bluuebunny/crossref_metadata_2025_split huggingface dataset:
NURSING PRACTICE AND OPTIMAL DELIRIUM CARE AMONG OLDER ADULTS IN ACUTE CARE SETTINGS
Authors: Mailhot Tanya , Bouaouina Zineb , Joannette Tania Valentine , Khetir Imene , Lavoie Patrick 
Published: January 2025

Abstract

Studies have emphasized the limited availability of data regarding the current practices of nurses in delirium care for patients in acute care settings. Similarly, there is a lack of information regarding the obstacles and facilitators in providing optimal care for the prevention, detection, and management of delirium.

Aim
To describe nurses’ practices about delirium care in acute care patients and their perceptions about barriers and facilitators regarding optimal care. Method: A two phase, multi method design was used. The quantitative phase utilized a self-reported survey to assess nurses’ knowledge, practice, confidence, and collaboration regarding delirium care. The qualitative phase employed focus groups to complement and explore survey data in-depth. Recruitment took place on nine acute surgical and medical units across two university-affiliated hospitals in Canada, involving nurses in direct patient care.

Results
231 nurses reveal diverse insights into delirium care in acute settings and survey participants showed solid knowledge of delirium symptoms and outcomes, yet 23% did not identify the hypoactive form’s prevalence. While 81% reported receiving information on delirium screening, challenges included time constraints and misuse of detection tools. Qualitative themes highlighted communication’s vital role, challenges posed by delirium presentations, the significance of staff support, time constraints, the impact of experienced staff, the role of families, and the importance of additional resources for optimal delirium care.

Conclusion
Findings align with existing literature, emphasizing the multifaceted nature of delirium care and the need for tailored approaches, education, and collaborative strategies to improve overall care quality.
CHATO NATIONAL TRIAL: USING OPEN-ENDED RESPONSE TO DEVELOP VIDEO TUTORIALS TO IMPROVE NURSING HOME IMPLEMENTATION
Authors: Jaros Maria , Coleman Carissa , Yang Frances , Shaw Clarissa , Hein Maria , Perkhounkova Yelena , Williams Kristine 
Published: January 2025

Abstract
The Changing Talk: Online (CHATO) intervention was developed to increase staff access to person-centered dementia care communication education in a national nursing home sample. A qualitative review of the post-evaluation survey responses (N=1605) from participants in the first year of the study was performed to determine issues associated with the modules to improve implementation across nursing homes. Three open-ended questions addressed technical difficulties and what participants liked most and least about the program. Technical difficulties were reported by 21.1% of participants, including internet connection (5%), video difficulties (3.8%), non-specific technical difficulties (3.7%), website interface (3.1%), registration (1.8%), and navigating the modules (1.1%). Sixty-nine percent of participants reported what they liked the best about the course. Participants indicated real-world application (22.4%) was liked best, followed by the videos in the modules (18.8%), and the presentation of the material (5.9%). When asked what participants liked least about the course, 54.3% of participants provided input. The length of the three-hour course (21.4%) was liked least, followed by the presentation of the material (7.7%), and the interactive components of the modules (6.5%). In response to these findings, video tutorials were created addressing components most reported in the post-evaluation which included outlining navigation features within the CHATO training, registering for the course, and navigating to the modules. Tracking new users accessing the video tutorials via the CHATO website as well as annual coding will provide ongoing monitoring of implementation success and will provide input for re-design of the modules in future research.
CHARACTERIZING THE CIRCUMSTANCES OF FALLS AMONG COMMUITY-DWELLING OLDER ADULTS
Authors: Kehrer-Dunlap Abigail , Bollinger Rebecca , Keleman Audrey , Ances Beau , Stark Susan 
Published: January 2025

Abstract
Falls are the leading cause of injury, institutionalization, and injury-related mortality among older adults. As the older adult population is expected to grow exponentially in the next decade, the cost and consequences of falls will continue to rise. While promising fall prevention interventions exist, the death rate due to falls continues to climb. Limited population health effectiveness of these interventions may be attributable to a poor understanding of contributing factors to falls, such as the environmental and contextual circumstances in which falls occur. The objective of this study was to characterize the circumstances of falls among community-dwelling older adults. We completed monthly, prospective fall monitoring with 350 cognitively normal (Clinical Dementia Rating=0) older adults for up to four years. Standardized interviews were conducted to gather the circumstances of all reported falls, including the location, time of day, and activity at the time of the fall. We qualitatively analyzed fall interviews to determine the reason for the fall and factors of limited or divided attention preceding the fall. There were a total of 1,133 falls reported by 212 (61%) participants. The majority of falls occurred outdoors (53%), in the afternoon (45%), while walking or running (50%), and due to tripping over or catching feet on an object (37%). Additionally, 37% of falls occurred during instances of limited or divided attention. Taken together, these findings provide a greater understanding of the circumstances of older adult falls that may inform future classifications of types of falls and lead to tailored fall prevention approaches.
DEVELOPING A TAILORED STRAIN INDEX FOR LONG-DISTANCE FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Falzarano Francesca , Cimarolli Verena , Boerner Kathrin , Chunga Richard 
Published: January 2025

Abstract
Most research has examined the experiences and consequences of dementia family caregiving among proximate caregivers, while the unique needs of the growing number of long-distance caregivers (LDCs) remain understudied. Since the vast majority of research and evidence-based intervention efforts have specifically focused on caregivers who reside in close proximity to their care-recipients, existing measures of caregiver strain do not adequately capture the unique distance-related challenges experienced by LDCs. Thus, the current study aims to evaluate the suitability of a nine-item strain index tailored for LDCs. The scale is comprised of: 1) a three-item measure assessing level of difficulty experienced with the physical, financial, and emotional aspects of care from the National Study on Caregiving (NSOC); and 2) six novel items assessing difficulty with LDC (e.g., monitoring care, traveling to the care-recipient). Baseline data (n=40) derived from a study examining the feasibility of LDCare - a virtual, multicomponent intervention for LDCs - were used to conduct an exploratory factor analysis (EFA) with the NSOC and LDC-specific items. Initial findings suggested the exclusion of two factors that did not significantly contribute to the scale’s underlying covariance structure. Further analyses suggested that a seven-item scale comprised of two components yielded the best model fit, accounting for 57.1% of the total variance. The final scale included three items capturing distance challenges and four items assessing general caregiving challenges. Findings provide evidence for the scale’s suitability among LDCs and underscore the importance of tailored assessments to adequately measure the unique challenges associated with LDC.
GRANDMOTHER INITIATIVES IN FAMILY TRANSFORMATION: OUTCOMES OF AN INTERVENTION STUDY
Authors: Musil Carol , Jeanblanc Alexandra , Burant Christopher , Zauszniewski Jaclene 
Published: January 2025

Abstract
To address the well-documented stress and health challenges faced by grandmothers raising grandchildren, a sample of 342 grandmothers living with grandchildren participated in a national online, NIH funded randomized clinical trial testing two methods to reduce stress. We evaluated whether the 4-week Grandmother Initiatives in Family Transformation (GIFT) intervention (Resourcefulness Training © via video plus structured journaling) compared to a 4-week unstructured journal-only condition (with video instruction) improved grandmothers’ individual and family well-being: a) mental health (general mental health and depressive symptoms), b) physical health (self-rated and general health), c) family well-being (family functioning) and d) resources (resourcefulness, support, and reward) at 2, 12, and 24 weeks post-intervention. We ran RM-ANOVA for each outcome, looking at changes over time, time by arm, time by days journaling, and time by number of video views for their arm. Grandmothers in both arms showed significant improvements on general mental health and family functioning and reduced depressive symptoms and stress across time, establishing that both arms received helpful interventions; there were no changes in physical health indicators. Participants in both arms reported improved resourcefulness, support, and caregiving reward. Significant improvements over time in mental health and support were reported by participants journaling more frequently. The number of video views was significant over time only for resourcefulness, although there were between-subjects effects for video views for general mental health and depressive symptoms. Implications for online interventions to reduce stress, and the impact of active participation (journaling, practice and video support) are discussed.
EFFECTS OF A THEORY-ORIENTED SOCIAL FACILITATION INTERVENTION ON SOCIAL ISOLATION: A RANDOMIZED CONTROLLED TRIAL
Authors: Xiao Huimin , Liu Huangqin , Huang Qiyuan 
Published: January 2025

Abstract
Transitioning to a nursing home represents significant life changes, which often result in a significant reduction and potential dissolution of pre-existing emotional bonds with family, friends, and social networks. Social facilitation is essential to help nursing home residents adapt a new life in nursing home. Thus, this study aimed to develop and examine the effects of the social facilitation program based on the cognitive-behavioral model of social isolation (SFCBSI), on social isolation, subjective well-being, cognitive tendencies, psychological adjustment, self-efficacy, and social support of nursing home residents. A randomized, controlled, assessor-blinded, parallel-arm trial was conducted in two nursing homes Fujian, Southeast of China from September 2023 to February 2024. 180 participants were randomly assigned to the intervention group (n = 90) and the control group (n = 90). The control group received routine institutional care. The intervention group received the SFCBSI program involving cognitive reconstruction, emotional management, and behavioral change, which was implemented by group for 4 weeks. Participants were assessed using the Cognitive Appraisal Orientation Test, Nursing Home Adjustment Scale, General Selfefficacy Scale, Perceived Social Support Scale, Social Isolation Scale and the Memorial University of Newfoundland Scale of Happiness Survey. Outcomes were evaluated at baseline and immediately after the intervention. The intervention participants showed significant differences in social isolation, subjective well-being, cognitive tendencies, psychological adjustment, self-efficacy, and social support, compared to the control group (P &lt; 0.001). It indicates that the SFCBSI could reduce social isolation and improve psychological well-being among nursing home residents.
INSIDE THE BLACK BOX OF MANAGED CARE: SERVING AT-RISK OLDER ADULTS IN MASSACHUSETTS’ SENIOR CARE OPTIONS PROGRAM
Authors: Nadash Pamela , Cohen Marc , Miller Edward , Fassi Janelle , Pallis Maryssa , Siebecker Megan , Simpson Elizabeth 
Published: January 2025

Abstract
People dually eligible for Medicare and Medicaid are at risk for poorly coordinated care, high-cost health service utilization, and poor outcomes. Commonwealth Care Alliance (CCA), a not-for-profit managed care organization, serves approximately 35,000 people dually eligible for Medicare and Medicaid in the Commonwealth of Massachusetts. CCA has two primary products: Senior Care Options, which has served people 65 years or older since 2003, and One Care, which has served people 18-64 years of age since 2013. Drawing from key informant interviews and other data collection, this study sought to understand the organizational experience of the CCA model. It identifies the challenges CCA faces in ensuring that its vulnerable membership has access to both appropriate clinical care and the broad range of health-related services that are critical to the health of members. It also identifies the plan’s mechanisms for addressing these challenges. The evolution of CCA’s model of care and the various mechanisms it adopted over time to adapt to the needs of its membership and comply with state and federal requirements are discussed. These changes are then placed in the context of ongoing conversations about the most effective models of integrated care. Findings highlight CCA’s focus on health-related social needs; the impact of member advocacy on program design; and the implications of non-profit status for workplace culture and resources.
PREVALENCE OF LIFESTYLE-BASED MODIFIABLE DEMENTIA RISK FACTORS AMONG CANADIAN ADULTS AGES 50+
Authors: D’Amico Danielle , Tan Brian , Binns Malcolm , Chertkow Howard , Anderson Nicole 
Published: January 2025

Abstract
Modifiable lifestyle behaviours are key determinants of cognitive health and dementia risk. The prevalence of lifestyle-based dementia risk factors is currently unknown among the Canadian adult population. The purpose of this study was to establish age- and sex-adjusted prevalence of risk in five domains using validated scales: 1) physical activity (CHAMPS); 2) brain-healthy eating (Eating Pattern Self-Assessment); 3) cognitive engagement (Florida Cognitive Activities Scale); 4) social connections (UCLA Loneliness Scale); and 5) mental well-being including depression, anxiety, distress, and perceived stress (DASS-21 and PSS-10). Males ages 70-79 (n=120) and females ages 60-69 (n=145), 70-79 (n=217), and 80+ (n=115) completed each scale online. Depending on the age decade x sex group, the percentage of individuals who exhibited mild depression, anxiety, distress, and perceived stress were 20.0-28.7%, 14.7-22.6%, 13.0-20.0%, and 43.3-54.7%, respectively. 33.1-54.5% did not meet the physical activity recommendations of 150 minutes/week of moderate to vigorous exercise. No participants met the brain-healthy eating recommendations. High-risk cut-off scores (below the 10th percentile) ranged from 8.0-11.6 for cognitive engagement and 23.4-24.4 for social engagement. The number of domains upon which individuals were at high risk ranged from 1 to 5 (median = 4). Data are currently being collected for females ages 50-59 and males ages 50-69 and 80+. This study is part of the first-of-its-kind research-based community centre at Baycrest delivering personalized dementia risk reduction programming. These data will be used to identify domains in which participants are at-risk in order to guide personalized dementia risk reduction program strategy.
ECONOMIC IMPACT OF FRAILTY OR PREFRAILTY IN THE ELDERLY AGED 75 OR OVER IN JAPAN
Authors: Yoshida Hiroto , Matsuzaki Yuriko 
Published: January 2025

Abstract
This study examined the impact of frailty or pre-frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 758 individuals (63.0%) who used medical services at least once during the follow-up period until the end of August 2019 (17 month-period). We defined frailty as a state in performing 4 items or more and pre-frailty 2 or 3 items of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 758 subjects, 202 subjects (26.6%) were judged to be frailty group, 210 subjects (27.7%) pre-frailty group, and 346 subjects (45.6%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures between the three groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in pre-frailty group than non-frailty group (HR=3.93, 95% CI∶1.37-11.22, P=.011). The average cumulative medical and long-term care expenditures per capita during the follow-up period were significantly (P=.025) larger for those in the frailty group (1,190,000 yen). We confirmed the accessibility of pre-frailty to long-term care service use and the strong economic impact of frailty in the elderly aged 75 or over in Japan.
FACTORS AFFECTING THE IMPLEMENTATION OF THE PRITAH INTERVENTION: LESSONS LEARNED
Authors: Ponstein Klarissa , Bleijlevens Michel , Erkens Petra , Hamers Jan 
Published: January 2025

Abstract
The implementation of effective healthcare interventions into routine practice is challenging and influenced by various factors, including the context of implementation, individuals involved, and intervention characteristics. This study aims to explore challenges by implementing the Prevention and Reduction of Involuntary Treatment At Home (PRITAH) intervention. After a careful preparation phase, we faced serious challenges that temporarily delayed implementation. To gain insights into the reasons and factors that led to implementation delay of PRITAH, two separate focus groups were conducted with 1) two policy staff members, a district nurse, two case managers dementia, and a middle manager, and 2) two senior managers and three directors. We examined both barriers and facilitators using the Consolidated Framework for Implementation Research (CFIR). Results show that relevant stakeholders, including members from focus group one, were not involved in a timely manner. Moreover, communication gaps between senior management and middle management, policy staff, district nurses and dementia case managers led to inconsistencies in knowledge of the implementation steps being taken and hindered the decision-making processes. Nevertheless, the members of both focus groups acknowledged the shared goal of preventing involuntary treatment at home as facilitator, emphasizing the importance of goal alignment. Furthermore, a clear implementation plan from the intervention developers ensured that implementation efforts were guided by organizational expectations. The delays in implementing PRITAH emphasize timely stakeholder engagement, effective communication, joint alignment of goals and a clear implementation plan. Based on the results an adapted implementation plan has been developed.
THE GENDERED LONG ARM OF CHILDHOOD: EARLY PARENT–CHILD RELATIONSHIP AND LATER-LIFE MENTAL HEALTH IN RURAL CHINA
Authors: Wang Jia , Ma Mingyue 
Published: January 2025

Abstract
The large body of literature examining adverse childhood experiences (ACE) on late-life health has paid relatively little attention to gender variation. We contend that a gender perspective is crucial for understanding if women’s disadvantages in health have an early origin from childhood. In particular, we suggest that non-material aspects of ACE, such as poor parent-child relationships, are more likely to exhibit gendered patterns in their influences on health, particularly in developing countries with traditional gender norms and higher gender inequality. Using five waves of data from the China Health and Retirement Longitudinal Study (CHARLES), we examine the associations between parent-child relationships in childhood and later-life mental health among Chinese men and women aged 45 and above in rural areas. Our analyses yield three important findings: 1) Compared to rural men, rural women tend to exhibit worse mental health in terms of both the baseline level and the developmental trajectory of mental health over time; 2) From a snapshot perspective, poorer parent-child relationship during early life is related to worse baseline level of mental health among both rural men and women, and this association is more pronounced among rural women; 3) From a temporal perspective, poorer parent-child relationship in early life is associated with higher likelihoods of experiencing depression throughout the whole survey period, particularly among rural women. Our study sheds new light on the significance of a gender lens when examining the early-life origins of health inequality.
ADVERSE CHILDHOOD EXPERIENCES AND MENTAL HEALTH IN MIDDLE AGE AND OLDER ADULTS: THE MEDIATIONAL EFFECT OF RESILIENCE
Authors: Griffith Christopher , Broen Tiana , Scott Julia , Feliciano Leilani 
Published: January 2025

Abstract
Adverse childhood experiences (ACEs), physical health problems, and poor health perception are known predictors of subsequent poor mental health later in life. To support aging adults in their mental wellbeing, it is crucial to understand how they may recruit internal resources, such as resilience, to cope with past adverse experiences and current health difficulties. The current study used structural equation modeling (SEM) to examine the mediational effect of resilience on the pathways between adverse childhood experiences, sociodemographic variables, and health-related variables to mental wellbeing (a latent factor represented by depression, anxiety, and stress scores, higher score = lower mental wellbeing). Survey data were analyzed from a sample of adults aged 40 to 94 years (N = 334; Mage = 60.46; 48.8% women; 86.2% white). Number of ACEs were significantly correlated with age (β = -8.86, p &lt;.001), number of physical health conditions (β = 0.44, p &lt;.05) and mental health conditions (β = 1.11, p &lt;.001), and poorer subjective health perception (β = 0.47, p &lt;.001). Resilience mediated the pathways from subjective health perception to poor mental wellbeing (β =.05, p &lt;.01), number of mental health conditions to poor mental wellbeing (β =.11, p &lt;.01), and number of ACEs to poor mental wellbeing (β = 0.03, p &lt;.05). Overall, these results highlight the significance of ACEs on mental wellbeing outcomes, and the importance of enhancing resilience in older clients with a history of ACEs.