bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFECTS OF ENVIRONMENTAL FACTORS ON THE INCIDENCE OF DEPRESSION IN OLDER ADULTS IN TAIWAN: A MULTI-LEVEL ANALYSIS
Authors: Li Chia Chun , Li Der-Chiang , Hu Susan C 
Published: November 2019

Abstract
Depression is a common mental disorder worldwide, and also a leading cause of disability and global burden of disease. The risk factors of depression are multi-facets; however, past studies have focused more on individual factors than ecological factors. This study aims to use a health map framework with multi-level analysis to analyze the effects of environmental factors on the incidence of depression of older adults in Taiwan. We connected 3 national datasets, including the National Health Interview Survey (NHIS), Age-friendly Dataset at city-level, and the National Health Insurance Research Databases (NHRID), to examine the relationship between environmental factors and the incidence of depression in Taiwan. The dependent variable was the new cases of depression in older adults during 2010-2016. The study variables were environment factors including 5 build environments and 8 social environments. A total of 6494 valid participants aged 50 and over were recruited from the 2009 NHIS and were followed up to 2016. There were 292 (4.5%) new incident cases of depression during 2010-2016. Results of multi-level analysis showed that only one built environment (no. of heritage sites) was associated with the incidence of depression. No social factors was found significantly in the study. It seems that factors of individual-level appear more important than that of ecological-level as the determinants of depression. Results of this study could provide an exploratory information for future research regarding the relationships between depression and environments.
RACIAL RESIDENTIAL SEGREGATION AND COGNITIVE DECLINE AMONG OLDER ADULTS
Authors: Jang Joy Bohyun , Hicken Margaret T , Clarke Philippa J , Sol Ketlyne , Melendez Robert , Kim Min Hee , Mullins Megan , Judd Suzanne 
Published: November 2019

Abstract
Racial residential segregation may be a fundamental cause of health disparities in the U.S., and few studies employ objective measures of segregation to estimate its impacts on cognitive decline. Using data from 21,446 REGARDS participants in urban areas, we employed race-stratified growth curve models to examine how city racial segregation was associated with trajectories of cognitive decline over time. Controlling for demographics and health conditions/behaviors, higher segregation for blacks was marginally associated with lower cognitive function at baseline (b=-0.159, p&lt;.10) while higher segregation for whites was associated with better cognitive function (b=0.158, p&lt;.01). For both blacks and whites, there were no significant associations between segregation and rate of cognitive decline but neighborhood poverty was adversely related to cognitive function (b=-0.171, p&lt;.01 for blacks, b=-0.289, p&lt;.001 for whites). Further research into mechanisms that contributes to heterogeneity in associations between racial segregation and cognitive function is needed to develop effective prevention interventions.
WALKING THE TALK: ENGAGING PATIENTS AND CAREGIVERS AS COLLABORATORS IN PALLIATIVE CARE RESEARCH
Authors: Rahman Anna N , Enguidanos Susan 
Published: November 2019

Abstract
Palliative care is inherently patient directed and family oriented. Given this, it is especially important that patients and caregivers participate in developing new services intended to meet their needs. Our experience with conducting a controlled trial of home-based palliative care demonstrates this point. This poster will describe the implementation and dissemination decisions that patient and caregiver stakeholders guided during a comparative effectiveness trial of palliative care. It also will present strategies for engaging stakeholders and identify the impact of these strategies on continuous study improvement. For the study, we convened an advisory committee (AC), which included eight patients and caregivers among its 34 members. These eight partners in particular helped us identify meaningful patient- and caregiver-reported outcome measures, Throughout the study’s 2.5-year period, they offered suggestions that influenced the tone and topics addressed in quarterly AC meetings. They also helped refine the study’s patient and caregiver assessment instruments by roleplaying with our research assistants. When we launched a Google group to promote discussion among AC members, patient and caregiver stakeholders were especially forthcoming. They identified gaps in care and consumer understanding of palliative care that we otherwise would have overlooked. Of note, our stakeholders provided input on how to best to introduce a new palliative care program to patients. These engagement strategies create feedback loops that open new opportunities for continuously improving research. Moreover, engagement of patients and caregivers in research planning and implementation provides important and otherwise overlooked perspectives while ensuring a patient-centered focus, consistent with palliative care goals.
LIFE RESTORATION AND CARE PREPARATION AMONG OLDER PARENTS WHO LOST THEIR ONLY ADULT CHILD IN SHANGHAI
Authors: Chen Lin , Song Yajun , You Yixin 
Published: November 2019

Abstract
The combination of aging and losing an only adult child challenges an increasing number of older adults in China. Current literature primarily focuses on older parents’ bereavement but seldom examines how they restore their lives. Guided by the Dual Process Model, this study explores how older parents who lost their only adult child restore their lives and prepare for future care in Shanghai. Twenty-four older adults were purposively sampled and participated in face-to-face, in-depth interviews. The findings suggest that participants tried to restore their lives by rationalizing grief and expanding their social networks. Despite their losses, participants remained in favor of family caregiving and reluctantly prepared for future care. They showed ambivalent attitudes toward current government support while proposing their preferred services. This study informs social work practice to incorporate caregiving plan services and emotional support for this vulnerable group.
NAVIGATING DISASTERS: A CASE STUDY VA AND NON-VA HOME-BASED LONG-TERM CARE IN PUERTO RICO FOLLOWING HURRICANE MARIA
Authors: Haverhals Leah M , Hernandez-Lujan Deisy 
Published: November 2019

Abstract
This research describes how Department of Veterans Affairs (VA) and non-VA home-based long-term care (LTC) environments prepared for and secured the safety and wellbeing of elderly and disabled persons in the wake of Hurricane Maria, which struck Puerto Rico on September 20, 2017. In-person interviews, home visits, and field observations were conducted in Puerto Rico from January-March 2019. Staff from three of the VA’s Caribbean Healthcare System’s home-based LTC programs were interviewed, as well as caregivers in non-VA LTC environments. Veterans, family members of Veterans, family members of VA caregivers, and community members with expertise in disaster recovery were also interviewed for a total of N = 58 interviews and N = 12 home visits. Preliminary results of qualitative content analysis show VA and non-VA LTC environments prepared residents and caregivers for Hurricane Maria through providing education and recommendations in advance, including having enough medications and food on hand. Participants described Hurricane Maria not simply as a disaster but a “crisis” and a storm unlike any they had ever experienced. The interconnected nature of the VA seemed to provide a stronger support network compared to non-VA environments that were often independently run. Health of Veterans and non-Veterans was reported to be mostly stable during recovery. Perspectives from VA and non-VA entities allowed for a fuller picture to emerge around how Hurricane Maria impacted home-based LTC environments in Puerto Rico. This research can inform policies and procedures for such environments caring for elderly and disabled populations in areas prone to disasters.
COMPARISON OF NURSING HOME STAFF’S PERCEPTIONS OF NOISE TO MEASURED NOISE LEVELS
Authors: Ames April , Dubin Stacie , Valigosky Michael , Steiner Victoria 
Published: November 2019

Abstract
A noisy environment may affect the ability of healthcare staff in nursing facilities to effectively complete tasks and provide quality care to residents. Staff may also become irritable or annoyed due to their perception that noise levels are too loud. The purpose of this descriptive study was to examine the differences in nursing home staff’s perceptions of noise levels compared to measured noise levels in four nursing home facilities in Ohio. A questionnaire was also distributed to examine the perceptions of noise levels by staff and the effects of noise on their health. The majority of the respondents (n=90) were white females. They described all facilities as being moderately noisy which was consistent with the measured noise levels. The loudest perceived noise sources included door/patients alarms and floor cleaners, which was confirmed by measured noise levels. The majority of facilities identified the nurses station as one of the noisiest locations; however, this was inconsistent with measured noise levels. Overall, respondents at all facilities felt neutral or disagreed that the noise levels impacted themselves or the residents. However, some respondents agreed that in a noisy environment it is easier to make job errors, difficult to concentrate on work, and they find themselves irritable or agitated. Perceptions of noise should be considered along with measured noise levels because tolerance levels differ among individuals and mental activities involving memory or complex analysis are sensitive to noise which may affect job performance.
MEMORY FOR PICTURES AND WORDS AFTER A NATURAL DISASTER
Authors: Cherry Katie E , McKneely Katelyn , Nguyen Quyen , Yu Shui , Sampson Laura , Galea Sandro , Calamia Matthew R , Elliott Emily M 
Published: November 2019

Abstract
The pictorial superiority effect (PSE) is the finding that memory for pictures exceeds that of memory for matching words for people of all ages (Cherry et al., 2012). We examined free recall of line drawings and matching words in adults enrolled in the LSU Flood Study, an interdisciplinary study of disaster stress and cognition. We tested the hypothesis that disaster stress would be associated with deficits in memory for pictures and words. Participants were sampled from a three-parish (county) region of Baton Rouge, LA that was severely devastated by the 2016 flood (N = 202, age range: 18-88 years). They received multiple tests, including the Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005), and self-report measures of executive function and functional impairment (Barkley, 2011). Three groups were compared: (1) non-flooded adults as controls, (2) once-flooded adults with structural damage to homes and property in 2016, and (3) twice-flooded adults who had relocated to Baton Rouge because of catastrophic losses in Hurricanes Katrina and Rita and flooded again in 2016. Results yielded a PSE in free recall for all disaster exposure groups (p &lt; 0.001). Follow-up analyses by age group revealed that older adults showed the same memorial advantage of pictures relative to words as did their younger counterparts across all disaster exposure groups. These results imply that single and multiple disaster exposures do not appear to disrupt cognition assessed with traditional, laboratory-based measures. This research was supported by a grant from the National Science Foundation (Award Number 1708090).
NEIGHBORHOOD SOCIAL ENVIRONMENT AND PHYSICAL FUNCTION: EVIDENCE OF RACIAL AND ETHNIC DIFFERENCES
Authors: Millar Roberto J 
Published: November 2019

Abstract
Empirical and theoretical scholarship suggest that as individuals age and their physical, cognitive, and social needs change, their neighborhood environment becomes increasingly important to their health and well-being. Despite recent advances in this area of research, a number of critical gaps remain. Namely, few studies examine the associations between neighborhood social environments and performance-based physical function. Furthermore, racial and ethnic differences are widely understudied. The objectives of this study are (1) to examine the association between neighborhood social cohesion and physical disorder on physical function in older adults, and (2) to identify potential racial/ethnic differences in these associations. Data come from round five (collected in 2015) of the National Health and Aging Trends Study (NHATS; N=5,619). A series of adjusted linear regression models were used to predict performance-based physical function based on characteristics of the neighborhood social environment (i.e., cohesion, disorder). Results showed that only neighborhood physical disorder was statistically significantly associated with poorer physical function (p &lt; 0.05). Similarly, when stratified by race/ethnicity, only neighborhood physical disorder was associated with poorer physical function in Whites (p &lt; 0.05). There was no significant association for either neighborhood social environment characteristic and physical function for Black or Hispanic older adults. Racial and ethnic differences warrant closer investigation in studies of neighborhood effects on health. Community-level interventions, policy makers, and researchers should consider the interactions between minority membership and neighborhood social environments when addressing issues of health and physical function.
TRANSITIONING OUT OF GRANDCHILDREN CAREGIVING: EFFECTS ON GRANDPARENTS’ EMOTIONAL WELL-BEING
Authors: Hu Rita X , Li Lydia , Antonucci Toni C 
Published: November 2019

Abstract
Research has suggested that grandparents caring for grandchildren experience both psychological gains and loss. Less clear is what happens to these grandparents after they exit from the caregiving role. This study used the Health and Retirement Study (HRS) 2010 to 2014 data to examine the effects of transitioning out of caregiving on the psychological well-being of grandparents. Psychological well-being was measured by the Positive and Negative Affect Schedule. We defined caregiving grandparents as grandparents who provide 100+ hours of care per year to their grandchildren. In the first wave, 8,278 respondents in the HRS were identified as caregiving grandparents. Among them, 3,914 continued to be caregivers and 4,364 transitioned out of the caregiving role by indicating they are no longer providing care in the second wave. Grandparents who transitioned out of caregiving are more likely to be older in age, less educated and not married. Linear regression analysis was conducted to compare the two groups (continuing vs. exiting caregiving) on positive and negative affect, controlling for the first wave’s measures of the dependent variable, sociodemographic characteristics and health status of respondents. Results show that grandparents who continued caregiving had less decline in positive affect than grandparents who transitioned out of caregiving (b = -0.05, SE = 0.02, p&lt;0.01), adjusting for covariates. But they were not significantly different in negative affect. These findings indicate that older adults may have fewer sources of joy after exiting the role of caregivers of their grandchildren.
BUILDING NETWORKS OF PROFESSIONALS TO SUPPORT KINSHIP CARE FAMILIES
Authors: Smith Andrea B 
Published: November 2019

Abstract
Numbers of American children being raised by relatives continue to rise. Over 7.8 million children, representing 10.5% of American children under age 18, lived in a relative-headed home. Of these, 2.5 million have no parent present in their home (Generations United, 2016). Kinship families’ needs are typically complex, needing prompt and sensitive responses. Varied professionals often serve kinship families but the majority report receiving little information or training related to kinship families. (Smith 2017 This pilot project surveyed professionals (n = 63) representing varied disciplines in a pre/post-test format to determine change in knowledge and strategies for working with kinship care family members. All respondents were enrolled in graduate courses specifically focused on kinship families. Respondents represented diverse fields including family therapists (n = 9), family service workers (n = 23), teachers (n = 16), school administrators (n = 4), child care providers (n = 2) and health care professionals (n = 7 ). Respondents completed a 17 question pre/post survey. Results demonstrated the majority (n = 59; 93%) had experience with kinship families but most (n = 47; 74%) had received little/no targeted professional training. Post-test results strongly indicated that completing any amount of kinship-related coursework positively impacted professionals’ knowledge, confidence, and readiness to utilize learned strategies in their work with kinship families. Additionally, post-test results of students completing the entire series of classes (9 credits) revealed significantly greater changes, demonstrating the importance of providing comprehensive information to enhance professional practices for working with kinship families.
THE IMPORTANCE OF EMOTIONAL CAPITAL ACROSS THE LIFESPAN: WHY THE LITTLE MOMENTS IN MARRIAGE MATTER
Authors: Neff Lisa , Walsh Courtney , Beer Jennifer 
Published: November 2019

Abstract
Throughout a marriage, couples will share countless ordinary moments together, such as laughing together or engaging in leisure activities. Although these moments may seem trivial in isolation, research suggests that accumulating small positive moments together helps couples build emotional capital, which serves as an essential resource for protecting marriages from the harmful consequences of relationship challenges. This study explored whether emotional capital may buffer couples not only from the negative effects of relational stressors, but also from the negative effects of life stressors encountered outside the relationship in a sample of younger (age 30-45) and older (age 60+) married couples. Drawing from theories of socioemotional expertise, we also examined whether the buffering effects of emotional capital may be stronger for older adults. One hundred forty-five couples completed a 21-day daily diary task assessing shared positive experiences with the partner, negative partner behaviors, marital satisfaction, life stress, and mood. Spouses who generally accrued more shared positive moments with their partner across the diary days maintained greater marital satisfaction on days of greater partner negativity compared to spouses who accrued fewer positive moments. Moreover, spouses who generally accrued more shared positive moments with their partner across the diary days also reported lower levels of negative mood on days in which they experienced more life stress compared to spouses who accrued fewer shared positive moments; in both cases, the buffering role of emotional capital was significantly stronger for older adults. All results held when adjusting for relationship length and general marital happiness.
CONDUCTING CLINICAL TRIALS AMONG PERSONS WITH DEMENTIA: METHODS, CHALLENGES, AND OPPORTUNITIES FOR IMPROVEMENT
Authors: Sefcik Justine S , Hodgson Nancy 
Published: November 2019

Abstract
Evidence-based interventions for persons with dementia and their caregivers are important to improve both their quality of life and quality of care. Conducting rigorous clinical trials is essential to build evidence, guide research, and inform clinical practice. Clinical trials involve multifaceted phases which present opportunities and challenges to the research team. In this presentation, we discuss obtaining consent, gathering information to inform refinement of an intervention, adaptation of an intervention, and fidelity checks to ensure the rigor of intervention delivery. The first session will discuss initial challenges faced when consenting nursing home residents with dementia and tailored approaches to enhance clinical trial enrollment. The second session will share highlights of usability testing of a novel mobile app to refine and improve its ease in a future clinical trial of use for persons with dementia and their caregivers. The third session will describe findings from focus groups that generated recommendations for culturally adapting an intervention to promote quality of life among older Latinos with dementia. The final session will discuss the advantages, disadvantages and ethical considerations of in-person fidelity monitoring during a home-based intervention clinical trial involving persons with dementia and their caregivers. Together, these presentations describe the complex nature of implementing clinical trials and highlight the important lessons learned to strengthen study implementation.
LESSONS LEARNED FROM SAVVY EXPRESS: A FEASIBILITY STUDY OF A PSYCHODUCATIONAL INTERVENTION FOR CARE PARTNERS
Authors: Aranda Maria P , Cherry Debra 
Published: November 2019

Abstract
An increasing number of families, funders, and community providers seek very brief psychosocial caregiver interventions, yet the evidence for such condensed interventions is not established. Based on the Savvy Caregiver Program, we explored the feasibility, acceptability, and outcome trends for a condensed 3-session version titled, Savvy Express. Based on a single-group, pre- and post-test intervention design, we examined post-intervention and 3-month data on 116 English-speaking racially and ethnically diverse care partners caring family members with Alzheimer’s disease and related dementias. 41% of the sample was non-Latino white and comprised of Latinas, African Americans and Asian American/API. Most care partners were either adult children or spouses caring for someone with AD or other dementia. Over 80% were college educated. Two of three participants completed all 3 classes. Our findings indicate significant improvements in caregiver levels of depressive symptomatology and anxiety, competence, management of the situation, reduction of expectations, making positive comparisons, and reactivity to the family member’s memory behavior. Upwards of 90% would recommend the program to other caregivers. Savvy Express is a brief caregiver intervention with high acceptability and feasibility. Improvements in care partner psychosocial outcomes signal a promising practice to reduce the burden of caregiving. A major focus of the paper focuses on barriers and facilitators to uptake of the study procedures and intervention with community-based partners. Future work is needed to establish the efficacy of Savvy Express across a longer observation period, and with less educated, low-income participants, and limited English-speaking families.