bluuebunny/crossref_metadata_2025_split huggingface dataset:
My Heart Has Always Been Set on Pediatrics, and Other Insights From First-Year Medical Students
Authors: Inker Jennifer , Marrs Sarah , McIntyre Madeline , Waters Leland , Gendron Tracey 
Published: December 2020

Abstract
Senior mentoring programs provide medical students exposure to a community-dwelling older adult mentor with whom they meet multiple times throughout the program. The goal of these programs is to expose students to healthy older adults, increase their knowledge of topics in geriatrics and aging, and increase the likelihood that students will pursue geriatric specialties. Though research findings show that senior mentoring programs have the potential to increase medical students’ attitudes towards older adults (Samra et al., 2013) and their willingness to consider working with older patients in the future (McManus et al., 2017), a critical shortage of doctors who specialize in geriatrics still exists. Moreover, the demand for geriatrically-trained physicians is expected to continue to increase (American Geriatrics Society, 2018). In order to develop avenues for successfully fostering interest in and pursuit of geriatrics specialties, we need to fully understand students’ perceptions of working with older adults. The purpose of this qualitative content analysis was to explore first-year medical students’ (n = 216) perceptions of working with older adults. We asked students to respond to the following reflection at the beginning and end of their Senior Mentoring program: How do you feel about working with older patients after you complete your training? Our findings suggest that while students feel more comfortable with and open to caring for older adults, they do not feel compelled to pursue geriatrics. Themes and sub-categories emerging from the data provide insight into why students continue to dismiss pursuing geriatrics.
A Scoping Review of Innovative Housing for Older Adults: Focus on Homesharing, Cohousing, NORC-SSPs, and Villages
Authors: Seetharaman Kishore , Mahmood Atiya , Chaudhury Habib 
Published: December 2020

Abstract
This scoping review explores the benefits, and challenges of major innovative housing and service models for older adults. Several countries are prioritizing housing and service innovation for older adults to address the limitations of traditional market housing in meeting their housing needs and challenges. This study contributes to this issue by reviewing peer-reviewed and grey literature on four well-established innovative housing and service models: cohousing, homesharing, Naturally Occurring Retirement Community Supportive Services Programs (NORC-SSPs), and Villages. Based on the findings synthesized from 65 sources, a pair-wise comparison of (i) cohousing and homesharing; and (ii) NORC-SSPs and Villages was conducted on the basis of: (a) financial aspects (e.g., affordability); and (b) psychosocial aspects (e.g., social interaction and engagement, intergenerationality, autonomy and interdependence, safety, diversity and inclusivity); and (c) long-term sustainability. While there were several financial and psychosocial benefits related to each model, the following challenges were identified that need to be addressed to further improve the relevance and effectiveness of these models: (i) lack of funding and resources to support NORC-SSPs and Villages; (ii) inter-resident conflict in homesharing and cohousing; (iii) limitations of informal support provided by fellow-residents in meeting the needs of older adults with complex needs in all four models; and (iv) lack of inclusivity and sociocultural diversity in cohousing and Villages. By integrating research on older adults’ housing needs and innovative solutions, the findings of this study could guide future housing initiatives that seek to adopt these innovative models by highlighting their strengths, while recognizing areas for improvement.
National Hospitalization Trends Among Centenarians in the United States
Authors: Twersky Sylvia , Davey Adam 
Published: December 2020

Abstract
Continued increases in life expectancy mean than an unprecedented number of individuals are reaching centenarian status, often with complex health concerns. Little research has addressed acute care experiences of centenarians. To address this knowledge gap, we analyzed 10 years of hospital admissions data from a total of 52618 centenarians (aged 100 to 115 years) in the nationally representative National Inpatient Study (NIS) with the aim of characterizing centenarian (mean age 101.4 years, 80% women, 24.2% non-White, 91.3% Medicare, 72.2% emergencies, 18.6% urgent) hospitalizations. Mean length of stay (LOS) decreased from 6.1 to 5.1 days (2000-2009). Over the same period, mean total charges rose from $13373 to $25026; they were $4478 lower for women than men and $4032 more for centenarians age 105 years and older than ages 100 to 104, despite comparable LOSs. Mean LOS was approximately 0.7 days longer for non-Whites than Whites, and mean total charges were approximately $6531 higher for non-Whites than Whites. The 10 most common admission diagnoses were consistent with frailty and end stage cognitive impairment including pneumonia, congestive heart failure, urinary tract infections, fracture of neck of femur, septicemia, fluid and electrolyte disorders, aspiration pneumonitis, acute cerebrovascular disease, acute myocardial infarction, and gastrointestinal hemorrhage, and 10.0% of centenarians died in hospital. We link individual-level data with hospital and state characteristics over the same time period in order to provide a more detailed analysis of individual and system-level characteristics that contribute toward health disparities in hospitalizations and health outcomes among centenarians.
Influence of Context as a Key Ingredient for High Performance on Skilled Nursing Facility Readmissions
Authors: Ayele Roman , Manges Kirstin , Leonard Chelsea , Lee Marcie , Galenbeck Emily , Molla Mithu , Levy Cari , Burke Robert 
Published: December 2020

Abstract
Improving hospital discharge processes and reducing adverse outcomes post discharge has become a topic of national importance, especially for older patients transitioning to skilled nursing facilities (SNFs). The substantial variation in rehospitalization outcomes suggests contextual factors may play a role in performance. We conducted rapid ethnography with opportunistic interviews (148 hours of observations, 30 clinicians) at hospitals that were high (n=2) or low (n=2)- performing in terms of their readmission rates from SNF, as well as 5 associated SNFs, to understand how contextual differences influenced performance variation. We used thematic analysis to categorize contextual factors and compare differences across high and low perfoming sites. We found three main contextual factors that differed across high- and low-performing hospitals and SNFs: team dynamics, patient characteristics, and organizational context. First, we observed high-quality communication, situational awareness, and shared mental models among team members in high-performing sites. Second, patients at high-performing hospitals had better insurance coverage that made it feasible for clinicians to place patients in SNFs based on their needs instead of financial abilities. Third, staff at high-performing hospitals were more engaged in the transitions process and rapport building with SNFs thereby facilitating smooth transitions of care from hospitals to SNFs. For example, clinicians at high- performing sites were actively engaged in directing the discharge process, but this was not observed in low-performing sites where a lack of clinician engagement lead to delays. Understanding how context affects transitions could be used to target organizational, policy, and staff level interventions to reduce adverse outcomes.
Using Latent Class Analysis to Identify Types of Elder Abuse: Multidisciplinary Team Interventions
Authors: Galdamez Gerson , Gassoumis Zachary , Wilber Kathleen 
Published: December 2020

Abstract
Elder abuse is a complex, multifaceted problem that can devastate the lives of older adults, and overwhelm medical, legal, and social service providers. To address this problem, the Elder Abuse Multidisciplinary Team (MDT) is an oft-utilized intervention that brings individuals from various professional disciplines together to address elder abuse. With the passage of the Elder Justice Act of 2010, the Federal Government included budgetary provisions in support of a particularly promising model of MDT: The Elder Abuse Forensic Center (EAFC). Although the EAFC model has been implemented at four sites in California with promising outcomes, the specific structures, processes, and practices that currently define this model have not been validated with rigorous research of other MDTs in the United States. In this study, we surveyed 81 elder abuse MDT key informants across the country, using instruments guided by the most current EAFC model (Yonashiro-Cho et al., 2019). We then used Latent Class Analysis (LCA) to group these teams based on EAFC model characteristics. We hypothesized that elder abuse MDTs would fall on a spectrum: those that were identical or nearly identical to the EAFC model, those that had some EAFC qualities, and those that were not identical. Results of the LCA supported our hypothesis and revealed three types of elder abuse MDTs: EAFCs (n=26), Semi-EAFCs (n=24), and Non-EAFCs (n=31). Policy makers, advocates, and professionals seeking to form new teams or support existing teams can draw on these findings to make decisions about MDT creation and sustainability.
Prescription Pain Reliever Use and Misuse Among Marijuana Users Age 50+ Years
Authors: Choi Namkee , DiNitto Diana 
Published: December 2020

Abstract
Marijuana use among individuals aged 50+ has steadily increased over the past decade, with 8% reporting past-year use in 2018. National epidemiologic data also showed a 36% rate of past-year prescription pain reliever (PPNR) use in the 50+ age group in 2018, a decrease from 40% in 2015, but still significantly higher than for younger age groups. Little research has, however, focused on older adults’ dual recreational and/or medical marijuana and PPNR use. This study, based on the 2015-2018 National Survey of Drug Use and Health, examined rates and correlates of dual marijuana and PPNR use and misuse among those aged 50+ who reported past-year marijuana use (N=2,632). Our findings showed that 43.6% of past-year marijuana users did not use any PPNR, 47.1% used PPNR but did not misuse, and 9.4% misused PPNR in the past year, showing that one in six dual marijuana and PPNR users reported misusing PPNR. The risks of PPNR use/no misuse and PPNR misuse were higher among those who had more chronic medical conditions and major depressive episode. Additionally, the risk of PPNR use/no misuse was associated with high frequency and medical marijuana use; and the risk of PPNR misuse was associated with younger marijuana initiation age and marijuana and other illicit drug use disorders. Thus, correlates of dual marijuana and PPNR use/misuse among older adults are poor physical and mental health problems and problematic marijuana use. Older adults with marijuana and PPNR misuse need access to evidence-based treatments for pain management and substance misuse.
Work of Art, Art of Work: Artistic Literacy and Quality in Long-Term Dementia Care
Authors: Aubrecht Katie 
Published: December 2020

Abstract
This paper shares results from a thematic analysis (Braun & Clarke, 2006) of semi-structured interviews with a purposive snowball sample of 15 leaders in dementia arts education and praxis from Canada, the United States and United Kingdom. Interviews were conducted as part of a multi-phased collaborative, interdisciplinary arts-informed research project that aimed to operationalize quality mental health and dementia care in long-term care (LTC) from a relational perspective, with a focus on LTC staff literacy. Artistic literacy that is cultivated through creative arts-making and public exhibiting was described by participants as crucial to supporting and promoting quality within long-term care. Quality was imagined as a work of art and operationalized in terms of artist competencies, capacities and conditions. Artists included LTC staff, residents and their family and friends. Our analysis identified five themes related to artistic literacy: space-making, validation, fostering community, means of engagement, vulnerability and resilience. Drawing on cultural sociology (Bourdieu, 1993, 1984) and aging studies theory (Basting, 2018), we consider and discuss the role of the arts in disrupting unexamined assumptions about quality in LTC and advancing innovation in LTC staff mental health and dementia care.
How do Senior Center Attendees Rate the Importance of Programs and Services Compared to Non-Attendees?
Authors: Somerville Ceara , Collins Saralyn , Gleason Shayna , Coyle Caitlin 
Published: December 2020

Abstract
Senior centers provide a wide range of programs and services to meet the needs of the growing aging population. As senior centers aim to serve all older community-members, it is important to assess the value of these services through the lens of both attendees and non-attendees of senior centers. Using a sample of 4,750 community-dwelling adults age 60 or older from Massachusetts, this project aims to analyze perceptions of program importance by center attendees versus non-attendees. Almost 60% of the sample never attend a senior center. Nearly a third of center attendees ranked exercise classes and education opportunities as important, compared to about 20% of non-attendees. Almost half of attendees rated application assistance and nutrition programs as not important, compared to 38% and 40% of non-attendees, respectively. Conversely, for all programs listed, non-users more frequently checked “unsure” of program/service importance. This was especially true for exercise classes, professional services, social or recreational activities, educational opportunities, and trips, for which 18% of non-attendees selected unsure. Center attendees more frequently view the programs/services offered at the senior center as important or very important, likely because they have greater awareness. Results highlight that that non-attendees are unsure of the value of programs or have no interest the programs and services provided. Not only do these results provide an opportunity to senior centers to assess how valuable certain programs and services are, they also emphasize the need for continued information streams regarding programs and services offered at senior centers to those who are unfamiliar.
Associations Between Smoking and Cognitive Function Among Community-Dwelling U.S. Chinese Older Adults in Chicago
Authors: Sun Shengxi , Zhang Nannan , Li Mengting , Dong XinQi 
Published: December 2020

Abstract
Previous studies on smoking and cognition reported mixed findings. The inconsistent results are partially explained by the fact that they were limited to specific populations and using different cognitive function measurements. This association between smoking and cognition has rarely been studied in the rapidly increasing U.S. Chinese older adults. This study aims to determine if smoking status and smoking amount are associated with global cognition and cognitive domains in U.S. Chinese older adults. Data was extracted PINE. Five cognitive function tests (East Boston Memory Test, East Boston Memory Delayed Recall, Digital Backward test, Symbol digit Modality Test, and MMSE) were used to measure cognitive domains including episodic memory, working memory, and processing speed. Five cognitive tests were converted to z scores and averaged to generate global cognition. Self-reported smoking status was used for generating smoking status and smoking amount (pack-years). Linear regression was used. The results showed that former smokers had lower global cognition (b=-0.111, SE=0.053, p&lt;.05) and perceptual speed (b=-0.185, SE=0.066, p&lt;.01) than never smokers; current smokers had lower global cognition (b=-0.240, SE=0.060, p&lt;.001), working memory (b=-0.340, SE=0.083, p&lt;.001) and perceptual speed (b=-0.370, SE=0.075, p&lt;.001) compared with never smokers. Smoking pack-years is negatively associated with global cognition (b=-0.003, SE=0.001,p&lt;.001), episodic memory (b=-0.005, SE=0.001, p&lt;.001), and perceptual speed (b=-0.004, SE=0.001, p&lt;.001). Findings revealed that among all smokers, current smokers had the worst cognition and heavier smoking was associated with worse cognition. Policymakers could take measures in lowering smoking amount among U.S. Chinese older adults to protect their cognition.
Factors Associated With Depressive Symptoms Among U.S. Older Chinese Immigrants
Authors: Chao Ying-Yu , Seo Jin Young , Chen Mei-Lan , Zha Peijia 
Published: December 2020

Abstract
Purpose: Chinese Americans represent the largest Asian ethnic subgroup in the United States. Depression is the most common mental health problem among older adults. However, we have a limited understanding of depressive symptoms among older Chinese immigrants. The study aimed to examine the potential factors associated with depressive symptoms among older Chinese immigrants in U.S. Methods: We recruited participants from psychiatric clinics who sought professional help in New York City. Inclusion criteria were Chinese immigrants from Asian countries 50 years or older; able to speak and understand either Mandarin or Cantonese; and had a diagnosis with major depressive disorder. Depressive symptoms were measured with Quick Inventory of Depressive Symptomatology; cognitive function was measured with Montreal cognitive assessment; sleep quality was measured with Pittsburgh Sleep Quality Index, and physical activity was measured with International Physical Activity Questionnaire. Descriptive statistics and multiple regression were performed. Results: Participants were ninety-nine Chinese older immigrants (mean age: 60.69 ± 7.62 years). Participants who had more children (p &lt; .05), poor health status (p &lt; .01), poor quality of life (p &lt; .01), less social support (p &lt; .01), and need help with activities of daily living (p &lt; .05) had more depressive symptoms. Cognitive function, sleep quality, and physical activity were significantly associated with depressive symptoms. Conclusions & Implications: Poor cognitive function, poor sleep quality, and less physical activity were associated with depressive symptoms. Our results provide knowledge for developing culturally tailored self-management interventions for older Chinese immigrants with depressive disorder in managed care settings.
The Prevalence of Prior Mental Health and Substance Use Problems in Older Persons and Their Families
Authors: Becker Todd , Cagle John , Sacco Paul 
Published: December 2020

Abstract
Although research has shown mental health and substance use problems (MHSUPs) are fairly prevalent in older adults (OAs), less research has considered MHSUPs in hospice beneficiaries and their families. This secondary analysis filled this gap using the Health and Retirement Study’s Core survey wave from 2014 and Exit wave data from 2016. These data are nationally-representative of OAs aged 50+. Each biennial wave introduces an experimental module to a random 10% of Core survey participants. One Core 2014 experimental module included self-report indicators assessing past MHSUPs, like depression and anxiety, using single items. Exit 2016 proxy-reported information about respondent deaths was used to create a decedent subsample. Descriptive statistics established MHSUP prevalence rates in OAs and their family. The self-report depression indicator was validated against the 8-item Center for Epidemiological Studies Depression Scale (CESD-8) at the ≥3, ≥4, and ≥5 cut points using χ2 analyses. The full sample’s (N=1,461) average age was 68 years. Participants were mostly non-Hispanic (87.5%), White (72.8%), and female (59.7%). The decedent subsample (n=64) was bifurcated by hospice (54.7%) versus nonhospice (45.3%) utilization. Most participants in the full sample (63.9%), hospice decedent subsample (77.1%), and nonhospice decedent subsample (75.9%) endorsed at least one MHSUP. Depression and anxiety were the most common MHSUPs in each study sample. The CESD-8 was associated with the self-report depression indicator across all cut points (p&lt;.001). Practitioners, policymakers, and researchers should consider the high prevalence rates of MHSUPs found in OAs and their families when designing programs, policies, and research.
Relationship Between Perceived Physical and Mental Fatigability and Physical Performance in Very Old Adults
Authors: Hu Yixin , Zhang Zhuangzhuang , Bair Woei-Nan , Bai Anying , Fan Li 
Published: December 2020

Abstract
To investigate the relationship between perceived physical and mental fatigability and physical performance in community-dwelling very old adults (≥80 years). We examined the association in one retired community in Beijing including 404 very old adults. Pittsburgh Fatigability Scale (PFS), Chinese version, was used to assess perceived fatigability in physical domain (PFS-P) and mental domain (PFS-M). High fatigability is defined as PFS-P ≥ 15, and PFS-M ≥ 13. Physical performance measures include grip strength, usual gait speed, chair stand and Short Physical Performance Battery (SPPB) test. Women have higher PFS scores (both PFS-P & PFS-M) and higher prevalence of high fatigability than men. After adjusting for sex, usual gait speed and SPPB scores were significantly associated with PFS-P & PFS-M, while grip strength and chair stand performance were significantly associated with PFS-P only. After multivariable adjustment, usual gait speed (B=-3.745, P=0.021) and chair stand performance (B=0.335, P=0.005) were significantly associated with PFS-P, while usual gait speed (B=-2.656, P=0.006) and SPPB scores (B=-0.214, P=0.029) were significantly associated with PFS-M. Perceived physical and mental fatigability is highly prevalent in very older adults and they differ by sex. The significant associations between PFS scores and performance measures suggest that PFS is of potential clinical importance, especially when testing performance measures are not feasible. Utilization of PFS score can assist in identifying target populations who are at risk of reduced physical functions, such as older with depression, older women. Interventions to improve usual gait speed are likely to reduce both perceived physical and mental fatigability.