Medicine and Health Sciences Commons^™

Investigations Into The Relationship Between Menopause And Alzheimer’S Disease Pathology In A Mouse Model With Ovarian Follicle Depletion, Amanda M. Leisgang Osse

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer’s Disease (AD) currently affects about 6.9 million Americans, with over two-thirds of those individuals being women. Interestingly, changes in the brain indicative of AD coincide with the onset of menopause. Post-menopausal women have significantly higher levels of AD pathologies, including amyloid beta and hyperphosphorylated tau, than pre-menopausal women. To investigate the relationship between AD pathologies and menopause, we induced menopause-like state in an AD mouse model, APP/PS1, by treatment with 4-vinylcyclohexene diepoxide (VCD) to accelerate ovarian follicle depletion. To monitor the transition to menopause, vaginal lavages and cytology was performed to determine if mice reached anestrous. Both female APP/PS1 …

A Sensory Room Protocol For Snf Staff To Improve Confidence With Emotional Regulation In Adults With Cognitive Challenges: Through An Occupational Therapy Perspective, Marisa Pagan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Adult sensory rooms are an emerging area of practice for occupational therapy, as this holistic approach uses sensory tools for input to one or more of the five senses, which promotes emotional regulation in individuals seeking calming and alerting outcomes. This sensory protocol proposal was created to assist healthcare workers within a skilled nursing facility and provide a tool that could be utilized in various settings to increase awareness of adult sensory rooms.

Methodology This quality improvement protocol project was conducted at Henderson Health and Rehabilitation to determine the need for and develop a protocol for an adult sensory room …

Increasing Swim Instructors' Perceived Knowledge Of Sensory-Based Strategies When Coaching Children Who May Have Sensory Differences, Gabrielle Palmer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Although swim instructors are solely taught water safety regulations and correct swimming techniques, they are nonetheless viewed as mentors by the kids they work with. They are required to finish both their basic swim instructor (BSI) course and their cardiopulmonary resuscitation (CPR) certification, which primarily covers the fundamentals (American Red Cross Training Services, 2023; Kraft & Leblanc, 2018). However, neither provides a method of teaching swimming to children who might have sensory processing differences. This lack of education may affect both the child's participation and the swim instructor's capacity to impart knowledge. Research revealed that swim instructors are not very …

Computational Study For Tissue-Specific Dosimetric Quantities Of Secondary Radiation For Mars Exploration, Sungmin Pak

UNLV Theses, Dissertations, Professional Papers, and Capstones

The two main sources of primary space radiation, Galactic Cosmic Rays (GCRs) and Solar Particle Events (SPEs), encompass a spectrum of ions, ranging from protons (Z=1) to nickel ions (Z=28), with energies spanning from less than 1 keV to exceeding a few TeV. While SPEs represent sporadic events primarily comprised of a high flux of low- to intermediate-energy protons, GCRs are characterized by continuous low flux of diverse ions with higher energies, peaking in intensity near the solar minimum. During a Mars mission, astronauts will encounter primary particles of high energy from GCR and SPE spectra, capable of penetrating spacecraft …

Development Of A Health Management Program For International Students And Scholars Using Occupational Therapy Lens, Bo Park

UNLV Theses, Dissertations, Professional Papers, and Capstones

Health management (HM) is essential to staying healthy. Many parts involve internal abilities, such as the cognitive ability to detect illness internally. However, knowing external sources is equally necessary to perform HM independently, such as knowing how to use health insurance and which healthcare services to use for specific symptoms. As HM is closely related to health and independence, occupational therapy recently expanded the practice by including the occupation of health management.

The International Students and Scholars (ISS) population has been often discouraged from performing parts of HM due to many cultural barriers and differences that exist in HM across …

Examining The Risks And Resilience Of Older Adults Living With Hiv/Aids: Qualitative Community-Based Participatory Research Studies In Southern Nevada, Brandon Ranuschio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Since the height of the HIV pandemic in the 1980s, medical interventions have significantly increased the life expectancy of people living with HIV/AIDS (PLWH) and made HIV/AIDS a livable, chronic health condition. Because of this, PLWH have been living longer lives and thriving with the help of HIV sector healthcare and service providers. However, with their longer life expectancy, older PLWH have been experiencing other health challenges. One such challenge is the risk of developing HIV-Associated Neurocognitive Disorder (HAND), which is a condition that affects up to 50% of PLWH at some point in their lifetime, with middle-aged and older …

Tummy Time Toolkit: Incorporating Social-Emotional Strategies To Increase Caregiver Home Programming Compliance, Marsha Rattler

UNLV Theses, Dissertations, Professional Papers, and Capstones

Tummy time is a crucial developmental activity for infants. However, many infants are not receiving the recommended amount of time in prone positioning. This doctoral capstone project aims to address this gap through the implementation of an occupational therapy (OT) based tummy time educational resource titled Bonding Through Tummy Time: A Caregiver’s Guide. The resource, a tummy time toolkit, focuses on caregiver and infant interaction during the co- occupation of play using social-emotional developmental strategies as a driving force to complete more tummy time in the home environment. Recruitment of caregivers was done through purposive sampling and participants were surveyed …

Students’ Learning About Occupation In An Occupational Therapy Program, Erik Regalado

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Describe the learning activities that occupational therapy students found helpful for learning the concept of occupation and describe what students know about the concept of occupation.

Design: Descriptive correlational

Setting: Occupational therapy program in the U.S

Participants: Occupational therapy students

Measure: Survey

Results: These students had a general understanding of occupation and its relationship to health, however, lacked the more conceptual understanding of occupation found in occupational science. Participants reported that activities such as fieldwork, group discussion, and lecture helped them understand the concept of occupation.

Conclusion and Relevance: These students missed aspects of occupation and would benefit from …

Development Of A Cue-Based Feeding Education Program To Enhance The Self-Efficacy Of Nicu Caregivers, Jazmin Rivera

UNLV Theses, Dissertations, Professional Papers, and Capstones

In the neonatal intensive care unit (NICU), a neonate may experience feeding difficulties due to their prematurity, physiological, and neurological status. Under these circumstances, a caregiver’s role can be diminished and cause a loss of self-efficacy due to the inability to provide care and feed their infant in the NICU. After examining the literature, guided by the Model of Human Occupation and the Transformative Learning Theory framework, a cue-based feeding (CBF) program was developed and implemented at the University Medical Center (UMC) Hospital NICU department to enhance the caregiver’s self-efficacy through an occupational therapy perspective. A feasibility evaluation of the …

The Effects Of A Low-Intensity Aerobic Exercise Program To Enhance Occupational Performance And Quality Of Life In Diabetic Patients, Asia Suriyachottakul

UNLV Theses, Dissertations, Professional Papers, and Capstones

Globally, diabetes mellitus (DM) is a prevalent chronic condition many people encounter. DM is one of the primary causes of mortality due to individuals struggling to manage or prevent the condition. The healthcare field is also failing to provide sufficient education on DM. Individuals with this condition may begin to experience co-morbidities and depressive symptoms, which make it difficult for them to engage in meaningful occupations, in addition to decreased quality of life (QOL). This project examines the effectiveness of a low-intensity aerobic exercise (LIAE) program to enhance occupational performance (OP) and QOL in those diagnosed with the condition or …

Video Monitoring For Fall Prevention, Atongane Taku

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patient safety is a vital aspect of healthcare. Falls and fall-related injuries continue to occur in hospitals worldwide and fall prevention is one of the top priorities in providing quality care. Fall assessment tools, bed alarms, patient rounding, patient education, physical restraints, environmental modification, bedside sitters, and remote video monitoring are some of the methods implemented to reduce falls. This project was a quasi-experimental study informed by Kotter and Cohen Model of Change. The initial purpose of this process improvement project was to educate staff on the significance of video monitoring in fall prevention and determine whether the education regarding …

Examining The Impacts Of Unlv's Tobacco-Free Policy Pre And Post Implementation, Kacie Washburn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the known harmful effects of smoking and secondhand smoke, tobacco-related disease, disability, and death continue to plague the United Stated and contribute to more than 480,000 individuals dying prematurely every year. Comprehensive smoke-free and tobacco free policies strive to prohibit the use of both traditional forms of tobacco (cigarettes, cigars) and smokeless forms of tobacco (vapes). The goal of this project was to examine the impact a tobacco control policy has on prevalence rates of use and knowledge regarding said policy among faculty, staff, and students. In the Fall of 2022, UNLV adopted a comprehensive tobaccofree and smoke-free policy …

Biopsychosocial Occupational Therapy Interventions For Complex Regional Pain Syndrome – A Pilot Manuscript, Cinthia Hartman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists (OTs) have an essential role in the treatment of upper extremity Complex Regional Pain Syndrome (CRPS) in outpatient therapy settings. Occupational therapy (OT) guidelines and research focus treatment on the Budapest Criteria’s biological signs and symptoms. The International Association for the Study of Pain (IASP) now recognizes CRPS as a primary chronic pain condition and not an autonomic disorder, as it was thought to be in the past. This recognition, along with the psychological and social impacts of the condition, highlight the need for updated OT treatment interventions incorporating a biopsychosocial model. Combining evidence-based CRPS OT interventions for …

The Impact Of Educating Interprofessional Healthcare Workers On The Role Of Occupational Therapy In The Cardiac Acute Care Setting, Jennifer L. Taosuvanna

UNLV Theses, Dissertations, Professional Papers, and Capstones

The acute care setting has been a vastly growing practice area for the occupational therapy profession. Occupational therapists assist clients in the acute care setting with activities of daily living retraining and functional transfer training to increase independence. Each client demonstrates a different discharge course from the acute care setting and occupational therapists play a key role in assisting the clients the most appropriate rehabilitative setting. All professionals in the acute care setting work cohesively to provide clients with the best outcome.

The doctoral project explored the importance of interprofessional healthcare worker education about occupational therapy practices in the acute …

A Comparison Of Spinal Reflex Function And Morphological Adaptations Of The Achilles Tendon Between Individuals Chronically Post-Stroke And Healthy Controls, Migi Contreras, Mira Seekins, Johanna Mendez, Trevor Diez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: The hallmark gait deviation in individuals with post-stroke hemiparesis is slow walking speed. Reduction in gait speed after stroke is influenced by decreased propulsive forces, which may likely be related to impaired spinal circuit function and spasticity of the paretic plantarflexors. Chronic muscle tone maladaptations in paretic ankle plantarflexors can result in altered Achilles tendon (AT) morphology, therefore leading to altered mechanical properties, force transmission capabilities and subsequent insufficient propulsive forces during walking. The purpose of this study is to characterize the chronic maladaptations in both the spinal Ia afferent loop excitability and AT morphology after stroke lesions in …

The Impact Of Anatomy Academy In Underserved Las Vegas Elementary Schools, Jean Angeles, Edgar Armengual, Katrina Myers, Perceval Vollmer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Anatomy Academy is an interactive, service-learning experience that allows doctoral physical therapy students to pose as educators for elementary-aged adolescents. Through instructional and activity-based learning, mentors formulated the program to encase anatomical, physiological, nutritional, and general health and wellness topics that translate into overall healthy behaviors. The experiment enveloped 7 major sectors of anatomy, including the musculoskeletal system, cardiovascular system, pulmonary system, oral cavity/nutrition, gastrointestinal system, sensory system, and central nervous system. Throughout the length of the program, the doctoral candidates reviewed the quality of the content delivered, the engagement of the students and staff, and the effects this had …

Modulating Cortical Excitability To Improve Functional Movements In Individuals With Patellofemoral Pain: A Randomized Controlled Trial, Jeno Aquino, Bryce Broadwell, Connan Wallace, Makenzie Whimple

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Persons with patellofemoral pain (PFP) often exhibit increased knee valgus during functional tasks that is traditionally addressed by strengthening weak hip musculature. However, research related to this topic has revealed altered cortical reorganization in individuals with PFP contributes to dysfunctional movements and underscores the critical role of central neural control in this condition. Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that alters cortical excitability to enhance neuroplasticity. Research using tDCS priming supports its feasibility as a possible treatment for other musculoskeletal conditions. However, its application specifically targeting the corticomotor function of the gluteal musculature in individuals with …

Effects Of Chronic Diabetes And Attentional Focus On Performance And Learning Of A Novel Stabilometer Balance Task, Rebeca Carolina Armagnac Gonzalez, Yinny H. Lee, Alicia Marie Letkiewicz, Meiko Nagano Mamauag

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Chronic diabetes is a prevalent systemic disease that impairs physical functioning and often leads to increased risk of falls. Adopting an external focus of attention during motor skill practice has been shown to improve learning outcomes, however, it has not been examined in this population. We examined how attentional focus instructions (internal vs. external) affect balance performance and learning in older adults with and without diabetes.

Methods: Fifty-three older adults (27 with diabetes, 63.7±7.0 years) participated in the randomized, pre-post intervention study. The balance training involved 50 practice trials of a stabilometer task that was novel to …

Implementing Physical Therapy Services And Screenings For The Students Of The Unlv College Of Fine Arts For Health And Injury Prevention: A Service-Learning Approach, Selene Barajas, Justin Dietrich, Brenna Ganzon, Payton Mack, Katherine Metzger, Tanner Mueller

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals who participate in Fine Arts such as orchestra, dance, and theater at high levels are predisposed to injury. Many of these injuries are preventable, and when not adequately managed, they can result in lost rehearsal time and prevent participation in performances required for degree completion. While collegiate athletes typically have access to healthcare resources such as a team physician, athletic trainer, and physical therapist, collegiate performing artists often must navigate the healthcare environment on their own. Furthermore, available healthcare providers may lack knowledge and experience working with performing artists and be less able to treat the unique healthcare needs …

Effect Of Asynchronous Virtual Interviews On Ethnic Minority Matriculation Into A Doctor Of Physical Therapy Program, Conner Clark, Nanea Lagasca, Gladys Miller, Jasmine Puspos

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Methods: This study examines the impact of the use of asynchronous virtual interviews (AVIs) in the admissions process of the Doctor of Physical Therapy (DPT) program at the University of Nevada, Las Vegas (UNLV). This research aims to examine racial and ethnic subgroup differences in AVI scores, evaluate the influence of AVIs on applicant scores in the admissions process, and assess the AVI inter-rater reliability among faculty evaluators using data from the 2019-2022 admissions cycles.

Results: Significant differences were found in AVI scores among racial and ethnic groups, with Black applicants scoring highest and Asian applicants scoring lowest. Additionally, inclusion …

Effects Of Exercise On Level Of Support, Mobility, And Quality Of Life In Adults With Down Syndrome, Jorge Lorza-Lopez, Jolena Sagaya, Simone Schroder, Paige Melvin Zink

UNLV Theses, Dissertations, Professional Papers, and Capstones

Down syndrome (Ds) is a genetic disorder characterized by the autosomal abnormality of a third copy of chromosome 21. Due to the physical and intellectual disabilities that many people with Ds experience, they often need support with (instrumental) activities of daily living. Since adults with Ds are living longer, it is important to determine how exercise can affect mobility and quality of life in the Ds community. The impact on more functional outcomes, such as level of support and quality of life has not been systematically investigated. Therefore, the aim was to investigate whether twelve weeks of a remote, structured …

Preparing Occupational Therapy Students In A Role-Emerging Private School-Based Setting, Jerome Amigo

UNLV Theses, Dissertations, Professional Papers, and Capstones

This capstone project occurred in collaboration with Cornerstone Christian Academy in Las Vegas, Nevada. As a role-emerging area of practice, occupational therapy must focus on integrating services in private schools just as much as public schools. The need for resources to support future fieldwork students at Cornerstone Christian Academy makes it difficult for occupational therapy students to enhance their experiential learning opportunities and serve an underserved population of primary and middle school students.

The capstone project consisted of daily engagement with Cornerstone Christian Academy’s educational personnel, attending students, and the parents of the students for 14 weeks to ensure all …

A Low Dose Of Electro-Psychedelic Treatment Increases Neuronal Dendritic Arborization And Filopodic Spine Density, Elaine Aquino Vasquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Neuropsychiatric disorders remain a formidable challenge to the global healthcare system, necessitating innovative treatments to address their complex pathophysiology. Alternative therapeutic approaches, including electroconvulsive treatment (ECT) and psychedelics, have gained attention for their capacity to relieve a broad range of symptoms. ECT is a long-standing effective therapy for patients, especially treatment-resistant ones. Psychedelics, like psilocybin, can induce profound and sustained therapeutic effects. The limited understanding of their mechanisms of action, compounded by the negative stigma surrounding ECT and psilocybin, prevents them from being used as adjunct agents. ECT and psilocybin promote synaptic plasticity and modulate neural remodeling, yet their comparative …

Impact Of Water Combined Wet Ball Milling Extraction And Functional Evaluation Of Dietary Fiber From Papaya (Carica Papaya L), Guihun Jiang, Kashif Ameer, Karna Ramachandraiah, Xiaoyu Feng

School of Medicine Faculty Publications

This study evaluates the structural, physicochemical, functional and rheological properties of papaya dietary fibers (DFs) extracted by alkaline, water and combination of water/wet ball milling. The particle size of DF subjected to water/wet ball milling (WB-DF) was considerably reduced compared to DF extracted by water (W-DF) or alkaline (AL-DF) methods. WB-DF in comparison AL-DF increased the water holding capacity (WHC) by 4.1 folds, oil holding capacity (OHC) by 1.7 folds and water swelling capacity (WSC) by 2.6 folds. WB-DF also improved the cholesterol adsorption capacity (CAC), glucose adsorption (GAC), nitrite-ion adsorption capacity (NIAC) and antioxidant activity. The FT-IR spectra displayed …

Development Of A Weight-Band Dosing Approach For Vosoritide In Children With Achondroplasia Using A Population Pharmacokinetic Model, Yulan Qi, Ming Liang Chan, Diane R Mould, Kevin Larimore, Elena Fisheleva, Anu Cherukuri, Jonathan Day, Ravi Savarirayan, Melita Irving, Carlos A Bacino, Julie Hoover-Fong, Keiichi Ozono, Klaus Mohnike, William R Wilcox, Michael B Bober, Joshua Henshaw

Faculty, Staff and Students Publications

BACKGROUND AND OBJECTIVE: Vosoritide is a recently approved therapy for achondroplasia, the most common form of disproportionate short stature, that has been shown to be well tolerated and effective in increasing linear growth. This study aimed to develop a population pharmacokinetic (PPK) model to characterize pharmacokinetics (PK) of vosoritide and establish a weight-band dosing regimen.

METHODS: A PPK model was developed using data from five clinical trials in children with achondroplasia (aged 0.95-15 years) who received daily per-kg doses of vosoritide. The model was used to simulate expected exposures in children with a refined weight-band dosing regimen. Simulated exposure was …

Representation Learning For Generative Models With Applications To Healthcare, Astronautics, And Aviation, Van Minh Nguyen

Theses and Dissertations

This dissertation explores applications of representation learning and generative models to challenges in healthcare, astronautics, and aviation.

The first part investigates the use of Generative Adversarial Networks (GANs) to synthesize realistic electronic health record (EHR) data. An initial attempt at training a GAN on the MIMIC-IV dataset encountered stability and convergence issues, motivating a deeper study of 1-Lipschitz regularization techniques for Auxiliary Classifier GANs (AC-GANs). An extensive ablation study on the CIFAR-10 dataset found that Spectral Normalization is key for AC-GAN stability and performance, while Weight Clipping fails to converge without Spectral Normalization. Analysis of the training dynamics provided further …

Multimodal Neurologic Monitoring In Patients Undergoing Extracorporeal Membrane Oxygenation, Khwaja Siddiqui, Muhammad U Hafeez, Ali Ahmad, Syed O Kazmi, Subhasis Chatterjee, Eric Bershad, Mohammad Hirzallah, Chethan Rao, Rahul Damani

Faculty, Staff and Students Publications

Introduction Extracorporeal membrane oxygenation (ECMO) is associated with a high rate of neurologic complications. Multimodal neurologic monitoring (MNM) has the potential for early detection and intervention. We examined the safety and feasibility of noninvasive MNM during ECMO. We hypothesized that survivors and non-survivors would have meaningful differences in transcranial Doppler (TCD) sonography and electroencephalographic (EEG) characteristics, which we aimed to identify. We also investigated adverse neurologic events and attempted to identify differences in EEG and TCD characteristics among patients based on the type of ECMO and the occurrence of these events. Material and methods We performed an observational study on …

Using Workplace-Based Assessments In Undergraduate Medical Education, Arindam Sarkar

Faculty, Staff and Students Publications

No abstract provided.

Cardiac Conduction Diseases: Understanding The Molecular Mechanisms To Uncover Targets For Future Treatments, Tingting Li, Qussay Marashly, Jitae A Kim, Na Li, Mihail G Chelu

Faculty, Staff and Students Publications

Introduction: The cardiac conduction system (CCS) is crucial for maintaining adequate cardiac frequency at rest and modulation during exercise. Furthermore, the atrioventricular node and His-Purkinje system are essential for maintaining atrioventricular and interventricular synchrony and consequently maintaining an adequate cardiac output.

Areas covered: In this review article, we examine the anatomy, physiology, and pathophysiology of the CCS. We then discuss in detail the most common genetic mutations and the molecular mechanisms of cardiac conduction disease (CCD) and provide our perspectives on future research and therapeutic opportunities in this field.

Expert opinion: Significant advancement has been made in understanding the molecular …

Robotic-Assisted Single-Site Abdominal Cerclage In The Bicornuate Uterus Patient With Cervical Insufficiency, Nurul Farhanah Binte Abdul Latif, Zhenkun Guan, Sylvia Asare, Xiaoming Guan

Faculty, Staff and Students Publications

Objective: To demonstrate the surgical techniques for improving safety in robotic-assisted abdominal cerclage in patients with bicornuate uteri complicated by recurrent pregnancy loss and cervical insufficiency.

Design: Stepwise demonstration with narrated video footage.

Setting: An academic tertiary care hospital.

Patients: Our patient is a 22-year-old G2P0020 with a history of recurrent pregnancy loss. During her first pregnancy, she was asymptomatic until 19 weeks and delivered because of a preterm premature rupture of membranes. A transvaginal cerclage was performed for her second pregnancy at 14 weeks, which ended at 16 weeks because of preterm premature rupture of membranes. The final magnetic …