bluuebunny/crossref_metadata_2025_split huggingface dataset:
NAVIGATING CAREWORKER CURRICULUM REVISION IN SOUTH KOREA: CHARTING COURSES FOR ELEVATING PRACTICE COMPETENCIES
Authors: Park Jihyun , Kim Jinhak , Sung Mira 
Published: December 2023

Abstract
The purpose of this study is to comprehensively investigate and analyze the process of revising the careworker curriculum in South Korea with a primary focus on augmenting practice competencies. This research involved an analysis of the existing 240-hour curriculum, complemented by a comprehensive literature review. Additionally, Focus Group Interviews were conducted with a cohort of 20 present careworkers to effectively identify the prevailing needs within the practice field. This study expanded the curriculum duration from 240 to 320 hours. Subsequently, pilot courses were executed, incorporating enhanced content related to dementia care, humanity in caregiving, and infectious disease management. These modifications were delivered via webinars to 64 active care workers, a method chosen due to the constraints imposed by the COVID-19 pandemic. This study employed a pre-post design to inquire about the perceptions of older adults and their job skills. Fifty-four female care workers (84.2%) and eleven male care workers (15.8%) participated in the study, with an average age of 52 years, experiencing 3 years and 8 months. Several areas exhibited statistical significance; understanding and managing depression and anxiety (2.175*), supporting leisure activities(2.956**), implementing abuse prevention behaviors (3.187**), creating a safe environment(2.496**), assisting with mobility(2.978**), aiding in illness management(2.805**), transferring responsibilities(2.726**), documenting cases(2.238*), and overseeing caregiver health and safety(2.805*). Based on our findings, we have devised a plan to incorporate the following content within the additional 80 hours. In a broader context, this study contributes to the ongoing discourse on caregiver education and training in South Korea.
NAVIGATING LIFE’S PHASES: CONTROL PERCEPTIONS AND GOAL ORIENTATION IN YOUNGER AND OLDER AGE GROUPS
Authors: Muskin Ryan , Allard Eric , Suri Sachin 
Published: December 2023

Abstract
This study examines age-related differences in the perceptions of control and goal orientation among younger adults (ages 18-35) and older adults (aged 60+). A cohort of 57 younger adults and 51 older adults were exposed to a series of emotionally evocative videos portraying diverse scenarios involving varying levels of control and distinct growth or preservation goals. Participants evaluated perceived control, growth orientation, and preservation orientation using 10-point Likert scales. Our findings reveal significant disparities between the two age groups. Older adults exhibited diminished perceptions of control across all videos (p &lt; .001) compared to their younger counterparts. Conversely, younger adults consistently displayed a heightened sense of growth orientation across the videos (p &lt; .001), without significant age-based variations in perceptions of preservation goals. These outcomes contribute to our comprehension of developmental trajectories in perception and relevance appraisal, along with emotion evaluation. Our hypothesis posits that the disparity in control perceptions stems from age-related losses such as diminished cognitive and physical capabilities, as well as experiences like bereavements. In contrast, the robust growth, competition, and development characteristic of younger adulthood may foster the tendency to perceive the world through these lenses. By shedding light on the intricate interplay between age, control perceptions, and goal orientations, this study advances our understanding of cognitive and emotional dynamics across the lifespan. The implications are far-reaching, offering insights into potential interventions for age-related emotional well-being and adaptive coping strategies.
NEIGHBORHOOD STRESSORS AND EPIGENETIC AGING AMONG OLDER ADULTS IN THE U.S
Authors: Choi Eunyoung , Ailshire Jennifer 
Published: December 2023

Abstract
Exposure to stressful neighborhood environments is a well-established risk factor for health deterioration and premature death. However, the underlying biological underpinnings driving these associations are not fully understood. Epigenetics may function as a key molecular pathway to adverse health outcomes among residents of high-stress neighborhoods. This study examines the association of neighborhood stressors (i.e., socioeconomic deprivation, disorder, and low social cohesion) with three epigenetic aging measures (i.e., DunedinPACE and Principal component adjusted (PC) PCPhenoAge and PCGrimAge) based on DNA methylation levels. Further, we identify sub-populations that are particularly vulnerable to the detrimental effects of neighborhood stressors. Data were from the 2016 Health and Retirement Study (HRS) DNA Methylation Sample, merged with neighborhood stressors measured in the HRS 2012/2014 and the 2012-2016 American Community Survey (N=3,201). Multilevel regression models adjusting for confounders showed that perceived high disorder was associated with accelerated DNAm aging for DunedinPACE (β=0.13, 95%CI=0.04-0.23). Perceived low cohesion was associated with accelerated DNAm aging for DunedinPACE (β=0.21, 95%CI=0.08-0.35) and PCGrimAge (β=0.09, 95%CI=0.04-0.14). High deprivation did not have any significant associations. In models of interactions, associations of low cohesion were more pronounced for females in DunedinPACE (β=0.36, 95%CI=0.13-0.60) and PCPhenoAge (β=0.21, 95%CI=0.07-0.35). No other interaction effects were found for race/ethnicity, living arrangement, and education. Our findings indicate that neighborhood stressors can speed up epigenetic aging, with older females being particularly vulnerable to the effects of low cohesion. This study provides insights into the biological foundations of health disparities rooted in neighborhood environments.
NURSING HOME INVESTMENT IN HEALTH INFORMATION TECHNOLOGY – AN ORGANIZATIONAL SLACK PERSPECTIVE
Authors: McHugh John , Alexander Gregory 
Published: December 2023

Abstract
Organizational slack refers to excess resources (e.g., financial, social capital, human capital) an organization accumulates to adapt to changing internal and external contexts. Nursing homes operate in a severely resource-constrained environment, and therefore have limited ability to accumulate organizational slack. However, nursing homes that do accumulate slack may be more likely to invest in health information technology (HIT). To test this, we examine associations between organizational slack and HIT maturity. HIT maturity is the level of IT capabilities, extent of use, and integration in resident care, clinical support, and administration. We linked 2018 data from a national nursing home HIT maturity survey (N=525) to nursing home characteristics from LTCfocus.org, CMS data, National Center for Health Statistics, Medicare cost reports, and other county-level statistics. We incorporated Simple Linear Regression, controlling for facility-level sex, race, case-mix, and urban/rural location. Average 3-year operating income for Stage 0 nursing homes was -$4,387 per bed (n=7) compared to $42,768 per bed in Stage 6 nursing homes (n=17). Higher HIT maturity was associated with greater percentages of Medicare patients and shorter distances to the closest hospital. Our regression model also demonstrated significant associations with operating income per bed, chain affiliation, total beds, occupancy percentage, moderately concentrated counties and case-mix adjusted staffing. In this sample, larger, more financially stable organizations (i.e., those with more slack) may be able to invest more in HIT. As HIT maturity has been shown to be associated with improved patient outcomes, disparities may widen in organizations with lower levels of slack.
NURSING STUDENTS’ EXPERIENCES REGARDING PHYSICAL RESTRAINTS: AN INTEGRATIVE REVIEW
Authors: Shin Juh Hyun , Kong Eun-Hi 
Published: December 2023

Abstract
Many harmful effects related to the use of physical restraints have been reported and restraint-free care has been advocated for in many countries. However, the prevalence of physical restraint use is still high in many care settings around the world. There has been no systematic review study focused on nursing students regarding physical restraints. This study aimed to critically review the existing studies targeting nursing students related to physical restraint using an integrative review method. This study was registered in PROSPERO(CRD42023414410). Eleven electronic databases were searched by two authors: CINAHL, PubMed, EMBASE, PsycINFO, ERIC, Education Source, SCOPUS, RISS, DBpia, Cochrane, and KoreaMed from the earliest year to 2023. A total of 19 studies including diverse research designs were selected. For quality appraisal, both the Mixed Methods Appraisal Tool (MMAT) and the Joanna Briggs Institutes (JBI) checklist were employed. Most studies were conducted in acute clinical care settings. Many studies used a cross-sectional study design, convenience sampling method, small number of participants, and weak measurements. There was a lack of experimental studies, mixed methods studies, and financially funded studies. The main outcomes were nursing students’ attitude, knowledge, perception, or practice regarding physical restraints. This integrative review provided new knowledge and understanding about nursing students’ experiences regarding physical restraints. Future studies must use more robust research design, sample size, and measurements with research funding. This study showed that more research and education targeting nursing students are needed to achieve restraint-free care.
NUTRITIONAL STATUS AS A RISK FACTOR FOR DEPRESSION AMONG OLDER ADULTS RECEIVING COMMUNITY-BASED AGING SERVICES
Authors: Goldsworthy Mary , Boaz Timothy , Gum Amber , Schonfeld Lawrence 
Published: December 2023

Abstract
Nutritional status is a significant determinant of overall health and well-being among older adults and is linked to adverse mental health outcomes, such as depression. This study examined nutritional status as a risk factor for depression among 4,469 older adults receiving home- and community-based services from agencies overseen by a five-county Area Agency on Aging in west central Florida. It was hypothesized that older adults with a higher nutritional score (i.e., increased risk of malnourishment) would be more likely to have elevated depressive symptoms compared to those with lower nutritional risk. The cross-sectional study used secondary data from the AAA, including demographic and social variables, a 20-point nutritional risk score, and the Patient Health Questionnaire-9 (PHQ-9; not depressed = 0-9, depressed = &gt;10) from clients in the AAA planning and service area. In logistic regression, the most significant predictor of depression was the client’s nutrition score (OR= 1.22, p &lt; 0.0001). This OR suggests that, for every 1-point increase of the nutrition score, the odds of being depressed increases by 22%. The findings suggest that older adults receiving aging services with worse nutritional status are at increased risk of depression, consistent with other studies. The findings suggest that programs focused on improving nutritional status among older adults may reduce depressive symptoms may improve and may potentially improve long-term physical and mental health outcomes and decrease healthcare burden.
OFFSPRING EDUCATIONAL (DIS)ADVANTAGE, MECHANISMS, AND COGNITIVE FUNCTION IN KOREA
Authors: Cha Hyungmin 
Published: December 2023

Abstract
Adult children’s education plays a significant role in parental cognitive well-being later in the life course. However, there is limited evidence in rapidly changing societies, leaving several key questions unanswered, including (1) whether the effects of offspring educational disadvantage can also flow upward, (2) whether these effects operate through similar explanatory mechanisms, such as financial, social, and informational support from their children, as seen in educational advantage, and (3) whether gender moderates these associations. Focusing specifically on Korea, a society where education has expanded rapidly and support from children is increasingly crucial, this study utilizes longitudinal data from the Korean Longitudinal Study of Aging (2006-2018) to demonstrate the role of offspring education in cognitive function during mid-to-late life. First, having adult children with a college degree or higher is associated with elevated levels of cognition and slower cognitive decline, whereas having adult children with less than a high school education is linked to lower levels of cognition and faster cognitive decline during mid-to-late life. Second, the association between adult children’s education and cognitive health, regardless of whether they have a college degree or less than a high school education, remains robust even after accounting for various other mediators. Third, while the effect of adult children’s education is more pronounced for mothers compared to fathers, children’s gender does not moderate the association. Together, I offer a novel explanation for the association between offspring educational advantage and disadvantage, and their connection to parental cognition and its subsequent decline in rapidly changing society.
ORGANIZATIONAL COMMUNICATION STRATEGIES IN NURSING HOMES: A SCOPING REVIEW
Authors: Gordon Julie , Smith Patsy 
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.
PERCEPTIONS OF OLDER ADULTS ON YOGA-BASED INTERVENTIONS FOR MULTIMORBIDITY IN MYSORE, INDIA
Authors: Muralidhar Kiranmayee , Madhivanan Purnima , Behal Anil , Srinivas Vijaya , Ningaiah Nagalambika , Jaykrishna Poornima , Shidhaye Rahul , Krupp Karl 
Published: December 2023

Abstract
Globally, over half of older adults suffer from ≥2 chronic diseases. In India, proven exercise interventions are limited by individual, social, environmental and policy-level factors. We aimed to qualitatively explore perceptions about yoga interventions for healthy aging in Mysore, India. In collaboration with the Community Advisory Board, we developed a qualitative assessment of knowledge, attitudes and behaviors around yoga among seniors. Between August-September 2022, we conducted focus group discussions (FGDs) with older adults, after obtaining informed consent. Interviews were recorded, transcribed, and translated from the local language Kannada. Data were coded manually, and emerging themes were identified. We conducted 4 FGDs of 7-8 participants each; 14 male and 13 female older adults participated, and their average age was 66.1±4.3 years; 88.9% had at least 10 years of education. Most participants expressed interest in yoga for health maintenance, specially mentioning its Indian roots, but did not prioritize it for routine practice. Yoga practice was also a means to reduce social isolation for many. Reported challenges in adopting yoga practice included inaccessibility to instructors and dependence on family members. Cultural barriers especially affected women, including ageism and gender role expectations. Women reported hesitancy to express their desire to learn yoga due to perceived negative reactions from their younger family members and their community. Promoting health promotion practices among older Indian adults is challenging primarily due to cultural norms and changing family dynamics with age. Promoting healthy behaviors among them through yoga will first involve family education and consent.
PERSON-CENTERED DEMENTIA TRAINING ONLINE FOR BSN STUDENTS: A PILOT STUDY
Authors: Sturdevant Diana , Broussard Kimetha , Kleszynski Keith , Jennings Lee 
Published: December 2023

Abstract
We launched a Person-Centered Dementia Training in March 2023, focused on Four interactive modules were offered via an Online Learning Platform. Topics included: Introduction to Dementia, Communication Process and Approach, Environmental and Cultural Implications in Dementia Care, and Best Practices in Responding to Difficult Behaviors. Subtopics included: Introduction to Age-Friendly and Dementia-Friendly Care, High-risk Medications and Dementia Care, Dementia vs Delirium, and Reframing Aging—Understanding and Recognizing Ageism Specific to People Living with Dementia. BSN students were recruited via (3) email blasts and (1) in-person announcement of participation opportunity. A total of (n=33) participants were recruited from 4 nursing programs, Traditional BSN Junior (34%), Traditional BSN Senior (48%), Degree Completion LPN to BSN (3%) and Accelerated BSN (14%). Most participants were female (96%), between the ages of 18-24 (60%). 24 participants completed the pre-/post-test and Final Program Evaluation. Participants rated the course content and structure as 4.5/5 on 5pt-likert scale. Common themes from evaluations included: need for additional content, more interactive activities, and inclusion as a required course for all nursing students. Future steps to include revising course content based on participant feedback, offer revised course over the next 2 academic semesters, and expand reach by offering course to practicing nurses to improve care of people living with dementia (PLWD).
PLANT PROTEIN BUT NOT ANIMAL PROTEIN CONSUMPTION IS ASSOCIATED WITH FRAILTY THROUGH PLASMA METABOLITES
Authors: Toshiko Tanaka , Das Jayanta , Tian Qu , Moaddel Ruin , Moore Ann Zenobia , Tucker Katherine , Talegawkar Sameera , Ferrucci Luigi 
Published: December 2023

Abstract
There is evidence that the association of protein intake and frailty may depend on the source of dietary protein. The mechanism underlying these associations are not clear. In this study, we explore circulating metabolites as mediators of the relationship between dietary protein and of frailty in participants of the Baltimore Longitudinal Study of Aging (BLSA). Cross-sectional analyses in 735 BLSA participants of associations between plant and animal protein intake and frailty. Usual protein intake from plant and animal sources were estimated with a Food Frequency Questionnaire (FFQ) and frailty was assessed with a 44-item Frailty Index (FI). Compared with the lowest quartile, higher quartiles of plant, but not animal, protein were associated with lower FI. Twenty-five plasma metabolites were associated with plant protein intake; of these, 15, including phosphatidylcholines, cholesterol esters, sphingomyelins, and indole metabolites mediated the association between plant protein intake and FI. The protective association between plant protein consumption and FI is mediated by lower abundance of lipid metabolites and higher abundance of tryptophan-related metabolites.
PREVALENCE AND CORRELATES OF DEPRESSION IN OLDER ADULTS: FINDINGS FROM THE LONGROAD STUDY
Authors: Xi Yitao 
Published: December 2023

Abstract
As an important public health issue, depression has been studied extensively in children and young adults. Epidemiologic data on depression for older adults are scant. The Longitudinal Research on Aging Drivers (LongROAD) project was a prospective cohort study of 2990 drivers aged 65-79 years at baseline and recruited between July 2015 and March 2017 from five sites (Ann Arbor, Baltimore, Cooperstown, Denver, and San Diego) in the contiguous United States. Study participants were assessed at baseline with the Patient-Reported Outcomes Measurement Information System (PROMIS). The objective of this study was to examine the prevalence and correlates of depression in older adults participating in the LongROAD project. Of the 2990 older adults studied, 186 (6.2%) participants had depression at the time of enrollment, with the lifetime prevalence of depression being 20.3%. Only 21.9% of the older adults with depression were taking antidepressants. A significantly higher prevalence of depression was found among those who were female (7.2%), not currently married (9.1%), with annual household income less than $20000 (11.9%), having diabetes (9.1%), having anxiety disorder (15.5%), with exercising routine (6.9%), and without doing volunteering work (7.9%). No significant difference was found between urban and rural residents, but urban residents had slightly higher depression prevalence (6.4%). About 1 in 16 older adults has depression. The majority (78%) of older adults with depression are not treated with antidepressants. Depression screening and treatment programs are needed for older adults, particularly women, those living alone, and those in poverty. Volunteering work could potentially decrease depression prevalence.
PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY ORGANIZATIONS FLIP THE SCRIPT IN RESPONSE TO COVID-19
Authors: Perry Morgan , McCall Stephen , Dorris Joseph , Nardone Michael , Turner Ani , Obbin Samuel , Stanik Christine 
Published: December 2023

Abstract
The Program of All-Inclusive Care for the Elderly (PACE) is a unique care delivery model providing comprehensive, community-based, person-centered services to older adults. The COVID-19 pandemic posed unprecedented challenges for PACE organizations to continue providing services while mitigating infection risk, and they were agile and creative in their response. This study leveraged two national surveys and six interviews with PACE directors to examine how PACE organizations met these challenges. The response rate was 71.2% for the first survey and 67.8% for the second. Results revealed a rapid transition of the PACE model from primarily center-based to home-based care. To aid this transition, PACE organizations redeployed staff, repurposed day centers, and leveraged technology, among other strategies. Most PACE organizations plan to continue delivering more services in the home, consistent with participant preferences. The findings from this study indicate that PACE organizations continued to keep participants at the forefront as they transitioned to a home-based model. These findings highlight PACE organizations’ ability to empower nursing-home-eligible older adults to remain living in their preferred residential setting and could inform lasting changes in PACE service delivery.