bluuebunny/crossref_metadata_2025_split huggingface dataset:
Text-Mining in Long-Term Care: Exploring the Usefulness of Computer-Aided Analyzing Methods
Authors: Aarts Sil , Hacking Coen , Verbeek Hilde , Hamers Jan , Sion Katya 
Published: December 2021

Abstract
In nursing homes, narrative data are collected to evaluate quality of care as perceived by residents or their family members. This results in a large amount of textual data which exceeds the capability of humans to analyse it. This study aims to explore the usefulness of text-mining approaches regarding narrative data gathered in a nursing home setting. Data has been collected as part of the project ‘Connecting Conversations’: assessing experienced quality of care by conducting individual interviews (n=125) with residents of nursing homes, family members and care professionals. Several pre-processing steps were applied to the textual data. Finally, a variety of text-mining analyses were conducted: individual and bigram word frequencies, correlation analysis and sentiment analysis. A survey was conducted to establish a sentiment analysis model tailored to text collected in long-term care for older adults. Residents, family members and care professionals uttered respectively 285, 362 and 549 words per interview. Word frequency analysis showed that words that occurred most frequently in the interviews are often positive. Although there are some differences in wording such as the use of ‘mother’ and ‘breakfast’, correlation analysis displayed that similar words are used by all three groups to describe quality of care. The majority of interviews displayed a neutral sentiment. Care professionals are more diverse in their sentiment than residents and family members: while some express a more positive sentiment, others express more negativity. This study demonstrates the usefulness of text-mining to extend our knowledge regarding quality of care in a nursing home setting.
The Dual-Language Semantic Computerized Program (DISC) Maintained Local Switch Costs in MCI Older Adults
Authors: Yow W Quin , Chen Hui-Ching , Lokanathan Tharshini 
Published: December 2021

Abstract
It has been proposed that switching cost deficit in executive control (Velichkovsky et al., 2020) could be used as an early marker for abnormal aging processes. Although research with technology-based intervention has shown benefits in improving cognitive performance with older adults, the overall results are mixed (Ge et al, 2018). This study aims to investigate whether computerized intervention program (e.g., DISC) would help to reduce the switching costs deficits in mild-to-moderate cognitively-impaired older adults (MCI-OA). Fourteen MCI-OA (79.75±6,94) and 9 cognitively-healthy OA (age 77,25±6,9) were randomly assigned to an experimental group or a control group (a final sample size of 30 MCI and 40 cognitive-healthy older adults would be ready by conference time). All participants first completed a set of cognitive tasks as part of a larger study (i.e., pre-tests) (e.g., MMSE, Ravens, cued-base Task Switching Task). The experimental group then played cognitive games on a touch-screen tablet for about 30-40 minutes per session with a total of 24 sessions over 8-12 weeks. The control group continued their daily activity as per usual for 8-12 weeks. Participants were then asked to complete the same set of cognitive tasks again post-test. Control group MCI-OA performed worse for the local costs in the cued Task Switching task (p&lt;.05), whereas experimental group MCI-OA maintained their performance (p=.40) post-test compared to pre-test. All cognitively-healthy OA did not show any difference in performance irrespective of condition. This suggests that the DISC program could be an effective tool in slowing down the abnormal accelerated aging process.
Age, Childhood Trauma, Post-Traumatic Stress Disorder, and Substance Use Disorder in the Deep South
Authors: Reel Candice , Allen Rebecca 
Published: December 2021

Abstract
We examined the relationship of reported childhood trauma and PTSD symptoms in a sample (N = 105) of individuals aged 19 to 80 receiving treatment for substance use and opioid use disorders in federally qualified health centers. Fifty-two percent of the sample was age 39 or younger, 30% were in their 40s and 18% were aged 50 and older. Thirty-two percent did not graduate high school and 36% had a high school education or equivalent. Seventy percent reported experiencing adverse childhood experiences (ACES). Although harmful alcohol use was low, 83% of the sample reported substantial or severe substance use, with 41% of the total reporting opioid use. ACES predicted current PTSD symptoms. Telehealth treatment considerations include: 1) internet access, 2) health and mental health literacy, and 3) monitoring for dissociation when using mindfulness-based relapse prevention treatment.
Inter- and Intrastate Variation of Mental Health Requirements for Assisted Living in Seven States
Authors: Dys Sarah 
Published: December 2021

Abstract
Little is known about states’ approaches to regulating mental health (MH) services in assisted living (AL) settings. Yet, one in nine AL residents are diagnosed with serious mental illness (Hua et al, 2020). This study describes the MH regulatory requirements in AL regulations within Arkansas, Louisiana, New Jersey, New York, Oklahoma, Pennsylvania, and Texas. Using health services regulatory analysis (Smith et al, 2021), we reviewed 2018 regulations for the 45 identified AL licenses within these states sourced from Nexis Uni. We summarize 16 MH requirements related to admission, care transitions, resident assessment, third-party services access, and staff training. Each state explicitly addressed at least one of the identified MH requirements, though few states have consistency across all AL types within a state. The most commonly addressed requirements related to admission limitations, assessment, and transfer to psychiatric units. Understanding these requirements promotes a holistic approach to practices that meet residents' needs.
We Should Have Talked About Hospice: Transforming Communication With Bereaved LGB Aging Women
Authors: Valenti Korijna , Janssen Leah 
Published: December 2021

Abstract
Because of historical discrimination, discomfort disclosing information, and differing definitions of family, lesbian, gay, bisexual, and transgender (LGBT) older adults with serious illness need both improved palliative and end-of-life (EOL) care communication with clinicians and recognized inclusion of spouses/partners. Communicating about palliative and EOL care may improve the care goals and emotional trajectory for patients and significant others. Using a descriptive qualitative approach, this study’s aim was to analyze the communication experiences during a spouse’s/partner’s EOL care for bereaved LGB women (n=16) 60 and older. Drawing on queer gerontology, issues relating to access to resources and information and the systemic silencing of older LGB women illuminate areas where policy and practice may be improved. Semi-structured, one-on-one interviews were used to provide deep and meaningful information about palliative and EOL care communication between participants, their spouse or partner, and clinicians. While results reflect certain outcomes found in prior studies with non-LGBT adults, thematic analysis revealed three main findings with evidence specific to this population: 1) avoiding deep discussions about EOL; 2) lack of understanding about palliative or EOL care; and 3) limited communication with clinicians. Findings illuminate the need for better understanding among clinicians regarding palliative and EOL communication with LGBT dyads as well as communication strategies based on recognition and acceptance. Further dyadic communication research may improve care goals for LGBT older adults. Understanding couples’ interactions and examining different communication behaviors may lead to improved palliative and EOL care goals for older LGBT adults with serious illness and their spouses/partners.
Metabolic Adaptations to Aerobic Exercise in Aged Mice
Authors: Marx Tyler , Vasileva Anastasiia , Hutchison Stephen , Stern Jennifer 
Published: December 2021

Abstract
Aerobic exercise training is a potent intervention for the treatment and prevention of age-related disease, such as heart disease, obesity, and Type 2 Diabetes. Insulin resistance, a hallmark of Type 2 Diabetes, is reversed in response to aerobic exercise training. However, the effect of aerobic exercise training on glucagon sensitivity is unclear. Glucagon signaling at the liver promotes fatty acid oxidation, inhibits De novo lipogenesis, and activates AMP Kinase, a key mediator of healthy aging. Like humans, aging in mice age leads to a decline in physical and metabolic function. To understand the role of glucagon signaling in exercise-induced improvements in physical and metabolic function in the mouse, we implemented a 16-week aerobic exercise training protocol in young and aged mice. 16 weeks of exercise training initiated at 6 months of age increased markers of physical function (P&lt;0.01) and attenuated age-related weight gain (P&lt;0.05) and fat mass (P&lt;0.0001). Additionally, exercise training improved glucose clearance (P&lt;0.01), enhanced glucose-stimulated insulin secretion (P&lt;0.01) and decreased hepatic lipid accumulation (P&lt;0.05). Importantly, exercise training decreased hypoglycemia stimulated glucagon secretion (P&lt;0.01), with no effect on hepatic glucagon receptor mRNA expression or serum glucagon. Thus, we propose that aerobic exercise training enhances glucagon sensitivity at the liver, implicating glucagon as a potential mediator of exercise-induced improvements in aging. Studies initiating the same aerobic exercise training intervention at 18 months of age in the mouse are currently underway to establish the role of glucagon receptor signaling in exercise-induced improvements in aging.
Validation of Perceived Mental Fatigability Using the Chinese Version of the Pittsburgh Fatigability Scale
Authors: Hu Yixin , Zhang Hangming , Xu Weihao , wang siyue , Bair Woei-Nan , Fan Li , Qiao Yujia (Susanna) , Glynn Nancy W 
Published: December 2021

Abstract
Background: Recently we validated the simplified-Chinese version of the Pittsburgh Fatigability Scale (PFS) Physical subscale. Next step is to validate the PFS Mental subscale in order to introduce a reliable measure of perceived mental fatigability among Chinese community-dwelling older adults. Methods: This cross-sectional study was conducted in an urban community in Beijing. Internal consistency of the PFS Mental subscale was evaluated by Cronbach’s alpha. The participants were divided in half to evaluate the factor structure validity by exploratory factor analyses and confirmatory factor analysis. Convergent validity and discriminant validity were evaluated against cognitive function (assessed by MOCA) and global fatigue from FRAIL Scale. Results: Our study included 370 participants (mean=83.8 years). The simplified-Chinese version of PFS Mental subscale showed strong internal consistency (total Cronbach’s alpha=0.82, each items Cronbach’s alpha ranged from 0.78 – 0.83). The results of exploratory factor analysis showed all 10 items loaded on two factors: moderate to high and low intensity activities, which explained 60.8% of the total variance. Confirmatory factor analysis showed fit indices: SRMSR = 0.090, RMSEA = 0.120, CFI = 0.89. PFS Mental scores demonstrated moderate concurrent and construct validity against cognitive function (r = －0.24, P&lt;.001). Additionally, the PFS Mental subscale had strong convergent validity, discriminating according to established cognitive impairment or FRAIL Scale fatigue testing cut points, with differences in PFS Mental scores ranging from 3.2 to 8.4 points. Conclusions: The PFS Mental subscale simplified-Chinese version is a valid tool to assess perceived mental fatigability in Chinese-speaking older adults.
Home-Based Care in the Context of COVID-19: Disruptions, Innovations, and Lessons for the Future
Authors: Franzosa Emily , Ornstein Katherine 
Published: December 2021

Abstract
During the initial surge of the COVID-19 pandemic, home-based primary and palliative care (HBPC) practices played a valuable role in maintaining access to health-related services and keeping older, medically complex patients out of hospitals and congregate settings that could heighten their risk for COVID-19. At the same time, these practices faced unique challenges in adapting a traditionally hands-on model of care to accommodate restrictions on in-person contact. In this symposium, we present innovative research highlighting the challenges faced by HBPC practices and patients during spring 2020, as well as their rapid innovations and adaptations. First, Ritchie et al. provide national context with findings from a survey of U.S. home-based primary care practices that highlights the field’s most pressing challenges and successful strategies. Shifting to the initial epicenter of the pandemic in New York City, Reckrey et al. present a qualitative study of the perspectives of paid and unpaid caregivers of dementia patients served by an HBPC practice, while Franzosa et al. describe care disruptions among individuals with dementia who died during the initial surge, using a novel chart-based abstraction technique. Finally, two studies (Gorbenko et al. and Kalicki et al.) explore HBPC practices’ experience of rapidly transitioning to telehealth through qualitative interviews with NYC-based practices and a provider survey exploring telehealth adoption and readiness in the homebound population. Together, these studies yield important insights into the challenges of providing community-based care for at-risk populations during a pandemic, and practical strategies for home-based models of care moving forward.
Listening to Clinical Teams: Developing Strategies to Support Sustained STAR-VA Implementation
Authors: Curyto Kim , Page Kyle , Benson Karen , Wray Laura , Karel Michele 
Published: December 2021

Abstract
Feedback obtained from program evaluations and interviews with CLC team members who participated in STAR-VA helped to inform the development of sustained implementation strategies guided by the CFIR-ERIC Mapping Tool. A CLC readiness assessment was developed to guide selection of new champions and assess for local team readiness to implement STAR-VA. Virtual training materials were developed along with a champion training checklist to prepare additional champions and support team training. We identified key implementation steps and optional strategies to support sustained implementation, developed a sustained implementation guide, associated sustained implementation checklist, and sustainability toolkit. We are piloting a regional community of practice model, encouraging development of and building on relationship networks to promote use of program tools, collaborative problem-solving, feedback, and a shared vision for implementation. We will discuss the importance of tailored strategies for integrating new practices into usual care.
Developing Multimodal IoMT Monitoring System of Geriatric Depression: A Feasibility Study
Authors: Kim Heejung , Cho Youngshin , Lim Kyuhee , Lee Sunghee , Kim Yuntae , Kim Mijung 
Published: December 2021

Abstract
The Internet of Medical Things (IoMT) is a promising tool to monitor depression and relevant symptoms. However, the multimodal IoMT monitoring system has been rarely developed considering the characteristics of older adults, particularly living in the community. Therefore, it is necessary to know how to develop multimodal IoMT monitoring systems tailored for older adults and evaluate the feasibility for research and practice. We developed a multimodal IoMT monitoring system that included a smartphone for facial and verbal expressions, smartwatch for activity and heart rates, and ecological momentary assessment (EMA) application. A convenience sample of 21 older Korean adults aged over 65 years was recruited from a community center, and 19 participants completed it. The data were collected in four weeks using self-report questionnaires, IoMT devices, and semi-structured interviews between July and December 2020 and were analyzed in mixed methods. Based on the Geriatric Depression Scale-Short Form scores, eight participants were classified in the depressive group (38.1%) and 13 in the non-depressive group (61.9%). A total of 1,505 (70.72%) EMA data were collected, and 1,277 (60.00%) were analyzed. Furthermore, 1,421 (66.78%) facial expression data were collected and labeled, including anger, happiness, neutral, sadness, surprise, and exception. Voice dialogues were transformed into 5,264 scripts. The depressive group showed lower user acceptance relative to the non-depressive group. However, both groups experienced positive emotions, had regular life patterns, and increased their self-interest. Thus, our multimodal IoMT monitoring system is a feasible and useful measure for acquiring mental health information in older adults’ depression.
The Sex Difference in Physical Functioning: How Do Risk Factors Contribute?
Authors: Sialino Lena , Picavet Susan , Wijnhoven Hanneke , Loyen Anne , Verschuren Monique , Visser Marjolein , Schaap Laura , van Oostrom Sandra 
Published: December 2021

Abstract
This study explores whether sex differences in the sensitivity to risk factors (strength of the association) and/or in the exposure to risk factors (prevalence) contributes to the sex difference in physical functioning, with women reporting more limitations. Data of the Doetinchem Cohort Study was used (n=5971, initial ages 26-70 years), with follow-up measurements every 5 years (up to 20). Physical functioning (subscale SF-36, range:0-100) and a number of socio-demographic, lifestyle and health-related risk factors were assessed. Mixed-model multivariable analysis was used to investigate sex differences in sensitivity (interaction term with sex) and in exposure (change of the sex difference when adjusting) to risk factors. The physical functioning score among women was 6.75 (95%CL:5.65,7.85,age-adjusted) points lower than among men. In general, men and women had similar risk factors, but pain was more strongly associated with physical functioning (higher sensitivity), and also more prevalent among women (higher exposure). The higher exposure to low educational level and not having a paid job also contributed to the lower physical functioning score among women. In contrast, smoking, mental health problems and a low educational level were more strongly associated with a lower physical functioning score among men and lower physical activity and higher BMI were more prevalent. So, few risk factors seem to contribute the more reported limitations in physical functioning among women aged 26 to 90 years. Our findings provide no indications for reducing this sex difference by promoting a healthy lifestyle but stress the importance of sex differences in pain, work and education.
Stakeholder-Driven Methods Can Enhance Care Delivery for Nursing Home Residents With Dementia
Authors: Leland Natalie , Chew Felicia , Martínez Jenny 
Published: December 2021

Abstract
The ongoing COVID-19 pandemic has underscored the need to optimize care for one of the most affected sectors: older adults in nursing homes and more specifically highly vulnerable populations such as residents with dementia. Research developed in collaboration with stakeholders can optimize impact, relevance, and trustworthiness of study findings thereby informing advances in care. Yet, evidence on stakeholder driven research for enhancing dementia care is limited. This symposium will provide examples of stakeholder-driven research questions that were addressed with stakeholder engagement. First, we will present current evidence about the perspectives of caregivers, including those from communities of color. The second presentation will discuss the perspective of clinical training stakeholders responsible for supporting system-wide clinical program implementation and their experiences with early and later adopter nursing homes within the context of a clinical trial. The third presentation will address the perspective of policy makers and payers via the effect of state-mandated dementia training on resident outcomes. The fourth and final present the findings from a study that examined how nursing home stakeholders responded to a payor requirements for pharmacy services and the relationship between that response and patient outcomes. We will conclude the session with a discussion of stakeholder-engagement methods and recommendations for future nursing home research, which champions stakeholder collaboration.
Exploring Informal Caregivers’ Priorities of Nursing Home Dementia Care From Communities of Color
Authors: Rouch Stephanie , Moscirella Marybeth , Harper Alexandra , Lekovitch Cara , Turner Rose , Piersol Catherine , Leland Natalie 
Published: December 2021

Abstract
Informal caregivers are critical stakeholders in nursing home (NH) care for individuals with dementia. Given racial and ethnic disparities in United States NHs, there is a need to understand informal caregivers’ perspectives, particularly among those that identify as members of a community of color. We conducted a scoping review of informal caregiver priorities of nursing home dementia care. Included studies exclusively examined priorities of informal caregivers identifying as Black, Indigenous, or people of color. The final sample (n=12) included two United States studies representing African American and Korean informal caregivers. The remaining studies were conducted in other countries. Informal caregivers expressed a desire for professional support during the nursing home transition, increased staff knowledge of dementia, and improved resident engagement. These findings highlight the paucity of informal caregivers identifying as Black, Indigenous, or people of color represented in US nursing home dementia research. Future efforts must include communities of color.
The Development of a Smart Reminder System to Promote Adherence to Technology-Based Intervention and Assessment
Authors: Boot Walter , Charness Neil 
Published: December 2021

Abstract
The overarching aim of the National Institute on Aging funded Adherence Promotion with Person-centered Technology (APPT) Project is to promote adherence to technology-based solutions designed to enhance the early detection and treatment of cognitive decline. The goal is to build and evaluate adaptive, tailored, and integrated technology-based adherence support systems for mobile software platforms that assess and train cognitive skill. The symposium describes the various steps of the development process of the APPT smart adherence support system. N. Charness will present an overview of the APPT project, its aims, and the clinical trials designed to assess the effectiveness of the APPT smart reminder system compared to typical reminder systems. S. Chakraborty will present detailed analyses of past cognitive intervention data to inform understanding of who is likely at risk for poor adherence and how adherence lapses might be predicted in advance to provide just-in-time adherence support. D. Carr will present an exploration of motivating factors for participants to engage in research, and these motivations will be tapped to help develop motivational messages for the APPT adherence support system to be used in the two planned clinical trials. M. Dieciuc will provide additional insights into motivations for engaging in home-based cognitive assessment and training derived from a focus group study. Finally, S. Zhang will describe the results of an initial pilot study examining the effectiveness of motivational reminder messages that match vs. mismatch participants’ own motivations. All results inform the design of the APPT system to maximize adherence.