Public Health Commons^™

Prevalence And Antimicrobial Agent Susceptibility Of Methicillin-Resistant Staphylococcus Aureus In Healthy Pediatric Outpatients In Las Vegas, Echezona E. Ezeanolue, Mark P. Buttner, Patricia Cruz, Joanne L. Henry, Chad L. Cross, Linda D. Stetzenbach

Nevada Journal of Public Health

Colonization and infection by community-associated resistant strains of Staphylococcus aureus are being reported in epidemic proportions. The purpose of this study was to determine the local prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in children and to characterize the MRSA isolates in the laboratory with regard to antimicrobial agent susceptibility patterns, and the presence of the mecA and the Panton-Valentine leukocidin (PVL) genes. Nasal swabs were collected at two pediatric clinics from a total of 505 children during health maintenance visits. A brief questionnaire was administered to collect demographic data and pertinent medical, family, and social history. Samples were cultured …

First-Year Compliance With The Nevada Clean Indoor Air Act, Leslie Elliott, Dana Loomis, Andrew B. Bridgforth, Stephanie O’Mara, Louise T. Brock, Brian Hansen, Melanie Marie Minarik, Kathryn Louderback

Nevada Journal of Public Health

Objectives: We quantitatively evaluated compliance with the Nevada Clean Indoor Air Act (NCIAA) by different types of businesses in Nevada and determined whether compliance affected indoor concentrations of benzene and 3-ethenyl pyridine (3-EP), markers of tobacco smoke.

Methods: Managers of 181 businesses in Washoe County, Nevada, were interviewed about business characteristics and practices and policies related to smoking. During unannounced visits, compliance data and air samples (n=66) were collected from interviewed businesses and from an additional sample (n = 56) of businesses without knowledge of the study.

Results: Overall compliance, as defined by the NCIAA, was low (28.2%). Benzene concentrations …

The Design And Testing Of A Solar Autoclave With Broad Spectrum Sterilization Capabilities, Sarah S. Trabia

Honors College Theses

Energy is difficult to come by in developing countries and this interferes with the ability of doctors to provide good healthcare to their patients. Without decent sterilization, patients can become infected and diseases can spread throughout hospitals. This study involves designing a solar autoclave for developing countries that is as efficient as electrical autoclaves. The design is intended to not require any electrical input and to be affordable to those who cannot afford advanced medical equipment. Once the solar autoclave is designed, it will be tested to determine if it can sterilize equipment against a variety of different bacteria, including …

Health Care Insurance And Advance Directive Completion: A Population Based Study, Wei Yang, Sally P. Hardwick, Noel Tiano, Clare T. Pettis

Nevada Journal of Public Health

Background: The relationship between advance directive (AD) completion and health insurance status is rarely studied.

Method: AD completion information was collected through the 2008 Nevada Behavior Risk Factor Surveillance System (BRFSS), a statewide cross-sectional telephone survey. Nevada non-institutionalized population over 18 were randomly selected as a population sample. Respondents were divided to “health care plan group” (HCPG) and “no health care plan group” (NHCPG). Demographic and behavior risk factors were also collected. Weighted multiple logistic regressions were utilized to assess the relationships between ADs, healthcare coverage and other factors.

Results: Of 4,461 respondents completing the survey, HCPG were six times …

Blood Lead Levels In Nevada Children, Arthur F. Di Salvo, Terry R. Hall

Nevada Journal of Public Health

The purpose of this study was to assess the prevalence of plumbism in children one to six years of age in Nevada. During a four-year period from 1992 – 1996, 10,700 children were screened for evidence of blood lead intoxication. The capillary specimens were analyzed by atomic absorption spectrometry. All children with a lead level => 10 ug/L were retested using venous blood. Ninety three percent of the children had blood lead levels < 10 µg/dL

Carbohydrate Consumption And Fatigue: A Review, Jennifer R. Pharr

Nevada Journal of Public Health

Fatigue is a condition that negatively impacts quality of life and occurs in about twenty four percent of adults worldwide. Many factors may contribute to fatigue. One factor is the macronutrient composition of a person’s diet, particularly, the amount of simple carbohydrates. This paper is a review of the current literature and examines the relationship of carbohydrate consumption and fatigue to determine if a diet low in simple carbohydrates results in an improvement in fatigue ratings. Results of studies regarding carbohydrate consumption and fatigue vary, the preponderance demonstrate a positive relationship between simple carbohydrate consumption and fatigue. Additionally, diets low …

Barriers To The Effective Implementation Of Immunization Information Systems In A Private Provider Setting, Echezona E. Ezeanolue, Ineada Jack, William Downey, Benjamin Hart, Chad L. Cross

Nevada Journal of Public Health

One of the goals of Healthy People 2010 is to increase the proportion of children less than 6 years of age with two or more vaccinations recorded in a fully operational population-based immunization information system to 95%. In 2008, we piloted the Nevada web-based immunization information system (WEBIZ) in a large private pediatric clinic in north-west Las Vegas. Our objectives were: (1) to determine compliance with the recommendation that all vaccine providers report immunization activities to the WEBIZ without a state mandate and (2) to determine perceived barriers to compliance and suggestions on how to overcome expressed barriers. We documented …

Adverse Maternal Outcomes In Nevada: Does Asthma Matter?, Jay J. Shen, Hong Wei, Robin Mukalian

Nevada Journal of Public Health

Objective. Asthma is a common clinical complication of pregnancy and women with asthma are at greater risk of having complications. This study compared adverse maternal outcomes between women with asthma and women without asthma in Nevada.

Methods. A total of 64,664 hospital discharges of delivery were abstracted from the Nevada 2003-2004 hospital discharges and thirteen adverse maternal outcomes were examined. Logistic regression was applied to compare the maternal outcomes between women with and without asthma.

Results. Women with asthma were more likely to have pre-eclampsia (OR [CI] 1.73 [1.13, 2.65]), transient hypertension of pregnancy (OR [CI] 1.76 [1.11, 2.78]), pregnancy-induced …

The Economic Impact Of The Nevada Clean Indoor Air Act In Clark County, Nevada – Preliminary Findings, Robin Mukalian, Fang Lin, Christopher R. Cochran, Jay J. Shen, Nancy L. York

Nevada Journal of Public Health

Objective. The primary purpose of this exploratory study was to quantitatively evaluate the economic impact of the Nevada Clean Indoor Air Act (NCIAA) on businesses in Clark County.

Methods. The goal of this research was to assess economic indicators over a ten year period utilizing measurable data points, including restaurant and drinking establishment employment rates, taxable sales, openings and closings, as well as slot gaming revenues. This ten year time period consisted of a seven year span prior to the enactment of the NCIAA, and three years post enactment. Researchers conceived this study as a means to independently evaluate and …

The Long-Term Coercive Effect Of State Community Benefit Laws On Hospital Community Health Orientation, Charles B. Moseley, Jay J. Shen, Gregory O. Ginn

Nevada Journal of Public Health

This study is an examination of the long-term coercive effect of state community benefit laws (CB Laws) on the provision of community health activities in U.S. acute care hospitals. The sample included all the not-for-profit and investor owned acute care hospitals for which 1994 and 2006 AHA Annual Survey data were available. A panel design was used to longitudinally examine the effect that state CB Laws had on hospital community health orientation activities and the provision of health promotion services, after controlling for the influence of other organizational and environmental variables that might affect these activities and services. The authors …

Prevalence And Antimicrobial Susceptibility Of Methicillin-Resistant Staphylococcus Aureus In Pregnant Women And Their Newborns In Las Vegas, Nevada, Mark P. Buttner, Echezona E. Ezeanolue, Patricia Cruz, Joanne L. Henry, Ineada Jack, Chad L. Cross

Nevada Journal of Public Health

Colonization and infection by resistant strains of Staphylococcus aureus are being reported in epidemic proportions. The goal of this study was to determine the local prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in pregnant women in southern Nevada and how it correlates with colonization and infection of their neonates. Signed consent was obtained, and a brief questionnaire was administered by the medical staff to each pregnant woman to collect demographic data and pertinent medical, family and social history. Nasal and vaginal specimens were obtained from pregnant women at ≥35 weeks gestation, and nasal and umbilicus specimens were obtained from their …

Effects Of The Master Settlement Agreement On Smoking Among Nevada Teens: A Decade After Implementation And Implications Of Reduced Funding, Christina A. Demopoulos, Christopher R. Cochran

Nevada Journal of Public Health

Background: Tobacco control programs that have adapted the Centers for Disease Control and Prevention (CDC) Best Practices for a Comprehensive Tobacco Control Program (CTCP) have been effective in reducing the rates of tobacco use. This paper investigates the effectiveness that Nevada’s tobacco control programs have had on teen tobacco use and rates to date and examines changes to programs given reduced Master Settlement Agreement (MSA) funding.

Methods: Aggregate data from the Nevada Department of Health and Human Services/Fund for a Healthy Nevada program was analyzed to determine if the tobacco control programs adapted the CDC’s Best Practices for a CTCP. …

Analysis Of Lead Levels In Deciduous Teeth From Children In Clark County, Nevada., Kristin Murphy, Jennifer Berger-Ritchie, Shawn L. Gerstenberger, Amol B. Amin, Jason K. Nitta, Frederick G. More, Jeanne A. Hibler, Karl Kingsley

Nevada Journal of Public Health

Background: Elevated blood lead levels (EBLL) are declining in the United States, although some population subgroups continue to exhibit significant health disparities. A childhood lead poisoning prevention program was recently started in Nevada, and many efforts have been made to support this program and increase the screening rates.

Methods: To expand the potential pool of children screened for EBLLs, a pilot study was performed to evaluate lead concentrations in extracted deciduous teeth using Graphic Furnace Atomic Absorption Spectrometry (GFAAS), Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and X-Ray Fluorescence (XRF) analysis.

Results: Lead concentrations as determined by GFAAS and ICP-MS were …

Chronic Disease And Risk Factors Among Nevadans With Disabilities: A 2009 Brfss Study, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Previous research has found that people with disabilities are more likely to have chronic diseases (coronary artery disease, stroke, cancer, asthma, diabetes), secondary conditions (high blood pressure, high cholesterol) and risk factors for chronic disease (physical inactivity and obesity) (Havercamp, Scandlin, & Roth, 2004; Kinne, Patrick, & Doyle, 2004; Nosek, Hughes, Petersen et al., 2006; Reichard, Stolzle, & Fox, 2011). The purpose of this study was to conduct a secondary analysis using data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) to identify differences in chronic disease risk factors and chronic disease/ secondary conditions between adults with and without …

Nutrition Education In Clark County, Nevada, Matt Bittle, Mildred Mcclain, Jeanne A. Hibler, Marcia M. Ditmyer

Nevada Journal of Public Health

Over 51 million school hours are missed annually by school-aged children due to a dental problem or visit, with 117 hours missed per 100 children (NIDCR, 2002). Approximately half a million of California's 7.2 million school-age children missed at least one day of school in 2007 because of dental issues such as toothaches (Pourat, & Nicholson, 2009). Independent research regarding various educational and intervention programs have been conducted in elementary schools across the country that focus on nutrition and/or physical activity, some of which have found that the programs positively impacted students’ dietary behaviors (Edwards, Mauch, & Winkelman, 2011; Muth, …

Utilization Of Preventative Health Services By Nevadans With Disabilities, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Health disparities are differences in access to health care, quality of health care and health outcomes observed between population-specific groups of people (Health Resources and Services Administration, 2000). Previous research has found that people with disabilities experience unequal access to preventative health care services. The purpose of this study was to conduct a secondary data analysis using data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) to determine differences in utilization of preventative health services between adults with and without disabilities in Nevada. Nevadans with disabilities were significantly more likely to have access to health insurance and to have …

2011 Annual Report Of Child Deaths In Clark County, Nevada, Nevada Institute For Children’S Research And Policy, Tara Phebus

Nevada Institute for Children's Research and Policy Reports

The primary goal of all Child Death Review Teams is to prevent future child deaths. The child death review process enables jurisdictions to come together in a collaborative, multidisciplinary forum to openly discuss detailed circumstances in an effort to gain a better understanding of child deaths. The team provides a venue for representatives from a variety of both public and private agencies as well as community organizations to share information in a confidential and non-threatening environment. The National Center for Child Death Review (hereinafter, National Center), which is supported by the Maternal and Child Health Bureau of the U.S. Department …

Utilization Of A Metabolic Syndrome Index In Evaluating The Life In Balance Lifestyle Intervention For Prevention Of Type 2 Diabetes Among Urban American Indians And Alaska Natives, Hongbin Jin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: A myriad of diabetes prevention programs modeled on the Diabetes Prevention Program (DPP) are carried out worldwide to fight against the current diabetes pandemic. The percentage of weight reduction is a widely used indicator to evaluate diabetes prevention programs. However, weight change alone may not fully reflect the efficacy of lifestyle intervention. A metabolic syndrome index is a promising novel scale for evaluation of diabetes prevention programs because it is a systematic, comprehensive, and stable indicator that reflects the metabolic risk reduction for diabetes and its complications at multiple levels and dimensions.

Methods: A total of 22 overweight and …

Model Provisions For Building A Successful Lead Poisoning Prevention Program: A Case Study For The Western United States, Kathleen Lauckner

UNLV Theses, Dissertations, Professional Papers, and Capstones

It has been 236 years since Benjamin Franklin voiced his concerns about lead poisoning from the occupational exposures in his printing shop, yet, in 2012 childhood lead poisonings and adult occupational exposures are still serious public health issues in the United States. Lead poisoning is a 100% preventable affliction if the ingestion or inhalation of lead from environmental exposures can be avoided.

The quality of blood lead detection methods and brain function studies have improved dramatically over the last few decades and far more is now known about the adverse health effects from low level (microgram- µg) exposures to lead. …

Unintentional Home Injury Risks Among The Elderly In Southern Nevada, Michelle Echauz Ching

UNLV Theses, Dissertations, Professional Papers, and Capstones

The elderly population (65 years of age and older) is one of the fastest growing populations in the US. A major public health concern involving the elderly population is unintentional injuries in the home. Since elderly adults typically spend the majority of their time in the home, minimizing unintentional home injury hazards is crucial for this population. The Nevada Healthy Homes Partnership (NHHP) program is a grant funded effort that helps to improve the quality and availability of safe and healthy homes in Nevada. Therefore, the purpose of this study is to determine the effectiveness of the NHHP program interventions …

Identifying And Correcting Health Hazards In The Home: A Pilot Test Among Homes In Clark County, Nevada, Sabrina La Monica

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Nevada Healthy Homes Partnership (NVHHP) is collaboration between University of Nevada - Las Vegas (UNLV), the Southern Nevada Health District (SNHD), and other public and private housing authorities and health agencies throughout Clark County, Nevada. The primary mission of the NVHHP is to improve the health of Nevada residents, particularly those in disadvantaged communities, by identifying and addressing conditions in the home environment. For this study, a program created by the NVHHP, entitled "Nevada Healthy Homes" (hereafter, Healthy Homes) was piloted. Home health and risk assessments were conducted in 52 homes, with one or more interventions being provided to …

From Engagement To Action: Assessing Community Readiness For Disparities Mobilization, Linda S. Sprague Martinez, Elmer Freeman, Flavia C. Perea

Journal of Health Disparities Research and Practice

In an effort to engage communities across the state of Massachusetts in tackling health disparities, Critical MASS (CM), in partnership with local researchers piloted a readiness assessment to identify community assets, perceptions of disparities, and interest in partnership. The research process was used to facilitate the development of partnerships between outside organizers, researchers, and community stakeholders. Partnership outcomes included a disparities conference aimed at bringing attention to concerns in the community, and a grant submission aimed at addressing community identified disparities. Despite the successes the partnership faced challenges. Logistics and limited resources hindered partner efforts to sustain the relationship. This …

Racial And Ethnic Health Disparities In Incarcerated Populations, Meghan E. Borysova, Ojmarrh Mitchell, Dawood H. Sultan, Arthur R. Williams

Journal of Health Disparities Research and Practice

Alarming disparities in population health and wellness in the United States have led to multi-disciplinary research efforts to create health equity. Identifying disparities, elucidating the etiological bases of disparities, and implementing solutions to eliminate disparities are part of the U.S. national health agenda. Racial and ethnic disparities have been identified throughout the cancer control continuum, in cardiovascular disease, diabetes and a multitude of other conditions. The causes of disparities are complex, condition specific, and conjectured to result from combinations of biological and socio-behavioral factors. Racial and ethnic health disparities within the vast incarcerated communities have been excluded from most studies, …

Smoke-Free Policies In The Workplace And In The Home Among American Indians, Carla Berg

Journal of Health Disparities Research and Practice

Objectives: American Indians are more likely to smoke, less likely to have smoke-free homes, and potentially less likely to have worksite smoke-free policies. We examined correlates of smoke-free policies at home and work among a community-based sample of American Indians in the Midwest.

Methods: We examined correlates of smoke-free policies at home and work in a sample of American Indians in the Midwest using a community-based participatory research approach.

Results: 66.7% were nonsmokers, 15.6% smoked on some days, and 17.6% smoked every day. The majority (72.4%) had complete smoke-free home policies, 13.1% had partial restrictions, and 14.5% …

Building Trust And Collaboration With Rural Minorities: Experiences With Minority Farmers In The Mississippi Delta, Ari Mwachofi

Journal of Health Disparities Research and Practice

The paper focuses on the question “What research approach is effective in building trust with minority farmers?” The question is answered through a documentation of researchers’ experiences building trust and collaboration with minority farmers in the lower Mississippi Delta. The researchers applied two research paradigms -logical positivism and paradigm of praxis. The logical positivism research approach was met with mistrust and open animosity and had to be abandoned for one based on the paradigm of praxis. Through this approach, and cognizant of the historical-social-political context, the researchers included insiders from the focus population as collaborators and researchers and succeeded in …

Disparities In Cause-Specific Cancer Survival By Census Tract Poverty Level In Idaho, U.S., Christopher J. Johnson, Aliza K. Fink, Robert R. German

Journal of Health Disparities Research and Practice

Objective. This population-based study compared cause-specific cancer survival by socioeconomic status using methods to more accurately assign cancer deaths to primary site. Methods. The current study analyzed Idaho data used in the Accuracy of Cancer Mortality Statistics Based on Death Certificates (ACM) study supplemented with additional information to measure cause-specific cancer survival by census tract poverty level. Results. The distribution of cases by primary site group differed significantly by poverty level (chi-square = 265.3, 100 df, p In the life table analyses, for 8 of 24 primary site groups investigated, and all sites combined, there was a significant gradient relating …

Influence Of Obesity, Race And Gender On Cardiac Catheterization After Stress Testing, Robert Finkelhor

Journal of Health Disparities Research and Practice

Female gender and black race have been associated with lower use of cardiac resources however; these patients also have a higher prevalence of obesity. Therefore we determined their relation to cardiac catheterization after stress testing. Clinical characteristics were determined for all patients stress tested over one year at a safety-net, urban, teaching hospital. Subsequent cardiac catheterizations were identified. Univariate and multivariate analyses were performed to determine the factors associated with catheterization. 3644 patients underwent stress testing and 484 (13%) underwent cardiac catheterization. The population was 58% female, 33% black, 53% were obese and 32% lacked insurance. Obese patients were mostly …

American Indian Community Leader And Provider Views Of Needs And Barriers To Colorectal Cancer Screening, Christine M. Daley

Journal of Health Disparities Research and Practice

Colorectal cancer is a great concern for the American Indian/Alaska Native (AI/AN) community, as incidence and mortality rates remain high and screening rates stay low. We conducted interviews with community leaders (n=13) and with providers from the Indian Health Service (IHS), tribal clinics, and urban safety-net clinics (n=17) in Northeast Kansas and the Kansas City Metro Area to determine their understanding of needs and barriers to colorectal cancer screening among American Indians. Using a community-based participatory research (CBPR) approach for this pilot study, community leaders and providers identified similar needs, including: culturally-appropriate education about colorectal cancer and screenings, the potential …

An Innovative Approach For Community Engagement: Using An Audience Response System, Jenna L. Davis, Kara E. Mcginnis, Margaret L. Walsh, Coni Williams, Kevin B. Sneed, Julie A. Baldwin, B. Lee Green

Journal of Health Disparities Research and Practice

Community-based participatory research methods allow for community engagement in the effort to reduce cancer health disparities. Community engagement involves health professionals becoming a part of the community in order to build trust, learn from the community and empower them to reduce disparities through their own initiatives and ideas. Audience Response Systems (ARS) are an innovative and engaging way to involve the community and obtain data for research purposes using keypads to report results via power point. The use of ARS within communities is very limited and serves to widen the disparity gap by not delivering new advances in medical knowledge …

Instructions For Authors

Journal of Health Disparities Research and Practice

The Journal of Health Disparities Research and Practice publishes research to guide the development of evidence-based solutions, policy and programs in an effort to reduce and ultimately eliminate health disparities. Published quarterly, the journal is an on-line publication that explores the problems and challenges of health disparities among the diverse populations of the United States. The journal welcomes submissions of original papers from researchers, public health practitioners, and students researching and working on health disparities solutions. Each issue will have four sections: a letter from the editors; original papers on health disparities research, practice, policy and/or evaluation; a student paper; …