Medicine and Health Sciences Commons^™

Fasting Insulin, Glucose, And Hba1c Among Young Adults With Overweight And Obesity, Benjamin Shambon

GW Research Days 2016 - 2020

We compared fasting blood glucose, insulin, and hemoglobin A1c using baseline data collected from 460 young adults ages 18-35 enrolled in an ongoing randomized controlled clinical weight-loss trial. The goal was to determine differences within the subject pool for insulin insensitivity and pre-diabetes based on demographics. We further modeled both pancreatic beta cell function and insulin sensitivity using the homeostatic model assessment for insulin resistance (HOMA-IR).

Use Of The Adult Myopathy Assessment Tool As A Predictor Of Functional Abilities In People With Multiple Sclerosis, Kimberly Benson, Michael O. Harris-Love, Bryant A. Seamon, Mitchel T. Wallin, Heidi Maloni, Brian Hoover, Marc R. Blackman

GW Research Days 2016 - 2020

Background: People with multiple sclerosis (PwMS) are at greater risk for decreased muscle performance which may lead to decreased functional abilities. The Kurtzke Expanded Disability Status Scale (EDSS) is commonly used as a disability status rating scale in PwMS. Nevertheless, the EDSS is largely comprised of neurological tests and may not best reflect functional performance. A functional battery such as The Adult Myopathy Assessment Tool (AMAT) may better reflect functional performance. The AMAT was designed to assess both functional strength and endurance in clinical settings. However, the AMAT has not been validated for the assessment of PwMS.

Objective: The purpose …

A Triple Threat: Alcohol Use Disorders In The Presence Of Comorbid Chronic Pain Conditions And Depressive Disorders In The Collaborative Psychiatric Epidemiology Surveys, 2001-2003, Chelsea Boyd, Sean Cleary, Scott Quinlan, Debra Bernat

GW Research Days 2016 - 2020

Background: Frequently patients with chronic pain conditions have comorbid depressive disorders. The relationship between the diagnoses is often bidirectional, with the effects of one condition exacerbating the effects of the other. Alcohol use disorders (AUD) are also independently associated with both conditions. This study aims to determine the prevalence of alcohol use disorders among patients with comorbid chronic pain conditions and depressive disorders in a nationally representative sample of US adults and ascertain the characteristics of patients with all three diagnoses.

Methods: This cross-sectional analysis utilizes data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003. The sample includes respondents who …

"As Parents, How On Earth Are We Going To Handle This Issue": Provider And Parent Views On Sexuality-Related Challenges During Adolescence Among International Hiv-Infected Adoptees In The U.S., Sarah Alger, Cynthia Fair

GW Research Days 2016 - 2020

As the number of internationally adopted children with HIV has increased since 2010 in the U.S., more children may have additional educational needs, particularly related to sexuality, as they mature. After conducting 48 hour-long, semi-structured interviews with parents and providers, the qualitative analysis shows that many parents' adoption decisions are driven by faith, which can influence the child's ability to gain vital sexual education given their HIV status. Parents of internationally adopted children with HIV could benefit from the support of healthcare providers to better understand the importance of sexual and reproductive health during adolescence.

Acute Particulate Matter Exposure And Suicide In North East Asia: A Literature Review, Shannon Haines, Lance Price, Amanda Northcross

GW Research Days 2016 - 2020

A systematic literature review was conducted on research exploring the relationship between acute exposures to ambient particulate matter and changes in suicide rates in North East Asian countries. From the eight studies analyzed limited evidence was found and additional research about the association is suggested.

A Pilot And Feasibility Study Of Virtual Reality Guided Meditations In First-Year Medical Students, King John Pascual, Benjamin Blatt

GW Research Days 2016 - 2020

Virtual reality (VR) is a popular technology that places users in an interactive 3D environment. VR has been used to enhance surgery training, rehabilitation of brain injury survivors, and telepsychiatry. Our aim for this study is to assess the perception of first-year medical students on the value of a VR meditation program on stress reduction, both immediate and longer term. We recruited 10 volunteer participants. Each participant completed a guided meditation using a commercially available VR headset paired with a meditation app and oximeter that calculates a heart rate variability (HRV) index. Each meditation was five minutes long and participants …

Occupational Risk Of Migrant Farm Workers In North Carolina: A Systematic Review, Ellie Ginsberg, David Michaels

GW Research Days 2016 - 2020

Latnix Migrant Farmworkers in North Carolina face a variety of occupational hazards while working in the fields. These hazards include exposure to the natural elements, pesticides, and tobacco. Sub standard housing conditions and lack of comprehensive workers compensation coupled with these hazards create an extremely dangerous working environment for these farmworkers.

Does Food Insecurity Predict Obesity And Educational Achievement: A Systematic Literature Review, Emily Youner, Ami Zota

GW Research Days 2016 - 2020

The objective of this study was to determine whether food availability predicts health outcomes among children in the U.S., such as obesity rates and academic performance. Though there was some inconsistency in the findings, based on the Navigation Guide methodology, we concluded that there is inadequate evidence of correlation between food insecurity and obesity rates, yet limited evidence of correlation between food insecurity and educational achievement. Given these findings, further research is warranted to inform policy action to mitigate the effects food insecurity.

Cognitive And Behavioral Effects Of Nitrogen Dioxide Exposure In Primary School Children: A Systematic Review, Dara L. Brown, Matias Attene Ramos

GW Research Days 2016 - 2020

A systematic literature review was conducted to identify relevant studies evaluating the relationship between nitrogen dioxide emissions and cognitive and behavioral health in children. Eight studies were identified, reviewed, and analyzed according to specific inclusion criteria. The results of the review show that there is strong evidence for an inverse relationship between nitrogen dioxide exposure and cognitive and behavioral health in primary school children. However, further research is needed to confirm the observed associations between nitrogen dioxide exposure and cognitive and behavioral health.

Interaction Between Intellectual Disability And Cerebral Palsy On The Co-Occurrence Of Autism Spectrum Disorder And Epilepsy, Prarthana Hareesh, Sean D. Cleary

GW Research Days 2016 - 2020

Intellectual disability (ID) is possibly a reason for the higher co-occurrence of Autism Spectrum Disorder (ASD) in children with epilepsy. Cerebral Palsy (CP) has also been found to co-occur with ASD (6.9%-hypotonic, 18.4%-spastic subtype) and with epilepsy (41%), but it is unclear if the co-occurrence of ASD and epilepsy varies by the presence of both, ID and CP. The purpose of this study to evaluate effect modification of CP and ID on ASD-epilepsy co-occurrence.

Perceived And Experienced Mental Health Needs Among Puerto Rican Community Responders In The Aftermath Of Natural Disasters, Gabriela Madrid, Amalis Cordova, Carlos Rodriquez-Diaz

GW Research Days 2016 - 2020

For the project, I will conduct a secondary data analysis using qualitative interviews that he conducted in the first semester of 2018. I will use the data he collected to describe the perceived mental health of the community responders both on the Island and in the United States. I will also provide recommendations, informed from a literature review, to address the population's needs.

The Social Determinants Of Health For Asthmatic Children In Low-Income Communities, Iesha Reid, Amy Price, Ariel Plante, Carlika Barbee, Jared Moore, Lufthansa Castro

GW Research Days 2016 - 2020

Background: Pediatric asthma morbidity is disproportionately concentrated among young children residing in the poorest neighborhoods of Washington, DC. ED visits were concentrated among children residing in Southeast DC. Historically, these geographic disparities in asthma outcomes are linked to socioeconomic disparities.

Objective: Our aim was to conduct a review of nursing interventions that addressed the social determinants of health in asthmatic children living in low-income communities.

Methods: We searched electronic databases CINHAL and PubMed for studies published within the last 5-10 years. A total of nine studies from 2009 through 2014 from the nursing literature were identified using the following criteria: …

Reducing Unnecessary Phlebotomy Testing Using A Clinical Decision Support System, Valerie Strockbine, Cathie E. Guzzetta, Eric Gehrie, Qiuping (Pearl) Zhou

GW Research Days 2016 - 2020

Overuse of phlebotomy testing offers little to improve patient outcomes but may subject patients to additional morbidity. Low-cost, high-frequency tests are ordered recurrently, unnecessarily, and contribute to the high cost of health care. Reducing unnecessary phlebotomy tests can cut costs without compromising quality. Type and screen tests are active for three days from the date the specimen is collected, yet our blood bank laboratory observed type and screen tests were often unnecessarily ordered in our organization. We set out to determine the effectiveness of a clinical decision support system (CDSS) on reducing unnecessary type and screen tests, estimate the cost …

Developing A Cognition Scale Using Items From Three Federally Mandated Assessments In Post-Acute Care, Jennifer Weaver, Alison M. Cogan, Trudy Mallinson, Leslie Davidson

GW Research Days 2016 - 2020

The purpose of this work is to create a cognitive measure detecting change in cognitive deficits for post-acute stroke patients. Many individuals with stroke experience cognitive impairment contributing to ongoing disability. Identifying change in cognitive skills in response to treatment is important for demonstrating the value of rehabilitation services. Yet, the ability of federally mandated post-acute assessments to detect change has not been described. A total of 147 stroke patients in post-acute care receiving rehabilitation services were assessed using 26 cognition items from the federally mandated assessments. Rasch analysis, using the partial credit model, was conducted to evaluate the construct …

An Examination Of The Flipped Classroom's Efficacy On Post-Baccalaureate Pre-Medical Students, Archita Chandra, Genevieve Schmitt, Rohini Ganjoo

GW Research Days 2016 - 2020

Existing flipped classroom (FC) research focuses on a typical, homogenous student population in terms of age. Research focuses on student satisfaction and perception of the FC to assess if student performance translates to actual perceived learning. Further, a growing number of studies show that outcomes of FC depend on student motivation. This study examines student performance, perception, and satisfaction in the FC in a novel demographic: Post-Baccalaureate Pre-Medical students. These students, who vary widely in age, experience, and prior knowledge of subject matter, are career changers who become full-time students to complete prerequisite coursework for medical school. Students enrolled in …

Nci Multi-Omics Mislabeling Challenge: A Machine Learning Approach, Yeshwant Chillakuru, Arjun Panda, Sindhu Kubendran, Norman Lee

GW Research Days 2016 - 2020

Sample mislabeling is a pervasive problem in biomedical research, especially large-scale multi-omics studies, contributing to errors and leading to false conclusions. The Food and Drug Administration (FDA) and the National Cancer Institute Clinical Proteomic Tumor Analysis Consortium (NCI-CPTA) have launched a data science challenge to address this problem. We developed a novel machine learning based approach that combines traditional machine learning with learning from cancer genomics literature to identify mislabeled tumors in the NCI-CPTA Multi-omics Mislabeling Challenge.

The training data contained a sample of a tumor from 80 different patients, each containing features on gender, microsatellite instability (MSI) status, and …

Gw Nursing, Spring 2019, George Washington University, School Of Nursing

GW Nursing Magazine

No abstract provided.

The Association Of Modified Early Warning Score On Patient Outcomes In Medical-Surgical Units In An Academic Medical Center, Gerundio Ursolino Iii, Msn, Mba, Ccrn-K

Doctor of Nursing Practice Projects

Background: A nationwide problem that has been regularly overlooked is poor recognition of deteriorating patients which can lead to increased severity of illness. One way to avoid adverse events is early detection of clinical deterioration using vital signs via Modified Early Warning Score (MEWS). However, the majority of the hospitals across the United States are not utilizing this. MEWS implementation can minimize adverse events by early recognition, which will lead to early intervention and improved patients’ outcomes.

Objective: The aim of this quasi-experimental study was to determine if MEWS implementation will reduce the number of adverse outcomes.

Methodology: …

Polishing Medical Students’ Presentation Skills: A Curriculum, Alexandra Gomes, Anne Linton

Himmelfarb Library Faculty Posters and Presentations

No abstract provided.

Elevating Medical Students Through Media Education, Alexandra Gomes, Anne Linton

Himmelfarb Library Faculty Posters and Presentations

No abstract provided.

Improving Nursing Staffing Methodology And Nursing Sensitive Outcomes With The Addition Of A Patient Centered Acuity Measure, Douglas C. Howard Rn, Ms, Ne-Bc

Doctor of Nursing Practice Projects

Background: Assigning the correct nursing resources to hospitalized patients positively impacts patient outcomes. The current process for matching nurses to patients is highly variable and involves a combination of simple ratios, historical workload data, and expert opinion but lacks objective measurement of the patient’s condition.

Objectives: This project evaluated change in selected quality indicators and the daily unit-level management of nursing resources after implementing the Troubled Outcome Risk (TOR) into existing nursing staffing methodology in a Department of Veterans Affairs hospital.

Methods: TOR provides objective measurement of individual patient allostatic load. Daily calculation of TOR scores for each patient on …

Opioid Dosing’S Impact On Numeric Pain Rating Scale And Urine Toxicology Results, Christine Couperus–Mashewske Fnp-Bc, Rn

Doctor of Nursing Practice Projects

Background: Concerns about opioid prescribing in the United States have been rising (Centers for Disease Control and Prevention [CDC], 2016). Assessing pain scores, along with urine toxicology screenings can provide information to both patients and providers about prescription opioids.

Objectives: The purpose of this retrospective chart review study was to compare numeric pain scores and urine toxicology results between two different groups of patients who were being prescribed daily≥ 90mg opioid dosing.

Methods: This retrospective chart review sample was of 134 adult chronic pain patients at one pain management clinic. Patients’ average numeric pain rating while using opioids for a …

Evaluation Of Patient Throughput In An Outpatient Pediatric Hematology, Oncology, And Bone Marrow Transplant Clinic, Samantha Depadova Msn, Rn, Anp-C, Ocn

Doctor of Nursing Practice Projects

Background: Outpatient oncology clinics are complex environments. The multi-step, sequential nature of oncology treatment contributes to delays. Prolonged wait time impacts patient compliance, satisfaction, and staff satisfaction.

Objectives: To assess throughput in the outpatient pediatric oncology clinic and explore staff’s assessment of throughput and their opinions of what might be improved.

Methods: Our descriptive-comparative study used retrospective reviews to measure four time intervals for 312 visits at our mid-Atlantic outpatient clinic. Patient and appointment factors were explored. Mean interval times were calculated and differences impacting throughput were analyzed using ANOVA. Prospective survey data were obtained from 22 clinic staff …

Analysis Of Parental Attitudes Of Adolescent Vaccinations In The Retail Health Care Setting, Patrick William Denning Mph, Msn

Doctor of Nursing Practice Projects

Background: The tetanus-diphtheria-acellular pertussis, meningococcal, and human papillomavirus vaccines have been recommended for adolescents since 2005. Retail health clinics can increase the delivery of vaccinations by reaching patients outside the traditional healthcare system.

Objectives: To measure parental attitudes of adolescent vaccinations utilizing the Vaccine Confidence Scale (VCS) and assess reasons parents decided to vaccinate or not. Attitudes were compared to previous studies. Our long-term purpose was to develop targeted interventions to increase adolescent vaccinations.

Methodology: A descriptive survey design measured the parental attitudes of adolescent vaccinations from total VCS scores and subscale scores of benefits, harms, and trust. A qualitative …

Effects Of Teach-Back Method Of Education On Knowledge Of Heart Failure Self-Care Management And Post-Discharge Knowledge Retention, Ama Awuah-Asamoah Msn, Rn, Acnp

Doctor of Nursing Practice Projects

Background: Approximately forty to eighty percent of patient education is immediately forgotten, and about fifty percent of retained information is inaccurate; knowledge is an essential bridge between patient teaching, comprehension and knowledge retention by using the teach- back method (Farris, 2015; Rouse et al., 2016; Stamp et al., 2014).

Objectives: The purpose of this study was to compare teach-back education method versus standard education and care, on knowledge of heart failure (HF) self-care management at discharge and retention of knowledge at three to ten days post discharge.

Methods: A non-probability convenience sampling of 22 HF patients, 65 years and older, …

Improving Nursing Students’ Attitudes And Beliefs About Transgender Clients Through The Use Of A Simulated Clinical Experience, J. Alex Thompson Msn, M.Ed., Rn, Cne

Doctor of Nursing Practice Projects

Background: Negative healthcare experiences may lead to poor health outcomes for transgender individuals, but nursing curricula give little attention to transgender healthcare. This study engaged nursing students in a simulated clinical experience (SCE) which featured a young adult transgender male in an acute care setting to determine whether participation would have a significant impact on student nurses’ attitudes and beliefs about transgender individuals.

Methods: The convergent parallel mixed-methods design used a one group pretest-posttest and a post-case debriefing interview to examine undergraduate nursing student attitudes and beliefs toward transgender individuals. Participants (N=27) reported their feelings via the Transgender Attitudes and …

Online Sexual Health Education With Rural Independent Study Charter School Students, Crystal L. Gardner Msn, Phn, Rn

Doctor of Nursing Practice Projects

Background: Sexually transmitted infections (STIs) and unwanted pregnancies continue to be public health problems in the United States. Each year there are about 20 million new STIs in the United States with about half of the infections occurring in people 15 to 24 years old (The Centers for Disease Control and Prevention, 2016).

Objectives: The purpose of this descriptive pre- and post-test study was to determine if an online STI prevention program increased knowledge about STIs, STI related resources, and lowered STI risk-taking behaviors in rural northern California students attending an alternative high school.

Methodology: “Positive Prevention PLUS” curriculum and …

Self-Efficacy In Emerging Nurse Leaders: The Effects Of A Virtual Community Of Practice On Nurse Educators In A New Practice Role, Kevin Daugherty Hook Msn, Ma, Ms, Agpcnp-Bc, Crnp

Doctor of Nursing Practice Projects

Background: Clinical nurse educators in long-term and skilled nursing facilities have an opportunity to exercise new leadership skills in bridging the gap between education and practice.

Objective: To assess the effects of a virtual Community of Practice (CoP) on the self-efficacy of clinical nurse educators who work in newly developing leadership roles in a large long-term and skilled nursing organization operating in multiple sites across the United States.

Methodology: The exploratory pilot study used a one group pre-test/posttest method. A convenience sample was used to enroll participants with newly created roles in clinical education. The Leader Efficacy Questionnaire (LEQ) was …

A Pre/Post Intervention Study To Assess Social Capital Through Bonding And Bridging Among Federal Nurse Teleworkers, Carrie Jeffries Mph, Ms, Rn, Anp-Bc, Aacrn, Aahivs, Nea-Bc, Fache

Doctor of Nursing Practice Projects

Background: The social capital components of bonding (within groups) and bridging (between external groups) are essential to building healthy and effective teleworking relationships that are required to retain staff.

Objectives: To identify if delivering a relationship building educational intervention to federal nurse teleworkers who used the internet daily would improve their total Internet Social Capital Scale (ISCS) scores and bonding and bridging subscale scores.

Methods: Our study employed a pre/post intervention design, aiming for a convenience sample of 75% (n=41/55) of federal nurse teleworkers. We delivered, via webinar, a 45-minute educational session on telework and techniques to increase bonding and …

Effects Of A Patient Progression Coordinator On Hospitalized Patient Progression Times, Amy C. Wright Msn, Rn

Doctor of Nursing Practice Projects

Background: Since 2005, the Joint Commission required moving patients through the hospital quickly. Previous efforts at our hospital improved Emergency Department throughput but hospital-wide congestion of patients remained.

Objectives: To examine the effects of implementing a patient progression coordinator (PPC) on hospital length of stay (LOS) for patients with ST-elevated myocardial infarction (STEMI), ischemic stroke, knee replacement, and hip replacement.

Methods: We used a separate sample, pre- post- intervention design conducted in a southern California community hospital. The intervention was implementation of a PPC to facilitate movement of patients through the hospital. LOS, from time of admission to discharge, was …