bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Race on Decision Making for Nursing Home Residents With Advanced Dementia: Can We Disrupt and Transform?
Authors: Lopez Ruth , Roach Ashley , Hendricksen Meghan , Rogers Anita , Epps Fayron , McCarthy Ellen 
Published: December 2021

Abstract
Despite 20 years of research and numerous experts and associations advocating a palliative approach to care for nursing home (NH) residents with advanced dementia, research consistently demonstrate striking and persistent racial differences in the use of burdensome interventions such as feeding tubes and hospital transfer. Most notable is that Black NH residents experience more burdensome interventions at the end of life. The reasons for these differences are poorly understood. The purpose of this study was to examine NH staff members’ perceptions of advance care planning with proxies of Black and White residents. We conducted thematic analysis of semi-structured interviews with 158 NH staff members gathered as part of the ADVANCE study. This is a large qualitative study in 13 NHs in 4 regions of the country aimed at explaining regional and racial factors influencing feeding tube and hospital transfer rates. We found that NH staff, regardless of region of the country, held several assumptions about Black proxies including: being attached or not wanting to let go; not wanting to talk about death, believing everything must be done; not wanting to play God; having large conflicted families, not trusting; putting on attitude, and tending not to use NHs. We found that these assumptions led some NH staff to feel that rather than engaging in shared decision making, they were engaged in a battle with proxies leading them to pick and choose their battles and at times even giving up trying. Whether these assumptions can be disrupted and transformed will be discussed.
Oral Health in Adult Patients Receiving Palliative Care: A Mixed Method Study
Authors: Chen Xi , D'Souza Violet , Thomsen Timothy , Gilbertson-White Stephanie , Madiloggovit Jirakate , Pendleton Chandler , Xie Xianjin , Munjal Arshi 
Published: December 2021

Abstract
Oral disease is highly prevalent in persons receiving palliative care (PRPC). Yet, little is known about how PRPC perceive their oral health status and related treatment needs. Forty-nine PRPC were recruited. They first completed a structured oral symptom review, followed by an oral exam. A nested sample of 11 participants also completed an in-depth interview querying their perceived oral health concerns and related treatment needs. Quantitative and qualitative data was analyzed and integrated for interpretation. Eighty-six percent of participants reported at least one oral symptom, including dry mouth (83.7%), a pain-related symptom (40.8%), or oral function difficulties (51.0%). About 40% of participants reported compromised quality of life due to oral conditions; however, the perceived impacts and treatment needs were modest. Oral disease was highly prevalent in PRPC, yet its overall impact was modest. Except for painful symptoms, most participants reported limited desire to seek treatment for oral health conditions.
Pandemic-Driven Disruptions in Oral Health: Transformative Trends in Care for Older Adults
Authors: Ghezzi Elisa , Zwetchkenbaum Samuel , Fisher Mary , Fukuoka Brooke , Dodge Jeffrey , Helgeson Michael 
Published: December 2021

Abstract
Oral healthcare for the aging was severely disrupted during the pandemic of coronavirus disease 2019 (COVID-19). Transformative changes in care delivery involved teledentistry, mobile/portable dentistry, minimally invasive dentistry, aerosol minimization, and interprofessional oral care. Management of chronic oral health problems evolved through periods of limited to no access to daily and professional oral healthcare. Access to care has been influenced by availability of the oral care workforce, variability in long term care policy, and the lack of funding to cover medically necessary services delivered via asynchronous telehealth technologies. Impacts were identified six and twelve months into the pandemic. These will be compared to the state of oral healthcare for the aging 18 months from the start of the pandemic. The impact of vaccination on access to care will be explored. Variability between states (Idaho/Michigan/Minnesota/Rhode Island) will be addressed. Directions of new and needed research opportunities will be discussed.
Funding Influencing Practice and Outcomes in Reablement
Authors: Parsons Matthew , Rouse Paul 
Published: December 2021

Abstract
Internationally, Home Care is invariably funded through fee-per-service, e.g., if an hour of care is delivered, the provider receives an associated amount of funding. However, the funding model discourages reductions in packages-of-care when a client’s functional capacity improves, and further disincentivises providers to discharge clients. Similarly, staff income is often directly associated to the delivered hours-of-care and if a client’s hours are reduced, so is their income; again, discouraging the right behaviour, such as reporting improvements in independence levels. In 2008 in New Zealand, we developed a case-mix funding methodology and have been progressively implementing the new model since that time. This presentation highlights the findings in relation to how Home Care service hour allocations titrate against needs following implementation of the model as well as a number of other key quality outcomes that have been observed as a result of the case-mix model.
Role of Emotional Attachment and Reciprocity in Sons’ Perceived Care Motivation for Parental Figures
Authors: Wakui Tomoko , Hirayama Ryo , Kai Ichiro 
Published: December 2021

Abstract
The collapse of the traditional Japanese household system and the subsequent social advancement of women has led supporting parents as a family matter, and led more men to assume caregiving roles; however, very few studies have focused on sons’ care motivation. This study aimed to understand adult sons’ perceived care motivation and to examine the respective related factors of emotional attachment and reciprocity. A total of 1322 men (M [age] = 44.5) participated in a web-based questionnaire survey. Perceived care motivation for providing five types of support (e.g., helping with daily activities and housework) to each parent and parent-in-law was assessed. Regression analyses revealed that emotional attachment with parents and parents-in-law predicted perceived care motivation for all types of support. Furthermore, the role of reciprocity was indicated by the association between rearing by mother-in-law and son-in-law’s motivation to provide assistance in financial matters, housework, and visiting a hospital.
It's Not Healthy Fellowship: Negative Interactions and the Implications for Middle- and Old-Age Black Men
Authors: Skipper Antonius , Marks Loren , Chaney Cassandra 
Published: December 2021

Abstract
Despite the benefits of social support on the well-being of Black men across the life course, scholars are more closely examining the potentially negative outcomes associated with some social networks. As one social support system, the Black church frequently serves middle and old age Black men who identify as religiously involved. Yet, higher levels of religious involvement have also been associated with more church-related negative interactions. The present study utilizes a grounded theory approach to examine the negative interactions of religious middle and old age Black men. A semi-structured interview protocol is used to gather data from 35 Black men between the ages of 45 and 76. Analyses reveal that church-related negative interactions broadly fall within the following themes: (1) Ageism Within Intergenerational Churches, (2) People are Messy, and (3) Issues with Leadership. Since negative interactions can be more detrimental than social support is beneficial, health-related implications are discussed.
Exploring Life Instability’s Relationship to the Mental Health of Older Adults With HIV
Authors: Weinstein Elliott , Harkness Audrey , Ironson Gail , Shrader Cho-Hee , Duncan Dustin , Safren Steven 
Published: December 2021

Abstract
The study is one of the first to examine both the prevalence of life instability among older adults with HIV (OAWH) in a community clinic and its relationship to their mental health. OAWH (N=623) from a community medical clinic completed an interviewer-administered assessment (English/Spanish) which included an additive Life Instability Index (LII) composed of indicators at the individual (e.g. education, housing instability, employment status) and community (e.g. poverty, transportation) levels. Participants were a mean age of 60 years (SD = 5.90) with the majority identifying as Black-non-Hispanic (65.9%), cisgender male (60.8%), and heterosexual (80.6%). Participants reported an average of 6.08 destabilizing factors (SD = 1.44). In multiple linear regression analyses LII was significantly related to increased substance use among participants (b= 0.08, p &lt; 0.01), but not with anxiety or depression. An LII is an innovative approach to assess the relationship between OAWH’s mental health and social determinants of health.
Content Development for a Virtual Social Engagement Intervention
Authors: Shende Shraddha , Lothary Allura , King Justine , Jones Sarah , Mudar Raksha , Myers Dillon , Rogers Wendy 
Published: December 2021

Abstract
Video technology has the potential to provide older adults with socially and cognitively engaging activities for in-home participation. We are exploring use of OneClick.chat, a video technology platform, to present older adults with and without mild cognitive impairment opportunities for engagement. In collaboration with iN2L we have developed events that will facilitate conversations that do not rely on episodic memory, cover a range of topics, and represent different cultures and interests. We selected event topics that were positive, socially and cognitively engaging, and included a range of pictures based on our previous research. Events were carefully controlled for length of presentation, picture type, and readability. Discussion questions related to the events were designed to stimulate engaging conversations through open-ended questions and to not burden memory recall or enforce stereotypes. Our work highlights potential future avenues for researchers and home and community-based organizations to use technology to promote social engagement.
Ethnicity and race in access and usage of health and social care: results from a scoping review
Authors: Torres Sandra 
Published: December 2021

Abstract
Scholarship on ethnicity and old age is at a crossroad now that increased diversity is a given in older populations. The same holds true for the study of the role that ethnicity and race play in access and usage of health and social care in old age. This presentation relies on a scoping review of scholarship published between 1998 and 2020 that brings attention to the ways in which ethnicity & race – as grounds for stratification and disadvantage - are made sense of in this scholarship. The presentation will describe the topics that the review divulged, whether racism has been acknowledged in this scholarship so far, and how this has been the case. In doing so, this presentation will argue that if we are to address the inequalities that older ethnic minorities face we need not only a diversity-astute research agenda but also an injustice-aware one.
Aging Equally? Employing Active Aging Policy in the United Kingdom
Authors: Foster Liam 
Published: December 2021

Abstract
The UK’s responses to the challenges of ageing have largely focused on productivist notions of active ageing, with more comprehensive responses tending to be reactive and largely remedial. This presentation will show that productivist policies, often characterised by individual responsibility, including raising the retirement age, restricting access to early retirement, and providing a stronger link between pension benefits and contributions, have incentivised remaining in the labour market. These strategies have been justified in the context of ageing populations and increasing pension costs. However, opportunities to extend working lives have not been experienced equally. In practice most policies are gender blind. Furthermore, a more comprehensive approach to active ageing in the UK needs a collective emphasis to mobilise a wide range of societal resources, underpinned by a commitment to public welfare, which is highly problematic under neo-liberalism. Therefore, a comprehensive approach to ageing in the UK requires a substantial ideological shift.
Efficacy of Online Goal Management Training for Age-Associated Executive Impairment
Authors: Zhu Lynn , D'Amico Danielle , Vandermorris Susan , Wang Yushu , Levesque Laryssa , Lass Jordan , Troyer Angela , Levine Brian 
Published: December 2021

Abstract
Goal Management Training® (GMT) is a standardized cognitive rehabilitation program that enhances individuals’ awareness of executive function impairments and trains them to regularly monitor and manage their goals. In-person GMT is well-validated among numerous subpopulations, including people experiencing age-related cognitive impairment or acquired brain injury, and people with psychiatric disorders. The goal of this study was to evaluate the efficacy and usability of online GMT relative to computerized “brain training” in a registered randomized controlled trial (protocol NCT03602768 at Trials.gov). Both interventions were administered in a self-paced format, with background therapist support provided for GMT. Primary outcomes were measured as self-reported executive impairment on standardized measures (the Dysexecutive Questionnaire and the Cognitive Failures Questionnaire) at pre-, immediate post-, and 6 weeks post-intervention. 62 older adults without psychiatric or neurological diagnoses completed the trial (online GMT: n = 37, age[mean] = 69 years; computerized brain training: n = 25, age[mean] = 64 years; both groups: 76% female). Improvements on the primary outcomes were observed post-intervention and were maintained at follow-up. GMT and computerized brain training groups could not be differentiated statistically, possibly due to restriction of range in the outcome measures at baseline. Additionally, the self-paced format prolonged the intervention beyond the recommended duration, which may have diluted efficacy. GMT was well-received, with participants reporting frequent use of the trained metacognitive strategies. Future studies will examine online GMT’s effectiveness in samples with documented executive impairment and with additional supports to promote engagement for this virtual program.
Evaluation of an Ecological Momentary Intervention for Depression in Older Adults Living Alone
Authors: Kim Heejung , Hong Soyun , Lee Sangeun , Song Kijun , Kim Mijung , Kim Yuntae , Kim Hyein 
Published: December 2021

Abstract
Depression is a common but treatable mental health problem among older adults. Daily management and monitoring is very important; thus, diverse approaches have been developed. The objective of this research was to develop and pilot-test a counseling-plus-mobile health (mHealth) intervention using ecological momentary intervention (EMI) to reduce daily depressive mood for older adults living alone. Of 64 older adults living alone in community settings, 44 completed mHealth training and EMI for 7 weeks between October 2018 and October 2019. Study participants were randomized into experimental and control groups. The intervention was based on the protocol developed for an mHealth program for older Korean adults. Participants wore an actiwatch that measured their depressed moods four times a day for 2 weeks. Depressive symptoms were measured using the Hamilton Depression Rating Scale (K-HDRS) and the Korean version of the Short Geriatric Depression Scale (SGDS-K). Sleep quality was assessed using the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K). The mean age of the study sample was 76.05±5.66 years, and the majority of the participants were female (61.0%, 36/59). There were no demographic characteristic differences between intervention and control groups. Based on multi-level modeling, EMI was not associated with significant improvements in depressive symptoms. However, depressive symptoms showed an initial decreasing trend, leveling off toward the end of the intervention period. This study finding could function as preliminary data to develop mHealth-based EMIs for older users in a larger, long-term study.
AgingPLUS: A Randomized Trial to Increase Physical Activity in Middle-Aged and Older Adults
Authors: Diehl Manfred , Schrack Jennifer 
Published: December 2021

Abstract
Engagement in physical activity (PA) has well-documented benefits for delaying or preventing age-related diseases. Thus, it is important to study innovative ways to increase PA in the adult population. This symposium describes AgingPLUS, an ongoing trial that addresses three psychological mechanisms to increase adults’ PA: Negative views of aging (NVOA), low self-efficacy beliefs, and deficient goal-planning skills. The symposium also presents preliminary findings, based on a pre-pandemic subsample, on changes in explicit NVOA, implicit VOA, and changes in PA. Diehl et al. describe the theoretical background and study design of the ongoing RCT. This also includes the main study hypotheses. Rebok et al. present preliminary findings showing significant effects of the intervention on NVOA and frequency of moderate intensity exercise. Effects on physical function and accelerometry measures were not statistically significant in this subsample. Tseng et al. examined the effects of the intervention on two measures of implicit VOA: a lexical decision-making task (LDMT) and the Brief Implicit Association Test (BIAT). Findings showed that differences in post-intervention latencies on the LDMT were not statistically significant. Differences on post-intervention BIAT d scores also failed to be significant. Finally, Nehrkorn-Bailey et al. tested a multiple mediator model examining the mediational role of self-efficacy (SE) and exercise intention (EI) on PA. Results showed that Week 4 SE significantly mediated the effect of intervention condition to Week 8 anticipated PA engagement. Week 4 EI significantly mediated the effect of intervention condition on Month 6 PA engagement. Anticipated PA effects predicted subsequent involvement in PA.
AgingPLUS: Theoretical Background and Study Design of the Randomized Trial
Authors: Diehl Manfred , Rebok George , Roth David , Li Kaigang , Nehrkorn-Bailey Abigail , Rodriguez Diana , Thompson Katherine 
Published: December 2021

Abstract
The AgingPLUS program targets three psychological mechanisms that are known barriers to middle-aged and older adults’ engagement in physical activity (PA): Negative views of Aging (NVOA), low self-efficacy beliefs, and poor goal planning skills. These risk factors are addressed in a 4-week intervention program that is compared to a generic health education program as the control group. Middle-aged and older adults (age 45-75 years) are enrolled in the trial for 8 months, with four assessment points: Baseline (pre-test), Week 4 (immediate post-test), Week 8 (delayed post-test), and Month 6 (long-term follow-up). The major outcome variables are participants’ engagement in PA as assessed via daily activity logs and actigraphs. Positive changes in NVOA, self-efficacy beliefs, and goal planning are the intervention targets and hypothesized mediating variables leading to increases in PA. This trial adopted the experimental medicine approach to assess the short- and long-term efficacy of the AgingPLUS program.
Examining the Effects of the AgingPLUS Program on Physical Activity: A Multiple Mediator Model
Authors: Nehrkorn-Bailey Abigail , Rebok George , Roth David , Chung Shang-En (Michelle) , Li Kaigang , Rodriguez Diana , Thompson Katherine , Diehl Manfred 
Published: December 2021

Abstract
This study examined the effect of the AgingPLUS program on anticipated physical activity (PA) and PA engagement, along with the hypothesized mediator roles of self-efficacy (SE) and exercise intention (EI). Data came from 147 participants (Mage = 60.11 years; SD = 8.28 years) of the ongoing trial. Structural equation modeling tested the effects of the intervention, week 4 EI, and week 4 SE on anticipated PA at week 8 and engagement in PA at 6 months. The pathway from week 8 anticipated PA to month 6 PA was also assessed. Results showed that week 4 SE significantly mediated the pathway of intervention condition to week 8 anticipated PA, whereas week 4 EI significantly mediated the pathway from intervention condition to engagement in PA at 6 months. Furthermore, anticipated PA predicted subsequent engagement in PA. Results from these analyses provide preliminary support for the efficacy of the AgingPLUS program.
Links of Short Physical Performance Battery Score with Incident Dementia: Results from the NHATS
Authors: Wu Di , Smail Emily , Schrack Jennifer , Wanigatunga Amal , Kasper Judith , Spira Adam 
Published: December 2021

Abstract
Physical performance is associated with cognitive function in later life, but few studies have examined the prospective association of physical performance with incident dementia. We studied 4539 community-dwelling National Health and Aging Trends Study (NHATS) participants aged ≥65 years with data on demographics and the Short Physical Performance Battery (SPPB) in 2011, who were followed through 2014. Our outcome was dementia diagnosis from a validated NHATS algorithm. We applied survey weights to make results nationally representative and performed Cox regression analyses. After adjustment for potential confounders, lower baseline SPPB scores were associated with incident dementia (HR=1.68, p &lt; 0.01). Slower gait speed was the SPPB component most strongly associated with incident dementia (HR=1.21, p &lt; 0.01). We found that poorer physical performance was linked to incident dementia in a cohort of older adults. More research is needed to examine the effect of improving physical performance on the prevention of dementia.
COP Cells in States of Bone Anabolism and Abnormal Calciﬁcation/Ossification
Authors: Pignolo Robert 
Published: December 2021

Abstract
Circulating osteogenic progenitor (COP) cells are a population of cells in the peripheral blood with the capacity for bone formation, as well as broader differentiation into mesoderm-like cells in vitro. There are several pathologies of accelerated bone formation and physiological responses to injury in which COP cells have been theorized to play a role. These include fracture, vascular calciﬁcation, and subtypes of heterotopic ossiﬁcation (HO). Overall, the available studies suggest COP cells are likely to be mobilized in response to fracture, home to the site of injury, undergo a maturation process, and contribute to the osteogenesis and angiogenesis required for fracture healing. HO is the pathological process of bone formation in nonskeletal tissue and can be acquired or hereditary. COP cells may seed sites of injury and inﬂammation that precede the formation of endochondral bone identiﬁed in both genetic and nongenetic forms of HO. Vascular calciﬁcation is a common occurrence in older adults and is strongly associated with poorer cardiovascular health outcomes. It appears that COP cells, particularly those expressing hematopoietic and vascular markers such as CD45 and CD34, contribute to the calciﬁcation and ossification of atherosclerotic plaques and aortic valves, and that they correlate to the severity of the calciﬁcation. Whether COP cells are attracted to sites of injury and inﬂammation and so are highly associated with fracture, vascular calcification/ossification and HO, or whether they underlie these processes at a more mechanistic level, remains to be more clearly demonstrated.