Achieving Equity For International Medical Graduates: A Systematic Review, Sangeeta G. Saxena, Elizabeth Tisdell, Elana Farace, Thomas Godfrey, Betsy Aumiller, Esther Dell, Omrana P. Razzak, Bernadette N. Kumar, Kristin K. Sznajder

Public Health

Introduction: Foreign-born and foreign trained International Medical Graduates (FIMGs) face greater challenges in acculturation to their host countries than IMGs who train abroad and return to practice in their home country. As FIMGs are likely to fulfill a shortage of physicians in High Income Countries in the foreseeable future, we conducted a systematic review of literature to identify acculturation interventions that help FIMGs assimilate better in their host country health systems. This improves their productivity and satisfaction, allows health systems to be more accepting of FIMGs, and most importantly, enhances patient outcomes.

Methods: Following the PRISMA statement, we searched PubMed, …

Distinct Patterns Of Weight Gain, Age, And Subcortical Microstructure In Early Adolescence, Shana Adise, Zhaolong Adrian Li, Jonatan Ottino-González, Filip Morys, Peter A Chiarelli, Tamara Hershey

2020-Current year OA Pubs

IMPORTANCE: Associations between childhood obesity and brain microstructural differences have been observed. It remains unknown whether these associations are driven by sex-specific excessive weight gain. Restriction spectrum imaging characterizes brain tissue microstructural health via water diffusion, where the restricted normalized isotropic (RNI) compartment assesses neuronal and glial cellularity, which may reflect neuroinflammation, synaptic pruning, or both.

OBJECTIVE: To identify associations among RNI scaling factor values, normal neurodevelopment, and weight gain during early adolescence.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from the Adolescent Brain Cognitive Development (ABCD) Study, a 10-year, ongoing, multisite longitudinal cohort study conducted among youths …

Automated Mycoplasma Genitalium Molecular Macrolide Resistance Detection And Nucleic Acid Target Semi-Quantitation: Patient Demographic Considerations, Josephine Moore, Trinity Krueger, Amanda Zapp, Stephen C Lavey, Kimber L Munson, Irene A Stafford, Michael E Newcomb, Brian Mustanski, Erik Munson

Faculty, Staff and Student Publications

Recent work has optimized parameters of a real-time reverse transcriptase PCR-based laboratory-developed test on the Panther Fusion system which detects Mycoplasma genitalium-specific macrolide resistance-associated mutations LDT (MRM-LDT) from primary swab and urine specimens. In this study, MRM-LDT was applied to a large multi-demographic study set to further characterize M. genitalium resistance in the United States. A total of 2,145 primary clinical specimens testing positive for M. genitalium 16S rRNA by transcription-mediated amplification (TMA) were initially titered by the same assay using serial 10-fold dilutions to determine relative target nucleic acid burden. Specimens were then processed for MRM-LDT. Findings were stratified …

Familiarity Moderates Education Level Of Stigma For Professional Efficacy Of Treating Mental Illness, Jason J. Burrow-Sanchez, Shawnda Schroeder, Thomasine Heitkamp, Brian Urlacher, Sharon Cook, Paula Bennett, Carolina Corrales

Indigenous Health Faculty Publications

Background: About one in five adults in the United States experience any mental illness (AMI) whereas 14.2 million experience serious mental illness (SMI). The perception of stigma among these individuals can be associated with care seeking behavior and treatment adherence.

Purpose: Two factors that mitigate stigma are familiarity with someone experiencing AMI/SMI and general level of education. Heretofore, these factors have not been tested together to determine if familiarity moderates the relation between level of education and stigma of professional efficacy for treating mental illness.

Methods: In fall 2020, an online survey in the state of Utah measured 1,300 adults’ …

Evidence-Based Human Clinical Trials On Antidiabetic Herbal 6 Remedies Commonly Used In The Middle East, Shihab Al-Makhmari, Abir Al-Aufi, Saleh Al-Kindi, Maha Al Riyami, Hussein Sakr, Mohamed-Rachid Boulassel, Khalid M Abu Khadra, Rahma Al-Haddabi, Ammar Boudaka, Jumana Saleh

Sultan Qaboos University Medical Journal

Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder with significant health and economic impacts. This review examined Middle Eastern herbs as alternative T2DM treatments in human randomised controlled trials and meta-analyses. A comprehensive PubMed search was conducted for human randomised controlled trials and meta-analyses on black seed (Nigella sativa), fenugreek (Trigonella foenum-graecum), ginger (Zingiber officinale), cinnamon (Cinnamomum cassia) and curcumin (Curcuma longa), with at least 6 human studies per herb. The results revealed that N. sativa and fenugreek improved glycaemic control and lipid profiles, while ginger regulated carbohydrate …

Gad-7 Screening In Middle School Students: Evaluating The Effectiveness On Referral Rate Scoping Review, Bailey Hall, Cara Dennis, Kayla Drennen-Ferguson, Pamela B. Taylor, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

The prevalence of anxiety disorders among adolescents, mainly middle school-aged students, highlights the critical need for practical screening tools to support early detection and intervention. The Generalized Anxiety Disorder-7 (GAD-7) scale is widely utilized in various settings, but its efficacy in this specific population remains underexplored. This scoping review examines the use of the GAD-7 in middle school-aged students, evaluating its reliability, validity, and impact on referral rates to mental health services. The review also considers factors influencing anxiety and identifies gaps in current research.

Methods

Ten articles, published in peer-reviewed journals within the past decade and involving human …

Efficacy Of Glucagon-Like Peptide-1 Receptor Agonists For Prevention Of Stroke Among Patients With And Without Diabetes: A Meta-Analysis With The Select And Flow Trails, Asmita Gera, Fakhar Latif, Vamsikalayan Borra, Sidra Naz, Vivek Mittal, Fathima Shehnaz Ayoobkhan, Tushar Kumar, Zarghoona Wajid, Novonil Deb, Tanisha Prasad

School of Medicine Publications

Background

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown a reduction in major adverse cardiovascular events (MACE) among patients with type 2 diabetes mellitus (T2DM). However, its efficacy on cerebrovascular events is yet to be well established among diabetic and non diabetic patients.

Objective

We sought to evaluate the efficacy of GLP-1 RAs on stroke risk among its different types in patients with and without Diabetes.

Methods

We performed a systematic literature search on PubMed, EMBASE, and ClinicalTrials.gov for relevant randomized controlled trials (RCTs) from inspection until 15th July 2024, without any language restrictions. Odds ratios (OR) and 95 % …

Inked Insight: A Consensual Qualitative Research Study Exploring The Perspectives Of Visibly Tattooed Counselors, Megan Ashley Lalonde-Pittman

Counseling & Human Services Theses & Dissertations

This study explored the experiences of visibly tattooed mental health counselors (VTMHC) through consensual qualitative research (CQR), examining how visible tattoos were perceived to have impacted the participants (N=14) professional experiences, development, and relationships within the counseling field. Seven domains arose from the data: Prejudices experienced by VTMHC, VTMHC Interactions with others, Culture experienced by VTMHC, Appearances of the VTMHC, Professional therapeutic work of the VTMHC, Workplace environment of the VTMHC, Processing the experience of being a VTMHC The implications for multicultural education and future research are explored.

Genomic Characterisation Of The Relationship And Causal Links Between Vascular Calcification, Alzheimer’S Disease, And Cognitive Traits, Emmanuel O. Adewuyi, Simon M. Laws

Research outputs 2022 to 2026

Background/Objectives: Observational studies suggest a link between vascular calcification and dementia or cognitive decline, but the evidence is conflicting, and the underlying mechanisms are unclear. Here, we investigate the shared genetic and causal relationships of vascular calcification—coronary artery calcification (CAC) and abdominal aortic calcification (AAC)—with Alzheimer’s disease (AD), and five cognitive traits. Methods: We analyse large-scale genome-wide association studies (GWAS) summary statistics, using well-regarded methods, including linkage disequilibrium score regression (LDSC), Mendelian randomisation (MR), pairwise GWAS (GWAS-PW), and gene-based association analysis. Results: Our findings reveal a nominally significant positive genome-wide genetic correlation between CAC and AD, which becomes non-significant after …

More Than Numbers: Black Adolescents’ Journey With Type 1 Diabetes Management, Vanessa Di Felice

Walden Dissertations and Doctoral Studies

Black adolescents with Type 1 diabetes mellitus (T1DM) face significant health disparities, yet their unique treatment journeys remain largely underreported. This phenomenological qualitative study explored the lived experiences of Black adolescents with T1DM. The study addressed two research questions examining how these individuals experience and navigate T1DM self-management, self-efficacy beliefs, and perceived barriers and facilitators to optimal self-care. Virtual semi-structured interviews were conducted with 15 Black adolescents with T1DM recruited from a pediatric hospital in Washington, DC. The study utilized Bandura's social cognitive theory as the theoretical framework. Thematic data analysis identified four key themes: (1) character development through knowledge …

The Efficacy Of Inspiratory Muscle Training Post Covid: A Systematic Review, Robert Dekerlegand, Sydney Brannen, Olivia Bunch, Amrit Deo, Erin Dopke, Kayleigh Moreland

Department of Physical Therapy Posters

Introduction

• Fatigue and dyspnea can persist post COVID infection and negatively impact both functional capacity and quality of life (QOL).^1,2
• Residual pulmonary impairments and/or inspiratory muscle dysfunction associated with COVID infection contribute to these symptoms.^2,3
• Ventilatory demands exceeding the capacity of the inspiratory muscles can exacerbate these symptoms accentuating activity limitations that restrict participation in life roles.
• As symptom-limited exercise and QOL are related to inspiratory muscle function post COVID,^4,5 inspiratory muscle training (IMT) may improve rehabilitation outcomes.³
• The purpose of this systematic review was to determine the potential efficacy of IMT in individuals post-COVID.

Mental Health And Wellness Among Plastic Surgeons During Oral Board Certification Examination Preparation., Hannah J. Bergman, Charles C. Jehle, Ibrahim Khansa

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The field of plastic and reconstructive surgery has recently made a dramatic shift toward attention to mental health, with residency curricula expanding to include training on burnout prevention and the promotion of well-being. After graduation, however, new surgeons face a difficult year of preparation for the oral board certification examination. This group of young surgeons remains largely unstudied and undersupported throughout what may be the most challenging period of their educational journey.

METHODS: In spring of 2024, an electronic survey was sent to members of the American Society of Plastic Surgeons who had completed their oral board examination within …

The Impact Of Roe V. Wade Overturning On Women’S Access To Medical Abortions: Exploring Alternative Care Models, Gillie Mason

Nursing | Senior Theses

This study explores the impact of educational interventions on California based Nurse Practitioners. And their willingness to provide telehealth abortion services in states with restrictions. By using a mixed methods approach it assesses how increased knowledge may help influence providers attitudes, adding to improved reproductive healthcare access. The study addresses the critical issue of reduced abortion access which stems from recent policy changes, which have left patients in certain regions with limited options. The literature shows that telemedicine and mail-order services hold promise for improving access. This research proposal explores the impact of educational interventions on California-based Nurse Practitioners’ willingness …

Recovery Housing And On-The-Ground Research Priorities: A Scoping Study Through The Lens Of Community Based Participatory Research, Patrick F Hibbard, Cameron W Tice, Jodie M Dewey, Kathryn R Gallardo, James Tompkins, Justin S Bell, Jasleen Sandhu, Michelle A Cruz, Kathryn Babbitt, Amy A Mericle, Ashli J Sheidow

Faculty, Staff and Student Publications

Introduction: Though communities have featured recovery housing (RH) for several decades, the base of evidence for best practices continues to grow - especially evidence needed by, and known to, those who operate and receive these services. The Initiative for Justice and Emerging Adult Populations (JEAP) engaged with three community boards (CBs) - consisting of young adults with experience in recovery from substance use issues, people who have a history of criminal legal system involvement and recovery, and payers and provider of substance use services and harm reduction - to understand on-the-ground priorities for research into recovery support services.

Methods: JEAP …

Moving Beyond Traditional Multiculturalism: Dis/Ability Awareness In Counselor Education, Alicia B. Becton, Eunae Han, Leeza Ong, Amber Johnson, Roy K. Chen, Gabriela Rangel, Stephanie Lusk

School of Rehabilitation Services & Counseling Faculty Publications

This chapter explores the experiences of individuals with disabilities, emphasizing how they navigate educational and societal norms while balancing various identities. It emphasizes the impact of societal issues, such as racism and sexism, on individuals with disabilities. The authors delve into current multiculturalism trends, advocating for culturally responsive approaches in counselor education and rehabilitation services. The goal is to advance discussions on the future directions of multiculturalism by exploring the following key areas (a) the sociopolitical aspects of disability, (b) the inclusion of disability in counselor education, (c) accessibility and the universal design for learning (UDL), (d) culturally competent counselor …

Factors Associated With Health Decision-Making Autonomy On Own Healthcare Among Tanzanian Women: A 2022–2023 Demographic Health Survey Study, Tausi Seleman Haruna, Henry Ofori Duah, Rebecca Lee

College of Nursing Faculty Research and Publications

Background

Women’s health decision-making autonomy is fundamental for the health and well-being of women and their children. It empowers women to make health decisions and exercise their rights and choices surrounding their health. Like most parts of Africa, women’s autonomy in Tanzania remains contentious, with an estimated 19% prevalence of health decision-making autonomy in 2015. Given the impact of women’s health decision-making autonomy on women’s health outcomes and the fact that women’s health decision-making autonomy is an ongoing process affected by advancements in technology, economic growth, and social and cultural shifts, understanding the sociodemographic correlates of women’s autonomy is imperative. …

A Prospective Cohort Study On Stereotactic Radiotherapy In The Management Of Dural Recurrence Of Olfactory Neuroblastoma, Christopher D Goodman, Franco Demonte, Theresa P Nguyen, Adam S Garden, Catherine He Wang, Xin A Wang, Kevin Diao, Anna Lee, Jay Reddy, Amy Moreno, Michael Spiotto, Clifton D Fuller, David Rosenthal, Renata Ferrarotto, Shaan M Raza, Shirley Y Su, Andrew Warner, Ehab Hanna, Jack Phan

Faculty, Staff and Student Publications

Background: Treatment for dural recurrence of olfactory neuroblastoma (ONB) is not standardized. We assess the outcomes of stereotactic body radiotherapy (SBRT) in this population.

Methods: ONB patients with dural recurrences treated between 2013 and 2022 on a prospective registry were included. Tumor control, survival, and patient-reported quality of life were analyzed.

Results: Fourteen patients with 32 dural lesions were evaluated. Time to dural recurrence was 58.3 months. Thirty lesions (94%) were treated with SBRT to a median dose of 27 Gy in three fractions. Two patients (3 of 32 lesions; 9%) developed in-field radiographic progression, five patients (38%) experienced progression …

Building Boundary-Crossers In Clinical-Translational Research: An Exploratory Study Of A Novel Communication Intervention, Carrie Cameron, Irene Rull-Garcia, Laura G Meyer, Jose-Armando Fernandez-Guerrero, Erin K Dahlstrom, Christine Bell, Christine Pribbenow

Faculty, Staff and Student Publications

INTRODUCTION: Integrating scientific research across multiple disciplines to advance breakthroughs is at the heart of clinical-translational science (CTS); among competencies that have been identified as essential for progress, skillful communication is critical. Few tools are available to address the social dynamics of the multidimensional diversity characteristics of CTS. We created the "Building a Diverse Biomedical Workforce Through Communication Across Difference (CAD)" workshop intervention. Based on principles of intercultural communication, CAD taught novel situationally-based communication skills to dyads of near-peer mentors and their undergraduate mentees. This study reports on the effectiveness of the operative mechanisms employed in CAD workshops for helping …

The Mediating Effect Of Injury On The Relationship Between Running Mileage And Depressive Symptoms In Division 2 Cross Country Athletes, Jaxon Leduc

Cal Poly Humboldt theses and projects

Training for a cross-country season requires athletes to accumulate a high volume of training miles at different intensities. Over a period of months and years, consistent high training volumes have been shown to contribute to overuse injuries in cross country athletes. Injuries have been shown to negatively impact athlete’s mental health; this is especially true in student athletes. The purpose of this research is to explore the mediating effect of injuries on the relationship between training volume and mental health in collegiate cross-country runners. Participants in this study were 40 members of NCAA Division 2 Cross Country teams with eligibility …

Integrative Multi-Omics Analysis Uncovers Tumor-Immune-Gut Axis Influencing Immunotherapy Outcomes In Ovarian Cancer, Spencer R Rosario, Mark D Long, Shanmuga Chilakapati, Eduardo Cortes Gomez, Sebastiano Battaglia, Prashant K Singh, Jianmin Wang, Katy Wang, Kristopher Attwood, Suzanne M Hess, A J Robert Mcgray, Kunle Odunsi, Brahm H Segal, Gyorgy Paragh, Song Liu, Jennifer A Wargo, Emese Zsiros

Faculty, Staff and Student Publications

Recurrent ovarian cancer patients, especially those resistant to platinum, lack effective curative treatments. To address this, we conducted a phase 2 clinical trial (NCT02853318) combining pembrolizumab with bevacizumab, to increase T cell infiltration into the tumor, and oral cyclophosphamide, to reduce the number of regulatory T cells. The trial accrued 40 heavily pretreated recurrent ovarian cancer patients. The primary endpoint, progression free survival, was extended to a median of 10.2 months. The secondary endpoints demonstrated an objective response rate of 47.5%, and disease control in 30% of patients for over a year while maintaining a good quality of life. We …

Parenting With Grace, Eva Nelson Cole

Capstone Projects and Master's Theses

Parents are often caught off guard by the upheaval of adding children to their lives. Feelings of guilt, shame, isolation, and depression can arise when parents are faced with the demands and stressors that come along with having children. Studies have shown that children who have distressed parents endure lasting negative outcomes that can extend into the primary school years (Mihelic et al., 2018). Educating parents and giving them some awareness about what to expect can make a real difference. To have these conversations, I created a two-part parenting workshop for new parents at Parents’ Place in Pacific Grove, CA. …

Comparative Efficacy And Safety Of Transcatheter Versus Mitral-Valve Surgery In Elderly Patients With Mitral Regurgitation: A Systematic Review And Meta-Analysis, Saif Almuzainy, Mohamed Lemine, Rayan Aljubeh, Sami Alsalem

Journal of the Saudi Heart Association

Objectives: Mitral valve surgery is the reference treatment for severe symptomatic mitral regurgitation (MR). Percutaneous mitral valve interventions, such as the MitraClip procedure, offer an alternative, particularly for high-risk patients. The aim of this systematic review and meta-analysis was to analyze the safety and effectiveness of transcatheter mitral valve repair (TMVR) compared to surgical mitral valve repair or replacement (SMVR) in elderly patients with mitral regurgitation. Methods: We searched PubMed, Scopus, Ovid, EBSCO, and ProQuest through July 2024. Eligible studies were randomized controlled trials and observational comparative studies of TMVR versus SMVR for patients with MR, reporting outcomes such as …

Impact Of Socioeconomic Deprivation On Care Quality And Surgical Outcomes For Early-Stage Non-Small Cell Lung Cancer In United States Veterans, Steven Tohmasi, Brendan T Heiden, Nikki E Rossetti, Ana A Baumann, Theodore S Thomas, Su-Hsin Chang, Nahom Seyoum, Yan Yan, Whitney S Brandt, Bryan F Meyers, Benjamin D Kozower, Varun Puri, Et Al.

2020-Current year OA Pubs

No abstract provided.

Institutional Experience Of Lymphoproliferative Disorders With Initial Diagnosis Made Via Fine Needle Aspiration At Otolaryngology Clinic, Alaa S. Hrizat, Jerald Gong, Stacey M. Gargano

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: This study characterizes lymphomas presenting as palpable head and neck masses and evaluates the role of fine needle aspiration (FNA) and flow cytometry (FC) in diagnosis.

DESIGN: A 5-year retrospective review of FNAs performed by pathologists in an ENT clinic identified cases with a predominant lymphoid population that lacked an epithelial component. Cytology, FC, and subsequent surgical pathology diagnoses were correlated.

RESULTS: Of 821 FNAs, 154 (19%) met selection criteria. Reactive lymph nodes accounted for 43% (67/154), with most diagnosed as 'negative for malignancy,' except one 'atypical' (ATY) case. Lymphoma was confirmed in 57% (87/154) of cases, categorized as …

Human Papillomavirus Vaccination Rates Among Adolescents In South Carolina, Rebecca Jane Morrison

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Among adolescents 11-17 years of age in South Carolina, low rates of human papillomavirus (HPV) vaccination can negatively impact health outcomes through increased risk of acquiring HPV-associated cancers.

Purpose: To determine if the 4 Pillars™ Immunization Toolkit increased HPV vaccination rates among adolescent patients.

Methods: The 4 Pillars™ Immunization Toolkit was the framework for this bundled intervention. Pillar 1, convenience and easy access, included after-school HPV express clinics. Pillar 2, communication, utilized staff motivational interviewing skills, campaign promotion materials, documentation of declination, and second-dose callback appointments. Pillar 3, enhanced vaccination systems, was designed to use …

Interventions Developed To Guide Pediatric Type One Diabetes Management And Transition Of Care: A Systematic Review, Danielle Pehr-Szeliga, Aneta Rutkowski

College of Science and Health Theses and Dissertations

Background: Within the context of pediatric Type 1 Diabetes (PT1D), transition management is the process of shifting PTID responsibility from caregiver to child as they approach adulthood. With PT1D on the rise, effective transition management strategies are increasingly important to ensuring safe self-management of PT1D. The main objective of this systematic review is to summarize developmentally appropriate interventions that support youth and caregivers through the transition of PT1D.

Methods: CINAHL, PubMed, and Web of Science were used to identify studies for this review. Inclusion criteria included primary research articles in English, published from 2014-2024, and focused on children ages 1-19 …

Matrilineal Ethnic Affiliation And Female Empowerment: Investigating Attitudes Towards Female Autonomy And Health In Ivorian Households, Martine Hind Stølan

Master's Theses

Kinship structure is a fundamental aspect of anthropology, however, there is still a gap in literature on its impact on economic research, particularly regarding female autonomy and health. This study aims to address this gap by examining the influence of matrilineal ethnic affiliation on attitudes towards female autonomy and health within Ivorian households. Using data from the 2011 IPUMS Demographic and Health Survey for the Ivory Coast, using female responses, this study investigates the complex dynamics shaping attitudes towards female autonomy and access to health care. Analysis on these aspects is done using ordinary least squares (OLS) and logistic estimations. …

The Relationship Between Ultrarunning Status, Subjective Well-Being, And Life Satisfaction, Raquel Ramirez Hernandez

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic resulted in a rise in mental health challenges across the United States. Consequently, two important well-being measures for Healthy People 2030—subjective well-being and life satisfaction—were negatively impacted. A plethora of evidence exists about the benefits of running for physical and mental health. Yet, there is no available evidence that shows the benefits of ultrarunning, subjective well-being, and life satisfaction. This quantitative cross-sectional study examined the relationship between ultrarunning status, subjective well-being, and life satisfaction among adult runners in the United States. The advanced triangle of epidemiology served as the conceptual framework. A convenience sample included 369 adult …

A Problem-Based Approach To Racial And Ethnic Inequities In The German Health System, Thomas C. Lane

German Studies Undergraduate Senior Theses

This work is the first comprehensive book-length survey of racial and ethnic inequities in Germany’s health system. It takes a novel approach to understanding health inequities by focusing on the overarching structures which shape them in the German context, using examples from various areas of the health system to clarify their nuances. The Introduction grounds the need for understanding and combating health inequities in Germany’s unique postwar constitutional commitment to human dignity. Next, Chapter 1 outlines the current methods by which inequities are measured in Germany and why they are problematic. Chapter 2 covers current inequities in the provision of …

Nurses' Perceptions Regarding Supportive Care In The Neonatal Intensive Care Unit, Brandi D. Garrett

Nursing Theses and Dissertations

NICU nurses are the primary supporters of NICU families and their infants, making it vital that nurses understand the impact of a NICU visit on families and how to improve the parental experience. The complex challenges begin at the NICU admission, where families are left bewildered and unprepared for the uncertainty that lies ahead. During the NICU stay, nurses support families by providing encouragement and empowerment as they navigate their new role as NICU parents. In addition, NICU nurses are advocates for supportive initiatives to help NICU families cope with challenges such as being away from their infant and better …