Effectiveness of telerehabilitation and home-based falls prevention programs for community-dwelling older adults: a systematic review and meta-analysis protocol.

INTRODUCTION: Falls among older adults are associated with adverse sequelae including fractures, chronic pain and disability, which can lead to loss of independence and increased risks of nursing home admissions. The COVID-19 pandemic has significantly increased the uptake of telehealth, but the effectiveness of virtual, home-based fall prevention programmes is not clearly known. We aim to synthesise the trials on telerehabilitation and home-based falls prevention programmes to determine their effectiveness in reducing falls and adverse outcomes, as well as to describe the safety risks associated with telerehabilitation. METHODS AND ANALYSIS: This protocol was developed using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Database searches from inception to August 2022 will be conducted without language restrictions of MEDLINE, EMBASE, Ovid HealthSTAR, CINAHL, SPORTDiscus, Physiotherapy EvidenceDatabase (PEDro) and the Cochrane Library. Grey literature including major geriatrics conference proceedings will be reviewed. Using Covidence software, two independent reviewers will in duplicate determine the eligibility of randomised controlled trials (RCTs). Eligible RCTs will compare telerehabilitation and home-based fall prevention programmes to usual care among community-dwelling older adults and will report at least one efficacy outcome: falls, fractures, hospitalisations, mortality or quality of life; or at least one safety outcome: pain, myalgias, dyspnoea, syncope or fatigue. Secondary outcomes include functional performance in activities of daily living, balance and endurance. Risk of bias will be assessed using the Cochrane Collaboration tool. DerSimonian-Laird random effects models will be used for the meta-analysis. Heterogeneity will be assessed using the I2 statistic and Cochran's Q statistic. We will assess publication bias using the Egger's test. Prespecified subgroup analyses and univariate meta-regression will be used. ETHICS AND DISSEMINATION: Ethics approval is not required. The results will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER: CRD42022356759.

Trends of clandestine laboratories manufacturing methamphetamine in New Zealand between 2009-2021: Evolution, enforcement, legislative, and COVID-19 effects.

The most common method of domestic methamphetamine manufacture encountered in New Zealand is the hydrogen iodide (HI) reduction of pseudoephedrine/ephedrine. While the overall method used to manufacture methamphetamine has remained consistent, the processes and chemicals utilized have evolved. Understanding the reason for any changes to methamphetamine manufacturing trends can assist jurisdictions with predicting the potential effects of enforcement and legislative initiatives. This paper presents data and trends amassed from suspected clandestine laboratories, associated with the manufacture of methamphetamine, in New Zealand between 2009 and 2021, along with data on methamphetamine, pseudoephedrine, and ephedrine seizures at the border. The data have shown that clandestine manufacturers in New Zealand have evolved the methamphetamine manufacturing process over the years. These changes in trends can largely be attributed to various enforcement and legislative effects and the COVID-19 pandemic response. Effects that enforcement, legislation, and the COVID-19 pandemic response may have had on the precursors, chemicals and equipment encountered are discussed.

H-2B Guest Workers and the Critical Role They Play in US Forests

A survey of businesses that provide a variety of forest management services indicated the importance of H-2B guest workers in performing important tasks which facilitate management and sustainability of forest resources in the United States.Those workers accomplish a wide variety of tasks with tree planting being most common. Although the positions filled by those workers are first made available to US workers at government-mandated wage rates, few apply. Businesses reported that it is becoming increasingly difficult for them to secure all of their guest visas to fulfill their contacts. Although former President Donald J. Trump's proclamation on June 22, 2020, suspending entry of workers with H-2B visas, would have resulted in approximately one million acres not being reforested by respondents in 2020, a National Interest Exemption process provided a reprieve through the end of 2020. A long-term solution is needed to ensure that there are enough H-2B workers available to continue providing these important services.

Social Policy Trends: COVID-19 Implications for Disability Assistance Clients

COVID-19 may pose an increased risk of hospitalization and mortality to persons with disabilities who are receiving disability income assistance

Utilizing What We Know About Tele-Mental Health in Tele- Financial Planning: A Systematic Literature Review

The coronavirus pandemic expanded the adoption of virtual financial planning, or tele-financial planning practices, as it's referred to in this paper. Unfortunately, limited empirical research on telefinancial planning exists to guide planners through this transition. However, there are similarities between financial planning and counseling;therefore, a systematic literature review on tele-mental health interventions was conducted to provide guidance for financial planning practices and future research. Research suggests the efficacy of tele-mental health is comparable to face-to-face delivery while creating greater efficiency for the therapist and the patient. The breadth and severity of conditions treated suggest that this delivery method is a viable channel, not a convenient stopgap for extraordinary circumstances or lower-value engagements. These findings suggest financial planners might leverage a virtual delivery channel to provide effective recommendations while expanding their reach and providing an experience that is less stressful and more convenient. The operational efficiencies experienced in tele-mental health suggest that financial planners could also improve the efficiency of their practices. Planners should proactively ensure that all clients have the resources and knowledge to engage in a virtual capacity and review their data security measures. For the financial planning profession to advance, practitioners cannot solely rely on research and best practices from related disciplines. Thus, this paper serves as a call for further study on telefinancial planning.

Tracheostomy guidelines developed at a large academic medical center during the COVID-19 pandemic.

BACKGROUND: During the SARS-CoV-2 pandemic, tracheostomy may be required for COVID-19 patients requiring long-term ventilation in addition to other conditions such as airway compromise from head and neck cancer. As an aerosol-generating procedure, tracheostomy increases the exposure of health care workers to COVID-19 infection. Performing surgical tracheostomy and tracheostomy care requires a strategy that mitigates these risks and maintains the quality of patient care. METHODS: This study is a multidisciplinary review of institutional tracheostomy guidelines and clinical pathways. Modifications to support clinical decision making in the context of COVID-19 were derived by consensus and available evidence. RESULTS: Modified guidelines for all phases of tracheostomy care at an academic tertiary care center in the setting of COVID-19 are presented. DISCUSSION: During the various phases of the COVID-19 pandemic, clinicians must carefully consider the indications, procedural precautions, and postoperative care for tracheostomies. We present guidelines to mitigate risk to health care workers while preserving the quality of care.