bluuebunny/crossref_metadata_2025_split huggingface dataset:
AGING ON THE JOB? THE ASSOCIATION BETWEEN OCCUPATIONAL CHARACTERISTICS AND ACCELERATED BIOLOGICAL AGING
Authors: Andrasfay Theresa , Kim Jung Ki , Ailshire Jennifer , Crimmins Eileen 
Published: December 2022

Abstract
There is a common saying that demanding jobs can make workers age faster, but there is little empirical evidence linking occupational characteristics to accelerated biological aging. We examine how occupational category (professional/managerial, sales/clerical, service, and manual) and occupational characteristics (e.g., psychosocial stressors, physical demands) are associated with a novel measure of physiologic aging, expanded biological age, that incorporates 22 biomarkers and captures physiologic dysregulation throughout several bodily systems. We assess how occupational characteristics for working individuals aged 51-60 in 2010 Health and Retirement Study (HRS) are associated with expanded biological age in the 2016 Venous Blood Study (VBS). We find that, compared to same-age individuals working in professional or managerial positions, those working in manual occupations appear 0.96-years older biologically while those in service jobs appear 2.8-years older biologically. Individuals whose jobs are high-stress, physically demanding, or require long working hours are nearly one year older biologically than their same-age peers without these adverse working conditions. These findings largely persisted after adjustment for educational attainment. Together these findings suggest that occupational characteristics may be an independent social determinant of accelerated aging.
EXPLORING ADJUSTMENT TO RETIREMENT: LEISURE IN THE LIVES OF FIRST-GENERATION KOREAN IMMIGRANT MEN
Authors: Chung Wonock , Liechty Toni 
Published: December 2022

Abstract
Baby boomers, born between 1946 and 1964, comprise a significant portion of the United States’ older adult population. Retirement is also a hallmark of their current life stage. While a body of literature points to the benefits of leisure activities in later life, the roles and relevance of leisure during the retirement transition among first-generation immigrant baby boomers are not well understood. The purpose of this study was to explore leisure throughout the lifespan among first-generation Korean immigrant men (N = 19) and how their cultural values and leisure involvement played out during the retirement transition. Guided by continuity theory of normal aging (Atchley, 1989) and leisure innovation theory (Nimrod, 2008), findings from interview data through interpretive phenomenological analysis (Smith et al., 1995) indicated that (1) perceptions and definition of leisure is shaped by their cultural backgrounds; (2) leisure in the working years mostly involved family leisure activities with an emphasis on providing their children with educational values; (3) leisure activities such as golf and fishing were a particular interest for this demographic, but meanings changed over time; (3) leisure provided continuity during the retirement; and (4) retirement was viewed as an opportunity for new leisure activities, but limited availability of sport and recreation programs was perceived as a barrier. These findings yield meaningful implications in that (a) leisure engagement can provide continuity in maintaining their social roles over the lifespan; and (b) more community-based sport and recreation programs targeting older adults would help them successfully transition to retirement.
STICKING WITH THE UNION? LABOR UNION MEMBERSHIP, WORKING CONDITIONS, AND POSTRETIREMENT HEALTH IN THE MIDWEST
Authors: Engelman Michal , Qin Yue 
Published: December 2022

Abstract
American Employment experiences over the past five decades have been shaped by growing prevalence of bad jobs – those that are precarious and offer few pension or health insurance benefits – and a marked decline in unionization. Previous health research has highlighted the deleterious implications of bad jobs and yielded mixed or inconclusive findings about union membership. However, most of this research focused on working-age adults, and few studies have examined the long-term impacts of working conditions and union membership. We fill this gap via data from the Wisconsin Longitudinal Study – a sample of men and women who graduated from Wisconsin high schools in 1957 and have been followed through their working years, past retirement, and into oldest-old ages. We estimated regression models examining the impact of union participation in 1975 on subsequent self-rated health and depressive symptoms (measured in 1993, 2004, and 2011). Our findings suggest that union participation was associated with poorer self-rated health in 1993 (OR=0.67, 95% CI (0.48, 0.96)), with a stronger negative effect for more active union members (OR=0.58, 95% CI (0.36, 0.96)), even after controlling for socioeconomic status in childhood and adulthood. This effect dissipated by 2004, when most WLS participants were nearing retirement and further diminished by 2011, when participants were in their 70s. We found no significant effects of union activity on depressive symptoms. Job characteristics and the historical decline in the prevalence and power of unions over the cohort’s lifetime provide important contexts for interpreting these results.
TOWARD AGE-FRIENDLY WORKPLACES: IDENTIFYING FACTORS THAT SUPPORT COGNITIVE FUNCTION IN OLDER WORKERS
Authors: Price Ashley , Lee Soomi 
Published: December 2022

Abstract
Older adults in the workforce face natural age-related decline that may impede their work performance. Sleep and cognitive function, both of which are degraded with age, may affect work performance in older workers. Workplace demands and support may also play roles in older workers’ performance. Yet there remains a lack of effort in identifying modifiable factors that contribute to older workers’ performance. This review compiled previous studies on modifiable factors across personal and workplace domains that support or impede older workers’ performance at work. Databases utilized for this systematic review include Google Scholar, AgeLine, and APA PsycINFO. Inclusion criteria were empirical studies conducted in developed countries, published in 2000 or later, that focused on older adults (age &gt;55) working full-time (≥ 35 hours/week). Keywords included: sleep, older adults, workforce, cognition, aging, work performance, aging workforce, workplace support, management strategies. Of the 32 studies initially identified, 13 qualified for this analysis. In 6 studies, poorer sleep (measured by actigraphy) was prevalent in older workers and was negatively associated with their cognitive performance at work. Across 7 studies, demanding and non-supportive workplace characteristics (i.e., greater job demands, lower supervisor support, and higher agism) were identified as common risk factors for poorer sleep, poorer cognitive function, and lower work performance in older workers. Bridging this information together may help identify specific factors that may be modifiable by workplace interventions to support optimal performance in workers and promote more age-friendly work environments.
TO TELL OR NOT TO TELL: TYPOLOGIES OF OLDER ADULTS PREFERENCES ON DIAGNOSIS DISCLOSURE OF CRITICAL ILLNESS IN CHINA
Authors: Lou Yifan , Liu Jinyu 
Published: December 2022

Abstract

Background
A priori of advance care planning, that older adults should know their diagnosis, is not guaranteed nor legally supported in China. Typically, doctors will inform the family members of the diagnosis and prognosis of critical illness and let family members decide whether to inform or not. This study aims to explore how older Chinese prefer diagnosis disclosure of their critical illness and the factors related to each typology of desired roles.

Methods
We surveyed 571 older adults in Shanghai from late-2021. We included 7 items measuring values of diagnosis disclosure on three levels: to self, to significant others, and regarding physician disclosure approach. We characterized preference types using latent class analysis. Multinomial regression models on class memberships were used with cultural, sociodemographic, and healthcare experiences predictors.

Results
Three latent classes were identified: 34% of respondents preferred control over own diagnosis and respected significant others’ rights to know their own diagnosis (“transparent”). 50% of respondents has conflicted values. They preferred to know own diagnosis and to discuss with physicians privately, but chose to conceal others’ diagnoses if their significant others have serious illness (“contradictory”). 16% preferred to delegate control over diagnosis to others and assumes that their families hold the same value (“avoidant”). Increased familism is significantly related to contradictory type. People with experience of hospitalization and making medical decisions for family members were more likely to be transparent. Discussions: We discussed research, practice, and policy implications on culturally-appropriate approaches to honor patients’ autonomy with serious illness in China.
NORTH AMERICAN CONTEXTS USING COMPUTERIZED NETWORKS TO IMPROVE CARE DELIVERY FOR OLDER ADULTS
Authors: Alexander Gregory 
Published: December 2022

Abstract
Evidence shows that technology provides a means to improve communication and quality of care, through greater efficiencies in information management. However, research demonstrates that technology use does not consistently improve care. Therefore, there is a continuing need globally to evaluate and discuss the impact of technology in clinical care, especially in settings where older people have higher care needs. The panel includes five interdisciplinary experts with backgrounds in care delivery systems for older adults, engineering, informatics, health systems, quality improvement, mobile health, medicine, and nursing from the U.S. and Canada. This expert panel has three objectives: 1) Describe informatics research initiatives using computerized networks to improve care delivery for older adults, 2) Contrast information technologies used to manage information in health systems caring for older adults, and 3) Explain opportunities to improve health information technology systems used in care delivery for older adults.
MEDICAL AID IN DYING: DOES POLICY PREVENT SUFFERING AT THE END OF LIFE?
Authors: Becker Todd , Kusmaul Nancy , Gibson Allison , Wallace Cara L 
Published: December 2022

Abstract
Medical aid in dying (MAID) reflects the legal provision for qualifying, terminally ill individuals to receive a prescription from their medical provider for self-ingestion to hasten death. This policy analysis examines current MAID policy with a focus on MAID’s intended relief of suffering. Using Wallace’s (2015) policy model, we evaluated MAID on: policy description, historical context, development of the policy, efficiency, alternative programs, effectiveness, and unintended consequences. Policy description: Currently legal in 10 jurisdictions (nine states and Washington, DC), common goals include relieving suffering and promoting self-determination. Historical context: Following a failed attempt at federal legalization, the U.S. adopted an incremental, jurisdiction-based approach to legalization beginning in Oregon (1994). Development of the policy: Although all statutes imitate Oregon’s model, subtle differences exist. Efficiency: Although each policy includes waiting periods that vary in sequential order and duration, revisions have targeted waiting periods to improve efficiency. Alternative programs: Frequently considered an alternative to MAID, existing statutes encourage providers to discuss palliative options. Effectiveness: Despite appearing effective in promoting self-determination, MAID-related complications (e.g., vomiting) may exacerbate suffering. Unintended consequences: MAID’s requirement of clinician participation may place providers in situations that challenge their self-determination and provoke distress. In sum, many questions remain unanswered regarding MAID’s effectiveness and efficiency. Thus, more data are needed. Ethical implications will continue to be debated, though policy implications (e.g., who uses MAID, the number of unique providers, the emergence of complications, those present during death) greatly impact implementation and overall choices to limit suffering at the end of life.
DO DIFFERENT ADVANCE DIRECTIVES CREATE CONFUSION ON A PATIENT'S WISHES? (MOLST VERSUS FIVE WISHES)
Authors: Perre Taylor , Young Yuchi 
Published: December 2022

Abstract
Introduction. The objective of this study is to compare perspectives of young adults toward advance directives (ADs) and their preferences for life-sustaining treatment and care options. Methods. Participants include graduate students (n=30) attending a New York State university. Data were collected using a structured survey questionnaire, the Medical Orders for Life-Sustaining Treatment (MOLST) form and the Five Wishes form. Summary statistics were performed to address the study aim. Results. Of the participants, the average age was 24 years (60% were female, 60% White, and 27% Black). In Five Wishes, participants who are close to death, 70% wanted all or some forms of life support; when in a coma (47%), or with permanent and severe brain damage (36.6%) chose similar options. In MOLST, without pulse and/or breathing, 87% want CPR; while with pulse and breathing, 96% want artificially administered fluids and nutrition, 90% want mechanical ventilation, 67% want to be hospitalized, 67% want antibiotics, and 53% want unlimited interventions. Conclusion. (1) The majority of participants had not previously completed an AD; however, they were capable of making decisions about their life-sustaining treatments. (2) The discrepancies in treatment preferences may be due to the language of advance directives. Further studies in this respect are warranted.
EXPLORING FIVE WISHES AND END-OF-LIFE CARE PLANNING IN YOUNG ADULTS
Authors: Perre Taylor , Stone Arianna , Young Yuchi 
Published: December 2022

Abstract
Introduction. Advance care planning (ACP) allows individuals to plan ahead and express their preferences for medical treatment and care options to health care providers, family, and loved ones before they are no longer able to make or voice decisions due to the event of a serious illness or injury. Advance directives (ADs) allow individuals to record their preferences. While unintentional injuries are the leading cause of death among young adults, limited studies focus on ACP, ADs, and end-of-life treatment and care. Our study aims to (1) examine the perspectives of young adults towards Five Wishes, and (2) measure their preferences related to personal, emotional, spiritual, and medical values in end-of-life care planning. Methods. Data were collected using Five Wishes and a one-time questionnaire. Participants include graduate students (n=30) at a New York State university. The average age was 24 years old (60% were female, 60% White, and 27% Black). Results. In the case of permanent and severe brain damage without expectation to wake up or recover, 63% do not want life-support treatment. In the event of coma without expectation to wake up or recover, 53% do not want life-support treatment. When close to death, 80% want to have religious or spiritual readings and well-loved - poems read aloud. Conclusions. Young adults are capable of making their decisions regarding appointing a health care proxy and giving specific instructions for personal, emotional, spiritual, and medical care. The present findings intend to make contributions in promoting population-based healthcare decision-making, education, and awareness.
ACCESS TO HOSPITAL-BASED PALLIATIVE CARE SERVICES FOR OLDER ADULTS IN IOWA
Authors: Yeo Hyesu , Childs Elisa 
Published: December 2022

Abstract

Background
U.S. Medicare covers many palliative services; however, Iowa’s rurality and high rate of older adults (OAs) aged 65 or over make it unclear whether older Iowans have equitable service access. Hospital-based palliative care services (HBPCSs) include curative treatment, whereas other providers of palliative care may not. Thus, this study only examined OAs’ geographic access to HBPCSs in Iowa.

Methods
This study used the American Hospital Association and U.S. Census Bureau estimate in 2017. The geographical distribution of hospitals and HBPCSs was examined using a county-level approach, considering rural/urban status (using the Office of Management and Budget’s definitions) and OA population proportion.

Results
Of the 99 counties in Iowa, 89 were rural. Of the 116 hospitals statewide, one urban county and nine rural counties had no hospital. A total of 52 hospitals provided HBPCSs in 43 counties across nine urban and 34 rural counties. HBPCSs were primarily located in central Iowa, with northern and southern Iowa having the lowest access to HBPCSs. The OA population ratio was higher in counties without HBPCSs (19%) than HBPCSs (15.7%). All 54 counties with over a 20% OA population were concentrated in rural counties, while only 37% of these rural counties had HBPCSs.

Conclusion
This study suggests a regional imbalance of HBPCS providers for OAs in Iowa. Results showed that rural communities with a high ratio of OAs lack HBPCSs and suggest HBPCSs should be expanded at hospitals in northern and southern Iowa counties where many OAs live.
STARTING THE CONVERSATION: FINDINGS FROM AN ADVANCE CARE DIRECTIVE WORKSHOP
Authors: Parsons Kelly , Barber Justin , Gibson Allison , Jicha Gregory , White Renee 
Published: December 2022

Abstract
Every adult that enters a hospital is asked about an advance care directive (ACD) document. The completion rates of care directives started to grow in 2016, when Medicare provided a reimbursement benefit in the annual wellness exam. Previous data shows only 37% of older Americans have an ACD, of that 64% are white. Previous studies report data from medical visits, however, advance directive discussions conducted in a community setting has not yet been explored. This pilot study examines readiness to have discussions with your appointed decision-maker, primary care provider, and complete ACD document. This was a community workshop with a physician-led presentation regarding medical choices, followed by break-out groups with trained moderators reviewing ACD materials. Data from pre/posttest along with qualitative comments addressing information seeking (pre) and additional comments (post) are included. The workshop increased participants readiness to identify an individual to make medical decisions and put into writing the type of medical care they desire. It also showed resistance to having conversations with a person's primary care provider and chosen health care agent. Challenges included the pre/posttest completion rate and the inability to compare a control group. Viewing advance directive completion within the self-determination theory assists in understanding the need for a novel setting to promote relatedness. Further research needs to be done on community setting ACD workshops to provide a space for participants to be better informed in the ACD process. Community workshops need to be examined to have a broader spectrum of inclusion within historically marginalized communities.
A QUALITATIVE EVALUATION OF A POSITIVE REAPPRAISAL INTERVENTION FOR HOSPICE CAREGIVERS
Authors: Cho HanNah , Demiris George , Oliver Debra Parker , Washington Karla 
Published: December 2022

Abstract
For older adults who receive hospice services in the United States, family members often become their primary caregivers playing an essential role in delivering care. Nearly 25% of hospice patients and families report the need for improved communication and additional emotional support. However, there are few interventions targeting specifically caregivers. Whereas the term caregiving implies a unidirectional flow of benefits from the caregiver to the care recipient, caregivers also experience emotional, cognitive, behavioral, or interpersonal rewards from caring for a loved one. Research has demonstrated that positive gains are common among caregivers, often manifested with negative experiences. Positive reappraisal, a form of emotion-focused coping, is especially relevant when dealing with intractable stressors. Positive reappraisal is supplemental to problem-solving therapy interventions, yet this component has never been tested in a hospice setting. In this study, we wanted to understand hospice caregivers’ impressions of a problem-solving therapy intervention enhanced with positive reappraisal modules (called PISCESplus). We conducted a qualitative study examining hospice caregivers’ perceptions of positive reappraisal. Participants received the intervention (as part of a larger clinical trial). Caregivers’ exit interviews were audio-recorded and transcribed. Thirty hospice caregivers’ interviews were analyzed. Many participants reported a paradigm shift in their thought processes. Positive reappraisal helped them reframe negative emotions to positive ones, declutter their minds, and acknowledge that caregiving required work and effort. Study findings demonstrate the potential of this intervention to improve the coping skills of caregivers in the hospice setting.
INTERPROFESSIONAL TEAM MEMBERS’ PERCEPTIONS OF PALLIATIVE SOCIAL WORKERS’ CONTRIBUTIONS TO PATIENT-CENTERED CARE
Authors: O'Donnell Arden , Gonyea Judith 
Published: December 2022

Abstract
Interprofessional collaborative practice (IPCP) is fundamental to the delivery of high-quality patient-centered care. An IPCP core tenet is that efficient and effective teams are crucial for the delivery of care that achieves patient satisfaction as well as positive patient-level outcomes. Although a growing number of IPCP studies explore how IPCP professionals work collaboratively, the vast majority focus on the interactions of physicians and nurses, few consider other professions or simply lump them into an “other” category. This qualitative study addresses this knowledge gap through the exploration of how hospital palliative care teams utilize the skills of advanced hospice and palliative care certified (APHSW-C) social workers to increase teams’ overall effectiveness. A two-step recruitment process was used to create matched samples of 17 palliative social workers and 24 interprofessional team members (i.e., physicians, nurses, physician assistants, chaplains). Using a constructivist grounded theory approach, semi-structured interviews were conducted, recorded, and transcribed. Analysis revealed six themes surrounding other profession's perceptions of social workers’ contributions: 1) providing continuity during and across admissions, 2) assessing and promoting the patient’s bio-psychosocial needs, 3) offering clinical expertise and support to patients with complex psychosocial needs, 4) allocating time to initiate, process and revisit difficult conversations with patients and families, 5) modulating the pace and intensity of emotionally laden conversations, and 6) supporting team well-being. Findings underscore that interprofessional team members view social workers as playing a significant role in developing, building, and sustaining a therapeutic alliance between the patient and the team.