Putting prospection into practice: Methodological considerations in the use of episodic future thinking to reduce delay discounting and maladaptive health behaviors.

In recent years, episodic future thinking (EFT) has emerged as a promising behavioral intervention to reduce delay discounting or maladaptive health behaviors; however, considerable methodological heterogeneity in methods for eliciting engagement in EFT has been observed in prior research. In this narrative review, we briefly describe methods for generating EFT cues, the content of EFT cues, common control conditions for experiments utilizing EFT, and considerations for cue delivery and implementation. Where possible, we make suggestions for current best practices in each category while identifying gaps in knowledge and potential areas of future research. Finally, we conclude by using the NIH Stage model to better frame the current state of the literature on EFT and propose gaps to be addressed if EFT is to be both an efficacious and effective behavioral intervention.

Diagnosis and Management of Osteoporosis.

Osteoporosis-related fractures affect approximately one in two white women and one in five white men in their lifetime. The impact of fractures includes loss of function, significant costs, and increased mortality. The U.S. Preventive Services Task Force recommends using dual energy x-ray absorptiometry to screen all women 65 years and older, and younger women who have an increased fracture risk as determined by the World Health Organization's FRAX Fracture Risk Assessment Tool. Although guidelines are lacking for rescreening women who have normal bone mineral density on initial screening, intervals of at least four years appear safe. The U.S. Preventive Services Task Force found insufficient evidence to recommend screening for osteoporosis in men; other organizations recommend screening all men 70 years and older. In patients with newly diagnosed osteoporosis, suggested laboratory tests to identify secondary causes include serum 25-hydroxyvitamin D, calcium, creatinine, and thyroid-stimulating hormone. First-line treatment to prevent fractures consists of fall prevention, smoking cessation, moderation of alcohol intake, and bisphosphonate therapy. Clinicians should consider discontinuing bisphosphonate therapy after five years in women without a personal history of vertebral fractures. Raloxifene, teriparatide, and denosumab are alternative effective treatments for certain subsets of patients and for those who are unable to take or whose condition does not respond to bisphosphonates. The need for follow-up bone mineral density testing in patients receiving treatment for osteoporosis is uncertain.

Dynamic contact angle analysis of silicone hydrogel contact lenses.

Contact angle measurements are used to infer the clinical wetting characteristics of contact lenses. Such characterization has become more commonplace since the introduction of silicone hydrogel contact lens materials, which have been associated with reduced in vivo wetting due to the inclusion of siloxane-containing components. Using consistent methodology and a single investigator, advancing and receding contact angles were measured for 11 commercially available silicone hydrogel contact lens types with a dynamic captive bubble technique employing customized, fully automated image analysis. Advancing contact angles were found to range between 20° and 72° with the lenses falling into six statistically discrete groupings. Receding contact angles fell within a narrower range, between 17° and 22°, with the lenses segregated into three groups. The relationship between these laboratory measurements and the clinical performance of the lenses requires further investigation.

Diagnosis and treatment of osteoporosis.

Osteoporosis affects approximately 8 million women and 2 million men in the United States. The associated fractures are a common and preventable cause of morbidity and mortality in up to 50 percent of older women. The U.S. Preventive Services Task Force recommends using dual energy x-ray absorptiometry to screen all women 65 years and older and women 60 to 64 years of age who have increased fracture risk. Some organizations recommend considering screening in all men 70 years and older. For persons with osteoporosis diagnosed by dual energy x-ray absorptiometry or previous fragility fracture, effective first-line treatment consists of fall prevention, adequate intake of calcium (at least 1,200 mg per day) and vitamin D (at least 700 to 800 IU per day), and treatment with a bisphosphonate. Raloxifene, calcitonin, teriparatide, or hormone therapy maybe considered for certain subsets of patients.