Public Health Commons^™

Implementation Of A Survey To Reduce Urine Pregnancy Tests Prior To Gynecology Procedures In Primary Care, Rachel Morgan Budihas

Capstone Experience: Master of Public Health

Excluding pregnancy in individuals prior to initiating contraception is important. The Pregnancy Reasonably Excluded Guide (PREG) uses twelve questions related to a patient’s reproductive history to effectively rule out pregnancy without administering a urine pregnancy screen, saving the patient both time and money. The PREG survey was given at Mayo Clinic in Rochester, MN, from 2015 to 2018 to all patients receiving an Intrauterine Device or Subdermal Implant.

This study examined data from the 2018 collection year to determine if urine screening requests by providers were reduced from the pre-PREG data. It also determined whether urine tests were requested disproportionally …

Effects Of Perioperative Hyperglycemia In Patients With Diabetes Compared To Patients Without Diabetes: A Retrospective Study Of Treatment And Outcomes, Matthew Anderson

Capstone Experience: Master of Public Health

The main goal of this project was to examine the differences in perioperative hyperglycemia treatment received by patients with a diagnosis of diabetes mellitus (DM) and patients without a diagnosis of diabetes (NDM); and how these treatment differences can affect the length of hospital stay. Studies have revealed that, when comparing DM and NDM patients with the same degree of perioperative hyperglycemia, NDM patients suffer worse outcomes. It has been suggested in previous research that this may be because NDM patients receive treatment that does not measure up to the standard of care treatment that DM patients receive. In this …

Do Molecular Subtypes Of Breast Cancer Affect Outcomes Following Hypofractionation Or Conventional Fractionation Radiation Therapy?, Richard Sleightholm

Capstone Experience: Master of Public Health

Introduction

Molecular subtypes of breast cancer (BC) are well-established prognostic markers in early-stage BC patients. The addition of radiation therapy (RT) to breast-conserving surgery has improved outcomes in this patient population, with conventional fractionation (CF) and hypofractionation (HF) regimens displaying comparable morbidity and mortality. However, most studies have not taken into account molecular subtype. Thus, it is still unknown if outcomes are similar between CF and HF for each molecular subtype. Herein, the effects of molecular subtype on the efficacy of CF and HF radiotherapy regimens for early-stage BC patients receiving adjuvant RT was investigated.

Methods

A retrospective review of …

Training For Evidence-Based Youth Physical Activity Leader Practices, A. Jake Larose

Capstone Experience: Master of Public Health

Purpose: From a social ecological viewpoint, the way in which individuals interact with their surrounding environment, has a direct effect on their actions. One approach to modify behavior change is to strive to change the environment, thus driving behavior change. Participating in physical activity (PA) is a behavior to be targeted, due to its numerous health benefits. A population to consider targeting for increasing PA is children, as creating PA habits in childhood has been shown to track into adulthood . Change at a population level should begin by focusing efforts on the environments in which children are spending their …

The Correlates Of The Maternal Fetal Attachment In The Democratic Republic Of The Congo, Orphee L. Tamba

Capstone Experience: Master of Public Health

Maternal-fetal attachment is defined as the relationship of affection that exists between the pregnant woman and her fetus during pregnancy. It increases throughout the pregnancy and predicts not only the attachment style between the mother and the child but also the chances of optimal socioemotional development during infancy. The Maternal Antenatal Attachment Scale measures the Maternal-Fetal Attachment (MFA). Several versions of this scale have been adapted in various parts of the world. However, to date no study has been conducted on the validation of this scale in sub-Saharan Africa and the identification of factors associated with the MFA. This cross-sectional …

Pilot Evaluation Of Oneworld's Education Sessions On Sexually Transmitted Infections For Adolescents And Young Adults In The South Omaha Community, Mariela Bahena

Capstone Experience: Master of Public Health

Background. Rates for sexually transmitted infections (STIs) in Douglas County, specifically gonorrhea and chlamydia, are among the highest in the nation. Adolescents and young adults between the ages of 15 and 24 are one of the most at-risk groups for acquiring either STI. Though not fatal itself, gonorrhea and chlamydia can lead to serious complications and physical discomfort in both males and females. Evidence-based and age-appropriate sexual health education has been proven to reduce the risk of STIs. Studies have shown that comprehensive education programs with a focus beyond abstinence are effective in promoting safe sex practices.

Aim. This project …

Great Plains Behavioral Risk Factor Surveillance System Project, Florence G. Duran

Capstone Experience: Master of Public Health

Background: Great Plains American Indians/Alaska Natives (AI/ANs) experience higher mortality rates than Non-Hispanic Whites from the same region. The National Behavioral Risk Factors Surveillance System (BRFSS) survey can have limitations of the estimates the health risks behaviors and services from one Tribal community to another. Goals and Objectives: The goal of this project is to address the lack of Tribal specific data among AI/ANs in the Great Plains region (ND, SD, NE, IA) by using Great Plains Tribal BRFSS data that captured information for three tribes in the Great Plains region. Tribal specific data will allow tribes to access, …

Domestic Violence Shelters For Survivors- A Needs Assessment, Tanushree Ojha

Capstone Experience: Master of Public Health

Background: Domestic violence (DV) is a serious public health issue in the United States, and globally. It includes physical violence, sexual violence, threats, emotional abuse, stalking, and psychological aggression (including coercive acts) by a current or former intimate partner. It is a serious, preventable public health problem that affects millions of Americans (CDC, 2017b). There is an alarming number of domestic violence cases encountered each year. Globally, 1 in 3 women has experienced some domestic violence in their lifetime. Globally, as many as 38% of women are murdered by an intimate male partner because of violence against an intimate female …

Creation Of Evaluation Tools For Workforce Development Opportunities Within A Local Health Department, Nancy Ann Esch

Capstone Experience: Master of Public Health

Improving the skills and competencies of the Central District Health Department’s (CDHD) workforce is essential in assuring the public’s health. However, to develop the desired skills and competencies of the workforce requires effective training programs. CDHD provides professional development funds to all staff to attend workforce development opportunities that can be used on specific training relevant to their position. Approved trainings at CDHD, however, are not evaluated for effectiveness. This capstone project aimed to develop evaluation tools to help determine the effectiveness of training programs at the CDHD. Kirkpatrick’s Four Levels of Training Evaluation (2016) was used to help build …

Initiation Of A Roundtable Meeting To Determine Safety Hazards And Provide Education To Range Bison Herd Workers, Lucia Finocchiaro

Capstone Experience: Master of Public Health

This capstone project serves as an important piece of greater project studying bison handling. Bison production is both a growing and dangerous industry. As a new enterprise in many parts of the country and on tribal lands, significant numbers of untrained employees may be hired. This project undertakes methods to better understand the risks associated with bison handling and to thereby improve handling procedures and increase safety. Herd managers (from tribal and non-tribal sites), researchers, safety experts, and stakeholders were brought together for a roundtable meeting in Omaha. This meeting was designed to provide stakeholders a forum to discuss common …

The Association Between Neurocognitive Impairment And Health-Related Quality Of Life Among People Living With Human Immunodeficiency Virus (Hiv)., Philip S. Amara

Capstone Experience: Master of Public Health

Background: Despite the use of combination antiretroviral therapy, HIV associated neurocognitive impairment (NCI) persists in HIV seropositive persons, albeit in milder forms than before therapy was available. Nevertheless, the relationship between NCI and health-related quality of life (HRQoL) is not well known.

Method: Baseline data from the CHARTER study was used to investigate the association between NCI and HRQoL. Factor analysis was employed to summarize the 35-item Medical Outcome Survey questionnaire into physical and mental HRQoL scores. General linear models were employed to investigate the association between NCI, as measured by global deficit scores (GDS), and HRQoL, and to control …

Examining The Prevalence Of Urban American Indians With Uncontrolled Diabetes In Nebraska., Nasreen Wahab Maiwandi

Capstone Experience: Master of Public Health

Diabetes is a major public health problem in American Indian Alaska Native (AI/AN) population which contributes to an increased number of morbidity and mortality.

Diabetes was largely unknown in AI/AN communities before the World War II but soon after the WWII Indian Health Service (IHS) providers began reporting diabetes among this population. (McLaughlin, 2010). A group of researchers in 1963 identified the first type II diabetes epidemic in Pima Indiana community of Arizona among AI/AN population. (Shultz, LO, et al, 2006). Soon, cases of diabetes in AI/AN more than doubled in prevalence rate compared to the general U.S. population, resulting …

An Analysis Of Postmastectomy Breast Reconstruction Due To Breast Cancer In Nevada And The United States From 2008-2013, Jenna Webb

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: In the United States, female breast cancer was the leading cause of new cancer cases from 2011-2015. Since the Women’s Health and Cancer Act of 1998 (WHCRA), the federal government mandates employee and private health insurance providers to cover breast reconstruction if they cover mastectomies. Postmastectomy breast reconstruction (PBR) rates increased after the WHCRA, but these rates have remained relatively low throughout recent years. Objective: The objective of this study was to determine factors associated with women having PBR due to breast cancer in Nevada and the United States from 2008 to 2013. Methods: Using two HCUP database, NIS …

Disease And De Soto: A Bioarchaeological Approach To The Introduction Of Malaria To The Southeast Us, Kelly Marie Schaeffer

Graduate Theses and Dissertations

It is well known through documentation in historical accounts that numerous diseases were introduced to the Americas during the time of Spanish and French exploration. Diseases such as smallpox, measles and yellow fever have been credited in playing a role in the Spanish conquest of the New World through drastic Native American population decline. Many researchers have studied the biological consequences of European contact, some using direct skeletal analyses to study changes in Native American health and disease. However, one major population disease that has not been part of these discussions is malaria. This is mostly due to the current …

A New Health Care Model For Pakistan, Mohammad Wasay, Ashar Malik

Section of Neurology

No abstract provided.

Mortality And Cardiovascular And Respiratory Morbidity In Individuals With Impaired Fev 1 (Pure): An International, Community-Based Cohort Study, Mylinh Duong, Shofiqul Islam, Sumathy Rangarajan, Darryl Leong, Om Kurmi, Koon Teo, Kieran Killian, Gilles Dagenais, Scott Lear, Romaina Iqbal

Community Health Sciences

Background: The associations between the extent of forced expiratory volume in 1 s (FEV₁) impairment and mortality, incident cardiovascular disease, and respiratory hospitalisations are unclear, and how these associations might vary across populations is unknown.
Methods: In this international, community-based cohort study, we prospectively enrolled adults aged 35-70 years who had no intention of moving residences for 4 years from rural and urban communities across 17 countries. A portable spirometer was used to assess FEV₁. FEV₁ values were standardised within countries for height, age, and sex, and expressed as a percentage of the country-specific predicted …

Determinants Of Disparities In The Colorectal Cancer Burden, Karen Elizabeth Callahan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Colorectal cancer (CRC) is the third leading cause of cancer incidence and mortality in the United States, with an estimated 140,000 new cases and 51,000 deaths expected in 2018. Like most cancers, the burden of CRC is unequally distributed among population groups. The current dissertation included two studies filling gaps in knowledge about CRC disparities. Study 1 characterized the relationship between educational attainment and CRC mortality by race/ethnicity. Six years of CRC mortality data (2012-2017) from the diverse state of California, with 30,180 deaths were analyzed. Sex-specific mortality rate ratios (MRR) stratified by race/ethnicity as well as by educational level …

Public Exposure To Outdoor Bioaerosols In Particulate Matter In Las Vegas: Daily And Seasonal Variations, Karey Renee Fortier

UNLV Theses, Dissertations, Professional Papers, and Capstones

Bioaerosols are airborne particles of biological origin including viruses, bacteria, pollen, fungi, and fragments of their metabolic products. Bioaerosol exposure may represent a health risk, in particular for risk groups such as immunosuppressed persons, and those suffering from allergies or respiratory diseases. Bioaerosols of sizes

This study seeks to assess outdoor bioaerosol number concentrations and size distributions in Las Vegas, NV, as the first step in understanding their health risks. PM2.5 and PM10 were collected on black polycarbonate filters for 24-hour duration using MiniVol air samplers on UNLV campus in the spring and fall of 2017. Bioaerosols in these samples …

Telomeres, Nutrition And Mortality: Risk Factors For The Rate Of Telomere Length Decline And The Associations Between Telomere Length, Nutrition And Mortality, Saruna Ghimire

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Telomeres are nucleoprotein structures located at the ends of eukaryotic chromosomes, thought to protect the DNA from damage. As a person experiences stressors, harmful exposures, and other diseases throughout their life, telomeres are thought to become damaged and their length shortened, decreasing their ability to protect the DNA. Nutrition is an important aspect of healthy aging. Preservation of telomere length (TL) is thought to be one of the mechanisms by which good nutrition can delay or prevent the development of chronic disease and death. Recent evidence of preservation of TL with good nutrition is promising. Thus, the aim of …

Health Disparities Among Sexual And Gender Minorities, Jennifer Keeley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Decades of research has shown that sexual and gender minorities (SGMs) experience adverse health and mental health outcomes to a greater extent than their heterosexual peers. The need to better understand and eliminate health disparities in the SGM population was recognized by the National Institute on Minority Health and Health Disparities (NIMHD) at NIH. The Secretary of Health at the Department of Health and Human Services approved the designation of the SGM population as a health disparities population in 2016 and called for SGM studies to examine the health needs of the SGM population across SGM subgroups via large representative …

Factors Associated With Food Insecurity Among Individuals, Aged Sixty And Older, In Clark County, Nv, Lisa M. Segler

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity is defined as a lack of consistent access to enough food for an active, healthy life. In Nevada, an estimated 80,000 individuals, aged 60 years or older, were food insecure in 2016. The primary aim of this study was to identify factors that are associated with food insecurity in older adults, aged sixty and older, in Clark County, NV. The secondary aim of this study was to identify which factors interact with each other to explain food insecurity among individuals aged sixty and older, in Clark County, NV. A secondary data analysis was conducted using data collected by …

Dusty Shoes: Appalachia Wisdom Fertilizing The Future Of Religious Leadership, Jill Crainshaw

Journal of Appalachian Health

Dust from their journeys through the hills and hollows of Appalachia clings to their shoes and has forever shaped their vocational journeys. This is a refrain I have distilled from the reflections of students who have participated in Wake Forest University School of Divinity’s multicultural contexts course that includes a 10-day sojourn in the mountains of North Carolina.

Identifying Priority And “Bright-Spot” Counties For Diabetes Preventive Care In Appalachia: An Exploratory Analysis, Peter J. Mallow, Michael Topmiller, Jennifer Rankin, Jene Grandmont, David Grolling, Jessica L. Mccann, Mark Carrozza

Journal of Appalachian Health

Introduction: Type 2 diabetes mellitus (T2DM) prevalence and mortality in Appalachian counties is substantially higher when compared to non-Appalachian counties, although there is significant variation within Appalachia.

Purpose: The objectives of this research were to identify low-performing (priority) and high-performing (bright spot) counties with respect to improving T2DM preventive care.

Methods: Using data from the Centers for Medicare and Medicaid (CMS), the Dartmouth Atlas of Health Care, and the Appalachia Regional Commission, conditional maps were created using county-level estimates for T2DM prevalence, mortality, and annual hemoglobin A1c (HbA1c) testing rates. Priority counties were identified using the following criteria: top 33rd …

Serum Cotinine Versus Parent Reported Measures Of Secondhand Smoke Exposure In Rural Appalachian Children, Samrat Yeramaneni, Kimberly Yolton, Kurunthachalam Kannan, Kim N. Dietrich, Erin N. Haynes

Journal of Appalachian Health

Background: Secondhand smoke (SHS) exposure in Appalachian children and associated adverse effects is understudied and not well documented. This study assessed the prevalence of SHS exposure in Appalachian children by parental self-report and internal biological measure.

Methods: SHS exposure was determined in children residing in rural Appalachian communities during their participation in the Communities Actively Researching Exposure Study between 2009 and 2013. Parents reported the number of smokers in the household and number of cigarettes smoked/day. Children ages 7-9 provided a serum sample for cotinine analysis. Parent reported measures and child serum cotinine measures of SHS exposure were compared with …

The Social Determinants Of Health And The Decline In U.S. Life Expectancy: Implications For Appalachia, Steven H. Woolf, Heidi Schoomaker, Latoya Hill, Christine M. Orndahl

Journal of Appalachian Health

For the past century, life expectancy in industrialized countries has increased, and the U.S. has shared in that progress. However, beginning in the 1980s, advances in U.S. life expectancy began to lose pace with peer countries. By 1998, U.S. life expectancy had fallen below the average for Organisation for Economic Cooperation and Development nations. U.S. life expectancy peaked in 2014 and has been decreasing for three consecutive years, a trend not been seen since the influenza pandemic a century ago. Put simply, U.S. health is in decline.

Delivering Health Knowledge And Wisdom From The Hills And Hollows Of Appalachia, F. Douglas Scutchfield Md, Erin N. Haynes, Robert M. Shapiro Ii, Charlotte S. Seidman

Journal of Appalachian Health

There is knowledge in the pages of Appalachia’s hills. This journal is positioned to find and publish those translations. It grows from a need to provide an outlet for scholarship about Appalachia’s health so that knowledge, and occasionally wisdom, is shared with those who care about and are committed to improving the region’s health.

Lightning Talk: Can This Be Redacted? Developing An Institutional Repository And Addressing Privacy Issues, Pamela Pierce

Digital Initiatives Symposium

“Can This Be Redacted? Developing an Institutional Repository and Addressing Privacy Issues” will explore privacy issues in terms of patient health information that have emerged as Oregon Health & Science University expands their institutional repository beyond theses and dissertations. The lighting talk presentation will focus specifically on student projects from the physician assistant program, School of Nursing, and the Northwest Native American Center, a center specifically focused on the health care needs of Native Americans in the U.S. The impact of a migration out of Bepress and into Samvera will also be discussed.

Exploring The Relationship Of Digital Information Sources And Medication Adherence, Cody Arbuckle, Daniel Tomaszewski, Lawrence Brown, Jon C. Schommer, Donald Morisky, Chelsea Parlett-Pelleriti, Erik J. Linstead

Pharmacy Faculty Articles and Research

We present a retrospective analysis of data collected in the United States from the 2015 National Consumer Survey on the Medication Experience and Pharmacists’ Role in order to model the relationship between health information sources and medication adherence and perception. Our results indicate that while the digital age has presented prescription users with many non-traditional alternatives for health information, the use of digital content has a significant negative correlation with pharmaceutical adherence and attitudes toward medication. These findings along with previous research suggest that in order to fully realize the potential benefits of the digital age in regards to patient …

Integrative Approaches To The Undergraduate Public Health Major Curriculum: Strengths, Challenges, And Examples, Marc T. Kiviniemi, Sarahmona M. Przybyla

Health, Behavior & Society Faculty Publications

Many “first generation” undergraduate public health degree programs were designed based on “siloed” course structures centered around subunits in the discipline (e.g., Introduction to Epidemiology, Introduction to Environmental Health) that may be meaningful primarily to experts in the field. An alternative to the siloed approach is an integrative curricular design, in which courses are designed around meaningful thematic units (e.g., explaining public health problems, asking and answering scientific questions in public health), with an emphasis on drawing connections between knowledge from different but complementary disciplinary areas as a means to improve student learning and retention. The integrative approach shifts the …

Targeted Advertising Can Increase Healthy Food Choices Among College Students, Stephanie Spera

Population Health Research Brief Series

Poor nutrition in young adulthood can increase risk of obesity, cancer, cardiovascular disease, and diabetes in mid- and later life. Targeted nutrition programs for young adults are essential to reduce the burden of chronic disease in the U.S. over the next several decades. This research brief describes a successful healthy food marketing strategy that was used at Syracuse University to promote healthy food purchasing among college students.