Nursing

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    A case study: Multidisciplinary faculty members’ study abroad experiences in a nursing course
    (Open Journals in Education, 2023) Talleff, Jennifer L.; Espinoza, Luis Enrique; Ollive, Madison
    This case study explores the lived experience of three faculty from different disciplines engaged in an experiential undergraduate nursing study abroad (SA) course, which is largely absent from the literature. This research found specific personal and professional transformative effects of multidisciplinary SA involvement of faculty. Considerations for faculty planning to engage in multidisciplinary SA will be identified, including impacts of faculty dynamics and physical and psychological demands. These findings further highlight, document, and contribute to the growing literature related to the experiential impacts of SA on faculty professional development.
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    Meeting the challenge of this gender-specific neurodevelopmental disorder
    (WebMD, 1997) Glaze, Daniel; Schultz, Rebecca
    Rett syndrome (RS) is an incurable neurological disorder that occurs in females. Although the biological basis is unknown, there is substantial evidence suggesting a genetic basis. RS is characterized by an initial period of apparently normal psychomotor development followed by loss of communication skills and purposeful hand movement. Then, hand stereotypies, gait dyspraxia, and deceleration of head growth become apparent. Other problems include growth failure and epilepsy. There is no biological marker for RS; the diagnosis is based on well-delineated clinical criteria. The prevalence of RS is 1:23,000 live female births. Survival to 30-40 years or beyond is the rule rather than the exception. Treatment is both palliative and supportive. A vigorous approach to all aspects of care, including educational, medical, and psychosocial issues, is recommended.
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    Public abandonment of newborns: Policies and practices in the United States and around the world
    (The American Professional Society on the Abuse of Children, 2002) Cesario, Sandra K.; Kolbye, Sharon; Furgeson, Evie Michelle
    Statistics suggest that the incidence of newborn abandonment is increasing. Is this the case, or has the increase in the amount of media coverage of such events given this perception? In actuality, the practice of abandoning newborns shortly after birth has always existed. Occurring in primitive and contemporary societies, this practice has varied motivations that are dependent upon the social norms of a specific geographic region at a given point in time (Rascovsky & Rogers, 1995). Although it is known that such practices exist, no official statistics have been maintained anywhere on the abandonment or murder of infants at or near the time of birth. In addition, no one has any idea of how many babies have faced this demise by being discarded and never found. The purpose of this article is to explore the historical and current practices of newborn abandonment throughout the world. Also, the formation of health policy, social programs, and the legislative process addressing this issue will be discussed.
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    A helping hand: A school nurse offers a desperate young mother compassion
    (Lippincott, 2023) Brooks, Andrea Nicole
    I remember going to my first year of high school feeling hungry, isolated, and afraid. At lunchtime, the smells of the food in the cafeteria were overwhelmingly enticing. It only made my stomach hurt more, knowing I didn't have the money to purchase any food for myself or my unborn child. My parents had employed the tactic of starvation to try to convince me to abort my baby. I started going to my school nurse during lunch so that I could lie down on one of the cots and avoid the fragrant smells of food. After lunch was over, I'd tell the nurse I felt better and return to class. Once a few days of this had passed, she asked me what was going on.
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    Dietary resource information for the oncology patient: Tips and tools
    (Journal of the Advanced Practitioner in Oncology, 2012) Madsen, Lydia, T.; Cesario, Sandra
    Oncology patients frequently request information about diet, exercise, and a healthy living approach during and after cancer treatment. Although a consultation with a registered dietitian is often the recommendation for patients in large multidisciplinary centers, a same-day consult may not always be available. Alternatively, patients might locate diet recommendations by an Internet search, retrieving diet or supplement information that may not follow established optimal health guidelines. The advanced practitioner is often the most appropriate and available individual able to provide diet and exercise resources and education for patients who request information or require guidance on best practices during treatment. The following information is provided as a concise resource list of books, websites, topics that oncology patients frequently ask about, and briefs that comprehensively address diet and exercise as they pertain to the oncology patient. They each meet the criteria of being readily available to the community and in language that is written for the layperson. There are many additional resources available; this list has been compiled as a small representative sampling of current, scientifically based, patient-directed information to begin or augment a healthful living approach.
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    Functioning outcomes for abused immigrant women and their children 4 months after initiating intervention
    (World Health Organization, 2014) Cesario, Sandra K.; Nava, Angeles; Bianchi, Ann; McFarlane, Judith; Maddoux, John
    Objective. To measure the impact of shelter intervention and protection orders on the mental health functioning, resiliency, and further abuse of documented and undocumented immigrant women and their children in Houston, Texas, United States. Methods. A prospective cohort study initiated in 2011 examined a subsample of 106 immigrant mothers, primarily from Mexico and Central America, and evaluated their functioning with a battery of 13 well-established instruments as they accessed either shelter or justice services; followed-up was conducted 4 months later to measure improvement. Data were analyzed with a series of repeated measures 2 x 2 x 2 factorial analysis of variance tests. Results. Large effect size improvements were observed in abused immigrant women’s mental health, resiliency, and safety, regardless of whether the intervention accessed was safe shelter or justice services, and regardless of duration of shelter stay and whether or not a protection order was issued. Similarly, large effect size improvements were observed in child functioning, independent of which type of intervention, the duration of shelter stay, or the issuance of a protection order. Conclusions. Accessing protective services has the potential to improve the health of immigrant women and their children, regardless of documentation status. Global policy for improved access and acceptability of shelter and justice services is essential to promote immigrant women’s safety and to maximize functioning of women and children.
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    Preventative health screening amongst women who have experienced intimate partner violence
    (Aras Part Medical International Press, 2015-10) Cesario, Sandra K.; Liu, Fuqin; Gilroy, Heidi; Koci, Anne; McFarlane, Judith; Maddoux, John
    Objectives: Partner violence affects one in three women worldwide and is linked to higher rates of women?s cancers with increased utilization of health care services. However, evidence of the association between severity of violence and health screening behaviors (i.e., Pap testing, mammography, & clinical/self-breast exams [SBEs]) is scant. The purpose of this study was to identify engagement of abused women in preventive health screening behaviors. Materials and Methods: This was a cross-sectional study of 284 abused women with children. Participants were part of a 7-year prospective study to examine the treatment efficacy of the 2 models most often offered to abused women. At the 24th month interview, data on health promotion behaviors were collected via investigator designed instrument. Both descriptive and chi square analysis were used for data analysis. Results: Abused women were more likely to engage in preventative health behaviors than the general US female population but had a higher incidence of sexually transmitted infections (STIs) and abnormal Pap test results with variance based on race, ethnicity, immigration status, language, and the type of intimate partner violence (IPV) services initiated. Preventative screening was adequate, but there was poor follow-up care for abused women who received abnormal results. Conclusion: Findings suggest urgent need to maintain high rates of screening and initiate better follow-up care. Recognition of the potential co-existence of gynecological infections or cervical cellular irregularities with the experience of partner abuse may lead health care providers to improved diagnosis and treatment for both IPV and abnormal gender-specific health care outcomes.
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    Increasing healthy lifestyle behaviors in cargo drivers
    (Digital Commons @ ACU, 2020) Bell, Ronda L.
    The purpose of this project was to examine the extent to which lifestyle behaviors of transportation drivers in North Texas can be improved with health education. This research study was conducted to examine the health behaviors of transportation drivers as a result of an educational partnership between nursing and the transportation industry. The goal was to improve healthy lifestyles through education to decrease chronic illness and comorbid conditions of a significantly at-risk occupational population. The impact of this education was immediate and verified with quantitative measurement and statistical analysis. Results demonstrated that after nurse-led health education, transportation drivers reported significant changes in health responsibility, nutrition, and physical activity. Key recommendations for transportation employers to improve driver health, extend the careers of experienced drivers, and contain insurance costs associated with worker’s compensation, disability, and health include (a) instituting employee health education programs, (b) encouraging and incentivizing participation in health and wellness programs, and (c) examining further dynamic education opportunities to improve the health of transportation drivers.
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    A shared mental model for teaching and assessing examination of the hand, wrist, and elbow in "The Training Rheum" Continuing Professional Development Program
    (2019) Battistone, Michael J.; Jonas, Beth L.; Bahr, Janet L.; Chrostowski, Susan; Dua, Anisha B.; Torralba, Karina D.; Konopasky, Abigail; Meyer, Holly S.; Barker, Andrea M.
    An increasing number of nurse practitioners (NPs) and physician assistants (PAs) are pursuing careers in rheumatology. To serve their educational interests, the Association of Rheumatology Professionals, the American College of Rheumatology and the American Association of Physician Assistants created “The Training Rheum”, a 3-day continuing professional development (CPD) course. This program includes instruction in physical exam skills of the hand, wrist, and elbow, reinforced through low-stakes, formative assessment.
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    Factors that impact the determination by medical examiners of elder mistreatment as a cause of death in older people
    (National Institute of Justice, 2008) Dyer, Carmel B.; Sanchez, Luis; Kim, Lucia; Burnett, Jason; Mitchell, Stacey; Reilley, Barbara; Pickens, Sabrina; Mehta, Michelle
    With medical examiners rarely considering elder mistreatment (EM) as a cause of death due to the possible lack of research and evidence to support this determination, this study was undertaken to begin to develop primary data and a literature base on the forensics of elder mistreatment. The four phases of this study shed light on multiple issues concerning the forensics of elder mistreatment (EM). Phase I results showed that medical examiners infrequently determined EM as a cause of death in older decedents. Phase II results show that while the medical examiners are expert at performing autopsies, interpreting toxicology and determining the cause and manner of death, they are not versed in the standard of care of older persons. Phase III shows that the scene investigation is not necessarily geared to the detection of forensic markers and risk factors for EM and that the training of investigators in the specifics of EM may be helpful. Phase IV showed that cases where dementia was documented or there were skin findings such as pressure ulcers were more likely to be autopsies and were more likely to have been an Adult Protective Service (APS) case prior to the death of the decedent. The four studies show that determination of death due to elder mistreatment is very difficult. There is not the data on forensic markers needed to support the medical examiners assessments, they have little training in geriatric medicine, and it is difficult to evaluate the differences in old age and disease versus EM. In this study a research team conducted four distinct projects to evaluate three aspects of death determination by medical examiners: autopsy or external examination, medical records and toxicology, and scene investigation. These included: (1) a survey exploring the views of medical examiners concerning all three areas of death determination; (2) evaluating scene investigation and medical records and toxicology by studying the medical examiners case conferences and case records; (3) studying the scene investigation; and (4) exploring autopsy and physical examination findings.
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    Elder mistreatment in the long-term care setting
    (American Geriatrics Society, 2011) Pickens, Sabrina; Halphen, John M.; Dyer, Carmel B.
    Elder mistreatment (EM) is a wellknown problem in nursing homes (NHs). Resident-to-resident aggression is the most common form of EM, but facility staff, family members, and other individuals can be perpetrators. As the population of older adults continues to grow, the demand for long-term care services will increase. The presence of more residents in NHs raises the risk for EM, especially if adequate staff-to-resident ratios are not maintained and staff education on EM is lacking. This article provides an overview of the types of EM; discusses reporting of EM; reviews intervention and prevention strategies; and outlines the epidemiology, risk factors, common perpetrators, signs and symptoms, morbidity and mortality risks, and screening and assessment of EM.
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    Newborn screening samples for diabetes research: An underused resource
    (MDPI, 2020) Estrella, Jane Frances Grace Lustre; Immanuel, Jincy; Wiley, Veronica; Simmons, David
    Inborn errors of metabolism and diabetes share common derangements in analytes of metabolic networks that are tested for in newborn screening, usually performed 48–72 h after birth. There is limited research examining the metabolic imprint of diabetes on newborn screening results. This paper aims to demonstrate the links between diabetes, biochemical genetics and newborn screening in investigating disease pathophysiology in diabetes, provide possible reasons for the lack of research in diabetes in newborn screening and offer recommendations on potential research areas. We performed a systematic search of the available literature from 1 April 1998 to 31 December 2018 involving newborn screening and diabetes using OVID, MEDLINE, Cochrane and the PROSPERO register, utilizing a modified extraction tool adapted from Cochrane. Eight studies were included after screening 1312 records. Five studies reanalyzed dried blood spots (DBS) on filter paper cards, and three studies utilized pre-existing results. The results of these studies and how they relate to cord blood studies, the use of cord blood versus newborn screening dried blood spots as a sample and considerations on newborn screening and diabetes research is further discussed. The timing of sampling of newborn screening allows insight into neonatal physiology in a catabolic state with minimal maternal and placental influence. This, combined with the wide coverage of newborn screening worldwide, may aid in our understanding of the origins of diabetes.
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    Rapid needs assessments for older adults in disasters
    (American Society on Aging, 2007) Burnett, Jason; Dyer, Carmel B.; Pickens, Sabrina
    Because the challenge for those planning and providing disaster relief efforts is to be able to triage elders who need immediate extra assistance in an efficient and timely manner so as to minimize harm, a rapid and accurate needs assessment could provide specific region-wide information used to educate individuals as to what they need to do in response to a disaster. In this article, the authors highlight the Seniors Without Families Triage (SWiFT) tool used to screen for vulnerable elders with urgent needs in the following realms: cognitive, medical, social service, and activities of daily living.
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    The ADIPS pilot national diabetes in pregnancy benchmarking programme
    (MDPI, 2021) Immanuel, Jincy; Flack, Jeff; Wong, Vincent W.; Yuen, Lili; Eagleton, Carl; Graham, Dorothy; Lagstrom, Janet; Wolmarans, Louise; Martin, Michele; Cheung, Ngai Wah; Padmanabhan, Suja; Rudland, Victoria; Ross, Glynis; Moses, Robert G; Maple-Brown, Louise; Fulcher, Ian; Chemmanam, Julie; Nolan, Christopher J.; Oats, Jeremy J. N.; Sweeting, Arianne; Simmons, David
    Background: To test the feasibility of benchmarking the care of women with pregnancies complicated by hyperglycaemia. Methods: A retrospective audit of volunteer diabetes services in Australia and New Zealand involving singleton pregnancies resulting in live births between 2014 and 2020. Ranges are shown and compared across services. Results: The audit included 10,144 pregnancies (gestational diabetes mellitus (GDM) = 8696; type 1 diabetes (T1D) = 435; type 2 diabetes (T2D) = 1013) from 11 diabetes services. Among women with GDM, diet alone was used in 39.4% (ranging among centres from 28.8–57.3%), metformin alone in 18.8% (0.4–43.7%), and metformin and insulin in 10.1% (1.5–23.4%); when compared between sites, all p < 0.001. Birth was by elective caesarean in 12.1% (3.6–23.7%) or emergency caesarean in 9.5% (3.5–21.2%) (all p < 0.001). Preterm births (<37 weeks) ranged from 3.7% to 9.4% (p < 0.05), large for gestational age 10.3–26.7% (p < 0.001), admission to special care nursery 16.7–25.0% (p < 0.001), and neonatal hypoglycaemia (<2.6 mmol/L) 6.0–27.0% (p < 0.001). Many women with T1D and T2D had limited pregnancy planning including first trimester hyperglycaemia (HbA1c > 6.5% (48 mmol/mol)), 78.4% and 54.6%, respectively (p < 0.001). Conclusion: Management of maternal hyperglycaemia and pregnancy outcomes varied significantly. The maintenance and extension of this benchmarking service provides opportunities to identify policy and clinical approaches to improve pregnancy outcomes among women with hyperglycaemia in pregnancy.
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    Differences in newborn screening results among women with gestational diabetes mellitus
    (Sage, 2021) Estrella, Jane; Wiley, Veronica; Immanuel, Jincy; Simmons, David
    Multiple studies undertaken on cord blood demonstrate analyte perturbations in infants exposed to gestational diabetes mellitus (GDM). Cord blood as a sample is influenced by maternal and placental metabolism. Newborn screening (NBS), performed after the first 24 hours of life reflects early neonatal metabolism. We compared NBS analytes between women with and without GDM with different management approaches in the Treatment of Booking of Gestational Diabetes (TOBOGM) pilot randomised controlled trial. Pregnant women with GDM risk factors were randomised to early or deferred GDM treatment following an oral glucose tolerance test (<20 weeks gestation). Women without GDM served as “decoys”. From the decoy group 11 developed GDM (screened at 26-28 weeks), were analysed separately; their results were compared with the other groups. De-identified controls were chosen from NBS results from the same analytic run matched for sex, birthweight and gestational age. Results were available for 73/78 women participating in the pilot and 358 de-identified controls. Tyrosine levels (μmol/l; whole blood)were higher in the late GDM group vs early, deferred treatment, and decoy groups (medians:106.28; IQR: 96.73-151.11) (76.33; 64.64-97.90) (75.68; 66.59-110.88)(73.74; 58.32-90.36) (p=0.009) and remained elevated when compared to normal, age-matched controls (106.28; 96.73-151.11) (87.26; 68.55-111.26) (p value=0.01) Immunoreactive trypsinogen (μgm/l; whole blood)was highest in the early treatment group when compared with group-specific controls (22.30; 13.90–29.90 vs 14.00, 10.60–21.10) (p=0.02). These results provide evidence of biochemical perturbations detectable on NBS of in-utero exposure to hyperglycemia and treatment and provide data for hypothesis building.
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    The relationship between body mass index and sleep in women with risk factors for gestational diabetes mellitus
    (Wiley, 2023) Acosta Reyes, Pamela; Immanuel, Jincy; Hague, William M.; Teede, Helena; Hibbert, Emily; Nolan, Christopher J.; Peek, Michael J.; Wong, Vincent; Flack, Jeffrey R.; McLean, Mark; Dalal, Raiyomand; Harreiter, Jürgen; Kautzky-Willer, Alexandra; Rajagopal, Rohit; Sweeting, Arianne; Ross, Glynis P.; Cheung, Ngai Wah; Simmons, David
    Background: Both obesity and sleep disorders are common among women during pregnancy. Although prior research has identified a relationship between obesity and sleep disorders, those findings are from women later in pregnancy.
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    The impact of COVID-19 on tenure clocks, the evaluation of productivity, and academic STEMM career trajectories
    (National Academies Press, 2021) Jefferson, Felicia A.; Hora, Matthew T.; Pickens, Sabrina L.; Salzman, Hal
    This is a commissioned paper for The National Academies report "Impact of COVID-19 on the Careers of Women in Academic Sciences, Engineering, and Medicine." This paper and the report addresses: the "change in how almost everyone conducted their personal and professional lives, both within science, technology, engineering, mathematics, and medicine (STEMM) and beyond. The COVID-19 pandemic disrupted global scientific conferences and individual laboratories and required people to find space in their homes from which to work. It blurred the boundaries between work and non-work, infusing ambiguity into everyday activities. While adaptations that allowed people to connect became more common, the evidence available at the end of 2020 suggests that the disruptions caused by the COVID-19 pandemic endangered the engagement, experience, and retention of women in academic STEMM, and may roll back some of the achievement gains made by women in the academy to date. Impact of COVID-19 on the Careers of Women in Academic STEMM identifies, names, and documents how the COVID-19 pandemic disrupted the careers of women in academic STEMM during the initial 9-month period since March 2020 and considers how these disruptions - both positive and negative - might shape future progress for women. The full report on the impact of COVID-19 on the Careers of Women in Academic STEMM will inform the academic community as it emerges from the pandemic to mitigate any long-term negative consequences for the continued advancement of women in the academic STEMM workforce and build on the adaptations and opportunities that have emerged."
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    Development of a conceptual framework for severe self-neglect (SN) by modifying the crest model for self-neglect
    (Frontiers, 2021) Pickens, Sabrina; Daniel, Mary; Jones, Erick C.; Jefferson, Felicia
    Self-neglect is an inability or refusal to meet one's own basic needs as accepted by societal norms and is the most common report received by state agencies charged with investigating abuse, neglect and exploitation of vulnerable adults. Self-neglect is often seen in addition to one or multiple conditions of frailty, mild to severe dementia, poor sleep and depression. While awareness of elder self-neglect as a public health condition and intervention has significantly risen in the past decade as evidenced by the increasing amount of literature available, research on self-neglect still lacks comprehensiveness and clarity since its inception to the medical literature in the late 1960s. With the burgeoning of the older adult population, commonness of self-neglect will most likely increase as the current incidence rate represents only the “tip of the iceberg” theory given that most cases are unreported. The COVID-19 pandemic has exacerbated the incidence of self-neglect in aged populations and the need for the use of intervention tools for aging adults and geriatric patients living alone, many of which may include in-home artificial intelligence systems. Despite this, little research has been conducted on aspects of self-neglect other than definition and identification. Substantial further study of this disorder's etiology, educating society on early detection, and conceivably preventing this syndrome altogether or at least halting progression and abating its severity is needed. The purpose of this research is to provide a definition of severe self-neglect, identify key concepts related to self-neglect, comprehensively describe this syndrome, present a conceptual framework and analyze the model for its usefulness, generalizability, parsimony, and testability.
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    Dementia and hospital readmission rates: A systematic review
    (Karger Publishers, 2017) Pickens, Sabrina; Naik, Aanand D.; Catic, Angela; Kunik, Mark E.
    Background: Although community-dwelling persons with dementia have an increased risk of hospital readmission, no systematic review has examined the contribution of dementia to readmissions.
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    Elder abuse in America
    (Bentham Open, 2015) Pickens, Sabrina; Dyer, Carmel B.
    Elder abuse is a serious social and public health issue with estimates of approximately five and a half million annual reports in the U.S. Identifying and treating abused elders is difficult due to unstandardized protocols and identification guidelines as well as a lack of public awareness to the problem. An interdisciplinary approach in collaboration with Adult Protective Services investigation is paramount to the assessment and care for mistreated elders. Educating healthcare professionals, other professions, and the lay public through social media, local news, and community education can increase awareness to this often overlooked problem.