Medicine and Health Sciences Commons^™

Parents’ Acute Illnesses, Hospitalizations, And Medication Changes During The Difficult First Year After Infant Or Child Nicu/Picu Death, Dorothy Brooten, Joanne M. Youngblut, Carmen Caicedo, Teresa Del Moral, G. Patricia Cantwell, Balagangadhar R. Totapally

JoAnne Youngblut

Infant/child death is described as a most stressful life event; however, there are few reports of effects on parent physical health during the first year after the death. The study's purpose is to examine the patterns of parent acute illnesses, hospitalizations, and medication changes over 1 to 13 months after neonatal intensive care unit (NICU) or pediatric intensive care unit (PICU) infant/child death in 3 racial/ethnic groups.

METHODS:

Secondary analyses were conducted with longitudinal data on parent health and functioning 1 to 13 months after infant/child NICU/PICU death. Parents (176 mothers, 73 fathers; 44% Hispanic, 35% black non-Hispanic, and 21% …

Lessons Learned From Testing The Quality Cost Model Of Advanced Practice Nursing (Apn) Transitional Care, Dorothy Brooten, Mary D. Naylor, Ruth York, Linda P. Brown, Barbara Hazard Munro, Andrea O. Hollingsworth, Susan M. Cohen, Steven Finkler, Janet Deatrick, Joanne M. Youngblut

JoAnne Youngblut

Purpose

To describe the development, testing, modification, and results of the Quality Cost Model of Advanced Practice Nurses (APNs) Transitional Care on patient outcomes and health care costs in the United States over 22 years, and to delineate what has been learned for nursing education, practice, and further research.

Organizing Construct

The Quality Cost Model of APN Transitional Care.

Methods

Review of published results of seven randomized clinical trials with very low birth-weight (VLBW) infants; women with unplanned cesarean births, high risk pregnancies, and hysterectomy surgery; elders with cardiac medical and surgical diagnoses and common diagnostic related groups (DRGs); and …

Infant And Child Deaths: Parent Concerns About Subsequent Pregnancies, Dorothy Brooten, Joanne M. Youngblut, Jean Hannan, Carmen Caicedo, Rosa M. Roche, Fatima Malkawi

JoAnne Youngblut

Purpose—examine parents' concerns about subsequent pregnancies after experiencing an infant or child death (newborn to 18 years). Data Sources—39 semi-structured parent (White, Black, Hispanic) interviews 7 and 13 months post infant/child death conducted in English and/or Spanish, audio-recorded, transcribed and content analyzed. Mothers' mean age was 31.8 years, fathers' was 39 years; 11 parents were White, 16 Black, 12 Hispanic. Conclusions—Themes common at 7 and 13 months: wanting more children; fear, anxiety, scared; praying to God/God's will; thinking about/keeping the infant's/child's memory and at 7 months importance of becoming pregnant for family members; and at 13 months happy about a …

High-Risk Pregnancy: Postpartum Rehospitalization, Margaret S. Hamilton, Dorothy Brooten, Joanne M. Youngblut

JoAnne Youngblut

OBJECTIVE

Examine frequency, timing, and reasons for maternal postpartum rehospitalizations and acute care visits 1 year postpartum after a high - risk pregnancy.

STUDY DESIGN

Secondary analysis of data collected during a randomized clinical trial of advanced practice nurses giving transitional care for women with high - risk pregnancies. The 171 women were primarily African American, never married, Medicaid eligible, diagnosed with pregestational diabetes (20), gestational diabetes (23), either diagnosed (48) or at risk (44) for preterm labor, and chronic hypertension (36).

RESULTS

Of the total rehospitalizations (17%) and acute care visits (32%), over one third occurred in the first …

Editorial: Parent, Grandparent, And Sibling Responses To The Death Of An Infant Or Child In Intensive Care, Joanne M. Youngblut, Juanjuan Li

JoAnne Youngblut

The death of a child is a devastating event for most parents and other family members1. However, responses to a child’s death vary by culture, generation, and often the age of the deceased child. For the Chinese, child death is a “bad death” and brings shame to the family2. Filipino parents of a deceased child feel severe guilt after their loss3. In some Caribbean cultures young mothers are prevented from attending the child’s funeral or going to the cemetery by women in the previous generation in the belief that if you “take one to …

Health And Functioning In Grandparents After A Young Grandchild’S Death, Joanne M. Youngblut, Dorothy Brooten, Kathleen Blais, Colleen Kilgore, Changwon Yoo

JoAnne Youngblut

This cross-sectional study examined the physical and mental health, grief and role functioning of 136 grandparents in the first year after death of their young grandchild (newborn through 6 years). Grandparents were 36–77 years old; 73 % female; 24 % Hispanic, 38 % Black/African American, and 38 % White. Mean age of the 115 deceased grandchildren was 12.8 months (SD = 20.71) with 37 %\1 month old; 65 % were male, 77 % died in the hospital. Grandparents were recruited through state death records and interviewed by telephone. Grandparents experienced: clinical depression (31 %), PTSD (35 %); illnesses (28 %), …

Grandparent Health & Functioning After A Grandchild’S Death, Joanne M. Youngblut, Dorothy Brooten, Kathleen Blais, Jean Hanna, Theophile Niyonsenga

JoAnne Youngblut

Approximately 160,000 grandparents experience the death of a grandchild each year; this represents a permanent, irrevocable loss for the grandparent resulting in physical and emotional responses. Grandparents who lose a grandchild experience increased alcohol and drug use, thoughts of suicide, and pain for their adult child who is also grieving. Supportive resources available to grieving grandparents, the effects of the grandchild’s death on the grandparent-parent relationship and the influence of race/ethnicity on grandparent grieving are discussed. Despite about 40,000 child and infant deaths each year, knowledge about grandparent health and functioning following the death of a grandchild is limited.

Effects Of Maternal Employment And Prematurity On Child Outcomes In Single Parent Families, Joanne M. Youngblut, Dorothy Brooten, Lynn T. Singer, Theresa Standing, Haejung Lee, Willard L. Rodgers

JoAnne Youngblut

Background

Effects of maternal employment for preschool children vary based on specific characteristics of the mother’s employment, the family’s economic status, and the mother’s attitudes about employment. However, there is limited research on a growing group of children at developmental risk—those born prematurely and living in a single-parent family.

Objective

To examine the effects of maternal employment and prematurity on child cognition and behavior in single-parent families.

Methods

Sixty preterm and 61 full-term preschool children were recruited through NICU admission records and birth records. Data were collected with the Kaufmann Assessment Battery for Children, Peabody Picture Vocabulary Test, Child Behavior …

Health Problems And Apn Interventions In Pregnant Women With Diabetes, Dorothy Brooten, Joanne M. Youngblut, Jean Hannan, Frank Guido-Sanz, Donna Felber, Wannee Deoisres

JoAnne Youngblut

The purpose of this study was to compare health problems and advanced practice nursing (APN) interventions in two types of APN care provided to 41 childbearing women with diabetes. The study’s design involved content analysis of interaction logs containing the process of APN care during two clinical trials: 1) APN care was added to physician care (n = 22); and, 2) half of physician care was substituted with APN care (n = 19). Women’s’ health problems and APN interventions were classified using the Omaha System’s Problem Scheme and Intervention Scheme. The women, in the study, had a mean age of …

Death Rituals Reported By White, Black, And Hispanic Parents Following The Icu Death Of An Infant Or Child, Dorothy Brooten, Joanne M. Youngblut, Donna Charles, Rosa M. Roche, Ivette Hidalgo, Fatima Malkawi

JoAnne Youngblut

Purpose

To examine rituals (disposing remains, wakes, funerals/burials, celebrations) of White, Black, Hispanic parents post ICU infant/child death.

Design and methods

Qualitative design, 63 parents completed English or Spanish semi-structured interviews at 7 & 13 months after infant’s/child’s death. Interviews were audio-recorded, transcribed verbatim, and entered into Atlas.ti for analysis. An inductive approach to thematization was used to develop codes.

Results

Parents: mean age 35.1 years (SD = 9.03); 33% Black, 27% White, 40% Hispanic; from 17 countries. Three themes emerged: immediately after death - shock and stress, needing help with arrangements, decisions on burial or cremation (conflicts due to …

Apn-Physician Collaboration In Caring For Women With High-Risk Pregnancies, Dorothy Brooten, Joanne M. Youngblut, Kathleen Blais, Deborah Donahue, Ivette Cruz, Michelle Lightbourne

JoAnne Youngblut

Purpose

To examine: (a) frequency and focus of APN-physician collaborations in a clinical trial in which half of physician prenatal care for women with high-risk pregnancies was substituted with APN prenatal care delivered in women’s homes; and (b) characteristics of women requiring greater numbers of collaborations.

Design and Methods

Descriptive study with secondary analysis of data from 83 of the original trial’s 85 intervention participants followed by APNs prenatally through 8 weeks postpartum. APN practices, recorded in logs, included APN interactions with the women and the physician, and type of APN contact (e.g., home visit, telephone call). Each APN-physician collaboration …

Child Care Use By Low-Income Single Mothers Of Preschoolers Born Preterm Versus Those Of Preschoolers Born Full Term, Joanne M. Youngblut, Dorothy Brooten, Sandra L. Lobar, Laura Hernandez, Mary Mckenry

JoAnne Youngblut

This study describes prewelfare reform child care use by 64 primarily low-income single mothers (65.6% African American) with preschoolers (half born preterm). Forty percent used child care for more than 75% of their children's lives, 20% did when not employed. Preschool children born preterm were more likely to receive child care from nonrelatives throughout their lives than children born full term. Children with health problems used a greater number of child care arrangements. Findings suggest addressing child care issues with both employed and nonemployed mothers and adequacy of child care for children with special needs.

A Comparison Of Maternal Attachment Between American Adolescent And Adult Mothers Of Preschoolers, Ratchaneewan Ross, Joanne M. Youngblut

JoAnne Youngblut

American adolescent mothers have been viewed as less effective parents than adult mothers. The socioeconomic disadvantages of adolescent mothers should be taken into account. The objectives of this study were to compare maternal attachment between adolescent and adult mothers of preschoolers and to examine changes of adolescents’ maternal attachment over time. A secondary analysis of data from a larger study of maternal employment and low birth weight infant outcomes were used. Data were collected through home visits using structured questionnaires at two different time points. Forty-three pairs of adolescent and adult mothers who could be matched on family structure, maternal …

Adolescents’ Experiences 7 And 13 Months Following The Death Of A Brother Or Sister, Dorothy Brooten, Joanne M. Youngblut, Rosa M. Roche

JoAnne Youngblut

This qualitative study used semi-structured interviews to describe adolescents’ responses at 7 and 13 months to siblings’ NICU/PICU/ED death. At 7 months, adolescents were asked about events around the sibling’s death; at 7 and 13 months, about concerns/fears, feelings, and life changes. Seventeen adolescents participated (13-18 years; M=15); 65% Black, 24% Hispanic, 11% White. Themes included death circumstances, burial events, thinking about the deceased sibling, fears, and life changes. Adolescents reported shock and disbelief that the sibling died; 80% knew the reason for the death; many had difficulty getting through burials; all thought about the sibling. From 7 - 13 …

Comparison Of Mothers And Grandmothers Physical And Mental Health And Functioning Within 6 Months After Child Nicu/Picu Death, Joanne M. Youngblut, Dorothy Brooten

JoAnne Youngblut

Background

Losing a child is devastating for parents and grandparents. Family and friends generally focus on comforting and supporting the bereaved parents, unintentionally ignoring the bereaved grandparents. Grandmothers and grandfathers often struggle with wanting to help their adult children (deceased child’s parents) without usurping the parents’ responsibilities and decisions regarding the deceased child. Research on mothers’ and grandmothers’ health at about the same time after the same child’s death in the neonatal or pediatric intensive care unit is lacking. The aim of this study was to compare mothers and grandmothers on physical health, mental health, and functioning in the first …

Comparing Mothers' Postpartum Concerns In 2 Clinical Trials 18 Years Apart, Jean Hannan, Dorothy Brooten, Joanne M. Youngblut, Ali Marie Galindo

JoAnne Youngblut

Background/purpose

To determine if US women's postpartum concerns have changed overtime.

Methods

Mothers' postpartum concerns were compared in 2 clinical trials: 1997 (High Risk Pregnancy); 2015 (First Time Mothers). Advanced Practice Nurses (APNs) provided care through 8 weeks postpartum and recorded interactions in clinical logs. Content analysis of logs was used to identify concerns.

Results

95% of 58 1997 mothers were African American; 64% of 62 2015 mothers were Hispanic. Number of infant concerns (129 vs 144) was similar as were 4 of top 5; infant feeding was the top concern for both. 1997 mothers were concerned with body changes, …

Mengenal Manfaat Melakukan Sunat.Docx, Klinik Sentosa

Klinik Sentosa

An Emergency Department Staff Tackles The Healthy Workplace Initiative : A Staff Nurse Perspective., Paul R. Clark

Paul Clark

This article describes the Healthy Workplace Initiative in the adult emergency department from the staff nurse perspective. Examples of one action planning team's processes and outcomes are delineated. The Rapid Diagnostics action planning team is delineated as lived while caring for patients in today's high-pressure emergency department. The Healthy Workplace Initiative empowers staff, with the guidance of facilitators, to make changes that improve the workplace and to create a healthy workplace for staff and patients. The result is greater staff ownership of the emergency department which leads to greater job satisfaction and improved patient care.

Assessment In The Interpersonal Domain: Experiences From Empathy Assessment In Medical Education, Neville Chiavaroli

Neville Chiavaroli

Frameworks for the teaching and assessment of 21st-century skills commonly recognise the importance of learning and skill development in the interpersonal domain. They also usually acknowledge the challenge of reliably and validly assessing students in this domain. In the field of medical education and in selecting students for medical courses, the concept of empathy has become central to representing the particular interpersonal understandings and skills expected of students and practising doctors. Attempts to assess these attributes during medical training are just as challenging as in school contexts. This presentation draws on several years’ experience of working with medical educators to …

Obat Ambeien Berdarah Untuk Ibu Menyusui, Arfa Herbal

Arfa Herbal

Ceres Community Feeding Program, Erica Gomez

Erica Gomez

Sunat Dengan Laser Untuk Dewasa, Amankah.Docx, Klinik Sentosa

Klinik Sentosa

Cd21 And Cd24 Co-Expression: A Translational Model Between Mouse And Human, Abigail Benitez

Abigail Benitez, PhD

Systemic Lupus Erythematosus and Rheumatoid Arthritis are B cell-mediated autoimmune diseases that afflict millions of people worldwide. B cell-targeted therapies for these diseases result in variable clinical outcomes. Thus, a need exists to better understand the dynamics of human B cell production and function. The mouse model has provided a foundation for understanding the mechanisms involved in human B cell development and autoimmune disease. However, differences in mouse and human B cells are not fully understood. Our work shows that the co-expression of CD21 and CD24, determined by 7-color flow cytometry, can be used to demarcate developmental subsets of B …

N6810 19 Hillmarissa Poster.Pdf, Marissa Hill

Marissa Hill

Angiotensin Ii Type I Receptor Agonistic Autoantibodies Are Associated With Poor Allograft Survival In Liver Retransplantation., Qingyong Xu, Vivian C. Mcalister, Steve Leckie, Anton Skaro, Paul Marotta

Vivian C. McAlister

Factors Affecting The Quality Of Services Provided To Female Survivors Of Sexual Violence In Nairobi, Kenya: Perspectives From Health Practitioners, Leso Munala

Leso Munala

This study examined the experiences of practitioners facing the challenges of providing services to female survivors of sexual violence in Kenya. Specifically, the study examined how health practitioners understand their experience in responding to the needs of sexual violence survivors, how they view these women, in what ways they are helping them to heal, and in what ways the health system fails to help these women. In-depth interviews were conducted with 28 health practitioners, from eight post-rape care facilities located in Nairobi, Kenya. The questions focused on the practitioners’ workload, challenges and rewards, the emotional impact of working with survivors, …

Essay Review: Blood Work: Menstrual Cycle Scholarship Comes Of Age, Camilla Mørk Røstvik

Chris Bobel

No abstract provided.

Smoking And Cancer, Cardiovascular And Total Mortality Among Older Adults: The Finrisk Study, Noel C. Barengo, Riitta Antikainen, Kennet Harald, Pekka Jousilahti

Noel Barengo

Little information is available about the deleterious effect of smoking in older adults The objective of this study was to assess the relationship of smoking habitswith cancer, CVD and all-cause mortality in late middle-age (45–64 years) and older (65–74) people. This cohort study of 6516 men and 6514 women studied the relationship of smoking habits with cancer, cardiovascular disease (CVD) and all-cause mortality among middle-aged and older Finnish men and women during 1997–2013. The study cohort was followed up until the end of 2013 (median follow-up time was 11.8 years). Mortality data were obtained from the National Causes of …

Cognitive Dysfunction In Naturally Occurring Canine Idiopathic Epilepsy, Rowena M.A. Packer, Paul D. Mcgreevy, Hannah Salvin, Michael Valenzuela, Chloe M. Chaplin, Holger A. Volk

Paul McGreevy, PhD

Globally, epilepsy is a common serious brain disorder. In addition to seizure activity, epilepsy is associated with cognitive impairments including static cognitive impairments present at onset, progressive seizure-induced impairments and co-morbid dementia. Epilepsy occurs naturally in domestic dogs but its impact on canine cognition has yet to be studied, despite canine cognitive dysfunction (CCD) recognised as a spontaneous model of dementia. Here we use data from a psychometrically validated tool, the canine cognitive dysfunction rating (CCDR) scale, to compare cognitive dysfunction in dogs diagnosed with idiopathic epilepsy (IE) with controls while accounting for age. An online cross-sectional study resulted in …

Shining A Humanistic Light On Racism.Docx

Carroy U "Cuf" Ferguson, Ph.D.