Medicine and Health Sciences Commons^™

Procedural Sedation: Policy, Practice & Knowledge, Jennifer A. Martin

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

Diagnostic and invasive procedures performed outside of the operating room with nurse- administered procedural sedation are increasing. As procedural sedation practice national guidelines are evolving, there are inconsistent state regulations and a great deal of variability in staff training. These challenges lead to potential knowledge gaps and practice variation that create unsafe patient environments. A local hospital has continued to experience near miss events when procedural sedation is administered. In an attempt to investigate this issue and create improved practice, an organizational policy analysis was conducted. The aims of this project were to: 1) analyze current hospital policy content compared …

Implementing Post-Hospital Interprofessional Care Team Visits To Improve Transitions Of Care And Decrease Hospital Readmission Rates, Stacy M. Baldwin

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

Background: Today’s healthcare climate is comprised of a population of patients who are more complex, presenting with multiple comorbidities, and requiring frequent hospitalizations. It is imperative for acute care and primary care landscapes to bridge silos and form collaborative relationships to ensure safe and effective transitions of care from hospital to home. An interprofessional, post hospital follow-up clinic is one approach that can be utilized to improve transitions of care and decrease preventable hospital readmissions.

Purpose: The purpose of the project's discharge clinic was to improve transitions of care and decrease thirty day hospital readmission rates. The primary objective of …

Minimizing The Inappropriate Use Of Physical Restraint, Shiela Marie C. Telmo

Master's Projects and Capstones

The aim of this project is to be able to improve patient safety by minimizing the inappropriate use of physical restraints from 45% to about 20% in the acute respiratory unit which caters to patients with acute respiratory issues, such as exacerbation of chronic obstructive pulmonary disease (COPD), patients with new or old tracheostomy, needing bipap, rigorous nebulizer treatment, and other respiratory-related devices, not to mention the multiple comorbidities that oftentimes very difficult to stabilize which makes the hospital stay longer than usual. The Clinical Nurse Leader (CNL) as an educator and an outcome manager is an agent to empower …

The Development, Implementation, And Evaluation Of A Transgender Health Resource Bundle, Lovejeet Kaur

Doctor of Nursing Practice (DNP) Projects

Transgender populations experience disproportionate social and health disparities that can negatively impact quality of life. Healthcare barriers due to gender based discrimination and lack of medical insurance and culturally competent providers contribute to low levels of access to preventative health care screenings, resulting in sub-optimal health outcomes. The unique health circumstances of transgender individuals have been understudied in the literature. As a result clinicians are often under-informed of their specific health maintenance needs and screening guidelines. To help address this disparity, a Doctor of Nursing Practice (DNP) student at the University of San Francisco facilitated the collaborative assessment, development, implementation …

Bone Loss Quantification Following Extraction In Rats: A Foundation For Grafting And Regenerative Studies, Emily Willett

Theses & Dissertations

Background: Loss of the alveolar ridge width and height following extraction is well-documented and several techniques, including grafting, have been proposed to reduce bone loss. Purpose: To characterize the pattern of bone turnover and inflammation after extraction and to initiate a study of the effect of grafting and local administration of simvastatin (SIM). Methods: Thirty-two retired-breeder rats underwent extraction of the right maxillary first molar and standard surgical defect creation under inhalation anesthesia. The left side of each animal served as the unmanipulated control. Comparison of groups (n=8, ANOVA) was done at days 0, 7, 14, and …

Effects Of Flash-Free Technique On Plaque Retention, White Spot Lesions, And Bracket Failure: A Randomized Clinical Trial, Payam Ishani Afousi

Theses & Dissertations

A side effect of orthodontic treatment is the development of white spot lesions (WSLs). This thesis attempted to evaluate the effects of the use of APC™ Flash-Free (FF) and conventional adhesives in bonding of orthodontic brackets on plaque formation and retention, WSL development, and bracket failure in-vivo. This was accomplished by collecting plaque samples from around orthodontic appliances and analyzing them using ATP-driven bioluminescence; scanning enamel surfaces using the Canary System™ to evaluate WSL development, and counting the number of spontaneous debonding of brackets of the 4 maxillary incisors in the first 6 months of treatment. It was found …

The Effects Of Lung Volume On Swallowing In Chronic Obstructive Pulmonary Disease, Teresa C. Drulia

Dissertations, 2014-2019

Chronic Obstructive Pulmonary Disease (COPD), a respiratory disease that leads to reduced airflow, may result in difficulty swallowing with disease progression. The coordination between the respiratory and swallowing systems decouple and they may experience increased risk of aspiration. This study aimed to determine the effects of lung volume on swallowing in individuals with COPD compared with older healthy. Specifically, the study examined if altering lung volume at the time of the swallow changed swallowing timing, specifically pharyngeal swallow duration, and impacted the respiratory-swallow pattern in individuals with COPD. Measurement of estimated lung volume (ELV), pharyngeal swallow duration, and respiratory-swallow patterning …

Ihss: Repackaging Consumer Information, Deloras N. Puran

Master's Projects and Capstones

Currently, qualified Californians with disabilities and aging individuals can receive consumer-directed care through the IHSS program. Despite the strong demand for the program, new consumers are still struggling to begin their service after enrollment.

This study assisted San Francisco In Home Supportive Services Public Authority to understand how new consumers can navigate the IHSS program services after enrollment. Focus group and semi-structured in-depth interviews were conducted to gather feedback from consumers regarding what type of information would they need after enrollment, and how would they want to receive the information. Based on the feedback, written and virtual deliverables were designed …

Relationship Between Preponderance Of Adhd In The African American Community And How Teachers Are Trained To Type Students As Adhd, E Madison

Capstone Collection

The following capstone paper “Relationship between preponderance of ADHD in African American community and how teachers are trained to type students as ADHD” explores the epidemic of Attention Deficit Hyperactivity Disorder (ADHD) diagnosis in students and the prevalence of ADHD in the African American community. In recent years the number of African American children with ADHD have skyrocketed concerning parents about the over diagnoses and misdiagnoses of the disorder (Ahmann, 2016). A recent study by Getahun and colleagues found a "70 percent increase in the number of ADHD diagnoses among African American children, with a 90 percent increase among African …

Examining The Impact Of The Affordable Care Act On Small Businesses And Industries In Northwest Indiana, Onias Muza Taruwinga

Open Access Dissertations

This research examined the lived experiences of small businesses in Northwest Indiana with the implementation of the Affordable Care Act. The interviews were conducted over a period of six months with an attempt to answer the question, “What was the impact of the Affordable Care Act on small businesses and industries in Northwest Indiana?” Additional research questions were, “Did the Affordable Care Act extend coverage to the uninsured, include other medical services that were not covered before, and reduce cost sharing and what lessons can be learned from the implementation of the Affordable Care Act for future policy implementation?” 15 …

A Systems Intervention For The Transition Of Postpartum Women To Primary Care, Charlotte Jeannette Matthews

Doctor of Nursing Practice

The Institute of Medicine (2001) describes the United States’ healthcare system as poorly organized and difficult for patients to navigate. Patients are often lost during the transition between providers, failing to establish subsequent care (Thomas, 2015). Gaps in care lead to worsening conditions that result in billions of dollars in healthcare costs (National Quality Forum, 2016). Following discharge from the care of the obstetrician, postpartum women should establish care with a primary care provider (American College of Obstetrics and Gynecology, 2016). The American College of Obstetrics and Gynecology recommends that postpartum women transition to a primary care provider within the …

Intercanine Distance Used As A Measure To Rule Out Biters In Bite Mark Forensics, Alana Joy Scudiere Ohana

Masters Theses

The science of identification by bite mark analysis has recently been called into serious question. (Reesu and Brown 2016) Human dentition is truly variable, but often not unique. When animal bites are considered, a proper ID of the perpetrator is nearly impossible. Primary distortion (when the bite is made) and secondary distortion (during decomposition or healing) both further disrupt landmarks that might be used for identification. (Sheasby and MacDonald 2001) Using only ink marks and intercanine distance on live subjects, this study attempts to determine maximum distortion possible for a variety of bite mark locations on skin. (Pretty and Sweet …

Socio-Demographics And Exclusive Breastfeeding In The Medicaid/Women Infant And Children (Wic) Population In Spartanburg County, April D. Miller

Nursing Theses and Capstone Projects

Breast milk is recognized as the optimal source of nutrition for infants because of its unique nutritional and immunological characteristics. The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of an infant’s life. "Exclusive breastfeeding (EBF)" is defined as no other food or drink except breast milk for the first six months of life. Despite its countless benefits to children and mothers, the continuation rates of exclusive breastfeeding are low in the United States, especially in the Medicaid/Women Infant and Children population. It is vital to understand how multiple factors affect breastfeeding practices in order to …

Improved Medication Management For Elderly Patients Through Increased Review And Documentation, Esmeralda Rivera

Doctor of Nursing Practice

The purpose of this quality improvement project was to improve medication management processes for patients in a wellness center. Medication reconciliation is a safe practice shown to reduce the potential for patient harm by preventing prescribing errors and adverse drug effects. Medication reconciliation includes assessment of medications, development of medication lists, education, and medication counseling for patients (Snyderman, Salzman, Mills, Hersh, & Parks, 2014). Assessment of medication reconciliation in a geriatric wellness center revealed poor medication management. Education on medication management was provided to staff (N = 10) and the workflow was altered to improve processes. Electronic medical records of …

A Multi-Channel 3d-Printed Bioreactor For Evaluation Of Growth And Production In The Microalga Dunaliella Sp, Cristian A. Cox

Electronic Theses and Dissertations

We explored the capabilities of additive manufacturing using a photo-cured jetted material 3D printer to manufacture a milli-microfluidic device with direct application in microalgae Dunaliella sp growth and intracellular compounds biosynthesis tests. A continuous microbioreactor for microalgae culture was CAD designed and successfully built in 1 hour and 49 minutes using black photopolymer cured by UV and a support material. The microreactor was made up of 2 parts including the bioreactor itself and a microchannel network for culture media fluids and microalgae. Both parts were assembled to form a single unit. Additional optical and auxiliar components were added. An external …

The Transcriptional Effects Of Photobiomodulation In An In Vitro Model Of Diabetic Retinopathy, Hannah Jane Therese Fisher

Theses and Dissertations

Diabetic retinopathy (DR) is the most common complication of diabetes mellitus and a leading cause of blindness. The pathophysiology of DR is complicated, involving inflammation, oxidative stress, retinal vascular proliferation, and vascular degeneration. Symptomatically, the growth and subsequent rupture of vessels within the frame of view leads to the development of vision loss and eventual blindness. Prior to the development of symptoms, oxidative stress involved in DR leads to the activation of the transcription factor, nuclear factor-kB (NF-kB), resulting in the excess production of vascular endothelial growth factor (VEGF) and intracellular adhesion molecule-1 (ICAM-1), proteins involved in vascular development and …

Gastrointestinal Health As A Stimulus For Native American Attraction To Medicinal Asteraceae And Further Implications For Human Evolution, Christopher David Stiegler

Graduate Theses and Dissertations

The Asteraceae, or the daisy family, is the largest family of flowering plants in the world, and its ethnobotanical, medical, and economic value is readily apparent cross-culturally. The aim of this thesis is to examine why constituent genera of the Aster family have remained such an integral part of human medicinal plant knowledge, and thereby to reveal any potential physiological, biological, or evolutionary mechanisms underlining human patterns of use regarding the Asteraceae. The present study focuses specifically on Native American plant knowledge made available by the expansive database in the works Daniel Moerman (Moerman 2003). Frequencies of plant use and …

Neuroprotective Molecules And Strategies In A Rat Model Of Neonatal Hypoxic Ischemic Encephalopathy, Brandon Joseph Dixon

Loma Linda University Electronic Theses, Dissertations & Projects

Neonatal hypoxic ischemic encephalopathy (HIE) is a devastating disease that primarily causes neuronal and white matter injury and is among the leading cause of death among infants. Currently there are no well-established treatments; thus, it is important to understand the pathophysiology of the disease and elucidate complications that are creating a gap between basic science and clinical translation. In the development of neuroprotective strategies and translation of experimental results in HIE, there are many limitations and challenges to master based on an appropriate study design, drug delivery properties, dosage, and use in neonates. Since there are no established therapies for …

Utilizing Culturally Congruent Educational Interventions To Improve Native American Diabetic Outcomes, Laurie Ann Hamilton

Doctoral Projects

Native Americans suffer from diabetes type II at a proportionately higher rate than other populations. Management of diabetes in this population is problematic and compounded by multiple influences such as socioeconomic, cultural and linguistic variables. The purpose of this DNP project was to investigate cultural influences on Native American diabetic outcomes.

Do cultural influences act as barriers to diabetic medication, diet and education understanding? Would a Native American nurse applied education on medication, diet and exercise improve diabetic outcomes in a 3 month period?

A convenience sample of 6 Native American participants obtained at a primary care clinic were given …

Opioid Use In The Cesarean Section Patient With The Preoperative Administration Of Intravenous Acetaminophen, Dana Edwards Bernardo

Doctoral Projects

Cesarean sections are one of the most common surgical procedures and there are no current guidelines for the management of postoperative pain control (Darvish, Ardestani, Shali, & Tajik, 2013). Unresolved pain in this population can lead to long lasting problems, such as chronic pain and depression (Booth, Harris, Eisenach, & Pan, 2015). The goal of multimodal therapy with IV acetaminophen for CS mothers was to ensure a rapid and safe recovery process with reduced adverse complications and shortened hospital length of stay. The independent t-test was used to compare the mean time for length of stay, first request of pain …

Mid-Level Dental Care Provider: Awareness And Attitudes Of Ohio’S Dental Hygienists, Cynthia S. Leverich

Electronic Theses and Dissertations

The purpose of this study was to determine the awareness and attitudes of dental hygienists in Ohio regarding the Advanced Dental Hygiene Practitioner (ADHP) as an occupation proposed by the American Dental Hygienists’ Association and to determine whether the ADHP could be a viable career option for Ohio dental hygienists.

I developed a survey to assess dental hygienists’ awareness, attitudes, and their views regarding the new mid-level dental provider. The study was limited to licensed dental hygienists in Ohio. The study included a simple random sample of 400 of the 4100 dental hygienists in Ohio obtained by a systematic approach, …

The Effects Of Orthodontic Appliance Base Plate Material, Pmma, Infused With Silver And A Novel Antibacterial Compound On Biofilm Formation, Ryan D. Jolley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Retention is required in the majority of orthodontic patients throughout the remainder of their life. The traditional Hawley style retainer is still considered by many orthodontic professionals to be the gold standard in retention appliances. The orthodontic population, in general, is at a higher risk for caries due to plaque accumulation from poor diet, suboptimal oral hygiene, and often a lack of motivation. A Hawley retainer that reduces caries-causing oral microbes could improve oral health and be very beneficial to the post-orthodontic patient. Developing methods to safely include antibacterial products within the Hawley retainer’s base plate material could help effect …

Accuracy Of Implants Placed With Surgical Guides: Thermoplastic Vs. 3-D Printed, Caitlyn K. Bell

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: The purpose of this study was to evaluate the accuracy of placed implants using two different guided implant surgery materials: thermoplastic vs. 3-D printed surgical guides. Materials and Methods:Twenty duplicate mandibular models, ten thermoplastic and ten 3-D printed surgical guides were used. Twenty implants were placed following the guided surgery protocol. Cone beam computed tomography scans of placed implants and the control implant were superimposed to measure deviations. Results: The thermoplastic group showed average deviations of 3.4 degrees, 1.3mm at the head, and 1.6mm at the apex of the implant compared to 2.36 degrees, 0.51mm, and …

Exploring The Role Of Pharmacists In Management Of Hypertension In A Safety Net Clinic, Pandora Lau

Master's Projects and Capstones

Potrero Hill Health Center through the San Francisco Department of Public Health aims to deliver health promotion, disease prevention, heath maintenance, counseling, and health education of acute and chronic diseases. Hypertension is a common problem to both the health center and to the general population, and Potrero Hill Health Center aims to understand and develop a program that will aid in hypertension management at their local clinic. A supplemental pharmacist service was implemented at Potrero Hill Health Center to help manage hypertensive patients. Systolic and diastolic blood pressure levels were compared in patients receiving pharmacist counseling versus those receiving physician …

Effects Of A Text Message-Based Motivational Interviewing Intervention On Cigarette Smoking In College Students., Anna Jorayeva

Electronic Theses and Dissertations

Purpose: The purpose of this dissertation was to examine the effects of a novel text message-based motivational interviewing intervention on cigarette smoking behavior in college students. Three manuscripts comprised this dissertation and included: a state of the science review of motivational interviewing and text message-based smoking behavior interventions in adolescents and young adults; a critical review and analysis of instruments used to measure nicotine dependence in young adults; and a quasi-experimental study testing the effects of a novel text message-based motivational interviewing intervention on cigarette smoking behavior in college students. Background: Cigarette smoking is the number one preventable cause of …

Differential Cbct Analysis Of Collum Angles In Maxillary And Mandibular Anterior Teeth In Patients With Different Malocclusions, Erin Shane Wan Ma

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The collum angle is an angular measurement of the difference between the longitudinal axis of the crown and the longitudinal axis of the root. The aim of this study was to determine the mean collum angles for all maxillary and mandibular anterior teeth. In addition, the collum angles of different molar and skeletal classifications were compared for each anterior tooth.

Methods: Based on patient records obtained from the University of Nevada, Las Vegas Department of Orthodontics and Dentofacial Orthopedics, 326 CBCT scans were selected and divided into four molar and skeletal classifications. The patients were divided into Class I, …

The Effects Of Cryopreservation On Human Dental Pulp-Derived Mesenchymal Stem Cells, Allison Elaine Tomlin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Many studies have demonstrated clinical applications for the use of dental pulp stem cells (DPSC) for the treatment of various conditions. This has driven medical and scientific interest in the collection, isolation and banking of DPSC tissues for research into these potential therapies. Few studies to date have evaluated the viability of DPSC following long-term cryopreservation. The purpose of this study is to evaluate the effects of cryopreservation on dental pulp-derived stem cells (DPSC) viability over a period of three years. Dental pulp-derived stem cells were isolated and cultured from thirty-one healthy teeth. DPSC isolates were assessed for doubling-time and …

Oral Microbial Burden Of Periodontal Pathogens Among Orthodontic Patients, David Jolley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objectives

Many research studies involving orthodontic patients have a natural inclination to focus on changes in levels of cariogenic pathogens after bracket placement, and very few studies examine the role of changes of periodontal pathogens – particularly among adult patients. Interestingly, recent evidence suggests that increased levels of a specific periodontal pathogen, Fusobacterium nucleatum, may elevate risk for development of colon cancer in adults through direct pathways. Based upon this new evidence, the objective of the current study was to screen saliva samples taken from orthodontic patients to determine the prevalence of periodontal pathogens, including F. Nucleatum, T. denticola, and …

Mechanism Of Interaction Of Peptide Modified Nanoparticles With Porphyromonas Gingivalis., Ankita Jain

Electronic Theses and Dissertations

Studies suggest that P. gingivalis functions as a keystone pathogen and interacts with primary colonizers in the supragingival biofilm such as S. gordonii. This interaction contributes to the initial colonization of the oral cavity by P. gingivalis and thus represents a potential target for therapeutic intervention. We have identified a peptide (BAR) derived from the streptococcal SspB protein that functions to inhibit P. gingivalis adherence to S. gordonii. In addition, we showed that nanoparticles (NPs) functionalized with BAR inhibit this interaction more potently than free soluble peptide, possibly by promoting interaction with P. gingivalis at higher valency than …

Comparison Of Treatment Effects Of The Forsus Fatigue Resistance Device In Class Ii Patients With Different Underlying Vertical Skeletal Patterns, Michelle C. Watroba

Electronic Thesis and Dissertation Repository

The purpose of this study was to evaluate the differences in dental and skeletal changes induced by the Forsus^TM Class II dentoalveolar corrector in Class II patients with varying vertical skeletal growth patterns. The sample consisted of 26 (mean age 12.9 ± 1.3 years) Brachyfacial (BF) (SN-MP < 30^o) consecutively treated Forsus subjects, 16 (mean age 13.1 ± 0.8 years) BF untreated Class II subjects (control subjects), 12 (mean age 12.3 ± 1.2 years) Nonbrachyfacial (NBF) (SN-MP ≥ 30^o) consecutively treated Forsus subjects, and 8 (mean age 13.2 ± 0.9 years) NBF untreated Class II subjects (control). …