Introduction: Orthodontic treatment is meant to provide patients with stable occlusion and an esthetic smile, and often improves a patient's self-esteem. Unfortunately, and too often, an ideal orthodontic finish in terms of alignment and occlusion is tarnished by the appearance of white spot lesions on the facial surface of teeth after removing the fixed appliances. These white spots detract from the esthetics of a patient's smile. Purpose: The objective of this study was to evaluate the effectiveness of MI PasteTM (GC America, Alsip, Illinois), MI Paste PlusTM (GC America, Alsip, Illinois), and Topex RenewTM (Sultan Healthcare, Hackensack, NJ) in increasing remineralization and improving the esthetic appearance of white spot lesions in patients after treatment with fixed orthodontic appliances. In addition, at-home only versus in-office and at-home treatment protocols were evaluated. Methods and Materials: Thirty patients were enrolled in four treatment groups and a control group, with six patients in each group. The study lasted three months and results were analyzed with normal and QLF photographs. Results, Discussion, and Conclusion: Upon completion of this clinical study, the following conclusions can be drawn. First, the visible area and the fluorescence decrease of white spot lesions will both significantly lessen after orthodontic treatment regardless of products used, or even with a non-prescription fluoride toothpaste control. Second, there is some evidence that an at-home treatment protocol using Topex Renew, or a combination in-office and at-home treatment protocol with MI Paste Plus, may be more beneficial in reducing the appearance of white spot lesions after orthodontic treatment than other treatment protocols.

Diseases of the heart have been the number one cause of death in the Native American population for decades and is an adverse health disparity for this population. Heart disease mortality rates are higher in Native Americans than in the U.S. population (American Heart Association, 2015; Veazie et al., 2014). The purpose of this Doctor of Nursing Practice (DNP) project is to describe the acute coronary syndrome (ACS) experience among Native American adults who reside in northern Arizona and diagnosed with an acute myocardial infarction .A qualitative dominant mixed methods design (QUAL→quan) was used to describe the ACS symptom experience among this population. Data was collected from a convenience sample of nine Native American men residing on the Navajo and Hopi reservations in northern Arizona diagnosed with an acute myocardial infarction. The qualitative portion of this study consisted of a semi-structured interview and the quantitative portion consisted of the completion of a demographic questionnaire and the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey. Qualitative description were used to analyze the data and develop codes, subcategories, categories and themes. Descriptive statistics were used to analyze the data from the demographic questionnaire and MAPMISS results. The findings in this study revealed the average age of the first heart attack for these participants was 58 years. The average time from symptom onset to hospital presentation was 7.4 hours. A common prodromal symptom was very tired/unusual fatigue. Common acute symptoms were chest pain, shortness of breath, gastrointestinal symptoms and diaphoresis. Neck/throat, generalized chest, and top of shoulders were most frequently reported areas of acute pain or discomfort. Influences to not seeking treatment included ignoring symptoms or thinking symptoms would go away. Influences to seeking treatment included worsening or non-resolution of symptoms. Accessing health care was difficult for almost all participants and contributed to treatment delay. Findings from this study gave new insight on ACS symptoms and the ACS experience of Native American men, reinforced current knowledge of the health disparities that exist in this population, and will assist in the development of culturally-sensitive, community-based education programs directed toward the Native American population.

No description available.

In the face of economic, demographic, and infrastructural decline, Detroit, Michigan has become a destination for tourists interested in viewing the city's iconic ruins. Using data collected through participant observation, interviews, and document analysis, this thesis examines these emerging practices of ruin tourism in order to understand how such tourism operates, how it is related to representations of the city in popular media, and how it contributes to economic redevelopment in Detroit. Situated in literature about ruination and liminality, tourism geography, and critical urban geography, the study contributes to understandings of urban redevelopment in the post-industrial United States.

Purpose: The purpose of this study is to evaluate the effectiveness of MI Paste Plus™ in increasing remineralization and improving the esthetic appearance of white spot lesions in patients who have been treated with fixed orthodontic appliances. Material and Methods: A total of twelve subject participants aged twelve to twenty years were selected in this pilot study. The six treatment group subjects were treated with MI Paste PlusTM every three weeks in-office (4 applications) and via invisible retainer every night for a total of 12 weeks. The in-office application consisted of a 1 minute 35% phosphoric acid and a 5 minute MI Paste PlusTM contact time. At home, the subjects went about their routine oral hygiene practices, but added MI Paste PlusTM to their invisible retainer before bedtime which was worn throughout the night. Photographs and quantitative light-induced fluorescence (QLF) were used to calculate white spot lesion area and ∆F values respectively. Results: A significant difference was found in the control group for the area of the white spot lesion in antimere teeth #6 and #11. When analyzing the white spot lesion area in the treatment group, significant differences were found in tooth #6, antimere teeth #6 and #11, antimere teeth #8 and #9, as well as all teeth. ∆F values for all teeth in both the control and treatment groups were significant. Conclusion: In-office and at home treatment with MI Paste Plus™ showed a statistically significant reduction in photographic lesion area when compared to controls. Both MI Paste Plus™ and a fluoride toothpaste will provide some remineralization of white spot lesions.

Situated at seaside, Mi-Tuo area is lack of natural resources since long time ago. In addition our government didn¡¦t put much effort and budget into area development for quite long time, the fishing harbor and seaside are merely regarded as natural resources for Min-Tuo area. The rest is contributed to our local resident¡¦s hard work in this barren and salty land. Yet tourism sector gains dominance in recent years and five-day workweek is adopted by our government, this kind of area poses great potential to develop its own characteristics. Besides tourism sector will certainly bring enormous economical effect to local area. While emphasis shall be put on sustainable development of tourism and natural resources. Besides strength and weakness of internal development as well as external opportunity and threat should be recognized. Therefore the contingency strategy will be timely drafted to maintain sustainable growth in the changing environment. This research aims to study the current tourism sector in Mi-Tuo county and focus on ecological tourism as well as sustainable development for local area under industrial operation environment. After recognizing strength and weakness of internal development and internal opportunity and threat, the feasible marketing strategy is thus drafted with hope of benefiting tourism sector in Mi-Tuo area. To prevent analytical process from falling into subjective judgement, it is suggested to cope with practical research. As a result development of tourism sector in Mi-Tuo will adapt market change. It is further expected that scenery of fishing village, seaside fishing, sunset gazing at turn of century, returning of fishing boat, sleeping in windbrerk, sea wind listening, stars counting, enjoying milkfish feast, and so on will not only become the best recreational place for people, but draft feasible marketing strategy to industrial development environment.

Syfte: Att beskriva orsaker till brister i uppföljning, dess effekter och den motivation som sjuksköterskor kan möta hos patienter som är gastric bypass opererade i samband med fortsatta livsstilsförändringar och ökad livskvalitet, samt att som kvalitetsgranskning redogöra för undersökningsgrupper, deltagare och bortfall i artiklarna. Metod: Litteraturstudie med deskriptiv design. Sökning av kvantitativa och kvalitativa vetenskapliga artiklar i databaserna CINAHL och Pubmed. Artiklarnas resultat har sedan utifrån syfte och frågeställningar analyserats. Resultat: Det är betydelsefullt att få patienterna att komma på uppföljande återbesök för att hjälpa de till fortsatt livsstilsförändring. Högt BMI innan operationen kunde vara orsak till brister i att komma till uppföljning och återbesök vilket medförde förlust av stöd och hjälp till att följa dieten, samt att komplikationer upptäcktes sent och att information gick förlorad. Även om livskvaliteten ofta förbättrades markant så upplevde många en mer bristande grad av livskvalitet än förväntat och depression förekom. Hinder till motivation till förändrad livsstil och förbättrad livskvalitet kunde vara att pressas för hårt vilket kunde innebära att patienterna ofta ledsnade helt på att röra på sig. Slutsats: För att uppnå viktminskningsresultat och en förbättrad livskvalitet genom motiverande samtal behövs kunskap om hinder till motivation. Uppföljning och återbesök behöver prioriteras både av patienter och av sjuksköterskor.

Introduction: Physical inactivity, related lifestyle diseases and back pain are severe problems in today’s society. One way to increase physical activity level is through Motivational Interviewing (MI).   Purpose: Comparing participants who were in need of MI for physical activity due to risk of heart- and coronary disease with participants not in need of MI, and to describe whether MI for physical activity and other factors can predict change of physical activity level.   Method: A cohort was followed during two years and measured on lifestyle factors, socioeconomic and psychological factors, general health, motivation to change lifestyle and back pain by questionnaires. Based on risk of heart and coronary disease, participants underwent an MI-session for increased physical activity (n=393) or no MI-session (n=380) at baseline.   Results: Besides having a deteriorated lifestyle, the majority of participants who received MI were females, had lower self-estimated economy, had lower health-related quality of life, scored lower on psychological factors and had comorbidity and back pain to a larger extent. Factors related to increase of physical activity level included being physically inactive at baseline, being a female, not having MI and not having disability due to back pain.   Conclusion: Participants in the MI-group had poorer health and more back pain. Having MI did not predict an increase of physical activity, but a low level of physical activity in the past and being a female did play a part in the prediction. More research is needed on MI for increase of physical activity level for an individual with risk of heart- and coronary disease and/or with back pain. / Introduktion: Fysisk inaktivitet, livsstilssjukdomar, och ryggsmärta är stora problem i dagens samhälle. Ett sätt att öka fysisk aktivitet är motiverande samtal (MI).   Syfte: Att jämföra deltagare som på grund av ökad risk för hjärt-/kärlsjukdom har behov för MI för ökad fysisk aktivitet med de som inte har behov, samt att beskriva om MI för ökad fysisk aktivitet och andra faktorer kan predicera en ökning i fysisk aktivitetsnivå efter två år.   Metod: En cohort följdes genom två år och mättes med enkäter beträffande livsstils-, socioekonomiska och psykologiska faktorer, hälsa, motivation till ändrad livsstilsbeteende samt ryggsmärta. Baserad på sin risk för hjärt-/kärlsjukdom fick deltagare ett MI-samtal syftat till att öka sin fysiska aktivitetsnivå (n=393) eller inget MI-samtal (n=380) vid baslinjen.   Resultat: Deltagare som fick MI för ökad fysisk aktivitet var oftare kvinnor, hade lägre själv-estimerad ekonomi, sämre hälsorelaterad livskvalitet, sämre psykologisk hälsa, mera komorbiditet och mera ryggsmärta. Faktorer relaterade till ökning av fysisk aktivitetsnivå var att vara inaktiv vid baslinjemätningen, att vara kvinna, att inte ha haft MI och att inte ha funktionsnedsättning på grund av ryggsmärta.   Konklusion: Deltagare i MI-gruppen hade sämre hälsa och mera ryggsmärta. MI predicerade inte en ökning av fysisk aktivitetsnivå. Däremot predicerade tidigare låg aktivitetsnivå och att vara kvinna en ökning. Mer forskning behövs avseende effekt av MI för ökning av fysisk aktivitetsnivå för individer med risk för hjärt-/kärlsjukdom och/eller ryggsmärta.

SAMMANFATTNING   Syfte: Att undersöka om isolerade hematologiska patienters fysiska aktivitetsnivå kunde förbättras med hjälp av en skriven individuell vårdplan och ett motiverande samtals förhållningssätt, samt om en ökad fysisk aktivitetsnivå kunde påverka behovet av transfusioner, analgetika, antibiotika och antalet isoleringsdagar.   Metod: En kvasiexperimentell design valdes och interventionsgruppen jämfördes med hematologiska patienter på en motsvarande avdelning i södra Sverige. Personalen på interventionsavdelningen fick en kort motiverande samtals utbildning. Sexton patienter inkluderades i varje grupp, 13 patienter slutförde studien på interventionsavdelningen och 12 i jämförandegruppen. Patienterna skrev aktivitetsdagböcker dagligen och all aktivitet räknades om till METs (Metabolic Equivalent of Task), ett validerat sätt att mäta fysisk aktivitet.   Resultatet: En signifikant skillnad på METsmedelvärden framkom i de två grupperna, 11,1 METs/dag i interventionsgruppen mot 6,8 METs i jämförandegruppen. Avseende behovet av transfusioner, analgetika, antibiotika och antalet isoleringsdagar är det signifikant skillnad enbart på isoleringstiden. Däremot är det signifikanta skillnader gällande alla testade variabler utom för antalet erytrocytkoncentrat när samtliga patienters METs värden kategoriserades i tre grupper enligt aktivitetsnivå.   Slutsats: Ett motiverande samtals förhållningssätt tillsammans med en skriven individuell vårdplan kan ha betydelse för patienternas fysika aktivitetsnivå. Patienter som rör sig dagligen från 5 METs och uppåt har lägre behov av trombocyter, antibiotika och analgetika och de är inte isolerade lika länge. / ABSTRACT   Purpose: To investigate if the physical activity level of isolated haematological patients can be improved by using individual care plans and a motivational interviewing approach (MI), as well as if an increasing level of physical activity affects the need of transfusions, analgesics, antibiotics and number of days in isolation.   Methods: A kvasiexprimental design was chosen and the intervention group was compared to haematological patients at a ward in the southern Sweden. The staff at the intervention ward received a short MI education. Sixteen patients were included in each group, 13 patients completed the study at the intervention ward and 12 in the comparing group. The patients wrote daily activity diaries and every movement was counted as METs (Metabolic Equivalent of Task), a validated way of measuring physical activity.   Results: A significant difference in METs means was seen between the two groups, 11,1 METs per day in the intervention group compared to 6,8 METs in the comparing group. A difference in the need of transfusions, analgesics, antibiotics and the number of isolation days was only seen in time of isolation. There were significant differences in all tested variables except for the number of blood transfusions when all patients together were categorized into three groups according to activity level.   Conclusions: An MI approach together with an individual care plan may have an impact on patients’ physical activity level. Patients that are active from 5 METs per day need less thrombocytes, antibiotics and analgesics and they need shorter times of isolation.

No description available.