Digital Commons Network^™

Serum Nutrient Levels And Aging Effects On Periodontitis, Jeffrey L. Ebersole, Joshua Lambert, Heather Bush, Pinar Emecen Huja, Arpita Basu

Dental Medicine Faculty Publications

Periodontal disease damages tissues as a result of dysregulated host responses against the chronic bacterial biofilm insult and approximately 50% of US adults >30 years old exhibit periodontitis. The association of five blood nutrients and periodontitis were evaluated due to our previous findings regarding a potential protective effect for these nutrients in periodontal disease derived from the US population sampled as part of the National Health and Nutrition Examination Survey (1999–2004). Data from over 15,000 subjects was analyzed for blood levels of cis-β-carotene, β-cryptoxanthin, folate, vitamin D, and vitamin E, linked with analysis of the presence and severity of periodontitis. …

Associations Between Opioid-Related Hospitalizations And Intravenous Drug Users, Jacklynn De Leon

UNLV Theses, Dissertations, Professional Papers, and Capstones

The opioid epidemic has led to a chain reaction of public health concerns, including an increase in heroin usage, injection drug abuse, incidence of hepatitis C virus (HCV), and HIV transmission. There have been few population-based studies investigating the clinical and socio- demographic data associated with opioid use in Nevada (Feng et al., 2016; Frank, 2000) and few studies investigating the intravenous drug user (IDU) population in Clark County. On February 2017, Clark County’s first syringe exchange program (SEP) opened its doors to the IDU population. This study provides an updated analysis of opioid-related injuries within Nevada and provides a …

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. …

The Privilege Of Healthy Eating: A Qualitative Study Exploring The Local Food Choices Of Low-Income Families From Appalachia, Iryna Sharaievska Dr., Stephanie West Dr., Melissa Weddell Dr.

Journal of Health Disparities Research and Practice

Using qualitative semi-structured interviews, 15 low-income women of different ages were asked to discuss their perceptions of healthy eating, local farmers’ markets, as well as their visitation of farmers’ markets. The participants were also asked to share what features of farmers’ markets they found appealing. The results showed that most of the participants had either a deep or moderate understanding of what it means to eat healthy. However, many of them also believed they could improve their own patterns of eating. The data also showed that the low-income women who took part in the study had positive attitudes overall toward …

An Examination Of Active Commuting By Race/Ethnicity, Income And Location, Dangaia Sims, Melissa Bopp

Journal of Health Disparities Research and Practice

Introduction

Active commuting (AC; walking and biking to work) is associated with a number of positive health outcomes, low participation remains low in the USA. Our objective was to examine the multi-level influences on AC considering social determinants of health: race/ethnicity, income level and location.

Methods

We conducted a cross-sectional survey examining correlates of AC in the Mid-Atlantic region of the United States. The sample consisted of 1,310 adults over the age of 18 who were employed part- or full-time outside of the home and physically able to walk and bike. One-way ANOVAs, t-tests, and Pearson correlation analyses were run …

Food Insecurity And Healthy Behavior Counseling In Primary Care, Andrea Nederveld, Mandy Allison, Elizabeth A. Bayliss, Matthew Cox-Martin, Matthew Haemer

Journal of Health Disparities Research and Practice

Objective: While food insecurity (FI) has been associated with obesity in some studies, few have examined the relationship between FI and health attitudes and behaviors. We hypothesized that families who experienced FI would report lower importance of discussing health-related behavior change, report lower physical activity (PA) and have children who were more likely to be obese.

Design/Methods: We conducted a cross-sectional analysis of data collected from 2012 - 2015 from three clinics serving primarily low-income, Latino patients. Parents of 6 to 12 year old children presenting for well child care were surveyed about their experience of food insecurity, the importance …

Promoting Community And Population Health In Public Health And Medicine: A Stepwise Guide To Initiating And Conducting Community-Engaged Research, Scott D. Rhodes, Amanda E. Tanner, Lilli Mann-Jackson, Jorge Alonzo, Florence Siman, Eunyoung Y. Song, Jonathan Bell, Megan B. Irby, Aaron T. Vissman, Robert E. Aronson

Journal of Health Disparities Research and Practice

Various methods, approaches, and strategies designed to understand and reduce health disparities, increase health equity, and promote community and population health have emerged within public health and medicine. One such approach is community-engaged research. While the literature describing the theory, principles, and rationale underlying community engagement is broad, few models or frameworks exist to guide its implementation. We abstracted, analyzed, and interpreted data from existing project documentation including proposal documents, project-specific logic models, research team and partnership meeting notes, and other materials from 24 funded community-engaged research projects conducted over the past 17 years. We developed a 15-step process designed …

Ultrasound Guided Placement Of Single-Lumen Peripheral Intravenous Catheters In The Internal Jugular Vein, Tony Zitek, Elizabeth Busby, Heather Hudson, John D. Mccourt, Jamie Baydoun, David E. Slattery

School of Medicine Faculty Publications

Introduction: The peripheral internal jugular (IJ), also called the “easy IJ,” is an alternative to peripheral venous access reserved for patients with difficult intravenous (IV) access. The procedure involves placing a single-lumen catheter in the IJ vein under ultrasound (US) guidance. As this technique is relatively new, the details regarding the ease of the procedure, how exactly it should be performed, and the safety of the procedure are uncertain. Our primary objective was to determine the success rate for peripheral IJ placement. Secondarily, we evaluated the time needed to complete the procedure and assessed for complications. Methods: This was a …

Utilization Of Imaging To Identify A Benign Condition Mimicking Acute Appendicitis In A Child, Neelam Phalke Md, Zubin Mehta Md, Samrat Das Md

School of Medicine Faculty Publications

One of the most concerning causes of abdominal pain affecting children is acute appendicitis. However, there are benign conditions that can closely mimic appendicitis in children. In this article, we present a case of a child admitted for possible acute appendicitis and determined to have a condition known as omental infarction. The patient was managed medically and made a full recovery without surgical intervention. The aim of this case report is to review omental infarction and present a way of differentiating this disease from appendicitis, utilizing imaging, with the goal of avoiding surgical intervention. We also discuss the presentation and …

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

Measuring Inequity: A Systematic Review Of Methods Used To Quantify Structural Racism, Maya Groos, Maeve Wallace, Rachel Hardeman, Katherine P. Theall

Journal of Health Disparities Research and Practice

Abstract

Objective: To summarize the ways in which researchers have quantified measures of structural racism for the purposes of empirical, quantitative investigation of its associations with physical and mental health outcomes.

Methods: Systematic review of literature published January 1, 2007-June 30, 2017. We searched PubMed and EMBASE databases for studies including at least one of the following search terms in the title or abstract: “structural racism”, “systemic racism”, “institutional racism”, “institutionalized racism”. Excluded studies were not original research, not US based, did not quantify an explicitly named indicator of structural racism, or were qualitative designs. Data from full …

Higher Quality At Lower Cost: Community Health Worker Interventions In The Health Care Innovation Awards, Caitlin Cross-Barnet, Sarah Ruiz, Megan Skillman, Rina Dhopeshwarkar, Rachel Singer, Rachel Carpenter, Suzanne Campanella, Maysoun Freij, Lynne Snyder, Erin Colligan

Journal of Health Disparities Research and Practice

Background: Published evidence regarding cost savings, reduced utilization, and improved quality associated with employing community health workers (CHWs) is largely lacking. This paper presents findings from the Centers for Medicare & Medicaid Services Health Care Innovation Awards (HCIA), with a focus on six diverse programs that employ CHWs. We examine outcomes associated with programs incorporating CHWs into care teams for a broad age range of patients with various health issues such as cancer, asthma, and complex conditions.

Methods: This mixed-methods study used data from claims and site visits to assess the effectiveness of CHW programs. In difference-in-differences analyses of Medicare …

Racial/Ethnic Disparities In Diabetes Care And Outcomes: A Mixed Methods Study, Yhenneko J. Taylor, Marion E. Davis, Rohan Mahabaleshwarkar, Melanie D. Spencer

Journal of Health Disparities Research and Practice

Limited research has examined racial/ethnic differences in diabetes care and outcomes among primary care patients. This study examined racial/ethnic differences in diabetes care and outcomes among an ambulatory patient population and explored patient perceptions of the patient-provider relationship to inform strategies to improve care delivery. Using data from 62,149 adults with diabetes who received care within Atrium Health in 2013, regression models assessed associations between race/ethnicity and the following outcomes: glycated hemoglobin (HbA1c) tests, low density lipoprotein (LDL) and blood pressure (BP) screening, foot and eye exams, and HbA1c, LDL, and BP control. Eleven patients with diabetes and uncontrolled hypertension …

Application Of Photovoice With Focus Groups To Explore Dietary Behaviors Of Older Filipino Adults With Cardiovascular Disease, Jane Jih, Trish La Chica, Luisa M. Antonio, Ofelia O. Villero, Mary N. Roque, Joseph R. Domingo, Joshua F. Landicho, Anna M. Napoles, Celia P. Kaplan, Tung T. Nguyen

Journal of Health Disparities Research and Practice

Filipino Americans have high rates of cardiovascular diseases (CVD). This study explored the dietary behaviors, a modifiable risk factor, of Filipinos with CVD. Filipinos with CVD were recruited and trained to do Photovoice. Participants took photos to depict their “food experience,” defined as their daily dietary activities. Participants then shared their photos during focus groups. Focus group transcripts were analyzed using an iterative, grounded theory approach. Among 38 Filipino participants, the mean age was 70 years old and all were foreign-born. Major themes included efforts to retain connection to Filipino culture through food, and dietary habits shaped by cultural health …

Blood Pressure And Job Domains Among Hotel Housekeepers, Marie-Anne Sanon Rosemberg Phd, Mn, Rn, Bidisha Ghosh Ms., John Shaver Bsn, Maria Militzer Ma, Julia Seng Phd, Cnm, Faan, Marjorie C. Mccullagh Phd, Rn, Aphn-Bc, Cohn-S, Faaohn, Faan

Journal of Health Disparities Research and Practice

Hotel housekeepers have challenging working conditions, putting them at risk for poor health such as hypertension. Despite their risks, few studies have measured their blood pressure (BP). The purpose of this study was to explore hotel housekeepers’ blood pressure and the associations between work and BP. Methods: A community engagement approach was used to recruit study participants. Data sources included questionnaires, and BP measurement. Results: Over 25% of the 39 hotel housekeepers reported hypertension diagnosis and/or antihypertensive medication used. Across the job domains, job satisfaction was correlated with diastolic BP, and workload was correlated with systolic BP. There were difference …

Examination Of A Screening Tool For Athletes’ Mental Health And Its Direct Implications To Sport Training And Competition, Jesse Scott

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Sport Interference Checklist (SIC) is a psychometrically validated instrument designed to assess how often cognitive and behavioral factors interfere with athletes performance during training and/or competition as well as the extent to which athletes are interested in pursuing sport psychology to address these problems. The success of this scale inspired an interest in developing new items that assess the influence of specific mental health concerns on sport performance using the SIC format. The Sport Interference Checklist’s Sport Specific Screen for Mental Health (SIC-SSSMH) was empirically developed using 259 athletes to assist in the identification of mental health problems explicitly …

Electronic Health Record Instruction In First-Semester Nursing Students: A Comparative Study, Angela Ruckdeschel

UNLV Theses, Dissertations, Professional Papers, and Capstones

The use of health information technology has been shown to have positive effects on patient outcomes and provider efficiency. New nurses make more than half of the 7 million life-threatening medication errors that occur each year, and electronic health records (EHRs) have been shown to significantly reduce these errors. Nurses now are expected to enter practice with a solid foundation in health information technology and the use of the EHR. Unfortunately, the vast majority of nursing schools do not specifically train their students in effective EHR utilization. Academic EHRs (AEHRs) are software packages with learning features that can be incorporated …

Selective Use Of Pericardial Window And Drainage As Sole Treatment For Hemopericardium From Penetrating Chest Trauma, Paul J. Chestovich Md, Christopher F. Mcnicoll, Douglas R. Fraser, Purvi P. Patel, Deborah A. Kuhls, Esmeralda Clark, John J. Fildes

School of Medicine Faculty Publications

Background

Penetrating cardiac injuries (PCIs) are highly lethal, and a sternotomy is considered mandatory for suspected PCI. Recent literature suggests pericardial window (PCW) may be sufficient for superficial cardiac injuries to drain hemopericardium and assess for continued bleeding and instability. This study objective is to review patients with PCI managed with sternotomy and PCW and compare outcomes.

Methods

All patients with penetrating chest trauma from 2000 to 2016 requiring PCW or sternotomy were reviewed. Data were collected for patients who had PCW for hemopericardium managed with only pericardial drain, or underwent sternotomy for cardiac injuries grade 1–3 according to the …

Concept Interview Assignment To Foster Intentional Learning In Nursing Students, Sarah Mollman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Intentional learning is the process of acquiring skills and attributes that facilitate knowledge attainment and application, and this process may foster learning skills and attributes in nursing students so they may thrive in student-centered nursing curricula and competently practice in today’s dynamic and complex healthcare system. The purposes of this study were to determine 1) if there are any associations between academic achievement and intentional learning and 2) if there is an effect of a nursing concept interview assignment on academic achievement and intentional learning scores in second-semester nursing students.

The majority of studies on intentional learning were quasi-experimental designs …

3-D Upper Airway Comparison Between Class I And Class Ii Adults With Excessive Daytime Sleepiness, Nga Nguyen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: The aim of the study is to determine whether there is a relationship between the risk for daytime sleepiness in adults with Class I and Class II malocclusion and the airway volume, minimum cross-sectional area, and shape at the minimum cross sectional area.

Introduction: Sleep disordered breathing (SDB) is a category of conditions defined by airway complications while a person is sleeping. Obstructive sleep apnea (OSA) is the most common of these disorders and is defined as the presence of repeated episodes of complete or partial airway obstruction, which may be associated with loud snoring and daytime sleepiness. Daytime …

Prevalence Of Cariogenic Microbial Flora Among Scardovia Wiggsiae-Positive And Negative Patients, Amy Tam

UNLV Theses, Dissertations, Professional Papers, and Capstones

The formation of dental caries (cavities) is a complex, multi-dimensional process that necessarily involves many risk factors – including the acquisition and colonization of cariogenic oral bacteria. The most frequently associated oral pathogens are the acid-producing and acid-tolerant oral streptococcus species, such as Streptococcus mutans (S. mutans or SM). Many studies have established and confirmed the critical role of the formation of biofilm in the virulence of S. mutans, and the critical role this may play in determining the balance of the oral microbiome towards health or disease.

More recent efforts have discovered a novel cariogenic pathogen, Scardovia wiggsiae (S. …

Implementing Dietary And Physical Activity Guidelines In A College Health Center, Terry Lynn Bartmus

UNLV Theses, Dissertations, Professional Papers, and Capstones

Obesity has been classified as a major national health care problem that results in a significant increase in morbidity, mortality, and health care related costs. Seventy percent of all adults age 18 and older have a body mass index (BMI) of 25 or greater, indicating they are overweight or obese. Thirty-six percent of college students are overweight or obese. Research has shown that lack of time has further decreased weight-related counseling by primary-care providers. Printed materials have been shown to be effective in cueing individuals to engage in healthy behaviors such as following physical activity and recommended nutritional guidelines. Currently, …

Motor Impairments In Children With Autism: Insight Into The Complexity Of The Disorder, Jeffrey Douglas Eggleston

UNLV Theses, Dissertations, Professional Papers, and Capstones

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder which has seen an increasing prevalence rate in recent decades. Currently, the diagnostic criteria for the disorder evaluate a multitude of social communication and interactions, in a variety of contexts, and restricted or repetitive behavioral patterns (stereotyped movement, resistance to changes in routines, restricted interests, and hyper- or hypo-reactivity to sensory stimulus). Furthermore, ASD severity is based upon the marked severity of the above described impairment and they must also fall within one of three potential categories: 1) symptoms being present in early development, although potentially not manifested fully; 2) the …

Implementing High-Fidelity Simulation To Meet Undergraduate Clinical Requirements, Tammy Lynn Mccoy

UNLV Theses, Dissertations, Professional Papers, and Capstones

Increased demand for clinical experiences, lack of clinical sites, and shortages of qualified nursing faculty are reasons undergraduate nursing programs are seeking to utilize simulation to meet student learning needs. High-fidelity simulation (HFS) gives students the

opportunity to develop technical skills, enhance critical thinking skills, and apply theoretical concepts to clinical presentations in a controlled, safe environment. There is mounting interest in replacing traditional clinical hours with simulated practice experiences, particularly in specialty nursing areas like obstetrics. Despite literature supporting HFS and the positive effects of its use in undergraduate nursing education, faculty remain unfamiliar with the process of integrating …

Screening For The Novel Cariogenic Pathogen Scardovia Wiggsiae Among Orthodontic Patients, Adam Whiteley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Screening for the Novel Cariogenic Pathogen Scardovia wiggsiae among Orthodontic Patients

by

Adam Whiteley

Dr. Karl Kingsley, Examination Committee Chair Professor of Biomedical Sciences University of Nevada, Las Vegas School of Dental Medicine

The recent discovery of a novel cariogenic pathogen Scardovia wiggsiae has led many scientists and oral health researchers to re-evaluate and re-examine existing saliva repositories to determine the prevalence among patient populations. Recent efforts at this institution have used existing saliva samples to determine the prevalence among both adults and pediatric patients. These studies have revealed this organism may be found in approximately one-quarter of all samples …

An Evaluation Of Food Insecurity Rates And Its Correlates In A Filipino American Population Sample Residing In Clark County, Nevada, Prescott M. Cheong

UNLV Theses, Dissertations, Professional Papers, and Capstones

Filipino Americans comprise over half of the Asian American population in Clark County, Nevada. In 2016, 1.6% of Asian American households in Clark County reported being food insecure, which was considerably lower than food insecurity rates for White, non-Hispanic households (14.5%). Yet, Clark County demographic data reveals that 24% of Filipino-headed households report incomes at 200% or below the federal poverty level compared to 33% for Whites. Food insecurity rates specific to Filipino Americans in Clark County are lacking. Moreover, available food insecurity data aggregates Filipinos with other Asian American subgroups, which ignores the heterogeneity inherent to the Asian American …

Asian Americans’ Cancer Information Seeking, Fatalistic Belief, And Perceived Risk: Current Status And Relationships With Cancer Prevention And Detection Behaviors, Jungmi Jun, Xiaoli Nan

Journal of Health Disparities Research and Practice

This study pursues four research goals: (1) to examine Asian Americans and Asian ethnic groups’ (i.e., Chinese, Filipinos, Japanese, Koreans, Vietnamese) information seeking, fatalistic belief, and perceived risk of cancer, in comparison to non-Hispanic Whites; (2) to identify characteristics of Asian Americans who seek cancer information, hold fatalistic cancer belief, and perceive cancer risk; (3) to assess cancer prevention and detection behavior gaps between Asian Americans and Whites, and (4) to explore whether such gaps can be explained by cancer information seeking, fatalistic belief, and perceived risk. Data from 2011-2014 Health Information National Trends Surveys (HINTS) were analyzed. Asian Americans …

Household Financial Assets Inequity And Health Disparities Among Young Adults: Evidence From The National Longitudinal Study Of Adolescent To Adult Health, Shiyou Wu, Xiafei Wang, Qi Wu, Kathleen Mullan Harris

Journal of Health Disparities Research and Practice

Introduction: Research has established a strong relationship between financial resources and health outcomes. Yet, little is known about the effects of assets disparities on health outcomes, especially during the critical period when adolescents transition to adults.

Methods: Using data from the National Longitudinal Study of Adolescent to Adult Health (n = 10,861), this study investigated the relationships between three household total assets value groups (low, moderate, and high assets) and three net worth groups (negative, neutral, and positive) on young adults’ general health, obese, and depression.

Results: Both assets and debts were related to young adults’ health status, …

Graduating Into Lower Risk: Chlamydia And Trichomonas Prevalance Among Community College Students And Graduates, Janet E. Rosenbaum

Journal of Health Disparities Research and Practice

Background: Community colleges enable youth from economically disadvantaged and minority populations to access college and may enable social mobility including improved health outcomes. However, educational health disparities studies rarely assess the health outcomes for community college graduates.

Methods: Chlamydia and trichomonas prevalence were assessed with nucleic acid based tests in a nationally representative sample of 6233 high school graduates (ages 18–25) from five educational levels: young adults without post-secondary credentials who were not enrolled in college, community college students, 4-year college students, associate’s degree, and bachelor’s degree. To reduce confounding between educational attainment and STI status, we used full matching …

Development Of A Culturally Appropriate Smokeless Tobacco Cessation Program For American Indians, Kathryn Rollins, Charley Lewis, T. Edward Smith, Ryan Goeckner, Jason Hale, Niaman Nazir, Babalola Faseru, K Allen Greiner, Sean M. Daley, Won S. Choi, Christine M. Daley

Journal of Health Disparities Research and Practice

This study describes a multiphasic approach to the development of a smokeless tobacco cessation program targeted for American Indians (AI) of different tribal nations. The authors gathered formative data from a series of focus groups and interviews to investigate the knowledge, attitudes, and beliefs of AI and smokeless tobacco (SLT) use. Predominant themes emerged from four major topic areas (SLT use, initiation and barriers, policy, and program development) across both studies. This study further assessed educational materials developed for the cessation program for scientific accuracy, readability, and cultural appropriateness. Program materials were scientifically accurate and culturally appropriate. The average corrected …