Awareness of Nutrition\u27s Impact on Mental Health and Ketogenic Diet’s Therapeutic Potential for Mental Illness and Other Chronic Disorders

Mental health affects millions of people worldwide, and current pharmaceutical treatment approaches often lead to worse outcomes, weight gain, and increased cardiovascular risk. The ketogenic diet offers hope in the treatment of schizophrenia and other neurological and psychiatric disorders. The aim of this project is to explore public awareness of nutritional psychiatry and the ketogenic diet’s clinical utility for various conditions including schizophrenia, mood disorders, Parkinson’s, and multiple sclerosis. Study participants (n=108) completed a 12-question survey about individual nutritional habits and current knowledge of KD. Responses were obtained from medical students, practicing healthcare professionals, college undergraduate students, and members of the general public. It was found that 74.5% of participants consciously utilize nutrition to improve their wellbeing. 84.9% of participants reported negative mental wellbeing when eating unhealthy foods. Similarly, results showed that 63.2% of individuals noted improved mental health when eating healthier food options. While 85.4% of participants agree with the statement that KD has a role in weight management, there was no significant difference in the perceived role of KD in depression and psychosis. The perceived role of KD for relieving symptoms was observed for chronic seizures, Parkinson’s and MS. The findings of this study highlight the need for future research on KD’s clinical utility in chronic disease. With greater public awareness in both the medical and non-medical communities, healthcare teams can reduce the alarming rate of metabolic syndrome that is comorbid with many chronic conditions and prevent premature deaths in severe mental illness

It’s More than Skin Deep: Evaluating Mental Health Care in Dermatology Settings

Background: There is a high prevalence of mental health comorbidities in those with dermatologic conditions given the visible nature of many conditions. However, mental health often fails to be addressed due to lack of mental health education, stigma around mental health, and lack of mental health resources for patients. Purpose: This research study aims to assess how patients and providers experience and address mental health in dermatology settings. Methods: A systematic literature review was performed analyzing the relationship between dermatologic conditions and mental health. Additionally, a survey was conducted to assess how dermatology providers approach mental health in dermatology settings. Results: The survey found that conversations surrounding mental health, screening for mental health symptoms, treating mental health issues, and referring patients to mental health services, rarely occur in dermatology settings. The research suggests that the topic of mental health needs to continue to be discussed to reduce the stigma surrounding it, specifically in the specialty of dermatology, given the high correlation between dermatologic diseases and mental health conditions. Conclusion: Findings suggest that mental health is underappreciated in dermatology settings. Additionally, barriers to mental health services remain prevalent and add difficulty to treating dermatologic patients with mental health comorbidities. Continued efforts to improve medical education to include holistic evaluation of patients, along with the implementation of mental health screening and increased utilization of mental health providers will be beneficial to ensure that mental health is adequately addressed in dermatology settings

The Efficacy of Common Prosthetic Joint Infection Prevention Strategies: A Systematic Review

Thousands of total hip and knee arthroplasty patients suffer from prosthetic joint infections every year, making them a leading cause of arthroplasty failure. As the number of these procedures continues to grow, so will the healthcare and socio-economic burden of prosthetic joint infections. A comprehensive search for up-to-date literature was completed via the PubMed database, identifying eighteen retrospective and prospective cohort studies that focused on the four prosthetic joint infection prevention methods of interest. Tobacco use cessation of all forms is an efficacious prosthetic joint infection prevention strategy. The common practices of withholding intra-articular injections prior to surgery, using prophylactic single dose cephalosporins, and using the glycemic marker of HbA1c were found to be partially efficacious but require further considerations. Surgeons should be aware of the various considerations involved in validating or discrediting their preferred prevention strategies in order to prevent prosthetic joint infection

Optimizing Nutrition Status and Patient Outcomes in Adults Receiving Post-ICU Care

Background: Nutrition interventions for hospitalized patients can provide meaningful benefit on patient recovery outcome, length of hospital admission, and overall healthcare costs. Preventing and treating malnutrition is one aspect of optimizing patient outcomes following a prolonged clinical course, including stays in the intensive care unit (ICU). Purpose: This literature review aims to address how nutrition status can be maximized for a patient’s post intensive care unit clinical course. While early enteral nutrition (EN) when appropriate is accepted as optimal care, there is little standardization for removal of devices to provide artificially administered nutrition and hydration (AANH). Methods: A comprehensive literature review was conducted using PubMed and Google Scholar, using the search terms post extubation dysphagia, malnutrition, post ICU rehab, post ICU nutrition, ICU nutrition, feeding tube in the ICU, post extubation rehab phase, and dysphagia and feeding tube. Inclusion criteria were studies that were published in 2018 or later. Systematic reviews, case studies and research prior to 2018 was excluded unless it was needed to provide appropriate historical background or context for discussion. Conclusions: In order to best time the removal of artificially administered nutrition and hydration devices to optimize patient rehabilitation and minimize determinate outcomes related to malnutrition, further research is warranted. Research should focus on assessing outcoming randomized control trials, with defined malnutrition criteria across institutions

Efficacy of Probiotics in Decreasing Rates of Necrotizing Enterocolitis and Sepsis in Preterm Neonates

Background: The incidence of preterm infants developing serious infections is a common finding in many neonatal intensive care units. Probiotics have been a supplement that has been used by numerous people to improve the microbiota of the intestine for prevention of infection. Purpose: The purpose of this literature review is to explore the efficacy of using probiotics in preterm infants for prevention of serious infections such as necrotizing enterocolitis (NEC) and sepsis. Methods: A comprehensive literature review was conducted using Lindell Library, Pub Med, Science Direct and Google Scholar. Using the search terms probiotics, probiotics in premature infants, probiotics and microbiota, probiotics and NEC in infants. Inclusion criteria were studies that were in English that were published in the last decade and studies that were trials. Exclusion criteria were studies that were not in English and research that did not help to answer the research question. Conclusions: There are many circumstances that put preterm infants at a disadvantage for developing serious infections such as prolonged hospital stay, low birth weight, early gestational age, antibiotic use and feeding method. Probiotics were found to be beneficial from numerous clinical studies in preventing serious infections. It is important for the provider to decide with the parents of the patient if the benefits of using probiotics in infants outweighs the risks of probiotic induced sepsis

The Effects of Medical Respite on Healthcare Systems for Individuals Experiencing Homelessness

Background: Homelessness is associated with elevated risks of mortality and morbidity due to infections, substance abuse, and untreated mental health conditions. Individuals experiencing homelessness often seek healthcare primarily through emergency departments, leading to increased hospital admissions and longer stays due to poor discharge planning. Medical respite care is a potential solution, providing a space for patients that are too ill for shelters, but not ill enough to stay inpatient. Purpose:The purpose of this research is to evaluate the impacts on the healthcare system when medical respite programs are available for patients facing homelessness. Methods: The current review was synthesized using data from peer-reviewed articles accessed through CINAHL, Google Scholar, and Augsburg University’s Lindell Library. Keywords included “Homelessness,” “Medical Respite,” and “Health Utilization.” Conclusions:The financial impact of medical respite programs was a recurring theme, highlighting their potential to alleviate the burden on the healthcare system. Various studies also showed that respite programs could reduce hospital readmission rates and overall healthcare costs by providing necessary post-discharge services. Long-term benefits such as improved continuity of care were also shown. Essentially, medical respite care can bridge gaps in care, improve health outcomes, and contribute to the effective management of healthcare resources when available for patients facing homelessness

Impact of Physical Intimate Partner Violence on Postpartum Depression and Breastfeeding Duration in American Indian and Alaska Native Women

In Alaska, 46 to 91 percent of American Indian and Alaska Native women have experienced physical intimate partner violence (IPV), compared to all women in other states, where the prevalence ranges from seven to 51 percent (Tjaden & Thoennes, 2000). Experiencing physical IPV has negative consequences on the mother’s physical and mental well-being, and has been associated with increased vulnerability to postpartum depression (PPD). Compared to other populations, American Indian and Alaska Native women are at greater risk for PPD due to less access to resources and less research on treatments (MacDorman, 2011). Additionally, American Indian and Alaska Native women face shared historical trauma, including cultural genocides and forced relocation (Brown, 2019; Brown-Rice, 2020). This trauma is believed to play a role in the prevalence of both physical IPV and PPD in these cultures (Rosay, 2016). Protective factors against the development of PPD after IPV also exist in these cultures, including spirituality, family values, and group unity (Kenyon & Hanson, 2012). Despite protective factors, physical IPV and PPD are detrimental to the health of mothers and could impact the mother’s choices, such as choosing to breastfeed (Hamdan & Tamim, 2012). While research shows that physical IPV and PPD separately lead to a shorter duration of breastfeeding, there is no research on how these factors contribute to breastfeeding duration in the among American Indian and Alaska Native peoples. The author sought to fill this gap in the research using the Pregnancy Risk Assessment Monitoring and Surveillance (PRAMS) Alaska 2020 dataset. Results showed that women who reported physical IPV both before and during pregnancy had more PPD symptoms than women who reported no physical IPV. The results also showed no relationships between physical IPV and breastfeeding duration, and PPD symptoms and breastfeeding duration. Findings of this study shed light on the mental health consequences of physical IPV in the American Indian and Alaska Native population. Despite significant challenges in this community, there are numerous strengths, such as spiritual factors, healing traditions, wisdom, and community support (Heck, 2018; Kenyon & Hanson, 2012)

Exploring the Implementation of a Nurse Professional Development Specialist (NPDS) in the Cardiac-vascular Ambulatory Care Setting: a Role Proposal

In the modern healthcare environment, increasing patient acuity, and ongoing staffing challenges have placed strain on nursing staff. Nurses in ambulatory care need leaders to be champions of change. The project coordinator used Jean Watson’s Theory of Human Caring as a framework to propose the addition of a Nurse Professional Development Specialist (NPDS) into the cardiac-vascular service line (CVSL) of a large-scale health care organization located in multiple suburbs and rural outreach areas of Minneapolis-St. Paul. The NPDS role aims to fill in gaps in orientation and continuing education to meet patient quality standards. Following a literature search focused on the ambulatory care environment, the nurse professional development specialty, and key concepts related to teaching and learning, a letter introducing the proposed new role, a detailed proposal document with key details regarding the rationale for the role, and an NPDS job description were created. The plan was to present these documents to the CVSL’s executive leadership team. Ultimately, the project was halted due to the abrupt announcement of nursing layoffs within the CVSL. Reflection and review of the project illustrated a need for resilience amongst nurses and strengthened work relationships to further encourage innovation. Transformational leadership skills allowed the project coordinator to identify a gap in ambulatory services and implement a process designed to improve the health of the organization

Preserving Pediatric Wellness: Enhanced Recovery After Surgery Protocols and Pain Management in Pediatric Surgery

Background: Enhanced recovery after Surgery (ERAS) protocols and multimodal pain management strategies have revolutionized perioperative care in adult surgical practice by leading to improved postoperative outcomes and better pain management. However, the adoption of these protocols to pediatric surgical care remains underexplored. Purpose: This systematic review aims to examine recent randomized clinical trials on the implementation of ERAS protocols and multimodal pain management strategies in pediatric surgical patients. Methods: A computer-based literature search of databases through Google Scholar and PubMed with manual reference searches was used to identify eligible studies. The review includes randomized controlled trials focusing on multimodal pain management and ERAS protocols’ efficacy in pediatric surgical patients. Conclusion: ERAS protocols were effective at decreasing pain levels and decreasing hospital stay in adult patients, with most studies calling for future research and implementation in pediatric surgical patients. The most effective pain management strategy was early multimodal pain management with an emphasis on a shared decision-making model. Future research emphasis was centered on adapting the same early pain intervention in pediatric patients, compared to the research that shows delayed pain management initiation. Findings highlight the urgent need to address pediatric pain management, advocating for earlier implementation of pain management strategies in this population. The analysis highlights the lack of clinical trials implemented in ERAS protocol application in this population. Recommendations for future research and clinical practice are proposed and this systematic review serves as a comprehensive resource for health care providers, researchers, and policymakers striving to enhance pediatric surgical care

The Status of Abortion Care Training for Medical Providers Amidst the Current Abortion Access Crisis: a Literature Review

Background: While a common, safe, and essential aspect of reproductive healthcare, abortions have been subject to countless legal restrictions and bans in the United States, especially after the overturn of Roe v. Wade. This has also exacerbated the current shortage of abortion providers. Within this crisis of worsening abortion access, it is imperative to appropriately train future clinicians to provide abortion care. Purpose: This literature review will investigate the status of abortion training in medical schooling. It will explore physician-specific education in abortion and look specifically at the impact of recent legal threats on the availability of this training. Finally, the review will discuss the role of non-physician clinicians in the area of abortion care, especially as this relates to expanding abortion access. Methods: A comprehensive literature review was conducted using PubMed and Google Scholar. Search terms included “abortion training,” “abortion + medical school,” “abortion + physician assistant,” and “abortion + nurse practitioner.” Major studies that contributed to this review were published after 2018 in the United States and present original survey research, observational, or prospective studies. Results: Both physicians and advanced practice clinicians (APCs) are often inadequately prepared to provide abortion care. Up to 40% of medical students and more than one in three OB-GYN residents do not receive routine abortion training, which is likely to worsen as legal bans disrupt access to this care. Research demonstrates that APCs can provide high-quality abortion care; however, limited studies reveal their training in abortion needs improvement. Conclusion: To expand abortion access and confront current abortion provider shortages, it is imperative to better equip future clinicians to provide abortions. Future research should focus on the status of abortion training for APCs, providers who may be uniquely able to expand abortion care access in their communities