Medicine and Health Sciences Commons^™

Clinical Instructors' Cultivation Of Pre-Licensure Nursing Students' Pharmacology Ksas, Rieneke Holman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Adverse drug events affect up to 5% of inpatients; half of these events are caused by preventable medication errors (Agency for Healthcare Research and Quality, 2015). Nurses are the final checkpoint between a medication being ordered and the patient taking it. This profound responsibility requires nurses to possess well-developed pharmacology knowledge, skills, and attitudes (KSAs). To acquire these abilities, they must not only receive pharmacology content as part of their educational preparation, but also translate what they have learned during student clinical experiences. This is important in bridging the gap between what is learned in the

classroom and clinical practice. …

Modeling Impaired Hippocampal Neurogenesis After Radiation Exposure, Kapukotuwa Walawwe Sidath Chathuranga Kapukotuwa

UNLV Theses, Dissertations, Professional Papers, and Capstones

The birth of neuronal cells from neuronal stem cells is known as neurogenesis, and the granular cell layer of the dentate gyrus of hippocampus is one of the two regions in the brain this process occurs. Cognitive damages following radiation therapy for brain cancers in both children and adults have been linked to impairment of neurogenesis in the hippocampus. Studies followed using mice and rats as model animals have shown impairment in neurogenesis process following exposure to radiation. Obtaining experimental data for radiation-induced changes in neurogenesis in humans is very difficult. Model was developed and applied to mouse data previously; …

Effect Of Bmp Treatment On Periostin Gene Expression In Pre-Osteoblastic Mc3t3-E1 Mouse Cells, Vincent Lee Khang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Periostin is a secreted, extracellular matrix (ECM) protein widely expressed within collagen-rich fibrous connective tissues of the body including the periodontal ligament (PDL), bone, skin, heart, and cornea. Periostin has been shown to serve many important regulatory functions including cell adhesion, cell motility, wound healing and of particular importance to the dental field, differentiation of osteoblasts. The deletion of periostin compromises osteoblast attachment to bone matrix and induces a reduction in mineralization and expression of bone markers, including type I collagen, osteocalcin, osteopontin and alkaline phosphatase. Periostin has also been shown to play a significant role in collagen fibrillogenesis by …

Implementing High-Fidelity Simulation To Meet Undergraduate Clinical Requirements, Tammy Lynn Mccoy

UNLV Theses, Dissertations, Professional Papers, and Capstones

Increased demand for clinical experiences, lack of clinical sites, and shortages of qualified nursing faculty are reasons undergraduate nursing programs are seeking to utilize simulation to meet student learning needs. High-fidelity simulation (HFS) gives students the

opportunity to develop technical skills, enhance critical thinking skills, and apply theoretical concepts to clinical presentations in a controlled, safe environment. There is mounting interest in replacing traditional clinical hours with simulated practice experiences, particularly in specialty nursing areas like obstetrics. Despite literature supporting HFS and the positive effects of its use in undergraduate nursing education, faculty remain unfamiliar with the process of integrating …

Concept Interview Assignment To Foster Intentional Learning In Nursing Students, Sarah Mollman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Intentional learning is the process of acquiring skills and attributes that facilitate knowledge attainment and application, and this process may foster learning skills and attributes in nursing students so they may thrive in student-centered nursing curricula and competently practice in today’s dynamic and complex healthcare system. The purposes of this study were to determine 1) if there are any associations between academic achievement and intentional learning and 2) if there is an effect of a nursing concept interview assignment on academic achievement and intentional learning scores in second-semester nursing students.

The majority of studies on intentional learning were quasi-experimental designs …

Interleukin-1 Beta (Il-1Β) Gene Polymorphisms In Pre-Treatment Orthodontic Patients Exhibiting Short Root Anomaly (Sra), Satyaprasad Nayak

UNLV Theses, Dissertations, Professional Papers, and Capstones

Root resorption is a frequent unwanted occurrence during orthodontic treatment. Biological factors include the quantity of specific inflammatory mediators, growth factors, and hormones as well as an individual’s specific alleles for the genes encoding these mediators. Studies have shown an association between external apical root resorption (EARR) and the single nucleotide polymorphism (SNP) at +3954 of the IL-1β gene. Studies have also shown associations between chronic periodontitis and IL-1β gene polymorphisms in the region of +3954, -511 and -31. All previous studies to date, have evaluated genetic factors and root resorption in orthodontic patients in-treatment or post-orthodontic treatment. This study …

3-D Upper Airway Comparison Between Class I And Class Ii Adults With Excessive Daytime Sleepiness, Nga Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: The aim of the study is to determine whether there is a relationship between the risk for daytime sleepiness in adults with Class I and Class II malocclusion and the airway volume, minimum cross-sectional area, and shape at the minimum cross sectional area.

Introduction: Sleep disordered breathing (SDB) is a category of conditions defined by airway complications while a person is sleeping. Obstructive sleep apnea (OSA) is the most common of these disorders and is defined as the presence of repeated episodes of complete or partial airway obstruction, which may be associated with loud snoring and daytime sleepiness. Daytime …

Educating Perinatal Nurses To Promote Bonding Techniques And Increase Support Of Neonatal Intensive Care Unit Parents, Kandice Perez

UNLV Theses, Dissertations, Professional Papers, and Capstones

NICU treatment team members and perinatal nurses must strive to educate parents and promote parent/infant bonding; failure to do so can result in poor emotional well-being of the parent. Supportive behaviors of nursing staff, and the promotion of bonding techniques inside and outside of the NICU setting can provide aid to parents throughout their NICU journey. However, perinatal nurses are often not provided the necessary knowledge and skills to promote parental bonding, emotional support, empowerment, and education to parents whose infants are unexpectedly admitted to the NICU. Purpose: The purpose of this DNP project was to increase perinatal nurses’ knowledge …

Prostate Cancer Survival Among Hispanics: A Surveillance, Epidemiology, And End Results (Seer) Population-Based Cohort Study, David Rivas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hispanics are now the youngest, largest, and fastest growing minority group in the U.S. Prostate cancer (PC) is the most commonly diagnosed cancer in men and is the second-leading cause of cancer deaths among Hispanics. For the first time, we examined PC-specific survival among distinct Hispanic groups that include Mexicans, Cubans, Dominicans, Puerto Ricans, as well as Central and South Americans. We compared these groups to the main reference population in the U.S., non-Hispanic Whites (NHW), after adjustment for prognostic factor risk categories (prostate-specific antigen (PSA) level, Gleason score, and tumor stage), as well as sociodemographic covariates (e.g., health insurance, …

Prevalence Of Cariogenic Microbial Flora Among Scardovia Wiggsiae-Positive And Negative Patients, Amy Tam

UNLV Theses, Dissertations, Professional Papers, and Capstones

The formation of dental caries (cavities) is a complex, multi-dimensional process that necessarily involves many risk factors – including the acquisition and colonization of cariogenic oral bacteria. The most frequently associated oral pathogens are the acid-producing and acid-tolerant oral streptococcus species, such as Streptococcus mutans (S. mutans or SM). Many studies have established and confirmed the critical role of the formation of biofilm in the virulence of S. mutans, and the critical role this may play in determining the balance of the oral microbiome towards health or disease.

More recent efforts have discovered a novel cariogenic pathogen, Scardovia wiggsiae (S. …

Design & Delivery Of Automated Winston-Lutz Test For Isocentric & Off-Axis Delivery Stability Utilizing Truebeam Developer Mode & Electronic Portal Imaging Device, Mahmoud Mohammad Yaqoub

UNLV Theses, Dissertations, Professional Papers, and Capstones

The uncertainties in treatment delivery cannot be ignored in radiation therapy. Thus, the quality assurance QA tests are very important task of the medical physicist in clinical practice. Assuring the coincidence between the mechanical isocenter of the Linear Accelerator (LINAC) and its radiation beams isocenter is one of the most important qualities need to be tested, and the Winston Lust (WL) test is the

most popular technique to perform this task, especially for the treatment modalities which need high precision in beam delivery such as the stereotactic radiosurgery/stereotactic body radiotherapy (SRS/SBRT). The linear accelerator-based SRS/SBRT is a well-established method in …

Electron Monte Carlo Dose Calculation Model Dependency On Optional Applicator Specific 1d Profiles, Ryan Sharp

UNLV Theses, Dissertations, Professional Papers, and Capstones

The accuracy of a calculated dose distribution compared to the actual dose administered to a patient undergoing electron radiation treatment is dependent upon the configured electron dose calculation algorithm in the treatment planning system (TPS). Configuration of the electron Monte Carlo (eMC) algorithm in the Eclipse TPS requires a variety of beam scan data. One of the required data sets is the inclusion of optional in air crossplane (CP) and inplane (IP) profiles. It is unknown if the inclusion of the optional profiles into the eMC algorithm greatly influences the output of the TPS. Two eMC algorithms were configured in …

An Examination Of The Community And Environmental Impact Of A Las Vegas Convention Food Rescue Program, Samantha H. To

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity affects millions of Americans each year, inflicting negative consequences on the physical and mental health outcomes at all ages. Concurrently, millions of tons of leftover edible foods are sent to landfill each year. Not only does this pose a question of ethics, but increasingly harms the environment by misusing resources and increasing the release of

greenhouse gases.

Food rescue advisory meetings highlighted the need for more focused research to be conducted that assessed the impacts of donating rescued convention food on local environmental and community health. A mixed-method approach was used to detail the food rescue process between …

Hiv Mortality Difference Between Black And White Women, Carlos O. Nesbeth, Rajiv Kandala, Syed Najeeb, Ruksana Nazneen, Banglore Murthy

Journal of Health Disparities Research and Practice

OBJECTIVE

In the United States, human immunodeficiency virus (HIV) continues to be among the top 10 leading causes of mortality for black women between the ages of 20 and 54¹, but does not rank among the top 10 leading causes of death for white women amongst all age groups^². This study describes the HIV mortality difference between black and white women and formulate hypotheses that may reduce or eliminate disparities.

METHODS

Information was accessed through public data, the US Census, and the US Compressed Mortality File.

RESULTS

In these descriptive data from 1987 through 2015, including reliable HIV …

Asian Americans’ Cancer Information Seeking, Fatalistic Belief, And Perceived Risk: Current Status And Relationships With Cancer Prevention And Detection Behaviors, Jungmi Jun, Xiaoli Nan

Journal of Health Disparities Research and Practice

This study pursues four research goals: (1) to examine Asian Americans and Asian ethnic groups’ (i.e., Chinese, Filipinos, Japanese, Koreans, Vietnamese) information seeking, fatalistic belief, and perceived risk of cancer, in comparison to non-Hispanic Whites; (2) to identify characteristics of Asian Americans who seek cancer information, hold fatalistic cancer belief, and perceive cancer risk; (3) to assess cancer prevention and detection behavior gaps between Asian Americans and Whites, and (4) to explore whether such gaps can be explained by cancer information seeking, fatalistic belief, and perceived risk. Data from 2011-2014 Health Information National Trends Surveys (HINTS) were analyzed. Asian Americans …

Household Financial Assets Inequity And Health Disparities Among Young Adults: Evidence From The National Longitudinal Study Of Adolescent To Adult Health, Shiyou Wu, Xiafei Wang, Qi Wu, Kathleen Mullan Harris

Journal of Health Disparities Research and Practice

Introduction: Research has established a strong relationship between financial resources and health outcomes. Yet, little is known about the effects of assets disparities on health outcomes, especially during the critical period when adolescents transition to adults.

Methods: Using data from the National Longitudinal Study of Adolescent to Adult Health (n = 10,861), this study investigated the relationships between three household total assets value groups (low, moderate, and high assets) and three net worth groups (negative, neutral, and positive) on young adults’ general health, obese, and depression.

Results: Both assets and debts were related to young adults’ health status, …

Graduating Into Lower Risk: Chlamydia And Trichomonas Prevalance Among Community College Students And Graduates, Janet E. Rosenbaum

Journal of Health Disparities Research and Practice

Background: Community colleges enable youth from economically disadvantaged and minority populations to access college and may enable social mobility including improved health outcomes. However, educational health disparities studies rarely assess the health outcomes for community college graduates.

Methods: Chlamydia and trichomonas prevalence were assessed with nucleic acid based tests in a nationally representative sample of 6233 high school graduates (ages 18–25) from five educational levels: young adults without post-secondary credentials who were not enrolled in college, community college students, 4-year college students, associate’s degree, and bachelor’s degree. To reduce confounding between educational attainment and STI status, we used full matching …

A Cohort Study Of Public Health Insurance Coverage Loss Among Oregon Adolescents, Heather Angier Mph, Carrie Tillotson Mph, Lorraine Wallace Phd, Miguel Marino Phd, Jean O'Malley Mph, Aleksandra Sumic Mph, Lynn Baker Bsee, Christine Nelson Phd, Rn, Nathalie Huguet Phd, Andrew Suchocki Md, Mph, Heather Holderness Mph, Jennifer E. Devoe Md, Dphil

Journal of Health Disparities Research and Practice

ABSTRACT

Introduction: Churning on and off and/or experiencing coverage gaps is common among public health insurance recipients. Although the Affordable Care Act (ACA) provisions to extend parental coverage for adolescents transitioning to young adulthood on private insurance plans were implemented in 2010, no such protection was mandated for adolescents with public health insurance.

Methods: Oregon public health insurance enrollment and electronic health record data from community health centers were used to conduct a retrospective, observational cohort study of Oregon adolescents (17-19 years of age) with public coverage [January 1, 2011-December 31, 2013 (n=51,988)] to assess loss. Time-to-event methods determined the …

Food Insecurity And Pre-Hypertension, Pre-Diabetes In Adult Women: Results From The 2007-2010 National Health And Nutrition Examination Survey, Michelle L. Redmond, Phd, Ms, Fanglong Dong, Phd, Philip Twumasi-Ankrah, Phd, Robert B. Hines, Phd, Mph, Lisette T. Jacobson, Phd, Mpa, Ma, Elizabeth Ablah, Phd, Mph, Judy Johnston, Ms, Rd/Ld, Tracie C. Collins, Md, Mph, Mhcds

Journal of Health Disparities Research and Practice

Background

Being food insecure is generally defined as the limited or uncertain availability of safe and nutritious foods and is linked to poor nutrition and fully progressed diet-sensitive chronic diseases. However, little is known about the association between food insecurity and pre-clinical disease such as pre-hypertension and pre-diabetes. This study sought to examine the associations between food insecurity and pre-clinical disease among a racially/ethnically diverse population of women.

Methods

Using data from 2007-2010 NHANES, we examined associations between food security and pre-clinical disease among women 18-65 years. Chi-square tests were used to examine differences in demographic variables. Bivariate and multivariable …

Development Of A Culturally Appropriate Smokeless Tobacco Cessation Program For American Indians, Kathryn Rollins, Charley Lewis, T. Edward Smith, Ryan Goeckner, Jason Hale, Niaman Nazir, Babalola Faseru, K Allen Greiner, Sean M. Daley, Won S. Choi, Christine M. Daley

Journal of Health Disparities Research and Practice

This study describes a multiphasic approach to the development of a smokeless tobacco cessation program targeted for American Indians (AI) of different tribal nations. The authors gathered formative data from a series of focus groups and interviews to investigate the knowledge, attitudes, and beliefs of AI and smokeless tobacco (SLT) use. Predominant themes emerged from four major topic areas (SLT use, initiation and barriers, policy, and program development) across both studies. This study further assessed educational materials developed for the cessation program for scientific accuracy, readability, and cultural appropriateness. Program materials were scientifically accurate and culturally appropriate. The average corrected …

Nativity Differences In Stress Among Asian And Pacific Islander American Women, Brittany N. Morey, Gilbert C. Gee, Salma Shariff-Marco, Gem M. Le, Alison J. Canchola, Juan Yang, Laura Allen, Sandra Lee, Roxanna Bautista, Trish Quema La Chica, Winston Tseng, Pancho Chang, Scarlett Lin Gomez

Journal of Health Disparities Research and Practice

According to the Stress Process Theory, people who are marginalized in society encounter more stress than those in more advantaged positions. Immigrants are one such marginalized group in the United States (US) who may experience greater psychological stress than their US-born counterparts due to (1) severing of social ties; (2) social disadvantage and marginalization; and (3) adaptation to a new environment. This study examines the disparity in stress by nativity, and how social factors contribute to this disparity for Asian and Pacific Islander (API) women. Data come from the Asian Community Health Initiative, which included a sample of 291 foreign-born …

Application Of The Imb Model To The Reported Intake Of Fruits And Vegetables Of Native American Children, Rachel C. Sinley, Julie A. Albrecht

Journal of Health Disparities Research and Practice

The purpose of this study was to evaluate the applicability of the Information-Motivation-Behavioral Skills (IMB) model to identify variables that are associated with fruit and vegetable intake among Native American children. A cross-sectional study design was employed with a convenience sample of 92 English-speaking caregivers of Native American children between the ages of 2 and 5 from several tribes representing the Midwest, including Omaha, Santee Sioux, Ponca and Winnebago. Caregivers completed an IMB model survey, fruit and vegetable food frequency questionnaire and demographic survey. Multivariate linear regression and path analysis were conducted to assess association between model constructs and fruit …

Are Parent Activation And Health Literacy Distinct Concepts? A Study In Low Income Urban Populations, Harita S. Shah, Kate Leifheit, Sarah Polk, Elizabeth Sloand, Tina L. Cheng, Lisa Decamp

Journal of Health Disparities Research and Practice

Patient activation (the knowledge, confidence, willingness, and skills to manage one’s healthcare) and health literacy have well-established associations with health and healthcare outcomes in adults. However, little is known about parent activation on behalf of children and its relation to health literacy. Our objective was to examine relations between parent activation, health literacy, and parent-provider relationship quality. We surveyed 316 Spanish- or English-speaking parents of publicly-insured patients of a general pediatrics clinic. Surveys included the Parent-Patient Activation Measure (P-PAM), the Newest Vital Sign (NVS), and parent-provider relationship measures. We used chi-square analyses and logistic regression to explore associations stratified by …

Does Exam-Targeted Training Help Village Doctors Pass The Certified (Assistant) Physician Exam And Improve Their Practical Skills? A Cross-Sectional Analysis Of Village Doctors' Perspectives In Changzhou In Eastern China, Xiaohong Li, Jay J. Shen, Fang Yao, Chunxin Jiang, Fengshui Chang, Fengfeng Hao, Jun Lu

Public Health Faculty Publications

Background Quality of health care needs to be improved in rural China. The Chinese government, based on the 1999 Law on Physicians, started implementing the Rural Doctor Practice Regulation in 2004 to increase the percentage of certified physicians among village doctors. Special exam-targeted training for rural doctors therefore was launched as a national initiative. This study examined these rural doctors’ perceptions of whether that training helps them pass the exam and whether it improves their skills. Methods Three counties were selected from the 4 counties in Changzhou City in eastern China, and 844 village doctors were surveyed by a questionnaire …

Neuromuscular Adaptations Following Slope Walking In Individuals Post-Stroke, Eric Akoopie, Brooke Conway Kleven, Trisha Koch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The excitability of the H-reflex pathway in the non-impaired nervous system can be augmented by altering the different parameters of a walking task, specifically slope. We sought to examine the adaptations in soleus H-reflex excitability and foot force control following an acute bout of upslope or downslope treadmill walking in people post-stroke compared to those who are non- impaired. Methods: We recruited 12 individuals with chronic post-stroke hemiparesis and 9 age-similar non- neurologically impaired individuals. Each subject was tested over 2 sessions separated by at least 7 days. For each session, subjects walked at a self-selected walking speed on …

Immediate Effects Of Cervical Spine Thrust Joint Manipulation On Gait Parameters In Individuals With Neck Pain, Marc Anthony D. Albano, Emily Blok, Beau Gronert, Ryan Masuda

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypotheses: 1. To investigate for any change in gait parameters in individuals with neck pain while walking with different functional neck conditions immediately following cervical thrust joint manipulation (TJM) versus a sham intervention. 2. To investigate any association between Global Rating of Change (GROC) scores and gait parameters immediately following cervical thrust joint manipulation versus a sham intervention. The hypotheses were that, a) cervical TJM would have an immediate effect on gait parameters during walking with the neck in at least one of three conditions (neutral, flexion/extension and rotation) among individuals with neck pain; and b) higher scores on the …

Patellofemoral Joint Stress During Uphill And Downhill Running In Healthy, Theresa French, Brooks Klein, Young Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Subjects: Twenty recreational runners participated (mean age of 24.9 years). Methods: Kinematics and kinetics of the trunk and lower extremity were obtained at 3 conditions: level, 6° uphill, and 6° downhill, at a speed of 2.3 m/s. PFJ stress was determined using a biomechanical model that incorporates knee flexion angle and knee extensor moment as subject-specific input variables. The model output consisted of PFJ reaction force, PFJ stress, and PFJ contact area. One-way ANOVAs with repeated measures and post-hoc t-tests with a Bonferroni adjustment were used to compare outcome variables across the 3 conditions. Results: Peak PFJ stress during downhill …

The Moderation Effect Of Bdnf Genotype And Self-Reported Habitual Physical Activity Levels On Age Of Onset, Disease Progression, And Postural Instability In Parkinson's, Kyle Johnson, Danielle Salgo, Jessica Zorn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Brain-derived neurotrophic factor (BDNF) levels have been reported to play an important role in driving neuroprotection in people with neurologic disorders, and levels of BDNF are known to increase in response to physical activity. Moreover, the level of BDNF produced is also affected by BDNF genotype. It is not known, however, whether one’s BDNF genotype interacts with physical activity throughout life to affect a neuroprotective response in people with Parkinson’s disease (PD). Therefore, the purpose of this study was to determine if BDNF genotype interacts with lifetime self-reported physical activity levels to affect disease severity and progression …

The Influence Of Socioeconomic Factors On Fear Of Falling And Mobility Outcomes After Lower Limb Loss: A Preliminary Study, Tyler Chin, Heather Fox, Juan Gutierrez Jr.

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Current research has revealed that as much as 52.4% of individuals with lower limb loss report falling at least once in the past year. Previous research has also indicated that rehabilitation, including physical therapy (PT), generally improves patient outcomes after definitive amputation. Socioeconomic status has been shown to be an important factor in accessing healthcare but has yet to be investigated in this population. The purpose of this study was to investigate the effects of socioeconomic status and access to PT, and how limb loss affects mobility and fear of falling perception. We hypothesized: [1] individuals with …

Successful Patient Participation In Acute Hospital Physical Therapy, Jesse Kim, Joseph Fertitta, Patrick Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Research has demonstrated that physical therapy plays a crucial role in patient recovery in the acute hospital setting. Despite known benefits, scheduled sessions do not always occur and are called nontreatment (NT) events. Reported NT ranges from 15% to 26% of scheduled sessions. Previous studies have found an association between NT and patient diagnosis as well as between NT and day of the week on which treatment was scheduled. Identifying additional factors that affect NT is important if therapists and administrators are to make improvements. The purpose of this study is to determine if an association exists between physical …