Medicine and Health Sciences Commons^™

Implementation Of The Obesity Prevention And Management (Opm) Guideline To Increase Recognition And Treatment Of Childhood Overweight And Obesity In An Urgent Care Setting, Krystle Denise Apodaca

UNLV Theses, Dissertations, Professional Papers, and Capstones

Childhood obesity carries multiple significant and costly health associated risk factors. Obese children have a higher risk of cardiovascular disease, diabetes, sleep apnea, bone and joint problems, as well as self-esteem issues. Childhood overweight and obesity are associated with $14.1 billion in healthcare utilization each year. New Mexico (NM) has experienced significant increase in overweight and obesity with associated chronic illnesses over the past 15 years. Addressing the public health crisis of childhood overweight and obesity requires an innovative and broad approach beyond primary care and health policy changes. Urgent care settings are highly accessed by pediatric patients. To address …

The National Diabetes Prevention Program An Intervention For Diabetes Risk Reduction, Kavita Batra

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes mellitus is among the most frequently occurring chronic conditions, affecting 28 million adults in the Nation. The Nevada diabetes prevalence rate is approaching the National average, with 1 out of 4 diabetic patients experiencing serious clinical complications. Diabetes is typically preceded by a preventable condition classified as prediabetes, in which the blood sugar level exceeds the normal level, yet not enough to be classified as Type 2 diabetes. Prediabetes increases the risk of developing diabetes within 10 years, if not effectively managed. In an attempt to help reduce this risk, the CDC recently introduced an evidence-based intervention, the National …

The Radionuclide Concentration In Dust Collected At The Nellis Dunes Recreational Area, Mathew John Bensen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dust Samples were collected from three different location at the Nellis Dunes Recreation Area, each being of a different soil type. These samples were sieved to different particles sizes and then analyzed using a high-purity germanium gamma well detector. The isotopes found in each sample were: Pb-214, Th-231, Pb-212, Cs-137, and K-40. The activities for these isotopes ranged from: 8.36 * 10-7 µCi/g to 3.11 * 10 -6 μCi/g, 2.53 * 10-7 µCi/g to 9.98 * 10-7 µCi/g, 2.17 * 10-7 µCi/g to 2.51 * 10-7 µCi/g, 7.41 * 10-8 µCi/g to 4.22 * 10-7 µCi/g, and 7.38 * 10-6 …

Standardization Of Military Rapid Response Teams, Kristine Patricia Broger

UNLV Theses, Dissertations, Professional Papers, and Capstones

The healthcare industry is continuously challenged to improve patient outcomes while remaining focused on cost-containment and patient safety. The National Patient Safety goals (2009) provide healthcare organizations with performance standards aimed at reducing morbidity and mortality rates. Rapid response teams (RRT) are one of the initiatives intended to decrease cardiopulmonary arrests outside the Intensive Care Unit (ICU), decrease unplanned admission into the ICU, and decrease mortality rates.

The last twelve years at war has created a high deployment rate for military medical personal. Each year military hospitals lose an average of eight to ten providers to support the War of …

The Development Of Sexual Attitudes In The Family Of Origin And Sexual Satisfaction Later In Life, Bryant Christlieb

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if variance for individuals’ sexual satisfaction as well as attitudes toward sexual instrumentality, sexual permissiveness, sexual communion and attitudes could be predicted by family sexual communication during adolescence as well as various demographic factors such as age, years together, gender, race, income level, religion, religiosity and sexual orientation. This was done by recruiting 250 people via Mechanical Turk (www.mturk.com) and through undergraduate courses at the University of Nevada-Las Vegas. The researcher used an enter-method multiple regression model and Kendall’s Tau for non-parametric data. The results of this study show that sexual satisfaction …

Differences In Perceived Importance Of Preventative Services And Healthcare Provider Trust Among Hispanics, Jonathan James Gore

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Hispanic population varies greatly in their risk factors, health outcomes and access to care by country of origin, level of education and language dominance (Vega & Amaro, 1994) (Fiscella, Franks, Doescher, & Saver, 2002b). The differences within the Hispanic population also extend to their knowledge and attitudes toward health choices and maintenance, where they receive their health information, and what they access to meet their health care needs. Subpopulations within the Hispanic community as defined by language dominance and nativity must be understood as separate and distinct so that the health needs of each can be adequately addressed. The …

Cancer Among Asian American Population In The United States: Incidence And Survival Disparities, Hongbin Jin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Part I

Cancer incidence disparities exist among specific Asian American populations. However, the existing reports exclude data from large metropoles like Chicago, Houston, and New York. Moreover, incidence rates by subgroup have been underestimated due to the exclusion of Asians with unknown subgroup. Cancer incidence data for 2009 to 2011 for eight states accounting for 68% of the Asian American population were analyzed. Race for cases with unknown subgroup was imputed using stratified proportion models by sex, age, cancer site, and geographic regions. Age-standardized incidence rates were calculated for 17 cancer sites for the six largest Asian subgroups. Our analysis …

A Qualitative Study Of Job Competencies For Healthcare Social Work Administrators: An Application Of The Short Competency Model Process Used To Identify The Behaviors And Personal Characteristics Of Exemplary Performers, Lashonda Jones-Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Job competencies are central to every organization’ s human resource management system. Competencies can be used to help organizations create high performance cultures, select and hire a workforce, develop leaders, and establish a foundation for training strategies. Social work, as a profession, has developed competency models for many specialized fields of social work. Health is the second most common practice area reported by social workers with a master’ s degree in social work, the predominant social work degree for licensed social workers. In highly structured, rapidly evolving, and complex organizations such as healthcare systems, leaders and managers require distinctively different …

Investigation Of Sequential Intermittent Pneumatic Compression Effect On Run Performance, Max Evan Jones

UNLV Theses, Dissertations, Professional Papers, and Capstones

The main aim of this study was to determine if IPC after a 5000 m run influences maximal effort 1600 m run performance. A secondary purpose was to determine if the level of IPC pressure used influences run performance. Nine subjects (6 male and 3 female were included in the study; 30 years±5.19 years; Height 173.72cm±8.25; Weight; 72.54±9.97 kg). These subjects were recruited to be in this study via word of mouth or social media advertisement in the Las Vegas area. Participant inclusion criteria was 18- 50 year old apparently healthy, had been running a minimum of 20 miles a …

A Study On Automated Process For Extracting White Blood Cellular Data From Microscopic Digital Injured Skeletal Muscle Images, Bibek Karki

UNLV Theses, Dissertations, Professional Papers, and Capstones

Skeletal muscle injury is one of the common injuries caused by high-intensity sports activities, military related works, and natural disasters. In order to discover better therapies, it is important to study muscle regeneration process. Muscle regeneration process tracking is the act of monitoring injured tissue section over time, noting white blood cell behavior and cell-fiber relations. A large number of microscopic images are taken for tracking muscle regeneration process over multiple time instances. Currently, manual approach is widely used to analyze a microscopic image of muscle cross section, which is time consuming, tedious and buggy.

Automation of this research methodology …

Creating A Dynamic, Multi-Purpose Correction For Multiple Geometries And Field Sizes To Account For Off-Axis And Asymmetric Backscatter With Varian Portal Dosimetry, Remy Manigold

UNLV Theses, Dissertations, Professional Papers, and Capstones

Intensity modulated radiation therapy and volumetric modulated arc therapy are increasingly common in radiation therapy due to their benefits of target conformity and normal tissue sparing. Due to the complexities of plan delivery and the precision required, the dose delivered must be accurately measured for quality assurance (QA). One of the most efficient ways to perform patient-specific QA when using clinical linear accelerators (linac) is to use an electronic portal imaging device (EPID). Amorphous silicon (aSi) Electronic Portal Imaging Devices (EPIDs) are attached to the linac and can provide real-time feedback with spatial resolution on the order of sub-millimeter pixel …

Understanding The Preparation And Support Needed For Undergraduate Clinical Faculty, Sara Mcpherson

UNLV Theses, Dissertations, Professional Papers, and Capstones

ABSTRACT

Even as nursing programs attempt to meet public demands for more registered nurses in the workforce, they are challenged with finding qualified clinical faculty to teach them. Many programs have had to turn away otherwise qualified applicants due to lack of faculty. One solution to the shortage of nursing faculty has been to increase the number of part-time clinical faculty. Many clinical faculty hired for part-time positions hold degrees outside of nursing education. Additionally, new, full-time faculty are frequently expected to immediately begin teaching one or more clinical groups. While those new full-time and part-time faculty enter their role …

The Effect Of Attachment Placement And Location On Rotational Control Of Conical Teeth Using Clear Aligner Therapy, Pouya Momtaz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To determine the optimal method to correct rotations of conical teeth using

thermoplastic appliances with and without attachments.

Introduction: Despite the increasing popularity of clear aligner therapy there are still questions as to its effectiveness, efficiency, case selection and limitations. It has been reported that the full prescription for clear aligners is not expressed, and that the mean accuracy of any type of tooth movement using clear aligners is only 41% (Drake, 2012). One of the major limitations of clear aligner therapy is correction of rotated conical teeth, especially canines and premolars (Kravitz, 2008). According to Simon, et al. …

Effectiveness Of Commercially-Available Cosmetic Cleaners On Cosmetics And Cosmetic Brushes, Vanessa Ortiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

The complex nature of skin contributes to the microbial population present on its surface. While normal skin flora is either beneficial or has no effect on the body, there are instances where pathogenic microorganisms are present and can cause infections. Damaged skin is more susceptible to infections from these microbes. Behavioral characteristics, such as the use of cosmetics, can affect the microbial population present on the skin. Staphylococcus aureus is the organism most commonly isolated from cosmetics, and it can be responsible for conjunctivitis, impetigo, boils, and folliculitis.

There are many ways microbial contamination of cosmetics can occur, such as …

Delirium Education Program For Critical Care Nurses: A Mixed Methods Study, Meredith Padilla Padilla

UNLV Theses, Dissertations, Professional Papers, and Capstones

Approximately 10-30% of hospital admissions develop delirium where nearly 30-40% of the delirium cases are preventable. Non-detection rates by acute care healthcare workers were reported at 72-75%. Hence, it is crucial for hospitals to develop delirium education programs focused on early recognition and prevention. Thus, the purpose of this mixed method study was to develop and evaluate the effect of a delirium education program (DEP) on improving critical care nurses’ knowledge and self-confidence in identifying delirium and the associated risk factors. In the quantitative strand (Phase I) of the study, both the intervention and control groups completed the online pre-tests …

The Relationship Between Clinical Teaching Models And Perceived Clinical Self-Efficacy And Attitude Toward Team Process, Christina H. Plemmons

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurse educators are called to transform the education of nursing students, a process that is paramount to meet the needs of an increasingly complex health care system. The complexity of health care requires graduate nurses who are self-efficacious, yet also function well as full members of a health care team. In response to this call, clinical instruction, an essential component of nursing education, is receiving increased attention. Clinical education is vital, not only to the development of clinical self-efficacy, but also to the integration of future nurses into a health care team. To further this education process, faculty members from …

Cultural Competence Of Nurse Practitioners: Providing Care For Gay And Lesbian Clients, Paul Steven Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurse practitioners provide care to an increasing number of diverse individuals who are faced with specific healthcare needs, as well as health disparities. This care encompasses those individuals who identify as lesbian, gay, bisexual, or transgender (LGBT). These individuals may have experienced delivery of healthcare by providers who lacked the necessary knowledge and/or skills needed to adequately address the needs of this specific client population. Many in the LGBT population have faced prejudice, bias, or homophobia from healthcare providers that became a barrier to accessing healthcare. In order to avoid potential barriers, nurse practitioners who function increasingly as primary care …

Impacts To Phytoplankton After The Establishment Of Quagga Mussels In Lake Mead, Nevada, Warren Bruce Turkett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Quagga mussels (Dreissena rostriformis bugensis) are an invasive species that were discovered in Lake Mead in January of 2007, and rapidly spread throughout the lake. Quagga mussels are about the size of a fingernail, but are known to clog pipes, damage infrastructure and alter ecosystems. In large numbers, mussels can have a dramatic impact on an ecosystem by reducing the phytoplankton and potentially increasing toxin producing cyanobacteria. This research analyzed data collected from three separate basins in Lake Mead to determine if water quality characteristics that are commonly impacted by invasive mussels have changed. Transparency, chlorophyll-a, phytoplankton and zooplankton samples …

Eight Steps To Weight Loss: Development Of An Evidence-Based Collaborative Provider-Patient Workbook For Overweight Or Obese Adults, Katherine Ann Wagner

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite decades of effort on the part of health care providers and policy makers to reduce the prevalence of obesity, the prevalence of obesity in the United States remains high (CDC, 2015). In the adult population ages 20 years of age and older, 35.7% are considered obese. The annual medical costs for people who are obese are $1,429 higher than people of a healthy weight (CDC, 2013). Obesity increases the risk for chronic health conditions such as hypertension, type 2 diabetes, hypercholesterolemia, coronary heart disease, stroke, asthma, arthritis, and cancer (Hammond & Levine, 2010). Over-weight and obesity are the main …

Human Touch: Perceptions Of Self-Efficacy From A Non-Pharmacology Treatment For Individuals Living With Hiv/Aids, Anne Elizabeth Weisman

UNLV Theses, Dissertations, Professional Papers, and Capstones

HIV/AIDS and a subsequent drug regimen can create many negative symptoms and side

effects that lead those infected to seek out alternative and complementary therapies as treatments. Massage therapy is an ancient form of treatment that is now gaining popularity as part of the integrative medicine movement. A phenomenological, qualitative research study was conducted at Aid for AIDS of Nevada (AFAN). Participants received a massage and rich descriptive narratives were captured from the 12 participants, six female and six male, ranging in age from 30-67 years of age. The interviews were transcribed and coded for themes. For the purpose of …

Microbial Contamination Of Ice At Food Establishments In Las Vegas, Nevada, Jerry Wills

UNLV Theses, Dissertations, Professional Papers, and Capstones

When food establishments make ice for consumption, it is important to use water free of pathogens and to employ hygienic practices. Freezing can reduce the number of culturable microorganisms present in water but does not eliminate them completely. Coliform bacteria are used as an indicator of water quality and are used to test for fecal contamination. The U.S. Environmental Protection Agency (EPA) establishes standards for drinking water, and has set a goal for zero total coliforms. Another commonly used tool to measure water quality is the heterotrophic plate count (HPC). The EPA limit for HPC is 500 colony forming units …

The Effect Of Dry Needling To The Multifidus Muscle On Resting And Contracted Thickness Of Transversus Abdominis In Subjects With Low Back Pain, Shane Collins, Abbay Dow, Daniel Rincon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Randomized, double-blinded, controlled clinical trial. Objective: To measure the effects of dry needling to the lumbar multifidus (MF) muscle for any change in resting and contracted thickness of the transversus abdominis (TrA) muscle as well as symptoms and disability in individuals with low back pain (LBP). Background: Recent studies have demonstrated that individuals with LBP have diminished co-activation of the lumbar MF and TrA muscles, which when working appropriately in healthy individuals, contributes to spinal stability and function. A significant change in the resting and contracted thickness of TrA has been found with dry needling to the lumbar …

Preventing Non-Contact Acl Injuries In Female Athletes: What Can We Learn From The Dancers?, Sarah Crow, Thomas Crowther, Trenton Saupan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study design: Cross-sectional case control.
 Objectives: The purpose of this study was to investigate the effects of dance experience and movement instruction on lower extremity kinematics and muscle activation during landing tasks Background/Aim: Current research demonstrates that dancers exhibit a much lower incidence of ACL injuries when compared to athletes of other sports despite the fact that dancers jump and land frequently in their training and performance. The mechanism that underlies this disparity is unclear.
 Methods: We analyzed lower extremity biomechanics during landing in 27 subjects (age 18-25 years, 12 dancers and 15 non-dancers). In the non-instructed (NI) conditions, participants …

The Effects Of Patellofemoral Taping On Patellofemoral Joint Alignment And Contact Area, Ryan Epstein, Ron Garcia, Nicole Riley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: It is widely accepted that patellofemoral pain (PFP) is the result of excessive stress between the retro-patellar surface and the femoral trochlea. Elevated patellofemoral joint (PFJ) stress may be associated with a reduction in PFJ contact area resulting from patellar malalignment (e.g., lateral displacement, lateral tilt, or patellar alta and/or quadriceps imbalance). McConnell and Kinesio taping techniques are commonly used to address PFP and improve PFJ alignment. It has been theorized that PFJ taping can alter the PFJ alignment which may increase the patella’s contact area within the femoral trochlea, thereby resulting in a reduction in PFP. To date, …

Influences Of Body Composition, Multimorbidity And Polypharmacy On Physical Mobility Of Older Adults, Chieh Chen, Linna Sestini, Rachel Wilde

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: The prevalence of falls, and the resulting injuries and complications reflect a key concern in the older adult population. An increased risk of falls is highly correlated with decreases in physical mobility and related functions. The Timed Up-and-Go test (TUG) has an established reliability and validity in assessing physical function and the risk of falling in the older adult population. With age, a person typically has an increased number of health morbidities, which may be reflected in changing body composition and the number of medications associated with diseases. However, the influence of these factors on physical mobility …

Thrust Joint Manipulation Utilization By Us Physical Therapists, Sean Reilly, Rebecca Slaughter, Erwin Ventura

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Design: Online survey study. Objective: To determine physical therapists’ utilization of thrust joint manipulation (TJM) and their comfort level in using TJM between the cervical, thoracic, and lumbar regions of the spine. We hypothesized that physical therapists who use TJM would report regular use and comfort providing it to the thoracic and lumbar spines, but not so much for the cervical spine. Background: Recent surveys of first professional physical therapy degree programs have found that TJM to the cervical spine is not taught to the same degree as to the thoracic and lumbar spines. Methods: We developed a survey …

Sarcopenic Obesity And Myosteatosis Are Associated With Higher Mortality In Patients With Cirrhosis, Aldo J. Montano-Loza, Paul Angulo, Judith Meza-Junco, Carla M. M. Prado, Michael B. Sawyer, Crystal Beaumont, Nina Esfandiari, Ming Ma, Vickie E. Baracos

Internal Medicine Faculty Publications

Background and aims Obesity is frequently associated with cirrhosis, and cirrhotic patients may develop simultaneous loss of skeletal muscle and gain of adipose tissue, culminating in the condition of sarcopenic obesity. Additionally, muscle depletion is characterized by both a reduction in muscle size and increased proportion of muscular fat, termed myosteatosis. In this study, we aimed to establish the frequency and clinical significance of sarcopenia, sarcopenic obesity and myosteatosis in cirrhotic patients.

Methods We analysed 678 patients with cirrhosis. Sarcopenia, sarcopenic obesity and myosteatosis were analysed by CT scan using the third lumbar vertebrae skeletal muscle and attenuation indexes, using …

Energy Management Mechanisms Employed At The Human-Material Interface Of Traditional And Minimalist Shod Running, Nadine M. Lippa

Dissertations

From recreational to elite athletes, greater than 50% of runners sustain overuse injuries each year, prompting substantial research efforts to identify causes of—and solutions to—the high injury rate. Different shoe types and material property degradation have been related to injury. Two popular footwear types are traditional shoes with thick graded soles and minimalist running footwear with thinner foam and/or non-graded soles. Notwithstanding 45 years of significant modifications to shoe design features, gained knowledge in kinesiology, and advanced technologies in polymer science, runner injury rates have not decreased and EVA foam has remained the primary running shoe midsole material since the …

Influence Of Mechanical Choices On Development And Persistence Of Osteoarthritis: How Alexander Technique Can Promote Prevention And Management, Rachelle E. Lowry

Undergraduate Honors Theses

Is osteoarthritis a fate unconditionally vested in genetic makeup, or are joints aggravated into inflammation by the way they are treated? Humans are a complicated conglomeration of experiences, decisions, and inheritance. Osteoarthritis, likewise, has evaded simplicity in any explanation of its causation, so it necessitates a multi-dimensional perspective.

This research considers the relevance of Alexander Technique in filling a void in which treatment and management of osteoarthritis is not equally equipped to answer this multi-dimensional causation. Alexander Technique is classified as a movement therapy, but this does not quite encompass the mindset of it—that it is indeed largely a mindset …

Exploring Asian Indian's Perceptions Regarding Organ Donation, Sandip Suprai

Doctoral Projects

Organ donation saves many lives and gives many people a second chance at life. With over 123,000 candidates on the organ transplant list, it is crucial to increase organ awareness in an effort to increase organ allocation. The growing Asian Indian population in the United States along with low rates of organ donation in this unique cultural group provides an opportunity to explore perceptions and barriers that may exist. This study will explore the perceptions of Asian Indians regarding organ donation. Findings will provide much needed data for interventions to educate and promote organ awareness in this ethnic group. Increasing …