Opioid sensitivity in treated and untreated obstructive sleep apnoea: a prospective cohort study.

Background: Opioid administration to patients with obstructive sleep apnoea (OSA) is controversial because they are believed to be more sensitive to opioids. However, objective data on opioid effects in OSA are lacking. We tested the hypothesis that subjects with untreated OSA have increased sensitivity to opioids compared with subjects without OSA, or with OSA treated with continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BIPAP).

Exposure to Head Impacts and Cognitive and Behavioral Outcomes in Youth Tackle Football Players Across 4 Seasons.

Importance: Repetitive head impacts have been posited to contribute to neurocognitive and behavioral difficulties in contact sport athletes.

Objective: To identify associations between cognitive and behavioral outcomes and head impacts measured in youth tackle football players over 4 seasons of play.

Design, Setting, And Participants: This prospective cohort study was conducted from July 2016 through January 2020, spanning 4 football seasons.

The Feasibility of a School Nurse-Led Mindfulness Program.

The purpose of this study was to evaluate the feasibility of a school nurse-led mindfulness program in a public school. Elementary students in an urban public school system are exposed to many stressors including poverty, family disturbances, and mental health conflicts. Previous research suggests that mindfulness interventions given by teachers promote prosocial behavior and stress reduction; however, there are no studies that have determined whether the school nurse could lead the program.

Subconcussive Head Impacts and Neurocognitive Function Over 3 Seasons of Youth Football.

Objective: To determine the association between repetitive subconcussive head impacts and neurobehavioral outcomes in youth tackle football players.

Methods: Using helmet-based sensors, we measured head impacts for 3 consecutive seasons of play in 29 male players age 9-11. Cumulative impact 's were calculated.

The Feasibility of Kangaroo Care and the Effect on Maternal Attachment for Neonates in a Pediatric Cardiac Intensive Care Unit.

Background: As survival rates in neonates with congenital heart disease have improved, research has shown they are at an increased risk for brain injury and neurodevelopmental delay. One intervention shown to have a positive impact on the development in premature and full-term newborns, as well as a positive impact on mother-infant relationship, is kangaroo care (KC). There is limited evidence to support the use of KC in infants with congenital heart disease, some of who may also be premature.

A Randomized Controlled Trial Comparing Flat Times Versus Standard Care in Pediatric Patients Post Cardiac Catheterization.

Background: Pediatric patients undergoing cardiac catheterization procedures are required to lie flat for 4 hours for femoral venous access and 6 hours for femoral arterial access. Authors of research in adults suggest the flat time for the same access can be safely reduced to 1.5 to 2 hours post procedure.

Pain Control and Positioning in Children Following Selective Dorsal Rhizotomy Surgery.

Background: A practice was changed to elevate the head of bed from day 1 to day 3 on children after selective dorsal rhizotomy (SDR) surgery to improve pain control. Multiple methods to address pain post SDR include a continuous epidural infusion, medication administration, and repositioning/distraction. The length of time for the patient to remain flat was increased to potentially improve pain management.

A Randomized Controlled Trial to Compare Pain Medications in Children Undergoing Strabismus Surgery.

Purpose: The purpose of this study was to investigate optimal intraoperative combinations of analgesia for children undergoing strabismus surgery.

Design: A randomized controlled trial was employed to compare the difference in pain after administration of hydromorphone versus fentanyl.

Methods: Participants were randomly assigned to either arm of the study.

Neurocognitive Function and Head Impact Burden over Two Seasons of Youth Tackle Football.

This prospective cohort study sought to determine the association of repetitive sub-concussive head impacts with neurocognitive outcomes in youth tackle football players. The study sample included 166 youth tackle football players over two seasons: 70 primary school players ages 9-12 and 96 high school players ages 15-18. Helmet-based sensors recorded head impacts during practices and games, and impacts were summed to provide a cumulative measure of impact for each season.

Head Impact Burden and Change in Neurocognitive Function During a Season of Youth Football.

Objective: To determine the association of repetitive subconcussive head impacts with functional outcomes in primary and high school tackle football players.

Setting: Youth football fields and an outpatient sports neurology clinic.

Participants: A total of 112 primary school (n = 55, age 9-12 years) and high school (n = 57, age 15-18 years) football players.

Improving the Discharge to Home Experience for Pediatric Heart Center Patients and Families.

Purpose: The purpose of this study was to determine if implementation of the discharge specialist role improves family perception of discharge readiness and determines whether the use of the role decreases the number of tasks needing completion on the day of discharge.

Design And Methods: A prospective descriptive study was designed to compare parent readiness for discharge from two groups of participants. One group had a discharge specialist the day of discharge.

Lay Consultations in Heart Failure Symptom Evaluation.

Purpose: Lay consultations can facilitate or impede healthcare. However, little is known about how lay consultations for symptom evaluation affect treatment decision-making. The purpose of this study was to explore the role of lay consultations in symptom evaluation prior to hospitalization among patients with heart failure.

Assessment of Delirium in Intensive Care Unit Patients: Educational Strategies.

Background: Delirium is an acute brain dysfunction associated with poor outcomes in intensive care unit (ICU) patients. Critical care nurses play an important role in the prevention, detection, and management of delirium, but they must be able to accurately assess for it. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) instrument is a reliable and valid method to assess for delirium, but research reveals most nurses need practice to use it proficiently.

Effect of Reminder Devices on Medication Adherence: The REMIND Randomized Clinical Trial.

Importance: Forgetfulness is a major contributor to nonadherence to chronic disease medications and could be addressed with medication reminder devices.

Objective: To compare the effect of 3 low-cost reminder devices on medication adherence.

Design, Setting, And Participants: This 4-arm, block-randomized clinical trial involved 53 480 enrollees of CVS Caremark, a pharmacy benefit manager, across the United States.

Pediatric nurse practitioners effective in teaching providers the Asthma Action Plan using simulation.

Despite traditional education regarding the Asthma Action Plan (AAP), providers in the inpatient setting of a pediatric hospital reported lack of knowledge regarding the AAP and lack of confidence in teaching the AAP to patients and families. The purpose of this study was to assess the effect of a pediatric nurse practitioner (PNP)-led class incorporating simulation on resident physician knowledge of the AAP and confidence in teaching families the AAP. The study setting was a 250 bed Midwest academic pediatric hospital.

Lack of Recognition, Diagnosis, and Treatment of Overweight/Obesity in Children Hospitalized for Asthma.

Objectives: Information is lacking regarding recognition and treatment of overweight and obesity in children hospitalized for asthma. The study objectives were to determine the current practice of recognition, diagnosis, and treatment of overweight and obesity for children hospitalized for asthma and to describe demographic, asthma, and weight characteristics for these patients.

Methods: A retrospective record review was conducted for children admitted to the hospital with asthma in 2012.

Rationale and design of the Randomized Evaluation to Measure Improvements in Non-adherence from Low-Cost Devices (REMIND) trial.

Background: Long-term adherence to prescription medications for the treatment of chronic disease remains low. While there are many contributors to suboptimal medication use, simple forgetfulness is widely believed to be central. Relatively simple devices may be a particularly cost-efficient and scalable way to promote adherence, however limited data exists about their ability to improve adherence in real-world settings.

Effectiveness of high-fidelity simulation for pediatric staff nurse education.

A pre-test post-test control group design was used to compare the effectiveness of high-fidelity simulation (HFS) with traditional static mannequins as a teaching strategy for pediatric staff nurse education. Thirty-three nurses from a metropolitan pediatric Magnet hospital completed the study that evaluated knowledge retention, skill performance, and team confidence during the American Heart Association's (AHA) Pediatric Emergency Assessment, Recognition and Stabilization (PEARS) course. Written exams, competency and skill performance measures, and the Mayo High Performance Teamwork Scale (MHPTS) were used to compare the outcomes between the two groups.

Symptom perceptions and self-care behaviors in patients who self-manage heart failure.

Background: Patients with heart failure (HF) are at heightened risk for acute exacerbation requiring hospitalization. Although timely reporting of symptoms can expedite outpatient treatment and avoid the need for hospitalization, few patients recognize and respond to symptoms until acutely ill.

Objective: The purpose of this study was to explore patients' perceptions of symptoms and self-care behaviors for symptom relief, leading up to a HF hospitalization.

Knowledge and perceptions of HIV/AIDS among Cameroonian nursing students.

The HIV/AIDS pandemic impacts people throughout the world and is complicated by fear, prejudice, and stigma. Nurses play a major role in the health care delivery systems, yet in many parts of the world with high HIV sero-prevalence rates, nurses lack sufficient training and education to provide care to patients with HIV/AIDS. In an effort to build capacity and improve knowledge, attitudes and beliefs regarding care of patients with HIV/AIDS, a 4-day workshop was provided by American nursing students for Cameroonian nursing students.

Predicting long-term graft survival in adult kidney transplant recipients.

The ability to accurately predict a population's long-term survival has important implications for quantifying the benefits of transplantation. To identify a model that can accurately predict a kidney transplant population's long-term graft survival, we retrospectively studied the United Network of Organ Sharing data from 13,111 kidney-only transplants completed in 1988- 1989. Nineteen-year death-censored graft survival (DCGS) projections were calculated and compared with the population's actual graft survival.

Costs and Outcomes of Privately-Insured Kidney Transplant Recipients by Body Mass Index.

Background: Obesity presents an additional challenge to the procedure of and recovery from kidney transplantation. As the prevalence of transplant candidates with an elevated body mass index (BMI) grows, researchers need to examine and quantify the increased risks and additional costs associated with the full spectrum of body composition.

Study Design: A retrospective cohort study design was used.

Soothability and growth in preterm infants.

Purpose: This randomized control trial investigated the relationship between soothability, weight gain, and length of hospital stay in premature infants.

Method: Forty-eight preterm infants were randomized into control group or flaxseed pillow treatment group. The pillow group received two 15-minute treatments per day.