Digital Commons Network^™

A Landscape Analysis Of Rapid Evidence Curation During The 2022 Sudan Virus Disease Outbreak In Uganda, Jemimah J. Wachap

Capstone Experience: Master of Public Health

Uganda's 2022 Sudan Virus Disease (SVD) outbreak emphasized the need for rapid and effective evidence curation in public health emergencies. This analysis examines evidence curation practices during the SVD response, identifying challenges and assessing the timeliness and effectiveness of strategies in low-resource settings. While global responses to previous outbreaks, like COVID-19, have advanced evidence synthesis, the SVD outbreak revealed infrastructure and data integration gaps. The study aims to map the evidence curation landscape, focusing on models and tools, such as data-sharing platforms, mobile Polymerase Chain Reaction (PCR) labs, and Integrated Management Systems (IMS). It will also address gaps in surveillance, …

Evaluating The Nebraska Medical Center's Repatriation Of Inter-Hospital Transfers, Natalie Crump

Capstone Experience: Master of Public Health

Background: Bed capacity challenges at large academic medical centers delay the transfer of rural patients, negatively impacting their safety and quality of care. Repatriating inter-hospital transfer (IHT) patients to referral facilities upon completing specialized care can improve tertiary hospital bed capacity and community hospital financial sustainability.

Objectives: This project aims to identify the barriers and facilitators to successful IHT repatriation and the process and outcome variables influenced by the Nebraska Medical Center’s reverse transfer program.

Study Design: A retrospective observational cohort study was conducted to identify barriers and facilitators of NM’s IHT repatriation program.

Methods: Descriptive and comparative analyses of …

A Research Report: What Are The Challenges That Refugee Women Experience When Seeking Healthcare Related To Pregnancy In The United States?, Manuela Krieger-Adi

Capstone Experience: Master of Public Health

Background

Refugees in the United States, including African refugee women, face many challenges in seeking healthcare after moving to the United States to resettle. It is urgent and essential to look into some of the health challenges the refugee community faces here in Omaha, Nebraska, that prevent them from seeking healthcare, especially when pregnant. This Capstone research project aims to focus on African refugee women, specifically in Omaha, Nebraska, and the challenges they face seeking healthcare related to pregnancy.

Methods

This research report involved five in-depth interviews conducted over Zoom. The target population was refugee mothers who had given …

Assessing The Association Between Total Cholesterol And Hospitalized Myocardial Infarction In Women Ages 32-70: An Analysis Of The Framingham Heart Study, Jolene L. Stapleton Duree

Capstone Experience: Master of Public Health

Objective

Heart disease is the leading cause of death in women that may go undiagnosed due to unexpected symptoms. The purpose of this analysis was to assess the effect of total cholesterol on the odds of hospitalized myocardial infarction (MI).

Methods

This analysis used a sample of 2,445 women from the Framingham Heart Study, an observational prospective cohort study. The exposure was total cholesterol, and the outcome was hospitalized MI. Logistic regression was used to estimate crude and adjusted odds ratios (OR). The adjusted models controlled for age, blood pressure, and diabetes. Effect modification by diabetes status was evaluated in …

Prescription For Progress: A Retention Plan To Heal The Dying Nurse Workforce, Margaret Curd

Senior Honors Theses

The United States is currently facing an unprecedented nursing shortage which stems from many variables, including a lack of clinical rotation sites for students, increased burnout among current nurses, and a growing retiring workforce. Rising nurse turnover rates negatively impact patient outcomes, which should concern all levels of management. One specific hospital facing such an impact is Advocate Christ Medical Center in Oak Lawn, Illinois. This thesis seeks to address their substandard staffing ratios in an extensive, holistic strategic retention plan. Metrics for proving the plan’s success are provided alongside a discussion of proper calculations for each.

Managing Refractory Epilepsy In A Resource Limited Setting—Doing More With Less, Ruta Yardi, Kurupath Radhakrishnan, Pauline Samia, Janet Wilson, Amza Ali

Paediatrics and Child Health, East Africa

Drug-resistant epilepsy (DRE) disproportionately affects individuals in low- and middle-income countries (LMIC), where access to affordable and effective care remains a significant challenge. Patients with DRE face high healthcare costs, inadequate access to epilepsy surgery, and limited availability of trained professionals. This review explores a multifaceted approach to managing DRE in resource-constrained settings. Key strategies include rational polypharmacy with cost-effective antiseizure medications (ASM), implementation of dietary therapies like the ketogenic diet, and cost-conscious presurgical evaluations. Enhancing emergency care systems, particularly for conditions like status epilepticus, is critical, as is the development of standardized diagnostic and treatment protocols and training programs …

Patient Perspectives On The Role Of Healthcare Providers In Addressing Food Insecurity In A Nj Primary Care Setting, Anna Flts, Lisa Huang, Aarsa Moosavi, Jha Stuti, Philip B Collins

Rowan-Virtua Research Day

Background:

Food insecurity is a critical social determinant of health, yet is rarely discussed with patients in primary care settings. The objective of this project is to explore patient perspectives on the physician role in addressing food insecurity as well as to identify factors associated with food insecurity among patients in family medicine clinics.

Methods:

A cross-sectional survey was distributed to patients (n=250) across two academic family medicine clinics in South New Jersey between May 2023 and December 2024. Demographics, self-reported health status, and comfort with discussing food insecurity were collected. Additionally, food insecurity status was determined based on the …

Adherence To Follow-Up Among High-Risk Nicu Patients, Iryna Muryn, Susan Mbullah Ndimah, Lisa Renee Eiland, Tara Lozy

Rowan-Virtua Research Day

Background:

Preterm infants, especially those ≤32 weeks' gestational age (GA) are at increased risk of vision and hearing loss. Risks of both vision and hearing loss can be ameliorated and in some cases prevented by conscientious screening, follow up and treatment. Universally, infants ≤32 weeks are cared for in neonatal intensive care units and there is considerable confidence that screenings and treatment occur according to established guidelines. At hospital discharge, follow up responsibility shifts to infant caretakers likely resulting in reduced compliance.

Objective:

We aimed to determine if preterm infants at risk for vision and hearing loss, attended follow up …

Pain Management In Pregnant Women With Opioid Use Disorder: A Systematic Review, Adeena Javed

Rowan-Virtua Research Day

Background: The prevalence of opioid use disorder (OUD) among pregnant individuals has risen significantly, posing challenges in managing labor and postpartum pain. Factors such as opioid tolerance, opioid-induced hyperalgesia, and concerns about relapse complicate analgesic strategies. Despite these complexities, evidence-based guidelines for pain management in this population remain limited.

Hypothesis: Pregnant women with OUD experience disparities in pain management during labor and postpartum periods, leading to suboptimal outcomes.

Methods: A systematic review was conducted, analyzing peer-reviewed studies from databases including PubMed and Embase. Inclusion criteria encompassed studies focusing on pain management in pregnant women with OUD. Data extraction focused on …

Maternal Health And Nutrition: Combating Maternal Mortality Through Proper Nutrition, Archna Mahendru, Yeisanai Cardona Torres, Maya Blayne Partee, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality is an increasing concern in the United States. According to the WHO, from 2018-2022 the Maternal Mortality Rate (MMR) was 23.3 deaths per every 100,000 live births. New Jersey's MMR exceeded this average at 26 per 100,000 during the same period, with 91% of cases deemed preventable. While medical care plays a crucial role, research shows that non-medical determinants such as food insecurity, lack of nutritional education, limited access to transportation, and systemic barriers to health care contribute significantly to maternal health outcomes. Among these factors, proper nutrition plays a critical role before and during pregnancy, particularly in …

Assessing The Impact Of The Covid-19 Pandemic On Health Literacy In Patients Presenting To A Student-Run Free Clinic, Sabah Iqbal, Kirsten Carlberg, Krisha S. Patel, Ashlyn Mcclelland, Sarah Marotta, Rebecca Moore

Rowan-Virtua Research Day

Background

Health literacy as defined by the Center for Disease Control and Prevention (CDC), refers to an individual’s ability to find, understand, and use health information and services1. This definition has evolved with the onset of the COVID-19 pandemic and increasing emphasis on preventative healthcare. We aimed to observe the impact of the pandemic on the health literacy of patients in a free community clinic run by medical students.

Hypothesis

This study aims to assess the effect of various demographic and socioeconomic factors and the COVID-19 pandemic on health literacy levels estimated by the NVS assessment in the patient population …

Beyond The Label: Understanding And Addressing Occupational Stigma In Psychiatry, Mahesh Vasudevan, Madeeha Sheriff

Rowan-Virtua Research Day

Introduction:Stigma is a social classification that devalues individuals or groups, and occupational stigma targets entire professions. Psychiatry is particularly affected, often viewed by the public and medical community as lacking scientific rigor and prestige. This negative perception has far-reaching consequences.

Methods:A narrative literature review was conducted to explore the scope, sources, and impact of occupational stigma toward psychiatrists. Peer-reviewed articles and professional resources published between 2002 and 2023 were selected based on relevance to psychiatric stigma, education, and public perception. Databases searched included PubMed, Google Scholar, and professional association websites using keywords such as “psychiatry stigma” and “psychiatrist …

Bridging The Nature Gap: Understanding Barriers And Promoting Outdoor Engagement Among African Americans In Chattanooga, Kennie Almonor

Honors Theses

This paper outlines my process of writing a physical guidebook for outdoor engagement in Chattanooga. It explores the historical context of Black exclusion from outdoor spaces and examines the health disparities that disproportionately affect Black communities. The physical connection between outdoor activity and overall well-being will also be explained. Additionally, this paper details my methodology for conducting focus groups to better understand barriers to outdoor engagement and how participant insights could inform the guidebook’s development. This paper also outlines my research on best practices for structuring an effective guide, writing process, challenges faced, and considerations for extending this project in …

Addressing Pediatric Vaccine Hesitancy Through Medical Education: A Critical Review, Brooke M. Fasano, Chelsey Ameda, Juan G. Ruiz

Cooper Rowan Medical Journal

ABSTRACT

Background: Immunization rates among pediatric patients are declining, largely due to growing vaccine hesitancy among parents and guardians. Addressing public health concerns related to vaccines is critical to preventing a significant reduction in vaccination coverage.

Objective: This critical review examines the effectiveness of training physicians in communication strategies, such as motivational interviewing, on improving vaccine acceptance.

Methods: A systematic search was conducted in PubMed using MeSH terms “Training AND (Motivational Interviewing OR Online Systems) AND Vaccination Hesitancy NOT COVID-19.” The search yielded 26 results, from which 7 studies met the inclusion criteria for full-text review, focusing on training interventions …

Detection Of Covid-19 Variants, Christina Aglieco

Honors Scholar Theses

The outbreak of Covid-19 in December 2019 was devastating to many but led to major advancements in vaccine research and development. The development of a vaccine against SARS-CoV-2 infection offers protection for the public but cannot eliminate the risk of contracting Covid-19 due to the many viral mutations since the initial wild-type strain isolation in 2019. Analysis of these viral mutations will allow for the development of vaccines with greater protection against the new variants of the coronavirus. Secondary to Covid-19 infection seen in the pediatric population is Multisystem Inflammatory Syndrome in Children or MIS-C. Through qPCR analysis of pediatric …

Quality Of Affected Upper Extremity Use During A Ride-On Toy-Based Training Program In Children With Unilateral Cerebral Palsy: A Pilot Study, Megan Carlmark

Honors Scholar Theses

Unilateral cerebral palsy (UCP) is a subtype of cerebral palsy that impacts movement and coordination on one side of the body. This condition often leads to reduced use of the affected upper extremity in daily tasks. This pilot study explored the feasibility and potential of a joystick-operated ride-on-toy training program as an engaging home-based and play-based intervention to promote affected upper extremity use in children with UCP. Five children from a larger sample of 15 children with a diagnosis of UCP between the ages of 3 and 8 years old were used as data for this thesis. This study included …

Support, School Climate And Teacher Wellbeing In The Wake Of Covid-19: A National Study Using Ntsp Data, Annastashia M. Teepe

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Research indicates a significant number of teachers planned to leave the profession following the COVID-19 pandemic, with national surveys in 2021 revealing about 25% considering departure. Stress, low pay, remote teaching demands, and lack of support contributed to attrition, impacting school climate, which influences productivity, collaboration, and job satisfaction, and is inversely related to turnover. The shift to remote learning also demanded new skills and exposed technological disparities. This quantitative study examined the pandemic's impact on teachers' perceptions of school climate, support, resources, job satisfaction, burnout, and intent to leave using the 2020–2021 National Teacher and Principal Survey. Factor analyses …

A Comparative Analysis Of Women’S Health In Latin America And The United States: Geographical Context And Preventative Actions, Holly J. Robinson

Honors Program: Senior Projects (Public)

Cervical cancer, breast cancer, sexually transmitted infections (STIs), pregnancy complications, and gender-based violence are dangers faced by women everywhere. However, the severity of these risks can increase significantly due to a country’s geography, government control, and level of development. This thesis expands upon information gained directly from on-site experiences with medical professionals and locals (including doctors, nurses, nutritionists, and patients) in Peru, Ecuador, and Costa Rica, and further research to look at Latin America as a whole, in relation to the United States. Both the US and Latin America exhibit problems with their healthcare systems. The United States is more …

Scoping Literature Review: The Role Of Leptin In Autism Spectrum Disorder (Asd) And Associated Obesity, Diana B. Riestra, Andrea Iannuzzelli

Rowan-Virtua Research Day

Overweight and obesity (OW/OB) are significant concerns among individuals with Autism Spectrum Disorder (ASD), yet the underlying causes remain unclear. Emerging evidence points to metabolic and hormonal factors—particularly leptin, a hormone involved in appetite regulation—as potential contributors. This scoping review examined five key studies from 2003 to 2024 that investigated the relationship between leptin and ASD in overweight populations. Across studies, individuals with ASD consistently exhibited elevated leptin levels compared to controls. While some findings also noted changes in other adipokines, such as lower resistin or progranulin, leptin was the most consistently dysregulated. These patterns suggest systemic alterations in energy …

Health Professional Perspectives On Sudden Unexpected Infant Death In Arkansas, Laura Hansen, Bart Hammig

Health, Human Performance and Recreation Undergraduate Honors Theses

Arkansas has one of the highest Sudden Unexpected Infant Death (SUID) rates in the nation, with 173.6 deaths for every 100,000 live births (CDC, 2024). This is much higher than the national rate, indicating a significant need for prevention education. Sudden Unexpected Infant Death is an umbrella term used to categorize Sudden Infant Death Syndrome (SIDS), unknown death causes, and accidental suffocation in bed. SUID rate reduction can be achieved by following infant-safe sleeping guidelines, which include crib use, flat and firm mattresses, no blankets, and putting babies on their backs. In this proposed study, health care professionals across Arkansas …

I Am (Me)Dicine: An Analysis On The Influence Of Humanities Courses Within The Construction Of Internal And External Identities Within Pre-Med Students At Uno, Alix Barnes

Theses/Capstones/Creative Projects

The purpose of this project is to investigate how arts and humanities coursework may enhance the development of internal and external identities for premedical students beyond their traditional scientific coursework. A literature review shows positive findings on identity development and the influence of arts and humanities coursework on medical education. This investigation will take place through a mixed-method survey distributed to UNO premedical students and will explore themes of self-reflection, personal and professional growth, and understanding of external perspectives. An optional question prompts respondents to reflect further on their work within arts and humanities courses and their impact on these …

Promoting Safe Firearm Storage Through Media-Based Interventions, Abigail Bordelon

Health, Human Performance and Recreation Undergraduate Honors Theses

Given the ongoing phenomenon of unintentional pediatric firearm deaths, this project seeks to examine how the mainstream media reports on these events and how media frames could be altered to better promote public health prevention efforts.

The Relationship Of Peer Recovery Support Specialists And Recovery Of Perinatal Women With A Substance Use Disorder, Mary C. Talbot

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: Substance use in pregnant and postpartum women is a growing issue in the United States. Drug use while pregnant can lead to birth defects, stillbirths, and problems providing positive parenting to their children. Many women with substance use disorders (SUD) feel extreme shame and stigma related to their substance use and have trouble accessing recovery-related treatment and other services. Peer recovery support treatment uses the lived experiences of individuals in current recovery from SUD to facilitate and support recovery in others. Purpose: The purpose of this review was to evaluate the impact of peer recovery support specialists on the …

The Effect Of Maternal Anxiety On Breastfeeding Exclusivity And Duration, Zoe E. Treat

Health, Human Performance and Recreation Undergraduate Honors Theses

Background: The postpartum period, especially during the first year, presents a heightened risk for maternal anxiety. Research suggests a potential negative relationship between maternal anxiety and breastfeeding duration, though there is currently a gap in the existing literature regarding how maternal mental health impacts breastfeeding outcomes.

Purpose: This study seeks to investigate the influence of postpartum anxiety on both the duration and exclusivity of breastfeeding, crucial knowledge required to support and implement targeted interventions. We expected that maternal anxiety would predict shorter exclusive and total breastfeeding durations.

Methodology: To explore the relationship between postpartum anxiety and breastfeeding behaviors, we distributed …

Risk Communication And Public Health Emergency Responses During Covid-19 Pandemic In Rural Communities In Kenya: A Cross-Sectional Study, Wilberforce Cholo, Fletcher J. Njororai, Walter Ogutu Amulla, Caleb Kogutu Nyaranga

Population Health Leadership and Analytics Faculty Publications and Presentations

Background: The COVID-19 pandemic highlighted the crucial role of community preventive behaviors in controlling the virus’ spread. Studies show that people’s risk perceptions and awareness significantly contribute to the containment and prevention of infections by motivating adoption of desired actions and behaviors. This study aimed at assessing the role of risk communication and factors that influenced responses during the COVID-19 pandemic in rural communities in Western Kenya. Methods: A descriptive cross-sectional study was conducted using a quantitative research approach, collecting data from 806 individuals across Kisumu, Vihiga, and Kakamega counties. Descriptive statistics were used to detail the demographic characteristics of …

Community Voices, Climate Action Choices: Working Towards A Resilient Monterey County, Lesley A. Solano Alonso

Capstone Projects and Master's Theses

Vulnerable communities in Monterey County face disproportionate environmental and health impacts due to climate change, yet many residents remain unaware of the tools and resources available to support local action. This capstone project was implemented in partnership with Ecology Action (EA) and the Resilient Central Coast (RCC) campaign to increase awareness and engagement with the RCC platform. Serving diverse communities across Monterey County, the project included bilingual outreach efforts, community tabling, educational presentations, and a climate action survey. Over 650 residents were engaged directly, resulting in 99 new household sign-ups on the RCC website, a major milestone for the agency. …

The Sun Shines Beyond The Mountains: The Creation Of A Suicidality Needs Assessment For Lesotho, Layhla Currier

Theses/Capstones/Creative Projects

The country of Lesotho has the highest suicide mortality rate in the world. Although this is true, there has seldom been research into the cause of this astronomical rate, and even less evaluating how to address the issue. This study focused on the analysis of available data to better understand the possible causes of the high suicide rate in Lesotho. Additionally, a suicidality needs assessment was created to collect data regarding mental health, social support, risk factors, and previous suicidality from Basotho (moniker for residents of Lesotho) in a non-stigmatizing way. Two varying suicidality assessments were used to create this …

Assessing And Addressing The Needs Of Socially Vulnerable Populations To Enhance Community Emergency Preparedness And Resilience: A Mixed Methods Study, Jennifer E. Harris

Dissertations: Doctor of Public Health

Background: A robust understanding of the needs of individuals and communities can help reduce the impact of a disaster, especially on those communities that already have associated health disparities. By strategically including these populations into mitigation, preparedness, response, and recovery planning, emergency management plans can be enhanced to be more inclusive and effective by identifying targeted resources during a crisis. Additionally, understanding and improving upon individual resiliency can potentially bolster a community’s resiliency level and reduce overall susceptibility to a disaster event, and expedite the recovery phase. Purpose: The purpose of this study is to assess the emergency …

Local Systems Change: Applied Research Methods For Sustainable Communities, Taylor Barrett Hill

Graduate Student Portfolios, Professional Papers, and Capstone Projects

No abstract provided.

Digital Activism In Kenya: Moving From The Digital Center To The Digital Periphery Of Long Covid Experience, Emily Mendenhall, Lucy Kamau, Nora Kenworthy, Edna Bosire

Brain and Mind Institute

Digital activism around Long covid has reverberated around the globe, as patients, researchers, and clinicians worked together to understand the chronic condition. However, Long Covid networks, much like other social networks, have hierarchies and barriers that can impede equitable access. In this article, we examine how the global digital center and periphery shape how people with Long covid connect to networks to learn about their illness symptoms, diagnoses, treatments, and experiences. We introduce case narratives of two Kenyan women—one elite Nairobian who was connected to the digital center and another middle class woman who connected with her through a peripheral …