bluuebunny/crossref_metadata_2025_split huggingface dataset:
Embalming, Viewing and the Social Construction of the Corpse: Time for Another Look
Authors: Finney Redmond , Shulman Lisa , Kheirbek Raya 
Published: December 2021

Abstract
Embalming of the dead is more common in the United States than anywhere else in the world. Battles far from home during the Civil War with concern for contagion from dead bodies being shipped home, compelled President Lincoln to direct the troops to use embalming to allow the return of the Union dead to their homes. Viewings were common with war heroes and culminated with the viewing of Lincoln himself. In the 20th century embalming became a tradition despite substantial evidence indicating environmental and occupational hazards related to embalming fluids and carbon dioxide generated from manufacturing steel coffins before placing in concrete burial vaults. Embalming is promoted and considered helpful to the grieving process when families are comforted by a the appearance of a peaceful death. Embalmers are expected to produce an illusion of rest, an image that in some ways disguises death for the benefit of mourners. The dead are carefully displayed in a condition of liminal repose where the 'true' condition is hidden, and death is removed from the actual event. In this paper we highlight the spiritual and cultural complexities of embalming related- issues. We also provide data on the lack of grieving families’ preparedness for the financial burden associated with the death of a loved one and the lack of knowledge of alternative options. We propose an innovative process to empower people facing serious illness, and their families to make shared and informed decisions, especially when death is the expected outcome.
Emotional Intelligence Skills Enhance Responsive Care of Hospitalized Older Patients
Authors: Kahana Eva , Ermoshkina Polina 
Published: December 2021

Abstract
Our previous research focused on the value of creative problem-solving in late life (Kahana, Kahana, & Ermoshkina, 2021). This paper considers the role of emotional intelligence in creative problem-solving for improving late-life medical care experiences. Emotional intelligence, which is situated at the intersection between the domains of intelligence and personality, can serve as a useful resource promoting personal and social adaptation to problems of old age. Our paper argues for the usefulness of emotional intelligence as older adults deal with challenges of the health care system. Emotional intelligence is rarely studied in gerontological research. Yet, it is required to overcome lack of attention to the patient experience and to provider–patient communication. Problems in communication with staff and in obtaining responsive care are prevalent for hospitalized older adults due to lack of continuity of care as unfamiliar “hospitalist” physicians typically offer care to frail elders. A key adaptive task of older patients involves securing investment by overworked health care providers. A friendly and extraverted self-presentation by older patients signals to the health care provider the social worth of the patient. Such demeanor can go a long way toward eliciting interest and caring responses from providers. Our paper offers a taxonomy of patient behaviors that can facilitate patient-centered care. Emotional intelligence shown by older patients reflected in expressions of appreciation for staff is likely to facilitate the interest of medical and nursing staff. Potential interventions to foster emotional intelligence among older patients will also be discussed.
Older Couples’ Advance Care Planning Engagement Patterns and Associations with Individual and Spousal Factors
Authors: Lee Hyo Jung , Kim Bon 
Published: December 2021

Abstract
This study examines older couples’ dyadic patterns of informal and formal advance care planning (ACP) and determines the associations of these patterns with their own and spousal characteristics. Using data from the 2014 and 2016 Health and Retirement Study, we performed a) latent class analysis to identify distinctive ACP engagement patterns and b) multinomial regression models to describe related characteristics of older couples (N = 1,545 couples). We identified four dyadic patterns of ACP engagement: a) high ACP engaging couple (45%); b) high engaging husband – low engaging wife (13%); c) high engaging wife – low engaging husband (11%); and d) low engaging couple (31%). Engagement in informal and formal ACP was associated with both individual and spousal factors: Older couples with advanced age or higher levels of education and wealth were more likely to engage in both informal and formal ACP, whereas only wife’s high level of constrain or husband’s greater number of depressive symptoms was associated with discordant ACP engagements. Couple-based approach to promote ACP merits older couples with limited resources or poorer psychological health in both or either spouse.
Trends in Dementia Prevalence in the United States, 1995-2019: An Age-Period-Cohort-Interaction Analysis
Authors: Lee Mark , Luo Liying 
Published: December 2021

Abstract
Previous studies have indicated that age-specific dementia prevalence has declined in the United States and other high-income countries. However, these studies have been limited by estimating temporal change in dementia rates on a strictly period basis, with little attention to possible cohort effects. Distinguishing age, period, and cohort effects is both methodologically and theoretically important for identifying the etiological factors driving dementia decline in the population. In this study, we apply the novel Age-Period-Cohort-Interaction (APC-I) model, which defines cohort effects as the interaction between age and period main effects. The APC-I model improves on earlier APC models (e.g., the accounting method) by solving the linear dependence between predictors through theoretical clarification instead of statistical manipulation. We use the APC-I model to estimate period and cohort trends in dementia prevalence using data from the Health and Retirement Study (HRS). Our analysis points to significant period and cohort effects. Dementia prevalence declined significantly between the periods 1995-1999 and 2015-2019. At the same time, cohorts born in the 1940s had significantly lower odds of dementia than would be expected given age and period main effects. This cohort’s unique protection from dementia has been relatively stable as they have aged. Our study identifies the periods during which and cohorts for whom dementia risk has declined in the United States. Further research is needed to specify the period factors (e.g., broad based improvements in nutrition) and cohort factors (e.g., increases in educational attainment) that are responsible for these trends.
The Effects of Exercise on Cognitive Function in Older Adults With Different Types of Dementia: A Meta-Analysis
Authors: Balbim Guilherme , Falck Ryan , Barha Cindy , Davis Jennifer , Starkey Samantha , Bullock Alexis , Liu-Ambrose Teresa 
Published: December 2021

Abstract
Combating dementia is a public health priority, and exercise training is one promising strategy for dementia prevention. However, its efficacy in promoting cognitive outcomes in different types of dementia remains unknown. We conducted a systematic review (N = 27) and meta-analysis (N = 24) of randomized controlled trials with cognitive function as a primary or secondary outcome. We aimed to assess the effect of exercise interventions on the cognitive function of older adults (&gt;60 years) diagnosed with different types of dementia. We synthesized data from 2,441 older adults with dementia. Eleven trials included older adults with multiple types of dementia, eight with Alzheimer's disease, six with unspecified types of dementia, and two with vascular cognitive impairment. We performed random-effects models using robust variance estimation (RVE) and tested potential moderators using the approximate Hotelling-Zhang test (HTZ). Results suggest a small effect of exercise on cognitive function for all-cause dementia (g = 0.18; 95% CI: 0.04, 0.33; p = 0.016); however, the effects did not differ by type of dementia. Moderation analyses showed that trials that did not specify participants' severity of dementia, applied individual-level randomization, and had higher intervention adherence demonstrated larger exercise effects on cognitive function for all-cause dementia. We conclude that exercise promotes small improvements in the cognitive function of older adults with all-cause dementia. More research including different types of dementia is needed if we hope to determine the precise effects of exercise for each type of dementia.
Development of a Screening Tool for Feet/Footwear- Related Influences on Fall Risk
Authors: Wingood Mariana , Vincenzo Jennifer , Peterson Elizabeth , Neville Christopher 
Published: December 2021

Abstract
The effectiveness of multifactorial fall risk assessment and intervention strategies is well documented. Although identifying feet/footwear-related influences on fall risk is a vital fall risk assessment component, few evidence-based resources or screening tools are available. To address this need, we developed the Screening Tool for Feet/Footwear-Related Influences on Fall Risk. Our tool is designed for older adults who are identified as at risk for falling, based on the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) Algorithm for Fall Risk Screening, Assessment, and Intervention. Tool development was informed by results of our systematic review of lower-limb factors associated with balance and falls. Our initial tool was evaluated by an external group of 9 interprofessional content experts. Those experts recommended modification of 8 items and rated the tool’s clarity as 81.2/100, appeal as 79.1/100, and clinical feasibility as 76.1/100. After incorporating recommended changes, we completed a modified Delphi study using 8 new interprofessional experts (average years of experience: 19.3). During Phase 1, Delphi participants recommended we combine items with similar treatment recommendations, add a question about orthoses, and increase the specificity of 9 items. This refinement resulted in a 20-item screening tool, which met approval after two rounds of consensus voting. Approval was defined based on the Item Content Validation Index, percentage of agreement &gt; 80% on each item. The high level of agreement illustrates the tool’s content validity. Using our tool, an older adult’s feet/footwear-related risk factors can be identified and incorporated into an effective multifactorial fall prevention intervention.
Fall-related Injuries in Older Adults and Medications Prescribed within 30 Days Prior to the Injury
Authors: Ming Yu , Zecevic Aleksandra , Booth Richard , Hunter Susan , Johnson Andrew , Tirona Rommel 
Published: December 2021

Abstract
Fall-related injuries in older adults have serious consequences both for individuals and the public health care system. The purpose of this study was to identify medication classes prescribed within 30 days prior to the injury that were associated with fall-related injuries in older adults. This population-based, case-control study used secondary administrative health care data in Ontario, Canada. The cases were older adults, aged 66 years and older, who visited an emergency department for a fall-related injury. Controls were extracted from the Registered Person Database, and matched by same age, sex and residence area. Medication classes prescribed to both groups were recorded and logistic regression was conducted to examine the association between medications and fall-related injury. The case group included 255,270 older adults who experienced a fall-related injury over the five-year period (2010-2014). After adjustment for sex, age group, residence area, income level and number of medications prescribed, psychotropic medications (i.e., opioids, anti-epileptics, anti-Parkinson’s drugs, and antidepressants), drugs for treatment of constipation, infection and benign prostatic hyperplasia, antithrombotic agents, statins and bronchodilators were identified to be related to increased risk of fall-related injuries. In addition to medications already on the list of fall-risk increasing drugs or FRIDs, this study uncovered that drugs for benign prostatic hyperplasia, cephalosporins, biphosphates and bronchodilators increased the risk of fall-related injury in older adults. Well-designed prospective cohort studies considering prescription indication and drug-drug interactions are needed to provide more convincing evidence on medications that may be associated with increased risks of fall-related injury in older adults.
Intergenerational Conflict Among Asian Immigrant Families and Psychological Well-Being: Results from PIETY Study
Authors: Abdi Fatima , Bergren Stephanie , Lanza Lisa , Dong XinQi 
Published: December 2021

Abstract
Research suggests that stress from migration and cultural adjustment may lead to intergenerational conflict (IC) within Asian immigrant families. Current research reports management of IC but fails to acknowledge the consequences it may have on offspring. The PIETY study, a longitudinal study of Chinese adult children (n = 547) in the greater Chicago area, aims to examine the relationship between IC and psychological wellbeing in children of Asian immigrant families. IC is assessed by the sum of items on conflicting opinions with parents based on finances, health, parenting, and lifestyle. Psychological wellbeing was measured by the Perceived Stress Scale with a cutoff value greater than or equal to 14, R-UCLA Loneliness Instrument scored on a binary scale, and Hospital Anxiety and Depression Scale (HADS) Anxiety Subscale with a cutoff value greater than or equal to 8. Logistic regression was conducted and controlled for age, gender, education, income, marital status, and household composition. Every one-point higher conflict with parents was associated with being 2.31 times more likely to experience stress for the adult child (OR: 2.31, 95% CI: 1.49-3.57, p&lt;.001) and being 4.56 times more likely to experience loneliness (OR: 4.56, 95% CI: 2.79-7.43, p&lt;.001). IC, however, had a nonsignificant positive association with anxiety in adult children. The association between IC and psychological wellbeing suggests that conflict is a result of complex factors, for which interventions could be developed to improve psychological wellbeing and resiliency in families who continue to navigate cultural changes in a foreign land.
Intergenerational family leisure in the COVID-19 pandemic: Some potentials, pitfalls, and paradoxes
Authors: Rogers-Jarrell Tia , Vervaecke Deanna , Meisner Brad 
Published: December 2021

Abstract
COVID-19 has significantly changed the way we engage in leisure. The influence of public health measures and messaging on leisure put older and younger people alike at increased risk of stress, anxiety, loneliness, and isolation. Despite these similar experiences, ageism and tensions between generations intensified during the pandemic. Thus, it is imperative to encourage strategies that foster connections and solidarity between generations, such as participating in intergenerational family leisure. Intergenerational family leisure can both attenuate negative outcomes heightened or created by the pandemic (i.e., risk reduction) and increase positive experiences (i.e., wellness promotion). However, it is important to recognize that intergenerational family leisure may not be available, or ideal, for everyone, especially during the pandemic. There are longstanding and pandemic-specific pitfalls to engaging in intergenerational family leisure that need to be considered. Further, the conditions and handling of the COVID-19 pandemic have complicated family leisure in paradoxical ways. Many contradictions emerge as we navigate social systems and personal experiences when engaging in intergenerational family leisure during the pandemic. This paper critically presents some of the potentials, pitfalls, and paradoxes associated with connecting multiple generations in and through family leisure during the pandemic.
Family Caregiving Subtypes in the Caregiving Transitions Study: A Latent Class Analysis
Authors: Bentley John , Lupton-Smith Carly , Roth David 
Published: December 2021

Abstract
Family caregiving requires activities and experiences that have negative and positive features, producing stress but also providing benefits. The Caregiving Transitions Study (CTS) enrolled 283 caregivers from a national epidemiologic study, of which 32 were caregivers prior to enrollment in the parent study, and 251 became caregivers while participating in the parent study. Telephone interviewers were conducted after caregivers provided care for a minimum of 1.6 years (mean=7.7 years). Latent class analysis (LCA) was used to detect unobserved groups of caregivers. Number of problems (i.e., ADL, IADL, communication, emotional, disruptive behavior), average burden per problem, depressive symptoms, perceived stress, purpose in life, positive aspects of caregiving, hours of care, and duration providing care were used as indicators. Classes were subsequently compared on several external variables, including demographics, quality of life, leisure activities, and caregiving strain. The best-fitting model consisted of three classes (4.6% long-term, 27.6% high-distress, and 67.8% moderate-distress). Classes were similar with respect to sex, age, race, and primary caregiving status of the caregiver. Long-term caregivers had much longer caregiving durations and commonly provided care to a child. The high-distress class was noteworthy in terms of greater number of experienced patient problems; greater likelihood of caring for a person with dementia; higher levels of caregiving strain, depressive symptoms, perceived stress, and perceived burden; and lower levels of quality of life, purpose in life, positive aspects of caregiving, and leisure activities. These findings suggest that caregivers can be classified into distinct subtypes, with one subtype characterized as experiencing high distress.
Generation to Generation Project: Pairing Students With Older Adult Mentors During the COVID-19 Pandemic
Authors: Elfenbein Pamela 
Published: December 2021

Abstract
To meet the needs of older adults isolated in the midst of the COVID-19 pandemic, we began pairing Human Services and Gerontology students with community dwelling adults 55 years of age and older, recruited through senior centers and other organizations serving older adults.
Students paired with isolated older adults were tasked with building supportive relationships, assuring that basic needs were being met and that all available community resources were in place, and then documenting their mentor’s life stories with an emphasis on the resilience, strength and wisdom of their older adult mentors (to focus and build on their strengths, the older adults we engage with are referred to as our “mentors”). Oral histories and supporting artifacts are archived in the university’s library permanent repository.
The oral histories portray unique perspectives into life, strength, and resilience during the COVID-19 pandemic and quarantine. The older adult mentors participating in the Generation to Generation project reported feeling strengthened and connected through their participation in the Generation to Generation project.
To determine if social Isolation and loneliness can be ameliorated through participation in the Generation to Generation oral history project, researchers utilized the UCLA Loneliness Scale in pre- and post- participation interviews; findings will be shared.
Perceived Life Meaning and Purpose and Its Association with Mental and Physical Health among Family Caregivers
Authors: Chang Yu-Ping , Sessanna Loralee , Seo Young Sik 
Published: December 2021

Abstract
Evidence suggests that having a sense of life meaning and purpose is related to physical health. However, the association between life meaning and purpose and physical and mental health among family caregivers remains unclear. This study aimed to examine whether family caregivers’ perceived life meaning and purpose was associated with their physical and mental health (depression and anxiety). The National Study of Caregiving (NSOC) III cross-sectional survey (2017, N = 2,652) was utilized. One item was used to measure family caregivers’ perceived life meaning and purpose and two composite variables were generated to measure depression and anxiety. Physical health was assessed by questions including pain, breathing problems, limited arm/leg strength, low energy, and sleep problems. Weighted logistic regression analyses with covariate adjustments (i.e., caregiver’s age, sex, and race/ethnicity) were conducted to examine the association among family caregivers’ perceived life meaning and purpose, mental and physical health. Results indicated that family caregivers’ perceived life meaning and purpose was associated with a lower probability of having depressive symptoms (OR, .29, 95% Confidence Interval [CI], .15, .57) and anxiety (OR, .43, 95% CI, .23, .79). Furthermore, perceived life meaning and purpose was associated with a lower probability of having breathing problems (OR, .50, 95% CI [.25, .99]). Findings suggest that having a strong sense of life meaning and purpose is linked to better mental health and physical symptoms. Further research is needed to determine the mechanism regarding how life meaning and purpose may improve mental and physical health among family caregivers.
High Death Anxiety and Ambiguous Loss: Lessons Learned From Teaching Through the COVID-19 Pandemic
Authors: Weaver Raven , Bolkan Cory , Decker Autumn 
Published: December 2021

Abstract
For gerontological educators, topics such as mortality, loss, and end-of-life issues often emerge or are central in their courses. However, the COVID-19 pandemic has raised our awareness of loss and death on a global scale and teaching during the pandemic has raised questions about how educators, communities, or systems of higher education can support students’ learning while simultaneously experiencing losses during intense times of uncertainty. In this mixed-method study of 246 students enrolled in undergraduate thanatology courses, we explored their levels of death anxiety and their experiences with pandemic-related losses. We found that students’ death anxiety increased significantly during the pandemic, in comparison to the years prior (p &lt; .001). We also conducted a content analysis in a subset of students’ written narratives (n = 44) regarding their pandemic experiences. We identified three themes. Participants desired: (a) more flexibility from instructors, no questions asked; (b) more compassion and understanding; and (c) specific, targeted support resources. The voices of students were filtered through the authors’ interpretation as educators to provide several teaching recommendations that support student learning during challenging times. The recommendations align with a trauma-informed approach, given the high rates of death anxiety and ambiguous loss among students, and have immediate implications for educators teaching during the pandemic, and for years to come. Finally, we also advocate for more university and community-based thanatology, and gerontology education offerings in general, to help normalize conversations about death, loss, and bereavement.