<p> Participants (N= 227) completed questionnaires pertaining to depressive symptomatology and trait intrusive thinking, and subsequently engaged in tasks assessing executive functioning, working memory, prospective memory, and episodic memory. The dependent variables assessed the influence of intrusive thinking on the relationship between depressive symptomatology and the four previously mentioned cognitive domains. A three-way interaction was conducted using the PROCESS macro created by Hayes (2013). The results revealed a significant three-way interaction for the working and episodic memory measure. Younger participants with low levels of intrusive thinking performed better on the working and episodic memory task as depressive symptomatology increased, while older adults with low levels of intrusive thinking performed worse on these tasks as depressive symptomatology increased. It is important to note that performance on these measures did not significantly vary by depressive symptomatology at high levels of intrusive thinking. These findings suggest that intrusive thinking may be a beneficial factor to explore in future research regarding the impact of depressive symptomatology on cognitive functioning across age groups.</p>

<p> The purpose of this project was to demonstrate whether a multifaceted quality improvement intervention program would improve hand hygiene compliance of healthcare providers (HCPs) in the Emergency Department (ED). A descriptive design with an observational approach was used with a convenience sample of ED healthcare personnel at a large, 500 bed community hospital. Seven hundred and fifty-eight hand hygiene compliance direct observations were collected during 3 time periods (baseline, pre-intervention and post-intervention observation periods). Descriptive and inferential statistics were used to analyze differences in hand hygiene compliance across the observation periods and by HCP job category. </p><p> The results indicated a statistically significant increase in hand hygiene compliance among all groups combined after a multifaceted intervention program was implemented. Efforts to change behavior, lifestyle and the environment must be varied and the target audience must be involved to be effective. This model can be applied to HCPs in other healthcare settings to improve compliance with hand hygiene, a fundamental infection prevention practice to prevent healthcare acquired infections.</p>

<p><i>Bone Garden</i> is a collection of poetry that inspects interpersonal communication and an often misguided sense of connection with others. Through investigations of memory, disaster, aging, and gender, the collection depicts a world in which many of us fruitlessly search for empathy and a sense of solidarity. Leading this investigation is a narrator whose frustrations with isolation often result in passive aggressive behavior or violence that furthers her separation from others. <i>Bone Garden</i> proposes solidarity as a salted plot and despair as the bitter fruit harvested by those who believe in it. </p>

<p> This project report served as a framework for an aging and disability lifestyle blog named Evolving Abilities. It listed resources and highlighted the vitality and value in aging with a disability by promoting a realistic and dynamic perspective written by a disability gerontologist. The niche audience targeted people aging with disabilities (or chronic health conditions). Evolving Abilities supported connectedness and full inclusion by addressing ageism and ableism.</p>

<p> Decisions near the end of life must be made at a time of great emotional upheaval and rely on knowledge that few people possess outside of healthcare. Complicating this is that choices appear to change as older adults become more ill and approach death. Thus, healthcare providers must help older patients navigate this complexity to make decisions that are consistent with patients' priorities and wishes. Research examining end-of-life decisions has been descriptive in nature, looked at decisions from among younger adults, or examined decision making among those with cancer diagnoses. In addition, the research often focused on prospective decisions among healthy elders. Much less is known about decision-making processes used by older adults with a limited prognosis. </p><p> The aim of this dissertation was to examine decision-making processes among older adults with a limited prognosis who were in the midst of making significant healthcare decisions. The goal was to explore the phenomenon from within the context of the end of life to bring forth the missing voice of these elders. </p><p> Twenty community-based adults (13 men, 7 women, ages 67-97) with a prognosis of less than 12 months were recruited through the San Francisco Veterans' Administration Medical Center and the University of California, San Francisco, Division of Geriatrics. One-on-one interviews were conducted in participants' homes using a semi-structured interview guide. Interviews were recorded and transcribed verbatim. Grounded theory was used to analyze the interviews to allow themes and concepts to emerge organically from the data. </p><p> Two main themes emerged: <i>maintaining a sense of control </i> and <i>decision making in the context of ambiguity.</i> Participants rarely discussed actual decisions and preferred to delegate end-of-life decisions. By using different approaches to express their priorities and goals, they maintained the <i>sense</i> of control without being <i> in</i> control. The actual context of decisions could not be understood a priori, which resulted in uncertainty and ambivalence that influenced how decisions were made. </p><p> By understanding how older adults approach late-life decisions, healthcare providers can better support their patients as they make different choices and help guide patients to choices that are consistent with their stated preferences and priorities.</p>

Thesis (Ph.D.)--University of California, San Francisco, 2009. / Source: Dissertation Abstracts International, Volume: 71-02, Section: B, page: . Adviser: Cynthia Kenyon.

<p> Rural West Virginia has a very high percentage of older adults. The age-related disease of Alzheimer&rsquo;s threatens the health of older Appalachians, yet research on Alzheimer&rsquo;s disease (AD) in this population is scarce. In order to improve screening rates for cognitive impairment, Appalachians need to understand their vulnerability. The first step would be to assess their knowledge about AD but a suitable AD knowledge test has not been developed. The purpose of this study was to test the reliability and validity of a new measure of knowledge about AD that is culturally congruent, and to examine factors that may predict AD knowledge in this rural population. A correlational descriptive study was conducted with 240 participants from four samples of older adults in south central rural Appalachian West Virginia using surveys and face-to-face interviews. Results from tests for stability, reliability including Rasch modeling, discrimination and point biserial indices, and concurrent, divergent, and construct validity were favorable. Findings were that although more diversity in test item difficulty is needed, the test discriminated well between persons with higher and lower levels of education [<i>F</i>(2, 226) = 170.51, <i>p</i> = .001]. Using multiple regression, the predictors of AD knowledge included caregiver status, miles from a healthcare provider, gender, and education; (<i>R</i>²=.05, F(4,187) = 2.65, <i>p</i> =. 04). Only years of education accounted for a significant proportion of unique variance in predicting the total BKAD score (<i>t</i> = 2.14, <i>p</i> =. 03). Implications include the need for further tool refinement, testing for health literacy, coordination with recent statewide efforts to educate the public regarding AD, and community based participatory research in designing culturally effective education programs that will ultimately increase screening and detection of Alzheimer&rsquo;s disease in rural populations.</p>

<p> Breast cancer is a disease that continues to affect people of all ages, but especially older adults. The number of people impacted by this disease continues to grow and there is a rapid increase in women who are newly diagnosed with breast cancer. The primary risk factors for breast cancer are age and gender. The purpose of this project was to develop a breast cancer comprehensive resource packet for adults, age 65 years and older, who have been newly diagnosed with breast cancer. This packet incorporates patient education, possible coping strategies about living with breast cancer, useful tips for healthy living, and information on how to transition from living with breast cancer to becoming a cancer survivor. This packet provides a resource tool for breast cancer patients including beneficial tips directly from breast cancer survivors that may create an easier transition of living with breast cancer for those newly diagnosed.</p>

<p> The current study served to provide new knowledge that may benefit future researchers, policy makers, health care leaders, and health care professionals who aspire to improve the delivery status for quality end of life care. A missing link in the hospice care continuum was identified as the need for the use of music listening by patients and caregivers as a low cost viable non-invasive alternative intervention that can be effectively utilized in real life situations. The researcher chose the current study's generic qualitative design to enhance understanding of how informal hospice patients' caregivers perceived music listening as a means for the patients to accept the state of a good death. Generic qualitative research design offered the researcher with an opportunity to hear and inductively analyze the hospice patients' vulnerable voices per their caregivers. Data was collected during a semi-structured face-to-face interview process and was reflective of the perceptions of hospice caregivers (<i>N</i> = 4). The researcher incorporated an axial coding process with the use of NVivo 9 software to analyze the data. A <i> priori coding</i> method incorporated the use of four predetermined themes: three domains for the concept of a good death and one for music and a good death. Overall, the findings indicated that music listening had a positive effect on the hospice patients, according to their caregivers' perceptions. The study limitations reflected the use of a small sample size from one Southwestern city that consisted of four female caregivers and the study results were dependent upon the perceptions of these caregivers. Consequently, due to the study's limitations, health care researchers and health care administrators should cautiously generalize the study's findings and decide for themselves if the study benefits outweigh its limitations. Further studies are indicated to enhance and supplement the knowledge presented in this study. One suggestion to further research is to broaden the scope of recruitment to include younger hospice patients, including children, who receive care either in their own home or in a medical facility. Another suggestion to further research would be to compare the effects of different types of music preferred by hospice patients.</p>

<p> The purpose of this study was to explore how caregivers of patients with dementia are physically and mentally affected by their increase in responsibilities. The purpose of this project was to locate a potential funding source and write a grant to obtain funding for a caregiver support group for the Calabasas, CA community and its surrounding areas.</p><p> Caregiver intervention programs have been identified as a critical area of research by the Alzheimer's Association. Silverado Senior Living is a national organization that serves patients with dementia. The program consists of two support groups offering structure and flexibility through cognitive behavioral practices and a continuous feedback.</p><p> If funded and implemented, this program would add value to the body of research that exists for caregivers and drive awareness and change to current policy. In addition, Silverado would better serve its community and act as a model program for other Silverado locations.</p><p> The actual submission and/or funding of this grant was not a requirement for the successful completion of the project.</p>