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Public Perception About Covid-19 Vaccine Hesitancy In South Central Nebraska, Rita Nnenne Oparaocha

Biology Theses, Dissertations, and Student Creative Activity

The COVID-19 pandemic created a shift in the trajectory of vaccination hesitancy, altering risk perceptions and vaccination attitudes among individuals in rural communities. The 5C framework highlights confidence, complacency, constraints, calculation, and collective responsibility as influencing factors of vaccine hesitancy. This study assessed the proportion of adults who refused COVID-19 vaccination and identified the individual reasons for hesitancy among those who refused the COVID -19 vaccines in South Central Nebraska. Data was analyzed from a local cross-sectional public health survey administered to 2,034 adult participants over a six-month period (March-August 2024), including 91 respondents who were from outside the seven-county …

Long Covid Incidence Across Sars-Cov-2 Lineages And Identification Of Conserved Spike Targets For Multivalent Vaccines, Grace J. Kim, Md Ashad Alam, Judy S. Crabtree, Rebecca Rose, Susanna L. Lamers, San Chu, Ronald Horswell, Daniel Fort, Lucio Miele

School of Graduate Studies Faculty Publications

Background: Long COVID remains poorly characterized at the genomic level. The primary aim of this study was to examine the relationship between viral sequences and the incidence of Long COVID at a tertiary care center in Louisiana between April 2020 and December 2022. A secondary aim was analysis of the Spike protein to identify conserved regions for multivalent vaccine targets. Method: To estimate Long COVID incidence across variants, we linked 4,789 SARS-CoV-2 sequences to 3,090 de-identified patient electronic health record information. The base population was defined as any patient with an International Classification of Diseases-10-Clinical Modification COVID-19 diagnosis code (U07.1) …

P-15 Peptide Enhanced Bone Graft Improves Time To Fusion In Transforaminal Lumbar Interbody Fusion: A Randomized, Controlled, Investigational Device Exemption Study, James S. Harrop, Michael P. Steinmetz, John E. O'Toole, Christopher D Chaput, Rick C. Sasso, K. Brandon Strenge, Greg Maislin, Jeffrey P. Mullin, Thomas B. Freeman, Anthony Guanciale, Howard Lantner, Michael E. Janssen, David G. Schwartz, John M. Small, Wellington K. Hsu, Paul M. Arnold

Department of Neurosurgery Faculty Papers

STUDY DESIGN: Prospective, multicenter, single-blind, randomized, and controlled pivotal study.

OBJECTIVE: Compare time-to-fusion in patients treated with P-15L (PearlMatrix TM P-15 peptide enhanced bone graft) versus local autograft over 24 months and evaluate changes in pain and quality of life at 24 months relative to baseline.

SUMMARY OF BACKGROUND DATA: P-15L, an FDA-designated breakthrough device, is a composite bone graft with P-15, a 15-amino acid polypeptide that promotes cellular adhesion, proliferation, and differentiation to support bone formation.

METHODS: Patients (22-80 y) with degenerative disc disease were randomized to the investigational (P-15L) or control (local autograft) group during single-level transforaminal lumbar …

Facilitators Of Routine Cervical Screening Receipt For Women With Intellectual And Developmental Disabilities In Nebraska, Anne Woodruff Jameson

Theses & Dissertations

Women with intellectual and developmental disabilities (I/DD) experience disproportionately low rates of cervical screening relative to women without I/DD, despite its clear role in cancer prevention. This disparity is especially stark in Nebraska, where in 2023, only 56% of women with I/DD had cervical screen receipt, compared to 78.4% of their non-disabled peers.. Previous literature has explored barriers to cervical screening for women with I/DD using the socioecological model (SEM) as a framework. This dissertation used three methodologies: a case study, a scoping review, and survey research, to examine facilitators to cervical screening for women with I/DD using the SEM …

Personal Health Advice In The World Of Artificial Intelligence: An Assessment Of Responses From Chatgpt For Three Common Health Conditions In The Southern United States, Marion W. Evans Jr, Julie Harrison Swartz, Harrison Ndetan, Damian Francis, John Moore, Mary Kozub, Ernie Kaninjing, Jennifer Jones-Locklear, Debbie Greene, Josie Doss

Journal of Public Health in the Deep South

Background: Artificial intelligence (AI) applications within the health sciences including education and healthcare practice are now common. Patients are likely to apply AI to better understand their health status or to learn what they can do to improve their health.

Purpose: The purpose of this study was to evaluate outputs from ChatGPT for three common health conditions seen in the southern United States as to whether it would include medically biased care or lifestyle related advice, legitimate sources of information and to assess reading levels generated.

Methods: Health care professionals rated outputs in 4 areas and interrater …

Using Electronic Medical Records To Estimate The Prevalence Of Pediatric Obesity In Mississippi, Brian D. Christman, Abigail Gamble, Sonia Jain, Kalon Kl Ho, Lei Zhang, William B. Hillegass

Journal of Public Health in the Deep South

Background: Pediatric obesity is a major public health concern in Mississippi. However, existing surveillance systems, including the Youth Risk Behavioral Surveillance System, National Survey of Children's Health, and Child and Youth Prevalence of Obesity Survey, are limited by self-reported data, restricted age ranges, and incomplete subgroup coverage.

Purpose: This study evaluates the plausibility of using electronic medical records to improve population-level surveillance of pediatric obesity in Mississippi while addressing issues of data completeness, bias, and representativeness.

Methods: Electronic medical records from 40,215 patients aged 2–19 years who received care at the University of Mississippi Medical Center (2013–2022) were analyzed via …

Assessing Education And Training Of Developmental Screening Tools Among Residents In A Southern Academic Medical Center, Paige Seabrook, Dustin E. Sarver, Susan Buttross

Journal of Public Health in the Deep South

Background: Developmental disabilities are highly common. Early identification of developmental disabilities is critical, but many practitioners, including those in Southern U.S. states like Mississippi, do not utilize developmental screening tools.

Purpose: We aimed to identify modifiable targets within resident training experiences and their correlates using a quality improvement approach to serve as a baseline for intervention efforts.

Methods: Medical residents (N = 57) in pediatrics (n = 26), combined medicine-pediatrics (n = 12), and family medicine (n = 19) completed a survey assessing training, attitudes, practices, and perceived barriers regarding using screening tools. Perceived barriers were …

Enhancing Public Health Strategies: Addressing The Rsv Burden In Alabama Through Clinical Treatment, Community Prevention, And Surveillance Approaches, Martha K. Findley Roper, Jennifer S. Dawson

Journal of Public Health in the Deep South

Introduction: Respiratory Syncytial Virus (RSV) is a highly contagious pathogen driving morbidity, hospitalizations, and economic burden. This review uses the epidemiological triad and National Wastewater Surveillance System data to assess transmission, viral load spikes in Alabama, and strategies for treatment and prevention.

Methods: A review of literature on supportive care, vaccination, monoclonal antibodies, and emerging nanomedicine was reviewed to evaluate strategies for reducing viral burden and complications.

Results: Trends from December 2024–January 2025 were assessed with National Wastewater Surveillance System data. Primary prevention includes immunization, hygiene, air quality maintenance, and early diagnostics. Tertiary care addresses complications such as secondary …

Risk For Infant Mortality Among Childbearing Women In Alabama, Michael Rutalira Koko

Journal of Public Health in the Deep South

Background: Infant mortality is an important indicator of the health of a population. From 2016 to 2020, the infant mortality rate in Alabama significantly decreased. However, disparities remain among different groups. The objective of this analysis is to evaluate risk factors and disparities of infant mortality for the past five years.

Methods: We used the Alabama Center for Health Statistics database, a population-based state vital records registry. We included 290,832 births to women aged 15 to 44 years linked to 1,575 infant deaths from 2016 to 2020. We excluded births at less than 20 weeks of gestation and weighing 500 …

Trends In Drug Overdose Deaths In Alabama, 2010-2020, Michael Rutalira Koko, Raphu Wakumeki

Journal of Public Health in the Deep South

Background: Drug overdose deaths are the leading cause of injury-related death in the United States. Over the past two decades, drug overdose deaths have dramatically increased in the United States, and the rise in the number of drug overdose deaths is mostly due to opioids. This descriptive study aimed to examine trends in drug overdose deaths according to age, sex, and race/ethnicity from 2010 to 2020 in Alabama.

Methods: We used data from the National Vital Statistics System (NVSS) and the U.S. Census Bureau to calculate age-adjusted mortality rates for specific age groups, gender, and race/ethnicity. We used SAS Version …

Dual-Task Exercise Protects Healthy Older Adults Against In-Creased Risk For Dementia: A Controlled Trial, Helen Tatiane Santos Pontes, João Bento-Torres, Naina Yuki Vieira Jardim, Victor Oliveira Da Costa, Josilayne Patricia Ramos Carvalho, Cristovam Wanderley Picanço-Diniz, Natáli Valim Oliver Bento-Torres

Baltic Journal of Health and Physical Activity

Background: Functionality in aging is closely linked to the ability to divide attention during multitasking activities, which are essential for activities of daily life. However, coordination between motor and cognitive simultaneous tasks decreases with age, impairing functional ability and restricting older adults' participation and healthy aging. This study aimed to assess the effects of a multimodal dual-task exercise intervention on motor and cognitive dual-task costs and its potential to mitigate age-related declines in healthy older adults. Materials and Methods: A controlled trial was conducted with community-dwelling older adults assigned to either the Dual-Task Exercise group, which participated in a 24-session …

Unraveling The Drivers Of Inequality In Maternal Healthcare Utilization In Indonesia: A Decomposition Analysis, Wji Wahyuningsih, Kemal N. Siregar, Syifa Nurhakiki

Jurnal Ekonomi Kesehatan Indonesia

This study assessed socioeconomic inequalities in maternal healthcare utilization in Indonesia and identifies key factors driving these inequalities. We used data from 2013 and 2023 Indonesian Health Surveys, comprised of a total unweighted sample of 15,638 and 9,923 women aged 15-49 in the 2013 and 2023, respectively. Concentration index (CI) measured wealth-based inequality, and decomposition analysis identified primary drivers of inequalities in maternal healthcare access. Overall maternal healthcare service utilization has increased, but significant inequalities persist. Antenatal care showed minimal improvement, with the CI rising from 0.059 to 0.079, indicating a persistent higher socioeconomic distribution. Facility-based deliveries improved, with the …

Implementation And Outcomes Of A Digital Onboarding Taskforce In The Acute Care Setting, Julianna Lenoir, Alexzandra Gentsch, Akshay Krishnan, Jeffrey Ndubisi, Marissa Witmer, Kristin L. Rising, Brooke Worster, Angela M. Gerolamo

Jefferson Center for Connected Care Faculty Papers

INTRODUCTION: Use of digital health technology can improve patient health outcomes; however, not all patients have the knowledge and skills to download a health app and access a patient portal. Providing digital onboarding support to hospitalized patients has potential to overcome some barriers to accessing needed education in the community, including both having the time and a location to receive education. To address this, our team developed the Jefferson Digital Onboarding Taskforce (JeffDOT), a group of staff and students who approach hospitalized patients and provide one-on-one teaching on how to sign up for and use a patient portal.

METHODS AND …

Impact Of Postoperative Intraocular Pressure Spikes On Outcomes Following Goniotomy: A Comparative Study Of Surgical Techniques, Wesam S. Shalaby, Steven L. Chang, Julia Yu, Teresa Horan, Sagar Shah, Shahin Hallaj, Marlene Moster, Reza Razeghinejad, Daniel Lee, Michael Pro, Aakriti Shukla, Ping Huang, Jonathan S. Myers, Tina Xia, Dilru Amarasekera

Wills Eye Hospital Papers

AIM AND BACKGROUND:To compare postoperative intraocular pressure (IOP) spikes and 1-year surgical success among goniotomy procedures: Kahook Dual Blade (KDB), OMNI, bent ab interno needle goniotomy (BANG), and gonioscopy-assisted transluminal trabeculotomy (GATT).

MATERIALS AND METHODS: This single-center, retrospective chart review included glaucoma patients ≥18 years, who underwent goniotomy from January 2021 to December 2022 with ≥3 months of follow-up. Primary outcomes were IOP spikes (≥10 mm Hg increase within 3 months) and 12-month surgical success (≥20% IOP and/or ≥1 medication reduction without further surgery). Secondary outcomes included IOP and medication changes.

RESULTS: Among 247 eyes (107 KDB, 63 OMNI, 77 …

Violence Between Residents In Nursing Homes Is An Enduring Problem. The Agencies, Nursing Homes, And Residents Are Playing Hot Potato With The Responsibility, Cindy Marchionda, Rafael Escalara Montoto

Capstones

Resident-to-resident aggression in nursing homes is a persistent issue, far more common than the general public realizes. While many of these violent situations can be managed, some tragically escalate to fatal outcomes, leaving families mourning the loss of their loved ones at the hands of a facility that was meant to provide safety and care during their final years. Experts agree that this issue is largely driven by chronic understaffing and insufficient training for employees on how to manage patients with dementia and aggression issues.

Lycopene, Race And Periodontitis: Disparities In Older Adults, Katherine Kwong, You Lu, Zhuo Huan Li, Susu Luo, Zhaoyu Huang, Zhong Chen, Na Zhao, Tung Sung Tseng

School of Public Health Faculty Publications

Background Periodontitis is a severe gum disease that can be an indicator of other health conditions such as cardiovascular disease and diabetes. Lycopene has been suggested as an adjunct therapy for periodontitis. This study aims to investigate the association between insufficient lycopene intake and the risk of Periodontitis among non-Hispanic White (NHW) and non-Hispanic Black (NHB) older adults. Methods The study included 1,227 adults aged 65–79 years from the National Health and Nutritional Examination Survey (2009–2014). Total lycopene intake from daily diet was studied with age, race, marital status, smoking status, BMI, diabetes, sex, and education as independent variables in …

What’S That Smell? It’S Climate Change!, Perry Gregory

Capstones

Climate change is going to make New York City smell worse. Reporter Perry Gregory breaks down the process of olfaction and explains how heat affects what we smell. The piece features a collage of voices of New Yorkers describing the current smell profile of the city. The report features insight from several Atmospheric Scientists into why New York City is getting hotter and more humid, and how those climate changes will make the existing smells of the city stronger, and worse. The most economically vulnerable New Yorkers, who cannot afford air conditioning to buffer them from heat, will be the …

Health Implications Of Heavy Metal Contamination In Commercially Available Deodorant And Antiperspirant Products Sold In Benghazi, Libya, Maysson Yaghi, Khaled Elsherif

Al-Bahir

The extensive usage of deodorants and antiperspirants raises concerns about the potential health risks posed by heavy metal content. This study quantified the levels of five heavy metals: Aluminum, Zirconium, Lead, Cadmium, and Chromium in 22 commercial products widely used in Benghazi, Libya, and assessed the associated health risks. Samples, categorized into gel, stick, and roll-on formulations, were analyzed using iCAP TQ ICP-MS. Al and Zr showed the widest concentration ranges, reflecting their intentional use as active ingredients. Al levels ranged from trace amounts (0.032 mg/kg) up to a maximum of 99.10 mg/kg, while Zr was found exclusively in gel …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

From Fear To Familiar: Reducing Technology-Induced Anxiety In Seniors, Justin Kyle V. Manalang

Master's Projects and Capstones

Abstract

This quality improvement project focuses on reducing the average technology-induced anxiety score among senior community members through 1:1 mentorship sessions. Aim During an eight-week period from September 10, 2025, to November 5, 2025, this project will reduce the severity of technology-induced anxiety by 25% from the established baseline. Methods: A 5P Microsystem assessment was conducted alongside an initial questionnaire to gauge the residents’ interests and concerns regarding technology use. From the results, focused mentorship sessions were conducted once a week and pertained to the chief complaint the resident had for eight weeks. The mentorship sessions were one-to-one and individualised …

From Fear To Familiar: Alleviating Technology Anxiety In Older Adults Through A Community-Based Mentorship Program, Inyoung Jang

Master's Projects and Capstones

This quality improvement project was implemented in a senior residential facility in Richmond, California, catering to older low-income adults who frequently experience elevated levels of technology anxiety. Aim This project aims to reduce the mean modified technology-anxiety score among residents aged 65 and older by at least 25% from baseline by November 5, 2025. Methods The Abbreviated Technology Anxiety Scale (MTAS) was modified to consider the cognitive, linguistic, and experiential differences among target population. The original 11-item instrument, which was validated primarily within college-aged populations, used terms and repeated items irrelevant to older people. The adapted tool included five simplified …

Exploring The Association Between Nurse Characteristics And Intent To Leave Their Current Position In Counties With Rural Hospital Closures, Caroline A. King

2025 Fall Honors Capstones Projects - Archive

Increased rural hospital closures and nursing burnout may lead to greater morbidity/mortality for rural residents. Current literature fails to capture whether rural hospital closures influence nurses’ intent to leave their current position. In this cross-sectional study, descriptive and correlational statistical analyses were conducted on survey responses from a sample of nurses who lived in a rural county that experienced a hospital closure. 66% of nurses stated that, at one point, they had considered leaving their primary nursing position. Logistic regression model results revealed that nurse-reported age and gender were significant predictors of a nurse’s intention to leave their current position. …

Factors Influencing The Re-Emergence Of Vaccine-Preventable Diseases Using The Social Ecological Model: A Scoping Review, Glenda Dorina Rodriguez Lenarduzzi

Master's Projects and Capstones

Abstract

Background.

Several factors contribute to the resurgence of vaccine-preventable diseases, affecting coverage rates and vaccine uptake during recent outbreaks. The pandemic has underscored how crucial it is to comprehend vaccine literacy, as this understanding influences people's perspectives and behaviors toward vaccination, particularly in their approaches to problem-solving and decision-making.

Objective.

The present study conducts a scoping review of research on the impact of vaccine literacy and vaccine uptake on the re-emergence of vaccine-preventable diseases in the United States, framed by the social ecological model (SEM).

Design.

PubMed and Google Scholar were utilized as online databases to identify papers published …

Emergency Preparedness Education And Simulation Training For Nursing Students In Southern India, Kevin C. Cameron, Taryn Mccoy, Laura Gray, David Phillippi

DNP Projects

Introduction

To address the identified gap in emergency preparedness education and training among nursing students at a teaching hospital in southern India, a private university in the southeastern United States partnered with the site to develop a quality improvement initiative aimed at strengthening these skills. Nursing students at the partner hospital have limited access to simulation-based training opportunities due to constraints in both curriculum and availability of simulation resources. This lack of exposure may hinder the development of critical emergency preparedness competencies

Methods

Educational content focused on triage and basic life support (BLS). One hundred twenty-four students participated in the …

Improving Staff Satisfaction And Flu Vaccine Uptake Through Standardized Workflow Tools, Salma Adriana Blanco

Master's Projects and Capstones

Objective: Insufficient workflows can cause documentation to be confusing, which ultimately

limits staff engagement. This has led to staff dissatisfaction and a low vaccination uptake in

outpatient clinics. The implementation of a standardized workflow tool and proper staff

education and training can improve staff satisfaction and vaccination adherence, as indicated by

a review of literature. Aim: The purpose of this quality improvement project is to implement a

change in workflow in the electronic health record and staff training in an urban community

health clinic primarily serving low income and Latino patients. This intervention seeks to

increase medical assistant user satisfaction …

Application Of Augmented Reality Technology As A Dietary Monitoring And Control Measure Among Adults: A Systematic Review, Gabrielle Victoria Gonzalez, Bingjing Mao, Ruxin Wang, Wen Liu, Chen Wang, Tung Sung Tseng

School of Public Health Faculty Publications

Background/Objectives: Traditional dietary monitoring methods such as 24 h recalls rely on self-report, leading to recall bias and underreporting. Similarly, dietary control approaches, including portion control and calorie restriction, depend on user accuracy and consistency. Augmented reality (AR) offers a promising alternative for improving dietary monitoring and control by enhancing engagement, feedback accuracy, and user learning. This systematic review aimed to examine how AR technologies are implemented to support dietary monitoring and control and to evaluate their usability and effectiveness among adults. Methods: A systematic search of PubMed, CINAHL, and Embase identified studies published between 2000 and 2025 that evaluated …

Food, Fitness, And Filipino Culture: Evaluating And Reimagining Chronic Disease Interventions For Filipino Americans Through The Pen-3 Framework, Juliana Mastro

Master's Projects and Capstones

Filipino Americans experience high rates of chronic diseases such as diabetes and hypertension. This paper reviews nutrition and exercise interventions targeting this population through the strengths-based PEN-3 cultural framework, focusing on cultural identity, relationships and expectations, and cultural values. It identifies effective strategies that engage these cultural components, and highlights gaps such as limited research on Filipino-American health outcomes. Recommendations include family-centered approaches, culturally relevant activities like tinikling dance, and community-driven online healthy recipe archives to promote positive health behaviors. These culturally informed strategies aim to improve self-efficacy, support lasting health behavior change and reduce chronic disease prevalence nationwide.

Implementation Factors For Wearable Fall Injury Mitigation Technology: A Framework For Technology Adoption, Richard G. Stefanacci, Rebecca J. Tarbert, Nicole Hemenover

College of Population Health Faculty Papers

OBJECTIVES: To identify implementation factors influencing the adoption of wearable fall injury mitigation technology in long-term care (LTC) settings and develop a practical framework for technology implementation success.

DESIGN: Mixed-methods assessment of a multicenter evaluation examining organizational, staff, and resident factors affecting technology adoption.

SETTING AND PARTICIPANTS: Ten LTC facilities implementing the Tango Belt, a wearable airbag device for hip protection during falls. Analysis included 134 intervention participants (mean age 87.3 years, 76% female, 93% with fall history in past year) and comprehensive stakeholder feedback from staff, leadership, residents, and families.

METHODS: Quantitative measures included device adherence rates, training attendance, …

Neuroqueering The Australian Workplace, Myfan Jordan

Ought: The Journal of Autistic Culture

Neuroqueering the Australian Workplace

Artist’s Statement

The typical (Australian) workplace is hierarchical, heteronormative and neurotypical. It is focused on productivity and efficiency, priorities which denote specific ways of working as superior. For autistic and ADHD workers, who approach the world differently, ‘fitting in’ at work can often only be achieved with significant ‘accommodations’, appreciation of neurodiversity, and where a genuine sense belonging at work is encouraged. With around 80% of neurodivergent Australians experiencing unemployment, and studies indicating vulnerability to workplace bullying for up to 70%, this artwork depicts how hierarchies of value isolate and marginalise difference, resulting in barriers not …

Matrescence: An Emerging Concept For Birth Worker Practice, Kelsey B. Green

DNP Qualifying Manuscripts

The maternal mental health (MMH) crisis, affecting up to 25% of birthing individuals, is exacerbated by significant gaps in perinatal support. While birth workers are uniquely positioned to provide care, they often lack specialized training beyond basic screening checklists to address the complex transition to motherhood, defined as matrescence. This clinical innovation proposal outlines a matrescence-informed educational curriculum, guided by the Comprehensive Model of Mental Health during the Perinatal Period. The intervention is designed to build tangible, implementable skills, training birth workers to: (1) operationalize matrescence as a psychoeducational tool to normalize distress; (2) use clinical differentiation to distinguish the …