Public Health Commons^™

A Story Told, Carly Caldarella

Senior Honors Projects

How do we educate our future generations about topics that are difficult to discuss? Oftentimes, children ask us questions that make us think, "How do I respond to this?" It is essential for our young generations to understand the history of racism, its present manifestations, and solutions and methods of action in order for a bright and revolutionary future. It is not always a simple task for children to comprehend such intricate topics. However, through text and pictures in storybooks, children can better grasp the concepts of such subject matter. "A Story Told" shares the story of young children in …

Characterization Of The Sneathia Amnii Cytotoxin And Its Potential Role In Health Disparities Affecting Women Of African Ancestry, Ivypel Amankwa-Asare

Undergraduate Theses and Capstone Projects

Women of African descent are more likely to develop bacterial vaginosis (BV) and bear twice the risk of preterm birth and the increased risk of other pregnancy complications. Sneathia amnii is a pathogenic anaerobe found in the female urogenital tract that is associated with adverse outcomes such as preterm birth, BV, and chorioamnionitis. S. amnii has been found at a greater prevalence in the vaginal microbiota of women of African ancestry, which links it to a potential role in the disparities observed in health outcomes for these women. S. amnii encodes the cytopathogenic toxin A (CptA), an exotoxin that perforates …

Predictive Factors For Success Of Awake Proning In Hypoxemic Respiratory Failure Secondary To Covid-19: A Retrospective Cohort Study, Sujith V Cherian, Chang Li, Brad Roche, Stephan A Reyes, Siddharth Karanth, Aditya P Lal, Gabriel M Aisenberg, Rosa M Estrada-Y-Martin

Faculty, Staff and Student Publications

BACKGROUND: Awake prone positioning has been recommended as an adjunctive measure in spontaneously breathing patients with hypoxemic respiratory failure during the COVID-19 pandemic. It remains uncertain as to how long this should be implemented, what variables to follow and who would be the ideal candidates for this adjunctive therapy.

METHODS: A retrospective chart review of patients admitted from April to August 2020 within our institution with multifocal pneumonia and hypoxemic respiratory failure secondary to COVID-19 who underwent awake-proning for at least 3 hours was conducted.

RESULTS: Improvement in respiratory parameters including ROX (SpO2/Fio2/ Respiratory Rate) indices and inflammatory markers within …

Are School Lunches Contributing To The Obesity Epidemic Among Children?, Luis Chavez

Electronic Theses, Projects, and Dissertations

Background: Childhood obesity is a major public health issue in the United States (U.S.) and recent data have shown that the incidence and prevalence have been increasing over the past 20 years. Poor dietary habits are often attributed to these increasing rates. The National School Lunch Program (NSLP) provides meals and snacks to over 30 million students. Therefore, determining whether an association exists between student participation in the NSLP, and their respective body mass index (BMI) is critical. Few studies have examined a family’s economic stability and the child’s race as potential moderating variables. This study aimed to investigate …

How Covid-19 Has Fundamentally Changed Clinical Research In Global Health, Jay J H. Park, Robin Mogg, Gerald E. Smith, Etheldreda Nakimuli-Mpungu, Fyezah Jehan, Craig R. Rayner, Jeanine Condo, Eric H. Decloedt, Jean B. Nachega, Gilmar Reis, Edward J. Mills

Department of Paediatrics and Child Health

COVID-19 has had negative repercussions on the entire global population. Despite there being a common goal that should have unified resources and efforts, there have been an overwhelmingly large number of clinical trials that have been registered that are of questionable methodological quality. As the final paper of this Series, we discuss how the medical research community has responded to COVID-19. We recognise the incredible pressure that this pandemic has put on researchers, regulators, and policy makers, all of whom were doing their best to move quickly but safely in a time of tremendous uncertainty. However, the research community's response …

The Role And Challenges Of Cluster Randomised Trials For Global Health, Louis Dron, Monica Taljaard, Yin Bun Cheung, Rebecca Grais, Nathan Ford, Kristian Thorlund, Fyezah Jehan, Etheldreda Nakimuli-Mpungu, Denis Xavier, Zulfiqar Ahmed Bhutta, Jay J H. Park, Edward J. Mills

Department of Paediatrics and Child Health

Evaluating whether an intervention works when trialled in groups of individuals can pose complex challenges for clinical research. Cluster randomised controlled trials involve the random allocation of groups or clusters of individuals to receive an intervention, and they are commonly used in global health research. In this paper, we describe the potential reasons for the increasing popularity of cluster trials in low-income and middle-income countries. We also draw on key areas of global health research for an assessment of common trial planning practices, and we address their methodological shortcomings and pitfalls. Lastly, we discuss alternative approaches for population-level intervention trials …

Urgently Seeking Efficiency And Sustainability Of Clinical Trials In Global Health, Jay J H. Park, Rebecca F. Grais, Monica Taljaard, Etheldreda Nakimuli-Mpungu, Fyezah Jehan, Jean B. Nachega, Nathan Ford, Denis Xavier, Andre P. Kengne, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

This paper shows the scale of global health research and the context in which we frame the subsequent papers in the Series. In this Series paper, we provide a historical perspective on clinical trial research by revisiting the 1948 streptomycin trial for pulmonary tuberculosis, which was the first documented randomised clinical trial in the English language, and we discuss its close connection with global health. We describe the current state of clinical trial research globally by providing an overview of clinical trials that have been registered in the WHO International Clinical Trial Registry since 2010. We discuss challenges with current …

Exploring Equity In Health And Poverty Impacts Of Control Measures For Sars-Cov-2 In Six Countries, Sedona Sweeney, Theo Prudencio Juhani Capeding, Rosalind Eggo, Maryam Huda, Mark Jit, Don Mudzengi, Nichola R. Naylor, Simon Procter, Matthew Quaife, Lela Serebryakova

Community Health Sciences

Background: Policy makers need to be rapidly informed about the potential equity consequences of different COVID-19 strategies, alongside their broader health and economic impacts. While there are complex models to inform both potential health and macro-economic impact, there are few tools available to rapidly assess potential equity impacts of interventions.
Methods: We created an economic model to simulate the impact of lockdown measures in Pakistan, Georgia, Chile, UK, the Philippines and South Africa. We consider impact of lockdown in terms of ability to socially distance, and income loss during lockdown, and tested the impact of assumptions on social protection coverage …

Relationships Between Intimate Partner Violence, Pregnancy, Maternal Mental Health And Infant Care Behaviors, Brooke Ambrose

Boise State University Theses and Dissertations

Background: Intimate Partner Violence (IPV) is a public health issue that is known to have deleterious health effects for pregnant women and their babies. Women who experience IPV during pregnancy are also likely to develop and exacerbate already existing mental health conditions. Experiences with IPV are thought to impact health behaviors, particularly how a mother copes or cares for her baby. The objective of this study is to explore the potential relationships between experiencing IPV (before and/or during pregnancy), maternal mental health, and health-related infant care behaviors (i.e., breastfeeding initiation, breastfeeding duration, well-child visits).

Methods: Data from phases 6 (years …

Adolescent Substance Use: Risk And Protective Factors Of Family, School, Peer, And Leisure, Tara Woodward

Boise State University Theses and Dissertations

BACKGROUND

Adolescent substance use has long been a global public health issue. In this study, we explored developmental contexts that correspond with protective and risk factors associated with adolescent substance use. The developmental contexts of interest are the family domain, the school domain, the peer domain, and the structured and unstructured leisure domains. The leisure domain is of particular interest as it often corresponds with protective and risk factors different from those associated with the other domains. The purpose of this study was to assess whether the identified domains are associated with adolescent alcohol use and cannabis use.

METHODS

This …

The Effects Of Differences In Vaccination Rates Across Socioeconomic Groups On The Size Of Measles Outbreaks, Elizabeth Hunter, John D. Kelleher

Conference papers

Vaccination rates are often presented at the level of a country or region. However, within those areas there might be geographic or demographic pockets that have higher or lower vaccination rates. We use an agent-based model designed to simulate the spread of measles in Irish towns to examine if the effectiveness of vaccination rates to reduce disease at a population level is sensitive to the uniformity of vaccinations across socioeconomic groups. We find that when vaccinations are not applied evenly across socioeconomic groups we see more outbreaks and outbreaks with larger magnitudes.

Mapping Nevada's Dental Workforce, Kelvin Chen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Access to care is a concern at the forefront of public health. Due to socioeconomic and geopolitical pressures, the distribution of healthcare providers across a population often does not coincide with the demand for healthcare in a specific geographic area. Rural areas typically do not have enough providers and urban areas typically have too many. This stark reality underscores an inherent inefficiency in the allocation of healthcare resources and is a discrepancy that must be addressed by state-sponsored institutions and programs. From a public health perspective, the problem of insufficient or lack of access to care is the greater of …

Depression And Quality Of Life Among Adults With Asthma Presence In Nevada, Elizabeth D. Kahane

UNLV Theses, Dissertations, Professional Papers, and Capstones

Asthma is a lung disease that causes coughing, chest tightness, wheezing, and breathlessness. It is often controlled by medication use and avoidance of environmental triggers. It is a leading chronic, non-communicable disease affecting over 19 million adults in the United States (CDC, 2020a). Asthma and severe asthma have been shown to negatively affect mental health and quality of life among adults including limiting physical activity, lowering sleep quality, exacerbating economic challenges, missing work, and increasing healthcare use (Stanescu, et al., 2019). Approximately 8% of adult Nevadans reported current asthma symptoms and 12.6% reported having a diagnosis during their lifetime (CDC, …

Social Emotional Learning As A Universal Upstream Approach To Youth Suicide Prevention: A Secondary Data Analysis Of A Prevention Program Evaluation, Maria Amaris Knight

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Nevada has had consistently high rates of youth suicide in the past decade with 21.2 deaths by suicide per 100,000 population (ages 15-24), over the national rate of 14.5 deaths per 100,000 in 2019. National strategies, state agendas, and best practices in the field prioritize research on upstream strategies to prevent suicide. One such strategy is the use of social emotional learning (SEL) programs for youth to help increase and enhance protective factors against suicide, helping them to cope with negative life events. Research has identified leading outcomes of SEL programs as the improvement of attitudes, behaviors, and academic …

Food Insecurity And Adiposity Among Children And Adults Nhanes 2015-2016, Denise Vidal

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Obesity is a preventable disease that has been associated with many adverse health outcomes. A possible factor that may influence adiposity development is food insecurity. Although several epidemiological studies have been conducted examining the association between food insecurity and adiposity among children and adults, results have been inconsistent. Objective: This cross-sectional study investigates the relationship between food insecurity and adiposity among children and adults using recent data from a representative sample of the US population. Methods: We examined 3,391 adults and 2,837 children from the National Health and Nutrition Examination Survey (NHANES) 2015-2016. Household food insecurity was assessed using …

Opioid And Naloxone Training In A Rural School District, Allyson C. Waldron

UNLV Theses, Dissertations, Professional Papers, and Capstones

The opioid epidemic is a national health emergency in the United States, with over 128 people dying each day due to an opioid overdose. It is estimated that 4.3 million people over the age of 12 use opioids without a medical need, and 1.3 million youth ages 12-17 use opioids inappropriately. Drug overdose deaths have become the leading cause of accidental death in the United States, prompting the U.S. Surgeon General and the World Health Organization to advise that more Americans have access to naloxone and understand how to use this life-saving drug correctly. Naloxone is an opioid antagonist, used …

Does Social Support Moderate The Association Between Income And Food Security Status Among Seniors Living In Southern Nevada?, Adugna Teka Siweya

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Income is the strongest predictor of food insecurity among seniors, and social support also an essential factor to help mitigate the effects of food insecurity. However, little is known about the potential role that social support may play as a moderator of the association between income and food insecurity. Thus, we aim to examine social support as a moderator for the relationship between income and food insecurity among seniors. Methods: Logistic regression models were used to analyze data collected in 2019 from seniors residing in Southern Nevada. Predictors of food insecurity, sociodemographic factors, social support variables, and income and …

Food Insecurity And Risky Sexual Behaviors Among College Students, Bertille Octavie Mavegam Tango Assoumou M

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity and sexually transmitted infections (STIs) are growing public health problems in the United States. Young people in general, and particularly college students, exhibit high prevalence of food insecurity, STIs, and risky sexual behaviors (RSB). Food insecurity and STIs among college students can have short- and long-term impacts on their academic success and their lives. Several studies have reported an association between food insecurity and some risky sexual behaviors among specific populations including HIV-infected people and homeless people. However, little is known about the relationship between food insecurity and RSB among college students. Given the high prevalence of food …

Movement Integration In Classrooms: Factors Associated With The Adoption And Implementation Of Physical Activity In Us Elementary Schools, R. Blake Densley

Boise State University Theses and Dissertations

The intentional integration of movement in elementary school classrooms—including both brief instructional breaks for physical activity, or the integration of physical activity with lessons—can benefit children’s physical health and education outcomes. Teachers are key implementation agents, but despite movement integration (MI) being considered an educational best practice, many classroom teachers do not regularly use it. The aim of this study was to obtain updated nationally-representative prevalence estimates in US public elementary schools, regarding four key outcomes pertaining to teachers’ implementation of physical activity: 1) school adoption of physically active lessons (PALs); 2) school adoption of physical activity breaks (PABs); 3) …

A Descriptive Case Study Of The Challenges Of Drug And Alcohol Counselors, Ruben Herron

Graduate Theses and Dissertations

Substance abuse is the number one public health problem in Oklahoma and nationally. Annual related expenses of substance abuse in Oklahoma are nearly $2 billion. This qualitative descriptive case study asks the question what are the challenges of substance-abuse counseling? The researcher will be describing in detail the history of drug and alcohol treatment and counseling in America. Using interviews, observations and document collection which will allow the interviews voices to be heard.

Behavioral Economic Modeling Of The Effects Of Symptom, Severity, And Cost On Seeking Medical Care, Mark J. Rzeszutek

Dissertations

While the United States has some of the highest healthcare spending in the world, it has some of the worst health outcomes. For example, maternal mortality in the United States is almost five times as high as in other similarly wealthy countries. It also has the highest rates of avoidable deaths. One of the reasons for this may be the cost of accessing healthcare due to privatized insurance. For example, Americans may avoid important preventive medical visits and other health screeners due to cost. While lack of health insurance has been correlated with decreased health utilization, a precise understanding of …

Coronavirus Disease-19 And Cardiovascular Disease: A Risk Factor Or A Risk Marker?, Jing Liu, Salim S Virani, Mahboob Alam, Ali E Denktas, Ihab Hamzeh, Umair Khalid

Faculty, Staff and Students Publications

Severe acute respiratory syndrome coronavirus-2 causes the clinical syndrome of coronavirus disease of 2019 (COVID-19) which has become a global pandemic resulting in significant morbidity and mortality. While the virus primarily affects the respiratory system, it also causes a wide variety of complex cardiac manifestations such as acute myopericarditis, acute coronary syndrome, congested heart failure, cardiogenic shock and cardiac arrhythmias. There are numerous proposed mechanisms of cardiac injury, including direct cellular injury, pro-inflammatory cytokine storm, myocardial oxygen-demand mismatch, and systemic inflammation causing multi-organ failure. Additionally, medications commonly used to treat COVID-19 patients have various cardiovascular side effects. We aim to …

Coronavirus Disease-19 And Cardiovascular Disease: A Risk Factor Or A Risk Marker?, Jing Liu, Salim S Virani, Mahboob Alam, Ali E Denktas, Ihab Hamzeh, Umair Khalid

Faculty, Staff and Students Publications

Severe acute respiratory syndrome coronavirus-2 causes the clinical syndrome of coronavirus disease of 2019 (COVID-19) which has become a global pandemic resulting in significant morbidity and mortality. While the virus primarily affects the respiratory system, it also causes a wide variety of complex cardiac manifestations such as acute myopericarditis, acute coronary syndrome, congested heart failure, cardiogenic shock and cardiac arrhythmias. There are numerous proposed mechanisms of cardiac injury, including direct cellular injury, pro-inflammatory cytokine storm, myocardial oxygen-demand mismatch, and systemic inflammation causing multi-organ failure. Additionally, medications commonly used to treat COVID-19 patients have various cardiovascular side effects. We aim to …

Boots On The Ground And Shots In Arms: A West Virginia Pharmacist On Covid-19 Vaccinations., Charles Massey

Marshall Journal of Medicine

No abstract provided.

Covid-19: The Vaccine Race Continues, L. Hayley Burgess, Carley Castelein, Andrew Rubio, Mandelin K. Cooper

HCA Healthcare Journal of Medicine

Over a year has passed since the discovery of SARS-CoV-2 and the subsequent COVID-19 pandemic. As mitigation efforts continue, COVID-19 has claimed over half a million lives in the United States and 3.1 million lives globally. The development and availability of vaccines delivering immunity to prevent COVID-19 offers hope to end the pandemic.

Emergency use authorizations from the Food and Drug Administration have been issued in the United States for three vaccines, one each from Pfizer-BioNTech, Moderna and Janssen/J&J. Pfizer-BioNTech and Moderna are both mRNA vaccines with efficacy of 95% and 94.1% respectively, while the vector-based vaccine from Janssen/J&J has …

A Call To Action: Preventing Opioid And Substance Abuse In South Florida Youth, Julie A. Jacko, Katherine P. Cohen, Cathaerina Appadoo, Arkene S. Levy, Timothy F. Page, Michael J. Parker, Solina Pierre-Gilles, Francois Sainfort

HCA Healthcare Journal of Medicine

The opioid crisis poses a substantial threat to youth throughout the nation. This crisis has been exacerbated by the COVID-19 pandemic, reversing some of the positive national trends in the fight against the opioid epidemic. Some risk factors for youth opioid use have been identified nationally. The South Florida tri-county region of Miami-Dade, Broward and Palm Beach is a culturally distinct region which may not follow national trends and likely has unique risk and protective factors. To address the concerning spike in youth opioid use in South Florida, a community coalition was formed to identify factors unique to South Florida …

Food Safety Recommendations During The Era Of Covid-19 Pandemic, Nada El Darra

BAU Journal - Health and Wellbeing

The coronavirus disease COVID-19 is a respiratory illness declared on March 11, 2020 as a pandemic by the World Health Organization due to its rapid spread among countries since it is very contagious. Data on COVID-19 has shown that there is no evidence that the virus is transmitted by food. To reduce the risk of COVID-19 infection, it is imperative to follow a list of recommendations. It is essential within food establishments to emphasize on food safety systems implementations, including pre-requisites programmes such as good hygienic practices, good manufacturing practices, pest control, cleaning and sanitation as well as implementing Hazard …

Factors Affecting Pregnancy Outcome In Refugee Mothers In Lebanon, Hesham Elshal, Mohammad Chour, Sirine Abdel Halim, Sadika Kharpoutli, Hind Raad, Sami Abou Alfa, Rida Maaliki, Zeina Makki

BAU Journal - Health and Wellbeing

In recent years, Lebanon has been a destination for less privileged refugees who seek better living conditions and shelter from regional wars, conflicts and instabilities. Recently, it is estimated that more than 20% of residents in Lebanon are Syrian refugees who live under questionable conditions regarding quality of life. Pregnant women, among their population, are considered more vulnerable to the effect of such living conditions. This study aimed at assessment of pregnancy outcome (birth weight, infant complications…) in a sample of women in refugees areas who have recently given birth and relate this outcome to multiple factors including socioeconomic status …

Knowledge And Beliefs Of Adolescents About Acne: Baseline And Post-Intervention Assessments Using An Interactive Educational Tool, Mohammed Mehanna, May Saab

BAU Journal - Health and Wellbeing

Acne vulgaris is a common inflammatory skin condition affecting teenagers around the globe. Lack of knowledge and false beliefs about acne are factors contributing to non-adherence to acne treatment that would result in treatment failure. Since acne is a highly prevalent skin condition in Lebanon, educating Lebanese adolescents about acne is vital to achieve a better treatment outcome. The aim of the present study is to assess the baseline knowledge of a sample of Lebanese adolescents using a self-administered questionnaire, and increase the level through an educational intervention (interactive audio-visual presentation). The knowledge score was assessed before and after the …

Adherence To Mediterranean Diet Among Adolescents Attending Public Schools In North Lebanon, Rosy Mitri, Fouad Ziade

BAU Journal - Health and Wellbeing

The Mediterranean diet (MD) is a model of a healthy diet and healthy lifestyle. Adherence to the MD has been correlated with a reduction in many metabolic disorders including cancers. The factors associated with adolescents’ adherence to the MD in North Lebanon using the KIDMED index have never been explored. The objective of this study was to examine the factors associated with the Mediterranean diet (MD) adherence among a sample of Lebanese adolescents. A cross-sectional survey was conducted in the city of Tripoli, North Lebanon. A total of 298 students, aged 11-18 years, were randomly selected from public schools in …