Medicine and Health Sciences Commons^™

Physical Therapy Alumni Rural Employment Assessment, Karen Aleyda Santos, Nikkita Jacob Crozier

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction and Purpose: The University of Nevada, Las Vegas Doctor of Physical Therapy program (UNLVPT) encourages rural and underserved employment by requiring students to complete one clinical experience in either a rural or underserved setting. Students who participate in rural clinical experiences may be more likely to practice in rural settings. UNLVPT also assesses rural interest level during each student’s education. The purpose of this study was to determine if relationship exists between students’ pre- or post-clinical experience rural interest level and their practice location within the first two years after graduation. We hypothesized that an interest in rural practice …

Brain And Spinal Cord Adaptations Associated With Patellofemoral Pain: A Systematic Review And Meta-Analysis, Kara Meske, Savanna Budge Huerta, Austin Madriaga, Derrick Nguyenton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To evaluate the evidence for altered cortical and spinal cord functions in individuals with patellofemoral pain (PFP).

Methods: We conducted a comprehensive search of databases to appraise and analyze the studies published prior to December 10, 2021 that examined spinal reflex excitability measured using Hoffmann reflex (H-reflex) amplitudes, corticospinal excitability measured using transcranial magnetic stimulation (TMS)-elicited motor evoked potential (MEP) amplitudes, motor threshold (MT), or stimulus-response (SR) curves, cortical reorganization assessed using TMS cortical mapping or structural magnetic resonance imaging (MRI), or functional changes of the brain assessed using functional MRI (fMRI) in individuals with PFP.

Results: Eight studies …

Sight Deprivation And Metabolic Effects During The Ymca Bench Press Test, Kyle Cruz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Several studies have investigated the effect of sensory deprivation, particularly sight. However, very few have demonstrated the impact of sight deprivation while exercising to cadence blindfolded. This study aimed to determine exercise performance during a common muscular endurance evaluation, the YMCA Bench Press Test (YBPT), while blindfolded compared to a sighted condition. Twenty-five healthy participants (11 male, 14 female, 168 ± 7.7cm, 68 ± 11.7kg, 23 ± 7.5% fat mass) were recruited from the University of Nevada, Las Vegas student populations and communities. After a YBPT familiarization session, participants completed testing in a counterbalanced order, following the same procedures. A …

Healthcare Screenings In The Occupational And Workplace Setting: Taking Control Over Blood Pressure, Darryl W. Horton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Undiagnosed hypertension continues to be a growing concern worldwide leading to cardiovascular disease and other chronic illnesses and can contribute to death. The prevalence of hypertension continues to increase even with guidelines on screening, hypertension education, disease prevention, disease maintenance, and management. The purpose of this project was to determine if the implementation of a workplace blood pressure screening program would improve hypertension knowledge and reduce the burden of hypertension within workplace. A descriptive, cross-sectional design using convenience sampling was conducted. Participants were screened by measuring blood pressures, and the Hypertension Evaluation of Lifestyle Management scale (HELM) was utilized to …

Comparative Expression Of Exosome-Derived Dental Pulp Stem Cell (Dpsc) Microrna, Matthew Hunsaker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Dental pulp stem cells (DPSC) are pluripotent stem cells capable of differentiating into several tissue types. Several studies have demonstrated DPSC can be extracted from deciduous and permanent teeth, including third molars (wisdom teeth) - however, much less is known regarding the factors that determine and regulate pluripotency and differentiation responsiveness among these harvested DPSC. Recent evidence has suggested small, non-coding microRNAs mediate (in part) differentiation and self-renewal among some stromal and hematopoetic stem cells, although much remains to be discovered regarding microRNA regulation of DPSC phenotypes. Based upon this information, the overall goal of this study was to …

Parental Education On Human Papillomavirus Vaccination, Marguarette J. Suprien

UNLV Theses, Dissertations, Professional Papers, and Capstones

The human papillomavirus (HPV) is a worldwide condition that produces several diseases, including cervical, anogenital, and oral cancer, among others (Fishman et al., 2014). The Center for Disease Control and Prevention (CDC; 2016a) stated that HPV is among the most reported sexually transmitted diseases in the United States. Over 150 viruses are associated with HPV, and 40 types of the virus can be spread via sexual contact, including vaginal, oral, and anal sex (CDC, 2016; CDC, 2016b; CDC, 2016c). Evidence shows that approximately 79 million individuals are infected in the United States, and 14 million Americans are infected with the …

Communicating Pain Unseen: Addressing Health Outcomes In Sexual Activity For Women With Endometriosis, Madison Wiese

UNLV Theses, Dissertations, Professional Papers, and Capstones

Roughly 160 million women live with endometriosis, a chronic disease involving the uterine lining shedding on the outside of the uterus causing immense physical and emotional pain (Becker et al., 2020). One common symptom of endometriosis is dyspareunia, or painful sex (Ballard et al., 2008). This study aims to uncover how gender expectations from society impact women with endometriosis specifically in sexual encounters. Informed by the traditional sexual script theory and sexual script theory, the study examines how traditional gender norms might influence women’s prioritization of their own health needs as well as the physical, emotional, and relational health outcomes …

Increasing Genetic Testing Rates To Improve Early Detection And Prevention Of Breast And Ovarian Cancer In Women, Makensey Beth Durrant

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screening rates for cancer related genetic mutations are low in the primary care setting, despite evidence-based guidelines recommending screening in all patients who meet criteria. Genetic mutations, such as the breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations, drastically increase breast and ovarian cancer risk in patients. The United States Preventive Services Task Force (USPSTF) and the National Comprehensive Cancer Network (NCCN) provide evidence-based guidelines on criteria for genetic testing in women at risk for breast and ovarian cancer related gene mutations. Primary care providers (PCPs), including advanced practice registered nurses (APRNs), are at the front lines of preventative …

Direction Of Attentional Focus In Prosthetic Training: Current Practice And Potential For Improving Motor Learning In Individuals With Lower Limb Loss, Alexander Bonczyk, Maria Katrina Tillada Dimapilis, Sarah Partridge, Samantha Ruiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Adopting an external focus of attention has been shown to benefit motor performance and learning. However, the potential of optimizing attentional focus for improving prosthetic motor skills in lower limb prosthesis (LLP) users has not been examined. In this study, we investigated the frequency and direction of attentional focus embedded in the verbal instructions in a clinical prosthetic training setting.

Methods: Twenty-one adult LLP users (8 female, 13 male; 85% at K3 level; mean age=50.5) were recruited from prosthetic clinics in the Southern Nevada region. Verbal interactions between LLP users and their prosthetists (mean experience=10 years, range=4-21 years) during …

Essential Tools For Sustainability Of A Student-Led, Pro-Bono Back School, Cory Brown, Rosalie Gutierrez, Jennifer Montes, Rondale Scruggs

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: In 2018, University of Nevada Las Vegas Doctor of Physical Therapy (DPT) students and faculty, in cooperation with a community partner, created a student-led pro bono Back School to address a gap in healthcare for underinsured individuals with low back pain in Southern Nevada. To support the sustainability of the Back School, the authors of this paper set out to develop a student club to recruit and train DPT students to volunteer in the program using a specifically designed electronic training manual. Overall, the aim was to encourage students to join the new club's leadership team to prepare future …

Increasing Utilization Of Otago Fall Prevention Program By Nevada Physical Therapists: A Service-Learning Project, Jared Apostol, Erica Mooy Brown, Danielle Uptain

UNLV Theses, Dissertations, Professional Papers, and Capstones

Otago is an evidence-based program that is designed to reduce falls in community dwelling older adults by individualizing an exercise program with three key components: strength, balance, and a walking program. Unfortunately, Nevada clinicians do not utilize the program frequently or entirely with patients in outpatient and/or home health physical therapy. Evidence shows it reduces fall risk, but it has barriers to implementation in the United States. The barriers to integration are primarily due to the plan of care that stems from a 12-month timeframe and several phone call appointments which does not fit well in the American healthcare system. …

Effects Of A Remote Exercise Intervention On Aerobic Endurance In Individuals With Down Syndrome, Andrew Murata, Elena Wolf, Jonathan Crimm, Benjamin Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Down syndrome (Ds) or Trisomy 21 is a common genetic birth condition, and those with Ds typically display decreased cardiorespiratory fitness compared to those without Ds, potentially leading to an increased risk for cardiovascular conditions and mortality. Low cardiorespiratory fitness is partially caused by low physical activity levels in this population. The COVID-19 pandemic caused community-based activity programs to shut down, as individuals with Ds are at increased risk for COVID-19 hospitalization and death. Thus, it was vital to explore alternatives of in-person exercise during the pandemic. The purpose of this study was to investigate the effects of a …

Perceived Value Of Acute Care Physical Therapy, Juliana Amenta, Andrew Falcinelli, Erin Heenan, Hannah Kendall

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/Significance/Objective: Although there is some research regarding physical therapy in the acute hospital setting, much of it is focused on the role physical therapists play with specific patient populations or diagnoses. By understanding more about how physical therapy services can add value in the acute hospital, their skills could be better utilized to maximize benefit for both individual patients and the hospital. The purpose of this study was to investigate the perceived value that physical therapists bring to the acute care hospital from the perspective of both physical therapists and their supervisors in Southern Nevada.

Methods: This study used an …

Walking With Poles Improves Step Length Of Simulated Prosthetic Gait, Marissa Elquist, Daniel Perez, Jonathan Garcia, Brady Owens

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals with lower limb loss often demonstrate gait deviations which cause instability and asymmetry. Walking with poles has been shown to improve stride length and stability in older adult and other patient populations. The enhanced arm involvement in bipedal walking with poles has the potential to facilitate interlimb coordination among arms and legs, and therefore is likely to improve prosthetic gait. The purpose of this study was to examine the effect of walking poles on temporal gait parameters and the center of mass (COM) displacement during prosthetic and simulated prosthetic gait. It was hypothesized that walking with poles would improve …

Effects Of A 12-Week Telehealth Exercise Intervention On Gait Speed And Gait Deviations In Adults With Down Syndrome, Robert Lum, Taylor Souza, Christopher Roys, Daniel Stopka

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Down syndrome (Ds) is associated with impairments affecting overall motor development including gait pattern and speed. Research on the effects of exercise on adults with Ds is lacking. The purpose of this study is to evaluate the effects of a 12-week telehealth exercise program on gait impairments in adults with Ds.

Methods: Twenty participants performed a 12-week telehealth exercise program based upon a diagnosis-specific procedure developed by Sarah Mann, PT, DPT. Gait deviations were assessed with the Ranchos Los Amigos Observational Gait Analysis. Comfortable gait speed was evaluated with the 4-meter walk test.

Results: Improvements in comfortable gait speed …

Factors Predicting Fear Of Falling Avoidance Behavior In Parkinsonisms, Kameron Eckard, Franjo Vukojevic, Ryan Hammar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Fear of falling avoidance behavior (FFAB) is common in parkinsonisms and results in potentially mitigable downstream consequences.

Objective: Determine the characteristics of individuals with parkinsonisms most associated with FFAB.

Methods: A retrospective, cross-sectional study was conducted from medical records data of 142 patients with parkinsonisms. These data included: demographics (age, sex), disease characteristics (Movement Disorders Society – Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III), years since diagnosis), fall history (number of fall injuries in previous year), and gait and balance function (five times sit to stand, MiniBESTest, Timed Up and Go (TUG), dual-task TUG, ten-meter walk test …

Efficacy And Benefits Of Providing A Screening Clinic For Performing Arts Students, Shaun Bean, Joanna Centeno, Elizabeth Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

In past years, University of Nevada, Las Vegas physical therapy students (UNLVPT) have provided UNLV dance students with screening clinics, injury evaluations, and treatment sessions to help address their need for direct and specialized services. Through this project, UNLVPT has worked to help reduce injury risk in dancers and provided treatment and rehabilitation for injuries that have occurred. Due to the COVID-19 pandemic, our group was unable to treat dancers in person over the course of the 2020-2021 school year. In response to these limitations, we worked to reformat our screening process to make it practical in a virtual setting. …

Development Of Online Modules To Introduce Prospective Students To The Profession Of Occupational Therapy, Hosia Towery

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prospective students interested in Occupational Therapy academic programs are subject to the admission criteria of each educational institution, including experiential learning, clinical observation hours, volunteer experiences, or similar prerequisites. There are no standardized criteria established for these prerequisite requirements b the accreditation agency, as it is within the scope of Higher Education. There is no accountability at the regional or local level to ensure educational opportunities for prospective students interested in higher education, creating a gap as highlighted in the recent global pandemic, where student access to education was further challenged. Students are reliant on a variable set of requirements …

The Road Ahead: An Occupational Therapy Manual To Infant Development For Parents In The Nicu, Nicole Suzuki-Uyeno

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists have been collaborating with the parents of our tiniest patients in the neonatal intensive care unit (NICU) for quite some time. They have a wealth of information and expertise in the area on infant development and parent education. Admitting a baby to the NICU is a shock for most parents and can take a toll on a family. The role of the occupational therapist is to help educate the family and to provide the tools to safely take care of their baby and to smoothen the transition from the hospital to home.

In the NICU, the OT has …

Diurnal Regulation Of Exercise-Induced Myocardial Signaling And Transcription, Charli Aguilar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Exercise is well known for its many benefits on the body and most notably the heart. Recent emphasis, and significant resources, have been dedicated to elucidating the molecular mechanisms through which exercise exerts its pluripotent beneficial effects on health and the prevention of disease. A continuous evolution in this field has sought to modulate and optimize exercise in various ways to maximize the benefits. In recent years, a growing appreciation for the impact of circadian rhythms has gained traction and their influence on many essential biological functions have been integrated into exercise physiology (i.e. - chrono-exercise), as well as …

The Effect Of Attachment Design And Aligner Material On The Efficiency Of Maxillary Canine Distalization In Premolar Extraction Cases, Najem Anbari

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Clear Aligner Therapy (CAT) is regarded as a popular esthetic alternative to conventional orthodontic treatment with fixed labial appliances. The mechanism of action, force delivery and limitation of this treatment modality remain largely unknown despite its popularity, the high demand and the relatively long evolutionary track of clear aligners. There are only few studies that addressed the elements that influence the efficiency of clear aligners, namely, the attachment design and aligner materials. It is widely believed that clear aligners are not suitable for extraction cases due to their lack of control over the root movement.

Objectives: This in vitro …

Association Between Arthritis And Yoga Among Veterans, Anupreet Arora

UNLV Theses, Dissertations, Professional Papers, and Capstones

Yoga is a state of complete mindfulness and self-realization with an inwardly drawn focus, a state of mind – body integration in which there is a harmony between form and action. Yoga can help us treat a myriad of chronic health conditions like obesity, heart diseases, diabetes, depression, gastrointestinal problems, asthma, hypertension, chronic low back pain, and arthritis to name a few. Arthritis is a frequent, debilitating chronic disease which can cripple an individual if allowed to progress unchecked. In 2021, the prevalence of arthritis in USA was around 24% with a projection of 37% by 2030. Prevalence of arthritis …

Improving Nurse Self-Efficacy Regarding Depression Among Cardiovascular Disease Patients: An Education Intervention, Presten Beatty

UNLV Theses, Dissertations, Professional Papers, and Capstones

Depression is a principal cause of increased morbidity, mortality, and decreased quality of life for cardiovascular disease patients. Low levels of nurse confidence have been the outcomes of several studies and anecdotal reports regarding providing care for and approaching patients with acute and chronic illnesses in conjunction with behavioral and mental health issues. Current literature suggests that improving nursing education on the prevalence and impacts of depression improves nurse confidence. Depression screening tool education provided to nurses, with detailed disease information, empowers nurses in their attitudes, knowledge, and behaviors regarding patient depression. By improving depression screening rates among cardiovascular disease …

Examining The Role Of Prosocial Tendencies And Social Anxiety In Hazardous Drinking Practices Among College Students, Helena M. Berlin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 40% of the United States (US) population aged 18 to 25 is enrolled at postsecondary institutions, and 31.4% of college students report risky alcohol use (i.e., binge drinking). Identifying risk and protective factors for this population is a public health priority. The primary objective of this study was to examine the additive and multiplicative relationship of prosocial tendencies and social anxiety on hazardous drinking (AUDIT scores). A secondary aim was to examine whether these relationships differed by participation in college organizations (Greekaffiliation, athletic participation, both, and neither). Cross-sectional data were collected from 9,196 college students (ages 18-25) from 12 …

A Quality Improvement Project To Improve Health Care Provider Self-Efficacy In Rural Primary Pediatric Care Clinics Through Training Intervention, Alison Borgsmiller

UNLV Theses, Dissertations, Professional Papers, and Capstones

American Association of Pediatrics recommends screening for various developmental delays in children, but it does not explicitly recommend a tool for screening social and emotional development at well-child checks (WCCs). Therefore, provider self-efficacy (SE) is lacking, and screening rarely occurs. This quality improvement (QI) project sought to improve healthcare provider SE using the Ages and Stages Questionnaire: Social-Emotional, Second Edition (ASQ:SE-2), an evidence-based practice screening tool for identifying such delays in children at 30–60-month WCC visits.At rural healthcare centers in San Luis Obispo, California, participants completed the Self-Efficacy Twelve Questionnaire prior to and 30 days following a training intervention. While …

The Effects Of A Dedicated Education Unit On Nurse Retention And Turnover, Cherilyn Campbell

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the fast growth of healthcare jobs in the United States, there is a deficit in the nursing workforce. Literature has shown high nurse turnover within the first year as a new graduate nurse. Healthcare organizations will need to explore innovative ways to impact nursing retention and turnover to keep up with the growing demand. The purpose of this Doctor of Nursing Practice (DNP) project is to perform and evaluate a comprehensive review to determine the effect of a dedicated education unit (DEU) on nurse retention and turnover within an academic-practice partnership. Literature has shown the benefits of the DEU …

Family-Centered Psychosocial Care For Pediatric Oncology Patients, Jessica W. Casey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Psychosocial conditions are prevalent in pediatric oncology patients (Kahalley et al., 2013). Family and social support are essential aspects of a patient's health care outcomes (Merck & McElfresh, 2019). Anxiety and depression are common in pediatric oncology patients due to trauma during treatment (Pao & Kazak, 2015). These patients also can have preexisting developmental or behavioral conditions before starting treatment. Treatment side effects can also cause cognitive and behavioral changes (Nixon, 2014b). Nurses should be knowledgeable and confident in their ability to care for patients' psychosocial health and development. The purpose of this Doctor of Nursing Practice (DNP) project is …

Reducing Door-To-Balloon Time In Stemi Via Er Nurse Driven Protocol, Torrie Clontz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 605,000 patients will suffer an ST-segment elevated myocardial infarction in the United States each year. The gold-standard definitive treatment for this is percutaneous coronary angioplasty or the ballooning open and stenting of the blockage. The American Heart Association has set the evidence-based gold standard of 90-minutes from identification of blockage to reperfusion of heart muscle. In a health system in Las Vegas, NV, this goal is frequently missed due to lack of protocols in place to expedite patients towards definitive treatment. The purpose of this evidence-based practice change is to reduce STEMI patient morbidity and mortality via a nursing …

Evaluating Repetitive Transcranial Magnetic Stimulation To Reduce Opioid Cravings In Opioid Use Disorder, Cameron Duncan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opioid Use Disorder (OUD) is a multi-faceted, complex ailment affecting many individuals and their families across the globe. Currently, there are multiple interventions used in the treatment of OUD, many of which are designed to reduce cravings for opioids. Cravings for opioids are a strong predictor of relapse in the disorder. However, many of the interventions used in clinical practice have inherent risks including a potential for abuse and diversion. Repetitive Transcranial Magnetic Stimulation (rTMS) is an outpatient procedure that may be effective in reducing cravings for opioids, thereby reducing relapse. Methods: This study employed a randomized, single-blind, experimental design …

Decreasing Central Line-Associated Bloodstream Infections In The Critical Care Unit, Kimberly J. Foxworth

UNLV Theses, Dissertations, Professional Papers, and Capstones

Central line-associated bloodstream infections (CLABSI) are a rising problem in the critical care setting in the United States. According to Flogren et al. (2007), "an estimated 248,000 bloodstream infections occur in hospitals across the United States each year, and a significant amount of these infections are associated with the use of a central venous catheter" (p.160). The Center for Disease Control and Prevention (CDC) defines a CLABSI as "recovery of a pathogen from blood culture (a single blood culture for organisms not commonly present on the skin and two or more blood cultures for organisms commonly present on the skin) …