bluuebunny/crossref_metadata_2025 huggingface dataset:
Convergence and divergence in anti-predator displays: a novel approach to quantitative behavioural comparison in snakes
Authors: Davis Rabosky Alison R , Moore Talia Y , Sánchez-Paredes Ciara M , Westeen Erin P , Larson Joanna G , Sealey Briana A , Balinski Bailey A
Published: December 2020

Animals in nature use many strategies to evade or deter their predators. Within venomous snake mimicry, stereotyped anti-predator behaviours are hypothesized to be effective warning signals under strong selection for independent convergence across species. However, no studies have systematically quantified snake anti-predator displays across taxonomically broad clades to examine how these behaviours evolve within a comparative methods framework. Here we describe a new high-throughput approach for collecting and quantifying anti-predator displays in snakes that demonstrates both low observer bias and infinite extension. Then, we show this method’s utility by comparing 20 species spanning six taxonomic families from Peru. We found that a simple experimental set-up varying simulated predator cues was successful in eliciting displays across species and that high-speed videography captured a great diversity of anti-predator responses. Although display components show complicated patterns of covariance, we found support for behavioural convergence in anti-predator displays among elapid coral snakes and their distantly related mimics. Our approach provides new analytical opportunities for both behaviour and kinematics, especially macroevolutionary analyses across clades with similar difficulty in observing or comparing trait diversity.
Stability in the Balkans: phylogeography of the endemic Greek stream frog,Rana graeca
Authors: Jablonski Daniel , Gkontas Ioannis , Poursanidis Dimitris , Lymberakis Petros , Poulakakis Nikos
Published: December 2020

We still have little knowledge concerning the phylogeography of amphibians and reptiles from the Balkan Peninsula compared with the other two Mediterranean peninsulas. This raises concerns for endemic taxa from these peninsulas, because it might interfere with further conservation efforts. Here we focus on the endemic Greek stream frog (Rana graeca) and reconstruct its biogeography and evolutionary history. Using four genetic markers (Cytb, 16S, COI and BDNF) in > 350 sequences covering the whole distribution range, we conducted phylogenetic, demographic and ecological niche analyses, which revealed the phylogeography of this species. Surprisingly, this examination of R. graeca reveals a very shallow level of intraspecific genetic variability through the Balkans, with two main, statistically supported lineages having a partly sympatric distribution. The most variable marker was Cytb, which showed 19 haplotypes in 123 analysed sequences in the whole species distribution area. Here presented genetic data, together with the environmental niche projection and demographic analyses suggest that R. graeca was probably affected only marginally by climatic oscillations, with the Hellenides as the most suitable area for the occurrence of the species in different geological periods. This is consistent with the observed genetic diversity, which is mostly related to these mountains. Although the species shows a certain level of phenotypic variability and ecological preferences, this might be related to species plasticity affected by the micro-climatic conditions in small areas, which merits further research. Comparing phylogeography of other amphibian and reptile species in the Balkans, we showed that the observed pattern represents a new view on the phylogeography of the Balkan herpetofauna.
Effects of host plant growth form on dropping behaviour in leaf beetles
Authors: Matsubara Satoru , Sugiura Shinji
Published: December 2020

Many leaf-eating insects drop from their host plants to escape predators. However, they must return to the leaves of the host plant after dropping, which represents a cost associated with this behaviour. In woody plants, the positioning of leaves is generally higher than that of herbaceous plants, which suggests that dropping from woody plants might be costlier for leaf-eating insects than dropping from herbaceous plants. Therefore, we predicted that dropping behaviour would be observed less frequently in insects that feed on woody plant leaves than in those that feed on herbaceous plant leaves. To test this prediction, we investigated dropping behaviour experimentally in larvae (23 species) and adults (112 species) of leaf beetles (Coleoptera: Chrysomelidae) on their host plants (86 species of 44 families) in field conditions. Larvae on woody plants exhibited dropping behaviour less frequently than those on herbaceous plants. However, this pattern was not detected in adults. Thus, host plant growth form might affect the evolution of dropping behaviour in leaf beetle larvae, but not in winged adults, perhaps owing to their higher mobility.
Retrospective analysis of hemispheric structural network change as a function of location and size of glioma
Authors: D’Souza Shawn , Hirt Lisa , Ormond David R , Thompson John A
Published: December 2020

Gliomas are neoplasms that arise from glial cell origin and represent the largest fraction of primary malignant brain tumours (77%). These highly infiltrative malignant cell clusters modify brain structure and function through expansion, invasion and intratumoral modification. Depending on the growth rate of the tumour, location and degree of expansion, functional reorganization may not lead to overt changes in behaviour despite significant cerebral adaptation. Studies in simulated lesion models and in patients with stroke reveal both local and distal functional disturbances, using measures of anatomical brain networks. Investigations over the last two decades have sought to use diffusion tensor imaging tractography data in the context of intracranial tumours to improve surgical planning, intraoperative functional localization, and post-operative interpretation of functional change. In this study, we used diffusion tensor imaging tractography to assess the impact of tumour location on the white matter structural network. To better understand how various lobe localized gliomas impact the topology underlying efficiency of information transfer between brain regions, we identified the major alterations in brain network connectivity patterns between the ipsilesional versus contralesional hemispheres in patients with gliomas localized to the frontal, parietal or temporal lobe. Results were indicative of altered network efficiency and the role of specific brain regions unique to different lobe localized gliomas. This work draws attention to connections and brain regions which have shared structural susceptibility in frontal, parietal and temporal lobe glioma cases. This study also provides a preliminary anatomical basis for understanding which affected white matter pathways may contribute to preoperative patient symptomology.
Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure
Authors: Inoue Katsuji , Khan Faraz H , Remme Espen W , Ohte Nobuyuki , García-Izquierdo Eusebio , Chetrit Michael , Moñivas-Palomero Vanessa , Mingo-Santos Susana , Andersen Øyvind S , Gude Einar , Andreassen Arne K , Wang Tom Kai Ming , Kikuchi Shohei , Stugaard Marie , Ha Jong-Won , Klein Allan L , Nagueh Sherif F , Smiseth Otto A
Published: December 2020

Aims

The aim of this study is to investigate determinants of left atrial (LA) reservoir and pump strain and if these parameters may serve as non-invasive markers of left ventricular (LV) filling pressure.

Methods and results

In a multicentre study of 322 patients with cardiovascular disease of different aetiologies, LA strain and other echocardiographic parameters were compared with invasively measured LV filling pressure. The strongest determinants of LA reservoir and pump strain were LV global longitudinal strain (GLS) (r-values 0.64 and 0.51, respectively) and LV filling pressure (r-values −0.52 and −0.57, respectively). Left atrial volume was another independent, but weaker determinant of both LA strains. For both LA strains, association with LV filling pressure was strongest in patients with reduced LV ejection fraction. Left atrial reservoir strain <18% and LA pump strain <8% predicted elevated LV filling pressure better (P < 0.05) than LA volume and conventional Doppler parameters. Accuracy to identify elevated LV filling pressure was 75% for LA reservoir strain alone and 72% for pump strain alone. When combined with conventional parameters, accuracy was 82% for both LA strains. In patients with normal LV systolic function by GLS, LA pump strain >14% identified normal LV filling pressure with 92% accuracy.

Conclusion

Left atrial reservoir and pump strain are determined predominantly by LV GLS and filling pressure. Accuracy of LA strains to identify elevated LV filling pressure was best in patients with reduced LV systolic function. High values of LA pump strain, however, identified normal LV filling pressure with good accuracy in patients with normal systolic function.
Credit supply shocks and the Great Depression in Germany
Authors: Breitenlechner Max , GrÜndler Daniel , Mathy Gabriel P , Scharler Johann
Published: December 2020

At the peak of the Great Depression in mid-1931, Germany experienced a severe banking crisis. We study to what extent credit constraints contributed to the downturn by fitting a structural vector autoregressive model with data from January 1925 to September 1935. Adverse credit supply shocks contributed strongly to the downturn especially at the time of the 1931 banking crisis. Before that, credit supply shocks had also contributed to the expansion phase preceding the depression. We also find that aggregate demand and U.S. business cycle shocks were the primary drivers of the German Great Depression.
Using a Virtual Curriculum to Provide Interprofessional Student Education in Alzheimer’s Disease
Authors: Indelicato Alyssa , Germain Lauren , Una Liliana Barros , Krueger Alice , Ludwig Ann , Brangman Sharon , Stewart Telisa
Published: December 2020

As Alzheimer’s disease increases in prevalence among older adults, there is an increased need for health professionals to effectively communicate with patients and their caregivers. Interactions between providers and Alzheimer’s patients differ from a typical patient-physician encounter. The project created a virtual learning environment (VLE) to better prepare students to engage with Alzheimer's patients and their caregivers. The VLE includes a clinical space, clinical office, and a patient’s home environment for students to practice their health communication skills and to better understand the lived experience. Nursing, MD, and Physician Assistants students were recruited and assigned a virtual provider (avatar). Students engage with a virtual patient (bot) in an exam room and then are directed to engage with a virtual caregiver (bot) in a clinical office. The virtual patient and caregiver have been programmed to respond to questions respectively and provide detailed insight into their lived experiences. After these encounters, the student is asked to react on the information obtained. The student is asked to explore the virtual home environment and triangulate the home experience, the caregiver’s perspective, and the patient’s responses. We are enrolling students to participate in the project and will complete the evaluation data. Students will be assessed for knowledge, self-efficacy, and their overall satisfaction with the virtual learning environment. We anticipate students will have an increase in each of these areas and will have improved communication skills with this at-risk, older adult population.
Across Generations: A University Course Promoting Intergenerational Relationships
Authors: Foti Megan
Published: December 2020

In order to support University students in meeting general studies requirements, while also promoting knowledge and understanding related to aging, Across Generations was developed. Across Generations provides students with a basic understanding of intergenerational relationships and the importance of fostering intergenerational collaborations in order to positively influence our communities. Beyond topics in older adulthood, this course helps students learn more about different generations, diverse cultures, and how to interact and form meaningful relationships with those different from them. Students also have an opportunity to interact with older adults and reflect on their experiences. Additionally, they complete a needs assessment and program development activities in order to identify relevant needs and identify ways to address them. In some cases, actual programs are developed and continue after the course ends. Across Generations topics include: introduction to aging and intergenerational relationships, learning from each other and the benefits of fostering intergenerational relationships, public policy, grandfamilies, older adult isolation, cross-cultural considerations, conflict resolution from an older adult viewpoint, and identifying needs and creating opportunities. This presentation shares the course development process, course learning outcomes and topic outline, student experiences and feedback, and recommendations for similar course development.
Reducing Ageism in a Lifespan Development Course Using Service Learning: Does an Aging Focus Matter?
Authors: Graf Allyson , Bolling Callie
Published: December 2020

A rapidly growing older adult population underlies the importance of reducing ageism. Research shows that college students typically hold negative views of older adults. While education and demonstrations within aging-focused courses contribute to reducing ageist beliefs, attitudes, and behavior toward older adults, contact with older adults amplifies these effects. This study investigated whether integrating contact with older adults into a lifespan development course was effective in decreasing college students’ ageism. The sample (N = 104; Mage = 19.94, SD = 3.27) were enrolled in the psychology course, largely as a major requirement for social science majors (51.9%) and health science majors (38.5%). As part of the course curriculum, a portion of the students (n = 57) interacted with older adults to fulfill a service-learning requirement; a control group (n = 47) were not given this option. Knowledge (Facts on Aging), behavior (Relating to Old People Evaluation; aging-related career intentions), and attitudes (Anxiety about Aging and Ambivalent Ageism) were assessed at the beginning and end of the semester. Quantity and quality of contact with older adults was also measured at baseline as a covariate. In a series of ANCOVA analyses, students with aging-related experiences across the term did not differ significantly on any measure compared to those without these experiences, controlling for experience with older adults and baseline assessments. The implications of this finding in the context of research may signal that focus of the course content may be an important moderator of the effectiveness of service-learning experiences with older adults.
Seniors and Undergraduates Mutually Benefit From an Interprofessional Service-Learning Health Promotion Program
Authors: Howell Britteny
Published: December 2020

Although benefits of service-learning and interprofessional education (IPE) have been separately well documented to be effective for students in gerontology and geriatrics courses, few curricula appear to integrate both aspects into a single course for undergraduate students in public health. This poster discusses the development and implementation of a service-learning health promotion program utilizing IPE embedded within two courses in two different departments at a mid-sized university. Students worked in interdisciplinary teams and acquired interprofessional educational learning outcomes while they engaged in their first experiences working with diverse older adults at a low-income, independent-living housing community. Twenty-five students (N=25) each team-taught 2 sessions on nutrition, physical activity, and stress reduction techniques in a 10-week program. Qualitative and quantitative results are presented which demonstrate significant learning outcomes from the students about the health needs of the aging population and increased comfort in working with older adults. Older participants in the program also reported positive health and psychological outcomes from their participation. Limitations, challenges, and next steps are also presented.
Focused Ethnography in Gerontological Research and Education
Authors: Patton Susan
Published: December 2020

Gerontological researchers often use qualitative methods to understand beliefs, values, and shared practices. Focused ethnography (FE) has emerged as a form of qualitative research focused on a specific issue or shared experiences in sub-cultures in specific settings, such as older adults experiencing chronic illness. However, examples of FE in gerontological research literature are few and there is limited methodological guidance on using FE. This presentation provides descriptions of FE based on existing literature and experience in ethnographic research. A systematic review of extant literature was conducted using CINAHL Complete, MEDLINE Complete (Ebsco), and PubMed. Published studies using FE are summarized to demonstrate the methodological foundation and the versatility of FE in exploring health issues in different populations and specific groups of older adults. Nursing students completing a course in chronic illness were trained to conduct an FE on one of the patients in their care. Students were provided a semi-structured interview guide based on the eight questions in Kleinman’s Patient’s Explanatory Model of Illness. The focused ethnographies were then analyzed by qualitative content analysis. Beliefs older adults hold about their chronic illness fell into three categories: regretting lifestyle choices, grieving loss of self, and finding a “new normal”. Focused ethnography is a relevant research method that can be used to understand health behavior of older adults and can be used to teach and evaluate cultural competency in nursing students.
Interprofessional Healthcare Education on Aging Increases Students' Confidence in Medication Management Skills
Authors: Finn Laura , Summers Deborah
Published: December 2020

Students studying for health care professions have limited opportunities to learn about medication use and aging in an interprofessional experience. Health Care students who interact in a simulation of age-related sensory changes can identify adaptations for safe medication use and counseling necessary to promote healthy aging. This research assessed the impact of a simulated team experience on pharmacy and physician assistant students’ confidence in understanding age related changes and in learning adaptations to promote safe medication use for older adults who may experience those changes. 63 pharmacy and 113 Physician Assistant students participated in 2-hour Interprofessional Education (IPE) sessions. The teams of pharmacy/physician assistant students utilized glasses to simulate changes in vision and gloves to simulate conditions of arthritis and neuropathy which increase in prevalence with age. Teams practiced skills of medication counseling and empathy towards their peers experiencing the simulations and learned medication administration adaptations for aging well. Pre survey results show a deficit of Pharmacist-Physician Assistant IPE with less than 20% of students reporting a strong understanding of the other profession’s role in developing an older adult’s care plan. Post survey results demonstrate an increase in students’ confidence in both understanding how sensory impairments may affect a patient’s ability to properly administer medication and confidence in counseling older adults on safe medication use. Descriptive data on learning in Interprofessional teams, Pre/Post comparison data and application to students studying other majors will be presented.
Medical Students' Longitudinal Learning With Older Adults: Geriatrics Education Mentor Program
Authors: Gugliucci Marilyn , Thieme Victoria
Published: December 2020

The University of New England College of Osteopathic Medicine (UNECOM) Geriatrics Education Mentor (GEM) Program is in its sixth year. It's a joint project between older community living adults and 2nd year medical students within the Osteopathic Clinical Skills course. The GEM program goal is to foster understanding and importance of the person/patient-provider relationship. Pairs of osteopathic medical students (N=87 +/- 5) were assigned to an older adult GEM (mentor) volunteer (N=87 +/-5) living within a 50 mile radius of UNECOM. Snowball sampling was used to recruit the GEMs; student participation is required. Four (4) home visits were conducted over 9 months with an assigned GEM; each visit included a new assignment. Students observed, summarized, and recorded experiences communicated by the GEM for each cumulative assignment. Data from assignments were “graded” and content analyses of open ended evaluation/summary questions were conducted. This program is UNE IRB approved. Student pairs completed all assignments. Assignments analysis on Blackboard revealed that students developed respect and awareness of life and medical experiences of the GEM; expressed understanding of the GEM’s life experiences and goals for what “matters most”. Relationships with older adults were established while students maintained professionalism and succeeded in competent and confident interactions. Documentation review from the 4 assignments aided in building students’ geriatrics knowledge, attitudes and skills. Pre-clinical medical education tends to be episodic; providing an opportunity to establish longitudinal assignments over the course of the academic year with the same older adult augments relationship skills and learning in geriatrics.
Starting an Older Adult Lecture for First Semester Nursing Students With a Truth or Myth Game
Authors: Brown Lynn , Tsai Pao-feng
Published: December 2020

False ideas about the physical and psychosocial characteristics of older adults exist in America. It is especially important that nurses are not susceptible to myths and stereotypes as these myths can affect the quality of patient care. For example, some people stereotype older adults as forgetful, disabled, ill, and unable to understand new information. Misconceptions and negative stereotypes are also present in first year nursing students. It is vital that students assess their own attitudes about older adults to form positive attitudes and gain knowledge about aging and health care needs. To achieve this goal, the older adult lecture in a first semester theory and fundamental course begins with a PowerPoint slide presentation asking students to distinguish truths and myths. The truth or myth topics include a) developmental tasks; b) common physiological changes; c) a comparison of delirium, dementia, and depression; and d) addressing health concerns of older adults. Active discussion follows the activity. Seventy to ninety percent of students correctly answered nine of ten questions related to older adult content on the final exam. Considering the increasing number of older adults in the health care setting, nurse educators must dismantle negative stereotypes with creative teaching strategies.
The Relationship Between Dementia, Race, and Schizophrenia Labeling in Nursing Homes Following the CMS Partnership
Authors: Fashaw Shekinah , Shireman Theresa , McCreedy Ellen , Bynum Julie
Published: December 2020

Preliminary research demonstrated an increase in the reporting of schizophrenia diagnoses among nursing home (NH) residents subsequent to the Centers for Medicare & Medicaid Services (CMS) National Partnership to Improve Dementia Care. Given known health disparities and higher antipsychotic use for Black NH residents, we examined how race and dementia influence the rate of schizophrenia diagnoses among NH residents. Using a quasi-experimental study design, we examined changes in schizophrenia reporting among long-stay NH residents’ quarterly and/or yearly Minimum Data Set 3.0 assessments between 2011-2015. Employing a difference-in-difference analysis adjusting for independent variables (e.g. demographics, diabetes, heart conditions, and functional status), we examined the relationship before and after the partnership. There were over 4 million MDS assessments annually. Schizophrenia reporting increased 12.3% in the dementia group as compared to 9.3% in the non-dementia group (p<0.0001). Black residents had a significantly higher likelihood of schizophrenia reporting (4%, p<0.0001). After controlling for covariates, there was a 16.5% increase in schizophrenia reporting for Blacks with dementia and 14.9% increase for non-Blacks with dementia (p<0.0001). There were no racial disparities identified among the non-dementia group after controlling for covariates. NH residents were more likely to have schizophrenia documented on their MDS assessments, and following the partnership, schizophrenia reporting rates increased faster for Blacks with dementia than their non-Black peers and their peers without dementia. Further work is needed to determine if schizophrenia diagnoses are appropriately employed in NH practice, particularly for Black Americans and persons with dementia.
Culture Change Initiatives in High Medicaid Nursing Homes: Does Time of Adoption Make a Difference?
Authors: Chisholm Latarsha , Ghiasi Akbar , Lord Justin , Weech-Maldonado Robert
Published: December 2020

Racial/ethnic disparities have been well documented in long-term care literature. As the population ages and becomes more diverse over time, it is essential to identify mechanisms that may eliminate or mitigate racial/ethnic disparities. Culture change is a movement to transition nursing homes to more home-like environments. The literature on culture change initiatives and quality has been mixed, with little to no literature on the use of culture change initiatives in high Medicaid nursing homes and quality. The purpose of this study was to examine how the involvement of culture change initiatives among high Medicaid facilities was associated with nursing home quality. The study relied on both survey and secondary nursing home data for the years 2017-2018. The sample included high Medicaid (85% or higher) nursing homes. The outcome of interest was the overall nursing home star rating obtained from the Nursing Home Compare Five-Star Quality Rating System. The primary independent variable of interest was the years of involvement in culture change initiatives among nursing homes, which was obtained from the nursing home administrator survey. The final model consisted of an ordinal logistic regression with state-level fixed effects. High-Medicaid nursing homes with six or more years in culture change initiatives had higher odds of having a higher star rating, while facilities with one year or less had significantly lower odds of having a higher star rating. Culture change initiatives may require some time to effectively implement, but these initiatives are potential mechanisms to improve quality in high Medicaid nursing homes.
The Relationship Between Technology Use and Colon Cancer Screening
Authors: Sun Na
Published: December 2020

Population aging is accompanied by an increase in chronic diseases such as cancer. Colon cancer is the third most common cancer and a leading cause of cancer death. Screening tests can aid early detection and treatment. It is unclear how information and communication technology (ICT), especially media through mobile devices, influences cancer screening. This study analyzes the relationship between ICT usage and colon cancer screening among U.S. adults. Data are from the second cycle of the Health Information National Trend Survey 5. Cancer screening included having one of the following: colonoscopy, sigmoidoscopy and/or stool blood test to check for colon cancer. Approximately 70% of respondents had at least some college education, 51% were female, and the mean age was 48 years. More than half of respondents report using apps on a tablet or smartphone for health and wellness purposes, and around 70% of them used apps for health communication and decision-making. Based on results of a binary logistic regression model, people who use mobile apps for discussions with health care providers (p<0.01), who use the internet to look for information about cancer (p <0.01), and who do not use mobile apps to make decisions about how to treat an illness or condition (p<0.01) are more likely to conduct cancer screening. ICT usage may enable people to gather information about cancer screening and improve patient and physician communication. Future studies should explore longitudinal associations between ICT usage, cancer screening, and cancer outcomes.
Dual Trajectories of Social Isolation and Dementia in Older Adults: A Population-Based Longitudinal Study
Authors: Xiang Xiaoling , Lai Patrick Ho Lam , Sun Yihang , Dunkle Ruth
Published: December 2020

The purpose of this study was to identify patterns of changes in social isolation and dementia and the interrelations between these developmental trajectories. The study sample included 7,609 Medicare beneficiaries age 65 and older from the National Health and Aging Trends Study 2011 through 2018 surveys. A group-based dual trajectory modeling approach was used to identify distinct groups of developmental trajectories for social isolation and dementia status over the 8-year period. The dual model provided estimates of conditional and joint probabilities linking the two sets of trajectory groups. Changes in social isolation over an 8-year period followed four trajectories: rarely isolated (62.2%), steady increase (13.5%), steady decrease (7.4%), and persistently isolated (16.9%). Changes in dementia risk also followed four trajectories: persistently low risk (80.4%), increasing with early onset (3.9%), increasing with late onset (4.5%), and persistently high risk (11.2%). Over two-third (68%) of the persistently low dementia group were also in the rarely isolated group. Both increasing dementia groups were composed mainly of individuals from the increasing social isolation group (40-43%) and persistently isolated group (24-29%). The persistently high dementia group had the most overlap with the decreasing social isolation group (47%), followed by the persistently isolated group (28%). For the most part, social isolation and dementia evolve in the same direction for older adults over an 8-year period. However, the pattern of associations between these developmental trajectories is complex and may be reversed among long-term dementia survivors.
The African Immigrant Memory Loss Project: A University-Community Partnership
Authors: Nkimbeng Manka , McCarron Hayley , Bustamante Gabriela , Russell Wynfred , Shippee Tetyana , Gaugler Joseph
Published: December 2020

The few studies on dementia prevalence in immigrant communities show that immigrants from diverse racial/ethnic backgrounds have a higher prevalence of dementia compared with their U.S.-born counterparts. However, this body of work is small, resulting in a lack of reliable estimates of dementia prevalence among African immigrants. The AIMLP is a partnership between the African Career, Education, and Resources, Inc. (ACER) and the Families and Long-Term Care Projects (FLTC) of the University of Minnesota School of Public Health. Guided by an advisory board, the goal of this project is to develop culturally informed instruments, and use these to collect data to identify dementia care needs, knowledge, and resources in the African immigrant community. Study implementation started in August 2019, five advisory board meetings have been convened and 2 pilot focus groups have occurred. Twelve individuals participated in the focus groups. The majority (90%) were from Liberia and 60% were over the age of 55. Two participants currently care for a family member with dementia. Preliminary findings reveal a great need for education on dementia, and general lack of awareness on management, and limited access to services/supports. Focus groups will be finalized in March and the study survey will be developed and administered in the summer. These survey findings will be available and presented at the conference in November 2020. This is the first project to identify the extent of dementia care needs and resources among African immigrants; which will inform interventions for this population.
The Gendered Effects of Education and Acculturation on Older Korean Immigrants’ Cognitive Function
Authors: Choi Eun Young , Jang Yuri , Chiriboga David
Published: December 2020

This study advances knowledge concerning older immigrants’ cognitive health by examining the role of gender in the context of education, acculturation, and cognitive function. Guided by an emerging Gendered Process of Acculturation framework, we hypothesized that the cognitive health of men and women would benefit differently from a high level of education and acculturation. Cognitive health was measured with the Mini-Mental State Examination. Data were drawn from the Study of Older Korean Americans (SOKA), a multi-site survey of Korean Americans aged 60 and over (N = 2,061). Multivariate linear regression analyses were conducted to investigate the moderating role of gender in the effects of (1) education, (2) acculturation, and (3) the association of education and acculturation on cognitive function. Gender was found to be a significant moderator in the relationship of education and acculturation with cognitive health: the positive effect of both education and acculturation was greater among women than men. Furthermore, the three interaction among education, acculturation, and gender was significant: the positive impact of education on cognition was particularly pronounced among women with low acculturation and eliminated gender differences in cognitive status. Our findings suggest that gender plays a critical role in determining the cognitive health benefit arising from education and acculturation singularly and in concert, highlighting the vulnerability of women with low education and acculturation. These findings have implications for social interventions targeting immigrant populations.
The Mediation Role of Socioeconomic Status on Racial and Ethnic Differences in Advance Care Planning
Authors: Han Junghee , Nam Taekbeen
Published: December 2020

Background. Most research on EOL care planning has focused on racial/ethnic differences in completing advanced directives (AD) rather than the pathways of the disparities. Therefore, this study aims to examine the mediating role of education and income in racial/ethnic differences in EOL care planning. Methods. A secondary data analysis of Health and Retirements Study (HRS) 2004-2014 wave was used. The sample included 6,518 participants ((≥ 65 years old). The independent variable measured the respondents’ race and ethnicity and the dependent variable measured the completion rate of living wills or the Durable Power of Attorney of Health Care (DPAHC). Covariates included gender, age, marital status, religion, place f birth, educational attainment, income, cognitive function, limitations in physical functioning, geriatric syndromes, and the number of progressive chronic disease. Results. The hierarchical logistic regression analysis showed that race/ethnicity was a significant predictor of completing AD (p≤0.001). Mediation analysis, Karlson, Home, and Breen (KHB), revealed that both education and income explained 14.4% of racial/ethnic differences in completion of living wills for non-Hispanic Blacks and 17.6% for Hispanics. Similarly, education and income accounted for 17.6% of racial/ethnic disparities in completion of DPAHC for non-Hispanic Blacks and 20.9% for Hispanics. In particular, education had stronger mediating effect on the outcome variables than income. Discussion. The findings suggest the importance of targeted educational interventions for people of color with lower SES to raise their awareness of benefits of advance care planning and increase their access to higher quality of EOL care.
Toward a Comparative Study of Collective Memory and Citizenship Among Older Adults With Dementia
Authors: Robbins Jessica
Published: December 2020

This poster explores new directions for understanding possibilities for citizenship among older adults with dementia, who often experience loss of citizenship and diminishment of personhood due to their diagnosis. Drawing on data from two distinct ethnographic studies—one on memory and personhood in a day center for people with Alzheimer’s disease in Poland, and the other on gardening and wellbeing among older African Americans without cognitive impairment in Detroit—this poster asks how the collective past may shape experiences of dementia and possibilities for citizenship in the present. In Poland, practices of remembering involving collective memory can sustain personhood and foster ties of relatedness among people with dementia. This apparent paradox between people with dementia’s loss of memory and their capacity to build social relations based on remembering can be resolved through expanding understandings of personhood to include practices of remembering involving collective pasts (e.g., shared national frameworks, embodied practices of sociality). In Detroit, gardening fosters connections with the past, as older African Americans are reminded of deceased loved ones through practices and the plants themselves. These intimate connections and everyday activities are situated in racialized histories of migration, disinvestment, and “revitalization,” even as they provide the means to cultivate life in the present. This poster concludes that the potential for collective pasts to generate life in the present can become evident through ethnographic research among people with dementia, and in particular, through studying gardening among people with dementia.
Aging With HIV: Inflammation Is Associated With Pain, Poorer Physical Function, and Frailty
Authors: Derry Heather , Johnston Carrie , Burchett Chelsie , Siegler Eugenia , Glesby Marshall
Published: December 2020

With advances in antiretroviral therapies, people living with HIV have life expectancies similar to their HIV-negative peers. Yet, they experience elevated multi-morbidity that can compromise quality of life as they age. Links between inflammation and accelerated aging may inform interventions, but these links are understudied in older adults with HIV. We investigated cross-sectional relationships between inflammation, well-being, and geriatric syndromes among 161 HIV-positive older adults. Participants provided fasting blood samples (for serum cytokines and CRP) and completed surveys (MOS-HIV; falls) and cognitive (MoCA) and frailty assessments (using Fried criteria). Adjusted linear and logistic regression models tested relationships between inflammatory markers and age-related health outcomes, controlling for age, gender, BMI, race, comorbidity burden, statin use, and smoking status. 93% had suppressed viral load. 11% had CRP levels suggesting possible acute illness (>10 mg/L) and were excluded from analyses. Participants with higher IFN-γ reported greater pain (p=0.003), greater cognitive complaints (p=.02), and worse physical function (p=0.04), than those with lower IFN-γ. Similarly, higher IL-6 levels were related to worse physical function (p=0.01) and slightly greater cognitive complaints (p=0.06), but were not significantly related to pain in adjusted models. Compared to those with lower IL-6, those with higher IL-6 levels were more likely to be frail (p=0.04). CRP was not significantly related to these outcomes. Six-month fall history and objective cognitive scores were not significantly related to the assessed inflammatory markers. Our results illustrate key, expected links between inflammatory processes, frailty, physical function, and pain among older adults with HIV.
Racial Disparities in Cognitive Functioning: The Mediating Role of Social Resources
Authors: Haq Kazi Sabrina , Penning Margaret
Published: December 2020

Despite frequent recognition of disparities in cognitive functioning between White and non-White older adults, the pathways or mechanisms through which race affects cognitive functioning have yet to be elucidated. The research questions addressed in this paper are: 1) Is there a relationship between racial minority status and cognitive functioning in middle and later life? 2) To what extent do social resources (i.e., social support, social networks, and social participation) mediate the relationship between racial minority status and cognitive functioning? 3) Finally, drawing on intersectionality theory, if social resources do mediate the relationship between racial minority status and cognitive functioning, to what extent is this mediation effect moderated by the interaction of gender and Socioeconomic Status (SES)? Using cross-sectional data drawn from the Canadian Longitudinal Study on Aging (CLSA) with a sample of over 50,000 Canadians (2010-15) aged 45 to 85 years, multivariate regression analyses (OLS, logistic, multinomial logistic) assess the mediating effect of social resources on the relationship between racial minority status and cognitive functioning. Controlling for age, gender and other relevant determinants, preliminary results reveal that racial disparities in cognitive functioning (i.e., lower cognitive test scores) exist in Canada and that this relationship is partially mediated by some indicators of social resources (e.g., functional social support, emotional social support). Our findings suggest the need for interventions targeted at increasing social resources for racial minority groups to cope with the risk of developing cognitive impairment in later life.
Older Adult Volunteers in Intergenerational Programs in Educational Settings Across the Globe
Authors: Lee Youjung , Kim Young-Mi , Bronstein Laura , Fox Vince
Published: December 2020

Volunteerism is a global phenomenon that aids multiple generations. Considering the positive evidence of volunteering among older adults and their desire for intergenerational engagement, it is important to explore older adult volunteers’ experiences in intergenerational programs with a specific focus on the cultural and social impacts of volunteering in educational settings in later years. Using a phenomenological qualitative approach, 43 interviews with older adult volunteers (23 in Korea and 20 in the USA) in intergenerational programs were conducted. Participants were recruited from the Beautiful Story Grandma (BSG) in Korea and the Foster Grandparent Program (FGP) in the USA in 2019. Due to the prescribed nature of the BSG, all of the Korean volunteers were female. The USA volunteers from the FGP included three African Americans, one Asian, and 16 White older adults. Two FGP volunteers were male. Korean participants lived primarily in Busan Metropolitan city (mean age: 63, range: 61-73). The USA volunteers were from urban/suburban areas New York State (mean age: 74, range: 60-84). Two major themes emerged from the interviews revolving around the role of culture and other demographics in the experience of volunteering: (1) Older adults experience benefits from volunteering to support the younger generation that transcend demographic and geographic differences; and, (2) distinctive cultural views of education lead to different experiences of volunteering in the two countries. The comparative research highlights the need for development of a model for culturally responsive practice with older adult volunteers in a global context.
Understanding Nursing Turnover: The Case of Home Health Care
Authors: Spetz Joanne , Bergman Alon , Song Hummy , Rose Amber , David Guy
Published: December 2020

Only a few studies of nursing turnover have examined post-acute home health care. This study examines factors that are associated with home health licensed nurse turnover using linked employee-level and patient-level data from one of the five largest home health companies in the US. The data include variables from human resources and payroll systems, visit logs, discharge records, physical and mental health assessments, care plans, and patient encounters and is organized at the employee-day level. We measured turnover using human resources data, including measures of voluntary and involuntary job separation, and from exit interviews that allow classification of whether turnover was associated with agency-related factors (e.g., pay, schedule, supervisor, coworkers) versus personal factors (e.g., family needs, relocation). In bivariate and multivariate analyses, explanatory variables included nurse demographics, patient population characteristics, and the degree to which nurses can delegate tasks to home care aides. We found a downward trend in turnover for licensed nurses between 2016 and 2019. Attrition in the first year was 34% for full-time nurses and 45% for part-time nurses, most of it occurring in the first 180 days of employment. The rate of voluntary turnover was nearly four times as great as involuntary turnover. We found that agency factors accounted for 26% of monthly turnover on average, while personal factors accounted for 74%. In states in which licensed nurses could delegate more tasks to home care aides, turnover rates were slightly higher than in states with little delegation.
Assessing the Impact of Older Americans Act–Funded Services on Caregiver Stress
Authors: Chubb Racheal , Wilmoth Janet
Published: December 2020

Funding for OAA programs that support caregivers and care recipients has steeply declined since 2010. This is potentially problematic given these programs provide services that may reduce caregiver stress. To better understand what and for whom caregiving services reduces stress, we used data from the National Survey of Older Americans Act Participants (NSOAAP) to estimate logistic regression models predicting caregiver stress. These models include the following measures: services provided to the care recipient, services received by the caregiver, and caregiver satisfaction with services received; caregiver health, age, race, and gender; and care recipient health, age, gender, relationship to the caregiver, and coresidence with the caregiver. The results indicate that caregivers who were satisfied with services were less likely to be stressed compared to those who are not satisfied with services. Those who received respite care and counseling services were less likely to be stressed than those who attended classes and training. Consistent with the literature, caregivers who reported better health or cared for someone in better health were less likely to be stressed. Caregivers were also more likely to be stressed if they provided help with medical care compared to ADLs or if they lived with the care recipient. Overall, the results underscore the importance of continued, and possibly expanded, OAA funding for caregiver support services, especially those that provide respite and counseling to individuals who are providing care to frail and co-residential older adults.