Medicine and Health Sciences Commons^™

The Creation And Implementation Of Guidelines For The Appropriate Termination Of Patient-Provider Relationships, Rowena D. Nolasco

Doctor of Nursing Practice (DNP) Projects

Primary care providers have terminated patient-provider relationships when they deem them no longer therapeutic. Healthcare providers are increasingly considering this an acceptable practice. However, the criteria for this decision remain unclear. As providers discharge challenging or difficult patients from their practices, questions to support this decision arise. Discharged patients face displacement and healthcare is disrupted. This project will (a) describe problematic patient-provider relationships and its effects, (b) identify possible alternatives to the firing of patients, (c) list appropriate reasons for termination, and (d) present recommended procedures to avoid allegations of medical abandonment. The project's product is an Appropriate Discharge or …

Fnp Led Mobile Health Services For The Homeless Population, Tenzin D. Lama

Doctor of Nursing Practice (DNP) Projects

A small percentage of the U.S. population uses the greatest portion of the healthcare services. Homeless people are often such a group of “super-utilizers” of the healthcare system. Due to multiple medical and psychosocial conditions, people experiencing homelessness face numerous barriers to accessing healthcare, thus leading increased utilization of hospitals and emergency departments (EDs) services. Many of these events are preventable through improved primary care interventions. The literature on Respite/Recuperative Care, Transitional Care, and Mobile Health interventions have shown effectiveness in providing safe and quality care to homeless individuals during the critical transitional period post hospital discharge while also reducing …

Increasing Hpv Awareness And 3-Dose Series Compliance Among The Female Population (Ages 11-26) In A Community Health Clinic, Vanessa Orozco

Master's Projects and Capstones

Abstract

The overall goal of this project was to increase HPV 2nd and 3rd dose compliance rates by a combined 10% among the female adolescent population (ages 11-26). This was to be achieved by implementing EBP follow-up calls to not only schedule appointments but also to serve as a reminder for patients to come into previously scheduled appointments. This project was chosen as prior clinic and organization-wide meetings had delineated compliance rates at just 7%. There were various methods employed to implement this project including an initial microsystem assessment, which entailed a Root Cause Analysis, Process Mapping, SWOT analysis, Cost-Analysis, …

Developing Inter-Professional Oral Health Education: An Evaluation Of Educational Resources, Jordan A. Jew

Master's Projects and Capstones

As healthcare continues to evolve, providers will need to uphold the quality of patient care provided to patients. Traditional healthcare holds many gaps that do not recognize the unmet needs that exist within today’s society. To maximize the abilities of healthcare services, inter-professional education introduces a collaborative approach that develops a network of shared knowledge and clinical skills beyond the primary scope of practice.

In this project, oral health learning modules developed for family practice residents were introduced to first-year dental students at the Dugoni School of Dentistry to improve their knowledge and confidence to both educate and practice with …

Evaluation Of Upper Airway Changes Following Surgical Removal Of The Adenoids Using 3-D Cone Beam Ct, Christopher C. Schultz

Theses & Dissertations

Purpose: The purpose of this study was to evaluate the changes in volume, cross-sectional area and depth of the upper airway following the surgical removal of the adenoids.

Materials and Methods: 16 patients were diagnosed with hypertrophic adenoids and referred for surgical removal. Pre-surgical and post-surgical CBCT scans were taken on each patient. Volume measurements of the total airway, oropharynx and nasopharynx were recorded. In addition, cross-sectional areas and airway depths at the posterior nasal spine (PNS) and cervical vertebrae 2 were recorded. 15 patients diagnosed with no or mild adenoid hypertrophy were treated as the control group. The controls …

The Role Of Bone Sialoprotein In Periodontal Tissue Development And Bone Repair, Yohannes Soenjaya

Electronic Thesis and Dissertation Repository

Bone development and repair involve complex processes that include interaction between cells and their surrounding matrix. In the body, bone sialoprotein (BSP) expression is up-regulated at the onset of mineralization. BSP is a multifunctional acidic phosphoprotein with collagen-binding, hydroxyapatite nucleating, and integrin recognition (RGD sequence, which is important for cell-attachment and signaling) regions. Mice lacking BSP expression (Bsp^-/-), exhibit a bone phenotype with reductions in bone mineral density, bone length, osteoclast activation, and impaired bone healing. This thesis examined the role of BSP in tooth development and also its potential use as a therapeutic reagent for bone …

Quality Of Life And Subjective Outcomes Following Maxillomandibular Advancement Surgery For The Treatment Of Obstructive Sleep Apnea, Andrew D. Emanuele

Electronic Thesis and Dissertation Repository

Objective: The aim of this study was to assess outcomes related to general quality of life, daytime sleepiness and functional sleep outcomes, functional outcomes of orthognathic surgery, and facial aesthetics in patients undergoing maxillomandibular advancement (MMA) surgery for the treatment of obstructive sleep apnea (OSA).

Materials and Methods: This was a cross-sectional self-report study. A questionnaire was constructed using questions drawn from previously validated questionnaires. The survey was distributed to 25 patients who underwent MMA surgery for the treatment of OSA at LHSC in London, Ontario by a single surgeon between 2002 and 2013.

Results: The survey results showed that …

Relationship Between Job Satisfaction Among Frontline Staff And Patient Satisfaction: Evidence From Community Health Centers In South Carolina, Ashley Lynn Barnes

Theses and Dissertations

The role of frontline staff (FLS) is vital to the success of health delivery organizations as they are often the main point of patient contact and the primary source of feedback regarding the patient experience and satisfaction. Anecdotal evidence suggests that FLS have among the highest turnover rates in health delivery organizations, resulting in high recruitment and training costs as well as disruptions in day-to-day operations. However, few studies have examined the role of FLS and the factors affecting job satisfaction among FLS. Researchers have also not examined the impact of FLS satisfaction on patient satisfaction. To address these research …

Nurses Utilizing The V.O.I.C.E.S. Hiv Prevention Intervention In The Black Church Community, Jason Richard

Theses and Dissertations

The Human Immunodeficiency Virus (HIV) epidemic is a significant problem in the United States, especially in the “Bible Belt” Deep South where the epidemic is hitting this region the hardest. The HIV epidemic in the state of South Carolina is very real, significant, and quite alarming. In fact, the Center for Disease Control and Prevention (CDC) labels South Carolina as an HIV “hot spot.” All racial and ethnic groups are susceptible and impacted by HIV. However, evidence shows that African Americans – especially young adults 18-35, bear the brunt of the burden to the extent that the “new face” of …

Dental Insurance As A Mitigating Factor In Reducing The Risk Of Mortality Among Working-Age Adults With Dental Caries And Periodontitis, Naveed Sadiq

Theses and Dissertations

Background Poor oral health had been associated with increased risk of having systemic diseases and thus mortality. The purpose of this research was to find if dental coverage with health insurance could mitigate the risk of death due to untreated dental caries and periodontitis among working age U.S. adults. Methods Data were drawn from NHANES III (1988-1994) and linked to mortality updated till Dec. 31st, 2011. It was restricted to those in the age range of 20-64 years adults. Furthermore, it was restricted to those who had complete data collection on all measures. Unweighted propensity scores were calculated to control …

Health Education: An Unmet Needs For Refuges, Zahra Goliaei

Master's Projects and Capstones

Abstract:

The International Rescue Committee (IRC) is one of the organizations that serves refugees and asylums arriving into the United States. Each year between 4 to 500 individuals will resettle in Oakland through the IRC. However, after relocation, these individuals need information about life in the new country , community resources , and social services especially health care system in the country. Life pressures during the resettlement process, along with the language barrier and poverty usually lead to a less healthy diets and lifestyles. During the time, these factors will put refugees at the risk of obesity and later, chronic …

Using A Cost Benefit Analysis To Support The Development Of A Comprehensive Business Model For A Pre-Filled, Pre-Labeled, Pre-Diluted, Sterilely Packaged, Ready-To-Use, Syringe-Based Anesthesia Delivery System, Lance B. Kennedy

Doctoral Projects

The foundation of Certified Registered Nurse Anesthetists’ (CRNAs) entire profession is built on the ability to provide anesthetic services using a variety of medications in the safest, most efficient, cost-effective way possible. The purpose of this capstone is to address, via a comprehensive cost benefit analysis, whether pre-filled syringe drug trays are a more cost-effective way to address problems as compared to vial-filled drug trays and to implement the necessary transitions in order to improve outcomes. There are a number of identifiable problems related to anesthesia medication delivery via vial-filled medication, including increased cost of healthcare, decreased patient safety to …

The Effects Of Consistent Exercise On Work Productivity Among Anesthesia Providers, Samuel K. Self

Doctoral Projects

Studies have been done that link various measurements of workplace productivity with varying levels of individual health. A thorough literature review examined the research to find any significant relation between regular exercise (as defined by the American Heart Association) and an improvement in workplace productivity among anesthesia providers. A Qualtrics survey was used to measure specific results regarding exercise activity and work productivity from anesthesia providers. This group included 53 certified registered nurse anesthetists and anesthesiologists. Descriptive analysis, Chi-square test of Independence, Fisher’s Exact test, and Cramer’s V test were all used to analyze the data. One significant correlation was …

Restoring Digestive Health, Kristin M. Corbin, Dnp, Aprn, Fnp-C

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Purpose: The purpose of this translational research project was to outline the healthcare problems associated with Functional Gastrointestinal Disorders and to explore the effectiveness of a gastrointestinal protocol utilized at Atlanta Center for Holistic and Integrative Medicine. The goal of this protocol is to restore digestive health with probiotics, digestive enzymes, and glutamine.

Background: Functional Gastrointestinal Disorders affect one in every four adults in the United States. These disorders encompass a variety of symptoms including diarrhea, constipation, cramping, abdominal pain, flatulence, reflux, and bloating without an identified physiological cause. There is currently no cure for Functional Gastrointestinal Disorders and treatment …

Pathophysiologic Mechanisms Of Immune-Mediated Drug Hypersensitivity Reactions To Sulfonamides, Elham A. Sultan

Electronic Thesis and Dissertation Repository

As sulfonamide hypersensitivity reactions are serious clinical problem, it is necessary to determine which patients tolerate therapy and which patients are at risk. Although the exact pathogenesis of these reactions remains unclear, the imbalance in the production and detoxification of reactive sulfamethoxazole (SMX) metabolites appears to be important in the propagation of these reactions. It is known that these reactive metabolites can cause lymphocytes toxicity and produce reactive oxygen species (ROS) which can damage proteins, lipids, and DNA. The hypothesis of this research is that there are differences in cytotoxicity and expression of oxidative stress to reactive SMX metabolites in …

Health Assessment Of Two Reintroduced Populations Of American Martens (Martes Americana) In Michigan, Maria Catherine Spriggs

Doctoral Dissertations

The American marten (Martes americana) was extirpated from Michigan during the early-20th century due to loss of vast areas of mature conifer forest and unregulated trapping. The species was reintroduced into the Upper Peninsula (UP) and Northern Lower Peninsula (NLP) during the mid-20th century. While the American marten population in the UP has grown and is doing well, the population in the NLP has been less successful. The reasons for the limited success of the NLP population are unknown, but may include lack of suitable habitat, limited reproductive success, poor genetic diversity, disease, or negative environmental impacts. American …

Dental Hygienists' Cognitive Process In Periodontal Soft Tissue Charting, Kelsey M. Schwei

Theses and Dissertations

Introduction: Dental hygienists have not had the opportunity to be involved in the design and development of the periodontal soft tissue charts and the surrounding interface features that are used while examining dental patients in daily practice. In some cases, dentists are able to give their opinions, wants, and needs into the development of the health information systems that they use on a daily basis, but too often, the dental hygienist is forgotten about and no input is ever given to the developers from the dental hygienists. This project considers the impact of well-designed interfaces on effectiveness and workflow particularly …

Predicting Desired Outcomes From Applicants’ Medical School Admission Data, Mark D. Linville Jr.

Electronic Theses and Dissertations

Medical schools in the United States serve to train the next generation of physicians, admitting students who will continue to advance each school’s mission. Admission committees are tasked with identifying those candidates who will be successful academically and who promote the objectives of the school with respect to mission. The Quillen College of Medicine at East Tennessee State University in northeast Tennessee seeks to attract and retain physicians with an interest in rural and primary care medicine. A total of 630 students were included in this study representing classes from 2001 to 2011. This study examined admissions data including MCAT …

Cirugía Cosmética: Un Análisis De Su Historia Y Prevalencia En Latinoamérica, Elena R. Hamilton

Chancellor’s Honors Program Projects

No abstract provided.

Assessing Orthodontic-Bracket Impacts On Lip Profile At Bonding And Debonding Stages, Martin Trockel

Student Theses, Dissertations and Capstones

Introduction: One factor that contributes greatly to the lower face appearance and orthodontists have the ability to affect is lip profile. Clinical assessment of the lip profile is an important element in the decision of orthodontic treatment planning and in the evaluation of treatment progress and outcome. Three known factors influence the lip profile; the lip thickness, the underlying bone, and the tooth position. The positions and inclinations of the anterior teeth can affect the lip position, but it is unclear whether orthodontic brackets bonded to the labial surface of anterior teeth move the lip position and thereafter change the …

Effects Of Sodium Hypochlorite On Enamel Composition, Sonni Pellillo

Student Theses, Dissertations and Capstones

The purpose of this study was to evaluate the effects of sodium hypochlorite on the organic and inorganic composition of enamel. Background: With the advent of enamel bonding for orthodontic appliances in the late 1970s, it has been shown that traditional phosphoric acid etching affects the inorganic portion of the enamel.1, 2 In an attempt to enhance the acid etching pattern and, furthermore, the bond strength, additional pretreatment techniques that target the organic components of the enamel biofilm have been proposed. One such method is the non-invasive enamel pretreatment with 5.25% sodium hypochlorite (NaOCl) prior to phosphoric acid etching.3, 4 …

Evaluation Of Frictional Forces Between Brackets Of Different Types At Various Angulations And An Arch Wire: With And Without Pulsating Vibration, Benjamin M. Christman

Student Theses, Dissertations and Capstones

Objective: The objective of this study was to determine the effect of pulsating vibration on the sliding resistance between orthodontic brackets and stainless steel wires. Brackets were placed at two different angulations (0° and 5°) to simulate leveling of a tipped tooth during tooth movement. Pulsating vibration was delivered via the AcceleDent device.

Background: Friction is defined as a force that retards or resists the relative motion of two objects in contact, and its direction is tangential to the common boundary of the two surfaces in contact. This has been of interest to the orthodontist since the mid-20th century. Since …

A Comparison Of Beliefs And Attitudes About Body Image, Eating And Weight Between Incarcerated And Non-~Incarcerated Females, Anne R. Lindsay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Abstract

Incarceration and substance abuse are two of the largest public health issues in America. While the U.S. makes up only 5% of the world’s population, it accounts for 25% of its prisoners. Incarceration affects more than 2.2 million individuals who will eventually return to their families and communities with ongoing family, social and health issues. Women in prison are a particularly vulnerable and underserved population, generally of low education and socio-economic status and although they account for a small percent of the prison population, many are mothers of young children who are likely to become incarcerated themselves. Substance abuse …

Scardovia Wiggsiae Prevalence In Orthodontic Patients, Brandon Joseph Streiff

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dental caries has mainly been associated with Streptococcus, Lactobacillus, Actinomyces and Veillonella species. But in recent salivary studies a new cariogenic pathogen, has been identified. This new bacteria, Scardovia wiggsiae (SW), is currently being tested within the UNLV School of Dental Medicine patient population. Although these current studies are being conducted to study its prevalence in both pediatric and adult populations, it has not been evaluated among patients with an altered oral environment as seen in patients with orthodontic appliances. Fixed orthodontic appliances increase the difficulty of removing daily plaque on and in between the teeth with standard oral hygiene …

Comparison Of Digital Scanning And Polyvinyl Siloxane Impression Techniques By Dmd Students : Instructional Efficiency And Attitudes Toward Technology., Alexander M. Marti

Electronic Theses and Dissertations

The aim of this research was compare the ability of dental students to learn an digital scanner (3M LAVA) and material-based (PVS) impression techniques and to determine attitudes and preferences towards each. D2 dental students (n=25) were recruited and instructed on the use of 3M LAVA and PVS techniques using three pedagogic methods: 1) video lecture (P1), 2) investigator-led demonstration (P2), and 3) independent clinical exercise (P3). The amount of time for each pedagogic method was measured, averaged (± s.d.) and compared using Wilcoxon Signed-Ranks tests. A pre- and post-test was administered assessing their attitudes towards both techniques using a …

A 3d Radiographic Evaluation Of Crestal Bone Changes Around Immediately Loaded Endosseous Implants, Keerthi Senthil

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this clinical investigation is to evaluate and compare the 3-dimensional radiographic crestal bone changes around 4 immediately placed and loaded implants supporting full arch fixed mandibular prosthesis in 2 groups of patients. The Test group comprises of patients with failing mandibular teeth needing extraction. ( due to caries, periodontal disease, fractures or prosthetic reasons).The Control group comprises of patients with a fully edentulous mandible presenting for fixed implant supported prosthesis with at least 6 months after the last extraction or bone grafting procedure. Stereolithographic bone model obtained from the patient’s DICOM files was used to fabricate the …

Synthesis And Functional Evaluation Of Peptide Modified Poly (Lactic-Co-Glycolic Acid) Nanoparticles To Inhibit Porphyromonas Gingivalis Biofilm Formation., Paridhi Kalia

Electronic Theses and Dissertations

Periodontal disease is an oral inflammatory disorder that afflicts roughly 46% of the adults in the U.S. Currently, treatment of periodontal disease involves the removal of plaque from the gingival pocket (with possible antibiotic treatment) and if necessary, gingival surgery. To our knowledge, no therapeutic approach exists that promotes host-biofilm homeostasis by limiting pathogen recolonization of the oral cavity after prophylaxis or treatment. The interaction of the pathogen Porphyromonas gingivalis with commensal streptococci is critical for initiation of periodontitis and represents a target for limiting P. gingivalis colonization of the oral cavity. Previous studies showed that a synthetic peptide …

Reinventing The Medical Request Process In A Correctional Healthcare Setting, Leah Murphy

Master's Projects and Capstones

This project was developed as part of a Clinical Nurse Leader course of study with the goal of gathering and evaluating microsystem data, and the creation and implementation of a process improvement project. The project was conducted in a correctional setting which houses male and female detainees with a wide variety of medical needs. The project addressed long wait times for detainees who have submitted a request for services from the medical department. The goal of this project was to reduce wait times for medical requests, and provide service for a greater number of patients. This project is needed because …

Cbct Evaluation Of Adolescent Mandibular Morphology In Different Classifications Of Facial Type, Annie Hsu

UNLV Theses, Dissertations, Professional Papers, and Capstones

The goal of this study is to use the improved imaging capability of cone-beam computerized tomography (CBCT) to investigate the relationship between vertical facial patterns and mandibular tooth-alveolar morphology in the adolescent population. Pre-treatment orthodontic records were obtained from the UNLV School of Dental Medicine archival dental records. One hundred and seventy three patients (72 males, 101 females) between the ages of 12 and 18 years were included in this study. Among these patients, 61 displayed the vertical growth pattern, 30 displayed the horizontal growth pattern, and 82 displayed the average growth pattern. The samples were categorized into 4 age …

Assessment Of Orthodontic Patients' Preferences Regarding Treatment From General Dentists Or Orthodontists, Brian Robert Wilde

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study evaluated how parents of prospective orthodontic patients choose between taking their child to a general dentist or an orthodontist for orthodontic treatment. It also looked at which factors influence patients’ satisfaction with the progress of treatment and likelihood to refer other patients to the practice. This study included two phases. The first phase was a qualitative assessment of the decision making process through conducting and analyzing focus groups. The second phase was the development and administration of a nationwide online survey regarding the topics covered in the focus groups. Influential factors in the decision making process fell into …