Publications by authors named "Mary W Stewart"

47 Publications

STRIDES - STudying Risk to Improve DisparitiES in Cervical Cancer in Mississippi - Design and baseline results of a Statewide Cohort Study.

Prev Med 2021 Jul 20;153:106740. Epub 2021 Jul 20.

National Cancer Institute, Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, Rockville, MD, United States of America. Electronic address:

Cervical cancer rates in Mississippi are disproportionately high, particularly among Black individuals; yet, research in this population is lacking. We designed a statewide, racially diverse cohort of individuals undergoing cervical screening in Mississippi. Here, we report the baseline findings from this study. We included individuals aged 21 years and older undergoing cervical screening with cytology or cytology-human papillomavirus (HPV) co-testing at the Mississippi State Health Department (MSDH) and the University of Mississippi Medical Center (UMMC) (December 2017-May 2020). We collected discarded cytology specimens for future biomarker testing. Demographics and clinical results were abstracted from electronic medical records and evaluated using descriptive statistics and chi-square tests. A total of 24,796 individuals were included, with a median age of 34.8 years. The distribution of race in our cohort was 60.2% Black, 26.4% White, 7.5% other, and 5.9% missing. Approximately 15% had abnormal cytology and, among those who underwent co-testing at MSDH (n = 6,377), HPV positivity was 17.4% and did not vary significantly by race. Among HPV positives, Black individuals were significantly less likely to be HPV16/18 positive and more likely to be positive for other high-risk 12 HPV types compared to White individuals (20.5% vs. 27.9%, and 79.5% and 72.1%, respectively, p = 0.011). Our statewide cohort represents one of the largest racially diverse studies of cervical screening in the U.S. We show a high burden of abnormal cytology and HPV positivity, with significant racial differences in HPV genotype prevalence. Future studies will evaluate cervical precancer risk, HPV genotyping, and novel biomarkers in this population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ypmed.2021.106740DOI Listing
July 2021

Research News: Nurses as Heroes.

J Perianesth Nurs 2021 06;36(3):317-318

School of Nursing, University of Mississippi Medical Center, Jackson, MS. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2021.03.007DOI Listing
June 2021

Research News: Audiovisual Glasses Intraoperatively.

Authors:
Mary W Stewart

J Perianesth Nurs 2021 02;36(1):93-94

School of Nursing, University of Mississippi Medical Center, Jackson, MS. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2020.09.019DOI Listing
February 2021

Exploring Parents' Intentions to Monitor and Mediate Adolescent Social Media Use and Implications for School Nurses.

J Sch Nurs 2020 Dec 30:1059840520983286. Epub 2020 Dec 30.

School of Nursing, The University of Mississippi Medical Center, Jackson, MS, USA.

Social media may promote health and social connectedness, but its misuse and frequency of use may pose risks. Social media use during adolescence requires parental monitoring and mediation to mitigate potentially harmful effects such as depression, anxiety, and risk-taking behaviors. While parents and health care professionals convey concern surrounding exposure to inappropriate content, prolonged screen time, and cyberbullying, appropriate social media monitoring remains challenging. The purpose of this study was to explore parental monitoring and mediation of social media use in adolescents. Online recruitment yielded a nationwide sample ( = 836) of parents of adolescents. The results of the online survey indicated that parents are concerned about adolescent social media use and endorse positive attitudes toward monitoring. Yet parents perceived little control over monitoring. Findings from this study support the school nurse in promoting healthy social media use, media literacy among parents and adolescents, and the use of screening tools.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1059840520983286DOI Listing
December 2020

Enteral nutrition for intubated adults in the intensive care unit prior to general anesthesia: a scoping review.

JBI Evid Synth 2020 08;18(8):1701-1723

1School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA 2Mississippi Centre for Evidence Based Practice: A JBI Centre of Excellence.

Objective: The objective of this scoping review was to examine and map fasting times for intubated adult patients in the intensive care unit prior to general anesthesia, and patient outcomes following the cessation of enteral nutrition.

Background: Malnutrition in critically ill patients in the intensive care unit has been associated with increased infectious morbidity, increased length of intensive care unit and hospital stay, increased rate of infections, increased number of ventilator days, and impaired wound healing. One potential contributor to malnutrition is prolonged fasting times prior to general anesthesia. The American Society of Parenteral and Enteral Nutrition and the Society of Critical Care Medicine recommend minimizing fasting times prior to surgery; however, neither gives guidelines for intubated patients in the intensive care unit. By limiting fasting times with cuffed endotracheal tubes, nutritional goals could be improved without additional complications.

Inclusion Criteria: This scoping review considered studies that included patients in the intensive care unit who were 18 years and older possessing a cuffed endotracheal tube, requiring enteral nutrition, and undergoing surgery requiring general anesthesia. Specifically, fasting protocols, location of enteral nutrition being delivered, and patient outcomes were mapped for studies meeting these criteria. The review also looked at available protocols for preoperative fasting times for patients with cuffed endotracheal tubes prior to surgical procedures requiring anesthesia.

Methods: The JBI methodology was followed to complete this scoping review. The objectives, inclusion criteria, and methods of analysis for this review were previously established and documented in an a priori protocol.

Results: Three studies, one prospective observational study, and two retrospective chart reviews, with a total of 128 participants, were included in this review. Also, eight fasting protocols regarding adult intensive care unit patients with cuffed endotracheal tubes prior to general anesthesia were identified.

Conclusions: The identified studies and protocols conclude that institutions apply different fasting times depending on procedure types and feeding access for patients with cuffed endotracheal tubes. Some protocols require fasting to begin at midnight on the day of the procedure, while others allow enteral nutrition to be continued throughout the procedure. All identified protocols exclude some procedures from a reduced fast, typically airway procedures and abdominal surgeries. Each institution has specific requirements for patients that qualify for a reduced fast - such as feeding tube location, type of procedure, and positioning during the procedure - as well as specific times for enteral nutrition to be held. Following review of the studies, no aspiration events were witnessed during any operative procedure where a reduced fast was used.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11124/JBISRIR-D-19-00123DOI Listing
August 2020

COVID-19: Knowing the Data.

Authors:
Mary W Stewart

J Perianesth Nurs 2020 10 25;35(5):552-553. Epub 2020 Jun 25.

School of Nursing, University of Mississippi Medical Center, Jackson, MS. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2020.06.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315953PMC
October 2020

Substance Abuse.

Authors:
Mary W Stewart

J Perianesth Nurs 2020 06 22;35(3):340-341. Epub 2020 Apr 22.

School of Nursing, University of Mississippi Medical Center, Jackson, MS. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2020.02.008DOI Listing
June 2020

Racial differences in HPV type 16 prevalence in women with ASCUS of the uterine cervix.

Cancer Cytopathol 2020 08 3;128(8):528-534. Epub 2020 Apr 3.

National Cancer Institute, Rockville, Maryland.

Background: Understanding racial influences on human papillomavirus (HPV) distribution in women with atypical squamous cells of undetermined significance (ASCUS) cytology via partial genotyping in a statewide population can inform HPV-based prevention efforts.

Methods: Women aged 21 to 65 years with any cytology result and partial HPV genotyping for ASCUS triage between January 1, 2014, and December 31, 2017, were included. All women attended a Mississippi State Department of Health clinic. Age, race, cytopathologic, and HPV data were extracted from the electronic health record and analyzed. Cytologic specimens were processed with ThinPrep and HPV testing with the Cobas 4800 assay. HPV genotypes were evaluated in hierarchical categories. Chi-square tests and multinomial logistic regression models evaluated associations between race and type prevalence.

Results: There were 43,106 women who underwent cervical cancer screening with cytology and ASCUS triage. Of these, 34,363 (80.2%) had normal cytology, 4672 (10.9%) had ASCUS, 2683 (6.3%) had a low-grade squamous intraepithelial lesion, and 633 (1.5%) had a high-grade squamous intraepithelial lesion. Blacks represented 69.3% of the sample and had a higher proportion of HPV-positive ASCUS (6.5%) in comparison with whites (5.6%). Blacks had significantly decreased odds of HPV-16 (odds ratio [OR], 0.66; 95% confidence interval [CI], 0.6-0.9; P = .002) and significantly increased odds for 12 other types (OR, 1.37; 95% CI, 1.2-1.5; P < .0001) in comparison with whites.

Conclusions: In a diverse population, significant differences in HPV genotypes are shown by race. Importantly, blacks with ASCUS are less likely to be positive for HPV-16 in comparison with whites. Ongoing work is evaluating the individual genotype prevalence and genotype-specific risk of precancer by race.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/cncy.22267DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7728239PMC
August 2020

Perioperative Dextrose and Postoperative Nausea and Vomiting.

Authors:
Mary W Stewart

J Perianesth Nurs 2020 02;35(1):94-95

School of Nursing, University of Mississippi Medical Center, Jackson, MS. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2019.10.007DOI Listing
February 2020

Adults' and children's perceptions of barriers and facilitators of school-aged children's physical activity in an inner-city urban area.

J Spec Pediatr Nurs 2020 01 21;25(1):e12278. Epub 2019 Nov 21.

School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi.

In the United States, obesity rates among children remain a pressing public health concern Compounding that, disparities exist with higher childhood obesity among minority and lower socioeconomic neighborhoods. Physical activity is associated with more favorable weight status in children and adolescents.

Purpose: This study aimed to identify and explore factors that influence physical activity in children in a low-income neighborhood.

Design And Methods: An exploratory descriptive qualitative design was employed using Photovoice and focus group interviews to identify barriers and facilitators of physical activity.

Results: Eight adults and five children enrolled in the study. Photovoice was used to prompt discussions during the focus groups. Analysis of verbatim transcripts included constructed coding with categorization into themes. Four themes of (a) knowledge, (b) play, (c) opportunities and a changing environment, and (d) resources were identified. Among children, three themes from the children's focus group were identified as (a) knowledge, (b) play, and (c) environment. This study found both resource and knowledge challenges, as well as a strong commitment to providing physical activity opportunities.

Practice Implications: Continued efforts are needed to develop and implement physical activity interventions to reduce obesity and improve health among children in impoverished, urban areas.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jspn.12278DOI Listing
January 2020

Physical activity and postural balance in rural community dwelling older adults.

Appl Nurs Res 2019 08 11;48:1-7. Epub 2019 May 11.

University of Mississippi Medical Center, Jackson, MS, United States of America.

Aim: The purpose of this study was two-fold: 1) identify the types of physical activity being done among rural community dwelling older adults; and 2) determine the relationship between amount of physical activity and postural balance in that population.

Background: Balance impairment coupled with other fall risk factors pose a formidable challenge for aging adults. This study identified types of physical activity rural-community dwelling older adults do and explored the relationship between amount (in minutes) of physical activity and balance.

Methods: A cross sectional, correlational design was used to recruit rural community-dwelling older adults. Data were collected using the Jackson Heart Study Physical Activity Survey, Berg Balance Scale, and Timed Up and Go Test; ActiGraph accelerometers were worn to objectively measure physical activity.

Results: One hundred and one participants enrolled. Most were female (78%), White (74%), and between 65 and 91 years old. Berg Balance Scale scores positively correlated with average minutes of light (r = 0.262) and moderate (r = 0.276) physical activity; and the Jackson Heart Study Physical Activity Survey active living index (r = 0.320) and home and garden index (r = 0.324). In regression models, age and sex were the strongest predictors of Berg Balance Scale (adjusted r = 0.313, F(6, 89) = 8.203, P ≤ 0.001). Physical activity was not associated.

Conclusions: Minutes of light or moderate physical activity were not associated with balance. However, investigating factors such as physical activity that influence health functional status and balance deserve continuous attention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.apnr.2019.05.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6690351PMC
August 2019

Code Status Limitations.

Authors:
Mary W Stewart

J Perianesth Nurs 2019 Jun;34(3):667-668

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2019.03.003DOI Listing
June 2019

Effectiveness of School-based Health Center Delivery of a Cognitive Skills Building Intervention in Young, Rural Adolescents: Potential Applications for Addiction and Mood.

J Pediatr Nurs 2019 Jul - Aug;47:23-29. Epub 2019 Apr 22.

University of Mississippi Medical Center, MS, United States of America. Electronic address:

Purpose: Uniquely positioned, school nurses address two of the most critical adolescent health issues - addiction and mood. Cognitive behavioral therapy, the mainstay in management of adolescent mood disorders, demonstrates promise in the treatment and prevention of addictive behaviors. Quality decision-making may protect adolescents from substance abuse. Executive function, a neurocognitive aspect of decision-making, involves impulse control, future thinking, and behavioral regulation. Further, the continuum of addition implicates executive function, which makes executive function a viable target for prevention and treatment of substance use. This pilot study examined the effectiveness of a nurse-led cognitive skills training intervention, Creating Opportunities for Personal Empowerment, on executive function and mood in a novel population and setting.

Design And Methods: The study sample included adolescents ranging in age from 12 to 15 years and enrolled in a rural school-based health center. Fifteen (n = 15) adolescents completed the seven-week cognitive skills building intervention led by a nurse practitioner. Researchers measured executive function, anxiety, and depression at: baseline, after the intervention series, and three-months later.

Results: One domain of executive function - behavioral regulation - improved, as did anxiety. Depression showed short-term improvement. Metacognition did not change over time.

Conclusions: Preliminary results indicate that cognitive skills building delivered by school nurses may enhance aspects of executive function linked with addiction and coping, such as behavioral regulation. Further, this intervention may also improve mood in this population.

Practice Implications: Delivery of cognitive skills training by school nurses could be an accessible, effective piece in addressing addiction and mood in young, rural adolescents.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pedn.2019.04.013DOI Listing
January 2020

Postoperative Warming of Children With Hypothermia.

Authors:
Mary W Stewart

J Perianesth Nurs 2019 Feb;34(1):216-217

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2018.11.002DOI Listing
February 2019

Precancerous cervical lesions and HPV genotypes identified in previously unsatisfactory cervical smear tests after inexpensive glacial acetic acid processing.

Int J Gynaecol Obstet 2019 Jan 2;144(1):85-89. Epub 2018 Nov 2.

School of Graduate Studies and School of Nursing, University of Mississippi Medical Center, Jackson, MI, USA.

Objective: To determine the effectiveness of using glacial acetic acid (GAA) to convert unsatisfactory bloody ThinPrep (TP) cervical smear test to satisfactory, and identify associated missed diagnoses and high-risk HPV (hrHPV) genotypes.

Methods: In a retrospective descriptive cross-sectional analysis, all TP tests performed in Mississippi, USA, 2012-2016, were evaluated for unsatisfactory results owing to blood. Tests that were converted to satisfactory by GAA treatment, and corresponding anomalies and HPV genotypes were identified.

Results: Among 106 384 TP tests, there were 1460 (1.37%) unsatisfactory results, of which 1442 (98.77%) were converted to satisfactory after GAA treatment. Laboratory preprocessing with GAA increased costs minimally. Precancerous lesions were detected in 166 (11.51%) of 1442 GAA-treated samples, of which 12 (7.2%) were high-grade lesions, 110 (66.3%) were atypical squamous cells of undetermined significance, and 63 (57.3%) tested positive for hrHPV. Of 60 genotyped samples, 39 (65%) had non-HPV16 and non-HPV18. Including mixed infections, 48 (80%) contained less-common hrHPV types, reflecting an unexpected distribution in bloody specimens.

Conclusions: GAA pretreatment of bloody TP tests would reduce the incidence of unsatisfactory results and missed high-grade lesions, and prevent the cost of repeat tests and delayed treatment. Clinicians without access to GAA should consider HPV testing.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ijgo.12699DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6431532PMC
January 2019

Safety and Feasibility.

Authors:
Mary W Stewart

J Perianesth Nurs 2018 10;33(5):773-775

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2018.06.099DOI Listing
October 2018

Workplace Violence Against Nurses.

Authors:
Mary W Stewart

J Perianesth Nurs 2018 06;33(3):356-359

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2018.03.002DOI Listing
June 2018

Enteral nutrition for the intubated adult intensive care unit patient prior to general anesthesia: a scoping review protocol.

JBI Database System Rev Implement Rep 2018 Jan;16(1):27-34

School of Nursing, University of Mississippi Medical Center, United States.

Review Question: The objectives of this scoping review are to examine and map fasting times for adult intubated intensive care unit (ICU) patients prior to general anesthesia and patient outcomes following the cessation of enteral nutrition, to examine and conceptually map the evidence, and identify any gaps.Specifically, the review questions are.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11124/JBISRIR-2017-003356DOI Listing
January 2018

Postoperative Pulmonary Complications.

Authors:
Mary W Stewart

J Perianesth Nurs 2017 10;32(5):506-507

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2017.07.002DOI Listing
October 2017

Adolescence: A Time of Transition.

J Perianesth Nurs 2017 08;32(4):385-386

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2017.05.003DOI Listing
August 2017

Keeping Patients Warm.

Authors:
Mary W Stewart

J Perianesth Nurs 2017 06;32(3):264-265

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2017.04.003DOI Listing
June 2017

The Identity Threat of Weight Stigma in Adolescents.

West J Nurs Res 2017 08 24;39(8):991-1007. Epub 2017 Apr 24.

3 University of Alabama at Birmingham, Birmingham, AL, USA.

Obesity remains a serious public health issue in adolescents, who may be subjected to weight stigma leading to increased stress and poor health outcomes. Stigma can be detrimental to adolescents during self-identity formation. The purpose of this study was to examine weight stigma in adolescents in light of the Identity Threat Model of Stigma. A cross-sectional correlational design was used to examine the relationships among the variables of weight stigma, psychosocial stress, coping styles, disordered eating, and physical inactivity. Regression modeling and path analysis were used to analyze the data. Over 90% of the sample had scores indicating weight stigma or antifat bias. Avoidant coping style and psychosocial stress predicted disordered eating. The strongest path in the model was from avoidant coping to disordered eating. The Identity Threat Model of Stigma partially explained adolescents' weight stigma. Nursing practice implications are discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0193945917704201DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5511543PMC
August 2017

Healthcare Quality: A Concept Analysis.

Nurs Forum 2017 Oct 13;52(4):377-386. Epub 2017 Apr 13.

Professor of Nursing, University of Mississippi Medical Center, Jackson, MS.

Worsening quality indicators of health care shake public trust. Although safety and quality of care in hospitals can be improved, healthcare quality remains conceptually and operationally vague. Therefore, the aim of this analysis is to clarify the concept of healthcare quality. Walker and Avant's method of concept analysis, the most commonly used in nursing literature, provided the framework. We searched general and medical dictionaries, public domain websites, and 5 academic literature databases. Search terms included health care and quality, as well as healthcare and quality. Peer-reviewed articles and government publications published in English from 2004 to 2016 were included. Exclusion criteria were related concepts, discussions about the need for quality care, gray literature, and conference proceedings. Similar attributes were grouped into themes during analysis. Forty-two relevant articles were analyzed after excluding duplicates and those that did not meet eligibility. Following thematic analysis, 4 defining attributes were identified: (1) effective, (2) safe, (3) culture of excellence, and (4) desired outcomes. Based on these attributes, the definition of healthcare quality is the assessment and provision of effective and safe care, reflected in a culture of excellence, resulting in the attainment of optimal or desired health. This analysis proposes a conceptualization of healthcare quality that defines its implied foundational components and has potential to improve the provision of quality care. Theoretical and practice implications presented promote a fuller, more consistent understanding of the components that are necessary to improve the provision of healthcare and steady public trust.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/nuf.12207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640472PMC
October 2017

Therapeutic Play Intervention.

Authors:
Mary W Stewart

J Perianesth Nurs 2016 Oct;31(5):452-6

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2016.07.001DOI Listing
October 2016

Research News: Emergency Surgery in Ambulatory Settings.

Authors:
Mary W Stewart

J Perianesth Nurs 2016 Jun 23;31(3):277-9. Epub 2016 Apr 23.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2016.02.004DOI Listing
June 2016

Research News: Obstructive Sleep Apnea in Children.

Authors:
Mary W Stewart

J Perianesth Nurs 2016 Feb 17;31(1):103-5. Epub 2015 Dec 17.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2015.11.007DOI Listing
February 2016

Willful Blindness: Guest Editorial.

J Perianesth Nurs 2015 Oct;30(5):455-6

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jopan.2015.08.004DOI Listing
October 2015
-->