bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding Global Deprescribing Policy: Opportunities and Challenges
Authors: Kim Catherine , Thompson Allison , Kim Grace , Marcum Zachary , Keller Michelle , Sorensen Andrea , Brandt Nicole 
Published: December 2021

Abstract
The landscape of deprescribing, the planned process of dose reduction or stoppage for medications which are no longer of benefit, has been rapidly expanding with global efforts and the formation of regional and national deprescribing networks. The purpose of this qualitative study is to describe successes and challenges about deprescribing from thought-leaders across the world to inform future policy initiatives. We aim to conduct at least 15 key informant (KI) interviews; we have completed 13 to date. Codes were constructed to identify themes that depict the perspectives regarding deprescribing policy across the globe. The KIs primarily represent the fields of pharmacy and medicine from four global regions with years of deprescribing experience ranging from 5 to &gt; 20. We identified two emerging overarching themes through our qualitative analysis: Regional Organization Support and Evidence & Knowledge gaps. Within these overarching themes, we further identified sub-themes and their representative quotes: Network Structure: “idea of the network was threefold: 1) To try and figure out what we need to activate healthcare providers to deprescribe; 2) To do work with community-dwelling seniors to motivate them and give them opportunities to deprescribe; 3) ...getting pharmacists to provide the education to the patients.” Cost-effectiveness: “If we can show that it is cost-effective to deprescribe, that there is actually a return here, not just in health terms but in monetary terms, I think that would really push it along.” This research will help to advance global efforts to optimize medication management.
Is Age Just a Number? Influence of Caregiver Age on Injuries of Children Raised by Grandparents
Authors: Lopez Acacia , Scott Rachel , Nadorff Danielle 
Published: December 2021

Abstract
Unintentional injuries are the most common cause of death for children in the United States. One factor linked to their occurrence is parenting style (i.e., a collection of factors such as physical health, mental health, and possible cohort differences in parenting role expectations). Differences in parenting behaviors may be evident in grandparents caring for their grandchildren, due to cohort differences and age-related declines in cognitive and physiological processes. This may impact their abilities to monitor, supervise, and respond to children. Further, Hayslip & Kaminski report custodial grandparents are less likely than parents to understand and respond to the psychological and emotional needs of children but are more likely to enforce discipline. This study sought to explore the ways in which parenting styles are associated with unintentional injury behaviors in children (via caregiver age) for grandchildren raised by grandparents. Participants were grandparents raising their grandchildren, recruited via Qualtrics Panel Service (N = 323). Conditional process analyses were conducted using Model 1 of SPSS PROCESSv3.5. Age moderated the relation between consistency of discipline and child unintentional injury (F (1, 231) = 12.67, p &lt;.001) as well as level of supervision and child unintentional injury (F (1,146) = 6.23, p = .01). Age did not moderate the relation between positive parenting and unintentional injuries. These results imply that children being raised by older grandparents were especially at risk for increased injuries when their grandparents used less consistent discipline or lower rates of supervision. Pathways are suggested for age-specific psychoeducation interventions for custodial grandparents.
Using Life Story Techniques with Diverse Communities: Lessons Learned from a Focus Group Study
Authors: Wilk Christa , Cordell Ashlee , Orsulic-Jeras Silvia , Powers Sara , Ejaz Farida , Sanders Lisbeth 
Published: December 2021

Abstract
Providing high quality, cost-effective dementia care remains a major health challenge. Life story work, used in residential care settings, helps engage persons living with dementia (PWD) at a low cost with minimal staff burden. LifeBio, one such intervention, is designed to elicit life history data and care preference information through comprehensive life story interviews. LifeBio Memory, an adaptation of LifeBio, utilizes novel speech-to-text technology to process life story data more efficiently. Seven focus groups were conducted to evaluate the acceptability and feasibility of LifeBio Memory. Three types of focus groups were held (n=35) and audio recorded: 1) One group of early-stage PWDs (n=5); 2) Two groups of current and former users of original LifeBio (n = 12); and 3) Four groups of residential care staff and directors (n=18). Sessions were transcribed and thematic analyses were conducted. Findings indicated high levels of acceptability and feasibility of LifeBio Memory. Further, a secondary theme emerged signaling the need to prioritize the emotional safety of PWDs participating in life story work. This poster will discuss: 1) the life story interview process, 2) identifying PWDs who would most benefit from a life story program, 3) involving family and staff care partners to identify sensitive topics, 4) interview question design, selection and order, and 5) expanding life story work across diverse communities. Discussion will highlight the importance of protecting the emotional well-being of marginalized communities by identifying potential underlying traumas that could impact the safe delivery of otherwise effective life story interventions.
Multiple Streams Analysis of the Long-Term Care Insurance in South Korea: Understanding Policy Changes (2008 - 2014)
Authors: Jeong Mijin 
Published: December 2021

Abstract
The Long-Term Care Insurance (LTCI) Act in South Korea was enacted in 2008 to improve the quality of life of older adults by promoting better health and to mitigate the burden of care on family members. In 2014, the Enforcement Decree for the LTCI Act was revised to broaden criteria for eligible recipients of LTCI-related services and care. This policy analysis seeks to explore the political circumstances under which the Act was formed and how social environmental factors had evolved to revise the LTCI Act using a multiple streams policy analysis framework. A combination of factors influenced the status of LTCI policy agenda, including shifts in aged demographic structure and increasing medical expenditures. From the Korean National Dementia Plan, a pilot project of dementia care was conducting to prove the efficiency of dementia care service. While the Korean Senior Citizens Association (KSCA) was less successful gaining press attention around dementia care, the presidential election and candidates’ election pledges were key factors to suddenly open the opportunity to extend the recipients for dementia care. The process through which the LTCI Act was revised and expanded showed the importance of the political environment associated with the election. Based on the recognition of LTIC policy agenda and already testing the efficiency of dementia care services, the election leaded to revision of LTCI Act and it quickly diffused by the new administration. From the revision of LTCI, international policymakers and scholars should recognize how the political events might use the policy for older adutls.
The Influence of COVID-19 on Retirement and Longevity Planning: A Multigenerational Perspective
Authors: Miller Julie , Raue Martina , D'Ambrosio Lisa 
Published: December 2021

Abstract
For many, the COVID-19 pandemic has painted a new economic picture of longevity. Results from the series demonstrated that younger generations surveyed—Gen Xers, Millennials, and Zoomers— generally reported elevated levels of worry about how the pandemic would affect their long-term finances. Baby Boomers, by comparison, evinced significantly less worry. And, although the pandemic has had a disproportionate economic impact on lower-income individuals, a higher income did not appear to confer freedom from worry. When it comes to planning for longevity, worry can be paralyzing. Zoomers were the generation most likely to agree that the future is too uncertain for them to even think about planning financially for retirement, and this sentiment applied for other generations as well. This presentation will also describe other ways in which the COVID-19 pandemic had influenced respondents’ perceived longevity preparedness and attitudes across a variety of demographic and socio-economic characteristics.
Effects of Participating in a Volunteer Driving Program on Mental Health in Service Recipients and Volunteers
Authors: Tomita Machiko , Bhattacharjya Sutanuka 
Published: December 2021

Abstract
Objectives: To assess the effects of a volunteer transportation program on mental health in riders and volunteers. Methods: A cross-sectional study (N=133, age ≥60) compared pre- and existing (≥2 years) riders, pre- and existing (≥2 years) volunteer drivers, and riders (Rs) and pre-volunteers (PreVs), representing general older adults. The cohorts belonged to a large, community volunteer organization. Outcome measures, depression and quality of life, were analyzed using ANCOVA. Percentages of people who wanted to go to specific destinations with available transportation were identified for pre-riders (PreRs) and Rs. Results: Rs had better depression scores (p&lt;.001), no longer exhibited depressive symptoms (p=.005), and were better in quality of life (p=.002) than PreRs. Rs were similar to PreVs. PreRs’ major needs were going to medically related places (doctors’ offices – 74.4%, drug stores - 44.2%, hospitals – 37.2%) and basic living (grocery – 60.5%, clothing -37.2%). In Rs, these had significantly lowered, but still 40% wanted to go to doctors’ offices and 30%, grocery stores. Volunteer driver's (Vs)' depression (p=.009), health (p=.006), and social relationships (p=.004) were significantly better than PreVs'. Discussion: Although the use of free transportation up to four times a month may not be enough to improve perceived health for Rs, it was beneficial to prevent depression and increase quality of life. Since many PreVs were doing volunteer work other than driving, the type of volunteer work matters. Regularly helping people, in person, with their core needs for living resulted in positive outcomes for Vs.
Technology Based Cognitive Behavioral Therapy On Psychological Distress: Exploring Health, Pain, And Activity
Authors: Shah Avani , Morthland Martin , Scogin Forrest 
Published: December 2021

Abstract
This randomized controlled trial investigates two technologically based self-administered cognitive behavioral depression treatments (CBT) on psychological distress in older adults. Health may change the ability to participate in types of activities, thereby impacting mental well-being and treatment response. The aims of this research are 1) to understand the impact of technologically based cognitive behavioral treatment on psychological distress 2) explore how health, pain, and activity engagement may affect treatment response. Fifty one participants recruited were randomized to one of 3 groups: audio-based cognitive behavioral therapy, computer-based cognitive-behavioral therapy, and control group. The combined treatment groups are compared to the control group. Health was examined in multiple ways; the Vulnerable Elders Scale-13 score ; (Saliba et al., 2001); and a reported chronic pain condition. For overall psychological distress, improvement on the Brief Symptom Inventory General Severity Index (GSI; Derogatis & Spencer, 1983) scores from baseline to post-treatment indicated treatment response. The California Older Person’s Pleasant Events Scale (COPPES; Rider, Gallagher-Thompson, & Thompson, 2004) measured activity engagement. While controlling for the Time 1 GSI score, an ANOVA revealed a significant difference in psychological distress between the CBT treatment group and control group F(1, 43) =4.22, p=.046. A linear regression analysis with the VES-13 score and GSI baseline score as predictors and the GSI posttreatment score as the dependent variable, found that health did not significantly predict psychological distress outcomes. Observation of the descriptives and these analyses suggest that CBT can impact psychological distress, potentially even with variations in health and pain.
Management and Analysis of Large Qualitative Data Sets: Lessons Learned From Daily Journals for a Behavioral RCT
Authors: Musil Carol , Jeanblanc Alexandra 
Published: December 2021

Abstract
As part of a national RCT of a resourcefulness skills training intervention, 342 grandmother caregivers, completed daily online journals for 4 weeks, reporting “challenges or difficulties you faced today with your grandchildren or other family members and how you handled them.” In this paper, we describe the challenges and benefits of using an entirely online design for the distribution and collection of daily journals. We used NVIVO-12 Plus to perform directed content analysis to assess intervention enactment fidelity and compare content between intervention (trained in and prompted to discuss skills) and control groups. Over 92%(n=317) of participants completed daily journals. There was variation in reporting of skill use between groups: 36% of controls spontaneously used the skill “seek professional help” whereas only 4% of the control group reported the skill “change from usual reaction”. With careful management, qualitative data from large samples can be obtained and effectively analyzed for fidelity.
Multimorbidity Trajectory Classes as Predicted by Race, Ethnicity, and Social Relationship Quality
Authors: Newsom Jason , O'Neill AnneMarie , Denning Emily , Quiñones Ana , Botoseneanu Anda , Allore Heather , Nagel Corey , Dorr David 
Published: December 2021

Abstract
Growth mixture modeling was used to classify multimorbidity (≥2 chronic conditions) trajectories over a 10-year period (2006-2016) in the Health and Retirement Study (N = 7,151, mean age = 68.6 years). Race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White) and social relationship quality (positive social support and negative social exchanges, such as criticisms) were then used to predict trajectory class membership, controlling for age, sex, education, and wealth. We identified three trajectory classes: initial low levels and rapid accumulation of multimorbidity (increasing: 12.6%), initial high levels and gradual accumulation of multimorbidity (high: 19.5%), and initial low levels and gradual accumulation of multimorbidity (low: 67.9%). Blacks were more than twice as likely to be in the increasing (OR = 2.04, CI[1.29,3.21]) and high (OR = 2.28 CI[1.58,3.206]) multimorbidity groups compared with Whites, but there were no significant differences between Hispanics and Whites for either trajectory class (OR = .84 CI[.47,1.51]and OR = .74 CI[.41,1.34], respectively). Increments in perceived support were associated with significantly lower risk of membership in the increasing (OR = .59, CI[.46,.78]) and high classes (OR = .54 CI[.42,.69]), and increments in negative exchanges were associated with significantly higher risk of membership in the increasing (OR = 1.64 CI[1.19,2.25]) and high classes (OR = 2.22 CI[1.64,3.00]). These results provide important new information for understanding health disparities and the role of social relationships associated with multimorbidity in middle and later life that may aid in identifying those most at risk and suggesting possible interventions for mitigating that risk.
Perspectives on Aging Well Among Older Black Women in the US
Authors: Coats Jacquelyn 
Published: December 2021

Abstract
Despite changes in the demography of older Black women who are living longer, there is limited research on how older Black women conceptualize and understand successful and healthy aging. The objective of this presentation is to interrogate the meaning and cultural aspects of aging among older Black women, gaining insight into how gender and race operate and intersect to shape experiences and perceptions of aging. Using an intersectionality framework, this qualitative study was conducted with three older Black women. The women ranged in age from 58-65 years old, each residing in an US urban city (Detroit, St. Louis, Atlanta). Data were collected between October and November 2020, using a semi-structured, open-ended interview protocol to encourage participants to provide in-depth descriptions of how they conceptualized aging. Interviews were between 2 – 2.5 hours, conducted via videoconferencing, and audio-recorded for transcription. Participants discussed: the life experiences that have shaped their ability to age well; what it means to age well, and factors that might hinder someone from aging well. Transcripts were coded using a constructivist grounded theory approach. Results revealed six themes Black women in later life identify: aging well, aging as a mindset, independence and freedom, authenticity, personal control and preparation, and aging role models. This extends the knowledge base on how older Black women view aging and factors that enhance or diminish their ability to age well. Results from this study can be used to enhance the development of public health and social work interventions with older Black women.
The Interactive Effects of Education and Social Support on Blood Pressure in African Americans
Authors: Byrd DeAnnah , Jiang Yanping , Zilioli Samuele , Thorpe Roland , Lichtenberg Peter , Whitfield Keith 
Published: December 2021

Abstract
This study examined whether the effects of received and provided social support on blood pressure (BP) would differ by education. Data from 602 African American adults (48-95 years) enrolled in the Baltimore Study of Black Aging—Patterns of Cognitive Aging were analyzed using multiple linear regression. We found no main effects of received and provided social support on BP. However, a significant moderation effect was observed for systolic BP, such that greater received social support was positively associated with higher systolic BP among individuals with low levels of education, adjusting for age, sex, chronic health conditions, and depressive symptoms. The findings demonstrate that social support and education have joint effects on blood pressure, which highlights the importance of considering psychosocial determinants of adverse cardiovascular health outcomes that disproportionately affect African Americans.
Physical Function Transitions and Healthcare Utilization Among Older Mexican Americans.
Authors: Givan Amy , Chou Lin-Na , Kuo Yong-Fang , Snih Soham Al 
Published: December 2021

Abstract
The aim of this study was to examine the relationship between 2-year physical function transitions and one-year healthcare utilization among Mexican American Medicare beneficiaries. The sample consisted of 429 Mexican Americans ≥75 years old from the Hispanic Established Population for the Epidemiologic Study of the Elderly linked with Medicare claims data from the Centers for Medicare and Medicaid Services. Short Physical Performance Battery (SPPB) from Wave 5 (2004/05) to Wave 6 was used to create physical function transition groups. The outcomes were physician visits (&lt;6, 6-12, &gt;12 visits), number of emergency room visits, and number of acute hospitalizations one-year after physical function transitions. Multinomial logistic regression and Generalized Estimating Equation with negative binomial distribution were used to estimate the odds ratio of healthcare utilization as a function of physical function transition groups, controlling for socio-demographics and comorbidities. Participants who improved or remained moderate-high physical function had lower odds ratio (OR) of being hospitalized (0.40, 95% Confidence Interval [CI]=(0.18, 0.90)) or visiting the emergency room (OR=0.52, 95% CI=0.32-0.84) one-year later compared to participants who remained in the low physical function group. No difference in physician visits across physical function transition groups was found. This study showed healthcare utilization differed by physical function transition groups among Mexican American Medicare beneficiaries. Physical function improvement or maintenance of moderate-high physical function should be targeted in older Mexican Americans, a population at great risk of developing disability, to reduce or delay dependency and healthcare burden.
Human Capital and Employment Outcomes Among Foreign Educated and US Nurses Working in Long Term Care
Authors: Thompson Roy , Silva Susan , Corazzini Kirsten , Konrad Thomas , Cary Michael , McConnell Eleanor 
Published: December 2021

Abstract
Employing Foreign Educated Nurses (FENs) helps address Registered Nurse (RN) shortages in long-term care (LTC) in the United States (US). However, examination of factors explaining differences in their employment outcomes relative to US Educated Nurses (USENs) is limited. This study uses 2018 National Sample Survey of Registered Nurses data to compare income, work hours, job satisfaction, and human capital, defined as personal characteristics (knowledge, work experience) and behaviors (job mobility), of FENS and USENs working full-time in LTC. A human capital score, consisting of highest nursing education, skill certifications, state licensures, years of experience, multi-state employment history, and multi-lingual status was constructed. Covariates included nurse demographics, direct care role, and ability to practice to full scope. Covariate-adjusted group differences in employment outcomes and human capital were compared using ANCOVA and logistic regression. Mediation analyses explored whether human capital explained FEN vs USEN differences. FENs earned higher hourly wages (p=0.0169), worked fewer hours annually (p=0.0163), and reported greater human capital (p&lt;.0001) compared to USENs. FENs and USENs, however, had similar annual salaries (p=0.3101) and job satisfaction (p=0.1674). Human capital mediated FEN vs USEN effects on hourly wages but not annual work hours. FENs’ higher levels of human capital partially account for FEN vs USEN differences in hourly wages. Application of the human capital concept advanced our ability to examine differences in employment outcomes and highlight aspects of the value that FENs contribute to LTC settings.
Dementia Specialization Among Adult Day Services Centers: National Study of Long-Term Care Providers
Authors: Lendon Jessica , Sengupta Manisha , Melekin Amanuel 
Published: December 2021

Abstract
Adult day services centers (ADSC) are a source of community-based care for persons with Alzheimer’s disease/other dementias. This study compares dementia specialized ADSCs (DSADSC) and their participants to other ADSCs that do not specialize in dementia care using the 2016-2018 National Study of Long-term Care Providers. DSADSCs account for 10% of all ADSCs and serve 15% of all ADSC participants with dementia. About half of DSADSC participants have dementia, compared to 30% in other ADSCs. A higher percentage of DSADSCs, compared to other ADSCs, were in the Midwest, were nonprofit, had a social model, and employed nursing aides. Fewer DSADSCs, compared to other ADSCs, provided nursing, mental health, and transportation services. More DSADSC participants were 75 years of age or older and needed assistance with eating and toileting. Findings may help identify how ADSCs, particularly, DSADSCs, meet the unique care needs of older adults with dementia.