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Down-Regulation Of Natural Killer Cell Activation In Response To Influenza Virus In Older Adults, Yu Jing

Theses and Dissertations in Biomedical Sciences

Immune senescence contributes to influenza-associated high mortality and morbidity and reduced vaccine efficacy in elderly people. Type I T cell (Thl)-mediated immunity plays a significant role in Immune responses to influenza infection and vaccination. Natural killer (NK) cells secrete significant amount of IFN-7 , a hallmark Thl cytokine, in response to influenza infection. How aging influences human NK cell IFN-7 production in response to influenza virus has not been well documented. In this study we employed human peripheral blood mononuclear cells (PBMC) and performed intracellular cytokine staining and flow cytometry primarily to investigate how aging influences NK cell activation with …

Caring For People With Alzheimer's Disease Or Dementia In Maine, Stuart Bratesman Mpp, Julie T. Fralich Mba, Catherine Mcguire Bs, Louise Olsen, Romaine Turyn

Disability & Aging

It is clear that caring for people with Alzheimer’s disease and dementia is a growing public health issue. Alzheimer’s is a progressively deteriorating disease that can last anywhere from 1 to 15 years. Families are the primary caregivers and will continue to need support to manage the care of their loved ones, to coordinate services within the long term care system and to maintain their own health and well-being.

Fairfax County's Commitment: A Housing And Health Continuum For Seniors, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-day site visit focused on the range of services made available to seniors by Fairfax County, Virginia, including senior centers, adult day health care, and assisted living and independent housing. Services to low-income residents were emphasized. Participants were introduced to the different agencies and funding streams involved and were able to observe how county officials have acted on a stated commitment to help seniors who wish to age in place, staying in the county and in their own homes rather than in a nursing home or other institution. The day included tours of two Fairfax County multiservice sites, in …

Support By Migrants To Their Elderly Parents In Rural Cambodia And Thailand: A Comparative Study, Zachary Zimmer, Kim Korinek, John Knodel, Napaporn Chayovan

Poverty, Gender, and Youth

Internal migration in Southeast Asia raises questions about strains upon traditional systems of support for older adults. While remittances to parents’ households play a role in rural household economies, uncertainty remains regarding whether and under what circumstances children interact with their elderly parents. This paper focuses on the adult children of older persons living in rural Cambodia and Thailand and examines the determinants of personal visits, monetary remittances, and more general forms of household support. Analyses consider ways in which geographically distant children support parents, the extent to which characteristics of parents, children, and households enhance or detract from these …

Physical Activity And Physical Activity Adherence In The Elderly Based On Smoking Status., Theodore Cooper, M. Resor, C. Stoever, P. Dubbert

Departmental Papers (Psych)

No abstract provided.

Individual Differences In Well-Being In Older Breast Cancer Survivors, Elizabeth A. Perkins, Brent J. Small, Lodovico Balducci, Martine Extermann, Claire Robb, William E. Haley

Epidemiology: Faculty Publications (2002-2018)

Older women who survive breast cancer may differ significantly in their long-term well-being. Using a risk and protective factors model, we studied predictors of well-being in 127 women age 70 and above with a history of at least one year's survival of breast cancer. Mean post-cancer survivorship was 5.1 years. Using life satisfaction, depression and general health perceptions as outcome variables, we assessed whether demographic variables, cancer-related variables, health status and psychosocial resources predicted variability in well-being using correlational and hierarchical regression analyses. Higher age predicted increased depression but was not associated with life satisfaction or general health perceptions. Cancer-related …

Changes In Formal-Informal Caregiving In Elderly Stroke Survivors, Holly Anne Beard

Health Services Research Dissertations

The purpose of this study is to determine the extent to which the Andersen and Aday Model of Health Services Use to predict cross-sectional and longitudinal differences in the caregiving source among stroke survivors (n=477) over a six-year period. This study involves a secondary analysis of a longitudinal panel study focusing upon three waves of interview data from the HAS/AHEAD study spanning 1998 through 2002. Multinomial logistic regression was utilized to examine caregiving source cross-sectionally at each wave. Clustered multinomial logistic regression was used to examine relationships between predictor variables in the model and caregiving source across waves while holding …

Be Headsmart® Seniors! -- The Effectiveness Of A Psychoeducational Fall And Consequential Injury Prevention Program

Florida Public Health Review

This study tested the utility of the Be HeadSmart® Seniors! fall prevention intervention, HeadSmartz, a Cranium Challenge, in the promotion of safety improvement behavior change. It employed a quasi-experimental two-group design. Of the 106 individuals included in this study, 64 received the intervention and 42 only received the safety brochure. The Cranium Challenge is an interactive, visual, and auditory program based upon the popular board game CraniumTM. This game stimulated various parts of the participant’s brain verbally, through trivia questions and word games, visually, or by humming, whistling, or playing charades. The presentation included trivia questions created in a PowerPoint …

Community Mobility And Dementia: A Review Of The Literature, Nina M. Silverstein, Megan Vanderbur

Gerontology Institute Publications

By the year 2030, 70 million Americans will be 65 or older. Approximately 80 percent of this population will likely be driving themselves. And without appropriate and timely interventions, many are likely to be driving with Alzheimer’s disease (AD). Current estimates suggest that 2 percent of the population 65 to 74, 19 percent of the population 75 to 84, and 47 percent of the population 85 and older are likely to suffer from Alzheimer’s disease or a related disorder. By the year 2050, the number of Americans with Alzheimer’s disease could range from 11.3 million to 16 million. This significant …

Racial Differences In Perception Of Breast Cancer Risk In Rural Southeast Georgia, Stuart H. Tedders, Anthony V. Parrillo, Karl E. Peace, Jannell R. Knight

Journal of the Georgia Public Health Association

A university-public health collaborative was formed to more fully understand cancer risk among rural women in Georgia. Objectives: This study sought to gain an understanding of racial differences with regard to behavioral risk, perception of breast cancer risk, and perception of barriers to screening. Design: Differences in subjects’ risk and risk perception were assessed by creating, piloting, and administering a written survey at local health departments. Sample: A purposive sample of females enrolled in breast and cervical cancer screening programs in four rural counties in southeast Georgia (n = 147) were surveyed. Subjects were randomly invited to participate. Incentives were …

Obesity, Physical Activity, And Mortality In A Prospective Chinese Elderly Cohort, Mary Schooling, Tai Hing Lam, Zhi Bin Li, Sai Yin Ho, Wai Man Chan, Kin Sang Ho, May Ked Tham, Benjamin J. Cowling, Gabriel M. Leung

Publications and Research

Background
In older people, it is unclear whether obesity relates to mortality, which calls into question its etiologic role in disease and its public health relevance. This apparent lack of relationship in older people could be an artifactual result of their diverse health states.

Methods
We used Cox regression analysis to determine whether the effect of body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) or physical activity on mortality varied with health status in a prospective cohort study of Chinese people 65 years or older enrolled from 1998 to 2000 at …

Investigating Mediation When Counterfactuals Are Not Metaphysical: Does Sunlight Uvb Exposure Mediate The Effect Of Eyeglasses On Cataracts?, Brian Egleston, Daniel O. Scharfstein, Beatriz Munoz, Sheila West

Johns Hopkins University, Dept. of Biostatistics Working Papers

We investigate the degree to which a reduction in ocular sunlight ultra-violet B (UVB) exposure mediates a relationship between wearing eyeglasses and a decreased risk of cataracts. An estimand is proposed in which causal effects are estimated locally within strata based on potential UVB exposure without glasses and the degree to which glasses use reduces UVB exposure. We take advantage of the structure of the data in which the counterfactual UVB exposures if the participants in the study who wore glasses had not worn glasses are considered observable.

Measuring The Influence Of Built Neighborhood Environments On Walking In Older Adults, Yvonne L. Michael, Tracey Beard, Dongseok Choi, Stephanie Farquhar, Nichole Carlson

Community Health Faculty Publications and Presentations

Examined the degree of association between perceived and objective characteristics of the neighborhood environment and the relation of each type of measurement to neighborhood walking in older adults. Participants included 105 adults aged 65-92 (mean age 75.1) from 10 neighborhoods in Portland, Oregon, participating in Senior Health and Physical Exercise (SHAPE), a randomized walking intervention. Neighborhoods were stratified by a "walking friendliness" ranking variable. This variable was derived for each neighborhood based on available social and environmental data that were hypothesized to correlate with walking and physical activity: high income, high older adult population density, high proportion of white residents, …

Predictors Of Influenza Immunization Among Home Care Clients In Ontario, John P. Hirdes, Dawn M. Dalby, R. Knight Steel, G. Iain Carpenter, Roberto Bernabei, John N. Morris, Brant E. Fries

Kinesiology and Physical Education Faculty Publications

Background: This study examined factors associated with the receipt of influenza vaccination among Ontario home care clients.

Methods: Home care clients were assessed, as part of a routine home visit, during a pilot study of the Resident Assessment Instrument – Home Care (RAI-HC) in 12 Ontario Community Care Access Centres (CCACs). The RAI-HC is a multidimensional assessment that identifies clients’ needs and level of functional ability. Multiple logistic regression was used to identify factors associated with influenza immunization in the two years prior to assessment.

Results: The overall rate of immunization reached about 80% by 2002. Factors …

Achieving The American Dream: Facilitators And Barriers To Homeownership Among Immigrants, Lutchmie Narine, Marcia A. Shobe

Public Health, Food Studies, and Nutrition

As of March 2003, the immigrant population in the United States (US) has reached 33.5 million individuals. Finding a way out of poverty is very difficult for many immigrants due to both individual and institutional barriers to savings and asset accumulation. Given that the primary sources of wealth among native-born households is through homeownership, it is only fitting that foreign-born households would also wish to achieve the “American Dream.” This paper outlines significant supports and barriers to savings and, more importantly, homeownership among US immigrants. Several suggestions for asset-based policy development for immigrants are also included in the discussion. By …

Urban Versus Rural Mortality Among Older Adults In China, Zachary Zimmer, Toshiko Kaneda, Laura Spess

Poverty, Gender, and Youth

For some time, Chinese government policies have treated rural and urban areas very differently, and a by-product of China’s rapid development seems to be an even greater differentiation between urban and rural social and economic life. Over the next several decades, in part because of rapid fertility declines and in part as a result of mortality declines at older ages, China and other developing countries will experience enormous increases in the proportion of older adults and the proportion of the “oldest-old.” It is reasonable to expect that these age structure changes will alter the provision of health care, making an …

Poverty, Wealth Inequality, And Health Among Older Adults In Rural Cambodia, Zachary Zimmer

Poverty, Gender, and Youth

This working paper examines the distribution of household wealth and tests whether associations exist between wealth inequality and health outcomes among older adults living in one of the world’s poorest regions, rural Cambodia. Results confirm difficult economic conditions among most elderly in rural Cambodia. This study suggests there is some validity to generalizing the relationship between wealth inequality and health to extremely poor populations and that a very small difference in wealth makes a relatively large difference in regard to the association with health among those living in impoverished surroundings.

Association Between Smoking, Chemical Exposure And Hearing Loss In An Occupational Setting, Darlene W. Olive

Theses and Dissertations

Objective: Twenty-two million Americans or roughly 8% of the population are hearing impaired. This affects more than just the ability for one to hear. In the last three decades, younger Americans have shown a sharp increase in hearing impairment. Hearing loss affects social and emotional well being and thus has the ability to decrease one's quality of life. This study was designed to examine the association between smoking, workplace chemical exposure, and hearing loss.Methods: This cross-sectional population-based study was conducted in an occupational health clinic setting in Virginia. The study population consisted of employees from local businesses who visited the …

Clinical Case Mix And Other Challenges To Detroit's Medicaid-Dependent Nursing Homes, Richard L. Douglass, William Lavery, Paul Bridgewater, Gloria Long, Joyce Blair

Michigan Journal of Public Health

Nursing homes that care for the poor in Detroit are frequently dependent upon Medicaid as their principal source of revenue. These facilities face numerous challenges because they face limited resources for maintenance of facilities, staff and administrative supports, and other normal costs. They lack the kinds of support that are provided in-kind, or by more generous sources of revenue and are often characterized as institutions of poor quality; yet nearly 70% of the nation’s Medicaid-recipient elderly nursing home patients are in for-profit facilities that are sustained largely on Medicaid funding. These facilities are often sources of care for underserved minority …

Building An Institute To Translate Research Into Practice: A Facilitation Model, Nancy L. Chernett, Laura N. Gitlin, Lenard W. Kaye

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

Keeping Track Of Care: Quality And Technology At Lifebridge Health System (Baltimore), Judith Moore

National Health Policy Forum

This one-day site visit focused on quality and technology in acute, post-acute and long-term care at Sinai Hospital and Levindale Hebrew Geriatric Center and Hospital, both components of LifeBridge Health System in Baltimore. Participants traced the treatment paths of hypothetical cardiac and cancer patients through the hospital and explored the range of home- and community-based as well as institutional care available through the geriatric center. The role of clinical information technology was highlighted in both settings.

The Unique Wills-Jefferson Geriatric Psychiatry Program, Jerold A. Glick

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

Providing Community-Based Health Care To The Homeless, Diane Cornman Levy, Kevin J. Lyons, Laura N. Gitlin

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

A Comparison Of Seasonal Resident And Year-Round Resident Hospitalizations In Florida

Florida Public Health Review

No abstract provided.

Our Public Health History In Florida: Interview With Laurence G. Branch

Florida Public Health Review

No abstract provided.

Understanding The Relative Importance Of Positive And Negative Social Exchanges: Examining Specific Domains And Appraisals, Jason T. Newsom, Karen S. Rook, Masami Nishishiba, Dara H. Sorkin, Tyrae Mahan

Community Health Faculty Publications and Presentations

Negative social exchanges have been more reliably related to psychological health than have positive social exchanges. Little research, however, has sought to understand how underlying appraisal processes link such exchanges to psychological health. This study examined the frequencies of occurrence and appraisals of four parallel domains of positive and negative exchanges in relation to positive well-being and psychological distress in a national sample of 916 older adults. Structural equation analyses revealed that negative exchanges were related both to less well-being and greater psychological distress, whereas positive exchanges were related only to positive well-being. Furthermore, results supported a process in which …

Active Life Expectancy And Functional Limitations Among Older Cambodians: Results From A 2004 Survey, Zachary Zimmer

Poverty, Gender, and Youth

This study’s aims are to: (1) determine the prevalence of functional limitations among older adults in Cambodia using activities of daily living (ADLs); (2) compare limitation prevalence with other countries in the region; (3) estimate active life expectancy; (4) examine standard correlates of functional status and assess whether they are associated with limitation in expected ways. Elderly Cambodians appear more likely to report limitations than their counterparts in neighboring countries. A contribution of the analysis is the examination of a basic measure of health among a population that until recently has been isolated from the rest of the world.

Education Of Adult Children And Mortality Of Their Elderly Parents In Taiwan, Zachary Zimmer, Linda G. Martin, Mary Beth Ofstedal, Yi-Li Chuang

Poverty, Gender, and Youth

Research shows an older adult’s education is strongly associated with mortality. But in societies such as Taiwan, where families are highly integrated, the education of family members may be linked to survival. Such may be the case in settings where there are large gaps in levels of education across generations and high levels of resource transfers between family members. This Population Council study employs 14 years of longitudinal data from Taiwan to examine the combined effects of education of older adults and their adult children on mortality outcomes of older adults. Results indicate that educational levels of both parent and …

Reciprocal Effects Of Health And Economic Well-Being Among Older Adults In Taiwan And Beijing, Kristine R. Baker, Mary Beth Ofstedal, Zachary Zimmer, Zhe Tang, Yi-Li Chuang

Poverty, Gender, and Youth

The objectives of this Population Council study are threefold: 1) to examine whether socioeconomic status disparities in health are found in non-Western settings; 2) to assess whether socioeconomic status gradients in health endure into older ages; and 3) to evaluate the direction of causality between health and socioeconomic status. Findings provide evidence for reciprocal effects of economic well-being and health among older adults in both Taiwan and Beijing. Those with higher levels of economic well-being have lower levels of functional limitation over time, and those with higher levels of functional limitation have lower levels of economic well-being over time. Consistent …

Quality Improvement In Maryland: Partnerships And Progress, Judith D. Moore, Lisa Sprague

National Health Policy Forum

This one-and-a-half-day site visit to Easton, Maryland, explored the activities of the Delmarva Foundation, the Quality Improvement Organization (QIO) for Maryland and the District of Columbia. The program reviewed Delmarva’s responsibilities under their Medicare contract and the initiatives they have undertaken with hospitals and other providers to improve health care outcomes and to define, collect, and report quality data. Local hospital officials added their perspective on quality programs and working with Delmarva. Topics of particular interest were health information technology, patient safety, and quality reporting both to government agencies and to consumers.