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The Effects of Probiotics and the Risk of Obesity: A Systematic Review
No full textProbiotics are the subject of many current research studies with their role in gut health, weight management, and correlation to obesity. Recently, extensive studies have been initiated investigating the potential benefits of probiotic supplementation on the gut microbiome and a possible link to weight loss in individuals with obesity. More specifically, research has evaluated probiotic supplementation and its impact on the gut microbiome, brain-gut axis, hormones related to appetite, and BMI. This systematic review aims to analyze current research studies and the evidence available in hopes to uncover the relationship between probiotics and their role in decreasing the risk of obesity. Electronic databases such as PubMed, NIH, CINAHL and Viterbo Database Library were used to collect credible data for this review. Limited research was available relating probiotics to the risk of obesity and the results were inconclusive as to whether supplementation is beneficial in decreasing weight in individuals with obesity. Many research studies used multiple variables which created difficulties when looking at weight loss individually and the weight differences between control groups and supplementation groups were not significant. Further research and long-term clinical trials are needed to create a valid conclusion on this topic
Effects of Non-dieting Vs Dieting Approaches on Cardiovascular Health in Adults with Overweight and Obesity: a Look into the Need for PCOS Studies
No full textWeight-inclusive care is a newer health care approach that challenges the traditional weight-normative care for patient health and well-being. Research shows that the traditional way of viewing health, which focuses on weight and weight loss for well-being, is not effective and often leads to weight cycling. Several studies have suggested that a weight-neutral approach to health, which does not focus on weight or weight loss, can improve behavioral and physical indicators related to health and well-being. The aim of this meta-analysis was to assess the effects of a non-dieting versus a dieting approach on cardiovascular health in adults with overweight and obesity. This study will also elucidate on the need for future weight-neutral studies on polycystic ovary syndrome (PCOS). A literature search of PubMed and Google Scholar databases identified two studies, with a total of 91 participants, that reported on the impact of a non-diet versus diet approach on total cholesterol and triglycerides. The results of this study showed that a non-dieting approach was associated with an overall decrease for total cholesterol at six months, however the relationship was not significant. Future research should be conducted with larger trials and over a long period of time to investigate if a weight-neutral approach is effective for improving total cholesterol
Remimazolam Use During Gastrointestinal Procedural Sedation
No full textRemimazolam is a novel ultra-short-acting benzodiazepine currently being trialed by anesthesia to decide its utility. A quality improvement project compared the hemodynamic safety, efficacy, and time metric profile of remimazolam to evaluate the potential for a nurse sedation protocol in gastrointestinal procedures. A retrospective chart extraction of 60 patients divided into two groups (remimazolam or propofol-based sedation) was completed. Thirty patients who received remimazolam were selected based on inclusion and exclusion criteria and then matched with 30 patients who received propofol-based on ASA class, age, and procedure type. Eleven of 30 patients who received remimazolam-based sedation had the use of propofol during the case. Remimazolam comes in 20 mg vials, and 9 of the 11 patients converted to propofol-based sedation after 20 mg or 40 mg. No statistical difference in hemodynamics between the two groups was identified (p > .05). Of patients who received propofol-based sedation, 20% received phenylephrine compared to 3% of patients who received remimazolam. There was no difference in sedation time or recovery time between the two groups (p > .05). A provider survey displayed dissatisfaction with the medication for procedural sedation compared to propofol, as there is the need for an infusion, but providers felt the medication was safe for a nurse protocol. Based on this study, further research is necessary to evaluate appropriate infusion dosing, but remimazolam is hemodynamically stable, does not increase sedation time or discharge times and could be beneficial as a nurse sedation protocol. Keywords: remimazolam, colonoscopy, esophagogastroduodenoscopy, nurse sedatio
Evaluation of Video Simulation Emergent Anesthesia Scenarios
No full textMany studies have been published regarding simulation, techniques, and technology utilized during simulation. Simulation and technology advances allow anesthesia providers to view video-simulated emergent anesthesia scenarios to prevent deadly mistakes and prepare for complications. The primary aim of this quality improvement project was to provide a more efficient format, or alternative, for simulation and learning with anesthesia staff. A secondary aim of this project was to determine if this learning style is the preferred method. Two emergent anesthesia scenarios chosen for this video simulation were post-operative bleeding tonsil and airway fire. A convenience sample consisting of 24 certified registered nurse anesthetists and 8 anesthesiologists originally volunteered to participate. Out of this sample, a total of 24 providers began, with 18 completing. Each participant completed a pre-video survey, watched the 2 video simulations, and lastly completed a post-video survey. The mean score of the post-survey increased and it was found that this increase was statistically significant, p = .007. Participants were also asked to rate, using the 5-point Likert scale, their confidence in managing these situations pre-video and post-video, through self-reflection. The answer to the secondary aim of this project seems to indicate this style is preferred by providers, however, there remained enough that preferred the in-person simulation. Therefore, this method will likely be utilized as a back-up for those unable to attend the simulation and for graduate student learners. Key words: Anesthesia, Airway Fire, Post-Operative Bleeding Tonsil, Video-Simulation, Simulation, Educatio
Identifying Patients Requiring a Post Intensive Care Syndrome Clinic Appointment
No full textThe purpose of this study was to determine if patient and ICU characteristics could predict the need for a PICS clinic appointment supported by the acuity rating assigned to the patient at the time of their appointment. This retrospective descriptive, cross-sectional research study included 193 adult patients seen in the PICS clinic in 2020. Patients were screened into the clinic if they were 18 years of age or older and had spent 3 days or more in the ICU. Patients were screened out of the clinic if they were incarcerated, on comfort care or hospice, or admitted for substance abuse or suicide attempt. Variables of interest included patient demographics, ICU length of stay, interventions while in the ICU including drug exposure and oxygen delivery, and delirium. Pearson’s chi-square, Kruskal-Wallis, and logistic regression tests were used to analyze the data. Female sex assigned at birth (p = .05), increased length of ICU stay (p = .021), and high flow nasal cannula (HFNC) exposure (p = .005) were statistically significant in needing a PICS clinic appointment. When comparing acuity ratings, age (p = .007), length of ICU stay (p = .004), and HFNC exposure (p = .002) showed significance. Female sex assigned at birth and HFNC was found to be significant in needing a PICS clinic appointment. While many factors should be considered when assessing the need for a PICS clinic appointment, patients who are female sex assigned at birth and those exposed to HFNC should be considered a priority
Assessment of Dietary Intake and Eating Attitudes in Female Ultrarunners
No full textUltramarathon running is an extremely high expenditure sport, making the nutritional requirements respectively high and challenging to meet. Endurance running is considered a weight sensitive sport, leading to a high prevalence of eating disorders and disordered eating in these athletes, making the importance of dietary intake even more significant. Although there is significant research conducted on endurance running, there is a lack of nutrition research conducted specifically on the sport of ultrarunning. In addition, there is a lack of research conducted specifically on female athletes. There is even scarcer research conducted on female ultrarunners. On the nutrition research that does exist on ultramarathon runners, there are very few studies conducted on the day-to-day dietary intake in this population during training. To the best of our knowledge, there are no studies that look at the relationship between dietary intake and disordered eating attitudes in this population. 22 participants completed the entirety of the study. Each participant filled out two questionnaires: a background and training questionnaire and the Eating Attitude Test-26 (EAT-26). Participants then completed five consecutive days of food, fluid, and exercise tracking using the Cronometer app. The majority of participants failed to meet their minimum energy and carbohydrate needs, but over half of participants met their minimum protein needs. 22.7% of the participants displayed behaviors/attitudes related to disordered eating. EAT-26 scores were not related to energy, carbohydrate, or protein intake, nor were they related to running volume. The results of this study suggest that female ultrarunners are not consuming adequate energy or carbohydrates to support their increased training loads. Due to the low prevalence of disordered eating attitudes, inadequate fueling behaviors are likely from unintentional mismatch in expenditure and intake and lack of fueling education
Influence of Family Structure on Eating Disorders and/or Disordered Eating Behavior
No full textObjective: Research has shown a correlation between children in single parent homes and the development of emotional and behavioral disturbances, but little research has been done analyzing the prevalence of eating disorders. This research study aims to analyze how different household dynamics psychologically influence children, and if they are more likely to develop an eating disorder in one dynamic over the other. Methods: A research survey was created using Qualtrics and participants were included if they were at least 18 years old, had grown up under their parent(s) care until at least 18 years of age and had a history of or currently engage in an eating disorder/disordered eating behaviors. All requirements for participation were listed with the survey link and repeated in the consent section of the survey. The survey included 26 questions designed to capture information on the participants' personal and familial psychiatric medical history, eating disorder/disordered eating behavior, age of eating disorder development, age of eating disorder recovery (if applicable), household structures role in eating disorder development, main influence for eating disorder development, and various life stressors contributing to the development of their eating disorder. The survey also contained questions about the frequency and prevalence of disordered eating symptoms to evaluate severity. The research survey was posted to five different reddit forums after receiving approval to post the survey from that forum's moderator. Additionally, The National Alliance on Mental Health (NAMI) agreed to distribute information about the research survey to NAMI state and local leaders through email and their website. Results: A total of 197 participant responses were collected and included in the data analysis. The research hypothesis was that individuals with an eating disorder/disordered eating will have increased severity and earlier age of onset from single parent households versus double parent households due to increased stress and responsibility placed on the child. However, the results showed that there was no clinical significance in eating disorder severity or age of eating disorder onset between single versus double parent households. Despite that, one of the most significant results from this study was that participants had decreased Anorexia Nervosa (AN) severity when parents were included in their support system. An earlier age of eating disorder onset was found to be clinically significant for those that identified with AN at both lower and higher annual household incomes. Growing up with social isolation and living with a family member(s) with mental illness were the common life stressors that contributed to their eating disorder the most, and that mothers were the main influence for the development of their eating disorder/disordered eating. Conclusion: The research study emphasized the importance of examining AN severity based on frequency of disordered eating behaviors, which is how Bulimia Nervosa (BN) and Binge Eating Disorder (BED) severity are determined by the DSM-5. The study further supports previous literature findings of how growing up lack of a support system and mothers with an eating disorder/dieting behavior are significant risk factors for eating disorders/disordered eating development in their children. The results identified that including parents in the support system can decrease AN severity. Future research should expand on how to provide resources and coping skills for children whose mother is the main cause of their eating disorder. Additionally, research should strive to identify barriers for parents being involved in the support system since this serves as a potential avenue for early detection/prevention of eating disorders/disordered eating in these children
Promoting Counselor Wellness: A Mindful Response to Covid-19-Related Stressors
No full textThe purpose of this study was to explore whether the introduction of a four-week mindfulness-based intervention into a counseling program accredited by the Council for Accreditation of Counseling and Related Programs (CACREP) could increase wellness and reduce compassion fatigue, secondary traumatic stress, and burnout in clinical mental health counseling students enrolled in an internship. A single-subject-research design was used to collect pre-and post-test data, which indicated that while counseling education students who engaged in mindfulness-based practice did not experience a change in overall wellness, several second-order and third-order wellness factors that indicated significantly positive increases. Comparison scores pre- and post-test for Burnout and Secondary trauma remained consistent, with a noted decrease in the Compassion Satisfaction score. Independent of research results, was the low participant response rate (38%) and high attrition rate (60%). Students electing not to participate in the research study stated the thought of engaging in a structured wellness activity actually exacerbated their level of stress. Comparison wellness scores from prior research of counselor education students indicated the total wellness of participants in this study was significantly lower than that of counselor education students prior to the COVID-19 pandemic. These findings are important for professional counseling because the American Counseling Association (ACA, 2014) the Association for Counselor Education and Supervision (ACES, 2011) emphasize the ethical obligation of counseling supervisors, counselors, and counselors-in-training to prioritize self-care practices in order to prevent burnout. Integrating mindfulness education and mindfulness-based practices into counselor education programs can support students in prioritizing wellness. Keywords: wellness, counselor education, mindfulness-based stress reduction, mindfulness, COVID-19 mental health implications
Serving Students in a Learner-Centered Advanced Practice Nurse-led Clinic
No full textAccess to healthcare is imperative for all people. Not having healthcare access is a risk for poor health. Nursing professionals understand the critical need to promote health and prevent illness and disease. Students in college may lack knowledge of healthcare systems or may lack coverage because they are out of their parents’ medical network. To improve access to care for those who may not have healthcare options, an easily accessible on-site university nurse-led clinic utilizing the expanded practice advanced practice nurses could provide is a viable option. Not only are healthcare needs met, but students enrolled in healthcare majors have opportunities to gain valuable experience at an on-site clinic to support clinical requirements; the underlying objective of this demand feasibility study. The purpose of this project was to explore the feasibility of a learner-centered advanced practice nurse-led clinic to improve access to care. Surveys of students and interviews from key stakeholders took place to support this demand feasibility study. While the study demonstrated the lack of feasibility for the clinic, opportunities exist for students to receive expanded care, without the addition of a clinic with expanded healthcare. The literature, however, supports modifying the approach to a learner-centered advanced-practice nurse-led community clinic which may better support community needs. It is recommended that future research study community healthcare needs and access to care in the surrounding area. Keywords: nurse-led clinic, learner-centered, improved access, interprofessional learning opportunities, satisfaction, health disparitie
Evaluating the Integration of a Tobacco Treatment Specialist in Primary Care
No full textPrimary care providers play a key role in screening for tobacco smoking and assessing patients’ desire to quit. Tobacco treatment specialists (TTS) are certified experts in helping patients who desire tobacco cessation. A primary care nurse practitioner within one Midwestern healthcare organization obtained TTS certification and integrated specialized tobacco cessation visits within a primary care clinic from February 2021 to February 2022. Guided by the logic model framework, this program evaluation utilized retrospective electronic health record review to investigate efficiency and effectiveness of these visits. Thirty-three patients were included in this evaluation. Patients were referred by a provider (57.6%), nurse (15.2%), or themselves (27.3%). Patients waited an average of 13.8 days from referral to date of initial visit. Patients opted for in-person initial visits (81.8%) more than virtual visits (18.2%). A total of 73 visits were scheduled, and 8 (11%) were no-showed. Patients who referred themselves had the lowest no-show rate (5.6%) compared to those referred by a provider (12.8%) or nurse (12.5%). Six patients (18.2%) had no follow-up after their initial visit. Twenty-nine patients (87.9%) set a goal quit date. Average time until first and second follow-up timepoints was 34.6 and 130.4 days after initial visit, respectively. Cessation rates improved from 52% to 63% between first and second follow-up. TTS visits in primary care were less expensive than other primary care specialty visits and nicotine dependence specialty clinic visits. These results suggest efficiency and effectiveness and provide support for reintegration of a TTS in the primary care setting