Chronic pain impacts individuals with pain as well as their loved ones. Yet, there has been little attention to the social context in individual psychological treatment approaches to chronic pain management. With this need in mind, we developed a couple-based treatment, "Mindful Living and Relating," aimed at alleviating pain and suffering by promoting couples' psychological and relational flexibility skills. Currently, there is no integrative treatment that fully harnesses the power of the couple, treating both the individual with chronic pain and the spouse as two individuals who are in need of developing greater psychological and relational flexibility to improve their own and their partners' health. Mindfulness, acceptance, and values-based action exercises were used to promote psychological flexibility. The intervention also targets relational flexibility, which we define as the ability to interact with one's partner, fully attending to the present moment, and responding empathically in a way that serves one's own and one's partner's values. To this end, the intervention also included exercises aimed at applying psychological flexibility skills to social interactions as well as emotional disclosure and empathic responding exercises to enhance relational flexibility. The case presented demonstrates that healthy coping with pain and stress may be most successful and sustainable when one is involved in a supportive relationship with someone who also practices psychological flexibility skills and when both partners use relational flexibility skills during their interactions.

It is unclear how age affects rates and causes of unplanned early readmissions after percutaneous coronary intervention (PCI). We analyzed patients in the Nationwide Readmission Database in the United States from 2010 to 2014 and examined the impact of age on readmissions after PCI. The primary outcomes were age-specific 30-day rates and causes of unplanned readmissions. A total of 2,294,345 procedures were analyzed with a 9.6% unplanned readmission rate within 30 days. Unplanned readmissions were 8.1%, 8.1%, 9.5%, and 12.6% for age groups <55, 55.0 to 64.9, 65.0-74.9, and ≥75 years, respectively. With increasing age, there was an increase in the rate of noncardiac causes for readmissions (for ages <55, 55.0 to 64.9, and ≥75 years, the rates were 54.1%, 54.8%, 56.6%, and 57.1%, respectively; p <0.001). Older age was associated with an increased prevalence of infections (13.9% ≥75 years vs 7.7% <55 years), gastrointestinal disease (11.5% ≥75 years vs 9.5% <55 years), and bleeding (7.4% ≥75 years vs 2.9% <55 years) as causes for noncardiac readmissions and a reduced prevalence of nonspecific chest pain (9.9% ≥75 years vs 31.4% <55 years). For cardiac causes, older age was associated with increased prevalence for readmissions due to heart failure (34.6% ≥75 years vs 11.9% <55 years) but a reduced prevalence of coronary artery disease, including angina (25.7% ≥75 years vs 51.3% <55 years). In conclusion, older patients have the highest rates of unplanned 30-day readmissions after PCI, with different causes for readmission compared with younger patients. Interventions designed to reduce readmissions after PCI should be age specific.

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The aim of this study was to compare gluteus maximus-to-hamstring (GM:H) co-activation, hamstrings-to-quadriceps (H:Q) co-activation, and mean muscle activity in the vastus lateralis (VL), vastus medialis (VM), rectus femoris (RM), gluteus maximus (GM), semitendinosus (ST), and bicep femoris (BF) muscles across a range of training loads (40%, 50%, 50%, 70%, 80% 90% 1RM) of the barbell back squat in resistance trained females. Surface electromyography (EMG) was observed in 18 healthy resistance trained females for the VL, VM, RM, GM, ST, and BF during the ascending and descending phase of the back squat. During the ascending phase, the VL, VM, RM, GM, ST, and BF displayed significantly more EMG activation at 90% 1RM compared to 40%-70% (p < .03). During the descending phase, there were no significant differences displayed in mean muscle activity at 40%-80% of 1RM compared to 90% of 1RM. There were no significant differences in H-Q co-activation and GM-H co-activation during the ascending or descending phase across external loads. These findings are similar to the results found in similar studies using male participants and support that higher training intensities (80%-90% 1RM) of the barbell back squat significantly activate muscles surrounding the hip compared to lower loads (40%-70%). The results of this study also suggest that training intensities of 80% 1RM and 90% 1RM elicits the similar musculature activation in the muscle surrounding the hip in resistance trained females. Highlights. During the back squat, mean muscle activity of the hip and leg muscles increased linearly with exercise intensity (40%-90% of one-repetition max) in resistance trained females. . No significant difference in mean activity were noted between 80% and 90% of one-repetition max during the ascending and descending phases. . During the ascending phase, 80% of one-repetition max generated the highest gluteus maximus to hamstring activity co-activation ratio. . During the descending phase, 40% of one-repetition max produced a gluteus maximus to hamstring activity co-activation ratio closest to 1.0.