Medicine and Health Sciences Commons^™

The Role Of Psychological Safety On Employee Satisfaction And Retention In Healthcare Delivery Settings: A Systematic Literature Review, Jamey Paul

Capstone Experience

The healthcare industry typically has a high rate of employee turnover due to higher job stresses and burnout, lower job satisfaction, and insufficient organizational support and work culture. This turnover has worsened since the onset of the COVID-19 pandemic. Psychological safety, a shared belief by organizational members that the team/unit is safe for interpersonal risk-taking, can be one of the many ingredients that contribute to employee satisfaction and reduce turnover. This systematic literature review explored the role of psychological safety on job satisfaction and retention of healthcare workers in delivery settings by synthesizing the known antecedents and outcomes of psychological …

A Twin Study Of Genetic Heritage And Environmental Influences On Tobacco Susceptibility And Initiation On Early Age, Yadi Liu

Capstone Experience

Purpose: Tobacco product susceptibility is defined as the interest a person has to start smoking. Tobacco product initiation refers to whether a person has ever used tobacco products. We aim to understand and explain how genetic and environmental factors affect tobacco products' susceptibility and initiation in children. Methods: The classical twin model estimates three sources of variance: additive genetic (A), shared environmental (C), and unique environments (E). Each source of variance is latent and is calculated from the similarity in the correlations of twin pairs on a phenotype. The magnitude of difference in the correlation of a particular …

Utility Of Social Support And Social Networks Theory In The Prep Continuum Of Care For Adolescents: A Review Of The Literature, Emmanuel Nazaire Essam Nkodo

Capstone Experience

This literature review explores the potential of social support and social network theories in improving enrollment and retention in HIV pre-exposure prophylaxis (PrEP) care for at-risk adolescents aged 10-24. Seven peer-reviewed articles were analyzed to identify the critical role of social support and networks in providing informational, instrumental, emotional, and appraisal support. While biological family members are often the primary support figures, some studies acknowledge the importance of friend networks in promoting PrEP use. Families are generally willing to support their children's use of PrEP, especially if they have prior knowledge of PrEP. Communication between parents and their children about …

Program Evaluation: Utilizing Health Department’S Community Health Needs Assessment Data To Improve Emergency Preparedness Plans, Kathleen Gottschalk

Capstone Experience

Public health officials conducting emergency response plans must know how to easily identify the vulnerable populations in their community or jurisdiction. It is beneficial for access and functional needs appendices to include information and resources directed at the identified vulnerable groups before an emergency event to improve health outcomes. Community Health Needs Assessments (CHNA) can provide population-level statistics and information needed to easily identify vulnerable or at-risk groups. This report aims to evaluate the use of the CHNA data to guide the development of inclusive emergency response plans that account for vulnerable populations in local health department jurisdictions. The 2021 …

Assessing Occupational Exposure Risk And Covid-19 Incidence Rates In Nebraska By Industry And Occupation, 2020, Christopher Austin

Capstone Experience

Occupational outbreaks of COVID-19 have been described during the pandemic, yet the epidemiology of COVID-19 across a larger workforce population is currently not well characterized in the United States. Describing COVID-19 incident rates by industry and occupation will elucidate how the pandemic affected the workforce in Nebraska. However, nonresponse bias occurs in the employment information when participants are unwilling or unable to respond to contract tracer questions, thus affecting the results. Nonresponse bias will be analyzed, and appropriate statistical approaches will be utilized to adjust for any bias in the data. Adjusting for bias, incidence rates by detailed industry and …

A Systematic Literature Review On Long-Term Care Quality Improvement Initiatives In The United States, Daisy D. Pang

Capstone Experience

As the number of people 65 and older increases due to the baby boomer population, there will be a greater demand for long-term care (LTC) services. Quality improvement in LTC is essential to ensure positive health outcomes, patient satisfaction, and reduction in healthcare costs. The purpose of this systematic literature review is to identify the current quality initiatives for LTC in the United States and evaluate the outcomes, effects, and values of each quality initiative identified to support the claim that current the quality initiatives have a limited effect on quality improvement in LTC settings. The Preferred Reporting Items for …

Utilization Of Community Health Workers In Emergency Preparedness And Response: A Literature Review, Amelia P. Stoltman

Capstone Experience

As the frequency and magnitude of disasters worldwide continues to rise, so too does the devastation that follows. This devastation extends to the whole community. In guidance put forward by the Federal Emergency Management Agency (FEMA), emergency preparedness must be represented in and reflective of the whole community, but marginalized groups or segments of the population may be left out of the conversation. Community Health Workers (CHW)s serve as a trusted liaisons and community advocates within the health care landscape. That landscape, as recent events demonstrate, includes emergency preparedness and response. This literature review is designed to assess available publications …

Longitudinal Trends In Body Mass Index And Risk Of Obesity Among Blue Cross & Blue Shield Of Nebraska Insured Sample Population During 2017-2022, Devi Venkata Naga Akshay Dwarabandam

Capstone Experience

Objective: To estimate and compare the longitudinal trends in the crude prevalence of obesity in the Blue Cross and Blue Shield of Nebraska (BCBSNE) sample of the adult population with the Behavioral Risk Factor Surveillance System (BRFSS) of Nebraska during the pre-pandemic period (2017-2019) and COVID-19 pandemic period (2020-2022) using standardization methods.

Background: Studying the obesity disease burden in a commercial insurance company's administrative claims data can provide critical insights that can inform policy, practice, and interventions aimed at improving health outcomes, managing costs, and reducing the burden of obesity at the population level.

Methods: This study utilized a cohort …

A Qualitative Survey Research Study: The United States Department Of Agriculture Commodity Supplemental Food Program: An Examination Of Operational Challenges And Recommendations, Brianna Cochran

Capstone Experience

Background

The United States Department of Agriculture (USDA)’s Commodity Supplemental Food Program (CSFP) has been nationally adopted in 60 states or Indian Tribal Organizations (ITOs) to improve the health of low-income persons at least 60 years of age by supplementing their diets with nutritious USDA Foods. Despite the potential effectiveness of the program, less is known about the operational challenges in the program implementation at the state and local health department. The goal of the study is to identify factors related to program operations including facilitators and barriers of implementation of the USDA CSFP under a national lens.

Methods

An …

Association Between Socioeconomic And Behavioral Characteristics With Urinary Neonicotinoid Levels In The United States, 2015-2016, Komi Nomessi Akliku

Capstone Experience

Neonicotinoids are a class of pesticides developed in the 1980s and widely used in agriculture and households. They are sources of health damage in mammals, as identified in experimental studies in rats. The health effects identified were acetamiprid: memory dysfunction, respiratory failure, and digestive troubles; imidacloprid: liver and brain cell necrosis through Nitric Oxide formation: Thiacloprid induces an increase of cytokine proinflammation and causes cell division disturbance and genotoxicity; thiamethoxam is incriminated in reproductive system toxicity and cardiotoxicity; clothianidin is found to be associated with fertility troubles affecting spermatozoids’ motility. They have been said to be associated with thyroid cancer …

A Review Of Nebraska Public School Active Shooter/Armed Intruder Preparedness Requirements Compared To Other States, Anna Hansen

Capstone Experience

Approximately 17% of mass shootings which occurred between 2000 and 2013 took place in the public school K-12 setting. The incidence of school shootings is on the rise, with a particularly concerning increase in annual incidents beginning around 2010. A review of legal requirements for public school active shooter preparedness in FEMA Region VII, which includes the states Nebraska, Iowa, Kansas, and Missouri, was conducted. While Iowa clearly requires an emergency operations plan including provisions for the active shooter scenario, Nebraska and Kansas do not clearly require such provisions in school emergency operations plans, and Missouri does not appear to …

Quality Improvement Intervention To Improve Hpv Immunization Rates In Rural Primary Care Settings: Policy Recommendations From Post Intervention Survey, Isabel Stock

Capstone Experience

It is estimated that 8 billion dollars annually fund the prevention and treatment of Human Papillomavirus (HPV) associated cancers in the U.S. The HPV vaccine is the most effective way in preventing associated cancers when administered on-time, during adolescence. With HPV vaccination rates remaining low across the country, organizations have been researching effective interventions to improve uptake of the vaccine. In this paper we conducted a descriptive analysis of a survey completed by clinicians upon completion of an eighteen-month quality improvement (QI) intervention to increase HPV vaccination rates in rural primary care settings. New research indicates that differences in HPV …

Cultivating A Robust Safety Culture Through Identifying And Overcoming Barriers Within Organizations, Morgan Shradar

Capstone Experience

The hierarchical power structure within healthcare and response teams may impede communication about safety risks and violations. In developing or enhancing the safety culture within the emergency response to infectious disease events in healthcare organizations, the hierarchy of controls can be utilized to evaluate successful transmission prevention or further harm to responding teams. Within the tool, administrative controls focus on policies, procedures, and practices that minimize the risk of exposure/transmission. The idea of a safe culture emerged following the Chernobyl Disaster, in which a combination of human and system failures led to this emergency. Safety culture has been integrated into …

Comprehensive Literature Review: Assessing The Impact Of Covid-19 Policies, School Closures And Social Distancing, On The Mental Health Of School Age Children, Fatuma A. Hassan

Capstone Experience

Mental health is vital to the well-being of all individuals, especially children. COVID-19 unveiled a significant public health issue with poor mental health during the pandemic. There is limited literature about the mental health implications of COVID-19 policies for children and adolescents and preventive strategies for future pandemics. This comprehensive literature review seeks to further investigate the mental health impacts of school shutdowns and social distancing, which were nonpharmaceutical strategies, on school-aged children, 5-18 years old, and propose recommendations for public health officials to mitigate the mental health impacts for future pandemics. Additionally, the review aims to highlight the potential …

Reducing Burnout Using Emergency Planning: A Literature Review, Taylor Vaughn

Capstone Experience

Objective

The objective of this capstone is to gain knowledge on what burnout is, what causes it, what can be done to prevent it, and what can be added to public health emergency plans to reduce burnout in local emergency preparedness workforces.

Methodology

A literature review was completed through peer-reviewed articles, and documents from professional and governmental organizations. The results were used to search current plans to determine whether burnout-related recommendations were present.

Results

Burnout prevention at the personal level includes a good diet, routine exercise, and mindfulness activities. At the organizational level it should include providing emotional support, emphasizing …

A Scoping Review Of The Predictive Values And Use Of The Oraquick In-Home Hiv Test, Mariah Zinn

Capstone Experience

The OraQuick In-Home HIV Test was FDA-approved for over-the-counter use for people aged 17 years and older in 2012. The FDA reported on the sensitivity and specificity of the test, which looks at the accuracy of a test relative to a reference standard. However, the predictive values that account for prevalence still need to be thoroughly examined among tests distributed through community-based means. In this review, we looked at the predictive values for the OraQuick In-Home HIV Test for people aged 15 years and older when the test is distributed through community-based means. We calculated the predictive values for each …

Exploring How Social Determinants Of Health Affects Rates Of Chronic Obstructive Pulmonary Disease (Copd) In The Des Moines Metro, Kyla Winkelman

Capstone Experience

Chronic Obstructive Pulmonary Disease (COPD) is consistently in the top ten leading causes of death and most recently ranked fourth in the United States (Heron, 2021). Research on health disparities and SDOH has increased recently as investigators learn their importance in diagnosing chronic conditions. Several studies show that a person’s life and environment can determine their risk of exposure, susceptibility, course, and disease outcome. UnityPoint Health (UPH) clinics were utilized for this project to explore how the social determinants of health and health disparities affect COPD rates in Des Moines, Iowa. Initial data was obtained surrounding COPD statistics in the …

Associations Between Demographic, Social Determinant, And Health Factors And Self-Management Measures Among Insured Individuals With Type 2 Diabetes, Shari Bowers-Dueker

Capstone Experience

Background: Ensuring that individuals with type 2 diabetes properly manage their chronic condition is a nation-wide challenge, even among individuals who have health insurance coverage and access to the treatment they need. There exist several literature sources that suggest various factors that may influence an individual’s lack of self-management of type 2 diabetes. This study investigated some of these factors by determining whether various demographic, social determinant, and health factors were associated with three self-management measures among individuals with type 2 diabetes.

Methods: The self-management measures of interest included (i) whether the annual recommended two primary care visits were attended …

Examining The Effects Of Experiencing A Tornado On Rates Of Suicide, Jessica Lowder

Capstone Experience

Background: Suicide rates in the United States have been on the rise in recent years. As of 2020, suicide was the 12^th leading cause of death in the country. Climate change has also contributed to an increase in tornadoes. Studies have found that experiencing a natural disaster is associated with an increase in suicide rates. Studies examining suicide rates and tornadoes, specifically, are virtually nonexistent.

Methods: The exposure groups were those living in three different tornado-affected regions. The comparison group consisted of those living in the larger geographical region. Mortality data was obtained from the CDC, tornado-related data was …

Assessing The Impact Of Ebola Virus Inoculum Size On Likelihood Of Infection, Joseph Lukowski

Capstone Experience

Background: Indirect transmission of Ebola virus disease (EVD) is not uncommon but is poorly understood. Improving the understanding of the potential risk of EVD transmission from fomites should result in new or updated prevention or control measures for suspected or confirmed EVD cases or outbreaks.

Objective: This study aims to compile and understand pertinent data from peer-reviewed literature, establish the dose-response relationship between inoculum doses introduced to mucous membranes, and finally estimate the risk of EVD transmission from fomites.

Methods: A literature search was conducted through PubMed to obtain relevant data. This study employed this data to perform Poisson regression …

Identifying & Addressing Barriers To Child Care For Formerly Incarcerated Mothers, Joanne Bird

Capstone Experience

As women’s incarceration rates have risen significantly in recent decades, gender-specific programs are needed to meet the needs of formerly incarcerated mothers (FIM). Although child care can be difficult to access for many families, this marginalized population faces unique obstacles to accessing child care. In order for FIM to be employed and reintegrate, they must be able to access child care; however, FIM experience unique barriers to securing child care services. This policy brief aims to identify the special considerations FIM face, as well as to explore why existing programs are not meeting their specific needs. A literature review was …

The Merit Of Inclusion: A Policy Review Examining The Convergence Of Special Education And Inclusions Policies With Compensatory Medicaid Policies In The Wake Of The Covid-19 Pandemic, Corbyn Baggett

Capstone Experience

On March 11, 2020, the World Health Organization (WHO) formally recognized the novel coronavirus (COVID-19) outbreak as a global pandemic. This global issue compelled governments to announce careful virus containing policies in order to prevent further spread and control of the disease. Although it has been proven that measures like social isolation could aid in scaling the spread of illness, the resulting extended school closures that occurred in response to an increased number of COVID-19 outbreaks posed significant challenges for all students, but especially those students with special needs. The unpredictable nature of COVID-19 at the outset of the pandemic …

The Risk Factors Of Long Covid In The Acute Covid And Solid Organ Transplant Retrospective Cohorts, Ahmed Nyandemoh

Capstone Experience

Background: Coronavirus disease 2019 (COVID-19) in solid organ transplant (SOT) patients is associated with more severe outcomes than non-immunosuppressed hosts. The risk factors for developing the long COVID in acute COVID remain unknown, and the survival outcomes of long COVID in SOT patients remain understudied.

Methods: We developed several retrospective cohorts. This project included all patients identified with acute COVID in the National COVID Collaborative Cohort Registry from July 1, 2020, to June 30, 2022.

Patients with long COVID were compared to those without long COVID in the acute COVID cohorts. Similarly, we compared the patient demographic with long COVID …

The Association Of Lower Medication Adherence And Increased Medical Spending, Ryan A. Fuchs

Capstone Experience

Medical prescribing is a common occurrence in daily clinical practice. According to the Centers for Disease Control and Prevention, in 2015-2016 45.8% of the U.S. population used prescription drugs in the past 30 days. (CDC, 2019) Although drug therapy can be effective in treating disease, full benefits are often not realized because many patients do not take their medications as prescribed. There is quite a bit of research out there about non-adherence to medication. Some studies focus on the financial impacts of non-adherence, but most of the studies examine the reasons for medication non-adherence. A gap exists in research about …

Process Evaluation Of A Community Asset Mapping Protocol For Diabetes Prevention And Management, Andrea Peterson

Capstone Experience

Prediabetes and type 2 diabetes mellitus (DM) are highly prevalent conditions with new diagnoses occurring each year (Centers for Disease Control and Prevention, 2022a). Type 2 DM negatively impacts many aspects of life, to include social, financial, cultural, and everyday living. Asset mapping is a useful tool to build upon existing resources to help community members identify and expand services based on understanding the interconnected systems that influence type 2 DM prevention, screening, education, and care management. An Asset Mapping Protocol was created and piloted through a rural community coalition in Nebraska. The protocol includes an activity for community stakeholders …

Program Planning On Social Determinants Of Health For Rural Nebraska, Athena H. Ramos, Maria H. Cantu Hines

Capstone Experience

Social determinants of health (SDOH) are non-health factors that impact health in both direct and indirect ways. Research into SDOH and their effects has been extensive in recent years and has been further documented by the COVID-19 pandemic. Despite the wealth of the literature on the SDOH, awareness of these important factors is not prevalent among community residents. Rural communities are as subject to the impact of SDOH just as their urban counterparts and experience additional complexities related to geography and topography.

This capstone project aims to raise awareness, provide education, and assist with tools and resources, to empower rural …

An Epidemiological Synthesis Of Emerging And Re-Emerging Zoonotic Disease Threats In Cameroon, 2000-2022 And Community Stakeholder Mapping, Nancy Tahmo

Capstone Experience

Introduction: Population factors such as urbanization, socio-economic, and environmental factors are driving forces for emerging/re-emerging diseases in Cameroon, and the effects of these are experienced differently across demographics. Indigenous rainforest communities in the Congo Basin, for example, suffer worse health outcomes compared to neighboring communities, like the Pygmies, who have a life expectancy of 22 years less than neighboring Bantus. It is important to characterize the risk of exposure of these vulnerable communities and map out, through a systematic review, descriptive epidemiological data around zoonoses, to inform preparedness and research efforts.

Methods: Following the PRISMA guidelines, a protocol was registered …

Urban/Rural Disparities Of Thyroid Cancer Using The Integrated Cancer Repository For Cancer Research (Icare2), Sunita Regmi

Capstone Experience

Abstract:

Background and objective: Multiple studies have shown that the place of residence and the distance to travel from one's residence to nearby health care providers impact cancer diagnosis and treatment. The stage of cancer at the time of diagnosis is paramount for cancer treatment and affects survival. Disparities in cancer treatment exist which affect the outcome disproportionately to certain segments of the population. To date, much of the focus has been on the racial and socioeconomic disparities in the management of thyroid cancer. The effect of geography and location (urban-rural status) on thyroid cancer stage diagnosis has …

Evaluating How The Impacts Of Climate Change On Arizona's Water Supply Will Influence Public Health, Patricia Wrona

Capstone Experience

Over the last century, Arizona’s climate has increased more than 1.1 to 1.4 degrees Celsius or 2 to 2.5 degrees Fahrenheit. The temperature in Arizona is expected to increase an additional 2.2°C to 2.8°C in the next 40 years. Climate change poses various health and environmental hazards for the residents of Arizona. One of the most significant impacts is on water supply. As temperatures continue to rise in the desert, the demand for water will increase while the water supply will reduce. A literature review and program evaluation were conducted to evaluate how the impacts of climate change on Arizona’s …

Health Effects Of Neonicotinoids On An Agricultural Community, Jocelyn Rodriguez-Paar

Capstone Experience

Mead, Nebraska, a small United States agricultural community consisting of approximately 600 people, was accidentally exposed to high amounts of neonicotinoids when AltEn, an ethanol plant that used neonicotinoid coated corn and soybean seeds for biofuel, was discovered not disposing of the toxic byproduct safely. Coincidentally, there was also a leak in their wastewater system that also contaminated the nearby areas. Although neonicotinoids are not considered highly dangerous with low dose exposures, large dose exposures can cause symptoms similarly to nicotine poisonings, such as difficulty breathing, vomiting, nausea, hypertension, tachycardia, and lethargy (Imamura, T. et al., 2010). Neonicotinoid poisoning can …