We explored the role that exogenous and endogenous competitors for attention play in infants’ abilities to encode and retain information over a 6‐month period. Sixty‐six children visited the laboratory at 15 months, and 32 returned for a second visit at 21 months. Children observed models of conventional‐ relation and enabling‐relation action sequences. Half the children were distracted by a “Mister Monkey” mechanical toy during the conventional‐relation sequence, while the other half was distracted during the enabling‐relation sequence. The Early Childhood Behavior Questionnaire indexed endogenous factors at both ages. Immediate postmodel production of target actions indexed encoding efficiency, and 6‐month production of target actions indexed long‐term recall. The exogenous distracter impacted encoding efficiency (i.e., immediate recall), but not long‐term recall. Endogenous factors (i.e., temperament) were primarily associated with long‐term recall. Of special interest was our finding that endogenous factors, especially surgency, moderated the effect of the exogenous distracter. It appears that when learning conventional‐relation sequences in the presence of exogenous distracters, surgency mobilizes attentional resources toward the learning objective; however, when learning enabling‐relation sequences under the same conditions, surgency either boosts the saliency of the distracters or boosts children’s susceptibility to them.

Literature provides evidence for disparities and inequities in health and birth outcomes based on geographical location, which highlight differential mother characteristics. These differences influence behaviors associated with adverse birth outcomes such as premature birth and low birth weight (LBW), the leading causes of infant morbidity and mortality. Consistent with the Healthy People 2020 and Millennium Development goal, to reduce infant morbidity and mortality rates, we sought to compare maternal characteristics and behaviors and the occurrence of adverse birth outcomes in Northeast (NETN) region, as defined by the Tennessee Department of Health, compared to the rest of Tennessee (TN). TN vital statistics birth record data for the years 2009 - 2014 were used in this analysis; n = 20,786 and 482,681 live births for NETN and TN respectively. Bivariate analyses were performed to deduce the demographic and birth characteristics and their proportions across the years. Logistic regression was used to calculate crude odds ratios for pre-pregnancy smokers, with the dependent variables of preterm birth and LBW. We followed with adjusted odds ratios, which controlled for mother’s demographic variables; age, education years and reported household income and mother’s behavioral characteristics; pre-pregnancy cigarette smoking, prenatal care by first trimester and previous preterm birth. From 2009 through 2014, the percentage of teenage mothers decreased for both TN groups, with a larger proportion in NETN (%:13.8,12.2,12.5, 11.9,9.6,9.4) compared to TN (%:12.8,11.8,10.8,10.0,9.0,8.4). A larger percentage of TN mothers did not have a high school degree or completed GED compared to NETN. A larger proportion of NETN mothers were married at the time of birth of the infant (%:60.3,60.5,59.3,58.6,57.6,57.8) compared to TN mothers (%:55.5,55.9,55.9,55.8,56.0,56.0). Over the period, 34% of NETN women smoked during the 3 months prior to pregnancy versus 21% for TN mothers. Through the third trimester 24% of NETN mothers reported cigarette smoking compared to 13% of TN mothers. Throughout, more adverse birth outcomes were observed in NETN. Compared to non-smokers, for six consecutive years and overall, the odds of a LBW among pre-pregnancy smoking mothers were higher in NETN (odds ratio (OR):2.16,1.73,2.56,2.03, 2.02,1.83,2.05) than in TN (OR:1.51,1.53,1.56,1.56,1.56,1.52,1.54), p-values

Introduction: Irritable Bowel Syndrome (IBS) is estimated to affect 11% of the population globally with a significant female predominance. IBS appears to afflict all age groups and socioeconomic conditions, thus making it a disease that permeates a very large part of society. While often debilitating, only 30% of those with IBS will indeed visit their physician. In an era dominated by social media, it is no surprise that 40% of all consumers report that online information affects the way they deal with their health. YouTube is one of the top 5 most accessed online resources for medical information. The strong reliance on online information as well as the rising prevalence of IBS has prompted us to determine the educational quality of IBS YouTube videos. Methods: We performed a YouTube search using the keywords “Irritable Bowel Syndrome” from September 3-25, 2016. The top 297most viewed videos were included and analyzed for characteristics, source, as well as content. The source was classified as healthcare provider, alternative medicine provider, patient and/or parents, company, media, or professional society. Content was further classified as medical professional education, advertisement, personal experience, patient education, alternative treatment or increase awareness. A scoring system was designed based on current accepted guidelines from multiple professional and academic societies to evaluate quality (-10 to +25 points). Negative points were assigned for misleading information. Videos were also scored by a global quality score. Six blinded reviewers were asked to view the videos and score each video independently. Results: A total of two hundred and ninety-seven videos were analyzed, with a median of 6,671 views, 25 likes, and 2 dislikes. Females were most commonly depicted (36.4%). The most commonly depicted race was White/Caucasian (62.0%). Among video sources, alternative medicine was most represented (32.3%) with treatments that included water fasting, yoga, hypnotherapy, frequency healing, massage therapy, and essential oil therapy. The least represented source was professional societies such as hospitals (5.4%). Mean scores were statistically different from each other (pConclusion: YouTube videos on IBS are mostly produced by alternative treatment sources with often controversial treatments that did not align with Page 16 2017 Appalachian Student Research Forum current evidence based guidelines. Furthermore, videos from healthcare professionals provided better and more accurate quality of information compared to other sources.

Abstract available on the publisher's website.

Background: Food allergy affects an estimated 8% of children and 3% of adults in the United States. Food‐allergic individuals increasingly use the web for medical information. We sought to determine the educational quality of food allergy YouTube videos. Methods: We performed a YouTube search using keywords “food allergy” and “food allergies”. The 300 most viewed videos were included and analyzed for characteristics, source, and content. Source was further classified as healthcare provider, alternative medicine provider, patient, company, media, and professional society. A scoring system (FA‐DQS) was created to evaluate quality (−10 to +34 points). Negative points were assigned for misleading information. Eight reviewers scored each video independently. Results: Three hundred videos were analyzed, with a median of 6351.50 views, 19 likes, and 1 dislike. More video presenters were female (54.3%). The most common type of video source was alternative medicine provider (26.3%). Alternative treatments included the following: water fast, juicing, Ayurveda, apple cider, yoga, visualization, and sea moss. Controversial diagnostics included kinesiology, IgG testing, and pulse test. Almost half of the videos depicted a non‐IgE‐mediated reaction (49.0%).Videos by professional societies had the highest FA‐DQS (7.27). Scores for videos by professional societies were significantly different from other sources (P < .001). There was a high degree of agreement among reviewers (ICC = 0.820; P < .001). Conclusion: YouTube videos on food allergy frequently recommend controversial diagnostics and commonly depict non‐IgE‐mediated reactions. There is a need for high‐quality, evidence‐based, educational videos on food allergy.

Purpose: The purpose of this ethnographic study was to describe the culture of care and nonpharmacological nursing interventions performed by NICU nurses for infants with NAS. Background: Infants with NAS are increasingly being cared for in the inpatient hospital setting by NICU nurses. Interventions used for the care of premature and sick infants in the NICU may or may not be the exact interventions that should be used for the care of the fragile infant with NAS. Research studies on the nonpharmacological nursing care of infants with NAS encompass 5 main areas of practice: environment, adequate rest and sleep, feeding, assessment and evaluation using Finnegan scoring by nurses, and nurses as caregivers. Method: Roper and Shapira’s (2000) framework for the analysis of ethnographic data was used for this research and included participant observation, individual interviews, and the examination to existing documents. Data analysis included: (a) coding for descriptive labels, (b) sorting to identify patterns, (c) identification of outliers or negative cases, (d) generalizing constructs and theories, and (e) memoing to note personal reflection and insights. Focused ethnography allows for the articulation of research questions before fieldwork while observing and describing a culture. Results: Five themes emerged from the data: learn the baby (routine care, comfort care, environment, adequate rest and sleep, feeding), core team relationships (support, interpersonal relationships), role satisfaction (nurturer or comforter, becoming an expert), grief, and making a difference (wonderful insanity, critical to them). Implications: The results of this were a description of the culture of care provided to infants with NAS by NICU nurses and provide general recommendations to the nurse caring for an infant with NAS in the areas of environment, adequate sleep and rest, feeding, and the role of the nurse. This study also has implications for future study of evidence-based research strategies to decrease withdrawal symptoms in infants with NAS. Research is needed in the areas of clinical practice guidelines to help the bedside nurse care for these infants using current research and evidence for practice. Nursing theory and nursing education both contribute to nursing research in how to better understand the culture of care provided by nurses.

Health and feeding outcomes for preterm infants depend upon healthcare providers’ ability to recognize non-verbal signs of distress during bottle-feeding. Methods of training future providers’ to interpret feeding behavior in preterm infants are unclear. This study used a pre-test/post-test design to compare the effects of in- vivo simulation and video-simulation training on students’ knowledge of feeding abnormalities, clinical judgment, and documentation accuracy. Fifty-two graduate level speech-language pathology students were assigned to the in-vivo (N= 27) or video-simulation (N= 25) group. Results revealed that both methods proved beneficial for increasing knowledge and clinical judgment skills. Participants trained using video-simulation training documented a greater number of distress signs. The use of patient simulators to train graduate level speech-language pathology students to use correct clinical judgment for managing abnormal feeding behavior is efficacious.

With increased advances in technology, the overall survival rates in the Neonatal Intensive Care Unit (NICU) for premature infants at lower gestational ages, has also increased. Although premature infants survive at lower gestational ages, they are often discharged to home with unresolved medical issues. While the birth of a new baby for parents is a joyous occasion, they often have difficulty coping and transitioning into a parental role. Premature infants also have ongoing complications such as difficulty with feeding, developmental delays in growth, and long-term eye and respiratory complications. As a result of chronic health sequelae, premature infants require extensive utilization of hospital and community health resources. In addition, hospitals must coordinate between community resources, while preparing parents for specialized discharge teaching. Furthermore, individuals living in rural and underserved areas face unique challenges and barriers to access healthcare resources. An interpretive phenomenology study was conducted to bring insight and develop an understanding into how families perceive discharge readiness, accessing health care resources, and ability to cope at home after discharge from a Level III NICU located in Appalachia. Ten parents total were enrolled in the study and consisted of three couples, three married mothers, and two single mothers. Interviews were conducted over a period of six months and transcript analysis revealed development of major and minor themes. The studies overarching theme was Adapting to a New Family Roles, Finding Normalcy, which described parents experience of being prepared for discharge and their transition to home. Three major themes related to discharge readiness from detailed analysis included; 1) Riding out the storm, 2) Righting the ship, and 3) Safe port, finding solid ground. Subthemes that supported development of the major these were 1a) having the carpet pulled out from under me, 1b) things I lost, 1c) feel like an outsider, 1d) sink or swim, 2a) quest for knowledge, 2b) caring for me, care for my baby, 2c) customized learning, 3a) getting to know baby, 3b) becoming the expert, 3c) ongoing emotions, and 3d) adjusted parental role. Practice and research implications for discharge readiness include providing customized support for parents as they adjust to a new normal for their family, identify necessary resources, and become self-reliant once home.

Transitioning to the father role can be complex and stressful and fathers may not be fully prepared to assume the father role. Since fathers have little formal preparation for becoming a father, they may need more social support resources to support their adaptations to the father role. In addition, fathers are instrumental in supporting mothers’ breastfeeding and other infant feeding decisions, but may experience difficulties with infant care tasks, such as feeding and providing care to their infant. Studies show that many fathers want to be productive and nurturing in the father role but little is known about fathers’ parenting knowledge and needs. Therefore, the purpose of this study is to describe the social support resources of fathers with infant feeding and related parent educational learning needs during the first year after birth. Cross-sectional data was obtained for this descriptive, exploratory study by using a questionnaire and semi-structured interviews. Descriptive statistics were used to analyze questionnaire findings and directed content analysis was used to analyze the qualitative data. Since there is little evidenced-based literature on social support and parenting knowledge and needs of fathers in general, the study design was descriptive, exploratory and included new and experienced fathers. The study was guided by Bandura’s Self-Efficacy Theory. The findings reported in this study originated in a larger study on social support needs of urban fathers with infants during the first year after birth. Thirty experienced and new fathers were recruited from community organizations that offer services to low-income families in a southern part of the United States. The mean age range of the fathers was 30 (SD = 5) and 60% were experienced fathers and 40% were new fathers. The majority of the fathers were single (67%), Black (90%), had some or completed high-school education (81%) and 85% reported low annual incomes of less than $20,000. Most infants were bottle-fed (73%) and all infants were between 2-12 months. Inclusion criteria included being 18 years old with an infant that was born full-term. The study was reviewed and approved by the university internal review board. Findings revealed most fathers were confident with feeding their baby, however, some fathers were not confident because they were afraid to handle their baby due to the baby’s size or felt awkward when holding the baby. When fathers had difficulties with feeding their babies, they primarily asked family and friends for advice. Other resources included the internet and healthcare professionals. Fathers reported positive and negative attitudes towards breastfeeding and reasons why breastfeeding was stopped. After the baby’s birth, fathers reported the majority of parent educational learning needs related to how to take of infant, normal infant behavior, basic, daily care, and recognizing signs and symptoms of illness. At time of interview, the majority of parent educational learning needs related to how to cope with a difficulty baby, accessing positive parenting tips and resources, being responsive to the infant, coping with being a new father, and recognizing signs of depression. Recommendations for practice and research will be provided.

The proportion of obese adolescents in Southern Appalachia is among the highest in the nation. Currently there are few effective programs that address this issue, especially among high school students. Through funding from the National Institute on Minority Health and Health Disparities in the National Institutes of Health, the Team Up for Healthy Living Project targets obesity prevention in adolescents through a crosspeer intervention. The specific aims of the project are: 1) To develop a peer-based health education program focusing on establishing positive peer norms and supportive peer relationships toward healthy eating and physical activity among high school students, 2) To test the efficacy of the program, and 3) To explore the mechanisms underlying the program. The intervention is based on the Theory of Planned Behavior, which presupposes that human behavior is primarily driven by attitude, subjective norms, perceived behavior control, and social support. Through influencing these components, the intervention is expected to improve eating behavior, increase physical activity, and lead to healthier body weight among adolescents in Southern Appalachia. Ten area high schools were selected to be a part of the project, and schools were matched based on similar demographics (school size and number of students enrolled) and were randomized to intervention or control. Wave one of baseline data collection was completed in January 2012; with 265 students assigned to intervention and 276 to control. A second wave of subject recruitment will occur in fall 2012. To deliver the intervention, undergraduate students from the disciplines of Public Health, Nutrition, and Kinesiology were trained as peer facilitators. These peer facilitators are teaching the eight-week Team Up curriculum during Lifetime Wellness classes at intervention schools. The curriculum focuses on nutrition awareness, physical activity, leadership, and communication skills. Page 84 2012 Appalachian Student Research Forum Control group participants receive their regularly scheduled Lifetime Wellness curriculum. Body mass index percentile, dietary behavior, and physical activity among study subjects will be assessed at baseline, and at three and twelve months post-baseline. In addition, peer group norms, body image, supportive peer relationships, role modeling, behavioral control/self-efficacy, attitudes, and intentions toward healthy eating and physical activity will also be assessed. Group differences will be assessed at each data collection period. The long-term goal of the study is to establish an effective academia-community partnership program to address adolescent obesity disparity in Southern Appalachia.