Medicine and Health Sciences Commons^™

The Multilevel Factors Facilitating Or Impeding Healthcare Access Among Refugees Residing In Bexar County Texas, Howaida Werfelli

Dissertations and Theses (Open Access)

The goal of this study was to increase understanding of healthcare access among refugees by investigating the multilevel factors that facilitate or impede healthcare access among refugees who have resettled in Bexar County, Texas. The multilevel factors facilitating or impeding access to healthcare for refugees resettled in Bexar County were identified as follows: health literacy, level of educational attainment, proficiency (reading, writing and, speaking) in English, proficiency (reading, writing and speaking) in native language, translation services, public transportation, income level, a shortage of healthcare providers, navigation of the healthcare system, the fragmentation of the healthcare system, insurance status, staff shortages …

Health Disparities Across Funcitonal Disability Groups, Katherine Sanches

Dissertations and Theses (Open Access)

Background: People with disabilities experience higher rates of chronic disease and poor health status compared to those without disability. People with disabilities do not participate in community health programs to the same degree as those without disability due to social, programmatic, and environmental barriers. The Community Health Inclusion Index (CHII) is a community health assessment tool which evaluates the degree to which community-level health promoting opportunities to promote nutrition and physical activity are inclusive and accessible to people with disabilities. The CHII assess barriers to inclusion across five domains: build environment, equipment, program/services, staff, and policies. Objective: The purpose of …

The Legacy Of Mining In Southwest Missouri: Past And Present Conditions Of The Tri-State Mining District, Anastasia M C Mcclanahan

Graduate Theses/Dissertations

The historic Tri-State Mining District (TSMD) of southwestern Missouri, southeastern Kansas, and northeastern Oklahoma has a history of lead and zinc mining that extended over a hundred years. During the district’s peak production period, the TSMD was one of the world’s largest producers of lead and zinc. The mining activities in the TSMD produced economic growth that supported the local communities and were essential to the victory of the Allied Forces during World War I and World War II. Beginning in the 1920s, the mining activities in the district slowly began to cease due to depletion of metal ores and …

Systematic Review Of Psychometric Properties Of Instruments Measuring Patient Preferences For Engagement In Health Care, Teresa Jerofke-Owen, Mauricio Garnier-Villarreal, Alissa Fial, Georgia Tobiano

College of Nursing Faculty Research and Publications

Aim

To identify, critically appraise, and summarize instruments that measure patients’ preferences for engagement in health care.

Design

Psychometric systematic literature review.

Data sources

PubMed, Embase, CINAHL, and PsycINFO were searched from inception to March 2019.

Review methods

Three reviewers independently evaluated the ‘methodological quality’ and the ‘measurement properties’ of the included instruments using the Consensus‐based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and Terwee's quality criteria. Each instrument was given a Grading of Recommendations Assessment, Development and Evaluation (GRADE) score. The review was registered at PROSPERO (registry number CRD42018109253).

Results

A total of 16 studies evaluating …

Learning From The Past: Distributed Cognition And Crisis Management Capabilities For Tackling Covid-19, Seulki Lee, Jungwon Yeo, Chongmin Na

Research Collection School of Social Sciences

The outbreak of coronavirus disease 2019 (COVID-19) has presented an unprecedented public health crisis across the globe. Governments have developed different approaches to tackle the complex and intractable challenge, showing variations in their effectiveness and results. South Korea has achieved exceptional performance thus far: It has flattened the curve of new infections and brought the outbreak under control without imposing forceful measures such as lockdowns and travel ban. This commentary addresses the South Korean government’s response to COVID-19 and highlights distributed cognition and crisis management capabilities as critical factors. The authors discuss how the South Korean government has cultivated distributed …

Safety And Efficacy Of Hydroxychloroquine In Covid-19: A Systematic Review And Meta-Analysis, Waqas Ullah, Hafez M. Abdullah, Sohaib Roomi, Yasar Sattar, Talal Almas, Smitha Narayana Gowda, Rehan Saeed, Maryam Mukhtar, Ammar Ahmad, Tony Oliver, M. Chadi Alraies, Donald C. Haas, David L. Fischman

Abington Jefferson Health Papers

Background: During the initial phases of the coronavirus disease 2019 (COVID-19) epidemic, there was an unfounded fervor surrounding the use of hydroxychloroquine (HCQ); however, recently, the Centers for Disease Control and Prevention (CDC) has recommended against routine use of HCQ outside of study protocols citing possible adverse outcomes.

Methods: Multiple databases were searched to identify articles on COVID-19. An unadjusted odds ratio (OR) was used to calculate the safety and efficacy of HCQ on a random effect model.

Results: Twelve studies comprising 3,912 patients (HCQ 2,512 and control 1400) were included. The odds of all-cause mortality (OR: 2.23, 95% confidence …

Comparative Accuracy Of Non-Invasive Imaging Versus Right Heart Catheterization For The Diagnosis Of Pulmonary Hypertension: A Systematic Review And Meta-Analysis., Waqas Ullah, Artem Minalyan, Sameer Saleem, Nayab Nadeem, Hafez M Abdullah, Abdelmohaymin Abdalla, Vincent Chan, Rehan Saeed, Maria Khan, Sara Collins, Maryam Mukhtar, Harshwant Grover, Yasar Sattar, Ankur Panchal, Smitha Narayana Gowda, Uneza Khwaja, Bilal Lashari, David L Fischman

Abington Jefferson Health Papers

Background: Right heart catheterization (RHC) is the gold-standard in the diagnosis of pulmonary hypertension (PH) but at the cost of procedure-related complications. We sought to determine the comparative accuracy of RHC versus non-invasive imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), and transthoracic echocardiography (TTE).

Methods: Pulmonary hypertension was defined as a mean pulmonary artery pressure (mPAP) of>20 mmHg. Multiple databases were queried for relevant articles. Raw data were pooled using a bivariate model to calculate the measures of diagnostic accuracy and to estimate Hierarchical Summary Receiver Operating Characteristic (HSROC) on Stata 13.

Results: A total …

New World Mammarenaviral Hemorrhagic Fever Virus Determinants Of Infection And Disease, Brady T. Hickerson

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Several New World mammarenaviruses (NWM) are able to cause life-threatening hemorrhagic disease in humans. These agents use human transferrin receptor 1 (hTfR1), the main protein involved in cellular uptake of iron, to infect cells. Furthermore, use of hTfR1 correlates with the ability of these viruses to cause severe disease in humans. The most prevalent pathogenic NWM is Jun√≠n virus (JUNV), which is the etiological agent of Argentine hemorrhagic fever (AHF).The pathogenesis of AHF is poorly understood. A cardinal feature of severe cases of AHF is a prolonged increase of serum interferon-a (IFN-a) concentration. This increase is hypothesized to play a …

Evaluation Of Enrichment And Identification Media For Isolation Of Common Bovine Salmonella Serotypes, Katie Irene Swanson

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Salmonellosis is an important cause of diarrhea in humans and animals, which can lead to death in severe cases. Rapid and efficient detection of Salmonella spp. is essential to limit the spread of disease. Many enrichment procedures have been described for the isolation of Salmonella, and often include variations on Rappaport-Vassiliadis medium, which is recommended by the Food and Drug Administration (FDA). The current procedures vary in incubation temperature, incubation time, and type of media used for identification of Salmonella. This project compared four procedures for enrichment and identification of common bovine Salmonella serotypes. We determined the best …

Are Effort And Helpfulness Ratings Of Session Activities Associated With Improved Outcomes In Web-Based Acceptance And Commitment Therapy (Act) For Caregivers?, Hannah R. Cragun

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Family caregivers for people with dementia are providing care for up to ten years because people with dementia are living longer. This role can be demanding because the person with dementia can have behavioral and psychological symptoms that can be stressful for the caregiver to witness and manage. Acceptance and Commitment Therapy (ACT) in its traditional face-to-face format has strong scientific support in helping caregivers to be less depressed and better cope with the stress associated with taking care of their loved one. However, because caregiving is a time-demanding role, caregivers can struggle with accessing face-to-face therapy, making online ACT …

Qtc Cutoff, Gender, Race And Age On Reporting Of Prolonged Qtc, Supraja Thunuguntla, Michael Machiorlatti

School of Medicine Publications

Background
The aim of the study is to evaluate the association of QTc cutoff, gender, race, and age on reporting of QTc interval prolongation.

Methods
Retrospective study of 147 patients admitted to our hospital or ER visit from January 2016 to May 2020. Simple descriptive statistics and longitudinal linear mixed model was performed on the 213 total observations from 147 patients.

Results
The average age of the patients was 65 (±17.8, 18-98) years. Females were 32% (n=47) and Hispanics 78.4% of sample. QTc prolongation was reported in 65% (n=138) of the 213 EKG’s. Calculated 90th and 99th percentile for QTC …

“Tomorrow Never Dies”: Recent Advances In Diagnosis, Treatment, And Prevention Modalities Against Coronavirus (Covid-19) Amid Controversies, Partha Laskar, Murali M. Yallapu, Subhash C. Chauhan

School of Medicine Publications

The outbreak of novel coronavirus disease (2019-nCoV or COVID-19) is responsible for severe health emergency throughout the world. The attack of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is found to be responsible for COVID-19. The World Health Organization has declared the ongoing global public health emergency as a pandemic. The whole world fights against this invincible enemy in various capacities to restore economy, lifestyle, and safe life. Enormous amount of scientific research work(s), administrative strategies, and economic measurements are in place to create a successful step against COVID-19. Furthermore, differences in opinion, facts, and implementation methods laid additional layers …

Vulvar Intravascular Papillary Endothelial Hyperplasia Or Masson's Tumor: A Case Report, Vania Nwokolo, Ravindra Veeramachaneni, Saul D. Rivas

School of Medicine Publications

Masson's tumor, also known as intravascular papillary endothelial hyperplasia (IPEH), is a rare and benign vascular disease in which there is a reactive hyperplasia of intravascular endothelial cells. This tumor is most commonly found in soft tissues in the head, neck and upper extremities. We report a rare case of IPEH on the vulva. A Hispanic woman in her mid-thirties presented with a painful and pruritic left vulvar mass. On physical examination, a pedunculated mass was visualized on the left labia majora. Under pathologic examination, it was concluded the lesion was IPEH and it was surgically excised. This is a …

Investigating A Multimodal Approach To Clinical Diagnosis Of Mild Cognitive Impairment And Alzheimer’S Disease, Sean M. Flannery

Psychology Theses & Dissertations

An estimated 5.8 million Americans suffer from dementia due to Alzheimer’s disease (AD), with that number projected to grow to 13.8 million by mid-century (Alzheimer’s Association, 2019). Mild cognitive impairment (MCI) describes the stage between normal cognitive decline that comes with aging and a dementia diagnosis (Peterson, 1999). Due to a lack of a cure or particularly effective treatment, a major goal of treatment is to focus on improving quality of life (Budson & Solomon, 2016). An early and accurate diagnosis can address this goal in a variety of ways. Despite the high prevalence and immense amount of research in …

Social Vulnerability And Hurricane Evacuation Behavior In Hampton Roads, Va: Emergency Management Stakeholders’ Perceptions Of Low-To-Moderate Income Households In A Social Construction Paradigm, Mechelle Bonit Smith

School of Public Service Theses & Dissertations

The purpose of this research is to examine current emergency management (EM) evacuation policies and practices with respect to vulnerable populations’ hurricane evacuation behaviors. The response of vulnerable households and local and state governments’ implementation of emergency evacuation policies and practices provide possible linkages to continual problems faced by local governments in addressing its most vulnerable residents. Using social construction as a theoretical foundation provides context for the consideration of vulnerable populations in emergency management policy and hurricane evacuation.

This research is a qualitative case study of emergency management policies, practices, and perceived household evacuation behaviors in several cities of …

A Core Reference Hierarchical Primitive Ontology For Electronic Medical Records Semantics Interoperability, Ziniya Zahedi

Engineering Management & Systems Engineering Theses & Dissertations

Currently, electronic medical records (EMR) cannot be exchanged among hospitals, clinics, laboratories, pharmacies, and insurance providers or made available to patients outside of local networks. Hospital, laboratory, pharmacy, and insurance provider legacy databases can share medical data within a respective network and limited data with patients. The lack of interoperability has its roots in the historical development of electronic medical records. Two issues contribute to interoperability failure. The first is that legacy medical record databases and expert systems were designed with semantics that support only internal information exchange. The second is ontological commitment to the semantics of a particular knowledge …

Translating Provider And Staff Engagement Results To Actionable Planning And Outcomes, Roberto Cardarelli, Madeline Slimack, Ginny Gottschalk, Michael Ruszkowski, Jessica Sass, Kristen Brown, Rachel Kikendall, John J. Allard, Kelly Burgess, Maggie Luoma, Wanda Gonsalves

Family and Community Medicine Faculty Publications

Staff and provider engagement leads to better quality and experience of care and less turnover and burnout. In this program, we describe an approach to better understand underlying factors that lead to low staff and provider engagement and address such factors by creating actionable plans that drive improved engagement measures. Focus groups were conducted with staff, advance practice providers, and faculty to better understand low scored areas in an annual third-party engagement survey. Focus group results were analyzed, and thematic action plans were then developed by a leadership team. These plans and the status of addressing the identified issues were …

Decellularization Of Porcine Cartilage Promotes Chondrogenic Differentiation Of Human Chondrocytes, Roxanne Nicole Stone

Boise State University Theses and Dissertations

Knee osteoarthritis (knee OA) is the most common type of osteoarthritis (OA) and accounts for 70% of arthritis-related hospital admissions and 23% of clinical visits. Major limitations in both the current non-surgical and surgical methods are that they only relieve pain and show no evidence for restoring natural tissue anatomy. Leaders in the field propose that a stem cell treatment approach holds promise for the regeneration of a greater proportion of hyaline-like tissue at the repair site. (Cross et al., 2014; Escobar Ivirico, Bhattacharjee, Kuyinu, Nair, & Laurencin, 2017; Helmick et al., 2008; Toh, Foldager, Pei, & Hui, 2014).

It …

Rate Of Unscheduled Administration Of An Epidural Bolus Among Pregnant Women Receiving Labor Epidurals, Aleksandr A. Lyakhov, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background The labor and delivery process is a painful experience that pregnant women undergo and while various medical options are available for managing labor pain, labor epidurals are the most common.1,3 Breakthrough pain, or inadequate analgesia, is a significant complication of labor epidurals that is typically managed with the administration of an unscheduled epidural bolus. The purpose of this evidence-based practice (EBP) project is to describe the rate of unscheduled epidural bolus administration in pregnant women receiving continuous labor epidurals (CLE) at Providence Sacred Heart Medical Center (PSHMC) and Providence Holy Family Hospital (PHFH).

Methods • Design: Retrospective, observational, EBP …

Awareness Of Dying And Conflict Resolution: Texas Asian Perspectives, Gloria Duke, Charlotte Wood, Lobsang Tenzing

Nursing Faculty Publications and Presentations

Individuals in the end-of-life (EOL) period may not be fully aware of their prognosis or know they are facing a terminal illness. As Asian beliefs and cultural tendencies intersect with Western values, health care practitioners may find their assumptions about disclosing an EOL prognosis differs from patients and their family members. Disagreements among family members regarding the disclosure of EOL to their terminally ill loved one can result in conflict--making difficult and sensitive times more burdensome. Little scientific evidence is known about first generation Asians who live in the United States (US) regarding their practices with disclosing EOL and how …

Functional Capacity Profiles In Bipolar Disorder And Schizophrenia, Ashley Sara Emami

UNLV Theses, Dissertations, Professional Papers, and Capstones

Serious mental illnesses (SMIs) often have an onset early in life and go on to produce disability and functional impairment, which require ongoing supportive services and loss of productivity. Bipolar disorder (BD) and schizophrenia (SZ) are two of the most common SMIs. BD and SZ differ in their pattern of neurocognitive performance, which suggests differences in the severity of functional impairment between the illness groups. Within these psychiatric illness groups, subgroups may also be identified using cluster analysis. Evidence points to heterogeneity in functional outcomes in BD and SZ, yet very little research has assessed for subgroups based on functional …

An Intervention To Increase Nurses’ Knowledge Of Non-Opioid Pain Management In Post-Operative Elective Knee And Hip Replacement Patients, Kristen K. Grunerud

UNLV Theses, Dissertations, Professional Papers, and Capstones

Post-operative pain control is an enduring problem in health care. The extensive use of opioids since the 1980s has contributed to the current opioid crisis in the United States. In response, healthcare providers have begun to use a more biopsychosocial model to address pain control needs of patients. There is a demonstrated gap in knowledge for nurses in this area, and recent changes to hospital accreditation standards include a requirement to demonstrate both education provisions to staff and the use of non-opioid methods to control pain. The purpose of this Doctor of Nursing Practice (DNP) project was to assess, and …

The Influence Of Cerebellar Transcranial Direct Current Stimulation On Motor Function In Parkinson’S Disease, Lidio Lima De Albuquerque

UNLV Theses, Dissertations, Professional Papers, and Capstones

Parkinson's disease (PD) is the most common movement disorder and the second most common neurodegenerative disorder. PD is characterized by dopaminergic cell loss in the substantia nigra pars compacta, which leads to a reduction in dopamine in the striatum. These physiological mechanisms lead to a number of motor impairments such as bradykinesia, rigidity, tremor, and postural instability that severely limit the ability of individuals with PD to perform many essential daily living activities. Although current pharmacological, surgical, and physical exercise treatment approaches are valuable they are either only mildly effective, expensive, or associated with a variety of side effects. Therefore, …

Sexually Transmitted Infections And The 65 And Older Population: Knowledge And Perceived Risk, Alexus Miranda

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sexually transmitted infections (STI) can impact all persons. Since 2000, the number of STIs has steadily increased among persons aged 50 years and older in the United States (Purpora, 2012). Persons over the age of 60 accounted for the biggest increase of in-office treatments of STIs between 2014 and 2017 (Howley, 2018). The purpose of this study was to use the Sexual Health Model to examine the relationship between various predictors and these persons’ perceived risk of STIs, their STI knowledge, and other barriers that impact the sexual health of persons 65 years of age and older. This study used …

Countermovement Jump Assessment For Monitoring Prolonged Fatigue In Collegiate Female Soccer Players, Jeffrey A. Wilkins

Boise State University Theses and Dissertations

Introduction: Females are 4 to 6 times more likely to sustain an anterior cruciate ligament (ACL) injury than their male counterparts during running and cutting sports, such as soccer. This sex disparity is thought to result from altered lower limb neuromuscular control that females present when fatigued at the end of practice or games. Yet, current fatigue monitoring techniques typically vary in their reliability, applicability and efficiency. Purpose: The purpose of this study is to test the feasibility of the countermovement jump (CMJ) to quickly and reliably monitor fatigue in female soccer athletes. Methods: Twenty-two (age: 19.3 ± 1.1 yrs, …

Factors Affecting Esophageal Tissue Radiation Response, Latisha T. Pryor

UNLV Theses, Dissertations, Professional Papers, and Capstones

Radiation-induced esophageal cancer can be a deadly and unfortunate secondary outcome of radiotherapy or chronic occupational exposure to radiation. Although the esophagus is known to be a radiosensitive organ, it is under studied and further information regarding how dose and radiation quality impact its sensitivity may provide strategies to prevent esophageal cancer. The purpose of this thesis was to understand factors that play a role in the tissue’s radiosensitivity that may relate to its cancer risk. In this study, we used two esophageal 3D models, as well as both human and mouse cells, to define radiation quality and dose dependent …

Memory And Stereotypes For Lesbian/Gay Characters, Amber Rose Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Stereotype-consistency bias refers to the idea that people tend to remember stereotypical information about others better than non-stereotypical information (Fyock & Stangor, 1994). Limited research has examined how people may use stereotype-consistency bias when recalling information about LGBT characters in narratives (Bellezza & Bower, 1981; Clark & Woll, 1981; McGann & Goodwin, 2007; Snyder & Uranowitz, 1978). This line of research suggests that, instead of genuinely remembering stereotypical information better, participants tended to guess stereotypical answers to questions they do not know. In contrast to those studies, the experiment I conducted for this thesis suggests that heterosexual young adults tend …

Avoiding Covid-19 Complications With Diabetic Patients Could Be Achieved By Multi-Dose Bacillus Calmette–Guérin Vaccine: A Case Study Of Beta Cells Regeneration, Bassam M. Ayoub, Eman Ramadan, Nermeen Ashoush, Mariam M. Tadros, Moataz S. Hendy, Mohamed M. Elmazar, Shaker A. Mousa

Pharmacy

Diabetes mellitus (DM) is one of the major risk factors for COVID-19 complications as it is one of the chronic immune-compromising conditions especially if patients have uncontrolled diabetes, poor HbA1c and/or irregular blood glucose levels. Diabetic patients' mortality rates with COVID-19 are higher than those of cardiovascular or cancer patients. Recently, Bacillus Calmette-Guérin (BCG) vaccine has shown successful results in reversing diabetes in both rats and clinical trials based on different mechanisms from aerobic glycolysis to beta cells regeneration. BCG is a multi-face vaccine that has been used extensively in protection from tuberculosis (TB) and leprosy and has been repositioned …

Clinical Work With Adult Male Incest Survivors: Therapeutic Themes And Perspectives, Kathryn B. Rosenberg

Doctoral Dissertations

For psychotherapists, encountering clients who have experienced sexual trauma or abuse is inevitable, whether or not the abuse is disclosed to the therapist; however, mental health professionals receive extremely limited (if any) training on how to identify or effectively support adult clients who are survivors of childhood sexual abuse (CSA). Many people who experienced CSA, especially those who identify as male, remain isolated and invisible in their suffering as adults even within therapeutic spaces, facing what feel like insurmountable barriers – both internal and external – to getting help. When sexual abuse is intrafamilial, these barriers are both amplified and …

Postoperative Length Of Stay Following Enhanced Recovery After Surgery Protocol Implementation For Scheduled Cesarean Deliveries, Hannah Zimmerman, Emily L. Mcquaid-Hanson, Amanda Affleck, Kenn B Daratha

Books, Presentations, Posters, Etc.

Background Cesarean delivery is the most common major surgery worldwide. 1 In 2018, 1.2 million cesarean deliveries occurred in the United States, accounting for nearly 32% of all deliveries.2 Research has shown ERAS benefits include decreased length of stay, improved pain control, and improved patient satisfaction.2,3 Despite its use in numerous surgical specialties, ERAS implementation within obstetrics has been slow.2 The ERAS Society released a three-part guideline specific to cesarean deliveries in 2018 and 2019,4,5,6 yet few studies have assessed the impact of ERAS on cesarean postoperative outcomes.2 An improved perioperative course would be particularly beneficial for mothers undergoing cesarean …