Medicine and Health Sciences Commons^™

Recruitment Of African Americans For Obsessive Compulsive Disorder Treatment Research, Georgia Michalopoulou, Pamela Falzarano, David Rosenberg

Journal of Health Disparities Research and Practice

A systematic review of recruitment approaches was conducted as a step towards creating a culturally sensitive approach to enhance participation of African Americans into our Obsessive Compulsive Disorder (OCD) treatment research. From this review, a recruitment plan providing a collaborative partnership between the African American community and the clinical investigators was adopted. We sought to increase participation in OCD research by developing culturally sensitive educational materials, implementing strategies such as recruiter ethnic match, encouraging individuals to participate by a pastor, and providing education in the community that attempted to decrease stigmatization of mental illness and target cultural suspicion of institutional …

Inflammatory Biomarkers And Subclinical Atherosclerosis In African-American Women With Systemic Lupus Erythematosus (Sle), Edith Williams, Carlos Crespo, Joan Dorn

Journal of Health Disparities Research and Practice

Women with lupus are at increased risk for developing cardiovascular disease (CVD). Previous studies of atherosclerosis in SLE have not been representative of the minority groups most affected by lupus and its complications. Therefore, a study of 41 lupus cases and 83 controls was conducted to investigate the relationship between carotid atherosclerosis and inflammation in African-American women. Participation consisted of a questionnaire, physical examination, fasting blood draw, and ultrasound of the carotid arteries. There were observed differences between cases and controls with regard to carotid intima media thickness (IMT) and traditional cardiovascular risk factors, although few reached statistical significance. Tumor …

Association Of Vitamin D Deficiency With Hypertension In Uninsured Women, Sreenivasa R. Chandana, Lakshmi P. Kocharla, Susan S. Harris, Radhika R. Kakarala

Journal of Health Disparities Research and Practice

Vitamin D deficiency is an epidemic in the United States. Uninsured women are at high risk due to a lower intake of vitamin D and limited sun exposure. We examined the association between vitamin D deficiency and hypertension in 96 uninsured women at a County Free Medical Clinic in urban Michigan. Questionnaires were used to obtain information about demographics, medical history including hypertension, and dietary habits. Measurements including blood pressure and serum 25(OH)D level were also collected. Prevalence of hypertension was higher in subjects with 25(OH)D less than 50nmol/l compared with others (85% vs. 27.3%, p = 0.014). For every …

Stop Atherosclerosis In Native Diabetics Study (Sands): Baseline Characteristics Of The Randomized Cohort, Angela Silverman, Chun-Chih J. Huang, Marie Russell, Mihriye Mete, Mary J. Roman, Mario Stylianou, Elisa T. Lee, Fawn Yeh, Jerome Fleg, Charlton Wilson, Jeffrey A. Henderson, Matthew R. Weir, Robert E. Ratner, Barbara V. Howard

Journal of Health Disparities Research and Practice

Objectives: To present baseline characteristics of American Indians in the Stop Atherosclerosis in Native Diabetics Study (SANDS) and compare them with population-based data from American Indians and other ethnic groups. Design: 499 people with type 2 diabetes ≥ age 40, without known CVD, were recruited for a randomized 3-year trial to evaluate treatment targets for LDL-C (70 vs. 100 mg/dL) and systolic blood pressure (BP) (115 vs. 130 mmHg). Baseline evaluations included physical exam, collection of blood and urine samples, and carotid ultrasound and echocardiographic measures. Results: Mean age was 56 years; 66% were female. Average BMI was 33 kg/m2. …

Race/Ethnicity As A Risk Factor Of Mother To Child Transmission Among Hiv Infected Mothers, Wei Yang, Fares Qeadan, Mona L. Brown, Michelle Chino, Scott Hall, Mary Guinan

Journal of Health Disparities Research and Practice

Objectives: African American women, living with HIV, exhibit a higher percentage of giving birth as compared to other race/ethnicity groups. The aim of this study is to understand the apparent black and non-black differences (health disparities) among the HIV Infected Mothers group and examine whether race/ethnicity can explain the high variation in different prenatal and HIV mother-to-child-transmission (MTCT) risk factors.

Methods: Data-Linkage was conducted on all women HIV+ cases, who delivered a child during the time period and reported to the Nevada state HIV with the live birth registries. Demographic and social data, separated into black and Non-black groups, were …

A Human Capital Approach To Reduce Health Disparities, Saundra Glover, Sudha Xirasagar, Yunho Jeon, Keith Elder, Crystal N. Piper, Harris Pastides

Journal of Health Disparities Research and Practice

Objective: To introduce a human capital approach to reduce health disparities in South Carolina by increasing the number and quality of trained minority professionals in public health practice and research.

Methods: The conceptual basis and elements of Project EXPORT in South Carolina are described. Project EXPORT is a community based participatory research (CBPR) translational project designed to build human capital in public health practice and research. This project involves Claflin University (CU), a Historically Black College University (HBCU) and the African American community of Orangeburg, South Carolina to reduce health disparities, utilizing resources from the University of South Carolina (USC), …

Supervised Lower Extremity Strengthening Program To Improve Function In Women Over Fifty With Knee Osteoarthritis: A Time Series Design, Janelle Brooke Lemons, Diane Christine Sheesley, Pamela Reagan Sutton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Develop a simple, self-paced lower extremity strengthening program incorporating functional activities for women over the age of fifty to reduce limitations associated with knee OA.

Study Design: This was a pilot study utilizing a time series design with 8 women aged 55-65 (M + SD = 60 + 3) meeting the American College of Rheumatology's criteria for clinical diagnosis of knee OA.

Background: Lower extremity weakness in women with knee osteoarthritis is associated with pain and functional limitations.

Methods and Measures: Subjects began the 14-week program with 2 weeks of baseline treadmill walking. The following 12 weeks were divided …

Exercise-Induced Neuroprotection In A Hemiparkinsonian 6-Hydroxydopamine Rat Model, Merrill Russen Landers

UNLV Theses, Dissertations, Professional Papers, and Capstones

Outside of finding a cure, one of the preeminent goals of research in Parkinson's disease (PD) is finding a neuroprotective treatment that when applied prior to the onset of the disease will decrease the risk and severity of the subsequent disease. One such treatment that has potential as a neuroprotective agent in PD is exercise. Several studies have found forced exercise to be protective of Parkinson's disease in adult rodent models; however, few of these studies have used a design wherein voluntary exercise was evaluated. Moreover, no study has used a true neuroprotective design in which exercise was applied prior …

Provider Variations In Cesarean Section (Cs) And Vaginal Birth After Cesarean (Vbac) Practice, Rita Elizabeth Marrero

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Centers for Disease Control and Prevention's National Center for Health Statistics (2010) report that nearly one-third of babies were born by Cesarean section (CS) in 2007. Of interest, six states, including Nevada, experienced increases of more than 70% in the last 10 years (CDC, 2007). Based on the increased rate of CS deliveries, the National Institutes of Health (NIH) convened a consensus panel in 2010, which urged the medical community to reduce barriers to women who want to try a vaginal birth after Cesarean delivery (VBAC) in the hope this would safely decrease the total CS rate. For clinicians …

Modeling The Effects Of Substance Dependence On General Self-Reported Health Using Nominal Regression, Taylor Moseley

UNLV Theses, Dissertations, Professional Papers, and Capstones

The goal of this research project was to produce a model of the effects of drug dependence on general self-rated health. Due to power issues, two additional models, one for cocaine and one for heroin, were required. The models used data from the 2005-2009 National Survey on Drug Use and Health. The result of this effort was a ranking of the effects of drug dependence on general health for individuals and for the study population. The model controlled for infectious, chronic and mental illness as well as sociodemographic variables. Significantly increased odds ratios were found for alcohol, marijuana, analgesics, and …

Program Evaluation Of Stroke In Rural Nevada Hospital, Starla Cheri Ricks

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall goal of this Doctor of Nursing Practice (DNP) scholarly project is to complete a program evaluation using the Centers of Disease Control (CDC) Framework for Program Evaluation to measure the effectiveness of a stroke protocol in a rural Nevada hospital. This (DNP) scholarly project evaluates program strategies over third and fourth quarters of 2010 as well as the first, second, and third quarters of 2011, that have been initiated to reduce the burden of neurological disease with the application of a stroke protocol that complies with defined evidence-based strategies for assessment and management of stroke victims. As part …

Using Negative Feedback To Guide Behavior: Impairments On The Wisconsin Card Sorting Test Relates To Psychosis, Sally Barney

UNLV Theses, Dissertations, Professional Papers, and Capstones

There is increasing controversy regarding the distinction between schizophrenia and bipolar disorder as separate diagnostic categories because these disorders share many features in common. These and other findings suggest that bipolar disorder and schizophrenia may be better conceptualized along a continuum or within more homogeneous subsets of affective, psychotic, and mixed symptomatology.

Dopamine dysregulation has been found in schizophrenia and bipolar disorder, particularly those that experience psychosis during the acute phases of their bipolar illness. Dopamine has been found to play a role in reward and reward learning. Recently, research has found that individuals with schizophrenia experience deficits in reward …

Increasing Labor And Delivery Nurse Knowledge Of Triaging Non-Obstetrical Medical Emergencies In Pregnant Women Through The Use Of Simulation, Julie Hoffman

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to evaluate the effect simulation training has on an OB nurse's ability to correctly triage pregnant patients. Registered Nurses (RNs) working in OB triage must be able to correctly and expediently identify the care a pregnant patient needs. OB triage nurses are trained to recognize pregnancy related issues that commonly present during the months leading up to delivery. It is as important for these nurses to have the skills to realize when a pregnant patient is having a non-obstetrical health crisis. A group of OB triage RNs participated in simulation-training scenarios based on non- …

Variables Associated With Critical Illness Among Clark County Residence Hospitalized With H1n1 Influenza A Virus During The 2009 Influenza Season., Jonathan P. Hyatt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background:In 2009, a novel H1N1 Influenza A virus was detected in the population. Because it can potentially affect a different population than the influenza strains circulating for the past 35 years, it is critical for physicians, practitioners and public health organizations to understand who is susceptible to this disease, and which sub-populations are most likely to suffer critical illness. The objective of this study was to examine the factors unique to 2009 H1N1 infection, with the goal of finding the variables associated with ICU admission (Critical Illness) in the Clark County 2009 H1N1 patient.

Methods:Factors that were assessed in this …

Clinical Practice Guidelines For Primary Care Providers' Evaluation Of Patient Fitness To Fly, Kerry Colleen Palakanis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Commercial air travel is amongst the safest forms of transportation yet the environment within the aircraft cabin to which the passenger is exposed may have adverse physiological and psychological effects on passengers, especially for those with pre-existing medical issues. A comprehensive, systematic review and analysis of current literature was performed to develop evidenced-based guidelines for evaluation of passenger fitness to fly for integration into primary care practice. Recommendations from the most current fitness to fly guidelines and disease-specific published research related to in-flight medical issues were evaluated and the Grades of Recommendation Assessment, Development and Evaluation (GRADE) method was utilized …

Descriptive Experience Sampling Interactive Multi-Media Training Tool For Subjunctification And Illustrative Interviews, Stacy Lynne Reger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Modern experience sampling methods attempt to understand the phenomenology of inner experience through a variety of methods, including questionnaires, diaries, and verbalization of ongoing cognitive processes. The goal of such studies is to minimize potential roadblocks to accessing inner experience, such as retrospective recall, memory failures, and bias. The current project focuses on one such method, Descriptive Experience Sampling (DES). DES is an idiographic, exploratory, and ecologically valid method of studying inner experience. In this method, participants wear a beeper with an earphone that emits a random beep. When the beep sounds, the participant is to write down notes about …

The Acute Effect Of Endurance Exercise On Lipoproteins Measured By Nuclear Magnetic Resonance (Nmr) In Healthy Men, Hanaa Adnan Shaheen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cardiovascular disease (CVD) represents a major cause of death in the United States, with abnormal levels of blood lipids and physical inactivity considered as major modifiable risk factors. The conventional lipid profile has been used to assess for CVD risk by directly measuring the concentrations of blood lipids. However, lipoprotein particle size and number obtained from a novel method, Nuclear Magnetic Resonance (NMR) may also asses for CVD risk with greater sensitivity. Exercise and increased physical activity has been shown to produce favorable effects on blood lipids and consequently reduce CVD risk. To understand this effect, it is important …

Retrospective Evaluation Of Oral Health Services For Underserved Children In Clark County, Nevada, Earl Taylor Spader

UNLV Theses, Dissertations, Professional Papers, and Capstones

Disparities in utilization of oral health services have been shown to exist through epidemiological investigations and data analysis. Specifically, disparities exist for utilization of preventative dental care (PDC) and unmet dental need (UDN). The disparities in utilization of PDC and UDN are associated with demographic and insurance variables.

To address the oral health disparities, the University of Nevada, Las Vegas-School of Dental Medicine (UNLV-SDM) was created to improve the health of the citizens of Nevada through innovative programs of oral healthcare services to the community. More recently, UNLV-SDM opened a pediatric dental residency training program to provide care directly to …

Use Of Continuous Glucose Monitors In Type-1 Diabetes: An Analysis Of Wave Form Versus Glycemic Values In The Improvement Of Glucose Control And Fear Of Hypoglycemia, Tomas Charles Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Type-1 diabetes is a disease of subtle complexities. Patients struggle to understand glucose patterns and their responses to insulin or food intake while maintaining hectic lifestyles. Minor misjudgments in treatments can result in disastrous consequences with significant hypo- or hyperglycemic excursions.

Despite improvements in technologies available for diabetes management, including home monitoring of blood glucose, more predictable insulin therapies, and improved insulin delivery via insulin pump, the average HbA1c has remained relatively unchanged. Poor diabetes control is recognized as contributing to long-term diabetes comorbidities including neuropathy, nephropathy, retinopathy, and micro- and macrovascular disease.

Real-time continuous glucose monitors, such as the …

Attentional Focus During Balance Training In Idiopathic Parkinson’S Disease (Pd): A Randomized Clinical Trial, Alyssa Davis, Rebecca Hatlevig, Amanda Richards, Leslee Rosenlof

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to compare the effects of various attentional focus strategies on balance in people with PD. Forty-nine adults with idiopathic PD were randomized into one of four groups (internal focus, external focus, no focus, and control). The three intervention groups participated in a month-long balance program. The outcomes measured were the Sensory Organization Test, Berg Balance Scale, self selected gait velocity, Dynamic Gait Index, Activities-specific Balance Confidence Scale and obstacle course completion time. These outcomes were measured at baseline, post intervention, 2-weeks post intervention, and 8-weeks post intervention. Statistical analyses yielded no significant differences among …

Active Recovery And Electro-Muscular Stimulation On Delayed Onset Muscle Soreness After Endurance Running: A Randomized Clinical Trial, Amanda J. Gramly, Kitrick C. Rhodes, Andrea F. Smith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/Purpose: Current research on strategies to decrease delayed onset muscle soreness (DOMS) has focused on the effects of active and passive recovery on athletic performance across various sports, but there is little evidence regarding these recoveries at reducing DOMS induced by aerobic activities, such as running. In addition, there is limited research regarding the efficacy of recovery using electro-muscular stimulation (EMS). Therefore, the purpose of this study was to investigate the effects of active and EMS recovery in decreasing DOMS. Subjects: Forty-eight healthy subjects (25 males and 23 females) between the ages of 20 and 40 (25.1 ± 2.9) participated. …

Population-Based Survey Of Lumbar Surgery Beliefs In The United States, Amanda Elyse Mccauley, Zachery Clark Rasmussen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Studies have shown that poor lumbar surgery outcomes may be influenced by a person’s preconceived perceptions of low back surgery (LBS). However, the perceptions of the general population about issues related to lumbar surgery are not known. Therefore, the purpose of this study was to investigate the general population’s perceptions regarding LBS.

Number of Subjects: This study included 262 participants (Average age: 46.1, SD=16.9; 125 Males, 137 Females) who completed the questionnaire from the general population in the Las Vegas area.

Materials/Methods: Questionnaire development involved expert panel feedback from three physical therapists, three spine surgeons, two surgeon assistants/nurses, two …

Therapist Characteristics Influencing Physical Therapy Non-Treatment In The Acute Care Setting, Daniel Mcgarvey, Colby Olsen, Aaron Van Wagoner

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Research has found that participation in physical therapy (PT) services in the acute care setting increases functional outcomes and decreases patient length of stay. Certain physical therapist characteristics could be a potential source of influence on patient non-participation in physical therapy in the acute care setting. The purpose of this study was to determine whether specific characteristics of therapists and patients are predictive of physical therapy non-treatment.

Subjects: Subjects included 16 physical therapists or physical therapist assistants and 1225 patients at a community acute care hospital.

Methods: Characteristics of each therapist and their corresponding patient data were …

Foot Volume Change During Long Distance Running In Healthy Adults, Meghan Boni, Istvan Takacs, Rebecca Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and purpose: Healthy adults frequently engage in running as a means of cardiovascular exercise. Larger running shoes are often chosen based on common beliefs that feet swell during running, yet many continue to encounter foot injuries, such as blisters, as a result of this activity. Previous research has analyzed the changes in foot volume during short bouts of activity. However, there has been limited research on the effect of long distance running on foot volume, which is where many of these injuries are seen. The purpose of this study was to examine the effects of long distance running, defined …

Duration Of The Effects Of Three Static Stretching Conditions With Or Without A Dynamic Warm-Up In College Age Adults, Spencer Blackwell, Andrew Blomberg, Jonathan Griffith

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose. The purpose of this study was to determine the stretching duration (15, 30, 60 seconds) with or without a dynamic warm-up that resulted in the longest lasting acute effects in hamstring flexibility.

Subjects. Forty subjects (17 male, 23 female) (age: 20-35 years) were selected to participate in this study using a sample of convenience from university graduate students.

Methods. This study contained 7 treatment conditions in which each subject completed in random order. Three groups consisted of a 5-minute treadmill warm-up at a self-selected velocity (SSV) followed by one of three stretching durations (15, 30, or 60 sec). …

The Relationship Between Self-Efficacy And Fluid,And Dietary Compliance In Hemodialysis Patients, Ansy Paul John

UNLV Theses, Dissertations, Professional Papers, and Capstones

Patients with end-stage renal disease (ESRD) who receive hemodialysis often fail to follow a prescribed diet and fluid regimen, which undermines the effectiveness of care and leads to unpredictable disease progression and greater likelihood of complications. Non-adherence to dietary and fluid limitations compromises the outcomes of patients receiving hemodialysis. Noncompliance can lead to detrimental long-term outcomes including deterioration of the cardiovascular system, heart failure, hypertension, and pulmonary edema as well as short-term problems such as edema, itching, bone pain, and breathlessness.

Many studies have demonstrated that self-efficacy strategies are associated with improved dietary and fluid compliance among individuals receiving hemodialysis. …

Nutritional Management Of The Extremely Low Birth Weight Infant: An Evidence Based Clinical Practice Guideline, Dana J. Lunde

UNLV Theses, Dissertations, Professional Papers, and Capstones

Premature birth has risen steadily over the last decade resulting in an increased number of infants needing neonatal intensive care. The demand for neonatal intensive care has lead to many improvements in the delivery of such care with an increase in the survival of the smallest and most premature infants. However, most of these infants are being discharged from neonatal intensive care units (NICU) with severe extrauterine growth restriction (EUGR).

Extremely low birth weight (ELBW) infants born at 23-27 weeks gestation and who have a weight of less than 1,000 grams are at the highest risk for EUGR because of …

Kinesio Taping On Short-Term Changes In Shoulder Strength In Healthy Adults: A Randomized Clinical Trial, Dario A. Callegari, Cristobal E. Cordova, Julia R. Dunievitz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Study Type: A Randomized Clinical Trial

Introduction:

Kinesio tape is an elastic tape used in various settings and it is purported to assist in strengthening weakened muscles. The mechanism behind this claim is neuromuscular facilitation. The purpose of this study was to determine if the claims of Kinesio tape would be supported in its role in strength enhancing properties.

Methods:

Twenty-nine healthy, untrained male and female college-aged individuals participated in this study. Two baseline measurements assessing shoulder external rotation (ER) strength were collected using isokinetic dynamometry. Subjects were then randomized into two groups, Kinesio tape with ER strengthening (KT-Ex) and …

Elementary School Based Health Centers As Providers Of School Entry Health Exams: Do They Meet The Standards?, Roberta Bavin

UNLV Theses, Dissertations, Professional Papers, and Capstones

The health of today's children is crucial for the future of our society. There are many children without access to healthcare in these turbulent economic times; times that are increasingly uncertain as society maneuvers its way through the maze of healthcare reform. School based health centers (SBHCs) provide a safety net for children needing basic healthcare who are otherwise underserved. School entry health examinations (SEHE) are legal requirements in many states, and are a proven method for identifying health conditions early enough in a child's life that they can be corrected. Treating identified health conditions facilitates academic success for children, …

The Use Of A Pylon Mounted Transducer For Investigating The Gait Of Transtibial Amputees, Justin Robert Brink

UNLV Theses, Dissertations, Professional Papers, and Capstones

Two areas of research interest in the design and use of lower limb prosthetic devices are how foot performance varies with design and how prosthesis alignment affects gait. The current study addressed both of these areas through the use of the JR3 triaxial transducer mounted at the base of the socket. The transducer is an innovative form of instrumentation that measures forces and moments at the end of the socket. Traditional measurement of gait uses a force plate buried in the floor of a gait laboratory. The study established that the transducer offers a viable means of instrumentation for amputee …