Efficacy Of Invisalign Attachments: A Retrospective Study, Theresa Karras, Maharaj Singh, Emelia Karkazis, Dawei Liu, Ghada Nimeri, Bhoomika Ahuja

College of Nursing Faculty Research and Publications

Introduction: The purpose of this study was to compare the efficacy of Invisalign's (Align Technology, Santa Clara, Calif) optimized and conventional attachments on rotational and extrusive tooth movements. Methods: Initial, predicted, and achieved digital dental models from 100 orthodontic patients were exported from Invisalign's ClinCheck software as stereolithography files and subsequently imported into the Slicer CMF program (version 4.7.0; http://www.slicer.org) for superimpositions on posterior teeth with no planned movement. Rotational and extrusive measurements for both optimized and conventional attachments were made on 382 teeth from the superimposition of the initial and predicted models (predicted movement) and from the superimposed initial …

Using Debriefing For Meaningful Learning With Screen-Based Simulation, Kristina Dreifuerst, Cynthia S. Bradley, Brandon K. Johnson

College of Nursing Faculty Research and Publications

Background

COVID-19 has led to increased use of screen-based simulation. However, the importance of including a robust debriefing as a component of these simulations is often neglected.

Problem

Failing to include debriefing with screen-based simulation could negatively impact student learning outcomes.

Approach

Debriefing, including recollection, discussion to reveal understanding, feedback and reflection, is a process of helping learners make sense of learned content and knowledge as it is applied to the patient care experience. Debriefing for Meaningful Learning (DML) is an evidence-based method derived from theory, which can be easily incorporated into screen-based simulation to augment the clinical learning experience. …

Pregnant Women's Experiences With Gastrointestinal Discomforts And Strategies They Use To Cope, Heidi Jo Paquette

Dissertations (1934 -)

Problem The experience of gastrointestinal (GI) discomforts of pregnancy is almost universal. Heartburn, constipation, nausea and/or vomiting are the most common, with variation in frequency and intensity by trimester. GI discomforts of pregnancy are understudied. Most research on GI discomforts of pregnancy has employed quantitative instruments, before and after specific therapeutic approaches. Little research has focused on women’s experiences of GI discomforts of pregnancy and self-management strategies. Women are experts in their experience of their own pregnancies and their voices are rich sources of data, but have been largely ignored in the study of GI discomforts of pregnancy. Methodology The …

Securing Nasogastric Tubes In Children, Julie Ann Lavoie

Dissertations (1934 -)

Nasogastric tubes (NGTs) are commonly placed in children at risk for malnutrition in order to provide temporary nutrition support until the child achieves independent oral feedings or requires durable tube placement. Accurate securement of NGTs is necessary to safely provide nutrition, particularly in infants and toddlers who are at highest risk for dislodging their NGT. Dislodgement of an NGT has a cascade effect on the medical management, requiring increased exposure to the healthcare system with every replacement. Nasal bridles are widely used to secure NGTs in adults but are not widely used with children. The purpose of this retrospective, correlational …

Geographical Variations And Factors Associated With Recent Hiv Testing Prevalence In Ghana: Spatial Mapping And Complex Survey Analyses Of The 2014 Demographic And Health Surveys, Jerry John Nutor, Henry Ofori Duah, Precious Adade Duodu, Pascal Agbadi, Robert Kaba Alhassan, Ernest Darkwah

College of Nursing Faculty Research and Publications

Objective To examine the factors associated with recent HIV testing and to develop an HIV testing prevalence surface map using spatial interpolation techniques to identify geographical areas with low and high HIV testing rates in Ghana.

Design Secondary analysis of Demographic and Health Survey.

Setting Rural and urban Ghana

Participants The study sample comprised 9380 women and 3854 men of 15–49 years.

Results We found that 13% of women and 6% of men of Ghana had tested for HIV in the past 12 months. For women, being within the age groups of 15–39 years, being currently married, attainment of post-secondary …

Socio-Economic And Geographical Inequalities In Adolescent Fertility Rate In Ghana, 1993–2014, Bright Opoku Ahinkorah, Eugene Budu, Henry Ofori Duah, Joshua Okyere, Abdul-Aziz Seidu

College of Nursing Faculty Research and Publications

Background

Despite public health interventions to control adolescent fertility, it remains high in sub-Saharan Africa. Ghana is one of the countries in sub-Saharan Africa with the highest adolescent fertility rates. We examined the trends and socio-economic and geographical patterns of disparities in adolescent fertility in Ghana from 1993 to 2014.

Methods

Using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the 1993–2014 Ghana Demographic and Health surveys were analyzed. First, we disaggregated adolescent fertility rates (AFR) by four equity stratifiers: wealth index, education, residence and region. Second, we measured the inequality through summary measures, namely …

Effectiveness Of Home Health Care In Reducing Return To Hospital: Evidence From A Multi-Hospital Study In The Us, Danielle M. Siclovan, James Bang, Olga Yakusheva, Morris Hamilton, Kathleen L. Bobay, Linda L. Costa, Ronda G. Hughes, Jane M. Miles, Sarah J. Bahr, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Background

Home health care, a commonly used bridge strategy for transitioning from hospital to home-based care, is expected to contribute to readmission avoidance efforts. However, in studies using disease-specific samples, evidence about the effectiveness of home health care in reducing readmissions is mixed.

Objective

To examine the effectiveness of home health care in reducing return to hospital across a diverse sample of patients discharged home following acute care hospitalization.

Research design

Secondary analysis of a multi-site dataset from a study of discharge readiness assessment and post-discharge return to hospital, comparing matched samples of patients referred and not referred for home …

The Other “Front Line”: Public Health Nursing Clinical Instruction During Covid-19, Lyndsay G. Degroot, Jessica L. Zemlak, Sarah E. Lafave, Lea Marineau, Deborah Wilson, Nicole Warren

College of Nursing Faculty Research and Publications

No abstract provided.

Actual And Potential Impact Of A Home Nasogastric Tube Feeding Program For Infants Whose Neonatal Intensive Care Unit Discharge Is Affected By Delayed Oral Feedings, Joanne Lagatta, Michael Uhing, Krishna Acharya, Julie Ann Lavoie, Erin Rholl, Kathryn J. Malin, Margaret Malnory, Jonathan Leuthner, David C. Brousseau

College of Nursing Faculty Research and Publications

Objective

To compare healthcare use and parent health-related quality of life (HRQL) in 3 groups of infants whose neonatal intensive care unit (NICU) discharge was delayed by oral feedings.

Study design

This was a prospective, single-center cohort of infants in the NICU from September 2018 to March 2020. After enrollment, weekly chart review determined eligibility for home nasogastric (NG) feeds based on predetermined criteria. Actual discharge feeding decisions were at clinical discretion. At 3 months’ postdischarge, we compared acute healthcare use and parental HRQL, measured by the PedsQL Family Impact Module, among infants who were NG eligible but discharged with …

Providing Palliative And Hospice Care To Children, Adolescents And Young Adults With Cancer, Kimberly A. Pyke-Grimm, Beth Fisher, Amy Haskamp, Cynthia J. Bell, Amy Rose Newman

College of Nursing Faculty Research and Publications

Objectives

To describe palliative, concurrent, and hospice care in pediatric oncology in the United States (US), we present a clinical scenario illustrating palliative and hospice care, including eligibility for concurrent care, insurance coverage and billing, barriers to accessing quality pediatric palliative and hospice care, and implications for oncology nursing practice.

Data Sources

Peer-reviewed articles, clinical practice guidelines, professional organizations, and expert clinical opinion examining pediatric oncology, palliative care, and hospice care.

Conclusion

Understanding the goals of palliative and hospice care and the differences between them is important in providing holistic, goal-directed care.

Implications for Nursing Practice

Oncology nurses play …

Socioeconomic And Demographic Correlates Of Nonenrolment Onto The National Health Insurance Scheme Among Children In Ghana: Insight From The 2017/18 Multiple Indicator Cluster Survey, Pascal Agbadi, Joshua Okyere, Alberta Lomotey, Henry Ofori Duah, Abdul-Aziz Seidu, Bright Opoku Ahinkorah

College of Nursing Faculty Research and Publications

The goal of Ghana’s health insurance scheme is to achieve universal coverage. Despite NHIS’ benefits to children, not all children in Ghana are covered. This study investigates the sociodemographic covariates of nonenrolment onto the national health insurance scheme among children in Ghana. We used the child dataset of the 2017/18 Ghana Multiple Indicator Cluster Survey (G-MICS). We used STATA version 14 for the data analyses. We described each study variable using frequency and percentages. We used Poisson regression to estimate crude and adjusted prevalence ratios of the relationship between the covariates and the outcome variable. Approxi­ mately 57% of children …

Correlates Of Blood Pressure And Blood Glucose Screenings In Cameroon: Insights From The 2018 Demographic And Health Survey, Precious Adade Duodu, Pascal Agbadi, Henry Ofori Duah, Ernest Darkwah, Jerry John Nutor

College of Nursing Faculty Research and Publications

Background

Hypertension and diabetes, two major risk factors for cardiometabolic diseases, are associated with high morbidity and mortality rates. Early detection through screening can initiate early treatment to reduce adverse outcomes. The current study sought to investigate the correlates of blood pressure and blood glucose screenings in Cameroon.

Methods

We used secondary data from the 2018 Cameroon Demographic and Health Survey. Adjusting for a complex sample design, we performed multivariate prevalence ratio estimates of the blood pressure and blood glucose screenings.

Results

Approximately 60% and 30% of Cameroonians had undergone blood pressure and blood glucose screenings, respectively. More females (68%) …

Using Electronic Data And A Mixed-Methods Approach To Evaluate Short Peripheral Catheter Outcomes In Acute Care, Aimee A. Woda, Cailin Ford, Kelsey Meise, Maharaj Singh, Mary Hook

College of Nursing Faculty Research and Publications

Short peripheral catheters (SPCs) are commonly used in hospitals, guided by evidence-based standards to optimize dwell time and limit adverse outcomes. Although SPC insertions are common, real-world evaluation is rare. A theory-based framework and mixed-methods design were used to analyze findings from a unit-level survey and electronic data to evaluate SPC care delivered on units at a large quaternary medical center over a 6-month period (quarters 1 and 2, 2017). Dissemination without adoption and maintenance may limit effectiveness. The convergent results confirmed the feasibility of extracting electronic data to be used by leaders to clinically evaluate staff knowledge and use …

Using A Four-Phased Process When Implementing A Multisite Simulation Study, Aimee A. Woda, Kristina Dreifuerst, Jamie Hansen

College of Nursing Faculty Research and Publications

Multisite simulation studies are critical in nursing research as they allow researchers to obtain larger sample sizes, however, many components need to be addressed to ensure adequate compliance with research protocols. Multisite studies are important in research as they help promote generalizability. Many components go into successfully conducting multisite simulation studies. The purpose of this paper is to describe how the four-phase process of planning, project development, study execution, and dissemination of study findings were contributed to the success of this multisite simulation study. Locating sites that met inclusion criteria, keeping consistent communication with all sites, and ensuring that participants …

Risk Of Atrial Fibrillation And Stroke After Bariatric Surgery In Patients With Morbid Obesity With Or Without Obstructive Sleep Apnea, Ahmed Dalmar, Maharaj Singh, Zoe Heis, Tabitha L. Cumpian, Cheryl Ceretto, M. Eyman Mortada, Atul Bhatia, Imran Niazi, Thomas Y. Chua, Jasbir Sra, Arshad Jahangir

College of Nursing Faculty Research and Publications

Background and Purpose:

Weight loss in morbidly obese patients reduces atrial fibrillation (AF); however, it is unknown whether similar benefits are maintained in patients with obstructive sleep apnea (OSA). We sought to determine whether incident AF and stroke rates are affected by OSA after weight loss and to identify predictors of AF and stroke.

Methods:

Differences in laparoscopic adjustable gastric banding–induced weight loss on incident AF and stroke events in those with and without OSA in the entire and in propensity-matched cohorts were determined longitudinally, and independent predictors of AF and stroke were identified.

Results:

Of 827 morbidly obese patients …

Examining Social Factors In Self-Management For Older Adults Living Alone, Margaret Salinas

Dissertations (1934 -)

Older adults living alone are a rapidly growing and often vulnerable segment of the population. Patient activation is an established predictor of self-management engagement, ability, and behaviors, and may be impacted by many factors, including social factors such as loneliness, social isolation, and neighborhood conditions. However, relationships among these social factors and environmental factors and patient activation are unclear. Using the Individual and Family Self-Management Theory, the purpose of this cross-sectional study was to examine the factor structure and bivariate correlations of loneliness, social isolation, neighborhood conditions and to test the effect of these factors on patient activation using self-efficacy …

Effectiveness Of A Postpartum Breastfeeding Protocol For Avoiding Pregnancy And Descriptive Analysis Of The Physiology Of The Postpartum Transition, Mary Schneider

Dissertations (1934 -)

Traditionally, postpartum breastfeeding women used Natural Family Planning (NFP) methods that required observation of cervical mucus and basal body temperature as indicators of return to fertility. These indicators resulted in high unintended pregnancy rates (i.e., 14-32 over 12 months of use). High pregnancy rates were due to the inaccuracy and subjectivity of those fertility indicators which required extended periods of abstinence. Ineffectiveness of NFP methods is also related to changing patterns of fertility during lactation amenorrhea (LA) and the first six menstrual cycles postpartum.Studies of a NFP protocol where women used objective urine hormone biomarkers were 92-98% effective for …

Experiences Of Exclusively Expressing Breast Milk For Term Infants: A Qualitative Analysis, Lisa Anders

Dissertations (1934 -)

Breast milk feeding has numerous benefits for women and infants. Although positive maternal experiences with breast milk feeding impacts exclusivity, duration, and maternal mental health, most research focuses on women feeding directly at the breast. Breast milk can also be expressed and bottle-fed to the infant. This practice is encouraged in instances of maternal-infant separation or in cases of prematurity. However, there is an increasing number of women electing to feed exclusively expressed breast milk to term infants rather than feed directly at the breast. Little is known about what constitutes a positive, or salutary breastfeeding, experience in this population. …

Examining The Relationship Of Physical Activity, Inflammation & Adiposity On Physical Function With Gender Differences, Jeanne Hlebichuk

Dissertations (1934 -)

Older adults are a rapidly growing segment of the population in the United States. The ability to maintain physical function declines with age and is a critical factor that contributes to living independently. Physical activity has been shown to slow declines in physical function and decrease chronic inflammation. Increases in adipose tissue and decreases in muscle mass are associated with aging. The increase in adipose tissue produces inflammatory markers that can negatively impact older adults’ health. Males and females’ biological changes with aging have been hypothesized to differ. The purposes of this study were to :1) examine the relationship between …

New-Onset Heart Failure With Atrial Fibrillation: A Distinct Type Of Cardiomyopathy?, Vinay Mehta, Alexander Albers, Maharaj Singh, Ana Cristina Perez Moreno, Timothy E. Paterick

College of Nursing Faculty Research and Publications

Objective

There is limited research comparing demographic and clinical characteristics between patients who present with atrial fibrillation (AF) and new-onset cardiomyopathy (CM) to patients with new-onset CM without dysrhythmia. We aimed to evaluate clinical characteristics and outcomes in patients with new-onset CM with and without AF and to report their real-world treatment.

Methods and Results

The study population was identified using patient records from our healthcare system from January 1, 2012 to September 30, 2016. Patients with a left ventricular ejection fraction ≤40% without a prior history of CM were divided into two groups; those with an antecedent or concomitant …

Diverse Students Collaborating To Address Social Determinants Of Health Using Listening Sessions, Juanita T. Garcia, Leona Vandevusse, Gladys Simandl, Amber N. Johnson, Qiyan Mu, Jennifer Jean Dahlman

College of Nursing Faculty Research and Publications

In this article, a Nursing Workforce Diversity grant-funded project examined the social determinants of health (SDH) including diverse high school and baccalaureate nursing students. All involved students were from educationally and/or economically disadvantaged backgrounds and/or underrepresented minority groups. The purpose of this article is to report the project outcome data and analysis gathered from students' experiences of SDH, using the collaborative method, listening sessions. The project staff and student nurses discussed SDH with high school students, who then identified and prioritized key SDH in their neighborhoods during a series of facilitated listening sessions in their schools. Initial analysis included reviewing, …

Patients’ Experiences Of Recovery: Beyond The Intensive Care Unit And Into The Community, Kelly Calkins, Peninnah M. Kako, Jill L. Guttormson

College of Nursing Faculty Research and Publications

Aims

To understand barriers and facilitators of recovery for critical illness survivors’, who are discharged home from the hospital and do not have access to dedicated outpatient care.

Design

Multi-site descriptive study guided by interpretive phenomenology using semi-structured interviews.

Methods

Interviews were conducted between December 2017 -July 2018. Eighteen participants were included. Data were collected from interview recordings, transcripts, field notes, and a retrospective chart review for sample demographics. Analysis was completed using Interpretive Phenomenological Analysis which provided a unique view of recovery through the survivors’ personal experiences and perception of those experiences.

Results

Participants encountered several barriers to their …

Swim Program Pilot For Children With Autism: Impact On Behaviors And Health, Norah L. Johnson, Abir K. Bekhet, Tana Karenke, Mauricio Garnier-Villarreal

College of Nursing Faculty Research and Publications

The purpose of this mixed methods pre-/post-pilot intervention study was to assess parental psychological health and child challenging behaviors before and after a swimming program for children with autism. Participants were 10 parent–child dyads. Child’s challenging behaviors were lower in the post testing (Cohen’s d = 0.07–0.45). Mean scores were improved for parent perception of general health (Cohen’s d = 0.22). Three themes emerged from the post swim program focus group: (a) Parent satisfaction with instructors with sub themes (i) firmness (ii) creativity, and (iii) promotion of social interaction and sharing, (b) improved child sleeping, and (c) family dynamics with …

Implementation And Preliminary Testing Of A Theory-Guided Nursing Discharge Teaching Intervention For Adult Inpatients Aged 50 And Over With Multimorbidity: A Pragmatic Feasibility Study Protocol, Joanie Pellet, Marianne E. Weiss, Franziska Zúñiga, Cédric Mabire

College of Nursing Faculty Research and Publications

Background

Discharge teaching by nurses during hospitalization is essential to provide multimorbid inpatients with the knowledge and skills to self-manage their health conditions. However, available disease-specific teaching guidelines do not address the cumulative complexity of multiple chronic diseases that occur with greater frequency in older adults. Therefore, there is a need for a discharge teaching intervention which uses concepts that specifically address the needs of these patients, such as considering their level of activation (i.e. knowledge, skills and confidence to self-manage their health) and the burden of multimorbid disease. The objectives of this pragmatic study will be to (1) test …

Probiotics For The Management Of Infantile Colic: A Systematic Review, Jennifer Simonson, Kristin Haglund, Emma Weber, Alissa Fial, Lisa Hanson

College of Nursing Faculty Research and Publications

Background:

Colic is defined as periods of inconsolable crying, fussing, or irritability that have no apparent cause and present in healthy infants under 5 months of age. Although colic is a benign and self-limiting condition, it can be distressing to parents and there are few robust treatment interventions. This systematic review explored the evidence for administration of probiotics to prevent or decrease symptoms of colic.

Methods:

Literature searches were conducted in PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, and Web of Science.

Sample:

Twenty articles were included: 15 randomized controlled trials and 5 meta-analyses.

Results: …

The Effect Of Prolonged Pre-Operative Halo Gravity Traction For Severe Spinal Deformities On The Cervical Spine Radiographs, Kawdwo P. Yankey, Henry Ofori Duah, Cristina Sacramento-Dominguez, Henry O. Tutu, Mabel Adobea Owiredu, Rufai Mahmud, Irene Wulff, Gerhard Ofori-Amankwah, Harry Akoto, Oheneba Boachie-Adjei, Focos Spine Research Group

College of Nursing Faculty Research and Publications

Study Design:

Retrospective review of consecutive series.

Objective:

The study sought to assess the effect of prolonged pre-operative halo gravity traction (HGT) on the c-spine radiographs

Methods:

Data of 37 pediatric and adult patients who underwent ≥ 12wks pre-op HGT prior to definitive spine surgery from 2013-2015 at a single site in West Africa was reviewed. Radiographic assessment of the c-spine including ADI, SVA and C2-C7 Lordosis were done at pre HGT and at 4 weekly intervals. Paired T-Test was performed to evaluate changes in these parameters during HGT.

Results:

37pts, 18/19 (F/M). Average age 18.2yrs. Diagnoses: 22 idiopathic, 6 …

Natural Family Planning And Marital Chastity: The Effects Of Periodic Abstinence On Marital Relationships, Richard J. Fehring, Michael D. Manhart

College of Nursing Faculty Research and Publications

Marital chastity is the practice of periodic abstinence with use of natural family planning (NFP). The purpose of this study was to determine the influence of the most common methods of contraception (female sterilization, oral contraceptive pills, and condoms) and NFP on divorce/separation and cohabitation rates among reproductive age women. The study involved an extensive review of the literature on the effects of practice of NFP on marital dynamics and a statistical analysis of 2,550 ever-married women in the (2015–2017) National Survey of Family Growth data set. Importance of religion and frequency of church attendance were included in the analysis. …

The Relationship Between Accurate Knowledge On Hiv/Aids Transmission And Adolescent Pregnancy In Ghana: A Further Analyses Of The 2017 Multiple Cluster Indicator Survey, Emmanuel Brenyah Adomako, Kwabena Frimpong-Manso, Petronella Munemo, Henry Ofori Duah, Pascal Agbadi

College of Nursing Faculty Research and Publications

Background

The literature posits that HIV knowledge is associated with precautious sexual behaviour and practice. We hypothesised and investigated the association between knowledge of HIV transmission and adolescent pregnancy in Ghana, given that the relationship between HIV knowledge and adolescent pregnancy has not been extensively studied.

Methods

We did analyses on 5836 cases (weighted as 5121) of 15–24 years old reproductive age women in the female dataset of the 2017 Multiple Cluster Indicator Survey. Adolescent pregnancy was operationalized as reproductive age women between 15-24 years who became pregnant before the age of 18 years. Accurate HIV knowledge was measured by …

The History & Status Of The Impact Act, Lisa M. Grabert

College of Nursing Faculty Research and Publications

The ability to effectively study and compare Medicare patients—and the cost and outcomes associated with their care—has long been, and continues to be limited, by the lack of readily comparable, patient-level, clinical data. This is due primarily to Medicare’s reliance and use of historically-developed, and limited administrative data—data derived from traditional insurance claims records, not patient treatment records. Critics of this situation have long called for the development of more comprehensive patient-level and clinically focused data, particularly in support of increasing efforts to compare and promote higher quality of care in the system.

Calls to develop more comprehensive patient outcome …

Does Thoracoplasty Adversely Affect Lung Function In Complex Pediatric Spine Deformity? A 2-Year Follow-Up Review, Oheneba Boachie-Adjei, Arthur Sackeyfio, Henry Ofori Duah, Lawrence G. Lenke, Paul Sponseller, Daniel J. Sucato, Amer F. Samdani, Peter Newton, Suken Shah, Mark A. Erickson, Irene Wulff, Brenda Sides, Munish Gupta, Fox Pediatric Spinal Deformity Study

College of Nursing Faculty Research and Publications

Study design

Retrospective review of prospective multi-center cohort.

Objective

To investigate the impact of thoracoplasty on pulmonary function at 2-year follow-up among complex pediatric spine deformity patients.

Summary of background data

Complex pediatric spine deformities may be associated with significant rib prominence causing body image concerns. Surgical correction of spine deformity may include thoracoplasty to correct the rotational prominence. Some surgeons refrain from performing thoracoplasty due to its purported negative effect on pulmonary function. There is paucity of literature on the effect of thoracoplasty on pulmonary function at 2-year follow-up in pediatric patients with complex spine deformity.

Methods

We reviewed …