bluuebunny/crossref_metadata_2025_split huggingface dataset:
Daily Stressors Degrade Perceived Cognitive Abilities in Healthcare Professionals
Authors: Drury Rhitik Joshi Taylor , Lee Soomi 
Published: December 2020

Abstract
Stress negatively impacts cognitive functioning. Less is known about whether daily stress is associated with perceived cognitive abilities in healthcare workers who require mental sharpness and attention to provide high-quality patient care. We examined daily associations between stressors and perceived cognitive abilities in nurses and whether the associations differed between workday vs. non-workday. Using 14-day smartphone-based ecological momentary assessment, 61 inpatient nurses at a U.S. cancer hospital reported the frequency and severity of daily stressors (e.g., arguments, accidents). Each day, participants subjectively evaluated their mental focus, memory, and attention. Multilevel modeling examined the within- and between-person associations of daily stressors with cognitive abilities adjusting for sociodemographics, work shift, and workday. Nurses reported experiencing stressors once every other day. More stressors were associated with poorer cognitive abilities. At the between-person level, those with more frequent or severe stressors reported poorer mental focus (B=-22.4, p&lt;.01; B=-0.35, p&lt;.01, respectively), worse memory (B=-24.35, p&lt;.01; B=-0.37, p&lt;.01, respectively), and lower attention (B=-25.47, p&lt;.05; B=-0.40, p&lt;.01, respectively). At the within-person level, on days with more frequent or severe stressors, participants reported poorer mental focus (B=-2.05, p&lt;.05; B=-.03, p&lt;.05, respectively) and lower attention (B=-1.95, p&lt;.05; B=-.04, p&lt;.01, respectively). Some of the between-person associations were more apparent on workdays; those with more stressors reported poorer mental focus and lower attention on workdays than on non-workdays. Nurses’ perceived cognitive abilities at work vary by daily stressors. Disconnecting the linkage between stressors and perceived cognition may help improve work performance in nurses who may encounter frequent stressors at work.
Early detection of cognitive impairment by natural language among outpatients and community dwellers
Authors: Kiyoshige Eri , Kabayama Mai , Takeya Yasushi , Takami Yoichi , Takeda Shuko , Gondo Yasuyuki , Rakugi Hiromi , Kamide Kei 
Published: December 2020

Abstract
Background: Although early detection of cognitive decline has a significant relation to improving the quality of life of dementia patients, this early detection has been difficult due to requires of neuropsychological tests which people generally take when they notice their cognitive impairment. The timing of patients’ notice was reported to be worse cognitive decline already, thus, we aimed to determine if cognitive impairment from a short interview by using Natural Language Processing approach. Methods: The present study used cross-sectional analysis among elderly outpatients and community-dwelling elderly from Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. Cognitive decline was assessed by Telephone Interview of Cognitive Status for Japanese (TICS-J) and modeled as a binary outcome (cut-off &lt;33 points). Natural language data was collected by semistructured interviews about health conditions and cognitive orientation in space, time, and place. We used an open-source text segmentation library to parse natural language text into bag-of-words and term frequency-inverse document frequency (TF-IDF) representations. Results: There were 38 (19.9%) outpatients and 153 (80.1%) community dwellers, and 60 (31.4%) participants were defined as cognitive impairment. The maximized TF-IDF score was 0.49 in cognitive orientation in time questions. In this question, participants without cognitive impairment could not calculate the score. There were no significant differences in TF-IDF scores between participants with and without cognitive impairment. Conclusions: Elderly without cognitive impairment might not have an episode about cognitive orientation in time, and this may help for early detection of cognitive impairment
Understanding Subjective Comparison of Memory to Peers: A Biopsychosocial Approach
Authors: Walden Allison , Robertson Anna , Lag Madeline 
Published: December 2020

Abstract
Identifying factors that contribute to subjective reports of memory decline may have important implications for interpretation of objective memory performance. Research suggests that subjective memory decline is influenced by affective symptoms such as anxiety and stress that are subsequently associated with poorer performance on neurocognitive tests. Personality is an additional factor, as evidence demonstrates that neuroticism may predict subjective memory decline. More research is needed to understand how factors such as demographics, personality traits, and subjective health impact subjective memory. The present study applies a comprehensive, biopsychosocial approach to identify constructs that predict how individuals view subjective memory decline compared to others their age. Researchers used a national database, Midlife in the United States (MIDUS), due to its comprehensive and diverse sample (N = 3,291). Predictor variables pertained to demographics, personality traits, as well as physical and mental health self-reports, and the outcome variable captured subjective memory relative to one’s peers. A three-step hierarchical regression model indicated that demographic variables, personality traits, and self-evaluated health significantly contributed to 26.7% of the variance of self-evaluated memory compared to others their age, F(35, 2836) = 29.48, p &lt; .001, with each block incrementally adding to the significance of the findings. Results suggest that subjective evaluation of physical health, personality traits, and demographic variables uniquely influence subjective memory decline relative to others of the same age. Awareness of how biopsychosocial factors may contribute to affective symptoms may have implications for the interpretation of neuropsychological testing results.
Types of Insomnia Mediate the Relation between Anxiety and Depressive Symptoms Longitudinally in Late Life
Authors: Bolstad Courtney , Nadorff Michael 
Published: December 2020

Abstract
The current study examined onset and maintenance insomnia as mediators of the relation between anxiety and depressive symptoms over a three-year period in a sample of older adults. We hypothesized that anxiety symptoms at timepoint one would significantly predict depressive symptoms at timepoint four, while controlling for depressive symptoms at timepoint one. We also hypothesized that this effect would be significantly reduced when adding onset and maintenance insomnia at timepoint two and three, respectively, as mediators. Participants included 3,484 older adults, ages 66 to 103 (M = 77, SD = 7), included in the National Health and Aging Trends Study who completed measures of types of insomnia, anxiety, and depressive symptoms at four different timepoints (2012 through 2015). The model showed a significant direct effect of anxiety on depressive symptoms at timepoint four, independent of baseline depressive symptoms. The relation was mediated by onset and maintenance insomnia, though a significant direct effect remained. Therefore, types of insomnia contribute to the development of depressive symptoms in older adults with anxiety symptoms over time, even when controlling for baseline depressive symptoms. Further, onset and maintenance insomnia are unique outcomes and predictors of anxiety and depressive symptoms, respectively, even when controlling for baseline depressive symptoms. Our findings provide a foundation for future intervention research with clinical samples that control for confounding variables in further elucidating the development and change in depressive symptoms among older adults with anxiety through onset and maintenance insomnia.
Licensed Nurse/Certified Nurse Aide Collaboration in the Care of Nursing Home Residents
Authors: Beynon Cynthia 
Published: December 2020

Abstract
This mixed-method study explores how nursing team collaboration is perceived and experienced in four nursing homes (NHs) in the Western United States. Licensed nurse (LN) and certified nurse aide (CNA) participants completed two survey tools to assess their perception of collaboration and teamwork in their current work environment. The LNs and CNAs were paired and interviewed both individually and as a caregiving pair to explore the lived experience of collaboration in the care of NH residents. Quantitative survey results were analyzed using IBM® SPSS Version 25, and participants reported a collaborative working environment with equally strong ratings in the following categories: partnership, cooperation, and coordination; they agreed with statements reflective of teamwork including team structure, leadership, situation monitoring, mutual support, and communication. No significant difference was found between LN and CNA responses or between team members in any of the four participating facilities. Qualitative survey data were loaded in NVivo12 and analyzed using a thematic analysis approach. The findings revealed five primary themes, including essential elements in successful team collaboration—perspective, coworker connection, communication, and mutual support—and ways teamwork and collaboration impact resident care.
Racial Differences in the Impact of Subjective Life Expectancy on Advance Care Planning
Authors: Lou Yifan , Carr Deborah 
Published: December 2020

Abstract
The need for advance care planning (ACP) is heightened during the COVID-19 pandemic, especially for older Blacks and Latinx persons who are at a disproportionate risk of death from both infectious and chronic disease. A potentially important yet underexplored explanation for well-documented racial disparities in ACP is subjective life expectancy (SLE), which may impel or impede ACP. Using Health and Retirement Study data (n=7484), we examined the extent to which perceived chances of living another 10 years (100, 51-99, 50, 1-49, or 0 percent) predict three aspects of ACP (living will (LW), durable power of attorney for health care designations (DPAHC), and discussions). We use logistic regression models to predict the odds of each ACP behavior, adjusted for sociodemographic, health, and depressive symptoms. We found modest evidence that SLE predicts ACP behaviors. Persons who are 100% certain they will be alive in ten years are less likely (OR = .68 and .71, respectively) whereas those with pessimistic survival prospects are more likely (OR = 1.23 and 1.15, respectively) to have a LW and a DPAHC, relative to those with modest perceived survival. However, upon closer inspection, these patterns hold only for those whose LW specify aggressive measures versus no LW. We found no race differences for formal aspects of planning (LW, DPAHC) although we did detect differences for informal discussions. Blacks with pessimistic survival expectations are more likely to have discussions, whereas Latinos are less likely relative to whites. We discuss implications for policies and practices to increase ACP rates.
Difference in Parent-Child Care Experience by Demographic Characteristics: Focusing on Stress, Needs, and Meaning
Authors: Baba Ayako 
Published: December 2020

Abstract
OBJECTIVE: In super aging society, unpaid caregivers play important roles. Therefore, they should be supported to realize the lives they want. However, it is unclear what caregivers’ particular needs are under different conditions. This study aimed to explore the difference in forms of stress and needs of caregivers by demographic characteristics. METHOD: Adult children who were caring for or had cared for their parents at home under the Japanese long-term care insurance system (n=653) completed the three open-ended questions concerning caregiving stress, unmet needs, and meaning, combined with a demographic survey. Data were analyzed using text mining approaches such as correspondence analysis and co-occurrence network analysis, which illustrated differences in description according to demographic variables. RESULT: 1) Caregivers of fathers felt stressed when rebuked by care-recipients, whereas daughter caregivers of mothers felt stressed in coping with care-recipient dementia and complaint, and balancing caregiving with parenting. 2) Caregivers in economic difficulty needed instrumental and financial support, whereas others needed flexible support and accessible consultation services. 3) Caregivers living with care-recipients found meaning in experience and repaying parents for raising them, whereas caregivers living away found meaning in improved parent-child relationships and images of care-recipients. Caregivers of persons with dementia found meanings in sharing time of tranquility with care-recipients. CONCLUSION: The study revealed differences in caregiving experience by care dyads, economic situation, living arrangement, and dementia etc. These results suggest that family caregivers should be provided with services to help find meanings in work and reduce stress levels, according to caregiving conditions.
A Scoping Review of Social Housing Models for Older Adults
Authors: Sheppard Christine , Yau Matthew , Kwon Carol , Rios Jorge , Austen Andrea , Hitzig Sander 
Published: December 2020

Abstract
Access to affordable housing is a rising concern for many older adults, and government-sponsored social housing programs are one approach to support low-income older adult renters; however, these housing models are limited in availability and may not all be well-suited to support aging in place. To better understand how to promote the physical, mental and social wellbeing of older tenants in social housing, this scoping review mapped relevant literature to examine: 1) the characteristics of older adults in social housing; and 2) social housing service models and policies. Seven peer reviewed databases were searched for relevant articles, which were screened by two independent reviewers. A total of 140 articles met the inclusion criteria. Studies were predominately from the US and Canada; spanning over five decades of research, with publications surging in the 1980’s and in the 2010’s. Almost all studies reported on the sociodemographic and health characteristics of older tenants, and two thirds presented findings on social housing service models, including policies, staff positions and training, and access to on-site support services. This review points to a high level of vulnerability among older adult tenants living in social housing and highlights the importance of co-locating support services in social housing buildings, with dedicated tenant-support staff to identify vulnerable tenants and link them to these services. There is an acute need for more research on key issues related to housing retention, such as eviction prevention, in order to identify opportunities for social housing landlords to help older tenants age in place.
Understanding patient and clinician perspectives of antibiotic use for the treatment of UTIs
Authors: Hannum Susan , Heughan Ja Alah-Ai , Gurses Ayse , Katz Morgan , Zenilman Jonathan 
Published: December 2020

Abstract
Background. Multidrug resistant organisms are highly prevalent in post-acute long-term care [LTC] and skilled nursing facilities [SNF], driven by overdiagnosis of urinary tract infections [UTI] and overuse of antibiotics, despite clinical guidelines for UTI management. Using the Systems Engineering Initiative for Patient Safety [SEIPS] framework to understand sociotechnical work systems within LTC/SNFs, we are conducting mixed methodological research to examine work systems gaps that may require structural modification to ensure appropriate prescribing behaviors. Methods. To begin this research, we conducted semi-structured interviews with residents, caregivers, and clinical staff at three LTC/SNF locations. Resident and caregiver interviews queried knowledge, attitudes, and beliefs about UTIs and antibiotics, previous use, and communication with clinical staff. Clinical staff interviews queried procedures for diagnosing UTIs, prescribing decisions, communication with residents/caregivers, and resident/caregiver demand. Findings. Resident/caregiver interviews highlighted three common themes: (1) doctors have the right to deny antibiotics, but communication about decisions is critical; (2) trust doctors’ knowledge and use of objective testing for decision-making; (3) want detailed explanations and education about antibiotics, including potential side effects. Clinical staff described: (1) caregiver as the primary barrier, even with education about antibiotics; (2) using a general protocol for diagnosis, but also prior knowledge and experience with the resident; (3) importance of educating and communicating with residents/caregivers about antibiotic treatment, prescribing recommendations, or side effects. Conclusions. Our study highlights a gap in communication and workflow between residents, caregivers, and clinical staff that may be amendable to improved interventions that decrease inappropriate prescribing of antibiotics for this population.
Body Mass Index and 12-year Mortality Among Older Mexican Americans Aged 75 Years and Older
Authors: Jadhav Reshma , Markides Kyriakos S , Snih Soham Al 
Published: December 2020

Abstract
The objective of this study was to examine the effect of body mass index (BMI) on 12-year mortality among older Mexican Americans aged 75 years and older. Data are from wave 5 (N=1,367) of the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004/2005-2016). Measures included socio-demographics, self-reported medical conditions, body mass index (BMI), disability, Mini-Mental-State-Examination (MMSE), short physical performance battery (SPPB), high depressive symptoms, and falls. BMI was classified as underweight (&lt; 18.5), normal weight (18.5 to &lt; 25), overweight (25 to &lt; 30), obesity type I (30 to &lt;35), and morbid obesity (≥ 35).Cox proportional hazards regression analysis was performed to estimate the hazard ratio of 12-year mortality as a function of BMI categories at baseline. The average of the sample was 81.2 years, 17.2% were underweight, 22.7% were normal weight, 27.4% were overweight, 31.9% were obesity type I, and 38.6% were morbid obesity. Mexican Americans aged ≥75 years with overweight or obesity Type I had a reduced hazard ratio (HR) of death (HR=0.80, 95% CI=0.68-0.93 and HR=0.73, 95% CI=0.60-0.88, respectively) over 12-years of follow-up. The HR of death for underweight and morbid obesity participants was 1.78 (95% CI=1.13-2.80) and 1.03 (95% CI=0.79-1.36), respectively. Female participants and those with high scores in the MMSE and SPPB had decreased risk of death. This study confirmed the protective effect of overweight and obesity on mortality seen in this population at a younger age, which might have implications when treating older adults with overweight and obesity.
Dietary Administration of 2-Deoxy-D-Glucose Reduces High Fat Diet Induced Obesity and meta-inflammation in Mice
Authors: Pandey Sanjay , Joshi Diksha , Singh Saurabh , Ray Sushma , Bhatt Anant Narayan , Natarajan K , Dwarakanath B S 
Published: December 2020

Abstract
Obesity is a major risk factor for type 2 diabetes, NAFLD, chronic diseases and cancer. Insulin resistance, oxidative stress, high ectopic lipid levels and meta-inflammation are the mechanisms proposed to play a leading role in the morbidity associated with obesity. Energy restriction mimetics (ERMAs) has also been shown earlier to reduce the scale and the severity of these disorders by mimicking the physiological effects of the Energy Restriction. In present study we propose that the use of 2-DG as ERMA can be effective in regulating the High Fat Diet (HFD) induced obesity. Effect of 2-DG (0.4% w/v in drinking water) on the HFD and Insulin Resistance (IR). HFD induced change in body weight, adipose tissue mass, and ectopic lipid levels was assessed as the measure of obesity.IR and glucose levels were also estimated to evaluate the effect of 2-DG on the insulin sensitivity in HFD mice. 2-DG significantly altered HFD induced increase in the mice body weight, epididymal White Adipose Tissue (WAT) and liver weight. 2-DG fed mice also showed reduced lipid levels in serum and liver. Furthermore, 2-DG also reduced the oxidative damage in the liver with concomitant increase in enzymatic (SOD and Catalase) and non-enzymatic (reduced Glutathione) antioxidant levels. 2-DG fed mice also showed reduced levels of Leptin, IL-6 and TGF-β which are early drivers of the etiology of the metabolic diseases. Our results suggest that 2-DG as ERMA can prevent obesity and etiology of associated disorders. However, more relevant models are needed to further strengthen these observation
Racial Differences of Attitudes Towards Medical Marijuana Use Among American Older Adults
Authors: Ding Kedong , Lou Yifan 
Published: December 2020

Abstract
Background: Extensive evidence documented that medical marijuana (MM) could be used for pain management with fewer side effects. Although MM legalization remains controversial as it is perceived to be a “gateway drug”, more states are striving for MM legalization and calling for health insurance coverage. Racial difference in the use of opioids for pain management is well-documented, which may also exist in the use of MM. This study explored an understudied topic on how people from different racial backgrounds perceive MM and its behind mechanism. Method: Data is from Health and Retirement Study Wave 2018 who answered the special modules on MM (n=1340). The attitude is proxied by two dichotomous measures on whether they think MM is acceptable and would lead to hard drug. Logistic regressions were used to evaluate the relationships between attitude and race, adjusted for sociodemographic, health and mental health, and MM knowledge. Moderating effects of diseases and socioeconomic-status (SES) were tested using interaction terms. Results: Older adults who hold positive attitudes towards MM are more likely to be younger, high SES, using opioids. Hispanics and Blacks are more negative towards MM relative to White counterparts. Blacks with cancer (OR=.30) are less likely to believe MM is acceptable, whereas blacks with arthritis are more likely to accept MM (OR=2.08) compared to Whites. Hispanic females (OR=.26) are more likely to oppose MM while Hispanics with higher education background (OR=4.3) are more likely to hold positive attitudes. Implication: The results may guide development of future guidelines on MM prescription.