bluuebunny/crossref_metadata_2025_split huggingface dataset:
Federal Advisory Councils Established to Assist Working Caregiving Families
Authors: Gibson Ethlyn McQueen 
Published: December 2020

Abstract
This presentation will describe the legislative charge of two advisory councils established in 2018 through the Recognize, Assist, Include, Support and Engage Family Caregivers Act and the Supporting Grandparents Raising Grandchildren Act to support working family caregivers. The advisory councils are charged with 1) providing recommendations on effective models of family caregiving 2) improving coordination across federal government programs; and 3) identifying, coordinating, and promoting information, resources, and 4) best practices for working grandparents raising grandchildren, while maintaining their own physical, mental, and emotional well-being. The experiences of working family caregivers will be the foundation for these recommendations that are being developed over the next two years to present to Congress. These recommendations will support the development and execution of a national family caregiving strategy.
Intersectionality and Cognitive Impairment Risk in Older Persons With HIV: Age, Ethnicity, and LGBT Status
Authors: Mindt Monica Rivera , Savin Micah , Summers Angela , Stiver Jordan , Slaughter Alex 
Published: December 2020

Abstract
The Latinx population is disproportionately affected by HIV-infection and older Latinx persons living with HIV (PLWH) are at greater risk for neurocognitive impairment (NCI). However, no studies have examined whether intersectionality (including Lesbian Gay Bisexual Transgender [LGBT] status) increases NCI risk. This study investigated whether LGBT status increases NCI risk in 126 PLWH (Ages 19-73 years; 74% Male; 66% Latinx, 34% NHW) who completed a comprehensive NC battery. Domain average T-scores were based on demographically-corrected norms. Multiple regressions revealed that after accounting for covariates (cocaine use, premorbid IQ) and other dimensions of intersectionality (age, ethnicity), LGBT status significantly contributed to NCI risk in attention/working memory (B=-4.50, p=.01) and executive functioning (trend-level; B=-3.67, p=.06). LGBT status, a key dimension of intersectionality, should be considered in NC assessment of PLWH. Future research is needed to identify factors (e.g., discrimination) that may confer increased NCI risk in this population.
Implementing Oregon’s New Quality Measurement Program for Assisted Living Communities
Authors: Carder Paula , McQueen Ann , Tunalilar Ozcan 
Published: December 2020

Abstract
Oregon legislation requires assisted living (AL) communities to report selected quality measures to the state licensing agency. The Quality Measurement Program (QMP) includes five metrics that assess different areas of resident safety and wellbeing: falls, antipsychotic medication use, staff training, staff retention, and resident satisfaction. This paper describes findings based on our 2019 survey of AL communities and offers suggestions for stakeholders interested in public reporting and quality metrics. Assisted living providers reported 28% of AL residents and 38% of memory care (MC) residents fell at least once in the prior 90 days, with 39% and 45% reporting an injury, respectively. Antipsychotic medication use was 20% among AL and 44% among MC residents. These findings and the survey methods used to collect them, combined with stakeholder and state agency staff participation, informed the current QMP approach. We describe how to collect meaningful quality metrics within the AL context.
Resident Quality of Life and Family Satisfaction: Developing Measures for Minnesota Assisted Living Report Card
Authors: Wheatley Muriel , Cooke Valerie , Shippee Tetyana 
Published: December 2020

Abstract
The 2019 Minnesota Legislature requested the Department of Human Services (DHS) and Minnesota Board on Aging to develop and administer a report card for assisted living (AL), including conducting annual resident and family surveys in Minnesota AL settings. This presentation includes the perspectives of representatives from MN DHS and Vital Research, as well as the University of Minnesota team who worked together to develop survey items, carry out the cognitive testing, and conduct analyses. Survey items were developed from published literature and existing tools on assisted living quality and underwent testing with MN stakeholders and cognitive testing with MN AL residents. Pilot testing assessed any further changes that needed to take place for resident and family satisfaction with AL quality (n=400). Presenters will share lessons learned with implementing the new tools and different aspects of the of the report card development and implementation process as well as the survey findings.
Through Their Lens: Using Visual Methods to Illuminate the Lived Experiences of Diverse Older Adults
Authors: Yeh Jarmin , Perry Tam 
Published: December 2020

Abstract
Visual methods, like photovoice and photo-elicitation, have attracted modest attention in gerontological inquiry with diverse and vulnerable community-dwelling older adults. Visual methods are based on the idea of inserting images, produced by informants or not, into research interviews, allowing informants to be the experts of knowledge and meaning-making while the researcher becomes the student. The empowerment of informants as subject-collaborators in the research process is a distinctive feature of visual methods. Benefits include revealing unique insights into diverse phenomena by evoking elements of human consciousness, feelings, and memories that words may not easily express and surveys may not easily capture. This symposium presents qualitative research using visual methods to illuminate the lived experiences, voices, and perspectives of diverse and vulnerable older adults living in New Jersey, Connecticut, and California. Reyes’ research critiques how the operationalization of mainstream notions of civic participation becomes exclusionary and provides a more inclusive understanding of how civic participation is enacted and performed through the practices of Latinx and African American older adults living in New Jersey. Versey’s research with homeless older adults subverts the attention often focused within cities by interrogating the meaning of place with informants whose needs and desires are often overlooked or obscured by residing in a small, rural town in central Connecticut. Yeh’s research on aging in place inequalities chronicles the everyday lives of housed and unhoused older San Franciscans to reveal their tactics for negotiating a moving tension between the daily interiority of identity and contingencies of a changing environment. Qualitative Research Interest Group Sponsored Symposium.
Using a Performance Based Assessment Tool of Everyday IADL to Determine Driving Risk in Older Adults
Authors: Dickerson Anne 
Published: December 2020

Abstract
For older adults living in rural/suburban communities, driving is often their only means of transportation. Although considered safe drivers, drivers older than 70 years have higher crash rates with fatality rates amplified due to the increased frailty/fragility. However, research evidence clearly indicates that cognitive factors contribute to driving impairment in older adults. Occupational therapists, as experts in observation of functional performance, use the Assessment of Motor and Process Skills (AMPS), for measurement of performance in everyday activities using two scales (motor and process). Previously demonstrated as a sensitive tool for cognitive changes, this presentation will summarize the research outcomes between older adults with cognitive impairment (N=57+) and without (N=53) who completed a comprehensive driving evaluation. Analysis of the two samples using receiving operating curves suggests the AMPS has potentially excellent specificity and sensitivity, specifically AUC = 0.826(0.73-0.92) for motor, AUC = 0.909(0.84-0.98) for process, and AUC = 0.936(0.88-0.99) together. Part of a symposium sponsored by Transportation and Aging Interest Group.
Life Course Predictors of Allostatic Load Among LGBTQ Older Adults
Authors: Hoy-Ellis Charles , Kim Hyun , Goldsen Karen Fredriksen 
Published: December 2020

Abstract
LGBTQ older adults are at significantly increased risk for poor mental and physical health, likely consequential to lifelong bias. Allostatic load (AL), the net effect of “wear and tear” on the body resulting from repeated, chronic over-activation of the psychophysiological stress response system. Utilizing the Health Equity Promotion Model, the aim of this study was to test potential life course predictors of AL, including interpersonal violence, legal marriage, and identity management in a sample of LGBTQ adults 50 to 97 years of age (n=317). Results from a series of hierarchical linear regression models showed that adult physical abuse and late identity disclosure for those who had been in an opposite-sex marriage predicted higher AL in this sample of LGBTQ older adults, indicating need for increased research on bias over the life course as contributory to AL and biopsychosocial dysfunction among LGBTQ older adults.
Outpatient and Inpatient Service Use by Chinese Adults Living in Rural Low-Income Households
Authors: Lu Peiyi , Yao Jun , Yang Chunyu , Shelley Mack , Zhang Li 
Published: December 2020

Abstract
Background: This study applied the Andersen Model of Health Care Utilization to explore the variables associated with health service use among Chinese adults living in rural low-income households. Method: A survey of 2,429 adults living in 787 low-income households in Jiangsu, China was conducted. Respondents were asked the presence of outpatient service in the past one month and the amount of hospitalization in the past one year. Mixed effect logistic and negative binomial models were used to examine the relationship of individual-level and household-level characteristics with health service use. Results: Health condition was the predominant determinant of both outpatient and inpatient service use (Odds Ratio [OR] &gt;1, p&lt;0.001). Individuals living in a poor household were less likely to use outpatient service (OR=0.05, 95% confidence interval CI: 0.00, 0.71), and the longer in poverty status the less likely to use outpatient service (OR=0.92, CI: 0.86, 0.99). Age was associated with lower likelihood to use outpatient service (OR=0.93, CI: 0.93, 1.00), and this relationship was stronger for larger households (OR=1.01, CI: 1.00, 1.01). For inpatient service use, most household-level measures were insignificant. Conclusion: Rural Chinese health service use was influenced primarily by needs variables. Outpatient service use was constrained by household enabling variables. Older adults were at a disadvantage for using outpatient service when the family prioritized younger members in allocating resources. These results suggest the need for policy advocacy to expand insurance reimbursement and improve benefits for poor older adults.
Circadian Rhythms, Sleep, and Aging: New Visions on the Clock, Sleep, and Aging
Authors: Sehgal Amita 
Published: December 2020

Abstract
The symposium will highlight the reciprocal relationship between aging and sleep and circadian rhythms. Circadian rhythms and sleep deteriorate with age, but at the same time, disruptions in these processes can contribute too aging. Presenters will show how work in model organisms is providing insight into this relationship
Racial and Ethnic Differences in Perceptions of, and Barriers to, Cost-of-Care Conversations Among Older Adults in Florida
Authors: Conner Kyaien , Wiltshire Jacqueline , Anderson Erica , Colato Edlin Garcia , Carrion Iraida , Orban Barbara 
Published: December 2020

Abstract
Cost of care conversations (CoC) between patients and doctors have been shown to lower overall healthcare and patients’ costs. How, it is unclear why CoC are not occurring more frequently among high cost patients such as older adults. To address this important question, we conducted three race-stratified focus groups (n=10 Whites, n=9 African Americans, and n=8 Latino/Hispanics) to assess perceptions about, and barriers to, CoC in a convenient sample of adults ages ≥65 from Adult Centers in Tampa Bay, Florida. An inductive content analysis approach was utilized by research team members to analyze qualitative data. Findings indicated that CoC are not occurring. White participants perceived that CoC were not occurring because they did not have issues paying for care. African Americans perceived that CoC were not occurring because doctors are not trained to understand finances, insurance, and medical billing. Latinos/Hispanics perceived that doctors are meant to take care of patients, and receptionists, administrators and billing departments should handle CoC. Wait time and perceived stress/rush of doctors were identified as CoC barriers for whites, while doctors’ attitude was a barrier for Blacks/African Americans, and perceptions about CoC being “taboo” was a major barrier for Latinos/Hispanics. Overall, participants indicate that it is easier to have CoC if they had developed a good rapport with the doctor, had confidence in the doctor, and felt the doctor was interested in and cared about them. The findings suggest that promoting CoC among older adults will require addressing social and cultural concerns of racial/ethnic minority groups.
Sirtuins: New Roles for Sirtuins in Aging and Disease
Authors: Chua Katrin 
Published: December 2020

Abstract
Sirtuins are NAD+-dependent enzymes related to yeast silent information regulator-2, a histone deacetylase that prevents premature aging through chromatin silencing. Mammalian sirtuins, SIRT1-SIRT7, have key functions that protect against diverse aging-related pathologic states, from cancer to metabolic and neurodegenerative disease. In addition to chromatin regulation, mammalian sirtuins also govern myriad cellular processes through a growing list of enzymatic activities and substrates. This session will highlight new discoveries and directions in Sirtuin research.
Chromatin Regulation and Genome Maintenance by Mammalian SIRT7
Authors: Cho Joonseok 
Published: December 2020

Abstract
Members of the Sirtuin family of enzymes are important regulators of genomic stability, stress responses, and metabolic programs that impact on human physiology, aging, and age-related disease processes. We previously showed that the mammalian Sirtuins SIRT6 and SIRT7 have high-selectivity histone deacetylase activities at chromatin, and inactivation of SIRT6 or SIRT7 results in dysregulated histone acetylation states and gene expression programs, with pathological consequences at the cellular and whole organism levels. Recently, we have been exploring novel functions of SIRT6 and SIRT7 in silencing of heterochromatic regions of the genome, the deregulation of which has been linked to aging and cancer biology. We found that pericentric heterochromatin silencing by SIRT6 prevents acute cellular senescence that is triggered by pathologic pericentric transcripts. We also uncovered a second novel trigger of human cellular senescence, ribosomal DNA instability in nucleoli, and we showed that SIRT7 guards against senescence induced by this instability. In our studies, a long-term focus has been identifying substrates of SIRT6 and SIRT7 and their roles in aging and disease pathways. In new work, are studying a novel physiologic substrate of SIRT7 at chromatin, H3K36Ac, and we are characterizing the genomic landscape of this SIRT7-dependent deacetylation target, and its downstream chromatin and nuclear signaling mechanisms. We will also discuss mechanistic insights into the functions of SIRT6 and SIRT7 from new proteomic, cellular, and mouse model studies.
The Effects of Organizational-Level Factors on the National Disability Prevention Programs for Older Adults
Authors: Chen Ya-Mei , Chiu Wan-Yu , Mao Hui-Fen , Chang Ling-Hui 
Published: December 2020

Abstract
In 2017, Taiwan implemented nationwide disability preventive programs that aimed to maintain older adults’ function and prevent disability. This study aimed to evaluate the impact of organizational-level factors on older adults’ improvement through participating in the 2019 preventive disability programs. There were 202 disability preventive programs, which included a 2-hour sessions per week for 12 weeks, in Taiwan in 2019. Participants’ physical, mental, and social functions were assessed before and after participating the programs and reported to the government. A total of 7194 older adults’ assessments were received. This study administered survey by the end of 2019 in the 202 programs in Taiwan and 8 organizational-level factors were assessed, including effectiveness, efficiency, professional, support from the upper organization, and cooperation with community, adequacy, responsiveness, and sustainability. Multilevel analysis was conducted to assess the impacts of organizational-level factors on disability prevention programs. A total of 170 programs (84%) has responded to our survey. About 48.2% of the programs were implemented by local public health centers. The domains of responsiveness and sustainability are rated highest among these programs. Programs with the following characteristics were associated with better program outcomes among older adults: better ability to provide outreach services was associated with improved depression; higher level in profession domain was associated with improved f mobility; better program responsiveness was associated with improved in nutritional status and oral function, and depression risk. Our results shed lights on how to improve a national disability prevention programs from programs’ characteristics point of view.
Discovery of Novel Regulators of Autophagy in Animals
Authors: Baehrecke Eric 
Published: December 2020

Abstract
The clearance of organelles by autophagy is important for cell health, and defects in this process have been associated with age-associated degenerative disorders. Ubiquitination of proteins enables their recognition by cargo receptors that facilitate the delivery of both protein aggregates and organelles to forming autophagosomes for degradation. We have investigated developmentally programmed autophagy to identify novel regulators of organelle clearance. We identified an Atg7-independent autophagy program that is required for cell size reduction and clearance of mitochondria. We have used this system to screen for new factors regulate ubiquitin-dependent autophagy and clearance of organelles. We screened a collection of putative ubiquitin binding domain encoding genes, and identified the novel gene Vps13D. Vps13D is an essential gene that is necessary for autophagy, mitochondrial size, mitochondrial clearance, and is associated with human movement disorders. We have used genetics and biochemistry to identify factors that link Vps13D, mitochondrial biology and autophagy.
Nurse Practitioner’s Role as 3D Team Leader
Authors: Obuchon Kathleen 
Published: December 2020

Abstract
The nurse practitioner’s (NP) clinical activities during the 12-month intervention period include 4 monthly in-home visits and 8 monthly telephone contacts. This presentation will detail the clinical assessments and activities conducted during the initial home visit, and how subsequent home visit activities and interventions are structured for older adults and their informal caregivers depending on whether older adults have dementia, depression, and/or recent delirium. Because the potential for medication-related problems is a critical concern for older adults with cognitive vulnerability, this presentation also will detail how the NP works with the 3D Team pharmacist to determine potential inappropriate medications through a review and reconciliation process, and how the NP and pharmacist summarize these results and correspond accordingly with the older adult’s primary care physician. Finally, this presentation will explain how the NP manages communication among members of the 3D Team who provide interventions to the same older adult and caregiver.
When Do Medical Doctors Recommend Less Expensive Medication Prescriptions in U.S. Adults 50 Years or Older?
Authors: Aravena Jose 
Published: December 2020

Abstract
The US is the country with the greatest average spending for prescription drugs per person (US$ 1,200). 85.0% of older people consume prescription medications, with high rates of polypharmacy. The aim was to analyze the factors related to the recommendation of a less expensive prescription by a medical doctor in US older adults. A cross-sectional analysis using the data from The National Poll on Healthy Aging (NPHA) 2017 was conducted, with a total sample of 1666 adults age 50 to 80 residing in the US. People were asked if they have received a less expensive prescription by a medical doctor in the last two years (yes/no). Sociodemographic and health variables, active patient medication-cost behaviors, and doctor active medication-costs actions were measured as covariates. Weighted and stratified by region logistic regression model was conducted in a 70% random sample. The model was validated in the 30% remaining using ROC curve and AUC. In the parsimonious model, ≥4 visits to the doctor (OR=2.06, 1.33 - 3.18), perception of medication costs as a burden (OR=1.76, 1.25 - 2.47), the doctor talked about medication costs (OR=5.54, 3.90 - 7.88), doctor awareness of medication costs (OR=1.81, 1.34 - 2.46), and being Non-Hispanic Black (OR=1.90, 1.20 - 3.03) were linked to a higher odd to receive a less expensive prescription. The model presented a moderate-high fit (AUC:0.71; sensitivity:84.4%, specificity:49.8%). Awareness and training in the active prescription of less expensive medications by the medical doctor seem fundamental to reduce drug costs burden in older adults.
Nurse Practitioner’s Clinical Triggers for Referral to Other 3D Team Members
Authors: Ladda Shawn 
Published: December 2020

Abstract
This presentation features how 3D Team nurse practitioners (NP) use results of clinical assessments to determine whether older adults and caregivers enrolled in the study are referred to other Team members; these assessment results are called “clinical triggers”. Other team members who receive referrals based on NP-generated clinical triggers include: Licensed Clinical Social Workers, who deliver Problem Solving Therapy to older adults with significant depressive symptoms; Occupational Therapists, who deliver an evidence-based dementia care intervention; Physical Therapists, who deliver an adapted Otago exercise program; Registered Dietician, who provides nutrition and dietary instruction; and Community Health Educator, who provides community resource information to address social determinants of health. All clinical triggers will be detailed in this presentation, along with a description of each intervention delivered by other team members except the Community Health Educator. Case studies will be presented to illustrate how study participants receive multiple interventions from the 3D Team.