Medicine and Health Sciences Commons^™

Quantifying Uptake And Completion Of Pulmonary Rehabilitation Programs In People With Chronic Obstructive Pulmonary Disease Known To Tertiary Care, Sarah Hug, Vinicius Cavalheri, Daniel F. Gucciardi, Kylie Hill

Research outputs 2022 to 2026

Background: People with symptomatic chronic obstructive pulmonary disease (COPD) benefit from pulmonary rehabilitation programs (PRPs), but program attrition is common. Methods: For people with COPD who presented to tertiary care and appeared appropriate for a PRP, we prospectively mapped their PRP journey, explored factors influencing attendance to pre-program assessment and captured program attrition. Results: Of the 391 participants, 31% (95% CI 27 to 36) were referred to a PRP (n = 123; age 68 ± 10years, 62 males [50%], FEV1 45 ± 19%predicted). Of those referred, 94 (76% [69 to 84]) attended a pre-program assessment. Ex-smokers and those who had …

Frailty Knowledge, Training And Barriers To Frailty Management: A National Cross-Sectional Survey Of Health Professionals In Australia, Leila S. Hanjani, Sarah Fox, Ruth E. Hubbard, Emily Gordon, Natasha Reid, Sarah N. Hilmer, Rosemary Saunders, Danijela Gnjidic, Adrienne Young

Research outputs 2022 to 2026

Objective(s): To understand Australian health professionals' perceptions of their knowledge and previous training about frailty, as well as barriers to frailty assessment and management in their practice. Methods: A cross-sectional online survey was developed and distributed to health professionals (medical, nursing and allied health) engaged in clinical practice in Australia through convenience and snowball sampling techniques from March to May 2022. The survey consisted of five sections: frailty training and knowledge; confidence in recognising and managing adults with frailty; the importance and relevance of frailty; barriers to assessing and managing frailty in practice; and interest in further frailty training. Responses …

A Scoping Review Of The Impact Of Food Policy Groups On Local Food Systems In High-Income Countries, Stephanie Louise Godrich, Jess Doe, Sarah Goodwin, Laura Alston, Katherine Kent

Research outputs 2022 to 2026

This scoping review aimed to explore international evidence on the impact of Food Policy Groups (FPGs) on local food systems, in urban and rural regions of high-income countries. Peer-reviewed and grey literature were searched to identify 31 documents published between 2002 and 2022 providing evidence on the impact of FPGs. Activities spanned domains including increasing food equity (e.g. strengthening school meals programs); increasing knowledge and/or demand for healthy food (e.g. food literacy programs with children and adults); increasing food access (e.g. enhancing local food procurement); environmental sustainability (e.g. promoting low-waste food items on café menus); economic development (e.g. ensuring local …

Maximal Number Of Repetitions At Percentages Of The One Repetition Maximum: A Meta-Regression And Moderator Analysis Of Sex, Age, Training Status, And Exercise, James L. Nuzzo, Matheus D. Pinto, Kazunori Nosaka, James Steele

Research outputs 2022 to 2026

The maximal number of repetitions that can be completed at various percentages of the one repetition maximum (1RM) [REPS ~ %1RM relationship] is foundational knowledge in resistance exercise programming. The current REPS ~ %1RM relationship is based on few studies and has not incorporated uncertainty into estimations or accounted for between-individuals variation. Therefore, we conducted a meta-regression to estimate the mean and between-individuals standard deviation of the number of repetitions that can be completed at various percentages of 1RM. We also explored if the REPS ~ %1RM relationship is moderated by sex, age, training status, and/or exercise. A total of …

Physical Restraint In Older People: A Statement From The Early Career Network Of The International Psychogeriatric Association, Mustafa Atee, Claire V. Burley, Victor A. Ojo, Agboola J. Adigun, Hayoung Lee, Daniel J. Hoyle, Olufisayo Elugbadebo, Tomas Leon

Research outputs 2022 to 2026

The International Psychogeriatric Association (IPA) has expressed significant concerns over the use of physical restraints in older people across diverse aged care settings. Following an extensive analysis of the available literature, the IPA's Early Career Network (ECN) has formulated a collection of evidence-based recommendations aimed at guiding the use of physical restraints within various care contexts and demographic groups. Physical restraints not only infringe upon human rights but also raise significant safety concerns that adversely impact the physical, psychological, social, and functional well-being of older adults. Furthermore, their effectiveness in geriatric settings remains inadequate. Given these considerations, the IPA and …

Midline Brain Structures In Adult Niemann-Pick Type C Disease: A Cross-Sectional Study, Mark Walterfang, Tsutomu Takahashi, Maria A. Di Biase, Vanessa L. Cropley, Daiki Sasabayashi, Michio Suzuki, Dennis Velakoulis, Christos Pantelis

Research outputs 2022 to 2026

Objective: A range of neuropathological changes occur in the brains of individuals with adult Niemann-Pick type C disease (NPC), a recessive disorder of cholesterol trafficking that results in accumulation of cholesterol and gangliosides in lysosomes, particularly in neurons. One of the most significant regions of grey matter loss occurs in the thalami, which abut the midline. What is not known is whether these are neurodevelopmental in origin well prior to symptomatic onset. We aimed to examine other markers of midline developmental anomalies in adults with NPC. Method: We examined the size of adhesio interthalamica (AI) and cavum septum pellucidum (CSP) …

Differentiating Origins Of Outflow Tract Ventricular Arrhythmias: The Correction Of Transitional Zone Index Is Not Superior To The Original One, Ming Liu, Zhuoqiao He, Pengxiang Ying, Dong Lin, Min Yu, Xuerui Tan

Research outputs 2022 to 2026

Introduction: Our team once proposed a correction of transitional zone index (CTZI) based on the transitional zone index (TZI) in view of achieving a more precise prediction of outflow tract ventricular arrhythmia (OTVA). The predictive accuracy of these two electrocardiogram (ECG) algorithms has not been validated and compared. The purpose of this study was to compare the predictive accuracy of TZI and CTZI in a much larger population with idiopathic OTVA. Methods: The predictive accuracy of TZI and CTZI was compared in 695 individuals with idiopathic premature ventricular complex or ventricular tachycardia which exhibited a left bundle branch block pattern …

Effects Of Cognitive And Social Demands On Linguistic Production For People With Moderate, Mild, Or No Aphasia, Tyson G. Harmon, Emily Mcdonald, Kyle Steele

Faculty Publications

Background: Most everyday communication occurs in situations where cognitive and social demands are present. These types of situations may compound language deficits for people with aphasia (PWA). An understanding of the language interference that may occur from cognitive and social demands is an important precursor for assessment and intervention that addresses everyday communication situations.

Aims: To determine how cognitively and socially demanding conditions affect micro- and macrolinguistic production for people with moderate, mild, or no aphasia during narrative discourse and to compare effects among groups.

Method: Thirty participants with mild (n = 9), moderate (n = 9), or no (n …

Understanding And Addressing The Individualized Emotional Impact Of Aphasia: A Framework For Speech-Language Pathologists, Tyson G. Harmon

Faculty Publications

Emotion plays an integral role in communication and has long been considered relevant to aphasia rehabilitation. Speech-language pathologists (SLPs), however, may sometimes wonder how or whether to address emotional responses. The purpose of the present tutorial was to (1) present a framework that clinicians can use to understand individualized emotional responses in aphasia and (2) discuss examples of how the framework informs practical strategies that SLPs can use to provide emotional support to PWA. Drawing upon a cognitive-motivational-relational theory of emotions perspective combined with emerging research in aphasia, I show that emotion impacts and is impacted by both language processing …

Effects Of Cognitive And Social Demands On Linguistic Production For People With Moderate, Mild, Or No Aphasia, Tyson G. Harmon, Emily Mcdonald, Kyle Steele

Faculty Publications

Background

Most everyday communication occurs in situations where cognitive and social demands are present. These types of situations may compound language deficits for people with aphasia (PWA). An understanding of the language interference that may occur from cognitive and social demands is an important precursor for assessment and intervention that addresses everyday communication situations.

Aims

To determine how cognitively and socially demanding conditions affect micro- and macrolinguistic production for people with moderate, mild, or no aphasia during narrative discourse and to compare effects among groups.

Method

Thirty participants with mild (n = 9), moderate (n = 9), or no (n …

Insights From A National Database For Programs Supporting Neuropsychiatric Symptoms Of Dementia In Australia, Mustafa Atee, Thomas Morris, Daniel Whiting, Stephen Macfarlane, Marie Alford

Research outputs 2022 to 2026

No abstract provided.

Intersectoral Collaboration For Supporting The Health And Wellbeing Of Aboriginal Families And Children In Out-Of-Home Care: Perspectives From Western Australian Aboriginal Community Controlled Health Organisations, Sasha Moodie, Jocelyn Jones, Richard Chenhall, Robyn Williams, Cathy Garlett, Alison Gibberd, Melissa O’Donnell, Dan Mcaullay, Bridgette Mcnamara, Sandra Eades

Research outputs 2022 to 2026

Introduction: Western Australia has one of the highest rates of Aboriginal children entering out-of-home care in Australia. Kinship care is the preferred culturally safe out-of-home care option for Aboriginal children, yet all jurisdictions, including Western Australia, are far from meeting best-practice national standards. Intersectoral collaboration is a key primary healthcare principle and internationally recognized for improving health systems and outcomes. This paper presents findings from a qualitative research project investigating Aboriginal primary healthcare workers’ experiences of intersectoral collaboration challenges and strengthening opportunities. Methods: Constructivist grounded theory guided this research involving 55 semi-structured interviews and four focus group discussions with Aboriginal …

Music As A Determinant Of Health Among First Nations People In Australia: A Scoping Narrative Review, Brigitta Scarfe, Kristy Apps, Naomi Sunderland, Phil Graham, Brydie Leigh Bartleet, Glenn Barry, Darren Garvey, Rae Cooper, Clint Bracknell

Research outputs 2022 to 2026

Issue Addressed:

While social determinants frameworks are still popular in research about First Nations health in Australia, a growing body of research prefers cultural determinants of health models. Cultural determinants models provide a holistic, strength-based framework to explain connections between health and contextual factors, including the potential role of music and its impact on social and emotional well-being. Given the growing international recognition of links between music, health, and wellbeing through bodies such as the World Health Organisation, this article examines whether and how music practices are acknowledged in First Nations determinants of health literature.

Methods:

We conducted a scoping …

Psychedelic Trip Sitting, Dosages And Intensities: Supplementing Clinical Studies With Anecdotal Reports, Liam B. Engel, Sascha Thal, Stephen J. Bright, Mitchell Low

Research outputs 2022 to 2026

Background and aims: Online communities provide insights into psychedelic consumption, assisting in identification of trends, informing both harm reduction provisions and clinical research. This study extracts forum data on psychedelic substances, dosages, and administration routes, categorising and analysing self-reported consumption to inform care services and guide clinical work with psychedelics. Methods: Posts (n = 660) from online psychedelic forums (The Shroomery and DMT Nexus) on 'trip sitting' were analysed. Using a Delphi-style expert panel review facilitated by LE, we created drug weight and intensity charts (threshold, light, common, strong and heavy dosages) for psychedelics discussed in these posts. The psychedelic …

Rationale, Design, And Baseline Characteristics Of Participants In The Health@Nus Mhealth Augmented Cohort Study Examining Student-To-Work Life Transition: Protocol For A Prospective Cohort Study, Xin Hui Chua, Sarah Martine Edney, Andre Matthias Müller, Nicholas A. Petrunoff, Clare Whitton, Zoey Tay, Claire Marie Jie Lin Goh, Bozhi Chen, Su Hyun Park, Salome A. Rebello, Alicia Low, Janelle Chia, Daphne Koek, Karen Cheong, Rob M. Van Dam, Falk Müller-Riemenschneider

Research outputs 2022 to 2026

Background: Integration of mobile health data collection methods into cohort studies enables the collection of intensive longitudinal information, which gives deeper insights into individuals’ health and lifestyle behavioral patterns over time, as compared to traditional cohort methods with less frequent data collection. These findings can then fill the gaps that remain in understanding how various lifestyle behaviors interact as students graduate from university and seek employment (student-to-work life transition), where the inability to adapt quickly to a changing environment greatly affects the mental well-being of young adults. Objective: This paper aims to provide an overview of the study methodology and …

Resting Heart Rate And Risk Of Dementia: A Mendelian Randomization Study In The International Genomics Of Alzheimer’S Project And Uk Biobank, Xingxing Chen, Yi Zheng, Jun Wang, Blake Yue, Xian Zhang, Kenta Nakai, Lijing L. Yan

Research outputs 2022 to 2026

Background: Observational studies have demonstrated that a higher resting heart rate (RHR) is associated with an increased risk of dementia. However, it is not clear whether the association is causal. This study aimed to determine the causal effects of higher genetically predicted RHR on the risk of dementia. Methods: We performed a two-sample Mendelian randomization analysis to investigate the causal effect of higher genetically predicted RHR on Alzheimer’s disease (AD) using summary statistics from genome-wide association studies. The generalized summary Mendelian randomization (GSMR) analysis was used to analyze the corresponding effects of RHR on following different outcomes: 1) diagnosis of …

Role Of Short Chain Fatty Acids On Astrocytes And Microglia In Alzheimer's Disease Brain, Rathnayaka Mudiyanselage Uththara Sachinthanie Senarath, Matthew Burton, Welisarage Mary Kendrea Thiasangee Fernando, Vijay Jayasena, Charles Brennan, Wanakulasuriya Mary Ann Dipika Binosha Fernando

Research outputs 2022 to 2026

Short-chain fatty acids (SCFAs) hold exert many nutritional benefits on both physiological and pathological processes, including host metabolism, immune modulation, and appetite control. Originating from the microbial fermentation of resistant starches and dietary fibre in the colon, SCFAs have the capability to traverse the blood–brain barrier (BBB). It is evident that SCFAs play a critical role in the development of neurodegenerative disorders such as Alzheimer's disease (AD). AD is the most common form of dementia and is characterised by the deposition of amyloid β peptides (Aβ) and tau hyperphosphorylation. SCFAs have demonstrated the potential to interfere with the protein–protein interactions …

Utilisation Of Simulation-Based Learning To Decrease Student Anxiety And Increase Readiness For Clinical Placements For Speech-Language Pathology Students, Teresa Petrich, Brennen Mills, Abigail Lewis, Sara Hansen, Emily Brogan, Natalie Ciccone

Research outputs 2022 to 2026

Purpose: To investigate the use of two versions of a simulation-based learning experience (SBLE) to decrease speech-language pathology (SLP) students’ anxiety and increase their confidence and sense of preparedness for clinical placements. Method: Two cohorts of third-year SLP students (n = 33) participated in a mixed-methods study with each cohort completing one version of the SBLE. Participants completed pre- and post-program quantitative ratings of anxiety, confidence, and preparedness for clinical placements and participated in focus groups. Three clinical educators also provided qualitative data in debriefs and interviews. Result: Significant decreases in student ratings of anxiety, and increases in confidence and …

Using Image-Reflections To Support Undergraduate Students’ Relational Employability: A Practitioner Reflection, Ruth M. Wallace, Sally-Anne Doherty, Elizabeth Cook

Research outputs 2022 to 2026

This practitioner reflection explores our integration of the Relational Employability Framework within the Health Research Project capstone unit of a Bachelor of Health Science degree. To address the historically low quality of student reflections, we incorporated image-based reflective activities to improve engagement and depth. These activities encouraged students to use visual media to examine their developing relational employability. We developed and implemented a series of tutorial activities designed to scaffold this process, aiming to foster deeper reflective practice and highlight its importance for career development and employability. Our reflections indicate that, while grades did not significantly increase, students showed enhanced …

Alzheimer's Disease Genetic Risk And Changes In Brain Atrophy And White Matter Hyperintensities In Cognitively Unimpaired Adults, Anja Soldan, Jiangxia Wang, Corinne Pettigrew, Christos Davatzikos, Guray Erus, Timothy J. Hohman, Logan Dumitrescu, Murat Bilgel, Susan M. Resnick, Leonardo A. Rivera-Rivera, Rebecca Langhough, Sterling C. Johnson, Tammie Benzinger, John C. Morris, Simon M. Laws, Jurgen Fripp, Colin L. Masters, Marilyn S. Albert

Research outputs 2022 to 2026

Reduced brain volumes and more prominent white matter hyperintensities on MRI scans are commonly observed among older adults without cognitive impairment. However, it remains unclear whether rates of change in these measures among cognitively normal adults differ as a function of genetic risk for late-onset Alzheimer's disease, including APOE- ε4, APOE-ε2 and Alzheimer's disease polygenic risk scores (AD-PRS), and whether these relationships are influenced by other variables. This longitudinal study examined the trajectories of regional brain volumes and white matter hyperintensities in relationship to APOE genotypes (N = 1541) and AD-PRS (N = 1093) in a harmonized dataset of middle-aged …

Error In Jump Height Estimation Using The Flight Time Method: Simulation Of The Effect Of Ankle Position Between Takeoff And Landing, Carlos Gonçalves, Roberto Baptista, James Tufano, Anthony J. Blazevich, Amilton Vieira

Research outputs 2022 to 2026

During vertical jump evaluations in which jump height is estimated from flight time (FT), the jumper must maintain the same body posture between vertical takeoff and landing. As maintaining identical posture is rare during takeoff and landing between different jump attempts and in different individuals, we simulated the effect of changes in ankle position from takeoff to landing in vertical jumping to determine the range of errors that might occur in real-life scenarios. Our simulations account for changes in center of mass position during takeoff and landing, changes in ankle position, different subject statures (1.44–1.98 m), and poor to above-average …

Examining The Effects Of Dynamic And Isometric Resistance Training On Knee Joint Kinetics During Unplanned Sidesteps In Elite Female Athletes, Daniel Kadlec, Matthew J. Jordan, Jacqueline Alderson, Sophia Nimphius

Research outputs 2022 to 2026

Kadlec, D, Jordan, MJ, Alderson, J, and Nimphius, S. Examining the effects of dynamic and isometric resistance training on knee joint kinetics during unplanned sidesteps in elite female athletes. J Strength Cond Res XX(X): 000-000, 2024 - The purpose of this study was to examine the effects of a 4-week block of isometric (isometricRT) and dynamic resistance training (dynamicRT) on kinetic variables associated with anterior cruciate ligament (ACL) injury risk during unplanned sidesteps in elite female athletes. Twenty-one elite female athletes competing for a women's international rugby union team were recruited with 15 (n = 15; age: 23.4 ± 4.7 …

Resting Heart Rate Mediates The Association Between Circulating Neutrophil Count And Arterial Stiffness Progression: The Kailuan Study, Zhaogui Wu, Dan Wu, Shuohua Chen, Sichi Xu, Shunming Zhang, Shouling Wu

Research outputs 2022 to 2026

Objective: This study aimed to longitudinally investigate the association between circulating neutrophil count and the progression of arterial stiffness and to ascertain whether resting heart rate (RHR) mediates this association. Methods: The current study included 56,760 participants with brachial-ankle pulse wave velocity (baPWV) measurements from a real-life, prospective cohort in China. The associations of circulating neutrophil (exposure) with baseline baPWV, baPWV progression, and arterial stiffness (outcomes), as well as RHR (mediator) were assessed using multivariable linear and Cox regression models and mediation analysis. Results: After adjusting for cardiometabolic risk factors, for each 1-SD increase in neutrophil count, the corresponding increase …

Sleep Discrepancy And Brain Glucose Metabolism In Community-Dwelling Older Adults, Nadia Soh, Michael Weinborn, James D. Doecke, Rodrigo Canovas, Vincent Doré, Ying Xia, Jurgen Fripp, Kevin Taddei, Romola S. Bucks, Hamid R. Sohrabi, Ralph N. Martins, Melissa Ree, Stephanie R. Rainey-Smith

Research outputs 2022 to 2026

Sleep discrepancy (negative discrepancy reflects worse self-reported sleep than objective measures, such as actigraphy, and positive discrepancy the opposite) has been linked to adverse health outcomes. This study is first to investigate the relationship between sleep discrepancy and brain glucose metabolism (assessed globally and regionally via positron emission tomography), and to evaluate the contribution of insomnia severity and depressive symptoms to any associations. Using data from cognitively unimpaired community-dwelling older adults (N = 68), cluster analysis was used to characterise sleep discrepancy (for total sleep time (TST), wake after sleep onset (WASO), and sleep efficiency (SE)), and logistic regression was …

Systemic Treatment Of Recessive Dystrophic Epidermolysis Bullosa With Mesenchymal Stromal Cells: A Scoping Review Of The Literature And Conclusions For Future Clinical Research, Elke Niebergall-Roth, Kathrin Dieter, Markus H. Frank, Mark A. Kluth

Research outputs 2022 to 2026

Background: The ability of mesenchymal stromal cells (MSCs) to facilitate regenerative responses in inflamed and injured tissues, coupled with preclinical data suggesting potential to restore defective collagen VII at the dermo-epidermal junction, has raised the hope that MSCs may provide an effective disease-modifying therapy for patients suffering from recessive dystrophic epidermolysis bullosa (RDEB). Methods: We present a descriptive analysis of the clinical research on systemic MSC administration to RDEB patients available in PubMed, including six early-phase studies and one case report, involving 59 patients who received 1–3 intravenous infusions of MSCs from various sources. Results: Based on 133 MSC infusions, …

The Implementation And Evaluation Of A Family-Led Novel Intervention For Delirium Prevention And Management In Adult Critically Ill Patients: A Mixed-Methods Pilot Study, Gideon U. Johnson, Amanda Towell-Barnard, Christopher Mclean, Beverley Ewens

Research outputs 2022 to 2026

Background: Family-led interventions have been identified as effective in many areas of care including the management of delirium. However, because of the heterogeneity and ambiguity of family-led interventions, they are not consistently applied within intensive care units. A user-friendly digital intervention may therefore support consistent family integration into delirium management. Aim: To explore the feasibility and acceptability of a family member's voice reorientation intervention for delirium prevention and management in an adult intensive care unit. Study Design: Parallel, convergent mixed-methods pilot study was conducted in a general adult intensive care unit in the United Kingdom. Thirty participants (15 patients and …

Arid1a Loss Is Associated With Increased Nrf2 Signaling In Human Head And Neck Squamous Cell Carcinomas, Vinh Nguyen, Travis P. Schrank, Michael B. Major, Bernard E. Weissman

2020-Current year OA Pubs

Prior to the next generation sequencing and characterization of the tumor genome landscape, mutations in the SWI/SNF chromatin remodeling complex and the KEAP1-NRF2 signaling pathway were underappreciated. While these two classes of mutations appeared to independently contribute to tumor development, recent reports have demonstrated a mechanistic link between these two regulatory mechanisms in specific cancer types and cell models. In this work, we expand upon these data by exploring the relationship between mutations in BAF and PBAF subunits of the SWI/SNF complex and activation of NRF2 signal transduction across many cancer types. ARID1A/B mutations were strongly associated with NRF2 transcriptional …

Extensive Reactive Cutaneous Histiocytic Infiltrate Resembling Non-Langerhans Cell Histiocytosis As The Presenting Sign Of Underlying Vacuoles, E1 Enzyme, X-Linked, Autoinflammatory, Somatic Syndrome, Cynthia X Wang, Christine C Yokoyama, Ilana S Rosman, Amy C Musiek

2020-Current year OA Pubs

No abstract provided.

Neurosteroids Mediate And Modulate The Effects Of Pro-Inflammatory Stimulation And Toll-Like Receptors On Hippocampal Plasticity And Learning, Yukitoshi Izumi, Kazuko A. O'Dell, Anil G. Cashikar, Steven M. Paul, Douglas F. Covey, Steven J. Mennerick, Charles F. Zorumski

2020-Current year OA Pubs

Pro-inflammatory changes contribute to multiple neuropsychiatric illnesses. Understanding how these changes are involved in illnesses and identifying strategies to alter inflammatory responses offer paths to potentially novel treatments. We previously found that acute pro-inflammatory stimulation with high (μg/ml) lipopolysaccharide (LPS) for 10-15 min dampens long-term potentiation (LTP) in the hippocampus and impairs learning. Effects of LPS involved non-canonical inflammasome signaling but were independent of toll-like receptor 4 (TLR4), a known LPS receptor. Low (ng/ml) LPS also inhibits LTP when administered for 2-4 h, and here we report that this LPS exposure requires TLR4. We also found that effects of low …

Adherence To Practice Parameters In Medicare Beneficiaries With Amyotrophic Lateral Sclerosis, Osvaldo J. Laurido-Soto, Irene M. Faust, Susan Searles Nielsen, Brad A. Racette

2020-Current year OA Pubs

OBJECTIVE: Physician adherence to evidence-based clinical practice parameters impacts outcomes of amyotrophic lateral sclerosis (ALS) patients. We sought to investigate compliance with the 2009 practice parameters for treatment of ALS patients in the United States, and sociodemographic and provider characteristics associated with adherence.

METHODS: In this population-based, retrospective cohort study of incident ALS patients in 2009-2014, we included all Medicare beneficiaries age ≥20 with ≥1 International Classification of Diseases, Ninth Revision, Clinical Modification ALS code (335.20) in 2009 and no prior years (N = 8,575). Variables of interest included race/ethnicity, sex, age, urban residence, Area Deprivation Index (ADI), and provider …