Medicine and Health Sciences Commons^™

Influence Of Health Habits On The Success Of The Community Response Program, Hannah Harrington

Capstone Experience

The goal of this project is to determine how specific health habits can affect success of the Community Response (CR) program. Community Response is a program that brings government, non-profit and faith-based organizations together in one community to share resources, identify challenges and create solutions with the goal of strengthening the protective factors that help families raise happy, healthy children (Lift Up Sarpy County, 2018). Health habits include habits centered around everyday life including protective factors such as maintaining support systems, financial stability, and other ways to strengthen families, eliminate risk, and keep children out of the child welfare system. …

Using Syndromic Surveillance To Assess The Impact Of Environmental Factors On Asthma- And Copd- Related Ed Visits In Douglas County, Nebraska, Sandra Gonzalez-Ramirez, Anne Mardis O'Keefe, Tricia D. Levan, Lynette Smith

Capstone Experience

Background: Asthma and chronic obstructive pulmonary disease (COPD) are chronic diseases associated with health disparities in Douglas County, Nebraska and in the United States. Currently there is a lack of information describing the impact of environmental factors in Nebraska on the burden of emergency department (ED) visits or hospitalizations related to these chronic respiratory (CR) diseases. The aim of this study was to determine if there is an association between the numbers of seasonal viral respiratory (SVR)- related ED visits, outdoor air pollutants, aeroallergens, or meteorological factors on the number of CR- related ED visits in Douglas County, Nebraska.

Methods: …

Trends Of Endometrial Cancer Among Adult Women In The United States, Fnu Kanishka

Capstone Experience

Background: Endometrial cancer also referred to as uterine corpus cancer is the fourth most common cancer diagnosed among US women. It is also one of the few cancers in the US that has an increasing incidence and mortality rate. This study examined the overall and race specific age-adjusted incidence rate as well as incidence-based mortality rate of endometrial cancer in the United States from 1975-2016.

Methods: Surveillance, Epidemiology, and End Results (SEER) 1975-2016 data were used. Overall and race specific age-adjusted incidence rate, incidence-based mortality rates and 95% confidence intervals were calculated Trend graphs were created, annual average percent change …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Association Between Gastroduodenal Ulcer And Age Of Diagnosis Of Head And Neck, Gastroduodenal And Pancreatic Cancer, Rukevwe Madusor

Capstone Experience

Background: Cancer is the second leading cause of death in the United States and remains a major public health problem worldwide. Epidemiological studies have demonstrated that insulin like growth factor-1 (IGF-1) is linked to ulcers and most cancers. Although studies have investigated the role of IGF1 in ulcer healing and cancer pathogenesis, the link between ulcer and cancer remains unclear. Hence, we assessed the relationship between ulcers and cancers.

Methods: This study consists of a sample of 180 cancer patients obtain by convenience sampling who were seen at Nebraska Medicine and were enrolled in the integrated cancer repository for cancer …

Organizational Culture Change In The United States Government And Its Application In State And Local Public Health Agencies: A Literature Review, Katherine Barrow

Capstone Experience

State and local health agencies play a critical role in the assessment and assurance of public health in the United States. Their authority to shape the structure and delivery of health services makes organizational culture change imperative for the improvement of government services and ultimately, the health of the public. A systematic literature review using SCOPUS, PsycINFO, Business Source, and Academic Search Premier was conducted to 1) analyze organizational culture change efforts in United States federal, state, and local government settings and 2) make recommendations on how to implement organizational culture change initiatives in state and local health agencies. Of …

Evaluating Occupational Hazards And Personal Protective Equipment Use On Farms In Kyrgyzstan, Christopher Tougeron, Chandran Achutan, Kenesh Dzhusupov, Lorena Baccaglini

Capstone Experience

Objectives – The purpose of this study was to identify occupational hazards and personal protective equipment use on farms operating in Kyrgyzstan.

Methods – We recruited 20 farmers in Kyrgyzstan. They completed a questionnaire and responded to interview questions to determine their occupational hazards, personal protective equipment use, and work-related injuries. We measured noise levels using the National Institute for Occupational Safety and Health sound level meter application for Apple iOS.

Results – Most farmers reported knowing how and when to use personal protective equipment, however 95 percent had not received training on how to use them. Observation of farmers …

Evaluation Of Relationship Between Lead-Dust Loading, Lead-Dust Concentration, And Total Dust Loading Metrics Across Multiple Data Sets, Charles Bevington

Capstone Experience

Lead-dust monitoring studies report values as either lead-dust loadings µg/ft² or as lead-dust concentrations µg/g. It is rare for studies to report both metrics. When only lead-dust loading values are present, professionals require an approach to estimate lead-dust concentration values. A literature search identified five studies that contained raw data for both lead-dust loading and lead-dust concentration. An additional thirty-two studies had summary-statistics available for both lead-dust loading and lead-dust concentration. Studies with raw-data were used to develop an empirically-based loading to concentration statistical relationship. Raw data sets were critically evaluated to determine whether elimination or …

Assessment Of Particulate Matter Levels In Homes With Children, Ali Al Rabou

Capstone Experience

Children’s exposure to particulate matter (PM) is of great interest because it can cause adverse health effects, including asthma, and decreased lung function. The purpose of this study was to determine the levels of PM in low socio-economic status homes in Omaha, Nebraska. Between October 2018 and September 2019, we collected ambient air PM samples from 30 homes, of which 70% had at least one asthmatic child. Samples were collected at 2 feet and 4 feet to represent the breathing zones of toddlers and older children, respectively. We also asked the study participants questions related to indoor air quality (IAQ). …

The Association Between Melanoma And Exposure To Arsenic Among U.S. Adults Using The National Health And Nutrition Examination Survey (Nhanes) From 2003 To 2016, Ahmed Bedaiwi

Capstone Experience

Background: Melanoma is a deadly skin cancer at late stages, and its incidence has been increasing significantly over the last ten years in the United States. Chronic exposure to arsenic has been associated in many studies as a risk factor for non-melanoma skin cancer, notably squamous cell carcinoma. However, current knowledge is limited regarding melanoma and long-term arsenic exposure.

Methods: We conducted a cross-sectional study using the 2003-2016 cycles of the National Health and Nutrition Examination Survey (NHANES), to investigate the association between arsenic exposure and self-reported melanoma and non-melanoma skin cancer diagnoses. Univariate and multivariate logistic regressions were conducted. …

Developing A Training Program For Omaha Metro Area Sexual Assault Nurse Examiners Caring For Individuals With Developmental Disabilities, Emily Blanchard

Capstone Experience

Individuals with developmental disabilities experience many barriers to healthcare and are at a substantially higher risk for sexual assault and trauma. There is a need for more inclusive and collaborative healthcare policies, practices, and education to guide healthcare providers during their encounters with individuals with developmental disabilities as patients, especially during forensic examinations following sexual assault and trauma. In the Omaha metro area, physical therapists at the Munroe-Meyer institute provide clinical services in a transdisciplinary program that refer victims of sexual violence to local health systems’ Sexual Health Nurse Examiners (SANEs).

There is an existing service gap for individuals with …

Age-Adjusted Incidence Rates And Time Trends Of Non-Hodgkin Lymphoma By Subtype, 2000-2015, Daitrang Le

Capstone Experience

Background: Non-Hodgkin lymphomas (NHL) are a group of diverse and complex cancers of the lymphocytes. More than 60 subtypes have been identified based on certain characteristics of the cancer cell. The objectives of this study were to: 1) determine NHL age-adjusted incidence rates from 2000 to 2015 in the U.S. by age, sex, and race/ethnicity; 2) to examine age-adjusted subtype-specific NHL incidence rates by age, sex, and race/ethnicity; 3) to determine if there was significant time trend in age-adjusted NHL incidence rate from 2000-2015 in the U.S by age, sex, and race/ethnicity.; 4) and to examine time trend in age-adjusted …

Improving Internal Reliability Of A Trauma-Informed Care Program Evaluation Instrument, Ashley A. Raposo-Hadley

Capstone Experience

The project has analyzed the recent changes to the trauma-informed care (TIC) curriculum evaluation instrument by assessing the changes in Cronbach’s Alpha scores and effect significance. Data was collected from pre-training and post-training surveys completed at the time of delivery of the TIC curriculum training. Participants included hospital staff and medical or nursing students at Nebraska Medicine, University of Nebraska Medicine Center, and Health Creighton University Medical Center. The three research questions are (1) Did the item edits change item subgroupings? (2) Did the item edits increase instrument reliability? (3) Did the item edits impact statistical significance? 3 subscales, working …

The Lived Experience Of Psychological Occupational Stress In Early Childhood Education, Brooke Fletcher

Capstone Experience

Early childhood education (ECE) programs have been recognized by the Institute of Medicine and the Administration for Children and Families as excellent interventions to alleviate the long-term negative effects of poverty in the United States, but the quality of intervention provided and outcomes for the target population are adversely hindered by high occupational stress burdens for ECE teachers. According to Sheridan, Edwards, Marvin, and Knoche, the models used to address this concern are not empirically supported for specific applicability to ECE nonprofit settings. There is a need for deeper understanding of the lived experiences of ECE teachers, including the psychological …

Explore Barriers Associated With Not Testing For Hiv Among Men Who Have Sex With Men In Dodoma, City, Tanzania, Maria M. Mushi

Capstone Experience

Goal

The goal of the project is to explore barriers associated with not testing for HIV among men who have sex with men (MSM) in Dodoma City, Tanzania.

Objectives

In order to achieve the goal of exploring barriers associated with not testing for HIV among MSM, I will plan and conduct the study, analyze the data, and prepare the final research report.

Methods

A qualitative descriptive study will be conducted in Dodoma City, Tanzania. A total of 10 MSM 19 years of age and above will be purposefully selected by 3 peer educators to be part of the study. I …

Evaluation Of Family Inc.'S Home Visitation Program, Brooke A. Linnenbrink

Capstone Experience

FAMILY, Inc. is a nonprofit that provides public health and family support services to women, children, and families in Pottawattamie and Mills counties. It's home visitation program provides health education information to families in the communities that are expecting a child or have a child less than five years of age. This project looked at FAMILY, Inc.’s database regarding the health of children enrolled in their home visitation program and use that information to help develop health education tools as they prepare to expand their programming to include Early Head Start (EHS). Currently FAMILY uses the Parents as Teachers curriculum, …

Access To Care And Melanoma Incidence And Mortality In Nebraska, Natalia Trinidad

Capstone Experience

The purpose of this study is to determine incidence and mortality of melanoma across all counties in Nebraska in the context of access to primary care providers and dermatologists. Crude and age-adjusted incidence rates of melanoma from 2001-2016 by county were calculated for the following year intervals: 2001-2005, 2006-2010, 2011-2016. Variables for melanoma cases were obtained from the Nebraska Cancer Registry and included the case’s zip code at diagnosis, race, ethnicity, sex, age at diagnosis, year, cancer site, vital status, stage of disease, and the ICD-O code for the cancer type. Crude and age-adjusted mortality rates were calculated for the …

Association Of Copy Number Variations With Chronic Hepatitis B In Chinese Population, Fang Niu

Capstone Experience

With one third of the Hepatitis B virus (HBV) infection population of the world, chronic Hepatitis B (CHB) has become a top burden in China. CHB is a lifelong infection with HBV which can cause serious health problems, like cirrhosis, liver cancer or even death. HBV infection is known to result in various clinical conditions, including asymptomatic HBV carriers to chronic hepatitis and primary hepatocellular carcinoma. Several studies have shown that host genetic susceptibility could be an important factor that determines these various outcomes of HBV infection. Many Single Nucleotide Polymorphisms (SNPs) and Copy Number Variations (CNVs) have been associated …

Comorbidity Profile Of Head And Neck Cancer Patients With And Without Depression, Michaela Frenzel

Capstone Experience

This population-based retrospective study used SEER-Medicare data from 2002-2010 to assess depression, comorbidity, and substance use in the elderly head and neck cancer population. Out of 3,533 head and neck cancer patients, 10.6% had depression diagnoses two years prior to cancer diagnosis, 8.9% were newly diagnosed with depression within one year after cancer diagnosis, and 44.5% of those with preexisting depression had an additional depression diagnosis within one year following cancer diagnosis. Comorbid conditions (p<0.0001) and substance use (p=0.0017) showed associations with depression prior to cancer diagnosis yet, no significant associations with incidence of depression in this head and neck cancer population. This study affirms the need for continual depression screenings in head and neck cancer patients and suggests the need for increased research into the burden of comorbid conditions and substance use within the head and neck cancer population.

Do Molecular Subtypes Of Breast Cancer Affect Outcomes Following Hypofractionation Or Conventional Fractionation Radiation Therapy?, Richard Sleightholm

Capstone Experience

Introduction

Molecular subtypes of breast cancer (BC) are well-established prognostic markers in early-stage BC patients. The addition of radiation therapy (RT) to breast-conserving surgery has improved outcomes in this patient population, with conventional fractionation (CF) and hypofractionation (HF) regimens displaying comparable morbidity and mortality. However, most studies have not taken into account molecular subtype. Thus, it is still unknown if outcomes are similar between CF and HF for each molecular subtype. Herein, the effects of molecular subtype on the efficacy of CF and HF radiotherapy regimens for early-stage BC patients receiving adjuvant RT was investigated.

Methods

A retrospective review of …

Initiation Of A Roundtable Meeting To Determine Safety Hazards And Provide Education To Range Bison Herd Workers, Lucia Finocchiaro

Capstone Experience

This capstone project serves as an important piece of greater project studying bison handling. Bison production is both a growing and dangerous industry. As a new enterprise in many parts of the country and on tribal lands, significant numbers of untrained employees may be hired. This project undertakes methods to better understand the risks associated with bison handling and to thereby improve handling procedures and increase safety. Herd managers (from tribal and non-tribal sites), researchers, safety experts, and stakeholders were brought together for a roundtable meeting in Omaha. This meeting was designed to provide stakeholders a forum to discuss common …

Assessing Quality Of Life And Mental Health Differences Among Young Adult Informal Caregivers And Non-Caregivers In Nebraska, Emily L. Frankel

Capstone Experience

The goal of this project is to identify differences in quality of life and mental health between younger informal caregivers and non-caregivers, ages 19-40, in Nebraska. To address this goal, a demographic and health assessment battery was disseminated to eligible participants (N=60), comprised of informal caregivers (N=30) and age-, education-, and gender-matched non-caregivers (N=30). The health assessment included reliable and validated questionnaires, including the RAND SF-36, EuroQol 5D, Kessler Psychological Distress Scale, and the General Health Questionnaire. By discovering relationships between quality of life and mental health with the length of time providing care, programming and intervention recommendations can be …

Formative Evaluation Of An Online Access To Justice Triage And Intake System, Jessica A. Wiens

Capstone Experience

The objective of this project is to evaluate the usability of Legal Aid of Nebraska’s LawHelp Nebraska online intake and triage system. A mixed-methods approach consisting of observations, semi-structured interviews, and validated survey were used with 14 participants as they interacted with the system. A convenience sample was used through recruitment of clients at Legal Aid of Nebraska’s Omaha office during legal assistance walk-in hours. To analyze the qualitative data from the semi-structured interviews and retrospective observation forms, researchers used thematic analysis. For quantitative data collected through a survey, researchers used descriptive analysis and validated scoring. The project and results …

Great Plains Behavioral Risk Factor Surveillance System Project, Florence G. Duran

Capstone Experience

Background: Great Plains American Indians/Alaska Natives (AI/ANs) experience higher mortality rates than Non-Hispanic Whites from the same region. The National Behavioral Risk Factors Surveillance System (BRFSS) survey can have limitations of the estimates the health risks behaviors and services from one Tribal community to another. Goals and Objectives: The goal of this project is to address the lack of Tribal specific data among AI/ANs in the Great Plains region (ND, SD, NE, IA) by using Great Plains Tribal BRFSS data that captured information for three tribes in the Great Plains region. Tribal specific data will allow tribes to access, …

Rates Of Sudden Unexpected Infant Death And Potential Risk Factors For Unsafe Sleep Behaviors In Douglas County, Nebraska From 2008 To 2017, Balkissa Ouattara

Capstone Experience

Abstract unavailable.

Assessing The Workforce Of The Southwest Nebraska Public Health Department For The Development Of A Workforce Development Plan, Arnel Ramos

Capstone Experience

The purpose of this project was to assess the capacity and needs of the Southwest Nebraska Public Health Department (SWNPHD) workforce and to develop a workforce development plan that would meet the accreditation standards of the Public Health Accreditation Board (PHAB). An assessment survey was developed online through the Survey Monkey website using competency skills based on the guidelines established by the Council on Linkages Between Academia and Public Health Practice. The selected competency skills were reviewed and approved for relevance by the SWNPHD leadership and the University of Nebraska Medical Center, College of Public Health, Office of Public Health …

Impact Of Continuing Education In Reducing Perceived Challenges To Treating Patients Co-Prescribed Opioids And Benzodiazepines Among Midwest Clinicians, Kyle Stirewalt

Capstone Experience

Goal

The goal of this Capstone project was to provide meaningful Continuing Education (CE) to clinicians in the Midwest to reduce perceived challenges to safely treating patients co-prescribed opioid analgesics and benzodiazepines

Objectives

Using continuing education, increase clinician knowledge of effective alternative non-opioid and non-benzodiazepine therapies for chronic conditions while increasing clinician comfort in tapering patients off opioid analgesics and benzodiazepines

Methods

A one-hour CE presentation was prepared with the assistance of the Nebraska Department of Health and Human Services (NeDHHS) and broadcast to clinicians in the Midwest through a live webinar in coordination with the Great Plains Quality Innovation …

Pilot Evaluation Of Oneworld's Education Sessions On Sexually Transmitted Infections For Adolescents And Young Adults In The South Omaha Community, Mariela Bahena

Capstone Experience

Background. Rates for sexually transmitted infections (STIs) in Douglas County, specifically gonorrhea and chlamydia, are among the highest in the nation. Adolescents and young adults between the ages of 15 and 24 are one of the most at-risk groups for acquiring either STI. Though not fatal itself, gonorrhea and chlamydia can lead to serious complications and physical discomfort in both males and females. Evidence-based and age-appropriate sexual health education has been proven to reduce the risk of STIs. Studies have shown that comprehensive education programs with a focus beyond abstinence are effective in promoting safe sex practices.

Aim. This project …

Effects Of Perioperative Hyperglycemia In Patients With Diabetes Compared To Patients Without Diabetes: A Retrospective Study Of Treatment And Outcomes, Matthew Anderson

Capstone Experience

The main goal of this project was to examine the differences in perioperative hyperglycemia treatment received by patients with a diagnosis of diabetes mellitus (DM) and patients without a diagnosis of diabetes (NDM); and how these treatment differences can affect the length of hospital stay. Studies have revealed that, when comparing DM and NDM patients with the same degree of perioperative hyperglycemia, NDM patients suffer worse outcomes. It has been suggested in previous research that this may be because NDM patients receive treatment that does not measure up to the standard of care treatment that DM patients receive. In this …

Neighborhood Variability In Obesity In Children In Omaha, Nebraska, Ann Essay

Capstone Experience

BACKGROUND: The prevalence of childhood obesity is a serious public health concern in the United States. Although several individual-level factors have been found to be associated with obesity in children, neighborhood environmental and social factors likely play an important role. The main goal of this study was to describe the prevalence of child obesity in Omaha, Nebraska by various demographic subgroups, determine if obesity prevalence varies by neighborhood operationalized as zip code, and examine the association between neighborhood-level child obesity prevalence and neighborhood-level socioeconomic status. It was hypothesized that child obesity prevalence varies by demographic subgroup and by zip code …