Data Mining for Adverse Drug Events: Impact on Six Learning Styles.

Emerging technologies and big data influence the role of nurses, calling for new ways of thinking and teaching. Innovative educational methods are needed to prepare students for providing evidence-based care in today's complex healthcare environment. Active learning methods appeal to tech-savvy, self-directed learners who desire instant results during the learning process. The aim of this pretest/posttest study was to evaluate the impact of active learning methods on student attitudes and feelings, using the Grasha-Riechmann Student Learning Style Scale. Results were used to tailor active learning interventions using Twitter and Federal Adverse Event Reporting System data, for a research and evidence-based practice nursing course. Participants (N = 126) evaluated tweets describing adverse drug events and their concordance with federal reporting system data. Paired-samples t test results revealed significant differences (P < .05) between pretest/posttest for five of the six learning style preferences. Active learning methods resulted in high levels of student engagement and satisfaction. Data mining as an active learning intervention is popular with learners and offers a quick, valuable way to reveal real-world adverse drug event experiences while introducing basic research principles.

Access to Fresh Fruits and Vegetables in School Lunches: A Policy Analysis.

Consumption of fresh fruits and vegetables helps to reduce childhood obesity and improves academic achievement and attendance. However, providing fresh fruits and vegetables is challenging for some schools due to cost, administrative burden, and concern for food waste. To address these challenges, the Fruit and Vegetable Access for Children Act proposes to allow federally funded programs to substitute fresh fruits and vegetables with canned, frozen, or pureed versions. In this policy analysis, we propose options for providing fresh fruits and vegetables to children enrolled in the National School Lunch Program. We recommend that school nurses actively facilitate the process of obtaining fresh fruits and vegetables by being appointed members of Team Nutrition giving them authority to collaborate with local famers, entrepreneurs, and land-grant universities in Farm to School Programs. This strategy empowers school nurses in promoting healthy eating habits, reducing obesity, and improving academic performance and school attendance.

Underlying Beliefs Associated With College Student Consumption of Energy Beverages.

College students are heavy consumers of energy beverages, yet further study is needed to better understand determinants of use. The purpose of this cross-sectional study ( N = 283) was to identify beliefs explaining unsafe consumption practices. A principal components analysis revealed three eigenvalues >1 explaining approximately 55% of the variance (health and appearance, performance and fatigue, and recreation and alcohol). Multiple regression analysis explained 75% of the variance for intent to consume. Standardized beta for attitude and subjective norms was p < .001; perceived behavioral control was p < .05. MANOVA was used to determine the effect of gender on eight dependent variables (Wilks's lambda = 3.78, p < .001). Attitudes and subjective norms influenced the intent to consume energy beverages, particularly in males. Students viewed energy beverages as useful for managing health and appearance and performance and fatigue, and as a way to enhance recreation and alcohol consumption.

Increasing Colorectal Cancer Screening Using a Quality Improvement Approach in a Nurse-Managed Primary Care Clinic.

According to the American Cancer Society, 1 in 23 Americans will be diagnosed with colorectal cancer (CRC) in their lifetime. Screening for CRC is an effective, yet underused preventive approach. This is especially true in rural areas, where only 35% of patients were found to be up to date on their screenings in 2014. Increasing CRC screening can produce positive patient outcomes by early recognition and removal of precancerous polyps. The purpose of this project was to use quality improvement (QI) interventions to increase CRC screening rates at a nurse-managed clinic in rural Indiana. Using Deming's Plan-Do-Study-Act QI model, multiple interventions were implemented which resulted in a 37% increase in the number of screenings ordered on eligible patients and an overall increase of 28% in the completion of the screenings. This project contributes to healthcare quality knowledge by also suggesting that the fundamental principles of encouraging staff feedback to gain buy-in, improving processes informed by patient data, and valuing frequent performance feedback to staff, strengthened this QI project and ensured adoption and sustainability of these results.

Energy Drinks: Implications for the Breastfeeding Mother.

Breastfeeding women may experience disrupted sleep schedules and be tempted to turn to popular energy drinks to reduce fatigue and enhance alertness, prompting the question: What are the maternal and child health implications for breastfeeding mothers consuming energy drinks? Caffeine and vitamin-rich energy drinks contain a variety of herbal ingredients and vitamins; however, ingredient amounts may not be clearly disclosed on product labels. Interactions between herbal ingredients and caffeine are understudied and not well defined in the literature. Some infants can be sensitive to caffeine and display increased irritability and sleep disturbances when exposed to caffeine from breastmilk. Breastfeeding women who consume energy drinks may be ingesting herbal ingredients that have not undergone scientific evaluation, and if taking prenatal vitamins, may unknowingly exceed the recommended daily intake. Caffeinated products are marketed in newer ways, fueling concerns about health consequences of caffeine exposure. We present implications associated with consumption of caffeine and vitamin-rich energy drinks among breastfeeding women. Product safety, labeling, common ingredients, potential interactions, and clinical implications are discussed. Healthcare providers should encourage breastfeeding women to read product labels for ingredients, carbohydrate content, serving size, and to discourage consumption of energy drinks when breastfeeding and/or taking prenatal vitamins, to avoid potential vitamin toxicity.

Proposed actions for the US Food and Drug Administration to implement to minimize adverse effects associated with energy drink consumption.

Energy drink sales are expected to reach $52 billion by 2016. These products, often sold as dietary supplements, typically contain stimulants. The Dietary Supplement Protection Act claims an exemplary public health safety record. However, in 2011 the number of emergency department visits related to consumption of energy drinks exceeded 20,000. Nearly half of these visits involved adverse effects occurring from product misuse. Political, social, economic, practical, and legal factors shape the landscape surrounding this issue. In this policy analysis, we examine 3 options: capping energy drink caffeine levels, creating a public education campaign, and increasing regulatory scrutiny regarding the manufacture and labeling of energy drinks. Increased regulatory scrutiny may be in order, especially in light of wrongful death lawsuits related to caffeine toxicity resulting from energy drink consumption.

Diet pills, powders, and liquids: predictors of use by healthy weight females.

About 35% of healthy weight adolescent females describe themselves as overweight, and 66% report planning to lose weight.Body weight dissatisfaction is associated with unhealthy weight loss practices including diet pill/powder/liquid (PPL) use. Few studies have examined diet PPL use in healthy weight adolescent females; therefore, Youth Risk Behavior Survey data (n =247) were analyzed to identify predictors of use. Descriptive statistics and logistic regression analyses were conducted using Statistical Package for the Social Sciences Complex Samples software. Social cognitive theory served as the framework guiding the analysis. Approximately 8% of healthy weight females reported using diet PPL for weight loss. Describing self as overweight, planning to lose weight, being offered drugs at school, fasting to lose weight, cigarette/alcohol use, vomiting, and laxative use were significantly associated (p < .05) with diet PPL use. Health professionals, including school nurses, must assess for unhealthy weight loss practices in healthy weight females, in order to adequately address related issues.

Amiodarone-induced pulmonary toxicity: case study with syndrome analysis.

Amiodarone is often prescribed for the control of atrial and ventricular arrhythmias. While generally effective, the potential for a variety of side effects is substantial. Pulmonary toxicity, leading to acute or chronic respiratory failure, manifests with cough, dyspnea, infiltrates on chest radiograph, and a potential for progression to death. Although routinely cited as an adverse effect of amiodarone, it is relatively rare in terms of statistical incidence. In an effort to shed light on this syndrome, we present a stereotypical case study in amiodarone-induced pulmonary toxicity, as a prelude to a review of theorized pathophysiology, epidemiology, clinical presentation, diagnosis, therapeutics, monitoring recommendations, and areas for future research.

Implemented family presence protocols: an integrative review.

Family presence during resuscitation or invasive procedures is controversial, but research suggests multiple benefits. Professional organizations recommend developing family presence protocols; however, few hospitals have them. This integrative review examined research evidence regarding implemented family presence protocols for adults in the hospital setting-specifically, the use of protocols and providers' feedback. Four key findings include a positive trend in family presence practice, varying provider attitudes, problems with family facilitators, and factors inhibiting or facilitating protocol implementation.

Adolescent performance enhancing substance use: regional differences across the US.

Performance enhancing substances (PES) constitute a multi-billion dollar industry, fueling public health concerns regarding use in adolescents hoping to enhance athletic performance and body appearance, or fight obesity. Adverse effects may include violent behavior, suicide attempts, and premature deaths. Prevalence of use is difficult to ascertain due to secrecy issues and misinterpretation of survey questions. Healthcare providers are less familiar with PES than other types of substance use. A correlational secondary analysis of 2007 National Youth Risk Behavior Survey (YRBS) data was conducted (n =14,041) to better understand predictors of PES use (methamphetamines, steroid pills/injections, and diet pill/powder/liquids). Bandura's Social Cognitive Theory served as the organizing framework guiding the analysis. SPSS version 17.0 Complex Samples was used to examine relationships among variables; bi-variate and logistic regression analyses were performed. Feeling sad/ hopeless, considering suicide, perceiving being overweight, being offered drugs at school, geographic location, being sexually active, cigarette smoking, and alcohol use were significantly associated (p <.05) with PES use. Rates of being offered/sold/given illegal drugs at school ranged from 17-39%; PES use ranged from 5-17% across the US. Multiple factors predicted PES use; those contributing to morbidity and mortality may be preventable. Though policies are designed to ensure safe school settings, high rates of obtaining drugs at school were reported. The South US region reported the highest rates of PES use. Regional differences have implications for health professionals and policy makers who must address physical, psychological, and social issues related to adolescent PES use.