bluuebunny/crossref_metadata_2025_split huggingface dataset:
TRENDS IN COMMUNITY-BASED CARE STAFFING LEVELS IN OREGON: DIFFERENCES BY FACILITY CHARACTERISTICS
Authors: Dys Sarah , Tunalilar Ozcan , Carder Paula 
Published: December 2023

Abstract
The COVID-19 pandemic re-centered the workforce crisis across long-term care settings in the U.S. Variation in regulatory requirements, industry practices, staff training, and lack of longitudinal data introduces complexity in understanding workforce trends specific to assisted living and residential care (AL/RC). Pooling five waves of the Oregon Community-Based Care study, we examine trends in AL/RC care staff levels and associations with facility characteristics: license type, Medicaid census, profit status, and rurality. From 2017-2022, 548 unique facilities participated in the study, 55% contributing to four to five waves. The estimated average care staff-to-resident ratio was 0.79 (median= 0.67), increasing between 2017 (0.74) and 2022 (0.87). The average staffing level (care hours per resident per day; hours:minutes) was 3:28 (median= 2:58). We estimated ordinary least squares regression models with robust standard errors, controlling for facility-level characteristics and year. On average, staffing levels were higher by 1:38 in memory care (MC) and 0:42 in nonprofit settings. Compared to non-Medicaid settings, overall staffing levels were about 1:00-1:30 lower in mixed-payer settings, and 2:00 higher in settings providing specialty care (e.g., behavioral health, bariatric) at increased Medicaid reimbursement rates. Licensed nursing staff levels were slightly higher in MC, nonprofit, and special contract Medicaid settings. Certified nursing/medication aide levels were 0:30 higher in nonprofit settings. There were no differences in caregiver levels by profit status or rurality, though mixed-payer setting levels were lower by 0:32-0:44. Reduced occupancy during the pandemic resulted in higher staffing levels, though findings suggest continued disparities in staff mix by facility characteristics.
THE ASSOCIATION OF COVID-19 OUTBREAKS AND OTHER FACTORS WITH NURSING HOME RESIDENTS’ QUALITY OF LIFE
Authors: Hoben Matthias , Dymchuk Emily , Banerjee Sube , Estabrooks Carole 
Published: December 2023

Abstract
Nursing home (NH) residents’ Quality of life (QoL) is an important goal of care. However, it is understudied, particularly during the COVID-19 pandemic. Our objective was to examine whether COVID-19 outbreaks, care aide emotional exhaustion, and lack of resident access to geriatric professionals were associated with NH residents’ QoL. In this cross-sectional study (Jul-Dec 2021), we purposefully selected 9 NHs in Alberta, Canada based on their COVID-19 exposure (no or minor/short outbreaks vs repeated or extensive outbreaks). Using a validated questionnaire (DEMQOL-CH), we assessed dementia-specific QoL of 689 residents from 18 care units through video-based interviews with care aides. Independent variables included COVID-19 outbreak in the NH in the last 2 weeks (health authority records), proportion of care aides on a care unit with high emotional exhaustion scores (9-item short form Maslach Burnout Inventory), and resident access to geriatric professionals (validated facility survey). We ran mixed-effects regression models, adjusted for facility and care unit characteristics (validated facility and care unit surveys), and resident covariates (Resident Assessment Instrument – Minimum Data Set 2.0). COVID-19 outbreaks within two weeks of the data collection (β=0.189, 95% confidence interval [CI]: 0.058;0.320), higher proportions of emotionally exhausted care aides on a care unit (β=0.681, 95%CI: 0.246;1.115) and lack of access to geriatric professionals (β=0.216, 95%CI: 0.003;0.428) were significantly associated with poorer resident QoL. Policies aimed at reducing infection outbreaks, better supporting care staff, and increasing access to geriatric specialists, may help to mitigate negative effects of COVID-19 NH residents’ QoL.
AN INTERNATIONAL PERSPECTIVE ON OPTIMIZING FUNCTION AND ACTIVITY IN GERIATRIC CLIENTS ACROSS ALL SITES OF CARE
Authors: Zwakhalen Sandra , Metzelthin Silke , Resnick Barbara 
Published: December 2023

Abstract
With an increasing age, people are at risk for functional decline and care dependency. Frail older people in any site of care –at home, in nursing homes and in acute care– are supported by nursing staff to optimize their functioning, remain active, and maximize their independence. However, nursing staff often tend to work in a task-oriented manner and take over tasks unnecessarily which may deprive older people’s remaining abilities and adversely impact their life quality. Nursing staff require support to improve their activity supportive behavior in practice. This symposium presents the results of several international studies from primary care, home care, nursing home care and acute care, which aim to improve nursing staff behavior and –in turn– client outcomes. First, Prof. Galik will present the results of a randomized controlled theoretically-based trial testing the ‘Function-Focused Care’ approach in which over 350 patients participated. Dr. Vluggen will present the results of a cluster-randomized trial conducted in Dutch nursing home care in which the effectiveness of the ‘SELF-program’ is evaluated, including over 250 nursing staff and 200 patients. Dr. Metzelthin will discuss the feasibility of the SELF-program, which has been subjected to a thorough pilot-study in Dutch home care. Last, Prof. Graff will discuss the experiences of people with dementia and caregivers after following a coaching-based psychosocial program for primary care (SOCAV). The symposium is chaired by Dr. Vluggen and discussed by Prof. Resnick who has a considerable track record in intervention studies focusing on optimizing function and activity in geriatric clients.
EFFECTS OF COMPANION ROBOTS ON DEPRESSION AND SOCIAL ISOLATION AMONG KOREAN AMERICAN OLDER ADULTS
Authors: Lee Othelia 
Published: December 2023

Abstract

Objectives
During the COVID-19, older immigrants in low resource areas who are already excluded from much of social life, had to distance themselves even further, deepening their social isolation. Lack of stimulation can be particularly detrimental, as it influences mood and increases loneliness. Selected for cost-effectiveness and interactive features, we introduced the Companion Robot (CR) system. Preliminary studies conducted in South Korea found statistically significant improvement in quality of sleep and cognition among low-income older patients living alone with multiple chronic conditions and cognitive impairment. Method. Thirty CRs were deployed to solo-living Korean American older adults. We followed up with them after 3 months. In this Stage 1A clinical trial, we tested feasibility, usability and acceptability of CRs, investigating which features of CRs will help improve health behaviors such as medication adherence and daily exercises. Robotic Social Attitude (RoSAS) are assessed with a generic 18-items questionnaire (Krägeloh et al., 2019).

Results
The primary clinical outcomes measured at pre-and post-intervention were medication adherence and reduction of depression, social isolation and disabilities. The user-friendly doll-shaped design of CRs helped participants feel comfortable interacting with the CR on their own. Exposure to individualized CR-delivered content, including quizzes for brain training and inspirational messages, combined with consistent interaction with CR appeared to be beneficial for cognitive function.

Discussion
Since very few participants had reported diagnosis of dementia, we need to screen for undetected dementia using the Modified Mini-Mental Status Exam. The next stage is to implement further cultural adaptation for the U.S. participants.
BARRIERS AND FACILITATORS IN USING THE E-PAINSUPPORT INTERVENTION FOR ADRD PATIENTS AND CAREGIVERS
Authors: Mayahara Masako 
Published: December 2023

Abstract
Pain is one of the most common comorbidities of ADRD and is experienced by 45.8% of ADRD patients. The major barrier to effective pain management is poor adherence to pain management regimens, due in part to caregiver lack of knowledge and lack of self-efficacy in administering analgesics. Pain in ADRD patients is associated with depression, wandering, agitation, and aggression. Digital applications may facilitate pain management by: (1) delivering education to increase knowledge and self-efficacy, (2) expediting pain reporting to nurses, and (3) improving adherence to pain management protocols. e-PainSupport is a self-administered, digital pain management application. It has three elements: (a) Educational Module, (b) Patient Pain Record, and (c) Pain Summary for Nurses. The efficacy of the app is currently being tested in a randomized controlled trial funded by the National Institutes of Health. The preliminary findings support the efficacy of e-PainSupport in reducing patient pain intensity and increasing caregivers’ self-efficacy and knowledge. However, the current intervention relies on patients’ self-reporting of pain and thus is not appropriate for all ADRD patients. Therefore, the purpose of this study is to explore facilitators for and barriers to using e-PainSupport for ADRD patients and caregivers. The data will be collected through post-intervention, semi-structured interviews of nurses and caregivers with patients in the e-PainSupport condition. Findings will inform future adaptations of e-PainSuport for ADRD patients and caregivers.
AGING EDUCATION IN THE UNITED STATES: WHERE WE ARE AND HOW DID WE GET HERE?
Authors: Donorfio Laura 
Published: December 2023

Abstract
Aging education at the precollege level is relatively new in the United States, making its debut in the literature in the 1960s (Myers, 1977). The first White House Conference on Aging (WHCoA) in 1961, centered on the need for aging education and recommended it be integrated into curricula in public schools, higher education institutions, and libraries (McGuire, 2017). At the 1971 WHCoA it was noted that such educational efforts were indeed rare and again recommended that aging and life cycle education be mandatory at all levels of education, programs be developed to train teachers about aging, and older citizens be used as school volunteers (McGuire, 2017). Since then, aging curricula and intergenerational programming have made their way slowly and insufficiently into education at both the pk-12 and college levels. Interestingly, more recently, it seems more for-profit organizations are investing in aging education and training versus educational institutions to educate their workforce to better meet the needs of their older consumer base to increase their profit margins. Beyond profit margins, what is the heuristic value of aging education and why is it increasingly important and needed not only in the United States, but worldwide? This paper will kick off the symposium and set the stage with a retrospective account of what factors have propelled aging education in the United States and what we have learned to move aging education forward at both the pk-12 and higher education levels.
CELEBRATING CENTENARIANS IN ELEMENTARY SCHOOLS: PROMOTING POSITIVE VIEWS OF AGING AMONG YOUNG CHILDREN
Authors: Hancock Cynthia , Newsham Tina , Alston Daniel , Fugate-Whitlock Elizabeth , Nikzad-Terhune Katherina 
Published: December 2023

Abstract
Upon learning that some teachers celebrate the 100th day of school by asking young children to dress up “like a 100-year-old,” the presenters questioned what ideas about aging are reinforced by such an activity. Social media images reveal that many of these activities lead to stereotypical presentations of older people. Additionally, the “fun” activity of dressing like a centenarian teaches children that it is okay to have fun at the expense of another segment of the population and reinforces the belief that older people are frail, weak, confused, and out of touch. Partnering with experts in early childhood and elementary education, the presenters created a toolkit to offer accurate information about centenarians, aging, and ageism and to give teachers options for celebrating the 100th day of school that reinforce important academic content, address prekindergarten to second-grade learning standards/outcomes, and support age-inclusivity. The presenters will share data from a pilot study of the curriculum and suggest next steps for advancing aging education among very young learners.
INTER-ORGANELLE CROSSTALK IN THE REGULATION OF AGING AND LONGEVITY
Authors: Wang Meng 
Published: December 2023

Abstract
In eukaryotic cells, specific functions are compartmentalized into various organelles that are evolutionarily conserved across species. Many of these organelles play crucial roles in regulating cellular homeostasis and organismal health. Lysosomes, mitochondria, lipid droplets, and endoplasmic reticulum (ER) are highly metabolic active and support the metabolic balance of lipids, amino acids, carbohydrates, and nucleotides. These organelles also regulate signal transduction, transcriptional responses, and epigenetic dynamics, and contribute to the control of lifespan and healthspan in a variety of organisms. Importantly, these organelles do not act in isolation, instead exhibit complex intercommunication at structural, metabolic and signaling levels. The dysfunction of these organelles and their intercommunications have been associated with aging and age-related pathologies. This symposium aims to encourage innovative studies on the role of organelle interactions and communications in regulating aging and longevity. Speakers have been invited to share their new findings in this research topic. We will discuss how lysosomal metabolism couples with lysosomal signaling to regulate organelle crosstalk, tissue communication, and organism lifespan; how ER and mitochondria communicate through calcium signaling and promote longevity; how lipid droplets play a novel role in remodeling carbohydrate metabolism and define the metabolic balance in supporting organism health; and how lysosomal activity, mitochondrial function and cytosolic proteostasis orchestrate to support cellular homeostasis.
ER CALCIUM SIGNALING COORDINATES MITOCHONDRIAL DYNAMICS AND METABOLIC FUNCTION TO PROMOTE LONGEVITY
Authors: Burkewitz Kristopher 
Published: December 2023

Abstract
Inter-organelle communication is a critical determinant of cellular metabolic homeostasis, and defects in the interactions between organelles are increasingly correlated with age-dependent diseases. Despite these promising links, exploration of how inter-organelle signaling pathways can be targeted to promote healthy organismal aging is a nascent area of research. We have established a foundation in C. elegans to investigate how the communication between endoplasmic reticulum (ER) and mitochondria, two of the most central metabolic hubs in cells, controls the aging process. Combining electron microscopy, live-imaging and biochemical approaches, we provide evidence that C. elegans forms ER-mitochondrial contacts and that through molecular mechanisms conserved to mammals, ER calcium flux potently stimulates mitochondrial bioenergetics. Furthermore, genetic manipulation of the ER inositol triphosphate receptor (InsP3R) reveals that ER calcium signaling promotes mitochondrial homeostasis at multiple other levels, including mitochondrial gene expression and dynamics. Building on this foundation, we now reveal that ER calcium signaling is essential for longevity in contexts of mitochondrial reprogramming. Surprisingly, InsP3R-stimulated mitochondrial bioenergetics do not appear to be the key mechanism of longevity in these contexts, but rather the underappreciated roles of the ER in tuning mitochondrial gene expression and morphology. Our results thus highlight the InsP3R as a potent and central regulator of diverse mitochondrial properties and reveal that the connections between ER and mitochondria are deeper and more complex than current models suggest. Overall, we reveal that inter-organelle communication between ER and mitochondria is an essential mechanism of longevity in paradigms involving mitochondrial reprogramming.
POSTPENSIONABLE AGE AS A DISTINCT CAREER STAGE
Authors: Platts Loretta , Cahill Kevin 
Published: December 2023

Abstract
This paper presents a new, two-phase model of the late career. Drawing on life course theory, we assert the importance of age-norms for ordering the timing of people’s lives in countries with universal old-age pension systems. Three age boundaries may govern the transition to retirement: social security rules, employment rules and social norms. Upon reaching these boundaries: (1) old-age pension receipt provides a reliable income easing breadwinner pressures, (2) compulsory retirement may push older people out of the workforce, and (3) social expectations encourage participation in leisure rather than paid work. Once old-age pensions ease or eliminate bread-winning pressures, financial necessity no longer drives most of these oldest workers. Further, these working pensioners are defying social conventions calling on them to retire from paid work. Post-pensionable-age or “phase II” jobs tend to be more flexible and rewarding, and less stressful than those held by younger workers. Intriguingly, not only do these workers have quite distinctive motivations to work, they have unique ways of subduing the potential burdens of working. However, most research lumps together workers over pensionable age (in phase II) with workers still in their fifties (in phase I) who are fully exposed to labor market risks. This paper presents theoretical arguments and empirical evidence to support the idea that post-pensionable-age work is a discrete career phase economically, subjectively, and in terms of leverage with employers. It explores likely geographical and socio-economic limits to this two-phase model of the life course.
A QUALITATIVE EVALUATION OF RISE FROM THE PERSPECTIVE OF ADULT PROTECTIVE SERVICES CASEWORKERS
Authors: Rogers Geoff , MacNeil Andie , Connolly M T , Salvo Erin , Kimball Patricia , Lewis Stuart , Burnes David 
Published: December 2023

Abstract
Our understanding of effective elder abuse and self-neglect (EASN) response interventions is limited. Adult Protective Services (APS), the primary agency responsible for responding to EASN, lacks a coherent, conceptually driven, prolonged intervention phase. Informed by ecological-systems, client-centered, and relational perspectives and adapting evidence-based modalities from other fields, the RISE intervention addresses this systems gap and compliments and augments APS services. Based on a three-year pilot project involving a partnership between RISE and Maine APS, the current study conducted a qualitative evaluation of RISE, from the perspective of APS caseworkers (n=14) who worked with RISE. The purpose of this evaluation was to understand RISE strengths, areas for improvement, and qualities of the RISE/APS partnership. Findings suggest APS workers perceive that RISE benefits clients, complements the scope and nature of APS, enhances APS caseworker well-being, and reduces repeat APS cases. Further APS/RISE collaboration and clarification on RISE role responsibilities and referral eligibilities represent areas of growth. This study provides preliminary evidence for RISE as a community-based EASN intervention in partnership with APS
USING RISE IN CASES DIVERTING DEFENDANTS IN ELDER ABUSE SCENARIOS OUT OF THE CRIMINAL SYSTEM AND INTO TREATMENT
Authors: Connolly M T , Ulrey Page , Kimball Patricia , Rogers Geoff , Lewis Stuart , Burnes David 
Published: December 2023

Abstract
Criminal justice system interventions are a common response to elder abuse, neglect and exploitation (EA), but there is severely limited understanding of their efficacy in reducing EA or improving the well-being of older adults. A goal attainment scaling feasibility study revealed that APS clients’ goals often included getting help (like substance use or mental health treatment) for someone else, often family members harming them. Some APS and RISE clients reported reluctance to seek help or report harm, fearing that involvement of the criminal justice system might result in them losing control over their lives, losing a caregiver, being forced into a facility, or legal punishment of someone they care about. Given these findings, the RISE team engaged in a lengthy outreach and planning phase with state and local prosecutors, elder victim service providers, restorative justice experts, and researchers, to design a novel intervention, using RISE in conjunction with drug court, to divert cases involving substance using defendants alleged to have mistreated an older person. This session will describe the extensive planning and design process and provide a case study analysis, which suggests that a combination of drug court’s in-patient treatment for the defendant, services for the victim, and RISE’s focus on restorative justice approaches that repair breached relationships reduced harm and benefited the older person, the defendant, and their families. Implementation of RISE in partnership with the criminal justice system carries important implications for the integration of restorative justice practices in some EA cases.
NEIGHBORHOOD CONTEXT AND QUALITY OF LIFE OF OLDER ADULTS IN EASTERN NEPAL: A CROSS-SECTIONAL STUDY
Authors: Sapkota Krishna , Ghimire Saruna , Shrestha Aman 
Published: December 2023

Abstract

Introduction
Increased life expectancy has resulted in population aging and subsequently entails addressing the needs of older adults. Shifting family structures from multigenerational to nuclear have had a significant effect on the older adults’ livelihood and their ways of interaction with community members. This research aims to comprehend the relationship between neighborhood context and older adults’ quality of life (QoL) in Nepal.

Methods
A total of 847 non-institutionalized older adults (≥60 years) from eastern Nepal were interviewed in 2021. The QoL was measured by13-item version of the Older People’s Quality of Life questionnaire (OPQOL-brief), and each item was measured on a 5-point Likert scale. The OPQoL mean score &lt; 3 was recoded as low, and ≥3 was high QoL. Ethnic diversity, monthly income, connection with family, friends, and neighbors, cultural connection, residential instability, and accessibility were measured to see the effect of neighborhood context. Multivariable logistic regression assessed the relationship between neighborhood context and QoL.

Results
More than 20% of older adults reported low QoL. Participants engaged in occupation [OR=2.63], not consuming tobacco [OR=1.78], living in communities with higher ethnic diversity [OR=1.03], frequently in contact with family [OR=4.77] and neighbor [OR=13.79], and stable residence [OR=5.43] had significant associations with better QoL.

Conclusion
In this study, neighborhood context was a determinant of better QoL in older adults. Therefore, engagement in income generation activities, and strengthening families and neighborhood ties bring good QoL among older adults.