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Enhancing Coastal Community Resilience in North Carolina: Monitoring Erosion and Nature-based Solution Efficacy on a Fetch-limited Barrier Island
No full textFetch-limited barrier islands protect low-lying coastal communities like those in eastern North Carolina. They are natural barriers against powerful waves and storm impacts. However, coastal storms can subject barrier islands to elevated water levels and forceful waves, overwhelming their resistance to ongoing erosion. Sugarloaf Island in Morehead City, North Carolina has undergone noticeable and rapidly progressing changes in its physical and ecological features, linked to recent storms. This exemplifies a critical need for restoration measures on the island. To increase the resiliency of downtown Morehead City, a restoration committee was created to protect Sugarloaf Island from continued erosion by implementing an innovative approach that combines nature-based solutions with engineered structures. While this approach is innovative, there is an urgent need to support the Sugarloaf Island restoration project through assessments of the island's resilience before and after storm events, as well as an evaluation of the efficacy of these innovative nature-based solutions. To support the committee and understand the dynamic changes occurring on the island, we employ on-demand small Uncrewed Aircraft System (sUAS) remote sensing devices alongside survey-grade Real-Time Kinematic Global Navigation Satellite Systems (RTK-GNSS) and use innovative geospatial workflows to quantify seasonal erosion. Our results show: 1) consistent erosion during active and dormant marine weather seasons and 2) overall accretion once all restoration measures are in place. This project facilitates seasonal surveys throughout the year to gain insights into the short-term impacts of storms and coastal restoration efforts. The results of this study improve the assessment of erosion concerns, and our understanding of the effectiveness of nature-based solutions in enhancing the resiliency of a coastal community in North Carolina
Evaluating CRNA Perceptions of a Clinical Reference Guide for Aspiration Pneumonitis: A DNP Project
No full textNoneAspiration pneumonitis is a serious perioperative complication associated with increased
morbidity, extended hospital stays, and higher healthcare expenditures. Prompt recognition of
risk factors, early prevention strategies, and appropriate treatment regimens are essential to
mitigate adverse outcomes. However, variability in provider awareness and practice can
contribute to the delay or inadequacy of interventions. This Doctor of Nursing Practice (DNP)
project evaluated the perceived effectiveness of a quick reference guide (QRG) developed to
streamline the identification of aspiration risk factors and reinforce evidence-based prevention
and treatment techniques for perioperative aspiration pneumonitis. The QRG, along with a
narrated PowerPoint, was distributed to Certified Registered Nurse Anesthetists (CRNAs) at a
large academic hospital in Eastern North Carolina. Data from pre- and post-implementation
surveys demonstrated that the QRG was perceived to be effective in improving knowledge and
recognition of aspiration risk factors, increasing participant confidence in implementing
prevention strategies, and enhancing consistency in clinical practice. The transition of aspiration
prevention quality improvement projects, such as this QRG, into clinical practice can standardize
care, reduce aspiration-related complications, and improve perioperative patient outcomes.NoneD.N.P
LEAP FOR JOY: AMPLIFYING JOYFUL LEARNING FOR CHINESE ELL STUDENTS
No full textIn this qualitative study using participatory action research (PAR), educators explored how to understand and implement culturally and linguistically responsive pedagogy (CLRP) and joyful learning strategies to support Chinese ELLs. In PAR project and study over 18 months, we focused on building teacher capacity in working with Chinese ELLs in math instruction to elevate joyful learning. As we engaged in professional learning, I worked with a Co-Practitioner researcher (CPR) group, conducted PDSA (Plan, Do, Study, Act) cycles of inquiry, and supported teachers to select and implement CLRP joyful learning teacher practices for Chinese ELLs. I collected and analyzed data from the field notes, observations, post-observation conversations, and reflective memos. We co-developed an evidence-based observation tool for joyful learning practices. As a result of the study, we gained more insight for educators on how to improve equitable joyful learning experiences and better support Chinese ELLs. First, creating a sense of belonging and gracious space through coaching and peer relationships was a critical step in our ability to cultivate teacher capacity. Teachers transferred their sense of belonging and learning in a gracious space to cultivating relational trust with and among students in a safe and welcoming classroom environment. Secondly, joyful learning strategies and CLRP practices included more opportunities for peer dialogue and choice; teachers promoted student agency for independent learning. As a result, teachers and leaders in schools and districts can benefit from our tools and study findings. The processes we used for professional learning are transferable to multiple contexts
THE RELATIONSHIP BETWEEN MODES OF EXERCISE AND THE MEASURES IN VISCERAL ADIPOSE TISSUE
No full textPurpose: The increasing prevalence of obesity observed in the United States should be alarming to our nation, as it effects a large percentage of the population of the United States and is the cause of many thousands of deaths per year (NIH 2022). Obesity leads to many chronic disease states such as metabolic diseases, cardiovascular diseases, or fatty liver diseases. The most influential factor of obesity on chronic health conditions is the visceral adipose tissue (VAT). VAT is most influential due to these adipocytes being more metabolically active, and most VAT containing direct access to the hepatic portal which can lead to ectopic adipose storage. Physical activity and exercise have been shown to reduce VAT mass, however, it has been difficult to determine if resistance training (RT) or aerobic training (AT) are more influential in VAT differences. This study aims to better understand the effects of exercise training compared to a sedentary lifestyle and investigate the changes this will have on body composition. Subjects were separated into a "Highly Active" group and a "Sedentary" or control group. Both groups' body composition measurements were taken with DXA. The subject characteristics and adipose measurements were taken and compared through a 3x1 ANOVA. When comparing the measures of our Sedentary sample to both of the Highly Active groups, VO2 Max was significantly different from the Control Group. For Visceral Adipose Tissue Measures, the Resistance Training was significantly lower when compared to both the Control Group and the Aerobic Training group
GETTING INTO GOOD TROUBLE: BUILDING CULTURALLY RESPONSIVE TEACHING PRACTICES FOR AFRICAN AMERICAN STUDENT SUCCESS IN MATHEMATICS
No full textCollectively understanding the diligence and perseverance necessary for teachers to fully support student learning and not accept "give-up-itis" from students is essential for success in mathematics, especially for African American students. In the participatory action research (PAR), I examined the extent to which upper elementary school teachers in an urban school could effectively implement protocols during conceptual mathematics lessons that increased opportunities for African American students' equitable engagement in academic discourse. To do so, I engaged teachers in a professional learning community (PLC) model using improvement sciences and community learning exchange processes. To collect qualitative data, I observed classrooms, engaged in post observation conversations and collected and analyzed artifacts from our group discussions. The findings confirmed that (1) Teachers' experiences as students inform their current practices; and (2) the instructional leader's role is essential in operationalizing teachers' beliefs and skills into consistent engagement practices. This research has implications for practice, policy and research. When teachers co-construct learning, use common instructional tools and strategies, and reflect collectively upon their practice, they can begin to dismantle inequitable math practices. The PAR processes are useful to practitioners and should inform policy at the school and district levels. School-based practitioners can become action researchers and respond to their local issues and decide how to improve instruction. External researchers can study their processes to inform the educational research community
Reducing Emergency Department Bounce-Back Through Nurse-Driven Discharge Education
No full textA bounce-back is an emergency department (ED) visit by a patient previously treated and discharged who has subsequently checked back in within 48 hours for treatment (Montoy et al., 2019). Bounce-backs constitute a significant healthcare problem, causing decreased health in our population and an increase in the total cost of healthcare (Curcio et al., 2020). The national bounce-back average is 4%, and healthcare systems implement few interventions to solve the issue despite support within the literature to justify that thorough nursing education at discharge lowers bounce-backs. Nurse-to-patient educational gaps in the ED discharge process have decreased emergency nurses' competence and confidence in discharge teaching. The primary objective of this DNP project was to determine if improved nursing education at the time of discharge would decrease bounce-backs. This DNP project found a correlation between bounce-backs and teach-back method implementation, which led to nurse-driven education during discharge. The IOWA method and the Institute for Health Improvement (IHI) recommendations were utilized to implement the teach-back method and incorporate an emergency nursing discharge tool. In this DNP project, many emergency nurses were unaware of bounce-backs, never used the teach-back method, and never received teach-back or discharge training. The project’s barriers included a small sample size, no standardized discharge tool or process, and response bias. The study's findings suggest that emergency nursing staff's increased attention to the discharge process positively impacts the rate at which bounce-backs are seen. Further education should focus on the vulnerable populations contributing to bounce-backs.D.N.P
The Effects of Self-Disclosure on Attitudes Toward Seeking Professional Psychological Help Among Black Males
No full textBlack American males reported sadness and hopelessness and that everything takes an effort at a higher rate than Black women, Caucasian males, and other groups. Although the statistics related to Black males’ depression are high, their attitudes toward seeking professional psychological help remain unfavorable. Black males are often grounded and socialized in traditional masculinity and ethnic ideologies, including those that prevent professional psychological care, a normative method of coping with distress. As men, they are socialized not to self-disclose their feelings, and as Black Americans, they learn the importance of social support within the Black community
An Exploratory Study using Low-cost Drone Imagery to Analyze Post Disaster Recovery
No full textGlobally collected data supports the documented increasing trend of severity and frequency of natural disasters. This study investigates using drone imagery as a potentially effective method for visual damage evaluation. The study begins with a literature review of current disaster evaluation techniques and disaster appropriation and then proposes metrics that leverage a drone-based methodology. This proposed method uses drone images analyzed over six months from damaged areas in Nashville, Tennessee after an EF-3 Tornado went through the area in 2020. These locations, East Nashville and Mt. Juliet are located in separate counties, with differing acreage areas, population size, and median income. The study uses manually quantified metrics of blue roofs, unrepaired/under-construction, and debris piles to track the recovery. These quantified results are compiled into three tables incorporating previously collected government stakeholder opinion to assess metric potential. The quantified metrics are assessed as potential recovery metrics, specifically blue roofs, and a discussion commences regarding a potential contribution to equitable disaster assistance
Soul FOOD: An Examination on the Physical Activity of Black Women
No full textOverweight and obesity diseases lead to various critical health issues, including heart disease, high blood pressure, and type 2 diabetes. These diseases severely and disproportionately affect the Black female population as obesity rates are increasing at an alarming rate. Studies show that 80.6% of African-American women ages 20+ are overweight or obese and African American women have the highest rates of physical inactivity in comparison to other gender/ethnic groups. With African American women having the highest rates of overweight and obesity-related diseases and physical inactivity, it is a public health priority to develop and promote a program to develop and promote weight loss strategies for this underserved population. Intensive Lifestyle Interventions are used as a framework to combat obesity by providing increased physical activity recommendations, reduced caloric intake, and behavior therapy. These interventions have shown success in primarily White populations, but there has yet to be a feasible option provided specifically to the Black female community. Intervention guidelines such as physical activity recommendations and a reduced-calorie diet must be presented in a different manner than the traditional way. We have developed a program that not only provides an intervention that is feasible and attractive to the African-American female community but also creates a community amongst this population to continue to promote physical activity and healthier diet choices within the African-American female population. While ILIs incorporate behavioral counseling, they lack individualized tailored health coaching and the support for “how” to make the change. Focus group data collected in the Fall of 2021 provided data to develop a physical activity and nutrition program for Black women by Black women. This program was delivered virtually, due to COVID-19, to Black women to examine the impact of a tailored physical activity and nutrition program. Each week, Black women engaged in health behavior classes, social media groups, buddy programs, and either a physical activity or nutrition class. Women were provided with a Garmin physical activity tracker throughout the duration of the study and were asked to log their physical activity levels. We will examine physical activity data from the project to determine the impact the Soul FOOD intervention had on Black women’s physical activity levels
Pressure Injuries in Older Adult ICU Patients: Hemodialysis
No full textIntensive care unit (ICU) patients are at an increased risk of developing hospital acquired pressure injuries (HAPrI) due to various factors. Immobility, severity of illness, and various medical interventions place these patients at higher risk for developing a HAPrI. Patients in the ICU undergoing hemodialysis are at an increased risk of developing a HAPrI due to the severity of their illness and the toll hemodialysis takes on an individual’s body. This study examined the characteristics of patients ≥60 years who received hemodialysis and developed a HAPrI during their ICU admission. A retrospective study of hemodialysis patients (N=457) was conducted using data from the Medical Information Mart for Intensive Care (MIMIC) database. Variables included in this study are age, length of hospital stay, minimum hemoglobin, minimum albumin, Braden total and subscale scores upon ICU admission. Bivariate statistical analysis was used to identify statistically significant variables that characterized hemodialysis patients who developed a HAPrI. Eighty-six (19%) ICU patients developed a HAPrI. Occurrence of HAPrIs among hemodialysis patients was influenced by length of hospital stay, minimum albumin, minimum hemoglobin, total Braden score, and some Braden subscale scores: activity, mobility, sensory perception, and moisture. Understanding these factors can guide healthcare professionals in creating effective preventive measures for HAPrIs in the ICU