IMPACT OF AN EDUCATIONAL INTERVENTION ON PROVIDER PERSPECTIVES ABOUT THE USE OF PHENOBARBITAL IN THE MANAGEMENT OF ALCOHOL WITHDRAWAL SYNDROME

Twaddell, Kimberly. Impact of an educational intervention on provider perspectives about the use of phenobarbital in the management of alcohol withdrawal syndrome. Published Doctor of Nursing Practice scholarly research project, University of Northern Colorado, 2023. Alcohol withdrawal syndrome (AWS) is a clinical diagnosis that occurs when an individual who regularly consumes alcohol either reduces or stops consumption. Complications of AWS include admission to the intensive care unit, prolonged hospitalization, and increased risk of infection and mortality. These complications might lead to poor patient outcomes and increased healthcare costs. Currently, the standard of care in managing this inpatient population includes supportive and pharmacological interventions with sedatives such as benzodiazepines. However, recent research found that a long-acting barbiturate, phenobarbital demonstrated superiority in reducing both hospital length of stay and progression of AWS symptoms when compared to benzodiazepines. Healthcare providers, such as advanced practice providers and physicians, are responsible for prescribing medications to manage AWS. However, without education about the recent research findings of phenobarbital, healthcare providers might be underutilizing phenobarbital in the management of this serious condition. The purpose of this Doctor of Nursing Practice scholarly project was to evaluate if an evidence-based educational intervention delivered to advanced practice providers and physicians at a level one trauma center would influence their knowledge, attitudes, and intention to use an existing phenobarbital order set for the management of AWS among the adult inpatient population. As guided by the knowledge attitude practice model, this study had a pre-posttest design with a virtually delivered iii educational intervention based upon an integrated literature review that discussed the safety of phenobarbital and its superiority in the management of AWS among the inpatient population. The impact of the intervention was measured using a modified version of the Continuing Professional Development Reaction questionnaire

Molecular Interactions between MUC1 Epithelial Mucin, β-Catenin, and CagA Proteins

Interleukin (IL)-8-driven neutrophil infiltration of the gastric mucosa is pathognomonic of persistent Helicobacter pylori infection. Our prior study showed that ectopic over-expression of MUC1 in human AGS gastric epithelial cells reduced H. pylori-stimulated IL-8 production compared with cells expressing MUC1 endogenously. Conversely, Muc1 knockout (Muc1−/−) mice displayed an increased level of transcripts encoding the keratinocyte chemoattractant (KC), the murine equivalent of human IL-8, in gastric mucosa compared with Muc1+/+ mice during experimental H. pylori infection. The current study tested the hypothesis that a decreased IL-8 level observed following MUC1 over-expression is mediated through the ability of MUC1 to associate with β-catenin, thereby inhibiting H. pylori-induced β-catenin nuclear translocation. Increased neutrophil infiltration of the gastric mucosa of H. pylori-infected Muc1−/− mice was observed compared with Muc1+/+ wild type littermates, thus defining the functional consequences of increased KC expression in the Muc1-null animals. Protein co-immunoprecipitation (co-IP) studies using lysates of untreated or H. pylori-treated AGS cells demonstrated that (a) MUC1 formed a co-IP complex with β-catenin and CagA, (b) MUC1 over-expression reduced CagA/β-catenin co-IP, and (c) in the absence of MUC1 over-expression, H. pylori infection increased the nuclear level of β-catenin, (d) whereas MUC1 over-expression decreased bacteria-driven β-catenin nuclear localization. These results suggest that manipulation of MUC1 expression in gastric epithelia may be an effective therapeutic strategy to inhibit H. pylori-dependent IL-8 production, neutrophil infiltration, and stomach inflammation

Parent education needs of infants with complex life-threatening illnesses

Infant morbidity and mortality continues to be a significant problem in the U. S. Preterm birth and/or low birth weight and congenital anomalies are primary causes of infant morbidity and mortality. Analysis of an existing study was done on data from a prospective longitudinal, case based, mixed-methods research study to examine learning needs of parents in the Neonatal Intensive Care Unit (NICU) whose infants were born with complex cardiac anomalies or born extremely premature. The principles of Knowles' Theory of Adult Learning were used to frame the study and findings. Systematic review of the parent and provider interview transcripts from six cases and nurse-kept Interdisciplinary Patient and Family Education Records was conducted to determine parent education needs and provider given information during and after the infant's hospitalization. Findings revealed the theme of parents wanting to answer the question, `What is going on with my baby's care?' while information given by providers was classified under the theme `Whose Team are you on?' Resources utilized to find information by parents were explained by the theme, `Help me Learn'. Contextual variables of parents were also noted to impact learning needs of parents depending on whether the infant was hospitalized or discharged from the hospital and were grouped into themes of `Issues Before the Infant's Birth' and `Adjustment to Everyday Life'. Providers need to be aware of the learning needs of parents, potential factors that may influence this learning, and to consider these needs when giving infant care

Exploring Pedestrian Counting Procedures

DTFH61-13-D-00016Clear and comprehensive information about pedestrian travel patterns is critical to multimodal transportation planning, programming, and management. This report covers existing guidance and best practices to recommend strategies for accurate, timely, and feasible measurement of pedestrian travel. Recommendations include: 1) expand the use of multi-day/multi-week counts to reduce estimation error rates, and rotate counts around the network; 2) validate equipment at installation and regularly thereafter; 3) tailor quality checks appropriate for low volume versus high volume locations; 4) compute bias compensation factors (e.g., occlusion adjustment factors) to account for limitations related to equipment and locations; and 5) conduct both short-duration and continuous counts to fully consider temporal and spatial aspects of pedestrian traffic patterns

Trash to Table: Pleurotus pulmonarius Cultivation on Spent Coffee Grounds

This study investigated the potential for using spent coffee ground waste as a substrate material for Pleurotus pulmonarius, Phoenix Oyster mushroom cultivation. As a college campus, Loyola University Chicago produces vast amounts of coffee waste that, even when composted, contributes to carbon emissions. By diverting this waste product to hyper-local food production, we can hope to help further close the loop of Loyola’s food system. The results of the study suggest that coffee grounds on their own may not be a good candidate for a substrate, but as a supplement for more carbon-rich substrates they do have some promise

Assessing the developmental and learning needs of kindergarten children: construction, validation, and impact of a reliable in-school kindergarten screening instrument

A continuing problem in early childhood education has been a gap between concern for the full range of individual differences among kindergarten children and equal access to suitable assessment with appropriate intervention and instruction to accommodate these differences. The focus of this inquiry is issues associated with screening kindergarten children at entry to formal schooling, validation of a multifaceted performance assessment to identify kindergarten children's developmental and learning needs, and the impact of consequential decisions. The instrument developed in this study provides quantitative and qualitative results to guide referrals and instruction. Screening categories are: Outside Motor, Fine Motor, Language, Paper/Pencil and Reasoning, Personal Characteristics. Items are familiar criterion kindergarten tasks at which children age 4.6-6.0 would typically be expected to demonstrate success at the independent level of function or as necessary, with help. Screening sessions took place in the children's familiar school and classroom setting, and were completed for a whole class (divided into four groups), usually within two hours. Evaluation, scoring and interpretation of results were completed by teachers and the researcher. Specific scoring criteria are defined, minimal, and validated. The instrument was longitudinally validated with different comparison samples over three years, (1993,1995,1996). The Combined Samples totalled 776 children screened early in the year and 833 children late in the year, in 15 city, suburban or rural schools. Parent surveys informed issues such as readiness, preschool experience, and sample descriptives such as developmental milestones, medication, and behaviour. Classroom teachers (year one for the 1993 and 1995 Samples and years two and three for the 1993 Sample), were surveyed regarding those students' subsequent attainments to further inform the interpretation of their original early year kindergarten screening results. Evidence was obtained of internal consistency and the reliability of scores over time and across contexts and evaluators. Full tabulations of scores are tabled by whole samples and each school population, and by age, gender, language (English / ESL), and time of year within samples and schools. Target scores signalling specific risk are presented. Study results indicated in-school kindergarten screening can fairly evaluate and identify the developmental and learning needs of each child screened and differences among the children. School mean gains, from early to late screening results, indicated instructional interventions based upon assessed needs have positive outcomes for children

The reported shared experiences of six single mothers raising sons

The purpose of this research was to explore the life of single-mothers raising boys. The focus of this research was to provide information of life experiences for women who raised sons by themselves. The study also showed effects of divorce on single-mothers, pointed out experiences specific to raising boys, and looked at the issue of support. The study involved interviewing divorced single-mothers with standard, open-ended questions about raising boys. The questions discussed such issues as their relationships with their sons, and what types of support, if any, they had while they raised their sons. Participants included single-mothers who had not remarried, who were college graduates and whose language of communication was English. The interviews were then recorded and transcribed. The findings indicate that support to the mother does matter. The majority of the mothers interviewed had support for themselves and for their child. In most of the cases where support was offered, the primary figure was another female. In two-thirds of the cases, the other adult support figure was the grandmother. In one other case, it was the mother\u27s daughter. Much of the literature states that outcomes on the lives of boys raised by single divorced mothers should be heavily impacted by problems in their lives (Amato & Keith, 1991). The 6 boys of the mothers interviewed here were not. While 4 of the mothers also had girls, certain issues were specific to raising boys. While 3 of the boys were young, 3 were over the age of 18 and their lives had not followed the prevailing research. This study indicated that for this particular group of single-mothers, support from others, determination and hard work on the part of the mothers, have made a difference in the lives of their sons. By providing support to the mother, support was made available to the son