Community Health and Preventive Medicine Commons^™

Exploring Geographic Proximity To Fast-Food Restaurants And Convenience Stores With Dental Caries In Patients At The University Of Nevada Las Vegas School Of Dental Medicine, Charles K. Hill

UNLV Theses, Dissertations, Professional Papers, and Capstones

Dental caries is present worldwide and has afflicted over 90% of all adults in the United States. Biological determinants of the disease are well understood but social determinants and how they interact with biological factors are not. Programs designed to reduce incidence and prevalence of caries often target certain individuals and involve behavioral change. Some programs are more successful when environmental and societal issues are also addressed (Watt, 2002). Biological and behavioral processes leading to caries should include the modification of social factors to enhance results of prevention programs designed to reduce caries in populations. Preventing disease comes not only …

High-Risk Human Papillomavirus (Hpv): An Emerging Health Issue For Women And Minorities, Dierdre O. Turner

UNLV Theses, Dissertations, Professional Papers, and Capstones

The human papillomavirus (HPV) is the cause of nearly all cases of cervical cancers worldwide. HPV viral DNA is found in more than 99% of cervical cancers. In addition to cervical cancer, HPV is also associated with some breast and oral cancers. White women have been showing a decline in breast cancer rates while black women are continuously showing higher rates of mortality from both breast and cervical cancer. Minority women are also more likely to receive a late diagnosis and are showing increased incidence of oral cancer, which makes study of HPV in women and minorities significant.

To date, …

Lead Concentrations In Extracted Primary Teeth Among Clark County Pediatric Patients, Jennifer A. Berger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Childhood lead poisoning is a completely preventable condition, yet only a small portion of children in Nevada are screened for elevated blood lead levels. In 2009 only 6.11 percent of children in Nevada were screened for lead indicating that Nevada would benefit from an alternative method of screening for childhood lead exposure. Deciduous teeth are not currently recognized by the Centers for Disease Control and Prevention as diagnostic samples for the measurement for lead exposure. However, this unique and innovative detection method utilizes opportunistic samples that will contribute to the childhood lead poisoning prevention efforts in Nevada.

The objectives of …

The Effect Of Low-Cost Incentives On Active Transportation To School Rates Among Elementary School Students, Sheila G.J. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study assessed the effectiveness of a school-based active transportation to school (ATS) encouragement program for elementary school students. ATS shows promise for increasing physical activity and preventing excessive weight gain in children. ATS rates were assessed through frequency counts at the control school (N=697) and intervention school (N=693). The intervention encouraged ATS through the distribution of low-cost incentives on one weekday each week. It also required helmet use for participation and included a Walking School Bus component. Findings from this study suggest that the intervention effectively increased ATS on both intervention and non-intervention days.

Medicare's Accountable Care Organization Regulations: How Will Medicare Beneficiaries Who Reside In Medically Underserved Communities Fare?, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

On March 31, 2011, the Centers for Medicare and Medicaid Services (CMS) released proposed regulations implementing the Medicare Shared Savings Program (MSSP). The thrust of the MSSP is to promote savings to Medicare as well as the greater clinical integration of health care through incentive payments to accountable care organizations (ACOs) that meet Medicare standards for structure, performance, and health care outcomes. The effort to spur greater clinical integration through the MSSP was part of a broader set of reforms contained in the Affordable Care Act (ACA) whose aim was to improve health care quality and efficiency. Among these reforms …

Dual Testing Algorithm Of Bed-Ceia And Axsym Avidity Index Assays Performs Best In Identifying Recent Hiv Infection In A Sample Of Rwandan Sex Workers, Sarah L. Braunstein, Denis Nash, Andrea A. Kim, Ken Ford, Lambert Mwambarangwe, Chantal M. Ingabire, Joseph Vyankandondera, Janneke H. H. M. Van De Wijgert

Publications and Research

Background

To assess the performance of BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays in estimating HIV incidence among female sex workers (FSW) in Kigali, Rwanda.

Methodology and Findings

Eight hundred FSW of unknown HIV status were HIV tested; HIV-positive women had BED and Ax-AI testing at baseline and ≥12 months later to estimate assay false-recent rates (FRR). STARHS-based HIV incidence was estimated using the McWalter/Welte formula, and adjusted with locally derived FRR and CD4 results. HIV incidence and local assay window periods were estimated from a prospective cohort of FSW. At baseline, 190 HIV-positive women were BED and Ax-AI …

Dhhs' And Epa's Proposal To Lower Fluoride Levels In Drinking Water, Shannon Wirz

College of Health Sciences Poster Presentations

On January 7th, 2011 the U.S. DHHS recommended setting the level of fluoride in drinking water to the lowest end of the current optimal range (0.7 to 1.2 ppm). EPA is initiating a review of the maximum amount of fluoride allowed in drinking water based on scientific assessments of health effects from too much fluoride. MCL (Maximum Contaminant Level) is the legal threshold limit on the amount of a substance allowed in public water systems. EPA sets the MCL to address adverse health effects. Current MCL for fluoride is 4 mg/L. The EPA is unsure if they will revise the …

Youth Dating Culture In Urban Vietnam: Attitudes, Behaviors, And Influences, Alexa Difiore

Independent Study Project (ISP) Collection

This paper attempts to research urban youth’s attitudes and behaviors concerning everything having to do with dating (the process, PDA, typical dating spots and behavior) and opinions towards “hot issues” in contemporary, Vietnam such as pre-marital sex and co-habitation. My research question focuses on what the term “dating” means among youth in urban Vietnam, and the various influences that affect youth’s dating and sexual lives. Through an extensive literature review, I learned that there is an overall lack of information and discussion about sex in Vietnam. There is also a general idea that from parents, the government, and school that …

Influence Of Sexual Education On Sexual Behavior And Contraceptive Use Among 15 To 19 Year-Olds At Colégio Azevêdo Fernandes In Salvador, Brazil, Julia Still

Independent Study Project (ISP) Collection

Although sexual health education provided by the government through schools has shown positive results, such as those distributed by the Brazilian Ministry of Health, it is not the only source, nor the most implemented source, in which adolescents are exposed to and gain knowledge on the subjects of sexual behavior and sexual health. Just as Article 24 of the Convention on the Rights of the Child details, parents, schools and communities play important roles in the process of sexual education and are required to provide guidance and direction to youth (Pan American Health Organization, 2010). In addition to sexual health …

Let's Move! From Dc To Pc: Policy And Programming In Providence Charter Schools Around Student's Awareness Towards Living Healthy, Carmine Perrotti

Public & Community Service Studies Student Scholarship

A thesis developed out of an intership for the Office of the First Lady's "Let's Move Initiative". Following said internship, the author conducted original research on the local level - namely, Providence charter schools - to design, implement, and assess a series of educational “interventions”. These interventions were created to provide information to students and their parents about the benefits of healthy eating and exercise. Over 500 elementary-level students were surveyed for the research. See document abstract for more information.

A Case Study Of Health Interventions And The Caste System: Addressing The Social Determinants Of Health Through Development At Crhp Jamkhed, Laura Kroart

Independent Study Project (ISP) Collection

In the Southeast Asian country of India, the ancient but in some cases still rigidly intact caste system plays a role in determining health status and outcomes for much of its population of over 1.2 billion people.[1] The Comprehensive Rural Health Project, located in Jamkhed in the state of Maharashtra, India, approaches health interventions from a development standpoint, addressing biomedical needs, structural and environmental concerns, and the social and economic determinants of health that impact the lives of over a million villagers in the surrounding area.[2] This independent study project was designed to analyze how the Comprehensive Rural …

The Hospitalist: Better Value In Inpatient Care?, Lisa Sprague

National Health Policy Forum

From perhaps a few hundred practitioners in 1996 to an estimated 30,000 today, the discipline called hospital medicine has shown remarkably rapid growth. It represents a fundamental separation of the inpatient and outpatient components of internal and family medicine. The split has implications for the quality and efficiency of care delivery, the outlook for the physician workforce, and the development of new models such as accountable care organizations (ACOs).

Medicare's Bundling Pilot: Including Post-Acute Care Services, Laura A. Dummit

National Health Policy Forum

Fee-for-service Medicare, in which a separate payment is made for each service, rewards health care providers for delivering more services, but not necessarily coordinating those services over time or across settings. To help address these concerns, the Patient Protection and Affordable Care Act of 2010 requires Medicare to experiment with making a bundled payment for a hospitalization plus post-acute care, that is, the recuperative or rehabilitative care following a hospital discharge. This bundled payment approach is intended to promote more efficient care across the acute/post-acute episode because the entity that receives the payment has financial incentives to keep episode costs …

The Role Of Community Health Centers In Addressing The Needs Of Uninsured Low-Income Workers: Implications Of Proposed Federal Funding Reductions, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The severe economic downturn over the past few years has demonstrated the heightened importance of strengthening the health care safety net, particularly for working Americans who may have lost their health insurance coverage or do not have access to employer-sponsored benefits. Both historically and most recently during the current recession, health centers have played a critical role in providing services to the working poor, assuring that they continue to receive timely preventive care that obviates the need for, and minimizes use of, more costly services. We estimate that 1 in 4 low income, uninsured working adults depend on health centers …

The Health Care Access And Cost Consequences Of Reducing Health Center Funding, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

For over four decades, community health centers have served a critical role in providing affordable access to quality care to some of the nation's most vulnerable populations. Health centers have historically enjoyed broad bipartisan support, based on the evidence documenting their high quality care, crucial role in both urban and rural communities, and ability to "bend the cost curve."

On February 20, 2011, the U.S. House of Representatives voted to reduce discretionary health center funding by $1.3 billion in FY 2011 alone. Although the spending bill was rejected by the U.S. Senate on March 10, 2011, final spending measures for …

Substance Abuse In Georgia, The Burruss Institute Of Public Service And Research

Georgia Journal of Public Policy

In order to create a snapshot of substance use and abuse in Georgia, the Burruss Institute of Public Service and Research requested access to data from the National Survey on Drug Use and Health conducted on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA), a unit of the Department of Health and Human Services (HHS).  SAMHSA would not provide access to the raw data; instead, the Institute was given a series of tables with estimates of the average annual number of users of various substances among Georgians ages 12 and older between the years 2002 and 2008. …

Second-Hand Smoke In A University Campus: Attitudes And Perceptions Of Faculty, Staff And Students, Cecilia M. Watkins, Sandeep Mishra, Herpreet Kaur Thind, Srinivasa B. Gokarakonda, Grace Lartey, Monia Chahal

Public Health Faculty Publications

Purpose: To examine the attitudes and perceptions of faculty, staff and students concerning tobacco policies at a university campus in a tobacco producing state. Methods: A questionnaire was administered to faculty, staff and students to assess knowledge, attitudes and beliefs related to smoking and exposure to second-hand smoke on campus. A 3-wave e-mailing was used to send the questionnaire. Results: A total of 2,914 individuals responded to the questionnaire. Majority (60%) of the participants believed a smoke free policy would be a positive move and could possibly improve the quality of life for the campus community, while not negatively affecting …

Maternal Health Behaviours During Pregnancy In An Irish Obstetric Population And Their Assocations With Socio-Demographic And Infant Characteristics, Roslyn Tarrant, Katherine Younger, Margaret Sheridan-Pereira, John Kearney

Articles

Objectives: To examine the prevalence and combined occurrence of peri-conceptional folic acid (FA) supplement use, smoking and alcohol consumption during pregnancy in a sample of women in Dublin, and determine the factors associated with these health behaviours.

Subjects/Methods: A prospective observational study (2004-2006) involving the recruitment of 491 pregnant women from antenatal clinics in a Dublin maternity hospital, with postpartum follow-up of 450 eligible mothers. Data on FA use, maternal smoking and alcohol consumption patterns during pregnancy were collected from the antenatal patient-administered questionnaire, which was completed by participants, and returned to the investigator on the day of recruitment. …

Lifeskills Training Wellness Program: An Application For Young Adults In Supermarkets, Christopher Williams, Jessica Samuolis, Kenneth W. Griffin, Gilbert J. Botvin

Psychology Faculty Publications

To address the need for workplace substance use prevention programming, National Health Promotion Associates (NHPA) developed the LifeSkills Training Wellness Program (LST-WP) with funding from the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Young Adults in the Workplace (YIW) grant program. LST-WP adapts and extends the highly effective, school-based LifeSkills Training (LST) model program (Botvin, 1998; Botvin et al., 1995) and provides comprehensive skills training for adolescent and young adult employees in communication, problem-solving, conflict resolution, drug resistance, and related life skills. Overall, the program is designed to be highly flexible to meet employee and manager needs across different …

Who Are The Health Center Patients Who Risk Losing Care Under The House Of Representatives' Proposed Fy 2011 Spending Reductions?, Sara J. Rosenbaum, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

On February 20, 2011, the United States House of Representatives approved more than $61 billion in discretionary spending reductions for the remainder of FY 2011. The legislation includes $1.3 billion in direct spending cuts for community health centers. Using the NACHC patient estimates, we present evidence on the characteristics of patients whose continuing access to health center services is at risk. We arrived at these estimates using data from the Uniform Data System (UDS), the federal reporting system in which all health centers must participate, as well as national estimates from the Medical Expenditure Panel Survey (MEPS), and published reports …