Public Health Commons^™

Deprivation Matters: Understanding Associations Between Neighbourhood Deprivation, Unhealthy Food Outlets, Unhealthy Dietary Behaviours And Child Body Size Using Structural Equation Modelling., Victoria Egli, Matthew Hobbs, Jordan A. Carlson, Niamh Donnellan, Lisa Mackay, Daniel Exeter, Karen Villanueva, Caryn Zinn, Melody Smith

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Children residing in neighbourhoods of high deprivation are more likely to have poorer health, including excess body size. While the availability of unhealthy food outlets are increasingly considered important for excess child body size, less is known about how neighbourhood deprivation, unhealthy food outlets and unhealthy dietary behaviours are interlinked.

METHODS: This study involves children aged 8-13 years (n=1029) and resided in Auckland, New Zealand. Unhealthy dietary behaviours (frequency of consumption of unhealthy snacks and drinks) and food purchasing behaviour on the route to and from school were self-reported. Height and waist circumference were measured to calculate waist-to-height ratio …

Program Evaluation: Wellness For Life, Patricia Wagner

Capstone Experience: Master of Public Health

Specific Aim: The specific aim of this program evaluation is to assess the effectiveness of the employee wellness program (Wellness for Life program) at Community Hospital (CH) in McCook, Nebraska through the analysis of biometric data, personal health assessment results, and survey results.

Significance: The evaluation of this program is important to ensure CH is aiding their employees so they might lead healthy lives at a time when the health of our country is incredibly poor.

Background: CH is a small critical access hospital that employs 323 people in McCook, Nebraska. In 2013 CH decided to offer a formal employee …

Medical-Legal Partnerships: Assessment Of Mental Health & Substance Abuse Patients And Social/Legal Needs, Fung J. Liu

Capstone Experience: Master of Public Health

A medical-legal partnership (MLP) is a model which brings together health and legal services in the form of a multidisciplinary team that works to address medical and legal issues. Currently, Legal Aid of Nebraska is partnering with Bluestem Health, a local federally qualified health center (FQHC) located in Lincoln, Nebraska, to identify legal issues and provide civil legal aid services through a screening and referral process. The purpose of this capstone project was to assess the characteristics and determine the types of social/legal needs of FQHC patients referred to Legal Aid of Nebraska. Data collected was utilized to assess whether …

A Statewide Needs Assessment Of Perspectives On Training And Certification Of Community Health Workers In Nebraska, Jessica Ern

Capstone Experience: Master of Public Health

INTRODUCTION: Community Health Workers (CHWs) are a crucial growing component of the health care field in the U.S. According to the US Bureau of Statistics (2018), the CHW workforce is expected to grow 38% in the next ten years. While research has repeatedly shown the success of CHW-led programs and the financial benefits of CHWs, little work has been done to evaluate the training and certification preferences of CHWs in Nebraska. This project aimed to gather and analyze qualitative and quantitative data through an exploratory sequential mixed-methods approach to provide policy recommendations regarding the future training and potential certification of …

Surgical Care Perspectives: Exploring Barriers And Facilitators To Surgery In Rural Nebraska, Sarah Stanislav

Capstone Experience: Master of Public Health

Background: Minimally invasive surgery (MIS) is associated with less pain, faster recovery, and lower complication rates. Despite being the standard of care, it remains underutilized in rural Nebraska. Surgeon shortages and limited studies describing patient and provider factors influencing treatment gaps contribute to unnecessary complications and healthcare expenditure. Our study aimed to understand rural surgical care barriers and facilitators encountered by patients, providers, and stakeholders in Nebraska. Methods: This exploratory mixed methods study involved 17 semi-structured interviews using a snowball sampling of eligible participants affiliated with an MIS Advisory Committee. Two coders analyzed data using NVivo12. A follow-up review of …

Characteristics Of Tobacco Retailers And Proximity To Schools In A Midwest City, Sierra N. Garth

Capstone Experience: Master of Public Health

This descriptive epidemiology project provides an overview of the number, characteristics, and proximity of retailers that sell tobacco and vaping products to middle and high schools. ArcGIS was used to map the proximity of these retailers to public and private middle and high schools in Lincoln, Nebraska. Mapping the retailers and schools allowed us to explore the potential exposures to these products teens experience on a daily basis.

The Development Of A Suicide Prevention Program For American Indian Youth In Nebraskan Communities, Sara Donovan

Capstone Experience: Master of Public Health

In Nebraska and nationally, American Indian (AI) youth have higher rates of depression, suicide attempts, and suicide completions than other racial and ethnic groups. These statistics highlight the need for accessible and culturally aware behavioral health planning and support. In Nebraska, access to care by AI youth is limited by a behavioral health provider shortage and concerns of affordability, stigma, trust, cultural competence, and historical trauma. The developed culturally humble suicide prevention program for AI youth aged 19-24 to be implemented in community settings addresses an existing service gap. Strategies were developed with input from the population of focus, and …

Comprehensive Review Of Telehealth Law And Literature: Implications For Future Policy And Patients, Morgan Kristensen

Capstone Experience: Master of Public Health

PURPOSE: The purpose of this Capstone is to determine whether telehealth is effective at producing positive health outcomes, and what the current status of state telehealth law is in the United States and how can the law be changed to improve the implementation and use of telehealth services. METHODS: A literature review of PubMed was used to find articles relating to telehealth and its effectiveness. A law review of each state’s telehealth and telemedicine laws was conducted using Westlaw. RESULTS: The literature review uncovered that telehealth has the potential to produce positive health outcomes for a variety of conditions and …

Equivalency Testing For Two Formulations Of A Clinical Laboratory Control Material, Jessica M. Hart

Capstone Experience: Master of Public Health

Clinical laboratory control materials are an integral part of legally-mandated and highly regulated quality control protocols in all clinical laboratories. These controls ensure accurate performance of the laboratory testing and instrumentation used to produce medical test results for millions of patients. It is of clinical and public health interest to ensure the diagnostic test results which affect so many people are regulated by the most accurate and precise controls.

Formulation changes in control materials have the potential to impact laboratory quality control. In this study, data from two formulations of a hematology control were compared to assess equivalency of the …

An Assessment Of Occupational Heat Stress In A Central Utility Plant, Abdoulaye Abdoulaziz

Capstone Experience: Master of Public Health

Global climate change has been declared a threat to human health, which includes occupational safety issues. As temperatures continue to increase, heat stress and heat-related illness are occupational safety issues that need to be better understood. Assessments of workplace heat exposures are key to implement appropriate health and safety interventions. This study attempted to assess whether workers’ perception of work environment temperature in a Central Utility Plant was associated with heat-stress prevention behaviors. Therefore, we used a questionnaire to collect Central Utility Plant employees’ demographic characteristics, data regarding their perceived work environment temperatures, and their behaviors related to preventing heat-related …

Planning A Culturally And Linguistically Appropriate Obesity Intervention For Hispanic/Latino Children Living In Rural Nebraska, Ada V. Luna

Capstone Experience: Master of Public Health

Childhood obesity is a public health concern in the U.S; however, for the Hispanic/Latino community these concerns have grown to epic proportions. In Nebraska, the rate of childhood obesity is 25.1%; among Hispanic / Latinos students, the obesity rate is 30.9%. Unfortunately, specific Nebraska obesity rates by race and ethnicity are limited among rural communities, and programs that can effectively address this problem in the Hispanic / Latino community are limited or non-existent. Consequently, disparities between urban and rural communities exist. The purpose of this capstone project is to design a culturally and linguistically oriented intervention to address childhood obesity …

Prevalence Of Intimate Partner Violence Among The Maternal-Fetal Medicine Population, Sarah K. Larsen

Capstone Experience: Master of Public Health

Intimate partner violence (IPV) is increasingly understood as an important public health issue. It is well understood that intimate partner violence has many negative effects on its survivors ranging from physical to mental health conditions. The population of people who experience intimate partner violence and population of pregnant women are both vulnerable populations. Examining the two populations together demands a trauma-informed approach and an understanding of the intricacies of both pregnancy and intimate partner violence. While IPV has been studied among the pregnant population, intimate partner violence as it relates to the maternal fetal medicine (MFM) or high-risk pregnancy population …

The Wellbeing Partners’ Use Of The School Health Index To Identify Needs In Omaha Public Schools: A Process Evaluation, Sophia A. Quintero

Capstone Experience: Master of Public Health

The School Health Index tool from the Center for Disease Control and Prevention has been a useful tool to identify needs and areas of improvement for schools. This tool is most effective when used in collaboration with school staff and assistance from an outside facilitator. The purpose of this evaluation was to determine the administration efficiency of the School Health Index in select schools throughout the Omaha Public School (OPS) district by The Wellbeing Partners. A process evaluation was conducted to: 1) assess the relationship between the schools’ wellness champions at five Omaha Public School (OPS) elementary schools and The …

Closing The Loop: Pilot Evaluation Of Referral Navigator At Oneworld Community Health Centers, Oliver Ramirez-Gutierrez

Capstone Experience: Master of Public Health

Background. Low-income persons are subject to barriers to accessing health care and the additional complexity of the referral process, specifically for those receiving assistance from indigent care programs, contributes to those barriers. The requirements for patients receiving social assistance from indigent care programs leads to increased waiting time to be seen by specialists and contributes to health disparities.

Aim. Through a partnership with OneWorld Community Health Centers this project seeks to understand the efficacy of the implementation of a “referral navigator” at OneWorld and make recommendations to enhance the process. The proposed navigator is aimed to decrease the waiting time …

The Effect Of Childhood Farm Exposure On Adult Respiratory Symptoms And Proinflammatory Cytokine Responsiveness In Agricultural Workers, Jacob C. Grothe

Capstone Experience: Master of Public Health

Introduction: Studies have shown that the farm exposes workers and family members to countless microorganisms such as, gram-negative bacteria that possess endotoxins, which have been demonstrated to contribute to lung disease, such as asthma, in exposed workers. Results of studies of children show conflicting results regarding the development of asthma or asthma-like symptoms in response to farm exposures. European children show a “protective effect” against atopy and asthma during adolescence, while North American children show a higher prevalence of asthma or asthma-like symptoms. Also, whether this protective effect carries into adulthood is unclear. Some studies show a low prevalence of …

Effect Of Cigarette Smoking On Cd4 Count And Viral Load Among Hiv Patients Attending Treatment At Nebraska Medicine, Chacha Josiah Mwita

Capstone Experience: Master of Public Health

Background

Smoking is known to have a negative impact on both morbidity and mortality in people living with HIV (PLHIV). However, there is inconsistent information about the role of smoking on markers of HIV disease progression (CD4 count and HIV viral load). This study examined the effects of cigarette smoking on markers of HIV disease progression among PLHIV at Nebraska Medicine.

Methods

A retrospective cohort study was conducted utilizing electronic health information of 604 PLHIV who attended treatment at Nebraska Medicine between 2012 and 2020. Multiple linear regression was used to model the effects of smoking on the mean change …

The Association Of Demographic And Clinical Characteristics And Self-Reported Sleep Duration Among Patients With Prediabetes, Priyanka Chaudhary

Capstone Experience: Master of Public Health

Background: Sleep has been recognized as a critical component of healthy development and overall health. However, sleep duration has emerged as an important lifestyle factor that influences endocrine function and glucose metabolism. There remains a dearth of research to assess sleep duration among patients with prediabetes.

Objective: To evaluate the association between socio-demographic and clinical characteristics and self-reported sleep duration among patients with prediabetes.

Methods: Baseline data (n=599) was used from a diabetes prevention trial. A chi-square test was used to assess the differences between the groups of sleep duration for the categorical, whereas the t-test was used for the …

A Review Of The Characteristics Of Super-Utilizers And Evidence-Based Approaches To Reduce Healthcare Utilization, Suswara Mandala Rayabandla

Capstone Experience: Master of Public Health

A significant fraction of health care resources in the United States of America is utilized by a comparatively small number of people. An examination of the attributes and patterns and associated evidence-based interventions for such high-utilizing patients might aid clinicians to improve interventions to address the distinctive needs of these patients, decrease their risks for numerous hospitalizations, and contribute to reducing the costs. This study aims at exploring the existing literature on the characteristics of super-utilizers and interventions to reduce avoidable use of health care among this population. The method used for this research is a comprehensive literature review. Search …

Chloroquine Administration In Breastfeeding Mothers Associates With Increased Hiv-1 Plasma Viral Loads, William A. Paxton, Marloes A. Naarding, Ferdinand Wnm Wnm Wit, Nienke J. Veldhuijzen, Matthew F. Chersich, Brigitte Kankindi Kankindi, Rene Douma A. Douma, Samuel Tuyizere, Suzanne Jurriaans, Stanley Luchters

Population Health, East Africa

Chloroquine (CQ) and Hydroxychloroquine (HCQ) have been proposed to be effective at treating COVID-19 patients. We, and others, have previously reported on the capacity of CQ to reduce HIV-1 replication in vitro. We tested CQ administration in post-partum mothers on influencing HIV-1 viral loads in human milk as a means of lowering mother to child transmission. A Phase I/II, randomized, placebo-controlled study to evaluate chloroquine administration to reduce HIV-1 RNA levels in human milk: the CHARGE study. Thirty HIV-1 positive pregnant Rwandese women (CQ n = 20; placebo n = 10) were enrolled in a 16-week study, with the treatment …

Investigating Attitudes And Beliefs Of University Students Aged 18 To 24 Years That Influence Their Decision To Take Pre-Exposure Prophylaxis Medication, Philip Danquah

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Contemporary research findings affirm that young adults aged 18 to 24 years have high prevalence of new HIV infections. Pre-Exposure Prophylaxis (PrEP) medication is the latest strategy in HIV prevention. Rates of PrEP uptake or use have been negligible among university students aged 18 to 24 years, especially among racial and ethnic minority students.

Objective: The objective of this study is to investigate the attitudes and beliefs that influence the uptake of PrEP medications and the HIV risk behaviors associated with the willingness to take PrEP medications among university students aged 18 to 24 years attending the University of …

Seniors And Sexual Health: A Profile Of Sexual Behaviors And Perceptions Of Sexual Risks In Southern Nevada’S Older Adult Population, Amanda Elizabeth Morgan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Older adults, 65 and older, are one of the largest growing unique population groups in the United States, comprising 15% of the population of Southern Nevada. Medical advances have allowed people to live longer, experience improved sexual health outcomes, and maintain a better quality of life. Medicare provides healthcare for most people over 65, but some people may not feel comfortable talking with their doctor or are not aware that Medicare-covered these services.

Objective: The purpose of this study is to explore the sexual behaviors of older adults age 65 years or older in Southern Nevada, examine the protective …

The Relationship Between Tree Canopy And Social Capital On Physical Activity In Unlv Students, Melissa Bartshe

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the numerous health benefits, rates of physical activity are low, especially among the college student population. Neighborhood tree canopy is one aspect of the built environment that has been shown to positively impact physical activity. Social capital has also been correlated with higher rates of physical activity. The sprawling urban design and arid desert climate of Las Vegas pose unique challenges to both tree canopy and social capital. Additionally, the relationship between tree canopy, social capital, and physical activity is understudied in the college student population. The purpose of this study was to assess the relationship of tree canopy …

Dealing With Global Supply Chain Breaks, Shantanu Bhattacharya

Research Collection Lee Kong Chian School Of Business

Businesses need to adopt appropriate strategies to deal with the unprecedented impact of Covid-19 on global supply chains.

An Interdisciplinary Study To Understand Treatment Seeking Behavior Among Female Survivors Of Anorexia Nervosa, Meaghan Victoria Tipton

Graduate Theses and Dissertations

This study was done to examine what psychosocial factors influence treatment seeking behavior among female survivors of eating disorders. This study uses a mixed methods survey consisting of open-ended item questions regarding treatment experience and social environment, and close-ended items to measure constructs from the Health Belief Model. Fourteen participants were recruited for this study to retrospectively detail their experiences of treatment during their eating disorder. All fourteen participants identified as Caucasian, thirteen identified as female, one identified with other gender, each with a history of medically diagnosed anorexia nervosa. The mean of age of current participants was 29.46, and …

Associations Of Sickness Absence For Pain In The Low Back, Neck And Shoulders With Wider Propensity To Pain, David Coggon, Georgia Ntani, Karen Walker-Bone, Vanda E. Felli, Raul Harari, Lope H. Barrero, Sarah A. Felknor, Marianela Rojas, Anna Cattrell, Muhammad Masood Kadir

Community Health Sciences

Objectives: To explore the association of sickness absence ascribed to pain at specific anatomical sites with wider propensity to musculoskeletal pain.
Methods: As part of the CUPID (Cultural and Psychosocial Influences on Disability) study, potential risk factors for sickness absence from musculoskeletal pain were determined for 11 922 participants from 45 occupational groups in 18 countries. After approximately 14 months, 9119 (78%) provided follow-up information about sickness in the past month because of musculoskeletal pain, including 8610 who were still in the same job. Associations with absence for pain at specific anatomical sites were assessed by logistic regression and summarised …

Stress And Coping In Food-Insecure African Americans In Clark County, Nevada, Johanna Andrews

UNLV Theses, Dissertations, Professional Papers, and Capstones

African Americans have the highest rates of food insecurity than any other racial/ethnic group in the nation as a result of poverty, low household income, unemployment, food injustice, food mirages, and racial segregation. This consistent uncertainty in food access demonstrably results in poor mental health outcomes for food-insecure African Americans. Thus, the Transactional Model of Stress and Coping provides a theoretical framework to investigate how African Americans cope with food insecurity. The purpose of this study was to evaluate processes of coping with food insecurity and determine their impact on emotional well-being for African Americans in Clark County, Nevada. A …

Assessing The Health And Financial Burden Of Neonatal Abstinence Syndrome Among All Payer Inpatient Pediatric Discharges In Nevada, Kavita Batra

UNLV Theses, Dissertations, Professional Papers, and Capstones

Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome among neonates born to drug-dependent mothers. NAS poses a significant health and fiscal challenge nationally, with its incidence increasing by a factor of six (1.20 to 6.7 per 1,000 hospital births/year) along with the concomitant rise in health care cost from 2000-2016. Besides national data, it is critical to quantify NAS at the state-level to identify the target areas for prevention. Given the higher opioid prescribing rates among pregnant women in Nevada, it is critical to assess the health and financial magnitude of NAS in the state. The objectives of this …

Oral Localization Of Scardovia Wiggsiae, Graydon Ramos Carr

UNLV Theses, Dissertations, Professional Papers, and Capstones

Early childhood caries is one of the most prevalent diseases in the United States among children. The formation of caries is a complex, multifactorial process that is still being studied. Researchers have thought for years that Streptococcus mutans was the primary causative agent of early childhood caries. The recent discovery of a novel cariogenic pathogen, Scardovia wiggsiae and its significant contribution to the etiology of early childhood caries has led oral health researchers to re-evaluate this microorganism and its link to this disease. While there have been several projects undertaken within the University of Nevada, Las Vegas School of Dental …

The Use Of Female Permanent Contraception Among Women Desiring To Limit Childbearing In Sub-Saharan Africa: Analyses Of The Spatial Pattern And Individual- And Country-Level Determinants, Babayemi Oluwaseun Olakunde

UNLV Theses, Dissertations, Professional Papers, and Capstones

Female permanent contraception (FPC) is the most commonly used contraceptive method, globally. It is a convenient, safe, and cost-effective modern contraceptive method that permanently stops childbearing among women. Despite its benefits, previous reports suggest that the increasing proportion of women who desire to limit childbearing in sub-Saharan Africa (SSA) rely more on less effective contraceptive methods, predisposing them to unintended pregnancies and their associated consequences. This study aimed to add to the sparse body of evidence on the use of FPC and the associated determinants among women with demand for limiting childbearing in SSA. Using data from Demographic and Health …

Ubiquitination Of The Dna-Damage Checkpoint Kinase Chk1 By Traf4 Is Required For Chk1 Activation, Xinfang Yu, Wei Li, Haidan Liu, Qipan Deng, Xu Wang, Hui Hu, Zijun Y Xu-Monette, Wei Xiong, Zhongxin Lu, Ken H Young, Wei Wang, Yong Li

Faculty, Staff and Students Publications

BACKGROUND: Aberrant activation of DNA damage response (DDR) is a major cause of chemoresistance in colorectal cancer (CRC). CHK1 is upregulated in CRC and contributes to therapeutic resistance. We investigated the upstream signaling pathways governing CHK1 activation in CRC.

METHODS: We identified CHK1-binding proteins by mass spectrometry analysis. We analyzed the biologic consequences of knockout or overexpression of TRAF4 using immunoblotting, immunoprecipitation, and immunofluorescence. CHK1 and TRAF4 ubiquitination was studied in vitro and in vivo. We tested the functions of TRAF4 in CHK1 phosphorylation and CRC chemoresistance by measuring cell viability and proliferation, anchorage-dependent and -independent cell growth, and mouse …