Medical Specialties Commons^™

Childhood Mortality During And After Acute Illness In Africa And South Asia: A Prospective Cohort Study, Childhood Acute Illness And Nutrition (Chain) Network, Abdoulaye Hama Diallo, Abu Sadat Mohammad Sayeem Bin Shahid, Ali Fazal Khan, Ali Faisal Saleem, Benson O. Singa, Blaise Siezanga Gnoumou, Caroline Tigoi, Syed Asad Ali, Zaubina Kazi

Department of Paediatrics and Child Health

Background: Mortality among children with acute illness in low-income and middle-income settings remains unacceptably high and the importance of post-discharge mortality is increasingly recognised. We aimed to explore the epidemiology of deaths among young children with acute illness across sub-Saharan Africa and south Asia to inform the development of interventions and improved guidelines.
Methods: In this prospective cohort study, we enrolled children aged 2-23 months with acute illness, stratified by nutritional status defined by anthropometry (ie, no wasting, moderate wasting, or severe wasting or kwashiorkor), who were admitted to one of nine hospitals in six countries across sub-Saharan Africa and …

Dexmedetomidine Vs. Propofol In Postoperative Delirium Prevention, Jaclyn Burnett Rn, Srna, Montana Betts Rn, Srna, Christhian De Ochoa Rn, Srna, Maciej Chec Rn, Srna, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Postoperative delirium (POD) is an acute neurological condition affecting large numbers of surgical patients in various practice settings. Patients suffering from this condition face postoperative complications, increased lengths of stay, and tremendous financial burden. Understanding the contributing factors for POD, and how adjustments in intraoperative agents can prevent or reduce the incidence, is a crucial aspect of anesthesia practice. This scoping review will examine associations between POD and the intraoperative use of propofol versus dexmedetomidine with general anesthesia.

Methods Studies in this review were limited to peer-reviewed literature, published in medical and nursing journals within the last five years. …

The Effects Of Hormonal Contraceptive Use On Perceptions Of Social Stress In Women, Ashton Jones

Biological Sciences Undergraduate Honors Theses

Hormonal contraceptives are widely used due to their efficiency in preventing pregnancy. Although women are often informed of the physical effects of hormonal contraceptives, there is little emphasis on mental effects, such as increased rates of depression and changes in social perception. The current study examined perceptions of social stress among women before beginning hormonal contraceptives, and two months after using hormonal contraceptives. I hypothesized that women would experience increased social stress after beginning hormonal contraceptives, compared to a control group of women who were also assessed twice. Results did not support this hypothesis; there was no difference in interpersonal …

Barriers To The Use Of Palliative And Hospice Care Among The Latino Population, Diana Ramirez

Electronic Theses, Projects, and Dissertations

Patients suffering from irreversible and terminal illnesses may benefit from the services provided by Palliative and Hospice Care to control any symptom burden and assist in navigating complex medical decisions. Many patients may express hesitation in accepting and enrolling to this service due to misconceptions. Language barriers may add an additional layer of complexity. This study explored the challenges Palliative Care providers encounter when introducing concept of hospice to Spanish-speaking patients their families for the first time. This study implemented qualitative research methods by using semi-structured one-on-one interviews. Ten members of an In-patient Palliative Care Team at a University Hospital …

Sustainability Via Active Garden Education: The Sustainability Action Plan Model And Process, Rebecca E Lee, Jacob Szeszulski, Elizabeth Lorenzo, Anel Arriola, Meg Bruening, Paul A Estabrooks, Jennie L Hill, Teresia M O'Connor, Gabriel Q Shaibi, Erica G Soltero, Michael Todd

Children’s Nutrition Research Center Staff Publications

Sustainability of intervention programming is challenging to achieve under real world conditions, since few models exist and many studies do not plan far beyond the funding period. Programming content in early care and education centers (ECECs) is often driven by guidelines. However, implementation is very sensitive to contextual factors, such as the setting and implementer (teacher) characteristics. This paper presents the model, definitions, and methodology used for the sustainability action plan capitalizing on a community-based participatory research (CBPR) approach, developed for a multi-site, multi-level garden-based childhood obesity prevention study, Sustainability via Active Garden Education (SAGE). The Ecologic Model of Obesity …

Multi-Ancestry Genetic Study Of Type 2 Diabetes Highlights The Power Of Diverse Populations For Discovery And Translation, Anubha Mahajan, Cassandra N Spracklen, Weihua Zhang, Maggie C Y Ng, Lauren E Petty, Hidetoshi Kitajima, Grace Z Yu, Sina Rüeger, Leo Speidel, Young Jin Kim, Momoko Horikoshi, Josep M Mercader, Daniel Taliun, Sanghoon Moon, Soo-Heon Kwak, Neil R Robertson, Nigel W Rayner, Marie Loh, Bong-Jo Kim, Joshua Chiou, Irene Miguel-Escalada, Pietro Della Briotta Parolo, Kuang Lin, Fiona Bragg, Michael H Preuss, Fumihiko Takeuchi, Jana Nano, Xiuqing Guo, Amel Lamri, Masahiro Nakatochi, Robert A Scott, Jung-Jin Lee, Alicia Huerta-Chagoya, Mariaelisa Graff, Jin-Fang Chai, Esteban J Parra, Jie Yao, Lawrence F Bielak, Yasuharu Tabara, Yang Hai, Valgerdur Steinthorsdottir, James P Cook, Mart Kals, Niels Grarup, Ellen M Schmidt, Ian Pan, Tamar Sofer, Matthias Wuttke, Chloe Sarnowski, Christian Gieger, Darryl Nousome, Stella Trompet, Jirong Long, Meng Sun, Lin Tong, Wei-Min Chen, Meraj Ahmad, Raymond Noordam, Victor J Y Lim, Claudia H T Tam, Yoonjung Yoonie Joo, Chien-Hsiun Chen, Laura M Raffield, Cécile Lecoeur, Bram Peter Prins, Aude Nicolas, Lisa R Yanek, Guanjie Chen, Richard A Jensen, Salman Tajuddin, Edmond K Kabagambe, Ping An, Anny H Xiang, Hyeok Sun Choi, Brian E Cade, Jingyi Tan, Jack Flanagan, Fernando Abaitua, Linda S Adair, Adebowale Adeyemo, Carlos A Aguilar-Salinas, Masato Akiyama, Sonia S Anand, Alain Bertoni, Zheng Bian, Jette Bork-Jensen, Ivan Brandslund, Jennifer A Brody, Chad M Brummett, Thomas A Buchanan, Mickaël Canouil, Juliana C N Chan, Li-Ching Chang, Miao-Li Chee, Ji Chen, Shyh-Huei Chen, Yuan-Tsong Chen, Zhengming Chen, Lee-Ming Chuang, Mary Cushman, Swapan K Das, H Janaka De Silva, George Dedoussis, Latchezar Dimitrov, Ayo P Doumatey, Shufa Du, Qing Duan, Kai-Uwe Eckardt, Leslie S Emery, Daniel S Evans, Michele K Evans, Krista Fischer, James S Floyd, Ian Ford, Myriam Fornage, Oscar H Franco, Timothy M Frayling, Barry I Freedman, Christian Fuchsberger, Pauline Genter, Hertzel C Gerstein, Vilmantas Giedraitis, Clicerio González-Villalpando, Maria Elena González-Villalpando, Mark O Goodarzi, Penny Gordon-Larsen, David Gorkin, Myron Gross, Yu Guo, Sophie Hackinger, Sohee Han, Andrew T Hattersley, Christian Herder, Annie-Green Howard, Willa Hsueh, Mengna Huang, Wei Huang, Yi-Jen Hung, Mi Yeong Hwang, Chii-Min Hwu, Sahoko Ichihara, Mohammad Arfan Ikram, Martin Ingelsson, Md Tariqul Islam, Masato Isono, Hye-Mi Jang, Farzana Jasmine, Guozhi Jiang, Jost B Jonas, Marit E Jørgensen, Torben Jørgensen, Yoichiro Kamatani, Fouad R Kandeel, Anuradhani Kasturiratne, Tomohiro Katsuya, Varinderpal Kaur, Takahisa Kawaguchi, Jacob M Keaton, Abel N Kho, Chiea-Chuen Khor, Muhammad G Kibriya, Duk-Hwan Kim, Katsuhiko Kohara, Jennifer Kriebel, Florian Kronenberg, Johanna Kuusisto, Kristi Läll, Leslie A Lange, Myung-Shik Lee, Nanette R Lee, Aaron Leong, Liming Li, Yun Li, Ruifang Li-Gao, Symen Ligthart, Cecilia M Lindgren, Allan Linneberg, Ching-Ti Liu, Jianjun Liu, Adam E Locke, Tin Louie, Jian'an Luan, Andrea O Luk, Xi Luo, Jun Lv, Valeriya Lyssenko, Vasiliki Mamakou, K Radha Mani, Thomas Meitinger, Andres Metspalu, Andrew D Morris, Girish N Nadkarni, Jerry L Nadler, Michael A Nalls, Uma Nayak, Suraj S Nongmaithem, Ioanna Ntalla, Yukinori Okada, Lorena Orozco, Sanjay R Patel, Mark A Pereira, Annette Peters, Fraser J Pirie, Bianca Porneala, Gauri Prasad, Sebastian Preissl, Laura J Rasmussen-Torvik, Alexander P Reiner, Michael Roden, Rebecca Rohde, Kathryn Roll, Charumathi Sabanayagam, Maike Sander, Kevin Sandow, Naveed Sattar, Sebastian Schönherr, Claudia Schurmann, Mohammad Shahriar, Jinxiu Shi, Dong Mun Shin, Daniel Shriner, Jennifer A Smith, Wing Yee So, Alena Stančáková, Adrienne M Stilp, Konstantin Strauch, Ken Suzuki, Atsushi Takahashi, Kent D Taylor, Barbara Thorand, Gudmar Thorleifsson, Unnur Thorsteinsdottir, Brian Tomlinson, Jason M Torres, Fuu-Jen Tsai, Jaakko Tuomilehto, Teresa Tusie-Luna, Miriam S Udler, Adan Valladares-Salgado, Rob M Van Dam, Jan B Van Klinken, Rohit Varma, Marijana Vujkovic, Niels Wacher-Rodarte, Eleanor Wheeler, Eric A Whitsel, Ananda R Wickremasinghe, Ko Willems Van Dijk, Daniel R Witte, Chittaranjan S Yajnik, Ken Yamamoto, Toshimasa Yamauchi, Loïc Yengo, Kyungheon Yoon, Canqing Yu, Jian-Min Yuan, Salim Yusuf, Liang Zhang, Wei Zheng, Finngen, Emerge Consortium, Leslie J Raffel, Michiya Igase, Eli Ipp, Susan Redline, Yoon Shin Cho, Lars Lind, Michael A Province, Craig L Hanis, Patricia A Peyser, Erik Ingelsson, Alan B Zonderman, Bruce M Psaty, Ya-Xing Wang, Charles N Rotimi, Diane M Becker, Fumihiko Matsuda, Yongmei Liu, Eleftheria Zeggini, Mitsuhiro Yokota, Stephen S Rich, Charles Kooperberg, James S Pankow, James C Engert, Yii-Der Ida Chen, Philippe Froguel, James G Wilson, Wayne H H Sheu, Sharon L R Kardia, Jer-Yuarn Wu, M Geoffrey Hayes, Ronald C W Ma, Tien-Yin Wong, Leif Groop, Dennis O Mook-Kanamori, Giriraj R Chandak, Francis S Collins, Dwaipayan Bharadwaj, Guillaume Paré, Michèle M Sale, Habibul Ahsan, Ayesha A Motala, Xiao-Ou Shu, Kyong-Soo Park, J Wouter Jukema, Miguel Cruz, Roberta Mckean-Cowdin, Harald Grallert, Ching-Yu Cheng, Erwin P Bottinger, Abbas Dehghan, E-Shyong Tai, Josée Dupuis, Norihiro Kato, Markku Laakso, Anna Köttgen, Woon-Puay Koh, Colin N A Palmer, Simin Liu, Goncalo Abecasis, Jaspal S Kooner, Ruth J F Loos, Kari E North, Christopher A Haiman, Jose C Florez, Danish Saleheen, Torben Hansen, Oluf Pedersen, Reedik Mägi, Claudia Langenberg, Nicholas J Wareham, Shiro Maeda, Takashi Kadowaki, Juyoung Lee, Iona Y Millwood, Robin G Walters, Kari Stefansson, Simon R Myers, Jorge Ferrer, Kyle J Gaulton, James B Meigs, Karen L Mohlke, Anna L Gloyn, Donald W Bowden, Jennifer E Below, John C Chambers, Xueling Sim, Michael Boehnke, Jerome I Rotter, Mark I Mccarthy, Andrew P Morris

Faculty, Staff and Student Publications

We assembled an ancestrally diverse collection of genome-wide association studies (GWAS) of type 2 diabetes (T2D) in 180,834 affected individuals and 1,159,055 controls (48.9% non-European descent) through the Diabetes Meta-Analysis of Trans-Ethnic association studies (DIAMANTE) Consortium. Multi-ancestry GWAS meta-analysis identified 237 loci attaining stringent genome-wide significance (P < 5 × 10-9), which were delineated to 338 distinct association signals. Fine-mapping of these signals was enhanced by the increased sample size and expanded population diversity of the multi-ancestry meta-analysis, which localized 54.4% of T2D associations to a single variant with >50% posterior probability. This improved fine-mapping enabled systematic assessment of candidate causal genes and molecular mechanisms through which T2D associations are mediated, laying the foundations for functional investigations. Multi-ancestry genetic risk scores enhanced transferability of T2D prediction across diverse populations. Our study provides a step toward more effective clinical translation of T2D GWAS …

Machine Learning Automated Detection Of Large Vessel Occlusion From Mobile Stroke Unit Computed Tomography Angiography, Alexandra L Czap, Mersedeh Bahr-Hosseini, Noopur Singh, Jose-Miguel Yamal, May Nour, Stephanie Parker, Youngran Kim, Lucas Restrepo, Rania Abdelkhaleq, Sergio Salazar-Marioni, Kenny Phan, Ritvij Bowry, Suja S Rajan, James C Grotta, Jeffrey L Saver, Luca Giancardo, Sunil A Sheth

Faculty, Staff and Student Publications

BACKGROUND: Prehospital automated large vessel occlusion (LVO) detection in Mobile Stroke Units (MSUs) could accelerate identification and treatment of patients with LVO acute ischemic stroke. Here, we evaluate the performance of a machine learning (ML) model on CT angiograms (CTAs) obtained from 2 MSUs to detect LVO.

METHODS: Patients evaluated on MSUs in Houston and Los Angeles with out-of-hospital CTAs were identified. Anterior circulation LVO was defined as an occlusion of the intracranial internal carotid artery, middle cerebral artery (M1 or M2), or anterior cerebral artery vessels and determined by an expert human reader. A ML model to detect LVO …

Manual Therapy For Patients With Radiation-Associated Trismus After Head And Neck Cancer, Holly Mcmillan, Carly E A Barbon, Richard Cardoso, Abigail Sedory, Sheila Buoy, Christine Porsche, Kiara Savage, Lauren Mayo, Katherine A Hutcheson

Faculty, Staff and Student Publications

IMPORTANCE: Trismus is highly prevalent in head and neck cancer (HNC) survivorship. Current standards for trismus treatment include various stretch-based exercise protocols as a primary and single treatment modality with limited evidence regarding the role of manual therapy (MT) for this indication.

OBJECTIVE: To assess the effect size and associations of response to MT to increase oral opening in the setting of radiation-associated trismus.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective case series was conducted at the University of Texas MD Anderson Cancer Center between 2016 and March 2020 (before COVID-19 interruption) and included 49 disease-free survivors of HNC who were …

The Epidemiology Of Extended Spectrum Beta-Lactamase-Producing Enterobacterales In Nebraska, 2018 – 2021, Axel A. Vazquez Deida

Capstone Experience: Master of Public Health

Background: Extended spectrum beta-lactamase (ESBL)-producing Enterobacterales are considered a serious public health threat by the United States Centers for Disease Control and Prevention. However, surveillance of ESBL-producing Enterobacterales is currently limited to select states and the epidemiology of these antibiotic-resistant bacteria in Nebraska is still not well understood.

Objective: To describe the incidence of ESBL-producing Enterobacterales across local health department (LHD)-jurisdictions as well as at the state-level over time and assess population-specific factors associated with infection or colonization with these pathogens in Nebraska.

Methods: A retrospective, cross-sectional analysis of public health surveillance data reported to the Nebraska Department of …

Evaluation Of The University Of Nebraska Medical Center’S 4ms Geriatric Training Program At Nebraska Medicine Midtown, Holly M. Sesker

Capstone Experience: Master of Public Health

In 2015, the Health Resources and Services Administration (HRSA) created the Geriatrics Workforce Enhancement Program (GWEP) to address geriatric workforce challenges and improve the health outcomes of older adults. The GWEP redefines care delivery through a movement for age-friendly healthcare guided by evidence-based practices that align with the 4Ms: What Matters, Medication, Mentation, and Mobility. The 4Ms identify the key issues that should drive the decision-making and care for every older adult. 4Ms training sessions were conducted at the Nebraska Medicine Midtown Clinic and evaluated through a cross-sectional survey administered to both residents (trainees) and attendings (trainers). Data was collected …

An Evaluation Of Seasonal Maternal-Neonatal Morbidity Related To Trainee Cycles, Ayamo Oben, Paula Mcgee, William A Grobman, Jennifer L Bailit, Ronald J Wapner, Michael W Varner, John M Thorp, Steve N Caritis, Mona Prasad, George R Saade, Dwight J Rouse, Sean C Blackwell, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Maternal-Fetal Medicine Units Network

Faculty, Staff and Student Publications

BACKGROUND:

The existence of the “July phenomenon” (worse outcomes related to the presence of new physician trainees in teaching hospitals) has been debated in the literature and media. Previous studies of the phenomenon in obstetrics are limited by the quality and detail of data.

OBJECTIVE:

To evaluate whether the months of June to August, when transitions in trainees occur, are associated with increased maternal and neonatal morbidity.

STUDY DESIGN:

Secondary analysis of an observational cohort of 115,502 mother–infant pairs that delivered at 25 hospitals from March 2008 to February 2011. Inclusion criteria were an individual who had a singleton, nonanomalous …

Predictive Performance Of Newborn Small For Gestational Age By A Us Intrauterine Versus Birth Weight-Derived Standard For Short-Term Neonatal Morbidity And Mortality, Nathan R Blue, Lisa Mele, William A Grobman, Jennifer L Bailit, Ronald J Wapner, John M Thorp, Steve N Caritis, Mona Prasad, Alan T N Tita, George R Saade, Dwight J Rouse, Sean C Blackwell, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Maternal-Fetal Medicine Units (Mfmu) Network

Faculty, Staff and Student Publications

Objective:

The use of birth weight standards to define small for gestational age (SGA) may fail to identify neonates affected by poor fetal growth since they include births associated with sub-optimal fetal growth. Our objective was to compare intrauterine versus birth weight-derived standards to define newborn SGA to predict neonatal morbidity and mortality.

Study Design:

This was a secondary analysis of a multi-center observational study of 118,422 births. Liveborn singleton, non-anomalous newborns born at 23–41 weeks were included. Those with missing gestational age estimation or without a 1^st or 2^nd trimester ultrasound to confirm dating, birth weight, or …

Testicular Torsion Education: Improving Awareness Among Boys And Their Caregivers Regarding The Urgency Of Evaluating Scrotal Pain, Abby Taylor

Capstone Experience: Master of Public Health

Introduction: Testicular torsion is a urologic emergency that requires prompt medical evaluation and surgical intervention. The length of time from onset of the torsion to evaluation in the emergency department is often delayed due to lack of knowledge of the urgency of the situation amongst boys and their caregivers. We hypothesize that an animated educational video will increase awareness of the condition and prompt urgent evaluation in the emergency department.

Methods: A 5-minute animated educational video was created following a boy, Danny, as he develops testicular torsion. Four population groups: boys, parents, school nurses, and pediatricians, completed group-specific pre- and …

Tocilizumab In Patients Hospitalised With Covid-19 Pneumonia: Efficacy, Safety, Viral Clearance, And Antibody Response From A Randomised Controlled Trial (Covacta), Ivan O Rosas, Norbert Bräu, Michael Waters, Ronaldo C Go, Atul Malhotra, Bradley D Hunter, Sanjay Bhagani, Daniel Skiest, Sinisa Savic, Ivor S Douglas, Julia Garcia-Diaz, Mariam S Aziz, Nichola Cooper, Taryn Youngstein, Lorenzo Del Sorbo, David J De La Zerda, Andrew Ustianowski, Antonio Cubillo Gracian, Kevin G Blyth, Jordi Carratalà, Bruno François, Thomas Benfield, Derrick Haslem, Paolo Bonfanti, Cor H Van Der Leest, Nidhi Rohatgi, Lothar Wiese, Charles Edouard Luyt, Rebecca N Bauer, Fang Cai, Ivan T Lee, Balpreet Matharu, Louis Metcalf, Steffen Wildum, Emily Graham, Larry Tsai, Min Bao

Faculty, Staff and Students Publications

BACKGROUND: In COVACTA, a randomised, placebo-controlled trial in patients hospitalised with coronavirus disease-19 (COVID-19), tocilizumab did not improve 28-day mortality, but shortened hospital and intensive care unit stay. Longer-term effects of tocilizumab in patients with COVID-19 are unknown. Therefore, the efficacy and safety of tocilizumab in COVID-19 beyond day 28 and its impact on Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) clearance and antibody response in COVACTA were investigated.

METHODS: Adults in Europe and North America hospitalised with COVID-19 (

FINDINGS: By day 60, 24·5% (72/294) of patients in the tocilizumab arm and 25·0% (36/144) in the placebo arm died (weighted …

A D2 To D1 Shift In Dopaminergic Inputs To Midbrain 5-Ht Neurons Causes Anorexia In Mice, Xing Cai, Hailan Liu, Bing Feng, Meng Yu, Yang He, Hesong Liu, Chen Liang, Yongjie Yang, Longlong Tu, Nan Zhang, Lina Wang, Na Yin, Junying Han, Zili Yan, Chunmei Wang, Pingwen Xu, Qi Wu, Qingchun Tong, Yanlin He, Yong Xu

Faculty, Staff and Students Publications

Midbrain dopamine (DA) and serotonin (5-HT) neurons regulate motivated behaviors, including feeding, but less is known about how these circuits may interact. In this study, we found that DA neurons in the mouse ventral tegmental area bidirectionally regulate the activity of 5-HT neurons in the dorsal raphe nucleus (DRN), with weaker stimulation causing DRD2-dependent inhibition and overeating, while stronger stimulation causing DRD1-dependent activation and anorexia. Furthermore, in the activity-based anorexia (ABA) paradigm, which is a mouse model mimicking some clinical features of human anorexia nervosa (AN), we observed a DRD2 to DRD1 shift of DA neurotransmission on 5-HT

Family Perspectives On Developmental Monitoring: A Qualitative Study, Sarah Behrens, Evan Dean, Marisol Torres

Developmental Disabilities Network Journal

Developmental monitoring, an ongoing process to identify children at risk for developmental delays, is an essential component to the identification of a developmental disability in young children. In collaboration with families, medical professionals are expected to monitor the development of a child; however, current research focuses on screening with less attention on developmental monitoring and the role of the family. Here, we show the experiences of families with medical professionals specific to developmental monitoring and how families obtain and develop knowledge on child development. We analyze qualitative data from a sample of family caregivers using semi-structured interviews. With a thematic …

A Multimodal Intervention For Weight Loss In Primary Care, Amber Smith

Evidence-Based Practice Project Reports

Obesity is a worsening pandemic that requires immediate action. It is recommended that primary care providers screen patients for obesity and provide multimodal behavioral interventions to their patients to treat and prevent obesity (USPSTF, 2018). The purpose of this evidenced-base practice (EBP) project is to implement a multimodal intervention for weight loss in adults within primary care. Five search engines were utilized, and 16 articles were ultimately selected as evidence. The evidence supported self-monitoring and close follow-up while in active weight loss. The Iowa Model for EBP to promote quality care was used as the framework to guide the project …

Using A Food Insecurity Screening Tool In The Nicu, Emily Coffman Bsn, Rn, Fatina Caldwell Bs, Bsn, Rn, Cpn, Cpen, Mackenzie Box Bsn, Rn, Uche Anani Md, Faap, Christin Fritz Md, Mph, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background: Infants admitted to the NICU are disproportionately born to low-income families. This, combined with unique financial challenges of their long-term stay, may predispose caregivers to food insecurity (FI). FI among caregivers has far reaching implications for the health of infants who are already vulnerable related to comorbidities from their NICU stay.

Methods: Using the Iowa model to successfully engage key stake holders and begin a small pilot study, a randomized preintervention chart audit was performed (n=30) to evaluate if FI was identified by NICU Social Worker (SW). The FI screening tool was administered by nursing to a separate group …

Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: A Case Report, Tammy E. Phillips, Hammad A. Bhatti, Minh Q. Ho

The University of Louisville Journal of Respiratory Infections

Organizing pneumonia can be idiopathic or caused by multiple etiologies, including viral or bacterial pneumonia, drugs, and autoimmune disorders. It can rarely lead to cyst formation and pneumothorax with the exact mechanism remaining unclear. This case presents a previously healthy 50-year-old male who contracted COVID-19 with subsequent development of organizing pneumonia and pneumothorax. Patients presenting with hypoxic respiratory failure due to COVID-19 should be screened for organizing pneumonia upon discharge. This case also illustrates the importance of following such patients radiologically to monitor interstitial lung disease and consider pneumothorax for patients re-presenting with acute symptoms.

Advantages Of Early Utilization Of Palliative Care In The Pediatric Icu: A Scoping Review, Shelby Noel Cain Bsn, Rn, Cpn, Dana Pabalate Zimmerman Msn, Rn, Charis Elizabeth Oji Msn, Aprn, Cpnp-Pc/Ac, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Abstract Purpose/Background Despite the increased use of palliative care in adults, only a tiny percentage of children with life-limiting illnesses or life-threatening conditions receive palliative care before dying. Palliative care has low utilization, and consults are often made late in a child’s hospitalization or diagnosis. Palliative care remains underutilized among hospitalized pediatric patients resulting in unnecessary treatments, costly and lengthy hospitalizations, and deaths occurring in the intensive care unit (ICU) rather than at home. The purpose of this scoping review is to evaluate current literature to determine the use and effect of pediatric palliative care, specifically, whether consultation of palliative …

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …

Increasing Physical Activity In Women With Obesity To Promote Weight Loss, Ashley N. Kohler

Evidence-Based Practice Project Reports

Obesity is a chronic disease associated with a multitude of lifelong chronic illnesses. Obesity impacts more than 42% of the United States population (CDC, 2021b). Physical inactivity is a major determinant of obesity (Muerer et al., 2019). The purpose of this evidence-based practice (EBP) project was to promote a greater reduction in body mass index (BMI) of the participants enrolled in an existing wellness program at the EBP practice site by increasing the physical activity level of the participants compared to standard protocol. The existing wellness program’s standard protocol included diet modifications, physical activity encouragement, and medication management. The EBP …

Perceived Roles, Benefits And Barriers Of Virtual Global Health Partnership Initiatives: A Cross-Sectional Exploratory Study, Lisa Umphrey, George Paasi, William Windsor, Grace Abongo, Jessica Evert, Heather Haq, Elizabeth M Keating, Suet Kam Lam, Megan S Mchenry, Carolyne Ndila, Charles Nwobu, Amy Rule, Reena P Tam, Daniel Olson, Peter Olupot-Olupot

Faculty, Staff and Students Publications

BACKGROUND: Virtual global health partnership initiatives (VGHPIs) evolved rapidly during the COVID-19 pandemic to ensure partnership continuity. However the current landscape for VGHPI use and preference is unknown. This study aimed to increase understanding of GH partners' perspectives on VGHPIs.

METHODS: From 15 October to 30 November 2020, An online, international survey was conducted using snowball sampling to document pandemic-related changes in partnership activities, preferences for VGHPIs, and perceived acceptability and barriers. The survey underwent iterative development within a diverse author group, representing academic and clinical institutions, and the non-profit sector. Participants from their professional global health networks were invited, …

Consumer Experience Of Mental Health Services During The Covid-19 Pandemic: Evidence From An Australian Mental Health System, Sarah Kelshaw, Jason Boyd, Irene Gallagher, Grant Sara

Patient Experience Journal

COVID-19 has increased the need for mental health care but disrupted its delivery. We examined impacts of the first year of the COVID-19 pandemic on consumer experience of NSW hospital and community mental health services, compared to their pre-COVID baseline. We also examined whether increased telehealth use was associated with changes in the quantity or experience of community mental health care. Data were 73,488 Your Experience of Service (YES) surveys from state mental health services in New South Wales (NSW), Australia, grouped into three periods: pre-COVID (January 2018 to March 2020), early-COVID (April to June 2020) and stable-COVID (July to …

Family’S Sufferings From Asymptomatic Covid: Clinicians’ Perspective, Neha Joshi Dr, Jitender Nagpal Dr, Anand Sinha Dr

Patient Experience Journal

Anticipating dire consequences, in 2020 the world braced itself for the unparalleled pandemic by resorting to unprecedented measures including stringent lockdowns, unforeseen social isolations, spotlight focus, resource diversions besides reorganized healthcare systems to name the quintessential few. Such unifocal convergence enhanced the vulnerabilities of patients dependent on non-COVID healthcare assistance. For a nation with a meagre allocation of 0.7 hospital beds per 1000 people and a lopsided doctor-population ratio of 1:1800, COVID-centric measures created unintended complications. Ironically, many succumbed in myriad ways, not due to the pandemic but due to the attributes of the survival measures. While such consequences cannot …

Interventions To Improve Adherence To Recommended Diabetic Retinopathy Screening In Adult Patients With Diabetes Mellitus: A Scoping Review, Clare Anderson Bsn, Rn, Dnp, Fnp, Sarah May Bsn, Rn, Dnp, Fnp, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Diabetic retinopathy (DR) is the leading cause of blindness in adults. Current guidelines recommend that all patients with type 2 diabetes mellitus (T2DM) have a DR screening (DRS) upon diagnosis of T2DM and then annually, but the adherence rate is only approximately 60%. This scoping review aims to evaluate the effectiveness of primary care providers (PCPs) employing strategies to increase compliance with annual DRS among adult patients with T2DM.

Methods Between September 2021 and January 2022, a literature review was performed to collect studies evaluating interventions to increase adherence to DRS. Individual searches of PubMed, SCOPUS, and CINAHL were …

Prevention Of Diabetes-Related Hospital Readmission Following Initial Diagnosis Of Diabetes In Patients Over The Age Of Fifty: A Scoping Review, Nathan Miller Dnp, Agacnp, Fnp, Jasmine Harris Dnp, Fnp, Michael Clardy Dnp, Agacnp, Diana Dedmon Dnp, Acnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background: By reviewing multiple studies related to the treatment of patients with new diagnoses of diabetes, this scoping review will endeavor to determine which interventions, when implemented for patients over 50 years old which are newly diagnosed with type 2 diabetes, can decrease the likelihood of hospital readmission related to diabetes within 90 days when compared with those patients who did not receive or participate in follow-up.

Methods: For resources to be eligible to review they had to be from 2015 or after. Studies selected included patients over the age of 50 newly diagnosed with type 2 diabetes subject to …

Increasing Colorectal Cancer Screening Adherence: A Scoping Review, Megan E. Billingsley Bsn, Rn, Tiameria T. Ford Bsn, Rn, Mikayla E. Vican Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Rates have steadily increased in recent years due to high rates of obesity, smoking, and sedentary lifestyles. Screening for the disease can lead to early detection and reduced morbidity/mortality, yet screening rates remain low. Existing literature is extensive in discussing methods to increase CRCS adherence; therefore, a scoping review allows for increased understanding of barriers to CRCS and how to address those barriers to increase screening compliance.

Methods A literature search was completed from September 2020 to October 2021. Multiple databases were used, including …

Markers Of Kidney Function, Genetic Variation Related To Cognitive Function, And Cognitive Performance In The Uk Biobank, Erin L Richard, Linda K Mcevoy, Ian J Deary, Gail Davies, Steven Y Cao, Eyal Oren, John E Alcaraz, Andrea Z Lacroix, Jan Bressler, Rany M Salem

Faculty, Staff and Student Publications

BACKGROUND: Chronic kidney disease has been linked to worse cognition. However, this association may be dependent on the marker of kidney function used, and studies assessing modification by genetics are lacking. This study examined associations between multiple measures of kidney function and assessed effect modification by a polygenic score for general cognitive function.

METHODS: In this cross-sectional study of up to 341,208 European ancestry participants from the UK Biobank study, we examined associations between albuminuria and estimated glomerular filtration rate based on creatinine (eGFRcre) or cystatin C (eGFRcys) with cognitive performance on tests of verbal-numeric reasoning, reaction time and visual …

Covid-19 Newsletter (Vol. 116), Center For Disaster Medicine, New York Medical College

COVID-19 Newsletter

No abstract provided.