Medicine and Health Sciences Commons^™

Perceptions Of Voice Health, Voice Health Care, And Voice Health Education In The Performance Community, Katelyn Nelson

Capstone Experience

There is a medical consensus that proper voice health precautions can protect the voice and decrease the occurrence and severity of voice disorders in vocal performers. Similarly, seeking medical treatment for voice disorders can speed recovery time and preserve the voice. Voice disorders are common in performance students and professionals because of demanding curricula and frequent voice use, but little is known about their voice care needs, preferred voice care resources, and clinical care. The purpose of this study was to add to the research on voice health by interviewing faculty members in the College of Communication, Fine Arts, and …

A Preliminary Analysis Of Project Ag Aware: Sbirt In Agricultural Work Settings, Rachel L. Rutt

Capstone Experience

Background: An increasing number of individuals are being negatively affected by substance abuse in the U.S. and Nebraska communities. These communities are seeing immense increases in opioid prescribing rates, especially in rural areas. The aims of this study are to 1) describe the study population of agricultural workers in Nebraska; 2) estimate the prevalence of alcohol misuse, illegal drug use, and anxiety among agricultural workers in Nebraska; and 3) examine factors associated with alcohol misuse among agricultural workers in Nebraska.

Methods: Adult agricultural workers (N=1,206) completed a paper or online survey for Project Ag Aware. Alcohol misuse, illegal drug use, …

Agricultural Injuries Among Central State Region Operators Over A 5-Year Period: Cs-Cash Farm And Ranch Health And Injury Survey 2011-2015, Anthony Johnson Jr

Capstone Experience

Background The high risk of occupational fatalities in agriculture is well documented, but information on non-fatal injuries is lacking due to challenges in injury surveillance. This surveillance study explored the frequency, characteristics, and risk factors for non-fatal injuries among farmers and ranchers in the central United States.

Methods The Central States Center for Agricultural Safety and Health (CS-CASH), in collaboration with the USDA National Agricultural Statistics Service (NASS), conducted annual surveys (n=34,777 sent) during 2011-2015 covering a seven-state region (Iowa, Kansas, Minnesota, Missouri, North Dakota, Nebraska, and South Dakota).

Results The average response rate was 32% in the five consecutive …

A Qualitative Analysis Of Omaha Healthy Kids Alliance’S Client Educational Attainment, Shelby Larson

Capstone Experience

Housing and physical health are inextricably linked. Environmental hazards such as lead poisoning, radon, and mold negatively impact the health of a home’s occupants, particularly children. Omaha Healthy Kids Alliance (OHKA) was founded in 2006 to address these environmental hazards through education and construction interventions with the mission “to improve children’s health through healthy homes.” OHKA clients are primarily served through two direct service programs and are evaluated pre- and post-intervention for changes in educational attainment, behavioral outcomes, environmental characteristics, quality of life, and health. A program evaluation was conducted to 1) determine how OHKA clients utilize environmental education post-intervention, …

Non-Emergency Utilization Of Ems: Contributing Factors And Strategies To Promote Effective Care With Appropriate Resources, Jason Jones

Capstone Experience

Non-emergency use of EMS resources can impose a substantial burden on emergency response systems and the communities they serve by reducing the response capacity for time-sensitive and life-threatening situations and through the subsequent diversion of funding that could be used to more effectively address health disparities. National EMS response data suggest that a large proportion of EMS patient encounters are for non-emergent reasons. Despite being a nation-wide issue, inadequate research has been conducted to understand why non-emergency and frequent use occurs and what strategies may be effective in mitigating avoidable use. Community paramedicine (CP), an emerging specialty in EMS that …

Development Of A Web-Based Agriculture Health Risk Assessment Tool For Military Veteran Farmers And Ranchers, Alyssa Damke

Capstone Experience

In the U.S., significant health disparities exist among rural populations compared to their urban counterparts. These disparities can be compounded in agricultural workers due to the dangerous and unpredictable nature of their work. Agricultural producers who are also military Veterans may experience additional health pressures that are often overlooked in the healthcare setting. Over 2.5 million Veteran Health Administration (VHA) patients reside in rural areas and the healthcare infrastructure to care for these Veterans may not include an agricultural occupational approach. To address healthcare disparities in Veteran farmers and ranchers, this study, in collaboration with AgriSafe Network, will be used …

Effects Of Climate Change On The Epidemiology Of Flood-Related Waterborne Disease: A Systematic Literature Review, Sarah M. Cadarette

Capstone Experience

Natural disasters, such as flooding related to extreme precipitation, can lead to many adverse health effects (i.e. waterborne disease). Several outbreaks of waterborne disease have been linked to extreme precipitation, and gastrointestinal infection has been shown to increase after floods. Climate change is likely to lead to a higher frequency of waterborne disease through increases in extreme precipitation and associated flooding affecting water and sanitation infrastructure. This review sought to answer 2 research questions: 1. Has the epidemiology of waterborne disease related to floods changed over time? 2. Can this difference be related to climate change? A literature search was …

Developing A Program Evaluation Plan For Medicaid Prenatal Care Management Programs, Shardae Sims

Capstone Experience

Prenatal care management (PNCM) is an intervention that targets women during the perinatal period to improve birth outcomes. PNCM has the potential to address social determinants of health issues and gaps or barriers to care that could lower incidences of adverse birth outcomes in Nebraska. There is currently a gap in the literature for studies that fully assess the impact of prenatal care management programs and the program’s ability to reach set goals. The purpose of this research is to develop an evaluation plan and potential implementation strategies that can be utilized by the Medicaid PNCM program in Nebraska. The …

Developing A Rabies Prevention Program Based On Rabies Exposure Data In Nebraska, Jill Oatman

Capstone Experience

Eighty-nine percent of Nebraska’s towns are considered rural, with populations of less than 3,000 people and with many towns having less than 1,000 residents. Rural areas consist of crop ground, livestock facilities and regions inhabited by wildlife. Nebraska has two large urban cities, Lincoln and Omaha. Animal and human health in these communities can be greatly impacted by infectious diseases that are transmitted between animals and humans, known as zoonotic diseases. One zoonotic disease of great concern is rabies. Zoonotic diseases not only impact the health of animals and humans, but the social well-being of communities and result in increased …

Effect Of Climate Change On Lyme Disease Cases In 4 New Jersey Counties, Meredith Olson

Capstone Experience

Since its discovery more than 40 years ago, there has been an increasing occurrence of Lyme disease. Lyme disease is a tick-borne illness found predominantly in the Northeastern region of the United States. Studies have shown that environmental factors play an important role on the life cycle of ticks. Due to the complexity of environmental changes as well as the life cycle of different tick species, the variety of factors that could influence the increase in Lyme disease can be different depending on tick species and region. This study compared different regions of New Jersey, a highly Lyme disease endemic …

Developing A Community Innovation Grant In Response To Increasing Rural Critical Incidents In Agricultural Mental Health And Wellbeing, Community Trauma, And Natural Disasters, Chessa S. Quenzer

Capstone Experience

Spink Area Support Network (SASN) is a skilled team of community volunteers that facilitate rural critical incident response services in an effort to prevent a critical incident and offer structured support during the aftermath. SASN was developed in response to identified gaps in rural critical incident response and risk reduction through prevention in Spink County, South Dakota. SASN utilizes a collaborative team approach to fill in gaps between first responder silos and establish community interventions by providing support and resources while utilizing critical incident stress management methods. SASN requires funding to maintain response resources, training, prevention education, and follow-up services. …

Assessing Occupational Stress And Preparedness Among Campus Safety Officers And Dental School Employees At An Academic Medical Center During Covid-19, Decature Banker, Lorena Baccaglini, Miriam Mccann, Chandran Achutan

Capstone Experience

Job stress can lead to adverse physical and emotional health effects in employees and is worse during an emergency or pandemic. The complexity of the coronavirus disease 2019 (COVID-19) pandemic is taking a toll on the healthcare systems and their employees. This cross-sectional study looked at two different groups of academic medical center employees, Campus Safety Officers and Dental School employees, who’s work puts them at risk for COVID-19 exposure. We hypothesized that Campus Safety Officers and Dental School employees who felt adequately trained to conduct COVID-19 related work would not feel more stressed during the COVID-19 pandemic than they …

Evaluation Of The Humoral Immune Response As A Potential Indicator Of Disease Severity For Patients Hospitalized With Covid-19, Spencer Sterling

Capstone Experience

Members of the family Coronaviridae, including the severe acute respiratory syndrome coronaviruses (SARS-CoV-1 and SARS-CoV-2), Middle East respiratory syndrome coronavirus (MERS-CoV) and seasonal human coronaviruses (HCoV-HKU1and HCoV-OC43), are highly communicable respiratory viruses; SARS-CoV-1, SARS-CoV-2, and MERS can cause severe disease, while seasonal human coronaviruses present with mild to moderate illness. Coronavirus envelope spike (S) glycoproteins are involved in receptor binding and cell fusion, and are the primary target for a neutralizing humoral response. The S protein is comprised of the S₁ and S₂ subunits; the S₁ subunit contains the receptor-binding domain (RBD), while the S_{2 …}

Structural Magnetic Resonance Imaging As A Diagnostic Biomarker Of Hiv-Associated Neurocognitive Disorders (Hand), Mikki Schantell

Capstone Experience

Objective: The goal of this study was to do an exploratory analysis to determine if gray matter brain volumes and cortical thickness measures obtained from structural magnetic resonance imaging (sMRI) can discriminate people with HIV-associated neurocognitive disorders (HAND), neurocognitively unimpaired people with HIV (NU PWH), and HIV-negative controls (HIV- controls) using linear discriminant analyses.

Methods: A total of 231 participants, including 110 PWH and 121 HIV- controls, completed a neuropsychological (NP) battery and an sMRI protocol. The bilateral gray matter volumes and cortical thickness brain regions were analyzed using 18 linear discriminant models to assess the discriminability of gray matter …

Surgical Care Perspectives: Exploring Barriers And Facilitators To Surgery In Rural Nebraska, Sarah Stanislav

Capstone Experience

Background: Minimally invasive surgery (MIS) is associated with less pain, faster recovery, and lower complication rates. Despite being the standard of care, it remains underutilized in rural Nebraska. Surgeon shortages and limited studies describing patient and provider factors influencing treatment gaps contribute to unnecessary complications and healthcare expenditure. Our study aimed to understand rural surgical care barriers and facilitators encountered by patients, providers, and stakeholders in Nebraska. Methods: This exploratory mixed methods study involved 17 semi-structured interviews using a snowball sampling of eligible participants affiliated with an MIS Advisory Committee. Two coders analyzed data using NVivo12. A follow-up review of …

Planning A Culturally And Linguistically Appropriate Obesity Intervention For Hispanic/Latino Children Living In Rural Nebraska, Ada V. Luna

Capstone Experience

Childhood obesity is a public health concern in the U.S; however, for the Hispanic/Latino community these concerns have grown to epic proportions. In Nebraska, the rate of childhood obesity is 25.1%; among Hispanic / Latinos students, the obesity rate is 30.9%. Unfortunately, specific Nebraska obesity rates by race and ethnicity are limited among rural communities, and programs that can effectively address this problem in the Hispanic / Latino community are limited or non-existent. Consequently, disparities between urban and rural communities exist. The purpose of this capstone project is to design a culturally and linguistically oriented intervention to address childhood obesity …

The Association Of Demographic And Clinical Characteristics And Self-Reported Sleep Duration Among Patients With Prediabetes, Priyanka Chaudhary

Capstone Experience

Background: Sleep has been recognized as a critical component of healthy development and overall health. However, sleep duration has emerged as an important lifestyle factor that influences endocrine function and glucose metabolism. There remains a dearth of research to assess sleep duration among patients with prediabetes.

Objective: To evaluate the association between socio-demographic and clinical characteristics and self-reported sleep duration among patients with prediabetes.

Methods: Baseline data (n=599) was used from a diabetes prevention trial. A chi-square test was used to assess the differences between the groups of sleep duration for the categorical, whereas the t-test was used for the …

Prevalence Of Intimate Partner Violence Among The Maternal-Fetal Medicine Population, Sarah K. Larsen

Capstone Experience

Intimate partner violence (IPV) is increasingly understood as an important public health issue. It is well understood that intimate partner violence has many negative effects on its survivors ranging from physical to mental health conditions. The population of people who experience intimate partner violence and population of pregnant women are both vulnerable populations. Examining the two populations together demands a trauma-informed approach and an understanding of the intricacies of both pregnancy and intimate partner violence. While IPV has been studied among the pregnant population, intimate partner violence as it relates to the maternal fetal medicine (MFM) or high-risk pregnancy population …

A Review Of The Characteristics Of Super-Utilizers And Evidence-Based Approaches To Reduce Healthcare Utilization, Suswara Mandala Rayabandla

Capstone Experience

A significant fraction of health care resources in the United States of America is utilized by a comparatively small number of people. An examination of the attributes and patterns and associated evidence-based interventions for such high-utilizing patients might aid clinicians to improve interventions to address the distinctive needs of these patients, decrease their risks for numerous hospitalizations, and contribute to reducing the costs. This study aims at exploring the existing literature on the characteristics of super-utilizers and interventions to reduce avoidable use of health care among this population. The method used for this research is a comprehensive literature review. Search …

A Statewide Needs Assessment Of Perspectives On Training And Certification Of Community Health Workers In Nebraska, Jessica Ern

Capstone Experience

INTRODUCTION: Community Health Workers (CHWs) are a crucial growing component of the health care field in the U.S. According to the US Bureau of Statistics (2018), the CHW workforce is expected to grow 38% in the next ten years. While research has repeatedly shown the success of CHW-led programs and the financial benefits of CHWs, little work has been done to evaluate the training and certification preferences of CHWs in Nebraska. This project aimed to gather and analyze qualitative and quantitative data through an exploratory sequential mixed-methods approach to provide policy recommendations regarding the future training and potential certification of …

An Assessment Of Occupational Heat Stress In A Central Utility Plant, Abdoulaye Abdoulaziz

Capstone Experience

Global climate change has been declared a threat to human health, which includes occupational safety issues. As temperatures continue to increase, heat stress and heat-related illness are occupational safety issues that need to be better understood. Assessments of workplace heat exposures are key to implement appropriate health and safety interventions. This study attempted to assess whether workers’ perception of work environment temperature in a Central Utility Plant was associated with heat-stress prevention behaviors. Therefore, we used a questionnaire to collect Central Utility Plant employees’ demographic characteristics, data regarding their perceived work environment temperatures, and their behaviors related to preventing heat-related …

The Wellbeing Partners’ Use Of The School Health Index To Identify Needs In Omaha Public Schools: A Process Evaluation, Sophia A. Quintero

Capstone Experience

The School Health Index tool from the Center for Disease Control and Prevention has been a useful tool to identify needs and areas of improvement for schools. This tool is most effective when used in collaboration with school staff and assistance from an outside facilitator. The purpose of this evaluation was to determine the administration efficiency of the School Health Index in select schools throughout the Omaha Public School (OPS) district by The Wellbeing Partners. A process evaluation was conducted to: 1) assess the relationship between the schools’ wellness champions at five Omaha Public School (OPS) elementary schools and The …

Closing The Loop: Pilot Evaluation Of Referral Navigator At Oneworld Community Health Centers, Oliver Ramirez-Gutierrez

Capstone Experience

Background. Low-income persons are subject to barriers to accessing health care and the additional complexity of the referral process, specifically for those receiving assistance from indigent care programs, contributes to those barriers. The requirements for patients receiving social assistance from indigent care programs leads to increased waiting time to be seen by specialists and contributes to health disparities.

Aim. Through a partnership with OneWorld Community Health Centers this project seeks to understand the efficacy of the implementation of a “referral navigator” at OneWorld and make recommendations to enhance the process. The proposed navigator is aimed to decrease the waiting time …

The Effect Of Childhood Farm Exposure On Adult Respiratory Symptoms And Proinflammatory Cytokine Responsiveness In Agricultural Workers, Jacob C. Grothe

Capstone Experience

Introduction: Studies have shown that the farm exposes workers and family members to countless microorganisms such as, gram-negative bacteria that possess endotoxins, which have been demonstrated to contribute to lung disease, such as asthma, in exposed workers. Results of studies of children show conflicting results regarding the development of asthma or asthma-like symptoms in response to farm exposures. European children show a “protective effect” against atopy and asthma during adolescence, while North American children show a higher prevalence of asthma or asthma-like symptoms. Also, whether this protective effect carries into adulthood is unclear. Some studies show a low prevalence of …

Comprehensive Review Of Telehealth Law And Literature: Implications For Future Policy And Patients, Morgan Kristensen

Capstone Experience

PURPOSE: The purpose of this Capstone is to determine whether telehealth is effective at producing positive health outcomes, and what the current status of state telehealth law is in the United States and how can the law be changed to improve the implementation and use of telehealth services. METHODS: A literature review of PubMed was used to find articles relating to telehealth and its effectiveness. A law review of each state’s telehealth and telemedicine laws was conducted using Westlaw. RESULTS: The literature review uncovered that telehealth has the potential to produce positive health outcomes for a variety of conditions and …

Characteristics Of Tobacco Retailers And Proximity To Schools In A Midwest City, Sierra N. Garth

Capstone Experience

This descriptive epidemiology project provides an overview of the number, characteristics, and proximity of retailers that sell tobacco and vaping products to middle and high schools. ArcGIS was used to map the proximity of these retailers to public and private middle and high schools in Lincoln, Nebraska. Mapping the retailers and schools allowed us to explore the potential exposures to these products teens experience on a daily basis.

The Development Of A Suicide Prevention Program For American Indian Youth In Nebraskan Communities, Sara Donovan

Capstone Experience

In Nebraska and nationally, American Indian (AI) youth have higher rates of depression, suicide attempts, and suicide completions than other racial and ethnic groups. These statistics highlight the need for accessible and culturally aware behavioral health planning and support. In Nebraska, access to care by AI youth is limited by a behavioral health provider shortage and concerns of affordability, stigma, trust, cultural competence, and historical trauma. The developed culturally humble suicide prevention program for AI youth aged 19-24 to be implemented in community settings addresses an existing service gap. Strategies were developed with input from the population of focus, and …

Effect Of Cigarette Smoking On Cd4 Count And Viral Load Among Hiv Patients Attending Treatment At Nebraska Medicine, Chacha Josiah Mwita

Capstone Experience

Background

Smoking is known to have a negative impact on both morbidity and mortality in people living with HIV (PLHIV). However, there is inconsistent information about the role of smoking on markers of HIV disease progression (CD4 count and HIV viral load). This study examined the effects of cigarette smoking on markers of HIV disease progression among PLHIV at Nebraska Medicine.

Methods

A retrospective cohort study was conducted utilizing electronic health information of 604 PLHIV who attended treatment at Nebraska Medicine between 2012 and 2020. Multiple linear regression was used to model the effects of smoking on the mean change …

Equivalency Testing For Two Formulations Of A Clinical Laboratory Control Material, Jessica M. Hart

Capstone Experience

Clinical laboratory control materials are an integral part of legally-mandated and highly regulated quality control protocols in all clinical laboratories. These controls ensure accurate performance of the laboratory testing and instrumentation used to produce medical test results for millions of patients. It is of clinical and public health interest to ensure the diagnostic test results which affect so many people are regulated by the most accurate and precise controls.

Formulation changes in control materials have the potential to impact laboratory quality control. In this study, data from two formulations of a hematology control were compared to assess equivalency of the …

Medical-Legal Partnerships: Assessment Of Mental Health & Substance Abuse Patients And Social/Legal Needs, Fung J. Liu

Capstone Experience

A medical-legal partnership (MLP) is a model which brings together health and legal services in the form of a multidisciplinary team that works to address medical and legal issues. Currently, Legal Aid of Nebraska is partnering with Bluestem Health, a local federally qualified health center (FQHC) located in Lincoln, Nebraska, to identify legal issues and provide civil legal aid services through a screening and referral process. The purpose of this capstone project was to assess the characteristics and determine the types of social/legal needs of FQHC patients referred to Legal Aid of Nebraska. Data collected was utilized to assess whether …