bluuebunny/crossref_metadata_2025_split huggingface dataset:
EATING THE PAIN AWAY: THE USE OF FOOD AS A COPING MECHANISM IN OLDER ADULTS EXPERIENCING CHRONIC PAIN
Authors: Felpeto Alexandra , Ramos Alexandra M , Hincapie Diana , Lenox Madison B , Reinhardt Rebecca 
Published: November 2019

Abstract
Individuals experiencing pain rely on impulse to make decisions, including choices regarding food consumption (Darbor, Lench, & Carter-Sowell, 2016). This study examined whether older adults experiencing chronic pain report higher instances of emotional eating in comparison to a population of older adults not experiencing chronic pain. Data stemmed from the Midlife in the United States study was analyzed to investigate whether individuals used food as a coping mechanism for chronic pain symptoms (Ryff et al., 2017). The sample consisted of Americans aged 60 to 74 years of age. Pain conditions included: has chronic pain (n=686) and does not have chronic pain (n=1036). Results of the Independent Samples T-Test indicated that participants were found to be engaging in emotional eating when experiencing chronic pain symptoms, as hypothesized. Participants in the has chronic pain condition reported relying on food as a coping mechanism more (M= 3.66, SD= 1.87) than participants in the does not have chronic pain condition (M= 3.42, SD= 1.71); t(1370)= 2.71, p= .007, d= 0.13. Results suggest that older adults experiencing chronic pain report utilizing food as a coping mechanism more than older adults that do not experience chronic pain. These findings have health implications given the rising obesity rates associated with persistent pain. Future directions may include studies on the negative health outcomes that result from high instances of emotional eating in older adults experiencing chronic pain. Additionally, investigating alternative coping mechanisms for chronic pain would be beneficial to diminish the harmful health effects of emotional eating.
EXPERIENCE OF STROKE RECOVERY FOR WOMEN 60 OR OLDER: USING AUTO-PHOTOGRAPHY TO ENHANCE THE NARRATIVE PROCESS
Authors: Johnson Iona 
Published: November 2019

Abstract
Stroke is a common health concern in the U.S. with 795,000 new strokes each year. Women dominate these numbers, with 55,000 more strokes per year than men, yet they are underrepresented in stroke research. Some research indicates that women have worse physiological and psychosocial outcomes after stroke than men, yet little is known about how they experience recovery. This study used a qualitative phenomenological approach to address the question: “What is the experience of stroke recovery for community dwelling women age 60 or older?” The participants were 10 women, ages 60 – 78, with times post-stroke ranging from 4 months to 15 years. They participated in 2 semi-structured interviews, with auto-photography used to enhance sharing of information. Between the two interviews, they were provided with a digital camera and asked to take pictures that helped to explain their lives before and after stroke. During the 2nd interview, participants described their pictures, and answered additional questions about their recovery. Interviews were transcribed verbatim, and the narratives were coded and analyzed thematically to describe how this sample of individuals experienced stroke recovery. Four overarching themes emerged from the data: 1) the stroke event, 2) a new chapter, 3) meaning and process of recovery, and 4) self-identity. In general, narratives revealed that recovery is described as a complex, individualized, and subjective experience that extends beyond overt physical abilities. Participants in this study experienced changes in self-identity and described a “new normal” after stroke. Implications and recommendations for rehabilitation, research, and policy are discussed.
HOW MULTIPLE CHRONIC DISEASE BURDEN INFLUENCES COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAM PARTICIPANTS
Authors: Turner Keith W , Yin Cheng 
Published: November 2019

Abstract
Background: Studies have shown that participation in community-based self-management education programs can result in improved healthful behaviors (exercise, cognitive symptom management, coping, and communications with physicians), improved health status (self-reported health, fatigue, disability, social/role activities, and health distress), and decreased days in the hospital. Problem: One of the understudied factors thought to influence efficacy in community based self-management programs is the presence and impacts of multiple chronic conditions on participants within community based behavioral health program populations. Multiple chronic diseases when scaled collectively can be considered as a participant’s individual disease burden to be included in other analyses. Methodology: This investigation explores possible ways disease burden associates with such important constructs as participant personal characteristics and participant confidence in controlling impacts of their disease symptoms and participant preferences for use of various methods of coping with disease impacts. Outcomes: Results indicate a complex pattern of relationships between such factors as personal characteristics of program participants and their perceived mastery over the impacts of their disease symptoms, and their preferred mechanisms for coping. Implications: program designers and managers can better understand the differential influences of disease burden on participants analyzed with their personal characteristics and their preferential uses for coping mechanisms and their perceived ability to withstand the added burdens of multiple chronic diseases.
RURAL-URBAN DISPARITY IN BIOMARKER RISKS FOR CARDIOVASCULAR DISEASE AMONG CHINESE MIDDLE-AGED AND OLDER ADULTS
Authors: Wang Haowei , Stokes Jeffrey E 
Published: November 2019

Abstract
Cardiovascular disease (CVD) is a leading cause of adult mortality in China, accounting for 45% of deaths from noncommunicable disease. Moreover, Chinese health status and health services are disproportionately divided between urban and rural areas. This study examined rural-urban differences in age trajectories of CVD risk, measured by C-reactive protein (CRP), high-density lipoprotein (HDL) cholesterol, body mass index (BMI), and waist circumference. This study also investigated whether community factors, including recreational amenities, infrastructure availability, physical environment, public facilities, and health services, may explain such rural-urban disparities. We used data from the baseline data of the China Health and Retirement Longitudinal Study (2011), including 11, 528 respondents from 440 communities, who were aged 45 and older and participated in the biomarker survey. Multilevel models revealed that rural adults had a higher level of HDL and lower levels of CRP, BMI, and waist circumference compared to their urban counterparts. Rural adults also had slower age-related increases in trajectories for CRP, HDL and BMI. Associations of physical environment and public facilities with CVD risks were largely explained by rural-urban disparity. However, the availability of infrastructure explained both between- and within- rural-urban differences in BMI and waist circumference. Models were controlled for previously diagnosed CVD conditions, individual demographic characteristics, self-rated health, activities of daily living, depressive symptoms, physical activity, smoking and drinking behaviors. Findings contribute to the understanding of prevalence and disparities in biomarker risks for CVD among Chinese middle-aged and older adults. Intervention implications are discussed to address the emerging health disparities.
ASSOCIATION BETWEEN LEVEL OF PAIN AND DEPRESSION AMONG CHRONICALLY ILL OLDER ADULTS IN RURAL ALABAMA
Authors: Noh Hyunjin , Halli-Tierney Anne , Lee Lewis , Aladeokin Temilade 
Published: November 2019

Abstract
Pain and depression, two of the common symptoms among chronically ill older adults, have been found to be related in various populations; however, further knowledge is needed about their relationships and moderating factors among community-dwelling, chronically ill older adults, particularly in lower-income, rural areas with limited healthcare resources. Therefore, this study aimed to examine the association between pain level and depression among chronically ill older adults in rural areas. A total of 100 residents of a rural county in West Alabama, who are 55+ and have chronic illnesses and pain, were recruited from four community senior centers and were interviewed using a structured questionnaire. Pain levels were assessed by the Philadelphia Geriatric Center (PGC) Pain Scale, and depression by an abbreviated version of the Center for Epidemiologic Studies Depression Scale (CES-D). Bivariate correlation and multivariate analysis were conducted. The correlation between pain and depression was significantly positive (r = .35, p &lt; .001). The results of the model indicated that pain scores and other control variables explained approximately 18 percent of the variance in depression. The multivariate analysis results confirmed that those who had higher pain scores were significantly likely to have increased depression scores (b = 4.97, SE = 1.52, p &lt; .01). Education marginally significantly moderated the relationship between pain and depression (p = .059). The previously reported positive pain-depression relationship exists among chronically ill older adults in rural areas, calling for tailored interventions to reduce their pain and its impact on depression.
SELF-GLUCOSE MONITORING AND HYPOGLYCEMIA RISK IN OLDER RURAL VETERANS WITH TYPE 2 DIABETES
Authors: Valencia Willy Marcos , Wang Kaicheng , Muralidhar Kiranmayee , Dang Stuti 
Published: November 2019

Abstract
Hypoglycemia evaluation is expected in every encounter with diabetic patients. However, self-monitoring and self-management may not be complete at home, and limited by geriatric syndromes. Furthermore, hypoglycemia risk increases with age, and rurality may limit access to frequent monitoring. We identified 112 rural veterans with high hypoglycemia risk, using the local medication database (sulfonylureas and insulin), combined with age and glycated hemoglobin (HbA1c). Statistical analyses were conduct using SAS 9.4 (Cary, NC). We used Chi-square, Fisher’s, One-way ANOVA for baseline variables, and a multivariate logistic regression model to assess the association of hypoglycemia and risk factors, including age, HbA1c%, self-monitoring, and knowledge. Hypoglycemia was reported in 30.4% of cases, of whom the majority were younger than those not reporting hypoglycemia (72.0±4.3 vs 75.0±6.5 years, p=.015). Baseline HbA1c% was higher in cases with hypoglycemia compared to those without (7.7±1.6% versus 7.3±1.2%, not statistically significant). There were no significant differences between pharmacologic regimens, self-monitoring, and general knowledge. Veterans who knew hypoglycemia symptoms were 6 times more likely to reported hypoglycemia, compared with veterans who did not know any symptoms. We contacted primary care teams (PCT) for whom medications were adjusted. Hypoglycemia risk is high in the older population, and telemedicine programs can support primary care teams to improve management of their patients. Poor symptom knowledge needs to be addressed, while considering special attention for hypoglycemia unawareness in the oldest age group. We are implementing a project using continuous glucose monitoring in this high-risk population.
SLEEP APNEA ASSOCIATED COMORBIDITIES AND MORTALITY IN AN OLDER VETERAN POPULATION
Authors: Kresevic Denise M , pallaki muralidahar , Burant Christopher J , Gideon Clare , Schroeder Emily , Chen Peijun 
Published: November 2019

Abstract
Evidence continues to mount that sleep apnea (SA) occurs in 10-25% of Americans and is associated with significant morbidity and mortality (Schulman 2018). Among veterans, SA has been reported four times more often as compared to other non-veteran cohorts. (Wong 2015). The risk of developing dementia is increased in older individuals with OSA (Shastri, Bangar, & Holmes, 2015). The prevalence and characteristics of older adults with dementia and sleep apnea is not well known and long-term population-based studies on mortality have been lacking. Recent studies have reported overall mortality rates of 19%, in those individuals with SA, an increased rate of 1.5-3 times the mortality rate as compared to those individuals those without SA. Current recommendations support SA screening of high risk individuals including those with symptoms of snoring, fatigue, memory and concentration problems and mood changes. (Krist 2018). Despite a large number of older adults with suspected SA and comorbidities, the majority are not screened, referred, diagnosed and treated. In this VA pilot study of outpatient older male veterans with dementia and SA, N=195, mean age 75.83 years, SD=9.1, 51.3% were white, 37.5% were black. Frequently found comorbidities were: hypertension 88%, congestive heart failure 41%, Diabetes. 62% and, stroke 21%. Of note, among those who died, SA was significantly related to congested heart failure (r=.32, p&lt;.001) and COPD (r=.40, p&lt;.001). The overall mortality rate of 27% was higher than previous reports. Further investigation is needed to better understand the relationship between comorbidities, and SA, screening, treatment and mortality.
LIFITEGRAST 5% FOR DRY EYE DISEASE: COMBINED EFFICACY AND SAFETY FROM FIVE RANDOMIZED CONTROLLED TRIALS
Authors: Gonzalez Agustin L , Donnenfeld Eric , Baudouin Christophe , Holland Edward , Nichols Kelly , Karpecki Paul , Hamdani Mohamed , Shojaei Amir 
Published: November 2019

Abstract
Five randomized, double-masked, placebo-controlled trials were conducted in the US in adults with DED, an eye dryness score (EDS, visual analogue scale [VAS], 0–100) ≥40, and inferior corneal staining score ([ICSS], 0-4) ≥2.0 at study entry: four 84-day efficacy trials (phase 2, lifitegrast n=58, placebo, n=58; phase 3: OPUS-1, n=293, n=295; OPUS-2, n=358, n=360; OPUS-3, n=355, n=356) and a 1-year safety study (SONATA, lifitegrast n=220, placebo n=111). The pooled population had a mean age of 59.4 years, and 76% were females. Lifitegrast treatment, versus placebo, significantly improved EDS from baseline to day 84 in three of the four trials: OPUS-1 (treatment effect [TE] 4.7; P=0.0311), OPUS-2 (TE 12.3; P&lt;0.0001), and OPUS-3 (TE 7.5; P=0.0003). Lifitegrast significantly improved ICSS in the phase 2 (TE 0.25; P=0.0498) and OPUS-1 (TE 0.23; P=0.0007) trials, and nominally in OPUS-3 (TE 0.17; nominal P=0.0135). The responder analyses from OPUS-2 and OPUS-3 assessed the proportion of subjects with an EDS reduction from baseline (≥10, ≥15, ≥20 points), and percentage change from baseline (≥30, ≥50, ≥70%), to days 14, 42 and 84. More subjects achieved ≥30% EDS reduction with lifitegrast versus placebo in Opus-2, and Opus 3 at days 14, 42, and 84 (all nominal P&lt;0.0001). A similar trend was seen at other response thresholds. Pooled safety data (lifitegrast n=1287; placebo, n=1177) indicated Lifitegrast was well tolerated with no serious ocular adverse events. Lifitegrast significantly improved signs and symptoms of DED in adult subjects, with EDS improvements observed starting at day 14 after treatment.
INTRA-INDIVIDUAL PHYSICAL AND PSYCHOLOGICAL SYMPTOM VARIABILITY AND STRESS INFLUENCE ACTIVITIES OF DAILY LIVING
Authors: Moore Scott E , Wierenga Kelly , Hardin Heather K 
Published: November 2019

Abstract
Stress and symptomatology have been shown to have strong relationships to health outcomes in older adults. More specifically, perceived social stressors (PSS), whether related to disease, disability or demographics, is a contributor to health. Recently it was reported that intra-individual symptom variability (ISV) may predict poor health outcomes better than symptom severity in some chronic illnesses. Individual and combined influences of ISV and PSS on health behaviors are not fully described. Using a subset (n = 518, 46.5% men; mean age = 48.7) of MIDUS Refresher participants’ 8 day daily diary data, we sought to determine the influences of physical and psychological ISV and PSS on independent and basic activities of daily living (iADLs, bADLs). The ISVs represent an average of day-to-day variation across each of the 22 physical and 27 psychological symptoms for each participant. Psychological ISV, physical ISV, PSS, and total number of chronic conditions were entered into two structural equation models as predictors for each ADL outcome (p&lt;.01). The models depicted both direct and indirect influences of psychological ISV on ADLs (iADLs: B=-.43, P &lt; .001; B = .51, P &lt; .001 [through PSS]; bADLs: B=-.45, P &lt; .001; B = .51, P &lt; .001 [through PSS]). However, the influence of physical ISV on ADLs was indirect (B = .22, P = .001 [through PSS]). Individual-level influences of ISV and PSS on ADLs may better aide healthcare providers’ identifying and intervening to disrupt poor health outcomes for those at risk.
SOCIAL TIES AND SUICIDAL IDEATION AMONG OLDER ADULTS REFERRED FOR A BEHAVIORAL HEALTH EVALUATION
Authors: Mavandadi Shahrzad , Ingram Erin , Klaus Johanna , Oslin David 
Published: November 2019

Abstract
The association between the quality and nature of social relationships and suicidal outcomes across the lifespan is well established. However, social ties are rarely assessed in primary care and other clinical settings where older adults at high risk for suicide-related outcomes are seen. This study examined the unique associations between three indices of social ties (i.e., perceived social support, frequency of negative social exchanges, and degree of social integration) and death/suicidal ideation among 3,261 older veterans (aged 65+) who completed a clinical mental health/substance use (MH/SU) assessment upon referral to a Primary Care-Mental Health Integration (PCMHI) program. Data on sociodemographics, MH/SU conditions (e.g., depression, anxiety, and substance use), perceived health, the three indices of social ties, and death/suicidal ideation were extracted from clinical interviews. Veterans were on average 70.8 years old (+6.5 years) and primarily male. Approximately half were married and 60.3% were non-Hispanic white. Forty percent reported death ideation or suicidal ideation, as measured by the Paykel Suicide Scale. Logistic regression analyses revealed that, adjusting for covariates, while perceived social support was associated with a greater risk of reporting death ideation relative to no ideation, both social support and frequency of negative exchanges were uniquely associated with greater risk of reporting suicidal ideation relative to no ideation. Social integration was unrelated to odds of death or suicidal ideation. Findings underscore the value of integrating assessments of multiple aspects of social ties into routine PCMHI practice, as doing so has the potential to enhance suicide screening and intervention efforts.
HepCare Europe: a service innovation project. HepCheck: enhancing HCV identification and linkage to care for vulnerable populations through intensified outreach screening. A prospective multisite feasibility study
Authors: Barror Suzanne , Avramovic Gordana , Oprea Cristiana , Surey Julian , Story Alistair , Macías Juan , Cullen Walter , Crowley Des , Horan Aidan , Naughton Anna Marie , Iglesias Maria , Ianache Irina , Lazar Stefan , Popa Ionut , McHugh Tina , Menezes Dee , Tinago Willard , Lambert John S 
Published: November 2019

Abstract

Objectives
Hepatitis C is one of the main causes of chronic liver diseases worldwide. One of the major barriers to effecting EU- and WHO-mandated HCV elimination by 2030 is underdiagnosis. Community-based screening strategies have been identified as important components of HCV models of care. HepCheck Europe is a large-scale intensified screening initiative aimed at enhancing identification of HCV infection among vulnerable populations and linkage to care.

Methods
Research teams across four European countries were engaged in the study and rolled out screening to high-risk populations in community addiction, homeless and prison services. Screening was offered to 2822 individuals and included a self-administered questionnaire, HCV antibody and RNA testing, liver fibrosis assessment and referral to specialist services.

Results
There was a 74% (n=2079) uptake of screening. The majority (85.8%, n=1783) were male. In total 44.6% (n=927) of the sample reported ever injecting drugs, 38.4% (n=799) reported ever being homeless and 27.9% (n=581) were prisoners. In total 397 (19%) active HCV infections were identified and 136 (7% of total sample and 34% of identified active infections) were new cases. Of those identified with active HCV infection, 80% were linked to care, which included liver fibrosis assessment and referral to specialist services.

Conclusions
HepCheck’s screening and linkage to care is a clear strategy for reaching high-risk populations, including those at highest risk of transmission who are not accessing any type of care in the community. Elimination of HCV in the EU will only be achieved by such innovative, patient-centred approaches.
Pooled genotyping strategies for the rapid construction of genomic reference populations1
Authors: Alexandre Pâmela A , Porto-Neto Laercio R , Karaman Emre , Lehnert Sigrid A , Reverter Antonio 
Published: November 2019

Abstract
The growing concern with the environment is making important for livestock producers to focus on selection for efficiency-related traits, which is a challenge for commercial cattle herds due to the lack of pedigree information. To explore a cost-effective opportunity for genomic evaluations of commercial herds, this study compared the accuracy of bulls’ genomic estimated breeding values (GEBV) using different pooled genotype strategies. We used ten replicates of previously simulated genomic and phenotypic data for one low (t1) and one moderate (t2) heritability trait of 200 sires and 2,200 progeny. Sire’s GEBV were calculated using a univariate mixed model, with a hybrid genomic relationship matrix (h-GRM) relating sires to: 1) 1,100 pools of 2 animals; 2) 440 pools of 5 animals; 3) 220 pools of 10 animals; 4) 110 pools of 20 animals; 5) 88 pools of 25 animals; 6) 44 pools of 50 animals; and 7) 22 pools of 100 animals. Pooling criteria were: at random, grouped sorting by t1, grouped sorting by t2, and grouped sorting by a combination of t1 and t2. The same criteria were used to select 110, 220, 440, and 1,100 individual genotypes for GEBV calculation to compare GEBV accuracy using the same number of individual genotypes and pools. Although the best accuracy was achieved for a given trait when pools were grouped based on that same trait (t1: 0.50–0.56, t2: 0.66–0.77), pooling by one trait impacted negatively on the accuracy of GEBV for the other trait (t1: 0.25–0.46, t2: 0.29–0.71). Therefore, the combined measure may be a feasible alternative to use the same pools to calculate GEBVs for both traits (t1: 0.45–0.57, t2: 0.62–0.76). Pools of 10 individuals were identified as representing a good compromise between loss of accuracy (~10%–15%) and cost savings (~90%) from genotype assays. In addition, we demonstrated that in more than 90% of the simulations, pools present higher sires’ GEBV accuracy than individual genotypes when the number of genotype assays is limited (i.e., 110 or 220) and animals are assigned to pools based on phenotype. Pools assigned at random presented the poorest results (t1: 0.07–0.45, t2: 0.14–0.70). In conclusion, pooling by phenotype is the best approach to implementing genomic evaluation using commercial herd data, particularly when pools of 10 individuals are evaluated. While combining phenotypes seems a promising strategy to allow more flexibility to the estimates made using pools, more studies are necessary in this regard.