bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fireside Chats During COVID-19: Caregiver Community-Based Education
Authors: Dassel Kara , Rupper Rand , Butler Jorie , Telonidis Jacqueline , Witt Catherine , Edelman Linda 
Published: December 2020

Abstract
The Utah Geriatric Education Consortium (UGEC) provides education about Age-Friendly Health Care and Dementia-Friendly Communities to both informal and professional caregivers. As such, we have collaborated with our community partners to hold 12 “Fireside Chats” (2 in person, and 10 virtually due to COVID-19) between December 2019 and September 2020. Our expert speakers and panelists have given presentations on a variety of topics, specifically focused on coping with COVID-19, such as physical, music, and arts-based activities to do in the home, advance care planning, local services and supports, resiliency, and mindfulness. A total of 463 participants attended the Fireside Chats. A total of 169 attendees completed evaluations regarding the programs (a completion rate of 37%). Attendees were primarily White (86%), non-Hispanic (95%), well educated (86% had a college degree or higher), about half of the group were community caregivers (55%), while the other attendees were primarily from health professional backgrounds (e.g., nursing, social work, physical therapy). We obtained evaluation data in seven domains based on a 5-point Likert scale (1=strongly disagree to 5=strongly agree). The mean level of agreement in the seven following domains were: satisfaction (M=4.68/SD=.53), effectiveness (M=4.72/SD=.52), met stated goals (M=4.70/SD=.53), met educational needs (M=4.64/SD=.6), will improve the care they provide (M=4.57/SD=.70), included useful examples (M=4.59/SD=.66), and was better than similar trainings (M=4.23/SD=.86). These results along with steady attendance of our “Fireside Chats” demonstrate the need and satisfaction with our community-based education based on improving geriatric care practices within the community and in long-term services and support programs.
Functional Status, Meanings of Life Activities, and COVID-19 Related Disruptions among Disabled Older Adults
Authors: Yu Meng-Hsuan , Chao Shiau-Fang 
Published: December 2020

Abstract
Participating in meaningful activities has been proven beneficial to the well-being of disabled older adults. However, social distancing policies and restrictions on public activities have been implemented since the outbreak of COVID-19 at the beginning of 2020 in Taiwan. These restrictions not only prevent older individuals from performing meaningful activities but also have actual impacts on their daily life. This study aims to elucidate the intervening role of meanings of life activities on the relationship between functional status and COVID-19 disruptions. Data were collected from a sample of 526 community-dwelling older adults with disabilities in Taiwan between April and July, 2020. Utilizing Multiple Regression Analysis, the research findings were as follows. First, participants with better functional status experienced more COVID-19 related disruptions to their daily routine. In the meantime, they also valued their life activities as more meaningful than those with worse functional status. Second, higher levels of meanings in performing life activities also positively related to COVID-19 disruptions. Third, meanings of life activities fully mediated the relationship between functional status and COVID-19 disruptions. That is, disabled older individuals with better functional status may experience more COVID-19 related disruptions because their accessibility to meaningful activities was limited. Since preventive approaches to control the spread are necessary during COVID-19 epidemic, efforts should be made to sustain meaningful life activities participation among disabled older adults. Based on the findings of this study, this would be especially critical to the well-being of more capable older individuals with disabilities during the pandemic.
Material Hardship, Mental Health, and Parenting Stress among Grandparent Kinship Providers in COVID-19
Authors: Xu Yanfeng , Wu Qi , Levkoff Sue , Jedwab Merav 
Published: December 2020

Abstract
The COVID 19 pandemic has exposed the vulnerability of many families, including grandparent kinship families, to deal with a health/economic crisis. The fear of COVID-19 plus stay-at-home orders have increased individuals’ psychological distress. Moreover, school closures and homeschooling further increased parenting stress among caregivers. This study examined the relationship between material hardship and parenting stress among grandparent kinship providers and assessed grandparents’ mental health as a potential mediator to this relationship during the COVID-19 pandemic in the United States. Grandparent kinship providers (N=362) that took primary care of their grandchildren participated in a cross-sectional survey via Qualtrics Panels in June 2020 in the United States. Descriptive and bivariate analyses, binary logistic regression, and mediation analyses were conducted using STATA 15.0. Experiencing material hardship (OR = 1.67, p &lt; 0.001) was significantly associated with higher odds of parenting stress among grandparent kinship providers, and grandparents’ mental health (indirect effect = 0.11, 95% CI [0.01, 0.25]) partially mediated this association. Addressing material and mental health needs among grandparent kinship providers is critical to decreasing their parenting stress.
Precautionary Measures Against COVID-19 in Residential and Community-Based Facilities: Singapore’s Response
Authors: Yong Vanessa 
Published: December 2020

Abstract
The COVID-19 pandemic has disproportionately infected older adults who are also at higher risks of developing severe health complications and having case fatality if infected. In particular, older adults in residential and community-based facilities are at greater risks of contracting COVID-19, in part due to close proximities and frequent human interactions in these facilities. In Singapore, the Ministry of Health and its implementation agency, the Agency for Integrated Care (AIC), together with long-term care service providers, have jointly developed a number of precautionary measures against COVID-19. This paper defines and describes Singapore’s response in terms of the ‘ABC’ of COVID-19 safety measures for facilities, namely, safe Access, Behaviors, Compounds (i.e. spatial surroundings). These included infection prevention and control measures, access to PPE, distancing and zoning measures, suspension of visitors, alternative accommodation for long-term care workers, and testing to monitor people with long-term care needs and care workers. Incident response teams to support facilities providers in responding to COVID-19 infections were also swiftly set up. The outreach arm of AIC, the Silver Generation Office, further provided information and services support to older people during the pandemic. We share these measures as a set of practices and learning points for other countries undergoing the current pandemic and for future references.
Understanding contributors to quality of care in long-term care and changes under COVID-19
Authors: Luck Sara , Aubrecht Katie 
Published: December 2020

Abstract
Nursing home facilities are responsible for providing care for some of the most vulnerable groups in society, including the elderly and those with chronic medical conditions. In times of crisis, such as COVID-19 or other pandemics, the delivery of ‘regular’ care can be significantly impacted. In relation to COVID-19, there is an insufficient supply of personal protective equipment (PPE) to care for residents, as PPE not only protects care staff but also residents. Nursing homes across the United States and Canada have also taken protective measures to maximize the safety of residents by banning visitors, stopping all group activities, and increasing infection control measures. This presentation shares a research protocol and early findings from a study investigating the impact of COVID-19 on quality of care in residential long-term care (LTC) in the Canadian province of New Brunswick. This study used a qualitative description design to explore what contributes to quality of care for residents living in long-term care, and how this could change in times of crisis from the perspective of long-term care staff. Interviews were conducted with a broad range of staff at one LTC home. A semi-structured interview guide and approach to thematic analysis was framed by a social ecological perspective, making it possible to include the individual and proximal social influences as well as community, organizations, and policy influencers. Insights gained will improve the understanding of quality of care, as well as potential barriers and facilitators to care during times of crisis.
Innovative Partnership Between Primary Care, AAA, and Academia Connects 4Ms and Social Determinants of Health
Authors: Leahy Suzanne , Ehlman Katie , Maish Lisa , Conrad Brad , Hall Jillian , Wells Ron , Holscher Laura 
Published: December 2020

Abstract
Nationally, there is a growing focus on addressing geriatric care in primary care settings. HRSA’s Geriatric Workforce Enhancement Program (GWEP) has called for academic and health system partners to develop a reciprocal, innovative, cross-sector partnership that includes primary care sites and community-based agencies serving older adults. Through the University of Southern Indiana’s GWEP, the College of Nursing and Health Professions, the Deaconess Health System, three primary care clinics, and two Area Agencies on Aging (AAA) have joined to transform the healthcare of older adults regionally, including rural residents in the 12-county area. Core to the project is a value-based care model that “embeds” AAA care managers in primary care clinics. Preliminary evaluation indicates early success in improving the healthcare of older adults at one primary clinic, where clinical teams have referred 64 older adult patients to the AAA care manager. Among these 64 patients, 80% were connected to supplemental, community-based health services; 22% to programs addressing housing and transportation; and, nearly 10% to a range of other services (e.g., job training; language and literacy; and technology). In addition to presenting limited data on referred patients and referral outcomes, the presentation will share copies of the AAA referral log, to illustrate how resources were categorized by SDOH and added to support integration of the 4Ms.
Age Differences in COVID-19 Stress and Social Ties during the COVID-19 Pandemic: Implications for Well-being
Authors: Birditt Kira , Turkelson Angela , Fingerman Karen , Polenick Courtney , Oya Akari 
Published: December 2020

Abstract
The experience of the COVID-19 (coronavirus) pandemic and its implications for well-being may vary widely by age group across the adult lifespan. The purpose of this study was to examine age differences in stress related to the pandemic and social ties, and whether those experiences are linked to well-being. Participants included a total of 645 adults (43% women) ages 18 to 97 (M = 50.8; SD = 17.7) from the May 2020 nationally representative Survey of Consumers. Participants reported the extent to which they felt stress related to the pandemic in the last month as well as social isolation, negative relationship quality, positive relationship quality, and frequent depression, anxiety and rumination in the past week. Results showed that older people reported less COVID-19 related stress, less social isolation, and lower negative relationship quality than younger people. Greater stress, social isolation, and negative relationship quality were associated with poorer well-being and greater social isolation, and negative quality ties exacerbated the effects of stress on well-being. Although many researchers have indicated that older adults may be more vulnerable to COVID-19 related stress and social isolation, this study indicates that young adults may be relatively more vulnerable. Because isolation and negative relationship quality appear to exacerbate the effects of stress, reducing social isolation and negative relations are potential targets for intervention.
Long-Term Sequences of Intergenerational Living Arrangements Among Older Americans
Authors: Kim BoRin , Liang Jersey , Xu Xiao , Ofstedal Mary Beth , Raymo James 
Published: December 2020

Abstract
Living arrangements are critical for intra-family exchanges such as physical, financial, and emotional supports influencing older adults’ health and well-being. Existing research is largely based on short-term observations of living arrangements. This study aims to explore longer term dynamic patterns of intergenerational living arrangements among older Americans and their sociodemographic and health determinants. Data came from the 1998-2016 Health and Retirement Study. Sequence analysis was employed to identify long-term patterns of intergenerational living arrangements for 3,025 individuals who were age of 51-64 at the baseline (ages of 69-82 at the last wave), have at least one child, and were observed 10 consecutive times (Obs.=30,250). Living arrangements were categorized into co-residence, proximate residence (i.e., 10miles from children), and nursing home. Multinomial logistic regressions were used to evaluate the associations of individual characteristics with the different living arrangements sequences. Four patterns of eighteen-year living arrangement trajectories were identified: Transition to proximate residence (17%), stable in distant residence (24%), stable in proximate residence (38%), and stable in co-residence (22%). Younger age and working (vs. retired) status were associated with stable coresidence rather than proximate or distant residence. Respondents who retired during the study period were more likely to move close to their children. Contrary to expectations, changes in self-rated health and functional status had no significant effect in long-term living arrangement sequence patterns. These findings suggest that intergenerational living arrangements among older Americans tend to be stable and not to be significantly affected by their caregiving needs.
Meaning of Life and Well-Being: Preliminary Results of the Successful Aging Study
Authors: Gellis Zvi , McClive-Reed Kim , Kenaley Bonnie , Kim Eunhae 
Published: December 2020

Abstract
Meaning in life for older persons has become a focal research point, with findings that a greater sense of meaning is associated with better outcomes on a range of health and well-being factors. Our study examined relationships between scores on several personality scales, including the Meaning in Life Questionnaire (Steger et al., 2009) and the WHO-5 Well-Being Index, a proxy measure of mood/depression. Community-dwelling members (N=535) of Osher Lifelong Learning Institutes aged 50 and up (mean age 71.4, SD = 6.93) at 3 U.S. sites completed surveys. Higher wellness levels were significantly correlated with increased resilience, optimism, life satisfaction, and presence of meaning in life, while lower levels were associated with greater searching for meaning in life. A multivariate linear regression model (F = 55.597, df = 4, p = .000, R = .566, R2 = .320) showed that wellness scores increased with higher scores in optimism (ß = .348, p =.000), resilience (ß = .183, p = .000), and presence of meaning in life (ß = .106, p = .019). However, searching for meaning in life significantly predicted decreases in wellness scores (ß = -.084, p=.019). These results support those of previous studies, suggesting that for older persons, an ongoing search for meaning in life is linked to negative outcomes than a perception of existing meaning in life. A variety of available interventions aimed at increasing meaning and purpose in life (Guerrero-Torelles et al., 2017) may contribute to better health and well-being in older adults.
Defining the Response of Caenorhabditis elegans to Multiple Simultaneous Stressors
Authors: Sutphin George , Dang Hope , Turner Emily , DeNicola Destiny , Hamming Sage , Furtmann Amanda , Kelser Delaney 
Published: December 2020

Abstract
Cells are constantly subjected to a variety of intrinsic and extrinsic stresses—oxidative, protein misfolding, osmotic—and respond by activating a range of molecular pathways to mitigate and repair damage—oxidative stress response, unfolded protein response, osmotic stress response. While individual stress response pathways have been described in detail, and some interventions improve resistance to multiple forms of stress (e.g. dietary restriction, insulin signaling inhibition), surprisingly little is known about how these responses differ when cells are challenged with multiple types of stress simultaneously. The molecular architecture underlying multi-stress response has broad implications for aging and age-associated disease. One characteristic of aging is a progressive increase in multiple categories of cellular stress accompanied by a decline in cellular stress response capability. Human diseases rarely involve a single form of stress—Alzheimer’s disease is characterized by neuroinflammation, oxidative stress, and misfolded proteins, while cancer exhibits oxidative stress, DNA damage, and localized hypoxia. Determining how cells respond differently to one form of stress in the presence of another is critical to building an accurate model of the aging cellular environment. We are using Caenorhabditis elegans to systematically evaluate the molecular network that cells employ when challenged by multiple simultaneous stressors and how different stress combinations impact organismal survival and health. Here we present our initial characterization of C. elegans response to multiple categories of cellular stress (oxidative, osmotic, ER, Golgi, heavy metal), which stressors elicit non-additive interactions when combined, and how these combinations impact survival, health, and established stress response pathways.
Late-Onset Pharmacological or Dietary Interventions Improve Healthspan and Lifespan in Male and Female Mice
Authors: Mitchell Sarah , MacArthur Michael , Kane Alice , Torrence Margaret , Mehmet Huseyin , Vath James , Manning Brendan , Mitchell James 
Published: December 2020

Abstract
While late-onset dietary or pharmacological interventions can extend longevity in rodents, whether or not they can be used to reverse or forestall onset of aging-related symptoms (i.e. frailty) remains untested. Here, we employed three interventions to test this hypothesis. Male and female C57BL/6 mice were randomized to one of four groups: control, 15% calorie restriction (15CR), 0.1% Methionine Restriction (MR)or ZGN1062 (1.5mg/kg, drug in feed) starting at 21mo. Healthspan measurements (mouse clinical frailty index (FI), blood collection, and hematology) were performed every three months, and survival was assessed for all mice. At baseline there were no significant differences in frailty index. After 6mo FI increased consistent with reduced healthspan in control males (0.23□0.01 to 0.34□0.01 A.U, p&lt;0.0001) and females at this age (0.19□0.03 to 0.24□0.01, p&lt;0.0001). Male 15CR, MR and ZGN1062 mice had significantly lower FI scores at 27mo age (15CR: 0.32□0.01, p=0.02; MR: 0.31□0.01, p=0.0009; ZGN1062: 0.30□0.01, p&lt;0.0001). Female mice were less frail than males at 27mo, suggesting sexual dimorphism in the timing of frailty onset in mice. ZGN1062 significantly extended lifespan in males (HR=0.56, p=0.007) and females (HR=0.46, p=0.001). There was a sexual dimorphism in the ability of 15CR and MR to extend lifespan, and a trend towards increased lifespan in males (HR=0.69, p=0.057 and HR=0.71, p=0.09) but not in females. Histological analysis for cause-of-death is ongoing. Taken together these data suggest that a pharmacological intervention associated with weight loss, which may be a more practical therapeutic strategy towards mitigation of age-related healthspan decline than dietary restriction-based interventions.
Epigenetic Signatures of Cell States in Aging
Authors: Leung Diana , Levine Morgan 
Published: December 2020

Abstract
Epigenetic clocks based on DNA methylation (DNAm) show striking age correlations and predict various outcomes. Patterns of DNAm also reflect critical mechanisms in differentiation and proliferation. As such, an outstanding question is whether part of the signal epigenetic clocks are capturing represent shifts in the proportions of somatic stem cells, senescence cells, and/or tumorigenic cells. Here, we assembled various methylation datasets that captured relevant phenomena, including pluripotent stem cells, differentiation, senescence, and cancer, and performed weighted network analysis to cluster and compare DNAm modules. We find overlapping clusters between in vitro samples and in vivo tissue samples, suggesting that cell-level phenomena like cell replication, senescence, and cancer intersect with age-related epigenetic signatures. While the effects of aging manifest at multiple systems levels, from the genome to clinical phenotypes, these analyses may help provide insight to the contribution of cell phenotype dynamics to the general aging phenomenon.
Translating Research Findings Into an Evidenced-Based Approach to Improve Hospital Practices for Malnutrition
Authors: Deer Rachel , Lehe Janna , James Colleen , Hommel Erin 
Published: December 2020

Abstract
Malnutrition is a common problem that often goes unrecognized. In a recent UTMB-OAIC funded pilot, we found 49% of older adults were at risk of malnutrition at hospital admission. Malnutrition is associated with increased length of stay, poorer patient outcomes, and higher risk of mortality. Also, malnutrition severity alters hospital reimbursement rates. In 2018, the UTMB health system recognized the need for institutional guidelines to help identify, diagnose, document, and code mild/moderate/severe malnutrition. At baseline, compared to similar academic medical centers, UTMB ranked in the bottom quartile for malnutrition diagnosis. A multidisciplinary committee formed with physicians, nurses, researchers, dieticians, coding, and information technology. Preliminary data from the pilot study found the Nutritional Risk Screen (NRS) had the best sensitivity, specificity, positive and negative predictive values. The NRS was made more user friendly with scripting/prompts in the electronic medical record (EMR) to improve consistency/compliance among nurses. The Subjective Global Assessment was used in EMR by dieticians to document malnutrition diagnosis. A Best Practice Advisory was created to give physicians the option to easily add malnutrition diagnosis to the problem list. Since “go-live” in February 2019, NRS completion improved from 10.6% to 70.0%. Coding of malnutrition increased from 3.7% to 5.8%. In a 6 month follow-up, 113 patients were found to have direct benefits from the new process, resulting in an estimated financial impact of $945,605. Going forward, we have identified multiple areas of continued education needs to further improve the implementation and uptake of the new screening tool and diagnostic processes.