bluuebunny/crossref_metadata_2025_split huggingface dataset:
AGE MODERATES THE ASSOCIATION BETWEEN ENGAGEMENT IN MINDFULNESS AND PSYCHOLOGICAL DISTRESS AMONG CANCER SURVIVORS
Authors: Zhang Anao , Hu Rita X , Li Lydia , Wang Kaipeng 
Published: November 2019

Abstract
Geriatric cancer survivors constitute up to 65% of the U.S. survivorship population, and their psychosocial wellbeing are increasingly recognized. Facing high risk of psychological distress, many cancer survivors engage in mindfulness to reduce psychological distress. However, the acceptance of mindfulness across age groups was rarely examined. Based on the Motivational Theory of Life Span Development, mindfulness practice actives survivors’ secondary control strategies to better cope with the loss of primary control caused by cancer. In other words, older survivors may respond differently than their young counterparts when facing psychological distress. Therefore, it is important to examine to what extent engagement in mindfulness is different across age groups. Using the cross-sectional 2017 National Health Interview Survey (N=3,068), this study evaluated the association between engagement in mindfulness and psychological distress among cancer survivors and examined whether age moderates such relationship. Age significantly moderated the association between psychological distress and engagement in mindfulness, OR=0.97, p&lt;0.05. The correlation coefficient between engagement in mindfulness and psychological distress were significantly greater among younger cancer survivors (&lt;65 years old) than their older counter parts (65+), z=2.24, p&lt;0.05. Consistent with previous literature and the Motivational Theory, this study found age moderates the relationship between psychological distress and mindfulness engagement, and this relationship was much stronger among younger cancer survivors comparing to their older counter parts. Therefore, geriatric cancer survivors’ unique psychosocial challenges should be addressed in ways that are appropriate to their developmental characteristics.
PAYROLL-BASED STAFFING MEASURES FOR NURSING HOMES
Authors: Williams Christianna , Zheng Qing , White Alan 
Published: November 2019

Abstract
The Centers for Medicare & Medicaid Services (CMS) developed the Payroll-Based Journal (PBJ) system for nursing homes to electronically submit direct care staffing information based on payroll and other auditable data. In spring 2018, CMS started reporting PBJ-based staffing measures on Nursing Home Compare. The objective of this research is to examine nursing home staffing patterns using PBJ data. We created measures of staffing hours per resident day, using PBJ staffing information and resident census calculated from MDS assessments. We examined how PBJ staffing levels varied for different types of nursing homes and the relationship between staffing and performance on other parts of CMS’s Five-Star Quality Rating System. We also examined weekday/weekend variation in staffing levels. We tracked about 15,650 nursing homes from 2017 to 2018. The average staffing level was 3.85 hours per resident day, of which 0.66 hours were for RNs. Average staffing levels were higher for smaller, non-profit, and hospital-based facilities. They were also higher for facilities with higher health inspection and quality measure ratings. Staffing levels were about 17% lower on weekends than on weekdays, and RN staffing was 38% lower on weekends. About 20% of facilities had one or more weekend day without any RN staffing in the quarter, while only 8% of facilities had any weekday without RN staffing. The use of payroll-based staffing measures improves the accuracy of the staffing information reported on Nursing Home Compare, providing consumers with additional quality-related information that can help guide their nursing home placement decisions.
SAFETY CLIMATE IN NURSING HOMES: ARE SENIOR MANAGERS IN AGREEMENT WITH DIRECT CARE STAFF?
Authors: Quach Emma , Kazis Lewis , Zhao Shibei , McDannold Sarah , Hartmann Christine W 
Published: November 2019

Abstract
Nursing home safety climate in nursing homes reflects norms and attitudes about the safety of residents and is a key driver of safety. We investigated views of direct care staff and senior managers in 56 Department of Veterans Affairs nursing homes, because prior hospital studies reveal incongruent views of these two groups, which compromises quality of care. Each domain of the previously validated CLC Employee Survey of Attitudes about Resident Safety (CESARS) served as a dependent variable, with occupation as the major independent variable distinguishing senior managers (the reference group) from licensed nurses, nursing assistants, and clinicians/specialists. Mixed random effect models controlled for job tenure, work shift, ≤ 40 weekly work hours or more, as well as clustering effects (by VA hospitals, VA service networks, and geographic regions). We analyzed responses of 1316 direct care staff and senior managers, a 26% response rate. Senior managers were more favorable about their co-worker interactions regarding safety and their nursing home globally than each direct care staff group (small to moderate effects or ⅓ to ½ of a standard deviation) (p &lt; 0.05). Direct care staff had comparable ratings on these two safety climate domains. We found incongruence between senior managers and direct care staff in their perceptions of their facility’s safety. Results imply that regular and open conversations between direct care staff and senior managers around safety may keep senior managers informed about frontline safety issues and direct care staff about high-level quality improvement initiatives, bringing them closer to a mutual understanding.
EFFECT OF STIGMA ON OUTCOMES OF A MEMORY TRAINING INTERVENTION
Authors: McDougall Graham J , McDonough Ian M , Kraemer Kyle 
Published: November 2019

Abstract
Cultural stereotypes equated with aging that emphasize decreasing competence and increasing forgetfulness can be threatening to older adults. Even brief exposure via entertainment media or the patronizing behavior of others may induce stigma in elders and thereby impair memory and executive functions. The sample was recruited for an RCT known as Senior WISE and conducted in Central Texas. The average age was 75 years and average of 14 years of education. Sex and minority status were consistent across groups. Data were analyzed using SPSS, v21. First, Pearson Rs were calculated between stigma (MIA Anxiety subscale) and memory outcomes at baseline. Stigma related significantly to Rivermead (RBMT), HVLT, and Memory Self-Efficacy (MSQ). Then, after controlling for the effects of trait anxiety, stigma explained a significant portion of the variance within scores on the RBMT (β = -.139, R2 MIA Change = .016, p = .037), HVLT (β = -.145 R2 Change = .017, p =.032), and MSQ-35 (β = -.253, R2 Change = .053, p &lt; .001). Change in stigma was significantly associated with change in HVLT scores among those in the memory training group, r(105) = -.228, p = .018. Reductions in stigma were related to increases in HVLT score, β = -.14, F(1, 201) = 3.021, p = .084, R2 Change = .015; however, the overall regression model was not a good predictor of HVLT change, F(4, 201) = 1.793, p = .132, R2 = .034. Stigma is a high priority area of scientific inquiry and a self-fulfilling prophecy.
EFFECTS OF COGNITIVE TRAINING ON WHITE MATTER MICROSTRUCTURE AND COGNITION IN OLDER ADULTS: A SYSTEMATIC REVIEW
Authors: McPhee Grace M , Downey Luke A , Stough Con 
Published: November 2019

Abstract
Adults who remain cognitively active may be protected from age-associated changes in white matter (WM) and cognitive decline. To determine if cognitive activity is a precursor for WM plasticity, the available literature was systematically searched for Region of Interest (ROI) and whole-brain studies assessing the efficacy of cognitive training (CT) on WM microstructure using Diffusion Tensor Imaging (DTI) in healthy adults (&gt; 40 years). Seven studies were identified and included in this review. Results suggest there are beneficial effects to WM microstructure after CT in frontal and medial brain regions, with some studies showing improved performance in cognitive outcomes. Benefits of CT were shown to be protective against age-related WM microstructure decline by either maintaining or improving WM after training. These results have implications for determining the capacity for training-dependent WM plasticity in older adults and whether CT can be utilised to prevent age-associated cognitive decline. Additional studies with standardised training and imaging protocols are needed to confirm these outcomes.
LINKS BETWEEN NEIGHBORHOOD CONTEXT AND ACCESS TO SOCIAL CAPITAL IN LATER LIFE
Authors: Webster Noah J , Ajrouch Kristine J , Antonucci Toni C 
Published: November 2019

Abstract
Social capital is essential for healthy living in later life, and evidence indicates the importance of neighborhood context in facilitating access to this resource. However, additional research is needed to compare how objective and subjective indicators of context shape this association. We examine links between objective (census tract-level population density and composition) and subjective (perceived safety and quiet) indicators of neighborhoods and social capital (contact frequency, network size, trust others in neighborhood). Data include participants age 65+ (N=259) from Wave 3 (2015) of the longitudinal Social Relations Study based in Detroit, Michigan. Multivariate analyses indicate respondents living in more densely populated neighborhoods reported more frequent contact with network members. Those perceiving their neighborhood as safe reported larger networks, more trust in and greater support exchanged among neighbors. Findings suggest both objective and subjective indicators of neighborhood context shape access to social capital, but perceptions play a larger role.
HOW POLITICO-ECONOMIC SYSTEMS CAN SHAPE THE ATTITUDE TOWARD ELDERLY CARE: LESSONS FROM THE GERMAN REUNIFICATION
Authors: Diederich Freya , König Hans-Helmut , Brettschneider Christian 
Published: November 2019

Abstract
Migration flows have been rising over the past decades and are not expected to mitigate in the future. Migrants brings along values and preferences that were shaped by their origin countries, among those, their perceptions of how societies should care for the elderly. In this study, we examine how the attitude towards informal care is shaped by the politico-economic system an individual grew up in and if this attitude adjusts over time once an individual lives in a different system. After the fall of the Berlin Wall, Eastern Germans were exposed to the market-oriented western economy, a natural experiment that allows us to address these issues. By analyzing data from the German Family Panel (2009/10-2015/16), we assess differences in attitudes towards informal care among four birth cohorts that were born during the German separation (N=11,966) using random-effects models. We control for socio-demographic factors as well as the institutional and economic environment an individual lives in. The results reveal that, on average, older generations that grew up in East Germany exhibit up to a 6.7% (95% CI, 0.03-0.1) higher willingness to provide informal care to their parents than older generations that grew up in West Germany. There is no significant difference in younger birth cohorts. Attitudes do not significantly converge over the observed time horizon. The results provide evidence that individuals’ attitude towards informal care is deeply shaped by the system they grew up in such that migration flows can influence the supply of informal care in the future.
ALWAYS TRY TO DO MY BEST: A THEMATIC ANALYSIS OF CHINESE AMERICAN DEMENTIA CAREGIVERS
Authors: Liu Jinyu , Wu Bei , Mui Ada , Lou Yifan , Wei Wenxing , Jiang Jiyun 
Published: November 2019

Abstract
Objectives: Given the increasing prevalence of Alzheimer’s disease and related dementia (ADRD) in the United States and the rapid growth of the older Chinese American population, many older Chinese Americans are expected to need intensive care because of cognitive impairment. Prior studies on Chinese ADRD caregivers lack comprehensive examinations from a life course perspective that emphasizes the importance of time, context, process and meaning on human development. Using the life course perspective, this study aims to identify challenges and strength of caregiving experience for this population. Methods: We conducted semi-structured face-to-face interviews with 28 Chinese family caregivers of persons with ADRD in New York City. Thematic analysis method was used to assess the interview data. Results: Seven life-course themes emerged from the data. In the domain of challenges, four themes were identified: (1) physical and emotional exhaustion, (2) limited understanding on cognitive health, (3) difficulty in accessing effective and culturally-sensitive health care services for care recipients, and (4) caregivers’ inability to do self-care. Other three themes were found in the domain of strengths: (1) commitment to care due to cultural and religious values, (2) emotional closeness as resource to sustain caregiving, and (3) family support and cohesion. Conclusion: This study indicates that the life course perspective is an important lens to understand challenges and strengths of Chinese American caregivers. This study also suggests that health professionals could incorporate the life course perspective into assessment and intervention development when working with minority and immigrant ADRD family caregivers.
THE ASSOCIATION OF SUBCLINICAL HYPERTHYROIDISM WITH FRAILTY
Authors: Bhalla Nalini S , Vinales Karyne , Fawcett Janet , Li Ming , Bhattarai Richa , Harman Sherman M 
Published: November 2019

Abstract
The relevance of subclinical hyperthyroidism in the elderly has not been clearly defined. We studied whether the reported association of low TSH with frailty is an indicator of subclinical hyperthyroidism as assessed by free T3 levels. In a retrospective chart review of patients seen between January 2017 and December 2018 at the Phoenix VA Medical Center, we identified 100 patients aged ≥60 years with at least 2 low TSH measurements (&lt;0.5 µIU/ml) and a free T3 measurement within 6 months of the measured TSH and 50 sex- and age-matched controls (TSH 0.5-5.0 µIU/ml). Patients with exogenous or clinical hyperthyroidism were excluded. We used a deficit accumulation approach evaluating 31 factors, to create a frailty index between 0 and 1 for each patient. The higher the FI, the more likely (p&lt;0.001) it was that patients had expired in the interim. Patients with low (0.31±0.11 µIU/mL) vs. normal (1.84±0.84 µIU/mL) TSH had higher mean FI compared to controls (0.25±0.12 vs. 0.15±0.07, p&lt;0.001). TSH significantly predicted frailty score (p&lt;0.0001) independent of age. However, lower TSH was not associated with higher free T3 or free T4 levels. There was a nonsignificant inverse association of free T3 levels with FI (P = 0.09), which disappeared when adjusted for age. Similar to prior studies, low TSH predicted frailty. However, neither free T3 nor free T4 predicted low TSH or frailty index, suggesting that the association of low TSH with frailty is not due to subclinical hyperthyroidism, but perhaps to effects of comorbidities on TSH secretion.
A FRAMEWORK FOR CARE TRANSITIONS FOR OLDER ADULTS WITH COMPLEX HEALTH CONDITIONS
Authors: Stolee Paul , Elliott Jacobi B , Byrne Kerry , Sims-Gould Joanie , Tong Catherine , Chesworth Bert , Egan Mary , Forbes Dorothy 
Published: November 2019

Abstract
For older adults with complex health conditions, transitions between care settings are common and a major risk to quality of care and patient safety. Care transition interventions have shown positive impacts on continuity of care and health service use, however, most require additional human resources (e.g., transition coach), focus on one transition or “handoff”, and provide support for individual patients without addressing underlying challenges of health system integration. We sought to develop a framework for system-level enhancements to care transitions for older adults. We report a secondary framework analysis of an ethnographic investigation (the “InfoRehab” project) of care transitions for older persons who had experienced a hip fracture. The ethnographic study involved interviews, observations, and document reviews for 23 patients, 19 family caregivers, and 92 health care providers. Data were collected at each transition point (1-4/patient) along the care continuum, at three Canadian sites (large urban, mid-size urban, rural). Our framework analysis followed the approach described by Gale et al. (2013), using as cases 12 peer-reviewed papers which had reported InfoRehab results. Two researchers coded findings from each paper, then developed an analytical framework of eight themes by consensus; these include: patient involvement and choice, family caregiver involvement, patient complexity, health care provider coordination, information sharing, documentation, system constraints, and relationships. NVivo 11 was used to index findings into these themes and to generate a matrix. We are working with system stakeholders, including patients and caregivers, to apply this framework in the development of improved systems for care transitions.
TRANSGENDERED OLDER ADULTS IN LONG-TERM CARE: PREPARING FOR THE RISING TIDE
Authors: Henry Jean , Patton Susan K 
Published: November 2019

Abstract
Gender non-conforming older adults are more likely to be without traditional support systems in place; many may need to turn to nursing homes for long-term care (LTC). Little information is available about the experiences of LGBT older adults in these settings. Research questions: What is known about the experiences of transgender (TG) older adults in LTC? What evidence-based recommendations exist to guide LTC administrators in providing quality care to TG residents? What are key future research areas? Method: Systematic review of extant literature, using databases: PubMed, Medline, Psych Info, CINAHL, Academic Search Complete, and ProQuestCentral. Key Results:RQ1) Published research in transgender healthcare consists primarily of case reports, and retrospective and cross-sectional studies; minimal literature specifically on TG individuals; combining LGBT carries risk of minimizing or equating the TG experience to that of gays and lesbians. RQ2) Recommendations: take proactive approach; focus on awareness of relevant laws and regulations; establish non-discriminatory and inclusive environments, policies, and procedures; regular staff training, monitoring, and evaluation. RQ3) Need exists for quantitative and qualitative research into all aspects of the TG experience in LTC. Key areas include: lived experience of the TG in LTC; beliefs, attitudes, values and practices of LTC staff; administrative challenges and responses. Conclusions: Transgender and gender non-conforming individuals frequently experience discrimination in healthcare. Lack of cultural and clinical competence, and discrimination and bias by providers, create barriers to quality healthcare. Healthcare professionals and systems must be proactive in preparing for the inevitable growth of this population in the LTC setting.
ADVERSE CHILDHOOD EXPERIENCES AND ALCOHOL-IMPAIRED DRIVING IN LATER LIFE
Authors: Sahoo Shalini , Sacco Paul 
Published: November 2019

Abstract
Adverse Childhood Experiences (ACEs) are associated with a range of negative behavioral health outcomes in adulthood. Those with ACEs may use alcohol as a component of long-term coping, increasing risk of alcohol-impaired driving. Associations between ACEs and alcohol-impaired driving are relatively understudied. Using the 2012/2013 data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), logistic regression models examined the relationship between five types of ACEs (e.g. child abuse and neglect) and lifetime alcohol-impaired driving among a representative sample of American adults aged between 18 to 90 years (N = 36,309). ACEs were positively associated with lifetime alcohol-impaired driving for adults under age 50 (witnessed intimate partner violence (OR = 1.624, p &lt; 0.001), physical abuse (OR = 1.723, p &lt; 0.001), sexual abuse (OR = 1.651, p &lt; 0.001), physical neglect (OR = 1.571, p &lt; 0.001), and emotional neglect, (P &gt; 0.05). We found similar positive associations between ACEs and impaired driving among adults aged 50 and over (witnessed intimate partner violence (OR = 1.398, p &lt; 0.05), physical abuse (OR = 1.751, p &lt; 0.001), sexual abuse (OR = 1.690, p &lt; 0.001), physical neglect (OR = 1.455, p &lt; 0.001), and emotional neglect, p &gt; 0.05). Among adults under age 50, ACEs were associated with past-year alcohol-impaired driving, but this relationship was not seen in adults aged 50 and over. Findings suggest that the effect of ACEs on alcohol-impaired driving is in younger adulthood when alcohol use and driving occur most.
SUICIDE TRENDS AND DISPARITIES AMONG OLDER ADULTS IN THE UNITED STATES, 2008-2017
Authors: Ibrahimi Sanae El , Xiao Yunyu , Smith Matthew L 
Published: November 2019

Abstract
Background: Suicide ranks within the top fifteen causes of death among adults 55 and older in the United States and is a growing concern in the face of social isolation and other end-of-life issues. This study examined differences and trends in suicide rates and methods among older adults in the U.S. Methods: Suicide mortality rates from 2008-2017 were derived from the Multiple Cause of Death files in the CDC’s WONDER database. Suicide deaths were identified from the underlying causes of death using ICD-10 codes. Age-adjusted death rates (per 100,000) were calculated. Older adults were grouped into four age categories: 55-64, 65-74, 75-84, and 85+ years. Percent change in suicide rates between 2008-2017 were examined, which were then stratified by gender and top suicide methods. Results: Suicide rates increased by 16% among adults 55 years of age and older from 2008 to 2017 (15.4 vs 17.8 per 100,000 respectively). In 2017, the suicide rate among older adults was 27% higher than the general population (14.0 per 100,000). Suicide rates were significantly higher among men relative to women for those ages 85+ (14:1 ratio of males-to-females). However, females in the 65-74 age group experienced the highest increase of suicide rate (41%) compared to other females or males across age groups. The most common method of suicide was firearms, followed by poisoning and suffocation. Suffocation had the highest increase over time (37%). Conclusion: Rising suicide rates among older adults suggest the need for tailored intervention strategies that address upstream suicide-related risk factors.