bluuebunny/crossref_metadata_2025_split huggingface dataset:
PATIENT-CLINICIAN RELATIONSHIPS IN HOME HEALTH CARE
Authors: Bankole Ayomide , Girdwood Tyra , Addo-Mensah Dorothy , Toles Mark 
Published: December 2023

Abstract
Patient-clinician relationships are fundamental attributes of high-quality home health care (HHC); yet little is known about patient-clinician relationships in HHC (where 5 million Medicare beneficiaries receive care annually). The objective of the study was to describe perspectives of HHC patients and HHC clinicians about patient-clinician relationships in HHC. We conducted a secondary qualitative analysis of semi-structured interviews (n=34) from a completed qualitative study investigating perspectives of older adult HHC patients (or caregivers as proxy) and their HHC clinicians (17 pairs) on discharge preparedness in a large HHC organization in North-Carolina. A conceptual model of patient-clinician relationships guided content analysis of the interview data. HHC patients identified as White (65%) and black (35%). Most HHC patients reported female sex (53%) and average age was 83 years (range= 69-93). Clinicians were registered nurses and physical therapists. Across the patient-clinician pairs, HHC patients valued relationships with clinicians with shared commonalities and those who provided reciprocal informational exchange and respected their autonomy. HHC clinicians valued relationships in which they felt helpful and respected as a healthcare professional. Relational conflicts arose when there was discordance in expectations of care (e.g., type of HHC services provided). Conflicts also arose when organizational constraints, such as disruptive scheduling, limited HHC visit time, and when limited continuity of care prevented the formation of patient-clinician relationships. Relational conflicts and organizational constraints influence patient-clinician relationships in HHC. Multi-level interventions (targeting modifiable factors at the patient, clinician, and organizational levels) are needed to improve the patient-clinician relationships and the quality of HHC.
THE IMPACT OF A NATIONWIDE PHYSICAL ACTIVITY INTERVENTION FOR DIABETES AND HYPERTENSION PREVENTION
Authors: Chen Cynthia , Ang Gregory , Tan Chuen Seng , Müller-Riemenschneider Falk , Teerawattananon Yot 
Published: December 2023

Abstract
Increasing physical inactivity is a primary risk factor for diabetes and hypertension, contributing to rising healthcare expenditure and productivity losses. We examined the cost-effectiveness of the National Steps Challenge (NSC), an annual nationwide mHealth intervention to increase physical activity in Singapore. We used a Markov model to assess the long-term impact of increased physical activity from NSC on adults. Conducting NSC yearly for 10 years on a mean cohort size of 654,500 participants is projected to prevent 6,120 diabetes cases (95% credible interval: 3,690 to 9,040), 10,300 hypertension cases (6,260 to 14,700) hypertension cases and 4,950 death cases (3,280 to 7,040), leading to 78,800 QALYs (56,500 to 102,000) gained. From the health system perspective, assuming no differentiation of cost among different physical activity levels within each health state, the healthcare cost savings from the averted cases is estimated to be SGD674 million (239 million to 1.48 billion), with SGD364 million (57.8 million to 1.04 billion) for diabetes and SGD311 million (95.0 million to 690 million) for hypertension. Using a willingness to pay threshold of SGD10,000, NSC was cost-saving at -SGD4,510 (-14,000 to 1,430) per QALY gained. We project that increasing physical activity from a yearly nationwide physical activity intervention delays the incidence of diabetes and hypertension. Our results suggest that the intervention is cost-saving and improves the quality of life. The estimated cost savings are more significant when indirect costs are considered, hence providing important information for decision-making in countries when considering similar large-scale physical activity programmes.
GENDER AND HOUSEWORK IN THE POSTRETIREMENT CONTEXT
Authors: Hwang In Jeong , Svec Joseph , Lee Jeong Eun 
Published: December 2023

Abstract
In recent years, social scientists have noted an uptick in “unretirement” of older adults as a large number of retirees have reentered the labor force. Not only do older Americans’ labor-force reentry have implications for our economy as a whole, this also raises important questions regarding the social and interpersonal relationships within households. Specifically, women, compared to men, might be disproportionately subject to work-family conflicts, due to the gendered expectation that women take primary responsibility for household labor. In this study, we examine 758 American couples aged 65 and above from the 2005-2019 Health and Retirement Study (HRS) core survey and the supplemental Consumption and Activities Mail Survey. We examine whether and to what extent couple’s retirement and re-entry into the labor force correspond with changes in the distribution of household labor. Specifically, we expect that while both men and women shift their household labor contributions in accordance to changes in their formal work statuses, changes in men’s contributions are attenuated relative to women’s. The results show that while both male and female retirees spend more time housework when their spouses work, women tend to perform more housework when they re-enter the labor force whereas men’s contributions decline significantly upon their re-entry. These patterns are increasingly evident from the analysis focused on routine tasks, typically done by women. These results highlight how gender ideological scripts can frame relational contributions and expectations as well as their persistence despite shifts in economic contributions to the household.
GENDER, SEXUAL ORIENTATION, AND SPOUSAL CAREGIVING FOR THOSE WITH DEMENTIA: A FOCUS ON EMOTION WORK
Authors: Calasanti Toni , Giles Sadie , Geng Jing 
Published: December 2023

Abstract
This study draws upon and expands three research streams. The first relates to spousal caregiving for those with dementia, and gender differences in stress. Based on gender divisions of labor, men are more likely to take a task-oriented approach to caregiving; women take a more holistic, empathetic approach. The second strand relates to emotion work, wherein caregivers manipulate their own emotions to produce a desired outcome in another (Hochschild, 2003). Research shows that spouses find performing emotion work “draining” (Umberson, et al., 2020), and that women do it more. Finally, we draw upon research that finds that same-sex couples are more egalitarian in their division of labor than are straight couples; how this impacts caregiving approaches or emotion work is unclear. Weaving these together, our study explores how inequalities of gender and sexuality intersect in shaping caregiving by older adults who care for their demented spouses. Our analysis of in-depth interviews conducted among 69 straight, gay, and lesbian caregivers finds that, first, heterosexual men rarely engage in emotion work, though they do manage their own feelings. Second, heterosexual wives overwhelmingly manipulate their feelings in attempts to gain compliance from their spouses, calm them, and/or make them happy. Finally, both gay men and lesbians perform emotion work, and they tend to combine the task-oriented and holistic approaches to care. These findings make clear that gender differences found in previous caregiving research are not “natural,” and suggest that straight men’s lower stress levels may result from their tendency to skip emotion work.
STRUCTURAL AND FUNCTIONAL ASPECTS OF SOCIAL NETWORKS AND EMOTIONAL WELL-BEING AMONG LGBT OLDER ADULTS
Authors: Prasad Anyah , Burr Jeffrey , Miller Edward , Fredriksen-Goldsen Karen 
Published: December 2023

Abstract
Network size and composition are structural aspects and perceived support is a functional aspect of social networks. How these social network characteristics are related to LGBT older adults’ emotional wellbeing is not well understood. We investigated these relationships using data from The Caring and Aging with Pride study, a cross-sectional survey of 2,560 LGBT Americans aged 50 years and above, employing a series of mediated and moderated-mediated regression analyses. Results indicated that larger social networks were associated with more perceived support and perceived support partially mediated the association between network size and emotional wellbeing. Results also showed that stress was associated with poor emotional wellbeing via depletion of perceived support but less so when LGBT older adults were embedded in larger networks. These findings are in line with the Convoy Model of Social Relationships and The Stress Process Model; further, the results support Kondrat and colleagues’ suggestion that social network size has a moderating role, while social support has a mediating role between stress and health. Also, the Theory of Homophily postulates that shared identity may enhance group cohesion and feeling supported. Accordingly, we observed that perceived support and its mediation role were stronger with LGBT and older network members compared to non-LGBT and younger network members. A larger network of non-LGBT older adults had a more direct beneficial association with LGBT older adults’ emotional wellbeing. Our observations have practical implications for programs that aim to support LGBT older adults’ emotional wellbeing by strengthening social support through their social networks.
WOMEN’S STORIES: NARRATIVES ABOUT RELATIONSHIPS AND RESILIENCE
Authors: Watson Wendy , Faulkner Sandra , Stelle Charlie 
Published: December 2023

Abstract
Research has demonstrated that relationships are important in the lives of older women. Thirty-one women between the ages of 64-86 participated in interviews about their lives and relationships across the life course. In the interviews, women talked about their family of origin, friendships, romantic relationships, and their children and grandchildren. They explained how their relationships developed across the life course and how they have maintained their relationships, including how COVID-19 affected their maintenance behaviors. In the interviews, women constructed narratives that explained who they are as individuals and who they are in relationships. Through a poetic analysis of the interviews, resilience stood out as an overarching theme across the stories from women of different ages, marital statuses, economic backgrounds, and current and former occupations. Many women spoke of growing up in poor, rural areas and finding the strength to build a better life for themselves. There were stories of abuse, both in their family of origin and in chosen partners. Narratives included many instances of loss and hardships through caregiving, deaths of friends and relatives, and dissolution of relationships. Throughout it all, these women claimed resilience brought about through their own strength and determination and through relationships with people who supported them, mentored them, and built them up. This paper will discuss the many ways in which these thirty-one women exemplified resilience in their past, in their current lives, and as they looked toward their futures.
THE CRUCIAL ROLE OF LEPTIN IN MEDIATING VISCERAL ADIPOSITY-ASSOCIATED AGING PROCESS
Authors: Zhao Shangang 
Published: December 2023

Abstract
Visceral adiposity is a hallmark of aging and an important contributor to reduced healthspan and lifespan. The factors that mediate the detrimental effects of aging-associated visceral adiposity are poorly identified. Here, we have shown that hyperleptinemia, induced by a leptin transgenic cassette in adipose tissue, accelerates diet-induced obesity and glucose intolerance. In addition, hyperleptinemia promotes adipose tissue inflammation. Chronic culture of stromal vascular fraction (SVF) with leptin reduces the capacity of differentiation and increases inflammation. Moreover, chronic hyperleptinemia in fat depots accelerates the development senescent cells to establish a senescent-associated secretory phenotype (SASP), including increased local inflammation. This result indicates hyperleptinemia may be a “unidentified” driver for cellular senescence. Moreover, deletion of leptin in visceral fat depots significantly reduces visceral adiposity and senescent-associated secretory phenotype (SASP). These results highlight the crucial role of leptin in establishing SASP and targeting leptin may be a novel approach to alleviate aging-associated metabolic syndromes.
EVERY DAY I HAVE THE BLUES
Authors: Blues Elwood 
Published: December 2023

Abstract
The Blues Brothers are an American blues and soul revivalist band founded in 1978 by comedians Dan Aykroyd and John Belushi as part of a musical sketch on Saturday Night Live. Belushi and Aykroyd fronted the band, in character, respectively, as lead vocalist ’Joliet’ Jake Blues and harmonica player/vocalist Elwood Blues, donning black suits with matching fedoras and sunglasses.
IMPLEMENTATION SCIENCE: A STRATEGY FOR ADDRESSING HEALTH EQUITY AMONG RACIALLY DIVERSE OLDER ADULTS
Authors: Bullock Karen , Campos Barbara Mendez 
Published: December 2023

Abstract

Objective
Implementation science as a strategy for helping diverse populations of older adults address barriers to mental treatment, has become increasingly important since COVID19. This paper disseminates information about the results of an interdisciplinary intervention that tailored mental health services to racially and ethnically diverse community-dwelling older adults. Method: An interdisciplinary team of researchers (MD, APRN, MSW) performed an intervention that consisted of weekly visits to the community and provided diagnostic, triage, and psychosocial services to older adults. Evaluation of the intervention included data collected at baseline and three-month follow-up visits.

Results
350 elderly residents received mental health screening with some assessment of physical health and well-being. The number of visits per resident during the intervention phase, ranged from 1 to 11, with an average of 3. Tailoring the intervention to the specific cultural needs of the participants led to the development of a weekly community engagement group for monolingual Spanish-speaking residents and others. 49% of those receiving the intervention, self-reported their race and/or ethnicity as African American or Caribbean, 43% were Latino, and 8% were Caucasian, all of whom self-referred as participants in this health service outreach program. Initial evaluations resulted in referral to community providers (60%), team case management (20%), or no services needed (20%).

Conclusion
Research studies designed to have positive impacts on older adults that have been historically underrepresented in health services research may improve its effectiveness by tailoring processes to be community informed and culturally responsive to structural and system barriers to treatment.
DAILY STRESS CONTRIBUTES TO GENDER DISPARITIES IN LONG-TERM CHRONIC DISEASE RISK
Authors: Cichy Kelly , Koumoutzis Athena , Witzel Dakota , Stawski Robert 
Published: December 2023

Abstract
Compared to men, women exhibit worse health outcomes, including increased risk for chronic disease (Carmel, 2019). Exposure and affective responses to daily stressors represent a risk factor for long-term health (Piazza et al., 2013) with research revealing a complex pattern of gender differences in affective responses to stressors (Birditt et al., 2005; Witzel et al. 2022). Together, findings suggest stressor exposure and affective reactivity may represent accessible intervention targets to reduce chronic disease risk and health disparities. Using data from Wave II of the National Study of Daily Experiences and MIDUS Waves II and III, this study explores: 1) gender differences in chronic disease risk; 2) prospective effects of differential exposure and reactivity on chronic disease risk 10 years later; and 3) whether daily stress processes (DSP) partially account for gender differences in chronic disease. Respondents include adults ages 34-84 years (N = 1209), who reported on daily stressors and affect for eight days during NSDE II and on chronic conditions during MIDUS III. Covariate-adjusted multilevel models revealed women reported more chronic conditions compared to men (p &lt; .0001). DSP processes, including differential exposure (p &lt; .01) and affective reactivity (p &lt; .05) are associated with increased chronic conditions. Further, the magnitude of the gender differences in chronic conditions was reduced after accounting for DSP variables. Findings highlight the contribution of DSP for chronic disease risk and gender disparities in physical health. Implications for addressing DSP as accessible intervention targets will be discussed.
DAILY NEGATIVE AND POSITIVE EVENTS AND DAILY WELL-BEING: DYADIC LINKS IN COUPLES LIVING WITH EARLY-STAGE DEMENTIA
Authors: Polenick Courtney , Kaba Diarratou , Daniel Nikita , Lambert Olivia , Salwi Shreya , Valera Juhi , Birditt Kira 
Published: December 2023

Abstract
Spouses have powerful influences on well-being in middle and later life, but we know little about how daily events impact well-being in older couples that include persons living with dementia (PLWD). We examined associations between daily negative and positive events and daily well-being (negative mood and positive mood) in 36 heterosexual married couples living with early-stage dementia. Participants included PLWD (M = 71.47 years, SD = 6.90, range = 53-82 years) and their spouses (M = 69.69 years, SD = 7.26, range = 59-87 years) who both completed brief morning and evening phone interviews over 7 consecutive days. Longitudinal actor-partner interdependence models controlled for own and partner reports of daily well-being in the previous day, whether each day was a weekend day, and the gender of PLWD. We estimated separate models for negative mood and positive mood. Both PLWD and their spouses reported higher negative mood when they reported more negative events in the same day and when their partner reported more negative events in the previous day. Over and above these associations, both partners in the couple reported lower negative mood on days when spouses of PLWD reported more positive events. Spouses of PLWD reported higher positive mood on days when they reported more positive events, but lower positive mood on days when PLWD reported more positive events. These findings highlight the importance of understanding dyadic influences on daily well-being among PLWD and their spouses.
CHILDHOOD ADVERSITY, NEIGHBORHOOD CONTEXTS, AND COGNITIVE FUNCTION IN ADULTHOOD
Authors: Choi Jean , Muñoz Elizabeth , Scott Stacey , Sliwinski Martin 
Published: December 2023

Abstract
Childhood adversity may play an important role in cognitive health and aging. Neighborhood contexts in adulthood can serve as risks or resources that may modify the effects of childhood adversity on adult cognitive function, but these effects are not well-understood. We examined whether current positive (i.e., neighborhood cohesion) and negative (i.e., neighborhood violence) neighborhood contexts moderated the effect of childhood stress exposure on cognitive function in adulthood. We used data from 210 adults (Mage = 46.79, SD = 11.02; range: 25–65) residing in a single Zip code in Bronx, New York who completed measures of childhood adversity, current neighborhood contexts, and lab-based cognitive tasks. After adjusting for relevant demographic covariates, childhood adversity was not associated with cognitive function. The interaction between childhood adversity and neighborhood violence was significant, whereby lower childhood adversity was linked with worse performance in perceptual speed for individuals who reported both low (b = 1.19, SE = 0.37), p = .001) and high neighborhood violence (b = 0.75, SE = 0.26, p = .005), with higher scores indicating slower responses and worse performance. Unexpectedly, neighborhood violence was not predictive for those who reported greater childhood adversity. The interaction effect for neighborhood cohesion was not significant. Results indicate that childhood adversity may not have universal effects across all cognitive domains, but rather its effects are complex and may affect cognitive functioning to be adaptive to certain environmental contexts. This study underscores the need to replicate and examine the long-term consequences of these effects on cognitive aging.
THE IMPACT OF THE COVID-19 PANDEMIC ON FAMILY CARE PARTNERS OF PERSONS WITH DEMENTIA IN ASSISTED LIVING FACILITIES
Authors: Antonsdottir Inga 
Published: December 2023

Abstract

Background
The Covid-19 pandemic affected persons living with dementia and their family care-partners. Family care-partners are diverse, including spouses, children, and friends. Care-partners may live with the care recipient, or apart from them. Covid-19 policies and priorities isolated care-partners living at home, while banning others from supporting their loved ones in assisted living facilities (ALF). Purpose: The purpose of this study was to examine the impact the covid-19 pandemic had on family care-partners of persons living with dementia.

Methods
This study used an online survey of 133 family care-partners (89 living in ALF, 44 living in the community).

Results
Among family care-partners, 34.8% of those who lived in an ALF reported a severe change in routine compared to 38.6% of those living in the community. 78.7% of ALF care-partners reported that they were unable to visit their loved one in a care facility, compared to 31% of care-partners living in the community. 67.4% of ALF care-partners were separated from the person with dementia that they cared for, compared to 22.7% of care-partners living in the community. 70.5% of CPs in the community reported they had to spend a lot more time taking care of a family member with dementia compared to 13.5% of ALF CPs.

Conclusion
Unique differences exist in how the pandemic impacted the lives of family care-partners of community-based or ALF-based persons living with dementia. Understanding these differences can help tailor policies and healthcare priorities to best support family care-partners living in community or ALF settings.
AT THE NEXUS OF PUBLIC POLICY AND AGING: DOCTORAL STUDIES IN GERONTOLOGY AT THE UNIVERSITY OF MASSACHUSETTS BOSTON
Authors: Miller Edward , Burr Jeffrey , Boerner Kathrin , Silverstein Nina , Mutchler Jan 
Published: December 2023

Abstract
One in five PhDs in Gerontology are graduates of the Gerontology doctoral program at the University of Massachusetts (UMass) Boston. The mission of UMass Boston’s program is to provide advanced training and research in gerontology within an interdisciplinary framework drawn primarily, but not exclusively, from the social and behavioral sciences. The program is designed to prepare students for leadership roles as educators, researchers, planners, and policy makers. The program has a deep emphasis on policy development, analysis, and impact, an attribute that goes back to the roots of the Gerontology enterprise at UMass Boston in the late-1970s. This presentation provides an overview of the program’s history and curriculum, along with coursework, research and service-learning experiences, and career paths in policy research and implementation. The program also is committed to increasing diversity in the field of gerontology, with the aim of strengthening policy impact and reducing disparities in the aging experience.