bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring Caregiver Person-Centered Communication for Persons With Dementia via Video Observations
Authors: Jao Ying-Ling , Coleman Carissa , Williams Kristine , Berish Diane , Liu Wen , Berkley Amy , Liao Yo-Jen 
Published: December 2020

Abstract
Communication is fundamental for daily care activities in nursing homes (NHs). Second-by-second behavioral coding of video observations is an ideal approach to examine the interactive nature of communication but requires a reliable coding scheme. Recent studies have adapted the Peron-Centered Behavioral Inventory (PCBI) and Task-Centered Behavioral Inventory (TCBI) to analyze caregiver communication during mealtime interactions, but their use for coding general daily caregiving activities has not been widely evaluated. This pilot study adapted the PCBI and TCBI of video observations and determined their inter-rater reliability for measuring caregiver verbal communication with persons with dementia (PwD). We analyzed videos from a randomized controlled trial of an intervention to improve caregiver communication in NHs. We selected one 1-minute segment from 12 videos that included interactions of caregiver-resident dyads. One research assistant transcribed caregivers’ verbal communication and segmented the communication into utterances. Two other research assistants independently coded each utterance using the adapted PCBI and TCBI. The coding scheme was expanded by modifying the existing operational definitions, adding three new codes, and developing a coding decision guide. Residents were Caucasian (100%), mean age 86 years with dementia and resistive behaviors. The adapted PCBI and TCBI had an inter-rater reliability of Kappa=0.656 (p&lt;.001) across the 12 videos. Overall, our adapted PCBI and TCBI showed substantial inter-rater reliability. The results support the use of our adapted PCBI and TCBI to distinguish between person-centered and task-centered communication in video observations, which, in turn, allows for sequential analysis to examine the impact of caregiver communication on PwD.
The Breaking Point: Family Dementia Caregivers’ Recognition of the Need to Intervene
Authors: Harrington Candace , Dean-Witt Cheryl , Hardin-Fanning Frances 
Published: December 2020

Abstract
Family dementia caregivers are an under-recognized and valuable geriatric workforce whose services have broad implications for health care systems. Family dementia caregivers may experience uncertainty, loss of role identity, involuntary role assumption, or undesirable life transitions. Subsequent unintentional mistreatment or abuse of their family care recipient may occur. Approximately 50% of caregivers admit to some form of mistreatment of their loved one who lives with dementia. Using Selder’s (1989) life transition theory, this qualitative study explored family members’ life transition process toward their new role identities as family dementia caregivers to better understand the personal and historical contexts of caregiving. Semi-structured interviews were conducted with 10 participants to answer the questions: How does one acquire the role of primary family dementia caregiver?” and “How do personal and historical contexts inform the family dementia caregiver role?” Richness of data drove our sample size. Epistemological integrity ensured trustworthiness and rigor. A modification of Colaizzi’s (1978) analytic method was used for interpretative phenomenological analysis. The emergent themes uncovered by participants’ statements included: “It’s my turn”, “the breaking point”, and “a fine line” with the subtheme “balancing dignity and safety”. Participants described their introspective journeys toward a changed reality as family dementia caregivers. Our findings suggested the need for early recognition and vigilance to prevent the exploitation and mistreatment of those with dementia. Rural agriculture-based family caregivers in our study described unique and challenging characteristics. Further research is needed to explore the implications of these contextual nuances for rural agriculture-based family dementia caregivers.
Anthropometric Measures of Obesity and Food Consumption Among U.S. Chinese Older Adults
Authors: Zheng Shenglin , Le Qun , Dong XinQi 
Published: December 2020

Abstract
Most research uses body mass index (BMI) alone to measure obesity. Combined with waist circumference (WC), BMI may better identify obesity-related health risk. And diet is a key component of obesity management. To better understand the relationship between obesity and diet, this study aims to examine two anthropometric measures of obesity and the food consumption among U.S. Chinese older adults. Data were drawn from the PINE study wave III (2015-2017), a prospective cohort study of community-dwelling Chinese older adults (N=3053). We categorized participants into 6 groups: normal BMI (18.5-24.9) with normal WC (women ≤ 88cm and men ≤102cm), normal BMI with high WC (women WC &gt;88cm and men WC &gt;102cm), overweight (BMI=25.0-29.9) with normal WC, overweight with high WC, obese (BMI &gt;30) with normal WC, and obese with high WC. A forty-eight-item food frequency questionnaire was used to measure frequencies of vegetables, fruits, grains, protein foods, dairy, sweets, and alcohol intake. Almost 12% participants had normal BMI but high WC and 10% were overweight with high WC. Participants who were overweight with high WC reported the highest intake of vegetables among groups. Participants with higher WC had significantly higher fruit consumption, compared to those with normal WC, regardless of their BMI. Spearman correlation analysis showed that being overweight with a high WC was correlated with higher frequencies of vegetables and fruits intake and having normal BMI with normal WC was correlated with higher alcohol intake. The findings provide new insights for future research and interventions on obesity/chronic disease management.
Body Composition by CT vs. DXA: Long-Term Prediction of Mortality in the Health Health ABC Cohort
Authors: Farsijani Samaneh , Xue Lingshu , Boudreau Robert , Santanasto Adam , Kritchevsky Stephen , Newman Anne 
Published: December 2020

Abstract
Background: Early work in the Health ABC cohort found that strength, but not muscle size predicted mortality. Recent literature suggests that body composition by computerized tomography (CT) and magnetic resonance imaging (MRI) predicts adverse health outcomes in diverse populations, but has not been directly compared to dual-energy X-ray absorptiometry (DXA) for predicting mortality. Objective: With long term follow-up, we reexamined body composition and mortality in Health ABC, comparing DXA and CT measures of muscle and fat. Methods: The Health ABC study assessed body composition in 2911 older adults (age 73.6±2.9 years) in 1996-97. Mid-thigh CTs were read for muscle area, inter-muscular, subcutaneous-fat areas and muscle density (HU). DXAs were read for whole body fat mass and appendicular lean mass (ALM). Mortality was assessed every 6-months through 2014 (maximum 17.4 years). Cox proportional hazards models, adjusting for age, sex, race, height, weight, physical activity, smoking and comorbidities were used to assess mortality risk. Results: Strong correlations were observed between mid-thigh muscle and subcutaneous fat areas by CT and leg lean and fat mass by DXA (P&lt;0.05). Lower mortality rates, per SD, were associated with higher CT muscle area (HR-men=0.76 [95%CI: 0.68-0.86]; HR-women=0.84 [0.75-0.94]), muscle density (HR-men=0.86 [0.79-0.93]; HR-women=0.89 [0.81-0.97]) and higher subcutaneous-fat (HR-men=0.90 [0.81-0.99]; HR-women=0.87 [0.77-0.98]), adjusting for covariates. Similarly for DXA, greater ALM (HR-men=0.56 [0.44-0.71]; HR-women=0.77 [0.59-1.01]) and higher total fat mass (HR-men=0.53 [0.40-0.72]; HR-women=0.58 [0.37-0.90]) were associated with lower risk of death. Conclusion: With long term follow-up, both CT and DXA assessments of body composition predicted all-cause mortality risk.
Quality of End-of-Life Care for Vietnam Veterans: Implications for Practice and Policy
Authors: Carpenter Joan , Smith Dawn , Griffin Hilary , Kinder Daniel , Thorpe Joshua , Ersek Mary , Kutney-Lee Ann 
Published: December 2020

Abstract
In federal response to the aging population of Vietnam-era Veterans, Congress directed the Department of Veterans Affairs (VA) to create a pilot program to identify and develop best practices for improving hospice care for this population. A first step in VA’s response was to identify whether the end-of-life (EOL) care needs and outcomes of Vietnam-era Veterans differed from previous generations. Using medical records and bereaved family surveys, we examined clinical characteristics, healthcare utilization, and EOL quality indicators for Vietnam-era Veterans who died in VA inpatient settings between 2013-17. Contemporaneous comparisons were made with World War II/Korean War-era Veterans. Compared to prior generations, higher percentages of Vietnam-era Veterans had mental health/substance use diagnoses and disability. Similar percentages of family members in both groups reported that overall EOL care was excellent; however, post-traumatic stress disorder management ratings by families of Vietnam-era Veterans were significantly lower. Although current VA EOL practices are largely meeting the needs of Vietnam-era Veterans, greater focus on mental health comorbidity, including post-traumatic stress disorder, Agent Orange-related conditions, and ensuring access to quality EOL care in the community is warranted. Policymakers and healthcare professionals should anticipate more physical and mental health comorbidities among Veterans at EOL as Vietnam-era Veterans continue to age. Findings are being used to inform the development of standardized EOL care protocols and training programs for non-VA healthcare providers that are tailored to the needs of this population.
Chemotherapy and Anesthesia in Colorectal Cancer Survivors and the Risk of Alzheimer’s Disease
Authors: Akushevich Igor , Yashkin Arseniy , Kravchenko Julia , Kertai Miklos 
Published: December 2020

Abstract
Exposures common in cancer patients––chemotherapy, surgical injury and/or anesthesia, alone or in combination with predisposing factors––have been suggested as potential risk factors for Alzheimer’s disease (AD). We explored the relationship between chemotherapy and cumulative anesthesia exposure, and development of AD in colorectal cancer survivors. We conducted a retrospective cohort study of individuals age 65 and older diagnosed with colorectal cancer between 1998 and 2013, drawing on SEER-Medicare data and employing a proportional hazards model. We found that exposure to chemotherapy in colorectal cancer survivors demonstrated a protective effect for AD HR=0.821 (0.784-0.860). The beneficial effect held in race-, sex-, cancer-stage-specific subgroups, across chemotherapy agents (e.g., Fluorouracil, Oxaliplatin, or Fluorouracil+Leucovorin), in multivariable analyses, and in propensity score-based pseudorandomization based on 70 demographic, socioeconomic, cancer-diagnosis-related, and comorbidity variables. The effect was diminished or absent when non-AD dementias were analyzed. Findings further demonstrated that the association between chemotherapy exposure and AD was not affected by competing risk of long-term mortality or possible correlation between choosing chemotherapy and higher cognitive score or use of alternative health insurance. The effect of anesthesia on AD was not significant (0.998 per hour, 0.992-1.005) and this effect held in all subgroups, multivariable analyses, and for pseudorandomized subpopulations. Harmful effect was detected for cerebral degeneration, excluding AD, cognitive deficits following cerebral hemorrhage, cognitive disorder due to injury, hepatic encephalopathy, and hepatolenticular degeneration. Sensitivity analyses focused on SEER-Registry-specific effects and possible misspecifications in anesthesia records with alternative models demonstrated stability of estimates.
Fear of Falling and Cognitive Decline in Healthy Aging Adults
Authors: Kraut Rebecca , Holtzer Roee 
Published: December 2020

Abstract
Fear of Falling (FOF) is common and associated with poor mobility in aging but whether persistence of FOF endorsement influences cognitive decline has not been reported. Here we determined the effect of FOF, measured dichotomously and after accounting for persistence, on decline in global cognitive function (GCF), memory, and attention/executive functions. Older adults with persistent FOF (n=81; mean age=77.63±6.67 yrs; %female=74.1), transient FOF (n=60; mean age=76.93±6.01 yrs; %female=61.7), and no FOF (n=286; mean age=75.77±6.42 yrs; %female=49.3) were included. FOF was assessed through yes/no responses to “do you have a fear of falling?” at baseline. GCF was assessed using RBANS; memory was assessed using a composite score comprising the immediate and delayed recall index scores from RBANS; attention/executive functions were assessed via a composite score comprising TMT A & B, letter and category fluency tasks, and digit symbol modalities. Cognitive measures were administered annually for up to six years. Linear mixed effects models revealed that persistent FOF was associated with a worse decline in GCF compared to both transient FOF (estimate=0.78, p=.022) and no FOF (estimate=0.75, p=.004). Persistent FOF was also associated with a worse decline in memory compared to those with transient FOF (estimate=0.08, p=.004) and those with no FOF (estimate=0.06, p=.006). Associations between FOF status and decline in attention/executive functions were not significant. These findings demonstrate that persistent FOF is a risk factor for cognitive decline in community-residing older adults.
Understanding Alzheimer’s Disease Knowledge in Low-Income, Racially Diverse Older Adults
Authors: Zanjani Faika , Wilkerson Taylor , Rhodes Annie , Inker Jennifer , Richardson Joann 
Published: December 2020

Abstract
Individuals demonstrate varying levels of Alzheimer’s disease (AD) knowledge, as well as commonly held misconceptions about the risk factors and nature of the disease. Older adults often demonstrate low scores on AD knowledge scales and African Americans are often specifically not aware of their higher AD risk status compared to other racial groups. We measured the Alzheimer’s knowledge in 60+ community-dwelling adults, as part of a larger study on AD health coaching. Participants (n=20) were recruited from low-income communities within the Richmond, Virginia area. The study sample was 85% African American (n=17) and 55% male (n=11). Participants completed a behavioral psychosocial test battery, including the Alzheimer’s Disease Knowledge Scale. Similar to previous research, this sample of older adults held common misconceptions about AD, including the ideas that mental exercise can prevent AD (80% answered incorrectly) and individuals with AD are incapable of making decisions about their care (70% answered incorrectly). In this sample, the majority of African American older adults were aware of the fact that they have the highest risk for developing AD (20% answered incorrectly) compared to other racial groups. Analyses found no significant relationship between AD knowledge and health outcomes, alcohol consumption, or education. In conclusion to reduce AD risk, addressing AD knowledge in minority low-income population is important and needed. This is especially relevant since African American older adults are more likely to live in communities rather than nursing or assisted living facilities, receiving less access to interventions and research innovation.
Uses of Reminiscence in Dementia Care
Authors: Khait Abdallah Abu , Shellman Juliette 
Published: December 2020

Abstract
Improving the quality of life for older adults diagnosed with dementia is a public health research priority. Reminiscence is one non-pharmacological technique used to address the behavioral and psychosocial problems associated with dementia. The uses of reminiscence in dementia care have not yet been integrated, synthesized, critically analyzed, or delineated in the literature. Whittemore and Knafl’s five-step method provided the framework for this integrative review. A comprehensive search of PubMed, CINAHL Plus, SCOPUS, and PsycINFO was undertaken. Articles published in English, focused on participants with a diagnosis of mild to moderate dementia, and with evidence of using reminiscence in dementia care were included. Twenty-six studies published between 2009 and 2019 that met the inclusion criteria were analyzed. Four themes emerged from the integrated findings: (a) recovery from the darkness of depressive symptoms; (b) enhancement of cognitive functions and filling the memory gap; (c) living a fulfilling life in late adulthood, and (d) fulfilling reminiscence functions. The critical appraisal process revealed mixed effectiveness of the use reminiscence on health outcomes in dementia care due to diverse types of reminiscence, different outcomes measures, different data collection toolkits, and a lack of a standardized reminiscence protocol among research studies. Results from this review provide a better understanding of the potential benefits of using reminiscence in dementia care. However, improving the methodological rigor of future studies is necessary to attain conclusive evidence of the effectiveness of using reminiscence in dementia care. Implications of these findings for gerontological education, practice, and research will be presented.
Racial and Ethnic Health Inequalities in Accelerated Transitions in Mild Cognitive Impairment and Dementia
Authors: Natale Ginny , Zhang Yun , Clouston Sean 
Published: December 2020

Abstract
Background: It is unclear how the expected risk of Mild Cognitive Impairment (MCI) and conversion to dementia in the United States differs by Race/ethnicity and gender in older adults. It is unclear whether expectations about racial disparities have changed in light of changing trends in obesity and diabetes. Method: We analyzed six waves of the National Health and Aging Trends Study (NHATS), a nationally representative prospective cohort study of U.S. residents aged 65 and older. Participants were classified into four clinically meaningful mutually-exclusive groups: unimpaired, MCI, probable dementia and death. We used multistate survival models to examine individuals’ cognitive transitions and reported predictors using hazards ratios. Results: Participants (n=6,078) were 77 years old, on average, and the majority were white, females and high school graduates. Increased age was associated with risk of MCI and death. Adjusted for obesity status and diabetes, Hispanics were had a net reduced risk of death from dementia (HR=0.60; 95% CI [0.38-0.96]) but lived longer with MCI and dementia before death. Cognitively normal Blacks faced significantly increased risk of developing MCI (HR=2.54 95% CI [1.81-3.53]) and dementia (HR=1.77 95% CI [1.34-2.35]). Obese and overweight elderly had reduced risk across transitions to MCI then to dementia, but similar risks of death compared to lower body mass indices (BMI). BMI and diabetes reveal a suppression effect and racial inequalities became more apparent. Discussion: Results showed persistent racial inequalities in MCI, probable dementia, and death, supporting the theory that racial/ethnic factors are important to expectations of aging Americans.
Association Between Chronic Illness, Masculinity, and Well-Being in Older Black Men
Authors: Young Hana , Li Jessalyn , Esiaka Darlingtina 
Published: December 2020

Abstract
Research suggests that living with a chronic illness has deleterious impacts on the well-being and quality of life of aging adults. Specifically, it opposes traditional masculine constructs in men and impacts their physical and mental health outcomes. In this study, we examined the lived experiences of Black men, aged 55 years and over, and diagnosed with chronic illness using life history narratives. Participants responded to open-ended questions such as “what aspects of living with illness do you find relatively difficult or easy?” and “what situations make you particularly aware of your illness?” Common themes that emerged from the participants’ responses were the performance of masculinity, fulfilling family duty and obligation, limited sexual encounters, and feelings of exclusion in one’s community. Additionally, participants stated that chronic illness impacts their mental well-being and triggers behavioral responses that exacerbate their ability to cope with the illness. Their responses highlight the conflict between traditional masculine expectations and the presence of chronic illness and illustrate the extent to which ‘manhood’ is a determinant of health even in older men. Our findings can inform the development of tools and interventions designed to improve the experience of well-being among Black men aging with chronic illness.
A state-of-the-art review of the current role of cardioprotective techniques in cardiac transplantation
Authors: Cullen Paul P , Tsui Steven S , Caplice Noel M , Hinchion John A 
Published: December 2020

Abstract

OBJECTIVES
The use of ‘extended criteria’ donor hearts and reconditioned hearts from donation after circulatory death has corresponded with an increase in primary graft dysfunction, with ischaemia–reperfusion injury being a major contributing factor in its pathogenesis. Limiting ischaemia–reperfusion injury through optimising donor heart preservation may significantly improve outcomes. We sought to review the literature to evaluate the evidence for this.

METHODS
A review of the published literature was performed to assess the potential impact of organ preservation optimisation on cardiac transplantation outcomes.

RESULTS
Ischaemia–reperfusion injury is a major factor in myocardial injury during transplantation with multiple potential therapeutic targets. Innate survival pathways have been identified, which can be mimicked with pharmacological conditioning. Although incompletely understood, discoveries in this domain have yielded extremely encouraging results with one of the most exciting prospects being the synergistic effect of selected agents. Ex situ heart perfusion is an additional promising adjunct.

CONCLUSIONS
Cardiac transplantation presents a unique opportunity to perfuse the whole heart before, or immediately after, the onset of ischaemia, thus maximising the potential for global cardioprotection while limiting possible systemic side effects. While clinical translation in the setting of myocardial infarction has often been disappointing, cardiac transplantation may afford the opportunity for cardioprotection to finally deliver on its preclinical promise.
Indefinite derivative for stability of time-varying nonlinear systems
Authors: Hadj Taieb Nizar 
Published: December 2020

Abstract
This paper is concerned with stability analysis of nonlinear time-varying systems by using Lyapunov function based approach. The classical Lyapunov stability theorems are generalized in the sense that the time-derivative of the Lyapunov functions are allowed to be indefinite. Then, under quite general assumptions, we first present a new converse stability theorem for a large class of time-varying systems which will be used to prove certain stability properties of nonlinear systems with perturbation. Therefore, a new Lyapunov function is presented that guarantees global asymptotic stability under some restrictions on the perturbed system. Furthermore, some illustrative examples are presented.