bluuebunny/crossref_metadata_2025_split huggingface dataset:
LINC TOOL: USING QUALITY DATA, COACHING, AND AN IMPROVEMENT CYCLE FOR LEARNING AND IMPROVEMENT IN LONG-TERM CARE
Authors: Van Lierop Merel (E A ) , Meijers Judith , van Rossum Erik , Zwakhalen Sandra 
Published: December 2022

Abstract
Providing high quality of care can be challenging for nursing staff because of the continuous changes in healthcare. Nursing staff needs to learn continuously to remain employable and deal with these challenges. Therefore, availability of a continuous learning and improvement tool (LINC tool) using nursing quality data and an improvement cycle to maintain high quality of care in long-term care is important. The development of this tool took place in co-creation with researchers, experts, educational staff and nursing staff working in long-term care. Taskforces with researchers and experts on quality data and education were established to develop the main steps of the tool. Nursing staff was involved in the development and testing of the tool. The LINC tool consists of 1) Assessment of the current learning climate and preferred quality data for nursing staff to work with, 2) Discussing findings from step 1 with the nursing staff team and formulate learning topics, 3) Start improvement cycle (PDCA cycle) using one learning climate topic and one quality data topic as a case to improve quality of care and improve the learning climate. During this cycle, nurse coaches are available to help nursing staff use the LINC tool materials. The LINC tool can be used to improve long-term care and has proven to be feasible. However, the LINC tool is currently tested in more nursing staff teams to increase its usability and effectiveness. Further development of the LINC tool is therefore a constant cycle of developing, implementing, testing, and evaluating, all in cooperation with stakeholders.
"DID I ASK FOR YOUR ADVICE?”: EFFECTS OF ADVICE FROM PARENTS ON ADULT CHILDREN'S DEPRESSIVE SYMPTOMS
Authors: Suitor J Jill , Gilligan Megan , Frase Robert , Stepniak Catherine 
Published: December 2022

Abstract
Studies of intergenerational relations typically conceptualize advice as a positive dimension of exchanges between parents and adult children. In contrast, we suggest that advice may often be a source of interpersonal stress and thus have detrimental effects on psychological well-being. Further, we suggest that these effects vary by race and gender. To address these questions, we use data from 725 adult children regarding advice from mothers, collected as part of the Within-Family Differences Study. Multilevel regression analyses revealed that the impact of receiving advice varied by the combination of gender and race. Among sons, receiving advice predicted higher depressive symptoms, regardless of race. However, receiving advice predicted depressive symptoms among Black but not White daughters. Taken together, these findings question whether advice is a positive dimension of intergenerational interaction and suggest that mothers’ advice may have a negative impact on adult children’s depressive symptoms, particularly for sons and Black daughters.
CORRELATES OF RACIAL DISCRIMINATION TRAJECTORIES AMONG BLACK MIDDLE-AGED AND OLDER ADULTS
Authors: White Kellee , Huang Shuo , Bell Bethany 
Published: December 2022

Abstract
Single cross-sectional measures of racial discrimination may mask the dynamic nature and cumulative impact of repeated exposures to discrimination. Characterizing racial discrimination trajectories, patterns of repeated exposure, may provide insight on age-related patterns of health risk and resilience. However, there is a dearth of research exploring racial discrimination trajectories. This study characterizes racial discrimination trajectories and identifies trajectory correlates among a nationally representative sample of middle-aged and older black adults who participated in the Health and Retirement Study (2006-2018). Repeated measures latent profile analysis was employed to identify racial discrimination trajectories. Logistic regression models, estimating odds ratios (ORs) and 95% confidence intervals (CIs), were conducted to investigate sociodemographic and neighborhood-level predictors of racial discrimination trajectories. Two racial discrimination trajectories were identified: low to moderate (82%) and persistently high (18%). Individuals 65+ (OR: 0.45; 95% CI: 0.32, 0.64) and female sex (OR: 0.59; 95% CI: 0.45, 0.76) were associated with a lower odds of belonging to the persistently high racial discrimination trajectory class. Individuals reporting higher levels of major lifetime experiences of discrimination (OR: 1.47; 95% CI: 1.33, 1.63) and greater neighborhood social cohesion (OR: 1.30; 95% CI: 1.1, 1.50) predicted membership in the persistently high racial discrimination trajectory class. These findings suggest heterogeneity in the cumulative patterning of discrimination among black middle-aged and older adults. Discrimination trajectories may enable greater precision in estimating the health consequences of cumulative exposure to discrimination. Future studies are warranted to determine whether membership in specific trajectory classes confers differential risk to age-related conditions.
QUALITATIVE COMPARISON OF TWO INTERGENERATIONAL SERVICE-LEARNING PROGRAMS
Authors: Bartlett Sara , Bergman Sky , Solomon Phyllis , Gellis Zvi 
Published: December 2022

Abstract
Intergenerational service-learning programs are an effective and frequently used training modality in undergraduate education and are often examined using qualitative methods. It is less common to qualitatively examine two such programs to compare their outcomes. This study reports qualitative findings from a mixed-methods study comparing two intergenerational service-learning programs in an undergraduate Psychology of Aging class. The longer, more relational intervention, the Lives Well Lived program, matched students and older adults exemplifying “successful aging” in a mutual interviewing, life review project utilizing documentary film, photography, and memoir creation. The comparison intervention, the Meals That Connect/Lunch Bunch program, also exposed students to older adults exemplifying successful aging, but in a shorter, less relational way. A convenience sample of 128 students (65 in the intervention group and 63 in the comparison group) answered post-intervention open-ended questions about what they liked/disliked about the program in which they participated, as well as any viewpoints about aging they felt changed or were reinforced by the project. Thematic analysis revealed students in both groups experienced decreased ageism and improved attitudes about aging. However, those participating in the Lives Well Lived program had closer relationships with the older adults participating in the project, expressed more positivity about their own aging process, and indicated more willingness to engage in future intergenerational relationships. Use of a comparison project in qualitative examination of intergenerational service-learning adds greater insight into such programs’ outcomes, enhancing quantitative effectiveness examinations.
IMPLEMENTING FUNCTION-FOCUSED CARE IN THE HOSPITAL: LESSONS LEARNED
Authors: Boltz Marie 
Published: December 2022

Abstract
The mentorship provided by the nurse interventionist is an important implementation strategy to support Function-focused care adoption in hospitalized older adults with dementia. The nurse interventionist works with unit champions and interdisciplinary stakeholder teams over a 12 month period. The first interaction includes using a brainstorming approach to develop unit-specific goals to support the integration of function-focused care into routine care delivery. Implementation strategies at the unit level include flexible staff training, involving staff in evaluations of care interactions, targeting pragmatic measures, and a feedback loop. Based on content analysis of field notes we will describe stakeholder goals established, action plans, and barriers and facilitators to meet goals in four hospital units. Key findings include the influence of leadership support, communication strategies, engagement of direct care staff, interdisciplinary collaboration, access to human and material resources, and contextual factors within the hospital setting (including pandemic-related challenges).
THE EXISTENTIAL CONTEXT OF GRAY DIVORCE
Authors: Bildtgård Torbjörn , Öberg Peter 
Published: December 2022

Abstract
In later years divorce rates for older people has increased in many parts of the Western world in what has been described as a “grey divorce revolution”. In Sweden divorce rates for people 60+ have more than doubled since the millennium. The purpose of this paper is to study the reasons older people attribute to their late life divorce. Qualitative interviews were carried out with Swedish men and women aged 62–82 who after the age of 60 had divorced from a cross-gender marital or non-marital cohabiting union (n=37). The interviews covered themes regarding the divorce process, including reasons for divorce, experiences of divorce and life as a grey divorcee. The results were analysed using principles from Grounded Theory. The results revealed four different types of divorce narratives: 1) Incompatible goals for the third age, 2) Personality change caused by age related disease, 3) A last chance for romance, and 4) Enough of inequality and abuse. A central insight generated by the study was the importance attributed to the particular existential conditions of later life in the divorce decisions. The results are discussed in relation to theories of the third age as a time of self-fulfillment, where the partner can either be part of or an obstacle to that project.
THE IMPACT OF PUBLIC REPORTING ON INEQUITIES IN HIGH-QUALITY HOME HEALTH UTILIZATION
Authors: Fashaw-Walters Shekinah , Rahman Momotazur , Gee Gilbert , Mor Vincent , Thomas Kali 
Published: December 2022

Abstract
Literature suggests that public reporting of quality may exacerbate disparities in access to high-quality post-acute and long-term care for older adults. The objective of this study was to evaluate the impact of the home health (HH) 5-star ratings on changes in high-quality HH agency (HHA) use, by race, ethnicity, income level, and place-based factors. Using a difference-in-differences framework, we found that after introduction of 5-star ratings adjusted rates of high-quality HHA use increased for all HH users, except for Latinx, Asian American/Pacific Islander, and low-income HH users, and disparities in access to high-quality HHAs were exacerbated for each of these groups. Last, we found that users within predominantly Latinx and lower income neighborhoods had a significantly greater decrease in their use of high-quality HHAs. Policymakers should be aware of the potential unintended consequences of public reporting and should consider adding measures of equity to the publicly reported information.
EFFECT OF A 6-MONTH HOME-BASED WALKING PROGRAM ON COGNITIVE FITNESS IN OLDER ADULTS WITH CHRONIC KIDNEY DISEASE
Authors: Bronas Ulf 
Published: December 2022

Abstract
We have previously demonstrated that cognitive status and white matter integrity are highly associated with physical fitness in older adult patients with chronic kidney disease (CKD). We present data from a two group RCT determining effect of a 6-month home-based walking intervention on physical and cognitive fitness compared to usual care. The intervention included use of a wearable activity monitor, weekly didactic phone meetings, interactive tools and monthly coach-delivered feedback. The intervention group had a 78% compliance rate to the 6-month exercise program (159.9 (149.2) minutes/week). Executive function composite score and global cognitive for intervention group &gt; than control group. Additionally, global white matter integrity and functional connectivity improved in the intervention group and declined in the usual care group. We conclude that a home-based physical activity intervention can have significant improvement on cognitive health and neuroplasticity in older adults with CKD and lowering their risk of developing AD/ADRD
NOVEL GENOMIC AND EXCEPTIONAL LONGEVITY FINDINGS FROM THE LONG LIFE FAMILY STUDY
Authors: Wojczynski Mary , Glynn Nancy W , Hadley Evan 
Published: December 2022

Abstract
The Long Life Family Study (LLFS), funded by the National Institute on Aging, is an international collaborative study of the genetics and familial components of exceptional longevity and healthy aging. We phenotyped 4,953 individuals from 539 two-generational families (1,727 proband; 3,226 offspring) at baseline (2006-2009). A second visit (2014-2017) was conducted for 2,904 (478 proband; 2,426 offspring) participants. The longitudinal, comprehensive in-person visits measured domains of healthy aging, including physical performance, cognition, and blood markers. Extensive genetic analyses were performed using the baseline blood draw, including genotyping with the Illumina 2.5M Human Omni array, linkage analyses with the families, whole genome sequencing using the TopMED protocol, and metabolomic assays. Collectively, this symposium will present novel findings that examined differences in end of life events and cause of death between non-exceptional and exceptional long-lived women, elucidate potential rare variants associated with exceptional longevity, and examine new potential metabolomics pathways involved in gait speed and cardiovascular disease. Specifically, Dr. Galvin will share results from three Danish nationwide studies (including LLFS) on different end of life events in long-lived female siblings. Then, Dr. Gurinovich will share findings on new uncommon variants associated with extreme longevity. Next, Dr. Kuipers will discuss associations between lipid metabolomics and vascular health. Lastly, Dr. Santanasto will discuss lipid metabolomics associated with lower odds of slow gait speed. Dr. Evan Hadley, NIA, will be the discussant and will share insights and propose future directions for LLFS.
LIPIDOMIC ANALYSIS OF GAIT SPEED IN THE LONG LIFE FAMILY STUDY
Authors: Santanasto Adam , Fiestosa Mary , Lustgarten Michael , Christensen Kaare , Patti Gary , Zmuda Joseph , Cvejkus Ryan , Wojczynski Mary 
Published: December 2022

Abstract
Gait speed is a predictor of overall health and mortality in older adults. Metabolomics may provide insights into biological mechanisms underlying gait speed. Herein, we examined the association between 193 lipid metabolites with gait speed in 1,717 adults (52.1% women) aged 82.0 ± 14.5. Lipidomic analysis was performed using liquid chromatography-mass spectrometry. Gait speed was measured over 4-meters and slowness was defined as &lt;0.8m/s. Logistic regression, adjusted for age, sex, field center, height, fasting-duration and familial-relatedness, were used to examine the association between log-transformed metabolites with slowness. A false discovery rate (FDR) of p&lt;0.05 was employed to account for multiple comparisons. Gait speed was 0.83 ± 0.32 and 53.4% had slowness. Three lipid metabolites were significantly associated with lower odds of slowness: an acylcarnitine, sphingomyelin and a ceramide non-hydroxy fatty acid-sphingosine. Our results potentially link lipids involved with mitochondrial beta-oxidation and nerve signal transduction to gait speed in older adults.
ADULT CHILD PROXIMITY AND REPARTNERING AMONG PARENTS AFTER GRAY DIVORCE
Authors: Brown Susan , Lin I-Fen , Mellencamp Kagan 
Published: December 2022

Abstract
The rise in gray divorce is spurring growth in repartnering, which occurs more frequently after divorce than widowhood. Roughly 40% of men and 25% of women form a co-residential union following gray divorce. Drawing on the 1998-2014 Health and Retirement Study, we assessed whether parent-adult child proximity (living within 10 miles) was associated with men’s and women’s repartnering after gray divorce. Men’s relationships with their children tend to erode following gray divorce, and thus we anticipated that the association between proximity and repartnering was negligible. In contrast, women’s ties to adult children are largely resilient following gray divorce, which led us to expect that having a child nearby reduced chances of repartnering. Our analyses revealed that both men and women with a proximate child less often repartnered than those with no children nearby. Repartnering seemingly functions as an alternative means to “doing family” for those lacking nearby children.
HOSPICE UTILIZATION AMONG LONG-STAY NURSING HOME RESIDENTS DURING THE COVID-19 PANDEMIC
Authors: Wang Xiao (Joyce) , Belanger Emma , Thomas Kali , Dobbs Debra , Dosa David 
Published: December 2022

Abstract

Background
The COVID-19 pandemic has had significant impacts on nursing home residents. This study aims to examine how hospice utilization changed among long-stay nursing home residents between January and September in 2020, as compared with the same period in 2019, nationally. Design: A retrospective cohort study of residents present in US nursing homes as long-stay as of January 1st, 2019 and 2020, respectively. A subgroup of residents who died from January to September in each year was also examined. We utilized the Minimum Data and multiple administrative claims data. We compared hospice utilization rate between 2019 and 2020 nationally and by state.Outcomes: This study examined: 1) any hospice utilization among long-stay residents from January to September in 2019 and 2020 respectively, and 2) hospice utilization in the last 30 days of life among the decedent subgroup, which we also tracked as a factor of percent change in mortality rate at the state level.

Results
The hospice utilization rate among long-stay residents was 19.4% in 2019 and 19.7% in 2020. The rate was 27.5% in 2019 and 24.2% in 2020 among the decedent subgroup (χ2=553.1, p&lt; 0.001), although the absolute number of decedents using hospice in the last 30 days of life was higher in 2020 than 2019. Substantial state variation in hospice utilization was observed, mostly following patterns in community-level infections.

Conclusions
Hospice managed to continue service delivery despite many challenges. The pandemic highlights the importance of integrating hospice and palliative care into emergency preparedness planning.
ELDER ABUSE TRAINING NEEDS AMONG NURSING HOME SOCIAL SERVICES DIRECTORS
Authors: Roberts Amy , Anetzberger Georgia , Smith Kevin , Bern-Klug Mercedes 
Published: December 2022

Abstract
This study aims to identify elder abuse training needs among social services directors. Using nationally representative data from the 2019 National Nursing Home Social Services Directors Survey, we found that approximately three-quarters of directors reported either a moderate or strong interest in receiving training in the following areas: (1) the types of abuse, neglect, and/or exploitation by staff, residents, family and/or other visitors…; (2) establishing trust with a resident and/or family member who feels mistreated by the nursing home or a staff member…; and (3) interacting with visitors whose behaviors are perceived as threatening to residents or staff. Hierarchical logistic regressions found significant associations between strong interest in each training topic and facility, department, and director characteristics. Additional training may enhance directors’ skills in explaining basic information about elder abuse and supporting other staff with strategies to address elder abuse and difficult interpersonal dynamics among staff, residents, families, and visitors.
A DEGREE IN SOCIAL WORK INCREASES FAMILY ENGAGEMENT WITH THE SOCIAL SERVICES DEPARTMENT
Authors: Roberts Amy , Kusmaul Nancy , Alaniz Amber , Bern-Klug Mercedes 
Published: December 2022

Abstract
This mixed-methods presentation will examine the role of social services directors in supporting the family members of nursing home residents. A logistic, hierarchical regression (n= 924) found a positive association between the social services director having a degree in social work and strong agreement with "family members regularly engage the expertise of the social services department." A qualitative analysis of written-in comments to the question, “What do you like about your job?” identified 234 comments that described directors’ view of the importance of working with and supporting families. A content analysis revealed that two types of support are provided to families, instrumental and emotional. Instrumental support includes connection to resources for adjustment, financial needs, and discharge planning. Emotional support includes activities such as helping people through transitions, and coping with grief and loss. Appropriately trained social services directors can offer different types of support and be valued resources for families.
IMPACT OF UNINTENTIONAL WEIGHT LOSS AND EXHAUSTION ON CLINICAL OUTCOMES FOLLOWING SURGERY
Authors: Kaufmann Christopher , Mardini Mamoun , Smail Emily , Tighe Patrick , Price Catherine , Manini Todd 
Published: December 2022

Abstract
For patients undergoing surgery, unintentional weight loss and exhaustion, two hallmarks of frailty, may be salient markers for identifying patients at risk for adverse postsurgical outcomes. This study examined how these frailty components impact postsurgical outcomes including length of stay, 30-day mortality, and discharge disposition. Patients with weight loss and exhaustion pre-surgery experienced greater length of stay, and higher odds of 30-day mortality as well as lower likelihood of being discharged home. After adjustment for confounders including age, sex, race, and disease history, the above results for the most part remained significant, although statistical significance was lost for 30-day mortality and some discharge dispositions. Results highlight importance of assessing frailty components to enhance surgical care in older adults.
LOW PHYSICAL ACTIVITY AND SLOW GAIT AS PREDICTORS OF POSTSURGICAL CLINICAL OUTCOMES
Authors: Smail Emily , Mardini Mamoun , Tighe Patrick , Price Catherine , Kaufmann Christopher , Manini Todd 
Published: December 2022

Abstract
Low physical activity and slow gait are independently associated with adverse health outcomes of aging (e.g., hospital readmission and mortality). The objective of this study was to build on current knowledge using presurgical indicators of frailty to predict postsurgical outcomes (i.e., length of stay, 30-day mortality, and discharge disposition). In a sample of over 8,900 patients, low physical activity and slow gait were both associated with a greater length of stay, higher odds of mortality, and lower odds of being discharged to home (vs. more intensive care). Associations remained significant for 30-day mortality and discharge disposition in fully adjusted models (adjusting for age, sex, race, and disease history). These results suggest that measuring movement-based presurgical markers of physical activity and slow gait may be useful for identifying patients at risk for poor postsurgical outcomes.