Medicine and Health Sciences Commons^™

Examining The Experiences Of Lgbtq Dpt Students: A Critical Ethnography, Catherine Turner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to examine the experiences of LGBTQ Doctor of Physical Therapy (DPT) students at a large public university in the south-western United States, as it relates to the culture and climate of the program and campus. The LGBTQ community faces its own unique health disparities. Research in medicine suggests improving the diversity of the healthcare profession is a vital component in improving access to care, and this requires the creation of inclusive and supportive educational environments for LGBTQ identifying healthcare students. However, minimal research exists examining the experiences of LGBTQ physical therapy students.

The study …

Implementation Of A Protocol In The Freestanding Emergency Department To Screen For And Identify Possible Victims Of Human Trafficking, Joe Alvarado

UNLV Theses, Dissertations, Professional Papers, and Capstones

Human trafficking (HT) victims often seek medical care in the emergency room setting. In a recent study among HT survivors, 88% attested to receiving medical care while in captivity, with 63% treated in the emergency care setting. Freestanding emergency departments typically have lower acuity and lower patient volumes than hospital-based emergency departments. This setting creates shorter wait times and minimizes the length of stay at every point during the emergency room experience. For traffickers, this is an ideal situation if their victim needs medical attention, and they want to get in and get out of the emergency room with less …

Scardovia Wiggsiae And Streptococcus Sobrinus Prevalence Among Orthodontic And Non-Orthodontic Patients, Melissa Trumbo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Dental cavities or caries have been identified as among the most prevalent of preventable oral conditions. However, studies are discovering new information regarding the incidence and prevalence of several cariogenic organisms, including Streptococcus mutans (SM), the recently discovered Scardovia wiggsiae (SW), as well as Streptococcus sobrinus (SS). These studies have revealed varying prevalence among different populations, such as those undergoing orthodontic treatment. Based upon this information, the main goal of the current study was to assess the prevalence of specific cariogenic organisms (SS and SW) within saliva samples originally obtained from a dental school-based clinic.

Methods: The protocol for …

Assessment Of The Infrazygomatic Crest And Distal Infrazygomatic Crest For Bone Depth And Miniscrew Insertion, Kyle C. Tuttle

UNLV Theses, Dissertations, Professional Papers, and Capstones

The aim of this study was to analyze and compare the bone depth at various postulated miniscrew insertion angles in both the Infrazygomatic Crest (IZC) and Distal Infrazygomatic Crest (DIZC) regions. Furthermore, root morphologies of the maxillary 1st and 2nd molars and their effect on bone depth and the various miniscrew insertion angles were analyzed.

A total of 69 CBCT images were collected from pre-orthodontic adult patients at the UNLV orthodontic residency clinic. Bone depth measurements were made at 8 postulated miniscrew insertion angles starting at 40° up to 75°. All measurements were recorded from the buccal bone at the …

Gardasil Vaccine Trends Within Nevada, California, And The U.S.: A Comparative Study, Karen S. Gutierrez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite decreasing incidence in cervical cancer in the U.S., there continues to be an increase in public health concern for cervical cancer worldwide. Recent studies report that individuals are disproportionately affected based on region, sex, and race. Additionally, the human papillomavirus (HPV) attributable cancers may be reduced between 70% and 90% through the universal use of HPV-vaccines. In order to expand current knowledge and implement intervention programs in Nevada, it is critical to examine the associations among the Gardasil vaccine, cervical cancer screening, and adverse events following immunization as well as to understand the different socio-demographic subgroups affected. To our …

Patient And Facility Perceptions On The Feasibility Of A Student-Run Pro-Bono Back-School For Uninsured Patients With Low Back Pain, Javier Ascanio-Pellon, Sofia Cruz, Lauren Liebert, Trevor Pacuk

UNLV Theses, Dissertations, Professional Papers, and Capstones

A. Background of Knowledge: Nevada ranks 8th highest in uninsured population in the United States. People who are uninsured may be more affected by low back pain (LBP) than their insured counterparts. Volunteers in Medicine of Southern Nevada (VMSN), a non-profit organization, serves uninsured people in Nevada. VMSN partnered with UNLV Physical Therapy (UNLVPT) to provide a back-school for patients. UNLVPT proposed a service-learning model to provide both education and treatment for VMSN patients with LBP. B. Purpose: The purpose of this community-based research project is to create and implement a student-run pro-bono back-school for uninsured individuals with LBP in …

Analysis Of Palatal And Upper Airway Dimensions In Patients With Excessive Daytime Sleepiness: A Retrospective Cone-Beam Computed Tomography Study, Daniel Jarrett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Excessive Daytime Sleepiness (EDS) is the measure of ones propensity to fall asleep during normal daily activities. It has been reported in 20%-50% of adults in the United States and is the most frequent symptom of patients presenting to sleep clinics. EDS is the result of both primary hypersomnias such as narcolepsy and idiopathic hypersomnia and, more commonly, secondary hypersomnias such as sleep deprivation, psychiatric conditions, medications, illegal substances, and obstructive sleep apnea (OSA).

The etiology of OSA is multifactorial. Collapsibility of the upper airway is influenced by both neuromuscular tone and craniofacial anatomy. Common predisposing factors for small airways …

A Comparison Of Lateral Cephalometric And Arch Dimension Changes In Patients With Class Ii Malocclusions Treated With 2-Premolar And 4-Premolar Extraction Patterns, Melissa Marie Ven Dange

UNLV Theses, Dissertations, Professional Papers, and Capstones

The aim of this study is to gather and analyze data representing detailed changes in model and cephalometric variables that will support clinicians in the premolar extraction decision- making process during camouflage treatment of class II dental patients. It is expected that the models, as measured by intra-arch dimensions, overjet, overbite, and mandibular crowding, and cephalometric radiographs, evaluated by their anteroposterior skeletal discrepancy, incisor inclinations, dental and skeletal vertical positions, and soft tissue characteristics, will significantly differ from within the same treatment group, pre-treatment to post-treatment, and between treatment groups. This retrospective study evaluated the model and cephalometric changes in …

Assessing The Health And Financial Burden Of Neonatal Abstinence Syndrome Among All Payer Inpatient Pediatric Discharges In Nevada, Kavita Batra

UNLV Theses, Dissertations, Professional Papers, and Capstones

Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome among neonates born to drug-dependent mothers. NAS poses a significant health and fiscal challenge nationally, with its incidence increasing by a factor of six (1.20 to 6.7 per 1,000 hospital births/year) along with the concomitant rise in health care cost from 2000-2016. Besides national data, it is critical to quantify NAS at the state-level to identify the target areas for prevention. Given the higher opioid prescribing rates among pregnant women in Nevada, it is critical to assess the health and financial magnitude of NAS in the state. The objectives of this …

Oral Localization Of Scardovia Wiggsiae, Graydon Ramos Carr

UNLV Theses, Dissertations, Professional Papers, and Capstones

Early childhood caries is one of the most prevalent diseases in the United States among children. The formation of caries is a complex, multifactorial process that is still being studied. Researchers have thought for years that Streptococcus mutans was the primary causative agent of early childhood caries. The recent discovery of a novel cariogenic pathogen, Scardovia wiggsiae and its significant contribution to the etiology of early childhood caries has led oral health researchers to re-evaluate this microorganism and its link to this disease. While there have been several projects undertaken within the University of Nevada, Las Vegas School of Dental …

The Implementation Of A Respiratory Syncytial Virus Prevention And Awareness Pamphlet In The Daycare Setting, Kaylie Marie Humphreys

UNLV Theses, Dissertations, Professional Papers, and Capstones

Respiratory Syncytial Virus (RSV) is the number one cause of bronchiolitis in children under five years of age and regretfully the number one cause of hospitalization in the first year of life. RSV leads to over three million hospitalizations, two million outpatient visits, and 200,000 deaths in the pediatric population globally each year. While no vaccine is currently available to prevent the spread of RSV, efforts must be shown in spreading awareness of strategies utilized in infection prevention such as hand hygiene and properly covering a cough or sneeze.

This project aimed to present this education to a target population …

A Comparison Of Orthodontic Intraoral Scan Results Between Staff And Volunteers, Andrew Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: This pilot study is the first to assess and compare a trained staff’s intraoral scan to a clinical examination by comparing the overbite, overjet, Angle canine and molar classification, and gingival health. The second part of this study is to determine if the self-scan scan from a patient is as reliable to the staff’s scan. Introduction: Orthodontic treatment is usually provided over a sequence of appointments. During each appointment, the doctor clinically evaluates the patient, analyzes the progress and provides adjustments to continue with the treatment. The most common clinical criteria evaluated are overbite, overjet, upper and lower midlines, …

3d Upper Airway Analysis Of Skeletal Class I, Ii, And Iii Adults With High Or Low Risk For Excessive Daytime Sleepiness, Alexander Dao

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To investigate the differences in ethnicity, BMI, sex, total airway volume, minimum cross-sectional area, airway shape, and hyoid bone position in high risk for excessive daytime sleepiness vs low risk for excessive daytime sleepiness in skeletal class I, II, and III patients

Introduction: Obstructive Sleep Apnea (OSA) is an underdiagnosed medical condition with many negative consequences on a patient’s overall health (Dempsey, J.A., Veasey, S.C., Morgan, B.J., & O’Donnell, 2010). OSA is defined as the occurrence of at least 5 instances per hour of sleep during which breathing temporarily stops (Motamedi, McClary, & Amedee, 2009). Undiagnosed OSA could lead …

Comparison Of Digital Treatment Setups And Final Treatment Outcomes Of Class Ii Division 1 Malocclusions Treated With Premolar Extractions, Sogol Shantiyai

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: This study aimed to determine whether there are differences between pre-orthodontic treatment dimensions when compared to the virtual treatment simulations and actual orthodontic treatment outcomes in Class II malocclusions treated with two or four premolar extractions.

Introduction: The use of intraoral scanners has become commonplace in orthodontic practices, giving practitioners the ability to scan and assess maxillary and mandibular dental morphology and occlusal relationships chairside and in real-time. Practitioners can use virtual treatment planning to evaluate different extraction patterns, visualize potential non-extraction outcomes using interproximal reduction, and alter anchorage strategies based on the amount of retraction or protraction required …

Reduced Gabaergic Signaling At The Axon Initial Segment Decreases Vigilance State Transitioning, Austin John Boren

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sleep is a highly regulated homeostatic process that is disrupted in an estimated 50-70 million Americans. Regulation of sleep depends upon coordinated signaling of multiple neurotransmitter systems. In particular, inhibitory gamma-aminobutyric acid (GABA) signaling is required to suppress wake-active brain regions in order to initiate and maintain sleep states. GABA type A receptors (GABAARs) are ionotropic receptors with subunit compositions uniquely enriched on subcellular domains of target cells. α2 subunit-containing GABAARs are the primary target of GABA released onto the axon initial segment (AIS), a site critical for phasing the oscillatory activity of cortical cells. α2-containing GABAARs have previously been …

Health Care-Associated Infection Prevention Outcomes: Evaluating The Link Between Infection Prevention Practices In Healthcare Facilities And Their Health Care-Associated Infection Rates, Chidinma Veronica Njoku

UNLV Theses, Dissertations, Professional Papers, and Capstones

Healthcare-associated infections (HAI) are a pressing problem affecting vulnerable individuals who come to the hospital to receive care for one condition only to find that they have contracted another during their stay. Studies point to the importance of training and educating staff in order to implement and comply with recommended infection control and prevention control and prevention practices as lack of training and knowledge about infection control and prevention has been perceived to bring about a limited ability for direct care staff to adhere to recommended processes and activities. Although there are prior studies on the effects of assessments, infection …

Changes In Hippocampal-Anterior Cingulate Cortex Interactions During Remote Memory Recall, Ryan A. Wirt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Spatial memory is an important cognitive process that relies on extensive neural networks throughout the brain. The hippocampus (HC) is important for the formation of these memories but over time, in a process referred to as consolidation, recall becomes increasingly reliant on other brain areas. The anterior cingulate cortex (ACC), a region within the medial prefrontal cortex, is important for spatial learning, spatial working memory, and remote memory recall, but the mechanisms underlying recall processes are still unknown. To better understand the role of the ACC and HC during memory recall, we introduced rodents into a series of spatially and …

Prevalence Of Aggregatibacter Actinomycetemcomitans And Fusobacterium Nucleatum Among Clinical Orthodontic Saliva Samples, Jason Robert Klingler

UNLV Theses, Dissertations, Professional Papers, and Capstones

Changes to the oral microflora occur when there are shifts in the levels of the numerous bacterial species. Changes in bacterial load occur in health, disease, and dental treatments such as orthodontics and can be detected through saliva. Many studies dealing with saliva have centered around detecting bacteria known for correlation with chronic periodontitis and caries. Fewer have focused on bacterial species that contribute to microbial shifts not strictly correlated with disease. Measuring the degree of disease progression or future susceptibility is not always possible with traditional clinical parameters alone.

Aggregatibacter actinomycetemcomitans (AA) is a bacterial strain that serves as …

Dental Age Estimation Of A Southern Nevada Hispanic Non-Adult Population Employing The London Atlas To Evaluate Archival Orthodontic Cone Beam Computed Tomography (Cbct) Images, Haley Buchanan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Age estimation is of societal importance for legal, forensic, and clinical reasons. The London Atlas of Human Tooth Development and Eruption, hereafter referred to as the London Atlas, was introduced as an improved method for determining dental age estimation. The London Atlas was developed from panoramic images of 528 living British Caucasian and Bangladeshi males and females aged 2 to 24 years and panoramic images of 176 archival human skeletal remains, aged 32 in utero to 2 years old, from two specimen collections (AlQahtani, Hector, & Liversidge, 2010). Further investigation is warranted to determine validity of the atlas’s use in …

Effect Of Bmp Treatment On Periostin Gene Expression In Pre-Osteoblastic Mc3t3-E1 Mouse Cells, Vincent Lee Khang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Periostin is a secreted, extracellular matrix (ECM) protein widely expressed within collagen-rich fibrous connective tissues of the body including the periodontal ligament (PDL), bone, skin, heart, and cornea. Periostin has been shown to serve many important regulatory functions including cell adhesion, cell motility, wound healing and of particular importance to the dental field, differentiation of osteoblasts. The deletion of periostin compromises osteoblast attachment to bone matrix and induces a reduction in mineralization and expression of bone markers, including type I collagen, osteocalcin, osteopontin and alkaline phosphatase. Periostin has also been shown to play a significant role in collagen fibrillogenesis by …

Prevalence Of Cariogenic Microbial Flora Among Scardovia Wiggsiae-Positive And Negative Patients, Amy Tam

UNLV Theses, Dissertations, Professional Papers, and Capstones

The formation of dental caries (cavities) is a complex, multi-dimensional process that necessarily involves many risk factors – including the acquisition and colonization of cariogenic oral bacteria. The most frequently associated oral pathogens are the acid-producing and acid-tolerant oral streptococcus species, such as Streptococcus mutans (S. mutans or SM). Many studies have established and confirmed the critical role of the formation of biofilm in the virulence of S. mutans, and the critical role this may play in determining the balance of the oral microbiome towards health or disease.

More recent efforts have discovered a novel cariogenic pathogen, Scardovia wiggsiae (S. …

Interleukin-1 Beta (Il-1Β) Gene Polymorphisms In Pre-Treatment Orthodontic Patients Exhibiting Short Root Anomaly (Sra), Satyaprasad Nayak

UNLV Theses, Dissertations, Professional Papers, and Capstones

Root resorption is a frequent unwanted occurrence during orthodontic treatment. Biological factors include the quantity of specific inflammatory mediators, growth factors, and hormones as well as an individual’s specific alleles for the genes encoding these mediators. Studies have shown an association between external apical root resorption (EARR) and the single nucleotide polymorphism (SNP) at +3954 of the IL-1β gene. Studies have also shown associations between chronic periodontitis and IL-1β gene polymorphisms in the region of +3954, -511 and -31. All previous studies to date, have evaluated genetic factors and root resorption in orthodontic patients in-treatment or post-orthodontic treatment. This study …

3-D Upper Airway Comparison Between Class I And Class Ii Adults With Excessive Daytime Sleepiness, Nga Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: The aim of the study is to determine whether there is a relationship between the risk for daytime sleepiness in adults with Class I and Class II malocclusion and the airway volume, minimum cross-sectional area, and shape at the minimum cross sectional area.

Introduction: Sleep disordered breathing (SDB) is a category of conditions defined by airway complications while a person is sleeping. Obstructive sleep apnea (OSA) is the most common of these disorders and is defined as the presence of repeated episodes of complete or partial airway obstruction, which may be associated with loud snoring and daytime sleepiness. Daytime …

Levels Of Interleukin-1Β And Interleukin-17 In The Tension And Compression Sites Of Teeth During Orthodontic Movement, Suzanne Wen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Orthodontic tooth movement requires coordinated bone resorption and deposition in response to mechanical stimuli. Underlying this process is a complex network of biological signaling to activate osteoclasts and osteoblasts. The broad category of small proteins known as cytokines include many potential mediators involved in complex interactions to initiate tooth movement. One of the signaling factors is interleukin-1β (IL-1β), which plays a critical role in inflammation and bone erosion via the activation of osteoclasts. IL-1β is a key cytokine involved in osteoclast differentiation, multinucleation, and overall survival. Recently, interleukin-17 (IL-17) has been identified as a potent inducer of inflammation that influences …

Screening For The Novel Cariogenic Pathogen Scardovia Wiggsiae Among Orthodontic Patients, Adam Whiteley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screening for the Novel Cariogenic Pathogen Scardovia wiggsiae among Orthodontic Patients

by

Adam Whiteley

Dr. Karl Kingsley, Examination Committee Chair Professor of Biomedical Sciences University of Nevada, Las Vegas School of Dental Medicine

The recent discovery of a novel cariogenic pathogen Scardovia wiggsiae has led many scientists and oral health researchers to re-evaluate and re-examine existing saliva repositories to determine the prevalence among patient populations. Recent efforts at this institution have used existing saliva samples to determine the prevalence among both adults and pediatric patients. These studies have revealed this organism may be found in approximately one-quarter of all samples …

The Effects Of Orthodontic Appliance Base Plate Material, Pmma, Infused With Silver And A Novel Antibacterial Compound On Biofilm Formation, Ryan D. Jolley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Retention is required in the majority of orthodontic patients throughout the remainder of their life. The traditional Hawley style retainer is still considered by many orthodontic professionals to be the gold standard in retention appliances. The orthodontic population, in general, is at a higher risk for caries due to plaque accumulation from poor diet, suboptimal oral hygiene, and often a lack of motivation. A Hawley retainer that reduces caries-causing oral microbes could improve oral health and be very beneficial to the post-orthodontic patient. Developing methods to safely include antibacterial products within the Hawley retainer’s base plate material could help effect …

Differential Cbct Analysis Of Collum Angles In Maxillary And Mandibular Anterior Teeth In Patients With Different Malocclusions, Erin Shane Wan Ma

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The collum angle is an angular measurement of the difference between the longitudinal axis of the crown and the longitudinal axis of the root. The aim of this study was to determine the mean collum angles for all maxillary and mandibular anterior teeth. In addition, the collum angles of different molar and skeletal classifications were compared for each anterior tooth.

Methods: Based on patient records obtained from the University of Nevada, Las Vegas Department of Orthodontics and Dentofacial Orthopedics, 326 CBCT scans were selected and divided into four molar and skeletal classifications. The patients were divided into Class I, …

The Effects Of Cryopreservation On Human Dental Pulp-Derived Mesenchymal Stem Cells, Allison Elaine Tomlin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Many studies have demonstrated clinical applications for the use of dental pulp stem cells (DPSC) for the treatment of various conditions. This has driven medical and scientific interest in the collection, isolation and banking of DPSC tissues for research into these potential therapies. Few studies to date have evaluated the viability of DPSC following long-term cryopreservation. The purpose of this study is to evaluate the effects of cryopreservation on dental pulp-derived stem cells (DPSC) viability over a period of three years. Dental pulp-derived stem cells were isolated and cultured from thirty-one healthy teeth. DPSC isolates were assessed for doubling-time and …

Oral Microbial Burden Of Periodontal Pathogens Among Orthodontic Patients, David Jolley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objectives

Many research studies involving orthodontic patients have a natural inclination to focus on changes in levels of cariogenic pathogens after bracket placement, and very few studies examine the role of changes of periodontal pathogens – particularly among adult patients. Interestingly, recent evidence suggests that increased levels of a specific periodontal pathogen, Fusobacterium nucleatum, may elevate risk for development of colon cancer in adults through direct pathways. Based upon this new evidence, the objective of the current study was to screen saliva samples taken from orthodontic patients to determine the prevalence of periodontal pathogens, including F. Nucleatum, T. denticola, and …

Effects Of Human Maternal Placentophagy On Postpartum Maternal Affect, Health, And Recovery, Sharon Marie Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

Postpartum ingestion of the afterbirth by the mother, or maternal placentophagy, is a common behavior among eutherian mammals, including non-human primates, with humans as a rare exception. Despite the conspicuous absence of placentophagy in the cross-cultural ethnographic record, the practice appears to be gaining popularity among a small but growing number of advocates in various industrialized contexts who claim that the practice provides benefits to the postpartum mother, namely the relief and prevention of postpartum blues and depressive symptoms, improved breast milk production, and enhanced bonding with their infant. Because the placenta serves as an endocrine organ throughout pregnancy and …