Medicine and Health Sciences Commons^™

Health Literacy And Its Association With Human Papilloma Virus Vaccination Among Adults: Findings From The Behavioral Risk Factor Surveillance System, Vinodh Bhoopathi, Bhagavatula Pradeep, Maharaj Singh

College of Nursing Faculty Research and Publications

Health literacy is associated with the utilization of preventive health services. We examined the association between health literacy (HL) levels and receipt of at least one dose of the human papilloma virus (HPV) vaccination. We analyzed the data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) among adults aged 18 to 32. The primary outcome variable was the ‘yes/no’ response to the question that assessed whether the participant received at least the first dose of HPV vaccination. The primary independent variable was a summative HL score (range 3 through 12) we created for each respondent by adding the scores …

The Association Of Preoperative Frailty And Neighborhood-Level Disadvantage With Outcome In Patients With Newly Diagnosed High Grade Glioma, Pranav Mirpuri, Maharaj Singh, Richard Rovin

College of Nursing Faculty Research and Publications

Objective

Individual patient and socioeconomic factors are underexplored prognostic factors for glioblastoma (GBM). Frailty, a measure of physiological vulnerability, and area deprivation, a measure of socioeconomic status, are easily obtained during the preoperative evaluation. These metrics are predictors of outcome and access to treatments for other cancers. Therefore, we sought to determine the association of frailty and neighborhood disadvantage with outcomes of patients with newly diagnosed GBM.

Methods

This was a retrospective review of newly diagnosed patients with GBM undergoing surgery from 2015 through 2020. The 5-factor modified frailty index and national area deprivation index were determined for each patient. …

Cerebral Venous Sinus Thrombosis Associated With Coronavirus Disease 2019: Case Report And Review Of The Literature, Kessarin Panichpisal, Ilana Ruff, Maharaj Singh, Massihullah Hamidi, Pedro D. Salinas, Kyle Swanson, Stephen Medlin, Sudeepta Dandapat, Payton Tepp, Genevieve Kuchinsky, Amy Pesch, Thomas Wolfe

College of Nursing Faculty Research and Publications

Introduction:

Coronavirus disease 2019 (COVID-19) is associated with significant risk of acute thrombosis. We present a case report of a patient with cerebral venous sinus thrombosis (CVST) associated with COVID-19 and performed a literature review of CVST associated with COVID-19 cases.

Case Report:

A 38-year-old woman was admitted with severe headache and acute altered mental status a week after confirmed diagnosis of COVID-19. Magnetic resonance imaging brain showed diffuse venous sinus thrombosis involving the superficial and deep veins, and diffuse edema of bilateral thalami, basal ganglia and hippocampi because of venous infarction. Her neurological exam improved with anticoagulation (AC) and …

Knee Joint Biomechanics During Gait Improve From 3 To 6 Months After Anterior Cruciate Ligament Reconstruction, Kelsey Neal, Jack R. Williams, Abdulmajeed Alfayyadh, Jacob J. Capin, Ashutosh Khandha, Kurt Manal, Lynn Snyder-Mackler, Thomas S. Buchanan

Physical Therapy Faculty Research and Publications

Gait alterations after anterior cruciate ligament reconstruction (ACLR) are commonly reported and have been linked to posttraumatic osteoarthritis development. While knee gait alterations have been studied at several time points after ACLR, little is known about how these biomechanical variables change earlier than 6 months after surgery, nor is much known about how they differ over the entire stance phase of gait. The purpose of this study was to examine knee gait biomechanical variables over their entire movement pattern through stance at both 3 and 6 months after ACLR and to study the progression of interlimb asymmetry between the two …

Effect Of Educational Intervention On Improving Nurse’S General Health In Military Hospitals Of Iran: A Quasi-Experimental Study, Vahid Ranaei, Fatemeh Kalroozi, Mojtaba Sadeghi, Soudabeh Yarmohammadi, Kristin Haglund, Nahid Mehrabi

College of Nursing Faculty Research and Publications

Background Nursing in military hospitals affects their general health. Educational interventions can help to maintain the general health of nurses. This study aimed to evaluate the effect of an educational intervention to improve the general health of nurses in military hospitals. Methods In this quasi-experimental study, 146 nurses working in military hospitals in Tehran, Iran in 2021 were included in the study. The one-month educational intervention included videos, pamphlets, and motivational messages about promoting general health. General health questionnaire with 28 items (GHQ28) was study tool. The allocation of nurses to groups was not random, it was based on personal …

Vasopressin Resets The Central Circadian Clock In A Manner Influenced By Sex And Vasoactive Intestinal Polypeptide Signaling, Kayla E. Rohr, Thomas Inda, Jennifer A. Evans

Biomedical Sciences Faculty Research and Publications

Background/Aims: Circadian rhythms in behavior and physiology are programmed by the suprachiasmatic nucleus (SCN) of the hypothalamus. A subset of SCN neurons produce the neuropeptide arginine vasopressin (AVP), but it remains unclear whether AVP signaling influences the SCN clock directly.

Methods: Here, we test that AVP signaling acting through V1A and V1B receptors influences molecular rhythms in SCN neurons. V1 receptor agonists were applied ex vivo to PERIOD2::LUCIFERASE SCN slices, allowing for real-time monitoring of changes in molecular clock function.

Results: V1A/B agonists reset the phase of the SCN molecular clock in a time-dependent manner, with larger magnitude responses by …

Role Of Physical Therapists In The Management Of Individuals At Risk For Or Diagnosed With Venous Thromboembolism: Evidence-Based Clinical Practice Guideline 2022, Ellen Hillegass, Kathleen M. Lukaszewicz, Michael Puthoff

Physical Therapy Faculty Research and Publications

No matter the practice setting, physical therapists work with patients who are at risk for or who have a history of venous thromboembolism (VTE). In 2016, the first clinical practice guideline (CPG) addressing the physical therapist management of VTE was published with support by the American Physical Therapy Association’s Academy of Cardiovascular and Pulmonary Physical Therapy and Academy of Acute Care, with a primary focus on lower extremity deep vein thrombosis (DVT). This CPG is an update of the 2016 CPG and contains the most current evidence available for the management of patients with lower extremity DVT and new key …

Implications Of The Dunning-Kruger Effect: Finding Balance Between Subjective And Objective Assessment In Debriefing Professional Development, Cynthia Sherraden Bradley, Kristina Dreifuerst, Anne Loomis, Brandon Kyle Johnson, Aimee A. Woda, Jamie Hansen

College of Nursing Faculty Research and Publications

Background

The ability to debrief is considered an essential clinical and simulation teaching skill because of the deep learning cultivated. Regulatory bodies identify the need for debriefing training and professional development followed by formative and summative assessment.

Method

The Debriefing for Meaningful Learning Evaluation Scale (DMLES) is a behaviorally anchored rating scale developed to assess 20 behaviors aligned with Debriefing for Meaningful Learning (DML). Participants from five baccalaureate pre–licensure nursing programs were recruited to receive DML training, then facilitate and record a debriefing for subjective and objective assessment using the DMLES.

Results

A total of 52 debriefers submitted 81 recorded …

Brain-Wide Analysis Of The Supraspinal Connectome Reveals Anatomical Correlates To Functional Recovery After Spinal Injury, Zimei Wang, Adam Romanski, Vatsal Mehra, Yunfang Wang, Matthew Brannigan, Benjamin C. Campbell, Gregory A. Petsko, Pantelis Tsoulfas, Murray G. Blackmore

Biomedical Sciences Faculty Research and Publications

The supraspinal connectome is essential for normal behavior and homeostasis and consists of numerous sensory, motor, and autonomic projections from brain to spinal cord. Study of supraspinal control and its restoration after damage has focused mostly on a handful of major populations that carry motor commands, with only limited consideration of dozens more that provide autonomic or crucial motor modulation. Here, we assemble an experimental workflow to rapidly profile the entire supraspinal mesoconnectome in adult mice and disseminate the output in a web-based resource. Optimized viral labeling, 3D imaging, and registration to a mouse digital neuroanatomical atlas assigned tens of …

Cost-Effectiveness Of High-Intensity Training Vs Conventional Therapy For Individuals With Subacute Stroke, T. George Hornby, Miriam Rafferty, Daniel Pinto, Dustin D. French, Neil Jordan

Physical Therapy Faculty Research and Publications

Objective

This investigation estimated the incremental cost-effectiveness of high-intensity training (HIT) compared with conventional physical therapy in individuals with subacute stroke, based on the additional personnel required to deliver the therapy.

Design

Secondary analysis from a pilot study and subsequent randomized controlled trial.

Setting

Outpatient laboratory setting.

Participants

Data were collected from individuals with locomotor impairments 1-6 months poststroke (N=44) who participated in HIT (n=27) or conventional physical therapy (n=17).

Interventions

Individuals performing HIT practiced walking tasks in variable contexts (stairs, overground, treadmill) while targeting up to 80% maximum heart rate reserve. Individuals performing conventional therapy practiced impairment-based and functional …

‘If The Partner Finds Out, Then There’S Trouble’: Provider Perspectives On Safety Planning And Partner Interference When Offering Hiv Pre-Exposure Prophylaxis (Prep) To Women Experiencing Intimate Partner Violence (Ipv), Noelene K. Jeffers, Jessica L. Zemlak, Lourdes Celius, Tiara C. Willie, Trace Kershaw, Kamila A. Alexander

College of Nursing Faculty Research and Publications

Pre-exposure prophylaxis is an effective women-controlled HIV prevention strategy but women experiencing intimate partner violence fear partners’ interference and subsequent violence could limit its utility. This study explores provider perceptions of safety planning strategies to prevent escalating violence, mitigate partner interference, and promote daily oral PrEP adherence. We conducted interviews (N = 36) with healthcare providers (n = 18) and IPV service providers (n = 18) in Baltimore and New Haven. Using the Contextualized Assessment for Strategic Safety Planning model we organized data into two categories: the appraisal process and strategic safety planning. Themes revealed during …

Debriefing For Meaningful Learning: Implementing A Train-The-Trainer Program For Debriefers, Aimee A. Woda, Jamie Hansen, Kristina Dreifuerst, Brandon Kyle Johnson, Anne Loomis, Nolan Cox, Cynthia Sherraden Bradley

College of Nursing Faculty Research and Publications

Debriefing for Meaningful Learning (DML) is a method of debriefing grounded in the theory of reflection used following a simulation or clinical learning experience to engage participants in an interactive dialogue aimed at examining and evaluating their thinking and decision-making processes. With increasing adoption of DML worldwide, a sustainable training program for nurse educators is needed. Attending conferences and workshops that provide training is challenging for many nurse educators because of time and cost constraints. One promising solution is the train-the-trainer (TTT) model. In this article, the development and implementation of a TTT model of DML debriefer training, adaptable to …

Coaching For Childbearing Health: A Theory Synthesis, Jennifer Ohlendorf, Lisa Anders

College of Nursing Faculty Research and Publications

This article describes development of a theory to guide nurses promoting perinatal weight self-management behaviors. The Coaching for Childbearing Health (CoaCH) Model was developed through synthesis of the Individual and Family Self-Management Theory with Transitions Theory, following Walker and Avant's process of theory synthesis. Qualitative data were integrated to provide perinatal context. The CoaCH Model is composed of context factors that shape a nurse coaching intervention, supporting patients' self-management efforts. Sustained engagement in weight self-management behaviors will impact the long-term health of both the birthing person and the child. This model is a testable framework for future perinatal health promotion …

Acquiring, Applying And Retaining Knowledge Through Debriefing For Meaningful Learning, Anne Loomis, Kristina Dreifuerst, Cynthia Sherraden Bradley

College of Nursing Faculty Research and Publications

Abstract

Acquiring, Retaining and Applying Knowledge Through Use of Debriefing for Meaningful Learning (DML).

Background

Developing competence in nursing care is a critical expectation of nursing students. Knowledge acquisition, application and retention are the primary building blocks of competence. DML debriefing offers an opportunity to ensure that students master critical components of nursing they might not otherwise learn and to remove epistemological roadblocks to knowledge development.

Methods

Eighty-two traditional prelicensure baccalaureate nursing students from a single school participated in the study. This quasi-experimental pretest, posttest study explored the impact of the use of Debriefing for Meaningful Learning compared with customary …

Post-Surgical Emergency After-Hours Calls: Prevalence, Concerns, And Management, Vrisiis Kofina, Drake Lindholm, Abdulkareem Harunani, Andrew R. Dentino, Maharaj Singh, Dimitris N. Tatakis

College of Nursing Faculty Research and Publications

Objective

The purpose of this study was to investigate the prevalence, nature, and management of post-surgical emergency after-hours calls in a dental school setting with predoctoral students, graduate students/residents, and faculty providers.

Methods

A patient chart review (March 2018–February 2020) for post-surgical calls through the emergency after-hours pager system was conducted at the Marquette University School of Dentistry. The total number of surgical procedures, procedure type, the timing of call, operator experience, concern, and recommendation given during the call were documented.

Results

During the review period, 83 calls (from 75 patients) were recorded after 8,487 surgical procedures (1% of procedures). …

Identifying Gait Pathology After Acl Reconstruction Using Temporal Characteristics Of Kinetics And Electromyography, Naoaki Ito, Jacob J. Capin, Ashutosh Khandha, Thomas S. Buchanan, Lynn Snyder-Mackler

Physical Therapy Faculty Research and Publications

Purpose

Asymmetrical gait mechanics after anterior cruciate ligament reconstruction (ACLR) are associated with the development of posttraumatic knee osteoarthritis. Current measures of gait mechanics have focused heavily on peak magnitudes of knee kinematics, kinetics, and joint contact forces but have seldom considered the rate of knee loading, cumulative knee load, or the timing of motor input surrounding peaks. The purpose of this study was to introduce and describe novel metrics of gait using temporal characteristics of kinetics and EMG to identify neuromuscular deficits of the quadriceps in patients after ACLR.

Methods

Gait mechanics were assessed 6 months (n = …

Total Knee Arthroplasty Assessments Should Include Strength And Performance-Based Functional Tests To Complement Range-Of-Motion And Patient-Reported Outcome Measures, Jacob J. Capin, Michael J. Bade, Jason M. Jennings, Lynn Snyder-Mackler, Jennifer E. Stevens-Lapsley

Physical Therapy Faculty Research and Publications

Range of motion (ROM) and pain often define successful recovery after total knee arthroplasty (TKA), but these routine clinical outcomes correlate poorly or not at all to functional capacity after TKA. The purpose of this Perspective is to underscore the importance of muscle strength and performance-based functional tests in addition to knee ROM and patient-reported outcome (PRO) measures to evaluate outcomes after TKA. Specifically: (1) muscle strength is the rate-limiting step for recovery of function after TKA; (2) progressive rehabilitation targeting early quadriceps muscle strengthening improves outcomes and does not compromise ROM after TKA; (3) ROM and PROs fail to …

Parent Health-Related Quality Of Life For Infants With Congenital Anomalies Receiving Neonatal Intensive Care, Krishna Acharya, Erin Rholl, Kathryn J. Malin, Margaret Malnory, Jonathan Leuthner, Steven R. Leuthner, Joanne Lagatta

College of Nursing Faculty Research and Publications

Objective

To examine factors associated with parent quality of life during and after neonatal intensive care unit (NICU) discharge among parents of infants with congenital anomalies admitted to the NICU.

Study design

This secondary analysis of 2 prospective cohort studies between 2016 and 2020 at a level IV NICU included parents of infants with major congenital anomalies receiving NICU care. The primary outcomes were parent health-related quality of life (HRQL) during the NICU stay and at 3 months post-NICU discharge.

Results

A total of 166 parent–infant dyads were enrolled in the study, 124 of which completed the 3-month follow-up interview. …

Neoadjuvant Chemotherapy Is Associated With Improved Outcomes In Patients With Stage 1a And 1b Pancreatic Cancer Undergoing Surgery: An Ncdb Study, Noah Rozich, Maharaj Singh, Isaac Kriley, James L. Weese, Aaron Chevinsky, Wesley A. Papenfuss, Geoffrey Bellini

College of Nursing Faculty Research and Publications

Background: The use of neoadjuvant chemotherapy (NAC) for pancreatic ductal adenocarcinoma (PDAC) has shown clear advantages in locally advanced and borderline resectable disease. The benefit in upfront resectable PDAC is debated. Moreover, in early clinical stages IA/IB, potential benefits including improved R0 resection rate, decreased tumor upstaging, and survival, are not clear. We hypothesize that NAC will be associated with improved outcomes and survival compared to adjuvant therapy in patients with clinical stage IA/IB PDAC. Methods: The National Cancer Database (NCDB) PUFs (2004-2017) were used to perform a retrospective review of patients with clinical stage IA or IB PDAC undergoing …

Edge Chipping Of Translucent Zirconia, Joseph D. Flask, Geoffrey A. Thompson, Maharaj Singh, David W. Berzins

School of Dentistry Faculty Research and Publications

Statement of problem

More translucent dental zirconias have been developed by incorporating the cubic phase and reducing the tetragonal phase content that undergoes transformation toughening, leading to reduced mechanical properties. Whether the clinically relevant mechanical property of the edge chipping toughness of the material is also reduced is unclear.

Purpose

The purpose of this in vitro study was to evaluate the edge chipping toughness and translucency of translucent zirconia, 3mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP), and lithium disilicate.

Material and methods

Two translucent zirconia products, Katana and Lava Esthetic; one 3Y-TZP, Lava Plus; and one lithium disilicate, IPS e.max Press …

Emollients To Prevent Eczema In High-Risk Infants: An Integrative Review, Julie Armstrong, Nicole K. Rosinski, Alissa V. Fial, Selorm Ansah, Kristin Haglund

Library Faculty Research and Publications

The purpose of this integrative review was to assess the research on topical emollients to prevent atopic dermatitis (AD) also known as eczema, in infants at high risk for this condition. Atopic dermatitis is a common chronic inflammatory skin disorder. Skin barrier dysfunction plays a prominent role in its development. Topical emollients have been hypothesized to enhance the skin barrier and prevent AD.

Methods:

Searches were conducted in September 2021 in PubMed, CINAHL, Cochrane Library, and Web of Science using key word search terms dermatitis, atopic, emollients, petrolatum, and infant, newborn. Inclusion criteria were articles written in English …

Developing Situation Awareness In Simulation Prebriefing, Amanda L. Potter, Kristina Dreifuerst, Aimee A. Woda

College of Nursing Faculty Research and Publications

BACKGROUND:

Prebriefing before simulation is a recommended practice that increases learner satisfaction and improves performance. Promoting situation awareness through prebriefing facilitates optimal learning outcomes.

METHOD:

Endsley's Model of Situation Awareness is applied to the cognitive work of nursing practice that occurs during the prebriefing phase of simulation. Perceiving, comprehending, and projecting about elements of a situation lead to clinical judgement, reasoning, decision making, and ultimately nursing actions.

RESULTS:

Developing situation awareness in prebriefing is a supported process that connects learners' prior knowledge and experience with the needed knowledge, skills, and abilities in the simulation environment. These mental models become the …

Engagement Of Families In The Care Of Hospitalized Pediatric Patients: A Scoping Review, Teresa Jerofke-Owen, Natalie S. Mcandrew, Karen Gralton, Joan P. Totka, Marianne E. Weiss, Alissa V. Fial, Kathleen J. Sawin

College of Nursing Faculty Research and Publications

This scoping review was conducted to examine the range, nature, and extent of the published family engagement literature specific to the pediatric acute care setting to highlight future research and practice development opportunities. Included studies (N = 247) revealed global relevance. Engagement strategies ranged from more passive such as allowing/encouraging families to be present at the bedside to more active strategies aimed at promoting mutual and reciprocal nurse–patient interactions. Family engagement is distinguished by a mutually beneficial partnership of families with health care team members and care organizations. Future research in the area of family engagement in pediatric nursing …

More Than A Meme: The Dunning-Kruger Effect As An Opportunity For Positive Change In Nursing Education, Cynthia Sherraden Bradley, Kristina Dreifuerst, Brandon Kyle Johnson, Ann Loomis

College of Nursing Faculty Research and Publications

The Dunning–Kruger Effect (DKE) describes the cognitive bias in which novices tend to overestimate performance or competence while experts tend to underestimate. Those who are lacking in competence do not have the skills to accurately recognize deficient performance. Subjective assessment is used widely in simulation learning and in nursing curricula, yet often without expert feedback and reflective discussions, which can result in mistakes being overlooked and encoded, which could subsequently result in clinical errors. The prevalence of DKE should not be interpreted solely as a deprecation of the use of subjective measures, but rather as an indicator of the need …

Helping Nurses Identify And Report Sentinel Injuries Of Child Abuse In Infants, Elizabeth Cleek, Joan P. Totka, Lynn K. Sheets, Joshua P. Mersky, Kristin Haglund

College of Nursing Faculty Research and Publications

Sentinel injuries (SIs) are some of the earliest and most readily identifiable red flags of child abuse. SIs are unexpected bruising or intra-oral injuries in pre-mobile infants and highly correlated with child abuse. However, SIs are not always recognized and reported as red flags of child abuse. Infants are left at risk for continued harm when SIs are not identified and reported. Although increasing nurses' knowledge of SIs is important, child abuse researchers and behavioral theorists have identified that knowledge alone does not predict nurses' behaviors when identifying and reporting suspected child abuse. Other predictors may include implicit biases, interpersonal …

Beliefs About Safe Traffic Behaviors Among Male High School Students In Hamadan, Iran: A Qualitative Study Based On The Theory Of Planned Behavior, Vahid Ranaei, Alireza Sahab Jahanlu, Laleh Hassani, Ghodratollah Roshanaei, Kristin Haglund, Jagnoor Jagnoor, Forouzan Rezapur Shahkolaei

College of Nursing Faculty Research and Publications

Road traffic injuries are public health challenges with heavy economic and social burdens. Road traffic injuries are common in developing countries and occur disproportionately with adolescents. This study aimed to elicit beliefs about traffic behaviors based on the theory of planned behavior among male high school students in Hamadan, Iran. We used a constructivist-interpretive qualitative design with directional content analysis. Interviews were conducted with 19 adolescent males in Hamadan, Iran. Analysis revealed that theory of planned behavior fit well to explain how perceptions, attitudes, and beliefs influenced traffic behaviors. Perceived subjective norms in the forms of parental encouragement, traffic rules …

Economic Impression Of On-Farm Research For Sustainable Crop Production, Milk Yield, And Livelihood Options In Semi-Arid Regions Of Central India, Sunil Kumar, Purushottam Sharma, Prabhu Govindasamy, Maharaj Singh, Sant Kumar, Hanamant M. Halli, Bishwa Bhaskar Choudhary, Muthukumar Bagavathiannan

College of Nursing Faculty Research and Publications

Farming system research (FSR) is on-farm research that brings cutting-edge agricultural technologies to growers to enhance farm production, family income, and livelihood status. In 2007, an on-farm study was started on FSR in central India, and the effect was assessed after 5 yr (2012–2013) of implementation by comparing adopters and nonadopters of FSR-based promoted technologies. Further, in 2018–2019, the status of adoption of introduced technologies was also assessed. The study revealed that improved practices such as pre-sowing irrigation, high-yielding varieties, and crop protection measures collectively improved the system productivity of the adopters by 28%; the improved productivity was mainly due …

Symmetry Is Associated With Interlimb Coordination During Walking And Pedaling After Stroke, Brice T. Cleland, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

Background and Purpose:

Asymmetry during walking may be explained by impaired interlimb coordination. We examined these associations: (1) propulsive symmetry with interlimb coordination during walking, (2) work symmetry with interlimb coordination during pedaling, and (3) work symmetry and interlimb coordination with clinical impairment.

Methods:

Nineteen individuals with chronic stroke and 15 controls performed bilateral, lower limb pedaling with a conventional device and a device with a bisected crank and upstroke assistance. Individuals with stroke walked on a split-belt treadmill. Measures of symmetry (%Propulsion_walk, %Work_ped) and interlimb phase coordination index (PCI_walk, PCI_ped) were …

Predicting Duration Of Outpatient Physical Therapy Episodes For Individuals With Spinal Cord Injury Based On Locomotor Training Strategy, Mauricio Garnier-Villarreal, Daniel Pinto, Chaithanya K. Mummidisetty, Arun Jayaraman, Candy Tefertiller, Susan Charlifue, Heather B. Tayler, Shuo-Hsiu Chang, Nicholas Mccombs, Catherine L. Furbish, Edelle C. Field-Fote, Allen W. Heinemann

Physical Therapy Faculty Research and Publications

Objective

To characterize individuals with spinal cord injuries (SCI) who use outpatient physical therapy or community wellness services for locomotor training and predict the duration of services, controlling for demographic, injury, quality of life, and service and financial characteristics. We explore how the duration of services is related to locomotor strategy.

Design

Observational study of participants at 4 SCI Model Systems centers with survival. Weibull regression model to predict the duration of services.

Setting

Rehabilitation and community wellness facilities at 4 SCI Model Systems centers.

Participants

Eligibility criteria were SCI or dysfunction resulting in motor impairment and the use of …

Nonlinear Association Of Nurse Staffing And Readmissions Uncovered In Machine Learning Analysis, Olga Yakusheva, James Bang, Ronda G. Hughes, Kathleen L. Bobay, Linda L. Costa, Marianne Weiss

College of Nursing Faculty Research and Publications

Objective: Several studies of nurse staffing and patient outcomes found a curvilinear or U-shaped relationship, with benefits from additional nurse staffing diminishing or reversing at high staffing levels. This study examined potential diminishing returns to nurse staffing and the existence of a "tipping point" or the level of staffing after which higher nurse staffing no longer improves and may worsen readmissions.

Data Sources/Study Setting: The Readiness Evaluation And Discharge Interventions (READI) study database of over 130,000 adult (18+) inpatient discharges from 62 medical, surgical, and medical-surgical (noncritical care) units from 31 United States (US) hospitals during October 2014-March 2017.

Study …