Medicine and Health Sciences Commons^™

The Reliability Of The Thoracic Percussion Test, Casey Donaldson, Rey Veloz, Kaylee Waters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To investigate the reliability of the Thoracic Percussion Test (TPT), which is a quick screening tool used by manual therapists to assess hypomobility in the thoracic spine. Participants: 36 healthy subjects (18-60 years old), with or without back pain, and 10 therapists participated in the study. Six of the therapists with less than 5 years clinical experience were considered “novice” and 4 with at least 20 years experience were considered “expert” therapists. Methods: All participants were divided into a morning and an afternoon group. Both groups consisted of 18 subjects and a mix of novice and expert therapists. All …

Can Simple Postural Instructions Modify Running Forms In Recreational Runners, Casey Gray, Matthew Poggemiller, Ian Tracy

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Recent research suggests that alteration of trunk angle and foot strike pattern during running may result in beneficial changes that prevent running related injuries due to reduction in vertical ground reaction forces (vGRF). For example, running form emphasizing a forward trunk lean and a midfoot or forefoot strike pattern has been shown to be effective in reducing knee stress and the risks of other impact-related running injuries. In clinical practice however, it is currently unknown if simple postural cues given to runners can elicit motor learning that leads to modification of running form. The purpose of this study was …

High School Gardens Program Across The Nation: Current Practices, Perceived Benefits, Barriers, And Resources, Noehealani Cierra Bareng- Antolin

UNLV Theses, Dissertations, Professional Papers, and Capstones

School garden programs in the United States emerged near the end of the 19th century. The use and purpose of school gardens are multifaceted and is dependent on the school and individuals involved. Current research on school garden programs suggests positive benefits for student academic achievement, nutrition knowledge, and dietary behaviors. Research on school garden programs is predominately conducted at the elementary and middle school levels. High school garden programs do exist; however, there is limited research on the current practices, perceived benefits of, barriers to, and resources necessary for high school garden programs. The purpose of this study was …

The Impact Of Visual Impairments On Mobility Performance In Community-Dwelling Older Adults, Lauren Andrew, Talia Davis, Christian Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Falls are a major concern for elderly adults and can have a significant impact on overall health and well-being. Declines in vision with aging may be related to the development of fear of falling (FOF) and impaired mobility. It is possible that impaired vision due to common eye diseases can increase the FOF avoidance behavior and affect mobility function in this population. The purpose of this study was to investigate the relation among visual impairment, mobility performance, and FOF avoidance behavior in older adults. Methods: Inclusion criteria for eligible participants were: 50 years of age and older, …

The Effects Of Fatigue On Balance In Individuals With Parkinson's Disease: Influence Of Medication And Brain-Derived Neurotrophic Factor Genotype, Michael Baer, Bradley Klemetson, Diana Scott

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose was to investigate the effects of fatigue on balance in individuals with Parkinson’s disease (PD). Because falls in this population can have deleterious consequences, it is important to understand the influence of fatigue and PD medications on balance. Additionally, since brain-derived neurotrophic factor (BDNF) has been shown to be related to motor performance, we explored its role in balance fatigue. Participants: 27 individuals (age= 65.4±8.1; males= 14, females= 13) with neurologist-diagnosed PD. Of the 27, 13 were genotyped for BDNF as Val/Val, 11 as Val/Met, 2 as Met/Met, and one refused genotyping. Methods: Participants were …

Predictors Of Physical Therapy Non-Treatment Among Patients Scheduled For Treatment Two Times A Day In The Acute Hospital, Sara Bookout, Kyle Ozaki

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Consistent participation in physical therapy treatment is the key to the success of any physical therapy treatment program. Scheduled therapy sessions that do not result in treatment (non-treatment) may cause longer hospital stays and/or poor outcomes. A better understanding of the factors affecting non-treatment could allow proper adjustments to prevent non-treatment by hospital administration, improve patient-therapist interaction, and may result in improved care, greater patient satisfaction, and lower healthcare costs. The purpose of this study was to investigate characteristics of patients that affect physical therapy non-treatment events for patients scheduled for therapy twice a day (BID) in …

Gait And Balance In Alzheimer's Disease: A Retrospective Analysis Across Varying Levels Of Cognitive Impairment, Diana Contreras, Jessica Heim, Jun Nelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: It was once thought that Alzheimer’s disease (AD) affected mostly cognition with minor motor impairment; however, it is becoming apparent that motor impairment may also be a prominent feature. Determining the extent of motor impairments throughout the continuum of cognitive impairment is critical in developing timely interventions for this population. Purpose/Hypothesis: The aim of this study was to gain a greater understanding of motor impairment in AD by exploring the relationships among gait, balance, and falls. Specifically, we explored the association of fall history to measures of cognition and performance-based balance measures in individuals with AD. We hypothesized that …

Fine-Wire Intramuscular Insertion To The Lumbar Paraspinal Muscles Does Not Affect Muscle Activation And Performance During High Exertion Spinal Extension Muscle Contractions, James Dimascio, Rebeka Hicks, Matthew Kimber, Kelsey Synder

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Low back pain (LBP) is associated with paraspinal muscle dysfunctions. A method to study the deep lumbar paraspinal muscle activation is with intramuscular electromyography (EMG). However, it is currently unknown how paraspinal muscle performance is affected by the invasive intramuscular insertion and the presence of the fine-wire electrode in the muscle. The purpose of this study was to analyze how insertion of fine-wire EMG into lumbar paraspinal muscle affects the lumbar paraspinal muscle fatigue, endurance, activation, and peak extension torque during high exertion spinal extension exercises. Participants: 20 individuals between the ages of 18-40 participated. The participants …

Measurement Of Anterior Translation Of The Mandibular Condyle Using Ultrasonography, Brooke Laskowski, Danielle Hahn, Christensen J. Hardy

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Reliability of clinical measurement. Objectives: To establish a standardized ultrasonographic approach to quantify anterior translation of the mandibular condyle during mouth opening by examining the reliability of imaging acquisition and processing. Background: Restricted mouth opening is a common limitation in individuals with temporomandibular dysfunction (TMD), however the arthrokinematics of the temporomandibular joint (TMJ) during mouth opening have not been studied thoroughly. Furthermore, how anterior translation of the mandibular condyle contributes to mouth opening remains unclear. Methods: Twenty-eight subjects without TMD participated. During day 1 of data collection, all subjects performed maximal mouth opening while an examiner placed a …

Use Of Active Video Gaming In Children With Neromotor Dysfunction: A Systematic Review, Robert Manzanares, Lisa Popescu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Active video games (AVG) are gaining popularity as a strategy for improving motor function in children with neurologically-based movement disorders, but there is no consensus regarding AVG’s utility or effectiveness in this population. The purpose of this systematic review was to examine current evidence on the use of AVG to improve motor function in children 2-17 years of age with neurologically-based movement disorders. Methods: Authors followed standard criteria for systematic review conduct and rating quality of evidence including the PRISMA checklist. Databases searched were Scopus, MEDLINE, Cochrane Library, EMBASE, and CINAHL. Systematic reviews, randomized control trials, or …

Acute Effects Of Walking On The Deformation Of Femoral Articular Cartilage, Jayson Mcclaren, Skyler Sudweeks

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Knee osteoarthritis (OA) is characterized by a progressive loss of the articular cartilage, increasing the amount of friction in the joint, resulting in pain and decreases in mobility and function. Additionally, it has been demonstrated that frontal plane lower extremity (LE) malalignment (e.g., varus, valgus) is associated with onset and progression of OA. Previous studies showed that static loading of 50% body weight at the knee results in more cartilage deformation in those with knee OA compared to healthy controls. As walking produces forces in the knee that are 2-3 times body weight, it may result in …

An Evaluation Of Gabab Receptors On Modulating Neuroinflammation In A Non-Transgenic Animal Model Of Alzheimer's Disease, Monica Bolton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by progressive memory loss and distinct neuropathological hallmarks, including amyloid beta plaques and neurofibrillary tau tangles (NFT). Although the etiology remains to be discovered, several risk factors exist that significantly contribute to developing AD. Diabetes is one of the major risk factors associated with AD and is characterized by disrupted insulin signaling that may contribute to or exacerbate AD pathologies. Furthermore, both disorders result in increased neuroinflammation. Considerable evidence has demonstrated that a chronic inflammatory response, in particular chronic microglia activation, promotes A production as well as the hyperphosphorylation of tau through …

Postpartum Depression Educational Intervention, Leslie Feth (Kalyn)

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall mission of this project was to ensure mothers are knowledgeable about postpartum depression (PPD) risk factors, strategies to address the risk factors, and that they have the confidence to seek help for risk factors of PPD or symptoms of PPD after childbirth. The goals of the project included: 1) increasing the knowledge of women in the perinatal period about PPD and the risk factors for developing PPD, 2) increasing women’s intention to address/modify their risk factors for developing PPD, and 3) empowering women to seek help if symptoms of PPD occur. The Health Belief Model was the theoretical …

Thermal And Developmental Ecology Of Pupfish, Cyprinodon, Alexander Jones

UNLV Theses, Dissertations, Professional Papers, and Capstones

Pupfish from the genus Cyprinodon are among the most endangered groups of fishes on the planet, with nearly 40% of species being threatened with extinction. These pupfishes are often assumed to be the most temperature tolerant of all fish, coping with temperatures as low as 0 °C and as high as 44 °C. However, conflicting data exist and certain measures of thermal tolerance are not markedly higher in pupfish compared to common game fish. Pupfish egg production and growth has been known to be hampered at temperatures well below what they apparently experience in nature. I addressed why eggs fail …

Evaluation Of A Fluorescence Method For Quantifying Bioaerosol Concentrations On Air Quality Filter Samples, Rachel Kolberg

UNLV Theses, Dissertations, Professional Papers, and Capstones

Airborne particulate matter (PM) in outdoor environments contains many components that cause adverse human health effects. The size of the particulates determine in what manner the particles would bypass the body’s defense mechanisms to enter the respiratory system and is directly related to their health impacts. Currently the United States Environmental Protection Agency is enforcing the National Ambient Air Quality Standards (NAAQS) to regulate the annual and 24-hour average concentrations of PM2.5 and PM10 in the air. PM2.5 are fine particles with aerodynamic diameter <2.5μm, small enough to reach the deepest parts of the bronchi and lungs. PM10 include PM2.5 and larger particles with aerodynamic diameter of 2.5-10μm. Both PM2.5 and PM10 contain multiple components from multiple sources. Bioaerosols are an important component of PM, but there is limited knowledge about how bioaerosols contribute to PM2.5 and PM10 concentrations. There is also a lack of research about the incidence and prevalence of disease caused by bioaerosols and about the limits of exposure to bioaerosol particulates. The main barrier to assess bioaerosol concentrations and health-related effects is the absence of quick and inexpensive methodology for quantifying bioaerosols. This study explored the feasibility of using fluorescence microscopy to quickly quantify bioaerosols in PM2.5 and PM10 collected on polycarbonate filters. Bioaerosols were stained with a DNA marker directly on a filter, followed by fixation, microscopic imaging, and automatic counting. The method was first validated using reference samples prepared by depositing different known concentrations of E. coli onto blank polycarbonate filters. The results indicated a linear response over two orders of magnitude (R2 = 0.9) and an accuracy within ±25%. E. coli were also deposited onto selected ambient PM10 and PM2.5 filter samples to determine if pre-loaded particles would interfere with bioaerosol imaging and counting. It was found that despite an increase in uncertainty (variability), the calibration slope remained within ±10% of unity for both PM2.5 and PM10 samples. Bioaerosol concentrations in ambient samples, as quantified by this method, were on average 14% higher for PM10 than for PM2.5 acquired concurrently in a desert environment of Las Vegas, Nevada. The application of this method to other types of compliance filters, such as Teflon filters and tapes of a Beta Attenuation Monitor (BAM) were also explored in this study. By means of a high-yield approach this method is expected to facilitate bioaerosol research, support exposure and health assessments, and help refine NAAQS for PM2.5 and PM10.

Distracted Driving In Clark County, Nevada: Analysis Of An Intervention On College Students, Heidi Ann Manlove

UNLV Theses, Dissertations, Professional Papers, and Capstones

Distracted driving is a growing public health concern. Highlighted in the media, local and government agencies and in peer-review literature are increased associations of motor vehicle crash related injuries and fatalities with distracted driving, especially involving youth drivers. The goal of this thesis was to analyze the effects of a distracted driving intervention on college students at University of Nevada, Las Vegas. Quantitative statistical analysis was performed to compare self-reported pre and post-intervention questionnaire responses of the experimental and control groups. Between-group analysis was performed using independent t-tests and ANOVA. Within-group differences were analyzed with Repeated Measures ANOVA (RM-ANOVA) and …

A Rural And Urban Study Of The Food Environment In Select Nevada Geographies, Joseph Nickelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

National and county level examination of urban and rural food environments has taken place, but primary validation of venue existence and in-venue data are lacking. The literature show disparities in access to healthy foods through low density of large grocers/supermarkets, low variety and quality of produce and higher prices for a healthy diet in rural versus urban geographies. Rural areas are of unique concern due to poor health indicators such as higher obesity rates, higher diabetes rates, lower incomes and lower educations than urban residents. The goal of this study was to explore differences in the community and consumer level …

Association Of Genetic Factors With Chronic Kidney Disease In Us Young Adults, Sabra Stanford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Albumin, a protein that when found in urine, is an early indicator of Chronic Kidney Disease (CKD). Genetic contributions have been shown to illustrate the gene-environment interactions that may lead to CKD in an individual; however, few studies have highlighted the interaction between responses of gene variations associated with the risk of increased albumin in young adults. This study’s purpose is to evaluate the hypothesis that candidate genes are related to microalbuminuria in young adults of the third wave of the National Longitudinal Study of Adolescent Health (Add Health Wave III). This longitudinal study includes an assessment of various candidate …

Maintaining Nurses' Currency In Informatics, Jennifer Alaine Strawn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Technology has changed how registered nurses (RNs) provide care at the bedside. As more technologies are utilized to improve quality of care, safety of care, maximize efficiencies, and decrease costs of care, one must question how well the information technologies (IT) are fully integrated and utilized by the front-line bedside nurse in his or her practice. Despite the pervasiveness of IT in healthcare, there is a paucity of literature on how Chief Nursing Officers (CNOs) assure the ongoing education and training for nurses to maintain IT competencies in the practice environment.

From this author’s lived experience as a CNO, it …

Psychometric Testing Of The Malaria Critical Thinking Test, Tally Rae Tinjum

UNLV Theses, Dissertations, Professional Papers, and Capstones

Accrediting bodies of baccalaureate nursing programs require quantified assessment of critical thinking in students. The current literature indicates two types of critical thinking assessments: (a) standardized, psychometrically sound, and non-nursing specific, and (b) nursing specific, but lacking the established psychometric properties. Therefore, a nursing-specific critical thinking test with established psychometric properties would help nurse educators understand the unique critical thinking ability of baccalaureate nursing students. With information from a quantitative critical thinking ability assessment tool, instructional methods could be revised to target student characteristics that correlate with critical thinking ability. Additionally, nurse educators could use the information from a nursing-specific …

Understanding Transitions Of Trust Across Different Business Contexts: An Exploratory Sequential Mixed Methods Study, Sungsik Yoon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Airbnb’s influence has been growing rapidly in the last few years, and hotel operators are beginning to recognize the competitive threat it poses. However, consumers may perceive Airbnb differently than hoteliers. Thus, the current study attempts to explore hotel customers’ perceptions of the sharing economy business (Airbnb). It is important to pay attention to the different business settings of the channels that currently exist in the lodging industry. Moreover, investigating the relationship between trust and perceived risk in this new channel (i.e., Airbnb) is crucial due to the inherent risk of transactions on Airbnb, especially when compared with traditional Business-to-customer. …

Disposition And Success Of Patients Following Discharge In The Acute Setting, Ciera Cortney, Kathryn Lutjens, Kristopher Raines

UNLV Theses, Dissertations, Professional Papers, and Capstones

Abstract: Background & Purpose: Many patients are seen in the hospital by physical therapists who also help decide where the patient will go after discharge (e.g., home, rehab hospital, skilled nursing facility) with the goal being the safest and best quality of life. Therapists may use different tests and measures along with their own professional judgment to help make a recommendation for a discharge location. The purpose of this study was to examine how PT’s recommendation for discharge location, POMA score, “6-clicks” score, age, diagnosis, and gender determine patient’s fall/readmission status after being discharged by hospital. Subjects: There were 113 …

Pressure Injury Assesment Comparison: Bedside Nurse Vs. Experts, Ali'itasi Kelemete, Brandi Hillock, Casey Snell

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The National Pressure Ulcer Advisory Panel (NPUAP) defines a pressure injury (PI) as, “A localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear.” PIs affect millions of people each year creating a substantial financial burden. Medicare has created policies for reimbursement and reporting of PIs making it financially important for hospitals to correctly assess PIs upon admission. A basic skin assessment to categorize PIs has not been standardized among facilities, resulting in inaccuracies, poor documentation, and gaps in the reporting and quality …

Are Vending Machine Selections Healthier? Trends In Dietary Quality Of Vending Machine Food And Beverage Selections Among Nhanes Participants Age 6-19 Years Between 2003-2012, Aurora Maria Buffington

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dietary intake is related to 4 major causes of death and may be influenced by the food environment, which includes the $64.3 billion revenue-producing vending machine industry. Most machines contain low nutrient energy dense foods and beverages associated with poor dietary choices, while healthier vending initiatives are seen as a strategy to increase access to healthy foods. Elementary and secondary schools have increasingly adopted healthier vending standards in response to federal child nutrition regulation and student wellness policy implementation, however an association between vending and diet has not been made using a large sample of nationally representative data. The purpose …

The Implementation Gap Between Evidence-Based Guidelines And Primary Care Providers' Provision Of Care For Adult Obese Individuals, Linda Ailene Hagemann

UNLV Theses, Dissertations, Professional Papers, and Capstones

Adult obesity has become a significant problem in the United States. To reduce health consequences and the rising cost of obesity, evidence-based guidelines to identify and treat obesity are available to primary care providers (PCPs). Despite literature supporting favorable outcomes by PCPs who address obesity at a patient's visit, studies indicate obesity counseling is occurring infrequently, particularly in military primary care settings.

Guided by the Diffusion of Innovations Theory, this research utilization project evaluated whether there is an implementation gap between use of the Department of Veterans Affairs (VA) and Department of Defense (DoD) Clinical Practice Guideline for Screening and …

Does Educational Level Influence Postmenopausal Breast Cancer Mortality Among Asians In U.S.?, Sfurti Maheshwari

UNLV Theses, Dissertations, Professional Papers, and Capstones

Studies on mortality from postmenopausal breast cancer (PMBC) by education level have not shown consistent results among US women. For US Asians, often seen as a “model” minority in terms of affluence and education this relationship has never been studied despite PMBC being the most common cancer in the country.

We analyzed 2008-2012 California Vital Statistics data and population data from the American Community Survey 2012 to compute age and education adjusted mortality ratios using negative binomial regression model for White (as a reference category) and Asian women. In total 3,277,106 (80%) White women and 852,376 (20%) Asian women died …

The Psychophysiological Correlates Of Personality, Trauma, Posttraumatic Stress Disorder And Social Support, Meghan E. Pierce

UNLV Theses, Dissertations, Professional Papers, and Capstones

Theories considering the etiology of psychopathy suggest that trauma exposure, specifically childhood maltreatment and sexual abuse, is related to the development of callous-unemotional traits in children and adolescents, which are precursors to psychopathic traits in adulthood. Furthermore, posttraumatic stress disorder has an opposite relationship with many of the emotional and behavioral components of the two-factor model of psychopathy. Specifically, PTSD is positively associated to IA and traits associated with it and negatively associated with FD. Thus, this study sought to expand upon the current theories of a trauma-based etiology of psychopathy by investigating the relationship between trauma, PTSD, and psychopathic …

The Effects Of An Acute Bout Of Exercise On Hunger Hormones In Individuals At Risk For Type 2 Diabetes, Sydney Spoon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Hunger hormone levels are typically dysregulated in obese and diabetic

populations, however; postprandial exercise has been shown to influence hunger hormone levels. Purpose: To determine if hunger hormones including acylated ghrelin and GLP-1 levels are altered in response to an acute bout (15 minutes) of walking in individuals at risk for type 2 diabetes mellitus (T2DM).

Methods: Ten subjects at risk for prediabetes (fasting blood glucose 100–125mg/dL) participated in this randomized crossover design trial. Subjects arrived at the laboratory following an overnight fast and underwent one of two conditions: 1) Test meal with no walking (CON) or 2) Test …

Succession Planning For Nursing Leaders In A College Of Nursing, Cheryl Ann Tucker

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Institute of Medicine (2011) challenged nursing to ensure the nursing workforce includes a sufficient number of academic nurse leaders, nurse educators, and doctorally prepared nurses for the future healthcare needs of the people of the United States. National data reveals a fragile supply of academic nurse educators and leaders. This tenuous resource is shaped by multifaceted factors including: (1) an aging nursing workforce; (2) impending faculty retirements; (3) lack of qualified faculty; and (4) wage disparity between the academic and clinical settings. As these factors collide, it is imperative that academic nursing plan for the future by retaining, developing, …

Neural Processes Underlying Auditory Context Effects, Breanne Yerkes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Auditory information within our natural environments is disorganized and often ambiguous, leaving our auditory systems with a complex task: organizing sound into coherent objects. The auditory system uses both current and prior information to assist in completing this task. The influences of previous context on current perception have been referred to as context effects. A contrastive context effect results in a current perception that is opposite of what is expected based on the physical stimulus properties presented during an immediate context. A facilitative context effect results in a current perception that is the same as the perception during the immediate …