Background:Pain management is a frequent problem in the neonatal intensive care unit (NICU). Few studies examining effects of integrative care therapies on pain-related outcomes in neonates have included physiological outcomes or investigated the use of such therapies in a practice-based setting.Objective:The purpose of this practice-based retrospective study was to examine the associations between integrative care therapies, particularly massage and healing touch, and pain-related outcomes among hospitalized infants.Methods:We conducted a retrospective review of a clinical database from a level III NICU regularly delivering integrative care therapies. Paired-samples t-tests were used to examine associations between integrative care therapies and 4 pre-post outcome measures: therapist-rated pain and presentation (ranging from asleep to agitated) and neonates' heart rate and oxygen saturation.Results:Of 186 patients (Mage=68 days), 58% were male and 67% were Caucasian. Sixty-two percent received both massage and healing touch; the remainder received a single therapy. From pre-post therapy, statistically significant changes were observed in infants' heart rate (Mpre=156 vs Mpost=140 per minute; P<.001), oxygen saturation (Mpre=95.0% vs.Mpost=97.4%; P<.001), and therapist-reported pain (Mpre=2.8 vs Mpost=0.2; P<.001) and presentation (Mpre=3.2 vs. Mpost=1.0; P<.001).Conclusion:Observed improvements in pain-related outcomes suggest that massage and healing touch may be useful integrative therapies to consider as pain management options in the NICU.

Anxiety and depressive disorders are common in the pediatric primary care setting, and respond to both psychotherapeutic and psychopharmacologic treatment. However, there are limited data regarding the optimal treatment duration. This article systematically reviews guidelines and clinical trial data related to antidepressant treatment duration in pediatric patients with depressive and anxiety disorders. The extant literature suggests 9-12 months of antidepressant treatment for youth with major depressive disorder. For generalized, separation and social anxiety disorders, 6-9 months of antidepressant treatment may be sufficient, though many clinicians extend treatment to 12 months based on extrapolation of data from adults with anxiety disorders. Such extended treatment periods may decrease the risk of long-term morbidity and recurrence; however, the goal of treatment is ultimately remission, rather than duration of antidepressant pharmacotherapy. Moreover, while evidence-based guidelines represent a starting point, appropriate treatment duration varies and patient-specific response, psychological factors, and timing of discontinuation must be considered for individual pediatric patients.

Introduction Alzheimer's disease (AD) is a public health priority. AD biomarkers may vary based on race, but the recruitment of diverse participants has been challenging. Methods Three groups of Black and White participants with and without prior research advocacy or participation were interviewed individually or in focus groups to better understand perspectives related to AD biomarker research participation. A rapid qualitative data analytic approach was used to analyze the data. Results Identified barriers to AD biomarker research participation included hesitancy due to fear, distrust of research and researchers, lack of relevant knowledge, and lack of research test results disclosure. Drivers for engagement in biomarker research procedures included knowledge about research, AD, and related clinical procedures, perceived benefits of participation, and outreach from trusted sources. Discussion Participants’ comments related to the need for diversity in research and desire for results disclosure suggest opportunities to engage Black individuals. Highlights Black Americans experience more salient barriers to Alzheimer's disease (AD) biomarker research participation. Concerns about research diversity influence research participation decisions. Research test disclosure may affect research participation and retention.

Objectives To characterize pretransfer on‐site nursing home (NH) management, transfer disposition, and hospital discharge diagnoses of long‐stay residents transferred for behavioral concerns. Design This was a secondary data analysis of the Optimizing Patient Transfers, Impacting Medical Quality, Improving Symptoms: Transforming Institutional Care project, in which clinical staff employed in the NH setting conducted medical, transitional, and palliative care quality improvement initiatives and gathered data related to resident transfers to the emergency department/hospital setting. R software and Microsoft Excel were used to characterize a subset of transfers prompted by behavioral concerns. Setting NHs in central Indiana were utilized (N = 19). Participants This study included long‐stay NH residents with behavioral concerns prompting transfer for acute emergency department/hospital evaluation (N = 355 transfers). Measurements The measures used in this study were symptoms prompting transfer, resident demographics and baseline characteristics (Minimum Data Set 3.0 variables including scores for the Cognitive Function Scale, ADL Functional Status, behavioral symptoms directed toward others, and preexisting psychiatric diagnoses), on‐site management (e.g., medical evaluation in person or by phone, testing, and interventions), avoidability rating, transfer disposition (inpatient vs emergency department only), and hospital discharge diagnoses. Results Over half of the transfers, 56%, had a medical evaluation before transfer, and diagnostic testing was conducted before 31% of transfers. After transfer, 80% were admitted. The most common hospital discharge diagnoses were dementia‐related behaviors (27%) and altered mental status (27%), followed by a number of medical diagnoses. Conclusion Most transfers for behavioral concerns merited hospital admission, and medical discharge diagnoses were common. There remain significant opportunities to improve pretransfer management of NH transfers for behavioral concerns.

INTRODUCTIONAlzheimer’s disease (AD) is a public health priority. AD biomarkers may vary based on race, but recruitment of diverse participants has been challenging.METHODSThree groups of Black and White participants with and without prior research advocacy or participation were interviewed individually or in focus groups to better understand perspectives related to AD biomarker research participation. Thematic analytic approach was used to analyze the data.RESULTSIdentified barriers to AD biomarker research participation included hesitancy due to fear, distrust of research and researchers, lack of relevant knowledge, and lack of research test results disclosure. Drivers for engagement in biomarker research procedures included knowledge about research, AD, and related clinical procedures, perceived benefits of participation, and outreach from trusted sources.DISCUSSIONParticipants’ comments related to the need for diversity in research and desire for results disclosure suggest opportunities to engage Black individuals.