Medicine and Health Sciences Commons^™

Tablet-Based Collection Of Patient-Reported Data In Diverse, Low-Income Populations: A Case Study In Breast Cancer Risk Assessment, Cristina O'Donoghue, Celia P. Kaplan, Rebecca Howe, Laura J. Esserman, Eliseo J. Perez-Stable, Elissa M. Ozanne

Journal of Health Disparities Research and Practice

Background: Tablets and other technologies are evolving tools to collect personalized health data. However, the quality of data collected by these tools in vulnerable populations is unknown. We explore the acceptability and reliability of a Breast Health Questionnaire app’s use by diverse, low-income women against a pen/paper survey.

Methods: Women who spoke English or Spanish were recruited to complete a tablet and a paper/pen questionnaire prior to their screening mammography. The usability and reliability of the BHQ app were assessed and analyzed.

Results: Of 116 women, 94 (81%) found the app easy to use. Reliability between the app and the …

Food Insecurity And Healthy Behavior Counseling In Primary Care, Andrea Nederveld, Mandy Allison, Elizabeth A. Bayliss, Matthew Cox-Martin, Matthew Haemer

Journal of Health Disparities Research and Practice

Objective: While food insecurity (FI) has been associated with obesity in some studies, few have examined the relationship between FI and health attitudes and behaviors. We hypothesized that families who experienced FI would report lower importance of discussing health-related behavior change, report lower physical activity (PA) and have children who were more likely to be obese.

Design/Methods: We conducted a cross-sectional analysis of data collected from 2012 - 2015 from three clinics serving primarily low-income, Latino patients. Parents of 6 to 12 year old children presenting for well child care were surveyed about their experience of food insecurity, the importance …

Promoting Community And Population Health In Public Health And Medicine: A Stepwise Guide To Initiating And Conducting Community-Engaged Research, Scott D. Rhodes, Amanda E. Tanner, Lilli Mann-Jackson, Jorge Alonzo, Florence Siman, Eunyoung Y. Song, Jonathan Bell, Megan B. Irby, Aaron T. Vissman, Robert E. Aronson

Journal of Health Disparities Research and Practice

Various methods, approaches, and strategies designed to understand and reduce health disparities, increase health equity, and promote community and population health have emerged within public health and medicine. One such approach is community-engaged research. While the literature describing the theory, principles, and rationale underlying community engagement is broad, few models or frameworks exist to guide its implementation. We abstracted, analyzed, and interpreted data from existing project documentation including proposal documents, project-specific logic models, research team and partnership meeting notes, and other materials from 24 funded community-engaged research projects conducted over the past 17 years. We developed a 15-step process designed …

Estimates Of Female Breast Cancer Mortality-To-Incidence Ratio (Mir) Of The Counties And The Senatorial Districts Grouped To County Boundaries (Sdgcs) In Missouri 2008 - 2012, Awatef A. Ben Ramadan, Jeannette Jackson-Thompson, Chester L. Schmaltz

Journal of Health Disparities Research and Practice

Purpose: To measure Mortality-to-Incidence Ratios (MIRs) on Senatorial Districts Grouped to County Boundaries (SDGCs) to explore the female breast cancer (FBC) racial and age disparities in Missouri.

Methods: The MIRs and their 95% CI by age and race were calculated for the 20 SDGCs for the period from 2008-2012.

Results: For the 65+ years old FBC cases, the MIRs for whole Missouri and the 20 SDGCs were typically twice the MIR for thewhites.

Conclusions: FBC MIRs can be used as a measure of cancer inequalities in Missouri. These measures might be informative for policy makers to assess the existing policies …

Identification Of Chst9 As A Candidate Gene For Schizophrenia From Whole Genome Sequencing, Christopher Sharp, Jingchun Chen, Marvi Moreno, Mahtab Hamid, Francisco Servin, Bita Bashy, Travis Mize

LSAMP Poster Presentations

Recent results imply that rare variants contribute to the risk of schizophrenia. We conducted whole genome sequencing for 99 subjects from 20 Chinese families (parents and at least two siblings with a schizophrenia diagnosis and one unaffected sibling). Of the 9 frameshift mutations identified in more than 2 families, one was at chromosome 10:125780762 on the Carbohydrate Sulfotransferase 15 (CHST15) gene and another at chromosome 18:24722723 on the Carbohydrate Sulfotransferase 9 (CHST9) gene. We observed these deletions in 4 affected persons of two families from whole. At least two types of mutations (one or three bases insertion) have been identified …

Effect Of The Synthetic Bile Salt Analog Camsa On The Hamster Model Of Clostridium Difficile Infection, Amber Howerton, Cale O. Seymour, Senthil K. Murugapiran, Zhenlin Liao, Jacqueline R. Phan, Alan Estrada, Adam J. Wagner, Chrisabelle C. Mefferd, Brian P. Hedlund, Ernesto Abel-Santos

Life Sciences Faculty Research

Clostridium difficile infection (CDI) is the leading cause of antibiotic-associated diarrhea and has gained worldwide notoriety due to emerging hypervirulent strains and the high incidence of recurrence. We previously reported protection of mice from CDI using the antigerminant bile salt analog CamSA. Here we describe the effects of CamSA in the hamster model of CDI. CamSA treatment of hamsters showed no toxicity and did not affect the richness or diversity of gut microbiota; however, minor changes in community composition were observed. Treatment of C. difficile-challenged hamsters with CamSA doubled the mean time to death, compared to control hamsters. However, CamSA …

Justice Served Fresh: Associations Between Food Insecurity, Community Gardening, And Property Value, Micajah Daniels, Courtney Coughenour Ph.D

McNair Poster Presentations

Numerous stakeholders in Nevada have used a variety of efforts to combat the growth of food insecurity facing Nevadans. The purpose of this research project is to understand the association between food insecurity, community gardens, and property value. Following the wealth of scholarship on these topics and data collected from community garden agencies in Southern Nevada, the research questions for this project include: (1) Where are community gardens located in SNV? (2) What efforts community gardens agencies are doing to address food insecurity (most interested in their efforts using community gardens)? (3) What are the perceptions of supports and barriers …

An Evalutaion Of The Physical Properties Of A New Atraumatic Restorative Treatment Material Containing Azadirachta Indica (Neem), Divya P. Kumari, Shahnawaz Khijmatgar, Avidyuti Chowdhury, Philippe B. Wilson, Edward Lynch, Martin Grootveld, Chitta Ranjan Chowdhury

Dental Medicine Faculty Research

BACKGROUND This in vitro experimental study investigated and compared the physical properties of three newly developed atraumatic restorative treatment materials. MATERIALS AND METHODS Atraumatic Restorative Treatment materials (ART) with three different compositions were prepared by varying the percentage of Azadirachta indica (Neem) extract within the materials. Micro-hardness, compressive strength, marginal adaptation to tooth structure of the atraumatic restorative treatment materials were assessed. Statistical Analysis Used- Data was analysed using SPSS version 20 statistical software. One-Way ANOVA, Tukey's Highly Significant Difference (HSD), Scheffe's tests were conducted to assess the level of significance of differences between mean values in post-hoc testings. P …

Ultrasound Guided Placement Of Single-Lumen Peripheral Intravenous Catheters In The Internal Jugular Vein, Tony Zitek, Elizabeth Busby, Heather Hudson, John D. Mccourt, Jamie Baydoun, David E. Slattery

School of Medicine Faculty Research

Introduction: The peripheral internal jugular (IJ), also called the “easy IJ,” is an alternative to peripheral venous access reserved for patients with difficult intravenous (IV) access. The procedure involves placing a single-lumen catheter in the IJ vein under ultrasound (US) guidance. As this technique is relatively new, the details regarding the ease of the procedure, how exactly it should be performed, and the safety of the procedure are uncertain. Our primary objective was to determine the success rate for peripheral IJ placement. Secondarily, we evaluated the time needed to complete the procedure and assessed for complications. Methods: This was a …

Utilization Of Imaging To Identify A Benign Condition Mimicking Acute Appendicitis In A Child, Neelam Phalke Md, Zubin Mehta Md, Samrat Das Md

School of Medicine Faculty Research

One of the most concerning causes of abdominal pain affecting children is acute appendicitis. However, there are benign conditions that can closely mimic appendicitis in children. In this article, we present a case of a child admitted for possible acute appendicitis and determined to have a condition known as omental infarction. The patient was managed medically and made a full recovery without surgical intervention. The aim of this case report is to review omental infarction and present a way of differentiating this disease from appendicitis, utilizing imaging, with the goal of avoiding surgical intervention. We also discuss the presentation and …

Perceived Walkability, Social Capital, And Self-Reported Physical Activity In Las Vegas College Students, Melissa Bartshe, Courtney Coughenour, Jennifer Pharr

School of Public Health Faculty Research

College students are an understudied, vulnerable population, whose inactivity rates exceed those reported by U.S. adults. Walkability in sprawling cities, such as Las Vegas, is challenged due to automobile-oriented development. The purpose of this study was to assess the relationship between perceived neighborhood walkability, social capital, and meeting physical activity recommendations among University of Nevada-Las Vegas college students. Of the 410 participants, 42.2% met physical activity recommendations, 77.1% were female, 37.3% were white, and 79.5% owned a vehicle. Logistic regression showed that social capital (odds ratio (OR) = 1.25, p = 0.04) and gender... (see full text for full abstract

Developmental Dependence For Functional Eye Regrowth In Xenopus Laevis, Cindy X. Kha, Kelly Ai-Sun Tseng

Life Sciences Faculty Research

A key challenge in designing tissue repair strategies is knowing whether and how developmental mechanisms are used for successful repair of mature/adult tissues. Although it is known that developmental components are used in repair, it remains mostly unclear which ones are required and whether they act similarly as during development. This issue is further complicated by the fact that it is difficult to assess the similarities and differences between development and the repair of mature tissues, since the two contexts are highly dissimilar. A potentially useful yet underutilized approach is to understand developmental regrowth (defined here as the ability to …

Ptsd In U.S. Veterans: The Role Of Social Connectedness, Combat Experiences And Discharge, Sara Kintzle, Nicholas Barr, Gisele Corletto, Carl A. Castro

Social Work Faculty Research

Service members who transition out of the military often face substantial challenges during their transition to civilian life. Leaving military service requires establishing a new community as well as sense of connectedness to that community. Little is known about how social connectedness may be related to other prominent transition outcomes, particularly symptoms of posttraumatic stress disorder (PTSD). The purpose of this study was to explore the role of social connectedness in the development of PTSD, as well as its relationship to the known risk factors of combat exposure and discharge status. Data used were drawn from a needs assessment survey …

Limited Contribution Of Health Behaviours To Expanding Income-Related Chronic Disease Disparities Based On A Nationwide Cross-Sectional Study In China, Qing Wang, Jay J, Shen, Kaitlyn Frakes

School of Public Health Faculty Research

This study estimated the association of income and prevalence of cardiovascular diseases (CVD) and hypertension, and then quantified the contribution of health behaviors to the association in China. Using the 2013 survey of the China Health and Retirement Longitudinal Study (CHARLS), a logit model was applied to examine income-related health disparities in relation to CVD and hypertension. A four-step regression method was then constructed to measure the role of health behaviors in income-related health disparities. Using indirect effects, mediation by health behaviors was examined. Income-related health disparities in chronic diseases were found to exist in China. Specifically, individuals in the …

Education, Not Restriction, Is Key To Reducing Harm From Offshore Gambling, Sally Gainsbury, Alex Blaszczynski, Brett Abarbanel

Hospitality Faculty Research

Australian internet gambling policies have been refined and prohibitions on illegal gambling sites clarified in recent years. These offshore sites not only pose potential harm to consumers in the form of fraudulent and deceptive dealings, but also have long-term consequences through reducing the tax dollars generated by the licensed market. Our research takes a closer look at why gamblers use offshore sites, and the implications of this for policymaking.

Measuring Inequity: A Systematic Review Of Methods Used To Quantify Structural Racism, Maya Groos, Maeve Wallace, Rachel Hardeman, Katherine P. Theall

Journal of Health Disparities Research and Practice

Abstract

Objective: To summarize the ways in which researchers have quantified measures of structural racism for the purposes of empirical, quantitative investigation of its associations with physical and mental health outcomes.

Methods: Systematic review of literature published January 1, 2007-June 30, 2017. We searched PubMed and EMBASE databases for studies including at least one of the following search terms in the title or abstract: “structural racism”, “systemic racism”, “institutional racism”, “institutionalized racism”. Excluded studies were not original research, not US based, did not quantify an explicitly named indicator of structural racism, or were qualitative designs. Data from full …

Impact Of Race And Insurance On Door-To-Appendectomy Time Among Pediatric Patients, Carla M. Lopez, Emily R. Christison-Lagay, Daniel Solomon

Journal of Health Disparities Research and Practice

Racial and ethnic disparities in the rate of appendiceal rupture have been widely reported among the pediatric population. The main reasons for this remain largely unknown given that previous explanations pointing to signs of poor health care access have recently been shown to account for only a small percentage of the difference in perforation rates between white and minority children. Because the risk of perforation increases with time, racial disparities in time delay from emergency department presentation to OR appendectomy may help account for the higher appendiceal perforation rates observed among minority children. This is the first study dedicated to …

Collective Leadership, Academic Collaborations And Health Disparities: A Framework For Success, Phyllis R. Magrab, Suzanne M. Bronheim

Journal of Health Disparities Research and Practice

Implementing collaborative approaches to addressing health disparities involves multiple individuals who have leadership roles both within their own sectors and within the collaborative effort’s infrastructure. Understanding how that collective leadership operates and the skills and behaviors each member of the team brings to the collaborative process can shed light on what makes for a successful outcome. The Center of Excellence for Health Disparities in the Nation’s Capital (CEHD) was a collaborative effort between two universities and among multiple schools within the same institution, across departments and with multiple community partners. This paper presents a case example of collective leadership in …

Higher Quality At Lower Cost: Community Health Worker Interventions In The Health Care Innovation Awards, Caitlin Cross-Barnet, Sarah Ruiz, Megan Skillman, Rina Dhopeshwarkar, Rachel Singer, Rachel Carpenter, Suzanne Campanella, Maysoun Freij, Lynne Snyder, Erin Colligan

Journal of Health Disparities Research and Practice

Background: Published evidence regarding cost savings, reduced utilization, and improved quality associated with employing community health workers (CHWs) is largely lacking. This paper presents findings from the Centers for Medicare & Medicaid Services Health Care Innovation Awards (HCIA), with a focus on six diverse programs that employ CHWs. We examine outcomes associated with programs incorporating CHWs into care teams for a broad age range of patients with various health issues such as cancer, asthma, and complex conditions.

Methods: This mixed-methods study used data from claims and site visits to assess the effectiveness of CHW programs. In difference-in-differences analyses of Medicare …

Racial/Ethnic Disparities In Diabetes Care And Outcomes: A Mixed Methods Study, Yhenneko J. Taylor, Marion E. Davis, Rohan Mahabaleshwarkar, Melanie D. Spencer

Journal of Health Disparities Research and Practice

Limited research has examined racial/ethnic differences in diabetes care and outcomes among primary care patients. This study examined racial/ethnic differences in diabetes care and outcomes among an ambulatory patient population and explored patient perceptions of the patient-provider relationship to inform strategies to improve care delivery. Using data from 62,149 adults with diabetes who received care within Atrium Health in 2013, regression models assessed associations between race/ethnicity and the following outcomes: glycated hemoglobin (HbA1c) tests, low density lipoprotein (LDL) and blood pressure (BP) screening, foot and eye exams, and HbA1c, LDL, and BP control. Eleven patients with diabetes and uncontrolled hypertension …

Application Of Photovoice With Focus Groups To Explore Dietary Behaviors Of Older Filipino Adults With Cardiovascular Disease, Jane Jih, Trish La Chica, Luisa M. Antonio, Ofelia O. Villero, Mary N. Roque, Joseph R. Domingo, Joshua F. Landicho, Anna M. Napoles, Celia P. Kaplan, Tung T. Nguyen

Journal of Health Disparities Research and Practice

Filipino Americans have high rates of cardiovascular diseases (CVD). This study explored the dietary behaviors, a modifiable risk factor, of Filipinos with CVD. Filipinos with CVD were recruited and trained to do Photovoice. Participants took photos to depict their “food experience,” defined as their daily dietary activities. Participants then shared their photos during focus groups. Focus group transcripts were analyzed using an iterative, grounded theory approach. Among 38 Filipino participants, the mean age was 70 years old and all were foreign-born. Major themes included efforts to retain connection to Filipino culture through food, and dietary habits shaped by cultural health …

Blood Pressure And Job Domains Among Hotel Housekeepers, Marie-Anne Sanon Rosemberg Phd, Mn, Rn, Bidisha Ghosh Ms., John Shaver Bsn, Maria Militzer Ma, Julia Seng Phd, Cnm, Faan, Marjorie C. Mccullagh Phd, Rn, Aphn-Bc, Cohn-S, Faaohn, Faan

Journal of Health Disparities Research and Practice

Hotel housekeepers have challenging working conditions, putting them at risk for poor health such as hypertension. Despite their risks, few studies have measured their blood pressure (BP). The purpose of this study was to explore hotel housekeepers’ blood pressure and the associations between work and BP. Methods: A community engagement approach was used to recruit study participants. Data sources included questionnaires, and BP measurement. Results: Over 25% of the 39 hotel housekeepers reported hypertension diagnosis and/or antihypertensive medication used. Across the job domains, job satisfaction was correlated with diastolic BP, and workload was correlated with systolic BP. There were difference …

Effectiveness Of Community Health Workers In Healthcare Delivery: Evidence From The Field, Mohammad Shahbazi Professor, Mukesh Kumar, Anthony Mawson, Donna Antoine Lavigine, Cassandra Dove

Journal of Health Disparities Research and Practice

Evidence suggests that health care in the United States could benefit from including the services of Community Health Workers (CHW), provided through Community Health Houses, in the delivery of care. This research project evaluated the impact of three newly-established Health Houses and the services provided to patients by Community Health Workers at three locations in the Mississippi Delta. The patients were current enrollees in the Medicare administered by United Healthcare. The program began in February 2014 and continued through September 2015. After analyzing data for payments made for each enrollee, emergency room visits and hospital admissions for the years of …

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Journal of Health Disparities Research and Practice

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative in …

Alternative Financial Services And Health Status In U.S. Metropolitan Statistical Areas, Courtney Hundley, Richard W. Wilson 8520196, John Chenault

Journal of Health Disparities Research and Practice

Abstract

Alternative financial services (AFS) such as, payday lenders, pawn brokers, tax refund loans, and check cashers are more prevalent in minority and lower income neighborhoods. These are neighborhoods also found to have disparities in health, compared to more affluent neighborhoods and communities. The focus of this paper is to determine if any relationship exists between use of AFS and health disparities.

Using data from a survey performed by the Federal Deposit Insurance Corporation (FDIC), we compared four banking variables to several measures of health for 85 metropolitan statistical areas (MSA) across the nation. The four banking variables all related …

Implementing A Pre-Exposure Prophylaxis Intervention For Safer Conception Among Hiv Serodiscordant Couples: Recommendations For Health Care Providers, Mari-Lynn Drainoni, Dea L. Biancarelli, Ashley A. Leech, Meg Sullivan, Angela R. Bazzi

Journal of Health Disparities Research and Practice

Couples in HIV serodiscordant relationships frequently desire children. Although partners who are virally suppressed pose almost no risk of transmitting HIV to their partners, partners who are inconsistently on therapy may transmit HIV to their partners when attempting to conceive. Pre-exposure prophylaxis (PrEP) is an available safer conception strategy for these couples but is not consistently offered. We sought to better understand barriers to PrEP implementation for couples seeking conception and patient perceptions on what providers could do to encourage use. We conducted in-depth, qualitative interviews with 11 participants representing six couples taking PrEP for safer conception in a safety-net …

Human Papillomavirus Infections In The Southern And Other United States Regions, Dudith Pierre-Victor, Mary Jo Trepka, Dionne Stephens, Tan Li, Timothy Page, Purnima Madhivanan

Journal of Health Disparities Research and Practice

Human papillomavirus (HPV) infection is the most common sexually transmitted infection worldwide and has been linked to several cancers, including cervical cancer. In the United States, the Southern region has a disproportionate burden of cervical cancer, and research about the epidemiology of HPV in the region is scarce. This study estimates the prevalence and correlates of HPV infection among 14–59 year-old females.

Data from 4,250 females aged 14–59 years collected during the 2007–2010 National Health and Nutrition Examination Survey (NHANES) were used. We estimated the prevalence of HPV infection for the South and the rest of the country. We performed …

Recurrent Cutaneous Tuberculosis In An Immunocompetent 7-Year-Old Male, Alvaro Galvis, Vidyasagar Jaiswal, Iris Pecson, Craig Nakamura, Dena Austin

School of Medicine Faculty Research

Cutaneous tuberculosis (TB) makes up a small proportion of the 10.4 million cases around the world. Although it is more commonly found in the developing world, cutaneous TB is rarely reported in the developed countries. It is fairly challenging to diagnose without histological examination. In this report, we present an immunocompetent 7-year-old male with a complex medical history diagnosed with cutaneous Mycobacterium tuberculosis after multiple ventriculoperitoneal shunt (VPS) revisions. This case of cutaneous TB in an immunocompetent patient is remarkable in its uncharacteristic presentation with no obvious source of TB infected contacts or travel history.

Examination Of A Screening Tool For Athletes’ Mental Health And Its Direct Implications To Sport Training And Competition, Jesse Scott

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Sport Interference Checklist (SIC) is a psychometrically validated instrument designed to assess how often cognitive and behavioral factors interfere with athletes performance during training and/or competition as well as the extent to which athletes are interested in pursuing sport psychology to address these problems. The success of this scale inspired an interest in developing new items that assess the influence of specific mental health concerns on sport performance using the SIC format. The Sport Interference Checklist’s Sport Specific Screen for Mental Health (SIC-SSSMH) was empirically developed using 259 athletes to assist in the identification of mental health problems explicitly …

Designing National Indoor Radon Surveys According To Iaea Guidance, Charles Fitzpatrick

UNLV Theses, Dissertations, Professional Papers, and Capstones

Radon is a radioactive gas that can accumulate indoors, typically in buildings with unfinished basements, poor ventilation, and/or cracks in walls or floors that lead to underlying soil, from which radon emanates. Radon is estimated to be the second most prevalent cause of lung cancer worldwide and is a threat to public health, which is a concern for national health authorities in many countries. Fortunately, radon can be measured and controlled. In order to know if radon poses a threat on a national level, studies must be performed that allow these authorities to extrapolate data from a relatively small amount …