Medicine and Health Sciences Commons^™

Axon Initial Segment Morphology Across Typical Cortical Development And In Mouse Models Of Neurodevelopmental Disorders With A High Incidence Of Epilepsy, Rachel Ali Rodriguez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Neurodevelopmental disorders (NDDs) are commonly associated with a high incidence of epileptic seizures which result from excessive firing of neurons. The axon initial segment (AIS) is a neuronal compartment essential for the control of activity patterns of neurons. The AIS undergoes important modifications during development, but the molecular mechanisms that affect the development, morphology, and protein composition of the AIS are still not well understood. We examined AIS morphology of medial prefrontal cortex (mPFC) pyramidal neurons in wildtype mice across development and in two mouse models of NDDs. Results indicate restructurings at the AIS during typical development, some of which …

How Long-Term, Non-Monogamous Romantic Relationships Maintain Sexual Satisfaction, Anna Kessler

UNLV Theses, Dissertations, Professional Papers, and Capstones

Eroticism is an important element of couple's relationships. Sexual intimacy has the power to bring couples closer together, as higher levels of sexual intimacy results in higher relationship satisfaction, or hinder relationships if either or both partners aren’t sexually satisfied in their relationship. The current study’s purpose is to understand how long-term, non-monogamous relationships have successfully maintained “eroticism” throughout the course of their relationship. In this study, 24 couples who are in a committed, romantic relationship of at least 7 years were interviewed. The interviews were conducted individually over a video call platform, and each was completed withing approximately 60 …

Multiple Approaches To Auditory Rhythm: Development Of Sustained Musical Beat And The Relation To Language, Development Of Rhythmic Categories Via Iterated Production, And A Meta-Analytic Study Of Neural Entrainment To Beat, Karli Marie Nave

UNLV Theses, Dissertations, Professional Papers, and Capstones

Rhythm is ubiquitous to human communication, coordination, and experience of music. In this dissertation, I address three empirical questions through three different methodologies, all of which contribute to the growing body of literature on human auditory rhythm processing. In Chapter 2, I present a registered report detailing the results of independent conceptual replications of Nozaradan, Peretz, Missal, & Mouraux (2011), all using the same vetted protocol. Listeners performed the same tasks as in Nozaradan et al. (2011), with the addition of behavioral measures of perception. In neuroscience, neural correlates to musical beat perception have been identified, yet little to no …

Exploring Treatment Targets To Mitigate Fear Of Falling Activity Avoidance Behavior In Parkinson's Disease And Older Adults, John Vincent Rider

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fear of falling (FOF) is a significant concern among individuals with Parkinson’s disease (PD) and older adults in general. This FOF can lead to avoidance behavior resulting in activity restriction. Some level of fear of falling avoidance behavior (FFAB) may be protective (adaptive) and decrease the likelihood of falls, especially among individuals with physical limitations and high fall risk. However, excessive (maladaptive) avoidance behavior may lead to downstream consequences such as further physical and psychological decline and an increased likelihood of falls, especially when there is a disparity between the FFAB and physiological fall risk. While poor physical functioning, disease …

Social Support Of Mexican Immigrant Women With Gestational Diabetes Mellitus: A Constructivist Grounded Theory Study, Angela Sojobi

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to explore the perception of social support among Mexican immigrant women with gestational diabetes mellitus (GDM) within the context of their culture and discern the process through which social support can influence their adherence to the GDM management protocols. The incidence of GDM is highest in low-income, ethnic minority communities such as the Mexican immigrant community. Adhering to the GDM management protocols may prove challenging for some women, especially if social support is lacking. If uncontrolled, GDM can result in adverse maternal-fetal outcomes. Among Mexican immigrant women, the incidence of poor glycemic control and …

Investigating Acculturation, Health-Promoting Lifestyle, And Health Status Among Nigerian Immigrants In The United States, Frank Uche Akpati

UNLV Theses, Dissertations, Professional Papers, and Capstones

The United States has a significant number of immigrants from Africa. More come from Nigeria than other African countries. Even though acculturation influences health behavior in other cultures, this relationship is understudied in the Nigerian immigrant community in the United States which can influence their health care. This study examined the relationship between acculturation, health-promoting lifestyle, and health status of Nigerian immigrants. Key constructs from Berry’s acculturation model guided the study. Acculturation was conceptualized as occurring through varying levels of ethnic society immersion (ESI) and dominant society immersion (DSI). The study also examined the influence of education on acculturation using …

Determination Of The Presence Of Sars-Cov-2 In Environmental Surface And Air Samples From Public Areas In Las Vegas, Kristina Mihajlovski

UNLV Theses, Dissertations, Professional Papers, and Capstones

Contaminated surfaces and airborne spread are found to be among the main ways of coronavirus disease 2019 (COVID-19) transmission. Studies conducted in the hospital setting have shown that SARS-CoV-2 is found on frequently touched surfaces, personal protective equipment, and in air samples of patient isolation rooms. However, few environmental sampling studies have been done in public areas. Taking in consideration that COVID-19 cases may be symptomatic, presymptomatic, and asymptomatic, environmental monitoring may be essential for prompt detection of the virus. The objective of this study was to determine whether SARS-CoV-2 can be detected on environmental surfaces and from air samples …

Factors Influencing Us Residents' Willingness To Engage In Domestic Medical Tourism, Hananeh Derakhshan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Domestic medical tourism is a niche market in the medical tourism industry. The purpose of this study was to determine the association of different attributes on U.S residents’ willingness to participate in domestic medical tourism. Based on the medical tourism index (MTI) components, a total of fourteen possible attributes that may impact US residents’ willingness to seek out-of-town care were created and participants were asked to rate the importance of each attribute on their willingness to seek out-of-town care on a 10-point Likert scale. Using principal component analysis, the attributes were grouped into three components: (1) quality-of-care, (2) destination attraction, …

Factors Associated With Medication Decision Making In African American Families Of Children With Adhd: A Mixed Methods Study, Amy Glasofer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral pediatric disorder in the United States. Pharmacotherapy is a recommended component of treatment for ADHD. While medication treatment of ADHD is not optimized overall, minority groups experience medication treatment disparities. The persistently lower rates of medication treatment in minority groups may have culturally specific origins which cannot be generalized across minorities. The purpose of this dissertation was to assess and extend knowledge regarding medication decision making (MDM) in African American caregivers of children with ADHD. To assess the state of the science on ADHD disparities, a review of 41 descriptive studies exploring …

Designs And Outcomes Of Transcranial Magnetic Stimulation (Tms) And Repetitive Transcranial Magnetic Stimulation (Rtms) Circuits, Daniel Senda

UNLV Theses, Dissertations, Professional Papers, and Capstones

This thesis reports the design and outcomes of several circuits intended for transcranial magnetic stimulation (TMS) and repetitive transcranial magnetic stimulation (rTMS) research. In simple terms, TMS circuits are composed of four main blocks: high voltage power source, energy storage bank, control switch, and coil. Each one of these blocks has characteristics that influence how well the circuit will perform for TMS procedures. A successful TMS research circuit must have the ability to emit controlled electromagnetic pulses through a coil connected to it. For the first block, voltages ranging from 50 V to 2 kV were used. In the second …

Relationships Between Mindfulness, Nonacademic Factors, Stress, And Test Performance: A Cross-Sectional Study, Rebecca A. Baumeister

UNLV Theses, Dissertations, Professional Papers, and Capstones

Successful test performance is essential to nursing students. Poor performance comes with consequences such as inability to progress or removal from the program, leading to attrition. The influence of academic factors on test performance have been widely researched and stress is known to hinder it, yet other factors may also impact test performance.

Dispositional mindfulness has the potential to support test performance, but no known studies have focused on these two variables among undergraduate nursing students. A gap also exists in relation to the influence of nonacademic factors on undergraduate nursing students’ test performance. Due to the ongoing nursing shortage, …

Job Burnout: An Examination Of Outpatient Clinics, Aysa M. Chavarria

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to examine job burnout of medical providers in outpatient clinics. Job burnout is a psychological syndrome resulting from job interpersonal stressors; it is measured using three dimensions: (1) emotional exhaustion – feelings of being emotionally overextended and exhausted by one’s work, (2) depersonalization -a unfeeling and impersonal response toward patients, and (3) personal accomplishment – feelings of competence and achievement in one’s work (Maslach & Jackson, 2020). Using a convenience sample, healthcare providers in Southern Nevada were asked to participate. The study was approved by the University of Nevada, Las Vegas, Internal Review Board …

Turning Up The Sound! Senior-Level Sonographers' Perspectives On The Workforce Readiness/Competency Of Entry-Level Sonographers In The Workplace, Janice L. Glasper

UNLV Theses, Dissertations, Professional Papers, and Capstones

There has been a longstanding preoccupation with the workforce readiness and competency of our nation’s graduates since the release of the National Commission on Excellence in Education’s, April 1983 landmark report, A Nation at Risk: “The Imperative for Educational Reform”, which indicated that the educational foundations of our society were being eroded by a rising tide of mediocrity that threatened our very future as a Nation and a people. Now, more than 35 years since the release of A Nation at Risk, it appears that little has changed. Extensive research continues to report that graduates of post-secondary institutions are unprepared …

Effects Of A Discourse Intervention On End-Of-Life Knowledge And Attitudes Of Bsn Nursing Students, Jayme Gullone Haynes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction. A number of challenges exist to providing effective, formalized end of life (EOL) education for undergraduate nursing students. Despite advanced resources provided by the End-of-Life Nursing Education Consortium (ELNEC), many nursing program curricula are overloaded with content and have little opportunity to incorporate other content and information.

In addition, the topic of EOL care may elicit significant emotional responses from nursing students with numerous studies indicating nursing students experience fear and anxiety when caring for patients at EOL. Recent research demonstrates the need to approach emotionally laden topics such as EOL care from a pedagogical perspective that acknowledges and …

Are Gaming And Gambling Disorders Related? Examining The Roles Of Money, Relative Deprivation, And Upward Mobility, Anthony J. King

UNLV Theses, Dissertations, Professional Papers, and Capstones

Few studies have examined the financial motives and risks involved in modern video games, as well as the psychosocial factors contributing to this type of gaming involvement. Previous research on gambling has shown financial motives alone to be a major risk factor for the development of gambling disorder, with higher levels of personal relative deprivation (PRD) identified as a main contributor to this relationship. Therefore, the present study investigated whether this association applied to US adult video gamers, and if it would predict their problematic gaming behaviors. We hypothesized PRD and gaming disorder severity would have a positive association, with …

New Nurse Reality Shock & Early Burnout: Can Role Transition Education Received During New Nurse Residency Positively Affect Satisfaction?, Bonnie L. Stolzman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Newly licensed nurses are at incredibly high risk for reality shock leading to early burnout which results in many of them resigning their positions or leaving nursing altogether. Common feelings leading to reality shock often involve exhaustion, cynicism, depersonalization, decreased self-efficacy, and decreased job satisfaction. The result of early burnout presents significant financial strain and quality concerns for our already struggling healthcare systems. In the 1960s and early 1970s, Marlene Kramer brought her research regarding newly licensed nurses and their experience of “reality shock” to publication. Kramer felt strongly that reality shock was a key factor that led newly licensed …

The Effects Of Real-Time Computerized Needle Tip Location Feedback On State Anxiety And Immediate Performance Of Simulated Ultrasound-Guided Regional Anesthesia, Joseph Janakes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Complications of ultrasound-guided regional anesthesia (UGRA) in the clinical setting are severe and frequently related to improper needle tip placement, which is a challenging skill for novice student learners. Accordingly, anesthesia education programs are incorporating simulation-based teaching methods that use expensive procedural task trainers to aid in UGRA training. However, it was unknown if the task trainers with real-time computerized needle tip location feedback affect student anxiety and immediate simulated UGRA performance, leaving educators wondering if the cost was justified.Aims: The purpose of the study was to examine the effects of real-time computerized needle tip location feedback on students’ …

Quality Assurance Of Service Learning Back School, Eric Bashaw, Vu Pham, Tyler Parvin, Ryan Pauly

UNLV Theses, Dissertations, Professional Papers, and Capstones

Project Execution: Back School: During the 2019-20 academic year, two University of Nevada, Las Vegas Physical Therapy (UNLVPT) core faculty members, along with eight doctor of physical therapy students, provided three student-led, pro-bono back school classes at Volunteers in Medicine of Southern Nevada (VMSN). Each back school class consisted of two, 2-hour sessions where participants were screened for red flags, educated on pain management strategies and common causes of back pain, and given an individual home exercise program. Quality Assurance Surveys: Patient’s and VMSN staff were all given questions in the form of Likert-scale and open-ended questions via printed handouts …

Is Decreased Trunk Flexion Angle A Contributing Factor To Patellofemoral Joint Loading In Runners With Patellofemoral Pain?, Christine Duvall, Zachary Clark, Tavin Fox, Caitlin Howden

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Reduced trunk flexion during running is theorized to be a contributing factor of elevated patellofemoral joint (PFJ) stress in runners with patellofemoral pain (PFP); thus, the primary purpose of this research study was to determine if runners with PFP would exhibit differences in PFJ stress and trunk flexion angle during running as compared to pain-free runners across three speeds. We hypothesized that runners with PFP would exhibit higher PFJ stress and decreased trunk flexion while running compared to the pain- free runners. Number of Subjects: 7 runners with PFP and 5 similar pain-free control runners. Materials/Methods: Kinematics and kinetics …

Stepping On Fall Prevention Project, James P. Gaddi, Jordan T. Bowers, Lea M. K. Fung

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Falls are a major problem in the United States among the older adult population and provide opportunity for community outreach via student-led physical therapy projects. Objective: The purpose of this project was to investigate the relationship between fall related outcome measures and questionnaires with the completion of the Stepping On Fall Prevention program along with evaluating the benefits of Physical Therapy student development with participation in service learning projects. Methods: The research quantified the fall risk of 13 participants with assessment of: gait speed (Timed Up and Go), lower extremity strength (30-Second Chair Stand), balance (4-Stage Balance Test), and …

Dancer Screening Clinic, Kristen Manaloto, John Lencioni, Laura Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dance students at the University of Nevada, Las Vegas (UNLV) do not have access to sports medicine specialists, thus a pro-bono dance clinic was created as a service-learning project by the UNLV Department of Physical Therapy (UNLVPT) in 2018. In the second year of the service-learning project, three graduate students from the UNLVPT program, under the supervision of a clinical faculty member, have continued to provide free dance specific injury prevention screenings and management to students within the UNLV Department of Dance. To improve clinic operation and services, the group emphasized communication and accessibility as areas of growth. Injury prevention …

Effects Of Bimodal Transcranial Direct Current Stimulation On Modulation Of Spinal Circuitry In People With Chronic Post-Stroke Hemiparesis, John Patrick Gan, Rafael Cabrera, Lana Laudermilch, Benjamin Wolkenhauer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Stroke can lead to gait abnormalities such as foot drop. Foot drop can result from decreased corticospinal tract input to the ankle dorsiflexors and/or from exaggerated stretch reflexes on the soleus due to reduced reciprocal inhibition from spinal reflex pathways. Transcranial direct current stimulation (tDCS) attempts to modulate corticospinal tract input and spinal reflex pathways by delivering electrical signals to parts of the brain. The degree of neuromodulation from tDCS can be measured through the Hoffman Reflex (H-reflex)—a tool used to estimate alpha motor neuron excitability which is increased in individuals post-stroke. Purpose: The primary purpose of this study …

Am-Pac Basic Mobility Inpatient Short Form (Low Function) Psychometrics/Clinimetrics, Meghan Wonderling, David Miller, Selena Soria

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To determine whether the Activity Measure for Post-Acute Care® Basic Mobility Inpatient Short Form (Low Function) (6-clicks LF) has increased responsiveness for patients with lower levels of physical function compared to the Activity Measure for Post-Acute Care Basic Mobility Inpatient Short Form (6-clicks). Design: Retrospective cohort study using original scores and simulated scores for assessment of internal responsiveness of the 6-clicks LF compared to the 6-clicks. Simulated 6-clicks and 6-clicks LF scores were created as a hypothetical future AM-PAC® score. Results: We found a statistically significant difference between the 6-clicks and simulated 6-clicks, t=24.8, p < 0.00 [two-tailed]. The effect size was large (d=1.2, r=0.51).There was a statistically significant difference between the 6-clicks LF and simulated 6-clicks LF, t=19.7, p < 0.00 [two-tailed]. The effect size was medium (d=0.91, r=0.41). Finally, for patients with a 6-clicks score in the bottom five-percentile (n=27), we found a statistically significant difference between the 6-clicks and 6-clicks LF, t=11.9, p < 0.00 [two-tailed]. Conclusion: Among patients scoring less than 15, the 6-clicks LF has greater internal responsiveness than the 6-clicks and thus demonstrates that the new low-level questions in the 6-clicks LF better quantify low-level patients’ functional level. Research using non-simulated data should be completed in the future to confirm these findings.

Inter And Intra-Rater Reliability Of Dance Screening Tool, Kathleen Stone, Braden Waters

UNLV Theses, Dissertations, Professional Papers, and Capstones

Previous literature has indicated that injury rates of ballet and modern dancers are among the highest of any physical activity. These injuries can be detrimental to the athlete and can also result in financial burden for dance companies due to time loss related to injuries. Preventative intervention aimed at those who are most at risk for injury can be effective at reducing the cost associated with lost time due to injury. An effective approach to identifying those most at risk for dance related injuries is to administer a functional movement screen. One such movement screen is the ballet-based Dance Technique …

Effects Of Altered Somatosensory Input On Lower Limb Mechanics Via Different Shoes And Barefoot Walking In Individuals With Chronic Post-Stroke Hemiparesis, Aaron Abraham Simon, Jynelle Marie Guerrero Arches, Megan Leigh Keohane, Wee Jin Jed Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

[Purpose/Hypothesis] Stroke is a leading cause of disability that results in various neurological deficits. Stroke can cause impaired somatosensory input, which results in decreased balance and gait speed, ultimately increasing fall risks. Therapies to increase somatosensory input have shown promise for people with stroke as well as other neurological populations. However, few studies have systematically investigated varying somatosensory input via different footwear to improve walking in people post-stroke. The purpose of this study was to investigate the effects of altering somatosensory input via different types of footwear (i.e., barefoot, self-selected shoes, and memory foam shoes) on gait kinetics and ankle …

Recruitment And Advocacy For Clinician Involvement In Pro Bono Physical Therapy Service-Learning Program, Gilberto Carrillo, Gavin Brady, Felicia Doblado, Alyssa Woo Hatch

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Service-learning allows Doctor of Physical Therapy (DPT) students to develop important professional skills and addresses community-based needs. When integrated into physical therapy education, it can be a powerful tool for increasing students' altruism and social responsibility. Many clinicians desire to participate in pro bono physical therapy (PT) services. Therefore, the responsibility of promoting and advertising these programs falls upon the student. This paper describes various methods for recruiting clinician involvement to improve the sustainability of a student led pro bono clinic, as well as how the students advocated for pro bono services in the state of Nevada …

Patient Engagement In Cosmetic Designing Of Prostheses: Current Practice And Potential Outcome Benefits, Kenneth Repayo, Cailin Mitchell, Matthew Tillitt, Collin Weber

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Making a prosthesis for an individual with limb loss is a highly personalized process. A currently unexplored area is whether there are tangible benefits in greater patient engagement during the making of their prostheses. We examined the current practice of engaging patients in prosthetic cosmetic designing and identified factors associated with patient outcomes. Methods: This cross-sectional study surveyed 104 prosthetists and 25 prostheses users. The questionnaires covered aspects of prosthetic prescription, users’ perceived level of engagement, and self-reported outcomes. Regression analyses were used to examine the associations between perceived level of engagement, satisfaction, and other outcomes. Results: Among prosthesis …

Essential Competencies For Occupational Therapy In End-Of-Life Care, Karmella Bognot

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists carry an abundance of expertise in helping patients and caregivers navigate the end-of-life journey. The lack of knowledge of OT’s role impacts occupational therapy utilization and service provision in hospice. It reduces opportunities for this population to increase their understanding on how to maintain quality-of-life. The more a patient is able to do lessens the burdens shouldered by the caregiver. Education on pain management and promoting comfort are typical priorities addressed; however, not enough training is focused on maximizing independence or engagement in occupations. Competencies encompass a unique set of skills, knowledge, and abilities necessary for successful performance …

Health And Wellness Competencies For An Entry-Level Doctorate Occupational Therapy Course, Teresa Liccardo

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Accreditation Council for Occupational Therapy Education (2018) standards state that the entry-level occupational therapy curriculum must prepare students to practice in a broad range of practice settings, including new and emerging areas of occupational therapy. Health and wellness remain an emerging and not widely populated area of occupational therapy despite the growing research on its importance. Stancanelli (2020) stated that “with the expected growth of health care in the community and the expected increase in the older adult population, occupational therapy students need to be prepared to practice in the community and address health promotion and wellness needs of …

Implementation Of A Protocol In The Freestanding Emergency Department To Screen For And Identify Possible Victims Of Human Trafficking, Joe Alvarado

UNLV Theses, Dissertations, Professional Papers, and Capstones

Human trafficking (HT) victims often seek medical care in the emergency room setting. In a recent study among HT survivors, 88% attested to receiving medical care while in captivity, with 63% treated in the emergency care setting. Freestanding emergency departments typically have lower acuity and lower patient volumes than hospital-based emergency departments. This setting creates shorter wait times and minimizes the length of stay at every point during the emergency room experience. For traffickers, this is an ideal situation if their victim needs medical attention, and they want to get in and get out of the emergency room with less …