Medicine and Health Sciences Commons^™

Childhood And Adolescent Obesity: Related Comorbidities And Interventions, Jasmine Wong

Nursing | Senior Theses

Background

The prevalence of childhood and adolescent obesity in the United States has steadily risen over the years and has become a public health concern. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex. Obese children and adolescents are at risk for poor health and poor quality of life. Furthermore, there are numerous comorbidities associated with childhood and adolescent obesity. While some of the associated diseases are acute, others can become chronic and result in lifelong conditions.

Objective

The purpose of the present thesis is to explore …

Pick Your Plate: A Nutrition Education Study, Emmalyn Tucker

Honors College Theses

Childhood obesity has become a cause for concern among many nutrition experts. Childhood obesity can contribute to several health problems such as type 2 diabetes, asthma, high blood pressure. The large percentage of children affected with childhood obesity suggests a lack of essential nutrition education in our country. Junk food consumption and inadequate intake of the USDA’s MyPlate food groups have become essential areas for intervention. Multiple school-based nutrition education interventions have been explored to improve both children’s nutrition knowledge and improve healthy eating behaviors. “Pick Your Plate” is a nutrition education study designed to improve nutrition knowledge regarding junk …

Usability And Technology Acceptance Of An Electronic Child Abuse Screening Tool In A Pediatric Emergency Department, Angela Hayes

Translational Projects (Open Access)

Up to half of all child physical abuse victims with major abuse injuries seen in hospitals had sentinel injuries assessed by medical providers. Universal screening for child abuse and neglect in the emergency department can potentially increase detection at lower levels of injury. However, we must consider usability for the electronic health record embedded child abuse and neglect-screening tool to be most effective. The user most likely to interact with the screening tool is the bedside nurse. The interface of the initial screening tool and the process of inputting information must be perceived as useful, usable, and satisfying to the …

Resources For Parents Of Children With Feeding Issues, Miranda Gutierrez

Department of Occupational Therapy Entry-Level Capstone Projects

Occupational therapy provides a client-centered approach to enhance engagement in valued life occupations. Activities of daily living, specifically eating and swallowing, fulfills basic physiological needs and creates a social relationship between a parent and/or caregiver and their child. Stress associated with caring for children with feeding difficulties can physically and emotionally strain the family. There is a greater need for opportunities to learn more about managing feeding and eating issues in children, especially with varying presentations across multiple conditions seen in the pediatric setting. The outcome of this capstone final culminating project included online evidence-based resources and general advice from …

Postpartum And Pediatric Education Program For Mothers, Lacie T. Ellithorpe

Department of Occupational Therapy Entry-Level Capstone Projects

My capstone experience included the focus area(s) of Clinical Practice Skills and Education. The aim of this capstone project was to create an ergonomic education program to address new motherhood and their occupations of health management and maintenance, sleep and rest, breastfeeding and other baby care, community mobility, and leisure. My Capstone Mentor was Dr. Kari Rasmussen, OTD, OTR/L. Becoming a new mother is considered a major life event, due to significant role changes that impact a mother’s everyday occupations. The population I served was new and expectant mothers in order to provide ergonomic education as they relate to the …

Implementing A Child Friendly Menu Guide In A Pediatric Unit: Promoting Healthful Choices, Lauren Hull

Dissertations

Problem: Over 1/3 of children in the United States are overweight or obese and children’s nutritional status while hospitalized worsens rather than improves. Hospital meals have too many calories, too much sugar, and too few nutrients compared to recommended guidelines for children. The primary purpose of this quality improvement project is to increase the amount of healthy foods ordered by children in a southeastern pediatric hospital unit through implementation of a menu guide.

Methods: A quality improvement pre-post interventional pilot study was done through implementation of a child friendly menu guide promoting healthful eating. Data was collected by retrospective and …

Perioperative Tube Feeding Guidelines For The Pediatric Burn Patient, Jordan Swanberg

Doctor of Nursing Practice Projects

Pediatric burn patients require an astronomical amount of nutritional support to promote wound healing and prevent unwanted side effects. These patients often require multiple surgeries, and consequently, when following standard NPO guidelines, these patients go for hours without any nutritional support. For this reason, a protocol was implemented on how to administer tube feedings throughout the perioperative process safely. The purpose of this project was to give a PowerPoint presentation to the providers that tested their current knowledge on how to manage tube feedings in the operative setting best. A single group design consisting of CRNA’s and an anesthesiologist was …

Best Practice In The Perioperative Anesthetic Management Of Infants With Gastroschisis, Emily R. Lester

Doctor of Nursing Practice Projects

Gastroschisis, a severe abdominal wall defect, occurs in approximately 1 in every 2,000 fetuses. Despite care advancements, gastroschisis is associated with significant morbidity and mortality including prolonged time to tolerance of enteral feeds, prolonged ventilator support, and increased intensive care unit length of stay and hospital costs. A recent practice change in the care of infants with gastroschisis at a tertiary care facility in central Illinois lead to the request for an integrative review of the available literature and subsequent development of a comprehensive guideline discussing best-practice perioperative recommendations pertinent to the care of infants with gastroschisis. Through review of …

The Long-Term Health And Developmental Impacts Of Children Born At Low Birth Weight, Kathryn Grace Kelly

Honors Theses

The state of Mississippi currently has the highest incidence of low birth weight (LBW) births in the United States. LBW is a negative birth outcome which can lead to suboptimal pediatric health and development. The primary goals of this thesis are to identify the long-term outcomes associated with LBW and to present potential interventions to address LBW. A combination of literature review and quantitative data analysis were used to inform the objective of this thesis. A variety of physical health, behavioral health, and other long-term issues were found associated with LBW. The consequences of LBW place LBW children at a …

Regulation Of C-C Chemokine Receptor 7 (Ccr7) Ligand-Mediated Internalization And Chemotaxis By G Protein-Coupled Receptor Kinase Family 4 (Grk-4, 5, 6) In Human Pediatric T-Cell Acute Lymphoblastic Leukemia (T-All), Eduardo Elias Chaib

Open Access Theses & Dissertations

Background and Significance: The Hispanic population is disproportionally affected by T-ALL (T-cell acute lymphoblastic leukemia) when compared to other races in the US. C-C Chemokine Receptor 7 (CCR7) in T-ALL is used during disease progression, and may lead to migration of cancerous cells into the Central Nervous System (CNS) of patients. Goals and Objectives: This project aims to find relevant rates and risk factors for T-ALL for the Hispanic population in the US/Mexico border region. The other aim is to assess the effect of the G protein-coupled Receptor Kinase 4 (GRK-4) family proteins on migration and receptor internalization through CCR7 …

Pediatric Specific Assessment Modalities In Pediatric Blunt Trauma Cases: A Literature Review, Haley Ranne

The Eleanor Mann School of Nursing Undergraduate Honors Theses

With unintentional injury being the number one cause of death of children in the United States, it warrants the need for successful, cost effective ways to improve identification of severe injury and prevent mortality in children. The purpose of this review is to compile literature related to pediatric specific trauma assessments in the instance of blunt trauma. Twenty peer-reviewed articles that were published in notable journals were analyzed to include in this review. There are several assessments that are being utilized in pre-hospital and hospital emergency settings today, such as the Shock Index (Pediatric Age Adjusted), Pediatric BIG Score, and …

Pediatric Seizure Management With Ketogenic Diet, Lydia Beller

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Seizure disorders can be life altering and debilitating, especially for developing children. Children who have seizure disorders often require social, emotional, educational, and behavioral adjustments for children. Most medication regimes do not achieve complete management of seizure frequency and intensity. For children, seizure disorders can lead to unsuccessful education experiences, low self-esteem, severe injury, and difficulties with social skills and engagement. Discovering that a dietary means can reduce their frequency and intensity is groundbreaking. The ketogenic diet is a high protein, high fat, and almost no carbohydrate diet. The ketogenic diet is an effective non-pharmacological method for treating epilepsy (Karimzadeh, …

The Effect Of Telepractice On Vocal Interaction Between Provider, Deaf And Hard-Of-Hearing Pediatric Patients, And Caregivers., Abigail Betts

Electronic Theses and Dissertations

The purpose of this thesis is to examine how telepractice affects a vocal interaction between a speech-language pathologist (SLP), deaf and hard-of-hearing children who received cochlear implants (n = 7), and caregivers as they engage in speech-language interventions conducted in-person and via telepractice (tele). Frequency of vocalizations, vocal turns, pause duration, fundamental frequency (F0) mean and range, utterance duration, syllable rate per utterance duration, and mean length of utterance (MLU) were examined. The SLP vocalized more during in-person than tele-sessions, opposite result for the mother. There were more SLP-child turns during in-person sessions than tele-sessions; opposite result for mother-child turns. …

Improving Vaccination Rates In Pediatric Primary Care, Lauren E. Osbeck

Doctoral Dissertations

Objectives: In a small, rural pediatric primary care clinic, the effectiveness of electronic patient portal reminders were evaluated at improving vaccination rates for school required immunizations.

Methods: A quality improvement project was initiated utilizing The Social Ecological Model. All pediatric patients were sent reminders who were under-immunized. This QI project evaluated the effectiveness of vaccine reminders on the improvement of immunization rates in the clinic

Results: Total number of fully-vaccinated patients within the practice improved (2%) and patients under-immunized decreased by 1%. 87 immunizations were given to patients were given to patients who were under-immunized and an average of 10% …

Integrative Music Therapy: A Healing Intervention For Children With Disabilities, Francesca N. Do

Theses and Graduate Projects

Children with developmental delays have barriers to accessing early interventions to help develop their childhood milestones. An accessible intervention considered a universal language to all cultures is integrative music therapy. Music therapy paired with in-home care can create a healing environment for children to learn developmental skills, initiate play, and express their emotions with the nurse’s guidance. An integrative music therapy educational program was developed using Jean Watson’s Theory of Human Caring as a theoretical framework for the pediatric nurses working in a rural Midwest home health care company. The goal of the educational program is to promote awareness of …

Food Insecurity And Infant Feeding Methods Among Mothers With Infants In Children's Hospital, Sara Brobeck

Department of Nutrition Student Projects

Abstract

Introduction: Although breastfeeding is more sustainable and affordable compared to infant formula, mothers who are food insecure are shown to breastfeed less and turn to formula more. This paradox may result from beliefs surrounding diet and breastfeeding. For example, evidence shows that mothers may believe that the quality of their breastmilk may be negatively affected by insufficient diet and stress which is caused by food insecurity.

Objective: The objective was to find an association between food insecurity and method of infant feeding (breastfeeding or combination of breastmilk and formula).

Methods: Food insecurity surveys were administered to 31 mothers in …

Improving Advanced Practice Nursing Care To Children With Autism In The Emergency Department, Suzanne J. Bartell

Theses and Graduate Projects

Autism Spectrum Disorder (ASD) prevalence rates are increasing within the pediatric population. Often, these children present to emergency departments (EDs) for care that could typically be managed in a primary care setting. Furthermore, pediatric patients with ASD utilize EDs at a rate higher than children without (Baio et al., 2018). Parents, patients, and providers within the pediatric ED setting report a lack of understanding and tools needed to provide quality and meaningful care to this population. The utilization of nurse practitioners in the ED setting is increasing due to affordability and quality of care delivery. The intersection of these two …

Pediatric Manual Wheelchair Skills Handbook, Brooke Edwards

OTD Capstone Projects

The focus of this capstone project was to create a pediatric manual wheelchair skills group for the Vanderbilt Pediatric Seating & Mobility Clinic. Most current literature focuses on adult manual wheelchair mobility skills programs and this project seeks to contribute to the resources for the pediatric population. This was done through collaboration with stakeholders, review of manual wheelchair skills programs already developed, a literature review to identify skills needed for independent functional mobility and assessments of skills, and acquisition of manual wheelchair skills. The result was a handbook including both beginner and advanced pathways with instructions for skill acquisition and …

An Analysis Of The Psychological And Physical Effects Of A Physical Activity Program During In-Patient Pediatric Cancer Treatment, Zoë Winters

Undergraduate Theses

There is limited published research regarding the use of physical activity in cancer treatment programs, and even fewer in pediatric treatment plans; however, there is a common consensus that following the conclusion of cancer treatment an individual’s physical fitness has been majorly impacted. The inactivity that commonly coexists with cancer treatment often results in extended periods of time in rehabilitation programs and decreased independence. Along with the physical detriments caused by inactivity, increased dependence on others often brings about feelings of helplessness that can further cause emotional detriments. It has however been demonstrated in previous research that adding physical activity …

Behavioral Intervention Education For Pediatric Functional Constipation: A Feasibility Project, Meredith Brady, Jean Pelski Ph.D., Aprn, Nnp-Bc

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Functional constipation (FC) is a common condition frequently seen in pediatric primary care, with an estimated median prevalence of 16% among pediatric patients (Mugie et al., 2011). Standard care for this condition is typically limited to laxative therapy, however evidence supports improved outcomes for patients who also receive behavioral intervention education. Purpose: The purpose of this quality improvement study was to assess the feasibility of implementing a standardized intervention strategy in a primary care setting for pediatric patients with FC to inform a future pilot study. Methods and interventions: This feasibility study was completed in three steps. 1) A …

Knowledge Of Guidelines On Pediatric Patients In Foster Care, Katharine A. Stones

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: The American Academy of Pediatrics (AAP) identifies children living in foster care (CFC) as a special health care needs population due to a high prevalence of health conditions. To address these disparities, the AAP released guidelines regarding the timeliness of medical assessments for CFC. Lack of recognition of the guidelines further widens health disparities experienced by this population. This project’s purpose was to 1.) Improve pediatric providers’ and nurses’ knowledge of AAP guidelines by at least 50% and 2.) Initiate acknowledgment by participants that CFC represent a special health care needs population.

Methods: Following conduction of qualitative interviews and …

The Financial Effect Of Covid-19 On Children's Hospitals Without Pediatric Psychiatric Units, Patricia Tran

Theses, Dissertations and Capstones

Introduction: Boarding of pediatric psychiatric patients in emergency departments and inpatient medical units while awaiting placement in psychiatric facilities was common before the COVID-19 pandemic and was associated with significant hospital cost. The COVID-19 pandemic triggered a mental health crisis in the pediatric population. This study looked at the how the COVID-19 pandemic affected pediatric psychiatric boarding and the effects of pediatric psychiatric boarding on hospital finances.

Methodology: The methodology of this study utilized a literature review with semi-structured interviews of local subject matter experts. The literature review analyzed the effects of the COVID-19 precipitated pediatric mental health …

The Efficacy Of The Role Of Therapeutic Play In Alleviating Pain Or Anxiety In Pediatric Cancer Patients, Savannah B. Duke

Honors Undergraduate Theses

Aim: To evaluate the efficacy of therapeutic play in alleviating pain or anxiety in the pediatric cancer patient.

Background: Therapeutic play is an intervention often incorporated within the care of pediatric cancer patients and children with other disease processes to promote well-being. Even though play therapy is supported by research, nurses have the option to implement nursing care interventions in a play-like manner. Therapeutic play is an individualized technique that provides an intentional opportunity for children to express their emotional responses in a controlled environment.

Method: The databases used in this search included CINAHL, MEDLINE, APA PsycINFO, ERIC, and Education …

The Combinatory Effects Of Pediatric Obesity And Ontogeny On Monocarboxylate Transporter Expression In Tissues Of Drug Disposition, Michael Ng

University of the Pacific Theses and Dissertations

Proton-coupled and sodium-dependent monocarboxylate transporters are encoded by the SLC16A and SLC5A gene family of solute carriers, and are responsible for the transport of essential nutrients such as L-lactate, pyruvate, and ketone bodies. Basigin, or CD147, acts as an ancillary protein for MCT1 and MCT4, and is involved in membrane surface expression of transporters. MCT's are also involved in the shuttling of monocarboxylic xenobiotics across cell membranes, including the drugs valproate and gamma hydroxybutyrate. MCT’s are also important for normal mammalian development, particularly during embryogenesis and early neonatal life. Previous studies have shown that ketogenic diets increase MCT expression in …

The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett

DNP Projects

Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.

Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary …

Evaluation Of A Beverage Educational Intervention For Latino Parents Of Infants And Children Ages Nine Months To Five Years, Natalie Chelf

DNP Projects

Background: The Latino population has the highest rate of childhood obesity in the United States. Sugar-sweetened beverage (SSB) consumption has a positive correlation with increased rates of childhood obesity. Current research shows a deficit in culturally sensitive methods to reduce SSB consumption in the pediatric Latino population.

Purpose: The purpose of this project is to empower parents of Latino infants and young children with the knowledge to reduce or eliminate the consumption of SSBs in their child’s diet.

Methods: The project was a one group pre-test post-test quasi-experimental study design occurring in one pediatric outpatient clinic. The Information-Motivation-Behavioral Skills (IMB) …

Hypothermic Patient Warming In A Pediatric Emergency Department, Daniel Bileth

West Chester University Doctoral Projects

Hypothermia has been associated with increased morbidity and mortality in adults and increased mortality in children. Unplanned hypothermia increases adverse outcomes in patients, including increased blood loss, increased risk for blood transfusion, decreased oxygenation to major organs, and decreased immune response (Beedle et al., 2017; Brozanski et al., 2020; Erdoğan et al., 2019; Granum et al., 2019). Collaboration with Emergency Department (ED) physician leadership, clinical educators, and trauma leadership determined the need for a formal warming procedure. The purpose of this project was to implement a clinical warming algorithm for pediatric patients within the ED who had a temperature of …

Treating Gut Feelings: A Systematic Review Of Psychological Treatments For Pediatric Inflammatory Bowel Disease, Venus Mirbod

Theses and Dissertations

Psychological comorbidities and psychosocial challenges are prevalent among children and adolescents with Inflammatory Bowel Disease (IBD). However, a comprehensive review of the availability and effectiveness of psychological treatments for pediatric IBD patients is lacking. This systematic review aimed to determine the availability and efficacy of psychological interventions for children and adolescents with IBD. The systematic review was conducted in accordance with PRISMA guidelines and performed using two electronic databases, PsycINFO and PubMed, from inception until March 2022. Databases were searched for English-language, controlled trials of psychological interventions for children and adolescents with IBD. Outcomes of interest included: depression, anxiety, health-related …

Intractable Pediatric Epilepsy And Dietary Therapies: A Meta-Analysis Of Trials For Seizure Reduction, Victor Figueira M Dantas

Honors Undergraduate Theses

Objective: to compare dietary treatments and their effectiveness in reducing seizures through a systematic review and meta-analysis of clinical trials Methods: Using the PRISMA Method, the Primo database was searched to find peer-reviewed articles where researchers compared one treatment against another. The treatments of choice present in all studies are the Ketogenic Diet and the Modified Atkins Diet. Due to the nature of the experiments, the Ketogenic Diet was considered the control, as it was coined first. Results: Of the 450 articles identified, 378 met the primary peer review threshold and 190 were classified as Open Access. Eight met eligibility …

Equipping Advanced Practice Providers: Interprofessional Pediatric Airway Management Course, Kenton M. Schrock

Graduate Theses, Dissertations, and Problem Reports

Background: Developmental differences between pediatrics and adults requires intervention adjustments for airway management. Segregated intraprofessional training and limited provider exposure could result in poor collaboration and low-quality management. Patient outcomes depend on the proficient collaborative application of skill and knowledge. Purpose: The interprofessional pediatric airway management course paired unique airway considerations with interprofessional training strategies to equip providers to deliver safe airway management. Intervention: The course was delivered as a 3-hour training session. Participants completed team simulations and skill/concept stations. Pre- and post-intervention competency and confidence scores were measured and analyzed. Methods: Baseline confidence and competency scores in managing a …