Studying epidemiology is critical for healthcare because it provides professionals with the knowledge needed to promote health. In particular, it ensures the possibility to prevent, control, and treat health-related issues. It discusses numerous concepts that ensure understanding of public health and problems faced by it.
Disparity
The disparity is often faced by the representatives of the general public. This term means that they are deprived of something because of particular differences, such as race or income, etc. (ODPHP, 2017). Today, professionals also discuss the issue of health disparity. Discrepancy deals with health and is associated with peoples characteristics. For instance, these can be social (African Americans racial discrimination), economic (unemployed lack of finances), and environmental (house near a plant contamination of air, water, etc.) peculiarities.
As a result, these individuals cannot obtain free access to healthcare services and deal with other obstacles to health. Fortunately, professionals pay much attention to this problem today. They develop initiatives that can assist deprived populations because the absence of disease does not mean that their health condition is appropriate.
Societal and Public Health Perspectives
As health disparity presupposes that various populations are at different levels of risk for the occurrence of negative health conditions, it is critical to consider them from numerous points of view. Nevertheless, societal and public health perspectives are used in the majority of cases because their interventions are the most influential ones. Professionals should discuss several variables when coping with health disparities.
First of all, attention should be paid to a particular population, place, and time framework. These elements affect the occurrence of a problem and allow further generalization that is required for future changes. In other words, they can find out who suffers from what, where, and when. For instance, societal and public health professionals can gather information about the issue they consider to be critical for the population.
Those who live near busy streets often suffer from respiratory problems that are worsened because of air pollution caused by cars. Professionals need to conduct studies to prove the connection between these elements and approach governmental agencies to implement changes aimed at traffic reduction. In addition to that, they can educate their targeted population about this issue and improve access to health services (CDC, 2016).
Prevalence of Hypertension
As the prevalence of hypertension has not altered significantly, it is important to identify reasons for such a tendency. A descriptive epidemiologic study with the identification of a particular state and peoples characteristics is needed. Their age, race, sex, lifestyle, diet, and past medical history are to be addressed. Additional attention should be paid to such factors as stress, social support, and genetic predisposition. In particular, it would be advantageous to focus on individuals of both genders who are older than 65 years old (WHO, 2017).
They should be interviewed or asked to complete a questionnaire that addresses hypertension and access to healthcare services. For instance, it will be advantageous to find out what they know about this issue, how they deal with it, and who supports them, etc. This information will be extremely helpful for an experimental study, because it will reveal existing gaps, urging professionals to cope with them.
Conclusion
Thus, epidemiology discusses various health-related concepts, including disparity. It allows gathering information about various populations and their risks for having particular health issues. Unfortunately, people do not have the same access to healthcare services yet, and some of them live in those environments that affect their condition adversely. Nevertheless, these problems can be overcome with the help of epidemiology.
Revenue cycle management (RCM) is one of the key issues in health care billing system. To bill for services, it is important to collect data during a patients visit and properly treat insurance requirements and regulations. Taking into account that insurance system presents various options and tends to change rapidly, the billing process may sometimes be difficult to provide. RCM professionals are expected to assign correct codes to health issues and accompany the whole process of payment.
They are also responsible for reimbursement, eligibility, and other procedures involved in financial concerns. It should be noted that ambulatory (inpatient) and outpatient services have some differences in terms of revenue cycle management. In particular, ambulatory care setting requires paying great attention to financing comprehensive and coordinated care, while outpatient services focus more on out of the hospital treatment and may be reconsidered as per patients request if they disagree.
As reported by the official sources, the latter is characterized by the growth in recent years, since plenty of patients have transitioned to outpatient realm (Singh & Wheeler, 2012). In order to understand revenue cycle management in an in-depth manner, it is critical to identify differences between inpatient and outpatient care settings.
Literature Review
The thorough review of the recent literature indicates that the majority of scholarly sources explore RCM in a hospital setting. Abdelhak, Grostick, and Hanken (2016) state that the key internal revenue drivers include productivity that is also called provider capacity, patient volume, and fees. The mentioned drivers are quite easy to control, and they may be managed for every practice. In their turn, the key external revenue drivers involve patients payments, claims from commercial and government payers, and collections.
These drivers can hardly be controlled by a billing team, thereby significantly affecting ambulatory revenue cycle. Another distinctive feature of inpatient RCM is the very procedure of entering a patients demographics, health history, and other relevant data in the system, as stated by McDermott, Jones, and Stuckey (2012). By assigning proper codes and making claims, billing specialists ensure the reception of reimbursement. As for outpatient RCM, it begins after the discharge of a patient, when codes and claims are to be reconsidered and adjusted according to the diagnosis and further services. In case a claim was rejected by a payer, it is to be reviewed by billing team and resend.
Hospital Inpatient Prospective Payment (IPPS) is usually used by RCM in an inpatient care setting. It implies per case payment as well as the assignment of payment per diagnosis (Kahn et al., 2012). Hospital Outpatient Prospective Payment System (HOPPS or OPPS) is applied for outpatient care. It is also called Ambulatory Payment Classification (APC), since it helps professionals to classify certain costs and characteristics. It is possible to assign more than one classification for the same patient. When a patient is discharged after treatment in the hospital, he or she is reviewed in terms of the Uniform Hospital Discharge Data Set (UHDDS). The above set is used as the last billing procedure during inpatient stay to specify diagnosis and procedures.
Summary
To sum it up, ambulatory and inpatient revenue cycle management are quite similar, yet they have some distinctive features as well. Among the key differences, one may note procedures and payment options used by a billing team professional. The first difference refers to revenue codes and bills. If inpatient care settings imply that a patients data should be collected before the visit to a physician and then adjusted in accordance with the identified diagnosis and treatment options, then ambulatory care RCM begins with the discharge of a patient (Centers for Medicare & Medicaid Services (CMS) & HHS, 2013).
As for revenue codes reported to insuring companies and send to payers, RCM presents different coding systems. Namely, IPPS is used for inpatient services, and HOPPS or OPPS and APC are utilized to mark outpatient care provisions. When all the obligations and payments are provided, the revenue cycle is regarded as complete.
The literature review shows that ambulatory care settings require much more attention rather than inpatient services, since the former has a more complex nature and needs to be treated more comprehensively. According to the reviewed sources, namely, the one by the Centers for Medicare and Medicaid Services (CMS) and HHS (2013), patients tend to address outpatient care and physician offices to receive the required services. In this regard, it is possible to suggest that further research is necessary to establish proper understanding of the topic and implement relevant policies to improve the work of billing teams in the framework of revenue cycle management.
References
Abdelhak, M., Grostick, S., & Hanken, M. A. (2016). Health information: Management of a strategic resource (5th ed.). St. Louis, MO: Elsevier Health Sciences.
Centers for Medicare & Medicaid Services (CMS) & HHS. (2013). Medicare and Medicaid programs: Hospital outpatient prospective payment and ambulatory surgical center payment systems and quality reporting programs; Hospital Value-Based Purchasing Program; Organ procurement organizations; Quality improvement organizations; Electronic Health Records (EHR) Incentive Program; Provider reimbursement determinations and appeals. Final rule with comment period and final rules. Federal Register, 78(237), 4825-5200.
Kahn, C. N., Ault, T., Potetz, L., Walke, T., Chambers, J. H., & Burch, S. (2015). Assessing Medicares hospital pay-for-performance programs and whether they are achieving their goals. Health Affairs, 34(8), 1281-1288.
McDermott, P., Jones, J., & Stuckey, L. (2012). Maintaining revenue cycle health during IT change. Healthcare Financial Management, 66(9), 58-65.
Singh, S. R., & Wheeler, J. (2012). Hospital financial management: What is the link between revenue cycle management, profitability, and notforprofit hospitals ability to grow equity? Journal of Healthcare Management, 57(5), 325-341.
The Conflicts Between Customized and Standardized Care
Currently, the are two views on the organization of patient care: one emphasizes the customization of the services to the needs of individual patients while other advocates the standardization of practices based on research. A general consensus on the topic is that these approaches need to complement each other, but several conflicts exist between the two which complicate the integration. First, the standardization implies well-defined and regulated practices.
This excludes the human factor, which is known to be one of the chief concerns of the healthcare. However, it also compromises the flexibility which is necessary in certain cases. This conflict was partially addressed by introducing the regionalized care (Nguyen, Kahn, & Angus, 2010). However, this has led to a related conflict, which attempts to determine the boundaries of customization. Once the possibility emerges to introduce the customized practices on a certain level, the inevitable question is: which level should it be? Another conflict associated with these views is grounded in the patients perception of the service. The personalized care improves the patients involvement in the treatment, which coincides with the current understanding of the successful healthcare process (Geisler & Heller, 2012).
Besides, it appeals to the patients concept of a family doctor, a specialist who can account for all the individual needs. This, in turn, improves patient satisfaction. At the same time, it applies only to a fraction of health providers, while introducing unnecessary waste of time and resources and a possibility of a faulty judgment. Finally, the standardized procedures are more effective in terms of cost and administrative effort. Customization introduces the unpredictable number of variables and complicates planning.
The Applicability of Demings Concept of Waste to Health Care Entities
Edward Demings principles of quality improvement have initially been created for use in the business sector. However, they are flexible and universal enough to be utilized in a number of other areas, including healthcare. Of particular interest is the concept of waste. This concept is specifically mentioned in the fifth principle, Improve constantly and forever the system of production and service. (Orsini, 2012) While improvement is a broad and somewhat vague term, Deming offers one possible way to do it: through waste reduction.
Waste, in this case, mostly characterizes ineffective human resource management. According to Deming, the system which is intrinsically flawed will inevitably hamper the ability of people involved to develop their potential. This notion notably coincides with the established practice of just culture, which is aimed, among other things, at finding the weak points of the system by analyzing mistakes made by the personnel (Kaplan & Fastman, 2003).
According to the Demings concept of waste, the shortcomings of the system is considered an inhibitor which will render the effort of employees, their skill, training, and education useless (Orsini, 2012). As the constant improvement in healthcare is usually achieved by adding new entities to patch the already existing problems, it is almost a certainty that some of these additions will be of questionable value. Demings concept suggests making the reduction a part of the process, which will remove unnecessary complexity and allow for an improvement through personal achievement.
Besides the implementation in the administrative sector, the waste concept can be applied on a more material level. For instance, poorly organized work environment, e.g. improperly placed inventory, can slow down or disrupt the efficiency of the medical procedures, and can be categorized as waste. Thus, the concept of waste can be utilized in healthcare as a guiding principle for improvement through simplification and fighting redundancy.
References
Geisler, E., & Heller, O. (2012). Managing Technology in Healthcare (Vol. 1). Boston, MA: Springer Science & Business Media.
Kaplan, H. S., & Fastman, B. R. (2003). Organization of event reporting data for sense making and system improvement. Quality and Safety in Health Care, 12(suppl 2), ii68-ii72.
Nguyen, Y. L., Kahn, J. M., & Angus, D. C. (2010). Reorganizing adult critical care delivery: the role of regionalization, telemedicine, and community outreach. American Journal of Respiratory and Critical Care Medicine, 181(11), 1164-1169.
Orsini, J. The Essential Deming: Leadership Principles from the Father of Quality. New York, NY: McGraw Hill Professional.
During summer holidays, I visited a chiropractor in Delaware, U.S.A who uses various modalities independently or in combination in rehabilitation. To achieve a desired outcome, he employs a single modality or combines them to address non-responsive conditions, hasten wellness and maintain health.
In diagnostic approaches, he uses x-rays, magnetic resonance imaging (M.R.I), comprehensive history of clients and chiropractic analysis to determine the clients need of chiropractic adjustment (Huslig, 1986). For example, incase of failed chiropractic adjustments (using manual thrusts and hands-on approaches to correct distorted spine), he employs the Thompson drop technique by analyzing subluxation, turning the head at desired angles, applying the Thompson table (Terminal Point) as used in Derifield technique before giving a thrust. He also employs massage therapy to promote muscle relaxation. In most of his cases, nutrition, health education and weight approaches are necessary to correct stress on the spine and other body parts. In other methods e.g. the activator method, he uses body mechanics and balance of forces to correct subluxation (Family, Back and Neck Center, para. 2-5)
He uses chiropractic adjustment for non-musculoskeletal complains like those of visceral origin. Other techniques he employs include electrotherapy by electrically stimulating muscle at a certain frequency and intensity to attain a physiological response (Leach, 1986).
Since musculoskeletal problems may worsen with movement due to stress on other structures, he combines the above methods with orthotic (gadget) modalities. For example, he may prescribe foot orthotics which may be put in shoes to prevent pelvic and spinal distortion and enhance feet to achieve balance during motion. He uses holistic modalities (environmental, psychosocial, physical, spiritual, lifestyle and emotional) to foster a good relationship with his clients (Fitness Wellness Center, para. 1-4).
As a personal trainer, I can be incorporated in his rehabilitation practice in the activator method which uses body mechanics and balance of forces to correct subluxation. I will also fit in other methods such as orthotic use, Thompson-drop technique, flexion distraction and derifield technique. I will also be concerned with weight and dietary modalities to give desired results e.g. increased total body weight due to fat loss and muscle gain, reduced total body weight due to fat loss and muscle gain, constant body weight with fat loss and muscle gain. The above issues will be of concern because of the need to ascertain the frequency, duration, and intensity of the exercises given during rehabilitation exercises (Hatfield, 2005).
As a personal trainer, I learned that it is vital to employ various techniques either in combination or independently to meet my clients needs. Comprehensive case history of clients is important prior to training as it identifies the risks to which the client is predisposed. Client examination determines the need for training, unlike my previous perception that fitness can only exist in the presence of exercise (Hatfield, 2005). Moreover, risks such as musculoskeletal strains can be minimized by using orthotic modalities in combination with other methods as learned from the visit.
After the visit, I learned that it was crucial for me to employ nutrition, weight and health education modalities to enhance well being of my clients who may be my friends or family. A holistic approach to my family and clients in my practice was a key lesson to foster a good relationship for optimum health. Analysis of various factors (environmental, psychosocial, physical, spiritual, lifestyle and emotional) and handling clients with respect contributes to the well being of the clients.
References
Family, Back and Neck Center. Web.
Fitness Wellness Center. Web.
Hatfield, F. (2005). Fitness: The complete guide to dumbbell training. International Sports and Sciences Association.
Huslig, E.L. (1986).Hyperflexion sprain of cervical spine. Journal of manipulative physiology, 9, 143-145.
Leach, R.A. (1986). The chiropractic theories: A synopsis of scientific research (2nd ed.). Wilkins and Wilkins.
The research by Henneman (2017) aims to explore the nurses role in patient safety, including recovery of medical efforts and extraordinary actions for improvement of patient safety. The study found that the nurses role in the recovery of medical errors follows the near-miss model, thus stressing the importance of both organizational and human factors in preventing adverse patient outcomes.
Henneman (2017) provides a detailed analysis of the role of nurses in the recovery of medical errors. The author argues that the Nursing Near-Miss Model can be used to explain medical errors; it defines technical failure, organizational failure, and human failure as the main sources of error in nursing. In turn, human failure can result from skill-based, rule-based, and knowledge-based behaviors (Henneman, 2017).
Thus, medical errors caused by human failure can result from lack of skills, knowledge, and appropriate procedures. The researcher argues that modeling medical errors aids in discovering reasons for failure and developing defense mechanisms. For example, Henneman (2017) found that strategies used by nurses to address errors included physical presence, review of the care plan, collaboration with another nurse or physician, and referencing practice standards.
Moreover, research suggested that bedside surveillance could help to avoid adverse patient outcomes if implemented during the defense or nursing recovery stages. However, the effectiveness of surveillance also depends on a number of factors, such as system, human, and environmental. The research also suggested that eye-tracking data could be used to unravel the thought processes of nurses during routine yet error-prone processes (Henneman, 2017, p. 276). For instance, eye-tracking data can help to determine sources of information used by nurses during surveillance (Henneman, 2017).
All in all, the study could be used as a guide for the use of surveillance in mediating medical errors, as it outlines the main system factors affecting the effectiveness of surveillance, such as resources, collaboration, patient and family involvement, and the use of existing technology (Henneman, 2017). Moreover, the research suggests new ways of avoiding errors during patient treatment, thus helping to enhance patient safety outcomes.
For example, Henneman (2017) suggests that eye-tracking data could help to prevent and mediate interruptions during error-prone processes, such as blood transfusion, whereas the use of eye-tracking as a debriefing strategy could improve safety practices. Overall, the study provides valuable insight into the factors that contribute to reducing and interrupting medical errors; thus, using the findings in practice allows enhancing patient safety and improving strategies for the recovery of medical errors.
References
Henneman, E. A. (2017). Recognizing the ordinary as extraordinary: Insight into the way we work to improve patient safety outcomes. American Journal of Critical Care, 26(4), 272-277.
Throughout history, physicians have used herbs as medical remedies for the treatment of different illnesses. Today, there are over 12,000 plants implemented for their healing properties in both traditional medicine and ethnoscience (Wachtel-Galor & Benzie, 2011). In many cases, doctors combine herbs with other methods of treatment and disease prevention.
Although natural medicines are not characterized by quick or well-pronounced pharmaceutical activity as they tend to affect the user slowly and gradually, in some cases, they still may be more effective than their synthetic substitutes. Indeed, among the 3,000 synthetic drugs implemented in modern medicine, about 25% are of natural origin (Wachtel-Galor & Benzie, 2011). Moreover, the number of herb-based medicines continues to grow.
Even though herbal remedies serve as an excellent alternative to chemically produced drugs, their overuse or inappropriate intake may lead to a failure to improve health conditions or even to adverse treatment outcomes. Thus, health care practitioners should increase their competence regarding the use of medicinal herbs and educate their patients about the benefits and potential risks associated with the implementation of natural remedies.
Through an investigation of recent research findings, this paper aims to identify the role of herbs in modern medicine. The author argues that an evaluation of the advantages and disadvantages of natural methods of treatment, the characteristics of herbs, and their possible roles in disease prevention and treatment may help medical professionals and patients develop a more comprehensive view of the issue. Moreover, such an in-depth analysis will support the development of strategies for more frequent use of herbs in mainstream medical practices.
Historical Background
The implementation of herbs in medicine has its roots in antiquity. Through many evaluations of historical and anthropologic materials, researchers have revealed that herbalism was popular in many geographical regions and epochs including ancient Egypt and India. Indeed, there is extensive information about the use of medicinal herbs in Egyptian manuscripts. One of the most famous works of that region, the Papyrus Ebers, was written between the 15 and 16th centuries B.C. and describes recipes for the treatment of many diseases through herbalism (OSullivan, 2005). Some plants that were implemented in ancient Egypt a few thousand years ago are still used today, including mint, aloe, plantain, poppy, and castor.
The development of natural medicine was substantially encouraged in ancient India as well. One of the oldest medical Sanskrit manuscripts, the Ayurveda, includes a description of over 700 medical herbs and explains the interactions of herbal compounds with different body processes (OSullivan, 2005). The Ayurvedic texts were translated into many languages, and the knowledge built by Indian physicians served to enrich and improve medical practices in many other states as well including China, Tibet, Persia, and Greece.
Herbalism developed and transformed over time, but its evolution continues even today. As has been observed by many researchers, the combination of two types of medical approachesmodern Western medicine and traditional medicine (e.g., Chinese traditional medicine that dates back to the earliest days of human development)may work better together than either system would independently (Han & Miller, 2008). The growing body of literature devoted to the research of herbs properties and effects demonstrates significant interest in the subject and provides a more comprehensive view of herbs potential in the medical field.
Modern medicine actively uses herbs to complement the primary methods of treatment or to produce the drugs themselves. Indeed, it is clear that herbal medicine has formed the basis for many present-day medical practices. Moreover, as many researchers have observed, the increasing demand for naturalism and a growing awareness of the positive effects associated with herbal medicine will stimulate a wider integration of herbalism into mainstream healthcare systems and pharmaceutics in the future (OSullivan, 2005).
Characteristics
All herbs comprise bioactive elements and secondary elements: metabolites, proteins, essential oils, vitamins, inorganic salt, and more (Singh, Saharan, & Bhandari, 2014). The active substances that define the healing qualities of plants are alkaloids, glycosides, coumarins, resins, tannins, and some others (Singh et al., 2014). In comparison to purely synthetic substances, complex compounds formed biologically have more properties in common with the human body. Therefore, in many cases, herbs can be more easily assimilated into the body and have fewer side effects.
Alkaloids
Alkaloids constitute one of the most diversified groups of herb compounds. The most commonly used elements in this group are strychnine, caffeine, morphine, nicotine, quinine, and atropine (Shahid, Shahzad, Malik, & Sahai, 2013). Pilocarpus, belladonna, ephedra, Camellia sinensis (tea) are just a few examples of plants that naturally contain alkaloids. The medicinal properties of alkaloids are well known in modern medicine. For example, clinical researchers use vincristine derived from periwinkle in the production of drugs for the treatment of cancer, and atropine contained in Belladonna has a strong effect on humans and can be used to reduce spasms and relieve pain (Shahid et al., 2013).
Glycosides
Glycosides represent an essential category of biological compounds that comprise nitrogen and consist of saccharine and non-saccharine parts. The activity of glycosides is primarily determined by their non-sugary compounds (Shahid et al., 2013). Compared to alkaloids, they are quickly disintegrated by their enzymes and some other physical factors while stored, which usually leads to loss of healing properties. This biological disintegration may be slowed or stopped through adequate handling and preparation of the herbs, including quick-drying, short-term storage, and protection from moisture or other environmental impacts.
Anthraglycosides, saponins, cardiac glycosides, and flavonoid glycosides are commonly used to treat various diseases (Shahid et al., 2013). Of these, cardiac glycosides are the most significant, and many drugs implemented for the treatment of cardiovascular pathologies have an herbal basis. The plants included in this group are Convallaria majalis (lily of the valley), different kinds of foxglove, Adonis, and more. Herbs that contain cardiac glycosides are highly toxic and can be ingested only in moderate amounts (Shahid et al., 2013). Phenolic glycosides are also important in modern medicine. As recent research findings have revealed, they have well-pronounced anti-inflammatory and antioxidant effects (Shahid et al., 2013).
Coumarins
Many natural coumarins are biologically active and have a variety of effects on the body. Researchers first became interested in studying them after the discovery of coumarins anticoagulant. In the 1940s, the farmers noted that livestock bled to death after eating bad hay that contained a lot of white sweet clover (Meek, 2013). It turned out that this plant contains dicumarol, which prevents blood from clotting normally. This discovery led to the plants later use as an anticoagulant for the treatment and prevention of thrombosis and thrombophlebitis.
Many furocoumarins are photosensitizers (Dharmananda, 2000). This photosensitizing activity increases the sensitivity of the skin to ultraviolet rays, which causes increasing pigmentation and severe burns. This property of furocoumarins allows the treatment of vitiligo and some types of cancer.
Advantages and Risks
Herbal remedies have a great number of benefits that distinguish them from chemically derived drugs. First of all, herbalism is associated with a reduced risk of the occurrence of side effects because most medicinal plants are well tolerated by humans. As stated by Han and Miller (2008), many naturalist healthcare systems, especially Chinese medicine, pursue treatments without side effects. Since health care practices including herbalism usually emphasize the importance of a holistic and patient-centered approach to treatment, the occurrence of side effects is thus regarded by herbalists as a failure (Han & Miller, 2008).
The increased safety of natural ingredients and a profound understanding of the chemical processes in both the human body and plants, as well as plant-body interactions, allow for positive treatment outcomes and an improvement in the quality of life. Due to the reduced probability of adverse side effects, herbs are efficient in the treatment of chronic illnesses because the soft effects of herbs on the body allow the long-term implementation of natural medicines.
Moreover, they are usually more affordable than mainstream chemical drugs. Researchers also observe that herbalism may more closely correspond to patients beliefs and interests decreasing their concerns about the adverse impacts of synthetic drugs, satisfying their need for a personalized health care approach, and allowing specialists to promote health information and access (Wachtel-Galor & Benzie, 2011).
However, as mentioned by Dharmananda (2000), although people tend to link natural herbs with multiple health benefits and a reduced risk of harm, doctors in different lines of traditional herbal medicine have sometimes implemented toxic varieties such as foxglove or deadly nightshade. Therefore, to use herbs safely and efficiently, a patient or medical practitioner must attain a high level of competence. In potentially life-threatening situations, patients should always address well-trained herbalists to get the correct and most efficient herbal formulas. Additionally, in the case of serious illness, herbal remedies alone may not be sufficient, and both mainstream and natural methods of treatment should be carried out during treatment (Han & Miller, 2008).
Another potential risk is in the interactions between herbs and synthetic drugs. To avoid undesired outcomes, physicians need to pay greater attention to those patients who must undergo many medical therapies at a time. Researchers suggest that individuals whose health is fragile should not use most herbs (Dharmananda, 2000).
At the same time, a doctor should always stay up to date by researching recent study findings of the pharmacological actions of drugs and herbs, as well as the mechanisms of their interactions. It is of particular importance to consider the similar pharmaceutical activities of herbs and other medicines because the combined intake of different drugs may lead to the intensification of their therapeutic effects and, in this way, lead to adverse health outcomes (Dharmananda, 2000).
Implementation of Herbalism
Today, practitioners of the diverse medical traditions implement herbs in the treatment of multiple diseases including cancers, degenerative and progressive diseases, phycological conditions, immune system failures, and others. As researchers have observed, natural remedies can be effective even when a person has a genetic predisposition to an illness, and they can significantly improve his or her quality and length of life (Han & Miller, 2008).
One good example is Catharanthus roseus, also known as periwinkle, which is known for its numerous biological activities and is commonly used to treat various diseases. The diversified benefits of the plant are a result of its more than 130 alkaloids: catharanthine, vindoline, vincristine, and many others. All of these alkaloids are associated with different influences on body processes including the arrest of bleeding, cessation of tumor development, and reduction of inflammation (Shahid et al., 2013). Today, the anticancerous properties of vincristine and vinblastine contained in periwinkle are well known.
Clinicians usually use different extracts of leaves in modern medicine to treat neoplasms, but the alkaloid portion of dried leaves used externally has proved to be effective as well; in a clinical study, this method allowed for the healing of different types of warts (Shahid et al., 2013). The chloroform extract of periwinkle leaves is useful for the treatment of leukemia P388 cells. Moreover, along with its demonstrated antitumor activity, different combinations including the plant produce a great variety of effects: antimutagenic, antihypertensive, cardiotonic, cytotoxic, CNS depressive, and more.
Summary
As a review of the literature makes clear, herbal medicine has a long history of development. It prevailed in the past, but with technological and scientific advancements, synthetic drugs became more widespread in mainstream medicine. Nevertheless, the evolution of herbal remedies continues, and the number of research findings in the field of herbalism, as well as discoveries of new favorable properties of plants, is steadily growing. Even though herbs are usually not regarded as the principal method of treatment in the Western tradition today, drug producers use the extracts from many plants in the development of medicines for different serious illnesses.
Researchers also suggest that the combination of modern methods with centuries-old natural health care practices allows the achievement of better treatment outcomes. Herbal medicine is also deeply embedded in the concept of holistic medical practice, which pays attention to all aspects of individual life and aims to maximize patients health potential. Through learning and implementing the principles of herbalism, mainstream health practitioners may diversify their methodology, expand their knowledge base, and significantly improve the health of their patients, even in the toughest situations.
Han, H., & Miller, G. (2008). Ancient herbs, modern medicine: Improving your health by combining Chinese herbal medicine and Western medicine. New York: Bantam Books.
OSullivan, C. (2005). Reshaping herbal medicine: Knowledge, education and professional culture. Edinburgh, Scotland: Elsevier/Churchill Livingstone.
Shahid, M., Shahzad, A., Malik, A., & Sahai, A. (2013). Recent trends in biotechnology and therapeutic applications of medicinal plants. London, UK: Springer.
Singh, A., Saharan, V. A., & Bhandari, A. (2014). Pharmacognostic standardization with various plant parts of Desmostachya bipinnata. Pharmaceutical Biology, 52(3), 298-307. Web.
The movie Fire in the Blood depicts a sad tale of how multinational pharmaceutical companies and Western governments collaborated in blocking poor countries in Sub-Saharan Africa and Asia from gaining access to life-saving AIDS drugs due to the employment of a greatly monopolized profits-first approach in the sale of the drugs. Although the justification for this approach was nested on the patent system or intellectual property (IP) protections, it caused a lot of suffering and unnecessary deaths of millions of people who could not access the life-saving drugs.
Main body
Such a situation, in my view, could have been avoided by ensuring that governments contribute to a global health fund that could be used to pay or reward drug companies for their innovation instead of allowing them to recoup their investments through the use of the patenting system. From the movie, it is clear that patents and IP protections provided an enabling environment for monopolies to exist in the drug market, which in turn allowed drug companies to set very high prices in line with the principles of a market failure. A global health fund will ensure that the pharmaceutical companies are effectively compensated for their time and effort in producing the drugs before patents can be shared with generic drug manufacturers to enhance cost efficiencies. This way, the IP system will be safeguarded and pharmaceutical companies will be motivated to innovate more to benefit from the reward pool. On the other hand, generic drug manufacturing companies will be able to use the knowledge and expertise of the patent holders to manufacture cheap life-saving drugs, hence ensuring that drugs are easily accessible to millions of people who need them. This approach is ethical in nature as it provides access to life-saving drugs while ensuring that pharmaceutical companies are able to achieve their profit objectives.
Colleagues Postings
The students posting raises pertinent questions on ethics and law by arguing that pharmaceutical companies should neither be allowed to benefit unethically due to patent laws nor continue to put millions of lives at risk due to their profit-oriented objectives. Although the students concerns are valid, it may be difficult to implement laws and regulations that oblige pharmaceutical companies to make the life-saving drugs affordable to millions of people who require them as such a move is bound to compromise the free market dynamics. According to Universities Allied for Essential Medicines (UAEM), it is possible to increase access to life-saving drugs by supporting revolutionary research and development (R&D) practices. It is evident that multinational pharmaceutical companies charge exorbitant prices to recoup the high costs associated with research and development from the end consumers. As such, it would be plausible for governments and other stakeholders to come up with strategies that could be used to enable drug companies to cover their research and production costs so that the benefits are passed down to consumers in terms of sustainable drug prices. While activism and laws can be used to push pharmaceutical companies to lower their prices as suggested by the student, it is necessary to employ alternatives that will lead to competition in the marketplace.
Conclusion
The UAEMs alternative of supporting revolutionary R&D practices will definitely lead to competition as it empowers individuals and green companies to develop effective medicines at greatly discounted costs. Multinational pharmaceutical companies will be forced to lower their prices of life-saving drugs when it becomes clear to them that they no longer have the capacity to monopolize the market.
Day surgery health officers encounter a substantial challenge when it comes to balancing between attending all patients within the limited timeframe and the need to offer sufficient verbal information about the health of the same patients and their families. Mark Mitchells article, which forms the basis of this paper, examines this challenge in detail. This paper presents a critique of Mitchells article to gauge the authors expertise in assembling the content from the introduction to the studys conclusive remarks. Specifically, it will evaluate the authors style of introducing the article to assess the clarity and relevance of the underlying research problem. It will also comment on the methods applied in the study, including an assessment of the results, before appraising its implications for practice and the overall presentation.
Introduction
The article Day Surgery Nurses Selection of Patient Preoperative Information forms part of Mark Mitchells work. The research examines the pressure witnessed by elective day surgery medical doctors, especially when it comes to interacting or verbally communicating with the highly increasing number of patients in need of health professionals timely services. However, this research problem is not clearly stated since the author never specifies the extent of this problem, for instance, whether it is only prevalent in some countries, or it is a global phenomenon.
This problem is important to nursing because providing accurate verbal information in preoperative nursing immediately before and after surgery is significant. It helps to enhance professionalism in terms of improved nurse-patient contact. The justification for the study is that day-case surgery is on the increase. According to Mitchell (2016), despite the rising numbers of patients who need to be attended to by day surgery nurses, it is worrying that the level of nurse-patient interaction is getting inadequate, hence implying that such medical officers do not get ample time to disseminate sufficient information as expected to the patients and their families concerning their health status.
The author does not state the corresponding hypotheses or questions that this research seeks to address. However, the reader assumes that Mitchell wanted to respond to the question of whether increased verbal information between patients and day surgery nurses could enhance the speed of their (patients) recovery. However, the studys aims and objectives are well stated in the article. The research seeks to investigate the assortment and release of the appropriate preoperative oral information to patients immediately before and after they undergo a surgical procedure (Mitchell, 2016).
The conceptual framework used in the paper is founded on verbal message delivery mechanisms, information conveyance, and preoperative information. The framework is clearly identified in the entire article. The author links it to the research purpose of gauging the best and the most effective information that day surgery nurses can assemble for dissemination to their patients and their relatives, despite the limited time available for such a practice.
The research literature is current since the date of publication of most of the materials used ranges from 2009 to 2015. The other few older materials have been used intentionally as a way of comparing the situation then and now, a strategy that helps the author to confirm that indeed the rising patient turnover is negatively influencing the level of nurse-patient interaction in the course of service delivery (Mitchell, 2016). The literature review is organized logically. However, instead of having a distinct heading for the literature review, it is incorporated into virtually all sections of the article. The literature review adequately supports the need for the study. For instance, the materials selected are linked to the research problem that has been stated above.
Methods
The research adopts a mixed-methods study design where both qualitative and quantitative elements are gathered using an electronic questionnaire. The design fits the purpose of the study, given that the information to be sought is partly found in the existing literature (qualitative) and partly in the questionnaire (qualitative and quantitative). The design is linked to the sampling method, which entails a semi-structured questionnaire. A survey to investigate the patients choice of information is posted on a website that targets day surgery health officers in the UK (Mitchell, 2016). On the other hand, it is linked to the statistical analysis since it avails questions whose responses inform the selected data analysis tool (SPSS).
The sample in the article includes 137 participants who were required to undertake the survey within 2-3 weeks. The response level was 44%. The sample is adequately described in the article. The sampling procedure is described in detail. For instance, the article explains the sampling process, preparations, and logical data collection. The sampling procedure identifies a sample that is representative of the population. The authors do not justify the sample size of 137 participants and a 44% response capacity. However, the size is adequate based on the population capacity. The study follows a standard research procedure that is acceptable in the academic realm. For instance, the email sent acknowledges the need to clarify the logic behind the research, including inviting all willing day surgery nurses to engage in the study. Hence, the study protocol is clear and concise.
One of the instruments described in the article is the electronic questionnaire. The Bristol Online tool is used for collecting data via a unique URL. The third instrument is the Preoperative Teaching Questionnaire (PTQ). The fourth instrument is the SPSS, which was used for statistical analysis. Each instrument, as illustrated above, measures the intended concept. For instance, the PTQ tool analyzes the collected data while the Bristol Online tool helps in collecting data using URL. Besides, SPSS is used for statistical analysis. The author does not present information on the validity and reliability of all instruments apart from the Bristol Online tool. This issue raises questions concerning the soundness of the other tools deployed in this study.
The author addresses the threats to internal and external validity by providing some assumptions, which are geared towards eliminating some validity issues. Secondly, the author highlights the limitations of the study. The evidence the author provides for human subjects reviews includes his consideration of ethical issues in the survey. For instance, the author focuses on the consent and anonymity of informants. The author also considers identifiable private information.
Indications of ethical concerns are apparent. For instance, consent from the respondents to fill the questionnaire without revealing their identity is considered in the email. This study is described inadequate details for replication. For instance, the author begins with an introduction followed by the background of the study among other sections to help in providing conclusions and recommendations for the study.
Results
The characteristics of the sample are described succinctly. The study clearly indicates that 137 respondents were used, including their respective gender and career experience. The research questions are not indicated as stated earlier. However, based on the studys aims and objectives, such questions are described separately in the articles data analysis and discussion sections. The type of data collected in this study is both qualitative and quantitative. Qualitative data gathers the respondents opinions and observations. Besides, quantitative data is obtained in terms of the numerical details concerning operation, preoperative preparation, and anesthesia features among others.
The procedures deployed for data analysis include coding via the SPSS instrument to transform raw data into symbols for tabulating, counting, and analysis. The second procedure entails data tabulation, for instance, via the counting of preoperative expectations and information delivery levels. Tables and graphs are used to present data. Four tables and five bar graphs are evident. The text in the paper supplements and repeats the data in the tables. For instance, the data in Table 4 is supplemented by supporting information. The same content is also repeated in details in the text. In summary, the findings indicate that verbal information is important for preoperative nurses before and following a surgical procedure. However, nurses contact during this time is limited due to the increased number of patients in the facilities.
Discussion/Implications for Practice
The author relates the study findings to the purpose and objectives. For instance, the objective is to determine the importance of preoperative nurse-patient interaction. The author relates this objective to the findings that nurses need to relay verbal information to patients. The findings of the study are at par with previous observations. However, due to increasing number of patients, new findings indicate the need for an efficient verbal information conveyance framework (Mitchell, 2016). Besides, the author does not discuss results that reflect conflicting observations with reference to past studies. The study has several limitations. For instance, based on the 44% response level, the survey of the UK day surgery health officers implies that a good number did not respond to the questions.
New research that emerged from the study is that nurses who work with competing demands and numerous interruptions compromise patient safety. The potential for applying the findings in nursing practice is founded on the awareness that the conveyance of information is limited in nursing environments such as theatre settings. Therefore, providing personalized information by nurses as suggested in this study has the potential of solving the problem.
Overall Presentation and Final Summary
The title does not describe the type of study. However, it shallowly expresses major variables based on the implied relationship between day surgery nurses and the information to be relayed to patients in such complicated settings. The abstract accurately represents the study. It provides a general overview of the problem of day surgery nurses choice of information, including how to relay it to patients before and after an operation. The report is logically consistent. The author has arranged the paper in a coherent manner that captures the professional and academic requirements of such research work. The writing style is clear and consistent. The reader can follow the paper smoothly while comprehending what the author intends to present.
Reference
Mitchell, M. (2016). Day surgery nurses selection of patient preoperative information. Journal of Clinical Nursing, 26, 225-237.
Discuss agenda-setting as the confluence of three streams of activities. Include the concept of a window of opportunity for legislation development in your answer.
When the problems possible solutions and political circumstances flow together in a favorable alignment a window of opportunity opens. When all three of these things present themselves the window of opportunity opens for a new bill to be passed.
The three streams of activities included in the definition of agenda-setting are problems, a possible solution to these problems, and political circumstances that accompany these problems (McCombs, Shaw, and Weaver 2014). In other words, all these factors are interdependent. In the majority of cases, the appearance of a particular problem preconditions alterations in policies or even the creation of new legislation needed to solve this very problem or mitigate its negative impact on the environment. Therefore, when problems, possible solutions to them, and particular political circumstances come together, they create an ideal situation which is also called a window of opportunity (McCombs, Shaw, and Weaver 2014).
The appearance of these windows contributes to the creation of a new policy or approach to eliminate the causes which triggered the emergence of a problematic situation. The confluence of these streams of activity becomes fundamental in modern attempts to improve the efficiency of different processes and align the functioning of various organizations. For instance, the majority of laws and regulations peculiar to the healthcare sector exist because of critical issues which emerged from agenda-setting. However, alteration of the existing legislation becomes possible only if there is a potential solution to the problem. For this reason, the combination of the three streams of activities becomes crucial for agenda-setting theory.
Contrast decisions making in the public and private sectors as it relates to selecting from among alternative solutions to problems.
The most pervasive difference between the criteria sets used in the two sectors is in the roles of political concerns and considerations play. Public sector policymaker decisions must reflect greater political sensitivity to the public at large and to the performance of relevant individuals, organizations, and interest groups.
Problem solution could be considered an essential activity regarding the functioning of the majority of modern organizations. There are several basic patterns that are used both in private and public sectors to choose the most efficient solution to the problem and ensure that a final result remains appropriate for further evolution (McCombs, Shaw, and Weaver 2014). Usually, considerations related to the choice of a solution include the efficiency of the selected approach, its cost, available sources, technologies, and benefits that could be acquired from one or another method. However, these are mainly similar both in public and private domains.
Therefore, the most significant difference is in the role political concerns might play in decision-making and final results. In other words, public organizations are not able to disregard existing legislation and policies which determine the functioning of the given sphere. It is also crucial for them to preserve the image (McCombs, Shaw, and Weaver 2014). At the same time, organizations belonging to the private sector are free to choose from a wide variety of methods that are inadmissible for the public domain. In this regard, the greater political sensitivity becomes the main difference between public and private organizations because of the peculiarities of their functioning and setting.
Discuss the involvement of interest groups in the political circumstances that affect agenda setting. Incorporate the specific ways they influence agenda setting in your response.
Interest groups use lobbying, electioneering, litigations, and efforts to shape public opinion as tactics to seek to influence the policy agenda and the larger public policymaking process to the advantage of their members.
First, it should be said that the influence of interest groups is extremely powerful regarding agenda-setting. The fact is that in the majority of cases agents who can impact particular processes or final results preserve their own interests when making a particular decision. In such a way, they are also able to introduce alterations to different policies and regulations which exist at the moment (McCombs, Shaw, and Weaver 2014).
At the same time, various interest groups might use numerous tools to shape public opinion in a way that provides numerous benefits to them and guarantee the needed result. Under these conditions, interest groups create specific circumstances that affect agenda setting and result in the appearance of different problems and solutions to them. These groups also become powerful agents that impact policymaking and stipulate the appearance of diverse tendencies in different sectors (McCombs, Shaw, and Weaver 2014). In such a way, we could observe the interaction between all three essential aspects of the agenda and their impact on the environment.
Bibliography
McCombs, M., Shaw, D., and Weaver, D. 2014. New Directions in Agenda-Setting Theory and Research. Mass Communication and Society 17(6): 781-802. Web.
Considering the great impact of Botox as a cosmetic procedure, this practice becomes popular in the dental field as well. This paper aims at proposing the study regarding the use of Botox in dental practice to relieve pain. The current scope of literature presents controversial information regarding the healing effect of Botox. Some studies report about the mentioned treatment option and its capacity for reliving pain occurring during such diseases as bruxism, lockjaw, etc., while others show potential disadvantages of Botox in dentistry. The proposed study will be conducted based on the quantitative method, namely, a Likert scale will be used to collect data from respondents concerning their experience and perception of the mentioned topic. Data analysis will be provided using SPSS software to present the most credible results. The analyzed data will be properly interpreted and integrated with the existing literature to provide relevant conclusions and either reject or verify the hypothesis. The proposed study is expected to contribute to dentistry by clarifying the role and potential of Botox as a pain-relieving technique.
Introduction
Nowadays, Botulinum toxin A (Botox) is used in cosmetic therapy to treat wrinkles and other facial changes. The therapeutic use of Botox can be observed in the dental field, as well. As a substance preventing the formation of nerve signals, which lead to involuntary contraction of muscles, Botox promotes muscular relaxation. It is used in the treatment of dysfunction and disorders, including such dental issues as bruxism, lockjaw, and so on (Srivastava, Kharbanda, Pal, & Shah, 2015). The importance of the identified topic lies in its potentially beneficial role in pain treatment, thus leading to improved patient outcomes. The thesis for the proposed research may be formulated as follows: while some scholars consider Botox a rather safe and minimally invasive option for pain relief in dentistry, others believe the healing power of the mentioned treatment has been studied insufficiently.
The purpose of the proposed study is to identify the healing power of Botox in dentistry to relive pain, focusing on the thorough literature review and a Likert Scale. The research is expected to clarify the role of Botox and identify any biases and inconsistencies in the existing data regarding the mentioned topic. The terms to be used in the study include such concepts as Botulinum toxin A, bruxism, Temporomandibular joint (TMJ), lockjaw, and a Likert Scale. While the latter refers to the research method, others will be used to denote pain-related dental disorders. As for limitations, one of them is a small sample size.
It makes any generalizations on a global scale hardly possible. However, it is still important to explore the impact of Botox within the given conditions to understand its potential as a pain-relieving technique. The scope of the reviewed literature is another limitation worth paying ones attention to as only a limited number of scholarly articles will be included in the research. Even though credible sources will be used in the literature review section, it is still possible to make relevant assumptions yet necessary to avoid generalization. In this regard, the hypothesis may be identified in the following manner: Botox use in the dental field as a pain reliever can significantly enhance patient outcomes by reducing their painful sensations.
Literature Review
To explore the role of Botox in the treatment of pain in dentistry, it seems essential to identify its mechanism of work. Botulinum toxin is a protein compound, which is a potential neurotoxin derived from Clostridium botulinum bacteria. Botulinum toxin inhibits the release of not only acetylcholine, but also other mediators such as norepinephrine, dopamine, glycine, and methionine enkephaline in peripheral tissues and substances involved in the perception of pain. Botox therapy is primarily aimed at relaxing the muscles by injecting microscopic doses of this drug into them (Nayyar, Kumar, Nayyar, & Singh, 2014). In therapeutic doses, Botox is quite safe and has no side effects
Botox does not directly resolve the problems with dental pathology, but it significantly alleviates the severe pains experienced by patients. At the same time, there is no numbness or muscle weakness. As noted by Long, Liao, Wang, Liao, and Lai (2012), Botox injections are also introduced in bruxism when a person clamps teeth during sleep, causing their surfaces to rub against each other and leading to abrasion of the enamel, malocclusion, and the onset of headache and dental spasms. Botox injections can reduce the manifestation of the disease without affecting sleep. The study by Long et al. (2012) shows: in patients suffering from psychological and neurological bruxism, after application of botulinum toxin, patients note weakened muscle aches and decreased gnashing of teeth.
By applying Botox in lockjaw treatment, which is a type of the protective reaction of the muscles to pain manifesting itself in spasms, the injection relieves pain, and a patient can normally open his or her mouth. Botox has established itself as an effective treatment for pain caused by trigeminal neuralgia, which is accompanied by involuntary contractions of the muscles. Temporomandibular joint (TMJ) disorder is another problem associated with dental pain. Denglehem, Maes, Raoul, and Ferri (2012) focused on Botox as an analgesic treatment for TMJ and revealed its significant positive impact on patients pain decrease and improvement of their psychological states. During a day, people actively use these joints during eating, swallowing, and talking. When there is an overvoltage of the joints, a person may suffer from headache and maxillary pain. Botox injections can alleviate tension in the jaw, freezing the muscles, which cause pain. Nevertheless, it would not lead to such situations as follows: one would not be able to close his or her mouth as a dentist knows exactly where to inject.
Importantly, the use of Botox in dentistry to combat dental problems has not only a therapeutic but also an aesthetic effect, since the muscle tension in the mouth reflects on the contours of the face. Injections of botulinum toxin benefit the reduction of the masticatory muscles and make the jaws thinner, as suggested by Azam, Manchanda, Thotapalli, and Kotha (2015). The review of the recent studies by Azam et al. (2015) indicated the following results: patients receiving injections mention a significant reduction in pain, improvement in functioning, the ability to open their mouth easily, and the absence of pain during palpation. At this point, the authors emphasized the importance of using the correct injection technique and following the dosing regimen. The results achieved are another confirmation of the effectiveness of Botox for eliminating dental problems associated with overstrains in the jaw muscles. The mentioned injections are approved by the US Food and Drug Administration (FDA), thus illustrating their effectiveness. To date, a new method of treatment is becoming increasingly popular in dental centers.
At the same time, Botox has a number of side effects as a neurotoxin, and it can cause botulism when the dose is exceeded. Botulinum toxin is an immunogenic protein capable of inducing the synthesis of powerful neutralizing antibodies, which negatively affect the results of treatment of patients in some cases, especially on the neurological profile (Long et al., 2012). The factors increasing the risk of antibody formation are high doses of the drug (more than 100ED per procedure). It is not recommended to make injections of Botox after strokes and in cases of cerebral circulation disorders as well as in the presence of alcohol dependence. The persons under 18 years of age and those with parallel administration of antibiotics or drugs depressing the nervous system should also avoid Botox.
In general, since it is gradually eliminated from the body, Botox may be regarded as relatively safe treatment while used appropriately. Jain, Bansal, Agarwal, and Joshi (2014) emphasized such disadvantage of Botox as an inconstant manner compared to surgical options. According to the authors, as a rule, patients have to repeat the procedure after six months, yet it should not be provided earlier to prevent delusion of the previous injection. More to the point, both initial and repeated injections may cause asymmetry of the face. Consequently, there is a need to explore Botox in dentistry in an in-depth manner to understand its impact, side effects, and consequences to prevent any adverse events and provide patients with the best care possible.
Data Analysis
Quantitative method of data analysis will be used to scrutinize the collected information and present credible results. The survey answers provided by the respondents are to be properly systematized and interpreted. While processing the results, the arithmetic mean will be calculated for every pair of opposite points or any another indicator proposed in the scale (Sullivan & Artino, 2013). Let us consider how this test will be performed technically using Statistical Package for the Social Science (SPSS) package. In particular, for every proposition, a variable will be created based on information received from the respondents and entered into the table.
After this, a new variable will be constructed, the values of which are to be obtained by adding the values of all the variables corresponding to the presented statements. The final score is to be calculated for each of the respondents by summing up the values for individual items. The statements hitting biased answers will be deleted, since they can lead to ambiguous results or not to differ from the point of view of the correlation (Sullivan & Artino, 2013). As the values obtained during the analysis may be difficult to interpret, comparisons with some standard are needed to draw conclusions based on the values of this scale. Therefore, the average number of points will be determined for the sample of the participants.
Conclusion
In conclusion, the proposed study aims at the investigation of the healing power of Botox in dentistry to relive pain based on survey questionnaire and quantitative data analysis. As the literature review shows, several studies emphasize a significant potential of Botox in dental pain treatment, while others are concerned about side effects, safety, and length of its impact. Therefore, it is of great importance to study the given topic, thus contributing to both theory and practice of using Botox in the dental field.
References
Azam, A., Manchanda, S., Thotapalli, S., &Kotha, S. B. (2015). Botox therapy in dentistry: A Review. Journal of International Oral Health, 7(2), 103-105.
Denglehem, C., Maes, J. M., Raoul, G., & Ferri, J. (2012). Botulinum toxin A: Analgesic treatment for temporomandibular joint disorders. Revue de Stomatologie et de Chirurgie Maxillo-Faciale, 113(1), 27-31.
Jain, M., Bansal, A., Agarwal, D., & Joshi, M. (2014). Botox in dentistry: The healing side of A poison. Journal of Advanced Medical and Dental Sciences Research, 2(1), 95-99.
Long, H., Liao, Z., Wang, Y., Liao, L., & Lai, W. (2012). Efficacy of botulinum toxins on bruxism: An evidencebased review. International Dental Journal, 62(1), 1-5.
Nayyar, P., Kumar, P., Nayyar, P. V., & Singh, A. (2014). Botox: Broadening the horizon of dentistry. Journal of Clinical and Diagnostic Research, 8(12), 25-29.
Srivastava, S., Kharbanda, S., Pal, U. S., & Shah, V. (2015). Applications of botulinum toxin in dentistry: A comprehensive review. National Journal of Maxillofacial Surgery, 6(2), 152-159.
Sullivan, G. M., & Artino Jr, A. R. (2013). Analyzing and interpreting data from Likert-type scales. Journal of Graduate Medical Education, 5(4), 541-542.