Medicine and Health Sciences Commons^™

Exploring Staff Nurses’ Perceptions Of Nursing Student Enculturation Within Clinical Teaching: A Focused Ethnography, Larizza Limjuco Woodruff

UNLV Theses, Dissertations, Professional Papers, and Capstones

The traditional clinical education model in nursing has utilized on-site learning experiences in clinical settings with patient encounters. With the growing complexity and demands of contemporary nursing care today, it is imperative to question the principal assumptions that guide the design and use of traditional clinical teaching experiences. Staff nurses working with nursing students can illuminate the impact of sociocultural workplace factors on clinical teaching and learning when preparing students for practice. Yet there is little known about staff nurses’ perspectives of nursing culture and how enculturation prepares nursing students for the profession. By understanding the perceptions of enculturation among …

Development And Testing The Predictability Of An Instrument Based On The Multi- Theory Model (Mtm) Of Health Behavior Change For Pre-Exposure Prophylaxis (Prep) Uptake Among People Of Color, Siddharth Raich

UNLV Theses, Dissertations, Professional Papers, and Capstones

HIV/AIDS continues to be a significant public health problem in the US and globally. In the US, it disproportionately affects people of color. In 2012, Pre-exposure Prophylaxis (PrEP) was approved by the FDA for HIV prevention. PrEP reduces the chances of acquiring HIV by 99% among people at high risk. However, PrEP uptake among people of color remains low. Therefore, this study aimed to develop and test the predictability of an instrument to describe the intent to initiate and sustain PrEP use among people of color. This research utilized an exploratory sequential mixed methods design based on the fourth-generation, multi-theory …

Cultivating Nursing Student Competency Through Serious Gaming Simulation-Enhanced Prebriefing, Shopha M. Tserotas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Problem: Simulation is an effective teaching strategy for undergraduate nursing students, providing a safe environment for learning in a low-risk setting. However, students are not fully prepared to take full advantage of high-fidelity simulation activities. The purpose of this study was to examine the impact of serious gaming simulation-enhanced prebriefing on student competency and simulation effectiveness. Methodology: The study employed a quantitative, cross-sectional, quasi-experimental design using secondary data. Participants included undergraduate nursing students in a southern private university. The students were enrolled in the prelicensure nursing program and the obstetric or the transition to practice course. The control group received …

Alteration Of Peripheral Cytokines In Alzheimer’S Disease, Zhengshi Yang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer’s disease (AD) is a progressive neurodegenerative disease with the clinical symptoms of gradual cognitive decline and memory loss. Biologically, abnormal accumulation of Aβ (Aβ) plaque and tau tangles in the brain are the core pathological hallmarks in AD. Although inflammatory response is not specific to AD, emerging evidence suggests that the disrupted innate immune system within the central nervous system, particularly microglial activation, might act as the bridge linking Aβ aggregation to pathological phosphorylation and aggregation of tau. The inflammatory response was suggested to initially have a neuroprotective role of attempting to clear Aβ plaques, and then become neurotoxic …

Delineating Genetic Influences On Neurodegenerative Disorders And Infectious Diseases Through Advanced Computational Methods, Xiaowei Zhuang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Genetics plays a critical role in understanding the molecular mechanisms underlying neurodegenerative disorders and pathogen evolution in infectious diseases. For example, identifying genetic variants associated with a disease phenotype uncovers functional pathways that could lead to potential drug targets and therapeutic interventions. In addition, tracking the genetic evolution of pathogens enables early detection and warning of infectious disease outbreaks. In both applications, given the large amount of genetic data, advanced computational methods, including longitudinal and multivariate models, could significantly boost the statistical power and capture interrelationships among traits, environmental factors and genetic influences. This dissertation focuses on four applications of …

The Effects Of First Responder Stress & Trauma On Spouses And Romantic Partners, Eden Thiess

UNLV Theses, Dissertations, Professional Papers, and Capstones

First responder jobs pose unique difficulties due to the sheer number of traumatic events that they witness and personally experience. Research has demonstrated some effects of stress and trauma on family relationships, but the literature lacks an understanding of the ways that first responder trauma and stress affects their marriages and romantic relationships. The current study’s purpose was to investigate the experiences of first responder spouses and partners within the Las Vegas area in regards to stress, trauma, and relationship dynamics as influenced by the first responder role. In this study, 11 participants who were in a marriage or romantic …

Opioid Knowledge And Experiences In Nebraska College Students, Natalie Holding

Theses/Capstones/Creative Projects

This study investigated opioid-related knowledge and experiences among 83 Nebraska college students, with an emphasis on awareness, perceived risks, and educational needs regarding opioids and the overdose-reversing drug, naloxone. For participants who have used opioids outside of a doctor’s orders, questions were asked regarding motivations, comorbidities, coping mechanisms, and treatment experiences. Data were collected via an anonymous survey featuring closed- and open-ended questions. Results showed that 41% of participants reported feeling moderately knowledgeable about opioid risks, while 34% felt only slightly knowledgeable. Although 80.7% of participants were aware of naloxone, most were uncertain either about (22.9%) or did not know …

Keeping Mental Health Professionals In Nebraska: How Nebraska Recruits And Retains Working And Prospective Providers, Beckett Allen

Theses/Capstones/Creative Projects

For my capstone effort, I wanted to focus on the recruitment and retention of mental health professionals in Nebraska. Having familiarity with the status of mental healthcare itself in rural Nebraska, my goal was to focus on what is being done to recruit and retain mental healthcare providers in the state.

For this study, interviews were conducted with professionals with experience in examining and addressing provider recruitment and retainment related to mental health.

Federal and state agencies such as the Area Health Education Center (AHEC) and the Behavioral Health Education Center of Nebraska (BHECN) have been formed to address shortages …

Creating A Space For Relaxation And Wellbeing At The University Of South Alabama, Mary Wolf

Honors Theses

A program to provide supplementary support for the mental health and wellness of students at a midsize Southern University by providing a centrally located “relaxation space” for students on campus during the last two weeks of the semester is proposed and tested. A central location was found on campus to host the space. The researcher also developed an online survey for students to review the space. The trial was run for two weeks, and participants were able to access the online survey throughout those weeks. The results of the survey were analyzed to better understand the students’ responses to the …

Comparison Of Two Learning Methodologies: Virtual Reality And Osce Simulation, Connor Blackwell, Tabor Mcgee

Doctoral Projects

Anesthesia education has evolved immensely over the past twenty years, and with the new virtual reality (VR) simulations created by SIMVANA, the exponential growth can continue. The anesthesia program at The University of Southern Mississippi (USM) currently utilizes an educational platform known as the Objective Structured Clinical Examination (OSCE) for their students’ clinical curriculum. With the development of technology and education models, the purpose of the doctoral project is to determine if VR simulation can produce more effective learning than the OSCE modules. To determine the effectiveness, pharmacologic lessons for intraoperative hypotension were administered through both platforms and then tested …

Improving Consistency Of Quality-Of-Life-Assessments In Schizophrenia Patients Through Structured Education For Healthcare Providers, Dorothy Stewart

Doctoral Projects

Schizophrenia is a chronic and debilitating mental disorder that significantly impacts patients' quality of life (QoL). Effective management of schizophrenia requires not only symptom control but also a comprehensive assessment of QoL to guide treatment plans. The Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4) is a specialized tool designed to evaluate the unique challenges faced by patients with schizophrenia. However, inconsistencies in the administration and interpretation of the SQLS-R4 by healthcare providers have led to variability in patient care. This doctoral project aimed to address this gap by implementing a structured educational intervention for healthcare providers that focused on …

Utilization Of Quantitative Monitoring To Promptly Detect And Reduce The Occurrence Of Residual Paralysis In The Post-Anesthesia Care Unit, Kathryn Elizabeth Nokes, Erin Moran Travis

Doctoral Projects

Objective: To evaluate the effectiveness of an educational workshop using an Objective Structured Clinical Examination (OSCE) on quantitative neuromuscular monitoring. The goal was to improve the knowledge and skills among certified registered nurse anesthetists (CRNAs) and student registered nurse anesthetists (SRNAs) in identifying residual paralysis. The specific aim was to determine the effectiveness of quantitative monitoring in the Post Anesthesia Care Unit (PACU).

Background: Residual paralysis following the administration of neuromuscular blocking drugs (NMBDs) is a significant postoperative complication. Neuromuscular blocking drugs (NMBD) facilitate airway management and manipulation of surgical fields. Quantitative monitoring can be crucial in early detection and …

Breast Cancer: Her2-Mutant P53 Cooperation And The Cell-Of-Origin Dependent Dynamics, Abie Williams-Villalobo

Dissertations (2016-Present)

Subtype. Specifically, NCP172 and NCP245 tumors grew faster and were predominantly triple- negative than NCP245. RNA sequencing identified many differentially expressed genes (DEGs) between tumor and mammary gland controls. Ingenuity Pathway Analysis (IPA) of the DEGs revealed that pathways like Deubiquitination, Cell Cycle Checkpoints, RHO GTPase cycle, and HIF1α Signaling were associated with aggressive tumor characteristics, with heightened pathway activity in NCP172 likely contributing to greater growth and invasiveness.

This study further examined how different cells-of-origin contribute to breast cancer heterogeneity by inducing mutant p53 in either mammary myoepithelial or luminal cells. Tumors originating from myoepithelial cells (Tk5) exhibited …

Assessing The Impact Of An Individual Diabetic Education Program And Big Data App On Three Generations Of Patient Populations, Avery C. Carpenter, Rechendia C. Carpenter, Ester M. Felipe

Doctoral Projects

Diabetes is a chronic condition that affects numerous people worldwide. Diabetic education assists people with understanding the nature of diabetes, its side effects and how to successfully deal with the condition. The doctoral project incorporates finding out how glucose monitoring, prescription administration, dieting propensities, and the significance of customary activities. With proper education the impact on one’s health with this chronic condition can improve for the better.

The nature of this doctoral project is to assess the impact that a diabetic education program and big data app have on three generations. Members of the group partnered with Hutton Healthcare in …

Examining The Impact Of Eds And Meds Anchor Institutions On Local Communities: A Mixed Methods Case Study On University Medical Center New Orleans, Samuel P. Firmin

LSU New Orleans Theses and Dissertations

The purpose of this study was to examine how the University Medical Center New Orleans (UMCNO), a major Eds and Meds anchor institution, has contributed to the well-being outcomes of surrounding communities within the New Orleans BioDistrict since its opening in 2015. Eds and Meds institutions often have mixed impacts on their local communities, and little research has focused on their effects in the Deep South, particularly in New Orleans, a region with pronounced socioeconomic disparities. This study aimed to address this research gap by investigating the following question: to what extent does UMCNO's Community Health Needs Assessments align with …

A Proposed Instrument To Determine Mobility Eligibility Criteria And Levels For Mechanically Ventilated Patients In The Intensive Care Unit, Keira Gabrielle Miller

Doctoral Scholarly Projects & Capstones

Immobility is a problem among mechanically ventilated patients in the intensive care unit. Early mobility has been shown to benefit mechanically ventilated patient outcomes by minimizing hospital stays and costs, decreasing the risk of infection, and improving muscle strength to lead to a better quality of life. No inclusive checklists exist to evaluate patients progressing to varying levels of mobility based on specific criteria such as hemodynamics, neurological function, and disease acuity. This gap was identified after a current and comprehensive literature review on early mobilization among mechanically ventilated patients. The purpose of this project was to combine a comprehensive …

Incorporating The Pcl-5 Self Assessment Tool In The Treatment Of Post Traumatic Stress Disorder Using Virtual Reality Therapy, Janette Sanchez

Doctor of Nursing Practice

Background. Post-traumatic stress disorder occurs when individuals experience a traumatic event causing symptoms of depression, anxiety, and cognitive difficulties (Sadock et al., 2017). Failure to assess changes in post-traumatic stress disorder symptoms can result in ineffective treatments (Department of Veterans Affairs & Department of Defense, 2023). Purpose. Implement the Post Traumatic Stress Disorder Checklist for DSM-5 screening tool as part of an outpatient clinic’s virtual reality exposure therapy protocol evaluating patients’ perceived effectiveness of virtual reality exposure therapy in post-traumatic stress disorder management. Methods. All staff and providers were educated on the use of the PCL-5 screening tool. Patients were …

Effect Of Running Cadence On Tibial Acceleration: Implications For Runners Experiencing Stress Injuries, Victoria Hilfiker

Honors Theses

I. Purpose The purpose of this study was to determine the influence of cadence modification on tibial acceleration (TA) in the interest of exploring potential methods to reduce the incidence of stress-related running injuries. II. Methods Eleven injury-free distance runners were recruited to run at 6 different cadences with acoustic pacing. An inertial measurement unit (IMU) containing an onboard triaxial accelerometer was mounted on the right medial distal tibia to record acceleration at each of these paces. A repeated-measures ANOVA was conducted to determine differences in tibial acceleration over varying cadences. Effect sizes (╖2 and Cohen’s d) were examined to …

Access To Health Care And Glycemic Control: The National Health And Nutrition Examinations Survey (Nhanes) 2005-2018., Mohamed M. Ali

Electronic Theses and Dissertations

Background and Purpose: Diabetes mellitus is a chronic metabolic condition associated with numerous medical and financial sequences. In 2018, 34.1 million adults aged 18 years or older had diabetes in the U.S. Access to Care for diabetic Americans remains a public healthcare concern. This study aims to examine the relationship between access to healthcare and selected diabetes indicators. Methods: A quantitative, repeated cross-sectional study uses four of the National Health and Nutrition Examinations Survey's (NHANES) access measures (insurance, the number of times of annual healthcare visits, routine place for healthcare, and type of place) and four diabetes indicators (Hemoglobin A1C …

Identification Of Lncrnas Involved In The Host Response To Venezuelan Equine Encephalitis Virus Infection, Mahgol Behnia

Biomedical Sciences ETDs

Venezuelan equine encephalitis virus (VEEV) is an enveloped positive-sense RNA virus in the alphavirus genus of the Togaviridea family, that causes encephalitis in humans and equids. Currently no FDA-approved vaccine or treatment is available for human use, emphasizing the importance of studying host-VEEV interaction. lncRNAs are regulatory RNAs involved in modulation of antiviral pathways during viral infections. Here we report differential lncRNAs expression in primary mouse astrocytes and neurons during non-pathogenic (TC-83) but not pathogenic (TrD) VEEV infection. We further demonstrated that suppression of four lncRNAs increased TC-83 replication, with lncRNA small nucleolar RNA host gene 15 (Snhg15) increasing TC-83 …

Pharmacological Inhibition Of Lsd1/Kdm1a In Diffuse Midline Glioma Models And Impact On Kinase Signaling, Faith Angelina Hernandez, Faith Angelina Hernandez

Dissertations and Theses (Open Access)

Diffuse Midline Gliomas (DMG) occur in the midline structures of the brain such as the brainstem. DMG, a subset of pediatric high-grade gliomas (pHGGs), confers poor prognosis in children with survival rates below two years post-diagnosis. This is heavily due to limited treatment options as radiation and chemotherapy are only temporarily effective and surgery pose high risks. DMG are characterized by histone mutations typically occurring in histone 3.1 and 3.3 alleles, with about more than 80% of patients containing the H3K27 mutation. Recent publications, highlight epigenetic modulators as promising cancer-specific targets emphasizing their potential as a novel therapeutic strategy. Epigenetic …

Impact Of Human Immunoglobulin Genetic Variants On The Expressed Antibody Repertoire., Eric Engelbrecht

Electronic Theses and Dissertations

B cells produce immunoglobulins (IGs; antibodies), which are critical protein components of the immune system. Human IGs are composed of two pairs of identical ‘heavy’ chains and ‘light’ kappa or lambda chains, encoded by genes located at three loci in the genome: the IG heavy chain locus (IGH, chromosome 14), and the IG lambda (IGL, chromosome 22) and kappa (IGK, chromosome 2) loci. Each locus spans ~920-100 kilobase pairs (Kbp) of DNA and harbors families of gene segments that are somatically rearranged during B cell development. The IG loci collectively harbor >180 functional genes, many of which are part of …

Obesity: Influencing Behavioral Consumption Through Meal Kit Distribution, Alejandro Hernandez

Capstone Projects and Master's Theses

Founded in 2002, Everyone’s Harvest is a grassroots nonprofit dedicated to providing access to healthy, affordable fruits and vegetables through certified farmers markets and community food programs. Its key initiatives—Fresh Rx, Market Match, Edible Education and Farms Together —focus on alleviating nutrition insecurity and combating diet-related health conditions by providing vulnerable populations the resources to purchase, or receive, fresh produce and gain nutritional knowledge. This study explores a new intervention: the distribution of farmers' market meal kits as a complementary strategy to the current Edible Education program. These meal kits, which feature seasonally available produce and pre-measured ingredients, aim to …

Bridging The Gap: Fostering Open Dialogue On Resource Access And Service Needs, Cameron Castillo

Capstone Projects and Master's Theses

This project investigates whether there are additional resources desired by clients or are needed to better support said clients in their recovery at the Interim, Inc. organization. This agency is a nonprofit organization whose sole purpose is to build community connections through providing services to individuals facing mental health and substance use challenges. While there is a wide range of programs available, there may still be clients with unmet needs. The purpose of this project was to identify any service gaps by conducting separate surveys of clients and staff members. Through the use of open-ended questions, the expectation of receiving …

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

Parenting With Grace, Eva Nelson Cole

Capstone Projects and Master's Theses

Parents are often caught off guard by the upheaval of adding children to their lives. Feelings of guilt, shame, isolation, and depression can arise when parents are faced with the demands and stressors that come along with having children. Studies have shown that children who have distressed parents endure lasting negative outcomes that can extend into the primary school years (Mihelic et al., 2018). Educating parents and giving them some awareness about what to expect can make a real difference. To have these conversations, I created a two-part parenting workshop for new parents at Parents’ Place in Pacific Grove, CA. …

Analyzing Sars-Cov-2 Wastewater Surveillance Data For Public Health Impact In Southern Nevada, Casey A. Barber

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Early in the COVID-19 pandemic, researchers determined that levels of severe acute respiratory coronavirus 2 (SARS-CoV-2) genetic material in wastewater could provide information about COVID-19 occurrence in communities. Wastewater-based epidemiology (WBE) efforts have subsequently expanded throughout the U.S. and internationally; the U.S. Centers for Disease Control and Prevention (CDC) initiated its National Wastewater Surveillance System (NWSS) in September of 2020 and continues its SARS-CoV-2 wastewater monitoring efforts following the end of the federal COVID-19 public health emergency in May 2023. The field of WBE has reached a critical juncture in determining the future of how SARS-CoV-2 wastewater surveillance data …

How Culture Impacts Mental Health Help-Seeking Behaviors In College-Aged Chinese Americans, Hui Ching Chan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Adolescents are the most vulnerable to mental health issues in the United States, however, they are the least likely to receive relevant professional services. Particularly, young Chinese American adults who are influenced by traditional Chinese culture retain a higher reluctance to mental health-related help-seeking behaviors.

Chinese American culture is co-constructed with families through parents’ worldviews, parenting styles, socio-economic statuses, and English proficiency. Several studies also suggest that mothers and fathers in Chinese American families play distinct roles in shaping youngsters’ perceptions of mental health awareness. As a result, the culture perceived from families has a significant impact on young Chinese …

The Effects Of A Healthcare Simulation Escape Room On Clinical Judgment: A Randomized Controlled Trial, Jennifer Peltier

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The predominant pedagogy of traditional lecture-based learning should include meaningful active content to foster clinical judgment, engagement, and knowledge retention. Innovative active learning strategies must be tested to understand if they can better facilitate nursing learners’ readiness for practice.

Aims: This research study investigated the impact of a healthcare simulation escape room as an innovative platform on individual and team clinical judgment to determine whether this active learning strategy can benefit nursing learners’ preparedness and increase clinical judgment.

Method: A randomized, double-blinded, waitlist control design was used to examine the effect of a healthcare simulation escape room on clinical …

Synthesis Of Photocleavable Molecules For Neurological Applications, Nishal Madujith Egodawaththa Arachchilage Don

Theses and Dissertations

In recent biomedical research, the precise control of molecular dynamics through light activation has emerged as a powerful tool, particularly in the field of neurobiology. This approach involves the use of photocleavable cages or photoprotective groups (PPGs) that are chemically tethered to biologically active molecules such as neurotransmitters or calcium chelators. These cages remain inert until exposed to specific wavelengths of light, typically in the visible range, triggering the release of the active compound with high spatiotemporal precision.

For neurotransmitter systems, such as glutamate (Glu), which plays a critical role in synaptic transmission and memory formation, researchers have developed novel …