Medicine and Health Sciences Commons^™

Targeting The Beiging Of Muscle-Associated Adipose Tissue To Promote Muscle Regeneration, Jacob C. Parson

WUSM Theses and Dissertations – All Programs

The expansion of intra-muscular adipose tissue (IMAT) between myofibers and epi-muscular adipose tissue (EMAT) outside of the muscle boundary accompanies numerous pathologies including diabetes, muscular dystrophy, and aging. IMAT and EMAT are anatomically juxtaposed to myofibers. Some evidence supports that IMAT and EMAT impede muscle function. This is potentially due to paracrine factors that are secreted by IMAT/EMAT. Different adipose depots can be classified in numerous ways including where they are located anatomically as well as the factors in which they secrete. Unlike classical white fat, adipose depots classified as brown or beige, noted by the marker uncoupling protein-1 (UCP-1) …

Trauma-Informed Family-Centered Care Training For Neonatal Intensive Care Nurses, Sonja A. Alli-Casella

Doctor of Nursing Practice (DNP) Projects

Background The neonatal intensive care unit (NICU) is a high-stress environment that can cause or exacerbate emotional trauma for parents of critically ill infants. While NICU nurses are trained in neonatal care and basic family-centered principles, they often receive limited education on supporting adults in acute emotional distress, leaving them unprepared to manage dysregulated behaviors. Local Problem At a Level IV NICU in a Southern California pediatric hospital, nurses may underestimate their influence on parental stress levels due to a lack of formal training in supporting emotionally distressed adults. Methods A comprehensive literature review informed an evidence-based practice (EBP) initiative …

Increasing Formation Of Advance Directives In Acute Care Through Staff Education, Piper E. Parres

Doctor of Nursing Practice Scholarly Project

In the acute care setting, the condition and stability of patients can change in an instant. Oftentimes, patients that were ambulatory, independent, and high functioning may be rendered critically ill and unable to communicate due to the rapid onset of an illness. When this happens, the care team must act quickly to stabilize the patient by any means necessary. With the wealth of medical knowledge and technology available in modern healthcare, life may be sustained indefinitely with the help of machinery such as ventilators, continuous renal replacement therapy, or extracorporeal membrane oxygenation. While some patients may welcome these interventions, others …

Adults' Intention To Take An Arthritis Prescription Drug Based On Drug Advertisements, Amanda Radola

Seton Hall University Dissertations and Theses (ETDs)

Direct-to-Consumer Prescription Advertising (DTCPA) has rapidly expanded, particularly via social media, but research on its influence on individual decisions regarding prescribed medications remains limited. This gap is notable among chronic disease patients, such as those with arthritis, which affected over 58.5 million U.S. adults as of 2015 and is projected to rise to 78.4 million by 2040 (Barbour et al., 2017; Hootman et al., 2016). Social media discussions show significant activity following television ads for arthritis drugs (Curtis et al., 2017). However, few studies explore how DTCPA impacts patient intentions to take advertised arthritis medications. This study employed a novel …

Toward An Understanding Of Loneliness And Social Participation In Serious Mental Illness, Samantha B. Randolph

WUSM Theses and Dissertations – All Programs

Loneliness is an immense challenge facing the majority of Americans with Serious Mental Illness. Loneliness is linked to negative outcomes, including heart disease, reduced quality of life, and early mortality. Current loneliness interventions (e.g., social skills training, social support) do not effectively address all the complex factors that lead to loneliness in this population. More work is needed, therefore, to better understand how to optimally research and prevent loneliness among individuals with Serious Mental Illness, who experience unique barriers to social integration/participation and dwell in complex settings, such as permanent supportive housing. The presented dissertation aims to address current gaps …

A Theory-Based Examination Of Factors Influencing Caregivers’ Intentions To Disclose Sickle Cell Trait Status To Their Children, Christine A. Chaba

WUSM Theses and Dissertations – All Programs

Sickle cell trait (SCT), the heterozygous form of sickle cell disease, has significant implications for health and reproductive decision-making. Timely disclosure of SCT status to children by their caregivers is critical for promoting genetic awareness and supporting informed reproductive choices. However, many caregivers delay or avoid this conversation. This study examined the psychosocial and behavioral factors influencing caregivers’ intentions to disclose SCT status to their children, guided by the Theory of Planned Behavior and the Theory of Regret Regulation. A descriptive, cross-sectional study was conducted with 78 caregivers of Children with SCT, who completed an online survey. The study addressed …

Group Therapy For Young Adults With Intellectual Disabilities And Anxiety, Rayah Secrist

Educational Specialist, 2020-current

The purpose of this Ed.S. project is to propose a therapy group for individuals with intellectual disabilities who are struggling with anxiety. This paper will explore the literature on social and emotional barriers, mental health access inequality, and evidence-based practices in therapy for young adults with intellectual disabilities. Drawing on the research, this paper aims to provide clinicians with a guide for leading effective therapy groups tailored to this specific demographic.

Trauma-Informed Care: A Therapeutic Approach In Communication, Nicole A. Leonce

Doctor of Nursing Practice (DNP) Projects

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Bridging The Gap: Enhancing Medical Interpreter Utilization For Patients With Limited English Proficiency In Healthcare Settings, Rocio J. Tapia-Nuss

Doctor of Nursing Practice (DNP) Projects

The Impact of Utilizing Medical Interpreters and Associated Patient Outcomes

Abstract

Background: In the United States, approximately 21% of households speak a language other than English, emphasizing the need for accessible language services for patients with limited English proficiency (LEP).

Problem: Despite legal mandates, medical interpreters remain underutilized, leading to adverse health outcomes, such as misunderstanding discharge instructions, medication use, and disease processes.

Methods: This DNP student-led evidence-based project explored barriers to medical interpreter utilization among healthcare professionals.

Intervention: A continuing education module was implemented by a DNP student at the University of San Francisco’s School of Nursing and Health …

Saving Lives: Naloxone Education And Training For Mental Health Re-Entry Program Providers, Remigus C. Nwaokoro

Doctor of Nursing Practice (DNP) Projects

Background Opioid overdose fatalities are a major public health concern with significant cost implications. Naloxone effectively reverses opioid overdose symptoms and prevents fatalities, yet many healthcare professionals lack the confidence and knowledge to administer it. This knowledge gap delays efforts to combat opioid overdose. Local Problem Opioid-related fatalities are among the leading causes of preventable deaths. In a northern California county, opioid overdose deaths increased by 20% from 2018 to 2021, with 48 fatalities in 2021. A needs assessment revealed that healthcare providers at a reentry program in that county had limited knowledge and confidence in using naloxone. Methods A …

Empowering Schools: Suicide Prevention Education For School Nurses, Navjot K. Singh

Doctor of Nursing Practice (DNP) Projects

Background: Suicide among adolescents and youth is a serious public health issue that requires immediate intervention to reduce ideation and death. The increasing rate of suicide among children and adolescents has a profound effect on families, friends, and the community.

Problem: Suicide among school aged children and adolescents can create significant challenges for school nurses, who are often the first contact for students who recognize suicidal ideation and mental health crises. This issue is particularly significant for the Alameda school nurses in California, as they play a significant role in identifying and supporting students in a crisis.

Methods: A …

Trauma-Informed Care: A Therapeutic Communication, Nicole Anne Leonce

Doctor of Nursing Practice (DNP) Projects

As medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural …

Educating Community Health Workers: To Improve Maternal And Infant Health In Rural Areas, Katerina Markova Shikhvarg

Doctor of Nursing Practice (DNP) Projects

Background

Community Health Workers (CHW) are lay workers who are beneficial in reducing health disparities, in their communities. They provide culturally sensitive home visits and help coordinate resources for their patients. These visits have been shown to benefit the psychological, behavioral, and social health of their patients.

Local Problem

Despite the benefits of CHW involvement, they lack standardized training that could improve their services.

Methods

A partnership was entered by the University of San Francisco (USF) and an international philanthropic organization, focused on helping children. The partnership developed a certification program for CHWs in the Tulare County with USF Nurse …

Thinking Long-Term: Nursing Education On Long-Acting Injectable Antipsychotics, Arslan Amir Rashid

Doctor of Nursing Practice (DNP) Projects

Background Schizophrenia cases and their associated healthcare costs have drastically increased over time in the United States. Antipsychotic nonadherence is a primary contributor to the high rates of relapse and rehospitalization among adult patients with schizophrenia. The development of long-acting injectable antipsychotics (LAIs) has positively impacted medication adherence, however, this treatment modality is still underutilized in practice due to barriers, such as physician and patient negative attitudes toward LAIs and lack of education. Nurses hold a unique position to potentially change practice and address some of the barriers to LAI usage. Local Problem A Mental Health Rehabilitation Center in California …

Leading The School Team: A Professional Development Training On Eating Disorders For School Nurses, Michelle Samaniego Concepcion

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The COVID-19 pandemic sharply increased the prevalence of eating disorders (EDs) among youth. These conditions are associated with high treatment costs and have the second-highest mortality rate among mental illnesses, surpassed only by opioid overdose, making them a critical concern for school communities.

Local Problem: A learning needs assessment conducted by the Alameda County School Nurses Network identified gaps in school nurses’ knowledge and confidence regarding ED identification, referral, and care coordination. Methods: In response, a Doctor of Nursing Practice (DNP) student scholar developed and implemented an evidence-based, virtual professional development training focused on EDs. The module was …

Staff Education Program Utilizing A Workflow Template To Streamline Care In Occupational Health, Alicia Vogleson

Walden Dissertations and Doctoral Studies

This DNP Project is one designed to educate Occupational Health Staff. As there are varying levels of skills and education of staff working with patients, it is important to identify staff that who can play a large role in helping gather important information to help in treatment decisions early on in the process of patient care. The practice-focused question and the purpose of the project was to answer the following question: will a staff education program for Medical Assistants and Front Desk Staff in an Occupational Health clinic on the utilization of a template to streamline workflow improve their knowledge? …

Impact Of Safety Practices On Laboratory-Acquired Infections In Clinical Laboratories From 2018 To 2023, Lori Bane

Walden Dissertations and Doctoral Studies

Laboratorians identifying unknown pandemic pathogens face elevated risks of laboratory-acquired infections yet limited research examines how regulated safety practices influence these risks. This quantitative, correlational study used the Centers for Disease Control and Prevention’s secondary data (2018–2023) to examine two research questions. The first one questioned whether there were differences in safety incidents between registered and exempt clinical laboratories. The second research question investigated whether there was an association of laboratory incidents between BSL-2 and BSL-3 laboratories. The research was limited to incident reports from registered and exempted clinical laboratories working in BSL-2 and BSL-3 conditions. Guided by the Health …

Implementation Of Standardized Mobilization Assessment Tools To Promote Patient Ambulation At Medical Surgical Units, Yunxuan Su

Master's Projects and Capstones

The objective is the cardiac medical surgical unit in a hospital in San Francisco not meeting the ambulation goal. This study aims to provide a context for enhancing patients' ambulation levels by using standardized assessment tools Prior Level of Functional (PLOF) and Current Level of Functional (CLOF) in daily practice, thereby strengthening care plans and shortening hospital stay. The methods are microsystem evaluation, SWOT analysis, causal analysis, cost-benefit analysis, Gantt chart, pre & post survey, and flyer education for staff to guide the project implementation. The results are that after the intervention, the compliance of PLOF and CLOF documentation and …

Optimizing Pediatric Peri-Anesthesia Care: A Donna Wright Nursing Competency Framework, Marisa Elise Gauna

Master's Projects and Capstones

Problem: Preventable hospital errors are often associated with inconsistent nursing competency, especially in high-acuity areas such as pediatric peri-anesthesia units. Traditional evaluation tools like checklists have limited effectiveness, as they frequently fail to engage staff or adapt to changing clinical demands (Wright, 2005). Context: At a Bay Area children’s hospital, baseline data from August 2024 revealed that only 65% of peri-anesthesia nurses reported feeling “very” or “somewhat” comfortable with key clinical skills. To address this, a quality improvement project was launched with the goal of increasing comfort levels by 15% using the Donna Wright Competency Model, which emphasizes staff engagement, …

From Silence To Clarity: Enhancing Surgical Icu Communication Through Personalized Whiteboards, Braeden R. Woods

Master's Projects and Capstones

Objective: Critically ill patients in the intensive care unit (ICU) are at heightened risk of dehumanization due to sedation, mechanical ventilation, and prolonged hospitalization. This quality improvement (QI) initiative aimed to enhance patient-centered communication in the Surgical Intensive Care Unit (SICU) at a Northern California academic quaternary care hospital through the implementation of personalized communication whiteboards. Aim: To develop a personalized communication board that, once implemented, would achieve at least 75% utilization in patient rooms by May 2025. Methods: Guided by a Plan-Do-Study-Act (PDSA) framework, surveys were conducted with SICU patients, families, and staff to gather stakeholder input and inform …

Community Health Workers’ Lived Experience Of Using Videoconferencing With Community Members, Valdora Lejune Avery

Walden Dissertations and Doctoral Studies

Community health workers in the United States faced significant challenges in conducting in-person community practice during the COVID-19 pandemic, which adversely affected their communication, training, and service delivery outcomes. Videoconferencing enabled workers to connect with underserved populations for individual and community crisis response. The purpose of this study was to describe the lived experiences of community health workers in the Rural Community Health Worker Network (RCHWN) regarding the use of videoconferencing among community members in practice and how members in RCHWN perceive the availability of videoconferencing devices to communicate in the community. Transcendental phenomenology provided the conceptual framework and research …

Developing An Evidence-Based Continuing Education Program For Physical Therapists Working With Individuals With Down Syndrome, Luis Azpeitia, Chantel Montayre, Rebecca Peterson, Alyssa Pociernicki

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the abundance of resources available for physical therapists (PTs) treating children with Ds, the resources are limited for PTs working with teens and adults. This suggests that this population is underserved within the healthcare community. This project aimed to bridge this knowledge gap by developing a comprehensive continuing education program for physical therapists, focused on the treatment and care of teens and adults with Ds. This education program will give physical therapists a resource for treating teens and adults with Ds, an under-resourced population. Two modules focusing on musculoskeletal (MSK)/gait and communication strategies were developed, and then pilot tested …

Fostering Intergenerational Connection Through The Implementation Of Bingocize: A Community-Based Fall-Prevention Program, Dejeigh Herrera, Shelby Humphreys, Kayla Lee, Danielle Platt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Falling is an experience that can be traumatic and detrimental to the overall health of those aged 65 and older. As this portion of the population in the United States continues to grow, so does the importance of understanding the general health concerns of these individuals and the way they contribute to their risk of falling and impact their ability to live independently. One program to help address these risks is Bingocize, an evidence-based program designed by Jason Crandall, a professor of exercise science at Western Kentucky University in 2011. Bingocize is a 10-week fall prevention program designed to educate …

Effects Of Different Cannabis Compounds On Balance, Freezing Of Gait, And Bradykinesia In Parkinson’S Disease: Cross-Sectional Analysis Of Self-Report Data From The Fox Insight Study, Alexandria Dockery, Adan Hernandez, Cody Miyashiro

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To explore the effects of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD)) on self-reported balance problems, freezing of gait (FOG), and bradykinesia in Parkinson’s disease (PD).

Background: Recent research has indicated that a high proportion of people with PD are interested in using cannabis for symptom management. Given the known intoxicating and motor impairing properties of THC, it may negatively affect postural instability and increase fall risk in people with PD.

Methods: Data from the Fox Insight online clinical study were analyzed in February 2024. The analysis only included participants with PD who answered questions about cannabis use (n=2754). Responses were …

Does Student Interest In Rural Or Underserved Practice Change Following Exposure To A Full Time Rural Or Underserved Clinical Experience?, Hans D. Capistrano, Maxwell D. Giedlin, Kayla A. Houston

UNLV Theses, Dissertations, Professional Papers, and Capstones

Access to healthcare in rural areas remains a significant challenge, with rural communities facing unique barriers such as limited healthcare providers, increased travel distances, and lower insurance coverage rates. Nevada exemplifies this issue, ranking 45th in the United States in access to physical therapy services, with particularly low provider availability in its rural regions. Research suggests that clinical education experiences in rural and underserved areas may encourage healthcare professionals to practice in these communities post-graduation. This study examined the relationship between clinical experiences in rural and underserved settings amongst University of Nevada, Las Vegas Physical Therapy (UNLVPT) students’ interest in …

Unlv Admissions: Effect Of The In-Person Interview On The Holistic Admissions Of Minority Applicants Into The University Of Nevada, Las Vegas Doctor Of Physical Therapy Program, Jonathan Madamba, Walker Riley, Isaiah Taylor

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Methods: The goal of this study is to analyze the effect of an in-person interview on the admission of minority applicants into the Doctor of Physical Therapy (DPT) program at the University of Nevada, Las Vegas (UNLV). Using data from the 2014-2022 admissions cycles we assessed inter-rater reliability of the interviewer’s, differences in average in-person interview score between racial groups, and compared the difference in pre-interview scores between racial groups.

Results: We found that students identifying as Black scored higher on interviews than their White counterparts. However, a smaller proportion of them matriculated into the program due to the difference …

Correlation Between Atnr Retention And Sensory Processing Difficulties In A Pediatric Occupational Therapy Population, Cassaundra H. Abernathy

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study aimed to examine the correlation between retained Asymmetric Tonic Neck Reflex (ATNR) and sensory processing difficulties in children. A review of the literature available contributed to understanding the relationship between these; however, the limited research indicated a need for further examination to provide practitioners with evidence-based research for comprehensive care and improved occupational performance in children. A small correlational study was conducted using the snowball method with convenience sampling. The study yielded six participants from an occupational therapy outpatient clinic, A Clubhouse for Kids. Caregivers completed the Sensory Profile 2 in hard copy to assess their child's sensory …

Core Temperature While Swimming In Warm Open Water With And Without A Wetsuit, Katsiaryna Afanasyeva

UNLV Theses, Dissertations, Professional Papers, and Capstones

Triathlon is a popular sport which attract participants from all over the world. In general, triathlon is a safe sport with risk of death being about 1.74 deaths per 100,000 participants (Harris et al., 2017). The swimming portion of the race can be dangerous, posing particular risks due to open water conditions and the physical demands of the event. This study investigated the effects of wetsuit use on core temperature in warm open-water swimming (27.9–28.3°C). Four experienced triathletes (2 males, 2 females; age 49.50 ± 7.83 years) completed two 700-meter open-water swims at a submaximal pace—once wearing their personal full-sleeve …

Pre-Service Teacher Self-Efficacy For Classroom Management And Evidence Based Practices For Managing Classroom And Challenging Behaviors, Mathew Benthin

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study investigated the relationship between pre-service teachers' self-efficacy (TSE) and their knowledge of evidence-based practices. Teacher self-efficacy, defined as the belief in one's ability to achieve specific teaching goals, plays a pivotal role in shaping teaching behaviors and student outcomes. Evidence-based practices, grounded in scientific research, are essential for effective teaching and problem-solving in diverse classroom settings. This study highlighted the importance of the two specific resources of self-efficacy and knowledge of evidence-based practices for managing classrooms and challenging behaviors. By exploring pre-service teacher resources, this study aimed to contribute to the body of literature exploring the challenges facing …

Bridging The Gap: A Quality Improvement Initiative To Enhance Interoception Resources For Pediatric Oncology Ots, Dana Louise Lomotan Doolittle

UNLV Theses, Dissertations, Professional Papers, and Capstones

Chemotherapy administered to children and youth diagnosed with pediatric cancers may induce side effects such as pain, fatigue, anxiety, and other distressing symptoms that could impact the ability to meet occupational needs and desires in daily functioning. The occupational therapy discipline incorporates mindfulness strategies to target these symptoms for increased body awareness in children with cancer, though interoception’s role within the pediatric oncology population is obscure. Furthermore, there are implicated demands described in the literature for more established pediatric oncology rehabilitation programs to attend to the specific needs of the population and to advocate for occupational therapy’s role in the …