Medicine and Health Sciences Commons^™

The Effects Of Somatosensory Input On Gait In Individuals Post-Stroke, Victor Hung, Amanda Reilly, Rachel Wood, Nikita Yuskov

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Stroke is a leading cause of disability that results in various neurological deficits, one of which is hemiplegia. This deficit alters the gait cycle, resulting in decreased propulsion force by plantar flexor muscles, decreased activation of dorsiflexor (DF) muscles, and increased coactivation of antagonistic ankle muscles. Stroke also leads to altered somatosensory input which results in decreased balance and gait speed, ultimately increasing fall risk. Therapies targeting increased somatosensory input have been shown to be beneficial in stroke as well as other neurological populations. However, no known studies have investigated the acute effects of local vibration to …

Stress And Coping In Food-Insecure African Americans In Clark County, Nevada, Johanna Andrews

UNLV Theses, Dissertations, Professional Papers, and Capstones

African Americans have the highest rates of food insecurity than any other racial/ethnic group in the nation as a result of poverty, low household income, unemployment, food injustice, food mirages, and racial segregation. This consistent uncertainty in food access demonstrably results in poor mental health outcomes for food-insecure African Americans. Thus, the Transactional Model of Stress and Coping provides a theoretical framework to investigate how African Americans cope with food insecurity. The purpose of this study was to evaluate processes of coping with food insecurity and determine their impact on emotional well-being for African Americans in Clark County, Nevada. A …

Transitioning For Success: A Pilot Program For New Nurse Graduates In A Pediatric Intensive Care Unit, Valerie Charisa Barboa

UNLV Theses, Dissertations, Professional Papers, and Capstones

Global nursing shortages, increasingly complex patients, and rapidly evolving medical knowledge and technology make it necessary for today’s new graduate nurse (NGN) to enter practice with an already well developed set of skills (clinical judgment, technical skills, and a sound knowledge base). The protracted nursing shortage has prompted health care organizations to hire NGN’s directly into intensive care units (ICU), a rare, and previously unheard-of occurrence. Many NGN’s are unprepared for the highly complex, critically unstable patient in the ICU or the fast paced, independent, yet simultaneously collaborative nature of the ICU workplace. These deficits can quickly compromise patient safety …

Assessing The Health And Financial Burden Of Neonatal Abstinence Syndrome Among All Payer Inpatient Pediatric Discharges In Nevada, Kavita Batra

UNLV Theses, Dissertations, Professional Papers, and Capstones

Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome among neonates born to drug-dependent mothers. NAS poses a significant health and fiscal challenge nationally, with its incidence increasing by a factor of six (1.20 to 6.7 per 1,000 hospital births/year) along with the concomitant rise in health care cost from 2000-2016. Besides national data, it is critical to quantify NAS at the state-level to identify the target areas for prevention. Given the higher opioid prescribing rates among pregnant women in Nevada, it is critical to assess the health and financial magnitude of NAS in the state. The objectives of this …

Improving Type 2 Diabetes Mellitus In The Older Adult Population Utilizing Shared Medical Appointments In Primary Care Setting, Mailo Brantner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall management of Type 2 diabetes mellitus (T2DM) and its comorbidities is complex and costly. The American Diabetes Association (ADA, 2019c) recommends the use of team-based care and self-management tools to optimize the management of T2DM. Unfortunately, there is a national shortage of endocrinologists and certified diabetes educators (Stewart, 2008) along with a primary care provider shortage (Simmons & Kapustin, 2011). Thus, it is essential to implement a care model to increase efficiency while also promoting patient knowledge and self-management of T2DM to improve health outcomes. An example of an innovative care model is the shared medical appointment (SMA), …

Oral Localization Of Scardovia Wiggsiae, Graydon Ramos Carr

UNLV Theses, Dissertations, Professional Papers, and Capstones

Early childhood caries is one of the most prevalent diseases in the United States among children. The formation of caries is a complex, multifactorial process that is still being studied. Researchers have thought for years that Streptococcus mutans was the primary causative agent of early childhood caries. The recent discovery of a novel cariogenic pathogen, Scardovia wiggsiae and its significant contribution to the etiology of early childhood caries has led oral health researchers to re-evaluate this microorganism and its link to this disease. While there have been several projects undertaken within the University of Nevada, Las Vegas School of Dental …

Utilizing Breathing Techniques To Maximize Training Performance, Peyton Cater

UNLV Theses, Dissertations, Professional Papers, and Capstones

Anaerobic exercise causes metabolic acidosis to occur in the muscle, which is unfavorable for sustaining high intensity activity, as fatigue starts to set in. In order to compensate for the onset of fatigue produced by an acidic environment, respiratory alkalosis, induced by hyperventilation, can be performed to mitigate these effects. In contrast, research has shown that slowing down the breath rate, such as a two second inhale and three second exhale, has led to an increase in performance outcomes. Purpose: To investigate power output and the physiological responses after implementation of different breathing techniques during the recovery periods of intermittent …

3d Upper Airway Analysis Of Skeletal Class I, Ii, And Iii Adults With High Or Low Risk For Excessive Daytime Sleepiness, Alexander Dao

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To investigate the differences in ethnicity, BMI, sex, total airway volume, minimum cross-sectional area, airway shape, and hyoid bone position in high risk for excessive daytime sleepiness vs low risk for excessive daytime sleepiness in skeletal class I, II, and III patients

Introduction: Obstructive Sleep Apnea (OSA) is an underdiagnosed medical condition with many negative consequences on a patient’s overall health (Dempsey, J.A., Veasey, S.C., Morgan, B.J., & O’Donnell, 2010). OSA is defined as the occurrence of at least 5 instances per hour of sleep during which breathing temporarily stops (Motamedi, McClary, & Amedee, 2009). Undiagnosed OSA could lead …

The Impact Of Culturally-Tailored Education On Knowledge And Behavior Related To Screening And Lifestyle Management Of Blood Pressure In African Immigrants, Sarah Erskine

UNLV Theses, Dissertations, Professional Papers, and Capstones

The number of African Immigrants in the United States is increasing. The prevalence of hypertension among Blacks, including African Immigrants are high. In addition to the increased susceptibility to hypertension, lack of disease awareness and unhealthy lifestyle are documented barriers to achieving adequate blood pressure control. The purpose of this project was to determine the impact of implementing a 30-minute, culturally-tailored, evidence based educational session on hypertension to promote knowledge and initiate behavior change in African Immigrants. This was a descriptive, cross-sectional study. Blood pressures were measured and survey instruments such as the Hypertension Evaluation of Lifestyle and Management scale …

The Implementation Of A Respiratory Syncytial Virus Prevention And Awareness Pamphlet In The Daycare Setting, Kaylie Marie Humphreys

UNLV Theses, Dissertations, Professional Papers, and Capstones

Respiratory Syncytial Virus (RSV) is the number one cause of bronchiolitis in children under five years of age and regretfully the number one cause of hospitalization in the first year of life. RSV leads to over three million hospitalizations, two million outpatient visits, and 200,000 deaths in the pediatric population globally each year. While no vaccine is currently available to prevent the spread of RSV, efforts must be shown in spreading awareness of strategies utilized in infection prevention such as hand hygiene and properly covering a cough or sneeze.

This project aimed to present this education to a target population …

Physical Therapy Nontreatment Events With Primary Physical Therapist, Stephen Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Physical therapy improves prognosis reduces stay and is generally helpful in aiding recovery from a wide range of ailments. Nontreatment rates occur for multiple reasons and are also related to the personalities of physical therapists.

Methods: We used data from a research project involving physical therapy at an acute care facility in our community. Our study focused on the retrospectively determined primary physical therapist for each patient. We used the chi-squared tests to compare nontreatment rates between days of the week and disease type and the reasons for nontreatment events. Repeated-measure models were used to evaluate the effect of …

A Comparison Of Orthodontic Intraoral Scan Results Between Staff And Volunteers, Andrew Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: This pilot study is the first to assess and compare a trained staff’s intraoral scan to a clinical examination by comparing the overbite, overjet, Angle canine and molar classification, and gingival health. The second part of this study is to determine if the self-scan scan from a patient is as reliable to the staff’s scan. Introduction: Orthodontic treatment is usually provided over a sequence of appointments. During each appointment, the doctor clinically evaluates the patient, analyzes the progress and provides adjustments to continue with the treatment. The most common clinical criteria evaluated are overbite, overjet, upper and lower midlines, …

The Use Of Female Permanent Contraception Among Women Desiring To Limit Childbearing In Sub-Saharan Africa: Analyses Of The Spatial Pattern And Individual- And Country-Level Determinants, Babayemi Oluwaseun Olakunde

UNLV Theses, Dissertations, Professional Papers, and Capstones

Female permanent contraception (FPC) is the most commonly used contraceptive method, globally. It is a convenient, safe, and cost-effective modern contraceptive method that permanently stops childbearing among women. Despite its benefits, previous reports suggest that the increasing proportion of women who desire to limit childbearing in sub-Saharan Africa (SSA) rely more on less effective contraceptive methods, predisposing them to unintended pregnancies and their associated consequences. This study aimed to add to the sparse body of evidence on the use of FPC and the associated determinants among women with demand for limiting childbearing in SSA. Using data from Demographic and Health …

Management Of Atrial Fibrillation With Smartphone Technology, Teresa Praus

UNLV Theses, Dissertations, Professional Papers, and Capstones

Atrial fibrillation is the most common arrhythmia affecting over six million people; it is predicted to increase two-fold by the year 2050. This arrhythmia results in a lack of

atrial/ventricular communication, accompanied by ineffective atrial contraction, suboptimal ventricular filling, and thrombus formation. This may lead to stroke, and ultimately heart failure. The current economic burden related to the complications of atrial fibrillation is estimated to be greater than $6 billion annually with potentially catastrophic events, further increasing expenditure.

When patients experience symptoms related to atrial fibrillation, it is common for them to present to a hospital emergency department. These visits, …

Comparison Of Digital Treatment Setups And Final Treatment Outcomes Of Class Ii Division 1 Malocclusions Treated With Premolar Extractions, Sogol Shantiyai

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: This study aimed to determine whether there are differences between pre-orthodontic treatment dimensions when compared to the virtual treatment simulations and actual orthodontic treatment outcomes in Class II malocclusions treated with two or four premolar extractions.

Introduction: The use of intraoral scanners has become commonplace in orthodontic practices, giving practitioners the ability to scan and assess maxillary and mandibular dental morphology and occlusal relationships chairside and in real-time. Practitioners can use virtual treatment planning to evaluate different extraction patterns, visualize potential non-extraction outcomes using interproximal reduction, and alter anchorage strategies based on the amount of retraction or protraction required …

Patients Enabled, Engaged, And Empowered: Implementation Of A Mobile Patient Engagement Technology, Jud Simonds

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patient engagement technologies present an opportunity to enhance the patient experience by providing patient access to information throughout the entire, often complex, continuum of care. Growing evidence indicates that a lack of patient engagement is a significant contributor to preventable deaths. In contrast, engaging patients in their healthcare can positively affect patient outcomes and the overall patient experience. Unfortunately, traditional patient care models involve face to face patient-provider interactions, thereby limiting reach and impact. Exploring new roles for information technology (IT) within healthcare can contribute to addressing barriers encountered in more traditional healthcare models. Innovative IT solutions can assist patients …

Hdr Brachytherapy For Skin Cancer Using H.A.M. Applicator, Timothy Richard Thatcher

UNLV Theses, Dissertations, Professional Papers, and Capstones

Skin cancer is the most common type of malignancy affecting both men and women in the United States. A majority of these cases are nonmelanoma skin cancers (NMSC) such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The goal of any skin cancer treatment is to cure the lesion itself while also preserving function and optimizing superficial cosmesis. High dose rate (HDR) brachytherapy provides an alternative to superficial x-ray or electron beam for skin cancer treatment. Utilizing an Iridium 192 source soldered to the end of a wire, surface dose can be administered at predetermined positions with sharper …

A Comparison Of Lateral Cephalometric And Arch Dimension Changes In Patients With Class Ii Malocclusions Treated With 2-Premolar And 4-Premolar Extraction Patterns, Melissa Marie Ven Dange

UNLV Theses, Dissertations, Professional Papers, and Capstones

The aim of this study is to gather and analyze data representing detailed changes in model and cephalometric variables that will support clinicians in the premolar extraction decision- making process during camouflage treatment of class II dental patients. It is expected that the models, as measured by intra-arch dimensions, overjet, overbite, and mandibular crowding, and cephalometric radiographs, evaluated by their anteroposterior skeletal discrepancy, incisor inclinations, dental and skeletal vertical positions, and soft tissue characteristics, will significantly differ from within the same treatment group, pre-treatment to post-treatment, and between treatment groups. This retrospective study evaluated the model and cephalometric changes in …

Rapid Evolution Of Starvation Resistance In Drosophila: Physiological And Molecular Mechanisms, Austin Joseph Mckenna

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Gibbs lab has maintained starvation-selected Drosophila melanogaster for >130 generations. These starvation-selected flies evolved an obese phenotype with a suite of physiological differences compared to control-fed flies. Previous studies have shown that long-term starvation-selected Drosophila contain more lipids, have lower metabolic rates and develop more slowly than controls. This dissertation encompasses 1) Examining the molecular mechanisms contributing to starvation resistance, 2) Functional validation of the candidate plin1 allele, and 3) Rapid physiological and genomic evolution in starvation-selected Drosophila.

Starvation-selected Drosophila survive starvation conditions much longer than control-fed flies. This study took a simple approach to identify possible differences in …

Implementation Of A Training Program In The Use Of The Electronic Medical Record To Improve Performance On Quality Measures And Reduce Burnout Among Healthcare Providers, Mary Monica Nara

UNLV Theses, Dissertations, Professional Papers, and Capstones

Rapid adoption and implementation of the electronic medical record (EMR) in health care has contributed to worsening burnout among healthcare providers (HCPs), particularly primary care physicians. Other HCPs such as nurse practitioners (NPs) and physician assistants (PAs) who provide primary care have been equally affected by the increased clerical burden related to the increasing documentation requirements from payers and are at risk for burnout. Rates of burnout in NPs are currently not well known. Burnout has been linked to decreased quality of care for patients. Inadequate training and lack of skills in the use of the EMR have contributed to …

From Fighting Wasting To Shedding Excess: An Explanatory Sequential Mixed-Method Study Of Obesity Among People Living With Hiv In Nigeria, John Olajide Olawepo

UNLV Theses, Dissertations, Professional Papers, and Capstones

The human immunodeficiency virus (HIV) infection is a global epidemic, with initial high mortality rates since the first diagnosis over three and a half decades ago. However, the use of antiretroviral therapy (ART) has led to longer, healthier lives for many people living with HIV (PLHIV). Accordingly, aging comes with associated co-morbidities like obesity, diabetes, and cardiovascular diseases. The purpose of this mixed-methods study was to further understand the emergent phenomenon of obesity and overweight among PLHIV who are on treatment with ART, using Nigeria as a case study.

An explanatory sequential mixed-method design was used that involved the analysis …

Depressive Symptoms As A Moderator Of Diurnal Trends In Reward Seeking, Erick Albert William Rogers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Anhedonia, a cardinal symptom of a major depressive episode, is the decreased motivation to seek rewards. Individuals with depressive symptoms tend to report reduced positive affect, a distal measure of reward motivation, and engage in less reward-motivated behavior (i.e., reward seeking). However, diurnal rhythms may also influence reward-seeking. Both self-reported positive affect and behavioral measures of reward-seeking increase from the morning to the afternoon and then decreased in the evening. Therefore, the aim of this study was to examine whether reward-seeking varied across time of day and whether anhedonia moderated variation. Overall, reward-seeking did not vary across time of day. …

Integrating The Functional Movement Screen ® Into Strength And Conditioning Programs, Quincy Johnson, Chantel C. Coleman, Timothy Baghurst

Topics in Exercise Science and Kinesiology

• The purpose of this article is to provide an overview of the Functional Movement Screen (FMS®) and how it can be integrated into strength and conditioning programs of all levels.
• We utilized current literature and previous FMS ® field experience to develop and recommend approaches for implementing FMS® protocols into strength and conditioning programs.
• Description of FMS® Movements: The FMS® is a comprehensive biomechanical efficiency screen which is comprised of seven movements that have been deemed fundamental to athletic performance (7). Those movements include the; deep squat, hurdle step, in-line lunge, shoulder mobility, active straight-leg raise, trunk stability push-up, and …

Emergency Department Testing And Disposition Of Deaf American Sign Language Users And Spanish-Speaking Patients, Jason Rotoli, Timmy Li, Suejong Kim, Tina Wu, Jennifer Hu, Julie Endrizzi, Nathan Garton, Courtney Jones

Journal of Health Disparities Research and Practice

Objectives: Non-English speaking patients frequently present to the emergency department (ED) for acute care and may present a challenge to efficient clinical ED management and disposition. This study aimed to assess differences in the disposition and clinical management of Spanish-speaking patients and Deaf American Sign Language (ASL) users, who worked with a certified, in-person interpreter, compared with English proficient patients who did not utilize interpreter services.

Methods: A retrospective study querying electronic medical records was performed at an academic medical center ED. Patients with a chief complaint of abdominal pain were chosen for this study, as this is a common …

Sleep And Diet In Urban Pregnant African American Women, Erica C. Jansen, Louise M. O'Brien, Gwen L. Alexander, Gayle M. Shipp, Gwendolyn Norman, Kathryn Brogan-Hartlieb, Joseph C. Gardiner, Jean M. Kerver

Journal of Health Disparities Research and Practice

ABSTRACT

Objective: Sleep disturbances during pregnancy are associated with gestational diabetes and excessive weight gain. Diet could potentially play a role in these relationships, yet examinations of sleep and diet in African American pregnant populations are scarce.

Methods: The study population includes pregnant African American women from Detroit, MI (n=53). At the baseline study visit during late pregnancy, women were surveyed about typical bed and wake times, as well as usual food intake via a dietary screener. Sleep measures examined included time in bed and sleep midpoint (median of going to bed and wake time). Composite dietary measures …

Assets And Unmet Needs Of Diverse Older Adults: Perspectives Of Community-Based Service Providers In Minnesota, Hayley R. Mccarron, Alana Wright, Rajean P. Moone, Traci Toomey, Theresa L. Osypuk, Tetyana Shippee

Journal of Health Disparities Research and Practice

This paper examines assets and unmet needs of diverse older adults and highlights the need for programs and policies that address the social determinants of health. The United States is undergoing an unprecedented demographic shift, becoming increasingly diverse and aging rapidly. Given these changing demographics, it is important to understand the strengths and needs of our diverse population of older adults. This study captures perspectives of diverse service providers who work with older adults in communities, to identify existing assets as well as unmet needs and challenges facing diverse older adults in Minnesota. Qualitative data were collected using key informant …

Does Patient-Provider Race/Ethnicity Concordance Impact Outcomes For Adults With Lupus?, Pamela C. Delis Phd, Rn, Cne, Inge B. Corless Phd, Rn, Fnap, Faan, Indigo Young Ms, Ccc-Slp, Mary W. Hildebrand Otd,Otr/L, Jessica G. Bell Ms, Amanda Tarbet Mslis

Journal of Health Disparities Research and Practice

Background: Health disparities exist among the 1.5 million Americans with lupus, with women of color bearing higher disease rates and burden. Complex reasons include genetics, comorbidities, and socioeconomics. These factors may lead to differences in health-related outcomes in lupus.

Aim: To determine if patient-provider racial/ethnic concordance plays a role in outcomes for adults with lupus.

Method: For this scoping review, the authors searched PubMed Medline and CINAHL using keywords and subject headings for lupus, race or ethnicity, and patient-health professional concordance.

Results: Despite an intentionally broadened search of literature, the authors identified a lack of studies examining the topic.

Conclusions: …

Perceptions And Determinants Of Partnership Trust In The Context Of Community-Based Participatory Research, Arelis Moore De Peralta, Julie Smithwick, Myriam E. Torres

Journal of Health Disparities Research and Practice

Trust is difficult to conceptualize and define because of its diverse applications in different disciplines. Historic mistrust between vulnerable communities and researchers based on past adverse experiences can negatively affect the ability to collaborate and conduct effective research with such populations. Community Based-Participatory Research (CBPR) is a collaborative approach to research that can reduce historic mistrust and health disparities among minority populations. Although how trust development occurs in CBPR partnerships has been explored, there is a need to determine how to move from one stage to the next in fostering and maintaining that trust. The present study contributes to this …

Knowledge, Motivations And Concerns About Participation In Breast Cancer Clinical Trials In Puerto Rico, Marinilda Rivera-Díaz, Angélica N. García-Romero, Alelí M. Ayala-Marín, Camille Vélez-Alamo, Adrianna I. Acevedo-Fontánez, Mariana Arévalo, Vivian Colón-López

Journal of Health Disparities Research and Practice

Clinical trials (CT) in breast cancer have been crucial for new treatment discoveries. While participation in cancer CT is low, minorities are particularly underrepresented.This study aimed toidentify factors influencing the participation in CTs based on the experiences of Latina breast cancer survivors in Puerto Rico (PR), especially their CT knowledge, motivations, and concerns.Method:Focus groups (FG) were conducted by two social workers and the University of Puerto Rico/MD Anderson Community Health Educator. Participants were stratified into two subgroups: a) women with CT experience and b) those without CT experience. Seven FG were completed among breast cancer survivors (n=34) at …

Effect Of Poverty Level On The Relationship Between Hyperlipidemia And Cardiorenal Syndrome, Sri K. Banerjee Md, Phd, Raymond Panas, James Diegel, Karen Banerjee

Journal of Health Disparities Research and Practice

Purpose. Elevated cholesterol is known to be associated with chronic kidney disease (CKD) and cardiovascular disease (CVD) independently. Cardiorenal syndrome (CRS), a recently defined syndrome, is characterized by renal failure that is closely interrelated to cardiac dysfunction. The effect of socioeconomic status on cardiorenal syndrome has not been explored in a multi-ethnic population. In this retrospective secondary analysis, the hypothesis was tested if socioeconomic status modifies the effect of hyperlipidemia on CRS.

Methods. The National Health and Nutrition Examination Survey (NHANES) is a cross sectional survey done on the non-institutionalized population of the United States. All patients from the NHANES …