Nursing Commons^™

Developing Entry-To-Practice Nursing Informatics Competencies For Registered Nurses, Lynn M. Nagle, Kristine Crosby, Noreen Frisch, Elizabeth Borycki, Lorie Donelle Phd, Rn, Fcan, Kathryn Hannah, Alexandra Harris, Sylvie Jetté, Tracy Shaben

Publications

Information and communication technologies (ICT) have brought about significant changes to the processes of health care delivery and changed how nurses perform in clinical, administrative, academic, and research settings. Because the potential benefits of ICT are significant, it is critical that new nurses have the knowledge and skills in informatics to provide safe and effective care. Despite the prevalence of technology in our day to day lives, and the potential significant benefits to patients, new nurses may not be prepared to work in this evolving reality. An important step in addressing this need for ICT preparation is to ensure that …

Comparative Transcriptome Profiling Of Two Tibetan Wild Barley Genotypes In Responses To Low Potassium, Jianbin Zeng, Xiaoyan He, Dezhi Wu, Bo Zhu, Shengguan Cai, Umme Aktari Nadira, Zahra Jabeen, Guoping Zhang

Publications

Potassium (K) deficiency is one of the major factors affecting crop growth and productivity. Development of low-K tolerant crops is an effective approach to solve the nutritional deficiency in agricultural production. Tibetan annual wild barley is rich in genetic diversity and can grow normally under poor soils, including low-K supply. However, the molecular mechanism about low K tolerance is still poorly understood. In this study, Illumina RNA-Sequencing was performed using two Tibetan wild barley genotypes differing in low K tolerance (XZ153, tolerant and XZ141, sensitive), to determine the genotypic difference in transcriptome profiling. We identified a total of 692 differentially …

Peroral Endoscopic Myotomy: Establishing A New Program, Nikhil A. Kumta, Shivani Mehta, Prashant Kedia, Kristen Weaver-Toedtman Phd, Acnp, Anp, Reem Z. Sharaiha, Norio Fukami, Hitomi Minami, Fernando Casas, Monica Gaidhane, Arnon Lambroza, Michel Kahaleh

Publications

Achalasia is an esophageal motility disorder characterized by incomplete relaxation of the lower esophageal sphincter (LES) and aperistalsis of the esophageal body. Treatment of achalasia is aimed at decreasing the resting pressure in the LES. Peroral endoscopic myotomy (POEM), derived from natural orifice transluminal endoscopic surgery (NOTES) and advances in endoscopic submucosal dissection (ESD), presents a novel, minimally invasive, and curative endoscopic treatment for achalasia. POEM involves an esophageal mucosal incision followed by creation of a submucosal tunnel crossing the esophagogastric junction and myotomy before closure of the mucosal incision. Although the procedure is technically demanding and requires a certain …

An Analysis Of Interpreter-Mediated Healthcare Interactions, Robin Dawson Estrada

Theses and Dissertations

The content and quality of communication between nurse practitioners and patients in primary care encounters contributes to diagnostic decision making, the provision of culturally appropriate interventions, and ultimately may impact health outcomes. In caring for patients with limited English proficiency, the addition of language discordance increases the complexity of the interaction and communication processes and the potential for disparate health outcomes. Most prior research on interpreter-mediated healthcare interactions has focused on accuracy, cost, satisfaction, and role enactment, but there is a lack of systematic research examining the actual interaction processes within the context of primary care clinic visits.

The aim …

Best Practices In The Management Of Pediatric Obesity In Primary Care Clinics, Lori Moseley

Theses and Dissertations

Obesity prevalence among children and adolescents has nearly tripled since 1980. Children and adolescents are at risk for developing the comorbidities seen in obese and overweight adults such as hypertension, type 2 diabetes, and sleep apnea. Traditional treatment for obese and overweight children involved counseling children and their families. Current recommendations include a comprehensive staged approach to weight management that includes prevention plus structured weight management, comprehensive multidisciplinary intervention and tertiary care intervention. Unfortunately structured weight management programs have not been widely available, leaving the primary provider with limited options.

The purpose of this project was to analyze the literature …

Best Practice For Antipsychotic Medication Management In Community Dwelling Older Adults With Schizophrenia, Estelle Marie Brown

Theses and Dissertations

Schizophrenia, aging, and medication factors combine to present a very complex clinical presentation in caring for the elderly population with schizophrenia. The aging body displays a slowing of physiological processes, which alters the pharmacokinetics and pharmacodynamics of medications prescribed. Multiple comorbid health factors and the medications recommended for treatment may become detrimental to the overall body health, causing more problems for the older individual. This evidence based practice project reviewed literature and evidence to focus on the question, "In community dwelling older adults with schizophrenia, what is best practice for antipsychotic medication management?" The literature search resulted in classifying 16 …

Creating A Gold Medal Olympic And Paralympics Health Care Team: A Satisfaction Survey Of The Mobile Medical Unit/Polyclinic Team Training For The Vancouver 2010 Winter Games, D Ross Brown, Behrouz Heidary, Nathaniel Bell, Leanne Appleton, Richard K. Simons, David C. Evans, S Morad Hameed, Jack Taunton, Kosar Khwaja, Michael O'Connor, Naisan Garraway, Peter Hennecke, Donna Kuipers, Tracey Taulu, Lori Quinn

Faculty Publications

BACKGROUND:

The mobile medical unit/polyclinic (MMU/PC) was an essential part of the medical services to support ill or injured Olympic or Paralympics family during the 2010 Olympic and Paralympics winter games. The objective of this study was to survey the satisfaction of the clinical staff that completed the training programs prior to deployment to the MMU.

METHODS:

Medical personnel who participated in at least one of the four training programs, including (1) week-end sessions; (2) web-based modules; (3) just-in-time training; and (4) daily simulation exercises were invited to participate in a web-based survey and comment on their level of satisfaction …

Tissue Metabolic Responses To Salt Stress In Wild And Cultivated Barley, Dezhi Wu, Shengguan Cai, Mingxian Chen, Lingzhen Ye, Zhonghua Chen, Haitao Zhang, Fei Dai, Feibo Wu, Guoping Zhang

Publications

A thorough understanding of the mechanisms underlying barley salt tolerance and exploitation of elite genetic resource are essential for utilizing wild barley germplasm in developing barley varieties with salt tolerance. In order to reveal the physiological and molecular difference in salt tolerance between Tibetan wild barley (Hordeum spontaneum) and cultivated barley (Hordeum vulgare), profiles of 82 key metabolites were studies in wild and cultivated barley in response to salinity. According to shoot dry biomass under salt stress, XZ16 is a fast growing and salt tolerant wild barley. The results of metabolite profiling analysis suggested osmotic adjustment was a basic mechanism, …

Best Practice Guideline For Managing Interstitial Cystitis In Adult Women, Amanda Thomas Langford

Theses and Dissertations

Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic disease characterized by symptoms of urinary urgency, frequency, bladder pain, and chronic pelvic pain in the absence of known pathology. Selection of appropriate treatments depended on the severity of the patient's symptoms and patient's preference. This review found that it is important for providers and patients to set realistic goals for symptom improvement when starting a new treatment.

The purposes of this project was to 1) conduct a substantive literature review on treatment guidelines for IC/PBS, 2) analyze the literature for comparing oral pharmacological interventions and behavioral interventions for IC/PBS, and 3) …

Genome-Wide Association Analysis Of Aluminum Tolerance In Cultivated And Tibetan Wild Barley, Shengguan Cai, Dezhi Wu, Zahra Jabeen, Yuqing Huang, Yechang Huang, Guoping Zhang

Publications

Tibetan wild barley (Hordeum vulgare L. ssp. spontaneum), originated and grown in harsh enviroNment in Tibet, is well-known for its rich germpalsm with high tolerance to abiotic stresses. However, the genetic variation and genes involved in Al tolerance are not totally known for the wild barley. In this study, a genome-wide association analysis (GWAS) was performed by using four root parameters related with Al tolerance and 469 DArT markers on 7 chromosomes within or across 110 Tibetan wild accessions and 56 cultivated cultivars. Population structure and cluster analysis revealed that a wide genetic diversity was present in Tibetan wild barley. …

The Use Of Ultrasound As An Adjunct To X-Ray For The Localization And Removal Of Soft Tissue Foreign Bodies In An Urgent Care Setting, Stacy Lane Merritt

Theses and Dissertations

Embedded soft tissue foreign bodies are common complaints of patients presenting to rural urgent care centers. The removal of soft tissue foreign bodies present challenges for the healthcare provider when objects are radiolucent and cannot be identified on readily available diagnostic imaging modalities such as plain radiographs (X-rays). Ultrasound has been introduced in the literature as a useful adjunct to X-rays for the localization and removal of soft tissue foreign bodies. The purpose of this research utilization project was to report the use of bedside ultrasound by healthcare providers as an adjunct to X-ray for the localization and removal of …

Foot Assessment In The Dialysis Unit, Karen Robertson

Theses and Dissertations

ABSTRACT In 2010 the number of patients requiring renal replacement therapy in the United States increased by 1% to 593,086. This number was comprised of 593,086 in center hemodialysis patients, 179,361 functioning kidney transplants, and 29,773 peritoneal dialysis patients.

A principal difficulty in the end stage renal disease (ESRD) population is lower extremity amputation from vascular complications and nonhealing wounds. The incidence of nontraumatic lower extremity amputation among the end stage renal disease population in the United States is ten times higher when compared to the general public. Mortality rates for ESRD patients following amputation are elevated with less than …

Prevention Of Skin Breakdown In The Pediatric Intensive Care Unit, Lydia H. Palmer

Theses and Dissertations

Skin breakdown occurs when one or more layers of the skin have been disrupted (McLane et al., 2004; National Pressure Ulcer Advisory Panel, 2007). While some literature uses the terms skin breakdown and pressure ulcer interchangeably, these are actually two distinct conditions and pressure ulcers are encompassed in the definition of skin breakdown (Kuller, 2001; Lund, 1999; Suddaby et al., 2006). The consequences of skin breakdown in the pediatric population can include increased cost of treatment, infection, increased morbidity and mortality as well as psychological consequences from resulting alopecia or scarring (Schindler, 2010; Willock & Maylor, 2004). Development of skin …

A Pilot Intervention To Engage Nurses To Lead Transformation Of The Workplace, Molly Patton

Theses and Dissertations

The often toxic work environment in which nurses practice contributes to decreased well-being, job dissatisfaction, and poor retention rates, while negatively impacting quality and patient safety. Most leadership programs and resources target nurses in formal leadership positions and are exclusive of the bedside nurse. The purpose of this research utilization project was to determine immediate and short-term outcomes of an educational leadership workshop for nurses, including intent to change the work environment and subsequent action to change the work environment. The goal was to develop, deliver, and evaluate an evidence-based educational intervention to empower nurses at all levels of care …

Improving The Diagnostic Accuracy Of Failure-To-Rescue, Amelia Marie Joseph

Theses and Dissertations

The ability to successfully rescue patients from complications has been shown to be a good measure of quality care processes in hospitals. Failure-to-rescue (FTR) has been defined using secondary International Classification of Disease (ICD-9 CM) codes. Studies of FTR using these codes have demonstrated satisfactory accuracy when compared to clinical events documented in the medical record. However, a subset of the original codes for FTR, thought to be sensitive to nursing care, have failed to show the same level of accuracy. This study examined the possibility of using clinica lpredictors to identify failure-to-rescue.

Secondary analysis of a previous dataset was …

Emergency Department Triage Acuity Ratings: Embedding Esi Into The Electronic Medical Record, Candace Whitfield

Theses and Dissertations

A need for improvement in the triage process was identified in the ED of a southeastern healthcare facility. Lewin's Change Theory guided the implementation of an evidence-based quality improvement project (QIP) to improve the efficiency of the triage process using and embedded Emergency Severity Index (ESI) triage acuity-level assistant template in the electronic medical record (EMR). The target interventions were ED throughput times, the number of patients left without being seen (LWOT), and RN satisfaction.

Methods included the implementation of education interventions for all ED RNs that included a presentation, use of ESI algorithm badges for each nurse, and weekly …

Tibet Is One Of The Centers Of Domestication Of Cultivated Barley, Fei Dai, Eviatar Nevo, Dezhi Wu, Jordi Comadran, Meixue Zhou, Long Qiu, Zhonghua Chen, Avigdor Beiles, Guoxiong Chen, Guoping Zhang

Publications

The Near East Fertile Crescent is well recognized as a primary center of barley origin, diversity, and domestication. A large number of wild barleys have been collected from the Tibetan Plateau, which is characterized by an extreme environment. We used genome-wide diversity array technology markers to analyze the genotypic division between wild barley from the Near East and Tibet. Our results confirmed the existence of Tibetan wild barley and suggested that the split between the wild barleys in the Near East and those in Tibet occurred around 2.76 million years ago (Mya). To test the concept of polyphyletic domestication of …

A Two-Stage Cluster Sampling Method Using Gridded Population Data, A Gis, And Google Earth(Tm) Imagery In A Population-Based Mortality Survey In Iraq, Lp Galway, Nathaniel Bell, Al Shatari Sae, Amy Hagopian, Gilbert Burnham, Abraham Flaxman, Wiliam M. Weiss, Julie Rajaratnam, Tim K. Takaro

Faculty Publications

BACKGROUND:

Mortality estimates can measure and monitor the impacts of conflict on a population, guide humanitarian efforts, and help to better understand the public health impacts of conflict. Vital statistics registration and surveillance systems are rarely functional in conflict settings, posing a challenge of estimating mortality using retrospective population-based surveys.

RESULTS:

We present a two-stage cluster sampling method for application in population-based mortality surveys. The sampling method utilizes gridded population data and a geographic information system (GIS) to select clusters in the first sampling stage and Google Earth TM imagery and sampling grids to select households in the second sampling …

Identification Of A Phytase Gene In Barley (Hordeum Vulgare L.), Fei Dai, Long Qiu, Lingzhen Ye, Dezhi Wu, Meixue Zhou, Guoping Zhang

Publications

BACKGROUND: Endogenous phytase plays a crucial role in phytate degradation and is thus closely related to nutrient efficiency in barley products. The understanding of genetic information of phytase in barley can provide a useful tool for breeding new barley varieties with high phytase activity. METHODOLOGY/PRINCIPAL FINDINGS: Quantitative trait loci (QTL) analysis for phytase activity was conducted using a doubled haploid population. Phytase protein was purified and identified by the LC-ESI MS/MS Shotgun method. Purple acid phosphatase (PAP) gene was sequenced and the position was compared with the QTL controlling phytase activity. A major QTL for phytase activity was mapped to …

Gis And Injury Prevention And Control: History, Challenges, And Opportunities, Nathaniel Bell, Nadine Schuurman

Faculty Publications

Intentional and unintentional injury is the leading cause of death and potential years of life lost in the first four decades of life in industrialized countries around the world. Despite surgical innovations and improved access to emergency care, research has shown that certain populations remain particularly vulnerable to the risks and consequences of injury. Recent evidence has shown that the analytical, data linkage, and mapping tools of geographic information systems (GIS) technology provide can further address these determinants and identify populations in need. This paper traces the history of injury prevention and discusses current and future challenges in furthering our …

Online Role Play Activities For Developing Oral Presentation Proficiency, Joan M. Culley

Faculty Publications

No abstract provided.

Modelling Optimal Location For Pre-Hospital Helicopter Emergency Medical Services, Nadine Schuurman, Nathaniel Bell, Randy L'Heureux, Syed M. Hameed

Faculty Publications

BACKGROUND: Increasing the range and scope of early activation/auto launch helicopter emergency medical services (HEMS) may alleviate unnecessary injury mortality that disproportionately affects rural populations. To date, attempts to develop a quantitative framework for the optimal location of HEMS facilities have been absent. METHODS: Our analysis used five years of critical care data from tertiary health care facilities, spatial data on origin of transport and accurate road travel time catchments for tertiary centres. A location optimization model was developed to identify where the expansion of HEMS would cover the greatest population among those currently underserved. The protocol was developed using …

Using Gis-Based Methods Of Multicriteria Analysis To Construct Socio-Economic Deprivation Indices, Nathaniel Bell, Nadine Schuurman, Michael V. Hayes

Faculty Publications

BACKGROUND: Over the past several decades researchers have produced substantial evidence of a social gradient in a variety of health outcomes, rising from systematic differences in income, education, employment conditions, and family dynamics within the population. Social gradients in health are measured using deprivation indices, which are typically constructed from aggregated socio-economic data taken from the national census--a technique which dates back at least until the early 1970's. The primary method of index construction over the last decade has been a Principal Component Analysis. Seldom are the indices constructed from survey-based data sources due to the inherent difficulty in validating …

Predicting Learning From Asynchronous Online Discussions, Dezhi Wu, Starr Roxanne Hiltz

Publications

Online discussions play an important role in student learning. Currently, asynchronous learning courses and some primarily face-to-face courses at New Jersey Institute of Technology require asynchronous online discussions. Does this requirement improve the students' perceived learning? An exploratory study designed to investigate this issue was conducted in Spring 2002. The questionnaire drew responses to a post-course questionnaire from 116 students in two undergraduate courses and one graduate course. A set of items designed to measure perceived learning from online discussions formed a reliable, unidimensional index for this construct. The results indicate that online discussions do improve students' perceived learning. Variations …