bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXPLORING FACILITATORS AND BARRIERS TO CONDUCTING SPIRITUAL HISTORIES IN OLDER ADULTS
Authors: Beck Monica , Gallagher Amelia 
Published: December 2023

Abstract
Nurses can relieve spiritual suffering in older adult cancer patients through spiritual histories, yet may be reticent to engage in spiritual conversations. The qualitative aim of Lift the Spirit, a pilot feasibility and acceptability study, was to explore factors affecting cancer nurses’ perceptions of the barriers and facilitators to conducting spiritual histories in clinical practice. Lift the Spirit, an enhanced educational communication intervention, was designed to equip nurses with the knowledge, skills, and attitudes to conduct spiritual histories. A purposive sample of nurses (n = 17) independently engaged in an online multimedia course, Spiritual Assessment in Clinical Practice, then synchronously role-played conducting a spiritual history in dyads (nurse/patient), engaged in a skills performance, and participated in Debrief Interviews. Qualitative data were collected during Debriefing Interviews using the Debrief Interview Guide. Interpretive description guided the qualitative content analysis of Debrief Interview data. Structural coding was used to sort data into barriers and facilitators on the first pass. Next, within each structural code, data fitting the definition of barrier and facilitators were inductively descriptively coded. Participants described barriers and facilitators at the levels of institution/profession (lack of education and training), self (vulnerability, perceived riskiness), and patient (cultural difference) that were similar to barriers already noted in the literature. Facilitators included feeling equipped and supported and having external cues as reminders. The degree of angst, fear, and vulnerability expressed towards conducting spiritual histories was surprising. Equipping nurses with the knowledge, skills, and attitudes is essential to reduce spiritual suffering in older adults.
OLDER ADULT FALLS IN THE COMMUNITY: DOES UNSAFE HOME ENVIRONMENT HAVE A RISK ROLE?
Authors: Gupta Debasree Das , Kelekar Uma , Turner Sidney 
Published: December 2023

Abstract
Hazardous environmental conditions are frequent in older adult homes and are linked to a majority of the older adult falls in the community. However it is unclear whether it is the presence/absence of home hazards per se, or the interaction between unsafe home conditions and physical functioning that is of salience to older adults’ fall risk. To address this gap, we conduct a mediation analysis using the Karlson–Holm–Breen methodology to estimate: 1) whether home disorder (peeling/flaking paint, pests: cockroaches/rodents, broken furniture/lamp, unsafe flooring/tripping hazards, room clutter) and unsafe bathroom features (absence of bathtub/shower stall, grab bar, seat in shower/tub, raised toilet) adversely associated with subsequent fall risk of older adults, and 2) what proportion of those influences were mediated through limitations in daily and instrumental activities of daily living (ADL/IADL). Using a nationally representative large sample of Medicare beneficiaries (≥65 years) living in the community who were respondents in the 2018-2019 National Health and Aging Trends Study (NHATS; n=2,599), we examined baseline home environment in 2018 and its relation with subsequent falls in 2019, after controlling for covariates. Results indicate while home disorder had both a direct (adjusted Odds Ratio [aOR]: 1.11, 95% Confidence Interval [CI]:1.01,1.22) and an indirect (aOR: 1.01; 95% CI: 1.00,1.02) effect on subsequent falls through limitations in ADL and IADL, unsafe bathroom features did not significantly predict subsequent fall risk of older adults. Given these findings, addressing home disorder through policy/housing assistance initiatives and educational programs highlighting home environmental safety would be essential.
INTERGENERATIONAL REMINISCENCE AND DIGITAL STORYTELLING: EXPLORING THE EXPERIENCE OF COLLEGE STUDENT VOLUNTEERS
Authors: Fields Noelle , Xu Ling , Troutman Brooke , Daniel Kathryn , Miles Allyson 
Published: December 2023

Abstract
Research suggests that reminiscence combined with an intergenerational approach may yield significant psychosocial benefits for older adults with Alzheimer’s disease and related dementia (ADRD). Through intergenerational reminiscence, older persons may pass on their life experience and life lessons to younger generations. Intergenerational contact and relationships between older and younger adults can prevent stereotypes or negative attitudes from forming, or counter existing ones. Additionally, outcomes from intergenerational programming include the younger generation’s ability to build relationships with older adults and have positive changes in attitudes toward aging. The current paper is part of a larger telephone-based intervention that used intergenerational reminiscence with digital storytelling in sample of university student volunteers and community-dwelling older adults with ADRD. University student volunteers were provided with training before the intervention about the myths and facts about ADRD, communicating with persons with ADRD, and how to create a digital story. Using Rapid and Rigorous Qualitative Data Analysis (RADar), a research team examined the weekly written reflections of the student volunteers (N = 27) during the 10-week pilot study. The analysis yielded 6 themes: positive connections, resilience, life lessons, empathy, collaboration, and growth. Many students reported increased confidence in talking with older adults and shared an interested in remaining connected after the study ended. Few students reported technological challenges with the DST. Findings from the study extend the existing literature related to volunteer-based interventions for older adults with ADRD and highlight the potential of involving younger adults in new approaches to ADRD research and practice.
PERFORMANCE OF FUNCTION-FOCUSED CARE BY NURSING STAFF
Authors: Galik Elizabeth 
Published: December 2023

Abstract
To help acute care nurses learn to provide function focused care during care interactions the Function Focused Care intervention is implemented on nursing units. The Function Focused Care intervention is based on the Social Ecological Model, Social Cognitive Theory and the Evidence Integration Triangle and includes four components: (1) Development of a stakeholder team; (2) Education; (3) Development of functional care plans; and (4) Mentoring and motivating. Our nurse interventionist provides function focused care education as per the preference of the setting. Following education, direct observation during care interactions is done and the nurse interventionist provides recommendations related to the approach being used or provides positive reinforcement if function focused care is provided. The observation tool used to evaluate function focused care by the nursing staff includes 19 different care interactions (e.g., bathing, dressing, transferring). Guidelines are provided for what is and is not function focused care. In the first four treatment sites, at 2 months post implementation the nurses provided function focused care during 81% of the of care interactions observed, by 6 months this increased to 85% and by 10 months this increased to 88%. There was also a decline in the number of care interactions in which function focused care was not provided. The findings suggest that nurses can provide function focused care even during times of significant shortages and that continued oversight and education can help improve the use of this approach.
“IT SHOULDN’T BE LIKE THIS”: FAMILY CAREGIVERS NAVIGATING INSURANCE FOR FAMILY MEMBERS WITH DEMENTIA
Authors: Gordon-Wexler Mikayla , Watman Deborah , Reckrey Jennifer 
Published: December 2023

Abstract
Family caregivers of individuals with dementia who are dually eligible for Medicaid and Medicare must navigate the health insurance landscape to meet the complex medical and home care needs of their family members. The goal of this study is to explore how family caregivers make decisions around insurance and how these choices affect care. Semi-structured interviews were conducted from June-January 2022 with 15 family caregivers of dually eligible individuals with dementia enrolled in home-based primary care in New York City. Interviews were analyzed using both deductive and inductive thematic coding. Participants described how social workers and other professionals helped navigate insurance choices, but no centralized system for obtaining information existed. Once insurance plans were set-up, participants described advocating on behalf of their family member within the constraints of current insurance plans rather than considering alternatives due to high perceived burden of changing plans. Obtaining adequate home care hours (which frequently required multiple appeals) was a particular challenge. Caregivers did not see integrated Medicare-Medicaid plans as providing any inherent benefit to navigating insurance. This study highlights the barriers facing family caregivers as they navigate insurance choices and the limited support available. These challenges may contribute to resistance to changing plans even when gaps in needed coverage exist, especially gaps related to inadequate home care. Robust professional support for family members both immediately after loved one’s dementia diagnosis and as the disease progresses could alleviate burden on caregivers and increase their capacity to get their family members needed medical and home care.
ASSOCIATIONS BETWEEN SEDENTARY AND PHYSICAL INACTIVITY ON QUALITY OF LIFE IN THAI MIDDLE AGE AND OLDER OFFICE WORKERS
Authors: Akksilp Katika , Teerawattananon Yot , Chen Cynthia 
Published: December 2023

Abstract
Sedentary behaviour and physical inactivity negatively affect health-related quality of life in all age groups. Moreover, the ageing population needs even more sophisticated health promotion programmes to tackle the increasing prevalence of non-communicable diseases. This study aims to estimate the effects of sedentary behaviour and physical inactivity on health-related quality of life among middle-age and older office workers in Thailand. The analyses used secondary data from the Physical Activity at Work cluster-randomised trial. Objective physical activity data were collected using the ActiGraph™ accelerometer. Health-related quality of life was collected using EuroQol’s EQ-5D-5L. Sedentary was defined as spending more than nine hours per day in sedentary behaviours. Physically inactive was defined as spending less than 150 minutes of moderate-intensity equivalent activity per week. Tobit regression was used to compare utility indices. Being physically active alone was associated with a higher EQ-5D value (0.0746; 95%CI -0.0142 to 0.163) compared to the inactive. Also, non-sedentary participants had higher EQ-5D value (0.0548; 95%CI -0.0121 to 0.122) compared to sedentary, although not statistical significance. In addition, participants who were both physically active and not sedentary had a significant difference in the EQ-5D value of 0.0700 (95%CI 0.00187 – 0.138) compared to inactive and sendentary participants. This is the first study in Thailand to explore the association between sedentary behaviour, physical inactivity on health-related quality of life in middle-age and older population. It highlights the importance of incorporating health-related quality of life assessment for Thai physical activity promotion programmes, building a foundation for economic evaluation studies.
POWERFUL TOOLS FOR CAREGIVERS: THE ESTABLISHED BENEFITS OF A PERSON-CENTERED CARE INTERVENTION
Authors: Meinertz Naomi 
Published: December 2023

Abstract
Family caregivers account for 89% of caregivers in the United States, yet few evidence-based family care programs focus specifically on the caregiver’s needs rather than the care receiver. The challenges that caregivers experience, such as increased depression symptoms and feelings of burden, impede their ability to fulfill their role as care partner and can lead to lasting health and financial issues. Intervention literature underscores the importance of using person-centered models to incite behavior change, yet many caregiver interventions do not address the caregiver’s needs and instead approach caregiving from a practical perspective to caregiving such as establishing a power of attorney or educating caregivers about dementia. Powerful Tools for Caregivers (PTC) is a six-week program designed to provide caregivers with the skills to address their unique care challenges. Within in-person or virtual sessions, caregivers are provided with the skills to improve caregiver self-efficacy, emotional management, self-care, and resource access and knowledge. The study integrates empirical findings and demonstrates the effectiveness of PTC in improving caregiver well-being in each focus area. Findings also highlight the benefits of the group-based activities as well as improved depressive symptoms and reduced caregiver stress and burden. This research also demonstrates the same effectiveness of delivery format (in-person or virtual mediums) and location (rural or urban settings). The success of PTC sheds light on the need for more programs to approach family care through the lens of a person-centered model and emphasizes the benefit of evidence-based programs.
“WHEN WE ARRIVED IN THIS COUNTRY, WE WERE ALREADY VERY OLD”: HEALTH AND AGING IN WISCONSIN’S HMONG REFUGEE COMMUNITY
Authors: Engelman Michal , Lor Maichou , Xiong Mai , Lee Tou , Vang Casper 
Published: December 2023

Abstract
The Hmong arrived in Wisconsin as refugees following wars in Vietnam and Laos, and are the state’s largest Asian American group. They have a disadvantaged socioeconomic profile and face high rates of trauma-linked mental illness. Due to limited English proficiency, low literacy, and a lack of familiarity with and trust in research, the Hmong are underrepresented in existing data sources, which fold them into a pan-ethnic Asian-American group considered exceptionally successful. To address this gap, the Diversity, Inclusion, and Aging in the Midwest: Opportunities for New Directions with Wisconsin’s Hmong Community (DIAMOND-Hmong) project has engaged Hmong older adults in a research study designed to document their unique life experiences and social determinants of health. Drawing on semi-structured life history interviews with 40 older Hmong men and women in Wisconsin, we describe participants’ experiences during wars, forced relocations, and refugee camp spells, as well as the challenges and rewards of migrating to and aging in the U.S. Using a constructionist grounded theory approach, we show that participants’ narratives link life-course hardships with physical and mental health challenges, generating a historically and culturally-specific delineation of trauma as both individual and collective experiences. Our analysis situates individual trauma within broader geopolitical and institutional circumstances and demonstrates that familial and communal ties – and their absence – are sources of both tension and resilience in this population. Our findings point to the importance of a trauma-informed approach to health assessment for the Hmong, and the role of memory and storytelling in their healing process.
OLDER ADULTS AND CAREGIVERS AS PARTNERS IN PATIENT- AND FAMILY-CENTERED EDUCATION
Authors: Severance Jennifer , Cervantes Diana 
Published: December 2023

Abstract
Patient and family-centered education is an approach to the planning, delivery, and evaluation of curricula that is grounded in mutually beneficial partnerships among patients, families, students, and educators. Engaging patients and families in genuine partnerships through health professions education can broaden the student’s perspectives of health to include social, economic, and environmental factors while helping them recognize unique individual dimensions, such as cultural context, capacities, and values, that influence health. While patient-centeredness is a widely recognized component to high-quality healthcare, partnering with older adult patients and caregivers is a less recognized standard in health professions education. This symposium examines the role of older adults and caregivers in co-creating geriatric and gerontology education with a HRSA-funded Geriatric Workforce Enhancement Program (GWEP) to promote the knowledge, skills, and attitudes necessary for patient-centered clinical practice. First, presenters will share educational initiatives involving older adults as mentors and subject matter experts for health professions students and student teams. This is followed by projects engaging and empowering older adults and caregivers as advocates for quality care and advisors for educational improvements. Finally, presenters will explore evaluation tools and strategies to collect input and ensure the patient’s voice remains at the center of education planning, delivery, and improvement. Presenters discuss methods of adapting these models to a local context as well as strategies and opportunities to incorporate the input and feedback from older adults and caregivers into health professions education.
GENDERED PATHWAYS TO FINANCIAL CAPABILITY: IMPLICATIONS FOR PHYSICAL, MENTAL, AND FINANCIAL HEALTH IN LATER LIFE
Authors: Chen Yu-Chih , Sun Sicong 
Published: December 2023

Abstract
Financial capability, comprising financial literacy, access, and behavior, can influence an individual’s ability to effectively use financial resources, thus impacting their health and well-being. However, studies have predominantly focused on financial literacy and overlooked a more comprehensive measure of financial capability. Additionally, there is limited knowledge on the role of gender in these associations. This study investigated how gender may moderate the links between financial capability and health. The study recruited 1,109 community-dwelling adults (aged 45+) through an online survey and employed multivariate linear and logistic regression to examine the gender differences in the associations between financial capability and physical (perceived health and mobility limitations), mental (life satisfaction and depression), and financial (retirement worry and financial satisfaction) health. Results showed that financial access and behavior, compared to financial literacy, had a more significant influence on determining health outcomes. Gender differences in financial capability were also identified through simple slope analyses, with financial literacy being more important for men’s self-rated health and life satisfaction, while financial behavior was more critical for women. Additionally, although financial access was not related to retirement worry among men, it was significantly associated with lower retirement worry among women. Findings suggest that gender-specific pathways to financial capability may lead to health disparities. Policies and programs aimed at improving population’s health and well-being, particularly for women, should target not only financial literacy but also strengthen financial inclusion and encourage responsible financial behavior.
Causal relationships between risk of venous thromboembolism and 18 cancers: a bidirectional Mendelian randomization analysis
Authors: Cornish Naomi , Haycock Philip , Brenner Hermann , Figueiredo Jane C , Galesloot Tessel E , Grant Robert C , Johansson Mattias , Mariosa Daniela , McKay James , Pai Rish , Pellatt Andrew J , Samadder N Jewel , Shi Jianxin , Thibord Florian , Trégouët David-Alexandre , Voegele Catherine , Thirlwell Chrissie , Mumford Andrew , Langdon Ryan ,   InterLymph Consortium, INVENT-MVP Consortium
Published: December 2023

Abstract

Background
People with cancer experience high rates of venous thromboembolism (VTE). Risk of subsequent cancer is also increased in people experiencing their first VTE. The causal mechanisms underlying this association are not completely understood, and it is unknown whether VTE is itself a risk factor for cancer.

Methods
We used data from large genome-wide association study meta-analyses to perform bidirectional Mendelian randomization analyses to estimate causal associations between genetic liability to VTE and risk of 18 different cancers.

Results
We found no conclusive evidence that genetic liability to VTE was causally associated with an increased incidence of cancer, or vice versa. We observed an association between liability to VTE and pancreatic cancer risk [odds ratio for pancreatic cancer: 1.23 (95% confidence interval: 1.08–1.40) per log-odds increase in VTE risk, P = 0.002]. However, sensitivity analyses revealed this association was predominantly driven by a variant proxying non-O blood group, with inadequate evidence to suggest a causal relationship.

Conclusions
These findings do not support the hypothesis that genetic liability to VTE is a cause of cancer. Existing observational epidemiological associations between VTE and cancer are therefore more likely to be driven by pathophysiological changes which occur in the setting of active cancer and anti-cancer treatments. Further work is required to explore and synthesize evidence for these mechanisms.
The individual- and community-level women's empowerment and utilization of maternity care services in Afghanistan: a multilevel cross-validation study
Authors: Dadras Omid 
Published: December 2023

Abstract

Background
This study aimed to explore the relationship between women's empowerment and utilization of maternity care for married Afghan women aged 15–49 y in Afghanistan, assessing the convergence validity of the Survey-based Women's Empowerment Index in Afghanistan (SWEI-A).

Methods
The study used data from the 2015 Afghanistan Demographic Health Survey to examine the association of different domains of women's empowerment with the utilization of maternity care using multilevel Poisson regression at both individual and community levels.

Results
The utilization of maternity services was considerably higher among women with high scores compared with those with low scores in almost all domains of the SWEI-A, except for property owning, in which women with high scores appeared to have lower rates of utilization of such services compared with those with low scores. At the community level, those communities with high participation of women in the labor force were less likely to have adequate antenatal care (ANC), institutional delivery and postnatal care (PNC). Individual-level literacy was associated with higher utilization of ANC, institutional delivery and PNC, contrary to community-level literacy.

Conclusions
Except for property owning, the high score in almost all other domains was associated with higher utilization of maternity care, which indicates an acceptable level of convergence validity for the developed index (i.e. the SWEI-A) in measuring women's empowerment among married Afghan women aged 15–49 y.