bluuebunny/crossref_metadata_2025_split huggingface dataset:
A New and Worrisome Predictor of Attitudes Toward Suicide: Self-Rated Health
Authors: Cooney Julene 
Published: December 2021

Abstract
Do people have the right to end their own lives? The General Social Survey has monitored the attitudes of Americans towards suicide since 1977 using four questions: Do you think a person has the right to end his or her own life if this person has an incurable disease, has gone bankrupt, has dishonored his or her family, or is tired of living and ready to die? These four responses can be combined into a reliable index representing an individual’s attitude toward suicide. As average population education levels have increased and religiosity has fallen, attitudes favoring the right to suicide have increased across the population. This research project introduces a previously understudied predictor of attitudes toward suicide: self-rated health. Using logistic and ordinal logistic regression, and controlling for age, education level, religiosity, marital status, survey year, race, and sex, I find that, over time, self-rated health has become a significant predictor of attitudes toward suicide. Since 2002, respondents who perceived themselves to be in poor health are significantly more likely to favor the right to end one’s life, especially if the individual has an incurable disease. After stratifying by age and race, I find that the relationship between self-rated health and attitudes toward suicide is strongest among individuals in the mid-life and is equally significant as a predictor for White and Black Americans after 2010. These findings provide further evidence that mental health screening is an increasingly vital component of physician/patient interactions and highlight the importance of continuity of care.
Work Does Not End When You Leave: Concerns and Coping Strategies Among Nursing Home Social Workers During COVID-19
Authors: Fields Noelle , Miller Vivian , Anderson Keith , Kusmaul Nancy 
Published: December 2021

Abstract
Nursing home social workers (NH SW) at the frontline during COVID-19 are faced with many challenges in meeting the psychosocial needs of residents while balancing their own well-being needs. In order to explore the experiences of NH SW during COVID-19, the study utilized a cross-sectional survey distributed to social media sites (e.g., Reddit, Facebook) and professional networks. The survey asked participants (N = 63) open-ended questions which were analyzed using the rigorous and accelerated data reduction (RADaR) method. Themes suggested that fear for self, lack of administrative support, and overall stress were notable concerns among NH SW. Findings also suggested that support from family/friends and self-care were most personally helpful to NH SW. Lastly, themes related to coping strategies included talking with co-workers, mindfulness, and boundary setting. Findings suggest the need for increased supports for NH SW. Implications related to stress and coping during COVID-19 are offered.
The VA’s Long-Term Care Strike Team Supporting Florida’s Nursing Homes Workforce
Authors: Golden Adam 
Published: December 2021

Abstract
In coordination with the Florida Department of Health, the VA Sunshine Healthcare Network (VISN 8) established Long-Term Care Strike Teams to provide services to the LTC facilities most affected by the COVID-19 pandemic across the state of Florida. Between April 2020 through September 2020, the Strike Teams provided direct patient care to community residents, infection control/ prevention education, and patient/staff COVID-19 swabbing. We encountered facilities with large numbers of staff infected with COVID-19 and agency staff that were refusing to come to “COVID-infected” facilities. Remaining staff, including the administrators, were under much psychological distress. However, our experience supporting the long-term care facilities also had a major impact on our own perceptions of nursing home care. The bravery, dedication, and caring that we witnessed reinforced that the health care workers in long-term care facilities are true heroes.
Cardiovascular Risk Factors and Carotid Intima Media Thickness: Mediation and Interaction by Grip Strength
Authors: Mendo Christian , Keezer Mark , Sylvestre Marie-Pierre 
Published: December 2021

Abstract
Frailty is often described as being an increased vulnerability to the effects of stressors. There is little research investing how frailty may act as either a mediator or participate in interactions in the associations between risk factors and chronic disease. We will present novel analyses of the Canadian Longitudinal Study on Aging, focusing on the 30,000 study participants who underwent serial physical evaluations at one of 11 data collection sites between 2011 and 2018. Using the 4- way decomposition method elaborated by Vanderweele, we investigate the role of grip strength, as a component of physical frailty, in the effect of cardiovascular risk factors on the atherosclerotic burden of individuals (measured using carotid intima media thickness). Our findings clarify the mechanisms underlying of grip strength in the associations between cardiovascular risk factors and carotid intima media thickness.
The Frailty Syndrome: An Emergent Property of Parallel Dysregulation in Multiple Physiological Systems?
Authors: Cohen Alan , Ghachem Ahmed , Fried Linda , Legault Véronique , Bandeen-Roche Karen , Presse Nancy , Gaudreau Pierrette 
Published: December 2021

Abstract
Despite its widespread presence in older adults, frailty etiology is still unclear, being associated with dysregulation in diverse physiological systems. Here, we show evidence that frailty emerges from broad loss of homeostasis integrated through complex systems dynamics. Using the NuAge and WHAS cohorts, we calculated Mahalanobis distance-based physiological dysregulation in six systems and tested the breadth, diffuseness, and nonlinearity of associations between frailty and system-specific dysregulation. We found clear support for breadth of associations, but only partial support for diffuseness and nonlinearity: 1) physiological dysregulation is positively associated with frailty in many or all systems, depending on analyses; 2) the number of dysregulated systems or the total amount of dysregulation are more predictive than individual systems, but results only partially replicated across cohorts; 3) dysregulation trends are exponential, but not always significant. These results suggest, but do not fully prove, that frailty is an emergent property of complex systems dynamics.
Taking Age-Friendly Campus Efforts to New PEAKS
Authors: Elfenbein Pamela 
Published: December 2021

Abstract
The University of North Georgia’s Personal Enrichment, Action, Knowledge Series (PEAKS) was developed as a monthly series of engaging and seasonally appropriate presentations and activities designed to expressly meet the needs of the region’s large and quickly growing older adult population during the Covid-19 pandemic and resultant isolation. The PEAKS programs are available virtually to allow for broad participation throughout the 30 county UNG service region. While we developed PEAKS to specifically reach-out to older adults in our region, we have found that our audience is actually multi-generational, actively engaging with our speakers and one another. AFU underpinnings for PEAKS include Principle #8 - To enhance access for older adults to the university's range of health and wellness programs and its arts and cultural activities; and #9 - To engage actively with the university's own retired community.
An Age- Friendly Campus Partnership for Hospitalized Older Adults in the COVID Era and Beyond
Authors: Kheirbek Raya , Mojdeh Heavner , Fass Marjorie , Cafeo Christina , Netzer Giora , Gulati Mangla , Brandt Nicole , Resnick Barbara 
Published: December 2021

Abstract
As hospitals isolate COVID-19 patients to prevent the spread of this highly contagious disease, patients and family are separated during times of critical illness. For many older adults inflicted with coronavirus it is not the fear of dying that matters the most, it is the fear of dying alone. Utilizing the 4Ms approach, University of Maryland, Baltimore (UMB) and University of Maryland Medical Center (UMMC) responded with several initiatives including intergenerational programs designed to shape and inform the development of future healthcare clinicians in addressing what matters the most to patients and leveraging technology to connect them with families, provide mobility opportunities, monitor medications, and reduce errors.
Do Objective or Subjective Neighborhood Indicators Protect Against Adversity on Mental Health and Well-Being?
Authors: Staben Omar , Infurna Frank , Grimm Kevin , Luthar Suniya 
Published: December 2021

Abstract
The neighborhood context through which individuals interact is shown to be associated with mental and physical health across adulthood. Much less is known regarding potential underlying reasons why, such as protecting against the deleterious effects of stress. This study explores whether objective and subjective neighborhood factors are associated with maintenance of mental health and well-being in the context of monthly adversity. We use longitudinal data from a sample of midlife (N =362) who completed monthly questionnaires for two years. Results show that experiencing a monthly adversity was associated with poorer mental health and well-being. Living in a neighborhood with more disorder was associated with stronger declines in mental health and well-being when a monthly adversity was reported. Our discussion focuses on why the neighborhood context is relevant for middle-aged adults and the various ways through which neighborhood context has the potential to shape the course of development in adulthood.
Costs of Raising Grandchildren on Grandmother-Adult Child Relations in Black and White Families
Authors: Hou Yifei , Suitor J Jill , Gilligan Megan , Ogle Destiny , Stepniak Catherine , Jiang Yufu 
Published: December 2021

Abstract
The cost of raising grandchildren on grandmothers’ mental and physical health has been well-documented; however, little is known about whether raising grandchildren also has a cost on grandmothers’ relationships with the adult children whose children the grandmothers have raised. Drawing from theories of exchange and affect, stress process model, and racial differences in intergenerational solidarity, we tested how raising grandchildren affects grandmother-adult child relations. Further, we explored the extent to which these patterns differed by race. To address this question, we used mixed-methods data collected from 553 older mothers regarding their relationships with their 2,016 adult children; approximately 10% of the mothers had raised one or more of their grandchildren “as their own.” Data were provided by the Within-Family Differences Study-I. Multilevel analyses showed that raising grandchildren was associated with greater closeness in grandmother-adult child relationship in Black families; however, in White families, raising grandchildren was associated with greater conflict in the grandmother-adult child relationship. Further, the differences by race in the effects of raising grandchildren on closeness and conflict were statistically significant. Qualitative analyses revealed that race differences in the association between raising grandchildren and relationship quality could be explained by mothers’ reports of greater family solidarity in Black than White families. Our findings highlight the ways in which race and family solidarity interact to produce differences in the impact of raising grandchildren on Black and White mothers’ assessment of the quality of their relationships with their adult children, consistent with broader patterns of racial differences in intergenerational cohesion.
From Margin to Center: Intersectionality and the Politics of Environmental Gerontology
Authors: Oswald Austin , Yeh Jarmin , Yeh Jarmin 
Published: December 2021

Abstract
As the population becomes increasingly older and culturally diverse, so too does the need for critical scholarship that examines the complex lives of differently positioned older adults in relation to their social and physical ecologies. This innovative symposium reflects the importance of putting intersectional frameworks (Collins & Bilge, 2016) in conversation with environmental gerontology to critically examine structures of power in assessing who matters and who benefits from place-based initiatives that intend to support healthy aging (Phillipson, 2004). Perry et al.’s paper addresses the politics of responsibility, asking who is responsible for keeping older people safe in light of Covid-19 though a citywide senior housing coalition in Detroit. The second paper, authored by Johnson, speaks to the politics of access and structural inequalities that create disparities in end-of-life care for unhoused older adults. The third and fourth papers, by Stinchcombe and colleagues and Oswald, critically examine dominant paradigms of age-friendliness in Canada and the United States though a politics of representation that highlights who is (in)visible in these initiatives. The final paper by Reyes, on the civic participation of Latinx and African American older adults, illustrates how structural change cannot happen without engaging these populations in the political process. Together, these papers exemplify the politics of environmental gerontology and demonstrate that without acknowledgment of multi-layered identities and the structures contributing to their inequities, environmental gerontology is inadequate, as it may overlook important social and environmental factors that connect older people to the places where they live and die.
Educational Mobility and Age-Related Decrements in Kidney Function Across Adulthood Among Black and White Adults
Authors: Surachman Agus , Santos Alexis , Daw Jonathan , Alexander Lacy , Coe Christopher , Almeida David 
Published: December 2021

Abstract
This paper examines the association between educational mobility and age-related decrements in kidney function. Data from the main survey and the Biomarker Project of the Midlife in the United States (MIDUS) Wave 2 and Refresher samples were combined, resulting in 1,861 adults (54.5% female; age 25-84, Mage=53.37) who self-identified as non-Hispanic Black (n=326) and non-Hispanic white (n=1,535). The estimated glomerular filtration rate (eGFR) was based on serum creatinine, calculated using the CKD-EPI formula. Intergenerational educational mobility was based on the comparison between parental education (no high school/HS degree versus HS degree or higher) and participant’s education level (HS degree or lower versus some college versus bachelor’s degree or higher). Results from regression analysis indicated that Black participants in the moderate upward mobility group (parental education = no HS degree, participant’s education = some college) showed significantly steeper age-related decrements in eGFR across adulthood compared to Black adults with higher stable high status (parental education = HS degree or higher, participant’s education = bachelor’s degree or higher), B=-0.70, SE=0.26, p=.008, or white adults with higher stable high status, B= 0.58, SE=0.29, p=.044. A steeper age-related decrement in eGFR is known as a reliable risk factor for chronic kidney disease and cardiovascular disease. These findings support the notion of skin-deep resilience among Black adults who experience upward socioeconomic mobility. We explored multiple psychosocial factors that may explain these findings, including lifetime and daily discrimination, social status and financial strains, and perceived stress and depressive symptoms.
Responding to Intergenerational Food Security and Nutrition Education Needs With Remote Programming
Authors: Naar Jill Juris , Scrivano Rachel , Jarrott Shannon 
Published: December 2021

Abstract
In-person intergenerational programming focused on nutrition education and healthy food access among older adults and preschool children in care settings was abandoned last year when COVID forced center closures. Food for a Long Life (FFLL), a 5-year community-based participatory research (CBPR) project, re-oriented programming in response to heightened community food insecurity and social isolation during COVID. With county Extension agents, FFLL modified and initiated new partnerships to expand food pantry services for several hundred families and deliver nutrition programming to youth (n=28) and older adult (n=130) participants in two states. In this presentation we share how the CBPR method supported adaptive programming and evaluation while continuing to advance project goals, including to promote the sustainability of an intergenerational food pantry and nutrition programming delivery after funding ends in summer 2021.
Results of Optimize: A Cluster Randomized Trial of Patient, Family, and Provider Education in Primary Care
Authors: Green Ariel , Bayliss Elizabeth , Shetterly Susan , Drace Melanie , Norton Jonathan , Reeve Emily , Sheehan Orla , Boyd Cynthia 
Published: December 2021

Abstract
Individuals with cognitive impairment frequently have multiple chronic conditions (MCC), increasing their risk for polypharmacy and associated adverse outcomes. Optimizing medications through deprescribing (reducing or stopping the use of inappropriate medications or medications unlikely to be beneficial) may improve outcomes for this population. Optimize was a pragmatic, 12-month cluster-randomized trial of deprescribing in primary care within a not-for-profit integrated delivery system. Participants were age 65+ with dementia or mild cognitive impairment (MCI), 2+ chronic conditions, and 5+ chronic medications. The intervention consisted of a deprescribing educational brochure for patients/caregivers, and Tip Sheets for primary care clinicians. Outcomes were the number of chronic medications and presence of potentially inappropriate medications (PIM). In total, 1,433 patients received, and 1,579 control clinic patients would have been eligible to receive, the intervention (N=3,012). After 6 months, mean estimates of chronic medications were 6.23 in the intervention group and 6.33 in the control group adjusting for baseline counts, age, and gender (p=0.13). Excluding those without complete 90 days follow-up increased the adjusted effect size to 0.14 (p=0.08). In sub-analyses of individuals with 7+ medications at baseline (N= 1,434), the adjusted effect size was 0.19 (p=0.07) at 6 months and 0.21 (p=0.045) when excluding those without complete 90 days’ follow-up. Change in proportions of PIM did not differ between intervention and control groups. An educational intervention for patients, caregivers and clinicians may prompt reductions in chronic medications. The relatively small effect size highlights the complexity of medication management for individuals with dementia or MCI and MCC.
Health Concerns for LGBTQ+ Caregivers of People With Alzheimer’s Disease and Related Dementias
Authors: Kittle Krystal , Anderson Joel , Pharr Jennifer , Moonie Sheniz , Flatt Jason 
Published: December 2021

Abstract
We examined four states with data on LGBTQ+ identity and the ADRD caregiving modules from the 2019 Behavioral Risk Factor Surveillance System. Multivariable regression models examined the associations between LGBTQ+ identity and health outcomes. Among the ADRD caregivers, 55,920 (4.7%) identified as LGBTQ+. Compared with non-LGBTQ+ caregivers, LGBTQ+ caregivers were younger and more likely to live in rural counties. Half of LGBTQ+ caregivers spent 20+ hours per week providing care, and nearly 72% reported helping with personal care. LGBTQ+ caregivers reported more days when their mental health was not good than non-LGBTQ+ caregivers (B = 8.01;95% CI= 2.32-13.75). Female caregivers overall were twice as likely than males to experience depression (OR = 2.11;95% CI=1.29-3.45). These findings provide insight into characteristics of LGBTQ+ caregivers and their health concerns. Interventions that promote mental health and reach diverse LGBTQ+ caregivers in rural communities are crucial in supporting LGBTQ+ caregivers of people with ADRD.
The Impact of Visitation Guidelines During COVID-19 on Well-Being and Daily Life in Nursing Homes
Authors: Gerritsen Debby , Backhaus Ramona , de Boer Bram , Urlings Judith , Koopmans Raymond , Hamers Jan , Verbeek Hilde 
Published: December 2021

Abstract
Nursing homes across the world have taken very restrictive measures, including a ban for visitors, to prevent and control COVID-19 infections. This study reports on findings of a study investigating guidelines on allowing visitors in nursing homes and the impact on residents’ well-being, family caregivers and staff. In total, 76 nursing homes in the Netherlands were followed using a survey study, including three waves of data collection in (May 2020, September 2020, March 2021. Results indicated a negative impact of a visitation ban for residents’ overall well-being. There was a variety in guidelines of allowing visitors in nursing homes, and showed that safe visiting was possible during the COVID-19 pandemic. Staff perceived a fragile balance between infection prevention and the impact of restriction on residents. In conclusion, a general ban for visitors is not necessary and may do more harm than good for residents living in nursing homes.
Reablement Services Across the World: Effectiveness and Impacting Factors
Authors: Vluggen Stan , Buma Lise , Resnick Barbara 
Published: December 2021

Abstract
Due to the ageing of the world population, solutions are necessary to reduce the increasing demand for care. Besides the need for more care, older people often wish to remain as independent as possible and retain as much control as possible. A possible solution are services based on the concept of reablement, which includes working in a more rehabilitative and person-centered manner and has been researched in various forms internationally. Reablement services are promising and use the patient's strengths and, through interdisciplinary cooperation, aims to achieve the goals important for, and set by, the individual to remain/become as independent as possible. During this symposium, five presenters from the US, New-Zealand, Norway and the Netherlands talk about the impact and implementation of reablement services. The first presentation is about the results of a systematic review of the effects of reablement on daily functioning and identifying common features of effective interventions. The second presentation is about a systematic scoping review mapping how physical activity strategies are integrated and explored in reablement research and identifying knowledge gaps. The third presentation is about the significant impact of COVID-19 and its associated restrictions on residents in assisted living communities. The fourth presentation is on combining lessons learned and practical implications from research on reablement services into the SELF-intervention. The fifth presentation describes the implications of funding on practice and outcomes of reablement. This symposium represents the current practice and future directions regarding implementation and research of reablement services across the world.