bluuebunny/crossref_metadata_2025_split huggingface dataset:
A MEDITERRANEAN DIET INTERVENTION ALTERS AGE-ASSOCIATED PHYSIOLOGY IN A NOVEL NON-HUMAN PRIMATE MODEL
Authors: Snyder-Mackler Noah , Shively Carol , Johnson Corbin , Michalson Kristopfer , Appt Susan , Belsky Daniel , Register Thomas 
Published: November 2019

Abstract
Diet modifications are some of the most well-established aging interventions. For decades we have known that caloric restriction can dramatically increase lifespan and healthspan in organisms ranging from yeast to primates. More recently, other dietary modifications, including varying nutrient composition, have been experimentally shown to alter healthspan and lifespan. However, limitations inherent in human trials, such as diet adherence and heterogeneity of other lifestyle factors, mitigate our ability to identify the mechanisms through which diet alters healthspan and lifespan. Here, we conducted a randomized, long-term, whole-diet manipulation in a nonhuman primate, where cynomolgus macaques consumed either a Mediterranean or Western diet for 15 months. We hypothesized that individuals fed a Western diet would exhibit accelerated rates of cellular and physiological aging relative to their Mediterranean-fed counterparts. Indeed, we found that Western diet-fed animals exhibited increases in physiological measures that also increase with age, including body weight, fasting insulin, and triglycerides. Animals eating a Mediterranean diet, on the other hand, had a more sensitive and tuned autonomic response, and reduced HPA responses to an acute stress challenge. Probing further, we found that diet strongly affected monocyte function, altering the expression of 40% of expressed genes, leading to a more proinflammatory monocyte phenotype in Western diet fed animals. Experiments are underway to explore effects of diet on other markers of biological aging. Together, these data provide the first controlled evidence that Western and Mediterranean diets can alter aging-associated function in a species with clear biological similarity and relevance to humans.
SENIOR MODELS: SUCCESSFUL AGING AND SERIOUS LEISURE
Authors: Lee Sanghee , Bae Jaeyoon , Im Sua , Heo Jinmoo 
Published: November 2019

Abstract
Serious leisure involves productive engagement and commitment in leisure activities. Literature shows that participating in serious leisure is associated with physical and mental health benefits of older adults. The behavior of senior modeling reflects serious leisure engagement that might offer a new insight useful in understanding successful aging. We explored the experience of senior models as a form of serious leisure. Using selective optimization with compensation as well as serious leisure framework, we attempted to identify how senior modeling activity contributes to successful aging. This study used in-depth interviews using purposeful sampling, and data were collected over two months in 2019. The participants were 31 senior models (average age = 67). The analysis resulted in three themes which contained characteristics of serious leisure as well as selective optimization with compensation: identifying new possibilities, serious engagement, and rewards from meaningful experiences. This study demonstrated various experiential characteristics associated with modeling as a form of serious leisure. Through selection, optimization, and compensation process, the participants seemed to achieve successful aging. We found that senior model experiences promoted active lifestyle, health benefits, and interpersonal relationships. To our knowledge, this is the first exploration of the experience of senior modeling activity. Consistent with existing literature, our study provides evidence of the significant role of serious leisure in later life. We suggest that senior modeling program holds promise as an effective way for older adults because it can be used as a self-care approach and community programs not only in Korea, but at various locations.
DISCRIMINATION, STRESS, AND MORTALITY AMONG BLACKS AND WHITES
Authors: Choun Soyoung , Kang Sungrok , Lee Hyunyup , Aldwin Carolyn M 
Published: November 2019

Abstract
Mortality rates have declined significantly in the past decades. However, Case and Deaton (2015) showed that middle-aged white Americans with lower education levels have increasing mortality rates. Although some have suggested that stress is an important factor in both this and in racial/ethnic disparities in mortality, relatively few studies have examined vulnerability to stress and mortality, and typically have examined only one type of stress. We examined racial/ethnic and gender differences in different types of stressors, from everyday discrimination, to lifetime trauma, as well as differential mortality risk due to stress vulnerability. Using data from the Health and Retirement Study (HRS), the sample consisted of 6,810 (Mage=68.9 years, SD=10.1) who completed the Psychosocial Questionnaire (PQ) in 2006; mortality was assessed to 2014. Blacks were higher on most stressors except for lifetime trauma. Women reported higher level of financial strain but lower levels of everyday discrimination and lifetime trauma than men. Controlling for demographics and self-rated health, Cox proportional hazard models revealed that everyday discrimination, financial strain, SLEs, lifetime trauma were significantly associated with the risk of mortality. There were no significant racial/ethnic differences in mortality risk. However, interaction effects showed that whites had higher mortality risk with lifetime trauma than Blacks, while those with lower education had higher mortality risk for SLEs. This supports the idea that lower education whites may be more susceptible to some types of stressors, providing a possible mechanism for Case and Deaton’s finding (2015) of increasing mortality risk in this group.
PREDICTORS OF MORTALITY RISK AMONG MEDICARE ADVANTAGE ENROLLEES
Authors: Choun Soyoung , Doan Lan , Govier Diana J , Hooker Karen , Mendez-Luck Carolyn , Turner Shelbie , Irvin Veronica L 
Published: November 2019

Abstract
Overall all-cause mortality rates have declined significantly in past decades among individuals aged 65 and above in every racial and ethnic group. We explored demographic, overall health, and disability development as predictors of mortality in Medicare beneficiaries enrolled in Medicare Advantage plans. We used data from the 2014-2018 Medicare Health Outcomes Survey, a nationally representative panel survey with a two-year follow-up, administered by the Centers for Medicare and Medicaid Services. Our sample consisted of 1,273,494 community-dwelling adults aged 65 and older (Mage = 74.5 years, age range: 65-109 years) enrolled in Medicare Advantage plans. Mortality was assessed over a 2-year follow-up period. We used Cox proportional hazards regression analysis to predict risk of all-cause mortality by demographics, self-rated health, chronic health conditions, smoking status, and activities of daily living (ADLs). Among all participants, the mortality rate was 7.0% (n = 88,058) at 2-year follow-up. Advanced age and being male were significantly associated with greater risk of mortality, while higher levels of education and income were inversely associated with mortality. Controlling for other factors, white adults had higher mortality risk than black or African American, Hispanic, and Asian older adults. Individuals who were unmarried, had lower self-rated health, had more chronic health conditions, smoked, and had more ADL limitations had higher mortality risk. Our findings suggest that sustained health and better functional capacity are important elements in decreasing the risk of mortality in older adults.
TACKLING THE OPIOID EPIDEMIC: A STATE-WIDE INITIATIVE TO DECREASE OPIOID PRESCRIBING
Authors: Chahal Jasleen K , Northrip Kimberly 
Published: November 2019

Abstract
More than 500,000 preventable deaths annually have been attributed to the growing opioid epidemic and increased opioid prescribing rates by providers (CDC, 2016). A report by the American Medical Association (AMA) found that only 50% of physicians have taken continuing professional development (CPD) activities on managing pain with opioid alternatives (2016). In 2012, Kentucky passed a comprehensive law regulating the prescribing of controlled substances and requiring ongoing CPD in opioid prescribing and abuse. UK HealthCare CECentral partnered with the Kentucky Office of Drug Control Policy (KODCP) to provide CPD training. This study utilized retrospective learner data collected from CECentral between 2012 – 2017. Since the initiative began in 2012, CECentral has provided this training to 8,893 individuals: 5,877 physicians, 1,527 APNs, and 831 other health professionals. This initiative has resulted in more than 6,000 total participants committing to various forms of clinical practice change to help combat the opioid crisis. Between 2012 and 2016, these commitments resulted in an increase in Buprenorphine/Naloxone prescriptions and prescribers requesting controlled substance reports on their patients. An overall decrease in opioid prescriptions was also shown to be a result of this Kentucky opioid initiative. Results of the study indicate that partnerships between state agencies and CPD providers can lead to practice improvements that address public health concerns. Future research should focus on the efficiency and effectiveness of CPD training and such collaborations as public health initiatives.
THE SAGE SYMPOSIUM: A MODEL FOR HANDS-ON INTERACTIVE CONTINUING EDUCATION
Authors: Powers Becky 
Published: November 2019

Abstract
Current graduate and postgraduate medical education has minimal geriatric and palliative care curricular requirements, leaving Continuing Education (CE) programs poised to fill a critical educational niche. The San Antonio Geriatric and Palliative Education (SAGE) Symposium was a 3 day long interprofessional CE conference for providers caring for older adults. SAGE addressed geriatric knowledge, skill, and attitude deficits in practicing providers by incorporating: 1) a community and provider based needs assessment, 2) active skills sessions culminating in a health fair, and 3) multimedia based reflective exercises. Needs Assessment (Knowledge): A video needs assessments of older adults were performed using a convenience sampling methodology in 13 non-healthcare public locations in each quadrant of the city. 23 respondents were interviewed before reaching thematic saturation with 3 main themes: geriatric syndromes, patient-provider relationships, and support. Content areas for the course were derived from the needs assessment. Skills Sessions (Skills): In addition to standard plenary sessions, multiple active breakout session taught attendees common geriatric skills. On the last day of the conference, attendees applied these skills under supervision at a senior community health fair. Reflective Exercises (Attitudes): Videos, poems, and artwork with themes on aging were displayed during conference breaks. Attendees received CE credit for electronically submitting short reflections to each multimedia piece. Reflections were compiled and reported back to the group at the end of the conference. By changing the traditional CE conference format to an interactive experience, the SAGE Symposium was able to address knowledge, skills, and attitudes towards aging in its attendees.
PROMOTING SUCCESSFUL CHRONIC DISEASE SELF-MANAGEMENT THROUGH COMMUNITY-BASED INTERVENTIONS
Authors: Washington Tiffany R , Gitlin Laura N , Smith Matthew L 
Published: November 2019

Abstract
Persistent chronic conditions are among the top leading causes of death in the U.S. The majority of older adults live with two or more chronic conditions. When poorly managed, chronic conditions can result in negative psychosocial and health outcomes such as low quality of life, diminished mood, workforce withdrawal, high healthcare utilization, and disability. Fortunately, chronic disease self-management interventions show promise in reducing the negative impact of chronic conditions on health status. This symposium will highlight formative work and recent findings of community-based interventions that promote successful self-management. To start, presenter one will describe findings from four studies that constitute the formative work necessary to inform implementation of self-management interventions in community and healthcare settings. Next, presenter two will report findings from an effectiveness trial of a technology-based intervention to support hypertension self-management. Then, presenter three will describe findings on the feasibility of a Health Passport tool to promote self-health management among individuals with physical limitations. Finally, presenter four will describe factors affecting attendance among African Americans with arthritis who participated in a national dissemination of Chronic Disease Self-Management Education programs. Collectively, these presentations will provide practical evidence and science-based recommendations for ways to increase successful chronic disease self-management and ultimately improve population health among older adults.
THE USE OF CREATIVITY WITH CLIENTS WITH DEMENTIA TO ENHANCE STUDENT LEARNING AND POSITIVE PERCEPTIONS
Authors: Foti Megan , Ghaul Michelle 
Published: November 2019

Abstract
Funding and productivity demands combined with curative approaches of medicine can make working with older adults less appealing to health professionals (Samra et al, 2013 George et al, 2013). It is essential to recognize and address such perceptions to promote the provision of quality, humanistic healthcare. Educators can impact perceptions by facilitating innovative opportunities for interaction with older adults, especially those in dementia care. Creative therapies, such as art, music, and storytelling provide opportunities for reminiscence and self-expression and have been proven to yield potential psychosocial benefits for people with dementia including enhanced well-being, lessened cognitive decline, decreased anxiety and depression, and improvements in memory, social interaction, orientation, and cognitive functioning. (Phillips et al, 2010; Subramanium, Trentham, n.d.; Woods, & Whitaker, 2013). Similarly, these interventions yield benefits for facilitators such as increased comfort and higher levels of humanistic care for clients with dementia (George et al, 2013, & 2014). The proposed presentation will provide evidence related to the benefits of creative therapies for people with dementia and highlight methods for integrating this into healthcare curricula in addition to supporting evidence and positive outcomes.
KNOWLEDGE OF END-OF-LIFE CARE, LIFE-SUSTAINING TREATMENT, AND ADVANCE DIRECTIVES IN NURSING STUDENTS
Authors: Cheon Jooyoung 
Published: November 2019

Abstract
Knowledge of end-of-life (EOL) care and being able to make the appropriate decisions for patients who are dying is important for nursing students, who will soon play a critical role in EOL decision-making among patients and their caregivers. Accordingly, the purpose of this study was to examine the level of knowledge of EOL care, life-sustaining treatment, and advance directives among nursing students in South Korea. This cross-sectional descriptive study was conducted from December 2017 to February 2018. Data were collected from 220 undergraduate nursing students and analyzed using descriptive statistics, t-tests, one-way ANOVA, and a post hoc test with the SPSS 19.0 program. The score for knowledge of EOL care was 7.8 out of 11 points, for knowledge of life-sustaining treatment was 4.6 out of 6 points, and for knowledge of advance directives was 7.0 out of 9 points. There were significant differences in knowledge of EOL care scores by year of study, experiences in clinical practicum education, and experiences of caring for dying patients. Knowledge of life-sustaining treatment significantly differed by year of study, experiences in clinical practicum education, experiences of caring for and observing dying patients during clinical practicum education, and perceived self-rated health. There were significant differences in knowledge of advance directive scores by year of study, satisfaction with nursing major, experiences in clinical practicum education, and experiences of caring for and observing dying patients during clinical practicum education. Further studies should develop educational intervention programs that improve knowledge of EOL care, life-sustaining treatment, and advance directives.
IMPROVING COLLEGE STUDENTS’ ATTITUDES TOWARD AGING POPULATIONS: USING CBT-BASED GERONTOLOGICAL PEDAGOGY
Authors: Li Qiwei , Harllee Heath , Knight Becky P 
Published: November 2019

Abstract
The U.S. is facing a shortage of aging-related professionals. Lack of positive attitudes among undergraduate students towards the older population may restrict them from participating as aging professionals. However, research majorly focused on the attitudes among students already in the medical training fields instead of improvement of the attitudes among undergraduate students who potentially will devote themselves to be aging professionals. We seek to enhance attitudes toward the aging population through gerontological coursework at the undergraduate level. The introductory course is based on Cognitive Behavioral theory (CBT) which emphasizes to unlearn false concepts. Therefore, the class exposes students to positive aging images in contemporary films and literature demonstrating concepts such as successful aging, retirement, gender issues, and aging as minorities, etc. Students review their perceptions of the aging population at the beginning and end of the semester, presenting five words that best describe the aging images. The variances of occurrence of negative to positive descriptions are analyzed as an evaluation of the class. The class also stimulates civic responsibilities of the students toward the aging population with concepts such as generational equities by conducting team-based discussions. The results report increased positive words and improved attitudes on in-class team projects and post-class evaluations. The implication of the course outcomes is that discussing and exposing the positive images, and justifying typical aging-related behaviors significantly improves students’ attitudes toward the aging population, and may encourage undergraduate students to select an aging profession. Qualitative evaluation of the course will be conducted in future semesters.
RESIDENTIAL HOMES FOR THE DYING: AN UNTAPPED RESOURCE FOR TEACHING PATIENT- AND FAMILY-CENTERED END-OF-LIFE CARE
Authors: Sharpe Chantelle , Weisse Carol 
Published: November 2019

Abstract
Clinical training opportunities in end-of-life care are lacking, especially in home settings where death is expected and supported as a natural process. The Community Action, Research and Education (CARE) program provides students who are interested in healthcare a better understanding the challenges of providing end-of-life care. Over 8 weeks, undergraduate students serve as surrogate family members providing care to hospice patients in residential homes for the dying. Additionally, students engage with a formal curriculum by completing online learning modules each emphasizing different skills for providing end-of-life care. This study analyzed data from three cohorts of undergraduate students (n = 21) who participated in the CARE Program. Analyses from assessment surveys revealed that students reported improved knowledge and skills, including enhanced bedside education and training and increased ability to care for someone at the end-of-life after completion of the program. Also, 95% (n = 20) of students over the three cohorts reported that the formal coursework enhanced skills and training related to bedside care. Previous research has examined end of life training in a professional school setting, but the focus was on care in an institutional or facility setting (Billings et al., 2010; Supiano, 2013). The CARE program is a model for experiential learning in a home setting that provides a special lens to the dying experience in a holistic, patient and family centered way.
THE EFFECT OF PERCEIVED APPRECIATION ON CAREGIVER WELL-BEING: A TEST OF EQUITY THEORY
Authors: Meyer Kylie , Puga Frank , Pickering Carolyn E 
Published: November 2019

Abstract
Equity theory suggests that equal (reciprocal) exchange of support in social relationships leads to better outcomes for members. However, in caregiving, exchange of support may become unbalanced due to heightened instrumental support from caregivers (CG). Imbalance may be exacerbated in dyads where the care recipient (CR) has dementia, since cognitive changes can attenuate expression of social support. One way social support is demonstrated in through show of appreciation. We used data from National Study on Caregiving (NSOC) to test whether CGs who did not feel appreciated by CRs were more likely to experience depression in the future. To accomplish this, we applied lagged dependent variable (LDV) models to the 2011 and 2015 NSOC waves (N=150). CGs who felt appreciated by the CR in the 2011 wave had 0.22 times the odds of being depressed in 2015 as those who did not feel appreciated by the CR (CI 0.07 to 0.68). This effect appears to exist primarily among CGs to people with dementia. In stratified models, we found CGs to people with dementia in 2015 had 0.04 times the odds of being depressed in 2015 if they previously felt appreciated by the CR (CI 0.003 to 0.40). A statistically significant effect was not observed among those assisting someone without depression (OR=0.65, CI 0.22 to 1.91). Results suggest that CGs to people with dementia who feel appreciated have less risk of experiencing depression. Findings have applications for future interventions for caregiver wellbeing, such as enhancing perceived appreciation (e.g., cognitive restructuring, communication training).
BEING RESPECTED AND ADMIRED IN OLD AGE: DYNAMICS OF SOCIAL STATUS AND AGING
Authors: Weiss David , Bellingtier Jennifer A , Diehl Manfred 
Published: November 2019

Abstract
Social status - the standing of a person or group in the social hierarchy - is part and parcel of social life and a significant determinant of cognition and behavior. Status hierarchies are basis of virtually all human and primate societies and assign different roles and privileges to its members. However, the dynamic nature of social status and the underlying mechanisms in old age are not well understood. Therefore, this symposium addresses questions of how social status is influenced by aging-related changes in roles, life events, self-concept, and images of aging and how social status shapes in response personality, subjective age, prosocial behavior, performance, and well-being in old age. Bellingtier and colleagues examined objective and subjective social status and their connections to subjective age, attitudes towards aging, and awareness of age-related changes. Zhang shows paradoxical association between aging stereotypes and prosocial behaviors toward older adults. Barber and Hamel investigated how stereotypes of reduced physical competence in old age affect the gait performance on easy and difficult tasks. Weiss and colleagues take a cross-cultural perspective on the different sources of social status in China, Germany, and the US showing that generations in contrast to age groups represent a source of high social status in later life. Finally, Kornadt investigates the dynamic interplay of changes in social roles and personality in old age. Together, these presentations enlarge our understanding of the dynamics of social status in old age.