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Beyond Opioids: The Role Of Polysubstance Exposure In Neonatal Abstinence Syndrome Treatment And Hospitalization, Caelyn Harrison

Undergraduate Honors Theses

This thesis explores the impact of prenatal polysubstance exposure, specifically focusing on the need for pharmacological treatment for Neonatal Abstinence Syndrome (NAS) and the duration of their hospital stay. A retrospective analysis of 462 infants, including 121 exposed to polysubstances during pregnancy, showed significant associations between polysubstance exposure and adverse neonatal outcomes. Infants with prenatal polysubstance exposure were more likely to require pharmacological treatment for NAS (52.8%) compared to non-exposed infants (38.7%), as determined by chi-square analysis (χ²(1, N = 462) = 7.36, p = .007). Additionally, infants exposed to polysubstances experienced longer hospital stays on average (M = 14.88 …

Addiction In The Prison System: Recidivism And Alternatives, Daniel R. Bowers

Undergraduate Honors Theses

The United States criminal justice system has the highest number of incarcerated individuals in the world, with nearly 2 million people currently being behind bars, and around 7.5 million arrests per year according to the most recent available statistics. A key factor in this is addiction, specifically substance use disorders. Between 58% to 68% of adults arrested are addicted to one or more substances, with 68% of drug involved individuals being rearrested within three years of being released. This recidivism rate is incredibly high, and when combined with current prison and jail overcrowding, has created massive problems for the United …

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 …

Dose Prediction Via Deep Learning To Enhance Treatment Planning Of Lung Radiotherapy Including Simultaneous Integrated Boost Techniques, Wenhua Cao, Mary Gronberg, Stephen Bilton, Hana Baroudi, Skylar Gay, Christopher Peeler, Zhongxing Liao, Thomas J Whitaker, Karen Hoffman, Laurence E Court

Faculty, Staff and Student Publications

Background: Recent studies have shown deep learning techniques are able to predict three-dimensional (3D) dose distributions of radiotherapy treatment plans. However, their use in dose prediction for treatments with varied prescription doses including simultaneous integrated boost (SIB), that is, using multiple prescription doses within the same plan, and benefit in improving plan quality should be validated.

Purpose: To investigate the feasibility and potential benefit of using deep learning to predict dose distribution of volumetric modulated arc therapy (VMAT) including SIB techniques and improve treatment planning for patients with lung cancer.

Methods: The dose prediction model was trained with 93 retrospective …

Implementing A Sustainable Antimicrobial Resistance Surveillance Across Riverside County, Felipe Aperador

Electronic Theses, Projects, and Dissertations

This project focuses on improving health surveillance in remote communities, addressing antimicrobial resistance (AMR) enhancing connectivity and data collection. Geographic barriers, high shipping costs, and logistical challenges have historically hindered healthcare delivery in underserved areas. By integrating healthcare facilities into a cohesive surveillance systems, would improve specimen collection and data analysis. A systematic review of literature identified key strategies, including governmental support, strengthening laboratory capacity, addressing logistical barriers, and enhancing connectivity. Notable results include insights to integrate new facilities when creating a surveillance network, supported by training and state-funded resources. Actionable steps, such as implementing National Action Plans, establishing National …

Social Media Use In Health Education: National Children's Dental Health Month Social Media Toolkit, Jazmin Pelayo

Electronic Theses, Projects, and Dissertations

National Children's Dental Health Month (NCDHM) was created by the American Dental Association and is celebrated annually by local oral health programs all around the country. The celebration began as a one-day event on February 8, 1949, expanded to a week-long observance in 1955, and was later extended to a month-long celebration in 1981. Today local oral health programs celebrate NCDHM in a variety of ways but the one I will be focusing on is a social media tool kit. A social media tool kit consists of videos or posts that are posted on different platforms such as the www.smilesbc.org …

A Whole Person Care Approach To Ending The Hiv Epidemic In The Inland Empire, Roberto Daniel Gonzalez Coronado

Electronic Theses, Projects, and Dissertations

In the last 40 years, the United States has seen remarkable progress in the field of HIV treatment; however, the virus continues to burden the most vulnerable members of society, such as Men Who Have Sex with Men (MSM) and Intravenous Drug Users (IVDU). Unfortunately, these vulnerable members of society continue to lack stable social conditions to get into proper HIV treatment. These social conditions are referred to as social determinants of health, which are non-medical factors that influence whole-person care. With these members of society continuing to face greater social disparities, their linkage to care and retention to care …

Impact Of Water Quality On The Nutritional And Phytochemical Properties Of Culinary Herbs, Genesis Arroyo

Electronic Theses, Projects, and Dissertations

Water quality significantly affected food safety, especially since contaminated water impacted crop growth and the nutrient composition of foods. Nitrates occur naturally in vegetables. However, when introduced into the food supply through water contamination, excessive levels disrupted the natural physiological processes of vegetables and other agricultural plants. These excessive levels eventually led to nutrient imbalances, decreased phytochemical concentrations, and potential health risks such as the formation of carcinogenic N-nitroso compounds in humans. This study evaluated the effects of nitrates on the nutritional outcomes of food crops, focusing on commonly used culinary herbs. While synthesizing findings from relevant peer-reviewed articles, I …

Toward The Application Of Natural Language Processing In Electronic Health Record Analysis For Taxonomy Development, Latoya Mcdonald

All Dissertations

Electronic health records (EHRs) are pivotal resources for nurse practice because they increase the timeliness and reliability of patient information at the point of care and support access by multiple healthcare providers and the individual patients themselves. However, it is widely recognized that data extraction from EHRs is challenging due to the variability in the language used in clinical care notes and the lack of standardized terminology across healthcare systems. The broad objective of this dissertation is to develop taxonomy-based classification models for nursing care by applying feature engineering approaches to EHRs that include nursing care of ostomy patients following …

Demographic Groups’ Use Of Agency Intimate Partner Violence (Ipv) Services: A Quality Improvement Project To Identify And Engage Local Underserved Populations, Mia Parker

Capstone Experience: Master of Public Health

This quality improvement project intended to identify populations of adult intimate partner violence (IPV) survivors in Spokane County, Washington, by race/ethnicity and sex who are underserved by a local victim service agency and provide action-oriented, evidence-informed recommendations that the agency may utilize to increase engagement with these local underserved populations. Methods used include secondary data analysis, timeline creation, literature review, and interpretation of quantitative and qualitative data analysis. This was a capstone project designed to demonstrate multiple public health competencies.

Ocular Surface Squamous Neoplasia (Ossn) Risk Factors In Lusaka, Zambia: The Role Of Hiv And Socioeconomic Status, Stepfanie N. Siyumbwa, Peter Julius, Tabitha Nkhata, Obvious N. Chilyabanyama, Abraham Mengist, Gleb Haynatzki, Charles Wood

Capstone Experience: Master of Public Health

Objective

To identify and evaluate potential risk factors for OSSN at the University Teaching Hospital (UTH) in Lusaka, Zambia.

Methods

Data from 475 patients were analyzed retrospectively, and it included 390 with OSSN and 85 with benign biopsies. Variables with significance values

Results

Several key predictors of OSSN were identified after controlling for confounders in the household cooks sub-population, these were, a lower household income (adjusted odds ratio [aOR] = 0.64, 95% CI: 0.46–0.90, p = .009), a Lab confirmed HIV-positive status (aOR = 3.56, 95% CI: 1.72–7.21, p = .001) and exposure to biomass smoke (aOR = 2.47, 95% …

Is Diabetes A Predictor Of A Diagnosis Of Hypertension In The Population Of 32- To 70-Year-Olds In A Cohort Study? A Multivariate Logistic Regression Analysis Of A Subset Of Data Obtained From The Framingham Study, Walter Marquez-Lavenant

Capstone Experience: Master of Public Health

Objective: Assess the independent role of diabetes on hypertension using logistic regression, while adjusting for covariates such as age, sex, BMI

Methods: A subset of data from the Framingham Cohort study, with 5,209 participants and collected across three periods from 1956 to 1968, was analyzed. The dataset includes laboratory, clinic, questionnaire, and event data from 4,434 individuals and was analyzed using SAS software for logistic regression.

Results:In the adjusted model, diabetes was not associated with hypertension (aOR:1.1, 95% CI:0.67-1.81, p=0.7). Females had 26% higher odds of hypertension than males (aOR=1.26, 95%CI:1.09-1.25, p=0.00). Participants aged 51 or older (aOR=2.86, 95%CI:2.37-2.47, …

The Role Of Responsive Feeding In Childhood Development And Clinical Implications: A Comprehensive Literature Review, Alexander Burbach

Capstone Experience: Master of Public Health

Responsive feeding refers to caregiver-infant feeding interactions that encourage healthy eating behaviors and support the child’s autonomy by responding to their hunger and satiety cues. Responsive feeding supports healthy early childhood development, influencing self-regulation in eating behaviors and long-term health outcomes, particularly in obesity prevention. A comprehensive literature review was conducted to examine the impact of responsive feeding practices on childhood development in the United States and its clinical implications. The objectives were to explore the role of parental feeding practices in shaping childhood eating behaviors, understand the relationship between responsive feeding and obesity, and determine literature daps. Articles for …

Evaluating Surge Capacity In The Emergency Department: A Comprehensive Literature Review On Preparedness And Response Frameworks, Tanner J. Riscoe

Capstone Experience: Master of Public Health

Medical surge capacity in emergency departments is influenced by four critical factors: staff, stuff, space, and systems. Understanding these factors and the interplay between them is critical. Emergency departments are increasingly encountering issues with overcrowding, patient boarding, and medical surge events causing interruptions in care and depleting critical resources. Coordination of medical surge is challenging during normal operations but is intensified during times of crisis. This comprehensive literature review seeks to better understand the current state of the literature surrounding surge preparedness and response in emergency departments across the United States, identify gaps in the current literature, and ultimately recommend …

A Stakeholder Analysis For Engagement: A Pestle Framework For The Nebraska Coalition For Patient Safety, Kaleb Horton

Capstone Experience: Master of Public Health

The Nebraska Coalition for Patient Safety (NCPS) is a not-for-profit organization designed to collaborate with Nebraska’s hospitals and healthcare organizations to benefit patient safety. NCPS, as do all organizations, have varying types of stakeholders who are engaged at some level in the function of NCPS or the services of NCPS. Research across industries demonstrates the importance of stakeholder assessment and evaluation and it has been shown that collaborative efforts with stakeholders can improve outcomes (Newig et al., 2023). Acquiring input from those who are directly affected by the organization’s strategic planning can help determine and shape future direction. This capstone …

Feasibility Study Of Service Expansion To Non-American Indians At The Santee Health & Wellness Center, Phil D. Jaquith

Capstone Experience: Master of Public Health

Challenges with obtaining access to healthcare in rural communities continue to be a clear issue. There are both structural and economic issues that limit patient access to care. With geographic issues also affecting access, many patients in Nebraska must travel further and wait longer throughout most rural communities to receive needed care. Care services seem to be retracting vs expanding, and patients continue to seek options that are closer to home and more comprehensive in scope. It is vital for communities and health services organizations to assess all care options and services they can expand or currently have to attract …

Healthcare Emergency Management Salary Survey Analysis, Grace E. Thiel

Capstone Experience: Master of Public Health

The field of emergency preparedness is an often unknown and unrecognized aspect of healthcare, forming an integral component of patient and worker safety. While an important field, there is limited data focused on the field pertaining to salaries of workers, resources utilized and produced, and the typical working environment. The purpose of this project is to assess salary and other demographic markers of healthcare emergency preparedness professionals in the United States. The project will compare salary, full-time equivalent levels, preparedness program budgets, and other markers across the country. The data from this study will also be compared to previous survey …

A Comprehensive Literature Review Of Barriers And Facilitators To Alcohol Use Disorder Screening And Treatment, Lizette M. Orihuela

Capstone Experience: Master of Public Health

Background: Alcohol Use Disorder (AUD) remains a significant public health issue with extensive personal, societal, and economic impacts. Recent studies indicate that no amount of alcohol consumption is entirely safe, linking it directly to increased chronic disease risks, including cancer. Despite well-documented negative health outcomes, clear guidance on what constitutes AUD through diagnostic criteria provided by the DSM-5, AUD continues to be underdiagnosed and undertreated.

Objectives: This comprehensive literature review explores the key barriers and facilitators influencing AUD screening and treatment engagement.

Methods: A comprehensive literature review was conducted, gathering from various databases including, PubMed, PsycINFO, Scopus, Google Scholar, and …

Optimizing Case Management Manuals: A Ryan White Quality Improvement Project For Northwest Missouri, Megan Mcbane

Capstone Experience: Master of Public Health

The Ryan White HIV/AIDS Act, established in 1990, has played a critical role in providing essential services for individuals living with HIV, including medication access, adherence support, health coverage, housing, and transportation. In rural Missouri, particularly in the northwest region, HIV case management under the Ryan White program is guided by four separate manuals, creating inefficiencies and burdens for case managers. This paper presents a process evaluation plan utilizing the Plan-Do-Study-Act (PDSA) framework to address these challenges and improve service delivery. The aim of this quality improvement project is to enhance the efficiency and effectiveness of HIV case management in …

Cardiac Patient Care Coordination: A Comprehensive Literature Review On Outcomes, Payton Allen

Capstone Experience: Master of Public Health

Care coordination is a vital aspect of the U.S. primary care landscape. Care Coordination is the deliberate process of managing a patient across different provider settings and services and is a vital part of chronic patient care. Most primary care providers (PCPs) today have moved to adopt some form of patient-centered care that serves as the central hub for coordinating and managing a patient's complete healthcare journey. PCPs' access to specialist records and their familiarity with their patients' long-term disease courses uniquely position them as the prime coordinators of patient care. Care coordination is becoming increasingly important in cardiac care …

Utilizing The Health Belief Model To Design A Community-Based Program To Increase Cervical Cancer Screening Rates Among 21 To 25-Year-Olds In The Omaha Metro Area, Karli Baker

Capstone Experience: Master of Public Health

The 2021 Douglas County Community Health Needs Assessment found that cervical cancer screening rates have been on a downward trend since 2011. Previous studies on cervical cancer screening interventions have examined refugee populations, and current programs in Douglas County offer assistance to uninsured women, typically aged 40 and older. However, interventions have overlooked young women aged 21 to 25 in the Omaha metro area, who exhibit the lowest cervical cancer screening rates. We will use the PRECEDE-PROCEED Model as a framework to design an educational program for young women aged 21 to 25, guided by the theoretical underpinnings of the …

A Comprehensive Literature Review Of Barriers To Hormone Therapy Utilization: Strategies For Improving Menopause Management In Women Aged 40-60, Suhan Lee

Capstone Experience: Master of Public Health

Menopause is a natural transition marked by the cessation of ovarian activity, often accompanied by vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM), and psychological changes that significantly impact women’s quality of life. Hormone therapy (HT) has been the primary treatment for managing menopausal symptoms, particularly VMS, providing substantial relief when initiated within 10 years of menopause. Despite its effectiveness, HT usage has declined dramatically over the past two decades primarily due to barriers such as stigma, safety, misinformation, provider hesitancy, financial barriers, and cultural beliefs. This comprehensive literature review explores key factors influencing HT decision-making, including the media’s role …

Breaking Barriers To Smoking Cessation: Applying The Baby & Me - Tobacco Free Program To Improve Maternal And Child Health In Omaha, Nebraska, Madison Ravens

Capstone Experience: Master of Public Health

Smoking during pregnancy remains a pressing public health concern, contributing to adverse outcomes such as preterm birth, low birth weight, and developmental complications. In Nebraska, about 10% of pregnant women continue to smoke throughout pregnancy—above the national average, highlighting a critical gap in maternal health interventions. The Baby & Me – Tobacco Free (BMTF) program provides an evidence-based solution through structured counseling, carbon monoxide (CO) monitoring, and incentive-based rewards to support smoking cessation among pregnant women. This capstone project utilized the Getting to Outcomes framework to develop a detailed implementation plan to support Tobacco Free Nebraska (TFN) in launching the …

A Comparative Analysis Of Preventable Deaths And Healthcare Accessibility: The U.S. Healthcare System Vs. Canada, The United Kingdom, And Australia, Aleya K. Byrd

Capstone Experience: Master of Public Health

The United States continues to struggle to improve healthcare performance and patient outcomes in comparison with other developed nations. This study examines access to primary care services and preventable deaths by comparing the performance of the United States, Australia, Canada, and the United Kingdom. (Blumenthal et al., 2024). A comprehensive scoping literature review method was applied to examine the health systems of three countries' public health structures to better understand the factors that may influence the US health system performance in accessing primary care services and decreasing preventable deaths. Understanding the structures that lead to the outcomes can help provide …

Barriers To Medication-Assisted Treatment For Opioid Use Disorder In Prisons And Jails In The United States: A Comprehensive Literature Review, Amy C. Smith

Capstone Experience: Master of Public Health

Background: The American Society for Addiction Medicine guidelines state that all FDA-approved medication for opioid use disorder should be available for all patients (CDC, 2024). Medication-assisted treatments for opioid use disorders, also known as medication for opioid use disorder (MOUD), are treatments that help diminish the physical symptoms of addiction to opioids. Currently, there are three FDA-approved medications to treat opioid use disorder: buprenorphine, methadone, and naltrexone (FDA, 2024). Despite being at an increased risk for opioid misuse and overdose, incarcerated individuals in the U.S. often do not have access to MOUD. This comprehensive literature review aimed to determine the …

Surge Scramble: An Evaluation Of Combining The Medical Response And Surge Exercise With The Centers For Disease Control And Prevention’S Pan Flu Scramble, Rebecca L. Thompson

Capstone Experience: Master of Public Health

This report analyzes how Hospital Preparedness Program funding recipients in Nebraska adapted the Center for Disease Control’s Pan Flu Scramble format to meet Medical Response and Surge Exercise (MRSE) requirements in the 2023-2024 fiscal year. By combining the MRSE and Pan Flu Scramble, the recipients created an in-person functional exercise format for the six Nebraska health care coalitions to test their respective chemical plans and the Health Care Crisis Protocol for the State of Nebraska. The report explains the design and conduct of the exercises and provides a comprehensive evaluation of the exercise design and conduct. This report will outline …

State Case Count As An Indicator Of Successful Multistate Outbreak Investigation, Lorisa M. Pennell

Capstone Experience: Master of Public Health

Background/Objectives: Shiga-Toxin producing Escherichia coli (STEC) is a contaminant found in multiple food types and causes multistate outbreaks due to the industrialization of food production. In this report I examine the differences in outbreaks categorized by the regulating agency responsible in outbreak prevention and compare outbreak case counts when organized by positive outbreak investigation and response outcomes.

Methods: STEC Multistate outbreak data was obtained from the Center for Disease Control’s National Outbreak Reporting System (NORS) for outbreaks occurring from 2006-2023. Outbreaks were organized into those regulated by either the US Food and Drug Administration (FDA) or the US Department of …

Investing In Embedded Practitioners: Lessons From The Region Vii Public Health Expansion Program, Julia Quigley

Capstone Experience: Master of Public Health

Public health systems in the United States face mounting challenges, including workforce shortages, skill gaps, and increasing demands on practitioners. These issues are particularly acute in rural and Tribal communities, where systemic barriers and health disparities persist. The Region VII Public Health Expansion Program (PHES) addresses these challenges by investing in practitioners already embedded in their communities. Through fully funded public health degree programs, the PHES aims to enhance workforce retention, strengthen skills, and support the delivery of essential public health services in Missouri, Iowa, Nebraska, and Kansas. This study evaluates the program's innovative approach, which departs from traditional recruitment …

Recycling Infrastructure And Its Benefits: A Literature Review Of Economic And Community Impact, Grace Kollars

Capstone Experience: Master of Public Health

Lincoln currently relies on a recycling system with private haulers and limited recyclables collection sites. To increase recycling rates and waste diversion, this review focused on the economic benefits of implementing city-wide recycling, the costs of implementing that recycling program, and the economic effects of making no change to the recycling program. Subjects of job creation, landfill costs, and virgin materials are discussed, along with the analysis of the economic, environmental, and social costs of each recycling program scenario. By the end of this project, I have identified the best recycling program option for the City of Lincoln to implement …

Assessing The Impact Of Atrazine And Paraquat On Parkinson’S Disease Prevalence In Rural Nebraska Counties, Alex Egbuchiem

Capstone Experience: Master of Public Health

This study examines the association between exposure to the herbicides atrazine and paraquat and the prevalence of Parkinson’s Disease (PD) in various counties of Nebraska. PD is a neurodegenerative disorder that impacts rural agricultural regions in Nebraska, where pesticide application is prevalent. Through a thorough analysis of data sourced from the Nebraska PD Registry, environmental monitoring databases, and pesticide usage, this research aims to establish a correlation between the concentrations of atrazine and paraquat in both groundwater and surface water and the incidence of PD within this region. The study will employ statistical techniques to evaluate this association while accounting …