UMBC Gerontology Program

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    Marital Quality and Depressive Symptoms among Older Hispanic Adults in the United States
    (Oxford University Press, 2024-03-09) Nazario-Acevedo, Jaminette M.; Yamashita, Takashi; Bulanda, Jennifer Roebuck; Brown, J. Scott
    Objectives Despite the cultural importance of marriage as a social support system and its well-established link to mental health, older Hispanic adult populations, which are the largest racial and ethnic minoritized groups, remain understudied. The current study examined how positive and negative dimensions of marital quality are associated with depressive symptoms. Methods Data from Hispanic adults aged 51 years and older (n = 1,012) were obtained from the 2016 and 2018 Health and Retirement Study (HRS) waves. The CES-D scale (0-8 symptoms) was modeled as a function of positive and negative marital quality measures (1-4), as well as the relevant covariates. Results Results from a negative binomial regression model showed that a one-unit change in positive and negative marital quality was associated with a 23.61% reduction and a 23.74% increase, respectively, in depressive symptoms. The interaction terms with marital quality and gender, as well as marital quality and religion, were not statistically significant. Discussion In the U.S., a large percentage of older Hispanic adults are immigrants, and their extended family tends to reside in their countries of origin. As such, older Hispanic adults may have smaller social networks, and marital quality most likely represents a culturally important social support network in later life. Significant associations between depressive symptoms and marital quality among older Hispanic adults should receive more attention in family and public health policy discussions, particularly given the increasing diversity in U.S. society.
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    The Roles of Education and Literacy in the Digital Divide Among Middle-Aged Adults: Cross-National Evidence from the United States, Japan, and South Korea
    (ProLiteracy, 2024) Yamashita, Takashi; Kim, Giyeon; Liou, Chih-Ling; Ando, Takatoshi; Bardo, Anthony R.; Liu, Darren
    Internationally representative data of middle-aged adults 45 – 65 years old [n(United States) = 2,150; n(Japan) = 2,318; n(South Korea) = 2,800] from the 2012 Program for International Assessment of Adult Competencies were analyzed to examine the roles of education and literacy in relation to the digital divide. Results from survey-weighted binary logistic regressions showed that both educational attainment and literacy were positively associated with all four measures of information and communication technology (use of the computer, email, online information and transaction) use in all three countries. The middle-aged adults in the United States benefited more from the educational attainment than those in Japan, in terms of email and online information use. The middle-aged adults with lower education and basic skills (i.e., literacy) may benefit from the educational intervention and additional information and communication technology training, and in turn, improve the digital divide in later life, regardless of differences in culture and economy.
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    Examining Racial/Ethnic Disparities in Coping and Stress Within an Environmental Riskscape
    (Springer, 2023-02-17) Mair, Christine A.; Peek, M. Kristen; Slatcher, Richard B.; Cutchin, Malcolm P.
    Existing research on racial/ethnic differences in stress and coping is limited by small samples, single-item measures, and lack of inclusion of Mexican Americans. We address these gaps by analyzing data from the Texas City Stress and Health Study, a cross-sectional sample of Black (N = 257), White (N = 304), US-born (N = 689), and foreign-born (N = 749) Mexican Americans residing in proximity to a petrochemical complex. We compared active and avoidant coping by race/ethnicity and explored multivariable associations between coping and perceived stress. Black and foreign-born Mexican American respondents had the highest stressor exposure yet displayed different patterns of coping and perceived stress patterns. Active coping may be particularly effective for African Americans but may not offset extreme stress disparities. For Mexican Americans, the lack of association between coping and stress underscores the need for more work focused on the culturally diverse coping experiences.
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    End-of-Life Experiences Among “Kinless” Older Adults: A Nationwide Register-Based Study
    (Mary Ann Liebert, 2023-08-07) Mair, Christine A.; Thygesen, Lau C.; Aldridge, Melissa; Tay, Djin L.; Ornstein, Katherine A.
    Background: The population of older adults who are unpartnered and childless (i.e., “kinless”) is increasing across the globe, and may be at risk for lower quality end-of-life (EoL) experiences due to lack of family support, assistance, and advocacy. Yet, little research exists on the EoL experiences of “kinless” older adults. Objectives: To document associations between family structure (i.e., presence or absence of partner or child) and intensity of EoL experiences (i.e., visits to medicalized settings before death). Design: The study design is a cross-sectional population-based register study of the population of Denmark. Subjects: Participants include all adults age 60 years and older who died of natural causes in Denmark from 2009 to 2016 (n = 137,599 decedents). Results: “Kinless” older adults (reference = has partner, has child) were the least likely group to visit the hospital (two or more times; odds ratio [OR] = 0.74, confidence interval [CI] = 0.70–0.77), emergency department (one or more times; OR = 0.90, CI = 0.86–0.93), and intensive care unit (one or more times; OR = 0.71, CI = 0.67–0.75) before death. Conclusions: “Kinless” older adults in Denmark were less likely to experience medically intensive care at the EoL. Further research is needed to understand factors associated with this pattern to ensure that all individuals receive high quality EoL care regardless of their family structure and family tie availability.
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    The Subjective Construction of Disease Control among Older Adults with Type II Diabetes
    (2015-01-01) Girling, Laura; Eckert, J. Kevin; Gerontology; Gerontology
    While the development and progression of some chronic conditions is predominately beyond the control of the individual, diabetes, one of the most prevalent chronic conditions, is largely considered a controllable disease. Although diabetic control is well-defined within the medical community and associated literature, little is known about how the diabetic population themselves understand this concept. In order to address this gap in the literature, in-depth secondary qualitative analyses were conducted of interviews with 83 (European-American, n=42; African-American n=41) older adults (³50 years) diagnosed with diabetes. Inductive content analysis of 4,237 pages of interview data revealed an explanatory framework of five themes describing varied understandings of diabetes control: (a) glycemic control, (b) treatment adherence, (c) asymptomatic, (d) level of pharmaceutical need, and (e) illusory. Analyses also revealed several management approaches coinciding to oneÕs conceptualization of control: (a) reactive, (b) informed, (c) medicinal reduction, (d) fatalistic. Furthermore, race and gender differences emerged from the data. Results demonstrate that among those with diabetes, the term control is multifaceted and its meanings extend the standard clinical definition of this concept. Findings inform clinical practice, psychometric assessment, and refine research in this area.
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    ”Kinlessness” and Aging w/ Dr. Christine Mair
    (UMBC Center for Social Science Research, 2023-10-30) Anson, Ian; Mair, Christine A. ; Yamashita, Takashi
    On this episode I speak with Dr. Christine Armstrong Mair, Associate Professor of Sociology and Gerontology and Director of the Center for Health, Equity, and Aging (CHEA) in the Department of Sociology, Anthropology, and Public Health (SAPH) at UMBC. We discuss Dr. Mair’s ongoing research into aging and older adult lifestyles across the world. Dr. Mair mentioned the following resources in our discussion: Gateway to Global Aging Data SMaRT Scholars Program National Academies of Science, Engineering, and Medicine (NASEM), Seminar on Kinlessness and Living Alone at Older Ages (Drs. Margolis, Carr, Taylor, and Mair)
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    Associations between education, information-processing skills, and job automation risk in the United States
    (Sage, 2023-11-07) Narine, Donnette; Yamashita, Takashi; Chidebe, Runcie C. W.; Cummins, Phyllis A.; Kramer, Jenna W.; Karam, Rita
    Job automation is a topical issue in a technology-driven labor market. However, greater amounts of human capital (e.g., often measured by education, and information-processing skills, including adult literacy) are linked with job security. A knowledgeable and skilled labor force better resists unemployment and/or rebounds from job disruption brought on by job automation. Therefore, the purpose of this study was to advance understanding of the association between educational attainment and literacy, and job automation risk. Using the 2012/2014/2017 Program for the International Assessment of Adult Competencies (PIAAC) data, survey-weighted linear regression was used to model the risk of job automation as a function of education, and literacy proficiency. Higher educational attainment (college or higher vs. less than high school: b = −18.23, p < .05) and greater literacy proficiency (score 0–500 points: b = −.038, p < .05) were associated with a decrease in job automation risk among the U.S. workforce.
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    Reliance on Social Networks and Health Professionals for Health Information in the U.S. Adult Population
    (Springer, 2023-10-21) Narine, Donnette; Yamashita, Takashi; Punksungka, Wonmai; Helsinger, Abigail; Kramer, Jenna W.; Karam, Rita; Cummins, Phyllis A.
    Background: The subpopulation of adults depends on non-online health information sources including their social networks and health professionals, to the exclusion of online sources. In view of the digital divide and health information disparities, the roles of race/ethnicity and digital skills are yet to be explored. Methods: A nationally representative sample of 6,830 adults from the Program for the International Assessment of Adult Competencies (PIAAC) was analyzed, using binary logistic regression. Results: Black adults and adults with higher digital skills were less likely to be reliant on non-online health information sources, compared to White adults and those with lower digital skills, respectively. Discussion: Differences in non-online health information source reliance by race/ethnicity and digital skills might be further nuanced by the relevant demographic and socioeconomic characteristics. Increasing digital skills may expand one’s health information sources to include reliable online sources and empower adults to promote their health.
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    Examining Literacy Skill Performance of Black Adults in the U.S.: A Case of Civic Engagement and Political Efficacy
    (American Institutes for Research, 2023-10) Alston, Geleana Drew; Yamashita, Takashi; Goings, Ramon; Saal, Leah Katherine
    The Issue: Black adults’ beliefs about civic and political engagement are possible avenues toward social equality. The Black population is far from a monolith (Saal et al., 2023). Little is known about how Black adults’ literacy skill level impacts their civic engagement and political efficacy. Within the Black adult population, a better understanding of gender differences is critical to inform civic and democratic educational initiatives. The Research Question: 1. Are the levels of information processing skills (i.e., adult literacy proficiency) associated with civic engagement and political efficacy among Black adults in the U.S.? 2. Are there any gender differences in the associations between civic engagement, political efficacy, and information processing skills (i.e., adult literacy proficiency) among Black adults in the U.S.? The Findings: Black adults have comparable civic engagement and political efficacy to the general adult population. Black adults with college degrees (s) tend to volunteer more often than those without. Black adults with higher levels of literacy proficiency, college education, and older age tend to have higher political efficacy than those without. Black women and Black men had similar literacy proficiency. Black women with higher educational attainment had greater civic engagement. Black men who live with their spouses had greater civic engagement. Black women with high literacy proficiency had greater political efficacy than their counterparts with low literacy proficiency. Black men with higher educational attainment had greater political efficacy. The Implications: Promoting the political efficacy of Black adults with low literacy skills should be on a policy agenda. Civic and political education should be provided throughout adult life stages, and be considerate of sociocultural (e.g., race, gender) differences.
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    The STEM Wage Premium Across the OECD
    (Sage, 2023-05-11) Even, William E.; Yamashita, Takashi; Cummins, Phyllis A.
    Using data from the Program for the International Assessment of Adult Competencies, this paper compares the earnings premium and employment share of jobs in Science, Technology, Engineering and Mathematics (STEM) across 11 member countries of the Organisation for Economic Co-operation and Development. The results reveal that the STEM wage premium is higher in the United States than in any of the other comparison countries, despite the fact that the U.S. has a larger share of workers in STEM jobs. We also find evidence that the premium varies significantly across STEM sub-fields and education levels, and that the premium tends to be higher in countries with lower unionization rates, less employment protection, or a larger share of employment in the public sector.
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    Assessing Unmet Dementia-Related Care Needs of Informal Care Partners for Persons with Dementia by Spousal Status
    (2023) Tucker, Gretchen G.; Gruber-Baldini, Ann; Samus, Quincy; Girling, Laura; Eckert, J. Kevin; Wallace, Brandy; Orwig, Denise
    Background: 80% of persons with dementia reside in the community and are cared for by family and friends considered informal care partners (ICPs) • Research on ICPs for people with dementia has focused on spousal care partners and mother-daughter dyads. • There is a paucity of information on non-spousal ICPs, particularly male non spousal ICPs. Objective: Evaluate differences in the type and frequency of unmet dementia related care needs between spousal and non-spousal ICPs by gender and race.
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    Adult Numeracy Skill Practice by STEM and Non-STEM Workers in the USA: An Exploration of Data using Latent Class Analysis
    (Taylor & Francis, 2022-11-14) Yamashita, Takashi; Punksungka, Wonmai; Narine, Donnette; Helsinger, Abigail; Kramer, Jenna W.; Cummins, Phyllis A.; Karam, Rita
    Adult numeracy is one of the essential skill sets to navigate through numeric information-rich labour markets in general, and STEM industries in particular. Yet, relatively little is known about how numeracy skills are used in different settings in the USA. This study examined numeracy skill use patterns of STEM and non-STEM workers at work and home. Data were obtained from the 2012/2014/2017 Program for International Assessment of Adult Competencies, USA restricted-use file. Adults who were employed and aged between 25 and 65 years old (n = 5,220) were included in this study. Latent class analysis revealed four numeracy skill use patterns: non-users, non-occupational (i.e. at home) simple numeracy users, ubiquitous numeracy users, and occupational numeracy users. Additional multinomial logistic regression analysis showed that the STEM occupation was associated with a greater likelihood of being ubiquitous users than being non-occupational simple users. Results also showed that numeracy proficiency, socioeconomic statuses (i.e. educational attainment and income), as well as demographic characteristics (i.e. gender and race/ethnicity), were predictive of the numeracy skill use patterns in terms of the level of engagement and settings. Findings from this study inform policies and interventions which promote skill engagement and improvement among workers in the USA.
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    UMBC/UMB Gerontology w/ Dr. John Schumacher, Dr. Rob Millar, Dr. Sarah Holmes, Min-Hyung Park, Jenn Haddock, & Rachel McPherson
    (UMBC Center for Social Science Research, 2022-05-16) Anson, Ian; Schumacher, John; Millar, Rob; Holmes, Sarah; Park, Min-Hyung; Haddock, Jenn; McPherson, Rachel
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    Volunteering, educational attainment, and literacy skills among middle-aged and older adults by racial and ethnic groups in the U.S
    (Taylor & Francis, 2022-10-13) Narine, Donnette; Yamashita, Takashi; Punksungka, Wonmai; Helsinger, Abigail; Kramer, Jenna W.; Karam, Rita; Cummins, Phyllis A.
    Volunteer participation benefits societies and individuals. The objective of this study was to examine the roles of education and adult literacy in formal volunteering among a nationally representative sample of the U.S. middle-aged and older adults (45–74 years) by race and ethnicity (Whites, Blacks, Hispanics). Using cross-sectional data (n = 3,770) from the 2012/2014/2017 Program for the International Assessment of Adult Competencies (PIAAC), structural equation models were used to determine mediation relationships among educational attainment, literacy, and volunteering. The effect of educational attainment on formal volunteering was significantly greater among middle-aged and older Black adults compared to their Hispanic counterparts, as well as among middle-aged and older White adults compared to their Hispanic counterparts. However, literacy was the education-volunteering mediator among White adults only. Suggested policy implications include support for volunteer participation through culturally and socioeconomically sensitive approaches along with human capital development in adult life stages.
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    Neighborhood Social Environment and Lower Extremity Function in Older Adults
    (2020-01-01) Millar, Roberto J; Lehning, Amanda; Gerontology; Gerontology
    Background: Research examining the linkages between neighborhood social environments and physical function in older adults is scarce. In order to reduce functional health disparities in older adulthood, it is critical to understand the pathways by which neighborhood environments influence physical function, and whether there are differences in these pathways by race/ethnicity and economic status. Objective: The objectives of this research were to (1) examine the associations between the neighborhood social environment (i.e., social cohesion, disorder) and lower extremity function; (2) determine whether physical activity and depression symptoms were potential pathways linking the social environment to physical function; and (3) assess whether race/ethnicity and economic vulnerability moderated these potential pathways. Methods: Data came from wave seven (2017) of the National Health and Aging Trends Study (NHATS). The sample was composed of 3,934 community-dwelling Medicare beneficiaries (Non-Hispanic White (n =2,906), African American (n =781), and Hispanic (n =247)). The analysis for objective one was conducted using ordinary least squares (OLS) regression. Analyses for objectives two and three were conducted using the PROCESS macro, an OLS path analysis modeling tool for estimating mediation and moderated mediation. Results: There was a positive direct association between neighborhood social cohesion and function, while disorder was not directly associated with function. Social cohesion was also indirectly related to function through physical activity and depression symptoms; greater social cohesion was associated with higher levels of physical activity and with less depression symptoms, and both were linked to better function. Neighborhood disorder was only associated with function indirectly through physical activity; high disorder was associated with lower levels of physical activity. There was no evidence of significant differences in pathways by race/ethnicity. The indirect pathways between disorder and function differed by economic vulnerability; among older adults with high economic vulnerability, disorder was associated with poorer function via depressive symptoms, while for those with low economic vulnerability, disorder was associated with poorer function via physical activity. Conclusion: Findings highlight the associations between the neighborhood social environment and lower extremity function and bring attention to differences in the potential pathways linking the two. Policies and programs could strive towards optimizing neighborhood social environments in order to promote functional health in older adulthood.
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    Voice User Interfaces supporting older adults with differing physical and cognitive abilities complete daily activities
    (2019-01-01) Larsen, Alison; Madjaroff, Galina; Gerontology; Gerontology
    The number of older adults is expected to increase from 43.1 million in 2012 to 87.3 million people in 2050 and with that, the instances of aging related disorders such as Mild Neurocognitive Disorders (mNCD) and low vision will increase too (Ortman, Velkoff, & Hogan, 2014; WHO, 2019; Beaver & Mann, 1995). There will be a need for innovative technologies to support this rapid increase of older adults. This research looks at how VUI technology, the Amazon Echo, can support older adults with differing abilities in completing daily activities and what level of need can be satisfied. The VUI was installed for twenty-five weeks. After the study, the participants' interactions with the VUI were collected and a post study interview was conducted. Although the daily activities the VUI supported seemed trivial, they were more complex and contributed to a higher level of needs satisfaction from the BASICS model of care.
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    Quality and quality improvement in end-of-life care: Perceptions of hospice providers
    (2020-01-20) Johnson, Karen; Morgan, Leslie; Gerontology; Gerontology
    Hospice is both a philosophy of care and a system for delivering care to patients near the end of life. The goals of hospice are to provide comfort care around the process of dying and to support the dying individual and his/her family members. Hospice care focuses not only on physical aspects of care, but also on social, emotional, spiritual, cultural, and ethical aspects. In recent years, there has been increasing interest among clinicians, researchers, and others to improve the quality of care provided through hospice. Yet relatively little research has focused on the perceptions of quality improvement (QI) among hospice staff, even though such perceptions may influence both their engagement in, and the ultimate success of, agencies' QI efforts. The goal of this study was to examine how hospice staff perceive efforts to improve quality of care in the hospice setting. This qualitative study employed an ethnographic and phenomenological approach to elicit narratives and meanings of end-of-life (EOL) care quality and its improvement from 19 directors, nurses, chaplains, and social workers from five hospice agencies in Maryland. Study participants articulated five interrelated meanings of QI: formal processes, learning on the part of hospice providers, changes in documentation to support compliance, "doing better," and activities that positively impact patients and families. They agreed that the quality of EOL care can be improved, and, for the most part, their views of QI were positive. Yet they also expressed skepticism about QI efforts. Front-line hospice workers had fairly broad, generalized knowledge regarding the QI efforts of their agencies, but limited familiarity with how those efforts were chosen. Participants reported engaging in improvement activities, although not all of those activities were part of their agencies' formal QI efforts. Furthermore, they identified education as a key mechanism to help them more effectively improve the quality of care they provide. Finally, this study found that participants' perceptions of quality EOL care and QI were linked to their occupational roles, but not to the characteristics of their agencies. Implications of these findings for hospice policy and practice are discussed, as are ideas for future research.
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    Emergency Medical Services Providers' Perceptions of Nursing Homes, Assisted Living Facilities, and Older Adult Patients
    (2018-01-01) King, Laura Kimberley; Schumacher, John; Gerontology; Gerontology
    While inequalities in prehospital care may be attributed to ageism, studies that examine the perceptions of age and aging among prehospital Emergency Medical Services (EMS) providers are lacking. This qualitative study addressed this gap in the literature by utilizing grounded theory methodology and ethnographic interviewing techniques to more deeply understand EMS providers' perceptions of age and aging. Over 22 hours of audio were collected from 17 EMS providers, each with a minimum of 5 years EMS experience. Results of thematic analysis revealed a significant, overarching theme: EMS providers' strong dislike of nursing homes and assisted living facilities (ALFs). Two other themes emerged that related to the first theme, with EMS providers reporting the belief that responses to nursing home/ALFs are typically non-emergent, or not requiring an urgent response, and feelings of futility regarding the care of nursing home/ALF patients. In contrast to these perspectives on nursing home/ALF organizations, analysis revealed that participants tended to view older adult patients as generally more time-consuming in comparison to younger adult patients, interesting storytellers, and grateful patients. Given that older adults utilize EMS more than any other age group, understanding how providers perceive age and aging is crucial. Implications of these findings and their potential effects on patient care as well as suggestions for future research are discussed.
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    EXPERIENCE OF STROKE RECOVERY FOR WOMEN 60 OR OLDER
    (2019-01-01) Johnson, Iona; Morgan, Leslie; Gerontology; Gerontology
    Stroke is a common health concern in the U.S. with 795,000 new strokes each year. Women dominate these numbers, with 55,000 more strokes per year than men, yet they are disproportionately underrepresented in stroke research. Some research indicates that women have worse physiological and psychosocial outcomes after stroke than men, yet little is known about how they experience recovery. This research fills a gap in focusing on how women experience recovery after stroke. Through use of a qualitative phenomenological approach, this study provides insight regarding their lived experiences. The research asks, "What is the experience of stroke recovery for community dwelling women age 60 or older?” The following aims were developed: 1) To describe women’s experiences of recovery after stroke, 2) To determine how women experience self during the stroke recovery process, and 3) To establish how women define normal life before and after stroke. The participants were 10 women, ages 60 – 78, with times post-stroke ranging from 4 months to 15 years. They participated in 2 semi-structured interviews, with auto-photography used to enhance their sharing of information. Between the two interviews, they were provided with a digital camera and asked to take pictures that helped to explain their lives before and after stroke. During the 2nd interview, participants shared and described their pictures, and answered additional questions about their recovery. Interviews were transcribed verbatim and the narrative transcripts were the primary data source for analysis. The narratives were coded and analyzed thematically to describe how this sample of individuals experienced stroke recovery. Four overarching themes emerged from the data: 1) the stroke event, 2) a new chapter, 3) meaning and process of recovery, and 4) self-identity. Various subthemes emerged under each theme and are discussed in detail in the dissertations. In general, narratives revealed that recovery is described as a complex, individualized, and subjective experience that extends beyond overt physical abilities. Participants in this study experienced changes in self-identity and described a "new normal” after stroke. Implications and recommendations for rehabilitation, research, and policy are discussed.
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    Oldest-old Adults Face Higher Risk of COVID-19 Mortality
    (2020-04-30) Sahoo, Shalini; Roberto, Millar; Takashi, Yamashita