Medicine and Health Sciences Commons^™

Firefighter Fitness-For-Duty Medical Screening: A Peer Review Quality Improvement Pilot, Julie Collings Rochefort

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the overwhelming evidence that sudden cardiac death is the most frequent cause of firefighter fatalities, many fire departments do not have a program to measure or maintain basic firefighter fitness and health. This project evaluated and compared medical screening outcomes of four industrial fire brigades within a multinational oil and gas corporation and introduced a quality improvement plan. The goal of this project was to apply the evidence and measure outcomes to determine the most effective way to ensure that firefighters in a corporate setting are healthy. This was accomplished by utilizing established guidelines in developing an educational program …

Implementing A Bystander Awareness Program On A University Campus, Robert Joseph Vadovic

UNLV Theses, Dissertations, Professional Papers, and Capstones

Between 17% and 62% of college students experience some form of violence during their time at school. About 25% of female college students experience a sexual assault before graduating. One university had seen an increase in violence, including assaults and bias events. Administrators and nurses implemented a bystander awareness program to help alleviate this growing problem. Members of the college's residence life staff and its Greek organizations (fraternities and sororities) participated in the Step Up program, a prosocial training program to get people to intervene safely when witnessing acts of violence. Participants (N=236) completed surveys prior to the program, immediately …

Sickle Cell Disease: A Quality Improvement Initiative For Emergency Department Providers, Pretrescia Marie Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sickle Cell Disease (SCD) is an incurable, chronic condition that results in a constellation of disorders, frequent emergency department (ED) visits, and repeated hospital admissions. Those affected often suffer from pain crisis, infection, acute chest syndrome, stroke, and multi-organ impairment and frequently do not receive adequate pain management during acute pain episodes because ED providers view them as drug seeking. The majority of patients with SCD are African-American and may be low income, uninsured, or on Medicaid. As a result, these demographics make ED under-treatment of pain in patients with SCD a health equity issue. This was a pre-experimental one …

Evaluating The Efficacy Of A Hybrid Nutrition Course Offered To On-Campus And Distance Education Students, Mary Anne Dimmick

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

A record high number of students enrolled in The Science and Application of Human Nutrition (NDFS 1020), during the Spring semester of 2010. With enrollment rates projected to continue to rise, NDFS 1020 faculty recognized that the existing traditional, lecture-based course structure did not allow for further growth of the program if academic integrity was to be upheld. NDFS 1020 was, consequently, transitioned to a hybrid format presenting 2/3 of the course experience online, and the remaining 1/3 in a face-to-face format. Hybrid NDFS 1020 was offered to distance education and on-campus students alike beginning in the Fall semester of …

Completely Steroid-Free Immunosuppression In Liver Transplantation: A Randomized Study., Carlo B. Ramirez, Md, Cataldo Doria, Md, Phd, Adam M. Frank, Md, Stephen T. Armenti, Ignazio R. Marino, Md

Department of Surgery Faculty Papers

INTRODUCTION: Corticosteroids (CS) have been standard immunosuppression to prevent and treat rejection. However, CS are associated with increased risk of infection, obesity, hypertension, hyperlipidemia, diabetes, and accelerated hepatitis C virus (HCV) recurrence post-orthotopic liver transplantation (OLT). This study assesses the safety and efficacy of CS-free immunosuppressive regimen in adult OLT.

METHODS: A two-yr, prospective, randomized study of CS with delayed withdrawal (CS) or CS-free regimen with basiliximab, tacrolimus, and enteric-coated mycophenolate sodium (EC-MPS) was performed in 39 patients (CS=20; CS-free=19). CS group received intra-operative methylprednisolone weaned by six months. HCV patients had HCV PCR pre-OLT and 0.5, one, three, and …

Distribution, Prevalence, And Genetic Analysis Of Panulirus Argus Virus 1 (Pav1) From The Caribbean Sea, Jessica Moss, Donald C. Behringer Jr., Jeffrey D. Shields, Antonio Baeza, Alfonso Aguilar-Perera, Phillippe G. Bush, Clement Dromer, Alejandro Herrera-Moreno, Lester Gittens, Thomas R. Matthews, Michael R. Mccord, Michelle T. Schärer, Lionel Reynal, Nathanial Truelove, Mark J. Butler Iv

Biological Sciences Faculty Publications

The pathogenic virus Panulirus argus virus 1 (PaV1) was first discovered in Caribbean spiny lobsters Panulirus argus from the Florida Keys (USA) in 1999 and has since been reported in Belize, Mexico, and Cuba; its distribution in the wider Caribbean is unknown. We collected tissue samples from adult spiny lobsters from 30 locations in 14 countries bordering the Caribbean Sea and used molecular diagnostics to assay for the presence of PaV1. PaV1 occurred primarily in the northern areas of the Caribbean, where its prevalence was highest. The virus was not found in lobsters from the southeastern Caribbean, and its prevalence …

Nursing Students’ Cultural Immersion In Kenya: A Case For A Clinical Capstone Site, Nancy C. Wilk

Nursing Faculty/Staff Publications

Awareness of cultural concepts is an important component of nursing education and cultural immersion experiences are invaluable in fostering understanding of them. These types of experiences take students out of their comfort zone and challenge them both personally and professionally.

For several years, students on all levels have been participating in a 10-day trip to Kenya led by nursing faculty. Undergraduate students who go on the trip receive clinical credit for their community health course and are required to journal daily about their experiences while on the trip and write a reflection paper for the course when they return. The …

Myelin Is Not Required For Maintenance Of The Axon Initial Segment, Anna Josephson

Theses and Dissertations

Axonal pathology is a major contributor to impaired motor, sensory and cognitive dysfunction associated with multiple sclerosis particularly with the progressive forms of the disease. However, the early pathologic events responsible for axonal deterioration remain unclear. It is well recognized that maintaining proper axonal function is intimately related to proper establishment and maintenance of axonal domains such as the node of Ranvier and the axon initial segment (AIS). Numerous laboratories, including ours, have investigated the mechanisms that regulate node of Ranvier formation and maintenance. These studies have shown that node of Ranvier formation and maintenance require myelin contact. Interestingly, many …

Assessment Of 17beta-Estradiol Removal From Wastewater Via Abiotic And Biotic Routes And Potential Effects On Food Chain Pathways, Lance Beecher

All Dissertations

Estrone, 17beta-estradiol (E2), and estriol are three of the most relevant natural hormones and are often found to contaminate the environment. When emanating from endogenous sources, these three compounds are not toxic or of concern; however, when estrogens are released into the environment from wastewater effluent they become a concern. The overall goal of the project was to evaluate abiotic and biotic techniques for removal of E2 and to quantify survival and reproduction impacts on an algal species and on an invertebrate species. We accomplished this goal by: 1) quantifying E2 sorption rates to crushed brick, an industrial mineral aggregate …

Mobile Personal Health System For Ambulatory Blood Pressure Monitoring, Luis J. Mena, Vanessa G. Felix, Rodolfo Ostos, Jesus A. Gonzalez, Armando Cervantes, Armando Ochoa, Carlos Ruiz, Roberto Ramos, Gladys E. Maestre

School of Medicine Publications

The ARVmobile v1.0 is a multiplatform mobile personal health monitor (PHM) application for ambulatory blood pressure (ABP) monitoring that has the potential to aid in the acquisition and analysis of detailed profile of ABP and heart rate (HR), improve the early detection and intervention of hypertension, and detect potential abnormal BP and HR levels for timely medical feedback. The PHM system consisted of ABP sensor to detect BP and HR signals and smartphone as receiver to collect the transmitted digital data and process them to provide immediate personalized information to the user. Android and Blackberry platforms were developed to detect …

Activation And Suppression Of The Innate Immune System: Effects On Alcohol Intake, Marjorie Levinstein

Seton Hall University Dissertations and Theses (ETDs)

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Learning Styles, Critical Thinking Aptitudes, And Immersion Learning In Physician Assistant Students, Nora Lowy

Seton Hall University Dissertations and Theses (ETDs)

The changes in healthcare delivery systems and the global burden of disease along with the overwhelming corpus of new knowledge call for a re-evaluation of the educational process of health profession programs. The focus on how best to optimize the learning process necessitates an acknowledgement of the roles of learning styles and critical thinking aptitudes. It also requires attention to the learning experiences and how these, in turn, affect development of both the styles and aptitudes. A sample of 137 Physician Assistant students was recruited to complete a learning style inventory, the Gregorc Style Delineator, and a critical thinking aptitude …

Design And Implementation Of Wireless Point-Of-Care Health Monitoring Systems: Diagnosis For Sleep Disorders And Cardiovascular Diseases, Se Chang Oh

Graduate Theses and Dissertations

Chronic sleep disorders are present in 40 million people in the United States. More than 25 million people remain undiagnosed and untreated, which accounts for over $22 billion in unnecessary healthcare costs. In addition, another major chronic disease is the heart diseases which cause 23.8% of the deaths in the United States. Thus, there is a need for a low cost, reliable, and ubiquitous patient monitoring system. A remote point-of-care system can satisfy this need by providing real time monitoring of the patient's health condition at remote places. However, the currently available POC systems have some drawbacks; the fixed number …

Development Of A Predictive Modeling System For Validation Of The Cumulative Mirobial Inactivation Of The Salmonellae In Pepperoni Utilizing A Non-Pathogenic Surrogate Microorganism (Enterococcus Faecalis), Scott Donald Stillwell

Graduate Theses and Dissertations

Salmonellosis is the most frequently occurring bacterial foodborne illness in the United States and the human case rate has not improved for the past two decades. The federal agency responsible for oversight of meat and poultry processors has announced the intent to extend existing pathogen reduction performance standards for Salmonella spp. to cover all classes of products including fermented sausages that are currently produced under HACCP plans that are validated for control of Escherichia coli O157:H7. The proposed regulatory modifications will require processors to revalidate HACCP plan controls to achieve either a 6.5 or a 7.0 log10 inactivation of the …

Heavily Thickened Pericardium With Constrictive Pericarditis., Abid Laghari, Javed Tai

Department of Medicine

A middle-aged male presented with symptoms of exertional shortness of breath and leg swelling for the past six months. Examination revealed raised jugular venous pressure (JVP), pitting pedal oedema, muffled heart sounds, bilateral pleural effusion and hepatomegaly. Echocardiogram showed features of constrictive pericarditis with heavily thickened pericardium, which was confirmed by cardiac computed tomography (CT). The patient underwent pericardiectomy following which echocardiographic features of constriction were reversed and the patient became asymptomatic.

Spontaneous Coronary Artery Dissection: A Rare Cause Of Acute Coronary Syndrome., Abid Laghari, Aamir Hameed, K. Kazmi

Department of Medicine

We present a case of a 71-year-old man, with a history of hypertension and dyslipidaemia, who presented with typical cardiac chest pain and palpitations of 2 h duration. The examination revealed irregular pulse of 138 bpm, blood pressure 115/75 mm Hg, variable first and normal second heart sounds. The lungs were clear to auscultation. The ECG showed atrial fibrillation with a rapid ventricular rate. His heart rate was controlled with β blockers and the acute coronary syndrome treatment protocol was initiated. His baseline blood reports were within normal limits and two serial troponin I tests were negative. Coronary angiogram showed …

My Patient Has Intracranial Stenosis, Does He Need An Intracerebral Stent? Results Of The Sammpris Study., Muhammad Faisal Wadiwala,, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Bronchial Thermoplasty In The Endoscopy Unit Reducing Smooth Muscle Hypertrophy Asthmatic, Marie Porter Rn, Bsn, Cgrn

Patient Care Services / Nursing

No abstract provided.

Conference Learnings, Kimberly Bartman Rn, Bsn, Cvn

Patient Care Services / Nursing

No abstract provided.

Spanning The Bridge To Patient Safety Through Medication Bar Code Scanning In The Emergency Department (Ed) Setting, Susan Teti Bsn, Rn

Patient Care Services / Nursing

No abstract provided.

Delay And Probability Discounting Functions Of Adults With Attention-Deficit/Hyperactivity Disorder (Adhd), Gretchen Scheidel

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Impulsivity and risk-taking behaviors, concerns that are common for individuals with ADHD, can be measured using computerized tasks called delay and probability discounting measures. These measures can look at differences between individuals with ADHD and peers who do not have ADHD to determine how similar or different they are regarding these concerns. Individuals with ADHD often take stimulant medications, such as Ritalin or Adderall, to help reduce their impulsivity, hyperactivity, and risk-taking behaviors. The present study examined impulsivity and risk-taking for adults with ADHD while taking their stimulant medication and while not taking it, as well as comparing them to …

Medical Errors Related To Look-Alike And Sound-Alike Drugs, Samina Ismail,, Arshad Taqi

Department of Anaesthesia

Despite recent developments in the inventory management, introduction of electronic drug trolleys and cabinets, color coding of the filled syringes and many more interventions, medication errors could not be eliminated. The most common of these are syringe swap and human errors regarding wrong drug administration due to look-alike drug containers or sound-alike names of the drugs belonging to diverse groups. Many of the fatalities, that occur in third world countries due to these causes, go unnoticed and unregistered. This special article complements two special editorials on the same topic by Professor Joseph D. Tobias et al and Professor Robert Stoelting, …

Reliability And Validity Of The Ne1 Wound Assessment Tool (Wat), Stephanie Coon, Faustina Tran, Melinda Vicencio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Current literature indicates a lack of reliability and validity of existing pressure ulcer (PrU) staging systems. This prompted the development of the N.E. One Can Stage (NEOCS). Recently this tool was modified and renamed, the NE1 Wound Assessment Tool (NE1 WAT). The purpose of this study is to test the reliability and validity of the NE1 WAT.

Subjects:

A sample of convenience of nine physical therapists (PTs) and 11 nurses (RNs) with PrU staging as part of their routine work duties were included in this study.

Methods:

A written exam was administered and consisted of assessment questions …

Using Over-The-Counter Ear Filters As A Treatment To Improve Dizziness And Balance In Patients Diagnosed With A Traumatic Brain, Brandy Sue Whitney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: People diagnosed with a Traumatic Brain Injury (TBI) usually have physical, cognitive, emotional, and sleep deficits. Sensory overload is a common symptom of TBI. One treatment prescribed for sensory overload is over the counter ear filters. Ear filters have shown to decrease sensory input. Could the ear filters have an effect on balance and dizziness without much cost to the patient or the clinic?

Subjects: Patients diagnosed with a mild or moderate brain injury, ages of 18-65 years old. They needed to be medically stable, potential to walk, and have complaints of dizziness and/or balance problems.

Methods: …

Alpcs(2a)-Mediated Photochemical Internalization Of Bleomycin And Concurrent Hyperthermia Of Multicellular Tumor Spheroids, Aaron Andersen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Treatments for glioblastoma multiforme and invasive ductal carcinoma involve surgical resection and adjuvant or concurrent targeted therapies. The goal of the secondary treatment is to reduce the cancer cells in the resection margin and other areas of suspected involvement. Photochemical internalization is a targeted therapy using light to activate photosensitizers embedded in cellular structures to improve the delivery of macromolecules within the cell.

In a previous study, optimized treatment parameters including radiant exposure, and irradiance, concentration of AlPcS(2a), temperature, and the concentration of bleomycin were determined for human ACBT glioma multicell spheroids. The current study investigates the effectiveness of the …

An Examination Of Walkability In The Las Vegas Metropolitan Area, Courtney Coughenour

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The benefits to regular physical activity are well established. Walkability is one element of the built environment that has been correlated with increased levels of physical activity. The auto-centric design of Las Vegas Metropolitan area (LVMA) is unique in ways that may influence walkability. The purpose of this study was to determine which urban design characteristics are associated with walking and physical activity in moderate income neighborhoods in LVMA. Methods: The standard walkability measure developed by Frank et al. (2010) was used to calculate the walkability index of seven neighborhoods. Residents of the two most walkable and two least …

The Presence Of Methicillin Resistant Staphylococcus Aureus (Mrsa) On Environmental Surfaces In Healthcare Facilities Pre- And Post-Cleaning, Aaron Thomas Hunt

UNLV Theses, Dissertations, Professional Papers, and Capstones

The emergence of antibiotic resistant bacteria is a serious public health issue affecting millions of people. Methicillin-resistant Staphylococcus aureus(MRSA) is a leading cause of healthcare acquired infections today. Research has shown that patients infected or colonized with MRSA shed the bacteria into the environment, where the bacteria can survive for long periods of time and become potential sources of infection. Currently, infection prevention efforts focus on active surveillance, hand hygiene, personal protective equipment use and antimicrobial stewardship, with less attention given to environmental cleaning. Nevertheless, environmental cleaning is essential to remove infectious agents from environmental surfaces and prevent transmission. The …

Comparison Of Study/Article Characteristics And Methodological Quality Of International Nurse Workplace Violence Research Published Before And After The Joint Commission Sentinel Event Alert On Disruptive Behaviors, Terressa Margarette Stowell Love

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The majority of new nurses experience workplace violence from other nurses. The purpose of this study was to compare study/research characteristics and methodological quality of international nurse workplace violence research published before and after the 2008 release of the U.S. The Joint Commission (TJC) sentinel event alert on disruptive behaviors.

Methods: Thirty-nine quantitative nurse workplace violence research articles published between 2001 and 2012 were assessed and divided into two groups: articles published (a) before the 2008 TJC sentinel event alert or the same year, i.e., 2001-2008 (BTJC) and (b) after the 2008 TJC sentinel event alert, i.e., 2009-2012 (ATJC). …

Evaluating Shared Governance For Nursing Excellence, Evette Michelle Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The national challenges of nursing shortages, decreased staffing levels, and increased patient acuities have contributed to nurse's increased workload and job dissatisfaction. Nurses have become frustrated with the professional practice environment. The inability to make decisions about issues that affect their nursing practice and the care provided to their patients results in nurses leaving the work environment in search of higher job satisfaction. Employers are becoming more creative in their strategies to improve the work environment and retain nurses within their organizations. Healthcare leaders have implemented management strategies such as shared governance models. These models focus on providing a satisfying …

Listeria Monocytogenes Cholecystitis: A Possible New Syndrome., Jackrapong Bruminhent, Timothy K Lynch, Jonathan Gefen, Jerome Santoro

Division of Internal Medicine Faculty Papers & Presentations

: The U.S. Food and Drug Administration recently added potentially fatal Listeria monocytogenes infection to the list of opportunistic infections that can occur in patients who receive tumor necrosis factor inhibitor therapy. In this study, the first reported case of L monocytogenes cholecystitis associated with etanercept use is described. It also appears that tumor necrosis factor inhibitor therapy likely increases the risk for Listeria cholecystitis. Clinicians need to be aware of this association when selecting antimicrobial therapy for these patients.