bluuebunny/crossref_metadata_2025 huggingface dataset:
DELIVERING PERSON-CENTERED CARE IN TIMES OF CRISIS
Authors: Behrens Liza , Roberts Tonya
Published: December 2022

Preference-based person-centered care (PCC) is the gold standard for delivering high quality care in nursing homes (NH). A public health crisis makes it difficult for NH leaders to make decisions that honor residents’ preferences for care and activities while balancing the safety of others in the NH community. Based on the Operational Framework to Guide Decision-making During the COVID-19 Pandemic, the purpose of this symposium is to discuss several projects that are growing the evidence-base for person-centered risk management during a public health crisis. Data presented can guide NHs in balancing safety and risk during a public health crisis. Our first presentation speaks to the adoption of preferences as an important measure of care quality prior to a crisis, the next two presentations speak to how risk perceptions of NH staff and residents can support PCC delivery during a crisis, and the final presentation provides a potential evidence-based quality improvement strategy for integrating PCC in the pandemic recovery phases. First Dr. Abbott will present on the impact of using the preferences for everyday living inventory as a quality and safety indicator in NHs, then Dr. Carpenter will present on direct-care staff members risk perceptions while during the COVID crisis, followed by Dr. Behrens who will discuss residents’ risk perceptions around having their preferences honored during the COVID crisis, and finally Ms. Heilbrunn will discuss an ongoing clinical trial evaluating the impact of using the ECHO platform to improve infection control and care quality during the COVID crisis.
THE DEVELOPMENT AND IMPLEMENTATION OF PILOT PROGRAM EVALUATION MEASURES
Authors: Kropp Denise
Published: December 2022

This presentation describes measurement tools and techniques for the pilot. Anonymous pre- and post-surveys were based on the Brief Tool for Dementia-Friendly Education and Training Sessions, modified for the ODRC population. The Brief Tool is a 7-item scale measuring the impact of dementia education sessions on knowledge, attitudes/perceptions, and interacting with people living with dementia. Based on ODRC feedback, we added an item on recognizing dementia. The pre-session survey asked about experiences with dementia prior to the session. The post-session survey included items on satisfaction, including the usefulness of the session in their work within the ODRC, whether they learned new information, and whether they would recommend the training. Open-ended items asked about dementia-related topics participants wanted to learn more about. All four online pilot sessions were led by the Ohio Council of Cognitive Health. Recordings of the sessions were made available for people unable to attend a scheduled session.
PUTTING THE 4MS INTO PRACTICE: IMPLICATIONS FOR TRAINING AND TECHNOLOGY
Authors: Crittenden Jennifer , Coleman Rachel , Jain Jennifer , Wihry David , Kaye Lenard , Wehry Susan , Metcalf Judith
Published: December 2022

The AgingME Geriatrics Workforce Enhancement Program (AgingME GWEP), a statewide collaboration led by the University of New England and the University of Maine, is guided by an annual statewide survey of community and professional stakeholders. The aim of this research is to identify training and resource gaps related to age-friendly healthcare and topics of interest. Of the 245 survey respondents, 15% indicated existing knowledge of the 4Ms framework. The top sources of 4M’s framework exposure included trainings or webinars (30%) and web-based resources (19%). Of those with knowledge of the 4M’s, 33% of providers and 29% of older adults/community members reported employing the 4Ms in their professional practices and personal lives, respectively. Respondents also noted the need for more training on how to use technology to locate healthcare information (33%), using technology to reduce isolation and loneliness among older adults (29%), and keeping providers connected with older patients (26%). Additional write-in responses (11%) suggest a need for general technology training and improving access to technology overall. Respondents' (N = 157) top five categories for needed aging-related training topics were community resources for older adults (15%), aging-in-place (14%), exercise and nutrition (11%), improving provider/patient communication (9%), and 4M’s of age-friendly healthcare overview (8%). Responses also identified themes related to improving patient/provider communications, availability of resources, and ageism that could be addressed through upcoming GWEP activities. Results indicate a need to facilitate the translation of 4Ms knowledge into practice and increasing technology training and access.
SUPPORTING RESIDENT ENGAGEMENT VIA WEB-BASED ASSESSMENT: EXPERIENCE OF ACTIVITY PROFESSIONALS IN LONG-TERM CARE
Authors: Li Xiaoli , Yin Cheng
Published: December 2022

Background

Resident engagement and activities have positive relationships with emotional wellbeing and physical health. However, regularly offered activities may not be suitable for all individuals and may be unsustainable when there are changes in residents’ health. Loneliness, depression, and social isolation are observed among residents in long-term care facilities. A web-based assessment system, “Elder Engagement Performance Improvement (EEPI),” has the potential to support resident engagement. Activity professionals are crucial in utilizing EEPI and engaging residents in meaningful activities, especially regarding their role in helping enhance resident engagement and wellbeing. This study aims explores activity professionals’ experiences in implementing the EEPI assessment. Method: Semi-structured interviews with 23 long-term care activity professionals (e.g., certified activities professionals, therapeutic recreation specialists, and activity assistants) were conducted and analyzed using qualitative content analysis.

Results

Activity professionals` experiences showed the EEPI was a means in improving residents’ engagement quality and making engagement a more targeted outcome. Four main themes emerged: (a) Lack of assessment tools, (b) Acceptance of a web-based assessment system, (c) Barriers to using the EEPI (time arrangements, staffing issues, and being on the same page), and (d) Areas for job improvement (person-center care and measurable practices).

Conclusions

The EEPI may serve as a valuable tool in long-term care facilities. The web-based assessment system facilitated activity professionals' daily work and involved the residents' input in their care, which may enhance resident engagement and reduce the risk of social isolation in long-term care facilities.
IMPLEMENTATION OF AN EDUCATION INTERVENTION FOR MULTIPLE MYELOMA PATIENTS RECEIVING STEM CELL TRANSPLANT
Authors: Halpin Sean , Konomos Michael
Published: December 2022

Older adults have an increased risk for multiple myeloma (MM), yet they are often unable to collect sufficient healthy stem cells for autologous stem cell transplant (ASCT). We sought to assess the implementation of educational intervention videos, termed Ready for Transplant (R4T), for MM patients both during the 18-month study and at 12 and 18-months post-study. Guided by the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework, we observed 152 clinical encounters for 70 patients who received the intervention. Patients who reported viewing the R4T videos (56%) tended to be older and male and were more likely to admit for transplant than those who did not report viewing the videos (risk ratio, 2.3; 95% CI, 0.61, 3.88). At 12- and 18-months-post, nurses reported still using the R4T videos and found them particularly useful during times when patients were unable to attend the hospital for in-person visits due to the pandemic.
THE ASSOCIATION BETWEEN RELIGIOSITY AND COGNITIVE FUNCTIONING AMONG OLDER ADULTS WITH HEMATOLOGICAL CANCERS
Authors: Krok-Schoen Jessica , Rosko Ashley , Huang Ying , Funderburg Allesia , Dvorak Katy , Stevens Erin
Published: December 2022

Religiosity is positively associated physical health outcomes, yet longitudinal research on this association among older adults with cancer is limited. Participants were enrolled in a longitudinal study assessing chemotherapy’s impact on the health of older adults with hematological cancers. Religiosity was assessed by the Duke University Religion Index (DUREL), with higher scores indicating higher religiosity. Cognitive functioning was assessed by the Blessed Dementia Scale, with higher scores indicating more impairment. Participants (n=97) had a median age of 70 years (range:60-88) and were 58% male and 97% white. DUREL scores were unchanged with a mean score of 22 (range:5-27). Cognitive functioning significantly improved with a median score of 4 (range:0-22) at baseline to 0 (range:0-20) at end-of-treatment. Religiosity was not significantly correlated with cognitive functioning over time. Future research should explore the trajectory of cognitive functioning and other sources of coping (social support, palliative/supportive care) among older adults with hematological cancers.
INTERSECTIONALITY OF SENSORY LOSS AND RACE: IMPLICATIONS FOR BRAIN AND MENTAL HEALTH IN OLDER ADULTS
Authors: Deal Jennifer , Brenowitz Willa , Thorpe, Jr. Roland J
Published: December 2022

Despite recent evidence that sensory loss may increase risk of dementia, mood disorders, and poor physical health in older adults, nearly all research to-date has been conducted in populations that are predominantly White and from high-income countries. This session will investigate the intersectionality of race with sensory loss with a focus on health equity and inclusion of traditionally underrepresented populations. It will evaluate sensory loss across multiple senses, how patterns vary by race, and whether socioeconomic status can explain these differences. In the US, prevalence of impairment in vision, touch, and smell is lower in Whites compared to Black or Hispanics. Interestingly, hearing loss prevalence is lower in Blacks than Whites, but dementia incidence is higher. This session will describe incident dementia risk associated with hearing loss in Black compared to White Americans. It will also address the relationship between dual (hearing and vision) loss and depressive symptoms in India to explore the generalizability of findings to lower middle-income countries. Sensory impairments may intersect with racial discrimination to exacerbate social and health disparities. This session will also describe racial disparities in food insecurity among Americans with vision loss. Finally, we will present results of a randomized controlled trial of an innovative, community-delivered approach to affordable, accessible hearing care. The study represents the largest U.S.-based trial cohort to date of low-income older adults and older African American adults with hearing loss.
HEARING LOSS AND INCIDENT DEMENTIA OVER 7 YEARS IN BLACK AND WHITE OLDER ADULTS IN ARIC-NCS
Authors: Shin John , Jiang Kening , Reed Nicholas , Knopman David , Mosley Thomas , Sharrett Richey , Lin Frank , Deal Jennifer
Published: December 2022

Hearing loss is a risk factor for dementia; whether this association differs by race is unknown. Although hearing loss is less prevalent in Blacks than Whites, we hypothesized the hearing loss-dementia relationship is stronger in Blacks. All-cause dementia and mild cognitive impairment (MCI) were adjudicated using longitudinal cognitive data. Hearing was measured using pure tone better-ear thresholds (0.5-4 kHz). Cox proportional hazards models adjusted for demographic and clinical covariates and included an interaction term between hearing and race. In 3,605 participants from a population-based cohort (68-89 years, 23% Black, 59% female), estimates for 7-year dementia risk per 10 decibels increase in hearing loss were stronger in Blacks (hazard ratio [HR]:1.24, 95% Confidence Interval (CI):1.07,1.43) than Whites (HR:1.07; 95%CI:0.96,1.19). Hearing loss is a risk factor for dementia in Black Americans. These findings emphasize the need to address existing racial disparities in hearing healthcare.
TO LOVE AND LOATHE: EXAMINING THE COSTS AND BENEFITS OF AMBIVALENT TIES IN OLDER ADULTHOOD
Authors: Hamilton Lucas , Peng Siyun , Krendl Anne , Perry Brea
Published: December 2022

Ambivalent ties are relationships that offer support but beget stress, which generally has a detrimental impact on health. Existing theory suggests that older adults gradually remove such ties over time; however, it is not uncommon for ambivalence to exist in older adults’ close relationships (i.e., partners, children). Social network data was used from 286 older adults with about half having mild cognitive impairment. Roughly two-thirds of the sample reported at least one ambivalent tie, most commonly partners, children, and friends. Logistic regressions revealed distinct characteristics of these ties. Participants who reported at least one ambivalent tie (most notably, partners and friends) had social networks with structures known to confer cognitive benefits. Importantly, these effects dissipate with diminished cognitive status. Altogether, ambivalent ties may confer benefits when resources are available to manage such relationships. When resources are taxed, however, ambivalent ties may contribute to cascading health declines.
LATE-LIFE SOCIAL NETWORKS AND INCIDENT ALZHEIMER'S DISEASE: THE KUAKINI HONOLULU-ASIA AGING STUDY
Authors: Kallianpur Kalpana , Masaki Kamal , Chen Randi , Willcox Bradley , Allsopp Richard , Davy Philip , Dodge Hiroko
Published: December 2022

We assessed longitudinal associations between social networks and incidence of all-cause dementia, Alzheimer’s disease (AD) and vascular dementia in Kuakini Honolulu-Asia Aging Study participants over a 10-year follow-up period. Median split of Lubben Social Network Scale (LSNS) scores defined weak/strong social networks among 2636 men who were dementia-free at baseline (median age 77 years) and during the first 3 years. Kaplan-Meier curves showed that those with strong networks at baseline were less likely to develop all-cause dementia (p<0.0001) and AD (p=0.0006); probability of dementia-free survival at 10 years for strong and weak social network groups was 93.8% and 89.0%, respectively. Cox regression models adjusting for age and other baseline factors revealed associations of weak networks with increased risk of all-cause dementia (HR=1.52, 95%CI=1.11-2.08, p=0.009) and AD (HR=1.67, 95%CI=1.11-2.51, p=0.014). As strong social networks may protect against incident dementia and AD, and are associated with other health benefits, prevention of social isolation of older adults should be considered a priority.
UNDERSTANDING CULTURAL NARRATIVES OF DEMENTIA: TASKS AND TOOLS FOR HUMANITIES SCHOLARSHIP
Authors: Berlinger Nancy
Published: December 2022

Humanities scholarship on dementia has long focused on the depiction of dementia in literature, film, and other genres. Recent research on neurodiversity includes humanistic scholarship on creativity within dementia. It is time for interdisciplinary humanities scholarship to focus on narratives of dementia that circulate within aging societies, are embedded in policy, and shape experiences of typical people living with dementia or providing dementia care. This paper argues for the normative importance of studying values-laden cultural narratives, recognizing competing or evolving narratives within a society, and demonstrating how to reframe flawed narratives beyond necessary attention to ageist and ableist language. It presents examples of approaches to social narrative analysis; describes tools and training that could be integrated into humanities scholarship on dementia and aging, and considers the potential role of social narrative analysis in articulating and launching policy ideas for aging societies.
NARRATIVE MEDICINE AS INTERDISCIPLINARY PRACTICE
Authors: Kriebernegg Ulla
Published: December 2022

When dealing with patients who talk about their illnesses, medical doctors need to interpret the stories they hear. Also, they need to make sense of their own experiences regarding their medical encounters. Narrative and its analysis plays a central role in such processes that require empathy and self-reflection. The interdisciplinary practice of teaching medical students concepts and theories from literary studies as well as discussing literary texts with them can expand their scientific medical understanding. This paper explores the concept of narrative in the context of geriatric medical humanities and narrative medicine, looking at how narrative competence translates into medical practice. Presenting findings from a seminar on Narrative medicine at the Medical University of Graz, Austria, it also addresses some methodological and didactic challenges of this interdisciplinary approach.
LONG-TERM PREDICTION OF DEMENTIA USING MACHINE LEARNING ALGORITHMS
Authors: Berglund Johan Sanmartin , Javeed Ashir
Published: December 2022

The core interest of this project is the development of predictive estimates and the identification of modifiable risk factors for the development of neurocognitive disorders based on multifactorial data from multiple health databases.We are conducting epidemiological research on predicting neurocognitive diseases of older adults included in the National E-Infrastructure on Aging Research (NEAR) using deep learning and other AI methods. Exploring the impact of lifestyle and environment on dementia development in the subjects together with biomarkers and images and predicting dementia using machine learning techniques would give insights into the long-term development. In addition, the possibility of screening a large number of persons and consequent early prediction of dementia based on optimized machine learning techniques could be of great importance for early treatment.
IMPACT OF FRAILTY ON THE DIGNITY OF COMMUNITY-DWELLING OLDER PEOPLE
Authors: Kakhki Ali Darvishpoor , Moradoghli Fereshteh , Esmaeili Roghayeh
Published: December 2022

The population of people aged 60 and older is rapidly increasing in developing countries such as Iran due to declining birth rates and increased life expectancy. Old age is associated with increased risk for frailty and reduced dignity. This study investigated the impact of frailty on the dignity of older people in Tehran, Iran. This cross-sectional study was conducted on 200 individuals aged 60 years and older. Data collection relied on the Demographic Questionnaire, Frailty Index for Elders (FIFE) and the Patient Dignity Inventory (PDI). Data were analyzed with SPSS 25. The mean age of the participants was 68 (±5.05) years; 62% of the participants were at risk for frailty, and 69% had few dignity-related problems. The multiple regression results showed that frailty was significantly associated with dignity (ß = -0.571, p < 0.001). The association was significant across all the dimensions of dignity measured by the PDI. The highest predictors of frailty included dependency (ß = -0.584, p < 0.001), followed by existential distress (ß = -0.560, p < 0.001), symptom distress (ß = -0.400, p = 0.400), social support (ß = -0.391, p < 0.001), and peace of mind (ß = -0.338, p < 0.001) in dignity. The results show that higher levels of frailty in older people are associated with decreases in their dignity, and frailty was the leading predictor of dignity. Providers should develop programs to prevent and reduce frailty in those at risk and to enhance the dignity of the already frail.
PHYSICAL ACTIVITY TRENDS IN A NATIONWIDE MHEALTH PROGRAM: A POPULATION-BASED COHORT STUDY
Authors: Ang Gregory , Edney Sarah , Tan Chuen Seng , Lim Nicole , Tan Jeremy , Riemenschneider Falk , Chen Cynthia
Published: December 2022

Physical inactivity is a global public health challenge, leading to an increase in chronic diseases. Effective large-scale physical activity interventions are needed. We examined the effectiveness of a nationwide mHealth intervention in Singapore, National Steps Challenge Season 3 (NSC3). NSC3 included gain-framed financial incentives for reaching pre-defined daily step targets, nudging via reminders and real-time feedback on physical activity levels. Our study includes 411,528 participants, with 53,371 (13.0%) participants aged 59 and above. Regression discontinuity design examined changes to daily step counts prior to and during NSC3. NSC3 was associated with an overall mean increase of 1437 steps per day (95% CI: 1408 to 1467). Participants in older age groups were associated with larger mean step increases. Females aged between 59 to 68 and 69 and above were associated with average increases of 1640 steps per day (95% CI: 1510 to 1770) and 2300 steps per day (95% CI: 2050 to 2550), respectively. Males in the same age groups were associated with average increases of 1360 steps per day (95% CI: 1200 to 1520) and 1640 steps per day (95% CI: 1370 to 1900), respectively. We provide real-world evidence that suggests NSC3 improved participants’ step counts, with a larger increase among older adults. As older adults have a higher risk of chronic diseases, lower physical inactivity has potential health benefits such as reducing the incidence of hypertension and improving cardiovascular health biomarkers. While results are promising, further investigations are necessary to ensure sustained engagement among older adults.
SOCIAL PARTICIPATION AND DEPRESSIVE SYMPTOMS AMONG SPOUSAL AND ADULT CHILD CAREGIVERS
Authors: Irani Elliane , Wang Fei
Published: December 2022

Participating in social activities through formal (e.g., social or religious organizations) and informal (e.g., gatherings with family members or friends) avenues is known to positively contribute to mental wellbeing. Family caregivers are at risk for limited social participation and increased depressive symptoms. However, little is known about which social activities are associated with depressive symptoms among spousal and adult child caregivers. The purpose of this study was to examine the effects of participating in various social activities on depressive symptoms among spousal (n=422) and adult child (n=1,112) caregivers using data from the 2017 wave of the National Study of Caregiving. Caregivers reported on participating in six social activities in the past month (e.g., visiting family and friends, attending religious services, doing volunteer work, working for pay) and completed the 2-item Patient Health Questionnaire to assess depressive symptoms. Data were analyzed using multiple linear regression, with separated models for spousal and adult child caregivers. Sociodemographic characteristics, self-rated health, and dementia caregiving status were included as covariates. For spousal caregivers, visiting friends or family and attending religious services were associated with lower depressive symptoms (b=-.55, p=.010 and b=-.33, p=.036, respectively). For adult child caregivers, going out for enjoyment was associated with lower depressive symptoms (b=-.80, p<.001). Findings suggest that spousal and adult child caregivers may benefit from participating in different types of social activities. Interventions targeting social participation to reduce depressive symptoms need to be tailored to the needs and preferences of spousal and adult child caregivers to be most effective.
THE MULTIDIMENSIONAL SUCCESSFUL AGING SCALE: DEVELOPMENT AND VALIDATION
Authors: Chung Edwin K H , Yeung Dannii
Published: December 2022

Subjective successful aging involves a self-appraisal of individual aging process over multiple dimensions of later life (Feng et al., 2015). However, studies often ignore its multidimensional nature and simply utilize a single item as the measurement (e.g., Stewart et al., 2019). Two studies were hence conducted to develop and validate the Multidimensional Successful Aging Scale (MSAS). In Study 1, MSAS was administered among 414 community-dwelling older Chinese adults (Mage=64.50 years, SD=4.01; range = 60 – 82; 55.3% females). Repeated exploratory factor analysis revealed a nine-factor solution of 25 items, accounting for 64% of the variance. The nine factors include harmonious family, active engagement, supportive friendship, adaptive coping, social contribution, living independently, civic awareness, positive attitudes, and perceived constraints. The nine factors exhibit similar strength of associations with most of the well-being measures, but certain factors show stronger correlation with depressive symptoms, suggesting the uniqueness of each factor. In Study 2, the nine-factor model of MSAS was replicated in a sample of 558 older adults (Mage=69.11 years, SD=6.68; range = 60 – 97; 59.2% females) and the results of CFA indicated a good model fit (χ2 = 527.86, df = 239; CFI =.97; TLI =.96; RMSEA =.05; SRMR = .04). The strict and metric forms of measurement invariance were shown across age groups and gender, respectively. Overall, the MSAS demonstrates satisfactory psychometric properties. These findings disclose that the older adults’ perceptions of successful aging cover broader dimensions than those identified in the Rowe and Kahn’s (1997) model.
EFFECT OF STATE WAGE POLICIES ON DIRECT CARE WORKER WAGES
Authors: Tyler Denise , Khavjou Olga , Hunter Melissa , Squillace Marie , Dey Judith , Oliveira Iara
Published: December 2022

Direct care workers (DCWs) have low wages and some states have tried to improve their wages through policies such as Medicaid wage pass-throughs and wage floors specific to DCWs. The purpose of this study was to examine the wages of DCWs in comparison to those of other entry level workers and assess the effect of state wage policies on changes in DCW wages. We analyzed state-level hourly wages using Bureau of Labor Statistics (BLS) data for two categories of DCWs separately—(1) home health and personal care aides and (2) nursing assistants and compared these to wages for other entry-level workers. Results show that many states that implemented policies to improve the wages of DCWs reduced the gap between these workers’ wages and the wages of other entry-level workers, but the gap was still substantial in many states. Additional efforts will be needed to increase DCW wages.
COVID-19 PANDEMIC INCREASED NURSING FACILITIES' RELIANCE ON CONTRACT STAFF TO ADDRESS STAFFING SHORTAGES
Authors: Porter Kristie , Segelman Micah , Gasdaska Angela , Squillace Marie , Dey Judy , Oliveira Iara , Tyler Denise
Published: December 2022

Nursing facilities (NFs) used a variety of strategies to mitigate worsening nursing staff shortages during the COVID-19 pandemic. We conducted analysis of payroll based journal PBJ data and interviewed 9 experts to understand COVID’s impact on NF staffing, especially changes in contract staffing. In 2020, NFs increased their use of contract staff hours per resident day (HPRD) by 24%. Use of contract staff during the first year of the pandemic (comparing 2020 to 2019) varied by some facility characteristics (e.g., profit status). NF providers, and industry and academic experts confirmed facilities used multiple strategies beyond using contract staffing, such as temporary nurse aides, hazard pay and flexible schedules to maintain staffing throughout the pandemic. Competition for nursing staff from other healthcare settings and non-healthcare industries has grown throughout the pandemic, continuing to threaten the stability of the NF workforce.
EXPLORING QUALITY AND COVID MEASURES OF NEW YORK STATE LONG-TERM CARE FACILITIES INVOLVED IN THE SAFE STAFFING LAWSUIT
Authors: Semprini Jason , Kaskie Brian
Published: December 2022

In April 2021, New York's "Safe Staffing" law capped Long-Term Care Facility (LTCF) profits. LTCFs with "excess profits" are now challenging the law in court. This study examined how LTCFs involved in the lawsuit differed from other NY state LTCFs before and during the COVID-19 pandemic. LTCF “Safe Staffing” lawsuit data were obtained from Long Term Care Community Coalition, then linked with Centers for Medicare and Medicaid Services COVID-19 and Small Business Association Paycheck Protection Program (PPP) data. First, we tested for differences across quality measures. We found that, compared to LTCFs not involved in the lawsuit, LTCFs in the lawsuit were more likely to be located outside of a hospital, report more certified beds and higher occupancy rates, and have higher overall quality scores. LTCFs in the lawsuit also reported lower staff ratings and staffing hours, which have previously been identified as a determinant of higher mortality in LTCFs. To create valid comparisons given these systematic differences, we specified “Doubly Robust” Augmented Inverse Probability Weighted regression models and tested if lawsuit involvement was associated with COVID-19 outcomes. Despite finding higher rates of admitting patients infected with COVID-19 in “excess profit” LTCFs, we did not find that COVID-19 deaths differed by lawsuit involvement. Finally, lawsuit involvement was associated with a higher probability of receiving a PPP loan. Before and during the pandemic, LTCFs with "excess profits" appeared fundamentally different than other NY LTCFs. How these differences impact the health of older adults receiving long-term care beyond the pandemic remains unknown.
FACTORS ASSOCIATED WITH THE AVAILABILITY OF SPECIALIZED RESOURCES TO TACKLE OBESITY IN HIGH MEDICAID NURSING HOMES
Authors: Orewa Gregory , Davlyatov Ganisher , Pradhan Rohit , Lord Justin , Weech-Maldonado Robert
Published: December 2022

The purpose of this research is to explore the factors associated with the availability of specialized resources required to care for obese residents in high Medicaid nursing homes (NHs) (85% or higher). Due to the vagaries of payment models---Medicaid payments lag other modes of NH reimbursements—high Medicaid NHs typically report poorer quality and financial performance. Operating in a financial perilous environment, and with obesity among the elderly on the rise, high Medicaid NH may particularly struggle to obtain the appropriate resources essential to cater to obese residents' needs.Utilizing the resource-dependent theory, we hypothesized that occupancy rate, acuity index, and payer mix may be positively associated with the availability of obesity related specialized equipment in high Medicaid NHs. The study was conducted by merging survey and secondary data sources for the year 2017-2018. Obesity related data was collected via mail surveys sent to Directors of Nursing in high Medicaid NHs, The survey data was merged with the following secondary data sources: Brown University’s LTC Focus, Area Health Resource File, and the Medicare cost reports. The dependent variable was the summative obesity score that ranged from 0-19 with the larger number indicating greater availability of obesity-related equipment/services. An ordinary least square regression with propensity score weights (to adjust for potential non-response bias), and appropriate organizational/market level control variables were used for our analysis. Results suggest that payer mix (>Medicare residents) and acuity index were positively associated with the summative obesity score (p < 0.05). Policy and managerial implications are discussed.
INFORMATION SHARING TO SUPPORT CARE TRANSITIONS FOR PATIENTS WITH COMPLEX MENTAL AND BEHAVIORAL HEALTH NEEDS
Authors: Bucy Taylor , Cross Dori
Published: December 2022

Information sharing practices between hospitals and skilled nursing facilities (SNFs) are insufficient to effectively support patient handoffs. Information needs are even greater for SNFs that admit patients with complex behavioral needs. It is unclear whether these needs have prompted hospital investment in enhanced information sharing with these SNFs, and what strategies these facilities are using to meet informational needs. We use data from a 2019 nationally representative SNF survey (N=265, response rate 53%) designed to gather information on information sharing practices with hospital partners. 122 SNFs (57% of respondents) report accepting at least two of the following complex conditions: serious mental illness, substance use disorder, or medication assisted treatment. Using logistic regression models that adjust for facility ownership and rurality, SNFs that accept complex patients are significantly more likely to receive information on behavioral, mental, and functional status compared to facilities who accept none or only one type of complex patient (odds ratio=2.42; p=0.023). Unadjusted models indicate that facilities that accept complex patients lag in IT-facilitated access to hospital information, and report more difficulty securing timely access to information. The significance of these findings do not persist after adjustment, suggesting structural differences in the types of SNFs that hospitals are partnering with to improve information sharing. We conclude that while SNFs that accept complex patients are mostly keeping pace or even doing slightly better in terms of access to hospital information that supports transitional care, further investment is needed to improve hospital information sharing behaviors.
TECHNOLOGY DESIGN AND IMPLEMENTATION TO PROMOTE EQUITY, INCLUSION, AND DIVERSITY
Authors: Boot Walter
Published: December 2022

The design of technology and technology-based solutions for the challenges many older adults face must consider principles of equity, inclusion, and diversity, or there is a risk of exacerbating digital divides in our society. This session focuses on the design, evaluation, and implementation of technologies to support older adults considering the diversity of the older adult population with respect to factors such as race and ethnicity, income level, health conditions, and cognitive status. M. Harris will discuss the facilitators and barriers identified by Black older adults related to the use of wearable devices for health monitoring. J. Chung will present on the development of a smart speaker application to support wellness among low-income senior housing residents. C. Berridge and E. Sanders will discuss designing technology solutions related to diversity with respect to cognitive status, with Berridge discussing preferences of older adults with mild Alzheimer’s disease for a technology-delivered planning tool, and Sanders presenting technology-based solutions to support the prospective memory of older adults with diverse cognitive impairments. Finally, Schiaffino will present a study examining the acceptability of community-based telehealth programs among vulnerable older adults as a function off health, language, and ethnicity. General themes of inclusive design to ensure that all older adults can benefit from existing and emerging technology-based solutions will be highlighted.
A Relational Approach to Gift-Giving: China's Aid Exchanges in the Global South
Authors: Benabdallah Lina
Published: December 2022

This article expands gift-giving theories by shifting the focus of international relations scholarship from Euro-American-centric views on foreign aid to South–South perspectives to gift exchanges. It does so by recentering relationality and analyzing gifts as encompassing favors, symbolic gestures, support in international arenas, and intangible expressions of solidarity as can be seen in China–Africa relations. Building on work in critical theories in international relations and revisiting Marcel Mauss’ work on gift-giving, this article develops a tripartite relational framework to examining foreign aid and gift-giving from Global South perspectives. The elements of the framework are (1) recentering reciprocity as a necessary element (or norm) in gift exchange, which helps break the rigid donor versus recipient binary; (2) capturing nonmaterial modalities of aid by accounting for solidarity gestures; and (3) expanding the temporal horizon of reciprocation by accepting that the circulation of gifts, favors, and solidarity does not have to occur on a tight timeline of immediate transaction exchanges. Together, these three moves go beyond stigmatizing developing states as chronic “recipient” states and highlight how they engage in mobilizing agency to reciprocate aid in ways other than material.
Multi-objective particle swarm optimization with dynamic population size
Authors: Shu Xiaoli , Liu Yanmin , Liu Jun , Yang Meilan , Zhang Qian
Published: December 2022

There are many complex multi-objective optimization problems in the real world, which are difficult to solve using traditional optimization methods. Multi-objective particle swarm optimization is one of the effective algorithms to solve such problems. This paper proposes a multi-objective particle swarm optimization with dynamic population size (D-MOPSO), which helps to compensate for the lack of convergence and diversity brought by particle swarm optimization, and makes full use of the existing resources in the search process. In D-MOPSO, population size increases or decreases depending on the resources in the archive, thereby regulating population size. On the one hand, particles are added according to local perturbations to improve particle exploration. On the other hand, the non-dominated sorting and population density are used to control the population size to prevent the excessive growth of population size. Finally, the algorithm is compared with 13 competing multi-objective optimization algorithms on four series of benchmark problems. The results show that the proposed algorithm has advantages in solving different benchmark problems.
circFOXK2 promotes the progression of osteoarthritis by regulating the miR-4640-5p/NOTCH2 axis
Authors: Shao Chen , Niu Guoqi , Su Peng , Zhang Jingquan , Zhu Xunbing , Han Guansheng , Xu Panpan , Bai Jianzhong , Sun Kui , Sun Yongming
Published: December 2022

Objectives

Osteoarthritis (OA) is the most common age-related chronic and disabling joint disease, frequently causing pain and disability in the adult population. Given that there are no proven disease-modifying drugs for OA, it is urgent to gain a deeper understanding of OA pathogenesis. This study intended to uncover the circFOXK2 regulation in OA.

Methods

First, an in vitro OA cell model was constructed by treating murine chondrocytes with interleukin (IL)-1β. Then, a series of functional assays were conducted to evaluate the effect of circFOXK2 on OA progression in murine chondrocytes. Bioinformatics analysis and mechanism investigations were performed to investigate the competitive endogenous ribonucleic acid (RNA) network of circFOXK2 in OA.

Results

circFOXK2 is overexpressed in IL-1β-treated chondrocyte. We confirmed the cyclic structure and cytoplasmic distribution of circFOXK2. Functionally, circFOXK2 promotes chondrocyte apoptosis and extracellular matrix degradation but inhibits chondrocyte proliferation. Mechanically, circFOXK2 competitively binds to microRNA-4640-5p (miR-4640-5p) to enhance NOTCH2 expression in OA, affecting OA progression. Besides, circFOXK2 could motivate the NOTCH pathway to accelerate OA progression.

Conclusions

The circFOXK2/miR-4640-5p/NOTCH2 axis stimulates the NOTCH pathway to promote the transcription of inflammatory cytokines (IL33, IL17F, and IL6), consequently facilitating OA progression in murine chondrocytes.
Challenges and opportunities in remote sensing-based crop monitoring: a review
Authors: Wu Bingfang , Zhang Miao , Zeng Hongwei , Tian Fuyou , Potgieter Andries B , Qin Xingli , Yan Nana , Chang Sheng , Zhao Yan , Dong Qinghan , Boken Vijendra , Plotnikov Dmitry , Guo Huadong , Wu Fangming , Zhao Hang , Deronde Bart , Tits Laurent , Loupian Evgeny
Published: December 2022

Building a more resilient food system for sustainable development and reducing uncertainty in global food markets both require concurrent and near-real-time and reliable crop information for decision making. Satellite-driven crop monitoring has become a main method to derive crop information at local, regional, and global scales by revealing the spatial and temporal dimensions of crop growth status and production. However, there is a lack of quantitative, objective, and robust methods to ensure the reliability of crop information, which reduces the applicability of crop monitoring and leads to uncertain and undesirable consequences. In this paper, we review recent progress in crop monitoring and identify the challenges and opportunities in future efforts. We find that satellite-derived metrics do not fully capture determinants of crop production and do not quantitatively interpret crop growth status; the latter can be advanced by integrating effective satellite-derived metrics and new onboard sensors. We have identified that ground data accessibility and the negative effects of knowledge-based analyses are two essential issues in crop monitoring that reduce the applicability of crop monitoring for decisions on food security. Crowdsourcing is one solution to overcome the restrictions of ground-truth data accessibility. We argue that user participation in the complete process of crop monitoring could improve the reliability of crop information. Encouraging users to obtain crop information from multiple sources could prevent unconscious biases. Finally, there is a need to avoid conflicts of interest in publishing publicly available crop information.
Multi-chord observation of stellar occultation by the near-Earth asteroid (3200) Phaethon on 2021 October 3 (UTC) with very high accuracy
Authors: Yoshida Fumi , Hayamizu Tsutomu , Miyashita Kazuhisa , Watanabe Hiroyuki , Yamamura Hidehito , Akitaya Hiroshi , Asai Akira , Fujiwara Yasunori , Goto Tateki , Hashimoto George L , Hatanaka Akitoshi , Horaguchi Toshihiro , Ida Miyoshi , Imamura Kazuyoshi , Isobe Ken , Ishiguro Masateru , Kaizuka Noboru , Kasebe Hisashi , Kawasaki Yohei , Kim Taewoo , Kitazaki Katsuhiko , Manago Norihiro , Matsumura Masafumi , Matsushita Hiroshi , Matsuura Shuji , Nakamura Takahiro , Nagata Toshihiro , Noda Hirotomo , Ogawa Masaaki , Ohshima Osamu , Owada Minoru , Saitou Kazuyuki , Tsumura Mitsunori , Ueyama Yoshihiro , Watanabe Hayato , Yamamoto Masa-yuki , Yoshihara Hideki , Fujiwara Takao , Haraguchi Miyu , Hayashi Hironori , Hitotsuda Tomoya , Horikawa Toshihiro , Ishida Kai , Ito Tadashi , Jin Sunho , Kang Wonseok , Katayama Toshihiko , Kawabata Koji S , Kawasaki Ryosuke , Kim Kihyeon , Kita Masayuki , Kitazaki Naoko , Kurisu Hiroya , Matsushima Makoto , Matsumi Chika , Mihari Ayami , Naka Masaru , Nakaoka Tatsuya , Nishihama Reiko , Nishiyama Yukio , Nukui Sadao , Oba Masahiko , Okamoto Takaya , Omori Yujiro , Seo Jinguk , Shirakawa Hiroki , Sugino Tomoshi , Tani Yuki , Takagaki Kazuhiko , Ueda Yukikazu , Urakawa Seitaro , Watanabe Masanari , Yamashita Kouhei , Yamashita Misato , Sato Isao , Murayama Shosaku , Arai Tomoko , Herald David , Higuchi Arika
Published: December 2022

We observed a stellar occultation by (3200) Phaethon, which occurred in western Japan on 2021 October 3 (UTC). This observation was requested by the DESTINY+ mission team, which plans to conduct a flyby of asteroid Phaethon in 2028. Overall, this research effort contributes towards a large-scale observation campaign with a total of 72 observers observing from western Japan to southern Korea. 36 stations were established, and stellar occultation by the asteroid Phaethon was detected in 18 of them. This is the first time that this many multiple chord observations have been made for such a small asteroid (it has a diameter of 5–6 km). Observational reductions show that the apparent cross-section of Phaethon at the time of the occultation could be approximated using an ellipse with a major diameter of 6.12 ± 0.07 km and a minor diameter of 4.14 ± 0.07 km, and a position angle of 117.°4 ± 1.°5. As can be seen from the small error bars of the fitted ellipse, we have succeeded in estimating the shape and size of the asteroid with an extremely high degree of accuracy. Our observation results, together with other observations, will be used to create a 3D model of Phaethon and to improve its orbit. The instruments that we used for this observation are commonly used by many amateur astronomers in Japan for occultation observations and are not difficult to obtain. This paper describes the method and results of our observations using a CMOS camera and a GPS module, so that many people can participate in occultation observations in the future.
QUANTITATIVE EVALUATION OF CONSERVATISM INCLUDED IN PARAMETER SETTINGS FOR CLEARANCE LEVEL CALCULATIONS: A CASE STUDY IN JAPAN
Authors: Sasaki Michiya , Kimura Tatsuki , Hattori Takatoshi
Published: December 2022

In the evaluation of radiation safety standards, representative, average or conservative parameter values are set for dose calculation, and it is expected that excessive conservatism may be occasionally included in the standards already established. In this study, we attempted to quantitatively evaluate the ‘factor of conservatism’ for parameters used in the dose calculations for an actual case of clearance level calculations in Japan. The ‘factor of conservatism’ was calculated using the selected value for the parameter actually applied in the clearance level calculation and the expected values evaluated from the probability distribution. As a result, it was estimated that the ‘factor of conservatism’ for the parameters used in the clearance level calculation for the main nuclear facilities in Japan is approximately 1 to 7.
Thermal adaptation of photosynthetic physiology of the invasive vineIpomoea cairica(L.) enhances its advantage over nativePaederia scandens(Lour.) Merr. in South China
Authors: Chen Minghao , Cai Mingling , Xiang Ping , Qin Zhangfen , Peng Changlian , Li Shaoshan
Published: December 2022

Ipomoea cairica (L.) Sweet is an invasive vine in South China with strong ecological adaptability in tropical and subtropical ecosystems. However, its invasion mechanism under global warming still remains unknown. In the present study, the thermal adaptability of I. cairica was investigated from the perspective of photosynthetic physiology to explain its successful invasiveness in South China, compared to a niche-overlapping native vine Paederia scandens (Lour.) Merr. Results of field photosynthesis measurements indicated a higher photosynthesis of I. cairica than P. scandens, which was also more temperature-sensitive. Under heat treatment (40 °C), the thermal-avoidance strategy of P. scandens and the thermal-adaptation strategy of the I. cairica enhanced the photosynthetic growth advantage of I. cairica over P. scandens. In I. cairica, the increase of soluble sugar and antioxidant enzyme activity along with the decrease of Malondialdehyde and oxide accumulation demonstrated that I. cairica has superior thermal-adaptation, contrary to P. scandens. Expression of IcOr and IcSRO1 in I. cairica was induced at 40 °C, maintaining the stability of photosynthetic system II and enhancing antioxidant ability. Out study suggested that a higher frequency of heat disturbance under global warming will enhance the invasion capability I. cairica but inhibit the native vine P. scandens.

Highlight

This paper reveals that contrary thermal-adaptation strategies expanded the photosynthetic, growing, and physiological advantages of invasive I. cairica over native P. scandens under high temperature.
Cost, health impacts and cost effectiveness of iceless refrigeration in India's last-mile vaccine cold chain delivery
Authors: Plewes Katherine , Khonputsa Panarasri , Day Nicholas P J , Lubell Yoel
Published: December 2022

Background

Compared with ice-based vaccine carriers (IBVCs), iceless vaccine carrier (ILVC) last-mile delivery could optimize vaccine effectiveness by reducing spoilage. We estimated ILVC-associated spoilage costs averted and cost effectiveness.

Methods

IBVC vaccine spoilage costs were estimated for six vaccines. ILVC incremental costs were based on yearly ILVC cost over total doses. Cost effectiveness was estimated via Markov modeling of rotavirus vaccine.

Results

The spoilage cost using IBVCs was US$9 603 294. Using ILVCs, the incremental cost per vaccine dose was US$0.026, the cost-benefit ratio was 0.28, the number of averted disability-adjusted life years was 0.03 per child and there was a saving of US$0.80 per child vaccinated.

Conclusions

ILVCs may bring cost savings and health gains compared with IBVCs.
Emerging treatment of heart failure
Authors: Tait Mindy
Published: December 2022

The use of selective sodium-glucose cotransporter-2 for heart failure is a new and emerging practice that's imperative for nurses to learn about.