bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Associated With Food Intake, Nutritional Status, and Function Among Nursing Home Residents With Dementia
Authors: Taani Murad , Plotkin Adam 
Published: December 2020

Abstract
Declined food intake is prevalent among long-term care (LTC) residents with dementia and associated with deleterious health outcomes. This study explores food intake, nutritional status, and function and its associated factors in LTC residents with dementia. Data from 82 LTC residents with dementia were used in this secondary analysis. In the primary study, appetite was assessed using the Short Nutritional Assessment Questionnaire (SNAQ). Dementia level, comorbidity, agitation, pain, mood, food intake, nutritional status, and function variables were extracted from the electronic medical record, including the most recent Minimum Data Set (version 3.0) assessment. The majority of residents were either malnourished or at risk of being malnourished and demonstrated a worse appetite than previously described in the literature. Comorbid illness, depressed mood, and appetite were associated with 37.1% of the variance in food intake over 30 days. Dementia level and appetite were associated with 22.2% of the variance in nutritional status. Food intake and nutritional status were associated with 29.1% of the variance in function. This study also highlights a new demographic that may require extra assistance in combating declined food intake: LTC residents with dementia who reside in a facility that follows restrictive food practices such as a kosher diet. The potential reversibility of factors associated with food intake and nutritional status provides opportunities for intervention.
Is Handgrip Strength a Valid and Reliable Measure in Older Adults?
Authors: Spicher Jefferson , Silva-Smith Amy , Benton Melissa 
Published: December 2020

Abstract
Handgrip strength is related to mortality, disability, functional independence, and quality of life in older adults, and cut points for diagnosis of sarcopenia have been proposed. However, there is no standardized procedure or device, so measurement may not be accurate. To assess validity and reliability we compared hydraulic (HD) versus digital (DD) handgrip dynamometers. Sixty-seven older (76.2 ± 0.9 years) men (n=34) and women (n=33) completed two measurements on sequential days (T1, T2) using both devices in random order. Participants sat in a chair with the device held in their dominant hand, their arm supported on a table or other stable surface, their wrist in a neutral position, and their elbow bent at a 90° angle. To avoid muscle fatigue that has been attributed to multiple attempts, participants squeezed the device one time as hard as possible for 3 seconds. Strong (p&lt;0.001) intraclass correlations were observed for both devices (HD=0.98; SS=0.96) indicating good reliability. However, there were significant differences between devices and between measurements. Strength measured with HD was greater than DD at T1 (27.4 ± 1.4 vs. 23.4 ± 1.1 kg, p&lt;0.001) and T2 (25.3 ± 1.4 vs. 21.8 ± 1.2 kg, p&lt;0.001). Day-to-day measurements were also significantly different. Between T1 and T2 strength decreased 8% with HD (p&lt;0.001) and decreased 7% with DD (p=0.001). In this group of older adults, significant differences in handgrip strength were observed between devices and timepoints indicating poor validity. As a diagnostic tool, standardization is needed for handgrip measurement procedures to improve accuracy.
Older Adults’ Experience of Health and Life Events as Reported Online Over 150 Consecutive Weeks
Authors: Kaye Jeffrey , Mattek Nora , Beattie Zachary , Sharma Nicole , Riley Thomas , Dodge Hiroko 
Published: December 2020

Abstract
Key activities and life events that impact quality of life and health may be gleaned from cross-sectional annual surveys or for medical data, derived intermittently from electronic health records. These methods cannot reflect the day-to-day and week-to-week changes that typically occur in domestic life. To assess the frequency and types of major life activities and events occurring at finer-grained temporal scale, we queried online, every week, three domains of activity and function (life events such as having an overnight visitor, travel away from home; health-related events such as medication changes, falls, ER/hospital visits, health limitations; and internal states such as pain, mood, or loneliness). Over a mean assessment period of 2.9 ± 1.2 years, 16,738 online surveys were completed by 129 community-residing volunteers with mean age 84 years. Overall the most frequent events reported were physical health limitations (14%), travel away from home (12%) and overnight visitors (9%). Needing new in-home assistance for medication management, bathing, dressing or grooming was rare (1%). Accidents were also rare (1%). Low mood, pain ratings (0-10 scale) and loneliness were infrequently reported; 4% low mood, 8% pain rated &gt; 5, 3% reporting loneliness. Low mood and increased pain intensity were highly correlated with health changes (medication changes, ER/hospital visits, health limitations, falls; all p&lt;0.0001). Continuous home-based online assessment of life activities and health can provide a more detailed and timely characterization of older adult function. These data may be used to guide more timely and effective health maintenance programs and interventions.
Bidirectional Association Between Knee Osteoarthritis and Depressive Symptoms: A Nationwide Cohort Study
Authors: Lu Han , Shang Shaomei , Wang Limin , Chen Hongbo 
Published: December 2020

Abstract
Both knee osteoarthritis (KOA) and depressive symptoms are common health issues affecting the quality of life of old adults. Although it is presumed that KOA has a bidirectional relationship with the depressive symptoms, no cohort study has proven it. This is the first study to determine the strength of association for the bidirectional relationship between KOA and depressive symptoms. Data were gathered from the nationally survey of China Health and Retirement Longitudinal Study in 2011-2015. The presence of depressive symptoms was defined by the 10-item Center for Epidemiologic Studies Depression Scale score of 10 or higher. The adjusted Cox proportional hazards regression model was conducted to estimate hazards ratios (HRs). Controlled covariates include gender, age, education, marital status, residence, number of chronic diseases, and disability. The analysis of KOA predicting the depressive symptoms onset consisted of 4,377 participants free from depressive symptoms at baseline. During 4 years follow-up, diagnosed KOA participants were more likely to have depressive symptoms than their peers without KOA (HR = 1.50, 95% CI: 1.23-1.83). The parallel analysis of depressive symptoms predicting KOA onset included 6,848 participants without KOA at baseline, those with depressive symptoms had a higher relative risk of developing KOA (HR = 1.64, 95% CI: 1.41-1.92). Our results provide compelling evidence that the KOA-depressive symptoms association is bidirectional, highlighting the importance of evaluating the relationship between physical and mental health among older people. Particularly, taking this association into consideration in the risk assessment and primary prevention of KOA and depression symptoms.
A Practical and Validated Fall Risk Screening Instrument: A Systematic Review
Authors: Meekes Wytske , Korevaar J C , Leemrijse C J , van de Goor L A M 
Published: December 2020

Abstract
Early detection of a high fall risk is important to start fall preventive interventions in time and to reduce fall risk among older people. Several fall risk screening instruments are available, however it is unclear which instrument is validated and most suitable for the primary care setting. This systematic review aims to identify the most suitable fall risk screening instrument(s) for the primary care setting (i.e. requires limited time, no expensive equipment and no additional space) with good prognostic ability to assess high fall risk among independently living older people. An extensive search was conducted in the databases PubMed, EMBASE CINAHL, Cochrane and PsycINFO. Twenty-six out of 2277 articles published between January 2000 and February 2019 were included. Six fall risk screening instruments were identified; TUG test, Gait Speed test, BBS, POMA, FR test, Fall History. Most articles reported AUCs ranging from 0.5-0.7 for all instruments. Sensitivity and specificity varied substantially across studies (e.g. TUG, sens.: 10-83.3%, spec.:37-96.6%). The results showed that none of the included screening instruments had sufficient (AUC&gt;0.7) predictive performance (Šimundić, 2009). As suitability for the primary care setting prevails for now, Fall History appears to be the most suitable screening instrument. Compared to the other instruments, Fall History requires the least amount of time, no expensive equipment, no training, and no space (adjustments). Patient’s fall history together with a health care professional’s clinical judgment, might be a promising screening strategy for the primary care setting to identify high fall risk among older people.
Relationship Between Patient and Informant Assessment of Personality and Cognitive Status
Authors: Tolea Magdalena , Galvin James 
Published: December 2020

Abstract
Personality has been linked to risk of dementia. Most studies ask individuals to rate their own personality traits or for a knowledgeable informant to perform the rating; few collect data from both. When informants are asked to give an estimate of the patient’s lifelong personality traits, they often describe personality before disease onset. When asked to self-rate, patients may instead assess their personality as they see themselves, providing a personality-state measure. The goal of this study was to assess agreement between two independent measures of personality and evaluate whether stage of cognitive impairment and characteristics of patients or caregivers impact concordance. In 79 consecutive patient-caregiver dyads presenting to our center (mean age:76.8±8.4; 44.1% female; 6% cognitively normal, 41% MCI; and 53% dementia) with in-depth psychosocial and neuropsychological evaluations, we found informants rated patients lower on openness (O) (ICC=0.434; 95%CI: 0.235-0.598) and agreeableness (A) (ICC=0.491; 95%CI: 0.302-0.643) and higher on extraversion (O) (ICC=0.396; 95%CI: 0.191-0.568) and neuroticism (N) (ICC=0.444; 95%CI: 0.247-0.607). Greater discordance was observed in established dementia (ICCE=0.497; 95%CI: 0.222-0.700; ICCA=0.337; 95%CI:0.031-0.586; ICCN=0.422; 95%CI: 0.191-0.683), compared with MCI (ICCO=0.568; 95%CI: 0.282-0.762). We explored the effect of patient and caregiver mood and caregiver burden on personality ratings. Although personality is typically described as a trait, we present evidence that in the eyes of patients, personality ratings may represent a state that changes across the spectrum of cognitive impairment. Understanding how patients and caregivers differentially perceive personality may assist in developing novel psychotherapeutic interventions and approaches dealing with behavioral manifestations of dementia.
Beyond Hip Fracture: Orthopaedic Trauma in an Aging America
Authors: Reider Lisa , Levy Joseph , Pollak Andrew 
Published: December 2020

Abstract
Trauma related death and disability is common among working-age Americans, however the impact on older adults is consequential and increasing. Fractures are the most common traumatic injury diagnosis among Medicare beneficiaries, and though fragility fractures continue to be an important health problem, recent data indicate an increase in high-energy fractures. The purpose of this study was to produce national incidence estimates among US men and women ≥ 65 years using data from the 2003-2014 National Inpatient Sample (NIS). The study cohort included hospitalizations involving upper and/or lower extremity fractures which were further classified by mechanism as high or low energy using external cause of injury codes. Incidence was computed using survey weights provided by NIS, and population estimates from the Census Bureau. The incidence of high-energy fractures increased from 744.1/100,000 persons (95%CI: 681.1–807.1) in 2003 to 821.4/100,000 (95%CI: 795.0 – 874.8) in 2014 in women, and from 359.1/100,000 (95%CI: 331.4–386.8) to 408.2/100,000 (95%CI: 394.–809.2) in men. Over 80% were motor vehicle related. The greatest increase was among those ≥ 85 (1,856.4/100,000 to 2,126.3/100,000 in women; 1,069.1/100,000 to 1,215.1/100,000 in men). Simultaneously, the incidence of low-energy fractures declined: 748.4/100,000 (95%CI: 687.5–809.2) to 443.8/100,000 (95%CI: 423.5 -464.1) in women, and 310.6/100,000 (95%CI: 285 – 336.2) to 206.3/100,000 (95%CI: 196.5 - 216) in men. Results suggest that fractures commonly seen in younger adults will be seen more frequently in older age. It is therefore essential to establish treatment pathways to optimize outcomes for the growing number of injured older adults.
Information Seeking Behavior of Latino Family Caregivers of People With Alzheimer’s Disease and Related Dementias
Authors: Ramirez Magaly , De Anda Sofia , Jin Haomiao , Herrera Joseph , Wu Shinyi 
Published: December 2020

Abstract
Latinos are disproportionately affected by Alzheimer’s disease and related dementias (ADRD) compared to non-Latino Whites. Family caregivers need access to high-quality information, education, and support. The study objective was to understand the information seeking behavior of Latino caregivers of individuals with ADRD. We conducted qualitative interviews in Los Angeles County with Latino caregivers of individuals with ADRD (N=21) and with healthcare and community stakeholders serving Latinos with ADRD and their caregivers (N=6). Caregivers sought information about ADRD, healthcare services and treatment, available community resources, caregiving skills, and short- and long-term care. Having limited time to seek information, lacking skills to navigate the Internet, and insufficient availability of information created barriers to accessing information. With access to information, caregivers increased their knowledge about ADRD, enrolled the person with ADRD in a memory/dementia clinic, participated in treatment decisions, attended community events, learned how to respond to challenging behaviors, and enrolled in daycare/respite programs. Caregivers experienced barriers to using information due to the insurance and immigration status of the person with ADRD and due to services only being available in English. Our study contributes new knowledge on the accessibility and use of information by Latino caregivers and their unique barriers in transforming information access into meaningful results. Healthcare and community-based providers can use our study findings to tailor informational interventions to the needs and preferences of Latinos and to the unique barriers they face in using information to support their caregiving role.
Sex and Asex: A Clonal Lexicon
Authors: Orive Maria E , Krueger-Hadfield Stacy A 
Published: December 2020

AbstractOrganisms across the tree of life have complex life cycles that include both sexual and asexual reproduction or that are obligately asexual. These organisms include ecologically dominant species that structure many terrestrial and marine ecosystems, as well as many pathogens, pests, and invasive species. We must consider both the evolution and maintenance of these various reproductive modes and how these modes shape the genetic diversity, adaptive evolution, and ability to persist in the species that exhibit them. Thus, having a common framework is a key aspect of understanding the biodiversity that shapes our planet. In the 2019 AGA President’s Symposium, Sex and Asex: The genetics of complex life cycles, researchers investigating a wide range of taxonomic models and using a variety of modes of investigation coalesced around a common theme—understanding not only how such complex life cycles may evolve, but how they are shaped by the evolutionary and ecological forces around them. In this introduction to the Special Issue from the symposium, we give an overview of some of the key ideas and areas of investigation (a common clonal lexicon, we might say) and introduce the breadth of work submitted by symposium participants.
What is the role of andexanet alfa in the reversal of anticoagulant effects?
Authors: Sewell Jenna Hill , Williams LaKeisha , McKnight Ellen , Nguyen Anthony , Sarac Miroslav 
Published: December 2020

ABSTRACT
Although using direct oral anticoagulants increases patient risk for hemorrhagic events, FDA-approved options for reversing anticoagulant effects are limited. This article discusses one of the more recent FDA-approved antidotes, andexanet alfa, and provides guidelines for its safe and effective use.
Collateral Damage: A Narrative Review on Epidemics of Substance Use Disorders and Their Relationships to Sexually Transmitted Infections in the United States
Authors: Strathdee Steffanie Ann , Bristow Claire C. , Gaines Tommi , Shoptaw Steven 
Published: December 2020

Abstract
Associations between substance use disorders and outbreaks of HIV and acute viral hepatitis have received considerable attention, but less research has focused on links between substance use disorders and sexually transmitted infections, apart from alcohol misuse. This narrative review describes the history of this public health crisis in the United States and direct and indirect effects opioids and specific stimulants have on high-risk sexual behaviors. We also review the epidemiology of sexually transmitted infections associated with opioids and stimulants in the United States and discuss opportunities for integrated interventions.
The internationalization process of agrifood firms: a proposed conceptual framework
Authors: Santos Alexandre Borges , Batalha Mário Otávio , Larue Bruno 
Published: December 2020

PurposeThis research seeks to develop a better understanding of internationalization patterns of agrifood firms and explains why different paths are adopted. Further, a conceptual framework to support public and private decision-making is proposed.Design/methodology/approachAn exploratory qualitative research framework was developed featuring case studies about three highly internationalized Brazilian meat processing firms. Top managers were interviewed, and documents were collected to support the intraand crosscase analyses.FindingsResults suggest that meat processing firms tend to adopt a dual internationalization pattern. Distribution-oriented foreign direct investment (FDI) is normally established gradually, whilst horizontal FDI – the establishment of foreign production facility – tends to be conducted through a fast-paced expansion mode. Interestingly, it was found that food safety issues play a central role in internationalization decisions.Originality/valueAn extension to the Uppsala model was provided by considering agrifood characteristics in the analysis. The results have broad appeal to managers and policymakers. Agribusiness managers could use the theoretical and empirical evidence to support their internationalization decisions. Policymakers can also use this research to gain a better understanding of how agrifood firms expand internationally to either attract or foster FDI.
Aggregate metric model for evaluating business processes
Authors: Eleonu Henry Chika 
Published: December 2020

PurposeThe purpose of this paper is to present a business process measurement framework for the evaluation of a corpus of business processes modelled in different business process modelling approaches. The results of the application of the proposed measurement framework will serve as a basis for choosing business process modelling approaches.Design/methodology/approachThe approach uses ideas of the goal question metric framework to define metrics for measuring a business process where the metrics answer the questions to achieve the goal. The weighted sum method (WSM) is used to aggregate the measure of attributes of a business process to derive an aggregate measure, and business process modelling approaches are compared based on the evaluation of business process models created in different business process modelling approaches using the aggregate measure.FindingsThe proposed measurement framework was applied to a corpus of business process models in different business process modelling approaches and is showed that insight is gained into the effect of business process modelling approach on the maintainability of a business process model. From the results, business process modelling approaches which imbibed the principle of separation of concerns of models, make use of reference or base model for a family of business process variants and promote the reuse of model elements performed highest when their models are evaluated with the proposed measurement framework. The results showed that the applications of the proposed framework proved to be useful for the selection of business process modelling approaches.Originality/valueThe novelty of this work is in the application of WSM to integrate metric of business process models and the evaluation of a corpus of business process models created in different business process modelling approaches using the aggregate measure.
Learning from intelligent failure: an organizational resource for school improvement
Authors: Benoliel Pascale , Berkovich Izhak 
Published: December 2020

PurposeSchools are complex and imperfect organizations; thus, it is not possible for school leaders to completely avoid failures. The capacity to learn from failure is essential to the effectiveness of teachers as individuals and for teams and schools. However, it is hardly practiced in most schools. The present theoretical article seeks to offer an integrative conceptual framework in which intelligent failure is conceptualized as an organizational learning process. The purpose is twofold: first, to address the question of why school faculty fails to learn from failure; second, to show how learning from intelligent failure in the school context can be framed as a resource for school improvement.Design/methodology/approachThe present theoretical article seeks to offer an integrative conceptual framework in which intelligent failure is conceptualized as an organizational learning process.FindingsThe present study draws upon the social capital theory as an overarching framework to develop a conceptual model that incorporates the learning settings and a leadership tolerant of “intelligent failure” that might enable us to identify the root causes of failure and the kinds of lessons that can be drawn from failure analysis. In the proposed conceptual model, school organizational features combine with a leadership tolerant of intelligent failures to enhance opportunities to analyze, manage and learn from intelligent failures in school settings.Originality/valueAn important lacuna in educational scholarship is that although detecting and correcting school failures is normal, investigating the root causes of these failures or pinpointing the behaviors necessary to avoid their reoccurrence is often neglected in both theory and practice. By integrating research from both non-educational and educational literature, this study may provide a new perspective for school management, since it emphasizes the reframing of intelligent failure as an organizational asset for school improvement. The present study broadens the literature on educational management and organizational learning and provides a new approach for school failures and failure management.