Digital Commons Network^™

Experience In Managing Child With Congenital Fiber Type Disproportion With Rehabilitation Outcome: Casereport, Po-Cheng Hsu, Sung-Yin Chuang, Tsui-Fen Yang

Rehabilitation Practice and Science

Congenital fiber type disproportion（CFTD）為一非進行性先天性肌肉病變，須經肌肉切片病理確診，其特點為第一型骨骼肌纖維體積比第二型肌纖維至少小12%。現有文獻提及此疾病之臨床表現變異性大，除肌肉無力，可能併有弓狀顎（High-arched palate）、眼肌麻痺症（Ophthalmoplegia）、呼吸障礙等。患者皆因肌肉無力造成顯著功能障礙。本案例為一10歲確診CFTD男童之長期追蹤與復健介入之描述。患者出生時明顯肌張力不全，自四個月起因生長遲滯、吞嚥功能障礙而接受鼻胃管置入，但診斷未明；後續持續安排物理治療與與語言及吞嚥治療，該患者於一歲八個月時開始走路，三歲時成功移除鼻胃管，並於此時才確診CFTD。患者定期接受完整發展評估，結果顯示明顯動作發展遲緩，其社會心理領域評估結果皆為正常範圍。該患者的肌力與肌耐力隨著年紀增大與物理治療介入而有進步。日常生活能力評估於運動部分仍部分依賴。此外，長期追蹤過程發現該患者有多種肌肉病變之併發症，包括脊柱側彎、雞胸（pectus carinatum）、以及關節與肌肉疼痛。物理治療介入以及教導患者以及家屬運用節省能量之日常生活方式，包括輪椅使用、自我安排活動。本病例報告紀錄CFTD肌病變患者之長期追蹤與復健過程，根據患者之狀況設定個人化復健目標，及處理相關之併發症。

Acute Exacerbations Of Progressive-Fibrosing Interstitial Lung Diseases., Martin Kolb, Benjamin Bondue, Alberto Pesci, Yasunari Miyazaki, Jin Woo Song, Nitin Y. Bhatt, John T. Huggins, Justin M. Oldham, Maria L. Padilla, Jesse Roman, Md, Shane Shapera

Department of Medicine Faculty Papers

Acute exacerbation of interstitial lung disease (ILD) is associated with a poor prognosis and high mortality. Numerous studies have documented acute exacerbation in idiopathic pulmonary fibrosis (IPF), but less is known about these events in other ILDs that may present a progressive-fibrosing phenotype. We propose defining acute exacerbation as an acute, clinically significant respiratory deterioration, typically less than 1 month in duration, together with computerised tomography imaging showing new bilateral glass opacity and/or consolidation superimposed on a background pattern consistent with fibrosing ILDs. Drawing on observations in IPF, it is suspected that epithelial injury or proliferation and autoimmunity are risk …

Capsule Integrated Polypeptide Multilayer Films For Effective Ph-Responsive Multiple Drug Co-Delivery, Shichao Zhang, Malcolm Xing, Bingyun Li

Clinical and Translational Science Institute

Many applications using drug-carrying biomedical materials require on-demand, localized delivery of multiple therapeutic agents in precisely controlled and patient-specific time sequences, especially after assembly of the delivery vehicles; however, creating such materials has proven extremely challenging. Here, we report a novel strategy to create polypeptide multilayer films integrated with capsules as vehicles for co-delivery of multiple drugs using layer-bylayer self-assembly technology. Our approach allows the multilayered polypeptide nanofilms and preimpregnated capsules to assemble into innovative biomedical materials with high and controllable loading of multiple drugs at any time postpreparation and to achieve pH-responsive and sustained release. The resulting capsule-integrated polypeptide …

Week Of December 24, 2018, New York Medical College

InTouch

• Department of Surgery Hosts 15th Annual Louis R.M. DelGuercio Distinguished Visiting Professorship and Research Day
• SHSP Hosts Winter Meet and Greet
• GSA Sponsors Third Annual Snowman Project

Trends In Opioid Use In Pediatric Patients In Us Emergency Departments From 2006 To 2015, Daniel M. Tomaszewski, Cody Arbuckle, Sun Yang, Erik J. Linstead

Pharmacy Faculty Articles and Research

Importance The use of opioids to treat pain in pediatric patients has been viewed as necessary; however, this practice has raised concerns regarding opioid abuse and the effects of opioid use. To effectively adjust policy regarding opioids in the pediatric population, prescribing patterns must be better understood.

Objective To evaluate opioid prescribing patterns in US pediatric patients and factors associated with opioid prescribing.

Design, Setting, and Participants This cross-sectional study used publicly available data from the National Hospital Ambulatory Medical Care Survey from January 1, 2006, to December 31, 2015. Analysis included the use of bivariate and multivariate models to …

The Effect Of Competency-Based Education On Medical And Nursing Students' Academic Performance, Technical Skill Development, And Overall Satisfaction And Preparedness For Future Practice: An Integrative Literature Review, Haris Saud, Ruth Chen

International Journal of Health Sciences Education

Purpose: This article provides an integrative review of competency-based education (CBE) in medical and nursing programs and examines the effect of CBE on students’ academic performance, technical skill development, and overall satisfaction and preparedness for future practice.

Background: In recent decades, CBE has increasingly been discussed in medical and nursing education programs. The impact of the CBE curriculum on learning outcomes including academic performance, technical skill development, overall satisfaction, and preparedness for future practice has not been fully elucidated.

Method: A review of the literature was conducted, and multiple databases were searched for studies that analyzed the impact of CBE …

Evaluation Of The New Onset Diabetic Education Program For Navajo Adults, Denise S. Bartley

Nursing ETDs

The prevalence of diabetes mellitus (DM) is higher in American Indians/Alaska Natives (AI/AN) than in any other racial or ethnic group in the United States (U.S. Department of Health and Human Services [USDHHS] Centers for Disease Control and Prevention [CDC], 2018). In response to this escalating health issue, the U.S. government funded a number of DM education and treatment programs focusing on AI/AN populations. The purpose of this study was to evaluate the New Onset Diabetes Education Program (NODEP) based at Northern Navajo Medical Center (NNMC) in Shiprock, N.M.

The Navajo philosophy of learning was used as a guiding framework. …

Acquired Bracket Pellicle Modulation Via Exposure To Histatin 3, Niklas W. Neilson

Electronic Thesis and Dissertation Repository

Objectives: To investigate the effect of histatin 3 on the protein pellicle formation on the orthodontic bracket surface.

Methods: Our study consisted of 4 sample groups. A sample of human parotid saliva without histatin functioned as a control group. Other groups were immersed with or without histatin 3 and human parotid saliva. Each group was incubated for 2 hours in their respective substrate at 37°C. The acquired pellicle from each group was harvested, then analyzed with SDS-PAGE and LC-ESI-MS/MS.

Results: Thirty-nine proteins were identified in the control group, 18 were identified in group 2, and 21 were identified in group …

Effect Of Strong Electrolyte Containing Gelling Aids On The Sol-Gel Transition Temperature Of Hypromellose 2910, Elnaz Sadeghi

Biomedical Engineering ETDs

Hypromellose, or hydroxypropyl methylcellulose (HPMC) - has been widely used for biomedical and pharmaceutical applications due to its advantages, including that it is modifiable in terms of viscosity, and it has the ability to form thermally reversible hydrogels. The thermal gelation temperature (T_Gel) of a given HPMC solution strongly depends on its characteristic grade and the solution concentration. Applying certain additives can modify the T_Gel even further; depending on their nature and concentration. With the addition of said additives, a lower or higher T_Gel can be obtained. For example, the addition of sodium chloride (NaCl) reduces …

Women Are Being Cut During Childbirth Without Need Or Consent, Molly Cora Enking

Capstones

An episiotomy, a surgical cut used to enlarge the vaginal opening during childbirth, can be extremely painful, hard to recover from and can increase the risk of severe complications. In 2018, episiotomies are rarely necessary, but at some U.S. hospitals they happen much more than they should. And in the course reporting this story, New York City News Service found that it is common for doctors to cut women without the mother’s consent.

https://medium.com/@mollyenking/women-are-being-cut-during-childbirth-without-need-or-consent-7677de7eddae

The Effectiveness Of Bispectral Index Monitoring On Intraoperative Awareness In Adult Surgical Patients Undergoing General Anesthesia, Eugene D. Lee

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Intraoperative awareness (IA), or the unexpected and explicit recall by patients of events that occurred intraoperatively, is a rare but serious event. Incidences of IA have been associated with extreme anxiety, physiologic stress, and the development of post-traumatic stress disorder. Anesthesia has debated the efficacy of brain monitoring devices, such as the Bispectral (BIS) index monitor, to reduce the incidence of IA. By analyzing EEG waves, these monitors can be used to alert the anesthesia provider when the patient may not be sufficiently anesthetized. An integrative review was conducted to evaluate the current evidence on the use of BIS monitoring …

Serum Nutrient Levels And Aging Effects On Periodontitis, Jeffrey L. Ebersole, Joshua Lambert, Heather Bush, Pinar Emecen Huja, Arpita Basu

Dental Medicine Faculty Publications

Periodontal disease damages tissues as a result of dysregulated host responses against the chronic bacterial biofilm insult and approximately 50% of US adults >30 years old exhibit periodontitis. The association of five blood nutrients and periodontitis were evaluated due to our previous findings regarding a potential protective effect for these nutrients in periodontal disease derived from the US population sampled as part of the National Health and Nutrition Examination Survey (1999–2004). Data from over 15,000 subjects was analyzed for blood levels of cis-β-carotene, β-cryptoxanthin, folate, vitamin D, and vitamin E, linked with analysis of the presence and severity of periodontitis. …

Serum Nutrient Levels And Aging Effects On Periodontitis, Jeffrey L Ebersole, Joshua Lambert, Heather Bush, Pinar Emecen Huja, Arpita Basu

Biostatistics Faculty Publications

Periodontal disease damages tissues as a result of dysregulated host responses against the chronic bacterial biofilm insult and approximately 50% of US adults > 30 years old exhibit periodontitis. The association of five blood nutrients and periodontitis were evaluated due to our previous findings regarding a potential protective effect for these nutrients in periodontal disease derived from the US population sampled as part of the National Health and Nutrition Examination Survey (1999–2004). Data from over 15,000 subjects was analyzed for blood levels of cis-β-carotene, β-cryptoxanthin, folate, vitamin D, and vitamin E, linked with analysis of the presence and severity of periodontitis. …

Improving Infection Management Of The Institutionalized Elderly, Jovel Angela Viloria Broqueza

Doctor of Nursing Practice Projects

Abstract

As the elderly population rapidly grows in the United States, the burden of managing infection in long-term care facilities (LTCF) escalates. The use of evidence-based infection identification algorithms for early recognition and treatment of pneumonia, urinary tract infections (UTI) and skin and soft tissue infections (SSTI) was evaluated at a Midwest suburban 110-bed long-term care facility. Focus group sessions were conducted at the facility with four nurse practitioners, the medical director, eight nurses and certified nursing assistants (CNAs) prior to an educational in-service which was provided to all staff at the facility. As criteria of infection were reported, nurses …

Improving Lead Screening In A Pediatric Practice: A Quality Improvement Project, Audrey Myers

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Abstract

Background: Detectable lead levels in children’s blood have been associated with increased cognitive difficulties, attention deficits, and poorer academic performance. Children enrolled in Medicaid have higher rates of elevated blood lead levels, yet requirements to test all children at age 1 and 2 who are enrolled in Medicaid are not being met. Nationally, 34% of children enrolled in Medicaid do not undergo proper blood lead level screening. The aim of this project was to increase required blood lead level screening rates for children with Medicaid insurance at a private pediatric practice in the Shenandoah Valley in Virginia.

Methods: The …

Normalizing Masculinity: Explaining Processes, Factors, And Contexts That Influence How Rural Male Farmers Seek Health Information In Southwest Ontario, Bradley C. Hiebert

Electronic Thesis and Dissertation Repository

Disproportionately high mortality and morbidity rates experienced by rural men are often related to the high prevalence of rural male farmers (RMFs) who are consistently exposed to chemicals, animal waste, and dust, or injured or killed while working. This dissertation aimed to explain processes by which RMFs seek health information (HI), and how these processes are influenced by rural social, cultural, political, and geographical factors.

Three studies were conducted as part of this dissertation. The first study was a literature review that explored the relationship between rural men’s health, health information seeking (HIS) theory, and masculinity theory. The second study …

Effect Of Npo Status On Aspiration Risk In Pediatric Patients Undergoing Procedural Sedation, Stacey Waldron, Kelsey Woycik

Physician Assistant Capstones, 2016 to 2019

Objective:To conduct a review of literature to determine if no solid food or liquids by mouth for more than or less than six hours impacts the incidence of pulmonary aspiration during procedural sedation in pediatric patients. Methods: A PubMed search was conducted utilizing the following terms: “sedation, fasting, and aspiration” and “NPO, pediatrics, and pre-procedural.” Filters included: “within five years,” “review articles,” and “English.” Articles were then screened and assessed for eligibility based on pediatric population, NPO status, procedural sedation, and risk of pulmonary aspiration. Results: Two prospective observational studies and one retrospective review were selected. Beach et al. …

Effects Of Class Ii Correctors And Functional Appliances On The Periodontal Health Of The Mandibular Incisors – A Prospective Cone-Beam Computed Tomography (Cbct) Study, David C. Duevel

Theses & Dissertations

The purpose of this investigation was to evaluate the effects of Class II correctors and functional appliances on the dentoalveolar support of the mandibular incisors during orthodontic treatment. Twenty six patients who were treated with a Forsus^TM, Herbst, or MARA participated this study. Lateral cephalometric radiographs, limited field-of-view CBCTs, and periodontal measurements were collected both the day of appliance activation and day of appliance deactivation. Ten hard tissue measurements on all four mandibular incisors were collected at each time point on CBCT images. Bone thickness increased at 6 and 9 mm apical from the cementoenamel junction (CEJ) on …

Post-Traumatic Stress Disorder Screening Project For Adult Males From The Middle East And Afghanistan, Ricky Norwood

Master's Projects and Capstones

Current research indicates a significant rise in PTSD signs and symptoms of adult males arriving from the Middle East and Afghanistan. In an effort to increase the awareness of Post-Traumatic Stress Disorder (PTSD) in clinical personnel and adult males from the Middle East and Afghanistan, the Sacramento Refugee Health Clinic implemented a PTSD Screening Project. This project was designed to ensure the maximum number of the adult males from the Middle East and Afghanistan would be appropriately screened for PTSD and provided additional opportunities to meet the mental and acute primary care needs of these patients in an adequate and …

Root Cause Analysis To Improve Incident Reporting In An Ambulatory Care Setting, Lisa Ann Duncan

Doctor of Nursing Practice (DNP) Projects

Problem: The subject organization (SO) is a Federally Qualified Health Center (FQHC) with an internally developed incident reporting system. The SO wanted to improve patient and employee safety using data from incident reports, but the incident reporting system did not give enough information to recognize patterns and develop countermeasures.

Context: Supervisors welcomed the opportunity to learn more about incident report follow-up and conducting root cause analysis (RCA). Members of the Safety Committee were eager for data to use to develop countermeasures to improve patient and employee safety. Decreases in employee injuries can save the SO from increases in the …

Changes In The Transverse Dimension Of The Nasomaxillary Complex Following Rapid Palatal Expansion – A Post-Retention, Cbct Evaluation, Allison Schubert

Theses & Dissertations

Purpose: The purpose of this investigation was to evaluate the immediate and long-term effects of palatal expansion on the transverse dimension of the nasomaxillary complex.

Materials and Methods: Twenty-eight patients’ CBCTs were obtained at four time points: pre-expansion (T₁), post-expansion (T₂), pre-treatment (T₃), and middle or end of orthodontic treatment (T₄). The patients’ age, sex, cervical vertebral maturation stage, and the number of instructed expander turns were recorded. Measurements of the nasal floor, nasal passage, maxillary sinus, maxillary first molar mesiolingual cusp, maxillary first molar palatal cusp, maxillary first molar buccal cortical …

Perceptions And Clinical Applications Of Feedback Type If Dental Hygiene, Elmer Eleazar Gonzalez

Individual, Family, and Community Education ETDs

Purpose/Objectives: The study assesses whether or not feedback type and feedback delivery method play a significant role in students’ learning and clinical performance. The study explores Ego Stroking Sandwich feedback and Non-Sandwich feedback as the feedback types and Instructors feedback vs. Scoring guide feedback as the feedback delivery method. Students’ perceptions and clinical applications were considered as part of the study.

Methods: Eleven participants were included in the study. One group was the Ego Stroking Sandwich type feedback (n=5) and the other was the Non-Sandwich Type feedback (n=6). Each group performed two dental impressions (a maxillary and a mandibular) while …

Essays On The Patient-Centered Medical Home In The United States Military Health System, Glen N. Gilson

Theses & Dissertations

The Patient-Centered Medical Home has been endorsed by the primary care community as the model of the future, with hopes that it will increase quality of care and the patient and provider experience while decreasing costs. Many aspects of the implementation of the Patient-Centered Medical Home model remain unexplored. This dissertation comprises three independent studies examining Patient-Centered Medical Home implementation in the Military Health System, including (1) the effects of environmental correlates on the time to implement the model, (2) the impact of differences in implementation on preventive care quality outcomes, and (3) the effect of differences in implementation on …

Staff Retention Through Standardized Training Materials In Adult Primary Care Clinic, David Smith

Master's Projects and Capstones

As non-profits, community health clinics face a unique set of challenges. Primary amongst these is a shortage of financial resources. Staff turnover, including Registered Nurses (RNs) and Medical Assistants (MAs), can result in avoidable increased wage costs related to training of newly-hired RNs/MAs (clinical staff). Retention of experienced RNs/MAs can be directly correlated with job satisfaction, the obverse of which is job frustration. The intent of this RN/MA training and orientation project is to ameliorate frustration related to a lack of informational resources and clear competency expectations. Upon completion and implementation, project efficacy will be assessed via four longitudinal measures: …

Virtual Reality Simulation Of Glenoid Reaming Procedure, Mohammadreza Faieghi

Electronic Thesis and Dissertation Repository

Glenoid reaming is a bone machining operation in Total Shoulder Arthroplasty (TSA) in which the glenoid bone is resurfaced to make intimate contact with implant undersurface. While this step is crucial for the longevity of TSA, many surgeons find it technically challenging. With the recent advances in Virtual Reality (VR) simulations, it has become possible to realistically replicate complicated operations without any need for patients or cadavers, and at the same time, provide quantitative feedback to improve surgeons' psycho-motor skills. In light of these advantages, the current thesis intends to develop tools and methods required for construction of a VR …

The Influence Of Depression On Pain In The Postoperative Setting: A Systematic Review, Lewis Lateef Olaoluwa

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Over 5% of Americans over the age of 12 reported depression between 2005–2006, and it remains the second leading cause of death in the adolescent and the early adulthood population. The estimated worldwide impact of depression affects approximately 300 million people (World Health Organization [WHO], 2017). Few research studies analyzed the correlation of depression and postoperative pain. The impact of depression on physiological wellbeing, and evidence from various studies suggest a correlation between psychological illnesses such as depression and the physiological manifestations of pain. This systematic review will consider Randomized Controlled Trials (RCT’s), however in the absence of RCT’s, a …

Feeding And Oral Care Guidelines For Certified Nursing Assistants Working With Patients With Head And Neck Cancer, Emma Eisert

Graduate Independent Studies - Communication Sciences and Disorders

No abstract provided.

Feeding And Oral Care Guidelines For Certified Nursing Assistants Working With Patients With Head And Neck Cancer, Emma Eisert

Graduate Independent Studies - Communication Sciences and Disorders

No abstract provided.

Ada News - 12/10/2018, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

Tardive Dyskinesia, Joseph J. Gossman

Nursing Capstones

No abstract provided.