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Outpatient Intravenous Antibiotics
Get PDFThis paper discusses the use of outpatient intravenous antibiotics in comparison to inpatient intravenous antibiotics. Hospital admission rates, cost of care for patients and facilities, length of stay, patient experience, and patient outcomes are compared and evaluated with treatment to determine the efficacy of use
DNP Final Report: AN EVIDENCE-BASED INITIATIVE TO REDUCE RISK OF VENTILATOR-ASSOCIATED EVENTS
Get PDFVentilator-associated events have been considered an outcome metric for quality patient care. Ventilator-associated events are associated with unnecessary medical expenses. These events are multifactorial, yet bedside nurses can help decrease this nosocomial infection through proper oral care. A PICOT question was constructed to search the evidence systematically. The systematic literature search evidence was appraised to provide recommendations for the bundle of care process regarding ventilator-associated event prevention, specifically oral care. The body of evidence was comprised of five articles reporting statically significant outcomes. The evidence-based oral care protocol was implemented for a quarter of a year in patients with mechanical ventilation in a pilot unit. Project outcomes were assessed and compared to the body of evidence findings. The project had similar findings to the reported literature: the rate of ventilator-associated events decreased by 31.56%, the length of stay decreased by 43.96%, and ventilator days were reduced by 29.91%. Quality oral care is essential for mechanically ventilated patients to decrease nosocomial infection rates. Oral care provided with a toothbrush or swab, utilizing an antiseptic solution every eight hours with subglottic suction, is effective and will improve patient outcomes. Policy and procedure revisions are warranted after the project\u27s expansion to a generalized acute care population. Continued education and feedback on the oral care process are also necessary
Prevalence and beliefs associated with vaccine hesitancy among Muslim-Americans
Get PDFBackground. Vaccine hesitancy hinders the eradication of preventable illnesses. Furthermore, there are gaps in public health research on vaccine hesitancy among Muslims in heterogenous societies.
Objective. This study aimed to determine whether socioeconomic demographics, political beliefs and trust in public institutions were associated with vaccine hesitancy beliefs. Additionally, two models were applied to determine which factors had the strongest influence in rejecting vaccines.
Method. Participants were recruited through Facebook group posts. Seventy-three responses were received. Sixty-three responses met the inclusion criteria and were included in the final analysis. Participants rated their opinions on political beliefs, religious practices, trust in institutions and vaccines. Answers were compiled into the following belief scores: political leaning, religiosity, trust in public institutions, and vaccine hesitancy.
Results. From bivariate analysis, participants who were older in age, attained higher levels of education, were employed, were not married, and identified with the Sunni sect were less vaccine hesitant. From multiple regression analysis, participants with higher education levels and trust in public institutions were the least likely to express vaccine hesitancy. No belief score had a significant correlation with vaccine hesitancy. Most participants (36.5%) were more likely to receive a vaccine it had no potential safety issues. Moreover, they were hesitant with vaccines if they had safety concerns or had poor efficacy.
Discussion. Results both align with and contradict previous studies in Muslim majority and religiously heterogenous countries. This study is the first of its kind to find an association between Islamic sect and proclivity towards vaccines. Follow up studies are necessary to gauge a larger, more diverse population of Muslim-Americans. Based on this study’s findings, healthcare professionals can better promote vaccines by addressing their patient’s trust in public institutions
Commitment to Collaboration: Development of a School Nursing Collaboration Instrument
Get PDFRegistered nurses (RNs) have an ethical responsibility to collaborate, thereby promoting the scope of nursing practice and working to positively influence health outcomes. This responsibility encompasses RNs employed as school nurses (SNs). Examples of SN collaboration with campus, school district, and community health partners exist. However, SNs’ commitment to collaboration in these relationships has not been examined.
Chapter 2, “COVID-19: Planning and Postpandemic Partnerships,” explores surges in school nursing partnerships that occur during healthcare emergencies. The significance of partnering with SNs in the school, school district, and community setting is discussed. The need to develop school nursing partnerships that extend beyond healthcare crises is established.
Chapter 3, “Development of a School Nursing Collaboration Instrument: A Pilot Study,” describes the psychometric soundness and results of an instrument designed to explore collaborative experiences of SNs with campus, school district, and community health partners. Although reliability is confirmed, differences between the Likert-type responses and free responses indicate the need for instrument revision. Resulting recommendations for a revised instrument to understand SNs’ perceptions of their role as a collaborator are presented.
Chapter 4 provides results of the primary study, a survey distributed to a random sample of United States school nurses via their professional organization, using the revised Bullard School Nurse Collaboration Survey (BSNCS-R). In the study, the instrument, which focuses on SNs’ commitment to collaboration, is tested for psychometric soundness; reliability of the instrument is confirmed. Three components of commitment to collaboration at the campus, school district, and community level, which together comprise total commitment to collaboration, are analyzed through multiple linear regression to evaluate their relationship with collaboration. Written responses to a free-response survey question are coded by themes and evaluated using descriptive statistics.
Finally, Chapter 5 provides a summary of the body of work regarding school nurse collaboration. Implications for school nursing practice are discussed. Plans for continuing research are presented
IJV’s political ties and R&D strategy: Asymmetric contingencies of market versus governmental policy turbulence
Get PDFThe purpose of this article is to empirically explore (1) the impact of political ties on international joint ventures’ (IJVs) R&D strategy and (2) the moderating effects of market turbulence and governmental policy turbulence on the relationship between IJV political ties and R&D investment in China. Our sample consists of 1,344 observations taken from 224 IJVs over a period of 6 years (2012–2017), and we applied hierarchical moderated regression analysis (HMRA) with panel data to analyze our three hypotheses. Our findings show that IJVs with political ties tend to invest more in R&D than their counterparts without political ties. Interestingly, this positive relationship grows stronger with high market turbulence, but wanes under high governmental policy turbulence. While the issues regarding the importance of political ties to IJVs competing in China have been discussed, the issues related to why political ties influence IJV’s decisions on R&D investment have been largely overlooked. Hence, this study applies the environmental contingency view to fill this gap and shows how asymmetric contingencies for market turbulence and governmental policy turbulence occur in this context
Modifiable health disparities and cardiovascular disease risk factors in Latino migrant seasonal farmworkers: A meta-analysis
Get PDFBACKGROUND: Cardiovascular disease is the leading cause of death in the United States (U.S.). Existing literature concluded that Latino migrant seasonal farmworkers endure higher rates of adverse health disparities and chronic diseases than the general U.S. population. However, research on the Latino migrant seasonal farmworkers’ modifiable health disparities (i.e., alcohol use and smoking) and cardiovascular disease risk factors (i.e., high cholesterol, diabetes mellitus, hypertension, and overweight/obesity) is scarce, particularly studies comparing male and female Latino migrant seasonal farmworkers. PURPOSE: This meta-analysis had two aims. First, examine whether male or female Latino migrant seasonal farmworkers in the U.S. have a higher prevalence of modifiable health disparities. Second, examine whether male or female Latino migrant seasonal farmworkers in the U.S. have a higher prevalence of cardiovascular disease risk factors. METHODS: A meta-analysis of prevalence was utilized to examine whether male or female Latino migrant seasonal farmworkers in the U.S. have a higher prevalence of modifiable health disparities and cardiovascular disease risk factors. RESULTS: The prevalence of alcohol use and smoking for 95% of all comparable female Latino migrant seasonal farmworkers were 0%-71% (95% CI: 0.04-0.21) and 1%-35% (95% CI: 0.04-0.12), respectively, and 2%-96% (95% CI: 0.22-0.64) and 6%-71% (95% CI: 0.19-0.39) for males, respectively. The prevalence rates for high cholesterol, diabetes mellitus, hypertension, and overweight/obesity for 95% of all comparable female Latino migrant seasonal farmworkers were 1%-54% (95% CI: 0.04-0.15), 2%-57% (95% CI: 0.08-0.21), 3%-54% (95% CI: 0.10-0.22), and 1%-100% (95% CI: 0.26-0.84), respectively, and 5%-42% (95% CI: 0.12-0.23), 1%-63% (95% CI: 0.07-0.21), 4%-68% (95% CI: 0.15-0.31), and 1%-99% (95% CI: 0.29-0.81), respectively, for males. CONCLUSION: The meta-analysis concluded that male Latino migrant seasonal farmworkers in the U.S. have a higher prevalence of alcohol use, smoking, diabetes mellitus, and hypertension than female Latino migrant seasonal farmworkers. Female Latino migrant seasonal farmworkers in the U.S. have higher rates of high cholesterol than males. However, female and male Latino migrant seasonal farmworkers have an equal prevalence of overweight/obesity. Subsequently, this meta-analysis drives and supports existing theories, fills the gap in the literature concerning the Latino migrant seasonal farmworkers’ cardiovascular health, namely modifiable health disparities and cardiovascular disease risk factors, and delivers specific inconsistencies between male and female Latino migrant seasonal farmworkers
Using Classification of Instructional Program Codes in HRD: Invited Reaction
Get PDFThis reaction begins by highlighting four strengths of the article: (a) the clear introduction of CIP codes and how they are utilized; (b) where the discipline of HRD fits with the CIP code system; (c) the illustration of how CIP data can be utilized in HRD research; (d) the call for faculty to become more aware or CIP codes and impacts of this system upon programs. This reaction will also present some challenges and highlight an important use of CIP codes that was not discussed in the article. This reaction will then present a case that demonstrates why we as HRD program leaders cannot ignore the importance of CIP codes. Finally, implications of CIP codes for HRD and the role of higher education faculty members will be presented. The Rose (2023) manuscript holds valuable information that can lead to better program data and possibly some new streams of HRD research
Static and Dynamic Analysis of a Bistable Frequency Up-Converter Piezoelectric Energy Harvester
Get PDFUsing energy harvesting to convert ambient vibrations efficiently to electrical energy has become a worthy concept in recent years. Nevertheless, the low frequencies of the ambient vibrations cannot be effectively converted to power using traditional harvesters. Therefore, a frequency up-conversion harvester is presented to convert the low-frequency vibrations to high-frequency vibrations utilizing magnetic coupling. The presented harvester consists of a low-frequency beam (LFB) and a high-frequency beam (HFB) with identical tip magnets facing each other at the same polarity. The HFB, fully covered by a piezoelectric strip, is utilized for voltage generation. The dynamic behavior of the system and the corresponding generated voltage signal has been investigated by modeling the system as a two-degrees-of-freedom (2DOF) lumped-parameter model. A threshold distance of 15 mm that divides the system into a monostable regime with a weak magnetic coupling and a bistable regime with a strong magnetic coupling was revealed in the static analysis of the system. Hardening and softening behaviors were reported at the low frequency range for the mono and bistable regimes, respectively. In addition, a combined nonlinear hardening and softening behavior was captured for low frequencies at the threshold distance. Furthermore, a (Formula presented.) increment was achieved in the generated voltage at the threshold compared to the monostable regime, and the maximum generated voltage was found to be in the bistable regime. The simulated results were validated experimentally. Moreover, the effect of the external resistance was investigated, and a 2 MΩ resistance was found to be optimal for maximizing the generated power. It was found that frequency up-converting based on magnetic nonlinearity can effectively scavenge energy from low-frequency external vibrations
RESIDENTIAL INDOOR AIR QUALITY STUDY – ASSESSMENT AND MITIGATION
Get PDFAn increased awareness in residential indoor air quality (IAQ) has led to an increase in technologies that assist in improving IAQ. Two such technologies include Electro-static (ES) air cleaners and Photocatalytic Oxidizing (PCO) air cleaners. ES air cleaners remove particulate matter from indoor air, but are known to emit ozone, a contaminant, as a by-product. PCO air cleaners abate gaseous pollutants (i.e., Volatile Organic Compounds, VOCs); however, a lack of testing standards creates confusion about their effectiveness in improving IAQ in a real residential home. On the other hand, environmental variables such as temperature and humidity were found to affect VOC sensor readings which complicated the data analysis. In the case of two tested ES air cleaners, the data showed that although the ES air cleaners increased the ozone concentration in the house, the levels are not of concern as they were less than the Food and Drug Administration’s (FDA) limit on indoor ozone generation. Regarding two tested PCO air cleaners, minimal indications of an acceleration in VOC abatement were seen. Nevertheless, further insight is given into the methodology behind the real-world testing of PCOs and a correction technique that was used to remove the effect of temperature and humidity on VOC sensor readings
Toward an Evidence-Based Framework to Guide Health Care Responses for Patients Impacted by Human Trafficking: Evaluation of the HEAL Trafficking Protocol Toolkit
Get PDFTrafficked persons seek health care during exploitation, but few health professionals know how to respond appropriately, and few institutions have protocols to guide this response. Currently, no empirically tested framework exists to guide protocol development for human trafficking response protocols in health care settings. Our aim was to empirically evaluate the HEAL Trafficking Protocol Toolkit\u27s usability and effectiveness through cross-sectional survey methodology. We invited users who downloaded the free Toolkit from January 2017 through January 2018 to participate in an electronic survey and conducted descriptive quantitative and qualitative thematic analyses. Survey respondents were professionally and geographically diverse. Eighty-four percent who used the Toolkit for educational purposes, and 91% whose objective was to develop, implement, or improve a health care response protocol, found it to be helpful or very helpful. We identified 22 discrete qualitative response themes. The HEAL Trafficking Protocol Toolkit for Developing a Response to Human Trafficking Victims in Health Care Settings is the first peer-reviewed, empirically tested framework to guide protocol development to respond to trafficked persons in diverse health care settings, and is perceived as a helpful, informative, practical tool for creating and improving patient-centered, trauma informed protocols and advancing sustainability for institutional, human, and fiscal resources