Digital Commons Network^™

A Review Of Praziquantel Resistance In Schistosomes And The Future Of Schistosomiasis Control, Gabriela G. Eastham

Senior Honors Theses

Schistosomiasis is a group of both acute and chronic parasitic trematode infections of the genus Schistosoma. Praziquantel (PZQ) has been the drug of choice to treat schistosomiasis for decades. Though it is effective against all three clinically relevant species, heavy reliance on PZQ has led to concerns of schistosome resistance, especially in areas that have implemented this drug in mass drug administration (MDA) programs. Although there is currently insufficient evidence to conclude that schistosomes are becoming resistant to PZQ on a large scale, other control methods are a necessity to best treat and eliminate schistosomiasis. This article summarizes the …

Labour Companionship And Respectful Treatment Of Women During Childbirth: A Cross-Sectional Study Across 16 Hospitals In Benin, Malawi, Tanzania And Uganda, Soha El-Halabi, Kristi Sidney Annerstedt, Christian Agossou, Fadhlun Al-Beity, Andrea B. Pembe, Phillip Wanduru, Bianca Kandeya, Jean-Paul Dossou, Helle Molsted-Alvesson, Claudia Hanson

Centre of Excellence in Women and Child Health

Introduction: Evidence suggests that women value and benefit from having a labour companion during childbirth. However, the applicability of the evidence to low-income and lower-middle-income countries is limited and varies. Thus, we assessed the association between the presence of labour companions and mistreatment in 16 hospitals of Benin, Malawi, Tanzania and Uganda.

Methods: We conducted a cross-sectional survey using a validated questionnaire administered to women at discharge after birth between December 2021 and March 2024. The main outcomes were factor-weighted respectful treatment score and its subscores on maintained respect and dignity, privacy and maintained confidentiality and no physical and verbal …

Highly Pathogenic Avian Influenza Outbreak Preparedness In The United States: A Scoping Review, Emma J. Gurley

Honors Theses

In order to gauge preparedness for an outbreak of highly pathogenic avian influenza (H5N1) in the United States, a scoping review of the current literature was conducted. This process involved (1) identifying the research question, (2) identifying studies relevant to the topic, (3) selecting studies for inclusion (4) charting the data, and (5) analyzing and reporting the final data. Ultimately, seventeen studies were deemed appropriate for examination within this scoping review and several key themes were identified. The results emphasize the importance of adopting a One Health approach, the key role that vaccination may well play in preventing the spread …

Restoring Trust In Public Health: An Analysis Of The Lasting Implications Of The Covid-19 Pandemic Response On Community Trust In Public Health In Nebraska, Kerri Dittrich

Capstone Experience: Master of Public Health

Background and Significance

Public trust is essential for effective public health efforts. In Nebraska, as in many regions, the pandemic response exposed strengths and vulnerabilities in the public health system. Misinformation, political discourse, inconsistent messaging, and poor communication contributed to growing mistrust, threatening the long-term success of public health programs and initiatives. While national trends have been studied, Nebraska-specific research remains limited.

Methods

An original descriptive survey was designed and administered to public health professionals in Nebraska to assess their perceptions of public trust in the local public health system before and after the COVID-19 pandemic. The survey also explored …

Transgender And Gender-Diverse Health Care Access And Availability Of Care According To Resident Leaders In The Mahoning County, Ohio, Robin A. Perry

Capstone Experience: Master of Public Health

BACKGROUND: Transgender and gender diverse health is significantly under attack in the United States and there is a continued need to further research to identify ways to increase their access to both inclusive care as well as gender affirming care. The purpose of this study was to explore barriers and supportive factors that professionals and community leaders perceive surrounding the availability and accessibility of inclusive and gender affirming care for transgender and gender diverse people in Mahoning County, Ohio.

METHODS: Key informant interviews were conducted with professionals and community leaders who could be considered “facilitators” helping transgender and gender diverse …

Focus Group Study Of Racial Disparities And The Effects Of Parental Marijuana Use On Youth Marijuana Use, Avina K. Mahroke

Capstone Experience: Master of Public Health

Marijuana has become one of the most used drugs in the United States. There has been an increase in use among both adults and youth during the past several years. Public health interventions are needed to address marijuana use because of its detrimental effects on youth well-being. Research shows that marijuana can lead to problems with memory, learning, attention, and even depression among youth. Furthermore, marijuana exposure in-utero can lead to developmental issues and problems with other organs such as the lungs. Youth are influenced to start using drugs, like marijuana, for numerous reasons, and parents are one of those …

Active Shooter And Radiological Contamination Full-Scale Exercise, Elise M. Lowe

Capstone Experience: Master of Public Health

Planning and conducting exercises in rural settings highlights the unique features and challenges of emergency preparedness in rural America. Exercise designers must employ creative solutions to plan for player/controller contingencies, limited resources, and patient management across large geographical areas. This paper outlines the process by which a full-scale mass casualty exercise was conducted in a small Wyoming town. It analyzes some of the major problems encountered in rural exercise development and the solutions employed. The focus is on the success and failures of the exercise design based on direct observation/participation, hotwash forms, the after-action review, and direct feedback from participants. …

Kansas City Health Department – Childhood Lead Poisoning Prevention Program – Quality Improvement, Hanh Pham

Capstone Experience: Master of Public Health

This capstone manuscript evaluates the Kansas City Health Department's Childhood Lead Poisoning Prevention Program’s effectiveness. Through comprehensive data analysis of grant utilization, return-on-interest (ROI) and participant satisfaction evaluation, the project will provide actionable recommendations for improving sustainable long-term outcomes in lead poisoning prevention.

Improving Oral Hygiene Practices In A Long-Term Care Setting For Individuals With Advanced Dementia: A Quality Improvement Initiative, Rachel L. Mcinerney

Capstone Experience: Master of Public Health

This quality improvement project utilized the Plan-Do-Study-Act framework to enhance oral hygiene practices in a long-term care setting for individuals with advanced dementia. Advanced dementia often leads to significant oral health challenges due to the individuals’ inability to communicate needs or independently manage oral care. Poor oral hygiene results in pain, systemic infections, and reduced quality of life. The project aimed to identify and address barriers to effective oral care delivery by focusing on organizational factors such as leadership, training, and caregiver support. This capstone paper provides insights into the quality improvement initiative’s aims, background, and methodology, while emphasizing its …

The Politics Of The Black Womb: How Education And Power Reinforce The U.S. Black Maternal Health Crisis, Foluke Akinkunmi

Honors Scholar Theses

This study investigates the alarming maternal mortality rates among Black women in the U.S. today first by exploring the historical exploitation of Black maternal bodies during enslavement and with the rise of professionalized gynecology. It challenges the narrative that attributes these outcomes to individual choices or supposedly inherent biological factors, arguing instead that the devaluing of Black women’s well-being and authoritative knowledge have been constructed along with the United States itself. To advance a constructive response, the paper analyzes curriculum competencies for obstetric and midwifery healthcare providers, surveys of Black women's birthing experiences in the previous 20 years, and interviews …

Disability Inclusion In Local Public Health Community Health Assessments And Community Health Improvement Plans, Haleigh Leslie

Electronic Theses and Dissertations

Introduction: Local health departments (LHDs) use community health assessments (CHAs) and community health improvement plans (CHIPs) to identify and address health needs of the populations they serve. People with disabilities experience health disparities, and there is limited information about how the health needs of people with disabilities are included in CHAs and CHIPs. The purpose of this study was to describe and quantify disability inclusion in LHD CHAs and CHIPs.

Methods: This cross-sectional, mixed methods study used the CHAs and CHIPs of accredited local health departments, data about LHDs and populations served, and interviews with LHD staff and community partners …

Assessing The Relationship Between The Incidence Of Campylobacteriosis And Ecological Risk Factors In Tennessee, Emmanuel Angmorteh Mensah

Electronic Theses and Dissertations

Background: Campylobacteriosis although is the leading causes of bacterial diarrheal illnesses, have not gained prominent awareness and there are gaps in the understanding of transmission routes for sporadic, non-outbreak cases and their risk factors at the communal level to humans. This study, therefore, aimed to identify the campylobacteriosis risk factors and risk perception from the existing literature in the United States, determine the incidence and ecological risk factors for campylobacteriosis zip code level in Tennessee, and to perform spatiotemporal analysis of campylobacteriosis incidence cases in Tennessee.

Method: To achieve the first aim, a scoping review was conducted to synthesize …

Rewriting The Rules: Impact Of Covid-19 On Norms In Science, The International Order, And China, Jacob Kissling '25

Honor Scholar Theses

The Covid-19 pandemic exposed both strengths and vulnerabilities in global responses, many of which were shaped by underlying norms and behavioral expectations within key institutions. Understanding how these norms influenced decision-making, collaboration, and communication—and how they were themselves challenged or reshaped by the crisis—can provide valuable insights for improving future responses. While some norms adapted in response to the evolving crisis, others remained stagnant or were inconsistently enforced, contributing to fragmented and, at times, ineffective responses. This paper investigates the role of norms in three critical sectors: the scientific community, the international order, and China. Within the scientific community, norms …

Health Education And Sexual Health Education In High Schools Focused On Training And Curriculum, Kylee R. Horton

Electronic Theses, Projects, and Dissertations

Background: Health education instruction in schools is essential due to mandated state standards that require a range of topics to be taught at specific ages. Education Codes must be followed and integrated into the curriculum. Objective: To develop a handbook for middle and high school teachers in San Bernardino County, California, that explains the mandatory Health Education codes and provides resources to help teachers maintain compliance with these regulation codes. Methods: The research was conducted in a systematic review, and the data was collected from published secondary sources at the state and local levels. Results: Education Codes from the California …

The Role Of Medical-Legal Partnerships On Social Determinants Of Health For Vulnerable Populations In The Inland Empire, Sabrina C. Kinnally

Electronic Theses, Projects, and Dissertations

San Bernardino and Riverside counties face significant challenges in addressing the Social Determinants of Health (SDOH) for vulnerable populations, including housing instability, healthcare access, and food insecurity. This project examined the role of Medical-Legal Partnerships (MLPs) in providing services to vulnerable populations. Through a systematic review, the study explored the current state of MLPs and their effectiveness in addressing SDOH to reduce health disparities. The other purpose is to assist Agape Legal Service, Inc. (AGAPE), a non-profit organization, in completing their strategic plan, which aims to address the legal needs of vulnerable populations within the Inland Empire. The systematic review …

Evaluating The Impact Of Community Gardens On Social Equity And Public Health: A Case Study Of Caramel Connections Foundation's (Ccf) Seeds Of Joy Community Garden, Elizabeth Pinder

Electronic Theses, Projects, and Dissertations

Community gardens have been increasingly recognized as effective public health interventions that address food insecurity, foster social cohesion, and promote environmental sustainability. This evaluation examines the impact of the Caramel Connections Foundation (CCF) Seeds of Joy Community Garden in Ontario, California, by assessing its effectiveness in advancing social equity, improving public health outcomes, and fostering community engagement. Using an evaluation framework, this study measures key program outcomes, including improvements in community well-being, inclusivity, and access to green spaces.

A mixed-methods evaluation design was applied, incorporating process and impact evaluation methodologies. Secondary data collected from CCF’s existing program records, survey responses, …

Reducing Extreme Heat Impacts On Health In Pregnant Women And Infants: A Community Based Intervention In Kilifi, Kenya, Adelaide Lusambili, Fiona Scorgie, Martha Oguna, Matthew Chersich, Stanley Luchters, Giorgia Gon, Veronique Filippi, Sari Kovats, Kevin Mccawley, Jeremy Hess

Institute for Human Development, East Africa

High ambient temperatures affect maternal and newborn health outcomes and wellbeing. The Climate Heat and Maternal and Neonatal Health in Africa (CHAMNHA) consortium conducted formative qualitative research in rural Kilifi, Kenya, to examine perceptions of heat risks among women, household members and community stakeholders. An intervention was co-designed together with community members. This paper presents the development, implementation, and evaluation of a behavior-change intervention aimed at reducing the burden of heat on maternal and newborn health. The intervention used Digital Audio-Visual (DAV) storytelling (encompassing short videos and a set of photographs) and facilitated group discussions. Intervention groups included pregnant and …

The Influence Of Scientific, Genetic, And Health Literacy On Carrier Screening Decision-Making, Brenna D. Albracht

Dissertations and Theses (Open Access)

For those wishing to assess their reproductive risks and make informed decisions in their reproductive planning, carrier screening for autosomal recessive and X-linked conditions, as well as cell-free DNA (cfDNA) screening for aneuploidy, are recommended during pregnancy. Despite similarities in purpose, sample requirements, insurance coverage, and safety, a lower percentage of individuals elect carrier screening than cfDNA screening, suggesting there may be a disconnect in what patients perceive as valuable information for their pregnancy. Previous studies have attempted to explain the factors associated with carrier screening uptake or decline; however, no models have yet accounted for a patient’s literacy level …

Planning For Scale: Analysis Of Adaptations And Contextual Factors Influencing Scale-Up Of The Quali-Dec Intervention To Optimize Caesarean Section Use, Soha El-Halabi, Claudia Hanson, Alexandre Dumont, Amanda Cleeve, Helle Mölsted Alvesson, Charles Kaboré, Guillermo Carroli, Pisake Lumbiganon, Quoc Nhu Hung Mac, Ana Pilar Betran

Centre of Excellence in Women and Child Health

Background: Researchers are encouraged to plan for scale through purposeful and guided assessment of scalability of an intervention. This study analysed factors potentially influencing scale-up and synthesised early adaptations of the QUALI-DEC intervention aiming to improve the appropriate use of caesarean section. The intervention consists of opinion leader engagement, audit and feedback for caesarean section, a tool to help women make an informed decision on the mode of birth, and labour companionship.

Methods: We conducted a framework analysis, which was guided by the scalability assessment framework by Zamboni et al., a 34-item checklist with a three-point scale. We used data …

Pregnancy Care Integrating Translational Science, Everywhere (Precise): A Prospective Cohort Study Of African Pregnant And Non-Pregnant Women To Investigate Placental Disorders – Cohort Profile, Rachel Craik, Joseph Akuze, Marie-Laure Volvert, Hannah Blencowe, Moses Mukhanya, Angela Koech, Grace Mwashigadi, Marleen Temmerman, Marvin Ochieng, Emily Mwadime

Centre of Excellence in Women and Child Health

Purpose: The Pregnancies' Care Integrating translational Science, Everywhere Network was established to investigate specific placental disorders (pregnancy hypertension, preterm birth, fetal growth restriction and stillbirth) in sub-Saharan Africa. We created a repository of clinical and social data with associated biological samples from pregnant and non-pregnant women. Alongside this, local infrastructure and expertise in the field of maternal and child health research were enhanced.

Participants: Pregnant women were recruited in participating health facilities in The Gambia, Kenya and Mozambique at their first antenatal visit or at the time a placental disorder was diagnosed (Kenya and The Gambia only). Follow-up study …

An Updated Systematic Review And Consensus Definitions For Standardised Endpoints In Perioperative Medicine: Patient Comfort And Pain Relief, Paul S Myles, Sophie Wallace, Oliver Boney, Mari Botti, Frances Chung, Allan M Cyna, Tong J Gan, Michael P W Grocott, Mark P Jensen, Henrik Kehlet, Andrea Kurz, Maxime Leger, Ulrica Nilsson, Phillip Peyton, Daniel I Sessler, Martin R Tramèr, Christopher L Wu, Alfred Health Patient Experience And Consumer Engagement Group

Faculty, Staff and Student Publications

Background: Improving comfort during and after surgery is a key concern for anaesthetists and other clinicians. With the inclusion of patient and public involvement, we undertook a Delphi consensus process to update previously recommended endpoints to be used in clinical trials evaluating treatments aiming to improve patient comfort after surgery.

Methods: We undertook a systematic review to identify domains and outcome measures of patient comfort used in perioperative studies. Focus groups, workshops, and a multi-round Delphi consensus process that included clinician-researchers and a patient experience and consumer group updated a recommended list of standardised endpoints focused on patient comfort. Consensus …

Public Health Messaging About Dengue On Facebook In Singapore During The Covid-19 Pandemic: Content Analysis, Shirley S. Ho, Mengxue Ou, Nova Mengxia Huang, Agnes S.F. Chuah, Vanessa S. Ho, Sonny Rosenthal

Research Collection College of Integrative Studies

Background:Dengue, a mosquito-borne disease, has been a health challenge in Singapore for decades. In 2020, during the COVID-19 pandemic, Singapore encountered a serious dengue outbreak and deployed various communication strategies to raise public awareness and mitigate dengue transmission.Objective:Drawing on the Crisis and Emergency Risk Communication (CERC) framework, this study examines how dengue-related messages communicated on Facebook (Meta) during the COVID-19 pandemic fall into the CERC themes. This study also seeks to understand how these themes differ between dengue outbreak (eg, 2020) and nonoutbreak years (eg, 2021). In addition, we explore how message themes on dengue changed across different CERC phases …

Gender And Ethnic Differences In Mental Health Outcomes In Sexual And Gender Minority (Sgm) Youth And Young Adults In Texas And California, 2022-2024, Michelle Gil

Open Access Theses & Dissertations

Background: Depression and anxiety affect populations differently, particularly LGBTQ+, ethnic minorities, and youth with limited access to competent care. Risk factors include harassment, victimization, and discrimination. Purpose: To examine gender identity and ethnic differences in depression and anxiety among SGM youth in Texas and California. It is hypothesized that both Latinx and gender minority youth will report higher rates of depression and anxiety compared to non-Latinx and cisgender youth. Methods: Secondary analysis used data from the Family, Housing, and Me (FHAM) Project, following 83 LGBTQ+ youth from South Texas and California's Inland Empire over 25 months. Data includes sociodemographic characteristics, …

Exploring Willingness To Seek Help And Well-Being In Rural Veterans With Health Conditions: A National Rural Health Study, Jimena Isabel Ortiz

Open Access Theses & Dissertations

The population of Veterans in the United States has increased significantly, with a substantial number residing in rural areas. This study aims to highlight and understand the correlation between military service members' physical and mental well-being and the quality/access to care they receive. This study also aims to explore mental health-seeking behaviors, health, and well-being in rural Veterans with health conditions. The study included 400 rural-dwelling Veterans with documented physical and mental health conditions. Data was collected through surveys distributed via various media channels, including social media platforms, and the results demonstrated that willingness to seek psychological help was positively …

Pilot Study To Compare A Therapeutic Exercise Protocol And Neuromuscular Taping On Improving Plantar Foot Pressure Among Type 2 Diabetes Patients, Sandra Rivera

Open Access Theses & Dissertations

Background: Diabetes has become one of the most prevalent non-communicable diseases worldwide. Diabetic foot ulcers (DFU) are a common complication of diabetes as it causes peripheral neuropathy. It is estimated that up to 50% of peripheral neuropathy in patients with diabetes may be asymptomatic. Justification: The purpose of this study was to determine if the therapeutic exercise protocol and/or Neuromuscular taping can delay changes in the plantar pressure of the foot in patients with Diabetes. Methods: A two-group quasi-experimental design was used in this study; data was collected at two different points in time; pre- and post-intervention. Baropodometric was used …

Testing A Benign Multi-Modal Bilingual Intervention To Increase Self-Efficacy, Intentions, And Willingness To Administer A Covid-19 Antigen Rapid Test In A Predominately Hispanic Sample, Uchenna Gbugu

Open Access Theses & Dissertations

Introduction. Testing is one of the most effective methods for reducing the spread of COVID-19. COVID-19 antigen tests can detect proteins from the COVID-19 virus called antigens and produce results within minutes, making them suitable for at-home use. Several factors have been identified as barriers to self-administering a COVID-19 antigen test, including the language of the testing instructions, the cost of testing, and access to tests. Interventions to reduce barriers to self-administering COVID-19 rapid tests are warranted to reduce the spread of COVID-19. The purpose of the present study is to test the impact of a benign multi-modal bilingual intervention …

Racial And Ethnic Differences In Knowledge Of Gender-Affirming Care Among Community And Student Participants In The Bloom Transgender Health Education Program In The Paso Del Norte Region, 2022-2024, Tandra Ghosh

Open Access Theses & Dissertations

SUMMARY OF BACKGROUND AND SIGNIFICANCE: There is a noticeable lack of training and knowledge regarding gender-affirming care (GAC) among providers and within the general community. OBJECTIVE: Assess racial and ethnic disparities in knowledge of GAC among participants in BLOOM, a quasi-experimental transgender health education program in the Paso Del Norte region. HYPOTHESES: Among community and student participants at pre-survey, assess racial and ethnic differences in sociodemographic characteristics, preparedness, attitudes, and basic knowledge regarding LGBT clients/patients and GAC. METHODS: Secondary data among community (pre: 53; post: 14) and student (pre: 29; post: 17) BLOOM participants in 2022-2024 were used. Descriptive statistics …

Insights Into Cancer Awareness And Health Practices In Rural Kenya: A Cross-Sectional Study Of Esophageal, Breast, Prostate, Cervical, And Colorectal Cancers, Rosebella Iseme-Ondiek, Joseph Abuodha, Anthony Ngugi, Mansoor Saleh, Innocent Abayo

Population Health, East Africa

PURPOSE; In sub-Saharan Africa (SSA), there has been an epidemiologic transition from infectious diseases to noncommunicable diseases, including a projected doubling in incidence of cancer. Understanding the underlying factors driving this surge is crucial for designing effective strategies to mitigate the cancer burden. This study focuses on assessing knowledge, attitudes, screening practices, and health behaviors related to five most prevalent cancers in SSA: prostate, breast, cervical, esophageal, and colorectal—among a predominantly rural coastal population in Kenya.

MATERIALS AND METHODS ;We used a cross-sectional study design targeting 1,500 adult respondents randomly selected from an existing community health and demographic surveillance system. …

Educational Leadership In A Vuca World: The Crisis Management Experiences Of Rural School Superintendents, Lucas J. Grossnicklaus

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

The job of both urban and rural superintendents is challenging, but it is the rural school superintendency that comes with unique challenges that aren’t always faced by their urban and suburban counterparts. The COVID-19 Pandemic brought about a number of crises for school superintendents such as school closures, mask mandates, and navigating positions taken by governors, teachers unions, and school boards. While concerns about school closures and mask mandates has dissipated, conflict within school districts has only seemed to grow since the pandemic.

This multi-case study explored the lived experience of rural superintendents in the Midwest who have experienced a …

Racial And Geographic Disparities In Primary Care Transitions For Postpartum Women With Gestational Diabetes And Hypertension In South Carolina, Kajol Dahal

Electronic Theses and Dissertations

Introduction Gestational diabetes (GDM) and gestational hypertension (GH) are significant public health issues with lasting implications for maternal and child health (MCH). Despite clinical guidelines recommending postpartum care for all women, especially those with chronic conditions, less than 50% receive a visit within 12 months of childbirth. Recent policy changes extend postpartum Medicaid coverage from 60 days to 12 months. This study assessed differences in postpartum care visits by race/ethnicity and geography after the extension of postpartum coverage in South Carolina. Methods A retrospective cohort of 27,056 women (aged 20-44) who gave birth in 2021 were analyzed using Medicaid claims …