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Medical School Watercooler Newsletter - June 10, 2012, Lindsey Lyle

Watercooler Newsletter

This is the June 10, 2012 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.

Contents Include:

• June Med School Café - "Nonsurgical Treatment for Dupuytren's Contracture"
• Department of Internal Medicine to Host Endowed Lecture
• Dr. Hanes Swingle Speaks at USA Board of Trustees Meeting
• Reminder: AOA Visiting Professorship Lectures
• Patient Care Network Program Being Implemented for Mobile, Washington Counties
• USA Chairs Honored by Via Center

Neurological Soft Signs In Persons With Amnestic Mild Cognitive Impairment And The Relationships To Neuropsychological Functions, Hui-Jie Li, Peng-Yun Wang, Yang Jiang, Raymond C.K. Chan, Hua-Li Wang, Juan Li

Behavioral Science Faculty Publications

BACKGROUND: Neurological abnormalities have been reported in people with amnestic mild cognitive impairment (aMCI). The current study aimed to examine the prevalence of neurological soft signs (NSS) in this clinical group and to examine the relationship of NSS to other neuropsychological performances.

METHODS: Twenty-nine people with aMCI and 28 cognitively healthy elderly people were recruited for the present study. The NSS subscales (motor coordination, sensory integration, and disinhibition) of the Cambridge Neurological Inventory and a set of neuropsychological tests were administered to all the participants.

RESULTS: People with aMCI exhibited significantly more motor coordination signs, disinhibition signs, and total NSS …

Caudate Nucleus Volume Mediates The Link Between Cardiorespiratory Fitness And Cognitive Flexibility In Older Adults, Timothy D. Verstynen, Brighid Lynch, Destiny L. Miller, Michelle W. Voss, Ruchika Shaurya Prakash, Laura Chaddock, Chandramallika Basak, Amanda Szabo, Erin A. Olson, Thomas R. Wojcicki, Jason Fanning, Neha P. Gothe, Edward Mcauley, Arthur F. Kramer, Kirk I. Erickson

Kinesiology, Health and Sport Studies

The basal ganglia play a central role in regulating the response selection abilities that are critical formental flexibility. In neocortical areas, higher cardiorespiratory fitness levels are associated with increased gray matter volume, and these volumetric differences mediate enhanced cognitive performance in a variety of tasks. Here we examine whether cardiorespiratory fitness correlates with the volume of the subcortical nuclei that make up the basal ganglia and whether this relationship predicts cognitive flexibility in older adults. Structural MRI was used to determine the volume of the basal ganglia nuclei in a group of older, neurologically healthy individuals (mean age 66 years, …

Successful Again Through A Family Resilience Lens, A'Verria Sirkin Martin

Loma Linda University Electronic Theses, Dissertations & Projects

This study examined successful aging through a family resilience lens by developing a psychometrically tested assessment that can be used to measure family and individual resilience in a population of older adults and by then applying these latent structures to predict successful aging across four domains; self-rated successful aging, psychosocial health, cognitive decline, and physical health. Data from 1,006 older adults were analyzed in three steps. The first identified the underlying latent structure through principle component (exploratory) factor analysis (EFA). The second included the use of confirmatory factor analysis to validate the structure from the first step. The third utilized …

Co-Diagnosis Frequency Of Peripheral Vestibular Disorders And Physical Therapy, Summer M. San Lucas

Loma Linda University Electronic Theses, Dissertations & Projects

Dizziness is among the most common reasons that people consult a physician. The two most common causes of dizziness related to peripheral vestibular dysfunction are benign paroxysmal positional vertigo (BPPV) and vestibular hypofunction (VH). Physical therapy (PT) is an effective component of the medical management for both conditions. The occurrence rate of concurrent BPPV and VH in the same patient has not been described in the literature. Identifying patients with co-diagnosis of BPPV and VH will allow the PT to construct a proper treatment sequence. We conducted a retrospective chart review of 500 consecutive medical records of Veteran's Administration male …

Mental Health Of Elders In Retirement Communities: Is Loneliness A Key Factor?, Abir K. Bekhet, Jaclene Zauszniewski

College of Nursing Faculty Research and Publications

No abstract provided.

Evaluation Of Lift Up Your Voice! Advocacy Training For Older Adults And Their Caregivers: Executive Summary, Alison Gottlieb, Nina M. Silverstein, Kelli Barton

Gerontology Institute Publications

The Lift Up Your Voice! (LUYV) training, a component of Community Catalyst’s effort to support the Campaign for Better Care (CBC), is designed to mobilize grassroots advocacy structures of vulnerable older adults by directly engaging and empowering older adults and their caregivers. The goal of the evaluation is to assess the effectiveness LUYV in recruiting potential advocates, educating them about the health care reform, empowering them via advocacy skills training, and engaging them in state-based CBC activities.

Inhibition Of Soluble Tumor Necrosis Factor Ameliorates Synaptic Alterations And Ca2+ Dysregulation In Aged Rats, Diana M. Sama, Hafiz Mohmmad Abdul, Jennifer L. Furman, Irina A. Artiushin, David E. Szymkowski, Stephen W. Scheff, Christopher M. Norris

Graduate Center for Gerontology Faculty Publications

The role of tumor necrosis factor α (TNF) in neural function has been investigated extensively in several neurodegenerative conditions, but rarely in brain aging, where cognitive and physiologic changes are milder and more variable. Here, we show that protein levels for TNF receptor 1 (TNFR1) are significantly elevated in the hippocampus relative to TNF receptor 2 (TNFR2) in aged (22 months) but not young adult (6 months) Fischer 344 rats. To determine if altered TNF/TNFR1 interactions contribute to key brain aging biomarkers, aged rats received chronic (4-6 week) intracranial infusions of XPro1595: a soluble dominant negative TNF that preferentially inhibits …

Student Attitudes Toward Older Adults, Anna Feenstra

Honors Theses

An aging American population means more older adults will be entering the health care system. The purpose of this study is to evaluate the attitudes of nursing students toward older adults and to determine if these attitudes change over the course of a nursing program. This study was carried out in a university in the Midwest United States. A pre-test post-test single group design was used for this study. Students were surveyed three times throughout the program using Kogan’s Old People scale (KOP) and a demographic questionnaire. Testing was conducted at the beginning and end of the sophomore geriatric course …

Golf: An Alternative Form Of Physical Activity For An Aging Population, Lisa Richardson

Honors Theses

It has been found that breaking an exercise into multiple ten minute bouts can provide the same results as a lump bout of the same time (American College of Sports Medicine, 2010). Though little research has been done on its effectiveness as a modality of physical activity, golf, due to the considerable amounts of walking involved and the social and leisure nature of the game, could be used as an option of physical activity for older adults. In this literature review, the primary goal is to investigate the literature regarding how much energy an older adult could predictably expend while …

Differential Effects Of Race And Poverty On Ambulatory Care Sensitive Conditions, Farrukh B. Hakeem, Daniel L. Howard, Timothy S. Carey, Yhenneko J. Taylor

Journal of Health Disparities Research and Practice

This study is a continuation of an earlier study that examined hospitalization rates for ambulatory care sensitive (ACS) conditions, as a proxy for quality of care, and found evidence of a racial disparity among African American and White Medicare beneficiaries. The current study sought to determine whether neighborhood socioeconomic status (SES) explained this disparity. Differences in rates of ACS hospitalizations by race were assessed using Cochran-Mantel Haenszel tests and Poisson regression. Unadjusted rate ratios for ACS hospitalization for African Americans vs. Whites were found to be higher in low poverty areas (rate ratio (RR)=1.13; 95% CI (1.08, 1.17)) than in …

Fire Safety In 17 Irish Nursing Homes, John Moore, Victor Hrymak

Reports

Fire risk assessments were carried out in 17 Nursing Homes in Ireland. The results show that fire safety management needed to be improved. The recommendations include the need for improved training, management and regulation for fire safety in nursing homes.

Fostering Aging In Place: "Healthy Naturally Occurring Retirement Community" (H-Norc) Qualities In A Southwest Ohio Suburb, Laura A. Previll

Master of Public Health Program Student Publications

This community assessment uses the concept of “H-NORCs” or Healthy Naturally Occurring Retirement Communities as a framework to analyze supports for aging (Masotti, Johnson-Masotti, Fick, & MacLeod, 2006) in Kettering, Ohio -- a first tier suburb of Dayton where the proportion of people over the age of 60 was 23.8% in 2010. In this study, I used focus groups and interviews to collect qualitative data on five H-NORC attributes: (1) economic policies that benefit seniors; (2) types of transportation support for seniors; (3) neighborhood design for physical activity; (4) opportunities for social integration and sense of belonging; and (5) health …

Breast Health And Mammography Screening In Older Women, Martha A. Ibarra Phd, Msn, Anp, Rn

Dissertations

Age-related health disparities in breast cancer screening are a public health concern. From 2002 to 2006, the median age for newly diagnosed cases of breast cancer was 61 years and the median age for breast cancer mortality was 68 years of age (Surveillance Epidemiology and End Results [SEER], 2009). Mammography is the best available screening tool for breast cancer detection (Susan G. Komen Foundation, 2008). The Centers for Medicare and Medicaid Services (CMS, 2006) reported that only about half of older women who are eligible for mammograms through Medicare obtain a mammogram every two years. The literature identifies psychosocial barriers, …

Using The Framingham Risk Score To Evaluate Immigrant Effect On Cardiovascular Disease Risk In Mexican Americans, Jennifer J. Salinas, Bassent Abdelbary, Jeffrey Wilson, Monir Hossain, Susan P. Fisher-Hoch, Joseph B. Mccormick

Physician Assistant Studies Faculty Publications

Background—This study uses the Framingham Risk Score (FRS) for 10-year cardiovascular disease (CVD) to evaluate differences between Mexican American immigrants and the U.S.-born population. Methods and Results—Data from the Cameron County Hispanic Cohort (N=1,559). Average total risk scores were generated by age group for each gender. Regression analysis was conducted adjusting for covariates and interaction effects. Both women and men in the CCHC sample who were long-term immigrant residents (mean FRS scores women 4.2 with p<.001 vs. men 4.0 with p<.001) or born in the U.S. (mean FRS scores women 4.6 with p<.001 vs. men 3.3 with p<.001) had significantly higher risk scores than immigrants who had only been in this country for less than 10 years. The interaction model indicates that differences between immigrant and native-born Mexican Americans are most greatly felt at lowest levels of socioeconomic status for men in the CCHC. Conclusions—This study suggests that in terms of immigrant advantage in CVD risk, on whom, where, and how the comparisons are being made have important implications for the degree of difference observed.

Attentional Focus During Balance Training In Idiopathic Parkinson’S Disease (Pd): A Randomized Clinical Trial, Alyssa Davis, Rebecca Hatlevig, Amanda Richards, Leslee Rosenlof

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to compare the effects of various attentional focus strategies on balance in people with PD. Forty-nine adults with idiopathic PD were randomized into one of four groups (internal focus, external focus, no focus, and control). The three intervention groups participated in a month-long balance program. The outcomes measured were the Sensory Organization Test, Berg Balance Scale, self selected gait velocity, Dynamic Gait Index, Activities-specific Balance Confidence Scale and obstacle course completion time. These outcomes were measured at baseline, post intervention, 2-weeks post intervention, and 8-weeks post intervention. Statistical analyses yielded no significant differences among …

Influence Of Upper Extremity Assistance On Lower Extremity Force Application Symmetry In Individuals Post–Hip Fracture During The Sit-To-Stand Task, Janet A. Kneiss, Jeff R. Houck, Susan A. Bukata, J. Edward Puzas

Faculty Publications - College of Physical Therapy

STUDY DESIGN: Controlled laboratory study using a cross-sectional design.

OBJECTIVES: To compare lower extremity force applications during a sit-to-stand (STS) task with and without upper extremity assistance in older individuals post–hip fracture to those of age matched controls.

BACKGROUND: A recent study documented the dependence on upper extremity assistance and the uninvolved lower limb during an STS task in individuals post–hip fracture. This study extends this work by examining the effect of upper extremity assistance on symmetry of lower extremity force applications.

METHODS: Twenty-eight community-dwelling elderly subjects, 14 who had recovered from a hip fracture and 14 controls, participated in …

Moving Toward Culture Change: Defining Skilled Nursing Facility Residents Dining Style Preferences, Katheryn Adams

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

Background Public policy fulfillment coupled with skilled nursing facility's desire to increase quality of service to meet changes in residents' expectations and improve marketability warrant a new look at culture change and home like dining as defined by the residents in skilled nursing facilities.

Objective The objectives of this study were to determine residents' home dining practices, define residents' desired dining style practices in the skilled nursing facility and determine the relationship between at home dining and dining preferences in skilled nursing facilities.

Design The quasi-experimental study started with a convenience sample taken from a facility generated potential participant list. …

Use Of Standardized Mastery Content Assessments Given During The First Year Of A Baccalaureate Nursing Program For Predicting Nclex-Rn Outcomes, Deanna Jan Emory

Graduate Theses and Dissertations

The purpose of this study was to evaluate the relationship between standardized content specific mastery assessments and NCLEX-RN outcomes. Three content-specific standardized assessments testing Fundamentals, Pharmacology and Mental Health concepts were used to explain the dichotomous NCLEX-RN outcome of pass or fail. The three assessments were developed by Assessment Technologies Institute, LLC (ATI). The assessments were administered to baccalaureate nursing students (N = 119) during the first year of a nursing program in one public university over a period of five consecutive semesters. Group comparisons between those passing and those failing NCLEX-RN on the first attempt and correlations were calculated …

Ministry Of Memories: Keys To Pastoral Care Of Non-Cognitive Persons, Reginald Corfield

Doctoral Dissertations and Projects

This work is intended to examine and study the theological and moral reasons to provide pastoral care to persons who have limited or no cognition. Dementia, Alzheimer's, certain other medical conditions and the aging process cause a loss of brain function that affects memory, thinking, behavior and judgment. Most Clergy wrestle with the fact as to whether there is any purpose in ministering to such persons especially when there is no verbal or non-verbal response. This paper involves surveys, research, collection of historical and biblical data and medical science to evaluate the disease process and explore ways in which to …

Documentation: Delirium In The Hospitalized Older Adult, Jacqueline Fitzgerald Close Phd

Dissertations

Background: Delirium is a common, life threatening and preventable geriatric syndrome. Because this condition is frequently addressed by administering dangerous antipsychotic drugs, it is imperative that accurate systematic assessments are charted to determine the actual need for these medications. The purpose of the study was to describe medical record documentation of a systematic assessment of delirium in older adults who had been administered an antipsychotic medication. Methods: A descriptive correlational retrospective design was used for this medical record data based study. The setting was a 107 bed acute care community hospital located in southern California. Inclusion criteria were medical records …

Surgical Delay For Hip Fracture Clients And The Use Of Clopidogrel: An Integrative Review, Phoebe Genevieve Waller

Senior Honors Theses

Abstract

Hip fractures in elderly patients have very high postoperative mortality rates and the number of hip fractures in the United States is expected to increase exponentially before 2030. Early surgery is essential to improve outcomes, but patients on clopidogrel (Plavix) have a high risk for increased bleeding if surgery is performed within the usual 72 hour window. This paper presents literature and research addressing the dangers of delaying surgery versus undergoing surgery before the effects of the clopidogrel are gone. Based on articles published after 2006, most researchers advocated earlier surgical intervention than previously recommended and emphasized an individualized …

Long-Term Services And Supports (Ltss): Arlington County's Integrated Approach, Carol O'Shaughnessy, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum sponsored a local site visit looking at community-based aging programs and long-term services and supports (LTSS) in Arlington County, Virginia. Arlington County human services are integrated under an umbrella agency in the Department of Human Services (DHS) which administers multiple programs for the elderly and people with disabilities. These include the Older Americans Act services, Medicaid LTSS, transportation services, a nursing case management program, and mental health services for those living in nursing homes and assisted living facilities. Arlington County integrates its aging and disability programs under the auspices of an Administration on Aging-funded Aging …

Improving Access To Primary Healthcare And Cost Effective Care For Underserved Populations, Patricia T. Dey

Regis University Student Publications (comprehensive collection)

Abstract Background: Research findings continue to demonstrate populations who lack healthcare insurance have limited or restricted access to primary healthcare. Lack of health insurance has been shown to be the most significant contributing factor to poor quality of care for some of the core measures captured by the Agency for Healthcare Research and Quality. Health insurance coverage is highly correlated with an individual's ability to gain access to health care, from doctor visits to filling prescriptions. Purpose: The purpose of the this Capstone Project was to analyze the potential impact of independent Nurse Practitioner models of care on accessibility and …

Cholesterol Levels And Cardiovascular Health Indicator Changes In A Holistic Health Treatment Program: An Archival Study, Carolyn Taylor

Capstone Research Projects

Approximately 16.3% of the adult population in the United States maintains elevated levels of total cholesterol, and the components of the cholesterol profile—HDL, LDL, and triglyceride levels, among others—are particular determinants of cardiovascular disease risk. High levels of LDL in particular are associated with coronary atherosclerosis and cardiovascular disease. Conversely, high levels of HDL remove cholesterol from the blood and aid in metabolism. The HDL/LDL ratio is considered a marker of carotid plaque and is specifically used as an indicator for cardiovascular disease risk. Traditional cholesterol control treatment utilizes statin therapy and antihypertensive medication; however, recent trends toward alternative methods …

Com Outlook Spring 2012, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

Kebijakan Pembaharuan Agraria Di Indonesia : Studi Pilihan Kebijakan Landreform Pada Pola Kepemilikan Lahan Komunal, Dwi Kristianto

Jurnal Ilmu Kesejahteraan Sosial

No abstract provided.

Motherhood Spirit Dalam Kedermawanan Sosial Perempuan : Sebuah Perspektif Pemberdayaan Perempuan Berbasis Komunitas Dalam Rangka Mewujudkan Pembangunan Berpusat Pada Manusia, Rissalwan Habdy Lubis

Jurnal Ilmu Kesejahteraan Sosial

No abstract provided.

Nursing Satisfaction In Caring For Elders, Sarah L. Vlachos

Honors Theses and Capstones

Despite the increasing number of Americans who are over 65 years of age, little research exists about the satisfaction of nurses who care for this population. This qualitative descriptive study investigated the factors that influence the satisfaction of such nurses, and yielded five main themes. Registered Nurses (RNs) reported providing high-quality care, developing relationships, and making a difference to be rewarding components of geriatric nursing. The nurses also discussed challenges, which included caring for elders with dementia and being unable to deliver the high-quality care they felt patients deserve. Several of these finding were consistent with existing studies that addressed …

Two Cultures Of Caring: A Comparative Study, Lisa Armstrong, Chistina Polito

Honors Theses and Capstones

There is much that the UK and the US could and should learn from each other to understand the quality of end-of-life care, through comparison of practice, analysis of care patterns and via original research (Higginson, 2005, p.170). Although comparisons between end-of-life care in the United Kingdom and United States have demonstrated similarities and disparities in many contexts, there is little evidence of research that directly compares nursing perspectives between the two Atlantic partners. This research explores nurse’s perceptions and experiences of caring for people within a hospice context and identifies themes of commonalities and disparities in theory and practice, …