bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual Geriatric Education Preferences of Rural Social Workers
Authors: Ilardo Joan , Haque Raza , Zell Angela 
Published: December 2021

Abstract
Older adults in rural communities need access to comprehensive healthcare services provided by practitioners equipped with geriatric knowledge and skills. The Geriatric Rural Extension of Expertise through Telegeriatric Service (GREETS) project goal is to use telemedicine and telehealth to expand geriatric service options to underserved Michigan regions. GREETS educational programs train health practitioners to provide geriatric care for vulnerable older adults. To determine gaps in geriatric competencies, the team conducted an online survey of health professionals including behavioral health practitioners. Respondents identified educational topics and preferred virtual delivery methods. Demographic information included respondent’s professional position, practice setting, and county. The respondents were asked to indicate level of educational need using a scale ranging from a low, medium, or high need. Fifty (47%) of 106 total responses were from social workers. We compared the percent of social workers to other practitioners’ responses in our analysis. Four topics emerged for both groups as medium or high educational needs: 1) transitional care when changing residential settings or post-hospitalization; 2) assisting family caregivers cope with caregiving responsibilities; 3) incorporating community-based services into care plans; and 4) and managing frail older adults. Social workers noted higher need than the other respondents for: 1) managing chronic pain; 2) managing care of patients with multiple chronic conditions; 3) having serious illness conversations; 4) diagnosing dementia; and 5) discussing advance care planning. Both social worker and other respondents indicated interactive case-based webinars; published tools, toolkits, tip sheets; and didactic webinars as their top three learning formats.
Reframing Older Adults’ Violence Toward Staff as Self-Protection
Authors: Shippee-Rice Raelene , Taylor Rosemary , Mistler Lisa , DiNapoli Pamela , Armenti Karla 
Published: December 2021

Abstract
One of the first studies on workplace violence in nursing homes was published in 1985. Forty-five (45) years later, resident violence against staff continues to increase in incidence and severity. At the request of a state senator, a New Hampshire psychiatrist formed a research group to conduct the first New Hampshire survey on staff experience of workplace violence. Study questions focused on experiences of workplace violence and incident reporting, and the availability and benefit of workplace violence training programs. Results were consistent with recently published literature: violence is an expected, normalized element when providing care; potential repercussions and perceived resident lack of intent were major reasons for incident non-reporting. Analysis of study results and review of the literature led to the question: Are older residents’ violent behaviors towards staff an act of self-protection?
Metformin Suppresses Monocyte Inflammation and Metabolic Reprogramming by SARS-CoV-2 Spike Protein
Authors: Pence Brandt , Cory Theodore , Emmons Russell , Yarbro Johnathan 
Published: December 2021

Abstract
COVID-19 disproportionately affects older adults, and a hallmark of the disease is a hyperinflammatory state that is associated with severity. Various anti-inflammatory therapeutics have shown mixed efficacy in treating COVID-19, and the mechanisms by which hyperinflammation occurs are not well understood. Previous research indicated that monocytes, a key innate immune cell, undergo metabolic reprogramming and produce inflammatory cytokines when stimulated with SARS-CoV-2. We hypothesized that binding by the viral spike protein mediates this effect, and that drugs which regulate immunometabolism – including the geroprotector drug metformin – could inhibit the inflammatory response in monocytes. Monocytes stimulated with recombinant SARS-CoV-2 spike protein subunit 1 showed a dose-dependent increase in glycolytic metabolism that was associated with production of pro-inflammatory cytokines including interleukin-6 and tumor necrosis factor-alpha. This response was dependent on hypoxia-inducible factor-1alpha, as chetomin inhibited glycolysis and cytokine production. Inhibition of glycolytic metabolism by 2-deoxyglucose (2-DG) or glucose deprivation also inhibited the glycolytic response, and 2-DG strongly suppressed cytokine production. Glucose-deprived monocytes rescued cytokine production by upregulating oxidative phosphorylation, an effect which was not present in 2-DG-treated monocytes due to the known effect of 2-DG on suppressing mitochondrial metabolism. Finally, pre-treatment of monocytes with metformin strongly suppressed spike protein-mediated cytokine production in monocytes, and abrogated glycolytic and mitochondrial metabolism. In summary, the SARS-CoV-2 spike protein induces a pro-inflammatory immunometabolic response in monocytes that can be suppressed by treatments that interfere with glycolytic activation, including metformin. This has potential implications for the treatment of hyperinflammation during COVID-19, which disproportionately affects older adults.
Maxwell A. Pollack Award Lecture
Authors: Pillemer Karl 
Published: December 2021

Abstract
The lecture will feature an address by the 2020 Pollack Award recipient, Karl Pillmer, PhD, FGSA of Cornell University. The 2021 Pollack Award recipient is Namkee G. Choi, PhD, FGSA, of the University of Texas at Austin. The Maxwell A. Pollack Award for Contributions to Healthy Aging Award recognizes instances of practice informed by research and analysis, research that has directly improved policy or practice, and distinction in bridging the worlds of research and practice.
Past, Present, and Future of Human Rights in Gerontological Education
Authors: Howe Judith 
Published: December 2021

Abstract
The rights of older persons, essential to our work as gerontologists, were discussed in the World Assembly on Aging (1982) and adopted through the United Nations Principles of Older Persons and followed by the Madrid International Plan of Action on Aging (MIPPA) in 2002. Although it has been endorsed by the General Assembly of the United Nations, in contrast to conventions, it is not binding on member states. This paper discusses the rights of older persons and our obligations as educators and researchers to focus on core issues associated with the rights and quality of life of older people. We will review the role of education in meeting this call to action through examples like the UN Decade of Healthy Ageing where education is a required element to accomplish the action areas and the Age-Friendly University movement. Both have involved multiple university communities on a global scale.
Space, Context, Human Capital: A Macro-Micro Perspective on Social Environment and Financial Literacy in Later Life
Authors: Li Yang , Mutchler Jan , Miller Edward , Xiao Jing Jian , Tucker-Seeley Reginald 
Published: December 2021

Abstract
Despite a large body of literature documenting the association between individual characteristics and financial literacy, our understanding of the impact of macro-environmental conditions on individual financial literacy remains limited, particularly in later life. Drawing from a micro-macro perspective on the social environment and individual processes, we examined the extent to which three state-level contextual characteristics were associated with individual later-life financial literacy in the United States: tertiary educational attainment, poverty prevalence, and Internet penetration. We utilized data from the 2019 Understanding America Study (UAS) for adults aged 50 years or older to assess financial literacy (n=2,930), and data from the American Community Survey to evaluate contextual conditions. The UAS is a nationally representative survey panel supported by the Social Security Administration and the National Institute on Aging. Cross-sectional multilevel regression models were used to examine the hypothesized effects. We found that state-level poverty prevalence was negatively associated with individual financial literacy while state-level Internet penetration was positively associated with individual financial literacy, over and above individual characteristics known to impact financial literacy. No association was found between state-level educational attainment and individual financial literacy after controlling for respondents’ own education. Findings suggest that the social environment may condition financial literacy in later life through exposure to opportunities that promote knowledge acquisition. Interventions to enhance later-life financial literacy may benefit from targeted approaches that take into account the environmental characteristics of their locations of residence.
Cognition in Primary Care Community Resource Directory for Individuals, Caregivers, and Providers
Authors: Suchsland Monica Zigman , Fitzpatrick Annette , Gaster Barak , Raetz Jaqueline , Illes Judit , Olivari Benjamin , McGuire Lisa , Belza Basia 
Published: December 2021

Abstract
A KAER Model recommendation is to refer individuals diagnosed with dementia to resources that help them prepare for the future and services that provide ongoing support. The purpose of this project was to locate local quality services and develop a resource directory for persons with cognitive impairment for use by providers, staff, individuals, families, and caregivers. We worked with a Community Advisory Board and interviewed individuals and caregivers to understand what resources are useful and important to include in the resource directory. We built a web-based resource directory that allows users to query resources based on specific needs. We integrated the resource directory within the electronic health record for providers to include after visit summaries. A resource directory was deployed for community use, with goals of sustainability and longevity after this project is completed.
Caring From Afar: Long-Distance Caregivers’ Use of Supportive Services for Themselves
Authors: Cimarolli Verena , Wylie Molly , Zucchetto Jillian Minahan , Falzarano Francesca , Horowitz Amy 
Published: December 2021

Abstract
Although long distance caregivers (LDCs) are starting to be recognized as a subgroup of care partners experiencing unique challenges and stresses, it is unknown 1) what types of supportive services LDCs use for themselves and 2) what factors are associated with supportive service use in this understudied caregiving population. In our sample of 304 LDCs (Mage=56.9), the most frequently utilized service was video phone/webcam systems to monitor the care recipient (CR). Guided by Andersen’s Model of Health Care Utilization and using multiple hierarchical regression analysis, younger age of the LDC (a predisposing factor) and need-related characteristics (greater caregiving burden and depressive symptoms, more time spent helping the CR, and worse CR functional status) were associated with greater use of supportive services. Enabling factors were not associated with service use. These study findings can help inform how to engage LDCs in supportive service utilization.
Preferences and Determinants of End-of-Life Care Among Older Chinese Americans
Authors: Kong Dexia , Kozlov Elissa , Dong XinQi 
Published: December 2021

Abstract
End-of-life (EOL) care awareness and practice remain particularly low among older Chinese Americans. More empirical evidence regarding EOL is needed to develop culturally-relevant interventions to promote EOL engagement in this minority population. Using population-specific data, this study investigates preferences and associated sociodemographic and health determinants related to EOL among older Chinese Americans. Data were from the Population-based Study of Chinese Elderly in Chicago (collected 2017-2019, N=3,124). Linear and logistic regressions were conducted. Of the sample, 46.1% considered EOL care planning as important or somewhat import. Nearly 22% had EOL discussions with families. The most preferred EOL locations were home (43.7%), hospital (35.5%), nursing home (10.1%), and hospice (4.3%). Overall, 47.1% perceived EOL care as family decisions, 39.6% regarded EOL care as personal decisions, 7.5% preferred children to make EOL decisions, and 3.3% preferred a spouse to make EOL decisions. Chinese older adults who were female (B=0.10, p&lt;0.01), married (B=0.11, p&lt;0.01), had higher education (B=0.02, p&lt;0.001), acculturation level (B=0.02, p&lt;0.001), and religiosity (B=0.12, p&lt;0.001), and more chronic conditions (B=0.05, p&lt;0.001) were more likely to consider EOL as important. Those with older age [Odds Ratio (OR)=1.02, 95% Confidence Interval (CI)=1.01-1.03], female gender (OR=1.44, 95% CI=1.18-1.77), higher levels of education (OR=1.02, 95% CI=1.01-1.04), acculturation (OR=1.04, 95% CI=1.01-1.06), and religiosity (OR=1.11, 95% CI=1.02-1.21), longer U.S. residence (OR=1.02, 95% CI=1.01-1.03), and more chronic conditions (OR=1.13, 95% CI=1.06-1.21) were more likely to have discussed EOL preferences with their families. Study findings underscore low engagement in EOL planning in this population and the need for culturally-appropriate interventions.
Unmet Family Needs in Hospice and Research Priorities: Perspectives From a National Sample of Hospice Agencies
Authors: Becker Todd , Cagle John 
Published: December 2021

Abstract
Although hospice cares for nearly 1.5 million patients and families annually, little is known about practitioners’ opinions of current gaps in care and research. To this end, we posed two open-ended questions to hospice representatives to identify practice-relevant research priorities. Data stem from two optional questions (Q1: N = 72; Q2: N = 73) appended to Cagle et al.’s (2020) national survey of 600 randomly selected hospices, stratified by state and profit status. Most participants provided the majority of care in-home (84.7%; 79.5%) and worked at a medium-sized hospice (50.0%; 49.3%). Responses to Q1 (“What is the biggest unmet need for hospice patients and families?”) and Q2 (“In your opinion, what is the most pressing topic that hospice researchers need to study?”) were analyzed for content and then synthesized. Analyst triangulation and peer debriefing improved trustworthiness. Emerging domains included: access to hospice, hospice services and workforce issues, and education. The access to hospice domain contained a subtheme regarding the need for earlier referrals. Participants noted that short lengths of stay undermine the clinical benefits to patients and families, and that hospice enrollment criteria may contribute to inadequate lengths of stay. The hospice services and workforce issues domain largely focused on burnout prevention. Participants acknowledged that provider self-care was linked to the quality of patient care. The education domain contained subthemes related to improving physician knowledge regarding prognostication and referral, and to patients and families regarding misconceptions about hospice care. Findings highlight critical needs for future hospice research and policy change.
Communicative Coping and Friendship Among Persons Living With Dementia: Findings From Long-Term Care
Authors: Saunders Pamela 
Published: December 2021

Abstract
The study of identity is central to many disciplines, however there is a special link that connects language and discourse to identities. The way people speak reveals a lot about who they are. Through discourse and communication individuals convey and negotiate their sense of self (de Fina, 2020). Regardless of cognitive status, persons living with dementia (PLWD) use language to construct for themselves a social identity of being included in friendship networks (de Medeiros et al., 2011). This paper uses data from the Friendship Study to examine the use of such communicative coping behavior (CCB) for friendship formation. Ethnographic observations of PLWD were conducted in a Long-Term Care residential setting. Sociolinguistic discourse analysis of verbatim transcripts with reference to the CCB Checklist (Saunders et al., 2016) reveal evidence of CCB use. Results suggest that different types of CCBs were used to construct identity and negotiate friendship challenges in different contexts.
Leveraging ACL Funding to Implement an Evidence-Based Falls Prevention Program in Three GWEPs
Authors: Flaherty Ellen , Tumosa Nina 
Published: December 2021

Abstract
Primary care practices have a robust capacity to screen older adults for falls risk and refer them to evidence-based falls prevention programs delivered by Community Based Organizations (CBOs). However, due to a difference in the culture and nature of the work done in these two systems of care, there is often a lack of coordination and communication. Dartmouth has worked to bridge this gap for the past five years through our Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Program (GWEP). GWEP goals include the promotion of Age-Friendly Health Systems by focusing on the 4 Ms: What Matters Most, Medication, Mentation and Mobility. GWEPs commonly operationalize the Mobility component via falls risk screening and prevention programs. Though CBOs are well suited to deliver falls prevention programs, implementing, disseminating and sustaining community-based falls prevention programs in an environment of cost containment, limited funds for community-based services and workforce issues is challenging. Previous Administration for Community Living (ACL) grant funding enabled us to develop the Dartmouth Falls Prevention Training Center (D-TC) using our expertise in training and community-based implementation of evidence-based interventions. The D-TC offers training and implementation support to primary care and CBOs on screening, referring and capacity-building for falls prevention programs. We will discuss challenges and successes implementing the Dartmouth falls prevention model with two additional GWEP grantees, Baystate and the University of Rhode Island. Benefits of leveraging ACL and HRSA funding to achieve synergistic goals to reduce falls in older adults will be explored.
Adopting and Adapting a Falls Prevention Program: Lessons Learned From Implementing a Model From a Different Context
Authors: Morelli Alexandra , Petrie Carol , Ferrone Christine , Clark Phillip 
Published: December 2021

Abstract
Geriatric Workforce Enhancement Programs (GWEPs) are ideally suited to develop and implement educational programs to transform the geriatric care system. They link academic programs, clinical partners, and community-based organizations to bridge care system gaps to improve the health and social care of older adults. Such a collaboration is especially important in falls prevention, where primary care assessments generate referrals to community programs that enroll older adults to reduce their risk of falling. However, exporting an evidence-based model developed in one context for implementation in another is not without its perils and pitfalls. This paper explores the challenges of applying a model developed elsewhere to the Rhode Island context, including the need to understand how structural differences in academic, primary care, and community-based systems require flexibility, innovation, and persistence in overcoming the networking challenges in these different settings. Recommendations for implementing program models in a variety of settings are explored.
Promising Long-Term Residential Care Policy Guidance for Staff to Support Resident Quality of Life
Authors: Hande Mary Jean 
Published: December 2021

Abstract
This paper reviews 63 policy documents in four Canadian jurisdictions that guide long term residential care staff on how to enhance 11 resident quality of life in Canada. We found guidance in each jurisdiction that provide clear language to support staff discretion and flexibility to navigate regulatory tensions and enhance resident quality of life. Newer policies tend to reflect more interpretive approaches to staff flexibility and broader quality of life concepts. We argue that if interpreted through a resident quality of life lens and with the right structural supports, these promising texts offer important counters to the rigidity of long term residential care policy landscape and can be leveraged to effectively broaden and enhance quality of life for residents in long term residential care.
Energy and Exhaustion May Explain Different Subdomains of Perceived Fatigability
Authors: Katz Rain , Cohen Rebecca , Gmelin Theresa , Moored Kyle , Qiao Yujia (Susanna) , Slavin Maggie , Glynn Nancy W 
Published: December 2021

Abstract
Fatigability is a more sensitive measure of one’s perception of fatigue. To identify an appropriate fatigue question when a fatigability measure is unavailable, we examined associations between widely used global fatigue questions and perceived physical and mental fatigability. Participants (N=896, age=74.7±6.6, 58.1% women) from two aging research registries completed the valid Pittsburgh Fatigability Scale (PFS, 0-50) and five global fatigue questions: energy level (0-10), running out of energy (0-5), feeling energetic (0-6), feeling tired (0-6), and feeling exhausted (0-6) over past four weeks. All fatigue measures were correlated (p&lt;0.0001) with physical (|r| range=0.48-0.57) and mental fatigability (|r| range=0.31-0.39). “Energy level” and “feeling exhausted” had strongest associations with physical and mental fatigability, respectively, in age, sex, BMI-adjusted regression models (p’s&lt;0.001), suggesting older adults can distinguish between physical and mental domains. Future work will explore how these constructs are distinct but related, and confirm the optimal proxy for the two fatigability subdomains.
COVID-19 Impact on Alberta Nursing Home Workers: An Interpretive Descriptive Study With Direct Care Providers
Authors: Spiers Jude , Titley Heather , Savage Amber , Thorne Trina , Young Sandra , Asadi Neda , Schalm Corinne , Estabrooks Carole 
Published: December 2021

Abstract
COVID-19 has devastated the LTC sector, but we lack systematic information on the impact on frontline staff. Our research, a partnership with the continuing care branches of Alberta Health and Alberta Health Services, was aimed at assessing COVID-19 impacts on staffs’ well-being and quality of work-life and quality of care and life among residents. Here we report on staff. Using an interpretive descriptive approach, we interviewed 140 staff from January through April 2021, in 34 nursing homes. Facilities selected varied in ownership (public/private) and COVID-19 status (high, moderate, or low incidence). Virtual interviews focused on three key areas of impact: (a) staff mental and physical health, well-being, and work-life, (b) the facility, and (c) on residents. Interviews were analyzed using inductive content analysis. Dominant themes included a commitment of staff to resident wellbeing; a norm of stoicism in which accumulative stress of COVID-19 is recognized in participants’ private lives but not their work; the critical role of teamwork in managing extra workload associated with COVID-19 protocols; role flexibility, particularly managers’, enables workers to minimize interruptions to care activities; governmental wage subsidies and the restriction of workers to only one facility benefits residents and workers in terms of time and familiarity, but some health care aides faced a wage reduction of 30-40%. Alongside the research component, we regularly met with stakeholders and end-users to discuss emerging findings and potential areas needing urgent intervention, as well as longer-term programming as the impact of COVID-19 will persist for many years.