6th Annual Research Week- Event Proceedings

6th Annual Research Wee

Predicting Decision-Making in Relation to Health-Risk Behavior in College Freshmen

Method/Measurements: A cross-sectional correlational design explored the relationships between decision-making, health-risk behaviors and social support systems in college freshmen. The aims of the study were: 1) to explore the relationship between decision-making and health-risk behaviors among college freshmen; 2) to determine whether or not family support and social support jointly predict decision-making among college freshmen; and 3) to ascertain whether or not the effect of family support on decision-making is different for male and female college freshmen. Measurement was collected at one time-point and participants in this study completed on-line questionnaires through a web-based online survey software application with measures of the following variables: decision-making (Adolescent Decision-Making Questionnaire); health-risk behavior (Adapted National Youth Risk Behavior Survey); and family support and social support (Multidimensional Scale of Perceived Social Support). A convenience sample of 200 freshmen aged 18 to 19 years participated from a local, private Catholic university located in Chicago. This study was approved by the institutional review board at Loyola University Chicago. Data Analysis: The primary study hypothesis was that decision-making will be associated with health-risk behaviors in college freshmen. SPSS Statistics version 24 was used to perform all statistical analyses. To test the primary hypothesis, the analysis included descriptive statistics on all study variables and correlations. Findings include positive decision-making was associated with a decrease in health risk behavior, and negative decision-making was associated with an increase in health risk behavior. The secondary and tertiary hypotheses were tested using linear regression and multiple regression analyses. Family support and social support was found to be significant predictors of positive decision-making and negative decision-making . Hence, social context played a significant role that impacted freshmen decision-making. Also, the effect of family support on positive decision-making was the same for male and female college freshmen and was statistically significant. Correspondingly, regression analysis results found that family support predicted negative decision-making in female college freshmen. Together, these findings extend the evidence that adolescence involves a period of developing decision-making processes which may help explain health-risk behavior, and more specifically, findings demonstrate a synergistic impact of social support systems on decision-making in college freshmen. Nursing and Healthcare Implications: Overall, findings from this study support the need to identify and implement interventions that may be developed to improve freshmen\u27s decision-making skills and to enhance their ability to exercise mature control over their own behavior, leading to better early college experiences. Integrated care team models, comprised of nursing professionals, especially nurse practitioners along with mental health professionals and health promotion educators have been shown to be effective in improving college students\u27 physical, psychological and emotional health. Ultimately, nurse practitioners have the unique opportunity to develop evidence-based practice guidelines to improve freshmen\u27s decision-making and coping skills while engaging in simultaneous collaborative care. The overall benefit could potentially reduce freshmen health-risk behavior thereby achieving positive health outcomes and successful educational outcomes that, in turn may result in improved undergraduate retention rates. This research, while making an important contribution to the literature, contributes to the health of college freshmen by highlighting key social support systems, hence focusing efforts on strengthening decision-making and coping skills in this subset of students

Optimizing Electronic Medication Prior Authorization: Reducing Prescription Delays

Background: Within the United States, chronic disease in children has doubled over the last 20 years. Many diseases defined as chronic (attention deficit, epilepsy, and diabetes) require daily medication regimens for optimal management. To be covered by insurance, many of these medications require prior authorization (PA) from the patients’ pharmacy benefits policy. Delays in processing and receiving PA orders can lead to worsening disease and inadequate disease management. In 2014, a pediatric academic medical center in the Midwest found that processing medications from prescription order to PA approval took nurses an average of over 90 hours. In August 2020, the organization implemented an electronic prior authorization (ePA) system that interfaced with the organization’s electronic health record (EHR). The primary goals of this implementation were to reduce medication PA turnaround times and to increase employee engagement with the ePA system. The goals of this quality improvement (QI) project are to optimize the existing ePA system with the medication PA process to reduce average medication PA turnaround times and to increase the approval rates for medication PAs by five percent. Project Design: Three interventions support the outputs of this QI project. Increase the availability of the ePA system by changing the patient and pharmacy benefits insurance matching interface logic. Reduce the number of medications falsely requiring PA by removing them from the ePA system. Increase PA processing efficiency by improving the workflow for attaching documents required for PA approval. To accomplish and measure these interventions, data reports and surveys were developed to establish baselines and to measure ePA turnaround times, PA approval rates, and user satisfaction both pre- and post-intervention. User satisfaction was measured utilizing a secure online survey emailed to ambulatory division nurses. Results: The median medication ePA turnaround pre- and post-interventions was unchanged at 36 hours. The ePA approval percentage dropped from 55.7% in June 2021 to 46.9% in August 2021. The primary QI project outcomes of reducing turnaround time and increasing the approval rate by 5% were not met. A user involvement survey was sent to 194 nurses with a response rate of 29% pre intervention and 8% post intervention. Overall user satisfaction was measured using a net promotor score which registered scores of –70 pre- and –82 post-intervention, revealing overall dissatisfaction with the ePA system. The use of an alternative ePA system outside the organization’s EHR was discovered after the QI project data was reviewed and showed that roughly 45% of ePAs were completed using this alternative system during the QI project timeframe. Recommendations: User involvement surveys measure user engagement with electronic systems and measuring user satisfaction is beneficial to providing direction for interventions as well as predicting future utilization of healthcare informatics projects. Conclusion: Though most of the goals for this QI project outcome were not met, use of the alternative ePA system confirmed the Technology Acceptance Model that users prefer the electronic system that they perceive as being the most useful. Nurses using ePA will use the system that best addresses their own user experiences regarding content, accuracy, format, timeliness, ease of use, and overall satisfaction

Retrying Leopold and Loeb: A Neuropsychological Perspective

They called it the crime of the century; in 1924 in Chicago two brilliant, well-educated, and wealthy young men kidnapped and murdered a 14-year-old boy and killed him for the thrill of it . Expert testimony was presented by several well-known psychiatrists and psychologists, but even with all their clinical insights, none could reach a conclusion about the causal relation between their disturbed childhoods and a violent senseless crime. In fact, the well-known criminal defense attorney Clarence Darrow made little mention of the extensive psychiatric and psychological workups, and the judge did not deal with it in his sentencing. A review of the findings does suggest a delusional disorder for one of the defendants and psychopathy for the other; the interaction of these two disordered personalities led to a perfect storm a confluence of factors that only in combination could result in the brutal crime. Recent developments in neuropsychology allow us to see how these two disordered personalities interacted; the neuropsychological basis of delusional disorder and of psychopathy will be explored in this presentation along with a re-imagined closing argument by their attorney

McNair Research Journal - Summer 2015

Journal articles based on research conducted by undergraduate students in the McNair Scholars Program Table of Contents Biography of Dr. Ronald E. McNair Statements: Dr. Neal J. Smatresk, UNLV President Dr. Juanita P. Fain, Vice President of Student Affairs Dr. William W. Sullivan, Associate Vice President for Retention and Outreach Mr. Keith Rogers, Deputy Executive Director of the Center for Academic Enrichment and Outreach McNair Scholars Institute Staf