bluuebunny/crossref_metadata_2025_split huggingface dataset:
ETHIOPIAN CENTENARIANS: HEALTH CONDITIONS AND SENSORY/COGNITIVE FUNCTIONALITY
Authors: Chane Samson , Adamek Margaret 
Published: December 2022

Abstract
Globally, the centenarian population is expected to increase in the coming three decades reaching 3 million by 2050. In Ethiopia, like other Sub-Saharan African countries, information about the health condition, sensory and cognitive functionality of centenarians is scanty. This study examined the health conditions and sensory/cognitive functionality of Ethiopian centenarians. A qualitative case study design was employed. Nine centenarians (1 woman, 8 men) between age 100 and 108 were identified using snowball sampling. Data were generated through in-depth interviews and analyzed using descriptive analysis. All 9 were Orthodox Christians and lived in rural areas either with their wives (3) or other relatives. Four centenarians could read and write, two attended grade eight and nine, and three were non-literate. Before retirement the centenarians engaged in different occupations as farmers (4), shoemaker, government employee, school teacher, priest, “bounty hunter” and mechanic. Most perceived that their sensory and cognitive functionality was normal until their later 90s except for minor complaints. Centenarians faced walking difficulty (5), joint tightness (4), back pain (4), fatigue, dental issues, stuttering, hypertension (3), insomnia, diabetes, anorexia, severe headache, constipation and anxiety. Two centenarians identified themselves as escapers. Centenarians faced hearing defect (4), sight problems, and a decrease in taste and smell. Two reported proper functioning of their sensory organs. Despite various health problems, the Ethiopian centenarians aspired to live longer resiliently. Findings call for further study and the need for social workers, caregivers, and health care practitioners to consider the health conditions, sensory and cognitive functionality of centenarians.
INTERGENERATIONAL TRANSMISSION OF "SEVA": ELDERS MODEL SELFLESS SERVICE IN SOUTH ASIAN HOMES FOR CHILDREN
Authors: Corley Connie , Sherwood Laura , Ghosh Dibendu , Willis David 
Published: December 2022

Abstract
Life course theory is a framework for examining the role of elders in modeling altruistic behavior or "seva" (selfless service) in two homes for children: Unatti (Bhaktapur, Nepal) and Ramana's Garden (Rishikesh, India). Two American women, compelled to impact the plight of children subject to poverty, trafficking and/or caste discrimination (Dalits, the former "untouchables"), each founded homes 20+ years ago and modeled selfless service exemplified by children, some now in "emerging adulthood," who are giving back to their communities. In this intergenerational/intercultural multiple case study, narratives of the program founders now in mid- to late adulthood are presented along with narratives of six young adults who continue to provide nurturance to younger children and engage in projects to educate and feed residents of the homes and nearby communities. The life course principle of time and place situates the children in areas of their countries with relatively low literacy rates. The founders saw the value of education to empower young people, especially girls, to expand their opportunities and serve as role models for children coming into the homes after them. The linked lives principle is evident through shared relationships with the founders as these young people navigate political crises, disasters like the Nepal earthquake, and health crises like the Covid-19 pandemic. Some become leaders themselves as they have been mentored over their life course. A sense of agency is experienced in their young adulthood as more choices for their lives become available as an alternative to subsistence existence and early marriage/childbearing.
ACHIEVING UNIVERSAL HEALTH COVERAGE FOR OLDER ADULTS: A REVIEW OF GHANA’S NATIONAL HEALTH INSURANCE SCHEME
Authors: Asante Samuel , Karikari Grace 
Published: December 2022

Abstract
Universal Health Coverage (UHC) is defined by the World Health Organization (WHO) as ensuring that all people receive quality health services they need without financial hardship. Predicated on the idea of providing universal healthcare to all Ghanaians, Ghana’s National Health Insurance Scheme (NHIS), established in 2003, has done considerably well among some age categories than others. While most studies on this healthcare program have focused on the health-seeking behaviors among users, its implementation, financial sustainability, and the role of national politics in its administration, little has been done to understand the program’s effectiveness in achieving a universal health coverage for and its impact on older Ghanaians. Consistent with WHO’s objective of achieving UHC, as enshrined in the Global Strategy on Aging and Health, this review examines Ghana’s progress toward achieving UHC for all. The paper specifically provides a narrative review of the National Health Insurance Scheme in advancing the interest and welfare of older Ghanaians. Findings revealed that not all individuals considered as older adults, either conventionally or legally, are beneficiaries of the programs; that WHO’s objective of obtaining needed care without financial hardship may be far from reach for most older Ghanaians; and the program only offers basic protection to current beneficiaries. We address these areas of concern to achieving UHC. We also make recommendations for a path forward where all stakeholders—older adults, families, healthcare providers, and policymakers—involved can play a role in ensuring all eligible older adults get the quality of health care they deserve.
PUBLIC MENTAL HEALTH SERVICE USE AMONG US ADULTS AGE 50+ COMPARED TO YOUNGER AGE GROUPS
Authors: Choi Namkee , DiNitto Diana 
Published: December 2022

Abstract
Despite increasing numbers of older-adult mental health service users, few studies have examined their use of public mental health services. Using the 2018 and 2019 Mental Health-Client Level data (N=4,291,737 in 2018 and N=4,513,946 in 2019 for those age 18+), we examined age group differences in the types of mental disorders diagnosed in outpatient-only, both outpatient and inpatient, and inpatient-only service settings. Of all users, 25.3% were age 50-64 and 6.7% were age 65+. Multivariable logistic regression results, controlling for gender, race/ethnicity, census region, and alcohol/substance use disorder, showed that compared to the 30-49 age group, the 50-64 and 65+ age groups had higher odds of having depressive disorder in outpatient-only settings (aOR=1.28 [95% CI=1.28-1.29] and aOR=1.08 [95% CI=1.08-1.09] for the 50-64 and 65+ age groups, respectively). Both older groups also had higher odds of delirium/dementia disorder in all three service settings. In addition, they had consistently higher odds of a diagnosis of schizophrenia or other psychotic disorder in all three service settings (aOR=1.88 [95% CI=1.86-1.89], aOR=1.70 [95% CI=1.65-1.74], and aOR=1.44 [95% CI=1.39-1.49] in outpatient, both outpatient and inpatient, and inpatient-only settings, respectively). Community mental health centers (CMHC) are on the frontlines in serving vulnerable communities and received increased federal funding during the COVID-19 pandemic. Our findings indicate that CMHCs also need programs dedicated to and tailored for older adults. More research is also needed on older adults who receive public mental health services and unmet mental health needs among low-income older adults with serious mental illness.
PARTNERING TO DEVELOP COUNTY-LEVEL DATA PROFILES
Authors: Phillips Karon , Wolfe Megan 
Published: December 2022

Abstract
Building robust data systems that include information on the health of older adults is crucial to developing programs and services that meet their health and social needs. Organizations and agencies can use this information to target resources and identify community partners, as well as using data to support grant applications. But there are challenges to building such systems, even within the public health system, due to lack of expertise, funding, and access to underlying data sources. Through its Age-Friendly Public Health Systems initiative, Trust for America’s Health’s has worked directly with several state public health departments to explore opportunities to develop and expand their county-level data profiles on older adults. This session will highlight the unique collaborations and partnerships between departments of health and other institutions, including academia, to develop data profiles. Through these innovative partnerships, departments of health have been able to develop dynamic data profiles that they share with aging services providers to discuss strategies to support their older adults in their communities. Best practices and lessons learned through the profile development process will also be discussed.
EFFECTS OF A SPECIFIC NARRATIVE GROUP PRACTICE ON HEALTH OUTCOMES OF CHINESE OLDER ADULTS: AN RCT STUDY
Authors: Chow Esther , Fung Sai-fu 
Published: December 2022

Abstract
In view of the rising chronicity during older adulthood, a specific narrative group practice is developed to improve well-being. Narrative therapy (NT), views people as experts in their own lives, and have accrued their life wisdom through their lifespan. To test its effects, a randomized controlled trial design was used to assess and compare outcomes between the intervention and waitlist-controlled group. A total of 157 older adults were recruited, 82 of which was randomly assigned to 9 intervention groups to receive four 2-hour NT sessions, recording difficult life circumstances, through narrative conversations, which made them stronger. Quantitative assessment of well-being, and depression were conducted at baseline (T0), at the end of treatment (T1), and at two (T2) and 8 months after treatment (T3). By employing the SEM parallel-process latent growth curve model, the results from the 4 waves of longitudinal data suggesting that the NT intervention have positive impact the participants, in particular the improved well-being of the participants contributed to the reduction of depressive symptoms with standardised estimate -0.502, p = 0.007. The estimated model fulfilled the criteria of mediocre fit, with TLI = 0.943; CFI = 0.969; RMSEA = 0.053. No adverse reaction was recorded in any of the cases mentioned at all study-sites. These findings have significant theoretical and practice implications for both health and social care professions. NT offers an effective practice to develop a strength- and meaning-based group practice and ground a new theory for to develop a constructive perspective to late life development.
SUPPLEMENTAL PAYMENTS AND NURSING HOME STAFFING: A CASE STUDY OF INDIANA
Authors: Sharma Hari , Xu Lili 
Published: December 2022

Abstract
Adequate reimbursements are key to improving quality in nursing homes (NHs), but Medicaid payments remain low. Indiana implemented Medicaid supplemental payment program to non-state government (NSGOs) owned NHs to boost Medicaid payment rates. Under the program, NSGOs contribute the state-share of the supplemental payments through intergovernmental transfers allowing the state to claim federal matching funds. The supplemental payments are distributed between NSGOs and NHs but little is known about whether NHs invested the supplemental payments to improve staffing levels. In this study, we examine whether NHs receiving supplemental payments, proxied by NSGO-ownership, have higher staffing hours per resident day (HPRD) for registered nurse (RN), licensed practical nurse (LPN), and certified nurse aide (CNA) compared with NHs without supplemental payments. We use facility-year data on NSGO ownership (State of Indiana), staffing levels (Nursing Home Compare), and facility and resident characteristics (LTCfocus.org) on 500 NHs from 2009 to 2017. We use difference-in-difference (DD) regressions with year and facility fixed effects to estimate the potentially causal effect of NSGO ownership on NH staffing controlling for facility and resident characteristics. DD estimates suggest that NSGO-ownership is associated with decreased staffing level across all three types of staffing. More specifically, RN staffing decreased by 0.019 HPRD (p&lt; 0.05), LPN staffing decreased by 0.041 HPRD (p&lt; 0,05), and CNA staffing decreased by 0.089 HPRD (p&lt; 0.001). Policymakers should increase the transparency of supplemental payment programs and audit the expenditures to ensure that supplemental payments are tied to quality improvement.
VARIATION AND CONSISTENCY IN ALLOCATION OF HCBS: MASSACHUSETTS AGING SERVICES ACCESS POINTS
Authors: Flieger Signe , Katz Gabrielle , Bishop Christine 
Published: December 2022

Abstract
Massachusetts’ 27 Aging Services Access Points (ASAPs) are nonprofit organizations responsible for guiding clients and families in their geographic service areas through a maze of financial and functional eligibility criteria to receive needed home and community-based services (HCBS). These services aim to sustain function and promote engagement for older adults and persons with disabilities, and to maintain individuals in the community rather than in residential settings. Payment for HCBS flows from numerous state and Federal funding programs, including but not limited to state Medicaid waivers and Older American Act programs. We conducted semi-structured interviews with 10 ASAP directors and gathered information from documentary sources to delineate the pathways to funded HCBS that these agencies open for clients. We identified variation in the 27 ASAPs’ contractual relationships with service providers. State data revealed variation in budgetary resources and area population characteristics. These nonprofit corporations appear to flexibly adapt to local conditions and needs. Understanding variation across ASAPs will support analysis of client data to examine whether ASAP processes result in different service outcomes for similar clients. Alternate payment models for health services (managed care, managed long-term services and supports, accountable care organizations) are broadening their reach, encouraging health systems to recognize the importance of functional supports and services. Some health systems are charging their own dedicated units with assigning HCBS to enrollees, avoiding the ASAPs. Understanding and modeling the allocation of services by the ASAPs will allow investigation of trends in services for persons with varying needs under various payment methods.
FROM PILOT TO PRODUCT: EVOLUTION OF A REMINISCENCE THERAPY INTERVENTION FOR PERSONS LIVING WITH DEMENTIA
Authors: Orsulic-Jeras Silvia , Ejaz Farida , Rose Miriam , Powers Sara , Cordell Ashlee , Wilk Christa , Sanders Lisbeth 
Published: December 2022

Abstract
Reminiscence therapy (RT) and life story work are effective techniques for eliciting engagement in persons living with dementia (PLWD) and helping inform direct care staff about residents’ lives and preferences to facilitate quality person-centered care. However, there are challenges in bringing such programs to scale in a feasible and cost-effective way. Two studies were conducted to test development and evolution of an RT program, LifeBio Memory. A pilot study of the original LifeBio protocol was conducted with 238 residents in 16 Ohio nursing homes. Most residents (88%) indicated at posttest that they enjoyed telling their life stories, and 87% would recommend the program to other residents. However, manually gathering and processing life story data led to challenges with feasibility. Subsequently, novel software was developed to streamline the process using machine learning and artificial intelligence via a tablet application. Acceptability and feasibility were examined in two rounds, 9 months apart, of seven focus groups (n=35) conducted with PLWD, family care partners, and residential care staff. Audiotapes of the groups were transcribed; thematic data analysis was used to generate a list of recommended changes and showed high levels of acceptability and feasibility. Based on these results, it was determined that LifeBio Memory was preferred for obtaining life story information over the previous manual method (e.g., handwriting life story notes). Potential barriers to implementing the new platform in residential care settings were also identified. Implications include the importance of maintaining person-centered care practices when creating technological solutions to address PLWD needs.
MULTIPLE SCALES OF SOCIAL RELATIONS IN REMINISCENCE ACTIVITIES FOR OLDER ADULTS
Authors: Robbins-Panko Jessica 
Published: December 2022

Abstract
Memory, especially autobiographical memory, is central to personhood in contemporary North America and Europe (Herskovits 1995). Cultivated practices of reminiscence, in which older adults are prompted to remember events and experiences from the past, can be pleasurable, meaningful, and therapeutic activities that shape personhood and contribute to wellbeing (Coleman, 1999; Sherman, 1987). Although reminiscence practices include both individual (e.g., Butler, 1963; Woods et al., 2018) and social (Hash et al., 2021; Sass et al., 2021) elements of remembering, less attention has focused on the myriad scales of social relations that are part of reminiscence activities. Moreover, the mechanisms through which reminiscence creates positive transformations remain unclear (Menn et al., 2020). Anthropological theories of personhood show that social relations at multiple spatiotemporal scales play key roles in transforming personhood (Carsten, 1995; Robbins, 2021), thus suggesting a nuanced framework within which to understand how social relations shape personhood and contribute to wellbeing for older adults. Drawing on a systematic review of interdisciplinary literature on reminiscence activities for older adults, this paper documents the multiple scales of social relations (interpersonal, institutional, regional, [trans]national) that are part of reminiscence activities, and interpretively analyzes their significance for personhood and wellbeing. Key findings of this study are: 1) collective memory plays an important role in reminiscence activities; and 2) fostering reminiscence activities that focus on meaningful elements of the shared past can promote wellbeing for older adults. These findings have implications for 1) refining gerontological theories of reminiscence, and 2) improving reminiscence-based practices for older adults.
SOURCES OF INTRINSIC MOTIVATION IN LATER ADULTHOOD: A QUALITATIVE ANALYSIS
Authors: Heinz Melinda , Benton Nathan , Gleissner Laura 
Published: December 2022

Abstract
A distinct sense of purpose and motivation is increasingly recognized as a contributing factor in successful aging and prolonged health in older adults. While prior studies have established the relationship between intrinsic motivation, defined purpose, and health outcomes, it is essential for care providers and researchers to understand the underlying sources of purpose and motivation for older adults. This study examined qualitative data collected over a two-week period from a sample of older adults (N = 15) in the Midwest. Participants documented daily, through written journal entries and photography, aspects of their lives that they felt illustrated sources of purpose and motivation. The journal entries were then transcribed, aggregated, coded, and analyzed for potential themes. Two researchers coded the data; and a codebook was used to increase coding consistency. Using latent thematic analysis, three distinct themes developed from the dataset. First, engagement in behaviors and activities that incorporated aspects of mindful practices, particularly sensory awareness and grounding, proved to be motivating for many of the participants. The second theme discovered that participants found purpose in active social participation, where a subtheme regarding the impact of technology on maintaining relationships emerged. In the third theme, a goal-oriented mindset proved to be a key aspect of ongoing motivation, with a particular focus on cognitive and physical development, lifelong learning, and planning for the future. Overall, the data pointed to three distinct themes that can be used to foster ongoing opportunities for greater meaning in the lives of older adults.
VARIABLE PREDICTORS OF COGNITIVE PERFORMANCE WITHIN ETHNIC/RACIAL GROUPS USING A COMPUTERIZED COGNITIVE BATTERY
Authors: Deters Kacie 
Published: December 2022

Abstract
The Computerized Cognitive Composite (C3) may provide an efficient assessment of early cognitive impairment to inform early interventions and screening criteria for Alzheimer’s disease clinical trials. The C3 battery, which includes the CogState Brief Battery, has components assessing memory, reaction time and aspects of executive function. The battery has little demand for spoken language and may reduce the sociocultural biases of traditional paper-and-pencil tests. The goal of this project was to determine demographic and genetic predictors of cognitive performance on the C3 battery across different ethnic/racial groups. We examined 4,026 cognitively normal participants (self-identified non-Hispanic Black, Asian, or White; Hispanic) at baseline visit from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) clinical trial. Linear models were performed to examine the association of C3 and years of age, years of education, gender/sex, and Apolipoprotein E (APOE) genotype, within ethnic/racial group. We found variation in demographic and genetic risk factors that predicted cognitive performance within ethnic/racial groups. These findings highlight the importance of within group analysis to identify risk factors for cognitive impairment.
LAY PERSPECTIVES ON SUCCESSFUL AGING IN ROMANIA
Authors: Roquet Angélique , Barbut Mariana , Pocnet Cornelia , Jopp Daniela 
Published: December 2022

Abstract
Successful aging is a topic of world-wide interest, yet much work focuses on specific and highly industrialized countries, such as the USA. The present study investigated lay perspectives of the concept of successful aging in young, middle-aged, and older adults from Romania. Ninety-three participants aged between 20 and 84 years were asked about definitions and determinants of successful aging. Based on a previous study, codes were developed to capture common themes among the answers, resulting in 14 categories. Participants mentioned four themes on average to describe successful aging, which varied by sociodemographic, health and psychological variables: individuals of younger age, with higher levels of education, in better health and those more satisfied with their aging mentioned more themes. Regarding specific topics, Social resources and Health were mentioned most frequently, followed by Quality of life, Financial situation, and Attitudes/Mechanisms. Young adults were more likely to mention Social resources, Success/Respect, and Aging themes, while older adults mentioned more often Meaning of life themes. Finally, we found that the themes mentioned were related to self-perception of aging, particularly among older adults: Older adults more satisfied and with positive views own aging were more likely to mention Social resources, Independence, and Attitudes/Mechanisms themes, while those with negative views on aging were more likely to mention Micro-environment themes. In sum, findings support the multidimensionality of lay perspectives of successful aging and offer insights on the understanding of successful aging in Eastern Europe, including topics and links to general and personal aging experiences.