Medicine and Health Sciences Commons^™

The Effects Of Environmental Prompts On Stair Usage, Lori Andersen, Tim Bungum, Sheniz Moonie Phd

Nevada Journal of Public Health

Experts have advocated exercise with little success, and have turned to encouraging physical activity by incorporating it into daily activities such as taking the stairs over elevators. Much literature exists suggesting that environmental prompts can encourage the use of stairs and literature has established that some messages may be more effective than others. This study aimed to assess the effects of selected signage prompts on stair usage. Methods: Stair and elevator use were monitored in three, two-story buildings. One building served as a control, while a fitness message was placed in another building, and the final building received a weight …

Environmental Health In Southern Nevada, Courtney Coughenour, Jennifer Pharr, Shawn Gerstenberger

Nevada Journal of Public Health

There are a multitude of environmental factors that influence public health. The purpose of this manuscript is to evaluate the Southern Nevada community with respect to environmental conditions and health, including both positive and negative traits, and develop realistic goals and strategies aimed at improving these conditions. Southern Nevada is located in one of the most arid regions of North America. Since annual rainfall averages less than four inches per year, Southern Nevada depends upon the Colorado River for its water supply. It is predicted that water flow to the area will decrease by 5% to 20% by 2050. As …

Use Of Craigslist.Org To Hook Up: Age Differences In Sex Requests, Hiv Disclosure And Negotiated Safety Among Men-Seeking-Men, Kristen Clements-Nolle, Aliya Buttar, Lindsey Dermid-Gray, Tyler Peterson, Andrea Esp

Nevada Journal of Public Health

Data from 984 “men-seeking-men” Craigslist.org postings in five cities were analyzed to assess differences in sexual requests, HIV status disclosure, and negotiated safety between young (18-24 years) and older (25 years and older) men who have sex with men (MSM). Young MSM were less likely than older MSM to post their HIV status or the preferred status of a partner (p=0.04), disclose and/or request a partner who was disease and drug free (p=.01), and request use of a condom in their posting (p=0.01). Interventions aimed at changing the culture and content of postings on Craigslist.org by encouraging HIV status disclosure …

Community Health Indicators In Southern Nevada, Courtney Coughenour, Jennifer Pharr, Shawn Gerstenberger

Nevada Journal of Public Health

Community design and access to services are essential components of healthy and sustainable communities. The purpose of this manuscript is to evaluate Southern Nevada with respect to community design and access, including both positive and negative traits, and to suggest realistic changes that could be made to improve these conditions. The region’s network of parks and open space recreation areas is one of its strongest assets. Clark County enjoys over 42 million acres of federal and state lands which offer a large variety of recreational opportunities. The region has an extensive trail system, with a total of 179 miles of …

Effective Smoking Cessation Methods Among Smokers With Diabetes In Nv, Salome Kapella-Mshigeni, Eunice Kimunai, Peter Anderson, Elizabeth Fildes, Tam Villar

Nevada Journal of Public Health

Smoking and diabetes could both be prevented if individuals would abstain from smoking, eat healthy, and exercise regularly. Smokers with diabetes have an increased risk of serious health outcomes, hence effective smoking cessation interventions are critical. The transtheoretical model was used in this quantitative study analyzing secondary data from the state of Nevada Quitline to examine the relationships between smoking cessation method (counseling versus counseling and medication) and quitting smoking for 720 smokers with/without diabetes. Participants were Nevada residents, ages 18+, men and women, English or Spanish speakers. Descriptive statistics, logistic regression, and a test of two proportions were conducted. …

Education And Educational Attainment In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Failure to complete high school has a direct impact on a person’s earning potential and quality of life. Higher levels of education are associated with better health. Because of this association, it is important for children and adults to have access to quality education. The percentage of adults who have successfully pursued higher education in Southern Nevada is lower than the peer Mountain West metropolitan areas and the national average. Nevada high school graduation rates are the lowest in the nation. High school graduation rates and dropout rates vary by race/ethnicity in the Clark County School District. High school graduation …

Employment And Economic Development In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Wealth influences a person’s health. People who are higher on the socioeconomic scale tend to have better health outcomes. To improve the health of a community, it is important to understand the employment opportunities of the people living in the community.

Southern Nevada’s economy was hit hard between 2008 and 2012. Unemployment rates in the region exceeded national and peer regions between during this time period. Construction; leisure and hospitality; trade, transportation and utilities; and professional and business service sectors experienced the greatest job loss during the recession. The Education and Health Services sectors did not experience a decrease in …

Healthcare Access And Health Outcomes In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

In a publication from the Robert Woods Johnson Foundation, it was recognized that a person’s zip code was a more important predictor of health than their genetic code. Where we live influences not only our access to health care, but other health indicators as well. Clark County has a low primary care physician to population ratio compared to other counties in Nevada and in the US. Clark County also has highest rates of uninsured in the Mountain West and among the highest in the nation.

Southern Nevada fared worse than other Mountain West Metropolitan areas in health indicators and preventative …

Demographic Makeup And Population Projections For Southern Nevada: Understanding The Emerging Healthcare Needs In Our Community, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Even with a leveling-off of population growth from 2008 to 2011, Southern Nevada had one of the fastest growing populations in the nation over the past decade. While population growth is projected to increase for the next ten years, the rate of growth will be slower than in the past decade. The Hispanic population, as a percentage of the total population, is projected to surpass the White population somewhere near the year 2030. The Southern Nevada population is aging, as the median age in the region increased between 2000 and 2010. The 65+ age group is projected to increase as …

Building A Sustainable Community Through Public Engagement: A Study Of Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

This manuscript is the first of a series written for the Nevada Journal of Public Health. The series is result of research conducted for the Southern Nevada Strong, Sustainable Communities Grant. During Year One of the planning process, we created a Southern Nevada Existing Conditions Report. This report highlighted where the region stood on key metrics including: demographics and population projections, access to healthcare and health outcomes, healthy community, housing, environment, economy and education. For this special issue of the Nevada Journal of Public Health, the report was separated into seven articles related to each of these metrics. The articles …

Refining Best Practices For The Diagnosis Of Autism: A Comparison Between Individual Healthcare Practitioner Diagnosis And Transdisciplinary Assessment., Jessica Rae Stewart, Debra C. Vigil, Erika Ryst, Wei Yang

Nevada Journal of Public Health

The purpose of this study is to compare the diagnostic decision-making of individual healthcare practitioners against that of a transdisciplinary team. Despite national recognition of transdisciplinary assessment as the gold standard diagnostic approach, autism is most frequently diagnosed by individuals working independently in a variety of disciplines. The current study examined how closely these individual practitioners make diagnoses matching that of a transdisciplinary team. Twenty professionals from five different disciplines viewed videotape clips of fifteen children previously assessed by a transdisciplinary team. Results confirmed that individual healthcare practitioners matched the transdisciplinary team diagnosis on average only 65.6% of the time. …

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

Nevada Journal of Public Health

Throughout the duration of any influenza season, influenza strains have the ability to evolve through mutation causing alterations in virulence. These changes may result in severe illness or death among susceptible populations; therefore, it is important to closely monitor influenza-associated hospitalizations and deaths. The University of Nevada, Las Vegas in collaboration with the Southern Nevada Health District analyzed data from the hospitalized influenza morbidity and mortality surveillance project for Clark County for the 2010-2011 influenza season. Among the study population (N= 158): the influenza strain type was found to be significantly associated with deaths (n= 25), vaccination status was not …

Environmental Correlates Of Physical Activity Among African-American Adults, Tim Bungum, Jennifer Pharr, Paulo S. Pinheiro, Maria Azzarelli

Nevada Journal of Public Health

The purpose of this cross-sectional study was to identify perceived environmental correlates of meeting physical activity guidelines among African-American adults living in Southern Nevada. Trained interviewers phoned potential participants who lived in the 12 zip codes of Clark County, Nevada with the highest proportions of African-American residents. Respondents (n=237) answered 52 health-related and demographic questions. Slightly less than 50% of participants met physical activity guidelines. A factor analysis procedure produced two environmental variables, neighborhood safety and environmental supports for physical activity. Age, gender and educational attainment (p<.05) predicted the meeting of those guidelines (R2=.214), while neighborhood support for physical activity, neighborhood safety, and BMI failed to do so. This finding suggests that environmental factors are not strong predictors of physical activity among African- American adults, although environmental supports for physical activity approached significance. Future studies should consider assessing additional aspects of the built environment as an influence on physical activity.

Effectiveness Of A Portable, Large-Area Ultraviolet Germicidal Device, Mark P. Buttner, Thomas Yee, Patricia Cruz, Vanessa Stevens

Nevada Journal of Public Health

Effective disinfection of the hospital environment is a key component in the prevention of healthcare-associated infections. The objective of this project was to evaluate the effectiveness of an ultraviolet germicidal device in reducing the concentrations of culturable bacteria on indoor surfaces. The ultraviolet germicidal device was installed and operated in four experimental trials conducted in a microbiology research chamber. Agar plates inoculated with known concentrations of two test microorganisms were placed on benches inside the chamber at two distances, 1.5 meters and 3.0 meters from the machine, for exposure times of 5 minutes, 10 minutes, and 20 minutes. With test …

Selective Screening Of Type 2 Diabetes For Washoe County’S Hispanic Population, Linda M. Dunn

Nevada Journal of Public Health

Hispanic Americans with unrecognized, asymptomatic diabetes are more likely to experience poor quality of life and diabetic complications such as heart, eye and kidney disease than non-Hispanic whites of similar age. Multiple factors, such as cultural beliefs, lack of knowledge and limited access to health care, contribute to the fact that one-third of total diabetes among Hispanic Americans is undiagnosed. For Washoe County, Nevada, the actual percentage of adult Hispanics with diabetes may be almost 12%. In 2003, the Defeat Diabetes Screening Project provided three screenings targeting the Hispanic population in Reno and Sparks. Seventy-one percent of 348 screened were …

How We Want To Be Treated! What Clark County African American Patients Want Their Health Providers To Know, Charlene A. Day, Joyce Woodson, Erica Archuleta

Nevada Journal of Public Health

Research continues to validate the fact that cultural values and beliefs play a major role in determining the extent to which an individual will engage in healthy behaviors, adhere to medical regimen, and seek care when necessary. A 2000 survey of 950 members of predominately African American churches in Clark County, Nevada (a county which comprises Las Vegas) conducted by the University of Nevada Cooperative Extension found members preferred healthcare providers as a source of information on health-related matters. Yet, research shows that for a variety of reasons, many African Americans do not regularly see a health care professional, and …

Screening For Mental Health Problems Among Incarcerated Youth In Nevada: Practice And Policy, Michelle Chino, Jennifer Personius-Zipoy, Denise Tanata

Nevada Journal of Public Health

Incarcerated youth in Nevada with serious mental health problems are not being effectively identified. The current study examined the utility of simple screening instruments as a mechanism for identifying incarcerated youth who may have a mental health disorder. Adjudicated youth, incarcerated at each of Nevada’s 12 juvenile detention facilities, participated in the study by completing a demographic questionnaire and a standardized mental health screening instrument: the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2). Findings indicate a high prevalence of mental health disorders among incarcerated juveniles in Nevada. Identifying youth with mental health problems is complicated by the lack of a systematic …

Exercise Determined Promise 2003 Logandale, Nevada Plague Prophylaxis Clinic: Exercising The Strategic National Stockpile, Kay Godby, Mary Ellen Harrell, Bonnie Sorenson, Maureen Fanning, Nancy Gerken, Jane Shunney

Nevada Journal of Public Health

The Department of Defense asked the Clark County Health District (CCHD) to participate in the disaster drill entitled Determined Promise ’03 (DP ‘03) from August 18 -23, 2003. The purpose of this exercise was to test the capacities of the U.S. Northern Command (U.S.Northcom) Homeland defense/homeland security mission and integration of the Joint Task Forces-Civil Support (JTF-CS) with state and local responders. Part of the JTF-CS mission was to coordinate military support to civilian state and local authorities when it was requested.

Patient Satisfaction In A Statewide Cervical Cancer Screening Program, Christopher R. Cochran, Salome Kapella

Nevada Journal of Public Health

A cross-sectional study of patients participating in the Nevada State Health Division’s Women Health Connection Program (WHC) was conducted to assess patient satisfaction for cervical cancer screening. In this study, 528 WHC program patients provided information regarding their satisfaction with the treatment services they received, accessibility issues, breast and cervical cancer health education and information, and overall program satisfaction. A large majority of patients reported high levels of satisfaction with the program services and clinic personnel. Significant positive correlations were found when comparing satisfaction with services received at the clinic to treatment received by physicians, nurses, and admissions personnel, how …

The Contributions Of Two Public Health Pioneers: John Snow And Joseph Goldberger, Timothy J. Bungum

Nevada Journal of Public Health

Similar to many professional disciplines, public health was shaped by pioneers who made important contributions. Two trailblazers, whose work current public health officials should be aware of are Drs. John Snow and Joseph Goldberger. Although Snow is a well known public health figure, mentions of his work in contemporary health promotion and public health text books are generally limited and typically comment only on his study of the Broad Street Pump (BSP) cholera outbreak. The accomplishments of Joseph Goldberger receive even less coverage than those of Snow. Goldberger’s work in identifying the cause of pellagra was instrumental in creating the …

Protecting Children From Overexposure To Lead In Candy And Protecting Children By Lowering The Blood Lead “Level Of Concern” Standard, Bryan Wagner, Colleen C. Hughes, Robert Sobsey

Nevada Journal of Public Health

The American Public Health Association: Recognizing that in April 2004, the Orange County Register in an investigative report, published for the first time information that the state of California had been testing for lead in candies for decades but had not informed the public about the high lead levels in many candies, candy wrappers and seasonings (sold as a snack item and consumed as candy) imported from Mexico, the Philippines and other countries.

Oral Health Needs And Parental Attitudes, Behavior, And Knowledge Of Lower Ses Children, Mildred Mcclain, Clifford R. Mcclain, Anthony Paventy

Nevada Journal of Public Health

Despite the declining prevalence of dental caries over recent decades, caries remain the most common chronic childhood disease, especially in high-risk (low socio-economic status) populations. This appears to be true even when parents are aware of good oral health habits. The purpose of this study was to gather oral hygiene data on high-risk children in Nevada and to assess parental attitudes and education concerning their children’s oral health. Using visual examinations and a dmft (decayed, missing, filled, teeth) severity index, 235 lower SES children were screened and given treatment recommendations. The screenings showed larger than expected prevalence in both caries …

Findings From The Nutrition Challenge Program, Rayleen Earney, Nicole Bungum, Timothy J. Bungum

Nevada Journal of Public Health

Obesity is an epidemic in the United States. Over 61% of U.S. adults and 58% of Nevada adults have Body Mass Index’s (BMI) that classify them as either overweight or obese (Behavioral Risk Factor Surveillance System [BRFSS], 2005). According to a recent article published in the Journal of the American Medical Association, obesity was the second leading cause of preventable death in the United States behind tobacco use (Mokdad, Marks, Stroup & Gerberding, 2004).

While obesity and overweight are complex, multi-factorial health conditions, an important contributor to the overweight and obesity epidemic is poor dietary habits. One of the major …

Evaluation Of The Impact Of A Health Care Administration Student Practicum, Christopher R. Cochran, Michelle Sotero

Nevada Journal of Public Health

As the health care industry becomes increasingly complex, many leaders and practitioners in the field are worried about the quality and preparation of health care administration graduates (Robbins, Bradley, & Spicer, 2001). Academic health care administration programs prepare students for a professional career in the health care field. One of the biggest challenges for university health care administration programs is to meet industry needs by effectively incorporating practical skills and knowledge into the academic curricula. For students, coursework provides some insight into the demands of the industry, but they also require hands-on experience to be relevant in a highly competitive …

Lead Shot Deposition And Distribution In Southern Nevada, Shawn Gerstenberger, Darren D. Divine

Nevada Journal of Public Health

Densities of lead (Pb) shot in soil and the presence of Pb shot in waterfowl gizzards from past hunting activities at the Overton Wildlife Management Area (OWMA) in southern Nevada were determined. Soil shot densities in fields managed for doves, pheasants and geese, and adjacent fields strictly managed as waterfowl habitat were examined. Soil shot densities ranged from 2,691 to 107,642 Pb shot/ha in waterfowl areas to 649,085 to 862,275 Pb shot/ha in dove management areas. Pb shot deposition rates for the 1998-1999 dove hunting season were also calculated and ranged from 8,970 to 22,559 shot/ha in fields managed primarily …

Nevadans Without Health Insurance, Charles B. Moseley, Michelle Sotero

Nevada Journal of Public Health

Individuals without health insurance in this country represent a serious public health concern. Nevada has one of the highest rates of uninsured in the country. This article provides a demographic and socioeconomic profile of the uninsured in Nevada and describes how Nevada’s uninsured rates compare with other states. The article also addresses the impact of Nevada’s private and public health insurance programs on the uninsured.

Adverse Maternal Outcomes For Women With Different Health Insurance Statuses In Nevada, Jay J. Shen, Hong Wei

Nevada Journal of Public Health

Objective. Nevada women with unfavorable health insurance status may face greater barriers than women in the rest of the nation, since the development of healthcare infrastructure in Nevada is running behind population growth. This study examines the relationship between health insurance status and adverse maternal outcomes in Nevada.

Methods. Hospital discharge information of 33,149 women aged 13 or older who delivered in 2004 was abstracted from the 2004 State Inpatient Data for Nevada. A total of 13 measures of complications associated with pregnancy were identified, including preterm labor, hypertensive disorders of pregnancy, gestational diabetes, ante-partum hemorrhage, membrane disorders, cesarean section, …

A Study To Determine If University Athletic Teams In Desert Environments Experience Risky Diet-Related Behaviours, Susan Meacham, Christine Bergman, Marcia M. Ditmyer, Kyle Wilson, Connie Mobley

Nevada Journal of Public Health

Training and competing in desert environments may exacerbate concerns related to disordered eating, supplement use, and hydration in some student athlete populations. A survey administered equitably to both genders solicited self-reported responses from members of 18 different teams over four years from a southwestern United States university athletic program. More than 1,700 athletes responded to 42 items on the questionnaire. Teams, not individual student athletes, were the units of measure for statistical analyses. Initial analysis of results indicated that there were no overt concerns regarding dietary behaviors due to training and competing in the desert environment. Further analysis subjected the …

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 …

The Effects Of Television Food Advertising On Childhood Obesity, Aleathia Cezar

Nevada Journal of Public Health

Children’s food choices are influenced by the media, television advertising, focusing directly at infants and toddlers. This literature review presents multiple studies that explain how TV advertising of fast food, sugary cereals and other foods high in calories, fat, sugar, sodium and low in nutrients are contributing to the increase rates of childhood obesity. It is concluded that children are exposed to high amounts of food advertisements which affect young children’s food choices and poor food consumption. Due to the growing numbers of hours that children sit in front of the television, less physical activity and the epidemic of childhood …