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Effect Of Aspirin On Disability-Free Survival In The Healthy Elderly, John J Mcneil, Robyn L Woods, Mark R Nelson, Christopher M Reid, Brenda Kirpach, Rory Wolfe, Elsdon Storey, Raj C Shah, Jessica E Lockery, Andrew M Tonkin, Anne B Newman, Jeff D Williamson, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Suzanne G Orchard, Ruth E Trevaks, Lawrence J Beilin, Geoffrey A Donnan, Peter Gibbs, Colin I Johnston, Joanne Ryan, Barbara Radziszewska, Richard Grimm, Anne M Murray Oct 2018

Effect Of Aspirin On Disability-Free Survival In The Healthy Elderly, John J Mcneil, Robyn L Woods, Mark R Nelson, Christopher M Reid, Brenda Kirpach, Rory Wolfe, Elsdon Storey, Raj C Shah, Jessica E Lockery, Andrew M Tonkin, Anne B Newman, Jeff D Williamson, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Suzanne G Orchard, Ruth E Trevaks, Lawrence J Beilin, Geoffrey A Donnan, Peter Gibbs, Colin I Johnston, Joanne Ryan, Barbara Radziszewska, Richard Grimm, Anne M Murray

Faculty, Staff and Student Publications

BACKGROUND: Information on the use of aspirin to increase healthy independent life span in older persons is limited. Whether 5 years of daily low-dose aspirin therapy would extend disability-free life in healthy seniors is unclear.

METHODS: From 2010 through 2014, we enrolled community-dwelling persons in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or physical disability. Participants were randomly assigned to receive 100 mg per day of enteric-coated aspirin or placebo orally. The primary end …


Older Adults' Health Care Utilization A Year After Experiencing Fear Or Distress From Hurricane Sandy, Laura P Sands, Yimeng Xie, Rachel Pruchno, Allison Heid, Yili Hong Oct 2018

Older Adults' Health Care Utilization A Year After Experiencing Fear Or Distress From Hurricane Sandy, Laura P Sands, Yimeng Xie, Rachel Pruchno, Allison Heid, Yili Hong

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: To determine whether self-reports of disaster-related psychological distress predict older adults' health care utilization during the year after Hurricane Sandy, which hit New Jersey on October 29, 2012.

METHODS: Respondents were from the ORANJ BOWL Study, a random-digit dialed sample from New Jersey recruited from 2006 to 2008. Medicare hospital, emergency department (ED) and outpatient claims data from 2012 and 2013 were matched to 1607 people age 65 and older in 2012 who responded to follow-up surveys conducted from July 2013 to July 2015 to determine their hurricane-related experiences.

RESULTS: In total, 7% (107) of respondents reported they experienced …


Humanin Prevents Age-Related Cognitive Decline In Mice And Is Associated With Improved Cognitive Age In Humans., Kelvin Yen, Junxiang Wan, Hemal H Mehta, Brendan Miller, Amy Christensen, Morgan E Levine, Matthew P Salomon, Sebastian Brandhorst, Jialin Xiao, Su-Jeong Kim, Gerardo Navarrete, Daniel Campo, G Jean Harry, Valter Longo, Christian J Pike, Wendy J Mack, Howard N Hodis, Eileen M Crimmins, Pinchas Cohen Sep 2018

Humanin Prevents Age-Related Cognitive Decline In Mice And Is Associated With Improved Cognitive Age In Humans., Kelvin Yen, Junxiang Wan, Hemal H Mehta, Brendan Miller, Amy Christensen, Morgan E Levine, Matthew P Salomon, Sebastian Brandhorst, Jialin Xiao, Su-Jeong Kim, Gerardo Navarrete, Daniel Campo, G Jean Harry, Valter Longo, Christian J Pike, Wendy J Mack, Howard N Hodis, Eileen M Crimmins, Pinchas Cohen

Articles, Abstracts, and Reports

Advanced age is associated with a decline in cognitive function, likely caused by a combination of modifiable and non-modifiable factors such as genetics and lifestyle choices. Mounting evidence suggests that humanin and other mitochondrial derived peptides play a role in several age-related conditions including neurodegenerative disease. Here we demonstrate that humanin administration has neuroprotective effects in vitro in human cell culture models and is sufficient to improve cognition in vivo in aged mice. Furthermore, in a human cohort, using mitochondrial GWAS, we identified a specific SNP (rs2854128) in the humanin-coding region of the mitochondrial genome that is associated with a …


Comprehensive Geriatric Assessment: A Primer, Thomas M. Meuser Sep 2018

Comprehensive Geriatric Assessment: A Primer, Thomas M. Meuser

Social Work Faculty Publications

Comprehensive Geriatric Assessment is an integrative approach to diagnosis, treatment and management of older adults that takes the whole person into account. While deficits may be a primary focus, strengths are also considered.


Life Review In Aging: A Primer, Thomas M. Meuser Sep 2018

Life Review In Aging: A Primer, Thomas M. Meuser

Social Work Faculty Publications

Humans are narrative beings. We understand and speak of ourselves and the events of our lives in the context of stories. The stories we tell are influenced by our lived experiences, the quality of our memories (what’s recalled and forgotten), relationships, personality styles, values, accomplishments, regrets, spiritual beliefs, and a host of other factors. Telling our stories from the vantage point of old age is reflective of a maturational process of introspection and discovery called life review.


Examining Relationships Between Age At Diagnosis And Health-Related Quality Of Life Outcomes In Prostate Cancer Survivors., Christine J. Kurian, Amy Leader, Melissa S.Y. Thong, Scott W. Keith, Charnita Zeigler-Johnson Aug 2018

Examining Relationships Between Age At Diagnosis And Health-Related Quality Of Life Outcomes In Prostate Cancer Survivors., Christine J. Kurian, Amy Leader, Melissa S.Y. Thong, Scott W. Keith, Charnita Zeigler-Johnson

Department of Medical Oncology Faculty Papers

BACKGROUND: Patient reports of health related quality of life can provide important information about the long-term impact of prostate cancer. Because patient symptoms and function can differ by age of the survivor, the aim of our study was to examine patient-reported quality of life and prostate symptoms by age at diagnosis among a registry of Dutch prostate cancer survivors.

METHODS: A population of 617 individuals from the Patient Reported Outcomes Following Initial Treatment and Long-Term Evaluation of Survivorship (PROFILES) database was surveyed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) and prostate symptom …


Designed Environment For Healthy Aging, Attila Lawrence Jul 2018

Designed Environment For Healthy Aging, Attila Lawrence

Architecture Faculty Research

A growing number of aging adults want to remain in multi generational communities rather than relocating to retirement communities, or having to resort to an institutional setting. To productively function in an environment where all generations interact and live well together, however, one’s ability to manage diminishing cognitive and physical conditions precipitated by the aging process is a major factor that bears on everyone’s quality of life. Because the designed environment frequently plays a significant role in the occurrence of neurodegenerative disorders that involve biological changes, it is self-evident that design strategies intended to support the management of these symptoms …


Influence Of Built Environment And Social Capital On Mental Health Of Residents Of Assisted Living Communities In Louisville, Ky., Sarah E. Walsh, A. Scott Lajoie Jul 2018

Influence Of Built Environment And Social Capital On Mental Health Of Residents Of Assisted Living Communities In Louisville, Ky., Sarah E. Walsh, A. Scott Lajoie

Faculty and Staff Scholarship

Objectives: Prior research has shown social capital and built environment quality are associated with overall health status and the incidence of mental illness. This study explores the relationship between social capital, built environment, and quality of life specifically for assisted living residents, currently a gap in the literature. Method: A total of 76 assisted living residents were interviewed for the study using researcher-administered questionnaires. In addition, site audits were conducted to quantitatively evaluate the built environment surrounding 12 assisted living communities in the Louisville Metro region. Results: There was a moderate, positive correlation between social capital and mental health, r …


Broadening The Lens: A Systems Approach To Nursing Home Quality Improvement, Kelly M. Smith Jun 2018

Broadening The Lens: A Systems Approach To Nursing Home Quality Improvement, Kelly M. Smith

USF Tampa Graduate Theses and Dissertations

The National Quality Award Program, sponsored by the American Healthcare Association National Center for Assisted Living, was implemented to cultivate continuous quality improvement in nursing homes and assisted living facilities. Based upon the Baldridge Criteria for Performance Excellence, the program utilizes a systems-based or Big “Q” approach to quality and requires applicants to examine seven categories of their organizational environment including: 1) leadership, 2) strategy, 3) customers, 4) measurement, analysis, and knowledge management, 5) workforce, 6) operations, and 7) results. The subsequent dissertation examines whether award status is associated with better performance on publicly reported quality measures and financial performance …


Volume Vii (2018), Unm Department Of Orthopaedic Surgery Jun 2018

Volume Vii (2018), Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.


Factors Affecting Inpatient Mortality In Elderly People With Acute Kidney Injury, Muhammad Mabood Khalil, Safia Awan, Rabeea Azmat, Muhammad Ashhad Ullah Khalil, Nazish Naseer,, Jackson Tan May 2018

Factors Affecting Inpatient Mortality In Elderly People With Acute Kidney Injury, Muhammad Mabood Khalil, Safia Awan, Rabeea Azmat, Muhammad Ashhad Ullah Khalil, Nazish Naseer,, Jackson Tan

Section of Nephrology

Background: Acute Kidney Injury (AKI) is common in elderly people (EP). There is paucity of data on predictor of mortality in EP with AKI.
Objective: This study was done to know more about factors associated with inpatient mortality in EP with AKI.
Methods: We retrospectively reviewed medical records of patients aged 65 years or above hospitalized with a diagnosis of AKI at Aga Khan University Hospital, Karachi, between January 2005 and December 2010. Binary logistic regression models were constructed to identify factors associated with mortality in EP with AKI.
Results: 431 patients had AKI, with 341 (79.1%) having stage I …


Factors Affecting Inpatient Mortality In Elderly People With Acute Kidney Injury, Muhammad Abdul Mabood Khalil, Safia Awan, Rabeea Azmat, Muhammad Ullah Khalil, Nazish Naseer, Jackson Tan May 2018

Factors Affecting Inpatient Mortality In Elderly People With Acute Kidney Injury, Muhammad Abdul Mabood Khalil, Safia Awan, Rabeea Azmat, Muhammad Ullah Khalil, Nazish Naseer, Jackson Tan

Section of Nephrology

Background: Acute Kidney Injury (AKI) is common in elderly people (EP). There is paucity of data on predictor of mortality in EP with AKI.
Objective: This study was done to know more about factors associated with inpatient mortality in EP with AKI.
Methods: We retrospectively reviewed medical records of patients aged 65 years or above hospitalized with a diagnosis of AKI at Aga Khan University Hospital, Karachi, between January 2005 and December 2010. Binary logistic regression models were constructed to identify factors associated with mortality in EP with AKI.
Results: 431 patients had AKI, with 341 (79.1%) having stage I …


Resilience And Protective Factors In Older Adults, Jessica Mcclain, Katelyn Gullatt, Caroline Lee May 2018

Resilience And Protective Factors In Older Adults, Jessica Mcclain, Katelyn Gullatt, Caroline Lee

Dissertations, Masters Theses, Capstones, and Culminating Projects

Evidence suggests resilience promotes successful aging in place and protective factors promote resilience. This study sought to investigate whether or not the combination of three protective factors, physical health, social support, and self-efficacy are all of equal importance in predicting resilience among Marin County older adults, or if some individual protective factors have a greater impact on resilience than the others. Fifty-eight participants ages 62 and higher were recruited from senior community programs and personal contacts. Four self-report questionnaires were completed by the participants in this exploratory, cross-sectional, quantitative design. SPSS was used for a descriptive and multivariate analyses to …


Out Of The Shell: Exploring The Phagocytic Capabilities Of The B Cell And Isolated Lymphoid Follicle-Lie Structures In The Red-Eared Slider, Trachemys Scripta, Marc A. Ashford Jr. Apr 2018

Out Of The Shell: Exploring The Phagocytic Capabilities Of The B Cell And Isolated Lymphoid Follicle-Lie Structures In The Red-Eared Slider, Trachemys Scripta, Marc A. Ashford Jr.

Theses and Dissertations

Management of immunity is crucial for survival in all living organisms. While there is a large amount of research for established model organisms, such as the mouse model, much less is known about reptiles. When compared to immunity in mammals, we discover many differences such as susceptibility to certain pathogens, alteration of immune processes due to environmental temperature, the total absence of certain lymphoid organs contained in mammals, among many others. Despite this, the reptile has shown in many studies that they are worthy systems to study immunity in an evolutionary perspective and recent studies may show that they may …


Individualized Music Improves Social Interaction Of Women, But Not Men, With Dementia, Emily Farrer, Diana Hilycord Apr 2018

Individualized Music Improves Social Interaction Of Women, But Not Men, With Dementia, Emily Farrer, Diana Hilycord

Butler Journal of Undergraduate Research

Dementia is tragic both for patients with the disease and for their family members. As this neurodegenerative disorder progresses, cognitive functions deteriorate, agitation and aggression increase, and mood worsens (McDermott, Orrell, et al., 2014; Spiro, 2010; Vasionyté & Madison, 2013). Non-pharmacological approaches, such as active music therapy or passive music listening, can be effective in reducing these symptoms. However, no past studies have examined how music listening affects the social interactions of patients with dementia. As such, this study examined whether nursing home residents with dementia are more engaged and interactive if they listen to individually selected music for 15 …


Meditation As A Tool For Blood Pressure Management, Maggie Ray Apr 2018

Meditation As A Tool For Blood Pressure Management, Maggie Ray

Thinking Matters Symposium Archive

PURPOSE: Appraise existing evidence about meditation and blood pressure in persons with cardiac risk factors and offer evidence-based recommendations about the use of meditation in management of blood pressure


Educating Oncology Nurse Practitioners To Provide Basic Palliative Care, Lynn Adams, Dnp, Ms, Anp-Bc, Aocn Apr 2018

Educating Oncology Nurse Practitioners To Provide Basic Palliative Care, Lynn Adams, Dnp, Ms, Anp-Bc, Aocn

Doctor of Nursing Practice Projects

Background: Approximately 1.66 million Americans are diagnosed with cancer each year and another 589,430 die from the disease. As treatment options have expanded, many cancer patients are living longer with worsening symptoms and disabilities and an increased illness burden. These patients are ideal candidates for palliative care. Palliative care involves care delivered by a team of clinicians with specialty training and a focus on improving the quality of life for patients with serious illnesses. A number of major organizations have made formal recommendations regarding the integration of palliative care into comprehensive cancer care including the American Society of Clinical Oncology …


Serum Tumour Necrosis Factor Alpha In Osteopenic And Osteoporotic Postmenopausal Females: A Cross-Sectional Study In Pakistan, Rafat Murad, Zahra Shezad, Saara Ahmed, Mussarat Ashraf, Murad Qadir, Rehana Rehman Mar 2018

Serum Tumour Necrosis Factor Alpha In Osteopenic And Osteoporotic Postmenopausal Females: A Cross-Sectional Study In Pakistan, Rafat Murad, Zahra Shezad, Saara Ahmed, Mussarat Ashraf, Murad Qadir, Rehana Rehman

Department of Biological & Biomedical Sciences

Objective: To compare biochemical parameters serum tumour necrosis factor alpha, calcium, magnesium, bone-specific alkaline phosphatase and vitamin D in postmenopausal women.
Methods: This cross-sectional study was carried out from June 2015 to July 2016 at Jinnah Medical and Dental College, Karachi, and comprised postmenopausal women. Bone mineral density done by dual energy X-ray absorptiometryscan categorised subjects by World Health Organisation classification into normal (T score > -1) osteopenic (T score between -1 and -2.5) and osteoporotic (T score < -2.5). Biochemical parameters like tumour necrosis alpha, calcium, magnesium, bone-specific alkaline phosphatase and vitamin D were measured by solid phase enzyme amplified sensitivity immunoassay method. SPSS 16 was used to analyse the data.
Results: Of the 146 women, 34(23%) were normal, 93(67%) were osteopenic and 19(13%) were osteoporotic. There was significant difference in mean body mass …


Adult Day Service Providers: Untapped Potential For Care Coordination, Nicole Ruggiano, Ellen L. Brown, Karen L. Fortuna Feb 2018

Adult Day Service Providers: Untapped Potential For Care Coordination, Nicole Ruggiano, Ellen L. Brown, Karen L. Fortuna

Nursing & Health Sciences Research Journal

Adult Day Services (ADS) have become increasingly available for community-dwelling older adults who are often experiencing multiple chronic conditions and/or dementia. ADS providers spend a significant amount of time with their clients and offer the opportunity for a wealth of clinical information that can be used by primary care providers and specialists for decision-making about patient care. There are also opportunities for hospitals to coordinate care transitions with ADS providers by involving them with discharge planning with appropriate patients who require post-hospital care. However, ADS providers are often viewed as social service providers, and there is little known about the …


Word-List Intrusion Errors Predict Progression To Mild Cognitive Impairment, Kelsey R Thomas, Joel Eppig, Emily C Edmonds, Diane M Jacobs, David J Libon, Rhoda Au, David P Salmon, Mark W Bondi, Alzheimer’S Disease Neuroimaging Initiative Feb 2018

Word-List Intrusion Errors Predict Progression To Mild Cognitive Impairment, Kelsey R Thomas, Joel Eppig, Emily C Edmonds, Diane M Jacobs, David J Libon, Rhoda Au, David P Salmon, Mark W Bondi, Alzheimer’S Disease Neuroimaging Initiative

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: Preclinical Alzheimer's disease (AD) defined by a positive AD biomarker in the presence of normal cognition is presumed to precede mild cognitive impairment (MCI). Subtle cognitive deficits and cognitive inefficiencies in preclinical AD may be detected through process and error scores on neuropsychological tests in those at risk for progression to MCI.

METHOD: Cognitively normal participants (n = 525) from the Alzheimer's Disease Neuroimaging Initiative were followed for up to 5 years and classified as either stable normal (n = 305) or progressed to MCI (n = 220). Cox regressions were used to determine whether baseline process scores on …


Physical Therapy Faculty, Unm Department Of Orthopaedic Surgery Jan 2018

Physical Therapy Faculty, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.


Fighting Frailty With The Mediterranean Diet, Edward F. Ansello Jan 2018

Fighting Frailty With The Mediterranean Diet, Edward F. Ansello

Director's Editorials from Age in Action

It’s appropriate for each of us to examine our eating habits, not just our nutrition intake. The various aspects of the Mediterranean Diet hold potential benefits beyond the important feature of helping to reduce frailty.


Our Anniversary, Edward F. Ansello Jan 2018

Our Anniversary, Edward F. Ansello

Director's Editorials from Age in Action

The Virginia Center on Aging celebrates 40 years.


Gerontology Theory Communicated In The Primary Grades Through Picture Books, Edward F. Ansello Jan 2018

Gerontology Theory Communicated In The Primary Grades Through Picture Books, Edward F. Ansello

Case Studies from Age in Action

Educational Objectives

1. To recognize children’s first literature as a means of socialization to aging and older people.

2. To identify children’s books that reflect basic principles of gerontology theory.

3. To help primary school teachers, grandparents, and others interested in human development use books and activities to capture children’s attention.

4. To identify a unit of six brief, overlapping modules, each with objectives, activities, and recommended readings.


Into The Elder Law Trenches At Wake Forest University School Of Law, Kate Mewhinney Jan 2018

Into The Elder Law Trenches At Wake Forest University School Of Law, Kate Mewhinney

Case Studies from Age in Action

Educational Objectives:

1. Examine the benefits of a medical-legal partnership for training law students how to represent older clients.

2. Review common legal issues in the field of elder law.

3. Explore broader policy concerns facing an aging population.


Comparing Daily Drivers Of Problem Drinking Among Older And Younger Adults: An Electronic Daily Diary Study Using Smartphones, A. Kuerbis, H. Treloar Padovano, S. Shao, J. Houser, F. J. Muench, J. Morgenstern Jan 2018

Comparing Daily Drivers Of Problem Drinking Among Older And Younger Adults: An Electronic Daily Diary Study Using Smartphones, A. Kuerbis, H. Treloar Padovano, S. Shao, J. Houser, F. J. Muench, J. Morgenstern

Journal Articles

© 2018 Elsevier B.V. Background: By 2030, numbers and proportions of older adults with substance-use problems are expected to increase. While risk factors for problem drinking in late life have been identified, it remains unknown whether these factors drive daily drinking among older problem drinkers. This study examined the daily drivers of drinking among problem drinkers, moderated by age, utilizing ecological momentary assessment (EMA). Method: Participants (N = 139), ages 20–73, received daily EMA online surveys completed via a smartphone prior to initiation of treatment. Multilevel modeling tested the moderating impact of age on within- and between-person relationships between drinking …


The Age-Related Perfusion Pattern Measured With Arterial Spin Labeling Mri In Healthy Subjects, N. Zhang, M. L. Gordon, Y. Ma, B. Chi, J. J. Gomar, S. Peng, P. B. Kingsley, D. Eidelberg, T. E. Goldberg Jan 2018

The Age-Related Perfusion Pattern Measured With Arterial Spin Labeling Mri In Healthy Subjects, N. Zhang, M. L. Gordon, Y. Ma, B. Chi, J. J. Gomar, S. Peng, P. B. Kingsley, D. Eidelberg, T. E. Goldberg

Journal Articles

No abstract provided.


Training Neurodegenerative Disease Support Group Leaders: A New Support Group Functioning Scale, Therese V. Cash, Christopher Kilbourn, Sarah K. Lageman Jan 2018

Training Neurodegenerative Disease Support Group Leaders: A New Support Group Functioning Scale, Therese V. Cash, Christopher Kilbourn, Sarah K. Lageman

Neurology Publications

Support group leaders play pivotal roles in maintaining healthy community support groups; however, these leaders also have personal support needs and typically lack formal training in managing complex behaviors of neurodegenerative disorders. A support group well-being questionnaire, assessing support group functioning, was developed and piloted among participants of an educational training program designed for support group leaders of various neurodegenerative disorder-specific support groups. An exploratory factor analysis evaluated the questionnaire’s psychometric properties and identified a reliable single factor five-item solution, which was titled the Support Group Functioning Scale (SGFS). Preliminary interpretation guidelines were proposed. Development of this scale is a …


The Year In The Rear-View Mirror, Edward F. Ansello Jan 2018

The Year In The Rear-View Mirror, Edward F. Ansello

Director's Editorials from Age in Action

The year 2018 is the Virginia Center on Aging's 40th anniversary. Our programs and activities have evolved over time but we have remained true to the charges given us in the Code of Virginia, essentially to conduct interdisciplinary studies, including training practitioners and offering educational opportunities for older adults, conducting research on and advancing knowledge about dementia, and serving as an information resource to those committed to the well-being of older adults. Our current operations feature four program areas: abuse in later life (domestic violence and elder abuse); dementia research; geriatrics and gerontology education; and lifelong learning.


A New Measure For End Of Life Planning, Preparation, And Preferences In Huntington Disease: Hdqlife End Of Life Planning, Noelle E Carlozzi, E A Hahn, S A Frank, J S Perlmutter, N D Downing, M K Mccormack, S Barton, M A Nance, S G Schilling, Hdqlife Site Investigators And Coordinators Jan 2018

A New Measure For End Of Life Planning, Preparation, And Preferences In Huntington Disease: Hdqlife End Of Life Planning, Noelle E Carlozzi, E A Hahn, S A Frank, J S Perlmutter, N D Downing, M K Mccormack, S Barton, M A Nance, S G Schilling, Hdqlife Site Investigators And Coordinators

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Huntington disease is a fatal inherited neurodegenerative disease. Because the end result of Huntington disease is death due to Huntington disease-related causes, there is a need for better understanding and caring for individuals at their end of life.

AIM: The purpose of this study was to develop a new measure to evaluate end of life planning.

DESIGN: We conducted qualitative focus groups, solicited expert input, and completed a literature review to develop a 16-item measure to evaluate important aspects of end of life planning for Huntington disease. Item response theory and differential item functioning analyses were utilized to examine …