bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is “Culture” Needed in Aboriginal Elder Care Station? An Study from the Perspective of Service Providers
Authors: Liu Li-Chuan 
Published: December 2021

Abstract
Many studies show that cultural perspective is an important factor in caring for elderly tribal adults. To understand the level of attention that the Cultural Health Station of Indigenous People attaches to culture during its operation, this study selected Taitung County as the region of study. A qualitative focus group research method and quantitative questionnaire, we try to understand “What are the demands of elderly tribal adults?” “Do services provided by the Tribal Cultural Health Station satisfy the demands of elderly tribal adults?” and “What are the gaps between the service demands and provided to elderly tribal adults?” The results showed that service providers believe that culture is markedly important to elderly tribal adults, that culture-based care designs offered by the Tribal Cultural Health Station is currently insufficient, and that to enhance the capacity of the multiethnic Tribal Cultural Health Station, the cognition and understanding of policy makers and enforcers must be elevated.
Measurement Invariance of a Latent Dementia Index by Gender in the Aging, Demographics, and Memory Study
Authors: Saenz Joseph , Kim Alice , Beam Christopher 
Published: December 2021

Abstract
Population-based aging studies allow researchers to study dementia and its correlates. Few include dementia diagnoses. Latent variable models have been used to create latent dementia indexes (LDI) using cognitive and functional ability to approximate dementia. The LDI is applied across diverse populations, but it is unclear whether gender affects its measurement properties. We assess whether the LDI can be used to measure dementia equivalently for men and women. We use the 2001-2003 Aging, Demographics, and Memory Study (n=856, 355 men, 501 women). Cognitive ability was assessed using memory, executive function, attention, spatial ability, orientation, and language tasks. Functional ability was informant-reported. We used confirmatory factor analysis to test factorial invariance across gender and compare latent means to determine which group had lower means, consistent with greater dementia likelihood. Model fitting results suggest metric invariance of the LDI but only partial scalar invariance across gender. Latent mean differences in the LDI were observed (Mdiff = .39, SE = 0.19, p = .042), with women lower, on average, than men. Correlations between LDI and dementia diagnosis were stronger for both men (r=-.82) and women (r=-.85) than correlations between dementia and Mini-Mental Status Exam scores (-.69 and -.73, respectively). The LDI may be reliably and validly used to measure and compare dementia likelihood in men and women. Results suggest lower LDI scores in women, indicating greater dementia likelihood. Gender differences may be partially attributed to differences in measurement properties of items, possibly due to gender differences in educational returns and employment factors.
Montani Semper Liberi: Age And Depression Among Veterans In Appalachia
Authors: Dang Alex , Nimako Maxwell , Fiske Amy 
Published: December 2021

Abstract
Depression is higher in rural areas and military veterans (Kimron et al., 2019; Bedard-Gilligan et al., 2018). West Virginia, the only state contained entirely within Appalachia, has a higher percentage of military service among its citizenry than other states. Thus, the purpose of the current study was to examine the association between veteran status and depression among adults in WV. Using 2018 WV data from the CDC’s Behavioral Risk Factor Surveillance System, we examined depression as a function of veteran status and age, among 612 younger adults, 1813 middle-aged adults, and 2445 older adults (N = 4,870; 12.4% veterans). Our ANOVA revealed a significant overall effect, F(5, 4864) = 14.64, p &lt; .001, a main effect for veteran status (18.8% of veterans and 26% of non-veterans reported depression), and an age effect emerged, with more younger (28.6%) and middle-aged adults (30.5%) reporting depression than did older adults (20.3%). No significant interaction between age and veteran status emerged, F(2, 4864) = 1.75, p = .175. Of note, 25% of the sample reported having depression. Given that place-based mental health disparities exist, this finding is not unexpected. But fewer older adults and fewer veterans reported depression. At least three possibilities warrant further investigation. Future studies should examine whether these age and veteran status differences in depression reflect differences in resilience, differences in reporting, and/or differences in selective survival.
Outcomes and Treatment Costs of Skilled Nursing Facility Patients with Pressure Injuries and Malnutrition
Authors: Kerr Kirk , Brunton Cory , Arensberg Mary Beth 
Published: December 2021

Abstract
Skilled nursing facilities (SNF) provide care for individuals requiring skilled care while transitioning to a more permanent residence post hospitalization. This analysis shows that diagnosed malnutrition and pressure injuries (PI) adversely impact SNF patients’ health and recovery. Length of SNF stay, total charges, and discharge disposition were analyzed using SNF claims from 2016-2020 Centers for Medicare & Medicaid Services (CMS) Standard Analytical File databases. An average of 4.5% SNF patients had diagnosed PIs, and 4.9% had diagnosed malnutrition. Patients with diagnosed malnutrition were more likely to have PIs than patients without diagnosed malnutrition (11.9% vs 4.1%). Patients with PIs had higher charges ($12,304 vs. $10,937), were less likely to be discharged home (11.1% vs 18.9%), and more likely to be discharged to a hospital (15.8% vs 11.0%) or deceased (2.8% vs 1.6%). Patients with diagnosed malnutrition displayed a similar pattern for charges ($11,587 vs $10,969), and discharge to home (14.5% vs 18.8%), hospital (13.5 vs 11.1%) or deceased (2.8% vs 1.6%). Length of SNF stay did not differ between patients with and without PIs (18.5 vs 18.6) and was slightly shorter for patients with diagnosed malnutrition (17.3 vs 18.9). While higher probability of rehospitalization or death could impact these results, drivers behind these differences need further investigation. Because malnourished patients were more likely to have PIs and both PI and malnutrition are associated with poorer patient discharge outcomes and higher costs, efforts to identify malnutrition and implement proper nutrition interventions should be prioritized as part of SNF quality improvement initiatives.
Poor Performance in SNF-VBP Program is Associated with Worse COVID-19 Outcomes in Nursing Homes
Authors: Hefele Jennifer Gaudet , Aldag Matt , Elmor Riad , Kaushik Charanya , Ballard Jessica Simpson 
Published: December 2021

Abstract
Skilled Nursing Facility Value-Based Purchasing (SNF-VBP) was a new Medicare payment program when COVID-19 began. SNF-VBP aims to improve care through payment bonuses and penalties. However, studies have shown that minority-serving nursing homes (NHs) tend to fare worse under SNF-VBP (more likely to receive penalties, less likely to receive bonuses). This study sought to examine whether SNF-VBP performance prior to the pandemic was associated with COVID-19 outcomes and whether associations varied in NHs where the majority of residents are Black/African American (majority-Black/AA). Using publicly available data on COVID-19 outcomes and vaccinations, SNF-VBP performance, and NH characteristics, we found that majority-Black/AA NHs were less likely to have zero infections; had higher case fatality rates; and had lower resident and staff vaccinations rates compared to NHs where the majority of residents are White. Across all NHs, worse SNF-VBP performance was associated with worse COVID-19 outcomes (the bottom quintile of SNF-VBP performers were more likely to experience COVID-19 infections and had lower vaccination rates; the highest performers had higher vaccination rates). However, in stratified analyses, SNF-VBP performance was not significantly associated with COVID-19 outcomes in majority-Black/AA NHs compared with majority-White NHs. The association between poor SNF-VBP performance and poor COVID-19 outcomes is concerning. Overall findings suggest that SNF-VBP performance prior to the pandemic is an important indicator of subsequent COVID-19 outcomes. However, it is unclear whether poor SNF-VBP performance is signaling overall poor quality or whether it is signaling a financial disadvantage caused by the program itself that in turn impacted COVID-19 outcomes.
The Impact of Supervisor Support on the Job Satisfaction of Immigrant and Minority Long-Term Care Workers
Authors: Hawes Frances , Wang Shuangshuang 
Published: December 2021

Abstract
The need for long-term care workers (LTCW) will grow significantly as the American population ages. Understanding the factors that impact job satisfaction of this workforce has important implications for policy and practice. Previous research has demonstrated the effect of supervisor support on the job satisfaction of these workers; however, much less is known about how this effect differs among different race/ethnicity or immigration groups. This study examined how supervisor support mediates the associations between race/ethnicity, immigration status, and job satisfaction among nursing assistants (NAs). Data of 2,763 NAs were extracted from the National Nursing Assistant Survey (2004). Race/ethnicity groups included White (54%), African American (30%), Asian (2%), Hispanic (10%), and others (4%). Immigration status included U.S.-born citizens (87%), naturalized (7%) and resident/alien (6%). Bivariate analyses showed that Asian NAs perceived higher levels of supervisory support than other races, whereas U.S.-born NAs reported lower levels of supervisory support than naturalized and residents/aliens. Findings from multivariate analyses indicated that non-Hispanic Asians and Resident/Alien workers reported significantly higher levels of job satisfaction than their counterparts, and the associations were fully mediated by NAs’ perceived supervisor support. These findings support prior research that supervisor support is important to improving job satisfaction and contribute to the literature that Asians/Residents/Aliens long-term care workers may be more sensitive to supervisory support and may be more grateful if they received support from supervisors. Managers should be aware of these racial differences and by being supportive they may improve NAs job satisfaction and reduce turnover rates.
Using Taiwanese Universal Health Insurance Data to Estimate LTC Needs with Machine Learning
Authors: Chen Kuan-Ming , Hsiang Chen-Wei , Chao Shiau-Fang , Lin Ming-Jen , Tseng Kuan-Ju , Chou Yu-Hsuan , Hsieh Ji-Lung , Chen Ya-Mei 
Published: December 2021

Abstract
One of the core issues in long-term care (LTC) policy is the growing imbalance between demand and supply of LTC services due to aging population. To estimate the imbalance and allocate LTC resources, the government regularly conducts surveys. These surveys are expensive given the sample size requirements and imprecise given their subjective nature. This study links the administrative records of the universal health insurance database with LTC program usage records in Taiwan to explore this issue. Machine learning algorithms are used in projecting LTC needs from administrative records. LTC program usage records provide detailed LTC needs information and the amount of service each individual used. In addition, health insurance claim data provides rich health information. Specific LTC needs are predicted for each individual. By further extrapolating to future demographics, long-term LTC needs could be projected. There are several findings in this study. Prediction of difficulties in activities of daily livings (ADL), measured by Barthel index, works best using the Gradient Boosting algorithm. The mean absolute error is 17.67 out of a 0 to 100 scale. In addition to dementia and stroke, diagnosis of pressure ulcer (ICD 10 code: L89) and pneumonia (ICD 10 code: J18) have high predictive power for LTC needs. Prediction of Instrumental ADL (IADL) also performs well with a mean absolute error 1.31. The prediction model suggests high LTC needs and excess demand as the demographics changing. Our study provides a reliable way of using rich information to estimate future LTC needs without conducting additional costly surveys.
Accelerometry-Based Assessment of Physical Activity in Older Adults During COVID-19 Pandemic
Authors: Choudhury Renoa , Thiamwong Ladda , Garcia Oscar , Xie Rui , Stout Jeffrey , Park Joon-Hyuk 
Published: December 2021

Abstract
COVID-19 pandemic has caused a severely detrimental effect on the physical, psychological, and functional well-being of older adults by forcing them to limit their social activities. This study investigates the amount and intensity of daily physical activity (PA) in older adults, living under the social distancing guidelines during COVID-19 pandemic. In this cross-sectional study, 124 community-dwelling older adults (Age:60–96 years, mean:75±7.14) were recruited via word-of–mouth and key person approach between March 2021-August 2021. Participants completed an online survey on COVID-19 questionnaires and wore an ActiGraph GT9X accelerometer on their non-dominant wrist for consecutive 7 days in free-living conditions. Euclidean Norm Minus One cut-points were used to estimate the total time spent in sedentary behavior (SB), light PA (LPA) and moderate-to-vigorous PA (MVPA). Results showed that, 7% had COVID-positive, 55% perceived moderate severity of COVID in their area, 31% reported fear of COVID, and 14.5% were afraid of losing their life to COVID. On average, participants obtained 12.43±2.1 hours/day of SB, 3.47±1.05 hours/day of LPA and 42.71±29.71 minutes/day of MVPA. MVPA minutes/day was significantly higher (P = 0.006) in participants aged 60-85 years than those aged 85+ years (45.38 minutes/day vs 14.25 minutes/day). When age-adjusted data was compared to pre-COVID-19 studies, we found COVID-19 pandemic had negatively impacted the physical activity level in older adults (29.33% decrease in MVPA and 39.2% increase in SB). These findings can be useful in developing guidelines and/or interventions to promote physical activity and healthy aging among older adults, particularly those in social isolation.
Analyzing the specific role of cognitive functioning on successful aging
Authors: Mendoza-Ruvalcaba Neyda Ma , Arias-Merino Elva Dolores , Flores-Villavicencio Maria Elena , Rodriguez-Diaz Maria Elena 
Published: December 2021

Abstract
Introduction The cognitive functioning, as a general measure, is a criterion commonly used to define and operationalize successful aging. (Project-Conacyt-256589) The aim of this study is to analyze specific domains of cognitive function and its relationship with the successful aging in older adults. Methods Population based, random sample included n=453 community-dwelling older adults 60-years and older (mean age=72.51,SD=8.11 years,59.4% women). Cognitive functioning was assessed by a comprehensive battery including working memory(Digit Span Backward WAIS-IV), episodic memory, meta-memory(self-report), processing speed(Symbol Digit WAIS-IV), attention(TMT-A), executive functioning(TMT-B), learning potential(RAVLT), language(FAS), visuospatial skills(Block Design WAIS-IV). Successful aging was operationalized as no important disease, no disability, physical functioning, cognitive functioning, and being actively engaged. Sociodemographic and health data were also asked. Data were analyzed in SPSSv24, MANOVAs and size effects were calculated. Results In total 11.2% were successful agers and 11.4% had Mild Cognitive impairment. Global cognitive functioning was significantly related to the achievement of successful aging criteria. Cognitive functioning had a significant effect on successful aging, specifically executive functions (F=1.07,p=.000) explained 32.7% of the variance, attention explained 29.8% (F=1.19,p=.006), processing-speed 21% (F=1.38,p=.000), and learning potential 21.5% ((F=1.12,p=.005). Language, visuospatial skills, working memory and meta-memory had a very small effect. Conclusion Knowledge generated by this study reveals the specific role of cognitive domains on successful aging, and sets a scenario to promote successful aging, through alternatives centered in the improvement of cognition in the older adults.
Assisted Living Administrators’ Mental and Emotional Health During the COVID-19 Pandemic
Authors: Tunalilar Ozcan , Winfree Jaclyn , Kyler-Yano Jason , Hasworth Serena , Carder Paula 
Published: December 2021

Abstract
Little is known about assisted living (AL) administrators’ mental and emotional health, particularly during a global pandemic in which most of their residents are highly vulnerable to infection, hospitalization, and death. Considering that administrator turnover and burnout have been associated with negative outcomes such as decreased quality of resident care, low staff morale, and reduced financial solvency, this study examined how AL administrators described their mental and emotional state throughout the first year of the COVID-19 pandemic. Using thematic analysis, our team coded 18 qualitative interviews conducted from May-August 2021. The themes included declining physical health due to stress, feelings of inadequacy and self-doubt, and increased burnout. Many administrators described increased staffing challenges as directly impacting their daily stress levels. Some administrators described feeling guilty and doubting their interpretation or implementation of regulations, particularly in incidents that further distanced residents from peers and loved ones. A few administrators described their disposition or personality changing due to what they experienced during the pandemic. One administrator stated, “I'm not an anxiety person, but I feel anxiety about a lot of things. In fact, my doctor has talked to me about starting some medications to help with that.” Multiple administrators made comments such as, “I don't know that there could be a more stressful position than executive director of assisted living…the COVID pandemic reinforced that. This is rough.” Understanding AL administrators’ mental and emotional health during a public health crisis allows for understanding, supporting, and retaining critical leaders in long-term care communities.
Descriptive Evidence of COVID-19’s Impact on Black LGBTQ Adults Amidst Ongoing Health Inequities
Authors: Flohr Charleigh , Burton Cassandra 
Published: December 2021

Abstract
Black LGBTQ people significant challenges and discrimination as they face the barriers of living at the intersection of multiply marginalized identities, which have worsened during the coronavirus pandemic. At a baseline, LGBTQ people exhibit elevated risk of being negatively impacted by the pandemic across health, economic and other social outcomes (Cahill et al., 2020; Heslin & Hall, 2021; Human Rights Campaign, 2020). Black LGBTQ people have also suffered significant economic losses (Human Rights Campaign Foundation, 2020) . Methods: The Human Rights Campaign Foundation and AARP supported and partnered with Community Marketing & Insights to conduct a survey of 1,815 Black LGBTQ adults in the United States. The online survey was fielded between September 21 and October 30, 2020. Many Black LGBTQ adult participants report healthcare discrimination in the last three years, with 19% reporting racial discrimination and 11% reporting sexual orientation-based discrimination. Furthermore, 31% of Black transgender adults report healthcare discrimination in the last three years. Preventing or treating COVID-19 is an important health concern to 67% of Black LGBTQ adults aged fifty-five and older, 63% of Black LGBTQ adults aged thirty-five to fifty-four and 53% aged eighteen to thirty-four. Overall, Black LGBTQ adults report being significantly impacted by the pandemic, including negative impacts on their social health (60%), mental health (44%), the physical health of their close friends and family (33%), their finances (30%), and their employment status (22%). Overall, one-quarter (25%) of Black LGBTQ adults had at least one close friend or family member die from coronavirus illness.
Does Retirement Age Impact Functional Limitations in Later Life?
Authors: Xu Ziyao 
Published: December 2021

Abstract
The US government is gradually shifting the full retirement age in Social Security to age 67. However, previous studies suggest that this shift could negatively impact the mental and physical health of retirees. To understand the potential impact of raising the full retirement age on the functional health of retirees, this longitudinal study examined changes in physical functioning over time in retirees by age at retirement. Twelve waves of the Health and Retirement Study (1994 – 2018) were used. A total of 8,261 retirees was included. The retirement age was a categorical variable: very early age (&lt;62), early age (62-64), traditional age (65-67), and late age (&gt;67). Physical functioning was measured using 15 Activities of Daily Living and Instrumental Activities of Daily Living. A GEE model was used to assess the relationship between the retirement age category and the number of functional limitations. In the adjusted model, after controlling for all the other variables including baseline health and functioning, late retirement was associated with an 8.9% increased risk of functional limitations compared to traditional age retirement (IRR: 0.91, 95% CI:0.84 –0.98). Compared to late retirees, the risk of functional limitations was increased by 28.6% in very early age retirees (IRR: 1.29, 95% CI:1.21–1.36). Compared to those retiring at traditional retirement age, those retiring late, after 67, have increased the risks of functional limitations. Although levels of disability could influence age of retirement, these results suggest that for some workers efforts to increase age of full retirement, could have negative effects.
Dyadic Perceptions of COVID-19 Pandemic Impact on Everyday Life
Authors: Margrett Jennifer , Reese-Melancon Celinda , Russell Dan , Stratton Lauren , Harrington Erin , Savla Jyoti 
Published: December 2021

Abstract
It is important to understand the effects of the COVID-19 pandemic not only on individuals’ daily lives, but also their close partners. Current literature suggests that the COVID-19 pandemic has impacted older adults’ lives in several ways, including the frequency of social interactions and change in various life habits (Lesbrasseur et al., 2021). Data from 42 middle-aged and older, long-term married or cohabitating dyads were collected as part of an ongoing study of everyday cognition and functioning among couples. Participant age ranged from 40-85+, and couples were partnered for 9-60+ years. During this study, COVID-19 pandemic impact was assessed using six items (1 = No change to 4 = Severe change) examining daily routines, medical and mental health access, social contacts, and pandemic and family-related stress; reports ranged from six to 19. On average, women reported significantly higher COVID-19 pandemic impact compared to men. For both partners, the greatest disruptions reported related to routines and social contacts. Further analysis examined COVID-19 pandemic impact in dyads. For eight dyads, both partners reported relatively lower COVID-19 impact (6-11), whereas for six dyads, both partners reported higher impact scores (14-19). Discussion focuses on within-dyad and between-dyad differences related to perceptions of the pandemic’s impact.