bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of the dementia nursing competence e-learning program for nurses in acute care hospitals in Japan
Authors: Suzuki Mizue , Ishihara Tetsuro , Sasaki Nanayo , Yoshimura Hiromi , Sakai Ikuko , Mastushita Kimiyo , Mimuro Soichiro , Sawaki Keisuke 
Published: December 2021

Abstract
Objective: The number of older patients with dementia hospitalised in acute care hospitals increased and these patients underwent physical restrictions leading to a degeneration of essential mental and physical function. The dementia nursing competence e-learning program with audio-visual materials has been developed in acute care hospitals. Methods: An application form that explained the research was distributed to 1,944 registered nurses from seven hospitals, and 110 people applied. Nurses used an e-learning program for a month in May and practiced applying the knowledge learned from programs June through November 2020. The nurses completed a questionnaire survey at four periods: first (before program/baseline), second (after program), third (three months later), and fourth (six months later). In the second, third, and fourth periods, ‘Technical knowledge of the dementia nursing’ and ‘dementia nursing intervention’ were significantly improved as compared with the first. In the fourth period, ‘confidence of reduce of physical restriction’ showed significant improvement compared to the first. In ‘Ethical sensitivity scale of nurses’, the first of the four sub-scales significantly increased as compared with the first period. In ‘Self-assessment Scale of Nursing Practice for Elderly Patients with Cognitive Impairment with the Aim of Person-centred Care in Acute Care Hospitals’, the fourth sub-scale showed significant improvement compared to the first. In the ‘Personhood’ sub- scale of the Japanese version of Approaches to Dementia　Questionnaire, the fourth period showed a significant increase compared to the first. Conclusion: The results suggest that this program was effective and led to reduced physical restrictions in nursing practice.
Experience of Physical Therapy Students Mentoring Older Adults with Health Literacy Tools
Authors: Milidonis Mary , Keehan Jane , Montgomery Katherine , Deuley Rebecca , Formoso Sara , Kopera-Frye Karen 
Published: December 2021

Abstract
Health literacy is a top priority for Healthy People 2030. Healthy People 2030 defines personal health literacy as “the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.” The purpose is to understand the experience of physical therapy students using health literacy tools with older adults to promote the adoption of health literacy tools in healthcare encounters. This project analyzes the reflection responses from students using qualitative methods. The qualitative methods included student reflection papers, word clouds, and focus groups. Twelve students participated in focus groups/ reflections. Thirty-seven students participated in word clouds. Health literacy tools included plain language, teaching teach back and “Ask me 3”®. Students were taught by student leaders and faculty about the meaning of health literacy and oral communication tools. Pairs of students provided health education with health literacy tools to older adults. Students then participated in a small group reflection to create word clouds. Students answered questions and provided five words that best answer each question. Students believed the benefits of health literacy tools for older adults includes better learning, participation and engagement. Reasons to use health literacy in the future were improved older adult independence, education and adherence. Students completed reflections and interviews at the end of the year to detail their experience with the health literacy tools. The pedagogical approach highlighted the value of experiential learning for the students while mentoring older adults.
Older Adults' Perceptions and Use of Patient Portals: A Comparative Analysis of Two Samples
Authors: Son Hyojin , Nahm Eun-Shim , Zhu Shijun , Galik Elizabeth , Van de Castle Barbara , Seidl Kristin , Russomanno Vince 
Published: December 2021

Abstract
Older adults can benefit from using patient portals. Little is known whether the perceptions and use of patient portals differ among diverse older adult populations. The aim of this study was to assess the difference in perceived usability of patient portals, self-efficacy for using patient portals, and patient portal use between two adult samples aged 65 years or older. One sample was recruited from a health care system, including hospitals and clinics (n = 174), and the other sample was recruited from nationwide communities (n = 126). Conducting a secondary data analysis using two survey datasets, this study performed a series of linear and ordinal logistic regression analyses. The health care system sample had a higher mean number of chronic diseases and proportion of recent hospitalization than the community sample. The health care system sample showed higher perceived usability, self-efficacy, and usage frequency of patient portals compared to the community sample. eHealth literacy was a significant predictor of perceived usability and self-efficacy. Perceived usability was another significant predictor of self-efficacy. Self-efficacy and health condition variables significantly predicted the more frequent use of patient portals. Compared to the health care system sample, the relationship between perceived usability and use of patient portals was stronger and significant in the community sample. These findings suggest that approaches for promoting patient portal use should consider personal characteristics and health conditions of diverse older adult populations. Future research needs to focus on assessing the impact of using patient portals on older adults’ health care outcomes.
The Positive and Negative Affect Relation in the Context of Stress and Age
Authors: Blaxton Jessica , Nelson Niccole , Bergeman Cindy 
Published: December 2021

Abstract
Research suggests that the within-person inverse relationship between negative affect (NA) and positive affect (PA) indicates poorer emotional well-being, and this interaffect correlation fluctuates in relation to the context of the individual. Specifically, age, stress, and global PA all relate to changes in the interaffect correlation. The current study uses comprehensive data from the Notre Dame Study of Health & Well Being (NDHWB), which allows us to uniquely examine between-person differences in within-person change and variability in the interaffect correlation, thereby examining these constructs from a process-oriented perspective. Midlife and later life participants (N = 965) completed daily questionnaires assessing stress, NA, and PA. Three-level multi-level models illustrated that the interaffect correlation becomes more negative during times of stress, adults with greater global PA experience a stronger inverse interaffect correlation during times of stress, and days of higher stress relate to a stronger inverse interaffect correlation for older adults compared to midlife adults. The findings illustrate the idiographic nature of these relationships and suggest that later life adults and adults with high levels of global PA undergoing higher than typical stressful situations experience stronger inverse interaffect correlations.
Asset Transfers among those Accessing the Medicaid Program: Are Wealthy Older Adults Gaming the System?
Authors: Tavares Jane , Cohen Marc 
Published: December 2021

Abstract
Medicaid is the largest payer of long-term services and supports and millions of older Americans rely on the means-tested program for health care coverage. There has been longstanding concern that wealthy older adults are taking advantage of the program by divesting assets in order to qualify for coverage. The existing research on the issue is somewhat dated, does not focus on the question of asset transfer, and often lacks a significant longitudinal view. Thus, questions remain about whether states need to tighten asset eligibility rules to prevent the wealthier older adults from accessing the program. This analysis explores longitudinal data from the Health and Retirement Study (1998 to 2016) to determine the extent to which wealthier Americans age 50 and older engage in asset transfer to access Medicaid. Our findings demonstrate that this may occur among a relatively small proportion of wealthy older adults, and that tightening Medicaid eligibility criteria would likely have a small to modest impact on the financial status of the program.
Differential Effectiveness of the Minnesota Safe Patient Handling Act by Health Care Setting
Authors: Rosebush Christina , Schofield Katherine 
Published: December 2021

Abstract
The Minnesota Safe Patient Handling (SPH) Act requires nursing homes, hospitals, and outpatient facilities to develop comprehensive SPH programs and acquire mechanical lifts. The law was designed to prevent the adverse outcomes of manual patient handling among workers (e.g., musculoskeletal injuries) and care recipients (e.g., falls, skin tears). Reducing manual handling is of particular concern in nursing homes where residents’ care needs necessitate frequent lifts and transfers. To date, research has focused on the effects of SPH laws separately in nursing homes and hospitals. Our study aimed to assess whether change in worker injury rate differed between nursing homes and other health care settings following enactment of the 2007 Minnesota law. We used 2005-2017 claims data from a large workers’ compensation insurer and assessed the effects of time, health care setting, and their interaction on claim rate using negative binomial regression models. The claim rate for patient handling injuries was highest in nursing homes (2.8/million payroll), followed by hospitals (1.4/million payroll), and outpatient facilities (0.04/million payroll). Across settings, patient handling claims declined by 38% (95% CI 19-53%) between pre-law (2005-2007) and post-implementation (2014-2017). The decline in claims over time did not differ by health care setting (Wald χ2 for interaction=3.40, p=0.758). Our results suggest that nursing homes are successfully addressing the unique mobility needs of their residents in their mandated SPH programs. Future work should seek to describe the magnitude and nature of care recipient injuries caused by lifting and transferring and evaluate trends in care recipient injuries over time.
Support for Adjusting the Intentions of Family Members and Users Regarding Care Service Use: Aimed at Care Management
Authors: Masuda Kazutaka 
Published: December 2021

Abstract
In Japan, there are key healthcare professionals for home nursing care for elderly people called Care Managers. The care manager coordinates the service while adjusting the family situation and the user's intentions. The purpose of this study was to examine the practical structure of support for adjusting the intentions of family members and users regarding care service use. Data from seven cases, where family members and users have different intentions regarding care service use, were analyzed using the grounded theory approach. The phenomenon of "confirmation of discrepancies" was discovered with six sub-categories: adjusting the intentions of users and their families, effort to restore relationships, expression of intention to refuse involvement, expression of desire for adjustment, arrangement of opportunities for adjustment of intentions, and appropriate service adjustment. Four patterns occurred in the process of "confirmation of discrepancies": smooth adjustment, restoration and promotion of mutual relationships, failure to reach an agreement, and negative feedback loops. These patterns were based on a combination of the care managers' degree of understanding strength, the managers' degree of insistence, the managers' degree of representation of mutual feelings, the degree of managers' prediction of life prospects, the degree of trust in care managers, and the degree of expression of family anxiety.
Influence of Depression and Personality on Social Functioning in Older Adults
Authors: Freedman David , Lederer George , Atlas Lauren , Waldman Rachel , Ho Jennifer , Geramian Helene , Francois Dimitry , Zweig Richard 
Published: December 2021

Abstract
Among older adults there is significant comorbodity between depression and personality pathology and both are associated with poorer social functioning. Personality pathology is associated with greater prevalence, poorer recovery, and a higher likelihood of recurrence of depression in older adults. This study is a secondary analysis examining the relationships between personality traits associated with personality pathology (i.e. high neuroticism and low agreeableness), depression, and social functioning across older adults surveyed in primary care and psychiatric inpatient settings (N = 227). Individual variable as well as interaction models were examined. Higher neuroticism (FChange [1,217] = 40.119, p &lt; .001), lower agreeableness (FChange [1,217] = 20.614, p &lt; .001), and clinical status (i.e. primary care vs. psychiatric inpatient) (FChange [1,217] = 19.817, p &lt; .001) were associated with poorer social functioning. Clinical status moderated the relationships between neuroticism and social functioning (B = -.0147, p = . 0341) and between agreeableness and social functioning (B = .0268, p = .0015). Interaction effects were not observed between neuroticism and depression or agreeableness and depression as they relate to social functioning. However, depression severity was observed to mediate the relationship between neuroticism and social functioning [Indirect effect = .0212, 95% CI = .0141, .0289]. These findings highlight the importance of accounting for depression and clinical status in the assessment and treatment of older adults with personality pathology. Findings warrant future research focused upon mechanisms through which personality pathology and depression influence functional status in older adults.
Protective Effects of Perceived Control on Prescription Drug Misuse 10-years Later in the MIDUS Study
Authors: Miller Sara , Almeida David 
Published: December 2021

Abstract
The current study examined if control beliefs predict prescription drug misuse (PDM) 10-years later and how problem drinking status moderates this relationship. PDM refers to taking medications without a prescription or in a manner not intended by the prescriber. Older adults are especially vulnerable to PDM due to drug sensitivity, comorbid health conditions, and high rates of polypharmacy. Participants were adults (n=2162, 56% female, mean age=54, range=30-84) who completed Waves 2 and 3 of the Midlife Development in the United States (MIDUS) study. At Wave 2, participants reported on two subscales of perceived control (personal mastery and constraints) and past 12-month problem drinking behaviors. At Wave 3, participants reported past 12-month PDM of five substances (painkillers, sedatives, stimulants, tranquilizers, and depression medications). Results indicated that at Wave 3, 10% of the sample reported misusing at least one prescription drug in the past year. Logistic Regression analysis revealed that problem drinking was associated with higher odds of PDM (p&lt;0.001), and perceived control was associated with lower odds of PDM (p&lt;0.05) after controlling for previous PDM and sociodemographic, health behavior, and health status covariates. However, there was an interaction effect such that perceived control was not protective for those individuals who engaged in problem drinking at Wave 2 (p&lt;0.05). Future analyses will explore the meaning of this interaction. Identifying psychosocial protective factors, such as perceived control, predicting PDM will be critical for designing interventions that prevent the adverse consequences of PDM among this population.
Saving fall-injured older adults from depressive symptoms: The mediating role of social participation
Authors: Zhang Yalu , Zhang Lei , Sun Jiling , Zhang Xinhui , Sun Jingjing , Song Xinming , Chen Gong 
Published: December 2021

Abstract
Falls are the second primary cause of unintentional injury deaths globally. Prior studies found that fall incidences are associated with depressive symptoms among older adults, which could reversely lead to repeated fall incidences. However, few have investigated the role of social interventions in saving fall-injured older adults from experiencing depressive symptoms among older adults. Using the Chinese Health and Retirement Longitudinal Study (CHARLS) 2011-2018 data and multiple levels of fixed-effect analysis, this study examined the potential mediating role of social participation in alternating the effect of fall injuries on depressive symptoms. For the first time, this study specified the fall-injured older adults among those who had fall incidences. It also implemented the current literature by removing the bias caused by unobservable confounding variables at provincial and city levels. The descriptive results show that 22.2% and 20.6% of rural (n=4,972) and urban (n=3,258) older adults (65+), respectively, experienced fall incidences, among whom 45.1% needed one or more times of medical treatment. The fixed-effect results show that for urban older adults, social participation accounted for partial effects (17.2%) of fall injuries on their depressive symptoms. For rural older adults, fall injuries are significantly associated with more depressive symptoms, but social participation no longer functions as the mediator. Findings from this study emphasize the necessity of collecting efforts from multiple levels to improve the social engagement of urban older adults who had fall injuries. Future studies could further specify what types of social participation would be more helpful in buffering the intervention effects.
Geographic variation in gender gap among older adults in India and China: Application of a new ageing measure
Authors: Balachandran Arun , Chen Feinian 
Published: December 2021

Abstract
A continuous rise in the life expectancy of females above that of the males among older adults in India and China may give an impression that the gender gap in health is decreasing. However, given the systemic bias against females in these countries across multiple facets, and the diversity across provinces, a fuller understanding of gender gap calls for (a) understanding the gender gap in multiple dimensions of health, and (b) understanding the variations across provinces. We estimate a multi-dimensional old-age threshold (MOAT) across provinces in India and China, that specifies different old-age thresholds for female and male populations after simultaneously accommodating for multiple dimensions related to their health. These aspects of health include remaining life expectancy, intellectual and functional health. We estimate the gender gap across provinces in these countries by differencing the MOAT of males against that of females. In addition, we also illustrate the gender gap across individual dimensions of health. Our results show that females in almost all the provinces of India and China have a lower MOAT than their male counterparts, showing an earlier advent of ‘old-age’ among females compared to males. The estimates based on remaining life expectancy shows gender gap in favor of females, but the estimates of multi-dimensional gender gap are higher and biased against females. A huge variation is seen across provinces, with Karnataka and Hubei showing lower levels of gender gap and Rajasthan and Yunnan showing higher gender gaps in India in China respectively.
The Relationship between Social Isolation and Sense of Community among Older Adults in Puerto Rico
Authors: Buckley Thomas , Burnette Denise 
Published: December 2021

Abstract
Psychological sense of community (SOC) is linked to key health and wellbeing outcomes for older adults and among Latin American populations. Prior research shows that social factors may affect SOC, but this has yet to be studied among Puerto Rican older adults. This study draws on Social Resource Theory to test the hypothesis that social isolation is associated with SOC among older adults in Puerto Rico. We collected data through face-to-face interviews in a non-probability sample of community dwelling adults aged 60+ throughout Puerto Rico in 2019-2020 (N = 154). We measured social isolation with the Spanish translation of the LSNS-6 (range 0-30, mean= 14.00, SD= 5.99), where higher scores indicate less isolation, and SOC with the Spanish translation of the Brief Sense of Community Scale (range 0-32, mean= 24.75, SD= 6.04). This cross-sectional study used multiple linear regression to test the association between social isolation and SOC, while controlling for gender, age, income and living arrangement. Higher scores on the LSNS-6 were associated with higher SOC (β=0.31, SE=0.08, p&lt;0.001). Among the sociodemographic covariates, increased age was associated with higher SOC (β=0.12, SE=0.05, p&lt;0.05). This study demonstrates that older adults in Puerto Rico who are more socially isolated have lower SOC, and that SOC increases with age. In order to promote SOC in this population, interventions should focus on reducing social isolation and may benefit from targeting young-old older adults. Future research should continue to examine these relationships and extend to other Latin American cultures.
Risk Factors of Walking While Talking Decline in Older Adults: Central Control of Mobility and Aging Study
Authors: Jayakody Oshadi , Blumen Helena , Ayers Emmeline , Verghese Joe 
Published: December 2021

Abstract
Background: Slow gait speed during walking while talking (WWT-speed) is associated with an increased risk of falls and dementia. Age-related changes in WWT-speed and associated risk factors, however, are poorly understood. This study examined 1) change in WWT-speed over time 2) factors associated with change in WWT-speed. Methods: A total of 431 older participants (M Age=76.8±6.4 years; M follow-up 4.5±2.3 years) enrolled in the Central Control of Mobility in Aging study were examined. WWT-speed was measured with a computerized walkway while participants recited alternate letters of the alphabet while walking. The following baseline measures were examined as risk factors: demographic [age, sex, education], medical [hypertension, diabetes, cardiac arrhythmias, history of stroke, Parkinson’s disease, kidney disease, arthritis, depression], cognitive [global cognition, executive function, processing speed], sensorimotor [balance, grip strength, vision], falls and frailty. Linear mixed effect models were used to examine 1) change in WWT-speed over time 2) risk factors of WWT-speed change. Results: WWT-speed declined over time (b -1.06, 95%CI -1.45, -.68) independent of baseline age, sex and education. Rate of WWT-decline was modified by age (b -.10, 95%CI -.17, -.03) and poorer balance (b -1.12, 95%CI -1.95, -.28). Lower scores in tests of global cognition and processing speed and, kidney disease predicted slow WWT-speed on average. Conclusion: Greater age and poorer balance accelerate WWT-speed decline while poorer global cognition, slow processing speed and kidney disease predicts slow WWT-speed. These factors may provide potential targets for future interventions to prevent decline in WWT-speed and associated adverse health outcomes.