INTRODUCTION: Telemedicine may help improve older adults' access, health outcomes, and quality of life indicators. This review aims to provide current evidence on the effectiveness of telemedicine in the aged population. METHOD: A systematic literature search was conducted in PubMed, Google Scholar, and Web of Science electronic databases between January 2015 and September 2021 using the keywords "telemedicine" or "telehealth" and "older people" or "geriatrics" or "elderly." The articles were classified under three headings according to the purposes: feasibility, diagnosis and management of chronic diseases, and patient satisfaction. RESULTS: A total of 22 articles were included. Across most disciplines, evidence has shown that telemedicine is as effective as usual care, if not more so, in the feasibility, chronic disease management, and patient satisfaction of the elderly. However, a few studies reported challenges such as difficulty with technology, hearing problems, and the inability to perform hands-on examinations for physicians. CONCLUSION: Findings from this review support the view that health care providers can use telemedicine to manage elderly individuals in conjunction with usual health care. However, future research is needed to eliminate barriers to increasing telemedicine use among older adults.

Objectives: The aim was to synthesize evidence on the use of person-centered outcome measures to facilitate integrated palliative care for older people and build a logic model depicting the mechanisms through which person-centered outcome measures support integrated care. Design: Mixed methods systematic review using a data-based convergent synthesis design. Setting and participants: Older people aged ≥60 years who are approaching the end of their lives in multiple settings. Methods: The study was underpinned by a conceptual framework of integrated palliative care, which informed the search strategy, data extraction, analysis, and synthesis. A hybrid search strategy was implemented, with database searches (PsycINFO, MEDLINE, CINAHL, and ASSIA) complemented by snowball searches. Qualitative and quantitative data were analyzed by narrative synthesis to summarize and explain the findings. The findings informed a logic model depicting the mechanisms of using person-centered outcome measures to support integrated palliative care. Results: Twenty-six studies were included. Three mixed methods studies, 2 qualitative studies, and 21 quantitative studies were included. There was evidence that person-centered outcome measures could support integrated palliative care through informing palliative care policy development (n = 4), facilitating joint working across settings (n = 5), enabling close collaboration of multidisciplinary teams (n = 14), promoting joint education (n = 1), facilitating timing and specialist referral (n = 6), and enhancing patient-centered care (n = 3). Conclusions and implications: This review makes an important, novel, and theoretically informed contribution to the delivery of scalable and sustainable integrated palliative care into the care of older people using person-centered outcome measures. The constructed logic model provides a conceptual framework and practical approach to how person-centered outcome measures support multilevel integration. A future area of research is the development of person-centered outcome measure interventions informed by the logic model to meet clinical needs.

Introduction: Many experts and communities have concerns about how National Disability Insurance Scheme services are provided to Aboriginal and Torres Strait children. This study was undertaken at the request of the NPY Women's Council in partnership with the researchers, to explore supports for Aboriginal and Torres Strait Islander children living with a disability in their remote areas. Objective: This scoping review aims to (a) explore the barriers and enablers to accessing disability support services for families of young Aboriginal and Torres Strait Islander children (0-8 years) living in regional, rural and remote settings, and (b) summarise best practice approaches for accessing support for young children in these settings. Design: The search was run in three electronic databases, as well as grey literature sources. We assessed the quality of included publications using the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange tool. A narrative synthesis was supported by thematic analysis. Findings: From an initial search (557 citations), we identified 13 eligible documents. Most documents were peer-reviewed articles of qualitative studies. Key themes identified included the following: (1) Holistic approach, (2) Understanding disability, (3) Consistent relationships, (4), Flexibility, (5) Simplify system and (6) Enhance communication. Discussion/conclusion: This scoping review has revealed gaps in the provision of quality, culturally responsive disability services for families of Aboriginal and Torres Strait Islander children living in regional, rural and remote areas of Australia. A family-centred, flexible approach will help address their needs. Future research is required to design and evaluate models of care for Aboriginal and Torres Strait Islander children.

Introduction: Indigenous people in Canada encounter negative treatment when accessing primary health care (PHC). Despite several qualitative accounts of these experiences, there still has not been a qualitative review conducted on this topic. In this qualitative systematic review, we aimed to explore Indigenous people's experiences in Canada with PHC services, determine urban versus rural or remote differences and identify recommendations for quality improvement. Methods: This review was guided by the Joanna Briggs Institute's methodology for systematic reviews of qualitative evidence. MEDLINE, CINAHL, PubMed, PsycInfo, Embase and Web of Science as well as grey literature and ancestry sources were used to identify relevant articles. Ancestry sources were obtained through reviewing the reference lists of all included articles and determining the ones that potentially met the eligibility criteria. Two independent reviewers conducted the initial and full text screening, data extraction and quality assessment. Once all data were gathered, they were synthesized following the meta-aggregation approach (PROSPERO CRD42020192353). Results: The search yielded a total of 2503 articles from the academic databases and 12 articles from the grey literature and ancestry sources. Overall, 22 articles were included in this review. Three major synthesized findings were revealed-satisfactory experiences, discriminatory attitudes and systemic challenges faced by Indigenous patients-along with one synthesized finding on their specific recommendations. Conclusion: Indigenous people value safe, accessible and respectful care. The discrimination and racism they face negatively affect their overall health and well-being. Hence, it is crucial that changes in health care practice, structures and policy development as well as systemic transformation be implemented immediately.

AIM: To identify the experiences of shared decision-making (SDM) for adults with end-stage kidney disease undergoing haemodialysis (HD) and their family members. DESIGN: A scoping literature review. METHOD: A scoping literature review, using Joanna Briggs Institute guidelines. DATA SOURCES: Medline (OVID), EMBASE, CINAHL, Psych Info, ProQuest, Web of Science, Open grey and grey literature were searched covering years from January 2015 to July 2022. Empirical studies, unpublished thesis and studies in English were included. The scoping review was conducted using the Preferred Reporting Items for Systematic Meta analysis-scoping review extension (PRISMA-Scr). RESULTS: Thirteen studies were included in the final review. While SDM is welcomed by people undergoing HD, their experience is often limited to treatment decisions, with little opportunity to revisit decisions previously made. The role of the family/caregivers as active participants in SDM requires recognition. CONCLUSION: People with end-stage kidney disease undergoing HD do and want to participate in the process of SDM, on a wide range of topics, in addition to treatment. A strategy is needed to ensure that SDM interventions are successful in achieving patient-driven outcomes and enhancing their quality of life. IMPLICATIONS FOR CLINICAL PRACTICE: This review highlights the experiences of people undergoing HD and their family/caregivers. There is a wide variety of clinical decisions requiring consideration for people undergoing HD, including considering the importance who should be involved in the decision-making processes and when decisions should occur. Further study to ensure nurses understand the importance, and influence of including family members in conversations on both SDM processes and outcomes is needed. There is a need for research from both patient and healthcare professional (HCP) perspectives to ensure that people feel supported and have their needs met in the SDM process. PATIENT AND PUBLIC CONTRIBUTION: No patient or public contribution.

Aims: To conduct an integrative literature review to reveal any evidence supportive of the integration of traditional therapies for First Nations peoples in Australia within a western healthcare model, and to identify which, if any, of these therapies have been linked to better health outcomes and culturally safe and appropriate care for First Nations peoples. If so, are there indications by First Nations peoples in Australia that these have been effective in providing culturally safe care or the decolonisation of western healthcare practices. Design: Integrative literature review of peer-reviewed literature. Data sources: Online databases searched included CINAHL, Medline, Scopus, ScienceDirect InformitHealth, and ProQuest. Review methods: Databases were searched for papers with full text available and published in English with no date parameter set. The PRISMA guidelines were used during the literature review and the literature was critiqued using the Critical Appraisal Skills tool. Results: Seven articles met the inclusion criteria and were included in the review. Four articles selected were qualitative, two used a mixed method design, and one used a quantitative method. Six themes arose: (i) bush medicine, (ii) traditional healers, (iii) traditional healing practices, (iv) bush tucker, (v) spiritual healing, and (vi) therapies that connected to cultures such as yarning and storytelling. Conclusion: There is limited literature discussing the use of traditional therapies in Western healthcare settings. A need exists to include traditional therapies within a Western healthcare system. Creating a culturally safer and appropriate healthcare experience for First Nations people in Australia and will contribute to advancement in the decolonisation of current healthcare models.

Background: Young people are increasingly seeking employment in the informal sector due to increasing global unemployment. However, the precarious nature of work in the informal sectors, coupled with the high risk of occupational hazards, calls for a greater need for effective healthcare for informal sector workers, particularly young people. In addressing the health vulnerabilities of informal workers, systematic data on the determinants of health is a persistent challenge. Therefore, the objective of this systematic review was to identify and summarise the existing factors that affect access to healthcare among young people from the informal sector. Methods: We searched six data databases (PubMed, Web of Science, Scopus, ProQuest, Crossref, and Google Scholar), which was followed by hand searching. Then we screened the identified literature using review-specific inclusion/exclusion criteria, extracted data from the included studies and assessed study quality. Then we presented the results in narrative form, though meta-analysis was not possible due to heterogeneity in the study design. Results: After the screening, we retrieved 14 studies. The majority were cross-sectional surveys and were conducted in Asia (n = 9); four were conducted in Africa, and one in South America. Samples ranged in size from 120 to 2,726. The synthesised results demonstrate that problems of affordability, availability, accessibility, and acceptability of healthcare were barriers to young informal workers seeking healthcare. We found social networks and health insurance as facilitators of access for this group of people. Conclusion: To date, this is the most comprehensive review of the evidence on access to healthcare for young people in the informal sector. Our study finding highlights the key gaps in knowledge where future research could further illuminate the mechanisms through which social networks and the determinants of access to healthcare could influence the health and well-being of young people and thus inform policy development.

Introduction: International organisations have called to increase young people's involvement in healthcare and health policy development. We currently lack effective methods for facilitating meaningful engagement by young people in health-related decision-making. The purpose of this scoping review is to identify deliberative priority setting methods and explore the effectiveness of these in engaging young people in healthcare and health policy decision-making. Methods: Seven databases were searched systematically, using MeSH and free text terms, for articles published in English before July 2021 that described the use of deliberative priority setting methods for health decision-making with young people. All titles, abstracts and full-text papers were screened by a team of six independent reviewers between them. Data extraction followed the Centre for Reviews and Dissemination guidelines. The results are presented as a narrative synthesis, structured around four components for evaluating deliberative processes: 1) representation and inclusion of diverse participants, 2) the way the process is run including levels and timing of participant engagement, 3) the quality of the information provided to participants and 4) resulting outcomes and decisions. Findings: The search yielded 9 reviews and 21 studies. The more engaging deliberative priority setting tools involved young people-led committees, mixed methods for identifying and prioritising issues and digital data collection and communication tools. Long-term and frequent contact with young people to build trust underpinned the success of some of the tools, as did offering incentives for taking part and skills development using creative methods. The review also suggests that successful priority setting processes with young people involve consideration of power dynamics, since young people's decisions are likely to be made together with family members, health professionals and academics. Discussion: Young people's engagement in decision-making about their health is best achieved through investing time in building strong relationships and ensuring young people are appropriately rewarded for their time and contribution. If young people are to be instrumental in improving their health and architects of their own futures, decision-making processes need to respect young people's autonomy and agency. Our review suggests that methods of power-sharing with young people do exist but that they have yet to be adopted by organisations and global institutions setting global health policy.

OBJECTIVES: To identify studies that delivered an intervention to frail older people to improve medicines optimisation; identify the outcomes reported in these studies; and assess the effectiveness of these interventions on chosen study outcomes. METHOD: Eight electronic databases and four trial registries were systematically searched from the date of inception to April 2020. Inclusion criteria were randomised controlled trials and non-randomised studies of interventions to improve medicines optimisation (including administration, adherence, deprescribing, prescribing and/or medication review) in community-dwelling older people (aged 65 years) with a frailty diagnosis. Only studies published in English were included. A narrative synthesis was conducted, and quality was assessed using an appropriate risk of bias tool. KEY FINDINGS: Searches identified 601 articles; one study met the criteria for inclusion. The single eligible study used a quasi-experimental pre-test-post-test study design to evaluate the impact of a pharmacist-led, team-based medication review for 54 frail older patients living in primary care. Improvements in the total number of medications and prescribing appropriateness were observed. The study was judged to be at an overall serious risk of bias. CONCLUSION: There is a dearth of high-quality evidence demonstrating the effectiveness of medicines optimisation interventions for older people with frailty within primary care. Due to the strong association between patients' level of frailty and adverse outcomes, it is important that future research focuses on proactive interventions which may be beneficial to this patient population.

PURPOSE: The proportion of people living with HIV being older adults is increasing and due to high rates of multimorbidity and frailty within this group geriatricians are well placed to contribute to their care. However, little is known about how geriatricians feel about this new opportunity. METHODS: A scoping review was performed following the Arksey & O'Malley's methodological framework with nine databases searched in December 2021 for studies reporting the experiences or views of geriatricians on caring for people living with HIV. Study inclusion was not limited by language or year of publication. Narrative reviews were excluded. Two reviewers independently performed the extraction using predetermined criteria. A descriptive analysis of extracted information was performed. RESULTS: Six publications reporting four studies, all conducted in the USA, were identified. The current barriers to geriatricians being involved in the care of older people living with HIV are: their current experience in managing people living with HIV, their knowledge of HIV, specific issues related to older people living with HIV and screening for HIV in older people as well as their attitudes to people living with HIV and experience of managing older LGBTQ + people. CONCLUSION: Prior to geriatricians being routinely involved in the care of older people living with HIV further research outside of the USA is required. Geriatricians will also require specific training which should be incorporated into geriatric medicine training curricula as well as the creation of learning tools and quality clinical practice guidelines ideally created in collaboration with HIV organisations.

The ageing of the population has resulted in an increase in the demand for long-term care services for older people, but with limited resources, its challenges have also been highlighted. Although factors affecting the willingness of older people to engage with long-term care services have been widely reported, however, systematic review has not synthesised the evidence, and its associated factors remain unclear. This systematic review aims to study and synthesise the best available evidence on the potential factors related to the willingness of older people to engage with long-term care services. Eight electronic databases were comprehensively searched from inception to January 2021: the Cochrane Library, PubMed, Web of Science, CINAHL, Wanfang Database, China Knowledge Resource Integrated Database (CNKI), Weipu Database (VIP), and Chinese Biomedical Literature Database (CBM). The original literatures were screened according to selection criteria. Two researchers used 11-item checklist recommended by the Agency for Healthcare Research and Quality to evaluate the quality of the included literatures. And the review used narrative synthesis to integrate factors related to the willingness of older people to engage with long-term care services. In total, 7794 studies were screened and 35 studies were included in this review. Among them, 23 studies were rated as moderate quality and 12 was high quality. Data synthesis identified that age, education, number of children, living arrangements, the relationship with children, primary caregivers, place of residence, social support, household income, medical insurance, activities of daily living ability and spiritual comfort should all be taken into account when establishing the appropriate long-term care service model or formulating relevant policies. However, many factors remain undetermined and require more rigorous original literature support. And multiple areas can be also considered in the future studies, especially psychological factors.

BACKGROUND: Mental health difficulties in children and adolescents are highly prevalent; however, only a minority receive adequate mental health care. Internet-delivered interventions offer a promising opportunity to increase access to mental health treatment. Research has demonstrated their effectiveness as a treatment for depression and anxiety in adults. This work provides an up-to-date examination of the available intervention options and their effectiveness for children and young people (CYP). OBJECTIVE: In this systematic review and meta-analysis, we aimed to determine the evidence available for the effectiveness of internet-delivered interventions for treating anxiety and depression in CYP. METHODS: Systematic literature searches were conducted throughout November 2020 using PubMed, PsycINFO, and EBSCO academic search complete electronic databases to find outcome trials of internet-delivered interventions treating symptoms of anxiety and/or depression in CYP by being either directly delivered to the CYP or delivered via their parents. Studies were eligible for meta-analysis if they were randomized controlled trials. Risk of bias and publication biases were evaluated, and Hedges g between group effect sizes evaluating intervention effects after treatment were calculated. Meta-analyses used random-effects models as per protocol. RESULTS: A total of 23 studies met the eligibility criteria for the systematic review, of which 16 were included in the meta-analyses, including 977 participants in internet-delivered treatment conditions and 1008 participants in control conditions across 21 comparisons. Random-effects models detected a significant small effect for anxiety symptoms (across 20 comparisons; Hedges g=-0.25, 95% CI -0.38 to -0.12; P<.001) and a small but not significant effect for depression (across 13 comparisons; Hedges g=-0.27, 95% CI -0.55 to 0.01; P=.06) in favor of internet-delivered interventions compared with control groups. Regarding secondary outcomes, there was a small effect of treatment across 9 comparisons for impaired functioning (Hedges g=0.52, 95% CI 0.24-0.80; P<.001), and 5 comparisons of quality of life showed no effect (Hedges g=-0.01, 95% CI -0.23 to 0.21; P=.94). CONCLUSIONS: The results show that the potential of internet-delivered interventions for young people with symptoms of anxiety or depression has not been tapped into to date. This review highlights an opportunity for the development of population-specific interventions and their research to expand our current knowledge and build an empirical base for digital interventions for CYP.

BACKGROUND: People with dementia or mild cognitive impairment (MCI) and their family carers face challenges in managing medicines. How medicine self-management could be supported for this population is unclear. This review identifies interventions to improve medicine self-management for people with dementia and MCI and their family carers, and the core components of medicine self-management that they address. METHODS: A database search was conducted for studies with all research designs and ongoing citation search from inception to December 2021. The selection criteria included community-dwelling people with dementia and MCI and their family carers, and interventions with a minimum of one medicine self-management component. The exclusion criteria were wrong population, not focusing on medicine management, incorrect medicine self-management components, not in English and wrong study design. The results are presented and analysed through narrative synthesis. The review is registered [PROSPERO (CRD42020213302)]. Quality assessment was carried out independently applying the QATSDD quality assessment tool. RESULTS: 13 interventions were identified. Interventions primarily addressed adherence. A limited number focused on a wider range of medicine self-management components. Complex psychosocial interventions with frequent visits considered the person's knowledge and understanding, supply management, monitoring effects and side effects and communicating with healthcare professionals, and addressed more resilience capabilities. However, these interventions were delivered to family carers alone. None of the interventions described patient and public involvement. CONCLUSION: Interventions, and measures to assess self-management, need to be developed which can address all components of medicine self-management to better meet the needs of people with dementia and MCI and their family carers.

BACKGROUND: Entrustable professional activities (EPAs) have become an important component of competency-based medical education. The aim of this study is to evaluate how geriatric medicine learning objectives are addressed by undergraduate medical curricula including EPAs. METHODS: We performed a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines to identify undergraduate medical curricula that include EPAs. A content analysis was conducted to examine how these curricula address the care of older individuals. In addition, we mapped the curricula to 19 geriatric medicine learning objectives identified from the European curriculum of undergraduate medical education. RESULTS: We found nine curricula, each containing between 4 and 16 core EPAs. In the sections describing the EPAs, three of the nine curricula specify that all core EPAs apply to all age groups including older patients, whereas the remaining six curricula either only refer to older patients in selected EPAs or not at all. Mapping revealed that some geriatric medicine learning objectives are covered by most curricula (e.g. medication use, multidisciplinary team work), whereas others are lacking in the majority (e.g. normal ageing, geriatric assessment, cognitive assessment, nutrition assessment, decision-making capacity assessment, long-term care). Three curricula cover most geriatric learning objectives by using a matrix aligning EPAs with geriatric competencies. CONCLUSIONS: Geriatric learning objectives continue to be missing from undergraduate medical curricula, also from those adopting the novel approach of EPAs. However, this review also identified some curricula that might serve as models for how geriatric learning objectives can be successfully covered within future EPA frameworks.

Bibliotherapy is an important part of art therapy and many publications regarding bibliotherapy have been published in the past. However, there has none about the scientometric study to systematically analyze the development and emerging research trends on bibliotherapy. Therefore, we performed a scientometric investigation to describe trends of this theme. All publications related to bibliotherapy published from 1980 to 2020 were identified and selected from Science Citation Index Expanded, Social Sciences Citation Index, and Arts & Humanities Citation Index of Web of Science Core Collection. VOSviewer was used to create collaborative network plots of countries, institutions, and authors and to perform cluster analysis of keywords. A total of 703 articles were searched, and we retrieved the 100 most cited articles published by 146 institutions from 15 countries in 57 academic journals. The United States occupied a leading position in the field of bibliotherapy and Linkoping University was the most productive institution. Journal of Consulting and Clinical Psychology was the most productive journal. Andersson G, Carlbring P, and Cuijpers P may have an important influence on bibliotherapy research. The applications in depression, anxiety, panic disorder, insomnia, and aphasia are the hot themes. This scientometric review provided a comprehensive understanding of the bibliotherapy research using quantitative and qualitative methods, which can provide references for researchers in the bibliotherapy field. As investigators continue to work, we look forward to the development of bibliotherapy efficacy and the implementation form and steps.

BACKGROUND: Pharmacotherapy in older adults is one of the most challenging aspects of patient care. Older people are prone to drug-related problems such as adverse effects, ineffectiveness, underdosage, overdosage, and drug interactions. Anticholinergic medications are associated with poor outcomes in older patients, and there is no specific intervention strategy for reducing drug burden from anticholinergic activity medications. Little is known about the effectiveness of current interventions that may likely improve the anticholinergic prescribing practice in older adults. AIMS: This review seeks to document all types of interventions aiming to reduce anticholinergic prescribing among older adults and assess the current evidence and quality of existing single and combined interventions. METHODS: We systematically searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL, and PsycINFO from January 1990 to August 2021. Only studies that examined the effect of interventions in older people focused on improving compliance with anticholinergic prescribing guidelines with quantifiable data were included. The primary outcome of interest was to find the effectiveness of interventions that enhance the anticholinergic prescribing practice in older adults. RESULTS: We screened 3168 records and ended up in 23 studies that met the inclusion criteria. We found only single-component interventions to reduce anticholinergic prescribing errors in older people. Pharmacists implemented interventions without collaboration in nearly half of the studies (n = 11). Medication review (43%) and education provision (26%) to healthcare practitioners were the most common interventions. Sixteen studies (70%) reported significant reductions in anticholinergic prescribing errors, whereas seven studies (30%) showed no significant effect. CONCLUSION: This systematic review suggests that healthcare practitioner-oriented interventions have the potential to reduce the occurrence of anticholinergic prescribing errors in older people. Interventions were primarily effective in reducing the burden of anticholinergic medications and assisting with deprescribing anticholinergic medications in older adults.

Depression in the United States (US) is increasing across all races and ethnicities and is attributed to multiple social determinants of health (SDOH). For members of historically marginalized races and ethnicities, depression is often underreported and undertreated, and can present as more severe. Limited research explores multiple SDOH and depression among African American adults in the US. Guided by Healthy People (HP) 2030, and using cross-disciplinary mental health terminology, we conducted a comprehensive search to capture studies specific to African American adults in the US published after 2016. We applied known scoping review methodology and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. From 12,315 initial results, 60 studies were included in our final sample. Most studies explored the HP 2030 Social and Community Context domain, with a heavy focus on discrimination and social support; no studies examined Health Care Access and Quality. Researchers typically utilized cross-sectional, secondary datasets; no qualitative studies were included. We recommend research that comprehensively examines mental health risk and protective factors over the life course within, not just between, populations to inform tailored health promotion and public policy interventions for improving SDOH and reducing racial and ethnic health disparities.

Long-term care (LTC) facilities, in which older adults are institutionalised, have the responsibility to address their residents' rights, privacy and comfort in expressing themselves sexually in an acceptable manner. However, many older adults have reported barriers in their sexual expression, which is often a result of the care staff's attitudes in the facilities. This review synthesis evidence from qualitative studies on the challenges faced by care staff when supporting sexual expression of older residents in LTC facilities. The systematic review and meta-synthesis is reported according to the Enhanced Transparency in Reporting the Synthesis of Qualitative Research Statement. A systematic literature search for peer-reviewed studies was conducted on PubMed, Cochrane Library, EMBASE, Scopus, Web of Science, PsycINFO, CINAHL and ProQuest Theses and Dissertations from inception until December 2020. Sandelowski and Barroso's two-step approach was used to synthesise the evidence. Seventeen qualitative studies published between 2004 and 2020 were included. This review encapsulated the experiences and challenges of 4,387 care staff whose age ranged from 18 to 69 years. Through the meta-synthesis, four themes were identified: varying manifestations of sexual expression and situations encountered, a spectrum of care staff's attitudes, setting boundaries in dementia care and workplace support. Managing sexual expression can be challenging for the care staff, given the complex interplay between personal beliefs, social contexts, moral dilemmas, practical barriers and the lack of clear policies. This review highlighted the need to equip them with knowledge, skills and confidence in managing sexuality in LTC facilities.

Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.

BACKGROUND: Psychosocial issues, such as social isolation and loneliness among older adults and people with dementia, continue to pose challenges with a rapidly aging population worldwide. Social robots are a rapidly emerging field of technology, developed to help address the psychosocial needs of this population. Although studies have reported positive findings regarding their psychosocial benefits, their implementation in real-world practice remains a challenge. Nevertheless, little is known about the factors affecting their implementation. The purpose of this review is to provide a systematic overview of the barriers and facilitators affecting the implementation of social robots for older adults and people with dementia. METHOD: The Arksey and O'Malley approach with methodological enhancement by Levac et al. was used to guide the conduct of this review. Seven electronic databases were searched. In addition, hand searching and backward citation tracing was conducted. Three independent reviewers were involved in the screening and data charting process. Findings were synthesised and categorised into the five domains outlined in the Consolidated Framework of Implementation Research (CFIR). RESULTS: A total of 53 studies were included in the final review. Most of the included studies were based in participants' homes and in care facilities. Barriers and facilitators were mapped onto 18 constructs in the five domains of the CFIR. The most frequently cited barriers were mapped to the constructs within the domain of "Intervention characteristics", where issues such as the complexity of using the technology and technical obstacles impeded implementation. Most facilitators were mapped onto the domain "Patient needs and resources". Overall, existing research are disproportionately focused on the internal validity (i.e. characteristics) of social robots, and there is significantly less research investigating their external validity, such as organisational or wider contextual factors that can affect their implementation in real-world practice. CONCLUSION: This review has identified and synthesised the breadth of evidence on the barriers and facilitators to the implementation of social robots for older adults and people with dementia. Future research should pay more attention to investigating the contextual factors, using an implementation framework, to identify barriers and facilitators to guide the implementation of social robots.