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The US has lost its lead position in satellite technology to Japan, which has successfully planned and developed the aerospace industry and maintained international systems. The US's Milstar is a tri-service communications system, used as a Military Satellite Communications system to provide the military with strategic and tactical data. The success of the Milstar program has revealed that the communications satellite industry's vital growth areas includes broadcast, mobile and personal communications systems.

Introduction: Vertebral fractures are the most prevalent fractures among individuals living with osteoporosis, affecting at least 20% of the older population. Our objective was to understand health care professionals' (HCPs) experiences and perceptions of post-vertebral fracture rehabilitation, use of non-pharmacological strategies, and virtual rehabilitation. Methods: We performed a thematic and content analysis of semi-structured interviews that were conducted over web conference/telephone with HCPs within Canada. Criterion, purposeful, and snowball sampling was used to recruit HCPs that have experience treating patients with osteoporotic vertebral fractures. Questions for the interview guide were centred on current practices, non-pharmacological treatments, and virtual rehabilitation. Results: 13 HCPs (7F, 6M, aged 46 ± 12 years) were interviewed. Two major themes emerged from our interviews: (1) rehabilitation of vertebral fractures is dependent on the acuity of fracture, and (2) care gaps in referral and access to rehabilitation. Early rehabilitation interventions included pain and osteoporosis medicine, education on harmful and high-risk movements, and non-pharmacological strategies to help reduce patient pain and increase early mobilization. Rehabilitation in the chronic stage of vertebral fractures incorporated more exercise-based strategies to help increase strength, mobility and functionality and was informed by a comprehensive assessment. Regardless of the stage of recovery, barriers such as delayed identification of fracture, delayed or no referral to physiotherapy, and lack of knowledge of osteoporosis or vertebral fracture among HCPs may reduce the access to or effectiveness of non-pharmacological interventions. HCPs believed that virtual rehabilitation that includes an online educational component, an online assessment, and online exercise classes in groups tailored to individuals could be a feasible alternative. Conclusion: We have identified that rehabilitation provided by HCPs was dependent on the acuity or stability of fracture, and that non-pharmacological interventions were facilitated by physiotherapy. To select and individualize physical therapy interventions, physiotherapists emphasized using assessments to determine patient goals, physical functioning, and identify comorbidities. To improve access and address barriers, virtual rehabilitation could be a feasible and effective alternative for patients but may require further evaluation. [ABSTRACT FROM AUTHOR]

Purpose: To understand experiences and perceptions on non-pharmacological treatment of vertebral fractures and virtual-care from the perspective of care professionals' (HCPs)., Design and Setting: We conducted semi-structured interviews with 13 HCPs within Canada (7 F, 6 M, aged 46 ± 12 years) and performed a thematic and content analysis from a post-positivism perspective., Results: Two themes were identified: acuity matters when selecting appropriate interventions; and roadblocks to receiving non-pharmacological interventions. We found that treatment options were dependent on the acuity/stability of fracture and were individualized accordingly. Pain medication was perceived as important, but non-pharmacological strategies were also considered helpful in supporting recovery. Participants discussed barriers related to the timely identification of fracture, referral to physiotherapy, and lack of knowledge among HCPs on how to manage osteoporosis and vertebral fractures. HCPs reported positive use of virtual-care, but had concerns related to patient access, cost, and comprehensive assessments., Conclusion: HCPs used and perceived non-pharmacological interventions as helpful and selected specific treatments based on the recency of fracture and patient symptoms. HCPs' also believed that virtual-care that included an educational component, an assessment by a physiotherapist, and an exercise group was a feasible alternative, but concerns exist and may require further evaluation.

Objective: This project aimed to develop a virtual intervention for vertebral fractures (VIVA) to implement the international recommendations for the nonpharmacological management of osteoporotic vertebral fractures and to test its acceptability and usability., Methods: VIVA was developed in accordance with integrated knowledge translation principles and was informed by the Behavioral Change Wheel, the Theoretical Domains Framework, and the affordability, practicability, effectiveness and cost-effectiveness, acceptability, side effects/safety, and equity (APEASE) criteria. The development of the prototype of VIVA involved 3 steps: understanding target behaviors, identifying intervention options, and identifying content and implementation options. The VIVA prototype was delivered to 9 participants to assess its acceptability and usability., Results: VIVA includes 7 1-on-1 virtual sessions delivered by a physical therapist over 5 weeks. Each session lasts 45 minutes and is divided in 3 parts: education, training, and behavioral support/goal setting. Four main themes emerged from the acceptability evaluation: perceived improvements in pain, increased self-confidence, satisfaction with 1-on-1 sessions and resources, and ease of use. All of the participants believed that VIVA was very useful and were very satisfied with the 1-on-1 sessions. Four participants found the information received very easy to practice, 4 found it easy to practice, and 1 found it somewhat difficult to practice. Five participants were satisfied with the supporting resources, and 4 were very satisfied. Potential for statistically significant improvements was observed in participants' ability to make concrete plans about when, how, where, and how often to exercise., Conclusion: VIVA was acceptable and usable to the participants, who perceived improvements in pain and self-confidence., Impact: The virtual implementation of the recommendations for the nonpharmacological management of vertebral fractures showed high acceptability and usability. Future trials will implement the recommendations on a larger scale to evaluate their effectiveness., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objective: To understand perceptions on rehabilitation after vertebral fracture, non-pharmacological strategies, and virtual care from the perspective of individuals living with vertebral fractures., Design and Setting: We conducted semi-structured interviews online and performed a thematic and content analysis from a post-positivism perspective., Participants: Ten individuals living with osteoporotic vertebral fractures (9F, 1 M, aged 71  ±  8 years)., Results: Five themes emerged: pain is the defining limitation of vertebral fracture recovery; delayed diagnosis impacts recovery trajectory; living with fear; being dissatisfied with fracture management; and "getting back into the game of life" using non-pharmacological strategies., Conclusion: Participants reported back pain and an inability to perform activities of daily living, affecting psychological and social well-being. Physiotherapy, education, and exercise were considered helpful and important to patients; however, issues with fracture identification and referral limited the use of these options. Participants believed that virtual rehabilitation was a feasible and effective alternative to in-person care, but perceived experience with technology, cost, and individualization of programs as barriers.

The importance of online learning tools has grown significantly, especially in the field of anatomy which relies heavily on in-person laboratories. To support anatomy learners in remote and in-person contexts, we created an online library of 45 digital three-dimensional cadaveric models matching specimens in Grant's Atlas of Anatomy and Museum., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s) under exclusive licence to International Association of Medical Science Educators 2022.)

Background: Regular exercise is advocated in osteoporosis guidelines to prevent fractures. Few studies have evaluated the effect of exercise on functional performance, posture, and other outcomes that are important to patients after vertebral fractures., Objective: This pilot study will explore the effect of home exercise versus control on functional performance, posture, and patient-reported outcome measures., Design: This study was a parallel 2-arm pilot feasibility trial with 1:1 randomization to exercise or attentional control groups., Setting: This study took place in 5 Canadian and 2 Australian academic or community hospitals/centers., Participants: This study included 141 women ≥65 years of age with radiographically confirmed vertebral fractures., Intervention: A physical therapist delivered exercise and behavioral counseling in 6 home visits over 8 months and monthly calls. Participants were to exercise ≥3 times weekly. Controls received equal attention., Measurements: Functional performance, posture, quality of life, pain, and behavior-change outcomes were assessed at baseline and after 6 (questionnaires only) and 12 months. Adherence to exercise was assessed by calendar diary. All t tests examined between-group mean differences (MD) in change from baseline in intention-to-treat and per-protocol analyses., Results: There was a small effect of exercise on 5 times sit-to-stand test versus control (MD = -1.58 [95% CI = -3.09 to -0.07], intention-to-treat; MD = -1.49 [95% CI = -3.12 to 0.16], per-protocol). There were no other major or statistically significant MDs for any other measured outcomes after follow-up. Adherence declined over time., Limitations: Treatment effects on variables may have been underestimated due to multiple comparisons and underpowered analyses., Conclusions: Our exploratory estimate of the effect of exercise on functional leg muscle strength was consistent in direction and magnitude with other trials in individuals with vertebral fractures. Declining adherence to home exercise suggests that strategies to enhance long-term adherence might be important in future confirmatory trials., (© 2020 American Physical Therapy Association.)