Medicine and Health Sciences Commons^™

Statistical Advances In Clinical Trials And Clinical Research, Guogen Shan, Sarah Banks, Justin B. Miller, Aaron Ritter, Charles Bernick, Joseph Lombardo, Jeffrey L. Cummings

School of Public Health Faculty Research

Introduction New treatments for neurodegenerative disease are urgently needed, and clinical trial methods are an essential component of new drug development. Although a parallel-group study design for neurological disorder clinical trials is commonly used to test the effectiveness of a new treatment as compared to placebo, it does not efficiently use information from the on-going study to increase the success rate of a trial or to stop a trial earlier when the new treatment is indeed ineffective. Methods We review some recent advances in designs for clinical trials, including futility designs and adaptive designs. Results Futility designs and noninferiority designs …

Biomedical Informatics Applications For Precision Management Of Neurodegenerative Diseases, Justin B. Miller, Guogen Shan, Joseph Lombardo, Gustavo Jimenez-Maggoria

School of Public Health Faculty Research

Modern medicine is in the midst of a revolution driven by “big data,” rapidly advancing computing power, and broader integration of technology into healthcare. Highly detailed and individualized profiles of both health and disease states are now possible, including biomarkers, genomic profiles, cognitive and behavioral phenotypes, high-frequency assessments, and medical imaging. Although these data are incredibly complex, they can potentially be used to understand multi-determinant causal relationships, elucidate modifiable factors, and ultimately customize treatments based on individual parameters. Especially for neurodegenerative diseases, where an effective therapeutic agent has yet to be discovered, there remains a critical need for an interdisciplinary …

Using Cluster Analysis To Identify Subgroups Of College Students At Increased Risk For Cardiovascular Disease, Dieu-My Tran, Kevin A. Kupzyk, Lani M. Zimmerman

Nursing Faculty Research

Background and Purpose: To examine the co-occurrence of cardiovascular risk factors and cluster subgroups of college students for cardiovascular risks. Methods: A cross sectional descriptive study was conducted using co-occurrence patterns and hierarchical clustering analysis in 158 college students. Results: The top co-occurring cardiovascular risk factors were overweight/obese and hypertension (10.8%, n = 17). Of the total 34 risk factors that co-occurred, 30 of them involved being overweight/obese. A six-cluster-solution was obtained, two clusters displayed elevated levels of lifetime and 30-year cardiovascular disease risks. Conclusions: The hierarchical cluster analysis identified that single White males with a family history of heart …

Exploring Challenges In Conducting E-Mental Health Research Among Asian American Women, Andrew Thomas Reyes, Rose E. Constantino, Rogelio A. Arenas, Judzia N. Bombard, Alvin Ryan Acupan

Nursing Faculty Research

In this discussion paper, we explore the challenges of conducting e-mental health intervention research among Asian American women and propose a model for addressing these barriers. Based on an extensive literature review, we identify two main types of barriers to conducting e-mental health intervention research among Asian American women: recruitment barriers and adherence barriers. Recruitment barriers are further subcategorized into those related to (1) stigmatized cultural beliefs about mental illness and mental health services; (2) lack of awareness about mental health services; and (3) language barrier. As to adherence barriers, the two identified subtypes concern (1) acuity and severity of …

Resilience, Acculturative Stress, And Family Norms Against Disclosure Of Mental Health Problems Among Foreign-Born Filipino American Women, Andrew Thomas Reyes, Reimund Serafica, Chad L. Cross, Rose E. Constantino, Rogelio A. Arenas

Nursing Faculty Research

The present study explores the relationships between resilience, acculturative stress, and family norms against disclosure of mental health problems among foreign-born Filipino American women. The sample consisted of 159 foreign-born Filipino American women aged 18 years and above and residing in Las Vegas, Nevada, United States. Participants completed paper-and-pencil questionnaires. Results indicated high levels of resilience and moderate levels of acculturative stress. Findings also showed a significant negative correlation between resilience and acculturative stress, and a significant predictive effect of resilience on acculturative stress. We also found a significant negative relationship between resilience and family norms against disclosure of mental …

Introduction To Special Issue By Guest Editor, Reimund Serafica, Reimund Serafica

Nursing Faculty Research

Nurses are masters at multitasking—that is performing several nursing interventions simultaneously during a patient encounter. While the new technologies such as smart pumps, bar-code medication, administration systems, electronic health records (EHRs), wearables, and smartphones being introduced into our practice environments are designed to increases efficiency, promote safety, and streamline the work of nursing, we also need to see what is current and emerging in the research arena. We need to continue to seek new evidence-based practice to care effectively for the Asian/Pacific Islander populations and promote a healing environment while incorporating the advantages and efficiencies that technologies provide.

Proof-Of-Concept Testing Of A Real-Time Mhealth Measure To Estimate Postural Control During Walking: A Potential Application For Mild Traumatic Brain Injuries, Hyunhwa Lee, Sunchul Lee, Laura Salado, Jonica Estrada, Jacob White, Venkatesan Muthukumar, Szu-Ping Lee, Sambit Mohapatra

Nursing Faculty Research

Background: Most individuals with mild traumatic brain injury (mTBI) experience post-injury deficits in postural control. Currently available measures of postural control are lab-based or supervised, which may hinder timely symptom assessment for individuals with mTBI, including Asian populations, who do not seek initial screening post-injury. In this proof-of-concept testing study, we introduce a real-time mobile health (mHealth) system to measure postural control during walking. The proposed mHealth system can be used for home-based symptom assessment and management of mTBI. Methods: In our proposed mHealth system, a smartwatch, a smartphone, and a cloud server communicate to measure, collect, and store body …

The Use Of Social Media And Mema Technology In Comparing Compliance Rate Among Users, Reimund Serafica, Nada Lukkahatai, Brendan Tran Morris, Kelly Webber

Nursing Faculty Research

Compliance can be defined as the extent to which a person’s behavior corresponds with agreed recommendations. Within the context of lifestyle intervention, this may refer to physical activity, diet modifications, or lifestyle intervention program attendance or attrition. For lifestyle intervention programs to be successful (as measured against a variety of health and lifestyle markers), it is crucial for individuals to comply as best they can to the recommendations or instructions provided by the researchers. Those who disengage prematurely are likely to have poorer treatment outcomes. Hence, a better understanding and an added component, such as engagement, is vital to the …

Inflammation As A Central Mechanism In Alzheimer's Disease, Jefferson W. Kinney, Shane M. Bemiller, Andrew S. Murtishaw, Amanda M. Leisgang, Arnold M. Salazar, Bruce T. Lamb

Psychology Faculty Research

Alzheimer's disease (AD) is a progressive neurodegenerative disorder that is characterized by cognitive decline and the presence of two core pathologies, amyloid β plaques and neurofibrillary tangles. Over the last decade, the presence of a sustained immune response in the brain has emerged as a third core pathology in AD. The sustained activation of the brain's resident macrophages (microglia) and other immune cells has been demonstrated to exacerbate both amyloid and tau pathology and may serve as a link in the pathogenesis of the disorder. In the following review, we provide an overview of inflammation in AD and a detailed …

The Applicability Of The Decisional Conflict Scale In Nursing Home Placement Decision Among Chinese Family Caregivers: A Mixed Methods Approach, Yu-Ping Chang, Loralee Sessanna, Joanne Kraenzle Schneider

Asian/Pacific Island Nursing Journal

This study aimed to 1) examine relationships between uncertainty, perceived information, personal values, social support, and filial obligation among Chinese family caregivers faced with nursing home placement of an older adult family member with dementia; and 2) describe the applicability of the Decisional Conflict Scale in nursing home placement decision making among Chinese family caregivers through the integration of quantitative and qualitative data.

We used a mixed-methods approach. Quantitative data analysis consisted of descriptive and correlational statistics. We utilized a thematic analysis for the qualitative data. Data transformation and data comparison techniques were used to combine qualitative and quantitative data. …

Physical Exercise During Pregnancy And Its Related Factors: An Observational Study In Japan, Megumi Haruna, Masayo Matsuzaki, Mie Shiraishi, Seonae Yeo

Asian/Pacific Island Nursing Journal

This study aimed to investigate the exercise habits of pregnant women in the third trimester (N = 303). We assessed participation in physical activities, including exercise or sports, using the Japanese version of the Pregnancy Physical Activity Questionnaire. A total of 183 (60.4%) pregnant Japanese women participated in some form of exercise and 87 (28.7%) exercised for 2 hours or more, per week, in the third trimester. Multiple logistic regression analyses indicated that women who set themselves a gestational weight gain target (adjusted odds ratio [AOR] = 8.10, 95% CI [2.82, 23.4], p< .001), were more likely to participate in exercise or sports. In contrast, multiparous women (AOR = 0.44, 95% CI [0.26, 0.72], p = .001), and those whose …

Lived Experience In Patients With Recurrent Glioblastoma In Japan: A Narrative Study, Ai Chikada, Asako Takekuma Katsumata, Mariko Asase, Sayaka Takenouchi, Yoshiki Arakawa, Kazuko Nin

Asian/Pacific Island Nursing Journal

Glioblastoma (GBM) is well known to have one of the poorest prognoses among all cancers. Patients with GBM in progression-free survival (PFS) may be relatively stable and can often maintain their quality of life. Thus, PFS is a desirable goal. In Japan, the median PFS is 11 months. It is difficult to grasp a patient's thoughts and hopes when, after PFS, they are readmitted due to recurrence or acute deterioration. Therefore, this study aimed to describe the lived experience of illness in patients with recurrent GBM, focusing on PFS. We enrolled five patients into the study; however, only four patients …

“These Classes Have Been My Happy Place”: Feasibility Study Of A Self-Care Program In Native Hawaiian Custodial Grandparents, Loriena Yancura, Heather Greenwood-Junkermeier, Christine A. Fruhauf

Asian/Pacific Island Nursing Journal

Native Hawaiian custodial grandparents have a distinctive set of strengths and challenges that may lead them to benefit from a structured self-care program. The purpose of this paper is to describe a feasibility study with nine Native Hawaiian custodial grandparents who participated in a 6-week self-care intervention. Based on open-ended questions during the post-questionnaire and at the 6-month follow-up focus group, grandparent participants noted that their grandchildren needed education and clothing. Most grandparents did not endorse statements that their grandchildren had any mental or physical health conditions. Grandparents reflected that the intervention provided them with skills to help cope with …

Vietnamese American Women’S Beliefs And Perceptions On Cervical Cancer, Cervical Cancer Screening, And Cancer Prevention Vaccines: A Community-Based Participatory Study, Connie Kim Yen Nguyen-Truong, Kim Quy Vo Nguyen, Thai Hien Nguyen, Tuong Vy Le, Anthony My Truong, Keara Rodela, Rachael Allan

Asian/Pacific Island Nursing Journal

Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach.

Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of …

Korean Sibling Caregivers Of Individuals Diagnosed With Schizophrenia, Mijung Park, Kwang-Ja Lee

Asian/Pacific Island Nursing Journal

Siblings of individuals diagnosed with schizophrenia are an important source of family caregiving. Unfortunately, limited information is available about sibling caregivers because existing studies have focused on other family relationships such as parents, spouses, and children. To fill the knowledge gap, the purpose of this study is to describe Korean sibling caregivers’ experience with individuals diagnosed with schizophrenia.

Guided by Colaizzi’s descriptive phenomenological methodology, we conducted in-depth, semi-structured, face-to-face interviews with eight individuals who have a sibling (1) diagnosed with schizophrenia and (2) hospitalized in an inpatient psychiatric unit. We discerned six key themes: sorrow, burnout, shame, different perspectives in …

Attitudes, Attachment Styles, And Gender: Implications On Perceptions Of Infidelity, Christian M. Stewart

UNLV Theses, Dissertations, Professional Papers, and Capstones

Understanding the impact infidelity has on individuals, couples, families, and societies has increasingly become a topic of interest over the last few decades. In recent years, scholars have sought to increase understanding of infidelity through investigating the relationship between infidelity and attachment theory. This research study examines the impact attitudes about infidelity, attachment styles, and gender have on the way in which individuals perceive infidelity. Data was gathered from 310 participants recruited from the University of Nevada, Las Vegas and social media. Participants were 18 years of age and older and were, at the time of the study, either in …

Worked To Leisure: The Intersections Of Volunteerism, Work, And Leisure, Denise Nicole Cook

UNLV Theses, Dissertations, Professional Papers, and Capstones

Volunteerism and work are topics which academics in several disciplines research. This study is an examination of the intersection of work and volunteerism via the lens of role theory. According to role theorists, the term role refers to behaviors which are either a result of social position or expectations (Biddle 1986). Cognitive role theorists use vocabulary such as “role conflict” and “role overload” to identify incongruences sometimes found in roles individuals have in their lives (Biddle 1986). These incongruences are primarily examined as they relate to individual level consequences. This research explores volunteerism and work as they relate to role …

Sex Worker And Proud: A Phenomenological Study Of Consensual Sex Workers' Lives, Michael Gerald Curtis Jr.

UNLV Theses, Dissertations, Professional Papers, and Capstones

Ten consensual sex workers who were currently working in Nevada were qualitatively interviewed in an effort to explore their perceptions of the adult industry. Interviews specifically focused on their experience disclosing their profession to others and the potential effects that it has on their personal relationships, and access to effective treatment. The Moustakas method of phenomenological inquiry was used to analyze data from ten participants who self-identified as direct sex workers. Seven essential themes emerged from this analysis: (1) the adult industry provides professional and personal agency, (2) the industry is often transient, (3) disclosure is an impactful and ongoing …

The Role Of Pre-Existing Type 2 Diabetes Mellitus In Colorectal Cancer Stage And Survival In Elderly Americans: A Seer-Medicare Population-Based Study 2002-~2011, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes is a common comorbid condition among colorectal cancer (CRC) patients, yet its effects in CRC outcomes, particularly stage at diagnosis, risk of death and variations by diabetes severity (complications vs no complications) and Hispanic ethnicity have not been adequately studied. The purpose of this study was to investigate the association between pre-existing T2DM and advanced stage at diagnosis in elderly patients with CRC; to examine whether diabetes is an independent predictor of poor survival from all-cause and CRC-specific mortality; to assess whether variations exist by diabetes severity and to analyze the outcomes for the Hispanic group.

The Surveillance Epidemiology …

The Impact Of Economic Recession On The Health Of Adult Nevadans, Ariana Goertz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Recessions are generally considered to cause negative consequences, but recent studies have provided evidence that some health outcomes improve as the economy deteriorates. The relationship between economic downfalls and health is not straightforward; it is important to look at how health has been impacted in one of the areas hit hardest by the recession. Las Vegas, Nevada was previously considered recession-proof, seemingly unaffected by previous economic downturns exhibited by the rest of the country. However, during the Great Recession of 2007-2009, Las Vegas led the country in highest rates of unemployment and foreclosures. This was quite a collapse for a …

Client’S Perception Of Therapist’S Way-Of-Being, Derek Holyoak

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this research is to investigate how clients’ perception of their therapist’s way of being impacts client engagement during the therapeutic process. By utilizing a common factors perspective, which emphasizes the importance of a strong therapeutic alliance between clients and therapists, the researcher aims to provide empirical evidence supporting the Therapeutic Pyramid Meta-Model. The Meta-Model, which was created by Fife and colleagues (2014), lays the foundation of effective psychotherapy as a therapist’s way-of-being. The meta-model is concurrent with the common factors literature which accounts for almost 30 percent of therapeutic change to therapist-relationship factors. A phenomenological framework, in …

Exercise, Learning And Emotional Health: Interdisciplinary Approaches To Translational Action, Tessa L. Koschel

UNLV Theses, Dissertations, Professional Papers, and Capstones

Exercise positively effects physical, psychological and neurological wellbeing. Though the population at large is becoming increasingly aware of the multi-faceted benefits of exercise, the majority of people fail to meet daily exercise recommendations. Largely, demands of everyday life such as work, school and family take priority over fitness. The issue therefore becomes a matter of time. In a world of media multi-tasking and immediate gratification, the challenge to health professionals becomes incorporation and manipulation of these consistencies to improve exercise uptake and adherence. Focus must shift from the idea of making additional time for exercise, to adding exercise to time …

Acculturation And Causes Of Death Among Filipinos In The Us: Focus On Cancer, Abegail Terso Reyes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Filipinos in the US are 3.4 million, yet the main causes of death among this primarily immigrant population have not been well characterized nor compared with the mortality experience of their counterparts in the Philippines. Age-adjusted mortality rates were computed for the main causes of death for three populations: Filipinos living in the Philippines (FPHs), Filipinos living in California (FCAs), and non-Hispanic whites in California (WCAs). Regression-derived mortality rate ratios stratified by sex were used to compare the populations, using WCA as the referent population. Included causes of death were ischemic heart disease, stroke, cancer and chronic lower respiratory disease, …

Dietary Intake And Energy Expenditure Of Pararescuemen During Routine Training, Andrea Woita

UNLV Theses, Dissertations, Professional Papers, and Capstones

Pararescuemen are one group of Air Force Special Operations Forces (SOF) who engage in vigorous physical training to achieve mission readiness. This type of training requires high energy expenditures and matching dietary intake to support basic physiological needs and to meet performance demands. However, few studies have investigated the energy expenditure and dietary intake of SOF and none have specifically examined these behaviors in Pararescuemen. The goal of this investigation was to determine the energy expenditure and dietary intake of Pararescuemen during routine training - a period when these operators receive supervision and guidance for performance improvements, recovery, and career …

Parents' Perceptions Of Smartphone Use And Parenting Practices, David Jackson Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The present study is a qualitative examination aiming to gain insight into parents’ perceptions of their smartphone use and the effects it may be having on their children as well as parenting practices. Participants (N=12) were smartphone using parents that consisted mostly of young college-educated females. Thematic analysis of individual interviews resulted in five primary themes: (1) Disengagement, (2) Concern for Future, (3) Change in Social Norms, (4) Boundaries, and (5) Cognitive Dissonance. These findings indicate significant effects parental smartphone use is having in the lives of study participants. These thematic findings call for additional research examining the impact parental …

Latino Lgbq Young Adults' Coming-Out Experiences, Monica Munoz

UNLV Theses, Dissertations, Professional Papers, and Capstones

There is limited research on Latino LGBQ individuals and their coming-out experiences. To understand the coming out process of Latino LGBQ individuals, interviews were conducted with 10 Latino LGBQ young adults between the ages of 18 and 30 years old. Using Moustakas (1994) phenomenological approach, six themes derived from the study: (a) The disclosure process impacts family closeness and distance, (b) Latino LGBQ individuals’ family members enter a state of disbelief about their sexual orientation, (c) control of disclosure influences Latino LGBQ young adults’ perception of their coming-out experience, (d) the experience of coming-out for Latino LGBQ individuals is influenced …

The Relationship Of Religion, Religiosity, And Parental Communication In The Sexual Behaviors Of Filipinos Aged 18-25 Years In The United States And The Philippines, Ivy C. Tuason, Racidon Bernarte, Fanglong Dong

Asian/Pacific Island Nursing Journal

This cross-sectional survey research aims to explore and compare the relationship of religion, religiosity, and parental communication to the sexual behaviors of Filipinos aged 18-25 years in the United States and the Philippines. The Duke University Religion Index and Parent-Teen Sexual Risk Communication Scale-III was used to measure religiosity and parental communication. There were 130 participants living in the United States and 247 living in the Philippines included in this study. Among respondents from the Philippines, low levels of parental communication were associated with an increased report for the lack of condom use during the last intercourse. Catholics had a …

Hospice Utilization Of Medicare Beneficiaries In Hawai‘I Compared To Other States, Deborah Taira, Merle Kataoka-Yahiro, Angela Sy

Asian/Pacific Island Nursing Journal

The objective is to examine hospice utilization among Medicare beneficiaries in Hawai‘i compared to other states. Data were from the 2014 Medicare Hospice Utilization and Payment Public Use File, which included information on 4,025 hospice providers, more than 1.3 million hospice beneficiaries, and over $15 billion in Medicare payments. Multivariable linear regression models were estimated to compare hospice utilization in Hawai‘i to that of other states. Control variables included age, gender, and type of Medicare coverage. Medicare beneficiaries using hospice in Hawai‘i differed significantly from beneficiaries in other states in several ways. Hawai‘i beneficiaries were more likely to be Asian …

Mālama Nā Makua I Nā Keiki Me Ka Hānō: Native Hawaiian Parents Caring For Their Children With Asthma, May K. Kealoha, Merle Kataoka-Yahiro

Asian/Pacific Island Nursing Journal

Native Hawaiian children have the highest prevalence rate of asthma among all ethnicities in the State of Hawai‘i. Literature is limited regarding native Hawaiian parents’ perception and experience caring for their children with asthma. The purpose of this study is to explore contemporary native Hawaiian parents’ perspective and experience of caring for their children with asthma in the context of uncertainty. We applied a descriptive qualitative approach by means of directed content analysis using focus groups. Directed content analysis applied Mishel’s Uncertainty in Illness Theory to guide data collection, organization, and analysis. We found that parents’ personal stories about their …

The Importance Of Clinicians And Community Members Receiving Timely And Accurate Information About Waterborne Hazards, Steven S. Coughlin Phd, Osman Yousufzai

School of Medicine Faculty Research

It is important for clinicians and community members to receive up-to-date information about the microbiological and elemental composition of local water supplies. Clinicians play an important role in helping their patients to interpret water quality data and understand the potential impact of water quality on their health. Expanding the medical school curriculum to include environmental health, public health, and health disparities—including disparities related to environmental quality and waterborne hazards—is key to clinicians’ fulfilling this role.