Digital Commons Network^™

Impact Of A Novel Multi-Specialist Telemedicine Consultation Program Model Of Care For Homebound Older Adults, Samir K. Sinha Dr, Kristina Marie Kokorelias, Nicoda Foster, Pauline Kabitsis, Alfiya Mukharyamova, Mary Ann Hamelin, Nga Truong, Anna Grosse Dr, Janny Lee

Journal of Geriatric Emergency Medicine

BACKGROUND: In 2015, a centralised Multi-Specialist Telemedicine (TM) Consultation Program was established to improve access to specialist care and enhance continuity of care for homebound older adults in Toronto, Canada. Community-dwelling patients were referred to the program by their primary care providers (PCP), treating specialists, and inpatient physicians for specialist-led post hospital discharge follow-up care. A clinical nurse specialist (CNS) thereafter collaborated with hospital-based consulting specialists, utilizing videoconferencing technology to facilitate consultations and follow-up visits for homebound patients

METHODS: We conducted a retrospective observational study of the overall intervention including patient characteristics and the number/type of consultations provided by analyzing …

Screening Patients For Physical Frailty In The Preoperative Phase, Sean V. Pottenger, Amanuel Gebeyehu

Doctor of Nursing Practice (DNP) Student Projects

Background: Frailty is a syndrome characterized by an increased burden of symptoms and higher susceptibility to adverse health, including higher functional decline rates, pressure ulcers, falls, delirium, extended hospital stay, and discharge to assisted living facilities. Screening patients for frailty before undergoing a surgical procedure is recommended to minimize postoperative complications. In the preoperative phase at a midwestern academic hospital, surgical patients are not screened for frailty using a validated screening tool.

Purpose: This project sought to calculate the Clinical Frailty Scale (CFS) score using a novel algorithm. After validating the novel algorithm, this research project predicted that clinicians would …

Overcoming The Inner Critic: The Therapeutic Use Of Self-Portraits With Older Adults, Brenda Echeverry

Expressive Therapies Capstone Theses

Older adults are a growing and vulnerable population who experience discriminatory practices that impact their access to equitable housing, employment, and healthcare which was made even more obvious during the Coronavirus pandemic in the United States. A community engagement project was developed and facilitated by the writer to support older adults with the psychological effects of surviving the pandemic. This project also helped to increase accessibility to expressive arts therapy in the writer’s local community. Expressive arts therapy is an effective and accessible method to support mental health and wellness for people of all ages. Engagement with the arts helps …

Overcoming The Inner Critic: The Therapeutic Use Of Self-Portraits With Older Adults, Brenda Echeverry

Expressive Therapies Capstone Theses

Older adults are a growing and vulnerable population who experience discriminatory practices that impact their access to equitable housing, employment, and healthcare which was made even more obvious during the Coronavirus pandemic in the United States. A community engagement project was developed and facilitated by the writer to support older adults with the psychological effects of surviving the pandemic. This project also helped to increase accessibility to expressive arts therapy in the writer’s local community. Expressive arts therapy is an effective and accessible method to support mental health and wellness for people of all ages. Engagement with the arts helps …

Nursing Panel Presentation: Certification Champion Pilot Project To Increase Rn Specialty Certification Rates, Ari Meyers, Trisha Saul, Miriam Bender

2023 South Division Nursing Research Conference

No abstract provided.

The Mex-Cog Cognitive Assessment Battery: Discriminant Analysis Of The Cognitive Performance Profile In Older Adults, Silvia Mejia-Arango, Sara Aguilar-Navarro, Alberto José Mimenza-Alvarado

School of Medicine Publications

Objective. To analyze the cognitive profile of a clinical sample using the Mex-Cog cognitive battery and establish which cognitive measures and domains contribute most to group separation.

Materials and methods. A group of 145 older adults previously diagnosed with dementia (n= 47), mild cognitive impairment MCI (n= 47), or as cognitively normal (n= 51) were assessed with the Mex-Cog cognitive battery. Six linear discriminant analyses (LDA) were estimated to compare dementia vs. cognitively normal, MCI vs. cognitively normal, and MCI vs. dementia, using ten individual measures and six cognitive domains. We used a leave-one-out cross-validation procedure to evaluate the predictive …

Using Medicaid Data To Identify Factors That Predict Reinstitutionalization Of Mississippians With Disabilities And Elderly People, Hwanseok Choi

Journal of Public Health in the Deep South

Background: Mississippi Bridge to Independence (B2I) was Mississippi’s Money Follows the Person (MFP) program seeking to rebalance the state’s long-term care system by transitioning Medicaid beneficiaries from institutional living to home- and community-based settings (HCBS). Success of initial transitions has been documented in state cost-savings and participants’ quality of life increases. However, reinstitutionalization poses a challenge to sustaining a positive outcome for the initiative. Purpose: Therefore, the purpose of this research is to identify the underlying causes of participants’ reinstitutionalization. Methods: The Quality of Life (QoL) survey designed by Mathematica Policy Research was used to measure variables in 7 categories. …

Evaluation Of The Electronic Clinical Dementia Rating For Dementia Screening, Rachel L Nosheny, Daniel Yen, Krista Moulder, Connie Mayo, Maureen Mcmillan, John C Morris, Yan Li, Et Al.

2020-Current year OA Pubs

IMPORTANCE: The Clinical Dementia Rating (CDR) is a well-validated instrument widely used to detect and stage dementia due to Alzheimer disease. The digital Electronic Clinical Dementia Rating (eCDR) can be remotely self-administered and automatically scored, with potential to facilitate efficient dementia screening and staging.

OBJECTIVE: To evaluate the association of the eCDR with the CDR and other in-clinic assessments for screening older adults for cognitive impairment.

DESIGN, SETTING, AND PARTICIPANTS: This multisite, cross-sectional study used baseline data from a longitudinal, observational study from 2020 to 2023, including up to 3 years of follow-up. Participants were enrolled from 3 Alzheimer Disease …

Multiancestry Analysis Of The Hla Locus In Alzheimer’S And Parkinson’S Diseases Uncovers A Shared Adaptive Immune Response Mediated By Hla-Drb1*04 Subtypes, Yann Le Guen, Guo Luo, Aditya Ambati, Vincent Damotte, Iris Jansen, Eric Yu, Aude Nicolas, Itziar De Rojas, Thiago Peixoto Leal, Akinori Miyashita, Céline Bellenguez, Michelle Mulan Lian, Kayenat Parveen, Takashi Morizono, Hyeonseul Park, Benjamin Grenier-Boley, Tatsuhiko Naito, Fahri Küçükali, Seth D Talyansky, Selina Maria Yogeshwar, Vicente Sempere, Wataru Satake, Victoria Alvarez, Beatrice Arosio, Michael E Belloy, Luisa Benussi, Anne Boland, Barbara Borroni, María J Bullido, Paolo Caffarra, Jordi Clarimon, Antonio Daniele, Daniel Darling, Stéphanie Debette, Jean-François Deleuze, Martin Dichgans, Carole Dufouil, Emmanuel During, Emrah Düzel, Daniela Galimberti, Guillermo Garcia-Ribas, José María García-Alberca, Pablo García-González, Vilmantas Giedraitis, Oliver Goldhardt, Caroline Graff, Edna Grünblatt, Olivier Hanon, Lucrezia Hausner, Stefanie Heilmann-Heimbach, Henne Holstege, Jakub Hort, Yoo Jin Jung, Deckert Jürgen, Silke Kern, Teemu Kuulasmaa, Kun Ho Lee, Ling Lin, Carlo Masullo, Patrizia Mecocci, Shima Mehrabian, Alexandre De Mendonça, Mercè Boada, Pablo Mir, Susanne Moebus, Fermin Moreno, Benedetta Nacmias, Gael Nicolas, Shumpei Niida, Børge G Nordestgaard, Goran Papenberg, Janne Papma, Lucilla Parnetti, Florence Pasquier, Pau Pastor, Oliver Peters, Yolande A L Pijnenburg, Gerard Piñol-Ripoll, Julius Popp, Laura Molina Porcel, Raquel Puerta, Jordi Pérez-Tur, Innocenzo Rainero, Inez Ramakers, Luis M Real, Steffi Riedel-Heller, Eloy Rodriguez-Rodriguez, Owen A Ross, Luis Jose Royo, Dan Rujescu, Nikolaos Scarmeas, Philip Scheltens, Norbert Scherbaum, Anja Schneider, Davide Seripa, Ingmar Skoog, Vincenzo Solfrizzi, Gianfranco Spalletta, Alessio Squassina, John Van Swieten, Raquel Sánchez-Valle, Eng-King Tan, Thomas Tegos, Charlotte Teunissen, Jesper Qvist Thomassen, Lucio Tremolizzo, Martin Vyhnalek, Frans Verhey, Margda Waern, Jens Wiltfang, Jing Zhang, Eadb, Gr@Ace Study Group, Degesco Consortium, Demgene, Eadi, Gerad, Asian Parkinson’S Disease Genetics Consortium, Henrik Zetterberg, Kaj Blennow, Zihuai He, Julie Williams, Philippe Amouyel, Frank Jessen, Patrick G Kehoe, Ole A Andreassen, Cornelia Van Duin, Magda Tsolaki, Pascual Sánchez-Juan, Ruth Frikke-Schmidt, Kristel Sleegers, Tatsushi Toda, Anna Zettergren, Martin Ingelsson, Yukinori Okada, Giacomina Rossi, Mikko Hiltunen, Jungsoo Gim, Kouichi Ozaki, Rebecca Sims, Jia Nee Foo, Wiesje Van Der Flier, Takeshi Ikeuchi, Alfredo Ramirez, Ignacio Mata, Agustín Ruiz, Ziv Gan-Or, Jean-Charles Lambert, Michael D Greicius, Emmanuel Mignot

Faculty, Staff and Students Publications

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. …

The Impact Of Covid-19 On Carotid-Femoral Pulse Wave Velocity: A Systematic Review And Meta-Analysis, Iwona Jannasz, Michal Pruc, Mansur Rahnama-Hezavah, Tomasz Targowski, Robert Olszewski, Stepan Feduniw, Karolina Petryka, Lukasz Szarpak

Faculty, Staff and Students Publications

COVID-19 is a complex multisystemic disease that can result in long-term complications and, in severe cases, death. This study investigated the effect of COVID-19 on carotid–femoral pulse wave velocity (cfPWV) as a measurement to evaluate its impact on arterial stiffness and might help predict COVID-19-related cardiovascular (CV) complications. PubMed, Web of Science, Embase, and the Cochrane Library were searched for relevant studies, and meta-analysis was performed. The study protocol was registered in PROSPERO (nr. CRD42023434326). The Newcastle–Ottawa Quality Scale was used to evaluate the quality of the included studies. Nine studies reported cfPWV among COVID-19 patients and control groups. The …

Early Mobilization In Open Heart Patients, Jon Platia Bsn, Rn, Morgan Kreider Bsn, Rn, Jie Min Lee Bsn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

照顧者實用資訊手冊, 嶺南大學亞太老年學研究中心 Asia-Pacific Institute Of Ageing Studies, Lingnan University, Meng Soi, Florence Fong, Chak Kwan, Dickson Chan, Kin Chung Cheung, Lai Ieng Jay Lau, Sin Yui Sharon Chan, Kin Ho William Li, Ka Ho, Alan Li

Manual & Guide 手冊及指引

手冊源起

香港面對人口高齡化，醫療和福利系統無可避免面臨持續的挑戰。照顧者因壓力問題而引發的家庭悲劇時有發生，反映照顧者自身亦極需要社會的重視和支援。

現時照顧者人數眾多，當中不乏配偶、父母、子女、女婿、媳婦，對長者照顧及社會無酬的付出，確實值得社會的認同和肯定。然而，儘管本港為長者及照顧者提供不少支援服務，由於不同的原因，照顧者似乎未有善用現有的服務，常常需要一力承擔所有照顧的責任，這無疑增加了他們的壓力。

照顧者需求多樣性

照顧者有不同種類，所需要的服務或支援亦有所不同。例如：「新手照顧者」剛開始接觸照顧工作，需要盡快提升日常護理和相關的疾病知識，以及獲得合適的離院/復康服務支援。「隱蔽照顧者」一直承擔照顧工作但沒有接受任何支援，因此，他們需要的是服務提供者/鄰里的主動接觸，並被轉介合適的照顧服務，以分擔他們部分照顧工作。「高危照顧者」幾乎長時間被照顧的工作佔據了其生活，他們需要的是喘息空間和暫託服務，甚至可能是情緒支援。即使「資深的照顧者」也可能需要喘息或暫託的支援服務去減輕壓力；而結束了照顧工作的「畢業照顧者」，無論是情緒的支援，還是重新規劃財務與就業的安排，都有非常實際的需求。基於照顧者的不同需要，照顧者的支援和服務也是多樣化，如何讓不同種類的照顧者能夠輕易了解現有的社區支援服務、可考慮甚麼因素選取相關服務、如何獲取所需的支援包括申領經濟支援或預早準備長期護理開支、如何自強增值等，都是這本手冊希望解答的問題。

手冊的目的

編製這本手冊的目的就是要減少照顧者四處尋找資訊的麻煩，提供一個整全且易於瀏覽的資訊來源。本手冊主要有兩大目標：其一，幫助照顧者認識不同的服務和資源，積極尋求援助；其二是一站式提供豐富的資訊服務，提升照顧者的能力和平衡身心健康。

手冊的意義

此手冊的社會意義是期望提高大眾對照顧者需要的關注，並引導更多的行動以支援照顧者。如果您的親友是照顧者，又或您認識的朋友甚至鄰居正面對照顧家人的困難，您可以主動伸出援手，又或利用這本手冊作為啟示，向他們介紹相關的服務。

另外，這本手冊可以視作為支援照顧者的工具，讓照顧者明白在承擔照顧家人的重任時並不需要孤軍奮戰，也可以善用社區提供的各種資源和服務。

手冊架構

本手冊由四個主要部分組成，每部分都專注於特定的主題，旨在提供照顧者的全方位支援和資訊，幫助他們在面對挑戰時能夠有所依賴，並從中獲得力量：

第一部分主要提供基礎知識，其中包括不同種類的照顧者的介紹、四種長者常見疾病（包括認知障礙、中風、老年抑鬱和癌症）的病徵說明、以及照顧者可能面臨的壓力與「喘息服務」的重要性。第二部分專注介紹長者常用的社區及健康服務。我們按照地區將服務機構進行了分類，羅列「認知障礙、中風、老年抑鬱、癌症」常用的服務機構，此外，我們還提供家居安全、樂齡科技租賃服務，以及財務支援等相關建議。第三部分將焦點重新放回照顧者身上，提供了支援照顧者的社福機構介紹、照顧者同路人的心得分享，以及照顧者的培訓資訊，旨在幫助照顧者在面對困難時能自強不息。最後，在本手冊的結尾部分，我們特別邀請了四位專家學者就照顧者政策提出見解和建議，為加強照顧者支援服務提供新思路。

如果按持份者來分類，手冊的四個部分的重點如下：

第一部分：照顧者的基礎知識

◎ 針對預備照顧者、新手以及隱蔽照顧者，讓他們了解照顧者的角色和需要；照顧體弱長者的基礎知識，並提供應對壓力的建議，包括自我照顧和喘息服務等。

第二部分：照顧者支援

◎ 針對所有護老者，提供長者常用的社區服務、健康服務和支援計劃，包括暫託、住宿、護送及陪診、善別支援、情緒支援、復康用品津貼及租賃的支援計劃，以及財務策劃師提供的理財貼士。

第三部分：照顧者自強

◎ 針對照顧者，資訊包括不同的照顧者支援組織、同路人和畢業照顧者的經驗心得、培訓課程，以及實用的電子資訊平台推介。

第四部分：對照顧者支援政策的看法和展望

◎ 針對服務提供者、政策倡議者及制定者，提供專家學者對照顧者服務及政策的未來發展方向的看法和建議，以期引發更多關於「如何為照顧者提供更好支持」的討論。

給讀者的使用指引

本手冊內容十分豐富，讀者可以先瀏覽目錄，選擇與您相關的部分進行細讀。對於新手照顧者或剛接觸/關注護老服務的人士(例如：學生、社區人士)，我們建議您可以參考手冊第24-33頁「給照顧者的智慧錦囊」的個案，了解不同照顧者可能面對的情境，這可能會給您一點概念，讓您可以考慮尋求哪些支援服務，又或您身邊照顧者朋友有哪些需要，以及如何協助他們獲取所需要的支援。我們深知閱讀本手冊時，您可能會遇到一些不明白的地方，請不必感到困惑。您可以嘗試找身邊的朋友、鄰居或社會服務機構的工作人員一起閱讀，或者向本中心的職員進行查詢。

此外，為方便讀者可以隨時隨地閱讀而不需要攜帶整本手冊，我們為本手冊設立了一個專屬網頁，免費下載整本手冊或某些章節內容。

希望您在閱讀的過程中能找到有用的資訊，並能從中獲得實際的幫助。

Acceptance Of Communication Technology, Emotional Support And Subjective Well-Being For Chinese Older Adults Living Alone During Covid-19: A Moderated Mediation Model, Ze Ling Nai, Woan Shin Tan, William Tov

Research Collection School of Social Sciences

Stringent social distancing measures implemented to control the spread of COVID-19 affected older adults living alone by limiting their social interaction beyond their households. During these restrictions, interactions beyond the household could be facilitated by communication technology (CT) such as voice calls, instant messages. Our study provides evidence on how CT acceptance could influence the emotional support and in turn, subjective well-being (SWB) of older adults living alone. We did a cross-sectional survey with 293 community-dwelling Chinese older adults. Participants were surveyed from September to November 2020 and had completed measures on CT acceptance (competency), emotional support, and SWB. PROCESS …

Life’S Essential 8: Optimizing Health In Older Adults, Manish Kumar, Ariela Orkaby, Caitlan Tighe, Dennis T Villareal, Hayley Billingsley, Michael G Nanna, Min Ji Kwak, Namit Rohant, Shreya Patel, Parag Goyal, Scott Hummel, Christina Al-Malouf, Amie Kolimas, Ashok Krishnaswami, Mike W Rich, James Kirkpatrick, Abdulla A Damluji, George A Kuchel, Daniel E Forman, Karen P Alexander

Faculty, Staff and Student Publications

The population worldwide is getting older as a result of advances in public health, medicine, and technology. Older individuals are living longer with a higher prevalence of subclinical and clinical cardiovascular disease (CVD). In 2010, the American Heart Association introduced a list of key prevention targets, known as "Life's Simple 7" to increase CVD-free survival, longevity, and quality of life. In 2022, sleep health was added to expand the recommendations to "Life's Essential 8" (eat better, be more active, stop smoking, get adequate sleep, manage weight, manage cholesterol, manage blood pressure, and manage diabetes). These prevention targets are intended to …

(2011) Grandparents Raising Grandchildren: The Effects, Counseling Challenges, And Strategies, Harriet A. Bachner

Louisiana Journal of Counseling

For more than 20 years the number of grandparents who have taken over the role of the primary custodial caregiver of their grandchildren has steadily increased. There has been burgeoning investigation and interest into this phenomenon that affects the largest segment of the U.S. population, the baby boom generation, as well as older adults. This report provides an overview of the most critical issues that have been covered in the literature and identifies some of the challenges for counselors who work with both the grandparents and the children. Some counseling strategies that have been shown to be promising in dealing …

An Update On The Healthy Soldier Effect In U.S. Veterans, Erin Sullivan-Baca, Rizwana Rehman, Zulfi Haneef

Faculty, Staff and Students Publications

Introduction: The healthy soldier effect (HSE) describes a phenomenon of enduring health and lower mortality among veterans due in part to initial screening procedures and health care access. Although early data were supportive of a broad HSE among former military members, more recent investigations have suggested a possible attenuation of the effect with older age. The present study aimed to provide an update of the HSE using an expansive Veterans Health Administration (VHA)-wide sample with a particular focus on age and sex effects.

Materials and methods: Mortality data for veterans within the VHA were obtained from the VHA Support Service …

Indonesia And Malaysia Students’ Quality Of Life After The Covid-19 Pandemic: A Mixed Methods Study, Juster Juster Sinaga, Mawaddah Sarif, Siti Aishah Hassan

Jurnal Kajian Bimbingan dan Konseling

Learning from home during the COVID-19 pandemic and learning face-to-face at school with strict health protocols during the COVID-19 pandemic have long-term negative effects on the psychological health of students. This situation may impact life quality (QoL). To measure students’ quality of life, mixed methods were adopted. Participants in this research ranged in age from 12 to 19 years. The study involved a total of 139 research participants. Kidscreen-27 questionnaires with a reliability coefficient of 0.913 percent were used. The interviews were conducted according to a set of defined rules. This data was collected online. The analysis was quantitative, qualitative, …

(2016) Pharmacology Training Of Counselors, Jessica Fanguy Cortez, Chris Rachal

Louisiana Journal of Counseling

As the use of psychotropic medications to treat mental illness increases across the lifespan, the need for psychopharmacology training for counselors intensifies. Research by Sepulveda (2011) concluded that counselor educators are not overwhelmingly supportive of including a psychopharmacology course in CACREP–approved school counselor curricula. Expanding on Sepulveda’s (2011) work, our findings indicate that most CACREP-approved counseling programs do not offer psychological or psychopharmacology courses. Most program directors favor such courses in their programs, and agree that licensed counselors are routinely confronted with medication issues in professional settings. But despite the fact that most programs lack training in psychopharmacology, directors believe …

Abdominal Aortic Calcification, Bone Mineral Density And Fractures: A Systematic Review And Meta-Analysis Of Observational Studies, Abadi K. Gebre, Joshua R. Lewis, Kevin Leow, Pawel Szulc, David Scott, Peter R. Ebeling, Marc Sim, Germaine Wong, Wai H. Lim, John T. Schousboe, Douglas P. Kiel, Richard L. Prince, Alexander J. Rodriguez

Research outputs 2022 to 2026

Background: Abdominal aortic calcification (AAC) has been inconsistently associated with skeletal health. We aimed to investigate the association of AAC with bone mineral density (BMD) and fracture risk by pooling the findings of observational studies. Methods: MEDLINE, EMBASE, Web of Science, and Google Scholar were searched (August 2021). All clinical studies that assessed the association between AAC and BMD or fracture were included. AAC was categorized into any/advanced (all higher reported groups) versus no/less advanced (lowest reported group). Pooled standardized mean differences (SMDs) and risk ratios (RRs) with 95% confidence intervals (CI) were determined for BMD and fracture, respectively, using …

Radioprotective Effects Of Melatonin And Thymoquinone On Liver, Parotid Gland, Brain, And Testis Of Rats Exposed To Total Body Irradiation, Mehmet Koç, Çi̇ğdem Damla Deni̇z, Mehmet Aki̇f Eryilmaz, Yilmaz Tezcan, Mehmet Gürbi̇lek

Turkish Journal of Medical Sciences

Background/aim: This study aimed to investigate thymoquinone (TQ), and melatonin's radioprotective effects on liver, parotid gland, brain, and testis of rats which were exposed to total body irradiation (IR). Materials and methods: Thirty adult Wistar rats were randomly divided into four groups that are Group 1 (control group): total body IR only, Group 2: IR-Melatonin (10 mg/kg), Group 3: IR-TQ (10 mg/kg), and Group 4 (sham group): nothing. Total body IR dose was 6 Gy. Tissue samples were taken 90 min after IR. The measurements of malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) were performed in all groups. …

Beyond Economics And Politics : A Sociological Review Of Local Long-Term Care Service Provision In China, Zhen Tian

Lingnan Theses (MPhil & PhD)

The socio-demographic transition presents a significant challenge that impacts the renewal of welfare arrangements and the reallocation of welfare responsibilities across sectors. Long-term care (LTC) services have emerged as a widely accepted strategy to promote the active daily living and human dignity of senior citizens. This study aims to assess the effective policy strategies employed in various Chinese contexts to address significant LTC policy concerns and synthesise lessons that can guide future policy decisions. The study addresses three questions to explore local variations in China's LTC service provision: (1) What differences exist in the long-term care services provision? (2) How …

Enigma Chek2gether Project: A Comprehensive Study Identifies Functionally Impaired Chek2 Germline Missense Variants Associated With Increased Breast Cancer Risk, Lenka Stolarova, Petra Kleiblova, Petra Zemankova, Barbora Stastna, Marketa Janatova, Jana Soukupova, Maria Isabel Achatz, Christine Ambrosone, Paraskevi Apostolou, Banu K Arun, Paul Auer, Mollie Barnard, Birgitte Bertelsen, Biobank Japan, Marinus J Blok, Nicholas Boddicker, Joan Brunet, Elizabeth S Burnside, Mariarosaria Calvello, Ian Campbell, Sock Hoai Chan, Fei Chen, Jian Bang Chiang, Anna Coppa, Laura Cortesi, Ana Crujeiras-González, Consortium Czecanca, Kim De Leeneer, Robin De Putter, Allison Depersia, Lisa Devereux, Susan Domchek, Anna Efremidis, Christoph Engel, Corinna Ernst, D Gareth R Evans, Lidia Feliubadaló, Florentia Fostira, Olivia Fuentes-Ríos, Encarna B Gómez-García, Sara González, Christopher Haiman, Thomas Van Overeem Hansen, Jan Hauke, James Hodge, Chunling Hu, Hongyan Huang, Nur Diana Binte Ishak, Yusuke Iwasaki, Irene Konstantopoulou, Peter Kraft, James Lacey, Conxi Lázaro, Na Li, Weng Khong Lim, Sara Lindstrom, Adriana Lori, Elana Martinez, Alexandra Martins, Koichi Matsuda, Giuseppe Matullo, Simone Mcinerny, Kyriaki Michailidou, Marco Montagna, Alvaro N A Monteiro, Luigi Mori, Katherine Nathanson, Susan L Neuhausen, Heli Nevanlinna, Janet E Olson, Julie Palmer, Barbara Pasini, Alpa Patel, Maria Piane, Bruce Poppe, Paolo Radice, Alessandra Renieri, Nicoletta Resta, Marcy E Richardson, Toon Rosseel, Kathryn J Ruddy, Marta Santamariña, Elizabeth Santana Dos Santos, Lauren Teras, Amanda E Toland, Amy Trentham-Dietz, Celine M Vachon, Alexander E Volk, Nana Weber-Lassalle, Jeffrey N Weitzel, Lisa Wiesmuller, Stacey Winham, Siddhartha Yadav, Drakoulis Yannoukakos, Song Yao, Valentina Zampiga, Magnus Zethoven, Ze Wen Zhang, Tomas Zima, Amanda B Spurdle, Ana Vega, Maria Rossing, Jesús Del Valle, Arcangela De Nicolo, Eric Hahnen, Kathleen B M Claes, Joanne Ngeow, Yukihide Momozawa, Paul A James, Fergus J Couch, Libor Macurek, Zdenek Kleibl

Faculty, Staff and Student Publications

PURPOSE: Germline pathogenic variants in CHEK2 confer moderately elevated breast cancer risk (odds ratio, OR ∼ 2.5), qualifying carriers for enhanced breast cancer screening. Besides pathogenic variants, dozens of missense CHEK2 variants of uncertain significance (VUS) have been identified, hampering the clinical utility of germline genetic testing (GGT).

EXPERIMENTAL DESIGN: We collected 460 CHEK2 missense VUS identified by the ENIGMA consortium in 15 countries. Their functional characterization was performed using CHEK2-complementation assays quantifying KAP1 phosphorylation and CHK2 autophosphorylation in human RPE1-CHEK2-knockout cells. Concordant results in both functional assays were used to categorize CHEK2 VUS from 12 ENIGMA case-control datasets, including …

Fall Risk Identification And Reduction Among The Gerontological Population At A Long-Term Care Facility, Esther A. Lowe, Breanna Cates, Lisa James, Ashley Samson, Jowel Ochoa, Matthew Ng

Master's Projects and Capstones

Abstract

Problem: Data obtained from the facility from February 2022 to July 2023 showed that there were a total of 110 falls at the facility with 51% resulting in injury. The facility also lacked a standardized fall assessment tool with minimal follow up after fall incidents.

Context: A microsystem assessment of the geriatric population at the long-term care facility indicated the need for a standardized fall risk screening tool to accurately assess patients.

Interventions: A staff presentation was created highlighting the high rate of falls at the facility as well as to educate on the implementation of the Morse Fall …

Reduce Extended Length Of Stay By Reducing In-Hospital Falls, Norberto Benitez

Master's Projects and Capstones

Abstract

Problem: Every year, there are many in-hospital falls (IHFs). Nationally there are between 700,000 to 1 million falls recorded each year. Hospital falls financially burden our healthcare industry, costing approximately 34 billion annually. Context: In a local hospital in Northern California, Marin County, the microsystem has had an extraordinary number of in-hospital falls (IHFs). To date (June 2023), 13 falls have been recorded thus far; the microsystem is on track to beat the previous year's record number of 21 falls in a calendar year. Interventions: The MSN–CNL student proposed re-educating staff, resetting expectations, and reestablishing workflow. We also sought …

The Association Of Hobbies And Leisure Activities With Physician Burnout And Disengagement, Yan Li, Cindy Y. Lai, Bill Friedrich, Chenxing Liu, Joel H. Popkin

Journal of Wellness

Introduction: Burnout among physicians is a worldwide burden. While many causes of physician stress have been reported, we have found few quantitative studies of associations between burnout and participation in hobbies and interests outside of medicine. Our objective was to determine if health care professional burnout/disengagement could be mitigated by incorporating leisure interests and to characterize which specific interests, if any, are most significantly related.

Methods: We conducted an online survey of 2,563 US-based physicians and 512 residents/fellows and queried their participation in a list of 117 individual hobbies, which we then further categorized into three perceived levels …

Implementing A Bedside Rounding Tool To Reduce Inpatient Falls, Steven W. Garcia

Master's Projects and Capstones

Problem: Each year, thousands of patients sustain falls while hospitalized, resulting in an increase in serious injuries or death. In a Neuroscience Step Down Unit (NSDU), fall rates in 2022 were higher than the NDNQI benchmark. Despite a thorough fall prevention policy, nurses inconsistently implemented preventative interventions, resulting in increased falls.

Context: The NSDU is a 15-bed inpatient unit providing intermediate-level care for patients with neurological and neurosurgical diagnoses. The unit is part of a 459-bed academic medical center and safety net hospital providing tertiary and quaternary care in southern California.

Interventions: A bedside safety rounds checklist for charge nurses …

Rounding With A Purpose: Reducing Falls In Geriatrics Residing In A Community Living Center, Ashley Wesson

Student Scholarly Projects

Practice Problem: Falls among geriatrics continue to be a significant concern for healthcare organizations and one of the costliest healthcare problems attributed to increased morbidity and mortality rates. Falls rates in residential dwellings such as nursing homes and community living centers (CLCs) continue to rise despite fall prevention efforts.

PICOT: The PICOT question that guided this project was In geriatrics, age 65 or older, who reside in the Community Living Center (P), how does one-hour purposeful rounding (I), compared to rounding without structured set time intervals (C), affect fall reduction rates (O), within eight weeks (T)?

Evidence: In fifteen high-quality …

A Multi-Stakeholder Perspective On Quality Of Care Among Residents, Family Members And Nursing Staff In Nursing Homes: A Balanced Centricity Approach, Sil Aarts, Erica De Vries, Hilde Verbeek, Gaby Odekerken, Katya Y. J. Sion

Patient Experience Journal

The objective of this study was to use a Balanced Centricity (BC) approach to describe how personal values related to experienced quality of care are defined for residents, family and nursing staff in nursing homes. Capturing the values from a multi-stakeholder perspective, a qualitative approach was conducted in which the stakeholders’ (e.g., residents, family members of residents and nursing staff; a triad) experiences, opinions and values were explored. Participants were recruited from ten nursing homes within the Living Lab in Ageing & Long-Term Care Limburg, the Netherlands. The audio recording of every interview was transcribed verbatim. The analysis made use …

The Role Of Occupational Therapy Practitioners In The Care Of Pets And Animals: A Guide To Aging In Place With Pets And Animals, Blake Randell, Mary Jan Greer, Sherry Pidgeon

Summer 2023 Virtual OTD Capstone Symposium

This capstone project explored the role of occupational therapy practitioners in the care of pets and animals among older adults which has been referred to as the forgotten instrumental activity of daily living (or IADL) for this population. A needs assessment was conducted to determine how to provide facilitators and remove barriers or hindrances to occupational performance in the care of pets and animals among a group of older adults (with a variety of disability- and non-disability-related needs) in independent living communities. This needs assessment identified compounding health disparities of physical and/or cognitive impairments and lack of financial and necessary …

The Impact Of Social Determinants Of Health And Acculturation On Quality Of Life In Older Chinese American Adults With Chronic Pain: A Quantitative Study, Chi Lam

Dissertations

Despite a rapid increase in the older Chinese American adult population, there are very few research studies examining the impact of social determinants of health and acculturation on the quality of life in older Chinese American adults. The purpose of the study was to determine the impact of social determinants of health and acculturation on quality of life in older Chinese American adults with chronic pain. This quantitative, descriptive correlational study utilized Madeleine Leininger’s Transcultural Theory as its theoretical framework. Two research questions guided this study: (1) Was there a difference in the quality of life in older Chinese American …