Digital Commons Network^™

Mapping Epidermal And Dermal Cellular Senescence In Human Skin Aging, Grace T Yu, Clarisse Ganier, David B Allison, Tamara Tchkonia, Sundeep Khosla, James L Kirkland, Magnus D Lynch, Saranya P Wyles

Children’s Nutrition Research Center Staff Publications

Single-cell RNA sequencing and spatial transcriptomics enable unprecedented insight into cellular and molecular pathways implicated in human skin aging and regeneration. Senescent cells are individual cells that are irreversibly cell cycle arrested and can accumulate across the human lifespan due to cell-intrinsic and -extrinsic stressors. With an atlas of single-cell RNA-sequencing and spatial transcriptomics, epidermal and dermal senescence and its effects were investigated, with a focus on melanocytes and fibroblasts. Photoaging due to ultraviolet light exposure was associated with higher burdens of senescent cells, a sign of biological aging, compared to chronological aging. A skin-specific cellular senescence gene set, termed …

Bridging The Dental Care Gap: Addressing Oral Health Disparities In New York State Nursing Homes, Apeksha Phulgirkar B.D.S., Pgcert, M.P.H., Stacy Mcilduff Cfre

The New York State Dental Journal

Oral health is a critical component of overall wellbeing, yet disparities in access to dental care disproportionately affect vulnerable populations, particularly elderly residents in nursing homes. Poor oral hygiene is linked to systemic health conditions, such as cardiovascular disease, diabetes and cognitive decline. Despite federal regulations mandating oral health assessments in nursing homes, many facilities lack adequate resources, and care often falls to undertrained staff. This study assesses the availability of onsite dental care services in New York State’s nursing homes and the role of mobile dental clinics in bridging the access gap, especially in rural and underserved areas. A …

"Pod Of Transient Orcas (To18'S & T049a'S) Off Of Speiden Island - San Juan Islands, Washington" And "Alaskan Coastal Brown Bear Munching On Sedge Grass In Lake Clark National Park - Alaska", Jayme Hoch

The Art of Medicine

No abstract provided.

Childhood Prosocial Behavior And Body Mass Index: Longitudinal Findings In The Millennium Cohort Study, Farah Qureshi, Krista Woodward, Laura D. Kubzansky, Julia K. Boehm

Psychology Faculty Articles and Research

Objective: Childhood obesity affects millions worldwide but is challenging to treat. Prosocial or helping behavior may help mitigate childhood obesity. We investigated whether prosocial behavior at ages 5–11 was associated with body mass index (BMI) and reduced obesity risk through age 17. Method: Data were from 8,894 participants in the Millennium Cohort Study. Parents reported children’s prosocial behavior using the Strengths and Difficulties Questionnaire at ages 5, 7, and 11. BMI scores (kg/m2) were calculated from children’s height and weight at ages 5, 7, 11, 14, and 17, which were then standardized by sex (M = 0, SD = 1) …

Effects Of High-Intensity Interval Training On Biomarkers And Inflammatory Factors In Patients With Heart Failure: A Meta-Analysis Of Randomized Controlled Trials, Wanting Zhang, Jooyeon Hwang, Beibei Lu, Xin Xu

Faculty, Staff and Student Publications

Background: There is still controversy about the effect of high-intensity interval training (HIIT) on the levels of cardiac and inflammatory biomarkers in patients with heart failure compared with moderate-intensity continuous training (MCT) and conventional healthcare activities. This article is to systematically investigate the effects of HIIT on the levels of cardiac and inflammatory biomarkers in patients with heart failure compared with MCT and conventional healthcare activities.

Methods: A computerized search of databases was conducted with the search year from the establishment of the database, and the screened results were subjected to quality assessment and data extraction, and the data was …

A Mixed-Methods Usability Pilot Of A Value-Goal Elicitation Tool In The Inpatient Setting For Older Adults Anticipating Post-Acute Care, Kirstin M Piazza, Caroline Pascal, Syama R Patel, Caroline Sefcik, Marilyn M Schapira, Caroline Madrigal, Katherine C Ritchey, Longyi Yip, Aanand D Naik, Robert E Burke

Faculty, Staff and Student Publications

Age-Friendly Health Systems (AFHS) emphasize aligning care with "What Matters" most to older adults. Hospitalization represents a critical period where value-based goals could shape key decisions about post-acute care transitions. However, few tools designed for eliciting such goals have been adapted for use in the inpatient setting, where the acute nature of care poses unique challenges. This mixed-methods study evaluates the usability of the Health Priorities Primer Tool (HPPT) in older hospitalized adults who anticipate needing post-acute care, aiming to identify necessary adaptations for the inpatient setting. We conducted interviews, observations, and surveys with older hospitalized patients to understand their …

Modeling Healthcare Managerial And It Sophistication, Gary Hackbarth, Teuta Cata

Journal of International Technology and Information Management

Sophisticated healthcare managers understand that managing information and selecting technology are two related but separate skill sets. Information Technology Governance (ITG) allows healthcare organizations to deal with complex issues, compete effectively, and support patient needs by integrating managerial and IT sophistication to improve business performance. An organizational model that merges IT and managerial sophistication by improving ITG to forecast business outcomes must grasp the intricacies of technology to acquire, manage, and utilize information technology in alignment with business strategies. The proposed model differentiates between internal and external IT management strategic thinking, emphasizing the critical need to govern IT effectively by …

Application Of Root Cause Analysis For Fall Prevention: A Quality Improvement Initiative For Older Adults In A Skilled Nursing And Long-Term Care Facility, Terrence Ranjo

Doctoral Projects

Falls in older adults are common and often have severe outcomes. They are the leading cause of fatal and non-fatal injuries among people aged 65 and older and continue to increase. Half of residents in nursing facilities fall annually, and one in every ten falls will lead to a severe injury. Federal regulations like the Centers for Medicare and Medicaid Services require long-term care (LTC) facilities to incorporate quality assurance performance improvement initiatives to address identified quality concerns in LTC facilities. Root cause analysis (RCA) can help clinicians identify several root causes of falls and guide clinicians in developing personalized …

"The Association Between Serious Psychological Distress And Life Satisfaction Among U.S Adults With Hypertension", Kellen Michael Lenz

All ETDs from UAB

Purpose: Given the observed link between psychosocial and physical health outcomes, this study investigates the association between serious psychological distress and life satisfaction among U.S adults with hypertension. Methods: A cross-sectional study using 2021 National Health Interview Survey data among U.S adults was conducted to investigate the association between serious psychological distress and hypertension and assess the role of life satisfaction in modifying this relationship. Hypertension (diagnosed, undiagnosed), serious psychological distress (≥ 13 on the Kessler 6 nonspecific distress scale), and life satisfaction (Very satisfied, Satisfied, Dissatisfied, Very dissatisfied) were self-reported by participants. Ordinal logistic regression was used to investigate …

Effect Of An Elective On Preparation For Fieldwork In An Acute Care Setting, Abbey Glenn, Brandi Fulwider

Journal of Occupational Therapy Education

The current study evaluated the effect of an eight-day elective course on preparedness for the acute care setting. The course was offered to Master of Science in occupational therapy students before their second Level II fieldwork experience and focused on developing necessary skills for success in acute care. Course content was based on feedback from previous students, fieldwork educators in acute care, and faculty experiences in that setting. Specifically, the course combined case-based and skills-based simulations to help students develop skills and to build confidence. Small group activities involving role-playing communication scenarios were also included, where students played the role …

Floor-To-Stand Transfers In Older Adults: Insights Into Strategies And Lower Extremity Demands, Lyndsay Stutzenberger, Tyler Whited

Faculty Publications - College of Physical Therapy

Background/Objectives: Getting up from the floor is an important functional skill for independence in older adults but is not often assessed clinically. The purpose of this study was to investigate how floor-to-stand transfer (FTS) ability is related to self-report measures and five-time sit-to-stand (5XSTS) performance, as well as compare peak joint angles during common FTS strategies and lower extremity demands between the 5XSTS and a commonly instructed FTS strategy. Methods: Thirty-four community-dwelling older adults completed self-report measures and performed the 5XSTS, a FTS in a self-selected manner, and an instructed FTS strategy. Biomechanical analysis of the lower extremities was used …

Running Biomechanical And Isokinetic Strength Differences In Masters Runners With And Without Achilles Tendinopathy, Matthew Klein, Christopher Patterson, Annette Karim, Tyler Cuddeford

Faculty Publications - College of Physical Therapy

Masters runners are an increasing proportion of the running com-munity. The most significant musculoskeletal changes in runners occur after the age of 50 in addition to changes in injury rates and types, the most common being Achilles tendinopathy (AT). Previous evidence has suggested similarities between risk factors for AT and age-related changes that are focused at the hip and the ankle during the propulsive stage of running. The purpose of this study was to investigate biomechanical and peak torque association to AT in masters runners. Thirty-two masters runners over age 50 with AT(60.31 ± 8.37, n = 16) and without …

Why Occupational Therapy?: A Qualitative Analysis Of Incoming Students’ Reasons For Entering The Profession, Laura H. Vanpuymbrouck, Carli Friedman

Journal of Occupational Therapy Education

Insight into students’ views and understandings of what occupational therapy (OT) practitioners do and what a career will be like can shed light into how the profession is socially perceived. Additionally, this knowledge can be useful for recruitment, retention, and curriculum design, especially for addressing misunderstandings and inaccurate perceptions. Therefore, the objective of this study was to examine the narratives of incoming OT students when asked why they chose to enter the profession of OT. Descriptive statistics were used to analyze sociodemographic data, and then thematic analysis was used to analyze qualitative data about why participants wanted to become occupational …

The Influence Of Student Personality Traits On Satisfaction And Success In Online Education In Higher Education: A Systematic Review, Elizabeth G. Hunter, Jayna Niblock, Samantha Barefoot, Jackson Miller, Jason Hughes, Lydia Kite, Edith Scarletto

Journal of Occupational Therapy Education

Online learning is a growing area in occupational therapy education. It is important for faculty to use the modality of online learning to understand the influence of student personality traits, defined as relatively stable characteristics that influence thinking and behavior, on student satisfaction and success in graduate level programs. By understanding the influence of personality traits, faculty can better develop online materials that are flexible enough to support individuals who may have a higher risk of low satisfaction and success. There has been plentiful research in the areas of education and psychology assessing the influence of personality on the online …

Vision Rehabilitation In Ot And Ota Curricula: A Survey To Academic Programs, Angela Butler, Beth A. Barstow

Journal of Occupational Therapy Education

Occupational therapists are trained to evaluate and treat occupational performance problems. Client factors, such as vision, greatly impact an individuals’ ability to participate in meaningful occupations. New accreditation standards do not include language related to vision. Therapists must be prepared to evaluate and treat the increasing prevalence of visual challenges from children with cerebral visual impairment to older adults with age related conditions. This survey explored how vision rehabilitation is covered in accredited occupational therapy and occupational therapy assistant programs and the expertise of faculty teaching vision content. A thirteen-question survey was sent to accredited programs. Questions included multiple response, …

Increasing Serious Illness Conversations In Patients At High Risk Of One-Year Mortality Using Improvement Science: A Quality Improvement Study, Kanishk D. Sharma, Sandip A. Godambe, Prachi P. Chavan, Agatha Parks-Savage, Marissa Galicia-Castillo

Department of Family and Community Medicine Faculty Publications

Background: Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores. Methods: This was a quality improvement study with data collected pre- and post-intervention at a large urban level one trauma center in Virginia, which also serves as a primary teaching hospital to …

The Use Of Music Therapy And Various Mechanisms Of Diversion To Aid Caregivers Of Those With Alzheimer’S Disease And Dementia, Sarah Elizabeth Kane

Doctor of Nursing Practice Projects

Background: Alzheimer’s Disease and Dementia inhabit an increasingly alarming number of individuals within the United States with the majority of their caregivers being loved ones with limited to no healthcare education. This DNP project was designed to specifically educate caregivers of those with Alzheimer’s Disease and Dementia. The goal of this project was to increase the knowledge of the disease while also increasing the ability and confidence to better care for their loved ones. In using the resources outlined in this project, such as music therapy and diversional tools, the caregiver would see a decrease in emotional outbursts and …

Chronic Circadian Misalignment Accelerates Sarcopenia Progression In Mice, Takashi Seya, Nobuya Koike, Naoki Okubo, Yasuhiro Umemura, Yoshiki Tsuchiya, Kazuya Yabumoto, Yasuhiro Endo, Kanako Iinuma, Akiyo Kakibuchi, Akira Sugimoto, Kenji Takahashi, Seung-Hee Yoo, Zheng Chen, Kazuhiro Yagita

Faculty, Staff and Student Publications

Introduction: In today's 24/7 society, circadian misalignment caused by environmental and lifestyle factors is associated with various adverse health consequences. Understanding tissue-specific pathology is required to counter this growing public health challenge. A potential association of environmental circadian misalignment with sarcopenia, or accelerated loss of skeletal muscle strength and mass, is poorly documented.

Methods: 14-week-old wild-type C57BL/6J male mice were exposed to a chronic jet lag (CJL) paradigm consisting of an 8-h phase advance every 4 days (the ADV group) or a fixed light-dark cycle (the LD group) for 64 weeks. Grip strength was measured during the experiment, and hindlimb …

Mechanisms Of How Sarcopenia Affects Functional Outcomes In Acute Ischaemic Stroke, Dong-Seok Gwak, Jinyong Chung, Dawid Schellingerhout, Hyerin Oh, Sang-Wuk Jeong, Ji Sung Lee, Dong-Eog Kim

Faculty, Staff and Student Publications

Sarcopenia, a common geriatric condition characterized by the loss of skeletal muscle mass and function, can negatively affect functional outcomes in acute ischaemic stroke; however, the underlying mechanisms remain unclear. We hypothesized that sarcopenia affects post-stroke outcomes, mediated through its impact on dysphagia, early neurological deterioration, or post-stroke recovery, particularly in patients with motor deficits. To explore this hypothesis, we included 600 consecutive elderly (≥65 years) patients with acute (< 1 week) ischaemic stroke and assessed: (i) the relationships sarcopenia has with dysphagia, early neurological deterioration and various phases of recovery after stroke (in-hospital, post-discharge [up to 3 months], and chronic [3 months to 1 year]) and (ii) whether either presenting symptoms or lesion locations modify the impact of sarcopenia on stroke outcomes. Temporal muscle thickness, a marker of sarcopenia, was measured by brain magnetic resonance imaging and dichotomized into low versus high temporal muscle thickness at the 25th percentile cut-off point. Logistic regression analysis, mediation analysis and statistical brain mapping were conducted. Mean age was 75.3 ± 6.1 years and 303 (50.5%) were male. Low temporal muscle thickness (< 5.1 mm) was independently associated with dysphagia (adjusted odds ratio 1.89 [95% confidence interval 1.06–3.37], P = 0.03), early neurological deterioration (adjusted odds ratio 2.75 [95% confidence interval 1.61–4.71], P < 0.001) and post-discharge recovery (adjusted odds ratio 0.56 [95% confidence interval 0.34–0.94], P = 0.03) but not with in-hospital or chronic recovery. In addition, dysphagia, early neurological …

Development And Validation Of Natural Language Processing Algorithms In The National Enact Network, Yanshan Wang, Jordan Hilsman, Chenyu Li, Michele Morris, Paul M Heider, Sunyang Fu, Min Ji Kwak, Andrew Wen, Joseph R Applegate, Liwei Wang, Elmer Bernstam, Hongfang Liu, Jack Chang, Daniel R Harris, Alexandria Corbeau, Darren Henderson, John Osborne, Richard E Kennedy, Nelly-Estefanie Garduno-Rapp, Justin F Rousseau, Chao Yan, You Chen, Mayur B Patel, Tyler J Murphy, Bradley A Malin, Chan Mi Park, Jungwei W Fan, Sunghwan Sohn, Sandeep Pagali, Yifan Peng, Aman Pathak, Yonghui Wu, Zongqi Xia, Salvatore Loguercio, Steven E Reis, Shyam Visweswaran

Faculty, Staff and Student Publications

Objective: Electronic Health Record (EHR) data are critical for advancing translational research and AI technologies. The ENACT network offers access to structured EHR data across 57 CTSA hubs. However, substantial information is contained in clinical narratives, requiring natural language processing (NLP) for research. The ENACT NLP Working Group was formed to make NLP-derived clinical information accessible and queryable across the network.

Methods: We established the ENACT NLP Working Group with 13 sites selected based on criteria including clinical notes access, IT infrastructure, NLP expertise, and institutional support. We divided sites into five focus groups targeting clinical tasks within disease contexts. …

Influence Of Virtual Reality On Lower Extremity Joint Kinematics During Overground Walking, Hunter Derby, Nathan Conner, Adam C. Knight, Harish Chander

Funded Scholarship

The inability to regain balance following a trip-induced event is one of the leading causes of falls and fall-related injuries in older adults. Virtual reality (VR) has the potential to expose individuals to realistic environments with minimal injury risk compared to real-world exposures. The purpose of this study was to compare lower extremity joint kinematics during overground walking when exposed to real and virtually generated trip obstacles. A total of 14 healthy participants [7 male, 7 female; age: 23.46 ± 3.31 years; height: 173.85 ± 8.46 cm; mass: 82.19 ± 11.41 kg; shoe size (men’s): 9.03 ± 2.71 s] were …

Daily Movement Activities Are Associated With Within-Person Instability Of Cognitive Function In Older Adults: Evidence From An Ambulatory Assessment Study, Chih-Hsiang Yang, Donald Hedeker, Jongwon Lee, Halle Prine, Donna Coffman, Jingkai Wei, Jonathan George Hakun

Faculty, Staff and Student Publications

Background and objectives: Physical inactivity and excessive sedentary time (ST) are associated with poor cognitive health in older adults. However, current literature largely relies on cross-sectional designs or in-lab cognitive assessments, which do not adequately reflect cognitive function in naturalistic settings. Further, existing studies have largely overlooked the variability or the instability in daily cognitive function, which represents a critical marker of cognitive decline. This ambulatory assessment study examined the temporal associations of daily movement behaviors with the mean levels and the variability of cognition among older adults at risk of dementia.

Research design and methods: 96 older adults from …

Information Seeking Behaviors And Attitudes Of Wives Of Former Football Players Regarding Chronic Traumatic Encephalopathy, Summer D Ott, Sukhnandan K Cheema, Alexa Ryder, Philip Schatz, Lorie A Gonzalez, Jecenia Duran, Paul E Schulz

Faculty, Staff and Student Publications

This study examines CTE-related knowledge and information-seeking behaviors of caregivers of persons who are at high risk of CTE. Online survey responses were collected from 64 females, ages 18-74, who were married to former college, semiprofessional, or professional football players and were fluent in English. Ranging from 0 to 18, a score was calculated to represent level of CTE knowledge. Participants were classified into groups based on their spouse's reported symptoms and diagnosis. Approximately 87% of participants reported that their spouses have been diagnosed with a football-related concussion and were significantly more likely to seek out information from a healthcare …

Multifactorial Fall Interventions For People Over 65 Years In The Acute Hospital Setting: Pre–Post-Test Design, Allison Wallis, Christina Aggar, Deb Massey

Research outputs 2022 to 2026

Background: Falls are the most reported patient safety incident for patients >65 years in acute hospital settings worldwide. While multifactorial fall interventions reduce the number of falls in subacute and rehabilitation settings, fall interventions in acute hospital settings are unknown. Aim: To evaluate the effectiveness of multifactorial fall interventions on the number of falls using codesigned education targeting staff and the patient and review the environment in acute hospital settings in NSW, Australia for patients over 65 years of age. Method: A pre–post-test design with a non-equivalent group was conducted. All acute hospital inpatient falls occurring both pre- and post-intervention …

Psychotropic Medications Versus Non-Pharmacologic Approaches For Managing Behavioural And Psychological Symptoms In Australian Aged Care Residents With Dementia: General Practitioners’ And Physicians’ Perspectives, Hunduma D. Ayeno, Mustafa Atee, Gizat M. Kassie, Vijayaprakash Suppiah, Imaina Widagdo, Tuan A. Nguyen

Research outputs 2022 to 2026

Background: Psychotropic medications are often inappropriately prescribed for behavioural and psychological symptoms of dementia (BPSD), posing significant risks such as falls, stroke and death. Although non-pharmacological interventions (NPIs) are the first-line treatment for BPSD, their use in practice remains limited. Objectives: This study explored general practitioners’ (GPs’) and physicians’ perspectives on using psychotropic medications compared to NPIs for managing BPSD in Australian residential aged care homes (RACHs). Design: Semi-structured online in-depth interviews were conducted with GPs and physicians managing BPSD in Australian RACHs. Methods: The interviews were audio-recorded, transcribed and analysed using inductive thematic analysis, with transcripts coded using NVivo …

Geriatric Care In Corrections: An Exploratory Study Of Cross-Disciplinary Perspectives On The Needs Of An Aging Prison Population, Cynthia A. Scheiderer

Antioch University Dissertations & Theses

The incarcerated population in the United States is aging. The proportion of adults 55 or older in prison rose from 3% in 1993 to 16% at year-end 2022 (Carson & Sabol, 2016; Carson & Kluckow, 2024). Researchers have consistently found evidence that the prevalence of disabilities and functional impairment is higher among older adults who are incarcerated than among those in the community. As the incarcerated population ages, corrections professionals responsible for providing safety, housing, and health care must respond to the needs of the population. In this qualitative study, 21 corrections professionals from the disciplines of custody, classification, medical, …

Sleep In Residential Aged Care: A Secondary Qualitative Analysis Of Data From The Australian Royal Commission Into Aged Care Quality And Safety, Aisling Smyth, Patricia Cain, Sabine Pangerl, Christopher Gordon, Kasia Bail, Davina Porock

Research outputs 2022 to 2026

Background:

Sleep is a crucial healing and restorative component of older person care but is often negatively impacted through the effects of institutionalization in residential aged care (RAC). Currently, information about how sleep occurs is limited.

Methods:

Through the lens of person-centered care, this study examined submissions to the Australian Royal Commission into Aged Care Quality and Safety. The Commission was established in 2018 with the aim of protecting and improving the safety, quality of life, and well-being of people receiving aged care. The commission received 10 000+ submissions from a range of stakeholders, including consumers, family members, expert witnesses, …

Food Allergies And Quality Of Life In Older Adults: Development Of A Food Allergy Questionnaire, Avalon F. Mustafa

UNF Graduate Theses and Dissertations

The United States is experiencing a rapid increase in the number of older adults, yet there is a lack of research on food allergies in this demographic. While there are survey instruments available to study food allergies and quality of life, none of these are tailored to the unique needs of elderly individuals. This study aims to create and validate an on-line survey instrument specifically designed for older adults, focusing on their quality of life in the context of food allergies. The survey will be used to establish a food allergy severity score and a quality-of-life score, enabling comparison between …

Examining The Relationship Between Cardiometabolic Risk Factors And Telomere Length In Women: A Systematic Review, Jeni Page, Catherine Stephens, Melissa A Richard, Elizabeth Lyons, Elizabeth Baumler, M Terese Verklan, Elizabeth Lorenzo

Faculty, Staff and Student Publications

Background and objectives: Cardiometabolic syndrome (CMS) poses a significant public health challenge due to its rising prevalence in aging and significant healthcare costs. Recent studies have suggested telomere length (TL), a marker of cellular aging, may be impacted by CMS among women, but comprehensive evidence remains limited. This study aimed to examine the association between CMS risk factors (increased waist circumference [WC], elevated blood pressure, impaired fasting blood glucose, elevated triglycerides, decreased high-density lipoproteins) and TL in women, with consideration of age and race or ethnicity.

Research design and methods: A systematic review was conducted following PRISMA guidelines, with searches …

System Readiness And The Patient Care Pathway For Alzheimer's Disease Diagnosis And Treatment, B Joy Snider, Et Al.

2020-Current year OA Pubs

Promising therapeutic interventions that target the underlying pathophysiology are changing the landscape of Alzheimer's disease (AD) research. The AD care pathway must be transformed to meet the challenge of bringing these new therapies to the increasing number of people living with AD within the existing healthcare framework. Challenges include identifying patients who may benefit from treatment interventions early in the course of the disease, ensuring that diagnostic tools are accessible and accurate, and developing capabilities to monitor the effectiveness of interventions over time. These challenges must be addressed at all levels, from primary care settings to tertiary treatment centers; this …