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Conflict, Climate, And Child Health: Evidence From Sub-Saharan Africa, Brian C. Thiede, Nigel C. James

Health Studies Faculty Publications

Many parts of the world are experiencing social and political instability, as well as ongoing climatic changes that are expected to accelerate in the years ahead. These changes can undermine children's health through multiple pathways, and the growing frequency of sociopolitical and environmental stressors increases the likelihood that individuals are exposed to multiple risks simultaneously. Few studies have quantified the effects of such concurrent shocks despite conceptual motivations for doing so. We address this gap by measuring the independent and compounding effects of conflict and climate exposures on the weight-for-height of 0–23 month-old children across 32 countries in sub-Saharan Africa. …

Conceptualizing Professional Identity Development In Art Therapy Supervision With Post-Graduate Art Therapists Who Are Pre-Licensed, Christine S. Atkinson

Expressive Therapies Dissertations

This study explored how art therapy supervisors conceptualize professional identity development (PID) in supervision with postgraduate art therapists who were pre-licensed. There was limited empirical research on how art therapy supervisors understood and support PID within art therapy supervision, particularly during the transitional period between graduate training and professional licensure. This study addressed the research question: How do art therapy supervisors conceptualize PID in supervision with postgraduate art therapists who are pre-licensed?

Fourteen art therapy supervisors participated in the study (86% female; 14% non-binary), ranging in age from 25 to over 65 years old. All participants identified their race or …

Poly(Adp-Ribose) Polymerase Inhibitor Maintenance Therapy In Ovarian Cancer: A Single-Center Retrospective Study., Sydney Pence, Kayla Dyson, Kristen Waters, John O Elliott, Kellie Rath, Stuart Pierce, Amy Harper, Corinne Calo, Aine E Clements

OhioHealth Research Institute Articles

OBJECTIVE: To determine the effectiveness and tolerability of PARPi maintenance in a real-world patient population. Specifically, to assess duration of PARPi, the rate of secondary malignancies, rate of side effects, and survival.

METHODS: A retrospective review of patients with ovarian, fallopian tube, and primary peritoneal cancer at OhioHealth Riverside Methodist Hospital in Columbus, Ohio was performed. All patients diagnosed since March 2015 were reviewed for eligibility. Data was collected via EMR query and stored in REDCap. Charts were reviewed for multiple data points, including duration of PARPi use, side effects, secondary malignancies, survival, and recurrence. Data were reported descriptively with …

Neurodiversity Among Nurses: Consequences For Wellbeing And Burnout, Megan Pohlmann

WUSM Theses and Dissertations – All Programs

Background/Introduction – Current research highlights three critical aspects of nurse wellbeing: the subjective personal perspective, multifaceted complexity, and variation across individuals. A particular gap in past research is a lack of understanding of how neurodivergence may impact nurses’ workplace wellbeing. Neurodiversity is the variation in human minds and neurocognitive functioning, and neurodivergence is the divergence from what society would consider the norm. Like wellbeing, it is difficult to capture, recognize, and define, which causes confusion among neurodivergent individuals and employers alike. With up to 20% of individuals displaying neurodivergent traits in the workplace, it is important to recognize that those …

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 …

Level Of Comfort And Barriers To Pediatric Vaccination Among Pharmacy-Based Immunizers In California, Laressa Bethishou, Karl Hess, Richard Beuttler, Jeffery Goad

Pharmacy Faculty Articles and Research

Background

Pharmacists are increasingly recognized as accessible immunizers, yet pediatric vaccination rates in community pharmacies remain lower than those for adults, likely due to unique barriers. This study aimed to assess the comfort level of pharmacy-based immunizers in California with administering vaccines to pediatric patients and to identify barriers limiting their participation in pediatric immunization.

Methods

An IRB-approved, cross-sectional survey was distributed electronically to pharmacists, student pharmacists, and pharmacy technicians administering vaccines in California community pharmacies between November 2022 and February 2023. The survey measured comfort with vaccinating pediatric age groups, perceived barriers, and collected demographic data. Data analysis included …

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 …

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 …

Validation And Implementation Of Automated Planning Optimization In Utah Valley Hospital, Oluwatobi Adeniji

UNLV Theses, Dissertations, Professional Papers, and Capstones

The increasing complexity of modern radiotherapy demands planning workflows that are efficient, standardized, and dosimetrically robust across diverse disease sites. Knowledge-based planning (KBP) systems such as RapidPlan offer a data-driven approach to automate and improve treatment planning by learning geometric–dosimetric relationships from high-quality clinical plans. In this work, I am evaluating the performance, generalizability, and clinical applicability of vendor-provided RapidPlan models across seven anatomical sites: intracranial SRS, prostate SBRT, right and left lung SBRT, liver SBRT, head and neck, and glioblastoma. Subsequently, a complementary institution-specific SRS model tailored to single-isocenter multitarget workflows was created. Seventy retrospectively selected patients were replanned …

Effectiveness Of Cognitive Stimulation Therapy On The Quality Of Life Of Adults With Dementia: A Secondary Analysis, Evelyn Airam

UNLV Theses, Dissertations, Professional Papers, and Capstones

This secondary analysis study evaluated the effectiveness of Cognitive Stimulation Therapy (CST) on quality of life (QoL), depressive symptoms, and cognitive function in 108 community-dwelling older adults with cognitive impairments, including dementia. Outcomes involved Quality of Life (QoL) measured by the Quality of Life in Alzheimer’s Disease (QoL-AD), symptoms of depression by the Cornell Scale for Depression in Dementia (CSDD), and cognitive function using the Saint Louis University Mental Status (SLUMS). After the CST, significant improvements were observed in QoL (p = .004), depressive symptoms (p = .002), and cognitive function (p < .001), with small effect sizes. Additionally, a significant interaction between sex and dementia diagnosis status was found in predicting cognitive changes, suggesting that the relationship between dementia diagnosis and cognitive improvement differs by sex. No between-group differences were found for QoL or depression. Findings support CST as a multidimensional, non-pharmacological intervention that improves cognitive, psychological, and social outcomes. Although effects were small, consistent improvements are clinically meaningful given the progressive nature of dementia. This study extends existing literature by demonstrating CST’s effectiveness in a community-based setting and reinforces its alignment with occupational therapy’s emphasis on participation and holistic care. Results highlight the need for early intervention and expanded access to CST programs to enhance quality of life in this population.

Integrating Social-Emotional Learning To Foster Regulation And A Positive Classroom Climate, Klarika Meghan V. Alquisada

UNLV Theses, Dissertations, Professional Papers, and Capstones

Social-emotional learning (SEL) supports the development of emotional regulation, interpersonal skills, and meaningful participation in academic environments. Increasing regulatory demands within classrooms highlight the need for structured approaches that support both educators and students in maintaining engagement and fostering positive learning environments. Occupational therapy (OT) practitioners are uniquely positioned to collaborate with educators to integrate regulation-focused strategies within daily classroom routines.This quality improvement project aimed to develop and implement an OT-informed SEL program for educators serving students with diverse learning needs. Teachers received consultation and tailored SEL strategies, implemented them for 5 weeks, and provided feedback on their effects on …

Unknowing Sacrifices: Public Health And Radiation Illness In New Mexico And Nevada, 1940s-1960s, Beatriz Avila-Marquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

The detonation of the first atomic bomb in the early morning of July 16, 1945, in New Mexico welcomed the atomic age that forever changed the world. After that day, thousands of lives were lost due to nuclear weapons, and hundreds of thousands more continued to suffer from the effects of atomic testing. The Atomic Energy Commission, fueled by the arms race of the Cold War, chose Nevada to continue the United States’ nuclear weapons testing. Knowledge of the dangers of radiation exposure, the effects of radiation, and techniques to prevent exposure are now available in part due to the …

Fostering Adolescents’ Social-Emotional Skills In A Community Setting, Elizabeth Benitez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Adolescents face growing emotional, behavioral, and social challenges, especially in community recreation settings with high energy, peer interaction, and sensory demands. These environments often expose difficulties in emotional regulation, communication, and conflict management, highlighting the need for structured social-emotional learning (SEL). This capstone project aimed to develop and implement an occupation-centered SEL program integrating the Zones of Regulation (ZOR), CASEL competencies, and Developmental, Individual Differences, Relationship-Based (DIR) Floortime principles within the Clark County Hollywood Parks and Recreation after-school program. Guided by the Person–Environment–Occupation (PEO) model, the project sought to help adolescents practice emotional awareness, self-management, and interpersonal skills in their …

Got Sleep?: The Introduction Of Sleep Hygiene To Justice Involved Individuals, Charisma Lynn Cato

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals transitioning out of incarceration often experience challenges with sleep due to the residual effects of confinement. Although this is common among justice-involved individuals, there is limited research on how to address their sleep hygiene self-efficacy after release. Furthermore, despite the wide use of social-emotional learning (SEL) across multiple disciplines, little is known about its influence on sleep-related behavior change in re-entry populations. To address this, the Got Sleep program, designed and implemented at Hope for Prisoners (HOPE), a community site geared toward re-entry assistance, integrated occupational therapy (OT) principles and an SEL approach with practical sleep hygiene strategies to …

Enhancing Accessibility And Inclusivity In The Performing Arts With Occupational Therapy Frameworks, Carmela Clarice Tabora Clave

UNLV Theses, Dissertations, Professional Papers, and Capstones

In live theater performances, there are numerous sensory demands, including unpredictable noises, lighting, crowd movement, vocalization, and transitions in and out of the theater. Teachers, support staff, and chaperones who attend these performances may face barriers in supporting their children in unfamiliar environments, and community volunteers who have never assisted during these shows may not know how to support children who need it if they have not had prior exposure to children with diverse needs. This capstone project provides families, teachers, and volunteers with pre-visit resource guides with occupational therapy perspectives on sensory processing for student matinees and sensory-inclusive performances …

Enhancing Independence: A Home Environmental Safety Program For Stroke Survivors, Ka'iulani-Joy Genevieve Conlu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Stroke is a common cause of physical limitations, leading to decreased independence and participation in daily activities. Individuals post-stroke transitioning from inpatient to outpatient care typically do not receive in-person home safety recommendations to decrease environmental challenges and improve overall well-being. Methods: Participants were recruited conveniently during the inpatient and outpatient care process at Post Acute Medical (PAM) Health Rehabilitation Hospital of Henderson. The Home Falls and Accidents Screening Tool (HOME FAST) was administered to identify environmental hazards and to guide individualized home safety recommendations. Participants will complete a questionnaire before and after the program within 14 weeks to …

Inclusiveness With Sensory Maps; Enhancing Engagement In A Children's Museum, Victoria E. Davila

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sensory processing challenges can affect a child’s ability to engage in play, especially when participating in community activities. When a child feels overwhelmed by sensory features in an environment, such as noise or bright lights in a community space, they may experience sensory overload. Caregivers often observe this behavior but may not have access to resources to help their child navigate these challenges. This capstone project aimed to implement a program development initiative at the Discovery Children’s Museum focused on developing sensory-inclusive resources for caregivers visiting the museum with a child. The role of occupational therapy in this project is …

The Lotus Project: An Occupation-Based Online Module To Support Healthy Matrescence, Virginia Genato

UNLV Theses, Dissertations, Professional Papers, and Capstones

Becoming a mother is a meaningful life event that occurs amid complex physical, psychological, and social changes. During this period, individuals undergo an occupational role transition as they assume new caregiver responsibilities while navigating contextual demands. The ease of this transition influences overall maternal adjustment. The dominant sociocultural model of intensive mothering promotes child-centered caregiving, often at the expense of maternal well-being and adjustment. Efforts to meet these expectations may disrupt an individual’s transition into motherhood and place them at risk for developing postpartum mental health challenges.

The concept of matrescence provides a developmental framework that views motherhood as an …

Promoting Classroom Management Through Elementary Teacher Education On Movement-Based Social-Emotional Learning, Daija Renee Georgette

UNLV Theses, Dissertations, Professional Papers, and Capstones

This doctoral capstone project addressed a knowledge gap among K–5 th–grade teachers at Cornerstone Christian Academy (CCA) regarding the purpose, benefits, and educational value of movement-based brain breaks. Although CCA currently incorporates social–emotional learning (SEL) frameworks such as the Zones of Regulation, teachers have received limited training on how structured movement opportunities can enhance student engagement, attention, and regulation. This program aimed to strengthen teachers’ understanding and confidence by providing a series of evidence-informed workshops that explored the connections among movement, self-regulation, and classroom management.

The project consisted of orientation, teacher recruitment, needs assessment, workshop development, and program delivery over …

Establishing A Comprehensive Framework For Sfrt Lattice Treatments: Optimization, Planning, And Clinical Evaluation, Gregory M. Gill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Spatially fractionated radiation therapy (SFRT) using lattice radiotherapy (LRT) has emerged as a promising treatment technique for bulky, nonresectable tumors by delivering spatially heterogeneous dose distributions consisting of high-dose vertices embedded within lower-dose regions. Although early clinical experiences have demonstrated potential therapeutic benefit, widespread clinical implementation of LRT remains limited due to the absence of standardized treatment planning workflows, consistent optimization strategies, and clearly defined evaluation metrics for heterogeneous dose distributions. The objective of this study is to develop and evaluate a structured framework to support efficient, reproducible, and safe clinical implementation of LRT.

To address these challenges, a comprehensive …

The Exploration Of Leisure Occupations For Older Adults, Chloe Jisoo Kang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: This capstone project involved the development and implementation of a community-based program for the exploration of leisure occupations for older adults. The program aimed to increase the life satisfaction and occupational balance of participants. A manualized program was created for the capstone site for potential continuation of the program.

Methods: The program was developed with the support of evidence-based research and the Occupational Therapy Practice Framework (OTPF-4). Two-hour events were held once a week for four weeks in a community area of the senior living community. A modified version of the Occupational Balance Questionnaire (OBQ11) and the Satisfaction with …

Feasibility Of High-Intensity Training (Hit) For Academic Engagement In Young Adult Women, Raleah Tenorio Kastner

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: This feasibility study aimed to identify the impact of a high-intensity training (HIT) exercise protocol on healthy behaviors related to academics to decrease stress levels and enhance academic engagement and overall quality of life in young adult female students, measured by a modified version of the National Survey of Student Engagement (NSSE) and the Occupational Experience Profile (OEP).

Methodology: One young adult female student enrolled at UNLV who is 18-25 years old was recruited via convenience sampling to engage in a 12-session HIT exercise program, developed by a certified personal trainer and licensed occupational therapist, with the participant’s target …

A Comparison Of Changes In Vertical Cephalometric Measurements In Patients Treated With Invisalign And Traditional Fixed Orthodontic Appliances: A Retrospective Study, Shayna Mesko

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Since their introduction into the field, clear aligners have significantly grown in popularity in orthodontics as they offer enhanced esthetics, improved oral hygiene, and patient comfort. Clear aligners have allowed clinicians to simulate treatment outcomes, streamline treatment with reduced office visits, control force and movement per tray, and provide more precise control of focal tooth movements. This can enhance efficiency in achieving specific and very finite orthodontic goals. Since their inception, clear aligners have evolved from only accomplishing simple tooth movements to achieving more complex and comprehensive mechanics. While they have significantly advanced, there are still limitations in efficacy …

Postpartum Depression Protocols In A Neonatal Intensive Care Unit: Benefits And Outcomes, Myrnnda Miller

UNLV Theses, Dissertations, Professional Papers, and Capstones

This capstone project aimed to reduce postpartum depression symptoms in mothers with infants admitted to the University Medical Center (UMC) of Southern Nevada’s neonatal intensive care unit (NICU) by integrating early screening with occupation-based, trauma-informed support. The intervention combined the Edinburgh Postnatal Depression Scale (EPDS) for early detection with occupational therapy–facilitated maternal support sessions, providing emotional validation, education, and strategies for coping and parent–infant bonding. Guided by Trauma-Informed Care and Backwards Design frameworks, the project prioritized maternal safety, empowerment, and confidence. A paired sample t-test was conducted to compare pre and posttest EPDS scores and showed that the participant’s EPDS …

Supporting Staff Social-Emotional Learning Through An After-School Program, Alexis Monique Molina

UNLV Theses, Dissertations, Professional Papers, and Capstones

This doctoral capstone project aimed to develop and implement an occupational therapy- informed social-emotional learning (SEL) training program for after-school staff at the Hollywood Recreation Center in Las Vegas, Nevada. The project addressed a critical gap in the skills and competence of staff needed to manage emotional and behavioral challenges in community-based youth programs. Guided by the Person-Environment-Occupation (PEO) model, adult learning theory, and the Collaborative for Academic, Social, and Emotional Learning (CASEL) framework, the fourteen-week program incorporated weekly lessons to enhance self-awareness, emotional regulation, and relational competence among staff. Through interactive lessons, reflection promotion, and feedback surveys, participants engaged …