Medicine and Health Sciences Commons^™

Recruitment And Advocacy For Clinician Involvement In Pro Bono Physical Therapy Service-Learning Program, Gilberto Carrillo, Gavin Brady, Felicia Doblado, Alyssa Woo Hatch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Service-learning allows Doctor of Physical Therapy (DPT) students to develop important professional skills and addresses community-based needs. When integrated into physical therapy education, it can be a powerful tool for increasing students' altruism and social responsibility. Many clinicians desire to participate in pro bono physical therapy (PT) services. Therefore, the responsibility of promoting and advertising these programs falls upon the student. This paper describes various methods for recruiting clinician involvement to improve the sustainability of a student led pro bono clinic, as well as how the students advocated for pro bono services in the state of Nevada …

Stepping On Fall Prevention Project, James P. Gaddi, Jordan T. Bowers, Lea M. K. Fung

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Falls are a major problem in the United States among the older adult population and provide opportunity for community outreach via student-led physical therapy projects. Objective: The purpose of this project was to investigate the relationship between fall related outcome measures and questionnaires with the completion of the Stepping On Fall Prevention program along with evaluating the benefits of Physical Therapy student development with participation in service learning projects. Methods: The research quantified the fall risk of 13 participants with assessment of: gait speed (Timed Up and Go), lower extremity strength (30-Second Chair Stand), balance (4-Stage Balance Test), and …

Effects Of Bimodal Transcranial Direct Current Stimulation On Modulation Of Spinal Circuitry In People With Chronic Post-Stroke Hemiparesis, John Patrick Gan, Rafael Cabrera, Lana Laudermilch, Benjamin Wolkenhauer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Stroke can lead to gait abnormalities such as foot drop. Foot drop can result from decreased corticospinal tract input to the ankle dorsiflexors and/or from exaggerated stretch reflexes on the soleus due to reduced reciprocal inhibition from spinal reflex pathways. Transcranial direct current stimulation (tDCS) attempts to modulate corticospinal tract input and spinal reflex pathways by delivering electrical signals to parts of the brain. The degree of neuromodulation from tDCS can be measured through the Hoffman Reflex (H-reflex)—a tool used to estimate alpha motor neuron excitability which is increased in individuals post-stroke. Purpose: The primary purpose of this study …

Quality Assurance Of Service Learning Back School, Eric Bashaw, Vu Pham, Tyler Parvin, Ryan Pauly

UNLV Theses, Dissertations, Professional Papers, and Capstones

Project Execution: Back School: During the 2019-20 academic year, two University of Nevada, Las Vegas Physical Therapy (UNLVPT) core faculty members, along with eight doctor of physical therapy students, provided three student-led, pro-bono back school classes at Volunteers in Medicine of Southern Nevada (VMSN). Each back school class consisted of two, 2-hour sessions where participants were screened for red flags, educated on pain management strategies and common causes of back pain, and given an individual home exercise program. Quality Assurance Surveys: Patient’s and VMSN staff were all given questions in the form of Likert-scale and open-ended questions via printed handouts …

Is Decreased Trunk Flexion Angle A Contributing Factor To Patellofemoral Joint Loading In Runners With Patellofemoral Pain?, Christine Duvall, Zachary Clark, Tavin Fox, Caitlin Howden

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Reduced trunk flexion during running is theorized to be a contributing factor of elevated patellofemoral joint (PFJ) stress in runners with patellofemoral pain (PFP); thus, the primary purpose of this research study was to determine if runners with PFP would exhibit differences in PFJ stress and trunk flexion angle during running as compared to pain-free runners across three speeds. We hypothesized that runners with PFP would exhibit higher PFJ stress and decreased trunk flexion while running compared to the pain- free runners. Number of Subjects: 7 runners with PFP and 5 similar pain-free control runners. Materials/Methods: Kinematics and kinetics …

A Vicious Cycle Of Fear Of Falling Avoidance Behavior In Parkinson’S Disease: A Path Analysis, Kameron Jacobson, Nicole Matsunami, Hannah Mccarl, Michelle Regis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Postural instability (PI) in Parkinson’s disease (PD) is associated with several negative down- stream consequences. Objective: The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance con!dence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI. Methods: A path analysis of cross!sectional data from 55 participants with PD was conducted. The four con- structs in the model connected in succession were: 1. PI (principal …

Essential Competencies For Occupational Therapy In End-Of-Life Care, Karmella Bognot

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists carry an abundance of expertise in helping patients and caregivers navigate the end-of-life journey. The lack of knowledge of OT’s role impacts occupational therapy utilization and service provision in hospice. It reduces opportunities for this population to increase their understanding on how to maintain quality-of-life. The more a patient is able to do lessens the burdens shouldered by the caregiver. Education on pain management and promoting comfort are typical priorities addressed; however, not enough training is focused on maximizing independence or engagement in occupations. Competencies encompass a unique set of skills, knowledge, and abilities necessary for successful performance …

Health And Wellness Competencies For An Entry-Level Doctorate Occupational Therapy Course, Teresa Liccardo

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Accreditation Council for Occupational Therapy Education (2018) standards state that the entry-level occupational therapy curriculum must prepare students to practice in a broad range of practice settings, including new and emerging areas of occupational therapy. Health and wellness remain an emerging and not widely populated area of occupational therapy despite the growing research on its importance. Stancanelli (2020) stated that “with the expected growth of health care in the community and the expected increase in the older adult population, occupational therapy students need to be prepared to practice in the community and address health promotion and wellness needs of …

Improving Therapeutic Communication In Mental Health Nursing: A Quality Improvement Project, Patricia A. Nill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 46 million adults in the United States (U.S.) live with a mental illness. Locally in Nevada, the psychiatrist to patient ratio is approximately 700:1, and patients are seen primarily in the inpatient setting, if seen at all, due to the wait average of 85 hours in the hospital emergency rooms for access into mental health hospitals or specialty units of a general hospital. Moreover, costs for mental health mood disorders alone are estimated at over seven million dollars annually. The Institute of Medicine (IOM) opined the need for change in healthcare to redesign practice and clinical communication with patients …

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 …

Nursing Toolkit For Care Of The Pediatric Patient With Suicidal Ideation, Christine Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nevada’s pediatric suicide rate is one of the highest in the country. Many patients require inpatient stabilization, either in an emergency department setting or on a pediatric unit, until they are ready for discharge to home or a subsequent behavioral health facility. In many instances, patients are assigned to nurses who have had no formal training on caring for pediatric patients with suicidal ideation. Providing care for these patients can increase nurses’ emotional stressors. Purpose: The purpose of this DNP project was to increase the knowledge of pediatric nurses in Nevada using a nursing toolkit containing information to aid in …

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 …

Transient Ischemic Attacks Evaluation And Management In Specialized Urgent Care Facilities, Zandra Kay Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: Transient ischemic attacks (TIA) are a health problem that affects many people each year. A local Las Vegas organization allowed this DNP student to develop and implement an intervention to increase the perceived ability of providers to manage low-risk TIAs in specialized urgent care facilities. The aim was to raise the comfort level of providers at on-demand medicine also known as urgent care. Additional goals were to increase awareness of stroke and TIA symptoms and educate providers on the new TIA guidelines.

METHODS: This quality improvement DNP study used a convenience sample of 30 providers. Eleven participants completed the …

Increasing Perioperative Outpatient Nurses’ Knowledge Of Pediatric Anxiety Through Use Of A Developed Clinical Guide, Christine Oliver

UNLV Theses, Dissertations, Professional Papers, and Capstones

Elevated perioperative anxiety levels in the pediatric population is a main concern when providing nursing care in a specialty area. In the United States, over five million pediatric patients will have some type of surgery each year and greater than 65 percent of those pediatric patients will exhibit preoperative anxiety. The care of pediatric patients in the outpatient surgical setting has grown significantly, and pediatric care is no longer restricted to specialized facilities or hospitals. This increased number of pediatric patients in day surgery centers has created a shift in nursing care for perioperative nurses. Anxiety has been directly related …

An Intervention To Improve Nurses’ Knowledge, Perceived Safety, And Confidence In Identifying And Managing Workplace Violence: A Translation Of Evidence Into Practice, Kayla Sullivan

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Occupational Safety and Health Administration (OSHA) reports that over two million workers are victims of workplace violence (WPV) (Papa, 2013). Registered nurses are subjected to high risk for workplace violence from patients and visitors, with 25.5% reporting at least one victimization incident (Gillespie et al., 2013). Research indicates that WPV has a significant impact on nurses' quality of working life, job satisfaction levels, turnover rates and has also been shown to negatively impact efficiency and productivity (Gacki-Smith et al., 2009). ED nurses are at substantial occupational risk for workplace violence. Emergency departments have been identified as areas within the …

Comparison Of 12-Hour Biweekly Shifts Versus 6-Hour Weekly Shifts On Learning Outcomes And Fatigue In Nursing Students On Dedicated Educational Unit, Alena Grewal

UNLV Theses, Dissertations, Professional Papers, and Capstones

Clinical experiences in nursing programs may take many forms and the goal of integrating clinical is to combine knowledge and skills learned in the classroom into the clinical practice setting. The Dedicated Educational Unit is an innovative approach in the State of Nevada and has demonstrated success in closing the gap between education and clinical practice. The Dedicated Educational Unit model is used for the medical-surgical clinical rotations at a local university and has been largely successful. However, some challenges affecting student learning have recently arisen that are not inherent to the Dedicated Educational Unit model. Challenges voiced by nursing …

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 …

Opioid And Naloxone Training In A Rural School District, Allyson C. Waldron

UNLV Theses, Dissertations, Professional Papers, and Capstones

The opioid epidemic is a national health emergency in the United States, with over 128 people dying each day due to an opioid overdose. It is estimated that 4.3 million people over the age of 12 use opioids without a medical need, and 1.3 million youth ages 12-17 use opioids inappropriately. Drug overdose deaths have become the leading cause of accidental death in the United States, prompting the U.S. Surgeon General and the World Health Organization to advise that more Americans have access to naloxone and understand how to use this life-saving drug correctly. Naloxone is an opioid antagonist, used …

Acute Care Nurse Practitioners’ Role In The Icu: A Retrospective Analysis Of Central Line Access Delays For Patients In Septic Shock, Violeta Aguirre

UNLV Theses, Dissertations, Professional Papers, and Capstones

Morbidity and mortality related to sepsis management have been popular research topics for a significant part of the last two decades. The Surviving Sepsis Campaign was launched in 2002 with goals to develop medical management guidelines, improving diagnosis by building awareness, expanding healthcare provider education, and improving appropriate treatment (Society of Critical Care Medicine [SCCM], 2019). Professional organizations and governing bodies continuously revise guidelines for the early identification and treatment of sepsis. The latest treatment recommendations for the Hour-1 Bundle of sepsis management (SEP-1) include initiating vasopressors in conjunction with fluid resuscitation to reach the hemodynamic goal of maintaining a …

The Role Of Nutrition And Hormone Signaling In Extended Larval Development And Obesity In Starvation-Selected Drosophila Melanogaster, Jennifer M. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

Brief periods of starvation are a common stressor that most animals encounter in the wild and must be able to survive in order to maximize their fitness. Starvation resistance of the adult fruit fly, Drosophila melanogaster, is thought to be primarily conferred by adult fat stores, body size, metabolic rate, behavior, and activity levels. Additionally, flies selected for starvation resistance also often show delayed pupariation, which is usually indicative of altered hormone signaling. How starvation selection extends development and if it contributes to adult starvation resistance remains incompletely studied. Identifying the targets of starvation selection that cause extended development and …

Improving Self-Care Measures Of Hypertension Through Implementation Of An Education And Action Plan, Crystal Celeste Huffaker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hypertension (HTN) is a leading cause of morbidity and mortality worldwide and one of the most common conditions seen by primary care providers. Current clinical practice guidelines recommend lifestyle modifications for patients with elevated blood pressure (BP) and diagnosed HTN. Despite these recommendations, many patients diagnosed with HTN make insufficient modifications to their lifestyle. The purpose of this project was to determine the impact of implementing an education session, with development of a patient action plan, along with 4-week, 8-week, and 12-week follow-ups on the adoption of self-care measures for HTN. Participants had their BP, height, and weight measured along …

Factors Influencing The Self-Reported Palliative Care Practices Of Acute Care Nurses, Keshia Ryan Kotula

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction Approximately 40 million people are currently in need of palliative care (PC), and this number is predicted to increase due to the aging population and increasing longevity. Providing PC in the acute care setting leads to better quality and clinical outcomes, reduced inpatient hospital costs, and improved efficiency. Despite evidence indicating the benefits of PC, timely referrals and provision of PC in the acute care setting are lacking in part due to the complex interplay of factors that nurses must navigate, such as limited preparation, knowledge, and self-efficacy; nurse/provider attitudes; and patient/family and institutional barriers. A paucity of research …

Food Insecurity And Risky Sexual Behaviors Among College Students, Bertille Octavie Mavegam Tango Assoumou M

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity and sexually transmitted infections (STIs) are growing public health problems in the United States. Young people in general, and particularly college students, exhibit high prevalence of food insecurity, STIs, and risky sexual behaviors (RSB). Food insecurity and STIs among college students can have short- and long-term impacts on their academic success and their lives. Several studies have reported an association between food insecurity and some risky sexual behaviors among specific populations including HIV-infected people and homeless people. However, little is known about the relationship between food insecurity and RSB among college students. Given the high prevalence of food …

Developing Strategic Partnerships To Impact Population Health: A Professional Development Module, Andra S. Scano

UNLV Theses, Dissertations, Professional Papers, and Capstones

Massive organizational changes occurring in our health care delivery system have provided opportunities for nurse leaders who think in terms of population health, to develop new skills needed to impact the populations they serve. Aspects of these changes include a focus on the delivery of primary and community-based care and the development of partnerships, alliances, and other linkages across settings to build integrated systems (Williams, 2020, p. 17). Turner (2020) asserts that population-focused nurse leaders are charged with creating a new future for healthier communities which often involves strategic partnership development. However, strategic partnership development is a complex task that …

Disrupting Gender Normativity Through A Social Learning Framework, Ashley Shank

UNLV Theses, Dissertations, Professional Papers, and Capstones

Through a social learning theoretical framework, this thesis seeks to understand the mechanisms by which gender normativity is perpetuated, as well as how it may result in the marginalization of transgender and gender nonconforming (TGNC) youth. Additionally, ways in which TGNC youth navigate oppression and how discrimination against TGNC youth may be reduced through disruption of gender normativity are explored. Using qualitative methods that include the analyzation of community meeting transcripts as well as townhall meetings with TGNC/queer community members, the present study will attempt to answer the following research questions through a social learning theoretical framework: 1. How can …

Food Insecurity And Adiposity Among Children And Adults Nhanes 2015-2016, Denise Vidal

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Obesity is a preventable disease that has been associated with many adverse health outcomes. A possible factor that may influence adiposity development is food insecurity. Although several epidemiological studies have been conducted examining the association between food insecurity and adiposity among children and adults, results have been inconsistent. Objective: This cross-sectional study investigates the relationship between food insecurity and adiposity among children and adults using recent data from a representative sample of the US population. Methods: We examined 3,391 adults and 2,837 children from the National Health and Nutrition Examination Survey (NHANES) 2015-2016. Household food insecurity was assessed using …

Social Emotional Learning As A Universal Upstream Approach To Youth Suicide Prevention: A Secondary Data Analysis Of A Prevention Program Evaluation, Maria Amaris Knight

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Nevada has had consistently high rates of youth suicide in the past decade with 21.2 deaths by suicide per 100,000 population (ages 15-24), over the national rate of 14.5 deaths per 100,000 in 2019. National strategies, state agendas, and best practices in the field prioritize research on upstream strategies to prevent suicide. One such strategy is the use of social emotional learning (SEL) programs for youth to help increase and enhance protective factors against suicide, helping them to cope with negative life events. Research has identified leading outcomes of SEL programs as the improvement of attitudes, behaviors, and academic …

Development Of A Novel Cognitive-Motor Dual Task Assessment Battery In Neurodegenerative Disease, Jason Longhurst

UNLV Theses, Dissertations, Professional Papers, and Capstones

Automaticity --- the ability to perform a task with directing attentional resources to its completion --- is commonly reduced among individuals with neurodegenerative diseases. These automaticity deficits result in impaired functional and daily activities and are sensitive to subtle, subclinical impairments. However, current measurement of automaticity by dual task paradigms is methodologically limited. In order to gain insight into the current state of the literature regarding cognitive-motor interference in symptomatic and prodromal neurodegenerative disease, the author of this dissertation conducted a scoping review (Chapter 1). To address the methodological limitations of current measurement of automaticity, a new measurement tool was …

Does Social Support Moderate The Association Between Income And Food Security Status Among Seniors Living In Southern Nevada?, Adugna Teka Siweya

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Income is the strongest predictor of food insecurity among seniors, and social support also an essential factor to help mitigate the effects of food insecurity. However, little is known about the potential role that social support may play as a moderator of the association between income and food insecurity. Thus, we aim to examine social support as a moderator for the relationship between income and food insecurity among seniors. Methods: Logistic regression models were used to analyze data collected in 2019 from seniors residing in Southern Nevada. Predictors of food insecurity, sociodemographic factors, social support variables, and income and …

Depression And Quality Of Life Among Adults With Asthma Presence In Nevada, Elizabeth D. Kahane

UNLV Theses, Dissertations, Professional Papers, and Capstones

Asthma is a lung disease that causes coughing, chest tightness, wheezing, and breathlessness. It is often controlled by medication use and avoidance of environmental triggers. It is a leading chronic, non-communicable disease affecting over 19 million adults in the United States (CDC, 2020a). Asthma and severe asthma have been shown to negatively affect mental health and quality of life among adults including limiting physical activity, lowering sleep quality, exacerbating economic challenges, missing work, and increasing healthcare use (Stanescu, et al., 2019). Approximately 8% of adult Nevadans reported current asthma symptoms and 12.6% reported having a diagnosis during their lifetime (CDC, …