Assessing feasibility of a novel approach to effective medication self-management for older persons.

The fact that nearly one-half of patients take medications differently than as prescribed, combined with the predisposition of older persons to adverse events, suggests a need for new strategies supporting medication self-management for older persons. This pilot study describes the development, acceptability and feasibility of a novel toolkit approach focusing on a systematic 4-step process for ensuring medication appropriateness. A preliminary qualitative assessment of the toolkit's acceptability and feasibility was carried out using a convenience sample of 39 residents aged 62-97 years in two senior living facilities convened in focus groups.

Recruiting an underserved, difficult to reach population into a cancer trial: Strategies from the 2 Rehabilitation Trial for gay and bisexual prostate cancer patients.

Background/aims: Sexual minorities are small and under-researched populations that are at disproportionate risk for cancer and poor cancer outcomes. Described as a "hidden population," the principal research challenge has been to develop effective methods to identify and recruit such cancer patients into cancer studies. Online recruitment strategies, as well as targeted clinic recruitment using patient-entered sexual orientation and gender identity data from electronic medical records have potential to transform recruitment, but studies testing the effects of how to recruit using these have not been published.

The Relationships of Nursing Home Culture Change Practices With Resident Quality of Life and Family Satisfaction: Toward a More Nuanced Understanding.

Transforming nursing homes (NHs) from restrictive institutions to person-centered homes, referred to as NH culture change, is complex and multifaceted. This study, based on a survey of administrators in Minnesota NHs ( = 102), tested the domain-specific relationships of culture change practices with resident quality of life (QOL) and family satisfaction, and examined the moderating effect of small-home or household models on these relationships. The findings revealed that culture change operationalized through physical environment transformation, staff empowerment, staff leadership, and end-of-life care was positively associated with at least one domain of resident QOL and family satisfaction, while staff empowerment had the most extensive effects.

An Empirical Typology of Nursing Home Culture Change Implementation.

Culture change in nursing homes (NHs) is a broad-based effort to transform NHs from impersonal institutions to genuine person-centered homes. Culture change practices have been implemented increasingly with varying levels of success. This study (a) generated an empirical typology of culture change implementation across Minnesota NHs using latent profile analysis based on the survey data from administrators in 102 NHs and (b) examined variations in NH characteristics and quality outcomes associated with the typology.

The Effects of Nursing Home Culture Change on Resident Quality of Life in U.S. Nursing Homes: An Integrative Review.

Culture change is intended to transform nursing homes from impersonal institutions into person-centered homes. Despite a growing interest in studying culture change, empirical evidence for its effects on quality of life (QOL) has not been synthesized. The current integrative review examined how QOL outcomes were measured in culture change studies and analyzed the current evidence for culture change effects on QOL.

Understanding Prostate Cancer in Gay, Bisexual, and Other Men Who Have Sex with Men and Transgender Women: A Review of the Literature.

Purpose Of Review: a)Prostate cancer in sexual and gender minorities is an emerging medical and public health concern. The purpose of this review is to summarize the state of the science on prostate cancer in gay, bisexual, and other men who have sex with men (GBM) and transgender women (TGW). We undertook a literature review of all publications on this topic through February 2017.

Reliability and Validity of Two Measures of Toileting Skills in Frail Older Women Without Dementia.

Urinary incontinence (UI) affects 43% of frail, community-dwelling older women and threatens their independence. For these women, remaining continent depends on their ability to toilet. Treatments should include improving toileting skills.

Restorative Care's Effect on Activities of Daily Living Dependency in Long-stay Nursing Home Residents.

Purpose Of The Study: (a) Identify the prevalence of nursing homes providing Medicare supported restorative care programs and of long stay participants, (b) compare characteristics between restorative care participants and nonparticipants, and (c) assess restorative care's effect on change in activities of daily living (ADL) dependency.

Design And Methods: Longitudinal analysis of Minimum Data Set assessments linked to the 2004 National Nursing Home Survey using a sample of 7,735 residents, age ≥ 65 years living in 1,097 nursing homes for at least 6 months. Receipt of any restorative care was used as a time varying predictor to estimate change in ADL dependency over 18 months using linear mixed models.

Change in Balance Confidence and Its Associations With Increasing Disability in Older Community-Dwelling Women at Risk for Falling.

Objectives: To describe change in balance confidence, and to identify associated factors and disabling consequences.

Method: Secondary analysis of 2 years of data collected from 272 older women enrolled in a randomized clinical trial of fall prevention. Balance confidence and disability measures were assessed at baseline, after the 12 week intervention, and at 1 and 2 years follow-up.

Factors associated with toileting disability in older adults without dementia living in residential care facilities.

Background: Older adults without dementia living in residential care facilities with toileting disability have increased care costs and dependency. Understanding associated factors could guide prevention and management strategies.

Objective: The aim of this study was to identify the prevalence of and factors associated with toileting disability in this population.

Not just specific diseases: systematic review of the association of geriatric syndromes with hospitalization or nursing home admission.

To examine the association between geriatric syndromes with hospitalization or nursing home admission, we reviewed studies that examined hospitalization and nursing home admission in community-dwelling older adults with multiple morbidities, cognitive impairment, frailty, disability, sarcopenia, malnutrition, impaired homeostasis, and chronic inflammation. Studies published in English language were identified through MEDLINE (1990 through April 2010), Cochrane databases, the Centers for Disease Control and Prevention website and manual searches of reference lists from relevant publications. The study had to include general (non-disease specific) populations of adults aged 65 years or older.

Association of frailty with survival: a systematic literature review.

Frailty is a known risk factor for those aged 65 and over, and its prevalence increases with age. Definitions of frailty vary widely, and prevalence estimates are affected by the way frailty is defined. Systematic reviews have yet to examine the literature on the association between definitions of frailty and mortality.

Older people's perspectives on fall risk and fall prevention programs: a literature review.

Despite evidence supporting fall prevention methods, fall-related injury and death rates continue to rise. Understanding older people's views on fall risk and prevention will help nurses and other health professionals in the design of fall prevention strategies that will broaden their scope, reach and adoption. This literature review synthesised 19 qualitative and quantitative studies examining older people's perspectives about fall risk and prevention using a social-ecological framework.

State of the science: conservative interventions for urinary incontinence in frail community-dwelling older adults.

This systematic literature review aimed to identify conservative interventions for reducing urinary incontinence (UI) in non-institutionalized frail older adults. Randomized and quasi-experimental studies published in English reporting outcomes on UI frequency, severity, or quality of life were included and rated for quality. Studies reporting improvements over 50% in UI outcomes were considered clinically significant.

Psychometric properties of the activities-specific balance confidence scale and the survey of activities and fear of falling in older women.

Objectives: To compare the psychometric properties of the Activities-specific Balance Confidence Scale (ABC) and the Survey of Activities and Fear of Falling in the Elderly (SAFE).

Design: Secondary analysis using baseline and 12-week data from a randomized, controlled trial on fall prevention.

Setting: Upper Midwest metropolitan area with assessments conducted in participants' homes.

Design of control-group conditions in clinical trials of behavioral interventions.

Purpose: To review considerations in the design of placebo (attention) control conditions for community-based clinical trials of health behavior change interventions and to provide practical strategies for the design of control conditions.

Organizing Constructs: A well-designed control condition is an essential component of a clinical trial to foster the unambiguous interpretation of study findings.

Methods: Pitfalls in the design of control conditions in clinical trials of behavioral interventions are identified and strategies to address them are offered.