Effects of injection and ignition timing of a large direct injection spark ignition engine fuelled with a hydrogen-CNG mixture on its operating conditions and emissions

The effects of ignition and fuel injection timing of an experimental 2-liter single cylinder direct injection spark ignition gaseous fuel engine were examined experimentally in this study. An online-prepared mixture of 10-40% hydrogen with compressed natural gas was injected at 8 bar into the cylinder during the intake stroke at 1500 rpm. Heat release rates, maximum indicated pressures, cycle-to-cycle variability, and gaseous emissions were compared for different settings. © The Authors, published by EDP Sciences, 2017

Improving Provider Knowledge on Surgical Site Infection Prevention Using a Surgical Surveillance Education Program

Background: Surgical site infections are a serious adverse outcome following any surgery. Despite the presence of international and standardized hospital guidelines, the prevention of surgical site infections remains a challenge for private practices and ambulatory centers. Currently, most ambulatory centers rely solely on provider reporting for their infection control reports and the education on prevention in these practices is minimal. It is critical that healthcare professionals have appropriate knowledge on surgical site infections, prevention methods and on their role in implementing evidence-based prevention strategies such as a surgical surveillance program. Purpose: The purpose of this quality improvement project (QIP) was to improve healthcare professionals’ knowledge on surgical surveillance and its potential impact on infection prevention in private and ambulatory settings. Methods/practice: The findings from the literature helped guide this QIP. A test was created to be used in the pre- and post-intervention phases. The test consisted of 4 demographic questions and 10 knowledge questions on current surgical infection prevention practices, surgical surveillance guidelines including telehealth follow ups, and 4 ungraded self-knowledge level questions. Ten participants completed the pre-test, and ten participants completed the educational session and post-test. A 30-minute evidenced-based educational session was conducted at a primary care clinic on indirect surgical surveillance and how it can be utilized in private practice to improve patient outcomes. Conclusion: The findings indicated that the participants lacked the appropriate education and information on what surgical surveillance entails and how it can be utilized in private settings. Findings from the post-test indicated that the educational session did increase the knowledge of the participants on surgical surveilling and how it can directly impact patient outcomes. Post-test scores improved 29% over pre-testing scores following the educational session. Implications for Practice: There is a lack of education and implementation of surgical surveillance guidelines in private practices across the country. Both educational leadership and management should implement the continuous and important education on how to properly utilize surgical surveillance to ensure the best and safest care is being provided to patients

Improving Transgender Patients\u27 Access to Care in the Primary Care Setting: A Quality Improvement Project

Background: In the United Sates, nearly 1 million people identify as being transgender and 2% (671) of transgender people were diagnosed with HIV in the U.S. and dependent areas in 2019 (CDC, 2022b). Studies have reported of transgender people avoiding the healthcare setting due to fear of facing stigma and discrimination. Due to this stigma and discrimination in the healthcare setting, transgender people may choose not to participate in HIV screening. The studies also emphasized a lack of LGBTQ+ education in the academic setting. The purpose of this quality improvement project (QIP) was to improve the knowledge of healthcare professionals regarding transgender stigma and discrimination in the healthcare setting and how it affects their willingness to participate in HIV screening in the primary care setting. Methods: The findings from literature reviews were used in the creation of this QIP. A survey was created for the pre- and post-intervention. The survey consisted of 12 demographic questions and 15 knowledge questions on transgender stigma, discrimination, and HIV. Twenty-three participants completed the pre-survey, and eighteen participants completed the educational session and post-survey. A 30-minute evidenced-based educational session was conducted at a primary care clinic on transgender stigma and discrimination in the healthcare setting and how it affects HIV screening. Results: There was a 31.05% mean increase from the pre-survey to the post-survey after the 30-minute educational session was conducted. The results indicated improvement in the knowledge question responses after the 30-minute educational session. Knowledge scores from the pre- and post-surveys were compared which were statistically significant based on the p-value. Conclusion: These findings indicated that by educating healthcare professionals on transgender stigma and discrimination in the healthcare setting, it can increase their knowledge and improve transgender patients experience when seeking medical care

Drinking patterns and outcomes of alcohol use by LGBT students at a minority-serving university

Session presented on Tuesday, November 10, 2015: Background/Purpose: The Institute of Medicine report (2011) on the health of Lesbian, Gay, Bisexual and Transgender (LGBT) persons noted that sexual minority youth may have higher rates of substance use than heterosexual youth, and that LGBT youth may have an elevated risk for attempted suicide and depression. Substance use has been linked to HIV infection because both casual and chronic substance users are more likely to engage in high-risk behaviors, such as sex without a condom, when they are under the influence of drugs or alcohol (CDC, 2013). Unsafe sexual practices among college students are often associated with the use of alcohol or other drugs, placing them at risk for HIV and other sexually transmitted diseases (STDs). The purpose of this study was to explore drinking patterns and negative outcomes of drinking by LGBT college students. This study was part of a larger study funded through the HIV and Substance Abuse Prevention initiative for Minority Serving Institutions, Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration (SAMHSA). Methods: A convenience sample of male and female LGBT students was used. After IRB approval was received, participants were recruited from two sites: 1) on campus at a minority-serving South Florida university from March - September 2014 and 2) from community venues on Miami Beach during Spring Break March-April 2014. Inclusion criteria for participants included: self-identity as LGBT, ages 18-24, enrolled as a college student, and able to speak and read English. After giving verbal consent, the participants completed a self-administered survey. The instrument used was the Core Alcohol and Drug Survey for Two- and Four-Year Universities (University of Southern Illinois, 2000). A variety of strategies were used to recruit participants. Results: The sample included 213 self-identified LGBT participants, ages 18-24, of which 114 (53.5%) were female, 91 (42.7%) were male, 4 (1.9%) were transgender female, 3 (1.4%) were transgender male, and 1 (0.5%) did not report their gender. In regards to drinking patterns, thirty five percent (n = 74) of the participants reported that over the last 2 weeks they had one to ten occasions of drinking 5 or more alcoholic beverages at a sitting, i.e., binge drinking. Sixty five percent (n = 138) of the participants reported that they consumed 1 to 69 alcoholic beverages a week. In terms of outcomes, the LGBT students reported that they experienced the following related to alcohol or drug use in the last year. In terms of academic performance, one-third of the students (n = 50; 33%) had performed poorly on a test or important project, and over one-fourth of the students (n = 58; 27%) had missed a class. There were also negative outcomes related to physical health. Over a third of the students had been nauseated or vomited (n = 79; 37%) and had suffered a hangover (n = 94; 44%), and one-fourth of the students (n = 54; 25%) had suffered a memory loss. Almost 20% (n = 41; 19%) of the students had driven a car while under the influence, and 27% (n = 58; 27%) had done something they later regretted. In terms of mental health and outcomes of use of alcohol and other substances, some students had seriously thought about suicide (n = 22; 10%) and some students had seriously tried to commit suicide (n = 17; 8%). Conclusion/Implication: Findings of this study will add to the knowledge base of risk behaviors for LGBT college students. Information derived from this study will be used to develop a campus-based HIV and substance abuse prevention program for LGBT students

Transforming caregiver barriers to HPV vaccinations in African-Americans and Afro-Caribbeans: A cultural collaboration

The purpose of this systematic review and implementation project is to transform caregiver barriers to Human Papillomavirus (HPV) vaccination in African-Americans and Afro-Caribbeans. This knowledge will guide the development of strategies to increase awareness, cultural collaboration, and immunization rates; thereby reducing disease incidence and/or comorbidities

A systematic review of strategies to optimize the professional development of providers disseminating sexual health content to prevent adolescent pregnancy

Problem statement: Adolescent pregnancy is at an extreme rate for minority adolescents of Hispanic and Non-Hispanic Black ethnicity/race, who reside within low socioeconomic geographic areas. Aim: Addressing adolescent sexual health education at the grass roots will further healthcare providers\u27 awareness and engagement in preventing unplanned pregnancy among adolescents. This will further standardize the knowledge among the youth while increasing positive decision-making. Background: CDC (2017) has prioritized adolescent pregnancy due to the nearly 230,000 unintended pregnancies documented in 2015, yet its overall 8% decrease results from comprehensive sex education and promotion of contraceptives which opposes current abstinence-only curriculum within various school districts. This creates an unprecedented responsibility for healthcare providers to properly and adequately disseminate comprehensive sex education to youth within the allocated time of the visit, especially within school health clinics. Framework: This literature review consisted of two frameworks, The Social Cognitive Theory and Lean Transformation, as baseline data to help with the analysis of evidence. Method: The method consisted of a search identifying scholarly peer reviewed articles from 2013 to present within 4 databases: 1) CINAHL; 2) CINAHL Plus with Full Text; 3) Education source; and 4) PubMed, using keywords: adolescent ; pregnancy ; prevention ; USA ; continuing education ; and social cognitive theory. 37 articles among 91 non-duplicate articles were retrieved using PRISMA (2015). A systematic review was conducted to categorize each article based on its relevance or potential of ways to converse with adolescents regarding sex education. Results: 25 articles were selected, of which 18 were categorized as relevant articles and 7 were categorized as potential background information. Findings suggest reduction in negative sexual health outcomes through systematic education on overall wellness promotion by healthcare professionals, educators, and family. Conclusion: This review suggests the need to develop an evidence-based continuing education for healthcare professionals and educators to address sexual health content effectively among adolescents and young adults. The practice should expend on the abstinence-only curriculum furthering the deliverables of the school health provider in engaging the youth on sex education

Cervical visual inspection with acetic acid (VIA) and oncogenic human papillomavirus screening in rural indigenous guatemalan women: Time to rethink VIA

Single-visit “screen-and-treat” strategies using visual inspection with acetic acid (VIA) and cryotherapy (liquid nitrous oxide ablation) in low-resource settings are commonly used to de-tect and treat precancerous lesions for cervical cancer prevention. This study compared VIA sensi-tivity and specificity in rural indigenous Guatemalan communities, to that of oncogenic human papillomavirus (HPV) testing for detection of precancerous changes, using cytology as the reference standard. Between 3–8 September 2017, trained nurses examined 222 women aged 23–58 years with VIA. Specimens for liquid-based cytology and HPV testing were obtained prior to VIA with a cyto-brush and transported in PreservCyt to a US clinical laboratory. VIA and HPV test sensitivities were assessed as proportions of women with abnormal cytology that had abnormal VIA or HPV results, respectively, and specificities, as proportions with normal cytology with normal VIA or negative HPV tests. Of 222 women, 18 (8.1%) had abnormal cytology (1 carcinoma in a participant who received VIA-based cryotherapy in 2015, 4 high-and 5 low-grade squamous intraepithelial lesions, and 8 atypical squamous cells of undetermined significance (ASCUS)). Excluding ASCUS, sensitivities of VIA and HPV were 20.0% and 100%, respectively. VIA-based screening may not be accepta-ble for detecting precancerous lesions, and field cryotherapy for preventing malignancy. The World Health Organization recommended in 2021 “…using HPV DNA detection as the primary screening test rather than VIA or cytology.”

Minority college students\u27 HPV knowledge, awareness, and vaccination history

Session presented on Saturday, July 23, 2016 and Sunday, July 24, 2016: Human Pepilloma virus (HPV) is the most common sexually transmitted infection (STI), and can cause cervical, anal and oropharyngeal cancer. There are several approved vaccinations to protect against HPV infection, a quadrivalent, bivalent, and 9-valent respectively. It is estimated that 79 million individuals are infected with human Pepilloma virus (HPV), while 20 million more Americans become infected each year (CDC, 2014 & CDC, 2012). HPV is yearly responsible for 26,000 new cancers (about 17,000 in women and 9,000 in men) yearly (CDC, 2013). Although HPV vaccination is recommended, rates in the United States are not increasing in comparison to other countries. The purpose of this study is to explore HPV knowledge and awareness, sources of information received on HPV, and HPV vaccination rates for ethnically diverse male and female college students ages 18-24. This study is part of a larger study funded by the HIV and Substance Abuse Prevention for Minority Serving Institution\u27s initiative, Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration (SAMHSA). Methods: After IRB approval was received, male and female students were recruited at two sites, a South Florida university and a South Florida state college, from February-August 2014. Inclusion criteria for participants included: ages 18-24, enrolled as a student, and able to speak and read English. After giving verbal consent, the participants completed a self-administered survey. The instrument used was a modified Health Department community health survey, which included demographics, and was adapted to include eight items on awareness and knowledge of HPV, information received on HPV, and history of HPV vaccination. Results: The sample included 842 students. Data was entered into a SPSS file for data analysis. Overall, 554 (66%) of the participants were vaccine naive. 63% of the respondents had received knowledge about HPV from family, internet, news student health centers, or other unspecified sources. The majority of these participants, 54%, felt that they were not at risk for acquiring HPV. Another of the major findings from this study is that 25% of the participants had a false assumption that males are not susceptible to HPV infection. Conclusions/Implications for Practice: Although HPV vaccination is recommended, little is known about vaccination histories for ethnically diverse college students. Less is known about HPV knowledge and vaccination rates of young adult men. This study will add to the growing body of knowledge related to HPV knowledge and vaccination history of minority college-age men and women