Medicine and Health Sciences Commons^™

Systematic Review Of The Barriers To Breastfeeding For Non-Hispanic Black Women, Ketty N. Floyd

Walden Dissertations and Doctoral Studies

Breastmilk provides the optimal food for newborns and contributes to improved lifelong health. A community hospital in the Eastern United States serving non-Hispanic Black (NHB) women has a breastfeeding exclusivity rate of only 8%, which is low compared to the state’s exclusivity rate of 40%. A systematic review of the literature was conducted to identify the breastfeeding barriers for NHB mothers and to identify strategies to address them. Guided by Fishbein and Yzer’s integrative model and the SQUIRE 2.0 knowledge reporting framework, 30 articles were appraised using Melnyk and Fineout-Overholt’s hierarchy of research and the Caldwell, Henshaw, and Taylor qualitative …

Current Effects Of U.S. Preventive Care Quality Narratives On Preventive Health Services, James Fisher

Walden Dissertations and Doctoral Studies

In the interest of improving patient outcomes, significant investments in operationalized quality of care within the Medicare space have promulgated a low-resolution narrative predicated on conflation of higher quality scores with improved population health. Concomitant financial incentivization of Medicare Advantage plans through aligned Star Measures places contracts as the fundamental unit of most care quality analyses, but no studies have considered how present incentivization schema have impacted physician use and associated quality scores over time for breast cancer screening (BCS), colorectal cancer screening (CCS), and annual flu vaccination (AFV) at a county level. Guided by the Evidence Based Model framework, …

The Causes And Control Measures Of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae In Long-Term Care Facilities, Ismaila Olatunji Sule

Walden Dissertations and Doctoral Studies

Due to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE), infections among residents are increasing in long-term care facilities (LTCFs), resulting in high rate of morbidity and healthcare costs. ESBL-PE resists empirical antibiotics and reduces treatment options, and a designated infection control team is unavailable to prevent the prevalence of the disease. Ecological theory guided this study. A systematic review and meta-analysis were conducted to characterize the causes of ESBL-PE and evaluate the infection control strategies within LTCFs. Multiple regression analysis (MRA) was included as supplementary statistical analysis to identify relationships between LTCFs, geographical locations, infection control measures (ICMs), and ESBL-PE. A systematic search …

Educating Nurses To Help Promote Diabetes Self-Care Management In Primary Care, Delphine E. Ikpasaja

Walden Dissertations and Doctoral Studies

Diabetes is a chronic disease that has a genetic and lifestyle component, and it affects individuals in various parts of the world. A lack of understanding of the nature of the disease has contributed to the complications experienced by patients with diabetes 2 (DM2), such as an elevated glycosylated hemoglobin (A1C) and hyperglycemia. At the clinic where this project took place, patients received an initial teaching but did not get any further support or resources to manage their disease. A four sections of a 30 minutes each was the educational presentation used with staff at the clinic to help them …

Lived Experiences Of Lassa Fever Survivors In Southsouth Nigeria, Albert Oamen Oyeribhor

Walden Dissertations and Doctoral Studies

AbstractLassa fever, a viral disease, was first isolated in the late 1960s and affects 300,000 to 500,000 people, causing 5,000 to 10,000 fatalities annually across West Africa. Although there are studies on the causes and prevalence of Lassa fever, there is a paucity of studies regarding the quality of life (QoL) and lived experiences of survivors. The purpose of this qualitative study, guided by Leininger’s culture care theory, was to describe the QoL and meanings of the lived experiences of Lassa fever survivors in the Southsouth region of Nigeria. Fifteen survivors of Lassa disease were interviewed. Data were analyzed using …

Applying A Staff Education Project To Increase Telemedicine Patient Safety, Kristy Michelle Wolff

Walden Dissertations and Doctoral Studies

A telemedicine education module (TEM) was designed and developed for this staff education project to improve the knowledge of nurses and providers about best practices in telemedicine and patient safety. A pretest and posttest design was used to evaluate if a gain in knowledge occurred after participants reviewed the TEM, which was designed and developed using Knowles theory of andragogy for adult learning outcomes. Thirty-seven potential participants who currently work as clinicians that provide telemedicine services were provided access to the pretest, TEM, and posttest. Nine participants responded, but only three participants’ scores could be used for analysis since there …

The Political Astuteness Of The New Mexico Registered Nurse, Gloria Sue Doherty

Walden Dissertations and Doctoral Studies

The United States spends the most per capita of all the developed countries on healthcare but demonstrates the worst healthcare outcomes. National agencies have turned to Registered Nurses (RNs) to improve healthcare outcomes through participation in healthcare policy development. Although the recommendation for participation in policy development exists, RNs, including those in the U.S. state of New Mexico have not participated at high levels. The purpose of this quantitative cross-sectional study was to measure the political astuteness of RNs in New Mexico and to determine to what extent nursing leaders have been successful in diffusing Institute of Medicine recommendations. Rogers’s …

Racial Disparities In Hypertension Self-Awareness And Hospitalizations For Hypertension-Related Illnesses Among Adult Arkansans, Chimfumnanya Nwanze-Smith

Walden Dissertations and Doctoral Studies

Black individuals in the United States are twice as likely as White individuals to die of cardiovascular diseases. Between 2010 and 2016 in Arkansas (AR), hypertension (HTN) and HTN-related diseases had an age-adjusted death rate of 230.4 deaths per 100,000 population compared to 173.6 deaths per 100,000 population for Whites. The purpose of this quantitative, cross-sectional study was to explore the potential association between HTN self-awareness and emergency department (ED) visits and hospitalization rates for HTN and HTN-related illnesses between Black and White individuals in AR. The socioecological framework was used to explore sociodemographic (SDF) and socioeconomic (SES) factors as …

Teleneurology Based Management Of Infantile Spasms During Covid-19 Pandemic: A Consensus Report By The South Asia Allied West Syndrome Research Group, Priyanka Madaan, Jitendra Kumar Sahu, Jithangi Wanigasinghe, Kanij Fatema, Kyaw Linn, Mimi Lhamu Mynak, Nicolás Garófalo Gómez, Pauline Samia, Prakash Poudel, Prem Chand

Department of Paediatrics and Child Health

With telehealth services rescuing patients with chronic neurological disorders during the COVID-19 pandemic, there is a need for simplified teleneurology protocols for neurological disorders in children. Infantile spasms is an epileptic encephalopathy where treatment lag is a significant predictor of outcome. It is one such condition where telemedicine can make a remarkable difference when in-person consultations are delayed or are not possible. However, the adverse effect profile of the first-line therapeutic options, the need for frequent follow-up, underdeveloped telemedicine services, lack of a rational protocol, poor awareness about infantile spasms, a lesser level of parental understanding, and scarcity of pediatric …

Cardio-Pulmonary Sequelae In Recovered Covid-19 Patients: Considerations For Primary Care, Zouina Sarfraz, Azza Sarfraz, Alanna Barrios, Radhika Garimella, Asimina Dominari, Manish Kc, Krunal Pandav, Juan C. Pantoja, Varadha Retnakumar, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care.
Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords "COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication." We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, …

Covid-19 Vaccine-Associated Thrombosis With Thrombocytopenia Syndrome (Tts): A Systematic Review And Post Hoc Analysis, Muhammad Usman Hafeez, Maha Ikram, Zunaira Shafiq, Azza Sarfraz, Zouina Sarfraz, Vikash Jaiswal, Muzna Sarfraz, Ivan Chérrez-Ojeda

Department of Paediatrics and Child Health

Background: A new clinical syndrome has been recognized following the COVID-19 vaccine, termed thrombosis with thrombocytopenia syndrome (TTS). The following systematic review focuses on extrapolating thrombotic risk factors, clinical manifestations, and outcomes of patients diagnosed with TTS following the COVID-19 vaccine.
Methods: We utilized the World Health Organization's criteria for a confirmed and probable case of TTS following COVID-19 vaccination and conducted a systematic review and posthoc analysis using the PRISMA 2020 statement. Data analysis was conducted using SPSS V25 for factors associated with mortality, including age, gender, anti-PF4/heparin antibodies, platelet nadir, D-dimer peak, time to event diagnosis, arterial or …

Achieving The Sustainable Development Goals: Evidence From The Longitudinal Parenting Across Cultures Project, Jennifer E. Lansford, W. Andrew Rothenberg, Sombat Tapanya, Liliana Maria Uribe Tirado, Saengduean Yotanyamaneewong, Liane Peña Alampay, Suha M. Al-Hassan, Dario Bacchini, Marc H. Bornstein, Lei Chang, Kirby Deater-Deckard, Laura Di Giunta, Kenneth A. Dodge, Sevtap Gurdal, Qin Liu, Qian Long, Patrick S. Malone, Paul Oburu, Concetta Pastorelli, Ann T. Skinner, Emma Sorbring, Laurence Steinberg

Psychology Department Faculty Publications

No abstract provided.

A Qualitative Case Study: Exploring The Application Of Physiological Measures In Prelinguistic Aac Intervention, Chloe Putnam

2021 Honors Symposium

Prelinguistic communication is defined as that which comes before linguistic development and consists of nonverbal means of communication, such as gestures, eye gaze, vocalizations, and expressions (Franco, Davis, & Davis, 2013). In typical development, prelinguistic communication is evident in infants during the beginning stages of communication, before language emerges. However, some individuals with intellectual and developmental disabilities (IDD) with communication limitations continue to use prelinguistic communication as a primary mode of communication later in life. The goal of completing this research is to explore the potential promise of the novel approach of applying physiological measures to AAC intervention for prelinguistic …

Family Needs For Witnessing Ventilator Withdrawal In Intensive Care Units, Azzah Moubaraki

Wayne State University Dissertations

Background: Witnessing ventilator withdrawal and the subsequent death of a loved one in the ICU is a traumatic experience for family members, whose needs thus differ from those of other families in the ICU. Although various studies have noted the importance of preparing family members for ventilator withdrawal, based on retrospective interviews, little is known about which needs should be met, prospectively, to equip family members to witness and cope with ventilator withdrawal or about how sociodemographic characteristics affect those needs. Purpose: To prospectively determine the needs of family members who will witness a loved one undergo the process of …

Clinical Significance, Functional Role And Molecular Mechanism Of 2’-O-Methyltransferase Ftsj3 In Promoting Cancer Progression, Morenci Manning-Powell

Wayne State University Dissertations

2’-O-methylation (2’-O-Me), one of the most common modifications within RNA, has multiple roles in modulating RNA structure, stability, and interactions, as well as gene transcription and translation. We previously performed integrative genomic and transcriptomic analysis of 58 RNA methyltransferases, and identified FTSJ3 (FtsJ RNA 2ʹ-O-methyltransferase 3) as significantly amplified/overexpressed in breast cancer. Knockdown of FTSJ3 inhibits breast cancer cell growth in vitro. However, the clinical significance, functional role, and molecular mechanism of FTSJ3 in human cancer remains to be elucidated. In the present study, we first analyzed the differential mRNA and protein expression of FTSJ3 between tumor and normal tissues …

Isolation And Characterization Of A Novel Bacteriophage Wo From Allonemobius Socius Crickets In Missouri, Jonah Kupritz, John Martin, Kerstin Fischer, Kurt C. Curtis, Joseph R. Fauver, Yuefang Huang, Young-Jun Choi, Wandy L. Beatty, Makedonka Mitreva, Peter U. Fischer

Journal Articles: Epidemiology

Wolbachia are endosymbionts of numerous arthropod and some nematode species, are important for their development and if present can cause distinct phenotypes of their hosts. Prophage DNA has been frequently detected in Wolbachia, but particles of Wolbachia bacteriophages (phage WO) have been only occasionally isolated. Here, we report the characterization and isolation of a phage WO of the southern ground cricket, Allonemobius socius, and provided the first whole-genome sequence of phage WO from this arthropod family outside of Asia. We screened A. socius abdomen DNA extracts from a cricket population in eastern Missouri by quantitative PCR for Wolbachia surface protein …

Computer-Assisted Challenge Point Intervention For Residual Speech Errors., Tara Mc Allister Byun, Elaine R. Hitchcock, Jose Ortiz

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Purpose: This preliminary case series investigated the effects of biofeedback intervention for residual rhotic errors delivered within a modified challenge point framework. In the challenge point framework, practice difficulty is adaptively adjusted with the goal of enhancing generalization learning. This study more specifically evaluated the feasibility of a computer-mediated implementation of challenge point treatment for rhotic errors using a custom open-source software, the Challenge Point Program.

Method: Participants were five native English speakers, ages 7;3–15;5 (years; months), who had established but not generalized correct rhotic production in previous treatment; overall treatment duration was flexible. Treatment incorporated either electropalatographic …

Improving Catheter Associated Urinary Tract Infection Rates Of Pediatric Patients Through Standardization Of Catheter Care, Shelby Beyers, Jenna Buys, Hayden Dutton

2021

Background/Significance: Pediatric patients with urinary catheters are at an increased risk for developing Catheter Associated Urinary Tract Infections (CAUTI). Standardization of urinary catheter care improves CAUTI rates. At Children’s Health, the CAUTI rate increased from 2 infections to 10 infections from 2018 to 2019. Review of organizational policy revealed that urinary catheter care practices were not standardized. Bedside staff performed catheter care with soap and water but utilized different methods and supplies, leading to variability in practice.

Purpose/EBP Question: The purpose of this Evidence Based Practice (EBP) project was to standardize catheter care throughout Children’s Health. Nurse resident sought …

Decreasing The Risk: Early Discontinuation Of Urinarycatheters Through Nurse Led Removal Program, Valerie Tidwell, Victoria Washington, Ginger Young

2021

Purpose- Improve outcomes and safety for PICU patients through an Evidence Based Practice (EBP) approach to reduce catheter associated urinary tract infections (CAUTI)

PICO For pediatric patients in the ICU does a nurse driven urinary catheter (UC) program with discussion in rounds decrease urinary catheter utilization as compared to current practice?

Background There was an increased rate of CAUTI in the PICU between 2018 and 2019. UC necessity was not often discussed in rounds. The cost of a CAUTI is estimated to be between $1000- $13,793 per episode. Also associated with CAUTI are increased LOS (approximated at 2.3 days), excess …

Improving Patient Safety By Predicting Early Deterioration In Thepediatric Pulmonary Population, Christina Smith, Lindsey Patton, Peng Chen

2021

Background: The inpatient pulmonary unit (D9) utilizes a modified pediatric early warning score (PEWS) to identify deteriorating patients. D9 emergency team activations and code event reviews found PEWS documentation discrepancies and inaccuracies. 66% of D9 nurses reported PEWS scores are inaccurate for the pulmonary population and this is a major barrier to using PEWS. The Iowa model was used to identify a different tool, compare psychometrics, and measure nurses’ perceptions to establish the best early warning tool for pediatric pulmonary patients.

Methods: Inclusion criteria was patients admitted to D9 with baseline tracheostomy, oxygen, or invasive/non-invasive ventilation. Literature review revealed no …

Initial Results Of The Asq (Ask Suicide Questions)Patient Questionnaire Inplemented At Children’S Health, Jane Miles, Karla Hutcherson, Jennifer Brown

2021

OBJECTIVE

Our goal was to assess the outcome of recently implemented hospital wide questionnaire ,Ask suicide Screening Questions (ASQ), for all patients seen at Children’s Health ER from April to December 2018.

BACKGROUND

Suicide is the second leading cause of death in youth ages 10-24 and is a significant public health problem. Early identification and treatment can have an impact on the number of youth suicides.

METHOD

Due to demand, a specific workflow was created and implemented hospital wide. ASQ questionnaire consists of 5 questions. If patient answers “no” to first four questions, the fifth question is not asked. If …

After Discharge Call Management Utilizing A Centralized Call Hub, Susan Webber, Ann Gosdin

2021

Practice Problem
No clearly defined process exists for clarification of discharge instructions or other parental concerns after discharge. Follow-up appointments with the primary care provider or a subspecialist are listed on discharge instructions with the main hospital number to call after discharge. Hospital operators send calls to inpatient units where the patient was most recently discharged. This causes disruptions for nursing floor staff and unnecessary emergency room visits. No literature was identified for calls to a centralized call center after discharge. Literature shows the most frequent reason for calling after discharge were common concerns such as fever, ENT, respiratory and …

Ir Unplanned Line Removals, Toni Haynes

2021

Problem
In 2020, the Hematology/Oncology unit noticed an increased trend in Intravascular Access Devices (IVADs) needing to be removed due to infection or dehiscence of the incision.

Key EBP Practices
A Clinical Nurse Specialist, Central Line Nurse, Bone Marrow Transplant Doctor, and four Interventional Radiologist Surgeons came together to discuss potential causes of the increase in line removals. Team decided to track unplanned line removals. Unplanned line removal criteria are met when a central line is removed within 30 days of placement from an infection or dehiscence. Evidence shows studies looked at 30-day periods for line removals, and line removals …

Nurse: Are You In Pain? Patient: (No Answer), Katie Mclaurin

2021

Many infants and children admitted to the pediatric intensive care unit (PICU) have difficulty self-reporting pain requiring nurses to score pain utilizing the FLACC scale. However, when surveyed, PICU nurses at Children’s Health expressed dissatisfaction with the FLACC scale because it did not accurately assess pain in the PICU population (mean=4.1). An extensive literature review was conducted to determine the best behavioral pain scale to use for nonverbal patients in the PICU. Based on the literature, the COMFORT-B scale was selected. The COMFORT-B scale is a behavioral pain scale validated in the PICU in children 0 to 10 years and …

Repeal Of The Antitrust Exemption For Health Care Insurance A Win For Consumers And Dentists, American Dental Association

News Releases

This collection includes standard news releases, information kits and other documents distributed for publicity, information, announcements of events, etc. as issued from the ADA. Items included in this collection are archival and any costs, links, contact information, or other figures may be out of date. Please contact the ADA to verify information.

Is 17 Alpha-Hydroxyprogesterone Effective For Preventing Preterm Labor In High Risk Women?, Hannah E. Mercado

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is 17- alpha hydroxyprogesterone effective for preventing preterm labor in high risk women?”.

STUDY DESIGN: Review of one randomized, double blind, controlled trial, one randomized, double blind, placebo controlled trial and one randomized controlled trial published in English between 2015 and 2018.

DATA SOURCES: All three studies were gathered from peer- reviewed journals and found using PubMed.

OUTCOMES MEASURED: Preterm delivery defined as birth less than 37 weeks gestation for Facchinetti et al., Shadab et al. and Winer et al.6,7,8

RESULTS: The RCT performed by Facchinetti …

Is Comprehensive Behavioral Intervention For Tics (Cbit) Effective In Decreasing Tic Severity In Individuals With Chronic Tic Disorders?, Rachel L. Brownstein

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not “Is Comprehensive Behavioral Intervention for Tics (CBIT) effective in decreasing tic severity in individuals with chronic tic disorders?”

Study Design: A systematic review of three randomized controlled trials (RCTs) published between 2010 and 2016.

Data Sources: All three RCTs were discovered using PubMed. The articles were published in English in peer-reviewed journals and selected based on applicability to the clinical question.

Outcome Measured: A reduction in tic severity was the outcome measured in all three studies using the Yale Global Tic Severity Score (YGTSS). Scores range …

Is Transcranial Magnetic Stimulation (Tms) An Effective Therapy In Reducing Depressive Symptoms In Adults With Bipolar Depression?, Emily M. Boylan

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not transcranial magnetic stimulation (TMS) is an effective therapy in reducing depressive symptoms in adults with bipolar depression.

STUDY DESIGN: Systematic review of three randomized controlled trials (RCTs) that were published in the English language between 2016 and 2019.

DATA SOURCES: Data sources included articles found using PubMed as the search engine and were selected based on their relevance to the research question as well as patient measured outcomes.

OUTCOMES MEASURED: Outcomes measured include changes in depression symptoms measured using the 17-item Hamilton Depression Rating Scale (HDRS-17) …

Protocol For Safe, Affordable, And Reproducible 1 Isolation And Quantitation 2 Of Sars-Cov-2 Rna From Wastewater, Monica Trujillo, Kristen Cheung, Anna Gao, Irene Hoxie, Sherin Kannoly, Nanami Kubota, Kaung Myat San, Davida S. Smyth, John J. Dennehy

Publications and Research

The following protocol describes our workflow for processing wastewater with the goal of detecting the genetic signal of SARS-CoV-2. The steps include pasteurization, virus concentration, RNA extraction, and quantification by RT-qPCR. We include auxiliary steps that provide new users with tools and strategies that will help troubleshoot key steps in the process. This protocol is one of the safest, cheapest, and most reproducible approaches for the detection of SARS-CoV-2 RNA in wastewater. Furthermore, the RNA obtained using this protocol, minus the pasteurization step, can be sequenced both using a targeted approach sequencing specific regions or the whole genome. The protocol …

The Influences Of Generational Membership And Practice Environment On Nurse Manager Job Satisfaction, Angela Keith

Electronic Theses and Dissertations, 2020-2023

The United States (US) is facing considerable shortages in all aspects of the nursing profession and this includes management. The nurse manager (NM) is a critical member of the healthcare team. They greatly influence the quality of patient care, staff retention, and the implementation of front-line and often progressive healthcare policy changes. Short tenures, high turnover rates, and poor recruiting outcomes, however, are threatening the current and future supply of experienced NMs. Today, there are three generations of NMs in practice: baby boomers, generation Xers, and generation Y'ers (also called millennials). Each of these cohorts has its own unique perception …