Study protocol for a quasi-experimental investigation of the effectiveness of the 'CATCH My Breath' vaping prevention curriculum at preventing vaping outcomes among high school students in Ontario, Ca

Dementia is a global health priority, with a forecasted 152.8 million people living with dementia by the year 2050 []. In the absence of a cure, the emphasis of care is on improving symptoms, promoting independence and optimising quality of life []. Pain is highly prevalent in people with dementia (50–70% in community-dwelling people with. dementia) [] and causes distress, reduced quality of life and impaired functional independence in people who already struggle with the impacts of dementia []. Dementia interacts with pain by reducing normal pain inhibitory responses, and communication impairments contribute to under-recognition of pain [, ]. This leads to pain being under-recognised and sub-optimally managed and is a key unmet need which may result in manifestation of behavioural or neuropsychiatric symptoms of dementia []. Almost everyone with dementia displays one or more neuropsychiatric symptom across the course of their illness []. Neuropsychiatric symptoms in dementia are caused by multiple factors such as the severity of cognitive impairment and unmet needs []. The relationship between pain and neuropsychiatric symptoms in people with dementia may be bidirectional: a systematic review of interventions for both pain and neuropsychiatric symptoms found that interventions aimed at improving pain reduced neuropsychiatric symptoms, and interventions targeting neuropsychiatric symptoms tended to reduce pain []. For people with dementia living in care homes, the neuropsychiatric symptoms with the strongest associations with pain are depression, agitation and aggression []. These associations may not be present in community-dwelling people with dementia because they may have less severe cognitive impairment as well as markedly different physical and social environments. Given the potentialbidirectional relationship between pain and neuropsychiatric symptoms, identification of specific pain-related neuropsychiatric symptoms could justify non-pharmacological or pharmacological management approaches for pain or neuropsychiatric symptoms to ameliorate both.