Medicine and Health Sciences Commons^™

Social Emotional Learning As A Universal Upstream Approach To Youth Suicide Prevention: A Secondary Data Analysis Of A Prevention Program Evaluation, Maria Amaris Knight

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Nevada has had consistently high rates of youth suicide in the past decade with 21.2 deaths by suicide per 100,000 population (ages 15-24), over the national rate of 14.5 deaths per 100,000 in 2019. National strategies, state agendas, and best practices in the field prioritize research on upstream strategies to prevent suicide. One such strategy is the use of social emotional learning (SEL) programs for youth to help increase and enhance protective factors against suicide, helping them to cope with negative life events. Research has identified leading outcomes of SEL programs as the improvement of attitudes, behaviors, and academic …

Factors Influencing The Self-Reported Palliative Care Practices Of Acute Care Nurses, Keshia Ryan Kotula

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction Approximately 40 million people are currently in need of palliative care (PC), and this number is predicted to increase due to the aging population and increasing longevity. Providing PC in the acute care setting leads to better quality and clinical outcomes, reduced inpatient hospital costs, and improved efficiency. Despite evidence indicating the benefits of PC, timely referrals and provision of PC in the acute care setting are lacking in part due to the complex interplay of factors that nurses must navigate, such as limited preparation, knowledge, and self-efficacy; nurse/provider attitudes; and patient/family and institutional barriers. A paucity of research …

Development Of A Novel Cognitive-Motor Dual Task Assessment Battery In Neurodegenerative Disease, Jason Longhurst

UNLV Theses, Dissertations, Professional Papers, and Capstones

Automaticity --- the ability to perform a task with directing attentional resources to its completion --- is commonly reduced among individuals with neurodegenerative diseases. These automaticity deficits result in impaired functional and daily activities and are sensitive to subtle, subclinical impairments. However, current measurement of automaticity by dual task paradigms is methodologically limited. In order to gain insight into the current state of the literature regarding cognitive-motor interference in symptomatic and prodromal neurodegenerative disease, the author of this dissertation conducted a scoping review (Chapter 1). To address the methodological limitations of current measurement of automaticity, a new measurement tool was …

Increasing Perioperative Outpatient Nurses’ Knowledge Of Pediatric Anxiety Through Use Of A Developed Clinical Guide, Christine Oliver

UNLV Theses, Dissertations, Professional Papers, and Capstones

Elevated perioperative anxiety levels in the pediatric population is a main concern when providing nursing care in a specialty area. In the United States, over five million pediatric patients will have some type of surgery each year and greater than 65 percent of those pediatric patients will exhibit preoperative anxiety. The care of pediatric patients in the outpatient surgical setting has grown significantly, and pediatric care is no longer restricted to specialized facilities or hospitals. This increased number of pediatric patients in day surgery centers has created a shift in nursing care for perioperative nurses. Anxiety has been directly related …

Improving Therapeutic Communication In Mental Health Nursing: A Quality Improvement Project, Patricia A. Nill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 46 million adults in the United States (U.S.) live with a mental illness. Locally in Nevada, the psychiatrist to patient ratio is approximately 700:1, and patients are seen primarily in the inpatient setting, if seen at all, due to the wait average of 85 hours in the hospital emergency rooms for access into mental health hospitals or specialty units of a general hospital. Moreover, costs for mental health mood disorders alone are estimated at over seven million dollars annually. The Institute of Medicine (IOM) opined the need for change in healthcare to redesign practice and clinical communication with patients …

Developing Strategic Partnerships To Impact Population Health: A Professional Development Module, Andra S. Scano

UNLV Theses, Dissertations, Professional Papers, and Capstones

Massive organizational changes occurring in our health care delivery system have provided opportunities for nurse leaders who think in terms of population health, to develop new skills needed to impact the populations they serve. Aspects of these changes include a focus on the delivery of primary and community-based care and the development of partnerships, alliances, and other linkages across settings to build integrated systems (Williams, 2020, p. 17). Turner (2020) asserts that population-focused nurse leaders are charged with creating a new future for healthier communities which often involves strategic partnership development. However, strategic partnership development is a complex task that …

An Intervention To Improve Nurses’ Knowledge, Perceived Safety, And Confidence In Identifying And Managing Workplace Violence: A Translation Of Evidence Into Practice, Kayla Sullivan

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Occupational Safety and Health Administration (OSHA) reports that over two million workers are victims of workplace violence (WPV) (Papa, 2013). Registered nurses are subjected to high risk for workplace violence from patients and visitors, with 25.5% reporting at least one victimization incident (Gillespie et al., 2013). Research indicates that WPV has a significant impact on nurses' quality of working life, job satisfaction levels, turnover rates and has also been shown to negatively impact efficiency and productivity (Gacki-Smith et al., 2009). ED nurses are at substantial occupational risk for workplace violence. Emergency departments have been identified as areas within the …

An Evaluation Of Care Coordination In Reducing Depression Symptoms And Emergency Room Visits, Stacy Sumpter

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Individuals living with multiple chronic conditions (MCC) account for 26% of the population; however, they consume 84% of healthcare resources, are three times more likely to have depression than healthy individuals, and have increase emergency room (ER) visits and healthcare resource use. This population requires coordinated health care to reduce unnecessary spending and the misappropriation of healthcare resources. The purpose of this project was to evaluate the efficacy of care coordination (CC) and the support system it provides in lowering depression symptoms and ER visit frequency as a viable measure to reduce overall healthcare costs.

Methods: The healthcare providers, …

Scardovia Wiggsiae And Streptococcus Sobrinus Prevalence Among Orthodontic And Non-Orthodontic Patients, Melissa Trumbo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Dental cavities or caries have been identified as among the most prevalent of preventable oral conditions. However, studies are discovering new information regarding the incidence and prevalence of several cariogenic organisms, including Streptococcus mutans (SM), the recently discovered Scardovia wiggsiae (SW), as well as Streptococcus sobrinus (SS). These studies have revealed varying prevalence among different populations, such as those undergoing orthodontic treatment. Based upon this information, the main goal of the current study was to assess the prevalence of specific cariogenic organisms (SS and SW) within saliva samples originally obtained from a dental school-based clinic.

Methods: The protocol for …

Examining The Experiences Of Lgbtq Dpt Students: A Critical Ethnography, Catherine Turner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to examine the experiences of LGBTQ Doctor of Physical Therapy (DPT) students at a large public university in the south-western United States, as it relates to the culture and climate of the program and campus. The LGBTQ community faces its own unique health disparities. Research in medicine suggests improving the diversity of the healthcare profession is a vital component in improving access to care, and this requires the creation of inclusive and supportive educational environments for LGBTQ identifying healthcare students. However, minimal research exists examining the experiences of LGBTQ physical therapy students.

The study …

Assessment Of The Infrazygomatic Crest And Distal Infrazygomatic Crest For Bone Depth And Miniscrew Insertion, Kyle C. Tuttle

UNLV Theses, Dissertations, Professional Papers, and Capstones

The aim of this study was to analyze and compare the bone depth at various postulated miniscrew insertion angles in both the Infrazygomatic Crest (IZC) and Distal Infrazygomatic Crest (DIZC) regions. Furthermore, root morphologies of the maxillary 1st and 2nd molars and their effect on bone depth and the various miniscrew insertion angles were analyzed.

A total of 69 CBCT images were collected from pre-orthodontic adult patients at the UNLV orthodontic residency clinic. Bone depth measurements were made at 8 postulated miniscrew insertion angles starting at 40° up to 75°. All measurements were recorded from the buccal bone at the …

Food Insecurity And Adiposity Among Children And Adults Nhanes 2015-2016, Denise Vidal

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Obesity is a preventable disease that has been associated with many adverse health outcomes. A possible factor that may influence adiposity development is food insecurity. Although several epidemiological studies have been conducted examining the association between food insecurity and adiposity among children and adults, results have been inconsistent. Objective: This cross-sectional study investigates the relationship between food insecurity and adiposity among children and adults using recent data from a representative sample of the US population. Methods: We examined 3,391 adults and 2,837 children from the National Health and Nutrition Examination Survey (NHANES) 2015-2016. Household food insecurity was assessed using …

Opioid And Naloxone Training In A Rural School District, Allyson C. Waldron

UNLV Theses, Dissertations, Professional Papers, and Capstones

The opioid epidemic is a national health emergency in the United States, with over 128 people dying each day due to an opioid overdose. It is estimated that 4.3 million people over the age of 12 use opioids without a medical need, and 1.3 million youth ages 12-17 use opioids inappropriately. Drug overdose deaths have become the leading cause of accidental death in the United States, prompting the U.S. Surgeon General and the World Health Organization to advise that more Americans have access to naloxone and understand how to use this life-saving drug correctly. Naloxone is an opioid antagonist, used …

Nursing Toolkit For Care Of The Pediatric Patient With Suicidal Ideation, Christine Young

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nevada’s pediatric suicide rate is one of the highest in the country. Many patients require inpatient stabilization, either in an emergency department setting or on a pediatric unit, until they are ready for discharge to home or a subsequent behavioral health facility. In many instances, patients are assigned to nurses who have had no formal training on caring for pediatric patients with suicidal ideation. Providing care for these patients can increase nurses’ emotional stressors. Purpose: The purpose of this DNP project was to increase the knowledge of pediatric nurses in Nevada using a nursing toolkit containing information to aid in …

Global Trends In Norovirus Genotype Distribution Among Children With Acute Gastroenteritis., Jennifer L. Cannon, Joseph Bonifacio, Filemon Bucardo, Javier Buesa, Leesa Bruggink, Martin Chi-Wai Chan, Tulio M. Fumian, Sidhartha Giri, Mark D. Gonzalez, Joanne Hewitt, Jih-Hui Lin, Janet Mans, Christian Muñoz, Chao-Yang Pan, Xiao-Li Pang, Corinna Pietsch, Mustafiz Rahman, Naomi Sakon, Rangaraj Selvarangan, Hannah Browne, Leslie Barclay, Jan Vinjé

Manuscripts, Articles, Book Chapters and Other Papers

Noroviruses are a leading cause of acute gastroenteritis (AGE) among adults and children worldwide. NoroSurv is a global network for norovirus strain surveillance among children(genotype and polymerase type) and uploaded 1,325 dual-typed sequences to the NoroSurv web portal during 2016-2020. More than 50% of submitted sequences were GII.4 Sydney[P16] or GII.4 Sydney[P31] strains. Other common strains included GII.2[P16], GII.3[P12], GII.6[P7], and GI.3[P3] viruses. In total, 22 genotypes and 36 dual types, including GII.3 and GII.20 viruses with rarely reported polymerase types, were detected, reflecting high strain diversity. Surveillance data captured in NoroSurv enables the monitoring of trends in norovirus strains …

Computational Sentiment Analysis Of An Online Left Ventricular Assist Device Support Forum: Positivity Predominates, Melissa Austin, Abhiraj Saxena, Thomas O'Malley, Elizabeth Maynes, Henry Moncure, Nathan Ott, H. Todd Massey, Francesco Moscato, Antonio Loforte, John M Stulak, Vakhtang Tchantchaleishvili

Division of Cardiology Faculty Papers

Background: The impact of left ventricular assist device (LVAD) complications on the individual patient, overall sentiment, and its effect on referral patterns, is not fully understood. We sought to better understand patient attitudes towards LVAD therapy using a computational sentiment analysis approach.

Methods: Posts, comments, and titles were parsed from MyLVAD.com's HTML as a text file using custom Python scripts (version 3.6). Individual word frequency was computed with word classification as 'positive', 'negative', or 'neutral'. Data transformation and cleaning, sentiment determination, and analysis was performed with a binary dictionary package using R software (version 3.6).

Results: Sixty-six thousand eight hundred …

Evaluation Of Antiplatelet-Related Bleeding Events In A Community Hospital, Frank C. Moreno Exposito, Heidi Clarke, Erika Dittmar

All Publications

Background:Bleeding rate among patients who take high-dose aspirin is approximately 1.92% with an expected 2-3 fold increase after a second antiplatelet is added. Similarly, the addition of an anticoagulant to single or dual antiplatelet therapy results in increased bleeding rates of approximately 13.9% and 15.7% respectively. The concomitant use of antiplatelets and anticoagulants has become a common practice due to the high incidence of clinical conditions for which these agents are used. Hence, reversal of antithrombotic agents is often needed during major bleeding events or invasive procedures. However, the use of antiplatelet reversal is still under-utilized, and its efficacy …

Educating Children During Covid-19 And Beyond, Alvin Lee

Asian Management Insights

Since the World Health Organization declared Covid-19 a pandemic in March 2020, school closures across the Asia-Pacific region have affected some 325 million children.

Hypercalcemia Of Malignancy Attributed To Cosecretion Of Pth And Pthrp In Lung Adenocarcinoma, Jeffrey Kroopnick, Ubaldo E. Martinez-Outshoorn, Madalina Tuluc, Caroline S Kim

Department of Medical Oncology Faculty Papers

Introduction: Hypercalcemia of malignancy (HCM) portends a very poor prognosis, and no established guidelines exist regarding its management. Most instances of HCM are due to local osteolysis or secretion of parathyroid hormone related-peptide, while less than 1% of all cases are due to ectopic secretion of parathyroid hormone.

Case report: We present an unusual case of HCM due to proposed cosecretion of both parathyroid hormone and parathyroid hormone-related protein in a 36-year-old man with a poorly differentiated lung adenocarcinoma. The patient's hypercalcemia was refractory to conventional measures, including intravenous bisphosphonate therapy (zoledronic acid), and was improved with administration of denosumab. …

Examining The Mental Health Of Older Hispanic/Latino Adults: Relationship Between Psycho-Social-Cultural Factors And Depressive Symptomatology, Anna Prado

Theses and Dissertations

The most prevalent disorders affecting the older adult population worldwide are dementia and depression. Ethnic minorities are disproportionately more likely to be affected by these two distressing and debilitating conditions. Hispanic/Latino older adults encounter numerous psycho-social-cultural factors that influence health behaviors, attitudes, and beliefs in positive and negative ways. Presently, research on the influence of these factors on Hispanic/Latino mental health is highly inconsistent. The purpose of the present study is to examine the relationship between selected psycho-social-cultural factors and the mental health of older Hispanic/Latino adults. Using data from the Health and Retirement Study, the association between the Hispanic/Latino …

Perspectives On Bilingualism In Persons With Autism Spectrum Disorder In The Rio Grande Valley, Rosa N. Benavidez Saldivar

Theses and Dissertations

The present study examined the perspectives of both professionals and parents regarding bilingualism in persons with autism spectrum disorder. The participants included 40 professionals and 5 parents from the Rio Grande Valley. Data was collected via an online survey. These findings will not only provide fundamental knowledge but will allow for breaking the silence on the topic of bilingualism in the field of ASD. Therefore, the outcome of this research is to expand the literature for both parents and professionals, in order for them to make informed decisions about this population, and to encourage the development of bilingual services and …

How Covid-19 Has Fundamentally Changed Clinical Research In Global Health, Jay J H. Park, Robin Mogg, Gerald E. Smith, Etheldreda Nakimuli-Mpungu, Fyezah Jehan, Craig R. Rayner, Jeanine Condo, Eric H. Decloedt, Jean B. Nachega, Gilmar Reis, Edward J. Mills

Department of Paediatrics and Child Health

COVID-19 has had negative repercussions on the entire global population. Despite there being a common goal that should have unified resources and efforts, there have been an overwhelmingly large number of clinical trials that have been registered that are of questionable methodological quality. As the final paper of this Series, we discuss how the medical research community has responded to COVID-19. We recognise the incredible pressure that this pandemic has put on researchers, regulators, and policy makers, all of whom were doing their best to move quickly but safely in a time of tremendous uncertainty. However, the research community's response …

Urgently Seeking Efficiency And Sustainability Of Clinical Trials In Global Health, Jay J H. Park, Rebecca F. Grais, Monica Taljaard, Etheldreda Nakimuli-Mpungu, Fyezah Jehan, Jean B. Nachega, Nathan Ford, Denis Xavier, Andre P. Kengne, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

This paper shows the scale of global health research and the context in which we frame the subsequent papers in the Series. In this Series paper, we provide a historical perspective on clinical trial research by revisiting the 1948 streptomycin trial for pulmonary tuberculosis, which was the first documented randomised clinical trial in the English language, and we discuss its close connection with global health. We describe the current state of clinical trial research globally by providing an overview of clinical trials that have been registered in the WHO International Clinical Trial Registry since 2010. We discuss challenges with current …

Referral Pattern And Outcomes Of Neonates From Secondary Care Setting Of Aga Khan University Hospital To Tertiary Care Centers In Pakistan, Suneeta Khemani, Nazia Shamim, Adnan Mirza, Nadia Mohammad, Safdar Kagazwala, Shakeel Ahmed

Department of Paediatrics and Child Health

Objective: To determine the reasons of neonatal referrals from secondary-care to tertiary-care setting, and to assess neonatal outcomes for the referred cases.
Methods: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data from July 2015 to June 2019 Related to all neonates born after 32 weeks of gestation at the satellite secondary-care centres in Kharadar, Garden and Karimabad who had been referred to the main tertiary care hospital. The reason for referral, need of mechanical ventilation, referral place and neonatal outcome were noted. Data was analysed using SPSS 22.
Results: Of the 348 cases, …

Introduction To Leadership Development Using The "Five Practices" Framework In A Co-Curricular Pharmacy Student-Development Program, Sumyya Wase, Melinda E. Lull

Pharmacy Faculty/Staff Publications

Introduction and leadership framework: With the increased expectation that pharmacy education should prepare students to become pharmacy leaders, schools of pharmacy are struggling to find ways to incorporate leadership topics. One way to incorporate content is to build co-curricular programs that introduce and practice leadership frameworks. The co-curricular program described in this study introduces leadership content using Kouzes and Posner's Student Leadership Challenge. Educational context and methods: Students were offered three workshops developed around the Five Practices framework. Each workshop provided background knowledge before engaging in self-reflection, discussion, and application activities. Students participated in a pre−/post-series assessment of leadership practices, …

Infective Endocarditis-Associated Glomerulonephritis Versus Cryoglobulinemic Glomerulonephritis: An Unfortunate Clinical Overlap, Yesha K. Shah Do, Emilee E. Kurtz Do, Sharon E. Maynard Md, Mohammad Saqib Md

Department of Medicine

No abstract provided.

Trends Contributing To Disparities In Inflammatory Breast Cancer, Anna Lehrberg, Nayana Dekhne, Amita Desai, Sayee Kiran

Conference Presentation Abstracts

Background/Objective: Breast cancer overall survival rate in Black American (BA) women is lower compared to White American (WA) women. Inflammatory breast cancer (IBC) is a rare but aggressive subtype of breast cancer that is found at higher incidence in the BA patients. The objective of this study was to evaluate trends and identify factors that contribute to racial disparities in outcomes of women with IBC. Methods: The National Cancer Database (NCDB) was used to evaluate patients with Stage III IBC from 2004 to 2014. Patient demographics, tumor characteristics, treatments and survival trends were stratified by race for comparison. Results: A …

Pegloprastide-Based Ratiometric Fluorescence Imaging Detects Intraoperative Positive Margins In Real-Time, Sarah A. Mclaughlin, M Catherine Lee, Sheldon M. Feldman, Barry Rosen, Valerie P. Grignol, Anne M. Wallace, Nayana S. Dekhne

Conference Presentation Abstracts

Background/Objective: Positive margins detected after breast conservation surgery can result in the need for a re-excision or completion mastectomy. We hypothesized that pegloprastide combined with a ratiometric fluorescence imaging system would allow surgeons to detect positive margins in real time. Methods: Pegloprastide (AVB-620) was to be administered to patients 3-20 hours before the start of surgery. During the operation, initial primary tumor removal was performed unaided. Following primary resection, a fluorescence imaging system optimized for use with pegloprastide was used to assess the primary specimen and the cavity. Cavity shaves were taken when fluorescence above pre-specified thresholds were noted. Additional …

Food Selection And Consumption During The Covid-19 Pandemic/Quarantine, Shawnyse Debaun, Pui Tan Lau

Loma Linda University Research Reports

Background: The Coronavirus disease 2019 (COVID-19) created an unexpected outbreak that led to a pandemic and the fear of scarcity regarding food. Due to those who shopped in panic, grocery stores began to limit the number of specific items purchased per family. The COVID-19 is a novel disease that has changed society by wearing face-coverings when out in public, temporarily closing indoor dining at restaurants, and converting schools online. The over-purchase of toilet paper and water caused many grocery and department stores to exhaust their inventory. This situation may have instilled fear of scarcity and leave to the over-purchase …

A Comparative Study Of Recovery Ecosystems For Opioid Use Disorder In Portugal And Appalachia, Jonathan David Mullins

Undergraduate Honors Theses

A comparison of the structure and effectiveness of recovery ecosystems for opioid use disorder in Portugal and Appalachia, with a focus on identifying areas for improvement within the Appalachian region.