bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Daytime Activity, Mood at Bedtime and Unit Tumult Predict Nighttime Sleep Quality of Long-Term Care Residents?
Authors: Taani Murad , Kovach Christine 
Published: December 2021

Abstract
Sleep quality declines in old age and is particularly poor for long-term care (LTC) residents with dementia. Compromised sleep quality is associated with severe cognitive and neuropsychiatric symptoms, agitation, aggressiveness, and poor quality of life. Based on the premise that stressors can have a cumulative effect on people with dementia throughout the day that contributes to negative consequences later in the day, we examined if daytime activity, mood, and unit tumult were associated with sleep quality. A convenience sample of 53 LTC residents with dementia participated in this correlational study. Objective sleep quality and activity variables were measured using Actigraphy, and mood was measured by the Observed Emotion Rating Scale. Unit tumult was defined as events in the residents living area that are deviations from the typical day (i.e., census changes, being cared for by a certified nursing assistant from a temporary staffing agency, and lower than usual staffing level). Comorbid illness and level of dementia were control variables. Half of the sample had a sleep efficiency that was less than .85 and were awake for more than 90 minutes at night. Comorbid illness, negative mood at bedtime, and daytime activity level accounted for 26.1% of the variance in total sleep minutes. Census changes and the use of temporary agency staff were associated with poor total sleep time and sleep efficiency. Findings suggest that daytime activity, mood at bedtime, and unit tumult should be considered when designing and testing interventions to improve sleep quality among LTC residents with dementia.
Factors Influencing Retention Intention of Nurses at Long-term Care Hospitals in Korea
Authors: Shin So Young , Kim Joo Hee 
Published: December 2021

Abstract
Purpose: This study aimed to investigate the levels and correlations of role conflict, nursing professionalism, nursing work environment and retention intention, and the factors influencing retention intention of nurses at long-term care hospitals. Methods: The subjects included 183 nurses at nine long-term care hospitals in one metropolitan city in Korea. A set of self-reported questionnaires was administered to assess general characteristics, role conflict, nursing professionalism, nursing work environment, and retention intention of the subjects. Collected data was analyzed using descriptive statistics, t-tests, one-way ANOVA, Pearson correlation coefficients, and multiple linear regression. Results: 183 subjects with a mean (±SD) age of 41.66 (±12.29) years were included in the final analyses. Retention intention had a significant positive correlation with nursing professionalism (r=.39, p&lt;.001) and nursing work environment (r=.51, p&lt;.001). Nursing work environment had a significant negative correlation with role conflict (r=-.30, p&lt;.001) and a significant positive correlation with nursing professionalism (r=.48, p&lt;.001). In the final multiple regression analysis, the factors influencing retention intention of subjects were number of beds (β=-.15 p&lt;.026), nursing professionalism (β=.19, p=.007) and nursing work environment (β=.36, p&lt;.001). The explanatory power of number of beds, nursing professionalism and nursing work environment on retention intention was 34.0% (F=16.66, p&lt;.001). Conclusion: Improving nursing professionalism and nursing work environment of nurses at long-term care hospitals will ultimately enhance their retention intention and positively impact on the quality of gerontological nursing service.
Potential Sources of Racial and Ethnic Disparities in Nursing Home Influenza Vaccination
Authors: Riester Melissa , Bosco Elliott , Bardenheier Barbara , Moyo Patience , Baier Rosa , Eliot Melissa , Zullo Andrew 
Published: December 2021

Abstract
Racial and ethnic disparities in influenza vaccination among nursing home (NH) residents are well-documented and have persisted over time, suggesting that new strategies are necessary to reduce disparities. We conducted a retrospective cohort study to examine the degree to which observable characteristics drove influenza vaccination disparities. We linked Minimum Data Set (MDS) assessments to facility-level data for short- and long-stay NH residents aged ≥65 years. We included residents with six-month continuous enrollment in Medicare and an MDS assessment during the influenza season (October 1, 2013 through March 31, 2014). Using nonlinear Oaxaca-Blinder decomposition, we decomposed the disparities in vaccination between White versus Black and White versus Hispanic residents. We analyzed short- and long-stay residents separately. Our study included 630,373 short-stay and 1,029,593 long-stay residents. Among short-stay residents, 67.2% of Whites, 55.1% of Blacks, and 54.5% of Hispanics were vaccinated against influenza; among long-stay residents, 84.2% of Whites, 76.7% of Blacks, and 80.8% Hispanics were vaccinated against influenza. Across the four comparisons, the crude disparity in influenza vaccination ranged from 3.4-12.7 percentage points. By equalizing 27 characteristics, these disparities could be reduced by 37.7%-59.2%. Living in a predominantly White facility and proxies for NH quality were important contributors to the disparity, although characteristics unmeasured in our data (e.g., NH staff attitudes and beliefs) contributed 40.8%-62.3% to the disparity across comparisons. Intervening on factors associated with NH quality may reduce racial/ethnic disparities in influenza vaccination. Qualitative research is essential to explore potential contributors not captured in our administrative data.
Technology Guided Assessment for Urinary Tract Infection: Creating a Common Interprofessional Language
Authors: Owen Donna , Ashcraft Alyce , Johnson Kyle , Song Huaxin , Culberson John 
Published: December 2021

Abstract
The Shared Meaning Model (SMM) is a grounded theory, derived in a previous study. This model demonstrates pathways for communication between nurse and primary care providers (PCPs) in the nursing home (NH), In this study we used the SMM for feasibility testing of a clinical decision support app (CDS app) using a descriptive, structured observational design. This study also provided a forum for initial testing of the SMM. The CDS app algorithm provided a common language to assess a resident with the goal of sharing this information with a PCP. The CDS app guided licensed vocational nurses (LVNs) (N=10) in assessing a standardized nursing home resident in a simulation setting experiencing symptoms of a potential urinary tract infection (UTI). Interviews with LVNs provided details of CDS app usability and concerns about using the CDS app with NH residents. Videos recorded LVNs interacting with the resident while using the CDS app on an iPad®. Time-stamps logged duration of the assessment. Bookmarked segments were used for discussion in LVN interviews. Videos were coded for eye contact, conversation, and touch between LVN and resident and documented personalized interactions. Findings indicated areas (lab values, drug names) for changes to language in the algorithm. In less than 12 minutes the CDS app enabled LVNs to collect information based on language used by PCPs to make decisions about the presence of a UTI. Relationships between initial constructs in the SMM were supported. This CDS app holds promise for building a common language to enhance interprofessional communication.
Attitudes and Beliefs of Older Black Americans Toward the COVID-19 Virus and Vaccine
Authors: Bass Dwana , Hanna Sophie , Shair Sarah , DiCerbo Loraine , Giordani Bruno , Kavcic Voyko 
Published: December 2021

Abstract
The COVID-19 pandemic, an unprecedented health emergency, has devastated the nation, and disproportionately affected persons of color, especially Black Americans. It has forced health officials to rapidly develop and distribute COVID-19 vaccines, resulting in the importance of understanding Black Americans’ attitudes and beliefs about COVID-19. We analyzed experiences of 167 Black Americans, ages 65 and older, recruited from Wayne State Institute of Gerontology Healthier Black Elders Center and surrounding communities. Participants were telephoned starting September 2020 and given the GAD-7 anxiety scale and a COVID-19 questionnaire measuring demographics, stressors, and emotional responses associated with the COVID-19 pandemic. A scale was also designed, adapted from the Health Belief Model, to measure fear of getting COVID-19, beliefs about the origins of COVID-19, uncertainty about vaccine safety, and intent to be vaccinated (5-point Likert scale). Of the 167 participants, 112 (67%) said they would agree to vaccination, 24 (14%) were ambivalent, and 31 (19%) said they would decline. T-tests comparing pro- and anti-vaccine participants showed that those not planning to get vaccinated expressed lower generalized anxiety (p=.002), COVID-19 fear (p&lt;.001), and concerns about vaccine safety (p=.01), but greater belief that COVID-19 is man-made (p=.05). The current study provides a snapshot of urban Black American older adults who are in general eager to get vaccinated for COVID-19. Counterintuitively, those unwilling to accept the COVID-19 vaccine also had lower concerns for vaccine safety. More research is needed to fully understand the attitudes and beliefs of this underserved population regarding the COVID-19 virus and vaccine.
Factors Predicting Community-dwelling Older Adults’ COVID-19 Experiences in Central Texas
Authors: De Main Atami , Xie Bo , Shiroma Kristina , Davis Nathan 
Published: December 2021

Abstract
Older adults, disproportionally affected by the COVID-19 pandemic, face health, social and structural vulnerabilities. Their experiences require systematic examination. Our study aimed to examine factors predicting community-dwelling older adults’ experiences during COVID-19. We collected data via the telephone between June-August 2020 from a convenience sample of older adults in Central Texas (N= 200; age range=65-92 years; Mean=73.6, SD=6.33). We conducted multinomial logistic regression analyses to model relationships between self-reported COVID-19 experiences (positive, mixed, negative) and age, gender, race, income, education, frequency of communication with family and friends, feelings of loneliness and amount of COVID-19 information obtained. Factorial analysis revealed no statistically significant interaction effect. Multinomial logistic regression analysis revealed statistically significant main effects of annual household income, feelings of loneliness and amount of COVID-19 information obtained on predicting COVID-19 experiences. Age, gender, race, education, and frequency of communication with family and friends were not significant predictors. The odds of having a positive COVID-19 experience rather than negative experiences increased by 6.94 for an annual household of $60,000- $99,999, and by 6.02 for not feeling lonely. The odds of having a positive experience during COVID-19 rather than mixed increased by 9.90 for an annual household income of $100,000 or more. Participants who reported having “too much information” about COVID-19 were more likely to have mixed experiences compared to those with positive experiences. Our findings underscore the crucial role of financial security and social connections in reducing economic and emotional challenges older adults are facing during this crisis.
Perceived fear of COVID-19 among Nepali older adults
Authors: Ghimire Saruna , Yadav Uday Narayan , Yadav Om Prakash , Subedi Janardan 
Published: December 2021

Abstract
Although coronavirus-disease-2019 (COVID-19) impacted everyone in some ways, it disproportionally impacted the older population. Given their increased vulnerability to severe illness and mortality, the ongoing pandemic has created greater distress, anxiety, and fear among the older population. In Nepal, a South Asian country nestled in the Himalayas between India and China, most stories of older adults are untold ̶ both in the pre-COVID-19 and the COVID-19 era. This study aimed to explore the perceived fear of COVID-19 among Nepali older adults. A cross-sectional study was conducted between July-September 2020 among 847 older adults (≥60years) residing in three districts of eastern Nepal. The seven-item Fear of COVID-19 Scale assessed the perceived fear of COVID-19; higher scores on the scale (ranges 7 to 35 indicated greater fear. A sizeable proportion of the participants' reported being afraid (35%), anxious (32%), uncomfortable (24%), clammy (14%), and sleepless (12%), while 28% were fearful of losing their life due to COVID-19. In adjusted regression analysis, older age group, Dalit (minority) ethnicity, and remoteness to the health facility were associated with greater fear of COVID-19. Surprisingly, pre-existing health conditions were inversely associated with fear of COVID-19. Greater fear of COVID-19 amidst the pandemic, although anticipated, urges us to reflect on the most vulnerable groups' psychological needs not just during COVID-19 but in the future events of pandemics and public health emergencies. Fear during emergencies could be battled with accurate and effective information as well as better preparedness and psychosocial interventions.
Sensory Health and Dementia Care: Understanding and Addressing Unmet Needs in ADRD
Authors: Nieman Carrie , Whitson Heather , Gitlin Laura 
Published: December 2021

Abstract
Sensory health in dementia stands at the intersection of two major public health challenges. Hearing and vision impairments are among the most common and disabling comorbidities in dementia and may worsen the trajectory of decline yet frequently go unrecognized and unaddressed. Improving sensory function may be an accessible and cost-effective nonpharmacological intervention to aid in the management of neuropsychiatric symptoms, improve quality of life for persons with dementia, and reduce burden for care partners. This symposium presents the latest evidence on the impact of sensory impairment in dementia and efforts to integrate sensory health into the care of persons with dementia. This symposium will cover emerging evidence of the impact of hearing loss and vision impairment on persons living with dementia, specifically around neuropsychiatric symptoms, disability, and cost. In moving toward solutions, we will discuss new approaches to provide vision and hearing care for persons with dementia in diverse settings, from audiology to specialized memory clinics to home-based care. This discussion will include findings from a systematic review of telehealth in dementia care, which highlights the limitations of existing literature on accounting for the sensory needs of persons with dementia and their care partners. Finally, we will share new international practice recommendations on vision and hearing impairment among persons living with dementia. The symposium highlights the large, yet often unrecognized, sensory health needs of persons with dementia and the multi-prong approach required to identify and support sensory health and, ultimately, healthy aging among persons with dementia.
Biomechanism and exercise effect of fitness walking using twin walking sticks
Authors: Yamauchi Ken , Ichikawa Tsutomu , Ogita Akira , Yoshida Hironori , Hasagawa Hiromichi , Matsui Hiroshi , kagawa Shota 
Published: December 2021

Abstract
In Japan, walking poles with pairs of sticks developed exclusively for fitness walking have been designed. A new concept of walking style (WS) has been conceived using these walking sticks to “effectively” walk around the city, comprehensive sports parks, or at rehabilitation hospitals. Stick manufacturers are promoting its health benefits; however, evidence supporting these claims is lacking. Hence, this study aimed to measure the influence of walking sticks and evaluate the exercise effect based on functional physical fitness related to WS characteristics. The participants were 12 WS instructors. They engaged in WS at a comfortable speed after walking normally at the same speed (WN) for ∼5 m (seven times), followed by WS again. The walking speed, step length, stride width, walk ratio, one-leg support time, and trajectory of the center of gravity (CG) (in the horizontal and vertical directions of one walking cycle) calculated from the whole-body skeleton model were analyzed. The gait of WS increased the step length, step width, and walking ratio as compared with that of WN (p&lt;0.05). WS likely reduce cadence and one-leg support time (p&lt;0.05). The CG locus in the left-right direction showed no significant differences between WS and WN. The maximum value of the CG locus in the vertical direction was high in WS (p&lt;0.05). WS can be used as a navigation training tool that improves a walker's exercise efficiency and left-right leg coordination, thereby improving walking posture. This may help reduce the anxiety due to injuries and pain that may occur while walking.
Effects of Different 16-Week Exercise Interventions on Bone Mineral Density of Sedentary Older Women
Authors: Ellis Amy , Crowe-White Kristi , Hunter Gary 
Published: December 2021

Abstract
Multicomponent exercise that includes both resistance and aerobic training is recommended to prevent loss of bone mineral density (BMD) in postmenopausal women. However, optimal training frequency has not been determined. Sixty-three non-osteoporotic sedentary women ages 60y and older were randomized to one of three exercise groups for sixteen weeks: 1) one resistance and one aerobic session per week, 2) two resistance and two aerobic sessions per week, or 3) three resistance and three aerobic sessions per week. Resistance exercise included supervised sessions on weight machines, and aerobic exercise was treadmill walking. BMD of the hip and lumbar spine (L1-L4) was assessed by dual energy X-ray absorptiometry (Prodigy, GE Medical Systems Lunar, Madison, WI, software version 6.10.029), and z scores were calculated from a reference population adjusted for age and sex. Among the total cohort with BMD measurements at week 16 (n=58; 83% white), z scores improved for the trochanter, Ward’s triangle, total hip, L1 and L4. Within-group comparisons showed improvement at the trochanter, total hip, and L1 for group 2 only, while only group 1 demonstrated an increase at L4 (p&lt;0.05 for all). However, no time-by-group interactions were observed. Sixteen weeks of combined resistance and aerobic training is effective for improving BMD of older adult women. Results suggest training frequency of two sessions per week may be optimal. Postmenopausal women should be encouraged to do aerobic exercise such as walking plus resistance training at least once weekly to prevent osteoporosis.
The association between vision acuity, sleep duration, and physical activity among US adults aged 50 years and older
Authors: Xu Shu 
Published: December 2021

Abstract
Studies suggested that people with low vision are more likely to have worse sleep quality and less frequent participation in physical activities compare with people with better vision. Studies also showed that physical activities is a very important factor for one’s sleep. However, there is relatively little research on the association between vision acuity, sleep, and physical activity. This study examines the relationships between vision acuity and sleep duration among middle-aged and older adults in the US, and the role of leisure-time physical activity in this relationship. Using nationally representative data from the National Health and Nutrition Examination Survey 2007-2008, a cross-sectional analysis on adults age 50 years and older was conducted (n=2.247). Visual acuity was assessed by participant’s vision of better-seeing eye (i.e., none, mild, moderate, and server visual impairment), and we measured sleep duration (i.e., short, average, and long duration) and leisure-time Physical Activity (i.e., inactive/insufficiently active and sufficiently active). Descriptive analysis showed that 31.06% of older adults experienced moderate or severe visual impairment, and 46.81% respondents experienced abnormal sleep duration. Multinomial logistic regression analyses showed that compared to people without visual impairment, people with moderate or severe visual impairment were more likely to have longer sleep duration than normal sleep duration (OR, 1.62, p&lt;0.05). Leisure-time physical activity was not found to significantly mediate the relationship between visual acuity and sleep duration. Other variables were controlled in the models. Findings suggest that US adults age 50+ with low vision are at greater risk of experiencing abnormal sleep duration.
Recalling Memories of Life’s Challenges with Purpose and Redemption: Resources to Foster Resilience?
Authors: Sharma Shubam , Perlin Joshua , Bluck Susan 
Published: December 2021

Abstract
Unique life challenges occur across life phases, including later life. Life story research suggests that the way challenges are narrated has consequences for multiple domains of well-being. Two factors for positively reframing challenges are one’s sense of purpose in life (Windsor et al., 2015) and redemption (McAdams et al., 2001). This study used moderated-mediation analyses to investigate whether: 1) challenge relates to psychosocial and cognitive well-being, differentially by age, and 2) narrating with greater purpose and redemption ameliorates effects of challenges on well-being, by age. Participants (N = 99 young, 88 older adults) rated self-disruption of challenging events from their lives (IV1) and reported number of recent life challenges experienced (IV2). Eudaimonic well-being (DV1) and cognitive well-being (DV2) were assessed. Purpose (M1) and redemption (M2) were reliably content-analyzed from participants’ narratives of autobiographical challenges (e.g., illness, loss of other). For Aim 1, young and older adults who experienced more challenges showed lower eudaimonic well-being but higher cognitive well-being. Perceived self-disruption was unrelated to well-being. For Aim 2, results showed that how individuals narrate (i.e., with purpose, with redemption) the challenges that have occurred in their lives mediates effects of challenge. Specifically, exhibiting a sense of purpose mediated the relation between perceived self-disruption and cognitive well-being. Redemption buffered negative effects of both self-disruption and number of challenges on eudaimonic well-being. Mediation results held regardless of age. Findings suggest purpose and redemption are two narrative mechanisms that act as psychological resources to support well-being in the face of life’s inevitable challenges.