Medicine and Health Sciences Commons^™

Status Of Women In Nevada: Health Snapshot (Part 1), Ana Rosas, Aika Dietz, Caryll Batt Dziedziak, Jean Munson

Research Briefs

A breakthrough for women's health and racial health inequity is the passing of Public Health Service Act section 492B and National Institute of Health (NIH) Revitalization Act of 1993 (P.L. 103-43) and the implementation by NIH to support full or partially funded clinical research by establishing guidelines to include sex and race of the participant in these studies.

Regional Variation In States’ Naloxone Accessibility Laws In Association With Opioid Overdose Death Rates-Observational Study (Strobe Compliant), Hyo-Sun You, Jane Ha, Cyra-Y. Kang, Leeseul Kim, Jinah Kim, Jay J. Shen, Seong-Min Park, Sung-Youn Chun, Jinwook Hwang, Takashi Yamashita, Se Won Lee, Georgia Dounis, Yong-Jae Lee, Dong-Hun Han, David Byun, Ji Won Yoo, Hee-Taik Kang

School of Public Health Faculty Research

Though overall death from opioid overdose are increasing in the United States, the death rate in some states and population groups is stabilizing or even decreasing. Several states have enacted a Naloxone Accessibility Laws to increase naloxone availability as an opioid antidote. The extent to which these laws permit layperson distribution and possession varies. The aim of this study is to investigate differences in provisions of Naloxone Accessibility Laws by states mainly in the Northeast and West regions, and the impact of naloxone availability on the rates of drug overdose deaths. This cross-sectional study was based on the National Vital …

Reduction Of Secondary Transmission Of Sars-Cov-2 In Households By Face Mask Use, Disinfection And Social Distancing: A Cohort Study In Beijing, China, Yu Wang, Huaiyu Tian, Li Zhang, Dandan Guo, Wenting Wu, Xingxing Zhang, Ge Lin Kan, Lei Jia, Da Huo, Beiwei Liu, Xiaoli Wang, Ying Sun, Quanyi Wang, Peng Yang, C. Raina Macintyre

Environmental & Global Health Faculty Research

Introduction Transmission of COVID-19 within families and close contacts accounts for the majority of epidemic growth. Community mask wearing, hand washing and social distancing are thought to be effective but there is little evidence to inform or support community members on COVID-19 risk reduction within families. Methods: A retrospective cohort study of 335 people in 124 families and with at least one laboratory confirmed COVID-19 case was conducted from 28 February to 27 March 2020, in Beijing, China. The outcome of interest was secondary transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within the family. Characteristics and practices of …

Evaluation Of Repetitive Jumping Intensity On The Digi-Jump Machine, T. Scott Lyons, James W. Navalta, Whitley J. Stone, Scott W. Arnett, Mark A. Schafer, Laura Igaune

Kinesiology and Nutrition Sciences Faculty Research

Cardiorespiratory endurance is an important element of aerobic fitness, particularly in weight management and reducing risk for cardiovascular disease. While there are numerous options for aerobic exercise, rope jumping is often overlooked. In addition to regular exercise and a healthy diet, the American Heart Association strongly recommends rope jumping. The first purpose of this study was to determine the steady state metabolic cost of repetitive jumping on the Digi-Jump machine to evaluate whether exercise on this device is more or less strenuous than similar exercise with a jump rope, as demonstrated in previous literature. A second purpose was to determine …

Mild Acute Inflammation Does Not Impair Maintenance Of Blood Pressure During A Hypotensive Stimulus, Elizabeth C. Schroeder, Thessa I.M. Hilgenkamp, Wesley K. Lefferts, Bo Fernhall

Physical Therapy Faculty Research

Severe acute inflammation, such as sepsis, disrupts autonomic nervous system function and jeopardizes blood pressure regulation [1]. Acute hypotension under normal conditions stimulates baroreceptors to restore blood pressure by activating the sympathetic nervous system to increase heart rate and vasoconstrict peripheral vasculature. Severe acute experimental inflammation (endotoxin) blunts baroreflex-mediated increases in muscle sympathetic nerve activity during reductions in blood pressure and uncouples baroreflex control of heart rate [2]. Whether mild acute inflammation alters the ability to maintain blood pressure during a hypotensive challenge is less clear.

Assessing Oral Health Status, Practice, And Access To Care Among War-Affected Refugees In San Antonio, Texas, David Cappelli, Rami Saadeh, Annaliese Cothron, Magda De La Torre

Dental Medicine Faculty Research

Objectives: Refugees encounter several health disparities including oral health problems. This study evaluated the self-reported oral health status, practices, and access to care of adult refugees living in San Antonio, Texas, United States. Materials and Methods: Adult refugees ( n = 207) who accessed services from two centers in San Antonio, completed this survey. Multivariate logistic regression was used to examine the relationship of the refugees’ demographics with oral health status, practices, and access to care. Results: Oral pain in the previous 12 months was common among refugees having been reported by almost 58.9% of the survey participants; 43% reported …

Association Between Patient Ability In Activities Of Daily Living At Hospital Admission And Key Indicators, Stephanie Rosen, Amber Steele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Illness and inactivity in the hospital frequently leads to disability that can reduce quality of life and increase costs. Early identification of people with limitations in activities of daily living (ADL) who are at risk for poor outcomes such as increased length of stay (LOS), hospital acquired conditions (i.e., falls and pressure injuries (PIs)), and discharge away from home can facilitate appropriate intervention. The Activity Measure for Post-Acute Care Inpatient Activity Short Form (AM-PAC IASF), a reliable and valid tool to measure ADL limitations, is scored at admission for all patients in our hospital. The purpose of this study …

Reliability Of The Lateral Reach Test In People With Unilateral Transfemoral Amputations, Stephen Hill, Samantha Leonard, Elizabeth Vianey Trujillo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lateral reach testing has been established as useful in quantifying stability and fall-risk for older populations without limb loss,1 and has potential for providing useful information about fall-risk, recovery, and rehabilitation of individuals after unilateral trans-femoral amputation. Investigators sought to determine the feasibility and reliability of the Lateral Reach Test (LRT) in people with unilateral trans-femoral amputations. Nine individuals, aged 20-68, with a unilateral trans-femoral amputation were recruited for this study. Two females and seven males participated, and the average height and weight for the group was 167cm and 76kg, respectively. Three participants had right trans-femoral amputations while six had …

Brain Volumes And Dual-Task Performance Correlates Among Individuals With Cognitive Impairment: A Retrospective Analysis, Jon Basterrechea, Daniel Krist, Caitlin Moreland, Morgan Wise

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. Objective: To examine associations between brain volumes, dual task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. Methods: We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual task performance, and measures of gait and balance. Results: Greater cognitive function and combined dual task effect (DTE) is associated with smaller brain volumes. In contrast, greater motor DTE is associated with larger …

Comparisons Of Patellar Bone Mineral Density Between Individuals With And Without Patellofemoral Pain, Chris Khuu, Allina Cummins, Steven Shepherd

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Although bone stress injuries have been reported in individuals with patellofemoral pain (PFP), especially within the lateral patella, it remains unclear whether persons with PFP exhibit altered patellar regional bone mineral density (BMD). The primary purpose of this study was to compare BMD of the patella (lateral, medial, and total regions) between individuals with and without PFP using quantitative computed tomography (QCT). The secondary aim was to examine the associations between patellar regional BMD and patellofemoral joint (PFJ) alignment. Methods: Ten individuals with retropatellar pain and 10 sex, age, weight, height, and activity matched pain-free controls underwent a QCT …

Dosage, Mode, And Timing Of Acute Care Physical Therapy: A Scoping Review, Brendan Acosta, Bradley Goins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Aims and Objectives: 1) To synthesize available evidence for mode, dosage, and timing of physical therapy in the acute care hospital setting. 2) To report the evidence about the effects of mode, dosage, and timing of physical therapy in the acute care hospital setting on LOS, associated costs, and PT-related outcomes. Background: Hospital based physical therapy quality depends on providing evidence-based interventions, however, the research regarding dosage, mode, and timing of physical therapy in the acute care hospital setting has not been synthesized for patient populations except for total joint arthroplasties or patients in the ICU. Design: A systematic search …

Partnering With The Nevada Physical Therapy Association To Improve Pt/Pta Engagement, Rachel Cooklin, Joshua Cooper, Madison Luna

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The American Physical Therapy Association (APTA) is the professional organization that represents Physical Therapy and exists to promote the needs of society by advocating access and availability of all Physical Therapy services. The Nevada Physical Therapy Association (NVPTA) is a chapter of the APTA that represents the Physical Therapy profession in Nevada. In 2017, only 38.9% of licensed Physical Therapists (PTs) and 7.9% of licensed Physical Therapy Assistants (PTAs) practicing in Nevada were members of the NVPTA. Objective: The purpose of this service-learning project was to explore membership trends in the NVPTA, explore why membership amongst PTAs is low, …

Physical Therapy After Amputation In Community Dwelling Older Adults: A Quantitative And Qualitative Interview Study, Amanda Ferraro, Jennifer Gorton, Lindsey Horn, Michaela Kubo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: To investigate participation in physical therapy in older adults after lower extremity limb loss. The secondary objective was to examine the associations between physical therapy attendance, fear of falling avoidance behavior, self-perceived prosthetic mobility, and mental well-being. Number of Subjects: 64 Materials and Methods: Community-dwelling older adults with amputation were recruited and individually interviewed. The data collection consisted of four surveys (Physical Therapy after Amputation Patient Perception Survey, Short-Form Health Survey [SF-36v2], Prosthetic Evaluation Questionnaire [PEQ, mobility group], and Fear of Falling Avoidance Behavior Questionnaire [FFABQ]). Participants' demographic characteristics were analyzed using descriptive statistics. Participant comments were qualitatively categorized. …

Fall Prevention Service-Learning Project, Alexis Mansoor, Kendra Morrison, Jeremy Nordfelt, Cheng Yang Tu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The purpose of this service-learning project was to: 1) reduce falls in the Las Vegas, Nevada community by implementing the Stepping On fall prevention program and 2) to investigate the effect of planning and implementing a service learning project (SLP) on physical therapy (PT) students’ education and professional development. Description: Under the supervision of our advisor, we planned and organized this SLP, became certified leaders of Stepping On, recruited and screened older adults using the STEADI fall risk screening tool, and facilitated the program at a local community hospital. We facilitated group discussion and instructed the exercises outlined in …

Patient, Student, And Faculty Perceptions Of A Student Led Pro-Bono Education And Treatment Based Back School For Uninsured Nevadans, James Tingey, Daniel Tiano, Rebecca Templeton, Meagan Duncan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Importance: To determine feasibility and benefits of student led back school in an underserved population. Perceptions were positive support benefits for all participants. Objective: To evaluate perceived benefits for uninsured participants, students, and faculty with implementation of an evidence based, student led back school. Design: Eight DPT students created curriculum delivered over two days of two-hour classes, one week apart including screening and abbreviated evaluation of LBP, group education, specific exercise selection, and home exercise program assignment. Following first session, analysis performed to improve subsequent sessions. Setting: Cooperative effort between the pro bono clinic, Volunteers in Medicine of Southern Nevada, …

Effects Of Transcranial Direct Current Stimulation On Gait And Balance Post-Stroke, Leonard Ubalde, Jordon Jacklin, Peyton Hobson, Sara Wright-Avila

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Non-invasive brain stimulation is effective in combination with traditional physical therapy to facilitate motor performance in patients who recently survived a stroke. Current literature has focused on transcranial direct current stimulation and transcranial magnetic stimulation efficacy for improving the completion of fine motor tasks in the upper extremities. However, there is a lack of current evidence regarding the efficacy of this therapy in the lower extremities. Objective: To measure the effects of transcranial direct current stimulation on lower extremity clinical outcomes in patients who had a stroke including gait speed, functional reach, and balance. Methods: Randomized control trial in …

The Effectiveness Of Implementing A Collegiate Dance Clinic At The University Of Nevada, Las Vegas, Quinn Williams, Kristin Allman, Matthew Mcarthur, Ryan Yim

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screenings are commonly employed in athletics to identify deficits in performance with the goal of providing interventions to decrease injury risk; however, their utilization is uncommon in collegiate dance programs. Therefore, the purpose of this service learning project was to address the needs of the University of Nevada, Las Vegas (UNLV) dance program through implementation of an injury screening and prevention clinic for collegiate-level dancers. Four second year Doctor of Physical Therapy students (SPTs) supervised by a clinical faculty member with dance medicine expertise researched, developed, and provided screenings to identify increased risk for dance-specific injuries, and education to decrease …

Patient And Facility Perceptions On The Feasibility Of A Student-Run Pro-Bono Back-School For Uninsured Patients With Low Back Pain, Javier Ascanio-Pellon, Sofia Cruz, Lauren Liebert, Trevor Pacuk

UNLV Theses, Dissertations, Professional Papers, and Capstones

A. Background of Knowledge: Nevada ranks 8th highest in uninsured population in the United States. People who are uninsured may be more affected by low back pain (LBP) than their insured counterparts. Volunteers in Medicine of Southern Nevada (VMSN), a non-profit organization, serves uninsured people in Nevada. VMSN partnered with UNLV Physical Therapy (UNLVPT) to provide a back-school for patients. UNLVPT proposed a service-learning model to provide both education and treatment for VMSN patients with LBP. B. Purpose: The purpose of this community-based research project is to create and implement a student-run pro-bono back-school for uninsured individuals with LBP in …

Efficacy Of An Anhydrous Stannous Fluoride Toothpaste For Relief Of Dentine Hypersensitivity: A Randomized Clinical Study, Danying Tao, Martin R. Ling, Xi-Ping Feng, John Gallob, Audrey Souverain, Wenjie Yang, Anousheh Alavi

Dental Medicine Faculty Research

Aim To compare efficacy of an anhydrous 0.454% w/w stannous fluoride/sodium fluoride toothpaste (Test) versus a sodium monofluorophosphate toothpaste (Negative control) and a stannous chloride/sodium fluoride toothpaste (Positive control) for dentine hypersensitivity relief after 8 weeks’ twice-daily use. Materials and Methods In this randomized, examiner-blind, stratified, parallel study, primary and secondary efficacy variables were mean changes in Schiff score (evaporative [air] sensitivity) and tactile threshold (Yeaple probe), respectively, from baseline to Week 8 between Test (n = 62) and Negative control (n = 62). Test and Positive control (n = 61) comparisons were exploratory objectives. Results All groups significantly improved …

A Mobile App Specifically Designed To Facilitate Exercise In Parkinson Disease: Single-Cohort Pilot Study On Feasibility, Safety, And Signal Of Efficacy, Merrill R. Landers, Terry D. Ellis

Integrated Health Sciences Faculty Research

Background: Many people with Parkinson disease do not have access to exercise programs that are specifically tailored to their needs and capabilities. This mobile app allows people with Parkinson disease to access Parkinson disease–specific exercises that are individually tailored using in-app demographic questions and performance tests which are fed into an algorithm which in turn produces a video-guided exercise program. Objective: To test the feasibility, safety, and signal of efficacy of a mobile app that facilitates exercise for people with Parkinson disease. Methods: A prospective, single-cohort design of people with Parkinson disease who had downloaded the 9zest app for exercise …

Scald Injury-Induced T Cell Dysfunction Can Be Mitigated By Gr1+ Cell Depletion And Blockage Of Cd47/Cd172a Signaling, Nadine Beckmann, Franziska Huber, Marc Hanschen, Barbara St. Pierre Schneider, Vanessa Nomelli, Charles C. Caldwell

Nursing Faculty Research

Infection is a common and severe complication of burn injury: Sepsis accounts for 47% of postburn mortality. Burn-induced T cell suppression likely contributes to the increased infection susceptibility in burn patients. However, little is known about the kinetics of T cell dysfunction after burn and its underlying mechanisms. In this study, we show in a murine scald injury model that T cell activation of both CD4+ and CD8+ T cells as well as T cell cytokine production is suppressed acutely and persistently for at least 11 days after burn injury. Purified T cells from scald-injured mice exhibit normal T cell …

The Role Of Clinical Trials In Preclinical Alzheimer’S Disease Drug Development Programs, Jeffrey Cummings Md, Scd

Integrated Health Sciences Faculty Research

No abstract provided.

Exercise As A Mitigator Of Poor Mental Health Among Lesbian, Gay, And Bisexual Adults, Jennifer R. Pharr, Jason D. Flatt, Lung-Chang Chien, Axenya Kachen, Babayemi O. Olakunde

Environmental & Global Health Faculty Research

Introduction: There is a positive association between exercise and improved mental health in the general population. Although there is a greater burden of psychological distress among lesbian, gay, and bisexual (LGB) people, little is known about the association between exercise and mental health in this population. The authors explored the association between exercise and poor mental health reported by LGB adults in the United States. Methods: Our analyses used data from the 2017 Behavioral Risk Factor Surveillance System survey. Multiple regression analyses were used to determine the association between exercising and mental health days adjusting for sociodemographic characteristics. Results: Data …

Increasing Nurses' Knowledge Of Advance Care Planning, Jocelyn K. Allen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Advance care planning (ACP) is a process that seeks to ensure patients receive medical care that is consistent with their values and preferences. The process has proven benefits for patients and their loved ones but is under-utilized in clinical practice. Nurses are capable of successfully supporting patients through ACP; however, they encounter barriers that prevent their engagement in the process. These barriers include a lack of knowledge regarding ACP, poor understanding of their role in the process, and a lack of confidence to embrace the practice.

The purpose of this DNP Project was to create an evidence-based educational intervention to …

Assessing The Cost-Benefit Of Hiring A Deu-Prepared Rn Graduate: Does It Help Reduce Organizational Costs?, Tonya D. Bryant

UNLV Theses, Dissertations, Professional Papers, and Capstones

Costs associated with training new nurses from the time of hire to the time of independent practice can cost organizations nearly $100,000 per nurse (Acuna, Yoder, Madrigal-Gonzalez & Yoder-Wise, 2017; Silvestre, Ulrich, Johnson, Spector, & Blegan, 2017; Trepanier, Early, Ulrich & Cherry, 2012). New-hire costs for a dedicated education unit (DEU)-prepared newly qualified newly hired nurse (NQNHN) may be prohibitive for some hospitals when considering the cumulative amount of time and costs dedicated to training these specially prepared nurses who have previous clinical and organizational experience from their time as nursing students within the organization over the duration of their …

Investigating Attitudes And Beliefs Of University Students Aged 18 To 24 Years That Influence Their Decision To Take Pre-Exposure Prophylaxis Medication, Philip Danquah

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Contemporary research findings affirm that young adults aged 18 to 24 years have high prevalence of new HIV infections. Pre-Exposure Prophylaxis (PrEP) medication is the latest strategy in HIV prevention. Rates of PrEP uptake or use have been negligible among university students aged 18 to 24 years, especially among racial and ethnic minority students.

Objective: The objective of this study is to investigate the attitudes and beliefs that influence the uptake of PrEP medications and the HIV risk behaviors associated with the willingness to take PrEP medications among university students aged 18 to 24 years attending the University of …

Creating A Structural Empowerment Culture: A Professional Development Module For The Novice Nurse Leader, Beth A. Hock

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nursing leadership shoulders the responsibility for the performance of their nurses (McNeeseSmith, 1992). When a nurse leader creates a culture of structural empowerment, the work environment is more likely to produce higher quality patient outcomes and highly satisfied healthcare consumers. Novice nurse leaders are often ill-equipped early in their careers to forge a structural empowerment culture. Unfortunately, education programs to address the developmental needs related to structural empowerment do not seem to exist. Incorporating the theoretical underpinnings from Kanter theory (1977, 1993) and the Donabedian model (1966) to create an educational tool for the novice nurse leader in learning how …

Analysis Of Palatal And Upper Airway Dimensions In Patients With Excessive Daytime Sleepiness: A Retrospective Cone-Beam Computed Tomography Study, Daniel Jarrett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Excessive Daytime Sleepiness (EDS) is the measure of ones propensity to fall asleep during normal daily activities. It has been reported in 20%-50% of adults in the United States and is the most frequent symptom of patients presenting to sleep clinics. EDS is the result of both primary hypersomnias such as narcolepsy and idiopathic hypersomnia and, more commonly, secondary hypersomnias such as sleep deprivation, psychiatric conditions, medications, illegal substances, and obstructive sleep apnea (OSA).

The etiology of OSA is multifactorial. Collapsibility of the upper airway is influenced by both neuromuscular tone and craniofacial anatomy. Common predisposing factors for small airways …

Seniors And Sexual Health: A Profile Of Sexual Behaviors And Perceptions Of Sexual Risks In Southern Nevada’S Older Adult Population, Amanda Elizabeth Morgan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Older adults, 65 and older, are one of the largest growing unique population groups in the United States, comprising 15% of the population of Southern Nevada. Medical advances have allowed people to live longer, experience improved sexual health outcomes, and maintain a better quality of life. Medicare provides healthcare for most people over 65, but some people may not feel comfortable talking with their doctor or are not aware that Medicare-covered these services.

Objective: The purpose of this study is to explore the sexual behaviors of older adults age 65 years or older in Southern Nevada, examine the protective …

The Relationship Between Tree Canopy And Social Capital On Physical Activity In Unlv Students, Melissa Bartshe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the numerous health benefits, rates of physical activity are low, especially among the college student population. Neighborhood tree canopy is one aspect of the built environment that has been shown to positively impact physical activity. Social capital has also been correlated with higher rates of physical activity. The sprawling urban design and arid desert climate of Las Vegas pose unique challenges to both tree canopy and social capital. Additionally, the relationship between tree canopy, social capital, and physical activity is understudied in the college student population. The purpose of this study was to assess the relationship of tree canopy …