bluuebunny/crossref_metadata_2025_split huggingface dataset:
MISSING IN ACTION: STRATEGIES FOR DEMONSTRATING ORGANIZATIONAL COMMUNICATION IN NURSING HOMES
Authors: Smith Patsy , Gordon Julie 
Published: December 2023

Abstract
A scoping review was conducted to learn more about strategic organizational communication within long-term care. Strategic organizational communication is a purposeful, system-wide, and system-level effort to transform the organization and delivery of care and services to make it easier to navigate, understand, and coordinate care. Care in nursing homes is complex and must consider residents’ goals, values, and preferences. Communication strategies enacted at the system-level may include direct care staff, human resources, nursing-to-resident and family interactions, and care planning. Strategies at the institutional or system-wide level also include corporate stakeholders, administration, and employee leadership. The aim of the literature search was to locate evidence of communication strategies that reflect corporate and organizational goals, and that exemplify the processes by which communication influences administrative policy. Key words in the search were entered in varying iterations and combinations with the guidance of a skillful research librarian. Key words were long-term care, communication, feedback, nursing homes, patient-centered care, quality improvement. Returns were greater than 2,000, yet seemingly relevant abstracts were fewer than 300, and selected articles were fewer than 30. The research reports reviewed were explanatory or explorative and just one article was found to explore the role of communication strategies and the impact on organizational outcomes. Further, no research reports were found to discuss strategic organizational communication and a combination of resident and organizational outcomes. Rather, most work described specific communication interventions among key groups, many of which lacked sustainable impact. Study results, limitations, and examples of communication strategies are presented herein.
NARRATIVE EXPLORATIONS OF CARE: THE TRANSFORMATIVE POWER OF CAREGIVING IN THE CONTEXT OF MENTAL HEALTH AND CANCER
Authors: Weiss Charlotte , Johnson-Koenke Rachel , Sousa Karen , Ulrich Connie , Hirschman Karen 
Published: December 2023

Abstract
Embracing the “narrative turn,” we used the post-modern and feminist informed research methodologies of narrative inquiry alongside photo elicitation to co-create an in-depth cancer family caregiver narrative with a 50-year-old daughter who cared for her mother (age 80) affected by lifelong schizophrenia and recent metastatic breast cancer. The participant was invited to share personal photos to support her in co-creating a caregiver narrative within the narrative interview environment. While these photos were not analyzed for content, they prompted the participant to share stories about her private caring experiences and make meaning of them. The I-statements of these stories were then used to create a research poem which explores a life lived alongside a parent with mental health issues, while highlighting the transformation and healing potential that life-limiting cancer introduced to their complex relationship affected by mental health barriers. The I-Poem rendering was analyzed for cognitive and emotional meaning resonant of the human experience. Emergent thematic threads of personal humanistic values include altruism, love, and forgiveness. Additionally, this I-Poem analysis contributes to new knowledge situated in human story telling while capturing a transformational personal experience of caring as an exemplar which resists discrimination and disunity among older persons and their family caregivers on the basis of mental health with concomitant serious illness.
OCCUPATIONAL COGNITIVE DEMANDS AND RISK OF MILD COGNITIVE IMPAIRMENT AND DEMENTIA: THE HUNT STUDY
Authors: Strand Bjorn Heine , Edwin Trine Holt , Zotcheva Ekaterina , Håberg Asta , Bratsberg Bernt , Mekonnen Teferi , Stern Yaakov , Skirbekk Vegard 
Published: December 2023

Abstract
The cognitive reserve hypothesis posits that cognitively stimulating work may delay onset of mild cognitive impairment (MCI) and dementia. However, the impact of work histories across midlife on the risk of these conditions is unclear. We evaluated trajectories of work-related cognitive demands from ages 33-65y and their association with later clinical MCI/dementia. The HUNT4 70+ Study was used (N= 7003 participants, 49.8% women, 2017-19). Group-based-trajectory-modeling was used to identify trajectories of work-related cognitive demands, measured by routine task intensity (RTI) index (Lower RTI indicates less routine-oriented work) from online Occupational Information Network (O*NET). Multinomial regression was used to estimate the relative risk ratios (RRR) of MCI/dementia after adjusting for covariates age, sex and education, income, hypertension, obesity, diabetes, psychiatric impairment, hearing impairment, feeling of loneliness, smoking status, and physical inactivity. Four trajectories were identified; low RTI (20.4%), intermediate-low RTI (22.7%), intermediate-high RTI (36.9%), and high RTI (20.1%). Participants in the high RTI group had higher risk of MCI (RRR 1.74, 95% CI: 1.41,2.14) and dementia (RRR 1.37, 95% CI: 1.01, 1.86) after adjusting for age, sex, and education compared to participants in the low RTI group. When accounting for potential mediators, the increased risk remained for MCI but was no longer significant for dementia, indicating these mediators may account for part of the observed relationship. Our results highlight the importance of cognitive stimulation in the workplace for maintaining cognitive function. This should be taken into account, together with other known risk factors to help prevent cognitive decline in older adults.
OLDER US ADULTS PREFER SHORT, FREQUENT RESISTANCE TRAINING PROGRAMS, ESPECIALLY THOSE WITH DIFFICULTY WALKING
Authors: Kurth Jordan , Sciamanna Christopher , Herrell Cheyenne , Danilovich Margaret , Conroy David , Schmitz Kathryn , Silvis Matthew , Ladwig Matthew 
Published: December 2023

Abstract
Though resistance training (RT) improves strength and physical function, fewer than 20% of older adults do RT at least twice weekly, as recommended by national guidelines. Even when programs are free, such as Silver Sneakers, fewer than 25% participate and those that do rarely attend (averaging &lt; 20 visits/year). Many individuals cite “lack of time” as the primary reason for not attending. Therefore, one approach to increase participation in RT programs could be making sessions shorter. However, little is known about older adult RT program preferences. Therefore, we conducted a nationwide survey among 611 US adults aged 65 and over. We compared their interest in a traditional (45 minutes, three days/week) RT program to a shorter, more frequent (5-minute, every day) RT program. Overall, 2.2 times as many older adults preferred the shorter vs. the traditional RT program (68.4% v. 31.6%; p&lt; 0.001). Furthermore, barrier self-efficacy for the shorter program was 50% greater than the traditional program. Adults with health concerns, like poorer self-rated health and a history of falls, were significantly more likely to be interested in the shorter program. Notably, 87% of older adults with difficulty walking also preferred the shorter program. These findings suggest strong interest in short RT programs among older adults, especially those with poorer health and mobility disabilities for whom traditional RT programs may be too challenging. Reducing the duration of RT programs may be an appealing option to engage older adults in RT, particularly among those for whom the program would provide the most benefit.
PERSONALIZED DEMENTIA PREVENTION IN LUXEMBOURG: INSIGHTS INTO THE PROGRAMME DEMENTIA PREVENTION (PDP)
Authors: Schröder Valerie , Skrozic Amna , Erz Dorothee , Kaysen Anne , Fritz Joëlle , Loureiro Joao , McIntyre Deborah , Krueger Rejko 
Published: December 2023

Abstract

BACKGROUND
Given that in an increasingly ageing society, the number of people with cognitive impairment is expected to increase, prevention strategies to reduce the high personal and societal burden of neurodegenerative diseases leading to dementia is of essence.

METHODS
As part of the “Dementia Prevention Programme (pdp)” in Luxembourg, individuals with Mild Cognitive Impairment (MCI) or Subjective Cognitive Decline (SCD) are recruited via referring physicians and other sources. All participants undergo a comprehensive neuropsychological evaluation and a risk factor profile is created. Factors known to increase the risk to develop dementia include hypertension, hypercholesterolaemia, physical or cognitive inactivity, depression, social isolation or hearing loss. Based on the results of this analysis, personalised lifestyle interventions are recommended to each participant, such as cognitive training, physical activities, psychological counselling or nutritional advice.

RESULTS
To date, 491 participants (mean age = 69.0 years; SD = 11.2) have been recruited at various sites across the country, of whom 424 (86.4%) present with MCI and 42 (8.6%) with SCD. 25 participants (5.1%) showed more advanced cognitive difficulties associated with loss of autonomy or had neither subjective nor objective cognitive difficulties and thus did not belong to the target group.

CONCLUSION
We provide evidence for the successful implementation of a nationwide dementia prevention programme and efficient recruitment of the target population by building a network of different health care providers. This may serve other countries as an example to rule out similar programmes targeting at promoting healthy ageing among the general population.
PHARMACIST INTERVENTION IS ASSOCIATED WITH MEDICATION ADHERENCE IN OLDER ADULTS WITH CHRONIC CONDITIONS
Authors: Smith-ray Renae , Feng Liang , Singh Tanya , Rudkin Kristi , Emmons Stacey , Groves Erik , Kirkham Heather 
Published: December 2023

Abstract
Hypertension, hyperlipidemia, and type 2 diabetes (T2D) are prevalent chronic diseases among older Americans, but related medication adherence rates are less than optimal. Consequences of poor adherence include increased mortality, healthcare utilization, and costs. Compounding evidence supports the integration of pharmacists in patients’ care across the care continuum. This study’s purpose was to examine the impact of a large national pharmacy chain’s pharmacist-led interventions to improve medication adherence among older adults with hypertension, hyperlipidemia, or T2D. Participants were Medicare D patients who had ≥2 prescription fills in ≥1 of the three therapeutic classes. The primary outcome, optimal adherence (OA), was defined as proportion of days covered (PDC) ≥80%. A difference-in-differences (DID) design with a generalized linear model approach was applied to examine differences between participants exposed to the intervention and controls across the study period (2020-2022). At baseline, intervention participants (n=317,613, age 70.1, female 57.0%) had lower OA for diabetes (76.9% vs. 79.8%), hypertension (79.0% vs. 83.0%), and cholesterol (78.6% vs. 82.1%) compared to controls (n=943.389, age 73.3, female 56.1%). The DID results showed that between 2020 - 2022, OA had significant absolute increases for intervention participants (diabetes: +4.0%, hypertension: +6.3%, cholesterol: +6.1%) versus controls (diabetes: -1.6%, hypertension: -0.4%, cholesterol: -1.4%). All DID models were significant at p&lt; 0.0001. The pharmacist-led intervention was significantly associated with increased OA over 2 years. These findings reinforce the potential for pharmacists as care providers among older adults with chronic conditions. Future research should examine the expansion of pharmacist-provided care.
PHYSICAL ACTIVITY BARRIERS AND INTENTIONS OF ALZHEIMER’S DISEASE (AD) AND RELATED DEMENTIAS (AD/ADRD) CAREGIVERS
Authors: Pickett Andrew , Krukowski Rebecca , Werner Nicole 
Published: December 2023

Abstract
Caregivers of people living with AD/ADRD often experience negative biopsychosocial health outcomes and have reduced capacity to engage in healthy behaviors (e.g., exercise). Physical activity is an established intervention for promoting physical and mental health across many populations. This research explored physical activity intentions and barriers among AD/ADRD caregivers, as well as potential relationships between physical activity intentions, cohabitation status, and caregiver/care recipient relationship. Data were collected via online survey from family caregivers of people living with AD/ADRD (n=117). The sample was predominantly women (n=89; 76.1%), white (n= 89, 76.1%), and averaged 55.3 (SD= 16.45) years old. Participants averaged 56.31 (SD= 49.15) hours per week on care responsibilities. Caregivers expressed strong desire to be more active (M=4.42 / 5; SD= .71) and that caregiving demands were a strong barrier (M=3.85 / 5; SD= 1.15). Significant differences were observed between caregivers who lived, or did not live with, care recipients across both physical activity intention (p= .022) and burden perceptions (p=.002), measured by the short form Burden Scale for Family Caregivers (BSFC-SF). No differences were observed based on caregiver-care recipient relationship (e.g., parent, partner). Primary themes among open-ended responses to physical activity barriers included: lack of time and energy, inability to leave care recipient, and competing responsibilities. Our findings suggest a need for behavioral interventions to facilitate physical activity among AD/ADRD caregivers, particularly those who live with their care recipient. Social network interventions that leverage social connections to support caregivers may increase physical activity by reducing barriers associated with care responsibilities.
PHYSICAL FUNCTION, DEPRESSION, AND COGNITIVE FUNCTION OF OLDER CHINESE AMERICANS: CROSS-LAGGED MODEL
Authors: Kwon Soonhyung , Zhu Yuyang , Tang Fengyan , Jiang Yanping 
Published: December 2023

Abstract

Introduction
Understanding the complex interactions of physical function, depression, and cognitive function is crucial for understanding healthy aging. However, few studies have empirically tested these relationships. This study examined the directional relationships of physical function, depression, and cognitive function among older Chinese Americans.

Methods
This study included a subsample of participants (n=2,811) from the Population Study of Chinese Elderly in Chicago who completed the baseline survey during 2011-2013 (W1) and at least one of the three follow-up surveys conducted in 2013-2015 (W2), 2015- 2017 (W3), and 2017-2019 (W4). Physical function, depression, and cognitive function were measured by a battery of physical mobility, the 9-item Patient Health Questionnaire, and cognitive performance tests (executive function, memory, and cognitive impairments). A random intercept cross-lagged panel model was performed to examine the bidirectional relationships among physical function, depression, and cognitive function.

Results
The cross-lagged panel model showed that higher levels of depression at W1 were associated with poorer physical function at W2. In turn, poorer physical function at W2 was related to higher levels of depression at W3. Higher levels of depression (W2) were linked to poorer physical function at W3. Poorer physical function at W2 was associated with poorer cognitive function at W3. Finally, poorer cognitive function at W3 was associated with poorer physical function and higher levels of depression at W4.

Discussion
Our results support a bidirectional relationship between physical function and depression. Also, as individuals age, cognitive function plays a key role in predicting physical function and psychological well-being.
POLYMORPHISMS IN INFLAMMATORY CYTOKINES NOT ASSOCIATED WITH COGNITIVE TRAJECTORIES IN OLDER ADULTS
Authors: Lawrence Karen , Gloger Elana , Pinheiro Cristina , Schmitt Frederick , Segerstrom Suzanne 
Published: December 2023

Abstract
Inflammation and key polymorphisms in inflammatory cytokine genes have been associated with increased Alzheimer’s disease (AD) risk. It is unclear if the same polymorphisms also predict domain-specific cognitive decline, that could eventually lead to AD/dementia, in otherwise healthy older adults. We investigated whether specific single nucleotide polymorphisms (SNPs) in three cytokine genes, IL-1β (rs16944; A or AA at -511), IL-6 (rs1800795; C or CC at -174), and TNFα (rs1800629; A or AA at -308), were associated with differential longitudinal trajectories of global cognitive function, episodic memory, attention and working memory, and executive function. Participants were 324 non-demented older adults (Mage=72.8 years at first visit, SD=6.09, age range 57-92 years) who completed 9 research visits, on average. Slopes were examined after adjustment for baseline age, sex, education, conversion to MCI or dementia during study, and APOE ɛ4 status. Findings indicated no statistically significant relationships between the SNPs of interest and longitudinal trajectories (spanning up to 16 years) of cognitive functioning in any cognitive domain examined. Other factors related to AD may be necessary for these SNPs to have significant brain-related effects. Attempts were made to further validate the non-significant findings by conducting post-hoc analyses to determine whether these SNPs were associated with plasma biomarker levels in this sample of healthy older adults. However, variability between and within the assays precluded confidence in the results. Further research is needed to determine whether these SNP genotypes are associated with concentrations of their respective blood-plasma biomarkers in non-demented older adults.
POST COVID-19 PANDEMIC EMPLOYMENT RECOVERY BY HEALTHCARE SECTOR IN US RACIAL MAJORITY-MINORITY COUNTIES
Authors: Xiang Lucille , Sreenivas Kiran 
Published: December 2023

Abstract
Health care sector employment trends following the COVID-19 pandemic have revealed a labor force participation gap. Racial/ethnic composition differences between counties may contribute to an uneven labor market recovery. This study’s objectives were to compare post-pandemic employment recovery between five health care sectors (ambulatory services (AS), home health care (HHC), nursing and residential care (NRC), assisted living (AL), nursing facilities/homes (NH)), and to examine whether health care sector recovery differences exist between racial majority-minority (MM) and non-racial MM counties in the USA. First Quarter 2020 and fourth Quarter 2022 data from the US Bureau of Labour Statistics Quarterly Census of Employment and Wages (QCEW) were used to calculate cumulative percentage change in health care sector employment. The Race Origin Variables from the latest 2021 data from the American Community Survey were used to identify racial MM counties. The sector with the greatest number of counties with positive employment recovery was the AS sector in 1562/3176 (49%) counties, and 252/468 (54%) MM counties. The NH sector had the lowest number of counties with positive employment recovery in 170/2818 (6%) counties, and 34/389 (9%) MM counties. This is the first analysis of post-pandemic health care sector employment recovery examining MM counties. Differences in county and state policies may account for varying degrees of recovery. Further research is necessary for the development of best practice guidelines and policies to improve post-pandemic health care employment recovery and the quality of nursing home care among older adults.
PROJECT, PERSUADE, AND PROTECT: ADULT CHILDREN’S PREDICTION OF PARENTS’ HEALTH STATE VALUATIONS
Authors: Hahne Jessica , Buenger Rachel E , Chung Tim , Silverstein Hannah , Carpenter Brian 
Published: December 2023

Abstract
Serious illness decision making for older adults frequently involves their adult children. Thus, it is important that adult children are familiar with parents’ illness preferences. In this mixed methods analysis (total N = 114), we examined concordance between older adults’ valuations of illness states, their children’s predictions of their valuations, reasoning behind children’s predictions, and children’s reactions to discordance between their predictions and parents’ valuations. Thirty-eight older parents (M age= 75.8) provided valuations for five different illness states. Two adult children (M age= 46.0) independently predicted their parent’s answers. Family triads participated in a semi-structured conversation about their responses. One-way random effects, absolute agreement, average measures intraclass correlation coefficients (ICCs) showed that average concordance within families was poor for incontinence (ICC = .172, 95% CI [-.497, .572]), dialysis (ICC = .300, 95% CI [-.264, .639]), tube feeding (ICC = .320, 95% CI [-.228, .649]), and chronic pain (ICC = .438, 95% CI [-.015, .710]), and moderate for Alzheimer disease (ICC = .556, 95% CI [.198,.771]). Results from qualitative thematic analysis indicated that children often projected their own values when attempting to predict parents’ valuations. When faced with discordance, many children attempted to persuade parents to change their valuations, while also making assertions to protect the parent’s autonomy. In summary, adult children navigating surrogate or shared decision making may face challenges inferring parent values versus their own and balancing their input with parent autonomy. Future research and interventions in late-life families could target these challenges.
RACIAL COMPARISONS OF RECEPTIVITY TO A BLOOD-BASED BIOMARKER TEST FOR ALZHEIMER RISK
Authors: Skemp Eleanor , Cho Hyun Jin , Carpenter Brian 
Published: December 2023

Abstract
Blood-based biomarker (BBB) tests to assess risk for developing Alzheimer disease (AD) have recently been approved for clinical use. Little is known about people’s interest and concerns about these new tests, although the relative simplicity of the tests may help reduce disparities in early diagnosis for AD in historically marginalized groups, such as African Americans. The current report uses data from a national survey of adults in the United States (N = 1,274) conducted in 2022, oversampling African Americans. In addition to demographic questions, respondents rated the importance of different factors they would weigh when deciding whether to take a BBB test and their trust with the healthcare system. The sample was diverse in age (M = 48.6, SD = 17.6, range = 18-91), balanced in gender (55.3% female) and race (48.1% African American), and ranging in education (41.1% &lt; BA). A higher percentage of respondents rated the accuracy (69.2%) and usefulness (64.5%) of the test as very important to their decision, compared to cost (40.8%) and convenience (38.0%). However, African Americans rated cost, convenience, confidentiality, and the potential for learning about other medical problems as more important than White respondents (chi-square p’s &lt; .01). Contrary to hypotheses, trust in the healthcare system was not significantly related to decisional factors. Results from this study have implications for how to tailor culturally sensitive messages about new tests for the early detection of dementia risk.