Medicine and Health Sciences Commons^™

Turning Up The Sound! Senior-Level Sonographers' Perspectives On The Workforce Readiness/Competency Of Entry-Level Sonographers In The Workplace, Janice L. Glasper

UNLV Theses, Dissertations, Professional Papers, and Capstones

There has been a longstanding preoccupation with the workforce readiness and competency of our nation’s graduates since the release of the National Commission on Excellence in Education’s, April 1983 landmark report, A Nation at Risk: “The Imperative for Educational Reform”, which indicated that the educational foundations of our society were being eroded by a rising tide of mediocrity that threatened our very future as a Nation and a people. Now, more than 35 years since the release of A Nation at Risk, it appears that little has changed. Extensive research continues to report that graduates of post-secondary institutions are unprepared …

Effects Of A Discourse Intervention On End-Of-Life Knowledge And Attitudes Of Bsn Nursing Students, Jayme Gullone Haynes

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction. A number of challenges exist to providing effective, formalized end of life (EOL) education for undergraduate nursing students. Despite advanced resources provided by the End-of-Life Nursing Education Consortium (ELNEC), many nursing program curricula are overloaded with content and have little opportunity to incorporate other content and information.

In addition, the topic of EOL care may elicit significant emotional responses from nursing students with numerous studies indicating nursing students experience fear and anxiety when caring for patients at EOL. Recent research demonstrates the need to approach emotionally laden topics such as EOL care from a pedagogical perspective that acknowledges and …

New Nurse Reality Shock & Early Burnout: Can Role Transition Education Received During New Nurse Residency Positively Affect Satisfaction?, Bonnie L. Stolzman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Newly licensed nurses are at incredibly high risk for reality shock leading to early burnout which results in many of them resigning their positions or leaving nursing altogether. Common feelings leading to reality shock often involve exhaustion, cynicism, depersonalization, decreased self-efficacy, and decreased job satisfaction. The result of early burnout presents significant financial strain and quality concerns for our already struggling healthcare systems. In the 1960s and early 1970s, Marlene Kramer brought her research regarding newly licensed nurses and their experience of “reality shock” to publication. Kramer felt strongly that reality shock was a key factor that led newly licensed …

Future Space Missions And Human Enhancement: Medical And Ethical Challenges, Konrad Szocik, Mark Shelhamer, Martin Braddock, Francis A. Cucinotta, Chris Impey, Pete Worden, Ted Peters, Milan M. Ćirković, Kelly C. Smith, Koji Tachibana, Michael J. Reiss, Ziba Norman, Arvin M. Gouw, Gonzalo Munévar

Health Physics and Diagnostic Sciences Faculty Research

Future human space missions to Mars and beyond may be realized for different research, economic, political or survival reasons. Since space remains a hazardous environment for humans, space exploration and exploitation requires the development and deployment of effective countermeasures. In this paper, we discuss prospects for human enhancement by gene editing, synthetic biology, or implants, for the purposes of future space missions. We argue that there are good reasons to consider such options, and that ethical arguments can be made in favor of human enhancement to enable long-term space exploration.

Barriers And Facilitators To Promoting Resilience To Hiv/Aids: A Qualitative Study On The Lived Experiences Of Hiv-Positive, Racial And Ethnic Minority, Middle-Aged And Older Men Who Have Sex With Men From Ontario, Canada, Renato M. Liboro, Sherry Bell, Brandon Ranuschio, Lianne Barnes, Jenna Despres, Aruna Sedere, Trinity Puno, Paul A. Shuper

Psychology Faculty Research

Evidence-based research has highlighted the need for exploring factors that support the mental health of men who have sex with men living with HIV/AIDS (MSMLWH), and environmental influences that promote their resilience to HIV/AIDS. This exploratory study utilized a community-based participatory research approach to investigate barriers and facilitators to promoting resilience to HIV/AIDS, specifically among racial and ethnic minority, middle-aged and older MSMLWH, a population that continues to be significantly impacted by HIV/AIDS today. This collaborative, qualitative study recruited participants who identified as racial or ethnic minority MSMLWH, were aged 40 or older, and resided in Ontario, Canada. Participants (n …

Surveillance Of The Incidence And Mortality Of Oral And Pharyngeal, Esophageal, And Lung Cancer In Nevada: Potential Implications Of The Nevada Indoor Clean Air Act, Kevin Foote, David Foote, Karl Kingsley

Dental Medicine Faculty Research

Reviews of national and state-specific cancer registries have revealed differences in rates of oral, esophageal, and lung cancer incidence and mortality that have implications for public health research and policy. Many significant associations between these types of cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans—including the Nevada Clean Indoor Air Act (NCIAA) of 2006 (and subsequent modification in 2011). Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of …

Narratives Of Distinctiveness Or Similarity And Connection - A Response To Korman, De Jong And Jordan’S Steve De Shazer’S Theory Development, Guy Shennan

Journal of Solution Focused Practices

In 2020 the Journal of Solution Focused Practices published an article called Steve de Shazer’s Theory Development. This surveyed the whole of de Shazer’s career, which the authors divided into four phases, from which they distilled six axioms they believe are foundational to de Shazer’s thinking and practice. In their commentary on the six axioms there is a considerable emphasis on the distinctiveness of SFBT, which the authors are keen to establish as different, in each of its foundational aspects, from most or perhaps all other therapies. This article is a response to this particular aspect of Steve de Shazer’s …

Creating A Common Language: How Solution Focused Brief Therapy Reflects Current Principles Of Change And Common Factors, Beverley Kort, Adam Froerer, Cecil Walker

Journal of Solution Focused Practices

The common factors and mechanisms of change have been investigated across many disciplines and in many fields. This study applies the common factors to Solution Focused Brief Therapy (SFBT) through a modified content analysis of the BRIEFER Practice Manual. Seven common factors themes are identified and applied to SFBT. The study concludes with a consideration of how this common factors approach broadens the evidence-base of SFBT and provides suggestions for implementation and application of this common factors approach.

Prevalence Trend And Disparities In Rheumatoid Arthritis Among Us Adults, 2005–2018, Yingke Xu, Qing Wu

School of Public Health Faculty Research

Rheumatoid arthritis (RA) trends among US adults and disparities in RA patients in recent years have not been well described. We aimed to examine the trend of RA prevalence and disparities among US adults. Data from the National Health and Nutrition Examination Survey (NHANES) of the years 2005–2018 were analyzed to examine the self-reported RA prevalence trend. Age-adjusted RA prevalence stratified by race/ethnicity and socioeconomic status (SES), as well as associated linear trends, were calculated for both genders. The multivariable adjustment was used to evaluate the association between race, SES, and RA. During 2005–2018, there was no significant linear trend …

Neurophysiological Changes Of Brain And Spinal Cord In Individuals With Patellofemoral Pain: A Systematic Review And Meta-Analysis Protocol, Jing Nong Liang, Savanna Budge, Austin Madriaga, Kara Meske, Derrick Nguyenton, Kai-Yu Ho

Physical Therapy Faculty Research

Introduction: Reduced neuromuscular control due to altered neurophysiological functions of the central nervous system has been suggested to cause movement deficits in individuals with patellofemoral pain (PFP). However, the underlying neurophysiological measures of brain and spinal cord in this population remain to be poorly understood. The purpose of this systematic review is to evaluate the evidence for altered cortical and spinal cord functions in individuals with PFP.

Methods and analysis: The protocol for conducting the review was prepared using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. We will systematically search the literature that examines cortical and …

The Influence Of Overbuilt Versus Game-Permitted American Football Facemasks On Peripheral Visuomotor Ability In Ncaa Division I Football Athletes, Jai'rus L. Creamer, Rebecca R. Rogers, Courteney L. Benjamin Cscs, J. Patrick Marsh, Tyler D. Williams Cscs*D, Christopher G. Ballmann Facsm

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 2: Issue 1, Article 9, 2021. Heavier facemask reinforcement has been shown to impair reaction time. While overbuilt facemasks are illegal for gameplay at all levels of competition, empirical rationale for this has not be realized and it is unknown if overbuilt facemasks are worse for peripheral vision than permitted ones. Thus, the purpose of this study was to investigate the effects of wearing an overbuilt facemask versus game permitted facemasks on peripheral visuomotor ability in collegiate football players. Male NCAA Division I football players (n=18) completed a 60-second peripheral visuomotor test on …

Trial Of Pimavanserin In Dementia-Related Psychosis, Pierre N. Tariot, Jeffrey L. Cummings, Maria E. Soto-Martin, Clive Ballard, Deniz E. Erten-Lyons, David L. Sultzer, Davangere P. Devanand, Daniel Weintraub, Bradley Mcevoy, James M. Youakim, Srdjan Stankovic, Erin P. Foff

School of Medicine Faculty Research

BACKGROUND Patients with dementia due to neurodegenerative disease can have dementia-related psychosis. The effects of the oral 5-HT2A inverse agonist and antagonist pimavanserin on psychosis related to various causes of dementia are not clear. METHODS We conducted a phase 3, double-blind, randomized, placebo-controlled discontinuation trial involving patients with psychosis related to Alzheimer's disease, Parkinson's disease dementia, dementia with Lewy bodies, frontotemporal dementia, or vascular dementia. Patients received open-label pimavanserin for 12 weeks. Those who had a reduction from baseline of at least 30% in the score on the Scale for the Assessment of Positive Symptoms-Hallucinations and Delusions (SAPS-H+D, with higher …

Concordance And Patient-Centered Care In Medicaid Enrollees’ Care Experience With Providers, Iwimbong Kum Ghabowen, Neeraj Bhandari

Healthcare Administration and Policy Faculty Research

Patient-centered care is at the nexus of several overlapping institutional reforms to improve health care system performance. However, we know little regarding Medicaid patients’ experience with their doctors along several key dimensions of patient-centered care, and how their experience compares with Medicare and privately insured patients. We studied 4 outcomes using the 2017 National Health Interview Survey: patient–provider concordance on racial/sexual/cultural identity, respectful provider attitude, solicitation of patient opinion/beliefs during the care encounter, and patient-centered communication (PCC). The primary independent variable was Medicaid enrollee status. We dichotomized responses and ran multivariate logistic regressions for each type of care experience outcome, …

Aducanumab: Appropriate Use Recommendations, Jeffrey Cummings, P. Aisen, L. G. Apostolova, A. Atri, S. Salloway, M. Weiner

School of Medicine Faculty Research

Aducanumab has been approved by the US Food and Drug Administration for treatment of Alzheimer’s disease (AD). Clinicians require guidance on the appropriate use of this new therapy. An Expert Panel was assembled to construct Appropriate Use Recommendations based on the participant populations, conduct of the pivotal trials of aducanumab, updated Prescribing Information, and expert consensus. Aducanumab is an amyloid-targeting monoclonal antibody delivered by monthly intravenous infusions. The pivotal trials included patients with early AD (mild cognitive impairment due to AD and mild AD dementia) who had confirmed brain amyloid using amyloid positron tomography. The Expert Panel recommends that use …

Exposure To Endocrine Disrupting Chemicals (Edcs) And Cardiometabolic Indices During Pregnancy: The Home Study, Ann M. Vuong, Joseph M. Braun, Andreas Sjödin, Antonia M. Calafat, Kimberly Yolton, Bruce P. Lanphear, Aimin Chen

School of Public Health Faculty Research

Background: Toxicology studies have identified pregnancy as a window of susceptibility for endocrine disrupting chemicals (EDCs) and cardiometabolic indices in women. No study in humans, however, has examined EDC mixtures and cardiometabolic indices during pregnancy. Methods: We used the Health Outcomes and Measures of the Environment (HOME) Study to examine whether bisphenol A (BPA), polybrominated diphenyl ethers (PBDEs), per- and polyfluoroalkyl substances (PFAS), and phthalates are associated with blood pressure, glucose, and lipids in 388 pregnant women. We measured PBDEs and PFAS in serum at 16 weeks gestation, while BPA and phthalate metabolites were quantified in urine at 16 and …

A Novel Behavioral Model In Initiation And Sustenance Of Toothbrushing Behavior Among Dental And Medical Students In India: An Exploratory Analysis, Dhiraj Panjwani, Mithun Pai, Shweta Yellapurkar, Aayush Poddar, Gururaghavendran Rajesh, Manoj Sharma

Environmental & Global Health Faculty Research

Purpose: Toothbrushing holds key importance in practical, competent, and efficacious design to limit the formation of dental plaque on the dental tissues, in turn, leading to a decrease in dental diseases. The recent addition to this growing knowledge in health behavior research is the multi-Theory model (MTM) which addresses two crucial modules of health behavior: initiation and sustenance. In spite of reinforcing the habit of brushing twice daily, a lack of sustenance is found among young adults; hence, the objectives were to explore the substratal structure of MTM and to test the fit of MTM questionnaire in dental and medical …

Using The Multi-Theory Model (Mtm) Of Health Behavior Change To Explain The Correlates Of Mammography Screening Among Asian American Women, Manoj Sharma, Chia-Liang Dai, Kavita Batra, Ching-Chen Chen, Jennifer R. Pharr, Courtney Coughenour, Asma Awan, Hannah Catalano

Environmental & Global Health Faculty Research

Globally, breast cancer is the most common malignancy affecting women. The incidence of breast cancer has been growing among Asian American women. Mammography is a screening procedure that provides early diagnosis for the timely treatment to reduce premature mortality due to breast cancer. However, there are no national data available that summarize the rates of mammography screening among Asian American women. Some small-scale studies have reported low rates of mammography uptake among Asian American women. This cross-sectional study utilized the fourth-generation, multi-theory model (MTM) of health behavior change to explain the correlates of mammography screening among Asian American women between …

Serum Urate And Cardiovascular Events In The Dcct/Edic Study, Alicia J. Jenkins, Barbara H. Braffett, Arpita Basu, Ionut Bebu, Samuel Dagogo-Jack, Trevor J. Orchard, Amisha Wallia, Maria F. Lopes-Virella, W. Timothy Garvey, John M. Lachin, Timothy J. Lyons

Kinesiology and Nutrition Sciences Faculty Research

In type 2 diabetes, hyperuricemia is associated with cardiovascular disease (CVD) and the metabolic syndrome (MetS), but associations in type 1 diabetes (T1D) have not been well-defined. This study examined the relationships between serum urate (SU) concentrations, clinical and biochemical factors, and subsequent cardiovascular events in a well-characterized cohort of adults with T1D. In 973 participants with T1D in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC), associations were defined between SU, measured once in blood collected 1997-2000, and (a) concurrent MetS and (b) incident 'any CVD' and major adverse cardiovascular events (MACE) through 2013. …

A Systematic Review Of The Rationale For Vaccine Hesitancy Among American Parents, Jordan Luttrell-Freeman, Timothy J. Bungum, Jennifer R. Pharr

Environmental & Global Health Faculty Research

Vaccines are one of the most successful interventions in the history of public health. They are largely responsible for the near eradication of several diseases. However, some people are vaccination averse which can lead to vaccine hesitancy. Vaccine hesitant parents are those that refuse or delay getting their children vaccinated despite the availability of vaccination services. This phenomenon often occurs despite parent’s belief that vaccines are effective. The purpose of this review was to exam available literature to identify predictors of vaccine hesitancy among parents and parental rationale for vaccine hesitancy

Sociodemographic Inequities In Nurturing Care For Early Childhood Development Across Brazilian Municipalities, Gabriela Buccini, Stefanie Eugênia Dos Anjos Coelho Kubo, Jéssica Pedroso, Juracy Bertoldo, Alberto Sironi, Marcos Ennes Barreto, Rafael Pérez-Escamilla, Sonia Isoyama Venancio, Muriel Bauermann Gubert

Environmental & Global Health Faculty Research

Providing an enabling nurturing care environment for early childhood development (ECD) that cuts across the five domains of the Nurturing Care Framework (i.e., good health, adequate nutrition, opportunities for early learning, security and safety and responsive caregiving) has become a global priority. Brazil is home to approximately 18.5 million children under 5 years of age, of which 13% are at risk of poor development due to socio-economic inequalities. We explored whether the Early Childhood Friendly Municipal Index (IMAPI) can detect inequities in nurturing care ECD environments across the 5570 Brazilian municipalities. We examined the validity of the IMAPI scores and …

Assessing Clinical Change In Individuals Exposed To Repetitive Head Impacts: The Repetitive Head Impact Composite Index, Charles Bernick, Guogen Shan, Lauren Bennett, Jay Alberts, Jeffrey Cummings

School of Public Health Faculty Research

Background: There is a current lack of any composite measure for the effective tracking and monitoring of clinical change in individuals exposed to repetitive head impacts (RHI). The aim of this study is to create a composite instrument for the purposes of detecting change over time in cognitive and behavioral function in individuals exposed to RHI. Methods: The data to derive the composite instrument came from the Professional Fighters Brain Health Study (PFBHS), a longitudinal study of active and retired professional fighters [boxers and mixed martial arts (MMA) fighters] and healthy controls. Participants in the PFBHS underwent assessment on an …

The Intersection Of Hiv, Covid-19 And Systemic Racism, Gary F. Spinner

Journal of Health Disparities Research and Practice

ABSTRACT

The Human Immunodeficiency Virus (HIV) pandemic has taken the greatest toll on racial and ethnic minorities in the United States. Blacks and Latinxs suffer greater disease incidence, prevalence, morbidity and mortality from HIV as compared with Whites. Similarly, the Covid-19 pandemic caused by SARS-CoV-2 has disproportionately affected Blacks, Latinxs, and Native Americans causing higher rates of infection, more severe disease, and higher rates of mortality as compared with Whites. The pandemic of racism is as ubiquitous as the pandemics of HIV and Covid-19. Its sustaining forces drive wealth inequality, poverty, racially segregated and overcrowded housing, unequal employment opportunities, unequal …

Can Community Gardens With Workshops Increase Gardening Behavior? A Navajo Wellness Collaboration, Kevin A. Lombard Phd, India J. Ornelas Phd, Desiree Deschenie, Felix Nez, Sonia Bishop, Katie Osterbauer Ms, Eileen Rillamas-Sun Phd, Shirley A.A. Beresford Phd

Journal of Health Disparities Research and Practice

This paper seeks to evaluate the potential efficacy of a community gardening intervention on the Navajo Nation to increase gardening and healthy eating behaviors, which are potentially important in preventing obesity and related health conditions. Rates of obesity are high among American Indians, including those living on Navajo Nation land. Eating fresh fruits and vegetables is part of healthy eating. However, availability and access to fresh fruits and vegetables are severely limited on the Navajo Nation, due to distance and cost. One way to increase both availability and consumption of fresh fruits and vegetables is through community gardening, yet …

Prostate Cancer: Social, Economic And Demographic Correlates Of Non Use Of Supplemental Diets Among Black Men In Florida, Jemal Gishe, Getachew Dagne, Mohamed Kanu, Kushal Patel, Revlon Briggs, Folakemi Odedina, Francis Pleban

Journal of Health Disparities Research and Practice

Background: Epidemiologic data consistently show that Black men in the U.S. are disproportionately affected by prostate cancer. The incidence rate is 60% higher and death rate is 2.1 times more for Black men compared to Whites. There is growing evidence from literature that nutritional supplements, such as selenium, lycopene, vitamin A, vitamin D and soy may reduce the risk of prostate cancer. However, the level of knowledge and usage of these supplemental diets among Black men is low. Therefore, it is important to understand why Black men are low users of the supplemental diets and develop intervention programs to change …

Health Disparities And Covid-19 Pandemic: Increasing Clinical Research Participation Among African Americans, Kashica J. Webber-Ritchey, Abbi D. Lane-Cordova

Journal of Health Disparities Research and Practice

Health disparities in African Americans is a persistent issue. Higher rates and severity of the novel coronavirus-19 [COVID-19] among African Americans only widens health disparities. Effective COVID-19 treatment options are imperative, requiring representation of African Americans in clinical research. However, low participation and under-representation of African Americans is complex in nature. This article describes health disparities, the impact of COVID-19, and participation in clinical research among African Americans. We offer strategies for researchers to enhance the inclusion of African Americans. We also offer strategies in conducting clinical research during COVID-19.

Social Injustice And Pediatric Health: Pediatric Covid-19 Guidelines Are Exacerbating Health Disparities, Sneha Thamotharan

Journal of Health Disparities Research and Practice

Fewer cases of COVID-19 and hospitalizations have been reported in children. This has impacted the prioritization of pediatrics in understanding the infection, transmission, and treatment of SARS-CoV-2 in children. Unfortunately, COVID-19 rates are higher among racial and ethnic minoritized children. Simultaneously unfolding during this pandemic is a national outcry to address systemic injustice, including institutional racism in healthcare which are driving these disparities. Aligned with social justice, this paper reflects on how Pediatric COVID-19 guidelines may be exacerbating existing health disparities among racial and ethnic minoritized youth, as well as urges for and provides possible ways to culturally tailor current …

A Community-Based Participatory Research Project To Increase The Understanding Of The Health Concerns Of African Immigrant Communities In Urban Missouri., Rhonda Belue, Covenant Elenwo, Clayton Adams, Adaobi Anakwe, Kelly Taylor, Sunita Manu, Sidee Conteh

Journal of Health Disparities Research and Practice

Background

African immigrants and refugees experience unique mental and physical health care needs that may be a result of pre-migration history and the acculturation process. The purpose of this project was to collaborate with African immigrant and refugee communities to identify health needs of the communities and lay a foundation for future action.

Methods

Key-informant interviews with five West, East and Central African immigrant and refugee communities included community leaders (n=10) and listening sessions with larger groups of community members totaling approximately 150 participants to identify health care needs. Content analysis was employed to identify themes related to immigrant and …

Lessons From The Health Care Innovation Awards: Productively Engaging Vulnerable Populations To Address Social Determinants Of Health, Maysoun Freij, Megan Skillman, Caitlin Cross-Barnet, Rachel Friedman Singer, Christina Rotondo, Michelle Dougherty, Sarah Ruiz, Adil Moiduddin, Lynne Page Snyder

Journal of Health Disparities Research and Practice

Objectives: This paper examines productive interactions—a cornerstone of the Chronic Care Model—between health care providers and vulnerable populations with chronic illnesses and/or disabilities. Methods: We conducted qualitative analysis of 16 focus groups and 29 interviews with patients and/or caregivers and 195 interviews with program leadership and providers across 15 Health Care Innovation Awards that targeted vulnerable populations. We analyzed how awardees addressed health concerns and social determinants of health (SDOH), and identified key components of productive interactions. Results: Providers achieved productive interactions through four primary strategies: establishing trust and showing respect; solving problems; building accuracy in health …

Association Between Insurance Status And Hospital Outcomes Among Acute Kidney Failure Patients, Khoa Truong, Thuan Thai, Lingling Zhang, Lu Shi, C. Jason Wang

Journal of Health Disparities Research and Practice

Objectives: To investigate the relationship between insurance status and the risk of acute kidney failure (AKF) and consequential hospitalization outcomes.

Methods: A cross-sectional regression analysis was conducted for inpatients ages 18-64 in South Carolina 2012–2013. One dichotomous dependent variable - diagnosed with AKF at hospital admission, and two continuous dependent variables of hospital outcomes - total charge and length of stay, were examined. The key explanatory variable was the patient’s insurance status. Other covariates included patient’s age, gender, and race as well as AKF risk factors - Type 2 diabetic mellitus (T2DM), chronic kidney disease (CKD), hypertension, and proteinuria.

Results: …

Menu Engineering And Dietary Behavior Impact On Young Adults’ Kilocalorie Choice, Christine Bergman, Yuan Tian, Andrew Moreo, Carola Raab

Hospitality Faculty Research

The obesity pandemic is associated with increased consumption of restaurant food. Labeling of menus is an intervention used to provide consumers with kilocalorie (calorie) information in hopes of them making healthier food choices. This study evaluated the relationship between young adults’ calorie choices on restaurant menus and menu design, dietary behaviors, and demographic characteristics. A 3 (fast-casual restaurants) × 4 (menu-designs based on menu engineering theories) between-subjects (n = 480, 18–24-year olds) experimental design was used. The relationship between the participants’ calorie choices (high versus low) and menu design, stage of change, gender, race, educational level and weight status was …