Medicine and Health Sciences Commons^™

Economic Impact Of Medical Education Expansion In Nevada: Economic Impact Assessment And Recommended Approach, Tripp Umbach

Lincy Institute Reports and Briefs

In May 2013, The Lincy Institute1 commissioned, Tripp Umbach2 to prepare an economic impact report to show the value of a new, four-year allopathic medical school (hereinafter referred to as the new four-year medical school) in Las Vegas. To accomplish this task, Tripp Umbach evaluated multiple medical school development models in order to recommend the optimal model that would provide the greatest economic impact to the state of Nevada and the Las Vegas Metropolitan area.

The Lived Experiences Of Acute-Care Bedside Registered Nurses Caring For Patients And Their Families With Limited English Proficiency, Jami-Sue Coleman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Approximately 8.6% of the total U.S. population is considered limited English proficient (LEP), a term that has been used by official US federal policy and will be used throughout this study. In a landmark report, the Institute of Medicine found that minorities received lower-quality health care than Caucasians even when insurance status, income, and other factors were equivalent. These differences were tied to issues such as bias, stereotypes and communication barriers between patients and their caregivers. In the hospital setting, registered nurses provide the most direct contact with patients and their families. Effective communication between patients and health care professionals …

3-D Oropharyngeal Airway Analysis Of Different Antero-Posterior And Vertical Craniofacial Skeletal Patterns In Children And Adolescents, Chi Kim Huynh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sleep apnea disorder has recently emerged as a significant public health issue. While the prevalence of obesity is on the rise among children, it is one of the main risk factors associated with apnea. Upper airway dimensions and morphology seem to be major components of obstructive sleep apnea (OSA) and can be affected by different craniofacial patterns. The purpose of this retrospective, cross-sectional pilot study is to correlate gender, Body Mass Index, risk for OSA, neck circumference, and 3-D oropharyngeal airway dimensions in children and adolescents with different antero-posterior (AP) and vertical craniofacial skeletal patterns. A total of 86 pre-orthodontic …

Examining The Inner Experience Of Four Individuals With Bipolar Disorder Using Descriptive Experience Sampling, Johanah Kang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Bipolar disorder is a lifelong mood disorder with diagnostic criteria that provide a description of expected experiences of individuals diagnosed with BD (e.g., elevated mood, sadness, difficulty concentrating). Despite these criteria, the inner experience of these individuals is largely unknown. Understanding the inner experience of individuals diagnosed with BD may prove essential in understanding and treating BD. The present study examined the inner experience of four individuals diagnosed with BD using the Descriptive Experience Sampling (DES) method (Hurlburt 1990, 1993, 2011). Results revealed all our participants had clear and prevalent experiences of sensory awareness. They also had difficulties apprehending and …

Factors Associated With Parental Decision Making And Childhood Vaccination, Zuwen Qiu-Shultz

UNLV Theses, Dissertations, Professional Papers, and Capstones

In order to better understand factors affecting immunization status, logistic regression was used to assess the association of various socio-demographic factors and whether parents would have their child immunized if not a state mandate. Factors included in the study were race, household income, number of children in the household, number of adults in the household, if the child had a primary provider, if the child had a health check-up in the last twelve months, and medical insurance status of the child. The combined Nevada Kindergarten Health Survey Result of 2009-2010 (Year Two) and 2010-2011 (Year Three) conducted by the Nevada …

What Works In Suicide Bereavement: What Helps And What Hurts?, Quintin Hunt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Suicide is one of the most painful grief experiences that any family may experience. The suicide bereavement literature, though small, is replete with research that shows family and systemic impacts of suicide. The literature also includes constant calls for family- and systemic-based intervention as every part of society is impacted. Research in the field of marriage and family therapy, however, has ignored suicide and suicide bereavement almost entirely. The purpose of this qualitative study is to develop a more thorough understand of the grief that survivors of suicide experience and to systemically understand what helps and hurts the grieving process. …

Developing Ethical Competence: The Perspective Of Nurse Educators From Pre-Licensure Baccalaureate Nursing Programs Accredited By The Commission On Collegiate Nursing Education, Jennifer Lee Bartlett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurses face ethically-charged situations every day, yet ethics education is not universally integrated into pre-licensure baccalaureate nursing programs. Like other forms of competence, ethical competence requires development. Nurse educators are poised to impact on the competence of their students, both defining the ethics content and designing students' exposure. The purpose of this study is to describe the concept of ethical competence from the perspective of baccalaureate nursing faculty and describe current methods of integration and evaluation of ethics education in pre-licensure baccalaureate nursing programs. This research will be conducted using a sequential (quantitative-qualitative) mixed method approach. The first phase of …

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 - …

New Mouthguard Design With Intermediate Nickel-Titanium And Foam Layer, Freddie Martinez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Mouthguards help prevent orofacial injuries in many physical activities, commonly to the maxillary incisors. Mouthguards have many different properties which can be idealized. One property involves the amount of impact force the mouthguard can dissipate, commonly referred to as shock absorption. The aim of this study was to improve shock absorption capabilities beyond the protection that a mouthguard made of Ethylene Vinyl Acetate (EVA) can offer. A Nickel-Titanium (NiTi) and/or foam intermediate layer was placed between EVA. Seven configurations were fabricated at 3 different thicknesses. The configurations consisted of an intermediate layer composed of NiTi, foam, or NiTi/foam. The NiTi …

Sex Determination Using Discriminant Function Analysis In Hispanic Children And Adolescents: A Lateral Cephalometric Study, Alyssa E. Sprowl

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lateral cephalometric radiographs have been used for years to help diagnose skeletal and dental patterns in Orthodontics. Within the last decade, these radiographs have caught the interest of the department of Anthropology for the identification of gender within the adult and adolescent population. Numerous publications have been made but failed to identify sexual dimorphism in the pre-adolescent population. 303 lateral cephalograms of pre and post Latino adolescence age ranging from 6.5 to 17.9 years old were obtained from University of Nevada, Las Vegas (UNLV) digital database. 25 variables were identified and plotted with all linear and angular measurements transferred into …

From (Un)Willingness To Involvement: Development Of A Successful Study Brand For Recruitment Of Diverse Msm To A Longitudinal Hiv Research, Paula M. Frew, Victoria A. Williams, Eve T. Shapiro, Travis Sanchez, Eli S. Rosenberg, Vincent L. Fenimore, Patrick S. Sullivan

Environmental & Occupational Health Faculty Publications

Background. HIV continues to be a major concern among MSM, yet Black MSM have not been enrolled in HIV research studies in proportionate numbers to White MSM. We developed an HIV prevention research brand strategy for MSM. Methods. Questionnaires and focus groups were conducted with 54 participants. Descriptive statistics and chi-square analyses were performed and qualitative data were transcribed and content analyzed to identify common themes. Results. Formative research results indicated that younger Black MSM (18–29 years) were less likely to think about joining prevention studies compared to older (≥30 years) Black MSM (, ). Qualitative and quantitative results indicate …

Identifying And Describing The Network Of Health, Education, And Social Service Non-Profit Organizations In Southern Nevada, Shannon M. Monnat, Anna Smedley

Lincy Institute Reports and Briefs

Many of the economic, social, and demographic issues facing southern Nevada are dynamic and interrelated, requiring a coordinated approach on the part of southern Nevada’s non‐profit community. The coordination of services, skills, and talents enables community needs to be addressed in ways that exceed the scope and capacity of any single organization. With the increasing desire of funding organizations to support collaborative efforts, maintaining sustainable connections between southern Nevada’s non‐profit organizations is needed now more than ever before.

This is the first comprehensive study of southern Nevada’s health, education, and social service non‐profit network. Via a web‐based survey of nearly …

Physiological And Pharmacokinetic Effects Of Oral 1,3-Dimethylamylamine Administration In Men, Brian Schilling, Kelley Hammond, Richard Bloomer, Chaela Presley, Charles Yates

Kinesiology and Nutrition Sciences Faculty Publications

No abstract provided.

How Are The Children: Challenges And Opportunities In Improving Children's Mental Health, Ramona W. Denby, Sandra D. Owens, Sarah Kern

Lincy Institute Reports and Briefs

The mental health of children is critical to their growth and development, but when their well-being is considered, discussions more often gravitate toward physical health, nutrition, education, parental influences, and living conditions. While these all represent important indicators of well-being, discussions also need to consider the importance of children’s mental and behavioral health. In this brief we explore the status of Southern Nevada’s children as it relates to mental health outcomes. Like physical health, good mental health is paramount to children’s overall functioning and maturation. Frequently when a child experiences mental and behavioral health challenges, signs and symptoms manifest in …

Prevention Of Type 2 Diabetes In Urban American Indian/Alaskan Native Communities: The Life In Balance Pilot Study, Daniel C. Benyshek, Michelle Chino, Carolee Dodge-Francis, Toricellas O. Begay, Hongbin Jin, Celeste Giordano

Environmental & Occupational Health Faculty Publications

Objective: The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American Indians/Alaska Natives (AI/ANs) living in a large urban setting (Las Vegas, Nevada). Research Design and Methods: A total of 22 overweight/obese AI/ANs (age, 39.6 ± 10.4 years; BMI, 34.1 ± 6.3 kg/m2) at increased risk for developing type 2 diabetes (HbA1c > 5.4 (36 mmol/mol) < 6.4 percent (46 mmol/mol) participated in the program between April and December, 2011. Study participants completed a 16 week intensive lifestyle coaching intervention. In addition to obtaining qualitative data regarding opportunities and challenges of applying the lifestyle intervention for AI/AN participants in an urban setting, clinical data, including BMI, waist circumference, blood pres- sure, fasting blood glucose, and blood lipids (HDL, LDL and Triglycerides), were collected. Results: Only 12 of the 22 participants remained in the LIB program at the final post-program follow-up. Participants demonstrated significant decreased waist circumference and elevated HDL cholesterol. Triglycerides manifested the highest percentage change without statistical significance. No significant change was ob- served in blood pressure or fasting blood glucose. Conclusions: LIB participants’ improvements in BMI, waist circumference, HDL cholesterol and triglycerides suggests type 2 diabetes prevention programs aimed at urban AI/ANs show significant potential for reducing the risk of developing type 2 diabetes among this underserved and high risk community. Qualitative data suggest the main challenge for type 2 diabetes prevention specific to this population is a need for improved community outreach strategies.

Do Life Style Factors And Socioeconomic Variables Explain Why Black Women Have A Remarkably Higher Body Mass Index (Bmi) Than White Women In The United States? Findings From The 2010 National Health Interview Survey, Mohammad Siahpush, Courtney A. Pinard, Gopal K. Singh, Melissa Tibbits, Raees A. Shaikh, Amy Yaroch

Journal of Health Disparities Research and Practice

Objective: There are marked inequalities in body mass index (BMI), overweight, and obesity across ethnic groups. We sought to examine the extent to which lifestyle factors and socioeconomic variables explain the higher BMI in Black women compared to White women in the United States.

Methods: We used data from the 2010 National Health Interview Survey (NHIS) and limited the sample to non-Hispanic Black and non-Hispanic White women (n = 9,491). We employed normal regression and compared the association of race with BMI before and after adjusting for lifestyle factors (diet, physical activity, smoking, and drinking) and socioeconomic variables (education, ratio …

Health Disparities In Colorectal Cancer Screening In United States: Race/Ethnicity Or Shifting Paradigms?, Adina Williams, Kirk Dabney, Holmes Laurens Jr

Journal of Health Disparities Research and Practice

Background: Colorectal cancer (CRC) remains the third leading cause of cancer death in the United States. The incidence, mortality, and screening vary by race/ethnicity, with African Americans and Hispanics being disproportionately represented. Early detection through screening prolongs survival and decreases mortality. CRC screening (CRCS) varies by race/ethnicity, with lower prevalence rates observed among minorities, but the factors associated with such disparities remain to be fully understood. The current study aimed to examine the ethnic/racial disparities in the prevalence of CRCS, and the explanatory factors therein in a large sample of U.S. residents, using the National Health Interview Survey, 2003. …

A Systematic Review Of Pregnancy Prevention Programs For Minority Youth In The U.S.: A Critical Analysis And Recommendations For Improvement, Sarah B. Maness, E R. Buhi

Journal of Health Disparities Research and Practice

African American and Latino youth experience disproportionate rates of both intended and unintended pregnancy in the United States. A public health priority to ameliorate the high rates among this population has been the creation and proposed expansion of pregnancy prevention programs designed specifically for minority youth. However, little is known about the role of incorporating cultural components into program curricula. To better understand the components and outcomes of existing programs for this population, this systematic review analyzed published outcome evaluations of adolescent pregnancy prevention programs for minority youth. This review of literature published from January 2002 to June 2012 and …

Up North They’Re Talking Sex: A Collaborative And Community Driven Model For Sexual Health Knowledge Mobilization, Karen Edwards, Steve Mitchell Phd, Nancy Gibson Phd, Cecilia Zoe-Martin, Anita Daniels, Jim Martin, Patrick Wansbrough Rn

Journal of Health Disparities Research and Practice

To address high STI rates in their aboriginal communities, the Tłı̨chǫ of the Northwest Territories adopted a collaborative participatory research approach to sexual health based on four key stages of development. First was community initiation and engagement, where local leaders identified a priority need and began community discussions around sexual health. Secondly, identifying that existing government statistics did not provide them with adequate information, the Tlicho Community Services Agency partnered with the University of Alberta and CIETcanda to conduct a baseline study in all four Tlicho communities, designed and administered by community-based researchers. Third, a community action research team (CART) …

Variance In Patient Access To Support Persons By Race/Ethnicity And Language Preference: An Analysis Of Patient Survey Data, Andrew J. Jager, Matthew K. Wynia

Journal of Health Disparities Research and Practice

Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had …

Racial/Ethnic Disparities In Infectious Disease Hospitalizations In Arizona, Laura Callinan, Robert Holman, Douglas Esposito, Marian Mcdonald

Journal of Health Disparities Research and Practice

Infectious disease (ID) hospitalizations in Arizona, a diverse population with nearly complete race/ethnicity data, were analyzed using the State Inpatient Database for 2005-2008. ID hospitalizations rates were calculated and compared by ID group, race/ethnicity, age, and sex. During 2005-2008, there were 383,597 ID hospitalizations reported in Arizona, resulting in an age-adjusted rate of 1498.1 per 100,000 persons. A range of racial/ethnic disparities in ID hospitalization rates were noted. Persons of Native American and black race/ethnicity had overall ID hospitalization rates higher than the rate for persons of white race/ethnicity; persons of Asian or Pacific Islander race/ethnicity had a lower rate. …

Health Disparity And Structural Violence: How Fear Undermines Health Among Immigrants At Risk For Diabetes, Janet Page-Reeves, Joshua D. Niforatos, Shiraz Mishra, Lidia Regino, Andrew Gingerich, Robert Bulten

Journal of Health Disparities Research and Practice

Diabetes is a national health problem, and the burden of the disease and its consequences particularly affect Hispanics. While social determinants of health models have improved our conceptualization of how certain contexts and environments influence an individual's ability to make healthy choices, a structural violence framework transcends traditional uni-dimensional analysis. Thus, a structural violence approach is capable of revealing dynamics of social practices that operate across multiple dimensions of people’s lives in ways that may not immediately appear related to health. Working with a Hispanic immigrant community in Albuquerque, New Mexico, we demonstrate how structural forces simultaneously directly inhibit access …

Development, Implementation, And Assessment Of Health Equity Action Training (Heat): Implications For Local Health Departments, Karen A. D'Angelo, Carmen Chaparro, Rita Kornblum, Grace Damio, Rafael Pérez-Escamilla

Journal of Health Disparities Research and Practice

As inequities in health persistently plague our nation, rates of chronic disease continue to escalate, and increasing health care costs further debilitate our economy, the profession of public health is faced with monumental challenges. As a central community health institution, the local public health department plays an essential role in eliminating health inequities and preventing chronic disease. With the objective of preparing the local public health workforce to address the root factors associated with health, the Health Equity Action Training project trained 85 staff of the Hartford Department of Health & Human Services in the social determinants of health, social …

Physical Activity And Social Cognitive Theory Outcomes Of An Internet-Enhanced Physical Activity Intervention For African American Female College Students, Rodney P. Joseph, Dorothy W. Pekmezi, Terri Lewis, Gareth R. Dutton, Lori W. Turner, Nefertiti H. Durant

Journal of Health Disparities Research and Practice

Background. African American women report low levels of physical activity (PA) and are disproportionately burdened by related chronic diseases. This pilot study tested a 6-month theory-based (Social Cognitive Theory, SCT) culturally-relevant website intervention to promote PA among African American female college students.

Materials and Methods. A single group pre-post test design (n=34) was used. PA and associated SCT constructs (outcome expectations, enjoyment, self-regulation, social support) were assessed at baseline, 3 months and 6 months.

Results. The sample was comprised of mostly obese (M BMI= 35.4, SD=6.82) young adults (M age= 21.21 years, SD=2.31). Fifty percent …

2012 Annual Report Of Child Deaths In Clark County, Nevada, Nevada Institute For Children’S Research And Policy, Tara Phebus

Nevada Institute for Children's Research and Policy Reports

The primary goal of all Child Death Review Teams is to prevent future child deaths. The child death review process enables jurisdictions to come together in a collaborative, multidisciplinary forum to openly discuss detailed circumstances in an effort to gain a better understanding of child deaths. The team provides a venue for representatives from a variety of both public and private agencies as well as community organizations to share information in a confidential and non-threatening environment. The National Center for Child Death Review (hereinafter, National Center), which is supported by the Maternal and Child Health Bureau of the U.S. Department …

Adult Permanent (Extracted) Teeth As A Source Of Dental Pulp-Derived Mesenchymal Stem Cells (Dpsc): A Pilot Study, Charles Hill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Mesenchymal stem cells (MSC) may be derived from a variety of adult human tissues, including dental pulp from extracted or exfoliated teeth. Evidence suggests differences in both the quality and quantity of the dental pulp-derived mesenchymal stem cells (DPSC) obtained from different sources, such as primary or "baby teeth" and adult, permanent teeth. This study aimed to evaluate the potential to obtain DPSC from intact, vital permanent teeth, and characterize the potential isolates using a randomized selection of active dental patients from the University of Nevada, Las Vegas School of Dental Medicine (UNLVSODM). DPSC were extracted, isolated, cultured and characterized …

Alternations Of Nmda And Gabab Receptor Function In Development: A Potential Animal Model Of Schizophrenia, Monica Bolton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Schizophrenia is a debilitating mental disorder that affects up to 3% of the world population. The behavioral symptoms are categorized into positive and negative symptoms, which appear during late adolescence/early adulthood. Unfortunately, the underlying cellular and molecular mechanisms of the disease are poorly understood. Several hypotheses exist to explain mechanisms contributing to these behavioral alterations. One model proposes that a reduced function of the NMDA glutamate receptor on specific GABAergic interneurons may be responsible for deficits in schizophrenia. Post-mortem investigations provide evidence of reductions in both glutamate and GABA-related proteins in patients with schizophrenia. Further, GABAergic interneurons that are activated …

Coping With Pediatric Cancer: Conversational Methods Utilized By Parents And Children When Dealing With Pediatric Cancer, Chelsi Morgan Walls

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study analyzed how people perceived parents should communicate with their child regarding pediatric cancer treatments. When dealing with pediatric cancer, it is vital that parents and their child communicate about the illness in order to effectively cope with the cancer. Using Uncertainty Management Theory, appraisals, inferences, and illusions, are examined in this study to discover how much affect-management and buffering would be used to manage the illness. Under UMT, the coping mechanisms of affect-management (i.e., religious coping and behavioral disengagement), and buffering (avoidance and child distraction) depend upon how individuals appraise the uncertain situation (positive vs. negative), the inferences …

Examining The Inner Experience Of Three Individuals With Major Depressive Disorder And Three Individuals With Bipolar Disorder, Janell Marie Mihelic

UNLV Theses, Dissertations, Professional Papers, and Capstones

The diagnostic criteria for major depressive disorder (MDD) and bipolar disorder (BD) provide a description of expected experiences of individuals diagnosed with those disorders (e.g., sadness, expansive mood, difficulty concentrating). However, much remains unknown about the inner experience of individuals with these disorders which may prove crucial in understanding and treating these disorders. The present study examined the inner experience of three individuals with MDD and three individuals with BD using the Descriptive Experience Sampling (DES) method (Hurlburt 1990, 1993, 2011). Results were not suggestive of any clear, consistent patterns of inner experience either within the MDD or BD groups …

Weight Gain In Pregnancy And Pre-Menopausal Breast Cancer: A Population-Based Case-Control Study, Arash Ardalan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The risk of breast cancer increases transiently after pregnancy and then falls to a lower level than for age-matched nulliparous women. Higher levels of estrogen are known as the primary reason. Several pregnancy characteristics are thought to be confounding the above link; however, except for the age at first pregnancy no other pregnancy-related factor has been proved to be significant. Specifically, it has not been established that an excessive weight gain in pregnancy is linked to the maternal risk of breast cancer.

Objectives: To identify independent influence of weight gain in pregnancy on the risk of pre-menopausal breast cancer …