Medicine and Health Sciences Commons^™

Retention Of Low Income Children In Three Dental Studies Investigating Early Childhood Caries, Ann H. Saba, John J. Warren, Karin Weber-Gasparoni, Deborah V. Dawson

Journal of Health Disparities Research and Practice

Background: To our knowledge no dental studies have looked closely at subject retention, which is crucial to better understand oral health disparities. In this paper, we report retention rates and review and attempt to assess which retention strategies utilized in 3 dental research studies investigating ECC were effective for retaining WIC-enrolled children. The purpose of this paper is to discuss challenges that were encountered when working with these populations, describe characteristics of those not retained, and summarize some recommendations for future dental studies working at WIC sites. Methods: Three dental studies were conducted at WIC clinics in Iowa. Retention strategies …

Can Mhealth Improve Risk Assessment In Underserved Populations? Acceptability Of A Breast Health Questionnaire App In Ethnically Diverse, Older, Low-Income Women., Carolina Bravo, Cristina O’Donoghue, Celia P. Kaplan, Judith Luce, Elissa Ozanne

Journal of Health Disparities Research and Practice

Background: Use of mobile health (mHealth) tools has expanded rapidly but little research has been done on its acceptability by low-income, diverse, older patient populations.

Objective: To assess the attitudes of a diverse group of underserved women on the acceptability and usability of mHealth tools in a clinical setting using a breast health questionnaire application (app) at a public hospital mammography clinic.

Methods: Semi-structured interviews were conducted in a breast-imaging center of an urban safety net institution from July-August 2012. Interviews included pre- and post-questions. Women completed the Athena breast health questionnaire app on an iPad and were asked about …

A Community Conversation On Adolescent Pregnancy And Parenting Services: Networks Of Support, Gatekeepers To Care, And Non-Compulsory Fathering In A Black Urban Community, Tamara G.J. Leech, Elizabeth A. Adams, Marci Bounds Littlefield

Journal of Health Disparities Research and Practice

This study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serves as a …

Strengthening Hiv Knowledge And Awareness Among Undergraduate Students At Historically Black Colleges And Universities, Ashley Murray, Monica J. Huang, Felicia Hardnett, Madeline Y. Sutton

Journal of Health Disparities Research and Practice

Objective: We describe baseline HIV knowledge among students at historically black colleges and universities (HBCUs) to inform and strengthen HIV education efforts at HBCUs.

Methods: We surveyed 1,230 African American HBCU students from 24 HBCUs; 1,051 responses (85.4 %) were analyzable.

Results: Although general HIV knowledge was high among respondents (95% of students correctly responded that having sex without a condom constituted unsafe sex), knowledge deficits were noted (only 25% of students reported that multiple sex partners is a form of unsafe sex, while 25% of students reported that withdrawal of the penis before ejaculation reduced HIV …

The Association Between Distances Traveled For Care And Treatment Choices For Pelvic Floor Disorders In A Rural Southwestern Population, Gena Dunivan, Pamela Fairchild, Sara Cichowski, Rebecca Rogers

Journal of Health Disparities Research and Practice

OBJECTIVES: To determine if distance traveled for care influenced patient choice for conservative vs. surgical treatment for pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI).

METHODS: Retrospective chart review of all new patients seen in the Urogynecology clinic at the University of New Mexico Hospital (UNMH) from January 2007 through September 2011. Data collected included medical history, Pelvic Organ Prolapse Quantification (POPQ) examination, and validated quality of life questionnaires.

RESULTS: 1384 women were identified with POP and/or SUI. Women traveled an average of 50 miles to receive care at UNMH. After multivariable analysis, greater distance traveled was associated with …

Documenting Nursing And Medical Students’ Stereotypes About Hispanic And American Indian Patients, Meghan G. Bean, Elizabeth S. Focella, Rebecca Covarrubias, Jeff Stone, Gordon B. Moskowitz, Terry A. Badger

Journal of Health Disparities Research and Practice

Objective: Hispanic Americans and American Indians face significant health disparities compared with White Americans. Research suggests that stereotyping of minority patients by members of the medical community is an important antecedent of race and ethnicity-based health disparities. This work has primarily focused on physicians’ perceptions, however, and little research has examined the stereotypes healthcare personnel associate with Hispanic and American Indian patients. The present study assesses: 1) the health-related stereotypes both nursing and medical students hold about Hispanic and American Indian patients, and 2) nursing and medical students’ motivation to treat Hispanic and American Indian patients in an unbiased …

Health Literate Organizations: Are Clinical Trial Sites Equipped To Recruit Minority And Limited Health Literacy Patients?, Jennifer Livaudais-Toman, Nancy J. Burke, Anna Napoles, Celia P. Kaplan

Journal of Health Disparities Research and Practice

Background. Racial/ethnic minority patients are less likely than non-Latino white patients to participate in cancer clinical trials. A key barrier to participation is limited health literacy which is more common among minorities. At the organizational level, it is important that clinical trials sites become better equipped to recruit minority patients by expanding their organizational health literacy including language competency and outreach efforts. We explored the characteristics of clinical trial sites that are associated with these health literate behaviors.

Methods. We identified 353 breast clinical trials recruiting participants in 2006 from four states (California, Florida, Illinois, and New York) through the …

Health Information Exchange: Growth And Patient Privacy, Niam Yaraghi

Brookings Scholar Lecture Series

Health Information Exchanges (HIE) provide the electronic movement of health-related information among organizations according to nationally recognized standards. The goal of health information exchange is to facilitate access to and retrieval of clinical data to provide safer, timelier, efficient, effective, equitable, patient-centered care. HIEs are becoming integral parts of the national healthcare reform efforts, chiefly owing to their potential impact on cost reduction and quality enhancement in healthcare services. However, the potential of a HIE platform can only be realized when its multiple constituent users actively participate in using its variety of services. In this research, Yaraghi models HIE systems …

Parental Factors That Influence Swimming In Children And Adolescents, Jennifer Pharr, Carol C. Irwin, Richard L. Irwin

Environmental & Global Health Faculty Research

Swimming can be an important source of physical activity across the life-span. Researchers have found that parents influence physical activity behaviors of their children. The purpose of this study was to determine what parental factors influenced the number of days that children swam. Survey respondents (n = 1,909) from six cities across the United States were surveyed at local YMCAs. Children were found to swim significantly more if their parents encouraged them to swim, members of the family knew how to swim and swam with them, or their parents were not afraid of the children drowning or afraid of …

Modeling Hedonic Processing And Anhedonia In Depression, Kevin Mercado

Honors College Theses

Depression is characterized by low positive emotion and a lack of pleasurable experiences, or anhedonia. Past studies have emphasized controlling negative affect, but there is an emerging trend in the depression literature to focus on positive emotion. The current study employed several psychophysiological tools, postauricular reflex, startle blink reflex, and event-related potential (ERP) components such as P3 and the late positive potential (LPP), to assess the dissociable components in positive emotion (consummatory and anticipatory processes). In addition, several different hypotheses of emotional dysfunction were evaluated to accurately model deficits in positive emotionality. A majority of the psychophysiological tools used supported …

Lack Of Awareness Of Human Immunodeficiency Virus (Hiv) Infection: Problems And Solutions With Self-Reported Hiv Serostatus Of Men Who Have Sex With Men, Travis H. Sanchez, Colleen F. Kelley, Eli Rosenberg, Nicole Luisi, Brandon O'Hara, Rodriques Lambert, Raphael Coleman, Paula M. Frew, Laura F. Salazar, Sijia Tao, William Clarke, Carlos Del Rio, Patrick S. Sullivan

Environmental & Global Health Faculty Research

Background. Lack of human immunodeficiency virus (HIV) infection awareness may be a driver of racial disparities in HIV infection among men who have sex with men (MSM). Lack of awareness is typically measured by comparing HIV test result to self-reported HIV status. This measure may be subject to reporting bias and alternatives are needed.Methods. The InvolveMENt study examined HIV disparities between black and white MSM from Atlanta. Among HIV-positive participants who did not report knowing they were positive, we examined other measures of awareness: … See full text for complete abstract.

Racial And Ethnic Disparities In Time To Cure Of Incontinence Present At Nursing Home Admission, Donna Z. Bliss, Olga Gurvich, Kay Savik, Lynn Eberly, Susan Harms, Jean F. Wyman

Journal of Health Disparities Research and Practice

Abstract

As many as half of older people that are admitted to nursing homes (NHs) are incontinent of urine and/or feces. Not much is known about the rate of cure of incontinence present at NH admission, but available reports suggest the rate is low. There have been racial and ethnic disparities in incontinence treatment, but the role of disparities in the cure of incontinence is understudied. Using the Peters-Belson method and multilevel predictors, our findings showed that there were disparities in the time to cure of incontinence for Hispanic NH admissions. A significantly smaller proportion of older Hispanic admissions were …

Disparities In Access To Health Insurance And Workers’ Compensation Benefit Between Non-Contingent And Contingent Farm Workers In U.S. Agriculture, Abay Asfaw

Journal of Health Disparities Research and Practice

The share of contingent employment has increased significantly in the last two decades. Not much is known about the impact of this shift on disparities in access to health insurance and other benefits. I examined disparities in access to any type of health insurance, employer-sponsored health insurance and workers’ compensation (WC) benefits between contingent and non-contingent workers in U.S. agriculture. I used the National Agricultural Workers Survey and the extended Oaxaca-Blinder decomposition technique to estimate disparities. Contingent employment could be a barrier to access of health insurance and WC benefit, which in turn could contribute to health inequalities in the …

Physicians' Attitudes About Recommending Surgery For Early Stage Lung Cancer And Possible Reasons For Racial Disparities, Franklin R. Mcguire

Journal of Health Disparities Research and Practice

PHYSICIANS’ ATTITUDES ABOUT RECOMMENDING SURGERY FOR EARLY STAGE LUNG CANCER AND POSSIBLE REASONS FOR RACIAL DISPARITIES

ABSTRACT

Purpose: Patient refusal for lung cancer surgery is significant, but other factors, such as negative framing of the treatment discussion, may be involved. Physician attitudes could influence the nuances of and therefore the conclusions of these discussions. We determined physicians’ attitudes and the influence it has on possible decisions against lung cancer surgery, particularly surgical rates for blacks, using a companion survey.

Methods: The study is a prospective, multicenter observational trial conducted at five sites in North and South Carolina from December …

Internet Use For Health Information Among American Indians: Facilitators And Inhibitors, Melissa K. Filippi, Christina M. Pacheco, Charlotte Mccloskey, Rebecca Jeanne Crosthwait, Justin Begaye, Jb Kinlacheeny, Won S. Choi, K Allen Greiner, Christine M. Daley

Journal of Health Disparities Research and Practice

Our research team explored Internet use among a heterogeneous American Indian (AI) population to determine Internet use in relation to health information seeking behaviors. Participants examined an AI culturally-tailored tobacco website as an example to explain what they wanted in an AI Internet health site. Using community-based participatory research, we conducted 10 focus groups with non-college AI men and women (N=96), stratified by age (18-29, 30-49, and 50 and over) to better understand their perceptions of Internet use and health information needs. We found that Internet use varied greatly among all strata. Participants referenced WebMD^© more than any other …

American Indian Men's Perceptions Of Breast Cancer Screening For American Indian Women, Melissa K. Filippi, Joseph Pacheco, Aimee S. James, Travis Brown, Florence Ndikum-Moffor, Won S. Choi, K Allen Greiner, Christine M. Daley

Journal of Health Disparities Research and Practice

Screening, especially screening mammography, is vital for decreasing breast cancer incidence and mortality. Screening rates in American Indian women are low compared to other racial/ethnic groups. In addition, American Indian women are diagnosed at more advanced stages and have lower 5-year survival rate than others. To better address the screening rates of American Indian women, focus groups (N=8) were conducted with American Indian men (N=42) to explore their perceptions of breast cancer screening for American Indian women. Our intent was to understand men’s support level toward screening. Using a community-based participatory approach, focus groups were audio-taped, transcribed verbatim, and analyzed …

Association Analysis Of Reported Attitudes And Culturally Competent Behavior Engagement Among Public Health Department Employees, Marla B. Hall Phd, Jeffrey J. Guidry Phd, E. Lisako Mckyer Phd, Corliss Outley Phd, Danny Ballard Phd

Journal of Health Disparities Research and Practice

Objective: The purpose of this research is to analyze the association of attitudes and beliefs on engaging in culturally competent behavior.

Design: Explorational case study of individuals employed within an urban public health department.

Participants: Employees (n=90) from four metropolitan clinical sites of an urban public health department located in the southwest region of the United States were solicited and recruited during a monthly staff meeting. This sample is representative of 84% of the total employees which is comprised of 107 individuals.

Main Outcome Measures: The Cultural Competence Assessment is designed to explore individual knowledge, feelings …

Trauma Patient Satisfaction Survey Opens Discussion About Bias In Health Care, Marie Crandall

Journal of Health Disparities Research and Practice

Background

Patient satisfaction is an important part of quality care, and patient backgrounds can influence satisfaction with care. Since trauma disproportionately affects the underserved, this study aimed to determine the effects of race and insurance status on trauma patient satisfaction.

Methods

The validated Trauma Patient Satisfaction Survey (TPSS) was administered to 143 hospitalized trauma patients. ANOVA and Chi2 statistics were used to compare demographics with patient satisfaction. Qualitative data were analyzed with EZ-Text.

Results

Of the 143 patients surveyed, 95 (66%) were African American, 33 (23%) were Caucasian, and 15 (10%) were Latino. Sixty-one patients (43%) were uninsured. No statistically …

Development Of A New Polymerase Chain Reaction Assay For The Rapid Detection Of The Oral Pathogenic Bacterium, Selenomonas Noxia, Patrica Cruz-Perez, Arthuro Mehretu, Mark P. Buttner, Katherine M. Howard, Theresa Trice

Environmental & Global Health Faculty Research

Background

In recent studies, periodontal health has been linked to being overweight and/or obese. Among common oral bacteria, Selenomonas noxia has been implicated in converting periodontal health to disease, and Selenomonas species have also been found in gastric ulcers. The objective of this study was to develop and validate a quantitative polymerase chain reaction (qPCR) assay for the specific and rapid detection of S. noxia.

Methods

Two oligonucleotide primer pairs and one probe were designed and tested to determine optimal amplification signal with three strains of S. noxia. The PCR assay was tested against fourteen non-target organisms, including …

An Efficient Standardized Method Of Maintaining Quality Assurance In Therapeutic Treatment Record Keeping, Kelsey Michael Bradshaw

UNLV Theses, Dissertations, Professional Papers, and Capstones

Quality assurance (QA) within the field of mental health is the practice of monitoring and reviewing services to ensure adherence to specified standards of care. Agents within State governments and various organizations influence record keeping procedures through ethical guidelines and law. For instance, client records must be maintained for all clients receiving mental health services, including informed consent, releases of information, treatment plans, and progress notes. Accurate and timely record keeping procedures assure quality mental health services. However, professionals sometimes err in the maintenance of client records, which can have a negative impact on services, clients, and practitioners. To assist …

The Percussionist Bodybuilder: Optimizing Performance Through Exercise And Nutrition, Anthony Joseph Merlino

UNLV Theses, Dissertations, Professional Papers, and Capstones

Do preventive therapies have the potential to help avoid common injuries among percussionists? This document investigates physiological therapy and nutrition in relation to percussion performance. My interest in this subject matter is derived from my personal experiences with injuries related to the performance of percussion. Although I have studied and played percussion professionally for more than a decade, I was unaware of certain methods of rehabilitation that were available to me prior to my injuries. As I learned about the rehabilitation process through first hand experience, I discovered that my injuries were very common among percussionists. This raised the question: …

The Effect Of Acute Lps-Induced Immune Activation And Brain Insulin Signaling Disruption In A Diabetic Model Of Alzheimer's Disease, Andrew Scott Murtishaw

UNLV Theses, Dissertations, Professional Papers, and Capstones

Alzheimer's disease (AD) is a neurodegenerative disorder marked by progressive cognitive impairments and pathological hallmarks that include amyloid plaques, neurofibrillary tangles, and neuronal loss. Several well-known mutations exist that lead to early-onset familial AD (fAD). However, these cases only account for a small percentage of total AD cases. The vast majority of AD cases are sporadic in origin (sAD) and are less clearly influenced by a single mutation but rather some combination of genetic and environmental risk.

The etiology of sAD remains unclear but numerous risk factors have been identified that increase the chance of developing AD. Among these risk …

A Qualitative Study Of The Perceived Health Care Needs Of Undocumented Latino Day Laborers Living In Las Vegas, Nevada, Siboney Zelaya

UNLV Theses, Dissertations, Professional Papers, and Capstones

Undocumented (unauthorized, illegal) immigrants seek employment on the street corners near home improvement stores offering their services and selling their labor to the employers who arrive in their cars or trucks to pick them up for a few hours of hard work. The number of undocumented immigrants in the United States continues to increase. By percentage of overall population, Nevada has one of the largest shares of undocumented immigrants in the United States, and the bulk of that percentage is Latino.

The purpose of this phenomenological qualitative research study is to gain knowledge about undocumented Latino day laborers' perceived health …

The Interrelationships Among A Concussion-Related Biomarker, Head Hits, And Impact Test In Collegiate Football Players, Lucas Bianco

UNLV Theses, Dissertations, Professional Papers, and Capstones

Head injuries are prevalent in collegiate athletics with concussions being common among contact sports, such as football. Concussion assessment and diagnosis is complicated by the lack of objective and assessment techniques. The purpose of the study was to determine if there is a relationship between the level of a concussion-related biomarker, self-report (subjective) head hits, video-analyzed head hits, and ImPACT test scores in college football athletes before and after a football practice session.

After being recruited and consented to participate, 29 Division I college football athletes provided a blood sample via finger stick two days before a 2014 spring football …

Stride Length-Speed Relationship During Body Weight Supported Running, Carmen Chona

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to determine if body weight support influences the stride length-speed relationship. Additionally, the purpose was to determine if impact characteristics of running are influenced by body weight support and speed. Subjects (n=10; 6 female, 4 male) volunteered to participate in this study. All subjects were injury free and were comfortable running on a treadmill for 30 minutes. Subjects ran on a lower body positive (LBPP, Alter-G, G-Trainer) treadmill for 4 conditions of body weight (100, 40, 30 and 20% of body weight) and 4 running speeds (100, 110, 120 and 130% of the preferred …

An Evaluation Of Kinematic Variables During Stance Phase Of A Training Endurance Run, Joshua Paul Bailey

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of the study was to evaluate kinematics of the lower extremity during the stance phase of an endurance training run. Fifteen participants (8 male, 7 female; 30.5 ± 8.4 years; 71.8 ± 11 kg; 1.73 ± 0.07 m) reported that they were currently signed up for, or planned on signing up for, an endurance race within the next six months of participation in the study (9 half marathon, 3 marathon, 1 triathlon, 2 21k trail run). All had a weekly running mileage greater than 20 miles (23.8 ±4.6 miles). Participants were required to complete the 15–kilometer training run …

Family Presence During Resuscitation Of Adults: The Impact Of An Online Learning Module On Critical Care Nurses' Perception And Self-Confidence, Kelly Powers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Family presence during resuscitation (FPDR) involves offering family members the option to remain with their loved one who is undergoing life-saving measures. FPDR has been shown to enhance comfort and facilitate grieving, and 90% to 100% of patients and family members support it as an option. However, critical care nurses are not fully supportive of FPDR and approximately only one-third implement it in their care of patients. The perceived risks of FPDR are cited as a primary reason for lack of support and implementation. Yet, the perceived risks have not been proven, while the benefits have been established in research. …

Impaired Theory Of Mind In Psychotic And Affective Disorders, Erik Nelson Ringdahl

UNLV Theses, Dissertations, Professional Papers, and Capstones

Psychotic symptoms in bipolar I disorder during mood episodes has been associated with several negative outcomes raising the question as to whether psychosis is a risk factor for a more severe form of this chronic and debilitating condition. However, relatively little research has been directed at understanding the relationships among social cognitive functioning in bipolar I disorder with and without a history of psychosis. Impaired social cognition has been identified as a putative endophenotypic markers in schizophrenia and the evidence is mounting as to whether similar impairments also exist in bipolar I disorder. Given the plethora of research supporting the …

Gate Monte Carlo Simulations In A Cloud Computing Environment, Blake Austin Rowedder

UNLV Theses, Dissertations, Professional Papers, and Capstones

The GEANT4-based GATE is a unique and powerful Monte Carlo (MC) platform, which provides a single code library allowing the simulation of specific medical physics applications, e.g. PET, SPECT, CT, radiotherapy, and hadron therapy. However, this rigorous yet flexible platform is used only sparingly in the clinic due to its lengthy calculation time. By accessing the powerful computational resources of a cloud computing environment, GATE's runtime can be significantly reduced to clinically feasible levels without the sizable investment of a local high performance cluster. This study investigated a reliable and efficient execution of GATE MC simulations using a commercial cloud …

Synthesis And Characterization Of Novel Platinum(Ii) And Platinum(Iv) Complexes Containing 4,4′--Disubstituted--2,2′--Bipyridine Ligands For The Treatment Of Cancer, Van Vo

UNLV Theses, Dissertations, Professional Papers, and Capstones

Three series of platinum(II) and platinum(IV) complexes containing 4,4′-disubstituted-2,2′-bipyridine ligands have been synthesized and characterized by 1H NMR, 13C NMR spectroscopy, elemental analysis, mass spectroscopy, and differential scanning calorimetry measurements. The MTS cell proliferation assay was used to examine the in vitro anti-proliferative activities of these complexes in various human breast, lung, and prostate cancer cells. The cell's response to the complexes varies between different cell lines; however, the low EC₅₀ values determined from the MTS data indicate that several of the complexes are much more potent than cisplatin.

Flow cytometric analysis of selected compounds revealed induction of apoptosis …