bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learner Attitudes on Interprofessional Education Through Formal Interprofessional Case Discussions
Authors: Halli-Tierney Anne , Carroll Dana , McKinney Robert , Allen Rebecca 
Published: December 2020

Abstract
Interprofessional education case sessions allow learners to apply discipline-specific knowledge to real-life scenarios through facilitated discussion of a patient case. Our interprofessional case discussion was implemented for learners to develop care plans for complex geriatric patients; learners have intentional time to learn with, from and about each other’s roles in geriatric patient care. Cases were de-identified from actual complex patients seen in geriatrics clinic. All learners receive the case and work through it from their discipline’s perspective, then join a facilitated group discussion to develop collaborative care plans. At session end participants are surveyed using the ICCAS and qualitative comments about perceptions on interprofessional case learning. Thirty-five learners (47%) completed the feedback survey. Disciplines represented were medicine, pharmacy, psychology and social work. Thirty learners (85%) indicated the case discussion session was very educational (n=22, 62%) to educational (n=8, 23%). Themes used most frequently regarding what was most educational were: “different professional approaches”, “professional roles”, “collaboration” and “problem solving”. Typically, learners were unable to identify “least educational” components to the activity, but some learners found the pace of information presentation too rapid or felt other professionals did not provide enough context for the suggestions they made for the case. Suggestions to improve the interprofessional case discussion activity included increased “time for discussion and consensus building”, more session structure, and addition of other professionals (e.g., nutrition, law). The majority of interprofessional learners participating in interprofessional case sessions have found them to be educational. Feedback from learners aligns with goals of interprofessional education.
Does the Coexistence of Food Insecurity and Obesity in Older Adults Explain Variations in Glycated Hemoglobin?
Authors: Chukwurah Queendaleen 
Published: December 2020

Abstract
Obesity and food insecurity are known public health concerns for older adults, and both are independent predictors of glycated hemoglobin (HbA1c). I examined the impact of the co-existence of food insecurity and obesity on HbA1c using the National Health and Nutrition Examination Survey (NHANES), 2005-2014. Body mass index /waist circumference (WC) cut- off values were used to create six body types: normal weight with normal WC, overweight with normal WC, obese with normal WC, normal weight with high WC, overweight with high WC, and obese with high WC. HbA1c was defined as normal &lt; 5.7% and abnormal &gt;5.7%. Food security status (FSS) was defined following USDA protocols (food secure-FS, food insecure-FI). The sample population included 5,772 participants 50 years and older with mean (SD) age of 61.8 (0.2). A weighted multivariable logistic regression controlling for age, gender, race/ethnicity, education, and poverty-to-income ratio was run for this analysis. The proportion of older adults with both FI and obesity with high WC (51.1%, p&lt;0.0001) was significantly higher than those FS (37.5%). Logistic regression model with body types and FSS had a maximum-rescaled R-square (MRRS) of 0.147 vs. 0.093 and 0.144 for FSS and body types alone. An increase in MRRS in the model with both body types and FSS compared to the models containing only body types or FSS demonstrates an improved model for fitting abnormal HbA1c levels. The knowledge of this effect may benefit health risk assessment and management in this population.
Predicting Perceived Health of Older Adults: The Role of Health, Personality, and Resilience
Authors: Arieli Rotem , Kim Joseph , Martin Peter 
Published: December 2020

Abstract
Past research has not addressed how domain-specific “health” personality traits are associated with resilience and well-being. The purpose of this study was to determine pathways from health personality to perceived health, mediated by resilience. Data included 3,907 participants, 65 and older, collected by a large provider of Medicare Supplemental Health Insurance. The Health Personality Assessment (health neuroticism, health extraversion, health openness, health agreeableness, and health conscientiousness), Brief Resilience Scale, and perceived health were measured. Structural equation modeling and bootstrap mediation were conducted in Mplus. The hypothesized model resulted in a marginal fit, so direct paths from health openness and health conscientiousness to perceived health were added, resulting in an improved fit, χ2(192)=1660.96, RMSEA=.04, CFI=.95; χ2∆(2)=403.99, p&lt;.001. Health neuroticism and health extraversion negatively predicted perceived health, fully mediated by resilience, β=-.11, p&lt;.001, and β=-.01, p&lt;.05, suggesting that people anxious about their health or that talk about their health had significantly lower levels of resilience. Resilience positively predicted perceived health, indicating that more resilient people reported better health. Higher levels of health openness predicted significantly lower levels of perceived health, β=-.19, p&lt;.001. Greater levels of health conscientiousness predicted better perceived health, β=.20, p&lt;.001, and resilience in-turn positively related to perceived health, β=.08, p&lt;.001. Health personality and resilience explained 25.3% of variance in perceived health. This study exemplifies the importance of health personality and resilience in predicting perceived health for older adults. Future research should examine interventions focused on health personality increasing resilience, as older adults with higher resilience reported significantly better health.
Clinical Screening for Lower Limb Muscle Weakness in Community-Dwelling Older Women
Authors: Abreu Daniela , Porto Jaqueline 
Published: December 2020

Abstract
The objective of the present study was to evaluate the ability of the five times sit to stand test (5TSST), grip strength (GS) and step test (ST) to detect older women with reduced lower-limb muscle strength (LLMS), and to investigate the clinical usefulness of the combination of such tests. One hundred and nineteen older women were submitted to the 5TSST, GS, ST and lower limb peak torque by an isokinetic dynamometer. The capacity of the clinical tests to detect older women with reduced LLMS was measured using the ROC curve, followed by calculation of posttest probability (PoTP). The results show that a ST score of 0.24 cm per cm of participant’s height shows the best PoTP for a positive test (72%). However, the combination of the ST and 5TSST enhances the accuracy from 48% (prevalence of weakness in the population) to 82.6% if both tests are positive, and decreases the PoTP from 48% to 11.4% if both tests are negative. The inclusion of GS provided additional benefits of small magnitude. In conclusion, the ST performed alone or in combination with 5TSST could be an alternative for clinical screening of LLMS reduction in older women. The early identification of impairment of lower-limb muscle strength in independent older adults may favor early intervention and prevention of negative outcomes such as falls and functional limitations.
The Association Between Personality and Homebound Status in Older Adults: Results From the NHATS
Authors: Sun Xiaocao , Liu Minhui , Miyawaki Christina E , Li Yuxiao , Hou Tianxue , Tang Siyuan , Szanton Sarah 
Published: December 2020

Abstract
Personality is associated with predictors of homebound status like frailty, incident falls, and depression. It has been rarely investigated whether personality predicts homebound status among older adults. Using the combining cross-sectional data of the Year 2013 and Year 2014 data from the National Health and Aging Trends Study (NHATS), this study examined the association between personality traits and homebound status in a sample of community-dwelling older adults aged 65 years and older (N=2,788). Homebound status (non-homebound, semi-homebound, and homebound) was determined by the frequency, difficulty, and help of outdoor mobility. Personality traits, including conscientiousness, agreeableness, openness, extraversion, and neuroticism were assessed using the 10-item Midlife Development Inventory on a rating scale from 1 (not at all) to 4 (a lot). Each personality trait was included as a predictor in an ordinal logistic regression model to examine its association with homebound status after adjusting demographic and health-related covariates. The sample was on average 79±7.53 years old, non-Hispanic White (72.0%), female (58.6%), living alone (35.4%) or with spouse/partner only (37.4%). Seventy-four percent, 18%, and 8% of participants were non-homebound, semi-homebound, and homebound, respectively. Homebound participants tended to be less-educated older females. The average scores of conscientiousness, agreeableness, openness, extraversion, and neuroticism were 3.19±0.75, 3.57±0.56, 2.81±0.83, 3.13±0.75, and 2.22±0.86, respectively. Among these five personality traits, high conscientiousness (OR=1.34, p&lt;0.001) and extraversion (OR=1.16, p=.03) were associated with a reduced likelihood of being homebound. These findings provided a basis for potential personality assessment to identify and protect individuals with high homebound risk.
Evaluation of Race as a Predictor of Fear of Falling in Black Older Adults
Authors: Washington Selena , Stark Susan , Synder Makenna , Hu Yi-Ling , Minor Brittany 
Published: December 2020

Abstract
Fear of falling (FOF) is a common issue and health concern reported by adults 65 years of age and older.There is mixed evidence about potential disparity in fall incident rates due to race and FOF, and it is unclear if and under what circumstance falls rates and risks differ by racial ethnicity. The purpose of this study is to determine if race predicts fear of falling in older adults at greater risk for falls; and to examine the relationship between activities of daily living (ADL) and mobility performance measures with FOF. A cross-sectional observational study was used to examine predictors of FOF among community dwelling-older adults using data from two longitudinal randomized clinical trials (RCT). Participants (N=259) had a mean age of 75.7 ±7.4, 78.8% female, 80.64% Black, and 77.03% White or Other, with ≥ 1 fall in the last 12 months. Subjects completed a demographic profile; the Tinetti and Short Falls Efficacy Scale to assess FOF; and activities of daily living (ADL) and mobility performance scales to assess function. The chi square analysis revealed Black older adults were two times more likely to report FOF (OR = 2.17, 95% CI = 1.14, 4.15; p=.05) in comparison to White older adults. The regression analysis demonstrated that race is a significant factor to predict FOF (OR = .67, 95% CI = 1.21, 3.24; p=.05); and the descriptive analysis revealed significantly worse ADL and mobility function scores within the high FOF group.
The Association of Early-Morning Eating Habits With High Nutrient Intake by Older Japanese Adults Living Alone
Authors: Matsuoka Yoko , Zhang Junhua , Lyu Weida , Aoyagi Kei , Takase Mai , Ogino Ryogo , Goto Jun 
Published: December 2020

Abstract
The consumption of essential nutrition is fundamental to maintain the health of older adults. Conventional studies report that community dwelling older adults who live alone have the tendency to skip meals and result in low nutrition intake. However, the details regarding the dietary behavior and its association with the status of nutrition intake remain unclear. In this study, a cross-sectional analysis was conducted to explore the association between the time of meals and nutrition balance. In October 2019, questionnaire surveys were distributed to 184 participants of a lunch event dedicated to older adults living alone (Kashiwa, Japan). The time of meals, number of meals per day, consumption status of 10 food groups, and self-rated health were used for the analysis (N=165). As a result, older adults who usually ate their first meal between 5 to 8 A.M. ate three meals/day, while those who ate their first meal after 8 A.M. ate two meals/day. Those who ate their meal between 5 to 8 A.M., frequently consumed meat, fish and seafood, milk, and green and yellow vegetables compared to those who ate after 8 A.M. Self-rated health score was also high. The consumption of early-morning meals was associated with good dietary behaviors. The importance of eating breakfast has been emphasized, however, the time of the breakfast could vary among individuals. This study proposed the importance of considering the time of the meal. Development of intervention programs which encourage early-morning meal consumption might be helpful to form healthy dietary behaviors of older adults.
Impact of Culture and Religion on End-of-Life Decisions Among Advanced Cancer Patients in Developing Countries
Authors: Johnson Justina Yevu , Popejoy Lori 
Published: December 2020

Abstract
Palliative care and end of life decisions are important components of quality care at the end-of-life. Individual’s perception of cancer diagnosis is affected by their customs and traditions, religious orientations and stigma. Culture and religion as a social determinant of health affects people’s interpretation of health and illness and is a major factor in deciding the type of care at end of life and death. The purpose of the review was to identify factors related to culture and/or religion that impact decision making at end of life among advanced cancer patients their primary family caregivers and healthcare providers. An extensive literature search was conducted in Psych Info, PubMed, Philosophy Index, Atlas Religion, and Academic Search Premier databases for primary studies on the topic. Primary studies conducted only in developing countries and among healthcare providers, advanced cancer patients and their primary family caregivers were included. Five studies met the inclusion criteria: two primary studies, one methodological paper, and two on perspectives. The studies reported economic status of the patient, family, culture, and religious beliefs as factors that affected decision making at the end of life. Improving cancer care in developing countries requires the accommodation of the culture, traditions, and religious beliefs of both healthcare providers, patients and family. Culturally appropriate care model is therefore needed to enhance palliative and end of life care in developing countries. Leininger’s Cultural Care Theory seem an appropriate path to take.
Midlife Plasma Aβ and Late-Life Risk of Cognitive Impairment: The Atherosclerosis Risk in Communities Study
Authors: Sullivan Kevin , Blackshear Chad , Sharrett A Richey , Gottesman Rebecca , Knopman David , Windham B Gwen , Griswold Michael , Mosley Thomas 
Published: December 2020

Abstract
Plasma-based biomarkers of amyloid beta (Aβ), a neuropathological hallmark of Alzheimer’s disease, show promise in predicting cognitive impairment and mapping onto cerebral amyloidosis, but little is known about how midlife plasma Aβ associates with late-life cognitive outcomes. Midlife plasma variants Aβ42 and Aβ40 were measured using a fluorimetric bead-based immunoassay in a subsample of visit 3 ARIC participants (1993-95; n=2585, mean age=59.4±5.2, 57% female, 23% African American). We investigated the relationship between midlife plasma Aβ and late-life mild cognitive impairment (MCI; n=923) and dementia (n=628) diagnosed from 2011-19. Multinomial logistic regressions estimated relative risk ratios (RRR) of MCI, dementia, and death vs normal cognitive status as a function of:(1) Aβ42:Aβ40 ratio, (2) Aβ42 and Aβ40 included as separate terms, and (3) Protected Aβ group (participants with Aβ42≥46 pg/ml and Aβ40 &lt;233 pg/ml). Adjusters included age, sex, education, site-race, and APOE4. Every doubling of midlife plasma Aβ42:Aβ40 up to a threshold of 0.20 was associated with 41% lower risk of developing MCI/dementia in comparison to cognitively normal (RRR=0.59 [95% CI:0.42, 0.82]), with no association for ratio values ≥0.20. Every standard deviation increase in plasma Aβ42 was associated with 17% lower risk of dementia (RRR=0.83 [0.70, 0.99]), whereas every standard deviation increase in plasma Aβ40 was associated with 16% higher risk of MCI (RRR=1.16 [1.02, 1.31]). The protected midlife plasma Aβ group had 86% lower risk of late-life dementia vs all others (RRR=0.14 [0.04, 0.47]). Early measurement of plasma Aβ may prove an accessible and effective population screener for future cognitive impairment.
Perspectives of Family Caregivers Confronted With Care-Resistant Behavior From Persons With Dementia
Authors: Jablonski Rita , Winstead Vicki , Geldmacher David 
Published: December 2020

Abstract
Problem: Care-resistant behavior is often bundled with other behavioral symptoms of dementia, but it is a unique behavior requiring targeted interventions. Purpose: To describe the experiences of caregivers receiving online coaching to manage care-resistant behaviors exhibited by persons with dementia. Design: Qualitative. Sample & Procedure: 20 caregivers (12 female, 8 male) were recruited from Memory Disorders and Geriatrics clinics to participate in 6 weeks of online coaching sessions delivered by a doctorally prepared nurse practitioner. Coaching sessions were recorded and transcribed. NVivo12 software was used to manage the thematic analyses. Results: Caregivers followed a general trajectory. They initially reported feelings of anger, frustration, and guilt. They believed that the person with dementia was purposefully “being stubborn and mean.” As the coaching sessions progressed, these negative emotions and the attributions of intent altered. By the conclusion of the six weeks, caregivers expressed feelings of success and ingenuity in applying coaching strategies. Conclusion: Online coaching is an effective way to individualize strategies that enable the caregiver to manage and reduce care-resistant behavior. Implications: The use of a doctorally-prepared nurse practitioner to deliver coaching, while effective, is not sustainable. Next steps include developing a coaching training program that could be embedded into existing community resources for community-dwelling caregivers. Limitations: Participants were limited to referrals from two clinics in the same institution.
Emory Roybal Center for Dementia Caregiving Mastery: Diverse Responses to Letter of Intent Call
Authors: Hepburn Kenneth , Perkins Molly , Waldrop Drenna , Aflatoony Leila , Song Mi-Kyung , Clevenger Carolyn 
Published: December 2020

Abstract
This new NIA-supported Roybal Center seeks to support Stage 1 pilot clinical trials of programs aimed at promoting caregiving competence and confidence in the great heterogeneity of dementia caregiving contexts. During our first cycle, we received 26 letters of intent (LOI) for full applications. Responses reaffirmed the Center’s premise that dementia caregiving is remarkably varied in nature. While most proposed programs focused on generic caregiving, a number addressed caregiving issues facing specific ethnic/racial groups (African American; Korean American; Native Alaskan/American Indian; Latino), and several focused on specific dementing conditions (MCI, Lewy Body Dementia,TBI-based dementia). Most described programs centered on knowledge development and daily management skill issues (e.g., management of behaviors); others specified development of physical care skills. Decision-making and communication constituted the second most common topic. Over 40% proposed adaptation of existing programs; more than 25% proposed apps or technology interventions. Investigators represented a wide range of disciplines: 45% each from Health sciences (nursing, medicine, and social work) and Social/Behavioral sciences (principally psychology) and the rest from engineering and communications. LOIs varied most in their readiness to complete a clinical trial within a year. About 40% were in very preliminary stages; 25% were clearly poised for a Stage 1 trial; 15% did not sufficiently address the Center’s aims. Key criteria for invitations to submit full applications (n=4) included: specificity of context; clinical trial readiness; reasonableness of proposed adaptation. These criteria should guide future LOIs addressing the diversity of important new research and intervention perspectives on the multifaceted work of caregiving.
Dual-Task Gait Cost and Frontal Lobe Integrity in Poststroke: Results From ONDRI
Authors: Pieruccini-Faria Frederico , McLaughlin Paula , Cornish Benjamin , Binns Malcolm , Bartha Robert , McIlroy Bill ,   ONDRI Collaborators, Odasso Manuel Montero , Faria Frederico 
Published: December 2020

Abstract
Dual-task gait performance is a marker of motor-cognitive interactions modulated by the frontal lobes. After a stroke, gait disturbances are more evident, particularly when concurrently completing a mental task and walking, an effect called high dual-task cost (DTC). Following a stroke, the potential association of high-DTC, integrity of the frontal lobes and cognitive functioning is unclear. This study screened 161 participants with stroke history from the Ontario Neurodegenerative Disease Research Initiative (ONDRI)-cerebrovascular disease cohort (69.2±7.41 years of age; 31.7% women). Individuals scoring zero in the National Institute of Health Stroke Scale were analyzed (n=102). DTC was the percentage change in gait speed from the single to dual-task condition. Standardized normal-appearing white matter (NAWM) and grey matter (NAGM) volumes from superior, middle and inferior frontal lobe were compared between DTC quartiles (adjusted for age, sex, and education) using a multivariate model (MANOVA), with total frontal lobe volume as a covariate. Another model compared group performance across 5 adjusted cognitive domains (attention, memory, language, visuospatial performance, and executive functioning). Univariate tests revealed that NAWM volume in the superior frontal lobe (F=4.50; p=0.005; partial eta-squared=0.122) was significantly different across DTC quartiles. Contrast tests suggested that the first quartile had larger NAWM than the second and fourth. DTC quartiles also showed differences in attention (F=2.93; p=0.03; partial eta-squared=0.083) and contrast tests indicated that the first quartile performed significantly better than second and fourth. DTC poststroke may be a proxy for structural integrity of superior frontal lobe regions and attention.