Background Since the start of the COVID‐19 pandemic and consequent lockdowns, the use of telehealth interventions has rapidly increased both in the general population and among transplant recipients. Among pediatric transplant recipients, this most frequently takes the form of interventions on mobile devices, or mHealth, such as remote visits via video chat or phone, phone‐based monitoring, and mobile apps. Telehealth interventions may offer the opportunity to provide care that minimizes many of the barriers of in‐person care. Methods The present review followed the PRISMA guidelines. Sources up until October 2020 were initially identified through searches of PsycInfo ® and PubMed ® . Results We identified ten papers that reported findings from adult interventions and five studies based in pediatrics. Eight of the adult publications stemmed from the same two trials; within the pediatric subset, this was the case for two papers. Studies that have looked at mHealth interventions have found high acceptability rates over the short run, but there is a general lack of data on long‐term use. Conclusions The literature surrounding pediatric trials specifically is sparse with all findings referencing interventions that are in early stages of development, ranging from field tests to small feasibility trials. The lack of research highlights the need for a multi‐center RCT that utilizes robust measures of medication adherence and other outcome variables, with longer‐term follow‐up before telehealth interventions should be fully embraced.

Objective Blacks have the highest incidence and mortality rates for prostate cancer (PCa) in the U.S. Black PCa patients (PCaP) also report high psychological distress. Identifying culturally specific coping strategies that lower distress among Black PCaP could help improve psychological interventions for this group. African‐centered coping (strategies unique to the structure of Black personality and the African‐centered worldview) have been identified. We hypothesized that these coping strategies and resilience would be associated with lower psychological distress (anxiety and depression) in Black PCaP. Methods Black PCaP (N = 95) completed a survey assessing African‐centered coping strategies, resilience, anxiety, and depression. Multiple regression was employed to examine African‐centered coping strategies and resilience as predictors of psychological distress. Results Participants were aged M = 67 ± 9 years and 52% had late‐stage PCa. Twenty percent met criteria for clinically significant anxiety, and 17% for depression. African‐centered coping strategies were not associated with lower anxiety or depression, while resilience was associated with decreased anxiety (r = −0.45, p < 0.001) and depression (r = −0.54, p < 0.001). Mediation analyses did not support an indirect association among African‐centered coping strategies, resilience, and anxiety and depression. Conclusions Contrary to hypotheses, African‐centered coping strategies were not associated with psychological distress. However, as predicted, greater resilience was associated with lower anxiety and depression. These findings support the relevancy of resilience in Blacks' psychological adjustment to PCa. It might be worthwhile to explore African‐centered coping strategies that help Black PCaP cope with distress.

Objective: Individuals diagnosed with low risk, localised prostate cancer (PCa) face a difficult decision between active surveillance (AS) and definitive treatment. We aimed to explore perceived influences on treatment decision-making from the patient and partner's perspectives.Methods: Patients (and partners) who met AS criteria and had chosen their treatment were recruited. Semi-structured individual interviews were conducted via telephone to explore experiences of diagnosis, impact on patient lifestyle, experiences with physicians, treatment preferences/choice, treatment information understanding and needs, and overall decision-making process. Interviews were audio recorded, transcribed verbatim, and analysed using Reflexive Thematic Analysis.Results: Twenty-four male patients (18 chose AS) and 12 female partners participated. Five themes relating to social-ecological influences on treatment choice were identified: (1) partner support and direct influence on patient treatment choice,(2) patient and partner vicarious experiences may influence treatment decisions,(3) the influence of the patient's life circumstances, (4) disclosing to wider social networks: friends, family, and co-workers, and (5) the importance of a good relationship and experience with physicians. Additionally, two themes were identified relating to information patients and partners received about the treatment options during their decision-making process.Conclusions: A range of individual and social influences on treatment decision-making were reported. Physicians providing treatment recommendations should consider and

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Chronic cold stress is associated with accelerated age‐related bone loss in circumpolar human populations, but the mechanisms involved remain unclear. Cold exposure upregulates the sympathetic nervous system, which can cause bone loss via osteoblast beta‐adrenergic receptors. However, sympathetic activation also increases nonshivering thermogenesis (NST) via uncoupling protein‐1 (UCP1) in brown adipose tissue, which should increase body temperature, decrease sympathetic activation, and reduce bone loss. The goal of this study is to understand the role of sympathetic tone and NST in mediating the skeletal effects of cold exposure. We used a mouse model to test three hypotheses: that sympathetic activation is a cause of cold‐induced bone loss; that blocking sympathetic tone during cold exposure reduces bone loss; and that the high fat, high protein diet traditionally consumed by circumpolar humans can decrease cold‐induced bone loss by providing additional calories for NST. To test these hypotheses, we compared skeletal phenotype in three groups of male C57BL/6J mice: 1) cold exposed, 2) cold exposed with sympathetic inhibition, and 3) cold exposed with high fat, high protein (HFHP) or normal (N) diet (all N=8/group). All mice were pair housed at 16°C (moderate cold stress) or 26°C (thermoneutrality) from 3–12 wks of age with food ad libitum. Groups assigned to sympathetic inhibition were treated with the beta‐adrenergic inhibitor propranolol in drinking water ad libitum (0.5 mg/mL). Groups assigned to HFHP diet were fed a calorie composition of 40% protein, 40% fat, and 20% carbohydrate, vs. the N diet of 20% protein, 10% fat, and 70% carbohydrate. We used general linear models to test for effects of temperature, propranolol, diet, and their interactions. Results indicate that 1) cold exposure decreased trabecular bone microarchitecture and cortical bone mass at 16°C vs. 26°C, despite increased core body temperature and higher UCP1 expression. 2) In mice at 16°C, propranolol prevented loss of both trabecular and cortical bone, despite significantly decreased UCP1 expression and unchanged body temperature. At 26°C, propranolol had no effect on bone mass, body temperature, or UCP1. 3) HFHP mice at 26°C but not 16°C gained more body mass and body fat vs. N. HFHP mice had markedly lower trabecular bone volume fraction at both 16°C and 26°C, as well as lower cortical bone area fraction and cortical thickness at 16°C, compared to N mice. These data show that prolonged cold stress decreases trabecular and cortical bone mass in mice even when nonshivering thermogenesis is increased. Blocking sympathetic tone prevents bone loss despite reduced nonshivering thermogenesis. High fat, high protein diet increases nonshivering thermogenesis and body fat, but is deleterious to trabecular bone both during cold exposure and at thermoneutrality. These findings support our hypothesis that sympathetic activation contributes to cold‐induced bone loss in humans, but do not support our hypothesis that high fat, high protein diet might protect against cold‐induced bone loss, and suggest such diets may be detrimental to human bone health.Support or Funding InformationFunding: NSF BCS‐1638553This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

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