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Objective: Both grip strength and gait speed can be used as markers of muscle function, however, no previous study has examined them in the same population with respect to risk of falls., Methods: In this prospective cohort study, utilising data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial and ASPREE-Fracture substudy, we analysed the association of grip strength and gait speed and serious falls in healthy older adults. Grip strength was measured using a handheld dynamometer and gait speed from 3-metre timed walks. Serious falls were confined to those involving hospital presentation. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for associations with falls., Results: Over an average of 4.0±1.3 years, amongst 16,445 participants, 1,533 had at least one serious fall. After adjustment for age, sex, physical activity, body mass index, Short Form 12 (state of health), chronic kidney disease, polypharmacy and aspirin, each standard deviation (SD) lower grip strength was associated with 27% (HR 1.27, 95% CI 1.17-1.38) higher risk of falls. The results remained the same for males and females. There was a dose-response relationship in the association between grip strength and falls risk. The higher risk of falls was observed in males in all body mass index (BMI) categories, but only in obese females. The association between gait speed and falls risk was weaker than the association between grip strength and falls risk., Conclusions: All males and only obese females with low grip strength appear to be at the greatest risk of serious falls. These findings may assist in early identification of falls., Competing Interests: Dr Hussain is the recipient of National Health and Medical Research Council (NHMRC) Early Career Fellowship (APP1142198), Professor McNeil is supported through an NHMRC Leadership Fellowship (IG 1173690). No other disclosures are reported by the other authors., (Copyright: © 2023 Pham et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Measuring patient reported outcomes can improve the quality and effectiveness of healthcare interventions. The aim of this study was to identify the final set of items that can be included in a patient-reported outcome measure to assess recovery of patients following percutaneous coronary interventions., Methods: A consecutive sample of 200 patients registered in the Victorian Cardiac Outcomes Registry participated in a telephone survey 30 days following their percutaneous cardiac procedure. Rasch analysis was used to select the best set of items to form a concise and psychometrically sound patient-reported outcome measure. Key measurement properties assessed included overall fit to the Rasch measurement model, unidimensionality, response formats (thresholds), targeting, internal consistency and measurement invariance., Results: Five items were identified as being reliable and valid measures of patient-reported outcomes: pain or discomfort, shortness of breath, confidence in performing usual activities, feeling unhappy and having trouble sleeping. Data showed overall fit to a Rasch model of expected item functioning (χ2 16.99; p = 0.07) and all items demonstrated unidimensionality (t-test less than 0.05 threshold value). Internal consistency was acceptable (equivalent Cronbach's α 0.65) given there are only five items, but there was a ceiling effect (mean logit score -1.24) with compromised score precision for patients with better recovery., Conclusions: We identified a succinct set of items that can be used in a patient-reported outcome measure following percutaneous coronary interventions. This patient-report outcome measure has good structural validity and acceptable internal consistency. While further psychometric evaluations are recommended, the items identified capture the patient's perspective of their recovery following a percutaneous coronary intervention., Competing Interests: The authors have declared that no competing interests exist.

Evidence for effective falls prevention interventions in acute wards is limited. One reason for this may be suboptimal program implementation. This study aimed to identify perceived barriers and enablers of the implementation of the 6-PACK falls prevention program to inform the implementation in a randomised controlled trial. Strategies to optimise successful implementation of 6-PACK were also sought. A mixed-methods approach was applied in 24 acute wards from 6 Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on barriers and enablers of 6-PACK implementation was obtained through surveys, focus groups and interviews. Questions reflected the COM-B framework that includes three behaviour change constructs of: capability, opportunity and motivation. Focus group and interview data were analysed thematically, and survey data descriptively. The survey response rate was 60% (420/702), and 12 focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Capability barriers included beliefs that falls could not be prevented; and limited knowledge on falls prevention in patients with complex care needs (e.g. cognitive impairment). Capability enablers included education and training, particularly face to face case study based approaches. Lack of resources was identified as an opportunity barrier. Leadership, champions and using data to drive practice change were recognised as opportunity enablers. Motivation barriers included complacency and lack of ownership in falls prevention efforts. Motivation enablers included senior staff articulating clear goals and a commitment to falls prevention; and use of reminders, audits and feedback. The information gained from this study suggests that regular practical face-to-face education and training for nurses; provision of equipment; audit, reminders and feedback; leadership and champions; and the provision of falls data is key to successful falls prevention program implementation in acute hospitals.

There is limited evidence to support the effectiveness of falls prevention interventions in the acute hospital setting. The 6-PACK falls prevention program includes a fall-risk tool; 'falls alert' signs; supervision of patients in the bathroom; ensuring patients' walking aids are within reach; toileting regimes; low-low beds; and bed/chair alarms. This study explored the acceptability of the 6-PACK program from the perspective of nurses and senior staff prior to its implementation in a randomised controlled trial. A mixed-methods approach was applied involving 24 acute wards from six Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including: Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention. Information on program acceptability (suitability, practicality and benefits) was obtained by surveys, focus groups and interviews. Survey data were analysed descriptively, and focus group and interview data thematically. The survey response rate was 60%. Twelve focus groups (n = 96 nurses) and 24 interviews with senior staff were conducted. Falls were identified as a priority patient safety issue and nurses as key players in falls prevention. The 6-PACK program was perceived to offer practical benefits compared to current practice. Nurses agreed fall-risk tools, low-low beds and alert signs were useful for preventing falls (>70%). Views were mixed regarding positioning patients' walking aid within reach. Practical issues raised included access to equipment; and risk of staff injury with low-low bed use. Bathroom supervision was seen to be beneficial, however not always practical. Views on the program appropriateness and benefits were consistent across nurses and senior staff. Staff perceived the 6-PACK program as suitable, practical and beneficial, and were open to adopting the program. Some practical concerns were raised highlighting issues to be addressed by the implementation plan.

Glyphosate-resistant (GR) Kochia scoparia has evolved in dryland chemical fallow systems throughout North America and the mechanism of resistance involves 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) gene duplication. Agricultural fields in four states were surveyed for K. scoparia in 2013 and tested for glyphosate-resistance level and EPSPS gene copy number. Glyphosate resistance was confirmed in K. scoparia populations collected from sugarbeet fields in Colorado, Wyoming, and Nebraska, and Montana. Glyphosate resistance was also confirmed in K. scoparia accessions collected from wheat-fallow fields in Montana. All GR samples had increased EPSPS gene copy number, with median population values up to 11 from sugarbeet fields and up to 13 in Montana wheat-fallow fields. The results indicate that glyphosate susceptibility can be accurately diagnosed using EPSPS gene copy number., Competing Interests: Funding has been provided to the University of Wyoming from the following organizations in support of ARK's research and education program, either through unrestricted gifts, research contracts, or grants: Arysta LifeScience, BASF, Bayer CropScience, Dow AgroSciences, DuPont, FMC, Hatch Act Funds – USDA, Loveland Industries, Monsanto, NovaSource, Repar Corporation, StateLine Bean Cooperative, Syngenta, USDA National Institute for Food and Agriculture, University of Wyoming Department of Plant Sciences, University of Wyoming School of Energy Resources, Valent, Western Sugar Cooperative, Winfield Solutions, Wyoming Agricultural Experiment Station, Wyoming Crop Improvement Association, Wyoming Department of Agriculture, and Wyoming Seed Certification. ARK currently serves on the Board of Directors for the Weed Science Society of America. ARK currently serves on the Farming Systems Trial Advisory Panel for the Rodale Institute. Funding has been provided to the Montana State University-Bozeman from the following organizations in support of PJ’s research and education program, either through unrestricted gifts, research contracts, or grants: Arysta LifeScience, BASF, Bayer CropScience, Dow AgroSciences, DuPont, FMC, Hatch Act Funds – USDA, Montana Wheat and Barley Committee, Montana Agricultural Experiment Station, Montana Department of Agriculture, Montana Fertilizer Committee, Montana Noxious Weed Trust, NovaSource, USDA National Institute for Food and Agriculture, Valent, Western Sugar Cooperative, Winfield Solutions. PJ currently serves on the Board of Directors for the Western Society of Weed Science and Associate Editor for Weed Technology journal. PJ currently serves on the education committee of Montana Ari-Business Association. Funding has been provided to Colorado State University from the following organizations in support of TG's research and education program, either through unrestricted gifts, research contracts, or grants: Aquatic Plant Management Society, BASF, Bayer CropScience, Biotechnology and Biological Sciences Research Council, Colorado Agricultural Experiment Station, Colorado Wheat Administrative Committee, Colorado Wheat Research Foundation, Dow AgroSciences, Hatch Act Funds – USDA, National Science Foundation (I/UCRC), United Sorghum Checkoff Program, United Phosphorus, Inc., and Western Sugar Cooperative. TG currently serves as the scientific chair and conference organizer for the Global Herbicide Resistance Challenge conference. TG has received travel grants to speak at meetings from the following organizations: AGRO division of American Chemical Society, Bayer CropScience, The Scotts Company, Canadian Weed Science Society, Limagrain Cereal Seeds, Brazilian Society of Weed Science, Tennessee Weed Science Society, and Crop Science Society of America. Funding has been provided to Colorado State University from the following organizations in support of PW’s research and education program, either through unrestricted gifts, research contracts, or grants: BASF, Bayer CropScience, Colorado Agricultural Experiment Station, Colorado Wheat Administrative Committee, Colorado Wheat Research Foundation, Dow AgroSciences, DuPont, FMC, Hatch Act Funds – USDA, Loveland Industries, Monsanto, Syngenta, United Sorghum Checkoff Program, USDA National Institute for Food and Agriculture, Western Sugar Cooperative, and Winfield Solutions. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.