Medicine and Health Sciences Commons^™

Interrogating Race And Place-Based Inequities In Hiv And Covid-19, Rohan Khazanchi

EMET Projects

Over the last four years, I have developed a research focus examining the intersections of race, place, and health. My M.D. Honors Thesis reflects a snapshot of these efforts. In this collection of brief research reports, I leverage area-based measures to investigate structural inequities in three contexts: the HIV epidemic in our hyperlocal community, the early stages of the COVID-19 pandemic, and clinical trials for novel COVID-19 therapeutics. I apply novel social epidemiologic tools to measure and explore disparate outcomes. And, in reflecting upon my findings, I discuss concrete implications for clinicians, researchers, and policymakers alike.

Chapter 1: Neighborhood-Level Deprivation …

Association Of Health Literacy And Provider Education With Knowledge Of Breast And Cervical Cancer Screening In An Underserved Female Population, Mallory Gandy, Karly A. Meyer, Jennifer Liu, Jenenne Geske

EMET Projects

No abstract provided.

Parents Perspective In Early Childhood Communicative And Learning Intelligence In Nebraska School Environment, Oluwaseun Famojuro, Na-Omi Hassane Dan Karami, Krishtee Napit, Rashmi Lamsal, Onoriode Kesiena

Posters and Presentations: College of Public Health

Introduction: Center for Disease and Prevention Control had reported a rising in the prevalence of social communication and learning disabilities, including autism in the United States. The role of parents as primary agents in childhood language and behavioral development has also been established. Parents have been linked to child communicative and learning intelligence. However, there have been few research studies in Nebraska about parental perspectives in an early child's intelligence development at preschool and school levels. Objectives:1. To explore the parents' attitude towards their children's (0 – 5 years) communicative and learning intelligence in the school environment. 2. To …

Be A Hero Too, Samantha S. Rohe, Sophie Cemaj

Books: Pediatrics

This children's book explains COVID-19 and how to decrease the incidence of transmissions.

Sé Un Héroe Tú También, Samantha S. Rohe, Sophie Cemaj

Books: Pediatrics

This children's book explains COVID-19 and how to decrease the incidence of transmissions.

Cs-Cash Pilot Grant: Improving Agricultural Worker Health & Safety Awareness Through Multimodal, Case-Based Physician Assistant Education, Carey Wheelhouse, Mia Hyde, Annie Wildermuth, Wayne Mathews

Posters and Presentations: Physician Assistant

The University of Nebraska Medical Center Division of Physician Assistant Education intends to improve health outcomes of patients in Midwest agricultural communities through didactic, clinical, and case-based instruction of Physician Assistant (PA) students.

Aims

1. Increase PA student awareness of agricultural health and safety issues
2. Increase PA student medical knowledge on respiratory health, chemical exposure, and noise-induced hearing loss
3. Enhance PA student communication skills with agricultural patients
4. Increase patient health care access in agricultural environments

UNMC PA students will undergo learning specific to agricultural-related respiratory health issues, chemical exposures, and hearing loss, including preventative health education and communication with agricultural patient …

Improving Antimicrobial Stewardship Programs In Small Community Hospitals Through An Assessment And Feedback Model, Philip Chung, Kate Tyner, Scott Bergman, Terry Micheels, Mark Rupp, Michelle Schwedhelm, Maureen Tierney, Muhammad Salman Ashraf, Trevor Van Schooneveld

Posters and Presentations: Nebraska ASAP

Small community hospitals often lack expertise and resources for antimicrobial stewardship program implementation. Using an assessment-and-feedback model, Nebraska ASAP performed onsite assessment of antimicrobial stewardship efforts in 5 small community hospitals and provided facility specific feedback on implementation/augmentation of antimicrobial stewardship program. As a result of this model, participating small community hospitals were able to increase the number of antimicrobial stewardship core elements implemented while reducing antibiotic use and incidence of CDI.

Assessment Of Trends In Population-Based Health Indicators In The Great Plain States, Jessica Pahwa, Shinobu Watanabe-Galloway

Posters and Presentations: College of Public Health

Purpose/Objective: The objective of this study is to analyze the geographic trends and to highlight the importance of social and geographic based health disparities using population health indicators and Health determinants among the great plains states (Nebraska, North Dakota and South Dakota).

Methods/efforts: Online databases (CDC, BRFSS, America’s Health Rankings, SAMHSA, County health rankings etc) were accessed to collect data population-based data for the great plains states. The incident rates of 10 health indicators and health determinants were chosen and studied. After tabulating the data in excel, the analysis was made through plotting graphs in SAS. Line graphs depicting the …

Birth Outcomes And Water: A Multidisciplinary Study, Moses New-Aaron, Jane L. Meza, Patrick J. Shea, Martha Rhoades

Posters and Presentations: College of Public Health

Evidence that agrichemicals are associated with the incidence of birth defects is inconsistent. We examined whether nitrate and nitrosatable agrichemicals present in well water are associated with birth defect rates in Nebraska counties. Birth defect data from the Nebraska Department of Health and Human Services, 2005-2014, were merged with well data obtained from the Quality-Assessed Agrichemical Contaminant Database for Nebraska Ground Water (1977-2014). Nebraska counties with higher rates of birth defects had a greater prevalence of agrichemicals in well water. Of the 33 contaminants sampled from different well types, nitrate and atrazine were of interest. Birth defect rates were negatively …

Effect Of N-Nitrosoatrazine On Embryogenesis In Avian Embryos, Nur Firyal Roslan, Moses New-Aaron, Martha Rhoades, Kent Eskridge

Posters and Presentations: College of Public Health

Preliminary studies suggest that the nitrosamine N-nitrosoatrazine (NNAT) is teratogenic and mutagenic. We hypothesized that the embryos exposed to NNAT would have higher mortality and lower growth rate compared to unexposed embryos. In this study, we evaluated growth and mortality in chick embryos after exposure to NNAT dissolved in dimethyl sulfoxide (DMSO). The study was divided into three experiments depending treatment design. First, the effect of DMSO on embryo growth and survival was tested. Second, we compared growth and survival between embryos treated with DMSO, 50:50 DMSO:water and NNAT at 0.245 µmol/l. Finally, we compared growth and survival between …

Economic Implications Of Tobacco Use For The State Of Nebraska Government, Fernando A. Wilson, Nizar K. Wehbi, Ali S. Khan

Reports: Center for Health Policy

We examine smoking-related expenditures for the state Medicaid program and for lost productivity among state government employees. The predicted number of new diagnoses of smoking-related illnesses among government employees ranged from 109 cases of kidney disease to 856 cases of arthritis and related diseases. We estimate over 6,000 lost workdays due to sick leave among currently smoking vs. non-smoking employees. Smoking-related illness is estimated to increase state budgetary expenditures on Medicaid by approximately $114.9 million annually.

Evaluation Of A Competency-Based Health Policy Training Program, Jim P. Stimpson, Kathleen Brandert, Brandon Grimm, Fernando A. Wilson

Reports: Center for Health Policy

No abstract provided.

Evaluation Of A Competency-Based Health Policy Training Program, Jim P. Stimpson, Kathleen Brandert, Brandon Grimm, Fernando A. Wilson

Reports: Center for Health Policy

An academic and practice partnership was formed to create and implement a competency-based training program for local health departments in health policy. We evaluated if the training program improved the policy knowledge and competency of participants.

Participants exhibited significant increases for self-assessed policy competency, including substantial improvements in “Critique the feasibility and expected outcomes of potential policy options”, “Identify and assess the strengths and motivations of key stakeholders and potential resistors”, and “Recommend a specific policy change”.

The policy competency instrument developed in this report could be used to measure policy knowledge and competency in future training implementations.

Effect Of Nitrosamine (Nnat) On Embryogenesis: Evidence From A Study Using Avian Embryos Exposed To Nnat, Moses New-Aaron, Martha Rhoades, Jane L. Meza, Jeffrey Wallman

Posters and Presentations: College of Public Health

Background

Birth defects are a known cause of infant death in the United States with higher rates in the Midwest perhaps due to higher use of agrichemicals for farm activities. Nitrate and atrazine are two of the most prevalent agrichemicals contaminating drinking water supplies. When ingested together, in the acidic environment of the human stomach, they can react to form a nitrosamine, NNAT. Many nitrosamines are known to be mutagenic, carcinogenic and teratogenic.

Significance

Preliminary studies have suggested that NNAT is a teratogen and mutagen. Several other agrichemical compounds have been detected in Nebraska groundwater wells that have the potential …

A Systematic Review Of Universal, Teacher-Led Interventions Targeting Anxiety In U.S. Schools, Sonja F. Tutsch, Patrick Fowler, Gaurav Kumar, Adam Weaver, Brian Mckevitt, Denise Britigan, Christian I.J. Minter, Lorena Baccaglini

Posters and Presentations: College of Public Health

Implications of anxiety symptomatology experienced among children and adolescents in the US constitute a major public health crisis, calling for promising universal mental health interventions in K-12 schools. Schools represent an ideal setting for the implementation of population based, public health interventions, as children and adolescents spend a significant proportion of time in school. Discussions within the scientific community document several advantages to utilization of universal, Tier1 interventions. However, the efficacy of universal, school-based anxiety interventions in the US are not consistently documented. The purpose of this study is to systematically review the literature to identify the efficacy of universal …

Cervical Cancer Screening Among Patients Receiving Arvs In A Resource-Limited Environment, Moses New-Aaron, Jane L. Meza, Martha Goedert, Stephen Kibusi, Samwel Sumba, Caroline Damien, Siraj Shabani, James Charles

Posters and Presentations: College of Public Health

Significance

Cervical cancer is the most common cancer worldwide with increased risk among women living with HIV in a resource limited environment. Hence the need to determine factors affecting awareness, prior uptake of cervical cancer screening and willingness to screen among patients receiving Antiretroviral (ARV) drugs.

Data analysis

The data was collected by administered questionnaires to patients presenting for monthly ARV refills in a HIV clinic in Dodoma, Tanzania. A total of 421 women in the clinic with an average monthly income of 39 (USD) were interviewed. A total of 306 (73%) were aware of cervical cancer. Among those who …

The Impact On Youth Smoking Of Increasing The Cigarette Tax In Nebraska: An Update For 2018, Fernando A. Wilson, Nizar K. Wehbi, Jamie Larson, Li-Wu Chen

Reports: Center for Health Policy

No abstract provided.

The Status Of The Healthcare Workforce In The State Of Nebraska, Fernando A. Wilson, Nizar K. Wehbi, Jamie Larson, Kavita Mosalpuria, Ethan Chen, Marlene Deras

Reports: Center for Health Policy

No abstract provided.

Factors Associated With Fatalities In Production Agriculture, Moses New-Aaron, Jessica Semin, Risto Rautiainen, Murray Madsen

Posters and Presentations: College of Public Health

Background: Studying the work environment and demographics of agricultural workers involved in fatal incidents can provide valuable information on the cause of fatalities and lead to better prevention measures.

Objectives: To determine populations at risk of fatalities and the determinants of fatalities in production agriculture.

Method: Agricultural injury and fatality data were obtained from Press clippings and Google alerts covering seven Midwest States (SD, ND, MN, IA, NE, KS and MO). Google Alerts were collected based on key words including: “farm accident”, “farm incident”, “farm death”, “ranch accident”, ”ranch incident”, “ranch death”, “ATV farm death”, “ATV ranch death”, “livestock death”, …

Frequently Identified Gaps In Antibiotic Stewardship Programs In Critical Access Hospitals, Philip Chung, Regina Nailon, Kate Tyner, Sue Beach, Scott Bergman, Margaret Drake, Teresa Fitzgerald, Elizabeth Lyden, Mark Rupp, Michelle Schwedhelm, Maureen Tierney-Brenran, Trevor Van Schooneveld, Muhammad Salman Ashraf

Posters and Presentations: Nebraska ASAP

Background: Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) is a CDC funded project. ICAP team works in collaboration with NE Department of Health and Human Services (NEDHHS) to assess and improve infection prevention and control programs (IPCP) in various health care settings including resource limited settings like critical access hospitals (CAH). Little is known about the existing gaps in antimicrobial stewardship programs (ASP) of CAH. Hence, we decided to study the current level of ASP activities and factors associated with these activities in CAH.

Methods: NE ICAP conducted on-site surveys in 36 CAH from October 2015 to February …

Comparison Of Agricultural Injury And Fatality Characteristics Obtained From Media Monitoring Versus Official Statistics, Moses New-Aaron, Jessica Semin, Risto Rautiainen, Murray Madsen

Posters and Presentations: College of Public Health

Objective of project:

1. Compare the characteristics of fatal injuries reported by CFOI and CS-CASH media monitoring

2. Analyze the agreement between CFOI reported injuries and CS-CASH media monitoring fatal injuries

Planning/Research Method:

Background:

The Bureau of Labor Statistics, Census of Fatal Occupational Injuries (CFOI) provides statistics on occupational fatalities, but information on individual cases is not reported. The Central States Center for Agricultural Safety and Health (CS-CASH) tracks media reports of agricultural injury and fatality cases to augment CFOI data.

Methods:

Data was obtained from variety of sources. The primary data source was "Google Alerts" and other sources includes …

Refugee Health Needs Assessment In Omaha, Nebraska, Dejun Su, Drissa Toure, Kandy Do, Naw Latt Nlam, Jessica Ern

Reports: Center for Reducing Health Disparities

No abstract provided.

An Analysis Of Correlation Between Agrichemical Contaminated Wells And Birth Defects In Nebraska, Moses New-Aaron, Martha Rhoades, Jane L. Meza, Jeff Wallman

Posters and Presentations: College of Public Health

Background:

Evidences that agrichemicals might be associated with the incidence of birth defects are inconsistent.

Objectives:

• Examine whether Triazine, Acetanilide, Carbamothioate, Nitrate, Trifluralin and Uracil present in well-water are associated with birth defect rates in Nebraska Counties
• Identify the well types contaminated with these pesticides.

Methods:

Birth defects data obtained from Nebraska Department of Human and Health Services were merged with data on wells tested for agrichemicals obtained from Quality-Assessed Agrichemical Contaminant Database for Nebraska Ground Water. The 33 contaminants sampled from the wells were sub classified into 6 predictors and expressed as percentages for analysis in a multiple regression …

Predicted Impact On Youth Smoking From Increasing The Cigarette Tax In Nebraska, Fernando A. Wilson, Nizar K. Wehbi, Jamie Larson, Li-Wu Chen

Reports: Center for Health Policy

No abstract provided.

Geographical Analysis Of Sudden Infant Death Syndrome (Sids) And Associated Risk Factors In Douglas County, Nebraska, Caitlin E. Fee, Ariel Tarrell

EMET Projects

Background: Sudden Infant Death Syndrome (SIDS) is defined as the sudden and unexpected death of a child less than one year of age without an identifiable cause. Known risk factors of SIDS include prone and side-sleeping positions, bed sharing, male sex, pre- and postnatal tobacco exposure, poverty, prematurity, low birth weight (1

Significance of Problem: In the United States, SIDS is the most common cause of death in infants between one month and one year of age with approximately 2,500 infant deaths caused by SIDS each year.¹ The incidence of SIDS has decreased by more than 50% in the …

2016 Refugee Health Needs Assessment In Omaha, Nebraska, Kandy Do, Drissa Toure, Naw Latt Nlam, Dejun Su

Posters and Presentations: College of Public Health

Refugees resettling to Nebraska undeniably have different health needs compared to native Nebraska residents. Capturing those differences is the start to catering local health care to refugees. A health needs assessment of refugees in Omaha, Nebraska seek to assess their perceived needs, barriers, and preferences regarding health care, in order to address them justly. The refugee population in Omaha, Nebraska has exponentially increased over the past decade and will continue to increase, bringing global health matters to our backyard. The data and results from surveying over 290 refugees will guide health care organizations and services to appropriately serve refugees and …

Anaesthesia Error In United States: Reasons For Mismanagement, Abby Wolfe, Anh Nguyen, Ashleigh Galles, Madison Wolfe, Ben Lundberg

Posters and Presentations: College of Public Health

A poster from the UNMC Undergraduate Public Health Workshop

Raising The Minimum Legal Sales Age For Tobacco Products In Nebraska, Fernando A. Wilson, Nizar K. Wehbi, Kavita Mosalpuria, Li-Wu Chen

Reports: Center for Health Policy

No abstract provided.

An Overview Of State Criteria For Declaring A Public Health Emergency, Fernando A. Wilson, Nizar K. Wehbi, Kavita Mosalpuria

Reports: Center for Health Policy

No abstract provided.

Race Inclusion Diversity & Equity: The Ride Report, Renaisa S. Anthony, Todd A. Wyatt, Chad Abresch, Maria Teel, Kandy Do, Olubadero Yerokun-Houessou, Talia Mcgill, Angela Benton

Reports: Center for Reducing Health Disparities

The Race, Inclusion, Diversity & Equity (RIDE) Report is presented as a resource to augment, strengthen and support existing and future diversity, inclusion & equity efforts at the University of Nebraska Medical Center (UNMC). It is organized into 7 sections and highlights the voices, perspectives and ideas of over 150 UNMC administrators, students, faculty, staff and community partners (key stakeholders).