Improving Health Literacy And Self-Management In Adults With Heart Failure: A Nurse-Led Virtual Intervention In Outpatient Support Groups, Vivian Efosa Osunde

Doctoral Projects

Heart failure is a leading cause of morbidity and hospital readmissions, with limited health literacy contributing to poor self‑management and adherence challenges. The purpose of this Doctor of Nursing Practice project was to evaluate the feasibility and preliminary outcomes of a nurse‑led, virtual education-intervention designed to improve health literacy, self‑care behaviors, and medication adherence among adults with chronic heart failure who participate in an outpatient support group. A quality improvement design was used. Convenience sampling yielded nine adult participants with a documented diagnosis of chronic heart failure who attended at least one virtual support group session. The intervention consisted of …

Whiny Women: How Medical Gaslighting Becomes Medical Trauma, Neena Marcus

Honors Projects

Background: The idea of “medical gaslighting” has been present since 1969, but it has increased in popularity in the recent century. Women in particular are at increased risk of being dismissed by their healthcare providers, as throughout history they have been deemed “hysterical” or untrustworthy when recounting their symptoms.

Methods: Articles were compiled from CINAHL Complete, Google Scholar, and the University of Washington library. A total of 33 articles were chosen and reviewed.

Results: Medical gaslighting results in lasting medical trauma, a decreased quality of life and detachment from standard healthcare. Six themes were recurrent in the papers utilized: sexism, …

Perception, Payment, And Pollution- Examining The Effects Of Air Quality On Health And Healthcare, Colin Sleeper

Economics ETDs

Abstract

This dissertation examines how air quality and public attention to environmental shock affect perceived health status and healthcare utilization. The first chapter uses publicly available survey data from BRFSS and a triple difference framework to analyze the effects of the 2018 wildfire season in Oregon on self-reported mental and physical health. Findings indicate that those in Oregon in 2018, during the period of heightened attention to wildfire smoke, experienced approximately 1.4 additional poor mental health days, on average. The second chapter includes Merative MarketScan commercial insurance claims data to test whether these changes translate into a behavioral response. Results …

Impact Of Third Trimester Alcohol Exposure (Ttae) On Oligodendrocyte Development And Behavior In Mice, Estrella Villicana

Biomedical Sciences ETDs

Prenatal alcohol exposure (PAE) during late gestation can cause cognitive, behavioral, and motor impairments associated with fetal alcohol spectrum disorders (FASDs). The third trimester corresponds to a critical period of brain growth and maturation. This study examined the effects of Third Trimester-equivalent Alcohol Exposure (TTAE) on oligodendrocyte development and adult behavior. Neonatal mice were exposed to ethanol or air vapor from postnatal day (P) 4–8. Immunohistochemical analyses were performed at P8 and P30 to assess myelination, apoptosis, and oligodendrocyte lineage progression. TTAE significantly reduced myelin basic protein (MBP) expression at P8, which was recovered by P30, indicating delayed developmental myelination. …

Design And Optimization Of Epitope Based Malaria Vaccine Targeting Pre-Erythrocytic Stage, Yogesh Nepal

Biomedical Sciences ETDs

Malaria remains a major global health challenge. Currently available vaccines provide only modest and transient protection. In this work, we developed virus like particles (VLPs) based vaccine to target vulnerable epitopes of circumsporozoite protein, a key surface protein of pre-erythrocytic sporozoite stage, across different structural contexts. The immunogenicity of these highly immunogenic vaccines were further enhanced using immune stimulating agents, adjuvants, and the most promising VLP and adjuvant combinations were evaluated in preclinical challenge models to assess efficacy. In parallel, we performed research in an antigen agonistic manner using VLP library immunization that displays different fragments of a target protein …

The Effects Of Behavior Skills Training To Teach A Clinician To Implement A Structured Work System, Megan E. Bowling

Masters Theses, 2020-current

Many children with autism spectrum disorder present with deficits in completing daily living tasks, which may be due to the sequencing of information required to complete these skills. Structured work systems present a support for children to visually organize and sequence events, though they are most used in the classroom setting. The study tested the effectiveness of behavior skills training to teach a behavior support clinician to implement a structured work system via least-to-most prompting. Data was collected on the clinician’s percent of accurate implementation, which was then analyzed across three daily living behaviors in a multiple probe design. Results …

Brain-Based Mechanisms Of Behavioral Impairment In Fetal Alcohol Spectrum Disorder (Fasd): The Neuroimaging Biomarkers Of Inhibitory Control, Zinia Pervin

Biomedical Engineering ETDs

The developing brain is highly susceptible to alcohol-induced toxicity, often resulting in long-term deficits in executive function and behavioral regulation. Inhibitory control impairments are among the most prominent deficits observed in Fetal Alcohol Spectrum Disorder (FASD). This study investigated the neural mechanisms of inhibitory dysfunction using a multimodal MEG–DTI approach in 67 children aged 6–8 years (34 with FASD, 33 controls) who performed a Go/No-Go task. Source-level MEG analyses revealed reduced stimulus-locked cortical activation in the anterior cingulate cortex and significant group-by-hemisphere interactions in the superior parietal cortex and cuneus. Time–frequency analyses showed diminished response-locked beta power in the sensory-motor …

Does Adjunctive Low-Level Laser Therapy Provide Additional Benefit Following Temporomandibular Joint Arthrocentesis With Hyaluronic Acid? A Randomized Clinical Trial, Moataz Bahaa, Abdelrahman Fahmy Dr., Hesham Morsi, Mahmoud Elfaramawy

Dentistry

Purpose This study aimed to evaluate whether adjunctive low-level laser therapy (LLLT) provides additional clinical benefit over an optimized arthrocentesis protocol with hyaluronic acid in patients with ADDwoR. Materials and methods From December 2022 to December 2023, a single-blinded prospective randomized clinical trial was conducted at The British University in Egypt’s Department of Oral and Maxillofacial Surgery. The study involved 40 female participants diagnosed with Anterior Disc Displacement without Reduction (ADDwoR). Following TMJ arthrocentesis, subjects were assigned to one of two parallel cohorts: Group A received ten subsequent sessions of low-level laser therapy (LLLT), while Group B served as the …

Negotiating Professional Identity Development Across Contexts: A Collaborative Autoethnography, Clark D. Ausloos, Rebecca J. Vannest, Hayley Ostlund

Journal of Counselor Preparation and Supervision

This collaborative autoethnography (CAE) explores how two counselor educators and one doctoral student navigate professional identity formation across three intersecting contexts: school counseling, clinical mental health counseling, and counselor education. Through critical reflection and collaborative analysis of focus-group data and individual reflections, we identify four themes: Career Flexibility & Adaptability, Identity Formation in Supportive and Restrictive Systems, Role Strain & Stigma, and Values-Driven Practices. Implications call for counselor education programs and higher education systems to embrace multiplicity, non-linear careers, redefine mentorship structures for doctoral students and faculty, and revise promotion criteria to value relationality, and creative, student- and community-engaged …

Predicting Counseling Student Well-Being: The Role Of Faculty And Stress, Kendall G. Woods, Elizabeth K. N. Harper, Michell L. Temple

Journal of Counselor Preparation and Supervision

Approximately one-third of Americans live in areas with limited access to mental health services, with only one mental health provider for every 350 people (Health Resources and Services Administration [HRSA], 2024; Reinert & Nguyen, 2022). The shortage of mental health providers persists as the need for services grows, a challenge compounded by the 40-60% attrition rate among counseling trainees (Chrzanowski, 2018). Improving counseling program completion is essential to address the mental health workforce shortage. While previous research has emphasized the importance of faculty support for graduate students (Estrada et al, 2019), little research has examined how faculty-student interactions and academic …

Enacting Leadership And Transforming The World: Hannah Arendt, The Private, The Public, And Transfigurations In Between, Xochitl Mendez

Educational Studies Dissertations

In this dissertation I propose a framework that emphasizes transitions between Private and Public. I argue that individuals can consciously reshape and reformulate these transitions to assert themselves in the world. How can the individual’s own internal realities, ventures, projects and selfhood assert themselves in a fraught world as an act of self-affirmation, leadership, and transformation? New approaches to this question can all be revealed by using transitions between Private and Public as actionable strategies. I re-interpret Hannah Arendt’s Private and Public as she presented them in The Human Condition (1958). I turn these into multivalent and multilayered spaces of …

Transforming Obesity Management In Primary Care: Shared Medical Appointments (Smas) – An Evidence-Based Practice Project, Glendy Chen

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose/Aims

The purpose of this DNP project is to implement a 10-week Lifestyle Intervention Shared Medical Appointment (LISMA) program in primary care to improve obesity outcomes. Aims include increasing structured visit frequency, enhancing multidisciplinary engagement, and improving metabolic indicators, mindful eating behaviors, and self-efficacy.

Background of Problem & Description of Current Practice

Obesity affects over 40% of U.S. adults and is associated with cardiometabolic morbidity, reduced quality of life, and rising healthcare costs. Guidelines recommend intensive, multicomponent behavioral interventions with frequent contact. Current practice primarily offers one-on-one visits at insufficient frequency with limited team integration, contributing to suboptimal management. LISMAs …

Improving Patient Education For The Management Of Crohn’S Disease, Mari K. Seward

Doctor of Nursing Practice Scholarly Project

For patients with Crohn’s disease, it can become overwhelming to learn how Crohn’s disease develops, the different types of management skills, and different treatment options. Many patients even feel they are not well educated on their diagnosis. Crohn’s disease patients typically have a poor quality of life. By improving the education given to patients and teaching ways to self-manage symptoms, their quality of life could be improved. It has also been shown that Crohn's disease can become worse over time with its symptoms (Definition & Facts for Crohn's Disease, n.d.). Due to this, by teaching patients' different triggers, symptoms, and …

Impact Of Travel Time To Health Facilities On Perinatal Outcomes: A Systematic Review With Narrative Synthesis And Meta-Analysis, Sanam Roder-Dewan, Marwa Ramadan, Paul Ouma, Alexander Manu, Emelda A. Okiro, Natalie Strobel, Bibian N. Robert, Emily Odipo, Peter M. Macharia, Anthony Danso-Appiah, David C. Goodman, Queen Dube, Gagan Gupta, Hema Magge, Karen Edmond

Research outputs 2022 to 2026

Background: Evidence-based global guidance on safe travel time for small or sick newborns who require transfer to health facilities after birth is lacking. A two-hour threshold is frequently cited in low- and middle-income countries (LMICs), while 30 minutes is commonly used in high-income countries (HICs). Although these thresholds are widely referenced, their empirical basis and consistency across levels of newborn care and journey types have not been systematically examined. This study synthesises the evidence linking travel time and perinatal outcomes. Methods: We conducted a systematic review with narrative synthesis and meta-analysis to assess the impact of travel time or distance …

Pediatric Trauma Trends Before And After Recreational Cannabis Legalization In Nevada: A Retrospective Repeated Cross-Sectional Study, Jenna Serr, Vidhani Goel, Roberto Sagaribay, Kavita Batra, Ami P. Shah

School of Medicine Faculty Research

Background: Cannabis legalization has raised concerns regarding its potential influence on injury patterns, particularly among children. However, evidence on pediatric trauma remains limited. Objective: To examine trends in pediatric trauma incidence, injury mechanisms, healthcare utilization, and socioeconomic characteristics before and after recreational cannabis legalization in Nevada. Methods: A retrospective repeated cross-sectional study of trauma registry data was conducted using pediatric trauma activations recorded between 2013 and 2023. Incidence rates per 100,000 population were calculated using census data. Pre-legalization (2013–2016) and post-legalization (2017–2023) periods were compared using incidence rate ratios (IRRs) and bivariate tests. Socioeconomic status was assessed using the Distressed …

“There Was Nothing Left To Give”: Experiences Of Compassion Fatigue Among Former In-Patient Psychiatric Clinicians, Katie Ladner

Counseling and Psychology Dissertations

Compassion Fatigue (CF) is a state of emotional and physical exhaustion resulting from prolonged exposure to stressful or traumatic experiences, specifically among healthcare workers, and it negatively impacts their ability to provide care to their patients and perform their jobs effectively (Singh et al., 2020). The purpose of this qualitative study is to explore the lived experiences of compassion fatigue in mental health clinicians who previously worked in in-patient psychiatric hospitals and their subsequent resignations. This phenomenological research explored participants' understanding and descriptions of their CF experiences in their roles within psychiatric hospitals and how CF contributed to their leaving …

Exploring The Biological Basis For Exercise Neuroprotection In Parkinson’S Disease: A Cross-Sectional Study Of Exercise And Physical Activity On Inflammatory Cytokines And Neurotrophins, Leah Isabelle P. Alegre, Jacob M. Brewer, Adeline Florschutz, Kate E. Hamiltonthompson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Regular exercise and physical therapy are known to increase production of neurotrophins, including brain-derived neurotrophic factor (BDNF), and anti-inflammatory cytokines. These changes combine to theoretically protect and slow the progressive loss of neurons in Parkinson’s disease (PD). The purpose of this study was to examine the effect of exercise and physical activity on various anti-inflammatory and pro-inflammatory cytokines and neurotrophins in people with PD (PwP). This was a cross-sectional design involving PwP (n=37), aged 43-85 years, who participated in two 30-minute bouts of exercise (with brief rest breaks during and pre/post blood draws) separated by a week. Measures collected prior …

Anatomy Academy: An Interdisciplinary Approach To Enhancing Youth Health Literacy, Roselle Antikoll, Jonathan Nakamine, Jessica Tran

UNLV Theses, Dissertations, Professional Papers, and Capstones

To enhance health literacy among the underserved youth population in Las Vegas, Nevada, Anatomy Academy (AA) is an eight-week, seven-lesson program that educates students through structured and interactive lesson plans covering basic anatomy, physiology, and nutrition. Our program was implemented in three different Title-I elementary schools between five different classrooms across Las Vegas. These lesson plans highlighted specific body systems including the cardiovascular, musculoskeletal, and gastrointestinal systems. Our primary aim was centered around involvement of more interdisciplinary healthcare professions including occupational therapy, dental medicine, osteopathic medicine, and nutrition to aid in the delivery of the AA program. Our secondary aim …

Postural And Load Dependent Modulation Of Lower Limb H-Reflex Excitability After Stroke, Daniel Bamiro, Matthew Berdiago, Ethan Hunter, Tia Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis

Leg stiffness is regulated by reflexive, intrinsic, and passive mechanisms, which are influenced by posture, body weight loading, and motor task demands. After a stroke, the capacity to modulate these mechanisms is often compromised. The H-reflex is a widely used electrophysiological tool to assess the excitability of the Ia afferent pathway within spinal circuitry. Although prior studies in healthy individuals have examined limb loading effects, results have been variable, and the role of postural and loading changes during standing remains underexplored, particularly in individuals post-stroke. This study investigated how different postural and limb loading conditions, specifically prone, standing, and …

Effect Of An Exercise Protocol On Balance In Adults With Down Syndrome, Juan Bernal, Natalie Sato

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Down syndrome (Ds) is a complex genetic condition that can impact multiple systems of the body, including functional balance. Ds-specific impairments such as muscle hypotonia, ligamentous laxity, and decreased muscle strength, coupled with a sedentary lifestyle can result in poor motor control, altered proprioceptive function, static and dynamic instability. Visual and vestibular impairments are also common in this population, increasing fall risk and fear of falling, and discouraging participation in physical activity. The aim of this study is to analyze the impact of a physical therapy-based exercise program on the functional balance of adults with Ds.

Number of Subjects: …

Feasibility Of A Functional Reach Tool For Individuals With Lower Extremity Amputations, Neil Bongolan, Dustin Hoy, Ashlyn Strange

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Patients with lower extremity amputations are at increased risk of falls due to decreased balance ability between amputated and sound side. The purpose of this study was to examine the usefulness of a reaching tool for practitioners to assess balance in an inpatient rehab facility. It was anticipated that clinicians will find the reaching device useful when administering the Functional Reach Test (FRT) in a clinical setting, given the frequent use of these assessments and the device’s demonstrated reliability.

Participants: Physical Therapists and patients at an Inpatient Rehab Facility in Henderson, Nevada

Materials/Methods: A prototype reaching tool was provided …

Uneven Terrain Treadmill Training For Lower Limb Prosthesis Users: A Feasibility Study, Brian Diep, Keegan Feroah, Ani Gasparyan, Nevena Jovanovic

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals with lower limb amputation (LLA) face an increased risk for falls which may limit mobility, confidence, and participation in daily activities. Current rehabilitation programs for this population rarely integrate surface training as an intervention, despite walking on different surfaces being a necessity to participate in the real world. This feasibility study aimed to evaluate the practicality, acceptability, and preliminary efficacy of an uneven treadmill training protocol for individuals with LLA. Five adults with LLA (P1: transfemoral, 38 years old, 1.75 m, 88.8 kg; P2: hip disarticulation, 38 years old, 1.60 m, 106.7 kg; P3: transfemoral, 53 years old, 1.81 …

Proceedings Of The 18th Indonesian Occupational Medicine Update (Iomu) 2026 - Occupational Medicine Without Borders: Emerging Risks, Evolving Workforces, And Inclusive Collaboration, Indonesian Association Of Occupational Medicine Specialists (Perhimpunan Kedokteran Okupasi Indonesia / Perdoki)

Occupational and Environmental Medicine Journal of Indonesia

This Supplemental Issue of the Occupational and Environmental Medicine Journal of Indonesia (OEMJI) compiles the scientific abstracts presented at the 18th Indonesian Occupational Medicine Update (IOMU) 2026, convened in Surabaya, Indonesia, from 15 to 17 May 2026. The IOMU has matured into the most prominent annual scientific platform of the Indonesian occupational medicine community, hosted by the Indonesian Association of Occupational Medicine Specialists (Perhimpunan Kedokteran Okupasi Indonesia / PERDOKI). Since its inception, the conference has served as a meeting point where clinicians, academics, industrial hygienists, regulators, employers, and worker representatives gather to translate emerging scientific evidence into …

Weighted Blankets: Implementation Of A Quality Improvement Pilot Project In The Neurosciences Intensive Care Unit, Anita Musafar

Doctoral Projects

The weighted blanket quality improvement pilot project was implemented at Stanford Healthcare (SHC) to address the limited number of nonpharmacological interventions available for agitation management in the critical care setting. Patients within the Neurosciences ICU (NSICU) at SHC are clinically complex and uniquely vulnerable to experiencing agitation. The objectives of this initiative were to understand nurses' perceptions surrounding weighted blanket use in the critical care setting and assess whether there was a decrease in Richmond Agitation-Sedation Scale (RASS) scores with this intervention. From September 2025 to December 2025, the nurses within the NSICU implemented the use of weighted blankets for …

College Of Fine Arts Outreach And Health Promotion For Injury Prevention: A Service Learning Project, Andrea Bejaran-Choto, Emily Horner, Marlene Quirarte, Shaye Robles, Dora Segura, Duc Tu, Trevor Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: This community-based academic initiative targeted a significant deficiency regarding rehabilitative care and wellness assets for Southern Nevada's fine arts practitioners. Despite possessing trauma frequency rates similar to those of collegiate-level athletes, this demographic lacks sufficient infrastructure for health support. The endeavor sought to bolster the University of Nevada, Las Vegas College of Fine Arts (CFA) and the regional performance art sector utilizing the UNLV College of Fine Arts Physical Therapy Clinic (CFA-PTC).

Description: The initiative focused on three essential objectives: (1) augmenting student consciousness and utilization of therapeutic care at the CFA-PTC, (2) broadening health-related guidance for the artistic …

Disparities Between Rural And Urban Patients With Epilepsy In Oregon From Time Of Seizure Onset To Genetic Testing And Surgical Treatment, Bahar Madani

University Honors Theses

Drug-resistant epilepsy (DRE) is associated with significant morbidity and worsened outcomes when access to specialized epilepsy care is delayed. Rural populations may face additional barriers to neurological evaluation, genetic testing, and epilepsy surgery due to geographic and healthcare access limitations. This retrospective cohort study evaluated disparities in epilepsy care timelines among rural and urban patients treated at Oregon Health & Science University (OHSU), one of Oregon's two Level 4 epilepsy centers. Electronic health record data were reviewed for 110 patients, including 80 urban and 30 rural patients. Variables included age at seizure onset, age at genetic testing, age at epilepsy …

Pain Management In Opioid Users, Dawn Starbinski

Seton Hall University Dissertations and Theses (ETDs)

ABSTRACT

Chronic pain remains a significant public health concern in the United States, contributing to disability, reduced quality of life, and over-reliance on traditional opioids. Amid the opioid epidemic, healthcare systems are increasingly seeking safer alternatives to conventional opioid prescribing. (NIDA, 2023).This Doctor of Nursing Practice (DNP) project aimed to evaluate nursing knowledge on the implementation of buprenorphine/naloxone (Suboxone) as a pain management strategy in adult patients with chronic opioid use. The project was conducted in an inner-city Subacute Nursing facility with a population of adult patients experiencing long-term pain who were either opioid-tolerant or at high risk for opioid-related …

A Quality Improvement Project: The Implementation Of A Nurse Driven Morbidity And Mortality Review In An Emergency Department Setting, Abby Beutel

Seton Hall University Dissertations and Theses (ETDs)

Abstract

Background: Morbidity and mortality reviews/conferences (MMR) are a mandatory curriculum requirement for medical residency programs throughout the United States to identify and reduce medical errors. Only within the past few decades have hospital organizations expanded MMRs to multidisciplinary teams to include medical professionals who are rendering care at the bedside more than medical providers.

Purpose: This quality improvement (QI) project focuses on the application of a nurse drive MMR amongst emergency department (ED) nurses in a community hospital in Northern Bergen County, New Jersey. This ED nurse driven MMR measured the ED nurse’s knowledge and confidence levels as it …

Exploring Practicing Registered Eeg Technologies' Opinions And Preferences Regarding Electroencephalographic Scope Of Practice Standard Forms Of Occupational Regulations, Richard A. Steer

Seton Hall University Dissertations and Theses (ETDs)

Abstract Background: Neurodiagnostic (NDT) is the study and recording of electrical activity in the central and peripheral nervous systems, it is essential for providing critical information that can aid in the diagnosis and treatment of neurological disorders. EEGs are the most frequently performed NDT procedures. The proportion of hospitalizations involving EEG use increased by 122.7% from 2003 to 2014, an average increase of 11.2% annually and continues to grow. The rate of rEEG use increased by 49.4% over 11 years (4.5% annually), while cEEG use increased by 302.3% (27.5% annually) (Bernheimer et al., 2018). Under existing law, the EEG profession …

Improving Appropriate Nephrology Referrals Using Epic Screening Tools And Nurse Practitioner (Np) Education, Diahann M. Volcy

Seton Hall University Dissertations and Theses (ETDs)

Nephrology referral has been recognized as a modifiable factor influencing patient outcomes (Cheng, 2025). This project aims to reduce delayed or missed CKD diagnoses at large suburban hospitals in north New Jersey by improving timely nephrology referrals. I used a mixed-methods approach, retrospective chart review, pre- and post-education surveys, and referral trend analysis to assess how an educational session affects nurse practitioner knowledge and nephrology referral behavior. Enhancing nurse practitioner (NP) awareness and decision tool usage may increase early kidney care for patients, leading to better outcomes (ISN-KDIGO, 2021; Van Mil et al., 2024).