Medicine and Health Sciences Commons^™

Development Of A Molecular Method For Detecting The Causative Agent Of Swimmer's Itch (Trichobilharzia) In Freshwater Ecosystems, Heidi Mcmaster

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cercarial dermatitis, commonly known as swimmer's itch, is caused by penetration of larvae of the schistosome,Trichobilharzia, into the dermis and epidermis layers of the skin. Symptoms are characterized by painful swelling and itching at the site of penetration. The normal hosts for the life cycle of the schistosome are aquatic birds and aquatic snails. The most frequently used method of detection forTrichobilharziais microscopy. With increases in the occurrence of cercarial dermatitis outbreaks in freshwater in the Southwestern United States, it is becoming increasingly important to develop and standardize a molecular method for rapid detection that can assist health professionals and …

The Effect Of Trigger Point Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Healthy Subjects, Sarah Buckingham, Crystal Montoya, Daniella Morton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, blinded, controlled cross-over trial with each subject receiving both interventions within a seven-day span.

Objective: To determine if differences occurred in resting- or contraction-thickness of the transversus abdominis (TrA) muscle following application of trigger point dry needling (TPN) of the lumbar multifidus (MF) muscle in asymptomatic subjects.

Background: Recent studies have shown TPN decreases pain in areas throughout the body. The effect of dry needling the MF on low back pain (LBP), and its effect on core stabilization have not been investigated.

Methods: Forty-three healthy individuals who had not experienced LBP in the previous six months were …

The Effects Of A Progressive Exercise Program On Functional Activity And Quality Of Life For Older Overweight Women With Knee Osteoarthritis, Ty Carlson, Devin Edvalson, Tyler Peck, Brad Robison

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose Osteoarthritis (OA) is a common symptomatic condition experienced by older adults, especially in the overweight population, that affects the knees in particular. This study compares the effectiveness of two progressive exercise protocols (walking and stepping) on function and quality of life in older, overweight women with OA. This study includes self-management training and assesses participant selfperceived efficacy in managing OA.

Subjects This is a quasi-experimental design utilizing 16 women ≥ 50 years of age (60.44 ± 6.04) with a BMI > 25 (34.21 ± 7.28) and radiographic diagnosis of OA in at least one knee.

Methods and Measures …

Ability Of Ages And Stages Questionaire 3rd Edition To Identify Children In Need Of Comprehensive Motor Evaluation, Courtney Michele Carmichael, Elizabeth Ann Willison, Qing Zhang

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: The Ages and Stages Questionnaire Third Edition (ASQ-3) is a widely used screening tool designed to identify children who need comprehensive developmental assessment. Its accuracy for identifying children in need of additional motor assessment has not been determined. The purposes of this study were to establish concurrent validity between ASQ-3 gross motor (GM) and fine motor (FM) scores and their corresponding Peabody Developmental Motor Scales Second Edition (PDMS-2) quotients, and to examine the diagnostic accuracy of the ASQ-3 using the PDMS-2 as a gold standard reference test.

MATERIALS/METHODS: This was a secondary analysis of a previous study in which …

Conceptual Framework Of A Novel Intervention To Improve Mobility In Children With Cerebral Palsy: The Successes And Challenges Of Implementing A Large Amplitude Movement Protocol, Tania Goodwill, Erin Jarrett, Beren Shah, Alanna Stockford

UNLV Theses, Dissertations, Professional Papers, and Capstones

While cerebral palsy remains one of the most common childhood disabilities, clinicians continue to face significant challenges developing effective treatment strategies for the widely variable presentation of motor function impairments associated with cerebral palsy. A large gap exists between current research based evidence and feasible clinical practice. The purpose of this paper is to introduce a novel intervention protocol, explore the theoretical framework behind the protocol and provide insight to clinicians about the successes and challenges faced while pilot testing the intervention. The novel intervention was adapted and implemented by researchers combining a large amplitude movement protocol with the well-researched …

Development And Evaluation Of An Opioid Monitoring Clinic, Richard Luna Talusan

UNLV Theses, Dissertations, Professional Papers, and Capstones

An APRN-led Opioid Monitoring Clinic was developed and implemented in the primary care setting of Las Vegas' Department of Veterans Affairs in July 2013 to assist primary care providers (PCP) in the management of high risk patients on chronic opioid

therapy for chronic noncancer pain. The clinic assisted in monitoring patients for abuse and misuse of opioids and referred patients for treatment when abuse and misuse were discovered. A study to evaluate the OMC was undertaken from November 22, 2013

through February 23, 2014 to assess the effectiveness of the OMC in meeting its objectives. A total of 61 patients …

Sentiments Of Community Stakeholders Living In Southern Nevada Neighborhoods, Erin Sheehy

UNLV Theses, Dissertations, Professional Papers, and Capstones

Community stakeholders provided insight to their local neighborhoods and shared their thoughts about the potential redevelopment of their neighborhoods. This study utilized data from the Southern Nevada Strong ethnographic research project. Ethnographic research was conducted over ten weeks in Summer 2013. Neighborhood observations and interviews with community stakeholders were conducted to understand how neighborhoods are utilized, how residents feel about potential redevelopment, and what areas of the neighborhoods residents would like to see improved in the future. Photographs were also collected to further examine the characteristics, aesthetics, and spatial landscape of the neighborhoods. The purpose of this qualitative research project …

Life History Tradeoffs And The Costs Of Reproduction In Arizona Bark Scorpions (Centruroides Sculpturatus), Michael Marie Webber

UNLV Theses, Dissertations, Professional Papers, and Capstones

Tradeoffs in life history evolution result from conflicts in the time and energy that can be simultaneously invested in activities such as growth, reproduction, and survival. Reproduction is an energetically costly activity for organisms, and is known to elicit alterations in the daily activity patterns of individuals. I investigated reproductive tradeoffs in the Arizona Bark Scorpion,Centruroides sculpturatus. To better understand the nature of tradeoffs in this species, I examined the influence of reproductive state on the predatory efficiency and thermal preference of reproductive females. Further, I examined the influence of reproductive activities (i.e. gestation) on the ability of reproductive females …

A Survey Of Antimicrobial Stewardship Practices In The Western United States: Successes And Challenges, Gayle Louise Allenback

UNLV Theses, Dissertations, Professional Papers, and Capstones

Antibiotics are one of the most important developments in medicine, and their ability to prevent and control infections has had a major impact in clinical medicine. However, the past three decades have shown an increase in multidrug-resistant organisms (MDROs) in both hospital patients and in the community, decreasing our ability to successfully control infection. Complicating the depletion of effective antimicrobials is the fact that, in the last 10 years, there has also been a decrease in the development of new antibacterial agents. Resistant infections have resulted in increased morbidity and mortality, with a consequential increase in healthcare costs. The utilization …

Factors Which Predict The Use Of Active Transportation To School Among Children In Clark County, Nv, Sheila G. J. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Active transportation to school (ATS) shows promise for increasing activity levels in children, but prevalence and correlates vary widely in cities and regions with different barriers and supports for active travel. Classification of ATS users is a current issue in the field. The purpose of this study was to determine the prevalence of ATS use and develop a predictive model of ATS for the novel population of children enrolled in grades K-8 in Clark County School District, a large metropolitan school district in Southern Nevada. Methods: This study used a secondary data from the National Center for Safe Routes …

The Reduction Of Central Line-Associated Bloodstream Infections In Intensive Care Units Through The Implementation Of The Comprehensive Unit-Based Safety Program, Michael Andrew Basinger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Central line-associated bloodstream infections (CLABSIs) are one of the most significant healthcare-associated infections (HAIs) in the Intensive Care Unit (ICU) setting resulting in increased lengths of stay, increased healthcare costs, and higher mortality rates (Institute of Healthcare Improvement [IHI], 2012). Evidence that CLABSIs are largely preventable has created opportunities for healthcare organizations to implement evidence-based bloodstream infection prevention practices to reduce or eliminate these infections (Lissauer, Leekisa, Prease, Thom, & Johnson, 2012). Other efforts to reduce CLABSIs include implementation of safety programs to improve the safety culture in ICUs (Lissauer et al., 2012). One program, the comprehensive unit-based safety program …

Use Of Standardized Tests Within Nursing Education Programs, Irene Coons

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study explored the use of standardized tests within nursing programs. Standardized tests have been used within nursing programs for several decades (Shultz, 2010), but recently their use has increased. This rise in utilization may be related to the need for nursing programs to satisfy various accreditation requirements, including annual state board of nursing pass rates. However, standardized tests are not without controversy. For example, some believe that the tests can be detrimental to minority nursing students (Spurlock, 2006). Therefore, the purpose of the study was to assess how and why standardized tests are utilized within nursing programs.

Literature was …

The Grass Shrimp, Palaemonetes, Pugio: Hypoxic Influences On Embryonic Development, Christensen C. Javier

UNLV Theses, Dissertations, Professional Papers, and Capstones

Grass shrimp,Palaemonetes pugio, can survive in brackish waters and estuarine ecosystems despite the frequent oscillations and fluctuations in salinity, temperature and oxygen. AdultP. pugiohave the ability to osmoregulate (Romney and Reiber 2011), change cardiac parameters to tolerate temperatures (not yet published, Mika and Reiber) and oxyregulate (Guadagnoli and Reiber 2013). Manipulation of cardiac parameters allows for these methods of regulation. However, cardiac contraction and internal convection of oxygen do not occur until later stages of embryonic development. Studies focused on these morphological and physiological advantages may provide further understanding of the regulatory mechanisms within grass shrimp embryos, larvae and adults. …

Determinants Of Head And Neck Cancer Survival In Nevada For 1995-2008, Xiao Q. Li

UNLV Theses, Dissertations, Professional Papers, and Capstones

Head and neck cancer (HNC), also known as oral cavity and pharyngeal cancer, comprises a group of cancers that arise in the head or neck region, such as the nasal cavity, sinuses, lips, mouth, salivary glands, and pharynx. Use of tobacco, alcohol, or a combination of the two, are major risk factors for head and neck cancer. Approximately 75% of oral cancers are attributable to smoking and/or alcohol consumption. More recently, the human papilloma virus (HPV) has also been associated with the development of head and neck cancer.

The objective of the present study is to investigate head and neck …

Evidence For The Validity Of A Tool For Improved Pressure Ulcer Staging By The Non-Expert In The Live Patient, Janelle Borg, Carrie Johnston, Megan Lucke, Jordan Sinclair

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Pressure ulcers (PrUs) are a costly issue for the health care system. The utilization of a tool that increases the accuracy of PrU identification and staging may allow the health care team to better manage these wounds. The purpose of this study was to determine the validity of the NE1 Wound Assessment Tool (NE1 WAT) for increasing the wound assessment accuracy of novice nurses.

Subjects: A convenience sample of 11 novice nurses evaluated 11 wounds on eight patients at a 730 bed, hospital in Las Vegas, Nevada.

Methods: Subjects assessed 11 wounds on the patients independently. They …

Blended Pedagogy Pathophysiology Course: Effectiveness And Student Satisfaction, Betsy Botsford, Samantha Corn, Alanna Keenan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Evidence supports the effectiveness of computer-assisted instruction (CAI) versus a traditional face-to-face teaching model, but little is known regarding the effectiveness of a blended pedagogy. The purpose of this study is to determine the effectiveness of a blended learning format in a pathophysiology course for entry-level Doctorate of Physical Therapy (DPT) students, to evaluate their level of satisfaction of a podcast formatted course, and to observe changes in cohort performance over time.

Subjects: Five University of Nevada, Las Vegas (UNLV) DPT cohorts (n = 139) participated in the study. Some cohorts were taught in a traditional classroom …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Morgan Lopker, Molly Newman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study was to compare individuals with Parkinson’s disease (PD) exhibiting fear of falling avoidance behavior to those with no fear of falling avoidance behavior. Because avoidance behavior can have deleterious downstream consequences, it is important to determine what potentially mitigated physical and psychological factors are associated with it.

Subjects: Fifty-six community dwelling individuals (age=72.1 years, SD=9.6; males=42, females=14) with PD (Hoehn and Yahr Scale stage median=2.0, mode=3.0) were classified into two groups using the Fear of Falls Avoidance Behavior Questionnaire (FFABQ): avoiders (n=26, ≥20 FFABQ), and non-avoiders (n=30, <20 on the FFABQ).

Methods: Avoiders and non-avoiders were …

The Relationship Among School Playground Design And Conditions And Physical Activity Levels In Children, Ipuna Estavillo Black

UNLV Theses, Dissertations, Professional Papers, and Capstones

Almost 20% of children aged 6 to 11 years are obese in the United States, tripling over the last ten years. The rise in childhood obesity challenges nurses in their efforts to improve community health and sustainability. A decrease in physical activity (PA) levels has been associated with an increase in obesity. Schools have been identified as a primary setting to provide children adequate amounts of daily PA, and nurses working in the area of child health promotion can work with schools to provide opportunities for children to increase PA levels. The playground is one environment where children can increase …

Evaluating The Impact Of A Home-~Based Childhood Asthma Intervention Program In Clark County, Nevada, Mackenzie Suzanne Burns

UNLV Theses, Dissertations, Professional Papers, and Capstones

Asthma is a chronic, incurable, costly, and potentially life–threatening disease that affects an estimated 7 million children in the United States; further, more than 56,000 Nevada children are currently living with asthma. The literature suggests that a number of factors that contribute to either the development of asthma or the exacerbation of asthma symptoms in sensitive individuals can be traced to the home environment. Given that the majority of Americans spend over 90% of their time indoors, of which two–thirds are spent at home, a home–based childhood asthma intervention program represents a unique primary prevention opportunity. This pre–experimental study evaluated …

Determining The Presence Of Carbapenem Antibiotic Resistance In Clinical Isolates, Fidelis Uzoma Enyinnaya

UNLV Theses, Dissertations, Professional Papers, and Capstones

Carbapenems are β-lactam antibiotics reserved for the treatment of severe microbial infections, especially those targeting the Enterobacteriaceae. Introduced in the 1980s, carbapenems have been used successfully in hospitals, and in the 1990s resistance was discovered. Carbapenem resistance is conferred through the production of carbapenemases. In the U.S., the most common carbapenemase is Klebsiella pneumoniae carbapenemase (KPC). In 2012, the National Healthcare Safety Network reported a carbapenem resistance rate of 13.0% among Klebsiella pneumoniae infections, and indicated that the mortality rate associated with carbapenem resistant Enterobacteriaceae (CRE) infections ranged from 48.0-71.9%. According to the Food and Drug Administration (FDA), carbapenem resistance …

The Effects Of A Single Bout Of Self-~Myofascial Release On Flexibility And Maximum Voluntary Contraction, Jonathan Robert Garcia

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to determine the effect of foam rolling on hamstrings flexibility, isometric and isokinetic torque. Participants: Thirteen female participants (N = 13; age: 28.5 + 6.8 years of age; height: 165.5 + 6.7 cm; mass: 64.2 + 8.4 kg) volunteered to participate in the study.

Methods: Hamstring flexibility was assessed using a sit and reach test; muscle strength was assessed by having participants complete a maximal voluntary isometric contraction (MVIC) of the hamstrings and maximal effort isokinetic knee flexion test using an isokinetic dynamometer. Participants completed these tests prior to any intervention (pre-rolling 1), …

The Lived Experience Of Black African Nurses Educated Within The United States, Amy Elizabeth Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the unprecedented growth of minority populations in the United States, the nursing profession has remained relatively homogenous. Nursing education has increased the number of minority students entering nursing programs; however, attrition rates for minority nursing students are as high as 85% (Gilchrist & Rector, 2007). As the population grows in diversity, the need for nurses who are fluent in foreign languages and who understand minority values, traditions, and cultural practice will be essential in delivering culturally competent care. Improving the retention of minority nursing students is an important step in increasing the diversity within the nursing workforce.

Although several …

Health Hazards In Rental Housing: An Overview Of Clark County, Nevada, Amanda Nicole Sokolowsky

UNLV Theses, Dissertations, Professional Papers, and Capstones

A wide range of health conditions are associated with housing conditions, including asthma, respiratory infections, injuries, mental health issues, and lead poisoning. People in modern societies spend more than 90% of their time indoors, the vast majority of which is spent at home. Therefore, any new information on housing related health hazards in a population provides an opportunity for a new prevention program. Reports have shown that rental properties have more health related hazards than owner occupied housing, and rental properties are frequently occupied by low-income and minority individuals. This descriptive study intended to provide an overview of housing related …

Comparing Perceptions Of Motivation To Change: Clinicians Versus Their Substance-Abuse Clients, Arthur Tabrizi

Graduate Research Symposium (2010 - 2017)

Although some clients enter treatment voluntarily to seek intervention for their substance abuse problems, most enter under coercive external pressures that may be perceived by clinicians as less influenced by addressing substance abuse than by appeasing mandates from the judicial system, family, or employers. Little research has examined and compared how clinicians assess clients’ extrinsic and intrinsic motivation to change as opposed to how the clients assess themselves. A congruency between the two parties’ assessments may inform the quality of the therapeutic relationship and facilitate an effective treatment plan. Using the Circumstance, Motivation, and Readiness Scales (CMR) and availability sampling …

Acceptability Of Sexting In Same-Sex Relationships, Carly Shadid, Katherine M. Hertlein, Sarah M. Steelman

Graduate Research Symposium (2010 - 2017)

For individuals who identify as part of the LGB community, the Internet can be seen as a tool to take control of their lives, may promote self-esteem, and foster a sense of belonging. The purpose of the study was to learn about sexting practices on college campuses. It builds on the existing body of knowledge by attending specifically to sexting rather than the previous literature about engagement in sexual behavior online (see, for example, Daneback, Cooper, & Månsson, 2005). Findings indicated that sexting is viewed as more acceptable in same sex relationships as compared to heterosexual relationships.

Family-Farm Therapy: An Urban Therapy Clinic To Address The Multifaceted Needs Of Multi-Stressed Families And Their Surrounding Communities, Felisa M. Huene

Graduate Research Symposium (2010 - 2017)

Family-Farm Therapy incorporates a therapeutic clinic within an urban farming community site, and focuses on multi-stressed family systems and the larger community system. The goal is for systemic change within the family and the community by creating positive relationships and personal acceptance. Farming has traditionally been a family endeavor which makes it a unique environment to be utilized as metaphors for family systems, their interactions, behaviors, and structure. Multi-stressed families have socioeconomic hurdles that complicate their ability to adjust to change and crisis in their family. Farming addresses such hurdles by offering economic sustenance, increased physical health, and community acceptance. …

A Critical Analysis Of Intellectual Disabilities And End-Of-Life Decision Making, Saritha Farris

Graduate Research Symposium (2010 - 2017)

Presently, research suggests the involvement of individuals with intellectual disabilities (IDs) in making end-of-life (EOL) decisions appears to be minimal (Ellison & Rosielle, 2008).

The reasons for the lack of involvement include but are not limited to communication challenges, lack of education on caring for individuals with IDs by the medical community, incorrect assumptions that the individual lacks cognitive capacity to consent, and fear of legal consequences if formal caregivers are accused of not providing enough care. (Wagemans et al., 2010).

These factors then often culminate in the individual with IDs having decisions made for them by someone else, whom …

Employment And Economic Development In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Wealth influences a person’s health. People who are higher on the socioeconomic scale tend to have better health outcomes. To improve the health of a community, it is important to understand the employment opportunities of the people living in the community.

Southern Nevada’s economy was hit hard between 2008 and 2012. Unemployment rates in the region exceeded national and peer regions between during this time period. Construction; leisure and hospitality; trade, transportation and utilities; and professional and business service sectors experienced the greatest job loss during the recession. The Education and Health Services sectors did not experience a decrease in …

Healthcare Access And Health Outcomes In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

In a publication from the Robert Woods Johnson Foundation, it was recognized that a person’s zip code was a more important predictor of health than their genetic code. Where we live influences not only our access to health care, but other health indicators as well. Clark County has a low primary care physician to population ratio compared to other counties in Nevada and in the US. Clark County also has highest rates of uninsured in the Mountain West and among the highest in the nation.

Southern Nevada fared worse than other Mountain West Metropolitan areas in health indicators and preventative …

Demographic Makeup And Population Projections For Southern Nevada: Understanding The Emerging Healthcare Needs In Our Community, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Even with a leveling-off of population growth from 2008 to 2011, Southern Nevada had one of the fastest growing populations in the nation over the past decade. While population growth is projected to increase for the next ten years, the rate of growth will be slower than in the past decade. The Hispanic population, as a percentage of the total population, is projected to surpass the White population somewhere near the year 2030. The Southern Nevada population is aging, as the median age in the region increased between 2000 and 2010. The 65+ age group is projected to increase as …