Using Kamishibai Cards to Identify Barriers and Display Adherence to the Central Line–Associated Bloodstream Infection Prevention Bundle

Clinical Nurse Specialist · 2025-02-18 · 1 citations

PURPOSE: Central line-associated bloodstream infection (CLABSI) rates have been consistently high at an academic comprehensive cancer hospital. CLABSI prevention bundles can mitigate central line infections, and many components focus on nursing practice. Identification of barriers to maintaining adherence to these elements is not always assessed or addressed. The purpose of this project was to increase adherence to CLABSI prevention nursing practices and to implement a sustainable program to elevate nurses' skills and documentation of CLABSI prevention bundle components. DESCRIPTION: Pre-implementation/post-implementation chart reviews, post-implementation visual audits, and a survey for nurses post project were completed over a 9-week period. This project identified and addressed barriers to CLABSI prevention bundle compliance. Audits assessed nursing practice elements of the CLABSI prevention bundle. Evidence-based Kamishibai cards (K-cards) were used as a visual audit tool to display compliance of CLABSI bundle elements. OUTCOMES: Compliant documentation of daily chlorhexidine gluconate (CHG) bathing increased to 75%. Inconsistent communication practices and knowledge gaps were frequent barriers to compliance. Seventy-five percent of nurses reported the K-card display changed their own CLABSI prevention practices. CONCLUSION: This project increased knowledge, adherence to CLABSI prevention practices, and awareness of components most often missed.

Describing Patterns of Drug Use and Service Delivery at Supervised Consumption Sites in Canada

Drug and Alcohol Dependence · 2025-02-01

Experiences of Street-Involved Youth in Canada who use Substances: Described Challenges and Solutions

SSRN Electronic Journal · 2025-01-01

Survival analysis under imperfect record linkage using historic census data

BMC Medical Research Methodology · 2024-03-13 · 1 citations

BACKGROUND: Advancements in linking publicly available census records with vital and administrative records have enabled novel investigations in epidemiology and social history. However, in the absence of unique identifiers, the linkage of the records may be uncertain or only be successful for a subset of the census cohort, resulting in missing data. For survival analysis, differential ascertainment of event times can impact inference on risk associations and median survival. METHODS: We modify some existing approaches that are commonly used to handle missing survival times to accommodate this imperfect linkage situation including complete case analysis, censoring, weighting, and several multiple imputation methods. We then conduct simulation studies to compare the performance of the proposed approaches in estimating the associations of a risk factor or exposure in terms of hazard ratio (HR) and median survival times in the presence of missing survival times. The effects of different missing data mechanisms and exposure-survival associations on their performance are also explored. The approaches are applied to a historic cohort of residents in Ambler, PA, established using the 1930 US census, from which only 2,440 out of 4,514 individuals (54%) had death records retrievable from publicly available data sources and death certificates. Using this cohort, we examine the effects of occupational and paraoccupational asbestos exposure on survival and disparities in mortality by race and gender. RESULTS: We show that imputation based on conditional survival results in less bias and greater efficiency relative to a complete case analysis when estimating log-hazard ratios and median survival times. When the approaches are applied to the Ambler cohort, we find a significant association between occupational exposure and mortality, particularly among black individuals and males, but not between paraoccupational exposure and mortality. DISCUSSION: This investigation illustrates the strengths and weaknesses of different imputation methods for missing survival times due to imperfect linkage of the administrative or registry data. The performance of the methods may depend on the missingness process as well as the parameter being estimated and models of interest, and such factors should be considered when choosing the methods to address the missing event times.

No difference in reproductive investment or success across urban and rural breeding pairs in an urban-adapted songbird

The Auk · 2024-09-25 · 4 citations

ABSTRACT Species classified as “urban-adapters” are often assumed to thrive in cities because they are commonly found across the urbanization gradient. However, urban-living populations of many urban-adapted species have been found to have lower reproductive success relative to their rural counterparts. Sturnus vulgaris (European Starling) is a common urban-adapted species found across most of the globe. While S. vulgaris have lowered reproductive success in urban areas in their native range, less is known about how urbanization impacts reproduction in their invasive ranges. We tested for differences in reproductive investment and success across urban and rural S. vulgaris populations in Georgia, which is part of their North American invasive range. We found few differences in reproductive output for urban vs. rural S. vulgaris—clutch size, egg mass, egg volume, incubation behavior, provisioning rates, brooding behavior, and nestling wing chord were all similar across S. vulgaris populations from more urban and more rural study sites. Although urban birds produced a higher number of hatchlings and rural birds produced young in higher body condition, neither of these factors influenced reproductive success because the number of fledglings produced were similar for urban and rural breeding S. vulgaris. Overall, S. vulgaris in their invasive range performed similarly well in more urban vs. more rural habitats. Future work should explore whether urbanization affects other components of fitness in starlings (e.g., adult survival).

Aspects of Sexual Isolation between Syntopic Two-Lined Salamanders: Mate Location, Courtship Success, and Sex Hormones

Herpetologica · 2024-04-18 · 2 citations

Studies of reproductive behavior can help reveal patterns of sexual isolation and clarify species boundaries. In northern Georgia, Blue Ridge Two-lined Salamanders (Eurycea cf. wilderae) and Brown-backed Salamanders (Eurycea aquatica) are syntopic but do not hybridize. Within this region, Eurycea cf. wilderae males exhibit a reproductive polymorphism, with “searching” males that appear adapted for terrestrial courtship and “guarding” males that appear adapted for aquatic mate-guarding. To understand better how inter- and intraspecific reproductive variation might contribute to sexual isolation between E. aquatica and E. cf. wilderae, we staged T-maze trials and courtship trials, and we conducted preliminary analyses of sex hormones from noninvasive fecal samples. We found that males of both species preferred conspecific female scents to heterospecific female scents, but that searching male E. cf. wilderae were not better than guarding males at locating a conspecific female scent. We also found evidence for strong propensity asymmetry, with male and female E. cf. wilderae much more likely than E. aquatica to engage in courtship behaviors in the lab. Still, we observed some instances of heterospecific courtship through spermatophore transfer. Finally, we found evidence for higher fecal testosterone concentrations in males than females and higher concentrations in guarding male than in searching male E. cf. wilderae. Together, our data provide further insight into the reproductive ecologies of and the nature of reproductive isolation between Eurycea aquatica and Eurycea cf. wilderae.

Outpatient Management of Coronary Artery Disease

2023-01-01 · 1 citations

Comparative effectiveness of safety planning intervention with instrumental support calls (ISC) versus safety planning intervention with two-way text message caring contacts (CC) in adolescents and adults screening positive for suicide risk in emergency departments and primary care clinics: Protocol for a pragmatic randomized controlled trial

Contemporary Clinical Trials · 2023-06-15 · 6 citations

ACS Non-ST Elevation Myocardial Infarction (NSTEMI)

2023-01-01 · 2 citations

Elevated lead (Pb) in urban European starling (Sturnus vulgaris) feathers is not correlated to physiology or behavior

The Science of The Total Environment · 2023-12-02 · 4 citations