bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE CHARM OF COUNTRY LIFE? IMPACT OF RURAL CHILDHOOD RESIDENCE ON PHYSICAL AND MENTAL HEALTH IN LATER LIFE
Authors: Nadorff Danielle , Duck Angela , Lim Crystal , Fastring Danielle 
Published: December 2023

Abstract
Background: Most studies of geographic health disparities are focused on adult rural residence. However, previous studies have shown that the residential area in which one grows up during childhood has lasting impacts on adult health. In one of the only studies to date to examine the impact of rural childhood residence on mental health in middle-aged and older adults, Murchland and colleagues (2019) evaluated inequalities by childhood residence and noted elevated depressive symptoms were more common among those living in rural areas compared to those living in non-rural areas. Aims: The current study expands the model proposed by Murchland and colleagues to include further antecedents related to rural childhood residence, and to include multiple outcomes of physical and mental health among middle-aged and older adults. Method: Participants included 4614 individuals aged 40 or older recruited as part of the Midlife in the United States (MIDUS) study. Results: Consistent with Murchland’s model, childhood rurality played an important part in middle-aged and older adults’ health, despite not having a direct influence. Rurality status was impacted by parental education level and SES during childhood and was associated with the level of education obtained by the participants (and thus their occupation), which played a direct role in their current health status. Mental and physical health had differential predictors. Limitations: The study was limited by its non-diverse sample and self-reported measures. Conclusion: Further research into the impact of childhood rurality on health is needed, utilizing comprehensive self-reported and observed outcome measures.
SELF-REPORTED COMPONENTS OF SELF-IDENTITY IN PERSONS LIVING WITH EARLY-STAGE DEMENTIA
Authors: Regier Natalie , Cotter Valerie 
Published: December 2023

Abstract
The impending loss of “self” is a common concern of persons diagnosed with dementia. However, in contrast to the traditional biomedical model, there is qualitative and quantitative evidence that self-identity persists across stages of the disease. An understanding of the components of self-identity of persons living with early-stage dementia (PLWED) can inform treatment approaches and communication from care partners and providers. Consequently, the aim of the present study is to examine what PLWED identify as the facets of their self-concept. Participants were a purposive sample of 20 community-dwelling PLWED who attended a voluntary health program aimed at facilitating aging-in-place. Focus groups were conducted and recorded on-site at the health program. The interviews were transcribed verbatim from the audio recordings and were analyzed through a conventional content analysis approach. Content analysis of the narratives gleaned from focus group participants revealed six self-identity themes: vocation, family role, personal characteristics, hobbies and interests, religious affiliation, and social networks. Although the deterioration of explicit memory, including autobiographical memory, is a hallmark of dementia, overfocusing on this as the sole component of self-identity contributes to the representation of persons living with dementia as less than whole and lacking “selves.” Our findings suggest critical components of self-identity other than memory that should be recognized and supported in persons living with dementia.
BETWEEN ISLANDS—A CREATIVE PRACTICE AND INTERGENERATIONAL CONTACT INTERVENTION
Authors: Lytle Ashley , Nowacek Nancy 
Published: December 2023

Abstract
Addressing ageism is a serious social issue in need of targeted, empirically based solutions (WHO, 2021). Facilitating intergenerational contact is one promising means of reducing ageism (Lytle et al., 2020). Between Islands were a creative practice and intergenerational contact intervention designed to promote creativity and intergenerational connection between younger and older adults while challenging stereotypes about aging. Over a four-week intervention, younger and older adults meet virtually (on zoom) for an hour each Wednesday to learn, create, and discuss with one another. Before the intervention began, participants received two 2.5 lb blocks of air-drying clay, paints, and paintbrushes. During the four-week intervention, participants engaged in creative practice (designed, sculpted, and decorated two hand-weights out of the provided clay). In addition, participants learned about the history of hand-weights and circuit training and got to know one another through group-based discussion as well as smaller group prompts and breakout rooms. Prior to the start of the intervention, baseline attitudes and stereotyping toward older adults were assessed among the younger adult participants. Attitudes and stereotypes were again measured after the intervention concluded. Younger adults reported a significant decrease in benevolent ageism and intergenerational tension after the Between Islands intervention. In addition, themes that emerged from the open-ended responses illustrated that the intervention challenged younger adults’ stereotypes about older adults, encouraged recognition of similarities between younger and older adults, and facilitated the connection between participants.
ADULT DAY SERVICES: THE OPTIMAL PLATFORM FOR GROUP INTERVENTION RESEARCH
Authors: Anderson Keith , Dabelko-Schoeny Holly 
Published: December 2023

Abstract
Group intervention research with older adults is fraught with challenges related to access, recruitment, implementation, and sustainability. In this presentation we explore these challenges and offer adult day services (ADS) as an alternative platform to traditional long-term care sites (e.g., nursing homes – NHs, assisted living facilities – ALFs) for group intervention research. Access: NHs and ALFs are often reluctant to engage in research due to concerns with liability and fears that “outsiders” will expose deficits in their services. ADS programs are typically quite receptive to researchers and are eager to learn about innovative ways to improve their services. Recruitment: NHs and ALFs are comprised of individuals living in their private apartments and rooms and recruitment is often a one-on-one, time-consuming process. ADS programs are naturally collective environments where recruitment efforts can occur in a more efficient group format. Implementation: NHs and ALFs often lack adequate physical space and staff support for group research activities – key elements that contribute to successful implementation. ADS programs are specifically designed and staffed for group activities and interventions. Sustainability: The primary focus of NHs and ALFs is on “bed and body” care and long-term buy-in regarding group interventions and activities from facilities and staff is rare. Group programming is central to ADS and there is a much greater potential for buy-in and long-term sustainability. Conclusion: Researchers interested in group interventions should strongly consider ADS as the optimal platform and may find that the ADS setting offers the greatest potential for success.
HOW OFTEN AND WHY DO PEOPLE MANAGE THEIR EMOTIONS?: EMOTION REGULATION IN HEALTHY AGING AND MILD COGNITIVE IMPAIRMENT
Authors: Springstein Tabea , English Tammy 
Published: December 2023

Abstract
Prominent theories of adult development suggest that individuals increasingly prioritize emotional goals and social relationships as they grow older. Accordingly, older adults are expected to invest more in maintaining their emotional well-being compared to younger adults. Prior work suggests that older adults may accomplish this goal by structuring their lives in ways that reduce the need to manage unwanted emotion. We tested the hypotheses that (1) older adults regulate their emotions less often in daily life compared to younger adults, and (2) when emotion regulation occurs, older adults are relatively more motivated by pro-hedonic and social concerns. Using experience sampling (7x/day for 9 days), we assessed whether emotion regulation frequency and motives differ between younger adults (N = 70), cognitively normal older adults (N = 88), and older adults with mild cognitive impairment (MCI; N = 60). We found that older adults with and without MCI regulated their emotions less frequently than younger adults, even when controlling for mean levels of positive and negative emotional experience. However, there were largely no group differences in emotion regulation motives (i.e., why people wanted to manage their emotions). Future work is needed to explore how age-related differences in life contexts might contribute to less need for emotion regulation in relatively older adults. Less frequent regulation could be beneficial in terms of helping older adults preserve their more limited cognitive resources. The findings regarding motives add to growing research on aging which suggest maintenance or similarity in many emotion regulation processes across adulthood.
EFFECT OF EMOTION NAMING ON EMOTION REGULATION IN YOUNGER AND OLDER ADULTS
Authors: Wolfe Hannah , Isaacowitz Derek 
Published: December 2023

Abstract
Prior research has shown that naming one’s emotions before regulation has a detrimental effect on regulation success (Nook et al., 2020). These researchers argued this effect was due to the affect crystallization that occurs after naming an emotion, which in turn makes it harder to modify or regulate that emotion. The aim of the current replication-extension study was to evaluate whether this effect would replicate in an older adult sample. Due to age-related changes in emotion regulation knowledge and behaviors, we hypothesized that age would moderate this effect, such that older adults would not be detrimentally impacted by naming their emotions, but younger adults would. Younger (18-25 years, N=50) and older adults (60+ years, N=50) viewed 80 IAPS images while being told to first ‘look’ or ‘name’ their experienced emotion and second to ‘look’ or ‘regulate’ their emotions (creating four within-subjects conditions). Unpleasant affect was measured on each trial, analyzed via a 2(age group) X 2(naming: yes/no) X 2(regulating: yes/no) mixed ANOVA. Results suggest a significant three-way interaction; within both age groups, the name-regulate trials were associated with significantly greater unpleasant affect compared to the look-regulate trials, suggesting that naming emotions was detrimental for both age groups. However, contrary to our hypothesis, this effect was larger in older adults (d=.82) than younger adults (d=.41). These findings suggest that affect crystallization may be stronger or faster in older adulthood.
AGE DIFFERENCES IN STRESSOR REACTIVITY AND RECOVERY
Authors: Minton Alyssa , Waugh Christian , Snyder Jason , Charles Susan , Haase Claudia , Mikels Joseph 
Published: December 2023

Abstract
Strength and vulnerability integration theory (SAVI; Charles, 2010) posits that age differences in emotional experiences vary based on the distance from an emotionally eliciting event. Before and after a stressor, SAVI predicts that older age is related to motivational strivings that often result in higher levels of well-being. During stressor exposure, however, age effects are predicted to be attenuated or disappear completely. The present study examined how younger (n = 85; M age = 22.56 years) and older (n = 85; M age = 71.05 years) adults reacted to and recovered from a cognitive stressor using repeated positive and negative emotion probes. Results showed that both age groups were negatively impacted by the stressor, and both reported an initial boost in recovery afterward. However, older adults continued to recover across the recovery period compared to younger adults. This work elucidates that older adults are significantly impacted by stress but exhibit a resounding recovery.
INTRINSIC HEALTH: TOWARD A FRAMEWORK FOR THE OBJECTIVE STUDY OF THE BIOLOGY OF HEALTH
Authors: Cohen Alan , Picard Martin , Bandeen-Roche Karen 
Published: December 2023

Abstract
Many definitions of health have been proposed over the years, but all share the characteristic of being subjective and therefore hard to tie to objective measures of biology. While there are undoubtedly subjective aspects of health, here we propose the notion of “intrinsic health” as the capacity of an organism to maintain its internal, biological dynamic equilibrium. Building on first principles, Cohen and Picard show how intrinsic health emerges from the dynamic interplay of energy, communication, and structure at multiple levels of biological organization. The following three talks then propose novel ways to measure intrinsic health. Khan and Wei show how quantile aberrance – modeling when biomarker values are extreme based on the joint distributions of many biomarkers – can be used to quantify intrinsic health. Liu, Xu, Honfo, and Cohen show how metrics of proteome dynamics reflect communication within the organism and can be extracted to quantify health. Finally, Wang and Pei show how transfer entropy – the synchronization between multiple time series – can be extracted to measure health. While these three metrics are still in preliminary stages of development, they show the potential to measure health based on the multivariate dynamics of our internal systems. Going forward, these and other approaches may be integrated to derive robust, objective metrics of intrinsic health, and could serve as the basis for a novel understanding of how aging emerges from declines in intrinsic health over time.
QUANTIFYING INTRINSIC HEALTH USING STRESS-EVOKED INFORMATION FLOW BETWEEN PHYSIOLOGICAL SYSTEMS
Authors: Wang Yan , Tsang Sze Pui , Khan Zain , Malinsky Daniel , Wei Ying , Cohen Alan , Picard Martin , Pei Sen 
Published: December 2023

Abstract
As a canonical complex dynamical system, human bodies require interactions between constituent physiological systems to perform functions and maintain health status. Quantifying the dynamic interactions between organ systems using biomarkers collected in the context of psychobiological challenges may provide a novel means of measuring the energy-dependent communication processes that underlie intrinsic health. In this study, we use transfer entropy (TE), an information-theoretic metric, to quantify information flow between three biomarkers (heart rate, blood pressure, and respiration) in 71 participants of the Mitochondrial Stress, Brain Imaging, and Epigenetics (MiSBIE) project. In this stress experiment, both healthy individuals (n=44) and participants with genetic mitochondrial disorders (Mutation n=16, Deletion n=11) were exposed to a standardized 5-minute socioevaluative challenge (i.e., public speaking). Heart rate, blood pressure, and ventilation were collected continuously across four phases (baseline, pre-task, during the challenge, and post-challenge) over a 2-hour period. Using time series constructed from the three biomarkers, we compute six pairwise TE values for each participant in each phase, measuring the direction and strength of the information flow between physiological systems. Across different phases, we identify significant differences in TE values between healthy participants and patients with mitochondrial diseases. For example, during the post-challenge phase, TE from blood pressure to respiration in healthy participants was 19% higher than the deletion group (p=0.038). Our finding highlights the potential use of TE as a computational tool for detecting mitochondrial disorders and, more broadly, quantifying intrinsic health using information transfer between physiological biomarkers.
NURSING HOME WORKFORCE CHALLENGES: INCREASED NURSING STAFF LABOR COSTS AND USE OF AGENCY STAFF FROM 2017 TO 2021
Authors: Bowblis John , Brunt Christopher , Xu Huiwen , Applebaum Robert , Grabowski David 
Published: December 2023

Abstract
Nursing homes face rapidly increasing wages and change their input mix as they face workforce shortfalls. For 15,959 freestanding NHs from 2017-2021, the proportion of hours worked by agency staff and the median wage cost per hour of agency and directly employed nursing staff were calculated from Medicare cost reports and Payroll-Based Journal data. The median hourly wage cost of directly employed staff (wage and fringe) increased 18.1% for RNs (to $41.99 in 2021), 19.8% for LPNs ($32.29), and 27.5% for CNAs ($19.62). The median hourly wage cost of agency staff (amount paid to staffing agency) increased at a faster rate and was substantially higher: 22.8% for RNs ($64.19); 28.3% for LPNs ($52.42), and 34.9% for CNAs ($33.73). The use of agency staff increased, starting from approximately 2% of all nursing staff hours for each of the nursing staff types in Q1 2017 to 5.6% hours for RNs, 9.4% hours for LPNs, and 8.8% hours for CNAs in Q4 2021. These observations have implications for quality and access to nursing home care. High use of agency staff may affect quality of nursing home care, and substantial wage differences between agency and directly-employed staff may affect worker satisfaction and attachment of directly employed workers. Hourly wage costs for all nursing staff have increased more rapidly than nursing home revenues, which only increased 16.6% over the study period; this suggests that, without payment rate increases, nursing homes may reduce labor inputs to contain costs, or may go out of business.
RESILIENCE AMONG BLACK FAMILY CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Robinson-Lane Sheria 
Published: December 2023

Abstract
Black family caregivers of persons with dementia often experience elevated levels of stress related to lower incomes, chronic health conditions, and care recipient behaviors. Resilience theory suggests that stress may be moderated by various resources and processes, however, few studies have examined factors that may influence emotional resilience among Black family caregivers. Spearman’s rank correlation coefficient was used to assess the relationships between adaptive coping, caregiving self-efficacy, and positive affect within a sample of current caregivers (n=20). Self-efficacy in obtaining respite care was significantly correlated with both positive affect (p=.041) and adaptive coping (p=.022). Self-efficacy for managing difficult behaviors was also correlated with positive affect (p=.001). Finally, we identified a significant correlation between body mass index and self-efficacy for controlling upsetting thoughts. Caregiver resilience may be enhanced by providing increased access to respite services and culturally responsive support programs aimed at enhancing positive emotions and affective balance.
IMPLICATIONS OF RESIDENT AND ENVIRONMENTAL CHARACTERISTICS ON RESIDENT-TO-RESIDENT AGGRESSION
Authors: Yan Elsie , Lai Daniel W L , Cheng Sheung Tak , Kwok Timothy , Lou Vivian Weiqun , Chaudhury Habib , Pillemer Karl , Lachs Mark 
Published: December 2023

Abstract
This study examines factors associated with resident-to-resident aggression (RRA) in long term care facilities in Hong Kong. A total of 800 personal care worker participated. Participants averaged 42.03 years of age (SD=7.63), were mostly female (92.7%), married (79.1%) and reported an average of 6.28 years of experience in long term care. 96.9 percent of the participants provided care to residents with dementia but 58.9% considered the training they received insufficient. RRA was common: All participants reported having witnessed verbal aggression (100%), 18% disruptive behaviors, 11.8% physical violence, and 3.1% sexual aggression. The following analysis used a subset of 412 participant from 29 long term care facilities where environmental assessments were conducted. General linear model analysis showed that RRA was associated with both resident and environmental characteristics. Victims’ neuropsychiatry symptoms, perpetrator male gender and neuropsychiatric symptoms were associated with higher RRA. Separation of residents with and without dementia, inappropriate use of nursing unit for residents as measured by Therapeutic Environment Screening Survey for Nursing Homes (TESS-NH), lack of functional and attractiveness courtyard, less cleanliness of spaces, insufficient lighting and insufficient orientation / cueing as measured by Professional Environmental Assessment Procedure (PEAP) were also associated with higher RRA. There is an urgent need to prevent and intervene RRA in long term care facilities. Improving management of neuropsychiatric symptoms and creating a supportive and accommodating environment could be helpful in this regard.
DESIGNING AND IMPLEMENTING A RESIDENT-TO-RESIDENT AGGRESSION PREVALENCE STUDY IN A NEW CONTEXT
Authors: Burnes David , Shanmuganathan Vasuki , Baxter Pamela , Hirst Sandra , Shnall Adriana , McDonald Lynn 
Published: December 2023

Abstract
Resident-to-resident aggression (RRA) is a prevalent issue in long-term care (LTC) settings with serious consequences. Research from the U.S. has found that approximately 20% of residents experience RRA each month and this issue is associated with several physical/mental health morbidities. Very little RRA research has been conducted in LTC settings in Canada. This study sought to estimate the prevalence of RRA in Canadian nursing homes and identify risk factors from different levels of social-ecological influence. Specifically, this study sought to replicate a gold standard RRA prevalence study in the U.S. by selecting a random sample of nursing homes (n = 10) across the province of Ontario and collecting RRA prevalence data using multiple sources/methods, including staff interviews, resident interviews, and direct observation from staff and research assistants. As this study is in early stages of design/implementation, the current presentation will focus on various issues requiring consideration and the challenges faced when setting up a large-scale RRA prevalence study. Specifically, the presentation will focus on the adaptation of existing measurement tools to a new context with unique local language, legal and legislative frameworks, and the development of a sampling strategy requiring considerations related to sample inclusion/exclusion criteria, temporal and geographical logistical concerns, and sample size. We will also discuss new realities and heightened sensitivities involved in conducting LTC-based research and recruiting nursing homes, residents and staff during the COVID era that includes staffing instabilities/shortages and outbreaks. This presentation will assist other researchers around the world in planning/implementing RRA prevalence study designs.