Medicine and Health Sciences Commons^™

Implementing A Bystander Awareness Program On A University Campus, Robert Joseph Vadovic

UNLV Theses, Dissertations, Professional Papers, and Capstones

Between 17% and 62% of college students experience some form of violence during their time at school. About 25% of female college students experience a sexual assault before graduating. One university had seen an increase in violence, including assaults and bias events. Administrators and nurses implemented a bystander awareness program to help alleviate this growing problem. Members of the college's residence life staff and its Greek organizations (fraternities and sororities) participated in the Step Up program, a prosocial training program to get people to intervene safely when witnessing acts of violence. Participants (N=236) completed surveys prior to the program, immediately …

Sickle Cell Disease: A Quality Improvement Initiative For Emergency Department Providers, Pretrescia Marie Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sickle Cell Disease (SCD) is an incurable, chronic condition that results in a constellation of disorders, frequent emergency department (ED) visits, and repeated hospital admissions. Those affected often suffer from pain crisis, infection, acute chest syndrome, stroke, and multi-organ impairment and frequently do not receive adequate pain management during acute pain episodes because ED providers view them as drug seeking. The majority of patients with SCD are African-American and may be low income, uninsured, or on Medicaid. As a result, these demographics make ED under-treatment of pain in patients with SCD a health equity issue. This was a pre-experimental one …

Anterior Cervical Decompression And Fusion On Neck Range Of Motion, Pain And Function: A Prospective Analysis, Kate Addis, Jason Longhurst, Bree-Lyn Vom Steeg

UNLV Theses, Dissertations, Professional Papers, and Capstones

Summary of background data: Intractable cervical radiculopathy secondary to stenosis or herniated nucleus pulposus is commonly treated with an anterior cervical decompression and fusion procedure (ACDF). However, there is little evidence in the literature that demonstrates the impact such surgery has on long term range of motion outcomes

Study Design: Prospective, non--‐experimental.

Objective: The objective of this study was to compare cervical range of motion and patient reported outcomes in patients before and after a 1, 2 or 3 level ACDF.

Patient Sample: 46 patients.

Methods: Patients undergoing an ACDF for cervical radiculopathy had their cervical range …

Land-Based Exercise And Its Effect On Quality Of Life Outcomes In Patients With Knee Osteoarthritis: A Systematic Review, Cody R. Buckner, Lindsay C. Martin, Michael L. Soukup

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The purpose of this systematic review was to examine effectiveness of land-based exercise interventions for improving quality of life (QOL) of individuals with symptomatic knee osteoarthritis.

Methods: A systematic search included PubMed, CINAHL, Scopus, Academic Search Premier, and the Cochrane Database of Systematic Reviews. Inclusion criteria included land-based exercise interventions aimed to improve lower extremity strength and QOL, published since 2000. Exclusion criteria included OA of joints other than the knee, and aquatic-based and surgical interventions. Studies were evaluated using a modified version of the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) methodology score.

Results: Level of …

Therapeutic Neuroscience Education For Patients With Chronic Low Back Pain And Its Effect On Activity Level, Pain Perception, And Function, Stephen Burton, Amber Domingo, Ryan Spencer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Chronic low back pain (CLBP) is a significant cause of disability and inactivity in the United States. Patients with chronic pain are often symptomatic even in the absence of tissue damage. This is a major reason patients need to be educated about their pain. Cognitions such as fear, anxiety and faulty beliefs may impact the pain experiences and changing cognitions are important in changing pain behavior. If patients understand that the pain they are experiencing may not be a true indication of the health of their tissues, they may experience less fear of their pain, and may be able …

Effects Of Footstrike Pattern On Low Back Posture, Shock Attenuation, And Comfort During Running, Traci L. Delgado, Emilia Kubera-Shelton, Robert R. Robb

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Barefoot running (BF) is popular in the running community. Biomechanical changes occur with BF, especially when initial contact changes from rearfoot strike (RFS) to forefoot strike (FFS). In addition, changes in lumbar spine range of motion (ROM), particularly involving lumbar lordosis, have been associated with increased low back pain (LBP). However it is not known how changing from RFS to FFS affects lumbar lordosis or LBP. Thus, the purpose of this study was to determine if a change from RFS to FFS would change lumbar lordosis, and/or decrease shock attenuation, and/or change comfort levels in healthy recreational/experienced runners.

Methods: …

The Acute Effects Of Upper Extremity Stretching On Throwing Velocity In Untrained Baseball Throwers, Ashley Delobel, Lanisa Harveson, Jason Melton, Michael Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to examine the effects of static and proprioceptive neuromuscular facilitation (PNF) stretching of shoulder internal rotators on throwing velocity as compared to a typical dynamic warm-up.

Subjects: 27 male untrained throwers (mean age = 25.1 years old, SD =2.4) with basic knowledge of throwing mechanics.

Methods:The study was conducted over a series of three sessions with at least one week between each session. During each session, subjects warmed-up, threw 10 pitches, were randomly assigned to one of three separate stretching protocols, and then threw 10 more pitches.The three protocols were static stretching, …

Effects Of Cervical Spine Manipulation On Balance And Joint Proprioception In Asymptomatic Individuals: Plausibility And Pilot Study, Kimberly Drayer, Michael Kauwe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Balance issues are prevalent in all ages of the population and can lead to many debilitating secondary impairments. There are various methods for treating balance problems, one of which is cervical spine manipulation (CSM). It seems to be biologically plausible that CSM would be an effective intervention, as it elicits effects in the same systems that are impaired in people with balance issues: vestibular, visual, and somatosensory.

Objective: The aim of this study is to investigate the immediate differences in balance and proprioception following a CSM in asymptomatic subjects.

Design: An experimental, cross-over study design was used

Methods: …

Characteristics Of Subjects Who Avoid Activities And Participation Due To A Fear Of Falling In Parkinson’S Disease, Russell Gourlie, Spencer Sorensen, Rithea Vong

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The purpose of this study is to examine and identify key characteristics of and differences between people with Parkinson’s Disease (PD) who exhibit moderate/high fear of falling avoidance behaviors and those that exhibit low fear of falling avoidance behaviors.

Subjects: A total of 24 subjects (5 females, 19 males; mean age= 72.2, SD=9.1) participated in this study.

Methods: A cross-sectional design was used to identify descriptive characteristics of subjects with PD associated with moderate/high levels of fear avoidance behavior (MHA) or low levels of fear avoidance (LA) as measured by the Fear of Falling Avoidance-Behavior …

Test-Retest Reliability And Responsiveness Of Gaze Stability And Dynamic Visual Acuity In High School And College Football Players, Denise Kaufman, Mallory Puckett, Mitchell Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objectives: The purpose of this study was to establish reliability and responsiveness of the active dynamic visual acuity test (DVAT) at speeds of 150 to 200 degrees per second (deg/sec) and the gaze stabilization test (GST) in high school and college football players.

Design: Reliability design

Setting, Participants, Main Outcome Measures: A total of 50 high school and college football athletes completed vestibulo-ocular reflex testing using the DVAT and GST in the yaw (horizontal) and pitch (vertical) planes on two separate occasions within 14 days.

Results: Test-retest reliability for the DVAT was good in yaw, Intraclass Correlation Coefficient (ICC) (3,3) …

Perceptions Of Hospital Patient Safety Culture In Department Of Veterans Affairs Station 593 Southern Nevada, Kimberly Falco

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opportunities for error exist, adverse events occur, and challenges endure. However, patients will continue to experience preventable adverse events unless steps are taken. Efforts to improve patient safety are critical to today's healthcare environment. The Department of Veterans Affairs (VA) believes that the identification of adverse events allows for creation of system improvements to increase patient safety.

Implementing safety culture requires a proper assessment of existing barriers and potential challenges. Patient safety culture assessments start by evaluating the current patient care environment. This assists the organization in identifying barriers to patient safety and in working toward creating a culture of …

Comparison Of The Pervasive Developmental Disorders Screening Test And Modified Checklist For Autism In Toddlers: Which Is The Better Predictor Of Autism In Toddlers?, Vanessa Marie Fessenden

UNLV Theses, Dissertations, Professional Papers, and Capstones

Early intervention for children with autism spectrum disorders (ASD) has significant impact on children and families. Early intervention optimizes long-term diagnosis for children with ASD. Unfortunately, many children with ASD are not diagnosed until after age three and often receive services from a local school district rather than through early intervention services. However, many of the symptoms of ASD can be hard to identify because symptoms during infancy may be more difficult to detect or may present differently than manifestations of the symptoms at older ages. Despite the difficulty in identifying symptoms of ASD in young children, there are certain …

Effect Of Racing Flats On Running Economy In Male Adolescent Runners, Paul Hafen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to investigate whether running economy differs in racing flats versus standard running shoes in high school cross-country runners. In order to measure running economy the oxygen cost of running (mL O₂∙kg^-1∙min^-1) was measured in 20 male adolescent runners (mean age = 16.25 ± 0.97 years, 5 km best time = 17.52 ± 0.78 min) when running two separate trials at a controlled speed. The speed was determined by estimating treadmill running speed at 85% of each runner's VO_2max. Each trial required the participants to run while …

Design And Testing Of Novel Mouthguard With Intermediate Nitinol And Foam Layers, Adam Kessler

UNLV Theses, Dissertations, Professional Papers, and Capstones

It is the aim of this study to investigate a novel mouthguard design that incorporates the use of a nickel-titanium (Nitinol) layer and thin foam layer in addition to EVA layers. It is thought that the Nitinol layer can distribute the force of an impact and that the thin foam layer may absorb this distributed force better than a solid EVA mouthguard of the same thickness. Rectangular, flat coupons representative of several mouthguard configurations were constructed for testing using an instrumented drop-weight impact tower. The coupon configurations include a control made of laminated EVA, a group of laminated EVA and …

Closed Loop Control Of A Cylindrical Tube Type Ionic Polymer Metal Composite (Ipmc), Benjamin Mead

UNLV Theses, Dissertations, Professional Papers, and Capstones

The goal of this research is to provide a framework for the integration of tube type, cylindrical Ionic Polymer Metal-Composite (IPMC) into conventional devices. IPMCs are one of the most widely used types of electro-active polymer actuator, due to their low electric driving potential and large deformation range. For this research a tube type IPMC was investigated. This IPMC has a circular cross section with four separate electrodes on its surface and a hole through the middle. The four electrodes allow for biaxial bending and accurate control of the tip location. One of the main advantages of using this type …

Development And Implementation Of A Quality Improvement Initiative: Systematic Follow-Up Of Patients Who Have Spinal Cord Stimulator Implants, Irina Rajala

UNLV Theses, Dissertations, Professional Papers, and Capstones

Recent medical advances and the rising prevalence of chronic pain in the US population contribute to the use of spinal cord stimulator (SCS) implant as a treatment modality for chronic pain management. As the numbers of patients receiving SCS implants steadily increases, the challenge of managing this device grows and the need for SCS implants follow-up programs rises. Follow-up programs need to focus on implant longevity and efficacy to improve the quality of care outcomes.

This Doctor of Nursing Practice (DNP) quality improvement initiative was developed to provide systematic follow-up for patient with SCS implant. The project includes the creation …

The Effects Of Chronic Calcium Dysregulation On Behavioral And Pathological Features Of Alzheimer's Disease, Jonathan Sabbagh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer's disease (AD) is a progressive neurodegenerative disorder whose etiology is unknown. Recent studies have implicated alterations in calcium homeostasis as a pathogenic contributor to AD. Calcium dysregulation has been observed in aged and AD brains, an event which could potentially facilitate the development of multiple pathologies observed in AD. Specifically, disrupting intracellular calcium levels in vitro has been demonstrated to increase amyloid-beta (Aβ) production, tau phosphorylation, and neuronal loss. However, there is a paucity of data on the behavioral and biochemical consequences of chronic in vivo perturbation of calcium homeostasis. In a series of experiments designed to evaluate the …

Perceptions Of Police Responses To Domestic Violence, Kelly Rae Stout

UNLV Theses, Dissertations, Professional Papers, and Capstones

Domestic violence, also known as, intimate partner violence (IPV), has become an epidemic in the United States. According to the Center for Disease Control and prevention (CDC), about 24 women and men are victimized by an intimate partner each minute, equaling about 12 million victims every year (2012b). In recent years, the public has become more aware of IPV situations. An increase in public service announcements has helped to inform the public and has brought these dangerous situations out from behind closed doors. In the age of technology, information is more easily distributed and exchanged which has also increased public …

School Nurses' Recognition, Attitudes, And Educational Needs Regarding The Care Of Children With School Refusal Behavior, Heather Strasser

UNLV Theses, Dissertations, Professional Papers, and Capstones

School refusal behavior can prevent a child from attending school or staying in class for a full day of instruction. School nurses are often one of the first professionals in the school with the opportunity to interact with these children, recognize school refusal behavior and its debilitating impact, and positively intervene to assist these children to stay in school. Few studies have examined school nurse recognition and attitudes regarding school refusal behavior. The purpose of this study was to assess school nurses' recognition of school refusal behavior, their attitudes regarding the nursing care of children with school refusal behavior, and …

A Comparison Of Nursing Service Demand In Title 1 Schools And Non-Title 1 Schools, Karen Ray Stratford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Children from low-income families are known to struggle academically, but lack of health services may also impact their education. School nurses must identify and manage health problems in the school-age child to improve academic success. Unfortunately, the school nurse-to-student ratio may limit the amount of time nurses can give to the recognition of health problems and appropriate follow-up. The Elementary and Secondary Education Act of 1965 provides Title 1 funding to schools whose enrollment includes at least 40% of low-income families. These federal funds are intended to be used to bridge the achievement gap between low-income students and other students. …

Oxidative Stress For An Acute Bout Of Bikram Yoga In Healthy, Trained Adults, Kimberly Anne Trocio

UNLV Theses, Dissertations, Professional Papers, and Capstones

BACKGROUND:Generation of free radicals resulting in oxidative damage has been linked to cellular damage, aging, and human disease. Many studies have reported that physical exercise can contribute to oxidative stress. Further, exercise in a hyperthermic environment can promote additional oxidative stress. It is important to consider that practices in yoga may be beneficial in reducing oxidative stress according to some studies. The compound effects of exercise and hyperthermic exposure are experienced in the practice of Bikram yoga, the original "hot" yoga. Because Bikram yoga and other hot exercise classes are an increasingly growing fitness trend, it is necessary to investigate …

Reliability And Validity Of The Ne1 Wound Assessment Tool (Wat), Stephanie Coon, Faustina Tran, Melinda Vicencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Current literature indicates a lack of reliability and validity of existing pressure ulcer (PrU) staging systems. This prompted the development of the N.E. One Can Stage (NEOCS). Recently this tool was modified and renamed, the NE1 Wound Assessment Tool (NE1 WAT). The purpose of this study is to test the reliability and validity of the NE1 WAT.

Subjects:

A sample of convenience of nine physical therapists (PTs) and 11 nurses (RNs) with PrU staging as part of their routine work duties were included in this study.

Methods:

A written exam was administered and consisted of assessment questions …

Using Over-The-Counter Ear Filters As A Treatment To Improve Dizziness And Balance In Patients Diagnosed With A Traumatic Brain, Brandy Sue Whitney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: People diagnosed with a Traumatic Brain Injury (TBI) usually have physical, cognitive, emotional, and sleep deficits. Sensory overload is a common symptom of TBI. One treatment prescribed for sensory overload is over the counter ear filters. Ear filters have shown to decrease sensory input. Could the ear filters have an effect on balance and dizziness without much cost to the patient or the clinic?

Subjects: Patients diagnosed with a mild or moderate brain injury, ages of 18-65 years old. They needed to be medically stable, potential to walk, and have complaints of dizziness and/or balance problems.

Methods: …

Alpcs(2a)-Mediated Photochemical Internalization Of Bleomycin And Concurrent Hyperthermia Of Multicellular Tumor Spheroids, Aaron Andersen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Treatments for glioblastoma multiforme and invasive ductal carcinoma involve surgical resection and adjuvant or concurrent targeted therapies. The goal of the secondary treatment is to reduce the cancer cells in the resection margin and other areas of suspected involvement. Photochemical internalization is a targeted therapy using light to activate photosensitizers embedded in cellular structures to improve the delivery of macromolecules within the cell.

In a previous study, optimized treatment parameters including radiant exposure, and irradiance, concentration of AlPcS(2a), temperature, and the concentration of bleomycin were determined for human ACBT glioma multicell spheroids. The current study investigates the effectiveness of the …

An Examination Of Walkability In The Las Vegas Metropolitan Area, Courtney Coughenour

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The benefits to regular physical activity are well established. Walkability is one element of the built environment that has been correlated with increased levels of physical activity. The auto-centric design of Las Vegas Metropolitan area (LVMA) is unique in ways that may influence walkability. The purpose of this study was to determine which urban design characteristics are associated with walking and physical activity in moderate income neighborhoods in LVMA. Methods: The standard walkability measure developed by Frank et al. (2010) was used to calculate the walkability index of seven neighborhoods. Residents of the two most walkable and two least …

The Presence Of Methicillin Resistant Staphylococcus Aureus (Mrsa) On Environmental Surfaces In Healthcare Facilities Pre- And Post-Cleaning, Aaron Thomas Hunt

UNLV Theses, Dissertations, Professional Papers, and Capstones

The emergence of antibiotic resistant bacteria is a serious public health issue affecting millions of people. Methicillin-resistant Staphylococcus aureus(MRSA) is a leading cause of healthcare acquired infections today. Research has shown that patients infected or colonized with MRSA shed the bacteria into the environment, where the bacteria can survive for long periods of time and become potential sources of infection. Currently, infection prevention efforts focus on active surveillance, hand hygiene, personal protective equipment use and antimicrobial stewardship, with less attention given to environmental cleaning. Nevertheless, environmental cleaning is essential to remove infectious agents from environmental surfaces and prevent transmission. The …

Comparison Of Study/Article Characteristics And Methodological Quality Of International Nurse Workplace Violence Research Published Before And After The Joint Commission Sentinel Event Alert On Disruptive Behaviors, Terressa Margarette Stowell Love

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The majority of new nurses experience workplace violence from other nurses. The purpose of this study was to compare study/research characteristics and methodological quality of international nurse workplace violence research published before and after the 2008 release of the U.S. The Joint Commission (TJC) sentinel event alert on disruptive behaviors.

Methods: Thirty-nine quantitative nurse workplace violence research articles published between 2001 and 2012 were assessed and divided into two groups: articles published (a) before the 2008 TJC sentinel event alert or the same year, i.e., 2001-2008 (BTJC) and (b) after the 2008 TJC sentinel event alert, i.e., 2009-2012 (ATJC). …

Evaluating Shared Governance For Nursing Excellence, Evette Michelle Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The national challenges of nursing shortages, decreased staffing levels, and increased patient acuities have contributed to nurse's increased workload and job dissatisfaction. Nurses have become frustrated with the professional practice environment. The inability to make decisions about issues that affect their nursing practice and the care provided to their patients results in nurses leaving the work environment in search of higher job satisfaction. Employers are becoming more creative in their strategies to improve the work environment and retain nurses within their organizations. Healthcare leaders have implemented management strategies such as shared governance models. These models focus on providing a satisfying …

Sociodemographic Characteristics, Distance To The Clinic, And Breast Cancer Screening Results, Seijeoung Kim, Beverly Chukwudozie, Elizabeth Calhoun

Journal of Health Disparities Research and Practice

Timely detection and follow-up of abnormal cellular changes can aid in early diagnosis of breast cancer, thus leading to better treatment outcomes. However, despite substantial breast cancer screening initiatives, the proportion of female breast cancer cases diagnosed at late stages remains high. Distance to screening clinics may affect access to care, particularly for women living in impoverished areas with limited means of reliable transportation. Utilizing breast cancer screening data collected by the Illinois Breast and Cervical Cancer Program between 1996 and 2010, we examined the effect of travel distance to the clinic from which women received breast cancer screening tests …

The Effect Of Race/Ethnicity On The Age Of Colon Cancer Diagnosis, Matthew Katz, Maryann E. Parrish, Ellen Li, Yuanhao Zhang, Wei Zhu, Kenneth Shroyer, Roberto Bergamaschi, Jennie L. Williams

Journal of Health Disparities Research and Practice

ABSTRACT

BACKGROUND: Colorectal cancer is the third most commonly diagnosed cancer in the United States. Notably, racial/ethnic disparities exist in both incidence and mortality.

PURPOSE: The aim of this case study was to investigate the impact of race/ethnicity on age at diagnosis of colorectal cancer in a defined population in Suffolk County, NY.

METHODS: Data were retrospectively collected on race/ethnicity, health insurance status, age at diagnosis, stage at diagnosis, gender, smoking status, alcohol intake, tumor location, and body mass index for colorectal cancer patients with medical records in the Stony Brook University Medical Center database (2005-2011). Population-based data on Hispanic …