bluuebunny/crossref_metadata_2025_split huggingface dataset:
MANAGING MANAGED CARE: PERSPECTIVES FROM KEY STAKEHOLDERS IN SKILLED NURSING FACILITIES
Authors: Daddato Andrea E , Drake Cynthia , Miller Edward A , Nadash Pamela , Tyler Denise , Boxer Rebecca S 
Published: November 2019

Abstract
In recent years, Medicare Advantage (MA) plan enrollment has increased, a trend that is expected to continue. Many skilled nursing facilities (SNFs) rely on MA managed care insurer referrals to maintain their census in a market with high competition for post-acute care patients. This study used semi-structured interviews to describe the relationship between MA plans and SNFs from the perspective of key decision-makers in SNFs. Twenty-three interviews were conducted with key stakeholders from 11 Denver Metropolitan area SNFs. A combined purposive-snowball sampling approach was used to identify and recruit select staff from the participating facilities. Interviews focused on the relationship between MA plans and SNFs, including mechanisms of control, power dynamics, and preferences for MA versus Fee-for-Service (FFS) Medicare patients. Key findings included: 1) challenges SNF staff had navigating MA plans’ case management processes, a key mechanism used by MA plans to influence the behavior of SNF decision-makers; 2) MA plans exercising power over beneficiaries’ length of stay, potentially leading to early discharge and heightened risk for rehospitalization; 3) SNF preference for admitting Medicare FFS over MA patients due to higher rates of Medicare FFS reimbursement and greater control over patient care. SNFs are increasingly reliant on MA plans for patient referrals and revenue. The themes suggest that this growing reliance may place SNFs at odds with MA plans on how best to manage overall patient care. It is therefore important that future research investigate how MA plans’ influence over care affects patient outcomes in SNFs and other post-acute settings.
HOSPICE SERVICES IN THE HOME SETTING AND CHARACTERISTICS OF MEDICARE DECEDENTS
Authors: Karikari-Martin Pauline , Zhao Lirong , Miescier Lynn 
Published: November 2019

Abstract
There is little empirical work documenting the characteristics of Medicare beneficiaries receiving hospice services in the home setting using the Medicare place of service codes. The objective of this study is to examine differences in Medicare decedents who received hospice services in traditional and non-traditional homes (assisted living, and nursing home settings) defined by these codes. We conducted a secondary analysis of 675,782 Medicare decedents who received hospice services in 2015. Chi-squared and ANOVA tests were used to describe the socio-demographics, health conditions, utilization, and hospice payments of the decedents. Most of the decedents received hospice care in a traditional home (64.9%), but beneficiaries, aged 85 years and over, received hospice services in assisted living (72.1%) or nursing homes (59.8%). Overall, decedents who received Medicare hospice benefits in assisted living had the highest number of hospice days (mean=149.7 lifetime days; median = 30; standard deviation (S.D.) =245), and decedents in traditional homes had the fewest number of hospice days (mean=86.7 lifetime days; median = 24; S.D. =179). Among Medicare–Medicaid (duals) decedents who used hospice care, 49% received hospice care in nursing homes, and infrequently, 7% at assisted living. Medicare hospice payments were highest ($20,439 per beneficiary) for decedents in assisted living, but least for those in traditional homes ($11,830). Hospice services offered to Medicare beneficiaries who are 85 years and older, duals, or have a diagnosis of dementia may require more oversight and coordination of resources to ensure that they receive appropriate hospice services in non-traditional homes.
TRADITIONAL NETWORK ON MENTAL HEALTH: SUPPORT FROM CHILDREN AND DEPRESSIVE SYMPTOMS FOR OLDER ADULTS IN RURAL CHINA
Authors: Chen Lei , Torres-Gil Fernando 
Published: November 2019

Abstract
In rural China, support from children is the traditional network for older adults. Their mental health problem is poorly understood and remains unsolved. The study aims to explore the relationships between older adults’ depressive symptoms and characteristics of support from children under the current social-structural conditions in rural China. The study is informed by the intergenerational solidarity theory and the theoretical framework of social relationships and their influence on health. The quantitative study is based on the recent wave of Harmonized China Health and Retirement Longitudinal Study (Harmonized CHARLS) in 2015, which is a high-quality national-level dataset. The study applies conditional process analysis to do the data analysis. The key findings include: the number of children has a negative association with older adults’ depressive symptoms (c= -.2390, p=.0002&lt;0.05); the number of children influenced older adults’ depressive symptoms indirectly through financial support from children (If children do not live with older parents, ab=-.0141, CI= -.393 to -.0038; If children live with older parents, ab=-.0153, CI= -.369 to -.0056;). However, both theses direct and indirect relationships do not depend on the co-residence situation between older adults and their children. The controlling variables include age, gender, and self-rated health. Under China’s current transition period of population policy, this study provides policy implications regards to the characteristics of children support and their influence on older adults’ mental health, especially in rural China. This study also tests the two theories to some extent under the Chinese context, which were initially developed in Western countries.
POSITIVE AND NEGATIVE SOCIAL INTERACTIONS ON MENTAL HEALTH IN OLDER KOREAN AMERICANS: GENDER DIFFERENCES
Authors: Park Nan Sook , Jang Yuri , Rhee Min-Kyoung , Chiriboga David , Chung Soondool 
Published: November 2019

Abstract
While there is substantial documentation of a positive relationship between objective social engagement and mental health, relatively little is known about how perceived quality of social interactions affects mental health and how men and women differ. Considering the gap, the purpose of this study was to investigate gender difference in how social interactions associate with self-rated mental health in older Korean Americans. Data came from a survey with older Korean Americans aged 60 or over that included 713 men and 1437 women living in five sites (California, New York, Texas, Hawaii, and Florida), conducted during 2017−2018. In multiple regression models run separately for men and women, self-rated mental health on a five-point scale (excellent/very good/good/fair/poor) was regressed on four blocks of variables: socio-demographic characteristics (age, marital status, education, financial status, self-rated health, and region), immigration-related variables (length of stay in the U.S. and acculturation), social engagement (family network, friend network, and activity participation), and perceived quality of social interactions (positive or negative family interactions and negative community interactions). In the final models with all covariates, younger age, more years in education, better physical health, higher levels of acculturation, and more positive family interactions were commonly associated with more positively rated mental health for both men and women. For women, stronger family network and fewer negative family interactions were additional contributors. Results suggest that negative and positive indicators of family interactions differentially affect self-rated mental health for older Korean American men and women.
RUMINATION, DEPRESSIVE SYMPTOMS, AND SLEEP QUALITY: SOCIAL SUPPORT AS A BUFFER
Authors: Marini Christina M , Wilson Stephanie J , Martire Lynn 
Published: November 2019

Abstract
Rumination, the act of dwelling on negative, unwanted thoughts, can stoke depression and disrupt sleep, both of which may threaten older adults’ well-being. In line with a support buffering hypothesis, a previous study of younger and middle-aged adults found that social support mitigated the positive association between rumination and negative mood. To extend this research, we distinguished between spousal and family/friend support as moderators of rumination’s links both to depressive symptoms and sleep quality among older adults. Data came from a sample of 128 adults who were, on average, 77 years old at study onset. Rumination was measured via the Rumination-Reflection Questionnaire. Perceived support was measured by items utilized in multiple nationally representative studies of older adults. Depressive symptoms were measured via the NIH PROMIS measure, and sleep quality was measured via items from the Pittsburgh Sleep Quality Index. Results indicated that support from family/friends (but not spouses) buffered the positive association between rumination and depressive symptoms, even after controlling for depressive symptoms six months prior. Conversely, when sleep quality served as the outcome, support from spouses (but not family/friends) buffered the negative association between rumination and sleep quality, even after controlling for sleep quality six months prior. Findings highlight the potential for specific sources of social support to buffer different consequences of rumination on older adults’ health and well-being.
IMPACT OF SOCIALIZATION IN LOW-INCOME URBAN ELDERLY COMMUNITIES
Authors: Wilkerson Taylor , Ward Schanea , Popovich Amy , Parsons Pamela , Zanjani Faika A 
Published: November 2019

Abstract
Older adults who experience social isolation have higher rates of mortality relative to their counterparts. Social interactions are an important way to combat this isolation. This research aims to better understand how social isolation in older adults living in low-income households in Richmond, Virginia (RVA) is related to their economic, physical, and psychological health status. As part of the VCU iCubed Health and Wellness Aging Core and in collaboration with the Richmond Memorial: East End Housing Coalition for Older Adults, older adults from a selected public housing unit (n=28) self-reported their financial status, experiences with physical and psycho-social health, and feelings of social isolation. Survey participants were 71.4% female, the mean age was 69.75 years, and 25% were high school graduates. Participants averaged 34 years living in the area and reported an average of $300 to spend on rent monthly. Overall, 55% (n=20) reported having two or more supports and 61% (n=22) reported hardly ever feeling isolated. However, a small subset of the sample reported having either no supports (5.6%, n=2) and 41.7% (n=15) lacked companionship some of the time or often. A one-way ANOVA was conducted and it was determined that participants who reported feeling left out more often were significantly more likely to report stress, anxiety, and depression (F[2, 25] = 6.998). Findings support the existence of supportive communities formed in low-income areas. Findings also indicate some older individuals residing in public housing in RVA experience social isolation, linking them to poorer psycho-social health.
IMPACT OF ICT AND SOCIAL NETWORKS SITES UTILIZATION ON OLDER PEOPLE’S WELL-BEING AND LONELINESS: A SCOPING REVIEW
Authors: Zaccaria Daniele , Casanova Georgia , Guaita Antonio 
Published: November 2019

Abstract
In the last decade the debate on ageing issues has been powered by the relationship between older people wellbeing, loneliness, Information Communication Technology (ICT) and Social Networks Sites (SNSs). A scoping review on social experiment studies, analysing the casual effect of technologies use on older adults’ wellbeing and loneliness, has been realized to support the randomized controlled trial included in “Aging in a Networked Society” project. The study aims to review the social experiments on the relationship between technology-use, older people wellbeing and loneliness, to provide a critical analysis of studies, to underline drivers and barriers in existing literature and to provide recommendations for future study and policy. 133 papers have been selected using interdisciplinary search engines (Scopus, Pubmed, Web of sciences, Google Scholar), taking into account contents and methods used. An in-depth examination of 9 experiences of social experiment have been provided, focused on six dimensions: “aims”, “design”, “sampling”, “intervention”, “findings” and “limitations". The literature show the positive effects of ICT, internet and SNSs use on older people wellbeing and quality of life. Our review underlines how the older people shown interest in ICT use to support their social relations, and how it should become a social driver. The low widespread of experimental studies impacts on the literature evidences. The main limits are related to the recruitment and sampling. Social experiment practices, based on controlled randomized trial, should be widespread to better support the evidences in ageing issue.
PROVIDER PERSPECTIVES ON IMPLEMENTING A PERSON-CENTERED COMMUNICATION TOOL
Authors: Heppner Alexandra , Hicks Nytasia , Poth Sarina , Van Haitsma Kimberly , Abbott Katherine 
Published: November 2019

Abstract
The PAL Card QIP Project sought to understand the intervention characteristics associated with effective implementation. Telephone interviews were conducted with n=26 NH providers who completed the project. Calls were recorded, transcribed verbatim and checked for accuracy. The Consolidated Framework for Implementation Research was utilized as an a priori coding scheme to identify factors associated with effective implementation of the PAL Card project. Major themes emerging from the data related to the evidence strength and quality of the intervention as well as the relative advantage to not assessing preferences (“turns out she doesn't even like TV and we have just been having her watch TV”), adaptability (tailoring for their needs), trialability (expanding offering of intervention after initial success), and complexity of the intervention (sharing the work across departments, difficulty using unfamiliar technology). Providers reported positive intervention characteristics of the PAL cards, however, barriers remain that require additional strategies to successfully implement.
A LIFE COURSE PERSPECTIVE OF LATE-LIFE FUNCTIONING: THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION
Authors: Karvonen-Gutierrez Carrie , Strotmeyer Elsa , Derby Carol 
Published: November 2019

Abstract
Early late-life deficits in physical functioning are highly relevant among women, who experience a more rapid decline in physical functioning vs. age-matched men. Trends showing an increasing prevalence of disability among mid-life adults, with an evolving understanding that late life health and functioning is the product of exposures accumulated across ones life, suggests an urgent need to understand the causes and consequences of functional limitations at the transition between mid- to late-life. The Study of Women’s Health Across the Nation (SWAN) is an observational multi-racial/ethnic (White, Black, Chinese, Japanese, Hispanic) longitudinal study of 3,302 women recruited in 1996 from 7 U.S. clinical sites; Boston, Chicago, Detroit-area, Los Angeles, Newark (NJ), Oakland (CA), and Pittsburgh. Over the past 23 years, women have participated in up to 16 near-annual study visits, spanning from mid-life (age 42-52 years at baseline) to late life (age 65-73 years at follow-up visit 15). Retention at the most recently completed in-person visit (2015) was 74%. This symposium identifies mid-life risk factors for poor late-life performance-based physical functioning among women, including race/ethnicity (Sternfeld) and chronic health conditions (Lange-Maia). Further, early late-life decrements in stair climb time and muscle power (Strotmeyer) and falls and fall injuries (Ylitalo) were observed with key factors identified. The Discussant will examine implications for life course epidemiology in advancing our understanding of predictors of late-life physical functioning. Consideration of functioning during the transition from mid-life to late life is critical to target interventions that are most efficacious in promoting late life health and function.
A MICROLONGITUDINAL ASSESSMENT OF SUBJECTIVE AGE AND MENTAL HEALTH DURING REHABILITATION
Authors: Shrira Amit , Palgi Yuval , Heyman Noemi , Zaslavsky Oleg , Bodner Ehud 
Published: November 2019

Abstract
Recent ecological momentary assessments focused on the concomitants of daily views on aging among community-dwelling participants, yet clinical samples are underexplored. Hence, this study examined the relationships between views on aging and daily mental health during rehabilitation following osteoporotic fractures and cerebrovascular events. Measures of daily subjective age, psychological distress, and mental health were assessed among 132 older adult patients (mean age=77.9, SD=7.5, 65.9% women). Multilevel models showed that on days patients felt younger, they reported lower psychological distress and higher mental health. Time lagged analyses further showed reciprocal effects between subjective age and mental health. Finally, the subjective age-mental health covariance was stronger among patients high on age awareness. The suddenness and brutality of acute medical events highlight subjective age as an important factor in patients’ wellbeing, especially among those more attentive to their age. These findings suggest that practitioners should consider interventions focused on patients’ age identity.
MITOCHONDRIAL SYSTEM BIOLOGY AS A WINDOW INTO DISEASES OF AGING
Authors: Cohen Pinchas 
Published: November 2019

Abstract
We identified multiple open-reading-frames (ORFs) within the mitochondrial genome. These ORFs encode putative peptides that we call Mitochondrial-Derived-Peptides (MDPs) which represent a sub-class of a growing group of novel micro-peptides (from both mtDNA and nuclear chromosomes) that serve as signals related to cell and organismal protection and energy expenditure. We described multiple peptides including humanin, SHLPs, and MOTS-c. Exploring mtDNA methylation patterns as well as mito-transcriptomics demonstrated changes in specific ORFs/MDPs in certain diseases. We developed a modified GWAS bioinformatic technique (MiWAS) that identifies SNPs within MDPs that associate with diseases of aging. MOTS-c, and MENTSH, novel anti-obesity/diabetes MDPs, harbors mutation in Asians and Native-Americans, associated with diabetes risk. Thus, MDPs are expressed in an ethno-specific fashion and may contribute to health disparities in a manner related to relevant mitochondrial DNA SNPs. In summary, MDPs are a new class of mitochondrial-hormones that have diagnostic and therapeutic potential in human disease.
NEPHROLOGY CARE AND MORTALITY RATES AMONG PATIENTS WITH END-STAGE RENAL DISEASE IN PUERTO RICO AND THE UNITED STATES
Authors: Rivera-Hernandez Maricruz , Swaminathan Shailender , Thorsness Rebecca , Lee Yoojin , Mehrotra Rajnish , Sommers Benjamin , Trivedi Amal N 
Published: November 2019

Abstract
Hispanics with incidence of end-stage renal disease (ESRD) have shown lower mortality despites their high incidence rates; However, prior research has excluded Puerto Rico (PR). This study compared mortality rates and predialysis nephrology care among Hispanics in the US, Hispanics in PR, and Whites in the US with ESRD from 2006-2015. We identified 791,443 patients using the Renal Management Information System. The primary outcome was age-adjusted 1-year mortality beginning with the 91st day following dialysis initiation. Secondary outcomes were the presence of arteriovenous fistula or graft at dialysis initiation, and receipt of predialysis nephrology care. Despite higher rates of insurance coverage, we identified substantial disparities in access to recommended nephrology care between PR and the US. In addition, the adjusted absolute difference in mortality rates was higher for PR Hispanics. This finding indicates shortcomings in quality of care for Puerto Rico with serious chronic illness and complex care needs.
A CROSS-NATIONAL COMPARISON OF THE SOCIAL SUPPORT NETWORKS OF OLDER MEN AND WOMEN WHO LACK TRADITIONAL FAMILY TIES
Authors: Mair Christine , Knopp Kasey 
Published: November 2019

Abstract
Existing literature on “aging alone” focuses on potential lack of support to “kinless” older adults who do not have traditional family ties (e.g., child, spouse; Margolis & Verdery, 2018), as well as the ways in which childless or unpartnered older adults may construct non-kin networks of support (e.g., friendship; Djundeva et al., 2018; Mair, 2019). In addition, older men’s and women’s social networks vary, with women reporting more network growth than men and potentially lower family involvement (Schwartz & Litwin, 2018). Finally, patterns of support (e.g., family care, friend interactions) differ by country context. However, it is unknown if and how the social networks of older adults who lack traditional family ties may differ by gender, as well as what forms of cross-national variation exist in these patterns. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE, N=17 nations, N=53,247 adults aged 50+), we take advantage of a unique social support network module in this cross-national dataset to compare closeness, proximity, quality, and type of ties by gender among older childless and unpartnered men and women by country. Among those without traditional family ties, we find that older women may be advantaged in terms of social support compared to older men, but that this advantage varies by nation. We discuss the details and implications of these results regarding potential policy implications about the differential risks faced by older men and women who lack traditional family ties in various country contexts.
INTEREST GROUP SESSION—HEALTH BEHAVIOR CHANGE: USING DATA ABOUT PATIENT CHARACTERISTICS TO IMPROVE FALL PREVENTION
Authors: Bergen Gwen 
Published: November 2019

Abstract
Over one in four U.S. older adults (age 65+) reports falling each year with fall-related medical costs estimated at $50 billion. The American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons recommends that healthcare providers assess and manage their patients’ fall risk. The Centers for Disease Control and Prevention’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative helps healthcare providers incorporate these guidelines by providing tools on how to screen, assess, and intervene to reduce risk. Evaluations of fall prevention have focused on the clinical process and outcomes. Understanding clinical activities is important in fall prevention but a better understanding of older adult characteristics that increase fall-risk, and attitudes that may affect their adoption of evidence-based interventions could improve the effectiveness of prevention strategies. The five presentations in this session include: 1. Demographic, health and functional characteristics of older adults with increased fall risk. 2. Caregivers of people with chronic conditions or disability as a group with increased fall risk. 3. The most effective and efficient ways of identifying older adults with increased fall risk. 4. Facilitators and barriers to older adults’ adherence to evidence-based fall interventions. 5. Applying knowledge of older adult attitudes to improving an implementation of STEADI-based fall prevention. Multifactorial fall prevention strategies such as STEADI focus on the clinical aspects of fall prevention but their success depends on understanding and incorporating older adult characteristics and attitudes. The information presented in this session can inform fall prevention strategies and improve health.