bluuebunny/crossref_metadata_2025_split huggingface dataset:
MEETING NEEDS: LINKING CLIENTS WITH A SELF-NEGLECT ALLEGATION TO HOME- AND COMMUNITY-BASED SERVICES
Authors: Tuft Samantha , Ejaz Farida , Reynolds Courtney 
Published: January 2025

Abstract
This paper describes results from a federal grant in which Oklahoma Adult Protective Services (APS) collaborated with the Oklahoma City Indian Clinic and gerontological researchers to enhance APS self-neglect practice. A total of 188 APS clients from 11 counties were interviewed by phone at baseline during the COVID pandemic. This paper focuses on a subset of 45 randomly selected clients who were offered extensive case management services for a period of four months beginning shortly after they were reported to APS. The clients were primarily white and female with a mean age of 62 years and average annual income between $12,000-$15,000. During the study, 24% of the clients were screened as experiencing self-neglect based on the Recognizing Abuse Tool (Ejaz, et al., 2017). More importantly, 76% of the 45 clients reported that they needed help in at least one area, resulting in a total of 175 identified needs. The top five most identified needs were home repairs/maintenance, in-home care, public benefits, transportation, and case management. We will describe whether client needs were met during the study along with barriers to service utilization. Findings will be explored in light of their implications for APS practice and policy, particularly the role time-limited, intensive case management can play in preventing further reports to APS.
ADVANCES IN INTERDISCIPLINARY SCIENCE: BRAIN CONTROL OF MOBILITY IN AGING AND DISEASE POPULATIONS
Authors: Holtzer Roee , Liu-Ambrose Teresa 
Published: January 2025

Abstract
Interdisciplinary research has demonstrated that cognitive and mobility performance and decline are inter-related and potentially coupled implicating the brain as a key common denominator shared by both domains of function. Novel studies in the current symposium utilize advanced neuroimaging methods to elucidate how structural and functional measures of brain integrity are utilized to predict mobility outcomes and mitigate against risk of developing mobility decline and impairments. Mark Wagshul demonstrates that whole brain latent patterns have differential associations with gait speed in older adults with and without multiple sclerosis. Paul Laurienti uses brain networks connectivity data to define cognitive reserve demonstrating that associations between amyloid beta and mobility decline are attenuated among older adults with high cognitive reserve. Chun Liang Hsu uses functional neural networks to define a novel construct - physical reserve. He demonstrates that among older adults with subcortical ischemic vascular cognitive impairment (SIVCI), high physical reserve attenuates the negative effect of white matter hyperintensities on postural stability. Roee Holtzer uses functional-near-infrared-spectroscopy (fNIRS) to assess oxygenated hemoglobin (HbO) in the prefrontal cortex during walking under single and dual-task conditions. He shows that higher fNIRS-derived HbO during dual-task walking is protective against future falls in older adults with relapsing-remitting but not progressive MS subtype. Combined, these studies shed light on novel discoveries concerning brain control of mobility in aging and disease populations. Furthermore, emphasis is placed on demonstrating how brain data are utilized to define constructs (cognitive and physical reserve) and elucidate theoretical models (compensatory reallocation) vis-à-vis mobility outcomes. Brain Interest Group Sponsored Symposium
ASSOCIATIONS BETWEEN FUNCTIONAL NETWORKS OF PHYSICAL RESERVE, POSTURAL INSTABILITY, AND WHITE MATTER LESIONS
Authors: Hsu Chun-Liang , Holtzer Roee , Tam Roger , Alkeridy Walid , Liu-Ambrose Teresa 
Published: January 2025

Abstract
White matter hyperintensities (WMH) are clinical markers of subcortical ischemic vascular cognitive impairment (SIVCI) associated with impaired postural balance and falls. Physical reserve (PR) is a recently established construct that reflects one’s capacity to maintain physical function despite brain pathology. This cross-sectional study aims to map functional networks associated with PR, and examining the relationship between PR, WMH, and postural balance. Physical reserve was defined in 22 community-dwelling older adults with SIVCI as the unexplained residual variance in Timed-Up-and-Go test (TUG) after accounting for age, global cognitive function measured by Alzheimer’s Disease Assessment Scale-Cognitive-13 (ADAS-Cog-13), and hippocampal volume. Functional neural networks associated with PR were extrapolated as TUG-correlated network connectivity maps computed using general linear models that removed the effects of age, ADAS-Cog-13, and hippocampus volume. Subsequent analyses examined whether PR and its associated brain networks moderated the relationship between WMH and postural balance under two conditions – eyes open while standing on foam (EOF) and eyes open while standing on floor (EONF). Physical reserve and its associated functional neural networks - frontoparietal network (FPN) and default mode network (DMN) - significantly moderated the association between WMH and postural balance. Specifically, in those with high PR, postural balance was maintained regardless of WMH load while in those with low PR, postural balance worsened as WMH load increased. These results suggest the attenuated effects of WMH on postural stability due to PR may be underpinned by functional neural network reorganization in the FPN and DMN as a part of compensatory processes.
SUPPORTING THE UPTAKE OF PERSON-CENTERED COMMUNICATION STRATEGIES IN NURSING HOMES USING THE PRISM
Authors: Douglas Natalie 
Published: January 2025

Abstract
The implementation of quality, person-centered care into nursing home (NH) settings is challenging due to the complexity of NH organizational structures, nationwide staffing shortages, and significant federal regulations. We used the Practical, Robust Implementation and Sustainability (PRISM) Model to assess key contextual factors that may influence the implementation of Dementia Collaborative Coaching, an evidence-informed communication coaching program designed to decrease negative, responsive behaviors and improve quality of life for people living with dementia in NHs. Employees (n=27) from three urban NHs including corporate leaders, managers, and direct care providers across a variety of disciplines engaged in n=5 focus group sessions to deepen understanding of barriers and facilitators to the implementation of Dementia Collaborative Coaching. Participants identified barriers to Dementia Collaborative Coaching implementation including the need to improve dementia care overall, inadequate leadership support, staffing concerns, and misinterpretation of NH federal regulations. Facilitators included enthusiasm for the program as well an agreed upon need for an NH-wide implementation and sustainability plan. Outcomes most relevant to the participants included decreased behavioral incidents and falls as well as increased engagement in both leisure and activities of daily living. Pre-implementation guided by the PRISM proved to be a critical step in maximizing the success of implementation of this intervention and developing relationships with key players in the NH. During this process, site-specific system and clinician level factors will inform future Dementia Collaborative Coaching implementation efforts which may also contribute to the implementation of other quality interventions for NH residents.
ENGAGING PEOPLE LIVING WITH DEMENTIA, CARE PARTNERS, AND STAFF TO INFORM REMOTE ME AND MY WISHES
Authors: Towsley Gail 
Published: January 2025

Abstract
Me & My Wishes, is a video recording approach for documenting, viewing, listening, and discussing nursing home (NH) residents’ preferences for daily and end-of-life care. This project addressed the alignment and measurement domains of the Readiness Assessment Pragmatic Trial Model. Using a qualitative descriptive design, we conducted focus groups with experts representing persons living with dementia (PLWD) (n=6), care partners (n=8), and NH staff (n=9) to inform us of what mattered to them when implementing and evaluating a remote format of Me & My Wishes. We coded and analyzed audio-recorded transcripts, resolved coding discrepancies in team meetings, and derived domains from finalized codes. Three domains for implementing Me & My Wishes remotely was shared across groups. Prioritizing Care Conferences included leadership providing staff resources and support to prioritize care conferences utilizing Me & My Wishes. Addressing Competing Demands that Prevent Key People Attending involved identifying times for care conferences that allow residents, care partners, and staff to participate. Utilizing Technology and Learning to Communicate in a Virtual Environment encompassed recommendations to have a trained facilitator whom engages attendees and additional support (e.g. technical, emotional) for the PLWD. Experts provided input on content, structure, and design of a template for capturing video highlights, changes in preferences, and results of conversations that could be included in the medical record. Outcomes most important to them included person-centered care, dignity, feeling heard and understood, and improved knowledge. Experts identified key alignment and measurement aspects that informed modifications for delivering Me & My Wishes remotely.
“DIAGNOSE AND ADIOS”: MULTIPERSPECTIVE INSIGHTS ON FORMAL SERVICE USE IN DEMENTIA FAMILY CAREGIVERS
Authors: Greenfield Annabelle , Mason Hannah , Osso Francesco , Bumbalova Katerina , Bloom Rachel , Falzarano Francesca 
Published: January 2025

Abstract
Over 11 million unpaid family caregivers currently provide care to 6.7 million individuals with Alzheimer’s disease and related dementias (ADRD). The diverse roles associated with ADRD caregiving range from physical care responsibilities, providing emotional support, in addition to more complex roles such as medical/legal/financial decision-making. Formal and informal supports (e.g., respite, training/education, social support) may be protective against adverse stress-related outcomes such as depression, anxiety, and burden. Despite the existence of such supports, caregivers’ utilization rates remain remarkably low. Using focus group methodology, the current study explored ADRD caregivers’ experiences with the formal services system and identified barriers that hinder service access and utilization. Five semi-structured focus groups were conducted with ADRD family caregivers (n=13) and Dementia Care Community Partners (n=17). Qualitative findings identified three overarching concepts: 1) “Pathways to Preparedness,” categorized primary domains of unmet needs of support, specifically regarding education, emergency preparedness, financial/legal guidance, and mental health. 2) “Multi-Level Barriers” examines obstacles identified across the individual, provider, and systemic levels that hinder service identification and access. 3) “Bridging the Gap” illustrates technology’s potential in mending the broken needs-to-services continuum by providing tailored and personalized support to caregivers. Findings underscore the complex disconnect between caregivers’ needs and existing services, leading to a lack of preparedness for caregiving roles and stress-related adverse outcomes. Yet, a viable solution lies in web-based behavioral interventions, creating a clear pathway for caregivers to identify, access, and utilize formal services, thus improving their overall experiences and outcomes.
THE TIMING OF SUPPORT UTILIZATION AND ITS IMPLICATIONS FOR THE EFFECTIVENESS OF FORMAL CAREGIVING SUPPORT
Authors: Svec Joseph , Meinertz Naomi , Lee JeongEun 
Published: January 2025

Abstract
Current literature on caregiving support indicates a mixed association between formal support (e.g., paid help, respite, training) and caregiver well-being. Compared to informal support from family and friends, formal support often comes with additional costs to caregivers in the form of financial, knowledge, and time barriers to access. This study seeks to examine those barriers, particularly the issue of when caregivers seek and utilize formal support as a predictor of its effectiveness. We utilize four waves of data from the National Study of Caregivers (NSOC) toward a series of fixed-effect linear regression models for caregiver emotional distress and physical health on formal support usage (N = 2,083). The dependent variable, experiencing any financial, emotional, or physical difficulties (M = 0.83, SD = 0.87), is regressed on whether the caregiver received support from paid help, financial help, or respite (M = 0.51, SD = 0.77). The findings show that formal support is positively associated with higher levels of caregiving difficulty (coeff = 0.22, p &lt; 0.05); however, when controlling for past levels of difficulty (previous wave difficulty) and past usage of formal support (previous wave formal support), the positive association of formal support is mitigated. This suggests that the timing of adopting formal support can play a role in the challenges faced by caregivers, with earlier adoption potentially leading to reduced burdens of informal caregivers. While formal support remains positively associated with perceived difficulty, the mitigated coefficient when including lagged variables suggests that formal support effectiveness is also time sensitive.
EXPLORING SECONDARY STRESSORS ON ADRD CAREGIVERS’ EXPERIENCES WITH HOME AND COMMUNITY-BASED SERVICES (HCBS)
Authors: Falzarano Francesca , McCarthy Megan , Mason Hannah , Greenfield Annabelle , Osso Francesco 
Published: January 2025

Abstract
Family caregivers are the primary care providers for the growing population with Alzheimer’s Disease and Related Dementias (ADRD), yet they often feel unprepared and ill-equipped to carry out their role. While caregivers report high unmet needs, the low uptake of home- and community-based services (HCBS) underscores major gaps between the family care unit and the formal healthcare system. Further, little research has examined how stressors outside of direct care provision influence how caregivers perceive HCBS. Thus, using the stress process model as a theoretical framework, the current study examines the differential influences of secondary stressors on caregivers’ experiences with and attitudes toward HCBS, and its subsequent impact on psychosocial outcomes. ADRD caregivers (n=63) completed an online survey of measures assessing multiple dimensions of care-related stress. Path analyses were used to test caregivers’ perceived experiences with HCBS as mediators influencing the relationship between care-related stress and psychosocial outcomes. Results showed that those with greater family conflict reported more negative experiences with HCBS, which subsequently predicted greater levels of burden. The magnitude of the direct effect was significantly reduced and became non-significant (from β=.26, p&lt;.05 to β=.16, p=.24), providing evidence of full mediation. Additionally, difficulty finding services partially mediated the relationship between cost-of-care and role captivity on burden, self-efficacy, and depression. Findings underscore the need for additional research focused on gaining a more holistic understanding of factors that influence how caregivers interface with the HCBS to promote advancement and continuity across the needs-to-service-use continuum.
DIGITAL HEALTH LITERACY AND SELF-EFFICACY IN USING E-HEALTH RESOURCES AMONG CAREGIVERS OF INDIVIDUALS WITH ADRD
Authors: Oh Kyeung Mi , Lee Jung-Ah 
Published: January 2025

Abstract
This study explored digital health literacy skills, self-efficacy in utilizing e-health resources, and self-efficacy in managing personal health, with a focus on caregivers of individuals with Alzheimer’s disease and related dementias (ADRD). Data from the Health Information National Trends Survey 2022 were analyzed, involving a sample of 96 family and unpaid caregivers of individuals with ADRD. Among these caregivers, 49.9% lacked confidence in utilizing e-health resources. While over 70% utilized certain digital health tools, such as accessing medical information and viewing medical test results, usage of health or wellness apps (57%) and wearable devices (48%) was relatively lower. Engagement in sharing health information (21%) or interacting with individuals with similar health problems (33%) on social media was low, while watching health-related videos on social media (72%) was relatively high. Telehealth (59%) and patient portal usage (87% for own health and 34% for care recipient) were moderate. Controlling for demographic characteristics, each digital health literacy skill was assessed in relation to self-efficacy in utilizing e-health resources. The skill for using health or wellness apps (AOR=111.13, 95%CI: 109.45-112.83) showed the strongest association with self-efficacy, followed by the use of patient portals (AOR=15.77, 95% CI:15.58-15.97) and accessing test results online (AOR=5.64, 95% CI: 5.59-5.69). Significant correlations were found between self-efficacy in using e-health resources and managing personal health among ADRD caregivers (r=.166, P&lt; 0.001). The insights from this study can guide the development of tailored e-health interventions to provide enhanced support for caregivers in their crucial role.
AACN COMPETENCY-BASED ESSENTIAL REVISIT: EVIDENCE-BASED VALIDATION VIA RANDOMIZED CONTROL TRIAL
Authors: Kao Hsueh-Fen , Kiani Shirin 
Published: January 2025

Abstract
In April 2021, American Association of Colleges of Nursing (AACN) approved The Essential for Professional Nursing Education, which calls for preparing future nurses using a competency-based approach in designing curricula for schools of nursing. Taiwan’s nursing education system follows the American Model. This study, conducted in fall 2022 to spring 2023, intended to validate the competency-based approach through entrustable professional activities (EPAs) in the yet widely used nursing education arena. EPAs are practical approaches in assessing competence in real-world settings. A randomized control trial was used in Registered Nurse to Bachelor of Science in Nursing (RN-BSN) students at a college in southern Taiwan. ‘Wound care for older adults with diabetes’ was chosen to be the EPA intervention. After random assignment, students in the experimental group (n=31) received extra EPA simulation laboratory practice with feedback, and those in the control group (n=34) received usual practice and evaluation without simulation laboratory practice and feedback. In the end of semester, data in Competency Inventory of Nursing Students, Learning Satisfaction, Objective Structured Clinical Examinations were collected using analysis of variance (ANOVA) and Student’s t test for analysis. The experimental group demonstrated significantly higher scores in competency and clinical examinations than the control group. However, both groups experienced an increase in learning satisfaction without reaching a significant difference, probably due to receiving more attention. Results of the study indicate that evidence-based pedagogy, e.g., EPAs, can serve as effective strategies in designing competency-based curricula in nursing education to meet the new AACN standards with compelling evidence.
LANGE/PAROLE, STRUCTURE/ACTION: TOWARD A REFRAMING OF AGENCY IN GERONTOLOGY AND LIFE COURSE STUDIES
Authors: Dannefer Dale , Zhou Nan 
Published: January 2025

Abstract
Almost by definition, “Emancipatory Gerontology” carries implications like “choice” and “freedom” which in gerontology have often presupposed what is often termed “agency”. Agency remains a popular concept in gerontology and related fields such as life-course studies when, e.g., exploring such matters as life transitions and decision-making in areas like family formation or retirement. Yet its often-glib and superficial invocation reflects daunting problems identified in recent scholarship, concerning agency’s conceptualization and measurement. For any construct, adequate measurement presupposes a sound conceptual definition. The very definition of agency remains unresolved and problematic, despite numerous recent efforts at theoretical reformulation and refinement. Some issues revolve around nuances in the history of the term and its dimensions, others around issues of measurement. We contend that an even more fundamental set of problems arise because of a continued lack of recognition of the force of culture-specific symbol systems and social structure to frame the categories and nuances of thought within which agentic intentions are externalized in action. For example, no one chooses their native language, yet even freely chosen and passionately pursued “agentic” acts represent an expression of conscious intent formulated within perceptions, aesthetics, etc., structured by that language and its accompanying culture. We suggest that the structure-agency tension corresponds closely to the distinction between language and speech (langue/parole) articulated by de Saussure, and to related insights offered by Bourdieu. We contend that emancipation ultimately requires rigorous attention to constraint, and hence recognition of the structuring of agency by unrecognized and naturalized features of context.
UNDERGRADUATE STUDENTS CONDUCTING GERONTOLOGY RESEARCH: AN AVENUE FOR INTERGENERATIONAL CONNECTION
Authors: Stephan Abigail , Martinez Vanessa , Moss Daniel , Walton Mary , McVey Ava , Cooper Kalvry , Phillips Christine , Ross Lesley 
Published: January 2025

Abstract
With the proportion of older adults and subsequent rates of age-related assets (e.g., wisdom) and challenges (e.g., Alzheimer’s disease/related dementias), projected to rise over the coming decades, it is imperative that professionals across disciplines understand how physical, cognitive, and everyday function in older adulthood impact individuals, families, and communities. As educators, we have a responsibility to train professionals to be competent and aware of older adults’ needs, whether or not students plan to pursue careers directly related to gerontology or geriatrics. Many forms of experiential learning have been employed to accomplish this goal, though students’ direct involvement in gerontology research has not been examined in detail. Our investigation debriefs the experiences of students and faculty involved in a pilot gerontology study where undergraduate students conducted in-person visits with older adult participants. Feedback was collected through anonymous online surveys, guided focus groups, and unstructured team conversations. A salient theme, and the focus of this presentation, was meaningful engagement between students and study participants. Students described gaining personal insights and professional skills from working with participants. Notably, we found that several structures supported positive connections (e.g., in-person interactions, pairing two student testers with a participant, shared goals, balance of structured activities and wait time for conversation). Areas for improvement included additional training for managing participants’ study task pacing. Although these findings reflect lessons learned from one case, they can guide future endeavors of faculty who want to include undergraduate students in their research while promoting intergenerational learning.