Health and Medical Administration Commons^™

Next Steps In Advancing Pediatric Care In Southern Nevada, The Lincy Institute

Lincy Institute Events

The Lincy Institute released new research evaluating the Southern Nevada pediatric care ecosystem. The report, "An Evaluation of Southern Nevada’s Pediatric Care Ecosystem," offers recommendations to develop a stronger and more coordinated pediatric care ecosystem before the stand-alone children’s hospital being developed by Intermountain Health opens in 2030 and identifies the components of an integrated statewide network to provide all of Nevada’s children with access to high-quality care. The event also featured panel discussions with pediatric care providers and policymakers.

Panel 1 - Pediatric Care Providers

Moderator — Tina Quigley, Project Facilitator, The Lincy Institute

Panelists — Lisa …

An Evaluation Of Southern Nevada’S Pediatric Care Ecosystem, David Damore, Tina Quigley, Nick Fiore

Policy Briefs and Reports

In 2024, The Lincy Institute and the Nevada Health and Bioscience Corporation released a report prepared by the consulting firm Tripp Umbach detailing the case for a stand-alone children’s hospital in Southern Nevada. Shortly thereafter, Intermountain Health announced it would build Nevada’s first such facility in Las Vegas, expected to open in 2030. To complement the hospital’s development, The Lincy Institute undertook an independent evaluation of the regional pediatric care landscape. The analysis draws on secondary data and discussions with advocates, health system administrators, practitioners, and providers. The report examines:

• Fiscal, resource, and workforce challenges underlying Nevada’s poor population-level pediatric …

Addressing Sexual Health For Older Veterans By Healthcare Providers: A Mixed Method Study, Andrew James White

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Older adults remain sexually active, yet sexual health is frequently under-discussed in healthcare settings, particularly within veteran populations. Sexual health is essential to overall quality of life, and prior studies have shown that older patients value these conversations. However, veterans often face unique factors such as military-related trauma, including military combat exposure and post-traumatic stress disorder, in addition to compounded stigma from these topics in regards to open discussions about sensitive health issues to their healthcare providers. This study is significant in its potential to uncover systemic, cultural, and interpersonal influences that shape these dynamics, with a particular emphasis …

Airborne Fungal Monitoring In Healthcare Environments: A Systematic Review, Dana L. Surwill, Patricia Cruz, Mark P. Buttner, Jennifer R. Pharr, Nancy Lough, Theresa T. Roehr

Environmental & Global Health Faculty Research

Background: Fungal infections pose a significant threat to public health, with over 6.55 million cases and 2.55 million deaths annually. Exposure to fungal spores in indoor environments primarily occurs through inhalation or direct contact with surfaces. Monitoring is critical for early detection and prevention of outbreaks, yet routine airborne fungal testing is not universally mandated across healthcare settings. Methods: A systematic review of peer-reviewed articles from four databases was conducted to identify current airborne fungal monitoring guidelines and best practices for sample collection, culture media, incubation conditions, and results interpretation. Results: Eighteen articles met the inclusion criteria, and four studies …

The Wear-Bot Checklist: A Risk Of Bias Tool For Evaluating Validity And Reliability Research In Wearable Technology, Bryson Carrier, Jennifer A. Bunn, Chris Eschbach, Joel D. Reece, Gregory J. Welk, Brett A. Dolezal, James W. Navalta

Kinesiology and Nutrition Sciences Faculty Research

This paper proposes an innovative tool designed to standardize the evaluation of validity and reliability studies in the rapidly evolving field of wearable technology. We introduce the WEArable Technology Risk of Bias and Objectivity Tool (WEAR-BOT), a tool that addresses the need for a comprehensive and systematic way to assess bias in studies examining consumer-grade and research-grade wearable devices. This is the first tool designed to evaluate the risk of bias in validation and reliability studies. Other risk of bias tools like the Cochrane ROB, COSMIN, or the many other risk of bias tools are designed for different study methodologies …

Betting On The Future By Re-Discovering The Past: History Of Hospital Infrastructure In Early Las Vegas And Southern Nevada, Aidy Weeks

Library Faculty Research

In the summer of 2025, the library director began reviewing resources available from the University Libraries Special Collections Portal to learn about early hospital infrastructure in Las Vegas and Southern Nevada. Using the keyword “hospital”, they reviewed 1,000 records to locate primary resources that could help tell the story of Las Vegas’s first hospital and Southern Nevada early history. In total, they located photos, oral histories, city documents, and newspaper articles, to help put together a timeline of which hospitals, current events, and key figures were critical in establishing a medical presence in Las Vegas and Southern Nevada. Information was …

Public Sector Employment In Mountain West Cities, 2019, Olivia K. Cheche, William E. Brown Jr.

Economic Development & Workforce

This fact sheet presents data on public sector employment in 16 cities within the Mountain West states of Arizona, Colorado, Nevada, and New Mexico. The Urban Institute’s “Public Sector Employment and Its Role in Local Economic Development” report provides data on publicly driven jobs in the 100 largest U.S. cities as of 2019. This fact sheet focuses on city-level data from the largest cities in the Mountain West.

Associations Of The Medicaid Expansion Policy With Racial/Ethnic Disparities In Breast Cancer Screening And Treatment, James Howard Smith Ii

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Aim. This dissertation examines Medicaid expansion’s effect on breast cancer (BC) screening and treatment disparities in two Medicaid-expanding states (MES) that passed Medicaid expansion (New Jersey and Vermont) relative to two non-expansion states (NES) (Georgia and Wisconsin). It then compares the association of Medicaid expansion to other states that did not undertake this policy on various subgroups, such as minorities by race and ethnicity, income, and age groups. Black women still bear significant BC disparities due to untimely screenings, treatments, and deaths. Therefore, it is critical to investigate how socioeconomic status influences racial/ethnic disparity gaps, given that BC …

Beyond The Nursery: Unraveling Maternal And Neonatal Factors Associated With Nicu Admissions In Nevada (2015–2021), Vidhani Goel, Ana L. Reyes, Bertille Assoumou, Dodds P. Simangan, Farooq Abdulla, Deborah A. Kuhls

Undergraduate Research Symposium Podium Presentations

Overview

This project focuses on investigating the relationship between maternal medical conditions, socioeconomic factors, and NICU admission levels among Medicaid beneficiaries in Nevada.

Approach:

•A retrospective analysis was conducted using linked data from the Birth Registry and Nevada Medicaid Claims from 2015 to 2021.

•Infant records were analyzed using univariate and bivariate statistical methods, with a significance level set at 5%.

•Logistic regression models were used to examine associations between maternal characteristics and NICU admission levels.

Key Objectives:

•Analyze NICU admission trends among Medicaid beneficiaries.

•Identify maternal health risk factors linked to NICU admissions.

•Examine neonatal characteristics influencing NICU admissions.

Does Physician-Hospital Vertical Integration Affect Hospital Output?, Soumya Upadhyay, Neeraj Bhandari

Healthcare Administration and Policy Faculty Research

Background: Physician-hospital vertical integration is gaining steam but it is unclear how they affect hospital output.

Objective: To examine the direct impact of vertical integration on hospital output.

Design: A pooled design with 6-year data using linear regressions was used. Then, panel data design with hospital fixed effects was used.

Methods: We linked American Hospital Association data (2016-2021) with AHRQ Comparative Health System Performance Initiative’s Compendium (2018, 2020, 2021; 34 987 hospital-year observations) to develop new measures of vertical integration and assess its relationship with several measures of hospital output including annualized total admissions, total number of inpatients days, …

The Assignment Despite Objection Construct: Its Efficacy And Utility In Measuring Nurse-Perceived Unsafe Staffing Events And Associated Outcomes, Debra F. Fox

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: This three-manuscript approach provided a progressively built overview of Assignment Despite Objection as a construct used by nurses to document their perceptions of unsafe staffing events and as an unstudied concept in the staffing outcomes literature.

Background: All nurses have an ethical, legal, and professional responsibility to refuse or object to assignments they believe are unsafe for their well-being or their patient’s safety. Assignment Despite Objection being the only widely used construct nurses use to document these perceptual details. No studies have focused on Assignment Despite Objection as a construct or concept, leaving a complete gap in understanding its …

The Southern Nevada Care Economy: Addressing Child Care And Elder Care Challenges, The Lincy Institute

Lincy Institute Events

This community forum examines the economic and societal impact of the “care economy” in Southern Nevada in collaboration with Tripp Umbach, a nationally recognized consulting firm that provides comprehensive services including research and strategic plans to further the operations and activities of healthcare services.

Central to the care economy is elder care and child care. Having access to elder care and child care services is essential to working age adults, many of whom need one or both types of services to continue participating in the workforce. The delivery of child care and elder care services have far-reaching implications for our …

The Southern Nevada Care Economy: Challenges And Opportunities, Tripp Umbach

Policy Briefs and Reports

National policymakers increasingly recognize the care economy as an essential economic driver, contributing $648 billion annually to the U.S. economy and supporting 3.6 million jobs. The care economy is also critical in driving economic development and prosperity in Southern Nevada. Yet, as this Tripp Umbach analysis finds, Southern Nevada’s care economy dramatically underperforms compared to national benchmarks and peer regions. High caregiving costs and limited access to care for children, seniors, and individuals with disabilities in Southern Nevada strain families, businesses, and public resources. This burden reduces workforce participation, productivity, and economic growth. Low pay and high turnover among care …

Temporal Variations In And Predictive Values Of Abg Results Prior To In-Hospital Cardiac Arrest, Mina Attin, Jie Rin, Chad Cross, Sidath Kapukotuwa, Ryan Shao, Peter G. Kaufmann, C.D. (Joey) Lin, Kim Arcoleo

Nursing Faculty Research

In-hospital cardiac arrest (IHCA) has been understudied relative to out-of-hospital cardiac arrest. Further, studies of IHCA have mainly focused on a limited number of pre-arrest patient characteristics (e.g., demographics, number and types of comorbidities). Arterial blood gas (ABG) analysis, one of the most common diagnostic tests for assessing and managing critically or acutely ill hospitalized patients, reflects pathophysiological changes associated with adverse events or complications, including IHCA. Yet the predictive and prognostic values of patterns of pre-arrest ABG parameters for IHCA have not been fully studied. The purpose of this retrospective pilot cohort study was to investigate temporal variations in …

Does Hospital–Physician Integration Improve Hospital Performance? Results From A Usa Longitudinal Study, Soumya Upadhyay, Randyl A. Cochran, William Opoku-Agyeman

Healthcare Administration and Policy Faculty Research

In a dynamic healthcare industry, aligning the goals and objectives of hospitals and physicians through integration has been suggested to influence performance. Physicians’ leadership and active involvement in governance can direct resource usage, Electronic Health Record (EHR) implementation, price negotiation, better coordination, and continuity of services for patients, thus affecting performance. This study aimed to examine the relationship between physician integration and hospital performance, investigating both financial and quality outcomes. We used a longitudinal study design. Our sample was hospital-level data from 2014 to 2019, which contained 6000 U.S. hospital-year observations. The dependent variables were quality outcomes (readmission rates) and …

Personalized Nutrition: Tailoring Dietary Recommendations Through Genetic Insights, Saiful Singar, Ravinder Nagpal, Bahram H. Arjmandi, Neda S. Akhavan

Kinesiology and Nutrition Sciences Faculty Research

Personalized nutrition (PN) represents a transformative approach in dietary science, where individual genetic profiles guide tailored dietary recommendations, thereby optimizing health outcomes and managing chronic diseases more effectively. This review synthesizes key aspects of PN, emphasizing the genetic basis of dietary responses, contemporary research, and practical applications. We explore how individual genetic differences influence dietary metabolisms, thus underscoring the importance of nutrigenomics in developing personalized dietary guidelines. Current research in PN highlights significant gene–diet interactions that affect various conditions, including obesity and diabetes, suggesting that dietary interventions could be more precise and beneficial if they are customized to genetic profiles. …

Occupational Therapy-Led Tai Chi: Elevating Perceived Competence In Daily Activities Among Semi/Fully Retired Adults, Lester Buenviaje

UNLV Theses, Dissertations, Professional Papers, and Capstones

This doctoral capstone project explored the impact of a Tai Chi intervention led by the occupational therapy student researcher, on self-perceived competence and engagement in Activities of Daily Living (ADLs) among semi/fully retired adults at the Osher Lifelong Learning Institute (OLLI) at University of Nevada, Las Vegas (UNLV). Using the Occupational Self-Assessment (OSA) questionnaire, the project measured changes in participants' confidence and abilities before and after the participation of the Tai Chi program.

The Tai Chi intervention was a six-week Tai Chi program designed to accommodate the physical and cognitive capabilities of semi-retired and retired adults. This program not only …

Cost Benefit Analysis Of Anesthesia Providers Within Gastroenterology Outpatient Practices, Jennifer Buffum Brown

UNLV Theses, Dissertations, Professional Papers, and Capstones

Anesthesia delivery in ambulatory and office-based settings has seen significant growth in the last 25 years. The advances in effective short-acting anesthetic drugs, combined with the rise in demand for minimally invasive surgery, allows for an increase in the number of surgical procedures to be achieved outside the hospital setting. Ambulatory anesthesia promotes patient health by reducing recovery times. It also contributes to sustainability by lowering costs otherwise associated with overnight hospital stays. Patient preferences for minimally invasive outpatient surgery, and faster recovery times have spurred an increased demand for business relationships between modern medical practices and anesthesia providers. Certified …

Patient–Provider Communication Quality: Socioeconomic Disparities In Smoking Outcomes, Soumya Upadhyay, Jalen Jones

Healthcare Administration and Policy Faculty Research

Introduction:
/="/">Patient–provider communication quality is instrumental for healthy outcomes in patients. The objective of this study is to examine the relationships between patient–provider communication quality and participant characteristics, perception of e-cigarette harmfulness, and smoking outcomes.
/="/">
/="/">Methods:
/="/">A pooled cross-sectional design was used on secondary data obtained from the Health Information National Trends Survey (HINTS) 5 from Cycle 1 through Cycle 4, from 2017–2022. Our final sample contained 3511 observations. Our outcome variable was the perception of electronic cigarette smoking status. The independent variable was patient–provider communication quality (PPCQ), measured from a series of questions with responses …

Emergency Remote Teaching And Transition To Nursing Practice During The Covid-19 Pandemic: An Interpretative Phenomenological Analysis, Carrie Watkins Jeffrey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this phenomenological study was to explore the lived experience of new nurses in the United States who experienced Emergency Remote Teaching (ERT) for most or all of their nursing education during the COVID-19 pandemic and how they perceive ERT influenced their transition to practice during their first year as registered nurses.

Background: The National Council of State Boards of Nursing reports that in 2021, the overall pass rate for first-time NCLEX-RN® demonstrated the sharpest decline since 2013. Most of the 185,000 nursing students who took the exam in 2021 and 2022 received their nursing education during …

Examining Health Literacy And Patient-Centered Communication: A Secondary Analysis Of U.S. Adults With A History Of Cancer, Kimberly Ann Dy Tomas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Racial/ethnic communities bear a disproportionate burden when examining cancer mortality and infection-related cancer incidence rates. According to the Office of Disease Prevention and Health Promotion (ODPHP), health literacy and clear communication between professionals and patients are crucial to improving health and the quality of healthcare. This study examined the relationship between personal health literacy and perceived patient-centered communication quality (PPCQ). A secondary data analysis was conducted using the Health Information National Trends Survey (HINTS) 5, Cycle 4 (2020), and STATA/BE 17.0 for Windows. The sample included respondents who have a history of cancer and have seen a healthcare provider within …

Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole

Journal of Health Disparities Research and Practice

Due to the underutilization of screening mammography, African American women (AAW) are more likely to experience negative health outcomes after receiving a late-stage breast cancer diagnosis than White Women (WW). The purpose of this article is to examine the roles of the media, health community and the African American church and pastor and their potential impact in AAW screening decisions. Fifteen AAW, ages 45 and older, were invited to participate in a semi-structured interview. Most women agreed the African American pastor and church as well as the health community, and media are an integral part of their lives. Therefore, specific …

Enhanced Iot-Based Electrocardiogram Monitoring System With Deep Learning, Jian Ni

UNLV Theses, Dissertations, Professional Papers, and Capstones

Due to the rapid development of computing and sensing technologies, Internet of Things (IoT)-based cardiac monitoring plays a crucial role in providing patients with cost-efficient solutions for long-term, continuous, and pervasive electrocardiogram (ECG) monitoring outside a hospital setting. In a typical IoT-based ECG monitoring system, ECG signals are picked up by sensors located on the edge, and then uploaded to the remote cloud servers. ECG interpretation is performed for the collected ECGs in the cloud servers and the analysis results can be made instantly available to the patients as well as their healthcare providers.In this dissertation, we first examine the …

Fear Of Recurrence As A Mediator Of Illness Perception And Perceived Stress In Acute Myocardial Infarction Survivors, Sarah E. Zvonar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The primary objective of this study is to evaluate fear of recurrence as a mediator of illness perception and perceived stress. This research will determine how illness perceptions and fear of recurrence affect perceived stress in the acute myocardial infarction (AMI) population. Other aims will observe how demographics predict patients who may experience increased fear of recurrence and stress in the AMI population, how the variables of fear of recurrence change over time, and if fear of recurrence is still a significant mediator after controlling for depression and anxiety.Rational/ Conceptual Basis/ Background: Acute myocardial infarctions (AMIs) are often accompanied …

New-R Intervention For Clients With Severe Mental Illness And Obesity: Grant Writing For Implementation Funds Supporting Occupational Therapy Interventions, Kaitlyn Hoffman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Increasing numbers of people suffer from obesity and severe mental illness co-morbidly. If these conditions remain untreated, they can harm an individual's health and well-being. Unfortunately, there are very few programs currently available that target both management and improvement of these conditions simultaneously. Even so, despite the lack of programming options, it must be noted that the NEW-R program strives to reach those goals, although there hasn't been an abundance of literature supporting the effectiveness of this program. This poses a concern for occupational therapy practitioners who hope to assist their clients in managing these conditions as occupational therapy treatments …

Healthcare Associated Infections, Nurse Staffing, And Financial Performance, Soumya Upadhyay, Dean G. Smith

Healthcare Administration and Policy Faculty Research

Healthcare associated infections (HAIs) are a concern to patients, hospital administrators and policymakers. For over than a decade, efforts have been made to hold hospitals accountable for the costs of HAIs. This study uses contingency theory as a framework to examine the association between HAIs and hospital financial performance. We use publicly available data on 2059 hospitals in 2014 to 2016 that include HAIs, staffing financial performance, and hospital and hospital market characteristics. The key independent variables are available infection rates and nurse staffing. The dependent variables are indicators of financial performance: operating margin, total margin, and days cash on …

Advancing Health Equity In The Us Military, James D. Mancuso, John Young, Jennifer Rusiecki, Shauna Stahlman, Natasha Schvey, Toya Randolph, Candy Wilson, Catherine Witkop, Patrick Hyde, Althea Green, Patcho Santiago, Donald Shell, Tracy Sbrocco

Journal of Health Disparities Research and Practice

Eliminating health disparities and achieving health equity are central to US national health objectives and the Military Health System’s “quadruple aim,” which has readiness as its core aim. Because military service members enjoy universal eligibility for health care, it is sometimes assumed that health disparities do not exist in the Department of Defense (DoD). However, while some studies have shown that disparities have been attenuated or eliminated in the DoD, others suggest that significant disparities remain. Reasons these disparities may remain include that universal eligibility for care does not necessarily result in equal to access to care, and that equal …

Implementation Levels Of Electronic Health Records And Their Influence On Quality And Safety, Soumya Upadhyay

Healthcare Administration and Policy Faculty Research

Improvement in quality and patient safety outcomes have been at the forefront of the United States healthcare system. Policies advocate for implementing different electronic health records (EHR) levels to support this effort. Several studies have demonstrated mixed results on the impact of EHR on quality and safety outcomes. Our study delves deeper into gaining an understanding of this influence on hospitals that have adopted various levels of EHR, especially intermediate and comprehensive. Using a longitudinal study design for general acute care hospitals within the U.S., we examine the relationship between intermediate and comprehensive EHR on quality (readmission rates for pneumonia …

Self-Reported Covid-19 Diagnosis And Severity And Its Association With Utilization Of And Delays In Needed Medical Care, Mohammad Hesam Alavi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Covid-19, caused by the virus SARS-CoV-2, was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. The pandemic-related disruptions and the pursuant lockdowns have adversely impacted every aspect of people’s lives including access to medical care, cancer care, preventive medicine, mental health, and dental care in an already imperfect healthcare system in the US. This study utilized the 2020 self-reported data from quarters 3 and 4 of the National Health Interview Survey, a cross-sectional interview survey by the Centers for Disease Control and Prevention, to determine the possible association of self-reported COVID diagnosis, test positivity, and …

Predictor Of Hospital Closure In The United States, Haniyeh Shariatmadari

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hospital closures have recently been more common and a crucial concern in the United States since they can influence many aspects of patients' health conditions. This situation has led many scholars to investigate the adverse effect of hospitals closure. Previous research has well documented the effects of a hospital closure. However, there is a lack of studies on the predictor of a hospital closure. To fill this gap, the objective of this longitudinal study is to explore organizational and market factors associated with hospital closure. We used Data from the American Hospital Association (AHA), the Centers for Medicare and Medicaid …