bluuebunny/crossref_metadata_2025_split huggingface dataset:
Family Caregiver Training During Medicare Home Health Care: Clinician Perspectives
Authors: Burgdorf Julia , Arbaje Alicia 
Published: December 2021

Abstract
During Medicare home health care, providers often rely on family caregivers to help meet patients’ care needs. Beginning in 2018, CMS requires home health agencies to provide training to family caregivers. This qualitative study is the first research to examine current patterns of family caregiver training, and related facilitators and barriers, during Medicare-funded home health care. We conducted semi-structured key informant interviews with home health nurses and physical therapists (n=19) from 4 diverse agencies, then performed thematic analysis of interview transcripts using a hybrid inductive and deductive coding approach. Clinicians described family caregiver education as a dynamic and cyclical process: simultaneously providing patient care, training family caregivers, and gathering additional information about patient needs and caregiver capabilities, then adjusting the care plan accordingly. We present a model of this cyclic process and describe its four major stages: Initial Assessment, Education, Reassessment, and Adjustment. Additionally, clinicians identified a range of structural, individual, and interpersonal factors which impact their ability to successfully train family caregivers. We define each factor and, using illustrative quotes from our interviews, elucidate its role as a facilitator and/or barrier to clinicians’ educational efforts. Findings provide the first model of caregiver training during home health care and highlight policy and practice changes to better support clinicians in these efforts; including greater visit flexibility, access to more experienced clinical mentors, and standardized caregiver assessment tools designed for this unique care setting.
A Culturally Adapted Timed-Activity RCT for Latinos With ADRD and Caregivers: Feasibility, Acceptability, and Effects
Authors: Perez G Adriana , Huang Liming 
Published: December 2021

Abstract
Latinos are twice as likely to develop Alzheimer’s disease (AD) compared to non-Latino whites, yet, account for &lt;2% of clinical trial participants in AD research. This randomized controlled trial examined the feasibility, acceptability and effects of a culturally-adapted timed-activity intervention designed to promote quality of life (QOL) and reduce behavioral symptoms in older Latinos with AD and their caregivers. Healthy Patterns [Pautas Saludables] was implemented among 40 Spanish-speaking dyads. Measures assessed at baseline and 4 weeks post-intervention, indicate improvements in sleep efficiency (p=.06) and QOL (p=.01) among intervention participants. Pautas Saludables was found to be feasible and acceptable. Intervention attendance rate was &gt;90% with low attrition (n=0); no adverse events. Most (74%) rated timed-activity sessions as helpful and appropriate; 58% recommended refreshers. Results provide evidence that Latinos with AD will participate in clinical trials and can improve on key health outcomes, when interventions are adapted to meet their cultural needs.
Implementation in Nursing Homes: Describing Early and Late Adopters of an Evidence-Based Dementia Care Program
Authors: Lekovitch Cara , Toto Pamela , Chew Felicia , Bieber Dawn , Leland Natalie 
Published: December 2021

Abstract
Despite national efforts to improve nursing home (NH) quality, care remains variable. Health system efforts to drive improvement often begin with a sub-group of NHs before scaling up across the organization. Yet, there is limited evidence on who to target for the first group. This study addressed this gap by examining facility characteristics of early and late adopters within a multi-site pragmatic clinical trial. Data were obtained from the Organizational Readiness to Change Assessment (ORCA), which was completed by expert trainers, and Nursing Home Compare. Early and late adoption was operationalized according to Roger’s Diffusion of Innovations. Sixty-percent of NHs (n=12) were late adopters and 40% (n=8) were early adopters. Between group differences (p&lt;.01) were found in number of health inspection citations and context domain within the ORCA. These findings equip health systems with evidence on how to strategically target partners for initial quality improvement efforts prior to system-wide implementation.
Intergenerational Ambivalence, Loneliness, and Well-Being Among Older Adults in the United States
Authors: Zhang Xiaoyan , Silverstein Merril 
Published: December 2021

Abstract
Intergenerational relationships are important sources of informal social support for older people to maintain their emotional well-being. Previous research has extensively investigated the relationship between intergenerational support and older adult’s psychological well-being. However, the existing research has not adequately examined intergenerational ambivalence – mixed or contradictory feelings toward a family member in another generation or explored the mechanism that links intergenerational ambivalence and psychological well-being. Further, most studies are cross-sectional, which prevents us from establishing causality. This study utilized data from 2006, 2008, 2010, 2012, 2014, and 2016 waves of Health and Retirement Study (HRS), a national representative sample of U.S. adults aged 50 and more (N= 8,017). Structural equation models were used to examine the longitudinal relationship between intergenerational ambivalence, loneliness, depression, and life satisfaction. The final model indicated very good fit (χ2 = 113.31, p &lt; .0001, CFI = 0.97, RMSEA = .05). The results revealed that ambivalence in older parent-adult child relationships predicted higher subsequent loneliness (β = 0.21, p &lt; .0001), which in turn predicted depressive symptoms (β = 0.25, p &lt;.0001) and life satisfaction (β = -0.30, p &lt; .0001). The results demonstrated that loneliness mediated the relationship between intergenerational ambivalence and depression, and life satisfaction. Multiple group analysis was performed to test whether the study relationships varied by gender. Gender differences were found. Findings have implications for prevention and intervention initiatives targeting improving relationships between parents and children, thereby protecting against mental problems.
Public Health Messaging and Measures During COVID-19: The Experiences of Family Caregivers
Authors: McGhan Gwen , McCaughey Deirdre , Flemons Kristin , Hindmarch Whitney 
Published: December 2021

Abstract
To mitigate the effects of COVID-19, Health Ministries across Canada have enacted numerous public health measures. Our mixed methods study examined the effect of COVID-19 related public health messaging and measures for family caregivers (FCGs) of people living with dementia (PLWD). Of the 230 FCGs completing the survey, most frequently used information sources were television, family/friends, and websites. FCGs over 60 more often used television, newspaper and radio versus websites and social media. FCGs rated public health messaging as good-excellent (64%) especially messaging around the disease spread, symptoms, and finding information. 46% believe the restrictions in long-term care facilities went beyond necessary with 97% reporting restrictions have negatively impacted them. 84% were willing to undertake personal protective equipment and infection control training to ensure continued access to PLWD. Focus groups highlighted concerns about continued access to PLWD, quality of care provision, and increased social isolation’s impact on dementia progression.
Aims of the Adherence Promotion With Person-Centered Technology (APPT) Project
Authors: Charness Neil , Boot Walter , Carr Dawn , Chakraborty Shayok , He Zhe , Lustria Mia , Terracciano Antonio 
Published: December 2021

Abstract
The APPT project supports the early detection and treatment of age-related cognitive decline and dementia by 1) enhancing adherence to cognitive intervention and assessment protocols, 2) improving understanding of barriers to long-term adherence, and 3) developing algorithms for predicting and preventing adherence failures. Two randomized controlled trials will test an adaptive technology support system predicted to boost adherence to cognitive protocols over a period of six months within samples of older adults with and without cognitive impairment. These studies will provide insight into the benefits of adherence support, and individual difference factors that should shape the adherence protocol, informing the process of identifying individuals who would benefit from additional support and predicting and preventing extended adherence failures before they happen. These studies should improve early detection and treatment of cognitive decline, extend functional independence, and improve lives of those with cognitive impairment as well as the lives of their families.
Positive Effect of a Successfully Implemented Model of Care on Unplanned Transfers to Hospital
Authors: Zuniga Franziska , Guerbaai Raphaëlle , Simon Michael 
Published: December 2021

Abstract
Models of care have shown effectiveness in reducing unplanned transfers in nursing homes (NHs) from 11.7% to 6.1%. These include coordination of care and access to skilled medical providers such as geriatricians, specialist nurses or registered nurses with additional training. A hybrid type-2 effectiveness-implementation project (INTERCARE) was developed to improve intervention uptake and to understand the mechanisms behind results. INTERCARE consisted of six core elements and was rolled-out to 11 Swiss NHs with a stepped-wedge design allowing all NHs to receive the intervention. 942 residents were recruited (June 2018 -January 2020). INTERCARE showed a significant reduction of unplanned transfers during the intervention period compared with baseline. The successful implementation of INTERCARE relied on the use of implementation science, building on stakeholder input and careful theory-driven contextual adaptations. INTERCARE’s success was driven by registered nurses with expanded roles, on-site coaching, and the use of tools for clinical decision making.
Learning to Work With Chronic Health Conditions: How Time Since Diagnosis Affects Older Workers' Vitality and Worries
Authors: Vanajan Anushiya , Bültmann Ute , Henkens Kène 
Published: December 2021

Abstract
Background. Chronic health conditions (CHCs) pose stark detrimental effects on the health and abilities of older workers. The extent of these effects depend on the CHC, the time since its diagnosis and the type of health measure: a rarely explored combination of heterogeneities. Objective. This study examined how four existing and newly diagnosed CHCs influences older workers’ vitality and worries about enduring physically and mentally until retirement age. Method. Data from two waves of the NIDI Pension Panel survey conducted in the Netherlands in 2015 and 2018 were used. We analyzed a sample of 1,894 older workers between the ages of 60-62 years at wave 1 using conditional change ordinal least square regression models. Results. Having a CHC at wave 1 was associated with lower levels of vitality and higher levels of worries at wave 2. These effects of CHCs on vitality and worries were much larger for older workers who were newly diagnosed with CHCs compared to those who experienced CHCs for longer. Intriguingly, the new diagnosis of physically disabling conditions increased worries about physical endurance at wave 2, while the new diagnosis of mentally disabling conditions increased worries about mental endurance at wave 2. Conclusion. By distinguishing the effects of four existing and newly diagnosed CHCs on vitality and worries, this study allows the identification of vulnerable groups of older workers. The findings may inform work accommodations and interventions which could improve both the quality and sustainability of work lives, while promoting healthy ageing of older workers.
(Re)Introducing the Gerontology and Geriatrics Curricular Standards and Guidelines in Higher Education
Authors: Shovali Tamar , Gugliucci Marilyn , Silverstein Nina 
Published: December 2021

Abstract
The Academy for Gerontology in Higher Education (AGHE), the education member group of GSA, is the only national institutional membership organization devoted primarily to gerontology and geriatrics education. Its mission provides for development and sponsorship of initiatives to advance the field of aging through its focus on education in gerontology/geriatrics. AGHE first published the Gerontology and Geriatrics Curricular Standards over three decades ago – a document that has been an integral resource for implementing/revising programs in liberal arts, the sciences, and more recently, health professions. To meet the needs in the field for increased breadth and depth of content, the new 7th edition of the educational guidelines fully embraces competency-based education for gerontology, as the health professions programs have for years. Our first presenter will provide an overview of the new edition. The second presenter will focus on associate degree programs in gerontology and their unique contribution to higher education. The third will present on undergraduate programs in gerontology explaining how these programs give students an edge in today’s job market. The fourth presenter will address graduate programs in gerontology, describing master’s degree programs and doctoral degree programs in gerontology and aging studies. The fifth presenter will discuss health professions programs including geriatrics curricula for osteopathic medical education, gerontology/geriatrics curricula for health-related programs and the doctor of pharmacy degree programs. Presentations will provide expert recommendations for program development through mapping AGHE’s Gerontology Competencies for Undergraduate and Graduate Education to programs in higher education. Nina Silverstein will serve as discussant.
Assessing Age-Friendly Community Progress: What Have We Learned?
Authors: Black Kathy , Oh Patricia 
Published: December 2021

Abstract
The Global Network of Age-friendly Cities and Communities has grown steadily over the past decade across the United States, however surprisingly little is known regarding their accomplishments to date. We utilized content analysis to assess the progress reported by American age-friendly communities (n = 30) that joined by end of year 2015 using the Age-Friendly Community Evidence-based Tool with expanded program evaluation measures including health equity as defined by the World Health Organization. We employed deductive analytic techniques to assess reported community performance in eleven thematic areas across the range of structures and processes that characterize age-friendly efforts. We found strong evidence in the areas of leadership and governance, harnessed resources, application of age-friendly framework, and in multisector collaboration as well as reported provisions. All of the communities reported health equity aims, particularly in promoting accessible physical environments and social inclusion efforts. Our analysis further revealed areas for continued improvement.
Age-Friendly Communities and Aging in Place: Findings From Latent Profile Analysis
Authors: Kim Seon , Kim Kyeongmo , kim junpyo 
Published: December 2021

Abstract
Older adults prefer to live in their current home or community and ‘Aging in place’ has been shown to reduce the cost of caring for older adults and help their successful aging. Although age-friendly communities (AFC) initiatives have been helpful to aging in place, little has been known about the relationship between the types of AFC and aging in place. Using the 2017 AARP Age-Friendly Community Survey, we included 1,079 adults aged 65 or older. We measured aging in place as ‘move to a different community’, ‘move into a different residence within your current community’, and ‘stay in your current residence’, and included eight AFC constructs. We identified the type of AFC using Latent Profile Analysis: low-friendly, mid-friendly, and high-friendly. We also ran multinomial logistic regression to examine whether the types of AFC were associated with aging in place. Of the total participants, 26.0% lived in the low-friendly community, 23.7% in the mid-friendly community, and 50.3% in the high-friendly community. Older adults living in the high-friendly community were more likely to stay in the current residence (64.7%) than those in the low-friendly (47.1%) (χ2=28.680, p&lt;.001). Also, older adults living in the low-friendly community (OR=3.05, p&lt;.001) and the mid-friendly community (OR=1.42, p&lt;.10) were more likely to move to a different community compared to those living in the high-friendly community. This result suggests that it is important to build an AFC to promote aging in place. For the growing number of older adults' lives, policymakers should consider expanding the AFC initiatives.
An Evolving Role for the Long Non-Coding RNA H19 in Aging and Senescence
Authors: Potnis Manali , Sell Christian 
Published: December 2021

Abstract
The long non-coding RNA (lncRNA) H19 is a maternally imprinted gene transcript that, in conjunction with the neighboring Igf2 gene, is critical in controlling embryonic growth. Loss of H19 results in fetal overgrowth associated with Beckwith Weidemann syndrome, while elevated H19 occurs in human cancers. In the adult, H19 functions in cancer cells where it promotes migration and is correlated with poor prognosis, and in adult stem cells where it is a key regulator of cell fate decisions during differentiation. While the function of H19 in primary somatic cells has not been defined, a reduction in the abundance of H19 has been reported during senescence in endothelial cells. Given the critical importance of H19 in cell fate decisions, it is likely that understanding the precise function of H19 in somatic cells in general and why reduced levels occur with cellular senescence will provide novel insights into both somatic cell maintenance and the senescence program. Towards this end, we examined the role of H19 in somatic cell growth using cardiac interstitial fibroblasts. Our results indicate that H19 is not only vital for somatic cell proliferation and survival, but that depletion of H19 leads to cell cycle arrest and the formation of abnormal nuclei resulting in senescent cells. We are defining both the upstream regulators of H19 and the downstream mediators of senescence following H19 depletion. Overall, these results indicate an essential role for H19 in cell cycle progression, chromatin structure, and possibly proper mitotic division.
Associations Between Perceived Physical and Mental Fatigability and Life Space Mobility in Older Men: The MrOS Study
Authors: Moored Kyle , Rosso Andrea , Gmelin Theresa , Qiao Yujia (Susanna) , Carlson Michelle , Cawthon Peggy , Cauley Jane , Glynn Nancy W 
Published: December 2021

Abstract
Physical performance and fatigue can limit mobility within the larger environment (life-space mobility). It is unknown whether perceived fatigability, fatigue anchored to activity intensity and duration, is independently associated with life-space. We assessed this cross-sectionally in the Osteoporotic Fractures in Men Study (MrOS; N=1,681, Meanage=85±4.1). The Pittsburgh Fatigability Scale (PFS, range: 0-50) measured physical (Mean=16.2±9.5) and mental fatigability (Mean=7.5±8.0). Life Space Assessment scores (range: 0-120, higher=greater life-space) incorporated level, frequency, and assistance used for life-space mobility (Mean=84.3±22.0). Compared to the lowest fatigability strata (Physical: PFS 0-4; Mental: PFS 0-3, modeled separately), men in the two highest physical strata (PFS 20-24: B=-4.10±1.67; PFS≥25: B=-6.23±1.72; p’s≤.05) and men in the three highest mental strata reported significantly lower life-space mobility (PFS 13-15: B=-3.42±1.74; PFS 16-19: B=-5.38±1.83; PFS≥20: B=-7.96±1.66, p’s≤.05), adjusted for physical performance and health covariates. Our results provide evidence linking fatigability and real-world mobility, independent of physical health, in older men.
The Association Between Older Adult Technology Use and Mental Health During the COVID-19 Pandemic
Authors: Drazich Brittany , Li Qiwei , Perrin Nancy , Samuel Laura , Hladek Melissa diCardi , Szanton Sarah , Cudjoe Thomas , Taylor Janiece 
Published: December 2021

Abstract
Physical distancing during the COVID-19 pandemic may impact the mental health of older adults, but technology use may buffer this impact. This study aimed to 1) examine changes in older adult technology use during the COVID-19 pandemic and 2) determine if technology use moderates the relationships between decreased in-person communication/activity and the mental health of older adults during the pandemic. Data were taken from the NHATS COVID-19 Round 10 (n= 3,188). Older adults engaged in more technology-based activity (b= .237, p&lt;0.001), technology-based healthcare communication (b=.112, p&lt;0.001), and technology-based food acquisition (b= .214, p&lt;0.001) during the COVID-19 pandemic, compared to before. Technology use did not moderate the relationship between decreased in person personal communication (b= .021, p= 0.662)/activity (b= .045, p= 0.749) and mental health during the pandemic. Although older adults are utilizing technology more during the pandemic, it might not be protective against negative mental health outcomes from physical distancing.
Integrating Life-Review and Drama Therapy for Community-Dwelling Older Adults: An Evidence-Based Model
Authors: Keisari Shoshi 
Published: December 2021

Abstract
Drama therapy is a widely acknowledged way to explore life-stories in late life. This presentation will describe a new model for creative interventions, based on the results of four studies that provide multiple perspectives on the integration of life-review and drama therapy for community dwelling older adults. The results of two quantitative studies (n=55, aged 62-93; n=78, aged 63-96) suggest that the drama therapy interventions have robust therapeutic potential to enhance mental health while aging. The findings of two qualitative studies with therapists (n=8), participants (n=27; aged 63-96) and staff (n=13) provide a better understanding of the process, and support the mechanisms that lead to positive effects on mental health. Combining the results yielded a multidimensional model which points to three potential transformative routes: the evolution of the life-story, the evolution of improvised dramatic expression, and the expansion of social engagement.
Online Dignity Therapy and Photo Collages: The Narratives of Israeli and Italian Older Adults in the COVID-19 Era
Authors: Keisari Shoshi , Elkarif Talia , Mola Giada , Testoni Ines , Piol Silvia 
Published: December 2021

Abstract
The social isolation imposed by the Covid-19 pandemic has significantly affected older adults, and has impacted both their physical and mental health. The pandemic has led to an increase in ageism associated with poorer mental health and a lower sense of dignity, self-esteem and contribution to society. This cross-cultural study involved 24 participants from Italy and Israel aged 79 to 92. The aim was to develop a brief art-based online intervention to enhance the participants’ sense of dignity and sense of meaning in life during this time of crisis. The process focused on the creation of digital photo-collages that captured the participants’ values through three perspectives: their past experiences, legacy, and future perspectives. It employed an arts-based research methodology to explore the participants’ experiences by analysing their relationship with the artistic expression, the photo collage, and its creative process.