bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing the Flipped Classroom to Enhance Nurse Practitioner Clinical Decision-Making in the Care of the Pediatric Asthma Patient
Authors: Mudd Shawna S. , Silbert-Flagg JoAnne 
Published: October 2018

Abstract
Pediatric asthma, while prevalent in primary care, relies heavily on the clinical decision-making process for diagnosis and management because of the common lack of observable symptoms on physical exam. The process of active learning through the “flipped classroom” has been shown to help engage students in the learning process. This pedagogy was implemented in a nurse practitioner course to improve clinical decision-making in the care of the pediatric asthma patient. A description of this method is described along with student feedback, methods of evaluation, and strategies for success.
Use of an Aquarium and Pump to Demonstrate Cardiac Function
Authors: Morales Kathleen A. 
Published: October 2018

Abstract
Student learning was facilitated by using an aquarium and pump to demonstrate advanced cardiac function. Evaluation of the teaching strategy was accomplished via pretest and posttest using an audience response system and students’ self-report of content comprehension. Students were asked to troubleshoot cardiac function problems demonstrated with an aquarium pump. Following the activity, students demonstrated an understanding of concepts and terminology. Overall, higher posttest scores were obtained after this demonstration.
Health Information Technology Scholars Program: From Implementation to Outcomes
Authors: Connors Helen B. , Skiba Diane J. , Jeffries Pamela R. , Rizzolo Mary Anne , Billings Diane M. 
Published: October 2018

Abstract

AIM
This article reports the development, implementation, and outcomes of the Health Information Technology Scholars (HITS) program.

BACKGROUND
HITS is one of nine faculty development collaborative projects funded by the Health Resource Service Administration to integrate information and other technologies in nursing education and practice.

METHOD
In addition to evaluating the content and context of the program, the evaluation includes descriptive statistics, goal attainment scaling, diffusion of innovation index, utilization of knowledge survey, and exemplars from scholars.

RESULTS
The HITS program developed 265 faculty across 132 nursing programs in 43 states over 5 years. HITS scholars impacted more than 59,000 students and 9,000 other faculty. These technology leaders have numerous presentations, publications, and awards.

CONCLUSION
Success of the HITS program is attributed to the strength of the faculty development collaborative partnership, the applicant selection process, and the program design.
Will BSN Students Consider a Future Nursing Faculty Role?
Authors: Bond Diana K. 
Published: October 2018

Abstract

AIM
The aim of the study was to determine the intent of baccalaureate nursing students to pursue a future nursing faculty role.

BACKGROUND
An impending nursing faculty shortage negatively affects the capacity to meet the need for nurses.

METHOD
Using the constructs of social cognitive career theory, a prospective correlational research design was used to survey prelicensure BSN nursing students regarding their intent for a future nursing faculty role.

RESULTS
Twenty-five percent of the students intend to pursue a future faculty role. The six statistically significant predictors for a future faculty role were type of nursing program (OR = 2.0), interest in the activities of a faculty role (OR = 2.3), outcome expectations-advantages (OR = 1.9), previous teaching experiences (OR = 1.7), encouragement (OR = 1.5), and outcome expectations-disadvantages (OR = 0.8).

CONCLUSION
Providing students with knowledge of the faculty role, teaching experiences, and encouragement may inspire them to pursue a future faculty role.
The Impact of Simulation Prebriefing on Perceptions of Overall Effectiveness, Learning, and Self-Confidence in Nursing Students
Authors: Chamberlain Jill 
Published: October 2018

Abstract

AIM
The aim of this study was to evaluate the impact of simulation prebriefing on nursing students’ perceptions of overall effectiveness, learning, and self-confidence.

BACKGROUND
Most research highlights debriefing as the most important component influencing learning outcomes; the focus on prebriefing is limited.

METHOD
This quasiexperimental design study compared outcomes among four groups of undergraduate students (n = 119) at two schools of nursing: no prebriefing, prebriefing with learning engagement and orientation activities, prebriefing with orientation activities, and prebriefing with learning engagement activities.

RESULTS
Perceptions of overall simulation effectiveness, learning, and self-confidence were significantly higher with prebriefing (p = .000) compared to no prebriefing. No significant distinction (p >.05) was found among the prebriefing activities.

CONCLUSION
Findings from this study support the use of learning engagement and orientation activities during prebriefing in order to enhance overall simulation effectiveness.
When the Nursing Student Also Wears Cleats: Successful Nursing Student Athletes
Authors: McDowell Betsy M. 
Published: October 2018

Abstract
Being a nursing student athlete carries both rewards and challenges. There is a dearth of nursing literature addressing the subset of nursing student athletes. This article offers the characteristics of successful nursing student athletes; the challenges they encounter; the advantages of having student athletes in the nursing student body; and the student-centered, program-centered, and institution-centered strategies that need to be in place for their success.
Life Balance in Nurse Educators: A Mixed-Methods Study
Authors: Owens Joan 
Published: October 2018

Abstract

AIM
The aim of the study was to explore relationships among nurse educator life balance, quality of life, and lived experience of life balance that may be used to develop strategies to prevent or minimize challenging aspects of the profession that lead to dissatisfaction and/or burnout.

BACKGROUND
Nurse educator balance is significant to the national nurse faculty shortage crisis. The inability to achieve life balance contributes to job dissatisfaction and burnout, which contribute to the educator shortage.

METHOD
Convergent parallel mixed-methods design.

RESULTS
Participants were found to have moderate life balance correlating with greater perceived satisfaction. Four themes emerged from the qualitative data: Support, Demands, Workload, and Personal/Time Attributes.

CONCLUSION
Findings from this study can be utilized to develop strategies to minimize the nurse educator shortage.
Effect of Unimodal and Multimodal Sensorimotor Interventions on Oral Feeding Outcomes in Preterm Infants
Authors: Rhooms Latisha , Dow Kimberly , Brandon Cara , Zhao Grace , Fucile Sandra 
Published: October 2018

Background:
Preterm infants often experience difficulty with the transition from tube to oral feeding. While many unimodal and multimodal sensorimotor interventions have been generated to optimize oral feeding skills, there has been little cohesion between interventions.

Purpose:
The aims of this systematic review were to examine the effect of sensorimotor interventions on oral feeding outcomes and to determine whether multimodal interventions lead to better oral feeding performances than unimodal interventions.

Search Strategy:
A systematic search of CINAHL, Embase, MEDLINE, and PsycINFO databases was conducted. Studies were reviewed to assess the types of interventions used to improve transition to full oral feeding, volume intake, weight gain, and length of hospital stay.

Results:
The search identified 35 articles. Twenty-six studies examined a unimodal intervention, with the majority focusing on oral sensorimotor input and the others on tactile, auditory, and olfactory input. Nine studies assessed multimodal interventions, with the combination of tactile and kinesthetic stimulation being most common. Results varied across studies due to large differences in methodology, and caution is warranted when interpreting results across studies. The heterogeneity in the studies made it difficult to make any firm conclusions about the effects of sensorimotor interventions on feeding outcomes. Overall, evidence on whether multimodal approaches can lead to better oral feeding outcomes than a unimodal approach was insufficient.

Implications for Practice:
The use of sensorimotor interventions to optimize feeding outcomes in preterm infants varies based on methods used and modalities. These factors warrant caution by clinicians who use sensorimotor interventions in the neonatal intensive care unit.

Implications for Research:
Large randomized clinical trials using a standardized approach for the administration of sensorimotor input are needed to further establish the effects on feeding outcomes in preterm infants.
Facial muscle movements encoding pain—a systematic review
Authors: Kunz Miriam , Meixner Doris , Lautenbacher Stefan 
Published: October 2018

Abstract
Facial expressions of pain are not undefined grimaces, but they convey specific information about the internal state of the individual in pain. With this systematic review, we aim to answer the question of which facial movements are displayed most consistently during pain. We searched for studies that used the Facial Action Coding System to analyze facial activity during pain in adults, and that report on distinct facial responses (action units [AUs]). Twenty-seven studies using experimental pain and 10 clinical pain studies were included. We synthesized the data by taking into consideration (1) the criteria used to define whether an AU is pain-related; (2) types of pain; and (3) the cognitive status of the individuals. When AUs were selected as being pain-related based on a “pain > baseline” increase, a consistent subset of pain-related AUs emerged across studies: lowering the brows (AU4), cheek raise/lid tightening (AUs6_7), nose wrinkling/raising the upper lip (AUs9_10), and opening of the mouth (AUs25_26_27). This subset was found independently of the cognitive status of the individuals and was stable across clinical and experimental pain with only one variation, namely that eye closure (AU43) occurred more frequently during clinical pain. This subset of pain-related facial responses seems to encode the essential information about pain available in the face. However, given that these pain-related AUs are most often not displayed all at once, but are differently combined, health care professionals should use a more individualized approach, determining which pain-related facial responses an individual combines and aggregates to express pain, instead of erroneously searching for a uniform expression of pain.
Evaluating the Efficacy and Anti-infective Effect of High-dose Intravenous Immunoglobulin Adjuvant Therapy for Acquired Aplastic Anemia Children
Authors: Bian Zhuli , Zhou Ning , Qiao Xiaohong , Lu Shuanglong , Song Xiaoxiao , Zhou Huimin 
Published: October 2018

Background:
The efficacy and anti-infective effect of high-dose intravenous immunoglobulin (HDIVIG) in severe or very severe aplastic anemia children were evaluated.

Patients and Methods:
In total, 61 patients who underwent immunosuppressive therapy were retrospectively reviewed. The non-IVIG group (30 cases) received rabbit-antithymocyte protein (R-ATG, 3 to 5 mg/kg/d, for 5 consecutive days)+cyclosporin A (CSA), and the HDIVIG group (31 cases) underwent R-ATG+CSA+immunoglobulin (1 g/kg/d, for 2 consecutive days, once a month, 6 times).

Results:
The early effective rate was higher in the HDIVIG group (P=0.020). However, the long-term effective rate and the 5-year overall survival rates difference were not statistically significant (P=0.717, 0.419). The infection rate and severe infection rate in the HDIVIG group were lower (P=0.003, 0.008). The infection-related mortality differences were not statistically significant after ATG application (P>0.05). In the HDIVIG group, 9 patients were nonresponders. Among the nonresponders, 8 patients’ first-dose IVIG was given within 7 days before ATG.

Conclusions:
HDIVIG may increase the early effective rate and reduce early infection and serious infection for aplastic anemia children, but failed to reduce the infection-related mortality.
Risk Factors for Compartment Syndrome in Pediatric Trauma Patients
Authors: Sees Jennifer A. , Cutler Gretchen J. , Ortega Henry W. 
Published: October 2018

Objective
This study aimed to identify risk factors for compartment syndrome (CS) in pediatric trauma populations.

Methods
We included patients younger than 19 years treated at trauma centers contributing to the National Trauma Data Bank between 2009 and 2012. Multivariable logistic regression was used to examine the association between risk factors and the development of CS. The final model adjusted for age, sex, race, number of comorbidities, Glascow Coma Scale, Injury Severity Score, mechanism of injury, and fracture of the lower limb.

Results
A total of 341,238 patients were eligible for analysis, and 896 patients developed CS (0.3%). In adjusted regression models, older patients had significantly higher odds of CS compared with patients 1 years or younger (odds ratio [OR], 3.29 [95% confidence interval [CI], 1.29–8.37; 2–6 years]; OR, 7.55 [95% CI, 3.08–18.55 [7–12 years]; OR, 10.34 [95% CI, 4.26–25.09 [13–18 years]). Male patients had significantly increased odds of CS compared with female patients, as did patients with lower limb fractures compared with patients without lower limb fractures (OR, 1.93 [95% CI, 1.56–2.40]; OR, 7.61 [95% CI, 6.48–8.94]; respectively). Finally, patients with a firearm injury had higher odds of CS compared with other mechanisms of injury (OR, 3.51 [95% CI, 2.70–4.56]).

Conclusions
Older pediatric trauma patients, male patients, and those with lower limb fractures and firearm injuries have increased odds of CS. Information on risk factors can be used to help identify patients most likely to develop CS, facilitating timely diagnosis and treatment.
Practice Pattern Variation in Test Ordering for Low-Acuity Pediatric Emergency Department Patients
Authors: Doctor Kaynan , Breslin Kristen , Chamberlain James M. , Berkowitz Deena 
Published: October 2018

Objectives
Rising costs in healthcare have focused attention on interventions to optimize efficiency of patient care, including decreasing unnecessary diagnostic testing. The primary objective of this study was to determine the variability of laboratory and radiology testing among licensed independent providers (LIPs) with different training backgrounds treating low-acuity patients in a pediatric emergency department (PED).

Methods
We performed a retrospective review of the electronic health records of all encounters with patients 21 years or younger, triaged as low-acuity, visiting 2 urban, academic PEDs from January 2012 to December 2013. We calculated frequency of orders for specific tests, including complete blood counts, aerobic blood cultures, urine cultures, and chest radiographs. Bivariable analyses were used to measure associations of test ordering between these LIP dyad groups: physician versus nurse practitioner (NP); physicians with pediatric emergency medicine fellowship training (PEM) versus physicians without PEM training and physicians with at least 5 years since residency graduation versus less than 5 years. We used multivariable logistic regression to adjust for potential confounders, including ED location, trainee co-management, and patient characteristics. We also performed sensitivity analyses by location.

Results
There were 148,570 total encounters treated by 12 NPs and 144 physicians, of whom 60 were PEM physicians. Seventy-three physicians had 5 or more years of experience. Testing rates per patient encounter ranged from 0% to 40% for individual providers. In bivariable analyses, testing was more likely when the LIP was a physician (odds ratio [OR] = 1.2, 95% confidence interval = 1.1–1.2) or PEM trained (OR = 1.3, 1.2–1.3). In multivariable analyses, testing was more likely for encounters with PEM providers (adjusted OR [AdjOR] = 1.2, 1.1–1.3). A sensitivity analysis on a subset of encounters seen exclusively at our PED-based urgent care revealed that testing was also more likely for encounters seen by PEM physicians (AdjOR = 1.5, 1.4–1.7) and with NPs (AdjOR = 1.2, 1.1–1.4) compared with physicians.

Conclusions
Our study identified substantial variation in test ordering patterns for LIPs treating low-acuity patients. There were significant differences in ordering practices between providers from different training backgrounds, most significantly when comparing PEM with non-PEM providers. Further research should examine interventions to standardize practice across disciplines.
Unsupervised Machine learning to subtype Sepsis-Associated Acute Kidney Injury
Authors: Chaudhary Kumardeep , Duffy Aine , Poojary Priti , Saha Aparna , Chauhan Kinsuk , Do Ron , Van Vleck Tielman , Coca Steven G. , Chan Lili , Nadkarni Girish N. 
Published: October 2018

AbstractObjectiveAcute kidney injury (AKI) is highly prevalent in critically ill patients with sepsis. Sepsis-associated AKI is a heterogeneous clinical entity, and, like many complex syndromes, is composed of distinct subtypes. We aimed to agnostically identify AKI subphenotypes using machine learning techniques and routinely collected data in electronic health records (EHRs).DesignCohort study utilizing the MIMIC-III Database.SettingICUs from tertiary care hospital in the U.S.PatientsPatients older than 18 years with sepsis and who developed AKI within 48 hours of ICU admission.InterventionsUnsupervised machine learning utilizing all available vital signs and laboratory measurements.Measurements and Main ResultsWe identified 1,865 patients with sepsis-associated AKI. Ten vital signs and 691 unique laboratory results were identified. After data processing and feature selection, 59 features, of which 28 were measures of intra-patient variability, remained for inclusion into an unsupervised machine-learning algorithm. We utilized k-means clustering with k ranging from 2 – 10; k=2 had the highest silhouette score (0.62). Cluster 1 had 1,358 patients while Cluster 2 had 507 patients. There were no significant differences between clusters on age, race or gender. We found significant differences in comorbidities and small but significant differences in several laboratory variables (hematocrit, bicarbonate, albumin) and vital signs (systolic blood pressure and heart rate). In-hospital mortality was higher in cluster 2 patients, 25% vs. 20%, p=0.008. Features with the largest differences between clusters included variability in basophil and eosinophil counts, alanine aminotransferase levels and creatine kinase values.ConclusionsUtilizing routinely collected laboratory variables and vital signs in the EHR, we were able to identify two distinct subphenotypes of sepsis-associated AKI with different outcomes. Variability in laboratory variables, as opposed to their actual value, was more important for determination of subphenotypes. Our findings show the potential utility of unsupervised machine learning to better subtype AKI.
Aerodynamic analysis of nonuniform trailing edge blowing
Authors: Liang Dong , Wang Wenjie , Thomas Peter J. 
Published: October 2018

Purpose
Numerical and experimental results for different oncoming base-flow conditions indicate that nonuniform trailing edge blowing (NTEB) can expand the performance range of compressors and reduce the thrust on the rotor, while the efficiency of the compressor can be improved by more than 2 per cent.

Design/methodology/approach
Relevant aerodynamic parameters, such as total pressure, ratio of efficiency and axial thrust, are calculated and analyzed under conditions with and without NTEB. Measurements are performed downstream of two adjacent stator blades, at seven equidistantly spaced reference locations. The experimental measurement of the interstage flow field used a dynamic four-hole probe with phase lock technique.

Findings
An axial low-speed single-stage compressor was established with flow field measurement system and nonuniform blowing system. NTEB was studied by means of numerical simulations and experiments, and it is found that the efficiency of the tested compressor can be improved by more than 2 per cent.

Originality/value
Unlike most of the previous research studies which mainly focused on the rotor/stator interaction and trailing edge uniform blowing, the research results summarized in the current paper on the stator/rotor interaction used inlet guide vanes for steady and unsteady calculations. An active control of the interstage flow field in a low-speed compressor was used to widen the working range and improve the performance of the compressor.
Prioritisation of factors contributing to human error for airworthiness management strategy with ANP
Authors: Yazgan Ebru , Yilmaz Ayşe Kucuk 
Published: October 2018

PurposeAirline business management is set on airworthy strategy. Airline sustainability depends upon corporate-based airworthy strategy as airworthiness is the base to any airline business management and strategy. An airline can ensize its corporate sustainability if it has airworthiness strategy and risk management. The main condition to survive in the airline business is to maintain airworthiness with the fleet, maintenance and corporate-risk management. Aircraft maintenance technician (AMT) has a dual role in aircraft maintenance system as the source of failure in maintenance process via his volatility and unmanageable qualifications and secondly source of manager of maintain airworthiness of the aircrafts in airline. Situational awareness of managers about both limitations and qualifications of human factors is vital determinant to the decision-making process in aviation. Although continuously improving in related literature, one of the biggest weaknesses of the current methods of AMT error or performance is that the ability to model the reciprocal effects of the factors affecting the fault is limited. For this reason, this study aims to develop an analytic network process (ANP) model that takes into account the effects of mutual dependences among factors.Design/methodology/approachFirstly, with the help of experts and extensive literature, 67 factors that contributed to AMT error are identified and grouped. Then, the factors identified as eligible criteria and sub-criteria that contributed to the AMT errors are determined. In this study, the weights of identified criteria that have influence on AMT error try to determine by using ANP method. ANP is the common method to solve multi-criteria decision-making problems and is used to calculate priorities of factors. Criteria determined in this study are classified into three main clusters: “individual-related criteria”, “working environment-related criteria” and “organisational-related criteria”. These main clusters include 15 sub criteria such as communication, documentation (quality/updating/availability) and peer pressure.FindingsThe result of this study shows that time pressure, organisational culture, safety culture and supervision are the most important criteria that contributed to AMT error. Their weights are 0.207, 0.172, 0.102 and 0.094, respectively.Originality/valueThere are many difficulties and limitations in measuring the factors that have an influence on AMT errors. For this reason, the weights of criteria and sub-criteria necessary are determined using ANP, and in this manner, it is possible to make better decisions in this process as ANP is a multi-criteria decision-making technique that considers qualitative factors in decision-making problems. The factors’ taxonomy determined as a result of the expert opinions and the extensive literature and the ANP model developed taking into account the dependencies between the factors will contribute to the literature.