Epidemiology Commons^™

Nevada Hpv Vaccine Completion Time And Adherence Among 9-14-Year-Olds From 2017-2023, Emily Sandoval

UNLV Theses, Dissertations, Professional Papers, and Capstones

The HPV (Human Papillomavirus) is one of the most common sexually transmitted infections, in the United States. Since its development in 1991, the HPV vaccine has been proven to be highly effective against the infection (Centers for Disease Control and Prevention [CDC], 2024). In order for an individual to receive optimal protection, the CDC has given guidelines dependent on age. It is important to understand changes in HPV vaccine completion for future public health immunization campaigns and objectives. To analyze how HPV completion and adherence has changed from 2017-2023 among the 9-14-year-old population, a retrospective cohort study was conducted utilizing …

“Do You Even Lift, Bro?”: Correlates Of Muscle Dysmorphia Symptomatology In Filipino Male University Students, Pamela Paula C. Pioquinto

UNLV Theses, Dissertations, Professional Papers, and Capstones

Muscle Dysmorphia (MD) is a subtype of Body Dysmorphic Disorder (BDD) and is marked by the desire to increase muscularity and reduce body fat. MD is typically more prevalent among younger male populations, and it often drives comorbid disorders, including substance abuse, eating disorders, and social anxiety. Despite the growing literature on MD, it remains understudied in certain racial/ethnic populations, such as Filipinos. Acculturation, defined as the process in which an individual adopts, acquires, and adapts to a new cultural environment as a result of immigration, influences body image by reshaping an individual’s perceptions of beauty and muscularity standards. Guided …

Analyzing Sars-Cov-2 Wastewater Surveillance Data For Public Health Impact In Southern Nevada, Casey A. Barber

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Early in the COVID-19 pandemic, researchers determined that levels of severe acute respiratory coronavirus 2 (SARS-CoV-2) genetic material in wastewater could provide information about COVID-19 occurrence in communities. Wastewater-based epidemiology (WBE) efforts have subsequently expanded throughout the U.S. and internationally; the U.S. Centers for Disease Control and Prevention (CDC) initiated its National Wastewater Surveillance System (NWSS) in September of 2020 and continues its SARS-CoV-2 wastewater monitoring efforts following the end of the federal COVID-19 public health emergency in May 2023. The field of WBE has reached a critical juncture in determining the future of how SARS-CoV-2 wastewater surveillance data …

The Development Of Environmental Dna (Edna) Sampling For Arbovirus Vector Surveillance In Southern Nevada, Katharine Brooke Major

UNLV Theses, Dissertations, Professional Papers, and Capstones

Vector-borne diseases account for 17% of all infectious diseases worldwide and are responsible for more than 700,000 deaths annually. Two-thirds of the global population are at risk of arthropod-borne RNA viruses (arboviruses), spread by mosquitoes, ticks, and sandflies, with these pathogens accounting for 37% of all emerging human diseases. Arboviruses are becoming increasingly important causes of neurological disease in the United States, presenting a significant public health problem. In the absence of available vaccines and efficacious treatment options, accurate, rapid, and cost-effective surveillance of arbovirus vectors is critical for monitoring species distribution and mitigating disease transmission risk. Currently, mosquito vector …

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. …

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. …

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 …

Covid-19 Severity Among American Indians And Alaska Natives In 16 States - January 1, 2020, To March 31, 2021, Jessica Arrazola, Scott Erickson, Chiao Wen Lan, Adrian Dominguez, Sujata Joshi, Andria Apostolou, Ashley Busacker, David Casey, Christiana Coyle, Kathryn Helfrich, Jennifer Kraszewski, Thomas Kim, Genelle Lamont, Richard Leman, Pamela Lemaster, Nick Lehnertz, Mike Mannell, Dakota Matson, Alex Merrill, Tracy Miller, Benjamin Schram, Ozair Naqvi, Samantha Rice, Samantha Hyde-Rolland, Alyssa Rowell, Dean Seneca, Victoria Warren-Mears, Laura Williamson

Journal of Health Disparities Research and Practice

Objective: To compare rates and risk factors of severe COVID-19-related outcomes between American Indian/Alaska Native (AI/AN) and non-Hispanic White people (NHW).

Methods: Aggregate Social Vulnerability Index (SVI), COVID-19-related risk factor, hospitalization, and mortality data were obtained from 16 states for January 1, 2020-March 31, 2021. Generalized estimating equation Poisson regression models calculated age-adjusted cumulative incidences, incidence ratios (IR), and 95% confidence intervals (CI) comparing AI/AN and NHW persons by age, sex, and county-level SVI status.

Results: Race data were missing for 42.7% of COVID-19 cases, 24.7% of hospitalizations, and 10.1% of deaths. Risk of AI/AN COVID-19 mortality …

Polygenic Risk Score Development And Validation For Early Detection And Risk Stratification Of Rheumatoid Arthritis And Osteoarthritis In Postmenopausal Women, Yingke Xu

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Around one in four adults worldwide suffer from arthritis. There are more than one hundred different forms of arthritis; the two most common forms of arthritis are rheumatoid arthritis (RA) and osteoarthritis (OA). RA is an autoimmune disease that can cause joint inflammation. Around 1.3 million adults in the US suffer from RA, representing 0.6%–1% of the population. The RA diagnosis in its early stages is difficult since its signs and symptoms are similar to other arthritis. OA is the most common form of arthritis. In the US, around 30.8 million people are affected by this disease. However, OA …

Epidemiological/Disease And Economic Burdens Of Cervical Cancer In 2010–2014: Are Younger Women At Risk?, Chuhao Xi, Jay J. Shen, Betty Burston, Soumya Upadhyay, Shoujun Zhou

Healthcare Administration and Policy Faculty Research

Objective: Cervical cancer is an important factor threatening women’s health in China. This study examined the epidemiological and economic burden of cervical cancer among the medically insured population, which could provide data support for government departments to formulate policies. Methods: All new cases of cervical cancer under the Urban Employee Basic Medical Insurance (UEBMI) plan in a provincial capital city in eastern China from 2010 to 2014 were collected. The Cox proportional hazard model was used to analyze the factors affecting the survival rates for cervical cancer. Outpatient and hospitalization expenses were used to assess the direct economic burden, and …

Covid-19 Isolation Compliance Among Students And Employees Of A Large Public University, Nicolette Harmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Isolation has been used to prevent the spread of many infectious diseases including COVID-19. The CDC’s isolation recommendations have changed over the course of the COVID-19 pandemic, currently infected individuals must stay at home for 5 full days. The CDC cites low compliance rates as one of the reasons for the recent reduction to the number of days in isolation. However, the CDC could only cite studies from other countries due to the lack of studies on isolation compliance in the United States. This study aimed to determine what percentage of UNLV students and staff complied with the isolation guidelines …

Markers Of Neuroinflammatory And Degenerative Processes In Professional Athletes With Traumatic Encephalopathy Syndrome, Brooke Conway Kleven

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The clinical criteria for Traumatic encephalopathy syndrome (ccTES) were developed to improve the diagnosis of Chronic traumatic encephalopathy (CTE). This study aimed to determine whether there was an association between a clinical diagnosis of Traumatic encephalopathy syndrome (TES) and changes in serum biomarkers, balance, neuroimaging, and cognition among athletes in the Professional Athletes Brain Health Study (PABHS).Methods: Of the cohort, 130 professional fighters met age or retirement criteria and went to a consensus conference, with 52 fighters (40%) meeting the criteria for TES. A generalized linear model with generalized estimating equations was utilized to assess the odds of disease …

Use Of Healthcare Utilization Records For Analyzing Trends In Clinical Toxoplasmosis: A Comparison Of Nevada And The United States, Elijah Kreutzer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Toxoplasmosis, a zoonotic disease caused by the parasitic protist Toxoplasma gondii, is a ubiquitous, global public health concern with a wide variety of clinical manifestations. Surveillance for the disease is lacking even in developed countries, and what surveillance is present most often focuses on pregnant women. This research investigated trends in clinical toxoplasmosis in Nevada and nationally to address the lack of knowledge concerning how Nevada discharges compare to national discharges in cases of toxoplasmosis. Specifically, this research sought to determine what characterizes toxoplasmosis in Nevada across inpatient, outpatient, and emergency department settings, as well as how these cases differ …

Omicron Variants Of The Sars-Cov-2: A Potentially Significant Threat In A New Wave Of Infections, Lukasz Szarpak, Michal Pruc, Alla Navolokina, Kavita Batra, Francesco Chirico, Charles De Roquetaillade

School of Medicine Faculty Research

From the beginning, the COVID-19 pandemic turned out to be a huge challenge and burden for medical services [1]. Currently, humanity is dealing with a new wave of the virus that has evolved and presents a new challenge, mainly due to its ability to avoid immune surveillance. Indeed, our main line of defense — vaccines — may be compromised. Omicron variants are characterized by an evolutionary force unprecedented so far. Among the several sublines that have already emerged, the BA.5 strain exhibit higher transmissibility and demonstrates a worrisome immune evasion. According to several laboratory investigations, vaccination-induced antibodies are less successful …

Assessing Covid-19 Booster Hesitancy And Its Correlates: An Early Evidence From India, Geetanjali C. Achrekar, Kavita Batra, Yashashri Urankar, Ravi Batra, Naved Iqbal, Sabiha A. Choudhury, Deepti Hooda, Roohi Khan, Suraj Arora, Aditi Singh, Francesco Chirico, Manoj Sharma

School of Medicine Faculty Research

The emergence of SARS-CoV-2 mutants, waning immunity, and breakthrough infections prompted the use of booster doses of the COVID-19 vaccine to fight against the pandemic. India started booster doses in January 2022 and it is critical to determine the intention of booster dose uptake and its correlates. Therefore, the current cross-sectional study aimed to investigate booster dose acceptability and associated predictors among the Indian population. A convenience sampling technique was utilized to recruit a sample of 687 Indian residents. A 55-item psychometric validated survey tool was used to assess booster dose acceptability, vaccine literacy and vaccine confidence. Univariate, bivariate, and …

Covid-19 Booster Vaccination Hesitancy In The United States: A Multi-Theory-Model (Mtm) Based National Assessment, Kavita Batra, Manoj Sharma, Chia-Liang Dai, Jagdish Khubchandani

School of Medicine Faculty Research

Background: Despite the availability of COVID-19 vaccines and the proven benefits of vaccinations outweighing the potential risks, hesitancy to accept vaccines and additional doses remains a persistent problem. Therefore, the purpose of the study was to investigate hesitancy, confidence, literacy, and the role of the multi-theory model (MTM) constructs in COVID-19 booster uptake. Methods: This cross-sectional study utilized a 52-item psychometric valid web-based survey conducted during the month of October 2021 to recruit a nationally representative sample of U.S. adults. Univariate, bivariate, and multivariate statistical tests were used to analyze the data. Results: Among the booster hesitant group (n = …

Assessing Psychological Impact Of Covid-19 Among Parents Of Children Returning To K-12 Schools: A U.S. Based Cross-Sectional Survey, Kavita Batra, Jennifer R. Pharr, Emylia Terry, Brian Labus

School of Medicine Faculty Research

Background and Purpose: While impacts of the pandemic on family well-being have been documented in the literature, little is known about the psychological challenges faced by children and their parents as schools reopen after mandated closures. Therefore, the purpose of this study was to determine if sending children back to in-person school impacts the mental health of parents and the perceived mental health of their children. Methods: This cross-sectional descriptive study recruited a nationally representative, non-probability sample of parents or guardians (n = 2100) of children attending grades K-12 in the United States (U.S.) through a 58-item web-based survey. The …

Mental Disorder Symptoms During The Covid-19 Pandemic In Latin America – A Systematic Review And Meta-Analysis, Stephen X. Zhang, Kavita Batra, Wen Xu, Tao Liu, Rebecca Kechen Dong, Allen Yin, Andrew Yilong Delios, Bryan Z. Chen, Richard Z. Chen, Saylor Miller, Xue Wan, Wenping Ye, Jiyao Chen

School of Medicine Faculty Research

Aims There is a lack of evidence related to the prevalence of mental health symptoms as well as their heterogeneities during the coronavirus disease 2019 (COVID-19) pandemic in Latin America, a large area spanning the equator. The current study aims to provide meta-analytical evidence on mental health symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population and university students in Latin America. Methods Bibliographical databases, such as PubMed, Embase, Web of Science, PsycINFO and medRxiv, were systematically searched to identify pertinent studies up to August 13, 2021. Two coders performed the screening using predefined eligibility criteria. …

Exploratory Analysis Of The Associations Between Neonicotinoids And Measures Of Adiposity Among Us Adults: Nhanes 2015–2016, Amruta M. Godbole, Sheniz Moonie, Courtney Coughenour, Cai Zhang, Aimin Chen, Ann M. Vuong

Environmental & Global Health Faculty Research

Background: Toxicology studies suggest that neonicotinoids may be associated with adiposity development via thyroid hormone disruption and increased oxidative stress. Prior epidemiological studies report mixed results for the association between neonicotinoids and adiposity measures.

Objective: To examine the association between detectable concentrations of parent neonicotinoids (imidacloprid, acetamiprid, clothianidin) and neonicotinoid metabolites (5-hydroxy-imidacloprid, N-desmethyl-acetamiprid) with adiposity measures among US adults, and whether sex modifies the associations for neonicotinoid metabolites with adiposity.

Methods: National Health and Nutrition Examination Survey (NHANES) 2015–2016 data was utilized to estimate covariate-adjusted associations between detectable neonicotinoids and fat mass index (FMI), lean mass index (LMI), waist …

Depression And Factors Impacting Quality Of Life Among Adults With Asthma Presence In Nevada, Elizabeth D. Kahane, Lung-Chang Chien, Brian Labus, Dharini M. Bhammar, Jocy-Anna Chevalier, Sheniz Moonie

Epidemiology & Biostatistics Faculty Research

Background: Asthma, a chronic, non-communicable disease has been shown to negatively affect mental health and quality of life among adults. Annually approximately 8% of adult Nevadans report current asthma symptoms and 12.6% report having a lifetime diagnosis. The purpose of this study was to evaluate the association between asthma and depression and explore quality of life factors affecting adult Nevadans with asthma. Methods: Using behavioral risk factor surveillance system (BRFSS) data, this study evaluated the association between self-reported asthma and depression in Nevada using weighted multiple logistic regression. BRFSS asthma call-back survey (ACBS) data were used to determine the frequency …

Knowledge Or Awareness Of Non-Communicable Diseases And Their Associated Risk Factors Among University Students In Fiji: A Cross-Sectional Study, Awadhesh Kumar Shirotriya, Kavita Batra

School of Medicine Faculty Research

Introduction: Chronic diseases (aka Non-communicable diseases, NCDs) contribute to the global burden of morbidity and mortality, with a significant share of premature deaths among low-and middle-income countries (LMICs), including Fiji. The early exposure to the risk factors of NCDs affects the entire life course; knowledge or awareness of adolescents towards NCDs and associated risk factors is critical for health promotion. This study aims to investigate the knowledge or awareness level of chronic conditions and their risk factors among Fijian students. Methods: In this cross-sectional study, a sample of 338 university students was recruited using the paper as well as web-based …

Cellular Dna Effects Of Radiation And Cancer Risk Assessment In Cells With Mitochondrial Defects, J. Chen, D. M. Sridharan, C. L. Cross, J. M. Pluth

Epidemiology & Biostatistics Faculty Research

Mitochondria play a key role in mediating non-targeted effects (NTE) post-radiation exposure. Mitochondrial DNA (mtDNA), due to its less efficient repair as compared to nuclear DNA, is more severely affected by radiation exposure and mutations in essential mtDNA genes can further exacerbate oxidative stress. Our objective was to evaluate the impact of mitochondrial defects on radiation-induced DDR and genomic instability, biomarkers that can foreshadow cancer development. To better understand this relationship, we used commercially available lymphoblastoid cell lines containing characterized mitochondrial mutations and studied the kinetics of DNA damage and relative telomere length (RTL) changes over time post 0.5 Gy …

Association Between Diagnosed Anxiety And Depression And Exposure To Life Stressors During The Covid-19 Pandemic, Emily Hallgren Phd, Don E. Willis Phd, Brett Rowland Ma, James P. Selig Phd, Pearl A. Mcelfish Phd

Journal of Health Disparities Research and Practice

Research suggests that mental health disorders heighten the risk of exposure to life stressors. Drawing on a sample of 754 adults from a survey distributed at six primary care clinics, we examine whether adults who reported ever being diagnosed with depression or anxiety were more likely to experience an employment disruption, a housing disruption, and/or report more COVID-19-related stressors during the COVID-19 pandemic. Individuals who reported ever being diagnosed with depression reported a greater burden (B=.75) of COVID-19-related stressors. Those who reported ever being diagnosed with anxiety had higher odds of experiencing an employment disruption (OR=1.90) and a housing disruption …

Social Support Needs Of Minority Breast Cancer Patients: Significance Of Racial Homogeneity And Kin Composition Of Social Networks, Ganga Vijayasiri, Garth H. Rauscher, Ifeanyi Beverly Chukwudozie, Richard T. Campbell, Richard Warnecke

Journal of Health Disparities Research and Practice

Social support from family and friends assists breast cancer patients navigate a life crisis, but more needs to be understood about specific social network characteristics that can benefit breast cancer patients. To address this need, the primary aim of this study was to identify social network factors that facilitate or reduce social support. Given racially patterned gaps in social support among breast cancer patients, a secondary goal was to identify network characteristics that are linked to gaps in support. We examined these research questions using data from a sample of 915 breast cancer patients (NHWhite=373; NHBlack=377; Hispanic=165) and 4,021 of …

A Theory-Based Analysis Of Covid-19 Vaccine Hesitancy Among African Americans In The United States: A Recent Evidence, Manoj Sharma, Kavita Batra, Ravi Batra

Environmental & Global Health Faculty Research

African Americans have been disproportionately vaccinated at lower rates, which warrants the development of theory-based interventions to reduce vaccine hesitancy in this group. The fourth-generation theories, e.g., multi-theory model (MTM) of health behavior change, are vital in developing behavioral interventions. Therefore, the current study aims to determine recent trends in COVID-19 vaccination rates and to test the MTM model in predicting the initiation of COVID-19 vaccines among vaccine-hesitant Blacks. A sample of 428 unvaccinated African Americans were recruited through a web-based survey using a 28-item psychometric valid questionnaire. Chi-square, independent-samples-t-test or Welch’s t test, and Pearson’s correlation tests were utilized …

Can Community Gardens With Workshops Increase Gardening Behavior? A Navajo Wellness Collaboration, Kevin A. Lombard Phd, India J. Ornelas Phd, Desiree Deschenie, Felix Nez, Sonia Bishop, Katie Osterbauer Ms, Eileen Rillamas-Sun Phd, Shirley A.A. Beresford Phd

Journal of Health Disparities Research and Practice

This paper seeks to evaluate the potential efficacy of a community gardening intervention on the Navajo Nation to increase gardening and healthy eating behaviors, which are potentially important in preventing obesity and related health conditions. Rates of obesity are high among American Indians, including those living on Navajo Nation land. Eating fresh fruits and vegetables is part of healthy eating. However, availability and access to fresh fruits and vegetables are severely limited on the Navajo Nation, due to distance and cost. One way to increase both availability and consumption of fresh fruits and vegetables is through community gardening, yet …

Health Disparities And Covid-19 Pandemic: Increasing Clinical Research Participation Among African Americans, Kashica J. Webber-Ritchey, Abbi D. Lane-Cordova

Journal of Health Disparities Research and Practice

Health disparities in African Americans is a persistent issue. Higher rates and severity of the novel coronavirus-19 [COVID-19] among African Americans only widens health disparities. Effective COVID-19 treatment options are imperative, requiring representation of African Americans in clinical research. However, low participation and under-representation of African Americans is complex in nature. This article describes health disparities, the impact of COVID-19, and participation in clinical research among African Americans. We offer strategies for researchers to enhance the inclusion of African Americans. We also offer strategies in conducting clinical research during COVID-19.

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, …

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 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 …