Scholars@Duke
Eleanor Schildwachter McConnell

Eleanor Schildwachter McConnell

Associate Professor in the School of Nursing
School of Nursing
eleanor.mcconnell@duke.edu
Box 3322 Med Ctr, Durham, NC 27710
School of Nursing, 307 Trent Drive, Durham, NC 27710

Scholarly Works - Journal articles

Characterizing Intervention Components and Complexity of Nonpharmacologic Healthcare Interventions to Manage Distress Behaviors in Older Adults.

Journal article J Appl Gerontol · January 2026 Distress behaviors are common in residential care settings and contribute to staff burnout and poor quality of life for older adults. While nonpharmacologic interventions reduce distress behaviors, implementation in routine care remains challenging. Our st ... Full text Link to item Cite

Association of Indoor Temperature Level and Mental Health Among Community-Dwelling Older Adults: Systematic Review.

Journal article JMIR public health and surveillance · November 2025 BackgroundThe association between indoor temperature level and mental health is becoming increasingly important as climate change leads to extreme temperature fluctuations. Older adults are particularly vulnerable to indoor temperature changes bec ... Full text Cite

PReventing Injury in Skilled nursing facilities through optimizing Medications (PRISM), a protocol for a cluster randomized trial to reduce injurious falls in post-acute care.

Journal article Trials · September 26, 2025 BACKGROUND: Patients who receive post-acute care in a skilled nursing facility (SNF) following a fracture are at high risk for subsequent fall-related injuries. Optimizing medication management may mitigate this risk. This manuscript describes the protocol ... Full text Open Access Link to item Cite

Co-Designed Mobile-Based Cognitive Training for Older Chinese Americans: Protocol for a Pilot Randomized Controlled Trial Assessing Feasibility and Acceptability.

Journal article JMIR research protocols · July 2025 BackgroundOlder Chinese Americans are at high risk of dementia, yet they often do not access culturally relevant services/programs to reduce their risks due to issues such as language barriers and transportation. BrainHQ is a mobile-based, effecti ... Full text Cite

Improving Postoperative Care for Veterans With Obstructive Sleep Apnea Through Preoperative Education and the Electronic Health Record: A Quality Improvement Project.

Journal article J Perianesth Nurs · June 2025 PURPOSE: The purpose of this quality improvement (QI) project was to establish and evaluate a process to improve use of positive airway pressure (PAP) therapy on the day of surgery, postoperative day 0 (POD 0), for Veterans using home PAP therapy for obstr ... Full text Link to item Cite

Geriatrics-Focused vs Traditional Primary Care in the Veterans Affairs Health Care System.

Journal article JAMA Netw Open · January 2, 2025 IMPORTANCE: Older adults often require specialized health care expertise, but the effects of geriatrics-focused models of primary care have not been fully evaluated. OBJECTIVE: To compare the effects of geriatrics-focused primary care vs traditional primar ... Full text Link to item Cite

The Impact of Later-Life Learning on Trajectories of Cognitive Function Among U.S. Older Adults.

Journal article Innov Aging · 2025 BACKGROUND AND OBJECTIVES: Low education in early life is a major risk factor for dementia. However, little is known about how education in later life is related to cognitive function in older adults. We assessed whether later-life learning was associated ... Full text Link to item Cite

"Have to Fight the Demon": Veteran Type 2 Diabetes Mellitus Behavioral Self-Management and Diabetes Specific Risk-Taking Behaviors.

Journal article J Prim Care Community Health · 2025 OBJECTIVES: Diabetes mellitus Type 2 (T2DM) requires a set of life-long, complex self-management strategies that affect both physical and psychosocial aspects of daily life. This study aimed to assess how Veterans with T2DM describe self-management behavio ... Full text Open Access Link to item Cite

Diabetes distress in Veterans with type 2 diabetes mellitus: Qualitative descriptive study.

Journal article J Health Psychol · December 2024 Diabetes distress (DD) is a negative psychosocial response to living with type 2 diabetes mellitus (T2DM). We sought insight into Veterans' experiences with DD in the context of T2DM self-management. The four domains in the Diabetes Distress Scale (i.e. re ... Full text Open Access Link to item Cite

The relationship between caregivers' behaviors and resistant behaviors of persons living with dementia during personal care in long-term care facilities: A lag sequential analysis.

Journal article Geriatric nursing (New York, N.Y.) · July 2024 Many older adults living with dementia exhibit resistant behaviors. Person-centered care is the gold standard of care; however, the sequential relationship between resistant and caregiving behaviors has not been identified. This study examined the sequenti ... Full text Cite

Psychosocial stressors associated with frailty in community-dwelling older adults in the United States.

Journal article Journal of the American Geriatrics Society · April 2024 BackgroundFrailty is multifactorial; however, psychosocial stressors contributing to frailty are poorly understood. This study aimed to examine whether gender, race/ ethnicity, and education are associated with differential exposure to psychosocia ... Full text Cite

Implementation Lessons Learned: Distress Behaviors in Dementia Intervention in Veterans Health Administration.

Journal article The Gerontologist · February 2024 Background and objectivesEvidence-based practices to manage distress behaviors in dementia (DBD) are not consistently implemented despite demonstrated effectiveness. The Veterans Health Administration (VA) trained teams to implement Staff Training ... Full text Cite

Structural determinants and cardiometabolic typologies related to frailty in community-dwelling older adults.

Journal article Archives of gerontology and geriatrics · February 2024 Frailty is a geriatric syndrome linked to adverse outcomes. Co-occurring cardiometabolic factors increase frailty risk; however, their distinct combinations (typologies) associated with frailty are unclear. We aimed to identify subgroups of older adults wi ... Full text Cite

Improving safety and preventing falls using an evidence-based, front-line staff huddling practice: protocol for a pragmatic trial to increase quality of care in State Veterans Homes.

Journal article BMJ open · February 2024 IntroductionFalls in nursing homes are a major cause for decreases in residents' quality of life and overall health. This study aims to reduce resident falls by implementing the LOCK Falls Programme, an evidence-based quality improvement intervent ... Full text Cite

Feasibility and Utility of Wearable Bluetooth and RFID Sensors to Measure Care Interactions

Journal article Work Aging and Retirement · January 1, 2024 Clinical care interactions influence important health outcomes in older adults such as nosocomial infections, falls, and care satisfaction. However, traditional measurements of interactions are often time-consuming, costly, biased, or they interfere with n ... Full text Cite

Comorbidity Patterns in Older Patients Undergoing Hip Fracture Surgery: A Comorbidity Network Analysis Study.

Journal article Clinical nursing research · January 2024 Comorbidity network analysis (CNA) is a technique in which mathematical graphs encode correlations (edges) among diseases (nodes) inferred from the disease co-occurrence data of a patient group. The present study applied this network-based approach to iden ... Full text Cite

Health Care Team Interventions to Reduce Distress Behaviors in Older Adults: A Systematic Review.

Journal article Clin Gerontol · 2024 OBJECTIVES: This review examines health care team-focused interventions on managing persistent or recurrent distress behaviors among older adults in long-term residential or inpatient health care settings. METHODS: We searched interventions addressing heal ... Full text Link to item Cite

Impact of Dementia on Incidence and Severity of Postoperative Pulmonary Complications Following Hip Fracture Surgery Among Older Patients.

Journal article Clinical nursing research · November 2023 Postoperative pulmonary complications (PPCs) are the leading cause of death following hip fracture surgery. Dementia has been identified as a PPC risk factor that complicates the clinical course. By leveraging electronic health records, this retrospective ... Full text Open Access Cite

Does cumulative psychosocial stress explain frailty disparities in community-dwelling older adults?

Journal article Archives of gerontology and geriatrics · October 2023 ObjectiveFrailty is a leading predictor of adverse outcomes in older adults. Although disparities in frailty are well-documented, it is unclear whether psychosocial stressors explain these disparities. This study aimed to examine the potential med ... Full text Cite

Nursing Home PRevention of Injury in DEmentia (NH PRIDE): A pilot study of a remote injury prevention service for NH residents.

Journal article J Am Geriatr Soc · October 2023 BACKGROUND: Medication optimization, including prescription of osteoporosis medications and deprescribing medications associated with falls, may reduce injurious falls. Our objective was to describe a remote, injury prevention service (NH PRIDE) designed t ... Full text Link to item Cite

A call to action to improve the completeness of older adult sexual and gender minority data in electronic health records.

Journal article Journal of the American Medical Informatics Association : JAMIA · September 2023 Sexual and gender minority (SGM) older adults experience greater health disparities compared to non-SGM older adults. The SGM older adult population is growing rapidly. To address this disparity and gain a better understanding of their unique challenges in ... Full text Cite

Examining Human Capital Among Foreign- and U.S.-Educated Nurses in Long-term Care

Journal article Journal of Nursing Regulation · July 1, 2023 Background: Recruiting foreign-educated nurses (FENs) is a strategy to reduce staffing shortages of registered nurses (RNs) practicing in long-term care (LTC) in the United States. However, little is known about how FENs compare to U.S.-educated nurses (US ... Full text Cite

Impact of Dementia on Long-Term Hip Fracture Surgery Outcomes: An Electronic Health Record Analysis.

Journal article Journal of the American Medical Directors Association · February 2023 ObjectiveOlder adults with dementia are at higher risk for sustaining hip fracture and their long-term health outcomes after surgery are usually worse than those without dementia. Widespread adoption of electronic health records (EHRs) may allow h ... Full text Cite

Perspectives on Deprescribing in long-term care: qualitative findings from nurses, aides, residents, and proxies.

Journal article BMC Nurs · January 31, 2023 BACKGROUND: Deprescribing initiatives in the long-term care (LTC) setting are often unsuccessful or not sustained. Prior research has considered how physicians and pharmacists feel about deprescribing, yet little is known about the perspectives of frontlin ... Full text Link to item Cite

Adoption of the Household Model Improves Nursing Home Quality: A Case Study.

Journal article Journal of nursing care quality · January 2023 Full text Cite

The interagency care team: A new model to integrate social and medical care for older adults in primary care.

Journal article Geriatr Nurs · 2023 To integrate management of social drivers of health with complex clinical needs of older adults, we connected patients aged 60 and above from primary care practices with a nurse practitioner (NP) led Interagency Care Team (ICT) of geriatrics providers and ... Full text Link to item Cite

Veterans Health Administration Models of Community-Based Long-Term Care: State of the Science.

Journal article Journal of the American Medical Directors Association · December 2022 The complex care needs of older adults arising at the intersection of age-related illnesses, military service, and social barriers have presented challenges to the US Department of Veterans Affairs (VA) for decades. In response, the VA has invested in cent ... Full text Cite

Care Coordination Processes in Transitional Care for Patients With Heart Failure: An Integrative Review Through a Social Network Lens.

Journal article The Journal of cardiovascular nursing · November 2022 BackgroundTransitional care components are well studied, but their coordination has not been systematically reviewed. Viewing transitional care through a social network framework can focus attention on processes leading to information and relation ... Full text Cite

Heart Failure and Hospital Utilization Trajectories Before and After Hip Fracture Surgery.

Journal article Journal of the American Medical Directors Association · November 2022 Full text Cite

Care rejection and aggression among veterans with dementia with and without posttraumatic stress disorder: A multi-group analysis.

Journal article International journal of nursing studies · November 2022 BackgroundIn residential long-term care, military service veterans with co-occurring posttraumatic stress disorder (PTSD) and dementia encounter a range of physical and social stimuli that may serve as triggers of trauma-related distress that mani ... Full text Cite

A Standardized Positive Physical Approach to Improve Oral Hygiene for Nursing Home Residents With Alzheimer's Disease and Related Dementias.

Journal article Journal of gerontological nursing · November 2022 Residents with Alzheimer's disease and related dementias (ADRD) in nursing homes (NHs) rely on direct care workers (DCWs) to assist with activities of daily living, such as oral hygiene. The current quality improvement project was implemented to evaluate t ... Full text Cite

Strengthening Resident, Proxy, and Staff Engagement in Injury Prevention in Skilled Nursing Facilities.

Journal article Gerontologist · September 7, 2022 BACKGROUND AND OBJECTIVES: Engaging residents, their proxies, and skilled nursing facility (SNF) staff through effective communication has potential for improving fall-related injury prevention. The purpose of this study was to understand how multiple stak ... Full text Link to item Cite

Using Technology to Measure Older Adults' Social Networks for Health and Well-Being: A Scoping Review.

Journal article The Gerontologist · August 2022 Background and objectivesSocial networks affect the health and well-being of older adults. Advancements in technology (e.g., digital devices and mHealth) enrich our ability to collect social networks and health data. The purpose of this scoping re ... Full text Cite

Implementation of Goals of Care Communication Innovation Among Nursing Homes: A Multiple Case Study Design.

Journal article Journal of the American Medical Directors Association · July 2022 ObjectiveNursing homes (NHs) provide care to residents with serious illness and related complex health care needs. As such, discussions about end-of-life care between NH staff and residents and families are necessary to ensure residents receive ca ... Full text Cite

Examining Face Validity of Visual Stimuli Used in Preference Assessments for Older Adults With Communication Impairments.

Journal article American journal of speech-language pathology · May 2022 PurposePreference assessment is integral to person-centered treatment planning for older adults with communication impairments. There is a need to validate photographs used in preference assessment for this population. Therefore, this study aimed ... Full text Cite

Surgery and Geriatric Medicine: Toward Greater Integration and Collaboration.

Journal article Journal of the American Medical Directors Association · April 2022 Full text Cite

Effect of Race/ethnicity, Insurance Status, and Area Deprivation on Hip Fracture Outcomes Among Older Adults in the United States.

Journal article Clinical nursing research · March 2022 This retrospective cohort study used electronic health records to explore the effect of race/ethnicity, insurance status, and area deprivation on post-discharge outcomes in older patients undergoing hip fracture surgery between 2015 and 2018 (N = 1, ... Full text Cite

Registered Nurse Migration to the United States and the Impact on Long-Term Care.

Journal article Journal of the American Medical Directors Association · February 2022 Full text Cite

Improving shared decision-making for osteoporosis pharmacologic therapy in nursing homes: a qualitative analysis.

Journal article Arch Osteoporos · January 3, 2022 UNLABELLED: Decisions on whether to use pharmacologic osteoporosis therapy in skilled nursing facility residents are complex and require shared decision-making. Residents, proxies, and staff desire individualized fracture risk estimates that consider advan ... Full text Link to item Cite

Sensory impairment and cognitive decline among older adults: An analysis of mediation and moderation effects of loneliness.

Journal article Front Neurosci · 2022 BACKGROUND: Multiple studies have reported that hearing and vision impairment are linked to cognitive decline. Yet little is known about factors that may influence the association between sensory impairment and cognitive decline. This study examined if lon ... Full text Link to item Cite

Veterans' Interpretation of Diabetes Distress in Diabetes Self-Management: Findings From Cognitive Interviews.

Journal article Sci Diabetes Self Manag Care · October 2021 PURPOSE: The purpose of this project was to identify additional facets of diabetes distress (DD) in veterans that may be present due to the veteran's military-related experience. METHODS: The study team completed cognitive interviews with veterans with typ ... Full text Open Access Link to item Cite

Relational processes in heart failure care transitions: A data-driven case report.

Journal article Heart & lung : the journal of critical care · September 2021 BackgroundEffective patient care transitions require consideration of social and clinical context, yet how these factors and relational processes in care coordination relate remains poorly described. This case report aims to describe provider netw ... Full text Cite

A mixed methods study on the manifestations of behavioural symptoms of dementia among veterans with and without posttraumatic stress disorder.

Journal article Journal of advanced nursing · July 2021 AimsTo explore how behavioural symptoms of dementia are manifested among veterans in residential long-term care settings, in the context of personal, interpersonal/social and environmental triggers and how the manifestations differ between veteran ... Full text Cite

Rejection of Care and Aggression among Older Veterans with Dementia: The Influence of Background Factors and Interpersonal Triggers.

Journal article Journal of the American Medical Directors Association · July 2021 ObjectivesTo test relationships among background factors, interpersonal triggers, rejection of care, and aggression among veterans living with dementia in residential long-term care settings, based on the need-driven dementia-compromised behavior ... Full text Cite

Caregiver Characteristics Associated With Cognitive Complaints in Women With Breast Cancer.

Journal article Oncology nursing forum · July 2021 ObjectivesTo explore whether caregiver characteristics were associated with cognitive complaints reported by women with breast cancer undergoing chemotherapy.Sample & setting61 dyads of women with breast cancer and their caregivers were r ... Full text Cite

The Contribution of Material, Behavioral, Psychological, and Social-Relational Factors to Income-Related Disparities in Cardiovascular Risk Among Older Adults.

Journal article J Cardiovasc Nurs · July 2021 BACKGROUND: Understanding the factors underlying health disparities is vital to developing strategies to improve health equity in old age. Such efforts should be encouraged in Korea. OBJECTIVE: This study explored how material, behavioral, psychological, a ... Full text Link to item Cite

Mealtime caregiving approaches and behavioral symptoms in persons living with dementia: a longitudinal, observational study.

Journal article BMC nursing · June 2021 BackgroundBehavioral symptoms during mealtime can prohibit persons living with dementia from obtaining sufficient nutrition. However, little research has examined the relationship between behavioral symptoms and caregiving approaches. This study e ... Full text Cite

Living With Cognitive Impairment in China: Exploring Dyadic Experiences Through a Person-Centered Care Lens.

Journal article Research on aging · March 2021 China has experienced a substantial increase in the number of older adults with dementia and milder forms of cognitive impairment. Being spouses of Persons with cognitive impairment (PWCI) and living with them for several decades does not necessarily mean ... Full text Cite

Longitudinal Association Between Hearing Loss, Vision Loss, Dual Sensory Loss, and Cognitive Decline.

Journal article J Am Geriatr Soc · March 2021 BACKGROUND/OBJECTIVES: To better understand the role of sensory loss as a potentially modifiable risk factor for cognitive decline, this study examined cognitive decline in relation to single modality hearing or vision loss and dual sensory loss. DESIGN: L ... Full text Link to item Cite

A 10-year trend in income disparity of cardiovascular health among older adults in South Korea.

Journal article SSM Popul Health · December 2020 OBJECTIVES: Although cardiovascular disease (CVD) risk has lessened in Korea, it is unclear whether older adults in all socioeconomic strata have benefited equally. This study explored trends in income disparities in CVD risk among older adults in Korea. M ... Full text Link to item Cite

Cognitive Impairment among Veterans in Outpatient Vision Rehabilitation.

Journal article Optom Vis Sci · June 2020 SIGNIFICANCE: Outpatient vision rehabilitation improves function in veterans with vision impairment, but the prevalence of cognitive impairment and the degree to which it may affect rehabilitation outcomes in the Veterans Affairs system are unknown. PURPOS ... Full text Link to item Cite

Mitigating the Effects of a Pandemic: Facilitating Improved Nursing Home Care Delivery Through Technology.

Journal article JMIR aging · May 2020 The coronavirus disease (COVID-19) pandemic has been particularly challenging for nursing home staff and residents. Centers for Medicare & Medicaid Services regulation waivers are burdening staff and affecting how care is delivered. Residents are experienc ... Full text Cite

Nursing home residents' perspectives on their social relationships.

Journal article Journal of clinical nursing · April 2020 Aims and objectivesTo explore nursing home residents' perspectives on their relationships with other residents, family members and staff.BackgroundThe cultivation of social relationships is central to promoting well-being in nursing homes ... Full text Cite

Understanding the Associations between Caregiver Characteristics and Cognitive Function of Adults with Cancer: A Scoping Review.

Journal article Asia-Pacific journal of oncology nursing · April 2020 Cognitive impairment (CI) is one of symptoms that adults with cancer frequently report. Although there are known factors that contribute to a patient's CI, these factors did not sufficiently explain its variability. Several studies conducted in patients wi ... Full text Cite

Measurement of older adults' social networks using technologies in the context of health and social care: a scoping review protocol.

Journal article JBI evidence synthesis · April 2020 ObjectiveThis scoping review aims to identify and map the use of technology in measuring and analyzing older adults' social networks in the context of health and social care.IntroductionResearch has shown that social networks impact the h ... Full text Cite

Resident Challenges With Pain and Functional Limitations in Chinese Residential Care Facilities.

Journal article The Gerontologist · January 2020 Background and objectivesPain and functional limitations can severely impede older adults' quality of life. In Chinese residential care facilities, limited research suggests that residents potentially have significant unmet care needs with pain an ... Full text Cite

Directed content analysis of Veterans Affairs policy documents: A strategy to guide implementation of a dementia home safety toolkit for Veterans to promote ageing in place.

Journal article Health & social care in the community · January 2020 Older adults' preference to age in place, coupled with an increasing prevalence of dementia, creates an imperative to address home safety risks that occur due to cognitive impairment. Providing caregivers with home safety items and education can facilitate ... Full text Cite

Screening for Adverse Drug Reactions in Dementia Patients on Cholinesterase Inhibitor Therapy.

Journal article Journal of the American Geriatrics Society · January 2020 Full text Cite

Academic-Practice Partnership for Caregiver Training and Support: The Duke Elder Family/Caregiver Training (DEFT) Center.

Journal article N C Med J · 2020 BACKGROUND After a hospital stay, many older adults rely on their caregivers for assistance at home. Empirical evidence demonstrates that caregiver support programs in hospital-to-home transitions are associated with favorable caregiver and patient outcome ... Full text Link to item Cite

Geriatric Resource Teams: Equipping Primary Care Practices to Meet the Complex Care Needs of Older Adults.

Journal article Geriatrics (Basel) · October 21, 2019 Primary care practices lack the time, expertise, and resources to perform traditional comprehensive geriatric assessment. In particular, they need methods to improve their capacity to identify and care for older adults with complex care needs, such as cogn ... Full text Link to item Cite

Community Health Centers: a Key Partner to Achieve Medicaid Expansion.

Journal article Journal of general internal medicine · October 2019 Medicaid expansion is an important feature of the "Affordable Care Act" and also is proposed as a component of some incremental plans for universal healthcare coverage. We describe (1) obstacles encountered with Medicaid coverage, (2) their potential resol ... Full text Cite

Emotional Expression of Persons with Dementia: An Integrative Review with Implications for Evidence-Based Practice.

Journal article Worldviews on evidence-based nursing · October 2019 BackgroundThe ability to express emotion typically is preserved longer than language and cognitive function in persons living with dementia. Emotional expression may be an important indicator of underlying individual needs and feelings and may the ... Full text Cite

Measurement of older adults' social networks using technologies in the context of health and social care: a scoping review protocol.

Journal article JBI database of systematic reviews and implementation reports · July 8, 2019 OBJECTIVE:This scoping review aims to identify and map the use of technology in measuring and analyzing older adults' social networks in the context of health and social care. INTRODUCTION:Research has shown that social networks impact the health and wellb ... Full text Cite

Neurocognitive and psychiatric comorbidities of posttraumatic stress disorder among older veterans: A systematic review.

Journal article International journal of geriatric psychiatry · April 2019 ObjectivesPosttraumatic stress disorder (PTSD) is associated with neurocognitive and psychiatric comorbidities, and older adults experience comorbid illnesses disproportionately. Little is known about the comorbidities of PTSD among older veterans ... Full text Cite

Dementia caregiver interventions in Chinese people: A systematic review.

Journal article Journal of advanced nursing · March 2019 AimsThe aim of this systematic review was to examine the characteristics and the efficacy of dementia caregiving interventions among the Chinese population.BackgroundIn recent years, an increasing number of dementia caregiving interventio ... Full text Cite

Person-Directed Care Planning in Nursing Homes: Resident, Family, and Staff Perspectives.

Journal article Journal of applied gerontology : the official journal of the Southern Gerontological Society · February 2019 Empowering individuals to direct their own care is central to person-centered care and health care policy. However, there is limited knowledge of how "person-directed care planning" (PDCP) can be achieved in particular settings. This study identifies key s ... Full text Cite

Gender differences in the association between migration and cognitive function among older adults in China and India.

Journal article Arch Gerontol Geriatr · 2019 OBJECTIVE: This study aims to examine gender differences in the association between migration and cognitive function among adults in China and India. METHODS: Data from the World Health Organization Study on global AGEing and adult health (SAGE) study were ... Full text Link to item Cite

Person-Centered Dementia Care in China: A Bilingual Literature Review.

Journal article Gerontology & geriatric medicine · January 2019 We conducted a bilingual literature review of the existing studies focusing on person-centered dementia care in China. We synthesized key findings from included articles according to three overarching themes: Chinese cultural relevance of person-centere ... Full text Cite

Assessing Quality for People Living With Dementia in Residential Long-Term Care: Trends and Challenges.

Journal article Gerontology & geriatric medicine · January 2019 The global prevalence of dementia is growing rapidly, driving an increased use of residential long-term care (LTC) services. Performance indicators for residential LTC should support targeting of limited resources to promote person-centered care, health, a ... Full text Cite

Person-directed care planning in nursing homes: A scoping review.

Journal article International journal of older people nursing · December 2018 AimFederal regulations require nursing homes in the United States to support residents in directing their own care rather than having their care plans developed for them without their engagement, but knowledge of person-directed approaches to care ... Full text Cite

Interchangeability of Licensed Nurses in Nursing Homes: Perspectives of Directors of Nursing.

Journal article Nursing outlook · November 2018 BackgroundLicensed nurse (registered nurse [RN] and licensed practical nurse [LPN]) roles in nursing homes are often viewed as interchangeable. Interchangeability occurs when the differences in RN and LPN education and scopes of practice are not r ... Full text Cite

Technology-based cognitive training and rehabilitation interventions for individuals with mild cognitive impairment: a systematic review.

Journal article BMC geriatrics · September 2018 BackgroundIndividuals with mild cognitive impairment (MCI) are at heightened risk of developing dementia. Rapid advances in computing technology have enabled researchers to conduct cognitive training and rehabilitation interventions with the assis ... Full text Cite

Implementation of Individualized Music in Long-Term Care: Application of the PARiHS Framework.

Journal article Journal of gerontological nursing · August 2018 The need to provide evidence-based, person-centered care for long-term care (LTC) residents, which often include individuals with dementia, has led to a surge of interest in the implementation of individualized music (IM) programs. An exploratory study was ... Full text Cite

Improving Oral Hygiene for Veterans With Dementia in Residential Long-term Care.

Journal article Journal of nursing care quality · July 2018 Oral hygiene care is neglected in long-term care (LTC) due to patient-, staff-, and systems-level barriers. A dementia-specific oral hygiene program, implemented and evaluated in a Department of Veterans Affairs LTC unit, addressed barriers to oral care at ... Full text Cite

A pilot-feasibility study of measuring emotional expression during oral care.

Journal article Geriatric nursing (New York, N.Y.) · July 2018 This study explored the feasibility of measuring emotional responses to oral care among individuals with dementia living in residential long-term care (LTC). Eleven residents with dementia were recruited from a U.S. Department of Veterans Affairs LTC unit ... Full text Cite

Resident Vignettes for Assessing Care Quality in Nursing Homes.

Journal article J Am Med Dir Assoc · May 2018 OBJECTIVES: Validated process measures that correlate with patient outcomes are needed for research and quality improvement. DESIGN: Cross-sectional analysis within a cluster-randomized fall prevention study. SETTING: Nursing homes in North Carolina (n = 1 ... Full text Link to item Cite

A New Community Health Center/Academic Medicine Partnership for Medicaid Cost Control, Powered by the Mega Teaching Health Center.

Journal article Acad Med · March 2018 Community health centers (CHCs), a principal source of primary care for over 24 million patients, provide high-quality affordable care for medically underserved and lower-income populations in urban and rural communities. The authors propose that CHCs can ... Full text Link to item Cite

Nursing home staff perspectives on adoption of an innovation in goals of care communication.

Journal article Geriatric nursing (New York, N.Y.) · March 2018 Nursing homes (NH) are important settings for end-of-life care, but limited implementation may impede goals of care discussions. The purpose of this study was to understand NH staff perceptions of adoption and sustainability of the Goals of Care video deci ... Full text Cite

Management Team Perceptions of Risks and Strategies for Preventing Falls Among Short-Stay Patients in Nursing Homes.

Journal article Health Care Manag (Frederick) · 2018 We sought to understand strategies reported by members of the nursing home management team used to prevent falls in short-stay nursing home patients. Using Donabedian's model of structure, process, and outcomes, we interviewed 16 managers from 4 nursing ho ... Full text Link to item Cite

Migration and cognitive function: a conceptual framework for Global Health Research.

Journal article Glob Health Res Policy · 2018 BACKGROUND: Migration is a fundamental demographic process that has been observed globally. It is suggested that migration is an issue of global health importance that can have an immediate and lasting impact on an individual's health and well-being. There ... Full text Link to item Cite

Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial.

Journal article JAMA Intern Med · November 1, 2017 IMPORTANCE: New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls. OBJECTIVE: To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interac ... Full text Link to item Cite

Experimental Comparison of Efficacy for Three Handfeeding Techniques in Dementia.

Journal article J Am Geriatr Soc · April 2017 BACKGROUND: Nursing home (NH) residents who require assistance during mealtimes are at risk for malnutrition. Supportive handfeeding is recommended, yet there is limited evidence supporting use of a specific handfeeding technique to increase meal intake. O ... Full text Link to item Cite

Study of Individualization and Bias in Nursing Home Fall Prevention Practices.

Journal article J Am Geriatr Soc · April 2017 OBJECTIVES: Little is known about how nursing home staff use resident characteristics to individualize care delivery or whether care is affected by implicit bias. DESIGN: Randomized factorial clinical vignette survey. SETTING: Sixteen nursing homes in Nort ... Full text Link to item Cite

Economic Analysis of Primary Care-Based Physical Activity Counseling in Older Men: The VA-LIFE Trial.

Journal article J Am Geriatr Soc · March 2017 OBJECTIVES: To perform an economic evaluation of a primary care-based physical activity counseling intervention that improved physical activity levels and rapid gait speed in older veterans. DESIGN: Secondary objective of randomized trial that assessed the ... Full text Open Access Link to item Cite

Improving Management of Behavioral and Psychological Symptoms of Dementia in Acute Care: Evidence and Lessons Learned From Across the Care Spectrum.

Journal article Nursing administration quarterly · July 2016 As the prevalence of Alzheimer disease and related dementias increases, dementia-related behavioral symptoms present growing threats to care quality and safety of older adults across care settings. Behavioral and psychological symptoms of dementia (BPSD) s ... Full text Cite

Effectiveness of Expanded Implementation of STAR-VA for Managing Dementia-Related Behaviors Among Veterans.

Journal article The Gerontologist · February 2016 Purpose of the studyNonpharmacological, psychosocial approaches are first-line treatments for managing behavioral symptoms in dementia, but they can be challenging to implement in long-term care settings. The Veterans Health Administration impleme ... Full text Cite

Delirium detection and improved delirium management in older patients hospitalized for hip fracture.

Journal article International journal of orthopaedic and trauma nursing · November 2015 Delirium is a common and potentially devastating problem for older patients following hip fracture. Although early detection is recommended, description and evaluation of standardized approaches are scarce. The aims of this quality improvement project were ... Full text Cite

Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework.

Journal article Gerontologist · August 2015 PURPOSE OF THE STUDY: To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. DESIGN AND METHODS: The study design was a qualitative, observational study of nursing home staff perceptions of the im ... Full text Link to item Cite

Pain and psychological well-being among people with dementia in long-term care.

Journal article Pain medicine (Malden, Mass.) · June 2015 ObjectiveTo examine the relationship between self-reported pain and psychological well-being of people with dementia (PWD) living in residential long-term care as indicated by displays of observed emotional expression over the daytime period.D ... Full text Cite

Adaptive leadership framework for chronic illness: framing a research agenda for transforming care delivery.

Journal article ANS. Advances in nursing science · April 2015 We propose the Adaptive Leadership Framework for Chronic Illness as a novel framework for conceptualizing, studying, and providing care. This framework is an application of the Adaptive Leadership Framework developed by Heifetz and colleagues for business. ... Full text Cite

A urinary incontinence continuing education online course for community health nurses in South Korea.

Journal article Journal of continuing education in nursing · April 2015 BackgroundAlthough urinary incontinence is prevalent among older women living in rural Korea, a lack of awareness and education exists in this population and among health professionals. Geographic isolation and limited resources also contribute to ... Full text Cite

Differentiating Scopes of Practice in Nursing Homes: Collaborating for Care

Journal article Journal of Nursing Regulation · April 1, 2015 Hospitalizations of nursing home residents are costly and adversely affect the health of already vulnerable residents, and reducing avoidable hospitalizations has been identified as a priority quality and safety outcome by the U.S. government. However, exi ... Full text Cite

The effect of a urinary incontinence self-management program for older women in South Korea: A pilot study

Journal article International Journal of Nursing Sciences · March 1, 2015 Background Although self-management approaches have shown strong evidence of positive outcomes for urinary incontinence prevention and management, few programs have been developed for Korean rural communities. Objectives This pilot study aimed to develop, ... Full text Open Access Cite

Perceptions of Nursing Practice: Capacity for High-Quality Nursing Home Care

Journal article Journal of Nursing Regulation · January 1, 2015 Emerging evidence indicates that harmful nursing home resident outcomes occur because of ineffective collaboration between registered nurses (RNs) and licensed practical nurses (LPNs) during assessment, care planning, delegation, and supervision. This obse ... Full text Cite

Differences between completely physically inactive and low active older men and their response to an exercise intervention: the Veterans LIFE study.

Journal article Healthy Aging Res · 2015 BACKGROUND: Physical activity interventions typically do not report behavioral changes in activity sub-groups. The aim of this study was to compare baseline differences and changes in physical activity between truly physically inactive men and low active m ... Full text Open Access Link to item Cite

Improving dementia care through behavioral interventions.

Journal article North Carolina medical journal · September 2014 Behavioral interventions are effective in treating neuropsychiatric symptoms of dementia, yet older adults with dementia who require long-term care lack consistent access to caregivers who are skillful in selecting and applying these interventions. This co ... Full text Cite

Teaching Delegation to RN Students

Journal article Journal of Nursing Regulation · July 1, 2014 Registered nurse (RN) students have difficulty learning delegation and supervision, and new RNs lack confidence in executing these skills. To improve safety, therefore, RN educators require new teaching and learning strategies to help prelicensure students ... Full text Cite

Connecting the learners: improving uptake of a nursing home educational program by focusing on staff interactions.

Journal article Gerontologist · June 2014 PURPOSE OF THE STUDY: The CONNECT intervention is designed to improve staff connections, communication, and use of multiple perspectives for problem solving. This analysis compared staff descriptions of the learning climate, use of social constructivist le ... Full text Link to item Cite

Relationship between observable emotional expression and wandering behavior of people with dementia.

Journal article International journal of geriatric psychiatry · January 2014 ObjectiveThis study explored the relationship between observable emotional expression and wandering behaviors of people with dementia (PWD).MethodsA secondary data analysis was conducted of a multi-site study that used a cross-sectional d ... Full text Cite

CONNECT for better fall prevention in nursing homes: results from a pilot intervention study.

Journal article J Am Geriatr Soc · December 2013 OBJECTIVES: To determine whether an intervention that improves nursing home (NH) staff connections, communication, and problem solving (CONNECT) would improve implementation of a falls reduction education program (FALLS). DESIGN: Cluster randomized trial. ... Full text Link to item Cite

Perceptions of Nursing Practice Scale Pilot Study: Directors of Nursing in Nursing Homes

Journal article Journal of Nursing Regulation · October 1, 2013 In nursing homes, the urgency to advance our measurement of nursing practice grows because nursing homes are increasingly regarded as an essential component of the care continuum needed to achieve national care quality goals. Prior qualitative case study r ... Full text Cite

Licensed practical nurse scope of practice and quality of nursing home care.

Journal article Nursing research · September 2013 BackgroundAlthough higher levels of registered nurse (RN) staffing in nursing homes are related to better care quality, licensed practical nurses (LPNs) provide most licensed-nursing care; prior research is mixed regarding how this influences qual ... Full text Cite

Transitional Care Partners: a hospital-to-home support for older adults and their caregivers.

Journal article J Am Assoc Nurse Pract · August 2013 PURPOSE: To describe the development, implementation, and preliminary results of the Transitional Care (TLC) Partners, a clinical demonstration program that supports the transition from hospital to home of older veterans. DATA SOURCES: Hospital records of ... Full text Link to item Cite

An advanced course in long term care for geriatric medicine fellows.

Journal article J Am Med Dir Assoc · July 2013 Long term care deserves focused attention within a geriatric medicine fellowship curriculum to ensure that graduates are prepared not only for clinical care but also for the leadership, administrative, educational, quality improvement, and health policy as ... Full text Link to item Cite

A low-vision rehabilitation program for patients with mild cognitive deficits.

Journal article JAMA Ophthalmol · July 2013 IMPORTANCE: We are unaware of any standardized protocols within low-vision rehabilitation (LVR) to address cognitive impairment. OBJECTIVE: To design and pilot-test an LVR program for patients with macular disease and cognitive deficits. DESIGN: The Memory ... Full text Link to item Cite

Daytime observed emotional expressions of people with dementia.

Journal article Nursing research · July 2013 BackgroundEmotional expression among people with dementia (PWD) may inform person-centered approaches to care and improvements in dementia-related quality of life.ObjectivesThe aim of this study was to examine frequency and variability of ... Full text Cite

Tool for evaluating research implementation challenges: a sense-making protocol for addressing implementation challenges in complex research settings.

Journal article Implement Sci · January 2, 2013 BACKGROUND: Many challenges arise in complex organizational interventions that threaten research integrity. This article describes a Tool for Evaluating Research Implementation Challenges (TECH), developed using a complexity science framework to assist res ... Full text Link to item Cite

Implementation and evaluation of a depression care model for homebound elderly.

Journal article Journal of nursing care quality · January 2013 Depression affects 14% to 46% of homebound elderly and is costly and disabling. Home health agencies face significant challenges delivering effective depression care. In response, an evidence-based depression care model was developed in a home health agenc ... Full text Cite

Memory deficit associated with worse functional trajectories in older adults in low-vision rehabilitation for macular disease.

Journal article J Am Geriatr Soc · November 2012 OBJECTIVES: To examine whether performance on a brief memory test is related to functional outcomes in older individuals undergoing low-vision rehabilitation (LVR) for macular disease. DESIGN: Observational cohort study of individuals receiving outpatient ... Full text Link to item Cite

Licensed Nurse Responsibilities in Nursing Homes: A Scope-of-Practice Issue

Journal article Journal of Nursing Regulation · April 1, 2012 A mailed survey of licensed practical nurses (LPNs) employed in nursing homes in Minnesota and North Carolina examined their role and responsibilities as well as barriers to and facilitators for working within their scope of practice. The study focused on ... Full text Cite

Licensed nurse responsibilities in nursing homes: a scope of practice issue.

Journal article Journal of Nursing Regulation · April 2012 Cite

Prioritizing culture change in nursing homes: perspectives of residents, staff, and family members.

Journal article J Am Geriatr Soc · March 2012 OBJECTIVES: To explore the perspectives and priorities of nursing home residents, family members, and frontline nursing staff concerning a broad range of items representing common targets of culture change initiatives. DESIGN: Qualitative study. SETTING: A ... Full text Link to item Cite

Diffusion of innovations in long-term care measurement battery.

Journal article Research in gerontological nursing · January 2012 Poor understanding of factors influencing integration of new practices into long-term care (LTC) hinders timely implementation of evidence-based practices (EBPs). Using the Diffusion of Innovations (DOI) framework, a new instrument measuring staff percepti ... Full text Cite

Staff interaction strategies that optimize delivery of transitional care in a skilled nursing facility: a multiple case study.

Journal article Fam Community Health · 2012 After hospitalization, more than 1.5 million older adults each year receive postacute care in skilled nursing facilities (SNFs). Transitional care services, designed to prepare older SNF patients (and their family caregivers) for their transitions from an ... Full text Link to item Cite

Health care utilization before and after an outpatient ED visit in older people.

Journal article Am J Emerg Med · January 2012 BACKGROUND: Older adults in the United States receive a significant amount of care in the emergency department (ED), yet the associations between ED and other types of health care utilization have not been adequately studied in this population. OBJECTIVES: ... Full text Link to item Cite

Jurisdiction over nursing care systems in nursing homes: latent class analysis.

Journal article Nursing research · January 2012 BackgroundIn the context of declining registered nurse (RN) staffing levels in nursing homes, professional nursing jurisdiction over nursing care systems may erode.ObjectiveThe aim of this study was to develop a typology of professional n ... Full text Cite

Pillars for the care of older persons in the Caribbean.

Journal article Public health nursing (Boston, Mass.) · January 2012 Pillars for the Care of Older Persons in the Caribbean: A Comprehensive Community-Based Framework (Pillars) is a hybrid of multiple public health frameworks developed through community-based participatory research processes. Health and social service profe ... Full text Cite

Regulation of LPN scope of practice in long-term care.

Journal article Journal of Nursing Regulation · July 2011 With changing staffing structures and persistent quality concerns in nursing homes, registered nurses are challenged to ensure that appropriate care is delivered. We describe differences in the nurse practice acts (NPAs) and related administrative code for ... Cite

Regulation of LPN scope of practice in long-term care.

Journal article Journal of Nursing Regulation · July 2011 With changing staffing structures and persistent quality concerns in nursing homes, registered nurses are challenged to ensure that appropriate care is delivered. We describe differences in the nurse practice acts (NPAs) and related administrative code for ... Cite

The Duke-NICHE program: an academic-practice collaboration to enhance geriatric nursing care.

Journal article Nursing outlook · May 2011 The Duke-Nurses Improving Care of Healthsystem Elders (NICHE) is an example of an academic-practice partnership between a university-based school of nursing and a health system that aims to improve care of older adults by simultaneously enhancing the exper ... Full text Cite

Long-term changes in physical activity following a one-year home-based physical activity counseling program in older adults with multiple morbidities.

Journal article J Aging Res · December 26, 2010 This study assessed the sustained effect of a physical activity (PA) counseling intervention on PA one year after intervention, predictors of sustained PA participation, and three classes of post-intervention PA trajectories (improvers, maintainers, and de ... Full text Open Access Link to item Cite

The Connected Learning Model for disseminating evidence-based care practices in clinical settings.

Journal article Nurse Educ Pract · July 2010 Clinical practice guidelines have been developed to improve patient care and outcomes. Guideline implementation is often stymied by the complexity of patients' conditions, complex care environments, and limited advanced clinical training of nursing staff. ... Full text Link to item Cite

Change in goal ratings as a mediating variable between self-efficacy and physical activity in older men.

Journal article Ann Behav Med · June 2010 BACKGROUND: Few studies have examined the associations between exercise self-efficacy, goals, and physical activity over time. PURPOSE: This study examines whether self-selected goals mediate the changes in exercise self-efficacy on physical activity over ... Full text Open Access Link to item Cite

Birds of a feather: introducing a virtual learning community for geriatric nurse educators.

Journal article Journal of continuing education in nursing · May 2010 The Duke Geriatric Nursing Education Virtual Learning Community (Gero-VLC) is a newly developed online inquiry network that enables geriatric nurse educators to borrow, share, and collaborate to promote in-depth learning and optimal communication among ins ... Full text Cite

Delegation in long-term care: Scope of practice or job description?

Journal article Online Journal of Issues in Nursing · May 2010 This article presents a qualitative, descriptive study of how registered nurses (RNs) (N=33) in leadership roles in institutional, long-term care settings delegate care. Findings from this study include both the strategies and processes these nurses used f ... Full text Link to item Cite

Staff perception of new pain care practices in dementia care psychometric properties of the Duke Diffusion of Innovation in long-term care battery

Journal article Alzheimer S Care Today · April 1, 2010 Approximately 80% of long-term care (LTC) residents suffer from chronic pain, and residents with dementia are at highest risk for inadequate pain control. Delayed implementation of evidence-based care practices is a key contributor to these poor outcomes. ... Full text Cite

The importance of organizational climate to training needs and outcomes in long-term care

Journal article Alzheimer S Care Today · April 1, 2010 Efforts to improve dementia care through training occur in an organizational context that may enhance or inhibit improvement. This article used linear mixed models to examine the relationship of contextual and organizational factors to baseline knowledge, ... Full text Cite

Outcomes of a Dementia Care training program for staff in nursing homes and residential care/assisted living settings

Journal article Alzheimer S Care Today · April 1, 2010 This article reports on the results of a nested cohort group-randomized trial of 6 training sessions of Foundations of Dementia Care, a national training curriculum for nursing home and residential care/assisted living staff. Staff from 9 nursing homes and ... Full text Cite

Delegation in long-term care: Scope of practice or job description?

Journal article Online Journal of Issues in Nursing · 2010 This article presents a qualitative, descriptive study of how registered nurses (RNs) (N=33) in leadership roles in institutional, long-term care settings delegate care. Findings from this study include both the strategies and processes these nurses used f ... Full text Cite

The Veterans Learning to Improve Fitness and Function in Elders Study: a randomized trial of primary care-based physical activity counseling for older men.

Journal article J Am Geriatr Soc · July 2009 OBJECTIVES: To determine the effects of primary care-based, multicomponent physical activity counseling (PAC) promoting physical activity (PA) guidelines on gait speed and related measures of PA and function in older veterans. DESIGN: Randomized controlled ... Full text Link to item Cite

Teaching evidence-based nursing practice in geriatric care settings: the geriatric nursing innovations through education institute.

Journal article Journal of gerontological nursing · April 2009 Evidence-based practice holds tremendous potential to optimize care outcomes for older adults, yet many nurses are ill prepared to identify, interpret, and apply the best evidence to their practice. The Geriatric Nursing Innovations through Education (GNIE ... Full text Cite

Use of a handheld computer observational tool to improve communication for care planning and psychosocial well-being.

Journal article Journal for nurses in staff development : JNSD : official journal of the National Nursing Staff Development Organization · January 2009 Featured Publication Staff development nurses in long-term care are challenged to implement training programs that foster quality unlicensed assistive personnel (UAP) care and improve the transfer of their observations to licensed nursing staff for care planning. This study de ... Full text Cite

A quality improvement program to enhance after-hours telephone communication between nurses and physicians in a long-term care facility.

Journal article J Am Geriatr Soc · June 2008 OBJECTIVES: To determine whether satisfaction of on-site nurses with after-hours telephone communication with off-site physicians improved in one long-term care (LTC) facility after a nurse-oriented intervention. DESIGN: Longitudinal quality improvement st ... Full text Link to item Cite

Elizabeth C. Clipp, PhD, RN, FAAN.

Journal article Journal of gerontological nursing · March 2008 Full text Cite

Project LIFE--Learning to Improve Fitness and Function in Elders: methods, design, and baseline characteristics of randomized trial.

Journal article J Rehabil Res Dev · 2008 Insufficient levels of physical activity have significant clinical consequences. Primary care settings typically do not emphasize physical activity counseling. We describe the design, methods, and baseline characteristics of "Learning to Improve Fitness an ... Full text Link to item Cite

After-hours calls from long-term care facilities in a geriatric medicine training program.

Journal article J Am Geriatr Soc · December 2007 OBJECTIVES: To describe after-hours telephone calls from nurses in long-term care (LTC) facilities to doctors in a geriatric medicine training program. DESIGN: Evaluation of 1,928 after-hours calls from LTC facilities over a 10-month period in 2005/06. SET ... Full text Link to item Cite

A novel function of VCP (valosin-containing protein; p97) in the control of N-glycosylation of proteins in the endoplasmic reticulum.

Journal article Archives of biochemistry and biophysics · June 2007 alpha-Chain of T-cell receptor (TCR) is a typical ERAD (ER-associated degradation) substrate degraded in the absence of other TCR subunits. Depletion of derlin 1 fails to induce accumulation of alphaTCR despite inducing accumulation of alpha1-antitrypsin, ... Full text Cite

Academic-practice partnerships to promote evidence-based practice in long-term care: oral hygiene care practices as an exemplar.

Journal article Nursing outlook · March 2007 Learning in practice disciplines suffers when gaps exist between classroom instruction and students' observations of routine clinical practices.(1) Academic institutions, therefore, have a strong interest in fostering the rapid and effective translation of ... Full text Cite

Development and implementation of the TrAC (Tracking After-hours Calls) database: a tool to collect longitudinal data on after-hours telephone calls in long-term care.

Journal article J Am Med Dir Assoc · March 2007 INTRODUCTION: Effective telephone communication between long-term care (LTC) nurses and physicians is an integral part of high-quality care, yet little is known about this key aspect of LTC practice. The authors describe the development and implementation ... Full text Link to item Cite

Inter-disciplinary focus groups on telephone medicine: a quality improvement initiative.

Journal article J Am Med Dir Assoc · September 2006 OBJECTIVE: To identify opportunities for quality improvement in long-term care telephone medicine using a model of interdisciplinary focus groups. DESIGN: Descriptive pilot project. SETTING: Extended Care and Rehabilitation Center (ECRC), Durham VA Medical ... Full text Link to item Cite

Translating evidence-based falls prevention into clinical practice in nursing facilities: Results and lessons from a quality improvement collaborative.

Journal article J Am Geriatr Soc · September 2006 OBJECTIVES: To describe the changes in process of care before and after an evidence-based fall reduction quality improvement collaborative in nursing facilities. DESIGN: Natural experiment with nonparticipating facilities serving as controls. SETTING: Comm ... Full text Link to item Cite

Destabilization of the VCP-Ufd1-Npl4 complex is associated with decreased levels of ERAD substrates.

Journal article Experimental cell research · September 2006 p97/VCP associated with Ufd1-Npl4 is considered a key player in ER-associated degradation (ERAD). RNA interference (RNAi) of one component of the Ufd1-Npl4 heterodimer destabilizes the VCP-Ufd1-Npl4 complex inducing proteasome-dependent degradation of the ... Full text Cite

Project LIFE: a partnership to increase physical activity in elders with multiple chronic illnesses.

Journal article J Aging Phys Act · July 2006 The authors describe a medical center-based randomized trial aimed at determining the feasibility and effectiveness of partnering patients and primary-care providers with an exercise health counselor. Study participants included 165 veterans age 70 years a ... Full text Link to item Cite

Highly variable sperm precedence in the stalk-eyed fly, Teleopsis dalmanni.

Journal article BMC evolutionary biology · June 2006 BackgroundWhen females mate with different males, competition for fertilizations occurs after insemination. Such sperm competition is usually summarized at the level of the population or species by the parameter, P2, defined as the proportion of o ... Full text Cite

A designed glycoprotein analogue of Gc-MAF exhibits native-like phagocytic activity.

Journal article Journal of the American Chemical Society · June 2006 Rational protein design has been successfully used to create mimics of natural proteins that retain native activity. In the present work, de novo protein engineering is explored to develop a mini-protein analogue of Gc-MAF, a glycoprotein involved in the i ... Full text Cite

Functional incidental training: a randomized, controlled, crossover trial in Veterans Affairs nursing homes.

Journal article Journal of the American Geriatrics Society · July 2005 Featured Publication ObjectivesTo test the effects of a rehabilitative intervention directed at continence, mobility, endurance, and strength (Functional Incidental Training (FIT)) in older patients in Department of Veterans Affairs (VA) nursing homes.DesignR ... Full text Cite

Functional Incidental Training: applicability and feasibility in the Veterans Affairs nursing home patient population.

Journal article Journal of the American Medical Directors Association · March 2005 ObjectiveTo examine the applicability and feasibility of an intervention directed at improving continence, endurance, and strength (Functional Incidental Training [FIT]), for older patients in Veterans Administration (VA) nursing homes.Design< ... Full text Cite

Inpatient care for elderly cancer patients: the role for Geriatric Evaluation and Management Units in fulfilling goals for care.

Journal article Crit Rev Oncol Hematol · September 2004 PURPOSE: To describe patterns of functional status, symptoms, therapeutic goals and outcomes among older adults with cancer diagnoses hospitalized on a Geriatric Evaluation and Management Unit (GEMU). DESIGN AND METHODS: Retrospective chart review of veter ... Full text Link to item Cite

Complexity theory: a long-term care specialty practice exemplar for the education of advanced practice nurses.

Journal article The Journal of nursing education · February 2004 Featured Publication This clinical exemplar highlights how an academic clinical practice supported gerontological nursing students as they learned evidence-based approaches to managing complex geriatric syndromes in long-term care. Urinary incontinence (UI), which occurs in mo ... Full text Cite

A conceptual framework for understanding decision-making processes of nursing assistants in providing dementia care.

Journal article Alzheimer’s Care Quarterly · 2004 Our current understanding of how nursing assistants (NAs) provide unlicensed nursing care to the cognitively impaired suggests NAs make choices about how to provide care in ways that may be classified as either rational or intuitive. ... Cite

A 6-month observational study of the relationship between weight loss and behavioral symptoms in institutionalized Alzheimer's disease subjects.

Journal article J Am Med Dir Assoc · 2004 Featured Publication OBJECTIVE: Weight loss is a common occurrence in Alzheimer's disease (AD). This study was undertaken to investigate the relationship between weight loss and behavioral symptoms in institutionalized AD subjects. DESIGN: Observational study. SETTING: Two fac ... Full text Link to item Cite

Natural history of change in physical function among long-stay nursing home residents.

Journal article Nurs Res · 2003 Featured Publication BACKGROUND: Few longitudinal studies exist to guide clinicians or administrators on what functional outcomes can be expected among nursing home residents with different levels of cognitive impairment. Extrapolating from cross-sectional studies or from long ... Full text Link to item Cite

Tailoring the environment of oral health care to the needs and abilities of nursing home residents with dementia.

Journal article Alzheimer’s Care Quarterly · December 2002 This study developed and tested an intervention to promote use of preserved abilities in oral care among nursing home (NH) residents with dementia. Changes were made to environmental support for oral care and in how nursing staff provided oral care. Five N ... Cite

Effects of cognitive performance on change in physical function in long-stay nursing home residents.

Journal article J Gerontol A Biol Sci Med Sci · December 2002 Featured Publication BACKGROUND: Determining the nature and rate of change in physical function among long-stay nursing home (NH) residents classified by cognitive performance is needed to inform judgments about prognosis and design of clinical trials to minimize functional de ... Full text Link to item Cite

A randomized controlled trial of the psychosocial impact of providing internet training and access to older adults.

Journal article Aging Ment Health · August 2002 Featured Publication The Internet (electronic mail and the World Wide Web) may provide new opportunities for communication that can help older adults avoid social isolation. This randomized controlled trial assessed the psychosocial impact of providing Internet access to older ... Full text Link to item Cite

Geriatric nursing research digest: Essay review.

Journal article Contemporary Gerontology · 2002 Cite

Development of a test of physical performance for the nursing home setting.

Journal article The Gerontologist · October 2001 PurposeThis study was undertaken to develop a performance-based instrument to measure a range of function present among nursing home (NH) residents and to establish the reliability and validity of the measures.Design and methodsFourteen i ... Full text Cite

Studying acute confusion in long-term care: clinical investigation or secondary data analysis using the minimum data set?

Journal article Journal of gerontological nursing · April 2001 Clinical investigations of acute confusion have largely been initiated in the acute care setting, where no uniform patient assessment exists. No reliable estimates of the prevalence of acute confusion in long-term care (LTC) residents have been reported. D ... Full text Cite

Quiet time: a nursing intervention to promote sleep in neurocritical care units.

Journal article Am J Crit Care · March 2001 Featured Publication BACKGROUND: Patients in intensive care units are often sleep deprived, yet little research exists on the impact of nursing care on promoting sleep. OBJECTIVES: To determine if implementing a "quiet time" protocol to reduce external environmental stimuli is ... Link to item Cite

Methods of contrast sensitivity testing in cognitively impaired patients

Journal article JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · August 1, 2000 Link to item Cite

Behavioral disturbance in NR residents with dementia and vision loss

Journal article JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · August 1, 2000 Link to item Cite

Treating excess disability among cognitively impaired nursing home residents.

Journal article Journal of the American Geriatrics Society · April 2000 Featured Publication Full text Cite

Pain in nursing home residents: an exploration of prevalence, staff perspectives, and practical aspects of measurement.

Journal article Clin J Pain · June 1999 Featured Publication OBJECTIVE: To help rectify the underdiagnosis of chronic pain in frail nursing home residents by developing a new feasible pain self-report instrument, the structured pain interview; to use this new tool to estimate pain prevalence and staff's knowledge of ... Full text Link to item Cite

Reliability of physical performance tests in four different randomized clinical trials.

Journal article Arch Phys Med Rehabil · May 1999 OBJECTIVES: (1) To assess the test-retest reliability of physical performance tests in subject groups with different levels of impairment and disability, and (2) to assess the stability of these tests over different time intervals. DESIGN: Test-retest, rep ... Full text Link to item Cite

Screening methods for thyroid hormone disruptors.

Journal article Environmental health perspectives · May 1999 The U.S. Congress has passed legislation requiring the EPA to implement screening tests for identifying endocrine-disrupting chemicals. A series of workshops was sponsored by the EPA, the Chemical Manufacturers Association, and the World Wildlife Fund; one ... Full text Cite

Surfing the net in later life: A review of the literature and pilot study of computer use and quality of life

Journal article Journal of Applied Gerontology · January 1, 1999 The Internet offers new opportunities for communication that can help older adults avoid social isolation. Although elders may need more time and assistance in learning computer systems, many are embracing this new technology. There is growing potential no ... Full text Cite

Pain measurement in elders with chronic low back pain: traditional and alternative approaches.

Journal article Pain · October 1996 Pain evaluation typically relies upon the use of self-report instruments. The validity of these tools is questionable in many older adults, however, particularly those with cognitive impairment. Rating of pain behavior (e.g. grimacing, sighing) by an objec ... Full text Link to item Cite

The reliability, validity, and stability of a measure of physical activity in the elderly.

Journal article Arch Phys Med Rehabil · August 1996 OBJECTIVE: To assess the reliability, validity, and stability of an accelerometer-based monitor of physical activity in an elderly population. DESIGN: Six studies were conducted to assess the Tritrac, a newly available accelerometer capable of storing thre ... Full text Link to item Cite

Do nursing diagnoses affect functional status?

Journal article J Gerontol Nurs · October 1989 1. Nurses in this study often made diagnoses pertaining to physiological or physical problems rather than psychosocial problems. One diagnostic category, "impaired home maintenance management," was consistently used incorrectly, suggesting a need for caref ... Full text Link to item Cite