Education Commons^™

Institutional Outcomes Of Blunt Liver & Splenic Injury In The Atomac Era, Shai Stewart Md, James Fraser, Rebecca M. Rentea, Pablo Aguayo, David Juang, Jason D. Fraser, Charles L. Snyder, Richard J. Hendrickson, Shawn D. St.Peter, Tolulope A. Oyetunji

Research Days

Background: The Arizona-Texas-Oklahoma-Memphis-Arkansas Consortium (ATOMAC) practice management guideline (PMG) was created to standardize management of blunt liver or spleen injury (BLSI) across pediatric trauma centers. Evaluations of institutional outcomes after its adoption remain scarce. We describe our outcomes since PMG adoption at our institution.

Objectives/Goal: The purpose of this study was to assess patient outcomes and resource utilization after implementation of this protocol. We hypothesized there is no difference in length of stay (LOS) or complications regardless of grade of isolated injuries to the liver or spleen. In addition, there is limited guidance on the management of concurrent injuries to …

Du Undergraduate Showcase: Research, Scholarship, And Creative Works, Caitlyn Aldersea, Justin Bravo, Sam Allen, Anna Block, Connor Block, Emma Buechler, Maria De Los Angeles Bustillos, Arianna Carlson, William Christensen, Olivia Kachulis, Noah Craver, Kate Dillon, Muskan Fatima, Angel Fernandes, Emma Finch, Colleen Cassidy, Amy Fishman, Andrea Francis, Stacia Fritz, Simran Gill, Emma Gries, Rylie Hansen, Shannon Powers, Jacqueline Martinez, Zachary Harker, Ashley Hasty, Mykaela Tanino-Springsteen, Kathleen Hopps, Adelaide Kerenick, Colin Kleckner, Ci Koehring, Elijah Kruger, Braden Krumholz, Maddie Leake, Lyneé Alves, Seraphina Loukas, Yatzari Lozano Vazquez, Haley Maki, Emily Martinez, Sierra Mckinney, Mykaela Tanino-Springsteen, Audrey Mitchell, Kipling Newman, Audrey Ng, Megan Lucyshyn, Andrew Nguyen, Stevie Ostman, Casandra Pearson, Alexandra Penney, Julia Gielczynski, Tyler Ball, Anna Rini, Christina Rorres, Simon Ruland, Helayna Schafer, Emma Sellers, Sarah Schuller, Claire Shaver, Kevin Summers, Isabella Shaw, Madison Sinar, Claudia Pena, Apshara Siwakoti, Carter Sorensen, Madi Sousa, Anna Sparling, Alexandra Revier, Brandon Thierry, Dylan Tyree, Maggie Williams, Lauren Wols

DU Undergraduate Research Journal Archive

DU Undergraduate Showcase: Research, Scholarship, and Creative Works

Physical Activity In Managing Stress Among Managers During The Covid-19 Pandemic – A Systematic Review, Anna Hryniewicz, Anna Gmiąt, Magdalena Jaroch-Lidzbarska, Mariusz Lipowski

Baltic Journal of Health and Physical Activity

Introduction: During the COVID-19 pandemic managers experienced additional stress connected with taking responsibility for workers at the time of a worldwide crisis. Maintaining a high level of physical activity in this specific group possibly could have contributed to keeping both management skills and health condition at a high required standard. The purpose of this review is to verify the range of scientific interest on the subject of physical activity among managers as a stress coping strategy during the pandemic. Materials and Methods: For this systematic review six studies were chosen (two of them are qualitative descriptive, three are cross-sectional, one …

A Comparison Of Large Tbsa Scald Versus Flame Burns In Young Children, Ashley Daniel

Research Days

Background: It is generally accepted that of children with the same total body surface area of burns, those with flame burns seem to have longer lengths of stay and more complications than those with scald burns. Anecdotally we have seen the opposite to be true. Among a consortium of five US pediatric burn centers participating in the Pediatric Injury Quality Improvement Collaborative (PIQIC), young children with scald burns seem to experience disproportionately more frequent and severe complications compared to their older counterparts and compared to patients of a similar age with flame burns.

Objectives/Goal: In this multi-institutional study, we compared …

Relationship Between Rurality And Access To Care For Families Of Hospitalized Children, Zoetta L. Mcloughlin Md

Research Days

Background: At Children’s Mercy Hospital, greater than 1 in 5 hospitalized children are from rural areas. Rural families often travel long distances for hospitalization at free-standing children’s hospitals, a median of 70 miles according to recent work. Rural families are more likely than non-rural families to experience financial insecurity, and these baseline hardships may be intensified during hospitalization due to out-of-pocket costs, lost work, inability to meet family needs, and removal from social support. However, little is known about the differences in healthcare access and resulting burdens between rural and non-rural families.

Objectives/Goal: To describe differences in demographics, health care …

Rural And Urban Caregiver Experiences Of Financial Strain And Food Insecurity During Pediatric Hospitalizations, Rachel E. Granberg

Research Days

Background: Stress is common among caregivers of hospitalized children. In addition to stress related to their child’s illness, caregivers experience stress related to financial strain and food insecurity during their child’s hospitalization. The burden of financial strain and food insecurity related to pediatric hospitalizations may vary between rural and urban populations.

Objectives/Goal: To identify financial strain and food insecurity experienced by caregivers of hospitalized children and to describe differences between rural and urban populations.

Methods/Design: A prospective cross-sectional survey enrolled a random sample of caregivers of hospitalized children between 8/31/2021 and 12/2/2022 at a single children’s hospital. Demographic information was …

Female Authorship Concordance In Academic Pediatrics, Roxana Guggenmous, Jessica L. Bettenhausen, Jessica L. Markham

Research Days

Background: Gender disparities are well described in medicine and academia. Despite a catalyzed movement towards gender equity, female physician-scientists remain at risk for experiencing biases in hiring practices, compensation, promotion, appointment to leadership positions, and achievement of extramural funding through the National Institutes of Health. In pediatrics, the female workforce has grown consistently over time, with female physicians comprising 72.3% of the workforce as of 2021, yet prior work suggests that this growth is not fully reflected in academic publications. Achieving gender parity in academic publication may help reduce gender-based disparities impacting career advancement. Therefore, we sought to describe the …

Supporting Families Impacted By Adverse Childhood Experiences (Aces), Jennifer Paumen, Laura Plencner, Jacqueline Kitchen

Research Days

Background: Adverse childhood experiences (ACEs) impact a majority of individuals, with approximately two-thirds of adults having experienced 1 or more ACE.1 The health consequences of ACEs are significant, including cardiovascular disease, cancer, autoimmune diseases, and mental illnesses.1 These health impacts can even start as early as childhood, leading to an increased risk of learning and behavioral concerns.2,3 Recent evidence has also identified the impact that parental ACEs may have on parenting and child development,4,5,6 which in turn may lead to an intergenerational transmission of ACEs.4,7 As a nurturing caregiver relationship is key for buffering adversity,2,8 it is imperative to address …

Socioeconomic Factors And Picu Interventions In High Mortality Risk Asthmatics, Hanh Ho, Paul N. Bauer, Jade B. Tam-Williams

Research Days

Background: Asthma mortality rates are overall lower in children, but studies estimate 5-10% of asthmatics have refractory mortality prone asthma. Asthmatics with repeat pediatric intensive care unit (PICU) admissions are believed to be at high mortality risk with increased health care utilization and socio-economic challenges.

Objectives/Goal: We aim to identify patients with repeat PICU admissions for status asthmaticus and characterize the levels of interventions and socio-economic status.

Methods: A retrospective chart review was done on patients with the following inclusion criteria: age 0- 18, PICU admission between January 2010 to December 2015, and a diagnosis of status asthmaticus on admission. …

Pediatric Educational Outreach To A Community Based Emergency Department: Clinical Management Of The Febrile Infant, Jess Parker, Frances Turcotte Benedict, Emily Hillman, Ryan C. Jacobsen, Ashley K. Sherman, Arjun Sarin

Research Days

Background: Multiple studies have shown variability in the approach to treatment of febrile infants ≤ 60 days of age in community emergency departments (EDs), and the American Academy of Pediatrics (AAP) recently published new guidelines on management of febrile infants. Therefore, an opportunity exists to provide evidence-based recommendations for the care of this patient population to providers in community EDs.

Objectives/Goal: To assess 1) alignment of community ED provider practices with an AAPinformed Clinical practice guideline (CPG) for management of febrile infants ≤ 60 days of age. 2) change in comfort level and degree of alignment after targeted education.

Methods/Design: …

Occupational Therapy's Role In Mealtime Participation In Schools, Jaidee Mae Reyes, Karen Park

Spring 2023 Virtual OTD Capstone Symposium

A mixed-methods research design was utilized to explore the role of occupational therapy in mealtime participation in school-based settings. Interviews and surveys were completed to understand occupational therapy practicers' perceptions, attitudes, and experiences with providing services related to mealtime. The themes that emerged from the study including (a) occupational therapy practitioners experience inhibiting and supporting contextual factors that affect their involvement in mealtime, (b) admin and occupational therapy culture and the interpretation of educational relevance can differ between each school, and (c) occupational therapy practitioners go through a decision-making process when deciding to address mealtime.

Influencing Influenza Immunization: Qi Project In A Pediatric Resident Continuity Clinic, Brittany Moore

Research Days

Problem Statement/Question: There have been a multitude of approaches to vaccine hesitancy in regard to childhood vaccinations. In light of the COVID-19 pandemic there was a noticeable decline in influenza vaccination among children aged 6 months to 18 years. The influenza vaccination rate in the pediatric resident continuity clinic at Children’s Mercy Hospital was below the national average for pediatric patients.

Background/Project Intent (Aim Statement): The aim of this study is to increase the percentage of patients aged 6 month and older currently enrolled in ROYAL clinic receiving at least one influenza vaccine from 38.6% to 55% by January 1, …

Increasing Utilization Of Gestational Age Based Table For Initial Intubation In A Level Iv Neonatal Intensive Care Unit, Maribel Martinez, Dianne Lee, Christopher R. Nitkin

Research Days

Problem Statement/Question: Most providers in our unit are not using the NRP recommended method to determine the initial ETT insertion depth in neonates.

Background/Project Intent (Aim Statement): Endotracheal tube (ETT) depth in neonates is of critical importance due to significant adverse events when malpositioned. While randomized trials comparing different methods have not shown superiority of any particular method, the weight-based method (weight (kg) +6) has been found to be highly inaccurate in extremely low birth weight neonates. Furthermore, the Neonatal Resuscitation Program (NRP) recommends using gestational age (GA)-based table (Kempley ST, et al, Resuscitation 2008) or nasal-tragal length for initial …

Hypereosinophilia With An Anterior Mediastinal Mass, Sonya Parashar, Aarti Pandya

Research Days

Background: Hypereosinophilia is defined as 1500 eosinophils/mL or above with evidence of end-organ damage due to the eosinophils at least 4 weeks apart.

Objectives/Goal: We describe a case of steroid resistant hypereosinophilia.

Methods/Design: A 3-year-old male was admitted for newly found anterior mediastinal mass and left pleural effusion. About 6 weeks prior to admission, he was seen in his primary care office for difficulty breathing. Despite the appropriate treatment for his symptoms, the patient continued to have significant respiratory symptoms and a chest x-ray showed a large left pleural effusion. He was immediately transferred to a tertiary care center and …

Improving Fluid Management Of Extreme Premature Infants By Providing A Restrictive Fluid Management Algorithm In The Nicu, Jacob S. Ward, Dena Hubbard, Nicholas Clark

Research Days

Problem Statement/Question: At our institution we found wide variability in and a lack of an evidence-based standard for fluid management in premature infants.

Background/Project Intent (Aim Statement): Excessive fluid intake in premature infants during the first week of life increases the risk of adverse events and overall mortality. Fluid restriction is recommended to help decrease morbidity and mortality in this patient population. We aimed to improve the fluid management of premature infants born < 29 weeks gestation admitted to our intensive care nursery (ICN) by implementing a fluid restriction protocol with the goal of >70% compliance over a 16-month period.

Methods (include PDSA cycles): Institution of daily weights started at beginning of baseline period. In April of 2021, we implemented a …

Unique Endoscopic Retrieval Of A Large Rectal Foreign Body, Laurie Mccann, Jose Cocjin

Research Days

Introduction: Large rectal foreign bodies are usually difficult to extract, usually requiring operative management.

Case: A 14-year-old male presented to the ER for a rectal foreign body. Earlier in the day, he had rectal itching and inflammation. He used a cylindrical reusable ice stick (for water bottles) for topical relief, which did not work, so he placed the tube in his rectum, then he was unable to retrieve it and sought medical help. Physical exam was significant for lower abdominal pain and palpable mass just below his umbilicus, which was painful to palpate. CT abdomen/pelvis showed a large foreign body …

Bone Marrow Transplant For Macrophage Activation Syndrome In Systemic Juvenile Idiopathic Arthritis, Shailly Gaur, Michael J. Holland, J Allyson Hays, Ibrahim A. Ahmed

Research Days

Background

The recognition of macrophage-activation-syndrome (MAS) in the setting of systemic-juvenileidiopathic-arthritis (sJIA) is complex, but a necessary distinction given emerging treatment options. With overlapping clinical manifestations including fever, end-organ involvement and lymphadenopathy, there is a focus on laboratory values to differentiate MAS from a sJIA flare. Once parameters are met, multiple treatment modalities can be considered, as monotherapy or in combination, including steroids, immunosuppression, chemotherapy, intravenous immunoglobulin, and cytokine-directed biologics. Given the long-term morbidity and mortality associated with progressive inflammation and immune dysregulation due to MAS with sJIA, it is imperative to regain control over this complication. However, these treatments …

Improving Frequency Of Peer Review Of Abnormal Genital Exam Findings In Patients Undergoing Sexual Abuse Evaluation, Lyndsey Hultman, Julia G. Harris, Terra N. Frazier, Jennifer B. Hansen

Research Days

Problem Statement/Question: Child Advocacy Centers (CACs) coordinate child abuse MDTs, and 2023 CAC accreditation standards require that “all medical professionals providing services to CAC clients must demonstrate that 100% of all findings deemed abnormal or “diagnostic” of trauma from sexual abuse have undergone expert review by an advanced medical consultant.” Scheduled Case Review occurs among Children’s Mercy child abuse pediatricians (CAPs), but current practice is to review cases only upon CAP request.

Background/Project Intent (Aim Statement): Appropriate interpretation of sexual abuse exam findings is crucial for accurate diagnosis and provision of medical information to multidisciplinary child protection teams (MDTs). Medical …

Multilingualism And Augmentative Alternative Communication: A Review Of The Literature, Hannah N. Lamarca, Natalie R. Andzik

Honors Capstones

Purpose: Individuals from culturally and linguistically diverse backgrounds who use Alternative and Augmentative Communication (AAC) are often offered English-only AAC systems that do not meet their language needs. Devices that host multiple languages often only offer one at a time.

Method: The authors reviewed the literature by searching relevant databases using a variety of search strings. Following our inclusionary and exclusionary criteria, 15 articles were yielded for analysis.

Results: Authors found that more than half of the included articles were discussion-based papers on AAC delivery, barriers to AAC and multilingualism, and codeswitching using AAC. The included interview studies aimed to …

Implementation Of A Nurse-Led Clinical Algorithm For Pressure Injury Prevention Associated With Non-Invasive Ventilation Medical Device Use, Capri Steinkuhler, Kaitlin Rogge

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Medical device related pressure injuries (PI) account for as much as 61-81% of all hospital reported wound incidents (Gefen et al., 2020) and are frequently caused by respiratory devices such as non-invasive ventilation (NIV). Use of NIV in critically ill patients dramatically increased during the pandemic. PI are one of the leading causes of injury to hospitalized patients and lengthens hospital stays (National Pressure Injury Advisory Panel [NPIAP], 2019). The NPIAP recommends routine skin assessment under devices, proper mask fit, protective barrier, moisture reduction, and interdisciplinary collaboration to prevent PIs from NIV masks. This feasibility study’s purpose …

School Psychologists’ Knowledge And Perceived Competence Regarding Concussion Management In Schools, Braelyn Tracy

Electronic Theses and Dissertations

A concussion is a type of traumatic brain injury that can have a serious effect on a young, developing brain. Following a concussion, it is common for children and adolescents to experience difficulties in the school setting. Schools may be the ideal setting to address some of the problems children experience as schools employ some personnel with expertise and experience in assessment and intervention. If return to learn is put to the side, students experiencing concussion signs and symptoms could potentially have long-term cognitive problems. School psychologists play a key role in the prevention and assessment of, and intervention for …

The Effects Of Peers For Young Adults On Anxiety And Quality Of Life For Young Adults With Autism Spectrum Disorder, Alysha Cecile Dagg

Electronic Theses and Dissertations

Social skills deficits as well as comorbid anxiety are two characteristics commonly experienced by people with Autism Spectrum Disorder - Level 1 (ASD-1; American Psychiatric Association, 2013). These characteristics are also both contributors to a lower quality of life for young adults (Smith et al., 2019). The current study aimed to identify how the quality of life and anxiety are affected by social skills intervention, specifically the PEERS® for Young Adults program (Laugeson, 2017). PEERS® for Young Adults is an evidence-based social skills intervention intended to support individuals with ASD-1 (Laugeson, 2017). Prior research has demonstrated its success in both …

Expansion Of Heart Failure Education From Hospital To Clinic, Abigail M. Fischer

Doctor of Nursing Practice Projects

Heart failure education is vital to the long-term management of this condition. Education recommendations for heart failure are given by the American Heart Association (AHA) and the American College of Cardiology (ACC). Recommendations include verbal instruction and written materials regarding the patient’s medication plan, recognition of symptoms, what to do when symptoms occur, and the importance of daily weights.

This project aimed to provide outpatient clinic providers and staff with resources and education necessary to educate heart failure patients. The project expanded use of an inpatient heart failure education packet for outpatient use. This was accomplished by conducting educational sessions …

Development Of Neuraxial Anesthesia Educational Videos For Nurse Anesthesia Students, Mackenzie Schutt, Kaylie Lajeunesse

Doctor of Nursing Practice Projects

Development of Neuraxial Anesthesia Educational Videos for Nurse Anesthesia Students

Kaylie LaJeunesse, BSN, RN, SRNA & Mackenzie Schutt, BSN, RN, SRNA

Performance and evaluation of anesthetic procedures, specifically neuraxial anesthesia, are core components of nurse anesthesia curriculums. Teaching methods must provide nurse anesthesia students with the proper tools and knowledge to perform skills confidently and proficiently. Traditional teaching methods have fallen short of providing the necessary instruction for optimal student success. Incorporating video-learning resources on neuraxial anesthesia into course curriculums can significantly improve nurse anesthesia practice by better-preparing students for the clinical setting. Video learning increases student engagement and facilitates …

School Of Nursing Class Of 2023 Hooding And Pinning Program, Cedarville University

B.S.N. and M.S.N. Academic Celebrations

No abstract provided.

Utilizing The Anatomage Virtual Dissection Table For Learning Neuroanatomical Structures In Nurse Anesthesia Programs, Domenica Camaci-Douleh, Nicole Gorris

Doctor of Nursing Practice Projects

Certified registered nurse anesthetists are responsible for developing expertise in neuraxial anesthesia. A thorough understanding of anatomy and physiology is essential in the performance of subarachnoid and epidural blocks. Although cadaveric dissection is considered the gold standard for learning anatomy, student use of cadavers can become limited due to supervisory, ethical, accessibility, and financial constraints (Periya and Moro, 2019). In recent years, the evolution of technology has produced a virtual option for cadaver dissection (Washmuth et al., 2020). The anatomage virtual dissection table is a tool that could be used to increase knowledge of neuroanatomical structures and their spatial relationships …

How Art Therapy Can Be Used To Teach Queer Inclusive Sex Education To Queer Youth: A Literature Review, Olivia Souza

Expressive Therapies Capstone Theses

This literature review examines the potential of art-making as a tool to educate and inform queer youth about queer sexual experiences. Many queer individuals lack information about safe and healthy sex due to the exclusion of queer experiences in sex education programs. Current sex programs solely focus on abstinence and heterosexual experiences, leaving queer youth in the dark about what to expect from future sexual experiences they may have and how to practice safe queer sex. Through a search of the literature, it was discovered that there is a gap in research using art therapy in this specific context. Through …

Black Male Educator Shortage In The Mississippi Public School System: Impact, Challenges, And Intervention Strategies, Jilkiah Bryant

Honors Theses

The shortage of Black male educators in Mississippi's public school systems is a critical issue with far-reaching implications for the state's education system. Despite the state's sizable Black population, the percentage of Black male teachers remains disproportionately low, and there is little evidence of progress being made to address this issue. This paper examines the impact of the Black male educator shortage on Mississippi's education system, the challenges faced by Black male educators, and related intervention strategies to increase the number of Black male teachers in Mississippi's public school systems. Through a comprehensive literature review and interviews with Black male …

An Occupational Therapy Guide To Regulation And Resilience In The Classroom, Catherine Newton, Jazminne Orozco-Arteaga

Spring 2023 Virtual OTD Capstone Symposium

An occupational therapy educational program that focuses on increasing teachers' knowledge surrounding childhood trauma as well as promoting regulation and resilience in the classroom.

Improvements In Cardiac Auscultation Utilizing Multisensory Learning In Medical Students: A Preliminary Study, Harrison Patrizio, Riley Phyu, Bum Kim, Nils V. Brolis

Rowan-Virtua Research Day

Objective: To explore interweaving visual, auditory, and tactical stimulus into traditional education methods to improve cardiac auscultation teaching outcomes.

Methods: A pilot randomized controlled trial was conducted at our institution’s simulation center with 32 first year medical students from a single medical institution. Participants were randomly divided into two groups, and completed an educational module on identifying and understanding the pathophysiology of five common cardiac sounds. Participants in the control group (n=16) utilized traditional education methods, while the interventional group (n=16) incorporated visual, auditory, and tactical stimuli. Afterwards, participants listened to randomly selected cardiac sounds and competency data was collected …