Medicine and Health Sciences Commons^™

Trauma Informed Care: Improving Staff Morale On 6 Henson, Kara Humphreys, Katherine Karstens, Kortney Neiderhauser, Briana Pina, Payton Tallent, Stephanie Assad, Madison Dexter

Posters

Six Henson staff reported feeings of burnout and compassion fatigue.

Aim Statements:

Decrease percentage of 6 Henson staff feeling sometimes or often "worn out because of [their] work as a helper" from 86% to 50% by August 1, 2019.

Increase the number of KUDOS cards submitted by 6 Henson staff from 2-3 per week to 10 per week by August 3, 2019.

Both aim statements were met and exceeded.

Improving Women, Infants, And Children Participation Using Quality Improvement Methodology, Samuel Little, Sarah Stone, Jeffrey D. Colvin, Sidney Smith, Brenda Hilboldt, Laura Williams, Patricia Marein, Keith Mann, Kristi Williams

Posters

Food insecurity, when a household is unable to acquire food for one or more of its members due to insufficient resources, has recently been on the decline in the United States, according to official 2017 USDA reports.

Unfortunately, this decline has not been observed to the same extent in the demographic of households with children.

WIC is a federal assistance program that works to alleviate the poor health outcomes associated with food insecurity in this demographic by providing eligible, enrolled families with nutritional aid and education.

The specific aim of the project is to increase the percentage of maximum potential …

Using A Standardized Admission Handoff (I-Pass) To Improve Communication Between Pediatric Urgent Care And Inpatient Providers, Amanda Nedved, Kathleen Berg, Amanda Montalbano

Posters

Ineffective hand-off communication is recognized as a critical patient safety problem in health care. A pre-interventions survey of pediatric urgent care providers and pediatric hospitalists demonstrated an opportunity for improvement of communication during admission handoffs.

Standardized handoffs improve communication without impeding provider workflow. We learned that subjective terms for illness severity ("stable," "watcher," and "unstable") did not translate well from urgent care to inpatient. We are planning on implementing an objective standardized tool (PEWS) to improve the communication of illness severity. We have also updated the I-PASS visual aid based on feedback.

Improving Pneumococcal Vaccination Rates In High Risk Patients Across Multiple Specialty Divisions, Rachel Moran, Julia G. Harris, Claire Olsen, Rana El Feghaly, Liset Olarte, Douglas Blowey, Luke A. Harris

Posters

Pediatric patients with deficient immune systems or certain chronic medical conditions have an increased risk of acquiring invasive pneumococcal disease.

The 23-valent pneumococcal (PPSV23) vaccine provides protection against 23 pneumococcal serotypes and is recommended for patients aged 2 years or older who are high-risk for invasive pneumococcal disease.

Unfortunately, many high-risk patients are not properly vaccinated due to lack of provider knowledge or understanding of accountability between primary care and specialty providers.

The goal of this project was to improve PPSV23 vaccination rates by 10-20% across multiple Children's Mercy Kansas City specialty divisions.

Pediatric Surgery Opioid Prescription Follow-Up, Gadison Quick, Nathaniel Aviles, Gabriel Melgarejo, Hunjung Choi, Elizabeth Edmundson

Posters

This quality improvement project is assisting general and orthopedic surgeons in gaining greater clarity when prescribing opioids for specific surgical procedures. Additional surgical services are being added to the project fall of 2019. Opioid prescribing patterns are, and will continue to be, key to all prescribing providers within our organization.

Decreasing Length Of Stay In Pediatric Urgent Care With Electronic Discharge Instructions, Jennifer Wooster, Aimy Patel, Brian R. Lee, Amanda Nedved

Posters

Time spent waiting in the urgent care clinic is dissatisfying for patient and staff. This "wasted time" accounted for more than 52% of the urgent care visit at our urgent care.

The aim of our project is to decrease length of stay by 10 minutes by April 30, 2019 for all patients discharged from Blue Valley Urgent Care by offering patients a paperless depart process. To be eligible for discharge without paper families must be enrolled in the online patient portal.

Electronic discharge instructions significantly decrease length of stay and is associated with improved patient experience scores. Patients who received …

The Kanga-Croo: Nurse Resident Champions Creating Momentum For Improvement, Brett Butler, Jacob Burden, Carly Creekmore, Blair Griffin, Taylor Godemann, Taylor Hagen, Theresa Koelling, Mary Anne Kucera, Halle Magid, Makenna Miller, Monica Page, Mary Riffel, Madison Stebbins, Sarah Stokes, Skylar Suppes

Posters

Topic Summary:

Kangaroo Care (skin to skin care) is a parent-led, evidence-based intervention which improves outcomes in neonatal patients including: decreased apnea, increased weight gain, increased parent satisfaction and decreased length of stay.

Results:

Nurse resident team interventions to support parent engagement and remove barriers to Kangaroo Care (KC) through iterative PDSA cycles from January 2018 to July 2019 yielded positive results within a subset of ICN patients.

The Vaccinia Virus (Vacv) B1 And Cellular Vrk2 Kinases Promote Vacv Replication Factory Formation Through Phosphorylation-Dependent Inhibition Of Vacv B12, Amber B. Rico, Zhigang Wang, Annabel T. Olson, Alexandria C. Linville, Brianna L. Bullard, Eric A. Weaver, Clinton Jones, Matthew S. Wiebea

Nebraska Center for Virology: Faculty Publications

Comparative examination of viral and host protein homologs reveals novel mechanisms governing downstream signaling effectors of both cellular and viral origin. The vaccinia virus B1 protein kinase is involved in promoting multiple facets of the virus life cycle and is a homolog of three conserved cellular enzymes called vaccinia virus-related kinases (VRKs). Recent evidence indicates that B1 and VRK2 mediate a common pathway that is largely uncharacterized but appears independent of previous VRK substrates. Interestingly, separate studies described a novel role for B1 in inhibiting vaccinia virus protein B12, which otherwise impedes an early event in the viral lifecycle. Herein, …

Application Strategy For An Anthraquinonebased Repellent And The Protection Of Soybeans From Canada Goose Depredation, Scott J. Werner, Matthew Gottlob, Charles D. Dieter, Joshua D. Stafford

United States Department of Agriculture Wildlife Services: Staff Publications

Agricultural crops can sustain extensive damage caused by Canada geese (Branta canadensis) when these crops are planted near wetlands or brood-rearing sites. From 2000 to 2015, South Dakota Game, Fish and Parks spent >$5.6 million to manage damages caused by Canada geese to agricultural crops (primarily soybeans) in South Dakota, USA. For the purpose of developing a repellent application strategy for nonlethal goose damage management, we comparatively evaluated the width of anthraquinone applications (i.e., 9.4 L Flight Control® Plus goose repellent/ha [active ingredient: 50% 9,10-anthraquinone] at 0–36 m versus 0–73 m perpendicular to the edge of wetlands in 2014), the …

A Review Of Rat Lungworm Infection And Recent Data On Its Definitive Hosts In Hawaii, Chris Niebuhr, Susan I. Jarvi, Shane R. Siers

United States Department of Agriculture Wildlife Services: Staff Publications

Rat lungworm (Angiostrongylus cantonensis) is a zoonotic nematode that causes rat lungworm disease (angiostrongyliasis), a potentially debilitating form of meningitis, in humans worldwide. The definitive hosts for rat lungworm are primarily members of the genus Rattus, with gastropods as intermediate hosts. This parasite has emerged as an important public health concern in the United States, especially in Hawaii, where the number of human cases has increased in the last decade. Here we discuss the current knowledge of the rat lungworm, including information on the life cycle and host species, as well as updates on known infection levels. Three species of …

Estimating Waterbird Abundance On Catfish Aquaculture Ponds Using An Unmanned Aerial System, Paul C. Burr, Sathishkumar Samiappan, Lee A. Hathcock, Robert J. Moorhead, Brian S. Dorr

United States Department of Agriculture Wildlife Services: Staff Publications

In this study, we examined the use of an unmanned aerial system (UAS) to monitor fish-eating birds on catfish (Ictalurus spp.) aquaculture facilities in Mississippi, USA. We tested 2 automated computer algorithms to identify bird species using mosaicked imagery taken from a UAS platform. One algorithm identified birds based on color alone (color segmentation), and the other algorithm used shape recognition (template matching), and the results of each algorithm were compared directly to manual counts of the same imagery. We captured digital imagery of great egrets (Ardea alba), great blue herons (A. herodias), and doublecrested cormorants (Phalacrocorax auritus) on aquaculture …

A Study To Assess The Relationship Between Attention Deficit Hyperactivity Disorder And Obstructive Sleep Apnea In Adults, Sean Hesselbacher, Akshar A. Aiyer, Salim R. Surani, Alishah A. Suleman, Joseph Varon

Internal Medicine, East Africa

The association between obstructive sleep apnea (OSA) and attention deficit hyperactivity disorder (ADHD) is well-established in children. However, there is a paucity of literature regarding this association in adults. The aim of this study was to determine if ADHD is more common in adult patients with OSA. All patients referred to a sleep center for sleep evaluation were administered the Adult ADHD Self-Report Scale and diagnostic polysomnogram. The ADHD screen is considered positive if 4 of 6 questions in part A of the screening questionnaire were answered abnormally. The study population consisted of 194 participants, predominantly male (62%), Caucasian (54%), …

Smartbfa: A Passive Crowdsourcing System For Point-To-Point Barrier-Free Access, Mohammed Nazir Kamaldin, Susan Kee, Songwei Kong, Chengkai Lee, Huiguang Liang, Alisha Saini, Hwee-Pink Tan, Hwee Xian Tan

Research Collection School Of Computing and Information Systems

At the Bloomberg Live `Sooner Than You Think' forum [1] held in Singapore in 2018, nearly 75% of delegates picked inclusiveness to be the key measure of success for a smart city. An inclusive smart city is a citizen-centered approach that extends the experiences provided by smart city solutions to all citizens, including seniors and persons with disabilities (PwDs).Despite existing regulations on barrier-free accessibility for buildings and public infrastructure, pedestrian infrastructure is generally still inaccessible to PwDs in many parts of the world. In this paper, we present SmartBFA (Smart Mobility and Accessibility for Barrier Free Access) - a publicly-funded …

Abdominal Tb, More To Abdominal Masses And Symptoms Than Meets The Eye, Johnathon Dallarosa Md, Breanna S. Goldner Do

Department of Medicine

No abstract provided.

Endoscopic Ultrasound-Guided Drainage Of Pancreatic Fluid Collections Using Axios™ Electrocautery Enhanced Delivery System: A Retrospective Experience At A Large Quaternary Care Center, Michal Kloska Md, Phd, Valery Hrad Md, Soorya N. Aggarwal Do, Shashin Shah Md, Zachary Zator Md, Hiral N. Shah Md

Department of Medicine

No abstract provided.

A Rare Case Of Biliary Pancreatitis Caused By Ampullary Somatostatinoma In A 46-Year-Old Female, Michal Kloska Md, Phd, Reema M. Vaze Md, Ricky Buckshaw Do, Hiral N. Shah Md

Department of Medicine

No abstract provided.

The Impact And Outcomes Of Integrating Health Literacy Education Into Adult Basic Education Programs In Boston, Lorna Rivera, Marcia Hohn

Gastón Institute Publications

Background: Adult basic education (ABE) is the national system that offers educational services in English language development, reading, writing, math, technology, and communications to adults with low literacy, limited English, or both. These services range from basic levels to high school equivalency, with specialty programs in transition to community colleges and family literacy. Objective: This study sought to analyze the role of ABE in increasing health literacy among low literate and limited English populations and to identify effective models for teaching and learning about health in this setting.

Methods: During a 2-year period, 90 students from three ABE programs in …

Evaluating The Efficacy Of Vertebral Axial Decompression Therapy In Treatment Of Patients With Chronic Lower Back Pain: A Systematic Review, James M. Mckivigan, Brittany Krisak, Brittni Vogel, Ashley Harrington, Van Nguyen

College of Health & Human Services (TUN) Publications and Research

The primary objective of the study was to explore the effectiveness of Vertebral Axial Decompression (VAX-D) in treating patients with chronic low back pain (CLBP) as a safe and competent therapeutic method. Also, to determine the quality of life in alleviating chronic lumbar pain using mechanical Lumbar traction force applied to the lumbar spine. A systematic review and meta-analysis involving detailed literature survey on Vertebral Axial Decompression (VAX-D) therapy for patients with chronic low back pain were conducted in three databases namely MEDLINE, EMBASE and Cochrane Library from (January 1994 to February 2019). Studies supporting the outcomes with qualitative statistical …

Implementing Mindfulness Practices With Parents Of Young Children In A Low-Socioeconomic Status Neighborhood, Andrew T. Roach, Josephine Mhende, Brian A. Barger, Douglas A. Roberts

Journal of the Georgia Public Health Association

Background: The purpose of this study was to investigate whether instruction in mindfulness practices would results in improved self-reported mindfulness and reduced depression, anxiety, and family stress in parents of young children living in a low socioeconomic status (SES) neighborhood.

Methods: The study utilized a pretest-posttest group design to evaluate the effectiveness of the Mindfulness Ambassador Council-Interactive curriculum with attendees in a parent support program. Participants (n=15) were recruited from families with young children who received support from a community-based organization in one low-SES neighborhood in Atlanta. Mental health assessments, measures of family stress and parenting competency, and a demographic …

Global Burden Of Atherosclerotic Cardiovascular Disease In People With Hepatitis C Virus Infection: A Systematic Review, Meta-Analysis, And Modelling Study, Kuan Ken Lee, Dominik Stelzle, Rong Bing, Mohamed Anwar, Fiona Strachan, Sophia Bashir, David E. Newby, Jasmit Shah, Michael Chung, Gerald S. Bloomfield

Internal Medicine, East Africa

Background: More than 70 million people worldwide are estimated to have hepatitis C virus (HCV) infection. Emerging evidence indicates an association between HCV and atherosclerotic cardiovascular disease. We aimed to determine the association between HCV and cardiovascular disease, and estimate the national, regional, and global burden of cardiovascular disease attributable to HCV.

Methods: For this systematic review and meta-analysis, we searched MEDLINE, Embase, Ovid Global Health, and Web of Science databases from inception to May 9, 2018, without language restrictions, for longitudinal studies that evaluated the risk ratio (RR) of cardiovascular disease in people with HCV compared with those without …

A Well-Being Vision: Transcending Care., Judith A Boerger, Pamela Bland, Carolyn Meyer, Kristen Ruble, Sue Ehinger Pnd

Nursing Publications, Posters, & Presentations

Well-being is a competitive strategy to attract the best and brightest talents and keep them from burning out or leaving.

The Benefits Of Early Referral To Palliative Care For End Stage Renal Disease (Esrd) On Dialysis, Omolola Akinmadelo

Doctoral Dissertations and Projects

Palliative care provides outstanding holistic nursing for the management of undesirable symptoms and suffering related to chronic illness disease processes such as end stage renal disease. When palliative care services are initiated early in course of a chronic illness, they improve the quality of care and life and reduce stress for patients and their families. While palliative care is slowly being recognized as the most effective means of improving quality of life and care in the management of chronic illness, most health care staff and providers are not aware of the full benefits of palliative care in the management of …

Improving Patient Satisfaction With Quietness At Night: An Integrative Review, Victoria Rondez Squier

Doctoral Dissertations and Projects

Despite the efforts to improve the environment of care in hospital settings by noise reducing interventions, building redesigns, and quiet hours, research maintains patients continue to report noise is problematic across all specialties in acute care settings. Patient satisfaction correlates to their perception of quality care and hospitals are economically impacted by their feedback on hospital rating surveys. Stagnant Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results across the country indicate “Quiet at Night” is in need of attention to be prioritized, as it continues to be the lowest scoring line item on hospital rating surveys since …

Ethical Approaches To Mandating Influenza Vaccinations For Local Health Department Workforce In Georgia, Melicent R. Miller, Maureen K. Akubu-Odero, Lashauna L. Hunt, Stephanie L. Irvin, Catherine T. Palmer, William A. Mase

Journal of the Georgia Public Health Association

Background: The seasonal influenza illness occurs every year in the United States during the cooler months from October to April, sometimes lasting longer. Although certain populations are more susceptible to this condition, data have shown that otherwise healthy individuals have experienced alarming rates of morbidity and mortality associated with these infections. Despite the CDC’s recommendation for influenza vaccination for all HCWs, compliance have been lagging among local health departments’ workforce. This practice arguably exposes a wide cross section of the U.S. population to the flu, while being served in these facilities. The utilitarian approach provides a framework to examine the …

Energy Balance Related Lifestyle Factors And Risk Of Endometrial And Colorectal Cancer Among Individuals With Lynch Syndrome: A Systematic Review, Adriana M Coletta, Susan K Peterson, Leticia A Gatus, Kate J Krause, Susan M Schembre, Susan C Gilchrist, Mala Pande, Eduardo Vilar, Y Nancy You, Miguel A Rodriguez-Bigas, Larkin L Strong, Patrick M Lynch, Karen H Lu, Karen Basen-Engquist

Faculty, Staff and Student Publications

Lifestyle factors related to energy balance, such as excess body weight, poor diet, and physical inactivity, are associated with risk of sporadic endometrial cancer (EC) and colorectal cancer (CRC). There are limited data on energy balance-related lifestyle factors and EC or CRC risk among individuals with lynch syndrome, who are at extraordinarily higher risk of developing EC or CRC. We conducted a systematic review of evidence related to weight status, weight change, dietary habits, and physical activity on EC and CRC risk among individuals with lynch syndrome. Findings are reported narratively. We searched Medline, EMBASE, CENTRAL, PubMed, and clinicaltrials.gov up …

Temperature, Placental Abruption And Stillbirth, Amal Rammah, Kristina W Whitworth, Inkyu Han, Wenyaw Chan, Judy Wendt Hess, Elaine Symanski

Faculty, Staff and Student Publications

BACKGROUND: Pregnant women may be vulnerable to changes in ambient temperature and warming climates. Recent evidence suggests that temperature increases are associated with placental abruption, a risk factor for stillbirth.

OBJECTIVES: We investigated the effect of acute exposures to apparent temperature on stillbirths in Harris County, Texas, 2008-2013.

METHODS: We conducted a case-crossover study to investigate the association between temperature and stillbirth among 708 women. We used data from the National Climatic Data Center to estimate maternal exposure to daily average apparent temperature over the days (lag days 1 through 6) preceding the stillbirth event. We employed symmetric bidirectional sampling …

Adolescent Dating Violence Prevention Program For Early Adolescents: The Me & You Randomized Controlled Trial, 2014-2015, Melissa F Peskin, Christine M Markham, Ross Shegog, Elizabeth R Baumler, Robert C Addy, Jeff R Temple, Belinda Hernandez, Paula M Cuccaro, Melanie A Thiel, Efrat K Gabay, Susan R Tortolero Emery

Faculty, Staff and Student Publications

Objectives. To test the efficacy of Me & You, a multilevel technology-enhanced adolescent dating violence (DV) intervention, in reducing DV perpetration and victimization among ethnic-minority early adolescent youths. We assessed secondary impact for specific DV types and psychosocial outcomes.

Methods. We conducted a group-randomized controlled trial of 10 middle schools from a large urban school district in Southeast Texas in 2014 to 2015. We used multilevel regression modeling; the final analytic sample comprised 709 sixth-grade students followed for 1 year.

Results. Among the total sample, odds of DV perpetration were lower among intervention students than among control students (adjusted odds …

Bridging The Gap On Schistosomiasis: A Cross-Sectional Study Examining The Knowledge Gap And Common Attitudes And Practices Regarding S. Mansoni Infections Among Varying Education Levels In Luanda K’Otieno, Western Kenya, Kathy Zhang

Independent Study Project (ISP) Collection

Background: Schistosomiasis is considered one of the most prevalent neglected tropical diseases in the world. According to the World Health Organization (WHO), the most effective strategy for schistosomiasis control is through preventive chemotherapy with praziquantel (PZQ). In order to successfully control morbidity rates, the WHO recommends mass treatment targeting high risk groups, such as school-age children and adults considered to be at risk.

Methods: This cross-sectional study examined the effects of the National School-Based Deworming Programme (NSBDP) on knowledge of schistosomiasis and subsequent prevalence rates and intensity. A total of 43 residents in Luanda K’Otieno were interviewed, and 34 of …

Syrian Refugee Mothers In Jordan: Perceived Social Support And Postpartum Depression, Marya Rana

Independent Study Project (ISP) Collection

Many women suffer from postpartum depression; migrant women experience postpartum depression at rates almost triple that of the general population. This study investigated the associations between perceived social support and postpartum depression among Syrian refugee mothers living in Amman, Jordan. Eleven mothers completed a sociodemographic questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), and the Interpersonal Support Evaluation List (ISEL) - Shortened Version. Four of those mothers also participated in individual interviews, and four others were included in a focus group. Multiple recurring themes were identified from the interviews and focus group, including: perceived differences in child and social support in …

Aneurysm Formation, Growth, And Rupture: The Biology And Physics Of Cerebral Aneurysms., Pavlos Texakalidis, Ahmad Sweid, Nikolaos Mouchtouris, Eric C. Peterson, Chrissa Sioka, Leonardo Rangel-Castilla, John Reavey-Cantwell, Pascal Jabbour

Department of Neurosurgery Faculty Papers

Cerebral aneurysms (CAs) are characterized by a pathological wall structure with internal elastic lamina and media disruption, which leads to focal weakened pouches of the arterial wall. The prevalence of unruptured CAs has been estimated to be 2%-5% in the general population. During the past few decades, the pathophysiological mechanisms behind the formation, growth, and rupture of CAs have been the focus of numerous research studies. In the present review, we have summarized the inflammatory pathways, genetics, and risk factors for the formation, growth, and rupture of CAs. In addition, we have discussed the concepts of geometric indexes, flow patterns, …