bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE IMPACT OF SOCIOECONOMIC STATUS ON AGE TRAJECTORY OF BODY MASS INDEX AMONG MIDDLE-AGED AND OLDER ADULTS
Authors: Lin Yu-Chun , Chang Yu-Hung 
Published: November 2019

Abstract
Body weight tends to decrease along with age. Weight loss and low body mass index (BMI) in the elderly, associated with socioeconomic status, are both strong predictors of subsequent mortality.This study aims to investigate the relation between income and BMI changes in later life. We used data from the Taiwan Longitudinal Study in Aging (TLSA) from 1999 to 2007. There were 5,131 participants aged 50 and over, who were excluded for those without primary study variables. Income was evaluated by asking the amount of annual income, including salary, pension, rent, interest, welfare benefit, etc. Participants’ BMI were assessed in each survey. General estimating equation models were performed to examine the association between age, annual income, and their interaction with BMI adjusting for covariates including sex, education, marital status, smoking, exercise frequency, appetite, and number of comorbidities. Totaling 11,350 person-times was in three follow-up surveys, which left 9,723 person-times of observations after exclusion. After adjusted for covariates, the low income group compared to the higher income, would have higher estimated BMI at age of 50 (BMI= 24.75 kg/m2 and 24.19 kg/m2 respectively), and more rapid reduction (-0.08 kg/m2 per year), while relatively stable BMI was found in higher income group (0.01 kg/m2 per year, slope difference= 0.10 kg/m2 per year, 95% confidence interval [CI] = 0.03-0.17). In conclusion, compared to invariable BMI observed among individuals with higher financial status, the economically disadvantaged experienced BMI decline with age among middle-aged and older adults.
LIFE HABITS AND LIPID PEROXIDATION OF WOMEN OVER 40 YEARS OLD
Authors: Oliveira Renata F , Mota Maria , Soares Jorge , Santos Zirlene , Rosa Bianca , Santana Caroline , Pessoa-Filho Dalton , Neiva Cassiano M 
Published: November 2019

Abstract
Oxidative stress is involved in degenerative processes, aging, and diseases. Lifestyle can be change oxidative stress. One of reactive oxygen species targets is polyunsaturated fatty acid, an important cellular membrane component. The aim of this study is to analyse the contribute of lifestyle in lipid peroxidation in over fourty years old women. Were included 60 women whith age ranged between 41 and 82 years old (53.3 ± 9.1 years). Lifestyle were explored doing a food frequency questionnaire, Perceptive Stress Scale (PSS) and International Physical Activity Questionnaire (IPAQ). The functional capacity was determinate by 6-min walking test (cardiorespiratory capacity) and Squat-jump (leg strength and power). Parameters of oxidative stress were determinate from plasma during fasting, lipid peroxidation was evaluated by TBARs, and antioxidant capacity was evaluated by catalase activity and ABTS. Spearman correlation and Multiple Linear Regression model, through Stepwise method, considering TBARs as dependent variable, and age, weight, body mass index, waist circumference, stress perception, physical activity level, total antioxidant capacity, catalase activity, cardiorespiratory capacity, leg strength and power, daily caloric intake, daily fruit, vegetables, coffee/tea, vitamin E and alcohol intake, as independent variable, was performed. Negative correlations were obtained between TBARs and cardiorespiratory capacity (r= -0.35; p=0.026) and between TBARS and ABTS (r= -0.33; p=0.038). Total antioxidant capacity was the model’s first variable (F= 5.50; p = 0.013), explaining 15.3% of TBARS, then cardiorespiratory capacity (F= 5.50; p = 0.047), explaining 10.5% of TBARs The results revealed total antioxidant capacity and cardiorespiratory capacity as predictors to lipid peroxidation damage.
USE OF COMPLEMENTARY THERAPIES BY SEXUAL MINORITY OLDER ADULTS: FINDINGS FROM THE NATIONAL HEALTH INTERVIEW SURVEY
Authors: Anderson Joel G , Flatt Jason D , Jabson Jennifer , Wharton Whitney 
Published: November 2019

Abstract
Sexual minority (lesbian, gay, bisexual; LGB) older adults age 50+ experience a higher prevalence of chronic disease and disability, as well as a poorer physical and mental health status. Many adults use complementary and integrative therapies, particularly mind-body therapies, as health-enhancing approaches and to support wellbeing. However, no study to date has examined the use of mind-body therapies among sexual minority older adults. We examined data from the 2017 National Health Interview Survey to determine the use of mind-body therapies by sexual minority older adults (aged 50+), as well as the influence of health and wellbeing characteristics on mind-body therapy use, compared with their non-LGB counterparts. Sexual minority older adults overall reported higher usage (36%) of mind-body therapies compared with their non-LGB counterparts (22%), with lesbians reporting the highest use (41%). Sexual minority identity was a significant predictor of mind-body therapy use, with LGB adults roughly two times more likely to use a mind-body therapy after controlling for chronic disease status and other wellbeing measures. Future research is needed to explore the reasons sexual minority older adults use complementary and integrative therapies, as well as potential development of mind-body interventions targeted toward this population to address stress and quality of life.
IMPLEMENTING THE AGE-FRIENDLY HEALTH SYSTEM INTO CVSMINUTE CLINICS
Authors: Dolansky Mary A , pohnert Anne 
Published: November 2019

Abstract
Each day, 10,000 individuals in the United States turn 65 and nearly 30% of our nation’s 884 million ambulatory care visits involve patients ages 65 and older. With this trend, the use of convenient care settings for treatment for chronic conditions associated with aging such as diabetes and hypertension is emerging. The need for the delivery of age-friendly care in convenient care settings is essential to ensure high quality and safe care. CVS MinuteClinic® and the Institute for Healthcare Improvement (IHI) will present the plan and preliminary findings for the extension of the IHI’s Age-Friendly Health Systems initiative into the CVS MinuteClinic. The Age-Friendly Health System model includes 4 M’s: What Matters, Medications, Mentation, and Mobility as essential components for care delivery. The presentation will include (1) the partnership with the IHI’s Age-Friendly Health System Action Community, (2) a demonstration of the Age-friendly Virtual Clinic and learning platform that includes training modules and practice-based tools to facilitate assessment and action steps for the implementation of the 4Ms based on Age-Friendly Health System content, and (3) the evaluation logic model that will be implemented. The implementation plan will provide the framework to embed age-friendly process and outcome measures into the CVS MinuteClinic electronic health record platform, Epic. The project will impact all 1,100 CVS MinuteClinic locations across the nation.
SIGNIFICANT PREDICTORS OF INTEREST IN GERIATRICS AMONG LOW, MIDDLE, AND HIGH INCOME COUNTRIES
Authors: Karikari Grace , Lohrmann David K , Huber Lesa L 
Published: November 2019

Abstract
Even though the demands for physicians with geriatric related specialties are higher than the available experts around the world, some countries and economies seem to be more impacted by the workforce shortage than others. This systematic review consolidated scientific evidence reporting the significant predictors of interest in pursuing a geriatric career among medical students’ in different countries. A 20-year (1998 – 2018) systematic literature review of high-quality primary research articles was conducted using PubMed, ERIC (EBSCO), Embase and Cochrane Library. Eleven articles (n =11) met the eligibility and quality assessment criteria. For analysis, studies were categorized into (i) low- and middle-income countries and (ii) high income countries, based on the WHO and the World Bank’s income grouping for the 2019 fiscal year. Medical students involved in this review were n = 1,683 representing students from different fields of medicine and year groups. The two most significant predictors of interest in geriatrics in the high-income countries were (1) positive attitudes towards the elderly and (ii) participation in a geriatric related intervention. Lack of published peer-reviewed articles from the low and middle-income countries limited the researchers’ ability to evaluate the similarities and differences between the two income groups. There is an overall need to stimulate interest in geriatric specialization among medical students. Leaders of the LMICs should invest in geriatric education and research in order to promote interest in the field, increase the geriatric workforce, and ultimately, improve the quality of life of the elderly in their respective countries
THE IMPACT OF AN INTERPROFESSIONAL SIMULATION ON TEAM COMMUNICATION AT THE END OF LIFE
Authors: Halli-Tierney Anne , Lippe Megan E , Stanley Alexandra , Ricamato Allison , McKinney Robert E 
Published: November 2019

Abstract
It is increasingly important that healthcare professionals understand how to care for patients at the end of life, especially as 75% of hospital deaths occur in the geriatric population. Many new healthcare profession graduates feel under-prepared to provide end-of-life care. Healthcare education programs must provide education on interprofessional communication and end-of-life care. This study explored the effects of an interprofessional end-of-life simulation on medical, social work, and nursing students’ communication skills. Across three simulation phases, teams were required to communicate with the patient (high-fidelity manikin), family members (scripted actors), and team members about treatment option, change in patient’s condition, and withdrawal of life-sustaining measures. A total of 16 teams participated in the simulation, with each team comprised of nursing students (n=7-8), social work students (n=1), and medical students or residents (n=1). Team communication skills were assessed using the Gap Kalamazoo Communication Skills Assessment Form. The average communication score for teams reflected fair to good communication (M=28.81, SD=5.55). The best communication domains were “Shares information” (n=8), “Communicates accurate information” (n=6), and “Builds a relationship” (n=5). The worst domains were “Demonstrates empathy” (n=7), “Provides closure” (n=6), and “Builds a relationship” (n=5). This simulation provides an interactive educational mechanism by which to educate interprofessional healthcare students on communication and care of patients at the end of life.
AGING IS VERY PERSONAL: INTERPROFESSIONAL GERONTOLOGY COURSE IMPROVING STUDENT ATTITUDES TOWARD OLDER ADULTS
Authors: Garbarino Jason T 
Published: November 2019

Abstract
Educational programs that foster the development of a robust healthcare workforce committed to the provision of exemplary care of older adults is vital. The Aging is Very Personal (AIVP) service learning gerontology course has demonstrated the ability to foster future student interest and improved attitudes towards working with older adults. The AIVP program provides mutual benefit for undergraduate students from a variety of health science majors and older adult resident volunteers at local senior living facilities. For students, AIVP serves as direct insight into the lived experience of aging among community older adults. Students are provided the opportunity to practice communication skills, relationship-building skills, and gain an understanding of the multitude of diverse needs within this population. Older adults who volunteer to participate in the activity are provided with the opportunity to speak to and actively engage with students and feel empowered by the opportunity to provide valuable life guidance. This presentation will provide a curricular overview of the steps required to construct, implement, and evaluate an interprofessional gerontology course. A review of student learning objectives, service-learning program construction, selected course topics, and student assignments will be presented. Attitudes and future interest in working with older adults measured in the initial interprofessional student cohort (n=106) will be presented. A pre-established, validated tool utilized to effectively measure student attitudes and interest pre/post-course participation will be reviewed.
HOME CARE NURSES CLAIM MEDICARE IGNORES SOCIAL DETERMINANTS OF HEALTH
Authors: Cabin William D 
Published: November 2019

Abstract
There is significant literature on the importance of addressing social determinants of health (SDOH) in order to improve health care outcomes. In response, the Centers for Medicare and Medicaid Services (CMS) has expanded Medicare Advantage plans ability to cover SDOH-related services. Medicare home health does not cover SDOH-related services. A literature review indicates no studies on the nature, significance, or impacts of the lack of SDOH coverage in Medicare home health. The current study is an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 37 home care nurses between January 2013 and May 2014 in the New York City metropolitan area. Results indicate nurses believe the lack of SDOH coverage in Medicare home health results in exacerbation of existing patient conditions; creation of new, additional patient conditions; increased home care readmissions and re-hospitalizations; increased caregiver burden; and exacerbation of patients’ mental health and substance abuse needs.
INS, OUTS, AND UNINTENDED CONSEQUENCES OF THE CMS NURSING HOME QUALITY MEASURES
Authors: Davila Heather , Shippee Tetyana P , Park Young Shin , Brauner Daniel , Konetzka R Tamara 
Published: November 2019

Abstract
Ongoing concerns about the quality of care provided to nursing home (NH) residents have led the federal government to develop quality measures (QMs) for NHs. Many of these QMs are included in the NH 5-star ratings and reported online via Nursing Home Compare. However, we know little about how NH providers view the QMs, challenges they experience in addressing the measures, and strategies they use to achieve better scores. As part of a broader mixed-methods study to understand how NHs are responding to the 5-star ratings, we conducted interviews with NH personnel (n=110) and observed organizational processes in 12 NHs in three states. We also interviewed policy and industry leaders (n=34) to gain their perspectives. Interviews focused on perceptions of the 5-star ratings, organizational strategies to improve 5-star scores, experiences with the survey/regulatory process, and perceptions and responses to individual QMs. Key themes show that a) NH providers view the QMs as important indicators of quality, but there is variability across indicators; b) providers face challenges related to measurement and definitions for certain QMs (e.g., pain, restraints); and c) there are potentially conflicting goals, where some QMs aim to promote safety at the expense of resident autonomy and quality of life and vice versa. This work provides organizational context to the 5-star measures and the balancing act providers engage in to assess and improve their scores. The findings also identify several potentially unintended consequences related to the QMs, which can adversely affect residents, particularly those with more complex care needs.
PERCEPTIONS OF LONG-TERM CARE RESIDENTS AND THEIR FAMILY MEMBERS ABOUT USING THE CONVERSATION STARTER KIT
Authors: Kaasalainen Sharon , Sussman Tamara 
Published: November 2019

Abstract
The need for a palliative approach in long term care (LTC) is widely recognized. However, advance care planning (ACP) is still rare. The purpose of this study was to explore the perceptions of LTC residents and their families about using an ACP tool called The Conversation Starter Kit (CSK). This study utilized a mixed methods approach. Data was collected in four LTC homes in Ontario, Canada from 31 residents and family members during an interview after they had completed the CSK. Data was analyzed using thematic analysis and descriptive statistics. All participants read all sections but only 73% completed all sections of the toolkit. Participants spent an average of 36 minutes discussing it with their family members and/or LTC staff. Participants reported: a better understanding of ACP after using the tool (80%), that the tool helped clarify the available resources and/or choices (53%), and that they felt less apprehensive about ACP after using the tool (60%). Qualitative findings revealed many strengths (e.g., usefulness, ability to start difficult conversations, content and clarification), and weaknesses of the tool (e.g., redundant information, difficulty understanding the content and lack of information regarding medically assisted dying). Family members noted that the toolkit would have been helpful to receive earlier on in their family members’ disease trajectory, perhaps before being admitted into LTC. These study findings support the CSK for residents and family members to have ACP discussions in LTC. Future work is needed to evaluate the effectiveness of the tool with a larger sample.
LGBTQ PROGRAMMING AT SENIOR CENTERS IN MASSACHUSETTS
Authors: Somerville Ceara , Collins Saralyn , Coyle Caitlin E 
Published: November 2019

Abstract
LGBTQ seniors have some different needs for programs and services, are at a higher risk of social isolation, and are often underserved in the community. Senior centers serve as a hub of resources in a community and are purposefully situated to address the needs and interests of all seniors in a community; they are a natural outlet for targeted programming for LGBTQ seniors. The purpose of this project is to demonstrate what municipal senior centers across Massachusetts are doing to meet the needs of their LGBTQ seniors. A total of 24 senior centers were identified by the Massachusetts Association of Councils on Aging (MCOA) as providing LGBTQ programming. Semi-structured interviews were conducted with 14 senior center directors or programming staff from different communities across Massachusetts to learn more about their specific programming. For almost all senior centers in this study, the main LGBTQ-specific programming was a congregate meal with an activity. Activities included both recreational activities like a film-screening and educational engagements such as guest speakers or specialists on housing, legal services, and health promotion. Distinguishing characteristics included whether or not programming had an intergenerational component, type of recruitment methods, and geographic clustering of programs. For example, two regions emerged as having shared activities for LGBTQ seniors. Results from this study will be used to illustrate models of best practice when it comes to LGBTQ programming for older people.
DISPARITIES IN ACCESSING DIFFERENT TYPES OF LONG-TERM CARE SERVICES IN TAIWAN
Authors: Chen Ya-Mei , Lin Shih-Chi , Yu Hsiao-Wei , Wu Shwu-Chong , Wu Shih-Cyuan , Wang Ying-Chieh , Chiang Tung-Liang 
Published: November 2019

Abstract
A growing body of evidence documents pervasive social and demographic factors relating to disparities in long-term care (LTC). In 2007, Taiwan implemented its Ten-year Long-Term Care Plan version 1.0 (TLTCP 1.0) that aimed to develop a home-and community-based (HCBS) LTC system. In 2016, Taiwan began to implement TLTCP 2.0. To continue providing effective LTC, this study aimed to assess the disparities in access to LTC services using Taiwan’s LTC claim database from 2010 to 2013. A total of 87,438 older adults who had applied for LTC services from the TLTCP 1.0 were included. The study assessed LTC disparities related to five sociodemographic factors, including age, gender, living status, urbanization, and income status. Sixteen types of LTC services, including HCBS, home-based professional care, meal services, transportation, and institutional services were assessed. After controlling for the level of disability, we found that those who were older-old (age 80&gt; over), male, and low-income were less likely to use HCBS, but more likely to use institutions services (p &lt; 0.001). We also found that those who lived in the city were more likely to use HCBS and transportation services (p &lt; 0.001). Yet, older adults living alone were more likely to use home care and meal services but not other types of LTC services (p &lt; 0.001). In conclusion, the social disparities in access to LTC services in Taiwan remains, suggesting LTC 2.0 should continue monitoring and placing the LTC equity issue on the top priority.
ADVANCE DIRECTIVES: STATE REQUIREMENTS, PRACTICES, AND PREVALENCE IN ADULT DAY SERVICES CENTERS
Authors: Lendon Jessica P , Caffrey Christine , Lau Denys 
Published: November 2019

Abstract
Advance directives (ADs) are documents that express a person’s healthcare preferences if he/she is unable to make decisions. Adult day service centers (ADSC) may serve as an entrée to advance care planning for many people. This study examined the relationships among: 1-state requirements on ADSCs to provide information on ADs; 2-ADSC’s awareness of their state requirement; 3-ADSC’s practice in providing AD information; and 4-the percentage of ADSC participants with an AD. From the 2016 National Study of Long-Term Care Providers, 3,300 ADSCs reported that they maintained documentation of ADs in participants’ files. Nine states required ADSCs to provide information on ADs; 22% of ADSCs were located in these states. About 24% of ADSCs did not know if their states had requirements; among the 76% of ADSCs that reported knowing, 62% were correct and 37% were incorrect. About 80% of ADSCs provided AD information to their participants, while 41% of ADSC participants had an AD on file. Regression models controlled for size, chain and profit statuses, Medicaid-licensing, medical or social care model, electronic health records use, and Census region. Having state requirements was not independently associated with ADSCs’ practice of providing AD information or with the percentage of participants with an AD. Instead, ADSCs that thought their state had a requirement had greater odds of providing information on ADs, regardless of state requirements. Similarly, ADSCs that thought their state had a requirement and that provided AD information had a higher percentage of participants with an AD, independent of state requirements.