Digital Commons Network^™

A Mixed-Methods Usability Pilot Of A Value-Goal Elicitation Tool In The Inpatient Setting For Older Adults Anticipating Post-Acute Care, Kirstin M Piazza, Caroline Pascal, Syama R Patel, Caroline Sefcik, Marilyn M Schapira, Caroline Madrigal, Katherine C Ritchey, Longyi Yip, Aanand D Naik, Robert E Burke

Faculty, Staff and Student Publications

Age-Friendly Health Systems (AFHS) emphasize aligning care with "What Matters" most to older adults. Hospitalization represents a critical period where value-based goals could shape key decisions about post-acute care transitions. However, few tools designed for eliciting such goals have been adapted for use in the inpatient setting, where the acute nature of care poses unique challenges. This mixed-methods study evaluates the usability of the Health Priorities Primer Tool (HPPT) in older hospitalized adults who anticipate needing post-acute care, aiming to identify necessary adaptations for the inpatient setting. We conducted interviews, observations, and surveys with older hospitalized patients to understand their …

Modeling Healthcare Managerial And It Sophistication, Gary Hackbarth, Teuta Cata

Journal of International Technology and Information Management

Sophisticated healthcare managers understand that managing information and selecting technology are two related but separate skill sets. Information Technology Governance (ITG) allows healthcare organizations to deal with complex issues, compete effectively, and support patient needs by integrating managerial and IT sophistication to improve business performance. An organizational model that merges IT and managerial sophistication by improving ITG to forecast business outcomes must grasp the intricacies of technology to acquire, manage, and utilize information technology in alignment with business strategies. The proposed model differentiates between internal and external IT management strategic thinking, emphasizing the critical need to govern IT effectively by …

Current Behavior Analytic Research On Assent And Assent Withdrawal Of Students With Disabilities, Zailey K. Greeno

Research Papers

The field of behavior analysis is ever-evolving, just as the seven dimensions of applied behavior analysis have instructed it to (Baer et al., 1968). Over time, certain procedures, such as electric shock, spanking, and restriction of movement (Leaf et al., 2021), have become unethical, which has resulted in modifications to the Ethics Code for Behavior Analysts (Behavior Analyst Certification Board, 2020), as well as everyday practice to ensure these unethical interventions are no longer utilized. Despite these advances, there are still areas that are lacking in the field. Therefore, the current paper will review the literature in behavior analysis that …

A Study Of Regulatory Compliance In U.S. Nursing Homes, Patrick Schumacher

Electronic Theses & Dissertations (2024 - present)

The federal government is responsible for ensuring that nursing homes comply with regulations designed to protect residents from abuse, neglect, and substandard care. To this end, the Centers for Medicare and Medicaid Services (CMS) partners with states to conduct onsite inspections of nursing homes, during which regulators may identify violations. The agency can take one or more actions in response to violations, including imposing civil money penalties (fines), appointing a state monitor, or mandating remedial education for staff. Despite this regulatory framework, the quality of care in nursing homes remains poor, with many facilities failing to protect the well-being of …

The Wind In The Willows Effect: Does Age Affect Human Versus Animal Faux Pas Recognition?, Gray Atherton, Lucy Robinson, Lucie Guy-Smith, Liam Cross

School of Psychology

Children’s literature is rife with anthropomorphic or non-human characters that may be used as a scaffold to teach children about theory of mind (ToM) or the ways in which people think or feel about the social world. In this study, 107 typically developing U.K. school children in Years 1, 3, and 5 (5–10 years of age) completed a human and anthropomorphic ToM test that tested their understanding of faux pas. Specifically, children from these three age groups were given a human version of 20 faux pas stories and an identical animal version of the same stories 1 week apart (with …

The Face Of Ageism, The Reach Of Ageism: Law, Medicine And Society, Janet Dolgin

Hofstra Law Faculty Scholarship

No abstract provided.

Teaching Functional Skills To Individuals With Autism Spectrum Disorder And Intellectual Disability Using Behavior-Analytic Curricula, Catrina Barber

Research Papers

No abstract provided.

Application Of Root Cause Analysis For Fall Prevention: A Quality Improvement Initiative For Older Adults In A Skilled Nursing And Long-Term Care Facility, Terrence Ranjo

Doctoral Projects

Falls in older adults are common and often have severe outcomes. They are the leading cause of fatal and non-fatal injuries among people aged 65 and older and continue to increase. Half of residents in nursing facilities fall annually, and one in every ten falls will lead to a severe injury. Federal regulations like the Centers for Medicare and Medicaid Services require long-term care (LTC) facilities to incorporate quality assurance performance improvement initiatives to address identified quality concerns in LTC facilities. Root cause analysis (RCA) can help clinicians identify several root causes of falls and guide clinicians in developing personalized …

Fp-25-06 First Divorce Rate By Age And Race/Ethnicity, Natalie Bankey

National Center for Family and Marriage Research Family Profiles

No abstract provided.

Fp-25-12 Functional Limitations In Relationship Quality Among Adults In Midlife, Natalie E. Bankey, Francesca A. Marino

National Center for Family and Marriage Research Family Profiles

No abstract provided.

"The Association Between Serious Psychological Distress And Life Satisfaction Among U.S Adults With Hypertension", Kellen Michael Lenz

All ETDs from UAB

Purpose: Given the observed link between psychosocial and physical health outcomes, this study investigates the association between serious psychological distress and life satisfaction among U.S adults with hypertension. Methods: A cross-sectional study using 2021 National Health Interview Survey data among U.S adults was conducted to investigate the association between serious psychological distress and hypertension and assess the role of life satisfaction in modifying this relationship. Hypertension (diagnosed, undiagnosed), serious psychological distress (≥ 13 on the Kessler 6 nonspecific distress scale), and life satisfaction (Very satisfied, Satisfied, Dissatisfied, Very dissatisfied) were self-reported by participants. Ordinal logistic regression was used to investigate …

Effect Of An Elective On Preparation For Fieldwork In An Acute Care Setting, Abbey Glenn, Brandi Fulwider

Journal of Occupational Therapy Education

The current study evaluated the effect of an eight-day elective course on preparedness for the acute care setting. The course was offered to Master of Science in occupational therapy students before their second Level II fieldwork experience and focused on developing necessary skills for success in acute care. Course content was based on feedback from previous students, fieldwork educators in acute care, and faculty experiences in that setting. Specifically, the course combined case-based and skills-based simulations to help students develop skills and to build confidence. Small group activities involving role-playing communication scenarios were also included, where students played the role …

Floor-To-Stand Transfers In Older Adults: Insights Into Strategies And Lower Extremity Demands, Lyndsay Stutzenberger, Tyler Whited

Faculty Publications - College of Physical Therapy

Background/Objectives: Getting up from the floor is an important functional skill for independence in older adults but is not often assessed clinically. The purpose of this study was to investigate how floor-to-stand transfer (FTS) ability is related to self-report measures and five-time sit-to-stand (5XSTS) performance, as well as compare peak joint angles during common FTS strategies and lower extremity demands between the 5XSTS and a commonly instructed FTS strategy. Methods: Thirty-four community-dwelling older adults completed self-report measures and performed the 5XSTS, a FTS in a self-selected manner, and an instructed FTS strategy. Biomechanical analysis of the lower extremities was used …

Running Biomechanical And Isokinetic Strength Differences In Masters Runners With And Without Achilles Tendinopathy, Matthew Klein, Christopher Patterson, Annette Karim, Tyler Cuddeford

Faculty Publications - College of Physical Therapy

Masters runners are an increasing proportion of the running com-munity. The most significant musculoskeletal changes in runners occur after the age of 50 in addition to changes in injury rates and types, the most common being Achilles tendinopathy (AT). Previous evidence has suggested similarities between risk factors for AT and age-related changes that are focused at the hip and the ankle during the propulsive stage of running. The purpose of this study was to investigate biomechanical and peak torque association to AT in masters runners. Thirty-two masters runners over age 50 with AT(60.31 ± 8.37, n = 16) and without …

Why Occupational Therapy?: A Qualitative Analysis Of Incoming Students’ Reasons For Entering The Profession, Laura H. Vanpuymbrouck, Carli Friedman

Journal of Occupational Therapy Education

Insight into students’ views and understandings of what occupational therapy (OT) practitioners do and what a career will be like can shed light into how the profession is socially perceived. Additionally, this knowledge can be useful for recruitment, retention, and curriculum design, especially for addressing misunderstandings and inaccurate perceptions. Therefore, the objective of this study was to examine the narratives of incoming OT students when asked why they chose to enter the profession of OT. Descriptive statistics were used to analyze sociodemographic data, and then thematic analysis was used to analyze qualitative data about why participants wanted to become occupational …

The Influence Of Student Personality Traits On Satisfaction And Success In Online Education In Higher Education: A Systematic Review, Elizabeth G. Hunter, Jayna Niblock, Samantha Barefoot, Jackson Miller, Jason Hughes, Lydia Kite, Edith Scarletto

Journal of Occupational Therapy Education

Online learning is a growing area in occupational therapy education. It is important for faculty to use the modality of online learning to understand the influence of student personality traits, defined as relatively stable characteristics that influence thinking and behavior, on student satisfaction and success in graduate level programs. By understanding the influence of personality traits, faculty can better develop online materials that are flexible enough to support individuals who may have a higher risk of low satisfaction and success. There has been plentiful research in the areas of education and psychology assessing the influence of personality on the online …

Vision Rehabilitation In Ot And Ota Curricula: A Survey To Academic Programs, Angela Butler, Beth A. Barstow

Journal of Occupational Therapy Education

Occupational therapists are trained to evaluate and treat occupational performance problems. Client factors, such as vision, greatly impact an individuals’ ability to participate in meaningful occupations. New accreditation standards do not include language related to vision. Therapists must be prepared to evaluate and treat the increasing prevalence of visual challenges from children with cerebral visual impairment to older adults with age related conditions. This survey explored how vision rehabilitation is covered in accredited occupational therapy and occupational therapy assistant programs and the expertise of faculty teaching vision content. A thirteen-question survey was sent to accredited programs. Questions included multiple response, …

Increasing Serious Illness Conversations In Patients At High Risk Of One-Year Mortality Using Improvement Science: A Quality Improvement Study, Kanishk D. Sharma, Sandip A. Godambe, Prachi P. Chavan, Agatha Parks-Savage, Marissa Galicia-Castillo

Department of Family and Community Medicine Faculty Publications

Background: Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores. Methods: This was a quality improvement study with data collected pre- and post-intervention at a large urban level one trauma center in Virginia, which also serves as a primary teaching hospital to …

The Use Of Music Therapy And Various Mechanisms Of Diversion To Aid Caregivers Of Those With Alzheimer’S Disease And Dementia, Sarah Elizabeth Kane

Doctor of Nursing Practice Projects

Background: Alzheimer’s Disease and Dementia inhabit an increasingly alarming number of individuals within the United States with the majority of their caregivers being loved ones with limited to no healthcare education. This DNP project was designed to specifically educate caregivers of those with Alzheimer’s Disease and Dementia. The goal of this project was to increase the knowledge of the disease while also increasing the ability and confidence to better care for their loved ones. In using the resources outlined in this project, such as music therapy and diversional tools, the caregiver would see a decrease in emotional outbursts and …

Assisted Living, Residential Care, And Memory Care Staffing Level Dynamics: Oregon, 2017–2023, Sarah Dys, Ozcan Tunalilar

Institute on Aging Publications

Objectives

To examine changes in staffing levels over time in Oregon assisted living and residential care (AL/RC) communities between 2017 and 2023.

Design

Longitudinal study of licensed AL/RC communities.

Setting and Participants

A total of 1720 setting-year observations from 535 individual AL/RC communities in Oregon between 2017 and 2023.

Methods

Primary data were collected through the Oregon Community-Based Care (CBC) study. Staffing levels were estimated as care staff hours per resident per day and reported overall and by staff type, including registered nurses, licensed practical nurses, certified nursing assistants, certified medication aides, unlicensed care staff, life enrichment staff, and social …

Biomarkers In Coronary Artery Disease: Systematic Review And Meta-Analysis, Nicola King, Neil A. Smart, Theodore Bungon, Martin Peacock, Shakil A. Awan

Faculty of Science and Engineering Datasets

Little information exists regarding the detection of early coronary heart disease protein biomarkers. The aim of this study was to investigate several potential candidates. Systematic review was carried out followed by meta-analysis. The standardized mean difference (95% confidence intervals) for each comparison was: Troponins 2.31 (1.18, 3.4), iL-6 1.3 (0.8, 1.81), fibrinogen 1.55 (1.16, 1.94), NT-proBNP 1.05 (0.72, 1.38), lipoprotein a 0.75 (0.48, 1.03) osteoprotegerin 0.92 (0.23, 1.62), VCAM-1 1.53 (0.87, 2.18), pentraxin 3 0.87 (−0.13, 1.87), PAI-1 2.51 (−0.65, 5.66) MMP9 1.25 (0.36, 2.14), MCP-1 1.99 (1.12, 2.85) and adiponectin −1.11 (−1.49, −0.73). Multiple biomarkers that could potentially be …

Multidimensional Health Outcomes In Lgbtq+ Older Adults In The United States: Individual And Community-Level Protective Factors, Emily P. Lapidus

Theses and Dissertations--Psychology

Despite a lifetime of systematic barriers, LGBTQ+ individuals age into late adulthood, likely due to various protective factors. Guided by the Iridescent Life Course Framework (ILCF; Fredriksen-Goldsen & Muraco, 2019), I analyzed unique protective factors at two levels: (1) individual psychological factors (i.e., resilience, identity management) and (2) community-level factors (i.e., LGBTQ+ community connectedness, social support). Health was operationalized as mental health, physical health, and health-promoting behaviors. The present study accounted for covariates (i.e., financial barriers to healthcare, felt subjective age discrepancy, lifetime discrimination). I hypothesized that both stronger individual and community factors would be associated with better physical and …

Chronic Circadian Misalignment Accelerates Sarcopenia Progression In Mice, Takashi Seya, Nobuya Koike, Naoki Okubo, Yasuhiro Umemura, Yoshiki Tsuchiya, Kazuya Yabumoto, Yasuhiro Endo, Kanako Iinuma, Akiyo Kakibuchi, Akira Sugimoto, Kenji Takahashi, Seung-Hee Yoo, Zheng Chen, Kazuhiro Yagita

Faculty, Staff and Student Publications

Introduction: In today's 24/7 society, circadian misalignment caused by environmental and lifestyle factors is associated with various adverse health consequences. Understanding tissue-specific pathology is required to counter this growing public health challenge. A potential association of environmental circadian misalignment with sarcopenia, or accelerated loss of skeletal muscle strength and mass, is poorly documented.

Methods: 14-week-old wild-type C57BL/6J male mice were exposed to a chronic jet lag (CJL) paradigm consisting of an 8-h phase advance every 4 days (the ADV group) or a fixed light-dark cycle (the LD group) for 64 weeks. Grip strength was measured during the experiment, and hindlimb …

Mechanisms Of How Sarcopenia Affects Functional Outcomes In Acute Ischaemic Stroke, Dong-Seok Gwak, Jinyong Chung, Dawid Schellingerhout, Hyerin Oh, Sang-Wuk Jeong, Ji Sung Lee, Dong-Eog Kim

Faculty, Staff and Student Publications

Sarcopenia, a common geriatric condition characterized by the loss of skeletal muscle mass and function, can negatively affect functional outcomes in acute ischaemic stroke; however, the underlying mechanisms remain unclear. We hypothesized that sarcopenia affects post-stroke outcomes, mediated through its impact on dysphagia, early neurological deterioration, or post-stroke recovery, particularly in patients with motor deficits. To explore this hypothesis, we included 600 consecutive elderly (≥65 years) patients with acute (< 1 week) ischaemic stroke and assessed: (i) the relationships sarcopenia has with dysphagia, early neurological deterioration and various phases of recovery after stroke (in-hospital, post-discharge [up to 3 months], and chronic [3 months to 1 year]) and (ii) whether either presenting symptoms or lesion locations modify the impact of sarcopenia on stroke outcomes. Temporal muscle thickness, a marker of sarcopenia, was measured by brain magnetic resonance imaging and dichotomized into low versus high temporal muscle thickness at the 25th percentile cut-off point. Logistic regression analysis, mediation analysis and statistical brain mapping were conducted. Mean age was 75.3 ± 6.1 years and 303 (50.5%) were male. Low temporal muscle thickness (< 5.1 mm) was independently associated with dysphagia (adjusted odds ratio 1.89 [95% confidence interval 1.06–3.37], P = 0.03), early neurological deterioration (adjusted odds ratio 2.75 [95% confidence interval 1.61–4.71], P < 0.001) and post-discharge recovery (adjusted odds ratio 0.56 [95% confidence interval 0.34–0.94], P = 0.03) but not with in-hospital or chronic recovery. In addition, dysphagia, early neurological …

Development And Validation Of Natural Language Processing Algorithms In The National Enact Network, Yanshan Wang, Jordan Hilsman, Chenyu Li, Michele Morris, Paul M Heider, Sunyang Fu, Min Ji Kwak, Andrew Wen, Joseph R Applegate, Liwei Wang, Elmer Bernstam, Hongfang Liu, Jack Chang, Daniel R Harris, Alexandria Corbeau, Darren Henderson, John Osborne, Richard E Kennedy, Nelly-Estefanie Garduno-Rapp, Justin F Rousseau, Chao Yan, You Chen, Mayur B Patel, Tyler J Murphy, Bradley A Malin, Chan Mi Park, Jungwei W Fan, Sunghwan Sohn, Sandeep Pagali, Yifan Peng, Aman Pathak, Yonghui Wu, Zongqi Xia, Salvatore Loguercio, Steven E Reis, Shyam Visweswaran

Faculty, Staff and Student Publications

Objective: Electronic Health Record (EHR) data are critical for advancing translational research and AI technologies. The ENACT network offers access to structured EHR data across 57 CTSA hubs. However, substantial information is contained in clinical narratives, requiring natural language processing (NLP) for research. The ENACT NLP Working Group was formed to make NLP-derived clinical information accessible and queryable across the network.

Methods: We established the ENACT NLP Working Group with 13 sites selected based on criteria including clinical notes access, IT infrastructure, NLP expertise, and institutional support. We divided sites into five focus groups targeting clinical tasks within disease contexts. …

Retirement Grief: Insights For Counseling Praxis, Colette T. Dollarhide

Adultspan Journal

From a personal perspective, this article documents one counselor educator’s experience that might inform the work of counselors who are providing counseling services for those experiencing challenges during retirement.

Influence Of Virtual Reality On Lower Extremity Joint Kinematics During Overground Walking, Hunter Derby, Nathan Conner, Adam C. Knight, Harish Chander

Funded Scholarship

The inability to regain balance following a trip-induced event is one of the leading causes of falls and fall-related injuries in older adults. Virtual reality (VR) has the potential to expose individuals to realistic environments with minimal injury risk compared to real-world exposures. The purpose of this study was to compare lower extremity joint kinematics during overground walking when exposed to real and virtually generated trip obstacles. A total of 14 healthy participants [7 male, 7 female; age: 23.46 ± 3.31 years; height: 173.85 ± 8.46 cm; mass: 82.19 ± 11.41 kg; shoe size (men’s): 9.03 ± 2.71 s] were …

Exploring The Interoperability For Information Exchange Between Acute And Post-Acute Care Settings, Madhu Gottumukkala, Cherie Noteboom, Omar F. El-Gayar

Research & Publications

The seamless transfer and assimilation of healthcare data are foundational to delivering holistic, timely, and effective patient care across the healthcare spectrum. However, disparities in Electronic Health Record (EHR) system adoption, especially in long-term and post-acute care (LTPAC) settings, consistently obstruct interoperability. This study explores the factors that impede and facilitate health information exchange in LTPAC environments, focusing on technical and organizational facets. Grounded theory guided our qualitative case study research, involving 35 stakeholder interviews. Key technical findings highlight the need for integrated, reliable data structures, robust infrastructure, and standardized practices. Organizational insights reveal a shift towards integrative, patient-centric strategies …

Tiny-Physics: A Compact Large Language Model For Physics Word Problems On Mobile Devices, Akhil Vallala

Electronic Theses and Dissertations 2020 - Present

This thesis offers Tiny-Physics, a compact large language model optimized for solving physics word problems on mobile devices. While Small Language Models (SLMs) offer potential for on-device learning, there is a lack of domain-specialized models for physics. This research fine-tunes smolLM2-360M, a state-of-the-art SLM, using a combination of publicly available datasets (e.g., camel-ai/physics) and a novel synthetic dataset generated through a multi-agent system based on GPT-4o and 1000 Solved Problems in Classical Physics.

The fine-tuning process incorporates both supervised and instruction-tuning methods, including LoRA for parameter-efficient training. The resulting model is converted to GGUF format for deployment on resource-constrained mobile …

Daily Movement Activities Are Associated With Within-Person Instability Of Cognitive Function In Older Adults: Evidence From An Ambulatory Assessment Study, Chih-Hsiang Yang, Donald Hedeker, Jongwon Lee, Halle Prine, Donna Coffman, Jingkai Wei, Jonathan George Hakun

Faculty, Staff and Student Publications

Background and objectives: Physical inactivity and excessive sedentary time (ST) are associated with poor cognitive health in older adults. However, current literature largely relies on cross-sectional designs or in-lab cognitive assessments, which do not adequately reflect cognitive function in naturalistic settings. Further, existing studies have largely overlooked the variability or the instability in daily cognitive function, which represents a critical marker of cognitive decline. This ambulatory assessment study examined the temporal associations of daily movement behaviors with the mean levels and the variability of cognition among older adults at risk of dementia.

Research design and methods: 96 older adults from …