bluuebunny/crossref_metadata_2025 huggingface dataset:
Mindfulness Meditation and Tai Chi Chuan on Sleep Disturbance in Chinese Older People: A Randomized Controlled Trial
Authors: Chan Sunny , Chan Wai Chi , Ng Siu Man , Yu Chong Ho Alex
Published: December 2020

Sleep disturbances are common during the aging process and can result in a reduced quality of life. Many older people who experience sleep disturbances would consider turning to complementary and alternative medicine (CAM) due to the limitations of traditional pharmaceutical or psychological and behavioural treatments. Mindfulness Meditation (MM) and Tai Chi Chuan (TCC) are two common forms of mind-body based CAM. The former focuses more on mind-based practices whereas the latter emphasizes predominantly on body or movement-based practices. An etiological model of sleep disturbance (Shallcross et al., 2019) can lay the groundwork for a better understanding of the mechanisms of MM and TCC in relation to sleep disturbances. This study aims at comparing the effects of MM and TCC with Sleep Hygiene Education (SHE) control group. A three-armed randomized controlled pilot trial was conducted involving 45 community-dwelling older adults aged 65 to 82 with symptoms of sleep disturbance. Moderate effect sizes (Cohen’s d = 0.7 and 0.56) were found for the primary outcome of insomnia severity at post-intervention as comparing MM and TCC groups with SHE control group, respectively. More specific, participants in the MM group showed more amelioration on mental health status, introspective awareness, and objective measure of EEG-based brain arousal level; whereas participants in the TCC group showed better improvement on physical health status and subjective measure of hyperarousal. Findings demonstrate the unique therapeutic effects of MM and TCC on improving sleep problem in older people. The application in a Chinese context will be discussed.
Factors Related to the Dignity of Older People in Tehran in 2020
Authors: Kakhki Ali Darvishpoor , Moradoghli Fereshteh , Esmaeili Roghayeh , Kakhki Ali
Published: December 2020

The elderly are the fastest growing segment of the population globally. This is also the case in developing countries such as Iran. The fear of aging and the refusal to accept older adults into the mainstream of society affects the dignity of older people. This study was conducted to describe factors and dignity of older people in Tehran, Iran. This descriptive, correlational study was conducted on a sample of 215 older people above age 60 in 10 public parks in five regions of Tehran in 2020. A socio-demographic questionnaire and patient dignity inventory were used for data collection. Content validity and Cronbach’s alpha were used for evaluating the validity and reliability of questionnaires. Data were analyzed with SPSS. 60% of subjects were male and 40% female with a mean age of 68(± 5.05) year. The mean scores for dignity domains ranged from 67.30 (±17.56) for symptom distress, to 93.01(± 10.90) for dependency on a 100-point scale. The scores of dignity domains were significantly associated with job status, housing status, income source, health insurance, chronic diseases, annual physician referral rates, and hospitalization in last year. The best predictors of dignity were health insurance and annual physician referral rates. The findings of this study showed that the dignity of older people is related to a number of factors. Monitoring modifiable factors such as health insurance and annual physician referral rates and non-modifiable factors such as chronic diseases will help us to preserve or improve the dignity of older people.
Measuring Hand Function in Older Adults: The Need for Better Assessment Tools
Authors: Logue Rachel , Goldenkoff Elana , Vesia Michael , Brown Susan
Published: December 2020

Aging is associated with a decline in hand muscle strength, dexterity, and tactile perception, leading to difficulties in activities of daily living and reduced independence (Millan-Calenti et al., 2010). However, current assessments do not adequately capture sensorimotor skills that underlie everyday activities such as dressing and food preparation. This study examined the ability of two novel assessment devices to detect age-related changes in hand force control and tactile pattern discrimination. Sensorimotor function was assessed in 13 healthy older adults (mean age 72.2 +/- 5.5y) and 13 young adults (mean age 20 +/- 1.4y). Maximum grip force (MVC), tactile sensation, and hand dexterity were measured using standard clinical techniques. Novel assessments consisted of submaximal (5-20% MVC) grip force tracking and computer-controlled tactile pattern recognition. Monofilament testing of tactile sensation was normal in the older group. In contrast, both the accuracy and speed associated with identifying tactile patterns was significantly worse in older (p<0.001) compared to young adults for both hands. While maximum grip force was similar in both groups, the ability to smoothly produce (p<0.05) and maintain (p<0.02) low grip force levels was compromised in older adults. Manual dexterity (Grooved Pegboard test) was significantly reduced in the older group (p<0.001) regardless of hand. These results indicate that the ability to extract meaningful information from tactile feedback and control low levels of force - aspects of fine hand control associated with activities of daily living – are impaired in older adults and underscore the need for more sensitive measures of hand function.
Pain and Its Management: Strategies and Outcomes in Older Adults With or at Risk for Knee Osteoarthritis
Authors: Johnson Alisa , Booker Staja , Cardoso Josue , Goodin Burel , Sibille Kimberly , Fillingim Roger
Published: December 2020

Knee osteoarthritis (KOA) is a leading cause of mobility disability that is characterized by chronic pain among older adults. Non-Hispanic Blacks (NHBs) suffer disproportionately from non-Hispanic Whites (NHWs), reporting higher pain intensity and disability. It is unclear how these differences in symptomatology translate into different patterns of utilization for self-management (SM) of pain, and if such patterns are associated with underlying biological pain mechanisms. This multisite observational study examined (1) use of self-management strategies among older NHB and NHW adults with/at risk for KOA and (2) associations among self-management strategies, clinical and experimental pain. After approval from institutional IRBs, NHB and NHW older adults (N= 202) with knee pain completed the McGill Pain Questionnaire-Short Form, questions on treatment strategies (e.g., massage, ice, heat, medications), and quantitative sensory testing. Covariates included study site and education. On average, participants reported using 2 ± 1.65 SM strategies, with 79% endorsing at least one SM strategy. Analysis of covariance revealed that clinical pain differed by race/ethnicity and use of SM and/or medical treatments (p’s < 0.01). SM use did not differ by race/ethnicity, p = 0.15, but did differ significantly by gender, p < 0.05. Multiple linear regression demonstrated significant positive associations between SM and heat pain sensitivity for both NHBs and NHWs, (p < 0.05). SM is an important component of OA management for NHBs and NHWs. Our study is one of the first to show that SM use is significantly associated with pain mechanisms. Improved understanding will facilitate better mechanism-targeted pain management.
The Pain Situation of Older Home-Care Recipients and Influencing Factors
Authors: Dräger Dagmar , Kreutz Reinhold , Kuhlmey Adelheid , Budnick Andrea , Draeger Dagmar
Published: December 2020

Chronic pain is a common symptom among older people. The international prevalence rate reaches 50% for older home-care recipients (aged ≥60). The most common causes of pain among older people are degenerative arthropathy and musculoskeletal diseases. Care recipients (81% aged ≥65) constitute a specific sub-group among pain patients, due to the restrictions they experience. In Germany, the prevalence rate in this group is 70%. Currently, no comprehensive information on the pain situation of older home-care recipients exists in Germany. The findings presented are based on a cross-sectional study of older (aged ≥65) home-care recipients (SGB XI) in Berlin, with chronic pain (n=225), capable of self-report (MMST≥18). Structured interviews comprised the primary data source. The pain situation was determined using the German Brief Pain Inventory (BPI-NH). Multiple regression analysis was applied to test how the most severe pain (dependent variable) was influenced by socio-demographic and medical parameters, mental and physical restrictions and pain medication. Analyses of the pain situation show a value of M=4.81 (SD±1.88) on the BPI intensity index, and a BPI pain interference index of M=5.47 (SD±2.15). The most intense pain averaged 6.96 (SD±2.15). On average, respondents reported 16.20 (SD±13.25) pain locations (range: 0-65). The number of pain locations, alongside other factors, had a significant influence, R²=0.038 (corrected R²=0.034), F (1.219) = 8.760, p<0.01), on pain intensity. The findings show severe pain intensity among older home-care recipients not reported in previous findings (e.g. in long-term in-patient care). Action in medical care, nursing care and educational aspects is urgently needed.
Transcranial Direct Current Stimulation Combined With Meditation for Older Adults With Knee Osteoarthritis
Authors: Ahn Hyochol , Park Lindsey , Miao Hongyu
Published: December 2020

Osteoarthritis (OA) of the knee is one of the most common causes of pain in older adults. Recent evidence suggests that knee OA pain is characterized by alterations in central pain processing in the brain. Two nonpharmacological pain treatments, transcranial direct current stimulation (tDCS) and mindfulness-based meditation (MBM), have been shown to improve pain-related brain function in older adults with knee OA. Because tDCS promotes neuroplasticity, it may potentiate the effect of MBM that also stimulates adaptive changes in the brain. However, no studies have examined whether tDCS combined with MBM can reduce OA symptoms in older adults with knee OA. Thus, the purpose of this study was to examine the preliminary efficacy of tDCS combined with MBM in older adults with knee OA. Thirty participants with knee OA were randomly assigned to receive 10 daily sessions of home-based 2 mA tDCS combined with active MBM for 20 minutes (n=15) or sham tDCS combined with sham MBM (n=15). We measured OA-related clinical symptoms using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Participants (60% female) had a mean age of 59 years. Active tDCS combined with active MBM significantly reduced scores on the WOAMC (Cohen’s d = 0.83, P = 0.02). Participants tolerated tDCS combined with MBM well without serious adverse effects. Our findings demonstrate promising clinical efficacy of home-based tDCS combined with MBM for older adults with knee OA. Future studies with larger-scale randomized controlled trials with follow-up assessments are needed to validate our findings.
Supportive Home Environments as a Mediator Between Sensory Impairment and Disability
Authors: Steinman Bernard , Pynoos Jon , Mittlieder Casandra , Overton Julie , Ahrenholtz Treva Sprout
Published: December 2020

Home environments are important to older adults and can help to preserve independence in every day functioning when they are supportive. Nevertheless, over time, the quality of “fit” between individuals and their homes can decrease because of age-related physical changes. A significant proportion of older Americans experience sensory impairments that impact their capacity to perform daily living activities necessary to remain independent at home. Home environments designed to support access and safety have potential to ameliorate disability associated with declines in sensory status. Data from the National Health and Aging Trends Study (NHATS) were analyzed to assess the role of supportive home environments in mediating the relationship between self-reported measures of vision impairment, hearing impairment, and dual vision-hearing impairment and related ADL/IADL outcomes in community-dwelling older adults. Guided by the International Classification of Functioning, Disability and Health (ICF), regression models included covariates for sociodemographics, chronic conditions, mobility functioning, and participation. Supportive home environments were operationalized using indicators of whether participants had access to homes from the outside without having to use stairs; presence of a bedroom, kitchen, and full bathroom with a shower or tub on the same floor; and whether bathroom fixtures had been modified with features such as grab bars. Results suggest a statistical relationship between sensory function and disability that is explained in part by the lack of supportive home features. Implications are that older adults with sensory impairments can benefit greatly by improving environments in areas of the home that are known to cause difficulty.
Distinct Trajectories of Recovery Within the First Year After Hip Fracture
Authors: Mutchie Heather , Orwig Denise , Gruber-Baldini Ann
Published: December 2020

Hip fracture patients experience heterogenous pathways of recovery. Knowing about these different groups can guide rehabilitation efforts. The sample was 339 hip fracture patients age 65+ recruited to the Baltimore Hip Studies 7th cohort [2006-2011; men(n=168) women(n=171)] assessed at baseline, 2.6, and 12 months. Group based trajectory modeling assessed participants’ cognitive and functional recovery trajectories as measured by the Modified Mini-Mental State Examination(3MS;0-100), Hooper Visual Organization Task(HVOT,0-30), Trail-Making Task(TrailsA,B:0-301s), Short Physical Performance Battery(SPPB,0-12), Lower Extremity Physical Activities of Daily Living(LPADL,0-12), and physical activity (YALE, hours/week). Participants were on average 80.91(7.88) years old with 13(3.41) years of education. Two groups were identified for Trails A [Consistent high performance (85.3%), declined performance (14.6%)] and YALE [low exercise(94.9%), small decline(5.0%)]. Three groups were identified for 3MS [consistently high(76.3%), consistently borderline(17.1%), consistently low-performing(6.4%)] and SPPB [failure(19.3%), low-performing with small improvement(55.7%), moderate improvement(24.9%)]. Four groups were identified for HVOT[low scoring(14.2%), mid-range(31.9%), borderline(32.4%), well-performing(21.3%)], Trails B [consistent high-performance(40.2%), improved(18.6%), declined(12.0%), consistent failure(29.1%)], and LPADL[low-performing(27.0%), small improvement(50.0%), dramatic improvement(17.0%), high-performing(5.7%)]. The polynomial functions of the trajectory groups were primarily quadratic with some cubic functions best representing the recovery trajectories. Many of the groups have similar trajectories but at different magnitudes. For most tests performance at baseline was able to differentiate performance at 1 year. These data show that there are very few changes in high or low performing groups, but mid-range participants can experience volatility.
Regional Associations of Cortical Thickness With Gait Variability: The Tasmanian Study of Cognition and Gait
Authors: Jayakody Oshadi , Breslin Monique , Beare Richard , Srikanth Velandai , Blumen Helena , Callisaya Michele
Published: December 2020

Gait variability is a marker of cognitive decline. However, there is limited understanding of the cortical regions associated with gait variability. We examined associations between regional cortical thickness and gait variability in a population-based sample of older people without dementia. Participants (n=350, mean age 71.9±7.1) were randomly selected from the electoral roll. Variability in step time, step length, step width and double support time (DST) were calculated as the standard deviation of each measure, obtained from the GAITRite walkway. MRI scans were processed through FreeSurfer to obtain cortical thickness of 68 regions. Bayesian regression was used to determine regional associations of mean cortical thickness and thickness ratio (regional thickness/overall mean thickness) with gait variability. Smaller overall cortical thickness was only associated with greater step width and step time variability. Smaller mean thickness in widespread regions important for sensory, cognitive and motor functions were associated with greater step width and step time variability. In contrast, smaller thickness in a few frontal and temporal regions were associated with DST variability and the right cuneus was associated with step length variability. Smaller thickness ratio in frontal and temporal regions important for motor planning, execution and sensory function and, greater thickness ratio in the anterior cingulate was associated with greater variability in all measures. Examining individual cortical regions is important in understanding the relationship between gray matter and gait variability. Cortical thickness ratio highlights that smaller regional thickness relative to global thickness may be important for the consistency of gait.
Uninterruptible Power Supply Improves Precision of Telomere Length Measurement via qPCR
Authors: Hastings Waylon , Shalev Idan
Published: December 2020

Epidemiological literature has produced robust associations between telomere length (TL) and health, wherein individuals with shorter TL are at increased risk for chronic disease and death. Even so, technical challenges associated with TL measurement have led some to question their utility as a biomarker of aging. Several pre-analytical factors influence TL assessment via qPCR including tissue source, sample storage, and DNA extraction method. Additional work has investigated how conditions within the PCR run (e.g. mastermix reagents) influences precision and reproducibility of TL measurements. However, the impact of power supply remains unclear. Momentary fluctuations in power supply can affect the functioning of high-performance electronics, including real-time thermocylers. These fluctuations can be mitigated by using an uninterruptible power source (UPS), an electronic apparatus capable of supplying constant, uninterrupted voltage to high-performance electronics. The current study investigated how using a UPS influenced TL assessment via qPCR. Standard deviation and coefficient of variation across replicates were compared for samples assessed with or without the use of a UPS. Samples run with a UPS had significantly lower standard deviation (p<0.001) and coefficient of variation (p=0.002) than those run without a UPS. Notably, neither the efficiency of exponential amplification (p=0.674) nor the standard curve R2 (p=0.638) varied as a function of UPS status. Thus, UPS status decreases variability within sample replicates while maintaining the overall quality of the qPCR assay. *The work presented was supported by the Telomere Research Network, an NIH-sponsored working-group recently established to coordinate best practices for measuring telomere length in population-based research.
Cognition, Depression, and Genetics: Examining Sex Differences Using Polygenic and Genetic Inference Techniques
Authors: Ware Erin , Gard Arianna , Fu Mingzhou , Schmitz Lauren , Bakulski Kelly , Ware Erin Bakshis
Published: December 2020

Alzheimer’s disease and its related dementias (ADRD) are debilitating neurodegenerative diseases. As nearly two-thirds of persons diagnosed with Alzheimer’s disease are women, more research is needed to understand sex differences in the biological mechanisms that underlie ADRD. Depression is a risk factor for Alzheimer’s disease and higher rates of depression among women, compared to men, suggest that depression-related phenotypes and underlying biological factors may contribute to sex differences in ADRD. Using the Health and Retirement Study (N = 9908, European ancestry), a US panel-cohort study, the current analysis leverages Mendelian randomization techniques to assess sex-specific inferred causality of depressive symptoms on odds of dementia. All analyses assess most recent cognition and account for sex, education, study cohort, age and year of most recent cognition visit, and genetic ancestry principal components. A one standard deviation increase in depressive polygenic score was associated with 1.11 times higher odds of dementia (95% confidence interval: 1.02-1.21) relative to normal cognition. Each additional endorsed depressive symptom was associated with 1.13 times higher odds of dementia (95% confidence interval: 1.09-1.18) relative to normal cognition. Using the depression genetic instrument, a significant inferred causal relationship was observed between depressive symptoms and dementia (P=0.01, 1.73 odds ratio, 95% confidence interval: 1.12-2.67). When stratified by sex, this relationship was only significant in females (P=0.02, 1.76 odds ratio, 95% confidence interval: 1.08-2.87). These findings demonstrate that depressive symptoms are likely causally related to dementia, and this relationship is most pronounced in females.
Impact of Family Caregiver Training on Hospitalization During Medicare Home Health Care
Authors: Burgdorf Julia , Wolff Jennifer
Published: December 2020

Medicare home health providers are required to offer family caregiver training; however, there is little information regarding the impact of family caregiver training on patient outcomes in home health or other care delivery settings. A better understanding of this relationship is necessary to guide development of caregiver training interventions and inform policy discussions surrounding family caregiver training access. This research assesses whether and how unmet need for family caregiver training is associated with acute care utilization during Medicare home health. We examine 1,217 (weighted n=5,870,905) fee-for-service Medicare beneficiaries who participated in the National Health and Aging Trends Study (NHATS) and received Medicare-funded home health care between 2011-2016. We link NHATS data with home health patient assessments and Medicare claims, drawing measures of family caregivers’ need for training from home health clinician reports and determining provision of training from Medicare claims. Using weighted, multivariable logistic regressions, we model the marginal change in probability of acute care utilization during home health as a function of family caregivers’ unmet need for training. We found that older adults whose family caregivers had an unmet need for training had a probability of acute care utilization during home health that was 18 percentage points (p=0.001) greater than those whose family caregivers both needed and received training, holding all covariates at their means. Findings support the importance of connecting family caregivers to training resources and suggest one avenue by which investing in caregiver training may be cost-effective for integrated payers and providers.
Systems Addressing Frail Elder Care: An Implementation Study
Authors: Aronow Harriet , Bolton Linda Burnes , Diniz Marcio , Kim Linda , Coleman Bernice
Published: December 2020

SAFE CareTM was developed at one hospital and found to be an effective care model for frail older adults. SAFE CareTM includes nurse screening for frailty risks, multidisciplinary assessments, team huddles and care recommendations. Underlying implementation is an organizational change process. Study aim was to evaluate the implementation and outcomes of SAFE CareTM in three additional hospitals. Two units from each hospital were randomized to SAFE CareTM or usual care. Process evaluation employed semi-structured interviews. Inpatients were aged 65+ years with positive frailty risks (N = 1,151). Outcomes evaluated ICU admission, length of stay (LOS), and discharge destination. All outcome analyses were conducted with intention to treat models. Patients were on average 80 years old, 54% female, 58% Caucasian, 83% English speaking, with 3.4 positive frailty risks. Median LOS was 4.2 days, 6.5% ICU admissions, 32% discharge institutional care. Hospitals differed in patient demographics and outcomes. While no differences between treatment groups in patient demographics, intervention patients had more frailty risks and longer expected LOS. 62% of intervention unit patients received intervention. There were no univariate treatment effects on outcomes. In multivariate analysis, intervention unit patients had shorter LOS. While hospitals reported different experiences, all reported challenges in preparing the electronic health record to support SAFE CareTM. Staff reported increased interprofessional team communications. Differences among the hospitals in patients and organizational attributes argue strongly that implementation should be tailored to meet varying institutional needs while common measures and processes underlying implementation should be followed closely.
Can Functional Performance Predict Long-Term Mortality Post Hip Fracture in Older Adults (65–100 Years of Age)?
Authors: Bajracharya Rashmita , Orwig Denise , Magaziner Jay , Guralnik Jack M
Published: December 2020

Functional performance measures (grip strength, Short Physical Performance Battery (SPPB), and 3-meter gait speed) represent underlying disease progression and predict mortality. However, there is little information regarding whether these measures assessed at 2-months post-hip fracture predict long-term mortality (10-year follow-up). To address this gap, a longitudinal analysis of Baltimore Hip Studies-7 cohort, with mortality verified by National Death Index, was conducted. Mean difference in 2-month functional performance measures (n=242, men n=121, female n=121) among those who survived and did not survive over 10 years was determined using t-test. Prediction of mortality by these measures, overall and by sex, was estimated using cox proportional hazard models, for which Hazard ratios (HR) with 95% confidence intervals (CI) were estimated. We found that, gait speed [0.47(standard deviation,SD=0.39) versus 0.31(SD=0.27)] and SPPB score [4.89(SD=3.31) versus 2.83(SD=2.24)] were significantly higher at 2 months among those surviving compared to those who did not. Adjusting for covariates, functional performance predicted long-term mortality in men and women. Increase in gait speed by 0.1m/s predicted 15% decrease in mortality for men [HR=0.85(0.55-0.96)] and 17% for women [HR=0.83 (0.74-0.93)]. Increase in SPPB by 1 unit predicted decrease in mortality by 14% for men [HR=0.86(0.77-0.95)] and 17% for women [HR=0.83(0.74-0.93). Increase in grip strength by 1 kg predicted 5% decrease in mortality for men [HR=0.94(0.92-0.97)] and 9% for women [HR=0.90(0.86-0.95)]. Functional performance measured at 2-months post-hip fracture predicted long-term mortality. Those with poor functional performance at 2-months can be referred for further assessment to optimize their care to promote survival.
Emergency Department Nurses’ Experiences in Caring for Older Adults With Dementia
Authors: Park YuJin , Kong Eun-Hi , Kim Hyejin
Published: December 2020

The aim of this study was to describe emergency-department nurses’ experiences in caring for older adults with dementia. A qualitative descriptive method was employed. A convenience sampling method was used to recruit nurses from seven regional emergency medical centers. Data were collected through to in-depth interviews and field notes until data were saturated. A total of 23 emergency-department nurses participated in the first interview and 18 of them participated in the second interview. Data were analyzed using qualitative content analysis with the ATLAS. ti 8.2 software program. Through data analysis of interview data, 36 codes and 10 categories were identified. Finally, four themes emerged from data analysis: lack of preparation for dementia care, tired of caring for older adults with dementia, an inappropriate emergency-department environment for older adults with dementia, and needs for improvements in dementia care. Emergency-department nurses felt completely unprepared for dementia care and felt exhausted after caring for older adults with dementia. In addition, the emergency department is considered to be an environment that does not consider older adults with dementia and thus is unsuitable for older adults with dementia. Also, nurses require systematic support when caring for older adults with dementia and improvement in awareness in the emergency department. Study results provide important data to develop educational material for emergency care including criteria for emergency medical assessments and policies of emergency medical institutions. In addition, the results provide evidence for clinical practice guideline for nurses who care for older adults with dementia in the emergency departments.
A Systematic Review of Observational Dyadic Persons Living With Dementia: Caregiver Communication Instruments
Authors: Kim Sohyun
Published: December 2020

To facilitate social interaction and providing quality care in persons living with dementia (PLWD), an effective means of evaluating communication quality between PLWD and their caregiver is needed. However, there is no systematic review of current instruments to assess dyadic PLWD-caregiver interactions in various care settings. The purpose of this review was to critically evaluate existing dyadic observational communication instruments used to provide recommendations. A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guideline was conducted. Literature that were published by May 2019 in English were searched from CINAHL, AgeLine, PsychINFO, Communication and Mass Media Complete, ProQuest Dissertations and Theses Global, and Scopus. Keywords were “communication strategy,” “communication,” “caregivers,” “dementia,” and any combination of these terms or MeSH terms. Data were extracted including development process, operational concept, target population and setting, items/scoring format, psychometric properties, and research/clinical use. A total of 3042 articles were identified and 15 instruments from 29 studies were evaluated by the scoring of 12 psychometrics: participants/items ratio, reliability (internal consistency, intra-rater, inter-rater), and validity (content, concurrent, predictive, known group difference, divergent/discriminant, convergent, structural). The total score was ranged from 0 to 22 (high quality: 16-22, moderate: 8-15, low: 0-7). There was no instrument with high quality assessing dyadic interaction. Only one instrument was evaluated as moderate quality (modified Behavioral Observation Scoring System, BOSS). While existing instruments are still in the early stages of development and testing, they demonstrate potential evidence that may require further testing before application in research and clinical practice.
Developing a Spatial-Skills-Focused Music Program for Older Adults With Changes in Cognition
Authors: Dorris Jennie , Rodakowski Juleen
Published: December 2020

Older adults with cognitive changes need stimulating programming to maximize their cognitive abilities. One area to maximize includes spatial skills, its decline can lead to disorientation and wandering. Music has potential to maximize spatial skills: reading music’s notation is associated with enhanced spatial skills in children and professional musicians. It’s critical to understand the potential impact of a spatially focused music program for older adults with changing cognition; if successful, future music programs could support people staying orientated in their environments and living independently longer. We developed and assessed a six-week marimba program focused on reading music with 15 older adults ages 65-89 with changes in cognition. We compared their scores on the Orientation Test from the Test of Visual Perceptual Skills pre- and post-intervention and assessed if participants self-selected to read music notation. Participants scored an average Modified Mini Mental State Examination (3MSE) score of 81.3 (SD = 11.0). On average, participants’ scores on the Orientation Test moved from 13.4 (SD =1.9) to 14.1 (SD= 2.7), providing a cohen’s d effect size of 0.3. Over the six weeks, 11 out of the 15 participants selected to read music for at least one class, indicating a statistically significant change using the Wilcoxon signed-rank test (Z = -3.16, p < 0.01), suggesting that older adults with cognitive changes may be able to learn to read music. This is important, as a spatially focused music program may maximize spatial skills that older adults need to successfully navigate their world safely and independently.
Likelihood of Participation in Home-Based Cognitive Assessment: The Role of Subjective Cognitive Decline and Age
Authors: Splonskowski Moriah , Cooke Holly , Jacova Claudia
Published: December 2020

Home-based cognitive assessment (HBCA) services are emerging as a convenient alternative to in-clinic cognitive assessment and may aid in mitigating barriers to detecting cognitive impairment (CI). It is unknown which older adults would be likely to participate in HBCA. Here we investigated the role of age and Subjective Cognitive Decline (SCD). SCD has demonstrated an increased risk for progression to CI/dementia. A nation-wide community-dwelling sample of 494 adults age 50+ were recruited via Amazon Mechanical Turk to complete an online survey assessing perceptions around HBCA and SCD. Our sample was 91.9% White and 66.8% female. It consisted of 174 respondents aged 50-60, 265 aged 61- 70, and 55 aged 71-79. Age groups were comparable with respect to their acceptance of cognitive assessment (Range 4-20, higher score=higher acceptance, 7.9±3.3, 8.15±3.2, 8.05±3.43) and SCD-Q total (43.1±5.8, 43.2±5.7, 43.3±5.7). Correlation analysis revealed a relationship between SCD-QSCD total and perceived likelihood of participation in HBCA for those ages 61-70 (r(263) = .222 p = .000), but not for ages 50-60 or 71-79 (r(172) = .102 p = .152; r(53) = -.102 p = .458). Our findings suggest that SCD influences the likelihood of participation in HBCA for older adults’ transitioning to old age (61-70). Findings show that for adults transitioning into old age (61-70), perceived cognitive state influences their likelihood of participation in HBCA. Importantly, concerns about CI/dementia may generate more favorable perceptions of HBCA for this group.
Rural Hoarding in Older Adults: A Pilot Characterization Study
Authors: Dozier Mary
Published: December 2020

There has been limited research on geriatric hoarding disorder in rural areas. Older adults living in rural areas are more likely to feel stigmatized due to mental health difficulties and to have multiple barriers to healthcare. The purpose of this study is to present the clinical picture of eight older adults (mean age 68, range 57-92) with hoarding disorder who live in the rural southeastern U.S. Participants completed a semi-structured interview and the NIH Toolbox Emotion and Cognition Batteries in their homes. Participants were mostly female (n = 6) and identified as White (n = 5) or African American (n = 3). All participants reported being Christian. Most participants were divorced or had never married (n = 6). All participants reported having at least one current medical condition, with the most commonly reported diagnosis being high blood pressure (n = 4). Half of participants reported that they had experienced at least one intervention from their family; however, only one participant reported ever experiencing an intervention from another source (i.e., property manager). On average, participants reported having a low level of emotional support and life satisfaction and a high level of loneliness and somatic symptoms of fear. Participants’ performance on tests of cognitive functioning was worst for processing speed, with three out of the eight participants performing at the level of borderline impairment or worse. Understanding the clinical presentation of hoarding disorder in rural-dwelling older adults is the first step to the development and implementation of evidenced-based treatments in this population.
Transforming Aging Services: Area Agencies on Aging and the COVID-19 Response
Authors: Gallo Haley B , Wilber Kathleen H
Published: December 2020

For over four decades, Area Agencies on Aging (AAAs) have served as focal points to help older adults remain in their homes and communities. AAAs partner with other organizations to administer services authorized under the Older Americans Act (OAA). AAAs represent loosely coupled systems; they are responsive to guidelines established by the OAA while maintaining flexibility to leverage limited resources, establish partnerships, and create innovative programs to meet community needs. As stay-at-home orders and concern for safety have kept many older adults homebound during the coronavirus disease 2019 (COVID-19) pandemic, an important question is how the Aging Network, including the over 600 AAAs, has responded to these rapidly changing needs. Although time and more systematic assessments are required, available information suggests that the loosely coupled network of AAAs has been a key, adaptable resource. This article begins with a description of the Aging Network and its history before turning to how the community-specific, collaborative, and evolving nature of AAAs places them at a unique position to respond to the challenges that arise with COVID-19. It concludes with how AAAs can continue to adapt to meet the needs of older adults and the people who care for them.
Pharmacokinetics of bedaquiline, delamanid and clofazimine in patients with multidrug-resistant tuberculosis
Authors: Alghamdi Wael A , Al-Shaer Mohammad H , Kipiani Maia , Barbakadze Ketevan , Mikiashvili Lali , Kempker Russell R , Peloquin Charles A
Published: December 2020

Background

Pharmacokinetic data are needed for newly implemented anti-tuberculosis drugs to help optimize their use.

Objectives

To help fill existing knowledge gaps, we evaluated the pharmacokinetic parameters of novel and repurposed anti-tuberculosis drugs among patients with drug-resistant pulmonary tuberculosis.

Methods

A prospective cohort study among patients ≥16 years with confirmed pulmonary drug-resistant TB was conducted in Tbilisi, Georgia. Patients receiving bedaquiline, delamanid and/or clofazimine were included. Blood samples were collected 4–6 weeks after drug initiation, and serum concentrations were measured using validated liquid chromatography tandem mass spectrometry assays. A non-compartmental analysis was performed, and the association of exposure parameters with covariates was explored.

Results

Among 99 patients, the average age and weight were 40 years and 65 kg, respectively. The median Cmin was 0.68 mg/L for bedaquiline, 0.17 mg/L for delamanid, and 0.52 mg/L for clofazimine. The median AUC0–24 was 30.6 mg·h/L for bedaquiline, 16.1 mg·h/L for clofazimine, and the AUC0–12 was 2.9 mg·h/L for delamanid. Among the significant covariates associated with drug exposure parameters were weight and sex for bedaquiline, alcohol use for delamanid, and weight for clofazimine.

Conclusions

We found a strong association of weight with bedaquiline and clofazimine exposure parameters, suggesting the need for weight-based dosing for those agents.
Characterizing the performance of high-speed data converters for RFSoC-based radio astronomy receivers
Authors: Liu Chao , Jones Michael E , Taylor Angela C
Published: December 2020

RF system-on-chip (RFSoC) devices provide the potential for implementing a complete radio astronomy receiver on a single board, but performance of the integrated analogue-to-digital converters (ADCs) is critical. We have evaluated the performance of the data converters in the Xilinx ZU28DR RFSoC, which are 12-bit, 8-fold interleaved converters with a maximum sample speed of 4.096 Giga-sample per second (GSPS). We measured the spurious-free dynamic range (SFDR), signal-to-noise and distortion (SINAD), effective number of bits (ENOB), intermodulation distortion (IMD), and cross-talk between adjacent channels over the bandwidth of 2.048 GHz. We both captured data for off-line analysis with floating-point arithmetic, and implemented a real-time integer arithmetic spectrometer on the RFSoC. The performance of the ADCs is sufficient for radio astronomy applications and close to the vendor specifications in most of the scenarios. We have carried out spectral integrations of up to 100 s and stability tests over tens of hours and find thermal noise-limited performance over these time-scales.
Simulating the inflation of bubbles by late jets in core collapse supernova ejecta
Authors: Akashi Muhammad , Soker Noam
Published: December 2020

We conducted 3D hydrodynamical simulations to study the interaction of two late opposite jets with the ejecta of a core collapse supernova (CCSN), and study the bipolar structure that results from this interaction as the jets inflate hot-low-density bubbles. The newly born central object, a neutron star (NS; or a black hole), launches these jets at about 50 to 100 d after explosion. The bubbles cross the photosphere in the polar directions at much earlier times than the regions at the same radii near the equatorial plane. The hot bubbles releases more radiation and the photosphere recedes more rapidly in the tenuous bubble. Our results strengthen earlier claims that were based on toy models that such an interaction might lead to a late peak in the light curve, and that an equatorial observer might see a rapid drop in the light curve. Our results might have implications to much earlier jets that explode the star, either jets that the newly born NS launches in a CCSN, or jets that an NS companion that merges with the core of a massive star launches in a common envelope jets supernova (CEJSN) event. Our results add indirect support to the CEJSN scenario for fast blue optical transients, e.g. AT2018cow, ZTF18abvkwla, and CSS161010.
The magnetic field in the dense photodissociation region of DR 21
Authors: Koley Atanu , Roy Nirupam , Menten Karl M , Jacob Arshia M , Pillai Thushara G S , Rugel Michael R
Published: December 2020

Measuring interstellar magnetic fields is extremely important for understanding their role in different evolutionary stages of interstellar clouds and star formation. However, detecting the weak field is observationally challenging. We present measurements of the Zeeman effect in the 1665 and 1667 MHz (18 cm) lines of the hydroxyl radical (OH) lines towards the dense photodissociation region (PDR) associated with the compact H ii region DR 21 (Main). From the OH 18 cm absorption, observed with the Karl G. Jansky Very Large Array, we find that the line-of-sight magnetic field in this region is ∼0.13 mG. The same transitions in maser emission towards the neighbouring DR 21(OH) and W 75S-FR1 regions also exhibit the Zeeman splitting. Along with the OH data, we use [C ii] 158 μm line and hydrogen radio recombination line data to constrain the physical conditions and the kinematics of the region. We find the OH column density to be ∼3.6 × 1016(Tex/25 K) cm−2, and that the 1665 and 1667 MHz absorption lines are originating from the gas where OH and C+ are co-existing in the PDR. Under reasonable assumptions, we find the measured magnetic field strength for the PDR to be lower than the value expected from the commonly discussed density–magnetic field relation while the field strength values estimated from the maser emission are roughly consistent with the same. Finally, we compare the magnetic field energy density with the overall energetics of DR 21’s PDR and find that, in its current evolutionary stage, the magnetic field is not dynamically important.
The Three Hundred project: quest of clusters of galaxies morphology and dynamical state through Zernike polynomials
Authors: Capalbo Valentina , De Petris Marco , De Luca Federico , Cui Weiguang , Yepes Gustavo , Knebe Alexander , Rasia Elena
Published: December 2020

The knowledge of the dynamical state of galaxy clusters allows to alleviate systematics when observational data from these objects are applied in cosmological studies. Evidence of correlation between the state and the morphology of the clusters is well studied. The morphology can be inferred by images of the surface brightness in the X-ray band and of the thermal component of the Sunyaev–Zel’dovich (tSZ) effect in the millimetre range. For this purpose, we apply, for the first time, the Zernike polynomial decomposition, a common analytical approach mostly used in adaptive optics to recover aberrated radiation wavefronts at the telescopes pupil plane. With this novel way, we expect to correctly infer the morphology of clusters and so possibly their dynamical state. To verify the reliability of this new approach, we use more than 300 synthetic clusters selected in the three hundred project at different redshifts ranging from 0 up to 1.03. Mock maps of the tSZ, quantified with the Compton parameter, y-maps, are modelled with Zernike polynomials inside R500, the cluster reference radius. We verify that it is possible to discriminate the morphology of each cluster by estimating the contribution of the different polynomials to the fit of the map. The results of this new method are correlated with those of a previous analysis made on the same catalogue, using two parameters that combine either morphological or dynamical-state probes. We underline that instrumental angular resolution of the maps has an impact mainly when we extend this approach to high-redshift clusters.
Galactic and cosmological fast radio bursts as scaled-up solar radio bursts
Authors: Wang F Y , Zhang G Q , Dai Z G
Published: December 2020

Fast radio bursts (FRBs) are bright milliseconds radio transients with large dispersion measures. Recently, FRB 200428 was detected in temporal coincidence with a hard X-ray flare from the Galactic magnetar SGR 1935+2154, which supports that at least some FRBs are from magnetar activity. Interestingly, a portion of X-ray flares from magnetar XTE J1810−197 and the Sun are also accompanied by radio bursts. Many features of Galactic FRB 200428 and cosmological FRBs resemble solar radio bursts. However, a common physical origin among FRBs, magnetar radio pulses, and solar radio bursts has not yet been established. Here, we report a universal correlation between X-ray luminosity and radio luminosity over 20 orders of magnitude among solar type III radio bursts, XTE J1810−197 and Galactic FRB 200428. This universal correlation reveals that the energetic electrons that produce the X-ray flares and those that cause radio emissions have a common origin, which can give stringent limits on the generation process of radio bursts. Moreover, we find similar occurrence frequency distributions of energy, duration, and waiting time for solar radio bursts, SGR 1935+2154 and repeating FRB 121102, which also support the tight correlation and the X-ray flares temporally associated with radio bursts. All of these distributions can be understood by avalanche models of self-organized criticality systems. The universal correlation and statistical similarities indicate that the Galactic FRB 200428 and FRBs seen at cosmological distances can be treated as scaled-up solar radio bursts.