Medicine and Health Sciences Commons^™

Program Evaluation Of Preceptor Preparation And Effectiveness In A Local Nurse Residency Program, Margaret Covelli

UNLV Theses, Dissertations, Professional Papers, and Capstones

Preceptors are vital to the success of new graduate registered nurses in their transition to practice as they assist the new nurse in developing skills, competency, and confidence. Most residency programs may include training for preceptors but there may not be evidence that preceptor preparation makes a difference in the retention of nurse residents or the relationship to favorable evaluations of preceptors from the residents. This study evaluated and compared the effects of preceptor training on competency levels of the resident and therefore retention.

The methodology was a post hoc descriptive study of variables that included demographics, surveys from residents …

An Investigation Of The Role Of Gabab Ligands On Cued And Contextual Fear Conditioning, Chelcie F. Heaney

UNLV Theses, Dissertations, Professional Papers, and Capstones

GABA is the primary inhibitory neurotransmitter in the brain and mediates several processes, including learning and memory. Activating or inhibiting GABA receptors allows for the examination of the effects of altered GABAergic signaling on these processes. The two main receptors, GABAA and GABAB, each have a different mechanism of action when activated, thus they may contribute differentially to learning and memory. The metabotropic GABAB receptor responds with the activation of several intracellular signaling cascades, which provide long-lasting inhibitory effects that primarily mediate network function. Conversely, the GABAA receptor is an ion channel that contributes more immediate inhibitory effects through the …

Why Access Barriers To Primary Care Exist For People With Mobility Disabilities: A Mixed Methods Study Of Health Care Administrators, Jennifer Renee Pharr

UNLV Theses, Dissertations, Professional Papers, and Capstones

Previous studies have been conducted to assess the barriers that limit access to health care services for people with disabilities. However, no study has been conducted to understand why barriers exist. Do practice administrators lack knowledge of the Americans with Disabilities Act (ADA) or is cost the issue? The purpose of this study was to examine why structural and equipment barriers exist that limit access to primary health care for people with disabilities.

A convergent parallel mixed methods design was employed. Practice administrators were selected for this study because of their oversight of the budget, equipment purchasing, facility operations and …

Effects Of Hyperthermia On Photochemical Internalization-Mediated Delivery Of Bleomycin, Christina Schlazer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Standard treatment protocols for high-grade gliomas, such as glioblastoma multiforme (GBM), are highly ineffective due to their inability to eradicate infiltrating tumor cells. Improvements in overall survival are likely to be realized only with the development of more effective localized therapies capable of eradicating tumor cells in the surgical resection margin and beyond. Photochemical internalization (PCI) is a localized light-based therapeutic modality that enhances the efficacy of therapeutic macromolecules including chemotherapeutic agents such as bleomycin. A number of studies have shown that this photodynamic therapy (PDT) - based modality may prove effective in the treatment of high-grade gliomas.

Three-dimensional multicell …

Cultural Competence In The Baccalaureate Degree Nursing Curriculum, Angela Elizabeth Silvestri

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." In the past 10 years, minority populations have increased in the U.S. For example, the African American population experienced an approximate 12.3% increase, and the Hispanic population increased by 43%. Just as it is necessary for health care professionals to respond to the increase in …

Improving Evidence Based Asthma Management In An Urban University Student Health Center, Hedian Cho Swanson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this project was to improve asthma management through focused staff education and training on national asthma guideline recommendations. The Student Health Center (SHC), located in a university in the southwest United States, performed annual reviews of asthma-related electronic medical records (EMR) in an effort to provide quality health care. These reviews used 23 quality improvement (QI) parameters extracted from the 2007 National Asthma Education and Preventive Program Expert Panel Report 3 (NAEPP EPR 3). The SHC QI findings were consistent with current asthma management literature indicating asthma control is often overestimated and undertreated. This project (a) provided …

Perceptions Of Barriers That Inhibit African American Women And Adolescent Girls From Participation In Physical Activity, Sonya Daniels Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study examined the barriers to leisure time physical activity for African American women and their adolescent daughters. Six mother-daughter dyads were interviewed who have access to physical activity opportunity. Three of the dyads participated in a follow-up focus group. A qualitative research design that utilized a grounded theory approach identified two themes for the women and two themes for the girls. Themes for the women include influence of culture and low physical activity IQ. Sub-themes of influence of culture are (a) hair and (b) body image. Sub-themes of low physical activity IQ are (a) mommy guilt, (b) perception of …

Immediate Effects Of High Intensity Training In Children With Cerebral Palsy Gmfcs Levels I-Iii: A Pilot Study, Andrea Blahovec, Andrea Kuiken, Jillian Mears, Heather Riggins

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cerebral Palsy is one of the most common causes of motor disability in the U.S., but there is still a lack of consensus for best intervention strategies to improve function and gait efficiency.

Objective: Determine if ambulatory children with CP, exposed to a brief, high intensity training session, will: 1) experience changes in temporal-spatial gait characteristics 2) demonstrate increased gait speed and 3) demonstrate improved gait kinematics.

Design: Five participants walked at preferred and fast speeds over an instrumented walkway followed by a 15-minute intervention. After a short rest, post-intervention walking was completed.

Results: Ten dependent variables were extracted …

Electrical & Magnetic Stimulation And Health, Yiyan Li

College of Engineering: Graduate Celebration Programs

1, Introduction Most of the patients with neural diseases such as Parkinson’s disease, Stroke and Depression, cannot be cured by taking pills or conducting surgery. In contrast to the conventional therapies, physical therapies such as TMS (transcranial magnetic stimulation) (Fig. 1) and tDCS (transcranial direct current stimulation) (Fig. 2) are the most popular methods in treating neural disorders with a non-invasive way. TMS employs electromagnetic (1-3 Tesla) induction generates an Electric field suitable for neural stimulation; tDCS employs a weak current (1-2 mA) to modulate neuronal excitabilities.

Comparative Study Of Various Data Collection Software Used For Seat-Belt Observation Surveys, Atul Sancheti, Puneet Lakhanpal, Sergio Contreras, Pushkin Kachroo, Masha Wilson

College of Engineering: Graduate Celebration Programs

Every year, Click It or Ticket (CIOT) mobilization is held in U.S. which aims at increasing seat-belt usage awareness among the people. Data collection for assessing current seat-belt usage rates and campaign design for influencing mass audience are the two most important components of the mobilization. This paper presents a comparative study of various data collections software used for seat-belt observational surveys. The comparison is based on the speed and accuracy of the data collected from different software at the same locations and at the same time of the day.

Instructions For Authors

Journal of Health Disparities Research and Practice

The Journal of Health Disparities Research and Practice (JHDRP) is an on-line journal that explores the problems and challenges of health disparities among the diverse populations of the United States. Our mission is to publish research that will guide the development of evidence based solutions, policy, and programs in an effort to reduce and ultimately eliminate health disparities. The JHDRP welcomes submissions of original papers from researchers, public health practitioners, and students researching and working on health disparities research, practice, policy, evaluation, and/or solutions. Questions about the suitability of a topic should be directed to the editor.

Research Brief: Technology And Health Education: An Exploratory Study Of Older Chinese Immigrants, Jenny H. Tsai, Vicky Taylor, Shin-Ping Tu

Journal of Health Disparities Research and Practice

Technology advances, especially in the Internet, provide new tools to deliver health education to limited English proficient immigrants. This paper presents the findings of a qualitative descriptive study of older limited English proficient Chinese immigrants’ perspectives regarding computer-based health education. The sample consisted of 33 foreign-born Chinese recruited in Seattle, Washington. Data were generated through six focus groups and an 18-item demographic questionnaire. The analyses revealed that the majority was not skillful in computer use and Internet browsing, and the Internet was not a common health information source. Nevertheless, participants were supportive of having computer-based health information designed for Chinese …

Preliminary Evaluation Of The Incharge Program Among Older African Americans In Rural Alabama, Cynthia Owsley, Gerald Mcgwin Jr., June Weston, Beth T. Stalvey, Karen Searcey, Christopher A. Girkin

Journal of Health Disparities Research and Practice

Objective: Blindness rates among older African Americans are two times higher than for older whites. Our purpose was to understand attitudes about eye care and perceived barriers to care among older African Americans living in rural Alabama and to determine whether an educational program reduced perceived barriers to care. InCHARGE, an eye health education program for older African Americans, promotes eye disease prevention by conveying the personal benefits of annual dilated comprehensive eye care and by teaching strategies to minimize barriers to eye care.

Design and Participants: InCHARGE was presented in five senior centers to 111 individuals. Using a questionnaire …

Obesity Prevalence, Weight-Related Beliefs And Behaviors Among Low-Income Ethnically Diverse National Job Corps Students, Jamie S. Bodenlos, Milagros C. Rosal, Diane Blake, Celeste Lemay, Diane Elfenbein

Journal of Health Disparities Research and Practice

The obesity rates of Job Corps students, a predominantly ethnic minority and low income group of youth, are unknown. The purpose of this project was to examine obesity rates among these youth as well as their weight-related perceptions and behavior. First, medical charts (N=641) of all Job Corps students (ages 16-25) who were enrolled in the program in the past year were examined for height and weight. In the second phase of the study, 344 Job Corp students were recruited and information on weight perceptions, knowledge of obesity consequences, and weight loss behavior were examined. Almost half of the participants …

The Significance Of A K-12 Diabetes-Based Science Education Program For Tribal Populations: Evaluating Cognitive Learning, Cultural Context, And Attitudinal Components, Carolee D. Francis, Doug Coulson, Bonnie Kalberer, Lemyra Debruyn, William Freeman, Janet Belcourt

Journal of Health Disparities Research and Practice

Preventing and reducing the onset of type 2 diabetes among American Indian/Alaska Native youth requires ground-breaking strategies to affect knowledge, attitudes, and cognitive decision-making skills. In an unparalleled endeavor to address the growing epidemic of type 2 diabetes in tribal communities, a K-12 Diabetes Education in Tribal Schools (DETS) curriculum was created by eight tribal colleges and three federal agencies. This article highlights the results of the implementation phase, the final evaluation step in acquiring and measuring student knowledge and attitude gains through pre-post standardized assessment.

Barriers, Control And Identity In Health Information Seeking Among African American Women, Jennifer R. Warren, Lynette Kvasny, Michael L. Hecht, Diana Burgess, Jasjit S. Ahluwalia, Kolawole S. Okuyemi

Journal of Health Disparities Research and Practice

Qualitative research methods were used to examine the role of racial, cultural, and socio-economic group (i.e., communal) identities on perceptions of barriers and control related to traditional and internet resources for seeking health information. Eighteen lower income, African American women participated in training workshops on using the internet for health, followed by two focus groups. Transcripts were analyzed using standardized coding methods. Results demonstrated that participants perceived the internet as a tool for seeking health information, which they believed would empower them within formal healthcare settings. Participants invoked racial, cultural, and socio-economic identities when discussing barriers to seeking health information …

Health Care Disparities For Persons With Limited English Proficiency: Relationships From The 2006 Medical Expenditure Panel Survey (Meps), Diane L. Smith

Journal of Health Disparities Research and Practice

Inadequate communication between patients with limited English proficiency (LEP) and providers can be associated with lower access to health care. The purpose of this research was to determine if there is a significant difference among those persons whose primary language is English and those with LEP in ability to access care and preventative screenings and perception of interaction with their physician. Chi square analysis was performed to determine if there was a significant relationship between primary language spoken and access to health care and patient-provider interaction. Data were obtained from the 2006 Medical Expenditure Panel Study. Results show that there …

Colorectal Cancer Brochure Development For African Americans, Kim L. Freeman, Lina Jandorf, Hayley Thompson, Katherine N. Duhamel

Journal of Health Disparities Research and Practice

Introduction: African Americans are more likely to die from colorectal cancer (CRC) than any other racial/ethnic group in the United States. Unfortunately, African Americans are also less likely to undergo screening for CRC than their White counterparts. Focus groups methodology was used to refine educational brochures designed to increase CRC screening among African Americans.

Methods: Two series of focus groups were completed, with a total of seven groups and 39 participants. Six different brochures (stage-matched and culturally sensitive) designed to promote CRC screening among African Americans were evaluated.

Results: All participants thought that the brochures motivated them …

Modeling Health Inequities Research In Context And The Minority Researcher’S Role, Ari Mwachofi, Ngure Wamwachofi

Journal of Health Disparities Research and Practice

Current health inequities research templates are flawed and self-defeating because they do not include historical inequalities as the central context that points to the root causes of health inequities. The context includes structural malformations which are products of the history of colonization and slavery that created racial separation and hierarchies which established Whites as the dominant group and non-Whites (minorities) as the subordinate group. Consequently it is difficult for mainstream researchers to capture the minorities’ core knowledge necessary for the creation of relevant and effective interventions for fundamental and sustainable improvement of their health. This paper proposes a health inequities …

Family Home Visitors: Increasing Minority Women’S Access To Health Services, Mechthild Meyer, Alma R. Estable, Lynne Maclean, Wendy E. Peterson

Journal of Health Disparities Research and Practice

The article describes how service access barriers (language, trust) were addressed at different levels (organization, service provider, community) by involving Family Home Visitors to support Nurse Practitioners in providing pre- and postnatal services to linguis­tic minority women in Ontario. The investigators undertook a secondary analysis of 18 semi-structured interviews with health unit informants, Nurse Practitioners, program us­ers, and community leaders, including Family Home Visitors. Health units facilitated col­laboration between two programs aimed at serving mothers with young children, result­ing in both programs using Family Home Visitors. They enhanced minority women’s trust in Nurse Practitioner services by providing interpretation, outreach and …

Instructions For Authors

Journal of Health Disparities Research and Practice

The Journal of Health Disparities Research and Practice (JHDRP) is an on-line journal that explores the problems and challenges of health disparities among the diverse populations of the United States. Our mission is to publish research that will guide the development of evidence based solutions, policy, and programs in an effort to reduce and ultimately eliminate health disparities. The JHDRP welcomes submissions of original papers from researchers, public health practitioners, and students researching and working on health disparities research, practice, policy, evaluation, and/or solutions. Questions about the suitability of a topic should be directed to the editor.

Hiv/Sti Risk Factors Among African-American Students Attending Predominantly White Universities, Marya L. Shegog, Lisa Lindley, Melva Thompson-Robinson, David Simmons, Donna Richter

Journal of Health Disparities Research and Practice

Introduction: The majority of African American college students in the U.S. attend predominantly white institutions (PWIs). However, there is minimal research examining this population’s HIV/STI risk behaviors. The purpose of this investigation was to assess HIV/STI behavioral risk factors among African American college students (aged 18 – 24years) attending PWIs. (n = 2,568)

Methods: Backwards step-wise logistic regression analyses were conducted to determine factors associated with a positive HIV/STI diagnosis (past year) among sexually active African American college students who participated in the Spring, 2006 National College Health Assessment.

Findings: Nine factors were significantly associated with an HIV/STI diagnosis among …

Using Concepts From Freire’S Pedagogy Of The Oppressed To Promote Colorectal Cancer Screening In An Urban Minority Population, Corey H. Brouse, Charles E. Basch, Randi L. Wolf

Journal of Health Disparities Research and Practice

This paper briefly introduces Freire’s philosophy of education, as well as examples of how this philosophy can be used in health education. Concepts from Freire’s work are highlighted along with how they are applicable to educating adults about colorectal cancer (CRC) screening, a health behavior that is less prevalent among poor and minority populations. Concepts highlighted in Freire’s writing can be directly applied to reducing disparities in health.

Prioritizing Interventions And Research To Address The Cancer Disparities Of Arizona’S American Indian Population, Norman J. Petersen, Sujata Joshi, Tim Flood, Kathryn Coe

Journal of Health Disparities Research and Practice

The aim of the Southwest American Indian Collaborative Network (SAICN) is to reduce cancer disparities by closing the gap between community needs and the promise of cancer prevention and cure through participatory education, training and research programs. In an effort to provide evidence-based recommendations and promote the use of relevant data in tribal communities, the SAICN Data and Evaluation Core developed two comparison matrices that present scientifically sound practices for use by community health decision makers in prioritizing activities likely to reduce the irrespective community’s burden of cancer. In their current configurations, Matrix A considers those cancers for which prevention …

A Communication Strategy To Address Health Inequities In Municipal Settings, Christine Unson, Ben Tyson, Angela Funaiole, Comfort Agaba

Journal of Health Disparities Research and Practice

This study assessed knowledge of health inequities, importance and benefits/barriers of addressing inequities, and ways of communicating information about inequities among municipal officials. Five focus groups (N=47) were conducted with officials from economic development, land use and housing, public safety, education, and environment departments. Discussions were recorded, transcribed and analyzed for key themes. Findings show that participants had an uneven understanding of the symptoms and causes of health inequities and identified limitations to participating in health equity initiatives and collaborating with local health departments. Recommendations are that a communication strategy to reduce health inequities should aim to increase awareness of …

Pap Test Follow-Up Pattern Among American Indian Women In Arizona, Merrill Eisenberg, Kathryn Coe, Charlton Wilson, Kathleen Evans, Elizabeth Brewer

Journal of Health Disparities Research and Practice

Objective: To quantify the loss to follow-up rate after abnormal Pap test results at the Phoenix Indian Medical Center, an Indian Health Service regional facility, and identify barriers to follow-up from the patients’ point of view.

Materials and Methods: Patient records were used to identify women who had abnormal Pap tests in 2002 and to document the status of their follow-up care. Women who had no clinical record of follow-up were contacted by telephone to arrange a follow-up appointment and to request participation in a structured qualitative interview to identify barriers to follow-up at the individual, family, community, and health …

Application Of The Pen-3 Model In A Diabetes Prevention Intervention, Joan E. Cowdery, Shandowyn Parker, Amy Thompson

Journal of Health Disparities Research and Practice

More effective strategies for addressing health issues in African American communities are needed. As part of a three year NIH funded Project Export grant, this community campus partnership used community-based participatory research principles and thePEN-3 Cultural Framework to develop a culturally specific, locally relevant intervention to prevent Diabetes among African-Americans. A comprehensive needs assessment which included 13 elicitation interviews, 3 focus groups, and 217 surveys resulted in identifying major themes including overall lack of knowledge regarding Diabetes,issues of denial and stigma, sense of inevitability, influence of family on perceptionsand behaviors, communication issues with health care providers, and lack of culturally …

Racial Differences In The Use Of Most Commonly Performed Medical Procedures In The United States, Syed S. Haque, Mohammad A. Faysel, Hafiz M. R. Khan

Journal of Health Disparities Research and Practice

Objective: This study investigates racial disparities in the use of commonly performed medical procedures in U.S. hospitals. Methods: To examine racial disparities, we calculated age-adjusted rate of procedures used by all Whites, Blacks, Hispanics, Asians or Pacific Islanders and Native Americans and calculated corresponding Relative Risks(RRs) of White vs. all other races based on procedure utilizations and insurance types using 20% random sample of Nationwide Inpatient Sample (NIS) data between 2001 and2003. Results: Whites were significantly more likely to receive 3 of the study procedures than Blacks, 3 of the procedures than Hispanics, 2 of the procedures than Asians or …

Racial Disparities In Cancer Screening Among Women With Chronic Joint Pain, Edith M. Williams, Laurene Tumiel-Berhalter, Christopher Purdy, Adrianne Ransom, Judith Anderson

Journal of Health Disparities Research and Practice

Chronic pain related disorders and breast and cervical cancer are more prevalent among African-American women compared with non-Hispanic White women. However, few studies address how racial differences in the context of comorbidity may compound these disparities. This study used secondary analysis of the National Health Interview Survey (NHIS) to assess racial differences in breast and cervical cancer screening and patient education among adult women with chronic joint pain conditions. Statistical analyses included chi-square and independent samples t-tests. African-American women compared with non-Hispanic White women were less likely to receive a pap smear or mammogram within the last two years and …

Community Gardening: Benefits Focused Strategies, Joseph Zaanan Tellschow

UNLV Theses, Dissertations, Professional Papers, and Capstones

Throughout history humans have had varying degrees of interaction with nature and natural environments. This interaction has shaped our species in almost every way possible from our physical traits to our behaviors and places we have chosen to occupy. Currently, humans have developed such overwhelming mastery of the planet that it is easy for many humans to feel disconnected from nature. This separation could have detrimental effects on various aspects of human well-being including physical and mental health. To understand these effects, it is important to evaluate the benefits that humans receive from exposure to nature and interaction with natural …