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Introduction: Providing integrated and evidence-based support to individuals and families following a diagnosis of dementia is essential in order to optimise their quality of life and assist them to live well. Memory clinics provide multidisciplinary services specialising in the assessment and post-diagnostic treatment of people with dementia. This study sought to identify current practices, barriers and facilitators to provision of postdiagnostic support and to obtain health professionals' opinion of ideal post-diagnostic support to be offered in Australian memory clinics. Methodology: This was a cross-sectional qualitative exploratory study. Data was collected from health professionals familiar with the process of diagnosis and post-diagnostic support through two expert panel meetings (n = 22). In addition, 5 focus groups (n = 22) were conducted including health professionals who are employed in Australian memory clinics. Data was collected between October 2020 and November 2021. Reflexive thematic analysis was undertaken. Results: Seven themes and three subthemes were identified under the three topics: Current Practices, Barriers and Facilitators, and Desirable Support. Themes relating to Current Practices were: Tailored Communication and feedback about diagnosis; Prescription of medications and follow-up; and Referrals to health and community services. Themes relating to Barriers and Facilitators were: The structure of the current system; Lack of funding; Lack of resources; Call for government investment. Themes relating to Desirable support were: A key/single point of support; Cognitive interventions; and Counselling and education. Conclusion: Post-diagnostic support in Australian memory clinics focused primarily on ensuring people understood their diagnosis, information about postdiagnostic support was provided, and dementia medications were prescribed. There were notable differences in practices in metropolitan compared to regional areas. A key concern was the need for increased funding, particularly to support the establishment of a single point of contact to facilitate continuity of care. [ABSTRACT FROM AUTHOR]

Interprofessional education (IPE) is recognized as a critical component in preparing students for effective interprofessional practice in health care. IPE is supported by the American Speech-Language-Hearing Association and students' competence in interprofessional practice is expected by clinical supervisors for effective work in any setting, whether that setting is medically or educationally oriented. IPE thus needs to be integrated into the curriculum of academic programs in Communication Sciences and Disorders and supported by clinicians in the field. This short tutorial is designed to acquaint readers with the concept of IPE, the collaborative competencies that students develop, available learning models, the importance of measuring the effectiveness of any interprofessional intervention, and ongoing challenges that need to be addressed to facilitate the implementation of this valuable learning strategy.

Objective: The online program began in 2012 to support aged care workers without a tertiary education or vocational qualification. This paper documents changes in the student profile since initiation of the program, and how the program may support recommendations of the Royal Commission into Aged Care Quality and Safety and engage other educators, providers and policymakers. Methods: Four hundred and seventy‐one commencing undergraduate students completed a 16‐item online survey in 2017 to document demographics and reasons for study. Categorical associations were assessed with univariate logistic regression in R v3.6. Results: Most students (71%; 336) were aged between 41 and 60 years but the program now included younger (<41 years) and older (>80 years) people. Unlike the 2012 students, about 41% had tertiary‐level qualifications, and 56% were employed in professional positions, including registered nurse, general practitioner and allied health professional. Professional and practice development was the primary reason for study; significantly so for younger (<41 years) participants in aged and dementia care (χ2 (5) = 18.15, p = 0.003) and for those with previous university experience (χ2 (4) = 22.17, p = 0.001). Older (≥61 years) participants enrolled to gain greater knowledge about dementia (χ2 (4) = 17.60, p = 0.002). Conclusions: Understanding the changed student profile guided program refinement to ensure the provision of effective, evidence‐based education in dementia understanding and care. Work now focusses on increasing partnerships with aged care organisations, community and postsecondary training institutions to support a continuum of workforce development options, guided by the recommendations of the Royal Commission. [ABSTRACT FROM AUTHOR]

Background: The oral health of many older Australians is poor and associated with many systemic health problems. However, nurses often have a limited understanding of the importance of oral healthcare for older people. This study aimed to investigate Australian nursing students' perception, knowledge, and attitude toward providing oral healthcare for older people and associated factors. Methods: A cross-sectional study was conducted among final year nursing students studying at accredited nursing programs using an online self-reported 49-item survey. The data were analysed using univariate and bivariate analysis (t-test, ANOVA, Spearman's correlation test). Results: A total of 416 final-year nursing students from 16 accredited programs in Australia completed the survey. Mean scores showed that more than half of the participants felt they lacked confidence (55%, n = 229) and had limited knowledge about oral healthcare for older people (73%, n = 304); however, their attitude towards providing such care was favourable (89%, n = 369). A positive correlation was found between students' confidence in delivering oral healthcare to older people and their perceived knowledge (r = 0.13, p < 0.01). Results revealed a statistically significant positive association between students' experience in providing oral healthcare to older people and students' perception (t = 4.52, p < 0.001), knowledge (t = 2.87, p < 0.01), and attitude (t = 2.65, p < 0.01) mean scores in such care. Nearly 60% (n = 242) of participants received education/training in oral healthcare for older people at university, but this was often for less than one hour. Around 56% (n = 233) believed that the current nursing curriculum did not prepare them to provide effective oral healthcare to older people. Conclusion: Findings suggested a need for nursing curricula to be revised to include oral health education and clinical experience. Knowledge of evidence-based oral healthcare by nursing students may improve the quality of oral healthcare for older people. [ABSTRACT FROM AUTHOR]

The health care needs of older adults can be complex and multifaceted. Safe, effective, equitable, and person-centered service provision relies on skilled interprofessional, team-based practice. Too often, students seeking a career specializing in gerontology are not exposed to such interprofessional, team-based learning and practice during their coursework. This article details the core interprofessional collaborative competencies that need to be an integral component of any program providing quality education on issues in aging. (Contains 2 tables.)

A national (USA) student-led, case-based CLinician/Administrator Relationship Improvement OrganizatioN (CLARION) competition focuses students in medical and related healthcare programs on the provision of healthcare that is safe, timely, equitable, patient-centred, effective and efficient. Students work in four-person, inter-professional teams to research and analyse a designated case. They then present their findings and recommendations to a panel of independent judges. Students, with support from their faculty advisors, approach the case as they see fit. Following initial participation in this CLARION competition, an inter-professional team of students from two universities and their advisory faculty developed a two-semester, pre-competition course as a model to facilitate transformation in healthcare education. The course is theoretical, empirical and practical. It has multiple levels of learning and is designed to mentor students, develop faculty, measure learning outcomes and stimulate administrators in higher education to think creatively about curriculum development across disciplines. This integrated and inter-professional approach is pivotal in healthcare education to ensure students learn safe and evidence-based clinical practice that meets the highest standards for quality care. (Contains 1 figure.)

The effectiveness of teaching is expected by an increasingly skeptical public that wants those in higher education to contain costs, increase access, and teach in ways that make sure students learn. An integral and under-used component of documenting teaching effectiveness is peer review. A framework for best practice to ensure a systematic and comprehensive approach to any peer review has been developed and a foundational aspect of this framework is education about the process and its implementation. In the current pilot study, administrators and non-administrators involved in university teaching were surveyed about their knowledge of, and experiences with, peer review. A striking finding was the notable degree of uncertainty about many components of the process on the part of non-administrators. Results verify the critical importance of education prior to and following any peer review, particularly for instructors in non-administrative positions. (Contains 7 tables.)

Methamphetamine (meth) exposure during fetal development has the potential to adversely affect the development of multiple organ systems. An interdisciplinary case study of a 4-year 11-month-old child born to a mother addicted to meth revealed significant cognitive and communicative delays. Possible meth-related consequences for these delays included stroke in utero with associated hemiparesis and epilepsy, congenital eye dysfunction, recurrent middle ear infections, attention-deficit/hyperactivity disorder (ADHD), social adjustment problems, and parental neglect. An important additional finding was the child's nondietary iron deficiency anemia, which could contribute to or compound meth-related behavioral problems. The influence of chronic iron deficiency anemia on cognitive-communicative function speaks to the importance of including dietitians in the interdisciplinary team assessment of children exposed to meth. (Contains 4 tables.)

In today's increasingly multicultural society, students need to be prepared for the work world they will encounter. Well-developed critical thinking skills appear essential to needed cultural competence. With its focus on community involvement, deep reflection and civic engagement, the possibility that Service-Learning (SL) could improve students' critical thinking abilities, and thus contribute to students' intellectual development and cultural competence, was explored. The critical thinking abilities of a group of 4th and 5th year university students were measured before and after 12 weeks of community-based experiences. The 4th year students were involved in an integrated SL course. The 5th year students had completed the SL course the previous year. There was a significant difference between the two groups with the 5th year students better able to think critically, particularly in deducing conclusions and evaluating arguments. Both quantitative and qualitative data from the two groups revealed a non-linear developmental trajectory of skills that provide insights for professionals in higher education. (Contains 1 table and 1 figure.)

Service-learning (SL) is a relatively new pedagogical approach to facilitate student learning at the university level. In SL, students enrolled in an academic course provide a needed service to a community partner. Through guided reflection, students link classroom-based, theoretical knowledge with clinical applications. Students' active engagement in learning facilitates thinking critically, questioning assumptions, considering varying perspectives, and appreciating the civic purpose of their profession. This article describes three SL applications, in dysphagia, educational audiology, and augmentative and alternative communication. We explain the rationale for each, along with ways in which to measure the effects of SL on student learning.

A 25-item survey was administered to 45 teachers to identify what they knew about Minimal Hearing Loss (MHL) and to verify or refute five possible misperceptions reported earlier by Goldberg and McCormick Richburg (2004). Results support the importance of an educational audiologist on the service delivery team to help teachers understand the ramifications of MHL and assist in meeting the educational and psychosocial needs of students with this type of loss. Results also suggest areas for in-service education for classroom teachers, especially regarding the issue of preferential seating.

This article addresses five commonly stated misperceptions concerning the effects of minimal hearing loss on the education of children. Helping educators and other professionals recognize these and other possible misperceptions is the first step in appropriately educating children with minimal hearing loss. Making educators and other professionals aware of the need for proper diagnoses and management strategies is crucial for the achievement of effective educational outcomes for these children. Furthermore, resolving these misperceptions will assist in reducing the financial and psychosocial costs frequently associated with the education of these children.

A review of current American Speech-Language-Hearing Association policies for the appropriate use and supervision of speech-language pathology assistants focuses on the importance of preserving the role of fully qualified speech-language pathologists. Seven issues are identified including registering assistants and approving training programs and discrepancies between state requirements and ASHA policies. Establishment of a National Leadership Council is proposed. (Contains references.) (Author/DB)

Keywords: esophageal dysphagia, pharmacologic, nonpharmacologic treatment Purpose: This case study illustrates the role speech-language pathologists (SLPs) can play in the treatment of older adults with diffuse esophageal spasm (DES), a [...]

Background aspiration pneumonia increases hospitalisation and mortality of older people in residential aged care. Objectives determine potentially pathogenic microorganisms in oral specimens of older people with aspiration pneumonia and the effect of professional oral care in reducing aspiration pneumonia risk. Data Sources PUBMED/MEDLINE, CINAHL, EMBASE, COCHRANE, PROQUEST, Google Scholar, Web of Science. Study Eligibility Criteria published between January 2001 and December 2019 addressing oral microorganisms, aspiration pneumonia, oral health and treatment. Participants people 60 years and older in residential aged care. Study Appraisal and Synthesis Methods the Newcastle–Ottawa Scale and the Standard Protocol Items: Recommendations for Intervention Trials checklist. Results twelve studies (four cross-sectional, five cohort and three intervention) reported colonisation of the oral cavity of older people by microorganisms commonly associated with respiratory infections. Aspiration pneumonia occurred less in people who received professional oral care compared with no such care. Isolation of Candida albicans , Staphylococcus aureus , methicillin-resistant S. aureus and Pseudomonas aeruginosa was related to mortality due to aspiration pneumonia. An interesting finding was isolation of Escherichia coli, a gut bacterium. Limitations more information may be present in publications about other co-morbidities that did not meet inclusion criteria. A high degree of heterogeneity prevented a meta-analysis. Issues included sampling size, no power and effect size calculations; different oral health assessments; how oral specimens were analysed and how aspiration pneumonia was diagnosed. Conclusions and Implications of Key Findings pathogenic microorganisms colonising the oral microbiome are associated with aspiration pneumonia in older people in residential care; professional oral hygiene care is useful in reducing aspiration pneumonia risk. [ABSTRACT FROM AUTHOR]

Objective: To describe the characteristics of hospital admissions for dental conditions, by Australian Statistical Geography Standard remoteness area for the 5 years 2010/2011 to 2014/2015. Design: Retrospective analysis of preventable hospital admissions due to dental conditions. Setting: National data set provided by the Australian Institute of Health and Welfare. Participants: Every hospital admission for patients who were admitted for dental conditions over five financial years, from 2010/2011 to 2014/2015. Main outcome measures: The number (and rate per 1000 population) of hospital admissions due to dental conditions in each Australian Statistical Geography Standard remoteness area (major city, inner regional, outer regional, remote and very remote). Results: There were 316 937 hospital admissions for dental conditions over the 5‐year period. The rate of potentially preventable dental hospital admissions ranged from an average of 2.5 per 1000 population in major cities to 3.2 in inner regional areas, 3.1 in outer regional areas, and 4.1 per 1000 in remote and very remote areas. The rate of admissions was highest among those aged 0‐14 years living in remote (9.0‐10.0 per 1000) and very remote (9.8‐12.5 per 1000) areas. Dental caries was the most common reason for admissions. Conclusions: There is an urgent need to address the social determinants of oral health in children aged 0‐14 years living in remote and very remote Australia. The delivery of mobile primary dental care services needs to be expanded in remote and very remote areas to prevent and treat dental caries. [ABSTRACT FROM AUTHOR]

Background: The completion rates for Massive Open Online Courses (MOOCs) generally are low (5-10%) and have been reported to favour participants with higher (typically tertiary-level) education. Despite these factors, the flexible learning offered by a MOOC has the potential to provide an accessible educational environment for a broad spectrum of participants. In this regard, the Wicking Dementia Research and Education Centre has developed a MOOC on dementia that is evidence-based and intended to address this emerging major global public health issue by providing educational resources to a broad range of caregivers, people with dementia, and health care professionals. Methods: The Understanding Dementia MOOC was designed specifically to appeal to, and support, adult learners with a limited educational background. The nine-week course was presented in three units. Participants passed a quiz at the end of each unit to continue through the course. A series of discussion boards facilitated peer-to-peer interactions. A separate "Ask an Expert" discussion board also was established for each unit where participants posted questions and faculty with expertise in the area responded. Results: Almost 10,000 people from 65 countries registered; 4,409 registrants engaged in the discussion boards, and 3,624 (38%) completed the course. Participants' level of education ranged from postgraduate study to a primary (elementary) school education. Participants without a university education (vocational certificate and below) were as likely as those with a university education to complete the course (χ2 = 2.35, df = 6, p = 0.88) and to engage in the online discussions (F[6, 3799] = 0.85, p = 0.54). Further, participants who completed the MOOC engaged in significantly more discussion board posts than participants who did not complete the course (t = 39.60, df = 4407, p <0.001). Conclusions: The high completion rate and level of engagement of participants across a broad spectrum of levels of education suggest that MOOCs can be successfully developed and delivered to students from diverse educational backgrounds. The high participation rate also highlights the combination of MOOC design as well as the scale of unmet need for quality dementia education. [ABSTRACT FROM AUTHOR]

Background: The most important and contested element of nursing identity may be the patient-centredness of nursing, though this concept is not well-treated in the nursing identity literature. More conceptually-based mapping of nursing identity constructs are needed to help nurses shape their identity. The field of computational text analytics offers new opportunities to scrutinise how growing disciplines such as health services research construct nursing identity. This paper maps the conceptual content of scholarly health services research in PubMed as it relates to the patient-centeredness of nursing. Methods: Computational text analytics software was used to analyse all health services abstracts in the database PubMed since 1986. Abstracts were treated as indicative of the content of health services research. The database PubMed was searched for all research papers using the term "service" or "services" in the abstract or keywords for the period 01/01/1986 to 30/06/2013. A total of 234,926 abstracts were obtained. Leximancer software was used in 1) mapping of 4,144,458 instances of 107 concepts; 2) analysis of 106 paired concept co-occurrences for the nursing concept; and 3) sentiment analysis of the nursing concept versus patient, family and community concepts, and clinical concepts. Results: Nursing is constructed within quality assurance or service implementation or workforce development concepts. It is relatively disconnected from patient, family or community care concepts. Conclusions: For those who agree that patient-centredness should be a part of nursing identity in practice, this study suggests that there is a need for development of health services research into both the nature of the caring construct in nursing identity and its expression in practice. More fundamentally, the study raises questions about whether health services research cultures even value the politically popular idea of nurses as patient-centred caregivers and whether they should. [ABSTRACT FROM AUTHOR]

Advocates of the Scholarship of Teaching and Learning (SoTL) argue that teaching and learning must be student-centered, experiential, collaborative, and interprofessional. Researchers must collect data on the outcomes of such learning systematically and disseminate it. This careful approach to documenting student learning and effective teaching facilitates public recognition of the scholarship involved in teaching and learning. Faculty and students can participate in the national, interprofessional, case-based CLinician/Administrator Relationship Improvement OrganizatioN (CLARION) competition in order to implement SoTL. In this paper, we describe the CLARION experience, present examples of the qualitative and quantitative data researchers can compile to document student learning, and show how participation in such an experience can result in additional collaborative and interprofessional activities for students and faculty. [ABSTRACT FROM AUTHOR]

This report describes the outcomes of a five-day, protocol-based interprofessional education (IPE) initiative to prepare undergraduate medical, nursing, and paramedic students for collaborative work with adults with dementia. Clinical placements provided a structured and supervised IPE experience for 127 students in two Residential Aged Care Facilities (RACFs) in Hobart, Australia, during 2013 and 2014. The IPE activity was based on a seven-step protocol formulated by an interprofessional team of educators and aged care practitioners that revolved around collaborative assessments of adults with complex health needs. This article describes the IPE protocol and presents the results of a pre- and post-placement attitude questionnaire and knowledge quiz administered to evaluate student attitudes towards IPE and knowledge of dementia. Data suggest that a five-day, supervised, and protocol-based IPE experience in a dementia-care setting can inculcate positive changes in student attitudes about collaborative practice and may encourage dementia-related learning outcomes. [ABSTRACT FROM AUTHOR]

This study analyzed students' written reflections following their initial exposure to interprofessional teamwork in case-based problem-solving. A three-hour seminar featuring three sequenced scenarios was developed and offered 12-times over two semesters. A total of 305 students from a variety of healthcare programs worked together with standardized patients in an on-campus laboratory simulating hospital ward and rehabilitation settings. A thematic analysis of students' reflections showed that they valued the shared learning and realistic case study. However, they felt the experience would be strengthened by working in smaller, more representative teams that included students from medicine, psychology, and social work to enable more effective communication and comprehensive case discussion. While useful for future planning, the identified themes did not enable a comparative statistical analysis of what students found helpful and difficult and a re-coding of students' responses now is underway. Implications for measuring the effectiveness of future interprofessional case-based learning center on addressing the identified weaknesses, and establishing a research design that enables a comparison of pre- and post-seminar data, and the effectiveness of the IPE experience compared to profession-specific experiences. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 32-year-old woman who gave birth to a healthy girl following an uneventful pregnancy and a spontaneous, uncomplicated, vaginal delivery. She had a split nipple that caused pain which was later on healed quickly, and further reported that the baby was feeling gassy and uncomfortable also it was difficult to feed. It states that physician assistants (PAs) know better how to test for diagnoses with symptoms similar to lactose intolerance.

Aims: To evaluate the nutritional status and needs of a person with dementia living in an aged care home, including identification of barriers to, and effective strategies for, the provision of person‐centred care. Background: Nutrition and hydration care are integral to quality of life for adults with dementia, but there is little research on whether staff knowledge around effective care strategies for residents is translated into optimal care. Design Focused ethnographic single‐case design. Methods: The perspectives of the resident, her prime family member, and six care staff were triangulated through interviews, observation, document audit, and medical file review to investigate the resident's nutrition and hydration status and needs (October 2014‐April 2015). Results: During 3 years in care, this resident had lost weight steadily. Staff appeared attentive but did not maintain a systematic record of body mass index. At meals, staff encouraged eating but used ineffective strategies. Food was not served in ways that facilitated active participation. Eating and drinking were structured as tasks to be completed rather than activities to be enjoyed. Conclusion: This instrumental case study identified a task‐oriented, rather than person‐centred, approach to nutrition and hydration care, adversely affecting the resident's nutritional health and capability to participate actively. SUMMARY STATEMENT: What is already known about this topic? Nutrition and hydration care are integral to quality of life for adults with dementia.Data are limited, but studies document that many point‐of‐care staff in aged care homes have limited knowledge of residents' nutrition and hydration needs and that evidence‐based and person‐centred care practices are not being followed in mealtime management.There is little research on whether staff knowledge around nutrition and hydration care strategies for residents is translated into optimal daily care.What this paper adds? It adds to the limited ethnographic research on nutrition care practices for aged care residents with dementia.This focused ethnographic single‐case description provides insight into key systematic barriers to person‐centred care and effective nutritional management that have wider relevance to the nutritional health of all residents.The case study identifies a task‐oriented, rather than person‐centred, approach to nutrition and hydration care, which adversely affects the resident's nutritional health and capability to participate actively.The implications of this paper: There are many opportunities for improved nutrition and hydration care practices in aged care homes, such as documentation of body mass index and facilitation of social engagement.While cachexia inevitably occurs in advanced dementia, it is important that nutritional status should not be further compromised by ineffective or inadequate care practices.The findings may be used as a basis for further research and to tailor education for aged care home staff to enhance nutrition and hydration care practices. [ABSTRACT FROM AUTHOR]

Introduction: Smartphones are proving useful in assessing movement and speech function in Alzheimer's disease and other neurodegenerative conditions. Valid outcomes across different smartphones are needed before population-level tests are deployed. This study introduces the TapTalk protocol, a novel app designed to capture hand and speech function and validate it in smartphones against gold-standard measures., Methods: Twenty different smartphones collected video data from motor tests and audio data from speech tests. Features were extracted using Google Mediapipe (movement) and Python audio analysis packages (speech). Electromagnetic sensors (60 Hz) and a microphone acquired simultaneous movement and voice data, respectively., Results: TapTalk video and audio outcomes were comparable to gold-standard data: 90.3% of video, and 98.3% of audio, data recorded tapping/speech frequencies within ± 1 Hz of the gold-standard measures., Discussion: Validation of TapTalk across a range of devices is an important step in the development of smartphone-based telemedicine and was achieved in this study., Highlights: TapTalk evaluates hand motor and speech functions across a wide range of smartphones.Data showed 90.3% motor and 98.3% speech accuracy within +/-1 Hz of gold standards.Validation advances smartphone-based telemedicine for neurodegenerative diseases., Competing Interests: The authors declare no conflicts of interest. Author disclosures are available in the supporting information., (© 2024 The Author(s). Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Objective: Acquired hearing loss (HL) in adult life is one of the most prevalent health conditions and is associated with several chronic diseases. Hearing loss can lead to reduced social activity and individuals' perceptions of supportiveness within social networks. This study explored the effects of corrected vs. uncorrected hearing loss on social support, social isolation, anxiety and depression., Methods: We undertook a cross-sectional study. An online survey was completed by 7442 Australian residents aged 50 years or older as part of the Island Study Linking Ageing and Neurodegenerative Disease (ISLAND). Respondents were grouped into those with no reported acquired HL, those with corrected HL (managed with hearing aids and other listening devices) and those with uncorrected HL., Results: Hearing loss was reported by 1274 participants (17%). Compared to male participants, there was a higher proportion of female participants in the No-HL group (25% male, 75% female). Compared to participants with corrected or no-HL, those with HL (n = 548, 7%) reported significantly smaller (p = .007) and less supportive social networks (p = .001), higher self-reported anxiety (p < .001) and depression (p < .001) symptoms. Depression scores were significantly higher in those with HL-corrected than No-HL (SMD = .10, p = .04)., Conclusions: Uncorrected HL was associated with poor mental health and social isolation, compounding the risk of dementia. Correcting for HL appeared to mitigate these outcomes, except for depression. Longitudinal studies are needed to track the effects of HL correction over time. Hearing status needs to be assessed when people present with mental health concerns, so health professionals can make appropriate referrals and provide relevant advice and support., (© 2024 The Author(s). Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc’.)

Introduction: Evidence suggests that the pathology underlying cognitive decline leading to dementia begins 15-20 years before cognitive symptoms emerge. Thus, identifying biomarkers in this preclinical phase is critically important. Age-related decrease in muscle mass and strength, a known risk factor for sarcopenia, frailty and cognitive decline, also affects the tongue. This paper describes an a priori protocol by a multidisciplinary team to address the following questions relating to adults ≥50 years of age: (1) What is the current evidence on the association of tongue strength with cognitive decline? (2) How does tongue strength associate with frailty and sarcopenia? (3) What is the association of tongue strength with nutritional health?, Methods and Analysis: Search terms will be identified then multiple electronic databases (PubMed, PsycINFO (Ovid), Scopus, Embase (Ovid), CINAHL and Web of Science) searched systematically for peer-reviewed articles published in English that address the following inclusion criteria: (1) human studies, (2) participants ≥50 years of age and (3) studies with tongue pressure values measured in relation to at least one of the following: frailty, sarcopenia, nutritional health, cognitive function and dementia (Alzheimer's, vascular, frontotemporal and Lewy body). Grey literature also will be searched to identify additional studies, clinical trials and policy papers appropriate for inclusion. The search will be from database inception. After removing duplicates, two research team members will independently screen abstracts and identify articles for full-text review. The team will use a data charting tool for data extraction. Data will be analysed quantitatively and qualitatively., Ethics and Dissemination: The scoping review does not require ethics approval as data will be from publicly available sources. Results will be disseminated in workshops and conferences and a peer-reviewed journal paper., Competing Interests: Competing interests: The authors have no potential conflicts of interest with respect to the research, authorship, and/or publication of this protocol., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: This paper details the journey of eight Aboriginal women from Circular Head, a rural and remote area of North-West Tasmania, as they undertook an innovative 2-year program of tertiary studies in dementia to address a documented community need. The Chief Executive Officer of the Circular Head Aboriginal Corporation (CHAC) had identified difficulties being experienced by older members of the community. These difficulties included changes in behavior, memory, and communication, with profound consequences on social engagement and care needs from both individual and community perspectives. The community wished to know if a combined vocational and university program, completed on Country and in community, could serve as a culturally safe education pathway to empower Aboriginal members of a rural and remote area in providing community health and dementia education and care., Methods: The nationally funded program included a year-long face-to-face vocational Certificate III in Individual Support (Aging, Home, and Community) on Country, including within-community experience with adults with dementia. This face-to-face learning was combined with online study in the award-winning Bachelor of Dementia care offered by the University of Tasmania. Students received a PhD level stipend to support them in their studies and were guided by an Elder from their community., Results: All students completed their Certificate III. The number of units they completed toward the eight required for their Diploma of Dementia Care varied. Emergent themes from students' reflections were holistic and relational, highlighting achievements and challenges, the importance of on Country individual connections and community support, and the value of their current and future contributions to the community. Data from this mixed methods approach documented the impact of the innovative coupling of authentic, culturally appropriate experiential learning with broad and deep academic knowledge about dementia and evidence-based care., Conclusions: This program provided students with a work-related qualification embedded within a university education and increased the capacity and capability of this Aboriginal community to provide care for its members with dementia, a documented concern. The combination of vocational learning on Country with online university study established a pathway to improve students' access to and success in higher education and the professional workforce. This assisted in counteracting the negative influences of racism, stigma, rurality, and socio-economic marginalization on educational opportunity for Aboriginal people. Data showed the need for flexibility with this learning journey, and the strengths and resilience of these women as they learned., Competing Interests: DB was employed by the Circular Head Aboriginal Corporation. TC is a member of the Aboriginal Community and not employed by the Circular Head Aboriginal Corporation. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Goldberg, Baldock, Cox, Hoang, Cross and Price.)