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Vital Signs, Summer 2011, Boonshoft School Of Medicine

Vital Signs

A forty-eight page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, a research spotlight, alumni notes, and more.

Oxidative Stress Accumulates In Adipose Tissue During Aging And Inhibits Adipogenesis, Hannes M. Findeisen, Kevin J. Pearson, Florence Gizard, Yue Zhao, Hua Qing, Karrie L Jones, Dianne Cohn, Elizabeth B. Heywood, Rafael De Cabo, Dennis Bruemmer

Saha Cardiovascular Research Center Faculty Publications

Aging constitutes a major independent risk factor for the development of type 2 diabetes and is accompanied by insulin resistance and adipose tissue dysfunction. One of the most important factors implicitly linked to aging and age-related chronic diseases is the accumulation of oxidative stress. However, the effect of increased oxidative stress on adipose tissue biology remains elusive. In this study, we demonstrate that aging in mice results in a loss of fat mass and the accumulation of oxidative stress in adipose tissue. In vitro, increased oxidative stress through glutathione depletion inhibits preadipocyte differentiation. This inhibition of adipogenesis is at …

Are Scores On The Ppt Useful In Determination Of Risk Of Future Falls In Individuals With Dementia?, Mary K. Farrell, Richard A. Rutt, Michelle M. Lusardi, Ann K. Williams

All PTHMS Faculty Publications

Individuals with dementia or Alzheimer’s disease (AD), exhibit both a progressive decline in cognitive function and accumulating difficulty with physical function.¹ As cognitive impairment begins, individuals will initially demonstrate difficulties with short-term memory and with instrumental activities of daily living. As the dementia progresses, individuals will increasingly demonstrate difficulties with long-term memory, communication, and basic activities of daily living.

Dimensions Of Aging And Belonging For The Older Person And The Effects Of Ageism, Laurence C. Nolan

Brigham Young University Journal of Public Law

No abstract provided.

Massachusetts’ Home Care Programs And Reasons For Discharge Into Nursing Homes, Cathy M. Wong, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) are a range of long-term care services intended to enable older adults and persons with disabilities to “age in place” in their own homes and communities. Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home. One study concluded that 84 percent of older Americans, aged 50 years and older, want to remain in their homes for as long as possible. Medicaid is a major source of funding for long term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional, …

Medical Education Digest, Vol. 13 No. 1 (January/February 2011), Nova Southeastern University

Medical Education Digest

No abstract provided.

Baby Boomers And Stereotypes, Edward F. Ansello

Director's Editorials from Age in Action

With age we become more and more like ourselves. This would mean millions and millions of individual Baby Boomers, each with his or her own characteristics and life trajectory. Stereotyping would, therefore, be wrong, but it is happening.

Evaluation Of Verbal Behavior In Older Adults, Amy Gross

Dissertations

Older adults make up a large and increasing portion of the population (U.S. apply those assessments to the evaluation of verbal behavior in older adults with and without dementia. The research addressed two questions. First, in what way do verbal behavior problems differ between older adults with and without dementia? Second, does language deteriorate in a pattern compatible with Skinner's analysis of functionally independent verbal operants? Thirty-one participants were categorized into Control (n=15) and Dementia (n=16) Groups based on their score on the Dementia Rating Scale-2. Verbal behavior assessments were administered to participants on two occasions, separated by one week. …

Preference Assessments For Older Adults With Dementia: Utility Of The Mswo Procedure And Assessment Of The Stability Of Preference, Paige B. Raetz

Dissertations

Individuals with dementia suffer from a variety of cognitive deficits that can lead to a lack of engagement in activities. In recent years, researchers have begun to look at ways to assess preferences in hopes that increased identification of leisure items may lead to increases in engagement. Due to the decline in cognitive status a simple questionnaire may not be sufficient to assess preference for this population. As a result, several recent studies have incorporated the use of systematic preference assessments to assess preference for leisure activities with adults with dementia using a paired stimulus format. The purpose of the …

Risk Factors For Driving Cessation Vary By Race And Ethnicity, Elizabeth Dugan, Frank Porell, Chae Man Lee

Gerontology Institute Publications

Driving is related to our identity and independence as well as allowing us to get needed goods, services, and social opportunities that enrich daily life. Yet with increasing age, the risk for developing threats to medical fitness to drive increases. Driving cessation is related to a long list of negative outcomes, such as: depression, social isolation, diminished access to health care, and diminished quality of life. We investigated risks for driving cessation, paying close attention to racial differences. This study used data from the Health and Retirement Study (HRS), 1998-2008. The study included N=46, 528 older people (age 65 and …

Effects Of Two Group Approaches On Life Satisfaction And Mood Of Older Females In Nursing Homes, Bede Redpath Ryan

Wayne State University Dissertations

The purpose of this study was to examine the effects of two group counseling therapy interventions on levels of life satisfaction and mood disturbance of older women, age 65+, living in two Detroit-based skilled nursing home facilities. This quasi-experimental, two-treatment group design examined the pretest-posttest data of two group counseling therapy interventions, Group Art Therapy (GAT) and Group Life Stories Narrative Therapy (GLSNT). Seventeen participants completed the bi-weekly, 90-minute sessions, over a four-week period. A univariate ANCOVA with group membership as fixed independent variable was used to compare life satisfaction post scores with pre scores as covariates. Mean scores were …

The Cultural Context Of Alzheimer’S Disease: The Impact Of Perception And Knowledge On Willingness To Seek Medcial [I.E., Medical] Help Among Ghanaian Immigrants In The United States., Olivia Owusu-Boakyewaah

Theses and Dissertations

This correlational study explored the knowledge, perceived seriousness, and willingness to seek medical help for Alzheimer’s Disease (AD) among Ghanaian Immigrants currently residing in the Unites States. Study participants were 163 Ghanaian Immigrants between the ages of 45 and 90, attending Ghanaian community churches in Virginia and Maryland. Significant results include a positive correlation between knowledge and perceived seriousness of the disease, perceived seriousness of the disease was negatively correlated with caregiving experience. These results as well as several seemingly counterintuitive findings are discussed in terms of the Health Disparities and Psychometric challenges. Specifically, these results points to the necessity …

Dementia Caregiving Outcomes: The Impact Of Caregiving Onset, Role Occupancy, And Care-Recipient Decline, Katherina Nikzad-Terhune

University of Kentucky Doctoral Dissertations

Dementia is characterized as a progressive loss of brain function that results in the deterioration of many cognitive and physical abilities. Alzheimer’s disease (AD) is the most common form of dementia, causing steady declines in memory, functional abilities, and mental functioning. With a projected increase of degenerative illnesses, such as AD, family caregiving for individuals with the disease is also steadily increasing. Caring for an individual with AD has been characterized as a “career,” and within this career are a number of key transitions, including the onset of caregiving. Preexisting caregiving research reveals a number of negative consequences for AD …

Adequacy Of Diabetes Care For Older U.S. Rural Adults: A Cross-Sectional Population Based Study Using 2009 Brfss Data, M. Nawal Lutfiyya, Joel E. Mccullough, Lori Mitchell, L. Scott Dean, Martin S. Lipsky

Community Health Faculty Publications and Presentations

Background: In the U.S. diabetes prevalence estimates for adults ≥ 65 years exceed 20%. Rural communities have higher proportions of older individuals and health disparities associated with rural residency place rural communities at risk for a higher burden from diabetes. This study examined the adequacy of care received by older rural adults for their diabetes to determine if older rural adults differed in the receipt of adequate diabetes care when compared to their non-rural counterparts.

Methods: Cross-sectional data from the 2009 Behavioral Risk Factor Surveillance Survey were examined using bivariate and multivariate analytical techniques.

Results: Logistic regression analysis revealed that …

Com Outlook Fall 2010, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Medical Education Digest, Vol. 12 No. 5 (September/October 2010), Nova Southeastern University

Medical Education Digest

No abstract provided.

Program Evaluation Of A Community-Based Door-Through-Door Medical Escort Service, Lauren A. Martin

Gerontology Institute Publications

This report summarizes the program evaluation findings of a Boston-based organization’s Medical Escort program. This “door-through-door” service strives to provide medical transportation, physical assistance, and emotional support to elders on their way to the doctor’s office, during medical appointments and on the way back home again. By offering added assistance the program attempts to remove environmental barriers associated with access to health care. This evaluation combines previously collected program statistics with surveys (32) from program volunteers and phone interviews (78) with recipients.

Medical Education Digest, Vol. 12 No. 4 (July/August 2010), Nova Southeastern University

Medical Education Digest

No abstract provided.

Self-Efficacy And Educational Interventions In Heart Failure: A Review Of The Literature, Karen S. Yehle, Kimberly Plake

School of Nursing Faculty Publications

Purpose: The purpose of this study was to conduct a systematic review of the literature to better understand how to structure educational interventions for heart failure patients to improve their self-efficacy for self-care behaviors.

Methods: A computer search of the literature from 1966 through May 2009 was conducted, yielding 84 manuscripts. All manuscripts were reviewed in relation to the search criteria, resulting in 12 articles that were evaluated.

Results: Each of the reviewed studies utilized an intervention plus education to improve self-efficacy. Self-efficacy was a primary outcome for seven of the studies, and a secondary outcome for five on the …

Medical Education Digest, Vol. 12 No. 2 (March/April 2010), Nova Southeastern University

Medical Education Digest

No abstract provided.

Com Outlook Winter 2010, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Aging And The Behavioral Problems Of Brain Injury, Paul F. Aravich, Marylin Copeland

Case Studies from Age in Action

Educational Objectives

1. List the various classes of brain injury.

2. Identify cognitive and emotional problems as among the most common and disabling complications of brain injury.

3. Assess challenges to successful aging with a brain injury.

4. Examine the consequences of inadequate systems of care for the challenging behaviors produced by brain injury.

The Mds Mortality Risk Index: The Evolution Of A Method For Predicting 6-Month Mortality In Nursing Home Residents, Davina Porock, Debra Parker-Oliver, Gregory F. Petroski, Marilyn Rantz

Publications and Research

Background: Accurate prognosis is vital to the initiation of advance care planning particularly in a vulnerable, at risk population such as care home residents. The aim of this paper is to report on the revision and simplification of the MDS Mortality Rating Index (MMRI) for use in clinical practice to predict the probability of death in six months for care home residents.

Methods: The design was a secondary analysis of a US Minimum Data Set (MDS) for long term care residents using regression analysis to identify predictors of mortality within six months.

Results: Using twelve easy to collect …

Independent Living Outcomes Evaluation Project, Craig J. Padgett

All Graduate Theses, Dissertations, and Other Capstone Projects

This project developed specific examples of skills and resources for three example categories of ILST and developed recommendations for enhancing the creation of goals. It was important to develop indicators into a tiered structure for reinforcing those skills and resources into knowledge through an added educational component. Methodology was developed and necessary instrumentation and processes were designed for implementation. And, an informed consent was designed for any organization providing Independent Living Skills Training (ILST).

The Effects Of Pet Ownership On Physical Well-Being In Older Adults, Tami Pohnert

Theses and Dissertations

A large percentage of Americans own pets which may impact their health. This study examines pet ownership’s effect on well being in older adults looking at race/ethnicity. A sample of 6,565 older adults (>60) was selected from the Third National Health and Nutrition Survey. Pet owners comprised 28.3% of the sample. The theories of symbolic interaction and social integration were used to examine pet ownership’s effect on physical components of well-being. The descriptive results showed statistically significant differences in age, education, income, and marital status between pet owners and non-pet owners. Pet owners were younger, more educate, higher income …

Our Grandparents, Our Parents, Our Future Selves: Optimizing Function In Old Age., Thomas Michael Gill

Center for Policy Research

Most of my research at Yale University School of Medicine over the past several years has focused on identifying older adults at risk of functional decline and disability, identifying events that may precipitate the transition from functional independence to disability, and developing strategies to postpone or reduce frailty and disability. As a result of the Precipitating Events Project (PEP) and other research conducted by the Yale Center on Aging/Pepper Center, we now realize that age is only a proxy for other factors that lead to disability, and that some of these factors can be modified to reduce the risk of …

Hereditary 1,25-Dihydroxyvitamin D-Resistant Rickets With Alopecia Resulting From A Novel Missense Mutation In The Dna-Binding Domain Of The Vitamin D Receptor., Peter J. Malloy, Jining Wang, Tarak Srivastava, David Feldman

Manuscripts, Articles, Book Chapters and Other Papers

The rare genetic recessive disease, hereditary vitamin D resistant rickets (HVDRR), is caused by mutations in the vitamin D receptor (VDR) that result in resistance to the active hormone 1,25-dihydroxyvitamin D(3) (1,25(OH)(2)D(3) or calcitriol). In this study, we examined the VDR from a young boy with clinical features of HVDRR including severe rickets, hypocalcemia, hypophosphatemia and partial alopecia. The pattern of alopecia was very unusual with areas of total baldness, adjacent to normal hair and regions of scant hair. The child failed to improve on oral calcium and vitamin D therapy but his abnormal chemistries and his bone X-rays normalized …

Assessing Gaps In Services For Geriatric Patients With Mental Health Needs, Angela Nelson

All Graduate Theses, Dissertations, and Other Capstone Projects

Older adults in southwest Minnesota have limited options regarding mental health services. Sanford Tracy Medical Center and Sanford Westbrook Medical Center sought to identify the needs of this population so they can better serve their patients. The following research questions were asked: Do local service providers feel gaps in services exist for older adults experiencing mental health needs in the rural southwestern Minnesota communities of Tracy and Westbrook and the surrounding areas? Do area service providers feel that geriatric patients would benefit from a mental health intervention implemented within the primary healthcare setting? A survey of area geriatric service providers …

Assessing Stakeholder Opinions Of Medical Review Of Impaired Drivers And Fitness To Drive: Recommendations For Massachusetts, Nina M. Silverstein, Kelli Barton

Gerontology Institute Publications

Driving is the main mode of travel for Americans age 65 and older, and although older adults are generally found to be safe drivers, aging often brings about functional limitations and an increase in medications that can impede safe driving and fitness to drive (Rosenbloom, 2003; Kissinger, 2008; Adler & Silverstein, 2008). Effective licensing policies and Medical Advisory Board practices are critical components in identifying medically at-risk drivers and may even have a role in the transition to alternative transportation options; yet, states vary greatly in their approach to licensing and renewal practices and in the utilization, composition, and function …

Using Internet‐Based Vignette Methods To Understand Elder Residential Choices, Francis G. Caro, Teck Ho, Daniel Mcfadden, Alison Gottlieb, Christine Yee, Taizan Chan, Joachim Winter

Gerontology Institute Publications

This paper illustrates an innovative method of administering fractional factorial surveys (vignettes) using the internet. The approach makes it possible to use video clips to deliver information. The method also provides subjects with interactive options before making judgments. A study to determine the views of older people regarding residential options is used to illustrate the method. The study found that the following characteristics of vignette persons affected subject recommendations: personal introduction, functional status, social network, and current housing characteristics. However, characteristics of retirement community features and personal financial status did not affect recommendations.