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54-LB: Control Yourself: Impact of Self-Regulation on Diabetes Management in Adolescents
No full textDiabetes 2020;69(Supplement_1):54-LB https://doi.org/10.2337/db20-54-LB
Adolescents have the poorest blood sugar control compared to other age groups (Foster et al., 2019). Adolescence is also a period of developing self-regulation (SR) abilities, defined as the ability to manage thoughts, emotions, and actions to achieve a desired outcome (Eisenberg, 2019). The attention, planning, and decision making required for optimal T1D management is both cognitively and emotionally draining on the developing system of adolescents, which may be contributing to difficultly with diabetes management and glycemic control (Duke & Harris, 2014). This project examines the relationship between specific aspects of SR, including executive functions and affect; and T1D outcomes, including diabetes management behaviors and HbA1c. As part of an ongoing clinical trial (NCT03688919), adolescents (13-17 yo) diagnosed with T1D for ≥ 6 months with HbA1c ≥ 7.0 were recruited from diabetes clinics (n = 56). They completed baselines measures of self-regulation including the Behavior Rating Inventory of Executive Functioning, Positive and Negative Affect Schedule for Children, and self-reported diabetes management behaviors. HbA1c was also collected.
Parent reported cognitive aspects of SR were negatively related to number of insulin boluses per day, specifically attentional shift, task completion and planning, (r(47)= -.36, -.31, -.33 respectively, all p \u3c .05); however, no association was found between inhibition, self-monitoring, and working memory and diabetes outcomes (p \u3e.05). With regard to emotional aspects of SR, positive affect, including excitement, enthusiasm, pride, determination, and activation (r(47)= .34, .33, .36, .31, .29 respectively, all p \u3c .05) were positively related to number of insulin boluses per day. No aspects of SR were related to blood glucose testing behaviors or HbA1c. SR in adolescents may be an important factor in successful T1D management. With evidence-based approaches, SR may be an optimal target for intervention
Postoperative Vital Signs: Traditional Versus Evidence Based
Get PDFThis study compares the current standard vital sign frequency in postoperative recovery patients to an investigator-designed vital sign algorithm, the Trax Algorithm. This tool guides nursing care based on assessments of the postoperative patient to determine appropriate vital sign frequency
Design for Self-Care
No full textSelf-care is a process with which all people will engage at some point in their lives, whether healthy, healing from an acute health situation, or living with chronic illness. As such, there are different types of self-care with unique components and challenges. Each challenge presents an opportunity to design interventions to improve the process and outcomes of self-care. This chapter describes the key actors, challenges, and solutions presented in human factors literature addressing self-care
Successful Pharmacist Intervention To Optimize Guideline Directed Medical Therapy in Heart Failure Patients
Get PDFMixed method study focusing on cost effectiveness of utilizing Guideline Directed Medical Therapy using Secondary and Primary Data
No full textProceedings of IMPRS Abstract
Background and Hypothesis:
In the United States, heart failure (HF) affects an increasing 5.8 million people, with healthcare costs estimated at $31 billion (2012). Guideline Directed Medical Therapy (GDMT) is the primary method to standardize medical care of patients diagnosed with Heart Failure reduced Ejection Fraction (HFrEF). GDMT lowers mortality rates, decreases readmission, and decreases the cost, but the success of GDMT is limited by adherence. We hypothesize increased GDMT prescription through integration of a pharmacist will decrease readmissions and hospital costs.
Methods:
This mixed-methods study involved a literature review and retrospective chart review. Online databases (PubMed, Embase, and Ovid) were searched using keywords related to GDMT and economic outcomes. The research was refined using empirical research and grey literature focusing on healthcare costs and readmission rates. The chart review is part of a larger study examining the impact of integrating a pharmacist into a cardiology center on GDMT prescription. Inpatient and outpatient charges data was analyzed to determine if integration of a pharmacist led to decreased healthcare costs. This project was supported by Parkview Health and received funding from ACC Accreditation Foundation Board.
Results:
The study is currently ongoing. 70 articles and abstracts were reviewed, and 10 articles fit the criteria focusing on GDMT, healthcare cost, or readmissions. Articles supported a correlation between decreased readmission and overall healthcare cost with compliance to GDMT. Literature also supports the addition of an intervention leading to decreased readmissions. Preliminary charges data analysis showed a decrease in cost by 46% in inpatients and 35% in outpatients after pharmacist intervention.
Conclusion:
We conclude GDMT is associated with decreased healthcare costs due to decreased readmissions. Although there are multiple confounding variables when evaluating the primary data, data showed a correlation between adding intervention (i.e. pharmacist) and decreasing readmissions and overall healthcare costs. Further studies need to be conducted to show causation
Technology interference in the parenting of young children: Implications for mothers’ perceptions of coparenting
No full textTechnology devices and their characteristics have become more pervasive and enticing. The use of these new devices is common, and interruptions due to these devices are likely. This study examines the frequency of technology interference in (a) coparenting relationships—the relationship between parents as they parent their children together—during early infancy/childhood and in (b) various parenting domains (bedtime, mealtime, etc.), as well as (c) associations between technology interference and perceptions of coparenting quality as reported by 203 married/cohabiting mothers. Many mothers perceived that technology interrupted coparenting interactions on occasion, especially during unstructured parenting such as playtime. Mothers rating more interference reported worse coparenting, relationship satisfaction, and depressive symptoms. Technology interference predicted coparenting even after controlling for relationship satisfaction and depressive symptoms. Technology interference likely decreases coordination between parents, leaving some mothers feeling frustrated. Parents may be advised to critically examine and potentially regulate technology use during family interactions
An Overview of Lung and Breast Cancer Using the National Cancer Database.
No full textINTRODUCTION: The National Cancer Database (NCDB) is a clinical oncology database utilized by many researchers and clinicians internationally. We sought to investigate the various trends in data of two of the most common cancers, breast and lung, published using the NCDB.
MATERIALS AND METHODS: We selected a multitude of pre-determined variables for analysis. We then performed two separate literature searches using an advanced PubMed search builder, and the data was combined to determine each variables\u27 association with journal impact factor (IF) using both univariate and multivariate analyses.
RESULTS: A total of 191 published studies were identified. We found that a journal IF \u3e 5 was associated with a publication year prior to 2017 (univariate analysis OR 2.68, 95% CI 1.38-5.21, p-value 0.004 and multivariate analysis OR 3.47, 95% CI 1.62-7.42, p-value 0.001) and a sample size \u3e 10,000 (univariate analysis OR 3.27, 95% CI 1.43-7.50, p-value 0.005 and multivariate analysis OR 4.68, 95% CI 1.89-11.6, p-value 0.0008). Variables such as number of authors, region, cancer type, stage, treatment outcome and treatment incidence were not significant for an association with an IF \u3e5.
CONCLUSION: Based on our data, studies published after 2017 using the NCDB were associated with a lower IF. This could suggest that the quality of the NCDB data may be declining over time, or NCDB is becoming more widely used.
Does Nurse Awareness of Sepsis Increase by Participating in an Interactive Sepsis On-line Education Program?
Get PDFThis study is to evaluate if there is an increase in knowledge gain and competence in sepsis among Parkview Health Caregivers after completion of sepsis course/s offered by Apex Innovations. This includes aligning sepsis care based on Centers for Medicare & Medicaid Services (CMS) core measures and regulatory requirements to improve patient outcomes through early recognition and initiation of treatment
Dispelling Myths and Unfounded Practices About Enteral Nutrition.
No full textMany protocols and steps in the process of enteral nutrition (EN) use are not overly supported with strong research and have been done the same way over many years without questioning the use of best-practices evidence. This article reports many of the myths and unfounded practices surrounding EN and attempts to refute those myths with current evidence. These practices include those about enteral access devices, formulas, enteral administration, and complications
Consensual Sexting among College Students: The Interplay of Coercion and Intimate Partner Aggression in Perceived Consequences of Sexting.
No full textRecent empirical data suggests that the majority of adolescents and emerging adults utilize digital technology to engage with texting and social media on a daily basis, with many using these mediums to engage in sexting (sending sexual texts, pictures, or videos via digital mediums). While research in the last decade has disproportionately focused on the potential risk factors and negative consequences associated with sexting, the data are limited by failing to differentiate consensual from non-consensual sexting and account for potential influences of intimate partner aggression (IPA) and sexting coercion in these contexts. In the current study, we assessed the positive and negative consequences associated with sexting, using behavioral theory as a framework, to determine the relationship between an individual\u27s personal history of IPA victimization and the perceived consequences. Undergraduate students