Digital Commons Network^™

The Effect Of Marriage On Stage At Diagnosis And Survival In Women With Cervical Cancer, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Marriage is associated with improved health outcomes for many conditions. Married persons enjoy financial stability, social and emotional support, and tend to have better control of health risk behaviors compared to the unmarried. The marriage scene is changing continuously. Americans are marrying less or delaying the engagement to an older age. They are divorcing more, they choose cohabitation as an alternative to marriage, or engage in premarital relationships. As a consequence, barely half of Americans were married in 2011 compared to close to three quarters of Americans were married in the sixties. With the increase of the unmarried population - …

What Works In Suicide Bereavement: What Helps And What Hurts?, Quintin Hunt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Suicide is one of the most painful grief experiences that any family may experience. The suicide bereavement literature, though small, is replete with research that shows family and systemic impacts of suicide. The literature also includes constant calls for family- and systemic-based intervention as every part of society is impacted. Research in the field of marriage and family therapy, however, has ignored suicide and suicide bereavement almost entirely. The purpose of this qualitative study is to develop a more thorough understand of the grief that survivors of suicide experience and to systemically understand what helps and hurts the grieving process. …

Factors Associated With Parental Decision Making And Childhood Vaccination, Zuwen Qiu-Shultz

UNLV Theses, Dissertations, Professional Papers, and Capstones

In order to better understand factors affecting immunization status, logistic regression was used to assess the association of various socio-demographic factors and whether parents would have their child immunized if not a state mandate. Factors included in the study were race, household income, number of children in the household, number of adults in the household, if the child had a primary provider, if the child had a health check-up in the last twelve months, and medical insurance status of the child. The combined Nevada Kindergarten Health Survey Result of 2009-2010 (Year Two) and 2010-2011 (Year Three) conducted by the Nevada …

Examining The Inner Experience Of Four Individuals With Bipolar Disorder Using Descriptive Experience Sampling, Johanah Kang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Bipolar disorder is a lifelong mood disorder with diagnostic criteria that provide a description of expected experiences of individuals diagnosed with BD (e.g., elevated mood, sadness, difficulty concentrating). Despite these criteria, the inner experience of these individuals is largely unknown. Understanding the inner experience of individuals diagnosed with BD may prove essential in understanding and treating BD. The present study examined the inner experience of four individuals diagnosed with BD using the Descriptive Experience Sampling (DES) method (Hurlburt 1990, 1993, 2011). Results revealed all our participants had clear and prevalent experiences of sensory awareness. They also had difficulties apprehending and …

Developing Ethical Competence: The Perspective Of Nurse Educators From Pre-Licensure Baccalaureate Nursing Programs Accredited By The Commission On Collegiate Nursing Education, Jennifer Lee Bartlett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurses face ethically-charged situations every day, yet ethics education is not universally integrated into pre-licensure baccalaureate nursing programs. Like other forms of competence, ethical competence requires development. Nurse educators are poised to impact on the competence of their students, both defining the ethics content and designing students' exposure. The purpose of this study is to describe the concept of ethical competence from the perspective of baccalaureate nursing faculty and describe current methods of integration and evaluation of ethics education in pre-licensure baccalaureate nursing programs. This research will be conducted using a sequential (quantitative-qualitative) mixed method approach. The first phase of …

3-D Oropharyngeal Airway Analysis Of Different Antero-Posterior And Vertical Craniofacial Skeletal Patterns In Children And Adolescents, Chi Kim Huynh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sleep apnea disorder has recently emerged as a significant public health issue. While the prevalence of obesity is on the rise among children, it is one of the main risk factors associated with apnea. Upper airway dimensions and morphology seem to be major components of obstructive sleep apnea (OSA) and can be affected by different craniofacial patterns. The purpose of this retrospective, cross-sectional pilot study is to correlate gender, Body Mass Index, risk for OSA, neck circumference, and 3-D oropharyngeal airway dimensions in children and adolescents with different antero-posterior (AP) and vertical craniofacial skeletal patterns. A total of 86 pre-orthodontic …

The Lived Experiences Of Acute-Care Bedside Registered Nurses Caring For Patients And Their Families With Limited English Proficiency, Jami-Sue Coleman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Approximately 8.6% of the total U.S. population is considered limited English proficient (LEP), a term that has been used by official US federal policy and will be used throughout this study. In a landmark report, the Institute of Medicine found that minorities received lower-quality health care than Caucasians even when insurance status, income, and other factors were equivalent. These differences were tied to issues such as bias, stereotypes and communication barriers between patients and their caregivers. In the hospital setting, registered nurses provide the most direct contact with patients and their families. Effective communication between patients and health care professionals …

Sex Determination Using Discriminant Function Analysis In Hispanic Children And Adolescents: A Lateral Cephalometric Study, Alyssa E. Sprowl

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lateral cephalometric radiographs have been used for years to help diagnose skeletal and dental patterns in Orthodontics. Within the last decade, these radiographs have caught the interest of the department of Anthropology for the identification of gender within the adult and adolescent population. Numerous publications have been made but failed to identify sexual dimorphism in the pre-adolescent population. 303 lateral cephalograms of pre and post Latino adolescence age ranging from 6.5 to 17.9 years old were obtained from University of Nevada, Las Vegas (UNLV) digital database. 25 variables were identified and plotted with all linear and angular measurements transferred into …

The Lived Experience Of The Novice Nursing Dean: Exploring The Meaning And Significance, Melissa Rae Bouws

UNLV Theses, Dissertations, Professional Papers, and Capstones

Deans of nursing hold a unique position for the future of the profession. Few others have the potential to bring about change within the academic setting, or hold such a strong influence on the future of nursing and on our students. Current statistics reveal multiple vacancies in nursing dean positions. Further understanding of how nursing deans begin their role, attain their identity as dean, and successfully execute this important position is needed to recruit and retain strong leaders who have the methods and skills to develop and support the advancement of the nursing profession. Understanding the process of becoming nursing …

The Meaning Of Visual Thinking Strategies For Nursing Students, Margaret M. Moorman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurse educators are called upon to provide creative, innovative experiences for students in order to prepare nurses to work in complex healthcare settings. As part of this preparation, teaching observational and communication skills is critical for nurses and can directly affect patient outcomes. Visual thinking strategies (VTS) are a teaching method that has been studied in primary education to develop communication and observational skills. VTS holds the possibility to improve these same skills in nursing students, but it has only been studied once with nursing students in a quantitative study. Therefore, this qualitative research study sought to explore how nursing …

Relationship Of Global Dna Methylation With Cardiovascular Fitness And Body Composition, Michael Steele Jarrett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Global DNA Methylation (GDM), an epigenomic modification has been linked to the development of Cardiovascular Disease and its risk factors. Purpose: The purpose of this study was to determine if there is a significant correlation between GDM and cardiovascular fitness, as well as, measures of body composition. Methodology: 26 apparently healthy, adults (11 males) completed a physical activity and diet questionnaire, as well as, had a small blood sample (600μL) collected via finger prick for the determination of GDM. Body composition was assessed by means of a Dual-Energy X-ray Absorptiometry (DEXA) scan, while cardiovascular fitness was evaluated by the …

Adult Permanent (Extracted) Teeth As A Source Of Dental Pulp-Derived Mesenchymal Stem Cells (Dpsc): A Pilot Study, Charles Hill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Mesenchymal stem cells (MSC) may be derived from a variety of adult human tissues, including dental pulp from extracted or exfoliated teeth. Evidence suggests differences in both the quality and quantity of the dental pulp-derived mesenchymal stem cells (DPSC) obtained from different sources, such as primary or "baby teeth" and adult, permanent teeth. This study aimed to evaluate the potential to obtain DPSC from intact, vital permanent teeth, and characterize the potential isolates using a randomized selection of active dental patients from the University of Nevada, Las Vegas School of Dental Medicine (UNLVSODM). DPSC were extracted, isolated, cultured and characterized …

Examining The Inner Experience Of Three Individuals With Major Depressive Disorder And Three Individuals With Bipolar Disorder, Janell Marie Mihelic

UNLV Theses, Dissertations, Professional Papers, and Capstones

The diagnostic criteria for major depressive disorder (MDD) and bipolar disorder (BD) provide a description of expected experiences of individuals diagnosed with those disorders (e.g., sadness, expansive mood, difficulty concentrating). However, much remains unknown about the inner experience of individuals with these disorders which may prove crucial in understanding and treating these disorders. The present study examined the inner experience of three individuals with MDD and three individuals with BD using the Descriptive Experience Sampling (DES) method (Hurlburt 1990, 1993, 2011). Results were not suggestive of any clear, consistent patterns of inner experience either within the MDD or BD groups …

Testing A Reflection Education Intervention On Baccalaureate Nursing Students' Level Of Reflection During Online Clinical Post Conference, Jaime Alicia Hannans

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background

The majority of faculty-student interactions are at low cognitive levels during nursing clinical post conference (CPC), a time often utilized for reflective thinking. Strategies have been implemented to promote or even teach reflection, but the level of reflection or impact of the intervention in nursing, such as the relationship to student attributes or clinical reasoning, is often not evaluated.

Specific Aims

The specific aims of this study are to (a) test the effect of a reflection education intervention on the baccalaureate students' level of reflection during online CPC, (b) examine the relationship between student attributes and level of reflection, …

Implementing A Bystander Awareness Program On A University Campus, Robert Joseph Vadovic

UNLV Theses, Dissertations, Professional Papers, and Capstones

Between 17% and 62% of college students experience some form of violence during their time at school. About 25% of female college students experience a sexual assault before graduating. One university had seen an increase in violence, including assaults and bias events. Administrators and nurses implemented a bystander awareness program to help alleviate this growing problem. Members of the college's residence life staff and its Greek organizations (fraternities and sororities) participated in the Step Up program, a prosocial training program to get people to intervene safely when witnessing acts of violence. Participants (N=236) completed surveys prior to the program, immediately …

Effects Of Footstrike Pattern On Low Back Posture, Shock Attenuation, And Comfort During Running, Traci L. Delgado, Emilia Kubera-Shelton, Robert R. Robb

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Barefoot running (BF) is popular in the running community. Biomechanical changes occur with BF, especially when initial contact changes from rearfoot strike (RFS) to forefoot strike (FFS). In addition, changes in lumbar spine range of motion (ROM), particularly involving lumbar lordosis, have been associated with increased low back pain (LBP). However it is not known how changing from RFS to FFS affects lumbar lordosis or LBP. Thus, the purpose of this study was to determine if a change from RFS to FFS would change lumbar lordosis, and/or decrease shock attenuation, and/or change comfort levels in healthy recreational/experienced runners.

Methods: …

Therapeutic Neuroscience Education For Patients With Chronic Low Back Pain And Its Effect On Activity Level, Pain Perception, And Function, Stephen Burton, Amber Domingo, Ryan Spencer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Chronic low back pain (CLBP) is a significant cause of disability and inactivity in the United States. Patients with chronic pain are often symptomatic even in the absence of tissue damage. This is a major reason patients need to be educated about their pain. Cognitions such as fear, anxiety and faulty beliefs may impact the pain experiences and changing cognitions are important in changing pain behavior. If patients understand that the pain they are experiencing may not be a true indication of the health of their tissues, they may experience less fear of their pain, and may be able …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Russell Gourlie, Spencer Sorensen, Rithea Vong

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study is to examine and identify key characteristics of and differences between people with Parkinson’s Disease (PD) who exhibit moderate/high fear of falling avoidance behaviors and those that exhibit low fear of falling avoidance behaviors.

Subjects: A total of 24 subjects (5 females, 19 males; mean age= 72.2, SD=9.1) participated in this study.

Methods: A cross-sectional design was used to identify descriptive characteristics of subjects with PD associated with moderate/high levels of fear avoidance behavior (MHA) or low levels of fear avoidance (LA) as measured by the Fear of Falling Avoidance-Behavior …

Comparison Of The Pervasive Developmental Disorders Screening Test And Modified Checklist For Autism In Toddlers: Which Is The Better Predictor Of Autism In Toddlers?, Vanessa Marie Fessenden

UNLV Theses, Dissertations, Professional Papers, and Capstones

Early intervention for children with autism spectrum disorders (ASD) has significant impact on children and families. Early intervention optimizes long-term diagnosis for children with ASD. Unfortunately, many children with ASD are not diagnosed until after age three and often receive services from a local school district rather than through early intervention services. However, many of the symptoms of ASD can be hard to identify because symptoms during infancy may be more difficult to detect or may present differently than manifestations of the symptoms at older ages. Despite the difficulty in identifying symptoms of ASD in young children, there are certain …

Development And Implementation Of A Quality Improvement Initiative: Systematic Follow-Up Of Patients Who Have Spinal Cord Stimulator Implants, Irina Rajala

UNLV Theses, Dissertations, Professional Papers, and Capstones

Recent medical advances and the rising prevalence of chronic pain in the US population contribute to the use of spinal cord stimulator (SCS) implant as a treatment modality for chronic pain management. As the numbers of patients receiving SCS implants steadily increases, the challenge of managing this device grows and the need for SCS implants follow-up programs rises. Follow-up programs need to focus on implant longevity and efficacy to improve the quality of care outcomes.

This Doctor of Nursing Practice (DNP) quality improvement initiative was developed to provide systematic follow-up for patient with SCS implant. The project includes the creation …

Anterior Cervical Decompression And Fusion On Neck Range Of Motion, Pain And Function: A Prospective Analysis, Kate Addis, Jason Longhurst, Bree-Lyn Vom Steeg

UNLV Theses, Dissertations, Professional Papers, and Capstones

Summary of background data: Intractable cervical radiculopathy secondary to stenosis or herniated nucleus pulposus is commonly treated with an anterior cervical decompression and fusion procedure (ACDF). However, there is little evidence in the literature that demonstrates the impact such surgery has on long term range of motion outcomes

Study Design: Prospective, non--‐experimental.

Objective: The objective of this study was to compare cervical range of motion and patient reported outcomes in patients before and after a 1, 2 or 3 level ACDF.

Patient Sample: 46 patients.

Methods: Patients undergoing an ACDF for cervical radiculopathy had their cervical range …

Perceptions Of Police Responses To Domestic Violence, Kelly Rae Stout

UNLV Theses, Dissertations, Professional Papers, and Capstones

Domestic violence, also known as, intimate partner violence (IPV), has become an epidemic in the United States. According to the Center for Disease Control and prevention (CDC), about 24 women and men are victimized by an intimate partner each minute, equaling about 12 million victims every year (2012b). In recent years, the public has become more aware of IPV situations. An increase in public service announcements has helped to inform the public and has brought these dangerous situations out from behind closed doors. In the age of technology, information is more easily distributed and exchanged which has also increased public …

A Comparison Of Nursing Service Demand In Title 1 Schools And Non-Title 1 Schools, Karen Ray Stratford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Children from low-income families are known to struggle academically, but lack of health services may also impact their education. School nurses must identify and manage health problems in the school-age child to improve academic success. Unfortunately, the school nurse-to-student ratio may limit the amount of time nurses can give to the recognition of health problems and appropriate follow-up. The Elementary and Secondary Education Act of 1965 provides Title 1 funding to schools whose enrollment includes at least 40% of low-income families. These federal funds are intended to be used to bridge the achievement gap between low-income students and other students. …

Sickle Cell Disease: A Quality Improvement Initiative For Emergency Department Providers, Pretrescia Marie Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sickle Cell Disease (SCD) is an incurable, chronic condition that results in a constellation of disorders, frequent emergency department (ED) visits, and repeated hospital admissions. Those affected often suffer from pain crisis, infection, acute chest syndrome, stroke, and multi-organ impairment and frequently do not receive adequate pain management during acute pain episodes because ED providers view them as drug seeking. The majority of patients with SCD are African-American and may be low income, uninsured, or on Medicaid. As a result, these demographics make ED under-treatment of pain in patients with SCD a health equity issue. This was a pre-experimental one …

Evaluating Shared Governance For Nursing Excellence, Evette Michelle Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The national challenges of nursing shortages, decreased staffing levels, and increased patient acuities have contributed to nurse's increased workload and job dissatisfaction. Nurses have become frustrated with the professional practice environment. The inability to make decisions about issues that affect their nursing practice and the care provided to their patients results in nurses leaving the work environment in search of higher job satisfaction. Employers are becoming more creative in their strategies to improve the work environment and retain nurses within their organizations. Healthcare leaders have implemented management strategies such as shared governance models. These models focus on providing a satisfying …