Medicine and Health Sciences Commons^™

Plagiocephaly In Premature Infants: Enhancing Nicu Caregiver Education, Hailee Efferson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To improve NICU nurses’ confidence in preventing and managing plagiocephaly in premature infants through a one-on-one educational session.Design: One-group post-test design for a quality improvement initiative. Setting: Neonatal Intensive Care Unit (NICU) at Summerlin Hospital Medical Center. Participants: 20 NICU Nurses. Measures: Post-session questionnaire including close-ended Likert scale and open-ended questions. Results: Mean scores ranged from 3.5 to 4.0, with the highest rating for the helpfulness of the session format (mean = 4.0) and the lowest for confidence in alternating infant positioning (mean = 3.5). Standard deviations ranged from 0 to 0.59, indicating strong agreement regarding the session format …

Expanding Anatomy Academy In The Las Vegas Metropolitan Area: A Service Learning Project To Improve Childhood Health Through Supplemental Educational Sessions, Alekzander Hall, Brandon Paige, Marlee Parkin, David Sanchez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Childhood obesity is a growing epidemic in the United States, with approximately 18.5% of US children presenting with obesity. High levels of obesity are less common in higher income communities, but increasingly more prevalent in lower income communities. Currently in Clark County, Nevada, more specifically in lower socioeconomic communities and Title I schools within the Las Vegas area, there is an opportunity to educate students about the components of a healthier lifestyle to provide children with the tools to improve their health. Anatomy Academy (AA) is an eight-week health education program that was created to teach fourth and fifth grade …

Chronic Exposure To Porphyromonas Gingivalis Disrupts Macrophage Innate Immune Responses, Corey Allen Foulk

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Porphyromonas gingivalis (Pg) is a pathogenic, “red-complex” bacteria found in higher concentrations in advanced gingivitis and periodontitis. Macrophages are capable of adopting numerous phenotypes depending on the surrounding environment. Classic M1 macrophages are the result of inflammatory signals including IFNγ. This study investigated whether naïve M0 macrophages can transition into classic M1 macrophages following stimulation with traditional agonists after cells have been exposed to formalin killed P. gingivalis.Methods: The THP-1 monocytes were differentiated into naïve macrophages (M0) using PMA treatment. The M0 cells were challenged with formalin killed P. gingivalis for 24 hours. After prolonged exposure to P. gingivalis, …

Patterns In Antibiotic Susceptibility Before And After Covid-19, Jessica Freely

UNLV Theses, Dissertations, Professional Papers, and Capstones

The COVID-19 pandemic led to a surge in antibiotic use, despite the viral nature of the disease. This widespread and often unnecessary use of antibiotics poses a serious threat on global health by accelerating the development of antibiotic resistance. Healthcare professionals utilize strategies, including Antibiotic Stewardship Programs (ASPs) and the use of antibiograms to mitigate the growing threat of antibiotic resistance. Antibiograms are tools used in healthcare settings to summarize and track bacterial susceptibility to various antibiotics. They provide clinicians critical information to guide selection of effective antibiotic treatment and monitor resistance trends overtime. The Centers for Disease Control and …

Enhancing Therapeutic Use Of Self: The Value Of Unfolding Case Studies In Occupational Therapy Education, Janel Marie Gozum

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: This capstone project evaluated the effectiveness of using unfolding case studies (UCS) as a supplemental instructional method to enhance occupational therapy (OT) students’ self-efficacy (SE) in applying therapeutic use of self (TUOS), a core competency in OT education.Methods: Four workshop modules were delivered to and completed by OT students (n=3) enrolled in the occupational therapy doctorate program at the University of Nevada, Las Vegas. The sessions included instructional content, guided discussions, unfolding case study activities, and a TUOS competency. The Self-Efficacy for Therapeutic Use of Self (SETUS) Questionnaire was administered at four points throughout to monitor perceived self-efficacy over …

Acquired Brain Injury Education: Utilizing Unfolding Case Studies To Improve Critical Thinking Skills In Occupational Therapy Students, Katherine Hathaway

UNLV Theses, Dissertations, Professional Papers, and Capstones

Acquired brain injuries (ABI), including traumatic brain injury, stroke, and anoxia, affect millions worldwide, and often result in long-term impairments in daily functioning. Despite the need for specialized, ongoing care, many individuals with ABI lack access to adequate long-term rehabilitation services, and families report substantial caregiver burden due to limited resources and poor care coordination. Occupational therapy plays a critical role in meeting the needs of this population; however, many entry-level practitioners feel underprepared to manage the complex challenges associated with ABI, largely due to limited training and exposure. This capstone project aimed to address this educational gap by implementing …

Ethnoracial Characterization Of Cognitive Function And Activities Of Daily Living In Neurodegenerative Diseases, Justine A. Bachmann

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Neurodegenerative diseases, such as Alzheimer's disease (AD), lead to progressive cognitive and functional decline, which significantly affects individuals’ ability to perform their everyday Activities of Daily Living (ADLs). Occupational Therapist (OTs) assess cognitive impairments and their impact on daily function by utilizing tools like the Montreal Cognitive Assessment (MoCA) to guide intervention planning. However, research on the MoCA’s effectiveness across ethnoracial groups is limited, raising potential biases in the accuracy of cognitive assessments. This study examines the relationship between cognitive function, measured by the MoCA, and functional impairment, assessed using the Functional Activities Questionnaire (FAQ), among ethnoracial older adults …

Oral Prevalence Of Selenomonas Noxia Differs Among Orthodontic Patients Compared To Non-Orthodontic Controls: A Retrospective Biorepository Analysis, Kyle Hodges

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The introduction of fixed orthodontic brackets in orthodontic therapy has the potential to significantly alter the oral microbial flora. Most orthodontic research has focused on cariogenic pathogens, while some evidence has demonstrated an increase in many known periodontal pathogens. However, little is known about the prevalence of the gram-negative periodontal pathogen, Selenomonas noxia (SN) among these patients.Methods: Using an existing saliva biorepository, n=208 samples from adult and pediatric orthodontic and non-orthodontic patients were identified and screened for the presence of SN using qPCR and validated primers. Results: In the pediatric study sample (n=89) 36% tested positive for the presence …

Cone Beam Ct Assessment Of The Zygomatico-Maxillary Buttress For Bone Thickness And Clinical Implications For Miniscrew Insertion, Zachary Hendrickson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Temporary anchorage devices (TADs) have changed the way many orthodontists practice orthodontics. TADs are mini-screw temporary implants made of titanium or stainless steel that are placed in the patient's bone in different locations to aid in complex biomechanical movements. This complete anchorage aids in distalization, intrusion, protraction, etc. with less reliance on patience compliance. While TADs have made many movements easier, there are limitations such as choice of where to place it, skill at placing them and patient individual physiology and anatomy that can limit the use of TADs.Objectives: Infrazygomatic crest (IZC) TADs are particularly useful for distalization and …

The Effectiveness Of Occupational Therapy Objective Structured Clinical Exam & Student Self-Efficacy In Preparation For Fieldwork Rotation, Angela Kay

UNLV Theses, Dissertations, Professional Papers, and Capstones

This capstone project focuses on exploring the effectiveness of the University of Nevada, Las Vegas Department of Occupational Therapy’s Objective Structured Clinical Exam (OSCE) on students’ perceived self-efficacy in preparation for and throughout fieldwork rotation. This retrospective study analyzed repeated measures of the New General Self-Efficacy (NGSE) Likert Scale collected from a sample of 49 occupational therapy students across five time points. Findings indicated a statistically significant increase in self-efficacy over time (p< .001). These results suggest that the OSCE may play a meaningful role in enhancing students’ self-efficacy in their clinical hands-on skills, supporting its continued use in occupational therapy academics.

The Impact Of Psychosocial Factors On Occupational Therapy Doctoral Students’ Communication With Fieldwork Educators: A Retrospective Analysis, Melissa Montes

UNLV Theses, Dissertations, Professional Papers, and Capstones

This capstone project investigates the impact of adverse psychosocial factors, such as depression, anxiety, and stress, on effective communication of occupational therapy doctoral (OTD) students with their fieldwork educators (FWEds) during level II fieldwork experiences at the University of Nevada, Las Vegas (UNLV). Using a convergent parallel mixed methods design and retrospective analysis, the study integrates quantitative data from the Depression, Anxiety, and Stress Scale (DASS-21) and qualitative data from the Fieldwork Experience Assessment Tool (FEAT) to explore how these factors affect communication and the management of the adverse psychosocial factors OTD students experience. This study involved 36 OTD students …

Assessing The Effects Of Streptozotocin-Induced Hyperglycemia On Amyloid Beta Accumulation And Cognitive Behavior In A Mouse Model Of Alzheimer’S Disease-Related Pathology, Andrew Adonay Ortiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer’s disease (AD) is an irreversible and devastating neurodegenerative disease characterized by progressive synaptic, dendritic, glial, and neuronal loss, collectively leading to impairments in learning, memory, and deterioration of cognitive and behavioral functions. AD is the most common form of dementia accounting for 60-80% of all cases. AD affects approximately 7 million Americans and is the 6th leading cause of death in the US. Furthermore, by 2050, the US is projected to spend over $1.1 trillion on AD-related treatments. Pathological hallmarks of AD include beta-amyloid (Aβ) plaques, intracellular neurofibrillary tangles (NFTs), and chronic neuroinflammation, which can promote and exacerbate both …

Exploring The Occupation Of Parenting With A Cognitive Disability, Alysa Polley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: To investigate how parents with cognitive disabilities perform child-rearing tasks and barriers associated with their disability, to determine their needs and self-efficacy to improve the role of occupational therapy in supporting child-rearing for parents with cognitive disability.Design: Qualitative Case-study, Phenomenology Setting: Gigi's Playhouse Participant(s): Inclusion criteria: parents or expecting parents, individuals with a cognitive disability resulting from an autism spectrum disorder diagnosis, English speaking, 18+, and autonomy to consent participation. Exclusion criteria: non-English speaking, individuals without a cognitive disability resulting from an autism spectrum disorder diagnosis, and under 18. Measure(s): Semi-Structured Interview and Tool for Measuring Parental Self-efficacy. Results: …

Detection And Quantification Of Total Airborne Fungi And Coccidioides Species In Environmental Samples, Theresa T. Roehr

UNLV Theses, Dissertations, Professional Papers, and Capstones

Fungal exposure can cause acute and chronic illnesses or exacerbate existing illnesses. Some fungi are opportunistic pathogens and can lead to serious systemic fungal infections. In 2020, more than 150 million cases of severe fungal infections were reported globally resulting in an estimated 1.7 million deaths. Coccidioidomycosis, or Valley fever, is classified as a serious fungal infection caused by the fungi Coccidioides immitis and C. posadasii. These particular fungi are prevalent in the soil of the Southwestern United States, including Las Vegas, Nevada. In 2024, there were a total of 269 cases of Valley fever reported in Nevada, and …

Maximizing Functional Independence And Well-Being: The Impact Of Sensory Impairments On Iadls And Functional Mobility Skills, Jessica L. Ryan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Sensory impairments involving vision and hearing among the adult population are predicted to double by 2030 (Gutherie et al., 2018). Individuals with experiences of sensory impairments like low vision are at risk of decreased functional participation in their homes and communities, which often leads to mental health concerns due to social withdrawal, experiences with environmental barriers, and limited occupational engagement (Bezyak et al., 2017; Gerami et al., 2015; Pfeiffer et al., 2020; Vreeken et al., 2020). This doctoral capstone focused on program evaluation to support adults with low vision and blindness in transferring learned skills from a simulated environment …

Gaming Participation: An Occupational Therapy Approach To Esports Ergonomics, Althea Rivera-Millare

UNLV Theses, Dissertations, Professional Papers, and Capstones

Competitive e-sport gamers are increasingly at risk for repetitive strain injuries (RSIs) due to the prolonged and repetitive nature of their gaming demands. Current healthcare protocols often overlook the unique ergonomic needs of this population, potentially leading to decreased occupational performance and dysfunction. This study aims to develop and evaluate an evidence-based ergonomic protocol tailored specifically to e-sport gamers who primarily use a mouse and keyboard, with the goal of reducing the risk of musculoskeletal injuries and enhancing gaming performance. Grounded in the principles of occupational therapy, the study emphasizes occupation-based interventions that address the specific occupational demands of e-sport …

Qualitative Analysis Of Clinical And Community Perinatal Providers’ Perceived Barriers To Equitable Care For Food Insecurity In Underserved Communities In Southern Nevada, Kaelia Lynn KeapomekuʻUaloha Saniatan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity is prevalent among underserved communities and contributes to increasing maternal-child health disparities. The perinatal period from pregnancy through one year postpartum provides a critical window of opportunity to identify and address food insecurity (FI). However, barriers such as inadequate staffing, lack of institutional and community resources have prevented perinatal providers from offering equitable care for FI, defined as providing screening, referrals, and follow-up services. The Social Ecological Model (SEM) is a framework that observes concepts at multiple levels, including (i) individual, (ii) interpersonal, (iii) institutional, (iv) community, and (v) policy. The objective of this study is to understand …

Torque Efficacy Of Cadmus Bracket Design Using Clear Aligners, Joseph Soderberg

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Clear aligner therapy (CAT) is an alternative option for clinicians to use for orthodontic treatment as opposed to fixed appliances. Many patients prefer clear aligner therapy due to its esthetic looks, removability, ease of oral hygiene, and comfort. Clear aligner companies boast to clinicians that it can be used more efficiently and effectively than fixed appliances in many orthodontic cases. Although these claims have been made, there is a lack of evidence to prove that clear aligner therapy is more efficient or effective. This research will focus on torque control. This project is designed around a new, pre-manufactured attachment …

Investigating The Influence Of Environmental Stressors To Exopolysaccharide Production In Soil Cyanobacteria: Genomic And Physiological Perspectives, Benjy Sedano-Herrera

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cyanobacteria are photosynthetic microbes with essential roles in Earth’s ecosystems. The secretion of long–chain polysaccharides, known as exopolysaccharides (EPS), is a key trait facilitating cyanobacterial adaptation to diverse ecosystems. Genomics studies have shown that aquatic cyanobacteria harbor multiple gene copies encoding EPS export proteins, likely conferring a selective advantage in lakes or oceans. In addition, physiological experiments showed that nutrient limitation in aquatic habitats influences EPS production, affecting cyanobacterial fitness. However, whether terrestrial cyanobacteria also harbor multiple EPS-related genes and how nutrient limitation impacts their EPS production is not well understood.In the first chapter of my thesis, we investigated the …

Peripheral Neuroimmune Mechanisms Of Chronic Back Pain, Aleyah Esther Goins

Biomedical Sciences ETDs

Chronic back pain (CBP) affects 1 in 10 people worldwide, reducing mobility, productivity, and quality of life. Despite its prevalence, non-addictive treatments remain limited due to an incomplete understanding of chronic pain mechanisms. This dissertation examines peripheral neuroimmune interactions in CBP using a urokinase-type plasminogen activator (uPA)-induced mouse model (uPA-CBP). uPA, a pro-inflammatory serine protease, was injected into the L2/L3 lumbar spinous ligament, inducing prolonged mechanical and cold hypersensitivity. Flow cytometry of dorsal root ganglia (DRG) showed increased CD45+CD11b+ myeloid cells in males and CD45+CD3+CD4+ lymphocytes in females. DRG neurons from male uPA-CBP mice exhibited heightened action potential firing. Pharmacological …

Empowering Nurses, Enhancing Mobility: A Qi Initiative Using Plof And Clof To Promote Patient Ambulation, Kaela Nguyen

Master's Projects and Capstones

The quality improvement project involves the intervention of implemented mobility educational flyers about the mobility tools, Clinician Reported Level of Function (CLOF) and Patient Reported Level of Function (PLOF) and aims to increase patient mobility post surgery. The quality improvement project was conducted in two medical surgical units in a San Francisco hospital. To address unmet mobility goals, during change of shift, in-services on the educational flyers about the mobility tools (CLOF and PLOF), were utilized to provide education about the importance of mobility, how to utilize the mobility tools, and correctly document ambulation. More than twenty flyers were posted …

The Wright Way: Advancing Pediatric Perianesthetia Nursing Competencies, Marisela E. Acevedo-Padilla

Master's Projects and Capstones

Objective Implementing the Donna Wright Competency Model at a Bay Area Children’s Hospital in its peri-anesthesia units. Throughout available literature it was possible to observe the positive effects of implementing a competency model such as the DWCM has on the confidence of nursing staff and patient outcomes. An important point shown by literature was addressing more than technical skills and incorporating critical thinking and ethical considerations regarding patient care. Aim We aim to improve nurse competency in pediatric peri-anesthesia units at a Bay Area Children's Hospital by implementing Donna Wright’s Competency Model. Data obtained in August 2024 from a series …

The Application Of Time-Frequency Analysis To Ocular Vestibular Evoked Myogenic Potentials, Hannah R. Richardson

Dissertations, 2020-current

Ocular vestibular evoked myogenic potentials (oVEMPs) are produced by highly synchronous bursts of extraocular muscle activity in response to bone or air-conducted stimuli. Surface electromyography (EMG) electrodes can be used to record these responses which reflect utricular function. The traditional analysis of oVEMPs has been limited to time-domain waveform measurements, such as amplitude and latency of response peaks.

Recently, a method grounded in synchrony-based time-frequency analysis was successfully applied to cervical vestibular evoked myogenic potentials (cVEMPs) by Clinard et al. (2022). This approach to VEMP analysis can be used as a means to differentiate synchrony from amplitude, quantifying how phase …

The Relationship Between The Vestibulo-Ocular Reflex And Vestibular Perception In Trained Dancers Using Sinusoidal Harmonic Acceleration Testing, Diana Trinidad

Dissertations, 2020-current

Early studies have found that engaging in vestibular training, such as dance, may result in enhanced VOR suppression and changes in vestibular perception (e.g., lower sensations of vertigo) attributed to top-down modulation of subcortical neuronal networks and changes in the cerebellum. Dancers use spotting techniques to help control dizziness which involve holding their gaze on a visual object at eye level as they turn. As a result of this training, dancers become habituated to vestibular stimuli leading to lower VOR responses and decreased sensations of vertigo. This study investigated the relationship between the vestibulo-ocular reflex (VOR) and vestibular perception in …

Unmasking Masculinities In Counseling: From Conformity To Connection, Kyle R. Rose

Dissertations, 2020-current

This dissertation explored the entanglements of professional counseling and masculinities across three manuscripts, to contribute to (1) healthier forms of gender expression within and beyond the spectrum of masculinities for individuals, (2) the counseling profession’s role in transforming hegemonic masculinity within communities, and (3) larger movements to subvert the patriarchy throughout society. The first manuscript is a conceptual article that presented the Relational Cultural Privileged Identity Counseling (RCPIC) model, an integrative framework designed to help counselors address hegemonic masculinity within the therapeutic relationship. Drawing from Relational-Cultural Theory (RCT) and Privileged Identity Exploration (PIE), this model provided a roadmap for compassionate …

Burnout And Self-Efficacy: Exploring The Rewards And Challenges Faced By Crisis Counselors Working In Emergency Department Settings, Ellen Dotas

Dissertations, 2020-current

This dissertation explores burnout and self-efficacy in counselors who work with clients in crisis in emergency department settings. Mental health and emergency departments are two areas that tend to report higher levels of burnout than are reported in other occupational fields. While much research has been done on the topics of burnout and self-efficacy, limited information is available about counselors who work in these crisis roles. This dissertation follows a three-manuscript format and includes a conceptual, qualitative, and quantitative manuscript. The conceptual manuscript explores the nature of the crisis assessment itself, focusing on the area of risk assessment. The qualitative …

Intertrial Coherence As A Measure Of Synchrony In Ocular Vestibular Evoked Myogenic Potentials And The Effect Of Gaze Angle, Sydney Brown

Dissertations, 2020-current

Ocular vestibular evoked myogenic potentials (oVEMPs) are produced by highly synchronous bursts of extraocular muscle activity in response to stimuli. These responses reflect utricular function and can be recorded using surface electromyography electrodes. Traditional analysis of oVEMPs is limited to time-domain waveform measurements, such as amplitude and latency of response peaks. Objective synchrony-based measures have not yet been applied to the analysis of oVEMPs, particularly in the comparison of synchrony across gaze angles. We followed the new time-frequency method of analysis developed by Clinard et al. (2022) that was successfully applied to cervical VEMPs to quantify response synchrony. Air-conducted oVEMPs …

Establishing The Feasibility Of Sustained Sinusoidal Cervical Vestibular Evoked Myogenic Potentials In Young Adults, Ashton Fowlkes

Dissertations, 2020-current

Cervical vestibular evoked myogenic potentials (cVEMPs) are used in clinics and research to assess the function of primarily the saccule. cVEMPs are typically stimulated with transient clicks or tone bursts through air conduction and are recorded from the sternocleidomastoid (SCM) muscle. The SCM is contracted by turning the head either left or right. In this study, we used sustained sinusoidal bone conducted stimuli. Using this new stimulus method allowed us to look at the possibility of a sustained cVEMP response, compared to the typically recorded transient response, as well as analyze the amplitude and signal-to-noise ratio (SNR) of the responses. …

The Influence Of Intrinsic Foot Muscles In Modulating Foot Shape Relative To Substrate And The Efficacy Of Different Strengthening Approaches, Luke R. Lotsis

Masters Theses, 2020-current

Cross-sloped surfaces create an asymmetrical substrate for foot contact, introducing a slip force within the transverse plane and a gravitational pull within the coronal plane that increases the tendency to topple downslope. To maintain stability, the foot must make structural adjustments across the hindfoot, midfoot, forefoot, and hallux. In chapter 1, I investigated how IFMs respond to varying substrate conditions and balance demands, providing insight into their functional role in maintaining stability and adapting foot structure in static and dynamic locomotor tasks. Twenty-four healthy adults participated in a series of dynamic walking trials on flat, cross-sloped and sandy substrates and …

Implementing A Mindfulness Program To Reduce Burnout Rates, Nadine G. Kakanou

Walden Dissertations and Doctoral Studies

Walden University College of Nursing This is to certify that the doctoral study by Nadine Kakanou has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Sue Bell, Committee Chairperson, Nursing Faculty Dr. Mary Bemker Houghtaling, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Summary Burnout rates among mental healthcare workers remain a concern affected by the increasing demands of the profession and the COVID-19 pandemic. The identified practice gap among mental healthcare staff members at the northern …