Social and Behavioral Sciences Commons^™

The Long-Term Coercive Effect Of State Community Benefit Laws On Hospital Community Health Orientation, Charles B. Moseley, Jay J. Shen, Gregory O. Ginn

Nevada Journal of Public Health

This study is an examination of the long-term coercive effect of state community benefit laws (CB Laws) on the provision of community health activities in U.S. acute care hospitals. The sample included all the not-for-profit and investor owned acute care hospitals for which 1994 and 2006 AHA Annual Survey data were available. A panel design was used to longitudinally examine the effect that state CB Laws had on hospital community health orientation activities and the provision of health promotion services, after controlling for the influence of other organizational and environmental variables that might affect these activities and services. The authors …

Prevalence And Antimicrobial Susceptibility Of Methicillin-Resistant Staphylococcus Aureus In Pregnant Women And Their Newborns In Las Vegas, Nevada, Mark P. Buttner, Echezona E. Ezeanolue, Patricia Cruz, Joanne L. Henry, Ineada Jack, Chad L. Cross

Nevada Journal of Public Health

Colonization and infection by resistant strains of Staphylococcus aureus are being reported in epidemic proportions. The goal of this study was to determine the local prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in pregnant women in southern Nevada and how it correlates with colonization and infection of their neonates. Signed consent was obtained, and a brief questionnaire was administered by the medical staff to each pregnant woman to collect demographic data and pertinent medical, family and social history. Nasal and vaginal specimens were obtained from pregnant women at ≥35 weeks gestation, and nasal and umbilicus specimens were obtained from their …

Effects Of The Master Settlement Agreement On Smoking Among Nevada Teens: A Decade After Implementation And Implications Of Reduced Funding, Christina A. Demopoulos, Christopher R. Cochran

Nevada Journal of Public Health

Background: Tobacco control programs that have adapted the Centers for Disease Control and Prevention (CDC) Best Practices for a Comprehensive Tobacco Control Program (CTCP) have been effective in reducing the rates of tobacco use. This paper investigates the effectiveness that Nevada’s tobacco control programs have had on teen tobacco use and rates to date and examines changes to programs given reduced Master Settlement Agreement (MSA) funding.

Methods: Aggregate data from the Nevada Department of Health and Human Services/Fund for a Healthy Nevada program was analyzed to determine if the tobacco control programs adapted the CDC’s Best Practices for a CTCP. …

Analysis Of Lead Levels In Deciduous Teeth From Children In Clark County, Nevada., Kristin Murphy, Jennifer Berger-Ritchie, Shawn L. Gerstenberger, Amol B. Amin, Jason K. Nitta, Frederick G. More, Jeanne A. Hibler, Karl Kingsley

Nevada Journal of Public Health

Background: Elevated blood lead levels (EBLL) are declining in the United States, although some population subgroups continue to exhibit significant health disparities. A childhood lead poisoning prevention program was recently started in Nevada, and many efforts have been made to support this program and increase the screening rates.

Methods: To expand the potential pool of children screened for EBLLs, a pilot study was performed to evaluate lead concentrations in extracted deciduous teeth using Graphic Furnace Atomic Absorption Spectrometry (GFAAS), Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and X-Ray Fluorescence (XRF) analysis.

Results: Lead concentrations as determined by GFAAS and ICP-MS were …

Chronic Disease And Risk Factors Among Nevadans With Disabilities: A 2009 Brfss Study, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Previous research has found that people with disabilities are more likely to have chronic diseases (coronary artery disease, stroke, cancer, asthma, diabetes), secondary conditions (high blood pressure, high cholesterol) and risk factors for chronic disease (physical inactivity and obesity) (Havercamp, Scandlin, & Roth, 2004; Kinne, Patrick, & Doyle, 2004; Nosek, Hughes, Petersen et al., 2006; Reichard, Stolzle, & Fox, 2011). The purpose of this study was to conduct a secondary analysis using data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) to identify differences in chronic disease risk factors and chronic disease/ secondary conditions between adults with and without …

Utilization Of Preventative Health Services By Nevadans With Disabilities, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Health disparities are differences in access to health care, quality of health care and health outcomes observed between population-specific groups of people (Health Resources and Services Administration, 2000). Previous research has found that people with disabilities experience unequal access to preventative health care services. The purpose of this study was to conduct a secondary data analysis using data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) to determine differences in utilization of preventative health services between adults with and without disabilities in Nevada. Nevadans with disabilities were significantly more likely to have access to health insurance and to have …

Nutrition Education In Clark County, Nevada, Matt Bittle, Mildred Mcclain, Jeanne A. Hibler, Marcia M. Ditmyer

Nevada Journal of Public Health

Over 51 million school hours are missed annually by school-aged children due to a dental problem or visit, with 117 hours missed per 100 children (NIDCR, 2002). Approximately half a million of California's 7.2 million school-age children missed at least one day of school in 2007 because of dental issues such as toothaches (Pourat, & Nicholson, 2009). Independent research regarding various educational and intervention programs have been conducted in elementary schools across the country that focus on nutrition and/or physical activity, some of which have found that the programs positively impacted students’ dietary behaviors (Edwards, Mauch, & Winkelman, 2011; Muth, …

Characteristics Of Children Attending Asthma Camp In Nevada, Priyank Shetty, Sheniz Moonie, Amy Beaulieu, Christopher M. Aquino

Nevada Journal of Public Health

The purpose of this study was to assess asthma trigger knowledge of camp attendees and the measure of agreement between physician and parent assessment of the children’s asthma severity. This study is based on cross-sectional data provided by the American Lung Association (ALA) and those children participating in summer asthma camps in Las Vegas and Reno, Nevada. Fifty-six children participated in the camp in August of 2008. The study results suggest a significant positive correlation between physician and parent assessment of asthma severity. With increasing asthma severity there was a relative increase in the number of school days missed among …

Reducing Unlawful Prescription Drug Promotion: Is The Public Health Being Served By An Enforcement Approach That Focuses On Punishment?, Vicki W. Girard

Georgetown Law Faculty Publications and Other Works

Despite the imposition of increasingly substantial fines and recently successful efforts to impose individual liability on corporate executives under the Park doctrine, punishing pharmaceutical companies and their executives for unlawful promotional activities has not been as successful in achieving compliance with the Federal Food, Drug, and Cosmetic Act (FD&C Act) as the protection of the public health demands. Over the past decade, the Food and Drug Administration (FDA) and the Department of Justice (DOJ) have shifted their focus from correction and compliance to a more punitive model when it comes to allegedly unlawful promotion of pharmaceuticals. The shift initially focused …

Introduction Of A Waterless Alcohol-Based Hand Rub In A Long-Term Care Facility, Lona Mody, Mcneil A. Shelly, Rongjun Sun, Bradley Suzanne, Carol A. Kauffman

Rongjun Sun

OBJECTIVE: To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF). METHODS: Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub. RESULTS: Hand hygiene practices, knowledge, and opinions did not change after …

The Relationship Between Ethnic Identity And Chlamydia And Gonorrhea Infections Among Low-Income Detained African American Adolescent Females, Dexter R. Voisin

Faculty Scholarship

This study explored the relationship between ethnic identity and Chlamydia and Gonorrhea infections among detained African American female adolescents. A cross-sectional survey was conducted among 123 African American female adolescents within eight detention facilities in Georgia. Using audio-computer assisted self-interviewing technology, data were collected on demographics, ethnic identity, laboratory-confirmed Chlamydia and Gonorrhea, and other known correlates for sexually transmitted infections (STIs), such as socioeconomic status, parental monitoring, and risky sexual behaviors. Rates of Chlamydia and Gonorrhea testing yielded incidence rates of 22.6% and 4.3%, respectively. Findings indicated that, controlling for STI correlates, participants who indicated high ethnic identity were 4.3 …

System Dynamics Modeling Of Prescription Opioid Pain Reliever Abuse, Alexandra Nielsen

Systems Science Friday Noon Seminar Series

The nonmedical use of prescription opioid pain relievers and associated overdose deaths have been labeled an epidemic by the Centers of Disease Control and Prevention. While these medicines play an important role in the treatment of pain, the benefits of opioids for the treatment of pain need to be balanced against these very real risks. Alex has been working closely with Professor Wayne Wakeland, Teresa Schmidt, and Dr. Dennis McCarty (OHSU) to create a dynamic systems-level model of opioid use, abuse, and diversion in order to give context to current research in this area and to provide a better understanding …

Filling The Gap: An Examination Of Hiv/Aids Treatment And Prevention At Uganda Cares Masaka, Andrew Robert Mcasey

Independent Study Project (ISP) Collection

A six week internship was conducted at Uganda Cares Masaka, a HIV/AIDS treatment organization, to learn about the development issues surrounding the HIV/AIDS pandemic. The internship was aimed at gaining practical experience at an HIV/AIDS clinic to learn about the challenges faced and the strategies used by Uganda Cares as wells as the effectiveness of their strategies. Uganda Cares represents a collaborative relationship between the private, international HIV treatment and advocacy group, the AIDS Healthcare Foundation (AHF), and the public Ministry of Health (MOH) in Uganda. A final objective of the internship was to gain an inside perspective on this …

Medical Tourism: Trends And Opportunities, Krista Wendt

UNLV Theses, Dissertations, Professional Papers, and Capstones

Medical tourism involves travel for the purpose of receiving medical, dental, or surgical care (Medical Tourism Association), and represents a rapidly growing niche market within the healthcare, tourism, and hospitality industries. Medical travelers are motivated to seek care outside of their area of residence by many factors, including more advanced technology, quicker access, higher quality of care, or lower costs for care in the destination locality (Ehrbeck, Guevara, & Mango, 2008). Multiple factors contribute to the growth of the medical tourism industry and suggest a continuing trend toward growth in the future. This nascent industry represents a significant market opportunity …

Health Implications Of A Delayed Transition Into Adulthood, Lisa K. Zaporzan

Electronic Thesis and Dissertation Repository

This thesis considers mental and physical health outcomes experienced by young adults who live in their parents’ home during young adulthood. The life course perspective suggests that this “off-time” transition may lead to stigmatization and stress, and subsequently, health problems. This research uses the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative longitudinal sample of adolescents living in the United States. Wave four was primarily used, during which respondents are between 25-34 years of age (N=2776).

Although living with parents did not significantly increase CES-D or BMI, findings suggest CES-D was affected for those who have physical …

Research Brief: "Access To Care For Women Veterans: Delayed Healthcare And Unmet Need", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study builds on previous research that shows there are female veteran-specific access barriers to health care, and explores reasons for those barriers. For policy and practice, the study shows that potential barriers to healthcare for female veterans include not being able to afford healthcare or time to seek treatment, and that healthcare reform policies could eliminate some of these barriers. Future research includes analyzing the health consequences of delayed care, various caregiver responsibilities that serve as barriers to seeking treatment, and non-VA users' access to healthcare.

"Proving Yourself" In The Canadian Medical Profession: Gender And The Experiences Of Foreign-Trained Doctors In Medical Practices, Vanessa Noelle Dolishny

Electronic Thesis and Dissertation Repository

In recent years the medical profession has become feminized. Additionally, there has been an increased representation of foreign-trained professionals in the Canadian medical profession; many of which are women. Thus, there is a significant number of female medical practitioners who are foreign-born and foreign-trained. This demographic faces many barriers, which are often characterized as a “double disadvantage”. This paper investigates the experiences of foreign-trained medical professionals once they have gained access to the profession and whether the feminization of medicine has impacted the experiences of these individuals. Immigrant status was found to be highly significant to one’s experiences in the …

Health Disparities Experienced By People With Disabilities In The Us: A Behavioral Risk Factor Surveillance System Study, Jennifer Renee Pharr, Timothy J. Bungum

Environmental & Occupational Health Faculty Publications

The Americans with Disabilities Act became law in 1990; since then research has shown that people with disabilities continue to experience barriers to health care. The purpose of this study was to compare utilization of preventive services, chronic disease rates, and engagement in health risk behaviors of participants with differing severities of disabilities to those without disabilities. This study was a secondary analysis of 2010 data collected in the Behavioral Risk Factor Surveillance System national survey in the United States. Rao Chi square test and logistic regression were employed. Participants with disabilities had significantly higher adjusted odds ratios for all …

Identifying Barriers To Adherence For Hiv+ Patients Placed On Renal Dosing, Richard S. Colon Jr

Master's Theses

No abstract provided.

Review Of Sex Cells: The Medical Market For Eggs And Sperm, By Rene Almeling., Medora Barnes

Medora W. Barnes

Racial And Ethnic Health Disparities In Incarcerated Populations, Meghan E. Borysova, Ojmarrh Mitchell, Dawood H. Sultan, Arthur R. Williams

Journal of Health Disparities Research and Practice

Alarming disparities in population health and wellness in the United States have led to multi-disciplinary research efforts to create health equity. Identifying disparities, elucidating the etiological bases of disparities, and implementing solutions to eliminate disparities are part of the U.S. national health agenda. Racial and ethnic disparities have been identified throughout the cancer control continuum, in cardiovascular disease, diabetes and a multitude of other conditions. The causes of disparities are complex, condition specific, and conjectured to result from combinations of biological and socio-behavioral factors. Racial and ethnic health disparities within the vast incarcerated communities have been excluded from most studies, …

An Innovative Approach For Community Engagement: Using An Audience Response System, Jenna L. Davis, Kara E. Mcginnis, Margaret L. Walsh, Coni Williams, Kevin B. Sneed, Julie A. Baldwin, B. Lee Green

Journal of Health Disparities Research and Practice

Community-based participatory research methods allow for community engagement in the effort to reduce cancer health disparities. Community engagement involves health professionals becoming a part of the community in order to build trust, learn from the community and empower them to reduce disparities through their own initiatives and ideas. Audience Response Systems (ARS) are an innovative and engaging way to involve the community and obtain data for research purposes using keypads to report results via power point. The use of ARS within communities is very limited and serves to widen the disparity gap by not delivering new advances in medical knowledge …

Dual Hiv Risk And Vulnerabilities Among Women Who Use Or Inject Drugs: No Single Prevention Strategy Is The Answer, Nabila El-Bassel, Wendee M. Wechsberg, Stacey Shaw

Faculty Publications

HIV prevention strategies and services need to address the unique and multilevel drivers that increase the vulnerabilities to HIV, HCV, and STIs among women who use drugs including those who engage in sex work. Scaling-up and improving access to multilevel and combined HIV prevention strategies for these women is central to combating the HIV epidemic.

Toward A Culture Of Healing: Why Alternative Therapies And A Feminist Framework Are Needed In The Care Of Pregnant Women And Treatment Of Postpartum Mood Disorders, Angela Leonardo

Anthós

Pregnancy, birth, and early motherhood are areas of human development that have systematically migrated away from their roots as a series of natural life events to a highly, and perhaps unnecessarily, medicalized arena. This shift has been detrimental for women, especially for poor, socially isolated, single, and/or ethnic minority women. In this paper, I outline my concerns with the increased medicalization of birth and postpartum care, as well as with the status of mothers in the United States, and critically examine the patriarchal context in which this shift has occurred. My focus is on maternal health and mortality, including depression …

Emerging Disparities Among Self-Pay Trauma Patients, Michelle Chino Dr, Deborah A. Kuhls, Mark K. Markarian, Sam Holland, John J. Fildes

Journal of Health Disparities Research and Practice

Preliminary results from a study of trauma patients in Southern Nevada are yielding some unexpected findings with implications for both trauma centers and the growing Hispanic population. Hispanic patients are more likely to be self pay irrespective of income level and employment status when compared to non-Hispanic patient groups. Further, self pay Hispanics, unlike their non-Hispanic, self pay counterparts, tend to be employed, have families, and report stable living conditions. The implication is that the financial and social cost of traumatic injury may place a significant burden on trauma centers, patients, their families and the community.

Disparities In Mental Health Utilization Among Persons With Chronic Diseases, Saundra Glover, Keith Elder, Sudha Xirasagar, Jong-Deuk Baek, Crystal Piper, Dayna Campbell

Journal of Health Disparities Research and Practice

This study used Aday and Andersen’s Behavioral Model of Health Services Use to examine the role of chronic disease and the joint impact of race and chronic disease type on mental health utilization. Using data from Community Tracking Survey Household Survey, we tested the assumption that chronic disease, chronic disease type, and race are related to lower rates of mental health visits when adjusted for predisposing, enabling, and need factors. After adjusting for population characteristics, we found that race significantly moderated the impact of chronic disease type on mental health utilization, showing that African Americans with cardiovascular disease were half …

Assessing Behavioral Health Risks, Health Conditions, And Preventive Health Practices Among American Indians/Alaska Natives In Nevada, Gwen Hosey, Shirley A. Llorens-Chen, Fares Qeadan, Daryl Crawford, Charlton Wilson, Wei Yang

Journal of Health Disparities Research and Practice

The 2004 Behavioral Risk Factor Surveillance System (BRFSS) survey was administered to American Indian/Alaska Native (AI/AN) adults in Nevada to determine whether health disparities exist between AI/ANs and the state’s general population. Results showed AI/ANs were 1.5 times more likely to smoke cigarettes, 3.5 times more likely to be exposed to secondhand smoke, 3.2 times more likely to lack leisure-time physical activity, 9.7 times more likely to report fair/poor health status, and 7.7 times more likely to have a disability. In addition, AI/ANs were more likely to have current asthma (OR=5.0) and diabetes (OR=1.8). AI/AN women were 4.8 times as …

The Hiv/Aids Pandemic In African American Msm: Targets For Intervention, Kelly Neff

Journal of Health Disparities Research and Practice

The Centers for Disease Control and Prevention estimated in 2005 that 46% of African American men who have sex with men (MSM) are HIV positive. This review explores the unique factors that contribute to risky sexual behavior and the spread of HIV within this population, suggesting that the disparate prevalence of HIV among African American MSM is rooted in experiences of stigmatization from multiple sources and lack of social support from society at large as well as from within the African American community. Beliefs in HIV conspiracy myths are also thought to hinder HIV education, awareness and prevention for African …

Racial Differences In Preventive And Complementary Health Behaviors And Attitudes, Steven E. Shive, Grace X. Ma, Yin Tan, Jamil I. Toubbeh, Lalitha Parameswaran, Lalitha Parameswaran, Joe Halowich

Journal of Health Disparities Research and Practice

Screening tests have been developed for many diseases—the presence of cancer, especially—but are differentially utilized among racial/ethnic groups. In addition to standard medical screening techniques, some patients opt to use Complementary and Alternative Medicine (CAM) for prevention and treatment. The purpose of the current study is to examine racial/ethnic disparities in primary and secondary preventive health behaviors, determine differences in use of complementary and alternative health regimens, and determine which health attitudes and health self-management factors are associated with use of complementary alternative medicine. If differences among ethnic/racial groups in perceived health status, preventive health care behaviors, and use of …

Equal Care, Unequal Outcomes: Experiences Of A Reach 2010 Community, Diane Neal, Barbara Carlson, Carolyn Jenkins, Gayenell Magwood

Journal of Health Disparities Research and Practice

Diabetes is growing in prevalence and costs. Guidelines for care have been available since 1983, yet diabetes care and outcomes remain less than ideal. CDC’s Racial and Ethnic Approaches to Community Health 2010 (REACH 2010) identified diabetes in African Americans as a priority for action. This article documents the activities, interventions, and current progress of the REACH 2010 diabetes coalition formed in Charleston and Georgetown counties, South Carolina, in reducing health care disparities and describes next steps for improving outcomes. The Chronic Care Model guided many of the implementation activities, and chart audits were used to document outcomes. Ambulatory care …