Mental Health Care Treatment Seeking Among African Americans and Caribbean Blacks: What is the Role of Religiosity/Spirituality?

According to the 2014 SAMSHA National Survey on Drug Use and Health (NSDUH), 18.1% of American adults (ages 18 and over) experienced some sort of mental health issue. Furthermore, estimations have shown that around 20% of older adults experience some sort of mental health problem. While the percentage of older adults increase, they are less likely to use mental health care services than younger and middle aged adults. In addition, racial/ethnic minorities, such as African American and Caribbean Blacks are less likely to use mental health care services. The percentage of older racial/ethnic adults is also increasing from 18% in 2004 to 22% in 2014, and this is expected to continue increasing. The underutilization of mental health services indicates that many members of the older population are left untreated, which can decrease an individual’s quality of life and can result in significant costs to families, employers, and health systems. The study explores the differences in relationships between mental health care seeking behavior and strength of religious/spiritual beliefs between older adults (aged 54 years or older) and adults (18-53) from two racial/ethnic groups, African Americans and Caribbean Blacks living in the US using data from the National Survey of American Life (NSAL). Descriptive statistics and logistic regression analyses were conducted using Stata version 13.1. Preliminary analyses show that mental health treatment seeking alone is related to spirituality and/or religiosity. Significant demographic controls are age, gender, and being from the South. The study indicated statistical support for strong religious/spiritual beliefs which may promote mental health treatment seeking. Future studies will need to examine the strength of religious/spiritual beliefs on mental health care seeking behavior among different demographic groups

Hip Manipulation Under Anesthesia for Post-Hip Arthroscopy Pericapsular Scarring: Indications and Techniques

Hip arthroscopy has become an increasingly common procedure with expanding indications over the last several decades. With the increase in number of procedures performed a complication profile has emerged, although there is yet to be a formal classification system for complications. The most cited complications include lateral femoral cutaneous nerve neuropraxia, other sensory deficits, chondral or labral iatrogenic damage, superficial infection and deep vein thrombosis. One complication that has not yet been well documented in the literature is pericapsular scarring/adhesions resulting in decreased hip range of motion and function. If this complication is noted to persist after adequate impingement resection and a rigorous post-operative physical therapy regimen, the senior author has addressed this with a hip manipulation under anesthesia. Therefore, this techniques paper aims to describe pericapsular scarring as a post hip-arthroscopy condition which may cause pain and demonstrate our technique to address this diagnosis through hip manipulation under anesthesia

A multifactorial \u2018Consensus Signature\u2019 by in silico analysis to predict response to neoadjuvant anthracycline-based chemotherapy in triple-negative breast cancer

BACKGROUND: Owing to the complex processes required for anthracycline-induced cytotoxicity, a prospectively defined multifactorial Consensus Signature (ConSig) might improve prediction of anthracycline response in triple-negative breast cancer (TNBC) patients, whose only standard systemic treatment option is chemotherapy. AIMS: We aimed to construct and evaluate a multifactorial signature, comprising measures of each function required for anthracycline sensitivity in TNBC. METHODS: ConSigs were constructed based on five steps required for anthracycline function: drug penetration, nuclear topoisomerase II\u3b1 (topoII\u3b1) protein location, increased topoII\u3b1 messenger RNA (mRNA) expression, apoptosis induction, and immune activation measured by, respectively, HIF1\u3b1 or SHARP1 signature, LAPTM4B mRNA, topoII\u3b1 mRNA, Minimal Gene signature or YWHAZ mRNA, and STAT1 signature. TNBC patients treated with neoadjuvant anthracycline-based chemotherapy without taxane were identified from publicly available gene expression data derived with Affymetrix HG-U133 arrays (training set). In silico analyses of correlation between gene expression data and pathological complete response (pCR) were performed using receiver-operating characteristic curves. To determine anthracycline specificity, ConSigs were assessed in patients treated with anthracycline plus taxane. Specificity, sensitivity, positive and negative predictive value, and odds ratio (OR) were calculated for ConSigs. Analyses were repeated in two validation gene expression data sets derived using different microarray platforms. RESULTS: In the training set, 29 of 147 patients had pCR after anthracycline-based chemotherapy. Various combinations of components were evaluated, with the most powerful anthracycline response predictors being ConSig1: (STAT1+topoII\u3b1 mRNA +LAPTM4B) and ConSig2: (STAT1+topoII\u3b1 mRNA+HIF1\u3b1). ConSig1 demonstrated high negative predictive value (85%) and high OR for no pCR (3.18) and outperformed ConSig2 in validation sets for anthracycline specificity. CONCLUSIONS: With further validation, ConSig1 may help refine selection of TNBC patients for anthracycline chemotherapy

Selective self-categorization: Meaningful categorization and the in-group persuasion effect

Research stemming from self-categorization theory (Turner et al., 1987) has demonstrated that individuals are typically more persuaded by messages from their in-group than by messages from the out-group. The present research investigated the role of issue relevance in moderating these effects. In particular, it was predicted that in-groups would only be more persuasive when the dimension on which group membership was defined was meaningful or relevant to the attitude issue. In two studies, participants were presented with persuasive arguments from either an in-group source or an out-group source, where the basis of the in-group/out-group distinction was either relevant or irrelevant to the attitude issue. Participants' attitudes toward the issue were then measured. The results supported the predictions: Participants were more persuaded by in-group sources than out-group sources when the basis for defining the group was relevant to the attitude issue. However, when the defining characteristic of the group was irrelevant to the attitude issue, participants were equally persuaded by in-group and out-group sources. These results support the hypothesis that the fit between group membership and domain is an important moderator of self-categorization effects

A systematic review of nudge interventions to optimize medication prescribing

Background: The benefits of medication optimization are largely uncontroversial but difficult to achieve. Behavior change interventions aiming to optimize prescriber medication-related decisions, which do not forbid any option and that do not significantly change financial incentives, offer a promising way forward. These interventions are often referred to as nudges. Objective: The current systematic literature review characterizes published studies describing nudge interventions to optimize medication prescribing by the behavioral determinants they intend to influence and the techniques they apply. Methods: Four databases were searched (MEDLINE, Embase, PsychINFO, and CINAHL) to identify studies with nudge-type interventions aiming to optimize prescribing decisions. To describe the behavioral determinants that interventionists aimed to influence, data were extracted according to the Theoretical Domains Framework (TDF). To describe intervention techniques applied, data were extracted according to the Behavior Change Techniques (BCT) Taxonomy version 1 and MINDSPACE. Next, the recommended TDF-BCT mappings were used to appraise whether each intervention applied a sufficient array of techniques to influence all identified behavioral determinants. Results: The current review located 15 studies comprised of 20 interventions. Of the 20 interventions, 16 interventions (80%) were effective. The behavior change techniques most often applied involved prompts (n = 13). The MINDSPACE contextual influencer most often applied involved defaults (n = 10). According to the recommended TDF-BCT mappings, only two interventions applied a sufficient array of behavior change techniques to address the behavioral determinants the interventionists aimed to influence. Conclusion: The fact that so many interventions successfully changed prescriber behavior encourages the development of future behavior change interventions to optimize prescribing without mandates or financial incentives. The current review encourages interventionists to understand the behavioral determinants they are trying to affect, before the selection and application of techniques to change prescribing behaviors. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42020168006]