bluuebunny/crossref_metadata_2025_split huggingface dataset:
A MOBILE HOME HEALTH CARE PHYSICIAN FOR OLDER PERSONS WITH EXTENSIVE HEALTH CARE NEEDS
Authors: Emmesjö Lina , Hallgren Jenny , Aslan Anna Dahl , Gillsjö (Gillsjo) Catharina 
Published: December 2023

Abstract

Background
The rapidly increasing older population with extensive care needs has shifted health care from institutions to the older person’s home. A cross-organisational integrated care model was created by health care authorities to meet these challenges, the Mobile integrated care model. The Mobile integrated care model with a home health care physician is a collaboration between regional and municipal health care, working in the patients’ home.

Methods
Semi-structured interviews with patients, next of kin and health care professionals.

Results
The home was described by all as the best place to provide health care to these patients, creating safety and increasing autonomy for the patients. The health care professionals found trust in working together as a team, but struggled because of the divided organizations. Patients and next of kin found the Mobile integrated care model to be hierarchic, where the structure sometimes improved participation, and at other times prevented it.

Conclusion
All participant groups emphasized that there was a need for more time for the health care personnel to spend with the patients. Furthermore, the patients and next of kin longed for a personal contact and being able to form a relationship with the health care personnel. The health care professionals found being employed by separate organizations as a challenge, where divided documentation systems and lack of equipment hindered the work.
RELIGIOSITY AND THE CONTROL OF DIABETES MELLITUS TREATMENT IN THE ELDERLY
Authors: Sales Juarez , Volpe Cris Renata , Lima Luciano , Stival Marina , Funghetto Silvana 
Published: December 2023

Abstract

Introduction
Diabetes Mellitus (DM) is an important health problem that affects thousands of Brazilians. Patients affected by the disease have many difficulties in following the correct treatment. Many studies point to religiosity as a factor that influences the health conditions of individuals. Objective: The study aimed to evaluate the influence of religiosity on diabetes mellitus treatment control in the elderly. Method: This is an outpatient-based explanatory cross-sectional study, in which a quantitative approach was taken. The study was conducted with 72 elderly people treated in primary health care in the Federal District. The instrument to evaluate the religiosity of the elderly was constructed through the defining characteristics and related factors of the NANDA-I nursing 6 diagnosis of impaired religiosity.

Results
Environmental barrier to the practice of religion was found to be a risk factor for DM treatment uncontrolled.

Conclusion
Religiosity plays an important role in the lives of the elderly, so it is becoming increasingly important to conduct research that assesses the importance of religion in the health-disease process of individuals. Nevertheless, nursing professionals must be attentive to this field of life attribute of the elderly and always encourage better relations of the patient with his religiosity.
ACCELEROMETRY-BASED PHYSICAL ACTIVITY (MIMS/DAY) AND FALL RISK APPRAISAL MATRIX IN OLDER ADULTS
Authors: Choudhury Renoa , Park Joon-Hyuk , Banarjee Chitra , Fukuda David , Xie Rui , Stout Jeffrey , Thiamwong Ladda 
Published: December 2023

Abstract
Fall Risk Appraisal Matrix (FRAM) is vital for understanding the discrepancy between perceived fall risk (i.e., Fear of Falling, FOF) and physiological fall risk (i.e., balance performance) in older adults. However, little is known about how habitual physical activity (PA) levels, expressed in Monitor Independent Movement Summary (MIMS) units, differ across FRAM categories. This cross-sectional study examines the associations of FRAM and wrist-worn accelerometer-based daily PA in community-dwelling older adults. FOF (Short FES-I scale), balance performance (BTrackS Balance) and PA data (ActiGraph GT9X) were collected from 156 older adults (Mean age = 76.74±9.62 years). FRAM categorizes the participants into four groups: i) Rational (low FOF-normal balance), ii) Incongruent (low FOF-poor balance), iii) Irrational (high FOF-normal balance), and iv) Congruent (high FOF-poor balance). PA data were summarized as MIMS/day (the average of daily MIMS) and peak 30-minute MIMS (the average of highest 30 non-consecutive MIMS minutes/day, representing a PA index of higher intensity epochs). Differences across groups were examined using one-way analysis of variance (ANOVA). Results indicate that, total accumulated PA (i.e., average daily MIMS) was 17% lower in Congruent FRA group than Rational FRA group (p=.02). The peak PA effort (i.e., peak 30-minute MIMS) decreased in Incongruent (9%, p=.027), Irrational (12%, p=.002) and Congruent (16%, p=.003) groups as compared to the Rational FRA group. Our results suggest that fall intervention strategies should integrate both cognitive behavioral therapy (for reducing FOF) and balance exercises to promote high-intensity PA in older adults.
ADHERENCE TO INTERVENTIONS AT A FALL CLINIC: PRELIMINARY DESCRIPTIVE DATA FROM A SINGLE ACADEMIC INSTITUTION
Authors: Shichijo Yuka , Ko Fred , Slon Renee , Rughwani Nisha , Yamada Yuji 
Published: December 2023

Abstract

Background
Falls and fall-related injuries are major public health concerns. Approximately 50 billion dollars are spent on annual medical costs related to falls. Fall prevention is a priority for promoting active and healthy aging in older adults. Fall prevention clinics enable focused evaluation, identification, and treatment of modifiable risk factors, specifically for falls; however, their effectiveness is dependent upon patient adherence to preventive interventions.

Methods
We analyzed patients aged &gt; 65 years who visited our fall clinic between February 2021 and February 2023. We took an interdisciplinary approach to improve adherence to recommendations, including follow-up phone calls by a dedicated nurse to confirm adherence, nurse-directed interventions such as Tai Chi sessions, and home environment assessments by a social worker.

Results
48 patients were included in this analysis, with a mean age of 84 (65-99), and 85% were female. Fall-specific risk factors identified included impairment of strength, gait, or balance (96%); use of fall-risk-increasing medications (54%); problems with feet affecting gait (40%); visual impairment (29%); and postural hypotension (6%). The adherence rates for our interventions were 48% for physical therapy referrals, 28% for podiatry referrals, 36% for ophthalmology referrals, 47% for other referrals, 75% for vitamin D prescriptions, and 50% for assistive device prescriptions.

Conclusions
There is room for improvement in adherence to referrals. A larger sample size and longer follow-up period are required to investigate factors related to non-adherence. The delivery of both verbal and written recommendations, the identification of each patient’s barriers, and same-day referrals may help improve adherence.
ARE COMPLETING ONLINE ASSIGNMENTS CORRELATED TO KIRKPATRICK’S LEVEL 2 AND 3 LEARNING OUTCOMES?
Authors: Cheng Huai 
Published: December 2023

Abstract

Background
Pre-class assignments such as online assignments are critical to a flipped classroom-based curriculum. However, it is unknown whether medical students are following online assignments and whether such compliance is associated with learning outcomes. The aim of this study was 1) to examine the compliance of the online assignments and 2) explore whether such compliance was associated with Kirkpatrick’s Level 2 and 3 learning outcomes. Summary of Works: Prior to classroom teaching, fourth-year medical students (MS4) were recommended (not required) to complete six online assignments. A simulated patient (SP) with chief complaint of fall was developed to assess students’ skills in interview, physical examination, and communication (Kirkpatrick’s level 2 learning outcome). Students’ clinical practice behavior was based on chart review (Kirkpatrick’s level 3 learning outcome). Pearson/Fisher correlations were used to examine the association of completing online assignments with SP performance and clinical practice behavior. Summary of

Results
158 from Class 2017 participated in this study. The complete rate of 1-6 online assignment was 88%, 86%, 82%, 61%, 51%, 34%, respectively. Completing three of six online assignments was significantly associated with higher SP performance, but not clinical practice behavior. Discussion and

Conclusions
Majority of MS4 didn’t complete online assignments. Online assignments should be required. Completing online assignments was associated with improving Kirkpatrick’s level 2, but not 3 learning outcomes. Take-home Messages: Online assignments need to be required. Improving Kirkpatrick’s level 2 learning outcome via a flip-based curriculum for MS4 might not improve Kirkpatrick’s level 3 learning outcomes.
ASSOCIATION BETWEEN COGNITIVE FRAILTY AND THE RISK OF FALLS AMONG OLDER ADULTS: A SYSTEMATIC REVIEW
Authors: Wang Shanshan , Yin Yueheng , Leung Isaac Sze Him 
Published: December 2023

Abstract

Background
Falls lead to numerous negative health outcomes and jeopardize the physical function and quality of life in older adults. Cognitive impairment and physical frailty were found to be associated with the risk of falls, but there was no systematic review that estimated the association between cognitive frailty and the risk of falls.

Methods
A systematic literature search of the cross-sectional, cohort, and case-control studies in Cochrane library, Scopus, CINAHL, EMBASE, and PsycINFO was conducted. Study quality was assessed by using the Joanna Briggs Institute (JBI) critical appraisal tool. A random effects meta-analysis was performed to estimate the odds ratio (OR) of the incidence of falls in older adults with cognitive frailty.

Results
Seven studies were included. The overall quality of the studies was acceptable. The meta-analysis of cohort studies showed older adults aged 60 and above with cognitive frailty had a pooled OR of 1.45 (95%CI 1.30, 1.61) for at least one fall compared with those without cognitive frailty. The meta-analysis of cross-sectional studies showed that the odds of older adults with cognitive frailty experiencing at least one fall was 1.64 times (95%CI 1.51, 1.79) higher than those without cognitive frailty.

Conclusion
Cognitive frailty is significantly associated with the risk of falls. Timely detection of cognitive frailty is essential for preventing falls in older adults
CAREGIVING APPROACHES TO RESISTIVE BEHAVIORS AMONG PERSONS LIVING WITH DEMENTIA IN LONG-TERM CARE
Authors: Lee Kyung Hee , Lee Ji Yeon , Park Ji Yeong 
Published: December 2023

Abstract
Many older adults living in long-term care have dementia sufficiently severe to interfere with the performance of basic activities of daily living; this number is expected to increase rapidly. Although resistive behaviors are common among long-term care residents with dementia during care, caregivers face difficulty to prevent and manage them. The purpose of this study was to examine how caregivers responded to resistiveness to care of persons living with dementia. We analyzed 107 videos from 24 residents with dementia and 34 caregivers in four long-term care facilities. Each interaction between resident with dementia and caregiver was taken nine times at 0, 3, and 6 months at three care events (i.e., personal care, mealtime, and activity). Resistiveness to care was assessed using the Resistiveness to Care Scale for Dementia of the Alzheimer’s Type; caregiving approaches were coded by the Person-Centered Behavior Inventory and the Task-Centered Behavior Inventory. Lag sequential analysis was conducted to examine caregiving approaches right after resistive behaviors of residents with dementia. We analyzed 25.1 hours of care events; 544 episodes of resistiveness to care were observed. When residents with dementia showed resistiveness to care, caregivers provided person-centered behaviors in 34.4% of cases, task-centered behaviors in 35.8% of cases, and nothing in 29.8% of cases. Caregivers used task-centered care approaches or nothing to manage resistiveness to care in more than 65% of cases. It is recommended to provide person-centered caregiving approaches to deal with resistiveness to care among persons living with dementia.
EXPLORING THE IMPACT OF AN EBOOK CLUB PROGRAM ON APATHY AMONG OLDER CANADIANS IN LONG-TERM CARE: A FEASIBILITY STUDY
Authors: Agboji Aderonke , Freeman Shannon 
Published: December 2023

Abstract
Apathy is a common and persistent problem among older people in institutional settings. Research has shown that apathy can lead to rapid decline in cognitive status, serious functional impairments and decrease in the life span of those affected, yet it is under-researched, and under-managed. The aim of this study was to explore ways by which apathy can be mitigated in this population using eReader technology during book club program implementation. We recruited participants from various long-term care facilities (N=18) and each participants took part in semi-structured interviews, and self-reported apathy assessment both at the start and end of the program. We tracked engagement in the eBook club and time commitment to reading using a logbook. The findings suggest that older people, including persons with mild to moderate dementia, are open to adopting new technologies and the use of eReaders during book club programs is feasible for long term care facilities. Overall, we found that the use of eReader technology is a safer and more effective way of delivering book club program to older people in long term care facilities particularly during pandemic such as COVID 19 as they are easy to disinfect in comparison to physical books. We recommend that long term care staff should adapt eReaders into their existing book club or literacy programs and consider utilizing it as a strategy to prevent or manage apathy in this population.
FEASIBILITY OF THE NUDGELTC CLINICAL DECISION SUPPORT APPLICATION
Authors: Ashcraft Alyce , Owen Donna , Culberson John 
Published: December 2023

Abstract
Long-term-care residents are at risk for under reporting of urinary tract infections due to insufficient point-of-care testing and indirect communication. Aim: Examine the feasibility of a Clinical Decision Support application (NudgeLTC) designed to guide Licensed Vocational Nurses (LVNs) in data collection to improve communication confidence and satisfaction between LVN and Primary Care Provider (PCP). Sample size: 4 LVNs and 4 PCPs across 10 events. Qualitative description of interview comments and NudgeLTC output documented data collection and communication between LVN and PCP within the app. Forced choice questions about resident signs, symptoms, and laboratory values guided LVN data collection. Information was collected and stored within NudgeLTC. A summary was relayed directly to the PCP and followed with a PCP response to the LVN. Questionnaires included visual analogue scales for confidence (LVNs M=81.6; PCPs M=100 [0 low, 100 high]), satisfaction (LVNs M=7.8; PCPs M=10 [0 low, 10 high]), and the Systems Usability Scale (LVNs M=85.4; PCPs M=100 [0 poor, 100 high]). The NudgeLTC summary included resident assessment, vital signs, and lab values. Particular signs and symptoms noted included indwelling catheter and confusion. Select Challenges: PCP received LVN message and data, but was unable to respond via app; LVN stated the app did not work as “expected.” Transmission issues occurred and were resolved. Asynchronous communication was valued and facilitated confidence in resident data. Difficulties with data collection may, in part, be due to discomfort with technology or infrequent use of electronic charting. Future studies should focus on improving point-of- care data collection.
IMPACT OF UNIFORMS IN LONG-TERM CARE FACILITIES: SYNTHESIS OF INTERNATIONAL EVIDENCE AND SURVEY OF UK STAFF VIEWS
Authors: Liddle Jennifer , Thomson Katie , Al-Azawi Abdulwahab , Esslemont Dawn , Hanratty Barbara , Henderson Christine , Jones Louise , Wilson Lisa 
Published: December 2023

Abstract
Non-uniform-based staff dress codes are beginning to emerge in UK long-term care facilities for older people. However, there is little research evidence on the impact of staff clothing on resident, staff and visitor experiences, wellbeing or quality of life. Uniforms may be reassuring and facilitate identification of staff; a non-uniform approach may create a home-like, relaxed environment. This study aimed to synthesise existing international evidence and explore staff views about work clothing in three not-for-profit long-term care facilities in the UK. Five bibliometric databases were searched from inception. A narrative synthesis of included papers was conducted due to heterogeneity of study designs and outcome reporting. 77 (49%) of 158 staff responded to the survey. 68 staff (88%) did not currently wear a uniform at work. Views about the importance and impact of uniform were mixed: 25 (32%) believed that their role needed a uniform; 60 (78%) thought staff clothing made no difference in resident care quality but 45 (58%) agreed the environment felt more home-like when staff did not wear a uniform. 36 staff (47%) would choose to wear a uniform and 17 staff (22%) reported finding it difficult to afford clothes for work. In the context of limited research evidence, staff clothing is perceived to have little impact on care quality but considerable impact on long-term care facility atmosphere and staff working experiences. There is a need to research the impact of staff clothing to support evidence-based decisions about staff clothing policies in long-term care settings.
REDUCING UNPLANNED HOSPITALIZATIONS OF NURSING HOME RESIDENTS: A PROCESS EVALUATION OF INTERCARE
Authors: Zuniga Franziska , Brunkert Thekla , Basinska Kornelia , Guerbaai Raphaëlle-Ashley , Serdaly Christine , Wellens Nathalie 
Published: December 2023

Abstract
The INTERCARE study provided evidence for a complex intervention to reduce unplanned hospitalizations in 11 Swiss nursing homes. The six intervention components were strengthening of interprofessional collaboration, introduction of a nurse with in-depth geriatric training (INTERCARE nurse), comprehensive geriatric assessment, advanced care planning, evidence-based tools, and data-driven quality improvement. This process evaluation aims to describe the intervention components’ use in practice and understand the mechanisms of change to optimize intervention components for scale-up. We used qualitative data from individual and focus group interviews and meetings notes from the research team’s conversations with nursing home care workers and leadership, INTERCARE nurses and physicians from five nursing homes participating in the INTERCARE study. Data was extracted into spread sheets before starting inductive coding. Findings were summarized and consolidated in a conceptual model. In connection with the four intervention elements interprofessional collaboration, INTERCARE nurse, advanced care planning and evidence-based tools, we identified four intervention mechanisms, grouped into 1) those changing reasoning of care workers e.g., following a more structured approach to do things and 2) those enabling existing resources e.g., availability of a responsible contact person. We also identified behavior changes in care workers, including faster reaction to changes in resident situations, more comprehensive assessment of resident situations and improved communication which contributed to reductions in hospitalizations. Understanding how interventions work in practice is crucial for informing potential adaptations to the intervention and the implementation strategies. Our findings can help optimize the intervention components for scale-up, ultimately reducing unplanned hospitalizations from nursing homes.
WHAT IS THE DIFFERENCE BETWEEN OLDER PERSONS WHO CONTINUE HOME CARE AND THOSE WHO DO NOT?
Authors: Sumikawa Yuka , Eltaybani Sameh , Fukui Chie , Igarashi Ayumi , Yamamoto-Mitani Noriko 
Published: December 2023

Abstract
Enabling older people to remain in and return to their homes after hospitalization or institutionalization (i.e., admission to care institutions, such as nursing homes), if they wish so, is a key principle of aging-in-place worldwide. This prospective cohort study examined the characteristics of older people who returned to their homes after hospitalization or their stay at other care facilities. The study started with 1,450 older persons (≥75 years) receiving home care services at multiple places in Japan. Data were collected at the baseline and 6-month follow-ups. The study was approved by the Research Ethics Committee of the Graduate School of Medicine, The University of Tokyo (No. 2019087NI). At the 6-month follow-up, 256 clients (female: 152 clients, mean age: 85.1 ± 6.1) were hospitalized or institutionalized at least once, of which 54 clients (female: 38 clients, mean age: 83.6± 6.8) returned home afterward. A multivariate logistic regression showed that females (odds ratio [95% confidence interval]: 2.01 [1.06 to 4.09]), those with more care assistance (1.27 [1.03 to 1.55]) were more likely to return to their home, whereas older clients had a lower likelihood (0. 93 [0.88 to 0.98]). Based on this finding that younger females were more likely to return home if hospitalized or institutionalized, older males may have different needs than females, influencing the type and level of support they require. Further research might identify the support needed for older males with less care assistance.
ACTIVITY LEVEL AND SUCCESSFUL AGING, SUBJECTIVE AGE, AND MENTAL, PHYSICAL, AND GENERAL HEALTH
Authors: Mancilla Isabel , Rivera Lucia , Bergstrom Jaclyn , Molina Anthony 
Published: December 2023

Abstract
Perceived well-being refers to an individual’s subjective evaluation of their quality of life. Importantly, perceived well-being takes into account an individual’s emotional, social, and psychological health, which are all critical components of a fulfilling and satisfying life. The purpose of this study is to evaluate the correlations between activity level from the International Physical Activity Questionnaire (IPAQ) and self-reported outcomes related to perceived well-being (successful aging, subjective age discrepancy), and mental, physical, and general health outcomes from the 36 Item Short Form Survey (SF-36). We utilized existing data from 595 individuals aged 50 years or older enrolled in UC San Diego’s Successful Aging Evaluation (SAGE) study. Participants were stratified into low, medium, and high activity levels from the IPAQ. Groups were then compared to self-rated successful aging, subjective age questions, and the SF-36. Our results indicate that increased physical activity is positively associated with subjective successful aging. We observed a significant linear trend in IPAQ physical activity correlated to mental health (p=.0242), physical health (p=&lt;.0001), and general health (p=(&lt;.0001). A possible limitation of this study includes that of the 595 participants, 81% of participants identified as Caucasian. It is critical for future studies to incorporate a more diverse sample size to accurately present future findings. Understanding the factors that influence perceived well-being can lead to strategies for improving the overall outlook to support successful aging.