bluuebunny/crossref_metadata_2025_split huggingface dataset:
A SCOPING REVIEW OF HOW NURSING HOME STAFFING LEVELS AND QUALITY OF CARE ARE MEASURED
Authors: Zhang Mutian , Brown Shelby , Tang Weizhou , Tucker-Seeley Reginald 
Published: December 2022

Abstract
The Centers for Medicare & Medicaid Services (CMS) is the largest payer of nursing home care in the US. CMS defines staffing levels as hours per resident day (HPRD) and staff turnover rates; it defines quality of care as nurse staffing levels, hospitalization rates, resident outcomes, and deficiencies (violations of regulations). However, these definitions have been inconsistently applied in the research literature, which has led to equivocal results in research on the association between staffing levels and the quality of care in nursing homes. We conducted a scoping review of how nursing home staffing levels and quality of care have been defined and measured in the research literature, guided by the PRISMA (Preferred Reporting Items for Systematically reviews and Meta-Analyses) framework. Out of the N=423 initially identified studies through PubMed, N=67 articles were selected, based upon the following inclusion criteria: 1) published after January 1, 2010; 2) published in the US; 3) focused on determinants of nursing home staffing levels or determinants of quality of care. Two independent reviewers conducted abstract screening and data extraction. The findings from our review showed that approximately 50% of studies partially adopted the definitions from CMS. For example, HPRD and deficiencies were utilized to measure staffing levels and quality of care in N=37 and N=12 studies, but none of them included all suggested measures. Future studies should carefully consider the approriate definitions as specific measures can yield contradictory associations between staffing level and quality of care, easily leading to confusion for policymakers.
ADIPOSITY CHANGE IN ADULTS: THE IMPACT OF TRAIT NEUROTICISM
Authors: Alderson Jacob , Willard Meredith , Turiano Nicholas 
Published: December 2022

Abstract
Increased body weight is a risk factor for poor health and shortened life expectancy. Thus, it is imperative to understand how body weight changes across adulthood and to identify factors that predict weight gain so effective prevention strategies can be implemented. It is well-known that eating habits and physical activity are two of the most important factors (along with genetic factors) contributing to weight gain. However, we seek to determine if personality levels predict weight gain because individual differences in personality are thought to be the root-cause of many behaviors related to weight gain. We utilized longitudinal data on over 6,000 adults (aged 20-75 at baseline) from the Midlife Development in the U.S. Study (MIDUS). The Big 5 personality traits, body weight, waist circumference, and body mass index were measured three times from 1995-2015. We estimated a growth curve model to determine whether each adiposity measure changed over 20 years, controlling for age, gender, and education. There was a significant increase in all adiposity measures over time. The rate of adiposity change over time varied among persons (random: weight b = 0.543; waist b = 0.008; BMI b = 0.009; p values &lt; .05). Higher levels of neuroticism predicted this variability (fixed: weight b = 0.211; waist b = 0.027; BMI b = 0.029; p values &lt; .05) such that those scoring higher in trait neuroticism had a steeper increase in all three adiposity measures. These findings suggest that personality traits are important in the progression of weight-gain in adults.
PERSPECTIVES ON THE RISK FACTORS ASSOCIATED WITH MISSING INCIDENTS IN PERSONS LIVING WITH DEMENTIA
Authors: Daum Christine , Perez Hector , Miguel-Cruz Antonio , Letts Elyse , Rutledge Emily , Liu Lili 
Published: December 2022

Abstract
Persons living with dementia are at higher risk of getting lost and going missing. The adverse outcomes of missing incidents are stressful for persons living with dementia and those who care for them. This study aimed to identify and describe the perspectives of persons with dementia, caregivers and community support organizations on risk factors. Generic qualitative description informed our methods. We conducted 30 virtual interviews with persons who live with dementia, professional and family caregivers and community support organization representatives. We used a card sort to elicit and describe perspectives on the importance of 27 risk factors commonly associated with missing incidents in persons living with dementia. Interviews were digitally recorded, transcribed verbatim, and subjected to content analysis to determine the presence of relevant words, themes, and concepts. Participants reported multiple experiences of a person going missing, impressions, and suggested relationships between factors such as environmental contexts. The most critical risk factors associated with getting lost and going missing were cognitive impairment, unmet needs, and inadequate concentration of services and resources. In contrast, race, education, and gender were perceived as unimportant pertaining to risk factors related to missing incidents in persons living with dementia. An understanding of the perceived importance of risks associated with missing incidents enhances a person-centered approach to addressing unmet needs, services and resources that balances quality of life with maintaining safety.
DEFICIENCY CITATIONS ON INAPPROPRIATE PSYCHOTROPIC MEDICATION USE WHEN CARING FOR BEHAVIORAL SYMPTOMS OF DEMENTIA
Authors: Yoon Jung Min , Trinkoff Alison , Galik Elizabeth , Brandt Nicole 
Published: December 2022

Abstract
The National Partnership to Improve Dementia Care in Nursing Homes in 2012, initiated by the Centers for Medicare and Medicaid (CMS), helped decrease antipsychotics use. However, inappropriate psychotropics use to control behavioral symptoms associated with dementia remains. Nursing homes (NHs) can be flagged for inappropriate psychotropics use as a deficiency of care citation (F-758 tag). The purpose of this study was to explore the nature of inappropriate psychotropic medication use deficiency, F-758 citations, in caring for NH residents with dementia using a mixed-methods study design. During the first quarter of 2018 (January–March), 444 NHs received F-758 tags related to care of residents with dementia. Information on deficiencies were obtained from 2018 Certification and Survey Provider Enhanced Reporting (CASPER) data. Deficiency reports were obtained from CMS Nursing Home Compare and ProPublica. Quantitative analysis was done to examine the frequency of involved psychotropic medications, scope and severity of F-758 tags, and reasons for the citations. Qualitative data analysis was conducted using content analysis with an inductive coding approach to summarize the inspection reports. Antipsychotics were the most involved drug category for F-758 tag citations. The three most common reasons for F-758 citations included failure to: identify and/or monitor behavioral symptoms (178 NHs), attempt gradual drug reduction (131 NHs), and maintain 14-day limitations on PRN psychotropic orders (121 NHs). This study suggests areas for improvement that could potentially reduce inappropriate psychotropics use. Supporting quality dementia care workforce and improving cooperation within healthcare professionals are recommended to ensure proper non-pharmacological and pharmacological interventions.
USING ACTIGRAPHY TO ASSESS CHRONOTYPE AND PHYSICAL ACTIVITY IN OLDER ADULTS
Authors: Hicks Hilary , Losinski Genna , Thangwaritorn Pilar , Laffer Alex , Watts Amber 
Published: December 2022

Abstract
Chronotype refers to the time of day that people prefer to be active or to sleep and varies predictably across the lifespan. In younger samples, the morning-chronotype is related to greater levels of physical activity (PA) and improved health outcomes. It is unclear whether this pattern holds in older adults, a group that commonly exhibits an “early bird” preference. We investigated differences in PA patterns between chronotypes in 109 older adults (Mage = 70.45 years) using wrist-worn ActiGraphs in a free-living environment. ActiGraphs captured data about PA and sleep using a novel approach to measuring chronotype with the mid-point of the sleep interval. We categorized participants as morning-, intermediate-, or evening-chronotypes. We used ANCOVA to predict total and average peak PA from chronotype, adjusting for age, sex, education, and BMI. Total PA significantly differed between chronotypes such that evening-types engaged in less PA than both morning- and intermediate-types, F (2,102) = 4.377, p =.015. Average peak activity did not differ between chronotypes, p =.112. Consistent with findings in younger samples, our evening type participants engaged in less overall activity. A unique finding was that evening-types did not differ from their morning- and intermediate-chronotype peers in peak activity levels. This implies a key distinction between total activity and peak activity levels consistent with recent trends in PA research using a 24-hour-a-day framework instead of average or total activity levels. Future research should consider whether these differences in activity patterns translate into meaningful differences in health benefits in this age group.
SENSE OF PURPOSE IN LIFE AND ALLOSTATIC BURDEN IN TWO LONGITUDINAL COHORTS
Authors: Lewis Nathan , Hofer Scott , Hill Patrick 
Published: December 2022

Abstract
Sense of purpose in life has been linked with better physical health, longevity, and reduced risk for disability and dementia, but the mechanisms linking purposefulness with diverse health outcomes is unclear. Chronic activation and dysregulation of neural, immune, and other bodily systems, known as allostatic load, may contribute to these underlying mechanisms. Specifically, sense of purpose may promote better physiological regulation in response to stressors and health challenges, leading to lower allostatic burden and disease risk over time. Data from the nationally representative US Health and Retirement Study (HRS) and English Longitudinal Study on Ageing (ELSA) (Total N=5846; Mean Age=67.24, SD=10.68, 59.08% female) were used to examine associations between sense of purpose and repeated assessments of allostatic load across 8 and 12 years of follow-up. Allostatic load scores were constructed from 12 blood-based and anthropometric biomarkers of cardiovascular, metabolic, immune, and lung function, with higher scores representing higher allostatic burden. Population-weighted multilevel models revealed that sense of purpose in life was associated with lower overall levels of allostatic load in HRS (b = -0.22, 95% CI: -0.27,-0.17) and in ELSA (b = -0.19, 95% CI: -0.35,-0.03). Sense of purpose in life did not predict rate of change in allostatic load in either sample. Associations with sense of purpose were highest among cardiovascular and immune biomarkers, suggesting that preservation of these bodily systems may underlie associations between purposefulness and reduced risk for chronic health conditions. Discussion will focus on biological and behavioral pathways connecting sense of purpose in life and health.
GOAL ADJUSTMENT CAPACITIES DURING COVID-19: CONTEXT-DEPENDENT BENEFITS FOR EMOTIONAL WELL-BEING
Authors: Hamm Jeremy , Barlow Meaghan , Tan Jaron , Garcia Odalis , Duggan Katherine 
Published: December 2022

Abstract
Increased constraints and lost opportunities inherent in the COVID-19 pandemic can threaten important life goals and erode emotional well-being. Theories of lifespan development have identified goal adjustment capacities (goal disengagement and goal reengagement) as core self-regulatory resources that can buffer against declines in well-being. However, little is known about the pandemic-related contextual circumstances under which goal adjustment capacities may become more or less beneficial for well-being. Using longitudinal data from a nationally-representative sample of Americans across the adult lifespan (aged 18-80, n=286), we examined the consequences of goal adjustment capacities for emotional well-being under circumstances when individuals reported lower or higher constraints than normal in their lives. Specifically, multilevel models tested whether the influence of between-person differences in (Level 2) goal disengagement and goal reengagement on well-being were moderated by (Level 1) within-person fluctuations in perceived constraints. Analyses controlled for age, sex, education, and income. We observed cross-level Goal Reengagement x Perceived Constraints interactions for depressive symptoms, perceived stress, and positive affect (bs = -.11 to .07, ps &lt; .05), but not negative affect. Results showed that the benefits of goal reengagement for depressive symptoms, perceived stress, and positive affect were pronounced on occasions when participants reported lower (vs. higher) than average perceived constraints in their lives. Findings point to the moderating role of pandemic-related contextual circumstances and suggest that goal reengagement may be most beneficial when individuals have fewer constraints than usual in their lives and may thus able to capitalize on opportunities to pursue new attainable goals.
WELL-BEING BEFORE AND DURING THE COVID-19 PANDEMIC: ASSOCIATIONS WITH RESILIENCE AND CHRONIC CONDITIONS
Authors: Kayser Jay , Smith Jacqui 
Published: December 2022

Abstract
Adults over the age of 60 tend to have higher well-being than younger adults, and high well-being is associated with a range of favorable mental and physical health outcomes. Resilience is related to the maintenance of well-being in the presence of challenging circumstances and stressors. Chronic health conditions are common in older adults and represent a stressor. Using longitudinal data, we address two research questions: 1) Are chronic health conditions and resilience predictive of changes in well-being before and during Covid-19? 2) Does the number of chronic health conditions and resilience interact in predicting changes in well-being before and during Covid-19? To answer these questions, we analyzed data from participants in the Health and Retirement Study (HRS) who completed both the 2016 and 2020 waves (N = 2276). On average, these participants were age 71.44 (SD = 7.35) and reported 2.40 chronic conditions. In unadjusted models, both the number of chronic conditions (β = -.21) and resilience (β = .09) were related to changes in well-being (R2 = .32). When covariates were added, these values were attenuated but remained statistically significant. The interaction between resilience and chronic health conditions was not statistically significant. Though the number of chronic health conditions and resilience play an important role in well-being for older adults, high resilience does not moderate the relationship between the number of chronic health conditions and changes in well-being. Further investigations using longitudinal data are needed to understand the relationship between resilience and well-being for those with chronic health conditions.
INTERPERSONAL DYSFUNCTION PREDICTS SUBSEQUENT FINANCIAL EXPLOITATION VULNERABILITY IN OLDER ADULTS
Authors: Han Duke , Lim Aaron , Mosqueda Laura , Nguyen Annie , Mason Tyler , Weissberger Gali , Fenton Laura , Lichtenberg Peter 
Published: December 2022

Abstract
The goal of this study was to test whether interpersonal dysfunction, characterized by loneliness and/or dissatisfaction with relationships, is an imminent predictor of financial exploitation vulnerability (FEV) among older adults within a 6-month observation period. This study also tests whether FEV prospectively predicts interpersonal dysfunction. Twenty-six adults aged 50 or older completed a study involving baseline data collection and 13 follow-ups over 6 months. Linear mixed models were used for primary analyses. After adjustment for demographic, psychological, and cognitive covariates, there were between-person effects of FEV and interpersonal dysfunction across follow-ups, suggesting that those with generally higher interpersonal dysfunction compared to other participants also reported greater FEV (B(SE)=1.09(.33), p=.003). There was a within-person effect (B(SE)=.08(.03), p=.007) of elevated interpersonal dysfunction predicting greater FEV two weeks later across all follow-ups. Within-person effect of FEV was not predictive of interpersonal dysfunction (B(SE)=.25(.15), p=.10). Among older adults, individuals with higher interpersonal dysfunction relative to others in the study reported greater FEV throughout the 6-month observation period. Increased loneliness and social dissatisfaction, relative to one’s average level, predicts subsequent increases in FEV, and may be an imminent risk factor for exploitation.
THE PROTECTIVE EFFECT OF RESILIENCE ON SHRINKAGE OF FRIENDSHIP IN LATER LIFE
Authors: Sugawara Ikuko , Takayama Midori , Ishioka Yoshiko 
Published: December 2022

Abstract
The purpose of this study was to examine the protective effect of trait resilience, a positive personality characteristic that enhances individual adaptation to life events and adversity, in the face of declining social relationships in later life. Social relations have a significant effect on our development and well-being throughout life. However, it is known that a decline in physical, cognitive, and mental functioning makes it difficult to maintain active participation in society and leads to shrinking social networks in later life. Therefore, it is important to identify protective factors that enable people to maintain positive social relations when functioning in daily life declines in old age. We analyzed longitudinal survey data from a representative sample of older Japanese adults aged 74 to 86 years (N=1064). The interaction effect of resilience in the relationship between functions (physical, cognitive, and mental) and relationships with friends (social support exchange and companionship) was examined using multi-group Structured Equation Modeling (SEM). Respondents were divided into upper quartile and lower quartile groups according to their Resilience Scale (RS-14) scores. The results showed significant group differences for the effect of cognitive function on friendship. The positive correlation between cognitive functioning and friendship was stronger among respondents with low resilience. For high resilience participants, cognitive functioning was not associated with friendship. The results suggest that resilient older adults cope well with poor cognitive health and maintain positive social relationships in very late life.
CHILDHOOD MALTREATMENT AND PROSOCIAL BEHAVIOR: A QUALITATIVE COMPARATIVE STUDY OF IRISH OLDER ADULT SURVIVORS
Authors: Rohner Shauna , Salas Aileen , Carr Alan , Thoma Myriam 
Published: December 2022

Abstract
Although childhood maltreatment can have lasting effects into later life, positive outcomes have also been observed, including an increased tendency towards prosocial behavior. However, little is known about the link between childhood maltreatment and later life prosocial behavior. Therefore, this study aimed to explore older adult’s experiences of childhood maltreatment and identify mechanisms linked to prosocial behavior in later life. The individual level, but also broader cultural and contextual mechanisms, were considered by comparing two adversity contexts and applying conceptual frameworks (socio-interpersonal framework model of trauma and recovery, motivational process model of altruism born of suffering). Semi-structured interviews (60-120 minutes) were conducted with 29 Irish (older) adult survivors of childhood maltreatment: 17 institutional (welfare care) abuse survivors (mean age: 61 years, range: 50-77), 12 familial abuse survivors (mean age: 58 years, range: 51-72). Interviews were analyzed using Framework Analysis. In both groups at the individual level, enhanced empathy, amelioration, and identity-related mechanisms were linked to prosocial behavior, with connections to caring roles and coping strategies from childhood. On a social contexts level, the limited resources or opportunities for help in childhood, and the social norms and beliefs of that time, influenced participants’ motivation to help others in later life. Group-specific mechanisms were also observed, such as compassion fatigue in the familial sample; and denouncing detrimental societal values in the institutional sample. The identification of individual, adversity-context, and culture-specific mechanisms linked to later-life prosocial behavior can promote a greater understanding of resilience and adaptability in older adult survivors of childhood maltreatment.
STRATEGIES TO ENSURE AUTHENTIC PARTICIPANTS AND VALID DATA WITH ONLINE RECRUITMENT OF FAMILY CAREGIVERS
Authors: Armah Henrietta , Vickers Jasmine , Wang Danny , Pickering Carolyn 
Published: December 2022

Abstract
Over the past years, recruitment of participants for behavioral and biomedical research through the internet has become more popular. Online has become an advantageous approach to recruitment, especially since the covid pandemic has posed a great challenge to most in-person research activities. Typically, internet-based recruitment strategies include website posting, emailing list of potential participants as well as using social media such as Facebook, Twitter, and Instagram to deliver recruitment information to groups who are often unrepresented in research. Although this mechanism has reduced barriers to participation, it has posed serious threats to data quality and validity. For example, some studies on data validity estimate that up to 90% of online survey responses are fraudulent when they rely on screening questions and CAPTCHA alone. Others have shown that vetted panel data such as Mechanical Turk (mTurk), has high rates of participant misrepresentation. Therefore, the aim of this paper is to highlight the challenges associated with internet-based recruitment of family caregivers and describe strategies for researchers to ensure data integrity. We discuss multi-faceted approaches to detect and prevent fraudulent and suspicious activities such as duplicate and automated enrollment by software applications known as bots as well by fraudulent human participants. We discuss data on several strategies that have proven effective in our previous and ongoing trails. We will also demonstrate the need to implement several strategies and a “fail-safe” to detect fraud after enrollment. It is imperative that researchers understand the need to address these challenges to preserve data integrity and replicability.