Medicine and Health Sciences Commons^™

Development And Evaluation Of An Opioid Monitoring Clinic, Richard Luna Talusan

UNLV Theses, Dissertations, Professional Papers, and Capstones

An APRN-led Opioid Monitoring Clinic was developed and implemented in the primary care setting of Las Vegas' Department of Veterans Affairs in July 2013 to assist primary care providers (PCP) in the management of high risk patients on chronic opioid

therapy for chronic noncancer pain. The clinic assisted in monitoring patients for abuse and misuse of opioids and referred patients for treatment when abuse and misuse were discovered. A study to evaluate the OMC was undertaken from November 22, 2013

through February 23, 2014 to assess the effectiveness of the OMC in meeting its objectives. A total of 61 patients …

Evaluation Of An Educational Intervention On Perceptions Of A Patient Safety Culture Among Staff In Acute Care Nursing Units, Cynthia Ann Parkman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patient safety has always been a central focus of nursing practice. Current research makes it increasingly clear that what occurs in the surrounding health care environment impacts patient safety. The protracted nursing shortage and nurse turnover may adversely affect patient outcomes and are exacerbated by an environment of disruptive behavior, conflict, and poor communication in the nursing workplace. The Joint Commission has identified these behaviors as key elements that jeopardize the "culture of safety" necessary to assure safe, quality patient outcomes. A culture of safety includes the attributes of teamwork, communication openness, collaboration, and a manager's positive focus on prevention …

Alternations Of Nmda And Gabab Receptor Function In Development: A Potential Animal Model Of Schizophrenia, Monica Bolton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Schizophrenia is a debilitating mental disorder that affects up to 3% of the world population. The behavioral symptoms are categorized into positive and negative symptoms, which appear during late adolescence/early adulthood. Unfortunately, the underlying cellular and molecular mechanisms of the disease are poorly understood. Several hypotheses exist to explain mechanisms contributing to these behavioral alterations. One model proposes that a reduced function of the NMDA glutamate receptor on specific GABAergic interneurons may be responsible for deficits in schizophrenia. Post-mortem investigations provide evidence of reductions in both glutamate and GABA-related proteins in patients with schizophrenia. Further, GABAergic interneurons that are activated …

Using Over-The-Counter Ear Filters As A Treatment To Improve Dizziness And Balance In Patients Diagnosed With A Traumatic Brain, Brandy Sue Whitney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: People diagnosed with a Traumatic Brain Injury (TBI) usually have physical, cognitive, emotional, and sleep deficits. Sensory overload is a common symptom of TBI. One treatment prescribed for sensory overload is over the counter ear filters. Ear filters have shown to decrease sensory input. Could the ear filters have an effect on balance and dizziness without much cost to the patient or the clinic?

Subjects: Patients diagnosed with a mild or moderate brain injury, ages of 18-65 years old. They needed to be medically stable, potential to walk, and have complaints of dizziness and/or balance problems.

Methods: …

Effect Of Racing Flats On Running Economy In Male Adolescent Runners, Paul Hafen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to investigate whether running economy differs in racing flats versus standard running shoes in high school cross-country runners. In order to measure running economy the oxygen cost of running (mL O₂∙kg^-1∙min^-1) was measured in 20 male adolescent runners (mean age = 16.25 ± 0.97 years, 5 km best time = 17.52 ± 0.78 min) when running two separate trials at a controlled speed. The speed was determined by estimating treadmill running speed at 85% of each runner's VO_2max. Each trial required the participants to run while …

The Effects Of Chronic Calcium Dysregulation On Behavioral And Pathological Features Of Alzheimer's Disease, Jonathan Sabbagh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer's disease (AD) is a progressive neurodegenerative disorder whose etiology is unknown. Recent studies have implicated alterations in calcium homeostasis as a pathogenic contributor to AD. Calcium dysregulation has been observed in aged and AD brains, an event which could potentially facilitate the development of multiple pathologies observed in AD. Specifically, disrupting intracellular calcium levels in vitro has been demonstrated to increase amyloid-beta (Aβ) production, tau phosphorylation, and neuronal loss. However, there is a paucity of data on the behavioral and biochemical consequences of chronic in vivo perturbation of calcium homeostasis. In a series of experiments designed to evaluate the …

Oxidative Stress For An Acute Bout Of Bikram Yoga In Healthy, Trained Adults, Kimberly Anne Trocio

UNLV Theses, Dissertations, Professional Papers, and Capstones

BACKGROUND:Generation of free radicals resulting in oxidative damage has been linked to cellular damage, aging, and human disease. Many studies have reported that physical exercise can contribute to oxidative stress. Further, exercise in a hyperthermic environment can promote additional oxidative stress. It is important to consider that practices in yoga may be beneficial in reducing oxidative stress according to some studies. The compound effects of exercise and hyperthermic exposure are experienced in the practice of Bikram yoga, the original "hot" yoga. Because Bikram yoga and other hot exercise classes are an increasingly growing fitness trend, it is necessary to investigate …

Closed Loop Control Of A Cylindrical Tube Type Ionic Polymer Metal Composite (Ipmc), Benjamin Mead

UNLV Theses, Dissertations, Professional Papers, and Capstones

The goal of this research is to provide a framework for the integration of tube type, cylindrical Ionic Polymer Metal-Composite (IPMC) into conventional devices. IPMCs are one of the most widely used types of electro-active polymer actuator, due to their low electric driving potential and large deformation range. For this research a tube type IPMC was investigated. This IPMC has a circular cross section with four separate electrodes on its surface and a hole through the middle. The four electrodes allow for biaxial bending and accurate control of the tip location. One of the main advantages of using this type …

Credentialing Success In Respiratory Therapy Education: Revisiting Bourdieu's Concepts Of Field And Capital, Karen Lightbody Shaw

UNLV Theses, Dissertations, Professional Papers, and Capstones

The field of Respiratory Therapy (RT) is expected to experience a workforce shortfall over the next decade. The numbers of both program applicants and graduates have declined in recent years, necessitating strategies to improve board exam pass rates for future graduates. In response to the pending employment crisis, the Commission on Accreditation for Respiratory Care has published Programmatic Outcomes Data detailing individual program statistics. A theoretical framework adapted from Pierre Bourdieu's Concepts of Field and Capital was proposed to explain a possible re-stratification of RT programs. It states, in part, that a modification of position-takings within the RT educational field …

Characterization Of Beryllium As A Novel Agent To Study Cell Cycle Arrest And Cellular Senescence, Priyatham Gorjala

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer cells evade senescence, apoptosis, and other constraints on proliferation, often via mutation of the p53 tumor suppressor gene (TP53). Normal human lung fibroblasts have been shown to enter premature senescence upon exposure to beryllium. In these cells, BeSO₄ stabilizes p53 protein, increases p21 gene expression, induces senescence-associated β-galactosidase activity and causes cell proliferation arrest. In the present study, we have investigated whether BeSO₄ is able to induce similar effects in cancer cells that have wildtype p53. We have demonstrated that beryllium salt at low concentration can induce molecular changes in the p53 signaling pathway leading to cell …

Medical Tourism: Trends And Opportunities, Krista Wendt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Medical tourism involves travel for the purpose of receiving medical, dental, or surgical care (Medical Tourism Association), and represents a rapidly growing niche market within the healthcare, tourism, and hospitality industries. Medical travelers are motivated to seek care outside of their area of residence by many factors, including more advanced technology, quicker access, higher quality of care, or lower costs for care in the destination locality (Ehrbeck, Guevara, & Mango, 2008). Multiple factors contribute to the growth of the medical tourism industry and suggest a continuing trend toward growth in the future. This nascent industry represents a significant market opportunity …

Frequency-Specificity And Pattern-Specificity Of The Buildup Of Auditory Stream Segregation, David Michael Weintraub

UNLV Theses, Dissertations, Professional Papers, and Capstones

During repeating sequences of low (A) and high (B) tones in an "...ABAB..." pattern, the likelihood of hearing two separate streams ("streaming") increases with more repetitions of the patterns, a phenomenon referred to as "buildup". Previous studies have shown that buildup is frequency specific (Anstis & Saida, 1985) and that its biasing effects decays over several seconds (Beauvois & Meddis, 1997). No study has examined whether the frequency specificity of buildup persists for such a long duration. To address these issues, Experiment 1 tested the decay of frequency-specific and non-frequency specific buildup. The results revealed that (1) frequency-specific buildup effects …

Effects Of Hyperthermia On Photochemical Internalization-Mediated Delivery Of Bleomycin, Christina Schlazer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Standard treatment protocols for high-grade gliomas, such as glioblastoma multiforme (GBM), are highly ineffective due to their inability to eradicate infiltrating tumor cells. Improvements in overall survival are likely to be realized only with the development of more effective localized therapies capable of eradicating tumor cells in the surgical resection margin and beyond. Photochemical internalization (PCI) is a localized light-based therapeutic modality that enhances the efficacy of therapeutic macromolecules including chemotherapeutic agents such as bleomycin. A number of studies have shown that this photodynamic therapy (PDT) - based modality may prove effective in the treatment of high-grade gliomas.

Three-dimensional multicell …

An Investigation Of The Role Of Gabab Ligands On Cued And Contextual Fear Conditioning, Chelcie F. Heaney

UNLV Theses, Dissertations, Professional Papers, and Capstones

GABA is the primary inhibitory neurotransmitter in the brain and mediates several processes, including learning and memory. Activating or inhibiting GABA receptors allows for the examination of the effects of altered GABAergic signaling on these processes. The two main receptors, GABAA and GABAB, each have a different mechanism of action when activated, thus they may contribute differentially to learning and memory. The metabotropic GABAB receptor responds with the activation of several intracellular signaling cascades, which provide long-lasting inhibitory effects that primarily mediate network function. Conversely, the GABAA receptor is an ion channel that contributes more immediate inhibitory effects through the …

Exercise-Induced Neuroprotection In A Hemiparkinsonian 6-Hydroxydopamine Rat Model, Merrill Russen Landers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Outside of finding a cure, one of the preeminent goals of research in Parkinson's disease (PD) is finding a neuroprotective treatment that when applied prior to the onset of the disease will decrease the risk and severity of the subsequent disease. One such treatment that has potential as a neuroprotective agent in PD is exercise. Several studies have found forced exercise to be protective of Parkinson's disease in adult rodent models; however, few of these studies have used a design wherein voluntary exercise was evaluated. Moreover, no study has used a true neuroprotective design in which exercise was applied prior …

A Diffusion Tensor Imaging Software Comparison And Between Control Subjects And Subjects With Known Anatomical Diagnosis, Michael C. Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diffusion weighted imaging (DWI) is a magnetic resonance imaging (MRI) method that produces in vivo images of biological tissues weighted with the local micro-structural characteristics of water diffusion. Diffusion tensor imaging (DTI), a form of DWI, is useful when a tissue, such as the neural axons of white matter in the brain, has an internal fibrous structure that allows water to diffuse more rapidly in alignment with the fibers. Changes in the water diffusion pattern indicate changes in the fiber structure which can result from damage to the fibers. Measurements of the water diffusion patterns include overall diffusivity, Apparent Diffusion …

Executive Function Profiles In Pediatric Traumatic Brain Injury, Erik Nelson Ringdahl

UNLV Theses, Dissertations, Professional Papers, and Capstones

Traumatic brain injury is a common cause of disability and death among children in the United States. Insult to the frontal and temporal lobes are frequent in closed head brain injury. Cognitive deficits in a variety of domains are common sequelae of brain trauma. In many cases, trauma to the frontal and temporal lobe regions engender prominent deficits in higher-order cognitive processing, memory, and attention.

Higher-order cognitive processing, or Executive Functions are the grouping of cognitive processes necessary for organization of thoughts and activities, attending to the activities, prioritizing tasks, managing time efficiently, and making decisions (Alvarez & Emory, 2006; …

Identifying And Reducing Lead Exposure Associated With The Use Of Cultural Practices In Southern Nevada Hispanic Communities, Maria Castillo-Couch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite large amounts of national data on lead and childhood lead poisoning, the status of childhood lead exposure in Nevada as a result of the use of cultural practices in the Hispanic population is unknown. The influx of immigrant Hispanic populations to Nevada, their low education level, the high number of them who are living in poverty present an increased risk for children to be exposed to lead through the use of imported consumables, home remedies and alternative medicine (i.e., healers/ sobadores).

A 61-question survey collected data from Hispanics over 18 years of age who have or take care …

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 …

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 …

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 …

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 …

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 …

The Effects Of Cellular Theta Breathing Meditation On Cell Mediated Immune Response: A Controlled, Randomized Investigation Of Altered Consciousness And Health, Marjorie D. Hardgrave

UNLV Theses, Dissertations, Professional Papers, and Capstones

Medical anthropology is well positioned to make contributions to consciousness research based on biocultural approaches that integrate methodologies from the biological, behavioral and social sciences to explore aspects of human health. The ubiquity and perseverance of health related activities involving altered states of consciousness (ASC) across cultures past and present suggest that these potentials are deeply rooted in human sociocultural evolution. Analyzing the relationship between immune function and meditative ASC represents an effort to empirically investigate the adaptive value of these human potentials.

A controlled, randomized investigation of two meditation practices was conducted at the University of Nevada, Las Vegas …

Development Of A Functional Mri Olfactory Protocol, Jeremy Mangum

UNLV Theses, Dissertations, Professional Papers, and Capstones

Many people can spend a few days with an acute form of sinusitis, a stuffy nose, or sinus congestion that inhibits their ability to smell, but there are fourteen million Americans over the age of fifty that suffer from some form of chronic olfactory dysfunction. Some neurological disorders such as Parkinson's disease and Alzheimer's disease have demonstrated that olfactory dysfunction is a frequent and early sign. While these diseases have no known cure, there are medicines that exist to slow the progression of such debilitating illnesses. By identifying such diseases in their early stages, we can improve the quality of …

An Evaluation Of Plastic Toys For Lead Contamination In Day Care Centers In The Las Vegas Valley, Joseph Alan Greenway

UNLV Theses, Dissertations, Professional Papers, and Capstones

The harmful effect of childhood exposure to environmental lead continues to be a major health concern. This study examined lead contamination within the plastic of children's toys. It was also hypothesized that the use of lead as a stabilizer would result in higher incidents of elevated lead (> 600 ppm) in polyvinyl chloride plastics (PVC) than non-PVC plastics. It was also hypothesized that, due to the use lead chromate, yellow toys would have higher incidents of elevated lead (> 600 ppm) than toys of other colors. Toy samples were limited to those found in day care centers in Las Vegas, …

An Evaluation Of Methicillin Resistant Staphylococcus Aureus Survival On Five Environmental Surfaces Under Two Different Humidities, With And Without The Addition Of Bovine Serum Albumin, Courtney Ann Coughenour

UNLV Theses, Dissertations, Professional Papers, and Capstones

The spread of antibiotic resistant bacteria is a major public health concern, as they result in greater healthcare costs and increased morbidity and mortality rates. Methicillin resistant Staphylococcus aureus (MRSA) is one organism of particular concern, with the number of infections increasing in epidemic proportion. Bacterial surface contamination with MRSA is significant, as it may serve as a reservoir for transmission and have negative health implications. The purpose of this study was to evaluate survival of MRSA on five environmental surface materials; glass, wood, vinyl, plastic, and cloth. The effect of relative humidity (RH) and bovine serum albumin (BSA) were …

Investigation Of Magnetic Resonance Imaging And Spectroscopy For The Detection Of Breast Cancer, Robert Thomas Etnire

UNLV Theses, Dissertations, Professional Papers, and Capstones

Magnetic resonance imaging (MRI) of the breast offers an alternative to screening mammography which may benefit those women at high risk for breast cancer, women under the age of 40, and those with dense breast tissue. One concern with MRI is the number of high false positives. Coupling MRI with magnetic resonance spectroscopy(MRS) may lower the number of false positives, and thus improve the diagnostic capabilities of MRI for the clinician. MRS for breast imaging focuses on the total choline containing compounds in the spectra in the suspected breast lesion to analyze areas of concern. The results of the study …