bluuebunny/crossref_metadata_2025_split huggingface dataset:
Talking about Complimentary and Alternative Medicine: A Conversation Analysis Study
Authors: Halpin Sean , Len Kathleen , Konomos Michael 
Published: December 2021

Abstract
Multiple Myeloma (MM) is a clonal plasma cell malignancy characterized by low blood counts and increased risk of infection, and primarily afflicts older adults. Although MM is incurable, advances in treatment, including autologous stem cell transplant (ASCT) has improved the lifespan of patients. MM patients commonly use over-the-counter complementary and alternative medicines (CAM) alongside conventional cancer therapies which, often without recognition by health care practitioners, may impact their treatment. Using data from an 18-month ethnographic study, we applied conversation analysis to examine 1180 minutes of audio-recordings to describe how patients and nurses interacted about CAM during ASCT education visits. Patients (n=12) had a median age of 62 years (IQR= 54-73), were mostly white (n=12, 75%), male (n=9, 56%), and had a moderate score on the FACT-G7 of 15 (IQR= 10-20). All patients had a caregiver present during their visit. Nurses (n=3) were aged 39 (IQR= 29-49) all with at least five years providing care to patients with blood cancers. Results suggested that nurses rarely provided direct feedback about CAM modalities, instead providing brief responses, and moving on to other topics. Excerpts were categorized into three groups, (1) demonstration of implicit epistemic authority, (2) demonstration of deferred epistemic authority in patient-initiated conversations, and (3) demonstration of deferred epistemic authority in nurse-initiated conversations. Understanding how conversations surrounding CAM are navigated can provide insights into patient-communication in general, and methods for improving ASCT education.
Development Of Diet Score For Reflecting Diet Patterns and Dietary Guidelines: A Case Of Singapore
Authors: Liu Yuezhong , Verma Rakhi , Ho Ringo , Theng Yin-Leng 
Published: December 2021

Abstract
Foods and dietary patterns substantially affect health outcomes. The overall dietary assessment score associated with dietary guidelines in Singapore has not been assessed previously. This study aimed to develop and evaluate diet score for identifying the relationship between dietary patterns and dietary guidelines in Singapore. Using a localised diet score survey collaborated with the Commonwealth Scientific and Industrial Research Organisation (CSIRO), we conducted a cross-sectional study of 600 Singapore persons in two-generational cohorts (40-64: 300 and &gt; 65 years: 300). The proposed local diet score was calculated to reflect their overall compliance with the Dietary Guidelines in Singapore. ANOVA analysis was used to identify the significant difference among socio-demographic variables associated with diet score and comparison analysis was performed to compare the diet patterns and diet score. There are significant differences among age, education, housing, residency associated with diet score. Diet score of older cohort (M= 67.71, SD= 13.38) is significantly higher than young cohort (M= 60.73, SD= 14.71). The highest education level (University or tertiary) obtain the lowest diet score (M= 58.58, SD= 14.41). The participants who live in the landed property (M= 69.45, SD= 14.43) are higher than those who live in Condominium and Public House. And the participants who live alone (M= 67.26, SD= 14.66) have a higher average diet score. Two-generational cohorts are not compliant with recommendations about dietary guideline well in Singapore. The present findings suggest that dietary patterns need improvement in aspects such as vegetables and extra food components.
Exploring Factors that Shape Adherence to Technology-Based Cognitive Interventions
Authors: Harrell Erin , Roque Nelson , Boot Walter , Charness Neil 
Published: December 2021

Abstract
A cognitive intervention study was conducted to explore methods to improve adherence to a technology-based cognitive intervention and uncover individual differences that predict adherence (N = 120). The study was divided into two phases: (1) in which participants were asked to follow a prescribed schedule of training that involved gamified neuropsychological tasks administered via a tablet, and (2), in which participants were asked to play as frequently as they wished. Positively and negatively framed messages about cognitive health were delivered via the software program, and measures of cognition, technology proficiency, self-efficacy, technology attitudes, and belief in the benefits of cognitive training were collected. We computed an aggregate measure of adherence during each of the two phases, as well as a measure of daily engagement. Across data modeling approaches, the finding was consistent: only during Phase 2, was there evidence that positively-framed messages encouraged greater adherence over negatively-framed messages. Measures of memory and self-efficacy demonstrated some, but limited, ability to predict individual differences in adherence.
Discrepancies in Objective and Subjective Fine Motor Abilities in Octogenarians
Authors: Fauth Elizabeth Braungart , Hooyman Andrew , Schaefer Sydney , Hall Anna , Ernsth-Bravell Marie 
Published: December 2021

Abstract
Older individuals may have discrepancies between self-reported and performance-based abilities on activities of daily living (ADL). We examined objective and self-reported fine motor abilities (FMA). FMA are required for many ADLs, but are examined less frequently than gross-motor tasks in this population. We used two waves of the population-based OCTO-Twin study including mono-/dizygotic Swedish twins, aged 80+. One twin was randomly selected for analyses (baseline N=262; wave 2 N=198; Meanage =83.27; SDage=2.90; 66.4% female). Participants self-reported their ability to manipulate things with hands (cannot do, some problem, no problem) and completed a timed FMA assessment including five everyday tasks (e.g. inserting a key in a lock). Slow performance was coded as 1+ SD from the mean (=80+ seconds). At baseline, 65.8% of slow performers reported ‘no problems’ with hand manipulation. Over two waves (two years), a two-factor ANOVA (including slowness-by-perception interaction) supported a significant difference in total motor task performance between slow performers reporting ‘no problems’ and fast performers reporting ‘no problems’, for both rate of change (diff = -26 seconds, p&lt;.0001) and wave 2 level (diff = 50 seconds, p &lt; .0001). 82% of slow performers at wave 2 reported ‘no problems’, which is surprising given that they had become even slower over the past two years. Findings suggest that objective FMA measures are needed, as self-report is inaccurate and not prognostic. Future work will examine if discrepancies in performance/perceived FMA predict poorer outcomes, and/or if reporting ‘no problems’ despite slower performance is protective against cognitive adaptation to slowing.
Trajectories of Functional Health Following Stroke: The Role of Social Resources
Authors: Nakagawa Takeshi , Noguchi Taiji , Komatsu Ayane , Ishihara Masumi , Saito Tami 
Published: December 2021

Abstract
Stroke is one of the major causes of disability in old age. Predictors for the functional prognosis have been studied, but the role of social resources in recovery has not studied as much. We examined whether social resources available before and after stroke onset improved functional prognoses. Data was derived from longitudinal data collected between 1987 and 2006 from Japanese adults aged 60 years and older. We identified 396 people who had experienced their self- or proxy-reported first stroke during follow-up (age at stroke onset: M = 76.0, SD = 6.9; 74.2% women). Functional health was measured by self- or proxy-reported activities of daily living. Social resources were indexed as residential status, contact with non-coresident children, social participation, and perceived support. Analyses were adjusted for age at stroke onset, gender, and education. A multiphase growth model showed that functional health typically deteriorated surrounding stroke and gradually declined thereafter. There were also individual differences in the trajectories of functional health. Individuals who more frequently participated in social groups prior to stroke and those who came to participate more frequently thereafter exhibited less functional decline immediately following stroke. Our findings indicate that social participation plays a protective role against adverse prognoses following stroke regardless of when individuals start participating. Inclusive communities would enable older adults to remain independent. Our study was limited in that crucial information about stroke, such as objective measures of initial severity, was not available and that individuals with more severe stroke may have dropped out after the onset.
Preventable? Long-Term Care Policy Successes and Failures During COVID-19 Pandemic: A Scoping Literature Review
Authors: Wu Chaoran , Zecevic Aleksandra , Smith Maxwell , Sibbald Shannon 
Published: December 2021

Abstract
The number of older adults who live in long-term care (LTC) is expected to increase worldwide. The COVID-19 pandemic has caused serious consequences in Canadian LTC homes, while homes in China and Japan reported minimal infection and death rates in residents. The differences in LTC policies may be one of the contributors. The purpose of this literature review was to identify elements of the LTC policies that might have impacted COVID-19 outcomes in LTC homes in Canada, China, and Japan. A scoping review was conducted following the framework proposed by Arksey and O’Malley. Scholarly articles and grey literature published between January 2015 and June 2020 were identified in six databases, four in English (CINAHL, Scopus, ProQuest, and PubMed), one in Chinese (CNKI), and one in Japanese (CiNii), using MeSH terms for LTC and health policy. Grey literature was identified using Google. Data were extracted, summarized and common themes identified through content analysis. A total of 52 articles and 26 grey sources were included in the review based on determined inclusion criteria. They were research articles, reviews, government or association reports, policy briefs, policy documents, and guides. Four common themes of challenges emerged: caregiver workforce, service provision, funding, and physical environments. Three sub-themes were identified for caregiver workforce and service provision. Differences in COVID-19 consequences in LTC homes in the three countries seem to be related mainly to the challenges with the caregiver workforce and the lack of funding. The result suggests Improvements of LTC policies are required, especially in Canada.
Scoping Review: Home and Community-Based Service Waiver Programs and Person-Reported Outcomes
Authors: Bucy Taylor , Mulcahy John , Jutkowitz Eric , Shippee Tetyana 
Published: December 2021

Abstract
State Medicaid programs are rebalancing their long-term care spending from nursing home to home and community-based services (HCBS). Emphasis on person-centered and person-directed care warrants investigation into models of HCBS delivery that promote quality of life. We performed a scoping review of the literature to catalogue the breadth of the studies describing HCBS waiver programs targeting adults (18+). We identified 757 articles, and after duplicate removal and reconciliation, we excluded articles on children or adolescents, non-peer reviewed reports, international studies, and articles that did not describe HCBS waiver programs. After abstract and title review, 292 articles met our inclusion criteria. Most included articles (22.3%) were single state descriptive evaluations or evaluations of service use patterns among participants. 17.8% of included articles examined multi-state or national variation in program trends, while 17.1% made national program conclusions without a major focus on interstate comparison. Less common were studies examining integrated care or dual-eligibles (7.5%), PACE (3.4%), medication management (3.1%), quality and satisfaction of both consumer and caretaker perspectives (3.8%) and consumer-only perspectives (5.1%). The remaining articles focused on HIV (4.1%), TBI (1.4%) or ID/DD (14.4%) waiver programs. The 8.9% of articles addressing quality and satisfaction consisted mostly of interviews, either with state Medicaid administrators or with care recipients and/or caregivers. Consumer reported satisfaction and unmet care needs were the primary outcomes examined. Given the heightened focus on long-term care as a result of the ongoing coronavirus pandemic, this review justifies further exploration into the delivery and outcomes of state-directed HCBS waiver programs.
Do Personality and Belief Influence the Ownership of Private Long-term Care Insurance?
Authors: Yeh Shu-Chuan Jennifer , Chou Hsueh-Chih , Chen Shih-Hua Sarah 
Published: December 2021

Abstract
Long-term care is the largest out-of-pocket expenditure risk for the elderly. Private long-term care insurance is one crucial source to cover the gap. The study aims to investigate (1) whether wealthy people are more likely to purchase private long-term care insurance (LTCI); (2) whether personality traits are associated with ownership of LTCI; and (3) whether individual experience influences the ownership of private LTCI. We surveyed 375 participants for three groups, including nurses, executive MBA, and MBA students. EMBA group had highest percentage of personal discretionary income (defined as greater than 1,780 US dollar per month)(77.6%), followed by MBA group (17.6%) and nurse group (8.8%). The nurse group had highest in long-term caring experience for sick family members (46.4%), self-experience catastrophic diseases (11.2%), and number of family/relatives/friends share responsibilities of caregivers (2.33 persons). The nurse group had lowest risk propensity score as well as openness to experience traits. The percentage of ownership in private LTCI was 48%, 45.6%, and 28.8% for nurse, EMBA, and MBA groups, respectively. After controlling for age and tenure, results from logistic regression indicated that MBA group was less likely to own LTCI compared with nursing group. Compared with less than 30,000, only personal discretionary income 30,001~ 50,000 had higher odds ratio to own LTCI. Wealthy is inconclusive in determining ownership of private LTCI. Nurses who were lowest risk propensity and openness traits and have more sickness experience were more likely to purchase private LTCI. Believe needing LTCI is the strongest predictor in ownership of LTCI.
Self-Reported Health, Well-Being, and COVID-19 Vaccination Willingness Across the Generations
Authors: Patskanick Taylor 
Published: December 2021

Abstract
The COVID-19 pandemic has impacted the generations’ health and wellbeing across a range of dimensions. In the first survey, the 50+ adopted the smallest number of health behaviors (e.g., handwashing, mask-wearing, etc.) in response to the pandemic compared to younger age groups. In the first and second surveys, the Baby Boomer generation reported less intense worry than other generations, especially regarding their socioemotional health and family members’ health. For younger generations, worries tended to increase from March to June—especially those related to socio-emotional health and COVID-19 in general. In the third survey wave, older generations self-reported better psychological wellbeing, less personal burnout, and better cognitive health compared to younger generations. Willingness to get the COVID-19 vaccine did not vary by generation in this sample; however, implications of this (including additional factors that may be influential such as psychological wellbeing) will be discussed.
Is Higher Nurse Aide Retention Associated with Fewer Nursing Home Allegations and Complaints?
Authors: Kennedy Katherine 
Published: December 2021

Abstract
Consumer voices are often left out from assessments of nursing home (NH) quality. For this reason, consumer allegations and complaints against nursing homes were studied in relation to facility rates of nurse aide retention. Analyses involved means and frequencies, correlations, ANOVAs with Tukey correction to examine the independent and dependent variables (N=690). Four quartiles of retention were created. In the final models, medium, high, and extremely high retention facilities are compared to the low retention facilities. Negative binomial regressions were estimated on total, substantiated, and unsubstantiated counts of allegations and complaints. All regressions controlled for the same characteristics, including nurse aide empowerment, consistent assignment, administrator turnover, director of nursing turnover, average age of residents, and percent female. The correlation between retention and the dependent variables was negative and statistically significant (r=-0.11, p&lt;.01). The ANOVAs showed that high retention NHs (61-72%) received significantly fewer allegations than low (0-48%) and medium (49-60%) retention NHs; they also received fewer unsubstantiated allegations, and fewer complaints, both substantiated and unsubstantiated. After controlling for other variables, each retention group was significantly related to having fewer allegations and complaints compared to the low retention NHs. Notably, high retention NHs received between 29 and 35% fewer allegations and complaints of all types. Unexpectedly, extremely high retention NHs had more allegations, complaints, and unsubstantiated allegations than high retention NHs. Policy and practice have a role to promote nurse aide retention, improve job quality, and ensure adequate support for this critical, in-demand workforce.
Care Aides’ Perceptions of Caring for Nursing Home Residents With Past Psychological Trauma
Authors: Thorne Trina , Titley Heather , Norton Peter , Lanius Ruth , Estabrooks Carole 
Published: December 2021

Abstract
The dynamic interplay between dementia and psychological trauma can exert powerful effects on nursing home residents’ behavioral symptoms and quality of life. Our objectives in this exploratory study were to assess care aides’ perceptions of how often they worked with residents with past psychological trauma, the types of trauma encountered, and reasons for these beliefs. We conducted semi-structured cognitive interviews (n = 10) with care aides in June 2019 to inform the development of a trauma needs assessment (4 questions) that we included in a large survey of nursing staff (2019 - 2020). Care aides (n = 3761) were sampled from 91 randomly selected urban nursing homes stratified by health region, owner operator model, and size. We completed basic statistics and content analyses. Care aides identified residents they believed to have psychological trauma histories and provided reasons for their beliefs. Approximately 12% of the reported traumatic events were disclosed to staff. The most common, broad categories of trauma to emerge during analysis were abuse (40%) and war exposure (30%). Each had sub-categories. The most common categories of signs of trauma were re-experiencing symptoms such as flashbacks and nightmares (28%), and avoidance of specific triggers, such as water or intimate care (24%). The majority of the reported signs of trauma were persistent and distressing for staff and residents. Some behaviours assumed to be responsive behaviours of dementia may relate to traumatic stress symptomatology. Implementing trauma-informed supports for residents and care aides is essential to person-centred care and optimal quality of life.
Distress Behavior Conversations: Supporting Whole Person Whole Team Responses in VA Community Living Centers
Authors: Loup Julia , Smith Kate , Wehry Susan , Sloup Sharon , Keleher Jennie , Nash Princess , Hartmann Christine , Snow Andrea 
Published: December 2021

Abstract
Resident distress behavior, a prevalent challenge in long-term care, contributes to resident morbidity, staff burden, and turnover. We describe an education model developed in the Veterans Administration (VA) Community Living Centers (CLC) through a CONCERT (VA CLCs’ Ongoing Center for Enhancing Resources & Training) quality improvement series. The Distress Behavior Conversation (DBC) uses a team meeting structure and process. Informed by unmet need and relational coordination theories, it guides the whole team, inclusive of interdisciplinary team members and front-line staff with resident contact, through a collaborative problem-solving action-planning discussion. DBC uses facilitated round-robins to identify potential resident behavior causes and individualized solutions. DBC supports the team in maintaining whole person and whole team mindsets, thus challenging the narrower medical model of discipline-specific clinical mindsets and staff level hierarchies. Over two years we have co-created and refined DBC through trainings and team debriefings with over 80 CLCs. Care teams reported “aha” moments during DBCs their thinking shifted (“we are now looking at the REAL why”; “we went from asking, how did he fall? to, why did he fall?; “tended to try to treat falls in a standardized way, [but] when you focus on a specific person you get to focus on HIS needs”; “personal information about the Veteran is the 5th vital sign!”). Teams additionally reported reduced strain and improved collaborative thinking (“I feel better about what I’m doing...more motivated to keep going!; “Now I see it is a team approach – don’t have to do it by myself.”).
Resilience and Mental Health Among Male Older Adults in Extreme Poverty in Long-term Care Facilities in Rural China
Authors: Ma Ying , Leung Patrick 
Published: December 2021

Abstract
Older adults in extreme poverty refer to “three-noes people”: no working ability, no income source, and no children or legal supporters. They are eligible for a government-funded welfare system called “Five Guarantee system”. The majority of residents in rural welfare institutes are male older adults in extreme poverty. Research demonstrates that resilience is a critical factor in shaping health. This study aims to examine the association between resilience and mental health for male older adults in extreme poverty, and its differences in young-old (60-69 years), old-old (70-79 years), and oldest-old groups (≥80 years). A cross-sectional study was conducted with 1,427 eligible subjects in rural long-term care facilities from Anhui province in China during 2019, with a response rate of 77.4%. Resilience was measured by the Chinese version of Connor-Davidson Resilience Scale, including three subscales of optimism, strength and tenacity. Mental health was assessed using General Health Questionnaire-12. A MANOVA test revealed a significant difference among age groups on three subscales of resilience [Pillai’s Trace=.023, F (6,1486) =2.709, p=.013, ηp2=.012]. Tukey Post hoc indicated the oldest reported significantly lower levels of strength, optimism, and tenacity compared to the other two groups. A multiple logistic regression identified a significant negative association between resilience and mental disorder for the old-old (OR=0.95, 95%CI:0.93-0.97) and oldest-old (OR=0.93, 95%CI: 0.88-0.99) groups. Our findings identified th differences in the link between resilience and mental health within the three different age groups. Resilience-training programs to improve mental health would require targeting specific subscales of resilience for each group.