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BackgroundCognitive frailty is the coexistence of physical frailty and cognitive impairment and is an at-risk state for many adverse health outcomes. Moderate-to-vigorous physical activity (MVPA) is protective against the progression of cognitive frailty. Physical inactivity is common in older people, and brisk walking is a feasible form of physical activity that can enhance their MVPA. Mobile health (mHealth) employing persuasive technology has been successful in increasing the levels of physical activity in older people. However, its feasibility and effects on older people with cognitive frailty are unclear. ObjectiveWe aimed to identify the issues related to the feasibility of an mHealth intervention and the trial (ie, recruitment, retention, participation, and compliance) and to examine the effects of the intervention on cognitive function, physical frailty, walking time, and MVPA. MethodsAn open-label, parallel design, randomized controlled trial (RCT) was employed. The eligibility criteria for the participants were age ≥60 years, having cognitive frailty, and having physical inactivity. In the intervention group, participants received both conventional behavior change intervention and mHealth (ie, smartphone-assisted program using Samsung Health and WhatsApp) interventions. In the control group, participants received conventional behavior change intervention only. The outcomes included cognitive function, frailty, walking time, and MVPA. Permuted block randomization in 1:1 ratio was used. The feasibility issue was described in terms of participant recruitment, retention, participation, and compliance. Wilcoxon signed-rank test was used to test the within-group effects in both groups separately. ResultsWe recruited 99 participants; 33 eligible participants were randomized into either the intervention group (n=16) or the control (n=17) group. The median age was 71.0 years (IQR 9.0) and the majority of them were females (28/33, 85%). The recruitment rate was 33% (33/99), the participant retention rate was 91% (30/33), and the attendance rate of all the face-to-face sessions was 100% (33/33). The majority of the smartphone messages were read by the participants within 30 minutes (91/216, 42.1%). ActiGraph (58/66 days, 88%) and smartphone (54/56 days, 97%) wearing compliances were good. After the interventions, cognitive function improvement was significant in both the intervention (P=.003) and the control (P=.009) groups. The increase in frailty reduction (P=.005), walking time (P=.03), step count (P=.02), brisk walking time (P=.009), peak cadence (P=.003), and MVPA time (P=.02) were significant only in the intervention group. ConclusionsOur mHealth intervention is feasible for implementation in older people with cognitive impairment and is effective at enhancing compliance with the brisk walking training program delivered by the conventional behavior change interventions. We provide preliminary evidence that this mHealth intervention can increase MVPA time to an extent sufficient to yield clinical benefits (ie, reduction in cognitive frailty). A full-powered and assessor-blinded RCT should be employed in the future to warrant these effects. Trial RegistrationHKU Clinical Trials Registry HKUCTR-2283; http://www.hkuctr.com/Study/Show/31df4708944944bd99e730d839db4756

Background: Youth with disabilities who have at least one paid work experience during high school are more than twice as likely to be employed after high school. However, barriers exist that limit work opportunities for youth with disabilities and subsequent entry to work as part of their adult lives. Objective: The study identified secondary education services that have been found to be scientifically valid and effective in improving transition to work of youth with disabilities. Methods: A scoping review was conducted of secondary services provided to transition-age youth with disabilities associated with employment outcomes. The final full-text review consisted of 30 articles. Findings: Findings describe five major themes related to secondary education services associated with employment. These themes are work experience, independence and autonomy, IEP and transition planning process, student characteristics, and medical restoration services. Conclusions: These findings suggest that secondary education services are effective in improving the transition to work for transition-age youth with disabilities. Recommendations are made for educators, rehabilitation professionals, and school administrators to enhance the rates of youth with disabilities in finding and maintaining meaningful employment.

Purpose: Americans with rheumatoid arthritis (RA) represent an emerging vocational rehabilitation (VR) clientele. Method: Following an overview of the etiology, incidence, prevalence, and impact of RA, the authors present strategies to meet the service and support needs of Americans with RA across the phases of the VR process. Results: The importance of individualized case planning, employer consultation, workplace accommodations, interface with medical and mental health professionals, and adherence to social distancing requirements resulting from the Coronavirus pandemic is emphasized throughout the article. Conclusions: RA is an emerging disability that can affect people at any age, and rehabilitation counselors must be prepared to meet the service needs of this growing clientele.

The authors describe the construction and use of tactile models for demonstrating intermolecular forces. These models are composed of inexpensive materials and can be used in college chemistry classrooms of varying levels including general and organic chemistry. The models were designed to be paired with an accompanying activity to encourage students to compare and contrast the three types of intermolecular forces (hydrogen bonding, dipole-dipole forces, and London dispersion forces) as well as determine the relationship between intermolecular forces and the physical properties of specific molecules. More importantly, the handheld models allow for visualization of molecular interactions to promote multisensory learning. In this work, the authors discuss the development, implementation, and survey results of a modeling activity for conceptualization and review of intermolecular forces in introductory, general, and organic chemistry classrooms.