bluuebunny/crossref_metadata_2025_split huggingface dataset:
CULTURAL COMPETENCE TRAINING FOR HOSPICE STAFF: FINDINGS FROM A NATIONAL HOSPICE SURVEY
Authors: Boucher Nathan , Johnson Kimberly S 
Published: November 2019

Abstract
Compared to whites, racial/ethnic minorities are less likely to enroll in hospice and if they enroll, more likely to experience poor quality care. Building cultural competence (CC) among hospice staff is a strategy that may reduce these disparities. We conducted a national survey of hospices’ practices to promote CC. A total of 197 hospices participated; most were not-for-profit (80%) with an average daily census over 100 (53%); 73% offered staff cultural competence training (CCT). There were no differences in characteristics of hospices who offered CCT and those that did not. Of hospices offering CCT, 54% held it annually. Most trainings were one hour (60%); content was delivered via web (58%) and/or lecture (57%). While over 90% of staff (i.e., nurses, social workers, and chaplains) completed CCT, a smaller proportion of medical directors (63%), senior leaders (70%) and board members (23%) did so. Most common (&gt;70%) topics were: cross-cultural communication, death and illness beliefs, and spirituality’s role, and healthcare disparities. The majority focused on African-Americans (83%), Hispanics (76%), and Asians (61%)—the most common U.S. minority groups. Almost 30% reported no assessment of effectiveness of CCT while 45% reported a quiz at the end. In this study, most hospices offered some CCT. CCT has been shown to improve healthcare providers’ knowledge and skills in caring for diverse patients and is associated with increased patient satisfaction. Future research should evaluate effectiveness of CCT in improving the ability of hospices to deliver high quality end-of-life care to diverse groups of older adults.
DEVELOPMENT AND PILOT TESTING OF THE END-OF-LIFE READINESS ASSESSMENT (ERA) SURVEY
Authors: Coulourides Kogan Alexis M , Taguchi Julie 
Published: November 2019

Abstract
An emerging conceptual framework on the relationship between serious and sensitive end-of-life (EOL) discussions and patient hope points to the mediating role that patient readiness may play. Additional research has also found that among some patients, engaging in and EOL conversation before they are ready may actually cause harm. Presently, health practitioners do not have a way to measure patient readiness. Therefore, the purpose of this study was to develop a survey assessment tool, rooted in research, to measure patient readiness to engage in an EOL discussion. The 16-item survey was initially developed by a gerontological researcher and clinical oncologist, and tested for face reliability and appropriateness among a geriatrician and three patients with chronic illness. In May 2018, the final version of the survey was pilot tested among 168 patients attending their regularly scheduled oncology appointment. On average, most participants identified as Caucasian (74%) females (61%) in partnerships (58%) and having a cancer diagnosis (64%). Bivariate analyses revealed that older age (60+, p=0.008), Caucasian race (p=0.04), and reported greater knowledge of community and supportive services (p=0.049) was significantly associated with increased readiness to engage in an EOL discussion. Additionally, a higher score on the Advance Care Planning Engagement Survey was significantly associated with increased readiness (p&lt;0.001). Findings reveal patient groups that might be more appropriate targets for interventions, education, and resources and highlight the role of interprofessionals in outpatient health settings to “prime the pump” for these types of conversations.
USING LONGITUDINAL HEALTH INFORMATION TO ENHANCE MORTALITY PREDICTION
Authors: Beckett Megan K , Elliott Marc N , Ritenour Doug , Giordano Laura A , Saliba Debra 
Published: November 2019

Abstract
The Vulnerable Elders Survey-13-Health Outcomes Survey (VES-13-HOS) 2.5 is a simple, validated method to predict two-year mortality using older adults’ responses to the Medicare HOS. We explore whether adding longitudinal function measures and expanded sociodemographic information significantly improves the performance of the VES-13-HOS 2.5. Using Medicare HOS data, we developed risk scores that used coefficients from three logistic regressions predicting two-year mortality (2013-2015): (1) standard 0-10 VES-HOS 2.5 inputs at 2013 (function and limited demographics), (2) expanded demographics at 2013 (adding gender, fine-grained age, race/ethnicity, marital status, missing income indicator, and Medicaid status), (3) expanded demographics at 2013 plus change in pre-baseline (2011) health score two years prior. Fine-grained age and sociodemographic information slightly improve VES mortality prediction. Holding the 2013 VES-HOS 2.5 0-18 enhanced-demographic risk score constant, seniors with worse 2011 than 2013 functioning had higher two-year mortality than seniors with better 2011 functioning. Adding this prior health status further improved model performance slightly- 80% of mortality prediction is explained by “current” health and function and 20% by status two years earlier; such weighted scoring could be employed. We find that prior health status measurements do not generally indicate a trajectory that is likely to continue. Rather, health and function information from two years prior reduces measurement error via a second assessment of health; those with much worse health and function two years earlier are at slightly higher mortality risk. The VES-HOS can be used to identify patients with high mortality risk and to guide their care.
EXPANDING THE NETWORK: NONTRADITIONAL ANIMAL MODELS IN GEROSCIENCE
Authors: Cohen Alan A 
Published: November 2019

Abstract
Important insights into the biology of aging are coming from research on animals that have not been traditional staples of geroscience research. This symposium will highlight cutting-edge approaches to understand aging biology in the African killifish, exceptionally long-lived mammals such as the Naked Mole Rat, and across primate species, including the short-lived Marmoset.
CAPTURING REAL-WORLD LOSSES OF BALANCE AND RECOVERY RESPONSES IN OLDER ADULTS AT RISK FOR FALLS
Authors: Alexander Neil , Handelzalts-Pereg Shirley , Nyquist Linda , Strasburg Debbie , Mastruserio Nicholas , Ojeda Lauro 
Published: November 2019

Abstract
Losses of balance (LOBs) such as trips can lead to falls in older adults; what actually happens during real-world LOBs is unclear. With 4 wearable inertial measurement units (IMUs), we recorded feet, trunk and wrist movements over 2 weeks. Using a wrist voice recorder to report the LOBs, we applied our IMU processing algorithms and reconstructed the full body LOB and recovery motions. We recruited 7 at-risk older adults (M=76 yrs) who reported 114 LOBs of which we reconstructed over 90%. Using a rating system, 52% of the LOBs involved a significant trip, stumble, recovery step, and/or large trunk motion. 25% involved double or stutter steps and smaller trunk motions. The other 23% had less striking associated motions. These data suggest that most, but not all, self-reported real world LOBs involve substantial postural destabilization and near falls. Analyses of the voice-recorded context under which the LOBs occurred are ongoing.
VALIDATION OF A WALKING SPEED MEASUREMENT DEVICE: GAITBOX
Authors: Jarvis Leighanne , Peterson Matthew J , Morey Miriam C , Caves Kevin 
Published: November 2019

Abstract
The NIH 4m Walk Test is a clinically validated tool to measure adult walking speed. Human reaction limitations can contribute to measurement error when manually timing gait speed. This is important considering a 0.10m/s decrease in walking speed is associated with a 12% decrease in life expectancy for older adults. The goal of this study was to validate a low cost, custom built device, Gait Box (GB), compared to human timer (HT) and a research grade Sprint Timing System (STS) with an older adult (mean 72.4 + 7.4 years of age) population (N = 35). Validity was assessed via accuracy (correlations), precision (mean differences), and bias (Bland-Altman plots). Results showed strong correlations between the GB and HT (0.99) and the GB and STS (0.98), with negligible mean differences. This demonstrates the GB can be used to accurately and precisely measure gait speed in clinical and research settings.
FEASIBILITY OF VIRTUAL REALITY TREADMILL TRAINING IN OLDER ADULTS WITH MOBILITY AND FITNESS DEFICITS
Authors: Castle Steven , Lee Cathy C , Blanchard Erin H , Roberts Christian K , Jones Malcolm J , Schroeder E T 
Published: November 2019

Abstract
Only 23.6% of adults and &lt;10% of adults age &gt;75 years meet physical activity (PA) guidelines (aerobic & muscle-strengthening). Health benefit gym memberships has not improved participation. Therefore, Blue Goji developed a Virtual Reality (VR) treadmill to improve PA through fitness gamification with cognitive involvement in postural control to improve balance. Feasibility testing was done with seven older Veterans and one spouse, mean age of 81.3 years who participate in the VA Gerofit program & were near the 50th percentile (by age & gender) in strength, balance and endurance. Even those with lower levels of fitness, balance or chronic conditions (i.e., kyphosis or vision impairment) strongly supported this for enjoyment, benefit, comfort, safety and strongly recommended this (mean of 4.65 out of 5). The Gamification approach supports anti-ageism and intergenerational fitness activities. Further study on the additive effect on exercise intensity and improvement in fitness, balance and cognition is needed.
VALIDITY AND RELIABILITY OF REMOTE, SMARTPHONE-BASED ASSESSMENT OF DUAL-TASK STANDING AND WALKING IN OLDER ADULTS
Authors: Manor Brad , Yu Wanting , Lo On-Ye , Zhu Hao , Travison Thomas G , Lipsitz Lewis , Zhou Junhong 
Published: November 2019

Abstract
Dual task walking assessments provide valuable insights into cognitive-motor function in aging. To date, such assessments have been limited primarily to laboratory-based settings. We thus created a smartphone App utilizing multi-media instructions and the phone’s motion sensors to record movements during normal and dual task walking, with the phone placed in the user’s pants pocket. Thirty younger and older adults completed two lab visits, during which walking data were simultaneously acquired by the App and the GAITRite mat. Participants also completed App-based assessments in their homes on three separate days. Across all detected strides in laboratory trials, gait metrics derived from the App correlated closely with those derived from the GAITRite mat (r2&gt;0.96). Across trials, gait metrics demonstrated excellent test-retest reliability, both within and between laboratory visits and home-based assessments (ICC: 0.79–0.90). Remote, smartphone-based dual task walking assessments may therefore be feasible for relatively healthy younger and older adults.
HARNESSING THE POWER OF PROFESSIONAL NETWORKS: IDENTIFYING FACILITATORS AND BARRIERS TO CAREERS IN GEROPSYCHOLOGY
Authors: Allen Rebecca S , Carpenter Brian 
Published: November 2019

Abstract
This symposium presents data from a mixed method study designed to explore how to harness the power of professional networks to increase the pipeline of trainees pursuing careers in academic and clinical geropsychology. Participants were recruited through professional websites, listserves, announcements at annual meetings, and emails from directors of clinical training at pre-and post-doctoral training sites. A total of 107 geropsychologists completed the survey, including 28 graduate students/interns and 76 post-doctoral psychologists ranging from early to late career. The mean age of respondents was 39.18 (SD = 12.05). The sample was largely female (71.7%) and Caucasian (88.7%), paralleling previous work. The first paper describes attractive and unattractive aspects of clinical and academic career options, including gender differences in perceptions of the feasibility of changing career foci. The second paper examines perceptions of clinically-focused and academic jobs, and discrepancies between professional psychologists’ actual and ideal job activities. Examining content analysis of 28 qualitative transcripts, the third paper focuses on VA training and the convenience and comfort of transitioning into a VA job after training within this system, identifying benefits and challenges of work in the VA. The fourth explores these 28 transcripts to identify perceptions of mentorship and supervision during training, including time spent in the training sites (graduate school vs internship) and observations of how working environments impact future career choices. Discussion will address the critical shortage of geropsychologists in academic and clinical settings and strategies to improve the professional pipeline to increase the numbers of trainees pursuing these careers.
REFLECTIONS ON VA TRAINING AND EMPLOYMENT FROM INTERVIEWS ON CAREER PATHS IN GEROPSYCHOLOGY
Authors: Shumaker Elizabeth M , Jacobs M Lindsey , Strong Jessica V , Allen Rebecca S 
Published: November 2019

Abstract
The U.S. Department of Veterans Affairs (VA) is one of the largest trainers and employers of psychologists in the world and many clinical geropsychologists have worked for the VA for some portion if not all of their careers. The current qualitative analysis was conducted on phone interviews with 28 psychologists and psychology trainees regarding careers in geropsychology that focused on participants’ reflections on factors that influenced their career paths. This presentation will summarize subthemes from the many participant responses that included statements about the VA. Examples include discussion of the convenience and comfort of transitioning to a VA job after training within this system as well as reflections about the timing of professional development conversations with supervisors and mentors on VA internships and fellowships given the proximity to entering the workforce. Identified benefits and challenges of work in the VA will also be discussed (e.g., varied roles and responsibilities).
NIA HEALTH DISPARITIES RESEARCH NETWORK: APPROACHES AND FINDINGS FROM GERIATRICS AND CLINICAL GERONTOLOGY
Authors: Joseph Lyndon , Hill CarlV 
Published: November 2019

Abstract
Health disparities are differences in the incidence, prevalence and burden of diseases, mortality rates and causes of death that exist among population groups. Health disparities are associated with a broad, complex, and interrelated array of factors that influence health, accelerate aging and reduce life expectancy. NIA’s health disparities research goals are to understand environmental and sociocultural factors and related behavioral and biological mechanisms that diminish health and reduce life expectancy for vulnerable populations, explore the biological mechanisms through which disparities influence age-related change, and identify where disparities emerge in diagnosis, prognosis or treatment in geriatric conditions. Presentations will focus on whether structural-level discrimination may be a key factor in potentiating well known race-related health disparities especially those with an accelerated onset and may be associated with MRI-indicators of subclinical brain pathology; identifying biomarkers for early detection of cognitive and functional decline in high risk subpopulations and how ethnicity influences cerebral spinal fluid and imaging biomarkers link to early identification of cognitive and functional impairment ; effects of medication management and deprescribing among African American and Hispanic older adults with Alzheimer’s disease and related dementias and multiple chronic conditions; examine the use of multi-level factors and technology to overcome the barriers to urban-rural health disparities in managing many chronic diseases such as hepatitis C virus infection and delivery of appropriate medical services; and understanding the racial and ethnic differences in the link between environmental exposures and auto-immune comorbid asthma.
ASTHMA IN OLDER ADULTS: IDENTIFYING PHENOTYPES AND FACTORS IMPACTING OUTCOMES
Authors: Folz Rodney 
Published: November 2019

Abstract
Asthma, of all chronic diseases, has the highest disease burden attributed to environmental exposures. Few studies have attempted to characterize the prevalence of co-existing auto-inflammatory disease and asthma, or to link environmental exposure as a factor that may increase asthmatic lung obstruction and racial disparity with auto-inflammatory comorbidity. While there is an increased risk for asthma development and severity linked to certain autoimmune diseases, there is a known racial disparity in the prevalence of these autoimmune diseases. Racial and ethnic differences in the link between environmental exposures and auto-immune comorbid asthma as a potential common trigger of inflammation is not well understood. This talk will focus on developing a model to longitudinally predict asthma control and quality of life associated with home environmental triggers and volatile organic chemical (VOC) exposure in older adults and investigate the direct and indirect effect of autoimmune disease in racial disparities of the longitudinal relationships of home environmental asthma triggers on airway obstruction and functional status in older adults with asthma.
UTILITY OF EXECUTIVE FUNCTION TO IDENTIFY EARLY COGNITIVE IMPAIRMENT IN AFRICAN AMERICANS
Authors: Garrett Stephanie , Goldstein Felicia C , Chen Yunyun , Easley Kirk , McDaniel Darius , Lea Janice , Thomas Tiffany , Saleh Sabria , Hajjar Ihab 
Published: November 2019

Abstract
Within diverse cohorts, African Americans (AA) demonstrate higher rates of Alzheimer’s dementia (AD) and Alzheimer’s dementia combined with multiple comorbid conditions. AA are also two times more likely to develop late-onset AD than whites and less likely to be diagnosed. Yet, our understanding of this disparity in cognition remains limited. Cognitive impairment (CI) and dementia are both underdiagnosed and underreported in primary care patients. The lack of early detection of cognitive and functional decline in high risk populations results in failure to provide care and interventions to members of vulnerable groups. This talk will focus on research that seeks to identify a more sensitive cognitive marker for early identification of cognitive impairment for AA and advances this objective by linking the cognitive marker to AD cerebral spinal fluid biomarkers (Aβ1-42, p-tau) and testing whether this association differs between AA and whites.
OLDER ADULTS’ SOCIAL RELATIONSHIPS AND WELL-BEING IN A DIGITAL WORLD
Authors: Mejia Shannon T , Czaja Sara J 
Published: November 2019

Abstract
As adults age into a digitally connected world, communication technologies such as the internet, email, social media, and video chats offer new opportunities to connect with others. The implications of older adults’ use of technology in the context of their social relationships—such as the implications for social integration, the relational circumstances of technology adoption, implications for daily experiences of well-being, and opportunities to form new relationships—are less understood. This symposium brings together diverse and complementary perspectives on the contribution of technology to older adults’ social experiences. We begin with inquiry into implications of internet use for social integration. Hees and colleagues use data from the German Ageing Survey to examine how internet use is associated with change in loneliness over a three-year period in older adults who are either before or after retirement. Our symposium continues with papers on technology use within the context of older adults’ existing close relationships. Chopik examines individual and dyadic predictors of technology adoption. Mejía and colleagues consider the implications for digital social interactions for older adult’s well-being on that day. Our final paper discusses the potential for technology to aid in the development of new relationships. Rogers and colleagues describe findings from their OneClick.chat project, a web-based video chat application that connects older adults based on their shared interests. Our session concludes with a discussion led by Czaja, who will integrate the four papers and discuss the challenges and opportunities of using technology to support older adults’ social relationships and well-being.
WHAT’S OLD IS NEW: USING ARTIFICIAL INTELLIGENCE TO ACCELERATE DISCOVERY OF NEW TREATMENTS
Authors: Marras Connie , Maclagan Laura C , Cheng Yi , Visanji Naomi , Tadrous Mina , Bronskill Susan E 
Published: November 2019

Abstract
Given the high cost of drug development and low success rates, repurposing drugs already proven safe provides a promising avenue for identifying effective therapies with additional indications. The IBM Watson artificial intelligence system was used to search 1.3 million Medline abstracts to prioritize medications that may be potentially disease-modifying in Parkinson’s disease. We assessed patterns of use of the top 50 Watson-ranked drugs among 14,866 adults with Parkinson’s disease aged 70 and older who were matched to persons without Parkinson’s disease on age, sex, and comorbidity. Sociodemographic characteristics, chronic conditions, and use of other medications were compared using standardized differences. Patterns of potentially disease-modifying drug use were examined prior to and following ascertainment of Parkinson’s disease. Preliminary findings from multivariable conditional logistic regression models on the association between previous exposure to potentially disease-modifying drugs and Parkinson’s disease diagnosis will be presented.
DEFINING THE RELATIONSHIP BETWEEN ACTIVE CITIZENSHIP AND HEALTHY RURAL AGING: A CRITICAL APPROACH
Authors: Winterton Rachel 
Published: November 2019

Abstract
Active citizenship is romanticized in policy for its role in keeping older adults healthy, and rural communities sustainable. However, as proportions of older adults resident in rural communities continue to increase, the gerontological literature has begun to highlight challenges associated with both the capacity and desire of rural older adults to be active citizens. Through an integrative review of the international literature, this paper interrogates how active citizenship trends among rural older adults support or hinder healthy aging in rural settings. Findings indicate that active citizenship among older adults can increase rural age-friendliness and facilitate individual wellbeing. However, practices associated with active citizenship among this cohort can disenfranchise certain groups of older adults, through reshaping societal norms relating to citizenship, age-friendliness and rurality. These findings indicate that programs designed to promote active citizenship must both consider, and account for, diverse capacities and desires for active citizenship among rural older adults.