Medicine and Health Sciences Commons^™

Environmental Sampling Techniques For Herd-Level Surveillance Of Bovine Viral Diarrhea Virus, Jaden Carlson

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

Control of Bovine Viral Diarrhea Virus (BVDV) relies on resource-intensive individual animal sampling to detect and remove persistently infected (PI) cattle. Herd-level surveillance tools would be useful for herds with unknown BVDV status and for monitoring herds with BVDV-free status. The overall objective of this thesis is to explore the viability of BVDV surveillance at a herd-level using samples collected without handling individual animals. The first objective was to determine the feasibility of using stable flies as a sampling tool to detect BVDV. The second objective was to determine the feasibility of using drinking water to detect BVDV. To accomplish …

Conocimiento, Actitudes Y Prácticas Sobre El Zika: Implicancias Programaticas Para La Prevencion Del Zika En Honduras, Breakthrough Research

Poverty, Gender, and Youth

This brief provides key insights for implementers of social and behavior change activities for Zika prevention in Honduras, based on data from a representative sample of people living in selected USAID Zika program implementation communities, supporting an evidence-based approach to increase Zika and other Aedes aegypti-transmitted virus prevention behaviors.

Mhealth Childhood Obesity Prevention: A Look Into The Hispanic Mother’S Perspective, Veronica Isabel Gonzalez

Dissertations and Theses (Open Access)

Along with increasing physical activity, improving nutrition is an important behavior to target to reduce the risk of obesity in children and adolescents. To date, a nutrition-focused mHealth intervention used to promote obesity prevention and healthy living among Hispanic children and adolescents has not been specifically developed for Hispanic mothers. The purpose of this study was to provide information on feasibility and acceptability of a mHealth child nutrition intervention among Hispanic mothers. The data was collected from an online survey and telephone interviews from 30 mothers of 8-12-year-old Hispanic girls. Most mothers were 40 years old or younger (70%), identified …

Climate Change And Chagas Disease In The Americas: A Qualitative Systematic Review, Brittany N. Graves

Dissertations and Theses (Open Access)

While many studies have found associations between climate change and factors affecting Chagas disease transmission, the future impact of climate change on the global spread of Chagas disease remains debatable. A qualitative, systematic review was conducted to assess the impact of climate change on Chagas disease transmission in the Americas (Central America, South America, and North America). The literature search was performed in January 2019 using the keywords climate, Chagas, and “trypanosoma cruzi” and the electronic databases PubMed, Scopus, and Ovid. Searches retrieved records from 1982 through 2019. The initial electronic database search identified a total of 191 record documents …

Perceived Discrimination From Providers On Latina Mothers’ Decision-Making On Hpv Vaccination Initiation And Completion In Houston, Tx, Fatima Frausto

Dissertations and Theses (Open Access)

Background: Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STI) in the United States (US). Certain HPV strains have the potential to develop into cervical, anal, penile, vulvar, and throat cancers. Latinos in the U.S. have the highest rates of cervical and penile cancers compared to non-Hispanic Whites. Despite the availability of HPV9v, uptake of the vaccine is suboptimal in the Latino community. Previous research has found factors such as provider recommendation and communication are important in HPV vaccine series initiation and completion. Discrimination in the medical setting is linked to poorer health outcomes and delayed …

“He’S Not Too Young”: Empowering Parents In Child Language Development Through Upwords, A Parenting Education Program, Lynda Chima Aririguzo

Dissertations and Theses (Open Access)

Community-based early literacy intervention programs show promise in improving the home language environment, particularly for children at increased risk of language delays and poor school readiness. However, the literature on parents’ perspective of these programs is limited. This study investigated the perspectives and language scores of participants in upWORDS, a community-based literacy intervention program in Houston, TX. Through mixed-methods, this study aimed to describe the program’s impact on parents’ views on child development, changes in child behaviors, and continued application of information from the program. It also aimed to identify patterns in parent-reported measurements of children’s language skills over time. …

Uses Of Continuous-Time Markov Chain To Describe Longitudinal Patient-Reported Outcomes For Survival Prediction And Dimension Reduction, Ting-Yu Chen

Dissertations and Theses (Open Access)

A patient-reported outcome (PRO) is a type of outcome reported directly from patients, and it has been widely used in medical research and clinical trials to measure a patient’s symptoms, health-related quality of life, physical functioning, and health status. Previous studies have linked PROs to survival outcomes, but most of them only used the PRO information at baseline or at a specific clinical time point [1, 2]. Even though some of these studies collected longitudinal PROs, only few of them evaluated the association between the longitudinal PROs and a survival outcome. One of the major challenges in longitudinal PRO studies …

Hepatitis C Infection In Men Who Have Sex With Men, Jing Zhao

Dissertations and Theses (Open Access)

Hepatitis C virus (HCV) infection is the leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation. Current treatment rates and efficacy are inadequate to manage the disease burden caused by HCV; thus, efforts are needed to control HCV transmission. Besides the well-known transmission routes, which are health-care-associated transmission and transmission through injecting drugs, HCV could also be transmitted by sexual contact, especially among men having sex with men (MSM). MSM also have higher drug use prevalence than the general population, which may contribute to HCV infection by sexual disinhibition and other risky behavior. Since 2000, there have been emerging reports …

Utilization Of Mind-Body Practices For Adults With Fibromyalgia: 2017 National Health Interview Survey, Jennifer Contreras

Dissertations and Theses (Open Access)

Fibromyalgia (FM) is a medical condition characterized by chronic pain and tenderness. Individuals with FM may experience burdensome symptoms, which impact their health-related quality of life. Treatment for FM includes pharmacological and non pharmacological practices. Non-pharmacological treatments for FM include dietary management, routine exercise, and physical and mind-body therapies. There is growing evidence that the utilization of mind-body practices is increasing in the United States, but there have been limited investigations done to observe the use of mind-body practices in the FM population. The purpose of this study is to identify predictors of the use of meditation and/or meditative movement …

The Impact Of Food Security Status On The Food Shopping Behavior And Patterns Of 2018 Brighter Bites Participants At Baseline, Sarah A. Crulcich

Dissertations and Theses (Open Access)

Households with children continue to have a greater prevalence of food insecurity compared to the national average. While the national food security rates have improved in recent years, it remains stagnant among children. The purpose of this study was to conduct a cross-sectional regression analysis on food shopping patterns and behavior among Brighter Bites participants stratified by food security status to offer more insight into how these households obtain fresh produce. We used baseline survey data from Brighter Bites participants completed during fall 2018. The results indicate that food insecure Brighter Bites households shop more frequently for produce at locations …

Novel Propensity Score Methods For Multiple And Continuous Treatments: Applications To Ehr Data, Derek W. Brown

Dissertations and Theses (Open Access)

Propensity scoring is often utilized to overcome the challenges posed by covariate imbalance to make causal inferences within observational studies. While methods for utilizing propensity scoring in a binary treatment case are well studied and established, generalizations to multiple unordered (multinomial) and continuous treatments are more complicated. In Aim 1, we developed and tested a novel multinomial treatment propensity score method, the GPS-CDF method, which derives a single scalar balancing score that can match and stratify subjects. Simulation results showed superior performance of the new methodology compared to standard multinomial propensity score methods. The proposed GPS-CDF method was also applied …

Tuberculosis Among Dairy Workers In Bailey County, Texas, Anabel Rodriguez

Dissertations and Theses (Open Access)

On January 2016, Texas State Department of Health Services (DSHS) Public Health Region 1 (PHR 1) conducted T-SPOT.TB tests in response to two requests to screen dairy workers potentially exposed to cattle infected with Mycobacterium bovis or bovine tuberculosis (bTB) in Bailey County, Texas. Out of 140 workers tested, 14 had confirmed latent tuberculosis infection (LTBI)—prevalence of 10.0%. This first study gave rise to questions concerning tuberculosis (TB) knowledge and exposure history among dairy workers in this same county. The second study focused on determining TB knowledge among dairy workers through a series of questions administered by research personnel on …

Assessing The Readiness Of Relatives To Undergo Cascade Genetic Testing For Inherited Predispositions To Cancer Using The Transtheoretical Model Stages Of Change, Erica M. Bednar

Dissertations and Theses (Open Access)

National guidelines recommend cascade genetic testing (CGT) for blood relatives after a cancer predisposition gene mutation is identified in an individual. Despite recommendations for CGT, only 30-60% of first-degree relatives (FDRs) complete CGT. The proportion of untested relatives who are planning to have CGT is unknown. We used the Transtheoretical Model to assess the readiness (stage of change) for CGT among living, untested FDRs at-risk for a hereditary predisposition to cancer. An anonymous, online survey was open to U.S. adults with an autosomal dominant, adult-onset, hereditary predisposition to cancer. Participants reported demographic information, their genetic testing information, and information on …

The Effect Of Hospital Engagement Network Participation On Central Line-Associated Bloodstream Infections And Readmission Rates, Tyler Wallace

Dissertations and Theses (Open Access)

In 2012, the Centers for Medicare and Medicaid Services (CMS) launched the Hospital Engagement Network (HEN) program to decrease patient harm events in United States’ (US) hospitals. The HEN program became the nation’s largest quality improvement collaborative (QIC) focusing on improving patient care. Results from the program’s formal evaluation were inconclusive on whether the HEN program was effective. There have been no other known studies on this program’s effectiveness. Even with the evidence lacking, the CMS continues to fund programs similar to the HEN program. This study’s research aim was to compare patient outcomes for HEN participants to nonparticipants to …

Evaluation Of Food Journal Application Validity In Comparison With Dhq Iii, Michael Roa

Dissertations and Theses (Open Access)

As chronic conditions associated with the high prevalence of obesity/overweight in the United States continue to rise, research focusing on nutrition has grown in recent years. The gold standard for collecting detailed nutritional information on individuals is food journals, mostly via pen and paper. Alternatively, smartphone food journal applications have become more popular and widely accessible in recent years. These applications allow the user to quickly make meal entries, often taking advantage of the application’s food and servings database.

This study compared the results of the third iteration of the Diet History Questionnaire (DHQ III) with a dietary journal data …

Minimally Invasive Technique Of Placing A Dual Chamber Permanent Pacemaker In Children, Muneer Amanullah, Somia Razaq, Asif Hasan Siddiqui, Fazal Wahab Khan

Section of Paediatric Surgery

Objective: To share the experience of a minimally invasive technique in the implantation of a dual chamber permanent pacemaker in paediatric population.
Methods: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised data of patients aged up to1 6 years who underwent epicardial dual chamber permanent pacemaker insertion via xiphisternal incision between April 2011 and August 2016. Demographic data included age, weight and gender of the patient. Indications for pacemaker insertion, electrocardiography findings, concomitant cardiac procedures and procedural complications were reviewed. Pacemaker thresholds and impedance at the time of implantation and throughout the course of follow-up …

Data-Driven Decision-Support For Process Improvement Through Predictions Of Bed Occupancy Rates, Kar Way Tan, Qi You Ng, Francis Ngoc Hoang Long Nguyen, Sean Shao Wei Lam

Research Collection School Of Computing and Information Systems

Managing bed utilization and ensuring the supply keeps up with the demand is not an easy task in a large public hospital with many medical disciplines. The bed managers who makes decisions on reserving and allocating beds centrally require high-dimensional data from several hospital information systems supporting emergency room, specialized clinics and bed management processes. In this work, we put together an automated process for cleaning, consolidating and integrating data from several hospital information systems to several reports required by the bed managers to analyse the bed occupancy situations across more than thirty medical disciplines. To prevent bed crunch situations …

From The Boots On The Ground: A Comparison Of The Attitudes And Beliefs Of Military Members And Mental Health Professionals Regarding The Moral Injury Construct, Karis L. Callaway

Dissertations

An increasing amount of research conducted in recent years indicates that, in addition to Posttraumatic Stress Disorder, moral injury is a key concept to recognize when considering the deployment experiences of service members. Although related to Posttraumatic Stress Disorder, which is a fear-based mental health diagnosis, moral injury is a distinct concept. It acknowledges the possible prolonged negative psychological, social, and spiritual consequences that may occur after experiences that challenge and transgress one’s deeply held moral beliefs. Events such as perpetration of harm, failing to protect or prevent harm, and witnessing or learning about distressing acts committed by influential others …

Preview Pal: Multimodal Learning Modules Devised To Facilitate Learning And Advance Metacognition In Graduate Students, Cierra Lewis

PCOM Biomedical Studies Student Scholarship

A student may possess the necessary skills to enter graduate level programs but may still struggle with metacognition and self-directed learning. The focus of this study is to provide targeted resources to graduate level students that will both facilitate learning and guide advancement of metacognitive skills. The general study design included the creation of digital learning modules for a single course, their distribution to students as well as the evaluation of student access and course performance. The learning modules, designated ‘Preview Pal’, were structured to creatively engage learners with varied learning style preferences in order to benefit all students in …

A New Woman-Controlled Contraceptive Vaginal Ring: A Global Step Forward, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

More than 40 years ago, the development of contraceptive vaginal rings began, based on the fact that the vaginal epithelium can absorb steroid hormones and the capacity of elastomers to release these hormones at almost constant rates. The growing interest in woman-controlled contraceptive methods has supported and accelerated the process.

Factors Associated With Eosinophilic Esophagitis In Nevada, Julia Lorraine Anderson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Eosinophilic esophagitis (EoE) is a rare immune-mediated illness with symptoms that range from difficulty swallowing to food impaction of the esophagus. Most published studies have been documented among patients residing in cool regions with significant annual rainfall. No published studies to our knowledge have been performed examining the healthcare utilization trends of EoE in Nevada. Utilizing two unique databases, the factors associated with EoE healthcare utilization patterns in Nevada were examined. All analyses were performed in R version 3.5.1. This study included a demographic and regional analysis identifying risk factors associated with having an EoE healthcare visit in Nevada. Several …

Optimization Of Motor Performance, Lee-Kuen Chua

UNLV Theses, Dissertations, Professional Papers, and Capstones

According to the OPTIMAL (Optimizing Performance Through Intrinsic Motivation and Attention of Learning) theory of motor learning, enhanced expectancies (EE), autonomy support (AS), and external focus (EF) augment the coupling of a person’s actions to intended movement goals. This goal-action coupling is postulated to boost a person’s focus on goal-related aspects of the motor task while reducing the person’s self-related thoughts, resulting in enhanced performance of skilled movements as well as in improving the acquisition outcomes for the learning of motor skills. The three studies in this compilation report were aimed at providing empirical evidence for the motor performance benefits …

A Controlled Examination Of Motivational Strategies: Reviewing Positive Consequences For Goal Achievement, Negative Consequences For Undesired Behavior, And A Relaxation Exercise, Yulia Gavrilova

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Motivation is an integral part of human life and one of the most fundamental aspects of behavior change. Of interest to the present study are two motivational approaches, Negative Consequences Review (NCR) and Positive Consequences Review (PCR). NCR is an intervention component originally designed as part of Family Behavior Therapy (FBT) to motivate individuals with their goals through a discussion of negative consequences associated with undesired behaviors. PCR was developed as an auxiliary component of FBT to inspire individuals’ motivation to achieve their goals through a discussion about positive consequences of reaching goals. Purpose: The purpose of this study …

Healthcare Access And Utilization By Transgender Populations: A United States Transgender Survey Study, Axenya Kachen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Transgender communities in the United States are highly marginalized and have been systematically and infrastructurally ignored due to the widespread fundamental belief that gender exists as a binary classification. The dichotomous theoretical framework of sex and gender prevented public recognition of this community as a population of interest for public health research and targeted intervention. Sexual and gender minority (SGM) populations have fought for basic human rights, including access to affordable healthcare. The National Center for Transgender Equality (NCTE) was founded in 2003 to advocate for the advancement of equality for transgender people. In 2015, the NCTE conducted the United …

Adolescent Pregnancy: A Clinical Guideline For School Nurses In New Mexico, Karin Ludi

UNLV Theses, Dissertations, Professional Papers, and Capstones

The overall purpose of this project is to ensure that school nurses and health assistants are knowledgeable and have the resources to care for pregnant adolescents in the public school system. New Mexico has consistently ranked in the top 10 in the United States for teen births to women aged 15-19 years. The New Mexico School Health Manual is currently used to guide school nurses and health assistants in the care of pregnant adolescents, but it is vague and addresses emergencies such as labor and bleeding.

From this author’s experience as a school nurse in the public school system, it …

Comorbid Symptom Treatment In Parkinson’S Disease Using Neurofeedback, Joanne Mcfarland O'Rourke

Dissertations

The purpose of this research was to determine the impact of neurofeedback (NFB) on Parkinson’s symptoms that patients identify as priorities. First, a focus group of patients helped identify priority symptoms, then a pilot study tested protocols resulting from the focus group, and finally, an intervention study using a single subject design was conducted.

In the focus group, tremor and activity planning were identified as issues affecting every group member. The pilot study was conducted with three mid-stage Parkinson’s patients, who received a sensory motor (SM) protocol to address tremor, a SM plus cognition protocol (SM+Cog) for tremor and planning …

Investigating The Effects Of Social And Temporal Dynamics In Fitness Games On Children's Physical Activity, Ankita Samariya

Boise State University Theses and Dissertations

Obesity in children has more than doubled in the last four decades. A variety of fitness technologies such as activity trackers, exergames, and mobile applications are available to promote physical activity, but few are designed adequately to meet children's specific needs. In my initial research, I found that children prefer having social interaction, a narrative, and flexibility while interacting with such technologies. Other research has shown that persuasive displays encouraged adults towards physical activity. As a part of this work, a collection of mobile applications, collectively known as KidFit Suite were developed. These applications encourage children to be physically active …

Deep Learning-Based Structure-Activity Relationship Modeling For Multi-Category Toxicity Classification: A Case Study Of 10k Tox21 Chemicals With High-Throughput Cell-Based Androgen Receptor Bioassay Data, Gabriel Idakwo, Sundar Thangapandian, Joseph Luttrell Iv, Zhaoxian Zhou, Chaoyang Zhang, Ping Gong

Faculty Publications

Deep learning (DL) has attracted the attention of computational toxicologists as it offers a potentially greater power for in silico predictive toxicology than existing shallow learning algorithms. However, contradicting reports have been documented. To further explore the advantages of DL over shallow learning, we conducted this case study using two cell-based androgen receptor (AR) activity datasets with 10K chemicals generated from the Tox21 program. A nested double-loop cross-validation approach was adopted along with a stratified sampling strategy for partitioning chemicals of multiple AR activity classes (i.e., agonist, antagonist, inactive, and inconclusive) at the same distribution rates amongst the training, validation …

The Medicalization Of Sleeplessness: Results Of U.S. Office Visit Outcomes, 2008-2015, Mairead Eastin Moloney, Gabriele Ciciurkaite, Robyn Lewis Brown

Sociology Faculty Publications

Previous analysis of U.S. physician office visits (1993–2007) indicated that the medicalization of sleeplessness was on the rise and had potentially negative implications for population health. Our study asks if the medicalization of sleeplessness at the level of patient-physician interaction has persisted over time. Using the most recent years available (2008–2015) of the National Ambulatory Medical Care Survey we calculated nationally representative estimates for four sleeplessness-related outcomes of physician office visits: sleeplessness complaint, insomnia diagnosis, and prescription of benzodiazepine and non-benzodiazepine sedative-hypnotics (NBSH). To test for the significance of the linear trajectory, we ran a series of bivariate linear models. …

Zika-Related Knowledge, Attitudes, And Practices: Programmatic Implications For Zika Prevention In Honduras, Breakthrough Research

Poverty, Gender, and Youth

This brief provides key insights for implementers of social and behavior change activities for Zika prevention in Honduras, based on data from a representative sample of people living in selected USAID Zika program implementation communities, supporting an evidence-based approach to increase Zika and other Aedes aegypti-transmitted virus prevention behaviors.