bluuebunny/crossref_metadata_2025 huggingface dataset:
Political context is associated with extent of everyday physiological synchrony in older couples
Authors: Pauly Theresa , Kolodziejczak Karolina , Drewelies Johanna , Ram Nilam , Gerstorf Denis , Hoppmann Christiane
Published: December 2020

Social units such as couples exist within a broader societal and cultural context. Characteristics of this macro-level context may indirectly shape couple dynamics by influencing opportunities and motivation for interdependence, e.g. through legislation and prevalent norms/values. The current study investigates the association between political context (left-right political spectrum) and physiological linkage (cortisol synchrony) in older couples’ daily lives. Older adult couples (N = 162) aged 56 to 89 years (M age = 72.3 years) and residing in Germany provided salivary cortisol samples 7 times daily for a 7-day period. Political context in which dyads lived was quantified with respect to where the federal state of residence was located on the left-right political spectrum using voting data from the 2017 federal election. Links between macro-context and extent of cortisol synchrony were examined using multilevel models, controlling for differences in diurnal rhythm, sex, age, body mass index, and individual-level political orientation. On average, there was evidence of synchrony in fluctuations in partners’ cortisol (b = 0.08, SE = 0.02, p < .001). The extent of cortisol synchrony was moderated by macro-context, such that couples living in a federal state placed further right on the left-right political spectrum exhibited greater cortisol synchrony (b = 0.03, SE = 0.01, p = .010). This new evidence provides a foundation for theorizing about and investigating how specific mechanisms contributing to political context, including family values, gender role attitudes, and laws supporting gender equality contribute to interpersonal linkages of physiological stress responses in daily life.
Ageism in COVID-19-Related Media Coverage: Examining Publications During the First Month of the Pandemic
Authors: Jeong Mijin , Jen Sarah , Kang Hyun , Riquino Michael
Published: December 2020

The media has consistently described older adults as the population most vulnerable to COVID-19. Anti-ageism critics have taken issue with the oft-repeated statement that “only” older adults are at risk, a construction that dismisses and devalues the nuances within this population. The purpose of this study was to analyze instances of ageism in national media sources during the first month of the COVID-19 pandemic. A systematic search returned 287 articles concerning older adults and COVID-19 published in four major newspapers in the United States—USA Today, The New York Times, Los Angeles Times, and The Washington Post—between March 11 and April 10, 2020. Combining the strengths of content analysis and critical discourse analysis, we deductively and inductively reviewed the articles for patterns related to implicit and explicit forms of ageism. While ageism was rarely discussed explicitly, ageist bias was evident in implicit reporting patterns, such as frequent use of the phrase the elderly, which was often paired with statements describing older adults as vulnerable. Infection and death rates among older adults, as well as institutionalized care practices, were among the most commonly reported topics, providing a limited portrait of aging during the pandemic. While some authors utilized a survivor narrative by portraying older adults as having survived hardships, this construction implicitly places blame on those unable to do so. Older adults, when quoted directly, produced more complex and nuanced narratives of aging during the COVID-19 pandemic. Such narratives can combat societal ageism and promote self-determination and -definition.
Covid-19 Swept Nursing Homes in the United States
Authors: Yu Lei
Published: December 2020

Nursing Homes experienced a colossal loss impacted by the Covid-19 pandemic in the United States. This study applied Covid-19 Nursing Home Dataset (updated on 08/16/2020) released by Data.CMS.gov to explore possible factors behind the death s at nursing homes. The results indicated 2.55 residents died per week at a nursing home averagely. Besides, the absence of nursing staff, aides, clinical physicians, PPE supplies contributes to more deaths at nursing homes. Lastly, the number of positive COVID-19 cases of nursing home staff positively associate with the number of total deaths of residents（R=0.65). These findings provide more pieces of evidence for nursing home administrators and policymakers to make adjustments to help nursing home residents better cope with challenges caused by the pandemic; however, this dataset is not the final data for the pandmic is not over. Also, the dataset covers few demographic information (gender, race, ethinicty and so on) ; therefore, researchers could explore the relationship between the demographic features and COVID-19 deaths at nursing homes.
Social Activities in Community Settings: Impact of COVID-19 and Technology Solutions
Authors: Adams Anne , Beer Jenay , Wu Xian , Komsky Jane , Zamer Jason
Published: December 2020

COVID-19 has created challenges for staff in promoting resident activity. To better understand the pandemic-related challenges that Activity Professionals are facing, we asked COVID-19 specific questions as part of a larger survey. The overall survey focused on identifying challenges and potential technology solutions (e.g., socially assistive robots) to assist Activity Professionals in their job duties. Activity Professionals (N=19) completed the online questionnaire. Respondents (aged M=48.00, SD=12.87; 95% female, 100% native English speakers, 68% White/Caucasian, 21% Black/African American) were highly educated/experienced: 68% had a Bachelor’s degree or above, and 53% had 10-35 years of experience. Respondents worked in Independent Living (68%), Assisted Living (37%), Memory Care (26%), Skilled Nursing (21%), or Personal Care (11%). All Activity Professionals reported impact by COVID-19, as follows: 1) Cancelled activities: Group activities/gatherings; hosting outside entertainment; fewer volunteers, vendors, paid sources. 2) New restrictions: Number of people in elevators, rooms; no contact with residents. 3) Unexpected new tasks: More 1:1 meetings; video conferencing; additional phone calls with residents, staff, and families; ordering groceries online. Daily duties changed significantly with less help and limited availability of technology. 4) Effect: Fewer activities and new delivery models (online, TV). Concerns about potential negative effects on residents while trying to meet the creativity challenge: “This has caused lots of “out of the box” thinking for ways to engage residents and keep things upbeat despite the challenges.” Results illustrate the breadth of challenges that staff are facing, some of which can be addressed by technology.
Technology Adoption Among Seniors During COVID-19 Pandemic Impacts Mental Health and Feelings of Companionship
Authors: Derynda Brittany , Goodyear Mary , Kushner Jade , Cook Nicole
Published: December 2020

Social isolation and lack of companionship, exacerbated by COVID-19 “stay at home” orders, has been an ongoing concern among seniors in the US. Among other strategies, Lifelong Learning Institutes (LLIs) were created to support continuing education for older adults. These programs bring seniors together to encourage engagement through lectures, art and fitness classes in a common space. LLI in South Florida adapted to COVID-19 “stay at home” orders by moving all programming online in March 2020. In May 2020 LLI members, faculty and students designed a research study to understand the experience of LLI members with social isolation and companionship prior to, and during, “stay at home” orders. Responses included 127 members (mean age 75.5). Respondents reported significantly lower social isolation (p<.01) and lack of companionship (p<.01) as a result of “stay at home”. Interestingly, social isolation had no significant explanatory variables. However, significant results (p<.05) showed that seniors who isolated alone were 6.7 times more likely to lack companionship compared to those who isolated with a friend or spouse; seniors who reported they are not tech savvy were 8.3 times more likely to lack companionship compared to those who reported they are tech savvy; and that for every additional day of poor mental health respondents had a 1.15 higher odds of lacking companionship. These results underscore the importance of technology adoption among seniors during times of social isolation and the positive impact this can have on companionship and mental health.
Virtual Funerals During COVID-19 and Beyond
Authors: Muturi Ivy , Freeman Shannon , Banner-Lukaris Davina
Published: December 2020

Physical distancing measures and the restrictions on large group gatherings following the COVID-19 pandemic have left many to consider alternative approaches to commemorating the death of a loved one. Advancements in information technologies and the availability of affordable electronic devices have brought forth the ability to use virtual platforms to host funeral services for those unable to be with their loved ones. The aim of this study was to identify existing and potential online platforms for hosting a virtual funeral, explore the safety considerations of hosting a service during the pandemic and share the experiences of individuals who have previously hosted a virtual service. To conduct the research, an environmental scan was undertaken searching academic, grey literature and online websites. The results showed that there are currently several online platforms made specifically for virtual services and many free public platforms that can be used. Death services must ensure staff who are in direct contact with the deceased have proper Personal Protective Equipment and companies must adhere to regulations regarding group gatherings, screening for symptoms and physical distancing. Some individuals expressed having a positive experience, stating that the virtual service felt more intimate, while others expressed difficulty in navigating the technology, particularly the older adult attendees. Virtual funeral services may prove to be a practical and safer alternative during COVID-19 and may provide some comfort for those facing such challenging times. By examining existing platforms and their use, an opportunity exists to generate recommendations for additional supports, particularly for older adults.
Financial Well-Being Across Age Cohorts and Its Impact on Retirement Security
Authors: Skees Stephanie , Roll Stephen
Published: December 2020

The lack of retirement savings in the United States has been well-documented. For example, in 2013 roughly one-third of households near retirement lacked either a defined benefit or defined contribution retirement plan (U.S. Government Accountability Office, 2015), and the median retirement account balance is $0 (Oakley, Brown, & Saad-Lesler, 2018). While this lack of savings is concerning, less clear is the relationship between retirement security and a household’s sense of financial well-being. To that end, this study uses the nationally representative 2017 Survey of Household Economics and Decisionmaking to investigate the relationship between both retirement security indicators and subjective financial well-being—as measured through the Consumer Financial Protection Bureau’s financial well-being scale—across the life course. Specifically, we use multiple regression approaches to compare how financial and knowledge-based indicators of retirement security contribute to the financial well-being of young, mid-career, and pre-retirement cohorts. Preliminary results indicate that feeling “on track” for retirement savings and comfort in making retirement savings decisions were among the strongest contributes to a sense of financial well-being across age cohorts. However, these indicators were particularly important to the financial well-being of older households. Surprisingly, having a 401(k), IRA or pension had no significant impact on savings when controlling for other factors. This study speaks to the importance of both providing effective retirement savings tools, including both educational and financial resources, at multiple points across the life course. It also contributes to a small but growing literature on the intersections between subjective financial well-being and financial decisionmaking.
Neutrophil-Lymphocyte Ratio and Mortality in the Long Life Family Study
Authors: Vivek Sithara , Thygarajan Bharat , Murabito Joanne M , Schupf Nicole , Zmuda Joseph , Mengel-From Jonas , Wojczynski Mary
Published: December 2020

Neutrophil to Lymphocyte Ratio (NLR) reflects the balance between the innate (neutrophils) and adaptive (lymphocytes) immunity. Though NLR is a strong predictor of mortality in the general population, the distribution of NLR and its association with mortality has not been evaluated in families with exceptional longevity. Hence, we evaluated this question in the Long Life Family Study, a family based study of exceptional longevity. We used data from offspring of long lived (n=2065) family members and spousal controls (n=673). We used multivariate linear regression models adjusted for age, family relatedness, sex, field center, BMI and comorbidities (diabetes, CVD, cancer) to evaluate differences in NLR between long lived family members and spousal controls. Cox proportional hazard models were used to examine the association between NLR and mortality. 157 (7.6%) offspring in long lived families and 68 (10.1%) spousal controls were deceased during 12 years of follow up. NLR was similar among offspring in long lived families and spousal controls (1.96±1.06 vs.1.98±1.28; p=0.64). There was a significant positive association between NLR and overall mortality [HR: 1.3, 95% CI (1.01, 1.67)), p:0.04]. There was no statistically significant difference in this association among offspring in long lived families and spousal controls (p for interaction =0.16). The association between NLR and overall mortality was no longer significant [HR: 1.24; p:0.36] after adjustment for IL-6 and hsCRP. These results suggest that NLR may be a predictor of mortality in families with exceptional longevity though this association may not be independent of other inflammatory biomarkers.
Tailored Strategies and Shared Decision-Making for Caregivers Managing Patients’ Pain: A Web App
Authors: Chi Nai-Ching , Nakad Lynn , Fu Ying-Kai , Demir Ibrahim , Gilbertson-White Stephanie , Herr Keela , Demiris George , Burnside Lee
Published: December 2020

Family caregivers (FCs) are essential in helping manage pain for patients who receive hospice care at home, but an accessible resource to prepare FCs in pain management is lacking. This study aims to develop an accessible resource that aids FCs in pain management. First, we conducted two literature reviews and two secondary data analyses to investigate the challenges that FCs face when managing pain for patients. Based on the results, we identified 20 common challenges that prevent FCs from providing effective pain management. Second, we developed evidence-based content to address each identified challenge, and a library to provide FCs with pain education. Third, experts and clinicians (n=10) in hospice care validated the content, and FCs (n=10) gave feedback on how to improve the understandability of the content. Currently, we are converting the content to a web app prototype. The web app will consist of: (1) an assessment tool with questions to assess the FCs’ challenges when managing patients’ pain, (2) computer-generated strategies tailored to address the identified challenges, (3) discussion questions for FCs to use with their care team to prioritize goals of pain management, and (4) a library to enhance access to educational materials. This study presented the process of developing an evidence-based and user-centered web app. This study will advance the field of pain management in hospice care by providing accessible and evidence-based tools to support and engage FCs in pain management. Also, this web app will allow best practices to be quickly translated from research into practice.
Student-Led Fall Prevention Care Management Reduced Fall Risks at Assisted Living Facilities
Authors: Kiyoshi-Teo Hiroko , McKinley-Yoder Claire , Lemon Erin , Ochoa Olivia
Published: December 2020

Older adults in residential care settings are four times more likely than those not living in care facilities to experience falls. Yet, fall prevention efforts at long-term care settings are under-resourced, under-regulated, and under-studied. To address this gap, we developed and studied the impact of a specialty clinical, Fall Prevention Care Management (FPCM), for nursing students to decrease older adults’ fall risks. We enrolled assisted living residents that facility liaison identified as being high fall risk (fall rates or fall risk were not tracked at the study sites) and MOCA ≥15, in 2 assisted living facilities in Northwest USA. Participants received weekly, 1-hour, individual, semi-structured, Motivational Interviewing-based care management visits by same students over 6 visits. Changes in fall risks were measured by the CDC STEADI assessment (unsteadiness & worry), Falls Self-Efficacy Scale International-Short (FESI-S), and Falls Behavioral Scale (FAB). Twenty-five residents completed the study. Students addressed the following (multiple responses possible): emotional needs (n=23), improved motivation to prevent falls (n=21), and individualized education/coaching (i.e., exercise, mobility aids) (n=10-17). FESI-S score improved from 16.0 to 14.4 (p=.001; decreased fear. FAB score improved from 2.94 to 3.10 (p=.05; more frequent fall prevention behaviors). Frequency of those who felt steady while standing or walking increased (24% to 40%, p=.07) and those who did not worry about falling increased (20% to 36%, p=.08). FPCM clinical offered valuable opportunity to address unmet care needs of older adults to reduce fall risks.
Priorities for End-of-Life Care Reporting in Nursing Homes: Results From a Mixed-Methods Study
Authors: Gruneir Andrea , Hoben Matthias , Jensen Charlotte , Buencamino Monica , Easterbrook Adam , Marshall Sheila , Keefe Janice , Estabrooks Carole
Published: December 2020

The aim of the “Trajectories” project is to compile measures of nursing home (NH) quality to better characterize the final year of life for residents. In the first phase, we worked with various stakeholder groups to identify their priorities to focus the selection of possible outcomes relevant to end-of-life needs. Policy- and decision-makers from 5 Canadian health regions participated in an on-line, modified Delphi process to reach consensus on 3-4 measures of each burdensome symptoms and potentially inappropriate care practices. NH residents and families or care aides participated in an interview process using the Action Project Method. To date, all participants identified pain, mental health care, polypharmacy, and dyspnea as priorities. Policy- and decision-makers additionally identified infections and acute care transfers as priorities, while residents and families additionally identified mobility, cognition, and pressure ulcer care as priorities. There was general consistency across groups in terms of priorities but additional measures seemed to reflect either a system-wide or more personal perspective, depending on the source. Data collection with frontline staff and managers is on-going. Moving forward, we will use this list of prioritized outcomes to quantitatively assess the trajectories of these outcomes and associated factors, and to create a profile that allows for monitoring of end-of-life care in NHs.
Reversals in Decisions About Life-Sustaining Treatment Among Terminally Ill Older Korean Patients
Authors: Kim Suhyun , Choi Jung-Ja
Published: December 2020

Purpose: The purpose of this study was to investigate the patterns and factors of reversals in decisions about life –sustaining treatment (LST) among older patients with terminal stage of chronic cardiopulmonary diseases. Methods: In a retrospective correlational descriptive study, data were collected using medical chart review from 124 deceased older patients with terminal stage of cardiopulmonary disease who had made reversals of LST decisions in an academic tertiary hospital in 2015. Multivariate logistic regression analysis was used to identify the factors associated with the reversal to higher intensity of LST treatment. Results: Primary decision makers were offspring (72.6%), spouse (13.7%), acquaintance (8.9%), and patients (4.8%), in order. While 31.5% of the reversed decisions were made toward higher intensity of LST, 21.9% were made toward lower intensity of LST, and 46.6% were made for each treatment without change of overall code status. The use of inotropic was the most frequently reversed LST treatment (47.5%), followed by CPR (30.6%), intubation (27.4%), ventilator therapy (24.2%), and hemodialysis (17.8%). Patients who had lung diseases (vs. heart diseases), were single, divorced or bereaved (vs. married), and had acquaintance as a primary decision maker (vs. patients themselves) were significantly more likely to reverse the LST decisions to higher intensity of LST treatment. Conclusion: This study demonstrate the complex and turmoil situation of the LST decision making process among older patients with terminal stage of cardiopulmonary disease and suggests the importance of support for patients and families in their LST decision making process.
Predictors of Caregiver Burden in Delirium: Patient and Caregiver Factors
Authors: Tabloski Patricia , Arias Franchesca , Flanagan Nina , Fong Tamara , Schmitt Eva , Jones Richard , Travison Thomas , Inouye Sharon
Published: December 2020

Delirium — an acute disorder of attention and cognition — is a common, life-threatening and costly syndrome occurring frequently in older hospitalized persons. The unexpected, rapid, and volatile nature of delirium can be difficult for family caregivers to experience and may contribute to subjective feelings of distress (i.e. “delirium burden”). The aim of this study was to examine whether pre-admission patient characteristics or patient-caregiver relationship and living arrangements were associated with caregiver burden as measured by the delirium burden scale for caregivers (DEL-B-C; score 0-40, higher score is more burden). Our sample consisted of 208 older adults and their caregivers from the Better Assessment of Illness (BASIL) study, an ongoing prospective, observational study of surgical and medical patients ≥70 years old; 22% of patients experienced delirium by the Confusion Assessment Method (CAM) and the average DEL-B-C score was 7.9, 95% CI(6.95-8.88). Results indicated that neither patient-caregiver relationship and living arrangement or patient factors including pre-admission pain, sleep disturbance, or new onset incontinence were significantly correlated with delirium-related caregiver burden. However, DEL-B-C scores were significantly higher in caregivers of patients with any ADL impairment (mean 8.5 vs. 5.2, p = .016) during hospitalization although none of the individual functional deficits alone were statistically significant. This finding suggests that the association of ADL impairment and DEL-B-C scores is not driven by a single functional domain. Future studies are needed to further understand how caregiver characteristics and patient factors occurring before and during hospitalization contribute to caregiver burden after the occurrence of delirium.
Proposed Features for a Digital Nutrition Intervention for Managing Parkinson’s Disease
Authors: LoBuono Dara , Dobiszewski Sarah , Tovar Alison , Leedahl Skye , Xu Furong , Delmonico Matthew , Mahler Leslie , Lofgren Ingrid
Published: December 2020

Digital health technologies can enhance quality of care for people with Parkinson’s disease (PwPD) and their informal caregivers (ICG), but research in this area is lacking. Developing digital health nutrition services incorporating end-user preferences is essential. This cross-sectional, mixed-method study assessed 20 PwPD and their ICG. Participants reported sources they first search for when seeking health information, the amount of effort it takes to find the information, their confidence level in finding reliable health information, and their level of trust of information obtained. Semi-structured dyadic interviews obtained information about technology, digital health, and nutrition. Transcripts were double coded by two researchers to identify nutrition service features and a >80% agreement was achieved. The mean age was 68.1±11.2 years and 65% of PwPD were male, while 80% of ICG were female. Most PwPD and ICG (82.5%) went to the internet the last time they looked up health information, and about 1/3 reported it took a lot of effort to get this information. Nearly half were concerned about the quality of the information, and approximately 70% had issues trusting health information from government agencies or diet programs. Six themes around key features for a digital nutrition intervention emerged: tailored and specific, inclusion of caregivers, promote self-efficacy, from a nutrition expert, contain a social element, and include a follow-up session. The results suggest that digital health interventions will need to be tailored to meet the needs of PwPD and their ICG.
Effectiveness of a Care Delivery Model for High-Need Community-Dwelling Older Adults
Authors: Chen Kuei-Min , Hsu Hui-Fen
Published: December 2020

The effectiveness of sufficient care coordination for high-need community-dwelling older adults has not been discussed. This study aimed to examine the effectiveness of a newly-developed care delivery model for high-need community-dwelling older adults. A cluster randomized controlled trial with repeated measures design was employed. A total of 145 high-need older adults participated in the study and were randomly assigned to either the intervention group or comparison group. A categorized list of care services based on the types of high-need older adults as the intervention allowed care coordinators to make adequate care service linkages. The intervention period ranged over 6 months with regulated home visits and assesssments. Functional ability, quality of life, depressive symptoms, and healthcare and social service utilizations were measured at baseline, and at 3 and 6 months into the intervention. The participants’ satisfaction with care delivery was measured at the end of 6-month intervention. Results showed that the intervention group had a better functional ability, a higher quality of life, reduced depressive symptoms, and more efficient healthcare and social service utilizations than the comparison group at both the 3-month and 6-month intervals (all p < .05). By the end of the 6-month study, the intervention group were more satisfied with the care service linkages than the comparison group (p < .05). The positive effects of providing a categorized list of care services for care coordinators to make service linkages have been evidenced by the outcomes. The promising findings supported a further longer-term implementation of the care delivery model.
Trajectories of Purpose in Life Following a Dementia Diagnostic Appointment
Authors: Wynn Matthew , Ju Catherine , Hill Patrick
Published: December 2020

Purpose in life has been linked with better well-being and reduced risk for major illness. As such, work has focused on understanding what leads to changes in sense of purpose during adulthood, with a focus on major life events. Receiving a dementia diagnosis is a major life event that could affect purpose in life both for older adults with dementia and their potential caregivers. To examine this issue participants answered questions at two timepoints, before their diagnostic appointment at a specialized memory clinic, and between two days and two weeks after the appointment. Participants provided self-report ratings of sense of purpose and as well as open-ended answers regarding their purpose in life. Data is available from both caregivers and patients and qualitative coding was performed on participants’ open-ended responses. While there was no significant, mean-level change in purpose in life for patients (t = -.14, p = .88) or caregivers (t = .73, p = .46), some participants exhibited reliable change in sense of purpose. Factors underlying individual increases and decreases in sense of purpose following a dementia diagnostic appointment are explored and discussed.
As We Age: Listening to the Voices of LGBTQ Older Adults
Authors: Cummings Cory , Dunkle Jennifer , Mayes Bianca , Bradley Carolyn , Hall Porsha
Published: December 2020

LGBTQ older adults present a range of biopsychosocial needs and life experiences that may differ from the general population of older adults. Researchers have broken LGBTQ older adults into three age brackets: the Invisible Generation born before the 1920s; the Silent Generation born in the 1930s and 1940s; and the Pride Generation born in the 1950s and 1960s (Fredriksen-Goldsen, 2016). Research is emerging on health disparities and is fueling calls for inclusive services for this population. This paper session reports on the work of a research collaborative between social work and public health (two universities and a statewide advocacy organization). A qualitative study, designed as phase one a statewide need assessment, engaged ten focus groups (N=48 participants) throughout a mid-Atlantic state. Study aims were to better understand the experiences and perceptions of LGBTQ older adults now and expectations and plans for care as they age. Findings included (1) emphasis on the nuance of connection as an ageing LGBTQ adult; (2) expectations for quality of services; (3) realities of planning for future living arrangements; and (4) two sides of advocacy, as both a personal responsibility and a call for allyship. Recommendations will be made on how attendees can: evaluate agency policies and procedures to create safe spaces and inclusive services, engage in needs assessments of older LGBTQ+ adults in their own communities, and advocate at the State and Federal levels to strengthen services in the aging network to better serve this group, with specific focus on the Older Americans Act.
Identifying knowledge, self-efficacy and response efficacy of alternative discipline strategies among low-income Black, Latino and White parents
Authors: Duong Hue Trong , Monahan Jennifer L , Kollar Laura M Mercer , Klevens Joanne
Published: December 2020

Corporal punishment (CP) leads to detrimental mental and physical consequences for a child. One way to prevent CP is to encourage parents to apply alternative discipline strategies that do not involve violence. Based on the knowledge—behavior gap framework in public health education, this study analyzed the focus group data of 75 low-income Black, Latino and White parents to uncover commonalties and differences in their knowledge, self-efficacy and response efficacy of alternative discipline strategies. Findings revealed that parents knew several alternative discipline strategies and had confidence in their ability to conduct these strategies. However, parents reported that some strategies were hard to implement because they lacked the relevant resources. Moreover, parents did not perceive that alternative discipline strategies were effective without using some forms of CP. Knowledge, self-efficacy and response efficacy of alternative discipline strategies are risk factors for child physical abuse and addressing them will help prevent injury and health impacts on children, while providing safe, stable, nurturing relationships and environments for child development.
Effects of latitudinal variation on field and common garden comparisons between native and introduced groundsel (Senecio vulgaris) populations
Authors: Zhu Bi-Ru , Li Xiao-Meng , Zhang Da-Yong , Liao Wan-Jin
Published: December 2020

Aims

Field and common garden comparisons are commonly performed to test the rapid evolution of increased vigor in introduced plant populations. Latitudinal clines in phenotypic traits can obscure such evolutionary inferences, particularly when native or introduced populations are distributed across large geographic ranges. We tested whether the latitudinal clines influence comparisons between introduced and native populations of Senecio vulgaris.

Methods

Senecio vulgaris is native to Europe but has been introduced in northeastern and southwestern China. To evaluate the performance in terms of growth and reproduction between native European populations and introduced Chinese populations, we compared plant height, number of branches and number of capitula in field populations in native and introduced ranges and in a common garden in Switzerland.

Important Findings

The introduced Chinese populations performed better than the native European populations in the field in terms of plant height and number of capitula, which was consistent with the prediction of the evolution of the increased competitive ability (EICA) hypothesis. The Chinese populations produced more capitula than the European populations when the latitudinal cline was considered in the common garden comparison. When we compared the traits of the northeastern Chinese, southwestern Chinese and European populations in both the field and common garden, the northeastern Chinese populations, at latitudes similar to those of the European populations, exhibited greater plant size and more capitula than the European populations in both the field and common garden. However, the southwestern Chinese populations, at latitudes much lower than those of the European populations, did not perform better than the native populations in terms of reproduction. In conclusion, our results suggest that latitudinal clines in phenotypic traits should be considered in field and common garden comparisons when introduced populations are geographically structured.
Multiscale mobility explains differential associations between the gross domestic product and COVID-19 transmission in Chinese cities
Authors: Xu Xiao-Ke , Wang Lin , Pei Sen
Published: December 2020

In this letter, we find a Simpson’s paradox in the association between gross domestic product and coronavirus disease 2019 transmission in Chinese cities stratified by location. The differential associations in cities within and outside Hubei province can be explained by the different patterns of short-range and long-range multiscale mobility from Wuhan to other cities.
Questioning COVID-19 Surface Stability and Fomite Spreading in Three Aeromedical Cases: A Case Series
Authors: Horoho Sean , Musik Stephen , Bryant David , Brooks William , Porter Ian M
Published: December 2020

It is well established that coronavirus disease 2019 is primarily transmitted through respiratory droplets, and there is mounting research speculation that it may also be transmitted via fomites. Several studies have shown that the virus can persist on both porous and nonporous surfaces for hours to days, depending upon the material. This article examines three cases of polymerase chain reaction–proven severe acute respiratory syndrome coronavirus 2 infection with several additional individuals meeting CDC close contact criteria. In 1 case, 195 downstream contacts were all tested to prevent a mass outbreak in a deployment posture. Analysis of these contacts yielded only a single positive test, which could be reasonably ascribed to respiratory droplet transmission. While these cases and their contacts ultimately represent a small sample size, we suggest fomite spread may not be a significant means of transmission for severe acute respiratory syndrome coronavirus 2 in real-world operational scenarios.
Serum albumin measurement in nephrology: room for improvement
Authors: van Schrojenstein Lantman Marith , van de Logt Anne-Els , Thelen Marc , Wetzels Jack F , van Berkel Miranda
Published: December 2020

Serum albumin is a widely used biomarker in clinical nephrology. Serum albumin cut-off values are used to define disease, to predict outcome and to guide patient care. The available commercial assays to measure serum albumin rely on different analytical principles, all with their own (analytical) specifications. This article provides an overview of the different clinical applications of serum albumin measurements in nephrology, the (dis)advantages of the available assays and the estimates of the effects of the measurement uncertainty between different assays in clinical decision making. This article concludes that harmonization of serum albumin assay results is needed.
Lying and Deception in Development
Authors: Rochat Philippe
Published: December 2020

Human self-consciousness and symbolic functioning bring deception to new levels, incomparable to all the other forms of deception found in other animals or in nature in general. It brings intention and open-ended delusional redescription of reality to fit our social needs, boost our self-worth, and maintain semblance of self-unity. Children learn and develop quickly the ability to use semblances as the primary tool in their navigation of the social world, gaining affiliation through the debunking and deliberate creation of false or pseudo beliefs. In fact, the catalogue of lies and deception found in toddlers starting at two years, even if they are at basic, putatively nonstrictly representational level (i.e., without explicit false belief understanding) is stunning.
Orders and Their Representations
Authors: Chambers Robert G.
Published: December 2020

An order concept, ≽(y), is introduced and interpreted as a correspondence. Some common structural properties imposed on ≽(y) are discussed. A distance function, d(x,y;g), is derived from ≽(y) and interpreted as a cardinal representation of the underlying binary relation expressed in the units of the numeraire g∈ℝ^{N}. Properties of distance functions and their superdifferential and subdifferential correspondences are treated. The chapter closes by studying the structural consequences for d(x,y;g) of different convexity axioms imposed on ≽(y).
Equilibrium, Efficiency, and Welfare
Authors: Chambers Robert G.
Published: December 2020

Competitive equilibria are studied in both partial-equilibrium and general-equilibrium settings for economies characterized by consumers with incomplete preference structures. Market equilibrium determination is developed as solving a zero-maximum problem for a supremal convolution whose dual, by Fenchel's Duality Theorem, coincides with a zero-minimum for an infimal convolution that characterizes Pareto optima. The First and Second Welfare Theorems are natural consequences. The maximization of the sum of consumer surplus and producer surplus is studied in this analytic setting, and the implications of nonsmooth preference structures or technologies for equilibrium determination are discussed.
Introduction
Authors: Plough Alonzo L.
Published: December 2020

This introductory chapter provides an overview of the Robert Wood Johnson Foundation’s third annual Sharing Knowledge to Build a Culture of Health conference on the Gila River Indian Community in Arizona. In February 2018, on lands that indigenous peoples have long held sacred, in a state with a complex cultural history and a strong sense of place, researchers, policymakers, practitioners, and advocates gathered to talk about advancing a Culture of Health. Participants brought a variety of training experiences, background knowledge, and personal experiences with them, along with the unique perspectives they had gained by working across academic, government, clinical, and community settings, in rural and urban milieus, as well as with the many and varied populations who live in the United States. This intersectionality—on display both at the Sharing Knowledge conference and in this book—underscores the importance of achieving health equity throughout the country, which is the crosscutting focus of how the Robert Wood Johnson Foundation (RWJF) is advancing a Culture of Health. The contributors to this volume offer both data and personal insight to help one consider the structural constraints and conditions that often shape individual behavior, as well as the strategies that can lift up populations.
Achieving Health Equity for Immigrants and Their Children
Authors: Plough Alonzo L.
Published: December 2020

This chapter presents a data-based portrait of American immigrants. Nearly 44 million immigrants live in the United States, and their health, and that of their children, is directly affected by their legal status and by U.S. policy. Indeed, public policy at both the federal and state levels—including Deferred Action for Childhood Arrivals (DACA), changes in “public charge” rules, and eligibility for driver's licenses and prenatal care—are all significant influences on health status and access to care. As such, ensuring that immigrant families are supported requires health care providers, policymakers, and community leaders to acknowledge the myriad factors influencing the health of their immigrant constituents. It is a path that will improve well-being for immigrants, while offering benefits more broadly as people work toward health equity.
Conclusion
Authors: Plough Alonzo L.
Published: December 2020

This concluding chapter looks at the Robert Wood Johnson Foundation’s (RWJF) renewed resolve to highlight connections, rather than differences, when it talks about common problems, and to take evidence-based action grounded in that shared understanding. Despite an abundance of political rhetoric, this book has shown that there is ample enthusiasm for doing just that. A cross-sectional movement to address climate change is on the rise, bringing together businesses, hospitals, and activists. The opioid epidemic and its intersections with rural health and mass incarceration are gaining attention across partisan divides. Medical systems are integrating the social determinants of health into their care interventions, and novel payer initiatives are making it feasible to pilot test and evaluate innovation. Resilience also has come to the forefront as people learn more about the risks associated with childhood trauma, weather-related and human-spawned disasters, and community fragmentation, as well as the protective factors that can counter those stressors and foster personal and collective renewal. Ultimately, the pursuit of health equity remains the underpinning of everything the RWJF does. As they explore further the cultural aspect of a Culture of Health, they are bolstering their commitment to empower historically marginalized people.
Introduction
Authors: Redstone Ilana
Published: December 2020

Campuses have long had unwritten rules about what can and can’t be said. But in recent years, social media have emerged as a powerful tool in academia both for direct censorship and for strengthening the incentives for self-censorship. Much of contemporary academic discourse is based on three foundational beliefs that are enforced in part through social media. The beliefs are grounded in good intentions and reflect understandable responses to historical and continuing societal wrongs. But when they are enforced in absolutist and uncompromising terms, they can unreasonably constrain discourse on issues that in fact merit more nuanced analysis.
The Stories the Numbers Do Not Tell
Authors: Graham Carol
Published: December 2020

This chapter discusses the measurement of well-being in a Culture of Health. The aggregate numbers and standard measures typically used to measure progress—growth rates, unemployment figures, and stock market trends—mask the underlying crisis of social ill-being. In contrast, well-being metrics uncover the stories that these numbers do not tell. As such, incorporating measures of well-being to provide a more nuanced view of how people are doing; to inform policies to address serious pockets of ill-being and to enhance aggregate societal well-being; and to create a new narrative about social progress is a proposition whose time has come. Surveys are a standard data collection mechanism for well-being data, and there is now established best practice for implementing well-being surveys. A key consensus is on the importance of measuring three distinct dimensions of well-being: hedonic, evaluative, and eudaimonic. The chapter then describes hedonic metrics, evaluative metrics, and eudaimonic metrics. Ideal measurement practice includes all three sets of measures, as they each reveal different elements of quality of life and well-being, ranging from daily moods to life course evaluations to purposefulness or lack thereof.
Capturing the Cultural Narratives of Well-Being
Authors: Thomas Felicity , Fietje Nils
Published: December 2020

This chapter examines how a greater awareness of people’s lived experience can shape a more robust well-being narrative that offers policymakers greater insight into what matters to the good life of their rich and varied publics. Recent years have seen a number of initiatives and publications emerge to support a new kind of narrative on well-being. Among the most influential is a call for “fifth wave” thinking, which recognizes that existing, individually-focused, and biomedical approaches to health and well-being are no longer amenable to challenges of the current era, and a radically new approach that focuses on “a culture for health” and that seeks to engage with the full complexity of subjective, lived experience is needed to address contemporary problems, such as social inequality and loss of well-being. Narrative research methods can provide insight into people’s understandings of well-being, and their health and well-being-related experiences and lifestyle choices can locate this within their broader socio-cultural and historical context. The chapter then discusses the need to move away from individualized formulations of well-being, to approaches that recognize the value of relational well-being. It also considers assets-based approaches; the impact of social media on well-being narrative; and the establishment of accountability for well-being actions and narratives.
The Racial Face
Authors: Parfitt Tudor
Published: December 2020

Racial immutability of Jews and blacks was proved through the unchanging features of the Jewish and negro face over thousands of years. From the time of Johann Kaspar Lavater, the Swiss Protestant poet and pastor from Zurich, it became almost axiomatic that there was something unique about the Jewish and negro face and head. Some argued that there was something goat-like about the Jewish face and something ape-like about the negro face. Jewish and negro eyes were considered special. Robert Knox discussed the racial face with respect to negroes and Jews, finding commonalities. For Frederic William Farrar, too, it was the overlapping categories of blacks and Jews that provided the best proof of the immutability of racial types. The indelibility of African blackness and the indelibility of Jewishness were common themes that linked Jews and negroes from medieval times to the twentieth century. Alfred Russell Wallace made the critical linkage between Jews and blacks that had underlined much racial speculation for the previous five hundred years and that would continue long after his death, particularly with respect to their unchanging, ancient pedigree and appearance. While many scholars opined that the Egyptian monuments offered the best proofs of the immutability of the Jewish and negro face, Alfred Cort Haddon considered that the Assyrian depictions of Jews were the most reliable as far as Jewish faces were concerned. Jewish faces were even to be found in west Africa.