scholarly journals Federal Interventions Targeting Social Isolation and Loneliness: An Exploratory Review

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 502-502
Author(s):  
Lauren Palmer ◽  
Jennifer Howard ◽  
Helena Voltmer ◽  
Abigail Ferrell ◽  
Natalie Mulmule ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Grey Literature ◽  
The United States ◽  
Rapid Review ◽  
State Agencies ◽  
Significant Heterogeneity ◽  
Care Providers ◽  
The Us ◽  
The Impact

Abstract Even prior to the COVID-19 Public Health and Medical Emergency, the experiences of chronic social isolation and loneliness (SIL) were growing among older adults. Countries began increasing national visibility for these issues and implementing programs and services focused on addressing them. In the United States (US), however, little is known about successful national interventions or their effectiveness in tackling SIL among older Americans. We conducted a rapid review of the peer-reviewed and grey literature from 2009-2019, focusing on existing federal programs, health systems, and health care models in the US that address SIL among older adults. Of the 110 articles identified, 36 met the inclusion criteria and were synthesized. Our review found few federal interventions that directly address SIL; several may be addressing SIL as an auxiliary outcome to addressing social determinants of health, such as group exercise, transportation support, or food insecurity. While these interventions may provide a promising opportunity, implementation and evaluation challenges were identified. Thus, federal and state agencies face significant obstacles to understanding the impact of existing interventions and their effectiveness in addressing SIL, hampering progress toward large scale implementation. As SIL receives increasing attention, we add another voice to existing literature that indicates significant heterogeneity among existing programs; we found that few evidence-based, scalable federal initiatives exist in the US that target SIL. Without resources from federal and state agencies, the ability of health entities, community-based organizations, and direct care providers to implement effective interventions is significantly diminished.

scholarly journals Major Disasters’ Impacts on Long-Term Care Settings, Vulnerable Older Adults, and Care Providers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 201-201
Author(s):  
Leah Haverhals ◽  
Katie Cherry
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Long Term Care ◽  
The United States ◽  
Care Providers ◽  
Term Care ◽  
The Us ◽  
The Impact ◽  
Hurricane Irma

Abstract The COVID-19 pandemic has disproportionately negatively affected older adults, and has specifically devasted older adults who are minorities and those who reside in long-term care (LTC) facilities. For professionals working in LTC facilities, major stressors and challenges due to the pandemic must be navigated, sometimes in parallel with the effect that major disasters like hurricanes can have on LTC facilities. This symposium will focus on the impact major disasters, including the COVID-19 pandemic and Hurricane Irma, had on LTC settings and those who live and work there, as well as older adults who are minorities and their communities. First, Dr. Roma Hanks will present findings from a study of community members and leaders in a majority African-American community in the United States (US) about their experiences with and challenges faced related to the pandemic. Second, Dr. Lisa Brown will share experiences and perceptions of mental health clinicians from across the US who worked in LTC settings before and during the pandemic. Third, Dr. Ella Cohn-Schwartz will describe how the pandemic impacted Holocaust survivors ages 75+ in Israel compared to older adults who did not experience the Holocaust. Fourth, Dr. Lindsay Peterson will present findings from interviews with nursing home and assisted living community representatives in the US regarding vulnerabilities LTC facilities experienced related to Hurricane Irma in 2017. As a whole, these presenters will provide insights into experiences of older adults, care providers, LTC facilities, and communities as they navigated challenges associated with the COVID-19 pandemic and a major hurricane.

scholarly journals 897 Infusion episode-related benefits of pembrolizumab Q6W dosing schedule for patients with melanoma treated in the adjuvant and metastatic settings in the United States (US)

2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A941-A941
Author(s):  
Raquel Aguiar-Ibanez ◽  
Emilie Scherrer ◽  
Dmitri Grebennik ◽  
Anvi Khandelwal ◽  
John Cook ◽  
...  
Keyword(s):  
Health Care Providers ◽  
The United States ◽  
System Capacity ◽  
Sensitivity Analyses ◽  
Care Providers ◽  
Duration Of Treatment ◽  
Dosing Schedule ◽  
Patient Capacity ◽  
The Us ◽  
The Impact

BackgroundA new dosing schedule for pembrolizumab (400 mg every six weeks (Q6W)) received accelerated FDA approval in 2020 across all approved adult indications. The Q6W dosing schedule provides an opportunity to reduce the number of infusions required over the treatment course, thereby decreasing time and costs for health care providers, patients and their caregivers. This study quantified the potential infusion episode-related benefits of pembrolizumab Q6W regimen for the treatment of patients with melanoma in the adjuvant and metastatic settings in the US.MethodsAn Excel-based tool was developed to quantify the infusion episode-related time and cost of using pembrolizumab Q6W compared to available nivolumab dosing regimens (Q4W/Q2W) to treat patients with melanoma in the adjuvant and metastatic settings from the patient, caregiver, provider, and payer perspectives. The number of infusion visits, time and costs were estimated considering a hypothetical infusion center. Time-related inputs were based on a survey of patients, physicians and nurses; cost-related inputs were obtained from published sources. Sensitivity analyses were performed to assess the robustness of results. Additional analyses assessed the impact of using alternative regimens with different frequencies of administration.ResultsBased on the tool, pembrolizumab Q6W reduced the number of infusion visits (31%), time at the infusion center (41%) and chair time (31%) in total, over one year, versus nivolumab Q4W. Because fewer visits are needed, travel time is estimated to decrease by 31%. The infusion-related direct and indirect costs borne by patients and caregivers are projected to decrease by $1,095 and $2,272, respectively over a treatment course. For a typical US infusion center treating 169 melanoma patients per week over a 1-year period, using pembrolizumab Q6W rather than nivolumab Q4W is estimated to reduce the number of infusions by 2,729 (31% reduction) for a total of 3,802 fewer hours of infusion chair time, allowing the infusion center to increase patient capacity by up to 45% using currently available resources. Time and cost savings are more prominent when comparing with nivolumab Q2W: 5,757 fewer infusion events (66% reduction) and 8,062 less hours of chair time, which would increase the patient capacity by 2.9 times.ConclusionsUtilizing pembrolizumab Q6W to treat patients with melanoma in the US is expected to substantially reduce the number of infusion visits and associated chair time required over the duration of treatment, reducing the time and monetary burden for patients and their caregivers. Additionally, it may also improve system capacity.

Psychometric Evaluation of the Social Isolation Scale in Older Adults

2019 ◽  
Vol 60 (7) ◽  
pp. e491-e501 ◽  
Author(s):  
Nicholas R Nicholson ◽  
Richard Feinn ◽  
E A Casey ◽  
Jane Dixon
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Factor Analysis ◽  
Social Isolation ◽  
Exploratory Factor Analysis ◽  
Internal Consistency ◽  
The United States ◽  
Care Providers ◽  
Effective Measure ◽  
The Social

Abstract Background and Objectives Social isolation is known to be detrimental to the health of older adults, yet there is no brief instrument to measure it. The objective was to describe the psychometric testing of a brief instrument constructed from theoretical underpinnings to measure social isolation in older adults. Research Design and Methods A sample of 9,245 participants, all aged 60 years and older, was obtained from 44 states in the United States. Summary descriptive statistics were calculated, followed by exploratory factor analysis using Geomin rotation and subsequently confirmatory factor analysis (CFA). After finding the best model, differential item functioning (DIF) was conducted using a multiple indicator multiple cause structural equation model to determine if item responses differed by gender or race after controlling for level of social isolation. Internal consistency was calculated and validity was assessed by correlating factor scores with 2 external measures. Results Exploratory factor analysis resulted in all items having statistically significant loadings. CFA showed the 2-factor model demonstrated excellent fit (CFI = 0.997, RMSEA = .038). The 2 factors were labeled connectedness and belongingness. After adjusting for demographic variables, no evidence suggested DIF. Internal consistency was good (alpha = .77) and the scale moderately correlated with the Social Network Index (r = .47). Discussion and Implications The Social Isolation Scale has been shown to be an effective measure of social isolation in older adults. Using this concise instrument to quickly measure social isolation in a fast-paced health care environment would be beneficial to health care providers and patients.

Addressing Social Isolation To Improve the Health of Older Adults: A Rapid Review

2019 ◽  
Author(s):  
Stephanie Veazie ◽  
Jennifer Gilbert ◽  
Kara Winchell ◽  
Robin Paynter ◽  
Jeanne-Marie Guise
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Rapid Review

The Impact of Monetary and Fiscal Policies on the Stock Market in the United States (U.S); Evidence from Linear ARDL Framework

2020 ◽  
Vol 11 (1) ◽  
pp. 132-132
Author(s):  
Aref Emamian
Keyword(s):  
United States ◽  
Stock Market ◽  
The United States ◽  
Real Effective Exchange Rate ◽  
Annual Data ◽  
Fiscal Policies ◽  
Long Run ◽  
The Us ◽  
Short Run ◽  
The Impact

This study examines the impact of monetary and fiscal policies on the stock market in the United States (US), were used. By employing the method of Autoregressive Distributed Lags (ARDL) developed by Pesaran et al. (2001). Annual data from the Federal Reserve, World Bank, and International Monetary Fund, from 1986 to 2017 pertaining to the American economy, the results show that both policies play a significant role in the stock market. We find a significant positive effect of real Gross Domestic Product and the interest rate on the US stock market in the long run and significant negative relationship effect of Consumer Price Index (CPI) and broad money on the US stock market both in the short run and long run. On the other hand, this study only could support the significant positive impact of tax revenue and significant negative impact of real effective exchange rate on the US stock market in the short run while in the long run are insignificant. Keywords: ARDL, monetary policy, fiscal policy, stock market, United States

Effects of Cardiovascular Disease and Related Risk Factors on Neurocognition

2019 ◽  
pp. 83-116
Author(s):  
Spencer W. Liebel ◽  
Lawrence H. Sweet
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Cognitive Processing ◽  
Health Care Providers ◽  
The United States ◽  
Research Literature ◽  
Neurocognitive Functioning ◽  
Care Providers ◽  
Cardiac Events ◽  
Related Risk

Cardiovascular disease (CVD) affects approximately 44 million American adults older than age 60 years and remains the leading cause of death in the United States, with approximately 610,000 each year. With improved survival from acute cardiac events, older adults are often faced with the prospect of living with CVD, which causes significant psychological, social, and economic hardship. The various disease processes that constitute CVD also exert a deleterious effect on neurocognitive functioning. Although existing knowledge of neurocognitive functioning in CVD and its subtypes is substantial, a review of these findings by CVD type and neurocognitive domain does not exist, despite the potential impact of this information for patients, health care providers, and clinical researchers. This chapter provides a resource for clinicians and researchers on the epidemiology, mechanisms, and neurocognitive effects of CVDs. This chapter includes a discussion of neurocognitive consequences of CVD subtypes by neuropsychological domain and recommendations for assessment. Overall, the CVD subtypes that have the most findings available on specific neurocognitive domains are heart failure, hypertension, and atrial fibrillation. Despite a large discrepancy between the number of available studies across CVD subtypes, existing literature on neurocognitive effects by domain is consistent with the literature on the neurocognitive sequelae of unspecified CVD. Specifically, the research literature suggests that cognitive processing speed, attention, executive functioning, and memory are the domains most frequently affected. Given the prevalence of CVDs, neuropsychological assessment of older adults should include instruments that allow consideration of these potential neurocognitive consequences of CVD.

scholarly journals Spring Freeze Damage of Pecan Bloom: A Review

Horticulturae ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. 82
Author(s):  
Amandeep Kaur ◽  
Louise Ferguson ◽  
Niels Maness ◽  
Becky Carroll ◽  
William Reid ◽  
...  
Keyword(s):  
Tree Height ◽  
The United States ◽  
Reproductive Organs ◽  
Tree Age ◽  
The Us ◽  
Nut Production ◽  
Freeze Damage ◽  
Terminal Buds ◽  
And Function ◽  
The Impact

Pecan is native to the United States. The US is the world’s largest pecan producer with an average yearly production of 250 to 300 million pounds; 80 percent of the world’s supply. Georgia, New Mexico, Texas, Arizona, Oklahoma, California, Louisiana, and Florida are the major US pecan producing states. Pecan trees frequently suffer from spring freeze at bud break and bloom as the buds are quite sensitive to freeze damage. This leads to poor flower and nut production. This review focuses on the impact of spring freeze during bud differentiation and flower development. Spring freeze kills the primary terminal buds, the pecan tree has a second chance for growth and flowering through secondary buds. Unfortunately, secondary buds have less bloom potential than primary buds and nut yield is reduced. Spring freeze damage depends on severity of the freeze, bud growth stage, cultivar type and tree age, tree height and tree vigor. This review discusses the impact of temperature on structure and function of male and female reproductive organs. It also summarizes carbohydrate relations as another factor that may play an important role in spring growth and transition of primary and secondary buds to flowers.

scholarly journals The impact of COVID-19 on the well-being and cognition of older adults living in the United States and Latin America

2021 ◽  
Vol 35 ◽  
pp. 100848
Author(s):  
Ganesh M. Babulal ◽  
Valeria L. Torres ◽  
Daisy Acosta ◽  
Cinthya Agüero ◽  
Sara Aguilar-Navarro ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Latin America ◽  
Well Being ◽  
The United States ◽  
The Impact

scholarly journals Measuring frailty in younger populations: a rapid review of evidence

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047051
Author(s):  
Gemma F Spiers ◽  
Tafadzwa Patience Kunonga ◽  
Alex Hall ◽  
Fiona Beyer ◽  
Elisabeth Boulton ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Predictive Validity ◽  
Data Extraction ◽  
Grey Literature ◽  
Frailty Index ◽  
Study Data ◽  
Rapid Review ◽  
Eligibility Criteria ◽  
Adult Age ◽  
The Impact

ObjectivesFrailty is typically assessed in older populations. Identifying frailty in adults aged under 60 years may also have value, if it supports the delivery of timely care. We sought to identify how frailty is measured in younger populations, including evidence of the impact on patient outcomes and care.DesignA rapid review of primary studies was conducted.Data sourcesFour databases, three sources of grey literature and reference lists of systematic reviews were searched in March 2020.Eligibility criteriaEligible studies measured frailty in populations aged under 60 years using experimental or observational designs, published after 2000 in English.Data extraction and synthesisRecords were screened against review criteria. Study data were extracted with 20% of records checked for accuracy by a second researcher. Data were synthesised using a narrative approach.ResultsWe identified 268 studies that measured frailty in samples that included people aged under 60 years. Of these, 85 studies reported evidence about measure validity. No measures were identified that were designed and validated to identify frailty exclusively in younger groups. However, in populations that included people aged over and under 60 years, cumulative deficit frailty indices, phenotype measures, the FRAIL Scale, the Liver Frailty Index and the Short Physical Performance Battery all demonstrated predictive validity for mortality and/or hospital admission. Evidence of criterion validity was rare. The extent to which measures possess validity across the younger adult age (18–59 years) spectrum was unclear. There was no evidence about the impact of measuring frailty in younger populations on patient outcomes and care.ConclusionsLimited evidence suggests that frailty measures have predictive validity in younger populations. Further research is needed to clarify the validity of measures across the adult age spectrum, and explore the utility of measuring frailty in younger groups.

A Rapid Review of the Detrimental Impact of Loneliness and Social Isolation in Caregivers of Older Adults

2021 ◽  
Vol 29 (4) ◽  
pp. S122-S123
Author(s):  
Sophia G. Perez ◽  
Alexandria G. Nuccio ◽  
Ashley M. Stripling
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Rapid Review ◽  
Detrimental Impact
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