bluuebunny/crossref_metadata_2025_split huggingface dataset:
GOOD ALZHEIMER'S CARE DEFINED BY FAMILY CAREGIVERS AND FORMAL CAREGIVERS IN KOREA
Authors: Chung Gawon 
Published: December 2022

Abstract
The purpose of this study is to explore the meaning of good Alzheimer’s care and the policy needs from the perspective of family caregivers and formal caregivers(in long-term care settings) in Korea and to provide policy suggestions to mainstream "care" and "caregivers" into the Korean National Dementia Plan. By using mixed methods, the Korean Government's policy efforts under the National Dementia Plan to respond to the issue based on Alzheimer’s patients' individual needs and care environments and to alleviate family’s caregiving burden are analyzed. Also, the formal caregivers’ working conditions, difficulties, and the level of knowledge/expertise are examined to find out whether they are well prepared for providing good Alzheimer’s care. The findings reveal that both family caregivers and formal caregivers desire Alzheimer’s care experts’ consulting and honest communication among the care triads. Family caregivers want formal caregivers not to infantilize the patients, to provide more cognitive services based on their individual history and characteristics. Also, the vulnerabilities of patients' spouses are identified that in many cases there is no one other than the spouse who can provide care for the patient, their self-rated health status is poorer, and their tendency to seek professional help is relatively lower. Formal caregivers want the Alzheimer’s patient-formal caregiver ratios to be lowered for better care and their Alzheimer’s care expertise to be acknowledged and properly compensated. Thus, it is crucial to reflect the experiences of the care triads(patients, family caregivers, and formal caregivers) in the Korean National Dementia Plan more rigorously.
LEVERAGING NATURAL LANGUAGE PROCESSING TO IDENTIFY CAREGIVER AVAILABILITY FOR PATIENTS WITH ALZHEIMER'S DISEASE
Authors: Mahmoudi Elham , Wu Wenbo , Najarian Cyrus , Aikens James , Bynum Julie , Vydiswaran Vinod 
Published: December 2022

Abstract
Identifying caregiver availability for patients with Alzheimer’s disease and related dementia (ADRD) can inform healthcare systems and hospital administrations on appropriate discharge planning. However, caregiver availability data is not systematically collected in the healthcare system. Our objective was to use medical notes (from physicians, nurses, or social workers) to assess caregiver availability and types of caregivers for hospitalized patients with ADRD. We used 2016-2019 telephone-encounter notes from a single institution. Rule-based natural language processing (NLP) was used to develop an algorithm to identify whether the patient (1) resides at home; (2) resides at an institution; (3) has a formal caregiver; and (4) has an informal caregiver. We evaluated the data at the note level and used chart abstraction as the “gold standard.” We examined the validity of the algorithm for both training (n=749) and test sets (n=227). Our results indicated a high level of accuracy and reliability for identifying an informal caregiver (F1=0.942; accuracy=0.947, sensitivity=0.970, and specificity=0.928). Identifying whether the patient lived at an institution was the least reliable measure (F1=0.638, accuracy=0.899, sensitivity=0.512, specificity=0.978). The most common causes of misclassifications were: (1) incomplete or misspelled names of the facilities; (2) past/uncertain/undecided situations; (3) lack of specificity; (4) use of uncommon abbreviations; and (5) irregular use of templates. Our NLP algorithm was able to identify whether the patient lived at home vs. an institution and whether the patient had a formal or informal caregiver. There is merit in continuing the NLP approach to identify more granular, caregiver-related information (e.g., hours available).
THE SENIOR COMPANION PROGRAM PLUS: A PROMISING LAY PROVIDER MODEL FOR ADRD FAMILY CAREGIVING
Authors: Xu Ling , Fields Noelle , Williams Ishan , Gaugler Joseph , Cipher Daisha 
Published: December 2022

Abstract
Considerable disparities exist in the prevalence of Alzheimer’s Disease and related dementia (ADRD) in older African American (AA) populations compared to older white populations. Given the need for caregiver interventions for family caregivers from racial and ethnic minority groups that hold potential for translation, implementation, and sustainability in their communities, peer-led, lay provider models may offer promise. We developed the Senior Companion Program Plus (SCP Plus), a peer-led psychoeducational program for AA family caregivers (CGs) provided by Senior Companions (SCs). Guided by sociocultural stress and coping model, the study was a randomized controlled trial that assessed the effects of SCP Plus on AA ADRD family caregivers’ stress and burden, coping skills, and social support. Although COVID-19 ended the trial early, study participants included Senior Companion-Caregiver dyads (N=20). Friedman tests for non-normally distributed variables, one-way repeated measures ANOVA for normally distributed variables, and post hoc between group significance tests were conducted. CGs in SCP Plus group reported significantly decreased caregiving burden (F(2,6) = 17.65, p = 0.003) especially between pre- and follow up-tests, as well as increased coping skills, especially at post-test (F(2,6) = 4.93, p = 0.05), satisfaction with social support (χ2(2) = 6.53, p = 0.04), and positive aspect of caregiving (χ2(2) = 6.53, p = 0.04) (especially between pre- and post-tests as well as between pre- and follow up-tests). Implications for future research are offered as well as lessons learned for culturally congruent, lay provider interventions for ADRD family caregivers.
EFFICACY OF A BRAIN HEALTH PROGRAM FOR OLDER MICHIGANDERS: SINGLE-GROUP DESIGN FINDINGS
Authors: Kim Ha-Neul , Sun Fei , Freddolino Paul 
Published: December 2022

Abstract
This study aims to examine the effectiveness of a brain health education intervention addressing four areas: dementia false beliefs, Alzheimer’s disease knowledge, confidence in managing cognitive changes, and dementia worries among older adults. A quasi-experimental design was used with 6 groups of participants of older adults in Michigan who received the intervention over an 8-week period via Zoom. Participants (n=39) included male = 8, female = 31; Caucasian = 19, African American = 20 that were 60 or older (M = 71.74, SD = 6.80). Participants’ MoCA score ranged from 18 to 30 (M = 26.36, SD = 2.43). Paired t-tests were used to compare pre-post differences on four main areas. At post-test, participants reported decreased false beliefs to dementia (p&lt;.001); increased Alzheimer’s disease knowledge (p=.003); and improved confidence in managing cognitive changes (p=.018) compared to their baseline scores. However, although the mean score of ‘dementia worries’ decreased on post-test (pre-test: 15.67, post-test: 14.53), it did not show statistical significance (p=.33). The 8-week brain health intervention showed a positive impact on lessening participants’ false beliefs on dementia, and enhancing knowledge of Alzheimer’s disease and confidence in managing their cognitive changes. The findings of this study laid the groundwork for future studies that use a larger sample size and randomized control trial design to test brain health education programs among older adults.
CHRONIC CONDITIONS AND MORTALITY: MODERATION BY SELF-RATED HEALTH
Authors: Voss Lauren , Teas Elizabeth , Friedman Elliot 
Published: December 2022

Abstract
Chronic conditions become more common with age and greater numbers and severity of chronic conditions, in turn, increase the risk of mortality. However, individuals with similar disease burden often have different mortality rates. The purpose of the present study is to examine potential explanations for divergent mortality outcomes. Self-rated health (SRH), or perceptions of one’s own health, consistently predicts mortality. Thus, we hypothesized that participants’ SRH would modify the association between chronic conditions and mortality. Data were from the second wave of the Midlife in the US (MIDUS study, N=5,524). Mortality data were collected through 2018. Chronic conditions were measured in two different ways. To assess disease severity, each chronic condition was weighted by its propensity to cause disability; these were then summed. The second was a count of chronic conditions, a common measure in many studies. SRH was measured on a scale of 1-5 (1 = poor, 5 = excellent). Results from logistic regression models showed probability of mortality increased significantly with greater disease burden (measured both as counts and severity of conditions) and decreased with higher ratings of SRH. Importantly, compared to lower ratings, higher ratings on SRH were associated with lower probability of mortality at the same levels of disease severity. In fact, participants who rated their health as excellent showed no increase in probability of mortality with increasing number or severity of conditions. Overall, this study suggests that even in the context of chronic diseases, positive perceptions of health predict greater longevity.
POST-COVID-19 ASSESSMENT: HEALTH LITERACY AND PREVENTION PRACTICES IN LTC FACILITIES IN INDIA: PROVIDER PERSPECTIVE
Authors: Balaswamy Shantha , Samuel Raja , Singh Rufus 
Published: December 2022

Abstract
There were no governmental issued guidelines directed specifically towards Long-Term Care residential facilities (LTCF) for older adults in India during COVID-19 pandemic (Rajagopalan 2020) and no data has been collected on care for resident in NGO’s and private facilities (WHO, 2021). Further, studies of level of knowledge of providers on health indicators of residents, health literacy and risks factors of contracting the virus is absent. In India, older adults who live in LTCF have higher rates of chronic diseases (hypertension, diabetes, respiratory, heart problems), live in crowded communal space, less access to medical care for underlying health conditions, and have untrained, multiple caregivers, thereby putting them at increased risk for exposure and contracting the COVID-19 virus, and significant risk of infection, illness and mortality. LTCF includes NGO’s, government funded old age homes and private paid retirement homes and is considered a multi-residence housing facility. This exploratory study, using online survey of providers of approximately 125 LTC facilities, examines the providers general health literacy level, prevention practices at their facility interventions, demands and rewards of caring for residents during COVID. Preliminary results less than 20% of providers tracked prevalence of illness, health symptoms, infection rate, hospitalization, mortality rate, or post-recovery. Majority reported difficulty in accessing vaccination, getting residents vaccinated, and accessing resources ( food/ medicine/sanitizers) and problem coordinating care due to staffing shortage. Only a small percent use and track health and psychological assessments of residents. Findings have implications for advocating for standardization care and support National and State LTCF policy.
NURSING HOME ADMINISTRATOR EXPERIENCES DURING COVID-19: AN EXPLORATORY STUDY
Authors: Beltran Susanny , Wagner Jennifer , Miller Vivian 
Published: December 2022

Abstract
Nursing homes have been the epicenter for the COVID-19 pandemic; 149,107 residents and over 2,200 staff have died of COVID-19. In addition to the loss of lives, 99% of nursing homes report staffing shortages. Various exploratory studies have emerged gathering the experiences of frontline nursing home staff during COVID-19, however less is known about the experiences of Nursing Home Administrators (NHA) responsible for overseeing personnel and operating a facility in line with shifting state and federal mandates. Thus, this study explores the experiences of NHA during the pandemic. A cross-sectional online survey was conducted. In addition to demographic and facility-level questions, open-ended questions explored prior training on infection prevention, day-to-day operational challenges, needs, and considerations of leaving their role as administrator. The total sample (N=60) included 47 NHA of record and 13 assistant administrators/other; 53% worked in corporate NHs and 23% were part of continuing care retirement communities. Respondents report prior infection prevention training, but indicate it was not adequate preparation for COVID-19. Moreover, administrators describe challenges in recruiting and retaining staff, and in supporting staff mental health needs (e.g., burnout, PTSD). The majority of NHAs endorse a desire to step away from their role, but indicate a commitment to residents keeps them from resigning. Findings indicate that NHAs, like other members of the NH team, have experienced the effects of COVID-19, and point to specific training and support needs to equip NHAs for work in the context of this pandemic and future emergencies.
A DATA-BASED PROPOSITION FOR THE CREATION OF NEW ICD-10 DIAGNOSIS CODES FOR POST-ACUTE SEPSIS SURVIVORS
Authors: Oh Sungho , O’Connor Melissa , Stawnychy Michael , Barrón Yolanda , Garren Patrik , Sang Elaine , Bowles Kathryn 
Published: December 2022

Abstract
Sepsis survivors have the second highest readmission rate among Medicare beneficiaries, next to heart failure. I-TRANSFER is an implementation science study to improve transitions and reduce readmissions among sepsis survivors transitioning from acute to home health care (HHC). A total of 63 semi-structured interviews were conducted with stakeholders among 12 hospitals and 5 affiliated home health agencies (HHAs). The purpose of this secondary analysis was to: 1) examine how the sepsis diagnosis is reflected in HHC documentation, 2) identify barriers in sepsis information transfer to HHC, 3) recommend a documentation strategy to enhance information transfer and HHC documentation. We analyzed the diagnosis coding within a national OASIS dataset and eight I-TRANSFER interviews with hospitalists, documentation specialists, and HHC coders. Findings include: a) sepsis diagnoses were nearly invisible in HHC records being documented for only 10% of 165,000 sepsis survivors transitioned to HHC, b) sepsis information in referral documentation can be unclear to HHC coders, c) the lack of sepsis diagnosis documentation might make HHC clinicians unaware of the patient’s risk for readmission, d) HHC coders recommended improved language in the acute care discharge summary to link the need for HHC to sepsis, thereby supporting the use of ICD-10 sepsis ‘A’ codes in HHC. The use of terms, such as “History of Sepsis” or “Sepsis Resolved,” leads to HHC using non-specific codes, thus is not recommended. We highlight the need for new ICD-10 codes for “Sepsis Aftercare” and “Post-Sepsis Syndrome” to clearly communicate and document the needs of sepsis survivors.
FEASIBILITY OF ECOLOGICAL MOMENTARY ASSESSMENT OF SURROGATES FOR COGNITIVELY IMPAIRED ICU PATIENTS: A PILOT STUDY
Authors: Taylor Tracy , Burke Emily , Slaven James , Pfeffer Bruce , Perez Shelley Varner , Banks Sarah , Torke Alexia 
Published: December 2022

Abstract
We explore the feasibility of ecological momentary assessment (EMA) with surrogate decision makers (SDMs) of critically ill hospitalized adults, to obtain in-the-moment participant-reported data. In this small pilot, 23 SDMs were approached. 82.6% were white, 53.9% were female, and 53.9% were 55 years and older. 25% were spouse or partner, 25% were adult children, 30% were parents, and 20% were other relations. Average ICU length of stay was 13.46 days (range 1.73-77.79). 13 SDMs enrolled (56.52%). Using Twilio, an automated text was sent to SDMs containing a secure link to the surveys. Up to five questions about anxiety, depression, distress, communication, and spiritual well-being were sent up to twice per day. Most participants (84.62%) completed EMA surveys for 5 or more days. Most SDMs stated that the surveys were not burdensome. Of those who declined participation (n= 10), accessibility to a smartphone, stress, and availability to complete texted surveys were noted as barriers to participation. The data suggest that EMA is a valuable tool to inform clinical interventionists and care providers interacting with SDMs. Future research will assess EMA with a larger group of SDMs, utilizing questions that help identify gaps in communication and opportunities to provide support to SDMs. Although surrogates are often under high stress in the ICU setting, they are willing to provide real-time EMA feedback on their experiences. EMA can provide a “just in time” option for research and clinical intervention that focuses on bridging gaps that may contribute to better outcomes for SDMs.
INCIDENCE AND ASSOCIATED FACTORS OF DEMENTIA IN PEOPLE WITH SCHIZOPHRENIA: A POPULATION-BASED COHORT STUDY
Authors: Zhang Yingyang , Wang Pengcheng , Tang Jennifer Y M , Wong Gloria H Y , Luo Hao 
Published: December 2022

Abstract
Existing evidence suggests that people with schizophrenia may have an increased risk of dementia. This study aimed to quantify the incidence of dementia and examine putative risk factors associated with dementia in people with schizophrenia. This is a cohort study using population-based electronic health records of people who visited public hospitals in Hong Kong. We included participants (≥ 45 years) with schizophrenia diagnosis between 2009 to 2018 without dementia and followed them until March 2021. Incidence of dementia was calculated, and Cox proportional hazard regression was utilized to estimate hazard ratios of dementia, adjusting for covariates. A total of 20,901 individuals (mean [SD] age, 58.4 [10.3] years, 55.7% were women) were followed for 154,630 person-years (median [interquartile range] follow-up, 7.6 [4.7-10.3] years). The incidence of dementia was 5.1 [95% CI, 4.7-5.4] per 1000 person-years (those aged 45-64: 2.0 [1.8-2.3]; those 65 and above: 17.0 [15.6-18.5] per 1000 person-years). Factors independently associated with all-cause dementia were age (Hazard Ratio, 1.11 [95% CI, 1.10-1.11]), diabetes (1.62 [1.36-1.93]), bipolar disorders with at least five-year duration (2.12 [1.50-3.01]), and schizophrenia duration (1.02 [1.01-1.04]). Stratified analysis indicated that the association of these factors with dementia had differences in different sex and age groups. The incidence of dementia after schizophrenia diagnosis was high and two risk factors of dementia that are different from the well-established ones were identified.
PEOPLE LIVING WITH DEMENTIA GUIDED THE WAY: ADAPTIVE STAKEHOLDER ENGAGEMENT TO DESIGN A PRAGMATIC CLINICAL TRIAL
Authors: Lepore Michael 
Published: December 2022

Abstract
Research on non-pharmacologic interventions for people living with dementia (PLWD) has shown many benefits, but healthcare systems do not offer these interventions widely. To strengthen understanding of the real-world effectiveness of evidence-based non-pharmacologic interventions for PLWD requires a pragmatic approach to trialing interventions in the contexts of healthcare systems where they are standardly delivered. Designing pragmatic trials with the engagement of primary stakeholders can support trial feasibility and meaningful outcome measurement, but little evidence is available on approaches for engaging PLWD in designing pragmatic trials. This longitudinal case study introduces adaptive stakeholder engagement, a three-phase approach to engaging PLWD in planning a pragmatic trial. First, a multistakeholder workshop including PLWD was held where participants prioritized topics for research, including research on the impact of increasing social activity. Second, an evidence-based non-pharmacological intervention that addresses this priority area was piloted with PLWD and qualitative feedback was collected from PLWD over the course of intervention piloting to inform the trial design. Finally, PLWD were engaged in facilitated monthly meetings to provide input on the pragmatic trial design. In addition to informing intervention selection, input collected from PLWD informed the pragmatic trial in several ways, including approaches to PLWD recruitment, disclosure of research to PLWD, and intervention orientation processes. The adaptive stakeholder engagement model involved PLWD in different roles, as workshop participants, intervention participants, and trial advisors. This model enabled PLWD to be engaged in priority setting, infrastructure development, and trial protocol design, and may be useful for researchers planning future pragmatic trials.
DEMENTIA CARE IN THE LAST YEAR OF LIFE: EXPERIENCES IN A COMMUNITY PRACTICE
Authors: Bartley Mairead , Manggaard Jennifer , Fischer Karen , Holland Diane , Takahashi Paul 
Published: December 2022

Abstract

Objectives
People with dementia often have high care needs at end of life. We compared care delivery in the last year of life for people living with dementia in the community (home/assisted living facilities, ALF) to those in skilled nursing facilities (SNF).

Methods
This was a retrospective study of people who died with a diagnosis of dementia in the community compared with SNF between 2013 and 2018. Primary outcomes of hospitalizations/ED visits in the last year of life were measured. Secondary outcomes included advance care planning (ACP) completion, hospice enrollment, provider visits and ICU admissions.

Results
Of 1203 people with dementia, 581 (48.3%) were living in a SNF and 622 (51.7%) in the home/ALF. At least one hospitalization was recorded for 70.7% in the home/ALF compared with 50.8% in the SNF (p&lt; 0.01), similar to ED visits (80.2% versus 58% in home/ALF and SNF groups, respectively, p&lt; 0.01). People in the SNF had more provider visits (median 9 (IQR 6, 12) compared with 5 (IQR 3,9) in the home/ALF group (p&lt; 0.01). There was no ACP for 12% of those in the home/ALF, compared with 4.6% in the SNF(p&lt; 0.01). Approximately half (56.5%) in the SNF were enrolled in hospice compared with 68.3% in the home/ALF group (p&lt; 0.01), Median time in hospice was 26.5 days in the SNF versus 30 days in the home/ALF (p=0.67).

Conclusions
People living with dementia have frequent acute care utilization in the last year of life. Hospice care was more common in the home/ALF. Time in hospice was short.
SIGMA PHI OMEGA PRESIDENTIAL SYMPOSIUM: ITS ROLE IN ADVANCING THE FUTURE OF GERONTOLOGISTS AND HEALTH PROFESSIONALS
Authors: Martin Diane , Felsted Katarina Friberg 
Published: December 2022

Abstract
Sigma Phi Omega, The International Academic Honor and Professional Society in Gerontology (aka Sigma Phi Omega), was established in 1980 to recognize excellence of those who study gerontology and aging, and the outstanding service of professionals who work with or on behalf of older persons. The formation of this society provided a much-needed link between educators, practitioners, and administrators in various settings where older persons are served. Through the efforts of the international office and executive board officers, Sigma Phi Omega builds avenues to further their members’ academic and professional gerontological excellence. The goals of Sigma Phi Omega are achieved primarily through activities of local chapters at higher education institutions worldwide. Sigma Phi Omega chapters serve as links within their respective communities to promote interaction between gerontology educators, students, alumni, and local professionals. This international organization has a laser focus on excellence within gerontology and health professions education. In this session, the first presentation will provide the history of Sigma Phi Omega and its outreach efforts; the second presentation will focus on the future goals of Sigma Phi Omega to expand its role as an international honor society in preparing gerontologists, service providers and health professionals working with or on behalf of older adults; and the third presentation will focus on the SPO Chapters and their relationship with the piloted Gerontological Society of America Student Chapters.