bluuebunny/crossref_metadata_2025_split huggingface dataset:
REDUCING HTN AMONG BLACK ELDERS THROUGH AN IMMERSIVE VIRTUAL FOREST
Authors: Mickus Maureen 
Published: December 2023

Abstract
Rates of uncontrolled hypertension (HTN) among Black individuals is higher than for any other racial or ethnic group in the U.S. The prevalence of HTN in this minority population, coupled with arterial aging, portend serious risks for cerebrovascular and cardiovascular diseases among Black elders. Past research has indicated that exposure to nature, specifically immersion within a forest setting, can be effective for reducing HTN. But deriving health benefits derived from time in a forest may be difficult for older persons from historically disadvantaged groups. This purpose of this study was to assess whether access to calm and immersive forest images delivered using virtual reality (VR) can modify HTN among community-dwelling Black elders. The study involved a quasi-experimental design and a sample of individuals ages 60-98 recruited from a senior center primarily serving minorities. Each of the 22 participants completed 4 biweekly VR trials using software with a soothing audiovisual simulation of a forest meadow including trees, birds, flowers, and wildlife. Results indicated an average decline of 10 mm HG (SD=7.0) in systolic blood pressure with Hedges g effect sizes ranging from .38 to .96 across sessions. The elders expressed a more relaxed mood and viewed VR as a pleasant distraction overall. Given that none of the participants reported any adverse effects from using this technology, further exploration of forest-based VR as a promising method for decreasing HTN in a high-risk population of older adults is warranted.
INTERPROFESSIONAL EDUCATION: STRATEGIES TO REACH RURAL STUDENTS THROUGH GERIATRIC EDUCATION
Authors: Jurkowski Elaine 
Published: December 2023

Abstract
Inter-professional collaboration across disciplines such as primary care medical practice, physician assistants, social workers, and nutritionists does not occur naturally, since educational programs are often taught independently of each other, but these disciplines are required to work collaboratively with each other. The objective was to promote communication across disciplines and help each discipline understand the roles played in promoting mental health and general health for older adults. Three specific strategies to address Interprofessional Education were devised and implemented within a rural context to address the goal of improving collaboration and communication. An educational seminar was conducted using cases and guide questions focused on identifying strategies for care. A second strategy was through “Student hot-spotting” where students worked with a high-need complex case over the course of a school year weekly, as a team-based approach. A third strategy made use of a weekly medical clinic for team-based patient care. The teams consisted of Medical Residents, Social Work students, Physician Assistant students, and nutrition students. Findings suggest professionals were surprised at what they learned from the other disciplines they were collaborating with. They also learned about community-based resources available as well as strategies to promote health outcomes. All participants felt that the opportunity to collaborate outside of their disciplines would strengthen their impact when working with older adults and their families. In conclusion, a problem-based learning approach coupled with the opportunity to collaborate with other disciplines through (IPE) improves overall collaboration among professionals. All strategies had positive learning outcomes.
MAKING AN IMPACT: AN INTEGRATED MODEL TO REDUCE AGEISM AND SUPPORT PROFESSIONAL IDENTITIES
Authors: Powell-Versteeg Amy , Perkins Rebekah , Ward R Scott , Edelman Linda , Supiano Katherine 
Published: December 2023

Abstract
Nearly one-million people in the U.S. are living with Parkinson’s disease (PD) and require skilled care. Despite this, only 20% of educational programs offer a geriatric rotation. Ageism is a major factor in healthcare students’ lack of clinical exposure, decreased self-confidence, and desire to specialize in geriatrics. Research shows positive exposure to older adults improves students’ knowledge, attitudes, and interest in this population. Yet, limited geriatric curriculum exists that integrates specialized knowledge combined with positive contact experiences to shape students’ professional identities as capable providers. This project combined two experience-based learning (ExBL) models to form the Intrinsically-Motivated learning, Professional identity, Awareness, Capacity, and Timing (IMPACT) model—to support specialized knowledge acquisition and positive, repeated contact experiences with older adults. Third-year Doctor of Physical Therapy (DPT) students who completed both didactic training and a 2-week PD Boot Camp were interviewed about their experiences in the program. Nine students participated in the PD Boot Camp and interviews. Qualitative thematic analysis revealed the following: 1) unexpected insights gained about clients’ unique abilities, 2) therapeutic alliances formed and mutually created functional goals, 3) improved decision-making through practice with mentorship, and 4) increased self-confidence to provide care to clients with complex conditions. The IMPACT model provided students specialized knowledge and practical skills to capably care for older adults with PD. This model can serve as a guiding educational framework to reduce ageism among healthcare students across a variety of settings, support students in developing their professional identities, and increase interest in caring for older adults.
THE AMBIVALENCE OF BACHELOR OF NURSING LECTURERS TOWARD MALNUTRITION EDUCATION: A QUALITATIVE STUDY
Authors: ten Cate Debbie , Van den Boomgaard Iris , Ziylan Canan 
Published: December 2023

Abstract
Malnutrition in older adults occurs multifactorially and should be prevented interdisciplinary. This requires an improvement in the competencies regarding the integral prevention of malnutrition in students of different Bachelor’s programs, such as dietetics, social work and nursing, who are the future professionals. A precondition is that this education is taught by lecturers who have a positive attitude toward malnutrition education. However, it is unknown what this attitude is. We started our exploration within Bachelor of Nursing lecturers. Therefore, the aim of this study was to gain insight into the attitude of these lecturers regarding malnutrition education. A qualitative study, where semi-structured, in-depth interviews were held with nine Bachelor of Nursing lecturers from four different educational institutes. The interviews were transcribed and thematically analyzed. Two main themes emerged from the data: (1) ‘malnutrition is important’, subdivided in three sub-themes: ‘personal experiences’, ‘nursing experiences’ and ‘theoretical knowledge’, and (2) ‘not acting consequently’, subdivided in four sub-themes: ‘unclear responsibilities’, ‘insecurity regarding own abilities’, ‘depending on experts’ and ‘problems with prioritization’. The results showed that lecturers have a positive perception regarding malnutrition education, but that there is a discrepancy between their attitude and actual behavior. This means that this may lead to difficulties in embedding and providing qualitative malnutrition education in the curriculum. It is advised that lecturers follow train-the-trainer courses to develop and enhance their competencies in providing malnutrition education. Also, an efficient integration of and interdisciplinary approach regarding malnutrition education is advised.
AGE-RELATED MICROAGGRESSIONS: A FOLLOW-UP DESCRIPTIVE STUDY
Authors: Lewis Hannah , Patt Stephanie , Gietzen Luke , Buchanan Jeffrey 
Published: December 2023

Abstract
Age-related microaggressions are forms of ageist discrimination that occur during day-to-day interactions. The aim of this study was to identify common types of age-related microaggressions as well as to determine how negative affect influences emotional reactions to microaggressions. Using an online survey, participants (n = 200) were asked if they had experienced any of the 20 most common examples of age-related microaggressions reported in previous research (Gietzen et al, 2022). Follow up questions inquired about the frequency, emotional reactions, and behavioral responses to these microaggressions. Participants also rated their physical health and completed the Positive and Negative Affect Scale (PANAS; Watson et al., 1988). The results indicated that participants were familiar with these microaggressions 53% of the time. Participants also reported having negative reactions to 43% of these microaggressions. The frequency of negative emotional responses to microaggressions was significantly correlated with scores on the negative affect subscale of the PANAS (r = .34, p &lt; .001) and with ratings of perceived physical health (r = -.32, p = .002). Finally, an analysis of the 20 survey items revealed that two items were “highly impactful” microaggressions, defined as microaggressions that older adults reported experiencing often and reported having a negative emotional reaction to at least one-third of the time. The results of the study provide further insight into what age-related microaggressions look like, and how older adults experience these interactions.
THROUGH THE LOOKING-GLASS: THE FAMILY SHAME OF ELDER ABUSE
Authors: Hsieh Jessica , Mirza Raza 
Published: December 2023

Abstract
Elder abuse (EA) has been recognized as a serious public health concern. Recent studies have found that approximately 10% of community-dwelling, cognitively intact older adults experience some form of EA each year. Although EA research has made substantial progress, EA is often under-reported, with only an estimated 15% of cases being reported to formal support services. One of the main reasons for the under-reporting of EA is the victims’ feelings of shame, which have been shown to be exacerbated when the perpetrator is a family member and/or an individual with whom the older adults have close trusting relationships. Qualitative interviews conducted with 12 older adult (parent) and adult child caregiver dyads (n=24) revealed that older adults who experience EA by their adult children experience intense shame. Thematic analysis focused on what led to these feelings of shame, and this resulted in four main themes: (1) Failure in their role as a parent; (2) Adult children viewing them as powerless and unworthy; (3) Experiencing negative psychological effects; and (4) Self-blame. With a sense of responsibility to protect their family, older adults tend to keep ‘family shame’ to themselves, leading to a reluctance to disclose EA. As spouses and adult children, the two most common caregiving types, have also been reported to be the two most common groups of EA perpetrators, gaining a better understanding of the root causes of shame can help to support older adults in living safely in their homes and communities for as long as possible.
RELATING THE ORGANIZATIONAL CULTURE ASSESSMENT INSTRUMENT TO ADHERENCE IN A PRAGMATIC TRIAL OF A MUSIC INTERVENTION
Authors: Zhu Enya , McCreedy Ellen , Dionne Laura , Mor Vincent 
Published: December 2023

Abstract
Embedded pragmatic trials encourage the translation of evidence-based interventions to “real-world” settings. Most pragmatic trials of behavioral interventions for people with dementia suffer from low adherence. Understanding how organizational values and structure may increase adherence is important. We report findings from an embedded, pragmatic trial (ePCT) of a personalized music intervention for managing behaviors in residents with dementia, conducted in 54 nursing homes (NHs) from four corporations between June 2019 and February 2020. Before the trial began, the administrator and a nursing staff member from each NH completed the Organizational Culture Assessment Instrument (OCAI). Using the OCAI, respondents rated their organizational culture by allocating a total of 100 points across four competing domains: Clan, Adhocracy, Hierarchy, and Market. Results were aggregated to understand how differences in culture impacted corporate-level adoption of the intervention. All four corporations allocated the majority of their points to Clan culture, which is focused on collaboration and staff engagement. However, corporations differed in their scoring of the secondary culture type. The two corporations that rated Hierarchical culture, which prioritizes consistency and efficiency, highly were more likely to adhere to the intervention protocols. The corporation with Market highly rated had the lowest adherence to the protocols. After controlling for other corporate characteristics, including for-profit status, size, and overall quality, hierarchical culture was associated with greater numbers of exposed residents and a higher dose of the music, compared to other culture types. Understanding the role of organizational culture on pragmatic implementation is an understudied area for research.
THE ASSOCIATION BETWEEN COGNITION AND UPPER EXTREMITY MOTOR REACTION TIME IN OLDER ADULTS: A NARRATIVE REVIEW
Authors: Jones Alexandria , Weaver Natalie , So Mardon , Jaffri Abbis , Heckman Rosalind 
Published: December 2023

Abstract
Response timing is essential to optimal sensorimotor control across the lifespan. While it is broadly assumed that reaction time increases as cognition declines with age, it is unclear if this assumption is supported by the literature. The purpose of this narrative review was to determine the association between cognition and upper extremity reaction time in older adults. Cognitive domains of sensation and perception, motor construction, perceptual motor function, executive function, attention, learning and memory, and language were considered. We conducted a systematic search using Scopus database. The search strategy was designed to meet four inclusion criteria: 1) community-dwelling adults &gt;60 years, 2) upper extremity motor task, 3) at least one cognitive assessment, 4) simple reaction time measure. 1154 articles were screened. Two articles met the full inclusion criteria, but the studies did not associate the cognitive assessment and simple reaction time measures. Nine articles that met three inclusion criteria were reviewed. We found that executive function and learning and memory have been associated with complex and choice reaction time measures. Language, perceptual motor function, and attention have been studied with mixed evidence for an association with reaction time; whereas, sensation and perception and motor construction have not been assessed. Overall, limited research has compared cognitive domain function and simple reaction time to determine if age-related changes are associated. While the complex interplay between cognition and motor function is of substantial interest, these measures are often interdependent and additional knowledge is needed to understand their influence on sensorimotor control with age.
ULTRAPROCESSED FOODS AND COGNITIVE FUNCTIONING IN OLDER ADULTS
Authors: Seago Elayna , Katz Benjamin 
Published: December 2023

Abstract
Consumption of ultra-processed foods (UPFs) is increasing globally. Previous research has explored the psychological effects of this dietary shift, including associations between diet and cognition. While this previous work shows that neuroprotective dietary patterns in general, and UPF consumption in particular, may have a deleterious effect on cognition, less research has explored the specific cognitive domains most closely associated with UPF consumption. The present study draws from the 2016 Harmonized Cognitive Assessment Protocol and the 2012 Health Care and Nutrition Study (HCNS) from the Health and Retirement Study to examine the relationship between UPF consumption and a wide a wide array of fluid and memory-based cognitive measures in older adults. Additionally, we used the food frequency questionnaire from the HCNS to categorize participants’ foods as ultra-processed using the NOVA system. Initial analyses using analysis of covariance with UPF bins, controlling for age, gender, and self-rated health, indicates that measures of processing speed, but not other fluid measures nor most measures of delayed recall, were most closely associated with UPF consumption. These initial findings provide more specific detail regarding the cognitive correlates of UPF-heavy diets and provide a pathway to future work that more closely examines the longitudinal effects and underlying physiological mechanisms of UPF consumption.
DEPRESSIVE COGNITIONS AND SYMPTOMS IN CAREGIVING GRANDMOTHERS: TESTING GROWTH CURVE MODEL STABILITY
Authors: Burant Christopher , Musil Carol , Zauszniewski Jaclene , Jeanblanc Alexandra 
Published: December 2023

Abstract
Grandmothers caring for grandchildren have elevated depressive symptoms levels compared to grandmothers who do not provide care. Depressive symptoms are state-like in nature and describe recent depressive symptoms. The Depressive Cognition Scale© captures changes in negative thinking patterns that often precede depressive symptoms. Depressive cognitions, according to Beck’s theory of depression, are the first depressive symptoms to appear and typically lead to more serious symptoms of depression. Previously diagnosed depression may also contribute to current levels of depressive cognitions and depressive symptoms. Data were collected on 342 participants in a longitudinal nationwide online research study of caregiving grandmothers. A latent growth curve model of how previously diagnosed depression and depressive cognitions impacted the trajectory of depressive symptoms at four time points (baseline, 2 weeks, 12 weeks, and 24 weeks) was tested. The model fit the data well (Chi Square=24.301.; df=12; p=.019; TLI=.977; CFI=.987; RMSEA=.055). This model was submitted to 6 separate multigroup nested model tests (levels of income, education, age, employment, number of children, and primary vs. multigeneration families) to provide evidence supporting generalizability of the model. All models fit the data well (TLI=.960-.991; CFI=.973-.992; RMSEA=.051-.025). Total invariance/stability, based on nonsignificant changes in chi square and CFI&lt;.01, was supported in the multigroup analyses across all levels testing equality in measurement and regression weights and residual variances. This lack of change in the model across 6 different grandmother scenarios provides further evidence supporting the need for interventions to address diagnosed depression and depressive cognitions for reducing depressive symptoms in grandmother caregivers.
FACTORS AFFECTING SUICIDAL IDEATION IN COMMUNITY-DWELLING OLDER ADULTS WITH DEPRESSION
Authors: Smith Shelby , Barry Lisa , Steffens David , Fortinsky Richard 
Published: December 2023

Abstract
Suicidal ideation (SI) within the older adult population represents a continuing public health crisis. The previously published 5D Framework utilizes a set of five domains (depression, disability, disconnectedness, disease, and deadly means) to explain multifaceted influences on late-life suicide. This study explored factors associated with SI among community-dwelling older adults with depression by including measures of selected 5D Framework domains and additional factors potentially associated with SI in an explanatory analytic model. We utilized baseline data from an ongoing clinical trial to assemble a cohort of older adults (age 65+) who screened positive for depression via provider diagnosis or scoring ≥16 on the Center for Epidemiologic Studies Depression scale (CES-D). Individuals joining the clinical trial between May 2017-March 2020 completed baseline assessments evaluating levels of depression, cognitive impairment, psychological resilience, dispositional optimism, social engagement, level of financial strain, and educational attainment. Sl was defined as endorsement of Question 9 of the PHQ-9. In the study cohort (N=171), mean age was 73.5 [SD: 5.76], 67.3% female, 92.4% non-Hispanic White, and 18.1% endorsed SI. In a multivariate logistic regression analysis, increased severity of depression was positively associated with SI (AOR 1.18 [95% CI:1.06-1.31]) while higher level of optimism was inversely related with SI (AOR 0.913 [95% CI:0.84-0.96]). No statistical significance was noted for age, gender, education, financial strain, resilience, cognitive impairment, or social engagement. We conclude that optimism is a protective factor against SI, and reporting more severe depressive symptoms represent an important risk factor for SI, among older adults with depression.
MIGRATION OVER THE LIFE COURSE AND LATER-LIFE DEPRESSION IN CONTEMPORARY CHINA
Authors: Zhang Nan 
Published: December 2023

Abstract
Migrating between rural and urban areas over the life course profoundly shapes the conditions of later life. In the Chinese context, living in urban areas with an urban Hukou is associated with socioeconomic advantage. This study is among the first attempt to investigate how migration into urban areas in China is related to these processes and the association with risk of depression in later life by focusing on the timing and the type of migration (rural-urban residential mobility and/or institutional transition of Hukou status) of migration. Using data from China Health and Retirement Longitudinal Study, we found strong associations between migration over the life course and risk of depression in later life in China. The timing and type of migration appears to play an important role. In-situ urbanisation is associated with lower depression scores in later life, and these effects are greater for in-situ urbanisation occurring in middle age compared with young adulthood. Forced urban-rural migration is associated with improved mental wellbeing. Formal social protection, particularly having a private pension, contributes substantially to the mental health advantage of social groups with an urban Hukou. Having an urban Hukou origin has an independent protective role in shaping mental wellbeing in later life in China, potentially partly due to the entitlement to a private pension attached to this status. When informal support has weakened in contemporary China, enhanced formal social protection in the form of adequate pensions should be put in place to mitigate structural inequalities associated with migration in old age.