Medicine and Health Sciences Commons^™

Post-Operative Endotracheal Reintubation Rates, Robert Erickson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Immediate post-operative endotracheal reintubation after major abdominal surgery a significant patient safety concern due to the potential for failure to rescue, or other adverse outcomes such as altered mental status, aspiration, and hypoxia due to respiratory or cardiac arrest if left unrecognized. To facilitate major abdominal surgery (outside of a cesarean section performed under spinal anesthesia), the patient must be anesthetized, pharmacologically paralyzed, and endotracheally intubated to facilitate ventilation via mechanical respiration. Those steps create the optimal environment to allow the abdominal muscles to relax, and permits the surgeon obtain appropriate exposure of the abdominal cavity. An induced chemical paralysis …

Sens"Ability" Coaching: Inspire And Empower Parents With Occupational Performance Coaching Using Dunn’S Model Of Sensory Processing – A Manualized Education Program For Clinicians, Kelby Christian

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The current literature found a need for improved collaboration styles and programs that can adapt to the needs of the various mental health diagnoses. This capstone project focused on creating a manualized education program called SensABILTY Coaching, which aims to improve clinicians’ confidence in educating caregivers of children with autism spectrum disorder (ASD) on Dunn’s Model of Sensory Processing using principles of Occupational Performance Coaching (OPC). Improving clinicians' confidence increases positive reactions and enhances caregiver and clinician collaboration. This capstone project outlines the benefits of using the principles of OPC intervention styles and sensory-based strategies for their effectiveness when …

Perceptions Of A Community-Based Playgroup To Promote Caregiver Knowledge Of Resources And Prevention Of Developmental Delays In A Rural Setting, Chesnee Clingman

UNLV Theses, Dissertations, Professional Papers, and Capstones

For children living in rural communities, the likelihood of having a developmental delay substantially increases compared to children living in urban areas (Weglarz-Ward et al., 2019). This can be due to a lack of access to resources, limited education, and geographical isolation. Despite the rising trend of developmental delays among rural children, there is a noteworthy lack of early intervention resources for both the child and their family. This trend of minimal resources is demonstrated in Lincoln County, Nevada. Using an occupational therapy lens, a community-based playgroup program was developed for residents in Lincoln County. Community-based playgroups involve a structured …

Effect Of Asynchronous Virtual Interviews On Ethnic Minority Matriculation Into A Doctor Of Physical Therapy Program, Conner Clark, Nanea Lagasca, Gladys Miller, Jasmine Puspos

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Methods: This study examines the impact of the use of asynchronous virtual interviews (AVIs) in the admissions process of the Doctor of Physical Therapy (DPT) program at the University of Nevada, Las Vegas (UNLV). This research aims to examine racial and ethnic subgroup differences in AVI scores, evaluate the influence of AVIs on applicant scores in the admissions process, and assess the AVI inter-rater reliability among faculty evaluators using data from the 2019-2022 admissions cycles.

Results: Significant differences were found in AVI scores among racial and ethnic groups, with Black applicants scoring highest and Asian applicants scoring lowest. Additionally, inclusion …

Can Occupational Therapy Take A Hit? A Guide To High-Intensity Training In Stroke Rehabilitation, Jared Demke

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Stroke has been considered a leading cause of functional impairment (Tsao et al., 2022). Recent evidence has supported a treatment approach that increases dosage (Scheets et al., 2021). High-intensity training (HIT) has shown promising evidence for functional recovery poststroke (Crozier et al., 2018). There have been minimal programs related to Occupational therapy (OT) and HIT have been created (Lamoureux, 2023). This doctoral capstone focused on program development of the OT-based HIT program. Theoretical frameworks included the Model of Human Occupation and Motor Learning Theory to provide a foundational structure.

Methods: A needs assessment was performed at the Saint George …

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

UNLV Theses, Dissertations, Professional Papers, and Capstones

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

Osteoarthritis In The Temporomandibular Joint And Knee Joint: A Macroscopic Study Of Cadaver Specimens, Jeremy James

UNLV Theses, Dissertations, Professional Papers, and Capstones

In this study, thirty-one TMJs and twenty-eight knee joints were dissected from seventeen cadaveric subjects aged 69 to 95. Degenerative/osteoarthritic changes on the mandibular condyles, mandibular fossae, and femoral condyles were evaluated macroscopically and assigned a score on a disease severity scale (DSS) from 0 signifying “normal cartilage” to 4 signifying “severe OA”. Osteoarthritic changes were found in all TMJ and knee specimens. The average mandibular condyle DSS score was 2.68 ± 0.96, while the average mandibular fossa score was 2.90 ± 0.76; this difference in scores was significant (P = 0.035). Additionally, the mandibular fossa was equally or more …

Increasing Self-Efficacy With Menstrual Management For Young Adults Experiencing Homelessness Using The Inclusive “U N Me” Education Program, Edellene Ignacio

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of the study was to increase self-efficacy with the occupation of menstrual management in young adults experiencing homelessness using the "Understanding and Navigating Menstrual Experience" or "U N ME" program. The objectives of this study were a reported increase in self-efficacy with menstrual management, the development of the U N ME program, and to promote the spread of accurate information to other menstruators in the community.

This study was a convergent parallel mixed-method study rooted in a phenomenological approach. The intervention featured four weekly workshops featuring education, group discussion, and an activity to tie the topic of the …

Linking Scholarly Learning Activities And Professional Identity In Otd Students, Andrew Loc Ho

UNLV Theses, Dissertations, Professional Papers, and Capstones

Professional identity formation is a critical aspect of education, training, and becoming an occupational therapist in Occupational Therapy Doctorate (OTD) programs. This capstone study explores the potential influences of learning activities related to research and scholarly writing professional identity development amongst OTD students using a cross-sectional descriptive design. This research study involved 32 OTD students across six cohorts participating in focus groups from the University of Nevada, Las Vegas (UNLV), and Kansas University Medical Center (KUMC). Through convenience sampling and latent content analysis managed with ATLAS.ti, the study identified categories underpinned by the Kawa Model to describe the dynamic interplay …

Developing A College Readiness Skills Program Aimed At Improving Self-Efficacy For Foster Youth In Academic Settings, Natasa Janjusic

UNLV Theses, Dissertations, Professional Papers, and Capstones

The proposed work focused on the development and feasibility of a project aiming to introduce college readiness skills to youth who were in the foster care system in order to increase their perception of self-efficacy in an educational setting. With this increase in self-efficacy, foster youth who are generally disadvantaged when attaining and completing a college degree can have the skills necessary to combat this barrier. The project involved the development of contents of the program and the procedures performed at Bamboo Sunrise Foster Care Agency, where this Capstone project was carried out. Participants in the program consisted of three …

Pain Management Series For Stroke: Identifying Teaching Methods To Increase Clinical Self-Efficacy For Occupational Therapy Doctoral Students, Apasara Jittprasert

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose

Post-stroke pain has been identified as a significant challenge for individuals experiencing a stroke. Occupational therapists play a crucial role in the complex treatment of post-stroke pain but often face challenges due to a lack of self-efficacy in implementing treatments for stroke-related pain. This project’s purpose was to,1) to identify which teaching methods are effective for increasing clinical self-efficacy in doctoral occupational therapy students for implementing pain management treatment for individuals’ post-stroke and 2) to increase reported clinical self-efficacy levels among these students following the completion of a pain management educational program for stroke pain.

Methodology

This project recruited …

The Feasibility Of High-Intensity Training To Improve Self-Control And Occupational Participation In At-Risk Adolescents, Tashia Kaplan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose

Adolescence is a challenging time navigating self-control and decision-making, creating vulnerability to developing poor habits and unhealthy behaviors. This feasibility study aimed to determine if a high-intensity training program (HIT) would improve self-control, health-related behaviors, and healthy occupational participation in at-risk adolescents in the Real Talk Youth Impact Program (Real Talk), measured by the Occupational Experience Profile (OEP).

Methodology

Three at-risk adolescent were recruited via convenience sampling from Real Talk to participate in a twelve-session HIT intervention, one participant completed all sessions. Researchers used a quasi-experimental exploratory sequential mixed-methods design to examine self-control, health-related behaviors, and occupational participation measured …

Educational Series On Sensory Processing Differences And Sensory-Related Responses: An Occupational Therapy Perspective To Promote Caregiver Understanding, Jessemae Delarmente

UNLV Theses, Dissertations, Professional Papers, and Capstones

The objective of this doctoral capstone was to create and conduct a five-part online educational series for caregivers of children ages 0-5 about the impact sensory processing differences (SPD) has on occupational participation and performance, as well as how to navigate sensory-related responses (SRRs) on a daily basis. SPD and SRRs are complex topics commonly talked about on a graduate level as it requires knowledge of the nervous system and child development. Caregiver resources on SPD and SRRs are difficult to obtain and may not present the information appropriately for varying health literacy levels. This leads many caregivers to have …

Characterization Of Fibronectin Adhesion Isolated Dental Pulp Progenitor Cell Populations, Heoijin Kim

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The DPSC constitutes a significantly small population, comprising approximately 1% of the total cells in the pulp tissue. Therefore, it is imperative to successfully culture and populate DPSCs in vitro before utilizing them for therapeutic purposes. Understanding DPSC heterogeneity is crucial for innovative regenerative therapies, prompting the investigation of mixed populations using fibronectin as a biological marker. It is reported that cellular phenotype and biological function may undergo alterations as cells replicate in a cultured environment or the substrate to which the cells adhere.

Objectives: In this study, we compared and analyzed the impact of various isolation methods on …

Interdisciplinary Education On Using The Combilizer For Grooming Tasks In The Intensive Care Unit, Bonnie Lei

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to provide a teaching and learning program to the interdisciplinary team on how to use the Sara Combilizer with critically ill patients to increase efficacy for early progressive mobility (EPM) by facilitating grooming tasks. Methods: A teaching and learning program on using the Sara Combilizer to facilitate grooming tasks was provided to the acute care therapy team at a hospital. The program included an evidence-based lecture, a practice case study, and a digital instructional manual. The program was evaluated through a pre- and post-survey, and a quality improvement survey. The Wilcoxon signed-rank test …

Promoting Positive Dementia Attitudes Through Occupational Engagement: The Development Of A Dementia Awareness Program For Community Older Adults, Cynthia Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: This capstone project explored the effects of adding occupational engagement into a dementia awareness program on attitudes toward dementia among community-dwelling older adults, aiming to challenge dementia myths and promote an inclusive environment through occupational therapy perspectives. Methods: This project used a pre-test, post-test design with convenience sampling to develop and assess a dementia awareness program based on insights from Silverado Red Rock Memory Care Community and participation from members of the Osher Lifelong Learning Institute (OLLI) at the University of Nevada, Las Vegas in the program. Changes in positive attitudes toward dementia were measured using the Dementia Attitudes …

Examining The Impacts Of Unlv's Tobacco-Free Policy Pre And Post Implementation, Kacie Washburn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the known harmful effects of smoking and secondhand smoke, tobacco-related disease, disability, and death continue to plague the United Stated and contribute to more than 480,000 individuals dying prematurely every year. Comprehensive smoke-free and tobacco free policies strive to prohibit the use of both traditional forms of tobacco (cigarettes, cigars) and smokeless forms of tobacco (vapes). The goal of this project was to examine the impact a tobacco control policy has on prevalence rates of use and knowledge regarding said policy among faculty, staff, and students. In the Fall of 2022, UNLV adopted a comprehensive tobaccofree and smoke-free policy …

The Effects Of A Low-Intensity Aerobic Exercise Program To Enhance Occupational Performance And Quality Of Life In Diabetic Patients, Asia Suriyachottakul

UNLV Theses, Dissertations, Professional Papers, and Capstones

Globally, diabetes mellitus (DM) is a prevalent chronic condition many people encounter. DM is one of the primary causes of mortality due to individuals struggling to manage or prevent the condition. The healthcare field is also failing to provide sufficient education on DM. Individuals with this condition may begin to experience co-morbidities and depressive symptoms, which make it difficult for them to engage in meaningful occupations, in addition to decreased quality of life (QOL). This project examines the effectiveness of a low-intensity aerobic exercise (LIAE) program to enhance occupational performance (OP) and QOL in those diagnosed with the condition or …

Improving Occupational Therapy Student Utilization Through A Community Engagement Program For Individuals With Dementia, Andrew Stevenson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The contents of this doctoral project include an introduction to some of the difficulties people with dementia face in regard to engaging in the community, and how that may impact their health. It goes on to support how occupational therapists (OTs) have the skills to provide treatment addressing this issue but have faced difficulty entering settings such as memory care. A literature review demonstrates some of the positive benefits that can result from providing people with dementia opportunities for community engagement and reveals some of the difficulties associated with providing quality dementia care. This helps to explain the purpose of …

Mixed Methods Approach To Assess ‘Placental Opioid-Enhancing Factor’ Activity Within ‘Alternative’ Health Contexts Of Human Maternal Placentophagy, Jacob C. White

UNLV Theses, Dissertations, Professional Papers, and Capstones

Rats with elevated opioid levels experience an even greater increase in pain threshold after placenta or amniotic fluid consumption via placental opioid-enhancing factor (POEF) in the afterbirth. POEF only enhances opioid hypoalgesia; it cannot produce hypoalgesia alone. Although the POEF molecule remains unidentified and its efficacy in humans is unknown, it could be a safe, novel pain treatment. People who consume placenta as an alternative postpartum health practice are ideal for testing POEF bioactivity. Though rat models show that bioactive POEF is highly sensitive, some forms of the practice in humans may conserve POEF.

This project is the first attempt …

An Educational Toolkit For Addressing Women’S Sexual Health And Activity: Preparation For Occupational Therapists, Brittan Wright

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite being an activity of daily living within the scope of Occupational Therapy, issues and concerns related to sexual health are infrequently addressed within practice. This gap is especially prevalent as it relates to women's sexual health and sexual activity specifically. This capstone project evaluated Occupational Therapists' level of knowledge and comfort when discussing sexual activity and women's sexual health. It measured the effectiveness of creating an online educational toolkit to increase knowledge and confidence. The project used a quality improvement approach with pre-and post-test surveys to determine the effectiveness of the educational toolkit to enhance knowledge and confidence in …

Video Monitoring For Fall Prevention, Atongane Taku

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patient safety is a vital aspect of healthcare. Falls and fall-related injuries continue to occur in hospitals worldwide and fall prevention is one of the top priorities in providing quality care. Fall assessment tools, bed alarms, patient rounding, patient education, physical restraints, environmental modification, bedside sitters, and remote video monitoring are some of the methods implemented to reduce falls. This project was a quasi-experimental study informed by Kotter and Cohen Model of Change. The initial purpose of this process improvement project was to educate staff on the significance of video monitoring in fall prevention and determine whether the education regarding …

Pediatric Trauma-Informed Care And Implications For Occupational Therapy Practitioners, Quaneka Hoskin-Chase

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapy practitioners are provided a wealth of knowledge through school and professional fieldwork experiences to understand and skillfully address the needs of children who have been exposed to trauma. Therapists are competently prepared to provide holistic and client-centered care that is dedicated to meaningful and volitional engagement (Lynch et al., 2021). However, many therapists still lack the confidence and awareness of their role related to trauma-informed care in the pediatric environment (Piller, 2022). Trauma compromises each domain of occupation (Lynch et al., 2021). As early intervention specialists, the lack of responsiveness to children’s trauma can have devastating and enduring …

Behavioral Health, Mental Health, And Overall Well-Being Of Informal Caregivers Before And After The Covid-19 Pandemic, Zahra Mojtahedi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Informal caregivers, such as relatives or close friends, are vital for maintaining the welfare of the individuals they provide care for. However, caregiving can be difficult and stressful that adversely impacts caregivers’ health. The extra stress brought on by the COVID-19 pandemic can potentially aggravate health problems, particularly mental health. The current research aimed to nationally analyze whether the COVID-19 pandemic was significantly associated with behavioral health (physical activity and smoking), mental health (worrying, nervousness, hopelessness, little interest, and psychological distress score), and the perception of overall well-being among informal caregivers in the United States. Whether behavioral health could mediate …

Impact Of Housing On Mentally Ill Unhoused Veterans’ Readmissions To Veterans Affairs (Va) Inpatient Psychiatric Services, Maryse-Noelle Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Unhouseness, also known as homelessness, coupled with mental illness, causes health problems for some veterans; financial difficulties, unemployment, and lack of affordable housing are factors contributing to veteran unhouseness (Tsai & Rosenheck, 2015). Approximately nine percent of the entire unhoused population in the United States are veterans (United States Interagency Council on Homelessness, 2020). Unhoused veterans experience negative health outcomes impacted by environmental and socioeconomic harshness, which are also factors of subsequent psychiatric hospital readmissions (Mascayano et al., 2022). The average cost per United States Veterans Affairs (VA) hospitalization was $30,282 in FY 2019 and $40,763 in FY 2020 (Wagner, …

Providing Parent Education On School-Based, Social-Emotional Learning Programs To Increase Parents’ Self-Efficacy For Managing Aversive Behaviors, Cerena Obra

UNLV Theses, Dissertations, Professional Papers, and Capstones

There is limited evidence on the imperative role that caregivers play in social-emotional learning development for effective social-emotional learning program implementation despite their crucial influence on childhood development. This doctoral project explored the effects of parent education for two school-based, social-emotional learning program techniques on caregivers’ self-efficacy in managing aversive behaviors. This doctoral project discusses aversive behaviors, social-emotional learning, the Zones of Regulation and Friendzy social-emotional learning programs, caregiver education, and caregiver self-efficacy. This project highlights the importance of including caregivers in effective school-based social-emotional learning programs by exploring caregivers' self-efficacy when provided education on school-based social-emotional learning techniques.

Effectiveness Of A Virtual Simulation Program As A Novel Approach To Improve Clinical Judgment In Prelicensure Nursing Students, Monica Millard

UNLV Theses, Dissertations, Professional Papers, and Capstones

Problem: Limited clinical placement opportunities for practicing decision-making skills have widened the academic-practice gap. Research shows a disturbing decline in entry-level competency among newly graduated registered nurses. Innovative strategies like virtual patient simulation may foster decision-making skills and prepare prelicensure nursing students for practice. However, research is lacking in examining virtual patient simulation (VPS) as an effective approach for developing clinical judgment in prelicensure nursing students. The American Association for Academic Nursing has determined that clinical judgment is an essential nursing attribute. Moreover, the National Council of State Boards of Nursing developed the Next Generation National Council Licensure Exam based …

The Mitochondrial Membrane Potential As A Screening Tool For Immunostimulation, Kendra Mcglothen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The rise of neuroinflammatory disorders highlights the importance of early detection and intervention for more effective treatment options. Neuroinflammation is associated with the pathogenesis of many neurological disorders, including Major Depressive Disorder, Alzheimer's disease, and Multiple Sclerosis. There has been a focus on neurons to advance our understanding of the underlying mechanisms of neuroinflammation and its role in neurodegeneration. However, recent studies have highlighted the pivotal role of glial cells, particularly microglia, in neuroinflammation due to their active participation in the immune response. This study investigates glial-specific indicators of morphology, metabolic changes, and drug efficacy in neuroinflammatory conditions. By analyzing …

Seated Athletes' Motivation For Participation In Wheelchair Sports: A Qualitative Study, Audrey Lynn Miller

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose for this phenomenological design qualitative analysis was to gain an understanding of the perspectives of seated athletes’ motivation for participation in adapted athletics and argues that there is a component of seating that affects motivation. Occupational therapists build client interventions using meaningful occupations. This study aimed to increase awareness of adapted athletics impact on occupational performance. There was a gap in the literature for qualitative research exploring the lens of adapted sports participation through the perspective of seated athletes. This study utilized one-time individual semi-structured interviews with five participants that currently participate on a wheelchair court sports team …

Feasibility Of An Occupation-Based Intervention Manual For Outpatient Hand Clinics, Mia Moralez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose

The purpose of this quality improvement study was to determine the usefulness of an Occupation-based Intervention Manual (OBI) for hand therapists in Southern Nevada and if the utilization of the OBI manual supported client-centered outcomes regardless of diagnosis, age, or population.

Methods

Convenience sampling was used, and five participants met the inclusion criteria in the twelve-week study. Pre-interview questionnaire responses from the therapists were used to develop the OBI manual content and corresponding Utilization Tracker. Post-interview questionnaire responses were used to determine the application and outcomes of the OBI manual. Descriptive statistics, frequency distribution, and thematic analysis were used …