bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medicare Annual Wellness Visit for Nursing Home Residents
Authors: Malmstrom Theodore , Little Milta , Sanford Angela , Berg-Weger Marla , Morley John 
Published: December 2020

Abstract
The 2010 Patient Protection and Affordable Care Act includes the Annual Wellness Visit (AWV) for older adult (OA) patients. Medicare pays for an initial AWV per beneficiary and subsequent visits annually. Many Medicare beneficiaries have not taken advantage of the AWV preventive health benefit. The Saint Louis University Geriatrics Workforce Enhancement Program (GWEP) developed an AWV for OA, NH residents. This project describes the NH AWV and reports results. Data include age, gender, comorbidities, medications, hospitalizations, depression, frailty, pain, sarcopenia, sensory impairment, cognition, nutrition, smoking, falls, and advance directives. Two suburban academic for-profit NHs are included in this study (2016-17). OA NH residents (N=247) completed an AWV and 36.8% (n=91) had a 1-year follow-up AWV. OA NH residents were female (n = 177, 71.7%) and a majority ages 75+ (n = 172, 69.7%). Most (96.3%) had a documented advance directive. Comorbidities (7.8±2), polypharmacy (92.3%), vision impairment (52.8%), hearing impairment (52.8%), depression (65.2%), frailty (75.7%), sarcopenia (84.4%), risk of weight loss (53.9%), MCI (11.7%), and dementia (75.8%) were prevalent. Among OA NH residents (n=91) with an AWV follow-up, there was modest worsening in total comorbidities and medications as well as frailty, sarcopenia, and cognition scores (ps≤0.05). Pain, depression, and nutrition did not change. To our knowledge, no one has specifically analyzed the Medicare AWV in NHs. Data from the traditional AWV is an extension of the routine clinical care of OAs and therefore could also be useful for healthcare professionals focused on providing care to OA patients in the NH setting.
Research on the Relationship of the Organization Capacity and Job Satisfaction in Nursing Homes
Authors: Liao Lulu , Chen Huijing , Zhao Yinan , Ning Hongting , Feng Hui 
Published: December 2020

Abstract
Objective: To explore the occurrence of organization capacity and to examine the relationships among the organization capacity and job satisfaction in nursing homes in China. Methods: A total of 577 participants in sixteen nursing homes in Hunan province of China were enrolled using a cluster randomized controlled trial. Staff job satisfaction was measured by Minnesota Satisfaction Questionnaire(MSQ) in short form, nursing homes’ organization capacity was assessed by Shortell’s Organization and Management Survey. One-way analysis of variance examined differences between variables. The relationship and correlation of organization capability, MSQ total score and scores in each dimension was analyzed. Results: Overall score of nursing homes’ organization capacity was 99.5±8.6(level ranking, 21–105), and MSQ score was 78.2±8.2 (level ranking, 20–100). Staff job satisfaction levels were significantly different among nursing staffs with different levels of organization capability (F=9.40, P＜0.001). Correlation analysis showed that organization capability level was positively correlated with staff job satisfaction (r=0.52, P&lt; 0.001). And Correlation analysis showed that Working conditions (r = 0.46, P &lt; 0.001), Leaders (r = 0.46, P &lt; 0.001), Responsibility (r = 0.51, P &lt; 0.001) and External reward (r= 0.42, P &lt; 0.001) were positively associated with organization capability. Conclusion: The organization capability can be improved by active staff job satisfaction. But the job satisfaction of nursing staffs was at a moderate level. Thus effective measures such as creating a supportive work conditions, appointing suitable leaders, enhancing responsibilities and providing external reward should be considered by nursing managers to promote organization capability in nursing homes.
Contraction Type Influences Critical Ages for Declines In Lower Body Specific Force in Women Ages 20 to 89 Years
Authors: Miller Ryan , Freitas Eduardo , Heishman Aaron , Bemben Debra , Bemben Michael 
Published: December 2020

Abstract
The ability for a muscle to produce force relative to its size, specific force, is an important characteristic for healthy aging. Few studies have identified the influence that different muscle groups or contraction types may have on the onset of declines in specific force. Therefore, the aims of the current study were to identify critical ages for changes in upper (quadriceps and hamstrings) and lower leg (soleus and tibialis anterior) specific force and to determine if the onset of decline is influenced by contraction type (isometric or dynamic) in women aged 20 to 89 years. One-hundred and fifty-two women (47.1±17.7years, 164.2±7.0cm, 67.1±10.7kg) matched for physical activity with approximately 10 participants per five-year interval (20-24, 25-29years, etc.), were included in the present analysis. Specific force was calculated from peak torque values measured from isometric (ISOM) or isokinetic testing (60deg/s and 240deg/s) and made relative to muscle area measured by peripheral quantitative computed tomography. An iterative segmental modelling approach was performed to identify critical age periods for changes in specific force. For the upper leg, ISOM and 60deg/s specific force was maintained across the lifespan, whereas 240deg/s revealed a critical age of 35.2±5.3years. Critical ages were identified for all contraction types for the lower leg and occurred earlier with increasing velocity (ISOM: 63±6.6years, 60deg/s: 53.9±4.5years, and 240deg/s: 49±3.9years). These data suggest that muscle groups of the leg do not display uniform changes across different contraction types and that high velocity contractions display earlier declines across the lifespan.
Effect of a Tai Chi-Based Exercise Program on Cognitive Function Among Older Adults With Dementia
Authors: Song Rhayun , Park Myonghwa , Jung Misook , Kim Hyun Li , Lee Hanna 
Published: December 2020

Abstract
Cognitive function with dementia is strongly associated with physical function decline. A low intensity aerobic exercise, such as Tai Chi, may help either prevent or slow down cognitive impairment. This study aimed to examine the effect of Tai Chi-based exercise program on cognitive function among older adults with early dementia. Individuals registered at the Dementia Support Center were invited to participate in the Tai Chi-based exercise program twice a week for one-hour session for 20 weeks. The comparison group with the same inclusion criteria but not participated in any formal exercise program were recruited by matching with age, education, and pre-cognitive function. Cognitive function (MOCA-K) was measured at the pretest and at the completion of the study period. Fifty-two older adults with dementia (29 in Tai Chi group, 23 comparisons) with the mean age of 80.5 years completed all measurements. All participants had at least one chronic disease. About 50% of the participants received no formal education. At the completion of the study, Tai Chi group improved their cognitive function, while their counterpart remained similar in their MOCA-K score, specifically in attention (F=5.21, p=.027) and short term memory recall (F=6.66, p=.013). In conclusion, Tai Chi-based exercise program was safely and effectively applied to older adults with early dementia. The participants were able to follow the movements with the attendance rates of 80% during the study period. Further studies are warranted to explore the relationship between physical exercise and cognitive function in this population with various types of cognitive impairment.
A Rural Tele-Video Model: Results From Educating Practitioners About Opioids and Alternative Pain Management
Authors: Tobey Leah , McAtee Robin , Hayes Corey 
Published: December 2020

Abstract
Providers in Arkansas wrote 105.4 opioid prescriptions for every 100 persons in 2017-nearly twofold greater than the average U.S. rate of 58.7 opioid prescriptions (CDC, 2017). This makes AR the second highest opioid prescribing state. AR-IMPACT (Arkansas Improving Multi-Disciplinary Pain Care and Treatment) is a tele-video case conference education model which was designed to improve AR providers’ knowledge and behavior in pain management and improve awareness of opioid-sparing alternatives. Conference panelists include a geriatrician, psychiatrist, physical therapist, psychologist, pharmacist, a chronic pain specialist and various guest speakers such as the Arkansas Drug Director. During weekly tele-video conferences, relevant actionable cases were presented regarding treating diverse patients who have chronic pain. AR-IMPACT provided hundreds of practitioners with up-to-date data and education regarding opioid use and misuse, methods and resources regarding titrating and eliminating opioids, and viable alternative pain-management solutions such as motivational interviewing and dry-needling. This poster will present the background of the opioid crisis in rural Arkansas followed by the specifics of the development and application of the AR-IMPACT tele-video model. Specific older adult cases studies, quantitative and qualitative outcomes, feedback from presenters and participants, and lessons learned will be reviewed. Specifically, lessons learned center around the practitioners’ culture of pain management and how that culture must evolve and change. New methods of pain management must be taught to practitioners and patients and adopted as the new norm. This will demonstrate that programs like AR-IMPACT are crucial in helping make that cultural change happen.
A Scoping Review of Current Telehealth Interventions for Care Partners of Persons With Dementia
Authors: Tran Leslie , Tarter Robin , Lindauer Allison 
Published: December 2020

Abstract
Many burdens come with caring for someone with dementia, but telehealth interventions can provide information and support and reduce barriers to access. In this review we describe current telehealth interventions for family care partners of people diagnosed with Alzheimer’s disease or related dementias (ADRDs). We conducted a systematic literature search using PubMed. Inclusion criteria were peer-reviewed, data-based research articles focusing on technological clinical interventions, published within the past two years, with participants providing unpaid care to persons with a diagnosis of ADRDs. We identified 53 relevant articles, of which 13 met our criteria. Included studies fell into three categories: peer support groups facilitated by gerontological social workers and psychologists, psychoeducation and behavior modification interventions delivered by nursing professionals, and symptom management advising overseen by physicians. Different technologies were used including computers, iPads, smartphones, and smartwatches. The duration of interventions also ranged from four weeks to three months, representing varying approached to participant engagement. The majority of caregivers were women, non-Hispanic white, spouses. Based on our findings of a lack of diversity in the samples of extant studies, and the need for interventions tailored to specific stages of ADRDs, future researchers can design studies to address these gaps. Overall, the interventions’ effectiveness and participant satisfaction were high, resulting in improvements in burden, competence, and coping skills. Although every approach has its own strengths and weaknesses, we believe that the continued expansion of telehealth interventions will not only offer many benefits, but also transform the delivery of health care.
Feasibility to Train Older Adults in India to Use Smart-Phone to Increase Participation in Daily Activities
Authors: Das Asish , Sethi Amit 
Published: December 2020

Abstract
Though 60% of 104 million older adults own a smart phone in India, up to 85% of these individuals find challenging to use smart-phone during daily activities. This is problematic because inability to use smart-phone limits their ability to participate in daily activities such as, managing their health, paying bills, shopping and communicating with their loved ones, resulting in social isolation and dependence on others. The purpose of this study was to examine the feasibility of training older adults to use smart-phone to increase participation in daily activities. This preliminary study was conducted over two phases. In phase-I, we used the principles of stakeholder engagement to interview 12 older adults to identify the barriers associated with the use of technology using a brief survey. Based on the results of Phase I, we implemented a single education and training session for 42 participant (&gt; 60 years) in using smart-phone based applications in Phase II. Older adults were trained to use smart-phone based applications to manage money using banking apps, pay bills, shop, manage health to monitor vitals and medications and communicate with their loved ones. All participants rated their satisfaction with the program, 70% participants showed the ability to use the applications independently. Seventy five percent rated the program extremely useful, and 70% rated it extremely relevant to them. It is feasible to train older adults in using smart-phone based applications. Future studies need to focus on providing follow-up sessions to increase retention and carry-over to increase participation in daily activities.
IT Is Not for Me: Why Age Matters in Technological Innovation
Authors: Blackberry Irene , Wilding Clare 
Published: December 2020

Abstract
During 2017-2019, we conducted a randomized stepped-wedge cluster trial of an online program to increase ease of access to information and support for caregivers of a person living with dementia in rural Australia. The program, called Virtual Dementia Friendly Rural Communities (Verily) Connect, was innovative; it consisted of a custom-designed website and mobile application (app) in Android and iOS, use of videoconferencing for peer support, chat forum and use of volunteers to build technological skills and confidence for online users. The program overcame barriers experienced by rural Australian caregivers, particularly geographical distance from services and other caregivers, stigma, and lack of localized supports. Although participants identified that Verily Connect program afforded several benefits, including increased flexibility in accessing support, easier access to localized dementia-related information, and more opportunities for attaining support, uptake of the program was disappointingly low. A strong theme in the program evaluation, which used the Consolidated Framework of Implementation Research, was that although the program was perceived as advantageous, adaptable, of high quality, and easy to implement, engaging participants failed because the target users, people over 65 years, eschewed involvement with online technology. Our future research plans include finding ways to offer hybrid online/face-to-face support programs specifically designed for older adults, so that older adults have equitable opportunities to access technological innovations. Older adults ought not to be disadvantaged because it is difficult to keep pace in a rapidly changing world.
Using Wearable Sensors to Remotely Evaluate Progress on Goals Set by Patients With Dementia
Authors: Freytag Jennifer , Zhou He , Dindo Lilian , Naik Aanand 
Published: December 2020

Abstract
Patient Priorities Care (PPC) is a communication framework designed to facilitate priorities-based conversations between clinicians and older adults with multiple chronic conditions. PPC focuses on collaboratively setting specific and measurable goals based on what matters most, and patients often set goals involving physical activity. Measuring goal achievement for patients with dementia is difficult because they often struggle to report activity accurately. In this pilot study, we assessed the feasibility of using a wearable sensor to evaluate patient-defined goal achievement. The wearable sensor measured daily mobility and sleep performance, including length of walking bouts, time sitting, postural transitions, and sleep duration. Patients wore pendant sensors for 48 hours at baseline (before PPC conversations) and 3-6 month follow-up. We present a case in which remote monitoring exhibited evidence of goal achievement and another case in which monitoring exhibited failure to achieve a goal. In the former, the patient set a goal of walking his dogs daily. At baseline, mobility performance suggested that he was not engaged in this activity. At follow-up, in contrast, all parameters showed accomplishment of the patient’s goal. In the latter case, the patient set a goal of maintaining his habit of walking a mile per day. At follow-up, sensor measures showed that the patient was not making progress on this goal. Conclusion: Remote monitoring using wearable sensors can provide objective information about goal achievement for patients with dementia. Sensor measurement can assist clinicians in evaluating goal achievement for patients with dementia and adjusting care based on these measures.
Virtual Reality Based Interventions Among People With Dementia: Applications and Health-Related Outcomes
Authors: Chang Yu-Ping , Zhou Yanjun , Zhang Hanbin 
Published: December 2020

Abstract
The use of virtual reality (VR) technology to improve health among older adults has been receiving increased attention. VR technology has many applications and can produce benefits for people with various medical conditions such as symptom reduction or improving the diagnostic process. Despite the increase in the number of research studies of VR technology, little is known about how it has been used to improve health-related outcomes among people with dementia. This systematic review aimed to synthesize research evidence regarding the scope and impact of VR based interventions among people with dementia. Five databases, CINAHL, Embase, PsychINFO, PudMed, and Web of Science were searched to identify studies leveraging VR to facilitate interventions designed for people with dementia. Multiple keywords were used in combination including: dementia, Alzheimer’s, VR, virtual reality, and Virtual Reality Exposure Therapy. Articles were screened if they were published between 2000 through 2020. Fifteen studies met the criteria, with ten utilizing a randomized controlled trial. The VR based interventions in those studies included virtual physical exercises, virtual forests or natural landscapes, and virtual basic living activities. The results of these studies show that VR as a display medium can greatly improve decision-making, hearing, vision, motor ability, and memory in people with dementia residing either in the community or in long term care settings. Our review demonstrated that VR showed positive benefits through various applications for people with dementia. Future research is needed to make VR interventions more customized toward effectively meeting the needs of people with dementia.
Effect of Perceived Social Support on Mortality Rate Among Older Chinese Americans
Authors: Verma Charu , Li Mengting , Dong XinQi 
Published: December 2020

Abstract
Most existing studies have examined the relationship between social support and health in cross-sectional data. However, the changing dynamics of social support over time and its relationship with all-cause mortality have not been well explored. Using data from the Pine Study (N = 3,157), this study examined whether social support was associated with time of death at an 8 years follow-up among older Chinese Americans. Social support from a spouse, family members and friend were collected at the baseline using an HRS social support scale. Perceived social support and time of death were ascertained from the baseline through wave 4. Cox proportional hazard models were used to assess associations of perceived support with the risk of all-cause mortality using time-varying covariate analyses. Covariates included age, sex, education, income, and medical comorbidities. All study participants were followed up for 8 years, during which 492 deaths occurred. In multivariable analyses, the results showed that positive family support [HR 0.91; 95% CI (0.86, 0.98)] and overall social support [HR 0.95; 95% CI (0.92,0.98)] were significantly associated with a lower risk of 8-year mortality. Results demonstrate robust association in which perceived positive family and overall social support over time had a protective effect on all-cause mortality risk in older Chinese Americans. Interventions could focus on older adults with low social support and protect their health and well-being. Future studies could further explore why social support from family is different from social support from other sources regarding mortality risk in older Chinese Americans.
Attitudes of Older Adults With Chronic Musculoskeletal Pain Toward Virtual Reality
Authors: Nakad Lynn , Rakel Barbara 
Published: December 2020

Abstract
Older adults are especially susceptible to chronic musculoskeletal (MSK) pain. Pharmacological treatment often provides inadequate relief and overuse can lead to adverse events. Preliminary research has demonstrated the effectiveness of virtual reality (VR) distraction therapy for chronic pain. Understanding attitudes of older adults towards VR distraction therapy will help develop and optimize this therapy for this population. Therefore, the purpose of this study is to explore the attitudes and treatment acceptability towards the use of immersive VR distraction therapy of older adults suffering from chronic MSK pain. This descriptive, exploratory study used mixed methods. Data collection consisted of a consent process, eligibility screening, survey completion, 2 VR simulations (passive and active) lasting 10-minutes each, and either a focus group or interview. Survey data was used to measure: pain intensity and interference, pain catastrophizing, treatment acceptability, usability, and side effects. A total of 21 older adults completed the study. Treatment acceptability was high with an average score of 32.5 out of 40. However, average usability scores (62.9 out of 100) indicated a need for system improvements. Few participants (14%) experienced moderate to severe side effects. The following themes were identified: 1) VR is an enjoyable distraction; 2) Perceived effectiveness depends on chronic pain experience; 3) VR simulation experiences should be individualized; 4) Design considerations to improve usability in older adults; 5) Recommendations for future directions. The findings from this study can inform intervention design considerations and future directions for the use of VR technology for chronic pain management in older adults.