Inequities in Physical Therapy Receipt of US Service Members and Veterans with Low Back Pain.

Objective: To investigate inequities in time-to physical therapy for patients with low back pain.

Design: Retrospective observational study utilizing data from the Department of Defense and Veterans Health Administration clinical and administrative data repositories derived from medical records, claims, and enrollment data.

Setting: Military Health System, Veterans Health System, and civilian healthcare facilities.

Case Reports in the Integration of Technology with Cognitive Rehabilitation for Individuals with Memory Concerns and Their Care Partners.

Objective: Technology can be combined with psychological interventions to support older adults with memory concerns. Using a bi-phasic design, cognitive rehabilitation (CR) was integrated with off-the-shelf technology and delivered to two people with cognitive impairment, and one care partner.

Method: Pre- and post-intervention assessments were completed for all participants.

Clinical pearls for the management of duloxetine patients with medical comorbidities.

The effective use of duloxetine can be complicated by acute kidney injury, acute and/or chronic hepatic dysfunction, dysphagia, enteral nutrition, and common pharmacokinetic interactions. This article aimed to review the pharmacological properties of duloxetine pertinent to its use and to discuss the management of duloxetine in patients with common acute and chronic medical comorbidities. Management strategies based on clinical data and expert opinion are reviewed in 3 patient cases.

Perspectives on Technology Use in the Context of Caregiving for Persons With Dementia: Qualitative Interview Study.

Background: Examining ways to support persons with dementia and their caregivers to help minimize the disease's impact on individuals, families, and society is critical. One emerging avenue for support is technology (eg, smartphones and smart homes).

Objective: Given the increasing presence of technology in caregiving, it is pertinent to appreciate whether and how technology can be most useful to a care partner's everyday life.

Impact of a national dementia research consortium: The Canadian Consortium on Neurodegeneration in Aging (CCNA).

The Canadian Consortium on Neurodegeneration in Aging (CCNA) was created by the Canadian federal government through its health research funding agency, the Canadian Institutes for Health Research (CIHR), in 2014, as a response to the G7 initiative to fight dementia. Two five-year funding cycles (2014-2019; 2019-2024) have occurred following peer review, and a third cycle (Phase 3) has just begun. A unique construct was mandated, consisting of 20 national teams in Phase I and 19 teams in Phase II (with research topics spanning from basic to clinical science to health resource systems) along with cross-cutting programs to support them.

Exploring the Qualitative Experiences of Administering and Participating in Remote Research via Telephone Using the Montreal Cognitive Assessment-Blind: Cross-Sectional Study of Older Adults.

Background: The COVID-19 pandemic caused a drastic shift in the practice of research and clinical services. It has been noted that cognition measured via in-person versus remote methods differ substantially, and it is possible that subjective and experiential differences exist between modalities.

Objective: The aim of the study is to explore the perceptions of both researchers and older adult participants on the experience of remotely conducted research using a cognitive screener.

Implementation of Cognitive (Neuropsychological) Interventions for Older Adults in Clinical or Community Settings: A Scoping Review.

Despite compelling evidence that cognitive interventions for older adults improve cognition, mood, and everyday function, few are implemented in clinical or community practice. This scoping review aims to understand the implementation frameworks and methods used and their contribution to implementation success of cognitive interventions for older adults. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRISMA-ScR), and searched CINAHL, EMBASE, MEDLINE, and PSYCINFO databases, using terms related to cognitive interventions, implementation, and older adults.

Study protocol for a randomized controlled trial of neurofeedback mindfulness in chronic migraines.

Chronic migraine is a debilitating headache disorder that is associated with excessive analgesic use. As the long-term use of analgesics could cause additional headaches due to medication overuse, there is a need to probe efficient nonprophylactic alternatives and migraineurs' long-term adherence to such possible treatments. This protocol investigates the integration of neurofeedback and mindfulness which are the two common nonpharmacological therapies for migraines.

A Multi-Method Exploration of Older Adults' Technology Use During the Pandemic in Two Canadian Provinces.

The pandemic caused a rapid shift to reliance on technology to meet basic daily needs related to both health and social interaction. As social isolation is known to be a major contributing factor to physiologic decline and psychological morbidity amongst older adults, we sought to study this shift, and conducted a multi-method study including; (1) a cross-sectional telephone survey and in-depth interviews with community dwelling older adults; and (2) interviews with community organizations supporting technology use for older adults. Quantitative data were analysed using descriptive, inferential statistics; qualitative data were analyzed using thematic analysis.

Technology Use for Social Interaction Amongst Older Adults During the COVID-19 Pandemic: A Qualitative Study.

The COVID-19 pandemic had an impact on socialization across all age groups but older adults experienced additional challenges. The purpose of this study was to explore older adults' perceptions and experiences of using technology to support social interactions during the COVID-19 pandemic. We used a qualitative interpretive descriptive approach to understand community dwelling older adults' perceptions of their experiences.

Services for older adults in rural primary care memory clinic communities and surrounding areas: a qualitative descriptive study.

Background/objectives: As part of a larger study, and in collaboration with rural primary health care teams, RaDAR (Rural Dementia Action Research) primary care memory clinics have evolved and continue to spread in communities across southeast Saskatchewan, Canada. This study focuses on the geographical areas of the four communities where RaDAR memory clinics were first developed and implemented and describes the services and supports available to older adults including memory clinic patients and families living in these areas. Our goal was to identify and describe existing programs and gaps, create inventories and maps, and explore the service experiences of family caregivers of people living with dementia in these rural areas.

Effectiveness of an interprofessional assessment and management approach for people with chronic low back disorders delivered via virtual care: A randomized controlled trial pilot intervention.

Objective: Virtual care for chronic conditions has seen uptake due to COVID-19. Evaluation of virtual models is important to ensure evidence-based practice. There is a paucity of research in the use of virtual care for management of chronic back disorders.

Rural-urban differences in use of health services before and after dementia diagnosis: a retrospective cohort study.

Background: Rural-urban differences in health service use among persons with prevalent dementia are known. However, the extent of geographic differences in health service use over a long observation period, and prior to diagnosis, have not been sufficiently examined. The purpose of this study was to examine yearly rural-urban differences in the proportion of patients using health services, and the mean number of services, in the 5-year period before and 5-year period after a first diagnosis of dementia.

Comparison across age groups of causes, circumstances, and consequences of falls among individuals living in Canada: A cross-sectional analysis of participants aged 45 to 85 years from the Canadian Longitudinal Study on Aging.

Falls are a leading cause of injury-related deaths and hospitalizations among Canadians. Falls risk has been reported to be increased in individuals who are older and with certain health conditions. It is unclear whether rurality is a risk factor for falls.

Racialized and beneficiary inequities in medication to treat opioid use disorder receipt within the US Military Health System.

Background: Medication for opioid use disorder (MOUD) can be critical to managing opioid use disorder (OUD). It is unknown the extent to which US Military Health System (MHS) patients diagnosed with OUD receive MOUD.

Methods: Healthcare records of MHS-enrolled active duty and retired service members (N = 13,334) with a new (index) OUD diagnosis were included between 2018 and 2021, without 90-day pre-index MOUD receipt were included.

Protocol for validating an algorithm to identify neurocognitive disorders in Canadian Longitudinal Study on Aging participants: an observational study.

Introduction: In population-based research, disease ascertainment algorithms can be as accurate as, and less costly than, performing supplementary clinical examinations on selected participants to confirm a diagnosis of a neurocognitive disorder (NCD), but they require cohort-specific validation. To optimise the use of the Canadian Longitudinal Study on Aging (CLSA) to understand the epidemiology and burden of NCDs, the CLSA Memory Study will validate an NCD ascertainment algorithm to identify CLSA participants with these disorders using routinely acquired study data.

Methods And Analysis: Up to 600 CLSA participants with equal numbers of those likely to have no NCD, mild NCD or major NCD based on prior self-reported physician diagnosis of a memory problem or dementia, medication consumption (ie, cholinesterase inhibitors, memantine) and/or self-reported function will be recruited during the follow-up 3 CLSA evaluations (started August 2021).

Aboriginal children with cancer: The patient and healthcare worker perspective.

There are inequitable health outcomes for Aboriginal children with cancer. A quality improvement audit performed at our institution through interviews with families and healthcare workers has highlighted individual, systematic and cultural barriers to equitable and culturally safe healthcare for Aboriginal patients, in addition to facilitators and recommendations for improvements.

Cognitive impairment indicator for the neuropsychological test batteries in the Canadian Longitudinal Study on Aging: definition and evidence for validity.

Background: Prevalence of overall cognitive impairment based on each participant's performance across a neuropsychological battery is challenging; consequently, we define and validate a dichotomous cognitive impairment/no cognitive indicator (CII) using a neuropsychological battery administered in a population-based study. This CII approximates the clinical practice of interpretation across a neuropsychological battery and can be applied to any neuropsychological dataset.

Methods: Using data from participants aged 45-85 in the Canadian Longitudinal Study on Aging receiving a telephone-administered neuropsychological battery (Tracking, N = 21,241) or a longer in-person battery (Comprehensive, N = 30,097), impairment was determined for each neuropsychological test based on comparison with normative data.

Virtual Dementia-Friendly Communities (Verily Connect) Stepped-Wedge Cluster-Randomised Controlled Trial: Improving Dementia Caregiver Wellbeing in Rural Australia.

Caring for people living with dementia often leads to social isolation and decreased support for caregivers. This study investigated the effect of a Virtual Dementia-Friendly Rural Communities (Verily Connect) model on social support and demand for caregivers of people living with dementia. The co-designed intervention entailed an integrated website and mobile application, peer-support videoconference, and technology learning hubs.

Does social connection mediate the association between neuroticism and cognition? Cross-sectional analysis of the Canadian Longitudinal Study on Aging.

Objectives: This study tested the association between neuroticism and six cognitive measures, and examined the potential mediating roles of social connection (social isolation and loneliness) among middle-aged and older adults.

Methods: This cross-sectional study was a secondary analysis of the Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort, a sample of Canadians aged 45-85 years at baseline. Respondents with data collected at the first follow-up, between 2015 and 2018, were included ( = 27,765).

Utilization of Health Services Before and After Diagnosis in a Specialist Rural and Remote Memory Clinic.

Background: Limited research exists on the use of specific health services over an extended time among rural persons with dementia. The study objective was to examine health service use over a 10-year period, five years before until five years after diagnosis in the specialist Rural and Remote Memory Clinic (RRMC).

Methods: Clinical and administrative health data of RRMC patients were linked.