Digital Commons Network^™

Master Of Public Health Research Project: Unmarried Women In Ghana, Africa: Predictors Of Condom Use- An Analysis Of The 2008 Ghana Demographic And Health Survey/Questionnaire Database, Emilie Hill

Theses and Dissertations

Background: Many factors affect whether women will insist that their sexual partners use a condom. This research project will identify some of the predictors of condom use among unmarried women in Ghana, Africa. Methods: This research project evaluated data from the 2008 DHS of women in Ghana, Africa for predictors of condom use among unmarried women. A total of 4,916 women completed the surveys. Of these, 1,966 women were unmarried. The research project employed multiple logistic regression analysis to determine condom use predictors at the time of the last sexual encounter for these 1,966 unmarried women. Results: Women with a …

Medical-Legal Partnerships: Addressing The Unmet Legal Needs Of Health Center Patients, Peter Shin, Fraser Rothenberg Byrne, Emily Jones, Joel B. Teitelbaum, Lee Repasch, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Medical-legal partnerships (MLPs), now available at over 180 hospitals and health centers across 38 states, are an important option for addressing the legal needs affecting low-income and vulnerable patients, and thereby improving their overall health. We estimate that each year, anywhere between 50 and 85 percent of health centers users - or between ten and 17 million people - experience unmet legal needs, many of which negatively impact their health. In a medical-legal partnership, health care staff at hospitals, clinics, and other sites are trained to screen for health-related legal issues, refer the patient to an affiliated lawyer or legal …

Perimenopausal Obesity, Colleen Keller, Linda Larkey, Johanna K. Distefano, Edna Boehm-Smith, Kathie Records, Alyssa G. Robillard, Sharry Veres, Manal Al-Zadjali, Anne-Marie O'Brian

Faculty Publications

Obesity is recognized as one of the most important underlying risk factors for a wide variety of diseases, including heart disease and diabetes. Women are particularly prone to obesity, and approaches that address life transitions across the life span suggest that a number of factors may converge at passage points, such as menopause, that contribute to weight accumulation in the aging woman. The menopausal phase of a woman's life brings a number of changes that may trigger and maintain weight gain. Although the prevalence of overweight and obesity is attributable to each of these factors, it is most likely the …

Assessing The Sensitivity Of The Canadian Adverse Event Following Immunization Surveillance System ( Caefiss), Mina Tadrous

Theses and Dissertations (ETD)

Background: Vaccines are important to public health, but because of the way they are manufactured, their mechanism of action, and their indicated population, careful monitoring of their adverse events is necessary. Canada has a national surveillance system that collects reports on adverse events that may be associated with vaccine administration. Sensitivity is one of the tools used with surveillance systems to study the extent and characteristics of reporting of a surveillance system. To date, the sensitivity of the Canadian system has not been assessed.

Purpose: To assess the sensitivity of the Canadian Adverse Event Following Immunization Surveillance System …

Latin America And The Caribbean: Assessment Of The Advances In Public Health For The Achievement Of The Millennium Development Goals, Amal K. Mitra, Gisela Rodriguez-Fernandez

Faculty Publications

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN …

Parental Report Versus Child Perception Of Familial Support: Which Is More Associated With Child Physical Activity And Television Use?, Daheia J. Barr-Anderson, Ramona Robinson-O'Brien, Jess Haines, Peter J. Hannan, Dianne R. Neumark-Sztainer

Faculty Publications

Background: Parent-report and child perception of familial support for weight-related behaviors may not be congruent. This research explores whether parent-report or child perception is more strongly associated with child-reported physical activity and television (TV) use. Methods: Elementary school children (n = 73) participating in Ready. Set. ACTION!, a theater-based obesity prevention pilot program in Saint Paul, MN, and their parents completed surveys assessing familial support for physical activity and limitations on TV use in fall 2006. Paired t tests examined congruency between parent-report and child perception. Linear regression models adjusted for sociodemographics explored the associations between familial …

Knowledge Transfer In Public School Food Service: Post-Implementation Of The Process Approach To Haccp Food Safety System, Lydia Rebecca Frass

Dissertations

Based on Havelock's (Havelock & University of Michigan. Center for Research on Utilization of Scientific Knowledge, 1969) Knowledge Transfer Model and using Kirkpatrick's Training Evaluation Model (1996a, 1996b) levels of Reaction, Behavior, and Learning, this study analyzed knowledge transfer between public school district managers, cafeteria managers, and line workers. These employees were trained through cascade training methods during the federally mandated implementation of the Process Approach to HACCP food safety system beginning in the 2005-2006 school year.

Measuring Behavior, an Observation Checklist (based on HACCP's 7 steps and 10 FDA food borne illness risk factors and interventions) was used to …

The Influence Of Cardiorespiratory Fitness On Lung Cancer Mortality, Xuemei Sui, Duck-Chul Lee, Charles E. Matthews, Swann Arp Adams, James R. Hébert, Timothy S. Church, Chong-Do Lee, Steven N. Blair

Faculty Publications

Purpose—Previous studies have suggested that higher levels of physical activity may lower lung cancer risk; however, few prospective studies have evaluated lung cancer mortality in relation to cardiorespiratory fitness (CRF), an objective marker of recent physical activity habits. Methods—Thirty-eight thousand men, aged 20 to 84 years without history of cancer, received a preventive medical examination at the Cooper Clinic in Dallas, TX, between 1974 and 2002. CRF was quantified as maximal treadmill exercise test duration and was grouped for analysis as low (lowest 20% of exercise duration), moderate (middle 40%), and high (upper 40%). Results—A total of 232 lung cancer …

Pain Management In Nursing Home Residents With Cancer And Dementia With And Without Hospice Services, Todd Bryant Monroe

Theses and Dissertations (ETD)

Aims: We sought to identify differences in pain management between two groups; nursing home residents with malignant cancer and dementia with and without hospice services.

Methods: Decedent records from 2003-2009 were assessed for diagnosis of dementia and cause of death as cancer. Ten malignant cancer diagnoses were determined a priori from the CDC 2004 data on the top 10 malignant cancers for all races and genders. Fifty-five decedents from 10 nursing homes were included in the final sample. Four instruments were used: Minimum Data Set (MDS) a standardized assessment tool required of most U.S. nursing homes. A large …

Impacts On Maternal Diet In A Transitional Community In Rural Costa Rica: Potential Implications For The Developmental Origins Of Obesity-Related Disorders, Allison Cantor

UNLV Theses, Dissertations, Professional Papers, and Capstones

This thesis examines maternal diet in a rural, transitional community in Costa Rica. Using cross-cultural categories recognized in the ethnographic literature (i.e. dietary taboos, dietary prescriptions, food cravings and the acknowledgment of a special post-partum period diet), maternal dietary practices were identified in the local community through surveys (n=45) and participant-observation (n=5), and to reflect the actual consumption patterns of pregnant and nursing women in the area, 24-hour diet recalls were administered to 5 pregnant or nursing women. In light of the recent changes that increased tourism has brought to the Monteverde Zone, focus groups were employed to determine impacts …

Opportunities For Intervention: Characteristics Of Alcohol Related Visits To United States Emergency Departments, 2003 - 2007, Jonathon Lavalley

UNLV Theses, Dissertations, Professional Papers, and Capstones

The cycle of alcohol intoxicated patients passing through United States (US) emergency departments (ED) and repeated inpatient detoxification for alcohol inebriates is costly, as these patients are continually exposed to injury and other health and legal consequences of their continued at risk alcohol use. The high proportion of ED resources used by these alcohol intoxicated patients has contributed to increased patient wait times, increased ambulance diversions, forced closures of US EDs, increased numbers of patients leaving without being seen, and an overall reduction in the quality of medical services provided in the ED. In order to contribute to efforts towards …

Lead Risk Hazards In Pre-1978 Childcare Facilities Located In Clark County, Nevada, Usa, Jessica Marie Newberry

UNLV Theses, Dissertations, Professional Papers, and Capstones

The harmful health effects of lead exposure have been known for centuries, yet lead is still produced and utilized in a variety of ways. There have been many movements to rid the environment of this toxic metal in hope to reduce the number of individuals who are and who may potentially be exposed. Lead exposure is responsible for a myriad of negative health effects most notably lowering IQ scores in children. Extensive amounts of data have been collected from areas of the country with known lead hazards, hazards that have been identified through hundreds of thousands of elevated blood lead …

Socioeconomic Status And Prevalence Of Obesity And Diabetes In A Mexican American Community, Cameron County, Texas, 2004-2007, Susan P. Fisher-Hoch, Anne R. Rentfro, Jennifer Salinas, Adriana Perez, H. Shelton Brown, Belinda M. Reininger, Blanca I. Restrepo, Jeff Gaines Wilson, Monir Hossain, Mohammad H. Rahbar, Craig Hanis, Joseph B. Mccormick

School of Nursing Faculty Publications

Introduction Mexican Americans are at increased risk for obesity and diabetes. We established a cohort on the United States-Mexico border to determine the prevalence of obesity and diabetes in this Mexican American population and to see whether minor economic advantages had any effect on health.

Methods We randomly selected and extensively documented 810 people aged 35 to 64 years. Weighted data were analyzed to establish prevalence of obesity and diabetes and other markers of poor health such as elevated glycated hemoglobin levels.

Results Rates of obesity (body mass index ≥30 kg/m²) were 57% in the first (lower) of …

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 …

Oral Cancer In Nevada: A Public Health Perspective, Karl Kingsley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer is the second leading cause of death in the United States, and oral cancer remains the eighth leading cause of cancer death among US males. Although previous epidemiologic studies have found that overall rates of cancer, including oral cancer, have declined in the US in recent decades – these declines are neither uniform nor consistent within this population. Anecdotal evidence has suggested that rates of oral cancer in Nevada are relatively high, although no evidence was available to support these assertions.

Oral Cancer Epidemiology: Based upon this information, a detailed and thorough epidemiologic examination of oral cancer rates in …

An Evaluation Of Lead In Imported Candies Within Clark County, Nevada, Usa, Lee Reuben Ibarra

UNLV Theses, Dissertations, Professional Papers, and Capstones

Imported candies from Latin America pose a danger to children because of the potential for those candies to contain harmful levels of lead. This study sought to identify characteristics of imported candies that typically display higher concentrations of lead. This study also explored the Integrated Exposure Uptake Biokinetic model developed by the EPA. Using lead exposure data specific to Clark County, Nevada, the IEUBK model was used to estimate the amounts of candy a child would have to consume in order to raise his blood lead level to over 10µg/dL (the federal allowable limit).

The results showed that candies with …

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 …

Factors Associated With Blood Lead Levels Of Children In Southern Nevada, Mackenzie Suzanne Burns

UNLV Theses, Dissertations, Professional Papers, and Capstones

Exposure to lead continues to be a public health concern, particularly for young children. The Centers for Disease Control and Prevention report that approximately 250,000 children currently have blood lead levels (BLLs) above the level at which adverse health effects are apparent and intervention is recommended (10μg/dL). National surveillance data on childhood lead exposure has been collected for children under the age of 6 years old since 1995. However, not until 2006 did a program begin in Nevada (limited to Clark County); therefore, statewide data about childhood lead exposure in Nevada remains limited. The goal of this study was to …

Health Care Access Disparities Among Children Entering Kindergarten In Nevada, Nadia Deashinta

UNLV Theses, Dissertations, Professional Papers, and Capstones

Access to health care is an important factor for the well-being of America's children. The principal goal of this study was examine the 2008-2009 Kindergarten Health Survey data to advance understanding and appreciation of the health status of children in addition to their discrepancies in accessing health care in the state of Nevada (n = 11,073). This dataset serves as a secondary data source to determine whether socio-demographic and medical factors are associated with disparity in accessing health care for children entering kindergarten. This study looked at both independent and combined effects of annual household income, race/ethnicity, primary language spoken …

Enhanced Food Marketing To Children On The Internet: A Content Analysis, Sarah A. Ochsner

UNLV Theses, Dissertations, Professional Papers, and Capstones

In light of the continuing epidemic of childhood obesity, aggressive food marketing strategies have come under increased scrutiny as a possible contributing factor. It has been acknowledged in numerous studies, that poor nutrient quality of food and beverages dominate children's programming. The growth in child-specific media envoys has further increased favorable opportunities to market food and beverages to children, notably less regulated and parentally unsupervised. According to the U.S. Census Bureau, 65% of children aged 6-11 have home access to the Internet; and today, the majority of food manufacturers operate websites appealing to children. The Institute of Medicine issued a …

Food Insecurity As A Barrier To Sustained Antiretroviral Therapy Adherence In Uganda, Sheri D. Weiser, David M. Tuller, Edward A. Frongillo Jr., Jude Senkungu, Nozmu Mukiibi, David R. Bangsberg

Faculty Publications

Background: Food insecurity is emerging as an important barrier to antiretroviral (ARV) adherence in sub-Saharan Africa and elsewhere, but little is known about the mechanisms through which food insecurity leads to ARV non-adherence and treatment interruptions.

Methodology: We conducted in-depth, open-ended interviews with 47 individuals (30 women, 17 men) living with HIV/ AIDS recruited from AIDS treatment programs in Mbarara and Kampala, Uganda to understand how food insecurity interferes with ARV therapy regimens. Interviews were transcribed, coded for key themes, and analyzed using grounded theory.

Findings: Food insecurity was common and an important barrier to accessing medical care and ARV …

Associations Between Sport And Screen-Entertainment With Mental Health Problems In 5-Year-Old Children, Lucy J. Griffiths, Marsha Dowda, Carol Dezateux, Russell R. Pate

Faculty Publications

Background: Few studies have examined the benefits of regular physical activity, and risks of sedentary behavior, in young children. This study investigated associations between participation in sports and screen-entertainment (as components of physical activity and sedentary behavior), and emotional and behavioral problems in this population.

Methods: Cross-sectional analysis of data from 13470 children (50.9% boys) participating in the nationally representative UK Millennium Cohort Study. Time spent participating in sports clubs outside of school, and using screen-entertainment, was reported by the child's mother at child age 5 years, when mental health was also measured using the Strengths and Difficulties Questionnaire.

Results …

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 …

Evaluating The Comprehensiveness Of Youth Access To Tobacco Legislation, Richard Clark

Graduate Research Symposium (2010 - 2017)

The deadly effects of smoking have been well documented since the 1960s. As laws and ordinances have been instituted at the state level, various measures have been developed in an attempt to measure both the comprehensiveness and effectiveness of such restrictions. This paper seeks to build on the rating systems already developed that currently look at individual laws by developing an overall rating scale of state level smoking restrictions and their effectiveness over time. Results of the overall rating scale will be shared along with recommendations for future research.

Factors Associated With Institutionalization For Treatment Of Active Tuberculosis: A Synopsis From In-Depth Patient Interviews, Robert J. Mcdermott, Carol A. Bryant, Jeannine Coreil, Aimee R. Eden, Lori K. Buhi

Florida Public Health Review

To increase the effectiveness of therapeutic regimens for tuberculosis (TB) and to reduce the societal risks for both infected and uninfected individuals, it is beneficial to be able to predict factors associated with non-adherence to treatment. The purpose of this study was to acquire detailed case histories of TB patients admitted to a hospital setting and to gain a better understanding of how patients explain the life events leading up to their admission for treatment. Twenty-one patients with active TB were interviewed concerning their knowledge of TB, diagnosis and treatment history, recent history prior to hospitalization, reactions to and life …

A Colorectal Cancer Screening Project In An Old Order Mennonite Community: Capstone Project Technical Report, Maria Eve Main

Nursing Faculty Publications

The purpose of this project was to determine if colorectal cancer (CRC) screening education and community access to fecal occult blood tests (FOBT) is associated with an increase in the uptake of FOBT in an old order Mennonite community. Utilizing a modified cultural model, an educational offering on CRC screening and access to FOBT in the community was delivered to a self-selected sample of age-eligible participants. Thirty-three age eligible residents completed the CRC screening questionnaires and received education on CRC screening. Twenty-nine of the age-eligible participants were found to be at average risk and twenty-three elected to receive FOBT testing …

An Intervention To Reduce Environmental Tobacco Smoke Exposure Improves Pregnancy Outcomes, Ayman El-Mohandes, Michele Kiely, Susan M. Blake, Marie G. Gantz, M. Nabil El-Khorazaty

Publications and Research

Objective—We tested the efficacy of a cognitive-behavioral intervention in reducing environmental tobacco smoke exposure (ETSE) and improving pregnancy outcomes among African-American women.

Methods—We recruited 1,044 women to a randomized controlled trial during 2001-2004 in Washington, DC. Data on 691 women with self-reported ETSE were analyzed. A subset of 520 ETSE women and salivary cotinine levels (SCLs)/ml was also analyzed. Individually tailored counseling sessions adapted from evidence-based interventions for ETSE and other risks, were delivered to the intervention group. The usual care group received routine prenatal care as determined by their provider. Logistic regression models were used to predict …

Hiv Risk Factors Among Moroccan And Turkish Same-Sex Attracted Youth In Amsterdam, Daniel Woznica

Independent Study Project (ISP) Collection

This report is the outcome of a month-long exploratory study on the main HIV risk factors among Moroccan and Turkish same-sex attracted (SSA) youth in Amsterdam. Data was obtained by way of interviews conducted with five experts, categorized as: academics, sexual and ethnic minority activists, and HIV professionals. Five main risk factors were determined: cultural differences; language barriers; stigma and taboo around sexuality and HIV within Islamic communities; socioeconomic marginalization; and lack of a positive term for same-sex sexual behavior and identity among the target group. Recommendations for future research include interviews with Moroccan and Turkish SSA youth themselves. Implications …

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 …