Medicine and Health Sciences Commons^™

Cost Benefit Analysis Of Anesthesia Providers Within Gastroenterology Outpatient Practices, Jennifer Buffum Brown

UNLV Theses, Dissertations, Professional Papers, and Capstones

Anesthesia delivery in ambulatory and office-based settings has seen significant growth in the last 25 years. The advances in effective short-acting anesthetic drugs, combined with the rise in demand for minimally invasive surgery, allows for an increase in the number of surgical procedures to be achieved outside the hospital setting. Ambulatory anesthesia promotes patient health by reducing recovery times. It also contributes to sustainability by lowering costs otherwise associated with overnight hospital stays. Patient preferences for minimally invasive outpatient surgery, and faster recovery times have spurred an increased demand for business relationships between modern medical practices and anesthesia providers. Certified …

Study Of Plan Of The Day Adaptive Radiation Therapy Validity, Zane W. Burnett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Radiation therapy is the use of radiation sources or generators to treat patients. The most common usage is in the treatment of cancers. Adaptive radiation therapy (ART) is the use of either multiple radiation therapy plans or adjusting a radiation therapy plan for daily anatomical changes. Soft tissue in the lower abdomen and pelvis can be greatly displaced depending on a variety of factors, especially bladder and rectum fill. This paper focuses on the creation of multiple plans prior to treatment to have options each day. Depending on the alignment and anatomical changes, clinicians can choose which one is most …

Linking Scholarly Learning Activities And Professional Identity In Otd Students, Andrew Loc Ho

UNLV Theses, Dissertations, Professional Papers, and Capstones

Professional identity formation is a critical aspect of education, training, and becoming an occupational therapist in Occupational Therapy Doctorate (OTD) programs. This capstone study explores the potential influences of learning activities related to research and scholarly writing professional identity development amongst OTD students using a cross-sectional descriptive design. This research study involved 32 OTD students across six cohorts participating in focus groups from the University of Nevada, Las Vegas (UNLV), and Kansas University Medical Center (KUMC). Through convenience sampling and latent content analysis managed with ATLAS.ti, the study identified categories underpinned by the Kawa Model to describe the dynamic interplay …

Increasing Self-Efficacy With Menstrual Management For Young Adults Experiencing Homelessness Using The Inclusive “U N Me” Education Program, Edellene Ignacio

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of the study was to increase self-efficacy with the occupation of menstrual management in young adults experiencing homelessness using the "Understanding and Navigating Menstrual Experience" or "U N ME" program. The objectives of this study were a reported increase in self-efficacy with menstrual management, the development of the U N ME program, and to promote the spread of accurate information to other menstruators in the community.

This study was a convergent parallel mixed-method study rooted in a phenomenological approach. The intervention featured four weekly workshops featuring education, group discussion, and an activity to tie the topic of the …

Osteoarthritis In The Temporomandibular Joint And Knee Joint: A Macroscopic Study Of Cadaver Specimens, Jeremy James

UNLV Theses, Dissertations, Professional Papers, and Capstones

In this study, thirty-one TMJs and twenty-eight knee joints were dissected from seventeen cadaveric subjects aged 69 to 95. Degenerative/osteoarthritic changes on the mandibular condyles, mandibular fossae, and femoral condyles were evaluated macroscopically and assigned a score on a disease severity scale (DSS) from 0 signifying “normal cartilage” to 4 signifying “severe OA”. Osteoarthritic changes were found in all TMJ and knee specimens. The average mandibular condyle DSS score was 2.68 ± 0.96, while the average mandibular fossa score was 2.90 ± 0.76; this difference in scores was significant (P = 0.035). Additionally, the mandibular fossa was equally or more …

Promoting Positive Dementia Attitudes Through Occupational Engagement: The Development Of A Dementia Awareness Program For Community Older Adults, Cynthia Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: This capstone project explored the effects of adding occupational engagement into a dementia awareness program on attitudes toward dementia among community-dwelling older adults, aiming to challenge dementia myths and promote an inclusive environment through occupational therapy perspectives. Methods: This project used a pre-test, post-test design with convenience sampling to develop and assess a dementia awareness program based on insights from Silverado Red Rock Memory Care Community and participation from members of the Osher Lifelong Learning Institute (OLLI) at the University of Nevada, Las Vegas in the program. Changes in positive attitudes toward dementia were measured using the Dementia Attitudes …

Seated Athletes' Motivation For Participation In Wheelchair Sports: A Qualitative Study, Audrey Lynn Miller

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose for this phenomenological design qualitative analysis was to gain an understanding of the perspectives of seated athletes’ motivation for participation in adapted athletics and argues that there is a component of seating that affects motivation. Occupational therapists build client interventions using meaningful occupations. This study aimed to increase awareness of adapted athletics impact on occupational performance. There was a gap in the literature for qualitative research exploring the lens of adapted sports participation through the perspective of seated athletes. This study utilized one-time individual semi-structured interviews with five participants that currently participate on a wheelchair court sports team …

Feasibility Of An Occupation-Based Intervention Manual For Outpatient Hand Clinics, Mia Moralez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose

The purpose of this quality improvement study was to determine the usefulness of an Occupation-based Intervention Manual (OBI) for hand therapists in Southern Nevada and if the utilization of the OBI manual supported client-centered outcomes regardless of diagnosis, age, or population.

Methods

Convenience sampling was used, and five participants met the inclusion criteria in the twelve-week study. Pre-interview questionnaire responses from the therapists were used to develop the OBI manual content and corresponding Utilization Tracker. Post-interview questionnaire responses were used to determine the application and outcomes of the OBI manual. Descriptive statistics, frequency distribution, and thematic analysis were used …

Effectiveness Of An Occupational Therapy-Focused Stroke Transitional Care Program In An Inpatient Rehabilitation Facility, Danniel Tapat

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: As a global health issue, stroke is one of the most common causes of disability for individuals around the world. The American Heart Association (2024) mentions that stroke is the fifth-highest cause of mortality and the top cause of disability in the United States. Objective: This project aimed to assess the change in the perceived readiness of individuals after implementing an occupational therapy (OT)-focused transitional care program for patients with stroke and their caregivers before returning home. Methods: The recruitment process for participants involved purposive sampling methods. The study utilized both the Readiness for Hospital Discharge Scale-Short Form (RHDS-SF) …

Mixed Methods Approach To Assess ‘Placental Opioid-Enhancing Factor’ Activity Within ‘Alternative’ Health Contexts Of Human Maternal Placentophagy, Jacob C. White

UNLV Theses, Dissertations, Professional Papers, and Capstones

Rats with elevated opioid levels experience an even greater increase in pain threshold after placenta or amniotic fluid consumption via placental opioid-enhancing factor (POEF) in the afterbirth. POEF only enhances opioid hypoalgesia; it cannot produce hypoalgesia alone. Although the POEF molecule remains unidentified and its efficacy in humans is unknown, it could be a safe, novel pain treatment. People who consume placenta as an alternative postpartum health practice are ideal for testing POEF bioactivity. Though rat models show that bioactive POEF is highly sensitive, some forms of the practice in humans may conserve POEF.

This project is the first attempt …

An Educational Toolkit For Addressing Women’S Sexual Health And Activity: Preparation For Occupational Therapists, Brittan Wright

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite being an activity of daily living within the scope of Occupational Therapy, issues and concerns related to sexual health are infrequently addressed within practice. This gap is especially prevalent as it relates to women's sexual health and sexual activity specifically. This capstone project evaluated Occupational Therapists' level of knowledge and comfort when discussing sexual activity and women's sexual health. It measured the effectiveness of creating an online educational toolkit to increase knowledge and confidence. The project used a quality improvement approach with pre-and post-test surveys to determine the effectiveness of the educational toolkit to enhance knowledge and confidence in …

Health Literacy And Cervical Cancer Prevention Behaviors Among Hispanic Women In Idaho, Delmy Flores

Boise State University Theses and Dissertations

Purpose

Explore relationships between health literacy, culture, accessibility and utilization of health care services, patient/provider communication, and “self-care” factors that influence cervical cancer prevention behaviors (i.e., HPV vaccination and screening) among Hispanic women between 40-65 years old living in Idaho. These factors were explored in relation to how participants obtained, processed, and understood information about cervical cancer and its prevention. Understanding these factors and potential relationships to health literacy is pivotal for tailoring effective communication strategies and interventions within this specific demographic.

Methods

Recruited (n=15) Hispanic women living in Idaho, between 40-65 years old, to participate in a semi-structured qualitative …

Utilizing Spatial Transcriptomics To Compare Gene Expression In Volumetric Muscle Loss Injury Recovery, Colton Gattis

Biomedical Engineering Undergraduate Honors Theses

Volumetric Muscle Loss (VML) injuries are known to disrupt the normal regenerative process via fibrosis leading to an extensive permanent loss of muscle function. The specific causation of this disruption remains to be defined; however, with new developments in transcriptomics, genetic trends can be identified across regions of tissue over time. This study follows VML injuries within the tibialis anterior of a mouse model for fifteen days after initial injury to attempt to identify expected transitions in healing. Genetic presence began to become more diversified as recovery progressed from four to fifteen days post injury with spatial clusters becoming globalized …

The Impact Of 16 Weeks Of Protein And Omega-3 Fatty Acid Supplementation On Appetite Regulation In Postmenopausal Women., Annjeanette Coambes

Biological Sciences Undergraduate Honors Theses

With life expectancy continuing to increase and menopause typically occurring at age 51, women now spend a significant portion of their lifespan in the postmenopausal stage, facing increased health risks such as obesity, diabetes, cardiovascular disease, osteoporosis, and cancer. Estradiol, which postmenopausal women show deficiency in, has been shown to be associated with appetite- related peptide hormones cholecystokinin (CCK), leptin, glucagon-like peptide 1 (GLP-1), and peptide tyrosine-tyrosine (PYY). This study aimed to investigate the effects of protein and omega- 3 fatty acid (O3FA) supplementation on appetite hormones, energy intake (kcal/day), and BMI (kg/m!) in postmenopausal women over a 16-week supplementation …

Representation Learning For Generative Models With Applications To Healthcare, Astronautics, And Aviation, Van Minh Nguyen

Theses and Dissertations

This dissertation explores applications of representation learning and generative models to challenges in healthcare, astronautics, and aviation.

The first part investigates the use of Generative Adversarial Networks (GANs) to synthesize realistic electronic health record (EHR) data. An initial attempt at training a GAN on the MIMIC-IV dataset encountered stability and convergence issues, motivating a deeper study of 1-Lipschitz regularization techniques for Auxiliary Classifier GANs (AC-GANs). An extensive ablation study on the CIFAR-10 dataset found that Spectral Normalization is key for AC-GAN stability and performance, while Weight Clipping fails to converge without Spectral Normalization. Analysis of the training dynamics provided further …

Incentive-Based And Media Literacy-Informed Approaches To Improve Vaping Cessation Among Young Adults: A Pilot Study Protocol, Troy B. Puga Jr

Capstone Experience: Master of Public Health

Introduction: Youth and young adult vaping is rapidly rising within the United States, and is approaching epidemic levels. Vaping has been marketed as a safe alternative to smoking, however, there has been clear negative health effects of vaping. Modern day vaping interventions targeting this population remain limited. With the rapid rise of vaping and the negative health effects, tested interventions are needed. This protocol research paper defines the background and methodology behind the registered clinical trial entitled Incentive-based and media literacy-informed approaches to improve vaping cessation among young adult: a pilot study protocol.

Methods: This protocol research paper will describe …

Physician Burnout In The United States: A Systematic Review Of Organizational And Systemic Approaches And Their Efficacies, 2014-2024, Nicole Butler

Capstone Experience: Master of Public Health

Physician burnout represents a critical public and clinical health concern in the United States. It compromises patient care and physician safety. Approaches to solve the issue are pervasive, with limited indication of effectiveness. Due to the essential job functions of physicians, the practice of medicine is inherently stressful. However, the introduction of new, more complex stressors, including those exacerbated by the COVID-19 pandemic, and the increase in chronic healthcare conditions have made burnout an unfortunate staple of physician life, with an estimated prevalence of up to 60%. Burnout involves three factors: emotional stress, depersonalization, and reduced job satisfaction. The consequences …

Development Of A National Core Indicators Dashboard Of Long-Term Services And Supports Outcomes For Individuals With Intellectual And Developmental Disabilities, Rhonda Haitz

Capstone Experience: Master of Public Health

The National Core Indicators (NCI) surveys are conducted annually across the United States, including Nebraska. Individuals with intellectual and developmental disabilities and/or their guardians are surveyed to learn more about their experiences and the quality of their services and lives (National Core Indicators- IDD, 2023). However, the data is only useful when understood and applied to make informed decisions to improve the lives of those with intellectual and developmental disabilities (McDonald et al., 2013). This project designed and developed two data dashboards for the state of Nebraska that publicly track, analyze and display the NCI survey results. The In-Person Survey …

Disparities In Seasonal Influenza Immunization Between Hispanic And Non-Hispanic White Populations Within The United States: Findings From The 2022 Behavioral Risk Factor Surveillance System, Susanna Stageberg

Capstone Experience: Master of Public Health

Objective: To determine if inequities in influenza immunization exist between Hispanic and non-Hispanic White populations living in the United States.

Methods: Statistical analyses were executed to study the association between ethnicity and influenza immunization. Logistic regression was performed to determine probabilities related to vaccination. Data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) was utilized.

Results: Hispanic respondents had higher odds of not being vaccinated against the flu when compared to non-Hispanic White respondents (COR = 1.82, 95% CI [1.73, 1.91]). Ethnicity, household income, education, insurance status, age, sex, preferred language, and primary care provider status …

Hiv Testing Among High-Risk Individuals In The Us: 2022 Brfss, Alissa Lorchick

Capstone Experience: Master of Public Health

Objective

Human Immunodeficiency Virus (HIV) infection is a global epidemic, and public health efforts are moderately effective to date. This cross-sectional study aimed to determine association between high-risk behavior (intravenous drug use, risky sexual behaviors) and odds of testing for HIV utilizing 2022 Behavioral Risk Factor Surveillance System (N= 445,132).

Methods

Using SAS 3.82, the age-stratified logistic regression model for exposure (high-risk behavior) and outcome (HIV testing) included covariates gender, race, income, mental health and checkup frequency.

Results

High-risk individuals had greater odds of testing compared to low-risk individuals (crude POR 2.98 [2.81 – 3.17]), with greatest odds observed among …

Examining The Association Between Smoking Frequency And Long Covid: A Brfss Study, Bhavya Patel

Capstone Experience: Master of Public Health

Objectives: To examine the relationship between self-reported smoking frequency and the presence of Long COVID among individuals who tested positive for COVID-19.

Methods: A cross-sectional study was conducted using a sample of 44,738 COVID-positive participants from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) dataset. Logistic regression was utilised to compute prevalence odds ratios (pOR) and was adjusted for potential sociodemographic confounders.

Results: Individuals who smoked daily were found to have a greater likelihood of reporting Long COVID in comparison with nonsmokers (Crude pOR=1.22; CI= [1.10-1.35]). However, in the adjusted regression model, daily smoking was no longer significant (Adjusted pOR=1.04; …

Cervical Cancer Screening And Affordability Of Medical Care: A Cross-Sectional Study, Sarah M. Johnson

Capstone Experience: Master of Public Health

Objective: To determine if, among women aged 21-65, there is a positive association between avoiding healthcare due to cost and not being up to date on cervical cancer screening.

Methods: This cross-sectional study utilized the 2022 Behavioral Risk Factor Surveillance System dataset. A total of 123,275 women, aged 18-69 without a hysterectomy, were analyzed with bivariate and multivariate analyses. The outcome was length of time since last cervical cancer screening. The exposure was avoiding healthcare in the last 12 months due to cost.

Results: Women who avoided healthcare due to cost had higher odds of not being up to date …

Heartache Beyond The Physical: Unraveling The Nexus Between Myocardial Infarction History And Depressive Disorders In Us Adults, Sonika Khanal

Capstone Experience: Master of Public Health

Objective: To estimate the prevalence of depressive disorders among US adults and explore the association between a history of Myocardial Infarction (MI) and depressive disorders, considering potential risk factors and demographic variables.

Methods: A cross-sectional study was conducted from 2022 Behavioral Risk Factor Surveillance System data, including 390,429 US adults. Logistic regression was used to estimate the association between the history of MI and depressive disorders, adjusting for age, gender, race, smoking status, health insurance, education level, and BMI. Effect modification by age was assessed.

Results: The prevalence of depressive disorders was 21.19%, with 4.46% reporting a …

A Literature Review Of Societal Obesity And Its Impact On United States Military Recruitment, Megan Thibodeaux

Capstone Experience: Master of Public Health

In recent decades, obesity rates have increased in the United States, raising significant health and societal concerns, especially in terms of military readiness. The ever-rising rates of weight-related health obstacles present a critical national security issue as it impacts the effectiveness of recruitment. This literature review aims to analyze how obesity impacts military recruitment and readiness to serve while utilizing the socio-ecological model to help determine gaps in evidence. Data was drawn from Embase, PubMed, and PsychInfo. Inclusion criteria consisted of academic journals and reports from government and non-profit organizations written in English. They focused only on the United States …

Pain Management In Individuals With Flat Feet Using The Footcore Max, Avery G. Dilley

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: Foot pain can significantly affect one’s quality of life and ability to perform activities of daily living. Current interventions for foot pathologies are often directed at externally supporting the foot, rather than training the small, intrinsic muscles to function as they are intended to. The FootCore MAX is an exercise device designed to strengthen and promote better activation of the intrinsic muscles of the foot in order to improve foot function.

Purpose: The purpose of this study was to determine the effectiveness of intrinsic foot strengthening exercises using the FootCore MAX on alleviating foot pain. It hypothesized that the …

Examining Young Adult E-Cigarette Users By Device Type: A Latent Class Analysis, Mufazzela Tabassum

Health, Human Performance and Recreation Undergraduate Honors Theses

Examining Young Adult E-Cigarette Users by Device Type: A Latent Class Analysis

Purpose. This study examined which factors influence the type(s) of e-cigarette devices someone uses and if there are heterogeneous groups of young adult e-cigarette users.

Methods. This study first quantitatively explored if there are heterogeneous groups of e-cigarette users by utilizing data from an online cross-sectional survey. E-cigarette users (n = 595) were able to participate in the survey if they were 18-29 years of age, used an e-cigarette for 1-5 days in the past 30 days, own their own e-cigarette, and live in the United States. Participants …

Providers As Patients: The Healthcare Provider Experience Of Infertility In Tennessee, Michelle M. Clayton

Theses and Dissertations (ETD)

While the effect of age and stress on fertility is widely known, those wishing to conceive children after career attainment or lengthy training programs are not adequately prepared with the knowledge or tools to mitigate the effects of these factors. Physicians and nurses, though trained to provide healthcare to others, are not immune to this struggle. In part due to the high prevalence of infertility in the United States (US), the lack of uniform policies to support this population, and the higher rates of infertility experienced by those in the healthcare field when compared to the general population, research focused …

Examining The Shared Decision-Making Preferences Of Adult Black Men With Hypertension In The U.S. Mid-South Region: A Mixed Methods Approach, Samantha Faith Calhoun

Theses and Dissertations (ETD)

Purpose. This study aimed to explore what factors are related to Black men’s shared decision-making (SDM) preferences for selecting hypertension (HTN) treatment and management options with a healthcare clinician. Methods. Researchers employed an exploratory sequential mixed methods design to explore factors influencing Black adult men's preferences for involvement in SDM regarding HTN treatment. Qualitative interviews with N=16 Black men identified factors related to SDM involvement, while a quantitative phase with N=105 Black men examined factors that could predict the level of involvement in SDM for HTN treatment. Results. Trust and having a female clinician were a significant independent predictor of …

Regulation Of Piezo Channels By Membrane Lipids, Luis Octavio Romero Garcia

Theses and Dissertations (ETD)

In cellular physiology, the transformation of energy from mechanical cues into electrical and/or chemical signals is called mechanotransduction. This ability to sense and react to external and internal mechanical forces is essential for the survival of single cell to multicellular organisms. As such, it is no surprise that mechanotransduction appeared early in the evolutionary history of life on our planet. At the cellular level, mechanotransduction is mediated by proteins and/or protein complexes that respond to mechanical stimuli in different timescales, including but not limited to changes in membrane electric potential, Ca2+ signaling, and gene expression. Among such protein complexes, mechanosensitive …

Loss Of The Sac Components Slda Kinase Or Sldb Or In Vitro Adaptation To Triazole Produces Aneuploidy Associated With Triazole Heteroresistance In Aspergillus Fumigatus, Ashley Nywening

Theses and Dissertations (ETD)

The opportunistic pathogen Aspergillus fumigatus represents the chief causative agent of human and animal invasive filamentous fungal infections. Triazoles, the primary therapeutic options to combat invasive aspergillosis (IA), target the fungal biosynthesis of ergosterol, a vital component of the fungal cell membrane. Unfortunately, resistance to this class of medical therapeutic has arisen globally and now threatens the future usefulness of these compounds for antifungal treatment. Infection with A. fumigatus that has acquired triazole resistance increases an already high associated mortality rate and reduces the limited arsenal of therapeutic options to combat IA. Moreover, how this specific fungal pathogen obtains resistance …