Digital Commons Network^™

Implementation Of The Wiegand Sun Safety Program Into Physicians’ Offices In Southern Nevada, Breanne Eddington

UNLV Theses, Dissertations, Professional Papers, and Capstones

In this study Nevada Cancer Institute’s Wiegand Sun Safety Program was implemented in 14 clinics in Southern Nevada as a pilot run to increase awareness in children and their guardians through educational materials in pediatricians’ and family physicians’ offices. It was hypothesized that the increased display of information regarding sun safety and skin cancer in physicians’ offices would increase patient and guardian awareness of the subject and increase the likelihood of patients and/or guardians asking their physician questions about skin cancer and sun safety, resulting in an increase in preventive actions by guardians to protect their children from damaging rays …

Relative Deprivation, Relative Gratification, Status, And Health, Samuel A. Holland

UNLV Theses, Dissertations, Professional Papers, and Capstones

The role of perceived inequity in health was assessed and compared to other social constructs predicted to be relevant in the relationship between inequity and health. Four studies were conducted that demonstrated that a social comparison-based measure of relative deprivation (RD) and relative gratification (RG) can predict health and continues to do so even after accounting for perceived stress, personal income, perceived control, and social participation. A measure of RD/RG was developed that was based on prominent social comparisons and objects of comparison. This measure was reliable and predictive of health in two samplings of different populations. Comparisons of the …

Association Of Body Mass Index, Fruit And Vegetable Intake, And Acculturation In A Sample Las Vegas Hispanic Population, Anne L. Bolstad

UNLV Theses, Dissertations, Professional Papers, and Capstones

The U.S. is experiencing a rising prevalence of overweightedness that has been identified as the second leading cause for chronic health conditions threatening public health. Overweightedness has grown disproportionately among ethnic sub-groups. In the fastest going minority population in the U.S., Hispanic Americans are observed with disparately high body mass index, placing them at heightened risk for poor health outcomes. Research suggests five servings of fruit and vegetables, in any combination, provides a sound nutritional base for healthful living and helps to maintain normal body weight.

Americans are known to have poor eating habits while foreign-born populations have well balanced …

Nonparametric Regression With Missing Outcomes Using Weighted Kernel Estimating Equations, Lu Wang, Andrea Rotnitzky, Xihong Lin

Harvard University Biostatistics Working Paper Series

No abstract provided.

Sensitivity Analysis – The Effects Of Glasgow Outcome Scale Misclassification On Traumatic Brain Injury Clinical Trials, Juan Lu

Theses and Dissertations

I. EFFECTS OF GLASGOW OUTCOME SCALE MISCLASSIFICATION ON TRAUMATIC BRAIN INJURY CLINICAL TRIALS The Glasgow Outcome Scale (GOS) is the primary endpoint for efficacy analysis of clinical trials in traumatic brain injury (TBI). Accurate and consistent assessment of outcome after TBI is essential to the evaluation of treatment results, particularly in the context of multicenter studies and trials. The inconsistent measurement or interobserver variation on GOS outcome, or for that matter, on any outcome scales, may adversely affect the sensitivity to detect treatment effects in clinical trial. The objective of this study is to examine effects of nondifferential misclassification of …

Neuroprotection With Anesthetics In Two Models Of Cerebral Ischemia, Rafael Eduardo Chaparro Buitrago

USF Tampa Graduate Theses and Dissertations

Neuroprotection with anesthetics has been studied for many decades; important advances in this field have modified the way Anesthesiologists treat patients in the operating room. Animal models have played an important role in the study of ischemia in the operating room. Recent studies have demonstrated that the effect of anesthetics seems to be different in different animal models. We decided to evaluate anesthetics in a well-known model of cerebral ischemia and also in hypotensive models designed by us. We used a model of cerebral ischemia (MCAO) to test anesthetics neuroprotective effect in a two-week period. Then, we used a model …

The Impact Of Coarsening The Explanatory Variable Of Interest In Making Causal Inferences: Implicit Assumptions Behind Dichotomizing Variables, Ori M. Stitelman, Alan E. Hubbard, Nicholas P. Jewell

U.C. Berkeley Division of Biostatistics Working Paper Series

It is common in analyses designed to estimate the causal effect of a continuous exposure/treatment to dichotomize the variable of interest. By dichotomizing the variable and assessing the causal effect of the newly fabricated variable practitioners are implicitly making assumptions. However, in most analyses these assumptions are ignored. In this article we formally address what assumptions are made in dichotomizing variables to assess causal effects. We introduce two assumptions, either of which must be met, in order for the estimates of the causal effects to be unbiased estimates of the parameters of interest. We title those assumptions the Mechanism Equivalence …

Stigma And Therapy Completion For Latent Tuberculosis Among Haitian-Origin Patients, Jeannine Coreil, Michael Lauzardo, Heather Clayton

Florida Public Health Review

A prospective cohort study of LTBI treatment conducted within the Haitian population of South Florida investigated the predictive association between illness-related stigma among patients near the beginning of treatment and completion of preventive therapy. Factors associated with perceived stigma were also investigated. Ninety patients from Broward and Palm Beach counties were administered a questionnaire that included items related to illness history, perceptions and understanding of latent tuberculosis, and a 25-item stigma scale adapted from previously developed measures of tuberculosis-related stigma. Therapy completion was determined through a follow-up chart review. Data analyses compared patients who completed therapy with those who defaulted …

An Approaching Epidemic: Exploring Diabetes Awareness & Care In Mombasa, Kenya, Benjamin Marhan Dropkin

Independent Study Project (ISP) Collection

The prevalence of Type II Diabetes Mellitus (T2DM) has become an increasing problem in virtually every city in the world due to lifestyle changes in recent decades that have greatly reduced healthy eating habits as well as exercise. Research has shown that T2DM is largely preventable through healthy lifestyle choices. It is crucial for every country’s population to be aware of the risk factors and complications of diabetes so that they can take active steps to avoid the monumental physical and financial burden of the disease. This study attempted to gauge diabetes awareness among patients living with diabetes and to …

Factors That Contribute To The Low Uptake Of Skilled Care During Delivery In Malindi, Kenya, Alexandra Carter

Independent Study Project (ISP) Collection

In Kenya, maternal mortality ratios remain high and the number of births attended by skilled health attendants hovers at just 44%. Using both qualitative and quantitative data, a study was conducted to determine the uptake of antenatal care and skilled attendance in Malindi District and to explore factors that contribute to the low use of maternal health services during delivery. It was found that after the first antenatal visit attendance to health facilities begins to decline ending in low rates of births attended by skilled care and that socio-cultural and economic factors play a larger role than access alone in …

75 Hours, 18 Babies, Dozens Of Women, And Me: Exploring Gynecological And Obstetrical Care In Bamako, Minnie Yordon

Independent Study Project (ISP) Collection

Mali has the third highest total fertility rate in the world, with each woman having an average of 6.62 children in the year 2009. Gynecological and obstetrical care, therefore, plays a large role in the lives of these women; 70% of women attend at least one prenatal consultation over the course of their pregnancy, and a skilled attendant is present at approximately 50% of all births. In this paper, I seek a better understanding of gynecological and obstetrical care in Bamako, the capital, from the perspective of an Ob/Gyn, which often centers on pregnancy and childbirth. Based on real experiences …

A Pda Intervention To Sustain Smoking Cessation In Clients With Socioeconomic Vulnerability, Lynne Buchanan, Deepak Khazanchi

Information Systems and Quantitative Analysis Faculty Publications

This article describes a pilot study to explore use of a personal digital assistant (PDA) to sustain smoking cessation after discharge in clients with socioeconomic vulnerability. The major aim is to describe technology acceptance (perceived ease of use, usefulness, and attitude), portability, technical difficulty, satisfaction, and use time. The sample includes 31 medical surgical clients with average age of 47.35 (±13.3), average household income of $13,629 (±8,204), average number in the household of 2.67 (±2.22), and average education of 11th grade. The results demonstrate mean use time of 9.28 (±3.23) hr, or about 1 hr over 8 weeks. Technology acceptance …

Intellectual Propriety: Compulsory Licenses Through The Trips Agreement And The Doha Declaration On Public Health, Samuel Mintzer Fuchs

Independent Study Project (ISP) Collection

The Agreement on Trade Related Aspects of Intellectual Property (TRIPS), part of the Uruguay Round of trade negotiations led to the creation of the World Trade Organization (WTO) in 1995, has led to a variety of interpretations and opinions. Though its application goes beyond matters of public health, it is this area that has come under the most scrutiny in the last fifteen years as the gaps between developed and developing countries have widened and exposed the health disparities between the two groups. Tensions over intellectual property and access to newly developed medicines to treat diseases such as HIV and …

“Tem Um Doido No Caps / Que Diz Que Louco É Gente/Que Diz Que Louco Sabe/Que Diz Que Louco Sente” Failures And Successes In Brazilian Mental Health Reform: A Case Study Of Caps – Quixadá, Zachary Fuhrer

Independent Study Project (ISP) Collection

In 1987, as public health decentralized and O Movimento da Luta Antimanicomial challenged the internment of loucuras in asylums, Brazil hosted its first National Conference of Mental Health. While the fight for mental health reform and the dehospitalization of the mentally ill in psychiatric hospitals began to take form in the 1970s with the Rede de Alternativas Psi and O Movimento dos Trabalhadores de Saúde Mental, Brazil has battled with questions of saúde loucura (treatment of the mad) since the country's colonial era and the reception of the epileptic and mentally ill family of Dom João VI. The Brazilian state …

Birth Order Modifies The Effect Of Il13 Gene Polymorphisms On Serum Ige At Age 10 And Skin Prick Test At Ages 4, 10 And 18: A Prospective Birth Cohort Study, Ikechukwu U. Ogbuanu, Wilfried J. Karmaus, Hongmei Zhang, Tara Sabo-Attwood, Susan L. Ewart, Graham Roberts, Syed Hasan Arshad

Faculty Publications

Background: Susceptibility to atopy originates from effects of the environment on genes. Birth order has been identified as a risk factor for atopy and evidence for some candidate genes has been accumulated; however no study has yet assessed a birth order-gene interaction.

Objective: To investigate the interaction of IL13 polymorphisms with birth order on allergic sensitization at ages 4, 10 and 18 years.

Methods: Mother-infant dyads were recruited antenatally and followed prospectively to age 18 years. Questionnaire data (at birth, age 4, 10, 18); skin prick test (SPT) at ages 4, 10, 18; total serum IgE and specific inhalant screen …

An Analysis Of Restaurant Food Safety Violations: Human Factors, Non-Human Factors, And Food-Borne Illness, Jai Choung

UNLV Theses, Dissertations, Professional Papers, and Capstones

An estimated 76 million food-borne illnesses occur in the United States each year, causing 325,000 hospitalizations and 5,000 deaths, according to the U.S. Food and Drug Administration. Food safety is an increasingly important topic to governmental food regulators, not only in trying to reduce the number of illnesses from contaminated food. Governmental regulators also are becoming aware of the vulnerability of the food supply chain as a target for bioterrorism. Recommendations have been developed to protect the U. S. food supply from terrorism, but little of the research and recommendations relate to the food-service level.

Eighty percent of reported cases …

An Analysis Of Continuous Chest Compression Cpr For Ems Providers During Out Of Hospital Cardiac Arrest, Megan L. Gleason

Honors Projects

A significant amount of research has been done in an attempt to improve the outcomes of patients found in cardiac arrest outside the hospital. The American Heart Association has long advocated Advanced Cardiac Life Support (ACLS), a procedure that encompasses cycles of chest compressions with advanced airway maintenance and defibrillation. Recent evidence has suggested that these current guidelines are ineffective due to prolonged “hands off” time. New research suggests utilizing a technique known as continuous chest compression CPR that delays advanced airway management and instead focuses on defibrillation and continuous chest compressions. Across the country, research has demonstrated that when …

Who Guidelines For Antimicrobial Treatment In Children Admitted To Hospital In An Area Of Intense Plasmodium Falciparum Transmission: Prospective Study, Behzad Nadjm, Ben Amos, George Mtove, Jan Ostermann, Semkini Chonya, Hannah Wangai, Juma Kimera, Walii Msuya, Frank Mtei, Denise Dekker, Rajabu Malahiyo, Raimos Olomi, John A. Crump, Christopher J. M. Whitty, Hugh Reyburn

Faculty Publications

Objectives To assess the performance of WHO’s “Guidelines for care at the first-referral level in developing countries” in an area of intense malaria transmission and identify bacterial infections in children with and without malaria.

Design Prospective study.

Setting District hospital in Muheza, northeast Tanzania.

Participants Children aged 2 months to 13 years admitted to hospital for febrile illness.

Main outcome measures Sensitivity and specificity of WHO guidelines in diagnosing invasive bacterial disease; susceptibility of isolated organisms to recommended antimicrobials.

Results Over one year, 3639 children were enrolled and 184 (5.1%) died; 2195 (60.3%) were blood slide positive for Plasmodium falciparum …

Hiv Prevention And Education: Leadership And Implications For African-American Churches, Khaliah F. Fleming

Florida Public Health Review

This paper illustrates use of John Kotter’s eight-stage process for creating change through leadership its potential for aiding African-American churches in addressing rising HIV/AIDS rates. The focus is on churches due to their large influence on the African-American community. Knowing that there are multiple influences surrounding HIV/AIDS, it is useful to highlight how certain ideological and theological factors are contributing to the current state of African-American churches work to increase HIV/AIDS awareness, prevention, and education.

Management Of Kawasaki Disease In Texas: Policy Implications, Alberto Coustasse, Doohee Lee, Cody Arvidson, Julius J. Larry Iii, Witold Migala

Management Faculty Research

Kawasaki Disease (KD) is the leading cause of acquired cardiovascular disease among children, but KD has received little attention on its management from a policy perspective. The core objective of this paper is to review the literature, identify problems related to KD, and evaluate and offer some policy alternatives to effectively prevent and treat KD epidemiologically in Texas. Policy options suggested in this paper include, among others, (1) establishing a mandatory national KD registry system (along with active surveillance), (2) introducing sentinel providers, (3) requiring mandatory reporting of KD by hospitals, and (4) sponsoring policy KD research and practice.

Using The Stages Of Change Model To Choose An Optimal Health Marketing Target, Paula Diehr, Peggy A. Hannon, Barbara Pizacani, Mark Forehand, Jeffrey Harris, Hendrika Meischke, Susan J. Curry, Diane P. Martin, Marcia R. Weaver

UW Biostatistics Working Paper Series

Background: In the transtheoretical model of behavior change, “stages of change” are defined as Precontemplation (not even thinking about changing), Contemplation, Preparation, Action, and Maintenance (maintaining the behavior change). Marketing principles suggest that efforts should be targeted at persons most likely to “buy the product.”

Objectives: To examine the effect of intervening at different stages in populations of smokers, with various numbers of people in each “stage of change.” One type of intervention would increase by 10% the probability of a person moving to the next higher stage of change, such as from Precontemplation to Contemplation. The second type would …

The Prevalence And Causes Of Vision Loss In Indigenous Australians: The National Indigenous Eye Health Survey, Hugh R. Taylor, Jing Xie, Sarah Fox, Ross A. Dunn, Anna-Lena Arnold, Jill E. Keeffe

Aboriginal Policy Research Consortium International (APRCi)

Aim: To determine the prevalence and causes of vision loss in Indigenous Australians. Design, setting and participants: A national, stratified, random cluster sample was drawn from 30 communities across Australia that each included about 300 Indigenous people of all ages. A sample of non-Indigenous adults aged 􏱄 40 years was also tested at several remote sites for comparison. Participants were examined using a standardised protocol that included a questionnaire (self-administered or completed with the help of field staff), visual acuity (VA) testing on presentation and after correction, visual field testing, trachoma grading, and fundus and lens photography. The data were …

High Volume Air Sampling For Viral Aerosols: A Comparative Approach, Casey W. Cooper

Theses and Dissertations

The United States Air Force has high volume biological air sampling equipment available including the XMX/2L-MIL and DFU-1000. Neither system has been evaluated for effectiveness in the collection of viruses. Furthermore, decontamination methods have not been evaluated for these systems after use in sampling for a viral agent. MS2 bacteriophage was used as a surrogate virus. Aerosolized MS2 was released into a 12 m3 exposure chamber. High and moderate airborne concentrations of MS2 were evaluated. Low volume impingers were used for comparative purposes as well. Samples were analyzed using plaque assay and polymerase chain reaction (PCR). At high viral loads …

Effects Of Leas And Mecury On The Blood Proteome Of Children, Robert E. Birsall, Michael P. Kiley, Zaneer M. Segu, Christopher D. Palmer, Milan Madera, Brooks B. Gump

Falk College Research Center

Heavy metal exposure in children has been associated with a variety of physiological and neurological problems. The goal of this study was to utilize proteomics to enhance the understanding of biochemical interactions responsible for the health problems related to lead and mercury exposure at concentrations well below CDC guidelines. Blood plasma and serum samples from 34 children were depleted of their most abundant proteins using antibody-based affinity columns and analyzed using two different methods, LC-MS/MS and 2-D electrophoresis coupled with MALDI-TOF/MS and tandem mass spectrometry. Apolipoprotein E demonstrated an inverse significant association with lead concentrations (average being one microgram/deciliter) as …

Emerging Issues In Adolescent Healthcare : An Urgent Call For Action, Waris Qidwai Dr, Tabinda Ashfaq Ashfaq

Department of Family Medicine

No abstract provided.

The President's Emergency Plan For Aids Relief (Pepfar): A Social Work Ethical Analysis And Recommendations, Robert J. Barney, Stephan L. Buckingham, Judith M. Friedrich, Lisa M. Johnson, Michael A. Robinson, Bibhuti K. Sar

The Journal of Sociology & Social Welfare

The President's Emergency Plan for AIDS Relief (PEPFAR) is the most recent international social program instituted by the U.S. Government to combat HIV/AIDS. Since its inception in 2003, this foreign policy initiative has dedicated $63 billion for HIV/AIDS prevention and treatment in foreign countries. Despite PEPFAR's many accomplishments, it continues to promote controversial prevention strategies. This paper analyzes these prevention strategies, utilizing social work values as described in the NASW Code of Ethics. Policy, practice, and research implications are discussed.

Maternal And Neonatal Outcomes By Labor Onset Type And Gestational Age, Jennifer L Bailit, Kimberly D Gregory, Uma M Reddy, Victor H Gonzalez-Quintero, Judith U Hibbard, Mildred M Ramirez, D Ware Branch, Ronald Burkman, Shoshana Haberman, Christos G Hatjis, Matthew K Hoffman, Michelle Kominiarek, Helain J Landy, Lee A Learman, James Troendle, Paul Van Veldhuisen, Isabelle Wilkins, Liping Sun, Jun Zhang

Faculty, Staff and Student Publications

OBJECTIVE: We sought to determine maternal and neonatal outcomes by labor onset type and gestational age.

STUDY DESIGN: We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean). Neonatal and maternal outcomes were calculated by labor onset type and gestational age.

RESULTS: Neonatal intensive care unit admissions and sepsis improved with each week of gestational age until 39 weeks (P < .001). After adjusting for complications, elective induction of labor was associated with a lower risk of ventilator use (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.28-0.53), sepsis (OR, 0.36; 95% CI, 0.26-0.49), and neonatal intensive care unit admissions (OR, 0.52; 95% CI, 0.48-0.57) compared to spontaneous labor. The relative risk of hysterectomy at term was 3.21 (95% CI, 1.08-9.54) with elective induction, 1.16 (95% CI, 0.24-5.58) with indicated induction, and 6.57 (95% CI, 1.78-24.30) with cesarean without labor compared to spontaneous labor.

CONCLUSION: Some neonatal outcomes improved until 39 weeks. Babies born with elective induction …

Smart Density: A More Accurate Method Of Measuring Rural Residential Density For Health-Related Research, Peter M. Owens, Linda Titus-Ernstoff, Lucinda Gibson, Michael L. Beach, Sandy Beauregard, Madeline A. Dalton

Dartmouth Scholarship

Studies involving the built environment have typically relied on US Census data to measure residential density. However, census geographic units are often unsuited to health-related research, especially in rural areas where development is clustered and discontinuous. We evaluated the accuracy of both standard census methods and alternative GIS-based methods to measure rural density.

Risky Business: Effectiveness Of State Market-Based Health Programs, Christopher Stream, Nathan Myers

Public Policy and Leadership Faculty Research

Since the 1990s, state governments have been leaders of health care reform. Today, approximately 47 million people are without health insurance. As health care costs and uninsurance levels continue to rise, states are pursuing a variety of government- and market-based strategies to address this growing social problem. Health care research has indicated that state-based programs have proven to be successful in extending access to coverage. However, the question remains as to whether the market-based programs have had a positive impact on state health care. Advocates for market-based state health programs argue that the reforms benefit the greater good because they …

Report: Fostering A Movement Towards Evidence-Based Screening, Assessment, And Treatment, Institute For Public Health And Justice, Evidence-Based Treatment And Services, Evidence Based Practices Dissemination Strategies

Policy & Position Papers

No abstract provided.