bluuebunny/crossref_metadata_2025 huggingface dataset:
GENOME-WIDE ASSOCIATION META-ANALYSIS OF PHYSICAL PERFORMANCE IN OLDER ADULTS
Authors: Santanasto Adam , Kiel Douglas , Karasik David , Cvejkus Ryan , Biggs Mary , Lunetta Kathryn , Murabito Joanne , Zmuda Joseph
Published: December 2022

Although measures of physical function such as walking speed and time to complete chair-rises are highly heritable, the genetic architecture underlying these phenotypes remains poorly defined. To identify potentially novel genes and pathways underlying physical performance in older adults, we conducted a genome-wide association meta-analysis of the short physical performance battery (SPPB) (Score 0-12) and one of its components, chair-rise time (seconds) in 24,033 Caucasian adults aged 60+ from 13 cohorts (mean cohort age 66.2 ± 5.3 to 84.3 ± 4.1 years; 56.5% women). Cohorts had a genome wide scan imputed to either the Haplotype Reference Consortium or Trans-Omics for Precision Medicine imputation panels. Single nucleotide polymorphism (SNPs) with a minor allele frequency ≥0.1% and imputation quality score ≥0.7 were included (range 7.5-10.5 million per cohort). Analyses were adjusted for age, sex, height, and population substructure. Meta-analysis was performed using a fixed-effects model. Although no genome-wide significant loci were identified, 67 and 60 suggestive loci (p< 5*10-5) were detected for SPPB score and chair-rises time, respectively. Pathway-based analyses indicated significant enrichment of genes affecting negative regulation of calcium channel activity (Bonferroni corrected p-value < 0.05). Sex-stratified gene-based analyses identified clathrin vesicle-associated sec14 protein 1 (CLVS1), significantly associated with chair-rise time in women (p= -1.5*10-7). CLVS1 is highly expressed in the cerebellum, which is involved in postural and motor function control. A larger sample size is needed to confirm and extend our findings, but our results potentially implicate a novel pathway and locus for physical performance in older women.
EXPLORING THE POTENTIAL OF VOICE INTERFACES FOR EMERGING TECHNOLOGIES: OPPORTUNITIES AND CHALLENGES
Authors: Rogers Wendy , Mois George , Blocker Kenneth , Mudar Raksha
Published: December 2022

Successful human-technology interactions require that people be able to communicate their intentions to the technology. Emergent technologies such as virtual assistants, digital home assistant, smart phones, robots, and smart appliances are enabling voice activation and communication. This is potentially a positive trend as people often express a preference for using familiar methods of communicating with other people in their interactions with technologies. Presumably they expect these methods to be easier to learn and more effective. However, current voice technology interfaces are often dependent on specific language, cadence, and terminology that pose challenges for older adults to master. Moreover, age-related changes in voice characteristics, speech patterns, and the variability between individuals may lead to comprehension failures on the part of the technology. We have utilized research findings to develop implementation guidelines for use of voice interfaces with older adults. We also identify research gaps to provide a roadmap for future efforts.
TECHNOLOGY TO SUPPORT AGING ADULTS: FUTURE APPLICATIONS
Authors: Czaja Sara , Boot Walter , Charness Neil , Rogers Wendy , Sharit Joseph
Published: December 2022

The aging of the population is projected to continue for the upcoming decades. Thus, innovative strategies are needed to support current and future cohorts of older adults. In this regard, there are exciting developments in technology that have the potential to meet the needs of population aging. This summary presentation will discuss emerging technology applications such as developments in artificial intelligence, sensing technologies, and robotics that can be used to foster everyday activities, cognitive, physical, and emotional health. A framework will be provided to characterize current and emerging technology applications for older adults within life domains. Current research examining the efficacy, feasibility, and acceptability of these technologies with older adult populations will be also summarized. Recommendations for needed future research in the aging and technology domain will also be provided to ensure that the emerging technology applications are designed to meet the needs, abilities, and preferences of aging adults.
RACE, GENDER, AND LATE-LIFE PRODUCTIVE ACTIVITIES AND DEMENTIA IN THE HEALTH ABC STUDY
Authors: Rooks Ronica , Tarraf Wassim , Ryan Lindsay , Antonucci Toni
Published: December 2022

We hypothesized productive activities, e.g., working and volunteering, would reduce dementia risk and mitigate racial disparities using longitudinal Health, Aging, and Body Composition data (n=3,069). We ran gender-stratified logistic regression models for dementia with socio-demographic and APOE adjustments. Among older men, no significant relationships existed between dementia with work, volunteering, or race in any models. Among older women, in unadjusted models, working vs. not (Yr1) was significantly related to 30% lower odds of dementia (OR=0.70, p≤0.05), and volunteering vs. not (Yr1) was significantly related to 24% lower odds of dementia (OR=0.76, p≤0.05). But, these activities were not significant in other models. Black vs. White women had 35% (OR=1.35, p≤0.05) and 32% (OR=1.32, p=0.052) higher odds of dementia in working and volunteering models with socio-demographic adjustments, respectively, but race was not significant after APOE adjustment. Productive activities are possible contextual interventions to reduce racial disparities in incident dementia among older women.
GRANDPARENTS’ EDUCATION IS ASSOCIATED WITH GRANDCHILDREN’S EPIGENETIC AGE IN THE NGHS STUDY
Authors: Surachman Agus , Hamlat Elissa , Zannas Anthony , Laraia Barbara , Epel Elissa
Published: December 2022

We leveraged information solicited from three generations (grandparents, mothers, and grandchildren) to examine the association between mothers’ childhood SES (based on grandparents’ educational attainment) and their children’s epigenetic age and whether the association was mediated by mothers’ life course socioeconomic and health-related factors. Mothers were recruited to the NHLBI Growth and Health Study when they were 9 or 10 and followed for ten consecutive years (1987-1998). Grandparents reported their highest education during the baseline interviews. Mothers were then re-contacted three decades later (ages 37-42) to participate in the National Growth and Health Study (NGHS), and health information of their youngest children (i.e., grandchildren; N = 241, ages 2-17) were collected, including their saliva samples to calculate epigenetic age. Two epigenetic ages were estimated (Horvath and Hannum), and DNA methylation age accelerations (DNAmAAs) were calculated using residuals from regressing chronologic age on each epigenetic age metrics. Mothers’ life course socioeconomic and health-related mediators included childhood BMI trajectories (from age 9 to 19), highest education level, adult health behavior, and adult c-reactive protein (CRP). Adjusted for age and sex, grandchildren with college degree grandparents showed significantly slower Horvath’s DNAmAA than those with no college degree. The association between grandparent’s education level and grandchildren’s DNAmAA was partially mediated by mothers’ life course socioeconomic and health-related factors, especially mothers’ education, health behavior, and CRP. Grandparents’ educational attainment is a critical socioeconomic context of mothers’ early rearing, and it might have a long-lasting impact on their grandchildren’s epigenetic marker.
FRAILTY-FOCUSED COMMUNICATION (FCOM) FOR OLDER ADULTS
Authors: Maxwell Cathy , Miller Sally , Lee Deborah
Published: December 2022

Frailty-focused communication (FCOM) equips older adults with a better understanding of factors and biological mechanisms related to decline, frailty, and eventual end-of-life, while also empowering them to engage in proactive measures for healthy aging in 8 domains (physical activity, nutrition, safety, mind/body health, relationships/community, sleep/rest, finances, health care decision-making). We aimed to develop and test: 1) an educational tool targeted to older adults, and 2) a FCOM workshop to train health care clinicians on how to explain the concept of frailty and facilitate goal-setting for proactive aging. We tested the tool and workshop in 2 prospective observational studies among community-dwelling older adults (N= 126) and clinicians (N=29) who provide care to older adults. Testing of the FCOM tool revealed that content on bioenergetics of aging increased motivation to make a plan for proactive aging (N=60, 68%), particularly among adults age 55-64 as compared to other age groups (p=.024). Testing of the training workshop demonstrated increased knowledge of frailty (pre score: 5.8, post score: 7.6; d= .55, p=.006) and increased self-reported competency with patient/clinician interaction (pre score: 33.2, post score: 42.0; d=.63, p=.001). Post course evaluations regarding understanding of best practice empathic skills was rated 3.6 (range: 1-4). FCOM promotes awareness of the importance of measures to mitigate development of chronic conditions and frailty, and provides a resource for clinicians in multiple settings to engage in conversations with older adults while physiologic compensatory mechanisms are still intact. FCOM discussions can facilitate a shift from disease-oriented discussion to patient-centered, holistic care.
LESSONS ON LEARNING IN LATER LIFE WITH THE MIT AGELAB 85+ LIFESTYLE LEADERS
Authors: Patskanick Taylor , Miller Julie , Yoquinto Lucas , D'Ambrosio Lisa , Coughlin Joseph
Published: December 2022

Previous research has established the role of lifelong learning in promoting psychological wellbeing and active aging. Population aging necessitates an understanding of the unique opportunities and challenges around formal and informal learning in later life. This paper will share findings from a mixed methods study with the MIT AgeLab 85+ Lifestyle Leaders, a panel comprised of octogenarians and nonagenarians from across the United States. Drawing on an online survey and virtual focus groups with 29 Lifestyle Leaders from January 2021, findings suggest the Lifestyle Leaders most often learned new things from talking with others (46%) and reading print (54%) or online (54%) sources. The majority were familiar with attending in-person lectures or classes (89.7%) and were now using videoconferencing to do these (78.6%). A majority (56.7%) had or are currently participating in a lifelong learning program. Most consider themselves lifelong learners and described this around remaining curious and engaged with life, choices around what one learns, and greater enjoyment of learning. In the survey, a plurality of Lifestyle Leaders indicated the top two challenges affecting their ability to learn were sensory burdens (e.g., hearing loss, declining eyesight) (35%) and their energy level (32.4%); focus group data revealed that recall also is a barrier. Focus group data further highlighted generational experiences around early life learning and career paths, specifically how gender roles, diagnoses of learning disabilities, and evolving digital technology have affected these and changed over the course of their lifetimes.
OLDER PEOPLE'S ACTIVITY PARTICIPATION (OPAP): FACTOR STRUCTURE AND PSYCHOMETRIC PROPERTIES OF A SCALE
Authors: Gan Daniel Rong Yao , Cao Yuxin , Liu Wen , Fung John Chye , Ng Tze Pin
Published: December 2022

Older people’s participation in activities is critical to their health and well-being. Active lifestyle in old age reduces the risk of mortality, prevents chronic diseases, promotes physical and mental wellbeing, and is conducive to active and healthy aging. While various measures of participation have been proposed, a holistic measure that includes both social and individual activity participation is currently unavailable. To enable lifestyle medicine recommendations, we developed the Older People’s Activity Participation (OPAP) scale to understand the constituent factors of older people’s everyday activities. This study examined OPAP’s internal consistency using Cronbach’s alpha, convergent validity using regression analysis, as well as factor structure using exploratory and confirmatory factor analyses in a dense urban setting. Preliminary items assessed engagement in 27 health-related, fitness, recreational, social, productive, and cognitive activities, and were administered to 270 community-dwelling adults aged 50 and older in Singapore. The 17-item OPAP showed acceptable internal consistency (Cronbach’s alpha= .69), and demonstrated convergence with a validated measure of social cohesion (B=.27, p<.001) and Instrumental Activities of Daily Living (B=.32, p<.001). It has a 5-factor structure, namely socializing (alpha=.63), physical training (alpha=.56), listening (alpha=.69), home-making (alpha=.59), and outing (alpha=.58). Acceptable model fit was obtained (RMSEA=0.48, SRMR=0.06, CFI=.90). The OPAP scale is valid and reliable to assess activity participation in Asian older adults. It can be a useful tool to understand older people’s everyday life and lifestyles, relationships between activity participation and health outcomes, and further guide the development and use of effective interventions to promote active and healthy aging.
WELL-BEING DURING THE COVID-19 PANDEMIC: A FUNCTION OF PERSONALITY, AGE, AND URBANICITY
Authors: Ryan Lindsay
Published: December 2022

The COVID-19 pandemic has differentially impacted population sub-groups over the last two years. For example, engagement in social isolation may have been particularly difficult for extroverted adults. The virus spread widely in densely populated regions and is more risky to health with increasing age. This paper explores the ways in which personality, age, and urbanicity are associated with subjective well-being during the pandemic. Longitudinal data from the Health and Retirement Study (N = 4316; M age = 69.0, Range 31 - 99) investigates Big Five personality characteristics from 2016 and interactions with age on life satisfaction and loneliness during the pandemic. Models are then stratified by Beale Rural-Urban Continuum codes denoting urban, suburban, and ex-urban residence. Results indicate the benefit of high conscientiousness on life satisfaction is weaker among older adults (p<.05) and associations of extroversion and age on loneliness are driven by individuals living in urban areas (p<.05).
REHABILITATION OUTCOMES AS A FUNCTION OF PATIENTS' AND HEALTHCARE PERSONNEL'S VIEWS OF AGING
Authors: Shrira Amit
Published: December 2022

The effect of subjective views of aging (VoA) on health outcomes is well established, yet this effect was rarely examined among older adults undergoing hospitalization or rehabilitation. Moreover, the additive effect of healthcare personnel’s ageist attitudes on treatment outcomes is unknown. Accordingly, these effects were examined within older adults hospitalized for osteoporotic fractures – a frequent late-life condition with cardinal functional implications. Study 1 (N=147 patients, mean age=79.3) found that feeling younger at admission predicted better rehabilitation outcomes. The reverse effect of functional independence at admission on subjective age at discharge was non-significant. Study 2 (N=52 patients, mean age=81.8, and N=55 hospital staff members, mean age=32.3) replicated these findings with additional VoA indices, and further demonstrated that rehabilitation outcomes were better when occupational and physical therapists reported low levels of ageist attitudes. Findings suggest that successful rehabilitation may be promoted by reducing negative VoA among patients as well as healthcare personnel.
PERCEPTIONS OF DISCHARGE READINESS AND ENGAGEMENT IN DISCHARGE PLANNING FOR SPOUSAL VERSUS NONSPOUSAL CAREGIVERS
Authors: Elmore Catherine , Bristol Alycia , Barry Lisa , Iacob Eli , Johnson Erin , Wallace Andrea
Published: December 2022

Informal caregivers are frequently excluded during hospital discharge planning, potentially impacting their ability to effectively care for older adults at home. Few studies have examined experiences of spousal versus non-spousal caregivers during hospital discharge planning. In a secondary analysis of a mixed-method study, we quantitatively examined how spousal relationships impact caregivers’ (n=266; 51.8% identified as a spouse or partner) scores of patient discharge readiness using the Readiness for Hospital Discharge Scale (RHDS-CG). We then conducted semi-structured interviews with a participant subset (n=23), and analyzed transcribed interviews using content analysis. First, comparing scores on the RHDS-CG, spouses/partners (88.4%) were more likely than non-spouses (75%) to report RHDS scores of 7+ corresponding with moderate to high readiness (X2 (1) = 8.070, p=.005). Among those interviewed, spouses/partners (65.2%) described their role as long-term, and shared strategies they had learned over time regarding how to seek involvement with healthcare professionals (HCPs). In contrast, non-spousal caregivers (34.8%) viewed their role as short term and struggled with how to communicate with HCPs, citing patient privacy rules and patient autonomy as perceived barriers. Overall, spousal caregivers had more experience with the healthcare system and felt better prepared to assume post-discharge care duties. Exploring the experiences of non-spousal caregivers, which make up more than one-third of our sample, is important since caregiving roles shift away from spouses to adult children and others as people age. Further consideration is necessary regarding how to support non-spousal caregivers in navigating the healthcare system.
COGNITIVE FUNCTION CONTRIBUTES TO THE NONLINEAR RELATIONSHIP BETWEEN AGE AND DUAL-TASK GAIT IN MID-AGED POPULATION
Authors: Zhou Junhong , Cattaneo Gabriele , Yu Wanting , Gouskova Natalia , Lipsitz Lewis , Pascual-Leone Alvaro , Bartres-Faz David , Manor Brad
Published: December 2022

The capacity to maintain safe walking is critical to functional independence in older adults. However, the timing/stage when such capacity starts to diminish, and its potential contributors have not been well characterized. To explore that, we here conducted analysis based upon the data of 651 participants of age between 40 and 65 years from Barcelona Brain Health Initiative Study. Each participants completed: 1) one 45-second trial of walking normally (single-task) and while performing a serial-subtraction-by-three task (dual-task), of which gait was measured using a smartphone-based gait-assessment application; and 2) a battery of cognitive tests. The dual-task cost (DTC) (i.e., percent changes from single- to dual-task condition) to mean stride time (ST) and stride time variability (STV) and the score of global cognitive function were obtained. The LOESS analyses demonstrated nonlinear relationships between age and DTCs with a turning point at age of 54 years (R2>3%). Regression models showed significantly greater associations (p=0.01~0.03) between age and DTCs (i.e., older age, worse gait) (β=0.22~0.28, p< 0.006), as well as between global cognitive function and DTCs (β=-0.28~-0.18, p< 0.002), in older group (i.e., age≥54 years) compared to younger group. The structural-equation-modeling suggested that in older group, cognitive function mediated the relationship between age and dual-task gait (p< 0.02) with a contribution of 43~47% to such relationship. The observations here revealed that as early at age of 54 years, dual-task gait starts to significantly diminish, and its dependence on cognitive function dramatically increases, providing critical knowledge for the management of mobility and cognitive aging in mid-age population.
INTEGRATING HEALTH AND HOME CARE THROUGH TECHNOLOGY: ACTIONABLE SOLUTIONS FOR PROGRESS
Authors: Dunning Lauren , Servat Caroline , Super Nora
Published: December 2022

Shifts toward virtual care driven by the pandemic have continued to blur the previously sharp lines between health care and home care. A new care ecosystem is emerging, bringing with it the opportunity to integrate health and home care through technology. Over the course of the pandemic, Medicare telehealth visits increased 63-fold between 2019 and 2020, innovative programs enabled acute hospital care at home using digital tools, and people in need of care could reach their providers through a broad range of devices and modalities. But many of the policy changes underlying these advancements and others were temporary, and permanent actions are needed to sustain momentum. To characterize the emerging landscape, the Milken Institute conducted informational interviews with over 40 experts representing health, technology, government and policy, research and academia, philanthropy, advocacy, and community-based organizations. From these interviews, themes emerged on barriers, innovations, and opportunities. Findings were further refined through a roundtable workshop and survey to develop guiding principles and consensus-built recommendations. Three sets of recommendations were then developed on: 1) pandemic-related and larger-scale policy and program design to support tech-enabled care, 2) practices and policies to develop a systems approach that integrates health and home care and bolsters equity, and 3) collaboration and coordination to accelerate efforts. This paper focuses on the interview themes and progress made to advance solutions in partnership with stakeholders.
SUPPORTING RESIDENTS WITH DEMENTIA LIVING AND DYING IN LONG-TERM CARE AND THEIR FAMILIES DURING COVID-19
Authors: Kaasalainen Sharon , Wickson-Griffiths Abigail , McCloskey Rose
Published: December 2022

TThis presentation will share research findings about experiences during COVID-19 about implementing a virtual palliative toolkit in long-term care in Canada. The toolkit includes tools and practices to: (a) engage residents and families with dementia within a palliative approach to care, (b) develop workforce capacity through online education modules, (c) reduce stress and improve psychological health of residents, families, and staff, and (d) develop organizational structures and processes to promote a palliative approach to care. Individual interviews were conducted with residents, family members, and staff before implementing a palliative toolkit and after using it. Findings highlighted the negative impacts of COVID-19 on resident health due to isolation within home, preventing family from being at the bedside and cancelling stimulatory activities especially at end of life that were exacerbated by the lack of resources and government supports. Families appreciated the virtual supports and stated that they helped prepare them for their loved ones’ death while feeling more empowered, engaged, and supported in their journey. Although feedback from families was mostly positive, stating the virtual toolkit improved accessibility to information and supports, it was clear that some misunderstood terms, particularly what a palliative approach to care means; and others had challenges navigating the virtual platform to use the toolkit. Future work is needed to make the virtual tools more user-friendly so that they can be scaled up more widely.
HOW HAS NARRATIVE BEEN USED IN GERONTOLOGY?: FINDINGS FROM A QUALITATIVE EVIDENCE SYNTHESIS
Authors: de Medeiros Kate
Published: December 2022

Narrative gerontology emerged as a concept in the 1990s to describe the ways that people age biographical as well as biologically. Since then, narratives and narrative approaches have gained popularity as methods and ways of knowing. This paper presents findings from a qualitative evidence synthesis (QES) of narrative within the gerontological literature. ). QES describes methods to systematically review qualitative evidence (e.g., extracted text). The purpose is to gain a deeper understanding of a concept rather than evaluate study designs or findings. An initial search returned 1,480 papers. Upon further analysis, the following three large categories with regards to narrative were identified: definitions, accounts, processes, and possibilities. Overall, findings provide an comprehensive overview of uses of narrative within gerontology.
NEAR: NEW OPPORTUNITIES FOR AGING RESEARCH
Authors: Rizzuto Debora , Hofer Scott
Published: December 2022

The global increase in life expectancy is one of the greatest achievements of the last half century. However, the demographic developments towards an older population also challenge many parts of the society, especially the health care. Promoting healthy ageing is therefore one of the most important commitments of the 21st century and to succeed, scientifically based knowledge of older individuals’ health- and care requirements are needed. To better understand the individual and population aging process, the National E-infrastructure for Aging Research (NEAR) was founded in 2018 to build and run a national infrastructure by integrating existing databases from the 15 major longitudinal studies on aging and health in Sweden. To show the added value of NEAR, this symposium will present results from four ongoing NEAR projects: 1) Developing a metric of global brain integrity in multiple Swedish studies with different scanners; 2) Functional aging trajectories and drug interactions; 3) Long-term prediction of dementia using machine learning algorithms; 4) The new aging – how different aspect of ageing has changed over half a century. The creation of national infrastructures is needed to achieve broad, multidisciplinary research perspectives that cannot be achieved by individual databases. Moreover, to address the increased health demands of an older population and enhance new opportunities for aging research, a critical mass of data is needed to increase sample sizes, variations, representativeness, and generalizability. Ultimately, this can lead to the identification of sustainable intervention strategies for better health and care for older persons during the coming decades.
IMPACT OF CARDIOVASCULAR RISK FACTORS IN ADOLESCENCE, YOUNG ADULTHOOD, AND MID-LIFE ON LATE-LIFE COGNITION
Authors: George Kristen , Gilsanz Paola , Peterson Rachel , Barnes Lisa , DeCarli Charles , Mayeda Elizabeth , Mungas Dan , Whitmer Rachel
Published: December 2022

Using the Study of Healthy Aging in African Americans (STAR), we assessed cardiovascular risk factors (CVRFs) in adolescence, young adulthood, and midlife with late-life cognition. Among 755 participants, body mass index, blood pressure, glucose, and total cholesterol were collected during Multiphasic Health Checkups (1964-1985). At STAR baseline (2018-2019; mean age=69(SD=9)), executive function (EF), verbal episodic memory (VEM), and semantic memory (SM) were measured using the Spanish and English Neuropsychological Assessment Scales. Linear regression models associated CVRFs with cognition. Hypertension was associated with worse late-life EF (β[95% CI]:-0.14[-0.28, -0.00]) and VEM (β[95% CI]:-0.22[-0.37, -0.07]). Diabetes was associated with worse EF (β[95% CI]: -0.43[-0.83, -0.03]). In age-stratified analyses, adolescent hypertension was associated with lower late-life EF (β[95% CI]:-0.39[-0.67, -0.11]). Young adulthood hypertension (β[95% CI]:-0.29[-0.49, -0.09]) and midlife hyperlipidemia (β[95% CI]:-0.386[-0.70, -0.02]) were associated with lower VEM. These results emphasize the importance of lifecourse cardiovascular health on the aging brain among Black Americans.
INTERSECTIONALITY AND QUALITATIVE HEALTH RESEARCH: POTENTIALS TO IMPACT QUALITATIVE RESEARCH
Authors: Roes Martina , Laporte-Uribe Franziska , Bhatt Jem , Smits Carolien , Johanessen Aud , Peters-Nehrenheim Viktoria , Tezcan-Guentekin Huerrem
Published: December 2022

With a growing interest in intersectionality, critical qualitative researchers acknowledge the benefit from incorporating an intersectional lens. Incorporated intersectionality can be beneficial since it allows researchers from different disciplines to consider and account for the participant identities as multidimensional, fluid and, interdependent at each stage of the research process. In this presentation we will offer insights how qualitative research can be enhanced by incorporating an intersectional lens when analyzing the interconnectedness of numerous socially constructed identities (such as sex/gender/ethnicity/transnational families). Furthermore, we will address challenges how to conduct intersectional qualitative research (e.g. intersectional oriented interviews) and analysis (e.g. anticategorial, intracategorial and intercategorial complexity). This approach challenges on many levels, but since qualitative and interdisciplinary research is about utilizing meaning of phenomena, incorporating an intersectional lens will not only expand the methodological horizon of researchers but also stimulate ethical and critical inquiry throughout the research process.
HEARING THE VOICE OF OLDER MIGRANTS WITH DEMENTIA: A DECOLONIAL APPROACH OF PARTICIPATIVE ACTION RESEARCH
Authors: Chaouni Saloua Berdai
Published: December 2022

Gerontological research has been proven not always to succeed in engaging older migrants and their families. Various attempts are made to give voice to this under-researched population. Qualitative methods like participative action research (PAR) have been put forward as a way to engage this population. However, this approach does not always succeed to achieve this goal. Drawing on insights from decolonial frameworks, we present a learning process in engaging older migrants with and without dementia and their family members in developing a migration-sensitive reminiscence approach as a psycho-social intervention for older migrants with dementia. The emphasis of decolonial perspectives on seeing this population as the “Knower”, deep reflection on own coloniality of mind as a researcher while critically looking at exclusive aspects of epistemology offers a supporting gaze to reshape PAR as an approach where this population is not only given voice but also heard.
THE IMPACT OF FFC-AC-EIT ON DECREASING USE OF PSYCHOTROPIC MEDICATIONS AND OPIOIDS IN ASSISTED LIVING
Authors: Resnick Barbara
Published: December 2022

The secondary aim of the study testing the impact of Function Focused Care for Assisted Living Using the Evidence Integration Triangle (FFC-AL-EIT) was to decrease psychotropic medications and opioids among assisted living residents. Function Focused Care is a philosophy of care in which direct care workers are taught how to evaluate older adults' underlying function and physical activity and optimize their participation in all activities. This randomized controlled trial included 85 communities and 781 residents across three states. A total of 501 out of 794 participants (63%) received at least one psychotropic medication or opioid. Except for opioid use at four months, there was no significant difference in the intervention groups with regard to medication use at any time point. The findings suggest that encouraging participation in physical activity during all care interactions does not result in an increase in the need for and prescribing of psychotropic medications or opioids.
REBALANCING LONG-TERM CARE: THE ROLE OF MEDICAID-MANAGED LONG-TERM SERVICES AND SUPPORTS
Authors: Degenholtz Howard
Published: December 2022

From 2018 to 2020, Pennsylvania conducted a phased implementation of a mandatory Medicaid managed long-term services and supports program called Community HealthChoices (CHC). The new program covers people receiving Medicaid financed long-term services and supports (LTSS) in nursing homes and home and community-based settings. The three participating MCOs are incentivized to serve people in the community. This study took advantage of the phased implementation to generate causal estimates of the effect of the new program on both the extensive margin (the proportion of people receiving HCBS vs. nursing homes), and the intensive margin (the type and amount of HCBS services). Medicaid claims data for the years 2013 to 2020 were analyzed to examine pre-program trends and program effects. There was a long-term pre-program trend away from nursing homes. The implementation of managed care did not appear to accelerate this trend, however, analysis of data from 2020 is complicated by the COVID-19 pandemic. However, MLTSS did appear to control to growth in hours of personal care per person both in the aggregate and longitudinally within the same individuals over time. There were decreases in the use of adult day services and home delivered meals. However, the decline in home delivered meals was more than offset by an increase in uptake of the supplementary nutritional assistance program (SNAP). This is the first causal analysis of the effects of managed care on use of long-term services and supports. The findings have implications for other states that are considering implementing similar policies.
Model-based deconvolution for particle analysis applied to a through-focus series of HAADF-STEM images
Authors: Ohsuna Tetsu , Oh-ishi Keiichiro
Published: December 2022

This paper presents an approach for determining the sizes and three-dimensional (3D) positions of nanoparticles from a through-focus series of high-angle annular dark-field scanning transmission electron microscopy images. By assuming spherical particles with uniform density, the sizes and 3D positions can be derived via Wiener deconvolution using a series of kernels prepared by the convolution of the 3D point spread function of the electron beam and the 3D density distribution of spheres with different radii. This process is referred to as a model-based deconvolution. Four 3D datasets with a volume size of 148 × 148 × 560 nm3 were obtained from the four sets of 256 high-angle annular dark-field scanning transmission electron microscopy images of 256 × 256 pixels taken from the same field of view under the through-focus condition. The 3D positions and radii of 14 particles in each 3D dataset were derived using the model-based deconvolution for ∼8 min. The observation errors of the 3D position were estimated as σx ≅ σy ≅ 0.3 nm and σz < 1.6 nm.
The 2019–2020 Dengue Fever Epidemic: Genomic Markers Indicating Severity in Dominican Republic Children
Authors: Simpson Brittany N , Mejía Sang Miguel E , Collado Puello Yonairy , Diaz Brockmans Elvira J , Díaz Soto María F , Rivera Defilló Stephanie M , Taveras Cruz Karla M , Santiago Pérez Javier O , Husami Ammar , Day Melissa E , Pilipenko Valentina , Mena Rafael , Mota Cesár , Hostetter Margaret K , Muglia Louis J , Schlaudecker Elizabeth , Gonzalez del Rey Javier , Martin Lisa J , Prada Carlos E
Published: December 2022

We performed an observational cohort study to assess associations between genetic factors of dengue fever (DF) severity in children in the Dominican Republic. A total of 488 participants had serologically confirmed DF. We replicated the association between the IFIH1 gene (rs1990760) and severe DF (n = 80/488, p = 0.006) and identified novel associations needing further investigation.
Impacts of climate and tree morphology on tree-ring stable isotopes in central Mongolia
Authors: Leland Caroline , Andreu-Hayles Laia , Cook Edward R , Anchukaitis Kevin J , Byambasuren Oyunsanaa , Davi Nicole , Hessl Amy , Martin-Benito Dario , Nachin Baatarbileg , Pederson Neil
Published: December 2022

Recent climate extremes in Mongolia have ignited a renewed interest in understanding past climate variability over centennial and longer time scales across north-central Asia. Tree-ring width records have been extensively studied in Mongolia as proxies for climate reconstruction, however, the climate and environmental signals of tree-ring stable isotopes from this region need to be further explored. Here, we evaluated a 182-year record of tree-ring δ13C and δ18O from Siberian Pine (Pinus sibirica Du Tour) from a xeric site in central Mongolia (Khorgo Lava) to elucidate the environmental factors modulating these parameters. First, we analyzed the climate sensitivity of tree-ring δ13C and δ18O at Khorgo Lava for comparison with ring-width records, which have been instrumental in reconstructing hydroclimate in central Mongolia over two millennia. We also compared stable isotope records of trees with partial cambial dieback (‘strip-bark morphology’), a feature of long-lived conifers growing on resource-limited sites, and trees with a full cambium (‘whole-bark morphology’), to assess the inferred leaf-level physiological behavior of these trees. We found that interannual variability in tree-ring δ13C and δ18O reflected summer hydroclimatic variability, and captured recent, extreme drought conditions, thereby complementing ring-width records. The tree-ring δ18O records also had a spring temperature signal and thus expanded the window of climate information recorded by these trees. Over longer time scales, strip-bark trees had an increasing trend in ring-widths, δ13C (and intrinsic water-use efficiency, iWUE) and δ18O, relative to whole-bark trees. Our results suggest that increases in iWUE at this site might be related to a combination of leaf-level physiological responses to increasing atmospheric CO2, recent drought, and stem morphological changes. Our study underscores the potential of stable isotopes for broadening our understanding of past climate in north-central Asia. However, further studies are needed to understand how stem morphological changes might impact stable isotopic trends.
Specialized Nurse-led Care of Chronic Wounds During Hospitalization and After Discharge: A Randomized Controlled Trial
Authors: Sili Alessandro , Zaghini Francesco , Monaco Dario , Dal Molin Alberto , Mosca Nella , Piredda Michela , Fiorini Jacopo
Published: December 2022

OBJECTIVE

To evaluate the effectiveness of specialized nurse-led care of patients with chronic wounds, provided both during hospitalization and postdischarge, on wound healing and readmission rates.

METHODS

An unblinded randomized controlled trial was conducted. Participants were patients with chronic wounds, randomly assigned to either the experimental group (cared for by wound care nurses both during hospitalization and postdischarge) or to the control group (cared for according to standard practice). Wound healing was identified as the primary outcome.

RESULTS

Overall, 1,570 patients were randomized, 1,298 of whom were included in the per-protocol analysis (707 in the experimental group and 591 in the control group). Nurse-led wound care quadrupled the probability of healing and reduced the number of treatment weeks and hospital readmissions.

CONCLUSIONS

Chronic wound care that was entrusted to specialized nurses improved outcomes in terms of wound healing, repair and regeneration, length of treatment, and rate of readmission, compared with standard practice. Future studies should evaluate the impact of care provided by specialized wound care nurses on patients’ quality of life and healthcare costs. Nurse managers should promote the implementation of chronic wound clinical-care pathways entrusted to specialized nurses to improve patients’ clinical outcomes and reduce hospital readmissions.
Timing of Post-bath Skin Moisturizer Application to Newborn Infants: A Randomized Controlled Study
Authors: Gözen Duygu , Akarsu Özlem , Dur Şadiye , Akça Burcu
Published: December 2022

OBJECTIVE

To investigate whether the timing of postbath moisturizer application affected the skin moisture (SM) and body temperature (BT) of newborn infants.

METHODS

The researchers conducted a randomized controlled study with 80 newborns who were monitored in a university hospital between March 2017 and May 2018. In both the control and experimental groups, newborns were bathed and dried. However, in the control group, moisturizer was applied immediately to the newborn’s body, whereas in the experimental group, moisturizer was applied 10 minutes after the completion of the bath. Researchers evaluated the BT and SM of all infants both before and immediately after the bath and at 10, 20, 40, and 60 minutes postbath.

RESULTS

The control and experimental groups were similar according to the descriptive characteristics of the infants (P > .05). In both groups, infants’ SM values increased in the first 10 minutes after the bath compared with the prebath values (P < .05). However, the whole-body SM value of the experimental group was significantly higher than that of the control group 60 minutes postbath (P = .027). There was also a statistically significant change in the body temperatures of infants in both groups after bathing (P = .004).

CONCLUSIONS

Waiting 10 minutes postbath before applying moisturizer positively affected newborns’ SM and BT. Additional research with a broader age range and a more diverse sample is needed to further clarify the effects of postbath moisturizer application timing on newborns’ SM and BT.
Influence of Nutrition Status and Compression Therapy on Venous Ulcer Healing: A Systematic Review
Authors: García-Rodríguez María Teresa , Rodríguez-Parrado Marta , Seijo-Bestilleiro Rocío , González-Martín Cristina
Published: December 2022

OBJECTIVE

To review the literature to determine whether compression therapies and nutrition status influence venous ulcer healing.

DATA SOURCE

A systematized bibliographic review was carried out by searching PubMed, Scopus, and Cochrane databases for studies published between 2015 and 2020, using descriptors in Spanish and English.

STUDY SELECTION

After establishing the research question and applying the filters based on inclusion and exclusion criteria, 114 articles were found. After screening, 11 articles were selected for the review: 8 were identified in the literature search, and 3 were added from the bibliographic references of other studies.

DATA EXTRACTION

The authors developed a data extraction sheet that recorded the following variables: author, country, year of publication, level of evidence, research design, therapy type, initial ulcer size, active ulcer history, pain, healed wounds, wound reduction, therapy tolerance, nutrition assessment method, body mass index, and nutrition disorders.

DATA SYNTHESIS

Four studies analyzed the relationship between nutrition status and venous ulcer healing, finding that these patients tend to have a high body mass index; a deficit of nutrients such as vitamin A, D, or zinc; and an excess of lipids and carbohydrates. Seven studies compared different types of compression to determine which provided the best results, with two- and four-layer therapy being the most commonly used. Variables such as small wound size and recent onset were associated with better prognosis.

CONCLUSIONS

In terms of nutrition, the parameters analyzed are very limited. Although several studies show that two-layer therapy produces the greatest ulcer healing, there is not enough information to recommend one type of therapy over the other. Therefore, more clinical trials are needed to study broader nutrition parameters and compare the types of therapy under matched conditions to determine their influence on ulcer healing.
ACE inhibitors and ARBs
Authors: Sturdivant Tyler , Allen-Thomas Katrina
Published: December 2022

Through the exploration and understanding of a clinical scenario, you can safely administer ACE inhibitors and ARBs in daily clinical practice.
Necessary but Insufficient and Possibly Counterproductive: The Complex Problem of Teaching Evaluations
Authors: Ginsburg Shiphra , Stroud Lynfa
Published: December 2022

The evaluation of clinical teachers’ performance has long been a subject of research and debate, yet teaching evaluations (TEs) by students remain problematic. Despite their intuitive appeal, there is little evidence that TEs are associated with students’ learning in the classroom or clinical setting. TEs are also subject to many forms of bias and are confounded by construct-irrelevant factors, such as the teacher’s physical attractiveness or personality. Yet they are used almost exclusively as evaluations of and feedback to teachers. In this commentary, the authors review the literature on what TEs are meant to do, what they actually do in the real world, and their overall impact. The authors also consider productive ways forward.

While TEs are certainly necessary to provide the crucial student voice, they are insufficient as the sole way to assess teachers. Further, they are often counterproductive. TEs carry so much weight for faculty that they can act as a disincentive for teachers to challenge learners and provide them with the critical feedback they often need, lest students give them poor ratings. To address these challenges, changes are needed, including embedding TEs in a programmatic assessment framework. For example, TEs might be used for formative feedback only, while other sources of data, such as peer assessments, learning outcomes, 360-degree feedback, and teacher reflections, could be collated into a portfolio to provide a more meaningful evaluation for teachers. Robust, transparent systems should be in place that dictate how TE data are used and to ensure they are not misused. Clinical teachers who do not “fail to fail” learners but instead take the time and effort to identify and support learners in difficulty should be recognized and rewarded. Learners need this support to succeed and the obligation to protect patients demands it.
Key Factors Related to Household Emergency Preparedness Among Parents of Newborn Infants
Authors: Nurse-Clarke Natasha , Heagele Tara
Published: December 2022

Background:

A natural disaster can have devastating consequences for newborn infants. Despite this fact, there are few studies that have explored household emergency preparedness (HEP) among parents of newborn infants or factors affecting HEP in this population.

Purpose:

The purpose of this study was to explore the relationship between various demographic and socioeconomic variables and levels of HEP among parents of newborn infants.

Methods:

Parents of newborn infants born at a single medical center in Brooklyn, New York, completed a pre- and posttest to determine their level of HEP before and after implementing the Nurses Taking on Readiness Measures (N-TORM) intervention. For this study, a secondary statistical analysis was performed on the HEP scores gathered prior to the intervention and the demographic data collected from participants.

Results:

There was a statistically significant relationship between HEP scores and homeownership t
(62) = 2.75, P = .008, level of education t
(66) = 2.31, P = .024, and income t
(46) = 2.39, P = .021.

Implications for Practice and Research:

Findings from this study indicate that there are various demographic and socioeconomic factors that influence HEP. Another critical finding was that most participants were significantly underprepared for an emergency with an average HEP score of 4.75 (SD = 2.61) out of a possible 11 points. Findings from this study support the need for neonatal and pediatric providers to develop targeted interventions to enhance the preparedness of parents of newborns in general, and in particular, those with lower household incomes, lower levels of education, and those who rent their homes.