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Full-Text Articles in Entire DC Network
Preconception Phthalate Exposure And Women’S Reproductive Health: Pregnancy, Pregnancy Loss, And Underlying Mechanisms, Carrie J. Nobles, Et. Al.
Preconception Phthalate Exposure And Women’S Reproductive Health: Pregnancy, Pregnancy Loss, And Underlying Mechanisms, Carrie J. Nobles, Et. Al.
Environmental Health Sciences Faculty Publication Series
Background:
Phthalates are endocrine-disrupting chemicals linked to adverse pregnancy outcomes. Despite the sensitivity of female reproductive processes to oxidation–reduction reaction stress and endocrine disruption, evidence for the impact of women’s phthalate exposure on the ability to establish and maintain pregnancy has been inconclusive.Objectives:
We aimed to determine the relationship of preconception phthalate metabolite exposure with a) fecundability and pregnancy loss and b) markers of potential biological mechanisms, including reproductive hormones, inflammation, and oxidative stress.Methods:
Data were collected from the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial, a preconception study following 1,228 women who were …Using Evidence-Based Interventions To Improve The Completion Rates Of Advance Care Directives, Fariba Sohrabi
Using Evidence-Based Interventions To Improve The Completion Rates Of Advance Care Directives, Fariba Sohrabi
Doctor of Nursing Practice (DNP) Projects
Background: Advance care directives reduce unnecessary suffering, improve life quality, and further engage patients and families in the decision-making process to ensure that end-of-life care preferences are considered and applied. Despite the proven benefits of advance care directives, advance directives completion rates are approximately 33% in the United States. Purpose: The purpose of this quality improvement project was to increase advance directive completion rates among patients at one clinic through an educational intervention. Methods: The intervention was used to educate patients about the benefits of advance care directives, and present opportunities for patients to complete the directive. The intervention included …
Timing Of Hospital Admission At First Childbirth: A Prospective Cohort Study, Kristen H. Kjerulff, Laura B. Attanasio, Jennifer Vanderlaan, Kristin K. Sznajder
Timing Of Hospital Admission At First Childbirth: A Prospective Cohort Study, Kristen H. Kjerulff, Laura B. Attanasio, Jennifer Vanderlaan, Kristin K. Sznajder
Health Promotion and Policy Faculty Publication Series
Background and aims
It is difficult for women in labor to determine when best to present for hospital admission, particularly at first childbirth. While it is often recommended that women labor at home until their contractions have become regular and ≤ 5-minutes apart, little research has investigated the utility of this recommendation. This study investigated the relationship between timing of hospital admission, in terms of whether women’s labor contractions had become regular and ≤ 5-minutes apart before admission, and labor progress.
Methods
This was a cohort study of 1,656 primiparous women aged 18–35 years with singleton pregnancies who began labor …
Dietary Fat Quality And Serum Androgen Concentrations In Middle-Aged Men, Miika M. Wynne-Ellis, Jaakko J. Mursu, Tomi-Pekka Tuomainen, Elizabeth Bertone-Johnson, Jukka T. Salonen, Jyrki K. Virtanen
Dietary Fat Quality And Serum Androgen Concentrations In Middle-Aged Men, Miika M. Wynne-Ellis, Jaakko J. Mursu, Tomi-Pekka Tuomainen, Elizabeth Bertone-Johnson, Jukka T. Salonen, Jyrki K. Virtanen
Health Promotion and Policy Faculty Publication Series
Average testosterone concentrations in men have declined over the last few decades. The reasons for this are not fully known, but changes in dietary fat quality have been suggested to have a role. This study aimed to investigate the associations of different dietary fatty acids with serum androgen concentrations.
The Challenges Of Defining Hormesis In Epidemiological Studies: The Case Of Radiation Hormesis, Ivo Iavicoli, Luca Fontana, Davide Guarino, Martina Laudiero, Edward J. Calabrese
The Challenges Of Defining Hormesis In Epidemiological Studies: The Case Of Radiation Hormesis, Ivo Iavicoli, Luca Fontana, Davide Guarino, Martina Laudiero, Edward J. Calabrese
Environmental Health Sciences Faculty Publication Series
In the current radiation protection system, preventive measures and occupational exposure limits for controlling occupational exposure to ionizing radiation are based on the linear no-threshold extrapolation model. However, currently an increasing body of evidence indicates that this paradigm predicts very poorly biological responses in the low-dose exposure region. In addition, several in vitro and in vivo studies demonstrated the presence of hormetic dose response curves correlated to ionizing radiation low exposure. In this regard, it is noteworthy that also the findings of different epidemiological studies, conducted in different categories of occupationally exposed workers (e.g., healthcare, nuclear industrial and aircrew workers), …
Educating Novice Nurses And Nurse Practitioners About Military Sexual Trauma Screening, Alyssa D. Freeman
Educating Novice Nurses And Nurse Practitioners About Military Sexual Trauma Screening, Alyssa D. Freeman
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Military sexual trauma prevalence has continually increased over the past 25 years. Exposure to sexual trauma, violence, and abuse result in notable health consequences. The Veterans Health Administration has led the integration of universal Military Sexual Trauma (MST) screening and training. Purpose: The purposes of this project were to educate novice nurses and nurse practitioners about MST and to increase their knowledge and comfort in MST screening techniques. Methods: Following an educational session, a pre- and post-study design was used to evaluate improvement in knowledge and comfort screening for MST. Thirty-two participants including PBRNR Nurse Residents, …
Improving Culturally Competent Lgbtq+ Care Among Primary Care Providers, Christopher Diaz
Improving Culturally Competent Lgbtq+ Care Among Primary Care Providers, Christopher Diaz
Doctor of Nursing Practice (DNP) Projects
Purpose: Although general efforts have been made to identify, address, and improve the standing of the lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ+) community, many of these individuals continue to experience stigmatization and discrimination daily. These experiences influence the health of these individuals, which leads to several health disparities including an increased risk for numerous physical and mental health conditions.
Methods: Using nationally developed guidelines, the author of this project developed two didactic-style educational presentations for primary care providers to improve cultural competency for LGBTQ+ individuals. Eight providers completed both presentations, which explored the attitudes, knowledge, and beliefs/practice intentions of …
A Toolkit To Adequately Screen Pregnant Women For Depression And Thus Increase Screening In An Outpatient Obstetrical Clinic, Katherine Doherty
A Toolkit To Adequately Screen Pregnant Women For Depression And Thus Increase Screening In An Outpatient Obstetrical Clinic, Katherine Doherty
Doctor of Nursing Practice (DNP) Projects
Background: Perinatal depression is a common health complication during pregnancy. Untreated depression among perinatal women is associated with adverse health outcomes for infants and mothers. Screening during the perinatal time period is needed to identify and treat depression and to prevent adverse health outcomes.
Purpose: The purpose of this clinical project is to equip health care providers with the knowledge and tools needed to screen pregnant women for depression and thus increase the amount of screening done in an outpatient obstetrical clinic.
Methods: An evidenced- based educational tool kit was developed to increase provider knowledge of perinatal depression …
Screening For Opioid Use Disorder In Emergency Department Observation Unit Patients, Kendra M. Cull (Lehman)
Screening For Opioid Use Disorder In Emergency Department Observation Unit Patients, Kendra M. Cull (Lehman)
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Opioid use disorder (OUD) is an issue that impacts the healthcare system daily, and has been declared a national public health concern Purpose: The purpose of this DNP Quality Improvement (QI) project was to screen patients aged 16 and older for Opioid Use Disorder (OUD) who presented to the Emergency Department Observation Unit (ED OBS) in a Urban Academic Medical Center regardless of chief complaint. The goal of this project was early identification of OUD and rapid referral to outpatient resources to facilitate recovery compliance. Methods: The QI project utilized a registered nurse led screening …
Shared Decision Making For Primary Care Patients With Medical Complexities, Cori B. Fappiano
Shared Decision Making For Primary Care Patients With Medical Complexities, Cori B. Fappiano
Doctor of Nursing Practice (DNP) Projects
No abstract provided.
Outcomes Of Directly Observed Therapy In People Living With Hiv Who Experience Homelessness And Substance Use Disorder, Mara C. Clawson
Outcomes Of Directly Observed Therapy In People Living With Hiv Who Experience Homelessness And Substance Use Disorder, Mara C. Clawson
Doctor of Nursing Practice (DNP) Projects
Background: Antiretroviral directly observed therapy, in which nurses or other allied health professionals provide patients with daily medication, is an evidence-based solution for viral load suppression in people living with HIV who experience homelessness. Purpose: This quality improvement project aimed to assess the outcomes of antiretroviral directly observed therapy at one urban clinic caring for people living with human immunodeficiency virus who experience homelessness and substance use disorder. Methods: Data was collected from the electronic health record for the antiretroviral directly observed therapy patient cohort (n = 33); 10 of them were surveyed. Fisher exact tests determined nonrandom associations between …
Mindfulness Training In A Pediatric Practice With Adolescents And Young Adults, Rebecca Brady
Mindfulness Training In A Pediatric Practice With Adolescents And Young Adults, Rebecca Brady
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Access to support for behavioral and mental health in adolescents and young adults difficult. Depressive symptoms go unrecognized which can lead to severe symptoms, hospitalizations, and suicides. The lack of mental health services challenge the management of depression in this age group. Mindfulness may be a helpful tool in supporting mental health. Purpose: The purpose of this project was to improve depression symptoms among youth through engagement in mindfulness activities. Methods: A pre/post-intervention approach was used to measure the effectiveness of a synchronous, online educational platform to guide participants in mindfulness activities. Practice sessions were utilized based on …
Enhancing Transgender Informed Healthcare For Nursing Students: An Educational Intervention, Olivia Bass
Enhancing Transgender Informed Healthcare For Nursing Students: An Educational Intervention, Olivia Bass
Doctor of Nursing Practice (DNP) Projects
Background: Limited teaching of transgender related healthcare competencies is seen in baccalaureate nursing curriculum, resulting in inadequate preparation of healthcare providers to care for this population of patients. This discord can prevent transgender patients from seeking healthcare and affect access to needed services. Purpose: The purpose of this DNP project was to educate accelerated Bachelor of Science in Nursing students at an institute of higher education on providing culturally responsive healthcare for transgender patients. Methods: An in-person educational intervention focused on improving clinical and cultural knowledge for transgender patients was implemented and evaluated. A pre-intervention survey and post-intervention survey …
Implementation Of An Acne Management Smartset To Guide Primary Care Providers’ Management Of Acne Patients, Emily Thomas
Implementation Of An Acne Management Smartset To Guide Primary Care Providers’ Management Of Acne Patients, Emily Thomas
Doctor of Nursing Practice (DNP) Projects
Background: Primary care providers (PCPs) commonly refer adult acne patients to dermatology due to lack of confidence in treatment initiation and maintenance, resulting in delayed patient care, limited access to dermatology appointments, and an ongoing knowledge gap within the primary care setting. Purpose: To support PCPs with acne diagnosis and treatment recommendations by hosting acne education sessions and implementing an Acne Management SmartSet for acne treatment. Methods: The DNP student held acne education sessions during staff meetings at two primary care sites, then disseminated surveys to participants to determine if the education session and SmartSet were clinically useful. Data pertaining …
Restorative Streetscapes: Promoting Positive Mental Health Outcomes Through Urban Landscape Design In Winooski, Vermont, Sean R. Fitzsimmons
Restorative Streetscapes: Promoting Positive Mental Health Outcomes Through Urban Landscape Design In Winooski, Vermont, Sean R. Fitzsimmons
Landscape Architecture & Regional Planning Studio and Student Research and Creative Activity
The global health burden of mental health disorders is immense. The World Health Organization ranks depression as the single largest contributor to global disability; anxiety disorders alone rank sixth. One in four people will have a diagnosable mental illness in their lifetime and mental health conditions are increasing worldwide, rising 13% in the last decade. The economic implications are also immense, costing the global economy US $1 trillion each year. Mental health is more than the absence of disorders or disabilities, however. It is defined by the WHO as “a state of well-being in which an individual realizes his or …
The Massachusetts Public Health Data Warehouse And The Opioid Epidemic: A Qualitative Study Of Perceived Strengths And Limitations For Advancing Research, Elizabeth A. Evans, Elizabeth Delorme, Karl D. Cyr, Kimberly H. Geissler
The Massachusetts Public Health Data Warehouse And The Opioid Epidemic: A Qualitative Study Of Perceived Strengths And Limitations For Advancing Research, Elizabeth A. Evans, Elizabeth Delorme, Karl D. Cyr, Kimberly H. Geissler
Health Promotion and Policy Faculty Publication Series
Due to the opioid overdose epidemic, Massachusetts created a Public Health Data Warehouse, encompassing individually-linked administrative data on most of the population as provided by more than 20 systems. As others seek to assemble and mine big data on opioid use, there is a need to consider its research utility. To identify perceived strengths and limitations of administrative big data, we collected qualitative data in 2019 from 39 stakeholders with knowledge of the Massachusetts Public Health Data Warehouse. Perceived strengths included the ability to: (1) detect new and clinically significant relationships; (2) observe treatments and services across institutional boundaries, broadening …
Transitions In Health Insurance During The Perinatal Period Among Patients With Continuous Insurance Coverage, Chanup Jeung, Laura B. Attansio, Kimberly H. Geissler
Transitions In Health Insurance During The Perinatal Period Among Patients With Continuous Insurance Coverage, Chanup Jeung, Laura B. Attansio, Kimberly H. Geissler
Health Promotion and Policy Faculty Publication Series
Importance Although health insurance continuity is important during the perinatal period to improve birth outcomes and reduce maternal morbidity and mortality, insurance disruptions are common. However, little is known about insurance transitions among insurance types for individuals who remained insured during the perinatal period.
Objective To examine insurance transitions for birthing individuals with continuous insurance, including those with Medicaid and Medicaid managed care coverage, before, during, and after pregnancy.
Design, Setting, and Participants This cohort study used January 1, 2014 to December 31, 2018 data from the Massachusetts All-Payer Claims Database. The sample included deliveries from January 1, 2015, to …
Simple Method For Cutoff Point Identification In Descriptive High-Throughput Biological Studies, Alexander Suvorov
Simple Method For Cutoff Point Identification In Descriptive High-Throughput Biological Studies, Alexander Suvorov
Environmental Health Sciences Faculty Publication Series
Background
Rapid development of high-throughput omics technologies generates an increasing interest in algorithms for cutoff point identification. Existing cutoff methods and tools identify cutoff points based on an association of continuous variables with another variable, such as phenotype, disease state, or treatment group. These approaches are not applicable for descriptive studies in which continuous variables are reported without known association with any biologically meaningful variables.
Results
The most common shape of the ranked distribution of continuous variables in high-throughput descriptive studies corresponds to a biphasic curve, where the first phase includes a big number of variables with values slowly growing …
Improving Dementia Caregiver Competency In Nursing Home, Disha Bhattacharya
Improving Dementia Caregiver Competency In Nursing Home, Disha Bhattacharya
Doctor of Nursing Practice (DNP) Projects
Background: Inadequate training of dementia care providers in nursing homes lead to adverse health outcomes in patients with dementia.
Purpose: To educate and train dementia caregivers in a nursing home to improve dementia care.
Methods: A Quality Improvement Project (QIP) was implemented in a nursing home with nine nurses engaged in two virtual education group sessions led by the DNP student over an eight- week timeframe. Topics discussed included education on the nature and progress of dementia, building trust with dementia patients, managing their behavior, communication strategies, and self-care. Pre-training and post-training surveys were completed prior to …
Postpartum Hemorrhage: Improving Patient Outcomes With Improved Communication And Post-Drill Debriefing, Sheila L. Lafortune
Postpartum Hemorrhage: Improving Patient Outcomes With Improved Communication And Post-Drill Debriefing, Sheila L. Lafortune
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: A woman is at risk of dying from postpartum hemorrhage every four minutes. Maternal hemorrhage is found to be the direct cause of maternal mortality, overall accounting for 27% to 75% of maternal deaths worldwide. In the United States, 54% to 93% of maternal mortality could have been prevented. Postpartum hemorrhage remains among the top causes of pregnancy-related deaths worldwide. The purpose of this project is to educate providers of obstetrical care regarding best practices for effective communication during a postpartum hemorrhage by implementing a debriefing educational tool during postpartum hemorrhage mock code drills. Methods: The postpartum …
Acute Care Nursing Education To Enhance Aggression Management Skills, Marybeth Hayes
Acute Care Nursing Education To Enhance Aggression Management Skills, Marybeth Hayes
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Workplace Violence (WPV) in healthcare settings is pervasive. Acute care nursing staff experience higher rates of aggression from patients. These experiences may cause physical and psychological injury to caregivers and stress healthcare systems.
Purpose: The purpose of this quality improvement (QI) project was to strengthen understanding of evidence-based principles for management of aggressive patients on acute care medical units. Education enhances nursing staff sense of self-efficacy and clinical reasoning skills and is associated with effective management of aggression. Ultimately, improved management of aggression may lead to lower rates of patient assault towards staff members.
Methods: A pre and …
Transition Readiness Tools To Improve Health Care Transitions Among Adolescents With Inflammatory Bowel Disease, Meagan Moffett
Transition Readiness Tools To Improve Health Care Transitions Among Adolescents With Inflammatory Bowel Disease, Meagan Moffett
Doctor of Nursing Practice (DNP) Projects
Inflammatory bowel disease is associated with severe disease in pediatric patients often requires treatment through adulthood. Collaborative efforts of patients, families, and health providers are needed to foster a smooth transition of care from pediatric to adult health care.
The purpose of this quality improvement project was to establish a baseline understanding of transition readiness among adolescents at one gastroenterology clinic to improve transition to adult care. A cross-sectional design was used to assess adolescents’ readiness for transition of care over a three-month period. Transitioning Readiness Assessment Questionnaire (TRAQ) was administered followed by individualized education on topics covered in the …
Promoting Exclusive Breastfeeding Among Racing/Ethnic Minority Women For The First Six Months, Linda A. Boateng
Promoting Exclusive Breastfeeding Among Racing/Ethnic Minority Women For The First Six Months, Linda A. Boateng
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Breastfeeding is the recommended way of feeding infants due to the numerous health benefits. However, racial/ethnic minority women in the United States are less likely to initiate and maintain breastfeeding for the recommended six months compared to white women. This has resulted in higher health issues such as obesity, diabetes type I, allergic sensitivity, acute otitis media, and gastrointestinal problems among racial /ethnic minority children. Purpose: The purpose of this Quality Improvement Project was to promote exclusive breastfeeding among racial/ethnic minority postpartum mothers for the first six months. This was done by providing breastfeeding education to postpartum nurses …
Perceptions Of The Flu Vaccine In The Setting Of Covid-19, Lauren A. Vogel-Hanley
Perceptions Of The Flu Vaccine In The Setting Of Covid-19, Lauren A. Vogel-Hanley
Doctor of Nursing Practice (DNP) Projects
Background: Vaccination is a key component to public and personal preventative health. The COVID-19 pandemic has illuminated the need for further research into how best to encourage vaccination, especially in harder to reach or vulnerable populations.
Purpose: This project sought to evaluate beliefs and perceptions of the flu vaccine in the context of the COVID-19 pandemic and to explore the views of the project site’s population in order to develop more targeted educational programs for increasing flu vaccination. The project focused on the ambulatory population of the emergency department.
Methods: The survey tool administered was based on the National Flu …
Enhancing Preventative Health Care For Latino Migrant Dairy Farm Workers In Addison County, Vermont, Elizabeth A. Douglas
Enhancing Preventative Health Care For Latino Migrant Dairy Farm Workers In Addison County, Vermont, Elizabeth A. Douglas
Doctor of Nursing Practice (DNP) Projects
Background: Latino dairy farmworkers, mainly from Mexico and Guatemala, help produce over 50% of Vermont’s milk. Latino dairy farmworkers may not seek health care for many reasons, including fear of immigration/law enforcement, language barriers, lack of transportation, and cost of care. Purpose: The purpose of this DNP project was to increase the utilization of health care services, including immunizations, of migrant farmers by educating and providing information about preventative, curative, and support services available in southern Vermont (VT). Methods: The intervention, one 60-minute educational program session took place at a local church service for migrant farmers, and an informational pamphlet …
Improvement Of Overweight And Obesity Screening And Intervention In Primary Care, Catherine Lehtinen
Improvement Of Overweight And Obesity Screening And Intervention In Primary Care, Catherine Lehtinen
Doctor of Nursing Practice (DNP) Projects
Background: Obesity is a chronic health condition, resulting in significant morbidity and mortality, and is inadequately managed and treated in primary care. The Obesity Pathway is an organization-specific algorithm for providers to treat patients with obesity.
Purpose: To improve provider use of an Obesity Pathway in a primary care clinic and to increase the screening and intervention of all adult patients with overweight or obese status.
Methods: The Obesity Pathway was reviewed with primary care providers as well as best practices for weight management, obesity bias and stigma. The NEW Attitudes Scale and satisfaction surveys were completed by providers before …
Implementing Intimate Partner Violence Screening In The Primary Care Setting, Deirdre F. Howard
Implementing Intimate Partner Violence Screening In The Primary Care Setting, Deirdre F. Howard
Doctor of Nursing Practice (DNP) Projects
Background. Intimate partner violence is a highly prevalent problem in the United States and leads to serious negative physical and psychological health outcomes, including death. There are screening tools that can detect IPV, yet screening rates in healthcare settings remain low, due to a variety of barriers, including lack of time, confidence, screening policies, and resources. Purpose. The purpose of this DNP project was to increase IPV screening rates within a primary care clinic.Methods. To accomplish the purpose of the project, an education intervention on IPV and available resources was provided to clinicians and staff. This was followed by …
Building Resilience In Undergraduate Nursing Students: Evaluation Of Changing Minds, Changing Lives, Rebecca Liljestrand
Building Resilience In Undergraduate Nursing Students: Evaluation Of Changing Minds, Changing Lives, Rebecca Liljestrand
Doctor of Nursing Practice (DNP) Projects
Background: Undergraduate nursing students report experiencing high levels of stress, which may negatively affect academic, personal, and professional outcomes. Resilience has been found to mitigate the effects of high, prolonged stress. Specifically, nursing students who engaged in a program to enhance resilience had positive outcomes related to themselves, others, and their nursing program.
Purpose: The purpose of this project was to implement and evaluate the feasibility, acceptability, and value of an evidence-based resilience program, Changing Minds, Changing Lives, designed to reduce nursing student stress levels by building resilience and increasing use of positive coping strategies.
Methods: Junior baccalaureate nursing …
Initiating Standardized And Structured Handoff For Nurses In The Outpatient Setting, Keri Wagner
Initiating Standardized And Structured Handoff For Nurses In The Outpatient Setting, Keri Wagner
Doctor of Nursing Practice (DNP) Projects
Background: Handoff is the transfer and acceptance of patient care responsibility achieved through effective communication. Patient-specific information moves from one caregiver to another, to ensure continuity and safety. Ineffective handoffs negatively impact patient safety, patient and staff satisfaction, adverse events, missed care, and treatment delays.
Purpose: To decrease adverse events associated with ineffective handoff and improve nurse satisfaction by implementing a structured, electronic handoff process, inclusive of a standardized handoff report in an outpatient setting.
Methods: This quality improvement project implemented an evidence-based, electronic, structured, handoff process, utilizing situation-background-assessment-recommendation (SBAR). A pre-implementation survey was created to identify intra-organization patient …
Evaluating The Implementation Of A Wellness Initiative In An Independent Living Community, Pamela L. Hannon
Evaluating The Implementation Of A Wellness Initiative In An Independent Living Community, Pamela L. Hannon
Doctor of Nursing Practice (DNP) Projects
Background: An independent living community in New England is transforming their philosophical approach to wellness by implementing a new wellness initiative based on the Eight Dimensions of Wellness framework. Purpose: Using implementation science, we evaluated the process of implementing the Eight Dimensions of Wellness. Methods: A Pre-Implementation Survey was given to residents prior to the implementation and Post-Intervention Interviews of residents and staff was planned post-implementation. The post-intervention phase was not completed due to the delay in implementation at the site related to COVID-19. The data analysis of the of the Pre-Implementation Surveys included Kendall’s tau and Kruskal-Wallis tests. …