Medicine and Health Sciences Commons^™

Childhood Health Status And Adulthood Cardiovascular Disease Morbidity In Rural China: Are They Related?, Qing Wang, Jay Shen

Public Health Faculty Publications

Cardiovascular diseases (CVDs) are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS), a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on …

Developing Therapeutic Communication Skills: Integration Of Standardized Client Simulation In An Associate Degree Nursing Program, Kristine Weber, Timothy Farrell

UNLV Theses, Dissertations, Professional Papers, and Capstones

By the year 2020, it is projected that there will be a shortage of 300,000 to one million registered nurses in the United States (Juraschek, Zhang, Ranganathan & Lin, 2012). Therapeutic communication skills are a fundamental and integral part of any registered nurse’s practice. Despite the importance of therapeutic communication, evidence suggests that the lack of skill development in nursing programs is having an adverse effect on the NCLEX-RN pass rate of graduating registered nurses. Identifying and addressing shortfalls in effective communication offers an opportunity to improve this pass rate. Learning to effectively communicate in a simulated situation will provide …

Low Back Pain In Student Nurses: Literature Review And Prospective Cohort Study, Nancy Menzel, Du Feng, Jessica Doolen

Nursing Faculty Publications

There is consensus that registered nurses worldwide have a high prevalence of work-related musculoskeletal disorders, particularly of the back. Patient handling activities such as lifting present the highest risk of injury, activities that begin in nursing school. A literature review identified 21 studies of back pain in nursing students, indicating a wide range of prevalence rates. A prospective cohort study of nursing students in a United States baccalaureate program followed 119 students who completed the Nordic Musculoskeletal Questionnaire upon beginning the 16 month upper division major and then a year later. There was no statistically significant change in low back …

The Effects Of Locomotion-Induced Shock Loading On Tibiofemoral Bone Stress Response, Alexa Standerfer, Suzenna Ngo, Karen Daun

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Knee osteoarthritis (Coats, Zioupos, & Aspden) is a degenerative joint disease that negatively impacts the quality of life. About 9.3 million people in the U.S. population are affected. It has been suggested via magnetic resonance imaging (MRI) studies that bone marrow edema (i.e., indicative of bone stress response) and joint structure changes may be the main contributing factors of pain in OA. Frontal plane lower extremity (LE) alignment has been a topic of much interest regarding development of OA in the knee joint. It is hypothesized that varus alignment increases forces through the medial compartment of the knee, thereby …

The Radionuclide Concentration In Dust Collected At The Nellis Dunes Recreational Area, Mathew John Bensen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dust Samples were collected from three different location at the Nellis Dunes Recreation Area, each being of a different soil type. These samples were sieved to different particles sizes and then analyzed using a high-purity germanium gamma well detector. The isotopes found in each sample were: Pb-214, Th-231, Pb-212, Cs-137, and K-40. The activities for these isotopes ranged from: 8.36 * 10-7 µCi/g to 3.11 * 10 -6 μCi/g, 2.53 * 10-7 µCi/g to 9.98 * 10-7 µCi/g, 2.17 * 10-7 µCi/g to 2.51 * 10-7 µCi/g, 7.41 * 10-8 µCi/g to 4.22 * 10-7 µCi/g, and 7.38 * 10-6 …

Differences In Perceived Importance Of Preventative Services And Healthcare Provider Trust Among Hispanics, Jonathan James Gore

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Hispanic population varies greatly in their risk factors, health outcomes and access to care by country of origin, level of education and language dominance (Vega & Amaro, 1994) (Fiscella, Franks, Doescher, & Saver, 2002b). The differences within the Hispanic population also extend to their knowledge and attitudes toward health choices and maintenance, where they receive their health information, and what they access to meet their health care needs. Subpopulations within the Hispanic community as defined by language dominance and nativity must be understood as separate and distinct so that the health needs of each can be adequately addressed. The …

A Qualitative Study Of Job Competencies For Healthcare Social Work Administrators: An Application Of The Short Competency Model Process Used To Identify The Behaviors And Personal Characteristics Of Exemplary Performers, Lashonda Jones-Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Job competencies are central to every organization’ s human resource management system. Competencies can be used to help organizations create high performance cultures, select and hire a workforce, develop leaders, and establish a foundation for training strategies. Social work, as a profession, has developed competency models for many specialized fields of social work. Health is the second most common practice area reported by social workers with a master’ s degree in social work, the predominant social work degree for licensed social workers. In highly structured, rapidly evolving, and complex organizations such as healthcare systems, leaders and managers require distinctively different …

Delirium Education Program For Critical Care Nurses: A Mixed Methods Study, Meredith Padilla Padilla

UNLV Theses, Dissertations, Professional Papers, and Capstones

Approximately 10-30% of hospital admissions develop delirium where nearly 30-40% of the delirium cases are preventable. Non-detection rates by acute care healthcare workers were reported at 72-75%. Hence, it is crucial for hospitals to develop delirium education programs focused on early recognition and prevention. Thus, the purpose of this mixed method study was to develop and evaluate the effect of a delirium education program (DEP) on improving critical care nurses’ knowledge and self-confidence in identifying delirium and the associated risk factors. In the quantitative strand (Phase I) of the study, both the intervention and control groups completed the online pre-tests …

Cultural Competence Of Nurse Practitioners: Providing Care For Gay And Lesbian Clients, Paul Steven Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurse practitioners provide care to an increasing number of diverse individuals who are faced with specific healthcare needs, as well as health disparities. This care encompasses those individuals who identify as lesbian, gay, bisexual, or transgender (LGBT). These individuals may have experienced delivery of healthcare by providers who lacked the necessary knowledge and/or skills needed to adequately address the needs of this specific client population. Many in the LGBT population have faced prejudice, bias, or homophobia from healthcare providers that became a barrier to accessing healthcare. In order to avoid potential barriers, nurse practitioners who function increasingly as primary care …

Impacts To Phytoplankton After The Establishment Of Quagga Mussels In Lake Mead, Nevada, Warren Bruce Turkett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Quagga mussels (Dreissena rostriformis bugensis) are an invasive species that were discovered in Lake Mead in January of 2007, and rapidly spread throughout the lake. Quagga mussels are about the size of a fingernail, but are known to clog pipes, damage infrastructure and alter ecosystems. In large numbers, mussels can have a dramatic impact on an ecosystem by reducing the phytoplankton and potentially increasing toxin producing cyanobacteria. This research analyzed data collected from three separate basins in Lake Mead to determine if water quality characteristics that are commonly impacted by invasive mussels have changed. Transparency, chlorophyll-a, phytoplankton and zooplankton samples …

Microbial Contamination Of Ice At Food Establishments In Las Vegas, Nevada, Jerry Wills

UNLV Theses, Dissertations, Professional Papers, and Capstones

When food establishments make ice for consumption, it is important to use water free of pathogens and to employ hygienic practices. Freezing can reduce the number of culturable microorganisms present in water but does not eliminate them completely. Coliform bacteria are used as an indicator of water quality and are used to test for fecal contamination. The U.S. Environmental Protection Agency (EPA) establishes standards for drinking water, and has set a goal for zero total coliforms. Another commonly used tool to measure water quality is the heterotrophic plate count (HPC). The EPA limit for HPC is 500 colony forming units …

Effects Of Simple Postural Instructions On Running Form Modification In Recreational Runners – Preliminary Findings, Elizabeth Billington, Scott Devries, Kenshin Scoggin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: Running is one of the most popular exercises but it is also an activity with a high incidence of injury. Running form modification involving a forward lean of the trunk and forefoot strike pattern has been shown to be effective in attenuating the impact forces of the lower extremity. However, it is currently unknown how these changes can be most effectively instructed and learned by the runners. Previous studies have shown that practicing a motor task with an external focus can facilitate learning and retention when compared to the more common internal focus instructions. The purpose of …

The Effect Of Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Subjects With Low Back Pain, Shane Collins, Abbay Dow, Daniel Rincon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, double-blinded, controlled clinical trial. Objective: To measure the effects of dry needling to the lumbar multifidus (MF) muscle for any change in resting and contracted thickness of the transversus abdominis (TrA) muscle as well as symptoms and disability in individuals with low back pain (LBP). Background: Recent studies have demonstrated that individuals with LBP have diminished co-activation of the lumbar MF and TrA muscles, which when working appropriately in healthy individuals, contributes to spinal stability and function. A significant change in the resting and contracted thickness of TrA has been found with dry needling to the lumbar …

Use Of A Mobile Application To Increase Patient Compliance To A Prescribed Home Exercise Program And Improve Outcomes, Ellie Cobb, Jed Hurst, Ethan Konshuk

UNLV Theses, Dissertations, Professional Papers, and Capstones

Methods: The creator of the app offered free use of their app to a physical therapy clinic. As the app is only compatible with Apple products, the clinic used the app with any patient that had an iPhone. Retrospective review was conducted to determine if differences in patient outcomes were observed. Patients who had access to an iPad or iPhone were considered part of the “app group” and used the mobile app to reference and report PT HEP compliance. Patients without access to an iPad or iPhone were considered part of the “non-app group” and received traditional PT HEP prescription …

Preventing Non-Contact Acl Injuries In Female Athletes: What Can We Learn From The Dancers?, Sarah Crow, Thomas Crowther, Trenton Saupan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study design: Cross-sectional case control.
 Objectives: The purpose of this study was to investigate the effects of dance experience and movement instruction on lower extremity kinematics and muscle activation during landing tasks Background/Aim: Current research demonstrates that dancers exhibit a much lower incidence of ACL injuries when compared to athletes of other sports despite the fact that dancers jump and land frequently in their training and performance. The mechanism that underlies this disparity is unclear.
 Methods: We analyzed lower extremity biomechanics during landing in 27 subjects (age 18-25 years, 12 dancers and 15 non-dancers). In the non-instructed (NI) conditions, participants …

Heel-Raised Foot Posture And Weightlifting Shoes Do Not Affect Trunk And Lowerextremity Biomechanics During A Barbell Back Squat, Javier Ibarra, Derek Oldroyd, Ryan Zane

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: It is claimed that wearing weightlifting shoes with a raised-heel can improve posture and leg muscle activation, and reduce the risk of back injuries during a barbell back squat. However, these proclaimed biomechanical effects have not been thoroughly investigated. The purpose of this study was to compare the thoracic, lumbar, and lower extremity biomechanics during barbell back squat in 3 foot posture conditions. Subjects: 14 healthy recreational weightlifters (7 male and 7 female) between the ages of 18-50 participated in the study. A minimum of 2 years weightlifting experience and regular training with the barbell back squat …

The Effects Of Patellofemoral Taping On Patellofemoral Joint Alignment And Contact Area, Ryan Epstein, Ron Garcia, Nicole Riley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: It is widely accepted that patellofemoral pain (PFP) is the result of excessive stress between the retro-patellar surface and the femoral trochlea. Elevated patellofemoral joint (PFJ) stress may be associated with a reduction in PFJ contact area resulting from patellar malalignment (e.g., lateral displacement, lateral tilt, or patellar alta and/or quadriceps imbalance). McConnell and Kinesio taping techniques are commonly used to address PFP and improve PFJ alignment. It has been theorized that PFJ taping can alter the PFJ alignment which may increase the patella’s contact area within the femoral trochlea, thereby resulting in a reduction in PFP. To date, …

Influences Of Body Composition, Multimorbidity And Polypharmacy On Physical Mobility Of Older Adults, Chieh Chen, Linna Sestini, Rachel Wilde

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The prevalence of falls, and the resulting injuries and complications reflect a key concern in the older adult population. An increased risk of falls is highly correlated with decreases in physical mobility and related functions. The Timed Up-and-Go test (TUG) has an established reliability and validity in assessing physical function and the risk of falling in the older adult population. With age, a person typically has an increased number of health morbidities, which may be reflected in changing body composition and the number of medications associated with diseases. However, the influence of these factors on physical mobility …

Balance Confidence And Fear Of Falling Avoidance Behavior Are Most Predictive Of Falling In Older Adults: A Prospective Analysis, Sarrie Oscar, Jessica Sasaoka, Kyle Vaughn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Evidence suggests that there are several fall predictors in the elderly population, including previous fall history and balance impairment. To date, however, the role of psychological factors has not yet been thoroughly vetted in conjunction with physical factors as predictors of future falls. Objective: The purpose of this study was to determine which measures, physical and psychological, are most predictive of falling in older adults. Design: This was a prospective cohort study. Methods: Sixty-four participants (mean age=72.2 years, SD=7.2; 40 women, 24 men) with and without pathology (25 healthy, 17 with Parkinson disease, 11 with cerebrovascular accident, 6 with …

Thrust Joint Manipulation Utilization By Us Physical Therapists, Sean Reilly, Rebecca Slaughter, Erwin Ventura

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Online survey study. Objective: To determine physical therapists’ utilization of thrust joint manipulation (TJM) and their comfort level in using TJM between the cervical, thoracic, and lumbar regions of the spine. We hypothesized that physical therapists who use TJM would report regular use and comfort providing it to the thoracic and lumbar spines, but not so much for the cervical spine. Background: Recent surveys of first professional physical therapy degree programs have found that TJM to the cervical spine is not taught to the same degree as to the thoracic and lumbar spines. Methods: We developed a survey …

Assessing Clinical Significance Of The Immediate Post-Concussion Assessment And Cognitive Testing Battery When Comparing Adjusted And Unadjusted Rci Methods For Different Ranges Of Baseline Scores, Ashley N. Figaro

UNLV Theses, Dissertations, Professional Papers, and Capstones

The growing concern revolving around the dangers of sports-related concussions have led to the most recent implementation of neurocognitive (NC) test batteries as a means to objectively determine the presence of a cognitive defect. Whereas any other sports-related injury can be diagnosed with tools such as an x-ray or MRI, a concussion represents a metabolic disturbance that cannot be identified by these diagnostic tools. Many neurocognitive test batteries employ statistical techniques to derive cut off scores in order to represent significant or insignificant changes as compared to individual baseline scores, or pre-established normative values. If an individuals’ post-injury score exceeds …

Developing Registered Nurse Competency In Diabetes Care, Elizabeth Ortiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: As the cost of health care continues to climb in the United States, hospitals are seeing longer lengths of stay and associated costs resulting from the complications of diabetes mellitus (DM). Registered nurses (RNs) play a critical role in caring for patients with DM. Rapid changes in the care of DM require continuing education on the current trends and the use of evidence-based practices to prevent hypoglycemia as a serious complication of lowering blood glucose levels. This doctoral project assessed the knowledge levels of RNs caring for patients with DM in the hospital setting.

Methods: Eighty-five RNs …

The Relationship Between Clinical Teaching Models And Perceived Clinical Self-Efficacy And Attitude Toward Team Process, Christina H. Plemmons

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurse educators are called to transform the education of nursing students, a process that is paramount to meet the needs of an increasingly complex health care system. The complexity of health care requires graduate nurses who are self-efficacious, yet also function well as full members of a health care team. In response to this call, clinical instruction, an essential component of nursing education, is receiving increased attention. Clinical education is vital, not only to the development of clinical self-efficacy, but also to the integration of future nurses into a health care team. To further this education process, faculty members from …

Identifying Learning Acquired During Debriefing, Shelly J. Reed

UNLV Theses, Dissertations, Professional Papers, and Capstones

Debriefing, the reflective activity following an experiential learning exercise, has been identified as the most important part of simulation learning and is also important for learning in other activities utilized in nursing education. There is general agreement that debriefing provides learning and improves performance. However, there is little specific evidence about the phenomenon of learning acquired during debriefing, including how it occurs, how it is defined and identified, and how it is evaluated by debriefing facilitators. In addition, there are no instruments or tools specifically measuring learning acquired during debriefing. Without practical and theoretically grounded tools, simulation activities will continue …

Eight Steps To Weight Loss: Development Of An Evidence-Based Collaborative Provider-Patient Workbook For Overweight Or Obese Adults, Katherine Ann Wagner

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite decades of effort on the part of health care providers and policy makers to reduce the prevalence of obesity, the prevalence of obesity in the United States remains high (CDC, 2015). In the adult population ages 20 years of age and older, 35.7% are considered obese. The annual medical costs for people who are obese are $1,429 higher than people of a healthy weight (CDC, 2013). Obesity increases the risk for chronic health conditions such as hypertension, type 2 diabetes, hypercholesterolemia, coronary heart disease, stroke, asthma, arthritis, and cancer (Hammond & Levine, 2010). Over-weight and obesity are the main …

Human Touch: Perceptions Of Self-Efficacy From A Non-Pharmacology Treatment For Individuals Living With Hiv/Aids, Anne Elizabeth Weisman

UNLV Theses, Dissertations, Professional Papers, and Capstones

HIV/AIDS and a subsequent drug regimen can create many negative symptoms and side

effects that lead those infected to seek out alternative and complementary therapies as treatments. Massage therapy is an ancient form of treatment that is now gaining popularity as part of the integrative medicine movement. A phenomenological, qualitative research study was conducted at Aid for AIDS of Nevada (AFAN). Participants received a massage and rich descriptive narratives were captured from the 12 participants, six female and six male, ranging in age from 30-67 years of age. The interviews were transcribed and coded for themes. For the purpose of …

Implementation Of The Obesity Prevention And Management (Opm) Guideline To Increase Recognition And Treatment Of Childhood Overweight And Obesity In An Urgent Care Setting, Krystle Denise Apodaca

UNLV Theses, Dissertations, Professional Papers, and Capstones

Childhood obesity carries multiple significant and costly health associated risk factors. Obese children have a higher risk of cardiovascular disease, diabetes, sleep apnea, bone and joint problems, as well as self-esteem issues. Childhood overweight and obesity are associated with $14.1 billion in healthcare utilization each year. New Mexico (NM) has experienced significant increase in overweight and obesity with associated chronic illnesses over the past 15 years. Addressing the public health crisis of childhood overweight and obesity requires an innovative and broad approach beyond primary care and health policy changes. Urgent care settings are highly accessed by pediatric patients. To address …

The National Diabetes Prevention Program An Intervention For Diabetes Risk Reduction, Kavita Batra

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes mellitus is among the most frequently occurring chronic conditions, affecting 28 million adults in the Nation. The Nevada diabetes prevalence rate is approaching the National average, with 1 out of 4 diabetic patients experiencing serious clinical complications. Diabetes is typically preceded by a preventable condition classified as prediabetes, in which the blood sugar level exceeds the normal level, yet not enough to be classified as Type 2 diabetes. Prediabetes increases the risk of developing diabetes within 10 years, if not effectively managed. In an attempt to help reduce this risk, the CDC recently introduced an evidence-based intervention, the National …

Standardization Of Military Rapid Response Teams, Kristine Patricia Broger

UNLV Theses, Dissertations, Professional Papers, and Capstones

The healthcare industry is continuously challenged to improve patient outcomes while remaining focused on cost-containment and patient safety. The National Patient Safety goals (2009) provide healthcare organizations with performance standards aimed at reducing morbidity and mortality rates. Rapid response teams (RRT) are one of the initiatives intended to decrease cardiopulmonary arrests outside the Intensive Care Unit (ICU), decrease unplanned admission into the ICU, and decrease mortality rates.

The last twelve years at war has created a high deployment rate for military medical personal. Each year military hospitals lose an average of eight to ten providers to support the War of …

The Development Of Sexual Attitudes In The Family Of Origin And Sexual Satisfaction Later In Life, Bryant Christlieb

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if variance for individuals’ sexual satisfaction as well as attitudes toward sexual instrumentality, sexual permissiveness, sexual communion and attitudes could be predicted by family sexual communication during adolescence as well as various demographic factors such as age, years together, gender, race, income level, religion, religiosity and sexual orientation. This was done by recruiting 250 people via Mechanical Turk (www.mturk.com) and through undergraduate courses at the University of Nevada-Las Vegas. The researcher used an enter-method multiple regression model and Kendall’s Tau for non-parametric data. The results of this study show that sexual satisfaction …