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In 2001 we created a 60-hour continuing education program for college faculty teaching in rural Arkansas. The pilot program, named the Arkansas Geriatric Education Mentors & Scholars for faculty (AR-GEMS II) consists of 24 didactic hours and 36 hours of clinical experience. Didactic content ranged from psychopharmacology to hearing loss; clinical experiences ranged from ambulatory to palliative care. Individualized needs assessments were conducted in the planning phase to help guide selection of clinical experiences and preceptorships. Evaluations of both components revealed a high level of learning, enthusiasm and satisfaction with the program. Evaluation scores of didactic content revealed an overall rating of 4.9 on a 5-point scale (5=excellent, 1=poor). Clinical evaluation scores included the following data: Met my expectations: M-4.87; Recommend to others, M=4.96; and Provided beneficial knowledge for faculty role: M=4.93, on a 5 point scale in which 5=strongly agree. Participants reported integration of new knowledge into course curriculum revisions at their institution. Future plans are to expand this faculty training into an annual event.

Parent-to-parent support programs have become an important part of the service system for children with chronic health conditions. Despite this growth, few empirical studies have examined the processes or outcomes of these support interventions. We review results of 3 randomized controlled trials of community-based support programs for parents of children with chronic illnesses. The 12- to 15-month programs provided informational, affirmational, and emotional support to mothers of school-aged children with chronic illnesses. Support was provided by trained 'veterans' (mothers who were raising or had raised children with similar conditions). Results indicate that each program reduced anxiety in high-risk mothers assigned to the experimental group compared to their counterparts in the control group. Results are discussed in terms of 'lessons learned' for research, practice, and policy. [ABSTRACT FROM AUTHOR]

Objective: To determine whether isosorbide-5-mononitrate (IS-5-MN), an active metabolite of isosorbide dinitrate, when given twice daily (in the morning and 7 hours later), prevents development of tolerance and reduction in exercise performance or is associated with a rebound increase in anginal attacks in patients with stable angina pectoris.Design: Multicenter, placebo-controlled, parallel-group, double-blind, randomized study.Setting: Four university teaching hospitals and five private cardiology outpatient clinics.Patients: 116 patients with stable exertional angina who stopped treadmill exercise because of angina pectoris.Intervention: After stopping all antianginal drugs with the exception of beta-blockers, patients received single-blind placebo for 1 week followed by either 20 mg of IS-5-MN (n = 60 patients) or placebo (n = 62 patients) twice daily at 0800 hours and 1500 hours for 2 weeks.Measurements: Serial symptom-limited exercise tests and patients' diaries recording activity and date, time, and severity of anginal attacks.Results: Compared with placebo recipients, patients receiving IS-5-MN walked significantly longer at 2, 5, and 7 hours after the 0800-hour dose (P < 0.01) and at 2 and 5 hours after the 1500-hour dose (P < 0.01). Before the morning (0800-hour) dose, exercise duration increased by 0.53 minutes in placebo recipients and by 0.85 minutes in those receiving IS-5-MN therapy (P = 0.10). Neither nocturnal nor early-morning anginal attacks increased during IS-5-MN therapy compared with placebo. Headaches occurred in 19 (32%) patients in the IS-5-MN group and in 9 (15%) patients in the placebo group but necessitated discontinuation of treatment in only 2 (3%) patients in the IS-5-MN group.Conclusion: Isosorbide-5-mononitrate, 20 mg twice daily given 7 hours apart, was well tolerated and improved exercise performance for 7 hours after the morning dose and for 5 hours after the afternoon dose without evidence of development of pharmacologic tolerance. No rebound increase in anginal attacks was found. [ABSTRACT FROM AUTHOR]

The nutritional requirements of older women is an area of great interest because the extended life expectancy leads to an increase in women living into their 80s, 90s, and longer. The recommended dietary allowances (RDAs) and dietary reference intakes (DRIs) are not specific for women living to advanced ages, and little research has been conducted specifically on the micronutrient needs of elderly women. Older adults are at greater risk for nutritional deficiencies than are younger adults due to physiologic changes associated with aging, acute and chronic illnesses, prescription and over-the-counter medications, financial and social status, and functional decline. Among the significant age-associated changes in nutrient requirements, the need for energy decreases and the requirements for protein increase with age. Among the micronutrients, the significant ones that may be associated with deficiencies in elderly women include vitamin B-12, vitamin A, vitamin C, vitamin D, calcium, iron, zinc, and other trace minerals. In old and very old women, these are micronutrients of interest but there is a great need for research to determine appropriate recommendations. The importance of these selected nutrients and the reasons for the likelihood of deficiency are discussed briefly. However, there is little specific information regarding micronutrient requirements for elderly women. One reason for this is the difficulty in conducting reliable and valid studies due to the heterogeneity of older adults and their unique rate of aging associated with their health status, limited income, disability, and living situation. Copyright © 2005 American Society for Clinical Nutrition [ABSTRACT FROM AUTHOR]

Purpose of Review: Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction that significantly impacts health-related quality of life (HRQOL). This article explores the potential role of virtual reality (VR)-based cognitive behavioral therapy (CBT) in treating patients with IBS., Recent Findings: While CBT is a proven, skills-based therapy approach that modifies behaviors and alters dysfunctional thinking patterns to influence the gut-brain axis and improve IBS symptoms, it is rarely prescribed given a paucity of CBT-trained clinicians. We developed a novel VR program that delivers a standardized CBT program over an 8-week period to help patients manage their symptoms. In initial qualitative validation testing, patients expressed positive perceptions about using VR CBT for IBS. Home-based, standardized VR CBT has the potential to be an effective and scalable treatment option for patients with IBS. While initial studies have shown proof-of-concept definitive randomized controlled trials are needed to demonstrate the efficacy of self-administered VR CBT in IBS., (© 2024. The Author(s).)

The increasing need for mental health support and a shortage of therapists have led to the development of the eXtended-reality Artificial Intelligence Assistant (XAIA). This platform combines spatial computing, virtual reality (VR), and artificial intelligence (AI) to provide immersive mental health support. Utilizing GPT-4 for AI-driven therapy, XAIA engaged participants with mild-to-moderate anxiety or depression in biophilic VR environments. Speaking with an AI therapy avatar in VR was considered acceptable, helpful, and safe, with participants observed to engage genuinely with the program. However, some still favored human interaction and identified shortcomings with using a digital VR therapist. The study provides initial evidence of the acceptability and safety of AI psychotherapy via spatial computing, warranting further research on technical enhancements and clinical impact., (© 2024. The Author(s).)