Medicine and Health Sciences Commons^™

Understanding Connections Between Public Health Districts And Individuals Who Have Recently Been Released From Carceral Systems In Idaho, Ashley Harris

Boise State University Theses and Dissertations

Background

Gaining a better understanding of the relationship between public health and individuals recently released from the carceral system in Idaho is vital. According to the Federal Bureau of Justice Statistics, in 2020 Idaho had the highest female incarceration rate of all US states at twice the national average (Bureau of Justice Statistics, 2020). The incarceration rate of women and girls has increased nearly 834% in the last 40 years and rates in Idaho follow this trend (Steinberg, 2018). Compared to 62% of women in prisons nationally, 80% of women in local jails report having children under the age of …

The Past, Present, And Future Of The Latino Paradox, Sheila Flores

University Honors Theses

The Latino/Hispanic paradox has left scholars and researchers puzzled as to how Latinos, despite facing socioeconomic challenges, show better health outcomes when compared to other racial/ethnic groups. The emergence of this phenomenon can be traced back to the 1980s/1990s when researchers first noticed Latinos in the United States having characteristics of lower mortality rates and improved health compared with non-Hispanic whites despite having a better socioeconomic status. Performing a literature review of scholars analyzing the past, present, and future of the Latino Paradox will thus allow for an understanding of its origin, current state, and the possible potential trajectories that …

A Literature Review Of The Psychosocial Impacts On Livestock Producers And Veterinary Responders Involved With Depopulation During And After An Animal Health Emergency, Beth Galles

Capstone Experience: Master of Public Health

A vital aspect of an animal health emergency in the United States is removing and disposing of diseased and healthy animals through depopulation. It is frequently required to prevent the spread of diseases that affect human health or economic stability. Production animals are eventually slaughtered, but this does not negate the human-animal bond felt between these animals and their caretakers. There is increasing recognition that participation in depopulation may be a traumatic event requiring care for the individuals involved, including livestock producers and veterinarians. Despite this, limited resources are available for these individuals when an animal health emergency occurs. This …

Evaluating Nebraska’S State Health Assessment (Sha) And State Health Improvement Plan (Ship) Methodology To Inform The Redesign Evaluation Plan, Austin J. Osborn

Capstone Experience: Master of Public Health

The Division of Public Health (DPH) within the Nebraska Department of Health and Human Services (DHHS) is redesigning its State Health Assessment (SHA) and State Health Improvement Plan (SHIP) procedures. This study aimed to support the Nebraska DPH SHA/SHIP redesign evaluation plan by determining the local health department (LHD) health priority determination processes, Tribal and LHDs’ (T/LHD) CHA/CHIP methodology, and if any differences exist between rural & urban and small, medium, and large jurisdictional size health departments in Nebraska. The results show that most health departments utilize the MAPP process to conduct their CHA/CHIP, one tribal entity utilizes a different …

Understanding Gendered Risks For Severe Covid-19 Through Surveying The Gender Diverse Community, Arden Tyree

Capstone Experience: Master of Public Health

Early on in the pandemic, the medical community began noticing that men were more likely to be hospitalized, require admission to the ICU, and die of COVID-19 than women but few studies of COVID-19 make mention of gender diverse people, an often-overlooked population who may have vastly different experiences than non-gender diverse men or women. Their variations in gender and sex characteristics may also help provide further insight into which traits are protective or risk factors for this disease. This project used Poisson regression in order to analyze self-reported survey data. The major associations of interest will be between disease …

Early Childhood Nutrition Education Implementation Evaluation And Planning: Learn, Grow, Eat & Go!, Alyssa L. Wessling

Capstone Experience: Master of Public Health

The obesity rate among American children aged two to five years old is 12.7% (Centers for Disease Control, 2022), indicating a need for health interventions at this critical life stage. Nebraska Extension’s Nutrition Education Program has identified a need for direct education materials to reach Nebraskans in early childhood. Learn, Grow, Eat & Go! Early Childhood was identified as an appropriate curriculum to be tested in an early childhood intervention pilot. Learn, Grow, Eat & Go! Early Childhood is a newly developed program built upon the foundation of teaching children about healthful foods and physical activity through gardening. An early …

A Qualitative Analysis Of Candida Auris Laboratory Surveillance In Nebraska, Lissa M. Young

Capstone Experience: Master of Public Health

Objectives: Candida auris is an emerging pathogenic yeast that was first identified in Japan in 2009 and detected in the United States in 2015. As of 2020, C. auris has been reported in cases throughout 41 countries, including the United States. The ability of this species of yeast to spread rapidly and survive for long periods of time on surfaces, the high mortality rate of those infected, and its multidrug resistant phenotype, have rendered it a urgent public health threat (the highest threat level) by the United States Centers for Disease Control and Prevention beginning in 2019 (CDC, 2019). Since …

Evaluating The Impact Of Culturally Informed Interventions On Nebraska's Refugees: A Pilot Study With Healthcare Workers, Falah Nayif Rashoka

Capstone Experience: Master of Public Health

Background: Refugees in the US are at increased risk of poor health outcomes, spanning mental health and general well-being, compared with American-born individuals. With the rapid growth of the refugee population in Nebraska, the need to train healthcare providers to provide culturally competent care has never been greater. A common point of access to healthcare for the refugee population after resettlement is via local health departments and the primary healthcare network. Recent estimates show close to five thousand Yazidi refugees living in Nebraska, most of whom moved after 2009 based on federal legislation admitting those who served in the …

Operation Wasatch: Scenario Based Planning To Assess The Cold Weather Preparedness Of The National Disaster Medical System, Alison Matthews

Capstone Experience: Master of Public Health

Background: The National Disaster Medical System has little experience with sustained mission operations under anything other than temperate environmental conditions. Extreme weather events increase the complexity of disaster response by presenting significant logistic, operational, and safety challenges. Identifying gaps and vulnerabilities in response capabilities can promote improved Disaster Medical Assistance Team preparedness.

Methods: This discussion based exercise utilized a scenario involving a 7.0 magnitude earthquake along the Wasatch Fault in winter. This exercise was conducted with members of the Wisconsin-1 Disaster Medical Assistance Team. Team members provided oral and written feedback in response to exercise objectives and prompts. This feedback …

Association Of Socioeconomic Status And Mental Health Characteristics And Participant Attrition In A Cohort Study, Mathews Thampi

Capstone Experience: Master of Public Health

The cohort study is an essential design for investigating associations between a variety of risk factors or exposures and a plethora of health outcomes. However, one of their biggest weaknesses is participant attrition, which can introduce bias and impact validity. Understanding whether this attrition is related to exposure and outcome is a critical aspect of assessing the potential for selection bias. The Women and Their Children's Health (WaTCH) study is a prospective cohort study designed initially to examine the health impacts of exposure to the Deepwater Horizon oil spill. The study has undergone two waves of data collection and is …

Examining The Experience And Impact Of Teen-To-Teen Crisis Line Work For Youth Volunteers: A Pilot Study, Taylor Kalgren

Psychology Theses & Dissertations

For young people, suicide is a leading cause of death. In addition, suicidal thoughts and behaviors begin during adolescence, and rates are high during this developmental period. Crisis lines are one of the oldest suicide prevention strategies used today. Crisis line work is challenging, and therefore, examining the health and safety of these operators is critical. Teen-to-teen (t2t) crisis lines are a unique resource where adolescent volunteers help their similarity aged peers. The goal of this pilot study was to begin to evaluate the impact of t2t crisis lines for youth volunteers. Twenty youth crisis line volunteers (ages 15-20) were …

Impact Of A Cancer Education Curriculum On Appalachian Kentucky Middle And High School Students, Lauren Hudson‑Rose, L. Todd Weiss, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Appalachian Kentucky is disproportionately affected by elevated cancer incidence and mortality rates. This disparity is driven by inequities in health behaviors and social determinants of health including decreased education attainment levels that cause lower health literacy. To increase cancer literacy in the region, a three-part cancer education curriculum was designed for Appalachian Kentucky middle and high school students. This study was designed to evaluate the effect the curriculum had on students’ cancer literacy. The curriculum lessons were disseminated to Appalachian Kentucky middle and high school teachers who engaged 223 students with the material. For each lesson, students filled out a …

Weighted Mean Difference Statistics For Paired Data In The Presence Of Missing Values, Yuntong Li, Brent J. Shelton, William St Clair, Heidi L. Weiss, John L. Villano, Arnold Stromberg, Chi Wang, Li Chen

Markey Cancer Center Faculty Publications

Missing data is a common issue in many biomedical studies. Under a paired design, some subjects may have missing values in either one or both of the conditions due to loss of follow-up, insufficient biological samples, etc. Such partially paired data complicate statistical comparison of the distribution of the variable of interest between the two conditions. In this article, we propose a general class of test statistics based on the difference in weighted sample means without imposing any distributional or model assumption. An optimal weight is derived from this class of tests. Simulation studies show that our proposed test with …

Use Of The Decipher Genomic Classifier Among Men With Prostate Cancer In The United States, Nicholas G. Zaorsky, James A. Proudfoot, Angela Y. Jia, Raed Zuhour, Randy Vince Jr., Yang Liu, Xin Zhao, Jim Hu, Nicola Schussler, Jennifer L. Stevens, Suzanne Bentler, Rosemary D. Cress, Jennifer A. Doherty, Eric B. Durbin, Susan Gershman, Iona Cheng, Lou Gonsalves, Brenda Y. Hernandez, Lihua Liu, Bozena M. Morawski, Maria Schymura, Stephen M. Schwartz, Kevin C. Ward, Charles Wiggins, Xiao-Cheng Wu, Jonathan Shoag, Lee Ponsky, Alan Dal Pra, Edward M. Schaeffer, Et Al

School of Medicine Faculty Publications

Background: Management of localized or recurrent prostate cancer since the 1990s has been based on risk stratification using clinicopathological variables, including Gleason score, T stage (based on digital rectal exam), and prostate-specific antigen (PSA). In this study a novel prognostic test, the Decipher Prostate Genomic Classifier (GC), was used to stratify risk of prostate cancer progression in a US national database of men with prostate cancer. Methods: Records of prostate cancer cases from participating SEER (Surveillance, Epidemiology, and End Results) program registries, diagnosed during the period from 2010 through 2018, were linked to records of testing with the GC prognostic …

Post Sbirt Implementation - Input From The Field To Improve Fins Engagement, Substance Use Screening & Referral To Treatment, Institute For Public Health And Justice, Screening And Assessment

Policy & Position Papers

No abstract provided.

Interrogations Of The Tumor Microenvironment Using Magnetic Resonance Imaging, Tianzhe Li

Dissertations and Theses (Open Access)

Both tumor acidosis and tumor hypoxia are characteristics commonly found in the microenvironment of solid malignant tumors. Accurate characterization of the two phenomena could provide important information to clinicians for devising suitable treatment plans. Tumor acidosis and hypoxia are closely linked to each other. Tumor acidosis is caused by the inclination of cancer cells towards anaerobic respiration, and one of the main contributing factors for the avoidance of aerobic respiration is tumor hypoxia. Both phenomena can indicate the high metastatic potential of cancers and can also cause resistance of the cancer systems against anti-cancer therapies. Therefore, developing novel molecular imaging …

Spanish-Speaking Limited English-Proficient Patient Satisfaction And Comfort When Comparing Spanish-Speaking Provider To An Interpreter, Cindy Hernandez

Dissertations and Theses (Open Access)

A large population of Americans have limited or no English proficiency (LEP) with about 64% of those being Spanish-speaking. This creates challenges in navigating the American healthcare system, where the majority of providers are solely English-speaking. Studies have demonstrated that when patients have language discordant appointments without interpreters, they are more likely to feel less understood, have questions and comments ignored, and are less likely to receive patient-centered care in communication. It is expected that interpreters improve access to healthcare, especially for Spanish-speaking patients. However, the patient comfort and satisfaction in language discordant genetic counseling appointments has not yet been …

Risk And Risk Factors For Colorectal Subsequent Malignancies In Survivors Of Childhood Cancer: A Report From The Childhood Cancer Survivor Study, Constance A. Owens

Dissertations and Theses (Open Access)

Survivors of childhood cancer are at risk for colorectal subsequent malignant neoplasms (SMNs); notably, these cancers are amenable to screening. To identify at-risk survivors that may benefit from early screening, descriptive and risk factor analyses were performed to ascertain risk factors for colorectal SMN in childhood cancer survivors. In particular, we explored detailed radiation therapy (RT) data – colorectal and substructure dose-volume metrics – as risk factors for colorectal SMN risk; metrics that have yet to be thoroughly investigated. We developed a novel population-based anatomical colorectal model with substructures for RT dosimetry in late effects studies of childhood cancer survivors; …

The Power Of A Story: How Emotions And Numeracy Affect Parental Decisions About The Human Papillomavirus Vaccine, Candice Fawn Coffman

Open Access Theses & Dissertations

The Human Papillomavirus (HPV) is the most common sexually transmitted infection (CDC, 2021). There are two strains of HPV known for causing cervical, penile, anal, vaginal, and oropharynx (throat) cancers (CDC, 2020). A vaccine is available to prevent these cancer-causing strains of HPV for individuals between the ages of 9-45. Unfortunately, vaccination uptake and completion rates are below the recommended rates to achieve herd immunity. A primary barrier to vaccination is concern about potential adverse events following vaccination. The purpose of the present study is to examine the influence of anecdotal versus statistical information on parents' intentions to vaccinate their …

Effectiveness Of Amiodarone, Propafenone And Synchronized Electrical Cardioversion For Conversion Of Atrial Fibrillation Paroxysm To Sinus Rhythm In Rigas Stradins University Hospital Department Of Emergency Medicine., Mihails Tracevskis

Digital Journal of Clinical Medicine

Abstract

Introduction: Atrial fibrillation remains a pervasive global health concern, contributing significantly to the incidence of stroke, heart failure, sudden death, and overall cardiovascular morbidity.

Materials and methods: The present study undertook a retrospective analysis involving a meticulous examination of 127 patients, representing a diverse cohort of individuals encompassing 73 men (with a median age of 62 and a range of 37-75) and 54 women (with a median age of 60 and a range of 42-78) duration of atrial fibrillation 48 hours or less.

Results: The results highlighted amiodarone's remarkable efficiency, as it successfully converted 81.2% of cases (56 …

Health Facilities Preparedness To Deliver Maternal And Newborn Health Care In Kilifi And Kisii Counties, Kenya, James Orwa, Marleen Temmerman, Lucy Nyaga, Kennedy Mulama, Stanley Luchters

Population Health, East Africa

Introduction: Health facility preparedness is essential for delivering quality maternal and newborn care, minimizing morbidity and mortality by addressing delays in seeking skilled care, reaching appropriate facilities, and receiving emergency care. A rapid assessment of 23 government health facilities in Kilifi and Kisii counties identified poor maternal and newborn indicators in 16 facilities. The Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project supported these facilities with training, equipment, and referral linkages. This study focuses on facility preparedness of the 16 facilities to deliver maternal and newborn health services, specifically delays two and three at the end …

Clinical And Environmental Factors Affecting The Survival Outcomes Among Stage 1a Tn0m0 First Primary Non-Small Cell Lung Carcinoma Patients In The United States., Naiya Patel

Electronic Theses and Dissertations

Background: Lung cancer is the second leading cause of death in the United States (U.S.). The most prevalent histological type of lung cancer is Non-Small Cell Lung Cancer (NSCLC), which has an overall five years survival of 5% if left untreated. Therefore, early treatment of NSCLC is vital to improve overall survival (OS) outcomes. Several factors affect survival outcomes, which can be categorized as modifiable or non-modifiable. The difference in timely receipt of guideline-concordant treatment affects the survival outcomes of patients with stage 1A NSCLC. This dissertation explored factors that affect treatment and survival outcomes among stage 1A NSCLC patients …

The Role Of E-Liquid Constituents In E-Cigarette-Induced Cardiac Arrhythmia And Autonomic Imbalance., Cory Kucera

Electronic Theses and Dissertations

Introduction. Accumulating evidence indicates that exposure to electronic cigarettes (e-cigs) promotes sympathetic dominance and electrophysiologic instability in the heart, potentially culminating in arrhythmogenesis. E-liquids contain various formulations of nicotine and flavorings, but the effects of specific e-liquid constituents and their concentrations on e-cig-induced autonomic imbalance and electrical dysfunction are unresolved. To that end, we tested the hypothesis that e-cigs modify cardiac autonomic balance and ventricular arrhythmogenesis in mice dependent on e-liquid constituent type and concentration. Methods. Using a crossover design and a serial exposure regimen, ECG-telemetered male C57BL/6J mice underwent whole-body exposure to e-cig aerosols generated from e-liquids containing different …

Effects Of Immunosuppressive Treatment On Patient Outcomes After Immune Checkpoint Inhibitor-Related Gastrointestinal Toxicity, Anusha S Thomas, Najib Ben Khaled, Mehmet Altan, Bryan Schneider, Yinghong Wang

Faculty, Staff and Student Publications

Purpose: Immune checkpoint inhibitors (ICIs) are increasingly used in the treatment of certain cancers but cause immune-related adverse events (irAEs). Gastrointestinal irAEs may necessitate extended periods of steroid use and the initiation of selective immunosuppressive therapy (SIT) which could theoretically counteract the effect of ICIs. In this study, we aim to explore the impact of immunosuppression use and duration on cancer progression and progression-free survival (PFS).

Methods: This is a single-center retrospective review exploring cancer outcomes in patients taking ICIs who developed gastrointestinal irAEs within 1 year of ICI initiation. Cancer outcome and progression free survival (PFS) were measured and …

Rare Genetic Variants Associated With Sudden Cardiac Arrest In The Young: A Prospective, Population-Based Study, Audrey Uy-Evanado, Vipin K Menon, Bing Yu, Eric Boerwinkle, Sumeet S Chugh, Zeynep Akdemir, Evan P Kransdorf

Faculty, Staff and Student Publications

No abstract provided.

The Importance Of Acculturation Orientation In Understaanding The Impact Of Pre- And Post-Migration Stressors On Behavioral Health: Evidence From A Crisis Migrant Sample, Eric C Brown, Seth J Schwartz

Faculty, Staff and Student Publications

OBJECTIVE: We examine the interplay of acculturation orientation, cultural stress, and hurricane trauma exposure with behavioral health among Puerto Rican crisis migrants who relocated to the US mainland after Hurricane Maria.

METHOD: Participants were 319 adult (Mage = 39 years; 71% female; 90% arriving in 2017-2018) Hurricane Maria survivors surveyed on the US mainland. Latent profile analysis was used to model acculturation subtypes. In turn, ordinary least squares regression was executed to examine the associations of cultural stress and hurricane trauma exposure with behavioral health while stratifying by acculturation subtype.

RESULTS: Five acculturation orientation subtypes were modeled, three of which-Separated …

T-Cell Receptor Beta Variable Gene Polymorphism Predicts Immune-Related Adverse Events During Checkpoint Blockade Immunotherapy, Jeffrey M Conroy, Mingxuan Xu, Abdulrazzak Zarifa, Sapna P Patel, Ying Yuan, Evan Kwiatkowski, Linghua Wang, Jordi Rodon Ahnert, Siqing Fu, Funda Meric-Bernstam, Geoffrey M Lowman, Timothy Looney, Aung Naing

Faculty, Staff and Student Publications

BACKGROUND: Immune checkpoint inhibitors have revolutionized cancer treatment. However, they are associated with a unique spectrum of side effects, called immune-related adverse events (irAEs), which can cause significant morbidity and quickly progress to severe or life-threatening events if not treated promptly. Identifying predictive biomarkers for irAEs before immunotherapy initiation is therefore a critical area of research. Polymorphisms within the T-cell receptor beta (TCRB) variable (TRBV) gene have been implicated in autoimmune disease and may be mechanistically linked to irAEs. However, the repetitive nature of the TCRB locus and incomplete genome assembly has hampered the evaluation of TRBV polymorphisms in the …

Ancestral Diversity In Lipoprotein(A) Studies Helps Address Evidence Gaps, Anna F Ballou, Adolfo Correa, Paul S De Vries, Zhaohui Du, Christopher R Gignoux, Penny Gordon-Larsen, Xiuqing Guo, Jeffrey Haessler, Annie Green Howard, Yao Hu, Helina Kassahun, Shia T Kent, J Antonio G Lopez, Keri L Monda, Kari E North, Ulrike Peters, Michael H Preuss, Stephen S Rich, Jie Yao, Rina Yarosh, Michael Y Tsai, Jerome I Rotter, Charles L Kooperberg, Ruth J F Loos, Christie Ballantyne, Christy L Avery, Mariaelisa Graff

Faculty, Staff and Student Publications

INTRODUCTION: The independent and causal cardiovascular disease risk factor lipoprotein(a) (Lp(a)) is elevated in >1.5 billion individuals worldwide, but studies have prioritised European populations.

METHODS: Here, we examined how ancestrally diverse studies could clarify Lp(a)'s genetic architecture, inform efforts examining application of Lp(a) polygenic risk scores (PRS), enable causal inference and identify unexpected Lp(a) phenotypic effects using data from African (n=25 208), East Asian (n=2895), European (n=362 558), South Asian (n=8192) and Hispanic/Latino (n=8946) populations.

RESULTS: Fourteen genome-wide significant loci with numerous population specific signals of large effect were identified that enabled construction of Lp(a) PRS of moderate (R

CONCLUSIONS: …

Polypharmacy And Prescription Medication Use In A Population-Based Sample Of Adolescent And Young Adult Cancer Survivors, Christine Markham

Faculty, Staff and Student Publications

PURPOSE: We examined prescription medication use and identified correlates of polypharmacy-taking multiple medications-in adolescent and young adult cancer survivors (AYAs), who experience early-onset chronic conditions.

METHODS: Our cross-sectional study pooled data (2008-2017) from the national Medical Expenditure Panel Survey. We estimated prevalence of polypharmacy (≥ 5 unique prescription medications over an approximate 1-year period) in AYAs (age 18-39 years with a history of cancer) and age- and sex-matched controls, overall and by sociodemographics, clinical factors, and health indicators. We compared survivors' and controls' medication use across therapeutic classes. To identify correlates of polypharmacy among AYAs, we included factors with p …

An Updated Report On The Prevalence Of Prior Cancer Among Persons Newly Diagnosed With Cancer In The Surveillance, Epidemiology, And End Results Program

Faculty, Staff and Student Publications

This cohort study uses population-based data from the National Cancer Institute Surveillance, Epidemiology, and End Results program of cancer registries to estimate prevalence of prior cancer among adults diagnosed with an incident cancer in 2019.