The University of Texas at Tyler
Scholar Works at UT Tyler (University of Texas at Tyler)Not a member yet
5042 research outputs found
Sort by
Impact of Baby Friendly on Exclusive Breastfeeding: Befriending Baby Friendly
Get PDFUnless you have personally breastfed a newborn baby or tried to help a struggling breastfeeding mother, chances are you would think breastfeeding is not only natural but comes easily. Breastfeeding is indeed a natural progression following delivery; however, various things can play a role in the success of a mother and newborn baby trying to breastfeed. Issues such as feeding position, waking a sleepy newborn, mothers not recognizing newborn hunger cues, a full day of well-meaning visitors impeding skin-to-skin time with mom, or delayed feedings are just a handful. Sometimes, breastfeeding is so difficult that moms who want to breastfeed are willing to quit because it is too frustrating.
World Health Organization (WHO) and United Nations Children\u27s Fund (UNICEF) started Baby-Friendly Hospital Initiative (BFHI) in 1991 as a global program to improve nutritional health, neurological development, and the overall wellness and survival of women and children around the world (Baby- Friendly USA, 2024). The rationale for Baby-Friendly Ten Steps is that exclusive breastfeeding (EBF) for at least six months leads to greater health outcomes for mom & baby and lower rates of infant mortality (CDC, 2021). BFHI defines EBF as not feeding any food sources other than breastmilk (directly from the breast, hand-expressed, pumped, or donated expressed breastmilk), yet recognizes there are instances when breastfeeding is not possible, or supplementation (formula) for the infant is medically necessary (Baby-Friendly USA, 2024).
Research has repeatedly pointed to breastfeeding improving health and wellness of both women and children
Patient Throughput in the Emergency Department
Get PDFIn response to ongoing overcrowding in emergency departments, it is imperative to explore effective strategies for mitigating the capacity crises. The purpose of this project is to investigate and implement throughput strategies for a large level 1 trauma emergency department in Houston’s Texas Medical Center. The proposal involves launching a process improvement project to identify opportunity potential for two main interventions: 1. Patient classification for split clinical pathways 2. Dedicated liaison role for throughput responsibilities. The review aims to answer the question: In emergency department patients, how does the implementation of a dedicated throughput liaison compared to a split flow clinical pathway process affect the overall patient length of stay? Both interventions hold significant potential for positively impacting patient throughput. By systematically evaluating these approaches, the project seeks to provide evidence-based recommendations to inform decision-making, decrease emergency length of stay, and improve the quality of care at the hospital
DNP Final Report: Promoting the Self-Efficacy of Caregivers of Children with Seizures Using Evidence-Based Practice
No full textEpilepsy is considered a widespread chronic illness, and it is estimated that approximately 1% of all children have the condition. Parents and caregivers of children with seizures experience fear and anxiety relative to their perceived confidence to manage their child\u27s seizures after leaving the hospital. Evidence supports the use of simulation to educate caregivers to improve their perceived level of self-efficacy. The DNP Scholarly Project examined the impact of utilizing a simulation training session on the self-efficacy of caregivers of children with seizures at a large pediatric medical center in the southern United States. Caregivers of children with newly diagnosed seizures or with a recent change to their seizure treatment plan attended a simulation training session individualized to their discharge instructions. Demographic data, pre and post-training self-efficacy measurements, and program satisfaction data were collected. Caregivers who participated during the 3-month implementation period experienced a statistically significant increase in self-efficacy (p \u3c .0001 to 0.002) and reported being satisfied with the simulation education training. The project outcomes suggested simulation training was an effective method for improving the self-efficacy of caregivers of children with seizures and could be a feasible practice change in organizations with access to simulation technology. The outcomes of the project aligned with the evidence available in the literature. The results reinforced that education that includes simulated learning opportunities was generally well received by caregivers and may improve their confidence to care for their child after discharge
DNP Final Report: IMPLEMENTATION OF INTRAOPERATIVE ELEMENTS OF ENHANCED RECOVERY AFTER SURGERY PROTOCOL IN GYNECOLOGIC SURGERY PATIENTS
Get PDFGynecologic surgeons at the hospital believe that patients undergoing minimally invasive gynecologic surgery (MIGS) experience an increased length of stay (LOS). Generic enhanced recovery after surgery (ERAS) order sets exist but are not consistently used, nor are the sets specific to MIGS patients. Preoperative education/counseling regarding ERAS is limited in pre-admission testing (PAT) and provider clinics. It is unclear what intraoperative and postoperative components of ERAS are being implemented consistently. The PICOT question to be answered is: In patients undergoing minimally invasive gynecology surgery (P), how will the implementation of Intraoperative ERAS elements (I), compared to the current absence of ERAS elements (C), affect the length of stay and same-day discharge rates (O) within four months of implementation (T)?
A literature search was performed, and the evidence was appraised to select interventions for implementation. After implementing the selected ERAS interventions, pre-and post-implementation outcomes were analyzed and compared. The outcomes achieved in the three months following implementation matched the outcomes found in the literature. The LOS decreased, and the same-day discharge (SDD) rate increased in the MIGS population; however, it is unclear if this was related to the ERAS implementation or a change in one surgeon\u27s practice. The results of this project were disseminated internally through department meetings and quality committees. The sustainability of this project is questionable since the outcomes appear to be related to surgeon practice and not the selected interventions
DNP Final Report: Resilience training for entry-level Bachelor of Science in Nursing students: An evidence-based practice project
No full textNursing students have moderate to high levels of stress due to responsibilities, high expectations, course grades, and clinical requirements. The practice problem identified for this evidence-based practice project was that undergraduate nursing students had elevated levels of stress but did not know how to manage it. Multiple interventions have been used to address the problem, including positive thinking, mindfulness, resilience training, and distraction-focused therapies. The PICOT question “Will resilience training (I) for entry-level BSN students (P) affect stress (O) in less than three months (T)?” was developed to guide the systematic search for evidence. Based on the evidence, one hour resilience training was implemented one day a week for six weeks starting at the beginning of the semester so that students had the opportunity to use their new skills as their stress increased through the semester. The training sessions included general resilience, communication/relationship building, physical exercise, self-care, positive thinking, and mental health resources. Mean stress scores, measured using the Perceived Stress Scale, decreased 6.15%, from 16.25 before the training to 15.25 after the training, which was consistent with the body of evidence. The resilience training was therefore effective in decreasing stress in the undergraduate nursing students in this project. Integration of resilience training into an established course would promote student participation and enhance sustainability of the resilience training program
Examining the predictive validity of a managerial coaching scale: a longitudinal study
Get PDFManagerial coaching remains a widespread and popular organizational development intervention applied across numerous industries to enhance critical workplace outcomes and employee attitudes, yet no studies to date have evaluated the temporal precedence within these relationships. This study sought to assess the predictive validity of the widely used Employee Perceptions of Supervisor/Line Manager Coaching Behavior Measure managerial coaching scale (CBI), employing a longitudinal design and following the testing of the causal hypothesized relationship framework. Three hypotheses were evaluated using three commonly associated variables with managerial coaching (role clarity, job satisfaction, and organization commitment), using longitudinal data collected over two waves from full-time US employees (n = 313). The study followed a two-wave design, collecting data over two time points to test for longitudinal measurement invariance and three reciprocal cross-lagged models. Results detected statistically significant cross-lagged and reciprocal cross-lagged effects in the role clarity and organization commitment models, highlighting a reciprocal relationship between managerial coaching behaviors and the two variables. However, only the reciprocal cross-lagged effect was statistically significant in the job satisfaction model. Findings suggest the predictive validity of the CBI scale for role clarity and organization commitment. Moreover, results indicate employee attitudes influenced managerial coaching behaviors over time across all three models, emphasizing the potential impact of employee attitudes on leadership effectiveness. This study highlights the complex relationships between managerial coaching and workplace outcomes, offering nuanced insights for improved understanding
Impact of Teacher Support Systems on Advanced Placement Achievement Outcomes
Get PDFIn the realm of Advanced Placement (AP) education, a persistent achievement gap exists, with low-socioeconomic students consistently underperforming compared to their affluent peers. This disparity is particularly notable in AP English Language and Composition, where 93% of students fail to achieve a score of three or higher, the score for earning college credit. This study hypothesizes that this gap is partly due to inadequate support for AP teachers, particularly the lack of collaborative planning time. In most high schools, AP English Language and Composition teachers have no dedicated time for collaboration, instead focusing on other areas like End of Course subjects or Dual Credit courses. Using a mixed-method approach with an embedded experimental model, this study examines how providing these teachers with structured collaborative planning time affects their perceptions of support and, ultimately, their students\u27 achievement outcomes. By addressing this systemic issue, the study seeks to enhance educational equity, empowering underserved students to fully benefit from AP opportunities
BRD4 mediates TGF-beta-induced vascular smooth muscle cell differentiation
Get PDFVascular smooth muscle cell (VSMC) differentiation is an essential component of vascular development. Vascular smooth muscle cells do not terminally differentiate, the regulatory factors modulate their phenotype between proliferative and differentiated states, which is a major factor contributing to vascular diseases like atherosclerosis, aneurysms, hypertension, etc. Transforming growth factor β (TGF-β) family is highly conserved in mammals and plays an essential role in VSMC differentiation. The canonical TGF-β pathway is propagated by phosphorylation of receptor-associated Smad proteins (R-Smads) following TGF-β stimulation.Bromodomain-containing protein 4 (BRD4) is a protein encoded by the BRD4 gene in humans. BRD4 is novel epigenetic modulator that has been implicated in different human diseases. It has gained wide attention in the field of cancer and lung diseases due to its multiple roles in the regulation of genes that are important for disease progression. There is increasing evidence that BRD4 also plays a significant role in a variety of cardiovascular diseases, proposing that understanding the mechanisms of BRD4 in these diseases is important for novel target development and clinical treatment. In this proposed study, the novel role and mechanisms of BRD4 in SMC differentiation is being investigated. In the process it was found that 10 T ½ cells successfully induce SMC differentiation, knockdown of BRD4 inhibit markers alpha-SMA and SM22alpha, qPCR showed knockdown by JQ1 and BRD4 does not influence smad phosphorylation (classic pathway). A combination of TAZ and Smad protein was tested
Artificial intelligence in human resource development: An umbrella review protocol
Get PDFThe recent surge in artificial intelligence (AI) has significantly transformed work dynamics, particularly in human resource development (HRD) and related domains. Scholars, recognizing the significant potential of AI in HRD functions and processes, have contributed to the growing body of literature reviews on AI in HRD and related domains. Despite the valuable insights provided by these individual reviews, the challenge of collectively interpreting them within the HRD domain remains unresolved. This protocol outlines the methodology for an umbrella review aiming to systematically synthesize existing reviews on AI in HRD. The review seeks to address key research questions regarding AI’s contributions to HRD functions and processes, as well as the opportunities and threats associated with its implementation by employing a technology-aided systematic approach. The coding framework will be used to synthesize the contents of the selected systematic reviews such as their search strategies, data synthesis approaches, and HRD-related findings. The results of this umbrella review are expected to provide insights for HRD scholars and practitioners, promoting continuous improvement in AI-driven HRD initiatives. This protocol is preregistered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/Z8NM6) on May 27, 2024
Perceived Barriers and Facilitators of Behavioral-Health Modality Change Adoption During the COVID-19 Pandemic: A Systematic Review
Get PDFIntroduction: During the Coronavirus Disease 2019 pandemic, there was a surge in demand for mental health services worldwide, presenting challenges for healthcare institutions as they navigated changes in policy and safety regulations. In the United States, this resulted in many behavioral health modality changes to remain in compliance with the Center for Disease Control guidelines. A growing body of literature has documented these, yet few explored barriers and facilitators affecting the adoption of these modality delivery changes. The researchers conducted a systematic review using the PRISMA method, focusing on service delivery changes across healthcare systems in the United States from March 2020 to May 2022. Objective: The study objective was to identify barriers and facilitators affecting the adoption of changes to modality delivery of behavioral health services due to pandemic restrictions. Methods: This was a systematic review that utilized the PRISMA method. The researchers identified 445 initial articles from eight databases using predetermined keywords and implemented a three-round screening process to select the most pertinent articles for this review. The researchers used a thematic analysis focused on user-related, program-related, technology, and environment-related constructs relevant to engagement with digital mental health interventions, and also addressed provider and administrative-related barriers and facilitators of virtual behavioral health modality changes. Barriers and facilitators were operationalized using the Borghouts Model. Results: This systematic review revealed several common barriers and facilitators, including underdeveloped technology infrastructure, privacy and confidentiality concerns, poor technology literacy, availability of diverse technology options, provider technology training, and ease of integration into everyday life. Conclusion: This review provides insights into barriers and facilitators of modality change adoption, which could inform the development and implementation of virtual mental healthcare services and may help optimize the application of these services by improving our understanding and ability to overcome barriers influencing their adoption