bluuebunny/crossref_metadata_2025_split huggingface dataset:
Who’s in the House: Staffing in Long-Term Care Homes During the COVID-19 Pandemic
Authors: McGilton Katherine , Vellani Shirin , Chu Charlene , Backman Annica , Escrig-Pinol Astrid , Mateos José Tomás , Zúñiga Franziska , Spilsbury Karen 
Published: December 2021

Abstract
There is an absence of high-quality workforce data that could be used globally for comparative research on workforce planning in the residential long-term care (LTC) sector. We know that older adults residing in the LTC settings have multimorbidities resulting in complex care needs, yet the workforce is insufficiently able to meet their needs. A further reduction in LTC workforce was noted during the COVID-19 pandemic which increased the risk of adverse outcomes for residents. Survey results focused on the workforce in LTC homes collected from several countries during the current pandemic, highlighted that several members of the workforce were either absent or worked virtually (e.g., physicians, social workers). A better understanding of who is/or should be in the house to meet the needs of residents during or after future pandemics requires a workforce data system that routinely collects this information to ensure best quality outcomes for residents and their carers.
Perceptions of the Government’s Response to the Pandemic: Voices From the COVID-19 Coping Study
Authors: Gallo Haley , Kobayashi Lindsay , Finlay Jessica 
Published: December 2021

Abstract
The COVID-19 pandemic was met with conflicting government strategies in the handling of the virus. Older adults were disproportionately impacted by the pandemic, yet little is known about their perspectives of the government response. Using data collected in September and October, 2020 from the online, nation-wide COVID-19 Coping Study, we conducted qualitative thematic analysis on a subsample of respondents (N=500) proportionate to the age, gender, race/ethnicity, and education of the U.S. population age 55+. Two researchers individually coded a random subsample of 50 open-ended responses to the question “How do you feel about federal government responses to and handling of the COVID-19 pandemic?” Using NVivo qualitative software, the researchers compared codes and reconciled differences to achieve a Kappa score of &gt;0.8. The first author coded the remaining responses using the established coding strategy. Analyses identified themes related to President Trump’s leadership, Congress, the broader federal government, and science. Some participants indicated that the federal government’s response to the pandemic was “inadequate,” “too political,” and “lacking coordination.” Others expressed that the president “did the best he could” or that “it’s not the federal government’s responsibility.” While some praised vaccine development efforts and expressed their appreciation for Dr. Fauci, others expressed scientific distrust. Participants’ perspectives were divergent, reflective of the country’s polarization surrounding COVID-19 policies and practices. Differences in perspectives exist by race/ethnicity, gender, geographic region, and age. Study results can help identify groups of older adults who may need targeted programs and policy support.
Self-Administrated Elder Abuse Screening Tool for Older Adults With Visual and Hearing Disabilities
Authors: Swierenga Sarah , Abujarad Fuad , Ismirle Jennifer , Edwards Chelsea 
Published: December 2021

Abstract
Older adults age 60+ with disabilities are at greater risk of elder abuse compared to those without disabilities. We will describe results from our study to evaluate the usability and feasibility of the VOICES tablet-based elder abuse screening tool with older adults who have visual and hearing disabilities. VOICES is a digital health tool that screens, educates, and motivates older adults to self-report elder abuse. The VOICES tool has been developed and tested to be used with older adults without disabilities. We conducted a usability study with (n=14) older adults who were blind, had low vision, or were hard of hearing. Our evaluation method included both quantitative and qualitative measures to evaluate the ease of use and usefulness of the VOICES tool. Usability was measured as the percentage of tasks completed successfully, the average time to perform a task and the issues observed during performance of the tasks. Usability satisfaction was measured by written or verbal feedback on the questionnaires, and verbal comments from each session. Six participants completed the tasks successfully on their own; seven participants (mostly blind participants) completed the tasks with some intervention or help from the moderator. The majority of participants had System Usability Scale (SUS) scores 80 or above. Of all the participants, twelve (92%) stated that they would recommend the VOICES tool to others. Our findings generated universal considerations for more inclusive digital health interventions that accounts for the needs, wants and limitations for older adults with disabilities.
Social Participation and Elder Mistreatment in a National Sample of Older Adults
Authors: Yang Emmy , Lisha Nadra , Kotwal Ashwin , Wong Jaclyn , Huang Alison 
Published: December 2021

Abstract
Little is known about how social participation influences older adults' susceptibility to elder mistreatment. We conducted a cross-sectional analysis of a national probability sample of community-dwelling U.S. adults from 2015-2016 (1,268 women and 973 men; mean age 75 and 76 years, respectively; 82% non-Hispanic white). Frequency of participation in formal activities (community meetings, religious services, and volunteering) and informal social activities (socializing with friends and family) was assessed by questionnaire. Additional measures assessed emotional, physical, and financial mistreatment since age 60. Multivariable logistic regression examined associations between social participation and elder mistreatment, adjusting for age, race/ethnicity, education, and comorbidity. Forty percent of women and 22% of men reported at least one form of mistreatment (emotional, physical, or financial). Women reporting at least monthly formal social participation were more likely to report emotional mistreatment (adjusted odds ratio (AOR) 1.57, 95% confidence interval (CI) 1.08-2.29) and financial mistreatment (AOR 1.56, 95% CI 1.02-2.38) than women with less frequent engagement. Older women who socialized at least weekly were more likely to report emotional mistreatment (AOR 0.59, 95% CI 0.44-0.78) and financial mistreatment (AOR 0.59, 95% CI 0.42-0.85). These associations were not seen among older men. Frequent social engagement in the community does not preclude risk for elder mistreatment, and informal socializing may be associated with decreased exposure to certain forms of mistreatment. Assessment of older adults’ social activities may help guide strategies for detecting and mitigating elder mistreatment in the community.
Negative Impact and Positive Value of Caregiving in Spouse Carers of Persons With Dementia in Sweden
Authors: Johansson Marcus , McKee Kevin J , Dahlberg Lena , Summer-Meranius Martina , Williams Christine , Hammar Lena 
Published: December 2021

Abstract
As welfare providers struggle to meet the care needs of persons with dementia (PwDs), most of their needs are being met by a family carers, most often a spouse. The situation for spouse carers is unique, e.g., with grief, loneliness and loss of intimacy combining with stress and poor health. Research is needed to develop adequate support for spouse carers based on evidence of what influences negative and positive outcomes of care. The present study investigated psychosocial correlates of spouse carers’ (i) negative impact and (ii) positive value of caring. Data from a cross-sectional survey of 165 spouse carers community-resident in Sweden was analysed in two hierarchical regression models to predict negative impact and positive value of caring. Results found that negative impact and positive value were explained by different variables, significant predictors for negative impact included carer stress, health, and emotional loneliness, and change in intimacy with the care-recipient, while positive value was predicted by mutuality, change in closeness to the care-recipient and quality of support. Negative impact and positive value shared variance of only 17.2%. Thus, negative impact and positive value represent different aspects of the carer situation. Consequently, support needs to target several aspects in carers’ life, aiming to; facilitate for spouses to manage PwD’s impairment, increase emotional support while also strengthening the relationship between carer and PwD to reduce negative impact while increasing positive value.
LTSS Direct Care Worker Employment During COVID-19
Authors: Dill Janette , Frogner Bianca 
Published: December 2021

Abstract
The crisis of COVID-19 in long-term care services and supports (LTSS) has brought attention to challenges in staffing long-term care organizations, as shortages of direct care workers led to a dramatic inability to provide needed care for many residents in nursing homes and other residential care settings. In this study, we examine unemployment among LTSS direct care workers during the crisis and recovery. This study uses monthly data from January 2019 to December 2020 from the Current Population Survey, a monthly household survey collected by the Bureau of Labor Statistics, and we compare an individual’s 2019 monthly employment patterns to their 2020 monthly employment. Long-term care workers had an unemployment rate of 2.8% in April 2020, when unemployment rates in the US reached a peak; however, new unemployment among long-term care workers has not declined as consistently as in other settings. Female health care workers were significantly more likely to be unemployed compared to their male counterparts, a trend that is consistent with the overall economy, and workers who earned the lowest wages were more likely to have transitioned to unemployment. COVID-19 has added significant complexity to the provision of direct care services, making LTSS a hazardous place to work. Concerns remain about unemployment in long-term care where demand for workers remains high; additional measures need to be taken to ensure that direct care workers have the resources they need to remain employed.
Perspectives Toward Long-Term Care Measurement From Frontline Workers in Brazil
Authors: de Mello Ruth Caldeira , Wachholz Patrick , Boas Paulo José Fortes Villas , Schutz Vivian , Lepore Michael , Myer Deanna , Olives Ester Villalonga , Corazzini Kirsten 
Published: December 2021

Abstract
The Brazilian long-term care (LTC) sector remains poorly structured and underdeveloped. COVID-19 did not bring unprecedented focus to the sector just because of the high mortality; it also affected the quality of care. In this pilot study, we evaluated the perspectives toward WE-THRIVE LTC measurements from Brazilian frontline workers in five long-term care facilities. For the four WE-THRIVE domains of LTC measurement (workforce and staffing, person-centered care, organizational context, and care outcomes), respondents used a 4-point Likert scale to rate their importance and answered open-ended questions about how these aspects of care changed since COVID-19. With few exceptions, respondents rated these aspects of LTC as extremely important or very important. Qualitative results highlighted concerns about and impacts of COVID-19, such as challenges related to the isolation of residents. The assessed measurement domains are confirmed to be important by frontline staff in Brazil. Measurement adoption must account for current issues.
Mild Parkinsonian Signs Are Related to Lower Cortico-Striatal Connectivity in Executive Networks
Authors: Hengenius James , Huppert Theodore , Rosso Andrea , Rosano Caterina 
Published: December 2021

Abstract
Mild Parkinsonian signs (MPS) affect up to 24% of community-dwelling older adults. We hypothesize that MPS are associated with Parkinson’s-like alterations of functional connectivity (FC) in sensorimotor, executive, and reward cortico-striatal networks. Participants (N=266; mean age=83; 57% female) without Parkinson’s completed resting-state fMRI and Unified Parkinsonian Disease Rating Scale (UPDRS). FC between striatum and cortex was measured within each network. Logistic regression tested associations of each network’s FC with MPS (UPDRS&gt;0), adjusted for MPS risk factors, then including white matter hyperintensities (WMH). MPS was associated with lower cortical-striatal FC in the left executive cortico-striatal network (OR [95%CI]: 0.188 [0.043,0.824]). Association survived adjusting for risk factors (0.162 [0.030,0.874]) but was attenuated after including WMH (0.209 [0.036, 1.200]). In stratified analyses, left executive cortico-striatal FC was associated with MPS only for those with higher WMH (0.077 [0.010,0.599]). Future work should examine whether higher FC protects against the influence of WMH on MPS.
Genetic Variants Correlate With Better Processing Speed
Authors: Song Zeyuan , Gurinovich Anastasia , Christensen Kaare , Nygaard Marianne , Mengel-From Jonas , Andersen Stacy , Perls Thomas , Sebastiani Paola 
Published: December 2021

Abstract
Some cognitive abilities, such as vocabulary, are resilient to brain aging, while others such as conceptual reasoning, memory, and processing speed, decline with age and their rate of decline is genetically regulated. Despite the strong genetic heritability of processing speed assessed by the digit symbol substitution test (DSST), previous studies have failed to identify robust common genetic variants associated with this test. The Long Life Family Study (LLFS) includes long lived individuals and their family members who maintain good DSST scores as they age and who may carry variants associated with better DSST. We therefore conducted a genome-wide association study (GWAS) of DSST in LLFS using ~15M genetic variants imputed to the HRC panel of 64,940 haplotypes with 39,635,008 sites and replicated the findings using genetic data imputed to the 1000 Genomes phase 3 reference panel combining two Danish cohorts: the Middle Aged Danish Twins and the Longitudinal Study of Aging Danish Twins. The GWAS in LLFS discovered 20 rare genetic variants reaching genome-wide significance (p-value &lt; 5x10-8), including 18 variants associated with better processing speed with large effect size. The genetic associations of rs7623455, rs9821776, rs9821587, rs78704059 in chromosome 3 were replicated in the combined Danish cohort. These genetic variants tagged two hormone receptor related genes, THRB and RARB, both related to cognitive aging. Further gene-based tests in LLFS confirmed that these two genes have protective variants associated with better processing speed.
Creation and Validation of a Polysocial Score for Mortality Among Community-Dwelling Older Adults in the United States
Authors: Wu Chenkai , Odden Michelle , Stawski Robert , Magid Hoda 
Published: December 2021

Abstract
The interrelatedness between social determinants of health impedes researchers to identify important social factors for health investment. Since the older population had highly diverse social backgrounds, a new approach is needed to quantify the aggregate effect of social factors and develop person-centered social interventions. Participants ([n = 7383], 54.5% female) were aged 65 years or above who complete an additional psychosocial questionnaire in the Health and Retirement Study (HRS) at study entry in 2006 or 2008. Social determinants of health encompassing five social domains: economic stability, neighborhood and physical environment, education, community and social context, and health care system. Five-year mortality was calculated as the number of years from the interview date to the death date. We used the forward stepwise logistic regression to construct the polysocial score and multivariate logistic regressions to assess the associations between polysocial score and five-year mortality. Polysocial score (range: 7 to 59, mean±SD: 35.5±7.5) was created using 15 social determinants of health. Of the 7383 participants, 491 (30.8%), 599 (17.2%), and 166 (7.8%) deaths occurred over five years among participants with a low (0-29), intermediate (30-39), and high (40+) polysocial score, respectively. Participants with an intermediate (Odds Ratio [OR]=0.76; 95% CI, 0.65-0.89) or high (OR=0.46; 95% CI, 0.36-0.59) polysocial score had higher odds of death than those in the low category in the fully adjusted model, respectively. The polysocial approach may offer possible solutions to monitor social environments and suggestions for older adults to improve their social status for specific health outcomes.
Sex Difference in All-Cause and Infection-Specific Mortality Over 10 Years Post Hip Fracture
Authors: Bajracharya Rashmita , Guralnik Jack , Magaziner Jay , Shardell Michelle , Rathbun Alan , Yamashita Takashi , Orwig Denise 
Published: December 2021

Abstract
Men die at a twice higher rate than women in the first two years after fracture and also experience higher infection-related mortality. Most research has only looked at differences in short-term mortality after hip fracture. The objective was to determine if cumulative incidence of all-cause mortality and infection-specific mortality is higher in men compared to women over ten years. Data came from Baltimore Hip Studies7th cohort. Women were frequency-matched (1:1) to men on timing of fracture to ensure equal numbers of men and women. The association of sex and all-cause mortality was analyzed using Cox proportional hazard model and a cause-specific hazard model for infection-specific mortality. Both models controlled for age, cognition, comorbidity, depressive symptoms, BMI, and pre-fracture ADL limitations. Complete-case sample size was 300 (men=145, women=155). By the end of ten years from the date of admission for a hip fracture, there were 237 (men=132, women=105) all-cause deaths and 38 (men=25, women=13) infection-specific deaths. Men had significantly higher all-cause mortality risk [73.7% vs 59.3%; HR=2.31(2.02-2.59)] and infection-specific mortality [17.2% vs 8.3%; HR=4.43(2.07-9.51)] compared to women. In addition to sex, older age, cognition, and comorbidities were associated with all-cause mortality whereas only BMI was associated with infection-specific mortality in adjusted models. Men had a higher risk of mortality over 10 years compared to women, specifically two-fold higher risk of infection-specific mortality compared to all-cause mortality. Findings imply that interventions to prevent/treat infection, tailored by sex, may be needed to narrow significant differences in long-term mortality rates between men and women.
Barriers and Facilitators of Pain Management in Persons With Dementia in Long-Term Care: A Scoping Review
Authors: Liao Yo-Jen , Jao Ying-Ling , Berish Diane , Kitko Lisa 
Published: December 2021

Abstract
Approximately 50% of individuals with dementia regularly experience moderate to severe pain, which is largely undermanaged. Several studies have explored the barriers and facilitators of pain management for persons with dementia; yet the evidence has not been systematically reviewed. This review aimed to synthesize current evidence on the barriers and facilitators of pain management in persons with dementia in long-term care. A PRISMA guided literature search was conducted in PubMed, CINAHL, and PsycINFO. Titles, abstracts, and full texts were screened. Included articles were original research examining the barriers or facilitators of pain assessment and treatment in individuals with dementia in long-term care. Quality assessment was conducted using the Risk of Bias tool and Johns Hopkins Level of Evidence. Ten studies were identified, including four quantitative studies, five qualitative studies, and one with both quantitative and qualitative research. Barriers of pain management identified include residents’ ability to self-report pain, pain medication side effects, need discrepancy among residents and their families, reluctance in administering analgesics, lack of pain assessment tools, lack of guidance in providing nonpharmacological interventions, and lack of clinical guidelines. Facilitators of pain management include clinicians with caring and enthusiastic characteristics, clinicians’ knowledge of residents, positive relationships among clinicians, good communication skills, using validated pain assessment tools, understanding pain indicators, clinical experience, and need-driven continuing education. These results can guide clinical practice in long-term care. Interventions should be developed to target these barriers and facilitators and improve pain management in persons with dementia.
The Sex Difference in Gait Speed: How Do Sociodemographic, Lifestyle, Social, and Health Determinants Contribute?
Authors: Sialino Lena , Schaap Laura , van Oostrom Sandra , Picavet Susan , Twisk Johannes , Verschuren Monique , Visser Marjolein , Wijnhoven Hanneke 
Published: December 2021

Abstract
This study explores whether a sex difference in sensitivity to (strength of the association) and/or in exposure to (prevalence) determinants of gait speed contributes to the observed lower gait speed among women compared to men. Data from the Longitudinal Aging Study Amsterdam (LASA) were used. In total 2407 men and women aged 55-81 years were included, with baseline measurements in 1992/2002 and follow-up measurements every 3-4 years for 15/25 years. Multivariable mixed model analysis was used to investigate sex differences in sensitivity (interaction term with sex) and in exposure to (change of the sex difference when adjusted) for socio-demographic, lifestyle, social and health determinants of gait speed. On average, women had a 0.054 m/s (95%CI:0.076-0.033, adjusted for height and age) lower mean gait speed compared to men. Higher BMI and lower physical activity were more strongly associated with lower gait speed in women compared to men (i.e. higher sensitivity). Lower educational level, living alone and having more chronic diseases, pain and depressive symptoms among women compared to men also contributed to observed lower gait speed in women (i.e. higher exposure). In conclusion, both a higher sensitivity and higher exposure to determinants of gait speed among women compared to men contributes to the observed lower gait speed among women aged 55 years and older. The identified (modifiable) contributing factors should be taking into account when developing prevention and/or treatment strategies aimed to enhance healthy physical aging. This might require a sex-specific approach in both research and clinical practice.
Intergenerational Relationships During the COVID-19 Pandemic: Challenges and Opportunities of Data Collection
Authors: Suitor J Jill , Gilligan Megan 
Published: December 2021

Abstract
Family scholars experienced numerous unique challenges and opportunities when studying intergenerational relationships during the COVID-19 pandemic. In this presentation, we draw examples from the Within-Family Differences Study to highlight some of the ways in which respondents’ patterns of study participation, reports of their relationships with their late-life parents and their own young adult children, and their psychological well-being, subjective physical health, and health behaviors reflected the fluctuating waves of the pandemic. Among the patterns we discuss are systematic variations in the intensity of respondents’ answers to both open and closed-ended items, respondents’ expressions of concern regarding choosing the “right” answers to questions, and their attempts to negotiate their responses with interviewers. Our observations led us to conclude that measures family gerontologists use to capture many constructs central to the field are subject to different “meanings” by respondents in the face of disaster.