Background: The ongoing "Sarcopenia and Physical fRailty IN older people: multi-componenT Treatment strategies (SPRINTT)" randomized controlled trial (RCT) is testing the efficacy of a multicomponent intervention in the prevention of mobility disability in older adults with physical frailty & sarcopenia (PF&S). Here, we describe the procedures followed for PF&S case finding and screening of candidate participants for the SPRINTT RCT. We also illustrate the main demographic and clinical characteristics of eligible screenees.
Methods: The identification of PF&S was based on the co-occurrence of three defining elements: (1) reduced physical performance (defined as a score on the Short Physical Performance Battery between 3 and 9); (2) low muscle mass according to the criteria released by the Foundation for the National Institutes of Health; and (3) absence of mobility disability (defined as ability to complete the 400-m walk test in 15 min). SPRINTT was advertised through a variety of means. Site-specific case finding strategies were developed to accommodate the variability across centers in catchment area characteristics and access to the target population. A quick "participant profiling" questionnaire was devised to facilitate PF&S case finding.
Results: During approximately 22 months, 12,358 prescreening interviews were completed in 17 SPRINTT sites resulting in 6710 clinic screening visits. Eventually, 1566 candidates were found to be eligible for participating in the SPRINTT RCT. Eligible screenees showed substantial physical function impairment and comorbidity burden. In most centers, project advertisement through mass media was the most rewarding case finding strategy.
Conclusion: PF&S case finding in the community is a challenging, but feasible task. Although largely autonomous in daily life activities, older adults with PF&S suffer from significant functional impairment and comorbidity. This subset of the older population is therefore at high risk for disability and other negative health-related events. Key strategies to consider for successfully intercepting at-risk older adults should focus on mass communication methods.
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http://dx.doi.org/10.1016/j.exger.2018.09.017 | DOI Listing |
Am J Manag Care
January 2025
Institute of Health Policy and Management and Master of Public Health Program, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 100, Taiwan. Email:
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January 2025
Executive Dean, Bond Business School, Bond University, Gold Coast, QLD, Australia; Harkness Senior Fellow, Commonwealth Fund of New York.
This article makes the case for taking a model-based management approach, specifically using the Viable System Model (VSM), to embed learning and adaptation into the New Zealand health system so it can function as a learning health system. We draw on a case study of a specialist clinical service where the VSM was used to guide semi-structured interviews and workshops with clinicians and managers and to guide analysis of the findings. The VSM analysis revealed a lack of clarity of organisational functioning, and of the systems, processes and integrated IT infrastructure necessary to support the fundamental requirements of a learning health system.
View Article and Find Full Text PDFAm J Respir Crit Care Med
January 2025
Assistance Publique - Hopitaux de Paris, Department of Respiratory and Intensive Care Medicine, Paris, Île-de-France, France.
Astrobiology
January 2025
Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA.
We review the current state of understanding of Ceres as it relates to planetary protection policy for future landed missions, including for sample return, to the dwarf planet. The Dawn mission found Ceres to be an intriguing target for a mission, with evidence for the presence of regional, possibly extensive liquid at depth, and local expressions of recent and potentially ongoing activity. The Dawn mission also found a high abundance of carbon in the regolith, interpreted as a mix of carbonates and amorphous carbon, as well as locally high concentrations of organic matter.
View Article and Find Full Text PDFPLOS Digit Health
January 2025
FIND, Geneva, Switzerland.
AI based software, including computer aided detection software for chest radiographs (CXR-CAD), was developed during the pandemic to improve COVID-19 case finding and triage. In high burden TB countries, the use of highly portable CXR and computer aided detection software has been adopted more broadly to improve the screening and triage of individuals for TB, but there is little evidence in these settings regarding COVID-19 CAD performance. We performed a multicenter, retrospective cross-over study evaluating CXRs from individuals at risk for COVID-19.
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