Digital Commons Network^™

Staff Education To Improve Fall Prevention Practices In The Home Health Setting, Chinemelum Okoye

Walden Dissertations and Doctoral Studies

Falls among adults aged 65 and older represent a significant public health concern, as they are the leading cause of injury and hospitalization within this demographic. According to the Centers for Disease Control and Prevention (CDC), nearly one in four older adults experiences a fall annually, leading to over 3 million emergency department visits. In home health settings, the risk of falls is heightened due to uncontrolled environments and insufficient staff training. This quality improvement project assessed the effectiveness of an educational intervention aimed at fall prevention strategies for home health staff, including registered nurses (RNs) and certified nursing assistants …

Graduate Student Paper: Aging In A Changing Japan: Gendered Adaptation To Changing Family Structure, Miki Izu, Clayton Chalmers

Asia Pacific Perspectives

Although Japanese seniors are very healthy, research shows that they are not very happy. Compared to seniors in other developed countries, Japanese elders have lower ratings of subjective well-being and are increasingly alone. This paper argues that changes to Japanese family life help explain why Japanese elders are struggling with low subjective well-being. Specifically, declining marriage rates and declining rates of elders living with their children (co-residency) have made it harder for elders to get the support they need. Moreover, the effect and the adaptations to these changes are not equal between men and women. While elderly Japanese men are …

Illness Severity And Marital Communication In Young Couples: The Moderating Role Of Marital Satisfaction, Jaime Lea Dick

Theses and Dissertations

The emergence of a chronic physical illness is unexpected in emerging adulthood and is accompanied by stress. Additionally, married partners of individuals with physical illnesses are likewise affected by the new diagnosis. Marriage outcomes of couples facing chronic illnesses together vary, being sometimes positive and sometimes negative. The current study examined the relationship between the emergence of chronic physical illness in emerging adults and marital communication of both the patient and partner, with marital satisfaction as a moderator. Gender differences are also addressed. From the Couple Relationships and Transition Experiences (CREATE) study, a nationally representative dataset of newly married emerging …

Physical Activity Mediates Age Differences In Cognition Among Tsimane Forager-Horticulturalists, Phoebe E. Imms, Nikhil N. Chaudhari, Daniel Cummings, Daniel Eid Rodriguez, Giuseppe Barisano, Paul L. Hooper, M. Katherine Sayre, Edmond Seabright, Randall C. Thompson, M. Linda Sutherland, James D. Sutherland, Benjamin C. Trumble, Michael Gurven, Jonathan Stieglitz, Caleb E. Finch, Hillard S. Kaplan, Wendy J. Mack, Margaret Gatz, Andrei Irimia

ESI Publications

Background: The Tsimane and Moseten of the Bolivian Amazon are highly physically active and exhibit low rates of cognitive impairment and brain atrophy.

Methods: We use structural equation modelling to examine how their physical activity levels mediate the relationship between (1) age and cognition, and (2) age and cognition via brain volume (BV).

Results: Tsimane males (n = 305, mean ± SD age = 59.94 ± 9.68) and Tsimane females (n = 265, mean ± SD age = 59.28 ± 9.79) exhibit significantly higher levels of physical activity than Moseten males (n = 106, mean ± SD …

No Evidence Of Pitavastatin Effect On Muscle Area Or Density Among People With Hiv, Kristine M Erlandson, Triin Umbleja, Heather J Ribaudo, Michael T Lu, Jana Taron, Marissa R Diggs, Pamela S Douglas, Kathleen V Fitch, Carl J Fichtenbaum, Markella V Zanni, Judith A Aberg, Maria C Rodriguez-Barradas, Katharine Breaux, Rosalba Gomez Morones, Craig A Sponseller, Judith S Currier, Gerald S Bloomfield, Sarah M Chu, Alex B Lu, Carlos D Malvestutto, Steven K Grinspoon, Todd T Brown

Faculty, Staff and Students Publications

Background: Skeletal muscle area (MA) and muscle density (MD) are key determinants of physical function and typically decline with increasing age. Statins have well-known musculoskeletal effects but whether statins impact MA or MD is not well established, especially in the setting of randomized treatment.

Methods: REPRIEVE is a double-blind randomized trial evaluating the effect of pitavastatin for primary prevention of major adverse cardiovascular events in people with HIV (PWH). Thoracic paraspinal, pectoralis, and infraspinatus MA and MD were assessed among Mechanistic Substudy participants with CT at baseline and month 24.

Results: Of 804 substudy participants, 510 remained on study treatment …

No Evidence Of Pitavastatin Effect On Muscle Area Or Density Among People With Hiv, Kristine M Erlandson, Triin Umbleja, Heather J Ribaudo, Michael T Lu, Jana Taron, Marissa R Diggs, Pamela S Douglas, Kathleen V Fitch, Carl J Fichtenbaum, Markella V Zanni, Judith A Aberg, Maria C Rodriguez-Barradas, Katharine Breaux, Rosalba Gomez Morones, Craig A Sponseller, Judith S Currier, Gerald S Bloomfield, Sarah M Chu, Alex B Lu, Carlos D Malvestutto, Steven K Grinspoon, Todd T Brown

Faculty, Staff and Students Publications

Background: Skeletal muscle area (MA) and muscle density (MD) are key determinants of physical function and typically decline with increasing age. Statins have well-known musculoskeletal effects but whether statins impact MA or MD is not well established, especially in the setting of randomized treatment.

Methods: REPRIEVE is a double-blind randomized trial evaluating the effect of pitavastatin for primary prevention of major adverse cardiovascular events in people with HIV (PWH). Thoracic paraspinal, pectoralis, and infraspinatus MA and MD were assessed among Mechanistic Substudy participants with CT at baseline and month 24.

Results: Of 804 substudy participants, 510 remained on study treatment …

Responding To The Needs Of Dementia Care Partners: Recommendations For Policy Change At The State And Federal Levels., Walter D. Dawson, Jenn Reed, Allison Lindauer, Sherril B. Gelmon

Institute on Aging Publications

The need to optimize supports of Alzheimer's disease and related dementias (ADRD) care partners through policy innovation is high. This study sought to frame the care and support needs of multiple historically underrepresented populations who may be underserved and/or have difficulty accessing culturally specific services and determine specific policies that may reduce ADRD care partner burden and improve wellbeing. Qualitative data were gathered through interviews ( = 24) with leaders of organizations that support people living with ADRD and focus groups ( = 5) with dementia care partners from four communities historically underserved in the United States (Asian, Black, Indigenous, …

Smartboot: Real-Time Monitoring Of Patient Activity Via Remote Edge Computing Technologies, Gozde Cay, Myeounggon Lee, David G Armstrong, Bijan Najafi

Center on Aging Staff Publications

Diabetic foot ulcers (DFUs) are a serious complication of diabetes, associated with high recurrence and amputation rates. Adherence to offloading devices is critical for wound healing but remains inadequately monitored in real-world settings. This study evaluates the SmartBoot edge-computing system-a wearable, real-time remote monitoring solution integrating an inertial measurement unit (Sensoria Core) and smartwatch-for its validity in quantifying cadence and step count as digital biomarkers of frailty, and for detecting adherence. Twelve healthy adults wore two types of removable offloading boots (Össur and Foot Defender) during walking tasks at varied speeds; system outputs were validated against a gold-standard wearable and …

Lgbt Young Adults’ Experience Of Exiting Foster Care, Shaylon Joseph

Walden Dissertations and Doctoral Studies

The scholarly community understands little about the experiences of lesbian, gay, bisexual, and transgender (LGBT) young adults as they transition out of the foster care system. This study explored the lived experiences and difficulties encountered by LGBT young adults after exiting foster care. Grounded in Erikson’s theory of psychosocial development, this qualitative dissertation employed a phenomenological design to interpret how participants made sense of their transitions. Recruitment was conducted through a flyer posted on Facebook and the Department of Children and Family Services; 10 LGBT young adults participated in 60-minute interviews. Using interpretative phenomenological analysis, the study revealed six overarching …

Computational Thinking As A Novel Framework For Enhancing Cognitive Organization In Older Adults With Cognitive Frailty (Letter To The Editor), Daisuke Akiba

Publications and Research

As aging populations grow, especially in high-income nations, the burden of dementia-related care continues to escalate both economically and socially. In response, this article introduces Computational Thinking (CT) as a novel, non-pharmacological framework to support cognitive organization in older adults experiencing cognitive frailty. Though CT has gained traction in fields like PK-16 education, including special education, for enhancing executive function and problem-solving, it has not yet been applied to geriatric- or memory-care contexts. This perspective proposes that CT’s core components (i.e., decomposition, pattern recognition, abstraction, and algorithmic thinking) may align with residual cognitive strengths in mild-to-moderate dementia, offering a strengths-based, …

Patient-Centered, Theory-Based, Online Intervention To Promote A Physically Active Lifestyle For People With Multiple Sclerosis: Protocol For A Randomized Controlled Trial, Chungyi Chiu, Vaishnavi Sridharan, Mojtaba Khaliji, Md Refat Uz Zaman Sajib, Xiaotian Gao, Kathleen Zackowski

Children’s Nutrition Research Center Staff Publications

Background: People with multiple sclerosis (MS) experience life challenges due to the nature of disease progression. Although an active lifestyle has been shown effective for symptom and relapse management, most people with MS lead a sedentary lifestyle and do not reach the recommended physical activity (PA) guidelines.

Objective: This study aims to test the preliminary efficacy of a codeveloped, online self-management intervention based on the health action process approach (HAPA) adapted for people with MS to cultivate a physically active lifestyle.

Methods: The 8-week intervention program was developed using community-based participatory research based on the HAPA. The program includes increasing …

Stimulated Cytokine Production, Attachment, And Emotional Well-Being In Dementia Spousal Caregivers, Daniel L. Argueta, Sarah Roberts, Kelly N. Brice, E Lydia Wu-Chung, Vincent D. Lai, Jensine Paoletti-Hatcher, Bryan T. Denny, Charles Green, Samantha Henry, Multiple Additional Authors

Psychology Faculty Publications and Presentations

Proinflammatory cytokine production may be related to poor emotional adjustment in dementia spousal caregivers. People who display attachment insecurity may be at increased risk for adverse caregiving experiences and poor psychosocial outcomes.

Childhood Skeletal Lesions Common In Prehistory Are Present In Living Forager-Farmers And Predict Adult Markers Of Immune Function, Amy S. Anderson, Aaron Blackwell, M. Linda Sutherland, Thomas Kraft, James Sutherland, Bret Beheim, Daniel K. Cummings, Suhail Ghafoor, Paul L. Hooper, Daniel Eid Rodriguez, Andrei Irimia, Margaret Gatz, Wendy Mack, Chris Rowan, Michael Miyamoto, Kenneth Buetow, Caleb Finch, L. Samuel Wann, Adel Allam, Randall C. Thompson, Gregory Thomas, Hillard Kaplan, Jonathan Stieglitz, Benjamin Trumble, Michael D. Gurven

ESI Publications

Porous cranial lesions (cribra cranii and cribra orbitalia) are widely used by archaeologists as skeletal markers of poor child health. However, their use has not been validated with systematic data from contemporary populations, where there has been little evidence of these lesions or their health relevance. Using 375 in vivo computed tomography scans from a cohort-representative sample of adults aged 40+ years from the Bolivian Amazon, among food-limited, high-mortality forager-farmers, we identified cribra cranii on 46 (12.3%) and cribra orbitalia on 23 (6%). Cribra orbitalia was associated with several hallmarks of compromised immune function, including fewer B cells, fewer naïve …

Implementation Of Mindfulness-Based Interventions And Weekly Visits To Reduce Loneliness In Older Adults, Victoria E. Cobb

Dissertations

Implementation of Mindfulness-Based Interventions and Weekly Visits to Reduce Loneliness in Older Adults

Abstract:

Problem: Social isolation and loneliness have emerged as a significant public health issue for the older adult population. Loneliness has been linked to both physical and mental health effects. According to current literature, there is no standard intervention to treat loneliness in the older adult population.

Methods: This quality improvement (QI) project utilized a descriptive cohort design and the Visit-A-Bit screening assessment instrument. Undergraduate nursing students implemented mindfulness interventions during weekly visits over an eight-week period at an independent living facility located in the Midwest. Descriptive …

Race-Neutral Pft: Implementing Patient Activation Measure Following Race- Neutral Pulmonary Function Testing, Ann M. Way

Dissertations

Abstract

Background

The introduction of a race-neutral equation to predict normal values on pulmonary function testing (PFT) has led to changes in the diagnosis of pulmonary diseases previously diagnosed using a race specific equation. Minority patients appear to be most likely impacted by this change, potentially impacting how they self-manage their pulmonary health. Patient self-management can be measured and assessed by using the Patient Activation Measure (PAM) tool.

Purpose

The purpose of this project is to assess patient activation levels amongst minority patients with a new or changed pulmonary diagnosis to identify a possible need for interventions to improve patient …

The Influence Of Coca-Cola Brands On Consumer Purchases In The Beverage Market_ Japan_S Perspective.Pdf, Ryo Nishizaki, Desmond Cherng En Lee, Ahmad Massu Ramli

Jesselton Journal of Educators and Scholars

This study examines the impact of Coca-Cola’s branding on consumer purchasing behavior in Japan’s beverage market. Employing a thematic qualitative approach, the research investigates brand recognition, cultural influences on marketing strategies, product differentiation, and consumer attitudes shaped by cultural values. Findings reveal that Coca-Cola’s global brand awareness combined with localized marketing efforts, including culturally relevant campaigns and health-oriented products, significantly influence Japanese consumer preferences. However, challenges remain due to increasing health consciousness and competitive market dynamics. The study contributes to understanding how multinational brands adapt to culturally distinct markets and offers practical recommendations for enhancing brand engagement in Japan. These …

The Virtual Kitchen Challenge: Psychometric Validation In Cognitively Healthy And Impaired Older Adults, Ross M. Divers

LSU Doctoral Dissertations

Decline in everyday functioning is core diagnostic criteria for mild cognitive impairment (MCI) and dementia. While historically, MCI was considered a stage of generally persevered everyday functioning, it is now widely accepted that subtle though clinically meaningful changes in everyday function can be observed and are predictive of increased risk of future decline and conversion to dementia. Despite this, self and informant report questionnaires of everyday function largely fail to capture this subtle decline in those with MCI, while performance-based measures that may be able to capture this decline are rarely administered clinically due to their laborious administration. Performance-based measures …

Native American Elders’ Perspectives On Death And Dying, Ji Hong, Stephenie M. Wescoup, Gul Nahar, Rockey Robbins

Journal of Indigenous Research

This article employs a qualitative method to facilitate the expression of 16 Native American elders about their feelings about aging and death. They discussed resentments, acceptance of their life experiences, the inevitability of death, participation in the natural re-cycling of nature, and hopes they had for Native Americans in future generations. Throughout the study, theoretical and empirical findings in the field of psychology and Native American literature are cited to help interpret the participants’ remarks. An extended clinical implications section may be helpful to practitioners.

Race/Ethnicity, Living Arrangements, And Access To Healthcare Among Older Adults With Alzheimer’S Disease In The United States: Multiple Systematic Reviews In Relation To Health Outcomes, Chela Reiss, Grace Vethacke

DePaul Discoveries

Alzheimer’s disease (AD) is a neurodegenerative condition primarily affecting older adults. It is a growing public health crisis that affects memory, thinking, and behavior. The number of adults aged 65 and older is projected to reach 98.2 million by 2060, leading to a continued rise in the prevalence of AD. Understanding the socioeconomic factors that influence health outcomes in patients with Alzheimer's Disease and Related Dementias (ADRD) is essential in addressing the disparities within patient care and quality of life. This systematic review examined three socioeconomic factors - race/ethnicity, living arrangements, and access to healthcare - and their related health …

The Role Of Self-Reported Health Ratings In Identifying Hospitalization Risk Among Older Adults: An Integrated Review And Secondary Analyses Of Medicare Claims Data, Mary B. Prybylo

MUSC Theses and Dissertations

Purpose: This study examined how Self-Reported Health (ratings), a person’s own evaluation of their overall health, relates to hospital admissions and emergency department utilization. It further assessed the extent to which demographic characteristics, Risk Adjustment Factor (RAF) scores (used to estimate healthcare expenditures based on clinical complexity), and the number of chronic conditions influence SRH rating and the likelihood of hospitalization.

Problem and Aim: The growing population of older adults places greater demands on healthcare services, leading to increased financial strain and a need for improved care strategies. Primary care teams, particularly those managing older adults, require effective assessment …

Ehealth Technologies In Transitional Care Interventions For Stroke Survivors And Caregivers: A Scoping Review, Orachorn Lumprom, Charuwan Kritpracha, Cansel Kocakabak, Jos M. Latour

School of Nursing and Midwifery

The high rate of stroke disability necessitates extensive care during transitions between hospitals and homes. While many transitional care interventions have emerged, no explicit evidence illustrates the details of those combining or integrating eHealth. The aim of this scoping review was to comprehensively map the literature on eHealth technologies within transitional care interventions for stroke survivors and their caregivers. Studies were included if they focused on transitional care interventions that combined or integrated eHealth technologies for adult and elderly survivors of post-hyperacute stroke, as well as for caregivers aged 18 years and older. A systematic search was conducted from inception …

Intergenerational Design Challenges: Participants’ Perspectives On Moving From Ideas To Implementation, Tina M. K. Newsham, Matthew J. Peterson, Alicia M. Sellon, Logan Elkins, Abrielle Leblanc, Tess Ryan, Andrew Zeldin

Journal of Community Engagement and Higher Education

Many social innovation efforts are aimed at meeting social challenges presented by the aging of the population, yet older adults are often excluded from such efforts. The purpose of this case study was to examine an approach used in a midsized university in southeast North Carolina to create intergenerational opportunities for students, local community organizations, and older adult residents of the surrounding area to collaboratively develop suggestions for addressing challenges facing the older adult population.

Introduction To Sociology: Socialization, Dr. Marcia Morrison Ph.D.

Open Educational Resources

Abstract

This paper offers a comprehensive examination of socialization and identity development through a comparative lens, focusing on American, Chinese, and Japanese cultures. It explores how distinct cultural values—individualism, loyalty, and cooperation—shape personal and collective identities from childhood through old age. Utilizing the life course perspective, the analysis considers how factors such as generation, socioeconomic status, race, and gender influence the trajectory of human development. The evolution of childhood is traced across historical and cultural contexts, highlighting shifting perceptions, the impact of industrialization on children's roles, and the persistent influence of class and ethnicity on access to education and well-being. …

Factors Associated With Falls Among Nursing Home Residents, Dorsenia Hendrix

Walden Dissertations and Doctoral Studies

Falls in nursing home facilities are prevalent, and numbers continue to rise as residents grow older and antipsychotic (AP) medications are prescribed more frequently. The purpose of this quantitative study was to investigate whether frequency of falls was related to the use of AP medications. Data (N=100) were collected from 2020 incident reports, investigation sheets, and patient charts generated by the State Department of Public Health regarding resident falls and the use of AP medications in a nursing home Facility located in the Southern United States. Social Cognitive Theory (SCT) was used to understand specific behavior patterns such as personal, …

Introduction To Sociology: Sex And Gender, Dr. Marcia Morrison Ph.D.

Open Educational Resources

Abstract

This paper explores the complex interplay between sex and gender, focusing on how societal structures, historical contexts, and cultural norms shape gender roles and expectations. Drawing on the works of influential theorists such as Margaret Mead and researchers like Maccoby and Jacklin, the discussion distinguishes between biological sex differences and socially constructed gender distinctions. The analysis highlights the pervasive influence of gender socialization through agents such as family, peers, educational institutions, and media, which collectively reinforce stereotypes and stratify opportunities for individuals. The evolution of gender stratification is traced from the post-World War II era to the present, documenting …

Nursing Homes As Total Institutions: Applying The Concept Of Quality Control To Improve Patient Care, Josephine A. Ruggiero

Sociology Between the Gaps: Forgotten and Neglected Topics

No abstract provided.

Introduction To Sociology: Class And Stratification, Dr. Marcia Morrison Ph.D.

Open Educational Resources

Abstract

This paper explores the intricate dynamics of class, stratification, and social inequality, emphasizing the interplay of wealth, power, and prestige in shaping individual opportunities and societal outcomes. Drawing on foundational theories from Marxist and functionalist perspectives, it examines the mechanisms by which economic and social structures reinforce or challenge class divisions. The analysis extends to the evolution of American economic disparity, particularly during the transformative 1980s, and examines policies aimed at addressing poverty, such as those articulated by Sar Levitan and the implementation of the Social Security Act. Through a nuanced discussion of cultural capital, the role of …

Modeling, Analysis, And Prediction Of Covid-19 Dynamics With Interacting Subpopulations And Implicit Behavior Using Physics-Informed Neural Networks, Naima Aubry-Romero, Alonso Ogueda-Oliva, Padmanabhan Seshaiyer

Spora: A Journal of Biomathematics

In this paper, we consider an extended SEIR compartmental model that incorporates young and old interacting subpopulations, allowing for cross-group transmission dynamics. Implicit behavioral changes are included to determine the influence of social behavior on coronavirus transmission dynamics. The basic reproduction number, the average number of secondary cases of infection produced by a single primary case, is derived for both the explicit and implicit model using the next-generation matrix method. We solve the associated differential equation systems and estimate useful parameters in the explicit model using physics-informed neural networks (PINNs). Our results point to how the PINNs approach offers an …

Interprofessional Collaboration To Address Social Isolation And Facilitate Intergenerational Service Learning Within Graduate Education, Angela Lavery, Erin Knight, Stephanie Cole, Stacie Metz

Journal of Community Engagement and Higher Education

This article presents an interdisciplinary collaboration to address the needs of older adults at risk of social isolation exacerbated by the COVID-19 pandemic. An intergenerational service-learning program developed by the Pennsylvania Department of Aging was offered to several universities across the state of Pennsylvania. The authors share their experience and lessons learned from pairing older adults with graduate students studying in the fields of Gerontology, Public Health, and Social Work.

Conversations In Isolation: A Mixed-Methods, Multi-Perspective Evaluation Of Extreme Electronic Service Learning During Covid-19, Lauren M. Dinour, Jennifer Y. Daclan

Journal of Community Engagement and Higher Education

Due to physical proximity constraints imposed by COVID-19, extreme electronic service learning (e-service-learning)—instruction and service offered completely online—allowed for the safe continuation of service-learning experiences. Using a combination of surveys and an autoethnographic approach, this study describes findings of an intergenerational extreme e-service-learning project from four perspectives: students, assisted living facility residents, community partner, and course instructor. Positive impacts were noted on personal, social, and learning contexts among each of the four perspectives.