Refining Parent SMART: User feedback to optimize a multi-modal intervention.

Introduction: The continuing care period following residential substance use treatment is a time when adolescents are at especially high risk for relapse, yet few families engage in traditional office-based care. Parent SMART (Substance Misuse among Adolescents in Residential Treatment) is a multi-component continuing care intervention for parents that combines three digital health technologies - an "off the shelf" online parenting program, daily phone notifications, and an online parent networking forum - with support from a parent coach. The current study solicited both qualitative and quantitative user feedback about Parent SMART to ensure responsivity to user preferences, refinement, and continuous improvement of the intervention.

Parent SMART: Effects of residential treatment and an adjunctive parenting intervention on behavioral health services utilization.

Introduction: Scant research has examined the impact of residential treatment on adolescent behavioral healthcare utilization post-discharge, even though behavioral healthcare utilization is major driver of healthcare costs. In the primary analyses of a pilot randomized trial, Parent SMART - a technology-assisted intervention for parents of adolescents in residential treatment - was found to improve parental monitoring and parent-adolescent communication, reduce adolescent drinking, and reduce adolescent school-related problems, relative to residential treatment as usual (TAU). The goal of this secondary analysis of the pilot randomized trial was to assess the effects of residential treatment and the adjunctive Parent SMART intervention on both the amount and type of subsequent behavioral healthcare utilization.

Gender diversity in autistic and neurotypical youth over adolescence and puberty: A longitudinal study.

Recent research in autism spectrum disorder (ASD) has suggested a higher prevalence of gender diversity in individuals diagnosed with ASD. Adolescence is a critical period for the consolidation of gender identity, yet the extent to which the experience of gender diversity is stable over adolescence and puberty in autistic youth is poorly understood. The aim of the study was to examine the consistency of gender diversity using the gender diversity screening questionnaire for self- and parent-report of youth (GDSQ-S, GDSQ-P) over a four-year longitudinal study of pubertal development in youth with ASD (N = 140, 36 assigned-female-at birth (AFAB)) and typical development (TD, N = 104, 58 assigned-male-at-birth [AMAB]) and their parents.

Variation in Sedative and Analgesic Use During the COVID-19 Pandemic and Associated Outcomes.

Background: Providing analgesia and sedation is an essential component of caring for many mechanically ventilated patients. The selection of analgesic and sedative medications during the COVID-19 pandemic, and the impact of these sedation practices on patient outcomes, remain incompletely characterized.

Research Question: What were the hospital patterns of analgesic and sedative use for patients with COVID-19 who received mechanical ventilation (MV), and what differences in clinical patient outcomes were observed across prevailing sedation practices?

Study Design And Methods: We conducted an observational cohort study of hospitalized adults who received MV for COVID-19 from February 2020 through April 2021 within the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) COVID-19 Registry.

Mental Health Conditions Associated With Strabismus in a Diverse Cohort of US Adults.

Importance: Greater understanding of the association between strabismus and mental health conditions across sociodemographic backgrounds may inform strategies to improve mental well-being in this population.

Objective: To describe the association of strabismus with mental health conditions in a diverse cohort of US adults.

Design, Setting, And Participants: This cross-sectional study used data from the National Institutes of Health's All of Us Research Program, an ongoing program launched in 2015.

Cardiac evaluation in pregnant patients with dyspnea and palpitations.

Background: Symptoms of underlying cardiac disease in pregnancy can often be mistaken for common complaints because of normal physiological changes in pregnancy. Echocardiographic evaluation of patients with symptoms of palpitations and dyspnea can detect structural changes and identify high-risk features.

Objective: This study aimed to examine transthoracic echocardiograms of perinatal individuals completed for palpitations or dyspnea to determine the frequency of identifying structural changes.

Prevalence and Outcomes of Patients With Acute Ischemic Stroke With Concomitant ST-Segment-Elevation Myocardial Infarction (Results From National Inpatient Sample 2016-2019).

Background: Acute myocardial infarction may concomitantly occur with acute ischemic stroke. The prevalence, complications, and outcomes of acute ST-segment-elevation myocardial infarction (STEMI) in patients hospitalized with acute ischemic stroke are not well studied.

Methods: We examined hospitalized patients with acute ischemic stroke who were included in the National Inpatient Sample from 2016 to 2019.

Multimodality Imaging of Patent Ductus Arteriosus Complicated by Severe Pulmonary Arterial Hypertension in a Pregnant Patient.

• Large uncorrected PDA may first be diagnosed during pregnancy. • Multimodality imaging may be safely utilized in these patients. • Multimodality imaging is safely utilized in these patients.

A Multimodality Imaging and Multidisciplinary Approach to Manage Anomalous Right Coronary Artery from the Pulmonary Artery in Pregnancy.

• ARCAPA can present with minimal symptoms. • A dilated RCA and intramyocardial collateralization are suspicious for ARCAPA. • CCT is the noninvasive diagnostic modality of choice to confirm ARCAPA.

Adolescent neurocognitive development and decision-making abilities regarding gender-affirming care.

Recently, politicians and legislative bodies have cited neurodevelopmental literature to argue that brain immaturity undermines decision-making regarding gender-affirming care (GAC) in youth. Here, we review this literature as it applies to adolescents' ability to make decisions regarding GAC. The research shows that while adolescence is a time of peak risk-taking behavior that may lead to impulsive decisions, neurocognitive systems supporting adult-level decisions are available given deliberative processes that minimize influence of short-term rewards and peers.

Male Breast Cancer: a Review on Diagnosis, Treatment, and Survivorship.

Purpose Of Review: Male breast cancer is a relatively uncommon and rare disease that is often managed based on evidence adopted from trials pertaining to female breast cancer due to low accrual rates or exclusion of males. This is despite the known differences in the biology and epidemiology of this condition. This review provides an update regarding the management and surveillance of male breast cancer.

Social Determinants of Health and Hearing Loss in U.S. Adults.

Objectives: Social determinants of health (SDH) are nonmedical, societal factors that influence health. There is limited information on the current relationship between SDH and hearing loss (HL) in the United States. This study aims to compare the odds of HL among US adults by race/ethnicity, education level, income-to-poverty level ratio, health insurance coverage, and health care access.

Perforated peptic ulcer disease in transferred patients is associated with significant increase in length of stay.

Background: Perforated peptic ulcer disease (PPUD) has a prevalence of 0.004-0.014% with mortality of 23.

Association of initial opioid prescription duration and an opioid refill by pain diagnosis: Evidence from outpatient settings in ten US health systems.

Objective: The Centers for Disease Control and Prevention's 2022 Clinical Practice Guideline for Prescribing Opioids for Pain cautioned that inflexible opioid prescription duration limits may harm patients. Information about the relationship between initial opioid prescription duration and a subsequent refill could inform prescribing policies and practices to optimize patient outcomes. We assessed the association between initial opioid duration and an opioid refill prescription.

Prescription Opioid Dose Reductions and Potential Adverse Events: a Multi-site Observational Cohort Study in Diverse US Health Systems.

Background: In response to the opioid crisis in the United States, population-level prescribing of opioids has been decreasing; there are concerns, however, that dose reductions are related to potential adverse events.

Objective: Examine associations between opioid dose reductions and risk of 1-month potential adverse events (emergency department (ED) visits, opioid overdose, benzodiazepine prescription fill, all-cause mortality).

Design: This observational cohort study used electronic health record and claims data from eight United States health systems in a prescription opioid registry (Clinical Trials Network-0084).

Future Directions in the Mental Health of Transgender Youth: Towards a Social-Affective Developmental Model of Health Disparity.

Mental health disparities in transgender and gender diverse (TGD) youth are well-documented. These disparities are often studied in the context of minority stress theory, and most of this research focuses on experiences of trauma and discrimination TGD youth experience after coming out. However, TGD youth may be targets of violence and victimization due to perceived gender nonconformity before coming out.

Long-term health outcomes for patients with obstructive sleep apnea: placing the Agency for Healthcare Research and Quality report in context-a multisociety commentary.

Unlabelled: This multisociety commentary critically examines the Agency for Healthcare Research and Quality (AHRQ) final report and systematic review on long-term health outcomes in obstructive sleep apnea. The AHRQ report was commissioned by the Centers for Medicare & Medicaid Services and particularly focused on the long-term patient-centered outcomes of continuous positive airway pressure, the variability of sleep-disordered breathing metrics, and the validity of these metrics as surrogate outcomes. This commentary raises concerns regarding the AHRQ report conclusions and their potential implications for policy decisions.

Female-specific risk factors of parity and menopause age and risk of carotid plaque: the multi-ethnic study of atherosclerosis.

Background: Female-specific factors of grand multiparity (≥5 births) and early menopause age are associated with an increased risk of cardiovascular disease (CVD). However, mechanisms are incompletely understood. Carotid plaque is a marker of subclinical atherosclerosis and associated with increased CVD risk.