bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between Activity Participation and Cognitive Functioning
Authors: Jeon Sangha , Charles Susan 
Published: December 2020

Abstract
Researchers are growing increasingly interested in how the diversity of daily activities are related to well-being. The current study examined how both frequency and diversity in daily activities are associated with cognitive functioning. Participants from the third wave (2013-2016) of the Midlife Development in the U.S (MIDUS) survey (N=1281) completed both a telephone-based cognitive assessment and a mailed survey asking about participation in three different types of activities: cognitive (e.g., doing word games, attending educational lectures or courses), physical (e.g,. exercise, home chores), and social (volunteer work, attending sports or social groups). Frequency of activity participation was assessed with items asking how often they engaged in these activities, and diversity of activity participation was calculated by summing the number of activities they reported doing in each category. All analyses included sociodemographic variables, health status, and openness to experience as covariates. Findings from multiple regression indicated that greater frequency in all activities (cognitive, physical, and social) was related to higher levels of cognitive functioning. Greater diversity of social activity was also related to higher cognitive functioning. Education mediated the association between diversity in cognitive activities and cognitive functioning, suggesting that the link between higher levels of cognitive functioning and education may be partly attributed to people with higher levels of education engaging in greater diversity of cognitive activity.
Daily Association Between Sleep and Stressors: Role of Personality Traits
Authors: Venetto Angelina , Vigoureux Taylor , Lee Soomi 
Published: December 2020

Abstract
Poor sleep is associated with more stress across adult populations. The sleep—stress relationship is particularly important in nurses who are vulnerable to daily work-related stressors and poor sleep. Nurses with certain personality traits may be more vulnerable, however, the role that personality plays in the sleep-stress relationship has not previously been examined with lack of research in nurses. We examined how personality moderated the association between sleep characteristics and the perception of daily stressors in nurses. Participants were 61 oncology nurses who responded to a background survey that included a personality measure and completed 14 days of ecological momentary assessments. Each morning, participants reported sleep characteristics (i.e., perceived sleep sufficiency, sleep duration). Three times daily, participants reported their stressor experiences. We used multilevel models adjusting for sociodemographic characteristics, work shift, and work day. Results showed that on average across 2 weeks, participants with higher sleep sufficiency (β=-21.06, p&lt;.05) and longer sleep duration (β=-11.80, p&lt;.05) reported lower stressor severity. Agreeableness moderated the sleep duration—stressor severity association (β=25.07, p&lt;.01), such that longer sleep duration was associated with lower stressor severity for participants with lower agreeableness (β =-17.39, p&lt;.01), but not those with higher agreeableness (β=5.66, p&gt;.05). These findings indicate that the protective nature of longer sleep duration on stressful experiences may not occur in nurses high in agreeableness. Nurses high in agreeableness may take on more responsibilities, exposing themselves to more daily stress. Thus, nurses who are high in agreeableness may be a good target population for stress-reduction interventions.
Overlap of Pain and Depression Among Nursing Home Residents With Advanced Alzheimer’s Disease and Related Dementia
Authors: Belanger Emmanuelle , Jones Richard , Epstein-Lubow Gary , Lapane Kate 
Published: December 2020

Abstract
Physical and psychological suffering are interrelated and should be assessed together as part of palliative care delivery. We aimed to describe the overlap of pain and depressive symptoms among long-stay nursing home (NH) residents with advanced Alzheimer’s disease and related dementia (ADRD), and to determine the incidence of pain and depressive symptoms. We conducted a retrospective study of a US national sample of fee-for-Service Medicare beneficiaries who became long-stay NH residents in 2014-2015, had two consecutive quarterly Minimum Dataset assessments (90 and 180 days +/- 30 days), and had a diagnosis of ADRD in the Chronic Condition Warehouse and moderate to severe cognitive impairment (N= 92,682). We used descriptive statistics and Poisson regression models to examine the incidence of each symptom controlling for age, sex, and concurrent hospice care. Sub-groups with self-reported and observer-rated symptoms (pain/PHQ-9) were modelled separately, as were those switching between the two. The prevalence of depressive symptoms was low (5.7%), while pain was more common (18.2%). Across various subgroups, 2% to 4% had both pain and depression, but between 20% and 25% were treated with both antidepressants and scheduled analgesia. Depressed residents at baseline had an incidence rate ratio (IRR) of pain of 1.2 at the second assessment, while the residents with pain at baseline had an IRR of depressive symptoms of 1.3 at the second assessment. Our results support the expected relationship between pain and depressive symptoms in a national sample of long-stay NH residents with advanced ADRD, suggesting the need for simultaneous clinical management.
Multidimensional Sleep Health and Physical Functioning in Older Adults
Authors: Tighe Caitlan , Brindle Ryan , Stahl Sarah , Wallace Meredith , Bramoweth Adam , Forman Daniel , Buysse Daniel 
Published: December 2020

Abstract
Prior studies link specific sleep parameters to physical functioning in older adults. Recent work suggests the utility of examining sleep health from a multidimensional perspective, enabling consideration of an individual’s experience across multiple different sleep parameters (e.g., quality, duration, timing). We examined the associations of multidimensional sleep health with objective, performance-based measures of physical functioning in older adults. We conducted a secondary analysis of 158 adults (Mage=71.8 years; 51.9% female) who participated in the Midlife in the United States (MIDUS) 2 and MIDUS Refresher studies. We used data from daily diaries, wrist actigraphy, and self-report measures to derive a composite multidimensional sleep health score ranging from 0-6, with higher scores indicating better sleep health. Physical function was assessed using gait speed during a 50-foot timed walk, lower extremity strength as measured by a chair stand test, and grip strength assessed with dynamometers. We used hierarchical regression to examine the associations between sleep health and gait speed, lower extremity strength, and grip strength. Age, sex, race, education, depression symptoms, medical comorbidity, and body mass index were covariates in each model. In adjusted analyses, better multidimensional sleep health was significantly associated with faster gait speed (B=.03, p=.01). Multidimensional sleep health was not significantly associated with lower limb strength (B=-.12, p=.89) or grip strength (B=.45, p=.40). Gait speed is a key indicator of functional capacity as well as morbidity and mortality in older adults. Multidimensional sleep health may be a therapeutic target for improving physical functioning and health in older adults.
Relationships Among Types of Activity Engagement and Sleep Quality Among Older Adults
Authors: Kim Da Eun , Roberts Tonya 
Published: December 2020

Abstract
There is increasing awareness that lack of activity engagement is associated with poor sleep quality. However, the majority of studies have focused on the effect of a single type of activity engagement on sleep quality. Little is known about the combined effect of multiple types of activity engagement on sleep quality. The aim of this study is to identify relationships among different types of activity engagement and sleep quality among older adults. This study is a secondary data analysis using the Health and Retirement Study data. The participants included 3,357 persons who were age 65 or older and who responded to survey modules on activity engagement and sleep quality in 2016. Before we conducted primary analysis, factor analyses and calculating coefficient omega were conducted to identify factor structure, construct validity and reliability of the activity engagement questionnaire. Then, regression was conducted to examine the relationships among multiple types of activity engagement and sleep quality after adjusting for covariates based on the senescent sleep model. Exploratory and confirmatory factor analysis showed the 14-item questionnaire was comprised of three factors; social, cognitive, and physical activity and the three-factor model showed adequate validity and reliability. In the regression model social (β=0.25, p=0.033) and cognitive (β=0.36, p=0.001) activity engagement were positively related to better sleep quality. Based on these results, future research is needed to identify the mechanisms in which social and cognitive activities influence sleep quality positively and to develop targeted activity interventions for older adults.
Medication Management Among Older Adults With Multiple Chronic Conditions: What Role Do Caregivers Play?
Authors: O’Conor Rachel , Eifler Morgan , Russell Andrea , Opsasnick Lauren , Benavente Julia Yoshino , Curtis Laura , Wolf Michael 
Published: December 2020

Abstract
Many older adults manage multiple chronic conditions (MCC) that require adherence to complex medication regimens. Few studies have investigated the degree to which caregivers support medication-related behaviors. We conducted semi-structured qualitative interviews with 25 caregivers of older adults with MCC to characterize caregiver medication assistance. Two coders used content and constant comparative analysis to analyze transcripts. The mean age of caregivers was 61 years; the majority were female (68%) and identified as non-white (Black, 52%; Hispanic, 8%). Caregivers were predominantly spouses (n=10), or children (n=11). Older adults were on average 73 years old, managing 5 chronic conditions and prescribed 7 medications. Caregivers acknowledged the importance of medications to the older adult’s health, but their involvement in daily medication management was limited. Some caregivers preferred that the older adult continue these tasks to maintain autonomy, especially when caring for older adults who valued maintaining independence. Caregivers assumed medication responsibilities after older adults experienced sudden changes in health or upon observing non-adherence (e.g. full pill bottles). Older adults with higher medication burden (12+ medicines) adopted inefficient, cumbersome medication management practices; caregivers suggested simplified strategies, but the older adults refused to adopt recommended strategies. To combat resistance from the older adult, caregivers disguised assistance and deployed workaround strategies to monitor medication-taking behaviors. These findings suggest older adults and caregivers share a value of promoting independence of medication management, up until safety is seriously questioned. Additionally, there is a breakdown in communication at the time when older adults may benefit from increased caregiver involvement.
Pain Acceptance Predicts Expansive Outlooks on the Future in Older Chronic Pain Patients
Authors: Fennell Gillian , Yip Abby Pui Wang , Reid M Cary , Enguidanos Susan , Zelinski Elizabeth , Loeckenhoff Corinna 
Published: December 2020

Abstract
As chronic conditions continue to rise in the US, associated pain symptoms are rising as well, affecting 65% of those 65 and older. In an attempt to help patients lessen the burdensome physical/psychological effects of chronic pain, researchers have investigated the effectiveness of therapeutic interventions with pain acceptance-based models yielding the most promising effect sizes. However, these interventions do not explicitly account for how patients perceive their future. Qualitative work has shown that chronic pain patients with positive and expansive views of their futures report fewer pain-related anxiety and depression symptoms, and are more likely to engage in long-term (and often more effective) treatment regiments. This study aims to investigate whether pain acceptance scores predict future time perspective to enhance treatment effects of chronic pain interventions. Multivariate linear regression analyses were conducted with a sample of 148 non-cancer patients age 45 and older with chronic pain, i.e. pain lasting three or more months. Pain duration, neuroticism, sex, race, income, and age were included in the model to explore potential mediating or moderating effects. A significant positive association was found between pain acceptance and future time perspective (r=.42, p&lt;.001, r2=.17). Additionally, with the inclusion of all covariates, our model significantly explained 24.1% of the variance in future time perspective in the sample, F(7,132)=5.99, p&lt;.001. With an established association between these two psychological constructs, strategies to bolster future time perspective can easily be integrated into pain acceptance interventions for older chronic pain patients, hopefully pushing effect sizes past the ‘moderate’ level.
Emergent Business Models for Homecare in England
Authors: Zimpel-Leal Karla 
Published: December 2020

Abstract
The purpose of this study is to examine how emergent homecare business models are shaping the care market in England. Homecare providers for older people are facing a rise in demand for their services which is driven not only by an ageing population but also from a market demand for personalised care, choice, continuity of care, and real time availability. Combined with a turbulent political and policy environment, the current care landscape presented an opportunity for innovative and emergent homecare models to establish themselves and in some occasions disrupt the market by offering a more inducing service design and value propositions that better match customers’ needs. Utilizing the Business Model Canvas, this study investigated various emergent models of homecare by using semi-ethnographic methods that included field observation and data collection, a narrative summary review and interviews. It has shown that homecare providers for an ageing customer base are becoming increasingly aware of emerging customer needs and expectations. Disruptive and emergent models such as uberisation, community-based, live-in and preventative models are becoming more pervasive in the current landscape. These models offer major shifts related to their value proposition, partnerships and customer segments. The value propositions are focused on several dimensions of wellbeing outcomes, choice and personalisation, whilst their care workforce is perceived as a major customer segments and their network of partners provides access to complementary services, investments and specialist knowledge. These changes are promoting more flexibility and responsiveness in the care market, enhancing service users’ experience and encouraging workforce development.
Investigating the Factors That Influence Self-Efficacy Among Home Care Workers Providing Dementia Care
Authors: Savundranayagam Marie , Ahmad Anaya , Basque Shalane 
Published: December 2020

Abstract
The self-efficacy beliefs of home care personal support workers (PSWs) play a crucial role in their professional competence and subsequent provision of quality care. Understanding the factors that influence self-efficacy of PSWs is critical to ensuring their job satisfaction and retention, and ultimately improving the quality of care provided to home care clients. Currently, there is a lack of literature exploring the factors influencing self-efficacy among home care PSWs who care for clients with dementia. Accordingly, the purpose of this study was to investigate the sources of self-efficacy for home care PSWs. Conventional content analysis of interviews with 15 home care PSWs yielded six categories of sources influencing self-efficacy: insufficient client information provided by employers, lack of supportive communication by employers, restriction of PSWs’ discretion and autonomy by employers, insufficient practical dementia-specific training, sufficient work experience with clients with dementia, and feedback from family caregivers. These findings call for a multi-pronged approach to enhance the self-efficacy of PSWs. In particular, these findings offer specific areas of improvement for employers on how to best support their PSWs. They also highlight the significant role of dementia-specific education and training for PSWs regardless of their experience in the field. Finally, the findings emphasize the importance of family caregivers in the home care context. Taken together, the study’s findings offer insights on how to best support PSWs and ensure stability in the dementia care workforce.
Low-Income Cooperative Living Environments: An Analysis of Universal Design Features That Support Aging in Place
Authors: Kaup Migette , Richardson Hannah , Adkins Mikayla , LaFleur Brett , Tucker Sydney , Tines Lauren 
Published: December 2020

Abstract
Affordable housing for low-income older adults is in significant demand in the United States. Housing options available, however may not recognize how design can support social infrastructure in addition to basic physical accessibility. The aim of this research was to provide an analysis of the efficacy of the planning and design principles applied to a recently constructed cooperative living home. The goal was assess the universal design (UD) of features that supported aging in place, and, to inform the planning of future projects for the community. A post-occupancy evaluation process was conducted at the home, and all five residents consented to structured focus group discussions as well as individual interviews regarding their specific experiences living in the home. An environmental assessment was completed through detailed field notes, measurements, and photo documentation. An analysis of specific features of each room of the home was then assessed by the seven UD principles. Results revealed the specific features of each space that contributed to the completion (or the limitations) of basic activities of daily living as well as instrumental activities of daily living. These assessments were validated through feedback provided by the users. Many features of the home were found to be positive and supportive of equitable use by all residents. Other design attributes that could be improved were related to size and space for approach and use, and providing flexibility in use. Specific design changes based on resident input, such as kitchen function, storage safety, and lighting details, are highlighted and discussed.
Safety or Autonomy in Dementia Care at Home, a Qualitative Study on Family Caregivers’ Experiences
Authors: Moermans Vincent , Bleijlevens Michel , Verbeek Hilde , Milisen Koen , de Casterlé Bernadette Dierckx , Hamers Jan 
Published: December 2020

Abstract
Persons with Dementia (PwD) living in their own home become increasingly dependent on support from especially family caregivers who often are confronted with dilemmas. Family caregivers feel responsible for PwD and predominantly want to ensure their safety, whereas PwD wants to engage in meaningful activity and make decisions autonomously. This study aims to identify how family caregivers caring for PwD at home deal with these dilemmas. Using a grounded theory approach, this study conducted in-depth interviews with 8 family caregivers. Results show that dealing with the dilemma of safety versus autonomy is considered as a calculated risk. By timely entering into dialogue with their loved one, family caregivers try to create a safe environment taking into account the needs and preferences of PwD. However, when situations evolve to such an extent that family caregivers think unsafety will occur, they take over control and overrule the autonomy of the PwD. This often results in resistance to care in PwD. Dealing with the dilemma is a continuous and exhausting learning process due to the ever-changing behaviour of PwD. Family caregivers said that they are in need of support of professional caregivers, but that this need is met insufficiently. As a result, family caregivers have to rely mostly on their own intuition and earlier experiences. The conclusion is that family caregivers experience serious dilemmas in the care of PwD living at home. Professional support in making adequate decisions related to safety and autonomy is warranted.
Adult Age Differences in Coping Strategies After the 2016 Flood
Authors: Cherry Katie E , Calamia Matthew , Elliott Emily M , Nguyen Quyen P 
Published: December 2020

Abstract
The 2005 Hurricanes Katrina and Rita had a devastating impact on south Louisiana, as did the more recent flooding in 2016. Multiple disaster exposures are associated with distress which may be lessened through adaptive coping behaviors, although prior disaster losses may affect current coping responses. In this study, we assessed self-reported coping strategies, resilience, and mental health outcomes after the 2016 flood. The sample was comprised of mostly middle-aged and older adults (N = 223, age range: 18-89 years). Three groups were compared: (1) non-flooded adults as controls, (2) once-flooded adults with structural damage to homes and property in 2016, and (3) twice-flooded adults who had relocated to Baton Rouge because of catastrophic losses in Hurricanes Katrina and Rita and they experienced damage in the 2016 flood. Analyses of variance confirmed that the three groups differed in coping responses, with non-flooded controls using significantly fewer strategies than their once and twice flooded counterparts. Correlation analyses demonstrated that age was positively associated with adaptive forms of coping (acceptance, religiosity) and negatively correlated with maladaptive coping (self-blame). These data suggest that awareness of prior severe weather experiences and catastrophic losses, which are likely for older adults living in hurricane prone areas, are an important consideration for disaster planning and the development of age-sensitive interventions to mitigate adversity.