Medicine and Health Sciences Commons^™

Adapting And Piloting An Evidence-~Based Hiv/Aids And Teen Pregnancy Prevention Intervention For Native American Teens, Murlynn Crystal Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Native American youth are at disproportionate risk for HIV infection. Native Americans represent about 1.7% of the U.S. population, yet they rank fifth in HIV/AIDS diagnosis nationwide (U.S. Census, 2012; CDCd 2013). Native Americans with HIV/AIDS are more likely to be younger than non-Native Americans with the disease. There are limited evidence-based HIV/AIDS and teen pregnancy prevention interventions that have been developed, adapted, and/or evaluated for Native American teens. The purpose of this study was to adapt an existing evidence-based HIV/AIDS and teen pregnancy prevention intervention into a culturally responsive intervention curriculum for Native teens. Methods: There were three …

The Lived Experience Of Registered Nurses With Substance Use Disorder Who Complete An Alternative To Discipline Program Through A State Board Of Nursing, Susan Melanie Ervin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Substance use disorder, defined as the misuse of drugs and/or alcohol, is a major health problem in the United States. Health care providers, including nurses, are at risk for this disorder. Risk factors for substance use disorder (SUD) in nurses include social factors such as family history of the disorder and biological factors such as genetic predisposition. Specific risk factors for nurses include easy access to controlled substances (such as opiates), stressful work environments, the belief that substance use assists with coping and a lack of education related to substance use disorder.

Substance use disorder in nurses is a significant …

Cbct Evaluation Of Adolescent Mandibular Morphology In Different Classifications Of Facial Type, Annie Hsu

UNLV Theses, Dissertations, Professional Papers, and Capstones

The goal of this study is to use the improved imaging capability of cone-beam computerized tomography (CBCT) to investigate the relationship between vertical facial patterns and mandibular tooth-alveolar morphology in the adolescent population. Pre-treatment orthodontic records were obtained from the UNLV School of Dental Medicine archival dental records. One hundred and seventy three patients (72 males, 101 females) between the ages of 12 and 18 years were included in this study. Among these patients, 61 displayed the vertical growth pattern, 30 displayed the horizontal growth pattern, and 82 displayed the average growth pattern. The samples were categorized into 4 age …

Differences In Disease Reporting: An Analysis Of State Reportable Conditions And Their Relationship To The Nationally Notifiable Conditions List, Brian Labus

UNLV Theses, Dissertations, Professional Papers, and Capstones

The basis of public health surveillance is the reporting of diseases and conditions to the health department by clinicians and laboratories. In the United States, over eighty diseases and conditions of national importance (e.g., tuberculosis, syphilis, and cancer) are included on the list of Nationally Notifiable Conditions (NNC) for submission to the Centers for Disease Control and Prevention (CDC) by the states. The legal basis for disease reporting is found at the state level, where inconsistent laws may differ in terms of which conditions are reportable and their reporting process. The process by which states require the reporting of NNCs …

Health Impact Assessment Of Proposed Rental Housing Policy Within Clark County, Nevada, Usa, Erika Raquel Marquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Homes serve as a central function of our everyday lives, they are where most Americans spend a significant amount of time and money. The quality of our homes can impact our health. Poor housing can cause and contribute to preventable diseases and injuries, such as the development or exacerbation of asthma, neurological deficits, cardiovascular diseases, and cancer. According to the American Housing Survey (2013) approximately 5.8 million homes, of 132 million homes in the United States, are in moderate to severe physical disrepair, with rental housing being at a disproportionate burden. According to 2013 U.S. Census, Clark County, Nevada has …

The Lived Experience Of Nurses Working In A Modified Therapeutic Community, Victoria Lynn Plagenz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Today over one million U. S. prisoners are being held in federal and state systems for substance use-related crimes. The financial, social, and emotional costs have turned policymakers’ attention to rehabilitation rather than incarceration. In an attempt to meet the challenge of recovery from addiction, prison systems around the nation have explored various options, including residential treatment programs. One such form of residential treatment is the modified therapeutic community (MTC) where inmates participate in a nine-month, cognitive-based treatment program. This model focuses on incarcerated individuals, addicted to substances, to assist them in developing behaviors to reduce antisocial peer associations and …

Scardovia Wiggsiae Prevalence In Orthodontic Patients, Brandon Joseph Streiff

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dental caries has mainly been associated with Streptococcus, Lactobacillus, Actinomyces and Veillonella species. But in recent salivary studies a new cariogenic pathogen, has been identified. This new bacteria, Scardovia wiggsiae (SW), is currently being tested within the UNLV School of Dental Medicine patient population. Although these current studies are being conducted to study its prevalence in both pediatric and adult populations, it has not been evaluated among patients with an altered oral environment as seen in patients with orthodontic appliances. Fixed orthodontic appliances increase the difficulty of removing daily plaque on and in between the teeth with standard oral hygiene …

Television Consumption And Child Obesity: Linking Children's Contemporary Television Use, Physical Activity, And Advertising To Putnam's Displacement Hypothesis, Brittany L. Altamirano

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study observed the relationship between television consumption and child obesity through the theoretical construct of Putnam’s displacement hypothesis. It did so by updating the previous research through the investigation of the displacement of both physical activity and advertisements on contemporary television platforms. The inclusion of Putnam’s displacement hypothesis was to provide a foundational framework, not found in previous literature, to study two important paradigms that were represented in previous research: 1) the displacement of physical activity; and 2) the displacement of traditional advertisement exposure.

Several trends became apparent within previous literature. Previous literature did not include an explicitly stated …

Evaluating A Novel Approach For Type 2 Diabetes Mellitus Patient Education: Modified Team -~ Based Learning, Corine Belle Lazaro

UNLV Theses, Dissertations, Professional Papers, and Capstones

One of the world’s most serious health issues today is the increasing prevalence of diabetes (Chobev, Sotirovska, Mihajilov, 2011). Indeed, the growth of this widespread and pernicious disease has been categorized as epidemic. The antidote for the diabetes epidemic lies in prevention and the use of a chronic care model that focuses on improving diabetes self-management. For both diabetes prevention and self-management, a core component pertains to knowledge—and specifically to improved public health literacy, public health education, and patient education. For example, ongoing patient education is a critical factor in helping patients to manage their diabetes and prevent the micro- …

A Comparison Of Beliefs And Attitudes About Body Image, Eating And Weight Between Incarcerated And Non-~Incarcerated Females, Anne R. Lindsay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Abstract

Incarceration and substance abuse are two of the largest public health issues in America. While the U.S. makes up only 5% of the world’s population, it accounts for 25% of its prisoners. Incarceration affects more than 2.2 million individuals who will eventually return to their families and communities with ongoing family, social and health issues. Women in prison are a particularly vulnerable and underserved population, generally of low education and socio-economic status and although they account for a small percent of the prison population, many are mothers of young children who are likely to become incarcerated themselves. Substance abuse …

An Evidence Based Approach To Sepsis: Educational Program, Dolores Perez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Evidence-based guidelines for recognizing and treating sepsis have been available for decades, yet healthcare providers do not adhere to the recommendations. Sepsis can progress rapidly if not recognized early. Literature reports reveal that sepsis is the leading cause of death in non-cardiac intensive care units (ICUs), and it is one of the most expensive conditions to treat. A hospital in the Las Vegas, Nevada area had previously introduced sepsis management prescriptions in 2011 with no formal education of sepsis guidelines to nurses. The original hospital’s sepsis management prescription sets followed guidelines dated 2008. The purpose of this project was to …

Assessment Of Orthodontic Patients' Preferences Regarding Treatment From General Dentists Or Orthodontists, Brian Robert Wilde

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study evaluated how parents of prospective orthodontic patients choose between taking their child to a general dentist or an orthodontist for orthodontic treatment. It also looked at which factors influence patients’ satisfaction with the progress of treatment and likelihood to refer other patients to the practice. This study included two phases. The first phase was a qualitative assessment of the decision making process through conducting and analyzing focus groups. The second phase was the development and administration of a nationwide online survey regarding the topics covered in the focus groups. Influential factors in the decision making process fell into …

The Presence Of Clostridium Difficile On Environmental Surfaces In Healthcare Facilities Pre- And Post-Decontamination Of Patient Rooms, Theresa Trice

UNLV Theses, Dissertations, Professional Papers, and Capstones

Healthcare-associated infections (HAIs) are infections related to receiving medical care. HAIs are responsible for an excess of morbidity and mortality among hospitalized patients. Though most HAIs rates are on the decline, Clostridium difficile infection rates are at an all-time high, primarily due to the persistence of C. difficile spores in the environment. In the United States, Clostridium difficile-related mortality rates per million have increased from 5.7 in 1999 to 23.7 in 2004, with an estimated 26,642 deaths due to Clostridium difficile infections (CDIs). Clostridium difficile is transmitted via the fecal-oral route or aerosolized endospores, but it can also be transmitted …

The Effect Of Sleep On Perceptual Learning And Memory Consolidation, Vanessa Claire Irsik

UNLV Theses, Dissertations, Professional Papers, and Capstones

An ability to segregate speech accurately is essential given that most auditory environments contain other overlapping conversations or environmental noise. While perceiving speech among background noise can be difficult in and of itself, those with hearing impairments can experience considerable difficulty. While training has been shown to benefit perceptual segregation of trained sounds, it is unclear how such training transfers to sounds not included in a training regimen. The current study aimed to address this question by training listeners on a portion of sounds during a vowel segregation task, and subsequently testing on both the trained sounds and untrained sounds. …

Educators’ Perspectives Associated With School Garden Programs In Clark County, Nevada: Practices, Resources, Benefits And Barriers., Tomomi Murakami

UNLV Theses, Dissertations, Professional Papers, and Capstones

School garden programs have been utilized in the U.S. since their introduction at the end of the 19th century. The use of school gardens and the teaching style implemented in them are dependent on individual schools and teachers. Educators’ attitudes, knowledge, and motivation for a school-based gardening program are crucial to implementing comprehensive school garden programs. To move toward an expansion of garden education, it is necessary to determine the concerns, resources, benefits or barriers that educators identify regarding the utilization of gardens to teach their students. The purpose of this pilot study was to determine principals’ and teachers’ perceived …

Comparing Functional Motor Control And Gait Parameters In Children With Autism To Those Of Age-Matched Peers Who Are Typically Developing, Patricia Stevenson, Samantha Novotny, Jillian May, Christopher Ancell

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to compare motor performance of children with Autism Spectrum Disorder (ASD) to that of age-matched peers who are typically developing (TD) on motor control tasks plus symmetry and variability of gait parameters across four walking conditions. A sample of convenience of children with ASD (n=6) and peers who are TD (n=6) were recruited. Motor control was assessed using initiation and completion times on the Timed Up and Go (TUG) test. Gait parameters were collected using a computerized walkway under four trial conditions: 1) walking at self-selected velocity (SSV); 2) walking during a tray-carrying task …

Four Weeks Of Minimalist Style Running Training Reduced Lumbar Paraspinal Muscle Activation During Shod Running, Stephanie Barton, David Brown, Talia Joyce

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Research has shown that the risk of low back dysfunctions in runners is related to the increased mileage of distance running. Repetitive shock loading of the spinal structures during running has been indicated as one of the important biomechanical mechanisms underlying such injury. Acute changes in foot strike pattern, like those seen during minimalist style running, have been shown to lead to modifications in lumbar range of motion. Minimalist style running could lead to changes in lumbar biomechanics and muscle activation, potentially reducing the loading on the musculoskeletal structures of the lower back. However, the long term …

The Voices Of The People: Lower Sioux Indian Community Members Speak Out On What They Need And Want In A Primary Health Care Clinic On The Reservation, Darin Michael Prescott

UNLV Theses, Dissertations, Professional Papers, and Capstones

American Indian/Alaska Native (AI/AN) people who live on reservations or in urban areas typically receive their health care in clinics that are operated by their tribe or are affiliated with Indian Health Service (IHS), a federal agency that provides care to AI/AN people. The Lower Sioux Indian Community (LSIC) is a federally recognized tribe located in southwest Minnesota near Morton, MN. LSIC members currently receive health care from outside providers at various locations near the reservation. The outsourced services include primary care, emergency care, hospitalization, surgery, dentistry, and podiatry. Because the providers are independent groups and do not work for …

The Effects Of Instruction On Landing Strategies In Female College-Aged Dancers And Non-Dancers: A Pilot Study, Brittany Keating, Jason Pyfer, Kimberly Vialpando

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background Female athletic participation has increased over the past decade and with it the prevalence of knee injuries. Current research demonstrates an increased risk of anterior cruciate ligament (ACL) injury for female athletes. However, a number of studies have pointed out that ballet and modern dancers exhibit a lower incidence of ACL injuries despite the fact that they perform jumping and landing frequently.

Objective The objective of this study was to examine how dance experience and instruction affect the lower extremity biomechanics during drop landings. Specifically, lower extremity joint alignment and muscle activation of gluteus maximus and gluteus medius were …

Immediate Effects Of Cervical Spine Manipulation On Gait Parameters In Individuals With And Without Mechanical Neck Pain, Jordan Isom, Shaylyn Kennedy, Justin May, Samuel Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to determine 1) if there were any differences in gait parameters between participants with mechanical neck pain and those without and 2) if cervical spine manipulation has an immediate effect on these gait parameters.

Methods: Twenty participants with mechanical neck pain and twenty participants without neck pain were randomly assigned into either the sham or manipulation group. The two intervention groups participated in walking across a GAITRite Walkway that recorded gait parameters such as stride length, cadence and step width before and after cervical spine manipulation. The participants walked at their own cadence …

Increasing Comfort With End-Of-Life Discussions, Theresa Catherine Berton

UNLV Theses, Dissertations, Professional Papers, and Capstones

End-of-life discussions and advanced care planning are part of the healthcare process, and within the scope of practice for providers. Despite the evidence supporting the effectiveness of these conversations, the system falls short. Talking about death is never easy. At times, it is difficult for healthcare providers to approach the topic with patients who are living with serious life-limiting illness. Reports in the end-of-life literature reveal that healthcare professionals avoid discussions about preparations for end-of-life care due to feeling unprepared, and a lack of framework for such discussions. Purpose: The purpose of this doctoral project was to improve the quality …

Understanding Perceptions Of Genetically Modified Food Among Natural Food Shoppers In Southern Nevada, Christian Murua-Aceves

UNLV Theses, Dissertations, Professional Papers, and Capstones

Today, 85% of corn, 93% of soybeans, and 88% of cotton in the U.S. are genetically modified (GM). Using laboratory methods, genes from one species, such as a plant, can be transferred to an unrelated species, such as an animal. Genetically modified crops may lead to higher yields, have improved food quality, texture, and nutritional value, and have an increased shelf life.

Despite these promising benefits, the potential health risks relating to the consumption of GM food remain inadequately assessed. Genetically modified food is not subjected to rigorous safety testing, such as epidemiologic studies, to identify potential health risks. Two …

Reliability Of A Multisegment Foot Model In Shod Running, Austin Coupe

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine kinematic and marker placement reliability of the Leardini multisegment foot model (LMFM) for tracking foot kinematics during barefoot and shod running without alteration of footwear. Eleven participants, five males (25.6±5 yrs, 73±15.8 kg, 1.75±0.05m) and six females (22.5±2.9 yrs, 66.6±7.2 kg, 1.71±0.05 m) granted institutionally approved written consent to participate. Three-dimensional motion capture (10 Vicon T40-S cameras) was used to capture kinematic data at 200Hz. Kinetic data was captured with an in-ground force platform (Kistler Instruments AG, Switzerland Model 9281B 60x40cm, 2000Hz). Participants were instructed to run at 3.5m/s ±5%. Velocity was …

Lead Hazard Control In Henderson, Nevada: Identifying Critical Areas And The Associated Costs, Khaye Gerazel Arcilla Rufin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lead poisoning is a common, yet preventable childhood health problem in the United States today. Studies show statistically significant (p < .05) associations between higher childhood lead exposure and subsequent negative developmental outcomes. Since 1993, the U.S. Department of Housing and Urban Development (HUD) Lead Hazard Control (LHC) Grant Program has devoted more than $1 billion in funding to several cities.

This study investigated a total of n=75 homes enrolled into the Henderson Lead Hazard Control and Healthy Homes Program (HLHCHHP) from December 2013 – February 2015. A logistic regression was performed to ascertain the frequency of lead-based paint (LBP) found in homes based on the year it was constructed. Of the 75 enrolled and tested for LBP, 58 homes (77.3%) were found to contain LBP and 17 homes (22.7%) did not contain LBP. The significance value of p=0.013 shows that …

The Effects Of Enhanced And Decreased Expectations On Balance Performance In Those With And Without Parkinson’S Disease, Joshua Ostrander, Granuaile Parrish, Jacob Blood

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: It has been reported individuals typically perform well on a task when enhanced expectancy was provided prior to task performance. It has also been reported people with Parkinson’s disease (PD) are especially susceptible to pre-task placebo cuing and suggestion. Evidence of this susceptibility has been previously demonstrated through brain imaging studies and with demonstration by individuals with PD improved balance performance.

Objective: This study was designed to further previous studies’ results for improved task performance with enhanced expectancy. The purpose of this study was to investigate if the pre-task verbal delivery of enhanced expectancy, decreased expectancy and no expectancy …

Patient No-Show For Outpatient Physical Therapy: A National Survey, James Bokinskie, Payton Johnson, Trevor Mahoney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Patients who fail to show for scheduled medical appointments (no-show) create a cascade of issues for the health care system, the provider, and themselves. No-show can affect clinical productivity, cost and quality of care, and treatment outcomes. There is an overwhelming lack of research on no-show as it relates to outpatient physical therapy in the United States. The purposes of this study were to report national no-show rates, describe the presence and characteristics of no-show policies, determine the relationship of these policies and other demographic information to no-show rates, and describe the most commonly perceived reasons for no-show.

Methods: …

Comparing Usability And Variance Of Low- And High Technology Approaches To Gait Analysis In Health Adults, John Mcconnell, Brian Silverman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to compare the usability, reliability, and objectivity of four tools that represented varying gait analysis technologies used in clinical practice and/or research. Low technology clinical tools included the Gait Abnormality Rating Scale (GARS-M) and the Rancho Los Amigos Observational Gait Analysis (Rancho OGA). High technology tools included the GAITRiteÒ computerized walkway, and the APDM Mobility LabÔ wearable sensor system.

Subjects: 74 healthy adults ages 18-41 years (mean = 24.82, SD = 4.39) 33 males and 40 females.

Methods: Subjects were instructed to walk at a self-selected speed for two minutes …

Understanding The Experience Of Medicare Advantage Patients In A Health Maintenance Organization, Curtis E. Boldman

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study was conducted using a single Health Maintenance Organization in Las Vegas, NV to determine the key drivers and attributes of quality in the patient experience for Medicare Advantage holders. The purpose of this study was to investigate these perceptions of quality to assist the provider in identifying the areas in their treatment process which could be refined in order to better serve their customer base. With the recent changes in healthcare laws, patient satisfaction is now a key determinant in the financial compensation providers receive for services performed.

Data was collected by doing patient intercepts outside of the …

Functional Capacity In Schizophrenia: Relationship Among Effort, Reinforcement Learning And Self-Beliefs, Sally J. Vogel

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals with schizophrenia exhibit a wide range of complex neurocognitive, psychiatric and behavioral impairments. Recent research suggests that this complex array of symptoms can be at least partially accounted for by dysfunction in more basic mechanisms, such as the ability to learn from positive and negative reinforcement, or the ability to exert adequate effort when completing simple tasks. Evidence also suggests that deficits in these basic mechanisms may contribute to more complex symptoms, such as functional impairment. Also, the relationship between neurocognitive deficits and functional impairment has been found to be mediated by defeatist performance beliefs. However, studies have not …

Changes In Sprint Kinetics Or Kinematics Following Static Or Dynamic Stretching, Kristyne Bartel

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine the effects of static or dynamic stretching on hip kinematics and kinetics during intermittent sprinting. To achieve this aim, intermittent sprint athletes were asked to complete either a static or dynamic stretch, followed by a repeated-sprint protocol. Hip joint kinematics and performance measures were evaluated during the sprint, including changes that occurred in these variables over the course of the sprint protocol. In addition, hip flexion torque was measured with an isokinetic dynamometer. Ten male (age = 25±2.3 years, 175±3.2 cm, 76.2±2.7 kg) and female (age = 20±1 years, 166±1.3 cm, 60±1.1 …