bluuebunny/crossref_metadata_2025_split huggingface dataset:
ATRA COMPETENCY STUDY: PROMOTING DEVELOPMENT OF RECREATIONAL THERAPISTS SERVING OLDER ADULTS
Authors: Kemeny Martha E , Hawkins Brent , Porter Heather 
Published: November 2019

Abstract
Competency concerns the knowledge, skills, and abilities needed to perform specific job tasks. In the field of recreational therapy (RT), four documents from the certification (NCTRC), accreditation (CARTE), and professional association (ATRA) broadly identify areas of competency for RTs. While broad competencies are defined, no specific competencies (i.e., diagnoses, assessments, interventions, theories) are identified. Sixty-seven RT experts, including 10 verified older adult experts with greater than five years experience and peer-reviewed publications, participated in three rounds of a Delphi study to gain content consensus. After experts in each setting identified key terms in the first round, experts reviewed the consolidated list twice to generate the final competency list. Next, all certified recreational therapists were invited to rate the extent that each competency item is being used in RT practice; the extent of their knowledge/skill for each item; and the degree of interest in gaining more knowledge/skill. A total of 1377 recreational therapists participated in the study (88% females, 11% male, 1% non-disclosed) with participants ranging in age from 20-60+ years of age. The study’s findings related to specific diagnostic populations served; interventions/modalities, techniques, standardized assessment tools, and theories utilized; education, training, and counseling topics in treatment; and on-the-horizon treatment and issues. This comprehensive two-part multi-year study is the first to explore current RT practice at a micro-competency level. In the effort to improve practice, these specific competencies necessary for RT practice with older adults are significant to both educators and practitioners in future curriculum and professional development efforts.
OLDER AUSTRALIAN WOMEN’S HUMAN CAPITAL: PERCEPTIONS OF SKILL LEVELS AND PARTICIPATION IN LEARNING ACTIVITIES
Authors: Taylor Philip 
Published: November 2019

Abstract
While business cases for older workers’ employment stress their value it is well-known that they participate less in training activities than younger workers. Women are at particular risk of not accessing training opportunities. Drawing on a survey of 2500 women aged over 50 we report a fine-grained analysis of the types of training women were undertaking and the factors associated with participation in training. The analysis indicates that training is infrequently undertaken in preparation for a new job and large majorities of women see no need to and are not interested in retraining. This is observed across occupational groups, but more commonly among those with low educational levels. A lack of employer support is much less commonly reported as a barrier to older women’s participating in training. The findings suggest that it is primarily at women themselves that efforts aimed at promoting human capital development need to be directed.
HOSPICE VISIT INTENSITY BY PHYSICIANS AND NURSE PRACTITIONERS ON THE GENERAL INPATIENT LEVEL OF CARE
Authors: Christian Thomas J , Teno Joan , Gozalo Pedro L , Plotzke Michael 
Published: November 2019

Abstract
The Medicare Hospice Benefit’s General Inpatient (GIP) level of care provides short-term services for pain and symptom management in an inpatient facility that cannot be managed in the patient’s home. Relatively little is known about how beneficiaries utilize services during GIP care. Among a cohort of Medicare hospice beneficiaries utilizing GIP during Federal Fiscal Year 2014 (FY2014), we used 100% Medicare hospice and Part B claims to identify physician and nurse practitioner services concurrent with GIP dates. We estimated logistic regression models to determine the likelihood a beneficiary never receives physician or nurse practitioner services. We found that among the 1.5 million GIP days serviced in FY2014, more than half (52.4%) lacked any recorded physician or nurse practitioner services. Absence rates for these services were particularly high among hospice GIP days provided in inpatient facilities (69.1% missing services), long-term care hospitals (84.3% missing services), and skilled nursing facilities (85.3% missing services). Moreover, one in five hospice episodes having at least three sequential GIP days lacked any physician or nurse practitioner services. Relative to hospice inpatient units, rates of absence were higher among episodes beginning in long-term care hospitals [59.3% long-term care hospital vs. 11.5% hospice inpatient units; AOR 9.65 95% CI 7.47-12.46] and skilled nursing facilities [51.3% skilled nursing facility vs. 11.5% hospice inpatient units; AOR 5.98, 95% CI 5.63-6.36]. More in depth research and monitoring is needed to further understand dimensions of GIP care provision, to ensure that hospice beneficiaries are receiving adequate services regardless of their inpatient setting.
IMPLEMENTATION OF THE GOALS OF CARE DECISION AID IN NURSING HOMES: AN EVIDENCE-BASED INTERVENTION
Authors: Chisholm Latarsha , Hanson Laura , Zimmerman Sheryl , Rosemond Cherie , Weiner Bryan , McConnell Eleanor S 
Published: November 2019

Abstract
Nursing homes (NH) must implement best practices to improve care. The purpose of this study is to understand NH characteristics that help or hinder implementation of the Goals of Care (GOC) intervention, an evidence-based decision aid to guide decision-making in advanced dementia. Study design was a cross-sectional staff survey at 11 NHs in North Carolina that participated in the GOC trial. Questions measured the dependent variable of implementation effectiveness (IE) (the consistency and quality of use of the GOC intervention). NH organizational characteristics were measured using publicly available data and administrator surveys. Averages were obtained, IE and NH factors above the average were ranked as high and vice versa. Analysis consisted of pattern matching logic, predicted results are compared to actual results, using within-case and cross-case analyses. NHs with high IE were expected to have the majority (five or more) of NH characteristics to be high to confirm the within (within-case analysis) and between (cross-case analysis) relationships. Within-case analysis expected results were met in 5 NHs, with 3 highs (IE high and five or more characteristics were high) and 2 lows (IE low and five or more characteristics were low). Among three NHs with high IE, the following characteristics were high: Medicare and SNF/ICF beds. Across 6 of the 11 NHs, high total beds and percent of White residents were related to high IE. NHs with enhanced resources may have fewer challenges implementing innovations compared to resource constrained NHs. Implementation strategies should account for resource limitations to promote successful implementation.
CONSERVATION OF INTEGRATIVE PHYSIOLOGICAL AGING MECHANISMS ACROSS PRIMATES
Authors: Cohen Alan A , Wey Tina W , Dansereau Gabriel , Roberge Emy , Legault Véronique , Brunet Marie , Kemnitz Joseph W , Ferrucci Luigi 
Published: November 2019

Abstract
Physiological dysregulation (PD) and integrated albunemia (IA) are organism-level aging mechanisms that can be measured using standard biomarkers, and in humans they have been shown to increase with age and predict health outcomes. Here, we use 10 species from the Internet Primate Aging Database (iPAD), a longitudinal database of biomarkers and mortality in captive primates, to analyze the generalizability of the role of PD and IA in aging, as well as the conservation of the underlying physiology. Human patterns are broadly but not universally replicated in primates. For example, PD increases with age in nine of eleven species, and predicts mortality in three of four. Both IA and PD can to some extent be cross-calibrated across species, indicating surprising conservation of underlying homeostatic norms; in the case of PD, the calibration weakens with phylogenetic distance.
MECHANISMS OF LONGEVITY: LESSONS FROM LONG-LIVED MAMMALS
Authors: Gorbunova Vera 
Published: November 2019

Abstract
Animals have evolved a dramatic diversity of aging rates with lifespans ranging from 2 years to 200 years. This natural diversity of lifespan can be exploited to understand the mechanisms of longevity and develop anti-aging interventions. Our goal is to identify mechanisms that allow such exceptionally long-lived animals to live long and healthy lives and then use these mechanisms to benefit human health. Naked mole rat is the longest-lived rodent with the maximum lifespan of 32 years. We discovered that the mechanism of longevity and cancer resistance in the naked mole rat mediated by high molecular weight hyaluronan. I will discuss the mouse model we generated that mimics the naked mole rat and shows increased healthspan and lifespan. I will also the role of SIRT6 in mediating longevity across mammals and in human centenarians by improving DNA repair and silencing transposable elements.
GENOME-WIDE RELAXATION OF SELECTIVE CONSTRAINTS UNDERLIES THE EVOLUTION OF SHORT LIFE SPAN IN AFRICAN KILLIFISHES
Authors: Valenzano Dario Riccardo , Cui Rongfeng 
Published: November 2019

Abstract
African killifishes independently evolved annual life cycles at least three times, offering a unique natural experiment of diversification of life history strategies. Using a comprehensive whole-genome sampling of 46 species of African killifishes, we found that genome size correlates with annual life style and climate. Annual species underwent genome-wide expansion of transposable elements, higher gene family turn-over rates and relaxed selection in genes in known aging pathways, such as mitochondrial replication and translation, mTOR pathway and DNA repair. Whole-genome resequencing in wild Nothobranchius populations showed bottle-necks and a genome-wide signature of relaxation of selection in populations evolved in dryer climates. In conclusion, evolution in ephemeral environments in African killifishes caused an extensive relaxation of selective constraints at genome-wide level. We discovered that, in African killifishes, ecology drove the evolution of short life span, associated to tens of thousands of slightly deleterious mutations driven to intermediate to high frequencies.
MARMOSET MONKEYS AS A MODEL OF AGING
Authors: Tardif Suzette , Ross Corinna 
Published: November 2019

Abstract
Interest in the New World Monkey, the common marmoset, as a nonhuman primate aging model is growing. Because marmosets have a fast maturation and short life span compared with more commonly used Old World monkey models, the aging research community began to explore the potential of this model species. In addition, the relative ease with which marmosets can be bred in a barrier environment enhances their value as a life-span model. Since that time, efforts to better define what aging actually looks like in marmosets has intensified. Important findings of the past decade include: (1) a refined definition of lifespan in this species and what affects age-specific survival; (2) assessments of age-related pathological changes; (3) development of functional phenotyping relevant to aging, such as activiyy, strength, body composition, cytokine profiling; (4) support of studies using the marmoset as a preclinical model to test intervention that may modulate the aging process.
THE PIPELINE OF GEROPSYCHOLOGY: INTEGRATION OF CLINICAL AND ACADEMIC CAREER TRAJECTORIES
Authors: Dorman Hillary , Strong Jessica V , Tighe Caitlan A , Mast Benjamin T , Allen Rebecca S 
Published: November 2019

Abstract
The current exploratory study aimed to identify factors influencing gerospychologists’ career trajectories, discerning what is “attractive” and “unattractive” across common career options. Participants rated career characteristics similarly (higher starting salary attractive, administrative tasks unattractive in a clinical VA; setting own hours attractive, few collaboration opportunities unattractive in a clinical non-VA; work variety attractive, publication expectations unattractive in academia). Interestingly, men found a clinical VA’s set hours more unattractive (t(50) = -2.59, p = .010). Sex differences also were evident in career change feasibility. 50% of respondents would consider switching careers (61% clinical to academia, 79% academia to clinical). Men were significantly more likely to consider switching from clinical to academia (χ2(2) = 6.33, p = .042) and find it feasible (χ2(2) = 8.92, p = .012). Enhancing our understanding of what encourages/discourages careers in geropsychology is needed to address the workforce shortage; this study takes important steps in this direction.
CAREER PERCEPTIONS AND IDEALS FOR CLINICALLY FOCUSED AND ACADEMIC PSYCHOLOGY CAREERS: A MIXED-METHODS STUDY
Authors: Strong Jessica , Allen Rebecca , Tighe Caitlan , Jacobs Mary , Dorman Hillary , Mast Benjamin 
Published: November 2019

Abstract
More psychologists who have specialty training in geriatrics are needed to meet the growing demand. However, there is a shortage of individuals in academic geropsychology, which feeds the clinical geropsychology pipeline. Barriers to recruiting trainees into jobs in academia are not well understood. The current mixed-methods study examined trainees’ perceptions of clinically-focused and academic jobs, and discrepancies between professional psychologists actual and ideal job activities. Results found that trainees have less accurate perceptions of the activities of academic compared to clinically-focused jobs. Interviews with trainees revealed negative perceptions of the university system, including bureaucracy, salary, and perceived workload. However, professional psychologists, both clinical and academic, reported high agreement between actual and ideal activities. Academic psychologists reported desiring more time in clinical work, without reducing research or teaching time. Clinically-focused psychologists desired and increase in research and teaching time without sacrificing clinical activities. Each group discussed struggles in obtaining work-life balance.
HEALTH INSURANCE AND HEALTH CARE DECISION-MAKING FOR ADULTS IN THE PRE-MEDICARE YEARS: FINDINGS FROM NATIONAL SURVEYS
Authors: Solway Erica , Tipirneni Renuka , Solway Erica 
Published: November 2019

Abstract
As more Americans approach retirement age and eligibility for Medicare coverage, many face difficult decisions about their health insurance and health care. This session explores how adults age 50-64 are navigating these choices following implementation of the Affordable Care Act (ACA), presenting data from two nationally representative surveys: The University of Michigan’s National Poll on Healthy Aging (NPHA) and the Health and Retirement Study (HRS). Erica Solway, Associate Director of the NPHA, will begin by presenting background information about the NPHA and an overview of critical health policy issues for adults age 50-64. Jamie Luster, Research Area Specialist at the University of Michigan, will then provide NPHA findings linking concerns about health insurance affordability with delayed/forgone health care. Next, Aaron Scherer, Associate of Internal Medicine at the University of Iowa Carver College of Medicine, will discuss NPHA findings on factors associated with adults’ concern about affordability of health insurance in retirement but before Medicare eligibility begins at age 65. Finally, Renuka Tipirneni, Assistant Professor of Internal Medicine at the University of Michigan, will present findings based on the HRS on changes in health care utilization for adults age 55-64 since implementation of the ACA’s Medicaid expansion. To conclude, Erica Solway will discuss current federal health care policy proposals for adults age 50-64, including the recent introduction of the Medicare at 50 bill, and how the perspectives and experiences of adults in this age group can help inform those policies.
CONFIDENCE IN HEALTH INSURANCE AFFORDABILITY AND DELAYED OR FORGONE HEALTH CARE AMONG ADULTS APPROACHING RETIREMENT
Authors: Luster Jamie , Tipirneni Renuka , Solway Erica , Malani Preeti , Kullgren Jeffrey , Kirch Matthias A , Singer Dianne , Scherer Aaron M 
Published: November 2019

Abstract
Recent challenges to the ACA may add uncertainties to decision-making about health insurance. We sought to determine if health insurance affordability concerns were associated with delayed/forgone health care among adults approaching retirement age. In October 2018, the NPHA conducted an online survey of US adults age 50-64. 45% of respondents had little/no confidence in ability to afford health insurance when they retire, and 27% little/no confidence in this over the next year. In the past year, 13% had not gotten medical care and 12% had not filled a prescription because of cost concerns. Controlling for demographic and health characteristics, having little/no confidence in health insurance affordability in retirement/within the next year was associated with delaying/forgoing health care (aOR 2.80, p&lt;0.001). Despite the ACA’s coverage expansions and consumer protections, these findings suggest adults worry about the affordability of health insurance in retirement and may avoid needed health care for that reason.
OPTIMAL MEDICATION MANAGEMENT IN ALZHEIMER’S DISEASE AND DEMENTIA
Authors: Green Ariel 
Published: November 2019

Abstract
For older individuals with Alzheimer’s disease and related dementias (ADRD) and multiple chronic conditions (MCC), taking more medications is associated with greater risk of adverse drug events, drug interactions, treatment burden, and cognitive changes from medication side effects. Optimizing medication through deprescribing (the process of reducing or stopping the use of inappropriate medications or medications unlikely to be beneficial) can help avoid adverse drug effects and improve outcomes for MCC patients, particularly for those with ADRD. Findings to date are limited to primarily Caucasian patients. This talk will focus on work geared to elicit perspectives on medication use, communication about medication, and deprescribing among African American and Hispanic older adults with ADRD and MCC, their family members, and clinicians caring for these populations.
USE OF NEW HEPATITIS C DRUGS IN MEDICARE: PERSISTENT URBAN-RURAL DISPARITIES AND POTENTIAL INTERVENTIONS
Authors: Du Ping 
Published: November 2019

Abstract
Chronic hepatitis C virus (HCV) infection, whose prevalence is concentrated among older adults, can bring serious health impacts and high financial burden. With the availability of highly effective and well tolerated direct-acting antiviral (DAA) therapy, treatment of chronic HCV infection has rapidly evolved, making HCV treatment less burdensome. However, the high cost of DAA and lack of clinical expertise are still important barriers for providing DAA therapy to rural patients, highlighting the urban-rural disparities in managing many chronic diseases for aging populations. Telehealth could serve as effective care-model to improve management of HCV infection for older, rural populations. This talk will present work that examines multi-level factors affecting HCV DAA treatment (focusing on urban-rural disparities), evaluates changes in urban-rural disparities in DAA utilization over time, and explores the role of a telehealth-based intervention in reducing urban-rural disparities in HCV DAA treatment in Medicare patients.
INTERNET USE AND LONELINESS: CURE OR CAUSE? LONGITUDINAL ANALYSIS OF OLDER ADULTS’ INTERNET USE
Authors: Hees Elena , Tesch-Römer Clemens , Huxhold Oliver 
Published: November 2019

Abstract
The internet provides an indispensable platform for social interaction, entertainment and everyday tasks. Especially older adults might benefit from staying engaged online to counteract loneliness. Yet, current research on how internet use effects loneliness still paints a contradictory picture. The current study investigates the longitudinal influence of social internet use forms as opposed to general internet use on loneliness across three years (2014-2017) separately in two age groups (pre-retirement: 40-64 years and post-retirement: 65-85 years), using data from the German Ageing Survey (DEAS). Structural equation modelling shows, that general web use predicts an increase in loneliness in both age-groups. However, contacting friends and family online seems to protect against loneliness over and above the effect of overall internet use, at least for the younger age-group. Therefore, the current study underlines the importance of investigating what exactly people do online instead of seeing the internet as a homogenous tool.
SOCIAL ENGAGEMENT THROUGH VIDEO CHAT FOR OLDER INDIVIDUALS WITH AND WITHOUT COGNITIVE IMPAIRMENT
Authors: Rogers Wendy , Nie Qiong , Nguyen Lydia , Mudar Raksha , Myers Dillon , Gibson Alan , Kerssens Chantal 
Published: November 2019

Abstract
Social engagement is a fundamental component of health and quality-of-life outcomes. However, there is a prevailing view that older adults primarily want to engage socially with current family and friends – that they are not interested in developing new relationships. That is an overgeneralization. We have found that older adults are interested in the opportunity to engage in social interactions with people who have shared interests. Technology can facilitate these interactions. We will describe our research with OneClick.chat, a web-based video chat system. We explored potential benefits of use by adults aged 70-85, including those with mild cognitive impairment (MCI), as well as barriers and facilitators to adoption. Participants saw value of this online social engagement platform and were able to use it with some initial training. They envisioned using OneClick not only for conversations but also for learning and doing activities with like-minded individuals.
ONDRI: A PROVINCIAL INITIATIVE TO UNDERSTAND THE HEALTH SYSTEM IMPACT OF AGING AND NEURODEGENERATIVE DISEASES
Authors: Bronskill Susan E , Maxwell Colleen J , Jette Nathalie 
Published: November 2019

Abstract
As populations worldwide are living longer, the impact of neurodegenerative diseases on health resource utilization is expected to increase. Providing care to older adults with neurodegenerative diseases is challenging, and requires adequate supports across multiple health sectors including community, acute care and nursing home settings to allow individuals to maximize their quality of life. The Ontario Neurodegenerative Disease Research Initiative (ONDRI) is a collaborative research program that aims to improve diagnosis, treatment and management of neurodegenerative diseases including Alzheimer’s disease and related dementias, Parkinson’s disease, Amyotrophic Lateral Sclerosis (ALS), and Vascular Cognitive Impairment. Using population-based linked health administrative and clinical databases--covering over 14 million individuals residing in the province of Ontario, Canada-- the ONDRI health services research platform will address knowledge gaps regarding the health service utilization and outcomes of older adults with neurodegenerative diseases and impacts on family and care partners. Access to over two decades of historical health administrative data on a large population of older individuals uniquely positions our collaborative to examine trajectories of health system use as well as rare neurodegenerative diseases which have been previously understudied. The health services research platform is embedded within a larger ONDRI network of biomedical researchers, provincial decision-makers and health system stakeholders. Our research findings will inform health system planning and interventions to support older adults to live independently in the community. This session will explore how health administrative databases may be used to address knowledge gaps regarding health service utilization and outcomes in older persons with neurodegenerative diseases.