Medicine and Health Sciences Commons^™

Detection And Quantification Of Total Airborne Fungi And Coccidioides Species In Environmental Samples, Theresa T. Roehr

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fungal exposure can cause acute and chronic illnesses or exacerbate existing illnesses. Some fungi are opportunistic pathogens and can lead to serious systemic fungal infections. In 2020, more than 150 million cases of severe fungal infections were reported globally resulting in an estimated 1.7 million deaths. Coccidioidomycosis, or Valley fever, is classified as a serious fungal infection caused by the fungi Coccidioides immitis and C. posadasii. These particular fungi are prevalent in the soil of the Southwestern United States, including Las Vegas, Nevada. In 2024, there were a total of 269 cases of Valley fever reported in Nevada, and …

Qualitative Analysis Of Clinical And Community Perinatal Providers’ Perceived Barriers To Equitable Care For Food Insecurity In Underserved Communities In Southern Nevada, Kaelia Lynn KeapomekuʻUaloha Saniatan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity is prevalent among underserved communities and contributes to increasing maternal-child health disparities. The perinatal period from pregnancy through one year postpartum provides a critical window of opportunity to identify and address food insecurity (FI). However, barriers such as inadequate staffing, lack of institutional and community resources have prevented perinatal providers from offering equitable care for FI, defined as providing screening, referrals, and follow-up services. The Social Ecological Model (SEM) is a framework that observes concepts at multiple levels, including (i) individual, (ii) interpersonal, (iii) institutional, (iv) community, and (v) policy. The objective of this study is to understand …

Empowering Nurses, Enhancing Mobility: A Qi Initiative Using Plof And Clof To Promote Patient Ambulation, Kaela Nguyen

Master's Projects and Capstones

The quality improvement project involves the intervention of implemented mobility educational flyers about the mobility tools, Clinician Reported Level of Function (CLOF) and Patient Reported Level of Function (PLOF) and aims to increase patient mobility post surgery. The quality improvement project was conducted in two medical surgical units in a San Francisco hospital. To address unmet mobility goals, during change of shift, in-services on the educational flyers about the mobility tools (CLOF and PLOF), were utilized to provide education about the importance of mobility, how to utilize the mobility tools, and correctly document ambulation. More than twenty flyers were posted …

Improving Healthcare Access Among Hunter College Students – Suggestions For A Hunter College Student Health Center, Jacob Villorente

Publications and Research

This study investigates disparities in healthcare access among students at CUNY Hunter College, an urban public university in Manhattan serving over 22,000 students. 89% of Hunter students receive financial aid, with 67% of students receiving Pell grants. Hunter College only offers limited health services, primarily short-term mental health counseling and wellness workshops. A cross-sectional survey (n = 33) assessed insurance status, coverage (dental, vision, psychiatric), access barriers (e.g., transportation), mental health symptoms, and impacts to academia. While 69.7% of respondents reported comprehensive insurance, students with public insurance (Medicaid, Medicare) experienced substantially higher access barriers than those with employer-sponsored plans and …

The Silent Killer In Women's Prisons, Samantha Boman

Themis: Research Journal of Justice Studies and Forensic Science

If present in the body for an extended period, the human papillomavirus (HPV) can cause aberrant cells to develop in the cervix. Left undetected, these abnormalities can manifest into cancer. Incarcerated women are among the highest demographic to be diagnosed with cervical cancer - diagnoses that could be averted through HPV vaccinations, regular cervical cancer screenings, Pap smears, and comprehensive sexual education. The lack of these preventative measures points to an insufficiency of reproductive healthcare within women’s prisons. In its early stages, cervical cancer is asymptomatic. Once symptoms appear, damage to the body is irreparable. The absence of symptoms before …

Piloting The Inclusion Of Dollar Stores In The Modified Retail Food Environment Index (Mrfei) In Urban Clark County, Nevada, Tiana T. Tu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity is the condition of having limited or uncertain access to adequate food. It contributes to poor diet-related health outcomes which are in turn influenced by the food environment. The Centers for Disease Control and Prevention (CDC) developed the Modified Retail Food Environment Index (mRFEI) to characterize food environments by measuring the proportion of healthy and non-healthy retailers. The CDC mRFEI considers a variety of establishments but fails to include dollar stores, which contribute to the food environment by offering food and, in some cases, fresh produce. This study proposed an “expanded mRFEI” that modified the CDC mRFEI methodology …

“Do You Even Lift, Bro?”: Correlates Of Muscle Dysmorphia Symptomatology In Filipino Male University Students, Pamela Paula C. Pioquinto

UNLV Theses, Dissertations, Professional Papers, and Capstones

Muscle Dysmorphia (MD) is a subtype of Body Dysmorphic Disorder (BDD) and is marked by the desire to increase muscularity and reduce body fat. MD is typically more prevalent among younger male populations, and it often drives comorbid disorders, including substance abuse, eating disorders, and social anxiety. Despite the growing literature on MD, it remains understudied in certain racial/ethnic populations, such as Filipinos. Acculturation, defined as the process in which an individual adopts, acquires, and adapts to a new cultural environment as a result of immigration, influences body image by reshaping an individual’s perceptions of beauty and muscularity standards. Guided …

More Than A Diagnosis: Elevating Person-Centered Care In The Surgical Intensive Care Unit Through Personalized Communication Boards, Sierra B. Poe

Master's Projects and Capstones

Objective: Intensive care units are associated with complex care and high acuity interventions, however, there is a potential for dehumanization of patients. With the focus being placed on life-saving interventions, many patients and their family members feel that they are not being treated beyond their medical diagnosis. Aim: This quality improvement project aims to address these barriers in care by designing and implementing communication whiteboards in the surgical intensive care unit (SICU) at Hospital A to enhance patient and family-centered care, improve patient satisfaction, and enhance interdisciplinary communication. Post-implementation, the goal was to increase utilization of the standardized whiteboards from …

Enhancing Intimate Partner Violence Screening: Implementing Standardized Ehr Protocols And Staff Education In A Community Health Center Serving The Latinx Community, Gabriela Alejandra Davila Barajas

Master's Projects and Capstones

Intimate Partner Violence (IPV) is a public health issue that disproportionately impacts Latinx populations, who often face barriers such as cultural stigma, language barriers, fear of legal consequences, and limited access to culturally competent care. Community Health Centers (CHCs) are well-positioned to identify and address IPV. This project aims to increase IPV screening rates in a CHC serving a predominantly Latinx population by implementing standardized EHR protocols and culturally responsive staff education. The project’s goal is to raise IPV screening rates to 25% by April 15, 2025. The intervention includes two key components: integrating the Hurt, Insulted, Threatened, and Screamed …

Strengthening The Birthing Bridge: Educating Labor And Delivery Nurses On Scope And Impact Of Volunteer Doulas, Catherine H. De La Torre

Master's Projects and Capstones

The objective of this quality improvement project was to address the lack of collaboration between the Labor and Delivery (L&D) nurses and the volunteer doulas on a L&D unit at a Bay Area hospital. There were reports of not understanding the role of the volunteer doula, which may have led to a lack of collaboration between both teams. The aim of this project was to improve the L&D nursing staff's understanding of the scope of practice of the volunteer doula to increase positive perception and collaboration between both professions by 25%, from 63% to 88%, following an educational intervention at …

Advancing Remote Monitoring For Patients With Alzheimer Disease And Related Dementias: Systematic Review, Mohmmad Arif Shaik, Fahim Islam Anik, Md Mehedi Hasan, Sumit Chakravarty, Mary Dioise Ramos, Mohammad Ashiqur Rahman, Sheikh Iqbal Ahamed, Nazmus Sakib

School of Nursing Faculty Publications

BACKGROUND: Using remote monitoring technology in the context of Alzheimer disease (AD) care presents exciting new opportunities to lessen caregiver stress and improve patient care quality. The application of wearables, environmental sensors, and smart home systems designed specifically for patients with AD represents a promising interdisciplinary approach that integrates advanced technology with health care to enhance patient safety, monitor health parameters in real time, and provide comprehensive support to caregivers. OBJECTIVE: The objectives of this study included evaluating the effectiveness of various remote sensing technologies in enhancing patient outcomes and identifying strategies to alleviate the burden on health care professionals …

Incorporating Latent Survival Trajectories And Covariate Heterogeneity In Time-To-Event Data Analysis: A Joint Mixture Model Approach, Fu-Wen Liang, Wenyaw Chan, Michael D Swartz, Bouthaina S Dabaja

Faculty, Staff and Student Publications

Background: Finite mixture models have been recently applied in time-to-event data to identify subgroups with distinct hazard functions, yet they often assume differing covariate effects on failure times across latent classes but homogeneous covariate distributions. This study aimed to develop a method for analyzing time-to-event data while accounting for unobserved heterogeneity within a mixture modeling framework.

Methods: A joint model was developed to incorporate latent survival trajectories and observed information for the joint analysis of time-to-event outcomes, correlated discrete and continuous covariates, and a latent class variable. It assumed covariate effects on survival times and covariate distributions vary across latent …

Cervical Cancer Screening Overuse Among Women With And Without Disability In The U.S. From 2007 To 2016, Preeti Zanwar, Chan Shen, Matthew Smith

College of Population Health Faculty Papers

INTRODUCTION: Persons with disability, a recognized health disparity population with complex care needs, may be at risk for cervical cancer screening overuse. However, limited studies have examined cervical cancer screening overuse among women with and without disability using large nationally representative survey data. Among women with and without disability, the authors aimed to provide national estimates of cervical cancer screening overuse and the proportion of cervical cancer screening overuse among younger, middle-age, and older women.

METHODS: The authors first utilized the U.S. Preventive Services Task Force guidelines to conceptualize and define cervical cancer screening overuse for women with and without …

Clinical And Fundamental Research Progressions On Tumor-Infiltrating Lymphocytes Therapy In Cancer, Jiandong Hu, Mengli Jin, Weihong Feng, Barbara Nassif-Rausseo, Alexandre Reuben, Chunhua Ma, Gregory Lizee, Fenge Li

Faculty, Staff and Student Publications

Malignant tumors represent a significant threat to human health. Among the various therapeutic strategies available, cancer immunotherapy-encompassing adoptive cell transfer (ACT) and immune checkpoint blockade therapy-has emerged as a particularly promising approach following surgical resection, radiotherapy, chemotherapy, and molecular targeted therapies. This form of treatment elicits substantial antigen-specific immune responses, enhances or restores anti-tumor immunity, thereby facilitating the control and destruction of tumor cells, and yielding durable responses across a range of cancers, which can lead to the eradication of tumor lesions and the prevention of recurrence. Tumor-infiltrating lymphocytes (TILs), a subset of ACT, are characterized by their heterogeneity and …

Theta Oscillons In Behaving Rats, M S Zobaer, Nastaran Lotfi, Carli M Domenico, Clarissa Hoffman, Luca Perotti, Daoyun Ji, Yuri Dabaghian

Faculty, Staff and Students Publications

Recently discovered constituents of the brain waves—the oscillons—provide a high-resolution representation of the extracellular field dynamics. Here, we study the most robust, highest-amplitude oscillons recorded in actively behaving male rats, which underlie the traditional θ-waves. The resemblances between θ-oscillons and the conventional θ-waves are manifested primarily at the ballpark level—mean frequencies, mean amplitudes, and bandwidths. In addition, both hippocampal and cortical oscillons exhibit a number of intricate, behavior-attuned, transient properties that suggest a new vantage point for understanding the θ-rhythms’ structure, origins and functions. In particular, we demonstrate that oscillons are frequency-modulated waves, with speed-controlled …

Role Of Systemic Therapy In Localized Renal Cell Carcinoma: Where Do We Stand And Where Are We Heading?, Deepa Raghavan, Viktoriya Gibatova, Nikhil Vojjala, Nagaishwarya Moka, Aihua Edward Yen

Faculty, Staff and Students Publications

The effectiveness of immunotherapy and targeted therapy has been well established in metastatic renal cell cancer (mRCC). These therapies demonstrated higher overall response rates and led to prolonged survival. In contrast, in localized RCC, conventional treatment is either partial or complete nephrectomy. While surgery is a curative option in early stages, high recurrence rates remain a concern, with survival rates ranging from 53% to 85%, depending on the initial stage at the time of diagnosis. Given favorable outcomes with systemic therapies in the metastatic setting, there has also been an increased interest in utilizing these therapies for the localized stage …

"Bridging Research, Outreach, And Care: Advancing Community-Driven Cancer Solutions", Rachel M. Ceballos Phd​, Angie Fausett Agnp-C, Dnp​, Allison Foust Mha, Mches​

Utah Conference on Community Engagement

"This panel will provide an overview of Huntsman Cancer Institute’s (HCI) collaborative efforts to enhance cancer care through innovative community outreach and local treatment programs, with a specific focus on rural outreach and care. Panelists will discuss HCI’s approach to fostering partnerships with community champions, integrating regional outreach through initiatives like the Mountain West Cancer Collaborative (MWCC), and expanding local treatment options to increase accessibility and equity in care, especially in rural areas. By highlighting how these initiatives align with HCI’s mission to reduce cancer disparities, the panel will emphasize strategies for improving cancer prevention, treatment, and survivorship in underserved …

The Effect Of An Audio-Recorded Intervention Program On The Knowledge And Self-Reported Practices Of Menstruation And Hygiene Among Visually Impaired Young Girls In Rwanda: A Mixed Method Study, Justine Bagirisano, Marie Laetitia Ishimwe Bazakare, Aimable Nkurunziza, Jean Bosco Henri Hitayezu, Godfrey Katende

School of Nursing & Midwifery, East Africa

Background Menstrual hygiene practices among visually impaired young girls are a significant public health concern in Rwanda. Limited knowledge about menstruation leads to inadequate hygiene practices, increasing the risk of cervical cancer, urinary tract infections, and reduced quality of life. The menstrual hygiene needs of visually impaired girls who depend on daily assistance for personal hygiene have not been adequately addressed in previous studies. Objectives To assess the effect of an audio-recorded program on the knowledge and self-reported practices of menstruation hygiene among visually impaired young girls in Rwanda. Methodology A pre-post mixed intervention study was conducted involving 93 visually …

5x-Multiplier Vs 3-Tier Model For Discharge Opioid Prescriptions After Intra-Abdominal Cancer Surgery: Randomized Clinical Trial Protocol, Brittany C. Fields, Timothy E. Newhook, Heather A. Lillemoe, Wei Qiao, Jose A. Karam, Surena F. Matin, Larissa A. Meyer, Ching-Wei D. Tzeng

Advances in Cancer Education and Quality Improvement

Background

Surgeons provide up to 10% of total opioid prescriptions across all specialties, and more than one-third of surgeon-prescribed medications are opioids. Patient-reported opioid consumption and risk of persistent opioid use beyond the postoperative recovery period correlate with the initial opioid quantity prescribed at discharge. Interventions to reduce postoperative opioid prescribing have demonstrated no adverse effects on pain control or increased need for prescription refill; however, in the absence of standardized prescription protocols, opioid prescribing practices vary widely.

Objective

The study objective is to identify the opioid prescribing model that provides the lowest oral morphine equivalents (OME) volume prescribed at …

Reducing Antibiotic Duration For Pneumonia And Sinusitis In The Emergency Department: A Quality Improvement Approach, Joshua Saucedo, Leslie Hueschen, Amanda Nedved, Marsha Dannenburg, Patricia Phillips, Jennifer Floyd, Alaina N. Burns, Rana El Feghaly

Research Days

Background: Our aim is to increase the percentage of children discharged home from the ED with a diagnosis of CAP or ABRS treated with an optimal antibiotic duration (3-5 days for CAP, 5-7 days for ABRS) from 13% to 70% by July 25.

Methods: Outcome metric is the percentage of patients receiving recommended antibiotic duration for CAP and ABRS. Process metrics include use of order set, "Quick Discharge” order set, and clinical pathway QR codes. Balancing metric is the number of return visits with the same diagnosis < 14 days. Plan-Do-Study-Act methodology was used. In Aug 23, our ASP disseminated a handbook that emphasized shorter durations. A new multidisciplinary team (infectious diseases, ED, and urgent care physicians, advanced practice providers, nurses, and pharmacy) formed in Dec 23. We utilized cause-and-effect analysis, driver diagram, and prioritization matrix, which helped identify other impactful interventions, including implementation of new internal CAP clinical pathway order set (April 24) and “Quick Discharge” order sets (May 24). Next, we surveyed prescriber comfort (June 24) with shorter duration identifying barriers and providing education, leading to posted evidence for lower duration treatment in practitioner workrooms and developing a new ABRS clinical pathway (Sept 24). Top prescribers providing optimal duration received email acknowledgement (Oct 24) and resident rotators received antibiotic handbook and CAP clinical pathway QR codes (Nov 24). New best treatment practices for ABRS were elucidated and disseminated through clinical pathway and internal article publishing to our hospital and associated clinics (Dec 24).

Results: We saw shifts in the outcome metric’s center line in Sept 23 …

Narratives Or Not? Examining The Roles Of Message Format And Individuals' Stages Of Change In The Context Of Hpv Vaccination Promotion, Mengfei Guan, Shawn C. Chiang, Regan M. Murray, Wen-Juo Lo, Larry T. Hill, Ann C. Klassen, Jennifer A. Manganello, Amy E. Leader, Philip M. Massey

Department of Medical Oncology Faculty Papers

Narrative persuasion has been widely used in health communication campaigns and persuasive message design. However, several meta-analyses showed that the relative effectiveness of narratives in promoting behavior change was not consistently observed in the existing literature. With the goal of exploring boundary conditions of narrative effects, this study investigates the interaction effects of narrative persuasion and stages of change on promoting behavior change in the context of encouraging parents to vaccinate their children against human papillomavirus (HPV). Findings from an online experiment (N = 593) showed that non-narrative messages were more effective in bolstering behavioral intention than narrative messages among …

Development Of A Light-Based Platform To Assess Cervical Mucus Barrier Function And Physical Mucus Properties, Elizabeth J. Buzbee

McKelvey School of Engineering Graduate Student Theses & Dissertations

Preterm birth is the leading cause of neonatal morbidity and mortality worldwide, yet current clinical tools for predicting its risk lack specificity and reliability. Cervical mucus plays a crucial role in maintaining pregnancy by forming a barrier that protects the uterus against infection. This study investigates the use of laser speckle rheology as a noninvasive technique to assess cervical mucus biomechanics. Synthetic cervical mucus was fabricated at varying hydration levels and tested using a conventional rheometer that confirmed that the mechanical properties of the synthetic mucus samples were representative of physiological cervical mucus. These results were compared to the complex …

Implementation Of An Adolescent Women’S Health And Wellness Education Program, Lauren Acker, Laynee Conner, Jennifer Cera

Doctor of Nursing Practice Projects: College of Nursing

Objectives: The goal of this research study was to provide scientific evidence supporting the importance and effectiveness of implementing a women’s health and wellness education course and its effect on (1) adolescent knowledge of sexual health and hygiene, (2) self-efficacy in menstrual management, and (3) self-empowerment in managing their own reproductive health.

Design: This was a mixed methods pilot study utilizing a pre/post-test single intervention efficacy trial. Quantitative and qualitative data were obtained.

Setting: The setting included two different sites including one outpatient ambulatory obstetrics/gynecology clinic and one community outreach center. Both sites were located within a midwestern metropolitan …

Identification And Preclinical Assessment Of Novel Therapeutic Modalities In Environmental Exposure-Induced Lung Disease, Aaron D. Schwab

Theses & Dissertations

Environmental lung diseases are preventable respiratory conditions either caused or made worse by inhaled environmental exposures. Contemporarily, environmental lung diseases are most associated with workplace exposures given specific occupational processes aerosolize inflammatory agents that can be inhaled at high concentrations. Although a considerable amount is known regarding immunoglobulin (Ig)E-mediated responses to environmental exposures, little is known about non-IgE mediated respiratory conditions resulting from lipopolysaccharide (LPS)-enriched organic dust exposure(s). Chronic respiratory diseases such as asthma, hypersensitivity pneumonitis, chronic obstructive pulmonary disease (COPD), and pulmonary fibrosis have all been identified as environmental lung diseases caused or exacerbated by such environmental dusts. Therapeutic …

Prevalence Of Well Water Contaminants In Georgia From 2010-2022, Angelique B. Willis, Suhasini Ramisetty-Mikler, Christine E. Stauber, Uttam Kumar Saha

Journal of the Georgia Public Health Association

Background: Safe, reliable, and clean drinking water sources are a basic necessity. More than 1.7 million individuals rely on private wells for drinking water in Georgia and are confronted with water quality challenges stemming from chemical contamination as private wells are not under mandated regulations as public water supplies. In Georgia, previous studies suggested that the variation of soil and rock in a physiographic province (region) plays an essential role in the quality of private well water. There is a need to understand the distribution of these chemical contaminants above the federal Maximum Contaminant Level (MCL) and how different geologies …

Schistosoma Haematobium Infection In Ethiopian Children: Evaluating Praziquantel Efficacy, Nutritional Effects, And Diagnosis Using Flukecatcher, Louis Fok

Theses & Dissertations

Urogenital schistosomiasis continues to impact the wellbeing of hundreds of millions of people worldwide and remains a significant public health challenge across Ethiopia. Despite existing knowledge on the disease, there remain significant unanswered questions with regard to its treatment and diagnosis. This dissertation evaluated the efficacy of praziquantel at treating urogenital schistosomiasis, improving nutritional parameters among children and the performance of FlukeCatcher at detecting and determining the intensity of infection. In effecting this, a total of 977 children aged 5 through 15 from the Afar and Gambella regions of Ethiopia were screened for S. haematobium infection using urine filtration microscopy …

Healthcare Experiences And Pain Dismissal By Healthcare Professionals, Amanda Warren

Honors Theses

Background. Pain dismissal by healthcare professionals has gained recent attention in popular culture as people have come forward to discuss their own experiences with this issue. Pain dismissal is prevalent within the healthcare system, and college-aged young adults may be particularly vulnerable to experiencing pain dismissal because of their age. College students may also be influenced by societal factors that may affect their attitudes towards seeking help and advocating for themselves during healthcare visits. There is limited research on college students' attitudes and behaviors on seeking help after experiencing pain dismissal by a healthcare provider. This study aims to 1) …

Opmed Seal: Engineering A Rapid-Response Biodegradable Device For Hemorrhage Control And Infection Prevention In Abdominal Trauma, Paula M. Cabrera, Wesley Stephen Murphy

Honors Theses

Abdominal gunshot wounds are amongst the deadliest injuries encountered in combat and remote emergency settings. For military medics and first responders, the challenge lies in controlling internal bleeding and preventing infection before patients can reach surgical care-often within a narrow window of time known as the “golden hour”. Currently available field treatments are either too slow, not designed for internal wounds, or fail to provide antimicrobial protection. To address this gap, our team developed OpMed Seal: a compact, dual-syringe delivery system that deploys a biodegradable, antibiotic-infused hydrogel directly into abdominal injuries. The system is designed for rapid hemorrhage control, localized …

A Modified Sir Model Used To Investigate The Relationship Between Congenital And Adult Syphilis, Kaleesta R. Waysman

Honors Thesis

A complex SIR model integrating the relationship between adult and congenital syphilis was developed. The goal of the project was to determine the specific population(s) or control strategies that should be enforced, altered, or removed to decrease the number of children experiencing clinical sequelae due to congenital syphilis. Early clinical sequelae include hydrops fetalis, preterm birth, central nervous system infection, hepatosplenomegaly, hyperbilirubinemia, cholestasis, hemolytic anemia, snuffles, osteochondritis, and lesions or rashes in the palms and soles. Late clinical sequelae include interstitial keratitis, hearing loss, Hutchinson teeth, saber shins, Clutton joints, mulberry molars, and saddle nose. After implementing real-world data into …

Cardiovascular Disparities In Mississippi: A Sociological Study Of Heart Health Literacy Among University Students, Laney Etheridge

Honors Theses

Mississippi ranks among the worst states in the United States for cardiovascular health, with high rates of heart disease, obesity, and hypertension. This thesis examines how race and gender influence heart health literacy and behavioral practices among University of Mississippi students. Utilizing a mixed-methods approach, this study combines quantitative survey data from a stratified random sample of 1,000 students with qualitative interviews from a public health professional specializing in cardiovascular health and a student heavily involved with on-campus heart health programs. The findings suggest that disparities in heart health literacy both align and differ with broader social stratification patterns observed …