Medicine and Health Sciences Commons^™

Staff Education Program On The Vanderbilt Adhd Diagnostic Rating Scale, Rabiatu Bangura

Walden Dissertations and Doctoral Studies

This DNP project evaluated the effectiveness of a structured staff education program designed to enhance healthcare professionals’ knowledge and utilization of the Vanderbilt ADHD Assessment Scale (VAS) in children aged ≥2 to ≤18 years. The practice problem addressed in this project was the inconsistent use and limited knowledge of the VAS among healthcare staff, which can lead to underdiagnosis or delayed diagnosis. The practice-focused question was: Will a staff education program specifically designed to instruct healthcare professionals on using the Vanderbilt ADHD Assessment Scale in children ≥2 years to ≤18 years increase their knowledge? Targeted educational sessions were implemented, and …

Intimate Partner Violence Prevention And Intervention At A Primary Care Clinic, Atticus Madrid

Master's Projects and Capstones

Abstract

Intimate partner violence (IPV) is a massive health concern in the Spanish-speaking community. There is a high rate IPV, worsening by factors such as language barriers, cultural stigma, and the constant fear of deportation. Resent data underscores the need for standardized IPV screening and trauma-informed care, thus supporting early recognition and intervention. The aim of this Quality Improvement (QI) project is to increase IPV detection rate by 25% from March 10, 2025, to April 15, 2025, in an San Francisco community clinic using an electronic tool called a HITS (Hurt, Insult, Threaten, Scream) and by trauma-informed staff training. Methods …

Ehealth For Older Adults: Building Digital Confidence For Better Health, Alejandra M. Fernandez

Master's Projects and Capstones

Abstract

Problem The healthcare field is becoming more technologically advanced than ever before, the older adults are often left behind due to decreased technology literacy. The quality improvement project revolves around enhancing the digital health literacy of older adults at Facility A a low income independent living facility in the greater San Francisco Bay Area. The technology workshops are imperative to improve the digital divide that older adults are experiencing. Aim The goal of the workshops is to improve the confidence of older adults through weekly workshops that were conducted over a six week period where they were instructed on …

Unlv Department Of Physical Therapy And The Fine Arts Clinic For Health And Injury Prevention, Madeline Cosgrove, Ashton Johnson, Keith Lopez, Diana Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

At the collegiate of performing arts, those who participate in classes and performances will often be at risk for musculoskeletal injury due to repetition and specific patterns of their movements. The establishment of a pro-bono physical therapy clinic for students enrolled in undergraduate and graduate-level fine arts programs may improve healthcare access for this often underserved community. The goals of this service learning project were to provide injury-prevention screenings to dancers and administer specialized physical therapy (PT) services in the form of evaluations and treatments to all students in the UNLV (University of Las Vegas, Nevada) College of Fine Arts …

The Effect Of Amputation And Prosthesis Use On The Ability To Differentiate Between Surfaces Underfoot, Allen Paul F. Aquino, Bradley C. Belasco, Kara D. Hlebak, Amanda B. Lewin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/ Purpose: There is limited understanding of how the sensory deficits associated with lower limb amputation (LLA) impact mobility during daily life. As a first step to developing this understanding, the aim of this study was to determine to what extent people with LLA can identify differences in commonly encountered walking surfaces beneath their feet. We hypothesized that people with LLA would demonstrate a poorer ability to discriminate between different surfaces than people without an amputation, and that discrimination ability would be surface characteristic-specific; discrimination would be poor for roughness discrimination due to the lack of plantar sensation in the …

Feasibility And Acceptability Of Tap Dance As A Therapeutic Intervention For Adults With Lower Limb Amputation: A Pilot Study, Julianne Roser, Allison Strande, Bailey Taggart

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objectives: This study aimed to evaluate the feasibility, acceptability, and potential efficacy of an 8-week adapted tap dance program as a therapeutic intervention for individuals with lower limb amputation (LLA).

Methods

Three participants with LLA (two with unilateral transfemoral amputation and one with bilateral transtibial amputations) attended weekly 1-hour tap dance classes, with movements adapted for their needs and mobility aids and dance barres available as needed. The Physical Activity Enjoyment Scale (PACES) and participant feedback assessed acceptability. Functional mobility, balance and quality of life were measured using the Activities-Specific Balance Confidence (ABC) scale, Timed Up-and-Go (TUG), Berg Balance Scale …

Effects Of Altered Somatosensory Input On Gait Kinetics And Kinematics Via Different Footwear In Individuals With Chronic Post-Stroke Hemiparesis, Daniela Casillas, Lesley Ruiz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Individuals with post-stroke hemiparesis walk with significant asymmetries, leading to slow, effortful walking, and a high risk of falls. One contributing factor is altered sensation on the plantar surface. Studies examining altered somatosensory input via insoles, vibration and other tactile stimuli observed improvements in hemiparesis gait. This study investigates whether altering somatosensory input through different footwear can affect kinetics, kinematics and muscle activity during walking post-stroke. We hypothesized the barefoot conditions would have increased dorsiflexion (heel-strike, swing), increased plantarflexion during toe-off, increased muscle activity and kinetics, compared to memory foam conditions.

Participants: 13 individuals with chronic post-stroke hemiparesis (4F/9M, …

Empowering Educators To Improve Social Emotional Behaviors Among K-8 Students: Quality Improvement Project, Paige Yael Bister

UNLV Theses, Dissertations, Professional Papers, and Capstones

Social and emotional learning (SEL) encompasses essential skills for effectively managing and expressing emotions. Studies have shown that SEL strengthens early education while supporting students' lifelong success by fostering positive behaviors within and beyond the classroom. In school settings, occupational therapists (OTs) aim to empower children to thrive as students and as social beings through targeted interventions and educational support for parents and teachers. In private school settings, limited access to occupational therapy services may impact teachers' ability to implement SEL strategies effectively.This capstone project addressed gaps in teachers' knowledge and confidence in applying the Zones of Regulation SEL curriculum …

Efficacy Of Dorsal Application Of Kt For Carpal Tunnel Syndrome In Esport Gamers: A Randomized Clinical Trial, Anthony Foreman

UNLV Theses, Dissertations, Professional Papers, and Capstones

This doctoral study investigated the impact of the dorsal application of kinesiotape on carpal tunnel syndrome (CTS) symptoms and performance among Esport gamers. The study was conducted in controlled environments at the UNLV Esports Lounge, Black Fire Innovation, and the Musculoskeletal Lab using a randomized two-group pretest-posttest design. To maintain ecological validity, participants were permitted to use personally owned gaming peripherals (e.g., computer mouse), and all received brief instruction on proper body mechanics to promote consistency during testing. Participants (n = 11) were systematically assigned by order of registration to either an intervention group receiving dorsal application of kinesiotape on …

Piloting The Inclusion Of Dollar Stores In The Modified Retail Food Environment Index (Mrfei) In Urban Clark County, Nevada, Tiana T. Tu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity is the condition of having limited or uncertain access to adequate food. It contributes to poor diet-related health outcomes which are in turn influenced by the food environment. The Centers for Disease Control and Prevention (CDC) developed the Modified Retail Food Environment Index (mRFEI) to characterize food environments by measuring the proportion of healthy and non-healthy retailers. The CDC mRFEI considers a variety of establishments but fails to include dollar stores, which contribute to the food environment by offering food and, in some cases, fresh produce. This study proposed an “expanded mRFEI” that modified the CDC mRFEI methodology …

Enhancing Motor Function In Individuals With Lower Limb Amputation Through Peerbased Learning Of Balance And Fall Recovery Skills, Zoe Castle, Jer Ja Chuang, Jewel Granados, Danna Shaw

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: Lower limb amputation (LLA) is a devastating condition that is becoming more prevalent in the United States. We examined the effects of peer-based action observation learning on the brain activation and the eyetracking pattern in individuals with LLA.

Methods: Fourteen individuals with LLA (51.9±12.6 years, 4 females, 9 with transfemoral amputations) were asked to learn a balance task through observing the movements demonstrated by individuals with LLA or persons with intact limbs. Electroencephalogram (EEG) signals, visual attention time, and peak saccade velocity were recorded when participants watched the demonstration videos. Power spectral density (PSD) was used to analyze the …

Secondary Educators’ Knowledge And Perceptions Of Their Own Self-Efficacy As It Relates To 504 Plan Accommodations For Students Diagnosed With Adhd, Anne Richardson

Seton Hall University Dissertations and Theses (ETDs)

This study investigated the role of Section 504 accommodations in meeting the needs of secondary students with attention-deficit/hyperactivity disorder (ADHD) in the United States. While legislation requires equitable education for students with disabilities, gaps remain in understanding how educators perceive their own abilities in implementing Section 504 plans for students with ADHD. The study used a qualitative research design to explore the academic and organizational challenges faced by secondary school students with ADHD, specifically examining the knowledge, perceptions, and self-efficacy of secondary educators regarding ADHD strategies and 504 plan accommodations. Semi-structured interviews were conducted via Zoom with 11 educators from …

Role Of The Pediatric Rdn In Conducting The Pediatric Nutrition Focused Physical Exam: Training, Clinical Practice And Barriers, Sarah M. Kowalewski

Masters Theses, 2020-current

Abstract:

Background: The pediatric nutrition focused physical exam (PNFPE) is important for completing comprehensive assessment in pediatric patients, particularly those at risk for malnutrition. The PNFPE helps to identify the depletion of fat and muscle stores, as well as micronutrient deficiencies.

Methods: Pediatric RDNs, self-identified through CDR and practice group membership, were surveyed-to investigate their training, clinical practice, documentation, and barriers to use of the PNFPE. The survey instrument, validated by content experts and analyzed for reliability, was approved by our university’s IRB.

Results: A total of 65.8% of respondents held a graduate degree and 81.6% held a specialty certification. …

Comparison Of Gluteal Muscle Central Activation In Individuals With And Without Patellofemoral Pain, Michael Carpio, John S. Donohue, Jacob P. Kissman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Individuals with patellofemoral pain (PFP) often present with knee valgus during weight-bearing activities. Weakness in the gluteal muscles is thought to contribute to this condition, but recent studies suggest that hip weakness might be a secondary problem in this population. Central nervous system adaptations have been noted in persons with PFP, which can lead to altered muscle function, faulty movement patterns, and poor function. Experimentally, central activation can be quantified by a central activation ratio (CAR) via superimposed burst (SIB) during a maximum voluntary isometric contraction (MVIC) where the ratio of volitionally activated motor units to total motor units …

Lower Limb Loss Related Physical Therapy Outcome Measures: A Scoping Review, Cassandra Evergreen, Harrison Hess, Ryan Orton

UNLV Theses, Dissertations, Professional Papers, and Capstones

This scoping review aims to explore the use of performance-based outcome measures (PBOMs) and patient-reported outcome measures (PROMs) in assessing the function of individuals with lower limb loss (LLL). The review identified common PBOMs, such as the 6- and 2-minute walk tests, Timed Up and Go (TUG), and Amputee Mobility Predictor (AMP), which evaluate mobility and overall physical function. PROMs, like the Prosthesis Evaluation Questionnaire (PEQ), focus on the prosthetic experience, including comfort, satisfaction, and quality of life. Both PBOMs and PROMs assess patient function, yet with differing emphases; PBOMs primarily evaluate physical performance while PROMs capture broader health attributes, …

The Effects Of Sugar Alcohols On The Growth Of Cariogenic Bacteria, Jake Sanders Boone

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to examine the potential of sugar alcohols, commonly used as sugar substitutes to reduce the activity of dental caries causing bacteria. Specifically, the sugar alcohols xylitol, erythritol, sorbitol, and mannitol were placed into the growth media of Streptococcus mutans and Lactobacillus acidophilus. The effects on their bacterial growth were observed. 10% xylitol, 10% erythritol, 10% sorbitol, 10% mannitol, 5% xylitol + 5% erythritol, and 3.3% erythritol + 3.3% xylitol + 3.3% sorbitol combinations were compared to the control groups for differences in bacterial growth. S. mutans samples were significantly inhibited by all groups except …

Accelerating Initial Cardiac Arrest Response In Medical-Surgical Nurses Through Virtual Reality Training, Carissa A. Hernandez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Through their limited exposure, non-critical care nurses may feel unprepared to respond when faced with a sudden emergency such as cardiac arrest. This Quality Improvement (QI) project employed virtual reality (VR) technology to improve nurse confidence, adherence to the American Heart Association (AHA) basic life support (BLS) algorithm, and documentation accuracy among medical-surgical nurses in a Veterans Affairs hospital in Nevada. The project addressed their ability to react promptly and effectively during these high-stakes emergencies. Methods: Following a scoping literature review from the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, and PubMed databases, this Evidence Based …

Enhancing Documentation Proficiency: Feasibility Of Integrating Ehr Go & Unfolding Case Studies In Occupational Therapy Education, Jeffery D. Holland Jr.

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: This capstone project evaluated the feasibility of integrating EHR Go and Unfolding Case Studies (UCS) into the first-year curriculum of the University of Nevada, Las Vegas (UNLV) Occupational Therapy Doctorate (OTD) program. The goal was to enhance students’ SOAP (Subjective, Objective, Assessment, Plan) note documentation proficiency and critical thinking skills through simulation-based learning and increased exposure to real-world documentation expectations and examples. Feedback from 33 clinicians at Dignity Health St. Rose Dominican Hospital – Siena Campus informed the workshop design, and OTD faculty and graduate assistants at UNLV provided input on curriculum integration feasibility.Methods: A quasi-experimental, non-equivalent groups pretest-posttest …

Clinical Benefit Analysis Of Modified Motion Management Protocols, Dyanne S. Macalinao

UNLV Theses, Dissertations, Professional Papers, and Capstones

Radiation therapy is crucial for treating cancer, using ionizing radiation to target and destroy cancer cells. This radiation is produced by machines like linear accelerators or through natural radioactive decay. Radiation therapy treatment planning involves prescribing doses and contouring target areas. However, managing tumors that move with breathing, such as in the lungs, remains a major challenge. Tumor motion exceeding 5 mm, as outlined in the AAPM’s Task Group 76, can compromise treatment accuracy, risking underdosing the tumor and overdosing healthy tissue. This issue is especially critical in high dose treatments like stereotactic body radiation therapy (SBRT). TG-76 provides different …

“Do You Even Lift, Bro?”: Correlates Of Muscle Dysmorphia Symptomatology In Filipino Male University Students, Pamela Paula C. Pioquinto

UNLV Theses, Dissertations, Professional Papers, and Capstones

Muscle Dysmorphia (MD) is a subtype of Body Dysmorphic Disorder (BDD) and is marked by the desire to increase muscularity and reduce body fat. MD is typically more prevalent among younger male populations, and it often drives comorbid disorders, including substance abuse, eating disorders, and social anxiety. Despite the growing literature on MD, it remains understudied in certain racial/ethnic populations, such as Filipinos. Acculturation, defined as the process in which an individual adopts, acquires, and adapts to a new cultural environment as a result of immigration, influences body image by reshaping an individual’s perceptions of beauty and muscularity standards. Guided …

How Returning To Work And Sense Of Belonging Influence Acquired Brain Injury Survivors: A Descriptive Case Study, Shaina Saribay-Talana

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose. This capstone project explored the experiences of an individual with acquired brain injury (ABI) returning to work (RTW), highlighting their sense of belonging (SoB) in the workplace. While literature emphasizes SoB's importance for mental health and quality of life, its impact on workplace reintegration for ABI individuals is underexplored. This project intended to address the gap in understanding ABI individuals' workplace belonging, potentially enhancing OT practices and outcomes for reintegration.Methods. A descriptive single case study approach using a qualitative phenomenology methodology, including semi-structured interviews and site observations, was used to gather insights from an individual who has re-entered the …

Clinical Decision Making In Pelvic Floor Therapy The Ot Difference, Diana Sisorova

UNLV Theses, Dissertations, Professional Papers, and Capstones

Pelvic floor dysfunction (PFD) is a life-altering and debilitating chronic condition that affects 28 millions of women in the United States alone, the prevalence of (PFD) among women ranges from 11.5% to 35%, (Radzimińska et al., 2017; Wu et al., 2009). This study affirms how occupational therapy practitioners can be essential resource in treating pelvic floor dysfunction from a holistic perspective by addressing the wide range of activities of daily living (ADL) and instrumental activities of daily living (IADL) impacted by pelvic floor dysfunction, particularly in women. Through a qualitative descriptive case study and a single key informant—an occupational therapist …

Associations Of The Medicaid Expansion Policy With Racial/Ethnic Disparities In Breast Cancer Screening And Treatment, James Howard Smith Ii

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Aim. This dissertation examines Medicaid expansion’s effect on breast cancer (BC) screening and treatment disparities in two Medicaid-expanding states (MES) that passed Medicaid expansion (New Jersey and Vermont) relative to two non-expansion states (NES) (Georgia and Wisconsin). It then compares the association of Medicaid expansion to other states that did not undertake this policy on various subgroups, such as minorities by race and ethnicity, income, and age groups. Black women still bear significant BC disparities due to untimely screenings, treatments, and deaths. Therefore, it is critical to investigate how socioeconomic status influences racial/ethnic disparity gaps, given that BC …

Less Pain, More Game: Red Kinesiology Tape On Carpal Tunnel Syndrome And Occupational Performance In Fps Esports, Sarah Ashley Taing

UNLV Theses, Dissertations, Professional Papers, and Capstones

Esports encompasses competitive video gaming, requiring tactical, mental, and physical skills. It offers benefits like improved cognition and social inclusion but poses risks such as musculoskeletal disorders (MSD) from repetitive movements. Prolonged gaming can lead to Carpal Tunnel Syndrome (CTS), with symptom severity correlating with gaming duration (Bibi & Khan, 2019; Basuodan et al., 2023). Kinesiology tape (KT), a treatment used for decades, shows promise for pain relief and functional improvement (Kase et al., 2013). Developed in 1973 by Kase, KT increases circulation, reduces pain, and improves joint stability, though its effectiveness remains ambiguous. Additionally, the psychosocial impact of tape …

Rebuilding Father-Child Bonds: Group Therapeutic Writing For Fathers Transitioning From Incarceration, Lynne Truong

UNLV Theses, Dissertations, Professional Papers, and Capstones

This project was a group therapeutic writing (TW) workshop that was an addition to the existing program at Hope for Prisoners (HFP) to facilitate self-awareness of father-children relationship for fathers who are previously incarcerated. This doctoral capstone project assessed the impact of a group therapeutic writing workshop led by the occupational therapist capstone student on emotional awareness, self-reflection, and communication skills among previously incarcerated fathers. The program aimed at helping fathers who were incarcerated in rebuilding relationships with their children by enhancing confidence, self-awareness, and emotional expression. The four-week therapeutic writing program provided the emotional and relational needs of participants …

Emerging Adult Gamers: Nutritional Insights On Dietary Intake, Physical Well-Being, And Occupational Performance, Justine Dualan Tuason

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study aimed to gather insights from Emerging Adult (EA) gamers (between 18 and 24) regarding their nutritional literacy, dietary patterns, and its potential impacts on their occupational performance and physical well-being. There is a need to gather gamers' perspectives to identify the specific facilitators and barriers regarding their ability to discern appropriate dietary choices, as it provides more information regarding preventative and client-centered measures for future healthcare professionals. Occupational Therapists (OTs) are uniquely equipped to address this population's needs, as the profession's holistic principles allow for a well-rounded and sustainable approach. Additionally, growing emphasis is placed on preventative rather …

Implementing Standardized Intimate Partner Violence Screening In A Predominantly Latinx Community Health Center: Enhancing Detection Through Ehr Integration And Staff Education, Sophia Robledo

Master's Projects and Capstones

Intimate partner violence (IPV) is a major public health concern that often goes unrecognized in clinical settings. Although national guidelines recommend routine screening, inconsistent practices and lack of staff training remain common issues. This quality improvement project was conducted in an adult outpatient clinic serving a predominantly Latinx population. To address the gap in IPV screening, an educational brochure and short slide presentation were developed for medical assistants. These tools focused on how to recognize signs of IPV, use trauma-informed language, and respond appropriately using the Hurt Insult Threat Scream (HITS) screening tool. The intervention aimed to increase awareness and …

More Than A Diagnosis: Elevating Person-Centered Care In The Surgical Intensive Care Unit Through Personalized Communication Boards, Sierra B. Poe

Master's Projects and Capstones

Objective: Intensive care units are associated with complex care and high acuity interventions, however, there is a potential for dehumanization of patients. With the focus being placed on life-saving interventions, many patients and their family members feel that they are not being treated beyond their medical diagnosis. Aim: This quality improvement project aims to address these barriers in care by designing and implementing communication whiteboards in the surgical intensive care unit (SICU) at Hospital A to enhance patient and family-centered care, improve patient satisfaction, and enhance interdisciplinary communication. Post-implementation, the goal was to increase utilization of the standardized whiteboards from …

Enhancing Bedside Mobility Assessment Tool (Bmat 2.0) Competency To Promote Early Mobilization, Ensure Patient Safety, And Maximize Health Outcomes, Shaun C. Cunanan

Master's Projects and Capstones

Objective: Immobility among hospitalized patients is linked to serious complications, including muscle deconditioning, increased risk of falls, and functional decline, particularly in older adults (Boynton et al., 2020). Early mobility interventions can help mitigate these risks and improve patient outcomes (Gabele et al., 2023). Context: The Bedside Mobility Assessment Tool (BMAT 2.0) is a standardized tool designed to assess patient mobility and guide safe mobilization practices. In two medical-surgical units (endocrine and stroke) of a 200+ bed general acute care hospital in Northern California, only 31.4% of staff reported being knowledgeable about BMAT 2.0. This quality improvement project aimed to …

Bridging The Gap In Early Mobilization: Implementing The Bmat 2.0 To Enhance Patient Care And Outcomes, Elyas Gul

Master's Projects and Capstones

Objective: Early mobilization of patients is correlated to enhanced functional recovery (Zhang et al., 2019), decreased hospital stays (Zhang et al., 2019), and a reduction in healthcare costs (Liu et al., 2019). Unfortunately, inconsistency in hospital staff training and an absence of mobility assessment standardization have served as barriers to successful implementation. Aim: This quality improvement project aims to increase the percentage of RNs and CNAs who effectively use the BMAT 2.0 to promote early mobilization of medical-surgical endocrine and stroke patients by 20%, from 31.4% to 51.4% by April 22, 2025. The project will occur during a 12-week …