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Background: Older adults comprise a substantial proportion of the US population requiring support during disaster events. Previous research demonstrates that older adults are resilient but deficient in disaster preparedness and lacking in community engagement. There is a gap in high-quality research in this area., Objective: This study aims to fill this gap by developing a 4-phase intervention to improve mobility and balance, decrease fall risks (mitigation), increase knowledge of disaster preparedness (preparedness), improve community emergency operation plans (response), and improve self-efficacy in disaster recovery (recovery) for older adults., Methods: This is a community-based, 10-month study in a large Midwestern urban and suburban location targeting community-dwelling older adults. The 4 phases of interventions address mitigation, preparedness, response, and recovery-aspects improving outcomes from disaster events. In total, 4 to 6 one-hour seminars each month are provided to community-dwelling older adults to improve disaster preparedness and recovery planning. A critical incident packet with resources on essential information such as medications, a communication plan, evacuation resources, and supplies was started and is being reviewed. Preintervention surveys are orally given, with research assistants aiding in any difficulties the participants have. After the surveys, 2 individual 20-minute presentations separated by a short break for snacks and initial completion of their disaster plan preserve the older adult's attention. Mitigation efforts to improve mobility and safety are offered with 10 visits to the older adults' residences, adapting physical activity and balance exercises to the individual's needs. To address response needs, the emergency operations plans for 2 of the major cities are being amended for specific functional needs and access guidelines. Measurements include accelerometers to assess improvement in mobility, fall risk assessments, an abbreviated Federal Emergency Management Association Household Survey, an assessment for disaster engagement with partners tool, a brief pain inventory assessment, and the General Self-Efficacy Scale. We analyze data descriptively and compare pre- and postintervention data for each phase with paired-samples t test and other nonparametric techniques (proportion tests and Wilcoxon signed-rank tests). Overarching objectives prioritized during this intervention include underscoring respect for the experience and resilience found in older adults and engaging them in specialized roles to support their communities during disaster events., Results: The intervention was funded in July 2023; enrollment began in November 2023 and is continuing. We will conclude data collection by July 2025. Published study results can be expected in early 2025., Conclusions: With improved disaster preparedness, mobility, recovery planning, and inclusion as a resource in community disasters, older adults are expected to be safer and be able to age in place. If successful, future studies will focus on outreach and sustainability. This study will serve as a model for older adult disaster preparedness and community involvement., International Registered Report Identifier (irrid): DERR1-10.2196/58895., (©Sharon White-Lewis, Joseph Lightner, Julia Crowely, Amanda Grimes, Kathleen Spears, Steven Chesnut. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 04.12.2024.)

Objective: The object of this study was to determine the effect of EAS (Equine-Assisted Services) on arthritis conditions, as measured by the sTnT (Skeletal troponin) and COMP (cartilage oligomeric matrix proteins) biomarkers, compared to an exercise attention control intervention., Design: This was a secondary analysis of a randomized clinical trial comparing equine-assisted therapy to exercise education attention-control on cartilage and skeletal biomarkers in adults with arthritis. Twenty-one adults (M age = 64 years) with arthritis who attended rheumatology clinics in the midwestern United States participated., Results: No changes were found in sTnT from baseline to week six within either intervention nor were there differences in changes between the two groups (p = 0.91). COMP increased from baseline to week six for both conditions, suggesting increased deterioration of cartilage and joints. Although the attention-control condition demonstrated larger increases in cartilage oligomeric matrix proteins level, compared to the EAS condition, these differences were not statistically (p = 0.58) or clinically significant (i.e., trivial effect, d = -0.16). When 3 outliers were removed, the differences in changes between EAT and attention-control group could be arguably of clinical significance (d = - 0.33), suggesting that the attention-control group demonstrated larger increases in levels of COMP than those in the EAS condition, though this difference was not statistically significant (p = 0.28)., Conclusion: Although equine-assisted therapy may reduce pain and improve quality of life for adults with arthritis, findings here are not fully corroborated with biomarkers., Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Medication administration timing error (MATE) leads to poor medication efficacy, harm, and death. Frequency of MATE is understudied., Purpose: To determine MATE frequency, and characteristics and quality of reporting studies., Methods: A systematic review of articles between 1999 and 2021 was conducted using the Cumulative Index of Nursing and Allied Health Literature, ProQuest, and PubMed databases. Articles were scored for quality using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist., Results: Initially, 494 articles were screened; 23 were included in this review. MATE was defined as administration beyond 60 minutes before or after the scheduled time in 13 (57%) of the included studies. Measurement procedures included data abstraction, self-report, and observation. Frequency of MATE was 1% to 72.6%. Moderate study quality was found in 78% of articles., Conclusion: Research on MATE is characterized by inconsistent definitions, measurements procedures, and calculation techniques. High-quality studies are lacking. Many research improvement opportunities exist., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Current standard practice for disaster response training is insufficient to prepare future responders. Interdisciplinary immersive education is necessary for disaster responders to react quickly to the devastating destruction, dangerous situations, and ethical dilemmas, while caring for survivors, families, and communities with limited resources. This study tests the effects of immersive emergency preparedness education on interdisciplinary college students., Methods: Thirty-four college students attended a 3-day immersive disaster training event. Interdisciplinary teams were given 6 challenges to adapt and overcome: mass casualty; field hospital triage, treatment, and transportation; water rescue; high building rescue; search and rescue; and a water treatment. A pretest and posttest survey, Emergency Preparedness Information Questionnaire (EPIQ), was administered to all participants., Results: Statistically significant improvements in triage, biological agent detection, assessing critical resources, incident command, psychological issues, clinical decision making, and communication (range of P = 0.000-0.003). Improvement in clinical significance resulted in a change from limited knowledge to familiarity with the subject in all cases except isolation, quarantine, and decontamination., Conclusions: Preparation and training of health care professionals need to include immersive disaster scenarios that create the experience of fatigue, psychological challenges, and physical stresses.

Background: Disasters cause significant human and monetary destruction and society as a whole is underprepared to address them. Disaster preparedness education is not covered extensively enough for health professionals or for the general public., Methods: A disaster preparedness education intervention was performed using a non-randomized controlled trial of a convenience sample with a pre- and post-intervention survey. The adapted Emergency Preparedness Information Questionnaire (EPIQ), a validated survey tool, was utilized. Participants came from a health professions educational enrichment program for students from under-resourced high schools in the Kansas City area., Results: The experimental group shows statistically significant improvement in knowledge of disaster topics post-intervention. Of 18 adapted EPIQ tool questions, 17 show statistically significant improvement in disaster knowledge post-intervention for the experimental group with significance set at p < .05 (range of significant p values .000-.017)., Conclusions: The education intervention was effective and cost-efficient. Disaster preparedness education should be included in THE secondary school curriculum., (© 2021 American School Health Association.)

Research Aim: To compare equine-assisted therapy to exercise education on pain, range of motion, and quality of life in adults and older adults with arthritis., Background: Quality of life for adults and older adults is negatively impacted by arthritis pain, stiffness, and decreased function. Equine-assisted therapy provides unique movements to the rider's joints and muscles improving pain, range of motion, and quality of life and has improved outcomes in balance, gait, strength, functional mobility, and spasticity for older adults, stroke, spinal cord injury, and multiple sclerosis patients. No research has investigated the effects on adults and older adults with arthritis., Methods: Twenty adults and older adults with arthritis recruited from rheumatology clinics participated in a randomized controlled trial for six weeks. Participants and research assistants were blinded to assignment. Standardized valid and reliable instruments were used to measure pain, range of motion, and quality of life targeting back, knees, shoulders, and hips., Results: Mean age was 63.85 (SD 6.885, 53-75) years. Pain significantly improved in shoulders (p = 0.007), hips (p = 0.027), and back (p = 0.006), not knees (p = 0.061). Range of motion improved for back (p = 0.02), hips (p = 0.04), shoulders (p = 0.005) and not knees. Quality of life improved for upper limb (p = 0.002), lower limb (p = 0.021), and affect (p = 0.030), not social interaction and symptoms., Conclusion: This randomized controlled trial provides evidence that equine-assisted therapy decreases pain, and improves range of motion, and quality of life for adults and older adults with arthritis. Further fully powered research with cost/benefit outcomes would be beneficial., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Aims: A concept analysis was conducted to clarify the attributes, antecedents and meaning of equine-assisted therapy and present an operational definition., Design: Concept analysis., Methods: Walker and Avant's concept analysis method was used to analyse equine-assisted therapy, using horses as healers by defining and enumerating the attributes, antecedents, consequences and empirical referents. Example cases are presented., Results: Defining attributes include the following: a human participant with an equine physically present to assist the human participant, a treatment or intervention as a result of the interactions between an equine and a human participant, a purposeful and regulated interaction and a positive health outcome goal from the interaction. Antecedents include a live horse with a human physically able to interact with the horse, a facilitator and accessibility to an equine-assisted therapy (EAT) programme. Consequences include improved balance, well-being, quality of life, trust, spasticity, self-efficacy, self-esteem, nurse presence, pleasure and a sense of accomplishment., Competing Interests: There are no conflicts of interest to declare associated with this manuscript., (© 2019 The Authors. Nursing Open published by John Wiley & Sons Ltd.)