Using Wearable Cameras to Investigate Health-Related Daily Life Experiences: A Literature Review of Precautions and Risks in Empirical Studies.

Automated, wearable cameras can benefit health-related research by capturing accurate and objective information about individuals' daily experiences. However, wearable cameras present unique privacy- and confidentiality-related risks due to the possibility of the images capturing identifying or sensitive information from participants and third parties. Although best practice guidelines for ethical research with wearable cameras have been published, limited information exists on the risks of studies using wearable cameras. The aim of this literature review was to survey risks related to using wearable cameras, and precautions taken to reduce those risks, as reported in empirical research. Forty-five publications, comprising 36 independent studies, were reviewed, and findings revealed that participants' primary concerns with using wearable cameras included physical inconvenience and discomfort in certain situations (e.g., public settings). None of the studies reviewed reported any serious adverse events. Although it is possible that reported findings do not include all risks experienced by participants in research with wearable cameras, our findings suggest a low level of risk to participants. However, it is important that investigators adopt recommended precautions, which can promote autonomy and reduce risks, including participant discomfort.

Measuring Ostracism-Induced Changes in Consumption of Palatable Food: Feasibility of a Novel Behavioral Task.

Purpose: Ostracism is a highly aversive interpersonal experience. Previous research suggests that it can increase consumption of highly palatable food in some individuals, but decrease it in others. Thus, we developed the Cyberball-Milkshake Task (CMT), to facilitate research investigating individual differences in ostracism's effects on consumption of highly palatable food. We present data on feasibility for the CMT in a sample of young adult women. Materials and Methods: Participants were 22 women, 18-30 years old, reporting very low or very high levels of emotional eating at screening. Participants performed the CMT, which consisted of 12 trials. Each trial included: playing a round of Cyberball (a computerized game of catch with fictitious "other participants" programmed to either include or exclude the participant); viewing a chocolate image; and then consuming a participant-determined amount of milkshake. Participants subsequently played an additional inclusion and exclusion round of Cyberball, each immediately followed by questionnaires assessing current mood and recent Cyberball experience. Results: Cyberball exclusion (vs. inclusion) was associated with large, significant increases in reported ostracism and threats to self-esteem; exclusion's effects on affect were in the expected direction (e.g., increased negative affect), but generally small and non-significant. Milkshake intake was measurable for 95% of participants, on 96% of trials. Intake decreased quadratically across trials, with a steep negative slope for low trial numbers that decreased to the point of being flat for the highest trial numbers. Discussion: The CMT is a generally feasible approach to investigating ostracism's effects on consumption of highly palatable food. The feasibility (and validity) of the CMT may benefit from modification (e.g., fewer trials and longer rounds of Cyberball). Future research should examine whether performance on a modified version of the CMT predicts real-world behavior in a larger sample.

Women's and men's experiences in group therapy for substance use disorders: A qualitative analysis.

BACKGROUND AND OBJECTIVES: This thematic analysis of qualitative interviews from participants in Stage II randomized controlled trial examined women's and men's experiences in group therapy for substance use disorders (SUDs). METHODS: Interviews were conducted with 77 women and 38 men after completion of either the gender-specific Women's Recovery Group (WRG) or mixed-gender Group Drug Counseling (GDC). Interviews were coded for themes using a deductive approach with a coding scheme modified from the Stage I trial. Satisfaction was measured quantitatively posttreatment. RESULTS: Participants had high satisfaction scores with no significant differences between groups. Women in GDC rated group gender composition as less helpful than those in WRG. In the GDC group, women more frequently discussed the theme of self-perception (e.g., feelings of comfort, safety, shame) compared with men. Men overwhelmingly expressed the benefits of having women in the group, whereas women expressed advantages and disadvantages of mixed-gender groups and preference for single-gender groups. Guilt and shame were discussed by women and men; however, only women discussed stigma and its important role in their addiction and recovery. DISCUSSION AND CONCLUSION: Men more frequently endorsed the helpfulness of mixed-gender groups than did women while women appreciated the enhanced support in single-gender SUD groups. Issues of stigma are especially salient for women. SCIENTIFIC SIGNIFICANCE: Men and women express differences in their experiences of SUD group therapy. Only women endorse stigma as an obstacle to their treatment and recovery. Tailoring treatment to meet women's and men's needs may enhance engagement, retention, and clinical outcomes.

Exploring Technology-Based Enhancements to Inpatient and Residential Treatment for Young Adult Women with Co-Occurring Substance Use.

OBJECTIVES: Young adults have the highest rates of substance use of any age group. Although men historically have higher rates of substance use disorders (SUDs) than women, research shows this gender gap is narrowing. Young adults with comorbid psychiatric disorders are at increased risk for developing a SUD. Co-occurring psychiatric disorders such as depression, anxiety, eating and post-traumatic stress disorders are more prevalent in women than men with SUDs, yet mental health treatment often does not adequately address substance use in patients receiving care for a comorbid psychiatric disorder. Tailored gender-responsive interventions for women with psychiatric disorders and co-occurring SUD have gained empirical support. Digital interventions tailored to young adult women with co-occurring disorders have the potential to overcome barriers to addressing substance use for young adult women in a psychiatric treatment setting. This study utilized a user-centered design process to better understand how technology could be used to address substance use in young adult women receiving inpatient and residential psychiatric care. Methods: Women (N = 15; age 18-25 years), recruited from five psychiatric treatment programs, engaged in a qualitative interview and completed self-report surveys on technology use and acceptability. Qualitative interviews were coded for salient themes. Results: Results showed that few participants were currently using mental health web-based applications (i.e., "apps"), but most participants expressed an interest in using apps as part of their mental health treatment. Participants identified several important topics salient to women their age including substance use and sexual assault, stigma and shame, difficulties abstaining from substance use while maintaining social relationships with peers, and negative emotions as a trigger for use. Conclusions: These data provide preliminary evidence that a digital intervention may be a feasible way to address co-occurring substance use problems in young adult women receiving care in a psychiatric setting.

Substance Use Disorders in Global Mental Health Delivery: Epidemiology, Treatment Gap, and Implementation of Evidence-Based Treatments.

LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Assess the treatment gap for patients with substance use disorders• Evaluate treatments and models of implementation for substance use disorders ABSTRACT: Substance use disorders (SUDs) account for substantial global morbidity, mortality, and financial and social burden, yet the majority of those suffering with SUDs in both low- and middle-income (LMICs) and high-income countries (HICs) never receive SUD treatment. Evidence-based SUD treatments are available, but access to treatment is severely limited. Stigma and legal discrimination against persons with SUDs continue to hinder public understanding of SUDs as treatable health conditions, and to impede global health efforts to improve treatment access and to reduce SUD prevalence and costs. Implementing SUD treatment in LMICs and HICs requires developing workforce capacity for treatment delivery. Capacity building is optimized when clinical expertise is partnered with regional community stakeholders and government in the context of a unified strategy to expand SUD treatment services. Workforce expansion for SUD treatment delivery harnesses community stakeholders to participate actively as family and peer supports, and as trained lay health workers. Longitudinal supervision of the workforce and appropriate incentives for service are required components of a sustainable, community-based model for SUD treatment. Implementation would benefit from research investigating the most effective and culturally adaptable models that can be delivered in diverse settings.

The Women's Recovery Group for Individuals with Co-occurring Substance Use and Eating Disorders: Feasibility and Satisfaction in a Residential Eating Disorders Program.

Despite the high rate of co-occurring eating disorders (EDs) and substance use disorders (SUDs) in women, there is a lack of integrated treatment. This study implemented the Women's Recovery Group (WRG), a gender-specific group therapy for women with SUDs, in an ED residential treatment program to assess the feasibility and satisfaction of the WRG for women with co-occurring SUDs and EDs. Women (N = 24) were enrolled in the study if they were aged 18 years or older and engaged in the WRG as part of their treatment. Patient and therapist satisfaction with the WRG were assessed post-treatment, and craving to use substances was measured at enrollment and post-treatment. Participants reported moderate satisfaction with the WRG, and therapists reported above average satisfaction with the WRG. Craving to use substances in the environment in which one previously used significantly decreased from enrollment to post-treatment. In its current form, the WRG was feasible to implement in ED residential treatment. Participants indicated that they would have liked more information on co-occurring EDs, self-image/self-esteem, shame and guilt, and maintaining sobriety at college. These results support the need for modifications to the WRG to better integrate treatment for women with co-occurring EDs and SUDs.

Feasibility and Acceptability of a Web-Based, Gender-Specific Intervention for Women with Substance Use Disorders.

Background: Women face unique issues related to their substance use. Treatment programs that incorporate gender-specific components can to lead to enhanced outcomes for women with substance use disorders (SUDs). Nevertheless, most women receive treatment in mixed-gender SUD treatment programs that lack women-specific components. Programs cite lack of expertise and staff time as barriers to providing gender-specific care. Leveraging technology can address some of the challenges of providing gender-specific care in a mixed-gender setting by offering an accessible, cost-effective alternative to in-person services. Materials and Methods: We developed a gender-specific, web-based, psychoeducational intervention for women with SUDs as an addition to treatment as usual in a mixed-gender SUD treatment program. Next, we examined the feasibility and acceptability of this single-session intervention in a prepilot study with 30 women with SUDs. Based on these data, we refined the intervention and tested feasibility and acceptability with 60 women with SUDs. Results: Participants indicated a high level of satisfaction with the intervention. Satisfaction did not significantly differ by level of care (inpatient, partial hospitalization, or outpatient) or age, and was not associated with the number of previous treatment episodes. Participants highlighted the importance of addressing co-occurring disorders, trauma, and sexual abuse in SUD treatment for women. Conclusions: Women in this study found this web-based gender-specific intervention relevant regardless of their previous experience in treatment. Delivery of this intervention is feasible and has the potential to be a highly sustainable strategy for increasing exposure to gender-specific SUD components of care.

Distress Tolerance as a Mediator of the Association Between Borderline Personality Symptoms and Obsessive Relational Intrusion: An Exploratory Analysis.

Obsessive relational intrusion (ORI) is the process by which a pursuer makes multiple attempts at establishing an unwanted, intimate relationship with an individual. It encompasses the more widely known behavior, stalking, which is a widespread problem, particularly among college-aged young adults. However, research on the underlying psychological processes involved in ORI and stalking perpetration is still in its infancy. Using relational goal pursuit theory and the emotional cascade model as guides to explore these processes, we investigated whether distress tolerance mediated the association between borderline personality disorder (BPD) symptoms and ORI, among a college student sample. Participants (N = 224; 62.5% female; Mage = 19.6 years) were recruited from an online survey panel and through the psychology research pool at a small, Northeastern university. Consistent with our hypotheses, path modeling showed that distress tolerance was a significant partial mediator between BPD symptoms and frequency of ORI perpetration. These results seem to provide new insight into the established link between BPD symptoms and ORI, and thus may contribute to our understanding of the underlying psychology of people who engage in unwanted pursuit. Future research should look toward replicating the current findings, testing potential gender differences in the model, and exploring other predictors of both the frequency and initiation of ORI behaviors.

Group therapy for women with substance use disorders: In-session affiliation predicts women's substance use treatment outcomes.

In-session affiliation among members is a hypothesized mechanism of action of group therapy for women with substance use disorders (SUDs). We evaluated group affiliation as an independent predictor of SUD treatment outcome in women (n = 100), 18 years or older diagnosed with substance dependence, who were randomized to the single-gender Women's Recovery Group (WRG) or mixed-gender group therapy (Group Drug Counseling; GDC). Affiliative statements made by members in both groups were measured for 39 women in each treatment arm. We studied the relationship between frequency of affiliative statements categorized in quintiles and the trajectory of days of any drug use during 3 months treatment and 6 months post-treatment using a Poisson regression model with estimation via generalized estimating equations. Furthermore, we investigated whether the effect of affiliation on substance use was moderated by group therapy type. The relationship between amount of affiliation and substance use reduction was non-linear. At the end of the treatment phase (3 months), women who experienced the highest level of affiliation (>65 affiliative statements on average) were found to reduce substance use by about 1.75 days more (p-value = 0.02) than women who experienced the lowest level of affiliation (<26). The effects of affiliation persisted 6 months post-treatment and were moderated by therapy group, whereby women enrolled in the single-gender WRG appeared to benefit more from affiliation post-treatment. Training therapists to facilitate verbal affiliation may provide added therapeutic benefit to group therapy for women with SUDs.

Pharmacological evaluation of NSAID-induced gastropathy as a "Translatable" model of referred visceral hypersensitivity.

AIM: To evaluate whether non-steroidal anti-inflammatory drugs (NSAIDs)-induced gastropathy is a clinically predictive model of referred visceral hypersensitivity. METHODS: Gastric ulcer pain was induced by the oral administration of indomethacin to male, CD1 mice (n = 10/group) and then assessed by measuring referred abdominal hypersensitivity to tactile application. A diverse range of pharmacological mechanisms contributing to the pain were subsequently investigated. These mechanisms included: transient receptor potential (TRP), sodium and acid-sensing ion channels (ASICs) as well as opioid receptors and guanylate cyclase C (GC-C). RESULTS: Results showed that two opioids and a GC-C agonist, morphine, asimadoline and linaclotide, respectively, the TRP antagonists, AMG9810 and HC-030031 and the sodium channel blocker, carbamazepine, elicited a dose- and/or time-dependent attenuation of referred visceral hypersensitivity, while the ASIC blocker, amiloride, was ineffective at all doses tested. CONCLUSION: Together, these findings implicate opioid receptors, GC-C, and sodium and TRP channel activation as possible mechanisms associated with visceral hypersensitivity. More importantly, these findings also validate NSAID-induced gastropathy as a sensitive and clinically predictive mouse model suitable for assessing novel molecules with potential pain-attenuating properties.

Internalizing and Externalizing Symptoms and Marital Relationship Functioning: The Mediating Role of Demand-Withdraw Communication Processes.

Marital outcomes are associated with internalizing and externalizing symptoms; however, the processes by which these domains are associated with marital outcomes are not well understood. This study examined how demand-withdraw (DW) couple communication accounts for the association between symptoms of mental illness and marital distress. A mediational model was tested in a sample of 100 newlywed couples to determine: (a) whether internalizing and externalizing symptoms influenced own and partner's level of DW communication, and (b) whether this communication pattern was associated with relationship outcomes, including lower marital satisfaction and presence of conflict. Results suggested that DW communication had significant effects on both partner's marital outcomes and mediated the association between externalizing symptoms (for husbands) and marital distress.

Using the epigenetic code to promote the unpackaging and transcriptional activation of DNA polyplexes for gene delivery.

Nonviral gene delivery has seen limited clinical application due in part to the inefficiency with which most nonviral vehicles navigate the intracellular gene delivery pathway. One key problem is the inability of most DNA-packaging materials to release DNA and enable its efficient transcription. Thus, our aim was to develop gene delivery polyplexes capable of initiating their own transcription upon arrival in the nucleus. We created nuclease-resistant polyplexes with plasmid DNA (pDNA) and post-translationally modified histone 3 (H3K4Me3) tail peptides known to signal transcriptional activation on chromosomal DNA. When the H3K4Me3-pDNA polyplexes were directly microinjected into the nuclei of NIH/3T3 mouse fibroblasts, protein expression occurred earlier and in a greater fraction of cells than when polyethylenimine-pDNA polyplexes were microinjected. The rate of protein expression initiated by the H3K4Me3-pDNA polyplexes was also significantly accelerated in comparison with the rate initiated by non-trimethylated H3-pDNA polyplexes. These differences in protein expression rates were quantified by the development of a noncompartmentalized cellular kinetics model. These results highlight the importance of polyplex unpackaging as a gene delivery barrier, and demonstrate for the first time that the epigenetic code can be utilized in nonviral gene delivery.

Polyplexes traffic through caveolae to the Golgi and endoplasmic reticulum en route to the nucleus.

The cellular machinery involved in the internalization of nonviral gene carriers and their subsequent trafficking to the nucleus directly impacts their therapeutic efficiency. Hence, identifying key endocytic pathways and organelles that contribute to the successful transfer of polyplexes to the nucleus generates new opportunities for improving carrier design. Previously, we showed that histone H3 tail peptides encoding a sequence known to participate in chromatin activation exhibit synergistic gene delivery activity with poly(ethylenimine) (PEI). Polyplexes containing H3 and PEI exhibited a reduced dependence on endocytic pathways that trafficked to lysosomes, and had enhanced sensitivity to an inhibitor associated with retrograde trafficking through the Golgi apparatus. Thus, we sought to determine whether caveolar uptake and transport through the Golgi and/or endoplasmic reticulum (ER) preceded nuclear delivery. By the use of a panel of chemical endocytic inhibitors, we determined that H3 polyplexes utilized caveolar pathways to a greater degree than PEI polyplexes. Caveolae-mediated endocytosis was found to be a productive route for gene expression by the H3/PEI-pDNA polyplexes, consistent with previous studies of polymer-mediated gene delivery. Additionally, the polyplexes substantially colocalized within the ER after only 5 min of incubation, and utilized retrograde Golgi-to-ER pathways at levels similar to pathogens known to traffic by these routes during infection. The results of this study have expanded our understanding of how caveolar polyplexes are trafficked to cell nuclei, and provide new evidence for the role of Golgi-ER pathways in transfection. These findings suggest new design criteria and opportunities to stragetically target nonviral gene delivery vehicles.

Histone H3 tail peptides and poly(ethylenimine) have synergistic effects for gene delivery.

This goal of this work was to explore histone H3 tail peptides containing transcriptionally activating modifications for their potential as gene delivery materials. We have found that these H3 tail peptides, in combination with the cationic polymer poly(ethylenimine) (PEI), can effectively bind and protect plasmid DNA. The H3/PEI hybrid polyplexes were found to transfect a substantially larger number of CHO-K1 cells in vitro compared to both polyplexes that were formed with only the H3 peptides and those that were formed with only PEI at the same total charge ratio; however, transfection was similarly high for polyplexes both with and without transcriptionally activating modifications. Transfections with the endolysosomal inhibitors chloroquine and bafilomycin A1 indicated that the H3/PEI hybrid polyplexes exhibited slower uptake and a reduced dependence on endocytic pathways that trafficked to the lysosome, indicating a potentially enhanced reliance on caveolar uptake for efficient gene transfer. In addition, whereas PEI polyplexes typically exhibit a cytotoxic effect, the H3/PEI hybrid polyplexes did not compromise cell viability. In total, the current studies provide new evidence for the potential role for histone-based materials as effective gene transfer agents, and support for the importance of subcellular trafficking for nonviral gene delivery.

Effect of pharmaceuticals on thermoreversible gelation of PEO-PPO-PEO copolymers.

Pluronic F127, a triblock copolymer of poly(ethylene oxide) (PEO) and poly(propylene oxide) (PPO), has generated considerable interest as a drug delivery vehicle due to its ability to gel at physiological temperatures. This work examines the gelation behavior of Pluronic F127 in the presence of a series of hydrophobic pharmaceuticals, to determine whether there is any correlation between gelation and physicochemical parameters of drug solutes. The study includes the local anesthetics dibucaine, lidocaine, and tetracaine; the pharmaceutical additives methyl paraben, ethyl paraben, and propyl paraben; the anti-cancer agents paclitaxel and baccatin III; and the anti-inflammatory agent sulindac. The results indicate that the presence of local anesthetics and pharmaceutical additives allows F127 solutions to form gels at lower copolymer concentrations; local anesthetics and pharmaceutical additives also shift gelation down to a lower gelation temperature. This behavior is strongly dependent on drug solubility; poorly soluble drugs (paclitaxel, baccatin III, sulindac) do not change the lower gelation temperature or minimum F127 concentration for gelation. An equation relating the decrease in gelation temperature to drug solubility is presented, and the equation fits the data well. The results have significant positive implications on the toxicity and economic issues related to use of Pluronic F127 in drug delivery.

The effect of pharmaceuticals on the nanoscale structure of PEO-PPO-PEO micelles.

We present results on the effects of various hydrophobic drugs and additives on the micellar structure of Pluronic F127 solutions. Small-angle neutron scattering experiments on 5wt% F127 solutions were used to measure micelle core size (R(1)), micelle corona size (R(2)), intermicellar interaction distance (R(int)), polydispersity (sigma), and aggregation number (N(agg)); dynamic light scattering was used to measure critical micelle concentration (CMC); and ultraviolet spectroscopy was used to measure drug solubility and apparent micelle-water partition coefficient (K(mw)). The core and corona size were found to generally increase in the presence of the drugs, as did R(int). Both sigma and N(agg) were found to decrease in the presence of most of the drugs, and the CMC was found to vary considerably with no clear correlation. A design of experiments (DOE) approach was used to analyze the results and build empirical correlations. All of the parameters from the SANS experiments were found to depend strongly on drug solubility, with a weak dependence on K(mw) in most cases. The aggregation number, however, was found to depend strongly on both K(mw) and solubility. The correlations can be used to roughly predict the structural parameters of F127 micelles for other hydrophobic drugs.

Influence of nociception and stress-induced antinociception on genetic variation in isoflurane anesthetic potency among mouse strains.

BACKGROUND: Genetic background influences anesthetic potency to suppress motor response to noxious stimulation (minimum alveolar concentration [MAC]) as well as nociceptive sensitivity in unmedicated animals. However, the influence on MAC of baseline sensitivity to the noxious stimuli used to assess MAC has virtually never been studied. The authors assessed room air nociceptive sensitivity and isoflurane MAC in multiple mouse strains. Isoflurane requirement for loss of righting response (MACLORR) was also measured. METHODS: One outbred and 10 inbred mouse strains were tested for latency to respond (in room air) to a tail clip (either 500 g or 2,000 g). Naive mice of the same 11 strains were tested for isoflurane MAC and MACLORR. To assess the role of opioid-mediated stress-induced antinociception, mice were also tested for nociceptive sensitivity after injection of naloxone (10 mg/kg) or saline. RESULTS: Robust strain differences were observed for all measures. The authors found that tail-clip latency (using a 500-g or 2,000-g clip, respectively) correlated significantly with MAC (r = -0.76 and -0.58, respectively) but not MACLORR (r = -0.10 and -0.26). Naloxone produced strain-dependent reductions in open air tail-clip latencies, and these reductions were also strongly correlated with MAC (r = -0.67 and -0.71). CONCLUSIONS: The authors suggest that genetic variability in isoflurane MAC (but not MACLORR) may reflect genetic variability in the underlying sensitivity to the noxious stimulus being used to measure MAC. This variable sensitivity to nociception in the awake state is at least partially mediated by endogenous antinociceptive mechanisms activated by the tail-clip stimulus itself.