Medicine and Health Sciences Commons^™

Does Space Matter? An Investigation Of The Spatial Variation In Gestational Weight Gain Associations With Country Of Birth Among Hispanic Women And Access To Care In Texas, Christopher R. Webb

Dissertations & Theses (Open Access)

Inadequate and excess gestational weight gain (GWG) are serious, but potentially preventable adverse pregnancy outcomes which affect as many as two-thirds of pregnant women in the United States. While location and space are associated with a variety of pregnancy outcomes, limited research has investigated potential spatial variation in GWG. The goal of this research is to improve the knowledge of how spatial geography is associated with GWG through secondary analyses of 70,000 to 160,000 birth certificate registry records for Texas mothers with a live birth delivery in 2014. Specifically, this research attempts to assess whether access to obstetrics and gynecologist …

Alternative Tobacco Products & Depressive Symptoms Among Young Adults, David Marsden

Dissertations & Theses (Open Access)

The association between cigarette use and depression has been documented in many studies. Fewer studies have examined other tobacco products such as electronic cigarettes (e-cigarettes) and hookah that are used by young adults. This study examined whether increased frequency of use of these products was associated with depressive symptoms in a cohort of n=5,236 Texas college students followed from 2014 to 2017. A hierarchical model showed that increased frequency of single product use of cigarettes, refillable e-cigarettes and hookah was associated with depressive symptoms. Refillable and disposable e-cigarettes were examined separately and results did not provide evidence of a different …

Investigation Of Hantavirus And Leptospira As Possible Contributing Factors Of The Unexplained Kidney Disease Epidemic In Nicaragua, Nicole J. Delgado

Dissertations & Theses (Open Access)

Throughout Latin America, an epidemic of a kidney disease of an unknown etiology has been occurring since the late 1990s, and this disease is being called “Mesoamerican nephropathy.” Mesoamerican nephropathy predominantly affects male sugarcane workers. In Chichigalpa, Chinandega, Nicaragua, there is sugarcane plantation that is being heavily impacted by the Mesoamerican nephropathy epidemic, and they invited researchers from Baylor College of Medicine to investigate the epidemic. The prospective epidemic investigation began in 2015, and it is an ongoing investigation. Based on the compilation of data collected during the preliminary investigation, our hypothesis is that a possible zoonotic disease, such as …

Hours Of Gaming Or Non-Academic Computer Use, Substance Use, Mental Health Status And School Performance Among Texas Adolescence: Findings From The 2017 Yrbs In Texas, Shanxiazi Gao

Dissertations & Theses (Open Access)

Online gaming activities among adolescents and adults has increased exponentially in the last decade, and mental health issues associated with excessive gaming have drawn attention from health care professionals worldwide (Griffith, 2016). Recognizing this trend, American Psychiatric Association (APA) categorized gaming disorder/addiction as a mental health condition in 2013 in an effort to prevent the expansion of relevant mental health issues (American Psychiatric Association, 2013). Additionally, the World Health Organization (WHO) declared gaming disorder/addiction as a mental health disease, (World Health Organization, 2018). As a result of this declaration, Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has established nine …

Adverse Childhood Experiences, Depression, And Resilience In African-American Adolescents, Jamie C. Freeny

Dissertations & Theses (Open Access)

Research shows that exposure to adverse childhood experiences (ACEs) is common among adolescents; however, no studies have examined the prevalence of ACEs in a racially homogenous sample of African-American adolescents. Thus, the present study examined the cumulative and individual prevalence of ACEs in African-American adolescents. Data were collected from African-American adolescents (n = 241) who attended youth events hosted by churches in Houston, TX. An expanded ACEs tool was used to collect data. ACE scores were summed and dichotomized to 0-3 ACEs versus 4-19 ACEs because a score of four or more indicates a higher risk for adverse mental and …

Development And Usability Testing Of Quit4health, A Smoking Cessation Smartphone App For Young Adults, Katarzyna Czerniak

Dissertations & Theses (Open Access)

Tobacco use is the leading cause of death in the United States. As of 2016, 23.5% of American 18-25 year olds reported having used cigarettes in the last month compared to 20.2% of adults and only 3.4% of adolescents. Due to the efficacy and widespread general use of mobile technology today, mobile-phone health, or mHealth apps, have become increasingly popular methods of delivering smoking cessation programs. However, there is a lack of evidence in regards to the quality and the effectiveness of using mHealth to deliver smoking cessation interventions to young adults. This study aims to fill this gap to …

Sociodemographic Determinants Of Mental Health Outcomes Among Unhealthy Weight Youth In The United States, Chenchita Malolan

Dissertations & Theses (Open Access)

Background

The prevalence of unhealthy weight (defined as a body mass index ≥ 85th %ile for age and sex) among children and adolescents in the United States remains unacceptably high. In parallel, the prevalence of mental health issues in youth is rising as well. Current research shows a strong association between overweight/obesity and poor mental health outcomes. Specifically, youth of unhealthy weight have higher rates of anxiety and depression. The objective of this study is to evaluate the specific the current (2016-17) population-level prevalence of unhealthy weight, mental health issues and the sociodemographic (e.g. sex, age, race, ethnicity, household income) …

A Secondary Data Analysis For The Refinement Of Empirical Modelling For The Estimation Of Environmental Health & Safety Program Resourcing For Colleges And Universities, Seth Michael Parker

Dissertations & Theses (Open Access)

The use of potentially hazardous physical, chemical, biological, and radiological agents is inherent to the teaching, research, and services missions of any university. To manage the risks associated with these agents, it is common for universities to host environmental health & safety (EH&S) programs to protect the safety of the institution’s students, faculty, staff, and visitors. However, since EH&S programs in universities are primarily focused on prevention, it is difficult to estimate the appropriate “industry average” in terms of budget and staffing resources a particular university needs for such programs. Historically, the Campus Safety, Health, and Environmental Management Association (CSHEMA) …

Philosophia Soteria: How Occupational Safety And Health Professionals Influence Decision Makers, Daniel Jay Snyder

Graduate Theses and Dissertations

The purpose of this study was to identify ideas about how occupational safety and health (OSH) professionals influence decision-makers on matters impacting occupational health and safety management systems. A modified nominal group technique was used that involved 67 participants in ten nominal groups and identified the most important ideas about how OSH professionals can influence workplace safety and health decision making. The research produced themes of communication, scientific, professionalism, leadership, adaptability, and business acumen that resulted in six domains of occupational safety and health professional influence.

An Evaluation Of Implementing Trauma-Informed Care Training In Healthcare Settings, Amanda Kis

Capstone Experience

Background: Trauma-informed care (TIC) has recently become a popular topic in medical science. Many patients’ health conditions have been diagnosed and treated purely as medical issues, yet emerging research indicates that trauma is sometimes the source of many physical and mental conditions. Implementing TIC education in healthcare systems may lead to preventing the onset of symptomology related to undiagnosed, chronic trauma experience.

Objectives: The primary goal of this Capstone project was to implement TIC training developed by Trauma Matters Omaha Coalition and assess preliminary evidence for changes in participants’ confidence, clinical knowledge, professional knowledge, self-awareness, and assumptions and biases regarding …

Compassion Fatigue Among Mental Healthcare Providers And The Impact On Overall Wellbeing, Ruchi Patel

Doctoral Dissertations

Compassion, a virtue of the helping profession, can be jeopardized by a provider’s continuous exposure to the trauma experiences of others. The impact of burnout, secondary stress and compassion fatigue on a mental healthcare provider’s work and personal life has been increasingly studied due to negative ramifications on our community healers. The present study used a cross-sectional design to survey mental healthcare providers across specialty and discipline in efforts to gain a better understanding of the relationship between a provider’s degree of compassion fatigue and specific demographic variables, physical health and their spirituality. One hundred and thirty-seven participants across the …

Incorporating Waist Circumference Screenings To Initiate Preventative Lifestyle Modification Education: A Feasibility Study For A Clinical Practice Change, Tracy Stahl

Doctor of Nursing Practice Scholarly Project

INCORPORATING WAIST CIRCUMFERENCE SCREENINGS TO INITIATE PREVENTATIVE LIFESTYLE MODIFICATION EDUCATION: A FEASIBILITY PILOT STUDY FOR A CLINICAL PRACTICE CHANGE

An Abstract of the Scholarly Project by

Tracy Stahl MSN, FNP-C

The purpose of this study was to evaluate provider perceptions and willingness to incorporate adult gender-specific waist circumference screenings as a clinical practice change. The project was conducted at the 4-State Advanced Practice Nurses (APN) conference in March 2018. The study consisted of a two-part study that utilized a pretest, educational PowerPoint presentation, posttest, and eight-week posttest to determine self-reported provider practices. Part one of the study analyzed the pretest …

Project Renew Worcester, Danni Yue, Amy Zhang, Jing Han, Omid Ashrafi, Yiming Xu

School of Professional Studies

n The client for this capstone project is RENEW Worcester which is a fledgling solar power project whose main goals are to bring renewable energy in the form of solar power into local, primarily low-income communities and are committed to the mission of making the transition off of fossil fuels to clean, renewable power. Based in Worcester, Massachusetts, they are a local chapter of Co-op Power which is a consumer-owned sustainable energy cooperative (co-op) made up of numerous different local chapters all over the New England area as well as the state of New York. The problem that we will …

The Role Of Non-Neuronal Acetylcholine In Urogenital Chlamydial Infection, Jessica R. Lockhart

Electronic Theses and Dissertations

Chlamydia trachomatiscauses a bacterial sexually transmitted infection, Chlamydia, that is often chronic and casues reproductive complications in women. We hypothesized that Chlamydia infection increases local acetylcholine (ACh) production, which regulates the host’s inflammatory response to the infection. Female mice infected with C. muridarumwere sacrificed at days 3, 9, 15, and 21 post-infection, genital tract tissues harvested, and immunohistochemistry performed to enumerate ACh-producing cells. Infection increased the number of ACh-producing cells in cervical tissue at days 3,15, and 21 post-infection (pi), uterine tissue at day 3 and 9 pi, and ovarian tissue day 3, 15, and 21 pi. These …

The Ecology Of Fecal Indicators, Dennis A. Gilfillan

Electronic Theses and Dissertations

Animal and human wastes introduce pathogens into rivers and streams, creating human health and economic burdens. While direct monitoring for pathogens is possible, it is impractical due to the sporadic distribution of pathogens, cost to identify, and health risks to laboratory workers. To overcome these issues, fecal indicator organisms are used to estimate the presence of pathogens. Although fecal indicators generally protect public health, they fall short in their utility because of difficulties in public health risk characterization, inconsistent correlations with pathogens, weak source identification, and their potential to persist in environments with no point sources of fecal pollution. This …

Descriptive Census Survey Of Community Gardens Supported By The Big Garden, Abigail R. Hughes

Capstone Experience

The goal of this capstone and service learning project is to provide The Big Garden, an Omaha, NE based nonprofit organization, with survey data on the growth of their sites and programming over the past five years along with information on current garden needs and capacity. A census survey of a subsample of gardens supported by The Big Garden will provide leadership with information needed as they plan next steps for the organization and specific programming planning. Surveys were distributed to all gardens within their network to collect data on garden characteristics (e.g., size, length of time in operation), production …

A Descriptive Analysis And Assessment Of Predictive Factors For Participation In A Clinical Trial As Front-Line Therapy For Patients Enrolled In The Nebraska Lymphoma Study Group Registry, Jonathan L. Tefft

Capstone Experience

Background: Clinical trial participation, especially among cancer clinical trials in adult populations, continues to be low despite the large number of clinical trials available across the U.S. Estimates for clinical trial participation are as low as 5% in some adult cancer populations, however in some lymphoma populations this figure may be as high as 13.9%. This figure can be confusing, given that as much as 70% of Americans are estimated to be willing to participate in a clinical trial. Previous research shows that as much as 95% of surveyed respondents who said they had previously participated in a clinical trial …

The Public Health Lens: An Introduction To Population-Based Care In Athletic Training, Jenna L. Allocco

Capstone Experience

Historically, the athletic training profession has been focused on the individual; however, potential exists to drive large-scale prevention efforts in the athletic community with a population-based, public health approach. Relationship between the two professions has been acknowledged in in previous literature to do with educational competencies and opportunities for research, as well as in policy development involving sudden cardiac death, sport-related concussion and osteoarthritis prevention. Incorporating public health concepts such as the ecological model, health literacy, health behavior and evidence-based program planning and evaluation may improve athletic training health outcomes and prove beneficial to each respective discipline.

Burden And Risk Factors Associated With Hcv Infection Among People Living With Hiv Infection In Nebraska: Population-Based Cross-Sectional Study From 1997 To 2017, Issaka Kabore

Capstone Experience

Background: Previous studies have shown high prevalence of HCV infection among people living with HIV infection. Coinfected people are at risk of developing liver diseases resulting an increase rate of mortality. Several risk factors for HIV/HCV coinfection have previously been identified with injecting drug users (IDU) as the common route of exposure.

Methods: This was cross -sectional study using HIV and HCV registries maintained by Nebraska Department of Health and Human Services (NE DHHS) from1997 to 2017. A descriptive analysis was used to characterize the sample. Chi-squared test and Fisher exact test were selected to compare the different groups. …

Stress Management In The Kitchen, Haley Rosano

Capstone Projects and Master's Theses

Catholic Charities - Diocese of Monterey has implemented Stress Management in the Kitchen though the Family Support Services department of the Seaside office. Stress Management in the Kitchen was implemented to address the knowledge gap between nutrition and healthy living.The purpose of the workshop series was to give clients a fun and digestible way to increase their knowledge on how their health and nutritional habits can or should be applied to how they deal with stress. These workshops were implemented through presentation and a series of activities.The measurement of these workshops will be obtained through an exit survey from participants. …

Assessing Medication Error Rates In Pediatrics Pre And Post Implementation Of The Handtevy App Within The San Antonio Fire Department, Bailey Cooper

Capstone Experience

Goal: The goal of this project was to determine if the implementation of the Handtevy app reduced medication error rates on calls run by the San Antonio Fire Department in the pediatric population with a diagnosis involving pain management or seizure. Background: Prior to the implementation of the Handtevy app, first responders used a tool called the Broselow tape to estimate a child’s weight and to determine the appropriate medication dose. Run reports were analyzed prior to the implementation of the Handtevy pediatric standard to determine medication error rates for Fentanyl and Versed in pediatric patients 13 years or younger. …

Factors Associated With Medical And Dental Compliance For Adults With Diabetes Mellitus, Mahua Saha

Capstone Experience

Background: Over the few decades, diabetes has become one of the most common chronic conditions in the U.S and worldwide. With the increasing number of incidences of diabetes and the cost associated with the treatment, adherence to treatment regimens is one key factor, which immensely affects the success of the diabetes treatment. The American Diabetes Association recommends annual preventive care for diabetes in terms of self-care practices such as daily blood glucose check and daily foot check. An eye examination with pupil dilation and a dental checkup are also recommended as part of annual care for diabetic patients. Considering the …

Hearing Conservation In A Meat Processing Facility, Abolore Muinat Idris

Capstone Experience

Introduction: The aim of this study was to evaluate personal noise exposures at a meat processing facility, and educate employees on the proper use of hearing protectors.

Materials and Methods: We collected full-shift personal dosimetry on thirty-six production floor employees, one quality control employee, and four maintenance employees. These were compared to the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) criteria. We also collected point source noise measurement at eight workstations from precook. We administered a questionnaire to assess production floor employees’ hearing loss perception and non-occupational source of noise exposure. …

Factors Associated With Participant Attrition In A Longitudinal, Survey-Based Rheumatic Disease Databank, Kathryn A. Grafel

Capstone Experience

Introduction: Participant attrition is a problem common to many longitudinal studies, and when it occurs nonrandomly, it can impact the study’s validity and generalizability. Identifying factors associated with attrition can help to detect bias and aid in developing targeted interventions to reduce attrition. Methods: Logistic regression and Cox proportional hazards regression models were constructed separately for patients with rheumatoid arthritis, systemic lupus erythematosus, and other rheumatic diseases who participated in the FORWARD study between 1998 and 2018. Results: Patient characteristics associated with attrition included male sex, younger age, non-White race, and less education, each of which was identified in multiple …

Nutritional Factors Associated With Thyroid Cancer And Nodules Using The Integrated Cancer Repository For Cancer Research (Icare2), Dong Liu

Capstone Experience

Introduction: The incidence of thyroid cancer in the United States has rising on average 3.1% each year over the last 10 years. Much of this increase is attributed to increased detection using ultrasound. Dietary habits can be an important modifiable risk factors for different types of cancer, but the association between dietary factors and thyroid cancer has not been well studied. The goals of this capstone were to: 1) review the literature for the association between dietary factors and thyroid cancer, 2) describe demographic and behavioral characteristics of patients with thyroid nodules and cancer in a hospital-based registry, and 3) …

Noise Induced Hearing Loss Accountability On Jobsites Within The Construction Industry, Joseph O. Lamphere

Construction Management

Noise induced hearing loss is a major issue on jobsites within the construction industry. Every day workers are exposed to hazardous levels of noise, but they are not being properly managed to mitigate this issue. Workers have misconceptions about the topic, but more surprisingly are sometimes indifferent to the effects; believing hearing loss is inevitable, or it can be cured with a hearing aide. Construction has inherent dangers that workers have to deal with every day. Hearing loss might not be on the top of their lists, but the effects are permanent, and they cannot be cured with a hearing …

Evaluation Of The Predictive Ability Of A Screening Instrument Used To Diagnose Co-Occurrence Of Anxiety In Children With High-Functioning Autism., Austin Zachary

Electronic Theses and Dissertations

Anxiety has shown to have a high co-occurrence in children with Autism Spectrum Disorder (ASD), but has been difficult to co-diagnose. This study analyzed the ability of the Screen for Child Anxiety-Related Emotional Disorders (SCARED) to predict positive ASD screenings of the Social Responsiveness Scale (SRS). Parents and children ages 8 to 18 years (N = 100) were screened for anxiety using the SCARED and autism using the SRS. Moderate correlation was found between parent-reported SCARED and positive screening of the SRS (r = .579), with weak correlation found in the child-reported SCARED (r = .105). LASSO regression was conducted …

Adolescent Sexual And Reproductive Health In The Gambia., Sandhya Lohani

Electronic Theses and Dissertations

Adolescence is a crucial period in human development. Knowledge and awareness about when to have children, when to have sex, and use of contraceptives impacts the chances of teenage pregnancy and risk of sexually transmitted diseases. The objective of this study is to determine the prevalence and associated risk factors related to age of sexual debut, teenage pregnancy, and use of contraceptives in the Gambia. This study also compares the data with 2014 survey research conducted in the Gambia. The total study population were 50 adolescents aged 13-21 years from Bafuluto and surrounding communities in the Gambia. Among 50 respondents, …

Lead And Crime: An Ecological Study Between Lead Contaminated Topsoil And Violent Crime., Brian Guinn

Electronic Theses and Dissertations

Lead is a known neurotoxicant. Human exposure to lead comes primarily through environmental exposures, including remnant lead paint, lead contaminated topsoil and lead contaminated water. Prenatal and early life lead exposure has been associated with numerous neurocognitive and neuropsychiatric disorders. This dissertation presents findings from an ecological study which evaluated the geospatial association between topsoil lead content and the incidence of FBI designated violent crime in Jefferson County, Kentucky. A total of 412 topsoil samples were collected along roadways (n=300) and from Louisville Metro Parks (n=112). Jefferson County crime data was obtained from the Louisville Metro Police Department – Crime …

Factors Associated With Follow-Up Compliance Among Clients Referred By A Local Health Department For Hiv Pre-Exposure Prophylaxis, Lauren R. Cirrincione

Capstone Experience

Background: Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) is a public health strategy to limit HIV infection among at-risk populations. Local health departments (LHDs) promote PrEP initiation by referring patients to private and academic specialty care centers. However, low follow-up compliance remains a challenge in this setting. Between January 2016 and September 2018, Douglas County Health Department, a LHD in Omaha, Nebraska, externally referred 126 clients for PrEP at an academic specialty care center, and only 20 (15%) clients completed a PrEP initiation follow-up appointment. The purpose of this study is to describe the characteristics of clients referred by …