Medicine and Health Sciences Commons^™

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 …

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 …

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 …

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 …

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 …

Trends In Childhood Elevated Blood Lead Levels In Nebraska, 2013 – 2017, Ellana Haakenstad

Capstone Experience

This project explored the exposure to lead among children in Nebraska. Using the Nebraska Department of Health and Human Services’ Blood Lead Level database, trends were investigated in screening; demographics; incidence; and prevalence of elevated blood lead levels, statewide and by census tract. The study further explored the geography of lead exposure and elevated blood lead level cases with maps. Based on these results, policy recommendations were made to the Nebraska Department of Health and Human Services’ Childhood Lead Poisoning Prevention Program, particularly about areas of Nebraska with high risk of lead incidence and exposure risk where testing should be …

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. …

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) …

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 …

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.

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. …

Characterization Of Cancer Incidence In Chronic Kidney Disease Patients: A Single Center Study, 2008 – 2018, Jagadeesh Puvvula

Capstone Experience

Background: Chronic kidney disease (CKD) is an established risk factor for cardiovascular disease, but the significance of lower Glomerular filtration rate on incidence and mortality from cancer is uncertain. There is evidence that cancer risk and cancer mortality may be increased in individuals with End Stage Renal Disease (ESRD) requiring dialysis or after renal transplantation but whether less severe kidney disease is associated with cancer remains poorly understood.

Some studies indicate that these associations do appear to be organ specific. It has been reported that reduced renal function is associated with an increased risk of cancers of the kidney and …

Association Of Adverse Birth Outcomes With Maternal Exposure To Nitrate In Private Well Drinking Water: An Action Plan For Prevention, Jessyka R. Johnson

Capstone Experience

Abstract

Goal: The goal of the capstone project is to collect information required to develop an action plan focusing on minimizing exposure to nitrate in pregnant women, which, if implemented, can either prevent or reduce adverse health outcomes associated with nitrate exposure in utero.

Objective: The capstone project objective is to gain a better understanding of what programs to prevent exposure to nitrate from private well drinking water in pregnant women are already in place throughout the United States; to identify any areas of improvement in these programs; and to utilize this information to create a unique action plan in …

Examining The Impact Of Hiv Medical And Social Case Management Program On Viral Load For Clients Living With Hiv/Aids In Nebraska, Abdulla Munir

Capstone Experience

Abstract

Case management (CM) is one of the standard practices that has been implemented since 1990 to help people living with HIV/AIDS (PLWHA) in the United States. The program is designed for low-income populations and it aims to address the barriers related to access to health care and improve the HIV outcomes. Previous studies identified a positive association with the provision of CM and improvement in viral outcomes. Increasing the viral suppression rates among HIV diagnosed individuals proved to reduce the risk of transmitting the infection, and disease incidence. Although CM program is provided to Nebraskans diagnosed with HIV, but …

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. …

Protecting And Serving Yourself: The Mental Health Of Police Officers In Kaukauna, Wisconsin, Caina Weiner

Capstone Experience

The service learning hours performed at the Kaukauna Police Department served as a valuable learning experience to better understand an organization that is involved in public health. Although some may view this as non-traditional, the police department is quite involved in the community’s health. They work closely with public health officials and are also involved in certain public health programs, such as drug and alcohol programs. The health of a police officer must also be considered as a public health topic. A police officer is part of a vulnerable population of individuals that are “first responders.” These individuals are at …

Perspectives, Challenges, And Oral Cancer Screening Practices Of Primary Care Providers At Nebraska Medicine, Nishitha Ponnamaneni

Capstone Experience

Background

High mortality and morbidity associated with oropharyngeal cancer (OPC) are due to delayed diagnosis. Early detection of OPC is possible by incorporating oral cancer screening (OCS) in the annual screening examination protocol of primary care providers (PCPs). The study was aimed to understand the perspectives and barriers of PCPs in screening their patients for OPC.

Objectives

1) To understand challenges PCPs’ face in performing OCS, 2) To determine the factors that influence PCPs’ decision to complete OCS, and 3) To determine if PCPs who received education on OCS are more likely to perform the screening compared to PCPs who …

Evaluating And Increasing Lead Poisoning Prevention Awareness In The Refugee Population Of Douglas County, Ne, Kara Albright

Capstone Experience

Background: Lead poisoning is a major public health concern. It accounted for twelve percent of the global burden for intellectual disabilities, and two and a half percent of the global burden for heart disease and stroke, as well as nearly 500,000 deaths in 2015 (World Health Organization, 2018). While everyone is at risk of lead exposure, refugee and immigrant children are at an increased risk because they have increased access and use of products from outside the United States that have been shown to contain lead (Moser, R., and Brownback, S., 2012; and New York State Department of Health, …

Health Professional Treatment Practices For Pediatric Sickle Cell Disease In Nigeria, Natalie Wichelt

Capstone Experience

Abstract

Sickle cell disease (SCD) is caused by a genetic defect that results in abnormal hemoglobin genes that can cause devastating health effects like chronic hemolytic anemia and vaso-occlusive crises. Additionally, sickle cell disease can cause defects in the immune system, leaving those with the disease highly susceptible to a variety of different infections. In the pediatric population specifically, the complications of sickle cell disease contribute significantly to the under-five mortality rate of Nigeria. In response to the Millennium Development Goals 4, 5 and 6, as well as with growing national concern over the challenges faced by sickle cell disease …

Equity Of Care Analysis At Chi Health Hospitals And Clinics In The Omaha Metro Area., Lindsey Cork

Capstone Experience

The goal of the project is to identify if health disparities exist between patient groups based on race, ethnicity, language, payer type, and location of residence who received healthcare services from CHI Health system in the Omaha Metro area during January 2017 – March 2018. The health outcomes of interest are HPV vaccination rates, diabetes control rates, breast cancer screening rates, colorectal cancer screening rates, and 30-day hospital readmissions. Patient data from six Omaha area clinics and five hospitals was analyze in this study.

Among the six CHI Health clinics in this study, Lakeside had the highest rates of A1c …

A Characterization Of The Medical-Legal Partnership (Mlp) Of Nebraska Medicine, Jordan Pieper

Capstone Experience

This research study was completed at Legal Aid of Nebraska’s Health, Education, and Law Project through the partnership it has formed working with Nebraska Medicine and Iowa Legal Aid. Traditionally, health and disease have always been viewed exclusively as "healthcare" issues. But with healthcare consistently growing towards holistic approaches to help patients, we now know there are deeper, structural conditions of society that can act as strong driving forces of a person's poor daily living conditions that can negatively impact health. The importance of a Medical-Legal Partnership is that it considers a patient's social determinants of health (SDHs). The goal …

Title X Family Planning Secondary Data Analysis Needs Assessment, Laura Triplett

Capstone Experience

The goal of the Title X Needs Assessment is to ‘Provide individuals the information and means to exercise personal choice in determining the number and spacing of their children', prevent unintended pregnancies, and reduce the number of abortions.’ Objectives include but are not limited to family involvement, abstinence and safer sex practice, intimate partner violence, human trafficking, contraceptive services, pregnancy testing and counseling, achieving pregnancy, basic infertility services, preconception health, STI/STD testing and treatment and HIV testing, Well Women/Men Exams; screening for breast cancer, cervical cancer, and testicular cancer in males. Sexual health education and reproductive life planning will be …

Collaboration Between University Centers For Excellence In Developmental Disabilities (Ucedds) And Independent Living Networks, Sarah Swanson

Capstone Experience

In every state and U.S. Territory, there is a University Center for Developmental Disabilities (UCEDD), which is part of the state Developmental Disabilities network and an Independent Living (IL) Network, composed of Centers for Independent Living and Statewide Independent Living Councils. Each of these receive federal funding (and frequently state funding) to support people with disabilities and their families. However, each has different federal funding sources, different origins within federal legislation and different requirements. Through discussions with IL and UCEDD leadership it is clear that there are collaborations between the two, yet this is not widely recognized. This research proposal …

A Strategic Approach To Employee Retention At Nebraska Families Collaborative, Rachel Walters

Capstone Experience

Nebraska Families Collaborative (NFC) is a nonprofit organization that supports children and families who are at risk, in eastern Nebraska. They offer a variety of services with the goal of moving children toward safety, permanency and well-being. Organizations such as NFC rely heavily on the commitment of the employees to carry out their mission, as do many other non-profit social service agencies across the country. The overall goal of the project was to identify reasons for high turnover and to identify potential solutions to reduce turnover and increase retention in the workplace at NFC. The main objectives were to analyze …

Massage Therapy Intervention For Pediatric Palliative Care Patients And Their Families, Taelyr Weekly

Capstone Experience

This study examined the feasibility and acceptability of a massage therapy intervention for pediatric palliative care patients and their adult caregivers to reduce their symptom impact at an urban pediatric hospital in Omaha, NE. Potential symptoms to be impacted by massage included stress for caregivers and pain, nausea, dyspnea, and anxiety for children. One hundred and thirty five massages were delivered to patients and caregivers in the PICU, NICU, and the inpatient hospital floor during the course of this non-randomized, pre-post study. Validated instruments were used to collect objective data from patients and caregivers, while observations were used to record …

Student Moves: A Mixed Methods Cross- Sectional Study Of Elementary School- Based Physical Education In Omaha Public Schools, Ashley Carroll

Capstone Experience

Childhood obesity is one of the leading pediatric health problems and a major concern among Omaha metro parents (Professional Research Consultants, 2015). While there are many inter-related factors that contribute to the development of obesity, physical inactivity is a prominent risk factor. Targeting physical activity in health promotion is desirable for its feasibility and effectiveness in balancing energy consumption and expenditure (Hill, 2012). The Student Moves research project sought to inform school district and community strategies for promoting youth physical activity by assessing current physical education practices among a random sample of third- grade students in Omaha Public Schools. Variables …

Occupational Health Challenges In Research, Anthony Blake

Capstone Experience

ABSTRACT

Introduction: Employees working in universities and hospitals are faced with common and unique health and safety challenges. Usually, the campus Department of Health and Safety is tasked with reducing employee exposure through risk assessments. Purpose: In this study, we present a unique risk assessment case study related to a research project undertaken by the campus Department of Health and Safety (DHES). This project also describes the activities done by DHES to improve campus safety. We hypothesized that carbon monoxide, particulate matter, formaldehyde, and VOCs emitted from burning wood chips in a closed laboratory space will exceed …

Winnebago County Dryhootch Outreach Program, Greg Brittnacher

Capstone Experience

Abstract

Winnebago County Veterans Dryhootch Outreach Program

Aims: The Dryhootch Outreach Program focused on increasing behavioral activation through social interaction in a population of military veterans with Post Traumatic Stress Disorder (PTSD). The goals of the intervention were to reduce the prevalence of anxiety, depression, and PTSD symptoms. Additionally, the project aims to assist veterans to develop and maintain healthy relationships, assimilate with the “civilian” community, and effectively contribute to society.

Methods: Twenty-seven veterans with PTSD attended the twelve-week Dryhootch Outreach program provided by the Winnebago County Veterans Service office and partnering organizations. A pre-post interventional study format was utilized …

Hipaa Compliant Patient-Provider Communication: Student-Clinician Perceptions, Rachel Wenzl

Capstone Experience

Purpose: To evaluate the service learning clinical training facility’s HIPAA training by assessing student-clinician knowledge of the clinic’s HIPAA Compliance Plan and the impact of its training on student-clinician perceptions toward HIPAA-compliant patient-provider communication (PPC). For example, do student-clinicians feel it is important to be HIPAA-compliant and are they confident in discussing health-related activities and programs with patients or caregivers? The purpose of this project is not, at this time, to measure student-clinician intention to perform the behavior.

Methods: This project employed a mixed-methods, non-experimental cross-sectional study design using a retrospective post-test survey and group interview. The survey …

Matters Of Trust: Examination Of The Patient-Provider Relationship In Cancer Care, Krista A. Brown

Capstone Experience

Background: The intangible concept of trust is critical in the patient-provider relationship. Cancer patients may experience positive and negative impacts of trust in this relationship to a higher degree due to the inherently serious nature of their disease and the level of dependence upon treatment providers.

Objective: The goal of this study was to compare colorectal cancer patients’ levels of trust in their primary care physician and oncologist, along with examining trust differences associated with demographics and other characteristics.

Methods: Colorectal cancer patients (n=158) treated at Nebraska Medicine and consented into the Integrated Cancer Repository for Cancer Research IRB …