Medicine and Health Sciences Commons^™

Healthy Food Options At Dollar Discount Stores Are Equivalent In Quality And Lower In Price Compared To Grocery Stores: An Examination In Las Vegas, Nv, Courtney Coughenour, Timothy J. Bungum, M. Nikki Regalado

Public Health Faculty Publications

Food deserts indicate limited access to and affordability of healthy foods. One potential mediator is the availability of healthy food in non-traditional outlets such as dollar-discount stores, stores selling produce at the fixed $1 price. The purpose of this study was to compare availability, quality, price differences in ‘healthier’ versus ‘regular’ food choices, price per each food item, and summary score in dollar-discount stores to grocery stores in Las Vegas using the NEMS-S; a protocol consisting of three subscores—availability, quality, price of healthier versus regular food, and a summary score. [...] see article for full abstract

The Life She Deserves: Medical Marijuana In The United States, John Hudak, George Burroughs, Maritza Bermudez

Brookings Scholar Lecture Series

Brookings Mountain West offered an event titled, "The Life She Deserves: Medical Marijuana in the United States on Monday, November 5, 2018. This event featured a viewing of the film, and was followed by a panel discussion with John Hudak, George Burroughs, and Maritza Bermudez. “The Life She Deserves” is an intimate portrait of Jennifer Collins and her family’s struggle to find a treatment to control her debilitating epilepsy. Because her legal pharmaceutical treatments cause severe side effects, Jennifer and her mother move across the country to access medical marijuana. The therapy provides Jennifer and her family with the relief …

Unlv School Of Medicine: Rethinking Governance, Planning, And Economic Impact, The Lincy Institute

Brookings Scholar Lecture Series

The launch of the UNLV School of Medicine presented a unique opportunity for Southern Nevada to address two critical issues: the absence of adequate healthcare services for a region of more than 2.2 million people, and the economic impact of a new medical school resulting in an expanded regional health care economy. A collaborative process that engages local, state, and private sector interests is essential to the development of the UNLV School of Medicine and the expansion of an effective, efficient, and profitable healthcare economy.

In this colloquium The Lincy Institute released new health policy publications prepared with the support …

Justice Served Fresh: Associations Between Food Insecurity, Community Gardening, And Property Value, Micajah Daniels, Courtney Coughenour Ph.D

McNair Poster Presentations

Numerous stakeholders in Nevada have used a variety of efforts to combat the growth of food insecurity facing Nevadans. The purpose of this research project is to understand the association between food insecurity, community gardens, and property value. Following the wealth of scholarship on these topics and data collected from community garden agencies in Southern Nevada, the research questions for this project include: (1) Where are community gardens located in SNV? (2) What efforts community gardens agencies are doing to address food insecurity (most interested in their efforts using community gardens)? (3) What are the perceptions of supports and barriers …

Limited Contribution Of Health Behaviours To Expanding Income-Related Chronic Disease Disparities Based On A Nationwide Cross-Sectional Study In China, Qing Wang, Jay J, Shen, Kaitlyn Frakes

Public Health Faculty Publications

This study estimated the association of income and prevalence of cardiovascular diseases (CVD) and hypertension, and then quantified the contribution of health behaviors to the association in China. Using the 2013 survey of the China Health and Retirement Longitudinal Study (CHARLS), a logit model was applied to examine income-related health disparities in relation to CVD and hypertension. A four-step regression method was then constructed to measure the role of health behaviors in income-related health disparities. Using indirect effects, mediation by health behaviors was examined. Income-related health disparities in chronic diseases were found to exist in China. Specifically, individuals in the …

Bibliometric Analysis Of Gaps In Research On Asbestos-Related Diseases: Declining Emphasis On Public Health Over 26 Years, Ro-Ting Lin, Matthew John Soeberg, Lung-Chang Chien, Scott Fisher, Jukka Takala, Richard Lemen, Tim Driscoll, Ken Takahashi

Public Health Faculty Publications

Objectives The global burden of asbestos-related diseases (ARDs) is significant, and most of the world’s population live in countries where asbestos use continues. We examined the gaps between ARD research and suggestions of WHO and the International Labour Organization on prevention. Methods From the Web of Science, we collected data on all articles published during 1991–2016 and identified a subset of ARD-related articles. We classified articles into three research areas—laboratory, clinical and public health—and examined their time trends. For all and the top 11 countries publishing ARD-related articles, we calculated the proportions of all ARD-related articles that were in each …

Wide Educational Disparities In Young Adult Cardiovascular Health, Elizabeth M. Lawrence, Robert A. Hummer, Benjamin W. Domingue, Kathleen Mullan Harris

Sociology Faculty Research

Widening educational differences in overall health and recent stagnation in cardiovascular disease mortality rates highlight the critical need to describe and understand educational disparities in cardiovascular health (CVH) among U.S. young adults. We use two data sets representative of the U.S. population to examine educational disparities in CVH among young adults (24–34) coming of age in the 21st century: the National Health and Nutrition Examination Survey (2005–2010; N= 689) and the National Longitudinal Study of Adolescent to Adult Health (2007–2008; N=11,200). We employ descriptive statistics and regression analysis. The results show that fewer than one in four young adults had …

Provider Perspectives On Demand Creation For Maternal Vaccines In Kenya, Irina Bergenfeld, Stacy W. Nganga, Courtni A. Andrews, Vincent L. Fenimore, Nancy A. Otieno, Sandra S. Chaves, Jennifer R. Verani, Marc-Alain Widdowson, Winnie N. Wairimu, Susan N. Wandera, Raphael O. Atito, Maxwell O. Adero, Paula M. Frew

Environmental & Occupational Health Faculty Publications

Background. Expansion of maternal immunization, which offers some of the most effective protection against morbidity and mortality in pregnant women and neonates, requires broad acceptance by healthcare providers and their patients. We aimed to describe issues surrounding acceptance and demand creation for maternal vaccines in Kenya from a provider perspective. Methods. Nurses and clinical officers were recruited for semi-structured interviews covering resources for vaccine delivery, patient education, knowledge and attitudes surrounding maternal vaccines, and opportunities for demand creation for new vaccines. Interviews were conducted in English and Swahili, transcribed verbatim from audio recordings, and analyzed using codes developed from interview …

Nonlinear Associations Between Working Hours And Overwork-Related Cerebrovascular And Cardiovascular Diseases (Ccvd), Ro-Ting Lin, Lung-Chang Chien, Ichiro Kawachi

Public Health Faculty Publications

Long working hours are recognized as a risk factor for cerebrovascular and cardiovascular diseases (CCVD). We investigated the relationship between working hours and different CCVD severity outcomes—death, disability, and illness—across industries in Taiwan from 2006 to 2016. We applied a generalized additive mixed model to estimate the association between working hours and the rate of each severity outcome, adjusted for salary, unemployment rate, time, and a random intercept. Industry-average working hours were significantly associated with each outcome level of overwork-related CCVD, especially when monthly working hours increased from 169 (relative risk [RR] = 1.46, 95% confidence interval [CI] 1.002–2.12) to …

Variation In Airborne Pollen Concentrations Among Five Monitoring Locations In A Desert Urban Environment, Tanviben Y. Patel, Mark P. Buttner, David Rivas, Chad L. Cross, Dennis A. Bazylinski, Joram S. Seggev

Environmental & Occupational Health Faculty Publications

The urbanization of the Las Vegas Valley has transformed this part of the Mohave Desert into a green oasis by introducing many non-native plant species, some of which are allergenic. Typically, one monitoring station is established per city to obtain pollen counts for an entire metropolitan area. However, variations in pollen concentrations could occur among different microenvironments. The objective of this study is to measure and compare pollen concentrations in five locations in Las Vegas to determine if there are significant differences between microenvironments within the city. Air samples were collected from five sites across the Las Vegas Valley over …

Pediatric To Adult Healthcare Transitioning For Adolescents Living With Hiv In Nigeria: A National Survey, Okikiolu A. Badejo, William A. Menson, Nadia A. Sam-Agudu, Jennifer Pharr, Salome Erekaha, Tamara Bruno, Gift Nwanne, Olabanjo Ogunsola, Jude Ilozumba, Olusegun Busari, Echezona E. Ezeanolue

Public Health Faculty Publications

Introduction The period of transition from pediatric to adult care has been associated with poor health outcomes among 10–19 year old adolescents living with HIV (ALHIV). This has prompted a focus on the quality of transition services, especially in high ALHIV-burden countries. Due to lack of guidelines, there are no healthcare transition standards for Nigeria’s estimated 240,000 ALHIV. We conducted a nationwide survey to characterize routine transition procedures for Nigerian ALHIV. Materials and methods This cross-sectional survey was conducted at public healthcare facilities supported by five local HIV service implementing partners. Comprehensive HIV treatment facilities with ≥1 year of HIV …

Provider Insight On Surmounting Specialty Practice Challenges To Improve Tdap Immunization Rates Among Pregnant Women, Arpita Mehrotra, Allison Kennedy Fisher, Jennifer Mullen, Leslie Rodriguez, Angela J. Jiles, Alison P. Albert, Laura A. Randall, Paula M. Frew

Environmental & Occupational Health Faculty Publications

Background Pertussis, or “whooping cough,” is an acute, contagious pulmonary disease that, despite being vaccine-preventable, has become an increasingly widespread problem in the United States. As a result, the Advisory Committee on Immunization Practices and American College of Obstetricians and Gynecologists updated recommendations stating clinicians should give a Tdap dose during every pregnancy, preferably at 27–36 weeks. Despite this recommendation, reported Tdap vaccine receipt rates during pregnancy vary from 16–61%, and previous studies have shown that clinician recommendation and vaccine administration are strongly associated with vaccine uptake among pregnant women. Methods Our aim was to inform new strategies to increase …

Factors Associated With Immunization Opinion Leadership Among Men Who Have Sex With Men In Los Angeles, California, Ian W. Holloway, Robert Bednarczyk, Vincent L. Fenimore, Cameron Goldbeck, Elizabeth Wu, Rebecca Himmelstein, Diane Tan, Laura Randall, Chelsea S. Lutz, Paula M. Frew

Environmental & Occupational Health Faculty Publications

We sought to identify the characteristics of men who have sex with men (MSM) who are opinion leaders on immunization issues and to identify potential opportunities to leverage their influence for vaccine promotion within MSM communities. Using venue-based sampling, we recruited and enrolled MSM living in Los Angeles (N = 520) from December 2016 to February 2017 and evaluated characteristic differences in sociodemographic characteristics, health behaviors, and technology use among those classified as opinion leaders versus those who were not. We also asked respondents about their past receipt of meningococcal serogroups A, C, W, and Y (MenACWY) and meningococcal B …

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 …

Jail, An Unappreciated Medical Home: Assessing The Feasibility Of A Strengths-Based Case Management Intervention To Improve The Care Retention Of Hiv-Infected Persons Once Released From Jail, Anne C. Spaulding, Ana Drobeniuc, Paula M. Frew, Tiffany L. Lemon, Emeli J. Anderson, Colin Cerwonka, Chava Bowden, John Freshley, Carlos Del Rio

Environmental & Occupational Health Faculty Publications

Background Linkage to and retention in care for US persons living with HIV (PLWH) after release from jail usually declines. We know of no rigorously evaluated behavioral interventions that can improve this. We hypothesized that a strengths-based case management intervention that we developed for PLWH leaving jail would increase linkage/retention in care (indicated by receipt of laboratory draws) and a suppressed HIV viral load (VL) in the year following release. Methods and findings We conducted a quasi-experimental feasibility study of our intervention for PLWH jailed in Atlanta. We recruited 113 PLWH in jail starting in 2014. “SUCCESS” (Sustained, Unbroken Connection …

Barriers To Addressing Hiv-Associated Neurocognitive Disorder (Hand): Community-Based Service Provider Perspectives, Renato M. Liboro, Francisco Ibanez-Carrasco, Sean B. Rourke, Andrew Easton, Claudia Medina, Daniel Pugh, Allan Rae, Lori E. Ross, Paul A. Shuper

Psychology Faculty Research

HIV-Associated Neurocognitive Disorder (HAND) is an emergent public health issue in developed countries. Consequently, people living with HIV who experience HAND will increasingly require support from community-based HIV service providers. The objective of our qualitative study was to identify barriers service providers face in addressing HAND among people living with HIV. Thirty-three providers from 22 AIDS service organizations across Ontario, Canada, were interviewed. Using thematic analysis, three types of barriers were identified: (a) personal/professional, (b) service access, and (c) systemic. This paper draws attention to HAND-related obstacles that service providers encounter in their work and presents options to overcome them.

The Price Of Progress: Funding And Financing Alzheimer's Disease Drug Development, Jeffrey Cummings, Carl Reiber, Parvesh Kumar

School of Medicine Faculty Publications

Introduction Advancing research and treatment for Alzheimer's disease (AD) and the search for effective treatments depend on a complex financial ecosystem involving federal, state, industry, advocacy, venture capital, and philanthropy funding approaches. Methods We conducted an expert review of the literature pertaining to funding and financing of translational research and drug development for AD. Results The federal government is the largest public funder of research in AD. The National Institute on Aging, National Institute of Mental Health, National Institute of General Medical Sciences, and National Center for Advancing Translational Science all fund aspects of research in AD drug development. Non-National …

Biomedical Informatics Applications For Precision Management Of Neurodegenerative Diseases, Justin B. Miller, Guogen Shan, Joseph Lombardo, Gustavo Jimenez-Maggoria

Public Health Faculty Publications

Modern medicine is in the midst of a revolution driven by “big data,” rapidly advancing computing power, and broader integration of technology into healthcare. Highly detailed and individualized profiles of both health and disease states are now possible, including biomarkers, genomic profiles, cognitive and behavioral phenotypes, high-frequency assessments, and medical imaging. Although these data are incredibly complex, they can potentially be used to understand multi-determinant causal relationships, elucidate modifiable factors, and ultimately customize treatments based on individual parameters. Especially for neurodegenerative diseases, where an effective therapeutic agent has yet to be discovered, there remains a critical need for an interdisciplinary …

Statistical Advances In Clinical Trials And Clinical Research, Guogen Shan, Sarah Banks, Justin B. Miller, Aaron Ritter, Charles Bernick, Joseph Lombardo, Jeffrey L. Cummings

Public Health Faculty Publications

Introduction New treatments for neurodegenerative disease are urgently needed, and clinical trial methods are an essential component of new drug development. Although a parallel-group study design for neurological disorder clinical trials is commonly used to test the effectiveness of a new treatment as compared to placebo, it does not efficiently use information from the on-going study to increase the success rate of a trial or to stop a trial earlier when the new treatment is indeed ineffective. Methods We review some recent advances in designs for clinical trials, including futility designs and adaptive designs. Results Futility designs and noninferiority designs …