bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE INFLUENCE OF ARTIFICIAL INTELLIGENCE ON CLINICAL DECISION MAKING: GERIATRIC REGISTERED NURSES’ PERSPECTIVES
Authors: Freeman Shannon , Henderson-Betkus Mary , Currie Leanne , Banner Davina , Jackson Piper 
Published: December 2023

Abstract
The emergence of ChatGPT highlights the potential of AI applications used in nursing care. AI in the form of machine learning or deep learning provides the ability to scan through clinical data using various algorithms to predict a clinical outcome for a client/patient and influencing clinical decisions. Registered nurses (RNs) are accountable for their decisions when caring for older adults receiving geriatric services and supports. Therefore, we conducted an online survey online cross-sectional survey from April to July 2023 to evaluate community focused RNs knowledge and awareness of the use of AI within their decision-making process. 233 RNs completed the survey. RNs were aware of AI in healthcare (56.7%) and in nursing (30.9%) with less familiarity with machine learning (ML) in geriatric nursing (16.3%). Source of knowledge of AI and ML came from informal sources such as media and social media and from family and friends whereas formal sources were less common. RNs agreed (69.8%) that automated outcomes to help them prioritize older adult clients and target services would be useful. However, 77.9% were concerned with who would be responsible if AI offered incorrect recommendations. Most RNs (90.2%) identified they should have the competency of how AI can improve processes and outcomes. RNs should be consulted if AI had implications on geriatric practice. Future phases of this research will examine how RNs can be better involved in AI that influences their practice and how they might be better prepared to evaluate AI outputs as part of their decision-making process.
THE PROTECTIVE LIFESPAN BENEFITS OF SOCIAL SUPPORT BUFFERS CHILDHOOD ADVERSITY
Authors: Willard Meredith , Best Ryan , Turiano Nicholas 
Published: December 2023

Abstract
Childhood adversity has negative effects across the lifespan including increased mortality risk. The support we receive from others, social support, has shown to be a protective factor against ACEs. However, little research has investigated the amplifying effects of poor social support, also known as social strain. Individuals with high levels of social strain and low levels of adversity would have the lowest mortality risk, it was hypothesized. Early life adversity was computed using 16 retrospective items assessing emotional and physical abuse, socioeconomic disadvantage, familial instability, and early-life poor health. Social support was computed using four-family, four-friend, and six-spouse items assessing reliability and emotion availability. Social strain was computed using four-family, four-friend, and six-spouse items assessing annoyance and disappointment. Cox proportional hazards models tested whether adversity, social support, and social strain were associated with the 20+year hazard of dying. Adjusting for age, gender, race, education, and marital status, higher ACEs (HR = 1.06) lower social support (HR = 1.07) and greater social strain (HR = 1.06) were all significantly associated with an increased hazard of dying (all ps &lt; .05). A significant ACE x Social Support interaction emerged (HR = 0.95) suggesting the association between ACEs and hazard of dying was strongly positive at low levels of social support, but that the relationship was negative at high levels of support. Thus, high levels of social support buffer the negative effects ACEs have on mortality risk. This provides robust evidence that interventions increasing social support could reduce the harmful effects ACEs.
THE RELATED FACTORS ON HEALTH DEFICIENCIES IN NATIONAL NURSING HOMES USING PANEL LARGE DATASET
Authors: Shin Juh Hyun , Ahn Jinhyun , Lee Soo-Kyoung , Harrington Charlene , Jung Sunwoo , Lee Yeonwoo , Ali Sanna 
Published: December 2023

Abstract
Health deficiencies are considered scientific research outcomes and should be reported as mandatory for all Medicare-Medicaid nursing homes (NHs). However, health deficiencies have been a concern for several decades. Previous studies have focused on regulatory deficiencies or used nurse staffing variables as control variables. This study investigated health deficiencies in relation to nurse staffing, facility size, and ownership across all Center for Medicare and Medicaid NHs in the United States. This study used secondary data analysis using Payroll-based Journal Daily Nurse Staffing data, Area Resource File, and LTCFocus. Data were merged with federal Medicare/Medicaid provider IDs as the basic unit of analysis for the 2019 fiscal year. A total of 7,802 NH data were analyzed using Poisson regression. The average total weighted health deficiencies survey score was 66.12. The average bed size was 114.02, where 74% were profit NHs. The average hours per resident day (HPRD) for each nurse staffing was as follows: 0.57 registered nurses, 0.86 licensed practical nurses, and 2.16 certified nurse aides. As total HPRD increases by 1 unit (exponential 0.83), it is likely that health deficiencies decrease by 17%. The bed size less than 60 (exponential 0.87) and not-for-profit NHs (exponential 0.09) was related with decreased health deficiencies of 13% and 91%. The worsened residents’ acuity was related with 2% more health deficiencies (exponential = 0.98). This large dataset analysis shows that professional nurse staffing is associated with superior NH quality of care with fewer deficiencies and supports the need for age-friendly long-term healthcare systems.
THE RELATIONSHIP BETWEEN INTERNET USE AND LIFE SATISFACTION IN LATER LIFE: A FOCUS ON THIRD-LEVEL DIGITAL DIVIDE
Authors: Khor Ern Chern , Choi Moon 
Published: December 2023

Abstract
The third-level digital divide highlights how social factors can shape disparities in real-life experiences derived from digital use. This study aims to examine how different types of internet use are related to the life satisfaction of older adults with varying health and wealth statuses through the lens of the third-level digital divide. The data for this study came from the 2022 Korea Digital Divide Survey. A sample of 1,165 older adults aged between 65 and 96 years old was grouped into four categories based on their health and wealth statuses, considering that these two factors tend to shape the social positions of older adults in Korean society. Life satisfaction was measured using 5 items from the 4-point Satisfaction with Life Scale (SWLS), while different types of internet use were accessed with 13 dichotomous items. The findings showed that a significant positive effect of internet use was observed only among older adults with good health status, indicating a stronger effect for those with good wealth status. Particularly, online public services (d=1.41, p&lt; 0.001), cloud services (d=1.35, p&lt; 0.001), and social networking services (d=1.27, p&lt; 0.001) exhibited significant effects. No significant effect was observed for older adults with poor health status, except for online entertainment content, which was found to be significantly related to the life satisfaction of those with low wealth status (d=0.87, p&lt; 0.01). The study findings imply diversity in terms of internet use and its association with life satisfaction, while highlighting social disparities.
THE RELATIONSHIP BETWEEN THE CAREGIVING ENVIRONMENT, BURNOUT AND QUALITY OF LIFE AMONG HOME HEALTH AIDES
Authors: Baek Sehyun , Park Soobin , Shin Oejin , Park Sojung , Ko Ahra 
Published: December 2023

Abstract
The well-being of home health aides (HHAs) is affected by the characteristics of their work environment. As South Korea’s population rapidly ages, there is an increasing demand for home aides. However, little is known about how the caregiving environment affects HHAs. Guided by the environment comfort model, we examined the association between care recipients’ home environment and HHA’s quality of life, focusing on how burnout mediates this relationship. Our data came from a national survey of home health aides in 2020 (N=981). We conducted an exploratory factor analysis to identify six factors related to the care environment in three dimensions: physical (1. space; 2. indoor/outdoor conditions), functional (3. home appliances; 4. heating/air conditioning), and psychological (5. satisfaction with the home environment; 6. relationships with care recipients and their families). We then used a path analysis to examine the relationship between these factors, burnout, and quality of life. Our findings show that safe indoor/outdoor conditions and positive relationships with care recipients and their families are associated with lower levels of burnout, leading to a higher quality of life (p&lt; 0.05, respectively). This highlights the importance of considering both physical and psychological aspects of the caregiving environment to prevent burnout and improve the quality of life for HHAs, ultimately contributing to high-quality services for care recipients.
THE ROLE OF OUTDOOR LIGHT EXPOSURE ON SLEEP QUALITY IN OLDER INDIVIDUALS WITH FRAILTY OF DIFFERENT LIVING TYPES
Authors: Hsieh Yi Chin , Chiu Ching-Ju 
Published: December 2023

Abstract
The study investigates the relationship between outdoor light exposure and sleep quality in older individuals with frailty in institutions and the community, where sleep disorders are common, and outdoor light exposure is inadequate.The study includes older individuals with frailty in community and institutions in Taiwan. Participants must be aged 65 or above and have a Clinical Frailty Scale score between 4 to 8. We collect sleep quality and outdoor light exposure data using questionnaires and actigraphy.The study includes 77 older individuals: 29 from day-care centers, 22 from conventional long-term care institutions, and 26 from unit care institutions. The average outdoor light exposure is 15 minutes per day, with an average Pittsburgh Sleep Quality Index (PSQI) score of 8, 74% sleep efficiency, and 125.8 minutes of wake after sleep onset. After controlling for multiple variables. Outdoor light exposure shows no relationship with PSQI, sleep efficiency, and wake after sleep onset.The average PSQI score is &gt; 5, indicating poor subjective sleep quality. Additionally, Wake After Sleep Onset &gt; 60 minutes, and sleep efficiency &lt; 75%, suggesting poor objective sleep quality. The average outdoor light exposure time &lt; 20 minutes, indicating a lack of outdoor light exposure. However, our study does not observe the effects of light exposure, possibly because the average daily light exposure is below the 30-minutes threshold. Older individuals with frailty experience poor sleep quality. It is possible that a longer duration of outdoor light exposure may be needed to observe its impact on sleep quality.
THE SOCIAL STRATIFICATION OF INFORMAL CAREGIVING ARRANGEMENTS IN EUROPE
Authors: Albertini Marco , Zanasi Francesca , Piccitto Giorgio 
Published: December 2023

Abstract
In ageing societies, the increasing quota of older and frail individuals creates unprecedented needs for care. As care is often costly and not adequately covered by the welfare state, care responsibilities for older individuals fall on the shoulders of family members. The study of informal care provision is acquiring centrality both in the social sciences and policy discourse, since the care load can bear negative consequences on a range of outcomes, from health (e.g., the “caregiver burden”) to employment. It is important to gain a better understanding of which individuals are the most likely to provide informal caregiving and face its consequences. In the present study, we explore the educational and income differences in the probability of providing informal caregiving to individuals living outside the household in Europe, using the Survey of Health, Aging and Retirement in Europe (SHARE, 2004-2020). As a contribution to the field, we aim at uncovering the mechanisms behind the socio-economic gradient in caregiving, such as differences in health and longevity and time constraints (due to employment and other care responsibilities) that are unequally distributed across social layers. Results show that individuals with tertiary education, and at the top of the income distribution, are more likely to provide care, net of several other factors. The study concludes with attempted explanations of the results, related to the fact that lower educated, and lower income individuals, can more often rely on publicly provided services and means-tested benefits.
THE SOUTHEAST FLORIDA VETERANS’ COMMUNITY PERSPECTIVES ON THE MEANING OF WELL-BEING: A PHENOMENOLOGICAL INQUIRY
Authors: Birmingham Cheryl 
Published: December 2023

Abstract
The Veterans are a unique community shaped by past military experiences that may have positive and negative effects on their well-being as soldiers. With nearly half of the 18.4 million Veterans in the United States living beyond 61 years the physical and mental health conditions may desolate the Veterans’ well-being. Promoting Veteran well-being has been studied extensively but scant on how they define it. It is critical to understand how Veterans define well-being to inform future program development addressing mental health needs. The purpose of this study is to discover the meaning and the live experience of well-being among Veterans. A qualitative hermeneutic interpretative phenomenological approach was used to understand the meaning of Veterans’ well-being. It allowed the phenomena to surface while exposing the essence of and the experience. Purposive sampling was used to recruit participants, with semi-structured interviews via ZOOM and observations at Veteran Service Organizations (VSOs). Fourteen Veterans participated in this study, 8 males and 6 females with majority greater than 61 years. 64% were White, 21% Hispanic and 15% African American. With the use of Max van Manen’s analysis strategy, 3 major themes emerged: (1) A Connection to a Military Sisterhood/Brotherhood; (2) The Lingering Effects of Military Service and (3) Healthy Companionship/Relationships advocating for Veterans’ well-being. The lingering effects persisted and challenged the Veterans’ emotional well-being; however, they were able express their military camaraderie continued in Veteran life. Programs based on social relationships that allow connections with Veterans and/or their significant others need to be established.
THE VOLUNTEER EXPERIENCE IN THE FAITH CARE FAMILY PROJECT FOR AFRICAN AMERICAN CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Fields Noelle , Xu Ling , Williams Ishan , Epps Fayron 
Published: December 2023

Abstract
African American adults are disproportionately affected by Alzheimer’s disease and related dementias (ADRD). Improving knowledge about ADRD in the African American community is also important for dispelling the myths and stigma about the disease. The Faith Care Family (FCF) Project was developed to help bridge gaps in ADRD knowledge by training volunteers from a predominantly African American church (N = 9) to work with ADRD caregivers in a 6-week, telephone-based pilot intervention. The Alzheimer’s Disease Knowledge Scale (ADKS) and qualitative interviews were used to examine the church volunteers’ knowledge of dementia. Non-parametric McNemar tests and Wilcoxon signed-rank tests were conducted for each item and the sum scores of the ADKS scale, respectively. Qualitative interview data were analyzed using thematic analysis. The results of the quantitative data indicated overall significant improvements in the sum scores of ADKS after the training (p = .008) as well as after the intervention (p = .05). Some specific ADKS items showed a significant increase after the training including items related to high cholesterol, using reminder notes, and mental exercise as well as after the intervention related to prescription medication. Thematic analysis of the interviews revealed six themes: types of ADRD, ADRD symptoms/behaviors of ADRD, early-onset, fatality, dignity, and previous knowledge. Overall findings suggest that the FCF Project is a promising intervention for enhancing knowledge about ADRD for African American church volunteers. Recommendations for future research and strategies for lay provider ADRD interventions in faith communities are offered.
THERANAP: AN EDUCATIONAL SLEEP HEALTH INTERVENTION FOR FRAIL OLDER ADULTS
Authors: Berkley Amy 
Published: December 2023

Abstract
Napping and other daytime sleep is often overlooked and poorly defined in insomnia research. Studies have shown correlations between older adults’ napping habits and increased medical co-morbidities and risks of dementia, but others report napping enhances memory consolidation and broader aspects of cognition in younger adults. Why is napping recommended for younger adults but considered problematic for older adults? In previous a research study, (18 older adults in an independent living facility: 6 men,12 women, mean age 84, SD= 7.62, range 67-96, who self-reported sleep problems) participants reported napping in qualitative interviews but denied daytime sleep on standard sleep assessments. Participants spoke about napping apologetically and expressed dread of its links to functional and cognitive decline. They stigmatized planned napping, which could potentially benefit their cognitive functioning, but seemed accepting of accidental napping, which could well indicate more serious physical or cognitive issues To address these issues, TheraNap teaches intentional napping as a therapy. This sleep health education intervention empowers sleep-deprived older adults to take control of their sleep habits by practicing intentional napping to improve overall sleep health. TheraNap includes: • Short sleep health training session with recommended napping guidelines • Two-week long planned napping routines • A sleep diary • Supplementary sleep meditations • Follow-session to assess perceptions of sleep health More research is needed into the ways napping can improve physical and cognitive function, and more education is needed for older adults, their families and caregivers, and LTC staff about the importance of sleep for older adults.
TRANSITIONS TO LIVING ALONE AND PSYCHOLOGICAL WELL-BEING OF OLDER ADULTS IN THE U.S: ARE THERE ANY RACE DISPARITIES?
Authors: Dong Wuyi , Song Qian 
Published: December 2023

Abstract
We extend the existing literature on living alone and psychological well-being in older adults by focusing on the transition process from other living arrangements to living alone. We examine how transitioning to living alone is associated with psychological well-being scores (measured by 21-item Ryff Measures of Psychological Well-being) and how the associations vary across racial and ethnic groups. Using data from 2016 and 2020 Health and Retirement Study, we specify the transitions to living alone from four living arrangements: living with spouse/partner only, living with spouse/partner and older parents, living with a spouse/partner, children, and parents, and living with others. Respondents consistently living alone were the reference group. Our analysis involves adults aged 50 and above (n=3160). After controlling for final psychological well-being scores and adjusting for age, gender, marital status, and education in 2016, results from multiple linear regression models suggest that the transitions from living with spouse/partner only to living alone are associated with significantly lower scores of psychological well-being (β= -1.71, p&lt;.01) than those consistently living alone. However, no statistically significant differences were observed between individuals transitioning from the other three living arrangements to living alone and those consistently living alone. The moderation effect shows that older Blacks experienced increased psychological well-being when transitioning from living with a spouse/partner to living alone (β=2.26) while their White counterparts had decreased psychological well-being during the same transition. This underscores the significance of the transition experience and emphasizes race disparities in its association with psychological health outcomes.
U.S. REMOTE CANCER CARE FOR OLDER ADULTS: A SYSTEMATIC REVIEW AND SOCIAL NETWORK ANALYSIS
Authors: Garces Edwin , Karakida Maki 
Published: December 2023

Abstract
Telemedicine and telehealth services are a promising solution for older cancer patients who are susceptible to infectious diseases, like COVID-19, and travel a longer distance to their closest hospital. To provide all-inclusive oncology care, understanding social disparities in access to remote cancer care is crucial. Yet, little is known about the accessibility of these technologies among US cancer patients in later life. The present study aimed to evaluate the main sociocultural factors associated with older patients of virtual oncology care interventions in the US. This systematic review explored the literature on telemedicine for geriatric oncology and patients’ accessibility to remote health technologies. PubMed, CINAHL, Scopus, and Web of Science databases were searched. Using Bibliometrix, Science of Science (Sci2) Tool, and Gephi, Social Network Analysis (SNA) was conducted to identify the central and intermediate factors linked to remote cancer care for older US adults. Among 427 retrieved articles, 19 articles, published between 2003 and 2023, met the eligibility criteria. The selected studies were focused on rural cancer patients (20%) and telehealth during COVID-19 outbreaks (20%), followed by lifestyle interventions (15%), ehealth literacy (10%), prostate or breast cancer (5%), older sexual minority men with prostate cancer (5%), and patients’ race, age, and region (5%). Findings also highlighted that gender, digital health literacy (technology readiness), and location are the key determinants of telemedicine access and use among older US cancer patients. Multiple socio-demographic aspects of older patients need to be considered for implementing equitable access to remote oncology care.
UNDERSTANDING “COMMUNITIES” IN COMMUNITY-BASED SENIOR HOUSING MODELS: A SCOPING REVIEW
Authors: Park Sojung , Baek Jihye , Ryu Byeongju , Ko Ahra , Kim Jeungkun , Amano Takashi , Kim Hyeji 
Published: December 2023

Abstract
Various community-based senior housing models have been developed to enhance social engagement and communal living among older adults, alongside their pursuit of independence and later life well-being. However, a comprehensive understanding of the efficacy of these housing models in cultivating “communities” which are integral to sustaining social ties in later life, remains limited. This scoping review investigated the conceptualization, establishment, and management of communities within diverse housing models, with an emphasis on community-related constructs. This scoping review examined empirical, peer-reviewed studies sourced from PsycINFO, CINAHL, MEDLINE, Scopus, and PubMed, resulting in the inclusion of twenty-one articles. Through thematic analysis, three predominant themes emerged: 1) residents’ well-being and lived experiences within the community (n=13), 2) engagement in communal activities and social programs (n=4), and 3) the spatial design and physical aspects of the community (n=4). We found that the way communities are defined and conceptualized differed across housing models. Also, residents’ individual characteristics (e.g., gender, age, income, health status) influenced their community lives and experiences. Community experiences were often conceptualized as a “sense of community” and “place attachment.” The majority of research focused on the experiences of residents’ communal living and their well-being. Still, some studies focused on how social and physical environments supported and facilitated community lives. This study underscores the need for further research into the dynamics of communities within diverse senior housing facilities. Also, more studies should be conducted on how those communities are formed and maintained to support older adults’ successful social lives in the community.