bluuebunny/crossref_metadata_2025_split huggingface dataset:
AVPR1A and Stress in Adults With Sickle Cell Disease–Related Chronic Pain
Authors: Roach Keesha , Dyal Brenda , Chamala Srikar , Yao Yingwei , Fillingim Roger , Wang Zajie , Molokie Robert , Wilkie Diana 
Published: December 2020

Abstract
Purpose: Emotional stress is a known pain trigger in patients with sickle cell disease (SCD). The Arginine vasopressin receptor 1A gene (AVPR1A), SNP rs10877969, is associated with acute pain and stress-related pain. Our study investigated the association between AVPR1A genotype with stress and age in adults with SCD pain. Methods: 169 participants with SCD and chronic pain (100% African descent; mean age 36.4 ± 11.6 years [range =18-74 years]) completed the Perceived Stress Questionnaire. The SNP was evaluated as the imputed score was R2&gt;0.8. ANOVA compared stress by genotype and age. Findings: Mean stress scores were significantly lower (p&lt;0.05) for the older adults (0.35 ± 0.18) than the younger adults (0.41 ± 0.17). Mean stress scores were not significantly different by genotype for younger or older adults. Discussion: The rs10877969 genotype frequency was not different by age. In contrast to prior research, there was no association between genotype and stress.
Partnerships Matter in Successful Aging: Collaborations That Put Research Into Practice Across the Community
Authors: Sadarangani Tina , Wu Bei 
Published: December 2020

Abstract
Healthy aging begins and ends in the community with age friendly health systems and communities. In order to promote healthy aging and help older adults make healthy choices we must engage them as partners in healthcare with access to appropriate information and resources. This symposium will examine four community based studies that engage stakeholders to improve care quality through evidence-based interventions for older adults. These programs are all novel as they seek to engage stakeholders, perform pragmatic interventions, and improve outcomes in non-academic, community-based settings which are often overlooked. Promoting healthy behavior through peer coaching, using early detection and treatment to impact cognitive decline in social day care programs, evaluating the feasibility of screening for palliative care in assisted living and implementing evidence-based dementia care in hospice settings are all explored. Analysis of these initiatives showed improvements in perceived-health, reductions in unnecessary healthcare utilization, and improvements in the physical and emotional health of caregivers, and positive changes in health behaviors. Our discussion will underscore the importance of engaging key stakeholders in study design and implementation to yield better outcomes. Community engagement is an essential part of facilitating aging-in-place, and findings illustrate that this can be achieved through innovative collaborations between researchers and community-based organizations across a variety of settings.
Partnering With Hospices to Develop, Test, and Implement Aliviado Dementia Care in a 25-Site Pragmatic Trial
Authors: Brody Abraham , Sadarangani Tina , Bristol Alycia , Jones Tessa , Convery Kimberly , McCabe Donna , Durga Aditi , Lin Shih-Yin 
Published: December 2020

Abstract
Almost half of hospice patients currently have a diagnosis of dementia. However, few pragmatic, evidence-based, programs have been developed and tested in this setting overall, and targeting persons living with dementia and their caregivers specifically. Furthermore, limited academic-hospice research partnership exist. We thus undertook efforts to develop and test Aliviado Dementia Care-Hospice Edition, a complex multi-modal quality improvement intervention, as part of the HAS-QOL Trial, a 2-phase, 25 site embedded pragmatic clinical trial, through partnership and engagement with hospice and caregiver stakeholders. We discuss methods for engagement and barriers to implementation. Stakeholders assisted with alignment of the intervention to their needs and how to flexibly implement, substantially strengthening the intervention. They also provided important input regarding how to sustain the intervention through technological, mentorship and communication support mechanisms. Barriers found include the nature of implementing in limited resource settings with multiple competing priorities and little research infrastructure.
Outcomes of Just-in-Time Patient and Stakeholder Engagement at 1 Year
Authors: Geary Carol , Eilers June , Leon Melissa , McClay James , Estabrooks Paul 
Published: December 2020

Abstract
The University of Nebraska Medical Center’s Rural Patient and Stakeholder Engagement in Research project used a novel approach to patient engagement in research: just-in-time engagement. In this approach, patients were identified and matched with researchers with shared research interests without preemptive patient and stakeholder education and training. Ten research teams initiated engaged research design between August and October of 2019. In this presentation, we will share process and outcomes measures of the just-in-time approach: measures of ongoing engagement at 6 and 9 months; evidence of research productivity, and patient and stakeholder satisfaction with their research involvement. We will also address ethical challenges, including challenges to engaging a diverse population. Part of a symposium sponsored by the Patient/Person Engagement in Research Interest Group.
Practical, Methodological, and Ethical Considerations of User Involvement
Authors: O’Sullivan Roger 
Published: December 2020

Abstract
Traditionally, older people were seen simply as ‘subjects’ of research but increasingly the case for utilizing the knowledge and insights of older people in planning research, policy, and services is gaining momentum. This presentation explores the nature of user involvement, focusing not just on the practical and methodological considerations, but the ethical aspects, which are often under-discussed. Prof O’Sullivan argues that the increasing focus on user involvement is welcomed but we need to understand and debate how it can be appropriate, meaningful, and beneficial for all involved. Using desk research as well as the results of a web-based survey and semi-structured interviews with researchers, government, and NGO representatives, Prof O’Sullivan will set out the practical as well as the ethical aspects of user involvement. He will recommend how researchers, funders, professional bodies and older people’s organizations and older people themselves can best advance the user involvement agenda. Part of a symposium sponsored by the Patient/Person Engagement in Research Interest Group.
GRECC Connect Increases Access to Geriatric Specialty Care for Rural, Older Veterans With Complex Care Needs
Authors: Nearing Kathryn , Dang Stuti , Dryden Eileen , Kernan Laura , Moo Lauren , Pimentel Camilla 
Published: December 2020

Abstract
A higher percentage of Veterans in rural areas are older, have multiple chronic conditions and select the VA for healthcare. To address the needs of rural older Veterans with complex needs, GRECC Connect hubs use case finding approaches combined with regular outreach and education to VA community-based outpatient clinic (CBOC) providers serving rural Veterans and caregivers. Alignment of GRECC Connect services with needs of providers and patients promotes establishment of therapeutic alliances in caring for medically complex older Veterans. After identifying high risk, high need patients, hubs use the following strategies to increase access to geriatric specialty care through telehealth modalities: 1) Co-management of patients through e-consultation and telehuddles (GRECC Connect interprofessional geriatric specialty care teams extend support to CBOC providers); 2) Clinical video telehealth to CBOCs and Video on Demand to Veteran homes (to reduce travel burden); and, 3) Tele-group visits (especially for behavioral health and caregiver support).
Telehealth Competencies for Interprofessional Teams Caring for Older Adults and Care Partners
Authors: Powers Becky , Nearing Kathryn , Dang Studi , Hung William , Lum Hillary 
Published: December 2020

Abstract
Providing interprofessional geriatric care via telehealth is a unique clinical skillset that differs from providing face-to-face care. The lack of clear guidance on telehealth best practices for providing care to older adults and their care partners has created a systems-based practice educational gap. For several years, GRECC Connect has provided interprofessional telehealth visits to older adults, frequently training interprofessional learners in the process. Using our interprofessional telehealth expertise, the GRECC Connect Education Workgroup created telehealth competencies for the delivery of care to older adults and care partners for interprofessional learners. Competencies incorporate key telehealth, interprofessional and geriatric domains, and were informed by diverse stakeholders within the Veterans Health Administration. During this symposium, comments will be solicited from attendees. Once finalized, these competencies will drive the development of robust curricula and evaluation measures aimed at training the next generation of interprofessional providers to expertly care for older adults via telehealth.
Sensory Loss and Delirium Among Medicare Beneficiaries
Authors: Morales Emmanuel Garcia , Reed Nicholas 
Published: December 2020

Abstract
Sensory impairment is prevalent among older adults and may increase risk for delirium via mechanisms including sensory deprivation and poor communication which may result in confusion and agitation. In the Medicare Current Beneficiary Study (MCBS), delirium was measured using a validated algorithm of claims data. Sensory impairment was defined as any self-reported trouble hearing or seeing, with the use of aids, and was categorized as no impairment, hearing impairment only (HI), vision impairment only (VI), and dual sensory impairment (DSI). Among, 3,240 hospitalized participants in 2016-2017, 346 (10.7%) experienced delirium. In a model adjusted for socio-demographic and health characteristics, those with HI only, VI only, and DSI had 0.84 (95% CI: 0.6-1.3), 1.1 (95% CI 0.7-1.7), and 1.5 (95% CI 1.0-2.1) times the odds of experiencing delirium compared to those without sensory impairment. Future research should focus on mechanisms underlying association and determine the impact of treatment of sensory loss.
Understanding Medicare With Hearing Loss
Authors: Willink Amber 
Published: December 2020

Abstract
Medicare has become an increasingly complex program to navigate with numerous choices available to beneficiaries with important implications on their financial exposure and access to care. While research has identified poor health literacy as a barrier to understanding Medicare, little information is available on the experience of individuals with hearing loss. Using the Medicare Current Beneficiary Survey (2016), a nationally-representative sample of 10,841 beneficiaries, we examined if difficulty understanding Medicare was associated with reported trouble hearing, while controlling for socio-demographic and health literacy factors. Compared to no trouble, Medicare beneficiaries with a little or a lot of trouble hearing had 44% (95% CI OR:1.34-1.55) and 63% (95% CI OR: 1.44-1.83) increased odds of reporting greater difficulty with understanding Medicare. The existing tools to support Medicare beneficiaries understand and navigate the program must evolve to meet the needs of those with hearing loss- a highly prevalent condition among Medicare beneficiaries.
Physician Suitability of an EHR Interface for Depicting Ecological Symptoms Derived From a Smartwatch
Authors: Manini Todd , Alpert Jordan , Mendoza Tonatiuh , Prabhakar Satya , Solberg Laurence , Rashidi Parisa 
Published: December 2020

Abstract
Physicians desire an electronic health record (EHR) interface to visualize data from mobile devices in rapid and unobtrusive manner. We developed an EHR interface after performing semi-structured qualitative interviews with 12 physicians. These interviews led to creating an EHR graphical interface that allowed seamless viewing of the top ranked patient attributes of pain, falls, hydration and mobility patterns. Physicians then evaluated the interface using the International Standard ISO 9241, Part 110— a survey to evaluate the design of human computer interactions. The median response for each of domains were as follows: suitability = 18.5 out of 24 (range: 9-24); conformity=34 out of 40 (range: 16-40); self-descriptiveness=25 out of 32 (range: 13-31); controllability=19.5 out of 24 (range: 8-23); error tolerance=5 out of 8 (range: 1-8). The median total score of 111.5 out of 140 (range: 88-128) indicated a relatively high level of usability of the EHR interface depicting smartwatch data.
Social and Behavioral Factors, Oral Health, and Dental Care Utilization
Authors: Wu Bei , Shuman Stephen , Ghezzi Elisa 
Published: December 2020

Abstract
Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the impact of early childhood disadvantages on oral health in later life among adults age 51 and above in the U.S. The second paper used large-scale epidemiological data that addressed the relationship between acculturation and subsequent oral health problems. It also tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The third paper demonstrated the importance of examining different pathways among foreign-born and native-born Chinese older adults with regard to offspring’s support on their oral health outcomes. While increasing evidence shows that cognitive function is associated with oral health, limited studies have been conducted to examine the impact of cognitive impairment, e.g., Alzheimer’s Disease (AD) and related dementias (RD), on dental care utilization and costs in older adults. The fourth paper aimed to address this knowledge gap. Results showed that AD and RD had different impacts on different types of dental care utilization and costs. The fifth paper further displayed that individuals with cognitive impairment face a significant challenge in handling dental-related medications. This symposium provides policy and clinical implications on improving oral health and dental care utilization among older adults in the U.S. Oral Health Interest Group Sponsored Symposium.
Beta Test of a PAC Dementia Knowledge Training Module Included in a Nursing Home Orientation Curriculum
Authors: Brown Jerry , Baylie Peter , Nwakasi Candidus , Reddy Pranay , Ehlman Katie , Nolan Beth , Snow Teepa 
Published: December 2020

Abstract
Providing quality care for older adults in long-term care can be challenging, and this issue appears to be more pressing with people living with dementia. Using the Positive Approach® to Care (PAC) model, a 2-hour module for new staff nursing home orientation curriculum was designed to help introduce the concept of working with people living with dementia. Twelve undergraduate students participated in a beta-test of the nursing home orientation. A pre-and-post 38-item survey was administered to measure knowledge level and improvement. Participants also responded to qualitative semi-structured questions after the orientation. Descriptive statistics and bivariate analysis were conducted. Results indicated an improvement on dementia-related knowledge in most of the survey items (21 of 34 items). Examples of statistically significant differences in the pretest and post-test identified are knowledge on the effect of pressure in the palm to comfort a person with dementia (p-0.039), vision as the most powerful sensory input during dementia caregiving (p-0.001), and functionalities lost when the left temporal lobe shrinks (p-0.014). The qualitative evaluation showed that most of the participants indicated a change in dementia caregiving views — including how to pause if permission is not given to engage, and to respect personal space. These findings prove important because the PAC orientation curriculum was successful in improving the students’ knowledge and perspectives on dementia. This training program could be a useful tool if implemented into nursing home employee orientation.
Navigating the Treacherous Waters of Geriatric Complexity and Heterogeneity With the Help of Team Science
Authors: Kuchel George 
Published: December 2020

Abstract
Multifactorial complexity and heterogeneity challenge the care of older adults and research into the pathophysiology of common geriatric syndromes. Multicomponent interventions matching intervention components with individual risk factors are grounded in precision medicine by ensuring that interventions may be offered to those who will more likely beneﬁt, sparing expense and side effects for those who will not. Nonetheless, the development of mechanism-guided interventions has been hampered by failure to identify single mechanisms for effective targeting within this multifactorial complexity, a problem worsened by historical barriers between research disciplines and silos. Geroscience-guided interventions target biological hallmarks of aging representing mechanisms that geriatric syndromes share with aging. We will present examples of multidisciplinary bench-to-bedside translational science seeking to transform the care of common geriatric conditions as diverse as frailty, voiding disorders and immunization against influenza and pneumococcal infections via geroscience-guided therapies applied with a greater emphasis on heterogeneity of aging and targeting.
Deprescribing in Older Adults: Is Evidence for Continued Medication Use Generalizable Beyond Age 75?
Authors: Niznik Joshua 
Published: December 2020

Abstract
Older adults over the age of 75 are severely underrepresented in many of the clinical trials used to justify the continued use of medications for chronic disease prevention in advanced age. The gaps in evidence in this population have fueled an interest in research to better understand the potential benefits and harms associated with the continued use of medications with uncertain benefit in advanced age. Deprescribing, the intentional reduction or discontinuation of medications, has recently gained traction as an important component of the prescribing process, but raises questions about the safety of stopping medications. This presentation will provide an overview of the evolution of deprescribing research and how this has shaped my career as a geriatric health services researcher. Specifically, I will address early studies that defined the field, challenges and opportunities for studying deprescribing in older adults, and future directions and priorities in deprescribing research.
The Past, Present, and Future of Health Sciences Research
Authors: Brown Cynthia , Batsis John 
Published: December 2020

Abstract
The health sciences have experienced an evolution in research over the past 75 years, moving along the translational spectrum from bench to bedside to the community. This transformation has impacted health outcomes for older adults at a global and public health level. Expansion in geroscience and implementation science research has changed the lens through which we view how aging occurs, precision management of disease, and has allowed the integration of tested interventions into healthcare systems. This Presidential symposium will showcase investigators, ranging from junior to senior researchers, who will share where their science began, how their research has built on the past, provide insights into their own work, and share their perspectives on the continuing trajectory of their scientific work.
Transitional Care Management: Evidence for Novel Implementation Models and Rehabilitation Implications
Authors: Danilovich Margaret , Danilovich Margaret 
Published: December 2020

Abstract
The transition between healthcare settings is a complex process presenting challenges for effective and consistent communication between older adults, their caregivers, and healthcare providers. These challenges often result in adverse health events and re-hospitalizations. Further, once transitioned to home, older adults often need ongoing care management and support and evidence for models remains unclear as to the precise parameters of supports needed for comprehensive care. This symposium will provide an overview of the evidence for both interdisciplinary care management models and transitional care programs, present the implementation of a care management program for low income older adults at one social service agency, and provide evidence-based tools for older adult functional assessment and decision-making for transitional care. The speakers will present new tools from the American Physical Therapy Association home health toolbox that promote patient-centered health care decision-making to facilitate successful transitions that reduce resource use and hospital readmission. The speakers will also discuss the implementation of a care management program for older adults in a care gap (having too much income for Medicaid home and community-based services, but still &lt;200% of the federal poverty line). An implementation framework for the needs assessment will be highlighted and 1-year program outcomes will be presented. Attendees will learn strategies for interprofessional collaboration, enhanced communication, and advocacy within the interprofessional team to facilitate improved care management and transitional services for older adults.
Understanding the Sensory Loss–Cognitive Function Relationship in Older Adults: Biomarker or Causal Risk Factor?
Authors: Deal Jennifer , Whitson Heather 
Published: December 2020

Abstract
Sensory impairment in older adults is common, over 55% of Americans 60 years and older have either hearing or vision impairment, and it is linked to accelerated cognitive decline and increased risk of incident dementia in population-based observational studies. However, whether sensory impairment is a marker or a cause of cognitive decline and dementia is unknown. Both sensory impairment and cognitive decline/dementia may be caused by a common underlying pathology (e.g., microvascular disease), or sensory impairment may be a marker of dementia-related pathological changes in the brain. Alternatively, causal mechanisms include increased cognitive load, changes brain structure/function, depression, social isolation and/or reduced activity. This session will investigate the role of sensory impairment in cognitive decline and dementia in older adults and discuss the ramifications of these different possibilities for risk prediction and stratification, and potentially, for disease prevention. The co-occurrence of multiple sensory deficits will be described, and the potential utility of the use of retinal signs as predictive markers for cognitive decline/dementia will be discussed. We will also describe current evidence for both non-causal and causal relationships between sensory impairment and cognition with a focus on hearing impairment. Finally, we will describe the relationship of dual sensory (both hearing and vision) impairment on cognitive performance and dementia in a biracial population-based study.