bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental studies to characterize gradation segregation of asphalt mixes
Authors: Kiran V , Jagadeesh H S , Anusha T M
Published: November 2019

Gradation segregation can be described as the non-homogeneity of the asphalt mix which includes coarse aggregates and fine aggregates which may tend to segregate during the process of crushing, stockpiling, mixing in hot mix plant, transportation and paving practices. There are various methods to determine the gradation segregation such as visual judgment, sand-paving test, digital image processing method, nuclear density meter measurement, ground penetrating radar, infrared thermal imaging etc., these detection methods are used to determine the segregation only on the paved asphalt mix but these methods cannot be used to evaluate the extent of segregation occurred before paving the asphalt mix. Since many researchers have carried out work on gradation segregation, still enormous work has to be carried out to determine the gradation segregation before paving the asphalt mix. Hence, in the present study, a test equipment is designed and fabricated to determine the gradation segregation that can be used in the laboratory. Using the test equipment and an index Δ∑Pi the extent of gradation segregation has been determined for various asphalt mixes such as Bituminous Concrete (BC) grading 1 and 2, Dense Bituminous Macadam (DBM) grading-1, Cold mix for Bituminous Concrete grading - 2 and Open Graded Friction Course (OGFC) mixes as per MORTH and ASTM are investigated. The results indicated that the extent of gradation segregation is severe for DBM grading-1, moderate segregation for BC grading-1 and no or slight segregation for BC grading-2, OGFC, and BC grading-2 cold. As the maximum nominal aggregates sizes increase segregation levels also increases and as the coarse aggregate sizes increases in the gradation of the mix the amount of segregation also increased and get segregated under gravity forces.
Predicting the Wear Rate of Aluminum Alloy AA2024-T351 using Hybrid Linear function and Radial Basis Function
Authors: Ashwin A , Hari Lakshman R B , Chand Swaroop C B , Vignesh M , Vaira Vignesh R , Padmanaban R
Published: November 2019

AA2024 is one of the heat treatable Al-Cu alloys with good strength to weight ratio and fracture resistance. It finds application mainly in aircraft and structural applications. In T351 tempered condition, AA2024 has improved hardness and strength. However, the softness of the matrix leads to high wear rate. In this study, tribological characteristics of AA2024-T351 is determined using a pin-on-disc tribometer by varying the sliding velocity, sliding distance and axial load as per face centered central composite design. A hybrid linear – radial basis function model is developed to explore the effect of normal load, sliding distance and sliding velocity on the wear rate of AA2024-T351 alloy. The predominant wear regimes in AA2024-T351 alloy is understood from the characterization study on the surface morphology of the worn specimens.
A comparative numerical study of standard 3D composite plate using virtual crack closure technique and cohesive zone modelling method
Authors: Sindhu B R , Raju J , Kamath Kiran
Published: November 2019

A standard square plate specimen made up of Carbon Fibre Reinforced Polymer (CFRP) and Glass Fibre Reinforced Polymer (GFRP) laminates with an artificially-introduced delamination was considered for evaluation of fracture parameters using Abaqus-Standard software. Though there are several methods to evaluate the initiation of delamination using software, Virtual Crack Closure Technique (VCCT) and Cohesive Zone Modelling (CZM) method are commonly used. By using the above-mentioned methods, the Quasi-Isotropic (QI) composite laminates were analysed for varying compressive loads. The Load-Displacement responses were reported and seen to be in overall good statement with each other, while the modelling effort and computational time required were quite higher in CZM method compared to VCCT. Onset of delamination growth for CFRP and GFRP laminates was studied using VCCT by evaluating Strain Energy Release Rates (SERR). The results for both the specimens were compared and reported.
Friction and wear characteristics of polyetheretherketone (PEEK): A review
Authors: Mir A H , Charoo M S
Published: November 2019

PEEK is a colourless organic thermoplastic polymer which is used for tribological applications. It is seen as a potential replacement to metal and ceramic tribo-components due to excellent property profile. Various reinforcements like carbon fibers, Al2O3, SiC, WS2, ZrO2, etc have been incorporated in PEEK to improve its wear resistance and to aid its further applications by improving its anti-wear properties. This study presents a review of the tribological properties of PEEK and its composites in dry as well as aqueous environments.The friction and wear characteristics of PEEK and its composites are discussed in the proceeding sections. The role of various fillers in improving the friction and wear characteristics of PEEK is enlightened. The current research trends in PEEK tribology are also presented.
Analyzing structural and tribological characteristics of different materials at micro- and nano-level using molecular dynamics simulations: An overview
Authors: Qurat-Ul-Ain  , Wani M.F. , Sehgal Rakesh
Published: November 2019

This review paper presents structural and tribological characterization of various materials at micro- and nano-level using molecular dynamics simulation. The investigated computational methods of molecular dynamics simulation are briefly explained. Molecular dynamics is the most accurate theoretical model to speculate motions at molecular level and are mainly used to study chemical and mechanical behavior of various phenomena with tribological properties like friction, wear and self-lubrication properties. The dynamics of transformation of structure, microstructure and composition with mechanical and chemical performances of different composites are reviewed. The mechanisms of friction, wear and self-lubricating behavior are analyzed for self-lubricating materials using available MD software models, LAMMPS being easily available and having low computational cost is the most widely used modeling software. These models are used to study and compare properties at micro and nano-level because in the first place friction and wear need to be controlled at molecular level. This paper is intended to render molecular dynamics simulation which is utilized to study the dynamics of various parameters of atoms and molecules in various phases at molecular level of different materials with main focus on friction and self-lubricating materials. The main focus behind this review is to present the potential and competence of computational modeling methods to envisage behavior and performance of different models at molecular level.
Bactericidal Activity of Zinc Oxide Nanoparticles
Authors: Mala R. , Hari Prasath N. , Ruby Celsia A. S.
Published: November 2019

The present study was aimed to evaluate the antibacterial activity of zinc oxide nanoparticles against the pathogen isolated from diabetic foot ulcer. The isolate was identified by MALDI-TOF. The susceptibility of the isolate to antibiotic was evaluated by disc diffusion assay. Chemically synthesized zinc oxide nano particle was characterized for its size distribution by dynamic light scattering, morphology by FESEM and elemental composition by energy dispersive X-rayspectroscopy. The wound isolate was identified asE. coli. Thestrain wasresistant to β lactam and aminoglycoside antibiotics. The size of zinc oxide nano particle was recorded as 55nm. FESEM revealed the spherical shape of zinc oxide nanoparticles. UV visible spectrophotometry confirms the presence of zinc oxide nanoparticles with an absorbance maximum at 372 nm. Zinc oxide nanoparticles inhibited E. coli with an inhibition zone of 25 mm.Thus, thestudy provedthe-bacterial activity of zinc oxide nanoparticles against multi drug resistant E. coli.
Significance of Incorporating Chebfunction Coefficients for Improved Machine Fault Diagnosis
Authors: Sachin Saj T K , Mohan Neethu , Sachin Kumar S , Soman K.P
Published: November 2019

For any industry the efficiency and performance of rotating machinery/mechanical systems is a major concern. Bearings and gears are two essential parts in a rotating machinery and any defects in these components can lead to a major breakdown of the system thus causing large economical loss for the company. An appropriate machine condition monitoring system is essential in such scenarios for identifying the health of the machines. Therefore in this paper fault diagnosis of rotating mechanical systems is performed as a feature dependent-pattern classification problem. The machine is made to run in different good as well faulty conditions and the vibration signals are collected. Then chebfunction coefficients are extracted from the vibration signals as part of the feature extraction process. Finally, the extracted features are classified using regularized least squares (RLS) for identifying the good and faulty bearing as well as gear conditions of the machine. The evaluations are performed using different kernel functions and the average accuracy reported is 98% for bearing and gear data. The various experiments performed claims that the proposed system can be used for real-time fault diagnosis in rotating mechanical systems with sufficient accuracy.
Performance Analysis of Quality Measurement for Biomedical Images
Authors: Rajyaguru Vipul C. , Thanki Rohit M.
Published: November 2019

With the rise used of biomedical images for diagnosis of diseases of a patient at various hospitals, the quality measurement of images is necessary for better diagnosis. The need for biomedical images quality measurement due to the transmission of images from one place to another place within hospitals or remote health centers. The lots of distortions may affect the quality of biomedical images during transmission. So, in this paper, the various image quality assessment parameters discussed for biomedical images. The paper gives information on various full reference-based objective assessment (OA) image quality measurement (FR-IQM) standards. The paper also gives performance analysis of FR-IQM standards for biomedical images.
Modelling and analysis of SU8/CB nanocomposite polymer flow sensor
Authors: Suraj  , Ansari Mohd. Zahid
Published: November 2019

This paper studies the effect of diaphragm size and stylus design on flow measurement characteristics of a polymer flow sensor. The sensor is made of two piezoresistive SU8/CB nanocomposite polymer cantilevers integrated with diaphragm carrying a free standing stylus its centre. The fluid flow drag force deflects the stylus which in turn deforms the anchoring cantilevers and changes their electrical resistivity. Finite element analysis software ANSYS Multiphysics used to determine the deflection, stress and sensitivity characteristics of the flow sensor at different velocities. Results show that sensitivity of flow sensor decreases with increase in diaphragm size and square stylus has better sensitivity.
Analysis of effect of core material on the performance of single phase transformer using FEM
Authors: Kaur Sarpreet , Kaur Damanjeet
Published: November 2019

The remark able progress of power systems set liability on the transformer engineering to sources table and economical transformers. Transformer is a complex three dimensional structures built of numerous modules such as core, windings, isolation, chamber, and several other equipments. There are many transformers available with different type of magnetic materials for core. But the Amorphous Magnetic material changes the whole scenario of the market. In this paper E-Core Transformer Finite Element model is simulated using FEM based software for different magnetic materials for core to find the losses of the transformer with same dimensions and supply conditions. The comparative analysis was conducted for different electromagnetic characteristics such as magnetic flux density, current density, magnetic vector potential etc.
Adopting sustainable construction in Nigeria: Major constraints
Authors: Akinshipe O , Oluleye I B , Aigbavboa C
Published: November 2019

The implementation of sustainable practices within the built environment has taken over the world of construction. In as much as man continues to build, sustainable practices will continue to be a significant necessity. Like every significant change in the world, most countries have been faced with numerous challenges when adopting sustainable construction practices and Nigeria is not an exception. This study, therefore, investigates the factors impeding the adoption of sustainable construction in Nigeria. The aim of this study was achieved by seeking the opinion of various built environment professionals within Ondo State, Nigeria. The survey research design was adopted for this study and the data collected was analyzed using descriptive statistics. Findings from the study revealed that inadequate knowledge and lack of expertise in sustainable construction practices are the greatest constraints faced in the bid to adopt sustainable construction. The study concluded that if attaining full sustainability is the goal of the Nigerian construction industry, professional bodies and relevant government agencies must organize workshops and training to educate construction professionals on their practicable roles in delivering sustainable development. Furthermore, experts in the field of sustainable construction preferably from countries which have fully adopted the concept should be invited to be part of some construction projects so as to provide on-site guidance and mentorship for local professionals.
Longitudinal Analysis Supports a Fear-Avoidance Model That Incorporates Pain Resilience Alongside Pain Catastrophizing
Authors: Slepian P Maxwell , Ankawi Brett , France Christopher R
Published: November 2019

Background

The fear-avoidance model of chronic pain holds that individuals who catastrophize in response to injury are at risk for pain-related fear and avoidance behavior, and ultimately prolonged pain and disability.

Purpose

Based on the hypothesis that the predictive power of the fear-avoidance model would be enhanced by consideration of positive psychological constructs, the present study examined inclusion of pain resilience and self-efficacy in the model.

Methods

Men and women (N = 343) who experienced a recent episode of back pain were recruited in a longitudinal online survey study. Over a 3-month interval, participants repeated the Pain Resilience Scale, Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Pain Self-Efficacy Questionnaire, the McGill Pain Questionnaire, and NIH-recommended measures of pain, depressive symptoms, and physical dysfunction. Structural equation modeling assessed the combined contribution of pain resilience and pain catastrophizing to 3-month outcomes through the simultaneous combination of kinesiophobia and self-efficacy.

Results

An expanded fear-avoidance model that incorporated pain resilience and self-efficacy provided a good fit to the data, Χ2 (df = 14, N = 343) = 42.09, p = .0001, RMSEA = 0.076 (90% CI: 0.05, 0.10), CFI = 0.97, SRMR = 0.03, with higher levels of pain resilience associated with improved 3-month outcomes on measures of pain intensity, physical dysfunction, and depression symptoms.

Conclusions

This study supports the notion that the predictive power of the fear-avoidance model of pain is enhanced when individual differences in both pain-related vulnerability (e.g., catastrophizing) and pain-related protective resources (e.g., resilience) are considered.
Work Tasks as Determinants of Respirable and Inhalable Indium Exposure among Workers at an Indium–Tin Oxide Production and Reclamation Facility
Authors: Hawley Blackley Brie , Cummings Kristin J , Stanton Marcia , Stefaniak Aleksandr B , Gibbs Jenna L , Park Ji Young , Harvey R Reid , Virji M Abbas
Published: November 2019

Increased global demand for touch screens, photovoltaics, and optoelectronics has resulted in an increase in the production of indium–tin oxide (ITO). Occupational exposure to indium compounds is associated with the development of indium lung disease. Although many previous epidemiologic investigations highlight an excess of lung abnormalities in workplaces where ITO is produced, few assessments of occupational exposure to respirable and inhalable indium are reported to date. The objective of this study was to identify the determinants of respirable and inhalable indium at an ITO production facility to target exposure interventions. In 2012 and 2014, we conducted exposure assessments at an ITO production facility and collected full-shift personal respirable (n = 159) and inhalable (n = 57) indium samples. We also observed workers and recorded information on task duration and location, materials used, and use of personal protective equipment (PPE). Tasks (n = 121) recorded in task diaries were categorized into 40 similar task groups using the Advanced REACH Tool and process-related information. Mixed-effects models were fit separately for log-transformed respirable and inhalable indium, with random effect of subject and fixed effects of task groups. Overall, respirable and inhalable indium measurements ranged from 0.1 to 796.6 µg m−3 and 1.6 to 10 585.7 µg m−3, respectively, and were highly correlated with Spearman correlation coefficient of 0.90. The final model for respirable indium explained 36.3% of total variance and identified sanding, powder transfer tasks in reclaim, powder transfer tasks in refinery, handling indium materials, and liquid transfer tasks in ITO production as tasks associated with increased respirable indium exposure. The final model for inhalable indium explained 24.6% of total variance and included powder transfer tasks in ITO production, cleaning cylinder or tile, and handling indium material tasks. Tasks identified as strong predictors of full-shift exposure to respirable and inhalable indium can guide the use of engineering, administrative, and PPE controls designed to mitigate occupational exposure to indium. Moreover, since the tasks were aligned with REACH activities, results from this study can also be used to inform REACH activity scenarios.
Review of Guidelines for Dental Antibiotic Prophylaxis for Prevention of Endocarditis and Prosthetic Joint Infections and Need for Dental Stewardship
Authors: Goff Debra A , Mangino Julie E , Glassman Andrew H , Goff Douglas , Larsen Peter , Scheetz Richard
Published: November 2019

Dentists prescribe 10% of all outpatient antibiotic prescriptions, writing more than 25.7 million prescriptions per year. Many are for prophylaxis in patients with prosthetic joint replacements; the American Dental Society states that “in general,” prophylactic antibiotics are not recommended to prevent prosthetic joint infections. Orthopedic surgeons are concerned with the risk of implant infections following a dental procedure and, therefore, see high value and low risk in recommending prophylaxis. Patients are “stuck in the middle,” with conflicting recommendations from orthopedic surgeons (OS) and dentists. Unnecessary prophylaxis and fear of lawsuits amongst private practice dentists and OS has not been addressed. We review The American Heart Association/American College of Cardiology, American Dental Association, and American Association of Orthopedic Surgeons’ guidelines on dental antibiotic prophylaxis for the prevention of endocarditis and prosthetic joint infections. We provide experience on how to engage private-practice dentists and OS in dental stewardship using a community-based program.
Population Incidence and Mortality of Sepsis in an Urban African Setting, 2013–2016
Authors: Lewis Joseph M , Abouyannis Michael , Katha Grace , Nyirenda Mulinda , Chatsika Grace , Feasey Nicholas A , Rylance Jamie
Published: November 2019

Background

Sepsis is an important cause of mortality globally, although population incidence estimates from low-income settings, including sub-Saharan Africa, are absent. We aimed to estimate sepsis incidence burden using routinely available data from a large urban hospital in Malawi.

Methods

We linked routine-care databases at Queen Elizabeth Central Hospital, Blantyre, Malawi, to provide admission and discharge data for 217 149 adults from 2013–2016. Using a definition of sepsis based on systemic inflammatory response syndrome criteria and Blantyre census population data, we calculated population incidence estimates of sepsis and severe sepsis and used negative binomial regression to assess for trends over time. Missing data were multiply imputed with chained equations.

Results

We estimate that the incidence rate of emergency department–attending sepsis and severe sepsis in adults was 1772 per 100 000 person-years (95% confidence interval [CI], 1754–1789) and 303 per 100 000 person-years (95% CI, 295–310), respectively, between 2013 and 2016, with a year-on-year decrease in incidence. In-hospital mortality for patients admitted to the hospital with sepsis and severe sepsis was 23.7% (95% CI, 22.7–24.7%) and 28.1% (95% CI, 26.1 – 30.0%), respectively, with no clear change over time.

Conclusions

Sepsis incidence is higher in Blantyre, Malawi, than in high-income settings, from where the majority of sepsis incidence data are derived. Worldwide sepsis burden is likely to be underestimated, and data from low-income countries are needed to inform the public health response.
Time evolution of restless legs syndrome in haemodialysis patients
Authors: Capelli Irene , Pizza Fabio , Ruggeri Marco , Gasperoni Lorenzo , Carretta Elisa , Donati Gabriele , Cianciolo Giuseppe , Plazzi Giuseppe , La Manna Gaetano
Published: November 2019

Background

Restless legs syndrome (RLS) is characterized by an urge to move the extremities, accompanied by paraesthesiae, in the evening and at night. Uraemic RLS, a type of secondary RLS, occurs commonly in chronic kidney disease and end-stage renal disease. Progression of uraemic RLS over time is unclear. Therefore we investigated the prevalence, progression over time, risk factors and impact on survival of uraemic RLS in a cohort of dialysis patients.

Methods

We reviewed at the 7-year follow-up a cohort of haemodialysis (HD) patients we had previously investigated for RLS, through interviews, validated questionnaires and analysis of demographic and clinical data.

Results

At the 7-year follow-up, RLS was present in 16% of patients, with a persistence rate of 33%. A correlation was obtained between RLS and older age, diabetes, low albumin and low body mass index. RLS was associated with reduced overall survival (median survival of 3.3 versus 3.7 years), particularly with the continuous form of RLS (1.61 years). There was a higher incidence of myocardial infarction and peripheral vascular disease, although not reaching statistical significance. RLS patients had absolute higher scores in all quality of life domains. A large majority of study patients (96%) reported being symptom-free within a few days or weeks following kidney transplantation.

Conclusions

The development of RLS, especially the continuous form, in patients undergoing HD has important consequences associated with decreased survival. Our results indicated an association between uraemic RLS and ageing, diabetes and malnutrition. Considerable efforts should be focused on the treatment of RLS, since it significantly and persistently impacts the quality of life of HD patients. Kidney transplantation could represent an effective treatment option for that RLS impacts on dialysis patients' quality of life, thus confirming the secondary nature of RLS in most HD patients.
Pulmonary hypertension detection by computed tomography pulmonary transit time in heart failure with reduced ejection fraction
Authors: Colin Geoffrey C , Pouleur Anne-Catherine , Gerber Bernhard L , Poncelet Pierre-Antoine , de Meester Christophe , D’Hondt Anne-Marie , Vlassenbroek Alain , Houard Laura , Gevenois Pierre-Alain , Ghaye Benoit
Published: November 2019

Aims

To evaluate the relationships between pulmonary transit time (PTT), cardiac function, and pulmonary haemodynamics in patients with heart failure with reduced ejection fraction (HFrEF) and to explore how PTT performs in detecting pulmonary hypertension (PH).

Methods and results

In this prospective study, 57 patients with advanced HFrEF [49 men, 51 years ± 8, mean left ventricular (LV) ejection fraction 26% ± 8] underwent echocardiography, right heart catheterization, and cardiac computed tomography (CT). PTT was measured as the time interval between peaks of attenuation in right ventricle (RV) and LV and was compared between patients with or without PH and 15 controls. PTT was significantly longer in HFrEF patients with PH (21 s) than in those without PH (11 s) and controls (8 s) (P < 0.001) but not between patients without PH and controls (P = 0.109). PTT was positively correlated with pulmonary artery wedge pressure (PAWP) (r = 0.74), mean pulmonary artery pressure (r = 0.68), N-terminal pro-B-type natriuretic peptide (r = 0.60), mitral (r = 0.54), and tricuspid (r = 0.37) regurgitation grades, as well as with LV, RV, and left atrial volumes (r from 0.39 to 0.64) (P < 0.01). PTT was negatively correlated with cardiac index (r = −0.63) as well as with LV (r = −0.66) and RV (r = −0.74) ejection fractions. PAWP, cardiac index, mitral regurgitation grade, and RV end-diastolic volume were all independent predictors of PTT. PTT value ≥14 s best-detected PH with 91% sensitivity and 88% specificity (area under the receiver operating characteristic curve: 0.95).

Conclusion

In patients with HFrEF, PTT correlates with cardiac function and pulmonary haemodynamics, is determined by four independent parameters, and performs well in detecting PH.
Asymptomatic phaeochromocytoma in a patient with Holt-Oram syndrome: a case report
Authors: Ng Perryn , Deepak Doddabele , Teo Lynette , Low Ting Ting
Published: November 2019

Background

Holt-Oram syndrome (HOS) is a rare congenital disease that affects the heart and upper limbs. Phaeochromocytoma, a catecholamine-secreting tumour, is a rare neuroendocrine disorder. We present an interesting case presentation of these two rare disorders in a patient who was asymptomatic for phaeochromocytoma.

Case summary

A 28-year-old woman who was diagnosed at birth with HOS, presented to the hospital with heart failure. She has a past medical history of corrected cyanotic congenital heart disease. She presented with dyspnoea but she did not have headaches, tremors, or diaphoresis. Cardiac magnetic resonance scan was done to investigate the cause of her heart failure and revealed right ventricular systolic dysfunction and a suspicious adrenal lesion. Magnetic resonance imaging adrenal confirmed the presence of the adrenal lesion and concerns were raised for a possible phaeochromocytoma. Biochemical tests showed raised plasma free metanephrine levels. Gallium-68 DOTA positron emission tomography scan showed intense right adrenal gland uptake in keeping with diagnosis of phaeochromocytoma.

Discussion

Phaeochromocytoma appears to be more prevalent in patients who are in a chronic hypoxic state. This hypoxic state has been postulated to cause the proliferation of adrenal tissue and therefore the formation of phaeochromocytomas. The hypoxia-inducing factor, which is increased in patients with phaeochromocytoma, has been identified as one of the key factors driving this process as it modulates genes that regulate angiogenesis and proliferation. Congenital heart defects seen in HOS can progress to cyanotic heart disease if left uncorrected and may have been the driver for the development of phaeochromocytoma in our patient.
Citizen consultation and organized breast cancer screening
Authors: Gocko Xavier , Spiga Radia , Chel Virginie , Court Anthony , Plotton Catherine
Published: November 2019

Scientific controversies on breast cancer screening have induced the French authorities to launch online citizen consultation. The objective of this netnography was to identify the knowledge and values underlying contributors’ choices. The choice of supporters was often based on emotions: impression of disease severity and efficacy of screening, fearfulness stemming from personal experience and testimony from relatives. Opponents emphasized the risks of the screening and the doctors’ perceived lack of relational and technical skills. The ‘non-decision’ profile was explained by information deemed simplistic, guilt-inducing and partial. Future research should focus on how to appeal to emotions to support shared decision.
WHY DON’T OLDER ADULTS USE SENIOR CENTERS? EVIDENCE FROM A SAMPLE OF MASSACHUSETTS ADULTS AGE 50 AND OLDER
Authors: Somerville Ceara , Roldan Nidya Velasco , Bui Cindy N , Coyle Caitlin E
Published: November 2019

Senior centers are an integral community resource, providing programs and services intended to meet the vast range of needs and interests of older adults. There is a growing literature describing senior center participants and benefits to participation, but little is known about those who choose not to participate at a local senior center. This presentation uniquely characterizes non-users of senior centers, based on a sample of community-dwelling adults aged 50+ from seven communities in Massachusetts (N = 9,462). To date, this is the largest data set that describes senior center usage. Most of the sample were women (60%) and in the 60-69 age group (36%). More than three quarters of the sample do not use the local senior center (77%). The most common reasons for non-usage were lack of interest (27%) and not feeling old enough (26%). There are significant differences in reasons of non-usage among age groups and gender (p < .001). Younger age groups’ (50-69) most popular reasons for non-usage were not feeling old enough, not having time, inconvenient senior center hours, and not knowing what is offered. In contrast, older age groups (80+) more frequently reported having no interest or using programs elsewhere. Men were more likely to report not being interested and not being familiar with what is offered. Women were more likely to report not having time, inconvenient hours of programming, and using programs elsewhere. Based on results from this study, this presentation will outline implications for the future of senior centers and their programming.
MANAGING MANAGED CARE: PERSPECTIVES FROM KEY STAKEHOLDERS IN SKILLED NURSING FACILITIES
Authors: Daddato Andrea E , Drake Cynthia , Miller Edward A , Nadash Pamela , Tyler Denise , Boxer Rebecca S
Published: November 2019

In recent years, Medicare Advantage (MA) plan enrollment has increased, a trend that is expected to continue. Many skilled nursing facilities (SNFs) rely on MA managed care insurer referrals to maintain their census in a market with high competition for post-acute care patients. This study used semi-structured interviews to describe the relationship between MA plans and SNFs from the perspective of key decision-makers in SNFs. Twenty-three interviews were conducted with key stakeholders from 11 Denver Metropolitan area SNFs. A combined purposive-snowball sampling approach was used to identify and recruit select staff from the participating facilities. Interviews focused on the relationship between MA plans and SNFs, including mechanisms of control, power dynamics, and preferences for MA versus Fee-for-Service (FFS) Medicare patients. Key findings included: 1) challenges SNF staff had navigating MA plans’ case management processes, a key mechanism used by MA plans to influence the behavior of SNF decision-makers; 2) MA plans exercising power over beneficiaries’ length of stay, potentially leading to early discharge and heightened risk for rehospitalization; 3) SNF preference for admitting Medicare FFS over MA patients due to higher rates of Medicare FFS reimbursement and greater control over patient care. SNFs are increasingly reliant on MA plans for patient referrals and revenue. The themes suggest that this growing reliance may place SNFs at odds with MA plans on how best to manage overall patient care. It is therefore important that future research investigate how MA plans’ influence over care affects patient outcomes in SNFs and other post-acute settings.
HOSPICE SERVICES IN THE HOME SETTING AND CHARACTERISTICS OF MEDICARE DECEDENTS
Authors: Karikari-Martin Pauline , Zhao Lirong , Miescier Lynn
Published: November 2019

There is little empirical work documenting the characteristics of Medicare beneficiaries receiving hospice services in the home setting using the Medicare place of service codes. The objective of this study is to examine differences in Medicare decedents who received hospice services in traditional and non-traditional homes (assisted living, and nursing home settings) defined by these codes. We conducted a secondary analysis of 675,782 Medicare decedents who received hospice services in 2015. Chi-squared and ANOVA tests were used to describe the socio-demographics, health conditions, utilization, and hospice payments of the decedents. Most of the decedents received hospice care in a traditional home (64.9%), but beneficiaries, aged 85 years and over, received hospice services in assisted living (72.1%) or nursing homes (59.8%). Overall, decedents who received Medicare hospice benefits in assisted living had the highest number of hospice days (mean=149.7 lifetime days; median = 30; standard deviation (S.D.) =245), and decedents in traditional homes had the fewest number of hospice days (mean=86.7 lifetime days; median = 24; S.D. =179). Among Medicare–Medicaid (duals) decedents who used hospice care, 49% received hospice care in nursing homes, and infrequently, 7% at assisted living. Medicare hospice payments were highest ($20,439 per beneficiary) for decedents in assisted living, but least for those in traditional homes ($11,830). Hospice services offered to Medicare beneficiaries who are 85 years and older, duals, or have a diagnosis of dementia may require more oversight and coordination of resources to ensure that they receive appropriate hospice services in non-traditional homes.
TRADITIONAL NETWORK ON MENTAL HEALTH: SUPPORT FROM CHILDREN AND DEPRESSIVE SYMPTOMS FOR OLDER ADULTS IN RURAL CHINA
Authors: Chen Lei , Torres-Gil Fernando
Published: November 2019

In rural China, support from children is the traditional network for older adults. Their mental health problem is poorly understood and remains unsolved. The study aims to explore the relationships between older adults’ depressive symptoms and characteristics of support from children under the current social-structural conditions in rural China. The study is informed by the intergenerational solidarity theory and the theoretical framework of social relationships and their influence on health. The quantitative study is based on the recent wave of Harmonized China Health and Retirement Longitudinal Study (Harmonized CHARLS) in 2015, which is a high-quality national-level dataset. The study applies conditional process analysis to do the data analysis. The key findings include: the number of children has a negative association with older adults’ depressive symptoms (c= -.2390, p=.0002<0.05); the number of children influenced older adults’ depressive symptoms indirectly through financial support from children (If children do not live with older parents, ab=-.0141, CI= -.393 to -.0038; If children live with older parents, ab=-.0153, CI= -.369 to -.0056;). However, both theses direct and indirect relationships do not depend on the co-residence situation between older adults and their children. The controlling variables include age, gender, and self-rated health. Under China’s current transition period of population policy, this study provides policy implications regards to the characteristics of children support and their influence on older adults’ mental health, especially in rural China. This study also tests the two theories to some extent under the Chinese context, which were initially developed in Western countries.
POSITIVE AND NEGATIVE SOCIAL INTERACTIONS ON MENTAL HEALTH IN OLDER KOREAN AMERICANS: GENDER DIFFERENCES
Authors: Park Nan Sook , Jang Yuri , Rhee Min-Kyoung , Chiriboga David , Chung Soondool
Published: November 2019

While there is substantial documentation of a positive relationship between objective social engagement and mental health, relatively little is known about how perceived quality of social interactions affects mental health and how men and women differ. Considering the gap, the purpose of this study was to investigate gender difference in how social interactions associate with self-rated mental health in older Korean Americans. Data came from a survey with older Korean Americans aged 60 or over that included 713 men and 1437 women living in five sites (California, New York, Texas, Hawaii, and Florida), conducted during 2017−2018. In multiple regression models run separately for men and women, self-rated mental health on a five-point scale (excellent/very good/good/fair/poor) was regressed on four blocks of variables: socio-demographic characteristics (age, marital status, education, financial status, self-rated health, and region), immigration-related variables (length of stay in the U.S. and acculturation), social engagement (family network, friend network, and activity participation), and perceived quality of social interactions (positive or negative family interactions and negative community interactions). In the final models with all covariates, younger age, more years in education, better physical health, higher levels of acculturation, and more positive family interactions were commonly associated with more positively rated mental health for both men and women. For women, stronger family network and fewer negative family interactions were additional contributors. Results suggest that negative and positive indicators of family interactions differentially affect self-rated mental health for older Korean American men and women.
RUMINATION, DEPRESSIVE SYMPTOMS, AND SLEEP QUALITY: SOCIAL SUPPORT AS A BUFFER
Authors: Marini Christina M , Wilson Stephanie J , Martire Lynn
Published: November 2019

Rumination, the act of dwelling on negative, unwanted thoughts, can stoke depression and disrupt sleep, both of which may threaten older adults’ well-being. In line with a support buffering hypothesis, a previous study of younger and middle-aged adults found that social support mitigated the positive association between rumination and negative mood. To extend this research, we distinguished between spousal and family/friend support as moderators of rumination’s links both to depressive symptoms and sleep quality among older adults. Data came from a sample of 128 adults who were, on average, 77 years old at study onset. Rumination was measured via the Rumination-Reflection Questionnaire. Perceived support was measured by items utilized in multiple nationally representative studies of older adults. Depressive symptoms were measured via the NIH PROMIS measure, and sleep quality was measured via items from the Pittsburgh Sleep Quality Index. Results indicated that support from family/friends (but not spouses) buffered the positive association between rumination and depressive symptoms, even after controlling for depressive symptoms six months prior. Conversely, when sleep quality served as the outcome, support from spouses (but not family/friends) buffered the negative association between rumination and sleep quality, even after controlling for sleep quality six months prior. Findings highlight the potential for specific sources of social support to buffer different consequences of rumination on older adults’ health and well-being.
IMPACT OF SOCIALIZATION IN LOW-INCOME URBAN ELDERLY COMMUNITIES
Authors: Wilkerson Taylor , Ward Schanea , Popovich Amy , Parsons Pamela , Zanjani Faika A
Published: November 2019

Older adults who experience social isolation have higher rates of mortality relative to their counterparts. Social interactions are an important way to combat this isolation. This research aims to better understand how social isolation in older adults living in low-income households in Richmond, Virginia (RVA) is related to their economic, physical, and psychological health status. As part of the VCU iCubed Health and Wellness Aging Core and in collaboration with the Richmond Memorial: East End Housing Coalition for Older Adults, older adults from a selected public housing unit (n=28) self-reported their financial status, experiences with physical and psycho-social health, and feelings of social isolation. Survey participants were 71.4% female, the mean age was 69.75 years, and 25% were high school graduates. Participants averaged 34 years living in the area and reported an average of $300 to spend on rent monthly. Overall, 55% (n=20) reported having two or more supports and 61% (n=22) reported hardly ever feeling isolated. However, a small subset of the sample reported having either no supports (5.6%, n=2) and 41.7% (n=15) lacked companionship some of the time or often. A one-way ANOVA was conducted and it was determined that participants who reported feeling left out more often were significantly more likely to report stress, anxiety, and depression (F[2, 25] = 6.998). Findings support the existence of supportive communities formed in low-income areas. Findings also indicate some older individuals residing in public housing in RVA experience social isolation, linking them to poorer psycho-social health.
IMPACT OF ICT AND SOCIAL NETWORKS SITES UTILIZATION ON OLDER PEOPLE’S WELL-BEING AND LONELINESS: A SCOPING REVIEW
Authors: Zaccaria Daniele , Casanova Georgia , Guaita Antonio
Published: November 2019

In the last decade the debate on ageing issues has been powered by the relationship between older people wellbeing, loneliness, Information Communication Technology (ICT) and Social Networks Sites (SNSs). A scoping review on social experiment studies, analysing the casual effect of technologies use on older adults’ wellbeing and loneliness, has been realized to support the randomized controlled trial included in “Aging in a Networked Society” project. The study aims to review the social experiments on the relationship between technology-use, older people wellbeing and loneliness, to provide a critical analysis of studies, to underline drivers and barriers in existing literature and to provide recommendations for future study and policy. 133 papers have been selected using interdisciplinary search engines (Scopus, Pubmed, Web of sciences, Google Scholar), taking into account contents and methods used. An in-depth examination of 9 experiences of social experiment have been provided, focused on six dimensions: “aims”, “design”, “sampling”, “intervention”, “findings” and “limitations". The literature show the positive effects of ICT, internet and SNSs use on older people wellbeing and quality of life. Our review underlines how the older people shown interest in ICT use to support their social relations, and how it should become a social driver. The low widespread of experimental studies impacts on the literature evidences. The main limits are related to the recruitment and sampling. Social experiment practices, based on controlled randomized trial, should be widespread to better support the evidences in ageing issue.
PROVIDER PERSPECTIVES ON IMPLEMENTING A PERSON-CENTERED COMMUNICATION TOOL
Authors: Heppner Alexandra , Hicks Nytasia , Poth Sarina , Van Haitsma Kimberly , Abbott Katherine
Published: November 2019

The PAL Card QIP Project sought to understand the intervention characteristics associated with effective implementation. Telephone interviews were conducted with n=26 NH providers who completed the project. Calls were recorded, transcribed verbatim and checked for accuracy. The Consolidated Framework for Implementation Research was utilized as an a priori coding scheme to identify factors associated with effective implementation of the PAL Card project. Major themes emerging from the data related to the evidence strength and quality of the intervention as well as the relative advantage to not assessing preferences (“turns out she doesn't even like TV and we have just been having her watch TV”), adaptability (tailoring for their needs), trialability (expanding offering of intervention after initial success), and complexity of the intervention (sharing the work across departments, difficulty using unfamiliar technology). Providers reported positive intervention characteristics of the PAL cards, however, barriers remain that require additional strategies to successfully implement.
A LIFE COURSE PERSPECTIVE OF LATE-LIFE FUNCTIONING: THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION
Authors: Karvonen-Gutierrez Carrie , Strotmeyer Elsa , Derby Carol
Published: November 2019

Early late-life deficits in physical functioning are highly relevant among women, who experience a more rapid decline in physical functioning vs. age-matched men. Trends showing an increasing prevalence of disability among mid-life adults, with an evolving understanding that late life health and functioning is the product of exposures accumulated across ones life, suggests an urgent need to understand the causes and consequences of functional limitations at the transition between mid- to late-life. The Study of Women’s Health Across the Nation (SWAN) is an observational multi-racial/ethnic (White, Black, Chinese, Japanese, Hispanic) longitudinal study of 3,302 women recruited in 1996 from 7 U.S. clinical sites; Boston, Chicago, Detroit-area, Los Angeles, Newark (NJ), Oakland (CA), and Pittsburgh. Over the past 23 years, women have participated in up to 16 near-annual study visits, spanning from mid-life (age 42-52 years at baseline) to late life (age 65-73 years at follow-up visit 15). Retention at the most recently completed in-person visit (2015) was 74%. This symposium identifies mid-life risk factors for poor late-life performance-based physical functioning among women, including race/ethnicity (Sternfeld) and chronic health conditions (Lange-Maia). Further, early late-life decrements in stair climb time and muscle power (Strotmeyer) and falls and fall injuries (Ylitalo) were observed with key factors identified. The Discussant will examine implications for life course epidemiology in advancing our understanding of predictors of late-life physical functioning. Consideration of functioning during the transition from mid-life to late life is critical to target interventions that are most efficacious in promoting late life health and function.
A MICROLONGITUDINAL ASSESSMENT OF SUBJECTIVE AGE AND MENTAL HEALTH DURING REHABILITATION
Authors: Shrira Amit , Palgi Yuval , Heyman Noemi , Zaslavsky Oleg , Bodner Ehud
Published: November 2019

Recent ecological momentary assessments focused on the concomitants of daily views on aging among community-dwelling participants, yet clinical samples are underexplored. Hence, this study examined the relationships between views on aging and daily mental health during rehabilitation following osteoporotic fractures and cerebrovascular events. Measures of daily subjective age, psychological distress, and mental health were assessed among 132 older adult patients (mean age=77.9, SD=7.5, 65.9% women). Multilevel models showed that on days patients felt younger, they reported lower psychological distress and higher mental health. Time lagged analyses further showed reciprocal effects between subjective age and mental health. Finally, the subjective age-mental health covariance was stronger among patients high on age awareness. The suddenness and brutality of acute medical events highlight subjective age as an important factor in patients’ wellbeing, especially among those more attentive to their age. These findings suggest that practitioners should consider interventions focused on patients’ age identity.