Medicine and Health Sciences Commons^™

Increasing Providers’ Adherence To Ordering Urine Microalbumin Tests, Florence Fadele

Student Theses, Dissertations and Capstones

Currently, a microalbumin urine test is an annual test for diabetic patients recommended by the American Diabetes Association, but primary care providers are not ordering the tests. This may be, in part, attributable to the fact that there are no guidelines for ordering microalbumin urine tests. The purpose of this capstone project was to assess providers' compliance in identifying the need for the microalbumin urine test for patients with diabetes, to develop evidence-based guidelines for monitoring and ordering microalbumin urine tests, and to evaluate providers' compliance. Rogers's theory of the diffusion of innovation provided the framework for this capstone project. …

Health Care Providers' Knowledge Of Childhood Obesity Within The Hispanic Community, Daysi Fardales

Student Theses, Dissertations and Capstones

Background: Recent studies indicate a rise in the prevalence of obesity in children of various age groups. Obesity was officially recognized as a disease by the American Medical Association (AMA) in June 2013. It has been acknowledged as a progressive epidemic public health crisis in the United States for the past 20 years. This is a health care concern that needs examination and the development of new and more effective prevention and treatment modalities for obesity in children. Environmental, hereditary, behavioral, and socioeconomic factors play a significant role in the prevalence of obesity (Rooney, Mathiason, & Schauberger, 2011). Childhood obesity …

Managing Diabetic A1c At A Primary Care Center: A Nurse Practitioner Perspective, Jacqueline Mcdonald

Student Theses, Dissertations and Capstones

Background: At a primary care center in Brooklyn, New York, approximately 27% of diabetic patients with abnormal Hgb A1C fail to return for follow-up appointments, as recommended by the Centers for Disease Control and Prevention (CDC). According to electronic medical records (EMR), healthcare providers demonstrated inconsistency in ordering and monitoring Hgb A1C and clinic follow-up appointments for patients.

Purpose: The purpose of this quality improvement project was to determine retrospectively the healthcare providers’ ordering, monitoring, and follow-up appointments for adult diabetic patients with abnormal Hgb A1Cs; to develop and implement astandardized process for healthcare providers to monitor and follow these …

Addressing Obstetric Health Care Providers' Nutritional Insight In The Low Socioeconomic Population, Nicole Theresa Marshall

Student Theses, Dissertations and Capstones

Background: During a woman's pregnant state, a diet that is adequate in nutrition is critical to the developing fetus, especially in the lower socioeconomic status population. The healthcare provider is charged with the acute fundamental awareness of this additional factor that can grossly impact pregnancy. Nutritional advice from the health care provider is one of many key points that contribute to the successful outcome of the pregnancy. Purpose: The purpose of this quality improvement project was to develop a standardized, evidence-based practice (EBP) protocol for the management of maternal nutrition, gestational weight gain, and physical activity for provider use at …

Immediate Effects Of A Seated Versus Supine Upper Thoracic Spine Thrust Manipulation Compared To Sham Manipulation In Individuals With Subacromial Pain Syndrome – A Randomized Clinical Trial, Jason Keith Grimes

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Individuals with Subacromial Pain Syndrome (SPS) often present with a variety of contributing factors. It is possible that a subgroup exists within SPS that has primary impairments of scapular mobility and/or muscle strength. In an attempt to better identify scapular contributions in SPS, the Scapular Assistance Test (SAT) and Scapula Reposition Test (SRT) have been described. Additionally, thoracic spine thrust manipulation has been shown to be effective for shoulder pain. Problem Statement: It is currently unknown whether or not there are impairments in scapulothoracic muscle force generation or scapular mobility in individuals with SPS who have positive results on …

Iliotibial Band Length And Patellofemoral Pain Syndrome: Relationship Between Two Measurement Techniques, Duane Michael Scotti

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: To determine the relationship between iliotibial band (ITB) length and the presence of patellofemoral pain syndrome (PFPS), compare the difference in ITB length between the painful knee and the non-painful knee in subjects with unilateral PFPS, determine the test-retest reliability, standard error of measurement, and minimal detectable change (MDC) of the Ober test and modified Thomas test, and explore the relationship between the Ober test and the modified Thomas test in measuring ITB length. Subjects: Forty-eight subjects were recruited (PFPS group n=24, control group n=24) from three different outpatient physical therapy clinics. Methods: The Ober test and modified Thomas …

Cost Of Physical Therapists Serving As A Musculoskeletal Providers Compared To Family Practice Providers In A Military Treatment Facility, Troy Edward Mcgill

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background. Physical therapists (PTs) in the U.S. military practice direct access and can order limited prescription medications, imaging studies. Military PTs function as autonomous primary care managers (PCMs) for patients with musculoskeletal (MSK) disorders. Objective. The study compared cost of PT management of patients with MSK disorders to management by traditional PCMs; medical doctors (MDs), doctors of osteopathic medicine (DOs), advanced registered nurse practitioners (ARNPs), and physician assistants (PAs). Methods. The researcher used a retrospective study of electronic medical records, using an exploratory, non-experimental, cross-sectional, and quantitative design method. Results. At an Air Force military medical clinic during an 18-month …

Educational Program Attributes And Faculty Teaching Behaviors As Predictors Of National Physical Therapy Examination Success, Natonya Frazier-Early

Department of Physical Therapy Student Theses, Dissertations and Capstones

Purpose: To determine the differences between PT program NPTE 3-year ultimate pass rates (3YUPR) based on program length and faculty scholarship. To explore relationships between 3YUPR and quality faculty behaviors. Subjects: A total of 112 CAPTE accredited PT educational programs in the United States and Puerto Rico during 2013. Method: A quantitative design method was used to retrospectively test differences between program and faculty traits and student NPTE 3YUPR using data from the Commission on Accreditation in Physical Therapy Education (CAPTE), PT Annual Accreditation Reports (AAR) and Federation of State Boards of Physical Therapy (FSBPT) score reports. A self-generated faculty …

Efficacy Of Kinesio Taping As An Adjunct Intervention To Traditional Physical Therapy In The Treatment Of Nonspecific Acute Low Back Pain: A Prospective Randomized Controlled Trial, Hossameldien Elkholy

Department of Physical Therapy Student Theses, Dissertations and Capstones

The Efficacy of Kinesio Taping as an Adjunct Intervention to Traditional Physical Therapy in the Treatment of Nonspecific Acute Low Back Pain: A Prospective Randomized Controlled Trial Background: Acute low back pain (LBP) is a significant health problem worldwide and is one of the leading causes of disability. Objective: The purpose of this study was to examine the effect of Kinesio Taping (KT) on disability, fear-avoidance beliefs, and pain intensity in patients with acute, nonspecific LBP. Research Design and Methods: A prospective, randomized controlled study of consecutive patients referred to physical therapy with a primary complaint of LBP. Seventy-eight patients …

Dry Needling Of Myofascial Trigger Points: Quantification Of The Biomechanical Response Using A Myotonometer., Joseph P. Kelly

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Biomechanical stiffness has been linked to risk of injury and found to be a measureable characteristic in musculoskeletal disorders. Specific identification of stiffness may clarify who is most likely to benefit from the trigger point dry needling (TDN). The purpose of this study is to investigate the reliability and concurrent validity of the MyotonPRO® to the criterion of shear wave ultrasound elastography for the measurement of biomechanical stiffness in the infraspinatus, erector spinae, and gastrocnemius of healthy subjects over increasing muscle contraction. Second purpose is to investigate the biomechanical effects of TDN to latent myofascial trigger points (MTrPs) in …

Gait Analysis Following Total Knee Arthroplasty During Inpatient Rehabilitation: Can Findings Predict Los, Ambulation Device, And Discharge Disposition?, Janet Anne Herbold

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background: Total knee arthroplasty (TKA) is the treatment of choice for end-stage knee osteoarthritis. Growth in the number of procedures performed annually in the United States is expected to increase steadily. Post-operative rehabilitation settings vary and include both institutional and community based physical therapy (PT) services. Despite access to PT, deficits in gait often persist for months and even years after surgery. Slow gait speed, asymmetrical walking patterns, and prolonged time in double-limb support following the TKA often lead to the need for an assistive device for walking and prolong the rehabilitation phase. Purpose: The purpose of this study is …

Evaluation Of Various Inspiratory Times And Inflation Pressures During Airway Pressure Release Ventilation, Tim Gilmore

Health Sciences Program Student Theses, Dissertations and Capstones

There are few recommendations on how best to apply certain modes of mechanical ventilation. The application of Airway Pressure Release Ventilation (APRV) includes strategic implementation of specific inspiratory times (I-times) and particular mean airway pressures (MAWP) neither of which is standardized. This study utilized a retrospective analysis of archived electronic health record data to evaluate the clinical outcomes of adult patients that had been placed on APRV for at least 8 hours. 68 adult subjects were evaluated as part of a convenient purposive sample. All outcomes of interest (surrogates) for short-term clinical outcomes to include the PaO2/FiO2 (P/F) ratio, Oxygen …

Pneumonia Readmissions In Older Adults With Dementia, Sara Knox

Health Sciences Program Student Theses, Dissertations and Capstones

Objective: The purpose of this study was to investigate pneumonia readmissions of older adults with dementia. Readmission rates and predictive factors of older adults with and without dementia were compared in this study. Subjects: A nationally representative sample of 389,198 discharge records, representing 370,003 patients, was extracted from the 2013 Nationwide Readmission Database. Methods: Descriptive statistics were utilized to describe the demographics of the sample population. Differences between groups were analyzed using chi-square or t test statistics as appropriate. A generalized linear model was used to examine predictive factors for pneumonia readmissions. Results: Older adults with dementia had a readmission …

Measuring Knowledge And Attitudes Regarding The Use Of Pharmacogenetic Testing Among Patients And Prescribers: Diffusion Of Innovation Theory, Suhaib Mohammad Muflih

Student Theses, Dissertations and Capstones

Background: Healthcare providers play a key role in patient care. Their knowledge and attitudes may play a critical role in the incorporation of pharmacogenetic (PGx) testing into routine practice. The knowledge and attitudes of patients are also equally important in determining the rate of diffusion and the adoption of PGx testing. This study aims to test Rogers’s diffusion of innovation theory to identify and evaluate the influence of knowledge, attitudes, and sociodemographic characteristics of patients and physicians on the adoption of PGx testing in current clinical settings. Method: A cross-sectional, descriptive survey design was implemented. The sample consisted of patients …

The Effect Of Road Noise On Sound Pressure Levels And Preferred Listening Levels Using Personal Listening Devices, Hayley Himstedt

Doctoral Dissertations

Using a PLD in an automobile introduces unique threats such as volume levels set at higher levels to reduce the masking effects of road noise that enters the automobile. Passengers enjoying prolonged PLD exposure may be at an increased risk of noise exposure or fluctuating sound pressure levels resulting in hearing loss. Historically, hazardous noise has been primarily associated with industrial/occupational activities; however, harmful noise from recreational activities is also prevalent. The Center for Disease Control (2015) lists turning down PLD volume as one of their top three methods for reducing the possibility of NIHL in children. Excessive listening level …