bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHANGES IN PHYSICAL ACTIVITY, SEDENTARY TIME, AND SELF-RATED HEALTH ACROSS THE RETIREMENT TRANSITION
Authors: Westerlund Hugo , Fröberg Andreas , Sacco Lawrence , Suorsa Kristin , Leskinen Tuija , Hettiarachchi Pasan , Svartengren Magnus , Stenholm Sari 
Published: December 2023

Abstract
The aim was to investigate concurrent changes in accelerometer-measured total physical activity (TPA), moderate-to-vigorous physical activity (MVPA) and sedentary time, and changes in self-rated health across the retirement transition. Data from two longitudinal studies was pooled: the Swedish Retirement Study (SRS) and the Finnish Retirement and Aging (FIREA) study that used similar methods. Data from three waves (each approximately 12 months apart) was included: one pre-retirement (wave 1, W-1) and two post-retirement follow-ups (W-2 and W-3). In total, 245 participants (27% men, mean age 64 years at W-1) were included. Thigh-worn accelerometers were used to collect data for TPA, MVPA and sedentary time at W-1 and W-2 and processed through ActiPASS and harmonized for time spent in different physical activity intensities. To be included in the analyses, a minimum of 4 days with at least 10 hours of accelerometer wear time during waking hours at both W-1 and W-2 was required. Questionnaires were used to collect data for self-rated health at W-1, W-2, and W-3. Ordinal regression models showed that 10 more minutes of MVPA at W-1 was significantly associated with higher odds of reporting better self-rated health at W-1 (OR: 1.12 [1.02-1.22]) in non-manual workers only. The association between MVPA and self-rated health was non-significant in the fully adjusted models. No significant associations were observed between changes in TPA, MVPA or sedentary time during retirement transition, and self-rated health at post-retirement follow-ups. In conclusion, this study showed a significant cross-sectional association between MVPA and better self-rated health before retirement.
DEPICTION OF OLDER ADULTS IN AN INTERNATIONAL PACIFIC RING STUDENT COMPETITION ON OLDER ADULT CARE
Authors: Guillemot Jonathan , Yunus Raudah Mohd , Rueda Ordoñez Carlos Joaquin , Withers Mellissa , Xin Meiqi , Rozelle Mary , Kubasova Ksenia , Hairi Noran Naqiah 
Published: December 2023

Abstract
The Global Health Program of the Association of Pacific Rim Universities (APRU), a consortium of universities in countries surrounding the Pacific Ocean, organized a competition in 2020 named “2020 Case Competition Challenge “Improving Elderly Care in the Asia-Pacific””. It yielded proposals from 28 teams from nine countries in Asia and the Americas in the form of 10-minute videos. Our study aimed to analyze the depiction of older adults to identify patterns of portrayal of older adults among university students. We coded the videos according to a two-step process, whereby we first filtered the videos to identify extracts related to the portrayal of older adults and subsequently coded the dataset according to a list of 10 codes, which were elaborated iteratively during the first step of coding. We analyzed the coded data and identified patterns, which served as a basis for analytical axes. Across included economies, we identified strong patterns of discriminatory discourse and depiction. Older adults were often assumed to be systematically sick, disconnected from the social and technological realities as well as incapable of being active contributors to society. Teams often proposed solutions medicalizing socialization, whereby social interactions were represented as clinical interventions void of meaning. In this unusual approach to studying portrayal of older adults among university students, we found concerning patterns of bias, therefore calling for immediate action towards tackling discrimination at university levels. Considering the pace of global aging, such intervention would contribute the essential view that demographic aging, as such, is not a problem.
CHALLENGES AND OPPORTUNITIES IN RECRUITING DIVERSE OLDER ADULTS WHO ARE FRAIL FROM THE MAPS-B STUDY
Authors: Tariq Suleman , Kouroukis Alexa , Kennedy Courtney , Adachi Jonathan , Leckie Carolyn , Papaioannou Alexandra , Rodrigues Isabel 
Published: December 2023

Abstract
Including diverse individuals at the research and participant levels are essential to improve the effectiveness of real-world interventions; however, there are challenges when including such individuals. Our study purpose was to report the challenges of recruiting diverse older adults for the Mapping Sedentary Behaviour study. Our methods were guided by Step 1 (“Establish Partnerships”) in the Knowledge-to-Action-Ethics Framework. We assembled a diverse team of eleven researchers, clinicians, and patient partners. To recruit a broad group of participants, we partnered with City Housing Hamilton, which provides subsidized housing for older adults. We met with the organization’s partnership development advisor who organized two recruitment orientations; 80 potential participants and returning attendees were present for both sessions. The organization provided coffee and donuts. Most attendees were from visible minorities and had visible disabilities (i.e., used a walker or cane). To build rapport, we met with attendees in groups of 5 to 6 to introduce the research team and explain the study. We recruited 13 participants (seven female, one transgender man; Morley FRAIL score≥3). Before their scheduled study visit, twelve participants dropped out citing medical mistrust (i.e., fearing unintentional medical tracking). The last participant dropped out after the initial study visit due to their family’s skepticism in research. Additionally, some individuals may have enrolled for financial incentives as they were interested in receiving immediate monetary compensation. We faced challenges when recruiting frail older adults from diverse backgrounds. Future studies should focus on developing methods to target medical mistrust with older adults and their families.
“THE ONLY WAY FOR US TO STAY SAFE IS TO HIDE”: THE EXPERIENCES OF OLDER CHINESE IMMIGRANTS DURING COVID-19 IN NYC
Authors: Wu Yiyi , Brennan-Ing Mark , Finkelstein Ruth 
Published: December 2023

Abstract
The COVID-19 pandemic disproportionately affected older adults, who were at heightened risk for COVID-19 morbidity and mortality, as well as social isolation. Challenges to accessing health information and vaccine resources were amplified among older immigrants due to language barriers, lack of established social networks, and experiences of systemic discrimination. Considering the surge of anti-Asian violence across the country and the high-profile violent incidents targeting Asian older adults, our analysis focuses on the lived experiences of older Chinese immigrants during the pandemic in New York City (NYC). To describe the support needed during the pandemic to inform service delivery, we conducted in-depth interviews with 9 low-income Chinese adults over 65 about their experiences in coping with COVID-19. Interviews were transcribed and subjected to inductive thematic analysis. Results show that driven by the pro-vaccination and science norms in China, participants shared an overall positive attitude towards vaccines and exhibited extraordinary resilience to COVID-misinformation. However, COVID-19 and anti-Asian violence amplified each other. Fear of contracting COVID-19 due to perceived age-related vulnerability and fear of anti-Asian violence were prevalent, leading to self-protective withdrawal and deferred health care. Many expressed concerns about traveling to public places alone. Deeply frustrated with the government’s role in controlling violent crimes, some participants decided to stay home indefinitely to evade trouble. Mechanisms to draw out people who have socially withdrawn are needed. Senior service providers in NYC should initiate discussions about perceived safety and implement peer buddy systems to enhance post-pandemic quality of life for Asian older adults.
SOCIOECONOMIC DISPARITIES IN PHYSICAL AND OCCUPATIONAL THERAPY HOME HEALTH CARE VISITS FOR PEOPLE WITH DEMENTIA
Authors: Muruganand Ashwath , Lassell Rebecca , Lin Shih-Yin , Convery Kimberly , Fletcher Jason , Brody Abraham 
Published: December 2023

Abstract
People living with Dementia (PLWD) utilize Home Health Care (HHC) services such as Physical Therapy (PT) and Occupational Therapy (OT), but little is known about service utilization patterns among PLWD from different socioeconomic backgrounds. We aimed to identify disparities in service utilization in PLWD in a HHC setting across socioeconomic backgrounds using a measure of geographic socioeconomic deprivation, the Area Deprivation Index (ADI). ADI is a composite measure of census variables describing socioeconomic disadvantage, reported as national percentile rank. This secondary analysis utilized data collected February 2017–May 2022 in a dementia symptom management clinical trial at a large, urban, Medicare certified nonprofit HHC agency in New Jersey. Demographic and service utilization data from 153 dyads of PLWD and caregivers was collected. PLWD’s area codes were used to calculate ADI. ADI national percentile was divided into quartiles, and PT and OT utilization for the highest quartile was compared to the three lowest quartiles using Poisson regression, consistent with previous literature. The highest quartile group was defined as ADI above the 36.5th percentile. ADI varied from 2nd to 73rd percentile, with a median of 24th percentile. Analysis controlled for pre-existing comorbidities using pre-trial Charlson Comorbidity Index scores, classified as high (&gt;5), medium (3-4), or low (1-2). High ADI classification was associated with a 50.2% decrease in OT utilization (IRR=.498, CI=.348-.713), and 39.4% decrease in PT utilization (IRR=.606, CI=.485-.759). Further investigation of disparities in PT and OT utilization in HHC is needed, given the disproportionate burden of disease on socioeconomically distinct populations.
HETEROGENOUS EFFECTS OF MEDICARE BENEFIT FOR ADVANCE CARE PLANNING CONVERSATION BY SOCIODEMOGRAPHIC FACTORS
Authors: Lou Yifan 
Published: December 2023

Abstract

Background
Although Medicare makes the option of physician-patient advance care planning (ACP) discussion available to everyone starting in 2016, older adults from disadvantaged backgrounds may be less likely to benefit from the policy. Motivated by Fundamental Cause Theory, this study examines the heterogenous policy effect, as a natural experiment, on older adults’ ACP uptake.

Methods
Data were from Health and Retirement Study 2012-2020 with 15,647 individuals. I used two quasi-experimental models – interrupted time series (ITS) analysis and difference-in-difference (DID) – to study ACP outcomes before and after the policy implementation between older adults who were Medicare-eligible and those who weren’t. I studied the heterogenous effects in stratified samples by race/ethnicity, immigration background, and socioeconomic status. I used coarsened exact matching to address the potential bias that the comparison group is not the ideal counterfactual control unit.

Results
DID reveals that, in the total population, Medicare expansion was associated with a significant increase (0.05 percentage point) in the proportion of older adults who completed advance directives, but not for having informal conversations. Furthermore, I find no evidence that the Medicare expansion was effective in improving the rates of ACP among Black, Hispanic, Asian or Native American, or non-US-born older adults. Lastly, based on ITS results, the policy only has significant immediate policy effects (level change) on ACP uptake, but not for sustained effects (slope change). Discussions: The current policy reproduced the disparities in ACP. I discuss health policy recommendations to improve the ACP rate among older adults with disadvantaged backgrounds.
DID COVID-19 CHANGE REPORTS OF LONELINESS AND SOCIAL ISOLATION AMONG OLDER AMERICANS ACT CLIENTS?
Authors: Menne Heather , Pendergrast Claire 
Published: December 2023

Abstract
COVID-19 raised immediate concern about the exacerbation of already high levels of loneliness and social isolation of older adults. Using the cross-sectional 2019 and 2021 National Survey of Older Americans Act Participants, we explored changes among selected populations of OAA clients – family caregivers (CGs), home-delivered meal clients (HDMs), and congregate meal clients (CMs). Descriptive statistics, t-tests, and review of 95% confidence intervals between years were conducted to understand rates of loneliness (UCLA 3-items) and social isolation (1-item). Results were not statistically significant but yield important findings. First, there were more cases of loneliness (48-70%) and social isolation (31-50%) than was known for the general older adult population before COVID-19. Second, the changes between 2019 and 2021 varied by service and gender. Among CGs, there was little difference in the cases of social isolation and loneliness from 2019 to 2021; however, male CGs reported a 20.3% increase in cases of social isolation. For HDMs there was a little difference over time in cases of social isolation and loneliness. There was a 23.3% increase in the number of CMs reporting social isolation and a small increase (9.3%) in CMs reporting loneliness; however, there was an 18.4% increase in cases of loneliness among male CMs. These results warrant further investigation to understand whether OAA services are a protective factor for social connections and further implementation of innovative approaches to lower overall rates of social isolation and loneliness among OAA clients.
ADVANCED CARE PLANNING: LEVERAGING PARTNERSHIPS TO IMPROVE STATE-WIDE DISSEMINATION
Authors: Bodenheimer Lisa , Rutberg Jennifer , Tadel Pat , DeGennaro Jennifer 
Published: December 2023

Abstract
Rowan-Virtua School of Osteopathic Medicine, The New Jersey Institute for Successful Aging (NJISA), in collaboration with the New Jersey Division of Aging Services (DoAS) and Respecting Choices, implemented a state-wide project training workforce professionals in Advanced Care Planning (ACP) conversations with older adults. The concept: proactively leverage the long-term care management relationships in community-based, high-touch programs. NJISA identified Respecting Choices, an evidenced-based program approved by the Administration for Community Living. Respecting Choices offers standardized certification for ACP facilitators and instructors, paving a pathway for workforce sustainability. To achieve state-wide penetration, NJISA partnered with NJ DoAS to target staff and professionals serving the state aging network. NJ DoAS provided access to county-level case managers serving the Jersey Assistance for Community Caregiving (JACC) program, Program of All-Inclusive Care for the Elderly (PACE) nurses and social workers, and NJ DoAS staff. Also included in training efforts were staff from select senior affordable housing sites. With funding support through the New Jersey Health Foundation, NJISA and Respecting Choices offered virtual, live training course for certification of First Steps ACP facilitators and instructors and Design and Implementation for state aging networks, and ACP Instructors. NJ DoAS modified the electronic documentation system utilized by JACC staff to capture on-going ACP conversations and outcomes. Despite barriers and mid-course corrections, training totals include (30) certified ACP Facilitators, (3) leaders for Design and Implementation, and (5) certified ACP Instructors. Response to curriculum was positive; participants indicating greater confidence navigating ACP conversations. Future plans to continue dissemination have been discussed.
EVALUATION OF DEMENTIA EDUCATION TRAINING IN GEORGIA NURSING HOMES
Authors: Chen Yun-Zih , Morgan Jennifer , Okwaro Lynnete 
Published: December 2023

Abstract
The increased use and misuse of antipsychotics and psychotropics in nursing homes have been well documented. Person-centered dementia care training that addresses skill development and practice change around communication strategies and non-pharmacologic approaches has the potential to impact the misuse of these drugs as chemical restraints. The goal of this study is to implement and evaluate an online team-based dementia education (Dementia Beyond Drugs: Changing the Culture of Care) program aimed at skill development and practice change. The program was delivered online over six weeks to teams of nursing home staff for a total of 12 hours of synchronous interactive learning. Teams were also assigned application exercises between meetings. Topics included “dementia, dementia beyond drugs, interpersonal approaches, and understanding personal expressions.” This study implemented the training with staff teams from 22 nursing homes in Georgia (N=97). Pre-post data analysis reveals a significant improvement in the nursing home environment and relationships as measured by the Kansas Culture Change Instrument, and increased attention to the use of antipsychotic drugs in staff meetings. This study indicates that team-based online learning has the potential to improve person-centered dementia care practices and attention to the use of non-pharmacological approaches to address behavioral expressions of residents living with dementia. Future research is needed to expand person-centered dementia care education programs to more nursing homes and evaluate their short and long-term effectiveness.
PERSON-CENTERED DEMENTIA CARE IN SOUTH KOREA: AN INTEGRATIVE REVIEW
Authors: Kong Eun-Hi , Park Hyunju , Shin Juh 
Published: December 2023

Abstract
Person-centered dementia care is a globally recognized best practice; however research on this practice is lacking. In Korea, the number of people living with dementia is rapidly increasing, expanding the need for person-centered care. Thus, we reviewed published studies regarding person-centered dementia care in Korea. We searched for studies in four databases (RISS, KISS, KoreaMED, and DBpia) and selected 14 primary studies published between 2007 and 2023. Two reviewers extracted data and three reviewers analyzed the data. Search keywords included person-centered care, person-centred care, person-centered dementia care, person-centred dementia care, dementia, demented, Alzheimer, or cognitive impairment. A total of 14 articles met inclusion criteria. The primary studies were published between 2007 and 2023, and most studies were conducted in long-term care settings and targeted formal care staff. The authors’ disciplines included nursing, social welfare, humanity, and human services. Many studies did not report theory or theoretical models. Research designs included non-experimental study (8), qualitative study (4), and experimental study (2), and randomized clinical trial (1). Many studies did not report on theory or theoretical models. Most quantitative studies included variables such as personhood in dementia, person-directed care, person-centered climate, dementia knowledge, or attitude toward dementia. Most quantitative studies reported that person-centered dementia care education programs enhanced personhood in dementia in long-term care settings. The qualitative studies explored the meaning of humanitude, readiness to adapt, effective communication, or education programs related to person-centered dementia care. Future scholars should conduct experimental studies or mixed-method studies to report on theory or theoretical models.
BLACK CAREGIVERS’ CULTURAL, RELIGIOUS, AND SYMPTOM MANAGEMENT EXPERIENCES WITH HOME HOSPICE CARE
Authors: Park Taeyoung , Sloan Danetta , Cruz-Oliver Dulce Maria , Reid M Cary , Czaja Sara , Adelman Ronald , Dignam Ritchell , Phongtankuel Veerawat 
Published: December 2023

Abstract
Informal Black or African American (Black/AA) caregivers are at high risk for caregiver burden due to both greater caregiving responsibilities and unmet needs. However, there has been minimal research on the challenges Black/AA caregivers face after hospice enrollment. This study seeks to address this knowledge gap by applying qualitative methods to understand Black/AA caregivers’ experiences around cultural, religious, and symptom management challenges during home hospice care. Data from semi-structured interviews with 11 bereaved Black/AA caregivers of patients who received home hospice care were qualitatively analyzed. Cultural needs (e.g., knowing their language, having familiarity with foods) were perceived as not on top of mind for many Black/AA caregivers. However, there was concern of stigma around mental health preventing care recipients from sharing their mental health concerns and seeking resources. Many caregivers relied on their personal religious networks rather than services provided by hospice chaplains. Regarding symptom management, caregivers struggled most with managing patients’ pain, lack of appetite, and decline near End of Life (EoL). Lastly, caregivers reported increased burden during this phase of caregiving but were satisfied with the overall hospice experience. Our results suggest that tailored approaches that target mental health stigma in the Black/AA community and reduce caregiver distress around EoL symptoms may improve hospice outcomes among Black/AA hospice caregivers. Hospice spiritual services should consider offering services complementary to caregivers’ existing religious networks. Larger quantitative studies are needed to examine the clinical implications of these results in terms of patient, caregiver and hospice outcomes.
EXPLORING THE BIOLOGICAL AGING DYNAMICS IN A RENAL DEVELOPMENT ORGANOID MODEL
Authors: Kasahara Tomoko , Zhang Bohan , Tyshkovskiy Alexander , Tongu Yoshiyasu , Abe Takaaki , Gladyshev Vadim 
Published: December 2023

Abstract
Aging clocks emerge have emerged as promising molecular estimators of biological age based on DNA methylation or transcriptomic profiles. Among other insights, they revealed “ground zero” of aging during mouse embryogenesis characterized by the lowest biological age. To model the biological age dynamics during human embryogenesis, we established a differentiation culture system that mimics embryonic kidney development from human iPSCs. We then applied multiple aging clocks to the samples from hiPSC to kidney organoid stages. This analyses revealed the lowest biological age around the intermediate mesoderm stage, indicating a potential rejuvenation event at an early stage of renal development. A principal component analysis suggested that development in this system may comprise two processes with distinct contributions to aging, with one process increasing monotonically during development, while the other increasing at primitive streak and decreasing after the mesoderm phase. We further examined the relationship between these two processes and our previously-established transcriptomic signatures of aging and reprogramming. Interestingly, the former process may represent mostly age-related genes, while the latter process reprogramming-related genes. These findings suggest the occurrence of “ground zero” in a cell culture model of early embryonic development and characterize it in the context of molecular pathways and transcriptomic signatures.