Medicine and Health Sciences Commons^™

Integrating Galectin-3 Into A Computational Model Of Cardiac Fibrosis Progression, Adam Pieratt

Chemical Engineering Undergraduate Honors Theses

Cardiac fibrosis, a large contributor to heart failure, is the excessive accumulation of extracellular matrix in response to stress or injury. There are no approved treatments for cardiac fibrosis, and targeting specific species involved creates complex problems for drug development, so a computational model of the cardiac fibroblast signaling network can be used to observe the interactions involved in the progression of cardiac fibrosis. In this paper, a new protein called galectin-3 is integrated into this existing model, and connections are established to expand the coverage of the network. The additions are described, simulated using Netflux biological system simulation software, …

Utilization Of The Reproductive Justice Framework In Contraceptive Counseling With Black And African American Women: A Comparison Of Patient Satisfaction And Provider Knowledge, Simranjeet K. Tagore

Doctoral Projects

Current practice in contraceptive counseling is characterized by great variation in both content and implementation. The literature indicates that African American women desire contraceptive counseling based in respect, trust, and equity. Conducted over 8 weeks, this quality improvement project compared satisfaction in African American and Black patients receiving contraceptive counseling by a provider trained in the Reproductive Justice Framework (RJF) versus those receiving contraceptive counseling by a provider not trained in the Reproductive Justice Framework. This project also evaluated the effects of Reproductive Justice Framework training on clinician knowledge. Inclusion criteria for the patients included identifying as Black and/or African …

The Impact Of The Covid-19 Pandemic On Undergraduate College Students, Rebecca C. Madson

Theses, Dissertations and Culminating Projects

The COVID-19 pandemic created significant disruption across the world. These two studies provide a mixed methods approach to understanding how undergraduate college students at one university were impacted by the COVID-19 pandemic. The first, a quantitative study, examines changes in mean, median, and standard deviation of GPAs in the semesters leading up to and during the pandemic (Fall 2018 - Spring 2022). The second, a qualitative study, involves interviewing students (n = 13) who began their undergraduate college career in Fall 2019, prior to the pandemic, and graduated in Spring 2023. Findings from these studies suggest that undergraduate students performed …

Athletic Identity Association And Prospective Basic Psychological Needs Satisfaction Predict Attitudes Of Collegiate Athletes Toward Seeking Help From The Athletic Department, Allie Zerr

Master's Theses

There is an epidemic of mental health issues that has begun to be more openly talked about in college athletics. In 2022, the National Collegiate Athletic Association has found that college student-athletes are now 1.5-2 times more likely to report struggling with mental health than ever before. Previous research has shown a significant association with basic psychological needs satisfaction and overall psychological well-being. Furthermore, the purpose of this study was to investigate the possible ways that reported of autonomy, competence, and relatedness need satisfaction predicted whether athletes would seek mental health services and identify how athletic identity plays into this …

Analyzing The Relationship Between Cannabis Use And Hearing Loss, Ashley Howe

Doctoral Scholarly Projects & Capstones

The purpose of this study was to assess the cross-sectional relationship between cannabis use and hearing thresholds to determine if cannabis use is associated with poorer hearing sensitivity while controlling for covariates and other risk factors in a large population-based data set. To answer this question, we analyzed audiometric hearing threshold data, drug use data, and covariate data from the U.S. National Health and Nutrition Examination Survey (NHANES) cycles. A total of 5,140 participants from 2009–2012 and 2015–2016 aged 20–59 years were included in the analyses. Univariable and multivariable main effects logistic regression models were used to compare cannabis use …

Pediatric Ototoxic Monitoring, Destiny Victoria Padilla

Doctoral Scholarly Projects & Capstones

The prevalence of children living with cancer is estimated to be 129,221 in the United States (National Cancer Institute, 2022). The chemotherapy treatment that these children receive can cause ototoxicity, especially when platinum-based chemotherapy agents are used. Ototoxic monitoring is beneficial for patients undergoing chemotherapy treatment as it allows for treatment modification, dosage modification, early intervention, or auditory rehabilitation to take place based on the patient’s hearing status. This is especially important due to the effect hearing loss may have on children’s development and quality of life. There are several objective and behavioral auditory tests that can be used to …

Intervention Measures Alleviating Bacterial Chondronecrosis With Osteomyelitis In Broilers: Experimental Lameness And Feed Additive Treatments, Andi Asnayanti

Graduate Theses and Dissertations

As the global population grows, the supply and demand for meat have dramatically increased. The poultry industry has managed to satisfy the high demand for chicken meat through fast-growing broilers. The poultry breeder industry has successfully provided modern broilers with high liveability, feed efficiency, and processing yields through genetic selection of the traits of interest such as growth rate, feed conversion rate, and breast quality. Nevertheless, the intensive selection of modern broiler chickens for fast growth and feed efficiency leads to unintended side effects, such as excessive fat, low reproductive performance, leg abnormalities, low immunity, cardiovascular diseases, and metabolic disorders. …

Macrophage Polarization And Colorectal Cancer Immune Checkpoint Protein Expression., Anne Macleod

Electronic Theses and Dissertations

The majority of patients with colorectal cancer do not respond to treatment with immunotherapy. Immunotherapy requires the expression of cell surface immune checkpoint proteins (e.g. PDL1) to exert its effect. Most (>85%) of colorectal cancers do not express these proteins and this contributes in part to the poor prognosis and survival in patients with advanced disease. The patients in which immunotherapy is a potential treatment option, are a genetic subtype known as mismatch repair deficient, and have demonstrated an excellent response to anti-PD-1/PDL1 immunotherapy. A key feature of mismatch repair deficient (MMRd) cancers is their immune cell rich tumor …

Amphipathic Hybrid Cyclic-Linear Peptides As A Drug Delivery System, Jonathan Moreno

Pharmaceutical Sciences (PhD) Dissertations

Amphipathic Hybrid Cyclic-Linear Peptides as a Drug Delivery System by Jonathan A. Moreno Peptides

[RW]₄ and [R₅W₄] have been previously identified as molecular transporter Cell Penetrating Peptide (CPP) and antimicrobial agents, respectively. These peptides consisted of alternating and non-alternating arginine (R) as positively charged residues and tryptophan (W) as hydrophobic residues. Herein we report the synthesis of two hybrid amphipathic cyclic-linear cell-penetrating peptides [RW]₄K-AH135 (1) and [R₅W₄]K-AH135 (2) composed of [RW]₄ and [R₅W₄] and a linear peptide AH-135 (Ac)NH-RWLRRWLRWWRR-COOH. The …

Approvals, Utilization, And Cost Of Biologics For The Treatment Of Rheumatoid Arthritis, Roya Hosseini

Pharmaceutical Sciences (PhD) Dissertations

Introduction: RA treatment has been revolutionized by the development and approval of biologic disease-modifying antirheumatic drugs (bDMARDs). However, the approval status, utilization, and high cost of bDMARDs pose challenges in RA management.

Objectives: This dissertation evaluated the association between the utilization of bDMARDs and the sociodemographic characteristics of the RA patient population. It also identified the FDA approval status of bDMARDs and assessed the annual cost of bDMARDs used in RA treatment, evaluated the factors explaining annual cost at market entry.

Methods: In the retrospective analysis of Medical Expenditure Panel Survey (MEPS) data from 2010-2021, the population includes RA patients …

Mechanistic Study Of Antimicrobial Cyclic Peptide [R4w4] Antibacterial Effectiveness Against Methicillin-Resistant Staphylococcus Aureus (Mrsa), Ajayi Akinwale

Pharmaceutical Sciences (PhD) Dissertations

Antimicrobial peptides (AMPs) are being explored as a potential solution to combat antibiotic resistance, as they have shown promise in reducing susceptibility to antibiotics. This study explores if [R₄W₄] peptide is bacteriostatic or bactericidal using modified two-fold serial dilution and evaluates synergism of gentamicin and [R₄W₄] against Escherichia coli (E. coli) and Methicillin-resistant Staphylococcus aureus (MRSA) by checkered board assay. The MRSA resistant to [R₄W₄] and possibility with other antibiotics was evaluated with serial passage. Moreover, we investigated the mechanism of action of [R₄W_{4 …}

Perceptions Of Metabolic Syndrome Management Utilization In Relation With Patient Characteristics And Health-Related Quality Of Life, Olajide Adekunle

Pharmaceutical Sciences (PhD) Dissertations

Challenges in managing MetS include untreated risk factors and ineffective management, resulting in poor health-related quality of life (HRQoL). A significant factor contributing to these challenges is the underutilization of management services, possibly due to patients' perceptions of disease management resource utilization (PMU). Therefore, understanding patients' PMU is crucial for improving health outcomes. The study investigated PMU, explored PMU predictors, and investigated the impact of PMU and patients’ demographics on HRQoL. Using a cross-sectional design, data on perceptions of healthcare, medication, and pharmacy service utilization, prior experience with pharmacy services, demographics, and HRQoL were collected from adult individuals with obesity …

Sleep Disturbances In Adults With Tsc: Influences Of Treatment And Clinical Features, Kirstin Risgaard

Dissertations and Theses (Open Access)

Tuberous sclerosis complex (TSC) is a rare genetic condition caused by pathogenic variants in the TSC1 or TSC2 genes. TSC is characterized by a multisystem, neurocutaneous phenotype including skin lesions, hamartomas, and epilepsy. Additionally, TSC can present with an array of behavioral, psychiatric, academic, psychosocial, intellectual, or neuropsychological difficulties comprehensively known as TAND, or TSC-associated neuropsychiatric disorders. Sleep disorders are a common feature of TAND; however, they are not well characterized in the adult TSC population. Likewise, little is known about how clinical features of the condition and commonly prescribed medications impact sleep. Therefore, this study aimed to determine the …

Mismatch Repair Deficient Neoantigen And Associated Circulating T-Cell Receptor Repertoires In Lynch Syndrome, Ana Bolivar

Dissertations and Theses (Open Access)

Lynch Syndrome (LS) is the most common inherited colorectal cancer (CRC) syndrome. It constitutes the perfect model to understand DNA mismatch repair deficient (MMRd) carcinogenesis, which underlies 15% of early-stage CRC. LS patients develop MMRd tumors with high loads of shared neoantigens (neoAgs), which are recognized by the immune system. Previous research has concentrated on discovering neoAgs and their potential as targets for vaccines in LS patients. However, these studies have primarily identified shared neoAgs from cancers, lacking detailed information on targetable neoAgs present in precancerous lesions. Understanding this landscape of pre-cancer derived neoAgs is crucial for intercepting cancer development …

Uncovering Capillary Endothelial Cells Response During Lung Injury-Repair, Celine Shuet Lin Kong

Dissertations and Theses (Open Access)

Once thought to be a homogenous population, capillary endothelial cells (ECs) have embodied organotypic specialization and heterogenous properties, both during homeostasis and tissue injury. In the lung, capillary ECs consist of two distinct populations, CAP1 and CAP2s; how each population responds to diverse tissue injury is incompletely understood. In this thesis, I report the induction and function of a truncated isoform of Ntrk2, Ntrk2^-tk (lacking the tyrosine kinase domain) in multiple injury models. Using a combinatorial approach of single-cell multiome, mouse genetics and viral infection models, I found that Ntrk2^-tk is broadly induced in CAP1s after the initial …

Beyond Rehabilitation: Exploring The Field Of Occupational Therapy And The Transformative Impact Of Care, Sierra C. Fox

Theses/Capstones/Creative Projects

As a profession that implements unique approaches to empower people of all ages and abilities to actively participate in activities that are meaningful to them, occupational therapy is an essential service for providing holistic healthcare (Darawsheh, 2018). As an undergraduate approaching graduation, the process for applying to graduate school programs has finally begun, and it has become obvious the lack of public knowledge there is regarding the profession. Even among other healthcare professionals, there is often an inadequate understanding of the field, which can be problematic and result in patients not being referred to receive the services that may benefit …

The Consequences Of Homophobia: Analysis Of Discriminatory Medical And Legislative Policies And Their Influence On Health Disparities, Kaiden J. Fandel

Honors Thesis

Are there specific roots that influence the introduction and incorporation of discriminatory medical policies? What are the sources of such stigma, discrimination, and prejudice, in what forms does such discrimination take place, and what negative impacts does such hatred have on health outcomes, quality of care, and health disparities? Through a review of existing literature on this topic, intertwining the examination of the evolution of discriminatory policies and other explanatory literature in the United States, this thesis aims to answer the questions above, and explain the roots of such homophobic discrimination and its prevalence in the United States. Through the …

Evaluation Of An Emergency Department Provider Information Update On The Initiation Of Suboxone With A Community Treatment Program Referral For Opioid Overdose And Opioid Use Disorder, Carmen Brewington

All Dissertations

Over 21 million people in the United States (U.S.) require substance use disorder (SUD) treatment; yet less than 4 million people receive treatment (Bressan & Kening, 2023). According to Thomas et al. (2022), opioid overdose deaths are increasing, and improving access to evidence-based treatment is critical. Hospital emergency departments (EDs) play a lifesaving in the emergency treatment of opioid overdoses; but can also serve as gateways to opioid treatment by healthcare providers for opioid addictions (Reuter et al., 2022). Mortality, after an ED visit for opioid overdose, is high (Thomas et al., 2022). Community resources are limited, thus making it …

Cost Saving And Resource Limited Public Health Interventions In Southeast Asia, Amanda Blackwelder

Electronic Theses and Dissertations

Background: Public health interventions are any activity with the objective of improving human health such as preventing or curing disease, reducing the severity or duration of a disease, or assisting in regaining function after a disease or injury. These interventions are known to be impactful; however, those living with the highest burden of disease such as individuals in low- and middle-income countries have limited money and resources to successfully implement these interventions. Southeast Asian countries are among some of the middle-income countries effected by the lack of affordable interventions. The aims of this study were to assess cost saving and …

Benefits Of Adapted Physical Activities For Students With Disabilities, Jason Mazzuca

Capstone Projects and Master's Theses

This senior capstone research project examines the benefits of adapted physical education for students with disabilities. Through the use of literature reviews, field observations, and interviews with three elementary school teachers, the findings revealed that adaptive physical activities , such as a program called Sami’s circuit has greatly benefited students with disabilities. This kind of adapted physical activities involve the participation of many classes with a large group of students through a virtual trainer, in which teachers can easily adapt to be implemented into their individual classroom setting, and to outdoor activities as well.

Restoring Meaning Through Leisure: Exploring The Benefits Of Leisure-Focused Occupational Therapy For Individuals With Neurological Diagnoses, Elizabeth Rose Stoutland

Occupational Therapy Capstone Presentations

There are limited findings in occupational therapy literature on leisure, despite being a highly meaningful area of occupation that has implications for both physical and mental health. This poster describes an occupational therapy Capstone experience in adaptive sports and inpatient rehabilitation at a Veterans Affairs Medical Center related to leisure restoration. The student investigated the role of occupational therapy in restoring leisure and recreation for individuals with neurological conditions and achieved the following main goals: (Goal 1) to gain skills in adaptive recreation for individuals with neurological conditions, and (Goal 2) to determine how leisure exploration can be implemented in …

The Importance Of Preferred Meaningful Occupations For Children With Medically Complex Conditions, Kaylee S. Schmit

Occupational Therapy Capstone Presentations

Children with medically complex conditions experience limitations in their ability to engage in preferred meaningful occupations. Additionally, when these children are in the hospital setting, the environment poses another barrier to accessing preferred meaningful occupation opportunities. This capstone project aimed to explore how preferred meaningful occupations could be utilized with children with medically complex conditions in the pediatric inpatient setting. The literature and needs assessment indicated the need for preferred meaningful occupations to be used as a motivator and a way to target specific skills a patient wanted to regain. With the focus of occupational therapy on return to occupation …

Occupational Therapy Services In Pediatric Mental Health, Hallie Jerome

Occupational Therapy Capstone Presentations

Children and youth experiencing mental health concerns often have limited or decreased engagement in meaningful occupations. Additionally, children and youth who experience mental health concerns at an early age are more likely to experience negative health outcomes such as poor occupational engagement, academic achievement, adverse childhood experiences (ACES), maltreatment/abuse/neglect, family and peer conflict/rejection, low self-esteem, early substance use, and many others impacting their overall health and well-being. My capstone project aimed to administer occupation-based interventions in a pediatric mental health program while I advance my skills working with an interdisciplinary team. The literature and needs assessment indicated a need for …

Incorporating Occupation-Based Activities Into Treatment For Adolescents With Substance Use Disorders To Increase Self-Efficacy, Brea E. Westberg

Occupational Therapy Capstone Presentations

In 2022, over 48.7 million people aged 12 and older reported having a substance use disorder in the past year. Adolescents are increasingly becoming involved in substance use behaviors that impact their lives daily. There is limited evidence for providing mental health interventions, including those provided by occupational therapy practitioners, to adolescents with SUDs within the substance use treatment setting. Self-efficacy is an important part of the substance use recovery process. Therefore, the purpose of the capstone project was to determine the effects on self-efficacy after incorporating occupation-based activities into programming for adolescents in treatment for SUDs. The Model of …

A Program Based On Meaningful Occupations To Improve Perceived Health And Well-Being For People Experiencing Homelessness, Annika Overgaard

Occupational Therapy Capstone Presentations

Individuals experiencing homelessness face a variety of barriers to occupational performance and participation, thereby negatively impacting their quality of life, health, and well-being. Occupational therapists are uniquely qualified to address the health and well-being needs of individuals experiencing homelessness due to their holistic client-centered approach, their efforts in promoting occupational participation, and providing opportunities for occupational empowerment. Occupational therapy with this population is a growing area of practice, and there is a lack of literature focusing on interventions related to meaningful occupations. My capstone project aimed to create a meaningful occupation-based program for individuals experiencing homelessness at a drop-in day …

Perceived Barriers Of Early Mobilization In The Intensive Care Unit, Melissa Sonderman, Emily Miles, Joshua Ferge

Doctor of Nursing Practice Projects: College of Nursing

Purpose

Early mobilization of Intensive Care Unit (ICU) patients can improve patient outcomes but also includes barriers to implementation. Nebraska Medicine has continued to have ongoing quality improvement initiatives like the ABCDEF liberation bundles and early mobilization that have been attempted but have never fully come to fruition. This project surveys Nebraska Medicines ICUs staff to better understand attitudes, knowledge and behavior regarding early mobilization using a validated tool. The aim was to identify barriers, so the organization could better understand the needs of ICU staff for future implementations of early mobility and related assessment tools.

Materials and Methods

A …

Understanding Practitioner’S Perceptions Of Speech And Language Therapy Services In The Juvenile Justice System, Julia Buendgen

Dissertations, Theses, and Projects

The purpose of this study was to gain more understanding of how individuals who work with the juvenile justice population understand language disorders and the scope of speech and language therapy services. In addition, this study explored potential supports for individuals working in this setting. This study consisted of twenty participants working in the juvenile justice system who completed a survey tool that was designed by the researcher to describe the participant's perceptions of speech-language pathology, current procedures, reported challenges, and potential areas in need of support. Participant knowledge of the scope of speech-language pathology varied among participants. The highest …

Pediatric Trauma-Informed Care And Implications For Occupational Therapy Practitioners, Quaneka Hoskin-Chase

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapy practitioners are provided a wealth of knowledge through school and professional fieldwork experiences to understand and skillfully address the needs of children who have been exposed to trauma. Therapists are competently prepared to provide holistic and client-centered care that is dedicated to meaningful and volitional engagement (Lynch et al., 2021). However, many therapists still lack the confidence and awareness of their role related to trauma-informed care in the pediatric environment (Piller, 2022). Trauma compromises each domain of occupation (Lynch et al., 2021). As early intervention specialists, the lack of responsiveness to children’s trauma can have devastating and enduring …

Introduction Of The Anatomy Academy Program To Children In A Rural Elementary School, Rox Aurelio, Madison Dobbs, Nicole Horn, Gianni Terrana

UNLV Theses, Dissertations, Professional Papers, and Capstones

Children in rural communities experience health and education disparities. Early exposure to health promoting habits can positively impact future health habits. Healthcare providers who grew up in rural areas are more likely to practice in rural areas. Doctor of physical therapy students and physical therapists implemented Anatomy Academy, a service-learning program aimed at promoting healthy living and introducing healthcare occupations, to elementary students in a rural area as this program had previously only been implemented in urban areas. The Biomedical Institutional Review Board at the University of Nevada, Las Vegas approved this study. A 40-minute lesson was delivered weekly for …

Implementation Of Evidence-Based Practices To Improve Treatment For Patients With Neck Pain: A Pilot Study, Kristine David, Sarah Kaderka, Christoffer-Judd Villarias

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: To determine physical therapists’ barriers to implementation and subsequent maintenance of evidence-based practices (EBPs) for treating neck pain from the American Physical Therapy Association (APTA) neck pain Clinical Practice Guideline (CPG) over the course of six months.

Materials and Methods: Participating physical therapists were trained on the EBPs of treating neck pain through a live 90-minute webinar followed by a hands-on, in-person 90-minute session. Clinics were supplied with all necessary equipment and reference guides. Assessment of participant maintenance to neck pain EBPs included data collection from a baseline Knowledge Check survey prior to educational sessions, an Implementation survey at …