Publications

Publications

An additional 1,440 minutes: What will you do with an extra day?

Newland, J. A. (2024). Nurse Practitioner, 49(2), 4. 10.1097/01.NPR.0000000000000142

Addressing School Connectedness, Belonging, and Culturally Appropriate Care for Newly Immigrated Students and Families

McCabe, E., Kaskoun, J., Bennett, S., Meadows-Oliver, M., & Schroeder, K. (2024). Journal of Pediatric Health Care, 38(2), 233-239. 10.1016/j.pedhc.2023.10.001
Abstract
Abstract
School connectedness is the degree to which students experience acceptance, inclusion, and care by school personnel and peers. A sense of belonging incorporates an emotional connection to the community. School connectedness and belonging are protective factors that promote student engagement, accomplishment, and community performance. Despite the rise in students from immigrant families in the United States, belonging and connectedness for youth from diverse cultural and linguistic experiences are understudied. School-based nurses, our term, is inclusive of advanced practice pediatric, family, and psychiatric nurse practitioners, are well-positioned to support school connectedness for youth who may encounter hurdles to health care because of cultural and linguistic differences. We present practice suggestions for language, culture, and inclusion using three health conditions experienced by youth: anxiety, asthma, and obesity. School-based nurses and other school personnel who provide linguistic and culturally appropriate care can support students in feeling connected and included in their school communities.

The Association Between Trajectories of Perceived Unmet Needs for Home and Community-Based Services and Life Satisfaction Among Chinese Older Adults: The Moderating Effect of Psychological Resilience

Wang, H., Liu, H., Wu, B., & Hai, L. (2024). Research on Aging, 46(2), 139-152. 10.1177/01640275231203608
Abstract
Abstract
This study examined whether trajectories of perceived unmet needs for Home and Community-Based Services (HCBS) were associated with life satisfaction among Chinese older adults and whether the association was moderated by psychological resilience. Data came from five waves (2005-2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Latent class growth analysis revealed three distinct trajectories of perceived unmet HCBS needs: “increasing” (n = 977, 36.24%), “persistent” (n = 570, 21.14%), and “decreasing” (n = 1149, 42.62%). Multiple regression estimates showed that the increasing group was associated with lower life satisfaction, and the association was moderated by psychological resilience, especially for older adults who were male, living in rural, and oldest-old. Results indicate that inequalities in cumulative exposure to perceived unmet HCBS needs may further lead to increasing inequalities in life satisfaction. Interventions focused on minimizing the provision-need gap of HCBS and enhancing personal resilience should be considered to improve the life satisfaction of older adults.

Caring for patients with life-threatening hemoptysis

Chen, L., & Fasolka, B. (2024). Nursing, 54, 44-47. 10.1097/01.NURSE.0000997996.22052.79
Abstract
Abstract
Life-threatening hemoptysis (formerly called massive hemoptysis), though relatively uncommon, imposes significant mortality risks. This article discusses the etiology, clinical presentation, assessment, treatment, and nursing interventions to promote effective clinical management of patients with this condition.

The development of social capital in a peer-led mHealth cognitive behavioral antiretroviral therapy adherence intervention for HIV + adolescents and young adults

Goldsamt, L. A., Liang, E., Handschuh, C., & Navarra, A. M. (2024). AIDS Care - Psychological and Socio-Medical Aspects of AIDS HIV, 36(4), 425-431. 10.1080/09540121.2023.2262981
Abstract
Abstract
Adherence Connection for Counseling, Education, and Support (ACCESS)-I is a peer-led mHealth antiretroviral therapy adherence intervention for adolescents and young adults living with HIV who are in treatment but have detectable viral loads. Participants received five online sessions with peer health coaches who followed a structured intervention manual. Peers maintained intervention fidelity but also engaged in casual discussion that was not directly related to ART adherence or HIV. We conducted a qualitative analysis of the casual interactions that occurred during the ACCESS I intervention. Sessions were transcribed and coded, and these casual interactions were then coded into 10 subcodes to document their content, and also coded for three types of social capital–emotional, informational, and instrumental. Emotional and Informational social capital codes were the most common, while instrumental codes were rare. Activities was the most common topic overall, while encouragement was more common in emotional social capital narratives and personal experience was more common in informational social capital narratives. These casual interactions may strengthen peer-participant relationships, building social capital that could then be used to encourage positive behavior change. Although social capital was not directly measured, these analyses illustrate the value of attending to seemingly casual interactions in peer-led interventions.

An Evolutionary Concept Analysis of the "Fighter" in the Intensive Care Unit

Moreines, L. T., Brody, A. A., & Murali, K. P. (2024). Journal of Hospice and Palliative Nursing. 10.1097/NJH.0000000000001017
Abstract
Abstract
The purpose of this article was to analyze the concept of "the fighter in the intensive care unit (ICU)" per the scientific literature and the impact this mentality has on care administered in the ICU. A literature review and a concept analysis based on Rodger's evolutionary method were performed to identify surrogate terms, antecedents, attributes, and consequences pertaining to the "fighter" in the ICU. Thirteen articles with a focus on "the fighter" were included in this analysis. There is a strong desire to remain optimistic and maintain high spirits as a coping mechanism in the face of extreme prognostic uncertainty. Themes that emerged from the literature were the need to find inner strength and persist in the face of adversity. The concept of "the fighter in the ICU" can serve as either adaptive or maladaptive coping, depending on the larger clinical picture. Patient experiences in the ICU are fraught with physical and psychological distress. How the patient and family unit cope during this anxiety-provoking time is based on the individual. Maintaining optimism and identifying as a fighter can be healthy ways to adapt to the circumstances. This concept analysis highlights the importance of holistic care and instilling hope particularly as patients may be nearing the end of life.

Feasibility, Acceptability, and Preliminary Effectiveness of a Sleep Intervention in Adults at Risk for Metabolic Syndrome With Short Sleep Duration

Malone, S. K., Patterson, F., Grunin, L., Yu, G., Dickson, V. V., & Melkus, G. D. (2024). Nursing Research, 73(1), 72-80. 10.1097/NNR.0000000000000693
Abstract
Abstract
Background: The prevalence of short sleep duration is rising and is linked to chronic comorbidities, such as metabolic syndrome (MetS). Sleep extension interventions in adults with MetS comorbidities and short sleep duration are limited and vary widely in terms of approach and duration. Objectives: This pilot study aimed to test the feasibility and acceptability of a personalized 12-week systematic sleep time extension intervention on post-intervention sleep outcomes in middle-aged adults at risk forMetSwith actigraphy-estimated short sleep duration. Methods: A single-arm, 12-week, 12-session systematic sleep time extension intervention was delivered weekly via videoconferencing. Feasibility and acceptability were assessed using retention rates and mean sleep diary completions. Sleep was estimated for 14 consecutive days prior to and immediately following the 12-week intervention using wrist actigraphy. Daytime sleepiness was assessed using the Epworth Sleepiness Scale. Paired sample t-tests modeled changes in study outcomes. Results: Study participants (N = 41) had a mean age of 52 years and were mostly female and White; 86% attended >80% of sessions, and mean sleep diary completion was 6.7 diaries/week. Significant improvements in sleep from pre- to post-intervention included increased total sleep time, earlier sleep onsets, more regular sleep onsets, a higher sleep regularity index, and reduced daytime sleepiness. Extending sleep, as well as improving sleep timing and regularity in middle-aged adults with actigraphy-estimated short sleep duration and at risk for MetS, is feasible and acceptable. Discussion: Behavioral sleep characteristics may be modifiable and present a novel behavioral paradigm for mitigating MetS risk. This pilot study provides a proof of concept for the feasibility, acceptability, and preliminary effectiveness of a systematic sleep time extension for middle-aged adults at risk for MetS with actigraphy-estimated short sleep duration.

Gut microbiota, nutrition, and mental health

Merlo, G., Bachtel, G., & Sugden, S. G. (2024). Frontiers in Nutrition, 11. 10.3389/fnut.2024.1337889
Abstract
Abstract
The human brain remains one of the greatest challenges for modern medicine, yet it is one of the most integral and sometimes overlooked aspects of medicine. The human brain consists of roughly 100 billion neurons, 100 trillion neuronal connections and consumes about 20–25% of the body’s energy. Emerging evidence highlights that insufficient or inadequate nutrition is linked to an increased risk of brain health, mental health, and psychological functioning compromise. A core component of this relationship includes the intricate dynamics of the brain-gut-microbiota (BGM) system, which is a progressively recognized factor in the sphere of mental/brain health. The bidirectional relationship between the brain, gut, and gut microbiota along the BGM system not only affects nutrient absorption and utilization, but also it exerts substantial influence on cognitive processes, mood regulation, neuroplasticity, and other indices of mental/brain health. Neuroplasticity is the brain’s capacity for adaptation and neural regeneration in response to stimuli. Understanding neuroplasticity and considering interventions that enhance the remarkable ability of the brain to change through experience constitutes a burgeoning area of research that has substantial potential for improving well-being, resilience, and overall brain health through optimal nutrition and lifestyle interventions. The nexus of lifestyle interventions and both academic and clinical perspectives of nutritional neuroscience emerges as a potent tool to enhance patient outcomes, proactively mitigate mental/brain health challenges, and improve the management and treatment of existing mental/brain health conditions by championing health-promoting dietary patterns, rectifying nutritional deficiencies, and seamlessly integrating nutrition-centered strategies into clinical care.

How academia can help to grow—and sustain—a robust nursing workforce

Margolis, M., Clancy, C., Hayes, R., Sullivan-Marx, E., Wetrich, J. G., & Broome, M. (2024). Nursing Outlook, 72(1). 10.1016/j.outlook.2023.102017
Abstract
Abstract
This panel paper is the second installment in a six-part Nursing Outlook special edition based on the 2022 Emory Business Case for Nursing Summit. The 2022 summit convened national nursing, health care, and business leaders to explore possible solutions to nursing workforce crises, including the nursing shortage. Each of the summit's four panels authored a paper in the special edition on their respective topic(s), and this panel paper focuses on the topic of nursing workforce growth. It discusses priority areas for academia to help ameliorate nursing shortages, including through changes to nursing curricula and/or programming, greater attention to nursing financial needs (including nursing student loans), and regulatory reforms.

The informal discussion of advance care planning among Chinese older adults: Do education and social media use matter?

Pei, Y., Qi, X., Zhu, Z., Zhang, W., Tsay, R. M., & Wu, B. (2024). Geriatric Nursing, 55, 1-5. 10.1016/j.gerinurse.2023.10.023
Abstract
Abstract
This study aimed to examine and compare the associations between education, social media use, and advance care planning (ACP) discussion among Chinese older adults in mainland China (Wuhan), Taiwan (Taichung), and the United States (Honolulu). Community-dwelling older adults (≥ 55) were recruited from 2017 to 2018. The ACP discussion rate in Wuhan, Taichung, and Honolulu were 15.2 %, 19.2 %, and 31.3 %, respectively. Logistic regression models revealed that education was positively associated with ACP discussion in Taichung and Honolulu. Social media use was positively associated with ACP discussions in Wuhan and Honolulu, and it attenuated the association between education and ACP discussion in Honolulu. The present study contributes to previous studies by comparing the associations between education, social media use, and ACP discussion in different settings within the same ethnicity. Policy and practice implications were also discussed.

Janus: Remembering the past and looking to the future

Newland, J. A. (2024). Nurse Practitioner, 49(1), 4. 10.1097/01.NPR.0000000000000133

Making the invisible visible: The importance of applying a lens of Intersectionality for researching Internationally Educated Nurses

Thompson, R. A., Lewis, K. R., Curtis, C. A., Olanrewaju, S. A., & Squires, A. (2024). Nursing Outlook, 72(1). 10.1016/j.outlook.2023.102086

The Moderating Role of Self-Rated Oral Health on the Association Between Oral Health Status and Subjective Well-Being: Findings From Chinese Older Adults in Hawaiʻi and Taiwan

Zhang, K., Wu, B., Tsay, R. M., Wu, L. H., & Zhang, W. (2024). Research on Aging, 46(1), 3-14. 10.1177/01640275231158771
Abstract
Abstract
This paper aims to address the research questions of whether individual’s oral health status is associated with subjective well-being, as well as if there is possible moderating role of self-rated oral health among two groups of Chinese older adults (≥55 years old) in Honolulu, Hawaiʻi and Taichung, Taiwan. Using survey data collected in 2018 (N = 430, Honolulu) and in 2017 (N = 645, Taichung), ordinary least square regressions were applied. Results showed that, for both samples, oral health status was negatively and significantly associated with subjective well-being, and both associations were moderated by self-rated oral health. In addition, the moderating effects were more salient for the Honolulu sample, who enjoyed higher levels of self-rated oral health and life satisfaction. These results suggest the significant associations of both oral health status and self-rated oral health on individual health and well-being for Chinese older adults residing in different cultural contexts.

Movement is muscle in hospitalized adults

Brennan, M. M. (2024). Geriatric Nursing, 55, 373-375. 10.1016/j.gerinurse.2023.11.015
Abstract
Abstract
Physical inactivity is a major public health concern, but for hospitalized adults, the results of immobility are even more alarming. The “trauma of hospitalization” is a syndrome that refers to the collective impact of immobility, sleep deficits, and malnutrition associated with hospitalization and contributes to functional deficits. Functional decline is a modifiable and preventable risk factor. Nursing, at the center of patient care, is poised to coordinate the patient's mobility activities. Multiple steps to stave off functional decline to improve health outcomes for older adults are in the control of nurses and nursing practice and reflect the goals of the NICHE practice model.

A New Focus on Global Health

Hallas, D. (2024). Journal of Pediatric Health Care, 38(1), 1-2. 10.1016/j.pedhc.2023.09.007

Pathway to emergency nursing: An innovative academic-practice partnership

Zieman, L., Fasolka, B., Blye, A., Gilles, S., & Thompson, T. (2024). Nurse Leader. 10.1016/j.mnl.2023.11.021
Abstract
Abstract
In the wake of the COVID-19 pandemic and recent state-level practice regulation changes, one health system sought innovative strategies to prepare new to practice registered nurses (RNs) to directly enter the specialty of emergency nursing. The emergency department (ED) nurse leaders and educators collaborated with an affiliated college of nursing to develop an academic–practice partnership for prelicensure students interested in emergency nursing. The program included both classroom-based instruction and clinical learning in the health system’s EDs. A descriptive study was completed to evaluate the program participants’ opinions regarding the classroom-based and clinical learning experiences during this program, as well as their plans for employment as RNs.

Patient experiences with tissue-based genomic testing during active surveillance for prostate cancer

Leapman, M. S., Sutherland, R., Gross, C. P., Ma, X., Seibert, T. M., Cooperberg, M. R., Catalona, W. J., Loeb, S., & Schulman-Green, D. (2024). BJUI Compass, 5(1), 142-149. 10.1002/bco2.277
Abstract
Abstract
Background: Tissue-based gene expression (genomic) tests provide estimates of prostate cancer aggressiveness and are increasingly used for patients considering or engaged in active surveillance. However, little is known about patient experiences with genomic testing and its role in their decision-making. Methods: We performed a qualitative study consisting of in-depth, semi-structured interviews of patients with low- or favourable-intermediate-risk prostate cancer managed with active surveillance. We purposively sampled to include patients who received biopsy-based genomic testing as part of clinical care. The interview guide focused on experiences with genomic testing during patients' decision-making for prostate cancer management and understanding of genomic test results. We continued interviews until thematic saturation was reached, iteratively created a code key and used conventional content analysis to analyse data. Results: Participants' (n = 20) mean age was 68 years (range 51–79). At initial biopsy, 17 (85%) had a Gleason grade group 1, and 3 (15%) had a grade group 2 prostate cancer. The decision to undergo genomic testing was driven by both participants and physicians' recommendations; however, some participants were unaware that testing had occurred. Overall, participants understood the role of genomic testing in estimating their prostate cancer risk, and the test results increased their confidence in the decision for active surveillance. Participants had some misconceptions about the difference between tissue-based gene expression tests and germline genetic tests and commonly believed that tissue-based tests measured hereditary cancer risk. While some participants expressed satisfaction with their physicians' explanations, others felt that communication was limited and lacked sufficient detail. Conclusion: Patients interact with and are influenced by the results of biopsy-based genomic testing during active surveillance for prostate cancer, despite gaps in understanding about test results. Our findings indicate areas for improvement in patient counselling in order to increase patient knowledge and comfort with genomic testing.

Perinatal Mood and Anxiety Disorder and Reproductive Justice: Examining Unmet Needs for Mental Health and Social Services in a National Cohort

Taiwo, T. K., Goode, K., Niles, P. M., Stoll, K., Malhotra, N., & Vedam, S. (2024). Health Equity, 8(1), 76-86. 10.1089/heq.2022.0207
Abstract
Abstract
Introduction: Perinatal Mood and Anxiety Disorders (PMADs) are the most common complications during the perinatal period. There is limited understanding of the gaps between need and provision of comprehensive health services for childbearing people, especially among racialized populations. Methods: The Giving Voice to Mothers Study (GVtM; n = 2700), led by a multistakeholder, Steering Council, captured experiences of engaging with perinatal services across the United States, including access, respectful care, and health systems’ responsiveness. A patient-designed survey included variables to assess relationships between race, care provider type (midwife or doctor), and needs for psychosocial health services. We calculated summary statistics and tested for significant differences across racialized groups, subsequently reporting odds ratios (ORs) for each group. Results: Among all respondents, 11% (n = 274) reported unmet needs for social and mental health services. Indigenous women were three times as likely to have unmet needs for treatment for depression (OR [95% confidence interval, CI]: 3.1 [1.5–6.5]) or mental health counseling (OR [95% CI]: 2.8 [1.5–5.4]), followed by Black women (OR [95% CI]: 1.8 [1.2–2.8] and 2.4 [1.7–3.4]). Odds of postpartum screening for PMAD were significantly lower for Latina women (OR [95% CI] = 0.6 [0.4–0.8]). Those with midwife providers were significantly more likely to report screening for anxiety or depression (OR [95% CI] = 1.81 [1.45–2.23]) than those with physician providers. Discussion: We found significant unmet need for mental health screening and treatment in the United States. Our results confirm racial disparities in referrals to social services and highlight differences across provider types. We discuss barriers to the integration of assessments and interventions for PMAD into routine perinatal services. Implications: We propose incentivizing reimbursement schema for screening and treatment programs; for community-based organizations that provide mental health and social services; and for culture-centered midwife-led perinatal and birth centers. Addressing these gaps is essential to reproductive justice.

A Qualitative Study of Breastfeeding Experiences Among Mothers Who Used Galactagogues to Increase Their Milk Supply

Ryan, R. A., Hepworth, A. D., Bihuniak, J. D., & Lyndon, A. (2024). Journal of Nutrition Education and Behavior, 56(3), 122-132. 10.1016/j.jneb.2023.12.002
Abstract
Abstract
Objective: To qualitatively describe breastfeeding experiences among mothers who used galactagogues to increase their milk supply. Design: One-time, semistructured phone interviews. Setting: US. Participants: Breastfeeding mothers (n = 19) who reported ever consuming foods, beverages, or herbal supplements to increase their milk supply in a cross-sectional online survey were purposefully sampled to participate in this qualitative study. Participants were diverse in terms of race and ethnicity, education, income, infant age (0–18 months), and prior breastfeeding experience (32% first-time breastfeeding). Phenomenon of Interest: Reasons for trying to increase milk supply, sources of information about increasing milk supply, and strategies tried to increase milk supply. Analysis: Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. Results: Participants expressed determination and commitment to breastfeeding but unexpectedly struggled to breastfeed and increase their milk supply. They sought information from multiple sources and used individualized approaches to address milk supply concerns on the basis of recommendations from others, as well as the perceived convenience, cost, palatability, and safety of potential strategies. Conclusions and Implications: Results suggest a need to expand breastfeeding education and support so that lactating parents anticipate common breastfeeding challenges and are aware of evidence-based strategies for increasing their milk supply.

The replication-competent HIV reservoir is a genetically restricted, younger subset of the overall pool of HIV proviruses persisting during therapy, which is highly genetically stable over time

Shahid, A., MacLennan, S., Jones, B. R., Sudderuddin, H., Dang, Z., Cobarrubias, K., Duncan, M. C., Kinloch, N. N., Dapp, M. J., Archin, N. M., Fischl, M. A., Ofotokun, I., Adimora, A., Gange, S., Aouizerat, B., Kuniholm, M. H., Kassaye, S., Mullins, J. I., Goldstein, H., … Brumme, Z. L. (2024). Journal of Virology, 98(2). 10.1128/jvi.01655-23
Abstract
Abstract
Within-host HIV populations continually diversify during untreated infection, and this diversity persists within infected cell reservoirs during antiretroviral therapy (ART). Achieving a better understanding of on-ART proviral evolutionary dynamics, and a better appreciation of how the overall persisting pool of (largely genetically defective) proviruses differs from the much smaller replication-competent HIV reservoir, is critical to HIV cure efforts. We reconstructed within-host HIV evolutionary histories in blood from seven participants of the Women’s Interagency HIV Study who experienced HIV seroconversion, and used these data to characterize the diversity, lineage origins, and ages of proviral env-gp120 sequences sampled longitudinally up to 12 years on ART. We also studied HIV sequences emerging from the reservoir in two participants. We observed that proviral clonality generally increased over time on ART, with clones frequently persisting long term. While on-ART proviral integration dates generally spanned the duration of untreated infection, HIV emerging in plasma was exclusively younger (i.e., dated to the years immediately pre-ART). The genetic and age distributions of distinct proviral sequences remained stable during ART in all but one participant, in whom there was evidence that younger proviruses had been preferentially eliminated after 12 years on ART. Analysis of the gag region in three participants corroborated our env-gp120-based observations, indicating that our observations are not influenced by the HIV region studied. Our results underscore the remarkable genetic stability of the distinct proviral sequences that persist in blood during ART. Our results also suggest that the replication-competent HIV reservoir is a genetically restricted, younger subset of this overall proviral pool. IMPORTANCE Characterizing the genetically diverse HIV sequences that persist in the reservoir despite antiretroviral therapy (ART) is critical to cure efforts. Our observations confirm that proviruses persisting in blood on ART, which are largely genetically defective, broadly reflect the extent of within-host HIV evolution pre-ART. Moreover, on-ART clonal expansion is not appreciably accompanied by the loss of distinct proviral lineages. In fact, on-ART proviral genetic composition remained stable in all but one participant, in whom, after 12 years on ART, proviruses dating to around near ART initiation had been preferentially eliminated. We also identified recombinant proviruses between parental sequence fragments of different ages. Though rare, such sequences suggest that reservoir cells can be superinfected with HIV from another infection era. Overall, our finding that the replication-competent reservoir in blood is a genetically restricted, younger subset of all persisting proviruses suggests that HIV cure strategies will need to eliminate a reservoir that differs in key respects from the overall proviral pool.

Substance Use Over Time Among Sexual and Gender Minority People: Differences at the Intersection of Sex and Gender

Flentje, A., Sunder, G., Ceja, A., Lisha, N. E., Neilands, T. B., Aouizerat, B. E., Lubensky, M. E., Capriotti, M. R., Dastur, Z., Lunn, M. R., & Obedin-Maliver, J. (2024). LGBT Health. 10.1089/lgbt.2023.0055
Abstract
Abstract
Purpose: Sexual and gender minority (SGM) people are at greater risk for substance use than heterosexual and cisgender people, but most prior work is limited by cross-sectional analyses or the examination of single substance use. This study examined substance use over time among SGM people to identify patterns of polysubstance use at the intersection of sex and gender. Methods: Data were collected annually over 4 years from SGM respondents (n = 11,822) in The Population Research in Identity and Disparities for Equality (PRIDE) Study. Differences in substance use patterns (any prior 30-day use of 15 substances) by gender subgroup were examined with latent class analysis, and multinomial regression models tested relationships between gender subgroup and substance use. Results: Eight classes of substance use were observed. The three most common patterns were low substance use (49%), heavy episodic alcohol use (‡5 alcoholic drinks on one occasion) with some cannabis and tobacco use (14%), and cannabis use with some tobacco and declining heavy episodic alcohol use (13%). Differences observed included lower odds of patterns defined by heavy episodic alcohol use with some cannabis and tobacco use in all gender subgroups relative to cisgender men and persons with low substance use (odds ratios [ORs] 0.26–0.60). Gender expansive people assigned female at birth, gender expansive people assigned male at birth, and transgender men had greater odds of reporting cannabis use with small percentages of heavy episodic alcohol and tobacco use (ORs: 1.41–1.60). Conclusion: This study suggests that there are unique patterns of polysubstance use over time among gender subgroups of SGM people.

Using mHealth to Improve Communication in Adult Day Services Around the Needs of People With Dementia: Mixed Methods Assessment of Acceptability and Feasibility

Zheng, A., Bergh, M., Murali, K. P., & Sadarangani, T. (2024). JMIR Formative Research. 10.2196/49492

Variation in Home Healthcare Use by Dementia Status Among a National Cohort of Older Adults

Burgdorf, J. G., Ornstein, K. A., Liu, B., Leff, B., Brody, A. A., McDonough, C., & Ritchie, C. S. (2024). The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 79(3). 10.1093/gerona/glad270
Abstract
Abstract
BACKGROUND: Medicare-funded home healthcare (HHC) delivers skilled nursing, therapy, and related services through visits to the patient's home. Nearly one-third (31%) of HHC patients have diagnosed dementia, but little is currently known regarding how HHC utilization and care delivery differ for persons living with dementia (PLwD). METHODS: We drew on linked 2012-2018 Health and Retirement Study and Medicare claims for a national cohort of 1 940 community-living older adults. We described differences in HHC admission, length of stay, and referral source by patient dementia status and used weighted, multivariable logistic and negative binomial models to estimate the relationship between dementia and HHC visit type and intensity while adjusting for sociodemographic characteristics, health and functional status, and geographic/community factors. RESULTS: PLwD had twice the odds of using HHC during a 2-year observation period, compared to those without dementia (odds ratio [OR]: 2.03; p < .001). They were more likely to be referred to HHC without a preceding hospitalization (49.4% vs 32.1%; p < .001) and incurred a greater number of HHC episodes (1.4 vs 1.0; p < .001) and a longer median HHC length of stay (55.8 days vs 40.0 days; p < .001). Among post-acute HHC patients, PLwD had twice the odds of receiving social work services (unadjusted odds ratio [aOR]: 2.15; p = .008) and 3 times the odds of receiving speech-language pathology services (aOR: 2.92; p = .002). CONCLUSIONS: Findings highlight HHC's importance as a care setting for community-living PLwD and indicate the need to identify care delivery patterns associated with positive outcomes for PLwD and design tailored HHC clinical pathways for this patient subpopulation.

2022 NASEM Quality of Nursing Home Report: Moving Recommendations to Action

Travers, J. L., Alexander, G., Bergh, M., Bonner, A., Degenholtz, H. B., Ersek, M., Ferrell, B., Grabowski, D. C., Longobardi, I., McMullen, T., Mueller, C., Rantz, M., Saliba, D., Sloane, P., & Stevenson, D. G. (2023). Journal of the American Geriatrics Society, 71(2), 318-321. 10.1111/jgs.18274

Adverse Childhood Experiences and Oral Health Conditions Among Middle-aged and Older Chinese Adults: Exploring the Moderating Roles of Education and Gender

Zhang, K., Wu, B., & Zhang, W. (2023). Research on Aging, 45(2), 221-238. 10.1177/01640275221088926
Abstract
Abstract
This study aims to examine whether adverse childhood experiences (ACEs) are associated with oral health conditions (denture use, difficulty in chewing, and edentulism) among middle-aged and older adults in China and if gender and adulthood education moderate the associations. Data were obtained from the 2014 and 2018 surveys from the China Health and Retirement Longitudinal Study (N = 17,091) and logistic regressions were carried out. Results show that childhood hunger (OR = 1.12), loneliness (OR = 1.10) and family relations (OR = 1.07) were significantly associated with higher odds of denture use and there were significant associations between hunger (OR = 1.16) and difficulty in chewing. For the female subsample, education significantly moderated the adverse effect of childhood hunger on denture use and difficulty in chewing. Findings suggest that ACEs have long-lasting impacts on oral health conditions in later life and adulthood education might offer critical resources for females, helping them buffer the detrimental health impacts of ACEs.