bluuebunny/crossref_metadata_2025_split huggingface dataset:
Up North and Down South: Regional Differences in Pain, Religious Coping, and Negative Affect in Osteoarthritis
Authors: Cheesman Katherine , Parmelee Patricia , Smith Dylan 
Published: December 2020

Abstract
Objective: This research examines regional differences (Northern vs. Southern) in pain, religious coping, and negative affect among African Americans (AA) and non-Hispanic Whites (NHW) over the age of 50 with physician-confirmed knee osteoarthritis (OA). Methods: As part of a larger study of racial/ethnic differences in everyday quality of life with OA, 116 persons were recruited from sites in Alabama (n = 64) and New York (n = 52). Participants completed global measures of pain (PGC Pain Scale) and religious coping (Brief RCOPE); daily variability in pain, coping, and affect was assessed using a daily diary methodology consisting of 4 daily phone calls over 7 days. Site comparisons were conducted using one-way multivariate analysis of covariance (MANCOVA) with covariates of race, sex, education, and marital status. Results: There was a significant multivariate effect of site on pain, religious coping, and affect, F(5, 104) = 3.846, p = .003, Wilk’s Λ = .844, partial η2 = .156. Follow-up univariate tests and mean examinations revealed that Southerners reported statistically more daily pain (M = 2.023, SD = .89), religious coping (M = .618, SD = .427), and negative affect (M = 6.556, SD = 2.661) than Northerners (M = 1.810, SD = .719; M = .386, SD = .417; M = 5.865, SD = 1.446). Implications: Results contribute to a growing understanding of how individuals use their religious beliefs to cope with daily pain. (Supported by R01-AG041655 D. Smith and P. Parmelee, PIs.)
Self-Efficacy Proxy Predicts Physical Frailty Incidence Over 8 Years in Non-Institutionalized Older Adults
Authors: Hladek Melissa , Zhu Jiafeng , Buta Brian , Szanton Sarah , Bandeen-Roche Karen , Walston Jeremy , Xue Qian-Li 
Published: December 2020

Abstract
Physical frailty is defined as a syndrome of decreased physiologic reserve conferring vulnerability to functional decline, mortality and other adverse outcomes in response to a stressor. One potential modifiable risk factor of frailty is self-efficacy, which is confidence in one’s ability to perform well at a task or domain in life. Self-efficacy is associated with improved health behavior and decreased chronic disease burden but has not been studied extensively in frailty research. Therefore, the purpose of this study was to evaluate a general self-efficacy proxy measure’s ability to predict frailty in a nationally representative sample of older adults using data from the National Health and Aging Trends Study (NHATS) collected from 2011-2018. 4,835 older adults (65+) were dichotomized into low and high self-efficacy groups using the one-item self-efficacy proxy measure in NHATS. The Physical Frailty Phenotype was used to assess frailty. A discrete time hazard model was used to obtain incident hazard ratios of frailty in two models. Model 1 was adjusted for age, race, sex, education and income. Model 2 contained Model 1 covariates and activities of daily living and co-morbidities. We found that low self-efficacy predicted a 41% increased risk of developing frailty over 8 years after adjustment for socio-demographics (P&lt;0.0001) and a 27% risk of incident frailty after further adjustment for activities of daily living and co-morbidities (P=0.004). This study provides preliminary evidence that self-efficacy may be a key modifiable element to incorporate into multi-modal frailty interventions.
Acute Life Interventions, Goals, and Needs Program: Social Determinants of Health Among the Most Vulnerable
Authors: Munoz Lizette , MacKenzie Blair , Chun Audrey , Fani Shamsi , Lavayen Susana , Chow Stephanie 
Published: December 2020

Abstract
The Acute Life interventions Goals and Needs program(ALIGN) at Mount Sinai Hospital in New York City, is an inter-professional team dedicated to offering temporary intensive ambulatory care services to the most complex older patient population. This allows us to care for the most vulnerable population which often incur multiple hospitalizations, emergency room visits. Mr.C is a 81 yo male with past medical history of Chronic COPD, Depression, Gait instability, Mild Neuro-cognitive disorder, Hearing Loss, Coronary artery disease. Most significantly he had 3 ED visits, 1 admission, where he was found on the floor of his apartment after two days, by a meals on wheels volunteer. Team conducted a comprehensive assessment of Mr.C’s social determinants of health and compiled a care plan. We learned that Mr.C does not like to bother others therefore found it difficult to seek help. Team built intensive rapport and gained his trust to help simplify medications, increase engagement and explore barriers to home care. Mr.C was connected to several community agencies including, meals on wheels for more stable food access, psychiatry to discuss depression and isolation, adult protective services for deep cleaning,financial management, pharmacy for blister packing, home care services and case management to continue encouragement with care plan. Mr.C is now able to reach out to the team as needed and has a navigator to help with managing care. This is one of many cases ALIGN encounters, that often go undetected due to comprehensive inter-professional care needed and minimal time given in traditional primary care.
Socioeconomic Correlates of Healthy Aging Among Older Cambodians
Authors: Kuy Kakada , Li Yuekang 
Published: December 2020

Abstract
Healthy aging is one of the most critical goals to attain on the World Health Organization’s global aging agenda for developing countries. However, healthy aging has not been widely studied among the many older adults living in those nations. For example, most of the Cambodia’s economically deprived older adults earn less than a dollar a day, while little scientific evidence is known about their healthy aging situation and their support system. Our study aimed to examine socioeconomic correlates of healthy aging among older Cambodians in three provinces. Data of a sample of older Cambodians ages 60 and above (N=210) from 12 districts were collected. Healthy aging was measured using the Healthy Ageing Index developed based on a Southeast Asian context. We measured social support using the Social Network and Social Support scale. Financial conditions were measured by an index derived from subjective and objective measurements. Multilevel mixed-effects models showed that better social supports from friends and family members, better financial conditions and education were associated with improved health aging among older Cambodians. Supports from friends had a stronger relationship than supports from family members. As one of the first studies examine the social determinants of health among older Cambodians, this study adds to the literature by substantiating the important roles of financial conditions and social support in determining their health and well-being. Findings point to the importance of improving living standard and maintaining social support of the older population in the country.
The Effect of Neighborhood Cohesion Across the Lifespan on Cognitive Health
Authors: Munoz Elizabeth , Ng Yee To , Han Sae Hwang 
Published: December 2020

Abstract
Neighborhood environments may serve as protective factors against cognitive impairment and decline. Recent evidence shows that neighborhood cohesion is associated with better cognitive health in adulthood. We extend the current literature by evaluating how neighborhood cohesion across the lifespan may influence cognitive function in adulthood. We used data from the Health and Retirement Study (HRS) and the HRS Life History Survey. Participants who were 50-89 years old at baseline, completed up to 10 longitudinal waves, and were not cognitively impaired in the last wave were included in the analyses (N=2,057). Early-life neighborhood cohesion was assessed with participants’ retrospective ratings of sense of belonging in their local areas at age 10, when they first had a full-time job, and at age 40. Participants’ assessment of neighborhood cohesion assessed at the final wave was treated as the current indicator of cohesion. Cognitive function was assessed with the full HRS cognitive battery. Preliminary findings from hierarchical mixed models showed an overall decline in cognitive function across time. Current and age 10 neighborhood cohesion were independently associated with better baseline cognitive function, but did not predict cognitive change. Interaction terms involving cohesion at age 10 and current neighborhood cohesion showed that current cohesion buffered the negative effect of low cohesion at age 10. No significant associations were observed for cohesion during the full-time job and age 40 periods. Although effect sizes were small, these results indicate that neighborhood cohesion in older adulthood may offset the detrimental effects of negative childhood environments on cognitive health.
Rural and Non-Rural Digital Divide Persists in Older Adults: Internet Access, Usage, and Perception
Authors: Lee Hee Yun , Choi Eun Young , Kim Youngsun , Neese Jessica , Luo Yan 
Published: December 2020

Abstract
Despite the overall increase in Internet use among older adults, the digital divide within older Americans remains substantial. This trend is particularly true for older adults living in rural areas. Informed by the Social Determinants of Health Framework, our study aims to examine how one’s residential area relates to (1) Internet Access, (2) subtypes of usage patterns, and (3) perceptions on technology use. Cross-sectional data were drawn from the 2012 Health and Retirement Study (HRS). The sample consisted of 18,196 older adults aged 50 and above (47.6% rural residents). A series of linear and logistic regression analyses were performed. Our models controlled for demographic characteristics, socioeconomic status, and health conditions. Compared to older adults living in urban areas, those residing in rural areas had 29% lower odds of internet access. Living in rural areas predicted lower levels of all sub-types of technology use (communication, financial, health, and media technology). In addition, non-users in rural areas showed more unfavorable perceptions of technology than urban residents. They were more likely to conceive technology as “too complicated”, “too hard to learn”, and “too difficult to keep up with all changes.” Our findings suggest that substantial segments of older adults in rural areas are still behind in accessing and adopting digital technology. Targeted intervention efforts are urgently needed to reduce technology inequality including comprehensive plans to expand broadband access and building mobile technology infrastructure for rural communities.
Poor Sleep Health and Next Day Work Impairment: The Mediating Role of Fatigue
Authors: LaRocque Breann , Mu Christina , Lee Soomi 
Published: December 2020

Abstract
Nightly sleep impacts next-day alertness and cognitive functioning. For healthcare professions, work impairment can be life-threatening for patients. Thus, understanding how sleep affects work quality is imperative to promoting medical safety and overall health of workers. The current study investigated whether nightly sleep health is associated with next-day work impairment in nurses and whether this association is mediated by daily fatigue. Sixty nurses reported their sleep characteristics, fatigue, and work impairment using ecological momentary assessment for two weeks. We used a series of multilevel models (a path: sleep→fatigue, b path: fatigue→work impairment, c path: sleep→work impairment, c′ path: sleep and fatigue→work impairment), adjusting for sociodemographics and work shift. At the between-person level, poorer sleep quality was associated with greater work impairment (βc=-23.36, p&lt;.001). This association was mediated by fatigue such that poorer sleep quality was associated with greater fatigue (βa=-19.54, p&lt;.01), which was further associated with greater work impairment (βb=0.79, p&lt;.001). After including fatigue, the association of sleep quality with work impairment was reduced (βc′ =-7.07, p=.08). Similarly, fatigue mediated the relationship between sleep sufficiency and work impairment (βa=-16.49; βb=0.79; βc=-19.36; p&lt;.001; βc′ =-6.32, p=.05). At the within-person level, on days after long sleep duration (&gt;8hrs), nurses reported greater work impairment (βc=10.08, p&lt;.01), however, this was not mediated by fatigue. Our results suggest that poor sleep health may impair next-day work performance, mostly through increased fatigue. Future interventions for nurses can target daily fatigue to reduce the adverse effects of poor sleep on work impairment.
Pre-Loss Group Therapy for Family Caregivers of Persons With Dementia: Translation Into Practice
Authors: Supiano Katherine , Andersen Troy , Luptak Marilyn , Beynon Cynthia , Iacob Eli , Li Hui 
Published: December 2020

Abstract
We developed Pre-Loss Group Therapy (PLGT) for dementia caregivers at risk for Complicated Grief (CG). PLGT is a manualized ten-session multi-modal group therapy that includes elements of cognitive behavior therapy, motivational interviewing, exposure therapy, memory revisiting, meaning-making, and self-care. We implemented and evaluated three PLGT cohorts in three long-term care facilities with family caregivers at-risk for CG whose care recipient had a life expectancy of 6 months or less and resided in a long-term care facility (NT = 24). Evaluation of participant preparedness for the death of the persons with dementia (PWD), self-care and grief outcomes showed significant improvement across multiple domains between pre and post-group, notably a statistically significant decrease in grief as measured by the Inventory of Complicated Grief score from baseline (M = 25.67, SE=1.80) to post-group (M = 14.41, SE=1.65) t(21)= 6.280, p&lt;0.001. Clinician-rated grief severity declined (N=22, β = –0.472, SE = 0.018, p &lt; 0.001) per week and grief improvement increased (N=22, β = 0.259, SE = 0.023, p &lt; 0.001) per week, as assessed on the Clinician Global Impressions Scale. We subsequently trained two LCSWs to conduct PLGT, and both clinical outcomes and treatment fidelity and skills measures achieved performance levels of master clinician-trainers. Family caregivers at risk for CG may benefit from group therapy targeting preparedness and pre-loss grief experience, as we provide with PLGT. Manualized PLGT is suitable for implementation by LCSWs in the settings of hospice and long-term care.
A Community Space With Diverse Activities Support Older Adults’ Social Participation and Sustain Social Connection
Authors: Kim Dongyool , Masuda Taichi , Higuma Shuichiro , Yang Yerim , Terazawa Sayaka , Takase Mai , Ogino Ryogo , Goto Jun 
Published: December 2020

Abstract
Active older adults in Japan participate in multiple social activities to be socially involved. However, physical limitation and decline in enthusiasm due to ageing decrease their participation. Diverse activities should be available at one place, close to older adult’s residence, to sustain social connections. A community space was launched at Toyoshikidai housing complex (Kashwia, Japan) in February 2018. The place offers about 25 activities per month. This research aimed to elucidate the relationship between activity type and motivation for participation, and study the effect of the community space on older adults’ social connection. A cross-sectional questionnaire survey was conducted targeting the attendees of community space (February 2020). Of attendees, 68% lived within 10-minutes walking distance to the community space (N=101). The activities were classified into craft, exercise, and music. The motivation for attending craft events were information exchange and relaxation, as was health maintenance for exercise events. Participating in group performance was the motivation to attend active music event, and casual gathering and network expansion was for passive music event. The frequency of social participation outside the community space was low in the group aged over 75 years. This group attended the activities at the community space more frequently than did the younger group. Differences in the number of social connections were not found. This result implies that older adults maintained their social connection by attending activities held at the community space. The diverse programs and close location of the community space might have contributed to the motivation of participation.
Substance Use Is Common in Elder Abuse Cases: Qualitative Findings From a Multi-Disciplinary Team
Authors: Khalili Seyed Parham , Elman Alyssa , Clark Sunday , Bao Yuhua , Zhang Yiye , Jeng Philip , Wen Katherine , Rosen Tony 
Published: December 2020

Abstract
Elder abuse is mistreatment of an older adult by a caregiver or another person in a position with an expectation of trust. Adversely affecting as many as 10% of community-dwelling older adults in the US, it may include physical abuse, sexual abuse, psychological abuse, financial exploitation and neglect. Mental illness and substance use by caregivers, family members and victims themselves have been described as risk factors for multiple forms of elder abuse in prior cross-sectional analyses but the impact on these cases is poorly understood. To explore this association we conducted a focus group using a semi-structured format involving an inter-disciplinary group of elder abuse professionals that are part of the New York City Elder Abuse Center enhanced multi-disciplinary team (EMDT) in Staten Island, New York. Focus group participants reported that opioid, cocaine, cannabis and alcohol use is common among perpetrators of elder abuse, especially in cases of financial mistreatment, verbal and physical abuse. Other potential consequences included eviction of the older adult victim, co-dependency and involvement of the older adult in the procurement of illicit substances, and substance use by the older adult. Respondents specifically expressed concerns that the opioid epidemic, including rising heroin use, may be changing the frequency and nature of elder abuse, and that case investigations offer an opportunity to facilitate referrals for formal substance use disorder assessment and treatment. Future work includes additional focus groups and quantitative analysis to clarify the intersection between substance use and elder abuse and inform intervention and prevention strategies.
Turning Seniors’ Voices into Action on Elder Abuse: Findings From a Project Empowering Older Adults to Assist Peers
Authors: Hsieh Jessica , Tan Sharon , Mirza Raza , McDonald Lynn 
Published: December 2020

Abstract
Elder mistreatment, often understood in the context of abuse and neglect, is a growing concern for the health and wellbeing of seniors and their families. A 2015 Canadian prevalence study by the National Initiative for the Care of the Elderly (NICE) found that seniors who are mistreated are more likely to talk to peers, and not clinicians, police or family. However, a lack of knowledge, access to resources, and community stigma may limit seniors’ abilities to address mistreatment. This study evaluated the impact on knowledge, attitudes, and behaviours of having seniors deliver workshops on mistreatment to other seniors. A seniors advisory committee developed content for sixteen workshops. Senior facilitators delivered sixteen workshops about mistreatment across Ontario. Participants completed pre/post-surveys assessing changes in knowledge, attitudes, and behaviours. Results indicate that workshops effectively increased awareness of mistreatment issues among participants, on average, by 37.32%. Participants experienced a 43.98% increase in their perceived preparation to provide information to an older adult asking about mistreatment. Barriers to help-seeking among seniors with knowledge of mistreatment include finding trustworthy sources and a lack of legal protection. Prior to the training, healthcare providers were the main sources of information for participants (57.75%); depending on the severity of the situation, 60.43% of participants indicated eventually reporting to police, who are not the preferred source of information. Senior-led workshops about mistreatment appear to be effective for increasing knowledge and encouraging disclosure and help-seeking behaviours. Results support prevention models that empower seniors to educate other seniors on issues around mistreatment.
Value-Based Purchasing Financial Outcomes Among Minority-Serving Skilled Nursing Facilities
Authors: Hefele Jennifer Gaudet , Sharma Hari , Conkling Bryant , Xu Lili , Wang Xiao (Joyce) 
Published: December 2020

Abstract
Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) ties post-acute payments to readmissions performance. Minority-serving SNFs tend to be poorly resourced and understanding the financial implications of SNF-VBP is important. Our study examined VBP payments and penalties among minority-serving SNFs. We conducted cross-sectional analysis using public data sources. We defined minority-serving as SNFs with &gt;50% of residents who are African American (AA)/Black (n=764) or with &gt;50% of residents who are Hispanic/Latino (n=164). Majority-White SNFs (&gt;50% residents who are White) were the reference group (n=11,002). Outcomes examined were: being in top 20% of performance rankings; receiving a bonus; receiving a bonus that was above the median bonus dollar amount; being in bottom 20% of performance rankings; receiving a penalty; receiving a penalty that was below the median penalty dollar amount. Logistic models estimated the likelihood of experiencing each performance outcome for AA/Black-serving and Hispanic/Latino-serving SNFs in reference to majority-White SNFs. Results show that minority-serving SNFs not only perform worse but also experience greater negative financial impacts. Among those penalized, Hispanic/Latino-serving SNFs had the largest average penalty amounts: $32,575 compared to approximately $26,000 for both AA/Black- and White-serving SNFs. Hispanic/Latino-serving SNFs had 1.69 times the odds of receiving larger than median penalties and AA/Black-serving SNFs had 27% lower odds of receiving higher than median bonus payments. Average penalties approximate the average salary for a certified nursing assistant, the primary direct care worker in this setting. Results from this study raise concerns over long-term impacts. Alternative approaches to encouraging quality should be considered.