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Emerging Technologies To Measure Neighborhood Conditions In Public Health: Implications For Interventions And Next Steps, M. Schootman, E. J. Nelson, K. Werner, E. Shacham, M. Elliott, Kendra Ratnapradipa, M. Lian, A. Mcvay

Journal Articles: Epidemiology

Adverse neighborhood conditions play an important role beyond individual characteristics. There is increasing interest in identifying specific characteristics of the social and built environments adversely affecting health outcomes. Most research has assessed aspects of such exposures via self-reported instruments or census data. Potential threats in the local environment may be subject to short-term changes that can only be measured with more nimble technology. The advent of new technologies may offer new opportunities to obtain geospatial data about neighborhoods that may circumvent the limitations of traditional data sources. This overview describes the utility, validity and reliability of selected emerging technologies to …

Maporal Hantavirus Causes Mild Pathology In Deer Mice (Peromyscus Maniculatus), Amanda Mcguire, Kaitlyn Miedema, Joseph R. Fauver, Amber Rico, Tawfik Aboellail, Sandra L. Quackenbush, Ann Hawkinson, Tony Schountz

Journal Articles: Epidemiology

Rodent-borne hantaviruses can cause two human diseases with many pathological similarities: hantavirus cardiopulmonary syndrome (HCPS) in the western hemisphere and hemorrhagic fever with renal syndrome in the eastern hemisphere. Each virus is hosted by specific reservoir species without conspicuous disease. HCPS-causing hantaviruses require animal biosafety level-4 (ABSL-4) containment, which substantially limits experimental research of interactions between the viruses and their reservoir hosts. Maporal virus (MAPV) is a South American hantavirus not known to cause disease in humans, thus it can be manipulated under ABSL-3 conditions. The aim of this study was to develop an ABSL-3 hantavirus infection model using the …

Effect Of Anthelminthic Treatment On Helminth Infection And Related Anaemia Among School-Age Children In Northwestern Ethiopia, Yonas Yimam, Abraham Degarege, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: Information about improvements in the health status of population at-risk of helminth infection after anthelminthic treatment helps to evaluate the effectiveness of the large scale deworming program. The objectives of this study were to assess the impact of anthelminthic treatment on the prevalence and intensity of intestinal helminth infection, haemoglobin level and prevalence of anaemia among school-age children.

METHODS: A total of 403 children attending Tikur Wuha Elementary School in Jiga, northwestern Ethiopia were enrolled in this study between February and March 2011. Formol-ether concentration and Kato-Katz methods were used to examine stool for intestinal helminth infections at baseline …

Epidemiology Of Plasmodium And Helminth Coinfection And Possible Reasons For Heterogeneity, Abraham Degarege, Berhanu Erko

Journal Articles: Epidemiology

Understanding the impact of helminth infections on clinical malaria is useful for designing effective malaria control strategies. Plenty of epidemiological studies have been conducted to unravel the nature of interactions between Plasmodium and helminth infection. Careful broad summarization of the existing literature suggests that Schistosoma mansoni and hookworm infections may increase the risk of clinical malaria and associated morbidities, but Trichuris trichiura infection is not associated with the occurrence of clinical malaria and related outcomes. However, findings about effect of Ascaris lumbricoides and Schistosoma haematobium infection on clinical malaria are contradictory. Furthermore, the nature of relationship of helminth infection with …

Are You Pepped And Prepped For Travel? Risk Mitigation Of Hiv Infection For Travelers, David Brett-Major, P. T. Scott, T A. Crowell, C. S. Polyak, K. Modjarrad, M. L. Robb, D. L. Blazes

Journal Articles: Epidemiology

The HIV pandemic persists globally and travelers are at risk for infection by the Human Immunodeficiency Virus (HIV). While HIV-focused guidelines delineate risk stratification and mitigation strategies for people in their home communities, travel issues are not addressed. In this review, direct and indirect evidence on HIV risk among travelers is explored. The burgeoning practice of employing pre-exposure prophylaxis (PrEP) with anti-retroviral therapy in the non-travel setting is introduced, as well as the more established use of post-exposure prophylaxis (PEP). Challenges in applying these lessons to travelers are discussed, and a new guidelines process is scoped and recommended.

Early Identification And Prevention Of The Spread Of Ebola - United States, Chris A. Van Beneden, Harald Pietz, Robert D. Kirkcaldy, Lisa M. Koonin, Timothy M. Uyeki, Alexandra M. Oster, Deborah A. Levy, Maleeka Glover, Matthew J. Arduino, Toby L. Merlin, David T. Kuhar, Christine Kosmos, Beth P. Bell

Journal Articles: Epidemiology

In response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC prepared for the potential introduction of Ebola into the United States. The immediate goals were to rapidly identify and isolate any cases of Ebola, prevent transmission, and promote timely treatment of affected patients. CDC's technical expertise and the collaboration of multiple partners in state, local, and municipal public health departments; health care facilities; emergency medical services; and U.S. government agencies were essential to the domestic preparedness and response to the Ebola epidemic and relied on longstanding partnerships. CDC established a comprehensive response that included two new …

It Came Across The Plains: The 1918 Influenza Pandemic In Rural Nebraska, Kristin Watkins

Theses & Dissertations

The purpose of this historical case study was to understand and describe rural community experiences during the 1918 influenza pandemic in Nebraska.

Examining the rural experience in Nebraska during the 1918 influenza pandemic provided a new level of insight into the differences and similarities between the urban and rural experience. As related by a detailed study of Omaha during the 1918 pandemic, the community was devastated by disease. Despite public ordinances and health department warnings, streetcars ran at capacity, parades were held to raise money for war bonds, and the annual Aksarben Coronation took place. Cases of flu were too …

Compensatory Mechanisms And T Cell Migration In Mouse Models Of Dopaminergic Loss, Kristi M. Anderson

Theses & Dissertations

Parkinson’s disease (PD) is the most common neurodegenerative movement disorder and second most common neurodegenerative disorder. PD is characterized by the selective loss of dopaminergic neurons and dopamine neurotransmitter within the substantia nigra and termini in the striatum. Progressive loss of dopaminergic neurons occurs over many years in PD, and by the time movement disorder symptoms manifest, up to 50-70% of dopaminergic neurons have been lost. Several aspects of PD pathology have been described in detail, but a better understanding of PD progression is needed to develop more efficient treatments.

Motor symptoms associated with PD do not manifest until significant …

Antiviral Peptide Nanocomplexes As Potential Therapeutics For The Treatment Of Infectious Diseases, Jinjin Zhang

Theses & Dissertations

Hepatitis C Virus (HCV) is recognized as a major burden in global public health, which can be further exacerbated by several cofactors such as human immunodeficiency virus (HIV). Currently, there is no vaccine for HCV. The emergence of potent and highly specific direct-acting antivirals (DAA) has marked a new era in HCV therapy, however, the remaining issues like affordability, genotype dependency, and potential resistance still necessitate the development of additional therapeutic approaches to be used instead or in combination with DAA.

Recently, the antiviral peptide C5A (in our studies designated as p1) and its cationic derivative p41 have been identified …

The Effect Of Standard Dose Multivitamin Supplementation On Disease Progression In Hiv-Infected Adults Initiating Haart: A Randomized Double Blind Placebo-Controlled Trial In Uganda., David Guwatudde, Molin Wang, Amara E. Ezeamama, Danstan Bagenda, Rachel Kyeyune, Henry Wamani, Yukari C. Manabe, Wafaie W. Fawzi

Journal Articles: Epidemiology

BACKGROUND: Efficacy trials investigating the effect of multivitamin (MV) supplementations among patients on Highly Active Antiretroviral Therapy (HAART) have so far been inconclusive. We conducted a randomized, double blind, placebo controlled trial to determine the effect of one recommended daily allowance (RDA) of MV supplementation on disease progression in patients initiating HAART.

METHODS: Eligible subjects were randomized to receive placebo or MV supplementation including vitamins B-complex, C and E. Participants were followed for up to 18 months. Primary endpoints were: change in CD4 cell count, weight and quality of life (QoL). Secondary endpoints were: i) development of a new or …

Effect Of Chemical Pocket Disinfection As An Adjunct To Non-Surgical Maintenance Therapy Of Inflamed Periodontal Pockets, Chad Riggs

Theses & Dissertations

Purpose: Scaling and root planing with adjunctive chemical pocket disinfection (SRP+C) utilizing sodium hypochlorite solution has been used to treat inflamed pockets of periodontal maintenance patients for many years, without evidence of its benefits. The primary objective was to determine if SRP+C is more effective than scaling and root planing alone (SRP) in improving clinical outcomes. The secondary objective was to compare the effect of SRP+C and SRP on pro-inflammatory IL-1β, anti-inflammatory IL-1ra, and anti-inflammatory index (IL-1ra/IL-1β ratio) found in gingival crevicular fluid (GCF).

Materials and Methods: Pockets (≥ 5 mm and BOP) of 31 maintenance patients were included. Test …

Improving Antibiotic Resistant Infection Transmission Situational Awareness In Enclosed Facilities With A Novel Graphical User Interface For Tactical Biosurveillance, Valeriya V. Kettelhut

Theses & Dissertations

Serious challenges associated with antibiotic resistant infections (ABRIs) force healthcare practitioners (HCP) to seek innovative approaches that will slow the emergence of new ABRIs and prevent their spread. It was realized that traditional approaches to infection prevention based on education, retrospective reports, and biosurveillance often fail to ensure reliable compliance with infection prevention guidelines and real-time problem solving. The objective of this original research was to develop and test the conceptual design of a situational awareness (SA)-oriented information system for coping with healthcare-associated infection transmission.

Constantly changing patterns in spatial distribution of patients, prevalence of infectious cases, clustering of contacts, …

Electronic Health Record Optimization For Cardiac Care, Lisa A. Grabenbauer

Theses & Dissertations

Electronic health record (EHR) systems have been studied for over 30 years, and despite the benefits of information technology in other knowledge domains, progress has been slow in healthcare. A growing body of evidence suggests that dissatisfaction with EHR systems was not simply due to resistance to adoption of new technology but also due to real concerns about the adverse impact of EHRs on the delivery of patient care. Solutions for EHR improvement require an approach that combines an understanding of technology adoption with the complexity of the social and technical elements of the US healthcare system. Several studies are …

Myeloid-Derived Suppressor Cells Contribute To The Subversion Of Innate Immunity During Staphylococcus Aureus Biofilm Infection, Cortney E. Heim

Theses & Dissertations

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of immature monocytes and granulocytes that are potent inhibitors of T cell activation. A role for MDSCs in bacterial infections has only recently emerged, and our laboratory was the first to demonstrate a functional role for MDSCs during Staphylococcus aureus (S. aureus) biofilm infection. Biofilm infections often lead to significant morbidity due to their recalcitrance to antibiotics and ability to subvert immune-mediated clearance by skewing the immune response toward an anti-inflammatory, pro-fibrotic phenotype. Therefore, we examined whether MDSCs could play a role in this process. CD11b⁺Gr-1⁺ MDSCs …

Role Of Macrophages In Muscle Transfection With Pdna/Pluronic Formulation, Vivek Mahajan

Theses & Dissertations

Non-ionic amphiphilic block copolymers of poly(ethylene oxide) (PEO) and poly(propylene oxide) (PPO), Pluronics, arranged in a tri-block structure PEO-PPO-PEO, have raised a considerable interest in skeletal muscle Gene Therapy. Previous studies have demonstrated that co-administration of Pluronics with naked plasmid DNA (pDNA) by direct i.m. injection enhanced transgene expression not only in muscle but also in distal lymphoid organs (spleen and lymph nodes) and this response was strain-dependent; not observed in athymic (BALB/c nu/nu) mouse; suggesting a role of immune cells in gene transfer to skeletal muscles. Therefore, we first evaluated the role of inflammation and inflammatory cells, on muscle …

Antiviral Activity Of The Human Cathelicidin, Ll-37, And Derived Peptides On Seasonal And Pandemic Influenza A Viruses., Shweta Tripathi, Guangshun Wang, Mitchell White, Li Qi, Jeffery Taubenberger, Kevan L. Hartshorn

Journal Articles: Pathology and Microbiology

Human LL-37, a cationic antimicrobial peptide, was recently shown to have antiviral activity against influenza A virus (IAV) strains in vitro and in vivo. In this study we compared the anti-influenza activity of LL-37 with that of several fragments derived from LL-37. We first tested the peptides against a seasonal H3N2 strain and the mouse adapted H1N1 strain, PR-8. The N-terminal fragment, LL-23, had slight neutralizing activity against these strains. In LL-23V9 serine 9 is substituted by valine creating a continuous hydrophobic surface. LL-23V9 has been shown to have increased anti-bacterial activity compared to LL-23 and we now show slightly …

Clinical Challenges In Isolation Care, Elizabeth L. Beam, Shawn G. Gibbs, Angela L. Hewlett, Peter C. Iwen, Suzanne L. Nuss, Philip W. Smith

Journal Articles: College of Nursing

OVERVIEW: In 2014, the authors published the results of a study investigating nurses' use of personal protective equipment (PPE) in the care of a live simulated patient requiring contact and airborne precautions. The 24 participants were video-recorded as they donned and doffed PPE. Variations in practices that had the potential to cause contamination were noted. In this article, the authors comment on those variations, analyzing each element of proper PPE protocols and examining why the behaviors are a safety concern for the nurse and a potential risk for disease transmission in the hospital or other clinical area. The authors note …

Prolonged-Acting, Multi-Targeting Gallium Nanoparticles Potently Inhibit Growth Of Both Hiv And Mycobacteria In Co-Infected Human Macrophages., Prabagaran Narayanasamy, Barbara L. Switzer, Bradley E. Britigan

Journal Articles: Pathology and Microbiology

Human immunodeficiency virus (HIV) infection and Mycobacterium tuberculosis (TB) are responsible for two of the major global human infectious diseases that result in significant morbidity, mortality and socioeconomic impact. Furthermore, severity and disease prevention of both infections is enhanced by co-infection. Parallel limitations also exist in access to effective drug therapy and the emergence of resistance. Furthermore, drug-drug interactions have proven problematic during treatment of co-incident HIV and TB infections. Thus, improvements in drug access and simplified treatment regimens are needed immediately. One of the key host cells infected by both HIV and TB is the mononuclear phagocyte (MP; monocyte, …

Predictors And Outcomes Of Mycobacterium Tuberculosis Bacteremia Among Patients With Hiv And Tuberculosis Co-Infection Enrolled In The Actg A5221 Stride Study., John A. Crump, Xingye Wu, Michelle A. Kendall, Prudence D. Ive, Johnstone J. Kumwenda, Beatriz Grinsztejn, Ute Jentsch, Susan Swindells

Journal Articles: Infectious Diseases

BACKGROUND: We evaluated predictors and outcomes of Mycobacterium tuberculosis bacteremia among participants undergoing baseline mycobacterial blood culture in the ACTG A5221 STRIDE study, a randomized clinical trial comparing earlier with later ART among HIV-infected patients suspected of having tuberculosis with CD4-positive T-lymphocyte counts (CD4 counts)/mm(3). We conducted a secondary analysis comparing participants with respect to presence or absence of M. tuberculosis bacteremia.

METHODS: Participants with a baseline mycobacterial blood culture were compared with respect to the presence or absence of M. tuberculosis bacteremia. Baseline predictors of M. tuberculosis bacteremia were identified and participant outcomes were compared by mycobacteremia status.

RESULTS: …

Smallpox Vaccination Of Laboratory Workers At Us Variola Testing Sites, Sharon J. Medcalf, Laura Bilek, Teresa L. Hartman, Peter C. Iwen, Patricia Leuschen, Hannah Miller, Anne O'Keefe, Harlan Sayles, Philip W. Smith

Journal Articles: Epidemiology

To evaluate the need to revaccinate laboratory workers against smallpox, we assessed regular revaccination at the US Laboratory Response Network's variola testing sites by examining barriers to revaccination and the potential for persistence of immunity. Our data do not provide evidence to suggest prolonging the recommended interval for revaccination.

Experimental Evolution Of An Rna Virus In Wild Birds: Evidence For Host-Dependent Impacts On Population Structure And Competitive Fitness, Nathan D. Grubaugh, Darci R. Smith, Doug E. Brackney, Angela M. Bosco-Lauth, Joseph R. Fauver, Corey L. Campbell, Todd A. Felix, Hannah Romo, Nisha K. Duggal, Elizabeth A. Dietrich, Tyler Eike, Jennifer E. Beane, Richard A. Bowen, William C. Black, Aaron C. Brault, Gregory D. Ebel

Journal Articles: Epidemiology

Within hosts, RNA viruses form populations that are genetically and phenotypically complex. Heterogeneity in RNA virus genomes arises due to error-prone replication and is reduced by stochastic and selective mechanisms that are incompletely understood. Defining how natural selection shapes RNA virus populations is critical because it can inform treatment paradigms and enhance control efforts. We allowed West Nile virus (WNV) to replicate in wild-caught American crows, house sparrows and American robins to assess how natural selection shapes RNA virus populations in ecologically relevant hosts that differ in susceptibility to virus-induced mortality. After five sequential passages in each bird species, we …

Being Ready To Treat Ebola Virus Disease Patients, David Brett-Major, Shevin T. Jacob, Frederique A. Jacquerioz, George F. Risi, William A. Fischer, Yasuyuki Kato, Catherine F. Houlihan, Ian Crozier, Henry Kyobe Bosa, James V. Lawler, Takuya Adachi, Sara K. Hurley, Louise E. Berry, John C. Carlson, Thomas C. Button, Susan L. Mclellan, Barbara J. Shea, Gary G. Kuniyoshi, Mauricio Ferri, Srinivas G. Murthy, Nicola Petrosillo, Francois Lamontagne, David T. Porembka, John S. Schieffelin, Lewis Rubinson, Tim O'Dempsey, Suzanne M. Donovan, Daniel G. Bausch, Robert A. Fowler, Thomas E. Fletcher

Journal Articles: Epidemiology

As the outbreak of Ebola virus disease (EVD) in West Africa continues, clinical preparedness is needed in countries at risk for EVD (e.g., United States) and more fully equipped and supported clinical teams in those countries with epidemic spread of EVD in Africa. Clinical staff must approach the patient with a very deliberate focus on providing effective care while assuring personal safety. To do this, both individual health care providers and health systems must improve EVD care. Although formal guidance toward these goals exists from the World Health Organization, Medecin Sans Frontières, the Centers for Disease Control and Prevention, and …

Soil-Transmitted Helminth Infections And Associated Risk Factors Among Schoolchildren In Durbete Town, Northwestern Ethiopia, Tilahun Alelign, Abraham Degarege, Berhanu Erko

Journal Articles: Epidemiology

Identifying determinants of soil transmitted helminth infection is vital to design control strategy for the disease. This study assessed the prevalence of STH infections and associated factors among schoolchildren in Durbete town, northwestern Ethiopia. Data about the sociodemographic and socioeconomic status of the children were collected using a questionnaire and stool samples were diagnosed using thick Kato-Katz smear. STH infection was more common among school-age children in Durbete town. Hookworm was the most frequent helminth species detected. The prevalence of STH infection was more in children who did not practice wearing shoes and washing hands before eating and in those …

Thinking About Ebola, David Brett-Major

Journal Articles: Epidemiology

No abstract provided.

Method For Investigating Nursing Behaviors Related To Isolation Care., Elizabeth L. Beam, Shawn G. Gibbs, Angela L. Hewlett, Peter C. Iwen, Suzanne L. Nuss, Philip W. Smith

Journal Articles: College of Nursing

BACKGROUND: Although an emphasis has been placed on protecting patients by improving health care worker compliance with infection control techniques, challenges associated with patient isolation do exist. To address these issues, a more consistent mechanism to evaluate specific clinical behaviors safely is needed.

METHODS: The research method described in this study used a high fidelity simulation using a live standardized patient recorded by small cameras. Immediately after the simulation experience, nurses were asked to view and comment on their performance. A demographic survey and a video recorded physical evaluation provided participant description. A questionnaire component 1 month after the simulation …

Day-To-Day Fluctuation Of Point-Of-Care Circulating Cathodic Antigen Test Scores And Faecal Egg Counts In Children Infected With Schistosoma Mansoni In Ethiopia, Abraham Degarege, Mengistu Legesse, Girmay Medhin, Tilahun Teklehaymanot, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: Determining the variation of circulating cathodic antigen (CCA) in urine and egg counts variation in stool between days in Schistosoma mansoni (S. mansoni) infected individuals is vital to decide whether or not to rely on a single-sample test for diagnosis of Schistosomiasis. In this study, the magnitude of day-to-day variation in urine-CCA test scores and in faecal egg counts was evaluated in school children in Ethiopia.

METHODS: A total of 620 school children (age 8 to 12 years) were examined for S. mansoni infection using double Kato-Katz and single urine-CCA cassette methods (batch 32727) on three consecutive days.

RESULTS: …

Anticancer Properties Of Distinct Antimalarial Drug Classes, Rob Hooft Van Huijsduijnen, R. Kiplin Guy, Kelly Chibale, Richard K. Haynes, Ingmar Peitz, Gerhard Kelter, Margaret A. Phillips, Jonathan L. Vennerstrom, Yongyuth Yuthavong, Timothy N. C. Wells

Journal Articles: Pharmaceutical Sciences

We have tested five distinct classes of established and experimental antimalarial drugs for their anticancer potential, using a panel of 91 human cancer lines. Three classes of drugs: artemisinins, synthetic peroxides and DHFR (dihydrofolate reductase) inhibitors effected potent inhibition of proliferation with IC50s in the nM- low µM range, whereas a DHODH (dihydroorotate dehydrogenase) and a putative kinase inhibitor displayed no activity. Furthermore, significant synergies were identified with erlotinib, imatinib, cisplatin, dasatinib and vincristine. Cluster analysis of the antimalarials based on their differential inhibition of the various cancer lines clearly segregated the synthetic peroxides OZ277 and OZ439 from the artemisinin …

Staphylococcus Aureus Sara Regulates Inflammation And Colonization During Central Nervous System Biofilm Formation, Jessica N. Snowden, Matthew K. Beaver, Karen Beenken, Alexander R. Horswill, Tammy L. Kielian

Journal Articles: Pediatrics

Infection is a frequent and serious complication following the treatment of hydrocephalus with CSF shunts, with limited therapeutic options because of biofilm formation along the catheter surface. Here we evaluated the possibility that the sarA regulatory locus engenders S. aureus more resistant to immune recognition in the central nervous system (CNS) based on its reported ability to regulate biofilm formation. We utilized our established model of CNS catheter-associated infection, similar to CSF shunt infections seen in humans, to compare the kinetics of bacterial titers, cytokine production and inflammatory cell influx elicited by wild type S. aureus versus an isogenic sarA …

Investigating Infection Control Behavior In Nurses: Impact Of Computer Charting, Elizabeth L. Beam, Shawn Gibbs

Posters and Presentations: College of Nursing

In a small mixed methods study, nursing behaviors related to infection control were evaluated as nurses participated in a video recorded patient care simulation. The scenario asked the nurse to care for a patient in both airborne and contact isolation precautions with small high definition cameras mounted in a real hospital room. The patient was simulated by a live actor with an artificial intravenous line. The simulation scenario asked the nurse to assess their patient and give them some pain medication. The simulation experience was followed by a Think Aloud session while participants watched their individual simulation performance. The session …

Public Health Aspects Of The Daugherty Water For Food Institute Strategic Plan, Eleanor G. Rogan, Bruce Grogan, Terry Huang, Alan Kolok, Risto Rautiainen, Oscar Araz, Christopher Fisher, Andrew Jameton, Ashish Joshi, Sharon Meaker-Medcalf, Jim P. Stimpson, Melissa Tibbits

Reports: College of Public Health

The University of Nebraska College of Public Health is committed to contributing to the research, service and education programs of the Daugherty Water for Food Institute. The College can offer a wide variety of expertise that can contribute to programs related to water, food and health. This document has been written to highlight the areas in which College faculty have particular interests, knowledge and experience to contribute.