bluuebunny/crossref_metadata_2025_split huggingface dataset:
SOCIODEMOGRAPHIC DISADVANTAGE, LIVING WITH A SMOKER, AND OBESITY IN MIDDLE-AGED AND OLDER WOMEN
Authors: Holahan Carole K , Holahan Charles J , Lim Sangdon , Chen Yen T , Powers Daniel A 
Published: November 2019

Abstract
Although sociodemographic disadvantage is a recognized risk factor for obesity, the potential role of living with a smoker in this relationship has been unexamined. This study investigated: (a) the association between sociodemographic disadvantage and living with a smoker, and (b) the role of living with a smoker in partially explaining the link between sociodemographic disadvantage and obesity. The study used limited access data from the Women’s Health Initiative Observational Study obtained from NHLBI. Participants were 91,888 women ranging in age from 50 to 79; 6,527 participants reported living with a smoker. Analyses were cross-sectional. Logistic regression analyses examined paths in the proposed model; bias-corrected bootstrapped confidence intervals tested indirect effects. All analyses controlled for age, marital status, and participants’ current smoking status. Results demonstrated a significant association (p &lt; .001) between sociodemographic disadvantage and living with a smoker across three measures of disadvantage (for low education, low income, and Black ethnicity, ORs were 1.95, 2.10, and 2.63, respectively), as well as between living with and smoker and obesity (OR = 1.71). Moreover, the unstandardized indirect effect (CIs are in brackets) from sociodemographic disadvantage to obesity through living with a smoker was statistically significant for all three measures of disadvantage (for low education, low income, and Black ethnicity, indirect effects = .05 [.04, .06], .06 [.05, .06], and .07 [.06, .08], respectively). These findings underscore the need for innovative household-level interventions for disadvantaged families living with a smoker integrating smoking- and obesity-prevention efforts. This project was supported by the NIH/NCI (R03CA215947).
OLDER ADULTS’ HEALTH AND SOCIAL ENGAGEMENT: THE MEDIATING ROLE OF SUBJECTIVE LIFE EXPECTANCY
Authors: Kim Dahee , Lee Kyuho 
Published: November 2019

Abstract
Older adults’ mental and physical health is likely to limit social engagement, but their perception of how much time they have left, according to the socio-emotional selectivity theory, might influence it as well. The aim of the research is to investigate the mediating effect of subjective life expectancy (SLE) on the pathways from older adults’ mental health and functional limitation to volunteering and contacts with close relationships. The current research used data of 5,285 older adults aged 50 to 75 from the Health and Retirement Study collected in 2014. Structural equation modeling was performed to investigate the direct effect of older adults’ depressive symptoms and functional limitation on volunteering and contact with close relationships. Predictors’ indirect effects via SLE was also assessed. The results indicated that older adults’ higher depressive symptoms and functional limitations significantly decreased volunteering time and frequency of contacts with close relationships. Older adults’ SLE attenuated the effects of depressive symptoms and functional limitations on their volunteering time and frequency of contact with close relationships. The findings describe the mechanism of how older adults engage in volunteering and contact with close relationships through their perception of remaining time. Further, this research highlights SLE as a motivator for encouragement of older adults’ social engagement.
FACE-TO-FACE AND FACEBOOK ACROSS THE LIFESPAN: SOCIAL INTERACTIONS BUFFER STRESS ON MOOD, BUT ONLY FOR ADOLESCENTS
Authors: Liu Yin , Fauth Elizabeth B , Maxey Myles , Beckert Troy 
Published: November 2019

Abstract
Social support serves as a protective factor, buffering stress in both adolescents and adults, however Socioemotional Selectivity Theory suggests developmental differences in stress reactivity and social support. It is unclear how modern forms of social contact, such as social media buffer stress, and the extent to which this differs across the lifespan. We utilized ecological momentary data to examine the moderating effects of age and two distinct types of social contacts the person had experienced in prior hours (frequency of face-to-face, or social media contacts) on the association between daily stress and momentary mood. Participants were recruited initially through Amazon.com’s Mechanical Turk (adolescents referred by a parent). A total of 119 adolescent (n = 44; Agemean= 15.73) and middle-aged/older adult participants (n = 75; Agemean= 59.67) provided momentary data three times a day, on three consecutive days, every two weeks, for up to 12 weeks. Multi-level models showed significant 3-way interactions between stress appraisal of avoiding an argument, age group, and frequency of social contact via face-to-face (β = 1.698, se = 0.542, p = .002) and social media (β = 3.341, se = 0.984, p = .001). Older adults experienced better mood than adolescents. When avoiding an argument was appraised as more stressful, both age groups displayed worse mood. Whereas high levels of recent social contact (both face-to-face and social media) seemed to exacerbate the impact of this stressor on poorer mood for older persons, high levels of recent social contact, particularly social media, had stress-buffering benefits for adolescents.
ADVANCING OUR UNDERSTANDING OF ELDERHOOD: A NARRATIVE REVIEW
Authors: Inker Jenny , Gendron Tracey , Brooks Marshall 
Published: November 2019

Abstract
There are relatively few explorations of later life in the peer reviewed gerontological literature that holistically embrace the duality of potential and decline. This is in striking contrast to a growing body of non-scholarly literature, frequently authored by elders, displaying deep interest in the phenomenon of elderhood, i.e. the holistic, lived experience of later life. We conducted a narrative review with the aim of describing the state of the science with regard to the bio-psycho-social-spiritual experience of elderhood. Following a search of multiple databases for English language, peer reviewed articles published from 2000-2017, we identified 24 articles in the disciplines of gerontology, anthropology, psychology, the humanities, and spirituality studies, reflecting elderhood in Eastern and Western cultures. While the articles offered no shared operational definition of elderhood, nor applied any unifying conceptual or theoretical structures, several common themes emerged. These included the description of elderhood as both inward facing (inner development) and outward facing (social contributions of elders). Numerous articles also recognized that ageism socially mediates the experience of elderhood, resulting in a failure of social systems and structures to recognize or provide opportunities for lifelong growth in later years, including a lack of mentors and role models for individuals transitioning into elderhood. This review demonstrates that there is a compelling need for the discipline of gerontology to strengthen our understanding of the phenomenon of elderhood by leading on the development and implementation of theoretically driven empirical research into the subject of the holistic, lived experience of later life.
TRAJECTORIES OF POSITIVE AND NEGATIVE AFFECT: A COORDINATED ANALYSIS OF 11 LONGITUDINAL SAMPLES
Authors: Bastarache Emily D , Graham Eileen K , Estabrook Ryne , Ong Anthony , Piccinin Andrea , Hofer Scott , Spiro III Avron , Mroczek Daniel K 
Published: November 2019

Abstract
This study assessed age-graded change in positive and negative affect over decades of the lifespan. We conducted a coordinated integrative data analysis (IDA) using data from 11 longitudinal samples, comprising a total of 74076 respondents, spanning the ages of 11 to 106. Positive and negative affect were measured using the CES-D in 8 studies, the PANAS in 3 studies, and the MIDI scale in the MIDUS with three to eleven measurement occasions across studies. To assess and compare the extent and nature of change in affect over time across studies, analyses were coordinated, deploying identical multi-level growth models on each dataset. The curvilinear models suggested PA was best characterized by an inverted U-shaped trajectory, peaking in the mid-to-late 50s, while change in NA was best described by a U-shaped curve, bottoming out in the late 60s. We also found measure-related differences in the proportion of variance in affect attributable to within- or between person differences; The majority of the variability in CES-D-assessed affect was attributable to within-person differences over time, while the variability in PANAS-assessed affect was predominantly attributable to between-person differences. Overall, the results did not support steady improvement of emotional experience over the entire life-course as previous studies have suggested, but show promise for midlife when PA peaks and NA bottoms out. This study demonstrates the value of coordinated conceptual replications, resolving some of the mixed findings in the literature regarding age-graded change in affect and enhancing the current understanding of the longitudinal affect phenomenon.
SOCIAL CHARACTERISTICS OF THE FOURTH AGE
Authors: Pothen John , Dore Emily C , Idler Ellen 
Published: November 2019

Abstract
How can we differentiate distinct phases of aging in later life? Theorizations of the third and fourth age posit that later life often involves a time of continued growth and increased opportunity (the “third age”) as well as a time marked by growing cognitive, physical, and social losses (the “fourth age”). In contrast to population-based definitions that place this transition around the age of 80, a person-based definition using frailty as a marker offers more sensitivity by focusing on ability and agency instead of age alone. In this study, we apply both definitions in order to examine the social characteristics of the fourth age. Using a nationally representative sample of adults over the age of 65 from from the National Health and Aging Trends Study (NHATS) seventh round (n=6,312) we find that the population-based definition overestimates the number of adults in the fourth age (2,834 vs 569; p&lt;0.001). Additionally, social network patterns observed when comparing adults above and below the age of 80 - increased rates of including a daughter or son and a decreased rate of including a friend - are not seen when comparing adults who do and do not meet criteria for frailty. Our findings suggest that common understandings of the social characteristics of the oldest old - understandings with important implications for policy and the promotion of human dignity - may be biased by focusing on age alone as a marker of change instead of ability and agency.
IDENTIFYING THE TRAJECTORIES OF MULTIMORBIDITY AND THEIR CORRELATES AMONG KOREAN OLDER ADULTS
Authors: Lee Sun Ah , Jun Hey Jung , Joo Susanna , Chai Hye Won 
Published: November 2019

Abstract
Multimorbidity, the co-existence of two or more chronic diseases, has become prevalent among the older population. This study focused on identifying different patterns of multimorbidity trajectories across older adulthood and examining their predictors. We used six waves of the Korean Longitudinal Study of Aging (KLoSA), a nationally representative longitudinal data collected every two years from 2006 to 2016. The sample was older adults aged 65 years and older in 2006 (N=1,668). Multimorbidity was measured as the self-reported number of medically-diagnosed chronic diseases, and Growth Mixture Modeling was used to examine multimorbidity trajectories. Identified patterns of multimorbidity trajectories were then used as outcome variables in multinomial logistic regression models. Independent variables were socio-demographic, psychological, health-related behavioral and interpersonal factors at baseline. At Wave1, 76% of the sample had no or one chronic disease and 24% had two or more. At Wave6, 49% had none or one and 51% had two or more. Results identified four patterns of multimorbidity trajectory: “maintaining-low” (59.1%; reference), “maintaining-high” (7.3%), “moderately increasing”(26.4%), and “rapidly increasing” (7.2%). In terms of the correlates of these patterns, female older adults and respondents with higher depressive symptoms were more likely to be in the “maintaining-high” group. In addition, respondents who had less frequent meetings with friends, neighbors or relatives were more likely to be in the “rapidly increasing” group. The findings suggest that there are distinct patterns of multimorbidity trajectories across older adulthood, and interventions focusing on depressive symptoms or social engagement may be useful in preventing the increase in multimorbidity.
KNOWLEDGE MANAGEMENT AND THE ADOPTION OF CULTURE CHANGE INITIATIVES BY HIGH-MEDICAID-CENSUS NURSING HOMES
Authors: Hearld Larry , Ghiasi Akbar , Szychowski Jeffery , Weech-Maldonado Robert 
Published: November 2019

Abstract
Culture change represents an organizational transformational process to become person-centered, through staff and resident empowerment. Culture change initiatives have been associated with fewer health-related deficiency citations and better psychosocial outcomes. Knowledge management, defined as the process of creating or locating knowledge, and managing the dissemination of knowledge within and between organizations, has been shown to be associated with the adoption of innovations such as culture change initiatives. This study examines the relationship between knowledge management activities of high Medicaid census (70% or higher) nursing homes (NHs) and the adoption of culture change initiatives. This study used facility survey data from approximately 324 nursing home administrators (30% response rate) from 2017- 2018, merged with data from LTCFocus, Area Health Resource File, and Medicare Cost Reports. Binary logistic regression models revealed that the probability of adopting a culture change initiative was 0.12 higher for facilities reporting a one-unit higher level of knowledge management activities. Additional interaction analysis revealed that knowledge management activities were associated with a greater likelihood of adopting a culture change initiative for NHs where the director had been in his/her position fewer years. Similarly, higher levels of overall knowledge management activities were significantly associated with greater adoption of culture change initiatives at intermediate levels of nurse retention. Results suggest that knowledge management activities may help high Medicaid NHs acquire and mobilize informational resources in ways that can support the adoption of patient-centered initiatives. These activities may be particularly effective in nursing homes with leadership and nursing staff instability.
ORGANIZATION OF WORK AND DECISION-MAKING OF PROFESSIONALS WORKING IN NURSING HOMES IN CATALONIA (SPAIN)
Authors: Gea-Sánchez Montserrat , Alconada-Romero Alvaro , Pastells-Peiró Roland , Bellon Filip , Teres-Vidal Lourdes , Blanco-Blanco Joan , McGilton and Katherine 
Published: November 2019

Abstract
The long term care environment demands specific requirements of the staff, namely that they provide a holistic approach to care. Providing holistic care leads to complex decision-making processes which go beyond just finding a solution to a specific health problem. It requires that staff are able to respond to the diverse needs expressed by the residents and which, in many cases, are only identified through the relationship that professionals have with them. However, this relationship that staff establishes with the resident often leads to burden for these professionals. The researchers sought to identify characteristics of the nursing homes that lead to positive outcomes for staff. The study involves collecting questionnaires (n=132) and conducting semi structured interviews (n=35) in 9 Catalan nursing homes with number of staff, utilizing a quantitative questionnaire and semi-structured interviews. Practices in organisations that led to positive outcomes for staff included coordinated care that includes processes of support for staff, effective communication and decision making practices, clear responsibilities for staff, and utilization of care plans. Effective long term care practices can favour both patient care and professional practice in residences for elderly.
A CASE STUDY: THE INVISIBLE LABOR OF CULTURALLY SENSITIVE CARE
Authors: Thao Mai See , Akosionu Odichinma C , Davila Heather , Shippee Tetyana P 
Published: November 2019

Abstract
Nursing homes are increasingly becoming more racially/ethnically diverse yet racial disparities in resident’s quality of life and quality of care continue to persist. One reason for these disparities is lack of culturally-sensitive care and racial/ethnic similarity between residents and staff. This study examines a case of a high proportion minority nursing home with racially/ethnically diverse staff to understand how shared culture among direct care staff and residents may influence care delivery. We used three months of participant observation, supplemented by in-depth qualitative interviews with 8 Hmong residents and 5 Hmong staff to explore the labor of culturally sensitive care in a large, urban NH. We discovered four themes: 1) Culturally sensitive care was often equated to fulfilling language needs for residents who didn’t speak English. 2) Hmong staff members had to take the initiative to inform non-Hmong staff members how to care for Hmong residents. 3) Hmong staff members also had to communicate the culture of NH care and its limitations to Hmong residents and their families. 4) Hmong staff members have to advocate for the culturally relevant needs of Hmong residents. The findings of this case study illuminate that having staff members from diverse cultural backgrounds and meeting language needs of residents does not reflect the everyday practices of culturally sensitive care. This type of emotional labor can also result in higher levels of burn-out for staff of color. Additional research into what constitutes culturally sensitive care to NH residents and staff is needed.
LACK OF POLICIES, TRAINING, AND SPECIAL CARE UNITS FOR OBESITY CARE IN PENNSYLVANIA NURSING HOMES
Authors: Harris John A , Castle Nicholas 
Published: November 2019

Abstract
It is unclear how nursing homes in the U.S. prepare for the specific needs of residents with obesity at a population level in terms of equipment availability, policies, staff training, and special care units. Using a mail survey of Directors of Nursing (DON) to 420 Pennsylvania Nursing Homes in 2017 and 2018, we examined the reported presence of obesity-specific equipment availability, organizational policies, staff training, and special care units. We compared the presence of these adaptation approaches by whether the DON strongly agreed that obesity was a problem for resident and staff safety using χ2 tests. One hundred fifty-one surveys were returned and included in the analysis (response rate of 36%). 80.7% of respondents were, on average, very concerned when asked about 11 resident medical, functional, relational, and staff-related safety outcomes (e.g., pressure ulcers, hospital readmissions, social isolation, and staff injury). DONs reported reduced equipment availability in nursing homes for obesity-specific beds (66%), walkers (34%), bedside commodes (30%), and gowns (28%). The presence of obesity-specific organizational policies (44%), staff training (26%), and special care units (7%) was limited. DON strong agreement with obesity-related resident and staff safety issues was significantly associated with obesity-specific bed availability (p=0.04) but was not significantly associated with obesity-specific organizational policies (p=0.17), staff training (p=0.51), and special care units (p=0.09). Despite a high concern for resident and staff safety related to obesity care expressed by DONs, there is little appropriate nursing home organizational response as measured by policies, staff training or special care units.
POLICY SERIES: POLICY UPDATE: OLDER ADULT NUTRITION AND MALNUTRITION
Authors: Whitmire Meredith , Blancato Robert 
Published: November 2019

Abstract
This symposium will provide an update on older adult nutrition policy, including background on the issues of older adult malnutrition and food insecurity. The federal policy update will include discussion of the Older Americans Act nutrition programs and their reauthorization progress, older adult programs under the US Department of Agriculture, and advances in nutrition services being made in healthcare programs such as Medicare Advantage and managed long-term care services and supports. It will also discuss funding for federal older adult nutrition programs and their sustainability moving forward.
DEMENTIA CARE FOR RESIDENTS IN ASSISTED LIVING: PERSPECTIVES OF STAFF RESPONDING TO BEHAVIORAL EXPRESSIONS
Authors: Dobbs Debra J , Zimmerman Sheryl , Beeber Anna , Carder Paula , Miller Stephanie , Hodgkinson Jennifer , Thorp Julia 
Published: November 2019

Abstract
Background: An estimated 42% of persons who live in assisted living (AL) have dementia. The majority of these individuals express behaviors (such as agitation, aggression, and wandering) that indicate a mismatch between their ability to cope and demands in the social and physical environment. In some cases, AL staff are able to successfully address those behaviors and in other cases they are not. This study explores behavioral expressions of persons with dementia residing in AL, strategies used to address those behaviors, and residents’ behavioral results, as reported by 251 AL healthcare supervisors across seven states. We also examine what differentiates situations deemed successful from situations that were not successful. Methods: Qualitative interviews conducted with healthcare supervisors revealed cases of successful and unsuccessful strategies for addressing severe/disruptive behavioral expressions of persons with dementia residing in AL. During initial analysis, a data-driven conceptual model was developed to identify common structural domains within and across responses, which ranged from recognizing antecedents to final discharge from the AL community. Additionally, content analysis was applied to identify themes. Results: A minority (&lt;5%) of reports indicated that staff recognized antecedents to behaviors, or noted including residents’ families in addressing behaviors. The majority of both successful and unsuccessful cases referenced the use of medications to address behaviors, and a notable proportion (10%) referenced professional psychiatric assessment. Discussion: Findings suggest the benefit of helping staff identify antecedents of behavioral expressions, and the important role of psychiatric assessment for AL residents who experience agitation, aggression, and similar behaviors.
OLDER ADULT MALNUTRITION: A GROWING CRISIS
Authors: Whitmire Meredith 
Published: November 2019

Abstract
Malnutrition, a caloric or nutrient imbalance, is particularly common in the older adult population, and food insecurity is a rising concern. This paper will discuss the incidence of malnutrition and food insecurity in the older adult population. It will also discuss federal and state programs in place that work to prevent and combat malnutrition. It will provide strategies for aging network members to engage in these policy discussions.