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Objectives: With support from others, individuals with depression can build skills and implement lifestyle changes that help them manage their illness. The objective of the current study was to understand how the CarePartners for Depression Program, a randomized clinical trial aimed at enhancing the role of caregivers in the management of depression, improved communication and shared understandings of depression among individuals with depression and their close others., Methods: We conducted in-depth, semi-structured interviews with individuals with depression and their caregivers who participated in the CarePartners program. Interviews were qualitatively coded using a thematic analytic framework., Results: We conducted individual interviews with 39 participants in the CarePartners program, including 18 individuals with depression, 14 out-of-home care partners, and 7 informal caregivers. Three central themes were derived from analyses: (a) The quality of interpersonal relationships influenced the management of depression; (2) having clearly defined roles for CarePartners improved communication between CarePartners and individuals with depression; and (3) shared understanding of depression improved management of depression., Discussion: Our findings established the conditions under which the management of depression was influenced in a dyadic intervention. Dyadic interventions may make it easier for individuals to support patients with depression by fostering communication and collaboration., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

People living with diabetes and their health care teams face an endless number of care decisions that are often compounded by limited access to needed resources, especially adequate food, medications, and monitoring tools. 1 Registered dietitians, as diabetes care and education specialists and as members of care teams, can help assess what barriers exist and how they can best be mitigated both in the short- and long term. 2 Examples of health equity challenges and tools to support efforts in type 2 diabetes (T2D) prevention and diabetes management are presented.

Background: Identifying caregiver availability, particularly for patients with dementia or those with a disability, is critical to informing the appropriate care planning by the health systems, hospitals, and providers. This information is not readily available, and there is a paucity of pragmatic approaches to automatically identifying caregiver availability and type., Objective: Our main objective was to use medical notes to assess caregiver availability and type for hospitalized patients with dementia. Our second objective was to identify whether the patient lived at home or resided at an institution., Methods: In this retrospective cohort study, we used 2016-2019 telephone-encounter medical notes from a single institution to develop a rule-based natural language processing (NLP) algorithm to identify the patient's caregiver availability and place of residence. Using note-level data, we compared the results of the NLP algorithm with human-conducted chart abstraction for both training (749/976, 77%) and test sets (227/976, 23%) for a total of 223 adults aged 65 years and older diagnosed with dementia. Our outcomes included determining whether the patients (1) reside at home or in an institution, (2) have a formal caregiver, and (3) have an informal caregiver., Results: Test set results indicated that our NLP algorithm had high level of accuracy and reliability for identifying whether patients had an informal caregiver (F 1 =0.94, accuracy=0.95, sensitivity=0.97, and specificity=0.93), but was relatively less able to identify whether the patient lived at an institution (F 1 =0.64, accuracy=0.90, sensitivity=0.51, and specificity=0.98). The most common explanations for NLP misclassifications across all categories were (1) incomplete or misspelled facility names; (2) past, uncertain, or undecided status; (3) uncommon abbreviations; and (4) irregular use of templates., Conclusions: This innovative work was the first to use medical notes to pragmatically determine caregiver availability. Our NLP algorithm identified whether hospitalized patients with dementia have a formal or informal caregiver and, to a lesser extent, whether they lived at home or in an institutional setting. There is merit in using NLP to identify caregivers. This study serves as a proof of concept. Future work can use other approaches and further identify caregivers and the extent of their availability., (©Elham Mahmoudi, Wenbo Wu, Cyrus Najarian, James Aikens, Julie Bynum, V G Vinod Vydiswaran. Originally published in JMIR Aging (https://aging.jmir.org), 22.09.2022.)

The human gut microbiome can be altered with probiotics, prebiotics, synbiotics, and anti-inflammatory foods and spices as part of an evidence-based strategy that targets inflammation and pain in common orthopedic conditions. Implementing these strategies avoids adverse effects associated with nonsteroidal anti-inflammatory drugs and minimizes the potential for opioid use. This review focuses exclusively on human trials studying the effects of gut microbiome alterations to address pain and inflammatory markers in common orthopedic conditions: osteoarthritis, rheumatoid arthritis, fractures/osteoporosis, and bone pain associated with chemotherapy. Individualized supplementation strategies can be further explored with the information in this review. [ Orthopedics . 2022;45(5):e226-e234.].

Physical therapy is a necessary part of the recovery process after most orthopedic procedures. Effective treatment, patient satisfaction, and financial reimbursement hinge on the successful implementation of both surgical and nonsurgical interventions. Evidence-based practice and open communication between therapists and orthopedic surgeons continue to form the foundation of patient care. The aim of this paper is to familiarize orthopedic surgeons with the relevant data behind some of the recent advances in rehabilitation adjuncts to better address the needs of our patients. Although each intervention has been found to be relatively safe, high-quality evidence is still sparse. Opportunities exist for improved outcomes with further well-designed studies to investigate the role of these therapy modalities among orthopedic patients., (© 2022 The Authors.)

Introduction: 'Task-shifting' or 'task-sharing' is an effective strategy for delivering behavioural healthcare in lower resource communities. However, little is known regarding the actual steps (methods) in carrying out a task-shifting project. This paper presents a protocol for a systematic review that will identify steps in adapting an evidence-based psychological treatment for delivery by lay/non-licenced personnel., Methods and Analysis: A systematic review of peer-reviewed, published studies involving a non-licenced, non-specialist (eg, community health worker, promotor/a, peer and lay person) delivering an evidence-based psychological treatment for adults will be conducted. Study design of selected articles must include a statistical comparison (eg, randomised controlled trials, quasiexperimental trials, pre-post designs and pragmatic trials). Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases including PubMed, the Cochrane Library, Cochrane Central Register of Controlled Trials, SCOPUS, Cumulative Index to Nursing and Allied Health Literature, APA PsycInfo and Google Scholar will be searched from 2000 to 2020. Risk of bias will be assessed using the Cochrane Collaboration's Risk of Bias (RoB 2) tool, and publication bias will be evaluated with the Cochrane GRADE approach. A narrative synthesis will be conducted for all included studies, and a summary table following Proctor's framework for operationalising implementation strategies will be included. This protocol was developed following the 2015 guidelines of Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols., Ethics and Dissemination: This review will analyse data from published studies only; thus, it will not require institutional board review. Findings will be presented at conferences, to the broader community via the Community Health Worker Translational Advisory Board and social media, and the final systematic review will be published in a peer-reviewed journal., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This study tested the applicability of the individual and family self-management theory (IFSMT) to self-management (SM) in patients with left ventricular assist devices (LVADs). From an existing data set, we extracted the following variables that correspond to IFSMT's conceptual dimensions: anxiety, depression, and cognition (context dimension); self-efficacy (SM process dimension); adherence and quality of life (QOL; outcome dimensions). Descriptive statistics and partial least squares path modeling procedures were used for data analyses. A total of 100 patients (mean age 52 ± 13.4 years) with continuous flow LVAD designs comprised the present study. Most patients were White (78%), married (69%), college-educated (72%), and on disability (53%). Their mean anxiety and depression scores were slightly above normal, while their cognitive function scores were slightly lower than normal. LVAD care self-efficacy, adherence, and QOL were within normal ranges. Factor loadings ranged from 0.50 to 1.0, and there were significant forward path relationships among the context, process, and outcome dimensions (β ranges from 0.02 to 0.60, all P values < 0.05). In conclusion, the IFSMT provides a good fit for SM in LVAD. Further research is needed to clarify how best to improve LVAD SM practice and treatment outcomes., (© 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Antidepressant drugs represent the mainstay of treatment for depression; however, nonadherence is a major problem. Attitudes are predictors of long-term adherence and drive medication use. The Attitudes Toward Medication-Depression (ATM-D) Inventory was developed and tested with 131 patients in primary care settings who reported a diagnosis of depression. Content validity was assessed by experts with a 94.4% agreement on item relevancy. Exploratory factor analysis showed three factors (course of medication treatment, identity, and control) that accounted for 57% of the total variance in the final 17-item scale. The instrument demonstrated good internal consistency reliability (α = .76-.84) and test-retest reliability (α = .74-.83). Results support the construct validity and reliability of the instrument and revealed unique insights into patients' cognitive representations of their antidepressants. This study supported that patients have cognitive representations related to depression and antidepressants that go beyond simple concerns about the effects of the medication.