Search

Background Individuals with mobility disabilities are less likely to meet physical activity standards and are at greater risk of developing non-communicable chronic diseases at earlier ages. Public parks are an essential resource for participation in physical activity. However, environmental factors may limit the participation of wheelchair users. The objective of this study was to evaluate the feasibility of using the Path Environment Audit Tool (PEAT) and to explore the wheelchair accessibility of five public parks in Saudi Arabia through descriptive analysis. Methods A descriptive study design was implemented to evaluate wheelchair accessibility features of five public parks in Riyadh, Saudi Arabia, and process, resource, and management assessments were conducted. Phone GPS-App Strava was used to track the segments and measure their distances. Results Audits in multiple parks using PEAT were time-consuming despite being user-friendly. The descriptive analysis of paths and trails across the five parks showed some positive features, such as adequate bollard/gate clearance, but the path slope and condition of the path surfaces were more variable. Conclusion This study is the first to examine wheelchair accessibility in public parks in Saudi Arabia. Preliminary audits of paths/trials in five public parks revealed the strengths and weaknesses of accessibility and features that promote physical activity participation for wheelchair users. These findings can guide future use of PEAT in large-scale studies and inform environmental modifications.

Vision and Robotic technologies are progressively becoming ubiquitous for automating and digitizing quality control in the food industry. This paper examines the crucial role of advanced automation technologies, including versatile or dedicated robotic systems, specialized end-effectors, machine vision, and efficient material handling systems, which collectively enhance food processing efficiency. This paper aspires to provide a high-level technical review on the crucial role of advanced automation technologies, including versatile or dedicated robotic systems, specialized end-effectors, machine vision, and efficient material handling systems, which collectively enhance food processing efficiency. While the manuscript aims to document the various automation sub-systems utilized generally in food processing, it places a particular emphasis on the primary processing phase of food production. Most food products in the primary processing phase exhibit a plethora of complex physical properties and manipulation conditions, making it difficult to reliably automate the various processes. This research aims to outline the contemporary advances and requirements for integrating various automation technologies, to enhance the efficiency and precision of primary food processing. Furthermore, it aspires to serve as a valuable, up-to-date survey and analysis of the latest advances in automation and vision technologies and their capability to automate a food processing line.

Background: Outdoor falls present a significant challenge to the health and well-being of older adults. Safe strategy use is an important component of falls prevention, yet little is known regarding use of outdoor falls prevention strategies. Aims: To examine outdoor falls prevention strategy use among naturally occurring retirement community residents at risk for falls, and to examine associations with neighborhood walkability. Methods: Descriptive analyses of pretest data from an intervention study (N = 97) were conducted to examine frequency of outdoor falls prevention strategy use. Walk Score® data were added to the dataset, and chi-square tests of independence were used to examine associations between walkability categories and outdoor falls prevention strategy use. Results: Some strategies, such as visual scanning and holding rails on stairs, were used by 70% or more of participants while others, such as route planning, were infrequently or inconsistently used. With the exception of avoiding cell phone use while walking outdoors, no significant associations were found between walkability categories and outdoor falls prevention strategy use. Conclusion: Study findings serve as a needs assessment for health education and behavioral training.

The COVID-19 pandemic has greatly impacted lifestyles and travel patterns, revealing existing societal and transportation gaps and introducing new challenges. In the context of an aging population, this study investigated how the travel behaviors of older adults (aged 60+) in New York City were affected by COVID-19, using an online survey and analyzing younger adult (aged 18–59) data for comparative analysis. The purpose of the study is to understand the pandemic's effects on older adults’ travel purpose and frequency, challenges faced during essential trips, and to identify potential policies to enhance their mobility during future crises. Descriptive analysis and Wilcoxon signed-rank tests were used to summarize the changes in employment status, trip purposes, transportation mode usage, and attitude regarding transportation systems before and during the outbreak and after the travel restrictions were lifted. A Natural Language Processing model, Gibbs Sampling Dirichlet Multinomial Mixture, was adopted to open-ended questions due to its advantage in extracting information from short text. The findings show differences between older and younger adults in telework and increased essential-purpose trips (e.g., medical visits) for older adults. The pandemic increased older adults’ concern about health, safety, comfort, prices when choosing travel mode, leading to reduced transit use and walking, increased driving, and limited bike use. To reduce travel burdens and maintain older adults' employment, targeted programs improving digital skills (telework, telehealth, telemedicine) are recommended. Additionally, safe, affordable, and accessible transportation alternatives are necessary to ensure mobility and essential trips for older adults, along with facilitation of walkable communities.

This study was to identify factors at the intrapersonal, interpersonal, and community levels that relate to physical leisure participation in Taiwanese community-dwelling older adults and to examine their relative importance. We used a cross-sectional study with purposive sampling (N = 160). Physical leisure participation was quantified as the variety, frequency, and duration of participation. Data were analyzed using a series of hierarchical multiple linear regressions. The results showed that higher variety, frequency, or duration of physical leisure participation was associated with older males and with those who reported having better health, fewer depressive symptoms, and greater social support. Intrapersonal- and interpersonal-level factors play a relatively more important role in predicting physical leisure participation than factors at the community level. Understanding factors that relate to these three levels of participation has the potential to inform interventions that are tailored to individual profiles. [ABSTRACT FROM AUTHOR]

Introduction: Anaphylaxis is a severe, life-threatening generalized hypersensitivity reaction. While guidelines to reduce the morbidity, risk, and mortality of anaphylaxis are widely available, adherence to these is often suboptimal. We aimed to audit paediatric anaphylaxis at a South African tertiary allergy referral centre, comparing our data to those of the large Network of Severe Allergic Reactions (NORA) registry. Methods: Children treated for severe allergic reactions between January 2014 and August 2016 were identified for screening using ICD-10 coding of all admissions and discharges, pharmacy records of adrenaline autoinjector dispensing, and additional referrals from the allergy department to the study. Screened participants not meeting the inclusion criteria after preliminary questioning and/or folder review were excluded. Data were collected via a standardized questionnaire using direct interviews, and captured on a local web-based registry. Results: Of the 156 episodes analysed, >40% were graded as severe and nearly two-thirds of patients were seen for a recurrent episode. Males, younger children, and individuals of mixed-race ethnicity were more frequently affected. Skin and mucosa were most commonly involved, followed by respiratory and gastrointestinal involvement; cardiovascular and other systemic involvement occurred infrequently. Specific IgE assay was the most frequently requested test. Food-related triggers (peanut, hen's egg, fish, cashew nuts and cows' milk) predominated and decreased with age. Anaphylaxis was strongly correlated with atopic conditions. While prophylactic measures were almost universally instituted, adrenaline was rarely used, by both lay persons and healthcare professionals. Hospital admissions were infrequent, and no deaths were recorded. Conclusion: Management of anaphylaxis should be improved. Specifically, the use of adrenaline prior to hospital arrival remains suboptimal. Ongoing education and training of patients, parents, teachers, and healthcare workers is identified as an area requiring intensification.

Chronic diseases affect more than 80% of older adults. One modifiable risk factor for secondary prevention is physical activity. Public parks are an essential resource for physical activity, but environmental features may limit participation. Our aims were (1) to assess the feasibility and utility of the Path Environment Audit Tool (PEAT) for use in a larger-scale study focused on older adults and (2) to examine the physical activity-promoting features of five public parks. Methods: A descriptive study design was used to assess five public parks in Riyadh, Saudi Arabia, from April to June 2022. Additionally, process, resource, and management assessments were also conducted. Results: The PEAT was easy to use, but additions are recommended to increase relevance to older adults with chronic disease. Descriptive analyses revealed positive features, such as adequate lighting, but other features such as path slope were more variable. Conclusions: Study findings can guide the future use of the PEAT for older adult participants and inform environmental modifications. [ABSTRACT FROM AUTHOR]

Introduction: Busulfan is a common component of allogeneic hematopoietic cell transplant (alloHCT) conditioning, however interpatient pharmacokinetic variability can result in enhanced toxicity or increased relapse risk. Therapeutic drug monitoring (TDM) can minimize variability, yet the optimal frequency of TDM is unknown. We compared outcomes for patients with one versus two sets of busulfan TDM during myeloablative conditioning (MAC) prior to alloHCT. Methods: We analyzed the impact of busulfan TDM frequency and dose adjustments, with the primary outcome being relapse-free survival (RFS). Other outcomes included the incidence of acute and chronic graft versus host disease (GVHD), oral mucositis, pulmonary toxicity, sinusoidal obstruction syndrome (SOS), the cumulative incidence of relapse (CIR), and overall survival (OS). Results: Twenty-two patients underwent one set of sampling while 53 patients underwent two sets. Similar baseline characteristics were observed between the groups. There were no significant differences observed in RFS by day +180 (77.3% vs. 79.2%, p = 1.0), CIR by day +180 (18.2% vs. 17.8%, p = 0.74), or OS (p = 0.73). The incidences of acute GVHD, chronic GVHD, SOS, and severe mucositis were also similar. In each group, 63% received busulfan dose adjustments after one set, with 52.8% receiving further dose adjustments following the second set. Conclusion: We observed no significant difference in alloHCT outcomes between patients who underwent one versus two sets of busulfan TDM sampling, suggesting that a single-time TDM and dose adjustment may be adequate to maximize outcomes after MAC alloHCT. [ABSTRACT FROM AUTHOR]

The article presents a study which developed a 5Ms-based geriatric assessment (GA) SmartPhrase, incorporating feedback from an informal resident focus group at the University of Pennsylvania. Topics discussed include trainee survey demographics, faculty survey results, and key elements to successfully implement a GA SmartPhrase for educational purposes.

Introduction Nearly six million American adults live with dementia, and dysphagia is a common comorbidity impacting their nutrition and quality of life. There is a shortfall in the number of geriatricians available to care for older adults. Thus, primary care physicians should be equipped with the knowledge to adequately care for the geriatric population. Modified diets are routinely prescribed for patients with dementia despite limited evidence that they protect patients from the sequelae of dysphagia and some suggestion of poor side-effect profiles. Methods We created a onetime, interactive, case-based session to educate medical residents on how to evaluate and treat dementia-associated dysphagia and address the discrepancy between the limited evidence for dietary modifications and their routine use. The session had a mixture of small-group discussion and didactic learning as well as a participatory component during which learners were able to sample thickened liquids. Results The session was implemented in an established primary care curriculum. Based on survey responses, which were obtained from 15 out of 17 participants, the session significantly improved participants’ knowledge of dysphagia-associated dementia and increased their comfort with caring for patients with dysphagia. Discussion Dementia-associated dysphagia, although an increasingly common clinical problem, remains an underexamined area of medicine. We successfully implemented a session on this topic for internal medicine residents on the primary care track. Limitations included generalizability due to the small number of residents in the course and inability to gather sufficient data to see if knowledge learned was sustained over time.

The role of standardized tests in general and college admission tests in particular is a hot topic for educators, administrators and others evaluating the outcomes of educational institutions. The importance of the test scores for both students and institutions is acknowledged, and the test preparation industry has spawned into a multi-billion dollar enterprise. Yet, objective evidence supporting the effectiveness of coaching for college preparatory tests, including the ACT, is virtually nonexistent. This study investigated the effectiveness of a four-week, 20-hour ACT coaching class offered at a large Midwestern high school. The results of this study show that students who participated in the coaching class increased their composite ACT score by 1.5 points over their previous highest ACT composite score. A comparable group at the same high school who did not participate in the coaching achieved an increase of 0.65 points, indicating an effect of coaching of 0.85 points. (Contains 5 tables.)

Introduction: Despite a growing number of older lesbian, gay, bisexual transgender, and queer (LGBTQ) adults in the United States, education on care for this vulnerable population has historically been inadequate across all levels of training. This research assessed the extent of LGBTQ education in geriatric medicine fellowship curricula across the United States. Methods: We designed a survey to anonymously collect information from geriatric medicine fellowship programs on LGBTQ curricular content. Eligible participants included all 160 fellowship directors on record with the American Geriatrics Society. The survey addressed demographics of the fellowship program, current state of inclusion of LGBTQ content in didactic curricula and in clinical settings, and other available training opportunities. Results: Out of those contacted, 80 (50%) completed the survey. Of the programs surveyed, 60 (75%) were housed in internal medicine, 19 (24%) were in family medicine, and one was in their own department. Forty‐seven fellowships (59%) reported some formal didactic session (e.g., lecture or case based), with the majority of these programs (72%) featuring 1–2 h of formal instruction. Forty‐five programs (56%) reported offering no formal clinical experiences. There was less than 50% coverage for all surveyed topics in the required curriculum (range 46% for discrimination to 9% for gender affirming care). Time and lack of expertise were cited as the main barriers to content inclusion. Conclusions: Curricular content regarding care for LGBTQ older adults is inadequate in geriatric medicine fellowships. Faculty development of current educators and providing standardized guidelines and curricula are steps toward addressing this deficit. See related editorial by Renee J. Flores in this issue. [ABSTRACT FROM AUTHOR]

This paper presents a web-based 3D imaging pipeline, namely 3Dnow, that can be used by anyone without the need of installing additional software other than a browser. By uploading a set of images through the web interface, 3Dnow can generate sparse and dense point clouds as well as mesh models. 3D reconstructed models can be downloaded with standard formats or previewed directly on the web browser through an embedded visualisation interface. In addition to reconstructing objects, 3Dnow offers the possibility to evaluate and georeference point clouds. Reconstruction statistics, such as minimum, maximum and average intersection angles, point redundancy and density can also be accessed. The paper describes all features available in the web service and provides an analysis of the computational performance using servers with different GPU configurations.

Background: We sought to describe neuropsychiatric symptoms (NPS) among people living with dementia (PLWD) from diverse racial and ethnic groups receiving home health services while accounting for dementia severity, individual symptom prevalence, and neighborhood disadvantage. Methods: A prospective study using cross‐sectional data from n = 192 PLWD receiving skilled home healthcare in New Jersey enrolled in the Dementia Symptom Management at Home Program trial. We prospectively measured symptom prevalence with the Neuropsychiatric Inventory Questionnaire and dementia severity using the Quick Dementia Rating System. A one‐way ANOVA determined NPS prevalence by dementia severity (mild, moderate, severe). Fisher's exact tests were used to assess the association of individual symptom prevalence with race and ethnicity and cross tabs to descriptively stratify individual symptom prevalence by dementia severity among groups. A Pearson correlation was performed to determine if a correlation existed among neighborhood disadvantages measured by the Area Deprivation Index (ADI) state decile scores and NPS prevalence and severity. Results: Participants identified as non‐Hispanic White (50%), non‐Hispanic Black (30%), or Hispanic (13%). NPS were prevalent in 97% of participants who experienced 5.4 ± 2.6 symptoms with increased severity (10.8 ± 6.6) and care partner distress (13.8 ± 10.8). NPS increased with dementia severity (p = 0.004) with the greatest difference seen between individuals with mild dementia (4.3 ± 2.3) versus severe dementia (5.9 ± 2.3; p = 0.002). Few differences were found in symptom prevalence by racial and ethnic sub‐groups. Nighttime behaviors were higher in non‐Hispanic Black (78%), compared with non‐Hispanic Whites (46%) with moderate dementia, p = 0.042. State ADI scores were not correlated with the number of NPS reported, or severity. Conclusions: NPS were prevalent and increased with dementia severity with commonalities among racial and ethnic groups with varying levels of neighborhood disadvantage. There is a need for effective methods for improving NPS identification, assessment, and management broadly for homebound PLWD. [ABSTRACT FROM AUTHOR]

The paper presents a collaborative image-based 3D reconstruction pipeline to perform image acquisition with a smartphone and geometric 3D reconstruction on a server during concurrent or disjoint acquisition sessions. Images are selected from the video feed of the smartphone’s camera based on their quality and novelty. The smartphone’s app provides on-the-fly reconstruction feedback to users co-involved in the acquisitions. The server is composed of an incremental SfM algorithm that processes the received images by seamlessly merging them into a single sparse point cloud using bundle adjustment. Dense image matching algorithm can be lunched to derive denser point clouds. The reconstruction details, experiments and performance evaluation are presented and discussed.

During the last two decades we have witnessed great improvements in ICT hardware and software technologies. Three-dimensional content is starting to become commonplace now in many applications. Although for many years 3D technologies have been used in the generation of assets by researchers and experts, nowadays these tools are starting to become commercially available to every citizen. This is especially the case for smartphones, that are powerful enough and sufficiently widespread to perform a huge variety of activities (e.g. paying, calling, communication, photography, navigation, localization, etc.), including just very recently the possibility of running 3D reconstruction pipelines. The REPLICATE project is tackling this particular issue, and it has an ambitious vision to enable ubiquitous 3D creativity via the development of tools for mobile 3D-assets generation on smartphones/tablets. This article presents the REPLICATE project’s concept and some of the ongoing activities, with particular attention being paid to advances made in the first year of work. Thus the article focuses on the system architecture definition, selection of optimal frames for 3D cloud reconstruction, automated generation of sparse and dense point clouds, mesh modelling techniques and post-processing actions. Experiments so far were concentrated on indoor objects and some simple heritage artefacts, however, in the long term we will be targeting a larger variety of scenarios and communities.

Background and Objectives Outdoor falls can negatively affect the independence and well-being of community-dwelling older adults. Although there is some overlap, there are also differences in risk factors for indoor and outdoor falls. There are no existing community-based fall prevention programs that specifically target outdoor fall prevention. To fill this gap, the Stroll Safe program was developed. Research Design and Methods A cluster-randomized controlled trial design was used with randomization at the site level. Participants (N = 86) were aged 60 and older, with a history of an outdoor fall or who had a fear of falling outdoors. Eight naturally occurring retirement community program sites were randomly assigned to the treatment or wait list control group. Outcome measures included the Outdoor Falls Questionnaire, the Falls Behavioral Scale for the Older Person, and the Falls Efficacy Scale-International to examine knowledge of risks, safe strategy use, protective behaviors, and fear of falling. An Analysis of Covariance (ANCOVA) was used to compare change scores between groups with covariates included for any initial differences between groups. A linear mixed model was also conducted to account for any clustering effects. Results Significant differences (p s <.05) were found between groups for knowledge of outdoor fall risks and safe strategy use. Effect sizes were large (Cohen's d = 1.2–1.9). Results were retained at 6-week follow-up. Discussion and Implications Stroll Safe is effective in improving knowledge of outdoor fall risks and increasing safe strategy use for community mobility. Stroll Safe fills a gap in outdoor fall prevention programs. Clinical Trials Registration Number: NCT03624777 [ABSTRACT FROM AUTHOR]

Background: Geriatrics Fellows Learning Online And Together (Geri‐a‐FLOAT) is a virtual curriculum designed to convene fellows nationwide for learning and peer support. This paper presents the expansion and evaluation of the program from the "Wave 1" pilot to the "Wave 2" year‐long curriculum. Methods: Kern's six‐step approach to curriculum development was used to develop the Wave 2 curriculum. Participation was collected via Zoom. Post‐session web‐based surveys evaluated participant satisfaction regarding speaker, content, and overall session quality; intent‐to‐change; and a free‐response section. A one‐year follow‐up survey sent to participants with valid e‐mail addresses assessed sustained knowledge, skills, and behavior change. Results: Nineteen sessions were held with mean (SD) of 23 (13) participants per session, totaling 182 unique participants. Fifteen of 19 sessions were evaluated with 96 evaluations completed (mean [SD] 6 [4] evaluations per session). Mean (SD) ratings per session that were excellent or above average was 100% (0) for content, 99% (4) for speaker, and 99% (4) overall. Mean (SD) evaluations per session noting intent to change was 90% (14). Respondents reported helpful aspects as sharing resources and examples, perspectives and experiences of others, professional connections, and collaborative discussion. Of 127 participants with valid e‐mail addresses, 40 (response rate = 31%) completed the one‐year follow‐up survey. Mean (SD) respondents reporting some or significant sustained impact was 89% (7) across all learning outcomes. Conclusions: This virtual, national curriculum for geriatrics fellows was well‐received and associated with high rates of self‐reported, sustained impact one‐year post curriculum. Geri‐a‐FLOAT may be a model to standardize education and build collaboration and peer support across a discipline. [ABSTRACT FROM AUTHOR]

A Community Mental Health and Wellbeing Team (CMHWT), that sits within Coventry and Warwickshire Partnership NHS Trust, developed a group intervention for clients that aimed to provide psychoeducation around trauma. In the face of Covid-19, barriers to accessing the group were evident and this consequentially resulted in increased waiting lists. The CMHWT responded to this by transforming the group intervention and developing a novel intervention, which took the form of a digital webinar. To assess the effectiveness of the webinar, an evaluation was conducted which aimed to measure the helpfulness of the webinar for clients under the care of CMHWT. A mixed-methods design was employed. For the quantitative data, paired samples t-tests and Wilcoxon signedrank tests were used. For the qualitative data, template analysis was used. Results showed that for all scales and subscales, the means were lower at post-intervention than pre-intervention, suggesting that the level of overall distress was lower following completion of the webinar. These differences were significant for four out of six subscales. Qualitative outcomes highlighted the strengths of the webinar and provided suggestions for how the webinar could be developed and improved for future delivery. In conclusion, the results suggested that the complex trauma webinar was effective in producing a global reduction of distress. [ABSTRACT FROM AUTHOR]

Introduction Because many older adults lack dental insurance and have limited or no access to dental care, it is essential to train future physicians to conduct brief oral health assessments on them. Likewise, interprofessional educational experiences are crucial in teaching medical students the skills necessary to provide comprehensive, team-based care to complex and vulnerable populations. Thus, this workshop was designed to increase fourth-year medical students' knowledge and confidence in performing oral health examinations on older adult patients using an interprofessional and hands-on approach. Methods The curriculum includes an online presession self-study module followed by a 75-minute workshop. The workshop is comprised of a brief introduction (5 minutes), a lecture about the impact of oral health on older adults (30 minutes), a hands-on skill session practicing a focused oral exam led by dental students (30 minutes), and a large-group debrief and wrap-up (10 minutes). Results A pre-/postsurvey assessed learners' knowledge, attitudes, and confidence in oral health skills. The results were compared to a lecture-only format that was in place prior to the implementation of the workshop. In comparison to medical students who received the lecture-only format, those who participated in the workshop showed a greater increase in confidence and skills over time. The medical students also expressed interest in more frequent opportunities for collaborative learning experiences with dental students. Discussion This workshop was successful in introducing an interprofessional experience to medical students in order to ensure more comprehensive and coordinated care for older adult patients in the future.

The past year amplified inequities in the care of older adults. Milestones focused on social determinants of health (SDOH) are lacking within Geriatric fellowship training. A virtual learning collaborative GERIAtrics Fellows Learning Online And Together (GERI-A-FLOAT) was developed to connect trainees nationwide. To address gaps in education around SDOH, a needs assessment was conducted to inform a curricular thread. A voluntary, anonymous survey was distributed to fellows through a broad network. We sought to understand prior curricula trainees had that were specifically focused on SDOH and older adults. Respondents prioritized topic areas for the curriculum. Seventy-five respondents completed the survey. More than 50% of participants indicated no training on homelessness, immigration, racism, or LGBTQ+ health at any level of medical training, with more than 70% having no training in sexism or care of formerly incarcerated older adults. The most commonly taught concepts were ableism, ageism, and poverty. Respondents prioritized the topic of racism, ageism, and ableism. There is a lack of consistent SDOH curricula pertaining to older adults across all levels of training. This needs assessment is guiding a curricular thread for GERI-A-FLOAT and ideally larger milestones for fellowships. The time is now to prepare future geriatricians to serve as change agents. [ABSTRACT FROM AUTHOR]

We present observations of linear polarisation in the southern radio lobe of Centaurus A, conducted during commissioning of the Australian Square Kilometre Array Pathfinder (ASKAP) telescope. We used 16 antennas to observe a 30 square degree region in a single 12-h pointing over a 240 MHz band centred on 913 MHz. Our observations achieve an angular resolution of 26 × 33 arcseconds (480 parsecs), a maximum recoverable angular scale of 30 arcminutes, and a full-band sensitivity of 85 μ Jy beam − 1 . The resulting maps of polarisation and Faraday rotation are amongst the most detailed ever made for radio lobes, with order 10 5 resolution elements covering the source. We describe several as-yet unreported observational features of the lobe, including its detailed peak Faraday depth structure, and intricate networks of depolarised filaments. These results demonstrate the exciting capabilities of ASKAP for widefield radio polarimetry.