Medicine and Health Sciences Commons^™

Covid-19 Isolation Compliance Among Students And Employees Of A Large Public University, Nicolette Harmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Isolation has been used to prevent the spread of many infectious diseases including COVID-19. The CDC’s isolation recommendations have changed over the course of the COVID-19 pandemic, currently infected individuals must stay at home for 5 full days. The CDC cites low compliance rates as one of the reasons for the recent reduction to the number of days in isolation. However, the CDC could only cite studies from other countries due to the lack of studies on isolation compliance in the United States. This study aimed to determine what percentage of UNLV students and staff complied with the isolation guidelines …

Use Of Healthcare Utilization Records For Analyzing Trends In Clinical Toxoplasmosis: A Comparison Of Nevada And The United States, Elijah Kreutzer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Toxoplasmosis, a zoonotic disease caused by the parasitic protist Toxoplasma gondii, is a ubiquitous, global public health concern with a wide variety of clinical manifestations. Surveillance for the disease is lacking even in developed countries, and what surveillance is present most often focuses on pregnant women. This research investigated trends in clinical toxoplasmosis in Nevada and nationally to address the lack of knowledge concerning how Nevada discharges compare to national discharges in cases of toxoplasmosis. Specifically, this research sought to determine what characterizes toxoplasmosis in Nevada across inpatient, outpatient, and emergency department settings, as well as how these cases differ …

Markers Of Neuroinflammatory And Degenerative Processes In Professional Athletes With Traumatic Encephalopathy Syndrome, Brooke Conway Kleven

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The clinical criteria for Traumatic encephalopathy syndrome (ccTES) were developed to improve the diagnosis of Chronic traumatic encephalopathy (CTE). This study aimed to determine whether there was an association between a clinical diagnosis of Traumatic encephalopathy syndrome (TES) and changes in serum biomarkers, balance, neuroimaging, and cognition among athletes in the Professional Athletes Brain Health Study (PABHS).Methods: Of the cohort, 130 professional fighters met age or retirement criteria and went to a consensus conference, with 52 fighters (40%) meeting the criteria for TES. A generalized linear model with generalized estimating equations was utilized to assess the odds of disease …

Depression And Quality Of Life Among Adults With Asthma Presence In Nevada, Elizabeth D. Kahane

UNLV Theses, Dissertations, Professional Papers, and Capstones

Asthma is a lung disease that causes coughing, chest tightness, wheezing, and breathlessness. It is often controlled by medication use and avoidance of environmental triggers. It is a leading chronic, non-communicable disease affecting over 19 million adults in the United States (CDC, 2020a). Asthma and severe asthma have been shown to negatively affect mental health and quality of life among adults including limiting physical activity, lowering sleep quality, exacerbating economic challenges, missing work, and increasing healthcare use (Stanescu, et al., 2019). Approximately 8% of adult Nevadans reported current asthma symptoms and 12.6% reported having a diagnosis during their lifetime (CDC, …

Does Social Support Moderate The Association Between Income And Food Security Status Among Seniors Living In Southern Nevada?, Adugna Teka Siweya

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Income is the strongest predictor of food insecurity among seniors, and social support also an essential factor to help mitigate the effects of food insecurity. However, little is known about the potential role that social support may play as a moderator of the association between income and food insecurity. Thus, we aim to examine social support as a moderator for the relationship between income and food insecurity among seniors. Methods: Logistic regression models were used to analyze data collected in 2019 from seniors residing in Southern Nevada. Predictors of food insecurity, sociodemographic factors, social support variables, and income and …

Gardasil Vaccine Trends Within Nevada, California, And The U.S.: A Comparative Study, Karen S. Gutierrez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite decreasing incidence in cervical cancer in the U.S., there continues to be an increase in public health concern for cervical cancer worldwide. Recent studies report that individuals are disproportionately affected based on region, sex, and race. Additionally, the human papillomavirus (HPV) attributable cancers may be reduced between 70% and 90% through the universal use of HPV-vaccines. In order to expand current knowledge and implement intervention programs in Nevada, it is critical to examine the associations among the Gardasil vaccine, cervical cancer screening, and adverse events following immunization as well as to understand the different socio-demographic subgroups affected. To our …

Investigating Attitudes And Beliefs Of University Students Aged 18 To 24 Years That Influence Their Decision To Take Pre-Exposure Prophylaxis Medication, Philip Danquah

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Contemporary research findings affirm that young adults aged 18 to 24 years have high prevalence of new HIV infections. Pre-Exposure Prophylaxis (PrEP) medication is the latest strategy in HIV prevention. Rates of PrEP uptake or use have been negligible among university students aged 18 to 24 years, especially among racial and ethnic minority students.

Objective: The objective of this study is to investigate the attitudes and beliefs that influence the uptake of PrEP medications and the HIV risk behaviors associated with the willingness to take PrEP medications among university students aged 18 to 24 years attending the University of …

Oral Localization Of Scardovia Wiggsiae, Graydon Ramos Carr

UNLV Theses, Dissertations, Professional Papers, and Capstones

Early childhood caries is one of the most prevalent diseases in the United States among children. The formation of caries is a complex, multifactorial process that is still being studied. Researchers have thought for years that Streptococcus mutans was the primary causative agent of early childhood caries. The recent discovery of a novel cariogenic pathogen, Scardovia wiggsiae and its significant contribution to the etiology of early childhood caries has led oral health researchers to re-evaluate this microorganism and its link to this disease. While there have been several projects undertaken within the University of Nevada, Las Vegas School of Dental …

Evaluating Parents Sociodemographic Factors And Childhood Vaccine Decisions, Mehret Girmay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Vaccination is considered one of the most successful public health achievements of the 20th century. However, with increasing vaccine skepticism emerging over the past decades, there is a threat to the ongoing sustainment of vaccine coverage within all US communities. This study evaluated and compared parents’ sociodemographic factors associated with childhood vaccine decisions. This study is a secondary analysis of 893 parents/guardians, age 18-55 years with child(ren) < 7 years living in the U.S.

Predictive analysis was conducted using multinomial logistic regression modeling was used to examine vaccine decisions (accept, hesitant, and refuse) in relation to parents’ sociodemographic factors. Overall, (66.6%) of parents accepted recommended vaccines, while …

An Evaluation Of Factors Associated With The Perceptions Of Diabetes In A Filipino American Sample Residing In Clark County, Nevada, Lawrence Nartatez Sagadraca

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study assessed beliefs about the contribution of the Filipino diet and genetics to diabetes burden and its ability to control it without medical interventions. The data from a need’s assessment survey of 200 Filipino Americans residing in Clark County, Nevada, were analyzed by using the logistic regression model. A significant proportion of the participants believed that diabetes is a problem in the Filipino community (79%) and is related to the Filipino diet (75%) and genetics (69.0%), and that it can be controlled without medical intervention (52.4%). In univariate analyses, age (Odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.01 …

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 …

Determinants Of Disparities In The Colorectal Cancer Burden, Karen Elizabeth Callahan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Colorectal cancer (CRC) is the third leading cause of cancer incidence and mortality in the United States, with an estimated 140,000 new cases and 51,000 deaths expected in 2018. Like most cancers, the burden of CRC is unequally distributed among population groups. The current dissertation included two studies filling gaps in knowledge about CRC disparities. Study 1 characterized the relationship between educational attainment and CRC mortality by race/ethnicity. Six years of CRC mortality data (2012-2017) from the diverse state of California, with 30,180 deaths were analyzed. Sex-specific mortality rate ratios (MRR) stratified by race/ethnicity as well as by educational level …

An Analysis Of Postmastectomy Breast Reconstruction Due To Breast Cancer In Nevada And The United States From 2008-2013, Jenna Webb

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: In the United States, female breast cancer was the leading cause of new cancer cases from 2011-2015. Since the Women’s Health and Cancer Act of 1998 (WHCRA), the federal government mandates employee and private health insurance providers to cover breast reconstruction if they cover mastectomies. Postmastectomy breast reconstruction (PBR) rates increased after the WHCRA, but these rates have remained relatively low throughout recent years. Objective: The objective of this study was to determine factors associated with women having PBR due to breast cancer in Nevada and the United States from 2008 to 2013. Methods: Using two HCUP database, NIS …

Telomeres, Nutrition And Mortality: Risk Factors For The Rate Of Telomere Length Decline And The Associations Between Telomere Length, Nutrition And Mortality, Saruna Ghimire

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Telomeres are nucleoprotein structures located at the ends of eukaryotic chromosomes, thought to protect the DNA from damage. As a person experiences stressors, harmful exposures, and other diseases throughout their life, telomeres are thought to become damaged and their length shortened, decreasing their ability to protect the DNA. Nutrition is an important aspect of healthy aging. Preservation of telomere length (TL) is thought to be one of the mechanisms by which good nutrition can delay or prevent the development of chronic disease and death. Recent evidence of preservation of TL with good nutrition is promising. Thus, the aim of …

Health Disparities Among Sexual And Gender Minorities, Jennifer Keeley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Decades of research has shown that sexual and gender minorities (SGMs) experience adverse health and mental health outcomes to a greater extent than their heterosexual peers. The need to better understand and eliminate health disparities in the SGM population was recognized by the National Institute on Minority Health and Health Disparities (NIMHD) at NIH. The Secretary of Health at the Department of Health and Human Services approved the designation of the SGM population as a health disparities population in 2016 and called for SGM studies to examine the health needs of the SGM population across SGM subgroups via large representative …

Air Pollution Related Asthma Inpatient Hospital Admission In The Las Vegas Valley, Joshua Allen Jensen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Asthma is a chronic respiratory condition characterized by inflammation in the lungs that causes airflow to be restricted. In Southern Nevada’s Las Vegas Valley, the natural basin geography causes air pollutants to accumulate. Research has linked air pollution with worsening asthma symptoms. The goal of this study was to determine the non-linear lagged relationship between Asthma Related Inpatient Hospital Admissions (ARIHA) and the Environmental Protection Agency’s (EPA) criteria air pollutants in the Las Vegas Valley using hospital and pollution monitoring station data. Overall, a statistically significant increased RR of ARIHA between 7 and 13 days after exposure to PM2.5 24-hour …

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, …

The Role Of Pre-Existing Type 2 Diabetes Mellitus In Colorectal Cancer Stage And Survival In Elderly Americans: A Seer-Medicare Population-Based Study 2002-~2011, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes is a common comorbid condition among colorectal cancer (CRC) patients, yet its effects in CRC outcomes, particularly stage at diagnosis, risk of death and variations by diabetes severity (complications vs no complications) and Hispanic ethnicity have not been adequately studied. The purpose of this study was to investigate the association between pre-existing T2DM and advanced stage at diagnosis in elderly patients with CRC; to examine whether diabetes is an independent predictor of poor survival from all-cause and CRC-specific mortality; to assess whether variations exist by diabetes severity and to analyze the outcomes for the Hispanic group.

The Surveillance Epidemiology …

The Impact Of Economic Recession On The Health Of Adult Nevadans, Ariana Goertz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Recessions are generally considered to cause negative consequences, but recent studies have provided evidence that some health outcomes improve as the economy deteriorates. The relationship between economic downfalls and health is not straightforward; it is important to look at how health has been impacted in one of the areas hit hardest by the recession. Las Vegas, Nevada was previously considered recession-proof, seemingly unaffected by previous economic downturns exhibited by the rest of the country. However, during the Great Recession of 2007-2009, Las Vegas led the country in highest rates of unemployment and foreclosures. This was quite a collapse for a …

Does Educational Level Influence Postmenopausal Breast Cancer Mortality Among Asians In U.S.?, Sfurti Maheshwari

UNLV Theses, Dissertations, Professional Papers, and Capstones

Studies on mortality from postmenopausal breast cancer (PMBC) by education level have not shown consistent results among US women. For US Asians, often seen as a “model” minority in terms of affluence and education this relationship has never been studied despite PMBC being the most common cancer in the country.

We analyzed 2008-2012 California Vital Statistics data and population data from the American Community Survey 2012 to compute age and education adjusted mortality ratios using negative binomial regression model for White (as a reference category) and Asian women. In total 3,277,106 (80%) White women and 852,376 (20%) Asian women died …

Determining The Effects Of Social Media Monitoring To Identify Potential Foodborne Illness In Southern Nevada, Lauren Diprete

UNLV Theses, Dissertations, Professional Papers, and Capstones

Foodborne illness, commonly referred to as food poisoning, affects an estimated 1 in 6 Americans every year, despite the fact that it is entirely preventable. Many cases of foodborne illness go unreported; however, better reporting leads to faster health department response and containment. Social media monitoring, using software to identify trends in social media posts, is a novel new tool that has been tested in a variety of public health fields with promising preliminary results. The Southern Nevada Health District (SNHD) has employed social media monitoring software to identify potential foodborne illness within Southern Nevada. The purpose of this study …

Distracted Driving In Clark County, Nevada: Analysis Of An Intervention On College Students, Heidi Ann Manlove

UNLV Theses, Dissertations, Professional Papers, and Capstones

Distracted driving is a growing public health concern. Highlighted in the media, local and government agencies and in peer-review literature are increased associations of motor vehicle crash related injuries and fatalities with distracted driving, especially involving youth drivers. The goal of this thesis was to analyze the effects of a distracted driving intervention on college students at University of Nevada, Las Vegas. Quantitative statistical analysis was performed to compare self-reported pre and post-intervention questionnaire responses of the experimental and control groups. Between-group analysis was performed using independent t-tests and ANOVA. Within-group differences were analyzed with Repeated Measures ANOVA (RM-ANOVA) and …

Association Of Genetic Factors With Chronic Kidney Disease In Us Young Adults, Sabra Stanford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Albumin, a protein that when found in urine, is an early indicator of Chronic Kidney Disease (CKD). Genetic contributions have been shown to illustrate the gene-environment interactions that may lead to CKD in an individual; however, few studies have highlighted the interaction between responses of gene variations associated with the risk of increased albumin in young adults. This study’s purpose is to evaluate the hypothesis that candidate genes are related to microalbuminuria in young adults of the third wave of the National Longitudinal Study of Adolescent Health (Add Health Wave III). This longitudinal study includes an assessment of various candidate …

Determining The Effects Of The Think Risk Initiative As Implemented By The Southern Nevada Health District, Karalin Nichole Cronkhite

UNLV Theses, Dissertations, Professional Papers, and Capstones

In the United States, someone becomes infected with a foodborne illness every 2 seconds, is hospitalized by a foodborne illness every 4 minutes and dies due to a foodborne illness every 3 hours. Foodborne illness is preventable, yet each year, 1 in 6 Americans is affected by it from contaminated foods or beverages. There are over 250 different foodborne diseases, and in 2015, there were 73 confirmed cases of Salmonella infection in Southern Nevada alone. Since the emergence of public health, food establishment inspections have been an important part of the regulation of food safety. Risk-based inspections were developed by …

Intra-Ethnic Diversity In Ischemic Heart Disease And Stroke Mortality Among Hispanics In The United States, Karen Elizabeth Callahan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Hispanics are the largest racial/ethnic minority group in the United States (US), comprising 17% of the total US population in 2014, and projected to increase to 28.6% by 2060. Yet, the intra-ethnic heterogeneity for the second and fourth leading causes of death among Hispanic populations, heart disease and stroke, has never been comprehensively studied. We examined ischemic heart disease (IHD) and stroke mortality among distinct Hispanic subgroups: Caribbean Hispanics (including Puerto Ricans, Cubans, and Dominicans), Mexicans, Central Americans and South Americans, comparing their mortality with non-Hispanic whites (NHWs).

Methods: Five years (2008-2012) of death certificate data from Florida and …

Differences In Perceived Importance Of Preventative Services And Healthcare Provider Trust Among Hispanics, Jonathan James Gore

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Hispanic population varies greatly in their risk factors, health outcomes and access to care by country of origin, level of education and language dominance (Vega & Amaro, 1994) (Fiscella, Franks, Doescher, & Saver, 2002b). The differences within the Hispanic population also extend to their knowledge and attitudes toward health choices and maintenance, where they receive their health information, and what they access to meet their health care needs. Subpopulations within the Hispanic community as defined by language dominance and nativity must be understood as separate and distinct so that the health needs of each can be adequately addressed. The …

Cancer Among Asian American Population In The United States: Incidence And Survival Disparities, Hongbin Jin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Part I

Cancer incidence disparities exist among specific Asian American populations. However, the existing reports exclude data from large metropoles like Chicago, Houston, and New York. Moreover, incidence rates by subgroup have been underestimated due to the exclusion of Asians with unknown subgroup. Cancer incidence data for 2009 to 2011 for eight states accounting for 68% of the Asian American population were analyzed. Race for cases with unknown subgroup was imputed using stratified proportion models by sex, age, cancer site, and geographic regions. Age-standardized incidence rates were calculated for 17 cancer sites for the six largest Asian subgroups. Our analysis …

Factors Associated With Rapid Readmission Among Nevada State Pyschiatric Hospital Patients, Christopher Owen Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Rapid readmission (RR) of psychiatric patients within 30 days of discharge places a costly burden on state psychiatric facilities and may be an indicator of suboptimal service provision. Several studies have previously considered RR to inpatient facilities, but there is a lack of information available about the variables associated with RR of psychiatric patients to state-operated inpatient facilities in Nevada. This study attempts to identify factors associated with RR at a southern Nevada state psychiatric hospital. Participants included 7,177 patients admitted between May 1, 2012 and April 30, 2014. All 12,068 admissions, including 2,220 RR, were reviewed, and rapid readmits …

A Survey Of Antimicrobial Stewardship Practices In The Western United States: Successes And Challenges, Gayle Louise Allenback

UNLV Theses, Dissertations, Professional Papers, and Capstones

Antibiotics are one of the most important developments in medicine, and their ability to prevent and control infections has had a major impact in clinical medicine. However, the past three decades have shown an increase in multidrug-resistant organisms (MDROs) in both hospital patients and in the community, decreasing our ability to successfully control infection. Complicating the depletion of effective antimicrobials is the fact that, in the last 10 years, there has also been a decrease in the development of new antibacterial agents. Resistant infections have resulted in increased morbidity and mortality, with a consequential increase in healthcare costs. The utilization …

Determinants Of Head And Neck Cancer Survival In Nevada For 1995-2008, Xiao Q. Li

UNLV Theses, Dissertations, Professional Papers, and Capstones

Head and neck cancer (HNC), also known as oral cavity and pharyngeal cancer, comprises a group of cancers that arise in the head or neck region, such as the nasal cavity, sinuses, lips, mouth, salivary glands, and pharynx. Use of tobacco, alcohol, or a combination of the two, are major risk factors for head and neck cancer. Approximately 75% of oral cancers are attributable to smoking and/or alcohol consumption. More recently, the human papilloma virus (HPV) has also been associated with the development of head and neck cancer.

The objective of the present study is to investigate head and neck …