A Pilot Home-Telehealth Program to Enhance Functional Ability, Physical Performance, and Physical Activity in Older Adult Veterans Post-Hospital Discharge.

Purpose: To test a pilot home-telehealth program to enhance functional ability, physical performance, and objective physical activity in Veterans after hospital discharge.

Method: A physical activity trainer and multidisciplinary team supported the progression of rehabilitation goals via a 6-month home exercise program. Pilot program feasibility, including recruitment, retention, reasons for early withdrawal, differences between those who did and did not complete the program, and completion of outcome measures are reported.

Applications of a Rayleigh-Taylor model to direct-drive laser fusion.

This paper presents a simple physics-based model for the interpretation of key metrics in laser direct drive. The only input parameters required are target scale, in-flight aspect ratio, and beam-to-target radius, and the importance of each has been quantified with a tailored set of cryogenic implosion experiments. These analyses lead to compact and accurate predictions of the fusion yield and areal density as a function of hydrodynamic stability, and they suggest new ways to take advantage of direct drive.

Role of the upper limb in limiting head impact during laboratory-induced falls in at fall-risk older adults.

Background: Fall-related head impact is the leading cause of traumatic brain injury in older adults. There is limited understanding of factors related to fall-related head impact. This investigation examined characteristics of upper limb movements during standing-height falls and examined their association with fall-related head impact in older adults at risk for falls.

Wrist-worn voice recorders capture the circumstances and context of losses of balance among community-dwelling older adults.

Background: Most falls among community-dwelling older adults are due to a loss of balance (LOB) after tripping or slipping. Unfortunately, limited insight is available on the detailed circumstances and context of these LOBs. Moreover, commonly used methods to collect this information is susceptible to limitations of memory recall.

Medicare's Hospital Readmission Reduction Program reduced fall-related health care use: An unexpected benefit?

Objective: To assess whether Medicare's Hospital Readmissions Reduction Program (HRRP) was associated with a reduction in severe fall-related injuries (FRIs).

Data Sources And Study Setting: Secondary data from Medicare were used.

Study Design: Using an event study design, among older (≥65) Medicare fee-for-service beneficiaries, we assessed changes in 30- and 90-day FRI readmissions before and after HRRP's announcement (April 2010) and implementation (October 2012) for conditions targeted by the HRRP (acute myocardial infarction [AMI], congestive heart failure [CHF], and pneumonia) versus "non-targeted" (gastrointestinal) conditions.

Mobile and Web-Based Partnered Intervention to Improve Remote Access to Pain and Posttraumatic Stress Disorder Symptom Management: Recruitment and Attrition in a Randomized Controlled Trial.

Background: Increasing access to nonpharmacological interventions to manage pain and posttraumatic stress disorder (PTSD) is essential for veterans. Complementary and integrative health (CIH) interventions can help individuals manage symptom burden with enhanced accessibility via remotely delivered health care. Mission Reconnect (MR) is a partnered, self-directed intervention that remotely teaches CIH skills.

Self-administered acupressure for veterans with chronic back pain: Study design and methodology of a type 1 hybrid effectiveness implementation randomized controlled trial.

Background: Chronic low back pain is prevalent and disabling in Veterans, but effective pain management is challenging. Clinical practice guidelines emphasize multimodal pain management including evidence-based complementary and integrative health treatments such as acupressure as a first line of care. Unfortunately, the ability to replicate interventions, cost, resources, and limited access are implementation barriers.

Minimizing fall-related injuries in at-risk older adults: The falling safely training (FAST) study protocol.

Background: Falls are the leading cause of accidental injury among the elderly. Fall prevention is currently the main strategy to minimize fall-related injuries in at-risk older adults. However, the success of fall prevention programs in preventing accidental injury in elderly populations is inconsistent.

Cost Analysis and Reimbursement of Weightbearing Computed Tomography.

Background: Weightbearing computed tomography (WBCT) is becoming a valuable tool in the evaluation of foot and ankle pathology. Currently, cost analyses of WBCT scanners in private practice are lacking in the literature. This study evaluated the costs of acquisition, utilization, and reimbursements for a WBCT at a tertiary referral center, information of particular interest to practices considering obtaining such equipment.

"Where do I even start?" Recommendations for faculty diversifying syllabi in ecology, evolution, and the life sciences.

Diversifying curricula is of increasing interest in higher education, including in ecology and evolution and allied fields. Yet, many educators may not know where to start. Here we provide a framework for meeting standard curriculum goals while enacting anti-racist and anti-colonial syllabi that is grounded in the development of a sustainable network of educators.

A proposed methodology for trip recovery training without a specialized treadmill.

Falls are the leading cause of accidental injuries among adults aged 65 years and older. Perturbation-based balance training is a novel exercise-based fall prevention intervention that has shown promise in reducing falls. Trip recovery training is a form of perturbation-based balance training that targets trip-induced falls.

Does computerized cognitive training improve diabetes self-management and cognition? A randomized control trial of middle-aged and older veterans with type 2 diabetes.

Aims: This randomized control trial compared an adaptive computerized cognitive training intervention with a non-adaptive version. The primary hypothesis predicted better diabetes self-management in type 2 diabetes patients at 6 months post-intervention than baseline in the adaptive arm, with seven secondary outcomes.

Methods: Intent-to-treat analysis of veterans without dementia aged 55+ from the Bronx, NY and Ann Arbor, MI (N = 90/per arm) used linear mixed model analyses.

Health of the Food Environment Is Associated With Heart Failure Mortality in the United States.

Background: Food environment factors contribute to cardiovascular disease, but their effect on population-level heart failure (HF) mortality is unclear.

Methods: We utilized the National Vital Statistics System and USDA Food Environment Atlas to collect HF mortality rates (MR) and 2 county food environment indices: (1) food insecurity percentage (FI%) and (2) food environment index (FEI), a scaled index (0-10, 10 best) incorporating FI% and access to healthy food. We used linear regression to estimate the association between food environment and HF MR Results: Mean county FI% and FEI were 13% and 7.

World guidelines for falls prevention and management for older adults: a global initiative.

Background: falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present.

Objectives: to create a set of evidence- and expert consensus-based falls prevention and management recommendations applicable to older adults for use by healthcare and other professionals that consider: (i) a person-centred approach that includes the perspectives of older adults with lived experience, caregivers and other stakeholders; (ii) gaps in previous guidelines; (iii) recent developments in e-health and (iv) implementation across locations with limited access to resources such as low- and middle-income countries.

Effect of the STRIDE fall injury prevention intervention on falls, fall injuries, and health-related quality of life.

Background: Falls are common in older adults and can lead to severe injuries. The Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) trial cluster-randomized 86 primary care practices across 10 health systems to a multifactorial intervention to prevent fall injuries, delivered by registered nurses trained as falls care managers, or enhanced usual care. STRIDE enrolled 5451 community-dwelling older adults age ≥70 at increased fall injury risk.

Physical Activity Patterns in Frail and Nonfrail Patients With End-Stage Liver Disease.

Background: Frailty commonly complicates cirrhosis and is associated with poorer outcomes. While patients with cirrhosis may be sedentary, there are few comprehensive descriptions of their physical activity (PA) patterns related to frailty. Our aim was to identify PA characteristics that may be used in interventions to improve PA and reduce frailty.

Psychometric evaluation of the Hopkins Rehabilitation Engagement Rating Scale in postacute physical therapy services.

Purpose/objective: Evaluate the reliability and validity of the Hopkins Rehabilitation Engagement Scale (HRERS) in a postacute rehabilitation sample. We hypothesized that HRERS items would comprise a single factor, and would demonstrate adequate internal consistency and temporal stability, and significant relationships with key constructs. Research Method and Design: Retrospective medical record review between 2016 and 2017 of older veterans ( = 107) admitted to a community living center postacute care (CLC-PAC) rehabilitation hospital unit to address targeted physical therapy rehabilitation goals.

Automated Loss-of-Balance Event Identification in Older Adults at Risk of Falls during Real-World Walking Using Wearable Inertial Measurement Units.

Loss-of-balance (LOB) events, such as trips and slips, are frequent among community-dwelling older adults and are an indicator of increased fall risk. In a preliminary study, eight community-dwelling older adults with a history of falls were asked to perform everyday tasks in the real world while donning a set of three inertial measurement sensors (IMUs) and report LOB events via a voice-recording device. Over 290 h of real-world kinematic data were collected and used to build and evaluate classification models to detect the occurrence of LOB events.

New horizons in falls prevention and management for older adults: a global initiative.

Background: falls and fall-related injuries are common in older adults, have negative effects both on quality of life and functional independence and are associated with increased morbidity, mortality and health care costs. Current clinical approaches and advice from falls guidelines vary substantially between countries and settings, warranting a standardised approach. At the first World Congress on Falls and Postural Instability in Kuala Lumpur, Malaysia, in December 2019, a worldwide task force of experts in falls in older adults, committed to achieving a global consensus on updating clinical practice guidelines for falls prevention and management by incorporating current and emerging evidence in falls research.

Potential Implementation of Reactive Balance Training within Continuing Care Retirement Communities.

Purpose: The purpose of the study was to evaluate the feasibility of implementing reactive balance training (RBT) in continuing care retirement communities, as a part of typical practice in these facilities.

Methods: RBT, a task-specific exercise program, consisted of repeatedly exposing participants to trip-like perturbations on a modified treadmill to improve reactive balance, and subsequently reduce fall risk. Semi-structured interviews were conducted with retirement community residents (RBT participants) and administrators, to assess the organizational context, perceptions of evidence for falls prevention, and facilitation strategies that could improve the likelihood of implementing RBT as a falls-prevention program.

Rapid Transition to Telehealth Group Exercise and Functional Assessments in Response to COVID-19.

Exercise is critical for health maintenance in late life. The COVID-19 shelter in place and social distancing orders resulted in wide-scale interruptions of exercise therapies, placing older adults at risk for the consequences of decreased mobilization. The purpose of this paper is to describe rapid transition of the Gerofit facility-based group exercise program to telehealth delivery.