bluuebunny/crossref_metadata_2025_split huggingface dataset:
DIETARY INTAKE AND NUTRITIONAL RISK AMONG OLDER AMERICANS
Authors: Choi Yeon Jin , Ailshire Jennifer A , Crimmins Eileen 
Published: November 2019

Abstract
A suboptimal diet and nutritional deficiency are among the leading causes of chronic diseases (e.g., cardiovascular diseases, metabolic syndrome, cancer, and osteoporosis), morbidity, and mortality. The objective of this study is to assess dietary intake and nutritional risk among older Americans. The dietary intake of 15 food and nutrients that are closely associated with the risk of poor health was assessed based on the dietary guidelines and nutritional goals for older Americans using a nationally representative sample of older adults (N=7,737) in the Health and Retirement Study Health Care and Nutrition Survey. The average consumption of most food and nutrients was out of the optimal range. For example, older men and women consumed 1.32-1.35 cups of dairy products and 1.23-1.29 ounces of whole grains, which is less than half of the suggested amount. The average consumption of sodium, on the other hand, was over 12 times greater than suggested dietary recommendation for older men and about 10 times greater for older women. The nutritional risk index (range: 0–15) was created by summing the number of dietary risk factors (not meeting the dietary guidelines and nutritional goals), the index scores for older men and older women were 11.05 (SD=2.31) and 10.09 (SD=2.60) respectively, suggesting the high level of nutritional risk. A healthy diet should be encouraged to prevent chronic diseases and improve the health of older adults. Nutritional education may be an effective way to promote a healthy diet.
FACTORS ASSOCIATED WITH HOSPITAL-TO-HOME DISCHARGE: USING A DECISION TREE ANALYSIS
Authors: Lee Ji Yeon , Kim Kwang Joon , Kim Chang Oh 
Published: November 2019

Abstract
Because the number of older adults discharged home is increasing, a comprehensive geriatric assessment (CGA) becomes a helpful tool to make a decision about discharge destination. This study aimed to examine the predictors related with discharge destination using the component of CGA. We used decision tree analysis with the Classification and Regression Trees algorithm. Study participants were older adults over 65 years old who were admitted to geriatric department at a university-affiliated hospital in Korea. The older adults were assessed by multi-professional team at the initial stage of their hospitalization and received blood tests and the CGA. A total of 184 patients was included. The mean age was 84.6 years old and 61.6% were female. The analysis revealed arm circumference and level of frailty were significant predictors of home discharge. Specifically, 90.1% of patients had discharged home if their upper arm circumference was more than 18.3 centimeters, and 36.4% was discharged home if it was less than 18.3 centimeters. Among older adults with the arm circumference more than 18.3 centimeters, 57% of robust older adults and 91.7% of prefrail or frail older adults were discharged home. These robust older adults had relatively better daily living ability, and discharged to other facilities rather than home for rehabilitation. As many frail older adults are discharging to their own home, clinicians need to pay more attention to them. Also it is encouraged to perform the CGA, which includes nutritional assessment in it, for inpatient older adults.
HEALTH PROMOTION FOR PEOPLE WITH EARLY-STAGE DEMENTIA: A QUASI-EXPERIMENTAL STUDY
Authors: Testad Ingelin , Kajander Martine , Henriksen Anne Torsvik , Meling Målfrid , Vagle Vigdis , Gjestsen Martha Therese 
Published: November 2019

Abstract
With the limited advancements in medical treatment, there is a growing emphasis on supporting people with early-stage dementia adjusting to their diagnosis and improve their quality of life. This study aimed to evaluate the effects and experiences of people with early-stage dementia attending a 12-week Health Promotion, consisting of 2-hour sessions at weekly intervals focusing on understanding the progression of dementia, promoting physical activity, nutrition, coping, relationships, home- and travel safety, medication and communication with health care providers. Quantitative and qualitative assessments were conducted at baseline and follow-up 1-2 months post intervention, including cognition, self-rated health and depressive symptoms and individual short interviews. A total of 90 persons with dementia participated in this study. The results demonstrated a stable cognitive function, measured by Mini Mental State Examination, of people with dementia during the 4 month follow-up, and a significant improvement in self-rated health measured by EQ VAS (95% CI 0.2 to 7.6, p=0.037). Depressive symptoms measured by Cornell Scale for Depression in Dementia, demonstrated a decline by one point, which is an improvement in depressive symptoms, although not significant. 32 of the 90 qualitative interviews with participants and their carers were included and analyzed with systematic text condensation. The results demonstrated that the intervention was well received by the participants, learning about dementia, practical strategies and focusing on remaining resources was particularly highlighted as well as improved family communication. In conclusion, the intervention had beneficial effects on the cognitive function, self-rated health and depressive symptoms of people with dementia.
MEANINGFUL ENGAGEMENT AND QUALITY OF LIFE AMONG ASSISTED LIVING RESIDENTS WITH DEMENTIA: EMERGENT FINDINGS
Authors: Ciofi Joy , Kemp Candace L , Bender Alexis A , Burgess Elisabeth O , Morgan Jennifer C , Epps Fayron , Doyle Patrick , Perkins Molly M 
Published: November 2019

Abstract
This poster provides an overview of the aims, methods, and emergent findings from an ongoing five-year NIA-funded project (R01AG062310) examining meaningful engagement and quality of life among assisted living (AL) residents with dementia. The overall goal of this project is to determine how opportunities for meaningful engagement can best be recognized, created, and maintained for individuals with different dementia types and varying levels of functional ability. Guided by grounded theory, this qualitative study will involve 12 diverse AL communities in and around Atlanta, Georgia, USA. Presently, our interdisciplinary team is collecting data in four communities using ethnographic observations, semi-structured interviews, and resident record review. We are studying daily life in each community, following 30 resident participants, and actively recruiting and interviewing their formal and informal care partners. Based on ongoing analysis, we offer key emergent findings. First, meaningful engagement is highly individualized and dynamic. Differing personal interests, along with wide variations in cognitive and physical abilities, can present challenges for AL community staff and other care partners when trying to recognize what constitutes meaningful engagement for residents. Second, multiple complex factors interplay to shape the experience of meaningful engagement among persons living with dementia, such as personal characteristics, care partner background and training, AL community design and philosophy, and state/corporate regulations. Finally, flexibility and ‘meeting the resident where they are at’ appear to be critical to identifying and fostering meaningful engagement for persons living with dementia. We discuss the implications of these preliminary findings for translation, dissemination, and future research.
SEQUENTIAL IMPLEMENTATION AS A LEARNING HEALTH ORGANIZATION: THE EQUIPPED GERIATRIC MEDICATION SAFETY MODEL
Authors: Vandenberg Ann E , Kegler Michelle , Hastings Susan , Hwang Ula , Vaughan Camille 
Published: November 2019

Abstract
A learning health organization (LHO) is one that systematically integrates internal data and experience with external evidence to improve internal healthcare practice. Yet collaborative research networks implementing evidence-based interventions across sites with the goal of widespread dissemination are also effectively LHOs. The EQUIPPED (Enhancing Quality of Prescribing Practices for Older Adults Discharged from the Emergency Department) network formed to address an important public health issue: potentially inappropriate medications (PIMs) prescribed to older adults at discharge from hospital Emergency Departments (ED). EDs nationwide serve increasing numbers of older adults but lack clinical decision support to avoid prescribing PIMs associated with adverse events including hospitalization and death. The EQUIPPED geriatric safety program was adapted from the VA and implemented sequentially at three different academic institutions sharing the same electronic health record (Epic)(AHRQ R18HS24499). Implementation challenges, solutions, and innovations informed successive iterations. Using the Replicating Effective Programs framework, we conducted a process evaluation using data from implementation team focus groups (n=3), meeting minutes (n=98 hours), and organizational profiles (n =3) to understand how organizations working together within a research network build an intervention package for program scale-up. We present structural characteristics of the three organizations, implementation steps as they developed across three sites, and the resulting process protocol and a prototype toolkit. Lessons learned include having multiple internal champions at the intervention site, observing workflow pre-intervention, and streamlining data collection with a relational database and visualization software. Insights from the EQUIPPED experience can serve as a model for other systems and collaborative networks.
QUALITY IMPROVEMENT IN LTC: EFFECTIVENESS OF MONTESSORI-BASED ACTIVITY PROGRAMMING IN VA COMMUNITY LIVING CENTER
Authors: Chacko Thomas , Curyto Kim , Hilgeman Michelle M , Keleher Virginia 
Published: November 2019

Abstract
Montessori-based Activity Programming (MAP) was adapted for Veterans Affairs (VA) Community Living Centers (CLCs) and aims to increase independence and meaningful engagement in residents with cognitive impairment. The Montessori model prioritizes offering choice, knowing and harnessing a resident’s abilities, and enabling them to carry out purposeful roles and activities. Any perceived deficit in cognitive functioning is “circumvented” by preparing the environment to support maximum independence. The implementation of MAP-VA in VA Western NY CLC involved 3 lodges, 52 staff, 16 champions, and 65 CLC residents. Standardized implementation measures demonstrated improvements over six months in five domains assessing development of a resident-directed community. Hypothesized outcomes included improved national percentile quality improvement (QI) rankings related to psychological symptoms and medications (e.g., depressive symptoms and use of antipsychotic/antianxiety medications) and physical functioning (e.g., less falls and ability to move independently). Scores six months prior to the implementation of MAP-VA (April, 2018 to September, 2018) were compared with scores during six months of implementation post training (November, 2018 to March, 2019). Compared to pre-intervention QI measures related to psychological symptoms, a clinically meaningful trajectory of symptom decrease was observed with rankings during implementation (e.g., depressive symptoms, amount of antipsychotic medications). Likewise, compared to pre-intervention QI rankings regarding physical functioning, post-training rankings showed a trajectory of improvement (e.g., help with ADLs, ability to move independently). Implementation of the MAP-VA intervention demonstrates preliminary evidence for improvement in QI measures related to psychological symptoms and physical functioning. Implications for QI efforts in VA CLCs will be presented.
SURVEILLANCE PROGRAM IDENTIFIES HEALTH OUTCOMES FOR FORMER WORKERS
Authors: Golden Ashley , Miller Jeffery , Hubbell Zachariah , Howard Sara , Cragle Donna 
Published: November 2019

Abstract
According to the US Bureau of Labor Statistics, the average age of retirement is 62. While many retirees may have employer-provided or other access to healthcare, others have limited access to affordable care until full Medicare eligibility at 65. Regardless of access, retirees with toxic occupational exposures may not have providers with specialized knowledge of tests or diagnoses for exposure-related health conditions, especially those with long-latency. The National Supplemental Screening Program for U.S. Department of Energy Former Workers is described here as a nationwide program providing recurring (every 3 years) integrated health screenings designed to identify both occupational and non-occupational conditions in the context of exposure so that early identification can enable appropriate and timely diagnoses and treatments to improve health outcomes. Since September 2005, there has been 18,518 initial exams for former workers, of whom 5,461 returned for rescreening exams through April 2019. The average age of those returning was significantly younger at initial exam (63.4 years) compared to those who did not return (65.1 years). The most common occupational condition was noise-induced hearing loss not attributable to natural, age-related loss (67%). Rare and long-latency occupational health conditions, such as asbestosis or silicosis, were identified at rates expected (1-4%). The most common non-occupational condition was elevated body mass index (BMI&gt;25, 77.3%), followed by hypertension (20.7%), of which 50% had no prior knowledge or clinical diagnosis. In conclusion, occupational health surveillance programs can provide value for identifying non-occupational health conditions and as a supplementary source of health information and care.
PERSONS LIVING WITH COGNITIVE IMPAIRMENT SHARE THEIR VIEWS ON TECHNOLOGY
Authors: Wehry Susan , Robnett Regula H 
Published: November 2019

Abstract
The purpose of this study was to examine the experience of adults living with cognitive impairments and that of their care partners with digital technology including current use of, ease with and openness to using smart assistive technologies (SATs). SATs for older adults with (and without) cognitive impairments have become increasingly commonplace. Research on various digital devices has focused primarily on supporting users’ independence and care partner concerns for safety and security. Our qualitative, interview-based research project provided digital devices chosen by participants to address a specific personal goal. Interviews were conducted in the home and set-up assistance was provided during the initial interview. At the conclusion of the trial period, a second interview was conducted in the home. We describe the participants’ commendations for, expectations of, and frustrations with current technology as well as recommendations for potential, helpful digital technology. Current technology offers great promise but a disconnect between the design of digital technologies and the needs and wishes of the end-user still exists. This study will help inform additional user-driven application SATs, including those aimed at enhancing enjoyment and a higher quality of life.
PATIENT PREFERENCES FOR LEVEL OF HEALTH LITERACY IN APPS FOR CHRONIC DISEASE SELF-MANAGEMENT
Authors: Goodyear Mary Louise , Toral-Garcia Juan J , Acevedo Amarilis , Waldrup-Valverde Drenna , Ownby Raymond 
Published: November 2019

Abstract
In spite of expert recommendations that written material should be provided at a level of health literacy that matches that of the person receiving it, there have been few studies of matching. In this study we evaluated the utility of a new strategy to assess patients’ preference for information at different difficulties and assessed the relation of their preference to measured health literacy and health locus of control (LOC). We measured health literacy in participants then asked them to choose between pairs of texts with the same content but at the 3rd, 6th, or 8th-grade levels. Statistical analyses assessed the relation of participants’ health literacy to their preference as well as personal characteristics. Participants (n = 155) were 84 women and 71 men aged from 40 to 82 years (mean=57; 136 African Americans and 19 whites). Participants had clear preferences: those with lower levels of health literacy preferred texts at the 3rd grade level and those with higher levels preferred more difficult texts. Preference was not related to age, gender or race but was to education and health literacy (p &lt; 0.05). Persons who chose more difficult texts reported higher levels of internal health locus of control (t [144] = 2.68, p = 0.01). A predictive analytic model using education and preference resulted in 80% correct classification of participants. Using this model may be a simple way to match information presentation to patients’ level of health literacy. Further research on this strategy is needed.
BENEFICENCE, COMPANIONSHIP AND FINANCES AS MOTIVATORS FOR PARTICIPATION IN INTERGENERATIONAL HOME SHARING
Authors: Sweeney Cary , Bell Rachel K 
Published: November 2019

Abstract
In January 2019, the UC Berkeley Retirement Center began piloting Berkeley Home Match (BHM), a program that matches graduate students who need affordable housing with retirees who live near campus and have an extra room. BHM seeks to address affordable housing challenges for retirees and students while creating meaningful relationships. While some data exists for home sharing programs, less is known about the motivators and outcomes of retirees and students participating in these programs. In addition to decreasing the financial burden of housing, Social Exchange Theory suggests the built-in reciprocity of intergenerational home sharing may facilitate meaningful relationships. The purpose of this program evaluation was to understand the motivating factors for participation in a University-based home sharing program. Applicants (N=35) rated factors that influenced their decision to participate using a 7-point scale (1=“Not Influential”, 7=“Very Influential”). On average, homeowners (N=6) rated “helping a student” 5.2, “income” 5.2, and “companionship” 3.6, while home seekers (N=29) rated “helping an older adult” 5.03, “rent price” 6.1, and “companionship” 4.76. Surprisingly, ratings for “helping a student” and “helping a senior” were the same or close to ratings for “income” and “rent prices,” suggesting beneficence could be a key motivator and interdependence a mechanism for relationship development. Additionally, students’ rating for “companionship” was higher than expected, indicating an openness to the relationship. These findings as well as other factors impacting home matching will be discussed, including participant demographics, reduced housing cost, housing characteristics, and long-term program feasibility.
TYPE I INTERFERON-MEDIATED NEUROINFLAMMATORY PROGRAM AND SYNAPSE LOSS IN ALZHEIMER’S DISEASE
Authors: Roy Ethan , Wang Baiping , Zheng Hui , Cao Wei 
Published: November 2019

Abstract
The cytokine family type I interferon (IFN) is a major innate immune mediator extensively studied in the peripheral immune responses but largely under-investigated in AD. Previously, we established that innate immune cells readily produce IFN in response to amyloid fibrils containing nucleic acids as cofactor. Here, we investigated whether IFN pathway is associated with amyloidosis in AD brain and contributes to neuroinflammation. By systemically characterizing neuroinflammation in multiple murine AD models, we established a comprehensive core AD neuroinflammation profile that includes several key proinflammatory cytokine families, among which IFN pathway is consistently activated. When hippocampal slice culture was stimulated with different forms of amyloid fibrils, nucleic acid-containing amyloid fibrils, but not heparin-containing fibrils, potently activated IFN pathway and triggered comprehensive neuroinflammation. In addition, stereotaxic administration of IFNβ induced an immune response in the brain of wild type mice analogous to the core neuroinflammatory profile associated with Aβ pathology; whereas selective IFN receptor blockade significantly blunted the ongoing microgliosis in AD models in vivo. Furthermore, IFN promoted microglia-mediated synapse uptake from neurons, which depended on the induction of complement C3, and blockade of IFN signaling significantly abolished the pathogenic synapse loss in AD brain. Consistent with the findings in mice, we found that genes stimulated by IFN were grossly upregulated in human AD brains. Therefore, type I interferon constitutes a major pathway within the neuroinflammatory network of AD and may represent a molecular target to restrain the pathogenic inflammatory responses.
COMPLEMENT CONTRIBUTES TO ALZHEIMER’S DISEASE-INDUCED SYNAPSE DECLINE IN THE MURINE RETINA
Authors: Li Fenge , Jiang Danye , Samuel Melanie 
Published: November 2019

Abstract
Alzheimer's disease (AD) is among the most debilitating form of cognitive impairment in aged patients. Synapse deficits are thought to be a central trigger of neural miswiring and brain dysfunction in AD. However, the pathways that control synapse connectivity remain largely unknown. The retina is an easily accessible system with two distinct synapse layers and three cellular layers comprised of distinct neural types. In this study, we leveraged this system to assess synapse and cell integrity in the APPNLGF amyloid-beta AD mouse model. We showed that the expression of the complement component C3 is significantly increased in APPNLGF retina synapses, and that there is a significant decline of several synapse-associated markers by RT-PCR. These mice also display disorganized horizontal cell processes and visual function deficits. These results suggest that complement may drive AD-related changes in the synaptic and functional properties of the retina, which could serve as assessable preclinical biomarkers for AD. In ongoing studies, we are testing whether and how complement regulates synapse refinement and shapes retina synapse specificity in AD.
PEOPLE LIVING WITH PARKINSON DISEASE WITH AND WITHOUT FREEZING: DIFFERENCES USING THE NEURO-QOL MEASUREMENT SYSTEM
Authors: Rawson Kerri , Duncan Ryan , DeAngelis Tamara , Nordahl Timothy , Cavanaugh Jim , Earhart Gammon , Ellis Theresa 
Published: November 2019

Abstract
Parkinson disease (PD) is the second most common neurodegenerative disease and approximately half of those diagnosed with PD will experience freezing of gait (FOG). FOG is a severe motor disturbance that prevents stepping despite the intention to do so and may be associated with anxiety, decreased cognitive functioning, depression, and poorer quality of life. In this study, we administered the short-form Quality of Life in Neurological Disorders (Neuro-QOL) measurement system to 43 people with PD (28 non-freezers and 15 freezers) and determined freezing status using the New Freezing of Gait-Questionnaire. Freezers had greater motor severity as measured with the MDS-UPDRS-III (p =.003) and poorer balance using the Mini-BESTest (p = .017). Data from the Neuro-QOL battery indicated freezers had greater difficulty with Lower Extremity Function (p = .019) and Upper Extremity Function (p = .027). Freezers also had poorer scores on the Positive Affect and Well-Being (p = .005), Satisfaction with Social Roles and Activities (p = .005), and Stigma (p = .026) scales, but less difficulty on the Communication scale (p = .005) than non-freezers. There were no differences between freezers and non-freezers on the Ability to Participate in Social Roles and Activities, Anxiety, Cognitive Function, Depression, Emotional and Behavioral Dyscontrol, Fatigue, or Sleep Disturbance scales. These findings suggest freezers are less likely to have a positive outlook and satisfaction with their daily lives in combination with poorer functioning. Interventions that target freezing with the potential to improve functioning may result in better quality of life among freezers.