Medicine and Health Sciences Commons^™

The Role Of Yes-Associated Protein 1 In Ovarian Physiology And Pathology, Xiangmin Lv

Theses & Dissertations

Ovarian granulosa cells are the major somatic components of the ovarian follicle. Proper proliferation and differentiation of ovarian granulosa cells are essential for successful follicle development. Accumulating evidence indicates that the Hippo-YAP signaling pathway plays critical roles in both development and tumorigenesis of several organs. The present study aims to investigate the role of Yes-associated protein 1 (YAP) in ovarian granulosa cell proliferation, differentiation, and malignant transformation. At first, we found that nuclear YAP (active) was highly expressed in proliferative granulosa cells, whereas cytoplasmic YAP (inactive) was detected mainly in terminally-differentiated luteal cells. Further studies suggested that endogenous YAP activity …

Evaluation Of Immune-Modulating Therapies For Parkinson's Disease, Katherine E. Olson

Theses & Dissertations

Parkinson’s disease (PD) is the second most common neurodegenerative

disorder, second only to Alzheimer’s disease (AD). It is characterized by a

progressive loss of dopaminergic neurons along the nigrostriatal axis and the

formation of proteinaceous inclusions of alpha-synuclein (α-syn). Secondary to

the loss of dopaminergic neurons is a progression in motor and non-motor

symptoms. Motor symptoms are characterized by slowness in movement,

stiffness and tremor. Non-motor symptoms include depression, constipation,

sleep abnormalities and loss of sense of smell. The cause of disease remains

incompletely understood. However, age, genetics, environment, viral infection,

and interplay between the innate and adaptive immune system …

The Effect Of Mechanical Vibration On Pain And Rate Of Tooth Movement During Initial Orthodontic Alignment, Leslie Ellingson

Theses & Dissertations

Purpose: The purpose of this investigation was to evaluate the effect of mechanical vibration on pain experienced and rate of tooth movement (OTM) during the initial alignment phase of orthodontic treatment.

Materials and Methods: Participants were randomly allocated to control, low frequency or high frequency. An electric toothbrush was modified to provide high frequency vibration. A low frequency vibration device was acquired from a commercial vendor. Experimental groups applied vibration to the dentition for 20 minutes daily. All participants completed questionnaires using visual analog scales at five time points. Pain experience was measured in millimeters (mm) with the scale measuring …

Cpap-Mad Combination Therapy For Cpap Intolerant Patients With Moderate To Severe Osa, Jacob Stadiem

Theses & Dissertations

The treatment of obstructive sleep apnea (OSA) allows for a multidisciplinary approach between dentistry and medicine. Continuous positive airway pressure (CPAP) is the gold standard for OSA treatment, but the non-adherence rates are high. The mandibular advancement device (MAD) has a higher acceptance rate than the CPAP, however the efficacy is much lower in cases of moderate to severe OSA. This thesis attempted to evaluate if there was a change in compliance when a MAD was added as a combination therapy to moderate to severe OSA subjects that were currently non-compliant with their CPAP. In addition, the change in air …

Novel Therapeutic Approaches For Juvenile Neuronal Ceroid Lipofuscinosis (Cln3), Megan Elizabeth Bosch

Theses & Dissertations

Juvenile Neuronal Ceroid Lipofuscinosis (JNCL) is a lysosomal storage disease caused by autosomal recessive mutations in CLN3. Neuronal loss is thought to occur via glutamate excitotoxicity; however, little is known about neuron-astrocyte glutamate regulation in JNCL. We discovered that Cln3^Δex7/8 astrocytes have significantly lower basal spontaneous Ca²⁺ oscillations and decreased responses to glutamate, indicating a disrupted signaling network. Cln3^Δex7/8 astrocytes also displayed significantly lower basal mitochondrial respiration and ATP production, suggesting impaired metabolic functions. Concurrent with diminished astrocyte metabolism and Ca²⁺ signaling, Cln3^Δex7/8 neurons were hyper-responsive to glutamate stimulation. These studies suggest that CLN3 …

Exploring Perceptions And Experiences With Resources Among Rural Alzheimer's Dementia Family Caregivers In The Midwest, Rita M. Million

Theses & Dissertations

Exploring PERCEPTIONS AND EXPERIENCES WITH RESOURCES AMONG RURAL Alzheimer’s Dementia Family Caregivers in the Midwest

Rita M. Million

University of Nebraska, 2017

Supervisor: Karen Schumacher, Ph.D., RN

Background. Despite vast amounts of research on informal caregiving in the Alzheimer’s dementia (AD) population, research on the experience and perceptions of rural caregivers is limited. A better understanding of rural caregivers’ knowledge, use, and nonuse of resources is essential to offset the impact of caregiving. Purpose. This study explored Alzheimer’s dementia family caregivers’ experiences and perceptions with resources in rural Midwest communities. Design. A descriptive qualitative approach with one-time semi-structured interviews was …

Self-Efficacy For Symptom Management In Adult Hematopoietic Stem Cell Transplant Patients, Lynn White

Theses & Dissertations

Hematopoietic stem cell transplant (HSCT) is a treatment for hematologic cancers and other hematologic conditions that causes severe treatment-related symptoms. The first 30 days after HSCT, or the acute phase, is when symptoms are most intense. During this time, the ability of patients to manage their symptoms, in collaboration with their health care providers, is crucial to reduce the distress caused by the symptoms. Self-efficacy is the person’s confidence in their ability to perform a behavior, such as symptom management. This body of work describes the concept of self-efficacy for symptom management (SESM), presents an integrated literature review on self-efficacy …

Novel Therapeutic Strategies For Treatment Of Castration-Resistant Prostate Cancer, Matthew A. Ingersoll

Theses & Dissertations

Prostate cancer (PCa) remains the most commonly diagnosed solid tumor and is the third leading cause of cancer-related death in United States men. While androgen deprivation therapy is the current standard-of-care treatment for metastatic PCa, most patients eventually relapse and develop castration-resistant (CR) tumors, for which there is currently no effective treatment. Therefore, synthesis of novel therapeutic agents and identification of alternative target proteins are necessary to improve treatment. Herein, I investigate the efficacy of novel imidazopyridine and statin derivatives as alternative therapeutic compounds. These molecules not only inhibit androgen receptor signaling, but also block activation of the AKT axis, …

Identifying The Role Of Janus Kinase 1 In Mammary Gland Development And Breast Cancer, Barbara Swenson

Theses & Dissertations

The development of the postnatal mammary gland is tightly controlled by peptide hormones and cytokines. The signaling of these extracellular ligands through their corresponding receptors rely on Janus Kinases (JAKs) that activate downstream Signal Transducers and Activators of Transcription (STATs). The JAK/STAT signaling pathway is crucial for processes such as growth, proliferation, and cell survival of the epithelial tissue, but also for the breakdown and remodeling of the mammary gland via IL-6 class inflammatory cytokines (e.g. LIF and OSM). JAK1 and JAK2, which are expressed in the mammary gland, are thought to have redundant functions. However, our previous studies demonstrated …

Risk Of Post-Ercp Pancreatitis In Liver Transplant Patients: Single Center Experience, Shailender Singh

Theses & Dissertations

Introduction: Acute pancreatitis remains the most common severe complication of endoscopic retrograde cholangiopancreatography (ERCP). The exact cause of post-ERCP pancreatitis (PEP) is unclear. Regardless of the mechanism that initiates PEP, the pathways of inflammation are similar to other forms of acute pancreatitis and include the activation of various inflammatory cytokines, released from the acinar cells and subsequently from helper T lymphocytes and macrophages. Liver transplants (LTx) patients on immunosuppressive medications have impaired T-cell response and hence decreased ability to generate these cytokines. The aim of this study was to review incidence rates and risk factors of PEP in this …

Public Health Perspectives On Sexual Health And Family Planning, Molly Mccarthy

Theses & Dissertations

Large bodies of evidence document the importance of sexual and reproductive health (SRH) in the lives of individuals and among populations. Of particular interest are sexually transmitted diseases (STDs), due to their potential for long-term health consequences, and unintended pregnancy because of its association with social and economic outcomes for women and families.

This dissertation addressed three distinct but related areas of reproductive health and family planning: counseling for condom use following an STD test, counseling for contraception following a pregnancy test in a clinical setting, and the effect of abortion on having and achieving long-term plans. These topics are …

Maternal Life Course Adversity: The Intersection Of Psychosocial And Biobehavioral Adaptive Response In Pregnancy, Crystal Modde Epstein

Theses & Dissertations

The link between life course adversity and adverse health outcomes is well established, particularly early life adversity (ELA). There is also evidence that the physiologic adaptations associated with stress, depression and ELA can be transmitted intergenerationally via long-term set-point changes within the maternal hypothalamic-pituitary-adrenal axis (HPA). It is unknown how the type and timing of maternal stress and adversity influences HPA regulation during pregnancy and whether maternal coping attenuates this relationship. Manuscript 1 was an integrative review of studies examining the association between maternal ELA and HPA regulation during pregnancy. In manuscripts 2 and 3 the findings of the dissertation …

Relationships Between Complex Pediatric Health Conditions And The Built, Physical And Social Environments, Brittany Corley

Theses & Dissertations

The relationship between human health and the environment is complex and overall poorly understood. The environment has a lasting impact on health, and the processes appear to start at conception. Thus, this dissertation examines the potential relationship between pediatric health and the environment.

The first relationship examined was between the built environment and comorbid Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder. Many publications have reported the relationship between socioeconomic disadvantage, Attention Deficient Hyperactivity Disorder, and Autism Spectrum Disorder. However, the link between the built environment and Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder symptom severity is poorly understood. …

Predictors Of Compliance And Predictive Values Of The Breast Cancer Screening Program Of The Oman Cancer Association (2009-2016), Sultan Al Balushi

Capstone Experience

Background: Most breast cancers in Oman are diagnosed at advanced stages and therefore early detection is important. The Oman Cancer Association (OCA) initiated a mobile mammography program in 2009 but no studies have evaluated the impact of the program. This study aimed to estimate the proportion of OCA-screened women who had repeated mammography (compliance) and the associated predictors. The sensitivity and specificity of the program were also evaluated.

Methods: Data for 13,079 women screened in the mammography clinic of OCA from 2009-2016 and medical records of all breast cancer patients seen at Royal and Sultan Qaboos University hospitals during the …

Analysis Of Food Security, Snap Benefit Duration, Income Level And The Relationship With Depression In Households With Children In Omaha., Tatiana Tchouankam

Capstone Experience

Food insecurity is defined as a lack of access to “sufficient, safe, and nutritious food that meets individuals’ dietary needs and preferences for an active and healthy life.” From 2015 to 2016, the number of people undernourished increased from 777 million to 815 million worldwide. Food insecurity affected 12.3 % of Nebraskans and 13.8% of the residents in Douglas County during the same year. There is evidence of associations between food insecurity, income level, and several adverse health outcomes, specifically with regards to mental health. The objective of this study was to examine food security, SNAP benefit duration (i.e., how …

Establishing An Active Reproductive Health Center And A Sliding Fee Scale At Bellevue Health Clinic, Gbadero Yerokun

Capstone Experience

Abstract

Goal

To collect preliminary data that will be used by Bellevue Health Clinic leadership to make decisions about expanding upon reproductive health services, and creating a sliding fee scale for services provided.

Objectives

To describe aspects of the scope of reproductive health care services provided by Title X-funded clinics in Lincoln, Omaha, Fremont, Grand Island, Tecumseh, Hastings, Gering, Norfolk and North Platte (14 total). The project will also compare and contrast existing sliding scale fees provided at these sites and provide subjective answers from key informants of how Title X funding and a sliding fee scale impact the population. …

Examination Of Collaborative Efforts Of Central District To Achieve Success Of The Community Health Improvement Plan, Liene Topko

Capstone Experience

This was a quality improvement project that helped Central District Health Department (CDHD) work more closely with their community partners to identify the activities and programs that are currently in place to address priority health needs that were included in the 2016 Comprehensive Community Health Needs Assessment (CHNA). The purpose of this project is to identify the specific activities and programs that are being implemented by the health department and community partners in relation to the priority needs. These activities and programs were identified by conducting a survey of the major community partners. The findings from the survey helped to …

Employee Wellness At Private Clinic In Omaha, Ne: Social Marketing And Health Communications Perspective, Olivia Chambers

Capstone Experience

Midwest Gastrointestinal Associates (MGI) is a private clinic in Omaha, Nebraska that reached out to the College of Public Health for assistance in the clinic’s employee wellness program. An MPH student with a background in health and wellness provided MGI with a health promotion intervention to increase employee participation rates. A change was made to the wellness program in 2017 away from monthly health challenges and points—to small gifts distributed to all employees to increase engagement and morale. An initial program evaluation was performed to understand employee understanding and needs. Discovered was the need for an outlet employees could turn …

Evaluation Of Adult Mental Health First Aid: Findings From 2015-2017 Post-Course Surveys, Gina Schwieger

Capstone Experience

Abstract

Introduction: Lack of knowledge about mental health, lack of access to mental health care, and stigma create substantial barriers to the overall United States adult population from seeking or helping individuals with behavioral health issues. This study evaluated Adult Mental Health First Aid (MHFA) courses, an evidence-based program for increasing mental health knowledge, decreasing stigma, and increasing the community’s confidence in helping and frequency of referring people in need.

Methods: This retrospective evaluation of 2015-2017 Adult MHFA courses, utilizes qualitative and quantitative data from post-course surveys completed by course participants. Quantitative data was measured using a five-point Likert Scale. …

The Current Burden Of Chlamydia And Gonorrhea Infections In The Three Rivers Health District, Donna Jordan

Capstone Experience

Background: The proportion of Chlamydia and Gonorrhea in Douglas County, Nebraska is significantly higher than Nebraska and the U.S. Consequently, the Douglas County Health Department has initiated numerous programs to combat STIs. However, the prevalence of Chlamydia and Gonorrhea has sharply increased in recent years. Adjacent to Douglas County is the Three Rivers Health District, including Dodge, Saunders, and Washington Counties. Few studies have assessed the burden of Chlamydia and Gonorrhea in the Three Rivers Health District.

Objectives: The objectives of the study were to 1) Compare Chlamydia and Gonorrhea by age, gender, and ethnicity for Dodge, Saunders, and Washington …

Hpv Vaccination Of Children Among Motherse Of Mexican Origin, Bibiana M. Carvajal-Suarez

Capstone Experience

Background. The Human Papillomavirus (HPV) is a causative agent for the development of cancer which is a public health concern worldwide. In the United States (US), the highest incidence of cervical cancer is among Hispanics/Latinos. Although Hispanics/Latinos show the highest utilization rate of HPV vaccine, in general, the vaccination rates are still behind the Healthy People 2020 goal of 80%. The knowledge about this virus has been found low or nonexistent among most populations in the US, especially among minorities and populations with lower education and socioeconomic status. The knowledge and beliefs of Hispanic/Latin mothers about HPV and HPV …

The Exploration Of Historical, Cultural, And Healthcare Utilization Factors When Clinically Treating Refugee Patients: Healthcare Providers’ View, Kandy Do

Capstone Experience

The objective of this project is to explore historical, cultural, and healthcare utilization factors that are significant to healthcare providers in their practice to clinically treat refugee patients holistically and equitably. Semi-structured interviews supported by a pre-interview questionnaire were conducted with 14 healthcare providers, who have experience in working with refugee patients. Purposive and snowball sampling method was used to recruit 14 healthcare providers. Thematic analysis was used to analyze qualitative data. Descriptive analysis was performed on the pre-interview questionnaire results. To our knowledge, there is limited research exploring historical, cultural, and healthcare utilization factors that are relevant for providing …

Survey Of Indoor Air Quality In Residences Of Wic Participants In Lincoln, Nebraska, Eun Hee Kwon

Capstone Experience

Since 1992, Women, Infants, and Children at the Lincoln Lancaster County Health Department has provided supplemental food benefits, nutrition information, breastfeeding support, immunization referrals, and dental services to support low-income families and their children. However, statewide, the retention rate has been dropping since 2009, and if this continues, it can result in adverse health outcomes. As part of the Service Learning activities, this study aims to evaluate current services on clients’ experiences and improve their satisfaction by conducting the WIC participant-centered services survey. This cost-effective intervention program has been working successfully, however it does not provide the information of environmental …

Epidemiologic And Spatial Differences In Colorectal, Lung, Breast, And Prostate Cancer Mortality-To-Incidence Ratios Between Blacks And Whites In Louisiana, Anas Almatrafi

Capstone Experience

Mortality and Incidence rates are widely used as indicators of health disparities among different racial groups. The current study used the mortality-to-incidence ratio (MIR) to provide a better population-based indicator of survival that can be used as an alternative and more accurate measure of the fatality based on incidence. This study intended to calculate and map MIRs for colorectal, lung and bronchus, breast and prostate cancers in Louisiana by race (Blacks vs Whites), sex, age groups, and geography. Age-adjusted mortality and incidence rates were calculated using the latest data release of the Surveillance, Epidemiology, and End Results (SEER) Program (1973-2014). …

Youth Focus Groups: Design And Analysis Plan For The Bears Project, M. Renee Beacom Claborn

Capstone Experience

This capstone project produced a qualitative research design and analysis plan for youth focus groups as part of a Quality Improvement project at OneWorld Community Health Center (OWCHC) School-Based Health Center (SBHC) located at Bryan High School (BHS) in a program called BEARS. The intended use of this project is to serve as a reference guide for BEARS program planners to utilize as part of the data collection and analysis processes. The purpose for collecting qualitative data for this project is three-fold. 1. To explore adolescents’ perspectives of risk behaviors and associated health determinants common to their age group 2. …

Multilevel Worksite Wellness Intervention To Improve Individual Behaviors And The Worksite Environment, Mariah Morgan

Capstone Experience

Due to increasing obesity rates, public health approaches must focus on improving healthy behaviors and reducing the risk of obesity-related health problems (“Nebraska State Nutrition Profile,” 2012; “State of Obesity,” 2016). Worksites offer opportunities to stimulate behavior change through environmental supports and provide natural structures for social support; therefore, worksites are ideal locations for teaching and implementing health promotion programs (Beresford et al., 2001; Salinardi et al., 2013; Sorensen et al., 1996; Touger-Decker et al., 2008). The Social Ecological Model (SEM), which illustrates that various factors are intertwined at multiple levels to influence behaviors, has been shown to produce significant …

Assessment Of Ems Workforce In Nebraska With Future Strategies, Matt Holt

Capstone Experience

Well-trained and fully staffed Emergency Medical Services (EMS) play a key role in improving the health of the surrounding community through rapid response, on scene care, and transportation to an appropriate facility. EMS is an integral part of the community, vital to limiting the severity of injuries, preventing morbidity, and improving the health of their populations. In order to ensure Emergency Medical Services in Nebraska are able to meet the needs of their populations and continue providing high-level care, an assessment of the State’s EMS workforce was conducted. By completing a workforce assessment, we gained a better understanding of the …

Primary Care Provider’S Perspectives Of Integrating Public Health Into The Prevention And Management Of Type Ii Diabetes Mellitus In Rural Nebraska, Emma Frost-Briley

Capstone Experience

Through the 2011 Community Health Needs Assessment, the Four Corners Health Department has identified type II diabetes mellitus as one of the communities top concerns within their communities. The goals of this project were: to develop a survey to assess the state of current practices of primary care providers on type II diabetes mellitus in the health department district, to identify primary care providers views on prevention, treatment, and management of type II diabetes mellitus in the health department district, and to examine primary care providers and local health department’s views on how primary care and public health can be …

The Use Of Electronic Health Records Data For Public Health: A Snapshot Of Current Practices In Nebraska’S Local Health Departments, Kushal Karan

Capstone Experience

Background: Public health issues are constantly changing and require local health departments (LHDs) to continually evolve in their approaches to address these issues. Advancements in health information technology (HIT), such as electronic health records (EHRs), play an important role in the collection of data that can be used to improve population health.

Objective: The purpose of this project was to assess the current use of electronic health records data by Nebraska’s local health departments and identify the data or tools they are using to address the health needs of the populations they serve.

Methods: In this study, a Mixed-Methods approach …

Awareness And Attitudes Of The Latino Community In Omaha On Colorectal Cancer And Screening, Roger Gonzales

Capstone Experience

No abstract