Digital Commons Network^™

Prevalence Trend And Disparities In Rheumatoid Arthritis Among Us Adults, 2005–2018, Yingke Xu, Qing Wu

Public Health Faculty Publications

Rheumatoid arthritis (RA) trends among US adults and disparities in RA patients in recent years have not been well described. We aimed to examine the trend of RA prevalence and disparities among US adults. Data from the National Health and Nutrition Examination Survey (NHANES) of the years 2005–2018 were analyzed to examine the self-reported RA prevalence trend. Age-adjusted RA prevalence stratified by race/ethnicity and socioeconomic status (SES), as well as associated linear trends, were calculated for both genders. The multivariable adjustment was used to evaluate the association between race, SES, and RA. During 2005–2018, there was no significant linear trend …

Utility Of Multi-Theory Model (Mtm) To Explain The Intention For Pap Adherence In Newly Diagnosed Sleep Apnea Patients, Manoj Sharma, Anuj Chandra, Ryan Toth, Vinayak K. Nahar

Public Health Faculty Publications

Purpose: The objective of this study was to assess the utility of a fourth-generation multi-theory model (MTM) in explaining the intention for initiation and sustenance of PAP adherence among newly diagnosed sleep apnea patients.
Patients and Methods: For this cross-sectional study, data were collected at a private sleep center located in the Southeastern United States. A total of 138 newly diagnosed patients with sleep apnea who had been prescribed PAP therapy completed a valid and reliable 41-item MTM instrument. Stepwise multiple regression modeling was conducted to assess MTM based explanatory variables of PAP adherence in this study sample.
Results: MTM …

Changes In Depression And Physical Activity Among College Students On A Diverse Campus After A Covid-19 Stay-At-Home Order, Courtney Coughenour, Maxim Gakh, Jennifer R. Pharr, Timothy Bungum, Sharon Jalene

Public Health Faculty Publications

The numerous negative health impacts of COVID-19, which include expected changes to psychiatric illness and physical activity (PA), are disproportionately distributed in the United States. Mental illnesses and physical inactivity are prevalent among U.S. college students. This study examined whether there was a change in minutes of PA and depression scores after a stay-at-home order and examined predictors of these changes. An online survey was sent to all undergraduate and graduate students attending a large, diverse university via an electronic newsletter. The survey requested information about demographic and academic data, cardiorespiratory fitness, and depression symptoms. Paired t-tests and logistic regression …

Prevalence Of Depression, Anxiety, And Stress During Covid-19 Pandemic, Ram Lakhan, Amit Agrawal, Manoj Sharma

Public Health Faculty Publications

The coronavirus disease 2019 (COVID-19) crisis has greatly affected human lives across the world. Uncertainty and quarantine have been affecting people’s mental health. Estimations of mental health problems are needed immediately for the better planning and management of these concerns at a global level. A rapid scoping review was conducted to get the estimation of mental health problems in the COVID-19 pandemic during the first 7 months. Peer-reviewed, data-based journal articles published in the English language were searched in the PubMed, Medline, and Google Scholar electronic databases from December 2019 to June 2020. Papers that met the inclusion criteria were …

Motivations For Treatment Engagement In A Residential Substance Use Disorder Treatment Program: A Qualitative Study, Patrick J. Dillon, Satish K. Kedia, Oluwaseyi O. Isehunwa, Manoj Sharma

Public Health Faculty Publications

Aims: The aim of this study was to explore perspectives on motivations for treatment engagement from substance use disorder (SUD) clients in a long-term residential rehabilitation program. Design and Methods: A convenience sample of 30 clients who were enrolled in a year-long SUD treatment program at a residential rehabilitation facility took part in in-depth interviews. Interview transcripts were analyzed using the directed content analysis approach. Results: Participant accounts indicated that their treatment engagement was motivated by factors that aligned with the six primary constructs of the Health Belief Model: (i) perceived susceptibility (eg, believing that their substance use required intervention …

Sociodemographic Determinants Of Physical Activity And Sport Participation Among Women In The United States, Jennifer R. Pharr, Nancy L. Lough, Angela M. Terencio

Public Health Faculty Publications

Regular physical activity and sport participation have been shown to improve women’s health; however, research has found that better health is associated with sport participation. Little is known about the sociodemographic determinants of physical activity among women, especially among the different subcategories of physical activity (sport, conditioning exercise, recreation, and household tasks). Because of the added health benefits associated with sport participation, the purpose of this study was to examine the sociodemographic determinants among subcategories of physically active women in the United States by analyzing Behavioral Risk Factor Surveillance System (BRFSS) data. We used data from the 2017 national BRFSS …

Opioid Use Disorders And Hospital Palliative Care Among Patients With Gastrointestinal Cancers: Ten-Year Trend And Associated Factors In The U.S. From 2005 To 2014, Jinwook Hwang, Jay J. Shen, Sun Jung Kim, Sung-Youn Chun, Pearl C. Kim, Se Won Lee, David Byun, Ji Won Yoo

Public Health Faculty Publications

This study aimed to analyze the trends of opioid use disorders, cannabis use disorders, and palliative care among hospitalized patients with gastrointestinal cancer and to identify their associated factors. We analyzed the National Inpatient Sample data from 2005 to 2014 and included hospitalized patients with gastrointestinal cancers. The trends of hospital palliative care and opioid or cannabis use disorders were analyzed using the compound annual growth rates (CAGR) with Rao-Scott correction for χ2 tests. Multivariate logistic regression analyses were performed to identify the associated factors. From 2005 to 2014, among 4,364,416 hospitalizations of patients with gastrointestinal cancer, the average annual …

Learning From Transmasculine Experiences With Health Care: Tangible Inlets For Reducing Health Disparities Through Patient-Provider Relationships, Nickolas H. Lambrou, Katherine M. Cochran, Samantha Everhart, Jason D. Flatt, Megan Zuelsdorff, John B. O'Hara, Lance Weinhardt, Susan Flowers Benton, Carey E. Gleason

Public Health Faculty Publications

Purpose: We examined health care experiences of transmasculine young adults to clarify factors contributing to mistrust in the health care system and identify tangible and modifiable means to address health disparities through improved patient-provider interactions. Thematic analysis highlights patterns within historical relationships between medical models and transmasculine embodiment, and provides guidance for health care clinicians, researchers, and policy makers to deliver competent services for transgender and gender diverse (TGD) individuals. Methods: The study team used qualitative methodology guided by interpretive phenomenological analysis. Semistructured interviews with 12 participants who self-identified as transmasculine were conducted, transcribed, and coded thematically. Results: Participants were …

Decline In Telomere Length By Age And Effect Modification By Gender, Allostatic Load And Comorbidities In National Health And Nutrition Examination Survey (1999-2002), Saruna Ghimire, Carl V. Hill, Francisco S. Sy, Rachelle Rodriguez

Public Health Faculty Publications

Background: This study aims to assess the decline in telomere length (TL) with age and evaluate effect modification by gender, chronic stress, and comorbidity in a representative sample of the US population. Methods: Cross-sectional data on 7826 adults with a TL measurement, were included from the National Health and Nutrition Examination Survey, years 1999–2002. The population rate of decline in TL across 10-year age categories was estimated using crude and adjusted regression. Results: In an adjusted model, the population rate of decline in TL with age was consistent and linear for only three age categories: 20–29 (β = -0.0172, 95% …

The Impact Of Pedestrian Crossing Flags On Driver Yielding Behavior In Las Vegas, Nv, Sheila Clark, Courtney Coughenour, Kelly Bumgarner, Hanns De La Fuente-Mella, Chantel Reynolds, James Abelar

Public Health Faculty Publications

Walking is the most affordable, accessible, and environmentally friendly method of transportation. However, the risk of pedestrian injury or death from motor vehicle crashes is significant, particularly in sprawling metropolitan areas. The purpose of this study was to examine the effect of pedestrian crossing flags (PCFs) on driver yielding behaviors. Participants crossed a marked, midblock crosswalk on a multilane road in Las Vegas, Nevada, with and without PCFs, to determine if there were differences in driver yielding behaviors (n = 160 crossings). Trained observers recorded (1) the number of vehicles that passed in the nearest lane without yielding while the …

Analysis Of Self-Reported Walking For Transit In A Sprawling Urban Metropolitan Area In The Western U.S., Courtney Coughenour, Hanns De La Fuente-Mella, Alexander Paz

Public Health Faculty Publications

Walkability is associated with increased levels of physical activity and improved health and sustainability. The sprawling design of many metropolitan areas of the western U.S., such as Las Vegas, influences their walkability. The purpose of this study was to consider sprawl characteristics along with well-known correlates of walkability to determine what factors influence self-reported minutes of active transportation. Residents from four neighborhoods in the Las Vegas Metropolitan Area, targeted for their high and low walkability scores, were surveyed for their perceptions of street-connectivity, residential-density, land-use mix, and retail–floor-area ratio and sprawl characteristics including distance between crosswalks, single-entry-communities, high-speed streets, shade, …

Practice And Lived Experience Of Menstrual Exiles (Chhaupadi) Among Adolescent Girls In Far Western Nepal. December 2018, Prabisha Amatya, Saruna Ghimire, Karen E. Callahan, Binaya Kumar Baral, Krishna C. Poudel

Public Health Faculty Publications

Background: Menstrual exile, also known as Chhaupadi, is a tradition of “untouchability” in far-western Nepal. Forbidden from touching other people and objects, women and girls are required to live away from the community, typically in a livestock shed, during menstruation. We assessed the lived experiences of Chhaupadi among Nepalese adolescent girls in the far-western Achham district of Nepal, observed the safety and sanitation of their living spaces during Chhaupadi, and assessed the perceptions of local adult stakeholders towards the practice of Chhaupadi. Methods: We collected data from 107 adolescent girls using a self-administered survey in two local schools in Achham. …

Perceived Walkability, Social Capital, And Self-Reported Physical Activity In Las Vegas College Students, Melissa Bartshe, Courtney Coughenour, Jennifer Pharr

Public Health Faculty Publications

College students are an understudied, vulnerable population, whose inactivity rates exceed those reported by U.S. adults. Walkability in sprawling cities, such as Las Vegas, is challenged due to automobile-oriented development. The purpose of this study was to assess the relationship between perceived neighborhood walkability, social capital, and meeting physical activity recommendations among University of Nevada-Las Vegas college students. Of the 410 participants, 42.2% met physical activity recommendations, 77.1% were female, 37.3% were white, and 79.5% owned a vehicle. Logistic regression showed that social capital (odds ratio (OR) = 1.25, p = 0.04) and gender... (see full text for full abstract

Lagged Influence Of Fine Particulate Matter And Geographic Disparities On Clinic Visits For Children’S Asthma In Taiwan, Lung-Chang Chien, Yu-An Chen, Hwa-Lung Yu

Public Health Faculty Publications

Recent studies have revealed the influence of fine particulate matter (PM2.5) on increased medication use, hospital admission, and emergency room visits for asthma attack in children, but the lagged influence of PM2.5 on children’s asthma and geographic disparities of children’s asthma have rarely been discussed simultaneously. This study investigated the documented diagnosis of children’s asthma in clinic visits for children aged less than 15 years old that were associated with PM2.5 in two counties located in west-central Taiwan during 2005–2010. The result shows that PM2.5 had a significant lagged effect on children’s asthma for up to 6 days. A significantly …

Reliability Of Self-Reported Mobile Phone Ownership In Rural North-Central Nigeria: Cross-Sectional Study, William Nii Ayitey Menson Md, Phd, John Olajide Olawepo Msc, Md, Tamara Bruno Mph, Semiu Olatunde Gbadamosi Md, Mph, Nannim Fazing Nalda Mph, Victor Anyebe Md, Amaka Ogidi Med, Chima Onoka Mph, Phd, Md, John Okpanachi Oko Md, Echezona Edozie Ezeanolue Md, Mph

Public Health Faculty Publications

Background: Health practitioners seek to leverage the ubiquity of the mobile phone to increase the impact and robustness of their interventions, particularly in resource-limited settings. However, data on the reliability of self-reported mobile phone access is minimal. Objective: We sought to ascertain the reliability of self-reported ownership of and access to mobile phones among a population of rural dwellers in north-central Nigeria. Methods: We contacted participants in a community-based HIV testing program by phone to determine actual as opposed to self-reported mobile phone access. ...(Please see full text for complete abstract)

The Relationship Between Sport Participation And Chronic Diseases Among Men In The Usa: An Examination Of The Behavioral Risk Factor Surveillance System, Jennifer Pharr, Nancy L. Lough

Public Health Faculty Publications

Sport participation has been associated with lower rates of chronic diseases when compared to other forms of physical activity (PA) among women. However, we do not know if this relationship holds true for men. The purpose of this study was to examine the relationship between sport participation and men’s health and chronic diseases in the USA. This study was a secondary data analysis of the 2015 national Behavioral Risk Factor Surveillance System (BRFSS) survey. Participants were questioned extensively about their PA behaviors. Seventy-six different activities were identified and these activities were categorized as sport, conditioning exercise, recreation, or household tasks …

Nutritional Assessment Of Community-Dwelling Older Adults In Rural Nepal, Saruna Ghimire, Binaya Kurmar Baral, Karen E. Callahan

Public Health Faculty Publications

Demographic transition in Nepal, like in many developing countries, has resulted in a burgeoning elderly population whose health status is not currently monitored. One pillar of health is adequate nutrition. Yet, little is known about the nutritional health status of the elderly in Nepal. The financial, material, and personnel limitations in Nepal’s health delivery services necessitate health screening instruments that require minimal clinical staff and resources. To our knowledge, no such nutritional assessment tool has been validated in Nepal. Therefore, our aims are two-fold: To assess the nutritional status of the elderly population in one typical Nepali village, Okharpauwa, in …

Childhood Health Status And Adulthood Cardiovascular Disease Morbidity In Rural China: Are They Related?, Qing Wang, Jay Shen

Public Health Faculty Publications

Cardiovascular diseases (CVDs) are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS), a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on …

Unemployment Rate, Smoking In China: Are They Related?, Qing Wang, Jay Shen, Christopher R. Cochran

Public Health Faculty Publications

Background: Studies on the relationship between unemployment rate and smoking have yielded mixed results. The issue in China has not been studied. This study aims to examine the influence of unemployment rate on smoking in China. Methods: Logit model and two-stage least squares (2SLS) estimation were used to estimate the effects. Estimations were done for 4585 individual over 45 using data from China Health and Retirement Longitudinal Study conducted in Zhejiang and Gansu provinces in 2008 and 2012. Results: A percent increase in the unemployment rate resulted in the increase in the likelihood of smoking by a combined 9.1 percent …

Culture, Caregiving, And Health: Exploring The Influence Of Culture On Family Caregiver Experiences, Jennifer Pharr, Carolee Dodge Francis, Christine Terry, Michele Clark

Public Health Faculty Publications

Ethnic minorities are expected to experience a greater demand for family caregiving than non-Latino Whites due to their projected population growth. Although the consensus of researchers on caregiving and culture finds that the caregiving experience differs significantly among cultural/ethnic groups, the question remains as to how cultural values and norms influence the caregiver experiences. We conducted an interpretative, phenomenological qualitative analysis of focus group transcripts from four groups (African American, Asian American, Hispanic American, and European American) for cultural influences on caregiving. Data were collected in Nevada between December 7, 2009, and August 20, 2010. Thirty-five caregivers participated in this …

Health Effects Associated With Foreclosure: A Secondary Analysis Of Hospital Discharge Data, Nancy N. Menzel, Sheniz Moonie, Melva V. Thompson-Robinson

Public Health Faculty Publications

Objectives. The purpose of this study was to assess the health effects of high home foreclosure rates in an area of the United States of America and the utility of hospital discharge data for this purpose. Methods.We analyzed hospital discharge data from three postal zip codes using the principal diagnosis for 25 Diagnostic Related Groups associated with stress. Descriptive statistics were used to characterize hospital discharge rates for each condition by year and zip code. To test for differences across time, the Cochran-Armitage trend test was performed. Results. Most conditions did not demonstrate a statistical change between 2005 and 2008. …

The Impact Of Unemployment On Mental And Physical Health, Access To Health Care And Health Risk Behaviors, Jennifer Renee Pharr, Sheniz Moonie, Timothy J. Bungum

Public Health Faculty Publications

The purpose of this study was to examine the impact of employment status and unemployment duration on perceived health, access to health care, and health risk behaviors. Data from Nevada's 2009 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. We compared participants who were unemployed (greater than and less than one year) to those who were employed and those who were voluntarily out of the labor force (OLF). Unemployed participants had significantly worse perceived mental health profiles, were more likely to delay health care services due to cost, and were less likely to have access to health care than employed …

Health Disparities Experienced By People With Disabilities In The United States: A Behavioral Risk Factor Surveillance System Study, Jennifer Renee Pharr, Timothy J. Bungum

Public Health Faculty Publications

The Americans with Disabilities Act became law in 1990; since then research has shown that people with disabilities continue to experience barriers to health care. The purpose of this study was to compare utilization of preventive services, chronic disease rates, and engagement in health risk behaviors of participants with differing severities of disabilities to those without disabilities. This study was a secondary analysis of 2010 data collected in the Behavioral Risk Factor Surveillance System national survey in the United States. Rao Chi square test and logistic regression were employed. Participants with disabilities had significantly higher adjusted odds ratios for all …

Injury In Nevada, Michelle Chino, Jonathon Lavalley, Darlene R. Haff, Deborah A. Harris, Andrea R. Rivers

Public Health Faculty Publications

Injury is a major threat to health and safety. In a typical day in the US, 400 people will die as the result of an injury, 7,500 will be hospitalized due to an injury, and more than 150,000 will suffer an injury severe enough to restrict activities and seek medical attention. Many of these deaths, hospitalizations, and disabling events will be the result of motor vehicle crashes. Others will result from vio­lence, falls, drowning, and poisoning – all of which are considered injuries.

The costs of injury are high. In the United States, the cost of injuries is estimated to …

Indigenous Health – Australia, Canada, New Zealand And The United States - Laying Claim To A Future That Embraces Health For Us All., Lisa Jackson Pulver, Melissa R. Haswell, Ian Ring, John Waldon, Wayne Clark, Valorie Whetung, Dianne Kinnon, Catherine Graham, Michelle Chino, Jonathon Lavalley, Christina Compher, Ritu Sadana

Public Health Faculty Publications

Improving the health of all peoples has been a call across the globe for many decades and unfortunately remains relevant today, particularly given the large disparities in health status of peoples found around the world. Rather than differences in health, or health inequalities, we use a different term, health inequities. This is so as mere differences in health (or "inequalities") can be common in societies and do not necessarily reflect unfair social policies or practices. For example, natural ageing implies older people are more prone to illness. Yet, when differences are systematic, socially produced and unfair, these are considered health …

Acquired Immuno-Deficiency Syndrome (Aids) And Human Immuno-Deficiency Virus (Hiv) In Nevada – Annual Surveillance Report (1999), Mary Guinan, Nancy Kreher, Drew Mather, Wei Yang

Public Health Faculty Publications

Background:

Acquired Immuno-Deficiency Syndrome (AIDS) is the most severe manifestation of Human Immunodeficiency Virus (HIV) infection. AIDS was first reported in the world in 1981 by the Centers for Disease Control and Prevention. Statewide surveillance for AIDS was begun in 1982. Because the cause of AIDS was unknown at that time, the surveillance case definition included many opportunistic infections and tumors. Persons with AIDS were noted to have abnormalities in their immune system that left them susceptible to certain infections. As more information became available, the AIDS surveillance case definition was modified.

In 1984, HIV was found to be the …

Three Cheers For Elective Hysterectomy, Mary Guinan

Public Health Faculty Publications

Hysterectomy is the second (after cesarean section) most commonly performed major surgical procedure in the United States today.1 About [650,000 American women will have hysterectomies in 1989. Thirty-seven percent of all US women will have had a hysterectomy by the time they reach age 60. The number of hysterectomies increased dramatically Born 1965 to 1975, but then leveled off and decreased to the present level of about 7 per 1000 women. The ~ghest rates occur in women aged 35 to 44 years, the age group the so called baby boomers are now entering in large numbers. Therefore, if the age-specific …

Virginity And Celibacy As Health Issues, Mary Guinan

Public Health Faculty Publications

Sexual behavior is both a health issue and a moral issue. Hence public education on sexuality has traditionally come from two main sources, those individuals or groups concerned with health and those concerned with morals. In his book No Magic Bullet (Oxford University Press, 1985), Allan Brandt describes the tensions that developed between these groups over the control of sexually transmitted diseases in the United States early in this century. Both groups wanted to control sexual behavior, but for different reasons. Public health personnel wanted to change sexual behavior in order to control infection and disease, while moralists believed that …