Medicine and Health Sciences Commons^™

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 …

The Effect Of Asynchronous Versus Synchronous Online Course Delivery On Hesi Scores And Student Engagement For Rural Pre-Licensure Nursing Students, Susan Luke Belliston

UNLV Theses, Dissertations, Professional Papers, and Capstones

Since nurses are the primary providers of direct patient care in the United States, a shortage in any community can impact the quality of health care available. Rural areas were among the first to be affected by the current nursing shortage. Further challenges to the rural nurse supply include a lack of access to nursing education, particularly baccalaureate education.Both distance and online education options allow for the increased reach of higher education to rural areas. Existing nursing education literature focuses on graduate nurse education and baccalaureate completion education. The pre-licensure nursing student is mostly absent from the existing literature concerning …

Association Between White Matter Hyperintensities, Cortical Thinning, And Clinical Outcomes In Mild Traumatic Brain Injury, Thomas Helmut Knoblauch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Traumatic Brain Injury (TBI) is a global health challenge, with over 4.6 million confirmed cases annually in North America alone. Mild traumatic brain injuries (mTBIs) are the most common and make up approximately 81% of all TBI diagnoses worldwide [1]. Studies indicate that 10–15% of patients suffer from trauma induced symptoms (i.e. headache, loss of balance, cognitive impairments, fatigue, and mental health/affective disorders) as far as 1 year post injury [2]. Prediction and management of these post-traumatic sequalae is complicated by a lack of symptom associated neuroimaging findings. In spite of a “prominent distribution” of frontotemporal WMHs in pediatric subjects …

How Does Stress And Coping Impact Undergraduate Students' Mental Health On A Racially Diverse Campus?, Kristina Ricker-Boles

UNLV Theses, Dissertations, Professional Papers, and Capstones

The study focuses on how subjective stress and mastery skills impact physical and mental wellbeing among UNLV undergraduate college students. Bovier, Chamot, and Perneger’s (2004) study was repeated within a racially diverse campus setting. The Transactional Model of Stress and Coping provided the foundation of this study with an emphasis on primary and secondary appraisal among racial and ethnic groups. The study utilized the Pearlin Coping Questionnaire, the Short Form-12 (SF-12), the Brief Encounter Psychosocial Instrument (BEPSI), and Duke-UNC Functional Social Support Questionnaire to assess subjective stress, mastery skills, and the moderator of social support while comparing the results among …

Exploring The Lived Experience Of Early-Career Millennial Nursing Faculty: Deriving Meaning From Their Perspective, Adrian Stamps

UNLV Theses, Dissertations, Professional Papers, and Capstones

An innovative way to combat the protracted nursing faculty shortage is to recruit up and coming generations of nurses to academia. The most recent generation to enter the academic ranks are millennials, often categorized in nursing by a birth year between 1981 and 2000. In contrast to preceding generations, millennials are seeking roles in academia earlier in their careers. Research has shown millennials have unique perspectives on the workplace and a tendency to leave positions if they are not satisfied. This pattern could pose a challenge for sustaining the nursing faculty workforce.

How millennials perceive their initial years in the …

Fluctuating Cohesion: A Grounded Theory Study Of Nursing Students Engaged In A Hybrid Debriefing Format, Carol Lynn Senette

UNLV Theses, Dissertations, Professional Papers, and Capstones

Debriefing is a key component of simulation that promotes development of students’ reflective processes. Instructor-led debriefing (ILD) is considered the gold standard; however, research conducted over the past decade demonstrates the negative effects of anxiety on student reflection during ILD. Nursing students’ experiences with ILDs have been substantially investigated; yet scant research explores students’ perceptions and experiences of more learner-centered debriefing formats that deemphasize the instructor role.

The purpose of this grounded theory study was to explore undergraduate nursing students’ perceptions and experiences of a hybrid debriefing format consisting of peer-led debriefing followed immediately by ILD. Specifically, I aimed to …

Becoming Myself: A Constructivist Grounded Theory Study Of The Gender Transition Experiences Of Practicing Nurses, Rhiannon Dawn Sullivan

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to construct a substantive grounded theory specific to the gender transition experiences of practicing nurses in their personal and professional lives and to explore the barriers and facilitative factors to gender transition for practicing nurses. There has been research regarding transgender individuals’ discrimination experiences in their daily lives related to their gender identity. These negative experiences increase their vulnerability to negative health outcomes, such as anxiety, substance abuse and depression. However, there is very little known about practicing nurses who are transgender. This research is important because the mental and physical health of nurses …

Validation Of Novel Obstructive Sleep Apnea Treatment With Silicone Gel Experimental Models, Dustin Walter Burd

UNLV Theses, Dissertations, Professional Papers, and Capstones

Predictive modeling to increase treatment success rates for surgical procedures is becoming more common in the scientific community. For obstructive sleep apnea (OSA), modeling has been predominately performed using computers as opposed to experimental models. Computer simulation saves time by eliminating the need to fabricate complex experimental models but comes at the expense of insight gained through physical observations made in real time. Experimental models for studying OSA are needed to validate computational work, provide perspective on anatomical scale and demonstrate complex deformations in real time. This work addresses prior hurdles in experimental model fabrication with a novel process using …

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 …

The Relationship Among Sociocultural Assimilation, Dietary Behavior, And Physical Activity In Adult Latinxs In The U.S., Erick Lopez

UNLV Theses, Dissertations, Professional Papers, and Capstones

This dissertation examines the relationship between sociocultural assimilation and health behaviors among adult Latinxs in the United States to address whether different assimilation models promote or hinder Latinx health. Existing research on assimilation and health behaviors among Latinxs relies heavily on the use of proxy measures of assimilation such as length of time in the U.S., nativity, age of arrival, and language preferences for surveys. These studies tend to show that greater assimilation to mainstream U.S. culture among Latinxs is associated with the adoption of poor health behaviors and the erosion of the immigrant health advantage. Research that uses sociocultural …

An Exploration Of The Numeracy Skills Required For Safe, Quality Nursing Practice, Anna Wendel

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to explore the numeracy skills required for safe, quality nursing practice. Using a descriptive mixed methods design, this study answered two research questions: 1) What numeracy skills do nurses perceive as important for providing safe, quality nursing care in the first three years of practice? 2) How do nurses incorporate numeracy skills into daily patient care during the first three years of practice? Early career nurses from a not-for-profit health care organization in the mid-Atlantic region of the United States (n=109) responded to an online survey tool developed by the student investigator that ranked …

An Intervention To Increase Nurses’ Knowledge Of Non-Opioid Pain Management In Post-Operative Elective Knee And Hip Replacement Patients, Kristen K. Grunerud

UNLV Theses, Dissertations, Professional Papers, and Capstones

Post-operative pain control is an enduring problem in health care. The extensive use of opioids since the 1980s has contributed to the current opioid crisis in the United States. In response, healthcare providers have begun to use a more biopsychosocial model to address pain control needs of patients. There is a demonstrated gap in knowledge for nurses in this area, and recent changes to hospital accreditation standards include a requirement to demonstrate both education provisions to staff and the use of non-opioid methods to control pain. The purpose of this Doctor of Nursing Practice (DNP) project was to assess, and …

The Influence Of Cerebellar Transcranial Direct Current Stimulation On Motor Function In Parkinson’S Disease, Lidio Lima De Albuquerque

UNLV Theses, Dissertations, Professional Papers, and Capstones

Parkinson's disease (PD) is the most common movement disorder and the second most common neurodegenerative disorder. PD is characterized by dopaminergic cell loss in the substantia nigra pars compacta, which leads to a reduction in dopamine in the striatum. These physiological mechanisms lead to a number of motor impairments such as bradykinesia, rigidity, tremor, and postural instability that severely limit the ability of individuals with PD to perform many essential daily living activities. Although current pharmacological, surgical, and physical exercise treatment approaches are valuable they are either only mildly effective, expensive, or associated with a variety of side effects. Therefore, …

The Prevalence And Predictors Of Complementary And Alternative Medicine (Cam) Use Among Racially/Ethnically Diverse College Students, Hermella Misiker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: National data on complementary and alternative medicine (CAM) use, available through the National Health Interview Survey (NHIS), convey higher prevalence of CAM use among college students compared to the general U.S population. NHIS findings also highlight non-vitamin non- mineral (NVNM) products are the most widely used form of CAM in the U.S. The purpose of this study was to identify the socio-cognitive and demographic predictors of CAM and NVNM use among a racially/ethnically diverse college student body.

Methods: An online survey was used to collect data from 392 University of Nevada, Las Vegas (UNLV) undergraduate, graduate, and professional students. …

Examination Of Factors Reported By Athletes To Interfere With Their Lives Outside Of Sports, Jesse Scott

UNLV Theses, Dissertations, Professional Papers, and Capstones

The original Sport Interference Checklist (SIC) is a mental-health screening instrument designed to assess the extent to which mental health factors interfere with athletes’ performance during sport training or competition. In addition, the SIC appraises whether athletes are interested in pursuing psychological treatment for the aforementioned factors. Although validated, the SIC does not assess how the aforementioned factors affect athletes’ performance outside of sports. Doing so would permit professionals to examine the influence of these factors across sport training, sport competition, and life outside of sports.

The purpose of this study was to determine the psychometric properties and clinical utility …

Factors Affecting Esophageal Tissue Radiation Response, Latisha T. Pryor

UNLV Theses, Dissertations, Professional Papers, and Capstones

Radiation-induced esophageal cancer can be a deadly and unfortunate secondary outcome of radiotherapy or chronic occupational exposure to radiation. Although the esophagus is known to be a radiosensitive organ, it is under studied and further information regarding how dose and radiation quality impact its sensitivity may provide strategies to prevent esophageal cancer. The purpose of this thesis was to understand factors that play a role in the tissue’s radiosensitivity that may relate to its cancer risk. In this study, we used two esophageal 3D models, as well as both human and mouse cells, to define radiation quality and dose dependent …

Memory And Stereotypes For Lesbian/Gay Characters, Amber Rose Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Stereotype-consistency bias refers to the idea that people tend to remember stereotypical information about others better than non-stereotypical information (Fyock & Stangor, 1994). Limited research has examined how people may use stereotype-consistency bias when recalling information about LGBT characters in narratives (Bellezza & Bower, 1981; Clark & Woll, 1981; McGann & Goodwin, 2007; Snyder & Uranowitz, 1978). This line of research suggests that, instead of genuinely remembering stereotypical information better, participants tended to guess stereotypical answers to questions they do not know. In contrast to those studies, the experiment I conducted for this thesis suggests that heterosexual young adults tend …

Functional Capacity Profiles In Bipolar Disorder And Schizophrenia, Ashley Sara Emami

UNLV Theses, Dissertations, Professional Papers, and Capstones

Serious mental illnesses (SMIs) often have an onset early in life and go on to produce disability and functional impairment, which require ongoing supportive services and loss of productivity. Bipolar disorder (BD) and schizophrenia (SZ) are two of the most common SMIs. BD and SZ differ in their pattern of neurocognitive performance, which suggests differences in the severity of functional impairment between the illness groups. Within these psychiatric illness groups, subgroups may also be identified using cluster analysis. Evidence points to heterogeneity in functional outcomes in BD and SZ, yet very little research has assessed for subgroups based on functional …

Sexually Transmitted Infections And The 65 And Older Population: Knowledge And Perceived Risk, Alexus Miranda

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sexually transmitted infections (STI) can impact all persons. Since 2000, the number of STIs has steadily increased among persons aged 50 years and older in the United States (Purpora, 2012). Persons over the age of 60 accounted for the biggest increase of in-office treatments of STIs between 2014 and 2017 (Howley, 2018). The purpose of this study was to use the Sexual Health Model to examine the relationship between various predictors and these persons’ perceived risk of STIs, their STI knowledge, and other barriers that impact the sexual health of persons 65 years of age and older. This study used …

Rejection Sensitivity And The Intent To Seek Medical Help Among Gender Minority Individuals, Kellyann Garthe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: As members of a marginalized and socially devalued group, gender minority (GM) individuals regularly experience rejection in healthcare experiences. These rejecting experiences lead to barriers to healthcare access and health disparities. Consequently, GM individuals’ may develop anxious and avoidant attitudes toward their healthcare needs. When considering healthcare, an individual’s inherent attitude informs their intent to seek medical help (ISMH), defined as the attitude that influences one’s decision to seek medical help. When an individual has a hyper-sensitive reaction to perceived rejection, this is termed rejection sensitivity (RS).

Purpose: The purpose of the study was to determine if the independent …

Association Between Patient Ability In Activities Of Daily Living At Hospital Admission And Key Indicators, Stephanie Rosen, Amber Steele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Illness and inactivity in the hospital frequently leads to disability that can reduce quality of life and increase costs. Early identification of people with limitations in activities of daily living (ADL) who are at risk for poor outcomes such as increased length of stay (LOS), hospital acquired conditions (i.e., falls and pressure injuries (PIs)), and discharge away from home can facilitate appropriate intervention. The Activity Measure for Post-Acute Care Inpatient Activity Short Form (AM-PAC IASF), a reliable and valid tool to measure ADL limitations, is scored at admission for all patients in our hospital. The purpose of this study …

Reliability Of The Lateral Reach Test In People With Unilateral Transfemoral Amputations, Stephen Hill, Samantha Leonard, Elizabeth Vianey Trujillo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lateral reach testing has been established as useful in quantifying stability and fall-risk for older populations without limb loss,1 and has potential for providing useful information about fall-risk, recovery, and rehabilitation of individuals after unilateral trans-femoral amputation. Investigators sought to determine the feasibility and reliability of the Lateral Reach Test (LRT) in people with unilateral trans-femoral amputations. Nine individuals, aged 20-68, with a unilateral trans-femoral amputation were recruited for this study. Two females and seven males participated, and the average height and weight for the group was 167cm and 76kg, respectively. Three participants had right trans-femoral amputations while six had …

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 …

Brain Volumes And Dual-Task Performance Correlates Among Individuals With Cognitive Impairment: A Retrospective Analysis, Jon Basterrechea, Daniel Krist, Caitlin Moreland, Morgan Wise

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. Objective: To examine associations between brain volumes, dual task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. Methods: We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual task performance, and measures of gait and balance. Results: Greater cognitive function and combined dual task effect (DTE) is associated with smaller brain volumes. In contrast, greater motor DTE is associated with larger …

Physical Therapy After Amputation In Community Dwelling Older Adults: A Quantitative And Qualitative Interview Study, Amanda Ferraro, Jennifer Gorton, Lindsey Horn, Michaela Kubo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: To investigate participation in physical therapy in older adults after lower extremity limb loss. The secondary objective was to examine the associations between physical therapy attendance, fear of falling avoidance behavior, self-perceived prosthetic mobility, and mental well-being. Number of Subjects: 64 Materials and Methods: Community-dwelling older adults with amputation were recruited and individually interviewed. The data collection consisted of four surveys (Physical Therapy after Amputation Patient Perception Survey, Short-Form Health Survey [SF-36v2], Prosthetic Evaluation Questionnaire [PEQ, mobility group], and Fear of Falling Avoidance Behavior Questionnaire [FFABQ]). Participants' demographic characteristics were analyzed using descriptive statistics. Participant comments were qualitatively categorized. …

Dosage, Mode, And Timing Of Acute Care Physical Therapy: A Scoping Review, Brendan Acosta, Bradley Goins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Aims and Objectives: 1) To synthesize available evidence for mode, dosage, and timing of physical therapy in the acute care hospital setting. 2) To report the evidence about the effects of mode, dosage, and timing of physical therapy in the acute care hospital setting on LOS, associated costs, and PT-related outcomes. Background: Hospital based physical therapy quality depends on providing evidence-based interventions, however, the research regarding dosage, mode, and timing of physical therapy in the acute care hospital setting has not been synthesized for patient populations except for total joint arthroplasties or patients in the ICU. Design: A systematic search …

Comparisons Of Patellar Bone Mineral Density Between Individuals With And Without Patellofemoral Pain, Chris Khuu, Allina Cummins, Steven Shepherd

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Although bone stress injuries have been reported in individuals with patellofemoral pain (PFP), especially within the lateral patella, it remains unclear whether persons with PFP exhibit altered patellar regional bone mineral density (BMD). The primary purpose of this study was to compare BMD of the patella (lateral, medial, and total regions) between individuals with and without PFP using quantitative computed tomography (QCT). The secondary aim was to examine the associations between patellar regional BMD and patellofemoral joint (PFJ) alignment. Methods: Ten individuals with retropatellar pain and 10 sex, age, weight, height, and activity matched pain-free controls underwent a QCT …

Fall Prevention Service-Learning Project, Alexis Mansoor, Kendra Morrison, Jeremy Nordfelt, Cheng Yang Tu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The purpose of this service-learning project was to: 1) reduce falls in the Las Vegas, Nevada community by implementing the Stepping On fall prevention program and 2) to investigate the effect of planning and implementing a service learning project (SLP) on physical therapy (PT) students’ education and professional development. Description: Under the supervision of our advisor, we planned and organized this SLP, became certified leaders of Stepping On, recruited and screened older adults using the STEADI fall risk screening tool, and facilitated the program at a local community hospital. We facilitated group discussion and instructed the exercises outlined in …

Patient, Student, And Faculty Perceptions Of A Student Led Pro-Bono Education And Treatment Based Back School For Uninsured Nevadans, James Tingey, Daniel Tiano, Rebecca Templeton, Meagan Duncan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Importance: To determine feasibility and benefits of student led back school in an underserved population. Perceptions were positive support benefits for all participants. Objective: To evaluate perceived benefits for uninsured participants, students, and faculty with implementation of an evidence based, student led back school. Design: Eight DPT students created curriculum delivered over two days of two-hour classes, one week apart including screening and abbreviated evaluation of LBP, group education, specific exercise selection, and home exercise program assignment. Following first session, analysis performed to improve subsequent sessions. Setting: Cooperative effort between the pro bono clinic, Volunteers in Medicine of Southern Nevada, …

The Effectiveness Of Implementing A Collegiate Dance Clinic At The University Of Nevada, Las Vegas, Quinn Williams, Kristin Allman, Matthew Mcarthur, Ryan Yim

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screenings are commonly employed in athletics to identify deficits in performance with the goal of providing interventions to decrease injury risk; however, their utilization is uncommon in collegiate dance programs. Therefore, the purpose of this service learning project was to address the needs of the University of Nevada, Las Vegas (UNLV) dance program through implementation of an injury screening and prevention clinic for collegiate-level dancers. Four second year Doctor of Physical Therapy students (SPTs) supervised by a clinical faculty member with dance medicine expertise researched, developed, and provided screenings to identify increased risk for dance-specific injuries, and education to decrease …