Digital Commons Network^™

Socio-Economic And Cultural Determinants Of Health Care Services Utilization In Ghana, Vickita Akosua Antwiwaa Harvey

UNLV Theses, Dissertations, Professional Papers, and Capstones

The study examines the relationship between socio-economic and cultural determinants of health care service utilization in Ghana using Ghana Demographic and Health Survey (GDHS) 2008 data collected by Ghana Statistical Service (GSS) in which a two-stage sample design was used. The first stage involved a systematic sampling, with probability proportional to size, of 412 clusters using the 2000 Ghana Population and Housing Census as the sampling frame. At the second stage, systematic samples of 30 households from each cluster were selected, making a total of 12,360 sampled households. According to the GSS, data were not collected in some of the …

Lung Cancer Survival Disparities In Nevada, Chima Osuoha

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lung cancer is the leading cause of cancer death in both men and women in the United States. Nevada shows moderate incidence rates of lung cancer for men but high rates for women. Little is known about the lung cancer experience and survival characteristics of the nearly 2000 new cases occurring every year in the State. The purpose of this study was to measure the extent to which geographic area of residency, gender, race, health insurance, social economic status (SES) and stage at diagnosis were associated with survival in patients diagnosed with lung cancer in Nevada. This was a retrospective …

Application Of The Transtheoretical Model: Assessing Exercise Behavior In African Americans In A Church-Based Setting, Robin Marie White

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sedentary behavior rates are higher among African-American men and women than in other American races and ethnicities, placing them at greater risk for chronic illness. Routine physical activity reduces the risk of chronic health problems such as: (a) overweight and obesity, (b) type 2 diabetes, (c) hypertension, (d) coronary artery disease, (e) stroke, (f) congestive heart failure, and (g) cancers. Assessment of African-Americans' exercise attitudes in a church-based setting may provide information with which to develop effective interventions to improve physical activity. This descriptive, cross-sectional study used components of the Transtheoretical Model (TTM) to assess whether any associations exist between …

Factor Structure Of The Cpt-Ii, Mary Vertinski

UNLV Theses, Dissertations, Professional Papers, and Capstones

The current study investigates the factor structure of the Conners' Continuous Performance Test-II (CPT-II) in four pediatric samples of participants: (a) patients with traumatic brain injury, (b) healthy controls, (c) patients with various clinical diagnoses, and (d) all of the previously mentioned subjects combined. Confirmatory factor analyses (CFA) were used to investigate a one-, three- and four-factor model fit of the data. None of the models examined were an adequate fit for the data; however, it appears that the four-factor model seemed to be the best fitting of the models examined. Failure to find reasonably adequate fit precluded further analyses.

Family Nurse Practitioner Mentoring Relationships' Impact On Organizational Commitment, Patricia Bartley-Daniele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Family nurse practitioners (FNPs) are vital primary care providers who are responding to increased primary health care needs in the United States. Organizational commitment is reflective of workplace relationships that foster professional development, innovation, and outcome achievement. An organizationally committed FNP workforce is essential to achieving primary health care goals.

Mentorship has been proposed as a strategy to foster FNP organizational commitment. Mentoring has been characterized as a teaching-learning relationship. The mentor can serve as a guide to foster graduate FNP practitioner transition into primary care practice. Types of mentoring relationships occur in formal workplace settings or develop as informal …

Listening To The Ranks: Perceptions Of The U.S. Air Force Occupational Health And Safety Training, Melissa Jo Breunig

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational health and safety hazards are abundant in military environments. Due to the hazardous occupational settings, injuries remain a public health concern in the United States military. Public health plays a critical role in injury reduction by addressing the need for comprehensive safety education training, and more specifically, exposure related injuries. A secondary data analysis was completed using Communication Theory as the overarching framework to analyze 13 qualitative interviews conducted with Airmen to gain their perceptions of the occupational health and safety training at Nellis and Creech Air Force Base (AFB). Pedagogy and training content were the two main themes …

Characteristics Of Unintentional Prescription Drug Poisoning Admissions Clark County, Nevada 2009-2013, Tamara Bruno

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prescription drug abuse has been the fastest growing drug problem in the United States in recent years, and is the second most commonly abused category of illegal and illicit drugs, after marijuana (SAMHSA, 2013; Carnevale, 2011). Reducing the morbidity and mortality associated with prescription drug abuse in challenging because multiple factors contribute to the problem. Prescribing behaviors and the lack of education among providers and pharmacists along with inadequate counseling and

monitoring of patients prescribed pain medication are important factors (Machikanti, 2007; Okie, 2010). Patients' misuse or abuse, diversion or the sharing or sell of pills, and doctor shopping are …

Physical Therapy Non-Treatment Of The Acute Hospital Inpatient, Daniel Lee Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

The detrimental effects of inactivity and mobility extend to the most ill and injured patients in the acute hospital setting. Facilitating the activity and exercise of these most critical patients often requires the skill and expertise of a physical therapist. When physical therapists are involved in the care of hospital inpatients they experience significant benefits; patients experience fewer secondary complications related to their primary illness or injury, they spend less time in critical care units and less time in the hospital overall, and when they leave they go to less restrictive environments and more comfortable care settings. These known benefits …

Stride Length-Speed Relationship During Body Weight Supported Running, Carmen Chona

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if body weight support influences the stride length-speed relationship. Additionally, the purpose was to determine if impact characteristics of running are influenced by body weight support and speed. Subjects (n=10; 6 female, 4 male) volunteered to participate in this study. All subjects were injury free and were comfortable running on a treadmill for 30 minutes. Subjects ran on a lower body positive (LBPP, Alter-G, G-Trainer) treadmill for 4 conditions of body weight (100, 40, 30 and 20% of body weight) and 4 running speeds (100, 110, 120 and 130% of the preferred …

An Evaluation Of Kinematic Variables During Stance Phase Of A Training Endurance Run, Joshua Paul Bailey

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of the study was to evaluate kinematics of the lower extremity during the stance phase of an endurance training run. Fifteen participants (8 male, 7 female; 30.5 ± 8.4 years; 71.8 ± 11 kg; 1.73 ± 0.07 m) reported that they were currently signed up for, or planned on signing up for, an endurance race within the next six months of participation in the study (9 half marathon, 3 marathon, 1 triathlon, 2 21k trail run). All had a weekly running mileage greater than 20 miles (23.8 ±4.6 miles). Participants were required to complete the 15–kilometer training run …

The Wetsuit Effect: Physiological Response To Wearing A Wetsuit, Aaron Prado

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to investigate the effects of wearing a wetsuit on resting cardiovascular parameters (mean arterial pressure (MAP), rate-pressure product (RPP), and heart rate variability (HRV)). Furthermore, the position (i.e., upright vs. prone) as well as the wetsuit size were explored as possible factors that influence the cardiovascular parameters. Twelve male participants (79.1±5.1 kg, 178.4±2.9 cm, 33.3±12.1 years) granted written consent and were assigned two wetsuits based on height, weight, and corresponding manufacturer recommendations. SWS signified the smallest possible wetsuit the subject could fit into according to recommendations, LWS signified the largest wetsuit the subject could …

Impaired Theory Of Mind In Psychotic And Affective Disorders, Erik Nelson Ringdahl

UNLV Theses, Dissertations, Professional Papers, and Capstones

Psychotic symptoms in bipolar I disorder during mood episodes has been associated with several negative outcomes raising the question as to whether psychosis is a risk factor for a more severe form of this chronic and debilitating condition. However, relatively little research has been directed at understanding the relationships among social cognitive functioning in bipolar I disorder with and without a history of psychosis. Impaired social cognition has been identified as a putative endophenotypic markers in schizophrenia and the evidence is mounting as to whether similar impairments also exist in bipolar I disorder. Given the plethora of research supporting the …

Conceptual Framework Of A Novel Intervention To Improve Mobility In Children With Cerebral Palsy: The Successes And Challenges Of Implementing A Large Amplitude Movement Protocol, Tania Goodwill, Erin Jarrett, Beren Shah, Alanna Stockford

UNLV Theses, Dissertations, Professional Papers, and Capstones

While cerebral palsy remains one of the most common childhood disabilities, clinicians continue to face significant challenges developing effective treatment strategies for the widely variable presentation of motor function impairments associated with cerebral palsy. A large gap exists between current research based evidence and feasible clinical practice. The purpose of this paper is to introduce a novel intervention protocol, explore the theoretical framework behind the protocol and provide insight to clinicians about the successes and challenges faced while pilot testing the intervention. The novel intervention was adapted and implemented by researchers combining a large amplitude movement protocol with the well-researched …

Merging Educational Technology Into Routine Care For Patients Living With Fibromyalgia, Toni Sparks

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fibromyalgia is a complex and challenging disorder of unknown etiology; however the management of patients with fibromyalgia is becoming facilitated more often by Advance Practice Registered Nurses (APRN). Unfortunately, the lack of clarity in diagnosis, variances in practice guidelines, time constraints and the resources required for APRNs to adequately manage fibromyalgia can be extensive. The evidence supporting nonpharmacological strategies is strong; yet implementation of these strategies into routine care has not been sufficient.

Substantial research in the past five years has resulted in new diagnostic criteria intended to simplify the fibromyalgia diagnosis. Moreover, new clinical practice guidelines stress the importance …

Retirement And The Registered Nurse: The Saver Study, Shanna Field Keele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sixty percent of U.S. registered nurses (RNs) age 45-60 have not participated in retirement planning. Further, in the next 10 to 15 years, this cohort of 1 million RNs will reach retirement age. Previous RN retirement studies have focused on RN retirement outlook, RN economic preparation for retirement, or retirement intent. However, no contemporary research explores the psychological influences in RN retirement preparation; a concern since retirement benefits have been suggested as a retention strategy to improve patient care outcomes, satisfaction, and safety by reducing RN turnover. The purpose of the SAVER study was to identify predictors of future time …

Development Of A Tool To Assess Children’S Perceptions Of Their Own Balance (The Pediatric Balance Perception Battery): A Pilot Study, Jillian L. Beckett, Ashlee A. Harmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Psychosocial aspects of balance including self-perception, behaviors, and experiences, have been found to contribute to activity limitations and participation restrictions in adults. Clinical tools have been established to measure how adults feel about their own balance and the extent to which fear of falling and other related characteristics interfere with participation. There are no clinical tools presently available to explore these relationships and quantify the extent to which they interfere with activity and participation in children.

Purpose: To develop and test reliability and validity of a tool to evaluate balance self-perception in a pediatric population.

Participants: This sample of …

The Effect Of Trigger Point Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Healthy Subjects, Sarah Buckingham, Crystal Montoya, Daniella Morton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, blinded, controlled cross-over trial with each subject receiving both interventions within a seven-day span.

Objective: To determine if differences occurred in resting- or contraction-thickness of the transversus abdominis (TrA) muscle following application of trigger point dry needling (TPN) of the lumbar multifidus (MF) muscle in asymptomatic subjects.

Background: Recent studies have shown TPN decreases pain in areas throughout the body. The effect of dry needling the MF on low back pain (LBP), and its effect on core stabilization have not been investigated.

Methods: Forty-three healthy individuals who had not experienced LBP in the previous six months were …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Morgan Lopker, Molly Newman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study was to compare individuals with Parkinson’s disease (PD) exhibiting fear of falling avoidance behavior to those with no fear of falling avoidance behavior. Because avoidance behavior can have deleterious downstream consequences, it is important to determine what potentially mitigated physical and psychological factors are associated with it.

Subjects: Fifty-six community dwelling individuals (age=72.1 years, SD=9.6; males=42, females=14) with PD (Hoehn and Yahr Scale stage median=2.0, mode=3.0) were classified into two groups using the Fear of Falls Avoidance Behavior Questionnaire (FFABQ): avoiders (n=26, ≥20 FFABQ), and non-avoiders (n=30, <20 on the FFABQ).

Methods: Avoiders and non-avoiders were …

The Effects Of A Progressive Exercise Program On Functional Activity And Quality Of Life For Older Overweight Women With Knee Osteoarthritis, Ty Carlson, Devin Edvalson, Tyler Peck, Brad Robison

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose Osteoarthritis (OA) is a common symptomatic condition experienced by older adults, especially in the overweight population, that affects the knees in particular. This study compares the effectiveness of two progressive exercise protocols (walking and stepping) on function and quality of life in older, overweight women with OA. This study includes self-management training and assesses participant selfperceived efficacy in managing OA.

Subjects This is a quasi-experimental design utilizing 16 women ≥ 50 years of age (60.44 ± 6.04) with a BMI > 25 (34.21 ± 7.28) and radiographic diagnosis of OA in at least one knee.

Methods and Measures …

Factors Which Predict The Use Of Active Transportation To School Among Children In Clark County, Nv, Sheila G. J. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Active transportation to school (ATS) shows promise for increasing activity levels in children, but prevalence and correlates vary widely in cities and regions with different barriers and supports for active travel. Classification of ATS users is a current issue in the field. The purpose of this study was to determine the prevalence of ATS use and develop a predictive model of ATS for the novel population of children enrolled in grades K-8 in Clark County School District, a large metropolitan school district in Southern Nevada. Methods: This study used a secondary data from the National Center for Safe Routes …

Ability Of Ages And Stages Questionaire 3rd Edition To Identify Children In Need Of Comprehensive Motor Evaluation, Courtney Michele Carmichael, Elizabeth Ann Willison, Qing Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: The Ages and Stages Questionnaire Third Edition (ASQ-3) is a widely used screening tool designed to identify children who need comprehensive developmental assessment. Its accuracy for identifying children in need of additional motor assessment has not been determined. The purposes of this study were to establish concurrent validity between ASQ-3 gross motor (GM) and fine motor (FM) scores and their corresponding Peabody Developmental Motor Scales Second Edition (PDMS-2) quotients, and to examine the diagnostic accuracy of the ASQ-3 using the PDMS-2 as a gold standard reference test.

MATERIALS/METHODS: This was a secondary analysis of a previous study in which …

Evaluating The Impact Of A Home-~Based Childhood Asthma Intervention Program In Clark County, Nevada, Mackenzie Suzanne Burns

UNLV Theses, Dissertations, Professional Papers, and Capstones

Asthma is a chronic, incurable, costly, and potentially life–threatening disease that affects an estimated 7 million children in the United States; further, more than 56,000 Nevada children are currently living with asthma. The literature suggests that a number of factors that contribute to either the development of asthma or the exacerbation of asthma symptoms in sensitive individuals can be traced to the home environment. Given that the majority of Americans spend over 90% of their time indoors, of which two–thirds are spent at home, a home–based childhood asthma intervention program represents a unique primary prevention opportunity. This pre–experimental study evaluated …

Use Of Standardized Tests Within Nursing Education Programs, Irene Coons

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study explored the use of standardized tests within nursing programs. Standardized tests have been used within nursing programs for several decades (Shultz, 2010), but recently their use has increased. This rise in utilization may be related to the need for nursing programs to satisfy various accreditation requirements, including annual state board of nursing pass rates. However, standardized tests are not without controversy. For example, some believe that the tests can be detrimental to minority nursing students (Spurlock, 2006). Therefore, the purpose of the study was to assess how and why standardized tests are utilized within nursing programs.

Literature was …

The Lived Experience Of Black African Nurses Educated Within The United States, Amy Elizabeth Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the unprecedented growth of minority populations in the United States, the nursing profession has remained relatively homogenous. Nursing education has increased the number of minority students entering nursing programs; however, attrition rates for minority nursing students are as high as 85% (Gilchrist & Rector, 2007). As the population grows in diversity, the need for nurses who are fluent in foreign languages and who understand minority values, traditions, and cultural practice will be essential in delivering culturally competent care. Improving the retention of minority nursing students is an important step in increasing the diversity within the nursing workforce.

Although several …

Development And Evaluation Of An Opioid Monitoring Clinic, Richard Luna Talusan

UNLV Theses, Dissertations, Professional Papers, and Capstones

An APRN-led Opioid Monitoring Clinic was developed and implemented in the primary care setting of Las Vegas' Department of Veterans Affairs in July 2013 to assist primary care providers (PCP) in the management of high risk patients on chronic opioid

therapy for chronic noncancer pain. The clinic assisted in monitoring patients for abuse and misuse of opioids and referred patients for treatment when abuse and misuse were discovered. A study to evaluate the OMC was undertaken from November 22, 2013

through February 23, 2014 to assess the effectiveness of the OMC in meeting its objectives. A total of 61 patients …

The Relationship Among School Playground Design And Conditions And Physical Activity Levels In Children, Ipuna Estavillo Black

UNLV Theses, Dissertations, Professional Papers, and Capstones

Almost 20% of children aged 6 to 11 years are obese in the United States, tripling over the last ten years. The rise in childhood obesity challenges nurses in their efforts to improve community health and sustainability. A decrease in physical activity (PA) levels has been associated with an increase in obesity. Schools have been identified as a primary setting to provide children adequate amounts of daily PA, and nurses working in the area of child health promotion can work with schools to provide opportunities for children to increase PA levels. The playground is one environment where children can increase …

Determinants Of Head And Neck Cancer Survival In Nevada For 1995-2008, Xiao Q. Li

UNLV Theses, Dissertations, Professional Papers, and Capstones

Head and neck cancer (HNC), also known as oral cavity and pharyngeal cancer, comprises a group of cancers that arise in the head or neck region, such as the nasal cavity, sinuses, lips, mouth, salivary glands, and pharynx. Use of tobacco, alcohol, or a combination of the two, are major risk factors for head and neck cancer. Approximately 75% of oral cancers are attributable to smoking and/or alcohol consumption. More recently, the human papilloma virus (HPV) has also been associated with the development of head and neck cancer.

The objective of the present study is to investigate head and neck …