bluuebunny/crossref_metadata_2025_split huggingface dataset:
HEALTH EXP ERIENCES OF SEXUAL AND GENDER MINORITY PEOPLE LIVING WITH DEMENTIA AND THEIR CAREGIVERS: A SCOPING REVIEW
Authors: Harris Melissa , May Jennifer 
Published: December 2022

Abstract
People living with dementia and older adults who identify as sexual and gender minority (SGM - lesbian, gay, bisexual, transgender, queer individuals) both represent minoritized groups of older adults, but little is known about the health experiences of older adults who are at the intersection of having dementia and also identify as SGM. This review explored the extent and nature of research focused on health and healthcare experiences of SGM people with dementia and/or their informal caregivers. A scoping review framework was used given the exploratory nature of the project’s purpose. Health librarians comprehensively searched four databases (MEDLINE, CINAHL, PsycINFO, AgeLine) to identify relevant studies. A total of 8,137 unique titles and abstracts were reviewed by 2 independent reviewers. Forty citations were determined relevant and reviewed by full text. Eight studies met inclusion criteria and were analyzed thematically. Study methods were quantitative cross-sectional (n=2), qualitative exploratory (n=4), and a mixed methods case study (n=1). Studies were published from 2010–2022. Sample sizes ranged from 1 to 415 (M=113, SD=116). Four studies focused on caregivers, 2 on persons with dementia, and 1 on dyads. Themes emerged pertaining to caregiver health and well-being, identity, relationships, disclosure, discrimination, and safety. Findings highlight the significance of inclusive care that addresses intersecting psychosocial and health-related identities (e.g., cognitive status, SGM status, race/ethnicity, substance abuse history, multimorbidity) and that protects the rights of families of choice. More research is needed to better understand how sociopolitical structure influences dynamics between cognitive health and SGM status among older adults.
GERIATRICIAN PERSPECTIVES ON THE MANAGEMENT OF MILD COGNITIVE IMPAIRMENT/MILD ALZHEIMER’S DISEASE
Authors: Gopalakrishna Ganesh , Pruzin Jeremy , Alford Susan , Hamersky Carol , Sabharwal Anup , Brunton Stephen 
Published: December 2022

Abstract
Mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia are characterized by cognitive impairment and in AD a progressive functional impairment. This study sought to understand the role of geriatricians in treating patients with MCI/mild AD dementia. An anonymous, online survey was conducted in the US with 301 healthcare professionals (HCPs), including 75 primary care providers who practice as board certified geriatricians, and treat ≥10 patients per month with MCI/mild AD dementia. Geriatricians reported that among their patients with MCI/mild AD dementia, they initially make this diagnosis 70% of the time. Geriatricians reported that the topics commonly discussed with patients at the time of diagnosis are treatment options (85%), care management strategies (81%) and disease progression (80%). When referring patients to other specialties for treatment, geriatricians most often referred to neurologists (41%). Most (83%) geriatricians considered themselves the coordinator of care for patients with MCI/mild AD dementia; however, only 5% of non-geriatrician HCP respondents view geriatricians as such. Geriatricians reported prescribing/recommending treatments for ongoing management of MCI/mild AD dementia, with the most common being mental exercises (76%), acetylcholinesterase inhibitors (75%), social interaction (73%), medications to manage comorbidities (72%), and lifestyle improvements (72%). Most (76%) geriatricians have received advanced formal training in MCI/mild AD dementia care with the majority (84%) expressing that they feel very confident in managing patients with MCI/mild AD dementia. Geriatricians are specialists that are well trained and confident in diagnosing, treating, and managing patients with MCI/mild AD dementia.
EXAMINING THE HEALTH EQUITY OF PEOPLE WITH DEMENTIA DURING THE COVID-19 PANDEMIC: FIRST INSIGHTS FROM A TWITTER STUDY
Authors: Bacsu Juanita-Dawne , O’Connell Megan E , Cammer Allison , Ahmadi Soheila , Berger Corinne , Azizi Mehrnoosh , Gowda-Sookochoff Rory , Grewal Karl 
Published: December 2022

Abstract
The COVID-19 pandemic has deepened issues of health inequity and social injustice against people with dementia. Despite having one of the highest mortality rates, little research focuses on the COVID-19 impact of people with dementia. This presentation aims to: 1) explore the COVID-19 experiences and key factors of health inequity among people with dementia during the pandemic; and 2) identify actions to improve the health equity of people with dementia in the pandemic. We collected 6,243 relevant tweets using the Twint application in Python from September 8, 2020, to December 8, 2021. Tweets were divided among eleven coders and analyzed using thematic analysis. Analysis identified three primary themes: structural inequities (e.g., restricted access to health and support services, ageism, social isolation, vaccination barriers, and inadequate staffing in care facilities); frustration and despair due to loss (e.g., loss of cognitive abilities, loss of time with loved ones, and loss of life); and resiliency and hope for the future (e.g., lifting of restrictions and COVID-19 vaccine). There is an urgent need for policymakers to improve the health equity of people with dementia in the pandemic. Tackling COVID-19 inequities requires revisiting infection control policies to improve access to health and support services, recognizing the essential role of family care partners, and providing resources to help support people with dementia during the pandemic. Moreover, it is essential that COVID-19 policy responses are informed by evidence-informed research and authentic partnerships that embrace the insight and lived experiences of people with dementia.
ENGAGING OLDER ADULTS WITH ALZHEIMER’S DISEASE IN EXERCISE: IMPACT ON CAREGIVERS
Authors: Sims Tai , Talley Kristine , Gaugler Joseph , Peden-McAlpine Cynthia , Kirk Laura , Yu Fang 
Published: December 2022

Abstract
Informal caregivers provide the bulk of care for persons with Alzheimer’s dementia (PWAD) living at home, resulting in increased burden, and deteriorations in wellbeing and health. The stress process model hypothesizes characteristics of PWAD influence caregiver outcomes. Few studies have identified if engaging PWAD in exercise influences caregiver outcomes. This ancillary mixed methods study of a RCT evaluated the impact of a 6-month, moderate-intensity aerobic exercise intervention for community-dwelling PWAD on family caregiver burden, wellbeing and general health. Quantitative data was collected at baseline, 3, 6, 9 and 12 months using Zarit Burden Interview, Caregiver Strain Index, Caregiver Wellbeing Scale, and 36-item Short Form Health Survey. Qualitative data was collected at 6 and 9 months using semi-structured interviews. The convergent mixed methods design included ANCOVA analyses of quantitative and content analysis of qualitative data. Participants were 25 (17 intervention, 8 control) caregivers aged 34–86 years who were primarily white, females that lived with care-recipient. Based on group assignment, quantitative and qualitative results provided mixed insight on influence of intervention on burden and wellbeing, and found no influence on general health. Quantitative findings indicated caregiver characteristics of relationship with care-recipient, gender and education influenced wellbeing, and relationship with care-recipient, co-residence and education influenced general health; and caregiver characteristics did not influence burden. Qualitative findings suggest improved burden and wellbeing were consequences of respite and social support, rather than the exercise intervention. This study provides insight that integrating family caregiver components into community-based exercise programs may benefit PWAD and their family caregivers.
DESCRIBING THE EVOLUTION OF MEDICATION USE OVER TIME IN PEOPLE LIVING WITH DEMENTIA USING NETWORK ANALYSIS
Authors: Emdin Abby , Boblitz Alexa , Maclagan Laura , Bethell Jennifer , Watt Jennifer , Harris Daniel , Maxwell Colleen , Bronskill Susan 
Published: December 2022

Abstract
Prescribing for community-dwelling older adults living with dementia is complex. Multiple medications may be used to manage symptoms associated with dementia and/or co-existing chronic conditions, and can lead to problematic polypharmacy. Our objective was to use network analysis, a data science method, to provide a comprehensive description of co-prescribed medications in persons with dementia and describe whether these patterns change over time. We created a population-based cohort of community-dwelling older adults (aged 67+ years) in Ontario, Canada, newly diagnosed with dementia (between April 2014 and January 2019), from health administrative data, and developed medication networks at one year prior to, at, and for up to five years following dementia diagnosis. Among 136,292 individuals newly diagnosed with dementia, the mean age was 82.2 years and 59% were female. The most common medication subclasses dispensed at diagnosis were primarily cardiovascular medications: statins (45.6%), proton pump inhibitors (27.3%), beta-blockers (27.0%), calcium blockers (25.1%), and ACE inhibitors (24.6%). Similar proportions of medication subclasses were found at five years after diagnosis, except cholinesterase inhibitors (34.0% at five years were dispensed cholinesterase inhibitors compared to 16.9% at diagnosis). The most frequent co-prescribed medication pairs at diagnosis included statins and beta-blockers (16.0%), proton pump inhibitors (16.0%), and ace inhibitors (15.4%), respectively. Co-prescription was similar at five years, but also included higher frequency of co-prescribing with cholinesterase inhibitors (e.g., 19.4% were prescribed cholinesterase inhibitors and statins). Network diagrams demonstrate the complexity of prescribing in this population and highlight concurrent prescribing which may require careful monitoring or deprescribing.
DEMENTIA-FRIENDLY IN THE CONTEXT OF HOSPITALIZATION: A CONCEPT ANALYSIS
Authors: Munsterman Ellen , Cacchione Pamela , Hodgson Nancy , Perez G Adriana 
Published: December 2022

Abstract
Persons living with dementia experience more and longer hospitalizations when compared to those without dementia. In response, initiatives to address the hospital experience for individuals with dementia and their families are becoming more common. The term “dementia-friendly” attached to terms such as “hospital”, “ward”, “initiative”, “program”, etc. is being used to describe this response. Literature has begun to summarize current knowledge of dementia-friendly initiatives and define characteristics of dementia friendly hospitals, however, a formal definition of the concept of “dementia-friendly” is lacking. A concept analysis was completed using the 8-step Walker and Avant method including: selecting the concept and aim, identifying use of the concept in the literature, determining defining attributes, antecedents, consequences, and empirical referents, and developing cases that further distinguish the concept. The goal of this analysis was to clarify the definition of dementia-friendly in the context of hospitalization. Attributes of dementia-friendly in the hospital include dementia-specific staff education, use of person-centered care practices, environmental modification, and nursing-specific factors such as attitude, time to spend with patients and adapting responses based on patient need. Antecedents include recognition of the impact of hospitalization on older people with dementia. Consequences include enhanced staff knowledge and patient outcomes including decreased length of stay and decreased use of antipsychotic medication. Based on the above analysis, a conceptual definition for dementia-friendly in the context of hospitalization is proposed. This definition highlights the identified antecedents and attributes with a focus on the essential role of nursing in delivering dementia-friendly care.
ASSISTED LIVING ADMINISTRATORS’ JOB SATISFACTION, WORK STRESSORS, AND INTENT TO LEAVE DURING THE COVID-19 PANDEMIC
Authors: McSweeney-Feld Mary , Barry Teta , Yang Bo , Nelson H Wayne 
Published: December 2022

Abstract
This study examines how job satisfaction in six sub-scales and selected stressors and demographic covariates influenced assisted living administrators’ (ALF) intentions to quit during the COVID-19 pandemic. Quantitative and qualitative data were collected from 103 ALF administrators as part of a national study of long-term care administrators’ intent to quit during the COVID-19 pandemic funded by the Foundation of the National Association of Long-Term Care Administrator Boards in Washington, DC. Descriptive statistics were collected for the sample, and correlations between variables were examined, as well as responses from 3 open-ended questions that were coded for analysis. Although generally satisfied, roughly 41 percent of ALF administrators reported that they were intending to quit. Qualitative data suggested that job satisfaction was influenced by a more nuanced interpretation of job characteristics and work environment intrinsic factors such as adequacy of staffing and resources, changing regulations during the COVID-19 pandemic, and external supports such as family and friends. Given the limited research on the impact of the COVID-19 pandemic on assisted living communities and their administrators, the results of this study can help to inform policies and strategies for providing support for this segment of long-term services and its workforce during widespread disasters.
COMPARTMENTAL FEMUR CORTICAL THICKNESS IN OLDER ADULTS DIFFERS BY DEMOGRAPHICS AND PHYSICAL FUNCTION
Authors: Lam Justin , Lynch Delanie , Fuentes Diana Madrid , Devane Karan , Howard Marjorie , Beavers Kristen , Weaver Ashley 
Published: December 2022

Abstract
Previous studies have examined the relationship between cortical bone properties and fracture risk in older populations, but they have yet to examine how these properties change within the femur. Most hip fractures are classified by their location: femoral neck, intertrochanteric, or subtrochanteric fractures. Since cortical thickness can vary throughout the femur, a quantitative method of examining thickness by region was developed using a cortical mapping approach applied to computed tomography (CT) scans. Subject-specific finite element (FE) models of proximal femurs were created from baseline CT scans of 107 older adults (ages 60 – 85; 70% White; 72% Female) with obesity as classified by BMI (33.8 ± 4 kg/m2). An existing FE model was morphed to the segmented geometry of each subject’s proximal femur. A nearest neighbor search assigned cortical thickness values to the nearest finite element model node. Cortical thickness was grouped into four femoral compartments: femoral head, femoral neck, intertrochanteric and subtrochanteric regions. Pairwise paired t-tests indicated that cortical thickness differed between femoral compartments (p &lt; 0.05). Multivariate regression models showed greater cortical thicknesses in femoral head, neck, and intertrochanteric regions in African Americans compared to Whites (p &lt; 0.05). Additionally, these models suggest an association between cortical thickness and physical function assessments, such as the timed up-and-go test and leg muscle strength test. Since cortical thickness is not constant throughout the femur, future studies can use the framework developed here to assess each compartment individually and investigate the relationships between cortical thickness, demographics, and functional assessments.
PANCREATIC CANCER PROLIFERATION IS INDUCED BY GLI2-COL1 SIGNALING IN FIBROBLASTS IN THE TUMOR MICROENVIRONMENT
Authors: Ross Madeline , Vera Renzo , Fernandez-Barrena Maite , Toruner Murat , Tolosa Ezequiel , Almada Luciana , Brekken Rolf , Fernandez-Zapico Martin 
Published: December 2022

Abstract
Pancreatic ductal adenocarcinoma (PDAC) affects many older adults in the United States. This aggressive type of pancreatic cancer is resistant to many chemotherapies, resulting in a poor prognosis and a five-year survival rate of less than ten percent. To study PDAC progression and develop novel therapies, it is important to better understand the tumor microenvironment (TME) and the contributing cell populations and molecular mechanisms. Despite the well-described role of soluble Type I collagen in the regulation of pancreatic cancer TME, the molecular events modulating its expression/activity remain elusive. Here, we describe a novel mechanism controlling the levels of soluble collagen in cancer associated fibroblasts (CAFs), a major producer of Type I collagen in pancreatic cancer TME. Specifically, we provide evidence that the transcription factor GLI2 is required for the expression of COL1A1, a key component of the Type I collagen fiber, stimulated by the transforming growth factor β (TGFβ). Our methodology included expression studies from patient samples, ChIP-qPCR, qPCR, RNA-seq analysis, gene set enrichment analysis, biological assays, and gene ontology analysis. Our results confirm that the TGFβ-GLI2 axis in CAFs is able to activate EGR1-proliferative signaling downstream of collagen signaling in pancreatic cancer cells contributing to our understanding of the molecular underpinnings of pancreatic cancer TME. Further studies that define the complete role of EGR1 in PDAC may lead to the development of novel therapies targeting EGR1 or CAFs to promote enhanced quality of life following a PDAC diagnosis.
OLDER CANCER SURVIVORS’ POST-TRAUMATIC GROWTH DURING THE COVID-19 PANDEMIC
Authors: Ligus Kaleigh , Fritzson Emily , Salafia Caroline , Park Crystal , Bellizzi Keith 
Published: December 2022

Abstract
Older adults and immune-compromised individuals (e.g., cancer survivors) were quickly identified as high-risk groups during the COVID-19 pandemic. Research has examined adverse psychological consequences due to the pandemic in older adults with chronic conditions. However, no research has examined the potential for positive consequences of COVID-19 in older adults with cancer. The current study examined the association between COVID-19 risk, stress, exposure, and perceived post-traumatic growth (PPTG) in adults with cancer. Cancer survivors (n = 231) enrolled in an ongoing longitudinal study completed a one-time COVID-19 experience assessment, including PPTG as a result of the COVID pandemic. Participants (mean age = 68 years) had completed primary treatment for breast, prostate, or colorectal cancer within the past two years. On average, survivors reported modest PPTG related to COVID-19 (mean = 6.03, range = 0–20). Using linear regression, we found that gender, cancer type, and marital status were related to PPTG. Higher COVID-19 risk, more COVID-19 stressors, and higher illness exposure (e.g., having had COVID-19) were significantly positively associated with PPTG scores (ps &lt; .05). In spite of the potential adverse psychological consequences of the COVID-19 pandemic, these results suggest adults with cancer, in our sample, report modest PPTG. Higher COVID-19-related perceived risk, stress, and exposure predicted higher PPTG scores. These findings are interesting in light of studies that suggest PPTG occurs only after time passes from the stressor. Future research could examine how coping with cancer may influence coping with a co-existing or subsequent stressor and its relationship to PPTG.
LESSONS FROM THE IMPLEMENTATION OF THE TRANSITIONAL CARE MODEL DURING THE COVID-19 PANDEMIC
Authors: McHugh Molly , Hirschman Karen , Morgan Brianna , Ahrens Monica , Hanlon Alexandra , Osokpo Onome , Naylor Mary 
Published: December 2022

Abstract
Multiple randomized controlled trials (RCTs) evaluating the Transitional Care Model (TCM)- an advanced practice registered nurse-led (APRN), team-based, care management strategy- have shown improved outcomes for older adults transitioning from hospital to home. In the current RCT, enrollment of older adults hospitalized with heart failure, chronic obstructive pulmonary disease, or pneumonia began in February 2020, just as the COVID-19 pandemic developed across the U.S. The COVID-19 pandemic dramatically impacted healthcare delivery across diverse local contexts. This parallel convergent mixed methods study aimed to explore the implementation of the TCM intervention as intended during Year 2 of the RCT (February 2021 to January 2022). This mixed-methods analysis presents the challenges and strategies to a key TCM component, “hospital-to-home,” which focuses on delivering in-person visits to patients, as identified through a qualitative descriptive analysis of 63 clinical team and leadership meetings combined with implementation fidelity data collected simultaneously on 188 TCM participants. In Year 2 of the trial, COVID-19-specific challenges continued, including COVID-19 exposure, policy changes, patients declining services, and limited safety equipment. Some challenges to the hospital-to-home TCM component occurred regardless of COVID-19, including patient (e.g., lack of engagement), nurse provider (e.g., TCM learning curve), and system (e.g., reduced primary care access) barriers. Collectively, these challenges resulted in lower fidelity to APRNs visit patterns during TCM delivery. Strategies to address these challenges were identified. The findings provide critical insight into how to target quality improvement strategies to improve the delivery of services, such as the TCM, from hospital to home settings.
INVESTIGATING THE ROLE OF STRESS PATHWAY ACTIVATION IN MEIOTIC DIFFERENTIATION AND REJUVENATION IN BUDDING YEAST
Authors: Biritwum Akosua , Bishop Alena 
Published: December 2022

Abstract
Sexually reproducing organisms undergo meiosis to produce gametes for the next generation. In budding yeast, meiosis resets replicative lifespan as gametes produced by aged progenitors are born young and devoid of any senescence-associated factors. In addition, certain transcription factors that are involved in stress response are expressed when yeast cells undergo meiosis. The overarching goal of this project is to determine the role of stress transcription factors in meiotic rejuvenation. As part of this goal, I set out to develop an assay to measure the fitness of yeast gametes that were depleted of a given stress response transcription factor. I focused on Yap1 and Skn7, two transcription factors involved in oxidative stress, and characterized gamete fitness by measuring survival in response to environmental stressors, including acid and alkaline. I found that gametes depleted for Yap1 have mild sensitivity to acid and dramatic sensitivity to alkaline. These findings implicate a role of Yap1 in gamete fitness in a physiologically relevant context since acidic and alkaline environments exist in the digestive tract of fruit flies, which are natural predators of yeast. Further investigation of how stress response transcription factors affect meiotic rejuvenation can help us develop strategies to counteract cellular aging in different contexts.