Medicine and Health Sciences Commons^™

Development Of A Novel Drug Delivery Platform To Treat Hiv-Associated Neurocognitive Disorder, Lina Zhou

Alternative Theses and Dissertations (AETDs)

Despite the significant reduction in HIV prevalence and improvement in life expectancy achieved through the availability of widespread antiretroviral therapy (ART), there remains no definitive cure for HIV. Further, HIV infects the brain as early as eight days after initial peripheral infection leading to neuroHIV and subsequently neuronal damage and cognitive impairment. HIV can enter the brain through several mechanisms, including the migration of infected immune cells (Trojan Horse Mechanism), direct infection of endothelial cells, and cytokine-mediated disruption of the blood-brain barrier (BBB). Consequently, HIV-associated neurocognitive disorder (HAND) remains a significant challenge in the ART era, with an estimated prevalence …

A Quantitative Examination Of Tobacco And Marijuana Use On Oral Health Outcomes Among Young Adults In Texas, Meenakshi Dasagi

Dissertations and Theses (Open Access)

This dissertation aimed to quantify the relationship between methods of tobacco and marijuana use and their impact on oral health. Tobacco use was defined as smoking combustible tobacco (cigarettes, cigars, and hookah) or electronic aerosolized vaping nicotine with an e-cigarette.5,9 Similarly, marijuana use was defined as smoking combustible marijuana (joints, blunts, and spliffs) or vaping marijuana with an e-cigarette.8 Despite the prevalence of nicotine vaping and marijuana use among young adults1,3-4,7,14-15, there is limited evidence of their association with oral health in Texas. To address this issue, this dissertation comprising three studies analyzed longitudinal data from the Texas Adolescent Tobacco …

Building Futures: How The Built Environment, Out-Of-School Time Programs, And Community Service Participation Relate To Social-Emotional Development Of U.S. Youth, Bailey A. Perez

Dissertations and Theses (Open Access)

Background: This dissertation aimed to explore the relationship between built environment features, participation in out-of-school time (OST) programs, participation in community service activities, and the social-emotional development of youth aged 6 to 17 years residing within the United States (US). Previous research indicates that built environment features, as well as participation in OST programs and community service activities, could impact youth’s social-emotional development. However, few studies have explored these effects on individual social-emotional development measures in this specific age group. In addition, little is known regarding whether built environment features and youth’s sex moderates the relationship between youth participation in …

Physicians’ Attitude, Knowledge, And Perceived Control Towards The Use Of Exercise As A Form Of Preventive Medicine, Matthew Robert Warner

All-Inclusive List of Electronic Theses and Dissertations

Exercise is a component of physical activity that can aid in the reduction of deaths, lowering obesity rates, and chronic illness. However, many Americans are not meeting the recommended physical activity levels (Carlson, et al., 2018). Quality and accurate health information regarding physical activity is one way to help combat health disparities. Health professionals such as primary care physicians can aid in promoting this lifestyle modification. However, there are shortfalls in physicians’ knowledge of using exercise as a form of preventive medicine for chronic illness. Many medical programs have little to no training in exercise principles (Cardinal et al., 2015). …

Not Ready: The Need For A Training Standard In Healthcare Emergency Preparedness, Patrina White

Dissertations: Doctor of Public Health

Background: Disasters, both natural and human-induced, are increasing. Disasters impact public health and safety in many ways including disruption of healthcare. Emergency preparedness mitigates disaster impacts. Training improves preparedness however no training standard exists. Purpose: This study aimed to explore the current state of U.S. healthcare preparedness and the impact of training on preparedness; determine the best strategies to improve healthcare emergency preparedness training; propose a standard for training in healthcare emergency preparedness; and identify barriers to adopting a standard for training in healthcare emergency preparedness including strategies to overcome identified barriers. Methods: A comprehensive literature review, …

Investigating The Quantitative Impact Of Varied Hair Densities On Proton Beam Planning For Head And Neck Cancer: A Dosimetric Analysis, Breanna M. Reed

Masters Projects

Abstract

Purpose: The purpose of this research was to investigate the impact of differing hair densities on dose distributions for proton plans in the head and neck region.

Methods: Four CT scans were acquired with varying hair densities. Plans were created on a no hair scan using both a 3cm and 5cm range shifter. Plans were then calculated using three additional datasets with varying hairstyles to analyze dosimetric differences. Water equivalent depth and distance from 80% isodose line to user origin were analyzed for each scan and compared.

Results: No statistically significant differences were observed between the no hair scan …

A Retrospective Comparison Between Analytical Anisotropic Algorithm (Aaa) And Acuros Xb (Axb) Calculation Algorithms Concerning The Left Anterior Descending Coronary Artery Radiation Dose In Left Breast Cancer Patients Utilizing Deep Inspiration Breath Hold, Melissa Wilkinson

Masters Projects

Abstract

Background: Minimizing radiation exposure to the left anterior descending coronary artery (LAD) is crucial during left-sided breast cancer radiation therapy to prevent cardiac complications. Dose calculation algorithms can significantly impact the estimated LAD dose. This study investigates the differences between the Anisotropic Analytical Algorithm (AAA) and Acuros XB (AXB) algorithms in LAD dose calculations.

Methods: Thirty patients treated with radiation therapy after breast-conserving surgery were included. Dosimetric data for LAD, including mean and maximum dose, was calculated using AAA and AXB algorithms. The results were compared using statistical analysis.

Results: Statistically significant reductions in mean LAD dose were observed …

Applying Emotionally Focused Group Therapy With Collegiate Student-Athletes Experiencing Disordered Eating And Poor Body Image, Emily Wagener

Educational Specialist, 2020-current

Rates of eating disorders and sub-clinical disordered eating continue to rise each year, with higher rates seen among athletes than non-athletes (Curry, 2010). Fueled Athletes is a group-style intervention for collegiate student-athletes that uses Emotionally Focused Therapy to help group members identify and transform emotions that contribute to poor body image and disordered eating behaviors. The mission of Fueled Athletes is to create a program that addresses eating problems and body image disturbances experienced by student-athletes by creating a safe space, building a support network which will lead to decreasing rates of ED / DE within the student-athlete population. Future …

Investigating Nature-Based Mindfulness In Nurse Anesthesia Students: A Pilot Study, Douglas Lovern

Dissertations

Across the country, the mental health crisis continues to rage. Varying degrees of depression, stress, and anxiety are commonly found in college-age students. The COVID-19 pandemic augmented this crisis, but the pandemic is not the sole culprit for the escalation of mental health disorders in the United States. Students across the globe suffer mental health disorders that include depression, anxiety, and stress. Research has shown that graduate students are six times more likely to develop anxiety and depression than the general population. Student registered nurse anesthetists (SRNAs) are vulnerable to mental health disorders. SRNAs enter labor-intensive doctoral programs fraught with …

Collegiality And Job Satisfaction Among Nurse Faculty, Kelsey Phillips

Doctor of Nursing Practice Projects

Nurse faculty turnover has been attributed to low levels of support, low wages, long work hours, uncertainty, and an unpleasant work environment. Leaders must find interventions that will impact the collegiality of nurse faculty, the perceived level of support from leadership, and in result retain their faculty. Purpose: Based on a literature review, this quality improvement project aims to determine if implementing a monthly catered lunch promotes collegiality and improves job satisfaction for nursing faculty in a community college in East Texas. Methods: To determine the impact of monthly catered lunches, a pre-and post-intervention tool [Perceived Organizational Support (POS)] will …

Exploring Healthcare Chatbot Information Presentation: Applying Hierarchical Bayesian Regression And Inductive Thematic Analysis In A Mixed Methods Study, Samuel Nelson Koscelny

All Theses

High blood pressure, also known as hypertension, significantly increases the risk of heart disease and stroke, which are leading causes of death in the United States. While contributing to over 691,000 deaths in 2021 alone in the United States (U.S.), it also imposes immense economic burden on the healthcare system, costing approximately $131 billion annually. One way to address this issue is for increased self-care behaviors and medication adherence, both of which require sufficient health literacy. Despite the importance of health literacy, 90% of U.S. adults struggle with health-related subjects. Overcoming the issues associated with health literacy requires addressing the …

Development Of A Thwarted Belonging Measure In Older Adults: An Application To Neighborhood Context And The Moderating Role Of Neuroticism, Jaclyn Elisa Keenoy

Theses, Dissertations and Culminating Projects

This research focuses on thwarted belonging (TB), its associations with the neighborhood contextual factors of social cohesion and physical disorder in older adults, and the moderating role of neuroticism. TB is a key component of the Interpersonal Psychological Theory of Suicide (IPTS) that has serious implications for health and well-being (Van Orden et al., 2012). Despite these implications, TB is less frequently investigated outside of the suicide literature. Thus, the first aim of this research was to create a valid measure of TB in a sample of 5,001 older adults using data from the Health and Retirement Study using a …

Engagement And Retention Of College Students With Anxiety And Depressive Symptoms In A Digital Mental Health Intervention Using A Brief Peer Support Model, Emily A. Kline

Theses, Dissertations and Culminating Projects

Digital mental health interventions (DMHIs) show promise in improving access to mental health care for college students suffering from depression and anxiety symptoms. Nonetheless, the usefulness of DMHIs is limited by high user attrition. Leveraging peer support among college populations may be a feasible and cost-effective option to improve DMHI engagement and improve mental health outcomes. This open pilot study evaluated the feasibility, acceptability, and initial efficacy of a skill-based peer support group in enhancing user engagement in a DMHI for depression and anxiety symptoms. Participants were 20 undergraduate students at a university in New Jersey with elevated depression and …

Exploring The Relationship Between Cognitive Inflexibility And Anxiety In Youth On The Autism Spectrum, Farah Mahmud

Theses, Dissertations and Culminating Projects

Anxiety symptoms are prevalent among autistic youth but frequently get overlooked due to issues of diagnostic overlap and atypical presentations of anxiety (Kerns et al., 2014; Wood & Gadow, 2010). Emerging literature suggests that cognitive differences specific to autism, such as cognitive inflexibility, may be associated with vulnerability of developing and maintain anxiety symptoms (Stark et al., 2021). Cognitive flexibility (CF), the ability to shift thinking and attention according to situational demands, is thought to be impaired in many autistic children, given the behavioral rigidity observed in this population (Geurts et al., 2009). However, further work is needed to tease …

Peer Mentorship’S Effect On Nursing Students’ Perceived Stress, Collaboration, And Overall Well-Being, Brooklyn Loxtercamp

DNP Projects

Peer mentorship has proven benefits for undergraduate nursing students, such as improving a sense of belonging and teamwork, improving relationships, helping foster student-directed learning, improving leadership skills, and providing another layer of support for students (Andersen & Watkins, 2018). Because of these notable benefits, this project aimed to extend the work of these researchers to create a sustainable peer mentorship program at one Midwestern nursing program to decrease perceived levels of stress, increase collaboration, and improve students’ overall well-being. Participants (n=58) were recruited from the undergraduate nursing program and consent was obtained. The intervention included a month-by-month toolkit for mentors …

Supporting Nursing Care Transition For Late Preterm Infants From Nicu To The Level 1 Nursery, Megan R. Deans

DNP Projects

Late preterm births are increasing each year due to increasing rates of IVF, multiple births, and advancing maternal age (Visruthan et al., 2015). This group has been traditionally cared for in the NICU, but facilities may consider transitioning this care to the level 1 nursery due to the relative physiologic stability of this population (Visruthan et al., 2015). The transition, without appropriate planning, creates a potential for inconsistencies in caring for the diverse needs of 35.0-35.6 week late preterm infants (LPIs), including variations in education provided to parents and care of the LPI (Visruthan et al., 2015). This project aimed …

Environmental Factors (Rurality, Distribution Of Prescribers, And Altitude) Of People Who Died By Suicide In Montana, 2013- 2022, Anne N. Brown

Electronic Theses and Dissertations

Introduction: Suicide is increasingly prevalent in rural areas across the United States, especially in the western Rocky Mountain states. The connection between suicide and rural residency is not well understood, nor is the relationship between the distribution of prescribers, altitude, and suicide. Purpose: This retrospective quantitative study aimed to describe the characteristics of individuals who died by suicide in Montana and investigate the associations among rurality, distribution of prescribers, altitude, and suicide rate. Methods: Montana suicide mortality data for 2013-22 was used to describe individual characteristics. A second dataset was created for each Zip Code Tabulation Area (ZCTA) level in …

Investigation Of Study Strategies In Undergraduate Preparation For The Mcat And Optimizing Preparation According To Current Medical Students, Makayla Gordon

Theses/Capstones/Creative Projects

The Medical College Admission Test (MCAT) is a pivotal assessment for aspiring medical students, serving as a measure of undergraduate readiness in preparation for this huge advancement in their academic careers. Success on the MCAT requires content mastery, but to do that, strategic study approaches that are tailored to the individual, and comprehension of the test’s unique format and demands are essential. It is a common misconception that there are limited ways to study for the MCAT, while also sacrificing a legitimate understanding of the content. This project investigates further into identifying effective study methods for MCAT preparation with promise …

Neural Interactions In Bottom-Up Communication, Prashant Chama Raju

Graduate Theses and Dissertations

The visual system’s remarkable ability to process vast amounts of sensory information rapidly and accurately is fundamental to cognitive neuroscience. This study investigates a key aspect of this capability: the compartmentalization of information into feature-specific subspaces during bottom-up communication. My primary question was: does Canonical Correlation Analysis (CCA) reveal a subspace that encodes color and direction of moving dot stimuli? I found that the first canonical component (CC1) does an excellent job decoding the stimuli, despite being one-dimensional while the stimuli were drawn from a two-dimensional space (red-green and up-down plane). I demonstrate that motion features are processed within distinct …

Child And Caregiver’ Perspective On Barriers To Asthma Management At A Tertiary Referral Hospital In Kenya, Joan Kwesigabo Ahimbisibwe

Master of Medicine in Paediatrics and Child Health

Background: Asthma is one of the most common chronic conditions in children, with significant morbidity and mortality, especially in Africa. Achieving adequate asthma control in children remains challenging due to gaps between standard recommended management strategies and treatment practices. This study explored barriers to asthma management as perceived by children and their caregivers in a private tertiary care setting in Kenya.

Methods: An exploratory phenomenological qualitative study was conducted at Aga Khan University Hospital (AKUH), Nairobi. Children aged 6–18 years with a confirmed diagnosis of asthma and their caregivers were recruited. Participants had been receiving treatment for at …

A Quality Improvement Project On The Evaluation Of A Community Gastroenterology Advanced Practice Providers’ Update On The Utilization Of The American College Of Gastroenterology (Acg) Recommendation For Annual Depression Screening In Patients With Inflammatory Bowel Disease, Yolanda Levy Dnp, Fnp-Bc

All Dissertations

Inflammatory bowel disease (IBD) is an autoimmune disease that can result in chronic inflammation in the gastrointestinal tract (Farbod et al., 2021). The two most common types of IBD are called Crohn’s disease and Ulcerative Colitis. There have been several studies that have shown how the psychological disorders, including depression, can be associated with flares of IBD (Farraye et al., 2017). The American College of Gastroenterology (ACG) published clinical practice guidelines in 2017, which recommended gastroenterology (GI) healthcare providers screen for depression in all patients with IBD at least once annually (Farraye et al., 2017). This quality improvement did show …

A Descriptive Study: Aging In Place In The Rural Southeastern United States, Dama G. Cooley

Electronic Theses and Dissertations

Older Americans will soon outnumber children and younger adults. In 2022, there were 58 million older adults. By 2050, older adult numbers will grow to 82 million, and by 2060, 100 million. The National Institute on Aging calls for ongoing research on the impact that a historically large aging population will have on health, well-being, and quality of life. A key concern is how to meet needs while decreasing costs associated with institutional long-term care.

Most of these elders reside in the community and wish to live in their homes throughout their lives, but they will experience an increased need …

Women's Experience Of Cancer Treatment During Covid-19 On The Texas-Mexico Border, Kayla E. Castañeda

Nursing Theses and Dissertations

The COVID-19 pandemic exposed existing racial, ethnic, socioeconomic, geographic, and gender disparities in cancer care and highlighted the need for more research in understudied populations. No studies have elucidated the experience of women living on the Texas-Mexico border receiving cancer treatment during the pandemic. This study explored the lived experience of receiving cancer treatment during the COVID-19 pandemic in 2020 for women living on the Texas-Mexico border and identified participants' self-identified unmet needs while receiving cancer treatment during the COVID-19 pandemic on the Texas-Mexico border. Following IRB approval and informed consent, ten women living on the Texas-Mexico border who received …

Canine Parasites In Southern Nevada Urban Dog Parks: Paravec Study, Miklo Azrael A. Alcala

UNLV Theses, Dissertations, Professional Papers, and Capstones

While dogs are one of humans’ greatest companions, they also serve as hosts for a multitude of parasites. Urban dog parks serve as environments where the transmission of diseases is likely to occur. Exposure to infective agents, contained within the soil, intermediate hosts (e.g., rodents, rabbits), and feces, can directly affect the health of dogs and their owners. Other factors that can further influence canine health include age, previous diagnoses of parasites/diseases, and migration. Many dog owners visit dog parks to encourage socialization and exercise. Such activities are meant to improve health, but unawareness of microbiological organisms can lead to …

The Impact Of The Covid-19 Pandemic On Device-Associated Healthcare-Associated Infections In Nevada, Gabriela Bran

UNLV Theses, Dissertations, Professional Papers, and Capstones

Healthcare-associated infections or hospital-acquired infections (HAIs) have remained prevalent despite the growth of infection control programs in healthcare facilities and are a large cause of morbidity and mortality. Device-associated HAIs (DA-HAIs) make up a large portion of HAIs. The devices include central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and ventilator-associated events (VAEs). DA-HAIs became a large concern during the COVID-19 pandemic as many healthcare facilities became overwhelmed by the influx of COVID-19 cases, illuminating the importance of studies to examine these changes. Therefore, this study aimed to evaluate how DA-HAI rates have changed during and after the …

A Culturally Responsive Approach To Mindfulness And Mental Health Informal Education, Anastasia Jerbic-Gonzalez

UNLV Theses, Dissertations, Professional Papers, and Capstones

The qualitative study examined the mental health aspects of marginalized elementary school students in addition to constructing and implementing a culturally responsive and sustaining mindfulness program to observe if there were improvements regarding emotional regulation and awareness. To achieve this, I constructed a culturally responsive and sustaining mindfulness program, implemented this program, and studied the responses from students. The research questions that fueled this study include: (1) What types of negative emotions do marginalized elementary students experience? What is the root cause for marginalized students experiencing negative emotions during their elementary school years? (2) How can incorporating mindfulness techniques embedded …

The Development Of Environmental Dna (Edna) Sampling For Arbovirus Vector Surveillance In Southern Nevada, Katharine Brooke Major

UNLV Theses, Dissertations, Professional Papers, and Capstones

Vector-borne diseases account for 17% of all infectious diseases worldwide and are responsible for more than 700,000 deaths annually. Two-thirds of the global population are at risk of arthropod-borne RNA viruses (arboviruses), spread by mosquitoes, ticks, and sandflies, with these pathogens accounting for 37% of all emerging human diseases. Arboviruses are becoming increasingly important causes of neurological disease in the United States, presenting a significant public health problem. In the absence of available vaccines and efficacious treatment options, accurate, rapid, and cost-effective surveillance of arbovirus vectors is critical for monitoring species distribution and mitigating disease transmission risk. Currently, mosquito vector …

Implementing Radformation At Personalized Radiation Oncology: Enhancing Efficiency And Precision, Devin J. Peart

UNLV Theses, Dissertations, Professional Papers, and Capstones

RadMachine is a data quality management application implemented at Personalized Radiation Oncology (PRO) to streamline quality assurance (QA) tests. It offers various functions assisting medical physicists in a radiation oncology clinic, including inputting, analyzing, managing, exporting, and monitoring QA data. Physicists create test lists following the recommendations provided by the American Association of Medical Physics (AAPM). These lists track results for units such as the Varian Edge, Varian BRAVOS, and Siemens SOMATOM go.Open Pro CT scanner. Ancillary equipment used for testing also has assigned test lists to store calibration factors and receive calibration expiration reminders. The primary goal of utilizing …

Assessing Chronic Exposure To Glyphosate Using Urine Analysis, Jianna Gimenez

Boise State University Theses and Dissertations

The herbicide glyphosate is the most heavily used agricultural chemical in the world, and exposure has been linked to carcinogenic and reproductive effects, although this remains controversial. Glyphosate has a short biologic half-life, challenging the assessment of associations between chronic exposure and potential health effects. Long-term glyphosate exposure has often been evaluated using a single urine sample, potentially resulting in exposure misclassification and resulting in systematic underestimation of the association between glyphosate exposure and health outcomes. To determine the minimum number of urine samples required to accurately characterize chronic glyphosate exposure during pregnancy, we collected and analyzed 453 urine samples …

Exploring The Relationship Of The Noncognitive Variables Of Grit And Mindset In Baccalaureate Nursing Students And Their Impact On Academic Success, Alecia Hollis

Dissertations

The study aimed to evaluate how the noncognitive variables of grit and mindset could impact the academic success of baccalaureate nursing students. With the present and growing shortage of nurses, attrition within nursing programs is cause for concern. Attrition is a multifaceted problem; however, academic failure is one contributing factor. While cognitive factors, such as the standardized aptitude test (SAT), pre-nursing science GPA, pre-nursing GPA, and standardized entrance exams (Al-Alawi et al., 2020; Chisholm-Burns et al., 2021), have traditionally been used for admission criteria, increasing evidence suggests that noncognitive factors, like grit and mindset, play a crucial role in academic …