Medicine and Health Sciences Commons^™

Implementing Community Health Workers To Improve The Management Of Chronic Non-Communicable Diseases In Children, Julia L. Newell

Doctor of Nursing Practice (DNP) Projects

Background: Childhood obesity, asthma, and untreated mental health conditions are three examples of chronic non-communicable diseases (CNDs) that pose a host of negative consequences later in life. Minority children from low-income families, especially those with environmental disadvantages, face additional risk factors for the development of these diseases. Community health workers (CHWs) are in a unique position to help address these negative health externalities by being attuned with the linguistic, cultural, and socioemotional needs of members of their communities. Research has demonstrated success in CHW-led interventions curtailing the negative impacts associated with these diseases in low-income, minority communities.

Methods: A literature …

Assessing Virtual Versus In-Person Experiential Learning And Medical High-Fidelity Simulation In Medical Student Pediatric Clerkship Training, Andrew Mitchell Berry

Electronic Theses and Dissertations

Simulation and experiential training have been incorporated into medical school training for decades. The utilization of medical simulations has become an invaluable tool in healthcare education and training. However, circumstances such as limited resources, geographical constraints, or global health crises may hinder the feasibility of conducting in-person medical simulations. In these scenarios, virtual medical simulations emerge as a compelling alternative. While there are many ways to accomplish experiential-based learning, many faculty and students feel Socratic learning styles provide the best learning experience.

As medical students had just finished a predominantly virtual preclinical year due to the COVID-19 pandemic, the research …

Screensafefuture: A Parent-Empathetic And Practical Mhealth Application For Toddlers' Brain Development Addressing Screen-Addiction Challenges, Nafisa Anjum

Master of Science in Information Technology Theses

The surging incidents of infants and toddlers screen addiction in the United States are becoming a pressing concern due to its detrimental and compound impact on cognitive development, mental health, and physical growth. To address this era's critical child health and human development problem, we propose an innovative mHealth application-- ScreenSafeFuture-- in this paper. ScreenSafeFuture provides practical and parent-friendly solutions that seamlessly fit into parents' busy lifestyles, also acknowledging the effectiveness and convenience of smartphones as a healthcare tool. Our offering includes essential features designed to enhance the experience between parents and their children under 3 years old. With an …

Comparison Of Physical Activity Levels Among School-Age Adolescents In The Rural And Urban Areas Of District Swat Kpk, Pakistan- An Analytical Cross-Sectional Study, Imran Uddin

Theses & Dissertations

Background: Obesity and overweight represent significant global public health concerns. Young adolescents are in particular increasingly experiencing obesity and overweight due to their sedentary lifestyles, excessive electronic media use, and lack of physical activity (PA). This trend is linked to the development of non-communicable diseases in later life. Moreover, data regarding the lack of PA is available in Pakistan, but a gap exists in the comparative analysis of physical activity levels between rural and urban adolescents. Rural and urban areas exhibit distinctions in both geographical settings and technological advancements, potentially influencing the PA levels of their respective inhabitants.
Purpose: The …

Analyzing Prominent Genes In Acute Lymphocytic Leukemia (All), Shima Z. Omar

Honors College Theses

Acute lymphocytic leukemia (ALL) is the most common type of childhood cancer. Leukemia is a type of cancer that involves the bone marrow and blood. This research study examined prominent genes in the disease. Two groups of genes, tumor suppressor and cell differentiation, were compared using statistical analysis to compare their binding potential and epigenetic potential. It is most likely that I failed to detect significant differences either because these genes’ function in the disease etiology is not strongly contexed to changes in expression, or that the magnitude of the differences were too slight to be detected with these methods. …

Enhancing Adherence To Best Practice Guidelines Related To Pressure Injury Prevention In The Operating Room At A Children's Hospital During Comprehensive Dental Procedures., Alyce Bailey Seaver

Doctor of Nursing Practice Papers

Background: 1,600,000 patients develop a hospital-acquired pressure injury every year, and 23% of these originate during surgery. Research has demonstrated that the incidence of hospital-acquired pressure injuries developing during surgery has risen over the past 5 years. This rise has been attributed to nurse circulators exhibiting poor knowledge regarding best practices for intraoperative patient positioning and intraoperative documentation that does not follow standards of care.

Purpose: This quality improvement project aimed to enhance circulator knowledge on best practices for intraoperative patient positioning and improve documentation of intraoperative patient positioning in the electronic medical record to comply with standards of …

Screening For Food Insecurity In A Suburban Pediatric Urgent Care, Rachel Foutz

Dissertations

Problem: Screening for Social Determinants of Health (SDOH), including food insecurity (FI) should be done on a regular basis at a child’s pediatrician. Many children in the state of Missouri do not have a pediatrician or do not regularly see their pediatrician and are therefore never being screened for FI.

Methods: This observational descriptive quality improvement (QI) project utilized a prospective observational analysis to implement a voluntary FI screening tool in a pediatric only urgent care. The project sampled pediatric patients aged two days to 21 years of life. All participants were given local resources after completing the screening. The …

Extubation Readiness Test In A Pediatric Cardiac Intensive Care Unit, Mary K. Holyoke

Dissertations

Extubation Readiness Test in a Pediatric Cardiac Intensive Care Unit

Abstract

Problem: The lack of standard extubation readiness tests (ERTs), that are practiced in pediatric ICUs to monitor extubation readiness, clinicians have the difficult task of weighing the risk versus benefit of extubation. ERTs can aid clinicians in deciphering patients ready to be successfully extubated and have shown to decrease length of mechanical ventilation and decrease extubation failures.

Methods: The quality improvement (QI) project utilized a descriptive observational design to assess the effects of the implementation of an ERT in a pediatric cardiac ICU. This project used a convenience sample …

Acute Agitation Intervention Tool For Reduction Of Polypharmacy, Brooks J. Propst

Dissertations

Introduction: Patients with behavioral health diagnoses are among the highest risk for
aggression. For pediatric patients with behavioral health needs, urgent treatment is
needed for aggressive behavior, due to the potential unwanted outcomes. The purpose of this Quality Improvement (QI) pilot project was to implement an Acute Agitation Intervention Tool that uses the Broset Violence Checklist (BVC) to guide
pharmacological intervention for mild and moderate to severe agitation in pediatric
patients with behavioral health needs ages 8 to 18 to decrease the number of medications that patients are getting per agitation event over a 12-week period.

Methods: This QI included …

Implementation Of A Patient Care Specialist Role To Enhance The Patient Experience In A Pediatric Emergency Department, Jillian Brodeur

Doctor of Nursing Practice Projects

Background: Patient-centered care (PCC) has been an emerging trend in healthcare for the past two decades (Walsh et al., 2022). PCC and the patient experience have become essential measures of the quality of care provided and are linked to reimbursement dollars and improved patient outcomes (Rapport et al., 2019).

Purpose: The purpose of the Doctor of Nursing Practice (DNP) project was to improve the patient experience in the Emergency Department (ED) of a metropolitan hospital. The DNP project focused on the benefit of a patient advocate in the ED to improve the patient experience. The project sought to improve …

Recognizing And Reporting Of Child Maltreatment In A Pediatric Primary Care Setting., Jennifer L. Dumey

Doctor of Nursing Practice Papers

Child abuse and neglect, together known as child maltreatment, is a global problem with grim lifelong consequences (WHO, n.d.). Education and confidence in reporting child maltreatment are imperative for medical providers who are responsible for the evaluation of children during routine visits with pediatric providers. Research continues to link child maltreatment with adverse health outcomes that span throughout a person's lifetime. For this reason, medical providers must be provided with continued education on early recognition and reporting of concerns for child maltreatment.

The purpose of this project is to increase provider knowledge on the identification and reporting of child maltreatment. …

Sociodemographic Factors And The Risk Of Paediatric Out-Of-Hospital Cardiac Arrest, Samina Idrees

Electronic Thesis and Dissertation Repository

Paediatric out-of-hospital cardiac arrest (POHCA) is associated with poor survival and severe neurological sequelae. This thesis aims to explore the relationship between sociodemographic factors and POHCA. The findings from our systematic review indicate that there are racial disparities in POHCA risk and in the provision of bystander cardiopulmonary resuscitation. There was little evidence of sociodemographic disparities in bystander defibrillation, survival and neurological outcome, particularly across adjusted analyses. The findings from our case-control study in Ontario, Canada, indicate that children living in marginalized areas have an elevated risk of experiencing POHCA. We also found that children living in northern urban or …

Education As A Source Of Hope: An Examination Of Teacher Beliefs And The Lack Of Support For Children With Chronic Health Conditions, Marissa Schow

Education | Master's Theses

As survival rates increase, more children with chronic health conditions are returning to K-12 classrooms after receiving medical treatments. Research has shown that many teachers believe that students with chronic health conditions should not have to worry about school while they are going through treatment (Irwin & Elam, 2011; Legislative Alliance for Students with Health Conditions, 2017). Research also suggests that many schools are violating the Every Student Succeeds Act of 2015 by withdrawing students from the district due to chronic absenteeism (Eaton, 2012; Wilkie, 2012). The purpose of this mixed methods study was to explore and examine the ways …

A Lifestyle Modification Intervention In Hispanic Adolescents With Nonalcoholic Fatty Liver Disease, Brianne Miller

Evidence-Based Practice Project Reports

U.S. population studies have confirmed that the Hispanic population has the highest prevalence and the worst prognosis for non-alcoholic fatty liver disease (NAFLD) (Katz et al., 2021). The purpose of this evidence-based practice project was to implement a multicomponent, lifestyle modification intervention in Hispanic pediatric primary care patients to combat the disease process and sequela of NAFLD. The PICOT question for this project was: In Hispanic adolescents aged 10-21 with obesity and NAFLD (P), what is the effect of a multicomponent, lifestyle modification intervention (I), on alanine aminotransferase (ALT) (O), over a 12-week time period (T)? A comprehensive literature search …

Evaluating The Impact Of Routine Enteral Iron Fortification On Gastrointestinal Dysbiosis In Premature Infants, Matthew Van Ormer

Theses & Dissertations

The gastrointestinal microbiome in preterm infants bears significant influence on optimal outcomes – dysbiosis is shown to substantially increase the risk of the life-threatening necrotizing enterocolitis, whereas optimal microbiome composition improves nutrient digestion and immune function. Iron is a vital nutrient especially during the perinatal window of rapid hemoglobin production, tissue growth, and foundational neurological development. However, excess colonic iron exhibits potent oxidation capacity and alters the competitive environment of microbes – potentially facilitating the proliferation of pathological bacterial strains in the gut. Of note, breastfed preterm infants routinely receive iron fortification starting at 14 days of life and are …

Automating The Radiation Therapy Treatment Planning Process For Pediatric Patients With Medulloblastoma, Soleil Hernandez

Dissertations & Theses (Open Access)

Over the past 50 years, pediatric cancer 5-year survival rates increased from 20% to 80% in high-income countries, however, these trends have not been mirrored in low-and-middle-income countries (LMICs). This is due in part to delayed diagnosis, higher rates of advanced disease at presentation and a growing lack of access to high quality medical personnel and technology necessary to deliver complex treatments.

The long-term goal of this study was to alleviate demanding workflows and increase global access to high-quality pediatric radiation therapy by harnessing the power of artificial intelligence to automate the radiation therapy treatment planning process for pediatric patients …

Occupational Therapists’ Role In Educating Caregivers On Pediatric Sensory Interventions Guided By Neurodiversity Principles, Deanna Bourgeois

Student Capstone Papers

Background: Neurodivergent children often experience differences in sensory processing and self-regulation. Traditional sensory-based interventions are frequently used by occupational therapy practitioners (OTP) and caregivers to address dysregulation. However, sensory-based interventions, while often strengths-based, are not always neurodiversity-affirming.

Problem: There are minimal educational resources available to both OTP and caregivers that promote neurodiversity-affirming sensory interventions to support neurodivergent children.

Methods: The purpose of this project was to create self-paced educational modules to teach neurodiversity-affirming sensory interventions that promote children's self-regulation. To achieve this goal, the student investigator developed virtual educational modules and piloted them with OTP, occupational therapy …

Maturation Of Default Mode Network Functional Connectivity Strength In Utero And The Association With Subcortical Macrostructure: Mapping Brain Ontogeny Supporting Early Cognitive Processing, Susana Correa

Electronic Thesis and Dissertation Repository

The third trimester of gestation is scarcely studied despite this being a key window for the development of learning and memory systems. In a prospective cohort study, 30 pregnant women participated in one or two fetal MR imaging sessions between 28- and 39 weeks of gestational age. Activation time courses were extracted from the default mode (DMN), medial temporal lobe (MTL), and thalamocortical (TCN) networks of the fetal brain. Generalized estimating equations were used to examine the association between the DMN-MTL, DMN-TCV connectivity strength, and subcortical volumes. Increased functional connectivity strength between the DMN-MTL networks was negatively associated with smaller …

Benefits Of Rooming-In On Infants With Neonatal Opioid Withdrawal Syndrome, Emma Ricioli

Nursing | Senior Theses

Neonatal opioid withdrawal syndrome (NOWS) is a significant public health concern, affecting infants born to mothers who use opioids during pregnancy. Those exposed in-utero exhibit numerous signs of withdrawal after delivery including tremors, gastrointestinal distress, inconsolability, and poor feeding. Typical treatment for infants suffering from NOWS included direct admission to the neonatal intensive care unit (NICU) for close observation and pharmacological interventions. However, NICU stays can interfere with bonding and breastfeeding. They can also lead to increased lengths of stay, higher costs, and more invasive pharmacological treatments. These infants typically do not have any other concerning health issues besides NOWS …

Impact Of A Parent Education Program On Parents Of Children With Complex Congenital Heart Disease Prior To Discharge Home, Laura Elkhoury

DNP Projects

Abstract

Background and Purpose: Children with complex medical needs, such as children with complex congenital heart disease, are at risk for hospital readmission, morbidity, and mortality related to disease complications. Parents must be adequately prepared to care for their children following hospital discharge to prevent hospital readmission and complications. This study seeks to evaluate the impact of an education intervention on parental knowledge and stress related to caring for their child with complex medical needs.

Methods: The study design is a quasi-experimental, nonequivalent control pre-test/post-test design. The pre-test was administered prior to the educational intervention, with the post-test …

Development Of A Community-Based Plan For An Effective Behavioral Intervention To Reduce Childhood Obesity In A Rural Appalachian Community, Jennifer Stacy Wells

Theses and Dissertations--Nutrition and Food Systems

Rural children experience increased rates of obesity and reduced access to specialized weight management facilities, which makes receiving the recommended frequency of care difficult. Clinical-community partnerships, recommended by the American Academy of Pediatrics (AAP) to expand access, have been shown to be a feasible strategy of care delivery. Examination of literature and stakeholder interviews were used to inform the development of a collaborative pediatric weight management program in a rural, Appalachian community. Screening articles as well as intervention articles were reviewed. Outcomes of screening articles reviewed included BMI measures (3), screening practices (7), and referral practices (4). Common outcomes of …

The Heads-Ed: A Psychosocial Screening For Pediatric Patients In Emergency Departments: A Systematic Review, Jessica Burns

Theses and Dissertations

The rates of mental health (MH) conditions among the pediatric population are rising steadily (Abramson, 2022; Clark et al., 2019). Given that MH symptoms and concerns frequently present in the emergency department (ED)-particularly since the onset of the COVID-19 pandemic-the ED setting may be a practical and effective setting to implement screening measures to identify youth at risk for mental illness and suicide (Leeb et al., 2020; Leff et al., 2021). This integrative systematic review examined the extent to which the HEADS-ED, one specific psychosocial screening measure, has been administered in the ED setting with youth and which healthcare professionals …

Factors Associated With Clinically Significant Hyperbilirubinemia Among Abo-Incompatible Newborns At A Tertiary Care Hospital In Kenya., Wandera Ivy Mwenesi

Theses & Dissertations

Background: ABO incompatibility is one of the most common causes of immune-mediated neonatal jaundice. It occurs in approximately 20-25% of all pregnancies. Literature shows that 60- 80% of newborns will develop physiological jaundice within the first week of life. Globally, the incidence ranges from 10-41%. Early detection of newborns with ABO incompatibility-related jaundice can prevent the incidence of bilirubin-induced neurological dysfunction. Whereas there have been extensive published data on rhesus isoimmunization, very few studies have examined ABO incompatibility and isoimmunization. From the published literature, there has been no known study that has assessed risk factors for developing clinically significant jaundice …