Digital Commons Network^™

Quality Improvement Initiative To Reduce Fall Risk In The Snf, Ramona C. Lancaster

Walden Dissertations and Doctoral Studies

Residents who fall in SNF either sustain significant decline to quality of life or die from their injuries. The average fall costs about $34,000 per incident. On average, 19.8% of residents fall at least once per month. The purpose of this project was to assess, identify, and advance nursing practice to decrease falls by evaluating current facility standard of practice, fall policy, procedures, and protocol. The objective was to create actions that would close the communication gap between clinicians and residents. This project encourages clinicians to intertwine resident feedback and strategies into the plan of care to help reduce fall …

Time To Refocus Assessment Of Vision In Older Adults? Contrast Sensitivity But Not Visual Acuity Is Associated With Gait In Older Adults, James Loughman, Eoin Duggan, Orna Donoghue,, Rose Anne Kenny, Hilary Cronin, Ciarán Finucane

Articles

Background:

The relationship between measures of visual function and gait related risk factors for falls is unclear. In this study, we examine the relationship between visual function (visual acuity [VA] and contrast sensitivity [CS] at multiple spatial frequencies) and quantitative spatiotemporal gait, using a large, nationally representative sample of community dwelling older adults.

Methods: Participants aged 50 and over were recruited as part of The Irish Longitudinal Study on Ageing (TILDA). VA was measured with the LogMAR chart according to the Early Treatment of Diabetic Retinopathy Study protocol. CS was measured at five spatial frequencies ranging 1.5 to 18 cycles …

An 8-Week Thoracic Spine Stabilization Exercise Program Improves Postural Back Pain,Spine Alignment, Postural Sway, And Core Endurance In University Students:A Randomized Controlled Study, Şeyda Toprak Çelenay, Derya Özer Kaya

Turkish Journal of Medical Sciences

Background/aim: To investigate the effects of an 8-week thoracic stabilization exercise program on back pain, spinal alignment, postural sway, and core endurance in university students. Materials and methods: University students were randomly allocated into exercise (n: 28) and control (n: 25) groups. The exercise program was carried out 3 days a week for 8 weeks. Postural pain, spinal alignment, postural sway, and core endurance were assessed via visual analogue scale, Spinal Mouse, Biodex Balance System, and McGill?s trunk muscle endurance tests at the baseline and after 8 weeks of training. Results: Differences were observed for postural pain, thoracic and lumbar …

Diabetes Self-Management Problems Of Older, Low-Income African American Women, Pearlean Day Day

Walden Dissertations and Doctoral Studies

Type 2 diabetes disproportionately affects low-income African American women, age 50 years and older: 30% to 40% of this population has this chronic disease. Two significant factors affecting poor diabetes practice adherence are food insecurity and depression; another is obesity. The purpose of this quantitative correlational study was to determine if either food insecurity or depression significantly affect Type 2 diabetes self-management practices; and/or if food insecurity significantly influences practice adherence indirectly, through the mediator of depression, while controlling for obesity. The research questions were aligned with the theoretical pathways posited in Matthews's reserve capacity model (RCM) and used the …

Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser

Walden Dissertations and Doctoral Studies

Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults …

Leadership Among Directors Of Social Services At Rehabilitative Healthcare Chains, John Paul Tuanqui Abenojarj

Walden Dissertations and Doctoral Studies

Rehabilitation and healthcare centers (RHCs) provide ongoing care to the elderly and chronically ill. To maximize the quality of this care, RHC staff must be properly trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies, and interactions of facility administrators and nursing directors, there is a substantial gap in the literature on the leadership styles and strategies employed by directors of social services (DSSs). The aim of this phenomenological study was to address this gap in the research by exploring how DSSs influenced leadership policies, prepared subordinates for crisis intervention …

Use Of Tai Chi To Treat Mental Health Disorders In Veterans, Mekeesha Mcclure

Walden Dissertations and Doctoral Studies

Clinicians have a challenge of discovering and implementing new ways to address their patients' health concerns. Some healthcare needs are not completely managed with pharmacotherapy and invasive procedures alone. Military veterans compose a special group due to multiple needs related to physical and emotional symptoms resulting from exposure to trauma. This project explored the benefits of a Tai Chi recreational therapy program. The goal of this trial was to examine gentle movement routines of Tai Chi for emotional benefits for veterans. The literature review provided insight from current evidence into the probable outcome of including alternative medicine options into regular …

Initial Findings Of A Medicare Annual Wellness Visit Program, Hesper B. Nowatzki

Walden Dissertations and Doctoral Studies

Despite the emphasis of benefits on preventive health, many older adults are not receiving the recommended age specific, evidence based screenings and vaccinations. The Medicare Annual Wellness Visit (AWV) is designed to address modifiable risk factors with aging adults and close gaps in care not captured in routine office visits. Although a free Medicare benefit to patients, and a reimbursable service to health care providers, participation in the AWV is low nationwide. The purpose of the project is to introduce an AWV program to a rural health clinic in Northwest Illinois that has a population consisting of over 25% of …

Physical Therapy Faculty, Unm Department Of Orthopaedic Surgery

UNM Orthopaedic Research Journal

No abstract provided.

Effectiveness Of A Wearable Fitness Tracker: Practice Implications In Allied Health -- A Single Case Study, Thomas William Miller

Internet Journal of Allied Health Sciences and Practice

ABSTRACT

Purpose: The purpose of this single case study was to examine the effectiveness of utilizing a wearable fitness tracker device in self-monitoring behavior change in complying with prescribed treatment. It was hypothesized that using a wearable self-monitoring device while involved in the treatment of multiple medical conditions will be beneficial to behavioral compliance and behavioral change in an overweight type 2 diabetic, geriatric subject being treated by a multidisciplinary health team utilizing an integrated treatment model.

Methods: An exploratory single case study research design is employed to explore those situations in which the intervention, a wearable monitoring device, is …

The Little Big Genome: The Organization Of Mitochondrial Dna, Iraselia Garcia, Edith Jones, Manuel Ramos, Wendy Innis-Whitehouse, Robert Gilkerson

School of Medicine Publications

The small (16,569 base pair) human mitochondrial genome plays a significant role in cell metabolism and homeostasis. Mitochondrial DNA (mtDNA) contributes to the generation of complexes which are essential to oxidative phosphorylation (OXPHOS). As such, mtDNA is directly integrated into mitochondrial biogenesis and signaling and regulates mitochondrial metabolism in concert with nuclear-encoded mitochondrial factors. Mitochondria are a highly dynamic, pleiomorphic network that undergoes fission and fusion events. Within this network, mtDNAs are packaged into structures called nucleoids which are actively distributed in discrete foci within the network. This sensitive organelle is frequently disrupted by insults such as oxidants and inflammatory …

Regulation Of Core Body Temperature And The Immune System Determines Species Longevity, Ian J. Martins

Research outputs 2014 to 2021

The anti-aging gene Sirtuin 1 has now major relevance to genetics and the fields of pharmacology, toxicology, neuroscience, immunology, biochemistry and cell/molecular biology. Advances in anti-aging therapy are now essential to prevent mitochondrial apoptosis to promote longevity with the prevention of accelerated ageing. Calorie restriction that maintains the anti-aging gens changes the core body temperature and promotes species longevity. Stress and calorie consumption are sensitive to Sirt 1 function with relevance heat shock protein 70 metabolism and mitochondrial biogenesis. Sirt 1 regulation of the circadian rhythm mediates melatonin effects on core body temperature regulation and immune responses. Diet and fat …

Multiethnic Genome-Wide Meta-Analysis Of Ectopic Fat Depots Identifies Loci Associated With Adipocyte Development And Differentiation, Audrey Y. Chu, Xuan Deng, Virginia A. Fisher, Alexander Drong, Yang Zhang, Mary F. Feitosa, Ching-Ti Liu, Olivia Weeks, Audrey C. Choh, Qing Duan, Thomas D. Dyer

School of Medicine Publications

Variation in body fat distribution contributes to the metabolic sequelae of obesity. The genetic determinants of body fat distribution are poorly understood. The goal of this study was to gain new insights into the underlying genetics of body fat distribution by conducting sample-size weighted fixed-effects genome-wide association meta-analyses in up to 9,594 women and 8,738 men for six ectopic fat traits in European, African, Hispanic, and Chinese ancestry populations, with and without sex stratification. In total, 7 new loci were identified in association with ectopic fat traits (ATXN1, UBE2E2, EBF1, RREB1, GSDMB, GRAMD3 and ENSA; PATXN1 and UBE2E2 …

Feasibility Of Presurgical Exercise In Men With Prostate Cancer Undergoing Prostatectomy, Favil Singh, Robert Newton, Michael Baker, Nigel Spry, Dennis Taaffe, Jeffery Thavaseelan, Daniel A. Galvao

Research outputs 2014 to 2021

Background:

Prostatectomy is associated with short- and long-term morbidity, which includes attenuation of muscle function and deterioration of lean body mass. Physical function is a known predictor of morbidity and mortality, with initial evidence indicating that presurgical exercise is associated with fewer postsurgical complications and shorter hospitalization. The aim was to determine the feasibility of a supervised presurgical exercise program for prostate cancer (PCa) patients scheduled for prostatectomy.

Methods:

Ten men (68+6.4 years old) with localized PCa undertook a 6-week resistance and aerobic exercise program prior surgery. Training was undertaken twice weekly and patients were assessed at baseline, presurgery, and …

Patterns Of New Physical Problems Emerging In Long-Term Care Residents With Dementia, Christine R. Kovach, Julie L. Ellis, Crystal-Rae Walton

College of Nursing Faculty Research and Publications

Individuals receiving skilled nursing care have multiple comorbid conditions that impact comfort and resource use. The current study describes variations in the trajectories of new physical problems emerging over 8 weeks and the predictive value for future health and behavior in a sample of 72 residents with dementia. Residents had two to 37 new physical problems occurring over 8 weeks. Sixty-five percent of the sample had five or more new problems and were identified by three unstable trajectories. Common problems, illnesses, and symptoms accounted for 28.2% of the variance in subsequent new physical problems (p < 0.001) and 25.7% of the variance in subsequent agitation (p < 0.001). This study found more new problems than earlier studies that only examined new acute illness. Findings suggest a higher intensity of need for skilled assessment and treatment than may be available in many long-term care organizations.

Pengembangan Media Layanan Informasi Menghadapi Perubahan Masa Pubertas Bagi Siswa Sekolah Dasar, Fitri Firdayati, Ella Faridati Zen, Elia Flurentin

Jurnal Kajian Bimbingan dan Konseling

This research aims to produce a product in the form of information service media "dealing with changes in puberty" for elementary school students. The research method used is research and development adapted from the Borg and Gall development model with the following procedures: (1) planning; (2) product development; (3) product testing; (4) final product revision. Product trial data is analyzed quantitatively and qualitatively. Based on the results of the product trial assessment, it can be concluded that the product is very appropriate, very useful, very easy and very interesting theoretically and practically, so it can be used as a medium …

Factors Related To Diagnosis Of Community-Acquired Pneumonia In The Elderly, Elza Febria Sari, C. Martin Rumende, Kuntjoro Harimurti

Jurnal Penyakit Dalam Indonesia

Introduction. Diagnosing community-acquired pneumonia (CAP) in the elderly remains a clinical challenge for various reasons. The clinical manifestation in the elderly is not frank and atypical manifestations, e.g. falls, decrease of functional status and food intake or urinary incontinence, may be present. These reasons may be associated with under or over diagnosis, which consequently contribute to the higher observed mortality rate in the elderly population with CAP. Study about factors related to diagnosis of CAP in the elderly was ra rely performed.

Methods. From January to October 2010, 158 elderly patients suspected of having pneumonia at RSCM were registered. Relationship …

Safety Culture And Fall Prevention: A Collaborative Effort, Cecilia Cortina

Seton Hall University DNP Final Projects

Patient falls in the United States (US) range from 700,000 to one million annually and one third of those falls can be prevented (Du Pree, Fritz-Campiz & Musbeno, 2014). Twenty to 30% of falls are moderate to severe (Schimke & Schimke, 2014). As of 2009, The Joint Commission’s (TJC) (2015) Sentinel Event databank held 465 reports of hospital falls with injury; deaths that resulted in those injuries were reported as 63 percent. Common denominators resulting in patient falls with injury are poor assessment, lack of communication, failure to follow protocols, insufficient training and supervision, staffing levels, unsafe environments and lack …

A Resident-Centered Dementia Care Staff Education Project To Reduce Challenging Behaviors At A Long-Term Care Facility, Margaret Huryk

Seton Hall University DNP Final Projects

Frequent use of antipsychotic medication (APM) for behavioral and psychological symptoms of dementia (BPSD) persists at high levels in long- term care (LTC) facilities despite extensive evidence of modest clinical benefits, serious adverse effects, public health advisories and a national initiative to improve dementia care. There is a gap between best-practice evidence and actual clinical practice related to pharmacological and nonpharmacological care for persons with dementia (PWD) and BPSD and/or neuropsychiatric symptoms (NPS) of dementia. The literature shows that clinicians often ignore FDA (Food and Drug Administration) warnings, CMS (the Centers for Medicare and Medicaid Services) initiatives and expert opinion …

Self-Care Among Older Adults With Heart Failure, Sumayya Attaallah, Kay Klymko, Faith Pratt Hopp

Social Work Faculty Publications

Background: It is estimated that 5.7 million Americans are living with heart failure (HF) today. Despite the fact that HF is one of the most common reasons people aged 65 years and older are admitted into the hospital, few studies describe the self-care in this older adult population. Purpose: The purpose of the study was to review the current literature on self-care in this population to better understand the influence of selected factors on self-care and health outcomes. Methods: A literature search was completed and resulted in including 28 studies. Results: Multiple factors have been reported as barriers to self-care …

Changes In Mitochondrial Homeostasis And Redox Status In Astronauts Following Long Stays In Space, Hiroko P. Indo, Hideyuki J. Majima, Masahiro Terada, Shigeaki Suenaga, Kazuo Tomita, Shin Yamada, Akira Higashibata, Noriaki Ishioka, Takuro Kanekura, Ikuya Nonaka, Clare L. Hawkins, Michael J. Davies, Daret K. St Clair, Chiaki Mukai

Toxicology and Cancer Biology Faculty Publications

The effects of long-term exposure to extreme space conditions on astronauts were investigated by analyzing hair samples from ten astronauts who had spent six months on the International Space Station (ISS). Two samples were collected before, during and after their stays in the ISS; hereafter, referred to as Preflight, Inflight and Postflight, respectively. The ratios of mitochondrial (mt) to nuclear (n) DNA and mtRNA to nRNA were analyzed via quantitative PCR. The combined data of Preflight, Inflight and Postflight show a significant reduction in the mtDNA/nDNA in Inflight, and significant reductions in the mtRNA/nRNA ratios in both the Inflight and …

Role Of A Plausible Nuisance Contributor In The Declining Obesity-Mortality Risks Over Time., Tapan Mehta, Nicholas M. Pajewski, Scott W. Keith, Kevin Fontaine, David B. Allison

Department of Pharmacology and Experimental Therapeutics Faculty Papers

CONTEXT: Recent analyses of epidemiological data including the National Health and Nutrition Examination Survey (NHANES) have suggested that the harmful effects of obesity may have decreased over calendar time. The shifting BMI distribution over time coupled with the application of fixed broad BMI categories in these analyses could be a plausible "nuisance contributor" to this observed change in the obesity-associated mortality over calendar time.

OBJECTIVE: To evaluate the extent to which observed temporal changes in the obesity-mortality association may be due to a shifting population distribution for body mass index (BMI), coupled with analyses based on static, broad BMI categories. …

Dna Methylation Signatures Of Chronic Low-Grade Inflammation Are Associated With Complex Diseases, Symen Ligthart, Carola Marzi, Stella Aslibekyan, Michael M. Mendelson, Karen N. Conneely, Toshiko Tanaka, Elena Colicino, Lindsay L. Waite, Roby Joehanes, Weihua Guan, Jennifer A. Brody, Cathy Elks, Riccardo Marioni, Min A. Jhun, Golareh Agha, Jan Bressler, Cavin K. Ward-Caviness, Brian H. Chen, Tianxiao Huan, Kelly Bakulski, Elias L. Salfati, Whi-Empc Investigators, Giovanni Fiorito, Charge Epigenetics Of Coronary Heart Disease, Simone Wahl, Katharina Schramm, Jin Sha, Dena G. Hernandez, Allan C. Just, Jennifer A. Smith, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background: Chronic low-grade inflammation reflects a subclinical immune response implicated in the pathogenesis of complex diseases. Identifying genetic loci where DNA methylation is associated with chronic low-grade inflammation may reveal novel pathways or therapeutic targets for inflammation.

Results: We performed a meta-analysis of epigenome-wide association studies (EWAS) of serum C-reactive protein (CRP), which is a sensitive marker of low-grade inflammation, in a large European population (n = 8863) and trans-ethnic replication in African Americans (n = 4111). We found differential methylation at 218 CpG sites to be associated with CRP (P < 1.15 × 10^–7) in the discovery panel …

Qualitative Health Research Involving Indigenous Peoples: Culturally Appropriate Data Collection Methods, Amy L. Wright, Olive Wahoush, Marilyn Ballantyne, Chelsea Gabel, Susan M. Jack

The Qualitative Report

Historically, health research involving Indigenous peoples has been fraught with problems, including researchers not addressing Indigenous research priorities and then subsequently often failing to utilize culturally appropriate methods. Given this historical precedence, some Indigenous populations may be reluctant to participate in research projects. In response to these concerns, the Government of Canada has developed the Tri-Council Policy Statement (TCPS2): Research Involving the First Nations, Inuit and Métis Peoples of Canada, which stipulates the requirements for research collaborations with Indigenous communities. Utilizing this policy as an ethical standard for research practices, this paper describes, critiques and synthesizes the literature on culturally …

Validation Of Evidence-Based Fall Prevention Programs For Adults With Intellectual And/Or Developmental Disorders: A Modified Otago Exercise Program, Mindy Oxman Renfro, Donna B. Bainbridge, Matthew Lee Smith

Health and Wellness

Introduction: Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer’s disease and related dementias, cerebral vascular accident, or traumatic brain injury.

Background: Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to …

Narrative Review Of Vitamin D And Its Specific Impact On Balance Capacity In Older Adults, Ray Marks

Publications and Research

Introduction and Aims: Falls injuries among older adults, a widespread well-established contributor to high disability levels, excess morbidity and mortality rates, have many causes. This review examines the association between vitamin D levels and postural stability or balance control—a fairly consistent predictor of falls among older adults.

Materials and Method: All relevant English language peer reviewed research publications detailing the relationship between vitamin D levels and balance control among the elderly were sought. Key words included “Vitamin D and Balance or Postural Control.” Databases used were Academic Search Complete, PubMed, Scopus, and Web of Science.

Results: Analysis showed no consistent …

Creativity And The Golden Years: Biopsychosocial And Cultural Influences For Living A Successful Life, Karen V. Duhamel

Health Sciences Faculty Publications

Living successfully into older adulthood is becoming the new social norm. As one ages, the older adult may experience doubt and insecurity about one’s ongoing purpose in life, leading to feelings of failure and stagnation. The purpose of this paper is to explore the role of creativity as a requisite to living a successful life into older adulthood. By examining creativity from a variety of perspectives, social scientists and healthcare professionals can better understand the importance of empowering older adults to tap into their inner resources to promote creative expression leading to self-transformation and personal satisfaction. This paper will discuss …

Older Adults Perspectives Of Bed Bathing, Nikki D. Sumner, Katherine C. Hall Phd

Undergraduate Honors Theses

The purpose of this qualitative pilot study is to explore the patient perspectives about what it is like to receive a bed bath. Examining studies of bath basins versus alternative methods has shown a decrease in the spread of nosocominal infections. However, there is not sufficient evidence evaluating the patient perspectives of assistive bed bathing and interactions with nurses and nursing support staff. This information can provide healthcare providers, especially nurses, with a better understanding of patient perspectives and values. It also supports the national healthcare approach towards patient-centered care.

2016-2017 Spring Bulletin, University Of Mississippi Medical Center

Bulletins/Catalogs

2016-2017 Spring Bulletin

Online Detection Of Behavioral Change Using Unobtrusive Eldercare Monitoring System, Thanh Tam La, Alvin Cerdena Valera, Hwee-Pink Tan, Cheryl Li Fang Koh

Research Collection School Of Computing and Information Systems

The rapid ageing population is posing challenges to many countries all over the world, particularly in the provision of care to the growing number of elderly who are living alone. Allowing the elderly to age-in-place, i.e., live safely and independently in the comfort of their own homes is a model that can potentially address the resource constraint in health and community care faced by many nations. To make this model a reality and provide appropriate and timely care to the elderly, unobtrusive eldercare monitoring systems (EMS) are being deployed in real homes to continuously monitor the activity of the elderly. …