Medicine and Health Sciences Commons^™

A National Study On The Physical And Mental Health Of Intersex Adults In The U.S., Amy Rosenwohl-Mack, Suegee Tamar-Mattis, Arlene B. Baratz, Katharine B. Dalke, Alesdair Ittelson, Kimberly Zieselman, Jason D. Flatt

Environmental & Global Health Faculty Research

Objectives: To describe the health of intersex adults (people with differences of sex development) in the U.S. using community-based research methods. Methods: In July–September 2018, we conducted a national health study of intersex adults aged 18 and older in the U.S., using a survey hosted on Qualtrics. The study describes the physical and mental health experiences of intersex adults, including differences by age (18 to 39 vs. 40 and older). Questions were derived from national (Behavioral Risk Factor Surveillance System) and intersex-related health studies. Results: A non-probability sample of 198 intersex adults completed the survey over three months. Over 43% …

Application Of Auricular Point Acupressure For Pain In Patients With Alzheimer’S Disease And Their Caregivers, Chao Hsing Yeh, Mengchi Li, Jennifer Wenzel, Mollie Fox, Aiguo Nni, Jennifer Kawi

Nursing Faculty Research

Objective: To explore the feasibility of Auricular Point Acupressure (APA) to self-manage pain among patients with Alzheimer’s disease and related disorders (ADRD) and their caregivers (patient-caregiver dyads). Methods: A two-phase study design was used. Phase 1 was designed to explore the experiences of the dyads in using APA to manage chronic pain. In Phase 2, we examined the revised intervention protocol to manage pain. All of the study activities were conducted at the participants’ homes. Results: In Phase 1, five dyads (patients and caregivers) who received the APA treatment reported marked and immediate outcomes but there were challenges in applying …

Legal And Ethical Approaches To Impaired Capacity: Balancing Autonomy And Non-Maleficence, Gregory Brown

Psychiatry & Behavioral Health Faculty Research

Goals and Objectives:

1. Articulate the two primary ethical principles in conflict when considering an assessment of capacity.
2. Define the legal authority provided under an L2K hold within the state of Nevada and the authority not granted under that form of detainment.
3. Clarify the difference between specific decision making capacity versus global impairment of cognition.
4. Differentiate the pros and cons of a “sliding scale” of competence model.
5. Apply the concept of an alternative decision maker legally in clinical care setting.

Comparison Of Physical Fitness Between Sport And Non-Sport Groups Among Elementary School Children, Junjiro Kubo, Saburo Nishimura, Takayuki Ogiwara

Topics in Exercise Science and Kinesiology

• We compared physical fitness factors between sport and non-sport groups of elementary school children in all grades. The subjects of this study were 1,079 1st- to 6th-grade male elementary school children. Their parents completed a questionnaire examining whether the child attended sports lessons as a regular after-school activity. Physical fitness was evaluated by a new physical fitness test recommended by the Japanese Ministry of Education, Culture, Sports, Science, and Technology (4). The test consists of the following items: 1) Grip strength (kg); 2) Sit-ups (number completed in 30 sec); 4) Sitting front stretches (cm); 5) Side steps (number completed in …

Improving Health Care In Nevada, Ember Smith, Kaylie Pattni

Policy Briefs and Reports

Across the United States, improvements in health outcomes lag while health care costs rapidly rise. Medical personnel and resource shortages combined with high underinsured and uninsured rates further complicate access to quality, affordable health care. In order to better understand state-level solutions, we explore factors that contribute to health care deficiencies and emphasize Nevada’s unique obstacles.

Changes In Preventive Care Utilisation And Its Influencing Factors Among Chinese Adults Before And After The Healthcare Reform: Cross-Sectional Evidence From The China Health And Nutrition Survey In 2004-2015, Tingting Wu, Wei Wei Liu, Mao Zou, Xun Lei, Qiang Yang, Manoj Sharma, Yong Zhao, Zu Min Shi

Environmental & Global Health Faculty Research

Objective China launched its health reform in 2009. This study aimed to assess changes in preventive care utilisation (PCU) and its relationship with the healthcare reform. Design A cross-sectional study using demographic characteristics, socioeconomic status, environmental factors, and lifestyle and health status data of adults from five waves (2004–2015) of the China Health and Nutrition Survey (CHNS) was conducted. Multilevel mixed-effects logistic regression models were used. Setting Data were derived from urban and rural communities of nine provinces in China. Participants Data were obtained from five waves of the CHNS, with 9960 participants in 2004, 9888 in 2006, 10 286 …

The Association Between Depressive Symptoms And Accumulation Of Stress Among Black Men In The Health And Retirement Study, Roland J. Thorpe Jr., Phd, Ryon Cobb Phd, Keyonna King Drph, Marino A. Bruce Phd, Msrc, Mdiv, Paul Archibald Drph, Lcsw, Harlan P. Jones Phd, Keith C. Norris Phd, Keith E. Whitfield Phd, Darrell Hudson Phd, Mph

Office of the President Faculty Publications

Background and Objectives: Among the multiple factors posited to drive the health inequities that black men experience, the fundamental role of stress in the production of poor health is a key component. Allostatic load (AL) is considered to be a byproduct of stressors related to cumulative disadvantage. Exposure to chronic stress is associated with poorer mental health including depressive symptoms. Few studies have investigated how AL contributes to depressive symptoms among black men. The purpose of the cross-sectional study was to examine the association between AL and depressive symptoms among middle- to old age black men. Research Design and Methods: …

Elevated Serum Il-21 Levels Are Associated With Stable Immune Status In Kidney Transplant Recipients And A Mouse Model Of Kidney Transplantation, Luying Guo, Junhao Lv, Jian Zhang, Hao Deng, Shi Feng, Shuaihui Liu, Pengpeng Yan, Jingyi Zhou, Hui Chen, Meifang Wang, Qin Zhou, Huiping Wang, Jianghua Chen, Yu Kuang, Jia Shen, Rendwing Wang

School of Medicine Faculty Research

Allograft rejection after renal transplantation remains a challenge to overcome. Interleukin (IL)-21, a cytokine with pleiotropic effects, maintains immune homeostasis post-transplantation. Here, we report higher levels of IL-21 in kidney transplant recipients with non-rejection (NR) than in recipients with T cell-mediated rejection (TCMR, P < 0.001) and antibody-mediated rejection (ABMR, P = 0.005). We observed a negative correlation between IL-21 and creatinine (Cr) levels (P = 0.016). The receiving operating characteristic (ROC) curve showed a promising diagnostic value of IL-21 to identify acute rejection with an area under the curve (AUC) of 0.822 (P < 0.001). In contrast, exogenous administration of IL-21 accelerated acute rejection in a comparative translational kidney transplant (KT) mouse model. Reduced IL-21 levels in the peripheral blood were observed in KT mice after IL-21 injection. Further analysis revealed that increased IL-21 levels in the spleen induced proliferation of CD4+ T cells and CD19+ B cells after IL-21 treatment. Our findings suggest a critical function of IL-21 in kidney transplantation and the potential involvement of the IL-21/IL-21R pathway in acute rejection management.

Covid-19 And Social Isolation Endangering Psychological Health Of Older Adults: Implications For Telepsychiatry, Kavita Batra, Amanda Elizabeth Morgan, Manoj Sharma

Environmental & Global Health Faculty Research

Coronavirus disease-19 (COVID-19) has created a public health emergency and had claimed 911,877 lives at the time of writing this manuscript (September 12, 2020). While everybody is at the risk of acquiring infection following the exposure to SARS-CoV-2, older adults are significantly more likely to experience severe illness, life-threatening complications, hospitalizations, and deaths. As the pandemic evolved, social distancing or shielding efforts as primary prevention were instituted to protect the physical health status of the vulnerable population, with no or limited consideration to the psychological health of the older population. Social isolation and loneliness are the long-standing public health concerns …

Musculoskeletal Injury In Reserve Officers' Training Corps: A Report From The Athletic Trainers' Practice-Based Research Network, Kara N. Radzak, Joellen M. Sefton, Mark K. Timmons, Rachel Lopp, Christopher D. Stickley, Kenneth C. Lam

Kinesiology and Nutrition Sciences Faculty Research

Background: Reserve Officers’ Training Corps (ROTC) cadets must meet the same physical standards as active duty military servicemembers and undergo organized physical training (PT). ROTC participation, like all physical activity, can result in trainingrelated musculoskeletal injury (MSKI), and of course, cadets could sustain MSKI outside of ROTC. However, MSKI incidence in ROTC programs is largely unknown. Purpose: To describe patient and injury demographics of MSKI in 5 universities’ Army ROTC programs. Study Design: Descriptive epidemiology study. Methods: A retrospective chart review of electronic medical records was performed using the Athletic Training Practice-Based Research Network (AT-PBRN). Athletic trainers at 5 clinical …

Expression Of Mir-720 Is Correlated With Dnmt3 In Oral Squamous Cell Carcinomas, Andrew Graves, Sukhdeep Sandhu, Karl Kingsley

Dental Medicine Faculty Research

Background: Many factors are involved with cellular differentiation and pluripotency, such as long non-coding and microRNAs (miRNA). miR-720 has been demonstrated to affect development, differentiation and pluripotency in dental pulp stem cells but has also been linked to many cancers (renal, prostate, skin, colorectal, breast, cervical and esophageal) through shared pathways including DNA methyltransferase family members (DNMT)3a and DNMT3b, which are highly upregulated in many oral cancers. However, little is known about the expression (or function, if expressed) of miR-720 in oral cancers. Based upon this lack of information, the primary objective of this project was to evaluate the expression …

Prevalence Of Hyperdontia, Hypodontia, And Concomitant Hypo-Hyperdontia, Nareh Eshgian, Tanya Al-Talib, Stanley Nelson, Neamat Hassan Abubakr

Dental Medicine Faculty Research

Background/purpose: Anomalies in human dentition are some of the most common occurrences of congenital abnormalities. Present study aimed to determine the prevalence of hypodontia, hyperdontia and concomitant hypo-hyperdontia (CHH) among patients attending the University of Nevada, Las Vegas (UNLV) School of Dental Medicine clinics. Materials and methods: Retrospective search was conducted on patients’ clinical notes in AxiUm. Search included using keywords such as “hypodontia”, “hyperdontia”, “supernumerary teeth” and “congenitally missing”. Panoramic radiographs were used to confirm the hyperdontia, hypodontia or CHH for patients attending the UNLV SDM clinics from 2010 to 2018. Collected data were analyzed using the chi-square test. …

Efficacy Of Transoral Outlet Reduction In Roux-En-Y Gastric Bypass Patients To Promote Weight Loss: A Systematic Review And Meta-Analysis, Banreet Singh Dhindsa, Syed Mohsin Saghir, Yassin Naga, Amaninder Dhaliwal, Dayl Ramai, Chad Cross, Shailender Singh, Ishfaq Bhat, Douglas G. Andler

School of Medicine Faculty Research

Background and study aims Transoral outlet reduction (TORe) is an endoscopic procedure used in patients with weight gain post Roux-en-Y gastric bypass (RYGB). We performed a systematic review and meta-analysis to evaluate the efficacy and safety of TORe with a full-thickness suturing device for treating patients with weight regain after RYGB. Patients and methods We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google-Scholar, MEDLINE, SCOPUS, and Web of Science databases (earliest inception to March 2020). The primary outcomes assessed were technical success, absolute weight loss (AWL) and percent of total weight loss (% TWL) …

Reporting The Spanish Influenza Epidemic In Nevada, Peter Michel

Library Faculty Research

The last great global pandemic before COVID 19 was the Spanish Influenza of 1918-20 which killed by some estimates over 30,000,000 people, 675,000 of those in the United States, ten-times the number of Americans who died in World War I. In another historical comparison, more people died of the Spanish Influenza in one year than died in four years of the Black Death of 1347-1351 in which a third of Europe’s population perished. In the early days of mass communication by telegraph and newspapers, compared to our own age of instant, constant streaming information, how did people know what was …

Covid-19 And Mental Well-Being: Guidance On The Application Of Behavioral And Positive Well-Being Strategies, Amar Kanekar, Manoj Sharma

School of Public Health Faculty Research

The raging COVID-19 pandemic has been a great source of anxiety, distress, and stress among the population. Along with mandates for social distancing and infection control measures, the growing importance of managing and cultivating good mental well-being practices cannot be disregarded. The purpose of this commentary is to outline and discuss some research-proven positive well-being and stress reduction strategies to instill healthy coping mechanisms among individuals and community members. The authors anticipate that usage of these strategies at the individual and the community level should greatly benefit the mental well-being not only in the current COVID-19 pandemic but also in …

Prevalence Of Depression, Anxiety, And Stress During Covid-19 Pandemic, Ram Lakhan, Amit Agrawal, Manoj Sharma

School of Public Health Faculty Research

The coronavirus disease 2019 (COVID-19) crisis has greatly affected human lives across the world. Uncertainty and quarantine have been affecting people’s mental health. Estimations of mental health problems are needed immediately for the better planning and management of these concerns at a global level. A rapid scoping review was conducted to get the estimation of mental health problems in the COVID-19 pandemic during the first 7 months. Peer-reviewed, data-based journal articles published in the English language were searched in the PubMed, Medline, and Google Scholar electronic databases from December 2019 to June 2020. Papers that met the inclusion criteria were …

Spotlight On Compulsive Sexual Behavior Disorder: A Systematic Review Of Research On Women, Ewelina Kowalewska, Mateusz Gola, Shane W. Kraus, Michal Lew-Starowicz

Psychology Faculty Research

Purpose of Review: World Health Organization recently included compulsive sexual behavior disorder (CSBD) to the upcoming 11th edition of International Classification of Diseases (6C72). Despite the potential benefits of this decision (eg, the acceleration of research in the field will allow the development of effective treatments), previous research focused mainly on men, and as a result, we do not have an accurate clinical picture of compulsive sexual behavior (CSB) among women. Therefore, in this systematic review, we aim to present available knowledge on this topical subject. Literature search was conducted in the guideline of PRISMA methodology. Studies were identified from …

The Association Between Medication Use And Gait In Adults With Intellectual Disabilities, S. Maas, D. A.M. Festen, Thessa I.M. Hilgenkamp, A. Oppewal

Physical Therapy Faculty Research

Background: Adults with intellectual disabilities (ID) often have polypharmacy and often use antipsychotics. Both polypharmacy and antipsychotics have a negative effect on gait in the general population, but this has not been studied in adults with ID. These negative effects may add to pre‐existing gait disturbances in adults with ID and increase the risk for adverse health outcomes in this population. Therefore, the aim of this study is to investigate the difference in gait parameters between adults with ID with and without polypharmacy and between adults with ID using and not using antipsychotics. Method: The gait parameters of 31 participants …

Imagining The Future Of Medicine Through A Lens Of Prejudice: Lessons From The American Past, Neil Nusbaum

Journal of Health Disparities Research and Practice

Many healthcare management decisions today, such as those about facility construction, will have impact even decades beyond the traditional 5 or 10 year planning horizon. In order to get some idea of the possibilities and challenges of today’s long range forecasts in healthcare, it is instructive to look at how well similar efforts fared a century ago. Looking in retrospect now, the task of prognostication then was impeded in part by a failure of vision due to prejudicial attitudes of the era.

Barriers For Cervical Cancer Screening In Women Living With Hiv: A Systematic Review, Vimala Ganta Md, Mph, Sheniz Moonie Phd, Brian Labus Phd, Karen Gutierrez Bs, Xan Y. Goodman Mlis, Ahip

Journal of Health Disparities Research and Practice

Cervical cancer is a prominent cancer in U.S. women caused primarily by the human papilloma virus and its incidence and mortality rates have decreased through screening programs. Certain barriers are perceived to be affecting the rates of cervical cancer screening among women living with HIV (WLWH). A systematic review was conducted to identify and summarize these barriers among WLWH nationwide. There is a need to increase awareness and education among WLWH. Public health programs and community-based interventions should target women of low SES and minority status while assessing the barriers among this population to improve cervical cancer screening rates.

Factors Affecting The Characterization Of Post-Exertional Malaise Derived From Patient Input, Carly S. Holtzman, Claire Fisher, Shaun Bhatia, Leonard A. Jason

Journal of Health Disparities Research and Practice

The National Institutes of Health/Center for Disease Control and Prevention (NIH/CDC) Common Data Elements (CDE) established a post-exertional malaise (PEM) workgroup with the task of describing PEM and recommending a standardized way of assessing it in patients with myalgic encephalomyelitis and chronic fatigue syndrome (ME/CFS). As a stigmatized group, patients with ME/CFS are in need of instruments which can properly describe their symptomatic experiences, which can help reduce the disparity between illness seriousness and appropriate attention from healthcare. The current study explored attitudes and preferences among 115 patients with ME/CFS who participated in the creation of a patient-driven instrument to …

Disparities In Health Behavior Risks Among Employed And Unemployed Black And White Older Adults, M. Courtney Hughes, Tamara A. Baker, Hansol Kim

Journal of Health Disparities Research and Practice

Objective: Examine health behavior risk rates and disparities in health behavior risks related to race and employment among older adults. Methods: A cross-sectional analysis of a representative sample of noninstitutionalized adults aged 65 and older (150,669 in 2015 and 168,011 in 2016) from the Behavioral Risk Factor Surveillance System. Self-reported health behavior risks were measured as well as multiple logistic regression analyses assessing the independent effects of demographic variables on health behavior risks. Results: Employed older adults have greater health behavior risks than unemployed older adults. Black employed older adults have greater health behavior risks than Black unemployed older adults …

A Lung Cancer Screening Personalized Decision-Aid Improves Knowledge And Reduces Decisional Conflict Among A Diverse Population Of Smokers At An Urban Academic Medical Center, Madeline Kaufman, Nilan Schnure, Andrea Nicholson, Frank Leone, Carmen Guerra

Journal of Health Disparities Research and Practice

Introduction: Few lung cancer screening decision aids have been tested in diverse populations. The study objective was to determine whether the online decision aid www.shouldiscreen.com impacts knowledge of and decisional conflict around lung cancer screening in a diverse population.

Methods: Eligible patients had significant smoking histories, were at increased risk for lung cancer (ages 45-80, >20 pack-years, smoking within last 15 years) and had no history of prior lung cancer or screening. Data was collected and analyzed in 2017.

Results: 40 patients were enrolled: 80% were female, 62.5% black, 33% white, and 48% had a high school …

Investigating Disparities In High School Athletes’ Attitude Toward Concussion And Predictors Of Continuing Play, Jessica Wallace, Jamie Mcallister Deitrick, Tywan Martin, Ryan N. Moran

Journal of Health Disparities Research and Practice

Objective: Studies related to attitudes of concussion have been growing in athletic populations. While racial and socioeconomic disparities exist in knowledge and awareness of concussion, it remains unclear the effect of disparities on attitudes of concussion and reporting behaviors. The purpose of this study was to examine racial and socioeconomic disparities on attitudes towards concussion and the decision to remain in play with a suspected concussion.

Design: This cross-sectional study included 577 athletes between the ages of 13-19 (16.0 ± 1.2) years from 14 high schools. Participants completed a knowledge and attitudes instrument assessing general attitudes of concussion using 7 …

Sex Differences In Risk Factors For Oral And Pharyngeal Cancer Among Puerto Rican Adults, Maira A. Castaneda-Avila, Cynthia Perez, Jose Vivaldi, Elba C. Díaz, Hilmaris Centeno, Ana P. Ortiz

Journal of Health Disparities Research and Practice

Background: Oral and pharyngeal cancer (OPC) is a frequent type of cancer in Puerto Rico, with the risk being higher in men relative to women. We assessed differences in OPC risk factors implicated in these sex disparities.

Methods: We analyzed data of 740 adult participants (40-65 years) from the San Juan Overweight Adults Longitudinal Study (SOALS). A comprehensive questionnaire was administered to collect information on sociodemographic characteristics, cigarette smoking, binge drinking, oral high-risk HPV infection, fruit and vegetable consumption, sexual behavior, and oral hygiene practices. A full-mouth periodontal examination was also performed. Sixteen OPC known and potential risk factors were …

Strategies For Increasing Impact, Engagement, And Accessibility In Hiv Prevention Programs: Suggestions From Women In Urban High Hiv Burden Counties In The Eastern United States (Hptn 064), Jasmine A. Abrams, Michelle Odlum, Emily Tillett, Danielle Haley, Jessica Justman, Sally Hodder, Linda Vo, Ann O’Leary, Paula M. Frew

School of Public Health Faculty Research

Background: Merely having the tools to end HIV is insufficient. Effectively ending the epidemic necessitates addressing barriers that impede engagement in biomedical and behavioral prevention and wide scale implementation and utilization of existing interventions. This qualitative study identifies suggestions for increasing access to, engagement in, and impact of HIV prevention among women living in cities in high HIV burden counties in the eastern US. Methods: Data analyzed for the current study were collected via a qualitative sub-study within the HIV Prevention Trials Network Study 064 (HPTN 064), a multisite observational cohort study designed to estimate HIV incidence among women residing …

Motivations For Treatment Engagement In A Residential Substance Use Disorder Treatment Program: A Qualitative Study, Patrick J. Dillon, Satish K. Kedia, Oluwaseyi O. Isehunwa, Manoj Sharma

School of Public Health Faculty Research

Aims: The aim of this study was to explore perspectives on motivations for treatment engagement from substance use disorder (SUD) clients in a long-term residential rehabilitation program. Design and Methods: A convenience sample of 30 clients who were enrolled in a year-long SUD treatment program at a residential rehabilitation facility took part in in-depth interviews. Interview transcripts were analyzed using the directed content analysis approach. Results: Participant accounts indicated that their treatment engagement was motivated by factors that aligned with the six primary constructs of the Health Belief Model: (i) perceived susceptibility (eg, believing that their substance use required intervention …

Immediate Effects Of Anodal Transcranial Direct Current Stimulation On Postural Stability Using Computerized Dynamic Posturography In People With Chronic Post-Stroke Hemiparesis, Jing Nong Liang, Leonard Ubalde, Jordon Jacklin, Peyton Hobson, Sara Wright-Avila, Yun-Ju Lee

Physical Therapy Faculty Research

Postural stability is commonly decreased in individuals with chronic post-stroke hemiparesis due to multisystemic deficits. Transcranial direct current stimulation (tDCS) is a non-invasive method to modulate cortical excitability, inducing neuroplastic changes to the targeted cortical areas and has been suggested to potentially improve motor functions in individuals with neurological impairments. The purpose of this double-blinded, sham-controlled study was to examine the acute effects of anodal tDCS over the lesioned motor cortex leg area with concurrent limits of stability training on postural control in individuals with chronic post-stroke hemiparesis. Ten individuals with chronic post-stroke hemiparesis received either anodal or sham tDCS …

Closing The Gap Between Mammalian And Invertebrate Peripheral Nerve Injury: Protocol For A Novel Nerve Repair, Maxwell Vest Md, Addison Guida Bsc, Cory Colombini Bsc, Kristina Cordes Bsc, Diana Pena Bsc, Marwa Maki Bsc, Michael Briones Bsc, Sabrina Antonio Bsc, Carmen Hollifield Bsc, Elli Tian Bsc, Lucas James Bsc, Christian Borashan Bsc, Johnnie Woodson Bsc, John Rovig Bsc, Hanaa Shihadeh Bsc, Alexander Karabachev Bsc, John Brosious Md, Ashley Pistorio Md

School of Medicine Faculty Research

Background: Outcomes after peripheral nerve injuries are poor despite current nerve repair techniques. Currently, there is no conclusive evidence that mammalian axons are capable of spontaneous fusion after transection. Notably, certain invertebrate species are able to auto-fuse after transection. Although mammalian axonal auto-fusion has not been observed experimentally, no mammalian study to date has demonstrated regenerating axolemmal membranes contacting intact distal segment axolemmal membranes to determine whether mammalian peripheral nerve axons have the intrinsic mechanisms necessary to auto-fuse after transection.Objective: This study aims to assess fusion competence between regenerating axons and intact distal segment axons by enhancing axon regeneration, delaying …

Not Society’S Sacrificial Lambs: It Is Wrong To Withhold Vaccination From Children To Benefit Others, Johan C. Bester

School of Medicine Faculty Research

No abstract provided.