Medicine and Health Sciences Commons^™

Attending, Ben Mcintire

The Art of Medicine

No abstract provided.

Unmc Sunset, Stephanie Dong

The Art of Medicine

No abstract provided.

Thoughts From A Med Student, Alicia Phillips

The Art of Medicine

No abstract provided.

Sherman Shakes: An Aquatic Story About Living With Seizures, Garrett Sacco

The Art of Medicine

No abstract provided.

Untitled, Tony Le

The Art of Medicine

No abstract provided.

Ragù Alla Bolognese, Susan Greni

The Art of Medicine

No abstract provided.

I Can't Fix That, Audrey Lane

The Art of Medicine

No abstract provided.

Untitled, Mary Pearson

The Art of Medicine

No abstract provided.

Exploring The Influence Of Contextual Factors And The Caregiving Process On Burden, Quality Of Life, And Outcomes Of Heart Failure (Hf) Dyads After A Hospital Discharge Guided By The Individual And Family Self-Management Theory (Ifsmt): A Mixed Method Study., Tamara Bernard, Breanna D. Hetland, Myra S. Schmaderer, Ronald Zolty, Christopher S. Wichman, Bunny J. Pozehl

Posters and Presentations: College of Nursing

No abstract provided.

Occupational Therapy Interventions For Activities Of Daily Living In Adults Post-Traumatic Brain Injury With Visual Symptoms: A Systematic Review, Danielle Adams

Student Systematized Reviews: Occupational Therapy

No abstract provided.

Social Participation In People With Developmental Disabilities: A Systematic Review, Anna Squiers, Madison Mckeever, Sydney Fitzgibbons

Student Systematized Reviews: Occupational Therapy

TITLE:

Social participation in people with a developmental disability: A systematic review

PURPOSE:

People with developmental disabilities often experience difficulty with social skills and engagement in social interactions. One in six children aged 3-17 have a developmental disability (CDC, 2023). People with developmental disabilities experience loneliness, which can affect participation in meaningful occupations (Petroutsou et al., 2018). Participating in social interactions can decrease stress and anxiety and improve overall quality of life (CDC, 2023). The purpose of this systematic review was to determine occupational therapy interventions that increase social participation for people with developmental disabilities.

DESIGN:

We conducted a systematic …

Occupational Therapy Intervention For Survivors Of Sex Trafficking: A Systematic Review, Alexis Spicer, Jensen Antilla, Madeleine Hubka, Sheridan Widhelm

Student Systematized Reviews: Occupational Therapy

PURPOSE: There are an estimated 15,000 to 50,000 women and children are forced into sex trafficking every year in the United States (Heinze, 2021). Sex trafficking leaves a lasting impact on survivors’ mental health and quality of life and presents these individuals with a complex set of barriers to occupational performance including various psychological challenges as well as cognitive impairments (Boyanapalli, 2020). Exposure to sex trafficking affects all aspects of a person’s life including work, community and social participation, self-care, and leisure (United Nations Office on Drugs and Crime, 2019). Occupational therapists are equipped to address these domains. The purpose …

Importance Of Complete Assessment In The Work-Up Of Late Onset Mania, Sarah Mullen, William Lyons

EMET Projects

A female, age 78, with generalized anxiety disorder (GAD), history of major depression, and hypothyroidism presents for mood and anxiety concerns. Her mood is depressed, and sleep, appetite, energy, and concentration are poor. She recently saw a geriatric psychiatrist and described no past manic episodes, psychotic symptoms, or family history for bipolar disorder. No one has concerns about her cognition. She began levothyroxine 150 mcg 3 weeks ago for newly diagnosed hypothyroidism. On exam, she is talkative, overinclusive, has almost pressured speech, labile mood, and lid lag. Neuropsychology testing, CBC, and CMP are normal. TSH is 0.173. She is diagnosed …

The Association Of Lower Medication Adherence And Increased Medical Spending, Ryan A. Fuchs

Capstone: Master of Health Administration

Medical prescribing is a common occurrence in daily clinical practice. According to the Centers for Disease Control and Prevention, in 2015-2016 45.8% of the U.S. population used prescription drugs in the past 30 days. (CDC, 2019) Although drug therapy can be effective in treating disease, full benefits are often not realized because many patients do not take their medications as prescribed. There is quite a bit of research out there about non-adherence to medication. Some studies focus on the financial impacts of non-adherence, but most of the studies examine the reasons for medication non-adherence. A gap exists in research about …

The Usability And Feasibility Of A Nursing Evidence-Based Comorbidity Educational Website For An Urban Mental Health Assertive Community Treatment (Act) Program, Andrea Brudigan, Laurie Sewell-Muller, Kokuvi Sena Tsogbevi

Doctor of Nursing Practice Projects: College of Nursing

Objective: Serious mental illness (SMI) causes an increased risk for comorbidities like heart disease, obesity, metabolic syndrome, and diabetes. Many times, these comorbidities are due to side effects of antipsychotics and poor self-management from low insight and other symptoms of mental illness. This project aims to enhance client care enrolled in an Assertive Community Treatment (ACT) program by providing evidence-based resources tailored to clients with SMI, providing ACT team members with support to promote healthy behaviors in clients.

Methods: A website was developed that provides printable, easy-to-read, evidence-based resources that address physical comorbidities. The ACT team integrated these resources into …

An Enhanced Enrollment Process To Impact Appointment Compliance In The Hf-Optimize Clinic, Carolyn Coons, Teri Diederich, Kyana Holder

Doctor of Nursing Practice Projects: College of Nursing

Background The HF-Optimize clinic showed improved utilization of guideline-directed medical therapy (GDMT) along with improved clinical outcomes from 2018 to 2020. Appointment compliance was poor with only 44% of patients completing all HF-Optimize visits. Missed appointments led to worse health outcomes, fragmented care, and provider inefficiencies. Interventions to improve appointment compliance are vital to improving heart failure outcomes. Objective The purpose of this quality improvement project is to evaluate the impact that an enhanced enrollment process has on appointment compliance in a culturally diverse, adult population referred to the HF-Optimize clinic at Nebraska Medicine. Methods This prospective quality improvement project …

The Link Between Fat Soluble Vitamin Deficiencies, Decreased Microbiota Diversity And Severity In Children With Sickle Cell Disease Followed In A Clinic In Omaha Nebraska, Chinenye R. Dike

Theses & Dissertations

Fat soluble vitamin (FSV) deficiencies are associated with worse pain in individuals with sickle cell disease (SCD). Data on the dietary and pancreatic function influence on fat soluble vitamin levels are limited. Additionally, individuals with SCD have gut dysbiosis but there are gaps in knowledge on the impact of this on severity. This thesis attempted to evaluate FSV prevalence and gut microbial profile in our cohort of children with SCD and compare this with matched healthy children and to ascertain if diet or pancreatic function affects these levels and see if these affects sickle cell severity.

Transcranial Direct Current Stimulation Of Frontal/Occipital Cortices Modulates Neural Correlates Of Cognition In Healthy Young Adults, Yasra Arif

Theses & Dissertations

An exponential rise in the use of transcranial direct current stimulation (tDCS) to modify the human brain and behavior has been observed over the last 20 years, with studies often yielding mixed outcomes. Such heterogeneity is partially attributed to the lack of a concise understanding of the underlying mechanisms. Though considered to exert modulatory effects by changing neuronal membrane polarization and synaptic efficacy, the interactive effects of offline tDCS and the neural underpinnings of cognition, both at the regional and network-level, are yet to be fully understood. Using High-Definition tDCS (HD-tDCS), Magnetoencephalography (MEG), a range of well-established cognitive paradigms, and …

Aerosols In Orthodontics: Characterization Of Particle Size And Travel Distance, Donte Jochum-Nesbitt

Theses & Dissertations

Introduction: Aerosol production is a key contributor to occupational risk and disease transmission in the dental clinic. These aerosols can host harmful pathogens, such as SARS-CoV-2. Considering the 2020 pandemic, researchers endeavored to bolster the existing body of literature related to disease transmission via aerosols and droplets to provide better recommendations for infection control. This investigation aims to support that mission by characterizing the risk to orthodontic professionals and patients based on aerosolized particle size and travel distance. Methods: The experimental protocol used in this study was validated through a smaller scale pilot study in 2021. High- and Low-risk orthodontic …

Essential Protections For Essential Workers: Ethical Considerations For Infection Prevention And Control, Abigail E. Lowe

Theses & Dissertations

Prior to the COVID-19 pandemic, ethical guidance for workers during epidemics and pandemics centered on healthcare workers, which meant there was not guidance to address critical contextual issues for many on the frontlines of the pandemic. Meat processing workers are a key example of workers deemed essential during the COVID-19 pandemic and facing conditions of elevated risk without adequate public health guidance or resources to control disease spread. Meat processing workers are an underserved, resource-limited, and vulnerable workforce that face occupational health and safety risks. Meat processing and other essential workers have heightened health disparities due to the social determinants …

Nanofabrication For Precision Vaccinology, Karen Zagorski

Theses & Dissertations

Vaccines are among the most effective and safe therapeutics known to mankind. Historically the approach to the creation of new vaccines has been dominated by empirical research, trial, and error. This thesis focuses on the more modern, rational approaches to vaccinology based on the current understanding of the inner workings of the immune system. We used nanotechnology for the generation of novel immunogens, addressed several challenges, and characterized the immune responses.

The preparation, characterization, and troubleshooting of several vaccines against dimeric amyloid beta are covered in chapters 4-6. Despite being ultimately unsuccessful, this part provided a deeper understanding of the …

Targeted Therpeutics For Prostate Cancer, Behind The Scenes Of Psma & Cysteine Protease Trapping Mechanism, Alireza Basiri

Theses & Dissertations

In an attempt to increase the residence time of PSMA-targeted theranostics inside the prostate cancer cells and tumors, we designed and prepared a CPTA-PSMATA resembling PSMA-617 by adding a well-known cysteine protease inhibitor (E-64) to the conjugate. Lysosomal proteases, including cysteine, serine, and aspartic families of hydrolytic enzymes, are expressed in high concentrations in the lysosomes and are responsible for the catabolism of proteins inside the cell [165, 278]. We proposed that after successful internalization of the PSMA-targeted conjugates into the cells, they will be conveyed to the endolysosomes. In these endolysosomal compartments, the E-64 moiety will covalently bind to …

A Cell Culture Model To Study Tobacco Associated Oral Cancer Progression And Treatment Resistance, Amanda Busch

Theses & Dissertations

Head and Neck Squamous cell carcinoma is the 6^th most common cancer in the world. Risk factors for HNSCC include alcohol and tobacco consumption, infection with Human Papilloma Virus, and exposure to environmental toxins. Unlike many other cancers, the incidence of HNSCC is growing, yet the treatment options and outcomes have not been significantly improved for decades. An increased understanding of the molecular mechanisms of these cancers is needed for improvement in early diagnosis, enhanced treatment effectiveness, and cancer prevention. 4-nitroquinoline 1-oxide (4NQO) is a well-tested, tobacco mimicking, carcinogen. 4NQO produces similar histological and chemical changes found in human …

Structural And Inhibitory Studies On (I)Two Mycobacterium Tuberculosis Enzymes Essential For Capsular Glucan Biosynthesis And Mrna Degradation: (Ii) Hantann Virus L-Protein Endonuclease Domain, Hettiarachchige Thilina D. Jayasinghe

Theses & Dissertations

Mycobacterium tuberculosis (Mtb) is the pathogenic bacterium species that causes Tuberculosis (TB). Understanding the major biosynthetic pathways responsible for cell viability is essential in developing new drugs against Mtb. The first two projects will reflect our approach in identifying inhibitors against Mtb GlgE, Mtb GpsI, and characterization of protein inhibitor interactions using X-ray crystallography.

The enzyme GlgE plays an essential role in the α-glucan biosynthesis pathway in Mtb cells. These α-glucans are one of the major structural units in the Mtb capsule. GlgE catalyzes the elongation of α-glucan by transferring maltose from maltose-1-phosphate (M1P) to the non-reducing end …

Structural And Biochemical Studies Of Three Enzymes Involved In Amino Acid Metabolism To Develop Novel Drugs, Yahani Pankaja Jayasinghe Arachchige

Theses & Dissertations

Intrinsic drug resistance in bacteria predates the clinical use of antibiotics. Additionally, heterogeneous metabolic states and the ability of many bacteria to form biofilms further enhances bacterial survival during infection and exacerbates treatment challenges. This necessitates the identification of novel drugs against new drug targets. These studies focus on the development of compounds targeting enzymes in Mycobacterium tuberculosis (Mtb) and Staphylococcus aureus that avoid intrinsic antibiotic defenses. The Mtb-encoded homoserine transacetylase enzyme (HTA) catalyzes the first step of the methionine biosynthesis pathway that produces methionine and S-adenosyl methionine. These compounds are shown to be essential for both dormant …

Mental Health Promotion, Early Identification & Treatment Services And Supports In Public K-12 School Districts: Three Case Studies To Explore Available Resources, Interventions, And Community Partnerships, Keenan Krick

Theses & Dissertations

Objective: This study: 1) identifies the multi-tiered efforts public K-12 school districts in a large Midwestern metropolitan area use to support mental health promotion activities and comprehensive mental health services, and 2) compares district efforts to domains defined by the National Center for School Mental Health (NCSMH). Participants: A sample of public K-12 school districts (n=12) in a large Midwestern metropolitan area participated in this study from August 2021 to October 2022. Methods: Using the Multi-Tiered Systems of Support (MTSS) intervention framework, a series of three case studies identify the resources public K-12 school districts utilize to support mental health …

Depression And Parenting: A Mixed Method Analysis Of Some Protective Factors For Depression Among African American Fathers Using A Community-Based Participatory Research Approach, Tatiana Tchouankam

Theses & Dissertations

In the United States (US), African American (AA) men often face oppression, discrimination, negative interactions with the justice system, and significant economic, neighborhood, and social hardships over their life course. These challenges increase the risk of chronic exposure to stressful events with negative mental health outcomes, such as depression. Most of the research on parenting and parental depression has focused on mothers based on the premise that women are more often primary caregivers for their children, especially during early childhood. However, a growing number of fathers take on childcare responsibilities. Despite dealing with different life stressors and negative circumstances, AA …

Frailty Determination And Responsiveness In Left Ventricular Assist Devices, Sarah Schroeder

Theses & Dissertations

Frailty, the state of being vulnerable with susceptibility to decreased age-related physical reserve, is found in 56-79% of adults with end-stage HF receiving durable left ventricular assist device (dLVAD) therapy. Frailty increases risk of adverse events, including increased mortality in the dLVAD population, but less is known about depression, quality of life (QOL), cognition and frailty responsiveness. Therefore, we aimed to describe and compare frailty (5-Meter Walk Test, 5MWT), depression (Patient Health Questionnaire-9, PHQ-9), quality of life (EQ5D Visual Analog Scale, EQ-5D VAS) and cognition (Trailmaking B) from pre- to 12-months post-dLVAD We also compared demographics, clinical characteristics, and post-dLVAD …

Characterization Of Metastatic Cutaneous Squamous Cell Carcinoma In The Immunosuppressed Patient, Megan E. Wackel

Theses & Dissertations

Patients who are immunosuppressed, such as solid organ transplant recipients (SOTRs), are known to have a higher risk of developing cutaneous squamous cell carcinoma (cSCC). This population is at a higher risk of metastasis and worse disease-specific survival, with over 1 million cases and an estimated 3,932 to 8,791 deaths each year in the United States. Large cancer genomic databases have reported on genomic drivers for many cancer subtypes, yet cSCC has not been included. The immunosuppressed population is generally ineligible to receive immunotherapy which poses a challenge for treatment options in cases that develop metastasis. After we performed a …

The State Of Oral Health In People With Disabilities And The Impact Of Family-Centered Care On The Oral Health Of Children With Special Health Care Needs, Bedant Chakraborty

Theses & Dissertations

Oral diseases are one of the most prevalent non-communicable, chronic diseases of the 21st century. Yet, dental diseases are generally neglected and are a top concern for policymakers globally. The burden of oral diseases disrupts routine activities that affect the overall quality of life, especially for those with special healthcare needs. Dental diseases have also been marked as the “silent epidemic” and are the leading secondary health condition that affects individuals with disabilities. Disabled people are less likely to receive timely and adequate dental care, which could be tied to poor oral health outcomes among them. This group of studies …