Net Energy Index: A New Way To Measure Energy Efficient Buildings

Energy efficiency indexes are useful for providing tangible measurements of energy efficiency in buildings. Buildings use approximately 70% of all electricity in the USA. Using that energy efficiently has two primary benefits: limiting greenhouse gas emissions and reducing grid strain. Utilizing local renewable energy sources contributes to the same benefits. Currently, there is no index that considers renewable energy sources when measuring energy efficiency. Therefore, this paper proposes the Net Energy Index, which compares the net power usage of a building to the floor area of the building in order to determine energy efficiency. If renewable energy supplies power to a building, this index is not only useful and justified, but it is also practical through advances in energy meters

An Examination of Social Media and the Tripartite Influence Model of Body Image Disturbance

The Tripartite Influence Model of body image disturbance demonstrates that parents, peers, and media play a role in the development of body image dissatisfaction and eating disorder psychopathology. Research suggests that parents, peers, and media play direct roles on the development of body dissatisfaction and eating disorder psychopathology in females as well as indirect roles through mediated relationships with appearance comparisons and thin ideal internalization. A form of media gaining recent attention is social media. Although there is limited research on social media and body image, studies suggest that use of social media is related to body dissatisfaction and eating disorder psychopathology. The current study examined the relationship between social media use, body image dissatisfaction, and eating disorder psychopathology using the conceptual framework of the Tripartite Influence Model. Participants were 746 undergraduate females of ages 18-30 at three Southern California universities and one university in North Dakota. Results indicated that there was a small, positive relationship between social media use and body dissatisfaction. Appearance comparison negatively moderated the relationship between social media use and body dissatisfaction. There was no relationship found between social media use and eating disorder psychopathology. These findings highlight the need to further examine the relationships found between social media use and body dissatisfaction. The impact of social media use on specific cognitive processes, such as appearance comparisons and maladaptive thoughts, can be targeted in future interventions to address body image and eating disorder psychopathology

The Effects of Appearance-Based Reality Shows on Body Image

Media seems to play the largest role in transmitting messages regarding societal standards of attractiveness; especially in reinforcing the thin ideal for females. There is strong evidence indicating that females who are more likely to make appearance comparisons with thin images in the media often experience negative outcomes. Research has shown that increased exposure to thin images in the media is associated with higher body dissatisfaction and eating disorder features. A form of media that has been given little research attention is reality television, specifically appearance-based reality television. The current study examined the effects of viewership of appearance-based reality television shows on body image and eating behaviors. Participants were 154 undergraduate females of ages 18-25 at two Southern California universities. Results indicated that although participants reported lower levels of viewership of cosmetic surgery shows and fashion, style, and self-improvement makeover shows, a small positive relationship was found between viewership of fashion, style, self-improvement shows and thin ideal internalization. However, no relationships were found for either type of reality show and body dissatisfaction. There were significant relationships between viewership of cosmetic surgery reality shows and several features of eating disorders, including restrictive dieting, eating concerns, weight concerns, and shape concerns. Furthermore, social appearance comparisons, thin ideal internalization, and body dissatisfaction were significant predictors of appearance comparisons with reality television. These findings highlight the need to further examine the relationships found between viewership of appearance-based reality television shows, body image, and eating behaviors. It is likely the impact of such media depends on the occurrence of specific cognitive processes, such as appearance comparisons and thin ideal internalization, which can be targeted in future intervention

Hepatoblastoma in a patient with Goldenhar Syndrome

Goldenhar Syndrome (GS), also known as oculo-auricular vertebral syndrome, is a congenital defect that occurs in 1 of 5,000 births characterized by the underdevelopment of the ears, soft palate, lip, and mandible due to an anomaly of the first and second branchial arches. Hepatoblastoma is the most common primary liver tumor in the pediatric population. However, it is still considered a rare malignancy because liver cancers only account for 1% of childhood cancers. Most children with hepatoblastoma are asymptomatic, however we describe a 2-year-old girl with Goldenhar Syndrome diagnosed with hepatoblastoma after experiencing abdominal pain and constipation. Findings from the case can further support the argument for an association between Goldenhar Syndrome and hepatoblastoma

Nursing programs strive for an increase in first time NCLEX pass rates for students

Advance For Nurses, 8(16): pp. 22

Quality Improvement Project to Increase Hepatitis C Virus Screening for Ambulatory GME Internal Medicine Clinic Patients

Background: In 2020, CDC established new guideline expanding Hepatitis C virus (HCV) screening to all adults aged 18 to 79 years. Our QI project objective is to enhance HCV screening amongst the UTRGV-DHR IM department by establishing suitable reminders and educational sessions. Methods: We reviewed HCV screening status of all adult patients 18 to 79 years old from June 1st 2020 to December 1st 2020. We then provided one lecture on the new screening recommendation from CDC 2020 guideline. We also encouraged residents to educate patients on the importance of HCV screening, and to identify and overcome barriers against screening. We then measured HCV screening performed from March 1st 2021 to May 1st 2021. The primary objective is to increase HCV screening in the ambulatory setting by 50%. Results: Among 843 patients from June 1st 2020 to December 1st 2020, 219 patients were screened for HCV (26%). The results from March 1st 2021 to May 1st 2021 was 190 out 548 patients (35%). The difference was significant with p-value of 0.0005 using Chi-square statistical analysis. Conclusions: Even though we did not achieve our primary objective, HCV screening performance in our clinic had increased significantly from 26% to 35%. With this positive result, we will continue to enhance awareness among the residents by implementing didactic lectures to support evidence –based medicine practice about HCV screening. It is also important to identify the drawbacks of HCV screening including stress on patients and their family, future costs and side-effects of further testing and treatments

The effect of human simulation on student outcomes

Poster presented at the American Nursing Informatics Association and Capital Area Roundtable on Informatics in Nursing Collaborative Conference

Psychosocial interventions for supporting women to stop smoking in pregnancy

Background: Tobacco smoking remains one of the few preventable factors associated with complications in pregnancy, and has serious long-term implications for women and babies. Smoking in pregnancy is decreasing in high-income countries, but is strongly associated with poverty and is increasing in low- to middle-income countries. Objectives: To assess the effects of smoking cessation interventions during pregnancy on smoking behaviour and perinatal health outcomes. Search methods: In this sixth update, we searched the Cochrane Pregnancy and Childbirth Group's Trials Register (13 November 2015), checked reference lists of retrieved studies and contacted trial authors. Selection criteria: Randomised controlled trials, cluster-randomised trials, and quasi-randomised controlled trials of psychosocial smoking cessation interventions during pregnancy. Data collection and analysis: Two review authors independently assessed trials for inclusion and trial quality, and extracted data. Direct comparisons were conducted in RevMan, with meta-regression conducted in STATA 14. Main results: The overall quality of evidence was moderate to high, with reductions in confidence due to imprecision and heterogeneity for some outcomes. One hundred and two trials with 120 intervention arms (studies) were included, with 88 trials (involving over 28,000 women) providing data on smoking abstinence in late pregnancy. Interventions were categorised as counselling, health education, feedback, incentives, social support, exercise and dissemination. In separate comparisons, there is high-quality evidence that counselling increased smoking cessation in late pregnancy compared with usual care (30 studies; average risk ratio (RR) 1.44, 95% confidence interval (CI) 1.19 to 1.73) and less intensive interventions (18 studies; average RR 1.25, 95% CI 1.07 to 1.47). There was uncertainty whether counselling increased the chance of smoking cessation when provided as one component of a broader maternal health intervention or comparing one type of counselling with another. In studies comparing counselling and usual care (largest comparison), it was unclear whether interventions prevented smoking relapse among women who had stopped smoking spontaneously in early pregnancy. However, a clear effect was seen in smoking abstinence at zero to five months postpartum (11 studies; average RR 1.59, 95% CI 1.26 to 2.01) and 12 to 17 months (two studies, average RR 2.20, 95% CI 1.23 to 3.96), with a borderline effect at six to 11 months (six studies; average RR 1.33, 95% CI 1.00 to 1.77). In other comparisons, the effect was unclear for most secondary outcomes, but sample sizes were small. Evidence suggests a borderline effect of health education compared with usual care (five studies; average RR 1.59, 95% CI 0.99 to 2.55), but the quality was downgraded to moderate as the effect was unclear when compared with less intensive interventions (four studies; average RR 1.20, 95% CI 0.85 to 1.70), alternative interventions (one study; RR 1.88, 95% CI 0.19 to 18.60), or when smoking cessation health education was provided as one component of a broader maternal health intervention. There was evidence feedback increased smoking cessation when compared with usual care and provided in conjunction with other strategies, such as counselling (average RR 4.39, 95% CI 1.89 to 10.21), but the confidence in the quality of evidence was downgraded to moderate as this was based on only two studies and the effect was uncertain when feedback was compared to less intensive interventions (three studies; average RR 1.29, 95% CI 0.75 to 2.20). High-quality evidence suggests incentive-based interventions are effective when compared with an alternative (non-contingent incentive) intervention (four studies; RR 2.36, 95% CI 1.36 to 4.09). However pooled effects were not calculable for comparisons with usual care or less intensive interventions (substantial heterogeneity, I2 = 93%). High-quality evidence suggests the effect is unclear in social support interventions provided by peers (six studies; average RR 1.42, 95% CI 0.98 to 2.07), in a single trial of support provided by partners, or when social support for smoking cessation was provided as part of a broader intervention to improve maternal health. The effect was unclear in single interventions of exercise compared to usual care (RR 1.20, 95% CI 0.72 to 2.01) and dissemination of counselling (RR 1.63, 95% CI 0.62 to 4.32). Importantly, high-quality evidence from pooled results demonstrated that women who received psychosocial interventions had a 17% reduction in infants born with low birthweight, a significantly higher mean birthweight (mean difference (MD) 55.60 g, 95% CI 29.82 to 81.38 g higher) and a 22% reduction in neonatal intensive care admissions. However the difference in preterm births and stillbirths was unclear. There did not appear to be adverse psychological effects from the interventions. The intensity of support women received in both the intervention and comparison groups has increased over time, with higher-intensity interventions more likely to have higher-intensity comparisons, potentially explaining why no clear differences were seen with increasing intervention intensity in meta-regression analyses. Among meta-regression analyses: studies classified as having 'unclear' implementation and unequal baseline characteristics were less effective than other studies. There was no clear difference between trials implemented by researchers (efficacy studies), and those implemented by routine pregnancy staff (effectiveness studies), however there was uncertainty in the effectiveness of counselling in four dissemination trials where the focus on the intervention was at an organisational level. The pooled effects were similar in interventions provided for women classified as having predominantly low socio-economic status, compared to other women. The effect was significant in interventions among women from ethnic minority groups; however not among indigenous women. There were similar effect sizes in trials with biochemically validated smoking abstinence and those with self-reported abstinence. It was unclear whether incorporating use of self-help manuals or telephone support increased the effectiveness of interventions. Authors' conclusions: Psychosocial interventions to support women to stop smoking in pregnancy can increase the proportion of women who stop smoking in late pregnancy and the proportion of infants born low birthweight. Counselling, feedback and incentives appear to be effective, however the characteristics and context of the interventions should be carefully considered. The effect of health education and social support is less clear. New trials have been published during the preparation of this review and will be included in the next update