Digital Commons Network^™

Community-Dwelling Older Adults' Adherence To Fall Prevention Recommendations, Suzänne Fleming Taylor

Theses and Dissertations

Falling among older adults is a leading cause of concern due to the known impacts including physical injury, loss of independence, increased health care costs, and mortality. In efforts to decrease the numbers of falls experienced by older adults, healthcare providers assess individuals’ fall risks and provide corresponding fall prevention recommendations. The effectiveness however, of these recommendations, is only as strong as the level of adherence to those recommendations; which has proven low in recent research. Using the theoretical foundation of the Health Belief Model, this study quantified adherence to environmental fall prevention recommendations. Twenty-two community-dwelling older adults participated in …

Dementia Caregivers: An Exploration Of Their Knowledge, Beliefs, And Behavior Regarding Advance Care Planning For End-Of-Life Care, Mariette Klein

Theses and Dissertations

The purpose of this study is to explore what knowledge dementia caregivers have about advance care planning (ACP), how they learn to execute formal advance directives (ADs) or have engaged in an informal ACP process, and how they understand their roles as decision makers for the patients. Factors that contribute to the completion of an ACP process such as demographic, psychosocial, and situational factors are identified. From the grounded theory data analysis, a theory emerged about how ACP is accomplished and used by caregivers. Findings reveal that caregivers understand ACP as having the power to shape the dying process for …

Virginia Commonwealth University Graduate And Professional Programs Bulletin [2014], Virginia Commonwealth University

VCU Bulletins

Graduate and professional programs bulletin for Virginia Commonwealth University for the academic year 2014-20015. It includes information on academic regulations, degree requirements, course offerings, faculty, academic calendar, and tuition and expenses for graduate programs.

Council For Community Engagement Grants Impact Report 2007-2012, Jennifer Jettner, Valerie Holton

Division of Community Engagement Resources

As Virginia Commonwealth University (VCU) takes its place among the nation‟s top 50 public research universities, our guiding principles have been an abiding focus on student success at all levels, unparalleled innovation through research, and a university-wide commitment to human health, and engagement and empowerment in our communities. To that end, VCU has named community engagement as a key focus area in its strategic plan with the aim of developing collaborative university-community partnerships that yield creative and relevant solutions for community-identified needs. These mutually-beneficial partnerships not only support the public good, but they also support our mission to advance knowledge …

An Annotated Review Of Scholarship: Measuring The Impact Of Community-University Partnerships, Kate Agnelli

Division of Community Engagement Resources

This series of annotations of scholarly products published between 2004 and 2013 seeks to provide readers with resources and scholarship regarding impact assessments for community-university partnerships. Articles reviewed include those that discuss the evaluation of individual partnerships, as well as those providing more general information and guidance. The document helps to illuminate work that is consistent with the Division of Community Engagement’s mission to mobilize effective partnerships and advance the university’s strategic plan, Quest for Distinction. These annotations will provide a resource to community-engaged faculty at VCU and other higher education institutions.

Older Prisoners, Edward F. Ansello

Director's Editorials from Age in Action

The impact of an aging prison population is causing concern among different stakeholders, including prison officials, legislative bodies, clergy, and some gerontologists. Prison officials are scrambling to accommodate the numbers and needs of older inmates, but they are confounded by constrained budgets, inappropriate prison architecture, lack of gerontologically and geriatrically trained staff members, indifferent legislative bodies, and a general lack of awareness among the public of these problems. Our states need not only retrofitted and newly designed physical facilities but also staffs and providers with gerontological and geriatric training, from corrections personnel to health care providers to clergy and mental …

The Necessity Of Leisure And Physical Activity, Alison Clarke, Stephanie Goode

Case Studies from Age in Action

Educational Objectives

1. Explain the value and benefit of physical and leisure activity across the lifespan, regardless of physical limitations.

2. Identify barriers to participation in physical and leisure activity.

3. Discuss strategies to engage and maintain physical and recreational activity participation.

Transitioning From A Traditional Nursing Home Environment To Green House Homes: What Are Stakeholders' Attitudes Toward And Satisfaction With The Small House Care Environment, Christine Harrop-Stein

Theses and Dissertations

This dissertation research was designed as two independent research studies. The first study, qualitative, and non-experimental, aimed to examine residents’, family members’, and staff members’ (stakeholders’) satisfaction with, and attitudes toward Green House living one month prior to moving and again at one and three months after moving. Focus groups were the primary method of data collection. Thirty residents and 40 staff members transitioned to one of three Green House homes beginning January, 2013. Data collected began in December, 2012. Following each focus group, tape recordings were transcribed, and coded. Using grounded theory and the constant comparative method of analysis, …

Sirt6 And Premature Aging Of Hutchinson-Gilford Progeria Syndrome Fibroblasts., Helal Endisha

Theses and Dissertations

The genetic disease Hutchinson-Gilford Progeria Syndrome (HGPS) arises from a de novo single nucleotide mutation (1824CàT) in the LMNA gene. As a result, the mutated lamin A protein (progerin) remains farnesylated and permanently attached to the nuclear membrane. Progerin accumulates and deforms the nuclear membrane leading to an array of cellular abnormalities driving the cells to enter a state of permanent cell-cycle arrest early on in replicative age i.e. premature cellular senescence. Cellular senescence has been extensively studied as one of the contributing factors to aging in HGPS patients and other age-related diseases. There has also been evidence to show …

Older Msm And Hiv/Aids: A Grounded Theory Study To Inform Prevention, Johnnie O'Neal

Theses and Dissertations

This study sought to increase knowledge as it relates to HIV-prevention for older adults, especially for MSM who are HIV-negative. In participating in this study, participants shared their experiences, stories and feelings related to their exposure to HIV and HIV-prevention initiatives. Using a Traditional Grounded Theory method, 22 interviews with older MSM were conducted with the aim of producing a theory that explained how these men lived prior to HIV, the different ways they responded to the onset of the virus, how they have lived their lives over the last three decades, and the extent to which the virus continues …

The Development Of A Discipline: Examination Of The Profession Of Gerontology And Gerontological Professionals, Tracey Gendron

Theses and Dissertations

The growth of the aging population has warranted increased training and education to prepare professionals with the specific knowledge needed to best serve older adults. Gerontology, as an academic discipline, provides professionals with the conceptual knowledge and the skills necessary to address the complexities of working with a diverse aging population. Little research has been done of the characteristics of professionals both with and without formal education in gerontology that are working with the aging population. The aim of this study was to investigate the roles of career motivation, job satisfaction, attitudes about aging, career commitment, and professional identity among …

Factors For Selecting A Consumer Directed Health Care Plan, David Jordan

Theses and Dissertations

Health Reimbursement Arrangements (HRAs) and Health Savings Account (HSA) eligible High Deductible Health Plans (HDHPs) emerged as a new health care insurance models referred to as Consumer Directed Health Plans (CDHPs) in the early 2000s. The purpose of this study is to examine the association between enrollees’ prior financial experiences as they relate to health care access and use with plan choice when a Managed Care Preferred Provider Organization (PPO), HRA, and HSA eligible HDHP are offered concurrently in an ESI program. It is important to examine new health insurance structures, such as CDHPs, to better understand their impact on …

Epigenetics In Research And Practice, Debra E. Lyon, Susan G. Dorsey, Leorey Saligan

School of Nursing Publications

This special issue focused on the intersection of epigenetics with nursing research and practice. The first paper in this series addresses the role of epigenetic modifications in pain and analgesia response, highlighting the need for future research on epigenomic modification in the development of chronic pain, and summarizes the therapeutic potential to alter epigenetic processes to improve health outcomes. The second studies the epigenetic alterations and an increased frequency of micronuclei in women with fibromyalgia, highlighting a difference in an epigenetic biomarker in participants versus controls. The third paper explored the role of epigenetics in critical illness and the need …

Recruiting For Epigenetic Research: Facilitating The Informed Consent Process, Nancy Jallo, Debra E. Lyon, Patricia Anne Kinser, Debra Lynch Kelly, Victoria Menzies, Colleen Jackson-Cook

School of Nursing Publications

Because the effects of epigenetic (gene-environment interaction) changes have been associated with numerous adverse health states, the study of epigenetic measures provides exciting research opportunities for biobehavioral scientists. However, recruitment for studies focusing on any aspect of genetics poses challenges. Multiple factors, including lack of knowledge regarding a research study, have been identified as barriers to recruitment. Strengthening the informed consent process through extended discussion has been found to be effective in recruiting for research studies in general, yet there is a paucity of information that focused on such a recruitment strategy for epigenetic studies. In this paper, we share …

Control Group Design: Enhancing Rigor In Research Of Mind-Body Therapies For Depression, Patricia Anne Kinser, Jo Lynne W. Robins

School of Nursing Publications

Although a growing body of research suggests that mind-body therapies may be appropriate to integrate into the treatment of depression, studies consistently lack methodological sophistication particularly in the area of control groups. In order to better understand the relationship between control group selection and methodological rigor, we provide a brief review of the literature on control group design in yoga and tai chi studies for depression, and we discuss challenges we have faced in the design of control groups for our recent clinical trials of these mind-body complementary therapies for women with depression. To address the multiple challenges of research …

Epigenetic Alterations And An Increased Frequency Of Micronuclei In Women With Fibromyalgia, Victoria Menzies, Debra E. Lyon, Kellie J. Archer, Kimberly Jones, Guimin Gao, Timothy P. York, Colleen Jackson-Cook

School of Nursing Publications

Fibromyalgia (FM), characterized by chronic widespread pain, fatigue, and cognitive/mood disturbances, leads to reduced workplace productivity and increased healthcare expenses. To determine if acquired epigenetic/genetic changes are associated with FM, we compared the frequency of spontaneously occurring micronuclei (MN) and genome-wide methylation patterns in women with FM () to those seen in comparably aged healthy controls ( (MN); (methylation)). The mean (sd) MN frequency of women with FM (51.4 (21.9)) was significantly higher than that of controls (15.8 (8.5)) (; df = 1; ). Significant differences ( sites) in methylation patterns were observed between cases and controls considering a 5% …

Htert Promoter Polymorphism, -1327c>T, Is Associated With The Risk Of Epithelial Cancer, Toshihiko Iizuka, Motoji Sawabe, Kaiyo Takubo, Miao Liu, Yukio Homma, Motofumi Suzuki, Tomio Arai

Internal Medicine Publications

Telomeres are repetitive nucleotide sequences that cap the end of eukaryotic chromosomes. Attrition of these structures has been associated with carcinogenesis in many tissues, and therefore, they are essential for chromosome stabilization. Telomeres are maintained by telomerase complexes, of which human telomerase reverse transcriptase (hTERT) is an essential component. A functional polymorphism, -1327C>T (rs2735940), located in the promoter of the hTERT gene is associated with telomere length in peripheral blood leukocytes. We hypothesized that this polymorphism might affect susceptibility to various epithelial malignancies. The -1327C>T polymorphism was examined in 1,551 consecutive autopsy cases (mean age, 80.3 years), and …

Family Composition And Expressions Of Family-Focused Care Needs At An Academic Memory Disorders Clinic, Brandalyn C. Riedel, Jamie K. Ducharme, David S. Geldmacher

Gerontology Publications

Objective. To understand who dementia patients identify as their family and how dementia affects family life. Background. Dementia care is often delivered in family settings, so understanding the constituency and needs of the family unit involved in care is important for determining contributors to family quality of life. Design/Methods. Seventy-seven families receiving care at an academic dementia clinic completed questionnaires regarding the affected person and the family. Responses were categorized as focused on an individual’s needs or the family’s needs. Results. Respondents identified a mean of 3.77 family members involved in care. Spouse (80.5%), daughter (58.4%), son (46.8%), and stepchild …

Dreams And Wonder, Edward F. Ansello

Director's Editorials from Age in Action

Many centenarians have dreams and a sense of wonder. Many of the very old possess dreams that push or pull them; these seem to act as goals still ahead. Perhaps this orientation to a future impels their continuation.

Partnering, Edward F. Ansello

Director's Editorials from Age in Action

Collaborative partnering has been a core value of Virginia Center on Aging. Several members are partnering with institutions of higher education, public schools, community businesses, and talented instructors.

Falling Down: Assessing The Risk Of Falls In Older Adults, Steven Morrison

Case Studies from Age in Action

Educational Objectives

1. To provide an overview of the problems associated with falling in older adults.

2. To outline the strengths and weaknesses of the various screening tools used for effective evaluation of an individual’s fall risk.

3. To highlight the benefits of assessing physiological function when screening for falls risk.

Genetic, Maternal And Placental Factors In The Association Between Birth Weight And Physical Fitness: A Longitudinal Twin Study, Robert N. H. Touwaslagar, Marji Gielen, Grans E. S. Tan, Antonius L. M. Mulder, Williem J. M. Gerver, Luc J. Zimmermann, Alfons J. H. M. Houben, Maurice P. Zeegers, Catherine Derom, Robert Vlietinck, Hermine Maes, Coen D. A. Stehouwer, Martine Thomis

Human and Molecular Genetics Publications

Background

Adult cardiorespiratory fitness and muscle strength are related to all-cause and cardiovascular mortality. Both are possibly related to birth weight, but it is unclear what the importance is of genetic, maternal and placental factors in these associations.

Design

Peak oxygen uptake and measures of strength, flexibility and balance were obtained yearly during adolescence (10–18 years) in 114 twin pairs in the Leuven Longitudinal Twin Study. Their birth weights had been collected prospectively within the East Flanders Prospective Twin Survey.

Results

We identified linear associations between birth weight and adolescent vertical jump (b = 1.96 cm per kg birth weight, …

Virginia Commonwealth University Graduate And Professional Programs Bulletin [2013], Virginia Commonwealth University

VCU Bulletins

Graduate and professional programs bulletin for Virginia Commonwealth University for the academic year 2013-2014. It includes information on academic regulations, degree requirements, course offerings, faculty, academic calendar, and tuition and expenses for graduate programs.

Cultural Inheritance And Fertility Outcomes: An Analysis From Evolutionary And Interdisciplinary Perspectives, Li Zhang, Dudley L. Poston Jr., Michael S. Alvard, Christopher Cherry

L. Douglas Wilder School of Government and Public Affairs Publications

Taking evolutionary and interdisciplinary perspectives, this study views the reproductive result as an evolutionary outcome that may be affected by parental characteristics through cultural inheritance. We hypothesize that inheriting more cultural traits from parents leads to a greater resemblance between fertility outcomes of the offspring and their parents. In societies that experience a demographic transition, a greater resemblance can be indicated by a higher level of fertility of the offspring and a sooner transition from union formation to childbearing. We operationalize inheriting cultural traits from parents as reporting a religious affiliation the same as those of their parents. Through analyzing …

Pilot Inventory Of Community Partnerships, Valerie Holton

Division of Community Engagement Resources

Partnerships with community organizations create increased opportunities for universities to promote community-engaged research, teaching, and service. Virginia Commonwealth University’s (VCU) mission states that the university is committed to "sustainable, university-community partnerships that enhance the educational, economic, and cultural vitality of the communities VCU serves." In recognition of its efforts, VCU is among a small number of institutions to be designated as very high research activity and community-engaged by the Carnegie Foundation. It is also a recipient of a NIH-funded Center for Translational and Sciences Award, which promotes community-engaged research.

In pursuit of the university’s goal to become a national model …

Major Depressive Disorder And Measures Of Cellular Aging: An Integrative Review, Patricia Anne Kinser, Debra E. Lyon

School of Nursing Publications

Major depressive disorder (MDD) affects millions of individuals and causes significant suffering worldwide. It has been speculated that MDD is associated with accelerated aging-related biological and functional decline. To examine the accelerated aging hypothesis, one of the biomarkers under study is leukocyte telomeres, and specifically the measure of telomere length and telomerase activity. This review integrates findings from eleven human studies which evaluated telomere length and telomerase activity, in order to synthesize the state of the current science and to inform the development of new knowledge and enhance nursing research of depression using appropriate biobehavioral measures. Although preliminary, the findings …

Medication-Related Problems Experienced By Patients During Transitions To Assisted Living, Deanna Flora

Theses and Dissertations

Medication reconciliation is a systematic and comprehensive review of medication regimens during care transitions aiming to prevent adverse drug events. Poorly executed transitions negatively impact patient welfare and cause financial burden. Medication-related problems (MRPs) experienced during transitions to an assisted living facility (ALF) were evaluated. Data was collected from pharmacy records for transitions to an ALF over three months, including demographics, medications, potentially inappropriate medications, and MRPs. MRPs were categorized and summarized using descriptive statistics. Forty-five patients (71% female) experienced 59 transitions. Average age was 85.6 years. Median length of stay away from the ALF was three days. There were …

Cohort Membership, Dental Insurance And Utilization Of Dental Services In Adults Age 47 And Over Receiving Dental Care At Virginia Commonwealth University’S School Of Dentistry, Patricia Brown Bonwell

Theses and Dissertations

This cross-sectional, non-experimental study evaluates associations between cohort membership, type of dental coverage, and utilization of dental services in all patients age 47 and over who received dental care at Virginia Commonwealth University’s (VCU) School of Dentistry in 2011. Structural Lag Theory poses that society’s institutions lag behind the actuality of a healthy and capable older adult population. The two dynamisms of the Structural Lag Theory were used for this study. The Dynamism of Changing Lives is represented by Cohort differences. Cohort differences include cohort size, people living longer and retaining more of their natural teeth along with different attitudes …

Factors Associated With Access To Palliative Care In A Large Urban Public Teaching Hospital With A Formal Hospital-Based Palliative Care Program, Leland Waters

Theses and Dissertations

Hospital-based specialist palliative care services are designed to address the needs of critically ill patients by psychosocial and spiritual support, improving symptoms management, and offering discussions on goals of care. Integrating palliative care upstream in the care continuum for patients who eventually die in the hospital will help to address the many individualistic needs of the critically ill patient. The diffusion of specialist hospital-based palliative care services requires an understanding of patterns of utilization by patients. The purpose of this study was to examine the population characteristics of decedents who may or may not have utilized specialist palliative care services …

Comparison Of Biomarkers In Blood And Saliva In Healthy Adults, Sarah Williamson, Cindy Munro, Rita Pickler, Mary Jo Grap, R. K. Elswick Jr.

School of Nursing Publications

Researchers measure biomarkers as a reflection of patient health status or intervention outcomes. While blood is generally regarded as the best body fluid for evaluation of systemic processes, substitution of saliva samples for blood would be less invasive and more convenient. The concentration of specific biomarkers may differ between blood and saliva. The objective of this study was to compare multiple biomarkers (27 cytokines) in plasma samples, passive drool saliva samples, and filter paper saliva samples in 50 healthy adults. Demographic data and three samples were obtained from each subject: saliva collected on filter paper over 1 minute, saliva collected …