Medicine and Health Sciences Commons^™

Role Of Oxidative Stress And Altered Thyroid Hormones In Unexplained Infertility, Rehana Rehman, Hiba Ismail Rajpar, Mussarat Ashraf, Najeeha Talat Iqbal, Salima Lalani, Faiza Alam

Department of Biological & Biomedical Sciences

Objective: To explore the link between altered thyroid profile and oxidative stress marker in females with unexplained infertility.
Methods: The cross-sectional case-control study was carried out at the Islamabad Clinic Serving Infertile Couples, Islamabad, Pakistan, from June 2016 to August 2017, and comprised women aged 18-40 years regardless of ethnic background who were divided into two groups; those with unexplained infertility were the cases, while fertile women acted as the controls. Serum was analysed for triiodothyronine, thyroxine and thyroid stimulating hormone as well as for oxidative stress markers including manganese superoxide dismutase, glutathione reductase and adrenaline using enzymelinked immunosorbent assay. …

Real-World Cost Of Treatment For Multiple Sclerosis Patients Initiating And Receiving Infused Disease-Modifying Therapies Per Recommended Label In The United States., Jacqueline Nicholas, Rachel Halpern, Marina Ziehn, Jesse Peterson-Brandt, Michael Leszko, Chinmay Deshpande

Neuroscience Articles

Aims: The study evaluated the real-world cost of treatment in multiple sclerosis (MS) patients initiating infused disease-modifying-therapies (DMT) in the United States.Materials and Methods: This retrospective cohort study using administrative claims data included adult patients with MS initiating index infusion DMT (ocrelizumab (OCR), natalizumab (NTZ) or alemtuzumab (ATZ)) from April 2017-September 2018 with 6-months pre/12-months post-index continuous enrollment. The primary cohort included patients who had prescribed annual dosing visits indicated by the approved product label (PL): 3 OCR, 5 ATZ, and 12-13 NTZ infusion visits within the first year of initiation. Annual treatment cost was the sum of all …

Coping Self-Efficacy As A Potential Moderator Of The Relationship Between Sexual Orientation And Negative Mental Health Outcomes, James M. Macchia

Psychology Theses & Dissertations

Sexual minority individuals (i.e., those who identify as a sexual orientation other than heterosexual) have consistently been linked to an increased risk of negative mental health outcomes. The process of coping can impact the content and severity of said outcomes, and one’s ability to cope is often predicted by the concept known as coping self-efficacy (i.e., one’s belief in his or her ability to cope). This study aimed to assess the effects of sexual orientation, coping self-efficacy, and their interactions on mental health by looking at different aspects of coping self-efficacy as potential moderating variables. Self-perceptions of coping skills were …

Atitiudes Tow Ards Computer Games For Learning And Pl.A Yer Archetypes: An Exploration Of Measures On Preintervention Player Characteristics For Serious Game-Based Interventions, Benjamin Lee

Dissertations and Theses (Open Access)

Serious game-based interventions offer promising health outcome results with the aid of pre-intervention player tailoring and the development of measurements that evaluate pre-intervention player characteristics and subgroups. Video gaming measures can potentially provide helpful tailoring information that discerns individual video gaming preferences which could influence their overall user experience. It is critical that measures that target adolescent video gaming be psychometrically validated. There is a gap in the literature with psychometrically validated measures evaluating adolescent attitudes towards computer games for learning and gaming archetypes. Therefore the aims of this dissertation were to 1) evaluate the psychometric properties (i.e., reliability and …

Epidemiology Of No -Syndromic, Orofacial Clefts In A Registry­Based, Birth-Cohort In Texas: Differences By Cleft Type And Presence Of Additional Defects, Maria Luisa Navarro Sanchez

Dissertations and Theses (Open Access)

Although orofacial clefts, which include cleft palate alone (CP) and cleft lip with or without cleft palate (CL±P), are among the most common birth defects, their etiology is complex and is generally not well understood. While some clefts are caused by rare syndromes, the majority occur in the absence of a syndrome, either in association with co-occurring defects or as isolated defects. Among these non-syndromic cases, epidemiologic studies have identified demographic variables that are associated with CP and/or CL±P, such as geographic location and infant sex, as well as several maternal characteristics, though some of these associations have been weak …

Engaging Patients In Atrial Fibrillation Management Via Digital Health Technology: The Impact Of Tailored Messaging., Tammy Toscos Phd, Amanda Coupe, Shauna Wagner, Ryan Ahmed, Amelia Roebuck, Mindy Flanagan, Michelle Drouin, Michael Mirro Md

Health Services and Informatics Research

Patients with atrial fibrillation (AF) demonstrate persistent knowledge gaps regarding their condition and a substandard adherence to oral anticoagulant (OAC) medication, which contribute to thromboembolic stroke and other clot-related complications. Tailored patient education and medication reminders may help reduce these negative health outcomes. We sought to improve disease knowledge and medication adherence among a sample of AF patients using tailored education and nudges. The intervention leveraged three digital health technologies: a patient portal, an electronic-prescribing data feed, and a smart pill bottle. The content of the educational messaging, nudges, and cadence were tailored according to findings from our user-centered design …

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 …

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 …

A Compilation Of Research Experiences, Samantha C. Gotcher

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Multiple projects comprised this thesis requirement. The projects ranged in breadth and depth and included 1) literature reviews across a variety of deaf education topics, including spreadsheets summarizing each literature review, 2) development of over 100 article summaries for the Hear to Learn website, 3) authorship on a manuscript submitted to a peer-reviewed journal, and 4) a peer-reviewed poster presentation at a national conference. My experiences in engaging in these activities immersed me into a greater understanding of the research in the field, resources for services, position papers of various entities, and recommended practices in Listening and Spoken Language (LSL) …

Clinical Presentation, Cardiac Magnetic Resonance Findings, And Prognosis Of Patients With Arrhythmogenic Right Ventricular Cardiomyopathy - An Experience From Pakistan, Intisar Ahmed, Fateh Ali Tipoo Sultan

Section of Cardiology

Objectives: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart-muscle disease, characterized by fibro-fatty replacement and ventricular arrhythmias, that primarily affects the right ventricle (RV). We aimed to look at the clinical presentation, cardiac magnetic resonance (CMR) imaging findings and prognosis of patients with ARVC in Pakistan.
Material and methods: It is a retrospective observational study, 17 consecutive patients with CMR and other findings consistent with ARVC, were enrolled from 2010 to 2019 at a single center.
Results: Out of 17 patients, 12 (70.6%) were male with a mean age of 33.5 ± 17.5 years. Family history of sudden cardiac …

Life, Liberty Or The Pursuit Of Happiness In A Post-Covid 19 Era, Aurobindo Ghosh, Amit Haldar, Kalyan Bhaumik

Research Collection Lee Kong Chian School Of Business

A multi-generational pandemic has afflicted economies and convulsed worldwide health systems putting policymakers on prongs of an unthinkable trinity of choice: life, liberty or the pursuit of happiness? These inalienable rights guaranteed by the US Declaration of Independence seem farcical with three of largest four democracies in the world accounting for the highest infections. In this opinion piece, we re-evaluate the clichéd debate between life and livelihood. Second, we investigate the implementation hurdles faced by the frontline medical policymakers expediting testing regimes and vaccine development to avert an unfolding catastrophe. Medical professional are opting for mitigation strategies like isolating infections …

Examining Provider Perceptions And Roles Associated To Breastfeeding Support And Medical Management In Primary Care, Meghan Ganio Molinari

Graduate Theses

Background: Human milk is recommended as the exclusive source of nutrition for all infants in the first six months of life. Current rates of exclusive breastfeeding at six months are well below the public health recommendations (24.9% as of 2015). New mothers may experience many challenges which impact both breastfeeding initiation and duration rates in the postpartum period. Studies indicate that breastfeeding rates improve when women receive a combination of prenatal education coupled with postnatal support. Primary care practitioners in outpatient settings have a unique opportunity to provide lactation education, support, and medical management for their patients to improve …

The Aids Virus And The Galvanization Of The Lgbtq Movement For Equality, Michael Ernest Wachowski

Graduate Theses

The LGBTQ community was greatly altered by the AIDS crisis and the organizations that were founded in the 1980s. AIDS would become associated with those of the gay community during the early years of the crisis. The government and leading health officials perpetuated the public’s ignorance about the relativity new disease leading to more misunderstandings and mishandlings of the HIV/AIDS crisis. The disease did not discriminate among people, however, and quickly spread throughout many of the communities in the U.S. Organizations with roots in the LGBTQ community established themselves during the 1980s to deal with not only the AIDS crisis, …

Improving Survival Rates In Patients Suffering Cardiac Arrest With Specialized Resuscitation Teams: An Integrative Review, John Campbell Holcomb

Doctoral Dissertations and Projects

Over 300,000 hospitalized patients suffer a cardiac arrest requiring a Code Blue activation each year in the United States. These patients have an extremely high mortality rate. These rates are not uniform across all hospitals and facilities that employ specialize Code Blue resuscitation teams have a higher percentage of patients that survive resuscitation events. This Integrative Review shows that these teams are essential to patient survival but are prone to barriers that must be overcome to provide effective teamwork. Quality improvement projects centered around Code Blue teams can be created at the local level and have been found to be …

Preventing Polypharmacy Amongst The Elderly In An Acute Care Setting Through The Integration Of The Deprescribing Tools Start, Stopp, And Beers Criteria, Samantha Bonita Wilkins-Copeland

Doctoral Dissertations and Projects

A significant percentage of medications prescribed in the United States are prescribed to elderly adults, which is due to the increase in chronic illness as Americans age. This increase in the use of medications amongst the elderly population has led to the issue of polypharmacy, which can lead to negative patient outcomes. An evidence-based practice pilot project was performed at a large tertiary care facility in Virginia. The aim of the scholarly project was to integrate three deprescribing tools into the everyday practice of pharmacists at the facility. Three outcomes were achieved: (1) Pharmacists understood how to accurately utilize the …

Ask, Advise, Assist And Follow: An Evidence Based Project To Address Unhealthy Alcohol Use In A Free Clinic Setting, Lisa K. Floyd

Doctoral Dissertations and Projects

Preventative care in free clinic settings aims to mitigate health risks for vulnerable populations. Heavy alcohol intake is a major threat to physical and mental health. Wellness care for free clinic patients must include regular screening for alcohol use in accordance with national guidelines. The purpose of this project was to implement and evaluate an evidence- based practice change to improve alcohol screening and intervention in a free clinic setting. The NIH/NIAAA screening, brief intervention, and referral for treatment (SBiRT) process was implemented. A convenience sample of de-identified patient charts was reviewed to assess alcohol screening before (n = 38 …

High Reliability In Medication Administration, Bradford White Jensen

Doctoral Dissertations and Projects

This research was designed to test the theory of Robust Process Improvement (RPI) as it has been applied to the problem of medication error at Navy medical treatment facilities (MTFs). Medication error is the greatest cause of patient injury in America. In an effort to duplicate the success of High Reliability Organizations (HROs), leaders of the Joint Commission advocated the application of Lean Six Sigma (LSS) as the key elements of RPI and the best way to increase safety and improve the quality of healthcare. The specific problem was that very little empirical evidence existed supporting the theory. The research …

A Different Strategy For Management Of A Case Of Adenoid Cystic Carcinoma Of Bartholin Gland, Rozilla Sadia Khan, Huda Saleem Abbasi

Department of Obstetrics & Gynaecology

Adenoid cystic carcinoma of the Bartholin gland is a rare vulval cancer. Available literature suggests an aggressive nature with protracted clinical symptoms and local recurrence despite adequate surgical excision with or without adjuvant radiotherapy. This case demonstrates the role of neoadjuvant chemotherapy and interstitial brachytherapy with less radical surgery, in the treatment of adenoid cystic carcinoma of the Bartholin gland. A 63-year-old woman presented in the clinic four months after the removal of vulvar mass with histopathology report showing adenoid cystic carcinoma of the Bartholin gland with positive margins. Clinical examination and imaging showed local disease extension up to the …

Activation Of Trpa1 Nociceptor Promotes Systemic Adult Mammalian Skin Regeneration, Jenny J. Wei, Hali S. Kim, Casey A. Spencer, Donna Brennan-Crispi, Ying Zheng, Nicolette M. Johnson, Misha Rosenbach, Christopher Miller, Denis H. Y. Leung, George Cotsarelis, Thomas H. Leung

Research Collection School Of Economics

Adult mammalian wounds, with rare exception, heal with fibrotic scars that severely disrupt tissue architecture and function. Regenerative medicine seeks methods to avoid scar formation and restore the original tissue structures. We show in three adult mouse models that pharmacologic activation of the nociceptor TRPA1 on cutaneous sensory neurons reduces scar formation and can also promote tissue regeneration. Local activation of TRPA1 induces tissue regeneration on distant untreated areas of injury, demonstrating a systemic effect. Activated TRPA1 stimulates local production of interleukin-23 (IL-23) by dermal dendritic cells, leading to activation of circulating dermal IL-17–producing γδ T cells. Genetic ablation of …

The Determinants Of Physical Activity, Self-Monitoring Of Blood Glucose, And Poor Glycemic Control Among Individuals Diagnosed With Type 2 Diabetes In Saudi Arabia: A Cross-Sectional Study Based On The Saudi Health Interview Survey (Shis), Mohammed Abdulrahman S. Alsuliman

Health Services Research Dissertations

The prevalence of diabetes and poor glycemic control in Saudi Arabia has increased that contributed to the growing number of deaths in Saudi Arabia. It is known that type 2 diabetes (T2DM) can be prevented but there is a lack information about the magnitude of the of diabetes at national level as well as the risk factors for physical activity (PA), self-monitoring of blood glucose (SMBG), and poor glycemic. Thus, through utilizing Health promotion model (HPM), the aims are to examine the personal factors, cognitive-perceptual, and behavioral determinants of three outcomes; physical activity, SMBG, and poor glycemic control. A secondary …

Predictors Of Dental Students’ Behavioral Intention Use Of Teledentistry: An Application Of The Unified Theory Of Acceptance And Use Of Technology (Utaut) Model, Jafar Hassan Alabdullah

Health Services Research Dissertations

Shortages of dental professionals and access barriers to dental care are challenges to improving oral health and decreasing the burden of dental diseases. There are more than 57 million individuals in the U.S. who live in dental health professional shortage areas (DHPSA). The U.S. DHPSA areas need 9,951 dental practitioners to overcome the obstacles to oral care access. Due to dental care needs for these populations, it is imperative to find a new method to reach these underserved populations. Teledentistry is an innovative technology that can be used to improve access to care and oral health outcomes. Unfortunately, there is …

Ureteroscopic Biopsy Of Upper Tract Urothelial Carcinoma And Role Of Urinary Biomarkers, Katherine E Smentkowski, Demetrius H. Bagley, Scott G. Hubosky

Department of Urology Faculty Papers

Ureteroscopic biopsy is an integral part of diagnosis of urothelial carcinoma of the upper urinary tract. It can be a technical challenge, but diagnostic rates have improved remarkably with refinements in surgical technique and specimen processing. Cytology aids with diagnosis and other urinary biomarkers continue to evolve, which may help further stratify patients for treatment. The current literature on the ureteroscopic biopsy and role of urinary biomarkers is reviewed and summarized below.

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 …

Rejection Sensitivity And The Intent To Seek Medical Help Among Gender Minority Individuals, Kellyann Garthe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: As members of a marginalized and socially devalued group, gender minority (GM) individuals regularly experience rejection in healthcare experiences. These rejecting experiences lead to barriers to healthcare access and health disparities. Consequently, GM individuals’ may develop anxious and avoidant attitudes toward their healthcare needs. When considering healthcare, an individual’s inherent attitude informs their intent to seek medical help (ISMH), defined as the attitude that influences one’s decision to seek medical help. When an individual has a hyper-sensitive reaction to perceived rejection, this is termed rejection sensitivity (RS).

Purpose: The purpose of the study was to determine if the independent …

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 …

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 …

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 …

Examination Of Factors Reported By Athletes To Interfere With Their Lives Outside Of Sports, Jesse Scott

UNLV Theses, Dissertations, Professional Papers, and Capstones

The original Sport Interference Checklist (SIC) is a mental-health screening instrument designed to assess the extent to which mental health factors interfere with athletes’ performance during sport training or competition. In addition, the SIC appraises whether athletes are interested in pursuing psychological treatment for the aforementioned factors. Although validated, the SIC does not assess how the aforementioned factors affect athletes’ performance outside of sports. Doing so would permit professionals to examine the influence of these factors across sport training, sport competition, and life outside of sports.

The purpose of this study was to determine the psychometric properties and clinical utility …

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 …