bluuebunny/crossref_metadata_2025_split huggingface dataset:
What’s Race got to do With it? How Palliative Care Consultation may Mitigate Racial Disparities in Future Care
Authors: Starr Lauren , Ulrich Connie , Perez G Adriana , Aryal Subhash , Junker Paul , O'Connor Nina , Meghani Salimah 
Published: December 2021

Abstract
It is unknown if care and cost outcomes differ by race and ethnicity following discharge from a hospitalization involving palliative care consultation to discuss goals-of-care (PCC). In this secondary analysis of 1,390 seriously-ill patients age 18+ alive at discharge who self-identified as Black, Hispanic, Asian, white, or other race and received PCC at an urban, academic medical center, we used binomial logistic regression and multiple linear regression controlling for demographic and clinical variables to identify factors associated with care experiences and costs following discharge from a hospitalization with PCC. In adjusted analyses, discharge to hospice was associated with Medicaid (p=0.016). Thirty-day readmission was associated with age 75+ (P=0.015), Medicaid (P=0.004), admission 30 days prior (P&lt;0.0001), and Black race compared to white (P=0.016). Number of future days hospitalized was associated with Medicaid (P=0.001), admission 30 days prior (P=0.017), and Black race compared to white (P=0.012). Having any future hospitalization cost was associated with patient ages 65-74 (P=0.022) and 75+ (P=0.023), Medicaid (P=0.014), admission 30-days prior (P&lt;0.0001), and Black race compared to white (P=0.021). Total future hospitalization costs were associated with female gender (P=0.025), Medicaid (P=0.009), admission 30 days prior (P=0.040), and Black race compared to white (P=0.037). Race or ethnicity was not a predictor of hospice enrollment. Randomized controlled trials are needed to understand if PCC is an intervention that reduces racial disparities in end-of-life care. Qualitative insights are needed to explain how PCC and socioeconomic factors such as Medicaid may mitigate future acute care use among racial and ethnic groups.
Moderators of Dual Task Gait Effects in Mild Cognitive Impairment and Dementia
Authors: Ofori Edward , James Dara , Kaczmarek Olivia , Gudesblatt Mark 
Published: December 2021

Abstract
Spatiotemporal gait parameters may provide indication about the cognitive status of individuals. Dysfunction in specific gait features has been associated with increased risk of cognitive decline. Here we use spatiotemporal gait patterns to determine whether specific cognitive domain scores moderate the effects during dual-tasking on individuals with mild cognitive impairment (MCI) and dementia. Participants (n=46; mean age: 77.0±8.9 years) with a diagnosis of cognitive impairment (n=16), or dementia (n=30) were included. They performed validated computerized cognitive assessment battery (CAB, NeuroTrax BrainCare) to obtain cognitive domain measures of executive function (EF), attention, memory, visual-spatial processing (VSP), information processing speed (IPS), and a global cognitive score (GCS) measure. Using the Zeno Walkway Gait Analysis System (Protokinetics), measures of velocity, stride width (SW), stride time (ST), stride length, cadence, double support (DS), and gait variability were obtained for both single-task and DT gait. Data analysis was conducted using SPSS 26 and PROCESS 3.5. As expected, the dementia group had lower cognitive domain scores and slower walking speed than MCI group. Results also indicated that visual-spatial processing skills was the only cognitive domain that did have a moderation effect on gait velocity (F=4.2, p&lt;0.05, R-square change 10%). Our results indicate that differences between walking speed in MCI and dementia groups are moderated by visual spatial skills. Improvement in visual spatial skills could improve the dual task effects of individual gait measures.
Racial and Ethnic Disparities in Pain Management for Nursing Home Residents: A Scoping Review
Authors: Dictus Cassandra , Cho Youngmin , Baker Tamara , Beeber Anna 
Published: December 2021

Abstract
Within nursing homes, residents commonly experience pain that unfortunately goes underrecognized and undertreated, having a dramatic negative impact on residents' quality of life. Nursing homes are becoming more racially and ethnically diverse, and there is concerning evidence documenting disparities in the quality of nursing home care. In other healthcare settings, people of diverse race groups often receive less optimal pain management, but the evidence regarding racial disparities has not been synthesized for nursing homes. Thus, the purpose of this review was to investigate what is known about racial disparities related to pain management (e.g. assessment, treatment, preferences) in US nursing homes. We completed a scoping literature review using PRISMA-ScR guidelines and searching PubMed, CINHAL, and Scopus for peer-reviewed, empirical studies. Most studies were older large retrospective cohort studies of administrative data documenting that White residents were more likely than residents of diverse race groups to have pain documented and treated. Only a few studies looked at possible reasons to explain the disparities; differences were not found to be related to nursing staff racial bias nor differences in pain-related diagnoses. However, there was evidence of racial differences in resident behavior and attitudes related to pain management. None of the studies examined systemic factors related to differences among nursing homes, which has been implicated in studies looking at other outcomes including COVID-19. More research is needed which examines the causal mechanisms behind the documented racial disparities in pain management so that gaps in care can be reduced.
Age Differences in the Use/Efficacy of Emotion Coping Strategies among Adults with Chronic Pain: A Scoping Review
Authors: Fennell Gillian , Wethington Elaine , Reid M Carrington , Sluys Erica , Donovan Kelsey , Cardenas Valeria , Zelinski Elizabeth , Enguidanos Susan 
Published: December 2021

Abstract
Active coping strategies (e.g., exercise and pharmacological treatments) typically do not leave chronic pain patients completely pain-free. Therefore, individuals turn to emotion-focused strategies to cope with associated impairment and psychosocial consequences. General coping strategy use has been shown to differ by age. This scoping review explored age differences in the use and effectiveness of emotion-focused strategies in adults experiencing chronic pain. Studies were located via advanced searches in PubMed, PsycINFO, CINAHL, Embase, Web of Science, and Proquest Dissertations and Theses Global and referral. Two reviewers independently conducted abstract screenings and full-text extractions. Conflicts were discussed and resolved by the PI. We identified 15 studies that met our inclusion criteria, of which 14 met criteria for high methodologic quality. The majority of studies utilized the Coping Strategies Questionnaire to assess differential use of pain-coping strategies. The remaining studies used one of five other questionnaires. Only one study examined the differential effect of age on the efficacy of emotion-focused strategies. Five of the eight studies that examined hoping/prayer coping reported the strategy’s positive association with age. Age was not associated with ignoring pain or reinterpreting pain sensations in any of the eight studies in which these strategies were measured. We concluded that older age was associated with the use of praying/hoping as a means of coping with pain. No other consistent associations between age and other measured coping strategies were identified. Future research should account for auxiliary stressors and pain characteristics while investigating the differential effect of age on pain coping efficacy.
Self-Reported Pain and Symptoms in Community Dwelling Older Adults: Results from the Study of Aging II
Authors: Allen-Watts Kristen , Rumble Deanna , Brown Cynthia , Kennedy Richard 
Published: December 2021

Abstract
Pain is a common concern for community-dwelling older adults. There are a range of symptoms that may occur with pain that can be recurring and severe, which are associated with decreased quality of life. This study aims to characterize overall symptom load by utilizing the Brief Symptom Scale in community dwelling older adults who experience mild to severe pain. Data were extracted from the UAB Study of Aging II, a prospective, population-based study of mobility among community-dwelling older adults 75 years and older. Self-reported pain in the past 4 weeks and symptoms (e.g., pain, tired, nausea, depression, anxiety, shortness of breath) were included. The SPSS version 27.0 statistical package was used for analysis. Sixty-six percent were Non-Hispanic White, 58% were female, 40% lived in housing designed especially for the disabled, 49% were widowed, and 30% had a High School degree or GED. The mean age was 81 years (standard deviation 4.8). Of interest, over one third of the sample (38.1%) experienced moderate to severe pain, upper back pain was the most common area where pain occurred and feeling tired was the most common symptom. As the aging population continues to increase, so will the prevalence rates for pain. Findings suggests older adults with pain have multiple concomitant symptoms. Because the elderly represents a fragile and large group of the population, it is important to pay close attention to these symptoms.
Neuropsychiatric Symptoms and Hearing Loss in Dementia: Unmet Need and Opportunity for Intervention
Authors: Nieman Carrie , Kim Alexander , Morales Emmanuel Garcia , Lyketsos Constantine , Reed Nicholas , Cotter Valerie , Mamo Sara , Oh Esther 
Published: December 2021

Abstract
Hearing loss is one of the most common comorbidities among persons with dementia, with prevalence of 60-&gt;90%. Most go untreated and disparities exist. However, sensory impairment may influence the health of individuals and care partners. We will share findings from a clinic-based cohort of persons with dementia (n=101). Controlling for demographic and clinical factors, we found that every 10 decibel increase in hearing loss was associated with nearly an additional neuropsychiatric symptom (b = 0.7 per 10 dB; p = 0.01) and 1.3-point increase in severity (b = 1.3 per 10 dB; p = 0.04). These findings provide the first estimates that utilize objective audiometry. Furthermore, hearing aid use appeared to be protective. Hearing care may represent an additional, but underutilized, non-pharmacological intervention. We will discuss these findings in the context of the epidemiology of hearing loss in dementia and highlight new opportunities for managing hearing loss through community-based approaches.
A policy mapping analysis of the U.S. Congressional approach to medical aid-in-dying
Authors: Kusmaul Nancy , Cheon Ji Hyang , Gibson Allison 
Published: December 2021

Abstract
Oregon was the first state to legalize medical aid-in-dying (MAID), in 1994. Since then eight states and Washington, DC have legalized MAID through legislation. Despite literature exploring the legal and ethical aspects of MAID, very little research examines MAID policy at the federal level. This study aimed to 1) examine the objectives of MAID legislation introduced to the US Congress, and 2) investigate whether these bills increase or decrease access to MAID. This study used the congress.gov website to search for bills related to MAID introduced by the US Congress between 1994 and 2020. From the 98 bills identified, we excluded bills that were not directly related to MAID or were introduced in subsequent congresses. In total, 23 bills were retained and analyzed. The greatest number of bills aimed to restrict funds for MAID, followed by bills that sought to regulate the drugs used for MAID. Other bills prohibited the development of policies supporting MAID, regulated penalties for practitioners related to the drugs used for MAID, and restricted legal assistance for accessing MAID. These bills intended to block or limit patient access to MAID by restricting drugs, funds, health care services, legal assistance, policy, and research. These findings suggest that the federal approach is incongruous with the growing numbers of states that have legalized MAID. Federal policymakers must develop policies to 1) prevent discrimination against vulnerable groups, 2) support funds to study MAID, and 3) build a system to allows eligible individuals to access MAID equally.
Caring for Persons With Dementia in Audiology
Authors: Reed Marilyn 
Published: December 2021

Abstract
While hearing loss is highly prevalent among patients with dementia, it frequently goes unidentified and unmanaged. It has been a commonly-held belief that older adults with dementia are unable to benefit from hearing rehabilitation, but recent evidence shows that many individuals with dementia can successfully use amplification, helping to improve communication, social interaction and quality of life for these individuals and their caregivers. This presentation will describe how modifications to practice led to successful outcomes for the majority of patients of a geriatric audiology clinic with co-morbid hearing loss and cognitive impairment. In a study of hearing aid use in 67 patients with these comorbidities, over 90% used hearing aids successfully with measurable benefit for both patients and caregivers. Furthermore, we will discuss approaches to improving communication for LTC residents with dementia and hearing loss through the support of audiologists during remote visits with physicians and families during the pandemic.
Preparing Effective InterProfessional Teams to Meet the Needs of Older Adults in Integrated Healthcare Settings
Authors: Bullock Karen , Stansbury Kim , Fitzpatrick David , Anderson Gloria 
Published: December 2021

Abstract
Background: Gerontology education has evolved from focusing primarily on the individual practitioner outcomes to promoting integrated, inter-professional team approaches to integrated care. Practicum training and service learning are effective pedagogy for paraprofessionals in integrated care settings to support clinicians and advance their effectiveness in meeting the needs of older adults. Interprofessional education (IPE) aims to enhance the capacity of practitioners to work collaboratively as integrated team members. Yet, little is known about the implementation of IPE in colleges and universities that are not affiliated with a medical center or medical school. This presentation will describe the implementation of IPE in a School of Social Work without a medical school system. We will explore students’ experiences with the implementation, facilitation, and evaluation of this workforce development model, and will discuss both challenges and successes. Methods: Narrative data collected over the past two-year period with social work student participants in IPE reflect their perspectives on the selection process for the specialized training, placement in an interprofessional integrated care setting, and the learning experience. Participants represented cohorts of more than 200 trainees. Results: Challenges of effective interprofessional health care teams include the approach taken to integrating the teams, level of knowledge and skills required to be an effective team member, and the need for supervision within integrated care experiences. Successes include increased professional self-efficacy. Participants reported post-completion of IPE, (1) desirable outcomes achieved for their patients, such as care satisfaction and role satisfaction for themselves as practitioners.
Development of International Practice Recommendations for Persons With Hearing, Vision, and Cognitive Impairment
Authors: Weinstein Barbara , Littlejohn Jenna , Leroi Iracema 
Published: December 2021

Abstract
Many older adults being evaluated for dementia have unrecognized hearing and/or vision problems which can confound results of neuropsychological assessment(s) and can impact care recommendations. International care standards for detection, assessment, and management of people living with dementia (PwD) are rarely addressed yet are critical. We propose a set of recommendations crafted to foster the highest quality health care to enable PwD to live well with these combined impairments. The focus is detection, diagnosis, treatment, and support of PwD who have age-related hearing and/or vision impairments. The guiding principles underlying the recommendations was a focus on promotion of a person-centered approach, but to be pragmatic in considering all contextual levels including professional care pathways and socio-economic/policy factors internationally. The recommendations are inclusive of all stakeholders who work together to promote equity and mutual respect across the domains. The guidelines are designed to be pragmatic, implementable, resource sparing, and sustainable.
The Role of Age, Religion/Spirituality, and Humor in the Optimism of Community-Dwelling Older Adults
Authors: Kenaley Bonnie , Kim Eun hae , McClive-Reed Kimberly , Gellis Zvi 
Published: December 2021

Abstract
Current literature reveals that perceived optimism decreases with age (D’Argembeau et al., 2011; Newby-Clark & Ross, 2003). However, replication of these studies is limited. In particular, a lack of investigations exists in examining optimism as individuals transition across older adulthood. Considering the dearth of literature that examines the influence of religion/spirituality and humor on the optimism of older adults, 203 members of Osher Lifelong Learning Institutes, age 65 years and older, from Idaho and California completed pen and paper or electronic surveys. The study used hierarchical multiple regression analysis to examine the impact of age, positive religion/spirituality coping skills, and humor on the optimism of community-dwelling older adults. The participant’s gender significantly explained a 19.3% variance in the optimism scores, whereas age did not significantly contribute to the model (R Change =.000). Positive religious or spiritual coping skills and humor significantly contributed to the variance in optimism scores, explaining a 2.3% and 21.6% variance, respectively. In the final model (F (1, 202, = 13.78, p = .000), all variables except age significantly contributed to the model with humor revealing the highest beta value (beta = .467, p = .000). The findings suggest that optimism is perceived differently by gender but does not change with age. While positive religious coping skills influence optimism, internal or external humor strategies may be more helpful to instill, promote or maintain optimism in older adults. The addition of humor assessment items in wellness evaluations and humor-infused interventions may foster optimism in community-dwelling older adults.
Socioeconomic Status, Time Scarcity and Well-Being in Retirement
Authors: Bo Boroka 
Published: December 2021

Abstract
We tend to think of retirement as a great equalizer when it comes to relief from the pernicious time scarcity characterizing the lives of many individuals in the labor force. Puzzlingly, this is not entirely the case. Using data from the MTUS (N=15,390) in combination with long-term participant observation (980 hours) and in-depth interviews (N=53), I show that socioeconomic characteristics are important determinants of retiree time scarcity. Neighborhood disadvantage gets under the skin via time exchanges that are forged by both neighborhood and peer network characteristics. The SES-based ‘time projects of surviving and thriving’ undergirding the experience of time scarcity lead to divergent strategies of action and differing consequences for well-being. For the advantaged, the experience of time scarcity is protective for well-being in later life, as it emerges from the ‘work of thriving’ and managing a relative abundance of choices. For the disadvantaged, the later life experience of time scarcity is shaped by cumulative inequality, further exacerbating inequalities in well-being. The final section of the article offers an analysis and interpretation of these results, putting retiree time scarcity in conversation with the broader literature on socioeconomic status and well-being.
Daily Evening Electronic Media Use and Sleep in Later Life
Authors: Kim Yijung , Zhang Shiyang , Fingerman Karen 
Published: December 2021

Abstract
Sleep complaints and disorders are one of the most common disturbances to health and well-being in later life. Evening electronic media use has been shown to influence the subsequent quantity and quality of sleep, but most research focused on younger age groups who are more likely to use new media (e.g., social media) to replace or complement traditional mass media such as television. To investigate how different types of evening media use is related to sleep in later life, we used ecological momentary assessment data from the Daily Experiences and Well-being Study (N = 231; Mage = 73.61) to examine how evening computer use and television viewing affect subsequent sleep hours and perceived sleep quality. Across all evening assessments, 43% of the evenings were spent using computers, and 80% of the evenings were spent watching television. Findings from a series of within-between random effects models indicated that evening computer use and television viewing had independent associations with sleep quantity and quality. That is, older adults reported fewer hours of sleep, more difficulty falling asleep, and worse overall sleep quality on nights following the evening computer use. In contrast, evening television viewing was associated with feeling less tired the next day morning. The results highlight the continued presence of television viewing in older adults’ daily lives and their distinction from general computer use. The social context in which older adults watch television in the evening may potentially explain how different electronic media use influences sleep in later life.
Adult Protective Services Study on the Impact of COVID-19
Authors: Roberto Karen , Teaster Pamela , Savla Jyoti , Fua Imogen , Urban Karl , Hoyt Emily 
Published: December 2021

Abstract
The purpose of study was to explore changes in implemented of APS programs in response to the COVID-19 pandemic. This three-phase study began with telephone interviews with eight state-level APS administrators of early phase “hot-spots” that were used to inform questions for the Phase II national survey of state APS programs. Forty-seven states completed an on-line survey on the effects of the pandemic on work and workload, policy and practice, staff, partnerships, and preparedness. Phase III interviews with 7 local APS programs provided an “on-the-ground” view of challenges of meeting clients’ needs. Although most APS programs reported fewer reports of adult maltreatment than before the pandemic, the stress and disruption of COVID-19 required new work arrangements, to which programs adapted technological and managerial support to care for the needs of both APS staff and the clients they served. Finding provide insight for policy and planning requirements for future catastrophic events.