Digital Commons Network^™

Creating A Standard In At-Home Pulmonary Exercise Maintenance Programs, Casey Caniglia

UNO Student Research and Creative Activity Fair

Between 12-24 million people in the United States suffer chronic obstructive pulmonary disease (COPD). COPD is linked to reduced physical activity and may be due to effects of the disease on the musculoskeletal system. Pulmonary rehabilitation (PR) clinics offer patients the chance for a better quality of life through exercise programs. However, PR typically lasts 36 sessions and is covered by Medicare. However, any maintenance past the 36 visits requires that costs to be covered by the patient. Cost and access to infrastructure are major barriers to continued supervised maintenance. Lack of confidence and motivation are barriers to at-home fitness …

Animal Assisted Therapy And Reducing Depression In Chronic Hemodialysis Patients, Dawn Delucia

Discovery Day (formerly Post & Beyond)

Chronic dialysis patients are dependent on a hemodialysis machine to cleanse their blood of waste that is normally excreted by healthy functioning kidneys. The average number of hemodialysis treatments required per week are three with an average treatment time being three to four hours per treatment. Discontinuation of hemodialysis will result in death. The only way to eliminate the need for hemodialysis is a kidney transplant (National Kidney Foundation, 2008, 2013). Hemodialysis is not without its inherent risks. Side effects can include but are not limited to: hypotension, cardiovascular complications, cramping from fluid removal, and bleeding (Aguera, Martin-Malo, Alvarez-Lara, Garcia-Montemayor, …

Can Individualized Music Reduce Agitation And Increase Meaningful Communication In Dementia Center Clients?, Catherine Pinas

Honors Capstones

No abstract provided.

Adverse Events And Treatment Discontinuations Of Antimuscarinics For The Treatment Of Overactive Bladder In Older Adults: A Systematic Review And Meta-Analysis, Scott Martin Vouri, Clark D. Kebodeaux, Paul M. Stranges, Besu F. Teshome

Pharmacy Practice and Science Faculty Publications

Introduction

Antimuscarinics should be used with caution in older adults with overactive bladder (OAB) due to anticholinergic adverse events (AEs). Systematic reviews and meta-analyses (SRMAs) have analyzed safety-related outcomes but have not specified risk in the elderly, the population at highest risk for AEs. The aim of this review is to explore and evaluate AEs and treatment discontinuations in adults 65 or older taking antimuscarinics for OAB.

Methods

Keywords were searched in MEDLINE, EMBASE, SCOPUS, and Cochrane Central Register for Controlled Trials. Randomized controlled trials (RCTs) along with sub-analyses and pooled analyses that compared antimuscarinics to placebo or another antimuscarinic …

Integrating Feminist Theory Into Myocardial Infarction Symptom Research, John R. Blakeman

Faculty Publications - Mennonite College of Nursing

Heart disease remains the number one killer of men and women globally, yet women have traditionally received less research attention in the cardiovascular literature, and an androcentric bias has persisted. Specifically, symptoms of myocardial infarction (MI) have been shown to be varied between men and women. Feminist standpoint theory is one perspective that researchers can use to explore the situated knowledge that women possess, given their unique experiences. This project incorporates a substantial body of literature, reviews feminist standpoint theory, and proposes three critical steps for MI symptom researchers to use as guides when conducting research. To advance the perspectives …

Nutritional Approaches To Achieve Weight Loss In Nonalcoholic Fatty Liver Disease., Christine C Hsu, Erik Ness, Kris V Kowdley

Articles, Abstracts, and Reports

Nonalcoholic fatty liver disease (NAFLD) can range in spectrum from simple hepatic steatosis to nonalcoholic steatohepatitis (NASH), which is characterized by lipotoxicity, hepatocellular ballooning, and inflammation and can progress to cirrhosis. Weight loss is the cornerstone treatment for NAFLD and NASH. Various randomized controlled trials have shown that weight loss of ≥5-10% leads to significant improvements in hepatic steatosis. Diets high in sodium and fructose have been implicated in the pathogenesis of NAFLD. Although some clinical studies suggest that an isocaloric high-fructose diet does not worsen NAFLD, these clinical studies are often short in duration. More recently, the Dietary Approaches …

Interleukin-1 Receptor Antagonist Polymorphism And Birth Timing: Pathway Analysis Among African American Women, Shannon L. Gillespie, Jeremy L. Neal, Lisa Christian, Laura A. Szalacha, Donna O. Mccarthy, Pamela J. Salsberry

College of Nursing Faculty Research and Publications

Background: Timing of birth is a major determinant of newborn health. African American women are at increased risk for early birth, particularly via the inflammatory pathway. Variants of the IL1RN gene, which encode the interleukin-1 receptor antagonist (IL-1Ra) protein, are implicated in early birth. The biological pathways linking these variables remain unclear. Evidence also suggests that inflammatory pathways differ by race; however, studies among African American women are lacking.

Objectives: We assessed whether an IL1RN variant was associated with timing of birth among African American women and whether this relationship was mediated by lower anti-inflammatory IL-1Ra production or …

Nutritional Assessment Of Community-Dwelling Older Adults In Rural Nepal, Saruna Ghimire, Binaya Kurmar Baral, Karen E. Callahan

School of Public Health Faculty Research

Demographic transition in Nepal, like in many developing countries, has resulted in a burgeoning elderly population whose health status is not currently monitored. One pillar of health is adequate nutrition. Yet, little is known about the nutritional health status of the elderly in Nepal. The financial, material, and personnel limitations in Nepal’s health delivery services necessitate health screening instruments that require minimal clinical staff and resources. To our knowledge, no such nutritional assessment tool has been validated in Nepal. Therefore, our aims are two-fold: To assess the nutritional status of the elderly population in one typical Nepali village, Okharpauwa, in …

Neighborhood Environment And Falls Among Community-Dwelling Older Adults, Emily Nicklett, Matthew Lohman, Matthew Smith

Dartmouth Scholarship

Falls present a major challenge to active aging, but the relationship between neighborhood factors and falls is poorly understood. This study examined the relationship between fall events and neighborhood factors, including neighborhood social cohesion (sense of belonging, trust, friendliness, and helpfulness) and physical environment (vandalism/graffiti, rubbish, vacant/deserted houses, and perceived safety walking home at night).

Neighborhood Environment And Falls Among Community-Dwelling Older Adults, Emily Joy Nicklett, Matthew C. Lohman Ph.D., Matthew Lee Smith

Faculty Publications

Background: Falls present a major challenge to active aging, but the relationship between neighborhood factors and falls is poorly understood. This study examined the relationship between fall events and neighborhood factors, including neighborhood social cohesion (sense of belonging, trust, friendliness, and helpfulness) and physical environment (vandalism/graffiti, rubbish, vacant/deserted houses, and perceived safety walking home at night). Methods: Data were analyzed from 9259 participants over four biennial waves (2006–2012) of the Health and Retirement Study (HRS), a nationally representative sample of adults aged 65 and older in the United States. Results: In models adjusting for demographic and health-related covariates, a one-unit …

The Association Of Serum Levels Of Brain-Derived Neurotrophic Factor With The Occurrence Of And Recovery From Delirium In Older Medical Inpatients, John Williams, Karen Finn, Vincent Melvin, David Meagher, Geraldine Mccarthy, Dimitrios Adamis

Department of Biological Sciences Publications

Limited studies of the association between BDNF levels and delirium have given inconclusive results. This prospective, longitudinal study examined the relationship between BDNF levels and the occurrence of and recovery from delirium. Participants were assessed twice weekly using MoCA, DRS-R98, and APACHE II scales. BDNF levels were estimated using an ELISA method. Delirium was defined with DRS-R98 (score > 16) and recovery from delirium as ≥2 consecutive assessments without delirium prior to discharge. We identified no difference in BDNF levels between those with and without delirium. Excluding those who never developed delirium (), we examined the association of BDNF levels and …

An Examination Of Students’ Perceptions Of Their Interprofessional Placements In Residential Aged Care, Karla L. Seaman, Rosemary Saunders, Elly Williams, Jane Harrup-Gregory, Helen Loffler, Fiona Lake

Research outputs 2014 to 2021

It is essential that health professionals are trained to provide optimal care for our ageing population. Key to this is a positive attitude to older adults along with the ability to work in teams and provide interprofessional care. There is limited evidence on the impact an interprofessional education (IPE) placement in a residential aged care facility (RACF) has on students. In 2015 in Western Australia, 51 students (30 % male, median age 23 years), from seven professions, undertook a placement between 2 and 13 weeks in length at 1 RACF. Pre- and post-placement measurements of attitudes to the elderly were …

Targeting Cancer Stem Cell Propagation With Palbociclib, A Cdk4/6 Inhibitor: Telomerase Drives Tumor Cell Heterogeneity., Gloria Bonuccelli, Maria Peiris-Pages, Bela Ozsvari, Ubaldo E. Martinez-Outshoorn, Federica Sotgia, Michael P Lisanti

Department of Medical Oncology Faculty Papers

In this report, we systematically examined the role of telomerase activity in lung and ovarian cancer stem cell (CSC) propagation. For this purpose, we indirectly gauged telomerase activity, by linking the hTERT-promoter to eGFP. Using lung (A549) and ovarian (SKOV3) cancer cells, transduced with the hTERT-GFP reporter, we then employed GFP-expression levels to fractionate these cell lines into GFP-high and GFP-low populations. We functionally compared the phenotype of these GFP-high and GFP-low populations. More specifically, we now show that the cancer cells with higher telomerase activity (GFP-high) are more energetically activated, with increased mitochondrial mass and function, as well as …

Understanding The Influence Of Stigma And Discrimination For The Functional Limitation Severity - Psychological Distress Relationship: A Stress And Coping Perspective, Robyn Lewis Brown

Sociology Faculty Publications

No abstract provided.

The Need For Standardized Assessment Of Muscle Quality In Skeletal Muscle Function Deficit And Other Aging-Related Muscle Dysfunctions: A Symposium Report, Rosaly Correa De Araujo, Michael O. Harris-Love, Iva Miljkovic, Maren Fragala, Brian Anthony, Todd Manini

Exercise and Nutrition Sciences Faculty Publications

A growing body of scientific literature suggests that not only changes in skeletal muscle mass, but also other factors underpinning muscle quality, play a role in the decline in skeletal muscle function and impaired mobility associated with aging. A symposium on muscle quality and the need for standardized assessment was held on April 28, 2016 at the International Conference on Frailty and Sarcopenia Research in Philadelphia, Pennsylvania. The purpose of this symposium was to provide a venue for basic science and clinical researchers and expert clinicians to discuss muscle quality in the context of skeletal muscle function deficit and other …

What Can A Primary Care Physician Discuss With Older Patients To Improve Advance Directive Completion Rates? A Clin-Iq, Judith M. Myers, Edmund Duthie Jr., Kathryn Denson, Steven Denson, Deborah Simpson

Journal of Patient-Centered Research and Reviews

Advance directives (ADs) provide patients with the opportunity to indicate their preferences for medical care while they still maintain the capacity to express their wishes, thus retaining autonomy. ADs increase the likelihood that patients will receive the care they desire, as their family members and physicians will better understand the level of care desired. Despite this, the AD completion rate by elderly patients continues to be low, especially for patients not facing serious illnesses. Primary care physicians (PCPs) are uniquely positioned to engage patients in discussions about ADs before a health crisis arises yet often do not due to time …

Dual-Task Does Not Increase Slip And Fall Risk In Healthy Young And Older Adults During Walking, Rahul Soangra, Thurmon Lockhart

Physical Therapy Faculty Articles and Research

Dual-task tests can identify gait characteristics peculiar to fallers and nonfallers. Understanding the relationship between gait performance and dual-task related cognitive-motor interference is important for fall prevention. Dual-task adapted changes in gait instability/variability can adversely affect fall risks. Although implicated, it is unclear if healthy participants’ fall risks aremodified by dual-task walking conditions. Seven healthy young and seven healthy older adults were randomly assigned to normal walking and dual-task walking sessions with a slip perturbation. In the dual-task session, the participants walked and simultaneously counted backwards from a randomly provided number. The results indicate that the gait changes in dual-task …

Neutrophil Function In Elderly Patients Hospitalized With Community- Acquired Pneumonia, Jorge Perez San Juan, Lisandra Rodriguez Hernandez, Timothy L. Wiemken, Robert R. Kelley, Rafael Fernandez-Botran, Martin Gnoni, Paula Peyrani, Madhavi J. Rane, Forest W. Arnold, Julio A. Ramirez, Silvia Uriarte, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Background: Advanced age is associated with immunosenescence as well as increased risk for poor outcomes during episodes of community-acquired pneumonia (CAP). Data on neutrophil function in hospitalized elderly patients with CAP is lacking. In this study we compared neutrophil function in elderly and non-elderly hospitalized patients with CAP.

Methods: Prospective study of healthy controls (HC) and patients hospitalized with CAP nonelderly (NE-CAP) and elderly (E-CAP). Blood samples were obtained on the day of hospitalization. The following neutrophil functional assays were performed: degranulation of secretory vesicles (CD35), degranulation of specific granules (CD66b), phagocytosis, and hydrogen peroxide (H₂O₂) …

Speech-Language Pathology Graduate Students' Perceptions Of Cultural Competency Experiences, Ragen Elizabeth Bray

Student Theses and Dissertations

This study utilized a 19-item survey to investigate whether graduate SLP students understand the spectrum of skills necessary to become “culturally competent,” and to assess the number and types of formal and informal activities used to achieve cultural competency instruction in the speech-language pathology curriculum. Graduate students enrolled in five accredited graduate programs for Communication Disorders in the state of Arkansas responded to the survey. Overall, results indicated that accredited university speech-language pathology programs in Arkansas are attempting to implement opportunities for expanding cultural awareness and sensitivity for their students. However, the results from the survey indicate that these programs …

Effect Of Life Review On Quality Of Life For Older Adults Living In Nursing Homes, Rene' Wren

Occupational Therapy Collection

Aim: To examine the effects of life review on daily activities, social participation, outlook on life, and perceptions of living in a nursing home measured by life satisfaction and quality of life in older adults.

Method: The study design was a two-phase quasi-experimental pre-post-tests including development and testing of a life review protocol. Nine residents, age ≥65, participated in a life review group once weekly for 6 weeks. Outcomes were analyzed using the Life Satisfaction Index-Z (LSI-Z) and pre-post surveys.

Results: LSI-Z scores improved post-intervention and survey outcomes indicated participation in activities of daily living (ADLs), socialization, …

The Use Of Physical Restraints In Long-Term Care In Spain: A Multi-Center Cross-Sectional Study, Gabriel J. Estévez-Guerra, Emilio Fariña-López, Eduardo Núñez-González, Manuel Gandoy-Crego, Fernando Calvo-Francés, Elizabeth Capezuti

Publications and Research

Background: Physical restraint is a procedure used frequently in long-term care. It is a controversial practice because its use is associated with numerous complications and also affects freedom and individual autonomy. The objective of this study was to examine the use of physical restraint of long-term care residents with the ability to move voluntarily.

Methods: We conducted a cross-sectional observational and correlational multi-center study. Nine centers agreed to participate. Of the 1,200 people present at the time of data collection, those without voluntary movement or in the facility for less than a month were excluded. Thus, the final sample was …

Novel Genetic Loci Associated With Hippocampal Volume, Derrek P. Hibar, Hieab H. H. Adams, Neda Jahanshad, Ganesh Chauhan, Jason L. Stein, Edith Hofer, Miguel E. Renteria, Joshua C. Bis, Laura Almasy, John Blangero, Joanne E. Curran, Ravi Duggirala, Harald H. H. Goring

School of Medicine Publications

The hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic underpinnings of hippocampal structure here we perform a genome-wide association study (GWAS) of 33,536 individuals and discover six independent loci significantly associated with hippocampal volume, four of them novel. Of the novel loci, three lie within genes (ASTN2, DPP4 and MAST4) and one is found 200 kb upstream of SHH. A hippocampal subfield analysis shows that a locus within the MSRB3 gene shows evidence …

Supporting Shared Decision-Making For Older People With Multiple Health And Social Care Needs: A Protocol For A Realist Synthesis To Inform Integrated Care Models, Frances Bunn, Claire Goodman, Jill Manthorpe, Marie-Anne Durand, Isabel Hodkinson, Greta Rait, Paul Millac, Sue L. Davies, Bridget Russell, Patricia Wilson

Dartmouth Scholarship

Introduction: Including the patient or user perspective is a central organising principle of integrated care. Moreover, there is increasing recognition of the importance of strengthening relationships among patients, carers and practitioners, particularly for individuals receiving substantial health and care support, such as those with long-term or multiple conditions. The overall aims of this synthesis are to provide a context-relevant understanding of how models to facilitate shared decision-making (SDM) might work for older people with multiple health and care needs, and how they might be applied to integrated care models.

Methods and analysis: The synthesis draws on the principles of realist …

Care Coordination In Bone Health Screening Between Individual Behaviors And Health Care Services Among Korean-American Women Across Three Age Groups, Young-Shin Lee

Asian/Pacific Island Nursing Journal

Integrated continuous care is important to prevent and treat brittle bone status in the aging process; however, minority groups often have limited access to health services. The purpose of this study was to identify the care coordination among women’s perceptions about their bone health, information from health care providers, and the results of Bone Mineral Density (BMD) tests across three age groups. The study was a cross-sectional comparative design. A total of 63 Korean American women completed both the assessment of BMD of the femoral neck and an interview survey. One’s own risks of osteoporosis, screening behaviors, and health care …

Pre- Versus Post-Exercise Protein Intake Has Similar Effects On Muscular Adaptations, Brad J. Schoenfeld, Alan A. Aragon, Colin Wilborn, Stacie L. Urbina, Sara E. Hayward, James Kriegor

Publications and Research

The purpose of this study was to test the anabolic window theory by investigating muscle strength, hypertrophy, and body composition changes in response to an equal dose of protein consumed either immediately pre- versus post-resistance training (RT) in trained men. Subjects were 21 resistance-trained men (>1 year RT experience) recruited from a university population. After baseline testing, participants were randomly assigned to 1 of 2 experimental groups: a group that consumed a supplement containing 25 g protein and 1 g carbohydrate immediately prior to exercise (PRE-SUPP) (nD9) or a group that consumed the same supplement immediately post-exercise (POST- SUPP) …

A Systems Approach To The Problem Of Falls In Old Age, Patrick A. Dillon

Theses and Dissertations--Gerontology

The problem of falls in old age is enormously costly and disruptive for the older individual, others, and society, and its severity is likely to intensify as our population ages. This dissertation takes a systems-oriented approach toward the falls problem and is presented in two parts. The first part critically develops a new approach to the problem of falls. The second part describes an empirical study that applies this new approach in a pragmatic manner.

Conventional fall prevention strategies employ a reductionist approach to the problem of falls. This approach is questioned because it corresponds poorly to the holistic nature …

Faith Community Nurses' Impact On Family Caregivers, Lori R. Anderson

All Electronic Theses and Dissertations

Title: What are the most compelling ways that faith community nurses support family caregivers? Background: The need for family caregivers will rise exponentially in the United States in the coming decades as older adults live longer lives and often with two or more chronic illnesses. Faith community nurses are uniquely positioned through their trusted presence in faith community settings to provide this support to family caregivers. Purpose: Family caregivers provide vital care to senior adults that our healthcare systems cannot absorb. Faith community nurses (FCNs) support family caregivers connected to their faith communities in tangible ways to strengthen the growing …

Validating The Health Literacy Promotion Practices Assessment Instrument, Allison P. Squires, H. Shonna Yin, Simon A. Jones, Sherry A. Greenberg, Ronnie J. Moore, Tara A. Cortes

Touro College of Pharmacy (New York) Publications and Research

Background: How health care professionals address health literacy as part of the provider-client relationship is important for prevention and promoting self-management and symptom management. Research usually focuses on patients’ health literacy and fails to examine provider practices, thus leaving a gap in the literature and patient outcomes analyses. Objective: The study tested the reliability and validity of a series of questions developed to evaluate health care provider health literacy promotion practices on an interprofessional sample. Methods: This exploratory cross-sectional study took place between 2013 and 2015. Participants included graduate level health professions students from nursing, midwifery, medicine, pharmacy, and social …

Meeting Physical Activity Guidelines And Health Outcomes In The Elderly: Are Racial Differences Important?, R. Michael Johnson

Master of Public Health Program Student Publications

Physical activity guidelines for health improvement were recommended by the Centers for Disease Control and Prevention (CDC) in 2008. Today, data on individuals’ adherence to the CDC guidelines are collected as part of its Behavioral Risk Factor Surveillance System (BFRSS) survey. While racial disparities in health outcomes are well documented, analyses of the BRFSS data have the potential to shed light on whether there are racial differences in the relationship between physical activity and health outcomes.

The 2015 (BRFSS) dataset contained responses from 441,456 individuals, including 42,516 over the age of 65 who had complete data on the variables that …

Lived Experience Of The Advanced Practice Provider On The Burn Surgery Service, Susan Lee Smith

Health Sciences Program Student Theses, Dissertations and Capstones

The purpose of this qualitative dissertation study was to examine the lived experience and meaning making of challenges, benefits, satisfaction, and professional sustainability for the advanced practice provider in the burn surgery specialty service. The problem addressed was the knowledge gap resulting from a lack of literature describing aspects of the advanced practice provider role in the burn specialty. An interpretive phenomenological analysis, informed by the philosophy of Dr. Martin Heidegger, was undertaken. Participants were solicited from the American Burn Association Advanced Practice Provider (APP) special interest group site. The results provided a thick description of the lived experience of …