Medicine and Health Sciences Commons^™

Comparative Cephalometric Study Between Class Ii Patients Treated With Herbst Appliance And Patients Treated With Mara, Mona Meky

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Comparative cephalometric study between Class II patients treated with Herbst appliance and patients treated with MARA

Mona Meky, D.D.S.

Background and Objectives: Functional appliances have been used for over 100 years in orthodontics to correct Class II malocclusions. The Herbst and the MARA appliances have different designs that may enhance mandibular growth. Recent clinical evidence has questioned whether they really have a lasting influence on facial growth and that the effects of these appliances were mostly dentoalveolar rather than skeletal. The objective of this retrospective comparative study was to compare the dental and skeletal changes between Class II division …

Association Between Early Childhood Feeding Practices And Parental Perception Of Picky Eating, Yue-Liang Brewerton, Anoud Mohammad, Linda Navarro, Cindy Kosch, Gurinder Bains, Liang Ji, Edward Bitok

Loma Linda University Research Reports

Introduction: This study aimed to investigate the association between early childhood feeding practices and picky eating behaviors in children aged 5-10 years.

Methods: Forty-three parents or legal guardians of children aged 5-10 completed the Child Feeding Questionnaires (CFQ) and the Children’s Eating Behavior Questionnaire (CEBQ) to assess parental control in child feeding and child eating behaviors, respectively. Logistic regression was used to analyze the relationship between the exposure and outcome variables.

Results: Infants fed store-bought food didn't differ significantly in picky eating from those fed self-made food, challenging conventional assumptions. Additionally, while socioeconomic status and parental education didn't show significant …

The Effects Of Hydration Status On Grip Strength, Loradelle Feri, Jordan Sales, Angela Li, Devon Cannata, Cindy L. Kosch, Gurinder Bains, Liang Ji, Everett B. Lohman, Lee Berk, Edward K. Bitok

Loma Linda University Research Reports

Introduction: This study aimed to investigate the influence of hydration status on hand grip strength in a sample of the general population.

Methods: Fourteen participants (4 males and 10 females) aged 18 and older, were recruited from the Loma Linda University area. Participants underwent multiple clinic visits, where they were randomly assigned to either optimal or suboptimal hydration conditions. Measurements included hand grip strength using a dynamometer, extracellular water ratio via bioimpedance analysis, and urine specific gravity.

Results: There was no significant differences in hand grip strength, extracellular water ratio, or urine specific gravity between optimal and suboptimal hydration states. …

The Effects Of Daily Magnesium Citrate Supplementationon Grip Strength, Carolina Cano, Holly King

Loma Linda University Research Reports

Magnesium (Mg) is thought to play an essential role in physical strength because it catalyzes more than 300 enzymatic reactions involved in energy metabolism and cell growth. Magnesium also aids in the hydrolysis of ATP in glycolysis, acting as a coenzyme in three critical reactions and in crossbridge formation in the muscle contraction cycle. Despite these roles, approximately 60% of the US adult population does not meet the RDA for Mg. Previous studies found inconsistent results on the effects of Mg on physical performance. However, most studies agreed on magnesium's potential as an ergogenic aid.

Assessment Of Nutrition Knowledge And Implementation Of Nutrition Education In Pilots, Tarika Chhabra, Susan Kumon, Savanna Malki, Bryan Ferrell, Cindy Kosch, Edward Bitok, Gurinder Bains, Lida Gharibvand

Loma Linda University Research Reports

This study assessed the effectiveness of a nutrition education program for Certificated Flight Instructors (CFIs). The program consisted of six video modules and briefs on various nutrition topics. Thirty-one CFIs participated in the study, and their nutrition knowledge was assessed before and after the program. The results showed a statistically significant increase in nutrition knowledge scores following the intervention (p < .001). Participants also reported that the program helped them improve their dietary habits. These findings suggest that nutrition education can be an effective way to improve the health and well-being of CFIs and potentially other populations.

Effects Of Intuitive Eating Principles And Magnesium Glycinate On Quality Of Life, Body Satisfaction, And Stress In Early- And Middle-Aged Adults, Numydia Cotry, Taylor Kalinowski, Angel Wilensky

Loma Linda University Research Reports

This study investigated the impact of combining Intuitive Eating (IE) principles with magnesium glycinate supplementation on adults aged 18 to 49. Participants were split into two groups: one practicing IE alone and another receiving magnesium supplementation alongside IE. Results showed significant improvements in body satisfaction, stress levels, and overall health among those receiving magnesium. Qualitative data indicated enhanced body awareness and well-being with IE. This suggests a promising synergy between IE and magnesium supplementation for better health and quality of life. However, further research with larger samples and longer durations is warranted.

Dietitian & Physician Preferences Of Fiber Use In Enteral Nutrition: A Pilot Study, Holly Gauthun, Thy Pham, Cory Gheen, Liang Ji, Edward Bitok, Susie Ray

Loma Linda University Research Reports

This pilot study examines the beliefs and preferences regarding fiber use in enteral nutrition (EN) among physicians and registered dietitians (RDs) for hemodynamically stable critically ill patients. A total of 30 RDs and 12 physicians participated. The majority of both physicians (80%) and RDs (83%) supported fiber use in EN for these patients. All participants with over ten years of experience and all Certified Nutrition Support Clinicians (CNSCs) endorsed fiber use. Despite expectations, no significant difference in support was found between RDs and physicians. The study reveals a noteworthy shift towards endorsing fiber use in enteral nutrition for hemodynamically stable …

Effectiveness Of Education For Type 1 Diabetes Patient's Caregivers At Loma Linda University Health, Epiphaneia Juarez

Loma Linda University Research Reports

Diabetes education is essential for patients and families to improve quality of life and minimize the challenges and complications of living with Type 1 Diabetes Mellitus (T1DM). The aim of the research study is to evaluate the knowledge and nutritional practices of caregivers in the management of T1DM in pediatric patients. 20 subjects were recruited at the Loma Linda University Children’s Hospital (LLUCH) Pediatric Diabetes Center before their outpatient T1DM class. A demographic survey, nutrition knowledge survey (NKS), and a 24-hour recall were administered to participants. The Mann-Whitney U test was used to evaluate NKS total score among binary variables …

An Endemic Issue: Malawi's Struggle To Prevent Childhood Malaria, Hailey A. Smalley

Graduate Student Theses, Dissertations, & Professional Papers

Malaria is one of the most prolific diseases in the world, generating hundreds of millions of cases and hundreds of thousands of deaths a year. In 2021, the World Health Organization initiated preliminary trials for the first malaria vaccine in three countries, including Malawi. This project explores the impact of the malaria vaccine on community perspectives and health outcomes related to malaria , describes ongoing challenges that health workers face when disseminating the vaccine, and explains how Malawi’s experience implementing the malaria vaccine reflects larger trends in international aid.

Nurses' Knowledge, Confidence, And Compliance With An Ambulatory Surgery Discharge Checklist, Heather Van Marion

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Preventable errors in healthcare are fueling the growth of patient safety cultures. Checklists have been found to increase discharge accuracy and efficiency and detection of patient safety concerns before discharge.
Local Problem: Oversight errors can be traced back to poor communication or outdated workflows. Ad hoc communication and knowledge of physician preferences are no longer sufficient for ensuring complete discharge instructions. Methods & Interventions: A discharge checklist was developed and implemented in an ambulatory surgery department to ensure discharge instructions were complete and accurate. Nurses completed a pre and 3-month post-checklist questionnaire assessing their knowledge and confidence in the …

Implementation Of An Induction Of Labor Protocol, Rebecca A. Erickson

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Nationwide focus has been placed on the reduction of incidence of adverse maternal and neonatal outcomes in nulliparous, term, singleton, vertex (NTSV) patients.
Local Problem: Nursing leaders of a maternal child health unit in the upper Midwest recognized a need to reduce the rate of adverse maternal outcomes with evidence-based practice. The facility does not currently have an induction of labor (IOL) protocol.
Methods: The California Maternal Quality Care Collaboration Toolkit to Support Vaginal Birth and Reduce Primary Cesarean Sections was used to create an IOL protocol to prevent adverse maternal outcomes. Categorical outcome data was compared for 6 …

Implementation Of An Oral Sucrose Protocol For Advanced Practice Providers, Cori Shatto

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background/Purpose: Pain in infancy due to immunization administration often goes untreated. The pain infants experience leads to negative effects on neurodevelopment and pain response. Needle fear develops in infancy and can extend into adulthood, leading to vaccine avoidance and endemic outbreaks. Methods: In a family practice clinic in an upper Midwest state, an oral sucrose protocol was implemented for use by advanced practice providers (APPs). Prior to education on the protocol, a survey was administered to assess the providers’ knowledge, attitudes, and practice (KAP) in relation to oral sucrose. The providers were educated on the benefits and intended use of …

Implementation Of A Non-Pharmacological Cognitive Stimulation Therapeutic Activities Protocol As A Delirium Prevention Method For Adults, Jada Hieb

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background/Purpose: Delirium is a complex clinical syndrome comprising a constellation of symptoms, including acute onset, inattention, altered level of consciousness, and disorganized thinking or cognitive dysfunction. Delirium is a common complication often unrecognized, expensive, and preventable. This project's focus was further exploring non-pharmacological delirium prevention strategies (NDPS).
Methods: A NDPS program using a therapeutic activity book (TAB) was implemented in a Midwestern acute care hospital measuring the impact on the number of positive delirium screens, the number of delirium diagnoses, and hospital length of stay (LOS).
Results: A causative relationship or association between the TAB and outcomes could not be …

Implementation Of A Prediabetes Risk Assessment And Motivational Interviewing In Adults Ages 35 And Older, Emma Lilleberg

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: The American Diabetes Association (ADA) recommends screening for prediabetes using a validated assessment tool in asymptomatic adults starting at age 35. An effective process to raise screening numbers to identify those at risk of prediabetes and diabetes is needed to provide quality care.
Methods: Nursing staff were educated on use of the risk assessment tool and principles of motivational interviewing (MI). Utilizing the ADA risk assessment tool identified those at risk. Nursing staff completed MI with individuals who scored 5 or higher. A readiness for change survey was completed by patients after receiving MI. Additionally, individuals received education on …

Impact Of An End-Of-Life Simulation On Nurses’ Attitudes, Self-Confidence, And Communication Skills, Amanda Scofield

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: New graduate nurses (NGNs) often lack exposure to end-of-life (EOL) care. Simulation experiences offer a safe place for learning and reflection. Implementation of an EOL simulation has the potential to increase NGNs attitudes, selfconfidence, and communication skills.
Methods: Forty-one NGNs in a nurse residency program participated in an EOL simulation. Attitudes toward EOL, self-confidence regarding EOL care, and EOL communication were evaluated using a pretest posttest format.
Results: Following the simulation, mean self-confidence scores increased, however the increase was not statistically significant (p = 0.53). Mean scores increased for 1 of 2 categories related to attitude toward EOL, however …

Impact Of Evidence-Based Interventions On Nurse Burnout Among Ambulatory Care Nurses, Haley M. Lupher

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: The physical and emotional demands of the nursing profession often cause increased stress and burnout in nurses. If burnout is not addressed, the negative consequences of burnout are perpetuated by one another. Evidence-based interventions, such as meditation, yoga, and physical activity can help reduce nurse burnout.
Local Problem: This project was completed at an ambulatory dermatology clinic that sees approximately 300 patients a day. In recent years, this department has noticed increased nurse turnover and low nurse morale.
Methods: A convenience sample from approximately 30 nurses was utilized. Burnout was measured using the Maslach Burnout Inventory for Medical Personnel …

Implementation Of A Daily Protocol To Reduce Central Line Days On A Medical-Surgical Unit, Katherine Wickstrom

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Central line associated bloodstream infections (CLABSIs) are preventable healthcare associated infections (HAI) in the United States. CLABSIs are associated with increased length of hospital stays, mortality, and financial implications for both patients and hospital systems. Extensive research has shown implementing CLABSI prevention bundles can reduce infections and costs. These bundles are often misused, highlighting the importance of bundle compliance and education.
Local Problem: A medical surgical unit in the upper Midwest continues to have delayed central line removal despite a CLABSI prevention bundle. Efforts to decrease central line days were identified as a priority.
Methods: Staff completed education on …

Improving Preventive Care Tasks In Adults Aged 50 And Older With Pre- Visit Planning In Primary Care: Review Of Literature, Destinee Rice

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Introduction: Primary care providers are seeing an increased number of elderly patients with several chronic health issues. The time required to address multiple chronic health issues during an appointment impedes timely completion of preventive care tasks. Previsit planning can aid in closing this gap in preventative care by having all necessary information prepared before a patient’s visit.
Evidence Summary: A literature search was conducted in Cumulative Index to Nursing and Allied Health Literature and PubMed using subject headings and MeSH terms. The search was refined to include articles within the last 10 years. Articles were further narrowed down by their …

Implementing The Teach-Back Method On Pessary Utilization In A Urogynecology Clinic, Marissa Eich

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: The effectiveness of pessary patient education using the teach-back method and improving nurse confidence and conviction related to pessary use are essential in improving patient outcomes.
/="/">Local Problem: The current limitations in pessary education stem from constraints in nurse availability and workload distribution.
/="/">Methods: The quality improvement initiative involved conducting surveys to evaluate nurse confidence using surveys adapted from the Agency for Healthcare Research and Quality toolkit before the nurse education session, 1 month into the intervention, and at 3 months, when the implementation period ended. These surveys assessed the effectiveness of the teach-back method.
/="/">Intervention: …

Reducing Emergency Department Decision To Admit To Disposition Time Using The Sydney Triage To Admission Risk Tool, Jolyn Sackmann

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Long emergency department (ED) length of stay (LOS) is associated with increased mortality, delay in care, longer inpatient (IP) stays, readmission risk, poor patient satisfaction, and opportunity for error. Within the ED LOS is a quality indicator measuring the time a provider determines a patient will be admitted to the time the patient leaves the ED for an IP unit, called ED-2. Prolonged ED-2 indicates impaired ED output.
/="/">Local Problem: Despite previous interventions, the ED-2 at a rural Midwest hospital was about 63.5 minutes; the goal set forth by the Centers for Medicare and Medicaid is 35 minutes …

Reduction Of Pressure Injury Development In Long-Term Care Residents Using A Pressure Injury Prevention Plan And Communication Alerts, Joseph Osazee

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Accurate communication of changes in residents' skin condition and the provision of appropriate intervention in long-term care is key to ensuring patient safety and well-being through the prevention of pressure injury (PI) development. Effective use of a PI prevention plan and communication tools by certified nursing assistants (CNAs) and nurses can help in this regard.
/="/">Methodology: Thirty-three nursing staff attended an initial I -hour education session on how to identify changes in skin conditions and report them using the as needed (PRN) skin check tool or custom alert tool and implement interventions to prevent PI progression. The Pieper-Zulkowski …

The Effect Of Mating Pheromone 2,6-Dichlorophenol On Gene Expression In Male Lone Star Ticks (Amblyomma Americanum), Mitchell E. Dyen

Honors Undergraduate Theses

Lone star ticks (Amblyomma americanum) are tick species known for their generalist feeding habits, pursuing blood meals with little preference for specific host species. They are found in the southern and midwestern United States but have been rapidly expanding northward due to climate change and white-tailed deer population expansion. Since they are a zoonotic disease vector, their increased abundance has caused the concurrent increased prevalence of a variety of tick-borne illnesses such as tularemia, heartland virus disease, alpha-gal syndrome, ehrlichiosis, and southern tick-associated rash illness (STARI), which effect both humans and animals alike. This increased prevalence of tick-borne …

Epitope Mapping Novel Monoclonal Antibodies Against Borrelia Burgdorferi Surface Proteins Ospc And Bmpa, Eliza M. Doyle

Honors Undergraduate Theses

In response to the progressive nature of Lyme disease, direct diagnostic testing of Borrelia burgdorferi surface proteins was proposed as a quicker and more sensitive alternative to the current indirect detection methods. To determine the ability of novel monoclonal antibodies to detect the surface lipoproteins BmpA and OspC, recombinant fragments of these proteins were created. These fragments were tested against the putative diagnostic antibodies via western blotting as a means to map the epitope of each of the proteins that the respective antibodies recognize. All BmpA fragments with deletions on the N-terminal end exhibited reactivity, indicating that the epitope is …

Health Equity Policy In Colombia: Improving Equal Access To Health Care Services For Individuals With Low-Income, Marian Marin

Honors Undergraduate Theses

In 1993, the last health reform “Law 100” was introduced in Colombia. It has been over 30 years since its implementation, and there have been many changes to the healthcare system in Colombia ever since. The policy increased health insurance coverage to almost 95% of the population, providing better and more affordable patient care. However, increasing the availability of resources does not necessarily make them accessible to all of Colombia’s residents. This study aims to analyze the outcomes of “Law 100” to the system and studies critical obstacles that halt healthcare equity in Colombia, particularly for those in rural and …

Co-Occurrence Of Autism Spectrum Disorder And Attention-Deficit/Hyperactivity Disorder With Idiopathic Hypersomnia: Data From The Hypersomnia Foundation Registry, Sophie Sevan Mikkelsen

Honors Undergraduate Theses

In recent years, hypersomnia patients and researchers alike have increasingly discussed the possibility of heightened comorbidities, or co-occurrences, of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) with the central disorders of hypersomnolence: idiopathic hypersomnia (IH) and narcolepsy (N). While a few scarce studies have investigated a link between ADHD and N, there has been no research on the co-occurrence of these conditions with IH. This study, using data from the Hypersomnia Foundation’s CoRDS Patient Registry, is the first to identify self-reported rates of ASD and ADHD diagnoses by people with idiopathic hypersomnia. Four chi-square tests were conducted to determine …

Examination Of The Morphological Changes And Genotoxic Effects Of Sodium Benzoate On Neuro-2a Cells In Vitro, Emily S. Larson

Honors Undergraduate Theses

Sodium benzoate is a food preservative present in sodas, fruit juices, and other acidic foods and beverages [1]. Its acceptable daily intake is 0-20 mg/kg body weight [2], and it is generally recognized as safe [1, 3]. However, sodium benzoate has been linked to hyperactivity in children [4, 5] and adults [6] and to deficits and behavioral changes in rodents [7-10], indicating potential negative impacts on the nervous system. Sodium benzoate has also induced genotoxic effects in human lymphocytes [11, 12] and Chinese hamster fibroblast cells [13] in vitro and in rat liver tissue in vivo [14]. The effect of …

Detection Of Micrornas In Blood Samples Using Biosensors For The Detection Of Early-Stage Lung Cancer, Nicholas Bruno

Honors Undergraduate Theses

Lung cancer kills more people in the U.S. a year than any other cancer. This is largely because patients often remain asymptomatic until stage 3, by which time the tumor is usually highly malignant. High radiation-producing screenings are the current method of lung tumor detection. These typically involve machinery for tumor visualization, such as computed tomography (CT) scans, positron emission tomography (PET scan), magnetic resonance imaging (MRI), and X-rays. Not only does radiation exposure from this equipment pose a risk to the patient, but any tumors detected by these scanning techniques are likely to be locally advanced. This suggests that …

How Hormonal Contraceptives Influence Injury In Female Athletes: A Systematic Review, Ashley V. Malvita

Honors Undergraduate Theses

Research indicates that female athletes have a higher risk of musculoskeletal injuries. Hormone fluctuations throughout the different periods of the menstruation cycle impacts the risk of injuries for women. Contraceptive use, most used in the form of an oral contraceptive pill, directly effects hormones and menstrual cycle related symptoms, with evidence of ameliorating some symptoms. Oral contraceptive use is suggested to influence musculoskeletal injuries in female athletes. However, there is little research and data that explores the direct relationship between oral contraceptive use and the injury rates of female athletes. Within this systematic review, five articles investigating this relationship fulfilled …

Breakfast Skipping In College Students And Its Association With Eating Behaviors, Rebekah E. May

Honors Undergraduate Theses

Background: Breakfast is important in maintaining optimal diet quality and decreasing preventable diet-related disease later in life. Breakfast skipping is highly prevalent in the college population, potentially decreasing self-regulation and diet quality and increasing habits of overeating. However, specific eating styles and diet quality have yet to be studied in breakfast skippers.

Objective: To explore and compare the characteristics of eating style, self-regulation, and diet quality among college students between a day when breakfast is skipped and a day when breakfast is consumed.

Methodology: Undergraduate students (n=103) participating in this observational crossover study completed demographics, the Self-regulation of Eating Behavior …

Serious Game-Based Training For Improved Utilization Of A Novel Temporalis Emg Interface For Controlling Powered Wheelchairs, Calvin Macdonald

Honors Undergraduate Theses

Amyotrophic lateral sclerosis (ALS) is a terminal neurodegenerative disease that leads to a lack of independent mobility. One solution uses a unilateral surface EMG (sEMG) interface on the temporalis muscle to provide autonomous control of a powered wheelchair. Limbitless Journey, an EMG-controlled serious game, intends to provide users with a virtual environment to train in before use in a real-world scenario. A recent study analyzed the effect of video game training on the use of sEMG systems on the forearm, showing significant improvement in the usage of the interface but no difference between Free Play and structured play. The study …