bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Organizational Climate on the Enrollment of People of Color Into Clinical Trials
Authors: Blinka Marcela , BrintzenhofeSzoc Karlynn , Zabora James 
Published: December 2020

Abstract
A significant need exists to improve enrollment of people-of-color (POC) in randomized clinical trials as the gold standard for evaluating new therapies so that health disparities can be reduced. Improving representation in clinical trials is expected to improve the applicability of clinical findings more broadly, especially for minority subgroups. This cross-sectional study assessed the perception of organizational climate (OC) among staff in five cancer research groups (CRGs) of a mid-Atlantic NCI-designated comprehensive cancer center. The Organizational Climate Measure (OCM), a measure of four OC models of the Competing Values Framework, was used. Enrollment data were obtained from the 2016 Cancer Research Management System data and 2017 enrollment rates. A statistically significant difference in mean scores was found in the Pressure to Produce Scale (F = 4.21, p &lt; .05). One CRG’s staff reported lower pressure to meet targets than three other CRGs (p &lt; .05) and trending towards significance for the fourth CRG (p &lt; .08). This suggests that organizational priorities considering all patients as potential clinical trial participants increases accrual. A statistically significant negative relationship between the Outward Focus sub-scale and POC enrollment (r = -.228, p &lt; .05) was also found, suggesting that an external organizational focus, alone, is insufficient to increase POC accrual. Implications for future research include 1) does the organizational priority of decreasing the pressure to produce influence accrual of POC? and 2) does an OC that is flexible and externally focused lead to a more effective means of accruing POC as clinical trial participants?
Immigrant Status Predicts Worse Subjective Memory Complaints
Authors: Franco Yujin , Jeong Yujin 
Published: December 2020

Abstract
The “Immigrant Health Paradox” suggests that immigrants experience better health and lower mortality than the U.S.-born population despite their lower average socioeconomic status. However, it is unclear whether this health advantage extends to all areas of cognitive functioning. This study investigates cognitive functioning and Subjective Memory Complaints (SMCs) as a function of immigrant status and identifies predictors of cognitive decline as well as SMCs among the immigrant population. Data were drawn from the 2010 wave of the Health and Retirement Study. The sample consisted of 9,812 older adults aged 65 and older (8,873 U.S.-born and 939 foreign-born). Logistic regression was used to examine whether immigrant status was associated with cognitive functioning and SMCs, controlling for socio-demographic (age, gender, education, and marital status), health conditions (diabetes, depression, hypertension, and stroke), and functional limitations. Being foreign-born was not a significant predictor of dementia (OR:1.18, 95% CI: 0.83-1.67). However, immigrants were 41% more likely to report SMCs compared to U.S.-born respondents (OR:1.41, 95% CI: 1.17-1.69). Among the immigrant population, immigrants with less than a high school education showed four- and two-times higher odds of having dementia and reporting SMCs than those with more than high school. It is necessary to provide dementia education and screening to immigrants, especially those with low education, as this may contribute to reducing disparities in cognitive functioning within the older population.
More Than Meets the Eye: Income and Racial Disparities in Vision Health of Older Adults
Authors: Iqbal Asif , Sarker Ananya 
Published: December 2020

Abstract
By the end of this decade, the USA is projected to experience an increase of more than 50% in the number of people with poorer vision health as the population grows older. Using data from the NHANES III (1988–1994) for 7,186 White, Black, and Hispanic adults of ages 50 to 90 (Mean=68.23, SD=10), this paper examines the racial/ethnic, and socioeconomic disparities in vision health in the older adult population. The focus of this paper is on Visual Impairment indicators: full/partial blindness and trouble seeing with glasses to demonstrate vision health disparities in these race/ethnic groups in terms of family income using logistic regression analysis. Controls include demographic characteristics like age, gender, marital status, region, education and behavioral features like alcohol consumption and smoking. We explore another component of vision health: days since last visit to healthcare provider to evaluate the inequalities in access to health care using OLS regression analysis. In Whites (OR=.85) and Blacks (OR=.63), people with less family income are more likely to experience blindness, however, there exists no significant variability in blindness in terms of family income among Hispanics. In Black (OR=.82) and Hispanics (OR=.85), people with less family income are more likely to have trouble seeing even with glasses, however, this relationship does not exist among Whites. Days since last visit can be explained by income for Whites (Beta=-92), not for Blacks and Hispanics. This compounded disparity puts a disproportionate economic burden on minority groups, but the current Medicare policy fails to address that.
The Role of Intergenerational Relationships: Applying the Family Stress Model to Grandfamilies
Authors: Scott Rachel , Nadorff Danielle , Yancura Loriena , Barnett Melissa 
Published: December 2020

Abstract
The Family Stress Model (FSM) of Economic Hardship (Conger, Rueter, & Conger, 2000) was developed to explain the impact of financial stress on families through links between economic difficulties, parental emotional distress, marital conflict, disrupted parenting behaviors, and child maladjustment. The FSM has been cross validated in samples of custodial grandparents (i.e., grandparents who provide substantial care for their grandchildren; Smith et al., 2017). The current study modified the FSM by replacing inter-parent relationship difficulties with inter-generational relationship problems between the custodial grandparents and their children to ultimately examine the adjustment of the grandchildren. This change to the model is supported by prior research conducted on intergenerational stress impacting the parenting and subsequent development of children in grandfamilies (Barnett, Mills-Koonce, Gustafsson, & Cox, 2012). Using a nationwide sample of 317 custodial grandparents aged 40 and older (M = 61 yr) the fit of the modified model was tested using AMOS 26. Latent variables in the model included Economic Pressure, Caregiver Distress, Disrupted Parenting, Intergenerational Relationship, and Child Adjustment. Moderate fit was achieved (χ2(308) = 574.88; CFI = .896; RMSEA = .052). All pathways were significant with the exception of Disrupted Parenting to Child Adjustment. These results indicate that intergenerational relationships are an important predictor of child adjustment, and an applicable substitute for inter-partner relationships when modeling family stress in custodial grandfamilies. Details and clinical implications will be discussed.
Job Strain and Late-Life Cognition: Findings From the Puerto Rican Elderly Health Conditions Study
Authors: Vigoureux Taylor , Nelson Monica , Andel Ross , Small Brent , Crowe Michael , Davila Ana Luisa , Drury Taylor 
Published: December 2020

Abstract
Chronic stress at work, represented by job strain, has been associated with adverse late-life cognitive outcomes in the United States and Western Europe. We examined the relationship between job strain and change in cognition in a less affluent, Hispanic sample of adults aged 60-100 from mainland Puerto Rico. Job strain indicators (i.e., job demands/job control/job strain) were quantified from (a) standardized occupation-based job strain scores from Karasek’s Job Content Questionnaire (JCQ; n=1102), and (b) O*Net variables forming factors of job demands and job control (n=1639). Occupation information, covariates, and cognition came from the Puerto Rican Elderly Health Conditions (PREHCO) Study conducted in 2002-2003, with cognition follow-up in 2006-2007. All analyses controlled for age, sex, baseline depressive symptoms, baseline financial problems, and childhood economic hardship. Across both operationalizations of job strain indicators, higher job control was associated with less decline in late-life cognition (JCQ: b=.18, p&lt;.05; O*Net: b=.31, p&lt;.001) until controlling for education (JCQ: b=.09, p=.248; O*Net: b=.12, p=.097). Job strain was associated with more decline in cognition (JCQ: b=-.75, p&lt;.05; O*Net: b=-.87, p&lt;.05) until controlling for education (JCQ: b=-.49, p=.098; O*Net: b=-.46, p=.262). For Karasek’s measure, the relationships were driven by more educated participants. Job control was related to less cognitive decline whereas strain related to more decline among older Puerto Ricans over four years, whether assessed with JCQ-based or O*Net-based scores. However, education emerged as more important for change in late-life cognition than job strain indicators overall, suggesting results that diverge from countries with higher average socioeconomic status.
Depression Screening and Rates of Mood Disorder Diagnosis and Suicide in Younger and Older Adults
Authors: Lutz Julie , Conner Kenneth , Hasselberg Michael , Fear Kathleen , Van Orden Kim 
Published: December 2020

Abstract
Rates of suicide are elevated among older adults in the U.S. and around the world, with the highest rates in older men (CDC, 2019; WHO, 2014). More than half of older adults who die by suicide were in contact with a primary care physician within the month prior to death, and almost one-third within the prior week (Luoma et al., 2002; Stene-Larsen & Reneflot, 2019), demonstrating the importance of better identification and treatment of mental health issues among older adults across healthcare systems. Depression, a well-established risk factor for suicide, goes under-diagnosed and under-treated, especially among older adults (Bryant, 2010). The University of Rochester Medical Center has led integration of patient-reported outcomes assessment via large-scale implementation of PROMIS measures across multiple departments. We compared results of PROMIS depression screening from 1/1/2015 to 8/31/2019 with mood disorder diagnoses within the year prior and year following screening. Twenty-six percent (39491/154669) of adults under age 65 and 23% (11694/51702) of those age 65 and older screened positive for mild, moderate, or severe depression. Whereas 29.0% of younger adults who screened positive received mood disorder diagnoses, 22.1% of older adults received a diagnosis (χ2(1)=214.69, p&lt;.001). Suicide outcomes using National Death Index data will also be reported. Results confirm depression is underdiagnosed (and, by extension, likely undertreated) at all ages, but show a distinct disparity for older adults, which may put them at greater risk for negative outcomes such as suicide.
Effects of Pain and Depression on ADL Disability Over 6 Years of Follow-Up Among Older Adult Americans
Authors: Sodhi Jaspreet , Snih Soham Al 
Published: December 2020

Abstract
The objective of this study was to examine the effect of co-occurring pain and depression on ADL disability over 6-years of follow-up among older adult Americans. We studied 5,236 participants aged 65 years and older from the National Health and Aging Trends Study (2011-2017) The primary outcome was ADL disability defined as any limitation in ADLs (eating, bathing, transferring, dressing, moving inside, and out of bed). The independent predictors were self-reported pain and depression. Covariates included socio-demographics (age, gender, marital status, race/ethnicity and years of formal education), body mass index, and comorbidities. Participants were categorized into four groups according to pain and depression: no pain and no depression, pain only, depression only, and depression and pain. Generalized Estimation Equation model was used to estimate the odds of ADL disability as a function of pain and depression. All variables were analyzed as time-varying except for age, race/ethnicity, and education. The odds of ADL disability as a function of pain only and depression only was 1.62 (95% CI 1.38-1.91) and 2.13 (95% CI 1.54-2.95), respectively. The odds of ADL disability as a function of pain and depression were 3.92 (95% CI 3.13-4.92). Older age, being married, Hispanics, and comorbid conditions were also predictive factors of ADL disability over time. Female participants and those with higher levels of education were less likely to report ADL disability over time. The findings suggest that both pain and depression significantly increased the risk of ADL disability in this population over 6-years.
A Confluence of Policy Inequality: Health Disparities in Old Age Among American Indian and Alaska Native Populations
Authors: Giles Sadie 
Published: December 2020

Abstract
Racial health disparities in old age are well established, and new conceptualizations and methodologies continue to advance our understanding of health inequality across the life course. One group that is overlooked in many of these analyses, however, is the aging American Indian/Native Alaskan (AI/NA) population. While scholars have attended to the unique health inequities faced by the AI/NA population as a whole due to its discordant political history with the US government, little attention has been paid to unique patterns of disparity that might exist in old age. I propose to draw critical gerontology into the conversation in order to establish a framework through which we can uncover barriers to health, both from the political context of the AI/NA people as well as the political history of old age policy in the United States. Health disparities in old age are often described through a cumulative (dis)advantage framework that offers the benefit of appreciating that different groups enter old age with different resources and health statuses as a result of cumulative inequalities across the life course. Adding a framework of age relations, appreciating age as a system of inequality where people also gain or lose access to resources and status upon entering old age offers a path for understanding the intersection of race and old age. This paper will show how policy history for this group in particular as well as old age policy in the United States all create a unique and unequal circumstance for the aging AI/NA population.
A Screening and Referral Intervention for Food Insecurity Among Older Emergency Department Patients
Authors: Aylward Aileen , Platts-Mills Timothy , Wardlow Liane , Sullivan Conor , Anderson Jessa Engelberg , Morris Andrea , Shams Rayad 
Published: December 2020

Abstract
Food insecurity is prevalent among older adults, negatively impacts health, and may increase healthcare utilization. Risk factors include poverty, lack of transportation, and social isolation. Community-based services may mitigate food insecurity and other social risk factors. However, identifying those at risk and connecting them to services can be challenging. We implemented a screening and referral program in an Emergency Department (ED) to identify older adults facing food insecurity and connect them to a local Area Agency on Aging (AAA), which arranged and tracked delivery of community-based services. ED nursing assistants used the Hunger Vital Sign screener to assess food insecurity in patients aged 60 years and older. ED Care Managers (CMs) saw all who screened positive and made referrals to the AAA. The AAA conducted an intake assessment and arranged services. Patients were contacted three months after their ED visit to evaluate health, quality of life, and satisfaction with services. Of 423 patients screened over 7 months, 45 (11%) reported food insecurity. Of those, 25 were referred to the AAA. Patients were not referred to the AAA due to CM inability to make a referral (7), declining services (4), or other reasons (11). The AAA reached 21 patients and 9 received at least one service. Of those, 5 were reached for follow-up and reported satisfaction with services. The most frequently requested service was Meals on Wheels (10). Food insecurity is common among older ED patients. An ED-AAA partnership is feasible and connects older adults to beneficial services in their communities.
Risk Profiles of Older Rural Residents With Functional, Nutritional, and Social Needs
Authors: Weaver Raven 
Published: December 2020

Abstract
Community-based service organizations are well positioned to address social determinants of health by offering a range of services/supports to community residents. To identify health needs and service delivery gaps among a geographically and economically diverse eight-county region, a needs assessment was conducted to support community-based agencies efforts to better support aging residents. A random sample of adults responded to the survey, with 1,280 respondents aged 60+ (mean age=71); the majority of participants were White, female, retired, reported at least some college education, and lived with at least one person. Cluster analysis distinguished three groups of residents, informed by typical enrollment-type data and a social engagement index. A series of one-way ANCOVA and chi-square analyses were conducted to examine how low-, moderate-, and high-risk groups differed on social, nutritional, and functional health needs. High-risk respondents were significantly more likely to report needing social, nutritional, and functional health services, compared to moderate- and low-risk respondents. High-risk respondents were more likely to experience barriers to seeing a physician (X2=34.054, p&lt;.001), a non-emergency ED visit (X2=22.799, p&lt;.001), and an unplanned hospital visit (X2=14.484, p=.001) compared to members of either low- or moderate-risk groups. Ongoing efforts to identify high-risk residents and proactively target moderate-risk residents support low-cost community interventions (i.e., assessing residents for services in locations regularly attended, such as senior meal centers), rather than high-cost interventions (e.g., emergency care, hospitalizations) are essential. Findings inform community-based outreach approaches that target social, economic, and environmental factors essential in improving health and achieving health equity.
Daily Stressors and Physiological Reactivity: The Role of Perceived Stress, Stress Reactivity, Neuroticism, and Age
Authors: Hughes MacKenzie , Hertzog Christopher 
Published: December 2020

Abstract
Exposure to stressful events is an inevitable aspect of everyday life, such as encountering work deadlines or interpersonal conflicts. The body’s physiological stress systems can become activated when exposed to stressors, resulting in increases in cortisol from the hypothalamic-pituitary-adrenal axis and/or increases in the alpha-amylase enzyme via the sympathetic-adrenal medullary system. We predicted physiological reactivity measured by salivary assay in an ecological momentary assessment (EMA) design, using The Perceived Stress Scale (PSS; Cohen, 1988), Perceived Stress Reactivity Scale (PSRS; Schulz, Jansen, & Schlotz, 2005), neuroticism, (Big Five Inventory; John, Donahue, & Kentle, 1991), and age. Adult participants (N=163) ages 20–80 years old (M=51.8 years) completed the individual differences measures and then provided seven saliva samples per day for 10 consecutive days while also completing five stress-related surveys per day via random-prompted EMA (Scott, Sliwinski, & Blanchard-Fields, 2013). Mean aggregate alpha-amylase correlated with the PSRS (r = -.20, p &lt; .05) but not with the PSS or with neuroticism, suggesting alpha-amylase may be a more sensitive measure of subjective stress reactivity. In contrast, mean cortisol levels were not correlated with any of those measures. Age correlated with subjective stress (r = -.23, p &lt; .05) and stress reactivity (r = -.20, p &lt; .05) but not with hormone levels. Multilevel modeling will be used to evaluate within-person and between-person variation in stress hormones and EMA measures of daily stress in relation to the PSS, the PSRS, neuroticism, and age.
The Effects of Word Use and Personality Pathology on Depression and Suicidal Behavior in Older Adult Inpatients
Authors: Park Hyunyoung Ellen , Geramian Helene , Ho Jennifer , Aronov Avner , Mak Wing Jin , Yenko Ira , Francois Dimitry , Zweig Richard , Park Hyunyoung 
Published: December 2020

Abstract
Few prior studies have examined whether word use is associated with personality pathology or is linked to depression and suicidal behavior in older adult inpatients. In this study, older adult depressed inpatients (N = 51; age M= 67, SD = 8.9; mean years of education = 15.49, SD = 2.6) provided narratives about high and low points in life, health challenges, and interpersonal conflicts, and completed measures of personality pathology (NEO Five Factor Inventory, Inventory of Interpersonal Problems-Personality Disorders-25), depression (Geriatric Depression Scale), and suicidal ideation or behavior (SCID-5). The Linguistic Inquiry and Word Count (LIWC) text analysis tool was used to examine the frequency of self-referential, negative emotion, or absolutist word use. After adjusting for word count, age, and occupational and marital status, the use of self-referential words in narratives about high points of life predicted suicidal behavior (OR = .563, p = .002), but word use did not predict depression or personality pathology. In regression analyses, neuroticism and maladaptive interpersonal functioning predicted depression (ß = .417, p = .002; ß = .364, p = .009, respectively) but not suicidal behavior. Together, these preliminary findings suggest that in depressed older adult inpatients, depression and suicidal behavior may have qualitatively different predictors.
The Relationship Between Big Five Personality Traits and Driving Styles in Older Adults
Authors: Tian Junyan , Raika Anabella , Stavrinos Despina , Ross Lesley 
Published: December 2020

Abstract
Older adults’ psychosocial factors, including personality, are correlated with driving performance and driving cessation. However, the relationship between personality and driving styles has been examined only among young and middle-aged drivers. This study examined the relationships of personality factors and self-reported driving styles among 72 healthy older drivers aged 65-85 (M=72.29, SD=5.36) using the Multidimensional Driving Style Inventory (MDSI) scale to measure reckless and careless, anxious, angry and hostile, and patient and careful driving styles. Personality was accessed with the Big Five Personality questionnaire. Correlational results indicated that less conscientiousness was significantly correlated with increased reckless and careless and less patient and careful driving styles; and lower agreeableness was significantly correlated with greater angry and hostile and less patient and careful driving styles. Being a man was associated with greater reckless and careless and angry and hostile driving styles. Age was not associated with driving styles. Accordingly, three regressions were tested. After controlling for gender, only lower conscientiousness was associated with greater reckless and careless driving style (β=-.007, p=.03). Men had a higher risk of reckless and careless (β=.342, p&lt;.01) and angry and hostile (β=.392, p&lt;.01) driving styles. Our results highlight the relationship between personality traits and self-reported driving styles among older adults, and how gender may influence some of these relationships. Future research should further investigate the associations between gender and personality traits and older adults’ driving mobility and safety.