Medicine and Health Sciences Commons^™

Understanding Perceptions Of Genetically Modified Food Among Natural Food Shoppers In Southern Nevada, Christian Murua-Aceves

UNLV Theses, Dissertations, Professional Papers, and Capstones

Today, 85% of corn, 93% of soybeans, and 88% of cotton in the U.S. are genetically modified (GM). Using laboratory methods, genes from one species, such as a plant, can be transferred to an unrelated species, such as an animal. Genetically modified crops may lead to higher yields, have improved food quality, texture, and nutritional value, and have an increased shelf life.

Despite these promising benefits, the potential health risks relating to the consumption of GM food remain inadequately assessed. Genetically modified food is not subjected to rigorous safety testing, such as epidemiologic studies, to identify potential health risks. Two …

The Impact Of Shift Work On Diabetes Self-Management Activities, Daniel Navarro

UNLV Theses, Dissertations, Professional Papers, and Capstones

In the United States 26 million people are affected by diabetes, which can result in microvascular and macrovascular complications. As a consequence, once a person is diagnosed with diabetes, aggressive clinical management is imperative to minimize poor glycemic control’s devastating outcomes. However, for some patients reaching optimum blood glucose levels is challenging due to the complexity of diabetes’ care. In order for patients with diabetes to achieve good blood glucose control, they must engage in self-care activities that include routine blood glucose checks, dietary control, physical activity, and routine medical provider visits, simultaneously with their medication regimen. Diabetes associated self-care …

Partnering With The Community For Establishment Of Alternate Care Sites During Disasters Or Emergencies: A Staff Training Matrix, Jean Marie Roberts

UNLV Theses, Dissertations, Professional Papers, and Capstones

An approach to fulfill a need for additional hospital beds during emergency and disaster situations has been establishment of alternate care sites (ACS). Kern County, California, with a population of about 856,000 and approximately 1,500 hospital beds, is at significant risk for inability to care for the medical needs of its residents in the face of a disaster or an emergency. Even the most conservative estimates of additional hospital beds requirements in a disaster or emergency would indicate the need for nine to ten ACSs accommodating up to 50 patients each in Kern County.

Recognizing the need for alternatives to …

Lead Hazard Control In Henderson, Nevada: Identifying Critical Areas And The Associated Costs, Khaye Gerazel Arcilla Rufin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lead poisoning is a common, yet preventable childhood health problem in the United States today. Studies show statistically significant (p < .05) associations between higher childhood lead exposure and subsequent negative developmental outcomes. Since 1993, the U.S. Department of Housing and Urban Development (HUD) Lead Hazard Control (LHC) Grant Program has devoted more than $1 billion in funding to several cities.

This study investigated a total of n=75 homes enrolled into the Henderson Lead Hazard Control and Healthy Homes Program (HLHCHHP) from December 2013 – February 2015. A logistic regression was performed to ascertain the frequency of lead-based paint (LBP) found in homes based on the year it was constructed. Of the 75 enrolled and tested for LBP, 58 homes (77.3%) were found to contain LBP and 17 homes (22.7%) did not contain LBP. The significance value of p=0.013 shows that …

Improving Transitions Of Care In The Perioperative Setting, Brian Wayne Selig

UNLV Theses, Dissertations, Professional Papers, and Capstones

It is estimated that nearly 200,000 Americans die each year due to preventable medical mistakes (Gupta, 2012), and nearly 80% of all medical errors involve some form of miscommunication between healthcare providers (Joint Commission Center for the Transformation of Healthcare, 2013). Handoffs, or the transitioning of patient care from one provider to another, occur multiple times each day in the hospital setting and done incorrectly can lead to significant mistakes in patient care.

The purpose of this project was to improve the quality of handoffs that occurred between perioperative and inpatient nurses at an urban, tertiary medical center. A shared …

In Vitro Efficacy Of Combined Macrophage-Mediated Plasmonic Photothermal Therapy And Chemotherapeutic Agents, En Chung Shih

UNLV Theses, Dissertations, Professional Papers, and Capstones

Although both chemotherapy and hyperthermia therapy have their inherent advantages, the non-specific targeting of chemotherapy and ineffectiveness of hyperthermia therapy alone suggests a better method can be developed. To overcome this problem, the combined treatment of chemotherapeutic agents with plasmonic photothermal therapy (PPTT) is proposed. This is the first study to investigate the efficacy of combined chemotherapy and PPTT using monocytes as delivery vehicles for gold nanoshells. The results of this investigation shows that PPTT combined with cisplatin resulted in some degree of synergism while additive effects were observed for concurrent treatments of PPTT and doxorubicin and PPTT and bleomycin.

An Evaluation Of Select Physical Activity Exercise Classes (Pex) On Bone Mineral Density, Tori Michelle Stone

UNLV Theses, Dissertations, Professional Papers, and Capstones

INTRODUCTION: According to the National Institute of Health consensus, Osteoporosis causes premature disability in approximately 44 million people (National Institute of Health [NIH], 2001), 80% of this population being women (Ulrich, Georgiou, Gillis, & Snow, 1999). This chronic disease causes 1.5 million fractures annually, 700,000 occurring at the spine (NIH, 2001). One prevention technique developed in recent years is to build a high peak bone mass during growth and in young adult life (Almstedt, Canepa, Ramirez, & Shoepe, 2011). Several publications positively correlate an increase in BMD with increased amounts of exercise. Bone mineral density can be observed through DEXA …

The Effects Of The Hcahps Learning Module On Undergraduate Nursing Students During The Simulated Hospital Day, Ronnie C. Stout

UNLV Theses, Dissertations, Professional Papers, and Capstones

The introduction of the Affordable Care Act has brought about change in the way the Centers for Medicare and Medicaid Services (CMS) reimburses for hospital care. Hospitals are being rewarded for making the patient experience a positive one as evaluated by the patients. This information is provided through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. These survey results allow consumers to compare hospitals locally and nationally with other hospitals. Patients are able to evaluate the hospitals in their area and make informed decisions about where they want to get their care based on previous patients’ experiences. …

Examining The Role Of Supportive Others In Substance Abuse Treatment And Child Welfare, Jessica Marie Urgelles

UNLV Theses, Dissertations, Professional Papers, and Capstones

Child neglect is a prevalent problem and often co-occurs with parental substance abuse. Mothers are most often the perpetrators of child neglect. The currently available treatment programs appear to be failing to meet the needs of these mothers. Most mothers are not completing treatment, putting them at risk of losing custody of their children. The literature suggests that women may have different risk factors associated with their substance use, as compared to men. Social networks appear to play a particularly important role in the maintenance of women’s substance abuse problems. The role of social networks may be distinct for different …

Functional Capacity In Schizophrenia: Relationship Among Effort, Reinforcement Learning And Self-Beliefs, Sally J. Vogel

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals with schizophrenia exhibit a wide range of complex neurocognitive, psychiatric and behavioral impairments. Recent research suggests that this complex array of symptoms can be at least partially accounted for by dysfunction in more basic mechanisms, such as the ability to learn from positive and negative reinforcement, or the ability to exert adequate effort when completing simple tasks. Evidence also suggests that deficits in these basic mechanisms may contribute to more complex symptoms, such as functional impairment. Also, the relationship between neurocognitive deficits and functional impairment has been found to be mediated by defeatist performance beliefs. However, studies have not …

Leukocyte Responsiveness To Exercise In Hcmv+ Individuals, Jared Nicholas Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Emerging research suggests that the lymphocyte immune response during exercise is amplified in individuals who are positive for human cytomegalovirus (HCMV+). However, the responses of monocytes and neutrophils in HCMV+ individuals are unknown. HCMV, a type of herpes virus, infects 50% or more of the adult population in the United States. This virus can become a cause for concern in individuals who have a compromised immune system, which has been shown to occur after high-intensity exercise.

Purpose: The purpose of this study was to characterize the lymphocyte, monocyte, and neutrophil responses to exercise in HCMV+ individuals.

Methods: Participants were …

Prevalence And Risk Factors For Neck And Shoulder Musculoskeletal Symptoms In Users Of Touch-Screen Tablet Computers, Betina Blair, Mariana Gama, Marissa Toberman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose:

Neck and upper extremity symptoms are common health complaints in the general population and cause a substantial financial burden to the health care system. Neck pain is known to be a multi factorial disorder, with head and spinal posture being one of the most important factors. Currently there is little evidence showing a relationship between touch-screen tablet computer usage and neck/upper extremity pathologies. However, it is fair to postulate that the incidence of neck/upper extremity pathologies is higher within touch-screen tablet computer users, considering how users maintain static postures while using the device. The primary purposes of …

Patient No-Show For Outpatient Physical Therapy: A National Survey, James Bokinskie, Payton Johnson, Trevor Mahoney

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Patients who fail to show for scheduled medical appointments (no-show) create a cascade of issues for the health care system, the provider, and themselves. No-show can affect clinical productivity, cost and quality of care, and treatment outcomes. There is an overwhelming lack of research on no-show as it relates to outpatient physical therapy in the United States. The purposes of this study were to report national no-show rates, describe the presence and characteristics of no-show policies, determine the relationship of these policies and other demographic information to no-show rates, and describe the most commonly perceived reasons for no-show.

Methods: …

Immediate Effects Of Cervical Spine Manipulation On Gait Parameters In Individuals With And Without Mechanical Neck Pain, Jordan Isom, Shaylyn Kennedy, Justin May, Samuel Moore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The purpose of this study was to determine 1) if there were any differences in gait parameters between participants with mechanical neck pain and those without and 2) if cervical spine manipulation has an immediate effect on these gait parameters.

Methods: Twenty participants with mechanical neck pain and twenty participants without neck pain were randomly assigned into either the sham or manipulation group. The two intervention groups participated in walking across a GAITRite Walkway that recorded gait parameters such as stride length, cadence and step width before and after cervical spine manipulation. The participants walked at their own cadence …

The Immediate Effects Of Cervicothoracic Manipulation Versus Stretching On Upper Trapezius Pressure Pain Thresholds And Range Of Motion In Individuals Without Neck Pain, Kevin Carr, Morgan King, Erin Oelklaus, Brendan Parry

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Myofascial pain may be considered one of the most common clinical findings in patients with neck pain (NP). Motor aspects of myofascial pain include disturbed motor function and muscle weakness secondary to motor inhibition, muscle stiffness, and restricted range of motion (ROM). Currently, it is unclear which interventions may have the greatest immediate impact on pressure pain sensitivity and ROM. Several studies have demonstrated improved pressure pain thresholds (PPT) after cervical manipulation; however, it is not clear if manipulation targeted to the cervicothoracic (CT) junction will have a similar effect. Others recommend stretching as a method to …

Pushing For New Options In Childbirth: A Case Study In Contemporary Integrative Midwifery, Kerie Ann Francis

UNLV Theses, Dissertations, Professional Papers, and Capstones

In this study, I investigate the concept of “integrative midwifery” in a major metropolitan area in the Southwest United States. Specifically, I look at a group of midwives, doulas, and other birthworkers who have organized into a collective business entity to provide services to pregnant and birthing women. Stemming from a perception that the medical model of maternity care is broken in this country, these practitioners seek to offer alternatives. I draw upon literature regarding complementary and alternative medicine (CAM) which shows that market conditions have created a situation in which alternatives to medical modes of care have become increasingly …

Oral Vs. Nasal Breathing During Submaximal Aerobic Exercise, Chase Ovila Platt Lacomb

UNLV Theses, Dissertations, Professional Papers, and Capstones

When comparing oral breathing versus nasal breathing more volume of air can be transported through the oral passageway, but nasal breathing can lead to slower respiration rates and cleaner inspired air. The purpose of this study is to find the most efficient mode of breathing during different intensities of submaximal aerobic exercise. There were 9 males and 10 females that completed this study. First test was a VO₂ Max test, 3.0 mph for 3 minutes, with increases in 1.0 mph every minute after that. Using a regression equation running speeds were determined for each individual’s submaximal intensities. The desire …

Sleep Duration Associated With Cardiovascular Conditions Among Adult Nevadans, Brianna Pergola

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cardiovascular disease (CVD) is the leading cause of mortality in the United States accounting for 1 out of every 3 deaths. Additionally, 43.9% of the population is expected to have some form of cardiovascular disease by the year 2030, with direct and indirect costs expected to rise upwards of 58 percent. To successfully prevent cardiovascular disease conditions such as myocardial infarction, coronary heart disease, and stroke, research must be done to identify risk factors, both modifiable and non-modifiable. In the existing literature, sleep duration as a risk factor for cardiovascular disease conditions has shown inconsistent associations. According to the National …

The Voices Of The People: Lower Sioux Indian Community Members Speak Out On What They Need And Want In A Primary Health Care Clinic On The Reservation, Darin Michael Prescott

UNLV Theses, Dissertations, Professional Papers, and Capstones

American Indian/Alaska Native (AI/AN) people who live on reservations or in urban areas typically receive their health care in clinics that are operated by their tribe or are affiliated with Indian Health Service (IHS), a federal agency that provides care to AI/AN people. The Lower Sioux Indian Community (LSIC) is a federally recognized tribe located in southwest Minnesota near Morton, MN. LSIC members currently receive health care from outside providers at various locations near the reservation. The outsourced services include primary care, emergency care, hospitalization, surgery, dentistry, and podiatry. Because the providers are independent groups and do not work for …

The Predictors Of Cultural Competence In The Baccalaureate Degree Nursing Curriculum: Implications For Nursing Education, Angela Elizabeth Silvestri-Elmore

UNLV Theses, Dissertations, Professional Papers, and Capstones

Health care providers are members of a helping profession and need to provide quality care to all members of society. As a result of current and projected demographic changes within the United States (U.S.), health care professionals are faced with the challenges of providing culturally competent care and fulfilling the role as the “helping profession.” From 2000 to 2010, the Asian population increased by 43.3%, the Hispanic population grew by 43%, the Native Hawaiian and other Pacific Islander population increased by 35.4%, the American Indian or Alaskan Native population increased by 18.4%, and the African American population increased by 12.3%. …

The Effects Of Adverse Childhood Experiences On Subsequent Injury In Young Adulthood: Findings From The National Longitudinal Study Of Adolescent And Adult Health, Michelle M. Sotero

UNLV Theses, Dissertations, Professional Papers, and Capstones

The objective of this study is to examine the association between adverse childhood experiences (ACEs) in the context of family and community and the likelihood of subsequent unintentional and intentional, nonfatal injury in young adulthood (ages 24-32 years). Using a cross sectional study design, data from Waves I and IV of the National Longitudinal Study of Adolescent and Adult Health, a nationally representative sample (n = 14,800) was used to examine the relationship between 16 types of ACEs and a cumulative ACE score and the odds of seven injury outcomes in young adulthood. Over a third (37.6%) of young adults …

The Feasibility Of Delivering A Home-Based Motivational Exercise Program To African-American Breast Cancer Survivors, Denise Spector, Claudio Battaglini

Journal of Health Disparities Research and Practice

Most African-American breast cancer survivors do not meet current exercise recommendations for cancer survivors, which include both aerobic and strength-training exercises. This pilot study tested the feasibility of delivering a home-based exercise intervention to African-American breast cancer survivors. Sedentary African-American breast cancer survivors were recruited for a 16-week motivational home-based progressive aerobic and strength-training exercise pilot study. Participants completed weekly exercise logs and received weekly phone calls. To assess feasibility, we evaluated recruitment, retention, and adherence rates, as well as participant acceptance and safety. 17 women enrolled; 13 completed the intervention (76%). Participants had moderately-high adherence (70%) to walking goals, …

Racial/Ethnic Disparities Related To Health Insurance Coverage, Access To Care And Ease In Health Care Services Among Children In 2012 Cchaps Data, Jacquelynn Meeks, Sweety Baidhya

Journal of Health Disparities Research and Practice

nObjective:The aim of this study was to examine racial/ethnic disparities in unmet medical care, dental care and prescription medications and ease of using heath care services.

Methods:This is a cross sectional study of households in a six-county service region in Texas (Tarrant, Johnson, Hood, Parker, Wise and Denton Counties). The participants included the parents/guardians of children aged 1-15 years. In 2012, a total of 8,439 parents completed the survey. In 2012, 4194 completed the version containing the health insurance type and unmet medical, prescription and dental health care and ease/difficulty in access to health care questions.The dependent variables …

Psychosocial Correlates Of Perceived Stress And Depressive Symptoms Among Help-Seeking Hispanic Smokers, Monica Webb Hooper Phd

Journal of Health Disparities Research and Practice

Objectives: Research has demonstrated robust associations between perceived stress, depressive symptoms, and cigarette smoking. The extent to which these findings from the general population generalize to Hispanic smokers is unknown. The present study examined (a) correlates of perceived stress and depressive symptoms among help-seeking Hispanic smokers and (b) whether maladaptive coping and social support were related to stress and depressive symptoms. Design: Hispanic smokers (N=123) enrolled in an RCT completed demographic and smoking history, perceived stress, depressive symptoms, perceived social support, and maladaptive coping measures. Results: Bivariate associations indicated that perceived stress was positively correlated with depressive symptoms …

Reducing Health Disparities Through The 2015 Mcat: A Bold Goal Requiring On-Going Assessment, Aliya G. Feroe, Stephen F. Loebs

Journal of Health Disparities Research and Practice

There is broad consensus that reduction in health care disparities is an important and multi-faceted challenge. One possible approach, among many others, starts with the attraction of women and men to the field of medicine who have a broad based education and who can demonstrate cultural understanding and sensitivity. In this context, the Medical College Admissions Test (MCAT) has been revised, effective in 2015, to include many additional questions concerning the psychological, social, and behavioral sciences. There are important assumptions fueling the revised Medical College Admissions Test (MCAT) and these will need to be tested. These assumptions range from influencing …

Chronic Physical Health Conditions Among Homeless, Nooshin Nikoo, Marjan Motamed, Mohammad Ali Nikoo, Verena Strehlau, Erika Neilson, Sahoo Saddicha, Michael Krausz

Journal of Health Disparities Research and Practice

ABSTRACT

Objective: Morbidity and mortality among homeless individuals is higher than the general population. This study aims to determine the prevalence of current self-reported, chronic physical health conditions in a large sample of homeless people with sub-samples from shelters and street in British Columbia, Canada. Methods: Cross-sectional survey applying modified version of the ‘National Survey of Homeless Assistance Providers and Clients (NSHAPC)’ questionnaire in multiple sites in Vancouver, Victoria and Prince George, British Columbia, Canada. Sample: Five hundred homeless individuals were surveyed between May and September of 2009. A person was defined as homeless if he/she had a …

Evaluation Of The Nci’S Community Cancer Centers’ Program (Ncccp): Impact On Disparities In Quality Of Cancer Care, Michael T. Halpern, Pamela Spain, Debra J. Holden, Andrew K. Stewart, Erica J. Mcnamara, Greer Gay, Steven B. Clauser, Irene Prabhu Das

Journal of Health Disparities Research and Practice

This study examined the effects of the NCCCP pilot on breast or colon cancer quality of care for patients from underserved populations and those treated at disparities-focused hospitals (NCCCP sites having fewer oncology resources or in communities with greater proportions of underserved populations). Data on five quality of care measures were collected using the Commission on Cancer’s Rapid Quality Reporting System. Following NCCCP initiation, we observed improvements in all five quality of care measures. There were similar quality of care improvements for Black vs. White patients, privately insured vs. Medicaid or uninsured patients, and men vs. women. Patients treated at …

Impact Of Social And Cultural Factors On Teenage Pregnancy, Devi Akella, Melissa Jordan

Journal of Health Disparities Research and Practice

United States has the highest level of teenage pregnancy amongst the industrialized nations. Further, the level of teenage pregnancy is highest amongst the minority population. This research study examines the reasons behind high rates of early childbirth amongst African American teenagers. This study uses Bandura’s (1977) Social Learning Theory to deconstruct the factors, which influence and manipulate the overall behavior of the teenagers and initiates them to choose early motherhood over education and career. To ensure better quality of empirical data, the authors collaborated with the pregnant teenagers and a local non-profit community agency using a phenomenological analysis.

Gathering Perspectives On Extended Family Influence On African American Children's Physical Activity, Natasha A. Brown, Katherine Clegg Smith, Rachel L.J. Thornton, Janice V. Bowie, Pamela J. Surkan, Darcy A. Thompson, David M. Levine

Journal of Health Disparities Research and Practice

Background: The family environment is a key determinant of children’s physical activity. The importance of the extended African American family is well established, but there is little research on its influence on school age children’s physical activity. Methods: We recruited eight families in which grandparents and other adult relatives played a central role in child supervision. Semi-structured interviews with parents, other adult relatives, and children revealed various perspectives on the influences of culture and families on children’s weight-related behaviors. Results: Children were between the ages of 6 and 11, and five of the families resided in neighborhoods in which at …

American Muslim Health Disparities: The State Of The Medline Literature, Aasim I. Padela, Afrah Raza

Journal of Health Disparities Research and Practice

Background: While religious beliefs and values influence health behaviors, conventional health disparities research rarely examines health outcomes by religious affiliation particularly within multi-ethnic minority communities.

Methods: Using a systematic strategy we searched the Medline literature to identify empiric studies that report on health disparities between American Muslims and non-Muslim groups residing in America. In addition to use religious affiliation descriptors for Muslim groups we utilized geographic and ethnicity terms such as “South Asian” or “Pakistani” as proxy terms to help uncover studies of American Muslims.

Results: 171 empirical studies were captured. South Asians and Arabs were the most commonly studied …