Medicine and Health Sciences Commons^™

Application Of A Judgment Model Toward Measurement Of Clinical Judgment In Senior Nursing Students, Tiwaporn Pongmarutai

UNLV Theses, Dissertations, Professional Papers, and Capstones

Clinical judgment, defined as “the application of the nurse’s knowledge and experience in making decisions about client care” (The National Council of State Boards of Nursing, 2005, p. 2), has been recognized as a vital and essential skill for healthcare providers when caring for clients. Undisputedly, nurses represent the largest component of the healthcare profession and, therefore, play a major role in ensuring quality patient care in the United States. Although the concept of clinical judgment in nursing has been discussed for more than three decades, and in spite of numerous efforts to improve student clinical judgment, the recent literature …

Variability Of Pacing In Marathon Distance Running, Thomas A. Haney Jr.

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purposes of this study were to describe variability of pacing during a marathon and to determine if there is a relationship between variability of pacing and marathon performance. A total of 301 race profiles that contained personal global positioning system (GPS) from the Rock „n‟ Roll Las Vegas (Race 1) and San Diego (Race 2) marathons were downloaded (http://connect.garmin.com) and analyzed. Each marathon finish time was placed into one of three finish time bins: Bin 1: 2.5 – 3.9 hrs, Bin 2: 4.0 – 4.6 hrs, Bin 3: 4.7 – 7.2. The coefficient of variation of velocity (Velcov) was …

Therapist-Initiated Addiction Assessment Procedures Of Marriage And Family Therapists In The Southwest United States, Emire Olmeztoprak

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to examine the addiction assessment procedures of marriage and family therapists. Addiction prevalence rates are growing therefore it is likely that marriage and family therapists will have clients affected by addiction. Undetected addictions can impede treatment and/or prevent the therapist from making appropriate treatment related decisions. Marriage and family therapists in Nevada, Arizona, and New Mexico were invited to complete a web-based survey containing a series of questions about their assessment procedures for addiction as well as a series of demographics questions. The data from the completed surveys was collected and analyzed. The data …

Development Of Novel Biomarkers In Cancer: Detection Of Circulating Mir-141 As A Potential Prognostic Marker For Prostate Cancer, Jason Cadaoas Gonzales

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prostate cancer (CAP) is the most common epithelial malignancy and the second leading cause of cancer deaths in American men. The identification of predictive and prognostic biomarkers in CAP patients is critical for improving clinical outcomes. Although the measurement of prostate-specific antigen (PSA) and radiographic studies are clinically approved to predict response to therapy, these tests can oftentimes prove to be inadequate in certain patients. Thus, it is important to discover new biomarkers to improve chances of survivability. We and others have shown that longitudinal measurements of circulating tumor cells (CTC) and lactate dehydrogenase (LDH) may aid in predicting response …

The Physical Activity Patterns And Constraints Of Diverse Female College Students, Kathleen Victoria Minkel

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diverse college aged females from a public university in the southwest were asked to participate in an online survey to determine their constraints to physical activity, as well as their current activity level. The groups were compared to establish the differences among the minority groups. Raymore, Crawford, and Godbey’s Hierarchical Model of Constraints was used as a framework when creating the survey. Data analysis showed only one significant difference among the racial/ethnic groups, when looking specifically at the intrapersonal, interpersonal, and structural constraints categories. Hispanic women differed significantly from Caucasian women in their perception of interpersonal constraints on their physical …

The Determinants Of Colorectal Cancer Survival Disparities In Nevada, Lucas N. Wassira

UNLV Theses, Dissertations, Professional Papers, and Capstones

Different population groups across Nevada and throughout the United States suffer disproportionately from colorectal cancer and its after-effects. Overcoming cancer health disparities is important for lessening the burden of cancer. There has been an overall decline in the incidence of and mortality from colorectal cancer (CRC). This is likely due, in part, to the increasing use of screening procedures such as Fecal Occult Blood Test (FOBT) and/or endoscopy, which can reduce the risk of CRC mortality by fifty percent. Nevertheless, screening procedures are routinely used by only fifty percent of Americans aged fifty years and older. Despite overall mortality decreasing …

Protocol Variation Analysis Of Whole Brain Ct Perfusion In Acute Ischemic Stroke, Peter T. Heiberger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Computed tomography perfusion (CTP) analysis is a rapidly advancing imaging modality that is improving diagnosis of brain abnormalities in patients suffering from hemorrhagic or ischemic stroke, traumatic brain injury, vascular occlusion and numerous other conditions. Through the advancements of computed tomography (CT) imaging, including the introduction of the 320-detector row CT with a 16 centimeter range in the z-axis enabling whole brain CTP, perfusion analysis now has a significantly increased clinical utility that is useful for both diagnosis and treatment of central nervous system (CNS) conditions. This study focuses on the procedural and analytical approach to the diagnostic evaluation of …

Vertical Transmission Of West Nile Virus In Culex Spp. Mosquitoes Of Clark County, Nevada, Vivek K. Raman

UNLV Theses, Dissertations, Professional Papers, and Capstones

West Nile Virus (WNV) is an RNA arbovirus that cycles between mosquitoes and birds, but also infects and causes disease in humans, horses and other vertebrate species. Although most infections are asymptomatic, WNV has emerged as the most common cause of epidemic meningoencephalitis in North America and the leading cause of arboviral encephalitis in the United States.

Mosquitoes of the genus Culex are the most active vectors of WNV in North America. Approximately 85% of human WNV infections in the United States occur in late summer with a peak number of cases in August and September. Vertical transmission is defined …

The Relationship Of Snowmobile Year, Track Length, And Riding Terrain To The Occurrence Of Musculosketetal Symptoms In Recreational Snowmobile Drivers, Erica L. Heisler

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this retrospective study was to examine the occurrence of musculoskeletal symptoms in recreational snowmobile drivers and relate them to the manufacture year of the snowmobile, the length of the track, and/or the riding terrain. Participants included 186 males and 57 females (n=243), aged 18 years and older, and were all snowmobile drivers. Subjects were asked to complete either an online survey or a paper survey to gather information about the year of snowmobile they drove, the track length of that snowmobile, the typical riding terrain they drove on, and any musculoskeletal symptoms they developed from driving snowmobile. …

Effects Of Environmental Prompts On Stair Usage, Lori Andersen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The objective of this study was to evaluate whether environmental prompts placed in two-story buildings on a university campus would increase stair usage. Three buildings were used. One served as a control, while the other two received an intervention. Participants of three buildings were observed taking the stairs and elevator for seven weeks. Baseline data was collected; signs were introduced, and then removed during this time period. Approximately 2700 observations were collected. Environmental prompts did not appear to increase stair usage. There were significant differences in the amount of stair users between buildings. The stair usage rates of this particular …

Development Of Software To Estimate Pressures On The Residual Limbs Of Amputees By Means Of A Pylon Mounted Transducer, Malli K. Yalamanchili

UNLV Theses, Dissertations, Professional Papers, and Capstones

The alignment of prosthesis has been recognized as one of the main factors that determine successful prosthetic outcomes for trans-tibial amputees. Alignment is defined as the relative position and orientation of the prosthetic components. Misalignment can result in changes in the position and orientation of the joints of the leg and moments experienced by them during gait, increases in energy use, and discomfort or even tissue breakdown at the socket/stump interface. Hence it is very important to align the prosthesis in correct manner. Gait analysis can be used to examine the effects of incorrect alignment of the prosthesis during gait. …

Donepezil And Galanin Interactions In An Animal Model Of Alzheimer’S Disease, Jonathan J. Sabbagh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer's disease (AD) is a neurodegenerative disorder marked by a progressive loss of cognitive function. One of the neurobiological hallmarks of AD is a progressive loss of cholinergic neurons and a decrease in the amount of acetylcholine in the brain. Pharmacological therapies have targeted the cholinergic system, specifically first-line, palliative treatment using acetylcholinesterase (AChE) inhibitors, such as donepezil. Donepezil has been shown to increase cholinergic tone and ameliorate some of the cognitive deficits in AD patients. Galanin, a neuropeptide that inhibits the evoked release of several neurotransmitters including acetylcholine as well as modulates seveal intracellular cascades, is overexpressed in AD …

Recent Accelerated Second-Degree Baccalaureate Graduates’ Perceptions Of Educational Preparation, Susan Candelaria

UNLV Theses, Dissertations, Professional Papers, and Capstones

As of 2008, the U.S. Department of Labor is predicting a need for greater than one million new registered nurses by the year 2016 (American Associations of Colleges of Nursing [AACN], 2008). One way that nursing schools around the country are dealing with this issue is through the creation of accelerated second-degree programs for non-nursing graduates.

The purpose of this descriptive study was to examine the perceptions of educational preparation of accelerated second-degree baccalaureate graduates, who have been out of school for at least one year, but no longer than four years. The sample consisted of 54 graduates from an …

Macrophages Loaded With Gold Nanoshells For Photothermal Ablation Of Glioma: An In Vitro Model, Amani Riad Makkouk

UNLV Theses, Dissertations, Professional Papers, and Capstones

The current median survival of patients with glioblastoma multiforme (GBM), the most common type of glioma, remains at 14.6 months despite multimodal treatments (surgery, radiotherapy and chemotherapy). This research aims to study the feasibility of photothermal ablation of glioma using gold nanoshells that are heated upon laser irradiation at their resonance wavelength. The novelty of our approach lies in improving nanoshell tumor delivery by loading them in macrophages, which are known to be recruited to gliomas via tumor-released chemoattractive agents. Ferumoxides, superparamagnetic iron oxide (SPIO) nanoparticles, are needed as an additional macrophage load in order to visualize macrophage accumulation in …

The Influence Of Perspective And Gender On The Processing Of Narratives, Jeremy A. Houska

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overarching aim of this research was to examine potential boundary conditions to situation model construction (Experiment 1) and narrative-based persuasion (Experiment 3). Variables such as narrative perspective (i.e., 2nd or 3rd person) and matched characteristics with the reader (i.e., participant-protagonist gender match) were first examined using situation model updating (Experiment 1) and behavioral measures (Experiment 3) as dependent measures. It was expected that situation model updating would be more likely for narratives written in the 2nd person perspective and with a participant-protagonist gender match. It was uncertain, however, for health promotion narratives, whether these manipulations would increase the likelihood …

The Live Experience Of Non-Degree Learners From A Time Modified Traditional Baccalaureate In Nursing Program, Stephanie S. Deboor

UNLV Theses, Dissertations, Professional Papers, and Capstones

By the year 2016, it is projected that a million new and replacement nurses will be needed throughout the United States. The traditional 4-year baccalaureate program alone cannot adequately sustain this demand. The immediacy of the current nursing shortage demands our educational systems respond by building and maintaining a workforce that is sufficient to support the health care needs of our society. In an attempt to meet this challenge, nursing schools around the country began exploring the option of creating accelerated programs for those who already possess a bachelor's degree in another field without compromising the integrity and quality of …

Neutron Flux And Energy Characterization Of A Plutonium-Beryllium Isotopic Neutron Source By Monte Carlo Simulation With Verification By Neutron Activation Analysis, Zachary R. Harvey

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this research was to characterize the neutron energy distribution and flux emitted from the UNLV plutonium-beryllium source, serial number MRC-N-W PuBe 453. This was accomplished through the use of the MCNPX/5 Monte-Carlo particle transport code to simulate radiation interactions within the physical environment of the source and its surroundings. The moderating drum currently containing the source as well as all of the sampling ports were accurately modeled in MCNPX/5. This geometry was then used to simulate the neutron interactions taking place in these geometries. The results of the simulations were then verified by the use of specifically …

Comparison Of Body Composition Between Physically Active And Inactive Wheelchair Users, Masaru Teramoto

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to examine the association between regular physical activity and body composition in individuals with physical disabilities. The study was designed to compare body composition parameters between wheelchair users participating in adapted sports programs and those being physically inactive. Male wheelchair users were recruited and classified based on physical activity level (active or inactive) and disability type (paraplegic or quadriplegic). Regional and whole-body percent body fat (%BF), lean body mass (LBM), and bone mineral density (BMD) were assessed by dual-energy X-ray absorptiometry. These variables were then compared among the groups using a two-way between-groups multivariate …

Nursing Compliance With Standard Fall Prevention Protocol Among Acute Care Hospital Nurses, Anuradha Thirumalai

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of the study was to determine the level of nursing compliance in implementing Fall Prevention Protocol (FPP) in an acute care hospital in a high fall risk patient population and to identify the barriers in complying. This study is important because falls are considered one of the nursing-sensitive quality indicators. The AACN Synergy model for patient care was used as the organizing framework for this study. A total of 24 nurses participated in the study, and a total of 29 high fall risk patients were assessed. The degree of compliance among nursing staff was measured using the modified …

Relative Deprivation, Relative Gratification, Status, And Health, Samuel A. Holland

UNLV Theses, Dissertations, Professional Papers, and Capstones

The role of perceived inequity in health was assessed and compared to other social constructs predicted to be relevant in the relationship between inequity and health. Four studies were conducted that demonstrated that a social comparison-based measure of relative deprivation (RD) and relative gratification (RG) can predict health and continues to do so even after accounting for perceived stress, personal income, perceived control, and social participation. A measure of RD/RG was developed that was based on prominent social comparisons and objects of comparison. This measure was reliable and predictive of health in two samplings of different populations. Comparisons of the …

Cultural Competence Of Rn To Bsn Students, Dierdre Michelle Riley

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this exploratory research study was to examine the cultural competence of registered nurses returning to school for an RN to BSN program in Nevada. Campinha-Bacote's model, The Process of Cultural Competence in the Delivery of Healthcare Services, was used as a theoretical framework for the study. A secondary analysis of data collected as part of a Health Resources and Services Administration (HRSA) Grant was completed. Fifty-three RN to BSN students voluntarily completed the Inventory for Assessing the Process of Cultural Competency Among Healthcare Professionals- Revised (IAPCC-R) electronically in the learning management system of the first nursing course …

The Relationship Of A Long-Term Exercise Program And Selected Coronary Risk Factors, Maryse Wells

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to investigate body composition and blood pressure as potential risk factors for coronary artery disease after 3 years of participation in a structured exercise program. The sample group was comprised of 21 male participants (66%) and 11 (34%) female participants with a mean age of 55 years who attended the exercise program and completed health and fitness testing annually. Participants did cardiovascular, strength, and flexibility training 5 days a week with an average attendance of 70%. After 3 years, BMI, waist circumference, and percent body fat increased significantly (p < .01); blood pressure levels did not change significantly (p > .05). Low control of diet …

Health Care Access Disparities Among Children Entering Kindergarten In Nevada, Nadia Deashinta

UNLV Theses, Dissertations, Professional Papers, and Capstones

Access to health care is an important factor for the well-being of America's children. The principal goal of this study was examine the 2008-2009 Kindergarten Health Survey data to advance understanding and appreciation of the health status of children in addition to their discrepancies in accessing health care in the state of Nevada (n = 11,073). This dataset serves as a secondary data source to determine whether socio-demographic and medical factors are associated with disparity in accessing health care for children entering kindergarten. This study looked at both independent and combined effects of annual household income, race/ethnicity, primary language spoken …

Implementation Of The Wiegand Sun Safety Program Into Physicians’ Offices In Southern Nevada, Breanne Eddington

UNLV Theses, Dissertations, Professional Papers, and Capstones

In this study Nevada Cancer Institute’s Wiegand Sun Safety Program was implemented in 14 clinics in Southern Nevada as a pilot run to increase awareness in children and their guardians through educational materials in pediatricians’ and family physicians’ offices. It was hypothesized that the increased display of information regarding sun safety and skin cancer in physicians’ offices would increase patient and guardian awareness of the subject and increase the likelihood of patients and/or guardians asking their physician questions about skin cancer and sun safety, resulting in an increase in preventive actions by guardians to protect their children from damaging rays …

Use Of An Animal Model To Explore Prenatal Predictors Of Insulin And Glucose Metabolism In Southwestern Alaskan Yupiit, Julie Jo Kachinski

UNLV Theses, Dissertations, Professional Papers, and Capstones

Compared to other North American indigenous populations, Southwest Alaskan Yupiit exhibit very low rates of type 2 diabetes despite the occurrence of common risk factors. Contemporary Yupiit obtain a substantial portion of their calories from traditional foods, which contain high amounts of omega-3 polyunsaturated fatty acids. Epidemiological and experimental animal research has linked glucose and insulin homeostasis with a diet high in omega-3s. This study used an experimental animal model to explore potential diabetes protective effects (for adult offspring) of prenatal maternal nutrition modeled on traditional locally-obtained Yupiit diets. The results of this study showed that the adult offspring whose …

Oral Cancer In Nevada: A Public Health Perspective, Karl Kingsley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer is the second leading cause of death in the United States, and oral cancer remains the eighth leading cause of cancer death among US males. Although previous epidemiologic studies have found that overall rates of cancer, including oral cancer, have declined in the US in recent decades – these declines are neither uniform nor consistent within this population. Anecdotal evidence has suggested that rates of oral cancer in Nevada are relatively high, although no evidence was available to support these assertions.

Oral Cancer Epidemiology: Based upon this information, a detailed and thorough epidemiologic examination of oral cancer rates in …

An Evaluation Of Lead In Imported Candies Within Clark County, Nevada, Usa, Lee Reuben Ibarra

UNLV Theses, Dissertations, Professional Papers, and Capstones

Imported candies from Latin America pose a danger to children because of the potential for those candies to contain harmful levels of lead. This study sought to identify characteristics of imported candies that typically display higher concentrations of lead. This study also explored the Integrated Exposure Uptake Biokinetic model developed by the EPA. Using lead exposure data specific to Clark County, Nevada, the IEUBK model was used to estimate the amounts of candy a child would have to consume in order to raise his blood lead level to over 10µg/dL (the federal allowable limit).

The results showed that candies with …

Self-Efficacy And The Predictors For Nclex-Rn® Success For Baccalaureate Nursing Students, Linda Anne Silvestri

UNLV Theses, Dissertations, Professional Papers, and Capstones

The National Council Licensure Examination for Registered Nurses (NCLEX) is the examination that nursing graduates must pass to attain the title of registered nurse and practice professionally. Each year a substantial number of nursing graduates are unable to enter the nursing profession because of failure on the NCLEX. Failure on this examination is a concern, especially since this country desperately needs nurses. Currently, the United States (U.S.) is faced with a nursing shortage. This shortage significantly impacts the U.S. health care system and requires urgent attention so that the health care needs of the people in this country are met. …

The Interim Window: Women’S Experiences During In Vitro Fertilization Leading To Maternal Embryo Attachment, Tammy Mackinnon Lampley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Infertility affects about 7.3 million women and their partners in the U.S., about 12% of the reproductive-age population. In vitro fertilization (IVF) has been used successfully in the United States since 1981. The number of women seeking artificial reproductive techniques (ART) has increased dramatically and the number of ART cycles performed in the United States has more than doubled, from 64,681 in 1996 to 134,260 in 2005 and 99% of these are IVF. Studies indicated that women rank waiting for the outcome of and IVF treatment and a negative pregnancy result as the most stressful events during their treatment. Although …

Association Of Body Mass Index, Fruit And Vegetable Intake, And Acculturation In A Sample Las Vegas Hispanic Population, Anne L. Bolstad

UNLV Theses, Dissertations, Professional Papers, and Capstones

The U.S. is experiencing a rising prevalence of overweightedness that has been identified as the second leading cause for chronic health conditions threatening public health. Overweightedness has grown disproportionately among ethnic sub-groups. In the fastest going minority population in the U.S., Hispanic Americans are observed with disparately high body mass index, placing them at heightened risk for poor health outcomes. Research suggests five servings of fruit and vegetables, in any combination, provides a sound nutritional base for healthful living and helps to maintain normal body weight.

Americans are known to have poor eating habits while foreign-born populations have well balanced …