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Technological interventions are increasingly popular methods of targeting and preventing loneliness in older adults. Research has identified various factors that influence the willingness and propensity of older adults to integrate technology into their social lives and the ways in which this may enhance their social connectedness. Given prevalence rates and negative outcomes associated with loneliness for this population, further research is warranted to clarify the mechanisms through which technological interventions may decrease loneliness. This study aimed to better understand the perspectives of older adults on the role of technology in their social relationships in later life. Four focus groups were conducted with 27 older adults, aged 65–80 years. Transcripts were analysed using thematic analysis, and results were validated via written participant feedback. Participants reported technology as one of many tools used to maintain their social relationships. Their choice to use technology for social interaction was influenced by their estimation of effort required, likely quality of the interaction, and the privacy and security provided. These factors were the same as those that influenced decisions to use other methods (e.g. face-to-face meetings). Based on the results, we recommend that loneliness interventions should be technology-agnostic and multifaceted, providing a wide range of tools that recognise the technological competencies of older adults and supporting different interaction types to meet the preferences of the individual. [ABSTRACT FROM AUTHOR]

BACKGROUND: Primary aldosteronism (PA) is a common but underdiagnosed cause of hypertension. Many patients experience preventable end-organ injury due to delayed or missed diagnosis but data on the experience of patients are limited. METHODS: We evaluated the lived experience of PA and determines factors associated with diagnostic delay through an international anonymous online cross-sectional survey, codesigned by researchers and PA consumers. We distributed the survey through academic medical centers, Amazon Mechanical Turk, Twitter, PA patient advocacy groups, and hypertension support groups on Facebook between March 21 and June 5, 2022. RESULTS: Of 684 eligible respondents, 66.5% were women. Diagnostic delay (defined as ≥5 years between the diagnosis of hypertension and PA) was reported in 35.6%. Delay was more likely in women than in men (odds ratio, 1.55 [95% CI, 1.10-2.20]) and respondents with ≥3 comorbidities versus none (odds ratio, 1.77 [95% CI, 1.05-3.02]), ≥10 symptoms versus none (odds ratio, 2.73 [95% CI, 1.74-4.44]), and on ≥4 antihypertensive medications versus none (odds ratio, 18.23 [95% CI, 6.24-77.72]). Three-quarters of patients (74.4%) experienced reduced symptom burden following targeted PA treatment. Quality of life improved in 62.3% of patients, and greater improvement was associated with being a woman (odds ratio, 1.42, [95% CI, 1.02-1.97]), receiving adrenalectomy (odds ratio, 2.36 [95% CI, 1.67-3.35]), and taking fewer antihypertensive medications following diagnosis (odds ratio, 5.28 [95% CI, 3.55-7.90]). CONCLUSIONS: One-third of patients with PA experienced prolonged diagnostic delays. Targeted treatment led to reduced symptom burden and improved quality of life. Gender differences in diagnostic delay and symptom burden are prominent. These findings suggest that routine screening for PA at the onset of hypertension may reduce diagnostic delay and facilitate timely diagnosis. [ABSTRACT FROM AUTHOR]

Background Implementing evidence into clinical practice is a key focus of healthcare improvements to reduce unwarranted variation. Dissemination of evidence-based recommendations and knowledge brokering have emerged as potential strategies to achieve evidence implementation by influencing resource allocation decisions. The aim of this study was to determine the effectiveness of these 2 research implementation strategies to facilitate evidence-informed healthcare management decisions for the provision of inpatient weekend allied health services. Methods and findings This multicentre, single-blinded (data collection and analysis), 3-group parallel cluster randomised controlled trial with concealed allocation was conducted in Australian and New Zealand hospitals between February 2018 and January 2020. Clustering and randomisation took place at the organisation level where weekend allied health staffing decisions were made (e.g., network of hospitals or single hospital). Hospital wards were nested within these decision-making structures. Three conditions were compared over a 12-month period: (1) usual practice waitlist control; (2) dissemination of written evidence-based practice recommendations; and (3) access to a webinar-based knowledge broker in addition to the recommendations. The primary outcome was the alignment of weekend allied health provision with practice recommendations at the cluster and ward levels, addressing the adoption, penetration, and fidelity to the recommendations. The secondary outcome was mean hospital length of stay at the ward level. Outcomes were collected at baseline and 12 months later. A total of 45 clusters (n = 833 wards) were randomised to either control (n = 15), recommendation (n = 16), or knowledge broker (n = 14) conditions. Four (9%) did not provide follow-up data, and no adverse events were recorded. No significant effect was found with either implementation strategy for the primary outcome at the cluster level (recommendation versus control [beta] 18.11 [95% CI -8,721.81 to 8,758.02] p = 0.997; knowledge broker versus control [beta] 1.24 [95% CI -6,992.60 to 6,995.07] p = 1.000; recommendation versus knowledge broker [beta] -9.12 [95% CI -3,878.39 to 3,860.16] p = 0.996) or ward level (recommendation versus control [beta] 0.01 [95% CI 0.74 to 0.75] p = 0.983; knowledge broker versus control [beta] -0.12 [95% CI -0.54 to 0.30] p = 0.581; recommendation versus knowledge broker [beta] -0.19 [-1.04 to 0.65] p = 0.651). There was no significant effect between strategies for the secondary outcome at ward level (recommendation versus control [beta] 2.19 [95% CI -1.36 to 5.74] p = 0.219; knowledge broker versus control [beta] -0.55 [95% CI -1.16 to 0.06] p = 0.075; recommendation versus knowledge broker [beta] -3.75 [95% CI -8.33 to 0.82] p = 0.102). None of the control or knowledge broker clusters transitioned to partial or full alignment with the recommendations. Three (20%) of the clusters who only received the written recommendations transitioned from nonalignment to partial alignment. Limitations include underpowering at the cluster level sample due to the grouping of multiple geographically distinct hospitals to avoid contamination. Conclusions Owing to a lack of power at the cluster level, this trial was unable to identify a difference between the knowledge broker strategy and dissemination of recommendations compared with usual practice for the promotion of evidence-informed resource allocation to inpatient weekend allied health services. Future research is needed to determine the interactions between different implementation strategies and healthcare contexts when translating evidence into healthcare practice. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618000029291., Author(s): Mitchell N. Sarkies 1,2,3,*, Lauren M. Robins 3, Megan Jepson 3, Cylie M. Williams 3, Nicholas F. Taylor 4,5, Lisa O'Brien 6, Jenny Martin 7, Anne Bardoel 8, Meg [...]

Background: Primary aldosteronism (PA) represents the most common and potentially curable cause of secondary hypertension. However, PA is not commonly screened for, and up to 34% of patients who screen positive do not complete the full diagnostic process. This suggests that the diagnostic process may pose a barrier to patients and may contribute to the under‐diagnosis of PA. Aims: To evaluate the willingness of the Australian general public to undergo testing for secondary causes of hypertension and identify enablers or barriers to testing from the patients' perspective. Methods: An online survey containing questions on knowledge and attitudes towards hypertension, willingness to be tested and enablers/barriers towards testing was distributed to the Australian community. Results: Of 520 adult respondents (mean age 50.4 years, SD 27.3 years; 28.8% hypertensive; 56.0% female), the majority of non‐hypertensive and hypertensive respondents (82.7% vs 70.0%; P = 0.03) were willing to undergo testing for a secondary cause of hypertension that involved blood and urine tests. Greater knowledge of hypertensive risk modification strategies and complications was predictive of willingness to be tested, whereas age, sex, education level, geographic location, socio‐economic status and cardiovascular comorbidities were not. The top three barriers to testing included fear of a serious underlying condition, lack of belief in further testing and increased stress associated with further testing. Conclusion: A high proportion of patients are willing to engage in testing for a secondary cause of hypertension. Education about the risks associated with hypertension and the testing process may overcome several barriers to testing. [ABSTRACT FROM AUTHOR]

Date Presented 03/23/24 PreActive-PD, a randomized controlled trial, will evaluate the effects of telehealth coaching to support physical activity goal setting and participation in people with early-stage Parkinson's disease. Design and baseline characteristics will be discussed. Primary Author and Speaker: Katrina M. Long Additional Authors and Speakers: Alissa C. Pacheco Contributing Authors: Lori Quinn [ABSTRACT FROM AUTHOR]

This paper presents the co-design process of a digital tool that may prevent or alleviate feelings of loneliness in older adults. Six workshops were conducted with older adults (n = 34) aged between 65–80 years old to investigate the role of technology in maintaining and establishing meaningful relationships. Participants' contributions throughout the workshops were used to inform the design and development of a web-based loneliness intervention for older adults called ElderConnect. ElderConnect is a web-based application that supports older adults to identify, prevent, and alleviate feelings of loneliness by providing knowledge and strategies to initiate new social connections and maintain existing connections. Several challenges were identified while co-designing the application with older adults, and suggestions are provided in this paper to overcome such challenges. The study highlights how to include older adults' concerns regarding technologies within an iterative co-design process, leading to an endorsed final product. [ABSTRACT FROM AUTHOR]

While mental illness is one of the leading causes of international disease burden, within fifteen identified reviews of healthcare simulation only three included papers are in mental health. Here we systematically review the use of simulation modelling in mental healthcare, identifying 160 papers. There were widespread and innovative applications of simulation in the areas of medical decision making and epidemiology, with health system planning and optimisation relatively underrepresented. Markov modelling was the preferred method across area and illness. However, the literature is currently undermined by a lack of coherence and evidence of implementation, and we acknowledge an ongoing issue of accessing unpublished models from healthcare and government organisations. To advance, the field requires a shared knowledge base. We propose that this may be facilitated by the use of existing epidemiological models as the basis of modelling in all other areas. [ABSTRACT FROM AUTHOR]