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Background: Informal caregivers of older adults play a vital role in improving the degree to which older adults access community and healthcare services in a seamless and timely manner. They are fulfilling important navigation and support roles for their older care recipients. However, there is still little knowledge of the most significant facilitators and barriers to effective and efficient system navigation among caregivers. This paper aims to fill these knowledge gaps through investigation of the key factors (i.e., social capital/cohesion, caregiving supports, and utilization factors) affecting navigation difficulties faced by informal caregivers of older adults., Methods: The Behavioural-Ecological Framework of Healthcare Access and Navigation (BEAN) model is used to frame the study. Using the General Social Survey on Caregiving and Care Receiving 2018, we analyzed 2,733 informal caregivers whose primary care recipients were aged 65 or older. Hierarchical logistic regression was conducted to identify the relationship between system navigation difficulties among informal caregivers and four sequentially ordered blocks of predictors: (1) sociodemographic (2), social capital/cohesion (3), caregiving supports, and (4) healthcare demand., Results: The fully adjusted model showed that the probability of reporting navigation difficulties was lower for caregivers with social capital/cohesion compared to those without social capital/cohesion. In comparison, the probability of reporting navigation difficulties was higher among caregivers with caregiving support and among caregivers whose care receivers use a higher amount of health service use. Several sociodemographic covariates were also identified., Conclusion: Our findings support certain aspects of the BEAN model. This study extends our understanding of potential facilitators and barriers that informal caregivers of older adults face while navigating complex community and health systems. There is a need to implement coordinated schemes and health policies especially for older adults with mental/neurological issues to address the challenges of their caregivers given the specific vulnerability identified in this study. The need for further research using different approaches to examine the disproportionate impact of COVID-19 on caregivers' system navigation experience is crucial., (© 2024. The Author(s).)

Microtubule-associated protein, MAP1B, is crucial for neuronal morphogenesis and disruptions in MAP1B function are correlated with neurodevelopmental disorders. MAP1B encodes a single polypeptide that is processed into discrete proteins, a heavy chain (HC) and a light chain (LC); however, it is unclear if these two chains operate individually or as a complex within the cell. In vivo studies have characterized the contribution of MAP1B HC and LC to microtubule and actin-based processes, but their molecular mechanisms of action are unknown. Using in vitro reconstitution with purified proteins, we dissect the biophysical properties of the HC and LC and uncover distinct binding behaviors and functional roles for these MAPs. Our biochemical assays indicate that MAP1B HC and LC do not form a constitutive complex, supporting the hypothesis that these proteins operate independently within cells. Both HC and LC inhibit the microtubule motors, kinesin-3, kinesin-4, and dynein, and differentially affect the severing activity of spastin. Notably, MAP1B LC binds to actin filaments in vitro and can simultaneously bind and cross-link actin filaments and microtubules, a function not observed for MAP1B HC. Phosphorylation of MAP1B HC by dual-specificity, tyrosine phosphorylation-regulated kinase 1a negatively regulates its actin-binding activity without significantly affecting its microtubule-binding capacity, suggesting a dynamic contribution of MAP1B HC in cytoskeletal organization. Overall, our study provides new insights into the distinct functional properties of MAP1B HC and LC, underscoring their roles in coordinating cytoskeletal networks during neuronal development., Competing Interests: Conflict of interest The authors declare that they have no conflicts of interest with the contents of this article., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The COVID-19 pandemic has presented numerous challenges to older adults in Canada, including the ability to volunteer. The purpose of this study is to improve the understanding of the social context surrounding volunteering in Canada, by (a) determining changes in associations between human, social, and cultural capital and volunteering among older adults; and (b) examining the relationship between ethnic minority status and volunteering, using data from the Canadian Longitudinal Study on Aging (CLSA), collected prior to and during the pandemic. This study utilized data from 24,306 CLSA Baseline, Follow-up 1 (FUP1), and COVID-19 Baseline Survey participants (aged 55+). Results confirm a decrease in volunteering during the early stages of the pandemic. Compared to pre-pandemic associations, volunteers during the early stages of the pandemic were more likely to be young-old, male, employed, and not involved in religious activities. Findings provide evidence of pandemic effects on volunteering among older adults in Canada.

Objective: Informal caregivers are playing a vital role in improving the degree to which older adults access community and healthcare systems in a more seamless and timely manner, thereby fulfilling their complex needs. It is critical to understand their experiences and perspectives while navigating these systems. This review aimed to identify and organise the research findings on the roles and experiences of informal caregivers of older adults while navigating community and healthcare systems., Design: This scoping review was undertaken according to the Joanna Briggs Institute's Reviewer manual. Four databases were used: AgeLine, PsycINFO, CINAHL and Medline to capture literature with a focus on informal caregivers whose care recipients are aged 55 years or older. Articles were included if they focused on examining the experience, perspective and/or role of informal caregivers in providing care for their older care recipients, while articles were excluded if they only focused on healthcare professionals or older adults., Results: A total of 24 studies were identified that met the study inclusion criteria. This review elucidated the roles of caregivers as a primary system navigator and as an advocate for older adults. Numerous challenges/barriers in system navigation were uncovered, such as lack of consistency in fragmented systems, as well as facilitators, including interface/coordination roles. Finally, recommendations for better system navigation such as caregiver engagement and integration of continuity of care services were identified., Conclusion: The need to raise the visibility of the roles and experiences of informal caregivers in system navigation was highlighted. Further research needs to focus on implementing interventions for informal caregivers incorporating a care coordinator to fill the care gap within community and healthcare systems. This review has the potential to foster greater integration of community and healthcare systems., Competing Interests: Competing interests: None declared., (© 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.)

SUNY Upstate Medical University (Upstate) recently revised two 1-year special master's programs (SMPs), designed to enhance academics in preparation for medical school through rigorous graduate science coursework. Upstate SMP program success was measured by graduate performance during the first year of medical school. First-year performance measures included academic deficiencies, exam performance, and participation grades in a longitudinal case-based course on ethics and public health. Upstate SMP students with MCAT scores below the 50th percentile or who self-report classified as underrepresented in medicine outperformed controls on several metrics. Upstate SMP students consistently bested controls in the longitudinal course. Overall, Upstate SMP graduates performed commensurately with classmates., Competing Interests: Conflict of InterestThe authors on this publication are all employed by the State of New York Upstate Medical University from which this inaugural study and data were collected and analyzed., (© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2022.)

The COVID-19 pandemic necessitated an abrupt conclusion of field placement for social work interns at a comprehensive cancer center. In response to social distancing requirements, social workers, but not interns, were granted access to work remotely. Virtual programming became necessary to meet the interns' remaining educational requirements and provided an opportunity for proper termination from the program. This article will delineate the program redesign for oncology social work interns using remote/virtual modalities. This melded approach involved creating simulated clinical interactions, based on selected points along the illness trajectory targeting specific clinical competencies, which were presented to interns by phone and/or videoconference. Examples will be provided related to developing clinical skills and critical thinking and preparing for professional responsibilities within a broad range of healthcare settings. Guidelines for working with individuals, couples/families, and groups will be included. Issues of individual and group supervision will be explored, with sensitivity to the parallel experience of existential uncertainty and mortality awareness among the interns in the context of the pandemic. Although in-person training is preferable, there are advantages to virtual learning for both supervisors and interns. This creative adaptation of field education provides an innovative programming model that can be used to enhance the experience for social work interns moving forward in various healthcare settings during ordinary or extraordinary circumstances., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021.)

Drawing from a sociocultural life course perspective, this study examines the linkages between two age-related family transitions: young adult children leaving home and parental retirement. A sample of 580 ethnically diverse parents aged 50+ with at least one adult child aged 19-35 living in Metro Vancouver, British Columbia, Canada, was used in this study based on four cultural groups: British-, Chinese-, Persian/Iranian-, or South Asian-Canadian. Separate survival analyses are used to predict the timing of, and associations between children's leaving home and parents' retirement. Later timing of adult children's leaving home is associated with delays in retirement of parents and is influenced by a number of predictors. Main and interaction effects were supported for ethnicity, where belonging to the Persian/Iranian ethnic group (compared to British) delays home leaving, and belonging to Persian/Iranian and South Asian ethnic groups (compared to British) delays retirement timing.

It is well established that family and work-retirement transitions are increasingly becoming more complicated, extended, and reversible among aging parents. Combined with improved life expectancy, older parents are now confronted with new opportunities and challenges including their access to leisure activities. However, a paucity of research exists with regard to the extent to which older-aged parents are satisfied with their amount of leisure time as well as their ideal leisure preferences. Drawing upon socio-cultural life course theory, this paper examines how socio-demographic and ethnocultural variables (i.e., gender, ethnic identity), family-related factors (e.g., presence of children in the household), and socio-economic and work contexts (i.e., income satisfaction and retirement status) shape leisure time satisfaction and activity preferences. Data are drawn from the "Families and Retirement Project," a sample of 588 diverse (British-, Chinese-, Iranian/Persian-, South-Asian Canadians) aged 50 + (mean age = 59.6) residing in Metro Vancouver with at least one young adult child aged 19-35. Quantitative analyses reveal that leisure time satisfaction is higher among: those reporting lower levels of parental stress, the fully retired, those with less education, and among Chinese parents (compared to British). Moreover, strong variations by ethnic background are shown in preferred leisure activity, based on a thematic analysis of data. Results are discussed in terms of contributions to a socio-cultural family life course activity theory. Implications for community service provision (e.g., culturally sensitive and relevant recreational programs and services) are also highlighted, given the salience of participation in enjoyable leisure activities to healthy aging., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

ABSTRACTSocial isolation, given its established association with mortality, and risk of poor physical and/or mental health over the life course, has attracted the attention of researchers. However, such measures have been highly variable and often lack conceptual clarity. This study, which drew on a conceptual framework for classifying social isolation measures, provides a rationale for the development and validation of a composite Social Isolation Index (SII) using the Canadian Longitudinal Study on Aging (CLSA), together abbreviated as CLSA-SII. CLSA-SII was developed using standard methodology for developing other measures, including the multimorbidity resilience and successful aging indices. Associations of the CLSA-SII and four key outcome variables (life satisfaction scale, depression, perceived mental health, and perceived health) were performed using regression analyses. Associations between the CLSA-SII index and the four outcome variables resulted in statistically significant moderate associations in the expected direction, and are consistent with prior research, demonstrating good concurrent validity.

Background: Multimorbidity is recognized as a major public health issue that increases with age and affects approximately two-thirds of older people in Canada, the US, Australia and many European countries. This study develops and tests a three domain (functional, social and psychological) multimorbidity resilience composite index based on a previously developed lifecourse model of multimorbidity resilience, incorporating measures of adversity and positive adaptation. The criterion validity of the measure is demonstrated by means of an analysis of key outcome variables drawn from the literature., Methods: We used the baseline data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging. Associations of functional, social, psychological as well as total resilience with two health utilization and three illness context outcome variables were examined using logistic regression analyses, adjusted for age, gender, marital status, income, education, region, and number of chronic conditions., Results: The sample included all 6771 Canadian adults aged 65 or older (mean age 73.0, 57% women) who reported two or more of 27 possible chronic conditions. Total resilience was associated with: perceived health (OR = 1.68, CI 1.59-1.77); sleep quality (OR = 1.34, CI 1.30-1.38); perceived pain (OR = 0.80, CI 0.77-0.83); hospital overnight stays (OR = 0.87, CI 0.83-0.91); and emergency department visits (OR = 0.90, CI 0.87-0.94)., after adjusting for socio-demographic factors, and number of chronic conditions. These associations were similar for the unadjusted models, as well as for the functional, social and psychological resilience sub-indices., Conclusions: Combining components of adversity and positive adaptation within functional, social and psychological domains produces a measure of multimorbidity resilience that is associated with more positive health outcomes. Several implications of a composite multimorbidity resilience measure for clinical practice are identified. This measure can be replicated using measures found in other secondary health data sets. Future validation using longitudinal data is warranted.

This study provided an exploratory analysis of key social determinants of health for older Canadian women, with a focus on differences between rural and urban residency, given that socio-economic status (SES) and social capital have been shown to differ by rural-urban residence. Secondary analysis was conducted using the 2000/2001 Canadian Community Health Survey. A comparative logistic regression analysis revealed, unexpectedly, that SES and social capital variables were more strongly associated with the health status of urban older women than for the health status of their rural counterparts. Associations between health status measures and household income, food insecurity, and community belonging were largely not supported among rural women, but were for their urban counterparts. Findings are discussed concerning applications of the social-determinants-of-health model for explaining health patterns among older urban and rural women. Cost of living, access to health services, and dimensions of rural culture are discussed as potential explanations.

CLMA volunteered to conduct an online pilot survey of its membership to help the Institute for Quality in Laboratory Medicine (IQLM) determine quality management activities in laboratories. Among the hospital-based members who were surveyed, approximately 25 percent responded. The data they volunteered provide a snapshot of the current state of laboratory quality management. The pilot survey is part of a larger IQLM plan to develop networks of laboratories to monitor and evaluate laboratory practices and services to enhance laboratory medicine. This pilot survey will be used by IQLM as a model to establish quality and patient safety networks, applicable to laboratories of all sizes and types. Performance comparisons and best practices may then be shared to reduce laboratory errors and improve patient safety.

This article investigates the propensity for young adults to live in the parental home between the ages of 25 to 34--termed "mature coresidency." Drawing upon a synthesis of life course theory and the concept of social capital, a rationale is developed for examination of emotional closeness to parents during childhood and a number of socio-demographic and structural factors deemed to be important. Using a subset of young adults aged 25 to 34 (N = 1,760) from the 1995 Canadian General Social Survey, it is found that emotional closeness to mothers and fathers are major determinants of mature coresidency. Other important predictors include child's age, gender, marital status, and several family background factors. The implications of the findings are discussed for transitions to adulthood and family development against a changing social and economic landscape.

Current methods of Listeria detection require days to complete and may fail to detect Listeria in some samples. In contrast, capture of Listeria on microscopic immunomagnetic beads reduces test time to 24 h and improves sensitivity. In this approach, which eliminates enrichment, samples are mixed with immunomagnetic beads coated with anti- Listeria antibodies. Listeria in the sample bind to beads. The beads, with their bound Listeria , are isolated from other sample material and microorganisms in a magnetic field. The beads are plated on medium and incubated overnight. The next day, a replica of the plate is made onto a thin plastic membrane. The membrane is treated with an anti- Listeria antibody, an alkaline-phosphatase conjugated antibody that binds to the anti- Listeria antibody, and a substrate for alkaline phosphatase. This treatment produces colored spots that correspond to Listeria colonies on the master plate. Immunomagnetic capture was compared to a standard cultural method for analysis of environmental samples. Immunomagnetic capture detected Listeria in 100% of the samples, at contamination levels where a standard cultural method gave detection in only 36% of the samples. At lower levels of contamination, immunomagnetic isolation allowed detection of Listeria in 58% of the samples, while the cultural method failed to detect Listeria in any samples. Immunomagnetic capture resulted in recovery of injured Listeria . Because immunomagnetic capture did not rely on enrichment, the number of Listeria colonies obtained was related to the original level of contamination. Quantitative results were produced within 24 h for both positive and negative samples, while the cultural method produced qualitative results in 6 days (for positives) or 3 days (for negatives). Immunomagnetic capture is thus both more rapid and more sensitive than a standard cultural method for detection of Listeria in environmental samples.