bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXAMINING AWARENESS AND USE OF COMPREHENSIVE GERIATRIC ASSESSMENTS IN CANCER CARE: A QUALITATIVE STUDY
Authors: Seaman Aaron , Wickersham Karen , Rowland Julia , Fairman Ciaran , Hebert James , Thomson Cynthia , Vogel Rosi , Friedman Daniela 
Published: December 2023

Abstract
Comprehensive geriatric assessments (CGAs) are critical tools for identifying the needs of older cancer survivors and planning effective treatment and follow-up care. Research on CGA implementation in clinical settings remains limited. We interviewed primary and cancer care providers to better understand current CGA practices, their potential, and the challenges of clinical use. Eight semi-structured interviews, lasting ~60 minutes, were conducted with participants identified through Cancer Prevention and Control Research Network partner listservs. Analysis was conducted iteratively. Providers reported that CGAs were useful and administering them with all incoming patients would be ideal but was not always possible. Instead, they used brief screening tools, which meant CGA domains were inconsistently assessed. Implementation was facilitated by clinic champions, multidisciplinary care teams, and institutional resources and buy-in. Findings from this research will provide potential solutions to addressing barriers to using CGAs related to staff capacity and competing demands, provider experience, and institutional priorities.
EXTENDING HOLISTIC, MULTIDISCIPLINARY SLEEP HEALTH INTERVENTION TO OVERLOOKED GROUPS OF OLDER ADULTS
Authors: Niemiec Stacey Schepens 
Published: December 2023

Abstract
Sleep health and overall well-being across the lifespan are inextricably linked. Sleep difficulties are a common occurrence in older adulthood, with disturbed sleep ranking only second to pain as a problematic symptom interfering with older peoples’ daily lives. Exacerbating the issue are sleep health disparities such that sleep disturbances disproportionately affect members of under-represented, marginalized, and resource-poor communities. Building, implementing, and mobilizing knowledge from sleep-promoting interventions with potential to effect change on sleep health and quality of life disparities are urgently needed. From an occupational therapy lens, “rest and sleep” is classified as one of nine fundamental “occupations”—other more widely recognized occupations include those such as ADL and work. The Person, Environment, Occupation-Performance (PEOP) Model, an occupation-centric guiding framework that considers multiple layers of dynamic and interacting factors pertinent to individuals’ occupational performance, has been applied to sleep intervention. From this model, one can appreciate the myriad facilitators of and barriers to realizing healthy and restorative rest and sleep, directing attention to a wide range of relevant issues such as cultural practices, societal attitudes, and resource scarcity. This presentation will overview the need for addressing inequities in sleep health and extending socio-culturally responsive services to traditionally overlooked subgroups of older people. Examples will be provided of holistic, multidisciplinary intervention research and programming that work to transform the landscape of sleep health disparities in later life.
CUMULATIVE LONELINESS AND ALL-CAUSE MORTALITY AMONG MIDDLE-AGED AND OLDER ADULTS IN THE UNITED STATES, 1996–2019
Authors: Yu Xuexin , Cho Tsai-Chin , Westrick Ashly , Chen Chen , Langa Kenneth , Kobayashi Lindsay 
Published: December 2023

Abstract
Recent studies have linked increased mortality to loneliness measured at a single point in time or over a short period of time, omitting the cumulative and dynamic nature of loneliness and its health effects. This study aimed to investigate long-term exposure to loneliness over an eight-year period in relation to subsequent all-cause mortality over 15 years. Data were from 9,032 individuals aged 50+ in the US Health and Retirement Study (HRS) from 1996-2019. Self-reported loneliness (yes; no) was measured biennially from 1996-2004. Cumulative loneliness was defined according to loneliness duration as never, intermittent (1-2 time points), and sustained (3+ time points). Mortality from 2004-2019 was identified from the HRS exit interviews and other sources (e.g., spouse). In the crude analysis, intermittent and sustained experience of loneliness was respectively associated with 137 (95%CI, 104-170) and 288 (95%CI, 233-343) excess deaths per 10,000 person-years, compared to those never feeling lonely. In the fully adjusted Cox proportional hazards model, a longer duration of loneliness was associated with additional 9% (HR=1.09, 95%CI, 1.02-1.17, intermittent vs. never) and 14% (HR=1.14, 95%CI, 1.03-1.27, sustained vs. never) mortality risk, indicating a dose-response relationship (P trend=0.009). Sustained loneliness may be a risk factor for mortality in mid-to-later life, and could be a potential intervention target to increase life expectancy.
PSYCHOSOCIAL CARE AFTER STROKE AS PROVIDED BY MULTIDISCIPLINARY TEAMS IN STROKE SERVICES
Authors: van Nimwegen Dagmar , Schoonhoven Lisette , Visser-Meily Johanna , de van de van Ginkel Janneke M de Man-van 
Published: December 2023

Abstract
About 18-31% of all persons with stroke develop one or more psychosocial impairments, such as depression or anxiety. They receive care in stroke services from multidisciplinary teams, consisting of several different healthcare professionals. Currently, it is unclear how psychosocial care is provided within these stroke services, what roles healthcare professionals play in this, and what psychosocial needs persons with stroke experience. Therefore, in this study the following research questions were answered: How do persons with stroke and healthcare professionals experience the current psychosocial care after stroke, and what psychosocial needs do persons with stroke experience? A qualitative study was conducted, which consisted of observations of care moments between 44 persons with stroke and 74 healthcare professionals, and individual interviews with ten persons with stroke. The observations showed that most care moments mainly focus on physical care. Healthcare professionals tend to focus on the care they give at that particular moment. In contrast, persons with stroke asked attention for a broader perspective on the whole rehabilitation process. In addition, the interviews showed that persons with stroke mostly need: clarity about the rehabilitation process, the ability to make their own decisions, a personal approach in stroke care, and to recover as fast as possible. To be able to provide care that fulfills the needs of persons with stroke, awareness about the differences in perspective between healthcare professionals and patients is essential in care programs, possibly leading to the necessity to change such programs to better fit these needs.
VA’S EXPERIENCE IN BUILDING CAPABILITY TO CONDUCT OUTREACH TO VULNERABLE PATIENTS DURING EMERGENCIES
Authors: Wyte-Lake Tamar , Brewster Pete , Hubert Terrence , Gin June , Davis Darlene , Holmes Chad , Dobalian Aram 
Published: December 2023

Abstract
The United States (US) has sustained more than 340 weather and climate disasters since 1980. Older adults with complex medical conditions, increasing in numbers, are typically most severely impacted by such events. A growing population of older, medically complex, individuals residing at home, and an increased frequency of severe natural disasters creates a compounded burden on local communities to reduce potential harm to these community-dwelling members during disaster response and recovery. In response, the Veterans Health Administration (VHA) established the Vulnerable Patient Care, Access, and Response in Emergencies (VP CARE) program to provide standardized data tools and guidance to assist VA medical facilities in conducting outreach to and care coordination of medically frail and older Veterans during major emergencies. VP CARE utilizes geographic information system (GIS) tools to allow outreach prioritization based upon geographic proximity to an event and patient clinical needs. In response to Hurricanes Ian and Fiona, the VP CARE team, with the support of the national VEText team, successfully deployed a new 2-way patient texting communication capability. During an emergency, patients receive a text from VEText, are asked whether they require assistance, and the specific help they need. The new VEText capability helped VA staff reduce outreach call volume by 20% and allowed for triage and prioritization of those indicated as needing assistance to the top of the outreach list. This presentation provides an overview of VP CARE approaches and what VHA has learned through its implementation to assist other healthcare systems with establishing similar capabilities.
EXPANDING THE ENGAGEMENT OF OLDER PERSONS IN CLIMATE CHANGE ACTION
Authors: Pillemer Karl , Luebke Matthew 
Published: December 2023

Abstract
Environmental volunteerism and civic engagement have been found to promote physical and mental well-being among older adults as well as helping communities address environmental issues. Despite the growing need for citizen action to address disasters and other climate change effects, however, little is known about how to promote such engagement. At present, few climate change organizations actively recruit or provide specific opportunities for older persons. Academics and policymakers have focused on how older people are particularly susceptible to the impact of climate change. Limited attention has been paid, however, to the ways in which older people can be actively involved on their own behalf in climate change mitigation, including engagement in disaster preparation and response. In this presentation, I review barriers to widespread mobilization of older adults in climate change action, including their lower levels of environmental concern and their systematic lack of access to opportunities for climate change activism. I report on findings from a recent international survey of local and regional organizational efforts to engage older persons in climate change prevention and mitigation. This survey identified successful models for mobilizing older persons to address climate change mitigation, and in particular in low- and middle-resource countries. Recommendations for effective program design to bring older persons more fully into climate change action are presented, as well as ways environmental organizations can expand their focus to include systematically older persons in their activities.
RACIAL/ETHNIC DISPARITIES IN ALZHEIMER’S DISEASE RISK: ROLE OF EXPOSURE TO AMBIENT FINE PARTICLES
Authors: Espeland Mark , Younan Diana , Wang Xinhui , Gruenewald Tara , Gatz Margaret , Serre Marc , Vizuere William , Chen Jiu-Chiuan 
Published: December 2023

Abstract
Whether racial/ethnic disparities in Alzheimer’s disease (AD) risk may be explained by ambient fine particles (PM2.5) has not been studied. We conducted a prospective, population-based study on a cohort of Black (n=481) and White (n=6004) older women (aged 65– 79) without dementia at enrollment (1995–98). Cox models accounting for competing risk were used to estimate the hazard ratio (HR) for racial/ethnic disparities in AD (1996–2010) and the association with time-varying annual average PM2.5 (1999–2010) estimated by spatiotemporal model. Over an average follow-up of 8.3 (±3.5) years with 158 incident cases (21 in Black women), the racial disparities in AD risk (range of adjusted HRBlack women=1.85–2.41) observed in various models could not be explained by geographic region, age, socioeconomic characteristics, lifestyle factors, cardiovascular risk factors, and hormone therapy assignment. Estimated PM2.5 exposure was higher in Black (14.38±2.21 µg/m3) than in White (12.55±2.76 µg/m3) women, and further adjustment for the association between PM2.5 and AD (adjusted HRPM2.5=1.18–1.28) slightly reduced the racial disparities by 2%–6% (HRBlack women=1.81–2.26). The observed association between PM2.5 and AD risk was ~2 times greater in Black (HRPM2.5=2.10–2.60) than in White (HRPM2.5=1.07–1.15) women (range of interaction Ps: &lt;.01–.01). We found similar results after further adjusting for social engagement (social strain, social support, social activity, living alone), stressful life events, Women’s Health Initiative’s clinic sites, and neighborhood socioeconomic characteristics. PM2.5 may contribute to racial/ethnic disparities in AD risk and its associated increase in AD risk was stronger among Black women.
TRANSCENDING BOUNDARIES AND BARRIERS: END-OF-LIFE CARE AND QUALITY OF LIFE FOR ASIAN POPULATIONS
Authors: Wang Kaipeng , Sun Fei , Carrion Iraida 
Published: December 2023

Abstract
End-of-life care and quality of life are critical issues for older Asian populations, as they face unique cultural, linguistic, and health-related challenges. This symposium will bring together scholars in this field to discuss the latest research and practices for improving end-of-life care planning and quality of life for older Asian populations. The symposium consists of four papers that focus on different Asian ethnic groups. Zhang and colleagues will use survey data to examine the barriers and sociocultural factors of advance care planning among older Chinese Americans. Xu will present a systematic review on non-medical factors that affect quality of life in the last year among older Chinese. Wang will compare the completion of advance directives and examine its psychosocial factors among older Vietnamese, Filipino, and Indonesian Americans. Using a case study of Somang Society, Lee will discuss how non-profit organizations can navigate social media to provide education and volunteer training to promote advance care planning and healthy aging for older Korean Americans. Collectively, these four papers compare the values, barriers, and resources related to end-of-life care between these groups and propose effective strategies for enhancing end-of-life care planning and quality of life for Asian communities. Findings will inform the development and adaptation of culturally sensitive interventions to promote end-of-life health outcomes for diverse Asian populations. Carrion, the discussant, will address the strengths and limitations of these papers and discuss their contribution to theories, practices, policies, and future research on end-of-life care for minority aging populations.
RELATIONSHIPS BETWEEN PERCEIVED HOUSING, HEALTH, AND QUALITY OF LIFE: DATA FROM AGES 65–70 IN SWEDEN
Authors: Eriksson Erik , Kylén Maya , Schmidt Steven 
Published: December 2023

Abstract
Theoretical and empirical advances have supported the notion of the importance of the perceived environment, and in particular the housing environment, as we age. For instance, previous research has found significant associations between aspects of perceived housing, such as control beliefs and meaningful aspects of home, and health and wellbeing. These associations have been found for both younger older, and older older, adults. However, much of previous research has been cross-sectional, in particular for younger older adults, leaving the question whether this association remains over time as we age. By using data from a Swedish longitudinal study (N=371, 57 % women) we analyzed associations between Meaning of Home (MOH) and two external subscales of Housing-Related Control Beliefs (HCQ), to a 6-year change in 31 self-reported health symptoms and health-related quality of life, measured by SF-12, using linear regression and modelling for demographic and housing characteristics. Significant results were found between both housing-related control beliefs and meaning of home, to changes in metabolism symptoms (MOH, R2 = 0.07, F(9, 259) = 3.258, p = .001; HCQ, R2 = 0.072, F(9, 281) = 3.494, p &lt; .000 and R2 = 0.066, F(9, 280) = 3.263, p = .001). However, for all other health symptom groups and for health-related quality of life, no significant associations were found. Our results show that while perceived aspects of housing are associated with health at a given point in time, they may not be predictive of future changes in health status.
EXPLORING THE ASSOCIATION BETWEEN CONTRACT NURSE STAFFING AND NURSE TURNOVER IN NURSING HOMES
Authors: Dayama Neeraj , Davlyatov Ganisher , Pradhan Rohit , Weech-Maldonado Robert 
Published: December 2023

Abstract
NHs face a significant problem with nurse staffing---a critical factor in providing high-quality care to residents. Although contract nurse staffing in NHs may provide a relatively flexible option to address acute nurse shortages, it raises its own challenges including requirement of increased supervision, lower levels of teamwork, and increased workload for the permanent staff. This may lead to disenchantment of the remaining nursing staff, increased turnover---a perfect vicious cycle. Therefore, we examined whether higher ratios of contract nurse utilization were associated with higher nurse turnover rates (RNs, LPNs, and CNAs). Employing a pooled cross-sectional observational study design, we extracted secondary data from PBJ nurse staffing, Nursing Home Compare, Rural-urban commuting area (RUCA) codes, and American Community Survey (ACS) for the period 2017-2021. We employed multivariate mixed-effects maximum likelihood regression to estimate the relationship between the ratios of contract nurses and nurse turnover rates while controlling for organizational/community variables. We ran three separate regressions for RNs, LPNs, and CNAs. Our results suggest that NHs with a high proportion of contract nurses had higher nurse turnover rates for all the three types of staffing (RNs, LPNs, and CNAs). Moreover, NHs with high RN turnover rates had low RN staffing, higher CNA staffing, lower occupancy rates, and higher share of Medicaid residents. High nurse turnover can adversely affect resident outcomes—for instance, due to reduced continuity of care. As such, it is important to closely monitor contract nurse staffing levels and their implications on staffing and resident outcomes.
INTERDISCIPLINARY APPROACHES TO EPIDEMIOLOGY AND PREVENTION OF FALLS IN OLDER ADULTS
Authors: Li Wenjun , Li Wenjun 
Published: December 2023

Abstract
Prevention of falls is important to independent living and good health in older age. This symposium brings together five interdisciplinary studies on falls among community-dwelling older adults. The first presentation examines the relationship between multisite pain and fear of falling among older adults with dementia. The second discusses the differential effects of anxiety on indoor vs. outdoor falls. The cohort study found that anxiety was associated with higher rate of indoor but not outdoor falls. The third investigates racial differences in association of accelerometer measured physical activity with indoor and outdoor falls. The study found that a 30-minutes increase in moderate-to-vigorous intensity physical activity was associated with 25% lower rate of indoor falls and 42% higher rate of outdoor falls among non-White but not White participants, an interesting example of effect modification by race and location of falls. The fourth reports findings of a cross-sectional survey of older adults in Thailand which observed high prevalence of falls, and substantial differences in fear of falling, daily activities and quality of life between fallers and non-fallers, and between persons with and without fear of falling. The fifth reports rural-urban differences in circumstances and correlates of falls from the same study in Thailand. The study found higher fall rates, higher level of fear of falling and worse general health in urban than rural residents, highlighting the need for considering urban-rural differences in falls prevention. Together, these studies demonstrate the complexity and promises of interdisciplinary approaches to falls research.
A FRAMEWORK FOR CONSIDERING SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH IN ALZHEIMER’S DISEASE RESEARCH AND CARE
Authors: Stites Shana 
Published: December 2023

Abstract
Social and structural determinants of health (SSDoH) refer to the conditions in which individuals live, work, and age. SSDoH can have cumulative effects across the life course that can have an impact on outcomes for persons with Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD) and their family members. In our two-part presentation, we first describe the theoretical and empirical underpinnings of core SSDoH constructs in AD/ADRD research and practice. We review empirical support for the specific SSDoH that we include and highlight their relevance in the care of older adults. The core set of SSDoH that we focus on have been identified as being important across a broad range of socially and culturally heterogeneous populations and we walk through the strengths and limits of this. We also report results from data obtained during a pilot test of these measures in the UPenn Alzheimer’s Disease Research Center (ADRC), which offer empirical support of their cultural appropriateness. We outline a rationale for the consideration of SSDoH in aging and AD/ADRD research, policy, and practice. In the second part of our presentation, we offer a case example of how sex, gender, and sexual orientation operate as core SSDoH in the healthy, aging population and in the care of older adults. In our case example, we also overview definitions, clinical considerations, and policy applications.
ONEIDA HELPING ONEIDA: DECISION MAKING ABOUT SERVICE USE BY ONEIDA NATION FAMILY CAREGIVERS
Authors: Wyman Mary , Buerger-Cole Haley , Lambrou Nickolas , Perzynski Joseph , Lawrence Sacheen , Miller Debra , Petri Florence , Lewis Jordan 
Published: December 2023

Abstract
Native American communities are disproportionately impacted by Alzheimer’s disease and related dementias and are more likely to identify as family caregivers compared to other racial groups. Caregiver resources such as educational, supportive, and respite services have been shown to decrease burden and improve health outcomes. However, government and tribal services to support caregivers are underutilized. Using a CBPR approach, within the framework of an existing partnership between the Oneida Nation of Wisconsin and the Wisconsin Alzheimer’s Disease Research Center, all phases of research were conducted with Oneida partners. We used a mixed-method approach to gain a better understanding of the cultural and community-related factors impacting resource utilization by Native American dementia caregivers. Ten caregivers of older adults with memory loss completed surveys followed by in-depth interviews. Caregivers were aged 38-69 years, 90% female, and living on or near the Oneida reservation; time caregiving varied from &lt;1 to &gt;10 years. Most care recipients had not received a formal diagnosis of memory disorder. Interviews revealed barriers to service use including low awareness, complexities of service funding structures, and care recipient preferences. Perceptions of alignment of traditional cultural values with service use were nuanced and varied. Our findings underline the multiple factors impacting Native families coping with dementia and contribute to the scant literature on ADRD caregiving among Native Americans. Results can inform public health initiatives to address ADRD disparities and improve outcomes for Indigenous persons with ADRD.