Environmental and Occupational Health Sciences Institute
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Evaluating the use of a smartphone-based peer-to-peer support application for the management of stress and the improvement of emotional well-being in night shift nurses
No full textPurpose of Project:Unmanaged stress among night-shift nurses can significantly impact their emotional and mental well-being, potentially leading to long-term health issues. This project aimed to assess the viability of a smartphone-based peer-to-peer support application, Dugri, as a self-help resource for stress management and emotional well-being improvement among night-shift nurses. Methodology:A 4-month pilot program evaluated the application's effectiveness through pre- and post-questionnaires distributed to participating nurses. Descriptive analysis of app usage data and questionnaire responses informed evidence-based recommendations. The literature review highlighted the significance of peer support and digital resources in stress management for nurses. Results:Results indicated positive feedback on the app's utility in providing emotional support, though further long-term research with controlled groups is warranted. Implications for Practice:While the project demonstrated promising outcomes, sustained support, and comprehensive studies are essential to enhance nurses' well-being and improve patient care.D.N.P.Includes bibliographical reference
Improving Mental Health Referrals of Students Within a High School Setting
No full textPurpose of Project: To improve mental health referrals for adolescents within a high school byimplementing a mental health referral protocol and improving educators’ ability to identify and respond to students’ mental health issues through an evidence-based educational training program.
Methodology: Within a 9-12th grade public high school, a referral protocol was implemented, and an online, two-hour synchronous training program was conducted to teach high school educators about adolescent mental health. Referral rates were collected, and participants completed pre- and post-test surveys to determine if the training was effective.
Results: Thirty-six educators completed the training and surveys. Results from the surveys indicated a significant relationship between the educational program and retention of educators’ mental health literacy, perceptions of mental illness, and confidence level to make a referral. Improvement of student referral rates, especially in the specific types of behavioral health concerns, indicated that high school educators were utilizing the referral protocol to identify at-risk students.
Implications for Practice: Early intervention and referral to appropriate services for adolescents is made possible by effectively training high school educators to identify mental health concerns in the classroom.D.N.P.Includes bibliographical referencesIncludes vit
The Development, Implementation, and Evaluation of an Evidence-Based Rounding Checklist in the Intensive Care Unit
No full textA structured approach to multidisciplinary rounds in the intensive care unit serves as a platform for collaboration and implementation of evidence-based practices, guidelines, and care bundles. The purpose of this DNP project was to standardize the process of multidisciplinary rounding at the project site as the current structure for intensive care rounds resulted in poor compliance with evidence-based practices and care bundles, specifically the ICU Liberation Bundle (A-F). This quality improvement project developed, implemented, and evaluated the use of an evidence-based rounding checklist in standardizing the process of multidisciplinary rounds. The outcomes measured included the percentage of accurately completed checklists and feedback regarding improvement in workflow among the multidisciplinary team via web-based anonymous survey. The results of this DNP project demonstrated the ability of an evidence-based rounding checklist to standardize the process of multidisciplinary rounds at the project site with the accurate completion of 76.64% of checklists, a total of 105 checklists, during implementation. A subsequent improvement in workflow among multidisciplinary team members was reflected in the responses from the web-based anonymous survey with unanimous understanding of the plan of care and majority reporting increased efficiency in completing daily tasks related to patient care.D.N.P.Includes bibliographical referencesIncludes vit
Midbrain cholinergic innervation to the thalamus: exploring behavioral functions and connectivity
No full textCholinergic neurons of the pedunculopontine nucleus (PPN) have traditionally been implicated in modulating brain states (i.e. wakefulness or REM sleep) and locomotion. However, recent advancements in cell-type-specific neuromodulation studies started a reassessment of these early theories, leading to new questions about the exact function of PPN cholinergic neurons. Notably, these neurons send cholinergic signals to key structures involved in behavioral flexibility, such as striatum and thalamus. Cholinergic signals are recognized as crucial components of behavioral flexibility, supported by both animal and clinical studies. Thus, we investigated the relationship between behavioral flexibility and PPN cholinergic neurons through behavioral tests and anatomical studies. Using chemogenetics, we transiently suppressed PPN cholinergic signaling during reversal learning tasks. We found that transient suppression of PPN cholinergic signals disturbed the adaptation from non-probabilistic to probabilistic outcomes, causing animals to persist with their previously learned non-probabilistic strategy. This persistence indicated a failure to revise their behavioral strategy by switching choices in every non-rewarded trial. Consequently, we aimed to identify the downstream targets of PPN cholinergic involvement in behavioral flexibility. The thalamus is the most prominent target of PPN cholinergic innervation, with virtually all thalamic nuclei receiving PPN inputs. Given recent evidence of direct PPN cholinergic innervation to the striatum, one hypothesis is that PPN cholinergic neurons target thalamic neurons that project to the striatum (thalamostriatal, TS). Alternatively, based on early studies of PPN function and brain state regulation, cholinergic innervation might target thalamic neurons projecting to the cortex (thalamocortical, TC). To determine whether PPN cholinergic neurons preferentially innervate TC or TS systems, we combined anterograde and retrograde tracing techniques. Retrograde labeling revealed that TC and TS circuits are largely exclusive to each other. Quantification of axonal appositions between cholinergic axons and TC/TS neurons showed a preferential apposition to TS neurons. Our findings suggest that PPN cholinergic neurons preferentially innervate TS neurons over TC neurons within the thalamic nuclei having both types of neurons, supporting their modulatory role in striatal circuits. These results provide insights into PPN cholinergic involvement in behavioral flexibility and highlight the potential for future clinical research aimed at early diagnosis and treatment of conditions related to cholinergic transmission deficits, such as atypical parkinsonian symptoms, including progressive supranuclear parsley and multiple system atrophy.Ph.D.Includes bibliographical reference
Lithium-ion intercalation mediated electrochemical nitrogen reduction
No full textChapter 1 includes an overview on nitrogen reduction reactions.Chapter 2, we investigated the synergistic role of in-situ intercalation of Li ions (Li+) and phosphorus (P) doping to enhance eNRR activity, using P-OV-WO3 and WO3 as model transition metal oxides (TMOs) with and without substitutional heteroatom doping, respectively. Unlike proton intercalation, Li ion intercalation in an aqueous solution is challenging due to the facile proton intercalation and severe HER competition. To overcome these competitive reactions and enable Li+ intercalation into the WO3 matrix in an aqueous electrolyte, we first focused on growing a high-quality solid electrolyte interphase (SEI) on the TMO surfaces, drawing insights from research on aqueous-based lithium-ion batteries (LIBs). We specifically chose a “water-in-salt” electrolyte (WISE) with lithium trifluoromethanesulfonate (LiOTF) instead of the
commonly used lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) to avoid any confusion about NH3 production from electrolyte decomposition. The eNRR performance of the P-OV-WO3 upon Li ion intercalation, unprecedented high Faradaic efficiency (FE) of 79.9 ± 4.0 % at -0.55 V vs RHE and a high NH3 yield of 163 ± 8.1 µg·mg cat-1 h-1 at -0.75 V vs RHE achieved.M.S.Includes bibliographical reference
Implementation of the evidenced-based PEN-FAST screening tool to help identify patients with low- risk penicillin allergies to increase the administration in cephalosporin antimicrobial therapy and improve patient outcomes in the perioperative setting.
No full textPurpose of Project: To increase antimicrobial stewardship through the utilization of the PEN-FAST screening tool in patients with low-risk, self-reported penicillin allergies. Methods: A retrospective chart review of 160 patients with self-reported low-risk penicillin allergies who underwent surgical intervention from October 01, 2023, to January 01, 2024, at Newark Beth Israel Medical Center. A pre- and post-implementation in-service was first provided to members of the Anesthesia, Pre-Admission Testing (PAT), Clinical Pharmacy and the Antimicrobial Stewardship department to explain advantages of the PEN-FAST tool. Patient data results was analyzed using an Excel spreadsheet. This data was then utilized to formulate a site-specific PEN-FAST policy/ protocol to guide staff on appropriate, safe, and effective utilization of the risk stratification tool. Inclusion criteria for the study included all patients scheduled for surgical intervention over the age of years. Exclusion criteria included all high-risk populations such as pediatric and obstetric patient. Results: Only approximately 21 % of the study’s population received Cefazolin with the highest frequency of antibiotic administration being Clindamycin at 42%. 5% received Vancomycin, 5% received Flagyl, 3% received Levaquin, 2% received Cefepime, 2% received Meropenem and 3% received unknown therapy. Post-survey data indicated that 95 % of anesthesia staff agreed that the education in-service increased their knowledge of the PEN-FAST tool with 100 % stating that they would be likely to utilize the PEN-FAST clinical tool after the in-service. Implications: Providers can help to facilitate antimicrobial stewardship through the appropriate utilization of the PEN-FAST screening tool to decrease surgical site infection rates, improve surgical patient health outcomes and lower hospital costs.D.N.P.Includes bibliographical reference
The implementation of math conferences in an elementary classroom by early-career teachers: struggles in agency and the messy middle
No full textMost elementary teachers (ETs) have majors in the humanities as undergraduates and much of the pedagogical training in a teacher preparation program tends to focus on literacy, so many ETs lack math pedagogical content knowledge and have a stronger knowledge of, and how, to teach literacy (Gonzalez-DeHass, et al., 2017; Bursal & Paznokas, 2006; Novak & Tassell, 2017; Malinsky, et al., 2006). This need for a deeper knowledge of mathematics, and how to teach it, exists during teacher training, and it is not necessarily narrowed when preservice ETs start working in the field as classroom teachers of record (Lui & Bonner, 2016; Newton, 2017; Fuller, 1997). Most ETs are not prepared to effectively teach math, and this results in an over-reliance on curriculum guides and procedural explanations of mathematics during instruction (Fuller, 1997; Lui & Bonner, 2016; Newton, 2017). Considering their training and background, it is not surprising that ETs use literacy structures in math, and this three-paper dissertation explores how a group of early-career ETs implemented math conferences as a way to support deepening student learning in math and increasing teacher understanding of student thinking during math instruction (Munson, 2018; Picha, 2022). What happens then when early-career ETs implement a new instructional practice in their classrooms? Each paper in this dissertation explores different elements of how early-career teachers implement this new practice and the ways that collaboration, school culture and climate, administrative supervision and support, professional development, and classroom structures either support successful implementation and spur teacher learning, or mire early-career teachers in the messy middle. The messy middle is the place before feeling completely competent with an instructional practice and where teacher learning is filled with approximation, failure, reflection, and success. Implications for practice and suggestions for future research result from the findings of this study.Ed.D.Includes bibliographical reference
Use of virtual reality to decrease pain and anxiety during vaccination
No full textPurpose of Project: The importance of routine childhood immunizations cannot be disputed for the health and safety of children, families, and communities both nationally and globally. However, the delivery method of routine vaccinations through needle injections are not without consequences, and are an underrecognized source of pain and anxiety among children in the healthcare setting. The use of virtual reality goggles as a multi-sensory distraction method was investigated in this project to reduce pain and anxiety related to routine vaccinations in the pediatric primary care setting. Virtual reality goggles are a straightforward, low-cost intervention that can be easily acquired and utilized in the primary care setting. Methodology: Children ages five to 12 years old were provided with virtual reality goggles to wear during vaccine administration in a suburban pediatric primary care office. Pain was measured using a 10-point scale post-procedurally and anxiety was measured both pre and post-procedurally using a 4-point scale. Overall patient satisfaction was also measured with a single-question questionnaire after pain and anxiety scores were obtained. Results: A total of 11 participants were recruited for this project, with nine participants completing the study until the end. The overall procedural pain score and post-procedure anxiety scores were found to be low, (M = 2.22, SD = 1.85) and (M = .22, SD = .66) respectively. Inferential statistical analysis also revealed a statistically significant decrease in post-procedure anxiety scores compared to pre-procedure anxiety scores (z = -2.2, p = .02). Finally, all participants reported a desire to use virtual reality for future vaccine procedures. Implications for Practice: The results from this project, including a one-hundred percent patient satisfaction rate, demonstrate that virtual reality is an effective, low-cost, safe, and appealing pain and anxiety management strategy among pediatric patients.D.N.P.Includes bibliographical reference
Tom Skinner and evangelical commitment to social justice
No full textBlack Evangelicalism plays a significant role in the traditional Evangelical narrative. Despite its unique and noteworthy figures, such as Tom Skinner and William Bentley, it has been largely overlooked, especially when compared to White Evangelicalism. This research focuses on Skinner and his social justice emphasis to illustrate the diversity of Evangelicalism beyond the monolithic White narrative. This paper also discusses Skinner's "third way" for the Black cause through his Black Evangelical representation with a strong emphasis on social justice through deconstruction calls. Examining Skinner's publications alongside secondary sources, it draws upon literary theory, close reading, and historical methodology for its analysis. This thesis sheds light on Skinner's role as a safeguard of Black identity, seeking social justice through "Evangelical" commitment during the turbulent 20th century in the United States.M.A.Includes bibliographical reference
Chris and Jerel’s Initial Idea of Fairness in Ordinary Dice Games (Part 1 of 3)
No full textThis analytic is the first of three analytics that showcase the formulation of two students’ ideas of mathematical fairness. The analytics follow the argumentation of two students, Chris and Jerel, throughout two after-school sessions and one interview session as they investigate what makes a game involving rolling one or two dice fair. The first after-school session occurred on April 29, 2004. The second after-school session occurred on May 5, 2004, with the interview happening directly after the second session on the same day. The first analytic begins with Chris and Jerel discussing the fairness of a game involving a single die during the first session. By the end of the first session, Chris has designed his own game involving rolling two dice. The second analytic looks at Chris and Jerel’s work during the second after-school session and interview session where the pair explore a task investigating the fairness of a game involving rolling two dice. This game is different from the one Chris creates in the first analytic. The third analytic includes an investigation on the probability of rolling a sum of 7 versus a sum of 6 when rolling two dice that occurs during the interview.
In this analytic (the first of three analytics) during the first after-school session Chris and Jerel, both sixth-grade students, are solving a problem about the fairness of a game using a single fair die. Gameplay involves rolling a single fair die: if a 1, 2, 3, or 4 is rolled Player A gets one point (and Player B gets 0) and if a 5 or 6 is rolled Player B gets one point (and Player A gets 0). The first player to accumulate ten points is the winner. The questions that students are asking about this game are: 1) Is this a fair game? Why or why not? 2) Play the game with a partner. Do the results of playing the game support your answer? 3) If you think the game is unfair, how could you change it so that it would be fair?
Chris and Jerel begin gameplay before making a prediction. They claim that the given game is unfair using the results of their playing the game as support for their conclusion. In this analytic the students provide two indicators of fairness. The first indicator is the number of possible outcomes for each player (in this case Player A has four outcomes and Player B has two outcomes). The second indicator is the score difference of the game. In their case, Player A won ten points to Player B’s two points. When asked to create their own fair game Chris and Jerel create a game where each player has three outcomes: Player A gets a point for a roll of 1, 2, or 3 and Player B gets a point for a roll of 4, 5, or 6.
After playing their fair game, Chris and Jerel play a new game invented by Chris involving two dice. In this game Player A gets a point for rolling a sum that is even and Player B gets a point for rolling a sum that is odd. They assert that this game is fair by the same two indicators, that there is an equal number of outcomes (Player A: 2, 4, 6, 8, 10 and 12, Player B: 1, 3, 5, 7, 9, 11) and that the score of the game is very close (Player B wins 10 points to Player A’s 9 points). In this game, Chris and Jerel exhibit the equiprobability bias, the belief that all outcomes have the same probability of occurring (Shay, 2008). At the end of the session, a researcher suggests to the students that it is not possible to roll a sum of 1 with two dice. The session concludes before the two students were able to explore this further. Chris and Jerel explore further the sample space of rolling two dice in Part 2 of this series.
Problem Task:
One dice problem:
Roll one die. If the die lands on 1, 2, 3, or 4, Player A gets one point (and Player B gets 0). If the die lands on 5 or 6, Player B gets one points (and Player A gets 0). Continue rolling the die. The first player to get ten points is the winner.
(1) Is this a fair game? Why or why not?
(2) Play the game with a partner. Do the results of playing the game support your answer? Explain.
(3) If you think the game is unfair, how could you change it so that it would be fair?
Chris’ Game:
Roll two dice. If their sum is 2, 4, 6, 8, 10 or 12, Player A gets one point (and Player B gets 0). If the sum of the dice is 1, 3, 5, 7, 9, or 11, Player B gets on point (and Player A gets 0).
Video References:
B82, 42a, Probability problems: Dice games for two players part 1 of 2 (Student view), Grade 6, April 29, 2004, raw footage
Raw footage link: https://doi.org/doi:10.7282/t3-mtf2-xx81
References:
Shay, K. (2008). Tracing Middle School Students’ Understanding of Probability: A Longitudinal Study. Rutgers University Dissertation