This study examines the antecedent role of organizational culture and the mediating role of digital transformation when promoting big data analytics capabilities. Employing the Competing Values Framework, we scrutinize the influence of various cultural typologies, including digital culture on the successful deployment of digital transformation and the enhancement of big data analytics capabilities. Our analysis utilizes Partial Least Squares Structural Equation Modeling on a dataset of 183 firms to evaluate our hypotheses. The findings reveal that adhocratic, digital and hierarchical cultures significantly foster big data analytics capabilities mediated by digital transformation, which is a dynamic process that needs supportive digital and innovative values. In contrast, market and clan cultures exhibit weaker linkages. By providing empirical evidence and practical implications, this study highlights how organizations with a strong adhocratic and digital cultures outperform those with traditional cultures in their digital transformation and big data analytics capabilities efforts.

Objectives: To analyze psychotic symptoms following pontine stroke to better understand the neuroanatomy underlying the symptoms.

Methods: A case series including three cases of poststroke psychosis following pontine lesions and a literature review will be presented.

Results: Case 1: 67-year-old female with hypertension, hyperlipidemia, hypothyroidism, chronic kidney disease, and stroke. She presented with daily tactile hallucinations on her left face and neck that felt like a snake wrapped around her, occasional visual and tactile hallucinations of a cat, and occasional sensations that her body was on fire. Initial MRI showed diffuse atrophy, small vessel ischemic changes, and chronic hemosiderin staining of the pons and left superior basal ganglia. Repeat MRI identified bilateral thalamic lacunar infarcts, an old left caudate/corona radiata intracranial hemorrhage, and prior left occipital intracranial hemorrhage. Symptoms were managed with quetiapine 12.5mg daily.

Case 2: 74-year-old female with anemia, hypothyroidism, orthostasis, depression, mild cognitive impairment, temporal lobe epilepsy, and two strokes. She presented with near-daily distressing tactile hallucinations of worms, rubber bands, insects, snakes, and toy car wheels in her mouth. MRI showed chronic ischemic changes and central pontine and periventricular white matter lesions bilaterally with mild/moderate atrophy. Multiple medication trials and ECT treatment were aborted due to confusion and paranoia. Symptoms were managed with risperidone 2mg daily.

Case 3: 80-year-old female with hypertension, hyperlipidemia, coronary artery disease, atrial fibrillation, gastrointestinal bleed, and depression. She presented with distressing delusions that she was infested with pinworms throughout her gastrointestinal tract, along with visual hallucinations of the worms. MRI showed nonspecific white matter changes and a small T2 hyperintensity in the left pons of either a lacunar infarct or ischemic microangiopathic changes. After a partial hospitalization program enrollment and a subsequent hospitalization, symptoms were managed with risperidone 1.5mg daily.

Conclusions: Few case reports exist that describe peduncular hallucinosis, auditory hallucinations, or persistent tactile hallucinations following ischemic or hemorrhagic pontine lesions. The above cases demonstrate additional evidence of tactile and visual hallucinations following pontine stroke in geriatric patients, with imaging data localizing the lesions. Further research is needed to better understand the differing presentations, functional circuits, and neurochemical imbalances of psychosis following pontine lesion to improve diagnosis and treatments.

Six four-element balun topologies are introduced that enable complex impedance matching in addition to common-mode rejection. Design equations for these topologies are presented. Three of these networks are universal, while the other three are capable of performing only specific impedance transformations. Examples of these networks were designed and fabricated along with a traditional lattice balun network for an operating frequency of 300 MHz. These networks were verified through extensive electromagnetic simulations and by measuring the fabricated networks. The fabricated novel network examples were able to achieve common-mode rejection ratios above 20 dB, power wave reflection coefficients below −20 dB, and insertion losses of approximately 0.1 dB; these results were similar to or better than the performance of the fabricated traditional lattice balun. The design example networks also provided power matching and low insertion loss over a greater bandwidth compared to the fabricated traditional network. These networks will allow for the footprints of lumped-element balun circuitry to be reduced, which is particularly useful in integrated circuit design. These topologies are also expected to further increase radio-frequency (RF) circuit design flexibility by offering more alternative realizations.

Introduction: Dementia and cognitive impairment are major causes of admission to Nursing Homes. These conditions also lead to caregiver burden and decrease quality of life. Cognitive Stimulation Therapy (CST) is an evidence-based psychosocial intervention for people with dementia, recommended and implemented in many countries, including Brazil.

Objectives: The aim of the current study is to explore the feasibility and preliminary results of CST protocol in nursing homes for elders with cognitive impairment or dementia in Brazil.

Methods: Older adults with cognitive impairment were invited to participate in this study. Thirteen participants from two nursing homes were assessed at baseline with the Cambridge Cognitive Examination (CAMCOG), Cornell Scale for Depression in Dementia (CSDD), Pfeffer Functional Activities Questionnaire, Katz Activities of Daily Living Scale, Quality of Life in Alzheimer’s Disease (Qol-AD) and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB). They were assigned to Usual Care/Waiting List and followed up for 7 weeks, being reassessed at the end of this period. Then, they underwent 14 CST sessions throughout 7 weeks and were reassessed at the end of the protocol. Repeated Measures ANOVA was selected to assess differences in time. This study was approved by the Ethics committee of the Federal University of Minas Gerais.

Results: There were no dropouts from the study, the CST protocol has shown to be feasible to be implemented in nursing homes. We found that the CST protocol had no statistically significant impact in CDR-SOB (F = 1.21, p = 0.315), CSDD (F = 1.61, p = 0.221), CAMCOG (F = 0.914, p = 0.414), but showed a statistically significant change in the Qol-AD scale (F = 3.618, p = 0.042). However, Mauchly’s test of sphericity is violated, and since it may lead to increased type I error, it is still premature to define a positive outcome.

Conclusions: These preliminary results are consistent with the previous literature, suggesting that the CST could be a useful psychosocial intervention to improve the quality of life of people with dementia living in nursing homes. Nevertheless, more participants need to be enrolled to address further consistent.

Objectives:

1. 1. Consider the role of Meaning in Life (MIL) in potentially promoting psychological resiliency and well- being and reducing suicide risk among older adults;

2. 2. Describe Online Meaning-Centered Groups (OMG) for older adults experiencing loneliness, social isolation, and/or psychological distress; &

3. 3. Discuss preliminary findings from a study of OMG for Canadian Retirement Home and Community residents 60 and older, both during and following the COVID pandemic.

Key words: Meaning-Centered Groups; Online Interventions; Psychological Well-Being; Upstream Suicide Prevention

Background: The COVID pandemic had a negative impact on the health and well-being of older adults. As older adults additionally have among the highest rates of suicide globally, psychological distress due to lockdowns, fear of infection, and reduced access to mental healthcare and social supports threatened to increase suicide risk, necessitating innovative interventions. Online Meaning-Centered Groups (OMG) were designed to address this concern.

Objectives: To summarize initial findings of an on-going study to adapt, initially evaluate, and disseminate OMG for older adults potentially at-risk for suicide by virtue of loneliness, social isolation, or pandemic-related psychological distress.

Methods: Participants included English-speaking, cognitively-intact, Canadians 60 years and older, experiencing loneliness, social isolation, or psychological distress. Participants of all sexes and genders were recruited primarily via online advertisements for an 8-session, online course of OMG, adapted from Meaning-Centered Men’s Groups (MCMG; Heisel et al., 2020) for men struggling with the retirement transition. Participants completed an online eligibility assessment, and were administered a demographics form, a cognitive screen, and measures of functioning, psychological risk and resiliency factors, and suicide ideation and behaviour. Eligible participants were invited to take part in a course of OMG, and to additionally complete online pre-, mid-, post-group, and 2-month follow-up assessments of psychological risk and resiliency factors and group process.

Results: Two courses of OMG have been delivered to date (n = 15), with a third planned for Spring-Summer 2024. Participants reported high satisfaction with group (M = 44.7, SD = 3.4, on a 0-50 Group Satisfaction scale), a strong working alliance with group facilitators (Working Alliance Inventory-Short Form: M = 5.1/7, SD = 0.8), and experienced significant pre-post reductions in hopelessness (Beck Hopelessness Scale: t(13) = 2.16, p ≤ 0.05) and anxiety (Geriatric Anxiety Scale: t(13) = 2.18, p ≤ 0.05). Improvements in other negative psychological factors and in psychological well-being have not yet reached statistical significance.

Conclusions: Preliminary findings suggest potential benefit in OMG in promoting social connection and reducing psychological distress among older adults experiencing social isolation and/or psychological distress. These and other findings will be discussed in the context of the need for accessible psychological interventions and the importance of promoting meaning in life to enhance psychological well-being among older adults.

Objectives: Effectively adapting innovative mental health evidence-based community interventions is critical, yet underdeveloped, for reducing the treatment gap among older adults with depressive and anxiety symptoms. The Program to Encourage Active, Rewarding Lives (PEARLS) is an evidence-based community intervention designed to reduce symptoms of depression and improve quality of life among older adults. PEARLS includes 6-8 sessions of in- home visits of trained social workers to deliver a multi-component intervention: problem- solving, behavioral activation activities, and psychoeducation. We used the Framework for Reporting Adaptations and

Modifications-Enhanced (FRAME) to document process and changes made to adapting PEARLS, branded as VIDACTIVA (Vidas Activas y Valiosas) in an urban, low- resource community in Lima, Peru.

Methods: We obtained data in two stages. First, we conducted formative interviews with several stakeholders, including older adults, health professionals, community health workers (CHWs), city officials, and church leaders from the community. Second, during the iterative pilot phase, we used a mixed-Methods approach, integrating interviews with fidelity assessments, field notes, and training evaluations. We employed an iterative, rapid content analytic approach to triangulate findings from multiple sources and stakeholders, allowing us to identify needed adaptations.

Results: We made several adaptations. Most adaptations occurred during the formative phase focused on the training plan for CHWs (VIDACTIVA delivers). We also made adaptations of the components of the intervention (problem-solving) and in the way supervision sessions were conducted. Adaptations involved researchers, CHWs, health professionals and older adults. All adaptations were fidelity-consistent with PEARLS. Due to this is the early stage of implement VIDACTIVA, the most common goal across adaptations was increased feasibility and acceptability of the intervention.

Conclusions: The current study is an early effort to apply FRAME in the low-income urban context in Lima, Peru. FRAME guided systematic documentation of the adaptation decision- making process while successfully balancing fidelity. These observations lend insight to continue implementation efforts of VIDACTIVA intervention, which is undergoing a pilot clinical trial.

Product engineering in general and advanced systems engineering in specific are highly complex and unique processes that strive to deliver innovations – successful new products. To reduce risk and time, product engineers refer to existing (socio-)technical systems or subsystems. These references are part of the reference system. A great variety of elements can be used as reference system elements in engineering projects, but the different types of reference system elements and their roles are not yet characterized. However, this is a necessary prerequisite to model and conduct product generation engineering effectively. Here, we show how reference system elements can be categorized into three types that differ regarding their intended application in the actual engineering project. Therefore, we introduce three subsystems: reference system of objectives, reference operation system, and reference system of objects. Furthermore, we provide definitions for all subsystems to specify the allocation. We believe these results will form the basis for a continuous description and continuous engineering of consecutive and parallel product generations based on model-based systems engineering. Furthermore, the results will be the starting point for the development of design supports to assist engineers in designing their specific reference systems and to make the reference system part of efficient engineering processes.

Experiments were conducted to assess the impact of crown architecture on light availability beneath the trees, flowering, fruiting, yield and quality of jamun (Syzygium cumini [L.] Skeels). Trees were maintained as control, palmette and open centre crown. Impact was evaluated for three consecutive years, i.e. 2017–2019. Diffuse light beneath the trees ranged from 69.7 ± 2.22 to 45.9 ± 1.45%, whereas direct light varied from 30.4 ± 0.97 to 54.1 ± 1.78%. At flowering and fruit development stage (June), photosynthesis rate (A) in control trees was 12.5 ± 0.43 μmol CO2/m2/s; however, at fruit maturity and dormancy (August), it was only 9.5 ± 0.35 μmol CO2/m2/s. Similarly, in palmette and open centre trees, photosynthesis rate at flowering and fruit development stage was 13.5 ± 0.46 and 15.7 ± 0.54 μmol CO2/m2/s, respectively; whereas at fruit maturity and dormancy, photosynthesis rate dropped to 10.5 ± 0.39 and 11.7 ± 0.43 μmol CO2/m2/s, respectively. Substantial variation in stomatal conductance (gs), vapour pressure deficit (VPD) and transpiration rate (E) was also found. Days to start flowering ranged from 92 ± 0.33 to 98 ± 0.33. Similarly, days to end flowering varied from 99 ± 0.07 to 107 ± 0.36, days to fruit set 132 ± 0.33 to 139 ± 0.33 and days to fruit maturity 176 ± 0.48 to 184 ± 0.63. Significant variation in fruit length, fruit width and fruit weight was also found. Total soluble solids in fruit pulp varied from 9.0 ± 0.15 to 12.2 ± 0.149°Brix and fruit yield 62.3 ± 1.5 to 86.7 ± 1.33 kg per tree. Noteworthy variation in fruit quality traits was also recorded. This study illustrates that crown architecture has considerable impact on gas exchange parameters, flowering, fruiting, yield and quality of jamun.

Overview: This highly interactive session will present an overview of a range of tools and approaches that utilize artificial intelligence (AI) in the mental health care of older adults and persons with dementia. This includes a review of existing evidence around the use of AI for diagnosis, monitoring and intervention. This session will also serve as a forum for perspectives and feedback from IPA membership around what they believe to be the biggest needs and gaps around the use of AI in the clinical realm. This session will also introduce the new IPA task force for AI in psycho geriatrics.

Summary: Specialist Memory Clinics play a crucial role in evaluating individuals suspected of dementia. While these clinics have long been established in developed economies, their introduction has only recently begun in developing countries. In Chile, Memory Clinics were implemented as part of the Chilean Memory Plan and the inclusion of dementia in the General Regime of Explicit Guarantees in Health. This legal framework ensures access to diagnosis and treatment for patients with dementia. The Chilean system prioritizes primary care, with specialist care reserved for cases where diagnosis or treatment cannot be adequately addressed at the primary care level. As a result, Memory Units serve only a subset of diagnosed dementia patients. So far, there is a lack of studies on the clinical profiles of patients evaluated in memory clinics and resourceutilization.

Objectives: This study aims to comprehensively describe patient demographics and clinical characteristics while examining the frequency of evaluations needed about their specific diagnoses and comorbidities.

Methods: We analyzed the total number of consultations, considering the primary diagnosis and any comorbidities present. Clinical records were managed using a customized web platform software, which enabled the healthcare team to document all patient interactions, including appointments, medication prescriptions, and care coordination.

Results: CMYN received 1,220 patients (57% women) and 36 caregivers in the first five years. Among the patients, 222 (20%) had mild cognitive impairment, while 622 (57%) had dementia, with 48% diagnosed with Alzheimer’s disease dementia and 58% with other types of dementia. More than 75% of patients had less than ten consultations. Patients with dementia had more consultations than those without, as presented in Table 1.

Conclusions: The recent establishment of Memory Clinics in developing countries addresses a crucial gap in specialist care for dementia patients. In our experience, the diagnosis and the number of comorbidities may predict the level of interventions patients require. A more comprehensive understanding of the patient profile and their needs will assist in tailoring resources for implementing memory clinics and estimating the cost of care. Further studies need to address the characteristics of patients that require specialist-levelattention.

This study hypothesized that the signal grass (Urochloa decumbens [Stapf] R. Webster) modifies its structural and productive characteristics under a silvopasture system with legume trees. The treatments were composed of (i) signal grass in monoculture and (ii) a silvopasture system intercropping signal grass + Mimosa caesalpiniifolia Benth. a legume tree, over two consecutive years. The experiment was set in a completely randomized block design with three replications. Grazing was carried out by cattle with an average body weight (BW) of 186 ± 26 kg. The type of system had no significant effect on the structural and productive characteristics of signal grass. In the first grazing season, the greatest canopy height (54 cm) and total forage mass (6473 kg DM/ha) occurred in the dry period. The leaf:stem ratio was greater in the rainy season. Forage accumulation (515 kg DM/ha/28 days) and forage accumulation rate (18 kg DM/ha/day) were greater in the rainy season. Higher total forage production (4583 kg DM/ha) occurred in the first grazing season. The silvopasture with double rows spaced 25 m apart and with a tree density of 600 plants/ha did not compromise the structural and productivity characteristics of the signal grass pasture. The legume M. caesalpiniifolia has the potential for use as an arboreal component in silvopasture systems with signal grass.

Governments and social scientists are increasingly developing machine learning methods to automate the process of identifying terrorists in real-time and predict future attacks. However, current operationalizations of ‘terrorist’ in artificial intelligence are difficult to justify given three issues that remain neglected: insufficient construct legitimacy, insufficient criterion validity, and insufficient construct validity. I conclude that machine learning methods should be at most used for the identification of singular individuals deemed terrorists and not for identifying possible terrorists from some more general class, nor to predict terrorist attacks more broadly, given intolerably high risks that result from such approaches.

Background: Black, Asian and Minority Ethnic (BAME) people continue to present later to specialist care centres and services for memory problems. This poses significant concerns due to implications for poorer treatment outcomes and higher treatment cost among this population. While diverse interventions to support improved help seeking for dementia have been proffered for other BAME communities, there is a paucity of research involving the Black African and Caribbean community. Furthermore, whilst community health professionals like the doctors and community nurses have been involved in such interventions, no previous research has considered the role of the community pharmacist. This research explored opportunities for community pharmacists to support improved help seeking for dementia among the Black African and Caribbean population.

Methods: This research was a multi-stage project involving surveys and interviews with community pharmacists and Black Africans and Caribbeans as participants.

Results: Knowledge, attitude and beliefs around dementia and it’s causes appeared to be major barriers to help seeking among the Black African and Caribbean population. For example, beliefs that dementia is caused by ‘the spirits’ and dementia is a repercussion for past wrongdoing and therefore not amenable to medical intervention. The community pharmacists believe they are well positioned to spot initial signs of dementia among their clients and are therefore willing to offer help seeking support to this population.

Conclusions: To offer intervention for timely help-seeking for dementia, a culturally tailored dementia education for the Black African and Caribbean population should be considered. In addition, training on the impact of cultural beliefs on help seeking for dementia should be considered for the communitypharmacists.

Introduction: Agitation in Alzheimer’s dementia (AAD) confers significant humanistic and economic burden; however, factors, and relationships between them, which drive the extent of this burden are poorly understood. The Objectives of this study was to review and gather evidence on the burden of AAD in order to develop a conceptual framework capturing its effects on patients, their families, clinicians (i.e., care teams), and society, which can then be used to guide further research into how the burden of AAD might be reduced.

Methods: Evidence on the burden of AAD was identified via a targeted literature review. Data were classified into societal, patient/family/care team, and mitigating factors. A conceptual framework (i.e., a visual representation of variables and associations between them) was developed to map the relationships between factors and illustrate the precedents and downstream effects of agitated behaviors on patient and caregiver outcomes, including healthcare resource utilization (HCRU), costs, and admission to long term care(LTC).

Results: Agitated behaviors were found to directly impact caregiving demands in terms of the number of hours required to care for patients. Similarly, levels of caregiver stress (i.e., total caregiver burden, personal strain, role strain, and guilt) were found to be associated with the frequency and intensity of AAD. Burden also extended to care teams via increased HCRU (i.e., pharmacy, outpatient, inpatient, and emergency room visits), and consequently costs, relative to non-agitated patients. Indirectly, through caregiving demands, agitation also affected the rate of placement in formal care and LTC, both of which are associated with incremental costs. Evidence also indicated that mitigating factors such as pharmacological treatment could impact the frequency and intensity of agitated behaviors, potentially affecting downstream HCRU and costs. Limited evidence exists on the optimal means of employing such strategies to limit caregiver demands and stress.

Conclusions: This study demonstrated the complex interplay of factors which drive the burden of AAD and the need which exists for novel ways to improve outcomes for those impacted by the disease. Better insight into the mechanism by which agitated behaviors influence caregiver demands and stress could help improve mitigation strategies both within family units and the larger health system.

Objectives: Health professionals in our setting rarely ask adequately about sleep disorders beyond insomnia in depressive patients. This presentation aims to review the possible clinical situations between geriatric depression (GD) and sleep apnea and hypopnea syndrome (SAHS) and highlight the clinical impact of their adequate detection and treatment.

Methods: Presentation of a sample of 25 older adult patients from the Geriatric Neuropsychiatry Clinic and the Psychogeriatric Section of the Department of Psychiatry of the CEMIC (Buenos Aires, Argentina) with diagnoses of GD and SAHS.

Results: Presentation of different groups of patients with possible relationships in which these two entities interact: a) GD as a risk factor for developing SAHS; b) SAHS as a risk factor for developing GD; c) GD and SAHS as comorbidities; d) GD and SAHS as risk factors for morbidity and mortality for multiple diseases; e) SAHS as a cause of pseudo-resistance to antidepressant treatment in GD; e) GD as a cause of pseudo-resistance to SAHS treatment; f) the treatment of GD as a cause of pseudo-resistance to SAHS treatment; g) the treatment of SAHS as “a cause of” and/or “aggravate” of GD.

Conclusions: Mental health professionals must actively investigate in their older patients the possible relationships between GD and SAHS in order to ensure the diagnosis and appropriate treatments adapted to such clinical situations.

Objectives: Loneliness is a modifiable risk factor for depression and dementia in older age. Validated interventions are needed to mitigate the impact of loneliness in older adults. Some evidence suggests that mindfulness meditation may reduce stress, improve mood and cognitive function, and may also impact loneliness per se. Many meditation apps offer an accessible way to meditate at home. However, robust research is needed to assess the benefits of meditation using this technology for older adults. Muse is a meditation app that analyzes brain signals during meditation and provides users with real-time neurofeedback on their level offocus.

Methods: We conducted a pilot, randomized controlled trial to establish the acceptability and feasibility of a remote, mindfulness intervention using Muse in older adults, and to obtain preliminary data on its impact on mood and cognition. Twenty-six adults reporting feeling lonely were enrolled and randomized to an 8-week Muse- based meditation (MM) or a brain- training active control (BT) program. The MM group completed meditation sessions with real- time neurofeedback and guided meditation sessions using Muse. The BT group completed cognitively challenging games on the commercially available Peak app and listened to podcasts. The groups were matched on the amount of interactions with study staff and total program duration. Outcome measures included standardized self-report scales of loneliness, stress, depression, well-being, quality of life, sleep disturbance, resilience, and mindfulness. Staff blinded to program assignment administered cognitive tasks of episodic memory, working memory, and sustained attention, as well as a breath counting task. Assessments were taken at Pre, Mid, and Post intervention, and after a 2-month and 4-month (4M) follow-upperiod.

Results: Participants found both programs engaging and the remote assessments were feasible. The MM group showed a greater improvement in depressive symptoms, and psychological andphysical QOL, compared to the BT group, at Post and at 4M.

Conclusions: A Muse-based mindfulness program is an acceptable and accessible intervention for older adults. A large-scale randomized trial is warranted to evaluate the efficacy of this intervention in this group.