The Contribution Of Psychophysiological Stress Factors On Muscle Cramp Susceptibility, Lauren D. Levine

UNLV Theses, Dissertations, Professional Papers, and Capstones

Exercise-associated muscle cramps (EAMCs) are painful phenomenon that involves involuntary muscle spasms occurring during physical activity or directly after. 1 The landscape of the research on EAMC etiology has expanded from focusing on a single prevailing cause (e.g., hydration status) to a more holistic approach of how numerous factors contribute to the onset of neuromuscular fatigue, and the significance of each factor in those who suffer from EAMC. Following the multifactorial theory of cramp pathophysiology, this research sought to advance the knowledge of cramp susceptibility by investigating if there is a relationship between common psychophysiological factors like high anxiety, sleep …

Sense Of Belonging And Professional Identity In Acute Care Occupational Therapists: A Phenomenological Study, Shania Marion D. Novilla

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapy practitioners (OTPs) play a crucial and demanding role in acute care, addressing complex diagnoses and facilitating safe discharge; however, the fast-paced biomedical environment often pressures them to compromise their occupation-based philosophy, potentially leading to professional burnout and low retention rates. Although professional identity (the self-perception of one's role) and a sense of belonging (feeling valued and connected) are recognized as correlated concepts vital for professional resilience, this relationship remains critically underexplored within the acute care OT population. Guided by the Occupational Adaptation Model (Schkade & Schultz, 1992), this qualitative study explores how experienced occupational therapists working in an …

Effect Of The Sava Syndemic On Hiv Viral Suppression Among People Living With Hiv In The United States: A Scoping Review And Meta-Analysis, Jacquelyn Rodriguez

UNLV Theses, Dissertations, Professional Papers, and Capstones

The SAVA syndemic highlights the interconnected and mutually reinforcing nature of substance use, violence victimization, and HIV/AIDS. The synergistic interaction of these conditions creates structural and behavioral barriers that disrupt the HIV care continuum and contribute to significant health inequities. Achieving a suppressed viral load is a critical clinical outcome for people living with HIV, while viral non-suppression can be an indicator of poor health, elevated transmission risk, and disease progression. Still, the association between SAVA factors and viral suppression/non-suppression outcomes within U.S. populations remains inconsistently characterized due to heterogeneous methodologies and variable inclusion of high-risk groups. This mixed-methods study …

Evaluating An Educational Intervention On Screen-Time And Behavior Change: A Pilot Study, Kayla L. Sweeney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Excessive screen time among adolescents has been associated with negative health outcomes, including sleep disturbances, anxiety, and depression. Despite growing awareness, many parents lack sufficient understanding of these risks and their impact on adolescent well-being. This project evaluated whether a brief educational intervention improved parents’ knowledge of the health effects of excessive screen time. Methods: A pre-and post-survey design was used to assess changes in parents’ understanding following an educational video intervention. The educational intervention consisted of evidence-based content highlighting the impact of screen time on mental health and sleep. The survey measured knowledge, beliefs, behavioral intentions, and strategies …

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 …

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).

Exploring Direct Support Professionals' (Dsps) Attitudes Regarding Trauma Informed Care And Its Impact On Turnover Intention, Lorraine D'Sylva-Lee

Seton Hall University Dissertations and Theses (ETDs)

The relationship between Direct Support Professionals’ (DSPs’) attitudes toward trauma-informed care (TIC) and their turnover intention has remained empirically untested, despite DSPs’ exposure to primary and secondary trauma. An estimated 8.38 million Americans with intellectual and developmental disabilities (IDD) depend on this workforce, yet 2024 turnover rates reach 53.7%. This convergent mixed methods study examined TIC attitudes, turnover intention, and their relationship among 109 DSPs in IDD provider agencies in New Jersey. Grounded in the Theory of Planned Behavior (TPB), the cross-sectional design used the ARTIC-10, TIS-6, and two open-ended items. DSPs with more favorable TIC attitudes were significantly less …

Multiple Interest Holder Perspectives Of The True Grit Sci Residential Program: A Mixed Methods Program Evaluation, Keara Mcnair

Seton Hall University Dissertations and Theses (ETDs)

Young adults with spinal cord injury (SCI) face significant challenges during the transition to adulthood, including barriers to independence, community participation, and psychosocial adjustment (Ingimarsdóttir et al., 2023; Zebracki et al., 2010). Current rehabilitation models in the United States prioritize short-term physical recovery and offer limited support for the developmental and contextual needs that shape long-term outcomes after SCI, particularly during transitions from inpatient rehabilitation to the community (Anderson et al., 2024; Bryden & Gran, 2024). Community-based programs may help address these gaps, though few have been rigorously evaluated using implementation science frameworks that attend to health equity, contextual influences, …

The Moderating Role Of Psychological Power Distance On The Relationship Between Moral Disengagement And Submissiveness To Authority In Senior Healthcare Executives, Carl Kirton

Seton Hall University Dissertations and Theses (ETDs)

Background: Understanding how senior healthcare executives respond to authority is critical in complex health systems where ethical decision-making, hierarchy, and organizational culture intersect. This study explored the relationships among moral disengagement, submissiveness to authority, and psychological power distance (PPD) in U.S. healthcare executives, as well as the influence of selected demographic and professional covariates.

Methods: A descriptive correlational design was used with a non-probability sample of senior healthcare executives (N = 98). Participants completed a demographic questionnaire and three validated instruments: the Submissiveness to Authority Scale (SOAS), the Moral Disengagement through Displacement of Responsibility Questionnaire (MDDR), and the Psychological Power …

Incivility In Nursing: The Experience Of Registered Nurses In The Emergency Department, Karen Voorhees

Seton Hall University Dissertations and Theses (ETDs)

The American Association of Colleges of Nursing (AACN) predicts that due to the anticipated retirement of the “baby boomer” generation coupled with an expanded need for medical care across the United States, the need for nurses will expand 6% by 2032 (AACN, 2024). This need will be impeded by nurses leaving the profession due to feelings of a poor work environment, burnout and job dissatisfaction. Incivility in nursing has been shown to be a contributor to nurses leaving their current work environments or the profession of nursing entirely.

Incivility in nursing has roots in organizational psychology and has been shown …

Healthcare Provider Trust As A Predictor Of Covid-19 Vaccine Hesitancy Among Nevada Residents, Joanna Joseph

UNLV Theses, Dissertations, Professional Papers, and Capstones

Trust in healthcare providers is one of the strongest predictors of vaccine hesitancy in the literature, yet it has not been examined as an independent predictor of COVID-19 vaccine hesitancy in Nevada. Nevada ranks last nationally in healthcare providers per capita and is among the lowest in immunization coverage for both adults and children. The COVID-19 pandemic exacerbated negative vaccine attitudes, and vaccine hesitancy continues to be a central public health issue. Prior Nevada analyses identified vaccine hesitancy across racial, political, educational, and economic groups but did not assess the role of provider trust in vaccine hesitancy. This cross-sectional study …

Tumor Implantation Site Of Syngeneic Oral Cancer Models Differentially Induces Site-Dependent Local And Systemic Immunosuppression, Andrea H Molina, Gemalene M Sunga, Shawn Nguyen, Neeraja Dharmaraj, Ratna Veeramachaneni, Roberto Rangel, Jeffrey N Myers, Jeffrey D Hartgerink, Andrew G Sikora, Simon Young

Faculty, Staff and Student Publications

Background/objectives: Preclinical studies of head and neck squamous cell carcinoma (HNSCC) commonly use subcutaneous heterotopic (flank) tumor models for simplicity; however, orthotopic models may better reflect the native tumor environment. Direct comparisons of the tumor immune microenvironments (TIME) and tumor-draining lymph nodes (tdLNs) between these models remain limited. Better understanding of site-specific immune differences could improve model selection and interpretation of translational HNSCC studies.

Methods: ROC1 tumors were established in murine heterotopic and orthotopic sites, followed by assessment of tumor growth kinetics, survival, and the tumor microenvironment. Immune composition of tumors, blood, tdLNs, and spleen was evaluated at three tumor …

Cardiac Computed Tomography And Echocardiography Integration For Chronic Secondary Mitral Regurgitation Quantification, Abdulameer Jasim Jawad Al-Gburi

Sultan Qaboos University Medical Journal

Objectives: This study aimed to determine whether it would be possible to reclassify the severity of secondary mitral regurgitation (MR) using an integrated mitral regurgitant volume (RVol) derived from computed tomography (CT) and echocardiography data. Methods: This cross-sectional study was conducted at Ibn al-Bitar Specialized Center for Cardiac Surgery, Baghdad, Iraq. Systolic CT data of patients with isolated secondary MR were evaluated from June 2023 to December 2025. The image with the highest regurgitant orifice area (ROA) and the smallest left ventricular volume was chosen from the CT systolic phase. To calculate the integrated RVol (iRVol), the velocity …

Mid- To Long-Term Recovery After Non-Traumatic Lower Limb Amputation: A Scoping Review Of Longitudinal Research Studies, Chloe Akiona-Bannan, Jocelyn Contreras, Kayla Cheyenne Bonsol Francisco, Kentaro Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective

Longitudinal research studies are essential for understanding the time course of functional recovery after lower limb amputation (LLA). The purpose of this scoping review was to evaluate the existing evidence base regarding mid- to long-term outcomes following non-traumatic LLA.

Data Sources

A scoping review was conducted per Joanna Briggs Institute and Open Sciences Framework guidelines. Based on purpose, seven databases (PubMed, CINAHL, Embase, Scopus, Web of Science, SportDiscus, and Google Scholar) were searched for studies published between 2000–2024, in English, Mandarin Chinese, Tagalog, Persian, or Spanish.

Study Selection

Eligible studies must include at least 50% of participants with non-traumatic …

Golden Steps: A Dance-Based Program To Improve Balance In Older Adults — A Feasibility And Acceptability Study, Ramyr Bognot, Sophia Botelho, Nolan Caberto, Lauren Valerio, Joshua Yu, Jason Zeidman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background

Falls are a leading cause of injury and loss of independence among older adults. Evidence-based programs such as Otago and Tai Ji Quan reduce fall risk, yet barriers to access and adherence remain. Dance-based interventions may offer a practical, enjoyable approach to engage older adults in balance training.

Purpose

This formative pilot study aimed to develop four dance routines grounded in evidence- based balance principles and evaluate their feasibility and acceptability among older adults, including factors influencing enjoyment and willingness to continue participation, to inform future clinical and community implementation.

Methods

Four routines (Polka, Country, Rockabilly, Salsa) were developed …

Unlv Pt Admissions: The Relationship Between Mismatched Gender Or Race Of Applicants Compared To Interviewer On In-Person And Asynchronous Interview Scores, Sarah Dudley, Calvin Kwok

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis:

Despite a growing push for diversity in healthcare, the impact of interviewer-applicant demographic alignment on scoring remains under-researched within the specific context of physical therapy admissions, particularly across different interview platforms. A sex or race concordance bias has the potential to compromise a program’s reliability of applicant evaluations and conflicts with the ethical standards of equity and nondiscrimination that guide healthcare education and practice. In this study we aimed to determine the relationship between sex and race concordance of interviewers and applicants for both in-person and asynchronous virtual interview scores at the University of Las Vegas Physical Therapy (UNLV …

Effects Of A 12-Week Physical Therapy-Based Exercise Intervention On Gait In Adults With Down Syndrome, Samantha Betts, Stephen Kiraly, Paige Lucero, James Malabanan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Individuals with Down Syndrome (Ds) frequently have sedentary lifestyles and Ds-specific physical impairments such as ligamentous laxity and hypotonia. These impairments often contribute to gait deviations that reduce the efficiency of ambulation. Purpose: The purpose of this study was to examine the effects of a 12-week exercise program on spatiotemporal characteristics of gait and kinematic variables at the hip, knee, and ankle in adults with Down syndrome (Ds). Methods: A randomized control trial of 40 participants was conducted with two groups: one group of adults with Ds who participated in a 12-week exercise program, and a control group who …

Evaluation Of Two Bioaerosol Sampling And Analysis Methods For The Collection Of Airborne Bacteria And Viruses, Elizabeth Detrick

UNLV Theses, Dissertations, Professional Papers, and Capstones

Bioaerosols, defined as airborne particles of biological origin, include bacteria, fungi, viruses, and their byproducts. They are ubiquitous in both indoor and outdoor environments and can cause respiratory infections, allergic reactions, and toxin-mediated illnesses. Air sampling plays a vital role in bioaerosol monitoring by enabling the collection and analysis of airborne microorganisms to assess exposure risk and inform mitigation strategies. The objective of this study was to determine the relative collection efficiency of two air samplers, the MD8 Airscan, a filtration sampling method, and the SKC BioSampler, an impingement sampling method. Aerosolization tests were conducted in a controlled test chamber …

Cortical Bone Density And Thickness Assessment Of Intraradicular Sites In Adolescent Patients Using Cbct Imaging, Sara Endo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The indications for the use of cone beam computed tomography (CBCT) in orthodontics has grown since it was first introduced and dentists are discovering new ways that 3D images enhance diagnosis and treatment planning. Evaluating bone quality and quantity can be measured as bone density and thickness in CBCT imaging and is helpful for temporary anchorage device (TAD) placement in orthodontic treatment. TADs rely on primary stability and are commonly used in orthodontic treatment to increase anchorage and expand the limit that nonsurgical orthodontics can provide.

Objectives: This study aims to assess the bone thickness and density at different …

Correlation Between Maxillary Transverse Width, Alveolar Housing Width And Palatal Bone Thickness: A Cbct Retrospective Study, Eric G. Hollensbe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background:

Accurate assessment of transverse maxillary dimensions and surrounding bone morphology is critical for safe orthodontic treatment planning. Orthodontic expansion should remain within the biological limits of the alveolar housing and palatal bone to prevent adverse periodontal outcomes, including dehiscence, fenestration, and gingival recession. Standard diagnostic methods, such as dental casts and two-dimensional radiographs, offer limited information about the three-dimensional anatomy that restricts orthodontic tooth movement. Cone-beam computed tomography (CBCT) provides detailed evaluation of skeletal dimensions and cortical bone boundaries. This study aimed to examine the relationships among maxillary transverse width, alveolar housing thickness, and palatal thickness using CBCT imaging. …

The Impact Of Youth Sport On Occupational Balance: A Survey Study, Sean Jones

UNLV Theses, Dissertations, Professional Papers, and Capstones

Youth sport has been highly researched, exploring both positive and negative health impacts (Adetunji & Akendutire, 2017; Brengtsson et al., 2025; Conway, 2024; Hoffman et al., 2022). Despite the high prevalence of youth sport participation, and variability of health-related outcomes, there has been no research regarding the impact youth sport participation has on occupational balance, an occupational therapy concept that has been linked with overall health and well-being (Park et al., 2021). A mixed-methods, cross-sectional survey study was used to gain better insights into the impact youth sport participation may have on occupational balance. A sample size of 466 Nevada …

Efficacy Of Dorsal Application Kinesio® Tex Tape On Esports Performance, Charlie Moua

UNLV Theses, Dissertations, Professional Papers, and Capstones

This mixed-methods pilot study examined dorsal Kinesio® Tex Tape as a nonrestrictive occupational therapy intervention for adult PC gamers with carpal tunnel–type symptoms. As gaming participation increases, players may experience repetitive wrist and hand movements, prolonged postures, and high performance demands that contribute to discomfort, overuse symptoms, and reduced participation in meaningful gaming occupations. Four adult PC gamers completed five in-person sessions and were assigned to either dorsal wrist taping or sham scapular taping. Quantitative outcomes included the Boston Carpal Tunnel Questionnaire– Symptom Severity Scale, visual analog pain ratings, and Kovaak’s Aim Trainer performance scores and accuracy. Qualitative data were …

Thermal Physiological Ecology Of The Relict Leopard Frog At Hot And Cold Springs, Robert P. Pelletier Iii

UNLV Theses, Dissertations, Professional Papers, and Capstones

The relict leopard frog (Rana onca) once ranged across drainages in southern Nevada, northwestern Arizona, and southwestern Utah. Following a decline, the species only persisted in a few geothermally influenced hot springs, which led to the perspective that hot springs were high-quality habitat. Rana onca has been under intensive, multiagency management and the species has been translocated to establish additional populations, including at cold-water sites. Three research studies are presented into the thermal physiological ecology of R. onca with the aim of informing conservation strategy. The research was focused at a thermally influenced hot spring and a cold-water spring to …

Exploring Lifestyle Habits Between Gamers And Non-Gamers: A Survey-Based Approach, Janavi Sathappan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Video gaming is a prevalent and meaningful occupation for a growing number of young adults, yet its relationship to health behaviors is inconsistent and unclear in literature. This cross-sectional survey-based study examined the differences in nutritional pattens, sleep hygiene, and physical activity between self-identified gamers and non-gamers in a sample of young adults aged 18-34. Recruitment occurred primarily through the University of Nevada, Las Vegas and associated networks. Participants were asked to complete the Mini Eating Assessment Tool, Sleep Hygiene Index, and the International Physical Activity- Short Form. Data was analyzed using Mann-Whitney U tests and Pearson’s chi-square tests, and …

Exploring Health Insurance’S Role In Chronic Disease Management Among Hispanics, Romelyn Dones

Seton Hall University Dissertations and Theses (ETDs)

This qualitative study examined how insured non-English- and English-speaking Hispanic adults perceive the role of health insurance in the management of chronic disease. Chronic conditions remain a leading cause of morbidity in the United States, and although prior research suggests that insurance coverage improves access to care, it does not always enhance how individuals understand or utilize support for chronic disease management. Limited research has explored how individuals with chronic conditions interpret the role of insurance in their daily self-management practices, particularly among Hispanic populations. Guided by Andersen’s Behavioral Model of Health Services Use, this study explored how contextual, enabling, …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …