Medicine and Health Sciences Commons^™

Musculoskeletal Injury Concealment In The Reserve Officers’ Training Corps, Joshua D. Wooldridge

UNLV Theses, Dissertations, Professional Papers, and Capstones

INTRODUCTION: Among service members, musculoskeletal injuries threaten military readiness and place a substantial burden on medical and financial resources. While musculoskeletal injuries (MSKIs) are a leading threat to military readiness, service members’ unwillingness to seek care constrains current prevention and surveillance efforts. A growing body of evidence shows US service members conceal a large proportion of injuries, especially in training environments. The Reserve Officers’ Training Corps is a critical training environment for future US military commissioned officers. Reserve Officers’ Training Corps (ROTC) is the largest commissioning source of new officers for the US military. ROTC cadets are college students concurrently …

Self-Reported Covid-19 Diagnosis And Severity And Its Association With Utilization Of And Delays In Needed Medical Care, Mohammad Hesam Alavi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Covid-19, caused by the virus SARS-CoV-2, was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. The pandemic-related disruptions and the pursuant lockdowns have adversely impacted every aspect of people’s lives including access to medical care, cancer care, preventive medicine, mental health, and dental care in an already imperfect healthcare system in the US. This study utilized the 2020 self-reported data from quarters 3 and 4 of the National Health Interview Survey, a cross-sectional interview survey by the Centers for Disease Control and Prevention, to determine the possible association of self-reported COVID diagnosis, test positivity, and …

Quality Of Care: A Business Case For Us Hospitals, Iwimbong Kum Ghabowen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Patient Protection and Affordable Care Act present some threats and opportunities to many hospitals across the USA. Under the Value-Based Purchasing Program, acute care hospitals' rewards are tied to incentive payments for the quality of care provided in the inpatient hospital. In the last 20 years, growing research has examined the effects of the quality of care on the financial performance of hospitals. There is a gap in the literature, particularly exploring the relationship between quality and hospital financial performance using national samples. This dissertation investigates the association between patients' experience of care, 30-day readmission rates, and case-mix-index (CMI) …

Perceptions Of The Built Environment Among Older Adults Who Live In Age-Restricted Communities Compared To Those Who Do Not In Southern Nevada, Sandra Annan

UNLV Theses, Dissertations, Professional Papers, and Capstones

As Americans are living longer, there has been exponential growth in the number of older adults. Growth in the aging population has created unique challenges. As seniors age, they face many changes in their health, financial stability, and lifestyle, making it challenging to remain independent. The inability to remain independent can be a stressful and depressing experience for older adults. Studies show that most seniors prefer to stay in their current living environment as they age, or age in place, rather than move into senior housing or other available housing options designed for aging. This study investigates how perceptions about …

Dietary Intake And Energy Expenditure Of Pararescuemen During Routine Training, Andrea Woita

UNLV Theses, Dissertations, Professional Papers, and Capstones

Pararescuemen are one group of Air Force Special Operations Forces (SOF) who engage in vigorous physical training to achieve mission readiness. This type of training requires high energy expenditures and matching dietary intake to support basic physiological needs and to meet performance demands. However, few studies have investigated the energy expenditure and dietary intake of SOF and none have specifically examined these behaviors in Pararescuemen. The goal of this investigation was to determine the energy expenditure and dietary intake of Pararescuemen during routine training - a period when these operators receive supervision and guidance for performance improvements, recovery, and career …

Distracted Driving In Clark County, Nevada: Analysis Of An Intervention On College Students, Heidi Ann Manlove

UNLV Theses, Dissertations, Professional Papers, and Capstones

Distracted driving is a growing public health concern. Highlighted in the media, local and government agencies and in peer-review literature are increased associations of motor vehicle crash related injuries and fatalities with distracted driving, especially involving youth drivers. The goal of this thesis was to analyze the effects of a distracted driving intervention on college students at University of Nevada, Las Vegas. Quantitative statistical analysis was performed to compare self-reported pre and post-intervention questionnaire responses of the experimental and control groups. Between-group analysis was performed using independent t-tests and ANOVA. Within-group differences were analyzed with Repeated Measures ANOVA (RM-ANOVA) and …

Health Impact Assessment Of Proposed Rental Housing Policy Within Clark County, Nevada, Usa, Erika Raquel Marquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Homes serve as a central function of our everyday lives, they are where most Americans spend a significant amount of time and money. The quality of our homes can impact our health. Poor housing can cause and contribute to preventable diseases and injuries, such as the development or exacerbation of asthma, neurological deficits, cardiovascular diseases, and cancer. According to the American Housing Survey (2013) approximately 5.8 million homes, of 132 million homes in the United States, are in moderate to severe physical disrepair, with rental housing being at a disproportionate burden. According to 2013 U.S. Census, Clark County, Nevada has …

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 …

Sentiments Of Community Stakeholders Living In Southern Nevada Neighborhoods, Erin Sheehy

UNLV Theses, Dissertations, Professional Papers, and Capstones

Community stakeholders provided insight to their local neighborhoods and shared their thoughts about the potential redevelopment of their neighborhoods. This study utilized data from the Southern Nevada Strong ethnographic research project. Ethnographic research was conducted over ten weeks in Summer 2013. Neighborhood observations and interviews with community stakeholders were conducted to understand how neighborhoods are utilized, how residents feel about potential redevelopment, and what areas of the neighborhoods residents would like to see improved in the future. Photographs were also collected to further examine the characteristics, aesthetics, and spatial landscape of the neighborhoods. The purpose of this qualitative research project …

An Examination Of Walkability In The Las Vegas Metropolitan Area, Courtney Coughenour

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The benefits to regular physical activity are well established. Walkability is one element of the built environment that has been correlated with increased levels of physical activity. The auto-centric design of Las Vegas Metropolitan area (LVMA) is unique in ways that may influence walkability. The purpose of this study was to determine which urban design characteristics are associated with walking and physical activity in moderate income neighborhoods in LVMA. Methods: The standard walkability measure developed by Frank et al. (2010) was used to calculate the walkability index of seven neighborhoods. Residents of the two most walkable and two least …

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 …

"Choices" Florida's Version Of Obamacare, Jason Lamarr Wasden

UNLV Theses, Dissertations, Professional Papers, and Capstones

"CHOICES" Florida's version of ObamaCare was a unique case voted in by the public in Alachua County Florida. A mixed methods research design was utilized and provided context in which policy entrepreneurs operated, as well as an explanatory model of internal determinants. Social, economic and political factors were examined to determine the predictor variable in the adoption of the "CHOICES" health services program. The results revealed that voters 51 years of age and older had a greater probability of voting for the Alachua Referendum. "CHOICES" legality has not been under contention but its effectiveness has. This study found that "CHOICES" …

Retrospective Evaluation Of Oral Health Services For Underserved Children In Clark County, Nevada, Earl Taylor Spader

UNLV Theses, Dissertations, Professional Papers, and Capstones

Disparities in utilization of oral health services have been shown to exist through epidemiological investigations and data analysis. Specifically, disparities exist for utilization of preventative dental care (PDC) and unmet dental need (UDN). The disparities in utilization of PDC and UDN are associated with demographic and insurance variables.

To address the oral health disparities, the University of Nevada, Las Vegas-School of Dental Medicine (UNLV-SDM) was created to improve the health of the citizens of Nevada through innovative programs of oral healthcare services to the community. More recently, UNLV-SDM opened a pediatric dental residency training program to provide care directly to …

A Comparative Study Of Indicator Bacteria Present In Ice And Soda From Las Vegas Food Establishments, Kimberly Jo Hertin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Microbial analysis has long been used as an indicator of water quality. Since the passing of the Safe Drinking Water Act in 1974, microbial standards have been strictly set by the Environmental Protection Agency (EPA) to ensure that the public health is protected from bacterial pathogens. The bacteriological quality of water generally deteriorates as it travels from water treatment facilities through the main distribution system and into private plumbing and distribution systems. For example, Heterotrophic Plate Count (HPC) values typically increase once the water has entered plumbing devices such as beverage vending machines. Upon reaching a private facility, the opportunity …

Independent Living Program Evaluation For Rebuilding All Goals Efficiently, Patricia Armour, Debra Moulton, Araceli Pruett

UNLV Theses, Dissertations, Professional Papers, and Capstones

This paper evaluates the outcome of independent living (IL) services provided to clients with Spinal Cord Injuries (SCI) by a local non-profit organization, Rebuilding All Goals Efficiently (RAGE). Agency services are directed at increasing client self-sufficiency, self-advocacy, and maintenance of least restrictive living environment. Secondary data provided by RAGE for 22 SCI clients who received services in FY10 was used in the evaluation. Outcomes were measured for living arrangement at case closure, impact of services on client’s life, and cost effectiveness of services provided. Descriptive statistical analysis of the data revealed successful outcomes for all 22 SCI clients. All clients …

The Effectiveness And Adoption Of Market-Based State Health Care Expansion Programs, Nathan Gregory Myers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Market-based state health expansion programs are alternatives to government programs like Medicaid and SCHIP which also seek to expand access to health insurance for uninsured populations. These programs either utilize the private health insurance market or function according to market principles. The market-based policies at issue in this research are state high-risk health insurance pools, limited benefit plans, group purchasing arrangements, reinsurance programs, and Health Insurance Flexibility and Accountability waivers. This research addresses two separate but related research questions: (1) Do these market-based programs provide general economic and social benefits for the citizens of a state? (2) What role does …

Disease In The Desert: Las Vegas As A Case Study Of How First Responders And Emergency Managers Understand Novel Threats To Human Health And Plan To Respond During Biological Emergencies, Monique Williamson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over recent years it has become clear that technological advancements, globalization, and ecological change, combined with the onset of increased terrorist incidents, are all currently working to create an extremely hazardous environment in terms of pathogenic invasion. Realizing that infectious diseases are both newly emerging and re-emerging in many parts of the world, the question of how prepared an expansive United States will be in the face of an oncoming global pandemic is easily raised. Using Las Vegas as an example of just how unequipped a largely visited U.S. city may be in the face of such a situation, this …

Camping: A Positive Developmental Context For Youth With Disabilities/Serious Illness, Christopher T. Troxell

UNLV Theses, Dissertations, Professional Papers, and Capstones

The paper will examine how elements of youth development can enhance the camp experience, so that new camps for youth with disabilities and/or serious illness, such as Flying Horse Farms, can start with a solid knowledge base of what works and why it works. Also, even though the paper is geared toward these specific types of camps, part of its recommendation could be modified to fit the purpose of any camp.

Factors That Contribute To Nursing Job Satisfaction At Valley Hospital, Christopher Jones

UNLV Theses, Dissertations, Professional Papers, and Capstones

The United States is in the midst of a nursing shortage and it is expected to get even worse in the coming years due to several trends. These trends include the aging of the workforce where many nurses will be retiring in the next few years, the low enrollment in nursing schools, nurses leaving the profession for other fields of work and the lack of interest that many people are showing towards a career in nursing.

The Corporate Culture Of Nevada Hospitals, Sherese Marie Warren

UNLV Theses, Dissertations, Professional Papers, and Capstones

The initial focus of this study is to identify the dominant culture of Nevada hospitals and to determine whether hospital organizations in Nevada share similar corporate values and beliefs. If differences exist, what are the distinctions in those organizations that make them different? The competing values framework was used to diagnose four corporate culture types of each hospital. The clan culture possesses high affiliation and concern with teamwork and participation. The developmental culture is based on risk taking, innovation, and change. The hierarchical culture reflects values and norms associated with bureaucracy. The rational culture emphasizes efficiency and achievement (Quinn & …

Nevada "Nurselessness": An Acute Or Chronic Condition? An Examination Of The Etiology And Possible Treatment Alternatives, Jeanine Warren-Newmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Data released by the Department of Health and Human Services in February, 2001, revealed that Nevada has the lowest number of registered nurses per 100,000 population in the nation. The state’s population is growing faster than the nursing programs are currently able to produce new graduates. Current predictions are that the existing nursing shortage will become more severe and have a longer duration than has ever before been experienced. While there may not be one single identifiable causative factor, the aging nursing workforce, low unemployment, and the universal nature of the shortage magnify the problem. This paper focuses on the …

Quality Improvement: Physician Providers, And The Women Health Connection Program, In The Provision Of Breast And Cervical Cancer Screening Services In Nevada., Salome K. Kapella

UNLV Theses, Dissertations, Professional Papers, and Capstones

Quality Improvement is one of the best solutions to the performance of healthcare services. The purpose of this study is to identify areas that need to be improved in relationship between physician providers and the Women Health Connection Program (WHC) in the provision of breast and cervical cancer screening services in Nevada. An assessment of how physicians view the program, their cooperation with the WHC program, an analysis of areas for improvement and the value of services to WHC clients have been discussed in order to improve the quality of breast and cervical cancer in the state. Comparisons have been …

Human Subjects Protection In Research: Are We Doing Enough?, Marsha L. Green

UNLV Theses, Dissertations, Professional Papers, and Capstones

Scientific research has produced substantial social benefits but has also posed troubling ethical questions with regard to the use and protection of human subjects. These questions have continued to be in the forefront of all biomedical and social research. The increased education of researchers on the subject of protection of human subjects has become of vital importance in the research world. This education involves program administrators, faculty, staff, students, research participants, and Institutional Review Board Committee (IRB) members. In this study of the University of Nevada, LasVegas (UNLV) human subjects’ protection program administration, the question to be answered was: has …

Lake Mead Hospital Conversion To Complete Delivery System, Roger W. Noorda

UNLV Theses, Dissertations, Professional Papers, and Capstones

The objective of this case study is to determine the cost difference between using a conventional type of inventory system in the operating room versus using a pack system in the operating room. In this study three different ways of delivering disposables for a laminectomy procedure were considered: 1) multiple distributors of disposables, 2) single distributor of disposables, and 3) the pack system (CDS by Medline). The first comparison was of multiple distributors vs. a single distributor with a cost difference of $90.08 per procedure and $18,916.80 annually, multiple distributor costing less. The second comparison was between Medline as a …

Nurses, Pharmacists, And Information Technology In Public Healthcare, Larry Allen Malato

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to explore the healthcare professional’s experience during the implementation of information technology. The focus is on the implementation of a computerized medication ordering, dispensing, and tracking system in acute care departments of a 600- bed public hospital. Spradley’s qualitative, ethnographic research methods were used to discover the personal meaning of the implementation. How do pharmacists and nurses feel about the implementation of an advanced technology system? Are there any barriers to implementation? Findings suggest a resistance to implementation by professionals in the disciplines of Pharmacy and Nursing. Resistance is based on their perceptions of …

The Rural Hospital Dilema: Will Nevada’S Rural Hospital System Survive?, Nancy L. Anderson

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study, prepared for the Department of Public Administration, will review and discuss the rural hospitals in the State of Nevada. By virtue of its size and population distribution, Nevada has a need for rural hospitals. These hospitals, which are of critical importance for Nevada residents, are constantly struggling with how to build and support their limited health system capacity and infrastructure. To survive, rural hospitals must offset the losses they have sustained as a result of decreased federal funding. Some ways these losses have been offset is by employing some of the programs created by the Balanced Budget Act …

Officer Involved Shooting: The Emotional Impact And The Effective Coping Strategies, Patrick P. Charoen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The emotional impact of a shooting incident on the individual police officer has been recognized and detailed by both police and mental health professionals (Lippert & Ferrara, 1984). The human cost and financial costs to Police Departments as a result of "post shooting" trauma has sensitized many departments to the need for professional support for officers involved in shootings. Recent survey research has provided information about the percentage of officers who experienced great, moderate, or no emotional impact after being involved in shootings (Stratton, 1982). However, information about the degree to which police departments have responded to this need has …