Educating Staff To Empower Parental Involvement While Visiting NICU Through The SENSE Program: A Quality Improvement Project

Preterm infants in neonatal intensive care units (NICUs) face significant neurodevelopmental risks due to immature sensory systems and limited exposure to developmentally appropriate sensory input. The Supporting and Enhancing NICU Sensory Experiences (SENSE) program is an evidence-based initiative designed to structure sensory care in the NICU, providing infants with consistent, age-appropriate exposure to tactile, auditory, visual, olfactory, vestibular, and kinesthetic stimulation. This Doctor of Nursing Practice (DNP) quality improvement project aimed to implement the SENSE program through targeted education for NICU staff and evaluate its impact on provider knowledge, confidence, and observed parent engagement in sensory-based care. A total of 15 NICU professionals, including registered nurses, therapists, and clinical care staff, completed matched pre- and post-intervention surveys. Baseline data revealed that only 13% of staff felt confident guiding parents in sensory-based care, and fewer than 30% reported observing consistent use of all five sensory modalities. Common barriers included lack of time, limited training, and low parental involvement. Following a structured educational session using a slide presentation and digital QR-coded resources, all participants (100%) demonstrated improved knowledge of the SENSE program, with a substantial increase in confidence and implementation. Post-intervention, 80% of staff felt moderately or very confident in guiding parents, and 100% reported observing auditory and tactile stimulation during parent-infant interactions. Observations of olfactory and vestibular input rose from 33% and 27% at baseline to 87% and 73%, respectively. Staff perceived the training materials as helpful, and 93% agreed their educational needs were met. While time constraints and inconsistent parental presence remained concerns, participants expressed strong interest in ongoing mentorship and additional resources to sustain improvements. The results suggest that integrating structured sensory education significantly enhances staff preparedness and fosters improved developmental support for preterm infants. This project reinforces the importance of consistent, interdisciplinary sensory care in NICU settings and highlights the SENSE program as a valuable tool to guide practice change. Keywords: SENSE program, NICU, sensory-based care, neurodevelopment, preterm infants, staff education, quality improvement, parent engagement, developmental care

Cross-sectional study identifying what socio-demographic and socio-economic factors are associated with meeting the recommended physical activity guidelines in older adults

Objective: To identify sociodemographic and socioeconomic factors associated with older adults meeting recommended physical activity (PA) guidelines. Methods: This analytical, cross-sectional study used data from the 2022 National Health Interview Survey (NHIS). The study population consisted of a random sample of 8189 older adults (≥65 years). Compliance with aerobic and strengthening PA guidelines was the main outcome variable. Covariates included sex, education, income, marital status, race, housing stability, urban/rural county, household region, among others. Unadjusted and adjusted log regression analyses calculated odd ratios (OR) and 95% confidence intervals (CI). Results: Only 14.4% (n=1235) met the PA guidelines. Odds of complying decreased by 40% in non-Hispanic single/multiple races (OR 0.6; 95 CI 0.4-1.0). Men had 1.4 times higher odds (OR 1.4; 95 CI 1.2-1.6) to meet guidelines than women. Compared with bachelor graduates, the odds of adhering were 1.4 (95 CI 1.2-1.7) in graduate participants, 0.3 (95% CI 0.2-0.4) in those with less than High School, 0.4 (95% CI 0.3-0.5) for High School and, 0.7 (95% CI 0.6-0.8) for those with some college education. The odds decreased by 40% for those with an income-to-poverty ratio threshold of \u3c 1 (OR 0.6; 95 CI 0.4-0.9), 1-1.99 (OR 0.6; 95 CI 0.4-0.7), and 2-3.99 (OR 0.6; 95 CI 0.5-0.8) compared with 5 or greater. Conclusion: Healthcare providers should develop targeted interventions to meet individuals’ unique circumstances to address these inequities. Future studies could compare PA compliance across countries to understand how cultural, environmental, and policy differences impact PA levels among older adults. Keywords: physical activity guidelines, socioeconomic factors, sociodemographic factors, cross-sectional stud

A Quality Improvement Project to Mitigate Menopausal Weight Gain in Primary Care

Menopausal weight gain (MWG) is a common concern among midlife women but is often overlooked in primary care. Healthcare clinicians (HCCs) are in a key position to offer early, supportive strategies for MWG, yet barriers such as limited menopause-related knowledge, low confidence, and time constraints often prevent effective intervention. MWG typically involves increased abdominal fat and body fat redistribution, which are associated with heightened risks of cardiovascular disease, type 2 diabetes, stroke and certain cancers. It can also worsen menopausal symptoms such as hot flashes and joint pain, ultimately reducing quality of life and increasing healthcare utilization. This quality improvement (QI) project took place in a South Florida primary care practice serving women aged 40 to 60, a population commonly experiencing perimenopause or postmenopause. The project aimed to enhance HCCs’ knowledge, confidence, and clinical behaviors in addressing MWG by providing brief, evidence-based tools suited to time-limited visits. Additional goals included recognizing patients at risk and promoting nonpharmacological strategies through supportive clinician-patient conversations. Fifty-three participants (N = 53) completed a webinar focused on lifestyle-based MWG management, including physical activity, nutrition, stress reduction, sleep hygiene, and decreased intake of salt, caffeine, and alcohol. The mnemonic N.A.M.A.S.T.E. was used to support recall and implementation of these strategies. Pre- and post-intervention surveys measured changes in knowledge, confidence, and clinical behaviors. Results showed significant improvements: knowledge rose by 21.55%, confidence by 39.08%, and practice behaviors by 46.14%. Paired t-tests confirmed these gains were statistically significant (p \u3c 0.0001), with large effect sizes across all domains

Territories and Coca and Cocaine: Bolivia\u27s Drug Economy, Political Movements, and Transnational Crime (2005-2025)

This study questions whether Bolivia in the period between 2005 and 2025 should be considered a narco-state, a narco-democracy, or a new hybrid model.1 The evidence suggests that Bolivia is best described as a narco-competitive authoritarian regime, a system in which elections are held and formal democratic institutions persist, but incumbents tilt the playing field through repression, judicial manipulation, and systematic harassment of opponents, while the cocaine economy penetrates unions, regions, and state institutions.2 Presidents Evo Morales and later Luis Arce sought to build a one-party state under the Movement Toward Socialism (MAS). Human rights violations were routine, political prisoners and exiles were common, and civic spaces were restricted. Both leaders kept Bolivia deeply enmeshed in the global cocaine economy.https://digitalcommons.fiu.edu/jgi_research/1084/thumbnail.jp

Access to Robotic and Minimally Invasive Cardiac Surgery for Chronic and Congenital Heart Disease: A Scoping Review of Health Inequities

This scoping review evaluates disparities in access to minimally invasive and robotic cardiac surgery in the United States. Findings highlight inequities related to race, socioeconomic status, and hospital volume, and explore their implications for patients with chronic and congenital heart disease