Infant Outcomes in Hypertensive Women: Are there Moderating Effects of Prenatal Care and Race/Ethnicity?

Background: Hypertensive disorders of pregnancy is one of the leading causes of adverse infant outcomes. Black women are disproportionately affected by hypertensive disorders of pregnancy, and it associated adverse outcomes. Adequate prenatal care may improve adverse infant outcomes.

Faculty Professional Development Strategies Supporting Increased Scholarship.

In this article, we describe the implementation of two nursing continuing professional development activities and a 15-week online course for faculty using American Nurses Credentialing Center accreditation program criteria. The application of the criteria ensured quality continuing nursing education and assisted the provider unit in meeting its goals and outcomes. Evaluation data for the activities were collected and analyzed to determine whether the learning outcomes were met and to prepare course adjustments.

Adverse Childhood Experiences and Cardiovascular Health: An Exploration of Protective Social Determinants Among Young Adult Black Women.

This study sought to advance the literature on Black women's cardiovascular health (CVH) by examining maternal relationship, religion and spirituality, and social connections as potential protective social determinants that buffer the stress of adverse childhood experiences (ACEs). The outcome was the American Heart Association's ideal CVH score. Neither maternal relationship nor religion/spirituality was able to buffer the stress of ACEs on ideal CVH.

Hypertension and infant outcomes: North Carolina pregnancy risks assessment monitoring system data.

This study examined the risk factors that moderate the relationship between hypertension and infant outcomes or were independent risk factors in a large and diverse sample of pregnant women with and without hypertension before conception. The sample included 2,996 women, where 197 had hypertension. Black women comprised 35.

Social determinants of human papillomavirus vaccine series completion among U.S. adolescents: A mixed-methods study.

Introduction: Human papillomavirus (HPV) vaccination can significantly reduce HPV-associated cancers. In the US, two doses are recommended for vaccine completion for younger adolescents. However, series completion rates remain below the nation's goal of 80% coverage.

The National Practitioner Database Malpractice Study of Severity of Alleged Malpractice Injuries Trends 2008-2018.

This research examined trends and severity of alleged injury in malpractice over a 10-year period. An understanding of the severity of patient outcomes is important to gauge improvements in care delivery. Analysis of the National Practitioner Database (NPDB) investigated malpractice payments from 2008 to 2018 by physicians, advanced nurse practitioners, and registered nurses and assessed the relationship of years of practice on the severity of alleged malpractice injury.

Self-Care Capacity and Its Relationship to Age, Disability, and Perceived Well-Being in Medicare Beneficiaries.

Background: Self-care is a multicomponent set of capacities that influence beliefs about health and well-being.

Objectives: We examined the relationship between self-care capacity, age, and disability status with two perceptions of well-being in a cohort of Medicare beneficiaries.

Methods: The current study is part of a multisite research project to determine factors associated with cross-sectional and longitudinal morbidity and mortality trajectories observed in Medicare beneficiaries.

Factors Associated With Human Papillomavirus Vaccine Series Completion Among Adolescents.

Introduction: Most cancers associated with the human papillomavirus are preventable through vaccination. However, adolescent series completion rates are at 75.8%.

Psychiatric-mental health nursing workforce in 2018: Implications for the future.

The workforce was examined using the 2018 National Sample Survey of Registered Nurses to determine supply characteristics and perspectives of psychiatric-mental health nurses. The study looked at the success in achieving some of the workforce related recommendations of the Future of Nursing. A strong foundation exists for increasing the contributions of psychiatric-mental health nursing to overcoming shortages of mental health professionals and to improving access to mental health care.

Identifying Individuals With Intellectual Disability Within a Population Study.

Background: Much remains unknown about the longitudinal health and well-being of individuals with intellectual disability (ID); thus, new methods to identify those with ID within nationally representative population studies are critical for harnessing these data sets to generate new knowledge.

Objective: Our objective was to describe the development of a new method for identifying individuals with ID within large, population-level studies not targeted on ID.

Methods: We used a secondary analysis of the de-identified, restricted-use National Longitudinal Study of Adolescent to Adult Health (Add Health) database representing 20,745 adolescents to develop a method for identifying individuals who meet the criteria of ID.

The health status of transgender and gender nonbinary adults in the United States.

The goal of this exploratory study was to delineate health differences among transgender subpopulations (transgender women/TW, transgender men/TM, gender nonbinary/GNB adults). 2015 Behavioral Risk Factor Surveillance System data were analyzed to compare the health of three groups (TW:N = 369; TM:N = 239; GNB:N = 156). Logistic regression and adjusted odds ratios were used to determine whether health outcomes (fair/poor health, frequent physical and mental unhealthy days, chronic health conditions, and health problems/impairments) are related to group and its interaction with personal characteristics and socioeconomic position.

Application of Behavioral Risk Factor Surveillance System Sampling Weights to Transgender Health Measurement.

Background: Obtaining representative data from the transgender population is fundamental to improving their health and well-being and advancing transgender health research. The addition of the Behavioral Risk Factor Surveillance System (BRFSS) gender identity measure is a promising step toward better understanding transgender health. However, methodological concerns have emerged regarding the validity of data collected from transgender participants and its effect on the accuracy of population parameters derived from those data.

Sickle-Cell Disease Co-Management, Health Care Utilization, and Hydroxyurea Use.

Background: Sickle-cell disease (SCD) causes significant morbidity, premature mortality, and high disease burden, resulting in frequent health care use. Comanagement may improve utilization and patient adherence with treatments such as Hydroxyurea. The purpose of this study was to describe acute-care utilization in Medicaid-enrolled patients with SCD, patient factors associated with comanagement, and adherence to Hydroxyurea.

"That Guy is Gay and Black. That's a Red Flag." How HIV Stigma and Racism Affect Perception of Risk Among Young Black Men Who Have Sex with Men.

Young Black men who have sex with men's (YBMSM) attitudes and personal beliefs about themselves and their risk for HIV can be modified as a result of experiences with racism and HIV stigma. In-depth qualitative interviews were conducted with 25 HIV-negative YBMSM, aged 18-24, in North Carolina and Maryland. Data were thematically analyzed to capture participants' experiences and thoughts related to stigmatizing experiences and their perception of risk for HIV.

Health Care Experiences of Transgender Adults: An Integrated Mixed Research Literature Review.

This integrated literature review, framed by the gender affirmation framework, sought to contextualize the experiences of transgender adults interfacing with health care after the release of Healthy People 2020. The constructs of the gender affirmation framework represented 4 a priori themes used to organize the findings. The 23 articles synthesized (quantitative, n = 13; qualitative, n = 7; case studies, n = 2; and mixed methods, n = 1) revealed numerous obstacles accessing health care, discrimination from health care professionals and clinicians, restricted health insurance benefits for medically necessary care, and barriers to medically necessary care, such as cross-sex hormones, as well as primary and preventative health care.

Hospital Readmission and Costs of Total Knee Replacement Surgery in 2009 and 2014: Potential Implications for Health Care Managers.

The purpose of this article is to describe changes in hospital readmissions and costs for US hospital patients who underwent total knee replacement (TKR) in 2009 and 2014. Data came from the Healthcare Cost and Utilization Project net-Nationwide Readmissions Database. Compared with 2009, overall 30-day rates of readmissions after TKR decreased by 15% in 2014.

Health, Physical Growth, and Neurodevelopmental Outcomes in Preterm Infants of Women With Hypertensive Disorders of Pregnancy.

Objective: To compare the health, physical growth, and developmental outcomes in preterm infants of women with and without hypertensive disorders of pregnancy (HDP).

Design: Cross-sectional analysis of health outcomes; physical growth (head circumference, height, and weight) collected at birth and 2 months, corrected for prematurity; and cognitive, language, and motor skills of preterm infants of women with and without HDP.

Setting: Four NICUs in the United States.

Modeling Health Disparities and Outcomes in Disenfranchised Populations.

The Health Disparities and Outcomes (HDO) model originally created to explain the complexity of obtaining healthcare in rural settings has been revised and updated using emerging theoretical models of adversity and inequity and two decades of empirical work by the authors. With a strong orientation to explaining population-based health inequities, the HDO is applied to individuals with Serious Mental Illness (SMI), to explain their high rates of morbidity and mortality compared to the general population. Individual-, community-, and system-level factors that reflect an understanding of life-long risk, accrued hazards associated with multiple and intersecting disadvantages, and difficulty obtaining healthcare that meets accepted standards are described.

Reducing RN Vacancy Rate: A Nursing Recruitment Office Process Improvement Project.

Objective: The aim of this study was to reduce the RN vacancy rate at an academic medical center by improving the hiring process in the Nursing Recruitment Office.

Background: Inability to fill RN positions can lead to higher vacancy rates and negatively impact staff and patient satisfaction, quality outcomes, and the organization's bottom line.

Methods: The Model for Improvement was used to design and implement a process improvement project to improve the hiring process from time of interview through the position being filled.

Hospital Readmission in Total Hip Replacement Patients in 2009 and 2014.

Objective: To document changes in 30-day hospital readmission rates and causes for returning to the hospital for care in THR patients.

Design: Retrospective cross-sectional descriptive design.

Setting: Community-based acute care hospitals.

A Patient Safety Dilemma: Obesity in the Surgical Patient.

Patient safety and the delivery of quality care are major concerns for healthcare in the United States. Special populations (eg, obese patients) need study in order to support patient safety, quantify risks, advance education for healthcare-workers, and establish healthcare policy. Obesity is a complex chronic disease and is considered the second leading cause of preventable death in the United States with approximately 300,000 deaths per year.

Are International Classification of Diseases Codes in Electronic Health Records Useful in Identifying Obesity as a Risk Factor When Evaluating Surgical Outcomes?

This research addresses an important methodological issue on patient safety and obesity for the purposes of examining clinical and administrative data for the reliability of using International Classification of Diseases (ICD) diagnoses codes alone to reliably identify obesity as a comorbidity and risk factor in care and management. The findings of this research confirm ICD codes for the obese surgical populations were underutilized. Despite more than 70% of patients classified as overweight or obese, ICD-9 codes for obesity were assigned in less than 10% of the overall sample.