Digital Commons Network^™

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 …

“In Principle We Have Agreement, But In Practice It Is A Bit More Difficult": Obtaining Organizational Buy-In To Patient-Centered Medical Home Transformation, Janelle Applequist, Michelle Miller-Day, Peter F. Cronholm, Robert Gabbay, Deborah S. Bowen

Communication Faculty Articles and Research

The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state. The analysis …

How We Care: Provider Perspectives On Services For Vietnamese Elderly In Boston’S Dorchester Neighborhood, Loan Thi Dao

Institute for Asian American Studies Publications

The need for culturally competent care for the elderly is of growing concern for Asian American and Pacific Islander (AAPI) communities and health providers. In 2012, a preliminary study was conducted to ascertain the perspectives of service providers about the cultural competency of services for elderly Vietnamese Americans in Boston, Massachusetts. The study includes interviews with key informants representing the five major community health centers (CHC) programs in Boston’s Vietnamese enclave in the Dorchester neighborhood. Secondary data collection from field observations and informal communications with other staff and elderly clients also inform the findings. While the study recognizes the value …

An Examination Of Cultural Competence Training In Us Medical Education Guided By The Tool For Assessing Cultural Competence Training, Valarie Blue Bird Jernigan

Journal of Health Disparities Research and Practice

In the United States, medical students must demonstrate a standard level of “cultural competence,” upon graduation. Cultural competence is most often defined as a set of congruent behaviors, attitudes, and policies that come together in systems, organizations, and among professionals to enable effective work in cross-cultural situations. The Association of American Medical Colleges developed the Tool for Assessing Cultural Competence Training (TACCT) to assist schools in developing and evaluating cultural competence curricula to meet these requirements. This review uses the TACCT as a guideline to describe and assess pedagogical approaches to cultural competence training in US medical education and identify …

Pubh 4231 - Health Aspects Of Aging, Jamie S. Cromley

College of Public Health: Faculty Syllabi (2014-2021)

This course is intended to familiarize students with promotion of health in an aging population, the notion that aging is a natural part of the lifecycle, community, state and federal health programs and services for the aged. Students will become acquainted with the process of and problems associated with aging in order to effectively manage this important public health issue. Specific health concerns of the elderly including the increase in life expectancy, current life extending research and technology and successful aging will also be examined. Knowledge and understanding of biological, psychological, and sociological aspects of aging as related to health …

Living With Traumatic Brain Injury In A Rural Setting: Supports And Barriers Across The Continuum Of Care, Anne L. Harrison, Elizabeth G. Hunter, Heather Thomas, Paige Bordy, Erin Stokes, Patrick H. Kitzman

Physical Therapy Faculty Publications

Purpose: Traumatic brain injury (TBI) is prevalent in Kentucky and comes with a high cost in care and quality of life for individuals and caregivers affected. Many people living with the condition of TBI have unmet needs. Research among people living with TBI in rural areas is limited. The purposes of this study were to (1) increase understanding of the lived experience of people with TBI and caregivers in rural regions of Kentucky across the continuum of their care and (2) provide their perspectives on barriers and facilitators of optimal function and well-being.

Methods: A qualitative descriptive interview study was …

Dementia In Prison: An Argument For Training Correctional Officers, Rachele Vogel

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Dementia is a significant public health problem that is occurring behind bars. However, the number of inmates suffering from this disease is unknown (Feczko, 2014). Current research has exposed a serious gap in correctional health care for older adults, and correctional institutions are being encouraged to make changes to better address the needs of this population (Fellner, 2012; OIG, 2016; Williams, Stern, Mellow, Safer, & Greifinger, 2012b). The purpose of this paper is to bring awareness to the aging problem behind bars and respond to the identified need for additional training for custodial staff (correctional, parole, and probation officers). Training …

Influences On Self-Care In Women With Heart Failure: A Pilot Study, Joy Corcione

Dissertations and Theses (Open Access)

Background: Heart Failure self-care becomes exceedingly difficult to perform as the disease progresses; therefore social support becomes important in facilitating heart failure self-care. Woman with heart failure represent a significant and growing vulnerable population. Women tend to have lower self-confidence in providing self-care, experience greater negative emotions, decreased social support, experience more adverse psychosocial factors affecting self-care and experience greater psychosocial adversity than do men. Self-care is vital in managing heart failure and social support greatly facilitates self-care behaviors.

Purpose: The purpose of this pilot study was to gain a deeper understanding about the sources of perceived social support and …

The Influence Of Strength-Training Exercises On The Functional Fitness In Older Adults, Susie Engle

Graduate Theses and Dissertations

The purpose of this study was to examine the influence of strength-training exercises on the functional fitness in older adults. The original convenience sample consisted of 658 participants who attended group strength-training classes offered through the Cooperative Extension Service. The Senior Fitness Test was used to assess baseline fitness levels at the beginning and end of the 12-week strength-training program. Data was collected from 2008 to 2015. Of the 658 participants, 110 were aged 60 to 94 and presented posttest scores occurring approximately 12 weeks after pretest dates. Of the 110 subjects, 99 were female and 11 were male. The …

When Actions Speak Louder Than Words: Extending The Reach Of Qualitative Data Collecting, Justine M. Mcgovern

Publications and Research

Through the lens of a study exploring dementia care partnering, the purpose of this methods article is to focus on the role of artifacts and embodied data in data collection. In addition, it illustrates how to use a range of data collecting methods. The article identifies benefits of additional data collecting methods to research and care. These include the need to expand data collecting methods beyond spoken word, integrate a range of data collecting approaches into research courses across disciplines, increase support of qualitative research, and advocate for greater inclusivity in research. Data collecting approaches can also have implications for …

Self-Care And Mobility Disability At Mid-Life In Lucky Few, Early-, And Late-Baby Boom Birth-Cohorts, Carlos Siordia

Journal of Health Disparities Research and Practice

Disability is related in definite ways with makers of social stratum, as it can be influenced by and has the potential to contribute to the production and reproduction of social stratification. Intersectional markers of social stratification processes are ignored determinants of health. The Class, Race, Sex (CRS) hypothesis presented here argues that a low-education, racial-minority, and female disadvantage will compound to affect the prevalence and risks of disability. The evidence presented validates the CRS hypothesis by showing that disability prevalence and risk clusters first by class, race, and then sex. The cross-sectional study of community-dwelling adults in the Unites States, …

Intersecting Positions Of Social Disadvantage And Self-Reported Health Status Disparities, Carla S. Alvarado, Chunhuei Chi

Journal of Health Disparities Research and Practice

Health disparities along the gender, race and class are particularly important to monitor and study given the predicted differential distribution of health along these social identities. Intersectionality is a theoretical framework that allows public health and health disparities researchers to account for the simultaneous, mutually constitutive, reinforcing and multidimensional effects of gender, class, and race with the aim to better understand health disparities. Disparities along gender, race and class have been noted in self-reported health status (SRHS) which has been shown to be a strong predictive factor of mortality, morbidity and mental health independent of other physiologic, behavioral and psychosocial …

Using The Theory Of Fundamental Causes To Show The Potential Effects Of Socioeconomic Status On Surgical Outcomes, Mehwish Qasim, A.B.D.

Journal of Health Disparities Research and Practice

Surgical procedures are both costly and common. There are large differences in surgical outcomes both within and between hospitals based on patient characteristics such as measures of income. In both 2000 and 2009, patients residing in low-income communities had worse morbidity and mortality rates, across a wide range of quality indicators. In this review, the author will explicate the Theory of Fundamental Causes as it relates to surgical care, review key empirical findings and address potential limitations of the theory. This review will provide a platform for researchers to discuss current research in surgical disparities using the Theory of Fundamental …

Physical Activity Among Older American Indians And Alaska Natives, David Hodgins, Linda Larkey, Barbara E. Ainsworth, Colleen Keller

Journal of Health Disparities Research and Practice

Introduction: Life style behaviors contribute to poor health among older Americans Indians/Alaska Native (AI/AN) in the United States, with low levels of physical activity (PA) particularly tied to the chronic disease profile of this population. Searched reviews of physical activity among AI/ANs are limited in assessing prevalence and correlates to PA among older adults > 40 years.

Methods: A literature search of reported physical activity studies among older AI/AN was assessed for prevalence and predictive factors associated with levels of physical activity.

Results: Fourteen studies were included in this review that either specifically quantified the amount of physical activity among older …

Blood Pressure Control For African American Parents And Children: Feasibility And Initial Outcomes Of A Faith-Based Intervention Pilot Study, Penny A. Ralston Ph.D., Tammye Farmer M.S., Iris Young-Clark Ph.D., Catherine Coccia Ph.D., R.D.

Journal of Health Disparities Research and Practice

The overall purpose was to determine the feasibility and initial outcomes of a faith-based intervention to improve blood pressure (BP) control in African American (AA) parents/guardians and their children, using a pre/post without control group design. Sample included AA parents and children (n=17) from three churches in North Florida. Health behaviors (daily servings of fruits/vegetables [F/V], minutes of physical activity [PA]) and physical health (BMI, systolic BP and diastolic SB) were examined. Data were analyzed using descriptive statistics, paired t-tests, and correlations. Feasibility outcomes showed high attendance (91% children, 88% parents) and completion (100%) rates. F/V significantly increased at post-test …

Exposure To Traffic-Related Air Pollution In Relation To Progression In Physical Disability Among Older Adults, Cynthia Curl

Public and Population Health Faculty Publications and Presentations

BACKGROUND: Physical disability is common though not inevitable in older age and has direct bearing on a person’s ability to perform activities essential for self-care and independent living. Air pollution appears to increase the risk of several chronic diseases that contribute to the progression of disability.

OBJECTIVE: We evaluated long-term exposure to traffic-related air pollution (TRAP) in relation to progression in physical disability.

METHODS: We conducted our investigation within the Chicago Health and Aging Project. We measured participants’ exposures to TRAP using two surrogates: residential proximity to major roads (1993 onwards) and ambient concentrations of oxides of nitrogen (NO …

The Effects Of Personal And Family History Of Cancer On The Development Of Dementia In Japanese Americans: The Kame Project, Adam Lee Slotnick

USF Tampa Graduate Theses and Dissertations

An increasing number of studies have shown an inverse association between a personal history of cancer (PHC) and dementia/Alzheimer’s disease (AD), both in those using dementia/AD as the outcome or cancer as the outcome. This is the first study to examine this potential association in Japanese Americans; and to examine family history of cancer and its association with incident dementia. Also, the association between these two diseases in the parents of participants were analyzed.

The Kame Project, conducted from 1992 through 2001 in King County, Washington was a population-based, prospective cohort study of older Japanese Americans. Conversion to incident dementia …

Demographic Profile, Geographic Distribution, Disability Prevalence, And Likelihood Of Being In-Poverty Amongst Grandparents Responsible For Grandchildren, Carlos Siordia, Mary E. Rauktis

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

Evidence-based research on Grandparents Responsible for Grandchildren (GRfG) continues to grow in recent decades. This brief report expands global knowledge on custodial grandparents by making use of a large data resource in the United States (US). The specific aim was to delineate the demographic profile, geographic distribution, and prevalence of specific-disabilities for the GRFG population in the US mainland. We also explore how demographic factors are associated with likelihood of being in-poverty. The analysis used data from the 2009-2013 American Community Survey (ACS) 5-year Public Use Microdata Sample (PUMS) file. The ACS is a nationally representative, yearly, statistical survey administered …

Factors And Outcomes Associated With Potentially Inappropriate Medication Use In Rural Community-Dwelling Older Adults, Marcia Y. Shade

Theses & Dissertations

Potentially inappropriate medications (PIMs) use in older adults is a significant public health concern. The use of PIMs to avoid may lead to negative outcomes such as adverse drug events. Prior conceptual analysis of PIMs use and observation of health-related factors in rural adults led to the design of this dissertation study. A sample was recruited from a population of rural community-dwelling older adults to examine the following specific aims: 1) Describe the use of PIMs to avoid, 2) Explore individual demographic characteristics (age, gender, income, education, and rural home location), health experience (comorbidity, number of medications and health providers), …

Facilitating Effective Communication Between First Responders And Older Adults During Fall Incidents: An Educational Intervention, Krystin M. Beeman, Erica L. Berger, Isabel A. Cabezas, Nicole M. Mathews

Dissertations, Masters Theses, Capstones, and Culminating Projects

PURPOSE. The purpose of this project was to provide first responders with communication strategies for older adults that may help when responding to fall- related calls. General information was also provided to First Responders on working with older adults with a focus on the aging process, fall risk factors, and communications strategies.

METHODS. A series of educational sessions to first responders at a local fire district were developed and presented by occupational therapy students. Materials were developed by presenters from evidence-based resources and tailored to the target population. Each presentation focused on statistics about older adults, the aging process, fall …

The Impact Of Education On Fear Of Falling In Elderly Women, Whitney R. Muller

Health, Human Performance and Recreation Undergraduate Honors Theses

Context: More than one third of individuals 65 and older fall each year. Approximately 85% of these falls occur in the homes of independent older adults. Falls can lead to an increased fear of falling, defined as a pervasive concern that a fall may occur. Fear of falling can decrease quality of life due to a lower sense of well-being, limiting mobility, and reduction of social interaction. Reduction in activity can result in a sedentary lifestyle and poor balance which increases the risk of falling. Fifty percent of women 75 years and older participate in no physical activity beyond …

Using An Online Learning Module In A Nursing Program To Improve Knowledge And Skills To Prevent Falls In The Community Dwelling Older Adult Population, Susan Kane Patton

Graduate Theses and Dissertations

Nationally, 28.4% of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence based protocols by providers to identify older adults at risk of falling is limited and rates of participation by older adults in prevention activities is low. Because of nursing’s increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community dwelling older adults and increased access of older adults to falls risk assessment. There is a …

Aging Converts Innate B1a Cells Into Potent Cd8+ T Cell Inducers, Catalina Lee-Chang, Monica Bodogai, Kanako Moritoh, Xin Chen, Robert Wersto, Ranjan Sen, Howard A. Young, Michael Croft, Luigi Ferrucci, Arya Biragyn

United States Public Health Resources

B cell dysregulation in aging is thought to mostly occur in conventional B2 cells without affecting innate B1 cells. Elderly humans and mice also accumulate 4-1BBL+ MHC class-IHi CD86Hi B cells of unknown origin. In this article, we report that these cells, termed 4BL cells, are activated murine and possibly human B1a cells. The activation is mediated by aging human monocytes and murine peritoneal macrophages. They induce expression and activation of 4-1BBL and IFN-gR1 on B1a cells to subsequently upregulate membrane TNF-α and CD86. As a result, activated B1a/4BL cells induce expression of granzyme B in CD8+ T cells by …

Development And Implementation Of A Culturally Tailored, Community-Based Intervention To Raise Awareness Of Brain Health Among African Americans, Mary Ann K. Hall, Ashani Johnson-Turbes, Felicia T. Fuller, Petra Niles, Shileah Cantey-Mcdonald

Journal of Health Disparities Research and Practice

African Americans bear a disproportionate burden of age-related cognitive impairment in the United States compared to Whites or Hispanics. African Americans experience greater prevalence, higher risk, and lower rates of treatment and diagnosis for dementia. In response to these health disparities the Alzheimer’s Association developed and implemented the Healthy Brain Initiative (HBI) demonstration project, the first community-level intervention to help reduce health disparities related to cognitive impairment among African Americans. The HBI promotes awareness of brain health, understanding of the heart-brain connection, and seeks to increase African American baby boomers engagement in health-protective behaviors to promote brain and overall health. …

Age And Employee Green Behaviors: A Meta-Analysis, Brenton M. Wiernik, Stephan Dilchert, Deniz S. Ones

Publications and Research

Recent economic and societal developments have led to an increasing emphasis on organizational environmental performance. At the same time, demographic trends are resulting in increasingly aging labor forces in many industrialized nations. Commonly held stereotypes suggest that older workers are less likely to be environmentally responsible than younger workers. To evaluate the degree to which such age differences are present, we meta-analyzed 132 independent correlations and 336 d-values based on 4676 professional workers from 22 samples in 11 countries. Contrary to popular stereotypes, age showed small positive relationships with pro-environmental behaviors, suggesting that older adults engaged in these workplace …

Trait Hope And Preparation For Future Care Needs Among Older Adult Primary Care Patients, Jodi L. Southerland, Deborah L. Slawson, Robert Pack, Silvia Sörensen, Jeffrey M. Lyness, Jameson K. Hirsch

ETSU Faculty Works

We examined associations between trait hope and preparation for future care needs (PFCN) among 66 older adult primary care patients in western New York. Participants completed a questionnaire assessing PFCN (awareness, information gathering, decision-making, concrete planning, and avoidance), and the Adult Trait Hope Scale. In multivariate regressions, lower hope, particularly less agency, was associated with more awareness of needing care, whereas higher hopefulness, particularly pathways thinking, was associated with increased decision-making and concrete planning. Greater hopefulness appears to be linked to goal-directed planning behaviors, although those with lower hope may actually be more aware of the need for planning. Evidence-based …

Alzheimer's Biomarkers Are Correlated With Brain Connectivity In Older Adults Differentially During Resting And Task States, Yang Jiang, Haiqing Huang, Erin Abner, Lucas S. Broster, Gregory A. Jicha, Frederick A. Schmitt, Richard Kryscio, Anders H. Andersen, David Powell, Linda J. Van Eldik, Brian T. Gold, Peter T. Nelson, Charles D. Smith, Mingzhou Ding

Behavioral Science Faculty Publications

β-amyloid (Aβ) plaques and tau-related neurodegeneration are pathologic hallmarks of Alzheimer’s disease (AD). The utility of AD biomarkers, including those measured in cerebrospinal fluid (CSF), in predicting future AD risk and cognitive decline is still being refined. Here, we explored potential relationships between functional connectivity (FC) patterns within the default-mode network (DMN), age, CSF biomarkers (Aβ₄₂ and pTau₁₈₁), and cognitive status in older adults. Multiple measures of FC were explored, including a novel time series-based measure [total interdependence (TI)]. In our sample of 27 cognitively normal older adults, no significant associations were found between levels of Aβ …

Factors Associated With Unmet Needs Among African-American Dementia Care Providers, P. J. Desin, Allison M. Caban-Holt, Erin L. Abner, Linda J. Van Eldik, Frederick A. Schmitt

Sanders-Brown Center on Aging Faculty Publications

Racial and ethnic minorities currently comprise 20% of the U.S. population; in 2050, this figure is expected to rise to 42%. As a result, Alzheimer’s disease (AD), the 5th leading cause of death for people aged 65 and older, is likely to increase in these groups. Most dementia caregiving for these populations comes from family and friends, especially among families with lower socioeconomic status. A convenience sample of 30 African-American dementia caregivers was interviewed to determine unmet needs. Participants expressed a limited desire for formal services, such as support groups, legal advice, case management, and homemaker services. Instead, commonly expressed …