Medicine and Health Sciences Commons^™

Health Literacy And Patient Reported Outcomes In Orthopaedic Surgery Patients, Thiran Udawatta, Lance Flesch, Michael Eng, Jane E. Oliphant, Scott G. Kaar

Journal of Health Disparities Research and Practice

Background: Health literacy may be an important factor in patient health outcomes, however, prior research has primarily focused on primary care patients with research in orthopaedic specific populations lacking.

Questions/purposes: The purpose of this study was to examine the relationship between health literacy and patient reported outcomes in an orthopaedic patient population.

Patients and Methods: 183 patients >18 years of age who presented to our institution’s sports orthopaedic surgery clinic with shoulder or knee complaints were analyzed. The primary outcomes were physical function recorded using Patient-Reported Outcomes Measurement Information System (PROMIS) physical function and Single Assessment Numerical Evaluation (SANE) scores. …

Understanding Medical Mistrust In Black Women At Risk Of Brca 1/2 Mutations, Arnethea L. Sutton, Jun He, Erin Tanner, Megan C. Edmonds, Alesha Henderson, Alejandra Hurtado De Mendoza, Vanessa B. Sheppard

Journal of Health Disparities Research and Practice

The benefits of genetic counseling and testing for hereditary breast and/or ovarian cancer (HBOC) are well documented; however, Black women are less likely to use these services compared to White women. Mistrust of the medical system has been associated with Black women’s use of genetic counseling and testing (GCT). However, relatively little is known about the correlates of medical mistrust in Black women at increased risk of HBOC. In this study, we examined the prevalence and predictors of medical mistrust in 94 Black women at-risk of HBOC. Most women were married (48.7%) and had at least some collegiate education (57.1%). …

Context Matters: Construct Framing In Measures Of Physical Activity Engagement Among African American Women, Stephanie M. Mcclure, Travis Loux, Enbal Shacham, Eileen Gillespie, Denise Hooks-Anderson

Journal of Health Disparities Research and Practice

Assessment of psychosocial factors influencing health behavior typically privileges conceptual consistency (framing constructs similarly across contexts) over conceptual specificity (context-specific framing). Modest statistical relationships between these factors and health behaviors, and persistent racial disparities in health outcomes raise questions about whether conceptually consistent framing fully captures relevant predictors. Ethnographic studies suggest not - that perceptions influencing health behaviors are multifaceted and contextual. To test this, we added items querying contextualized predictors of intention to engage in leisure-time physical activity (LTPA) to a Theory of Planned Behavior (TPB)-based survey and examined the psychometrics of the adapted subscales. We measured internal consistency …

Substance Abuse Treatment In Correctional Versus Non-Correctional Settings: Analysis Of Racial/Ethnic And Gender Differences, George Pro, Ricky Camplain, Samantha Sabo, Julie Baldwin, Paul A. Gilbert

Journal of Health Disparities Research and Practice

Background

Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services. We sought to better understand racial/ethnic and gender differences in determinants …

Biogeographic Study Of Human Gut-Associated Crassphage Suggests Impacts From Industrialization And Recent Expansion, Tanvi P/ Honap, Krithivasan Sankaranarayanan, Stephanie L. Schnorr, Andrew T. Ozga, Christina Warinner, Cecil M. Lewis Jr.

Anthropology Faculty Research

CrAssphage (cross-assembly phage) is a bacteriophage that was first discovered in human gut metagenomic data. CrAssphage belongs to a diverse family of crAss-like bacteriophages thought to infect gut commensal bacteria belonging to Bacteroides species. However, not much is known about the biogeography of crAssphage and whether certain strains are associated with specific human populations. In this study, we screened publicly available human gut metagenomic data from 3,341 samples for the presence of crAssphage sensu stricto (NC_024711.1). We found that crAssphage prevalence is low in traditional, hunter-gatherer populations, such as the Hadza from Tanzania and Matses from Peru, as compared to …

Us Trends Of Opioid-Use Disorders And Associated Factors Among Hospitalized Patients With Spinal Conditions And Treatment From 2005 To 2014, Se Won Lee, Jay Shen, Sun Jung Kim, Sung-Youn Chun, Pearl Kim, Jahan Riaz, Ji Won Yoo, Jinwook Hwang

School of Public Health Faculty Research

Study Design: Serial cross-sectional study utilizing the National Inpatient Sample (NIS) 2005 to 2014. Objective: The aim of this study was to examine the trends of opioid-use disorders among hospitalized patients with spinal conditions and treatment and to identify its contributing factors. Summary of Background Data: The opioid is widely used in chronic spinal conditions, and misuse of prescriptions is the main culprit of the opioid crisis. Cannabis, the most commonly utilized illicit drug, has recently been substituted for opioid despite increasing cannabis-use emergency room visits. There is limited information on opioid-use disorders, the association with cannabis, and other contributing …

Retrospective Analysis Of The Association Of Non-Carious Cervical Lesions With Bruxism, Angelica J. Bustos, Tanya Al-Talib, Neamat H. Abubakr

Dental Medicine Faculty Research

Recently, bruxism became the center of attention for the etiological research of non-carious cervical lesions (NCCLs). The present study aims to investigate the presence and types of NCCLs associated with bruxism. Retrospective keywords search of the clinical notes of all patient charts in axiUmTM was performed using the terms “bruxism”, “attrition”, “abrasion”, “erosion”, and “abfraction”. All bruxer patients 18 years and older who presented to the UNLV School of Dental Medicine (01/01/2014 to 09/30/2018) with the complete record were included. To determine the statistical analysis implications, the chi-square test was used. Commonest types of NCCL associated with bruxism were attrition …

Early-Morning And Late-Night Maximal Runs: Metabolic And Perceived Exertion Outcomes, Jenna L. Carducci, Matthew J. Garver, Whitley J. Stone, Meera Penumetcha, Dustin W. Davis, Nicolas M. Philipp, Josie N. Hair

Topics in Exercise Science and Kinesiology

• People may exercise at the ends of their day to fit activity into their schedule; the purpose of this investigation was to determine if metabolic or perceived exertion outcomes differed between maximal runs early in the morning and late at night.
• After consuming a standardized, glucose drink, thirteen recreationally active individuals completed an early-morning and a late-night run on the treadmill while researchers measured metabolic (aerobic capacity and substrate usage) and perceived exertion outcomes.
• Point of application #1: Aerobic capacity (maximal consumption of oxygen) and the usage of fat as a fuel to support energy production during exercise were …

Guidelines For Reviewers: Topics In Exercise Science And Kinesiology, James W. Navalta, Donald L. Hoover, Robert Salatto, Whitley J. Stone, Scott Lyons Phd

Topics in Exercise Science and Kinesiology

• The purpose of this document is to serve as a guide for evaluators who agree to review work submitted to Topics in Exercise Science and Kinesiology.
• To assist evaluators, a Reviewer Rubric has been created with the following sections: Title Page and Abstract, Introduction and Methods Page, Point of Application Page(s), Other Considerations, and Reviewer Decisions.
• Point of application: Reviewing the Title and Abstract page – rubric shared for title, author list, affiliations, the abstract, and key words.
• Point of application: Reviewing the Introduction and Methods page – evaluation of introductory paragraph, paragraph for methodology and/or results.
• Point of …

Trends In Mental Well-Being Of Non-Hispanic White Children Of Midlife Parents With Low Education, Neeraj Bhandari

School of Public Health Faculty Research

Background: It is unknown whether recent increase in mortality and morbidity linked to mental despair (eg, suicide, opioid addiction, alcoholism) in midlife non-Hispanic whites (NHWs) was accompanied by declines in mental well-being of NHW children. The author examined aggregate trends in the mental well-being of NHW children between 2003 and 2018. Methods: The author used linear (unadjusted) regression to generate estimates of long period (ie, between 2003-2005 and 2016-2018) and annual change in mental well-being and self-assessed health from the National Health Interview Survey data on 68 057 NHW children (aged 4-17 years). Results: The NHW children showed no significant …

Preoperative Maximization To Reduce Complications In Spinal Surgery, Sukanta Maitra, Christopher Mikhail, Samuel K. Cho, Michael D. Daubs

School of Medicine Faculty Research

Study design: Invited narrative review. Objectives: The aim of this review was to summarize current literature regarding risk factors that surgeons can optimize in the preoperative setting in the spinal surgery patient, in order to reduce complications and improve patient-reported outcomes. Methods: Review of the relevant literature by the authors. Results: Modifiable risk factors identified relative to the patient include obesity, malnutrition/nutrient deficiency, diabetes/hyperglycemia, preoperative anemia, vitamin D/DEXA (dual-energy radiograph absorptiometry), nicotine use/smoking, and opioid use/psychosocial factors. Conclusion: By maximizing a patient's physiological and psychological status prior to elective spine surgery, we may move closer to achieving the goals of …

Using Big Data To Promote Precision Oral Health In The Context Of A Learning Healthcare System, Joseph Finkelstein, Frederick Zhang, Seth A. Levitin, David Cappelli

Dental Medicine Faculty Research

There has been a call for evidence‐based oral healthcare guidelines, to improve precision dentistry and oral healthcare delivery. The main challenges to this goal are the current lack of up‐to‐date evidence, the limited integrative analytical data sets, and the slow translations to routine care delivery. Overcoming these issues requires knowledge discovery pipelines based on big data and health analytics, intelligent integrative informatics approaches, and learning health systems. This article examines how this can be accomplished by utilizing big data. These data can be gathered from four major streams: patients, clinical data, biological data, and normative data sets. All these must …

Geospatial Variation In Caesarean Delivery, Jennifer Vanderlaan, Johnathan A. Edwards, Anne Dunlop

Nursing Faculty Research

Aim: The purpose of this study was to evaluate the variation in caesarean delivery rates across counties in Georgia and to determine whether county-level characteristics were associated with clusters. Design: This was a retrospective, observational study.

Methods: Rates of primary and repeat caesarean by maternal county of residence were calculated for 2008 through 2012. Global Moran's I (Spatial Autocorrelation) was used to identify geographic clustering. Characteristics of high and low-rate counties were compared using student's t test and chi squared test.

Results: Spatial analysis of both primary and repeat caesarean rate identified the presence of clusters (Moran's I = 0.375; …

2017 Statewide Child Death Report, Nevada Institute For Children's Research And Policy, Dawn L. Davidson, Elizabeth Holka

Nevada Institute for Children's Research and Policy Reports

The purpose of this report is to provide comprehensive information regarding the circumstances by which children die in Nevada in order to prevent future child deaths and improve the health and safety of children in the state.

Physical Therapy For Gait, Balance, And Cognition In Individuals With Cognitive Impairment: A Retrospective Analysis, Jason Longhurst, Jason Phan, Elbert Chen, Steven Jackson, Merrill R. Landers

Integrated Health Sciences Faculty Research

© 2020 Jason Longhurst et al. Objectives. The purpose of this study was to determine if a pragmatic physical therapy (PT) program was associated with improved cognition, gait, and balance in individuals with cognitive impairment. This study investigated these associations for individuals with Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), and mild cognitive impairment (MCI) in order to better characterize outcomes to PT for each diagnostic group. Methods. Data before and after one month of physical therapy were extracted from patient records (67 with AD, 34 with VaD, 35 with DLB, and 37 with MCI). The …

Can The Augmented Web-Based Applicant Experience Replace An Audition Rotation?, Joshua J. Goldman, Vladislav Pavlovich Zhitny, Noama Iftekhar, Chad M. Teven, Richard Baynosa

School of Medicine Faculty Research

No abstract provided.

Recent Advances In Understanding And Management Of Bronchopulmonary Dysplasia, Vineet Bhandari, Mitali Sahni

School of Medicine Faculty Research

© 2020 Sahni M and Bhandari V. In the current era, the survival of extremely low-birth-weight infants has increased considerably because of new advances in technology; however, these infants often develop chronic dysfunction of the lung, which is called bronchopulmonary dysplasia (BPD). BPD remains an important cause of neonatal mortality and morbidity despite newer and gentler modes of ventilation. BPD results from the exposure of immature lungs to various antenatal and postnatal factors that lead to an impairment in lung development and aberrant growth of lung parenchyma and vasculature. However, we still struggle with a uniform definition for BPD that …

Understanding Disparities In Post-Mastectomy Breast Reconstruction Utilization In The Rural State Of Nevada, Maxwell O. Vest Md, Richard C. Baynosa Md, Shelley J. Williams Ms, Chad L. Cross Phd, Sabrina Antonio Bs

School of Medicine Faculty Research

Purpose: Despite federally mandated insurance coverage and clear benefits of breast reconstruction after mastectomy, reported rates remain low at 23-63%. We hypothesize that rates and types of reconstruction would be disproportionately lower in the rural state of Nevada. The goal of this study was to identify and understand disparities in breast reconstruction utilization in Nevada compared to the nation. Methods: Breast cancer patient information (2008-2013) was aggregated from AHRQ’s HCUP Nationwide Inpatient Sample (NIS) and the Nevada State Inpatient Database (NV SID). Chi-square analysis for two population proportions was used to determine differences between the NV SID (n=7,466) and NIS …

New Author Guidelines In Statistical Reporting: Embracing An Era Beyond P < .05, Samantha Johnson, Whitley J. Stone, Jennifer Bunn, Scott Lyons, James W. Navalta

Kinesiology and Nutrition Sciences Faculty Research

Statistical reporting of quantitative research data has been plagued by potential bias and reporting suppression due to a single numerical output: the p-value. While there is great importance in its merit, creating a pass-fail system (set at point of .05) has created a culture of researchers submitting their project’s data to a filing cabinet if it does not yield “statistical significance” based on this value. The editors of the International Journal of Exercise Science are following the American Statistical Association’s call for statistical reform by adjusting our reporting guidelines to the following requirements: [1.] make an intentional effort to move …

Review Of The Scientific Literature On Young Adults Related To Cardiovascular Disease Intervention, Dieu-My T. Tran, Angela Sojobi

Nursing Faculty Research

Many young adults are at risk for cardiovascular disease related to their behavioral choices. Irresponsible alcohol consumption, tobacco smoking, sedentary lifestyle, poor dietary habits, and excessive weight gain are some of the behaviors that put young adults at risk. The Centers for Disease Control and Prevention identified that 15% of young adults are diagnosed with chronic illnesses related to their behavioral choices. The purpose of this review is to identify, in the literature, interventions that are currently available to young adults and evaluate the adequacy and effectiveness of those interventions. An extensive electronic search was conducted using CINAHL, EBSCOhost, Cochrane, …

Exploring Factors Influencing Whether Residents Participate In Square Dancing Using Social Cognitive Theory: A Cross-Sectional Survey In Chongqing, China, Feng Peng, Hongjia Yan Bs, Manoj Sharma Phd, Ying Liu Bs, Ying Lu Bs, Shijie Zhu Bs, Peiqian Li Bs, Nianyong Ren Bs, Ting Li Bs, Yong Zhao Md

Environmental & Global Health Faculty Research

Physical inactivity is a worldwide public health problem, and it is a risk factor for several chronic diseases. Square dancing nightly may be an efficient way to promote physical activity among Chinese residents. This study aims to explore factors that affect resident participation in square dancing on the basis of social cognitive theory constructs (outcome expectations, outcome expectancies, self-efficacy, self-control, and environment) that may provide a scientific basis for designing interventions to promote physical activity in the future. Forty squares near neighborhood communities in Chongqing were randomly selected. A sample of 1732 residents who came to these squares at 18:00–21:00 …

Cognitively Normal Women With Alzheimer’S Disease Proteinopathy Show Relative Preservation Of Memory But Not Of Hippocampal Volume, Jessica Z.K. Caldwell, Jeffrey L. Cummings, Sarah J. Banks, Sebastian Palmqvist, Oskar Hansson

School of Medicine Faculty Research

Background: We examined interactive effects of sex, diagnosis, and cerebrospinal fluid (CSF) amyloid beta/phosphorylated tau ratio (Aβ/P-tau) on verbal memory and hippocampal volumes. Methods: We assessed 682 participants (350 women) from BioFINDER (250 cognitively normal [CN]; and 432 symptomatic: 186 subjective cognitive decline [SCD], 246 mild cognitive impairment [MCI]). General linear models evaluated effects of Alzheimer’s disease (AD) proteinopathy (CSF Aß/p-tau ratio), diagnosis, and sex on verbal memory (ADAS-cog 10-word recall), semantic fluency (animal naming fluency), visuospatial skills (cube copy), processing speed/attention functions (Symbol Digit Modalities Test and Trail Making Part A), and hippocampal volumes. Results: Amyloid-positive (Aβ/P-tau+) CN women …

Longitudinal Change In Regional Brain Volumes With Exposure To Repetitive Head Impacts, Charles Bernick, Guogen Shan, Henrik Zetterberg, Sarah Banks, Virendra R. Mishra, Lynn Bekris, James B. Leverenz, Kaj Blennow

Environmental & Global Health Faculty Research

Objective This study tests the hypothesis that certain MRI-based regional brain volumes will show reductions over time in a cohort exposed to repetitive head impacts (RHI). Methods Participants were drawn from the Professional Fighters Brain Health Study, a longitudinal observational study of professional fighters and controls. Participants underwent annual 3T brain MRI, computerized cognitive testing, and blood sampling for determination of neurofilament light (NfL) and tau levels. Yearly change in regional brain volume was calculated for several predetermined cortical and subcortical brain volumes and the relationship with NfL and tau levels determined. Results A total of 204 participants who had …

The Feasibility Of Vigorous Resistance Exercise Training In Adults With Intellectual Disabilities With Cardiovascular Disease Risk Factors, Stijn Wetering, Alyt Oppewal, Thessa I. M. Hilgenkamp

Physical Therapy Faculty Research

Background The cardiovascular disease (CVD) risk is high in adults with intellectual disabilities. This CVD risk can potentially be decreased with a resistance training (RT) programme at vigorous intensity, following previous research on successful High‐Intensity Training programmes. Our aim was to explore the feasibility of a vigorous RT‐programme for adults with intellectual disabilities with CVD risk factors. Method Twenty‐four adults with intellectual disabilities with at least one CVD risk factor participated in a 24‐week RT‐programme. The training intensity was increased from novice (50%1RM) to vigorous (75%–80%1RM). Feasibility was based on the achieved training intensity at the end of the RT‐programme. …

Altered Central Hemodynamics In Individuals With Down Syndrome, Thessa Irena Maria Hilgenkamp, Elizabeth Cornellia Schroeder, Sang Ouk Wee, Georgios Grigoriadis, Alexander Jacob Rosenberg, Tracy Baynard, Bo Fernhall

Physical Therapy Faculty Research

Background: Individuals with Down Syndrome (DS) have autonomic dysfunction impacting regulation of heart rate, Blood Pressure (BP), and peripheral vasoconstriction. This may alter central hemodynamics through different wave reflections. We investigated central hemodynamics including wave reflection during rest and a sympathoexcitatory stimulus [Lower Body Negative Pressure (LBNP)] in individuals with DS and controls. Methods: Radial applanation tonometry was performed on participants with and without DS before and during 5-min LBNP stimulus of −20 mmHg. Waveforms were calibrated to mean and diastolic BP. Generalized transfer function was used to estimate aortic pressures [Systolic Blood Pressure (aSBP), Diastolic Blood Pressure (aDBP), mean …

Safety Of Endoscopic Retrograde Cholangiopancreatography (Ercp) In Pregnancy: A Systematic Review And Meta-Analysis, Mohamed Azab, Shishira Bharadwaj, Mahendran Jayaraj, Annie S. Hong, Pejman Solaimani, Mohamad Mubder, Hyeyoung Yeom, Ji Won Yoo, Michael L. Volk

School of Medicine Faculty Research

Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is a technically challenging procedure rarely associated with severe postprocedure complications. Hormonal changes during pregnancy promote cholelithiasis, but there are limited clinical data available on the outcomes of ERCP in pregnant women. ERCP techniques without irradiation were recently introduced as potential alternative. We performed a systematic review and meta-analysis to assess the safety of ERCP in pregnancy and to compare outcomes of radiation versus nonradiation ERCP. Materials and Methods: A systematic search of PubMed, Medline/Ovid, Web of Science, and Google Scholar through April 18th, 2018 using PRISMA and MOOSE guidelines identified 27 studies reporting the …

Infection Control: The Nurse's Responsibility, Marisa Francis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Over the last century and a half, infection control measures implemented by nursing staff have continued to evolve, resulting in improved patient outcomes. While this progress is impressive, a decline in rates of hospital acquired infections (HAIs) seems to have slowed, with only a 0.5% decrease in the last seventeen years. Unfortunately, nurses are rarely provided educational support on infection control practices beyond undergraduate and new employee trainings. Meanwhile, the Centers for Disease Control (CDC) is frequently updating their infection control practice recommendations.

The purpose of this project was to observe the current rate of infection control compliance by nurses, …

Restructuring Of The Axon Initial Segment In Mouse Models Of Neurodevelopmental Disorders, Rachel Ali Rodriguez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Neurodevelopmental disorders (NDDs) affect more than 36% of children in countries with low- and middle- incomes (Boivin, 2015; McCoy, 2016). Interestingly, these heterogeneous disorders share a high incidence of epileptic seizures, suggesting a shared pathology. Seizures result when neuronal firing activity becomes disturbed and neurons fire excessively or in unregulated patterns. A key site in the control of neuronal firing patterns is the axon initial segment (AIS), where the local density of proteins and the morphology of the AIS in part determine the firing of neurons. We hypothesized that a disruption in the morphology and/or composition of the AIS can …

Evaluating Parents Sociodemographic Factors And Childhood Vaccine Decisions, Mehret Girmay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Vaccination is considered one of the most successful public health achievements of the 20th century. However, with increasing vaccine skepticism emerging over the past decades, there is a threat to the ongoing sustainment of vaccine coverage within all US communities. This study evaluated and compared parents’ sociodemographic factors associated with childhood vaccine decisions. This study is a secondary analysis of 893 parents/guardians, age 18-55 years with child(ren) < 7 years living in the U.S.

Predictive analysis was conducted using multinomial logistic regression modeling was used to examine vaccine decisions (accept, hesitant, and refuse) in relation to parents’ sociodemographic factors. Overall, (66.6%) of parents accepted recommended vaccines, while …

The Symbolism Of Play Behavior In Child-Centered Play Therapy, Kaitlin Andrewjeski

UNLV Theses, Dissertations, Professional Papers, and Capstones

Child-Centered Play Therapy (CCPT) is an evidence-based approach for mental health treatment with children. CCPT is based on the belief that play is a child’s natural language and so the therapist is required to make inferences of themes through observations of free play; however, there is no standard process by which themes are identified. The purpose of the current study is to gain detailed descriptions of play behavior in order to describe how themes emerge and how they are displayed in child-centered treatment. The themes were then used to describe the progression through the typical stages of child-centered play therapy. …