bluuebunny/crossref_metadata_2025_split huggingface dataset:
TEKIBEN --- DIGITAL DISIMPACTION AT HOME CARE IN JAPAN
Authors: Miyagawa Shoko , Seong Young Ah 
Published: December 2023

Abstract
Though this may not be the case worldwide, in Japan, digital disimpaction (Tekiben in Japanese) is one of the most frequently performed care procedures done by home-visit nurses. This study aimed to clarify the status of digital disimpaction at home care in Japan by interviewing nurses skilled in disimpaction. The interviews were conducted during the process of developing a simulator for digital disimpaction training and were conducted with seven nurses who provide home care. The interviews lasted between 50 and 75 minutes each. The interview data were transcribed, and descriptions of the frequency and target audience for digital disimpaction were extracted. The frequency with which each nurse performed digital disimpaction ranges from 10 to 30 times per month. The clients who require digital disimpaction include those who require the procedure regularly due to conditions such as cerebral infarction or neuropathy, as well those who are in the terminal stages of cancer or other conditions and require the procedure when assessed as necessary. Digital disimpaction techniques are not taught in educational courses at universities or vocational schools but are learned through on-the-job training at hospitals or in-home nursing. The reason for performing routine digital disimpaction is that it is difficult for family members to assist with defecation. The importance of passing stool at the time of digital disimpaction is pointed out, as it is difficult for family members to handle bowel movements in the absence of a nurse.
THE “DOUBLE JEOPARDY” OF MIDLIFE AND OLD AGE MORTALITY TRENDS IN THE UNITED STATES
Authors: Abrams Leah , Mehta Neil , Myrskyla Mikko 
Published: December 2023

Abstract
Since 2010, U.S. life expectancy growth has stagnated. Much research on U.S. mortality has focused on working age adults given adverse trends in drug overdose deaths, other external causes of death, and cardiometabolic deaths in midlife. We show that the adverse mortality trend at retirement ages (65+ years) has in fact been more consequential to the U.S. life expectancy stagnation since 2010, as well as excess deaths and years of life lost in 2019, than adverse mortality trends at working ages. These results reveal that the U.S. is experiencing a “double jeopardy” that is driven by both mid-life and older-age mortality trends, but more so by older-age mortality. Understanding and addressing the causes behind the worsening mortality trend in older ages will be essential to returning to the pace of life expectancy improvements that the U.S. had experienced for decades.
THE ASSOCIATIONS OF HANDGRIP STRENGTH AND ANTHROPOMETRIC MEASUREMENTS WITH UPPER LIMB BODY FAT MASS IN OLDER ADULTS
Authors: Suarez Jethro Raphael , Park Joon-Hyuk , Choudhury Renoa , Stout Jeffrey , Banarjee Chitra , Thiamwong Ladda 
Published: December 2023

Abstract
Body Fat Mass (BFM) is a crucial body composition measurement serving as a predictor for various health conditions and mortality in older adults. However, limited research has been conducted to investigate how upper limb BFM associates with anthropometric measurements and handgrip strength (HGS) in older adults. In this cross-sectional study, 119 older adults, ranging from 60 to 96 years of age (93 women, 26 men; mean age 74.71 ± 7.35 years), were assessed. Body composition was evaluated using the portable Bioelectrical Impedance Analysis (BIA) device, InBody S10, and average HGS was measured on each side using a hand grip dynamometer (JAMAR 5030J1). Multiple linear regression analysis was performed and found a significant, positive association for age (β = 0.048 , p = 0.024), height (β = 0.649, p = 0.024), and BMI (β = 1.371, p &lt; 0.001) with left arm BFM, while weight and left HGS showed a negative association (β = -0.152, p = 0.007; β = -0.070 , p = 0.004, respectively). Similar trends were seen for the right arm. However, height and right HGS became statistically insignificant (β = 0.536, p = 0.069; β = -0.046 , p = 0.054, respectively) for right arm BFM only. These results show that the independent variables may have the ability to predict upper limb BFM in older adults without the need for body composition measurement methods (e.g., BIA). Further research is warranted to examine the true predictive capacity of the independent variables in relation to upper limb BFM.
THE FEASIBILITY OF TAICHI WITH MUSIC FOR HEALTH IN INDIVIDUALS LIVING WITH ADRD AND THEIR CAREGIVERS
Authors: Du Yan , Blackmon Emma , Smith Christina , Robles Cindy , Subramanian Sandeep , Jee Sue , Meyer Kylie , Roberts Penny 
Published: December 2023

Abstract
Caregiving demands associated with cognitive and physical function decline in care recipients (CRs) living with Alzheimer’s disease and related dementias (ADRD) contribute to compromised health and quality of life among ADRD caregivers. In turn, the affected health of caregivers affects the care quality of CR and their health. TaiChi or music is evidenced to be beneficial for the generation population and those with various health conditions. This pilot project assessed the feasibility and preliminary efficacy of an 8-week TaiChi with music (TCM) program on individuals with ADRD (e.g., physical and cognitive function) and their family caregivers (e.g., caregiver distress and quality of life). Outcomes were compared between baseline and post-intervention using paired t-tests. Qualitative interview data exploring the perceptions of participating in TCM program were analyzed using content analysis. Five dyads were enrolled in this study (CR age=77.4±6.8; Caregiver age=62.6±6.7). The overall class attendance rate is 65%. Among the small but diverse sample, adult child care dyads had higher class attendance (93%); spousal care and CR with severe cognitive impairment dyads had lower attendance (46%). Improvements were found in assessed health outcomes for both CR and caregivers, and CR’s physical function significantly improved at 8-week (p=0.016). Qualitative data revealed perceived balance improvements; Caregivers perceived calmness and peace, and expressed their interest in participating in TCM in the future. TCM may be more feasible in ADRD individuals with mild to moderate cognitive impairment. Future research will evaluate the efficacy of this intervention in a larger sample with a longer follow-up period.
THE INFLUENCE OF SPIRITUALITY AND RELIGION ON NURSING HOME SOCIAL WORKERS PROFESSIONAL IDENTITY AND RESILIENCE
Authors: Garrison Brianna , Myers Dennis 
Published: December 2023

Abstract
The complexities of social workers’ behavioral integration of personal spirituality within nursing homes, where a highly regulated, stressful environment marginalizes professional identity and challenges retention, remains largely unexplored and untested. The paucity of data limits the profession’s commitment to resourcing current and future practitioners with evidence-informed integration of spirituality with professional identity, ethical practice, and continuation in the role. This qualitative study addresses this gap by interviewing and analyzing narratives authored by experienced NHSWs who daily navigate the spirituality-at-work opportunity and challenge. Researchers collected a purposive sample of licensed NHSWs working within these settings and consenting to participate. All respondents held a social work license at the baccalaureate or master’s level (LBSW, LMSW, or LCSW) and were employed as a social worker full time for an average of 3.2 years in their current nursing facility and their overall experience in nursing facility social work averaged 8.8 years, with a range of 2 to 30 years’ experience. Twenty NHSWs were interviewed and 80% (n=16) associated their role, at some level, with a higher power (God, Christ, Holy Spirit, unnamed) and religious beliefs and practices. Fifteen percent (n=3) stated faith and religious ideology had no impact or was irrelevant for practice, and one (5%) did not respond. It became clear that religion, spirituality, and faith practices matter for a majority of the respondents in how they view and enact their practice.
THE POTENTIAL OF MULTIDOMAIN MOBILE PROGRAMS IN SUPPORTING COGNITIVE HEALTH OF SENIORS IN RESIDENTIAL FACILITIES
Authors: Kim Junhyoung , Kim Yongseop , Cho Jeff , Ko Myungjin , Ory Marcia 
Published: December 2023

Abstract
This study pilot tested the efficacy of a mobile-based multidomain application, Silvia Program, on cognitive functioning of residents in assisted living facilities (ALFs). After a 12-week randomized pilot trial using a two-group pretest-posttest design (Silvia group vs. usual care group), we assessed the cognitive functioning using the Montreal Cognitive Assessment (MoCA). Results are that the total MoCA scores of the Silvia group showed significant improvement while the total scores of the control group declined. The present study provides suggestive evidence for an overall positive effect of the use of the Silvia Program on the cognitive functioning among residents in ALFs.
THE RELATIONSHIP BETWEEN ALLOSTATIC LOAD AND PROGRESS OF MULTIMORBIDITY AMONG OLDER AMERICANS
Authors: Mira Rolla Saud 
Published: December 2023

Abstract
To examine the relationship between allostatic load and progress of multimorbidity over 10 years among older Americans and whether it mediates socioeconomic inequalities in multimorbidity.
Methods Six Waves of Health and Retirement Study (HRS), a longitudinal survey of older American adults from 2006 -2016. Multimorbidity was indicated by 5 chronic conditions: diabetes, heart conditions, lung diseases, cancer, and stroke. Socioeconomic factors were education, total wealth, poverty-income ratio (income), and race/ethnicity. Behavioural factors were smoking, excessive alcohol consumption, physical activity, and body mass index (BMI). Allostatic load was used as a biomarker of stress and was indicated by a combination of total cholesterol, high-density lipoprotein, glycosylated hemoglobin, c-reactive protein, waist circumference, and high blood pressure. Two Multilevel mixed effects generalized linear models were constructed to assess the association between allostatic load and progress of multimorbidity and whether allostatic load explained socioeconomic inequalities in the progress of multimorbidity. All variables included in the analysis were time-varying except gender, race/ethnicity, and education.
Results Allostatic load was significantly associated with the progress of multimorbidity even after adjusting for socioeconomic and behavioural factors with a rate ratio (RR) of 1.12 (95%CI: 1.11, 1.13). The association between socioeconomic factors and multimorbidity was slightly attenuated after adjusting for allostatic load. Socioeconomic factors were also associated with changes in allostatic load.
Conclusion Biological markers of stress indicated by allostatic load were associated with the progress of multimorbidity. Allostatic load appears to be induced by adverse socioeconomic factors and mediates the relationship between socioeconomic factors and progress of multimorbidity.
THE ROLE OF SENSE OF PURPOSE IN HEALTH NAVIGATION AMONG MARGINALIZED OLDER ADULTS
Authors: Narine Ameesha , Mroz Emily , Sharma Shubam 
Published: December 2023

Abstract
A sense of purpose is a central, self-organizing life aim that guides choices and behaviors . In older adulthood, having a sense of purpose is linked with positive health. Understanding how older adults who identify as socially marginalized (e.g., racially/ ethnically diverse, LGBTQ+) leverage purpose to navigate their health, for example, when setting health values, making health decision, or adapting to health challenges may support development of tailored resources to combat social disparities embedded in healthcare systems.. This study used qualitative thematic analysis (Braun & Clarke, 2012). to explore the role of purpose in marginalized older adults’ current health navigation and including how purpose and health navigation change across adulthood. Nineteen older men and women who identified as socially marginalized (Mage = 66.5) participated in semi-structured interviews Analyses revealed that older adults draw on purpose to guide health by maintaining personally meaningful, health-related (e.g., health education, caregiving) vocations into late life and by modeling positive health behaviors for others . Further, the role of purpose in health navigation changed across their adulthoods: participants described shifts from adversity-driven purpose to wellness-focused purpose, translating early adversity into current health motivation, and finding space for their authentic purpose when health was considered to stabilize. Findings demonstrate that, for marginalize older adults, their relationship with their own health may improve across the lifespan as they overcome adversity and health becomes enmeshed in purpose. Findings support refining health interventions to account for the role of purpose for older adults who have faced undue social hardship.
THE SOCIAL RELATIONSHIP OF OLD ADULTS ACCORDING TO THE USE OF ASSISTIVE APPLIANCES IN SOUTH KOREA.
Authors: Yoon Yeojin 
Published: December 2023

Abstract
This study aims to examine the differences in the social relationship of the old adults between the use of assistive appliances. For the analysis, the data were obtained from “2020 National Data on the Elderly” published by the Ministry of Health and Welfare and the Korea Institute for Health and Social Affair. Data was a survey of people aged 65 and older conducted between June and August 2020, which included data from 10,097 people. The variables used for the use of assistive appliances were vision aids, hearing aids, chewing aids. The variables used to measure older adults’ social relationship resource are the frequency of visits and contact with non-resident children, grandchildren and children with whom they have the most contact, and the frequency of visits and contact with relatives, friends, neighbors, and acquaintances. The analysis used multiple regression analysis and t-test for comparison of means between groups, and the main findings were as follows. First, there is no statistical correlation between assistive appliances use and older adults’ social relationships. Second, there is no significant difference in the mean of the social relationships of older adults with and without assistive appliances use. In this paper, we overlooked the ease with which the elderly can use assistive appliances with support if they have functional difficulties. These findings confirm that there is no direct relationship between the use of assistive appliances and the social relationships of older adults, and suggest the need for further research on the social relationships of older adults.
TRIALS AND TRIBULATIONS OF CONDUCTING A GEROSCIENCE TRIAL
Authors: Millar Courtney , Baldyga Kathryn , Iloputaife Ikechukwu , Wolfe Alex , Kuo Jasmin , Lipsitz Lewis 
Published: December 2023

Abstract
Emerging trials of geroscience interventions show great promise in preventing age-related diseases and disabilities. However, there are many challenges that need to be considered when conducting such trials. Our objective is to describe the major challenges when conducting a geroscience intervention, utilizing the STAMINA study as an example. The STAMINA (Senolytics To Alleviate Mobility Issues and Neurological Impairments in Aging) study is a single-arm geroscience-motivated pilot study in which 12 older adults with mild cognitive impairment and slow gait speed are asked to take 12 doses of two senolytic agents (Quercetin and Dasatinib) over 12 weeks. Study challenges were identified and recorded by the study team and categorized into 3 groups: Regulatory, Recruitment, and Unexpected. This is a descriptive analysis and no formal statistical tests were conducted. Eleven major challenges were identified. The Regulatory Challenges included obtaining the IND from the FDA, hiring a clinical research organization (CRO) to monitor compliance with FDA regulations, and establishing FDA compliant data management tools and procedures. The Recruitment Challenges include drug-drug interactions, comorbidities, need for transportation to and from study visits, and fear of drug side effects. Unexpected Challenges included exorbitant drug costs (Dasatinib costs $500 per dose); requirements for drug storage, dispensing, and destruction; multiple safety lab tests; transportation; biomarker processing, transport, and assays; equipment failure; and intercurrent vaccinations and medicines (e.g., COVID-19 and flu vaccines) which may impact biomarker levels. Conducting a geroscience trial has numerous challenges that need to be considered when developing a budget, hiring staff, and assuring compliance.
TRYPTOPHAN: A POTENTIAL BIOMARKER DISTINGUISHING CHRONIC VENOUS LEG ULCERS HEALING IN OLDER ADULTS
Authors: Kim Jung Lyun , Stechmiller Joyce , Weaver Michael , Lyon Debra , Garrett Timothy , Kelly Debra 
Published: December 2023

Abstract
Chronic venous leg ulcers (CVLUs) affect 2 million persons annually, including 4% of people over age 65 years. Chronic wound healing is a complex process that is still not well understood. Indoleamine 2,3-dioxygenase (IDO) activity is highly active in chronic wounds. The study aims to examine the tryptophan (TRP) L-Kynurenine (KYN) metabolic pathway as a biomarker of CVLUs healing. We collected 60 serum samples from 30 older adult patients with CVLUs receiving weekly sharp debridement at a university wound clinic. Serum samples were collected at baseline, week 4, and week 8 until wound closure. Liquid chromatography-mass spectrometry (LC-MS) metabolomics was utilized to examine targeted metabolites. A robust Bayesian approach was employed to examine correlations between change of metabolites and linear healing slope. The mean age was 71.13 (±9.46); 25 (83.3%) were white; the mean wound area was 2823.54 (±6002.93) mm2; the mean wound duration was 341.67 (±538.29) days. A total of 11 participants had healed wounds during the study period. Those with healing CVLUs had higher levels of mean TRP at baseline and over time compared to individuals with non-healing CVLUs. Change in Kynurenic Acid (r:-0.36, Bayes factor: 3.70, 95% Credibility Interval [-0.62, -0.06]) was associated with a linear healing slope. Serum tryptophan may serve as a candidate biomarker for predicting wound healing trajectories, which can guide clinicians in making treatment decisions. Specifically, decreasing metabolites associated with the downstream activity of the kynurenine pathway, a pathway for tryptophan metabolism may be an indicator of healing under sharp debridement in CVLUs.
WHERE IS THE DIGITAL DIVIDE? INTRA-GENERATIONAL DIVIDE ON APP USAGE IN POST-PANDEMIC HONG KONG
Authors: Lau Bobo Hi-po , Shum Eric Ngai Yin , Lui Fan Yin-Fong , Lam Gigi , Kwok Alex Pak-Ki , Tsang Chung-Kin 
Published: December 2023

Abstract
The COVID pandemic has evoked extensive digitalization of our daily lives. This paper reports two studies conducted in the June/July 2023 that evaluated smartphone usage among Hong Kong middle-aged and older adults after 13 months of smartphone-based compulsory track-and-trace COVID policy. A focus group study with 145 adults aged 55 years or above (Max = 92) found that smartphones are used primarily for instant but asynchronous communication, thus, WhatsApp and WeChat are the most popular. Divisive usage is the most salient with apps that involve monetary transactions (e.g., mobile banking, online shopping) with participants having more trust towards the security provided by the device, the network, and the financial institutions as well as higher socio-economic status (SES) being more receptive. Higher SES was also related to a broader repertoire of app use. These findings corroborate with those from a concurrent survey with 750 smartphone users aged 45 or older (Max = 78). Using latent class analysis, we found two classes of users based on their usage on 18 categories of apps. Class 1 (64.3%) were more likely to use all categories of apps than Class 2 (35.7%), with the largest Chi-square values reported on apps for small-sum transactions, online shopping, private hire cab/courier, and mobile banking – all related to monetary transactions. Class 1 were younger, with higher SES, owning more smart devices, more proficient with mobile devices, and more optimistic with technologies than Class 2. Our findings elucidate directions for narrowing the digital divide within the older adult population.
MOBILE-BASED COGNITIVE TRAINING IN CHINESE AMERICANS: PERSPECTIVES FROM OLDER ADULTS AND ADULT CHILDREN
Authors: Xue Tingzhong (Michelle) , McConnell Eleanor , Wu Bei , Xu Hanzhang 
Published: December 2023

Abstract
The population of older Chinese Americans is growing rapidly. However, their access to culturally responsive dementia prevention services is very limited. Cognitive training may delay cognitive decline in older adults, but such training has not been widely accessible to older Chinese Americans. This study explored perspectives of older Chinese Americans and their adult children on dementia prevention and cognitive stimulating activities to inform co-design of a culturally appropriate, mobile-based cognitive training for this population. We conducted five focus groups in Mandarin using Zoom video conferencing, with four groups of older Chinese Americans (n=21) and one group of adult children (n=6). We applied rapid qualitative analysis, guided by the Health Belief Model. We identified seven themes. Overall, participants had modest knowledge of dementia, and viewed health care professionals as credible information sources for dementia prevention. Some participants thought any social activity would provide cognitive stimulation. Both older adults and adult children expressed strong interest in cognitive training but were concerned about losing interest over time and transportation and language barriers. Both groups noticed similar advantages (e.g. benefits for cognition, interesting exercises), and disadvantages (e.g. eyestrain, addiction) of mobile-based cognitive training but had different perspectives on acquiring health information online. Adult children were eager to provide support for older adults to participate in cognitive training, whereas older adults preferred to engage in cognitive training autonomously. Knowledge generated from this study forms the foundation for designing of a tailored mobile-based intervention to prevent cognitive decline among older Chinese Americans.