Digital Commons Network^™

Covid-19 Severity Among American Indians And Alaska Natives In 16 States - January 1, 2020, To March 31, 2021, Jessica Arrazola, Scott Erickson, Chiao Wen Lan, Adrian Dominguez, Sujata Joshi, Andria Apostolou, Ashley Busacker, David Casey, Christiana Coyle, Kathryn Helfrich, Jennifer Kraszewski, Thomas Kim, Genelle Lamont, Richard Leman, Pamela Lemaster, Nick Lehnertz, Mike Mannell, Dakota Matson, Alex Merrill, Tracy Miller, Benjamin Schram, Ozair Naqvi, Samantha Rice, Samantha Hyde-Rolland, Alyssa Rowell, Dean Seneca, Victoria Warren-Mears, Laura Williamson

Journal of Health Disparities Research and Practice

Objective: To compare rates and risk factors of severe COVID-19-related outcomes between American Indian/Alaska Native (AI/AN) and non-Hispanic White people (NHW).

Methods: Aggregate Social Vulnerability Index (SVI), COVID-19-related risk factor, hospitalization, and mortality data were obtained from 16 states for January 1, 2020-March 31, 2021. Generalized estimating equation Poisson regression models calculated age-adjusted cumulative incidences, incidence ratios (IR), and 95% confidence intervals (CI) comparing AI/AN and NHW persons by age, sex, and county-level SVI status.

Results: Race data were missing for 42.7% of COVID-19 cases, 24.7% of hospitalizations, and 10.1% of deaths. Risk of AI/AN COVID-19 mortality …

Surveillance Of The Incidence And Mortality Of Oral And Pharyngeal, Esophageal, And Lung Cancer In Nevada: Potential Implications Of The Nevada Indoor Clean Air Act, Kevin Foote, David Foote, Karl Kingsley

Dental Medicine Faculty Publications

Reviews of national and state-specific cancer registries have revealed differences in rates of oral, esophageal, and lung cancer incidence and mortality that have implications for public health research and policy. Many significant associations between these types of cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans—including the Nevada Clean Indoor Air Act (NCIAA) of 2006 (and subsequent modification in 2011). Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of …

Mapping Nevada's Dental Workforce, Kelvin Chen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Access to care is a concern at the forefront of public health. Due to socioeconomic and geopolitical pressures, the distribution of healthcare providers across a population often does not coincide with the demand for healthcare in a specific geographic area. Rural areas typically do not have enough providers and urban areas typically have too many. This stark reality underscores an inherent inefficiency in the allocation of healthcare resources and is a discrepancy that must be addressed by state-sponsored institutions and programs. From a public health perspective, the problem of insufficient or lack of access to care is the greater of …

Flame Retardants And Neurodevelopment: An Updated Review Of Epidemiological Literature, Ann M. Vuong, Kimberly Yolton, Kim M. Cecil, Joseph M. Braun, Bruce P. Lanphear, Aimin Chen

Public Health Faculty Publications

Purpose of Review: Flame retardant (FR) compounds can adversely impact neurodevelopment. This updated literature review summarizes epidemiological studies of FRs and neurotoxicity published since 2015, covering historical (polybrominated biphenyls [PBBs], polychlorinated biphenyls [PCBs]), contemporary (polybrominated diphenyl ethers [PBDEs], hexabromocyclododecane [HBCD], and tetrabromobisphenol A [TBBPA]), and current-use organophosphate FRs (OPFRs) and brominated FRs (2-ethylhexyl 2,3,4,5-tetrabromobezoate [EH-TBB] TBB), bis(2-ethylhexyl) tetrabromophthalate [BEH-TEBP]), focusing on prenatal and postnatal periods of exposure. Recent Findings: Continuing studies on PCBs still reveal adverse associations with child cognition and behavior. Recent studies indicate PBDEs are neurotoxic, particularly for gestational exposures with decreased cognition and increased externalizing behaviors. Findings …

Factors Associated With Eosinophilic Esophagitis In Nevada, Julia Lorraine Anderson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Eosinophilic esophagitis (EoE) is a rare immune-mediated illness with symptoms that range from difficulty swallowing to food impaction of the esophagus. Most published studies have been documented among patients residing in cool regions with significant annual rainfall. No published studies to our knowledge have been performed examining the healthcare utilization trends of EoE in Nevada. Utilizing two unique databases, the factors associated with EoE healthcare utilization patterns in Nevada were examined. All analyses were performed in R version 3.5.1. This study included a demographic and regional analysis identifying risk factors associated with having an EoE healthcare visit in Nevada. Several …

Prostate Cancer Survival Among Hispanics: A Surveillance, Epidemiology, And End Results (Seer) Population-Based Cohort Study, David Rivas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hispanics are now the youngest, largest, and fastest growing minority group in the U.S. Prostate cancer (PC) is the most commonly diagnosed cancer in men and is the second-leading cause of cancer deaths among Hispanics. For the first time, we examined PC-specific survival among distinct Hispanic groups that include Mexicans, Cubans, Dominicans, Puerto Ricans, as well as Central and South Americans. We compared these groups to the main reference population in the U.S., non-Hispanic Whites (NHW), after adjustment for prognostic factor risk categories (prostate-specific antigen (PSA) level, Gleason score, and tumor stage), as well as sociodemographic covariates (e.g., health insurance, …

Unique Breast Cancer Features Within The Vietnamese Population, Polly Niravath, Melissa Bondy, Susan G. Hilsenbeck

Journal of Health Disparities Research and Practice

BACKGROUND: Breast cancer is known to be a heterogeneous disease across women, and even within individual tumors. However, relatively little is known about heterogeneity across cultures. There has been some evidence to suggest that Asian women are more likely to have HER2+ breast cancer than their Caucasian counterparts.

PURPOSE: The aim of this study was to further investigate the unique pattern of breast cancer incidence and subtype in the Vietnamese population.

METHODS: We retrospectively collected data on all Vietnamese women diagnosed with invasive breast cancer at the Lester & Sue Smith Breast Center in Houston, Texas over a four year …

A Public Health-Based Approach To German Gaming Regulation, Knut Walter, Gerhard Buehringer

International Conference on Gambling & Risk Taking

The current situation of the German gambling market can be characterized by an unrelated framework of different legal systems, different regulatory authorities and different control principles, and has led to (1) an increasing number of court decisions and information requests by European Commission questioning parts of that regulatory system, (2) public tolerance of illicit gambling, and consequently (3) a lack of consumer protection.

Taking RENO Model 1.0 and 2.0 seriously, a new and comprehensive regulatory framework based on common consumer protection standards for all types of gambling – land-based and online, state-owned and private operated – has been developed and …

Monitoring Gambling Impacts In Massachusetts: Honing Strategies And Preventing Harm, Rachel A. Volberg, Amanda Houpt

International Conference on Gambling & Risk Taking

In November 2011, an Act Establishing Expanded Gaming in the Commonwealth of Massachusetts was signed into law (Chapter 194 of the Acts of 2011). This legislation permits casinos and slot parlors in Massachusetts under the regulatory auspices of the Massachusetts Gaming Commission (MGC). Section 71 of the Expanded Gaming Act requires the MGC to establish an annual research agenda to assist in understanding the effects of casino gambling in Massachusetts and in minimizing the negative impacts. Research activities launched thus far include a comprehensive study of the social and economic impacts of casino gambling in Massachusetts (SEIGMA), a cohort study …

The Effect Of Marriage On Stage At Diagnosis And Survival In Women With Cervical Cancer, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Marriage is associated with improved health outcomes for many conditions. Married persons enjoy financial stability, social and emotional support, and tend to have better control of health risk behaviors compared to the unmarried. The marriage scene is changing continuously. Americans are marrying less or delaying the engagement to an older age. They are divorcing more, they choose cohabitation as an alternative to marriage, or engage in premarital relationships. As a consequence, barely half of Americans were married in 2011 compared to close to three quarters of Americans were married in the sixties. With the increase of the unmarried population - …

The Effectiveness Of Health Education Materials In Influencing Hiv Testing Behavior: The Unlv-Siphi Study, Rebecca Tsegay

UNLV Theses, Dissertations, Professional Papers, and Capstones

The UNLV-SIPHI (Sexual Health Internet-Based Public Health Intervention) Study focused on HIV prevention by improving HIV testing behavior through the development and dissemination of health education materials. The goal of the UNLV-SIPHI Study was to develop effective, custom-made HIV health education materials that promote the knowledge, intention and practice of HIV testing among UNLV students. The UNLV-SIPHI Study was conducted during Spring 2012 semester in selected UNLV undergraduate classes. An online quasi-randomized-control trial (RCT) was used to measure the difference in HIV testing behavior contributing factors among students exposed to the health education materials. Several nonparametric tests were used to …

The Administrative Prevalence Of Autism Spectrum Disorders In Nevada School Districts: A Pooled Time Series Analysis, 1996-2004, John P. Tuman, Sheniz Moonie, Danielle Roth-Johnson

Nevada Journal of Public Health

Objective: To examine the administrative prevalence of Autism Spectrum Disorders (ASD) in all seventeen school districts in Nevada during the period of 1996 to 2004.

Methods: Normalized administrative prevalence rates (per 1,000 children ages 6-17) for ASD, Mental Retardation (MR), Learning Disability (LD), and Speech and Language Impairment (SLI) were calculated. Covariates for board certified pediatricians per 1,000 students, Federal special education funding per student, and other measures of school resources were employed. Models were estimated with pooled Ordinary Least Squares (OLS) regression with panel corrected standard errors. A separate analysis compared pooled OLS results to results from Latent Growth …

Increasing Rate Of Pneumonia Hospitalizations Among Older American Indian And Alaska Native Adults, Robert C. Holman, Krista L. Yorita, Rosalyn J. Singleton, James E. Cheek, Edna L. Paisano, Jay C. Butler, Larry J. Anderson, Alicia M. Fry

Journal of Health Disparities Research and Practice

Objective: To examine rates and trends of pneumonia hospitalization among older American Indian and Alaska Native (AI/AN) adults.

Methods: Pneumonia hospitalizations for older AI/AN adults ≥65 years of age living in the Alaska and Southwest Indian Health Service (IHS) regions during 1988 through 2002 from the IHS hospital discharge data were analyzed.

Results: The average annual hospitalization rate for first-listed pneumonia for older AI/AN adults in both the Alaska and the Southwest regions has increased (15.3 and 23.0 in 1988-1990 to 25.9 and 28.8 in 2000-2002 per 1,000 population, respectively), with the greatest increase seen among older AI/AN adults in …

Multistate Assessment Of Public Health Surveillance Relevant To American Indians And Alaska Natives, 2007, Jeanne Bertolli, Ed Chao, Michael Landen, Eden Wells, John M. Hayes, Zeenat Mahal, Ralph T. Bryan

Journal of Health Disparities Research and Practice

Improving the health of American Indian and Alaska Native (AI/AN) populations involves multiple agencies, levels of government, and jurisdictions. We assessed collaboration between state health departments and AI/AN Tribes and agencies through an online survey of State Epidemiologists. Frequencies and percentages of responses were examined by univariate and bivariate analyses. Among 39 states with federally recognized or state-recognized Tribes or federally funded urban Indian health centers, 25 (64%) participated. Nineteen had discussed public health surveillance with an AI/ AN government or nongovernment entity in the past 2 years (10 (53%) of these had ongoing, regular discussions about public health surveillance; …

Retrospective Evaluation Of Microbial Presence In Existing Saliva Repository: A Pcr Based Molecular Survey Of Oral Microbial Populations From Existing Saliva Samples, Jay Ericksen Davis

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall purpose of this research project is to explore the link between oral health and disease in the University of Nevada, Las Vegas - School of Dental Medicine (UNLV-SDM) clinic patient population. More specifically, the population of interest is the UNLV-SDM orthodontic clinic patient population, which is mostly composed of adults, females, and minorities. The University of Nevada, Las Vegas, School of Dental Medicine, with more than 70,000 active patients and a post-graduate specialty program in Orthodontics is uniquely positioned to perform this type of oral health epidemiology survey, as well as targeted oral microbial testing among populations within …

Analysis Of The Morbidity And Mortality Of Severe Influenza Infection In Clark County, Nevada For The 2010--2011 Influenza Season, Kindra Maureen St. Jacques

UNLV Theses, Dissertations, Professional Papers, and Capstones

Influenza circulates in the community in a fairly predictable manner each year; however, throughout the duration of any influenza season, influenza strains have the ability to evolve through antigenic mutations, viral reassortment, development of anti-viral resistance, and alterations in virulence. These changes are likely to cause illness among the unimmunized and can result in severe illness or death. Therefore, it is especially important to closely monitor severe influenza-associated hospitalizations and deaths. The University of Nevada, Las Vegas in collaboration with the Southern Nevada Health District (SNHD), Office of Epidemiology (OOE) analyzed data from the severe hospitalized influenza morbidity and mortality …

Modeling Mortality Rates For Leukemia Between Men And Women In The United States, Blessed Quansah

UNLV Theses, Dissertations, Professional Papers, and Capstones

Leukemia related deaths increased dramatically over the last forty years. Leukemia is a malignant disease or cancer of the bone marrow and blood. It is characterized by the uncontrolled accumulation of blood cells. Leukemia is divided into two categories: myelogenous or lymphocytic, each of which can be acute or chronic. The terms, myelogenous or lymphocytic denote the cell type involved.

In this thesis, the proposed modeling techniques are applied to leukemia deaths data from the Surveillance Epidemiology and End Results (SEER). In particular, annual deaths data from 1969 to 2007 are used in the data analysis, which includes three major …

Oral Cancer In Nevada: A Public Health Perspective, Karl Kingsley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer is the second leading cause of death in the United States, and oral cancer remains the eighth leading cause of cancer death among US males. Although previous epidemiologic studies have found that overall rates of cancer, including oral cancer, have declined in the US in recent decades – these declines are neither uniform nor consistent within this population. Anecdotal evidence has suggested that rates of oral cancer in Nevada are relatively high, although no evidence was available to support these assertions.

Oral Cancer Epidemiology: Based upon this information, a detailed and thorough epidemiologic examination of oral cancer rates in …

Herpes Simplex Virus Type 2 Antibodies: High Prevalence In Monogamous Women In Costa Rica, Mark W. Oberle, Luis Rosero-Bixby, Francis K. Lee, Maria Sanchez-Braverman, A J. Nahmias, Mary Guinan

Public Health Faculty Publications

We studied the prevalence of antibody to Herpes simplex virus types I and 2 (HSV-I and HSV-2) in 766 randomly selected Costa Rican women 25-59 years of age in a national household survey in 1984-1985. Overall, 97.1% were seropositive for HSV-l and 39.4% for HSV -2. Only 1.1% of HSV -2 seropositive women gave a history of symptomatic genital herpes. HSV-2 virus antibody increased with age and with the number of lifetime sexual partners. HSV -2 seroprevalence among women who reported only 1 lifetime sexual partner was almost twice as high as the prevalence among women who denied sexual experience …

National Case-Control Study Of Kaposi's Sarcoma And Pneumocystis Carinii Pneumonia In Homosexual Men: Part 1. Epidemiologic Results, Harold W. Jaffe, Keewhan Choi, Pauline A. Thomas, Harry W. Haverkos, David M. Auerbach, Mary E. Guinan, Martha F. Rogers, Thomas J. Spira, William W. Darrow, Mark A. Kramer, Stephen M. Friedman, James M. Monroe, Alvin E. Friedman-Kien, Linda J. Laubenstein, Michael Marmor, Bijan Safai, Selma K. Dritz, Salvatore J. Crispi, Shirley L. Fannin, John P. Orkwis, Alexander Kelter, Wilmon R. Rushing, Stephen B. Thacker, James W. Curran

Public Health Faculty Publications

To identify risk factors for the occurrence of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men, we conducted a case-control study in New York City, San Francisco, Los Angeles, and Atlanta. Fifty patients (cases) (39 with Kaposi's sarcoma, 8 with pneumocystis pneumonia, and 3 with both) and 120 matched homosexual male controls (from sexually transmitted disease clinics and private medical practices) participated in the study. The variable most strongly associated with illness was a larger number of male sex partners per year (median, 61 for patients; 27 and 25 for clinic and private practice controls, respectively). Compared with controls, …