Medicine and Health Sciences Commons^™

Dancer Screening Clinic, Kristen Manaloto, John Lencioni, Laura Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dance students at the University of Nevada, Las Vegas (UNLV) do not have access to sports medicine specialists, thus a pro-bono dance clinic was created as a service-learning project by the UNLV Department of Physical Therapy (UNLVPT) in 2018. In the second year of the service-learning project, three graduate students from the UNLVPT program, under the supervision of a clinical faculty member, have continued to provide free dance specific injury prevention screenings and management to students within the UNLV Department of Dance. To improve clinic operation and services, the group emphasized communication and accessibility as areas of growth. Injury prevention …

Stepping On Fall Prevention Project, James P. Gaddi, Jordan T. Bowers, Lea M. K. Fung

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Falls are a major problem in the United States among the older adult population and provide opportunity for community outreach via student-led physical therapy projects. Objective: The purpose of this project was to investigate the relationship between fall related outcome measures and questionnaires with the completion of the Stepping On Fall Prevention program along with evaluating the benefits of Physical Therapy student development with participation in service learning projects. Methods: The research quantified the fall risk of 13 participants with assessment of: gait speed (Timed Up and Go), lower extremity strength (30-Second Chair Stand), balance (4-Stage Balance Test), and …

Quality Assurance Of Service Learning Back School, Eric Bashaw, Vu Pham, Tyler Parvin, Ryan Pauly

UNLV Theses, Dissertations, Professional Papers, and Capstones

Project Execution: Back School: During the 2019-20 academic year, two University of Nevada, Las Vegas Physical Therapy (UNLVPT) core faculty members, along with eight doctor of physical therapy students, provided three student-led, pro-bono back school classes at Volunteers in Medicine of Southern Nevada (VMSN). Each back school class consisted of two, 2-hour sessions where participants were screened for red flags, educated on pain management strategies and common causes of back pain, and given an individual home exercise program. Quality Assurance Surveys: Patient’s and VMSN staff were all given questions in the form of Likert-scale and open-ended questions via printed handouts …

Recruitment And Advocacy For Clinician Involvement In Pro Bono Physical Therapy Service-Learning Program, Gilberto Carrillo, Gavin Brady, Felicia Doblado, Alyssa Woo Hatch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Service-learning allows Doctor of Physical Therapy (DPT) students to develop important professional skills and addresses community-based needs. When integrated into physical therapy education, it can be a powerful tool for increasing students' altruism and social responsibility. Many clinicians desire to participate in pro bono physical therapy (PT) services. Therefore, the responsibility of promoting and advertising these programs falls upon the student. This paper describes various methods for recruiting clinician involvement to improve the sustainability of a student led pro bono clinic, as well as how the students advocated for pro bono services in the state of Nevada …

Is Decreased Trunk Flexion Angle A Contributing Factor To Patellofemoral Joint Loading In Runners With Patellofemoral Pain?, Christine Duvall, Zachary Clark, Tavin Fox, Caitlin Howden

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Reduced trunk flexion during running is theorized to be a contributing factor of elevated patellofemoral joint (PFJ) stress in runners with patellofemoral pain (PFP); thus, the primary purpose of this research study was to determine if runners with PFP would exhibit differences in PFJ stress and trunk flexion angle during running as compared to pain-free runners across three speeds. We hypothesized that runners with PFP would exhibit higher PFJ stress and decreased trunk flexion while running compared to the pain- free runners. Number of Subjects: 7 runners with PFP and 5 similar pain-free control runners. Materials/Methods: Kinematics and kinetics …

A Vicious Cycle Of Fear Of Falling Avoidance Behavior In Parkinson’S Disease: A Path Analysis, Kameron Jacobson, Nicole Matsunami, Hannah Mccarl, Michelle Regis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Postural instability (PI) in Parkinson’s disease (PD) is associated with several negative down- stream consequences. Objective: The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance con!dence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI. Methods: A path analysis of cross!sectional data from 55 participants with PD was conducted. The four con- structs in the model connected in succession were: 1. PI (principal …

Effects Of Bimodal Transcranial Direct Current Stimulation On Modulation Of Spinal Circuitry In People With Chronic Post-Stroke Hemiparesis, John Patrick Gan, Rafael Cabrera, Lana Laudermilch, Benjamin Wolkenhauer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Stroke can lead to gait abnormalities such as foot drop. Foot drop can result from decreased corticospinal tract input to the ankle dorsiflexors and/or from exaggerated stretch reflexes on the soleus due to reduced reciprocal inhibition from spinal reflex pathways. Transcranial direct current stimulation (tDCS) attempts to modulate corticospinal tract input and spinal reflex pathways by delivering electrical signals to parts of the brain. The degree of neuromodulation from tDCS can be measured through the Hoffman Reflex (H-reflex)—a tool used to estimate alpha motor neuron excitability which is increased in individuals post-stroke. Purpose: The primary purpose of this study …

Patient Engagement In Cosmetic Designing Of Prostheses: Current Practice And Potential Outcome Benefits, Kenneth Repayo, Cailin Mitchell, Matthew Tillitt, Collin Weber

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Making a prosthesis for an individual with limb loss is a highly personalized process. A currently unexplored area is whether there are tangible benefits in greater patient engagement during the making of their prostheses. We examined the current practice of engaging patients in prosthetic cosmetic designing and identified factors associated with patient outcomes. Methods: This cross-sectional study surveyed 104 prosthetists and 25 prostheses users. The questionnaires covered aspects of prosthetic prescription, users’ perceived level of engagement, and self-reported outcomes. Regression analyses were used to examine the associations between perceived level of engagement, satisfaction, and other outcomes. Results: Among prosthesis …

Effects Of Altered Somatosensory Input On Lower Limb Mechanics Via Different Shoes And Barefoot Walking In Individuals With Chronic Post-Stroke Hemiparesis, Aaron Abraham Simon, Jynelle Marie Guerrero Arches, Megan Leigh Keohane, Wee Jin Jed Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

[Purpose/Hypothesis] Stroke is a leading cause of disability that results in various neurological deficits. Stroke can cause impaired somatosensory input, which results in decreased balance and gait speed, ultimately increasing fall risks. Therapies to increase somatosensory input have shown promise for people with stroke as well as other neurological populations. However, few studies have systematically investigated varying somatosensory input via different footwear to improve walking in people post-stroke. The purpose of this study was to investigate the effects of altering somatosensory input via different types of footwear (i.e., barefoot, self-selected shoes, and memory foam shoes) on gait kinetics and ankle …

Inter And Intra-Rater Reliability Of Dance Screening Tool, Kathleen Stone, Braden Waters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Previous literature has indicated that injury rates of ballet and modern dancers are among the highest of any physical activity. These injuries can be detrimental to the athlete and can also result in financial burden for dance companies due to time loss related to injuries. Preventative intervention aimed at those who are most at risk for injury can be effective at reducing the cost associated with lost time due to injury. An effective approach to identifying those most at risk for dance related injuries is to administer a functional movement screen. One such movement screen is the ballet-based Dance Technique …

Am-Pac Basic Mobility Inpatient Short Form (Low Function) Psychometrics/Clinimetrics, Meghan Wonderling, David Miller, Selena Soria

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To determine whether the Activity Measure for Post-Acute Care® Basic Mobility Inpatient Short Form (Low Function) (6-clicks LF) has increased responsiveness for patients with lower levels of physical function compared to the Activity Measure for Post-Acute Care Basic Mobility Inpatient Short Form (6-clicks). Design: Retrospective cohort study using original scores and simulated scores for assessment of internal responsiveness of the 6-clicks LF compared to the 6-clicks. Simulated 6-clicks and 6-clicks LF scores were created as a hypothetical future AM-PAC® score. Results: We found a statistically significant difference between the 6-clicks and simulated 6-clicks, t=24.8, p < 0.00 [two-tailed]. The effect size was large (d=1.2, r=0.51).There was a statistically significant difference between the 6-clicks LF and simulated 6-clicks LF, t=19.7, p < 0.00 [two-tailed]. The effect size was medium (d=0.91, r=0.41). Finally, for patients with a 6-clicks score in the bottom five-percentile (n=27), we found a statistically significant difference between the 6-clicks and 6-clicks LF, t=11.9, p < 0.00 [two-tailed]. Conclusion: Among patients scoring less than 15, the 6-clicks LF has greater internal responsiveness than the 6-clicks and thus demonstrates that the new low-level questions in the 6-clicks LF better quantify low-level patients’ functional level. Research using non-simulated data should be completed in the future to confirm these findings.

Knowledge, Protective Behaviors And Risk Perception Of Covid-19 Among Dental Students In India: A Cross-Sectional Analysis, Kavita Batra, Yashashri Urankar, Ravi Batra, Aaron F. Gomez, Meru S., Pragati Kaurani

School of Medicine Faculty Research

Objective: This study’s objective was to examine the knowledge, performance in practicing protective behaviors, and risk perception of Coronavirus disease-19 (COVID-19) among dental students of India. Methods: A web-based cross-sectional survey was conducted from 10–30 August 2020, involving 381 dental students that were enrolled at the Uttaranchal Dental and Medical Research Institute in India. A web-based structured questionnaire assessed the COVID-19 related knowledge, protective behaviors, and risk perception performance. The independent-samples-t and analysis of variance tests were used to analyze the differences in knowledge, protective behaviors, and perception across the groups. Results: Of the dental students surveyed, 83% had adequate …

Neurophysiological Assessments Of Brain And Spinal Cord Associated With Lower Limb Functions In Children With Cerebral Palsy: A Protocol For Systematic Review And Meta-Analysis, Leonard Ubalde, Jing Nong Liang

Physical Therapy Faculty Research

Background: Task-dependent neurophysiological adaptations in people with cerebral palsy have been examined using various techniques such as functional magnetic resonance imaging, peripheral nerve stimulation in order to assess H-reflexes, and transcranial magnetic stimulation. This activity-dependent plasticity is hypothesized to improve specific gross motor function in individuals with cerebral palsy. Although these adaptations have been examined extensively, most studies examined tasks utilizing the upper limbs. The aim of this review is to assess the neurophysiological adaptations of the central nervous system in individuals with cerebral palsy during lower limb functional tasks. Methods: A systematic review and meta-analysis will be conducted to …

Physical Activity Interventions For Older Adults In The Age Of Covid-19 And Beyond, Rachel N. Bragg, K. Jason J. Crandall

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 2: Issue 1, Article 6, 2021. As the coronavirus (COVID-19) pandemic continues, it is important to understand why older adults are at higher risk for more severe morbidity and higher mortality compared to younger age groups. At the same time, there is a growing body of evidence suggesting physical activity and exercise can have positive benefits for older adults’ health. Point of application #1: The first step in keeping older adults active is motivating them to adhere to a structured program either at home, in a community setting, or in a long-term care …

Utilization Of Inertial Measurement Units For Determining The Sequential Chain Of Baseball Strike Posture, Yun-Ju Lee, Po-Chieh Lin, Ling-Ying Chen, Yu-Jung Cha, Jing Nong Liang

Physical Therapy Faculty Research

The purpose of this study was to employ inertial measurement units (IMU) with an eyetracking device to investigate different swing strategies between two levels of batters. The participants were 20 healthy males aged 20 to 30 years old, with ten professional and ten amateur batters. Eye gaze position, head, shoulder, trunk, and pelvis angular velocity, and ground reaction forces were recorded. The results showed that professional batters rotated segments more rhythmically and efficiently than the amateur group. Firstly, the professional group spent less time in the preparation stages. Secondly, the maximum angular velocity timing of each segment of the professional …

Essential Competencies For Occupational Therapy In End-Of-Life Care, Karmella Bognot

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists carry an abundance of expertise in helping patients and caregivers navigate the end-of-life journey. The lack of knowledge of OT’s role impacts occupational therapy utilization and service provision in hospice. It reduces opportunities for this population to increase their understanding on how to maintain quality-of-life. The more a patient is able to do lessens the burdens shouldered by the caregiver. Education on pain management and promoting comfort are typical priorities addressed; however, not enough training is focused on maximizing independence or engagement in occupations. Competencies encompass a unique set of skills, knowledge, and abilities necessary for successful performance …

Health And Wellness Competencies For An Entry-Level Doctorate Occupational Therapy Course, Teresa Liccardo

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Accreditation Council for Occupational Therapy Education (2018) standards state that the entry-level occupational therapy curriculum must prepare students to practice in a broad range of practice settings, including new and emerging areas of occupational therapy. Health and wellness remain an emerging and not widely populated area of occupational therapy despite the growing research on its importance. Stancanelli (2020) stated that “with the expected growth of health care in the community and the expected increase in the older adult population, occupational therapy students need to be prepared to practice in the community and address health promotion and wellness needs of …

The Aftermath Of Sexual Assault: Creating The "I Am More Than My Experience" Workbook, Isabella Chung

Calvert Undergraduate Research Awards

The following thesis includes a literature review of the immediate and long-term effects of sexual assault on victims in regards to their physical, mental, and emotional health and romantic relationships, followed by a proposed workbook for sexual assault victims/survivors. Being that typical responses immediately after an assault are fear, disbelief, and activation of the sympathetic nervous system, it is to no surprise that long term issues of depression, anxiety, and Posttraumatic Stress Disorder (PTSD) often arise as well. Thus, a workbook was created with the intention of educating readers about sexual assault and helping victims/survivors to heal from the trauma …

Increasing Perioperative Outpatient Nurses’ Knowledge Of Pediatric Anxiety Through Use Of A Developed Clinical Guide, Christine Oliver

UNLV Theses, Dissertations, Professional Papers, and Capstones

Elevated perioperative anxiety levels in the pediatric population is a main concern when providing nursing care in a specialty area. In the United States, over five million pediatric patients will have some type of surgery each year and greater than 65 percent of those pediatric patients will exhibit preoperative anxiety. The care of pediatric patients in the outpatient surgical setting has grown significantly, and pediatric care is no longer restricted to specialized facilities or hospitals. This increased number of pediatric patients in day surgery centers has created a shift in nursing care for perioperative nurses. Anxiety has been directly related …

Nursing Toolkit For Care Of The Pediatric Patient With Suicidal Ideation, Christine Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nevada’s pediatric suicide rate is one of the highest in the country. Many patients require inpatient stabilization, either in an emergency department setting or on a pediatric unit, until they are ready for discharge to home or a subsequent behavioral health facility. In many instances, patients are assigned to nurses who have had no formal training on caring for pediatric patients with suicidal ideation. Providing care for these patients can increase nurses’ emotional stressors. Purpose: The purpose of this DNP project was to increase the knowledge of pediatric nurses in Nevada using a nursing toolkit containing information to aid in …

Acute Care Nurse Practitioners’ Role In The Icu: A Retrospective Analysis Of Central Line Access Delays For Patients In Septic Shock, Violeta Aguirre

UNLV Theses, Dissertations, Professional Papers, and Capstones

Morbidity and mortality related to sepsis management have been popular research topics for a significant part of the last two decades. The Surviving Sepsis Campaign was launched in 2002 with goals to develop medical management guidelines, improving diagnosis by building awareness, expanding healthcare provider education, and improving appropriate treatment (Society of Critical Care Medicine [SCCM], 2019). Professional organizations and governing bodies continuously revise guidelines for the early identification and treatment of sepsis. The latest treatment recommendations for the Hour-1 Bundle of sepsis management (SEP-1) include initiating vasopressors in conjunction with fluid resuscitation to reach the hemodynamic goal of maintaining a …

Implementation Of A Protocol In The Freestanding Emergency Department To Screen For And Identify Possible Victims Of Human Trafficking, Joe Alvarado

UNLV Theses, Dissertations, Professional Papers, and Capstones

Human trafficking (HT) victims often seek medical care in the emergency room setting. In a recent study among HT survivors, 88% attested to receiving medical care while in captivity, with 63% treated in the emergency care setting. Freestanding emergency departments typically have lower acuity and lower patient volumes than hospital-based emergency departments. This setting creates shorter wait times and minimizes the length of stay at every point during the emergency room experience. For traffickers, this is an ideal situation if their victim needs medical attention, and they want to get in and get out of the emergency room with less …

Mapping Nevada's Dental Workforce, Kelvin Chen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Access to care is a concern at the forefront of public health. Due to socioeconomic and geopolitical pressures, the distribution of healthcare providers across a population often does not coincide with the demand for healthcare in a specific geographic area. Rural areas typically do not have enough providers and urban areas typically have too many. This stark reality underscores an inherent inefficiency in the allocation of healthcare resources and is a discrepancy that must be addressed by state-sponsored institutions and programs. From a public health perspective, the problem of insufficient or lack of access to care is the greater of …

The Role Of Nutrition And Hormone Signaling In Extended Larval Development And Obesity In Starvation-Selected Drosophila Melanogaster, Jennifer M. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

Brief periods of starvation are a common stressor that most animals encounter in the wild and must be able to survive in order to maximize their fitness. Starvation resistance of the adult fruit fly, Drosophila melanogaster, is thought to be primarily conferred by adult fat stores, body size, metabolic rate, behavior, and activity levels. Additionally, flies selected for starvation resistance also often show delayed pupariation, which is usually indicative of altered hormone signaling. How starvation selection extends development and if it contributes to adult starvation resistance remains incompletely studied. Identifying the targets of starvation selection that cause extended development and …

Understanding The Role Of Ano1 In Oral Cancer, Mallary Forrest

UNLV Theses, Dissertations, Professional Papers, and Capstones

In 2008, the gene ANO1 was discovered to encode a calcium activated chloride channel. This gene is located on the 11q13 locus, a locus that is commonly amplified in many cancers including cancer of the head and neck. ANO1 is situated in close proximity to genes associated with growth and apoptosis. As rapid proliferation and lack of apoptosis are hallmark characteristics of cancer, growth factors and apoptosis mediators are expected to be altered in cancer. But what does a calcium activated chloride channel have to contribute to cancer’s pathogenesis? Is it an active gene in cancer progression or is it …

Comparison Of 12-Hour Biweekly Shifts Versus 6-Hour Weekly Shifts On Learning Outcomes And Fatigue In Nursing Students On Dedicated Educational Unit, Alena Grewal

UNLV Theses, Dissertations, Professional Papers, and Capstones

Clinical experiences in nursing programs may take many forms and the goal of integrating clinical is to combine knowledge and skills learned in the classroom into the clinical practice setting. The Dedicated Educational Unit is an innovative approach in the State of Nevada and has demonstrated success in closing the gap between education and clinical practice. The Dedicated Educational Unit model is used for the medical-surgical clinical rotations at a local university and has been largely successful. However, some challenges affecting student learning have recently arisen that are not inherent to the Dedicated Educational Unit model. Challenges voiced by nursing …

Transient Ischemic Attacks Evaluation And Management In Specialized Urgent Care Facilities, Zandra Kay Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

PURPOSE: Transient ischemic attacks (TIA) are a health problem that affects many people each year. A local Las Vegas organization allowed this DNP student to develop and implement an intervention to increase the perceived ability of providers to manage low-risk TIAs in specialized urgent care facilities. The aim was to raise the comfort level of providers at on-demand medicine also known as urgent care. Additional goals were to increase awareness of stroke and TIA symptoms and educate providers on the new TIA guidelines.

METHODS: This quality improvement DNP study used a convenience sample of 30 providers. Eleven participants completed the …

Depression And Quality Of Life Among Adults With Asthma Presence In Nevada, Elizabeth D. Kahane

UNLV Theses, Dissertations, Professional Papers, and Capstones

Asthma is a lung disease that causes coughing, chest tightness, wheezing, and breathlessness. It is often controlled by medication use and avoidance of environmental triggers. It is a leading chronic, non-communicable disease affecting over 19 million adults in the United States (CDC, 2020a). Asthma and severe asthma have been shown to negatively affect mental health and quality of life among adults including limiting physical activity, lowering sleep quality, exacerbating economic challenges, missing work, and increasing healthcare use (Stanescu, et al., 2019). Approximately 8% of adult Nevadans reported current asthma symptoms and 12.6% reported having a diagnosis during their lifetime (CDC, …

Social Emotional Learning As A Universal Upstream Approach To Youth Suicide Prevention: A Secondary Data Analysis Of A Prevention Program Evaluation, Maria Amaris Knight

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Nevada has had consistently high rates of youth suicide in the past decade with 21.2 deaths by suicide per 100,000 population (ages 15-24), over the national rate of 14.5 deaths per 100,000 in 2019. National strategies, state agendas, and best practices in the field prioritize research on upstream strategies to prevent suicide. One such strategy is the use of social emotional learning (SEL) programs for youth to help increase and enhance protective factors against suicide, helping them to cope with negative life events. Research has identified leading outcomes of SEL programs as the improvement of attitudes, behaviors, and academic …

Factors Influencing The Self-Reported Palliative Care Practices Of Acute Care Nurses, Keshia Ryan Kotula

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction Approximately 40 million people are currently in need of palliative care (PC), and this number is predicted to increase due to the aging population and increasing longevity. Providing PC in the acute care setting leads to better quality and clinical outcomes, reduced inpatient hospital costs, and improved efficiency. Despite evidence indicating the benefits of PC, timely referrals and provision of PC in the acute care setting are lacking in part due to the complex interplay of factors that nurses must navigate, such as limited preparation, knowledge, and self-efficacy; nurse/provider attitudes; and patient/family and institutional barriers. A paucity of research …