bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges and Perspectives on Breast Cancer Survivorship: The Journey Continues
Authors: Raveis Victoria , Kwon Simona 
Published: December 2020

Abstract
Women have a 1-in-8 lifetime risk of breast cancer. Earlier diagnosis and treatment advances have improved 15- and 20-year survival rates. Increased survival can mean coping with the effects of cancer and its treatment over an extended period of time, while experiencing age-related changes in functioning and the emergence of other health issues. To explore breast cancer survivors’ perspectives on their issues and concerns across the life-course, focus groups were conducted with a culturally diverse sample (N=18) of survivors (72% white, 28% Black, 11% Hispanic). Participants were 44-82 years old. Most, 83% were 50 and older, 56% were 60 and older. The majority (83%) were diagnosed in their 40’s and 50’s. Two were diagnosed in their early 30’s and one at age 68. Participants reaffirmed the necessity, as a breast cancer survivor, of being a life-long health advocate on their own behalf, and the importance of being self-informed. As one woman commented: “Knowledge is power”. Survivors shared that their emergent health issues were complicated by their cancer history, and, that, as a cancer survivor, “I never stop worrying”. A widespread concern was not knowing if the health issues and co-morbidities they experienced (such as joint pain, neuropathy, tendinitis, heart disease), were age-related, a consequence of their cancer, or a late treatment effect. An overriding sentiment expressed was that clinicians have not recognized the importance of quality of life in cancer survival. As a survivor succinctly stated: “We are living longer, but we need to live long with quality of life.”
Spatio-Temporal Gait Variable Differences Between Independent and Assisted Living Older Adults
Authors: Nightingale Christopher , McNulty Jennifer , Butterfield Stephen 
Published: December 2020

Abstract
As the US population continues to age, it is important to gain a better understanding of factors that differ between independently living older adults and those that require assisted living. Accidental falls contribute to decreased quality of life for many older adults, and considerable research has been conducted examining measures of fall-risk and potential interventions. In this pilot study, we investigated fall-risk via assessment of spatio-temporal variables associated with gait in independent and assisted-living older adults aged 65+. Two gender-matched groups of participants were tested on seven gait variables (step length, stride length, contact time, contact phase, foot flat, propulsive phase, and average speed) utilizing Opto-Gait technology. Each group included sixteen participants. Independent living participants were recruited through word of mouth and flyers at local senior centers. Assisted living participants all resided in one local health care facility and were recruited via word of mouth and flyers posted in the facility. A one way ANOVA with an alpha level of .05 revealed significant differences between groups in contact time, foot flat, propulsive phase, and average speed. The independent living group performed better on each variable. These findings indicate that older adults living in assisted living facilities may be at much greater risk of accidental fall than their independent living counterparts. While this study identified several key factors related to instability among old adults, additional investigation is warranted to further examine the relationships among gait, fall-risk, and differentiators between independently living and assisted living older adults in these variables.
Interventions to Reduce Stigma of Dementia: First Insights From a Rural Community-Based Participatory Study
Authors: Bacsu Juanita , Johnson Shanthi , O’Connell Megan , Viger Marc 
Published: December 2020

Abstract
Age is the greatest risk factor for dementia, and the number of rural older adults is rising. Although dementia-related stigma is widely documented, few studies focus on ways to reduce stigma, especially within rural communities. This late breaker presentation aims to: 1) explore the contributing factors of dementia-related stigma in rural communities; and 2) identify interventions to reduce stigma of dementia in rural communities. Drawing on a community-based participatory approach, data were collected through semi-structured interviews with 18 older adults, and a focus group with 7 community leaders in rural Saskatchewan, Canada. Thematic analysis was used to identify key themes and patterns within the data. Contributing factors of dementia-related stigma ranged from fear to lack of dementia knowledge. Several anti-stigma interventions were identified including: forming support groups; hosting educational workshops; inviting guest speakers with dementia; talking openly about dementia; learning more about dementia; asking questions; sharing your lived-experiences; being inclusive; developing inter-generational programs; and avoiding assumptions and hurtful jokes. As the rural population ages, there is a growing need for interventions, programs, and policies to address stigma of dementia. Engaging in rural partnerships and collaborative research is essential to developing community-informed strategies to reduce dementia-related stigma and improve the quality of life for people with dementia.
Senior Adults: Does Body Image Matter?
Authors: Larsen Keri , Graves Myia , Bowers Ashley , Saba Valerie , Himel Lauren 
Published: December 2020

Abstract
Through the theoretical framework of the Social Comparison Theory, the current study will examine general attitudes and perceptions of body image in senior adults who are currently participating in organized recreational activities. Participants between the ages of 50 years of age and older participating in organized recreational programs in the Southeast will be administered the Sociocultural Attitudes Toward Appearance Scale (SATAQ) to measure participants’ body image as influenced by general media, athletic and sport figures, as well as pressure to conform to the media ideal. The Figure Rating Scale will be administered, and is composed of nine drawings of bodies that progressively increase in size from very thin to overweight. Pearson product moment coefficient of correlation will be used to determine the association of scores between the SATAQ and Figure Rating Scale.
The Long-Term Effect of Job Loss on Mortality
Authors: Song Qian , Lim Emily 
Published: December 2020

Abstract
The associations between job loss and health were established. However, these associations were usually biased estimates of causality, as individuals with adverse health were self-selected into job loss. To address such selectivity, we take advantage of the case of massive layoffs of State-Owned Enterprise (SOE) workers in urban China, which was driven by policy change rather than individual characteristics and mimicked a quasi-experiment. We employ China Health and Nutrition Survey (1991-2015) that span more than two decades and survival analysis to analyze the effect of job loss on individual mortality. Our analyses with 3,494 SOE workers show that over the past twenty years, job loss has accelerated mortality (hazard ratio = 1.50; p&lt;0.05) for SOE workers in urban China. Further, these accelerated moralities occurred mostly for workers who lost their jobs between 30-39 (hazard ratio = 2.52, p&lt;0.05) and 40-50 (hazard ratio = 1.77, p&lt;0.1) years old, highlighting the adverse consequences of job loss for the young and middle-aged workers. Our analyses established the causality of job loss and mortality over an extended time, and identified the most vulnerable groups to job loss for policies to target to in an effort to improving the well-being of workers later in life.
“Doing the Impossible with the Inadequate”: COVID-19 Response in U.S. Assisted Living Settings
Authors: Dys Sarah , Winfree Jaclyn , Carder Paula , Dugle Kaylin , Zimmerman Sheryl , Thomas Kali 
Published: December 2020

Abstract
The COVID-19 pandemic has disproportionately affected long-term care operators, staff, residents and their families; although much attention has been given to nursing homes, largely lost in the discourse are assisted living, residential care, and dementia care (AL) communities. As part of a broader, ongoing study assessing states’ AL regulations regarding medical and mental health care for residents with Alzheimer’s and related dementias (ADRD), stakeholders across the United States were recruited in July and August 2020 for semi-structured interviews to provide their perspectives on AL policies and practices specific to COVID-19 response. Stakeholders (n=32) consisted of state healthcare and trade association representatives, clinical practitioners, operators, researchers, and dementia care experts experienced in AL-related operational, healthcare, and regulatory affairs. Using thematic analysis, we describe several emerging topics regarding the opportunities, challenges, and innovations of responding to COVID-19 within the unique context of AL. States’ public health responses to COVID-19 lacked an understanding of the broader long-term care system, especially AL’s scope and purpose, workforce, capacity to implement infection control practices and policies, and unintended consequences of social isolation for older adults, specifically residents living in dementia care units. Despite these challenges, stakeholders described opportunities to expand telehealth infrastructure, communication and collaboration across states and among operators, and several innovations to mitigate the effects of social isolation. It is imperative for policymakers to understand the nuances of the AL context and design regulations and public health responses grounded in a whole-person perspective and in partnership with operators during, and beyond, pandemic circumstances.
Brief telephone intervention for caregivers of medically complex patients during COVID-19
Authors: Stevens-Carr Mary , Sethi Kevin , Cochran Channing , Bencomo-Rivera Margaret , Marceaux Janice 
Published: December 2020

Abstract
The VA Home Based Primary Care (HBPC) program consists of an interdisciplinary team, including psychology, serving veterans with complex medical conditions who are supported by live-in caregiver(s). HBPC psychologists may work with caregivers to address caregiver stress. Some veterans enrolled in HBPC attend Adult Day Care (ADC) programs, allowing respite for caregivers. At the onset of COVID19 pandemic, ADC centers closed to minimize spread of the virus. The authors identified these caregivers to be at high risk for burnout and sought to develop a protocol to assist these caregivers via telephone and evaluate outcomes. PreCOVID-19 caregiver stress was known via a 4-item Zarit Caregiver Burden annual screening (Bédard et al., 2001). Following ADC closures, caregivers of veterans enrolled in ADC programs were contacted and re-administered the Zarit to determine impact of COVID-19 on caregiver stress. Caregivers of veterans not attending ADC were also contacted for comparison. Contacted caregivers were provided a brief CBT-based intervention via telephone, and post-intervention Zarit screening was administered after two weeks. Ultimately, 4 ADC caregivers and 4 non-ADC caregivers were contacted and provided with services before ADC centers reopened. Statistical analysis via mixed model ANOVA did not yield significant results, likely due to small sample size, although there was a large effect size (η_p^2 =.566). ADC caregivers generally reported increased stress from baseline following ADC closure and reduced stress following provision of intervention. The authors will present caregiver feedback about aspects of telephone intervention that were helpful, and not helpful, as well as authors impression.
Older Adults’ Attitudes Toward Virtual Volunteering During the COVID-19 Pandemic
Authors: Sun Peter , Morrow-Howell Nancy , Pawloski Elizabeth , Swinford Emma 
Published: December 2020

Abstract
This study explored older adults’ attitudes toward virtual volunteering during the COVID-19 pandemic. A 22-item survey was administered to 229 volunteers who previously worked with children through the Oasis Intergenerational Tutoring program in St. Louis. Questions focused on technology use patterns and attitudes toward virtual volunteering. Most respondents have used a computer, a smartphone, and the Internet before at home (90.3%), but 22.8% of respondents feel uncomfortable or very uncomfortable when using the Internet. Video conferencing software such as Zoom or Skype was not used before by 14.0% of the respondents, the top reasons being because they prefer other forms of communication (48.4%) or find it too difficult to keep up with technology (19.4%). If tutoring becomes virtual-only, 60.6% of the participants responded they were somewhat likely or very likely to participate, with significant variation by school districts (X2 = 21.92, p &lt; .05, Cramer’s V = 0.33) ranging from 42.6% to 96.0% (Bonferroni post hoc p &lt; .05). Tutors from school districts that were less likely to tutor virtually had lower levels of education and higher levels of discomfort when using the Internet. The respondents also voiced that while virtual tutoring may eliminate barriers to in-person tutoring, such as commuting to schools and inclement weather, they were concerned about establishing a personal connection with their students online. These findings suggest that tutors anticipate both benefits and challenges with virtual volunteering and efforts to engage older adults virtually should factor in prior use of technology and variations by geography.
Understanding the relationship between age and information-seeking in the context of COVID-19
Authors: Chu Li , Pauly Theresa , Garza Elizabeth Zambrano , Gerstorf Denis , Hoppmann Christiane 
Published: December 2020

Abstract
Socioemotional selectivity theory proposes that older adults engage in less information-seeking than younger adults as future time perspective becomes more limited and expansive goals are prioritized less. However, gathering information is crucial in emergencies like the COVID-19 pandemic, especially for older adults, who are particularly vulnerable to the virus. This study aims to better understand the association between age and information-seeking patterns during the current pandemic. Two hundred and sixty-six participants (age range = 18 – 84, Mage = 38.86, female = 77.06%, received postsecondary education = 83.08%, born in Canada = 73.68%) completed an online study between May and August 2020. We found that older age was associated with more information-seeking time (b = .45, SE = .16, p &lt; .001). We then investigated whether perceived worries of getting COVID-19 might provide insights into this association. Findings point to a partial mediation with a significant direct effect (b = .37, SE = .16, p = .02, 95% bootstrap CI=[.07, .68]), a marginally significant indirect effect (b = .08, SE = .04, p = .06, 95% bootstrap CI=[-.003, .18]) and a significant total effect (b = .46, SE = .16, p &lt; .001, 95% bootstrap CI=[.14, .77]). That is, older adults engaged in more information-seeking than younger adults in contexts in which information-seeking was personally relevant as indicated by perceived worries. These findings shed light on key correlates of information-seeking in older adulthood and highlight the importance for government and health organizations to make suitable information accessible for older adults.
“We are Scapegoats”: Front-Line Nursing Home Staff Experiences During the COVID-19 Pandemic
Authors: White Elizabeth , Wetle Terrie , Reddy Ann , Baier Rosa 
Published: December 2020

Abstract
The COVID-19 pandemic is an unprecedented challenge for nursing homes, where staff have faced rapidly evolving circumstances to care for a vulnerable resident population. To document these healthcare professionals’ experiences during the pandemic, we used social media and professional networks to disseminate an electronic survey with closed- and open-ended questions to a convenience sample of long-term care staff from May 11 through June 4, 2020. Four investigators identified themes from qualitative responses for 152 nursing home staff respondents from 32 states. Key themes included: constraints on personal protective equipment (PPE) and testing; burdensome regulations and guidance; concern for self, family, and residents; workforce burnout; organizational communication and teamwork; and public lack of recognition. Respondents described ongoing constraints on testing, and reliance on crisis standards for extended use and reuse of PPE. Administrators discussed implementing sometimes confusing or contradictory guidance from numerous agencies. Direct-care staff expressed fears of infecting themselves and their families, and expressed empathy and concern for their residents. They described burnout due to increased workloads and the emotional burden of caring for residents facing isolation, illness, and death. Respondents cited the presence or lack of organizational communication and teamwork as factors influencing their ability to work under challenging circumstances. They also described the demoralizing impact of negative media coverage of nursing homes, contrasting this with the heroic public recognition given to hospital staff. These challenges added significant burden to an already strained workforce and are likely to contribute to increased burnout, turnover, and staff shortages in the long-term.
Quality of Care Provided by Family Caregivers of Older People With Dementia: Measurement and Interpretations
Authors: Hazzan Afeez 
Published: December 2020

Abstract
Family caregivers of older people living with dementia are relatives, friends, or neighbors who provide assistance related to this condition, but who are unpaid for the services they provide. Although caregiving could be personally rewarding, many caregivers report a high level of strain. Compared to caregivers of older adults who do not have dementia, family caregivers of older people living with dementia report lower quality-of-life (QoL). In a published systematic review examining the relationship between family caregiver QoL and the quality of care provided, only one study was found to be somewhat relevant. The study suggested that the primary reason for an absence of research into the link between family caregiver QoL and quality of care was the absence of a questionnaire for measuring quality of care in dementia. Therefore, any attempt to investigate the impact of caregiver QoL on the care provided to older people with dementia must first address the lack of an instrument to measure quality of care. To address this issue, we interviewed approximately 20 family caregivers in order to elicit feedback on measurements and interpretation of the quality of care provided by family caregivers of older people living with dementia. Content analysis of the interview transcripts revealed that the quality of relationships with family, caregiver availability to provide or supervise care, and availability of paid or volunteer help are important for the quality of care provided. These results have important implications, particularly for the development of an instrument to measure quality of care in dementia.
Motoric Cognitive Risk Syndrome Using 3-Items Recall Test and Its Association With Falls
Authors: Shim Hayoung , Kim Miji , Jung Heeeun , Seo Yuri , Lee Seoyoon Jane , Won Chang Won 
Published: December 2020

Abstract
Motoric cognitive risk (MCR) syndrome is defined by the presence of subjective cognitive complaints (SCCs) and slow gait. Its components have synergistic effects to predict various adverse health outcomes. However, some studies reported SCCs might be influenced by cultural differences. Therefore, we devised another criterion to assess the cognitive aspect of MCR to enhance its utility irrespective of the cultural background of the subject by examining the association of MCR and its components with fall-related outcomes. This cross-sectional analysis included 2,641 community-dwelling older adults aged 70-84 years from the Korean Frailty and Aging Cohort Study. These participants did not have dementia and had no difficulties in performing activities of daily living. The newly devised criterion for cognitive aspects of MCR is based on three items recall test on Mini-Mental State Examination. One-hundred-ninety participants (7.2%) met the criteria of MCR using three items recall test. Unlike MCR using SCCs, newly defined MCR showed synergistic effects with fall-related outcomes. Participants with MCR using three items recall test showed a higher risk for falls in the past 1-year (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.08-2.34), recurrent falls (OR 1.86, 95% CI 1.10-3.13), fall with injury (OR 1.60, 95% CI 1.10-2.34), fear of falling (OR 2.77, 95% CI 1.90-4.03), and low activities-specific balance confidence (OR 2.86, 95% CI 1.78-4.60) compared to each component, except for fall with fracture. We found MCR with three items recall test helped predict fall-related outcomes in clinical settings regardless of the cultural context.
Should Caregivers Attempt to Assist Falling Patients?
Authors: Bulat Tatjana , Friedman Yvonne , Barrett Blake , Lind Jason , Chavez Margeaux , Cowan Linda , Martin Marie , Shaw Alicia 
Published: December 2020

Abstract
This quality improvement project seeks to provide guidance on whether caregivers should attempt to “assist” fallers, and if so, the safest way to minimize injury to themselves and the faller. Primary aims were to: 1) Identify common characteristics of documented assisted falls, 2) Identify cases where injuries to patients and/or staff occur, and 3) Provide guidance to the clinical field. Data sources for this project includes secondary databases of assisted falls events as well as primary data collection using computer simulation. Initial results for 2 VA quality tracking databases of assisted falls over a 9-year period are presented. Qualitative matrix analyses were conducted for both assisted falls datasets, which separately examined patient and employee injuries related to assisted falls. Two trained qualitative experts analyzed 195 fall narratives from the datasets to develop insights about the most common fall scenarios that result in injury. The most commonly reported assisted falls scenarios included 1) related to toileting, 2) while ambulating, and 3) while transferring from wheelchair. Findings of these analyses indicate current documentation does not capture the nuance of assisted falls. Additional variables such as 1) the direction of the fall; 2) the fall scenario; 3) how staff sought to assist; 4) staff injury description and 5) and other key variables (patient symptoms, environmental factors) that could improve fall documentation and understanding of assisted falls. Preliminary efforts are providing information for development of a computer simulation using a virtual environment to repeatedly test common fall scenarios and influences of caregiver assistance.