitates increasing numbers of clinicians to care for them. Educational programming related to community outreach with older adults may help inspire interest in future ADRD clinical careers, while increasing awareness of ADRD in the community and aiding recruitment of underrepresented participants into research studies.

Method: The Boston University Alzheimer's Disease Research Center (BU ADRC) created the BU ADRC Student Ambassador Program, where medical students, graduate students, and undergraduates interested in medicine completed a curriculum during the academic year that included six educational and three outreach events, including monthly dementia-focused didactic meetings and outreach focusing on Black participant recruitment.

Characteristics and Gender Differences of Headache in the Veterans Health Administration: A National Cohort Study, Fiscal Year 2008-2019.

Background And Objectives: To determine gender differences in headache types diagnosed, sociodemographic characteristics, military campaign and exposures, and health care utilization among US veterans in the Veterans Health Administration (VHA).

Methods: This study used a retrospective cohort design to examine VHA electronic health record (EHR) data. This cohort includes veterans who had at least 1 visit for any headache between fiscal years 2008 and 2019.

A Spotlight on Adaptation: Preimplementation of Montessori-Based Activity Programming in Long-Term Care Using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME).

Background And Objectives: Effectively adapting evidence-based interventions for nursing home (NH) implementation is a critical, yet underexamined, component of improving care quality. Montessori-based activity programming (MAP) is an evidence-based intervention that promotes person-centered care, engages persons living with dementia, and mitigates distress behaviors. Currently, there is sparse evidence of MAP in Department of Veterans Affairs NHs (i.

High heritability of ascending aortic diameter and trans-ancestry prediction of thoracic aortic disease.

Enlargement of the aorta is an important risk factor for aortic aneurysm and dissection, a leading cause of morbidity in the developed world. Here we performed automated extraction of ascending aortic diameter from cardiac magnetic resonance images of 36,021 individuals from the UK Biobank, followed by genome-wide association. We identified lead variants across 41 loci, including genes related to cardiovascular development (HAND2, TBX20) and Mendelian forms of thoracic aortic disease (ELN, FBN1).