Medicine and Health Sciences Commons^™

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 …

Reliability And Validity Of Using A Mobile Application To Asses Knee Valgus In Healthy And Post-Anterior Cruciate Ligament Reconstruction Participants, Brenda Benson Deaver, Tyrel Nelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To examine the reliability and validity of using a movement analysis application (MAA) to measure knee valgus angle during three functional activities used to assess return-to-sport after ACL reconstruction (ACLR). Design: Reliability and validity study Setting: University laboratory Participants: Twelve ACLR participants with a non-contact mechanism of injury and 20 healthy individuals. Independent Variables: Each subject performed single-leg drop landing, single-leg hop, and 90º cut with simultaneous 3-dimensional (3D) motion capture and video recording in the frontal plane on an iPad. Main Outcome Measures: Peak knee valgus angle during the landing phase of each task was measured using a …

The Effect Of Standardized Photodocumentation On Coding Of Pressure Injuries, Brandon Bales, Alex Preciado, Angela Sandoval

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Pressure injuries (PI) are prevalent and costly for hospitals. Hospitals implement different practices to accurately document PIs ranging from pen and paper to photodocumentation in electronic medical records (EMRs). In some instances, PIs that have been documented are not coded for billing and reporting. The purpose of this study is to determine if different documentation practices affect the number of coded PIs. Methods: Counts of coded PIs were collected from 2011- 2017 from two hospitals: a 500-bed acute care hospital (ACH) and a 42-bed acute rehabilitation hospital (ARH). A series of PI documentation practices were implemented over …

Individuals With Recurrent Low Back Pain Exhibit Significant Changes Of Paraspinal Muscle Performance After Lumbar Multifidus Intramuscular Fine Wire Electrode Insertion, Anthony Duong, Vincent Dinglasan, Russell Totten

UNLV Theses, Dissertations, Professional Papers, and Capstones

STUDY DESIGN: Case control study. BACKGROUND: Recurrent low back pain (RLBP) is associated with paraspinal muscle dysfunction. Intramuscular electromyography (EMG) is a common tool for studying activation of the deep lumbar paraspinal muscles such as multifidi muscles, but it is currently currently unclear how muscle performance and activation are affected by the pain and micro-injury associated with intramuscular fine-wire electrode (IFWE) insertion and how it interacts with the presence of RLBP. OBJECTIVES: The purpose of this study was to examine how IFWE insertion into the lumbar multifidus affects paraspinal muscle strength and endurance in subjects with and without RLBP. METHODS: …

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 …

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 …

Investigation Of The Cardiovascular Endurance Of Dance Majors, Arnold Huang, Ali Ross, Kelsey Taelour, Geneva Winters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: College dancers have demonstrated low levels of cardiovascular endurance compared to other athletes, which could be one of the factors that leads to more fatigue and injuries during performance. The effects of an education session on cardiovascular endurance and on college dancers’ attitudes towards cardiovascular exercise outside of dance class have not been previously studied. Purpose: The purpose of this study was to use the accelerated three-minute step test to compare lower level and upper level college dancers’ cardiovascular endurance before and 2 months after an education session emphasizing fitness and exercise. Additionally, assessed were the dancers’ attitudes towards …

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 …

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 …

Differential Tissue Response To Growth Hormone In Mice, Ryan Berry, Graham R. Mcginnis, Ronadip R. Banerjee, Martin E. Young, Stuart J. Frank

Kinesiology and Nutrition Sciences Faculty Research

Growth hormone (GH) has been shown to act directly on multiple tissues throughout the body. Historically, it was believed that GH acted directly in the liver and only indirectly in other tissues via insulin‐like growth hormone 1 (IGF‐1). Despite extensive work to describe GH action in individual tissues, a comparative analysis of acute GH signaling in key metabolic tissues has not been performed. Herein, we address this knowledge gap. Acute tissue response to human recombinant GH was assessed in mice by measuring signaling via phospho‐STAT5 immunoblotting. STAT5 activation is an easily and reliably detected early marker of GH receptor engagement. …

Factors Associated With Immunization Opinion Leadership Among Men Who Have Sex With Men In Los Angeles, California, Ian W. Holloway, Robert Bednarczyk, Vincent L. Fenimore, Cameron Goldbeck, Elizabeth Wu, Rebecca Himmelstein, Diane Tan, Laura Randall, Chelsea S. Lutz, Paula M. Frew

Environmental & Global Health Faculty Research

We sought to identify the characteristics of men who have sex with men (MSM) who are opinion leaders on immunization issues and to identify potential opportunities to leverage their influence for vaccine promotion within MSM communities. Using venue-based sampling, we recruited and enrolled MSM living in Los Angeles (N = 520) from December 2016 to February 2017 and evaluated characteristic differences in sociodemographic characteristics, health behaviors, and technology use among those classified as opinion leaders versus those who were not. We also asked respondents about their past receipt of meningococcal serogroups A, C, W, and Y (MenACWY) and meningococcal B …

Common Ribs Of Inhibitory Synaptic Dysfunction In The Umbrella Of Neurodevelopmental Disorders, Rachel Ali Rodriguez, Christina Joya, Rochelle M. Hines

Psychology Faculty Research

The term neurodevelopmental disorder (NDD) is an umbrella term used to group together a heterogeneous class of disorders characterized by disruption in cognition, emotion, and behavior, early in the developmental timescale. These disorders are heterogeneous, yet they share common behavioral symptomatology as well as overlapping genetic contributors, including proteins involved in the formation, specialization, and function of synaptic connections. Advances may arise from bridging the current knowledge on synapse related factors indicated from both human studies in NDD populations, and in animal models. Mounting evidence has shown a link to inhibitory synapse formation, specialization, and function among Autism, Angelman, Rett …

Dosimetric Feasibility Of 4dct-Ventilation Imaging Guided Proton Therapy For Locally Advanced Non-Small-Cell Lung Cancer, Qijie Huang, Salma K. Jabbour, Zhiyan Xiao, Ning Yue, Xiao Wang, Hongbin Cao, Yu Kuang, Yin Zhang, Ke Nie

Health Physics and Diagnostic Sciences Faculty Research

Background The principle aim of this study is to incorporate 4DCT ventilation imaging into functional treatment planning that preserves high-functioning lung with both double scattering and scanning beam techniques in proton therapy. Methods Eight patients with locally advanced non-small-cell lung cancer were included in this study. Deformable image registration was performed for each patient on their planning 4DCTs and the resultant displacement vector field with Jacobian analysis was used to identify the high-, medium- and low-functional lung regions. Five plans were designed for each patient: a regular photon IMRT vs. anatomic proton plans without consideration of functional ventilation information using …

Lagged Influence Of Fine Particulate Matter And Geographic Disparities On Clinic Visits For Children’S Asthma In Taiwan, Lung-Chang Chien, Yu-An Chen, Hwa-Lung Yu

School of Public Health Faculty Research

Recent studies have revealed the influence of fine particulate matter (PM2.5) on increased medication use, hospital admission, and emergency room visits for asthma attack in children, but the lagged influence of PM2.5 on children’s asthma and geographic disparities of children’s asthma have rarely been discussed simultaneously. This study investigated the documented diagnosis of children’s asthma in clinic visits for children aged less than 15 years old that were associated with PM2.5 in two counties located in west-central Taiwan during 2005–2010. The result shows that PM2.5 had a significant lagged effect on children’s asthma for up to 6 days. A significantly …

Freedom With Responsibility: A Consensus Strategy For Preventing Injury, Death, And Disability From Firearm Violence, Ronald M. Stewart Md, Facs, Deborah A. Kuhls Md, Facs, Michael F. Rotondo Md, Facs, Eileen M. Bulger Md, Facs

School of Medicine Faculty Research

We are surgeons who have committed our personal and professional lives to reducing needless suffering from injury. As leaders in the American College of Surgeons Committee on Trauma (ACS COT), we have put our hearts and souls into reducing firearm violence, yet we continue to experience the senseless tragedy of mass shooting events and the daily impact of violence on our patients and our communities. Two of us (DK, RMS) personally cared for innocent victims in 2 of the largest mass shootings in modern American history: the Las Vegas, NV and Sutherland Springs, TX tragedies, which, within a little more …

Disparity Of Imputed Data From Small Area Estimate Approaches – A Case Study On Diabetes Prevalence At The County Level In The U.S, Lung-Chang Chien, Ge Lin, Xiao Li, Xingyou Zhang

School of Public Health Faculty Research

This paper assesses concordance and inconsistency among three small area estimation methods that are currently providing county-level health indicators in the United States. The three methods are multi-level logistic regression, spatial logistic regression, and spatial Poison regression, all proposed since 2010. Diabetes prevalence is estimated for each county in the continental United States from the 2012 sample of Behavioral Risk Factor Surveillance System. The mapping results show that all three methods displayed elevated diabetes prevalence in the South. While the Pearson correlation coefficients among three model-based estimates were all above 0.60, the highest one was 0.80 between the multilevel and …

Stochastic Modeling Of Radiation-Induced Dendritic Damage On In Silico Mouse Hippocampal Neurons, Eliedonna Cacao, Vipan K. Parihar, Charles L. Limoli, Francis A. Cucinotta

Health Physics and Diagnostic Sciences Faculty Research

Cognitive dysfunction associated with radiotherapy for cancer treatment has been correlated to several factors, one of which is changes to the dendritic morphology of neuronal cells. Alterations in dendritic geometry and branching patterns are often accompanied by deficits that impact learning and memory. The purpose of this study is to develop a novel predictive model of neuronal dendritic damages caused by exposure to low linear energy transfer (LET) radiation, such as X-rays, gamma-rays and high-energy protons. We established in silico representations of mouse hippocampal dentate granule cell layer (GCL) and CA1 pyramidal neurons, which are frequently examined in radiation-induced cognitive …

Sling Complications, David L. Howard, Andrea Mcglynn, Joy A. Greer

Research Briefs

No abstract provided.

Jail, An Unappreciated Medical Home: Assessing The Feasibility Of A Strengths-Based Case Management Intervention To Improve The Care Retention Of Hiv-Infected Persons Once Released From Jail, Anne C. Spaulding, Ana Drobeniuc, Paula M. Frew, Tiffany L. Lemon, Emeli J. Anderson, Colin Cerwonka, Chava Bowden, John Freshley, Carlos Del Rio

Environmental & Global Health Faculty Research

Background Linkage to and retention in care for US persons living with HIV (PLWH) after release from jail usually declines. We know of no rigorously evaluated behavioral interventions that can improve this. We hypothesized that a strengths-based case management intervention that we developed for PLWH leaving jail would increase linkage/retention in care (indicated by receipt of laboratory draws) and a suppressed HIV viral load (VL) in the year following release. Methods and findings We conducted a quasi-experimental feasibility study of our intervention for PLWH jailed in Atlanta. We recruited 113 PLWH in jail starting in 2014. “SUCCESS” (Sustained, Unbroken Connection …

Gender And Posture Are Significant Risk Factors To Musculoskeletal Symptoms During Touchscreen Tablet Computer Use, Szu-Ping Lee, Ya-Ting Hsu, Betina Bair, Marissa Toberman, Lung-Chang Chien

Physical Therapy Faculty Research

[Purpose] To investigate the prevalence of neck and shoulder symptoms during the use of tablet computer, and to identify the risk factors associated with these symptoms. [Subjects and Methods] A cross-sectional survey was conducted to study tablet computer usage, posture during use, and neck and shoulder symptoms in 412 participants in a school setting. Significant risk factors for musculoskeletal symptoms during tablet computer use were identified. [Results] Overall prevalence of musculoskeletal symptoms during tablet computer use was 67.9% with greater prevalence of neck symptoms (neck: 84.6%; shoulder/upper extremity: 65.4%). Significant risk factors associated with symptoms during use were: current musculoskeletal …

Apolipoprotein-Defined Lipoprotein Subclasses, Serum Apolipoproteins, And Carotid Intima-Media Thickness In T1d, Arpita Basu, Alicia J. Jenkins, Julie A. Stoner, Ying Zhang, Richrd L. Klein

Kinesiology and Nutrition Sciences Faculty Research

Circulating apolipoprotein-defined lipoprotein subclasses (ADLS) and apolipoproteins predict vascular events in the general and type 2 diabetes populations, but data in T1D are limited. We examined associations of ADLS, serum apolipoproteins, and conventional lipids with carotid intima-media thickness (IMT) measured contemporaneously and 6 years later in 417 T1D participants [men: n = 269, age 42 +/- 6 y (mean +/- SD); women: n = 148, age 39 +/- 8 y] in the Epidemiology of Diabetes Interventions and Complications study, the follow-up of the Diabetes Control and Complications Trial (DCCT). Date were analyzed by multiple linear regression stratified by sex, and …

Integrating Information Literacy And Evidence-Based Medicine Content Within A New School Of Medicine Curriculum: Process And Outcome, Joanne M. Muellenbach, Kathryn M. Houk, Dana E. Thimons, Bredny Rodriguez

Library Faculty Research

This column describes a process for integrating information literacy (IL) and evidence-based medicine (EBM) content within a new school of medicine curriculum. The project was a collaborative effort among health sciences librarians, curriculum deans, directors, and faculty. The health sciences librarians became members of the curriculum committees, developed a successful proposal for IL and EBM content within the curriculum, and were invited to become course instructors for Analytics in Medicine. As course instructors, the librarians worked with the other faculty instructors to design and deliver active learning class sessions based on a flipped classroom approach using a proprietary Information Mastery …

Biomarker And Clinical Trial Design Support For Disease-Modifying Therapies: Report Of A Survey Of The Eu/Us: Alzheimer's Disease Task Force, Jeffrey Cummings, Nick Fox, Bruno Vellas, Paul Aisen, Guogen Shan

Environmental & Global Health Faculty Research

BACKGROUND: Disease-modifying therapies are urgently needed for the treatment of Alzheimer’s disease (AD). The European Union/United States (EU/US) Task Force represents a broad range of stakeholders including biopharma industry personnel, academicians, and regulatory authorities. OBJECTIVES: The EU/US Task Force represents a community of knowledgeable individuals who can inform views of evidence supporting disease modification and the development of disease-modifying therapies (DMTs). We queried their attitudes toward clinical trial design and biomarkers in support of DMTs. DESIGN/SETTING/PARTICIANTS: A survey of members of the EU/US Alzheimer’s Disease Task Force was conducted. Ninety-three members (87%) responded. The details were analyzed to understand what …

Effects Of Index Client And Geo-Targeting On Hiv Case Identification: An Observational Study, E. Oladele, William Menson, O-O Badejo, E. Onwasigwe, I. Iyamu, A. Olarinoye, C. Agbakwuru, T. Bruno, H. Khamofu, Ee Ezeanolue

School of Public Health Faculty Research

Background Despite huge investments in HIV prevention, treatment, and care in sub-Saharan Africa, fewer than one in 10 individuals knows their HIV status, and 40% of individuals living with HIV are not cognisant of their positive status. Efforts to improve and strengthen HIV service delivery, particularly in HIV testing, are necessary to increase efficiency in HIV case finding and optimise service delivery. Standard approaches to HIV testing have not been effective in addressing this gap. Our objective was to evaluate a targeted approach for HIV case identification in a PEPFAR-supported HIV programme in Nigeria. Methods Between October, 2016, and June, …

Surgeon Volume, David L. Howard, Andrea Mcglynn, Joy A. Greer

Research Briefs

No abstract provided.

Predictors Of Swimming Ability Among Children And Adolescents In The United States, Jennifer Pharr, Carol Irwin, Todd Layne, Richard Irwin

School of Public Health Faculty Research

Swimming is an important source of physical activity and a life skill to prevent drowning. However, little research has been conducted to understand predictors of swimming ability. The purpose of this study was to understand factors that predict swimming ability among children and adolescents in the United States (US). This was a cross-sectional survey conducted between February and April of 2017 across five geographically diverse cities. Participants were accessed through the Young Christian Men’s Association (YMCA) and included parents of children aged 4–11 years old and adolescents aged 12–17 years old. Independent t-test, analysis of variance (ANOVA), and univariate and …

The Effects Of Childhood Social Support And Family Resiliency On Mental Health In Adulthood, Korede K. Adegoke, Chukwudi Ufondu, Dania Al Agili, Estrellita L Berry L. Berry, Hamisu M. Salihu

Journal of Health Disparities Research and Practice

The effect of social support on the overall health and quality of life in adulthood has been well documented particularly in chronic disease populations. Very few studies examined the relationships between childhood social support, family resiliency and mental health in adulthood in the community and among disadvantaged minority populations. We examined the role of social support and family resilience during childhood on subsequent mental health-related quality of life (HRQoL) in adulthood among racial/ethnic minorities.

A needs assessment survey which was designed to explore health determinants and quality of life indicators using a community-based participatory research (CBPR) approach in a low-income …

American Indian Youth: A Residential Camp Program For Wellness, Francine C. Gachupin, Jennie R. Joe

Journal of Health Disparities Research and Practice

The American Indian Youth Summer Wellness Camp strives to increase physical activity and healthful eating among at-risk southwest American Indian youth. The Wellness Camp is one week in duration and involves youth, aged 10-15 years. Youth who attend camp are self-selected or referred by local tribal health programs. In any given summer, 35-60 youth attend camp. Approximately 20%-33% of youth return from one year to the next. We describe our program to increase healthy lifestyles among American Indian youth at risk for overweight, obesity, diabetes and cardiovascular disease. The Wellness Camp Program includes five primary components: (1) cultural capital, (2) …

Integrating Students Into Interdisciplinary Health And Health Disparities Research Teams, Tanya M. Coakley, Allyson Kelley, Robin Bartlett, Terri Shelton, Schenita D. Randolph, Debra C. Wallace

Journal of Health Disparities Research and Practice

Major initiatives by the U.S. Department of Health and Human Services as well as the World Health Organization have produced a large and compelling body of evidence on how to reduce health disparities, which entails having a clear understanding of how social factors shape health and healthcare outcomes. Specifically, there is a need for healthcare professionals to understand social determinants of health (e.g., low socioeconomic status, lack of health insurance, and poor education) and how these lead to disparities in health for people of minority racial and ethnic groups. Little is known about how students are developed as health disparities …

Health Insurance Enrollment Of Children And Young Adults In Wayne County, Michigan: A Qualitative Evaluation, Kristin Kan, Richard Lichtenstein, Michelle Famulare, Alison Jensen, Theresa Kowalski-Dobson, Joslyn Pettway, Erminia Ramirez, Madiha Tariq, Minal Patel

Journal of Health Disparities Research and Practice

Since the Affordable Care Act went into effect, community outreach to increase health insurance enrollment of young adults and children in low-income families of color has been a priority in Wayne County, Michigan. Our objective was to inform community efforts for improved outreach, we explored perceptions around the importance of health insurance and barriers to enrollment for children and young adults through a qualitative research study. We conducted a focus group with enrollment assisters and nine focus groups with Arab American, Latino/Hispanic, and African American community members. Several themes emerged about community members’ perceptions and experiences: they believe that children …