bluuebunny/crossref_metadata_2025_split huggingface dataset:
CELL NON-AUTONOMOUS SEROTONIN SIGNALING MEDIATES STRESS RESISTANCE AND LONGEVITY
Authors: Leiser Scott , Miller Hillary , Huang Shijiao 
Published: November 2019

Abstract
The ability of organisms to perceive and respond to their environment is crucial to their long-term survival. Recent studies in model organisms identify signaling pathways that perceive environmental stress and cell non-autonomously modify systemic physiology. These pathways often originate in the neurons, where key cells monitor the external environment for changes including food availability, air-quality, and the presence of dangerous toxins. Our previous work identified a key role for serotonin signaling in the induction of flavin-containing monooxygenase-2 (fmo-2) downstream of hypoxic signaling. fmo-2 expression is necessary and sufficient to promote stress resistance and longevity downstream of multiple genetic pathways, making it a useful tool for identifying key components of these pathways. Our current data defines environments, pathways, and signaling molecules that induce fmo-2 and subsequently increase lifespan. Our resulting data define key roles for serotonin signaling and fmo-2 that rely upon the perception of oxygen and food.
RESTORATION OF HYPOXIA SIGNALING IMPROVES AGING-ASSOCIATED LOSS OF SKELETAL MUSCLE REGENERATIVE POTENTIAL
Authors: Udeh Kodi , Li Bin , Endo Yori , Panayi Adriana , Sakthivel Dharaniya , Neppl Ron , Wagers Amy , Sinha Idranil 
Published: November 2019

Abstract
Skeletal muscle retains the ability to regenerate throughout life, but this decreases significantly with aging. The present study investigates whether aging-associated loss of muscle hypoxia signaling limits regenerative potential. Utilizing young (3 months) and old (22-24 months) mice, skeletal muscle from old mice exhibited a 40% decline in the cross-sectional area (CSA) of newly regenerating fibers following cryoinjury at day 10 (p &lt; 0.01) post-injury as compared to young. Focused PCR array demonstrated a greater than 3-fold decline in expression of the majority of hypoxia signaling genes. In particular, aryl hydrocarbon receptor nuclear translocator (ARNT), which is required for downstream hypoxia signaling and the transcription of hypoxia response genes, is 5-fold lower for both gene expression (p &lt; 0.01) and protein levels (p &lt; 0.01) in old versus young mice. To determine the effects of ARNT on muscle regeneration, we utilized a genetically modified mouse which results in an 80% decrease in ARNT gene expression following activation, specifically in skeletal muscle. Compared to littermate controls, mice with a muscle specific knockdown of ARNT (mKO ARNT) exhibit a 30% decline in regenerating fiber sizes at day 10 (p &lt; 0.01) following cryoinjury, without any loss of regenerative potential in FACS isolated satellite cells ex vivo. Administration of a pharmacologic hypoxia activator, ML228, induced a 30% increase in regenerating fiber CSA in both old mice and mKO ARNT mice (p &lt; 0.01) as compared to treatment with vehicle control. These data suggest hypoxia signaling declines with aging in skeletal muscle and activation of hypoxia signaling may promote regeneration.
CHRONIC DISEASE SELF-MANAGEMENT PROGRAM ATTENDANCE AMONG AFRICAN AMERICANS WITH ARTHRITIS AND COMORBIDITIES
Authors: Mingo Chivon A , Washington Tiffany R , Smith Matthew L 
Published: November 2019

Abstract
African Americans (AA) are 17% less likely to be diagnosed with arthritis compared to Whites, yet disproportionately burdened by arthritis symptoms. AA are overrepresented in the diagnosis and burden of other chronic conditions (diabetes, heart disease), highlighting the need to engage them in evidence-based Chronic Disease Self-Management Education (CDSME) Programs. This study examines how disease profiles may influence program attendance. Using a multinomial logistic regression, data were analyzed from AA with arthritis (N=20,541) who attended CDSME programs in 48 states. Relative to those with only arthritis, participants with more complex disease profiles were less likely to attend an arthritis-specific program (P&lt;0.001) and more likely to attend a diabetes-specific program (P&lt;0.001). Those with more complex disease profiles were more likely to attend programs at healthcare organizations and residential facilities, and less likely to attend in faith-based organizations (P&lt;0.001). Understanding barriers and facilitators to program attendance have policy and public health implications.
YOU HAVE TO BE STRONG TO GET OLD: MIDDLE-AGE CAREGIVING, WISDOM DEVELOPMENT, AND LIFE PLANNING AMONG OLDER ADULT WOMEN
Authors: Hartikka Kathryn 
Published: November 2019

Abstract
This study explores women’s development of wisdom in older adulthood resulting from caregiving of aging parents and spouses during their middle age years. As a way to grasp the complexity of middle age care work influencing wisdom development in older adulthood, this study used in-depth case analysis with in-depth interviews of three older adult women from the Silent Generation, ranging in birth years from 1933 to 1944. Women self-identified wisdom through themes such as compassion, knowledge attainment, and resilience resulting from their care work. This study also captured the significance of their caregiving in middle age as a turning point in their lives, marking their physical health and capabilities as notably stronger compared to their present selves in older adulthood. These women also illustrated increased awareness of their own mortality through caregiving. Jointly, these women self-identified their roles as caregivers as uniquely female roles. While all noted being confronted with care work as unexpected in their life path, these women believed in having a natural inclination to nurture and care, coupled with social pressures, leading to their ultimate caregiving. This study unearthed deeper meanings these women had for their lives resulting from caregiving, manifesting as knowledge gained about life, health, and aging. Thus, inspiring their own decision-making as they approach even older adulthood experiences such as dependency and death. This study ultimately illustrates the importance of caregiving on women’s lives: marking their middle age, increasing their wisdom development, and influencing their life planning as they age.
INFLUENCE OF HEALTH AND SOCIAL SUPPORTS ON OUTCOMES POST-REHABILITATION FOR HIP FRACTURE SURGERY: SYSTEMATIC REVIEW
Authors: McGilton Katherine , Vellani Shirin , Bayly Melanie , Tanjong-Ghogomu Elizabeth , Iaboni Andrea , Lapenskie Julie , Welch Vivian , Omar Abeer 
Published: November 2019

Abstract
Background: Older adults who sustain hip fractures encounter physical and functional decline after discharge from inpatient rehabilitation. Currently, a synthesis of literature is lacking on health and social supports that may impact outcomes in the community-dwelling older adults, post-discharge from rehabilitation. Methodology: We conducted a systematic review to a) evaluate how health and social supports influence outcomes for older adults and their caregivers following inpatient rehabilitation post-hip fracture surgery, and b) identify the factors that affect their impact on outcomes. We searched Medline, CINAHL, Embase, Emcare, Psychinfo, and Ageline for publications between 2000 and 2018. We followed Cochrane Handbook methods to screen titles and abstracts, appraise quality, collect data and synthesize results. Results: A total of 3364 articles were retrieved, and 34 studies were included for final synthesis, including 24 randomized control trials and 10 observational studies. Most studies excluded persons with moderate or severe cognitive impairment. Interventions can be broadly categorized as either comprehensive care delivered by interdisciplinary teams focusing on exercise, nutrition and fracture prevention; or exercise sessions delivered by health professionals, trained instructors or volunteers. Interventions involving interdisciplinary teams demonstrated moderate improvement of mobility and functional ability in the first 3 months. However, the longitudinal effects of interventions were not realized for all. Conclusion: This review provides evidence of the effectiveness of health and social supports provided to older adults post-hip fracture. We are uncertain of the applicability to people with cognitive decline due to exclusion from most studies. Implications for practice and research will be discussed.
THE IMPACT OF THE OPIOID EPIDEMIC ON OLDER ADULTS: FINDINGS FROM A NATIONAL SURVEY OF COMMUNITY-BASED ORGANIZATIONS
Authors: Cameron Kathleen A , Popham Lauren E , Herrera-Venson Angelica 
Published: November 2019

Abstract
The National Council on Aging (NCOA) conducted a national survey of community-based organizations (CBOs) in early 2019 to better understand how older adults, people with disabilities, and their caregivers are affected by the opioid epidemic and identify new resources and tools needed by CBOs to better serve their community needs. Specifically, the survey asked about the extent to which CBOs’ service delivery and level of effort has changed as a result of the opioid epidemic; unique issues reported by this population, directly or indirectly resulting from opioid misuse by them or loved ones; how organizations screen and refer older adults and individual with disabilities for support associated with opioid misuse; how organizations may be connecting with local or state initiatives addressing the opioid epidemic, or forming strategic partnerships to respond to emerging client needs; and pinpoint gaps in resources that may help organizations to more effectively respond to these issues. Over 200 organizations, representing urban, suburban and rural communities, responded to the survey and included senior centers, area agencies on aging, Senior Health Insurance Assistance Programs, as well as health care organizations. Seventy percent of organizations report spending more effort to address the needs of older adults/caregivers who are adversely affected by opioid misuse/abuse since 2 years ago. Common health and financial concerns, current strategies related to screening, partnership development, and educational programming as reported by CBOs will be presented. This session will include a discussion of opportunities to assist CBOs address the opioid-related needs of their older adult clients.
FAMILY CAREGIVER FACTORS AND HOSPITALIZATION IN DISABLED OLDER ADULTS WITH AND WITHOUT DEMENTIA
Authors: Amjad Halima , Mulcahy John , Kasper Judith D , Burgdorf Julia , Roth David L , Covinsky Kenneth , Wolff Jennifer L 
Published: November 2019

Abstract
Older adults with disabilities commonly rely on family caregivers’ help, yet effects of caregiver factors on patient outcomes are poorly understood. Within this population, dementia is common. Our objective was to evaluate the association between caregiver factors and risk of hospitalization in disabled older adults with and without dementia. We examined 2,589 community-living older adults with mobility/self-care disability and their primary family caregiver in four waves of the National Long-Term Care Survey and National Health and Aging Trends Study. We used Cox proportional hazards models to examine risk of one-year, Medicare claims-derived, all-cause hospitalization as a function of caregiver factors, adjusting for older adult characteristics (sociodemographics, comorbidities, healthcare utilization) and survey year, considering dementia a characteristic of interest. Among disabled older adults, 38% were hospitalized over one year, and 31% had probable dementia. Hospitalization rates were similar for older adults with and without dementia (39.5% and 37.3% respectively); dementia was not associated with hospitalization risk (HR 1.09, 95% CI 0.95-1.26). Older adults demonstrated greater risk of hospitalization if their caregiver was male (HR 1.31, 95% CI 1.10-1.56), new to caregiving (HR 1.61, 95% CI 1.27-2.04 for &lt; 1 year versus ≥ 4 years), or helped with healthcare tasks (HR 1.21, 95% CI 1.04-1.41). The association between most caregiving factors and hospitalization risk did not differ by dementia status. Results suggest that strategies to reduce hospitalization in older adults with disabilities could target select caregivers using similar strategies in populations with and without dementia.
IT’S THE LITTLE THINGS THAT COUNT: IMPLICATIONS OF DAILY EXPERIENCES FOR WELL-BEING AND BIOLOGICAL INDICATORS
Authors: Birditt Kira S 
Published: November 2019

Abstract
Middle-age and older adults vary widely in their physical health. This symposium describes studies that identify diverse daily experiences that account variation in health using multiple indicators of well-being (self-reported, biological). Fingerman et al. assessed daily TV viewing among older adults and found that more frequent television watching was associated with poorer physical health, worse health behaviors, and less energy expenditure (via actical watch). Leger et al., examined links between daily affect and sleep. Greater variability in daily positive affect is associated with fewer hours of sleep and greater morning tiredness even after adjusting for mean levels of affect. Luong et al. examined links between daily stress and affect. Interpersonal stressors were associated with greater affect reactivity than non-interpersonal stressors and links were reduced among older adults. Birditt et al. assessed links between daily social interactions and cardiovascular reactivity. More frequent social interactions and negative social interactions were associated with increased heart rate and links varied by gender and race. Polenick et al. examined links between daily social interactions and salivary DHEA-S (a marker of the stress response). Positive interactions predicted greater DHEA-S over the course of the day and links between negative interactions and DHEA-S varied by age group such that younger individuals appeared to be more reactive. These studies offer important clues regarding how daily experiences get under the skin to influence health and well-being.
AGE DIFFERENCES IN CONCORDANCE BETWEEN LAB AND DAILY LIFE STRESS RESPONSES
Authors: Luong Gloria , Arredondo Carla M 
Published: November 2019

Abstract
The literature is mixed with respect to how stress reactivity changes with age. Previous studies have overlooked contexts, ignoring whether stressors occurred in the laboratory or in daily life. The Health and Daily Experiences (HEADE) study includes 126 younger and older adults who completed both laboratory stressors and ecological momentary assessments (EMA) of affect and stressor experiences in daily life. We found that the laboratory stressor elicited the greatest levels of negative affect reactivity (i.e., larger increases in negative affect) and positive affect reactivity (i.e., larger reductions in positive affect) compared to the two types of daily life stressors. Interpersonal stressors were associated with greater negative and positive affect reactivity compared to non-interpersonal stressors in daily life. Younger adults exhibited greater stress reactivity than older adults. Together, these findings support age-related reductions in stress reactivity. Implications for understanding stressor-health links are discussed.
DAILY SOCIAL INTERACTIONS AND BIOLOGICAL STRESS REACTIVITY: ARE THERE AGE DIFFERENCES?
Authors: Polenick Courtney A , Zarit Steven H , Birditt Kira S 
Published: November 2019

Abstract
Older people experience fewer negative social interactions and report less anger and stress when faced with interpersonal tensions. Little is known, however, about age differences in biological responses to social interactions. We evaluated how salivary DHEA-S, a key indicator of stress reactivity, is associated with daily positive and negative social interactions among midlife and older adults. Participants were drawn from the Daily Health, Stress, and Relationship Study, which includes 93 adults age 40 to 95 who completed 14 days of daily diary interviews and provided saliva samples on four of those days. Multilevel models showed that people had higher DHEA-S on days in which they reported more positive interactions. Older respondents were less reactive to negative interactions relative to younger respondents. These findings indicate that positive social interactions may benefit biological stress reactivity regardless of age, whereas older adults are more resilient to the adverse effects of negative social interactions.
CULTURALLY COMPETENT CARE FOR OLDER SEXUAL MINORITY ADULTS: A SYSTEMATIC REVIEW FOR HEALTHCARE DELIVERY
Authors: Saliba Debra , MacCarthy Sarah , Darabidian Biayna , Elliott Marc N 
Published: November 2019

Abstract
Recent attention to culturally competent care has largely overlooked the needs of older LGB adults. To address this, we conducted a systematic literature review and make recommendations for how the healthcare workforce can reduce sexual-orientation-based disparities. We searched PubMed, PsycINFO & CINAHL for manuscripts 1/1/10-6/19/18 (n=799), deduplicating, dually-screening abstracts (n=80), reviewing full-text articles (n=44), and classifying relevant articles (n=27) into five domains of cultural competency and associated recommendations: 1) Physical environment: display pictures with older same-sex couples and LGB-identified symbols; 2) Education/staffing: expand to include older-specific LGB issues, especially for key conditions (e.g., cancer, dementia,) and hire LGB-identified administrative/clinical staff; 3) Inclusive language and communication: review terminology on forms, electronic health records, and used with patients to ensure a broad range of terms (e.g., partner/spouse) and note older LGB may have more limited understanding/comfort with terminologies (e.g., self-identify as ‘something else’ instead of ‘gay/lesbian’ or ‘bisexual’); 4) Patient histories: discuss how factors particular to their sexual orientation (e.g., level of outness) may affect their support networks; 5) Subgroup differences: consider specific health concerns by sexual minority subgroups (e.g., healthy weight for lesbian women, HIV for gay men, and negative health outcomes for bisexual adults related to their simultaneous isolation from sexual minority and heterosexual communities) and note additional challenges based on characteristics such as race/ethnicity and urbanicity. Cutting across these domains are the ways in which local and national policies affect healthcare access and surrogacy (e.g., legality of same-sex partners to obtain health insurance, participation in medical decision making/visitation).
IMPROVING HEALTH CARE OF LGBT OLDER ADULTS: INTERDISCIPLINARY PROJECT ENHANCES HEALTH OUTCOMES
Authors: Rowan Noell L , Smith Stephanie D , Arms Tamatha , Hohn Kris L 
Published: November 2019

Abstract
To date, there is a dearth of interdisciplinary simulation education and research that involves LGBT older adults within schools of social work and nursing. The purpose of this mixed method study was to examine the use of an intervention among social work and nursing students to determine if lecture and simulations impacted their health-related knowledge and cultural sensitivity/awareness of health provisions with LGBT older adults. Interprofessional faculty created lecture and interdisciplinary simulations with actual members of the older LGBT communities using simulation clinic/lab and health care scenarios. An adapted survey with permission from Grubb et al (2013) was used to include quantitative and qualitative measures of cultural awareness with LGBT populations. Pre-Post test data were analyzed using Generalized Linear Models in SAS software. Results indicated that the intervention positively changed perceptions and increased knowledge among (N=90; 32 social work; 58 nursing) allied health students. Statistically significant change experiences in their work with LGBT individuals were noted to positively alter their beliefs about sexuality, gender identity, and sexual development (Agree to Strongly Agree, X2(1)=26.51, p&lt;0.001). Qualitative findings include four primary themes about how gender identity and sexual orientation influences health: (a) bias of health care providers, (b) access to quality care, (c) specific health care needs, and (d) health risks of LGBT older adults. As older adults continue to be the largest population needing health care, it is imperative that professionals are trained to give culturally sensitive health care and demonstrate this competency in their practice and interpersonal interactions with clients.
SOCIAL ISOLATION AMONG LGBT OLDER ADULTS: LESSONS LEARNED FROM A PILOT FRIENDLY-CALLER PROGRAM
Authors: Perone Angie , Ingersoll-Dayton Berit , Watkins-Dukhie Keisha 
Published: November 2019

Abstract
Lesbian, gay, bisexual, and transgender (LGBT) older adults face heightened risks of social isolation, given decades of discrimination. Research on telephone buddy programs with non-LGBT participants have proved predominantly unsuccessful at addressing social isolation and have found the greatest success with same-age matches. However, evidence suggests that LGBT adults may actually benefit from telephone buddy programs and in ways uniquely different from other groups. This article shares lessons learned from 30 participants across a 12-month pilot program that matched LGBT older adults to both LGBT and non-LGBT volunteer callers of various ages. One-third of participants identified as African American or Black. This project employed community-based participatory action research to identify, execute, and evaluate the program. Data includes information from questionnaires and telephone interviews prior to and during the program. In contrast to other research, data here revealed strong support for intergenerational matches. LGBT older adults of color especially benefited from program referrals and matches with/from LGBT adults of color, regardless of age. While the project aimed to capture two groups (LGBT older adults experiencing isolation and volunteer callers), the project revealed a third group: LGBT adults at risk of social isolation. This third group usually emerged among the “volunteer” callers but also identified concerns and risk factors for social isolation. The program also revealed unexpected benefits to both LGBT and non-LGBT volunteers, including less loneliness and a stronger sense of community. This article concludes with recommendations for developing similar programs to reduce social isolation in the LGBT community.
LONG-TERM CARE II EFFECTS OF A NEW VALUE-BASED REIMBURSEMENT SYSTEM ON EXPENDITURES AND CARE QUALITY IN MINNESOTA NURSING HOMES
Authors: Hass Zachary , Cooke Valerie , Arling Greg 
Published: November 2019

Abstract
Although several states have implemented Value Based Reimbursement (VBR) systems in long-term care; little is known of their impact. In 2016, Minnesota passed new VBR legislation to tie payment to quality with increased funding earmarked for nursing and other care-related services. We evaluated the effect of the policy change on care-related expenditures and measures of care quality. Data sources were cost reports and quality measures for the years 2013-2017 from 348 Minnesota nursing homes. Analysis consisted of descriptive tables, time plots, and linear growth curve modeling. We found increased expenditures for nursing and care-related services, particularly nursing assistants, during the first year; while quality metrics did not appear to be impacted by the policy change. Some differentiation was seen across facilities in their response to the policy change based on occupancy rate, rural-urban continuum code, attachment to a hospital, and resident acuity. The lack of an improvement in care quality might be attributable to VBR design as the quality incentive affected very few facilities. Additionally, there is the challenge of improving quality metrics even with additional resources. The legislature is currently considering changes to VBR policies in response to the report from this study.