Medicine and Health Sciences Commons^™

Increasing Implementation Of The Comfortable Cafeteria Program To Promote School-Age Children’S Mental Health And Well-Being, Reinecka Mondesir, Angela Labrie Blackwell Phd, Otr

Summer 2025 OTD Capstone Symposium

Every Moment Counts (EMC) is a positive mental health promotion initiative that offers several initiatives to create inclusive environments that support student participation and emotional well-being throughout the school day. Comfortable Cafeteria, part of EMC, fosters positive mealtime experiences supporting peer interaction, emotional regulation, and inclusion. Many SBOT practitioners lack the resources to implement Comfortable Cafeteria, despite its benefits. This capstone project addresses the need for practical tools to help school-based occupational therapy (SBOT) practitioners integrate the Comfortable Cafeteria program into daily practice. Using the Multi-Tiered System of Supports (MTSS) framework, the project developed and disseminated an interactive, evidence-based video …

Addressing Psychosocial Barriers To Participation In People Experiencing Homelessness: An Occupational Therapy Workshop, Preston Bender, Steven M. Gerardi, Lacey Spark

Summer 2025 OTD Capstone Symposium

Despite the occupational therapy (OT) profession's emphasis on holistic, person-centered care, many OT practitioners and students report feeling a lack of self-efficacy and preparedness to navigate the complex psychological, social, and systemic barriers that hinder occupational participation in people experiencing homelessness (PEH). This capstone project aimed to address the perceived unpreparedness among clinicians through the creation of an 8-hour interactive educational workshop aligned with Experiential Learning Theory. The content is grounded in the Model of Human Occupation (MOHO) and informed by the Bridging the Transition from Homelessness: A Social Justice Framework (BTTF), trauma-informed care (TIC), harm reduction, and diversity, equity, …

Caregiver Training Program For Optimal Recovery Of Neuro Accidents: An Occupational Therapy Approach, Bennie L. Huitt Jr., Jennifer Featheringham, Cassandra Nelson

Summer 2025 OTD Capstone Symposium

Caregivers of individuals recovering from stroke, traumatic brain injury (TBI), or experiencing onset of dementia often are provided limited education and support after discharge, negatively impacting confidence and recovery outcomes. The Caremaster program was designed to bridge the educational gap between occupational therapists in the clinical setting and caregivers in the home settings through accessible online modules, support groups, and in-person demonstrations. Module topics included understanding neuro accidents and role of the caregiver, returning home (transition and adaptation), ADLs and Mobility, returning to roles, and social reintegration. This program aims to guide future development of scalable, community-based caregiver education that …

Differential Mirna Expressions Linking Environmental Risk Factors To Triple-Negative Breast Cancer Stages At Diagnosis, Amjila Bam, Yawen Hu, Xiaocheng Wu, Meng Luo, Nubaira Rizvi, Luis Del Valle, Arnold H. Zea, Fokhrul Hossain, Denise Moore Danos, Jovanny Zabaleta, Augusto Ochoa, Lucio Miele, Edward Trapido, Qingzhao Yu

School of Public Health Faculty Publications

Background/Objectives: Triple negative breast cancer (TNBC) is an aggressive, molecularly heterogeneous subtype of breast cancer, accounting for approximately 10–15% of all cases. While reproductive and metabolic factors contribute to breast cancer development, growing concerns about environmental exposures, alongside biological and socio-cultural influences, underscore the need for targeted prevention strategies across diverse populations. Despite increasing evidence linking biological, socioeconomic, and environmental factors to TNBC outcomes, the molecular mechanisms underlying these relationships remain poorly understood. Micro-RNAs (miRNAs), which regulate gene expression and play critical roles in cancer development, have emerged as potential mediators between environmental exposures and TNBC progression. The goal of …

Enhancing Client Intake Efficiency In The Removal Defense Program: A Nursing-Led Quality Improvement Initiative, Johnny Linares, Julia Tran Ngo, Daniel Orea, Atheana Yadira Lopez

Master's Projects and Capstones

This quality improvement project focuses on optimizing the intake process for the Removal Defense Program at a nonprofit immigration legal office serving asylum-seeking clients. The existing intake relied on unstructured, phone-call-based intake interviews that gathered incomplete information, leading to inconsistent documentation, reduced efficiency, and significant client processing delays. A structured, multilingual, and multiplatform new-client admission protocol coupled with the implementation of a client-facing resource guide for waitlist clients were co-developed and implemented using the Lippitt Change Theory framework. Utilizing a mixed methods approach, the study involved staff interviews and observational assessments with staff members from the program. Baseline intake process …

Associations Between Social Drivers Of Health And Breast Cancer Stage At Diagnosis Among U.S. Black Women, Mollie Barnard, Bo Qin, Marc Emerson, Etienne Holder, Matthew Dunn, Shromona Sarkar, Nuo Xu, Yutong Li, Christine Ambrosone, Elisa Bandera, Julie Palmer, Melissa Troester, Terry Hyslop

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

U.S. Black women have disproportionately high breast cancer mortality, partly due to later-stage diagnoses. We examined how social drivers of health (SDOH) relate to stage at diagnosis by analyzing data from 4,995 breast cancer survivors in the Black Women's Health Study, Carolina Breast Cancer Study, and Women's Circle of Health Studies. SDOH were self-reported and stage was ascertained from medical records. We used polytomous logistic regression to estimate odds ratios (ORs) for diagnosis at stages III/IV or II versus stage I (referent), adjusting for age, insurance status, and income. Meta-analyzed results indicated that underutilization of screening mammography (OR = 3.21, …

Rebounds Reconsidered: Exploring Perceived Causes And Consequences Of People's Beliefs About Rebound Relationships, Hunter Krampe

All-Inclusive List of Electronic Theses and Dissertations

Romantic breakups are common and can significantly impact emotional well-being. Many individuals enter rebound relationships despite the prevailing belief that these relationships are disingenuous or unhealthy. While limited empirical research exists, some studies suggest rebound relationships may have positive effects, contradicting common advice. This study examined perceptions of rebound relationships, assessing whether individuals who entered a new relationship shortly after a breakup (3 weeks) were perceived more negatively than those who waited longer (3 months). Using a 2x2 experimental design, participants rated targets on emotional state, personality traits, and expected relationship stability. Results indicated that rebounders were not perceived as …

Intergenerational Family Dynamics Among Caregivers And Children’S Social-Emotional Development In China, Weiman Xu

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The early years of a child’s life are pivotal for social-emotional development. While extensive research has explored the role of family settings in fostering children's social-emotional development (Bornstein, 2005), the impact of grandparental involvement, particularly the caregiving dynamics between generations, remains less well understood. This study aims to fill this gap by examining two critical aspects of intergenerational dynamics among caregivers (i.e. parent-grandparent coparenting and parent-grandparent relationship quality) and their associations with children’s social-emotional development (i.e. social skills and problem behaviors). Two specific aims were delineated: 1) examine the unique contribution of parent-grandparent coparenting, especially the power and authority domain …

Adolescent Online Leisure, Media Literacy, Online Victimization, And Multifaceted Well-Being During Covid-19: The Role Of Parental Support, Yunqi Wang

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The rapid advancement of the internet and digital technology has provided opportunities for adolescents to conduct leisure activities online on a daily basis. However, research on adolescent technology use and mental health often highlights negative effects without carefully examining the specific mechanisms, which overlooks the complexity of effects of online behaviors on adolescent well-being and the importance of developing adolescents’ media literacy skills. Moreover, despite the crucial role of family dynamics in adolescent development, research on how parental support and involvement might affect adolescent technology use and well-being is still limited. The current study retrieved data from Programme for International …

Hormonal Modulation Of Sexual Approach And Avoidance Among Women With A History Of Sexual Trauma, Anneliis Susan Sartin-Tarm

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

A history of sexual trauma places women at a high risk for sexual dysfunction and other health sequelae, yet the influence of ovarian hormones in this population is poorly understood. This dissertation tested the theory that the effects of ovarian hormones are mediated by cognitive approach-avoidance systems to shape sexual well-being, and that this process is moderated by sexual trauma history. This was investigated across three studies examining the menstrual cycle, hormonal contraceptive use, and menopause. Across each chapter, I present complementary evidence demonstrating that hormones interact with the interpretation of ambiguous internal and external cues with respect to sexual …

Chronic Pain After Traumatic Brain Injury: Treatment Experiences And Effects On Cognition And Functioning, Rachael L. Snyder

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Traumatic brain injury (TBI) can contribute to changes in cognitive and emotional functioning, quality of life, and psychosocial reintegration. Chronic pain is a common consequence of TBI which can uniquely impact such outcomes. Still, the exact nature of the contribution of pain on post-TBI outcomes remains unclear, and there are few existing studies exploring the treatment journey for chronic pain and injury rehabilitation through qualitative methods, specifically individual interviews with TBI survivors. This study aimed to document these narratives and to identify precisely how the experiences of TBI survivors seeking treatments, rather than the treatments themselves, impact outcomes. It also …

Resilience Of Interdependent Transportation And Healthcare Systems: A Simulation-Driven Framework Incorporating Social Equity And Facility Optimization, S. Yasaman Ahmadi

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The overarching goal of this dissertation is to develop an integrated, simulation-driven framework to assess and enhance the resilience of interdependent transportation and healthcare systems before, during, and after natural hazards. By examining how spatial disruptions, social vulnerability, operational constraints, and infrastructure interdependencies affect access to and functionality of hospitals, this research offers a multifaceted evaluation of system performance under stress. This dissertation examines the impact of natural hazards, particularly floods, on the interdependent transportation and healthcare systems. The proposed approach combines and advances GIS-based network analysis, graph-theoretical modeling, and discrete-event simulation to evaluate system performance under different scenarios. The …

“Self-Compassion Has To Be The Heartbeat Of How I Move Through Life”: A Mixed Methods Study Of Family Caregiver Emotional Well-Being, Sarah O. Rasby

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Often referred to as “hidden patients,” family caregivers endure numerous physical, emotional, psychological, and social hardships due to the demands of caregiving, which often results in their own needs going unmet. With the projected 61.3 million of the baby boomer generation entering the long-term care phase by 2029 along with a mass shortage of professional caregivers post-pandemic, more and more family members are expected to fill in for the role of care without sufficient access to support services (Pollard & Scommegna, 2014; Smith & Chang, 2016). An exploratory, mixed-methods study using a three-group intervention design was utilized to investigate the …

Experiences Of Disclosure Among Transgender And Gender Diverse Sexual Assault Survivors, Merle E. Huff Ii

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Around half of TGD people have experienced sexual assault victimization (Abern et al., 2023; Clements-Nolle et al., 2006; James et al., 2016; Martin et al., 2022; Risser et al., 2005; Stotzer, 2009), which leads to higher rates of depression and PTSD (Grant et al., 2011; Grocott et al., 2023; Fernández-Rouco et al., 2017; Hawkey et al., 2021; Matsuzaka & Koch, 2019; Parr, 2020; Ussher et al., 2020). Disclosure of victimization may be important among TGD survivors. The current study was guided by minority stress theory (Meyer, 2003) and the gender minority stress and resiliency model (Testa et al., 2015) to …

The Connection Between Workplace Wellness Activities And Job Satisfaction In Manufacturing, Lori Scott Dreiling

Graduate Theses and Dissertations

Employers in all industries are concerned with creating and maintaining a workplace where their employees are engaged in their work. Job dissatisfaction is shown to lead to higher levels of turnover, absenteeism, and presenteeism. The purpose of this quantitative study will be to examine the connection between workplace wellness activity participation and job satisfaction, specifically for manufacturers in Southwest Missouri, Southeast Kansas, and Northeast Oklahoma. Manufacturers have experienced increased global competition in the last three decades, not just for their products or services but for quality talent. The value of this study is to show manufacturing employers that by providing …

The Associations Of Childhood Adversities And Mental Disorders With Suicidal Thoughts And Behaviors - Results From The World Mental Health International College Student Initiative, Philippe Mortier, Xue Yang, Yasmin Altwaijri, Jacob Holdcraft, Nancy Sampson, Yesica Albor, Ahmad Alhadi, Jordi Alonso, Nouf Al-Saud, Lukoye Atwoli

Internal Medicine, East Africa

Objective: To investigate the associations of demographic variables, childhood adversities (CAs), and mental disorders (MDx) with onset, transition, and persistence of suicidal thoughts and behaviors (STB) among first-year university students.

Method: Poisson regression models within a discrete-time survival framework were constructed using web-based self-report survey data from 72,288 incoming university students across 18 countries (response rate=20.9%; median age=19 years, 57.9% female, 1.4% transgender, 21.0% non-heterosexual). These models examined the associations of four demographic variables, five CAs, and eight MDx with STB outcomes.

Results: Lifetime prevalence of suicidal ideation, plans, and attempts was 47.0%, 26.0%, and 9.6%, respectively; 12-month estimates were …

Supporting Autistic Students' Mental Wellness: A Community Readiness Model Approach, Cady Walker

Capstone Experience: Master of Public Health

Autism spectrum disorder or difference (ASD) is a lifelong neurodevelopmental disability, usually identified during childhood. However, many adults miss the opportunity for diagnosis during childhood due to previous misunderstandings about autism presentation, camouflaging behaviors, and misdiagnoses. While current diagnostic tools for assessing autism in children are more robust, similar measures are lacking for adults who were not diagnosed in childhood. This gap poses risks for poor mental health outcomes among adults who missed a timely ASD diagnosis, which can be especially challenging for autistic college students. Although some higher education institutions offer support programs for autistic students, most do not, …

Will There Be A Pill For That? ‘Money Dysmorphia’ And The Medicalization Of Struggles For Subsistence, Bojan Savic

Emancipations: A Journal of Critical Social Analysis

This article questions the rationality, operation, and effects of money dysmorphia as an emerging mental health diagnosis. It critiques the medicalization of financial angst amid the capitalist “polycrisis”, showing how the individuation and somatic pathologization of class subordination, socioeconomic precarity, and struggles for subsistence obscure capitalist inequalities, depoliticize them, and shield them from critique. I identify five concurrent strategies through which struggles for subsistence are medicalized: trivialization, reversal of social import, repetition, direct depoliticization, and the substitution of inequality with poverty. Furthermore, I show how the medicalizing discourse reifies money dysmorphia by constructing its social costs. The article concludes by …

Inequality And Covid Risk At School: Racial Disparities In Indoor Density, Vaccination Rates, And Consequences For Absenteeism, Michael C. Quinn, Michah W. Rothbart, Amy Ellen Schwartz, Brian Elbel

Center for Policy Research

During the COVID pandemic, schools were widely believed to be a venue that facilitated disease transmission. While some worried Black and Hispanic students would disproportionately face greater risk of COVID exposure at school (school COVID risk) – given well-documented racially disparate school environments and resources – little empirical evidence exists documenting or refuting potential disparities in school COVID risk. This paper begins to fill this gap by examining racial disparities in the school environments that contribute to COVID risk at school—specifically, vaccination rates and classroom space per pupil (indoor density) - in New York City elementary schools. We then document …

Temporal And Generational Changes In Depression Among Young American Adults, Ashley W. Kranjac, Dinko Kranjac, Valentine Chung

Sociology Faculty Articles and Research

The prevalence of depression among young American adults has risen significantly over the past two decades, but the mechanisms that underlie the population-level changes in depressive symptoms severity remain unclear. We used data from the 2005–2023 National Health and Nutrition Examination Survey (NHANES) and hierarchical age–period–cohort (HAPC) analysis to examine developmental (i.e., age), life stage (i.e., period), and generational (i.e., cohort) distribution of depressive symptoms among American adults aged 20–30 years old over an 18-year period. Our model results indicate that the probability of either mild, moderate, or severe depression increased among young adult females and males between 2005 and …

A Cancer Education Needs Assessment: Informing Middle-Aged Female Patients About The Relationships Between Obesity And Women’S Health Concerns In The Reproductive System, Breast, And Endometrial Health, Batul Mirza

MUSC Theses and Dissertations

Obesity significantly impacts women’s health, particularly among middle-aged women, by increasing the risk of hormone-sensitive cancers such as breast, endometrial, and reproductive system cancers. This study examines the educational needs of this demographic group regarding obesity-related cancer risks and explores effective intervention strategies. Obesity-induced mechanisms – hormonal imbalances, chronic inflammation, and insulin resistance – drive cancer susceptibility, emphasizing the need for targeted health education. The study employs a qualitative design, which includes interviews with subject matter experts (SMEs) and surveys of middle-aged women. The goal is to assess awareness, perceived barriers, and preferred learning methods. Findings suggest that with many …

The Perception Of Ai Impact Of Academic Processes: A Study Of Student Perspectives, Nora Murphy, Lana Perkovic, Andzelika Wyka

International Undergraduate Journal of Health Sciences

Artificial Intelligence (AI) has emerged as a transformative technology with the potential to revolutionise education. This research aimed to comprehensively explore students’ perspectives on the integration of AI in educational settings, focusing on understanding its role, advantages, challenges, and expectations. The study analysed responses from a sixteen-question survey created through Google Forms administered online to 196 students from diverse academic backgrounds and educational levels enrolled across two Cork third-level institutions.

The demographic distribution of the respondents showed 44.4% aged 18-20 years old, 43.9% aged 21-23 years old, and 11.7% aged 24 and above, with 67.9% female respondents and 32.1% males. …

Assessing The Lgbtq+ Beliefs, Behaviors, And Competency Of Nutrition Professionals: A Mixed-Methods Study, Anthony Dissen, Christina Riccardo, Liam Oliver Lair

Journal of Dietetic Education

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals often experience disproportionate levels of physical and mental health issues including nutrition-specific issues such as eating disorders, body dysmorphia, and food insecurity related to psychological distress from discrimination and stigmatization. This study sought to understand nutrition professionals’ LGBTQ+ competence, beliefs, and behaviors. Researchers distributed 2 data collection tools to registered dietitian nutritionists (RDNs): the Gay Affirmative Practice Scale (GAP-Scale) and the LGBT Competency Assessment Tool (LGBT-CAT). Data from the GAP-Scale were numerically scored using a 5-point Likert scale, and data from LGBT-CAT were scored on a scale of 0 to 3 points. …

Qualitative Insights Into Drug Use Safety Strategies And Social Support Among Sexual Minority Women Who Inject Drugs In Baltimore, Maryland, Jennifer L. Glick, Leanne Zhang, Aimee Huang, Megan Nguyen, Danielle German

School of Public Health Faculty Publications

Background: Sexual minority women (SMW) experience higher rates of substance use relative to heterosexual women in the U.S. but remain an under-studied population. SMW who inject drugs (SMWWID) navigate an unpredictable drug market and may experience complex relationships within their social spheres. We explore cisgender SMWWID’s strategies to maintain safety while injecting drugs, and the influence of their social support systems on those strategies. Methods: We conducted N = 16 phone-based, semi-structured, in-depth interviews with SMWWID in Baltimore, Maryland between June-October 2021. The interviews explored participants’ sexual orientation and gender identities, social networks and support systems, drug use behaviors and …

Co-Design Of A Program For Medical Students’ Experiential Learning In Community-Engaged Research, Daenique H. A. Jengelley, Tess D. Weathers, Dustin O. Lynch, Morgan E. Ness, Luis Garcia, Gina E. Claxton, J. Dennis Fortenberry, Tamara S. Hannon

Journal of Community Engagement and Higher Education

Medical education may lack experiential training on authentic community engagement (CE). Employing a human-centered design approach with medical faculty and students to identify goals, opportunities, needs, and barriers to implementing CE research, we developed an Experiential Community Engagement Learning Series (EXCELS) pilot program. EXCELS supported both our community partners and medical students as a platform from which to learn from each other. EXCELS can be accomplished virtually, incorporated in medical training, and disseminated broadly.

Feasibility Of A Peer-Facilitated Video-Based Mental Health And Substance Use Service-Learning Program, Mara Carmina A. Tamayo, King Filart, Maria Regina Hechanova

Journal of Community Engagement and Higher Education

This study examined the feasibility of implementing a peer-facilitated mental health and substance use video-based program delivered by psychology students as part of service learning. The program was delivered on-site and online. Findings reveal improvements in knowledge, attitudes, refusal self-efficacy, and adaptive coping among on-site participants. However, there was no effect on online participants given many implementation challenges. Recommendations include delivering the program on-site, strengthening training for facilitators, increasing program duration, and shortening the videos.

Teaching About Substance Use Recovery: The Pedagogical Power Of Community-Based Learning, Jumi Hayaki, Isabelle Jenkins

Journal of Community Engagement and Higher Education

Community-based learning (CBL) is a form of experiential learning that integrates academic theory and content with active service in an applied setting. CBL is especially well suited for teaching about complex social issues. We present the case study of a psychology course on substance use recovery that leverages CBL to dismantle stereotypes, humanize a highly stigmatized mental health problem facing society, and afford students the opportunity to consider their own privilege and positionality.

Impact Of Race On Admission, Clinical Outcomes, And Disposition In Cholangiocarcinoma: Insights From The National Inpatient Database, Tijin A. Mathew, Teresa M. Varghese, Nithya Krishnakumaran, George M. Varghese, Khwaja S. Haq, Akshita Khosla, Rojymon Jacob, Gina Vaccaro

School of Medicine Faculty Publications

BACKGROUND: Cholangiocarcinoma, malignancies arising from the intrahepatic and extrahepatic bile ducts, has increased in incidence in the United States over the past few decades. The reported incidence of cholangiocarcinomas is high, particularly in specific racial groups such as Asian and Pacific Islander patients. Race also significantly impacts disparities in healthcare utilization and clinical outcomes. Our study focused on the impact of race on admission, clinical outcomes, and disposition of cholangiocarcinoma. METHODS: We performed a retrospective analysis of cholangiocarcinoma-related hospital admissions, using the National Inpatient Sample for the year 2022. Patients were stratified according to race into the following groups: White, …

Community Engagement In Music Therapy: Reflections From The Field, Jess Rushing, Denise M. Cumberland

Journal of Community Engagement and Higher Education

This paper reflects on a music therapy community engagement project that incorporates clinical training, service learning, and community music therapy. Two faculty members and a practicum student in a Midwestern university engaged community members connected to Parkinson’s disease to create a music-based program. We offer a conceptual framework that connects approaches situated within community music therapy (CoMT) qualities and community-based participatory research (CBPR) principles. We share project processes, findings, and recommendations, emphasizing all as equal stakeholders.

Positively Impacting Traffic Safety Culture For Indigenous Youth: A Heritage-Focused Approach, Jacob Steven Pehrson, Ahmed Abdel-Rahim, Logan Prescott

Journal of Community Engagement and Higher Education

This paper presents the development of heritage-focused outreach materials with the objectives of positively impacting traffic safety culture for Indigenous youth to reduce the number and severity of traffic crashes impacting these communities. The approach presented in this paper includes involving local community leaders in traffic safety education and incorporating culturally based material in outreach education. This could empower Tribal communities to preserve their cultural identities while acquiring the expertise needed to promote traffic safety.