Medicine and Health Sciences Commons^™

Assessments Of Social Vulnerability On Laryngeal Cancer Treatment & Prognosis In The Us: Epidemiology, David J. Fei-Zhang, Camaren M. Cuenca, Angela D. Haskins, Andrew P. Stein, David G. Lott, Urjeet A. Patel, Stephanie S. Smith, Amy L. Dimachkieh, Nosayaba Osazuwa-Peters, Jill N. D’Souza, Anthony M. Sheyn, Jeffrey C. Rastatter, Daniel C. Chelius

School of Medicine Faculty Publications

Background: Previous social determinants of health (SDoH) studies on laryngeal cancer (LC) have assessed individual factors of socioeconomic status and race/ethnicity but seldom investigate a wider breadth of SDoH-factors for their effects in the real-world. This study aims to delineate how a wider array of SDoH-vulnerabilities interactively associates with LC-disparities. Methods: This retrospective cohort study assessed 74,495 LC-patients between 1975 and 2017 from the Surveillance-Epidemiology-End Results (SEER) database using the Social Vulnerability Index (SVI) from the CDC, total SDoH-vulnerability from 15 SDoH variables across specific vulnerabilities of socioeconomic status, minority-language status, household composition, and infrastructure/housing and transportation, which were measured …

Staff Education Program Utilizing A Workflow Template To Streamline Care In Occupational Health, Alicia Vogleson

Walden Dissertations and Doctoral Studies

This DNP Project is one designed to educate Occupational Health Staff. As there are varying levels of skills and education of staff working with patients, it is important to identify staff that who can play a large role in helping gather important information to help in treatment decisions early on in the process of patient care. The practice-focused question and the purpose of the project was to answer the following question: will a staff education program for Medical Assistants and Front Desk Staff in an Occupational Health clinic on the utilization of a template to streamline workflow improve their knowledge? …

Impact Of Safety Practices On Laboratory-Acquired Infections In Clinical Laboratories From 2018 To 2023, Lori Bane

Walden Dissertations and Doctoral Studies

Laboratorians identifying unknown pandemic pathogens face elevated risks of laboratory-acquired infections yet limited research examines how regulated safety practices influence these risks. This quantitative, correlational study used the Centers for Disease Control and Prevention’s secondary data (2018–2023) to examine two research questions. The first one questioned whether there were differences in safety incidents between registered and exempt clinical laboratories. The second research question investigated whether there was an association of laboratory incidents between BSL-2 and BSL-3 laboratories. The research was limited to incident reports from registered and exempted clinical laboratories working in BSL-2 and BSL-3 conditions. Guided by the Health …

Exploring The Public Health Agency Of Canada’S And The Ontario Government’S Vaccine-Related Crisis Communication On X During The Covid-19 Pandemic, Sheraza Burney, Lori Donelle Phd, Rn, Fcan, Anita Kothari

Publications

Crisis communication strategies must be tailored to the unique nature of social media. In response to the COVID-19 pandemic, public health agencies have widely used social media to address vaccine hesitancy and misinformation. This research utilized the social media pandemic communication model to describe the key themes disseminated through the Ontario government and the Public Health Agency of Canada's vaccine-related crisis communication on X (formerly Twitter). Between 27 January 2020 and 6 April 2021, 1271 posts related to COVID-19 vaccination were collected from three official government X accounts—two from the province of Ontario and one from Canada. Posts were analyzed …

Identifying Distinct Subgroups With Severe Pain In Sickle Cell Disease: A Cluster Analysis Of The Grndad Multi-Center Registry, Martha O. Kenney, Samuel Wilson, Morgan Rosser, Sophie Lanzkron, Julie Kanter, Susan Padrino, Payal Desai, Deepa Manwani, Alice Cohen, Stephanie Guarino, Ward Hagar, Joshua Field, Jane Little

Department of Medicine Faculty Papers

Sickle cell disease (SCD) affects millions of individuals worldwide, and is characterized by both acute, episodic pain and chronic, persistent pain. Despite the significant burden of the disease, clinicians continue to face significant challenges in treating SCD pain due to variability in pain experiences. The objectives of this study were (1) to identify distinct pain subgroups based on demographic and biopsychosocial characteristics and (2) to evaluate the relationship between the subgroups and pain impact - a SCD-disease specific measure of pain interference. To achieve these objectives, we performed a hierarchical cluster analysis on a cross-sectional sample of adults with SCD …

Secondary Educators’ Knowledge And Perceptions Of Their Own Self-Efficacy As It Relates To 504 Plan Accommodations For Students Diagnosed With Adhd, Anne Richardson

Seton Hall University Dissertations and Theses (ETDs)

This study investigated the role of Section 504 accommodations in meeting the needs of secondary students with attention-deficit/hyperactivity disorder (ADHD) in the United States. While legislation requires equitable education for students with disabilities, gaps remain in understanding how educators perceive their own abilities in implementing Section 504 plans for students with ADHD. The study used a qualitative research design to explore the academic and organizational challenges faced by secondary school students with ADHD, specifically examining the knowledge, perceptions, and self-efficacy of secondary educators regarding ADHD strategies and 504 plan accommodations. Semi-structured interviews were conducted via Zoom with 11 educators from …

Role Of Enhanced External Counterpulsation In Long Covid, Sachin A. Shah, Quy Phan, Joshua A. Radel

Pacific Faculty Work

No abstract provided.

Empowering Nurses, Enhancing Mobility: A Qi Initiative Using Plof And Clof To Promote Patient Ambulation, Kaela Nguyen

Master's Projects and Capstones

The quality improvement project involves the intervention of implemented mobility educational flyers about the mobility tools, Clinician Reported Level of Function (CLOF) and Patient Reported Level of Function (PLOF) and aims to increase patient mobility post surgery. The quality improvement project was conducted in two medical surgical units in a San Francisco hospital. To address unmet mobility goals, during change of shift, in-services on the educational flyers about the mobility tools (CLOF and PLOF), were utilized to provide education about the importance of mobility, how to utilize the mobility tools, and correctly document ambulation. More than twenty flyers were posted …

Effect Of Clean Closing Tray Use On Surgical Site Infection Following Colorectal Surgeries, Elizabeth Carlson, Nora Laban, Shelli Bergeron, Diana Lee, Donna Kayal, Kristin Lemarbe, Scarlett Hao, Jacob Mesiti, Bradley Krasnick, Harry Wasvary

Conference Presentation Abstracts

Introduction:  Reducing surgical site infections (SSIs) after colorectal surgeries remains a key quality improvement target. The summative effect of multiple pre-, intra-, and postoperative interventions bundled as part of Enhanced Recovery After Surgery (ERAS) programs are shown to effectively reduce SSIs, however the individual impact of each intervention has not been well-studied. This study evaluates the impact of clean closing tray use on the rate of SSIs in colorectal surgeries.  Methods:  A retrospective cohort study was conducted at a single tertiary care center of all intraabdominal colorectal surgeries performed between 2016 and 2021. Patients with documented infection present at the …

The Wright Way: Advancing Pediatric Perianesthetia Nursing Competencies, Marisela E. Acevedo-Padilla

Master's Projects and Capstones

Objective Implementing the Donna Wright Competency Model at a Bay Area Children’s Hospital in its peri-anesthesia units. Throughout available literature it was possible to observe the positive effects of implementing a competency model such as the DWCM has on the confidence of nursing staff and patient outcomes. An important point shown by literature was addressing more than technical skills and incorporating critical thinking and ethical considerations regarding patient care. Aim We aim to improve nurse competency in pediatric peri-anesthesia units at a Bay Area Children's Hospital by implementing Donna Wright’s Competency Model. Data obtained in August 2024 from a series …

Bridging The Gap In Early Mobilization: Implementing The Bmat 2.0 To Enhance Patient Care And Outcomes, Elyas Gul

Master's Projects and Capstones

Objective: Early mobilization of patients is correlated to enhanced functional recovery (Zhang et al., 2019), decreased hospital stays (Zhang et al., 2019), and a reduction in healthcare costs (Liu et al., 2019). Unfortunately, inconsistency in hospital staff training and an absence of mobility assessment standardization have served as barriers to successful implementation. Aim: This quality improvement project aims to increase the percentage of RNs and CNAs who effectively use the BMAT 2.0 to promote early mobilization of medical-surgical endocrine and stroke patients by 20%, from 31.4% to 51.4% by April 22, 2025. The project will occur during a 12-week …

Safety And Efficacy Of A Mesenchymal Stem Cell Secretome Therapy (Kpi-012) For Persistent Corneal Epithelial Defects: A Phase 1b Trial, Valeria Sánchez Huerta, Hugo Quiroz-Mercado, Enrique O Graue-Hernández, Alejandro Navas, Spencer Alford, Darius Kharabi, Stephen Pflugfelder

Faculty, Staff and Students Publications

Background: Persistent corneal epithelial defect (PCED) is a condition often refractory to conventional treatments. KPI-012 is a topical mesenchymal stem cell secretome therapy under investigation for PCED management.

Objective: To assess the safety, tolerability, and corneal wound healing efficacy of KPI-012 in a phase 1b, proof-of-concept, open-label, single-arm clinical trial.

Methods: The safety profile and tolerability of topical self-administered KPI-012 therapy (twice daily, 1-week duration) were first evaluated in an initial safety cohort of participants with pre-existing permanent vision loss and no active corneal disease (n = 3). The safety profile and efficacy of KPI-012 were then assessed in participants …

Plagiocephaly In Premature Infants: Enhancing Nicu Caregiver Education, Hailee Efferson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To improve NICU nurses’ confidence in preventing and managing plagiocephaly in premature infants through a one-on-one educational session.Design: One-group post-test design for a quality improvement initiative. Setting: Neonatal Intensive Care Unit (NICU) at Summerlin Hospital Medical Center. Participants: 20 NICU Nurses. Measures: Post-session questionnaire including close-ended Likert scale and open-ended questions. Results: Mean scores ranged from 3.5 to 4.0, with the highest rating for the helpfulness of the session format (mean = 4.0) and the lowest for confidence in alternating infant positioning (mean = 3.5). Standard deviations ranged from 0 to 0.59, indicating strong agreement regarding the session format …

Acquired Brain Injury Education: Utilizing Unfolding Case Studies To Improve Critical Thinking Skills In Occupational Therapy Students, Katherine Hathaway

UNLV Theses, Dissertations, Professional Papers, and Capstones

Acquired brain injuries (ABI), including traumatic brain injury, stroke, and anoxia, affect millions worldwide, and often result in long-term impairments in daily functioning. Despite the need for specialized, ongoing care, many individuals with ABI lack access to adequate long-term rehabilitation services, and families report substantial caregiver burden due to limited resources and poor care coordination. Occupational therapy plays a critical role in meeting the needs of this population; however, many entry-level practitioners feel underprepared to manage the complex challenges associated with ABI, largely due to limited training and exposure. This capstone project aimed to address this educational gap by implementing …

Cone Beam Ct Assessment Of The Zygomatico-Maxillary Buttress For Bone Thickness And Clinical Implications For Miniscrew Insertion, Zachary Hendrickson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Temporary anchorage devices (TADs) have changed the way many orthodontists practice orthodontics. TADs are mini-screw temporary implants made of titanium or stainless steel that are placed in the patient's bone in different locations to aid in complex biomechanical movements. This complete anchorage aids in distalization, intrusion, protraction, etc. with less reliance on patience compliance. While TADs have made many movements easier, there are limitations such as choice of where to place it, skill at placing them and patient individual physiology and anatomy that can limit the use of TADs.Objectives: Infrazygomatic crest (IZC) TADs are particularly useful for distalization and …

Clinical Benefit Analysis Of Modified Motion Management Protocols, Dyanne S. Macalinao

UNLV Theses, Dissertations, Professional Papers, and Capstones

Radiation therapy is crucial for treating cancer, using ionizing radiation to target and destroy cancer cells. This radiation is produced by machines like linear accelerators or through natural radioactive decay. Radiation therapy treatment planning involves prescribing doses and contouring target areas. However, managing tumors that move with breathing, such as in the lungs, remains a major challenge. Tumor motion exceeding 5 mm, as outlined in the AAPM’s Task Group 76, can compromise treatment accuracy, risking underdosing the tumor and overdosing healthy tissue. This issue is especially critical in high dose treatments like stereotactic body radiation therapy (SBRT). TG-76 provides different …

The Impact Of Psychosocial Factors On Occupational Therapy Doctoral Students’ Communication With Fieldwork Educators: A Retrospective Analysis, Melissa Montes

UNLV Theses, Dissertations, Professional Papers, and Capstones

This capstone project investigates the impact of adverse psychosocial factors, such as depression, anxiety, and stress, on effective communication of occupational therapy doctoral (OTD) students with their fieldwork educators (FWEds) during level II fieldwork experiences at the University of Nevada, Las Vegas (UNLV). Using a convergent parallel mixed methods design and retrospective analysis, the study integrates quantitative data from the Depression, Anxiety, and Stress Scale (DASS-21) and qualitative data from the Fieldwork Experience Assessment Tool (FEAT) to explore how these factors affect communication and the management of the adverse psychosocial factors OTD students experience. This study involved 36 OTD students …

Assessing The Effects Of Streptozotocin-Induced Hyperglycemia On Amyloid Beta Accumulation And Cognitive Behavior In A Mouse Model Of Alzheimer’S Disease-Related Pathology, Andrew Adonay Ortiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer’s disease (AD) is an irreversible and devastating neurodegenerative disease characterized by progressive synaptic, dendritic, glial, and neuronal loss, collectively leading to impairments in learning, memory, and deterioration of cognitive and behavioral functions. AD is the most common form of dementia accounting for 60-80% of all cases. AD affects approximately 7 million Americans and is the 6th leading cause of death in the US. Furthermore, by 2050, the US is projected to spend over $1.1 trillion on AD-related treatments. Pathological hallmarks of AD include beta-amyloid (Aβ) plaques, intracellular neurofibrillary tangles (NFTs), and chronic neuroinflammation, which can promote and exacerbate both …

Detection And Quantification Of Total Airborne Fungi And Coccidioides Species In Environmental Samples, Theresa T. Roehr

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fungal exposure can cause acute and chronic illnesses or exacerbate existing illnesses. Some fungi are opportunistic pathogens and can lead to serious systemic fungal infections. In 2020, more than 150 million cases of severe fungal infections were reported globally resulting in an estimated 1.7 million deaths. Coccidioidomycosis, or Valley fever, is classified as a serious fungal infection caused by the fungi Coccidioides immitis and C. posadasii. These particular fungi are prevalent in the soil of the Southwestern United States, including Las Vegas, Nevada. In 2024, there were a total of 269 cases of Valley fever reported in Nevada, and …

Maximizing Functional Independence And Well-Being: The Impact Of Sensory Impairments On Iadls And Functional Mobility Skills, Jessica L. Ryan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Sensory impairments involving vision and hearing among the adult population are predicted to double by 2030 (Gutherie et al., 2018). Individuals with experiences of sensory impairments like low vision are at risk of decreased functional participation in their homes and communities, which often leads to mental health concerns due to social withdrawal, experiences with environmental barriers, and limited occupational engagement (Bezyak et al., 2017; Gerami et al., 2015; Pfeiffer et al., 2020; Vreeken et al., 2020). This doctoral capstone focused on program evaluation to support adults with low vision and blindness in transferring learned skills from a simulated environment …

Gaming Participation: An Occupational Therapy Approach To Esports Ergonomics, Althea Rivera-Millare

UNLV Theses, Dissertations, Professional Papers, and Capstones

Competitive e-sport gamers are increasingly at risk for repetitive strain injuries (RSIs) due to the prolonged and repetitive nature of their gaming demands. Current healthcare protocols often overlook the unique ergonomic needs of this population, potentially leading to decreased occupational performance and dysfunction. This study aims to develop and evaluate an evidence-based ergonomic protocol tailored specifically to e-sport gamers who primarily use a mouse and keyboard, with the goal of reducing the risk of musculoskeletal injuries and enhancing gaming performance. Grounded in the principles of occupational therapy, the study emphasizes occupation-based interventions that address the specific occupational demands of e-sport …

How Returning To Work And Sense Of Belonging Influence Acquired Brain Injury Survivors: A Descriptive Case Study, Shaina Saribay-Talana

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose. This capstone project explored the experiences of an individual with acquired brain injury (ABI) returning to work (RTW), highlighting their sense of belonging (SoB) in the workplace. While literature emphasizes SoB's importance for mental health and quality of life, its impact on workplace reintegration for ABI individuals is underexplored. This project intended to address the gap in understanding ABI individuals' workplace belonging, potentially enhancing OT practices and outcomes for reintegration.Methods. A descriptive single case study approach using a qualitative phenomenology methodology, including semi-structured interviews and site observations, was used to gather insights from an individual who has re-entered the …

Adults' Intention To Take An Arthritis Prescription Drug Based On Drug Advertisements, Amanda Radola

Seton Hall University Dissertations and Theses (ETDs)

Direct-to-Consumer Prescription Advertising (DTCPA) has rapidly expanded, particularly via social media, but research on its influence on individual decisions regarding prescribed medications remains limited. This gap is notable among chronic disease patients, such as those with arthritis, which affected over 58.5 million U.S. adults as of 2015 and is projected to rise to 78.4 million by 2040 (Barbour et al., 2017; Hootman et al., 2016). Social media discussions show significant activity following television ads for arthritis drugs (Curtis et al., 2017). However, few studies explore how DTCPA impacts patient intentions to take advertised arthritis medications. This study employed a novel …

Improving Healthcare Access Among Hunter College Students – Suggestions For A Hunter College Student Health Center, Jacob Villorente

Publications and Research

This study investigates disparities in healthcare access among students at CUNY Hunter College, an urban public university in Manhattan serving over 22,000 students. 89% of Hunter students receive financial aid, with 67% of students receiving Pell grants. Hunter College only offers limited health services, primarily short-term mental health counseling and wellness workshops. A cross-sectional survey (n = 33) assessed insurance status, coverage (dental, vision, psychiatric), access barriers (e.g., transportation), mental health symptoms, and impacts to academia. While 69.7% of respondents reported comprehensive insurance, students with public insurance (Medicaid, Medicare) experienced substantially higher access barriers than those with employer-sponsored plans and …

A Pressure Injury Prevention Care Bundle (Pipcb) Education Approach To Improving Hcahps Scores In Nursing Communication Domain, Cathline Ma

Master's Projects and Capstones

Objective: Patient education is crucial for improving patient outcomes. An issue that has been consistent in healthcare is pressure injuries in inpatient care. Despite existing prevention efforts, there is an education gap between nursing communication and patient understanding. Aim: This QI project aims to improve HCAHPS scores, specifically in the nursing communication domain, by 5% and enhance patient understanding of pressure injury prevention strategies through the implementation of a Pressure Injury Prevention Care Bundle (PIPCB). Methods: The intervention included educational posters and fliers distributed to patients on a 93-bed acute care medical-surgical/telemetry unit. Educational materials focused on …

More Than A Diagnosis: Elevating Person-Centered Care In The Surgical Intensive Care Unit Through Personalized Communication Boards, Sierra B. Poe

Master's Projects and Capstones

Objective: Intensive care units are associated with complex care and high acuity interventions, however, there is a potential for dehumanization of patients. With the focus being placed on life-saving interventions, many patients and their family members feel that they are not being treated beyond their medical diagnosis. Aim: This quality improvement project aims to address these barriers in care by designing and implementing communication whiteboards in the surgical intensive care unit (SICU) at Hospital A to enhance patient and family-centered care, improve patient satisfaction, and enhance interdisciplinary communication. Post-implementation, the goal was to increase utilization of the standardized whiteboards from …

Spontaneous Coronary Artery Dissection In A Patient With A Progestin-Releasing Intrauterine Device, Enad Haddad, Sudeep Nugooru, Tyler Lee, Prerana Sevella, Asoka Balaratna

Division of Internal Medicine Faculty Papers & Presentations

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS), which predominantly affects women. This case report describes a 55-year-old female with SCAD potentially linked to a progestin-releasing intrauterine device (IUD) placed 1.5 years ago. The patient presented with acute chest pain and diaphoresis, and was eventually found to have ST-elevation myocardial infarction that led to coronary angiography, revealing type 1 SCAD from the proximal right coronary artery (RCA) to the mid-RCA with grade 3 thrombolysis in myocardial infarction (TIMI) flow distally. She was managed conservatively with antithrombotics, statins, and blood pressure control, achieving favorable outcomes …

The Application Of Time-Frequency Analysis To Ocular Vestibular Evoked Myogenic Potentials, Hannah R. Richardson

Dissertations, 2020-current

Ocular vestibular evoked myogenic potentials (oVEMPs) are produced by highly synchronous bursts of extraocular muscle activity in response to bone or air-conducted stimuli. Surface electromyography (EMG) electrodes can be used to record these responses which reflect utricular function. The traditional analysis of oVEMPs has been limited to time-domain waveform measurements, such as amplitude and latency of response peaks.

Recently, a method grounded in synchrony-based time-frequency analysis was successfully applied to cervical vestibular evoked myogenic potentials (cVEMPs) by Clinard et al. (2022). This approach to VEMP analysis can be used as a means to differentiate synchrony from amplitude, quantifying how phase …

The Relationship Between The Vestibulo-Ocular Reflex And Vestibular Perception In Trained Dancers Using Sinusoidal Harmonic Acceleration Testing, Diana Trinidad

Dissertations, 2020-current

Early studies have found that engaging in vestibular training, such as dance, may result in enhanced VOR suppression and changes in vestibular perception (e.g., lower sensations of vertigo) attributed to top-down modulation of subcortical neuronal networks and changes in the cerebellum. Dancers use spotting techniques to help control dizziness which involve holding their gaze on a visual object at eye level as they turn. As a result of this training, dancers become habituated to vestibular stimuli leading to lower VOR responses and decreased sensations of vertigo. This study investigated the relationship between the vestibulo-ocular reflex (VOR) and vestibular perception in …

Unmasking Masculinities In Counseling: From Conformity To Connection, Kyle R. Rose

Dissertations, 2020-current

This dissertation explored the entanglements of professional counseling and masculinities across three manuscripts, to contribute to (1) healthier forms of gender expression within and beyond the spectrum of masculinities for individuals, (2) the counseling profession’s role in transforming hegemonic masculinity within communities, and (3) larger movements to subvert the patriarchy throughout society. The first manuscript is a conceptual article that presented the Relational Cultural Privileged Identity Counseling (RCPIC) model, an integrative framework designed to help counselors address hegemonic masculinity within the therapeutic relationship. Drawing from Relational-Cultural Theory (RCT) and Privileged Identity Exploration (PIE), this model provided a roadmap for compassionate …