Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care settings or home. A patient centered transitional care program was implemented at an outpatient primary care facility to reduce readmission rates. Institutional Review Board approval was obtained.

Twenty adult patients with chronic diseases discharged from an acute setting were identified. A follow up phone call and/or a home visit within 24-72 hours post discharge was employed. The Care Transitions Measure (CTM®) and Medication Discrepancy Tool (MDT®) were utilized to identify quality of care of transition and medication discrepancies. A chart audit collected data on the age of participant, diagnosis for initial hospitalization, CTM score, home visit, and ED visits or re-hospitalizations after 30 days of discharge. The outcome indicated that transitional care within primary care utilizing evidence-based practices is beneficial in reducing readmission rates. A logistic regression showed model significance, p = .002, suggesting that the CTM score was effective for both telephone support (TS) and home visit (HV).

A correlation analysis showed that as age of participants increased, the CTM score decreased, indicating that older adults required more support. A significance p <.001, of a proportional test indicated that readmission rates after the intervention was lower. It is evident that providing a timely and effective transitional care intervention in a primary care setting can reduce hospital readmissions, improve symptom management and quality of life of adult patients with chronic diseases.

Survivors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) often experience chronic symptoms that include fatigue, shortness of breath, and brain fog. The collection of ongoing post-COVID-19 symptoms have been classified as Post-Acute Sequela of SARS-CoV-2 (PASC). Older adult patients are especially susceptible to experiencing PASC related complications and have a high risk for long-term cognitive impairment symptoms. Definitions for categorizing PASC- associated cognitive impairment and neuropsychological assessments used to evaluate cognitive impairment are inconsistent between studies examining older adults. This systematic review aims to identify which neuropsychological tests best identify cognitive impairments associated with PASC and suggest a guide to standardize the measurement of PASC-related cognitive impairments. Through a literature search using PubMed, we included within this review 14 studies that fulfilled our inclusion and exclusion criteria evaluating middle-aged and older adult populations affected by PASC-associated cognitive impairments. The majority of the studies used tests designed to screen for general cognitive function to test for the prevalence of cognitive impairment, with the most common one being Montreal Cognitive Assessment (MoCA), followed by MMSE and TICS. MoCA reported the highest prevalence of the general cognitive screeners which suggests higher sensitivity and specificity. Telephone Interview for Cognitive Status (TICS) demonstrated similar scores as MoCA despite administration being remote while MMSE identified the lowest prevalence. Four studies also used domain-specific cognitive evaluations and reported instances of cognitive impairment in individuals who had previously tested healthy. Furthermore, the results gathered in this review were stratified based on disease symptom severity. This review identifies MoCA to be better suited for evaluating general cognitive impairment in older adults. TICS has the added utility in being able to access a wider range of older adults through remote screening. Disease severity must be clearly defined to allow better comparisons between studies and allow for standardization. Early identification of PASC-associated cognitive impairment in middle-aged and older adults can be performed using general cognitive function evaluations and administering a baseline cognitive evaluation one month after infection is suggested.

This honors thesis explores the potential use of LoRa technology for detecting moisture in a diaper. Tests of both onboard and external humidity sensors coupled with LoRa transmission are incredibly promising. The potential scale of the final device also shows much promise, measuring smaller than a U.S. dime. However, the estimated cost for producing these proof-of-concept units in bulk is $19.41 per unit. While this is believed to be a pessimistic estimate of the price, the cost of production remains too high regardless for large-scale implementation. The thesis concludes by emphasizing the need for further research and development to optimize the design and reduce the cost of production. Despite the limitations imposed by price, the idea of using LoRa in detecting moisture in a diaper remains intriguing and promising, however, RFID technology has many advantages, such as size, cost, and passive power features.

Elective cosmetic surgery has grown more popular in the last several decades, including procedures specifically targeted at older adults and anti-aging. The aim of this study is to better understand elective cosmetic surgery rationale for older adults. The first part of the study summarizes literature on elective cosmetic surgery for older adults and determines what factors influence the desire for elective cosmetic procedures. From the research databases PubMed, JSTOR, and ScienceDirect, eighteen sources were referenced in the final review. The review found that there are differences in sociocultural views of men and women as they age as well as internal views of aging. The modest number of studies used in the literature review reflect a current gap in current research studying elective cosmetic surgery in older adults. For the second part of the study, data was collected from a 2018 survey designed to better understand aging, body image, and subjective age. The survey was limited to individuals living in the United States aged 40 and above and was deployed through MTurk (Mechanical Turk). A total of 1199 responses were received. Only participants 55 years and above are included for the purpose of this study. Most participants who answered the question for elective cosmetic surgery rationale answered that their primary rationale is to reduce age-related physical markers. For participants identifying as female, nine percent cited self-esteem as their rationale while no male-identifying participants responded similarly. Future research can include questions on internal and external factors older adults feel have the greatest impact on their decision to have elective cosmetic procedures.