Digital Commons Network^™

Essential Tools For Sustainability Of A Student-Led, Pro-Bono Back School, Cory Brown, Rosalie Gutierrez, Jennifer Montes, Rondale Scruggs

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: In 2018, University of Nevada Las Vegas Doctor of Physical Therapy (DPT) students and faculty, in cooperation with a community partner, created a student-led pro bono Back School to address a gap in healthcare for underinsured individuals with low back pain in Southern Nevada. To support the sustainability of the Back School, the authors of this paper set out to develop a student club to recruit and train DPT students to volunteer in the program using a specifically designed electronic training manual. Overall, the aim was to encourage students to join the new club's leadership team to prepare future …

Increasing Utilization Of Otago Fall Prevention Program By Nevada Physical Therapists: A Service-Learning Project, Jared Apostol, Erica Mooy Brown, Danielle Uptain

UNLV Theses, Dissertations, Professional Papers, and Capstones

Otago is an evidence-based program that is designed to reduce falls in community dwelling older adults by individualizing an exercise program with three key components: strength, balance, and a walking program. Unfortunately, Nevada clinicians do not utilize the program frequently or entirely with patients in outpatient and/or home health physical therapy. Evidence shows it reduces fall risk, but it has barriers to implementation in the United States. The barriers to integration are primarily due to the plan of care that stems from a 12-month timeframe and several phone call appointments which does not fit well in the American healthcare system. …

Effects Of A Remote Exercise Intervention On Aerobic Endurance In Individuals With Down Syndrome, Andrew Murata, Elena Wolf, Jonathan Crimm, Benjamin Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Down syndrome (Ds) or Trisomy 21 is a common genetic birth condition, and those with Ds typically display decreased cardiorespiratory fitness compared to those without Ds, potentially leading to an increased risk for cardiovascular conditions and mortality. Low cardiorespiratory fitness is partially caused by low physical activity levels in this population. The COVID-19 pandemic caused community-based activity programs to shut down, as individuals with Ds are at increased risk for COVID-19 hospitalization and death. Thus, it was vital to explore alternatives of in-person exercise during the pandemic. The purpose of this study was to investigate the effects of a …

Perceived Value Of Acute Care Physical Therapy, Juliana Amenta, Andrew Falcinelli, Erin Heenan, Hannah Kendall

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/Significance/Objective: Although there is some research regarding physical therapy in the acute hospital setting, much of it is focused on the role physical therapists play with specific patient populations or diagnoses. By understanding more about how physical therapy services can add value in the acute hospital, their skills could be better utilized to maximize benefit for both individual patients and the hospital. The purpose of this study was to investigate the perceived value that physical therapists bring to the acute care hospital from the perspective of both physical therapists and their supervisors in Southern Nevada.

Methods: This study used an …

Walking With Poles Improves Step Length Of Simulated Prosthetic Gait, Marissa Elquist, Daniel Perez, Jonathan Garcia, Brady Owens

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals with lower limb loss often demonstrate gait deviations which cause instability and asymmetry. Walking with poles has been shown to improve stride length and stability in older adult and other patient populations. The enhanced arm involvement in bipedal walking with poles has the potential to facilitate interlimb coordination among arms and legs, and therefore is likely to improve prosthetic gait. The purpose of this study was to examine the effect of walking poles on temporal gait parameters and the center of mass (COM) displacement during prosthetic and simulated prosthetic gait. It was hypothesized that walking with poles would improve …

Effects Of A 12-Week Telehealth Exercise Intervention On Gait Speed And Gait Deviations In Adults With Down Syndrome, Robert Lum, Taylor Souza, Christopher Roys, Daniel Stopka

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Down syndrome (Ds) is associated with impairments affecting overall motor development including gait pattern and speed. Research on the effects of exercise on adults with Ds is lacking. The purpose of this study is to evaluate the effects of a 12-week telehealth exercise program on gait impairments in adults with Ds.

Methods: Twenty participants performed a 12-week telehealth exercise program based upon a diagnosis-specific procedure developed by Sarah Mann, PT, DPT. Gait deviations were assessed with the Ranchos Los Amigos Observational Gait Analysis. Comfortable gait speed was evaluated with the 4-meter walk test.

Results: Improvements in comfortable gait speed …

Factors Predicting Fear Of Falling Avoidance Behavior In Parkinsonisms, Kameron Eckard, Franjo Vukojevic, Ryan Hammar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Fear of falling avoidance behavior (FFAB) is common in parkinsonisms and results in potentially mitigable downstream consequences.

Objective: Determine the characteristics of individuals with parkinsonisms most associated with FFAB.

Methods: A retrospective, cross-sectional study was conducted from medical records data of 142 patients with parkinsonisms. These data included: demographics (age, sex), disease characteristics (Movement Disorders Society – Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III), years since diagnosis), fall history (number of fall injuries in previous year), and gait and balance function (five times sit to stand, MiniBESTest, Timed Up and Go (TUG), dual-task TUG, ten-meter walk test …

Efficacy And Benefits Of Providing A Screening Clinic For Performing Arts Students, Shaun Bean, Joanna Centeno, Elizabeth Williams

UNLV Theses, Dissertations, Professional Papers, and Capstones

In past years, University of Nevada, Las Vegas physical therapy students (UNLVPT) have provided UNLV dance students with screening clinics, injury evaluations, and treatment sessions to help address their need for direct and specialized services. Through this project, UNLVPT has worked to help reduce injury risk in dancers and provided treatment and rehabilitation for injuries that have occurred. Due to the COVID-19 pandemic, our group was unable to treat dancers in person over the course of the 2020-2021 school year. In response to these limitations, we worked to reformat our screening process to make it practical in a virtual setting. …

Development Of Online Modules To Introduce Prospective Students To The Profession Of Occupational Therapy, Hosia Towery

UNLV Theses, Dissertations, Professional Papers, and Capstones

Prospective students interested in Occupational Therapy academic programs are subject to the admission criteria of each educational institution, including experiential learning, clinical observation hours, volunteer experiences, or similar prerequisites. There are no standardized criteria established for these prerequisite requirements b the accreditation agency, as it is within the scope of Higher Education. There is no accountability at the regional or local level to ensure educational opportunities for prospective students interested in higher education, creating a gap as highlighted in the recent global pandemic, where student access to education was further challenged. Students are reliant on a variable set of requirements …

The Road Ahead: An Occupational Therapy Manual To Infant Development For Parents In The Nicu, Nicole Suzuki-Uyeno

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists have been collaborating with the parents of our tiniest patients in the neonatal intensive care unit (NICU) for quite some time. They have a wealth of information and expertise in the area on infant development and parent education. Admitting a baby to the NICU is a shock for most parents and can take a toll on a family. The role of the occupational therapist is to help educate the family and to provide the tools to safely take care of their baby and to smoothen the transition from the hospital to home.

In the NICU, the OT has …

Diurnal Regulation Of Exercise-Induced Myocardial Signaling And Transcription, Charli Aguilar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Exercise is well known for its many benefits on the body and most notably the heart. Recent emphasis, and significant resources, have been dedicated to elucidating the molecular mechanisms through which exercise exerts its pluripotent beneficial effects on health and the prevention of disease. A continuous evolution in this field has sought to modulate and optimize exercise in various ways to maximize the benefits. In recent years, a growing appreciation for the impact of circadian rhythms has gained traction and their influence on many essential biological functions have been integrated into exercise physiology (i.e. - chrono-exercise), as well as …

The Effect Of Attachment Design And Aligner Material On The Efficiency Of Maxillary Canine Distalization In Premolar Extraction Cases, Najem Anbari

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Clear Aligner Therapy (CAT) is regarded as a popular esthetic alternative to conventional orthodontic treatment with fixed labial appliances. The mechanism of action, force delivery and limitation of this treatment modality remain largely unknown despite its popularity, the high demand and the relatively long evolutionary track of clear aligners. There are only few studies that addressed the elements that influence the efficiency of clear aligners, namely, the attachment design and aligner materials. It is widely believed that clear aligners are not suitable for extraction cases due to their lack of control over the root movement.

Objectives: This in vitro …

Association Between Arthritis And Yoga Among Veterans, Anupreet Arora

UNLV Theses, Dissertations, Professional Papers, and Capstones

Yoga is a state of complete mindfulness and self-realization with an inwardly drawn focus, a state of mind – body integration in which there is a harmony between form and action. Yoga can help us treat a myriad of chronic health conditions like obesity, heart diseases, diabetes, depression, gastrointestinal problems, asthma, hypertension, chronic low back pain, and arthritis to name a few. Arthritis is a frequent, debilitating chronic disease which can cripple an individual if allowed to progress unchecked. In 2021, the prevalence of arthritis in USA was around 24% with a projection of 37% by 2030. Prevalence of arthritis …

Improving Nurse Self-Efficacy Regarding Depression Among Cardiovascular Disease Patients: An Education Intervention, Presten Beatty

UNLV Theses, Dissertations, Professional Papers, and Capstones

Depression is a principal cause of increased morbidity, mortality, and decreased quality of life for cardiovascular disease patients. Low levels of nurse confidence have been the outcomes of several studies and anecdotal reports regarding providing care for and approaching patients with acute and chronic illnesses in conjunction with behavioral and mental health issues. Current literature suggests that improving nursing education on the prevalence and impacts of depression improves nurse confidence. Depression screening tool education provided to nurses, with detailed disease information, empowers nurses in their attitudes, knowledge, and behaviors regarding patient depression. By improving depression screening rates among cardiovascular disease …

Commercial Sexual Exploitation: A Survey Of The Knowledge, Concerns, And Training Of Transit Personnel In Las Vegas, Nevada, Elena A. Bejinariu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Transportation personnel, in particular bus drivers, encounter young people who are commercially sexually exploited frequently and throughout the course of their daily jobs. Given the frequency of this interaction, bus drivers are perceived to be the eyes and ears of the transportation industry, playing a key role in the identification and prevention of trafficking. To support national efforts in combating human trafficking, between September 1st, 2020 and June 15th, 2021, the Regional Transportation Commission (RTC) of Southern Nevada trained all its existing employees and new hires on human trafficking dynamics and reporting protocols. These included legal definitions, victim characteristics, recruitment …

Examining The Role Of Prosocial Tendencies And Social Anxiety In Hazardous Drinking Practices Among College Students, Helena M. Berlin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 40% of the United States (US) population aged 18 to 25 is enrolled at postsecondary institutions, and 31.4% of college students report risky alcohol use (i.e., binge drinking). Identifying risk and protective factors for this population is a public health priority. The primary objective of this study was to examine the additive and multiplicative relationship of prosocial tendencies and social anxiety on hazardous drinking (AUDIT scores). A secondary aim was to examine whether these relationships differed by participation in college organizations (Greekaffiliation, athletic participation, both, and neither). Cross-sectional data were collected from 9,196 college students (ages 18-25) from 12 …

A Quality Improvement Project To Improve Health Care Provider Self-Efficacy In Rural Primary Pediatric Care Clinics Through Training Intervention, Alison Borgsmiller

UNLV Theses, Dissertations, Professional Papers, and Capstones

American Association of Pediatrics recommends screening for various developmental delays in children, but it does not explicitly recommend a tool for screening social and emotional development at well-child checks (WCCs). Therefore, provider self-efficacy (SE) is lacking, and screening rarely occurs. This quality improvement (QI) project sought to improve healthcare provider SE using the Ages and Stages Questionnaire: Social-Emotional, Second Edition (ASQ:SE-2), an evidence-based practice screening tool for identifying such delays in children at 30–60-month WCC visits.At rural healthcare centers in San Luis Obispo, California, participants completed the Self-Efficacy Twelve Questionnaire prior to and 30 days following a training intervention. While …

Exodus Arena: Cashman Field And The (Re)Development Of Sports And Recreation In Downtown Las Vegas, Nevada, Ryan Browar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cashman Field is a minor league sport stadium one-mile north of the world famous “Fremont Street Experience” in Downtown Las Vegas, Nevada. Minor league sports stadiums are microcosms of their communities, and Cashman Field’s history is Las Vegas’s history. Although the city’s first permanent sports venue, the stadium endured numerous cycles of colonialism, stadium building, successful operation, neglect, decay, and abandonment. Now at the end of another cycle, Cashman Field is being forgotten as Las Vegas transitions into a major league sports town. Sports stadiums reveal the social, cultural, and economic factors that define twentieth-century American history, but Cashman Field’s …

Classroom Management Practices Appropriate To Children Of Military Families: A Case Study, Felicia Bucher

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this sociocultural study was to analyze the lived experiences of exemplary teachers who teach on a military base school. By teaching a lesser-known diverse group of students who are children of military families, the teachers in this study shared the sociocultural perspective of Vygotsky’s perezhivanie of the adjustment to how they approach classroom management and facilitate student learning despite the differences in teaching children of military families. The dissertation employed qualitative methodology using in-depth interviews with six teacher participants and a triangulation interview with the school principal. The findings are discussed in relation to classroom management strategies …

The Effects Of A Dedicated Education Unit On Nurse Retention And Turnover, Cherilyn Campbell

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the fast growth of healthcare jobs in the United States, there is a deficit in the nursing workforce. Literature has shown high nurse turnover within the first year as a new graduate nurse. Healthcare organizations will need to explore innovative ways to impact nursing retention and turnover to keep up with the growing demand. The purpose of this Doctor of Nursing Practice (DNP) project is to perform and evaluate a comprehensive review to determine the effect of a dedicated education unit (DEU) on nurse retention and turnover within an academic-practice partnership. Literature has shown the benefits of the DEU …

Family-Centered Psychosocial Care For Pediatric Oncology Patients, Jessica W. Casey

UNLV Theses, Dissertations, Professional Papers, and Capstones

Psychosocial conditions are prevalent in pediatric oncology patients (Kahalley et al., 2013). Family and social support are essential aspects of a patient's health care outcomes (Merck & McElfresh, 2019). Anxiety and depression are common in pediatric oncology patients due to trauma during treatment (Pao & Kazak, 2015). These patients also can have preexisting developmental or behavioral conditions before starting treatment. Treatment side effects can also cause cognitive and behavioral changes (Nixon, 2014b). Nurses should be knowledgeable and confident in their ability to care for patients' psychosocial health and development. The purpose of this Doctor of Nursing Practice (DNP) project is …

Reducing Door-To-Balloon Time In Stemi Via Er Nurse Driven Protocol, Torrie Clontz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over 605,000 patients will suffer an ST-segment elevated myocardial infarction in the United States each year. The gold-standard definitive treatment for this is percutaneous coronary angioplasty or the ballooning open and stenting of the blockage. The American Heart Association has set the evidence-based gold standard of 90-minutes from identification of blockage to reperfusion of heart muscle. In a health system in Las Vegas, NV, this goal is frequently missed due to lack of protocols in place to expedite patients towards definitive treatment. The purpose of this evidence-based practice change is to reduce STEMI patient morbidity and mortality via a nursing …

Built Environment, Land Use, And Crime: A Las Vegas Study, Stacey Lynn Clouse

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study examined land use and crime against persons and crime against property in Las Vegas, Nevada at varying spatial levels of analysis. Using crime data provided by the Las Vegas Metropolitan Police Department and the Clark County Assessor’s office, results at the macro-level of analysis reveal that property crime rates concentrated on commercial, transportation, communication and utilities, and industrial land use, whereas violent crime concentrated at commercial, multi-residential, and civic, institutional, and recreational land use. Upon examining the subtypes of land use that generate or radiate more crime, property crime concentrated on transportation land use, class 1 resorts, and …

Evaluating Repetitive Transcranial Magnetic Stimulation To Reduce Opioid Cravings In Opioid Use Disorder, Cameron Duncan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opioid Use Disorder (OUD) is a multi-faceted, complex ailment affecting many individuals and their families across the globe. Currently, there are multiple interventions used in the treatment of OUD, many of which are designed to reduce cravings for opioids. Cravings for opioids are a strong predictor of relapse in the disorder. However, many of the interventions used in clinical practice have inherent risks including a potential for abuse and diversion. Repetitive Transcranial Magnetic Stimulation (rTMS) is an outpatient procedure that may be effective in reducing cravings for opioids, thereby reducing relapse. Methods: This study employed a randomized, single-blind, experimental design …

That Hidden Country: The Travels Of Jacob Singleton, A Novel, James Earp

UNLV Theses, Dissertations, Professional Papers, and Capstones

Thomas Jefferson believed, or wanted to believe, that mammoths foraged the grasslands of the continental American interior. This was not an uncommon belief among the learned in Jefferson’s time and place, so it is not altogether remarkable that Jefferson did charge Meriwether Lewis and William Clark, when they led the Corps of Discovery to the Oregon coast, with keeping an eye out for signs of the living mammoth. This novel attempts an aesthetically viable narrative synthesis of American myths in several layers, the top layer being, in the words of cultural critic Cintra Wilson, a ‘‘ripping yarn’’ in the traditions …

Family Functioning In Youth With Bipolar Disorder, Kayla Fobian

UNLV Theses, Dissertations, Professional Papers, and Capstones

Family functioning encompasses a family’s ability to maintain an environment that supports and benefits each member of the family. Among families of youth with a bipolar disorder (BD), family functioning is impaired compared to healthy controls. However, few studies have examined family functioning across psychopathology in youth. Additionally, few studies have examined which symptoms (depressive, manic, or externalizing) are most strongly associated with family functioning. Therefore, the purpose of this manuscript is to benchmark impairments in family functioning in youth with BD compared to youth with other psychiatric disorders and to examine the differential influence of depressive, manic, and comorbid …

Decreasing Central Line-Associated Bloodstream Infections In The Critical Care Unit, Kimberly J. Foxworth

UNLV Theses, Dissertations, Professional Papers, and Capstones

Central line-associated bloodstream infections (CLABSI) are a rising problem in the critical care setting in the United States. According to Flogren et al. (2007), "an estimated 248,000 bloodstream infections occur in hospitals across the United States each year, and a significant amount of these infections are associated with the use of a central venous catheter" (p.160). The Center for Disease Control and Prevention (CDC) defines a CLABSI as "recovery of a pathogen from blood culture (a single blood culture for organisms not commonly present on the skin and two or more blood cultures for organisms commonly present on the skin) …

Women’S Use Of The Gym Space: How Physical Activity Spaces Communicate Inclusion And Exclusion To Women, Rachel Glaze

UNLV Theses, Dissertations, Professional Papers, and Capstones

Women are less likely than men to participate in recommended levels of physical activity. As gyms are built around exercise, this research sought to understand if women’s gym participation is limited, due to the space communicating messages of exclusion. Semi-structured interviews with seven women participants led to the discovery of three themes surrounding women’s experiences in the gym setting: Comfort and confidence in the space stem from self-perceived levels of attractiveness, women treat the space as communal to better understand how to navigate it, and organizational spaces can communicate messages of class and socioeconomic differences. Recommendations for future research included …

Changes In Cognitive Networks As A Result Of Sport-Related Concussion, Grace J. Goodwin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Given the high prevalence of concussion in sports, assessment of cognition has become a standard part of athletics, and results are used to inform return to play decisions. Neurocognitive measures (e.g., ImPACT) generate cognitive composite scores from individual subtests, and these scores are compared at baseline and post-concussion. Declines in scores provide evidence for concussive injury, and athletes undergo repeated assessments until their scores and symptoms improve. Recent research suggests that changes in the associations between test scores may provide important information about cognitive recovery. A network framework may help identify post-concussive cognitive changes that may not be apparent when …

Improving Nurse Leaders’ Knowledge And Confidence In Transformational Leadership Skills In The Online Environment, Tanya Haight

UNLV Theses, Dissertations, Professional Papers, and Capstones

Leadership is critical to the success of most organizations, and the achievement of an organization's goals is largely dependent on the leaders' ability to engage, motivate, and influence their teams—often referred to as Transformational Leadership. This is especially true for healthcare organizations wherein the morbidity and mortality of patients may be affected by the quality of leadership. At the start of the COVID-19 pandemic, in-person meetings transitioned to the online format without nurse leaders' formal training. Leaders cited this lack of orientation as impeding their ability to sustain an online-virtual transformational leadership presence with their teams. They reported varying degrees …