bluuebunny/crossref_metadata_2025_split huggingface dataset:
TECHNOLOGY TRANSLATING THE RELATIONSHIP BETWEEN QUALITY OF LIFE AND MEMORY USING A NOVEL EEG TECHNOLOGY
Authors: Roberts Mitchell , Kehat Orli , Gross Michaela , Lasri Nethanel , Issachar Gil , VandeWeerd Erica Sappington , Peremen Ziv , Geva Amir 
Published: November 2019

Abstract
Existing research has postulated a relationship between cognition and quality of life (QoL). Components of QoL such as satisfaction with social support may be particularly influential in memory for those with comorbidities. Additional research is needed to characterize the relationship between memory and QoL domains. Findings are presented from a clinical trial using BNA memory scores to assess brain health. BNA uses EEG technology and machine learning to map networks of brain functioning including working memory. Participants were older adults living in The Villages, an active lifestyle community in Florida, between the ages of 55-85, from 8/30/2017-3/11/2019. Participants were stratified into 2 groups: healthy (no CNS/psychiatric conditions; n=158) and multi-morbid (&gt;1 CNS and/or psychiatric conditions; n=106) and compared across memory and QoL indicators. Subjective QoL was measured by the WHOQOL-BREF across 4 domains (physical, psychological, social, environmental). Scores on QoL domains were divided into 3 levels (high-medium-low) and tested for their relationship to BNA memory scores using ANOVA. Results indicate a relationship between health status, subjective QoL and BNA memory scores. Healthy subjects who scored high in the psychological QoL domain had significantly higher memory scores [F(2,152)=4.30,p=.02)]. In healthy subjects, satisfaction with social support (p=.001) had the strongest impact on memory for social QoL, while body image (p=.06) and concentration (p=.06) were the most salient predictors of psychological QoL and approached significance. Multi-morbid subjects who indicated high social ratings had higher memory scores (F(2,100)=3.75,p=.03) which relied heavily on satisfaction with social support (p=.003). Implications for policy and practice are discussed.
DETECTION OF FORWARD PROPULSION USING A SINGLE ACCELEROMETER DURING WALKING IN OLDER POPULATION
Authors: Zahiri Mohsen , Najafi Bijan , Nguyen Hung , Kang Gu Eon 
Published: November 2019

Abstract
In the geriatric population, diminished ankle joint moment and weak plantar flexor can contribute to inadequate forward propulsion and negatively impact gait performance, which can lead to poor energetic efficiency. Detection of propulsion phase can help identify gait normality and guide rehabilitation therapy to improve functional performance. Current methods have limited application in daily life and unsuitable for continuous monitoring. In this study, we aim to develop algorithms based on a single sensor attached to the shin to accurately detect propulsion phase. Six elderly (age: 73 years, BMI: 30.4) were recruited. Participants walked at their normal pace while wearing a plantar pressure system and an accelerometer on the shin. The pressure data was used to define the beginning of the propulsion phase when the pressure switched from the heel to the forefoot. A wavelet algorithm was developed to automatically detect the start and end points of propulsion phase using an accelerometer. The Bland-Altman method was used to evaluate the agreement between these methods. Pearson’s Coefficient was used to quantify the correlation. Based on the Bland-Altman analysis, A high agreement was obtained between the proposed method using accelerometer and pressure sensor (bias =9 ms, precision = 30 ms). Both algorithms are significantly correlated (r = 0.85, p&lt;0.05). This study presents an innovative algorithm to automatically detect the propulsion phase for older adults during walking. Using wearable could facilitate the capture of propulsion phase during living activity, which might provide more insights into the mechanism of walking during rehabilitation therapy.
WEARABLES REVEAL A GAP BETWEEN GAIT PERFORMANCE IN THE LAB AND DURING 24/7 MONITORING IN OLDER ADULTS
Authors: Hillel Inbar , Avanzino Laura , Cereatti Andrea , Rikkert Marcel Olde , Din Silvia Del , Ginis Pieter , Mirelman Anat , Hausdorff Jeffrey M 
Published: November 2019

Abstract
We compared in-lab usual-walking (UW) and dual-task walking (DTW) to daily-living measures of gait obtained during 24/7 monitoring. In-lab gait features (e.g., gait speed, step and stride regularity) derived from UW and DTW were compared to the same gait features during daily-living in 150 elderly fallers (age: 76.5±6.3 years, 37.6% men). Features were extracted from a lower-back accelerometer. In daily-living setting, subjects wore the device for one week and pre-processing detected 30-second walking bouts. A histogram of all walking bouts was determined for each walking feature for each subject, then each subject’s typical, worst and best values were determined. Statistics of reliability were assessed using ICC and Bland-Altman. As expected, in-lab gait speed, step regularity, and stride regularity were worse during DTW, compared to UW. Gait speed, step regularity, and stride regularity during UW were significantly higher (i.e., better) from the typical daily-living values (p&lt;0.0001) and different (p&lt;0.000) from the worst and best values. DTW values tended to be similar to typical daily-living values (p=0.205, p=0.053, p=0.013 respectively). ICC assessment and Bland-Altman plots indicated that in-lab values do not reliably reflect the daily-walking values. Gait values during relatively long daily-living walking bouts are more similar to the corresponding values obtained in the lab during DTW, as compared to UW. Still, gait performance during most daily-living walking bouts are worse than that measured in-lab and do not reliably reflect each other. That is, an older adult’s typical daily-living gait cannot be estimated by simply measuring walking in a structured, laboratory setting.
ALEXA, ASSESS MY MEMORY: THE FEASIBILITY OF EXTENDED HEALTH MONITORING IN AN OLDER-ADULT-LIVING COMMUNITY
Authors: Davis Jensen , Howard Shannon , King Gregory , Boddu Phanidar , Jyothi Kiran , McDowd Joan 
Published: November 2019

Abstract
The goal of most older adults is to live independently in their own homes, for as long as possible. There are many advantages to aging in place for the individual, but also challenges as changes in cognitive and physical health can occur over time. Especially for older adults living alone, tracking these changes is critical for early intervention and prevention. The relatively easy availability of consumer technology may provide one mechanism for monitoring older adults in their homes. We designed a pilot study to test the feasibility and acceptability of using wearable sensors (Fitbit sensors), in conjunction with automated interactive voice recognition technology (Amazon Echo), to monitor older adults’ physical and cognitive health during daily activities. Participants (7 females, 2 males; 65-80 years of age) were recruited from a housing complex for older adults with low income. They were interviewed about health monitoring technology before and after a 2-week measurement period during which they were expected to wear the Fitbit daily and interact with the Amazon Echo for 8 consecutive days. Feasibility challenges included limited skill in Echo interactions, remembering to do the assessments, and charging/uploading Fitbit data. Qualitative analysis of interviews revealed generally positive attitudes about technology, but low comfort operating the devices. These preliminary findings suggest that with additional training for older adults, sensors and voice recognition technologies could have significant roles in maintaining older adult quality of life by contributing to early detection of decline and timely intervention.
NURSING HOME TELEED INTERVENTION: ADVANCING NEW CARE MODELS
Authors: Quinn Charlene C , Roggio Anthony , Erik Barr , Gruber-Baldini Ann 
Published: November 2019

Abstract
New reimbursement and managed care models demonstrate the need to reduce avoidable Emergency Department (ED) use and limit preventable inpatient admissions for older adults in Skilled Nursing Facilities (SNF). The objective was to develop an ED telemedicine consultation intervention for SNF residents with acute medical problems. Secondary objectives including evaluation of health care utilization, provider satisfaction. Demonstration evaluation in three urban SNFs, telemedicine linked to university medical center ED. Mobile telemedicine cart equipment assessed SNF residents for any change in condition. ED physicians used tablets with secure access to conduct the resident assessment. Provider satisfaction measures imbedded in EMRs were completed at consultation visit end. 460 patients had changes in condition, 327 resulted in 911 calls, 85 deemed eligible for telemedicine consult. Conducted 57 telehealth consults. Forty (70%) telemedicine consult residents remained in the SNF. Fourteen residents were transferred to the ED. Average satisfaction scores were 5.8/7 for SNF nurses (n=49) and 5.6 for ED physicians (n=45). Lower-rated items related to technical equipment problems. ED physicians reported residents transferred to ED after telehealth visit had better continuity of care. The intervention was effective in preventing or delaying transfer of acutely ill, medically complex SNF residents. Implementation of the intervention identified need for SNF admission policy and procedure changes; weekly telemedicine training; SNF clinical advocates; on-site tracking and linkage of EMRs across providers; HIPAA shared medical record concerns. Future research plans include analyses of detailed SNF resident characteristics and business case assessment for reduction of transfers, ED and hospital utilization.
DOES WEARING AUGMENTED-REALITY GOGGLES AFFECT OLDER ADULTS’ KINEMATICS DURING GAIT?
Authors: Vieira Edgar R , Estrazulas Jansen , Civitella Fernanda , Carreno Jorge , D’Souza Newton , Ozer Ebru , Ortega Francisco 
Published: November 2019

Abstract
Virtual-reality (VR) testing can cause motion sickness and impair safety, especially for older adults, but augmented-reality (AR) may allow the testing of holograms embedded into a mixed-reality environment without the VR impediments. However, wearing AR googles may affect the way people walk, but this possibility has not being tested. The objective of this study was to evaluate if wearing AR googles during gait would affect the kinematics of older adults. Ten older adults (68±5 years), who could walk without assistive devices, participated in this study. The participants walked outdoors in a public park with and without the AR googles. The participants were instrumented inertial movement units to track their kinematics (MTw Awinda trackers, Xsens Technologies B.V., Enschede, the Netherlands). The goal of the study was to assess if simply wearing the googles would affect gait, therefore no holograms were displayed. Ten gait cycles were analyzed and the mean of each subject was used to compare the joint kinematics between the conditions (with vs without googles) using T-tests in SPSS 18. The foot, ankle, knee and hip angles were not different between the conditions (p&gt;0.05), but there were significantly less trunk flexion at 44% of the gait cycle (p=0.035) and less forward head flexion throughout the gait cycle (p=0.023) when the participants were wearing the googles vs. when they were not. The findings indicate that wearing AR goggles changed the trunk and head posture cycle, but did not affect the lower limb kinematics during gait.
ASSESSING THE IMPACT OF A GAME-CENTERED MOBILE APP ON COMMUNITY-DWELLING OLDER ADULTS’ HEALTH ACTIVATION
Authors: Crandall Jason , Shake Matthew , Ziegler Uta 
Published: November 2019

Abstract
The objective of this investigation was to evaluate the impact of a game-centered mobile app (Bingocize®) on older adults’ knowledge, skill, and confidence for managing aspects of their healthcare. Rural community-dwelling older adults (N=85) with mobility, not engaged in any structured exercise program, used the app in a group setting for 10 weeks, twice per week, for one hour. Participants were randomly assigned to (a) a version that included health education, or (b) health education and an exercise component. The Patient Activation Measure (PAM-10) was used to assess group changes in knowledge, skill, and confidence for managing aspects of their healthcare. Two (Group: Exercise + Health Education vs. Health Education-only) x Two (Time: Pre- vs. Post-intervention) analyses of variance, with significance p&lt;.05, was used for statistical analysis. Results: PAM-10 values significantly increased from pre- to post-intervention for both groups, as did knowledge of the health topics (all p &lt; 0.05). Attendance was &gt;93% in both groups. Bingocize® engendered high attendance and improved health activation of older adults; however, additional research is needed to examine whether changes in activation result in long-term changes in health behavior. The Bingocize® mobile app is an enjoyable and effective way to increase health activation in community-dwelling older adults.
DO WELFARE RECEIPTS CROWD OUT PRIVATE TRANSFERS FROM FAMILIES AND FRIENDS? EVIDENCE FROM PANEL DATA IN CHINA
Authors: Zhang Yalu 
Published: November 2019

Abstract
Many countries are undergoing an unprecedented challenge to provide financial support to the older generation and guarantee their livelihood and wellbeing. China is no exception. Rural older adults in China have been becoming even more vulnerable to lack of care and inadequate financial resources as the growth of urbanization and labor migration has intensified. Therefore, it becomes increasingly difficult to follow the traditional family support model for the aged. Using the panel data of the China Health and Retirement Longitudinal Study 2011, 2013, and 2015 and a system generalized methods of moment (GMM), this paper examined the dynamic relationship between welfare receipts and monetary transfers from families and friends among rural and urban older adults (n=9,496) in China. The results show that the welfare receipts do not induce any “crowd-out” or “crowd-in” effects on rural older adults’ private transfer receipts. The incidence and amount of private transfers that occurred among rural older adults are more likely to be determined by the private transfers they received in prior waves. The intensity of catastrophic health expenditure itself does not affect the occurrence and size of private transfers. This study, on the one hand, confirms that among rural recipients, public transfers do not substitute private transfers, which most of the policymakers have long been concerned about. However, on the other hand, it also reveals the shortcoming of current public transfer policies—the generosity of public transfers does not enable rural older adults to be financially independent of intra-family transfers.
PROTECTIVE FACTORS IN THE CONTEXT OF SUCCESSFUL AGING IN URBAN-DWELLING ALASKA NATIVE ELDERS
Authors: Kim Steffi M , Lewis Jordan P 
Published: November 2019

Abstract
Recently, researchers have been exploring successful aging in rural communities of Alaska as it is experienced by Alaska Native Elders. Due to outmigration based on economic, medical, or familial influences, many Alaska Native elders leave their home communities to live in urban settings in Alaska, even though research suggests that most elders would like to remain in their home communities to grow old. Very little is known about the relocation process and how it impacts an elder’s views on successful aging. While established protective factors in rural communities involve family and extended family members, community, subsistence, and traditional activities, there is little knowledge of which protective factors exist in urban settlements supporting successful aging. This exploratory, qualitative study presents the protective factors of successful aging in the context of relocation of Alaska Native Elders from rural to urban dwellings. A life course approach and discourse analysis were used to analyze individual interviews asking how Alaska Native Elders experienced relocation and how successful aging was experienced similarly and differently in rural and in urban settings. A community-based participatory approach allowed for collaboration between researchers and communities as equal partners at all phases of the process, both contributing their expertise to enhance understanding of successful aging and supportive factors. Access to informal supports and meaningful community engagement were more important to rural Elders, and access to health care services and family engagement were important to Elders in urban communities. Challenges remain for Elders in urban environments to establish a sense of community.
THE IMPACT OF A PARO INTERVENTION ON DEPRESSION AND WELL-BEING IN OLDER ADULTS WITH DEPRESSION
Authors: Chen Shu-Chuan , Moyle Wendy , Jones Cindy 
Published: November 2019

Abstract
Aim: This study aimed to explore the effect of a social robot Paro intervention on depression and well-being in older adults with depression living in long-term care facilities in Taiwan. Methods: This study was adopted a single group and quasi-experimental with repeated measures design. Each participant participated in two stages: observation and Paro intervention stages. Stage 1 was an 8-week observation stage in long-term care facilities where the purpose was to observe the normal mood, behaviour and activities of older adults with depression. In stage 2, each participant was given a Paro by the researcher to keep for 24 hours for 7 days in for 8 weeks. Outcome measurements were obtained 4 times: a week before the intervention (T1), immediately the end of 8-week observation (T2), mid-point of Paro intervention (T3), and immediately the end of 8-week Paro intervention (T4). Instruments included the Geriatric Depression Scale, the UCLA Loneliness Scale version 3, and the World Health Organization Quality of Life Questionnaire-OLD. Results: There were 20 participants completed the study. The mean age of participants was 81.1years (SD = 8.2). After 8-week Paro intervention, statistically significant differences in changes were found on depression, loneliness, and quality of life from pre-intervention to post-intervention. Conclusion: This study was found that Paro intervention has beneficial effects on depression and mental well-being for older people with depression in long-term care facilities. Paro Intervention might be a suitable psychosocial intervention for older people with depression and should be considered as a useful tool in clinical practice.
ADMISSION AND CARE OF INDIVIDUALS WITH MENTAL ILLNESS IN MASSACHUSETTS NURSING HOMES: A PILOT STUDY
Authors: Barooah Adrita , Nadash Pamela 
Published: November 2019

Abstract
Due to the rising prevalence of mental illness in nursing homes (NHs), the US Congress passed the 1987 Pre-Admission Screening and Resident Review (PASRR) mandate, which aims both to limit inappropriate institutionalization of people with mental illness and to ensure that they are served appropriately when living in NHs. Although the PASRR is a federal mandate, states have considerable flexibility in implementing it, resulting in considerable variation across states. This study explores the Commonwealth of Massachusetts’ policies on admission and care of individuals with mental illness in NHs, focusing on implementation of PASRR regulations. Semi-structured phone interviews were conducted with key informants identified through purposive snowball sampling (N=8). Key informants included representatives from NHs, the State Mental Health Authority, state Medicaid office, and independent contractors and an academic expert. Data were analyzed using qualitative content analysis. Participants agreed that the PASRR tools efficiently identified and screened people with mental illness -- thus achieving PASRR’s first aim, but that the regulations did not successfully ensure appropriate services. Interviewees also identified a lack of services and options for diversion of people with mental illness into the community. Nursing home informants noticed a disconnect between the various supervising departments and felt instructions were unclear on the administration of the tool. This work builds a case for a national study to understand how PASRR implementation varies across states, resulting in variations in the proportion of people with mental illness admitted and served in NHs.
VALIDATING THE PREFERENCES ASSESSMENT TOOL FOR NURSING HOME RESIDENTS USING ITEM RESPONSE THEORY
Authors: Duan Yinfei , Ng Weiwen , Shippee Tetyana P 
Published: November 2019

Abstract
The Preference Assessment Tool (PAT), part of the Minimum Data Set (MDS), assesses residents’ preferences to enable preference-based care in nursing homes (NHs). The two PAT sections including daily routine preferences and activity preferences are assumed to measure autonomy and meaningful activities as the underlying constructs associated with residents’ psychosocial needs. Yet, the validity of this assumption has not been tested. This study examines PAT’s construct validity using item response theory. We fitted graded response models to the two PAT sections using 2017 MDS annual assessments of 8,829 long-stay residents in 291 Minnesota NHs. Most items discriminated well between residents who had at a low versus high intensity of these two types of psychosocial needs (i.e. have discrimination parameters &gt; 1). Two daily routine preference items (family’s involvement in care planning, and having snacks), and three activity preference items (having pets, keeping up with news, and reading) had poor discrimination in measuring autonomy and meaningful activities respectively. Overall, the PAT appeared to be more sensitive in measuring the lower middle range of the two constructs. We estimated the correlation between the two constructs as 0.65. In conclusion, the PAT performs fairly well in measuring the two types of psychosocial needs for NH residents. Nevertheless, more items are needed to capture a broader range of psychosocial needs beyond autonomy or basic leisure activities. The findings of this study brought attention to the utility of the PAT in measuring residents’ psychosocial needs and in guiding resident-centered care.
KEEPING COOL IN FLORIDA ASSISTED LIVING COMMUNITIES: BARRIERS TO POWER RULE IMPLEMENTATION
Authors: June Joseph , Dobbs Debra J , Dosa David , Peterson Lindsay J , Hyer Kathryn 
Published: November 2019

Abstract
In 2018, in response to deaths of nursing home residents after Hurricane Irma, Governor Scott and the Florida legislature enacted an emergency power rule for nursing homes and assisted living communities (ALCs). It mandates these settings to have a generator to regulate ambient air temperatures during loss of primary power by Jan. 1, 2019. However, due to cost and supply challenges the implementation of these plans has been difficult, particularly for small and independently owned ALCs. The purpose of this mixed methods study is to determine the characteristics of ALCs that were able to comply with the rule and concerns raised by ALC administrators. Using data from state regulatory agencies on all Florida ALCs (N=3082), we determine associations between ALC characteristics (size, specialty license, low-income residents) and non-compliance to the rule, using chi-square and t-tests. Additionally, we conducted interviews and focus groups with ALC administrators (N=60) about issues of implementing their emergency power plan. A content analysis approach was used and Atlas.ti v7 was used for initial and axial coding. Some prevalent themes were issues with time frames, coordination between local and state regulations, and financial burden. Themes varied by size and organizational structure of ALCs. Results will inform policy-makers on the barriers faced by ALCs to implement a new regulation that may cause financial difficulties and compromise quality care. This study has implications related to disaster preparedness regulations and their effects on independent ALCs with fewer financial resources.