Public Health Commons^™

A Cross-Sectional Analysis Of Adverse Childhood Experience Exposure On Cancer Diagnosis Utilizing The 2022 Behavioral Risk Factor Surveillance Survey Data, Emma Zipperer

Capstone Experience: Master of Public Health

Objective: To determine the association between Adverse Childhood Experiences (ACEs) and cancer diagnosis based on ACE exposure levels.

Methods: We utilized data collected in the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey. The study population (n=54,148) was restricted to states that reported on the optional model of experiencing ACEs and those who responded about cancer diagnosis. A univariate analysis, bivariate analysis and a multivariate logistic regression were performed. Odds of cancer diagnosis among those with differing ACE exposure levels were calculated.

Results: High ACE exposure had 20% higher odds of cancer diagnosis when compared to low ACE exposure. White, …

Mental Health Perceptions Among Us Veterans And Non-Veterans: 2022 Behavioral Risk Factor Surveillance System, Nicole Frederickson

Capstone Experience: Master of Public Health

Objective. To determine the association between veteran status and perceived mental health in US adults.

Methods. 2022 Behavioral Risk Factor Surveillance System cross-sectional telephone survey data were used. Analyses were adjusted for confounding sociodemographic and health-related characteristics. Weighted multinomial logistic regression was used to determine the association between veteran status and reporting 0, 1-13, or 14+ poor mental health days.

Results. A total of 430,653 individuals were included in this analysis. Veteran status was associated with decreased odds of reporting 1-13 poor mental health days than nonveterans (OR=0.81; 95% CI 0.77, 0.86) but greater odds of reporting 14+ poor mental …

Adverse Childhood Experiences As Individual Predictors Of Subjective Cognitive Decline: Analyzing The 2022 Behavioral Risk Factor Surveillance System, Ruthie Schmitt

Capstone Experience: Master of Public Health

Objectives. This study explored the association of Adverse Childhood Experiences (ACEs) and Subjective Cognitive Decline (SCD). This study aimed to determine within the United States which ACEs have a stronger association with SCD after 45 years of age by analyzing all 13 ACEs individually with SCD.

Methods. Data were obtained from the 2022 BRFSS. An analytic sample of 42,509 adults over 45 years of age from seven states was analyzed using binary and multivariate logistic regression. The outcome variable investigated in this study was SCD, and the explanatory variables were 13 ACEs.

Results. Of the respondents, 10.4% reported experiencing SCD …

Associations Between Long Covid And Healthcare Access: A Cross-Sectional Analysis Of The Behavioral Risk Factor Surveillance System (Brfss) 2022, Tiffany Elliott

Capstone Experience: Master of Public Health

Objective. To evaluate the association of healthcare access with Long COVID and clinical and sociodemographic factors.

Methods. Data were from the CDC's 2022 Behavioral Risk Factor Surveillance System (BRFSS) surveys regarding four measures of healthcare access and Long COVID. There were 25,549 respondents who reported Long COVID and 95,830 respondents who did not report Long COIVD.

Results. 25,549 (22.0%) of respondents reported Long COVID. Significant associations were found in respondents with public health insurance and delayed medical care due to cost. Those with chronic health conditions were more likely to report Long COVID. Women, certain racial/ethnic groups, …

Association Between Frequent Mental Distress And Insurance Status Using The 2022 Brfss, Christina Clayson

Capstone Experience: Master of Public Health

Objectives

Determine if there is a direct relationship between frequent mental distress and health insurance coverage.

Methods

Data from the 2022 BRFSS was used to calculate adjusted percentages. Crude odds ratios for both mental distress and insurance coverage. Multivariate analysis calculated crude and adjusted odds ratios for frequent mental distress by insurance coverage with income as a covariate.

Results

Individuals reporting frequent mental distress had lower income, less education, and were younger. Individuals without health insurance were more likely to be younger, Hispanic, and not have graduated high school. There was no significant association between frequent mental distress and not …

Assessing How Children Modify The Impact Of Having Health Insurance On Smoking Status Using The 2021 Behavioral Risk Factor Surveillance System Survey, Zak Lippert

Capstone Experience: Master of Public Health

Objective: To understand if children living in the home modify the relationship between health insurance and smoking.

Methods: This analysis used the 2021 Behavioral Risk Factor Surveillance System Survey. The outcome was being a current smoker with health insurance as the exposure. The analysis was stratified by children to determine if children changed how having health insurance impacted smoking. The odds ratios for each stratum were compared to determine if children was a modifying factor.

Results: Children had a modifying effect on health insurance. For someone with children, if they had insurance, their odds of smoking were 0.91 (95% CI: …

Examining The Impact Of Adverse Childhood Experiences (Aces) On Breast And Colorectal Cancer Screening Behaviors In Adulthood, Meagan A. Kraft

Capstone Experience: Master of Public Health

Objective: To investigate the relationship between adverse childhood experiences (ACEs) and screening for breast and colorectal cancer in adulthood.

Methods: This cross-sectional study utilized nationwide survey data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). Data regarding ACEs and compliance with breast and colorectal cancer screening guidelines were analyzed from 12 states. Weighted logistic regression models were used to assess the relationship between ACEs and breast cancer screening compliance in a population of 18,369 women, and colorectal cancer screening compliance in a population of 30,884 men and women. Screening compliance among those with a high ACE score was compared …

Relationship Of Adverse Childhood Experiences And Depression Using The 2022 Behavioral Risk Factor Surveillance System Data In 12 States, Ivy Sovine

Capstone Experience: Master of Public Health

Objective: To determine if reporting adverse childhood experiences (ACE) is linked to depression in adults, taking into consideration the influence of sociodemographic factors.

Methods: A secondary analysis was performed using the cross-sectional 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey data. Twelve states included the optional ACE module, respondents who did not answer the questions about depression, education, or at least one ACE question were excluded from the analysis. The study population included 59,860 respondents. We examined the relationship between depression and ACE by using weighted univariate analysis, bivariate models, and logistic regressions.

Results: Among the respondents, 21% (12,112) reported …

Ordinal Logistic Regression Analysis Of The Frequency Of Marijuana Use Among Adult Informal Caregivers In 20 U.S. States, Behavioral Risk Factor Surveillance System (Brfss) 2021, Athena Plichta

Capstone Experience: Master of Public Health

Objectives. To examine the association between frequency of marijuana use among informal caregivers of persons with dementia (PWD) and other health conditions compared to non-caregivers in 20 U.S. states.

Methods. We used complex survey data from the optional modules Caregiver and Marijuana Use of the 2021 BRFSS survey. Univariate and bivariate analyses were performed to determine the frequency and distribution of sample population characteristics and calculate crude relationships. Ordinal logistic regression modelled the relationship between the three-level outcome and covariates.

Results. Frequency of marijuana use and caregiver status were not associated. There was no difference in increased use among individuals …

Certified Midwives: An Exploration Of Their Impact On Maternal Health Outcomes – A Comprehensive Literature Review, Heather Hollister

Capstone Experience: Master of Public Health

Maternal health outcomes in the United States have been consistently worse than other high-income countries, with a disproportionate impact on women of color. Midwives have long played an important role in maternal health worldwide. The literature review examines the evidence for midwives as key contributors to improving maternal health outcomes. The paper reviews the existing literature on midwifery, including the impact on maternal health, labor and delivery outcomes, and patient satisfaction. Electronic searches were conducted through Cochrane Library, CINAHL, Medline and Embase. Articles were screened according to inclusion and exclusion criteria including that they must be a randomized study; participants …

A Policy Evaluation For California’S Care Act And The Application Of The Social Determinants Of Health, Adelina Mercedes Lang

Capstone Experience: Master of Public Health

In 2022, California passed a legislative bill, SB 1338: the Community Assistance, Recovery, and Empowerment (CARE) Act, which created a new statewide procedure for treating mentally ill homeless adults diagnosed with psychotic disorders through a court-ordered CARE plan. SB 1338 intends to alleviate the mental health and homeless crisis. This capstone project provides an early assessment of SB 1338 using a modified formative policy evaluation methodology, including a scoping literature review and applying a policy assessment using the CDC's Policy Evaluation Framework. A stakeholder survey was also applied to gather stakeholders' perspectives on SB 1338. The literature review supported the …

Both/And: Mixed Methods Analysis Of Network Composition, Communication Patterns, And Socio-Economic Support Within Social Networks Of Transgender Women Involved In Sex Work In Lima, Peru, Tijana Temelkovska, Kathleen Moriarty, Leyla Huerta, Amaya G Perez-Brumer, Eddy R Segura, Ryan Colby Passaro, Jordan E Lake, Jesse L Clark, Cheríe S Blair

Faculty, Staff and Student Publications

Introduction: Social networks contribute to normative reinforcement of HIV prevention strategies, knowledge sharing, and social capital, but little research has characterized the social networks of transgender women (TW) in Latin America. We conducted a mixed methods analysis of three network clusters of TW in Lima, Peru, to evaluate network composition, types of support exchanged, and patterns of communication.

Methods: We recruited TW residing in or affiliated with three "casas trans" (houses shared among TW) in Lima between April-May 2018. Eligible participants were 18 or older, self-reported HIV-negative, and reported recent intercourse with a cis-male partner. Participants completed demographic questionnaires, social …

A Case Study Of The Political Determinant Of Health On The Public Health Crisis Of Malaria In Nigeria, Bisola M. Olumegbon

Electronic Theses and Dissertations

Abstract

Globally, there were about 229 million cases of malaria in 2022. The sub-Saharan African region accounted for 92% of the reported cases and 94% of deaths. Nigeria had the highest number of malaria cases and deaths, representing 27% of global cases. This scholarly project was a case study guided by the political determinants of health. Triangulation of data using thematic analysis was used to identify the political determinants of malaria in Nigeria and to understand how the concept of interaction contributes to the persistence of the disease. The analysis involved a deductive and inductive approach based on the literature …

Examining Covid-19 Vaccine Hesitancy Among The Nevada African American Population Using The Social-Ecological Model, Katelyn Faulk

UNLV Theses, Dissertations, Professional Papers, and Capstones

In Nevada, COVID-19 vaccines have been widely available to the general population since March 2021; however, even with the wide availability of these vaccines only 40% of the African American population in Nevada has been fully vaccinated against COVID-19 as of May 2023. This is problematic as it has been shown that the African American population is disproportionately affected by COVID-19 with higher rates of cases, hospitalizations, and deaths when compared to other races or ethnicities. Through the literature, it has also been well documented that African Americans may experience hesitancy toward these vaccinations for a multitude of reasons including …

An Evaluation Of Lead Concentration In Commercially Available Tiles, Daidre N. Gamboa

UNLV Theses, Dissertations, Professional Papers, and Capstones

Workers in the manufacturing and construction industries are at risk of lead exposure in projects that involve removal or installation of tiles, and other individuals exposed to lead, including children may also be at risk. The concern with lead in tiles is thought to be related to the glazing process or the country where the tile was produced. Multiple regulations are in place in the U.S. to protect people from lead exposure, including through surface coatings or painted surfaces. But these regulations do not cover glazed tiles. This study examined whether there are differences in lead concentration in (1) tiles …

Healthcare Practices In The United States Aimed At Improving Care And Language Access Services For Limited English Proficiency Refugees: A Systematic Review, Bemnet Kebede

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: The United States has accepted over 3 million refugees from all around the world since 1975. However, many Limited English Proficiency (LEP) refugees face significant barriers when seeking healthcare due to limited access, lack of knowledge, mistrust in physicians, language differences, cultural concerns, and overall complexity of the U.S. healthcare system. The purpose of this systematic review was to identify practices in the last 10 years that have improved healthcare and language access services for LEP refugees living in the U.S.

Methods: A search was conducted in four electronic databases PubMed, Embase, CINAHL, and Scopus from January 2013 to …

The Impact Of The Covid-19 Pandemic Response On Food Safety Violations Observed In Southern Nevada Food Establishments, Samantha Morales

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food poisoning is a common term used to describe what is actually foodborne illness. Despite the fact these illnesses can become deadly, foodborne illnesses are endemic and common in the United States. Nonetheless, they are completely preventable simply by following proper food safety procedures. The Food and Drug Administration identified the most common foodborne pathogens responsible for most foodborne infections, as well as the five risk factor categories to target in order to decrease the risk of cases and outbreaks.

To ensure foodborne outbreaks and cases are prevented, health authorities are tasked with conducting routine inspections on permitted food establishments. …

Does Maternal Mental Health (Anxiety And Depression) Negatively Impact Exclusive And Continued Breastfeeding Practices?, Smriti Neupane

UNLV Theses, Dissertations, Professional Papers, and Capstones

Exclusive and continued breastfeeding practices are the optimal source of nutrition for an infant's well-being, cognitive growth, and development and have positive health outcomes for the mother too. Anxiety and depression are common perinatal mental health conditions associated with early breastfeeding interruption. However, Nevada lacks data on perinatal mental health and its influence on breastfeeding practices. The objective of this study was to assess whether maternal mental health (anxiety and depression) impacts exclusive and continued breastfeeding practices in Clark County, Nevada. A cross-sectional survey was conducted with 358 mothers having children 0-23 months old and residing in Clark County, Nevada. …

Examining Health Literacy And Patient-Centered Communication: A Secondary Analysis Of U.S. Adults With A History Of Cancer, Kimberly Ann Dy Tomas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Racial/ethnic communities bear a disproportionate burden when examining cancer mortality and infection-related cancer incidence rates. According to the Office of Disease Prevention and Health Promotion (ODPHP), health literacy and clear communication between professionals and patients are crucial to improving health and the quality of healthcare. This study examined the relationship between personal health literacy and perceived patient-centered communication quality (PPCQ). A secondary data analysis was conducted using the Health Information National Trends Survey (HINTS) 5, Cycle 4 (2020), and STATA/BE 17.0 for Windows. The sample included respondents who have a history of cancer and have seen a healthcare provider within …

Empagliflozin In Patients Admitted To Hospital With Covid-19 (Recovery): A Randomised, Controlled, Open-Label, Platform Trial, Recovery Collaborative Group

Faculty, Staff and Student Publications

BACKGROUND: Empagliflozin has been proposed as a treatment for COVID-19 on the basis of its anti-inflammatory, metabolic, and haemodynamic effects. The RECOVERY trial aimed to assess its safety and efficacy in patients admitted to hospital with COVID-19.

METHODS: In the randomised, controlled, open-label RECOVERY trial, several possible treatments are compared with usual care in patients hospitalised with COVID-19. In this analysis, we assess eligible and consenting adults who were randomly allocated in a 1:1 ratio to either usual standard of care alone or usual standard of care plus oral empagliflozin 10 mg once daily for 28 days or until discharge …

“Be Sustainable”: Eosc-Life Recommendations For Implementation Of Fair Principles In Life Science Data Handling, Romain David, Arina Rybina, Jean-Marie Burel, Jean-Karim Heriche, Pauline Audergon, Jan-Willem Boiten, Frederik Coppens, Sara Crockett, Katrina Exter, Sven Fahrner, Maddalena Fratelli, Carole Goble, Philipp Gormanns, Tobias Grantner, Björn Grüning, Kim Tamara Gurwitz, John M Hancock, Henriette Harmse, Petr Holub, Nick Juty, Geoffrey Karnbach, Emma Karoune, Antje Keppler, Jessica Klemeier, Carla Lancelotti, Jean-Luc Legras, Allyson L Lister, Dario Livio Longo, Rebecca Ludwig, Bénédicte Madon, Marzia Massimi, Vera Matser, Rafaele Matteoni, Michaela Th Mayrhofer, Christian Ohmann, Maria Panagiotopoulou, Helen Parkinson, Isabelle Perseil, Claudia Pfander, Roland Pieruschka, Michael Raess, Andreas Rauber, Audrey S Richard, Paolo Romano, Antonio Rosato, Alex Sánchez-Pla, Susanna-Assunta Sansone, Ugis Sarkans, Beatriz Serrano-Solano, Jing Tang, Ziaurrehman Tanoli, Jonathan Tedds, Harald Wagener, Martin Weise, Hans V Westerhoff, Rudolf Wittner, Jonathan Ewbank, Niklas Blomberg, Philip Gribbon

Faculty, Staff and Student Publications

The main goals and challenges for the life science communities in the Open Science framework are to increase reuse and sustainability of data resources, software tools, and workflows, especially in large-scale data-driven research and computational analyses. Here, we present key findings, procedures, effective measures and recommendations for generating and establishing sustainable life science resources based on the collaborative, cross-disciplinary work done within the EOSC-Life (European Open Science Cloud for Life Sciences) consortium. Bringing together 13 European life science research infrastructures, it has laid the foundation for an open, digital space to support biological and medical research. Using lessons learned from …

Physical Activity, Anthropometric Measurements, Quality Of Life And Menopausal Symptoms Among South-Indian Women, Lavanya N, Sathyaprabha B

Faculty, Staff and Student Publications

INTRODUCTION: Menopause is the period when the reproductive capacity ceases in women's life. A wide range of symptoms occur as a consequence of estrogen decrease during menopause. Evidence suggests that physically active women have a better quality of life (QoL) and fewer menopausal symptoms. The aim of the study was to analyze the relationship between physical activity (PA), anthropometric measurements, QoL and menopausal symptoms.

MATERIAL AND METHOD: A cross-sectional study was conducted online through WhatsApp and Facebook and via email among menopausal women (April 2021 - June 2021). In total 168 responses were received; 153 responses were included in the …

Influenza Viral Infection Is A Risk Factor For Severe Illness In Covid-19 Patients: A Nationwide Population-Based Cohort Study, Jeong-Hwan Hwang, Yeon Seok You, Sang Woo Yeom, Min Gyu Lee, Jong-Hwan Lee, Min Gul Kim, Jong Seung Kim

Faculty, Staff and Student Publications

In order to prepare for the twindemic of influenza and SARS-CoV-2 infection, we investigated the association between influenza infection and subsequent severity of SARS-CoV-2 infection. A population-based nationwide cohort study was performed using data from the National Health Insurance Service (NHIS) in the Republic of Korea. This study included 274,126 individuals who underwent SARS-CoV-2 PCR testing between 20 January 2020 and 1 October 2020. Among these patients, 28,338 tested positive for SARS-CoV-2, and 4,003 of these individuals had a history of influenza. The control group was selected through 1:1 propensity score matching. In the group of 4,003 COVID-19-positive individuals with …

The Impact Of Covid-19 On Managing Ophthalmic Diseases: An International, Descriptive Study, Ethan Waisberg, Joshua Ong, Nasif Zaman, Sharif Amit Kamran, Alireza Tavakkoli, Andrew G Lee

Faculty, Staff and Student Publications

Background: Anecdotally, the COVID-19 pandemic has resulted in more severe cases of eye disease, decreased medication compliance/availability, and decreased treatment volume due to the lockdown.

Aims: We aim to quantify and bring together a variety of international perspectives from ophthalmologists of different subspecialties to characterize the global impact of COVID-19 on managing various ophthalmic disease.

Methods: An online survey of 10 questions was conducted among ophthalmologists using a specialized survey program.

Results: Fifty-two ophthalmologists were successfully contacted. Survey respondents include ophthalmologists from USA, Canada, Korea, Mexico, and New Zealand. Based on the results of our survey, 1 year after the …

Posterior-Scleritis: Case Report Of An Uncommon Immune-Related Adverse Event In The Treatment Of Advanced Endometrial Cancer, Brandon I Ing, Derek Kuhl, Deanna Glassman, Cynae A Johnson, Shrina Patel, Amir A Jazaeri

Faculty, Staff and Student Publications

As Immune checkpoint inhibitors are being expanded for use in gynecologic malignancies, rare immune-related adverse events are more frequently being reported. Here we describe a 63-year-old with Stage IIIB mismatch repair deficient uterine adenocarcinoma who underwent six cycles of carboplatin and paclitaxel with partial response but persistent disease. She was then started on single agent pembrolizumab. After six cycles of pembrolizumab, she developed bilateral vision changes and was diagnosed with posterior scleritis. Pembrolizumab was held and she was treated with oral prednisone, with rapid resolution of symptoms. One month after completion of prednisone, vision changes were again reported and she …

Assessing The Risk Of West Nile Virus In The Southwestern United States, Bradon Bucher

UNLV Theses, Dissertations, Professional Papers, and Capstones

Climate change is an increasing public health threat that has been shown to influence Culex mosquito populations, the vectors of West Nile Virus (WNV). The main objective of this study was to determine which variables are most associated with WNV in the Southwest United States, defined herein as: California, Nevada, Arizona, and Utah. A Poisson regression model was used to analyze total cases from 2004-2020 using the following predictors: mosquito season temperature average, mosquito season precipitation average, bodies of water, and protected lands. Results indicated that precipitation average (P =.014) and the interaction between precipitation and temperature (P=.024) were significant. …

Factors Associated With Caregiver Responsive And Non-Responsive Feeding Styles In Clark County, Nevada, Amanda Castelo Saragosa

UNLV Theses, Dissertations, Professional Papers, and Capstones

Early childhood obesity has increased significantly over the last few decades, reaching epidemic levels in the United States. Many interventions exist to alleviate early childhood obesity; however, little focus is on preventing obesity-related risks for children under two. High-quality child-caregiver interactions are deemed critical for preventing early childhood obesity development, but there is little information on the socio-ecological factors that influence a caregivers' feeding styles. This study examined socio-ecological factors associated with caregivers' feeding styles (responsive vs. non-responsive) for infants under two in Clark County, Nevada. This cross-sectional study utilized a survey targeted to caregivers (18 and older) with infants …

Effect Of The Announcement Of Human-To-Human Transmission On Teleconsultation Services In China During Covid-19, Mairehaba Maimaitiming, Jingui Xie, Zhichao Zheng, Yongjian Zhu

Research Collection Lee Kong Chian School Of Business

Objectives: Telemedicine enables patients to communicate with physicians effectively, especially during the coronavirus disease (COVID-19) pandemic. However, few studies have explored the use of online health care platforms for a comprehensive range of specialties during the COVID-19 pandemic. This study aimed to investigate how telemedicine services were affected by the announcement of human-to-human transmission in China. Methods: Telemedicine data from haodf.com in China were collected. A difference-in-differences analysis compared the number of telemedicine use and the number of active online physicians for different specialties in 2020 with the numbers in 2019, before and after the announcement of human-to-human transmission. Results: …

Identifying The Optimal Deep Learning Architecture And Parameters For Automatic Beam Aperture Definition In 3d Radiotherapy, Skylar S Gay, Kelly D Kisling, Brian M Anderson, Lifei Zhang, Dong Joo Rhee, Callistus Nguyen, Tucker Netherton, Jinzhong Yang, Kristy Brock, Anuja Jhingran, Hannah Simonds, Ann Klopp, Beth M Beadle, Laurence E Court, Carlos E Cardenas

Faculty, Staff and Student Publications

PURPOSE: Two-dimensional radiotherapy is often used to treat cervical cancer in low- and middle-income countries, but treatment planning can be challenging and time-consuming. Neural networks offer the potential to greatly decrease planning time through automation, but the impact of the wide range of hyperparameters to be set during training on model accuracy has not been exhaustively investigated. In the current study, we evaluated the effect of several convolutional neural network architectures and hyperparameters on 2D radiotherapy treatment field delineation.

METHODS: Six commonly used deep learning architectures were trained to delineate four-field box apertures on digitally reconstructed radiographs for cervical cancer …

Relationship Between Occupational Safety And Health Policy Principles, Organizational Action On Work-Related Stress And The Psychosocial Work Environment In Italy, Stavroula Leka, Luis Torres, Aditya Jain, Cristina Di Tecco, Simone Russo, Sergio Iavicoli

Faculty, Staff and Student Publications

BACKGROUND: It is acknowledged that legislation acts as a motivator for organizational action on psychosocial risks. Our study aims to provide evidence on the relationship between key occupational safety and health (OSH) policy principles and organizational action on work-related stress, and, in turn, with reported employee job demands and resources and their experience of work-related stress. We focus on Italy where specific legislation and practices on work-related stress were introduced in 2008 which are underpinned by these key OSH policy principles.

METHODS: Secondary analysis of the Italian samples from the employer ESENER-2 and employee 6th EWCS surveys was conducted, using …