Digital Commons Network^™

A Study Of Innovation In Model Project Design: Addressing Mental Health Symptoms Among Co-Occurring Substance Use And Mentally Ill Clients Who Are Homeless In A Local Community Clinic Setting, Isis Dian Martel

Graduate Theses and Dissertations

Homeless persons with co-occurring substance use combined with mental illness constitute a particularly vulnerable subgroup with complex service needs. Unfortunately, the capacity to deliver critical treatment services has been extremely limited causing many from this population to remain untreated. Untreated co-occurring disorders can lead to a host of difficulties for both the individual and the community (Bouchery, Harwood, Sacks, Simon, & Brewer, 2011). Developing community based intervention services in Arkansas is a key activity necessary in strategically addressing this problem (Barbee, Gonzales, & Shelor, 2016). In partnership with the Arkansas Division of Behavioral Health Services, a local community treatment provider …

Physician Burnout: A Healthcare Crisis, Samantha Steinert

Renée Crown University Honors Thesis Projects - All

In recent years, burnout has been cited as a contributing factor impacting physicians’ health and the quality of health care in the United States. This paper examines causal factors, manifestations of burnout, and programmatic interventions to mitigate the effects of burnout. Mindfulness is emphasized as one approach to consider to reduce burnout and improve wellness in general. Final recommendations include two different attacks. First, a wellness based orientation is proposed as a preventative measure for residents during their intern year. Additionally, a long-term approach for all faculty and students is proposed. The intention is to create a multidisciplinary mental health …

Making Sex Work For The State : The Policing Of Sex Work In The United States., Madeline A Clabough

College of Arts & Sciences Senior Theses

This thesis analyzes the ways that sex work is regulated within the United States, and analyze the ways that regulation is shaped by contemporary feminist discourse. To do so, it analyzes the ways in which sex workers have been and pathologized since the 19th century, and address the ways that these conceptualizations have been incorporated into the legal regulation of sex workers. Finally, this thesis will look to contemporary practices in the state regulation of sex workers, and argue that the relationship between neoliberalism, the carceral state, and what has come to be termed “carceral feminism” operate in conjunction to …

The Effect Of Caffeine On Fecundability : Differences In Coffee, Tea, And Cola Consumption., Emily Kathleen Steinmetz

Electronic Theses and Dissertations

This study examined whether intake of caffeinated beverages (coffee, tea, and cola) was associated with fecundability (time to pregnancy) in a prospective cohort study. Data from 470 women from the Mount Sinai Study of Women Office Workers (1990-1994) were analyzed. Intake of coffee, tea, cola, and other variables were recorded in daily diaries and calculated as menstrual cycle level means for up to 20 cycles. Pregnancy was assayed using hCG and confirmed by physician diagnosis. The associations of caffeinated beverages with the probability of becoming pregnant during a given cycle were determined using discrete survival analysis, adjusted for potential confounders. …

Pediatric Anxiety And/Or Depression Problems : Associations With Pm10, Fly Ash, And Metal Exposure., Abby Nicole Burns Hagemeyer

Electronic Theses and Dissertations

Background: In the last several decades, the use of coal has become more prevalent in turn increasing the amount of coal ash being produced. Coal ash, the by-product of coal combustion, is composed of small particles that contain essential elements, hazardous metals, polycyclic aromatic hydrocarbons, and radioactive material. While a small proportion of coal ash is reused, the majority gets discarded in open-air landfills and ash ponds. Fly ash, the major component of coal ash, can become emitted into the air and potentially contribute to the air pollution and metal exposure in the surrounding community. Few studies, particularly in the …

Emergency Preparedness Competencies Among Nurses In Northwest Arkansas, Taylor A. Matlock

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Despite years of training and experience, evidence suggests nurses report wide gaps in emergency competencies and disaster preparedness. Further, nurses report low levels of familiarity in competencies related to planning for disasters, implementing disaster guidelines, and assessing patients exposed to biological and chemical agents. This research sought to establish the self-reported level of emergency preparedness competencies of nurses in Northwest Arkansas, an area that faces a diverse set of potential disasters ranging from nuclear accidents to pandemic disease. Additionally, differences between of the level of preparedness by education level or work specialty were studied. The results are alarming in that …

Illegitimate Bodies In Legitimate Times: Life, Liberty And The Pursuit Of Movement, Brian Culp

Faculty Articles

Drawing on Michel Foucault’s concepts of state racism and biopower, the author of the 26th Delphine Hanna Lecture presents several claims: (a) that the idea of the illegitimate outsider in Western world governments like the United States has largely been influenced by ancient Greek ideals, (b) that a host of policies and intentional actions by power brokers create derision and hierarchies between “old” and “new” immigrant groups, and (c) neoliberal ideology couched in actions that aim “to protect the state” is nothing more than a recoding of traditional racist rhetoric that expands systemic racism. The author identifies the capabilities approach, …

Evaluation Of A Fluorescence Method For Quantifying Bioaerosol Concentrations On Air Quality Filter Samples, Rachel Kolberg

UNLV Theses, Dissertations, Professional Papers, and Capstones

Airborne particulate matter (PM) in outdoor environments contains many components that cause adverse human health effects. The size of the particulates determine in what manner the particles would bypass the body’s defense mechanisms to enter the respiratory system and is directly related to their health impacts. Currently the United States Environmental Protection Agency is enforcing the National Ambient Air Quality Standards (NAAQS) to regulate the annual and 24-hour average concentrations of PM2.5 and PM10 in the air. PM2.5 are fine particles with aerodynamic diameter <2.5μm, small enough to reach the deepest parts of the bronchi and lungs. PM10 include PM2.5 and larger particles with aerodynamic diameter of 2.5-10μm. Both PM2.5 and PM10 contain multiple components from multiple sources. Bioaerosols are an important component of PM, but there is limited knowledge about how bioaerosols contribute to PM2.5 and PM10 concentrations. There is also a lack of research about the incidence and prevalence of disease caused by bioaerosols and about the limits of exposure to bioaerosol particulates. The main barrier to assess bioaerosol concentrations and health-related effects is the absence of quick and inexpensive methodology for quantifying bioaerosols. This study explored the feasibility of using fluorescence microscopy to quickly quantify bioaerosols in PM2.5 and PM10 collected on polycarbonate filters. Bioaerosols were stained with a DNA marker directly on a filter, followed by fixation, microscopic imaging, and automatic counting. The method was first validated using reference samples prepared by depositing different known concentrations of E. coli onto blank polycarbonate filters. The results indicated a linear response over two orders of magnitude (R2 = 0.9) and an accuracy within ±25%. E. coli were also deposited onto selected ambient PM10 and PM2.5 filter samples to determine if pre-loaded particles would interfere with bioaerosol imaging and counting. It was found that despite an increase in uncertainty (variability), the calibration slope remained within ±10% of unity for both PM2.5 and PM10 samples. Bioaerosol concentrations in ambient samples, as quantified by this method, were on average 14% higher for PM10 than for PM2.5 acquired concurrently in a desert environment of Las Vegas, Nevada. The application of this method to other types of compliance filters, such as Teflon filters and tapes of a Beta Attenuation Monitor (BAM) were also explored in this study. By means of a high-yield approach this method is expected to facilitate bioaerosol research, support exposure and health assessments, and help refine NAAQS for PM2.5 and PM10.

A Rural And Urban Study Of The Food Environment In Select Nevada Geographies, Joseph Nickelson

UNLV Theses, Dissertations, Professional Papers, and Capstones

National and county level examination of urban and rural food environments has taken place, but primary validation of venue existence and in-venue data are lacking. The literature show disparities in access to healthy foods through low density of large grocers/supermarkets, low variety and quality of produce and higher prices for a healthy diet in rural versus urban geographies. Rural areas are of unique concern due to poor health indicators such as higher obesity rates, higher diabetes rates, lower incomes and lower educations than urban residents. The goal of this study was to explore differences in the community and consumer level …

Association Of Genetic Factors With Chronic Kidney Disease In Us Young Adults, Sabra Stanford

UNLV Theses, Dissertations, Professional Papers, and Capstones

Albumin, a protein that when found in urine, is an early indicator of Chronic Kidney Disease (CKD). Genetic contributions have been shown to illustrate the gene-environment interactions that may lead to CKD in an individual; however, few studies have highlighted the interaction between responses of gene variations associated with the risk of increased albumin in young adults. This study’s purpose is to evaluate the hypothesis that candidate genes are related to microalbuminuria in young adults of the third wave of the National Longitudinal Study of Adolescent Health (Add Health Wave III). This longitudinal study includes an assessment of various candidate …

Schizophrenia And Its Effects On An American Family: A Call To Action For The 21st Century, Cynthia Newton Captain

Senior Theses

Our country’s healthcare system is at a moral crossroads. The way we treat those whom we call “the homeless” is deplorable. The majority of the homeless are mentally ill and need treatment. Our country needs to treat those with the severe brain diseases of schizophrenia, schizo-affective disorder, and bi-polar disorder just as we would Alzheimer’s disease and Parkinson’s disease. Those with severe mental illness, who have no insight into their illness, should not be allowed to dictate their own treatment. If a homeless person is brought to San Francisco General Hospital and is found to be a schizophrenic in psychiatric …

Reducing Tobacco-Related Health Disparities : Exploring The Barriers And Facilitators To Smoking Cessation Among Individuals Experiencing Homelessness., Bernadette Guzman Antoon

Electronic Theses and Dissertations

Although the prevalence of smoking has declined in the U.S., vulnerable populations continue to suffer from tobacco-related health disparities. An estimated 68.0-80.0% of homeless adults are current cigarette smokers compared to 15.1% in the general population. The large gap in smoking rates suggests that current tobacco cessation programs designed to reduce smoking have little impact among individuals experiencing homelessness. The purpose of this study was to explore the barriers and facilitators to smoking cessation among the homeless. The second aim of this study was to explore if the barriers and facilitators to tobacco cessation differed among male smokers experiencing homelessness …

The Particulars About Particulates : Metal Exposure And Self-Regulation Of Children Living Near Coal Ash., Clara G. Sears

Electronic Theses and Dissertations

The use of coal combustion for electricity and the storage of coal combustion by-products known as coal ash occur across the United States and around the world. The most abundant type of coal ash, fly ash, contains small particles with metals, some of which are known neurotoxins. Fly ash is currently stored in open-air landfills and surface impoundments that allow fugitive dust to escape into surrounding communities, potentially exposing children to small neurotoxic particles. This dissertation uses preliminary data from a larger cross-sectional study to investigate the relationship between particulate matter exposure, metal exposure, and problems with self-regulation. Recruitment of …

A Description Of The Methods Of The Aspirin Supplementation For Pregnancy Indicated Risk Reduction In Nulliparas (Aspirin) Study, Matthew K. Hoffman, Shivaprasad S. Goudar, Bhalachandra S. Kodkany, Norman Goco, Marion Koso-Thomas, Menachem Miodovnik, Elizabeth M. Mcclure, Dennis D. Wallace, Jennifer J. Emingway-Foday, Antoinette Tshefu, Adrien Lokangaka, Carl L. Bose, Elwyn Chomba, Musaku Mwenechanya, Waldemar A. Carlo, Ana Garces, Nancy F. Krebs, K. Michael Hambidge, Sarah Saleem, Robert L. Goldenberg, Archana Patel, Patricia L. Hibberd, Fabian Esamai, Edward A. Liechty, Robert Silver, Richard J. Derman

Community Health Sciences

Background: Preterm birth (PTB) remains the leading cause of neonatal mortality and long term disability throughout the world. Though complex in its origins, a growing body of evidence suggests that first trimester administration of low dose aspirin (LDA) may substantially reduce the rate of PTB.
Methods: Hypothesis: LDA initiated in the first trimester reduces the risk of preterm birth. Study Design Type: Prospective randomized, placebo-controlled, double-blinded multi-national clinical trial conducted in seven low and middle income countries. Trial will be individually randomized with one-to-one ratio (intervention/control) Population: Nulliparous women between the ages of 14 and 40, with a …

Assessment Of Social, Dietary And Biochemical Correlates Of Cardiometabolic Risk In Pre-Adolescent Hispanic Children, Abraham Basil Alhassan

Electronic Theses and Dissertations

Obesity, elevated blood pressure and dyslipidemia are highly prevalent in Hispanic children. Compared to their non-Hispanic White peers, Hispanic children experience higher prevalence of obesity and hypertension. The Hispanic population in Tennessee has been growing, with about a tenth of newborn babies being Hispanic. This study aimed to: 1. Examine the influence of sociodemographic factors on Hispanic children’s cardiometabolic risk; 2. Assess the relationship between food group intake and cardiometabolic risk in Hispanic children; and 3. Evaluate the efficacy of non-traditional biomarkers for detecting cardiometabolic risk in Hispanic children. Data for the study came from a larger cross-sectional pilot study …

Psychometric Evaluation Of The Nursing Child Assessment Teaching (Ncat) Scale In Two Samples Of Mothers And Children, Samantha H. Ransone

Theses and Dissertations (ETD)

The mother-child relationship (MCR) has received an increasing amount of attention over the last several decades regarding its effect on long-term child development. Because the quality and quantity of interactions in the MCR have been established as important predictors of the child’s development, early identification of areas in the relationship requiring support and intervention is essential for promoting positive child outcomes. Observational assessment of the mother and child is considered best practice in evaluating maternal-child interaction (MCI). The Nursing Child Assessment Teaching (NCAT) scale is an instrument that has been used to quantify the quality of interaction in the MCR …

The Increasing Risk Of Vector-Borne Diseases: Mapping The Effects Of Climate Change And Human Population Density On Future Aedes Aegypti Habitats, Julie Obenauer

Electronic Theses and Dissertations

The Aedes aegypti mosquito is the vector for four infectious diseases of global concern – Yellow Fever, Dengue, Chikungunya, and Zikavirus. Previous attempts to model the expansion of the vector habitat due to global climate change have rarely included characteristics related to the human populations on which this mosquito is dependent. The purpose of this research was to determine whether the inclusion of human population density improves model performance while creating risk maps that can be used to determine where humans are most likely to be exposed to the vector in the future. The resulting model demonstrated that the inclusion …

An Epidemiological Study Of Obesity Among Asian Americans In California, United States, Shaoqing Gong

Electronic Theses and Dissertations

Obesity has reached epidemic levels in the United States (U.S.). Despite an increasing number of studies on obesity, a very few have addressed this debilitating condition among Asian American adults. The overall objective of this study is to utilize the latest cycles of the California Health Interview Survey (CHIS) to better understand obesity and identify its correlates among Asian Americans. The study population comprised Asian American adults aged 18 years or older from the CHIS with data pooled from the 2013 and 2014 survey years. Obesity (≥27.5 kg/m²) was defined using the World Health Organization (WHO) Asian body …

Voices In Treble: Self-Reported Vocal Health Of Student Singers, Jane Dreier

Honors Projects

The investigator examined reports of vocal health among singers in two different choral groups on a university campus, a population consisting of both music majors and non-music majors. These student singers consented to filling out a 36-question survey that asked about their overall vocal health and daily habits that might affect that health. A section of this survey involved rating answers from 0-4, while the other section required write-in answers. Results indicate that there is no significant difference in self-reported vocal health between music majors and non-music majors, although there were minor differences between these populations regarding daily habits, such …

An Investigation Of The Relationship Between Child, Family, And Community Factors And Early Childhood Oral Health And The Utilization Of Dental Health Services, Nicole Holt

Electronic Theses and Dissertations

Background / Objective: Children under the age of 5 years bear a disproportionate burden of oral disease. The aim of this study is to investigate how child, family, and community determinants impact dental care utilization, and parental report of child’s oral health. Methods: Data for this study came from the 2011/2012 National Survey of Children’s Health for children aged 1 to 5 years old. Dependent variables evaluated were if the child had an oral health problem, been to a dentist in the past year, and parents description of the child’s teeth. Independent variables were selected from child, family, and community …

Salmonella And Aeromonas Contamination In A 303(D) Listed Water Body Compared To Fecal Indicators & Water Quality Parameters, Elizabeth M. Morgan Ms.

Undergraduate Honors Theses

Since the passage of the Clean Water Act, concern about surface water quality has increased. Reducing exposure to pathogens and adverse impacts on human health because of contact with surface waters has become the focus of many regulatory agencies. Fecal pollution is often a cause of surface water impairment. Fecal indicators, such as fecal coliforms and Escherichia coli, are used as surrogates to evaluate the presence or absence of fecal pollution. However, a growing body of research has shown that these species lack key characteristics necessary to be adequate indicators. As such, explorations into the efficacy of indicator species …

High School Gardens Program Across The Nation: Current Practices, Perceived Benefits, Barriers, And Resources, Noehealani Cierra Bareng- Antolin

UNLV Theses, Dissertations, Professional Papers, and Capstones

School garden programs in the United States emerged near the end of the 19th century. The use and purpose of school gardens are multifaceted and is dependent on the school and individuals involved. Current research on school garden programs suggests positive benefits for student academic achievement, nutrition knowledge, and dietary behaviors. Research on school garden programs is predominately conducted at the elementary and middle school levels. High school garden programs do exist; however, there is limited research on the current practices, perceived benefits of, barriers to, and resources necessary for high school garden programs. The purpose of this study was …

Knowledge And Awareness Regarding Cervical Cancer And Uptake Of Pap Smear Among Women In Karachi, Pakistan, Shama Razzaq, Sayeeda Amber Sayed Amber Sayeeda Amber Sayed, Sumera Aziz Ali

Community Health Sciences

Objective: To determine the knowledge regarding cervical cancer, its symptoms and risk factors among women of 18 years and above attending the gynecology OPD in two public hospitals Karachi, Pakistan.
Methodology: A cross-sectional survey was held from February to June 2013 in Karachi, Pakistan. 384 females aged 18 years and above attending gynecology clinics in two public sector hospitals were taken through non-probability sampling method. The knowledge was assessed using a point scale method which had binary response i.e. correct and incorrect. A score of 50% (≥ 11 correct responses) was considered as optimum knowledge.
Results: Overall knowledge of cervical …

Does Educational Level Influence Postmenopausal Breast Cancer Mortality Among Asians In U.S.?, Sfurti Maheshwari

UNLV Theses, Dissertations, Professional Papers, and Capstones

Studies on mortality from postmenopausal breast cancer (PMBC) by education level have not shown consistent results among US women. For US Asians, often seen as a “model” minority in terms of affluence and education this relationship has never been studied despite PMBC being the most common cancer in the country.

We analyzed 2008-2012 California Vital Statistics data and population data from the American Community Survey 2012 to compute age and education adjusted mortality ratios using negative binomial regression model for White (as a reference category) and Asian women. In total 3,277,106 (80%) White women and 852,376 (20%) Asian women died …

Chuukese Migrant Women In Guam: Perceptions Of Barriers To Health Care, Margaret Hattori-Uchima

Asian/Pacific Island Nursing Journal

This descriptive qualitative study examined perceived barriers to health care among Chuukese migrant women in Guam and explored which factors influenced health-seeking behaviors. Study participants recommended interventions which may reduce those perceived barriers. Since the Compact of Free Association with the United States was enacted in 1985, there has been a dramatic rise in the numbers of Chuukese migrating to Guam. This migration is anticipated to continue with more migrants needing health care, education, and social services. Little is known about their perceptions of barriers to health care services or the cultural, social, economic, and other factors that influence their …

Activity Of Distinct Growth Factor Receptor Network Components In Breast Tumors Uncovers Two Biologically Relevant Subtypes, Moom Roosan, Shelley M. Macneil, David F. Jenkins, Gajendra Shrestha, Sydney R. Wyatt, Jasmine A. Mcquerry, Stephen R. Piccolo, Laura M. Heiser, Joe W. Gray, W. Evan Johnson, Andrea H. Bild

Pharmacy Faculty Articles and Research

Background
The growth factor receptor network (GFRN) plays a significant role in driving key oncogenic processes. However, assessment of global GFRN activity is challenging due to complex crosstalk among GFRN components, or pathways, and the inability to study complex signaling networks in patient tumors. Here, pathway-specific genomic signatures were used to interrogate GFRN activity in breast tumors and the consequent phenotypic impact of GRFN activity patterns.

Methods
Novel pathway signatures were generated in human primary mammary epithelial cells by overexpressing key genes from GFRN pathways (HER2, IGF1R, AKT1, EGFR, KRAS (G12V), RAF1, BAD). The pathway analysis toolkit Adaptive Signature Selection …

East Meets West: Cultural Values And Duty To Care For Disaster Response, Tracy J. Nash

Nursing Theses and Dissertations

Nurses’ readiness for disaster response has assumed front and center-stage in recent years, due to the heightened number of natural and human-induced disasters across the globe. Scientific literature affirms that without nurses’ personal and professional readiness for disaster situations, patient and public health outcomes will likely decline. Three research manuscripts presented in this dissertation portfolio targeted this significant, but overlooked public health issue. First, a quantitative pilot study addressing nurses’ personal preparedness for disaster response was considered. Findings from the study not only justified personal readiness as a significant concept, but also prompted review of the scientific literature to further …

Point Of Care Technology For Underserved Populations, Anna Maloney

Annual Undergraduate Conference on Health and Society

Point of Care technology is an emerging healthcare field. This technology allows for rapid, inexpensive, on-site testing for otherwise lengthy and costly laboratory tests. Leading infectious diseases can be tested immediately in non-invasive ways similar to using a pregnancy test. This inexpensive, highly portable, and extremely accurate technology should be used for populations that have historically lacked access. Such access would result in immediate cost savings and life savings.

Underserved populations in America such as migrant workers or people living in poverty rarely receive the testing they require. Although clinics for illegal immigrants exist where they are protected and cannot …

Priority Hypertension Management Strategies For At-Risk African Americans As Perceived By Medical Clinicians And Academic Scholars, Shirley M. Timmons, Lu Shi, Amin Khademi

Journal of Health Disparities Research and Practice

African American adults, in the United States (US), bear the greatest burden of high blood pressure (HBP)--a primary risk factor for cardiovascular disease and premature death. Current research does not adequately inform the design of multi-level interventions that work to control HBP in this at-risk population. The purpose of this study was to uncover information about priority strategies recommended for HBP control in African American adults. Research questions are 1) what are factors that reduce or manage HBP in at-risk African Americans and 2) what factors are important to the design and implementation of successful HBP interventions in at-risk African …

Within-Person Associations Of Young Adolescents' Physical Activity Across Five Primary Locations: Is There Evidence Of Cross-Location Compensation?, Jordan A. Carlson, Tarrah B. Mitchell, Brian E. Saelens, Vincent S. Staggs, Jacqueline Kerr, Lawrence D. Frank, Jasper Schipperijn, Terry L. Conway, Karen Glanz, Jim E. Chapman, Kelli L. Cain, James F. Sallis

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Youth are active in multiple locations, but it is unknown whether more physical activity in one location is associated with less in other locations. This cross-sectional study examines whether on days with more physical activity in a given location, relative to their typical activity in that location, youth had less activity in other locations (i.e., within-person associations/compensation).

METHODS: Participants were 528 adolescents, ages 12 to 16 (M = 14.12, SD = 1.44, 50% boys, 70% White non-Hispanic). Accelerometer and Global Positioning System devices were used to measure the proportion of time spent in moderate-to-vigorous physical activity (MVPA) in five …