bluuebunny/crossref_metadata_2025_split huggingface dataset:
CLINICIAN EXPRESSIONS OF CONDOLENCE AFTER THE DEATH OF A PATIENT: AN INTERNATIONAL SURVEY
Authors: Van Ogtrop Katlynn , Nelson Sofie , Nouryan Christian , Carratu Kevin , Carney, MD Maria 
Published: December 2023

Abstract
There is little literature about expressions of condolence from providers to family members of those that have died, and no known literature reported during the COVID-19 pandemic. This study utilized an investigator-developed survey of healthcare clinicians about contacting families of patients who have died. It conducted via email and online from October to December 2021. Of 131 respondents, 67% were female, from 23 states, Canada, and UK. Half (49%) had &gt;15 years experience, and most (85%) were attending physicians. The majority (99%) reported that a patient had died in their care within last year, while 18% reported lost &gt;10 patients per month. Methods of condolences were phone calls, and personal letters. Most (67%) reported no change in contacting families, while 23% increased. When asked if they would be interested in education on expressing condolences, 47% responded “yes.” Barriers to condolences were time (64%), unsure of what to say (20%), afraid family will be upset (19%), medical/legal reasons (10%), no training (8%), and no personal relationship (7%). Most, (85%) reported that most calls “went well or better than expected.” Females (vs. male) reported often/always sending letters (45% vs 20%, p=0.13), and often/always calling by phone significantly more (71% vs 63%, p=0.04). Younger (&lt; 40) clinicians (vs. older) reported being very/moderately comfortable talking to families (72% vs 78%, p=0.79), phone calls (64% vs 69%, p=0.68) and personal letters (27% vs 42%, p=0.91). Nearly half of respondents requested training. This is a practice that should be further studied for clinician and family experience purposes.
MAINTAINING PERSONHOOD AND AUTONOMY: A GROUNDED THEORY OF COMMUNITY-BASED HOSPICE CARE TRANSITIONS
Authors: Mann Catherine , Sullivan Suzanne , Chang Yu-Ping 
Published: December 2023

Abstract
Supporting care transitions as decline occurs for patients facing serious illness and their families necessitates ongoing identification of person-centered, family-oriented goals. However, little is known about the process patients and caregivers undergo when making decisions while transitioning to home hospice care. Using a Straussian grounded theory approach, we explored processes patients and caregivers use when transitioning from cure- to comfort-focused care. Data were collected through eight interviews of patients, patient and caregiver dyads, and hospice nurses (n=11). Participants were recruited from hospice and palliative care agencies serving three counties in Western New York. Interviews were recorded and transcribed verbatim. Data were analyzed using constant comparative method. Our results generated a theory grounded in the process of maintaining personhood and autonomy (e.g., changing roles, losing sense of self, wanting to be heard, wanting privacy) while making decisions to transition to hospice care. This process includes five contemporaneous steps: Shopping for the right services (e.g., recognizing existing care limitations, overcoming systemic barriers), Involving caregivers (e.g., acting as an advocate, filling other family members in, accepting the patient’s decisions), Navigating the business of dying while living (e.g., dealing with legalities, planning for the end), Processing and expressing emotions (e.g., fear, anger, trauma, loss), and Seeking input as health declines/recognizing futility (e.g., pursuing a diagnosis, validating what is happening with the nurse and physician, recognizing options). The process identified in the study reveals important mechanistic targets for the development of interventions that promote patient-centered hospice care transitions in the home setting.
SERVICE PROVIDER PERSPECTIVES ON ADVANCE CARE PLANNING USE IN RURAL DEMENTIA PATIENTS AND CAREGIVERS
Authors: Zhang Peiyuan , Nketsiah Ebow , Noh Hyunjin 
Published: December 2023

Abstract
Compared to urban areas, advance care planning (ACP) utilization remains very limited in rural communities. ACP earlier in the disease trajectory is particularly important for people with dementia (PWD) due to its progressive nature affecting their decision-making ability. Considering well-documented benefits of ACP in improving quality of end-of-life (EOL) care, the rural vs. urban disparity may indicate poorer EOL quality for rural PWD. Moreover, research on factors affecting ACP use among PWD has been primarily based in metropolitan/urban areas. To address the knowledge gap, this study aimed to explore barriers and current resources for ACP of PWD from perspectives of health and social service providers in rural Alabama. Using a qualitative approach, semi-structured face-to-face interviews were conducted with 10 health and social service professionals serving older adults and their caregivers in rural communities of Alabama. Thematic analysis was used to find recurrent themes and patterns from transcribed interview data. Our analysis revealed four areas of barriers to rural PWD’s ACP: (1) PWD’s and caregivers’ lack of knowledge about ACP, dementia, EOL care options, and available resources, (2) misconceptions of completing formal documentations, (3) emotional barriers, and (4) limited access to existing resources. Elder law clinic and local Area Agencies on Aging were the most prominent, existing resources for ACP in rural Alabama. Participants also showed a type of misconception that a lawyer and/or a notary is required for ACP. The study highlighted an urgent need for social policy in ACP education for both caregivers and service providers in rural settings.
HEALTH STATUS AND ENVIRONMENTAL FACTORS ASSOCIATED WITH OLDER ADULTS’ MOBILITY IN 2021 COMPARED TO 2020
Authors: Choi Namkee 
Published: December 2023

Abstract
The COVID-19 pandemic has had significant negative impact on life-space mobility of people of all ages around the world. Using the 2019-2021 National Health and Aging Trend Study (N=3,063, age 70+) and the socioecological mobility framework, we examined the changes in the frequency of going outside among U.S. older adults between 2020 (during the pandemic) and 2021 (post-COVID vaccine). Respondents self-reported changes in their frequency of going outside: no change (=about the same), increased frequency (=more often), and decreased frequency (=less often). We then fit multinomial logistic regression to examine the associations of the changes in the frequency of going outside with physical, psychosocial, and cognitive health, environmental (COVID concerns and transportation) factors, and social media use, controlling for the 2020 frequency of going outside. We found that in 2021 compared to 2020, 13% and 16% of those age 70+ reported increased and decreased frequencies, respectively. Increased frequency was associated with social media use. Decreased frequency was associated with poor physical health, depression/anxiety, and perceived memory decline. COVID concerns and transportation problems, as well as female gender, age 90+, and being non-Hispanic Black, were also significant correlates of decreased frequency. In conclusion, most U.S. adults age 70+ appear to have resumed their 2019 level of frequency of going outside in 2021 after the COVID vaccines became available; however, 16% reported decreased frequency of going outside in 2021 compared to 2020. Older adults with physical, mental, and cognitive health challenges need help to increase their frequency of going outside.
NEIGHBORHOOD CHARACTERISTICS AND SLEEP PROBLEMS: MEDIATING ROLES OF HEALTH BEHAVIORS AND MENTAL HEALTH
Authors: Cheung Ethan Siu Leung 
Published: December 2023

Abstract
Existing studies have well-documented the relationship between the neighborhood environment and health among older adults. Yet very few have focused on how the neighborhood environment predicts late-life sleep quality. Using longitudinal data (Rounds 7-9) from the National Health and Aging Trends Study, this study examined the cross-sectional and longitudinal associations between neighborhood characteristics (physical disorder and social cohesion) and sleep problems among Americans aged 65 or older, as well as whether health behaviors and mental health mediated these associations. The analytical sample included 4,029 adults aged 65 or older. Logistic regressions with a lagged dependent variable were adopted to test longitudinal associations. Longitudinal mediation analyses were also used to examine the mediation effects of health behaviors and mental health. The results suggested that neighborhood physical disorder was a significant predictor of sleep problems cross-sectionally, whereas social cohesion was both cross-sectionally and longitudinally associated with sleep problems. Moreover, mediation analysis revealed that health behaviors and mental health significantly mediated the longitudinal relationship between social cohesion and sleep problems, though the strength of the indirect effect diminished over time. These findings suggest that neighborhood physical disorder and social cohesion are significant predictors of late-life sleep problems among older Americans. The study also highlighted older adults’ resilience and adaptability to adverse neighborhood environments and the long-term health benefits of social cohesion in late-life sleep quality. Therefore, community health interventions that facilitate older adults’ physical and social activity, along with mental health programs, may help community-dwelling older adults improve their sleep quality.
A SCOPING REVIEW OF LGBTQ+ MULTIGENERATIONAL PROGRAMMING: GAPS AND OPPORTUNITIES
Authors: Zhou Leyi , Perone Angela 
Published: December 2023

Abstract
Extensive research has revealed disparities in health, housing, employment, and economics among LGBTQ+ older adults (Emlet, 2016). However, the LGBTQ+ community has a long-standing tradition of multigenerational support that can potentially alleviate some of these challenges. Innovative caregiving models and non-traditional support systems involving multigenerational networks have emerged during crises such as the AIDS epidemic of the 1980s and 1990s and the recent COVID-19 pandemic (Cahill & Valadéz, 2013; Hafford-Letchfield et al., 2022). Nevertheless, despite the growing attention to LGBTQ+ multigenerational programs, the current state of scholarly research in this area remains uncertain. To address this gap, this scoping review aims to map the literature on intergenerational interventions for the LGBTQ+ community. This study includes peer-reviewed research in English with various study designs related to different categories of intervention, program, or activity that involve LGBTQ+ participants from more than one generation. To ensure accurate and reliable results, we conducted a comprehensive search on seven databases: PsycINFO, PubMed, Web of Science, Scopus, Sociological Abstract, Embase, and CINAHL. After deleting duplicates, 130 peer-reviewed articles were identified. Preliminary findings from the scoping review reveal historical moments when research on multigenerational programming surged, which aligns with pivotal crisis moments in the LGBTQ+ community. It also underscores emerging trends in multigenerational programming, including critical inquiry about what constitutes “multigenerational” and deeper commitment to inclusion of communities of color and transgender communities. These findings provide important insights for practitioners, policymakers, and researchers to strengthen services and support for LGBTQ+ older adults.
COVID-19 SYMPTOMS AND RISK OF COGNITIVE FUNCTION IMPAIRMENT/DEMENTIA AMONG COMMUNITY-DWELLING OLDER ADULTS
Authors: Amini Reza 
Published: December 2023

Abstract
Most studies investigating the correlation between cognitive function (CF) and COVID-19 are cross-sectional, with less than one-year intervals post-contracting COVID-19. Using three waves of the National Health and Aging Trends Study (NHATS), this study aims to investigate the correlation between COVID-19 and CF impairment/dementia among community-dwelling older adults. After excluding known cases of dementia, we used before (2019 N=3,292), during (2020 N = 2,756) and one year after COVID-19 pandemic (2021 N=2,379) data. The severity of the disease and COVID-19 preventing contact with family and friends (CFF) were self-reported (in 2020), executive function (EF) was measured by Clock Drawing Test (CDT), memory using delay 10-words recall test (DWRT), and NHATS dementia classification (in 2021). Multivariable ordered logistic regression results showed no significant correlation between dementia (i.e., normal, probable, and possible) and self-reported COVID-19 symptoms or preventing CFF. COVID-19 symptoms did not predict the risk of EF impairment. However, controlling for race/ethnicity interaction with CFF showed Blacks with limited CFF were 74% and 136% more likely to have dementia and EF impairment than their White counterparts, respectively. Experiencing COVID symptoms in 2020 increased the risk of delayed memory impairment in 2021 by 63%, while limited CFF increased this risk by 39%, which was 120% higher for Blacks than Whites. In conclusion, experiencing COVID-19 symptoms can affect delayed memory when this effect cannot be specified as dementia. The impact of social isolation caused by the COVID-19 pandemic on CF and increasing the risk of dementia is more harmful among Blacks than Whites.
FOSTERING PRACTICE CHANGE BY INTEGRATING INTERPROFESSIONAL EDUCATION IN A COMMUNITY HEALTH COLLABORATION
Authors: DeGennaro Jennifer , Bodenheimer Lisa , Perweiler Elyse , Avallone Margaret , Mock Marilyn , Prakash Sreelekha 
Published: December 2023

Abstract
NJGWEP undertook an interprofessional community/public health initiative collaborating with Rutgers University School of Nursing-Camden, Stockton University, NJ Housing and Mortgage Finance Agency, and four affordable housing sites located in underserved communities, with a potential to reach approximately 600 older residents. An IPE curriculum delivered to faculty, students, and staff from multiple health professions disciplines prepares them for assessing residents with chronic health problems using the 4Ms framework (What Matters, Mind, Medications, Mobility), adding the Geriatric 5th M for multi-complexity. Using a Resident Health Risk Assessment (RHRA) to assess residents’ health/biopsychosocial needs by capturing critical information needed to support “aging in place,” students and staff develop person-centered plans of care that address maintenance of independence, health, and referral to needed services/supports to delay or prevent institutional placement. From 2019-2022, 84 students from multiple disciplines (i.e., nursing, social work, counseling, OT) participated in community-based rotations, completed 279 RHRAs, and developed 101 IPE case reviews and person-centered plans of care. Evaluating residents’ co-morbid conditions (Hypertension 46%, Diabetes Mellitus 42%, Mental Health 40%; 8.6 medications per/resident, 44% Mini-Cog &lt; 3; 19% PHQ+, 51% + Falls Screen; 48% TUG&gt;12; 58% ADL/IADL deficits) highlighted the 5th M, Multi-Complexity. IPE is a sustainable venue for training a health care workforce that acknowledges/values the person-centered approach and encourages learning the roles and responsibilities of other disciplines. Implementation of a customized database in 2022 facilitates longitudinal tracking of outcomes related to resident needs, referrals, interventions, access to services to support aging in place, and informs policy and practice change.
CHALLENGES OF E-INTERVENTION RESEARCH: LESSONS FROM THE ISUPPORT FOR DEMENTIA-PT FEASIBILITY STUDIES
Authors: Teles Soraia , Paúl Constança 
Published: December 2023

Abstract
E-interventions have become popular in delivering healthcare services, offering benefits such as increased accessibility and scalability. However, they also present ethical, technological, and research-related challenges. This poster aims to identify challenges of e-intervention research by analyzing feasibility studies of “iSupport for Dementia-PT”, an online training and support program for informal dementia caregivers (IDC) culturally adapted to Portugal from the original version by the Word Health Organization. A mixed-methods study collected data on user satisfaction and requirements for the program’s contents and interface through focus groups and usability test sessions with IDC (N=17) and health/social support professionals (N=13). A subsequent pilot study followed a mixed-methods experimental parallel between-group design with two arms (iSupport, N=21 and e-book, N=21). Ethical challenges unearthed by both studies included data privacy, e-consent reliability, equity in accessing e-health interventions, and e-health literacy. Challenging methodological decisions for an RCT protocol included defining criteria for a per protocol analysis in the context of a self-help e-intervention, timing for post-test or follow-up assessments, managing attrition, and the implications of resorting to online outcome measurements. The feasibility studies suggest that iSupport for Dementia-PT is a promising resource to support informal dementia caregivers. However, innovation is required in e-intervention research as replicating conventional procedures and methods have shown to be inadequate. Guidelines are needed on how to address the ethical, technological, and research-related challenges in e-intervention research.
IDEA-EXECUTION ABILITY, SELF-DETERMINATION, AND CHEERFULNESS PREDICT DEMENTIA ONSET OVER NINE YEARS
Authors: Tu Yufang , Undem Teri , O’Connor Melissa 
Published: December 2023

Abstract
The prevalence of dementia and its negative effect on well-being has made it a global public health concern. It is important to understand factors that predict the onset of dementia above and beyond age and physical health, to aid in preventative efforts. The current study investigated idea-execution ability, self-determination, and cheerfulness as predictors of the onset of dementia across a nine-year period. Longitudinal data from the first nine waves of the National Health and Aging Trends Study (NHATS) were used. NHATS participants are nationally representative of Medicare recipients in the United States. Data were initially collected in 2011 and annually thereafter. The current study included 6780 participants; 678 participants reported having a diagnosis of dementia at either baseline or a follow-up visit. Cox regression was used to examine the following self-report items as predictors of months-to-dementia onset: idea execution ability (“when I really want to do something, I usually find a way to do it”); self-determination (“other people determine most of what I can and cannot do”); and cheerfulness (“how often I feel cheerful”). Each predictor was time-invariant and scored on a 3-point scale so that higher scores were more positive. Covariates included baseline age group (five-year groups), sex (dichotomized), years of education, and self-rated overall health. Statistically significant results were shown for idea-execution (HR=0.79, p=0.008), self-determination (HR=0.69, p&lt; 0.001), and cheerfulness (HR=0.91, p=0.047). Each of these potentially modifiable variables was associated with reduced odds of developing dementia, above and beyond demographic and health factors.
RACIAL/ETHNIC AND MULTIMORBIDITY DIFFERENCES IN DEMENTIA ONSET AMONG MIDDLE-AGED AND OLDER ADULTS
Authors: Chen Siting , Nagel Corey , Botoseneanu Anda , Allore Heather , Newsom Jason , Thielke Stephen , Kaye Jeffrey , Quiñones Ana 
Published: December 2023

Abstract
Racial/ethnic minoritized older adults in the U.S. have higher prevalence of multimorbidity and experience higher risk of dementia relative to non-Hispanic White older adults. This study examined the relationship between race/ethnicity and dementia onset within the context of multimorbidity during middle and later life in the U.S. Data from the Health & Retirement Study (1998-2018, HRS and War Babies cohorts, N=8,031) were applied to discrete-time survival models to estimate differences in the risk of dementia onset using the Langa-Weir Classification for up to ten time intervals (1998-2018). Models were adjusted for race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic), multimorbidity (no/one disease, advanced cardiovascular multimorbidity, metabolic multimorbidity, advanced cardiovascular-metabolic multimorbidity, and neither advanced cardiovascular nor metabolic multimorbidity), age at baseline, sex, education, and whether a proxy provided the interview. Over the 20 years, 9.8% of the respondents (n=785) developed dementia. In covariate-adjusted models, non-Hispanic Black (adjusted Odds Ratio (aOR) =2.27, 95%CI: 1.90, 2.72) and Hispanic (aOR=1.59, 95%CI: 1.26, 2.01) respondents had higher risk of developing dementia compared with non-Hispanic White respondents. Regarding multimorbidity categories, respondents with advanced cardiovascular-metabolic multimorbidity (aOR=1.80, 95%CI: 1.45, 2.24) had significantly higher odds of dementia onset relative to the neither advanced cardiovascular nor metabolic multimorbidity category. Significant differences were observed in dementia onset for up to 20 years between racial/ethnic minoritized and White adults, as well as among multimorbidity combinations. Our findings highlight the need to intervene earlier on modifiable risk factors, such as multimorbidity, to reduce the risk of developing dementia among racial/ethnic minoritized adults.
ADAPTING A DEMENTIA CAREGIVER CURRICULUM ACROSS THREE HEALTH PROFESSIONS
Authors: Duthie Edmund , Denson Kathryn , Simpson Deborah , Barnes Stacy , McAlister Jennifer , Szymkowski Amanda , Kavanaugh Rachel , Betley Wendy 
Published: December 2023

Abstract
Unpaid caregivers provide &gt;80% of the care for the 6.2 million Americans living with dementia, yet healthcare professionals rarely refer them to community services. The Alzheimer’s Association’s “Direct Connect” (DC) referral program is provider-initiated connecting patients/caregivers with resources to improve care and quality of life. Our interprofessional team created a 15-minute curriculum to educate students about DC and how to advocate for DC use at clinical sites. Champion faculty, from each profession, utilized a common presentation, with minor modifications for professional relevance. Delivery was both synchronous/asynchronous to learners from 2 different universities with knowledgeable clinician(s) available to answer questions. A Qualtrics survey collected feedback (N=218; 105 medicine, 57 nursing, 56 pharmacy). Relevance of the curriculum to each of the 3 professions was high (1-5 scale; mean range 4.46 – 5.00), with nursing rating it as most relevant. Feedback was also quite positive across the professions (78%-92% rated the curriculum quality as excellent/very good overall), with nursing giving the highest ratings. Most learners indicated a strong likelihood of using DC in clinical settings; 64-100% are very likely or somewhat likely to do so, with nursing being most likely to make referrals. In summary, a common dementia DC curriculum was successfully implemented for learners in 3 health professions; it was highly relevant to each profession, well accepted, and perceived to be clinically actionable. Nurses tended to be the most positive on these measures. While these results are promising, DC remains underutilized and initiatives to further increase referrals from providers must be expanded.