Medicine and Health Sciences Commons^™

Improving Nurse Leaders’ Knowledge And Confidence In Transformational Leadership Skills In The Online Environment, Tanya Haight

UNLV Theses, Dissertations, Professional Papers, and Capstones

Leadership is critical to the success of most organizations, and the achievement of an organization's goals is largely dependent on the leaders' ability to engage, motivate, and influence their teams—often referred to as Transformational Leadership. This is especially true for healthcare organizations wherein the morbidity and mortality of patients may be affected by the quality of leadership. At the start of the COVID-19 pandemic, in-person meetings transitioned to the online format without nurse leaders' formal training. Leaders cited this lack of orientation as impeding their ability to sustain an online-virtual transformational leadership presence with their teams. They reported varying degrees …

The Effects Of Executive Function Between Anxiety And Math Achievement In Adolescents, Mckenzie Hall

UNLV Theses, Dissertations, Professional Papers, and Capstones

Anxiety in Children can develop into pervasive disorders in adulthood if not treated. Research shows dysfunctional Executive Function (EF) and anxiety are both shown to have a negative impact on math achievement in children and adolescents (Trezise & Reeve, 2018; Kalaycioglu, 2015; Owens, Stevenson, Hadwin & Norgate, 2012). Chung, Weyandt, and Swentosky (2014) found biological and neuropsychological support for EF as a unitary and multifaceted processor for regulating our emotional states as well as our daily procedures. Anderson’s (2002) model of Executive Control System (ECS) allows the factors of EF to be examined using a developmental approach towards EF processes. …

Quality Of Care: A Business Case For Us Hospitals, Iwimbong Kum Ghabowen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Patient Protection and Affordable Care Act present some threats and opportunities to many hospitals across the USA. Under the Value-Based Purchasing Program, acute care hospitals' rewards are tied to incentive payments for the quality of care provided in the inpatient hospital. In the last 20 years, growing research has examined the effects of the quality of care on the financial performance of hospitals. There is a gap in the literature, particularly exploring the relationship between quality and hospital financial performance using national samples. This dissertation investigates the association between patients' experience of care, 30-day readmission rates, and case-mix-index (CMI) …

Exploring Gen Z Nursing Students’ Experience And Emotional Processing In Simulation: A Grounded Theory Study, Wendy Matthew

UNLV Theses, Dissertations, Professional Papers, and Capstones

Simulation is an integral teaching methodology used within current nursing curricula. The goal of simulation is to promote learning, develop clinical judgment and reasoning, and ultimately improve patient care. However, some factors can disrupt the goals of the simulation learning experience. Students may experience uncomfortable emotional responses, such as anxiety, during simulation events, which impairs students' thinking processes leading to decreased learning, poor performance, an inability to assess knowledge, and potentially prohibits the transfer of knowledge to practice. Over 90% of the general Generation Z (Gen Z) population report uncomfortable emotions such as stress and anxiety. Simulation is used in …

Is Dietary Teaching Via Telehealth Effective In Lowering Hgba1c In Adult Patients With Prediabetes Or Type 2 Diabetes?, Mia Mccallum-Crawford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prediabetes and Type 2 diabetes mellitus (T2DM) are two common conditions diagnosed in the primary care setting. Both conditions benefit from a healthy lifestyle, managing blood sugar levels, and getting diabetes self-management education and support (DSMES). Within the past two decades, the healthcare community in the US has witnessed a substantial rise in diabetes among adults. Overall, the self-management of diabetes continues to worsen nationally. The purpose of this project is to improve patients’ self-management of both Prediabetes and T2DM through nutrition and show how nutritional counseling via telehealth provided by a nurse practitioner can improve HgbA1C values over 3 …

The Nursing Leader’S Role In Decreasing Implicit Rationing By Improving The Nursing Work Environment, Allison Mchugh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite all the literature about missed care and its contributing factors, it is prevalent in most hospitals worldwide. Missed care is the result of care that is implicitly rationed. For this paper, implicit rationing is defined as how nurses decide what care is delivered based on the present work environment. Many factors influence implicit rationing. One such factor is the work environment. The association between the nursing work environment and implicit rationing is well described in the literature. The nursing leader is in a formal position responsible for patient outcomes and the nursing practice environment. Therefore, it is important to …

Improving Self-Efficacy And Knowledge While Reducing Anxiety In High-Risk Breast Cancer Patients Through Standardized Education, Shelley Miles

UNLV Theses, Dissertations, Professional Papers, and Capstones

Breast cancer is the leading cause of death of women in the United States. Patients at high risk for developing cancer are more easily identified in today’s world. Early identification might be due to strong family history or genetic mutations, such as BRCA1 or BRCA2. Screening and risk reduction guidelines have been developed over recent years for these patients. Adherence to these guidelines continues to be a problem. The factors stemming from this problem include lack of knowledge about being high-risk, understanding the guidelines, and anxiety and depression about the perceived risk of developing breast cancer. These factors can cause …

Ultrasonography-First Imaging Algorithm For Acute Appendicitis Diagnosis, Steven Lamar Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Acute appendicitis (AA) is the most common cause of acute abdominal pain requiring surgery in pediatric, adult, and pregnant patients. Several etiologies are believed to trigger luminal obstruction, which causes mucus and bacteria proliferation, resulting in inflammation and wall tension with subsequent necrosis and rupture of the appendix. Most AA patients present with the primary complaint of abdominal pain, which Murphy first described the characteristic diagnostic sequence seen in approximately 50% of patients as colicky centralized abdominal pain with subsequent vomiting with the migration of pain to the right lower quadrant (RLQ), specifically, the right iliac fossa. The typical AA …

Increasing Human Papillomavirus Vaccination Intent And Knowledge Through An Educational Intervention, Angelica E. Musumeci

UNLV Theses, Dissertations, Professional Papers, and Capstones

Human papillomavirus (HPV) is a widely discussed topic in healthcare as it affects patients of all genders and ages who partake in sexual activity. The most significant concern it poses to those at risk is HPV-related cancer. Fortunately, a vaccination exists that targets specific strains associated with these types of cancers. Despite evidence-based research supporting the vaccination’s efficacy and safety, lack of awareness and misinformation diminish the receipt of the vaccine and drive the lack of protection. Thus, educational interventions directed at parents and caregivers, which aims to improve their understanding of HPV and the vaccination’s benefits, is key to …

Evaluation Of An Advance Care Planning Workshop To Improve The Self-Efficacy Of Health Care Providers, Joy Patrick

UNLV Theses, Dissertations, Professional Papers, and Capstones

Advance care planning (ACP) involves discussions between the patient and their care providers and those close to them about future care. Every patient is entitled to ACP; however, research has shown that providers do not regularly implement them for various reasons. In addition, multiple barriers may be preventing providers from initiating ACP. Among them are lack of knowledge and confidence, apprehension, time, and fear. This Doctor of Nursing Practice (DNP) addresses the problematic barriers to regular ACP discussions between providers and the patients. Specifically, the purpose of this DNP project is to develop, implement and evaluate an online module to …

Differential Expression Of Cellular And Exosomal Microrna Isolated From Oral Cancer Cells And Their Resistance To Chemotherapy, Brady Petersen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: MicroRNAs are abundant small non-coding RNA with a variety of known functions, including transcriptional activation and inhibition. Recent evidence has suggested that microRNA expression may influence the responsiveness of some cancers to chemotherapy, including liver and lung cancers. Some evidence has now suggested that specific microRNAs, such as miR-21, miR-155, and miR-375, may influence oral cancer responsiveness to chemotherapy – although much remains to be discovered.

Objective: Based upon the lack of evidence in this area, the primary objective of this study was to evaluate microRNA expression and responsiveness among oral cancers.

Methods: Five commercially available oral cancer cell …

Identifying Gaps In Social Determinants Of Health Among Patients 65 Years And Older With Congestive Heart Failure: A Secondary Data Analysis, Sandra Pierre-Louis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Congestive heart failure (CHF) is one of the most common healthcare problems for older adults. Because of its high and rising prevalence in this population and its significant influence on healthcare costs and quality of life, CHF is becoming a serious public health issue in the United States. More effective strategies for preventing and managing CHF in older people are desperately needed (Rich, 2015). The disease accounts for 3% of hospital admissions in the United States and affects more than 6.5 million Americans (White-Williams et al., 2020). Further, CHF is exacerbated by adverse social determinants of health (SDOH). This study …

In The Image Of… Towards A Trans Talmud, Laurence Myers Reese

UNLV Theses, Dissertations, Professional Papers, and Capstones

In the Image of... (towards a Trans Talmud) is a body of work by artist Laurence Myers Reese that works to examine Jewish paradigms of gender through the transgender lens. Reading the archive diagonally, he examines historical Jewish writings, from poet and Rabbi Kalonymous Ben Kalonymous to “false Messiah” Shabbatai Tzvi. Contextualizing contemporary Jewish with notable exhibitions from the Jewish Museum New York and Spertus Museum, Chicago, In the Image of… draws from artists, writers, and Rabbis who use a gendered lens to interrogate Judaism. These include Yael Kanarek, who has worked to re-gender the entire Torah, Rena Yehuda Newman, …

Characterization Of Physical And Dosimetric Aspects Of Srs Hyperarc Treatment Technique, Emma S. Rickels

UNLV Theses, Dissertations, Professional Papers, and Capstones

HyperArc is a radiation therapy planning technique using stereotactic radiosurgical doses delivered via single isocenter volumetric modulated arcs (VMAT) for multi-lesion brain cancer. Due to the nature of these types of treatments it is imperative that the proper quality assurance is completed to ensure the safety of the patient. Geometric limits were assessed using a dose volume histogram (DVH) and known rotational errors of theoretical lesions of different dimensions and lengths from the isocenter. Dosimetric comparisons were evaluated using an ion chamber and Gafchromic EBT-XD film and portal dosimetry. The conclusions from these investigations were that patient rotation will result …

Evidence-Based Intervention To Improve Health Literacy Among Older Adults With Newly Diagnosed Atrial Fibrillation, Johana Rowe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Significance: Atrial fibrillation (AFib) is the most common arrhythmia encountered in the healthcare setting. As of 2018, approximately 6.1 million people in the United States were living with AFib which is projected to increase to 12.1 million by 2030. Older adults are at higher risk of developing AFib and its complications. AFib is a chronic condition that requires targeted patient education by healthcare providers in different healthcare settings. Patient’s low health literacy regarding the condition is a significant barrier to therapy adherence. Given the high rate of poor health literacy among individuals newly diagnosed with AFib and the …

The Association Between Neighborhood Social Media Use And Social Cohesion, Sense Of Community And Perceived Safety Among Adults In Clark County, Nevada, Emily Strickler

UNLV Theses, Dissertations, Professional Papers, and Capstones

Place-based health is a concept that suggests where you live has an effect on your health outcomes. Social health factors such as social cohesion, sense of community, and perceived safety are all influenced by the neighborhood environment, and positively associated with health outcomes such as self-reported minutes of physical activity and symptoms of depression. With the increasing popularity of social media sites used specifically for neighborhood purposes, more neighbors are connecting than ever before. The purpose of this study was to determine if use of neighborhood social media sites was associated with the social health factors of social cohesion, sense …

Comparative Effects Of High-Intensity Interval Warm-Up Exercise And Bronchodilator On Exercise-Induced Bronchoconstriction In Children With Mild Asthma, Michael Wong

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The troubling link between obesity and asthma in children, along with greater associated detrimental health effects, warrants investigation to better understand the mechanisms driving this relationship as well as its consequences, especially during exercise. Bronchodilators and interval warm-up exercises are recommended by the American Thoracic Society to prevent exercise-induced bronchoconstriction (EIB). Whether interval warm-up exercise can prevent EIB to the same extent as bronchodilators in asthmatic children is unknown but clinically important. Therefore, the first purpose of this study is to investigate the effects of obesity on pulmonary function, exercise tolerance, and exercise-induced bronchoconstriction in asthmatic children. The second …

The Occupational Therapy Approach To Pain Treatment: A Pain Curriculum, Rosalee Howell

UNLV Theses, Dissertations, Professional Papers, and Capstones

It is within the scope of the occupational therapy profession to treat patients experiencing pain. The holistic approach used to assess and treat patients to improve functional performance is vital in treating pain. The focus is to decrease the detrimental impact of pain on the patient’s mental health, enhancing their ability to function in social and vocational roles. However, education is not adequately addressed in occupational therapy programs and is vital in preparing clinicians to meet the patient’s needs effectively.

This Doctoral Capstone was developed to highlight the importance and the benefit of education in preparing clinicians to treat patients …

Assessment Of Oral Human Papillomavirus In Pediatric And Adult Patients Within A Multi-Ethnic Clinic Population, Melissa Kornhaber

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Human papillomavirus (HPV) encompasses a large family of oncogenic viruses responsible for increasing rates of both cervical and oral cancer, particularly among minority and low-income populations. Although this represents an increasingly significant public health risk, few studies have screened for oral HPV within Nevada. Based upon this information, the primary objective of this study was to provide a temporal analysis of oral HPV screening among a primarily low-income, minority patient population.

Methods: This retrospective analysis was reviewed and approved by the Institutional Review Board (IRB). In brief, unstimulated saliva samples were previously obtained from clinical patient volunteers that provided …

The Effects Of Transcranial Direct Current Stimulation On Motor Learning In Complex Motor Tasks, Milan Pantovic

UNLV Theses, Dissertations, Professional Papers, and Capstones

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has emerged over the past 10-12 years as safe, affordable, portable, easy to use, and potentially efficacious adjuvant training intervention in several aspects of human performance. tDCS has been shown to be able to improve both cognitive and motor function in a wide variety of populations such as young adults, older adults, stroke, Parkinson’s disease, and many others. However, the majority of tDCS research has been conducted in the motor system of healthy young adults, which will also be the focus of this dissertation.The basic effects of tDCS …

Regional Health Benefits Of The Nevada Renewable Energy Initiative, Alireza Rezaee

UNLV Theses, Dissertations, Professional Papers, and Capstones

In recent years, there have been tremendous efforts to replace fossil fuels with renewable energy to mitigate emissions of greenhouse gases and air pollutants in the United States. Nevada was among the first states that established the renewable portfolio standards (RPS), requiring a certain percentage of electricity sold to the customers for consumption coming from renewable resources. The recent Nevada Senate Bill 358, signed by Nevada’s Governor in 2019, set a target that by 2030 not less than 50% of electricity sold in Nevada should come from renewable resources. This research investigates how this Bill could provide health benefits for …

The Rey Auditory Verbal Learning Test: Cross-Validation Of Mayo Normative Studies (Mns) Demographically Corrected Norms With Confidence Interval Estimates, David W. Loring, Jessica L. Saurman, Samantha E. John, Stephen C. Bowden, James J. Lah, Felicia C. Goldstein

Brain Health Faculty Research

Objective: The Mayo Normative Studies (MNS) represents a robust dataset that provides demographically corrected norms for the Rey Auditory Verbal Learning Test. We report MNS application to an independent cohort to evaluate whether MNS norms accurately adjust for age, sex, and education differences in subjects from a different geographic region of the country. As secondary goals, we examined item-level patterns, recognition benefit compared to delayed free recall, and derived Auditory Verbal Learning Test (AVLT) confidence intervals (CIs) to facilitate clinical performance characterization. Method: Participants from the Emory Healthy Brain Study (463 women, 200 men) who were administered the AVL were …

The Responsiveness Of Muscle Strength Tests In Adults With Intellectual Disabilities, S. Weterings, A. Oppewal, S. M.A. Bierma-Zeinstra, T. I.M. Hilgenkamp

Physical Therapy Faculty Research

Background Muscle strength is both a strong predictor for future negative health outcomes and a prerequisite for physical fitness and daily functioning of adults with ID. Therefore, it is important to be able to monitor the muscle strength of adults with ID over time. The aim of this study is to assess the responsiveness of five field tests that measure muscle strength and endurance (grip strength, hand-held dynamometry of leg extension and arm flexion, 10RM-test of the seated squat and the biceps curl, 30-s chair stand and the 5-times Chair stand) in adults with ID after a 24-week resistance-exercise training …

Mourning The Marathon: Black Men Rappers, Homicide Survivorship Bereavement, And The Rap Tribute Of Nipsey Hussle, Melvin L. Williams, Justin K. Winley, Justin Causey

Far West Popular Culture Association Annual Conference

Eritrean-American rapper Ermias “Nipsey Hussle” Asghedom’s murder represented a cultural cataclysmic event that startled the hip-hop community and triggered previous memories of Black men’s homicidal deaths in rap and Black American urban communities. Nipsey Hussle’s death inspired touching rap tribute songs by Black men rappers, who sought to commemorate his cultural legacy and express their bereavement pains as homicide survivors. Rap tribute songs occupy a significant history, as rappers historically employed them to honor hip-hop’s fallen soldiers, communicate their homicide survivorship bereavement processes, and speak about social perils in the Black community. Framed by critical race (CRT) and gender role …

Powering A Sustainable Electric Vehicle Future, Harmony Ruth, Jordan Brickman

Undergraduate Research Symposium Posters

Electric vehicle sales account for roughly 20% of total sales world wide and are projected to be 80% by 2050. China's electric vehicle market holds a 13.3% market share. China exported 550,000 electric vehicles in 2021. China represents a 54% share of the world's coal consumption as of 2020. Why study China on this issue? China is a major player in the World Economy.

Associations Between State Regulations And Midwifery Workforce Access, Acacia Herndon

Undergraduate Research Symposium Podium Presentations

Background: U.S is worst in maternal care; Credible support for CNMs as a solution; Independent licensing has been ineffective; Other factors may influence access

The State Of Mental Health In The Mountain West, Olivia K. Cheche, Kristian Thymianos, Katie M. Gilbertson

Undergraduate Research Symposium Podium Presentations

How do the Mountain West states (Arizona, Colorado, Nevada, New Mexico, and Utah) perform in the quality of mental health care services? How prevalent are mental health issues in the Mountain West? How accessible is the mental health workforce to adults and youth?

The Effectiveness Of Using Motor Imagery As An Alternative To Exercise For Improving Mental Health, Madelyn Colbert

Undergraduate Research Symposium Podium Presentations

Exercise shown to improve mental health in variety of health histories. MIT shown to improve physical health in a variety of conditions when tested alone. Mental health problems and SUD have high comorbidity rates. Exercise shown to be effective recovery therapy for SUD.

Determining The Effects Of A Commonly Used Cystic Fibrosis Antibiotic On Nonmucoid Pseudomonas Aeruginosa Reversion, Vanessa Meza-Perez

Undergraduate Research Symposium Podium Presentations

Summary: 1. CF lung environment selects for mutations in Pa --> Mucoid 2. Mucoid can revert to nonmucoid 3. Reversion rate w/ antibiotic vs. Reversion rate w/o antibiotic 4. Induced reversion as a potential CF therapeutic strategy

The Meta-Mood Experience: Exploring The One-, Three-, And Four-Factor Models Of The Trait Meta-Mood Scale, Zain N. Raja, Jerald J. Novero, Susan E. Gutierrez, Orei Z. Odents, Fitsum A. Ayele

Undergraduate Research Symposium Posters

The meta-mood experience involves "thinking about mood, examining the relation between mood and thoughts, maintaining good moods, and altering bad moods" (Mayer & Gaschke, 1988). Meta-mood can help individuals have a better grasp of what they are feeling at different times.

The 30-item Trait Meta-Mood Scale (TMMS; Salovey et al., 1995) measures the extent to which people attend to, distinguish among, and regulate their mood and emotions.

Salovey et al. (1995) found three factors (Emotional Attention, Clarity, and Repair), while Palmer et al. (2003) found evidence for a fourth but left it unnamed.

We named the fourth factor in our …