Public Health Commons^™

The Prevalence And Predictors Of Complementary And Alternative Medicine (Cam) Use Among Racially/Ethnically Diverse College Students, Hermella Misiker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: National data on complementary and alternative medicine (CAM) use, available through the National Health Interview Survey (NHIS), convey higher prevalence of CAM use among college students compared to the general U.S population. NHIS findings also highlight non-vitamin non- mineral (NVNM) products are the most widely used form of CAM in the U.S. The purpose of this study was to identify the socio-cognitive and demographic predictors of CAM and NVNM use among a racially/ethnically diverse college student body.

Methods: An online survey was used to collect data from 392 University of Nevada, Las Vegas (UNLV) undergraduate, graduate, and professional students. …

Sexually Transmitted Infections And The 65 And Older Population: Knowledge And Perceived Risk, Alexus Miranda

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sexually transmitted infections (STI) can impact all persons. Since 2000, the number of STIs has steadily increased among persons aged 50 years and older in the United States (Purpora, 2012). Persons over the age of 60 accounted for the biggest increase of in-office treatments of STIs between 2014 and 2017 (Howley, 2018). The purpose of this study was to use the Sexual Health Model to examine the relationship between various predictors and these persons’ perceived risk of STIs, their STI knowledge, and other barriers that impact the sexual health of persons 65 years of age and older. This study used …

Stress And Coping In Food-Insecure African Americans In Clark County, Nevada, Johanna Andrews

UNLV Theses, Dissertations, Professional Papers, and Capstones

African Americans have the highest rates of food insecurity than any other racial/ethnic group in the nation as a result of poverty, low household income, unemployment, food injustice, food mirages, and racial segregation. This consistent uncertainty in food access demonstrably results in poor mental health outcomes for food-insecure African Americans. Thus, the Transactional Model of Stress and Coping provides a theoretical framework to investigate how African Americans cope with food insecurity. The purpose of this study was to evaluate processes of coping with food insecurity and determine their impact on emotional well-being for African Americans in Clark County, Nevada. A …

Assessing The Health And Financial Burden Of Neonatal Abstinence Syndrome Among All Payer Inpatient Pediatric Discharges In Nevada, Kavita Batra

UNLV Theses, Dissertations, Professional Papers, and Capstones

Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome among neonates born to drug-dependent mothers. NAS poses a significant health and fiscal challenge nationally, with its incidence increasing by a factor of six (1.20 to 6.7 per 1,000 hospital births/year) along with the concomitant rise in health care cost from 2000-2016. Besides national data, it is critical to quantify NAS at the state-level to identify the target areas for prevention. Given the higher opioid prescribing rates among pregnant women in Nevada, it is critical to assess the health and financial magnitude of NAS in the state. The objectives of this …

The Relationship Between Tree Canopy And Social Capital On Physical Activity In Unlv Students, Melissa Bartshe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the numerous health benefits, rates of physical activity are low, especially among the college student population. Neighborhood tree canopy is one aspect of the built environment that has been shown to positively impact physical activity. Social capital has also been correlated with higher rates of physical activity. The sprawling urban design and arid desert climate of Las Vegas pose unique challenges to both tree canopy and social capital. Additionally, the relationship between tree canopy, social capital, and physical activity is understudied in the college student population. The purpose of this study was to assess the relationship of tree canopy …

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 …

The Use Of Female Permanent Contraception Among Women Desiring To Limit Childbearing In Sub-Saharan Africa: Analyses Of The Spatial Pattern And Individual- And Country-Level Determinants, Babayemi Oluwaseun Olakunde

UNLV Theses, Dissertations, Professional Papers, and Capstones

Female permanent contraception (FPC) is the most commonly used contraceptive method, globally. It is a convenient, safe, and cost-effective modern contraceptive method that permanently stops childbearing among women. Despite its benefits, previous reports suggest that the increasing proportion of women who desire to limit childbearing in sub-Saharan Africa (SSA) rely more on less effective contraceptive methods, predisposing them to unintended pregnancies and their associated consequences. This study aimed to add to the sparse body of evidence on the use of FPC and the associated determinants among women with demand for limiting childbearing in SSA. Using data from Demographic and Health …

From Fighting Wasting To Shedding Excess: An Explanatory Sequential Mixed-Method Study Of Obesity Among People Living With Hiv In Nigeria, John Olajide Olawepo

UNLV Theses, Dissertations, Professional Papers, and Capstones

The human immunodeficiency virus (HIV) infection is a global epidemic, with initial high mortality rates since the first diagnosis over three and a half decades ago. However, the use of antiretroviral therapy (ART) has led to longer, healthier lives for many people living with HIV (PLHIV). Accordingly, aging comes with associated co-morbidities like obesity, diabetes, and cardiovascular diseases. The purpose of this mixed-methods study was to further understand the emergent phenomenon of obesity and overweight among PLHIV who are on treatment with ART, using Nigeria as a case study.

An explanatory sequential mixed-method design was used that involved the analysis …

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 …

A Retrospective Survey Of Exercise Habits In Low-Income Female Senior Citizens, Kelly L. Bumgarner

UNLV Theses, Dissertations, Professional Papers, and Capstones

American adults spend at least 50% of their time sedentary with the most inactive demographic being low-income women over 60. This is detrimental because routine physical activity benefits for senior women include balancing hormones, maintaining bone mineral density, and decreasing the risk of breast cancer. Statements like “good exercise habits begin during youth; children should play sports to establish healthy habits they’ll continue throughout their lives” are common, but not clearly supported by literature. Objective: The purpose of this retrospective, cross-sectional study was to identify whether physical activity/exercise habits during youth and young adulthood predict old age physical activity/exercise habits …

Community Exposure To Particulate Matter And Its Impact For Students And Residents Near A Construction Asphalt Plant: A Case Study, Aman Gebremariam Gebreselassie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Particulate matter (PM) consists of various small particles in the atmosphere that has been associated with environmental health risk factors for many deadly diseases. PM2.5 is particulate matter 2.5 micrometers or less in diameter, PM10 is particulate matter 10 micrometers or less in diameter and are both respirable particles that can penetrate the lungs and increase risk of cardiovascular problems and respiratory illness, among other health issues. Exposure to particulate pollution in the environment tends to cause lost income from work absence, students’ absences from school, hospital admissions as well as emergency and doctor room visits.

Although asphalt plants are …

Disparities In Administrative Pediatric Asthma Prevalence In Clark County, Aaliyah Goodie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Asthma is one of the most common chronic diseases affecting young children nationally and globally. Asthma affects more than 25 million people in the nation, of which 6

million are children. Lifetime asthma prevalence for children in Nevada is 11.5% (CDC, 2016). This is likely an underestimate due to a large undocumented Hispanic population. In Clark County School District (CCSD) during the 2016-2017 school year, 20,235 students (8%) listed asthma in school records as a health concern. Asthma burden varies by sociodemographic group with highest rates documented among Black/African American, Hispanic/Latino, and pediatric populations. The Centers for Disease Control …

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 …

Carbon Management And Volatile Fatty Acid Production In Primary Clarifiers At A Wastewater Treatment Plant, Brittany Nicole Radke

UNLV Theses, Dissertations, Professional Papers, and Capstones

An increasing number of treatment plants are required to remove nutrients from domestic wastewater to lessen the impact of nutrient loading to water bodies. Enhanced Biological Phosphorus Removal (EBPR) is one of the processes commonly used to remove phosphorus from domestic wastewater. The presence of an adequate quantity of volatile fatty acids (VFA) in the wastewater influent to EBPR is important for process efficiency and stability. The objective of this research was to investigate the production of VFAs through fermentation of sludge in primary clarifiers as it related to improving nutrient removal, primarily targeting phosphorus.

The research tested, in full-scale, …

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 …

Healthcare Access And Utilization By Transgender Populations: A United States Transgender Survey Study, Axenya Kachen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Transgender communities in the United States are highly marginalized and have been systematically and infrastructurally ignored due to the widespread fundamental belief that gender exists as a binary classification. The dichotomous theoretical framework of sex and gender prevented public recognition of this community as a population of interest for public health research and targeted intervention. Sexual and gender minority (SGM) populations have fought for basic human rights, including access to affordable healthcare. The National Center for Transgender Equality (NCTE) was founded in 2003 to advocate for the advancement of equality for transgender people. In 2015, the NCTE conducted the United …

Health Care-Associated Infection Prevention Outcomes: Evaluating The Link Between Infection Prevention Practices In Healthcare Facilities And Their Health Care-Associated Infection Rates, Chidinma Veronica Njoku

UNLV Theses, Dissertations, Professional Papers, and Capstones

Healthcare-associated infections (HAI) are a pressing problem affecting vulnerable individuals who come to the hospital to receive care for one condition only to find that they have contracted another during their stay. Studies point to the importance of training and educating staff in order to implement and comply with recommended infection control and prevention control and prevention practices as lack of training and knowledge about infection control and prevention has been perceived to bring about a limited ability for direct care staff to adhere to recommended processes and activities. Although there are prior studies on the effects of assessments, infection …

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 …

Public Exposure To Outdoor Bioaerosols In Particulate Matter In Las Vegas: Daily And Seasonal Variations, Karey Renee Fortier

UNLV Theses, Dissertations, Professional Papers, and Capstones

Bioaerosols are airborne particles of biological origin including viruses, bacteria, pollen, fungi, and fragments of their metabolic products. Bioaerosol exposure may represent a health risk, in particular for risk groups such as immunosuppressed persons, and those suffering from allergies or respiratory diseases. Bioaerosols of sizes

This study seeks to assess outdoor bioaerosol number concentrations and size distributions in Las Vegas, NV, as the first step in understanding their health risks. PM2.5 and PM10 were collected on black polycarbonate filters for 24-hour duration using MiniVol air samplers on UNLV campus in the spring and fall of 2017. Bioaerosols in these samples …

Factors Associated With Food Insecurity Among Individuals, Aged Sixty And Older, In Clark County, Nv, Lisa M. Segler

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity is defined as a lack of consistent access to enough food for an active, healthy life. In Nevada, an estimated 80,000 individuals, aged 60 years or older, were food insecure in 2016. The primary aim of this study was to identify factors that are associated with food insecurity in older adults, aged sixty and older, in Clark County, NV. The secondary aim of this study was to identify which factors interact with each other to explain food insecurity among individuals aged sixty and older, in Clark County, NV. A secondary data analysis was conducted using data collected by …

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 …

Associations Between Opioid-Related Hospitalizations And Intravenous Drug Users, Jacklynn De Leon

UNLV Theses, Dissertations, Professional Papers, and Capstones

The opioid epidemic has led to a chain reaction of public health concerns, including an increase in heroin usage, injection drug abuse, incidence of hepatitis C virus (HCV), and HIV transmission. There have been few population-based studies investigating the clinical and socio- demographic data associated with opioid use in Nevada (Feng et al., 2016; Frank, 2000) and few studies investigating the intravenous drug user (IDU) population in Clark County. On February 2017, Clark County’s first syringe exchange program (SEP) opened its doors to the IDU population. This study provides an updated analysis of opioid-related injuries within Nevada and provides a …

Telelactation And Breastfeeding Outcomes Among Low-Income Mothers In Mississippi: A Retrospective Cohort Study, Aaron Thomas Hunt

UNLV Theses, Dissertations, Professional Papers, and Capstones

New mothers are recommended to exclusively breastfeed their infants for the first six months to provide optimal health for infant and mother. However, only 13.0% of mothers in Mississippi reached this milestone among infants born in 2015, which was far below the Healthy People 2020 objective of 25.5%. One factor that impacts breastfeeding success is access to certified lactation consultants, but low-income women may lack access due to an inadequate number of providers, unreliable transportation, rural location, or cost. The use of “telelactation” programs, which provide access to lactation consultants via video conferencing on internet connected devices, has been suggested …

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 …

Examining Environmental Hazards In Rental Homes And Habitability Laws In Clark County, Nevada, Jorge Luis Bertran

UNLV Theses, Dissertations, Professional Papers, and Capstones

It is well established that home conditions are linked to the health outcomes of occupants. There are over 880,000 housing units in Clark County, Nevada; nearly half of those are renter-occupied units (ROUs). Currently, there is limited research on the characteristics of environmental hazards found in Clark County ROUs and the strength of habitability statutes created to protect tenants from substandard housing. Understanding how renters in Clark County are affected by environmental hazards in ROUs and the processes by which landlords and tenants resolve grievances related to those hazards would benefit public health. It would enhance the ability to quickly …

An Evaluation Of Food Insecurity Rates And Its Correlates In A Filipino American Population Sample Residing In Clark County, Nevada, Prescott M. Cheong

UNLV Theses, Dissertations, Professional Papers, and Capstones

Filipino Americans comprise over half of the Asian American population in Clark County, Nevada. In 2016, 1.6% of Asian American households in Clark County reported being food insecure, which was considerably lower than food insecurity rates for White, non-Hispanic households (14.5%). Yet, Clark County demographic data reveals that 24% of Filipino-headed households report incomes at 200% or below the federal poverty level compared to 33% for Whites. Food insecurity rates specific to Filipino Americans in Clark County are lacking. Moreover, available food insecurity data aggregates Filipinos with other Asian American subgroups, which ignores the heterogeneity inherent to the Asian American …

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, …