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Lower Nutritional Status And Higher Food Insufficiency In Frail Older Us Adults, Ellen Smit, Kerri M. Winters-Stone, Paul D. Loprinzi, Alice M. Tang, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Frailty is a state of decreased physical functioning and a significant complication of ageing. We examined frailty, energy and macronutrient intake, biomarkers of nutritional status and food insufficiency in US older adult (age ≥ 60 years) participants of the Third National Health and Nutrition Examination Survey (4731). Frailty was defined as meeting ≥ 2 and pre-frailty as meeting one of the following four-item criteria: (1) slow walking; (2) muscular weakness; (3) exhaustion and (4) low physical activity. Intake was assessed by 24 h dietary recall. Food insufficiency was self-reported as ‘sometimes’ or ‘often’ not having enough food to eat. Analyses …

Body Mass Index Trajectories From Adolescence To Midlife: Differential Effects Of Parental And Respondent Education By Race/Ethnicity And Gender, Katrina M. Walsemann, Jennifer A. Ailshire, Bethany A. Bell, Edward A. Frongillo

Faculty Publications

Objectives: Race/ethnicity and education are among the strongest social determinants of body mass index (BMI) throughout the life course, yet we know relatively little about how these social factors both independently and interactively contribute to the rate at which BMI changes from adolescence to midlife. The purpose of this study is to 1) examine variation in trajectories of BMI from adolescence to midlife by mothers' and respondents' education, and 2) determine if the effects of mothers' and respondents' education on BMI trajectories differ by race/ethnicity and gender.

Design: We used nationally representative data from the National Longitudinal Survey of Youth …

Quality Of Life For All Ages, By Design. A Conversation With Patricia Moore, Patricia Moore

Center for Policy Research

On November 3, 2011, Patricia Moore presented the Syracuse Seminar on Aging to a packed audience of over 250 faculty, students, and community members. She delivered an engaging lecture on “Quality of life for all ages, by design”. Afterwards Janet Wilmoth, Director of the Syracuse University Aging Studies Institute, and Patricia Moore had a chance to sit down and talk about her path-breaking career, ability-based design, and aging in America.

The Role Of Antioxidant Rich Berries In The Prevention Of Postmenopausal Bone Loss, Lydia Karimi Kaume

Graduate Theses and Dissertations

Postmenopausal osteoporosis is the most prevalent form of osteoporosis and results in fragility fractures. Smoking is one of the major risk factors for osteoporosis and is known to aggravate bone loss in postmenopausal women due to increased oxidative stress and inflammation. Diet-based interventions using berries have shown bone protective affects in animal studies partially due to antioxidant and anti-inflammatory properties of their phenolic compounds. The goal of this research was to determine the effects of antioxidant-rich fruits in the prevention of postmenopausal bone loss. Our first study examined the dose dependent effects of blackberries in preventing bone loss in an …

Building Trust And Collaboration With Rural Minorities: Experiences With Minority Farmers In The Mississippi Delta, Ari Mwachofi

Journal of Health Disparities Research and Practice

The paper focuses on the question “What research approach is effective in building trust with minority farmers?” The question is answered through a documentation of researchers’ experiences building trust and collaboration with minority farmers in the lower Mississippi Delta. The researchers applied two research paradigms -logical positivism and paradigm of praxis. The logical positivism research approach was met with mistrust and open animosity and had to be abandoned for one based on the paradigm of praxis. Through this approach, and cognizant of the historical-social-political context, the researchers included insiders from the focus population as collaborators and researchers and succeeded in …

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.

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 …

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.

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 …

Physical Activity Effects On Depressive Symptoms In Black Adults, Elisa R. Torres, Carolyn M. Sampselle, Kimberlee A. Gretebeck, David L. Ronis, Harold W. Neighbors

Journal of Health Disparities Research and Practice

Objectives: Randomized trials found physical activity (PA) effective in decreasing depressive symptoms. Few studies included Black participants. The purpose of this systematic literature review was to determine the effects of PA on depressive symptoms in Black adults. Methods: Articles were abstracted by conducting a computer and hand search of eligible studies. Results: Eight of 13 studies found a significant inverse relationship between PA and depressive symptoms in Black adults. Sources for the heterogeneity were explored. Conclusion: Future studies should include representative samples of Black adults, incorporate a theory which considers multiple levels of influence, account for genetic factors in the …

Hurricane Preparedness Of Community-Dwelling Dementia Caregivers In South Florida, Janelle J. Christensen

USF Tampa Graduate Theses and Dissertations

The aim of this dissertation is to explore how informal caregivers for people with dementia (PWD), who are community dwelling (i.e., not in nursing homes), prepare and plan for disasters. The research site is a particularly hurricane-prone region of Florida, second only to New Orleans in its vulnerability. An underlying assumption of this research is that caregivers for PWD have to plan and anticipate problems that are unique to their role. The rationale for the study described here is that disaster planning and mitigation save lives (Tengs et al. 1995), but there is little or no literature on disaster planning …

The Significance Of Race For Neighborhood Social Cohesion: Perceived Difficulty Of Collective Action In Majority Black Neighborhoods, Tamara Leech, Tara Hobson-Prater

Department of Public Health Scholarship and Creative Works

This article explores William Julius Wilson's contentions about community cultural traits by examining racial differences in middle class neighborhoods' levels of social cohesion. Specifically, we explore the perceived difficulty of these actions-as opposed to general pessimism about their outcomes-as a potential explanation for low levels of instrumental collective action in Black middle class neighborhoods. Our results indicate that, regardless of other neighborhood factors, majority Black neighborhoods have low levels of social cohesion. We also find that this racial disparity is statistically explained by shared perceptions about the amount of effort required to engage in group action in different neighborhoods. These …

Perceived Health In Lung Cancer Patients: The Role Of Positive And Negative Affect, Jameson K. Hirsch, Andrea R. Floyd, Paul R. Duberstein

ETSU Faculty Works

Purpose: To examine the association of affective experience and health-related quality of life in lung cancer patients, we hypothesized that negative affect would be positively, and positive affect would be negatively, associated with perceived health.

Methods: A sample of 133 English-speaking lung cancer patients (33% female; mean age = 63.68 years old, SD = 9.37) completed a battery of self-report surveys.

Results: Results of our secondary analysis indicate that trait negative affect was significantly associated with poor physical and social functioning, greater role limitations due to emotional problems, greater bodily pain, and poor general health. Positive affect was significantly associated …

Older Americans Act Of 1965: Programs And Funding, Carol O'Shaughnessy

National Health Policy Forum

This document offers a basic description of the Older Americans Act of 1965. The Act is considered the major vehicle for promoting the delivery of social services to the aging population. The Act's seven titles and multiple programs are described, along with a chart showing fiscal year 2012 federal appropriations.

Increasing Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. States design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control. The incorporation of multiple, sometimes conflicting incentives into state reimbursement systems has resulted in enormously complex and demanding methodologies that inhibit consumer participation in state rating setting decisions. In turn, the lack of consumer involvement has the potential to result in the adoption of reimbursement systems that favor industry and government interests at the expense of issues important …

The Role Of Medications In Predicting Activity Restriction Due To A Fear Of Falling, Dawn M. Guthrie, Paula C. Fletcher, Evelyn Williams, Nicole Boumans, John P. Hirdes

Kinesiology and Physical Education Faculty Publications

Objectives: To examine the role of medication use and other factors in predicting activity restriction due to a fear of falling (AR/FF). Methods: Older adults were assessed twice with the interRAI Community Health Assessment and the Berg Balance Scale (BBS). The main outcome was limiting going outdoors due to an AR/FF. Medications were recorded by trained assessors. Results: Participants (n=441) had a mean age of 80.3 (sd=7.1) years, most were aged 65+ (96.8%) and 29.3% reported activity restriction. Taking nervous system active or cardiovascular medications was associated with AR/FF. In a multivariate model, the main predictors were having 3+ comorbid …

Do Indigenous Australians Age Prematurely? The Implications Of Life Expectancy And Health Conditions Of Older Indigenous People For Health And Aged Care Policy, Philippa R. Cotter, John R. Condon, Tony Barnes, Ian P.S. Anderson, Leonard R. Smith, Teresa Cunningham

Aboriginal Policy Research Consortium International (APRCi)

Objective. To assess whether Indigenous Australians age prematurely compared with other Australians, as implied by Australian Government aged care policy, which uses age 50 years and over for population-based planning for Indigenous people compared with 70 years for non-indigenous people.

Methods. Cross-sectional analysis of aged care assessment, hospital and health survey data comparing Indigenous and non-indigenous age-specific prevalence of health conditions. Analysis of life tables for Indigenous and non-indigenous populations comparing life expectancy at different ages.

Results. At age 63 for women and age 65 for men, Indigenous people had the same life expectancy as non-indigenous people at age 70. …

Health Effects Associated With Foreclosure: A Secondary Analysis Of Hospital Discharge Data, Nancy Menzel, Sheniz Moonie, Melva V. Thompson-Robinson

Nursing Faculty Research

Objectives. The purpose of this study was to assess the health effects of high home foreclosure rates in an area of the United States of America and the utility of hospital discharge data for this purpose. Methods. We analyzed hospital discharge data from three postal zip codes using the principal diagnosis for 25 Diagnostic Related Groups associated with stress. Descriptive statistics were used to characterize hospital discharge rates for each condition by year and zip code. To test for differences across time, the Cochran-Armitage trend test was performed. Results. Most conditions did not demonstrate a statistical change between …

Health Effects Associated With Foreclosure: A Secondary Analysis Of Hospital Discharge Data, Nancy N. Menzel, Sheniz Moonie, Melva Thompson-Robinson

Environmental & Global Health Faculty Research

Objectives: The purpose of this study was to assess the health effects of high home foreclosure rates in an area of the United States of America and the utility of hospital discharge data for this purpose.

Methods: We analyzed hospital discharge data from three postal zip codes using the principal diagnosis for 25 Diagnostic Related Groups associated with stress. Descriptive statistics were used to characterize hospital discharge rates for each condition by year and zip code. To test for differences across time, the Cochran-Armitage trend test was performed.

Results: Most conditions did not demonstrate a statistical change between 2005 and …

Service Learning In Higher Education Exercise Science Programs, Wendy Bjerke Ph.D.

Journal of Sustainable Social Impact

Service Learning in Higher Education Exercise Science Programs

ABSTRACT

Research Category

INTRODUCTION: Service Learning (SL) describes teaching methods that incorporate student service activities with specific learning objectives. SL has been applied to allied health higher education programs.

PURPOSE: To determine the applicability of SL to exercise science courses. SL data associated with an undergraduate course in exercise physiology serving a local fire department is examined.

METHODS: Among 90 firefighters, resting heart rate, blood pressure, estimated relative VO2 max, body composition, lower extremity power, upper body strength, flexibility, and perceived stress was assessed pre and post an education and physical …

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

Current And Future Directions In Frailty Research., Anita Mohandas, Joanne Reifsnyder, Mimi Jacobs, Tim Fox

College of Population Health Faculty Papers

The concept of frailty has been evolving dramatically for the past 30 years. Through its evolution, a variety of single and multidimensional models have been used to describe frailty. This article reviews the current literature related to the defining dimensions of frailty and identifies the gaps in the literature requiring additional research. A detailed literature review was performed to identify key dimensions and models currently being used to define frailty, classify interventions that have been developed to reverse frailty, and identify potential areas for future research within this field. Despite the large body of research defining the dimensions of frailty, …

Is The Polst Model Desirable For Florida?, Sarah Catherine Spillers, Brittany Lamb

Florida Public Health Review

Florida has one ofthe largest and most rapidly growing elderly populations in the nation. Although advances in medicine are allowing physicians to extend the lives of elderly patients, advances must simultaneously be made in the end-of-life care arena to ensure that the comfort and quality of life of elderly patients is maintained. This paper argues that use of a Physician Orders for Life Sustaining Treatment (POLST) form in Florida would be effective in increasing the accuracy oftranslating patients’ end-of-life wishes into treatment orders, in ensuring the consistency of treatment across settings, and in improving health care provider compliance with patient …

Aligning Graduate Medical Education With Public Policy, Rob Cunningham

National Health Policy Forum

In late May–early June 2011, the Forum sponsored a site visit to Denver, Colorado, to observe innovative efforts to improve the health of Coloradans and reduce the cost of health care. The three-day agenda was designed to convey the breadth and interconnectedness of the efforts underway in Denver and to highlight both successes and challenges. The exploration concentrated on how three themes of national interest are unfolding in Denver: building and sustaining a robust and effective safety net in an evolving health care market; improving the health of people and their communities to prevent and reduce the need for health …

Modification By Frailty Status Of Ambient Air Pollution Effects On Lung Function In Older Adults In The Cardiovascular Health Study, Sandrah P. Eckel, Thomas A. Louis, Paulo H.M. Chaves, Linda P. Fried, Helene G. Margolis

Johns Hopkins University, Dept. of Biostatistics Working Papers

Older adult susceptibility to air pollution health effects is well-recognized. Advanced age may act as a partial surrogate for conditions associated with aging. The authors investigated whether gerontologic frailty (a clinical health status metric) modified the effects of ambient ozone or particulate matter (PM10) air pollution on lung function in 3382 older adults using 7 years of followup data from the Cardiovascular Health Study (CHS) and the CHS Environmental Factors Ancillary Study. Monthly average pollution and annual frailty assessments were related to up to 3 repeated measurements of lung function using novel cumulative summaries of pollution and frailty histories that …

Principal Component Analysis Of Dietary And Lifestyle Patterns In Relation To Risk Of Subtypes Of Esophageal And Gastric Cancer, Stephanie A. Navarro Silvera, Susan T. Mayne, Harvey A. Risch, Marilie D. Gammon, Thomas Vaughan, Wong-Ho Chow, Joel A. Dubin, Robert Dubrow, Janet Schoenberg, Janet L. Stanford, A. Brian West, Heidrun Rotterdam, William J. Blot

Department of Public Health Scholarship and Creative Works

Purpose

To carry out pattern analyses of dietary and lifestyle factors in relation to risk of esophageal and gastric cancers.

Methods

We evaluated risk factors for esophageal adenocarcinoma (EA),esophageal squamous cell carcinoma(ESCC), gastric cardia adenocarcinoma (GCA), and other gastric cancers (OGA) using data from a population-based case-control study conducted in Connecticut, New Jersey, and western Washington state. Dietary/lifestyle patterns were created using principal component analysis (PCA). The impact of the resultant scores on cancer risk was estimated through logistic regression.

Results

PCA identified six patterns: meat/nitrite, fruit/vegetable, smoking/alcohol, legume/meat alternate, GERD/BMI, and fish/vitamin C. Risk of each cancer under study …

Caloric Restriction, Aerobic Exercise Training And Soluble Lectin-Like Oxidized Ldl Receptor-1 Levels In Overweight And Obese Post-Menopausal Women, Tina E. Brinkley, Xuewen Wang, Noriaki Kume, Hirokazu Mitsuoka, Barbara J. Nicklas

Faculty Publications

Background—Elevated circulating levels of soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) have been observed in obese persons and are reduced by weight loss. However, it is not known if combining caloric restriction (CR) with exercise training is better in reducing sLOX-1 levels than CR alone.

Objective—We examined whether the addition of aerobic exercise to a weight loss intervention differentially affects sLOX-1 levels in 61 abdominally obese postmenopausal women randomly assigned to a CR only (n=22), CR + moderate-intensity exercise (n=22), or CR + vigorous intensity exercise (n=17) intervention for 20 weeks. The caloric deficit was ~2,800 kcal/week for …

Chronic Disease Self-Management Programs: Relevance For Persons With Dementia, Nina M. Silverstein, Alison S. Gottlieb

Gerontology Institute Publications

The context for this study is the work of the Healthy Brain Initiative. The CDC has established a cooperative agreement with the Alzheimer’s Association to develop and implement a multifaceted approach to look at cognitive health as a public health issue. Late in 2010, the Association commissioned a review of the major chronic disease prevention programs from a systems approach to begin to understand the source of findings that Medicare beneficiaries with Alzheimer’s and related disorders are much higher cost than those simply with a single chronic disease and no AD. This led to the conclusion that Chronic Disease Self‐Management …