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Background: Adults with spinal cord injury/dysfunction (SCI/D) face challenges with medications they take to manage their secondary conditions (e.g., pain, urinary tract infections, autonomic dysreflexia). With many healthcare providers typically involved in care, there are additional challenges with care fragmentation and self-management. Prior research emphasized the desire for more support with medication self-management among this population. Objective: To explore what content should be included in a medication self-management resource (i.e., toolkit) for adults with SCI/D, as well as considerations for delivery from the perspectives of adults with SCI/D, caregivers, healthcare providers, and representatives from community organizations. Methods: A concept mapping study was conducted. Participants took part in one or more of three activities: brainstorming; sorting and rating; and mapping. Participants generated ideas about the content to include in a medication self-management toolkit. Participants sorted the statements into conceptual piles and assigned a name to each. All statements were rated on a five-point Likert-type scale on importance and realistic to include in the toolkit. Participants decided on the final cluster map, rearranged statements, and assigned a name to each cluster to create visual representations of the data. Results: Forty-four participants took part in this study. The final map contained eight clusters: 1) information-sharing and communication; 2) healthcare provider interactions and involvement; 3) peer and community connections; 4) supports and services for accessing prescription medications and medication information; 5) information on non-prescription medication and medication supplies; 6) safety and lifestyle considerations; 7) general medication information; and 8) practical information and strategies related to medication-taking. Safety and lifestyle considerations was rated as the most important and realistic to include in the toolkit. Conclusions: Given the limited tools to help adults with SCI/D with managing their medications, there is great potential to better support this population across all areas of medication self-management. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Naturally occurring retirement communities (NORCs) are geographical areas that have naturally become home to a large concentration of older adults. This density means that NORCs have the potential to become a pillar for aging in place strategies, but at present, there is limited data on residents and their health needs. Our objective was to describe and compare the health and healthcare use of older adults living in high‐rise NORC buildings to those in all other housing types in the community.We conducted a population‐based descriptive study of community‐dwelling older adults aged ≥65 years by linking a provincial NORC registry in Ontario, Canada with health administrative records. Individuals were classified as NORC residents if their residential postal code on January 1, 2020 matched the NORC registry. Sociodemographic, clinical, and healthcare use characteristics were compared by NORC status using standardized differences (STD) and stratified by rurality, and further by age and sex in urban settings.Overall, 219,995 (7.7%) of 2,869,706 older adults were NORC residents. Compared to community‐dwelling older adults, NORC residents were older (mean 77.4 vs 74.6 years; STD 0.34), and more were female (61.8% vs 52.2%; STD 0.19) and had low income (16.0% vs 9.3%; STD 0.11). NORC residents also had more active chronic conditions (mean 1.9 vs 1.5; STD 0.27), medications (mean 3.4 vs 2.8; STD 0.21), home care use (15.3% vs 9.8%; STD 0.17), and primary care visits (mean 9.7 vs 7.6 visits in prior 2 years; STD 0.22). Findings were robust across rurality, age, and sex.Our findings suggest that NORC residents have greater health needs than other older adults living in the community and underscore NORCs as important targets for equity‐focused strategies to support aging in place. [ABSTRACT FROM AUTHOR]

Engineering has been playing an important role in serving and advancing healthcare. The term "Healthcare Engineering" has been used by professional societies, universities, scientific authors, and the healthcare industry for decades. However, the definition of "Healthcare Engineering" remains ambiguous. The purpose of this position paper is to present a definition of Healthcare Engineering as an academic discipline, an area of research, a field of specialty, and a profession. Healthcare Engineering is defined in terms of what it is, who performs it, where it is performed, and how it is performed, including its purpose, scope, topics, synergy, education/training, contributions, and prospects. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Naturally occurring retirement communities (NORCs) are geographic areas (generally high‐rise buildings or neighborhoods) that have a high concentration of individuals 65 years and older. Supportive service programs in NORCs can address resident needs and delay nursing home (NH) admission but understanding what factors are associated with NORC residents requiring NH admission is needed to tailor such programs. Our aim was to examine individual‐ and neighborhood‐level factors associated with NH wait‐list status in NORC residents in Ontario.We conducted a population‐based, cross‐sectional study of Ontario adults 65 years of age or older living in a NORC building as of January 1, 2020, by linking a provincial registry of NORC high‐rise buildings with health administrative data. Older adults were classified as being on the NH wait‐list if they had an open application for a NH on the index date. We conducted a multilevel logistic regression analysis using generalized estimating equations to determine individual‐ and neighborhood‐level factors associated with NH wait‐list status, including sociodemographic, clinical, healthcare use, and building factors. We explored the role of sex and age through stratification by sex (male, female) and age (65–80 and 80+ years).Among 220,864 NORC residents, 4710 individuals (2.1%) were on the NH wait‐list. Female sex, older age, immigrant status, dementia diagnosis, receiving homecare, multimorbidity, and polypharmacy (five or more unique drug names) were associated with an increased odds of wait‐list status. Several neighborhood‐level variables were associated with a significantly increased likelihood of wait‐list status, including low income, high dependency, high ethnic diversity, and living in a building with supports.NORC supportive service programs can be tailored to account for the factors associated with NH wait‐list status, allowing NORC residents who are living in the community to age in their desired place and achieve optimal health outcomes. [ABSTRACT FROM AUTHOR]

Our qualitative descriptive study compared how older patients and their informal caregivers experienced the care transition from acute care or rehabilitation to home. We recruited patients 65 years of age or older, or their informal caregivers, from in-patient units within acute care hospitals and rehabilitation facilities to participate in semi-structured interviews. We identified emergent themes via thematic analysis. In all, 16 patients and four patient caregivers participated. Across all care settings, caregivers were integral in facilitating the transition as well as experiencing variable discharge preparation, health care providers' optimizing transitions, and missed care and medication discrepancies at transition points. Orthopedic and rehabilitation patients more commonly voiced prior transition experiences in discharge preparation, including having to unexpectedly coordinate and wait for outpatient services. Differing responses between acute care and orthopedic settings suggest that transitional care practices and policies favor an individualized approach that considers patients' previous experiences, needs, and care expectations.