Medicine and Health Sciences Commons^™

Building A Sustainable Community Through Public Engagement: A Study Of Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

This manuscript is the first of a series written for the Nevada Journal of Public Health. The series is result of research conducted for the Southern Nevada Strong, Sustainable Communities Grant. During Year One of the planning process, we created a Southern Nevada Existing Conditions Report. This report highlighted where the region stood on key metrics including: demographics and population projections, access to healthcare and health outcomes, healthy community, housing, environment, economy and education. For this special issue of the Nevada Journal of Public Health, the report was separated into seven articles related to each of these metrics. The articles …

Refining Best Practices For The Diagnosis Of Autism: A Comparison Between Individual Healthcare Practitioner Diagnosis And Transdisciplinary Assessment., Jessica Rae Stewart, Debra C. Vigil, Erika Ryst, Wei Yang

Nevada Journal of Public Health

The purpose of this study is to compare the diagnostic decision-making of individual healthcare practitioners against that of a transdisciplinary team. Despite national recognition of transdisciplinary assessment as the gold standard diagnostic approach, autism is most frequently diagnosed by individuals working independently in a variety of disciplines. The current study examined how closely these individual practitioners make diagnoses matching that of a transdisciplinary team. Twenty professionals from five different disciplines viewed videotape clips of fifteen children previously assessed by a transdisciplinary team. Results confirmed that individual healthcare practitioners matched the transdisciplinary team diagnosis on average only 65.6% of the time. …

Analysis Of The Morbidity And Mortality Of Severe Influenza Infection In Clark County, Nevada For The 2010-2011 Influenza Season, Kindra St. Jacques, Patricia Cruz, Brian Labus

Nevada Journal of Public Health

Throughout the duration of any influenza season, influenza strains have the ability to evolve through mutation causing alterations in virulence. These changes may result in severe illness or death among susceptible populations; therefore, it is important to closely monitor influenza-associated hospitalizations and deaths. The University of Nevada, Las Vegas in collaboration with the Southern Nevada Health District analyzed data from the hospitalized influenza morbidity and mortality surveillance project for Clark County for the 2010-2011 influenza season. Among the study population (N= 158): the influenza strain type was found to be significantly associated with deaths (n= 25), vaccination status was not …

Environmental Correlates Of Physical Activity Among African-American Adults, Tim Bungum, Jennifer Pharr, Paulo S. Pinheiro, Maria Azzarelli

Nevada Journal of Public Health

The purpose of this cross-sectional study was to identify perceived environmental correlates of meeting physical activity guidelines among African-American adults living in Southern Nevada. Trained interviewers phoned potential participants who lived in the 12 zip codes of Clark County, Nevada with the highest proportions of African-American residents. Respondents (n=237) answered 52 health-related and demographic questions. Slightly less than 50% of participants met physical activity guidelines. A factor analysis procedure produced two environmental variables, neighborhood safety and environmental supports for physical activity. Age, gender and educational attainment (p<.05) predicted the meeting of those guidelines (R2=.214), while neighborhood support for physical activity, neighborhood safety, and BMI failed to do so. This finding suggests that environmental factors are not strong predictors of physical activity among African- American adults, although environmental supports for physical activity approached significance. Future studies should consider assessing additional aspects of the built environment as an influence on physical activity.

Risk Of Multiple Myeloma In Rheumatoid Arthritis: A Meta-Analysis Of Case-Control And Cohort Studies, Kaini Shen, Gufeng Xu, Qing Wu, Daobin Zhou, Jian Li

Environmental & Global Health Faculty Research

Multiple myeloma is a malignant neoplasm of plasma cells mainly affecting elderly patients. Despite the wealth of information available on therapeutic strategies, the etiology and pathogenesis of myeloma remain unclear. In the current study, a meta-analysis was conducted to assess the possible association between rheumatoid arthritis and myeloma.

Understanding Racial Hiv/Sti Disparities In Black And White Men Who Have Sex With Men: A Multilevel Approach, Patrick S. Sullivan, John Peterson, Eli S. Rosenberg, Colleen F. Kelley, Hannah Cooper, Adam Vaughan, Laura F. Salazar, Paula M. Frew, Gina Wingood, Ralph Diclemente, Carlos Del Rio, Mark Mulligan, Travis H. Sanchez

Environmental & Global Health Faculty Research

Background The reasons for black/white disparities in HIV epidemics among men who have sex with men have puzzled researchers for decades. Understanding reasons for these disparities requires looking beyond individual-level behavioral risk to a more comprehensive framework. Methods and Findings

Time To Talk: The Mental Health Of Adults In Nevada, Ramona W. Denby, Sandra D. Owens, Sarah Kern

Lincy Institute Reports and Briefs

About 11.3% of the adult population in Nevada report a past-year mental illness, with nearly 4% of them experiencing disorders serious enough to impair their functionality. Almost 13% of Nevada adults have substance abuse disorders, this is the second highest statewide substance abuse prevalence rate in the country; the District of Columbia is first at 14.7% of its population (SAMSHA, 2013). With most states (including Nevada) now increasing their mental health care budgets after years of spending cuts—between 2009 and 2012 there was a $4.35-billion drop in state mental health spending (Ollove, 2013)—pertinent questions center on needed treatment, research, and …

Effectiveness Of A Poverty Simulation In Second Life®: Changing Nursing Student Attitudes Toward Poor People, Nancy Menzel, Laura Helen Willson, Jessica Doolen

Nursing Faculty Research

Social justice is a fundamental value of the nursing profession, challenging educators to instill this professional value when caring for the poor. This randomized controlled trial examined whether an interactive virtual poverty simulation created in Second Life^® would improve nursing students’ empathy with and attributions for people living in poverty, compared to a self-study module. We created a multi-user virtual environment populated with families and individual avatars that represented the demographics contributing to poverty and vulnerability. Participants (N = 51 baccalaureate nursing students) were randomly assigned to either Intervention or Control groups and completed the modified Attitudes toward …

Culture, Caregiving, And Health: Exploring The Influence Of Culture On Family Caregiver Experiences, Jennifer Pharr, Carolee Dodge Francis, Christine Terry, Michele Clark

School of Public Health Faculty Research

Ethnic minorities are expected to experience a greater demand for family caregiving than non-Latino Whites due to their projected population growth. Although the consensus of researchers on caregiving and culture finds that the caregiving experience differs significantly among cultural/ethnic groups, the question remains as to how cultural values and norms influence the caregiver experiences. We conducted an interpretative, phenomenological qualitative analysis of focus group transcripts from four groups (African American, Asian American, Hispanic American, and European American) for cultural influences on caregiving. Data were collected in Nevada between December 7, 2009, and August 20, 2010. Thirty-five caregivers participated in this …

Hispanic Construction Workers And Assertiveness Training, Pramen Shrestha, Nancy Menzel

Nursing Faculty Research

BACKGROUND: Hispanic (Latino) construction workers experience disparities in occupational death and injury rates in the United States. The cultural value of respect for those in authority may hinder these workers from requesting safe working conditions from supervisors.

OBJECTIVE: To evaluate whether Hispanic construction workers in Las Vegas, Nevada found assertiveness training more useful than non-Hispanic trainees and whether or not they practiced this behavior at work after the training.

METHODS: An assertiveness training simulation was part of fall prevention classes offered to area construction workers. Eight weeks after the training, participants were interviewed by telephone about class topics they found …

Runner Identity And Sponsorship: Evaluating The Rock ‘N’ Roll Marathon, Nancy L. Lough, Jennifer Pharr, Jason O. Owen

Environmental & Global Health Faculty Research

The economic value of participation sport has been reported to eclipse spectator sport significantly. However, scholars have acknowledged the relative lack of research on this important segment of the sport market. The purpose of this study was to analyze the relationship between runner identity and race sponsor effectiveness. Surveys were sent to participants in the Las Vegas Rock ‘n’ Roll Marathon. The survey was constructed to measure runner identity, and sponsor effectiveness as interpreted through rates of recognition, recall and purchase intention. Runners were divided into three groups based on their runner identity score. Of the predictive variables, only runner …

An Introduction: Quantification Of The Hippocampal Bdnf Content Of Maternally Separated Rats Using A Western Blot Protocol, Bernajane M. Palisoc, Laurel M. Pritchard, Emily Hensleigh

McNair Poster Presentations

Among industrialized nations, the United States has the worst incidence of child maltreatment with 3 million cases per year (U.S. Department of Health and Human Services, 2012). Studies have shown that individuals who were maltreated when they were young are more susceptible to drug abuse such as alcohol, cocaine, and nicotine (Maddahian, Newcomb, & Bentle, 1988). Early life stress (ELS) causes hyperactivation of the Hypothalamic-Pituitary- Adrenal (HPA) Axis (Heim et al., 2000; Plotsky et al., 2005). The dysregulation of the HPA axis causes the secretion of glucocorticoid stress hormones by large amounts, which in return attenuates hippocampal Brain-derived neurotrophic factor …

Commercial Sexual Exploitation Of Teens, Tamieka Meadows, Alexis Kennedy

McNair Poster Presentations

This research explores whether commercially sexually exploited children (CSEC) abuse drugs or face greater histories of abuse than their delinquent peers. This research will evaluate whether girls who are CSEC victims experience more abuse of drugs or experience more physical, emotional, or sexual abuse. The study also explores whether CSEC victims witnessed more abuse than non-CSEC victims. A survey of needs and issues facing delinquent girls was given to 130 girls between the ages of 13 to 18. Questions asked about their drug use, abuse history, and whether they witnessed abuse. This research found that many girls who are CSEC …

Staying Together: The Journey Of Healing After Infidelity, Jennifer Bolick, Stephen Fife

McNair Poster Presentations

Relationships are an important aspect of a fulfilling life. They can bring joy and pleasure or pain and devastation. One of the most detrimental issues within the context of committed relationships is infidelity, and subsequently it is one of the most prevalent issues seen in therapy. Although it is a common presenting problem in couples therapy, research on the treatment and healing of infidelity is limited. A majority of the literature is focused on the clinician’s point of view rather than the couples’ perspective. The purpose of this study is to present the results of a qualitative study of eight …

Pre-Traumatic Factors Of Career-Related Ptsd: A Systematic Review Of The Literature, Michael G. Curtis, Russell T. Hurlburt

McNair Poster Presentations

This paper examined and synthesized the (limited) available literature on the pre-traumatic predictors of PTSD, specifically targeting populations in which traumatic events are experienced frequently because of the requirements of their positions, i.e., firefighters, police, and military personnel. A total of 21 articles were included in the final literature review and were used to assess the current available knowledge of the pre-traumatic traits of career-related PTSD, and address potential gaps in the literature. The culmination of this research was used to create specific risk profiles for each of the high risk careers included in this review, firefighters, police, and military …

Effects Of Anti-Inflammatory Foods On Hyperglycemia In Type-1 Diabetics, Primrose Martin, Michelle Chino

McNair Poster Presentations

Based on a case study administered by Dr. Charlotte Gerson, an IDDM patient referred to as R.H. reversed hyperglycemic symptoms within ten weeks while adhering to a diet of mainly vegetables and some low-glycemic index fruits. R.H. also ingested mineral supplements and underwent multiple coffee enemas each day (Gerson & Bishop, 2007, p. 56). This self-study hypothesizes that diet alone has a positive correlation coefficient with hyperglycemic blood glucose levels in type-1 diabetics (IDDM). Conducting this self-study contributes information to the limited research and database of alternative methods for managing IDDM hyperglycemia, and provides candid documentation of the effects that …

Ambulatory Extracorporeal Arterioveous Co2 Removal Via Subclavian Vessels, Alejandra Macias, Alvaro Rojas-Pena

McNair Poster Presentations

Lung transplantation is the last recourse for patients with severe respiratory failure. However, transplantable lungs do not keep up with the demand, and 15.4% of patients die awaiting transplant. An alternative therapy is extracorporeal life support (ECLS), which uses a pump and an oxygenator to serve as a bridge to transplant. However, this technology limits ambulation and requires ICU care. This novel study implements pumpless arteriovenous (AV) ECLS technology to remove CO2 via the subclavian vessels, providing respiratory support and hypercapnia (excessive CO2 retention) sympton relief for patients while allowing ambulation.

Correlates Of Gambling Disorder, Brittaney Benson-Townsend, N. Clayton Silver

McNair Poster Presentations

Gambling disorder is an addictive behavior in which valuables are wagered in neglect of financial losses and delusions of financial gain. To predict problem gambling behavior, a survey of Machiavellian personalities, money attitudes, and impulsive/compulsive buying behavior was administered to 410 students at UNLV. The results suggested that disordered gambling behavior may be predicted by Money Status scores. Specifically, amorality, money worship, and money vigilance were significant in predicting African-American pathological gambling. For Asians, only money vigilance loaded significantly.

A Computational Perspective Of Schizophrenia, Ernesto H. Bedoy, Geoff Powell, Jefferson Kinney

McNair Poster Presentations

The etiology of schizophrenia remains largely elusive, thus dampening the effectiveness of current treatment strategies. Abnormal neural migration and neurogenesis in the hippocampus have been suggested to be involved in schizophrenia (Jakob & Beckmann, 1994). A few approaches, including computational modeling, have investigated schizophrenia as a network disorder. Computational modeling uses mathematics to predict the behavior of biological systems based on the input of a set of parameters collected from laboratory experiments. In this study, we constructed a computational model to explore the ramifications of additional PV neurons migrating to an aberrant location in the hippocampus and interfering with a …

Economic Impact Of Medical Education Expansion In Nevada: Economic Impact Assessment And Recommended Approach, Tripp Umbach

Lincy Institute Reports and Briefs

In May 2013, The Lincy Institute1 commissioned, Tripp Umbach2 to prepare an economic impact report to show the value of a new, four-year allopathic medical school (hereinafter referred to as the new four-year medical school) in Las Vegas. To accomplish this task, Tripp Umbach evaluated multiple medical school development models in order to recommend the optimal model that would provide the greatest economic impact to the state of Nevada and the Las Vegas Metropolitan area.

3-D Oropharyngeal Airway Analysis Of Different Antero-Posterior And Vertical Craniofacial Skeletal Patterns In Children And Adolescents, Chi Kim Huynh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sleep apnea disorder has recently emerged as a significant public health issue. While the prevalence of obesity is on the rise among children, it is one of the main risk factors associated with apnea. Upper airway dimensions and morphology seem to be major components of obstructive sleep apnea (OSA) and can be affected by different craniofacial patterns. The purpose of this retrospective, cross-sectional pilot study is to correlate gender, Body Mass Index, risk for OSA, neck circumference, and 3-D oropharyngeal airway dimensions in children and adolescents with different antero-posterior (AP) and vertical craniofacial skeletal patterns. A total of 86 pre-orthodontic …

New Mouthguard Design With Intermediate Nickel-Titanium And Foam Layer, Freddie Martinez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Mouthguards help prevent orofacial injuries in many physical activities, commonly to the maxillary incisors. Mouthguards have many different properties which can be idealized. One property involves the amount of impact force the mouthguard can dissipate, commonly referred to as shock absorption. The aim of this study was to improve shock absorption capabilities beyond the protection that a mouthguard made of Ethylene Vinyl Acetate (EVA) can offer. A Nickel-Titanium (NiTi) and/or foam intermediate layer was placed between EVA. Seven configurations were fabricated at 3 different thicknesses. The configurations consisted of an intermediate layer composed of NiTi, foam, or NiTi/foam. The NiTi …

Developing Ethical Competence: The Perspective Of Nurse Educators From Pre-Licensure Baccalaureate Nursing Programs Accredited By The Commission On Collegiate Nursing Education, Jennifer Lee Bartlett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurses face ethically-charged situations every day, yet ethics education is not universally integrated into pre-licensure baccalaureate nursing programs. Like other forms of competence, ethical competence requires development. Nurse educators are poised to impact on the competence of their students, both defining the ethics content and designing students' exposure. The purpose of this study is to describe the concept of ethical competence from the perspective of baccalaureate nursing faculty and describe current methods of integration and evaluation of ethics education in pre-licensure baccalaureate nursing programs. This research will be conducted using a sequential (quantitative-qualitative) mixed method approach. The first phase of …

The Lived Experiences Of Acute-Care Bedside Registered Nurses Caring For Patients And Their Families With Limited English Proficiency, Jami-Sue Coleman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Approximately 8.6% of the total U.S. population is considered limited English proficient (LEP), a term that has been used by official US federal policy and will be used throughout this study. In a landmark report, the Institute of Medicine found that minorities received lower-quality health care than Caucasians even when insurance status, income, and other factors were equivalent. These differences were tied to issues such as bias, stereotypes and communication barriers between patients and their caregivers. In the hospital setting, registered nurses provide the most direct contact with patients and their families. Effective communication between patients and health care professionals …

What Works In Suicide Bereavement: What Helps And What Hurts?, Quintin Hunt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Suicide is one of the most painful grief experiences that any family may experience. The suicide bereavement literature, though small, is replete with research that shows family and systemic impacts of suicide. The literature also includes constant calls for family- and systemic-based intervention as every part of society is impacted. Research in the field of marriage and family therapy, however, has ignored suicide and suicide bereavement almost entirely. The purpose of this qualitative study is to develop a more thorough understand of the grief that survivors of suicide experience and to systemically understand what helps and hurts the grieving process. …

Examining The Inner Experience Of Four Individuals With Bipolar Disorder Using Descriptive Experience Sampling, Johanah Kang

UNLV Theses, Dissertations, Professional Papers, and Capstones

Bipolar disorder is a lifelong mood disorder with diagnostic criteria that provide a description of expected experiences of individuals diagnosed with BD (e.g., elevated mood, sadness, difficulty concentrating). Despite these criteria, the inner experience of these individuals is largely unknown. Understanding the inner experience of individuals diagnosed with BD may prove essential in understanding and treating BD. The present study examined the inner experience of four individuals diagnosed with BD using the Descriptive Experience Sampling (DES) method (Hurlburt 1990, 1993, 2011). Results revealed all our participants had clear and prevalent experiences of sensory awareness. They also had difficulties apprehending and …

Factors Associated With Parental Decision Making And Childhood Vaccination, Zuwen Qiu-Shultz

UNLV Theses, Dissertations, Professional Papers, and Capstones

In order to better understand factors affecting immunization status, logistic regression was used to assess the association of various socio-demographic factors and whether parents would have their child immunized if not a state mandate. Factors included in the study were race, household income, number of children in the household, number of adults in the household, if the child had a primary provider, if the child had a health check-up in the last twelve months, and medical insurance status of the child. The combined Nevada Kindergarten Health Survey Result of 2009-2010 (Year Two) and 2010-2011 (Year Three) conducted by the Nevada …

Sex Determination Using Discriminant Function Analysis In Hispanic Children And Adolescents: A Lateral Cephalometric Study, Alyssa E. Sprowl

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lateral cephalometric radiographs have been used for years to help diagnose skeletal and dental patterns in Orthodontics. Within the last decade, these radiographs have caught the interest of the department of Anthropology for the identification of gender within the adult and adolescent population. Numerous publications have been made but failed to identify sexual dimorphism in the pre-adolescent population. 303 lateral cephalograms of pre and post Latino adolescence age ranging from 6.5 to 17.9 years old were obtained from University of Nevada, Las Vegas (UNLV) digital database. 25 variables were identified and plotted with all linear and angular measurements transferred into …

The Effect Of Marriage On Stage At Diagnosis And Survival In Women With Cervical Cancer, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Marriage is associated with improved health outcomes for many conditions. Married persons enjoy financial stability, social and emotional support, and tend to have better control of health risk behaviors compared to the unmarried. The marriage scene is changing continuously. Americans are marrying less or delaying the engagement to an older age. They are divorcing more, they choose cohabitation as an alternative to marriage, or engage in premarital relationships. As a consequence, barely half of Americans were married in 2011 compared to close to three quarters of Americans were married in the sixties. With the increase of the unmarried population - …

From (Un)Willingness To Involvement: Development Of A Successful Study Brand For Recruitment Of Diverse Msm To A Longitudinal Hiv Research, Paula M. Frew, Victoria A. Williams, Eve T. Shapiro, Travis Sanchez, Eli S. Rosenberg, Vincent L. Fenimore, Patrick S. Sullivan

Environmental & Global Health Faculty Research

Background. HIV continues to be a major concern among MSM, yet Black MSM have not been enrolled in HIV research studies in proportionate numbers to White MSM. We developed an HIV prevention research brand strategy for MSM. Methods. Questionnaires and focus groups were conducted with 54 participants. Descriptive statistics and chi-square analyses were performed and qualitative data were transcribed and content analyzed to identify common themes. Results. Formative research results indicated that younger Black MSM (18–29 years) were less likely to think about joining prevention studies compared to older (≥30 years) Black MSM (, ). Qualitative and quantitative results indicate …