bluuebunny/crossref_metadata_2025_split huggingface dataset:
TAKING CHARGE AND FLEXING PROTOCOLS: SNF NURSING STAFF’S UTI IDENTIFICATION
Authors: Delgado Kimberly , Roberson Donna 
Published: January 2025

Abstract
Skilled Nursing Facility (SNF) residents are at increased risk of adverse reactions, including death, due to inappropriate antibiotic use, which accounts for up to 75% of all SNF antibiotic prescriptions; the most common indication being urinary tract infection (UTI). The structure of SNFs create barriers to appropriate diagnosis and treatment of UTIs, with limited registered nurse availability and health care providers (HCP) being off-site. The purpose of this study was to describe SNF nursing staff experiences with residents whom they suspected were presenting with a UTI. A better understanding of what takes place prior to HCP contact can assist SNF leadership with improving nursing-led interventions. This qualitative descriptive study used a semi-stratified purposive sample, snowball sampling, and social media recruitment. Single, semi-structured interviews were completed using open-ended questions. Data analysis resulted in three themes: way out of the norm, taking ownership, and flexing protocols. Participants identified SNF residents’ behaviors that were ‘way out of the norm,’ as a key indicator of a UTI. Approaches to care included nursing staff taking ownership, or responsibility, and flexing protocols to prioritize the care and well-being of their residents. SNF nursing staff spend more time with their residents than the HCP, which results in them being heavily involved in the process of UTI identification. Inclusion of SNF nursing staff in future research is critical to the exploration of practices and improving outcomes. Research study recruitment barriers illustrate the tremendous need for education among SNF facility leadership to garner support and permission to access facilities.
POLICIES FOR SUPPORTING CAREGIVERS OF OLDER ADULTS WITH LONG-TERM CARE NEEDS: A MIXED-METHODS SYSTEMATIC REVIEW
Authors: Albertini Marco , Bei Eva , Toth Federico 
Published: January 2025

Abstract

Background
In an era marked by the imperative to restrain costs within health and social care services throughout Europe, informal caregivers of older adults assume a pivotal role as primary providers of long-term care. Nevertheless, there remains a shortage in mapping the various social policies pertaining to both direct and indirect support for informal carers across the various EU member states. Objective: This mixed-method systematic review synthesizes data on care policies related to diverse support forms implemented across EU countries to assist caregivers.

Methods
A comprehensive search strategy was conducted in three electronic databases and grey literature to minimise publication bias.

Results
Preliminary findings of studies published between 2010 and 2023 indicate that various forms and levels of support have been introduced or reformed over the past 13 years across EU countries to support caregivers. Despite the challenges posed by population ageing, there is significant policy development disparity among EU members, with some countries to have established mechanisms aside financial assistance to support carers, while others to only now starting to express interest in developing such services. Financial support, primarily through cash-for-care schemes, emerges as the predominant form of assistance, followed by respite care, while other policies in terms of training and mental health services exhibit a notably lower level of development within the EU social policy landscape.

Conclusion
The review is expected to provide significant implications for policymaking, thoroughly mapping the implementation of diverse social care policies across Europe to ensure the sustainability of informal care.
RURAL DISPARITIES IN ELDERLY AMBULATORY CARE READMISSIONS: EVIDENCE FROM NATIONAL AMBULATORY MEDICAL CARE SURVEY
Authors: Kang Sunny , Miller Nancy , Zhang Ting 
Published: January 2025

Abstract

Objective
We examined factors associated with older patients’ readmission to ambulatory care within one week to two months’ discharge, and how this readmission pattern primarily varied by locality.

Methodology
We analyzed 7,619 older patients (age 50 and older) from the 2016 National Ambulatory Medical Care Survey. Logistic regression analyses were utilized to examine the risk factors for ambulatory readmission. Findings: Compared to the residence in Metropolitan Statistical Areas, the residence in rural areas (or micropolitan areas) will increase the odds of readmissions (OR=1.61, 95%CI[1.30, 1.99]), after controlling for other variables. Being Black was not statistically significant in predicting the likelihood of readmission, while black patients using Medicaid as the primary payment experienced higher risks of readmission (OR=2.09, 95%CI[1.02, 4.32]). The higher facility percentage (&gt;50%) of Medicare beneficiaries was associated with smaller odds of readmission (OR=0.65, 95%CI[0.58, 0.73]). Nursing home visiting within the prior week or seeing a physicians’ assistant each increased the odds of readmission, whereas seeing a mental healthcare provider decreased the risks for readmissions (OR=0.40, 95%CI[0.19, 0.83]). Patients diagnosed with cardiovascular disease and Type II diabetes were associated with smaller odds of readmission. Policy Implications: Residence in rural areas (or micropolitan statistical areas) or being black Medicaid beneficiaries predicted greater odds of readmission to ambulatory care among older patients. Rural patients experienced lower likelihood of staff responsiveness after adjusting for other factors. Further research should explore the basis of these disparities. Mental health diagnoses in depressive and psychosis disorders also called upon additional studies regarding special care needs.
ACTIVITY RECORDING CAPILLARY FEEDER (ARC): A HIGH-THROUGHPUT BEHAVIORAL PHENOMIC ASSESSMENT IN DROSOPHILA
Authors: Wu Serena , Pham Vivian , Nguyen Tiffany , Jafari Mahtab 
Published: January 2025

Abstract
Drosophila melanogaster is not only a well-established model organism in aging research but it is also considered an emerging animal model to screen and evaluate potential anti-aging compounds. Our lab developed an algorithm to screen and identify natural products and botanical extracts with lifespan extension and healthspan-improving properties. Once a compound or extract was shown to increase lifespan, we performed various phenotypic assays to determine its impact on biomarkers of health in Drosophila. This work established Drosophila as a model system in pre-clinical aging research. However, traditional behavioral phenotypic assays such as geotaxis are laborious and time-consuming, hampering screening efficiency. To address this challenge in the emerging field of phenomics, we have utilized an automated system, originally developed by Ja Lab, University of Florida, called the Activity Recording Capillary feeder assay (ARC). This recording system leverages high-resolution machine vision to monitor Drosophila behaviors such as movement, sleep, and feeding dynamics. This innovative approach enables rapid and simultaneous assessment of multiple behavioral parameters, offering greater reproducibility and scalability than conventional methods. In this work, we present preliminary data on the feasibility of using ARC as a high-throughput phenomics screening modality to evaluate natural product induced changes in aging-related phenotypes such as locomotion. This work was supported by UCI Calit2.
ASSOCIATION OF NEIGHBORHOOD CHARACTERISTICS AND RACE ON HEALTH STATUS AND HEALTH CARE USE FOR OLDER ADULTS
Authors: Toseef Mohammad Usama 
Published: January 2025

Abstract
Research suggests that neighborhood characteristics are important social determinants of health. However, there is limited evidence that explores the interaction of race/ethnicity and neighborhood characteristics on healthcare use. We study this issue and specifically focus our analysis on how older Arab Americans use healthcare relative to their White counterparts. We conducted a retrospective study among patients 65 years and older (N = 112,056) who were tested for SARS-CoV-2 at the emergency departments of a large integrated midwestern healthcare system between March 1, 2020, and July 31, 2022. We used area deprivation index (ADI) quintiles that allows ranking of neighborhoods based on socioeconomic disadvantage. The outcomes for our analysis were infection with SARS-CoV-2, hospitalization, ED revisit 30 days and readmission 30 days. We estimated logistic regression models controlling for race/ethnicity, ADI and interaction of these two. We found that older Arab Americans in the 3rd and 4th quintiles were more likely than Whites to test positive for SARS-CoV-2. Arab Americans in the 4th quintile were more likely to be admitted as compared to Whites while no significant differences were observed in the other quintiles. Arab Americans in the 3rd quintile of ADI were more likely to have an ED revisit within 30 days and re-hospitalized within 30 days as compared to Whites. This shows how culture and perception of healthcare provision can play a role in the use of healthcare resource and policymakers and stakeholders may find it useful to focus on neighborhood characteristics as captured by ADI or similar measures.
EXPLORING EARLY BARRIERS TO KIDNEY TRANSPLANT: THE MORAL ECONOMIES OF DIALYSIS CLINICS
Authors: McDonnell Jenny , Idler Ellen , Wilk Adam 
Published: January 2025

Abstract
Kidney transplant conveys steep survival and quality of life benefits, yet only one-third of patients with kidney failure are referred for transplant evaluation. We explore the dialysis clinic as a site of inequities in transplant, wherein dialysis care professionals’ (DCPs’) early resource allocation decisions shape patients’ downstream access to transplant. Using a modified grounded theory approach, we conducted 39 in-depth interviews during summer 2022 with DCPs (e.g., nephrologists, social workers, nurses) about their processes leading to transplant referral or non-referral. Phone interviews were recorded and transcribed verbatim. Textual data were coded using MAXQDA software. Combining within- and across-case strategies for analysis, we uncovered tension between DCP’s reported referral philosophies and their tacit strategies for selectively allocating resources. While most DCPs reported that they “refer all patients”, in practice, they selectively direct limited resources (e.g., time, education, advocacy, empowerment) toward “ideal” patients. DCPs described “ideal” patients as compliant, activated, and motivated, compared to “risky” patients who “don’t do what they’re supposed to do”, struggle with self-management, and may “get less use out of a transplanted kidney” due to advanced age. We extend previous research by framing the dialysis clinic as a moral economy in which resources flow through a web of specific norms, meanings, and practices related to DCPs’ perceptions of patients’ deservingness and worth. Findings indicate that within this moral economy, DCPs direct limited resources toward “ideal” patients and away from “risky” patients most in need of DCPs’ time and advocacy. Calls for future research and policy implications are discussed.
HEALTH EQUITY APPROACH TO EXAMINE COGNITIVE DIFFICULTY WITH AND WITHOUT A MENA CHECKBOX IN THE US
Authors: Kindratt Tiffany , Tnesh Basma 
Published: January 2025

Abstract
Federal guidelines for collecting race/ethnicity in the US include White, Black, Hispanic/Latino, Asian, American Indian/Alaskan Native (AI/AN), and Native Hawaiian/Other Pacific Islander (NH/OPI) as minimum reporting categories. Middle Eastern and North African (MENA) Americans are included in the definition for the White race group, which includes other individuals of European ancestry. In 2023, the Office of Management and Budget proposed adding a separate checkbox for MENA individuals. Several studies have identified that MENA Americans have a higher burden of cognitive health concerns compared to Whites. Having a separate checkbox for MENA Americans may provide a truer assessment of health disparities for other racial/ethnic groups. We examined whether removing MENA Americans from the White race group altered comparisons of cognitive difficulty between racial/ethnic minoritized populations and Whites. Using national data from the American Community Survey (ages &gt;=45 years; N=7,284,988), we identified 67,213 adults (ages 45+ years) with MENA ancestry/birthplace. Most self-reported as White (n=60,993) followed by some other race (n=3,699), Black (n=1,957), Asian (n=468), AI/AN (n=72), and NH/OPI (n=24). Cognitive difficulty was higher among Black, Asian, AI/AN, and NH/OPI compared to White adults before and after removing adults with a MENA ancestry or birthplace from the sample. Marginal changes were observed. For example, for Black adults, odds increased from 1.23 to 1.24. While we did not find a difference in cognitive difficulty when we removed MENA adults from the national sample, further research is needed to determine whether this finding differs in smaller samples (e.g., states) and for other health outcomes.
THE IMPACT OF CHILDHOOD ADVERSITIES ON INTERPERSONAL AND INSTITUTIONAL DISCRIMINATION IN MIDDLE AND LATE ADULTHOOD
Authors: Wei Wenxing 
Published: January 2025

Abstract

Introduction
Research on the impact of childhood adversities on later-life experiences of interpersonal and institutional discrimination is scarce. Drawing on the life course perspective, this study examines how childhood adversities influence interpersonal and institutional discrimination experienced in middle and late adulthood.

Methods
Utilizing the Health and Retirement Study (HRS), this study included a nationally representative sample of 14,268 adults aged 45 and older. Ordinary Least Squares (OLS) regressions were conducted to examine whether childhood adversities were associated with interpersonal and institutional discrimination, controlling for socio-demographic characteristics.

Results
Findings indicate a significant relationship between childhood adversities and both interpersonal and institutional discrimination in later life. Specifically, increased experiences of childhood adversities were associated with higher levels of reported discrimination, underscoring the persistent effects of early adversities on individuals’ later life experiences.

Discussion
This study contributes to the existing literature by focusing on the impact of childhood adversities on discrimination in an age group frequently neglected in studies. It underscores the importance of developing comprehensive prevention and intervention to mitigate the long-term effects of childhood adversities in middle and late adulthood. Additionally, the research identifies directions for future studies to delve into the mechanisms of these associations, to consider a wider range of childhood adversities (e.g., bullying), and to examine discrimination on broader levels (e.g., systemic). These explorations are crucial for the development of more effective support strategies and policy frameworks for individuals affected by childhood adversities and experiencing discrimination.
SELF-REPORTED WELL-BEING AMONG OLDER ADULTS WITH A PERSONAL OR FAMILY HISTORY OF INCARCERATION
Authors: Holaday Louisa , Stone Kimberly , Roy Brita , Williams Brie , Siu Albert , Wang Emily 
Published: January 2025

Abstract
The United States has one of the highest incarceration rates in the world. Prior work has demonstrated adverse health effects associated with personal or family history of incarceration, but none has focused on older adults. We conducted a cross-sectional study using data from the nationally representative Family History of Incarceration survey. Among the 1,114 adults aged 55 or older, we tested the association between personal incarceration and/or family member incarceration and overall; financial; social; physical; and mental wellbeing controlling for age; gender; race/ethnicity; income; education; employment; and marital status. We accounted for time since last incarceration, and duration of incarceration. Overall, 21% of respondents had been incarcerated (of whom 78% returned to the community over 10 years ago), and 64% had had an immediate family member incarcerated (of whom 30% were incarcerated 1 year or longer). “Thriving” overall wellbeing, which is associated with life expectancy, was less common among those with personal or family incarceration exposure (63.3% of those without incarceration exposure vs. 47.7-55.7% of those with incarceration exposure). In fully adjusted models, personal or family incarceration exposure was associated with lower odds of reporting “excellent” or “very good” physical health (OR: 0.50-0.55; all P&lt; 0.05); and “thriving” social wellbeing (OR: 0.44-0.60; all P&lt; 0.008). There existed a dose response relationship between longer durations of family member incarceration and lower wellbeing. Exposure to incarceration is independently associated with self-reported physical health and social wellbeing among older adults. Policy makers should consider methods to mitigate the harms associated with incarceration.
ASSOCIATION OF LIVING ALONE AND SOCIAL ISOLATION WITH ALL-CAUSE AND CARDIOVASCULAR MORTALITY: THE OTASSHA STUDY
Authors: Imamura Keigo , Kawai Hisashi , Ejiri Manami , Sasai Hiroyuki , Hirano Hirohiko , Fujiwara Yoshinori , Ihara Kazushige , Obuchi Shuichi 
Published: January 2025

Abstract
Living alone is considered a risk factor for all-cause and cardiovascular mortality, but this association may be confounded by social isolation status. This study examined how living alone while also being socially isolated affects older adults’ risk of all-cause and cardiovascular mortality. A total of 4,075 community-dwelling older adults (mean age: 72 years, male: 46%) who had participated in the 2012 or 2013 mail survey of the health checkup of the Otassha Study were included; the study period was October 2012 to November 2020. Social isolation was assessed by frequency of interaction with others, and less than once a week was defined as social isolation. Participants were classified into four groups: no social isolation – not living alone, no social isolation – living alone, social isolation – not living alone, and social isolation – living alone. A Cox proportional hazards model was used to analyze the association of combined living alone and social isolation with all-cause and cardiovascular mortality. A total of 203 (5.0%) of the participants were found to be living alone while being socially isolated. Social isolation was significantly associated with all-cause and cardiovascular mortality, regardless of whether the participants lived alone or not (p&lt; 0.05). On the other hand, there was no association with mortality among those who lived alone but were not socially isolated. These results indicate that living alone is not necessarily a risk factor for all-cause or cardiovascular mortality. In conclusion, engaging in regular social interactions could help older adults reduce mortality.
DAILY EMOTION EXPRESSION, MODES OF SOCIAL CONTACT, AND WELL-BEING IN LATE LIFE
Authors: Zhang Shiyang , Richards Nicole , Gao Sibo , Fingerman Karen 
Published: January 2025

Abstract
Older adults engage in in-person and remote forms of contact (phone, text). In-person contact may provide opportunities for sharing emotions and promoting well-being in ways that other modes of contact do not. This study examined expressing positive and negative emotions during different modes of social contact (in-person, phone), and the association between emotion expression and well-being throughout the day. Community-dwelling older adults aged 65 - 90 (N = 286, Mage = 73.95) from the Daily Experiences and Well-being Study completed ecological momentary assessments (EMA) during which they indicated their social contact as well as positive and negative mood every 3 hours for 5 to 6 days. Participants also wore Electronically Activated Recorders (EAR) to unobtrusively capture ambient sounds. Sound snippets that contained participants’ speaking (N = 30,311) were transcribed verbatim and processed using the Linguistic Inquiry and Word Count (LIWC) to obtain linguistic features pertaining to emotion expression. Multilevel models revealed that in-person and phone contact were both associated with an increased use of positive words (e.g., love, sweet), yet only in-person contact was associated with more words expressing negative feelings (e.g., worried, sad). Using both positive and negative words was associated with a better mood in the same 3 hours. No associations were found between either positive or negative words and negative mood. Findings suggest that older adults may benefit emotionally from expressing both positive and negative feelings during in-person contact. Interventions for older adults’ emotional well-being may focus on fostering emotionally meaningful social ties and providing in-person contact.
ECONOMIC INSECURITY DURING THE COVID-19 PANDEMIC AMONG HEALTH CARE WORKERS BY EDUCATIONAL ATTAINMENT
Authors: Mroz Tracy , Dunlap Ben , Frogner Bianca 
Published: January 2025

Abstract
The COVID-19 pandemic had unprecedented impacts on healthcare workers. Prior to the pandemic, healthcare workers in lower skilled jobs (e.g., nursing assistants, home care aides) versus higher skilled jobs (e.g., physicians, nurses) were more likely to experience economic insecurity. We examined economic insecurity among healthcare workers between July 2021 and August 2023 via secondary analysis of Household Pulse Survey data. We used multivariable logistic regression to investigate the relationship between economic insecurity and educational attainment as a proxy for higher versus lower skilled workers, controlling for other sociodemographic characteristics. Of the 108,206 respondents who reported working in healthcare, representing a weighted sample of 10,656,917 healthcare workers, 49.5% had less than an associate degree, 10.0% had an associate degree, 21.7% had a bachelor’s degree, and 18.9% had a master’s degree or greater. Among workers with less than an associate degree, associate degree, bachelor’s degree, and master’s degree or higher: an estimated 78.7%, 69.9%, 56.1%, and 40.0% reported difficulty with usual expenses; 53.6%, 42.7%, 27.6%, and 17.4% reported food insufficiency; and 11.1%, 8.1%, 4.6%, and 2.8% reported being behind on their rent or mortgage payments, respectively. Lower educational attainment was significantly associated with greater economic insecurity across all measures. This relationship was attenuated, but still significant, after controlling for other sociodemographic characteristics. Lower skilled workers are critical to the healthcare workforce, especially in long-term care. Policies to promote economic security among these workers are needed to ensure a robust workforce is available to care for older adults.