Medicine and Health Sciences Commons^™

Nevada Hpv Vaccine Completion Time And Adherence Among 9-14-Year-Olds From 2017-2023, Emily Sandoval

UNLV Theses, Dissertations, Professional Papers, and Capstones

The HPV (Human Papillomavirus) is one of the most common sexually transmitted infections, in the United States. Since its development in 1991, the HPV vaccine has been proven to be highly effective against the infection (Centers for Disease Control and Prevention [CDC], 2024). In order for an individual to receive optimal protection, the CDC has given guidelines dependent on age. It is important to understand changes in HPV vaccine completion for future public health immunization campaigns and objectives. To analyze how HPV completion and adherence has changed from 2017-2023 among the 9-14-year-old population, a retrospective cohort study was conducted utilizing …

An Analysis Of The Influence Of Human Disease Pathogens On Core Behaviors Of The Black-Legged Tick, Emily F. Marinko

UNLV Theses, Dissertations, Professional Papers, and Capstones

Ixodes scapularis, the black-legged or deer tick, is a vector for several different disease-causing microbes, including the causative agent of Lyme disease. As such, it is a major health concern for people living within its range in the eastern half of the United States, a habitation area that is increasing due to climate change. Despite its medical relevance as a disease vector, there is still much to learn about the basic behavior of these arachnids in the wild. Thus, the major hypothesis of this thesis is that ticks that are infected with specific human disease-causing microbes behave differently than those …

A Comparative Subnational Policy Analysis Of State Covid-19 Vaccine Policies And Application Of The Political Determinants Of Health Model, Demetrius Cianci Chapman

Nursing ETDs

A COMPARATIVE SUBNATIONAL POLICY ANALYSIS OF STATE COVID-19 VACCINE POLICIES AND APPLICATION OF THE POLITICAL DETERMINANTS OF HEALTH MODEL

By

Demetrius Cianci Chapman

Associate of Science Nursing, Jewish Hospital College of Nursing and Allied Health, 1998

Bachelor of Science of Nursing, Saint Louis University, 2000

Master of Public Health, Saint Louis University, 2004

Master of Science Nursing (Research), Saint Louis University, 2004

Doctor of Philosophy, Nursing, University of New Mexico, 2025

ABSTRACT

This study uses the political determinants of health (PDoH) framework to analyze state-level COVID-19 vaccine policies and their impact on population health. The PDoH model examines how structured …

The Association Of Walking Cadence With Sleep Quality In Adults 18-65, Almothana M. Matarneh

Masters Theses, 2020-current

Sleep quality is essential to physical and mental health, influencing physiological functions including muscle recovery, hormonal balance, immune response, and cognition. Poor sleep may impact physical activity (PA) and sedentary behavior (SB), potentially contributing to reduced overall well-being. Walking cadence, the number of steps per minute, is an accessible proxy for PA intensity, but its relationship with sleep quality remains unclear. Objective: This study examined the relationship between PA, SB, and sleep quality, as measured by step cadence, among adults aged 18–65 years. Methods: participants wore an ActiGraph GT3X accelerometer on the hip during waking hours and on …

Analyzing Food Access: An Investigation Of Food Insecurity Amongst Latinos In Rural Nebraska, Natalia Santos

Theses & Dissertations

Background: Food insecurity is a public health issue in the United States, with disproportionately higher rates among Latino/Hispanic households. Rural communities face unique geographical, socioeconomic, and systemic barriers that often exacerbate food access disparities. Despite the growing Latino population in rural areas, particularly in Midwestern states like Nebraska, there remains a critical gap in comprehensive research that integrates both objective and subjective understandings of their food environments. Understanding these multifaceted influences is crucial for developing effective, culturally sensitive interventions.

Problem Statement: This dissertation aims to answer the central question: How does food access and food insecurity manifest amongst Latinos in …

The Speech-To-Song Illusion Across Development And The Effects Of High-Level Expectations, Rodica R. Constantine

UNLV Theses, Dissertations, Professional Papers, and Capstones

The typical listener can readily categorize auditory stimuli as either speech or song even though these structures share many acoustic similarities. These musical and linguistic categories may nevertheless take time to develop as children acquire language- and music-specific knowledge. In the Speech-to-Song (STS) illusion, multiple repetitions of a natural spoken utterance can give rise to a perceptual switch wherein the stimulus begins to sound song-like to the listener. While the STS illusion has been well-researched in adult listeners, it had yet to be investigated in children. In our study, we examined whether children experience the STS illusion by presenting participants …

Evaluating Current Practices In Operative Nontechnical Skills Training And Feedback In General Surgery Residency: A Mixed Methods Approach, Madeline Cloonan

Theses & Dissertations

Background: Non-technical skills (NTS) are the interpersonal and cognitive abilities that are critical to accomplishing high-risk tasks. Deficiencies in NTS, including communication, teamwork, leadership, and decision-making, are linked to errors in the operating room. Structured training and feedback in NTS remain inconsistent and have not been integrated into daily training. This dissertation addresses this gap by evaluating current NTS training and feedback practices and developing a rubric to enhance the effectiveness of NTS feedback.

Methods: We conducted five complementary studies to assess current NTS training and feedback. The first was a systematic review aimed at identifying intraoperative NTS training interventions …

Colostrum Extracellular Vesicle Are Neuroprotective In The Mptp Intoxicated Mouse Model Of Parkinson's Disease, Samia Akter

Theses & Dissertations

Parkinson’s Disease (PD) is the second most common neurodegenerative disorder. Dopaminergic neuronal loss in the substantia nigra and the formation of Lewy bodies are the disease pathological hallmarks. We demonstrate that bovine colostrum extracellular vesicles (EVs) induce anti-inflammatory and neuroprotective activities during MPTP (methyl-4-phenyl-1,2,3,6-tetrahydropyridine) intoxication. Treatment these mice with colostrum EVs reduced the extent of activated microglia and neurodegenerative activities. RNA sequencing and transcriptomic analysis revealed a significant decrease in pro- inflammatory responses, as well as reduced recruitment and activation of immunocytes in affected brain tissues. Decreased expression of pro-inflammatory cytokines and chemokines, as well as suppressed canonical inflammasomes, was …

Study Of Peptide Amphiphiles As Antimicrobial Agents, Aramis J. Pereira

Theses & Dissertations

The global antimicrobial resistance (AMR) crisis presents a severe public health threat, with drug-resistant infections now the third leading cause of mortality worldwide. This escalating problem, driven by the rapid proliferation of multidrug-resistant organisms (MDROs) like the "ESKAPE" pathogens, severely limits treatment options and imposes substantial economic burdens. The crisis is further exacerbated by a limited pipeline of new antimicrobial agents, as most recently approved drugs are modifications of existing classes rather than novel compounds. Peptide amphiphiles (PAs) offer a promising alternative due to their membrane-targeting mechanism, which reduces the likelihood of resistance development. These molecules are amphiphilic and positively …

Exploring The Processing Of Objects, Settings, And Global Properties In Natural Auditory Scenes, Margaret A. Mcmullin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Our auditory system has a remarkable ability to make sense of complex environments, allowing us to identify what we are hearing and where sounds come from. This process of auditory scene analysis is essential for situational awareness, decision-making, and effective communication in daily life. While much is known about how listeners segregate and identify individual sound sources (e.g., voices), less is understood about how global properties of a scene (e.g., openness, naturalness) contribute to perception. This dissertation examined how object- and setting-level information in natural auditory scenes are processed, and whether they rely on distinct or overlapping mechanisms. In Experiment …

Factors Associated With Discrimination-Related Distress Among Sexual And Gender Minority Individuals: A Predictive Analysis, Emylia Terry

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sexual and gender minority (SGM) individuals face disparate rates of mental health outcomes, such as psychological distress, which contributes to suicidality. This may be attributable to minority stress, which posits that health inequities impacting this community are driven by increased exposure to stigma- and discrimination-related stressors. The negative physical and psychological health impacts of psychological distress and discrimination are well-documented in the literature. Structural stigma – in the form of harmful anti-LGBTQIA+ laws and policies – is associated with increased suicidality. However, little is known about factors associated with perceived discrimination occurrences and discrimination-related distress. First, a systematic review was …

Restoring Translational Control With Novel Small Molecule Activators Of Pp2a In Cancer Cells, Kayla A. Jonas

Theses & Dissertations

Hyperactivation of eIF4E-dependent translation in tumor cells is required for robust expression of oncogenic proteins and maintenance of the transformed phenotype. eIF4E binds to the 7-methylguanylate structure at the 5’ end of cellular mRNAs and nucleates the formation of the translation initiation complex, eIF4F, which recruits the preinitiation complex and resolves secondary structure in the mRNA. The ability of eIF4E to promote eIF4F assembly is negatively regulated by the translational repressor, 4E-BP1, and tumorigenesis depends on functional inactivation of 4E-BP1. A major mechanism of 4E-BP1 inactivation involves inhibitory phosphorylation by mTOR which prevents eIF4E binding. Functional inactivation can also occur …

Beyond The Bruise: Understanding Injury Risk Factors Among Livestock Workers In Cattle Feedyards And Animal Handling Farms And Ranches, Rishad Ahmed

Theses & Dissertations

Cattle feeding and livestock production are central to U.S. agriculture and represent some of the most hazardous occupational environments. Workers in feedyards and on cattle farms and ranches face elevated risks of injury due to physically demanding labor, frequent animal handling, and exposure to environmental and ergonomic hazards. Many feedyard workers are Hispanic/Latino immigrants who may experience additional barriers related to language, healthcare access, and job security. Similarly, injury risks among cattle producers are compounded by seasonal workload fluctuations, limited rest opportunities, and psychosocial stressors. Beyond individual impacts, agricultural injuries also pose a substantial economic burden. Recent estimates indicate that …

Symptom Clusters And Their Association With Health-Related Quality Of Life In Pediatric Cancer Survivors After Treatment Completion, Krishtee Napit

Theses & Dissertations

A critical area of cancer research, symptom management, has evolved from focusing on individual symptoms to recognizing the complexity of co-occurring symptoms, commonly referred to as symptom clusters. However, most studies on pediatric cancer symptom clusters have focused primarily on the treatment phase or long-term survivorship, overlooking the early post-treatment period. This dissertation examines the prevalence of multiple symptoms and symptom clusters in pediatric cancer survivors post-treatment; factors associated with the total number of symptoms and symptom clusters; and the association of the total number of symptoms and symptom clusters with health-related quality of life (HRQoL). We developed and tested …

Temporal Patterns Of Ectopic Pregnancy: Using The Electronic Health Record To Illuminate A Dark Corner In Women's Health, Kirsten Hepburn

Theses & Dissertations

Ectopic pregnancy remains a significant contributor to pregnancy-related morbidity and mortality, yet little is known about whether its occurrence follows discernible temporal patters that could inform prediction and prevention efforts. This dissertation aimed to explore the temporal characteristics of ectopic pregnancy through three interrelated projects: development of a new theoretical framework, a scoping review of the literature on ectopic pregnancy temporal patterns, and an empirical study using electronic health records data from a ten-year period at a single academic medical center. The Nursing Genomic and epigenomic, Environment, and Microbiome (N-GEM) situation-specific theoretical framework was introduced as a novel nursing theory …

Culturally Responsive Occupational Therapy Treatment Guide For African-American And Hispanic People With Eating Disorders, Desere N. Cooper

Student Capstone Papers

This capstone project addressed the critical need for a culturally responsive approach to occupational therapy in the treatment of African-American and Hispanic with eating disorders (EDs) in the United States. Although EDs impair physical, cognitive, and psychosocial functioning, these communities often encounter systemic barriers such as cultural stigma, food insecurity, and inadequate assessment tools rooted in Eurocentric norms—that contribute to underdiagnosis, limited access to care, and poorer outcomes. The central issue addressed was the absence of clear, culturally relevant guidance for occupational therapy practitioners working with these underserved populations. The project was informed by a comprehensive literature review and synthesis …

Risk Management Practices In The Healthcare Supply Chain: A Cross-Sectional Survey Of Professionals In Saudi Arabia, Maha Ghamedi

MUSC Theses and Dissertations

Healthcare supply chain disruptions threaten the quality of patient care, and can increase costs, particularly in systems reliant on global suppliers. This study examined the risk management practices of healthcare supply chain professionals in Saudi Arabia. A cross-sectional survey of 72 professionals from hospitals, regulatory agencies, and other healthcare organizations revealed that 72.2% experienced supply shortages in the past year, most often involving general medical supplies, specialty medicines, and essential medicines. The most frequently reported risks were supplier shortages, reliance on single-source suppliers, and logistics disruptions, while cybersecurity threats were rarely cited. Although 76.4% of organizations reported having formal risk …

Post-Translational Modifications Of Extracellular Matrix Domains As Prognosticators Of Hepatocellular Carcinoma Via Integrative Serum And Spatial Proteomics, Jade K. Macdonald

MUSC Theses and Dissertations

Hepatocellular carcinoma (HCC) remains a major global health challenge, with rising incidence, high mortality, and a five-year survival rate below 20%. Approximately 90% of HCC cases arise in cirrhosis, a stromal disease characterized by excessive deposition and remodeling of collagenous extracellular matrix (ECM). As HCC progresses, alterations in ECM composition and spatial distribution influence disease progression, emphasizing the potential of the ECM as a biomarker for HCC prognosis and treatment response. However, ECM proteomic analysis is challenging due to complex post-translational modifications, crosslinking, and insolubility. This dissertation molecularly and spatially characterizes the stromal landscape in and around HCC tumors in …

Disentangling The Effect Of Criminal Legal System Involvement On Mental Health In The United States, Pui Ying Chan

Dissertations and Theses

BACKGROUND: Interactions with the criminal legal system (CLS), such as through arrest or incarceration, are relatively common in the United States (US) and are increasingly recognized as social risk factors for poor mental health. Previous studies have reported a positive association between CLS involvement and poor mental health, with some theoretical frameworks, including the ecosocial theory and the stress process paradigm, supporting a plausible causal relationship. However, prior research has significant limitations in providing casual evidence given possible reverse causation in cross-sectional studies and insufficient consideration for the dynamics between CLS exposures, mental health status, and related confounders over time …

Staff Education To Improve Knowledge And Adherence To Diabetic Foot Ulcer Screening Protocols Using The Brief Diabetic Foot Ulceration Risk Checklist Tool, Sandrine Happi

Walden Dissertations and Doctoral Studies

This doctoral project implemented a structured nurse education module on the Brief Diabetic Foot Ulceration Risk Checklist to improve knowledge and adherence to diabetic foot ulcer screening, supporting preventive care, clinical consistency, and equitable patient outcomes in primary care. The practice-focused question guiding the project was whether providing structured education on the BDFURC would improve nurses’ knowledge and adherence to DFU screening protocols within 12 weeks. The goal was to equip nurses with standardized screening tools to support the early identification of high-risk patients and reduce the burden of DFU-related outcomes. The project involved 12 nursing staff and used a …

Staff Education Program On Medication Reconciliation In Primary Care, Virginia Ann Bloomer

Walden Dissertations and Doctoral Studies

Medication errors represent a persistent threat to patient safety, particularly during transitions of care in outpatient settings. Despite recognition of the problem, standardized medication reconciliation practices among primary care physicians and nurse practitioners (NPs) remain inconsistent, hindered by varied workflows, unclear responsibilities, and knowledge gaps. To address these issues, a staff education program focusing on medication reconciliation was introduced to seven NPs and three physicians in a primary care clinic. Pre- and post-intervention surveys measured participants’ knowledge and confidence in conducting medication reconciliation and documenting medications in electronic medical records. The average test score improved from 68% to 92%, demonstrating …

Role Of Perceived Social Support And Knowledge Of Postpartum Depression Among Women In Anambra State, Eastern Nigeria, Raphael Oluwasina Babatola Folorunsho

Walden Dissertations and Doctoral Studies

Postpartum depression (PPD) is an increasingly pressing public health issue, particularly in low-resource settings like Nigeria, where maternal mental health tends to receive limited attention. This study explored the relationship between maternal awareness of PPD, perceived social support, and prevalence of depressive symptoms among postpartum women in the Nnewi North Local Government Area (LGA) of Anambra State. Grounded in the social support theory, health belief model, and socioecological model, the study used a descriptive cross-sectional research design. A total of 406 postpartum women attending primary healthcare centers were surveyed using validated instruments, including the PHQ-9 and MSPSS. Statistical analyses included …

The Association Between Sunlight Exposure Duration, Region Of Birth And Skin Conditions Linked To Skin Cancer Risk Among Migrant Hispanic Farmworkers, Uchechukwu Fidelia Nnoruka

Walden Dissertations and Doctoral Studies

Prolonged exposure to sunlight increases the risk of developing skin conditions linked to skin cancer. Migrant Hispanic farmworkers are especially at risk due to extended outdoor labor, limited access to preventive care, and minimal occupational protections. The purpose of this quantitative study was to examine the association between sun exposure duration and region of birth with the presence of skin conditions associated with skin cancer among migrant Hispanic farmworkers in the United States. This study was grounded by the Social Ecological Model, which provided a comprehensive framework for examining multilevel factors influencing skin health outcomes. Using a cross-sectional design, secondary …

Addressing And Recognizing Secondary Traumatic Stress In Hospice And Palliative Care Clinicians, Laquisha La Chelle Jackson

Walden Dissertations and Doctoral Studies

In the emotionally demanding field of hospice and palliative care, the well-being of clinicians is critical. This Doctor of Nursing Practice (DNP) project focused on implementing a staffing education initiative to address secondary traumatic stress (STS). I designed this staffing education project to enhance clinician awareness, resilience, and coping strategies while informing organizational leadership on how improved staffing models and support systems can mitigate STS. Hospice and palliative care clinicians are uniquely vulnerable to STS due to constant exposure to trauma, death, and grieving families. The guiding question for this project was: In hospice and palliative care clinicians, how does …

Cardiometabolic Outcomes In The Obese African American Population With Rheumatoid Arthritis, Cecilia Jillo Walan

Walden Dissertations and Doctoral Studies

Rheumatoid arthritis (RA) disproportionately impacts African American adults, particularly those with obesity, due to overlapping cardiometabolic risks and health care disparities. The intersection of RA, obesity, and chronic conditions such as cardiovascular disease (CVD) and hypertension underscores the need for targeted public health interventions. This study investigated the association between RA and cardiometabolic outcomes among African American adults with obesity, aiming to identify significant predictors within this high-risk population. This quantitative study employed a cross-sectional design to analyze data from the 1999–2018 National Health and Nutrition Examination Survey undergirded by the social ecological change framework with N=23644 African American adults …

Implementing Age-Appropriate, School-Based Comprehensive Sexuality Education, Emira Romero

DNP Qualifying Manuscripts

Background: Sexual and reproductive health (SRH) education is a critical component of early health literacy and health promotion. Yet, there are no federal education requirements for sexuality education in the United States, leading to inconsistent and inadequate instruction.

Methods: In an effort to better understand the barriers beyond policy variability that affect successful implementation of SRH education, a literature search was conducted on CINAHL and ERIC with the following search terms and Boolean operators: (sex* education OR reproductive educat*) AND (elementary school OR school based) AND (United States OR California). The years of publication were limited to the past five …

Effect Of Whole-Food Plant-Based Diet On Ldl Cholesterol: A Scoping Literature Review, Joel Gregory Mueller

Nursing Capstones

Background: The whole-food, plant-based (WFPB) diet includes whole grains, whole plants, unrefined sugars, beans, and legumes. The diet excludes meat, dairy, and added fats. The diet has been popularized by documentaries .The diet claims to lower total and LDL cholesterol to a safe level as both a primary and secondary mode of prevention.

Purpose: Review existing studies to see whether the WFPB diet will lower LDL cholesterol in adult males over a 14 day or more duration.

Methods: A scoping literature review was completed of the University of North Dakota’s library system for keyword combinations. The returned 102 studies were …

Quality Improvement Project Integrating Educational Program For School Faculty In Childhood Diabetes, Sharon Anna-Marie Hill

Doctor of Nursing Practice Projects

In the United States, diabetes affects approximately 38.4 million individuals, including over 304,000 children and adolescents diagnosed with type 1 diabetes. As the most common chronic condition in children, diabetes management in school settings is critical to ensure health, safety, and academic success. However, a lack of standardized training for school faculty often results in inadequate knowledge and confidence in managing diabetes, exacerbating student health risks. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to develop and implement an educational program for school faculty, focusing on managing and treating childhood diabetes. A paired sample t-test was used …

Quality Improvement Project Integrating Clinical Decision-Making Tools Within An Ehr System For Provider-Enhanced Diagnosis And Treatment Of Depression In Primary Care, Theresa Ojoye

Doctor of Nursing Practice Projects

The inconsistent management of depression in primary care settings persists despite numerous available treatments, which current behavioral health literature frequently addresses.  A review of the project site highlighted the inconsistency in diagnosing and managing depression due to varying levels of provider familiarity with current guidelines and a lack of integrated decision-support tools within the Electronic Health Record (EHR) system. This project aims to evaluate the impact of integrating a clinical decision-making tool and patient outcomes in managing depression. This Quality Improvement (QI) project implemented UpToDate as an evidence-based clinical resource within the EHR system to address inconsistent application of evidence-based …

Assessment Of Faculty Perception Of Flipped Classroom Pedagogy, Jincymol Thomas

Doctor of Nursing Practice Projects

This DNP project assesses the faculty's perception of the flipped classroom (FC) pedagogy, which is an evidence-based teaching strategy to promote active learning and student success. The purpose of this project is to assess faculty members’ perception of implementing FC. The problem identified is the low progression and graduation rates for associate degree nursing (ADN) students at a North Central Texas Community College. This indicates that current teaching strategies need to be revised. As healthcare is constantly evolving and becoming more complex, the traditional methods of teaching nursing students are no longer sufficient. This QI project is aiming to educate …