Digital Commons Network^™

Conducting Comparative Effectiveness, Multisite Palliative Care And Advance Care Planning Trials: Lessons Learned And Future Directions From Pcori-Funded Studies, Areej El-Jawahri, Brittany Waterman, Susan Enguidanos, Lisa Gibbs, Victor Navarro, Maren Olsen, Jennifer Temel, Annette Totten, Corita R. Grudzen

Department of Medicine Faculty Papers

The Patient-Centered Outcomes Research Institute (PCORI) funded multiple large-scale comparative effectiveness clinical trials evaluating palliative care (PC) and advance care planning (ACP) healthcare delivery models. This article provides an overview of the most common barriers our investigative teams encountered while implementing these trials and the strategies we utilized to overcome these challenges, with particular attention to identifying research partners for multisite trials; addressing contracting and regulatory issues; creating a team governance structure; training and engaging study staff across sites; recruiting, consenting, and enrolling study participants; collecting PC and ACP data and study outcomes; and managing multisite collaborations. The goal of …

Interviewing The Interviewers: How Qualitative Professors Assess Interviews In Their Classes, Meredith C. Massey, Leia K. Cain

The Qualitative Report

When reviewing the literature relating to what instructors of qualitative research courses are teaching in their courses, we found a gap regarding qualitative faculty's motivations behind what they teach and whether they use teaching tools such as rubrics in their assessment practices. We utilized general qualitative methods to explore and describe how instructors of qualitative methodology courses conceptualize and design interview-based assessments. By conducting structured interviews with five faculty members, we embraced interpretivist descriptive traditions and sought to obtain thick, rich descriptions of each participant’s perspectives and experiences. After coding interview transcripts, we created themes to represent participant beliefs that …

A Survey Of Early-Career Speech-Language Pathologists: Determining Perceived Readiness For Clinical Management Of Adults With Dysphagia After Completing Graduate School, Christine A. Lee, Ashwini Namasivayam-Macdonald, Zuleikha Wadhwaniya, Juliana Mclaren, Rebecca H. Affoo

Teaching and Learning in Communication Sciences & Disorders

Several studies have identified a recurring trend that speech-language pathologists (S-LPs) in countries such as the United States (Caesar & Kitila, 2020), South Africa (Singh et al., 2015), and Malaysia (Kamal et al., 2012) report lower levels of confidence in dysphagia management, whether in comparison to other practice areas or in certain skill areas within the specialty of dysphagia. No data currently exists exploring self-perceptions of Canadian S-LP graduates with regards to clinical management of adults with dysphagia. Therefore, the purpose of this study was to determine the self-reported readiness of recently graduated Canadian S-LPs who manage dysphagia. Our survey …

Changes In Multimorbidity Among Hospitalized Adults In The Us, Christine Loyd, Lauren Picken, Richelle Sanders, Yue Zhang, Richard E. Kennedy, Cynthia J. Brown

School of Medicine Faculty Publications

OBJECTIVE: This investigation examines burden of comorbidity measured by the Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI) among inpatients based on age, sex, and race. METHODS: Cross-sectional analysis of 2012-2018 US NIS datasets. Participants were inpatients 55y+. ICD-9/10 codes for admitting diagnoses were used to calculate disease burden using the CCI and ECI. Unweighted mean CCI and ECI scores were compared across demographic variables. RESULTS: An increase in mean CCI and ECI scores across age, sex, and races (p < .001) was identified. Compared to the youngest age group (55-59y), all age groups had higher mean CCI and ECI adjusting for time (p < .001). Increases were greatest in older age groups until age 80-84 for CCI and 85-89 for ECI. The female group had lower CCI adjusting for time (p < .001) compared to males. There was no difference between sex groups in mean ECI (p=.409). Compared with the White group, all other race groups had higher mean CCI adjusting for time (p < .001). Black inpatients had the highest CCI followed by Native American inpatients. Findings were similar for ECI, but with no difference between Hispanic and White groups (p=.434). CONCLUSIONS: Growing multimorbidity burden among adult inpatients across age, sex, and race supports the continued need for programs for preventing and reducing multimorbidity, especially among communities that experience health inequity including older, Black, and Native American patients.

Prostate-Specific Antigen Testing Patterns And Prostate Cancer Stage At Diagnosis In Older Ohio Cancer Patients, Sajan N. Patel, Long Vu, Holly E. Hartman, Weichuan Dong, Siran M. Koroukian, Johnie Rose

Faculty Scholarship

Background: Prostate cancer (PCa) screening recommendations do not support prostate-specific antigen (PSA) screening for older men. Such screening often occurs, however. It is, therefore, important to understand how frequently and among which subgroups screening occurs, and the extent of distant stage PCa diagnoses among screened older men. Methods: Using the 2014–2016 linked Ohio Cancer Incidence Surveillance System (OCISS) and Medicare administrative database, we identified men 68 and older diagnosed with PCa and categorized their PSA testing in the three years preceding diagnosis as screening or diagnostic. We conducted multivariable logistic regression analysis to identify correlates of screening PSA and to …

Experience Of Loneliness Among Older People In Hong Kong : Ageism Perspective, Chi Kuen Wong

Lingnan Theses (MPhil & PhD)

The experience of loneliness is a significant concern among older people, as it can lead to serious health risks and impact overall well-being. This study, conducted in Hong Kong, explores the relationship between ageism and loneliness among older individuals. Employing qualitative research methods and thematic analysis, data were collected from 21 community-dwelling participants aged 65 to 86, including 8 males and 13 females.

The research focuses on how older individuals' experiences and perceptions of ageism contribute to feelings of loneliness. The study examines different forms of ageism, including institutional ageism and social exclusion, interpersonal ageism, and internalized ageism, as well …

Glycemic Control In Diabetic Patients Improved Overall Lung Cancer Survival Across Diverse Populations, Wayne Y Wu, Brian Luke, Xiao-Cheng Wu, J Jack Lee, Yong Yi, Samuel C Okpechi, Barry Gause, Paras Mehta, Steven I Sherman, Augusto Ochoa, Ethan Dmitrovsky, Xi Liu

Faculty, Staff and Student Publications

Background: The consequence of diabetes on lung cancer overall survival (OS) is debated. This retrospective study used 2 large lung cancer databases to assess comprehensively diabetes effects on lung cancer OS in diverse demographic populations, including health disparity.

Methods: The University of Texas MD Anderson Cancer Center database (32 643 lung cancer patients with 11 973 patients with diabetes) was extracted from electronic health records (EHRs) using natural language processing (NLP). Associations were between diabetes and lung cancer prognostic features (age, sex, race, body mass index [BMI], insurance status, smoking, stage, and histopathology). Hemoglobin A1C (HgbA1c) and glucose levels assessed …

Testamentary Freedom: A Constitutional Perspective, Richard J. Goralewicz

ACTEC Law Journal

No abstract provided.

Ce 640 Syllabus: Orientation To Clinical Mental Health Counseling, Karen Cathey

Counselor Education Syllabi

This course examines the counseling profession including history, philosophy, theory, and professional issues. Emphasis is on different counseling populations, social justice and multicultural issues.

Ce 640 Syllabus: Orientation To Clinical Mental Health Counseling, Rieko Miyakuni

Counselor Education Syllabi

This course examines the counseling profession including history, philosophy, theory, and professional issues. Emphasis is on different counseling populations, social justice and multicultural issues.

孫輩照顧者面對的挑戰研究報告, Chak Kwan, Dickon Chan, Kong Sang Lou, Meng Soi, Florence Fong, Sheung Wan, Wanda Wong, Ka Chung, Tom Kwong

APIAS Research Report 研究報告

背景和目的
香港人口老齡化和長期病患者的增加，令到更多老年人需要人照顧。現時社會對孫輩照顧者的認識不足，使到他們缺乏適切支援服務。本研究旨在探索孫輩照顧殘疾或患有慢性疾病的祖父母的情況，並提出政策與服務建議。嶺南大學亞太老年學研究中心聯同救世軍護老者協會及救世軍護老者服務於2024年4月25日舉辦了「孫輩照顧者的需要、實踐及政策」研討會，各方持份者分享他們對支援孫輩照顧者的經驗和看法，共同尋找方案支援這類照顧者。

研究方法
本研究於2023年4月至12月期間，採用深度訪談 (in-depth interview) 方式，訪問了共40位年齡介乎13至63歲的孫輩照顧者，瞭解他們成為照顧者的主要原因、提供了甚麼照顧，以及照顧過程中面對的困難。

研究結果

• 大部分受訪的孫輩照顧者 (67.5%) 為次照顧者，近半受訪者每周提供20小時以上的照顧工作。
• 共有47位祖父母/外祖父母受到照顧，年齡介乎62至99歲。大部分被照顧者 (91.5%) 行動不便，或患有長期病患 (76.6%)。被照顧祖父母當中過半 (57.4%) 沒有與孫輩同住，8.5%為獨居。
• 孫輩成為照顧者有數個原因，包括家庭成員無法提供照顧、減輕父母的壓力和回饋祖父母過往照顧之恩。
• 孫輩照顧者的照顧角色與他們的年齡、生活狀態、能力，以及被照顧者的需要有關。大部分孫輩照顧者和家人分擔照顧工作，並得到他們的協助。孫輩照顧者會主動運用各種輔助設備，以提高照顧成效。
• 孫輩照顧者除了要面對一般照顧者的困難外 (如支援服務及資訊不足、身心壓力和社交限制)，他們面對的壓力還包括學業及就業、家庭角色的衝突、「夾心」照顧者面對多重壓力，以及缺乏社會的認同。
• 政策建議
  研究報告建議政府須加強院校對就學照顧者的支持、提供額外假期予在職照顧者、將照顧者主題納入中學課程、推廣朋輩支援小組、提供線上及晚間照顧技巧課程、開發多元化暫託服務、建立個案管理制度，以及推動樂齡科技之運用。

Regulation Of P21 Function By A Sense Long Non-Coding Rna Generated By Alternative Polyadenylation, Anthony Ramadei

Dissertations, Theses, and Capstone Projects

As cells are continually undergoing damage to the genome, a coordinated change in gene expression across thousands of genes is required for the progression of the DNA damage response (DDR). After initial sensing of DNA damage, the transcription factor p53 induces expression of target genes to halt the cell-cycle to allow DNA repair and induce either senescence or apoptosis. One of the p53 target genes is CDKN1A which encodes the cyclin dependent kinase inhibitor p21. p21 halts cell-cycle progression in response to DNA damage and can also induce senescence. However, p21 expression in cancer cells undergoing chemotherapy allows survival by …

The Long Arm Of School Punishment: The Role Of School Suspension On Self-Rated Health From Adolescence To Midlife, Michael Niño, Alexa Angton, Kathryn Norton-Smith, Kayla Allison

Sociology and Criminology Faculty Publications and Presentations

School suspension has been linked to numerous adverse social outcomes in adolescence and adulthood. While research continues to highlight the deleterious consequences tied to suspension, less is known about how exposure to suspension influences health over the life course. Drawing from panel data, we address this gap by investigating whether school suspension is associated with self-rated health from adolescence to midlife. Compared to youth with no history of suspension, suspended youth were more likely to report poorer health in adolescence. Findings also demonstrate that school suspension plays a significant role in self-rated health patterns over time. Specifically, we find suspended …

Self-Perceived Cognitive Functioning In Motoric Cognitive Risk Syndrome: Enhancing Risk Detection In Health Disparity Older Adults, Caroline O. Nester

Dissertations, Theses, and Capstone Projects

Motoric Cognitive Risk Syndrome (MCR) is a predementia condition that combines two clinical presentations associated with dementia: slow gait speed and subjective cognitive concerns (SCC). MCR diagnosis is associated with increased risk for dementia over its individual components of SCC or slow gait alone, making it a valuable marker of early neurodegenerative changes. MCR does not require expensive, time-consuming assessments to be diagnosed, broadening accessibility in remote or under-resourced settings. At present, there is no consistent method to assess SCC in MCR – a key diagnostic feature of the syndrome. The lack of understanding about SCC in MCR may limit …

Geriatric Nutritional Risk Index Predicts Postoperative Delirium In Elderly: A Meta-Analysis, Siye Xie, Qi Wu

Saudi Medical Journal

Objectives: To review current evidence on using the geriatric nutritional risk index (GNRI) in predicting postoperative delirium (POD) in elderly patients. Methods: The literature search was performed in core databases to include all the cohort studies on the association between GNRI and risk of POD for further meta-analysis. Results: A total of 6 studies with 4242 patients underwent this meta-analysis, which showed that the risk of POD was higher in patients with moderate and high GNRI than the ones with low GNRI (odds ratio [OR]=2.04, 95% confidence interval [CI] [1.58, 2.64], p <0.001), and moderate and high GNRI significantly increased the risk of POD in patients of 60 to 75 years or above [OR=1.98, 95%CI (1.49, 2.62), p <0.001; OR=2.79, 95%CI (1.38, 5.64), p =0.004, respectively]. Conclusion: Therefore, moderate and high GNRI increased the risk of POD in elderly patients.

Admixture Mapping Of Cognitive Function In Diverse Hispanic And Latino Adults: Results From The Hispanic Community Health Study/Study Of Latinos, Rui Xia, Xueqiu Jian, Amanda L Rodrigue, Jan Bressler, Eric Boerwinkle, Biqi Cui, Martha L Daviglus, Charles Decarli, Linda C Gallo, David C Glahn, Emma E M Knowles, Jee-Young Moon, Thomas H Mosley, Claudia L Satizabal, Tamar Sofer, Wassim Tarraf, Fernando Testai, John Blangero, Sudha Seshadri, Hector M González, Myriam Fornage

Faculty, Staff and Student Publications

INTRODUCTION: We conducted admixture mapping and fine-mapping analyses to identify ancestry-of-origin loci influencing cognitive abilities.

METHODS: We estimated the association of local ancestry intervals across the genome with five neurocognitive measures in 7140 diverse Hispanic and Latino adults (mean age 55 years). We prioritized genetic variants in associated loci and tested them for replication in four independent cohorts.

RESULTS: We identified nine local ancestry-associated regions for the five neurocognitive measures. There was strong biological support for the observed associations to cognitive function at all loci and there was statistical evidence of independent replication at 4q12, 9p22.1, and 13q12.13.

DISCUSSION: Our …

Admixture Mapping Of Cognitive Function In Diverse Hispanic And Latino Adults: Results From The Hispanic Community Health Study/Study Of Latinos, Rui Xia, Xueqiu Jian, Amanda L. Rodrigue, Jan Bressler, Eric Boerwinkle, Biqi Cui, Martha L. Daviglus, Charles Decarli, Linda C. Gallo, John Blangero

School of Medicine Publications

Introduction: We conducted admixture mapping and fine-mapping analyses to identify ancestry-of-origin loci influencing cognitive abilities.

Methods: We estimated the association of local ancestry intervals across the genome with five neurocognitive measures in 7140 diverse Hispanic and Latino adults (mean age 55 years). We prioritized genetic variants in associated loci and tested them for replication in four independent cohorts.

Results: We identified nine local ancestry-associated regions for the five neurocognitive measures. There was strong biological support for the observed associations to cognitive function at all loci and there was statistical evidence of independent replication at 4q12, 9p22.1, and 13q12.13.

Discussion: Our …

Admixture Mapping Of Cognitive Function In Diverse Hispanic And Latino Adults: Results From The Hispanic Community Health Study/Study Of Latinos, Ru Xia, Xueqiu Jian, Amanda L. Rodrigue, Jan Bressler, Eric Boerwinkle, Biqi Cui, Martha L. Daviglus, Charles S. Decarli, Linda C. Gallo, John Blangero

School of Medicine Publications

Introduction: We conducted admixture mapping and fine-mapping analyses to identify ancestry-of-origin loci influencing cognitive abilities.

Methods: We estimated the association of local ancestry intervals across the genome with five neurocognitive measures in 7140 diverse Hispanic and Latino adults (mean age 55 years). We prioritized genetic variants in associated loci and tested them for replication in four independent cohorts.

Results: We identified nine local ancestry-associated regions for the five neurocognitive measures. There was strong biological support for the observed associations to cognitive function at all loci and there was statistical evidence of independent replication at 4q12, 9p22.1, and 13q12.13.

Discussion: Our …

Do Pedestrian Safety Improvements Affect Older Adults' Health And Social Outcomes Equitably? A Quasi Experiment In Singapore, Shin Bin Tan, William Tov, Paulin Tay Straughan

Research Collection School of Social Sciences

Pedestrian-friendly neighborhoods are believed to encourage greater social participation, community engagement, and sense of social inclusion, which are important to older individuals at higher risk of being socially isolated. However, most studies on neighborhood walkability, social participation and social inclusion are cross-sectional, making it difficult to robustly establish causal links. Much research on neighborhood walkability is also based in North America and Europe, leaving a knowledge gap on the impact of walkability within other geographic contexts. Furthermore, there is a lack of empirical evidence about whether benefits from traffic calming schemes are distributed equitably. To reduce these empirical gaps, our …

The Importance Of Sampling Frequency For Estimates Of Well-Being Dynamics, Stephen James Hoskins, David W. Johnston, Johannes S. Kunz, Michael A. Shields, Kevin E. Staub

ROSA Journal Articles and Publications

Using a high-frequency panel survey, we examine the sensitivity of estimated self-reported well-being (SWB) dynamics to using monthly, quarterly, and yearly data. This is an important issue if SWB is to be used to evaluate policy. Results from autoregressive models that account for individual-level heterogeneity indicate that the estimated persistence using yearly data is near zero. However, estimated persistence from monthly and quarterly data is substantial. We estimate that persistence to shocks typically lasts around six months and has a net present value of 75–80 per cent of the contemporaneous effect. Estimates are similar for different domains of SWB.

Dementia-Focused Programs In Older Adult Centers And Health Care Use Among Individuals With Dementia, Ayse Akincigil, Divya Bhagianadh, Clara J. Scher, Ceara Somerville, Caytln Coyle, Natalie E. Pope, Emily Greenfield

Health, Human Performance and Recreation Faculty Publications and Presentations

There is growing attention to community-based services for preventing adverse health care outcomes among people aging with dementia. We explored whether the availability of dementia-centered programming within older adult centers (ie, senior centers)—specifically, adult day services (ADS), social adult day centers (SADCs), memory cafes, and caregiver support—is associated with reduced hospitalization, emergency room use, and total Medicare costs for community-dwelling individuals ages 75 and older with Alzheimer's disease and related dementias (ADRD), and whether associations differ by the relative size of the local jurisdiction. We used a novel dataset that links Medicare claims data with data from an organizational census …

The Implementation Of A Fall Education Program To Enhance Functional Outcomes In An Acute Orthopedic Hospital Setting, Stacy Wentz Ms, Otr/L, Jared Schnell Pt, Dpt, Haily Roth Pt, Dpt

Department of Medicine

No abstract provided.

Histopathological Evaluation Of Geriatric Ophthalmic Veins: A Cadaveric Study, Farida Mehrhoff, Keanna Theobalt, Alla G. Barry, Robert Hillard

Student Publications

Context: The ophthalmic vein (OV) has become a source of increasing curiosity since many aspects of vascular surgery of the orbit have become feasible. At the same time, histochemical analysis of veins, in general, tends to skip the OV. Moreover, age‑related changes in the OVs remain untouched. Aims: Our research explores features of aging in the OV. Settings and Design: We immunohistochemically evaluated the superior and inferior OVs in 49 orbits of 28 formalin‑embalmed human cadavers (age 77.86 ± 13.38) without visible vascular malformations. Materials and Methods: Specimens were stained by hematoxylin and eosin. Verhoeff, laminin, and CD31 stains were …

Older And Better: A Narrative Review Of Successful Aging And Adaptation To Pain In Late Life, Emanuel Narcis Husu

Faculty, Staff and Students Publications

"Invariably, the self-assessed QoL was far better than I, as a physician, would have anticipated from the diseases and disabilities that you reported." -Ben Eiseman, MD, based on a survey of his octogenarian Yale University classmates.

Background: Chronic pain control is a high priority for the elderly; it is one of the most frequently encountered medical problems in this group. Chronic pain affects 60%-75% of people aged 65 years and older. Chronic pain's prevalence is even higher in those living in assisted living or nursing homes. Based on epidemiological data, the prevalence of chronic pain is directly proportional to age …

An Interpretable Machine Learning-Based Cerebrospinal Fluid Proteomics Clock For Predicting Age Reveals Novel Insights Into Brain Aging, Justin Melendez, Yun Ju Sung, Miranda Orr, Andrew Yoo, Suzanne Schindler, Carlos Cruchaga, Randall Bateman

2020-Current year OA Pubs

Machine learning can be used to create "biologic clocks" that predict age. However, organs, tissues, and biofluids may age at different rates from the organism as a whole. We sought to understand how cerebrospinal fluid (CSF) changes with age to inform the development of brain aging-related disease mechanisms and identify potential anti-aging therapeutic targets. Several epigenetic clocks exist based on plasma and neuronal tissues; however, plasma may not reflect brain aging specifically and tissue-based clocks require samples that are difficult to obtain from living participants. To address these problems, we developed a machine learning clock that uses CSF proteomics to …

The Minutes Of The Marshall University Graduate Council Meeting, August 30, 2024, Marshall University Graduate Council

Graduate Council Minutes

No abstract provided.

Fall Risk On Laboratory Instrumented Stairways, Parker Nelson

Summer Community of Scholars Posters (RCEU and HCR Combined Programs)

No abstract provided.

Using The Home Health Oasis To Promote Advance Care Planning Among Community-Dwelling, Frail Older Adults, Suzanne S. Sullivan

Dissertations

Despite an aging population with increasing proportions of frailty and decline, the rates of documented Advance care plans (ACP), meant to align goals for care with the level of treatment at end-of-life (EOL), are low (~30-40%). Patients expect clinicians to raise the question about serious illness goals for care when the time is right, however, there are a number of barriers to the initiation of these difficult conversations including provider bias and uncertainty. A review of the literature indicates that there are few prognostic indices available for use to identify the right time to initiate EOL conversations based on risk …

Increasing Self-Efficacy Of Nurse Practitioner Preceptors In Primary Care By Using The One-Minute Preceptor Model, Amy J. Lancaster

Doctoral Dissertations and Projects

Nurse practitioners represent the fastest growing profession in the United States, with 385,000 practitioners currently licensed. Over 70% of these licensed practitioners are serving in primary care settings. As the growth of this workforce continues, so does the need for nurse practitioner preceptors. The preceptor plays an essential role in championing clinical competencies for nurse practitioner students. This project was implemented in a primary care setting with an aim to improve the self-efficacy of nurse practitioner preceptors by using the One-Minute Preceptor teaching method to improve the practicum experience for both the preceptor and the nurse practitioner student. The One-Minute …

A Qualitative Study On Transnational Caregiving For Older Parents In China, Silai Dong

Lingnan Theses (MPhil & PhD)

The increasing number of international migrations in China poses challenges for the care of older parents who are left behind, considering China’s emphasis on family support. This study aims to investigate transnational care arrangements for older parents whose children are overseas. It mainly addresses three research questions:1) What are the contents of filial piety in the context of international migration? 2) How do Chinese transnational family members negotiate and distribute elder care responsibilities? 3) To what extent can the transnational caregiving model explain elder care in Chinese transnational families?

The transnational caregiving model proposed by Baldassar, Baldock, and Wilding, in …