Chronic Disease and Risk Factors among Nevadans with Disabilities: A 2009 BRFSS Study

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 disabilities in Nevada. Nevadans with a disability were significantly more likely to report having chronic diseases (cancer, coronary artery disease, diabetes, stroke and asthma), to be physically inactive, and overweight/obese and to report high blood pressure and high cholesterol. As a way to reduce chronic disease and secondary conditions among people with disabilities, Healthy People 2010 calls for all wellness and treatment facilities to be fully accessible for people with disabilities (US Department of Health and Human Service, 2002). More research is needed to determine if inaccessibility of wellness and treatment facilities is contributing to health disparities found among people with disabilities in Nevada

The Effects of Environmental Prompts on Stair Usage

Experts have advocated exercise with little success, and have turned to encouraging physical activity by incorporating it into daily activities such as taking the stairs over elevators. Much literature exists suggesting that environmental prompts can encourage the use of stairs and literature has established that some messages may be more effective than others. This study aimed to assess the effects of selected signage prompts on stair usage. Methods: Stair and elevator use were monitored in three, two-story buildings. One building served as a control, while a fitness message was placed in another building, and the final building received a weight control message. Observations took place twice per week for the seven weeks of the study. Results: Predictors of stair usage included age (

Characteristics of Children Attending Asthma Camp in Nevada

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 attendees. Trigger knowledge was low among 25.9% (n=7) of attendees, 40.7% (n= 11) had moderate trigger knowledge, and only 33% (n= 9) demonstrated adequate trigger knowledge. Asthma camp is an effective venue to improve asthma education among children and provide a clinical assessment of this condition among those that are without a current diagnosis

Analysis of Risk and Protective Factors for Arthritis Status and Severity Using Survey Data

This study looked at how cigarette smoking, alcohol consumption, obesity, and physical activity are associated with the prevalence and severity of arthritis among adults living in Delaware, U.S. through the analysis of survey data. We examined data from the 2009 Delaware Behavioral Risk Factor Surveillance System (BRFSS). Weighted percentages were calculated for the arthritis-related factors above by arthritis status and activity limitation due to arthritis/joint symptoms, and were analyzed using the Rao-Scott X2 test. A multiple logistic regression analysis was performed to determine an odds ratio (OR) while adjusting for gender, age, race/ethnicity, and education. Adult Delawareans self-reporting arthritis were more likely to be former and current smokers than those without self-reported arthritis (p < 0.001; OR = 1.58 for former smokers vs. non-smokers; OR = 1.52 for current smokers vs. non-smokers). Moderate and heavy alcohol consumption was associated with lower severity of arthritis (p < 0.001; OR = 0.66 for moderate drinking vs. no drinking; OR = 0.50 for heavy drinking vs. no drinking). There was a significant relationship of obesity to both arthritis status (p < 0.001; OR = 2.13 for obesity vs. not overweight/obesity) and severity (p < 0.008; OR = 1.67 for obesity vs. not overweight/obesity). Furthermore, people having arthritis-related activity limitation were more likely to not meet the current physical activity recommendations (p = 0.013; OR = 1.46). It appears that smoking and obesity have a negative impact on the risk and severity of arthritis, whereas alcohol consumption and physical activity may be protective against arthritis. A proper analysis of survey data is essential to truly understand how human behavior impacts people's health

Quality of Life Estimation with Structural Equation Modeling in School Aged Children with Asthma

Significant increases in childhood asthma prevalence and mortality has prompted federal and regulatory agencies to work towards a national framework to address childhood asthma. Quality of life is an important component of chronic disease, and the evaluation of healthcare outcomes. There is little discussion in the literature regarding the implications of QoL as a theoretical construct. This study determined the effect of asthma on the QoL of our study population and caregiver’s missed workdays on the child’s QoL scores. A negative relationship was found between the child’s QoL and the caregiver’s missed workdays due to their child’s asthma. The use of SEM and multiple group analysis can help increase awareness and understanding among the complex issues related to childhood asthma and quality of life constructs

Utilization of Preventative Health Services by Nevadans with Disabilities

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 seen a physician in the past year. Nevadans with disabilities were significantly more likely to engage in some preventative services (pneumonia and flu vaccination) and less likely to engage in other preventative services (pap in the past three years and dental cleaning in the past year). This may be the result of some preventative services being easily administered to patients whether they have disabilities or not (immunizations) while other preventative services are more difficult to administer to those with disabilities. Public health interventions are needed to address the unique needs of Nevadans with disabilities to ensure equal access to all recommended preventative health care services

Measuring enjoyment of ballroom dancing in Filipino Americans using the physical activity enjoyment scale

To advance knowledge about ways to promote physical activity in Filipino Americans, this feasibility study evaluated whether they enjoyed ballroom dancing and at the same time tested the validity of the Physical Activity Enjoyment Scale (PACES) for assessing enjoyment in this population. This study consisted of a single group of healthy Filipino Americans (N = 41) aged between 35 and 65 years residing in southern Nevada. Participants danced 45 min per week for 12 weeks and completed the PACES questionnaire to measure enjoyment at two time points (Week 4 and Week 12). Four participants dropped out during Weeks 2 to 5. Thirty-seven participants completed the 12 consecutive dance sessions. Descriptive statistics, paired- sample t test, Pearson correlation, and a mixed-model ANCOVA were used for data analysis. Principal components analysis assessed the construct validity of the PACES. The mean age of the sample was 50.7 years. On average, the participants’ PACES score significantly improved from Week 4 to Week 12. Age was negatively correlated with perceived enjoyment of dancing. In terms of the validity and reliability of the PACES, high construct validity and internal consistency of the PACES were noted. This study described the effectiveness of ballroom dance as a form of physical activity among first-generation Filipino Americans and confirmed the appropriateness of the PACES for assessing enjoyment in this population. Ballroom dance has the potential to promote physical activity and improve the cardiovascular outcomes of Filipino Americans and other populations who are at risk of heart disease

A Program to Change the Approach to Care of Children with Asthma in the Primary Care Setting Did Not Reduce Rates of Hospital Admissions: Lessons Learned from a Descriptive Study

Asthma is a critical global health issue. It affects people of all ages in countries throughout the world. The prevalence of asthma is increasing in most countries among young children who also represent the greatest proportion of health care utilization. Outpatient asthma-treatment programs managed by chest physicians or allergists have reduced hospitalizations, yet programs in pediatric offices have not successfully impacted hospitalizations. The Community Asthma Program (CAP) was designed to support pediatrician use of clinical guidelines in their everyday office practice. The goal was to reduce asthma hospitalizations by 15 percent from selected pediatric practices. A study was done in 4 pediatric practices closely associated with St. Louis Children’s Hospital. The program included a continuous quality improvement process quarterly

Health Effects Associated with Foreclosure: A Secondary Analysis of Hospital Discharge Data

Objectives: The purpose of this study was to assess the health effects of high home foreclosure rates in an area of the United States of America and the utility of hospital discharge data for this purpose. Methods: We analyzed hospital discharge data from three postal zip codes using the principal diagnosis for 25 Diagnostic Related Groups associated with stress. Descriptive statistics were used to characterize hospital discharge rates for each condition by year and zip code. To test for differences across time, the Cochran-Armitage trend test was performed. Results: Most conditions did not demonstrate a statistical change between 2005 and 2008. There was a marked spike in bipolar and depressive disorders in 2007 in all zip codes. Conclusions: The sharp rise for bipolar and depressive disorders in 2007 coincides with the doubling of foreclosure filings nationally. There are many confounding factors affecting hospital discharge data, which limit its specificity for assessing the health effects of foreclosure

Comparing NET and ERI Standardized Exam Scores between Baccaulureate Graduates who Pass or Fail the NCLEX-RN

In the United States, nursing programs are commonly evaluated by their graduates success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN). The purpose of this paper is to describe a change in NCLEX-RN success rates following the addition of standardized exams throughout our program\u27s curriculum, and to compare these exam scores between graduates who pass NCLEX-RN and those who do not. Our results indicate an 8.5% change (p \u3c 0.000) in the NCLEX-RN pass rate from our previous 5-year mean pass rate, and significant differences in standardized test scores for those who pass the NCLEX-RN compared to those who do not (p \u3c 0.03). We conclude that our selected standardized exam scores are able to significantly identify graduates who are more likely to pass NCLEX-RN than not