Medicine and Health Sciences Commons^™

Orthopaedic Physical Therapy Residency And Fellowship Program Mentoring Structure: A Survey Of Program Directors, Darren Q. Calley, Kirk R. Bentzen, Megan Frazee, Matthew D. Haberl

Posters and Presentations: Physical Therapy

Purpose/Hypothesis: Mentoring is a required component of physical therapy residency and fellowship training, and a primary reason applicants pursue training in these programs. Resources outlining core competencies for effective mentoring, mentor and mentee characteristics, and recommendations for effective mentoring have been described. However, little is known about the timing, structure, and process of how mentoring and feedback is implemented across residency and fellowship programs. The purpose of this study was to better understand the structure, timing, and delivery of mentoring and the role mentors and program directors (PDs) play in orthopaedic physical therapy residency and fellowship programs. A secondary purpose …

Effective Occupational Therapy Interventions To Decrease Picky Eating In Children: A Systematic Review, Savannah L. Jacobsen, Josie Cox, Alli Bos, Cherokee Ferguson, Stacey Smallfield, Molly Whitlow

Student Systematized Reviews: Occupational Therapy

PURPOSE: Picky eating is related to the lack of consumption in food variety by children when shown different foods (Wolstenholme et al., 2020). A 2015 study reported that almost half of children experience a period of picky eating at some point during early childhood, including almost 15% of children for whom picky eating does not resolve by age 6 (Cardona et al., 2015). The purpose of this systematic review is to identify interventions within the scope of occupational therapy that increase food acceptance in children under the age of seven years who demonstrate picky eating characteristics and who have no …

Student Wellness During Curriculum Implementation Of A Lifestyle Medicine Approach Within The Social-Ecological Model: A Longitudinal Study, Betsy J. Becker, Anne Skinner, Tessa Wells, Kathleen G. Volkman, Nicole M. Sleddens, Teresa Cochran

Posters and Presentations: Physical Therapy

Purpose

The student-life experience is an ideal time to implement lifelong wellness behaviors needed for the professional role. The ongoing effects of the COVID pandemic have amplified the need for Doctor of Physical Therapy (DPT) educational programs to train an emerging workforce that can, through personal wellness, withstand the stressors of personal and professional lives. The study purpose is to: a) evaluate the change in student wellness from matriculation to mid-program to completion after implementation of a curriculum based on a lifestyle medicine approach within the Social-Ecological Model, and b) compare student wellness between cohorts that matriculated before and during …

The Effect Of Interproximal Home Regimens Of Inflammatory Biomarkers In Periodontal Maintenance Patients, Grace Moore

Theses & Dissertations

A survey of dental hygienists in general practice (DHGP; n = 74) and periodontal practice (DHPP; n = 62) indicated a difference (p £ 0.04) in preference for interproximal cleaning with oral irrigators (DHGP) and interproximal brushes (DHPP) during periodontal maintenance therapy (PMT). The purpose of the subsequent blinded, randomized controlled clinical trial was to compare the effect of interproximal cleaning aids on reducing inflammation in posterior pockets during PMT. Seventy-six patients on PMT with a 5-7 mm interproximal probing depth were randomly allocated to one of three groups: 1) interproximal brush with tracking device (IB + TD; n=23), 2) …

Prenatal And Pregnancy Loss Evaluation By Noninvasive Screening And Diagnostic Genetic Testing, Abigail Haggerty

Theses & Dissertations

Noninvasive prenatal testing (NIPT) utilizing cell-free fetal DNA (cffDNA) in the maternal blood is the screening test of choice for physicians today. NIPT depends on the amount of cffDNA in the maternal blood, called the fetal fraction (FF). Researchers are investigating the implications of the FF value in reference to multiple variables in pregnancy outcome, including the risk for aneuploidy and maternal factors that influence the FF.

Diagnostic techniques utilized in patient care include cytogenetics, fluorescence in-situ hybridization (FISH), and microarray. Diagnostic testing is critical to confirm or rule out genetic abnormalities among women with abnormal screening results, …

Evaluation Of Medication Optimization In The Setting Of Ecmo Therapy: Assessment Of Therapeutic Effectiveness, Greg Peitz

Theses & Dissertations

A series of studies within the setting of extracorporeal membrane oxygenation (ECMO) was undertaken to specifically answer questions related to medication optimization during this complex therapy. These studies included medication therapies involving optimal anticoagulation, analgesia delivery, fluid resuscitation, and infection related outcomes in the context of ECMO. Each investigation was retrospective in nature and included patients from a single institution. The results of these studies indicated the following: 1.) various anticoagulation goals do not impact severe, life-threatening bleeding events during ECMO therapy; 2.) sepsis is a common occurrence in the setting of ECMO; 3.) the choice of either a crystalloid …

The Development And In Vivo Immunologic Assessment Of Biodegradable Microparticles Incorporating Cpdi-02 And Mucosal Protein Vaccine, Jacob E. Parriott

Theses & Dissertations

Encapsulation in biodegradable microparticles (MPs) is a promising approach to increase the efficacy of intranasally administered protein vaccines. The generation of long-lived adaptive immune responses against encapsulated protein vaccines, however, requires the incorporation of a suitable mucosal adjuvant. CPDI-02—a complement peptide-derived immunostimulant that selectively activates dendritic cells and macrophages over neutrophils while minimizing the inflammatory side effects of parent C5a—has previously been incorporated into both systemic and mucosal vaccine formulations via direct conjugation to chemical moieties, peptides, proteins, inactivated pathogens, and the surface of biodegradable particles, to enhance Th1-biased cellular immune responses. The effect of CPDI-02 surface conjugation to MPs …

Applications Of Population Pharmacokinetic Modeling In People Living With Hiv, Michelle M. Pham

Theses & Dissertations

Population pharmacokinetic modeling has become an important tool for the individualization of medicine in HIV care and clinical pharmacology in general. This dissertation explores many applications of population pharmacokinetic modeling to help identify drug exposure, drug-drug interactions, and sources of variability in populations living with HIV. Comprehensive HIV care involves simultaneous treatment of the disease and any co-infection and/or co-conditions.

The first objective was to identify potential drug-drug interactions affecting combination antiretroviral therapy (ART) consisting of efavirenz, tenofovir disoproxil fumarate and emtricitabine, from concomitant use of chemotherapy agents. Three models were developed with sparse sampling to characterize efavirenz, emtricitabine, and …

Agrichemicals (Nitrate And Atrazine) In Drinking Water And Adverse Health Outcomes In Children In Nebraska, Balkissa S. Ouattara

Theses & Dissertations

Objectives: This research was conducted to (1) determine the concentrations of atrazine, and nitrate, in Nebraska watersheds and counties; (2) calculate the incidence of pediatric cancers and prevalence of birth defects in Nebraska counties and watersheds, respectively; (3) assess the relationship between the contaminant levels and the incidence rate of pediatric cancers and birth defects prevalence.

Methods: Pediatric cancers and birth defects data were obtained from the Nebraska Department of Health and Human Services. Water quality data were collected and retrieved from the Water Quality Portal and the Nebraska Groundwater Quality Clearinghouse. Geospatial and statistical analyses were conducted at the …

A Systematic Literature Review Of The Prevalence, Distribution, Exposure, And Human Health Risks Of Tire Microplastics And The Contribution Of Their Physicochemically Diverse Properties, Luke Glastad

Theses & Dissertations

The history of synthetic plastics dates back to their first uses in 1907, continues with their expansion through the middle of the century with a diverse array of new polymers, and are so omnipresent today that many label this age of Earth the Plasticene Era. Tire microplastics (TMPs) have been increasingly identified as one of the environment's most bountiful types of microplastics (MPs). TMPs mainly enter the environment as tire-wear particles (TWPs) and recycled tire crumb (RTC). TWPs, in particular, have a high degree of variability, which impacts their distribution, degradation, and risk for adverse human health effects. This review …

Neuropilin-2 In Advanced Prostate Cancer And Its Targeting With Novel Small Molecule Inhibitors, Ridwan Islam

Theses & Dissertations

Despite the development of new therapies, clinical management of advanced metastatic castrationresistant prostate cancer (mCRPC) still remains challenging owing to the emergence of therapy resistance. Resistance to the therapies is driven by both AR and non-AR pathways. Non-AR pathway is characterized by a lineage switch that leads to the development of neuroendocrine-like (NE-like) prostate cancer (PCa), which has a fulminant clinical course due to the lack of effective treatment strategy. Therefore, novel molecular targets need to be identified to develop effective therapeutic regimen to improve the outcomes in advanced PCa patients including NE-like PCa. Recent investigation on advanced PCa patients …

Ewing Sarcoma Transcriptome: Identification Of Foxn3 As A Novel Target Of Ews-Fli1, Natasha Kreiling

Theses & Dissertations

Ewing Sarcoma is an aggressive cancer characterized by a fusion gene formed from a chromosomal translocation between a RNA binding protein and a transcription factor. The most common fusion gene is EWS-FLI1 a potent oncogenic transcription factor responsible for initiating genome instability. EWS-FLI1 promotes tumor growth by dysregulating several genes and pathways. We have identified FOXN3, an important gene in cell cycle control and development, as being suppressed by EWS-FLI1. In the future, a better understanding of FOXN3 and its ability to act as a tumor suppressor in EWS will unravel novel mechanisms of EWS pathogenesis, potential biomarker and drug …

Environmental Exposures And Human Health Challenges: Evidence-Based Insights From Health Surveillance Systems, Jagadeesh Puvvula

Theses & Dissertations

Human exposure to environmental hazards is associated with a variety of preventable adverse health outcomes. As the environmental health risks result from the complex interaction between hazard, exposure, and susceptibility, these exposure-outcome associations are heterogeneous across the population. Improving environmental health literacy by advocating evidence-based environmental risk communication could play a role in reinforcing protective behavior against environmental hazards. The use of public health surveillance systems to assess the exposure-response associations is one of the effective ways to quantify the environmental health risks. However, there are several gaps in effectively quantifying environmental health risks. This dissertation aims to address a …

Optimizing Antiretroviral Therapy With Modern Rifapentine Containing Tb Treatment, Anthony T. Podany

Theses & Dissertations

In the past decade there has been a multitude of phase 3 clinical trials targeting treatment shortening for tuberculosis (TB). The synthetic rifamycin derivative rifapentine (RPT) has been at the forefront of many of the treatment shortening approaches. RPT possesses greater potency and a longer pharmacokinetic (PK) half-life (t_1/2) as compared with the long used rifamycin, rifampin (RIF). For TB preventative treatment, a 3-month, once weekly regimen of RPT and isoniazid (INH; 3HP) was shown to be as effective as 9-months of daily INH therapy in the PREVENT TB trial. Similarly, a 4-week course of daily RPT and …

A Two-Part Satisfaction Evaluation Of The Recreational Therapy Department's Adult Respite And Habilitation Program At The Munroe-Meyer Institute, Hailey Humphrey

Capstone Experience: Master of Public Health

This project is a satisfaction evaluation of the Adult Night program offered to people 21+ with intellectual and/or developmental disabilities (I/DD) through the Munroe-Meyer Institute’s Recreation Therapy Department. Historically, people with I/DD face health disparities that impact all areas of their lives. Recreation therapy for I/DD populations could address and minimize access to and quality of care gaps. Current research on recreation therapy programs lacks generalizability and evaluation of non-specific recreation therapy programs for people of any age with I/DD. This project intends to fill that research gap and provide the first evaluation data of the program for the organization. …

Examining Mental Health Disparities In A Rural County: A Community Health Needs Assessment Analysis, Dustin M. Schulz

Capstone Experience: Master of Public Health

Over 20% of adults in the United States experience some form of mental illness each year. Those residing in rural areas can see increased prevalence of mental illness, and typically face disparities in access and availability of services for mental health. The goal of this project was to examine the impact of mental health in Woodford County, Illinois using data collected through the 2022 Community Health Needs Assessment (CHNA) process, with the intent of identifying areas of improvement that could be implemented at the local level. Analysis of the CHNA data was conducted using frequency analysis in SAS 9.4 through …

Assessment Of Ems Response And Hospital Arrival Times In Nebraska, Tina Vu

Capstone Experience: Master of Public Health

Timely EMS response and ground transport to the appropriate hospital are essential to patients’ survival and health outcomes during emergencies. This study utilizes interactive Geospatial Information System (GIS) mapping to assess emergency medical service (EMS) response and hospital arrival times in rural and urban Nebraska counties. The goal is to determine if there are underserved areas in the State and to propose potential interventions if identified. 2018 Social Vulnerability Index Scores (SVI) collected from Census Data were also reviewed for these areas to see possible correlations. The interactive GIS map revealed the Western and Central regions of Nebraska to be …

Overlaps And Gaps Of Preterm Birth Programs In The Triangle Area Of North Carolina, Amber Bobbitt

Capstone Experience: Master of Public Health

Background: Preterm birth rates are a long-standing issue that has yet to be adequately addressed and prioritized. Nationally about 1 in every 10 infants are born prematurely in the United States. In the state of North Carolina, 1 in every 9 live births was preterm in the year 2020. The aim of the study was to determine the strategies organizations use in North Carolina to reduce preterm births in comparison to the CDC’s Five Strategy framework and to understand how the organizations address health equity and measure/evaluate the success of their initiatives.

Methods: Semi-structured one-on-one interviews were conducted with four …

Analysis Of The Utilization Of Nebraska Medicine's Price Transparency Tool, Ingrid A. Olson

Capstone Experience: Master of Public Health

Healthcare costs have become a significant concern for patients, healthcare facilities, economists, and politicians within the United States. In an effort to understand and reduce health-related costs, price transparency laws were enacted at the beginning of 2021. Because of these new laws, hospitals must provide a price transparency tool for their patients. “Price transparency in healthcare makes pricing information more readily available, defines the value of services, and enables patients and other care purchasers to identify, compare, and choose providers that offer the desired level of value” (AAMC, 2022). However, research results on price transparency tools use and efficacy is …

Exploring Stakeholder Attitudes Towards Tobacco 21 Implementation, Enforcement, And Outcomes, Summer L. Woolsey

Capstone Experience: Master of Public Health

Objectives: This qualitative study seeks to assess the impact of the federal Tobacco 21 (T21) law by analyzing data collected from a nationwide sample of key tobacco control stakeholders towards the implementation, enforcement, and outcomes of the T21 law. Methods: A series of five focus groups were conducted in December 2021 with stakeholders (n=31) who were asked about T21 implementation and enforcement measures used in their own communities. Participating stakeholders included tobacco policy experts, tobacco evaluation experts, subject matter experts, and implementation personnel. Results: We conducted a thematic analysis of the data resulting in eight themes found under four broad …

The Patient-Centered Medical Home And The Value Of Heightened Care Coordination: A Systematic Literature Review, Garrett L. Vetter

Capstone Experience: Master of Public Health

Health care spending in the United States continues to increase at a pace that far exceeds inflation. Representing a greater proportion of the nation’s gross domestic product (GDP) than any other country, costs associated with health care services in the U.S. lend support to growing concern regarding the sustainability of current systems. Furthermore, the fragmented nature of the current landscape often presents challenges to the provision of high-quality and efficient care. Satisfaction among both patients and health care providers, alike, suffers under the weight of increasing regulatory burden, the lack of integrated medical records systems, and growing complexity among health …

An Analysis Of Demographics And Risk Factors Associated With Increasing Syphilis Cases In Iowa, Eleanore H. Nelson

Capstone Experience: Master of Public Health

Background:

Syphilis is easily detectable and treatable with the appropriate medical attention, yet national incidence rates have been on the rise since reaching an all-time low in 2000 (Shockman et al, 2014). Similar to HIV, men who have sex with other men (MSM), represent most syphilis transmission, yet in recent years, syphilis rates have concerningly increased among both genders and among all racial/ethnic groups (CDC, 2019).

Methods:

Surveillance data was collected on all syphilis cases reported to the Iowa Department of Public Health (IDPH) regarding demographics and risk factors of cases. Variables were analyzed using chi-square and Fisher’s exact tests, …

The Differences In Mental Well-Being For Individuals With And Without Service Dogs, Katelyn Morales

Capstone Experience: Master of Public Health

Trained service dogs can be used for many tasks, but the growing literature focuses on the benefits of the psychosocial health and well-being of individuals experiencing depression or anxiety. This study analyzes the effects of service dogs on the mental well-being of individuals with a diagnosed disability who have depression or anxiety. This quasi-experimental design assesses the mental well-being of individuals who have a service dog compared to those who do not have a service dog. Mental well-being was measured using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) and focused on individuals with a service dog and diagnosed depression or anxiety …

Beyond The Plant: Facing Systemic Barriers As A Meatpacking Community During The Covid-19 Pandemic, Shannon Barrientos

Capstone Experience: Master of Public Health

The COVID-19 pandemic has revealed and magnified health disparities and social inequities that disproportionately burden racial and ethnic minorities. These disparities are readily seen within meatpacking communities, considering a lack of protections offered by the meatpacking industry have heightened COVID-19 susceptibility. These conditions have aggravated health inequities within rural communities throughout the span of the pandemic. Despite significant advances in research investigating the effect of COVID-19 on essential workers within the meatpacking plants, this research remains isolated within the meat processing industry. Moreover, research has focused predominantly on the pandemic’s impact on rural communities and the institutional barriers that hinder …

Trends Of Human Papilloma Virus- Related Cancers And Hpv Vaccination In Nebraska From 2010 To 2018, Christelle Massumbu

Capstone Experience: Master of Public Health

Background:

Approximately 46,143 human papillomaviruses (HPV) related cancers are diagnosed annually in the United States. Although the HPV vaccine has been available in the United States since 2006, more than half of adolescents have not completed the HPV vaccine series. In Nebraska, the incidence rates of HPV-related cancers have increased from 2006 (5.7%) to 2018 (6.3%). Although cervical cancer has been highly studied, there is limited research and surveillance on head and neck, vaginal, vulvar, anal, and penile cancers in a state such as Nebraska, which experiences limited access to healthcare in its rural areas. Clarity about these aspects could …

Disparities And Attitudes Toward Sars Cov2 Vaccine Among People With Disabilities, Ahmed A. Omar

Capstone Experience: Master of Public Health

The pandemic caused by SARSCOV2 that began in late 2019 posed a significant public health challenge for communities worldwide. The pandemic negatively impacted people's health, economy, and living conditions. Pharmaceutical companies worldwide have begun a race against time to invest in vaccine development to control and eliminate the worst outcomes of the COVID 19 associated disease. Scientific research resulted in several effective vaccines being developed and authorized for use in people (Salmeron Ríos S et al.).

Public health agencies like the Center for Disease Control and Prevention (CDC) prioritized high-risk populations for vaccination. This process is meant to accomplish the …

Implementing Immersive Virtual Reality Into A Nursing Curriculum, Sue A. Schuelke, Krystal Davis, Sue Barnason

Innovations in Health Sciences Education Journal

Due to workforce demands, new undergraduate nurses are hired directly into fast-paced units and are expected to manage complex patients with rapidly changing conditions and respond to time-sensitive situations. It is important for nurse educators to prepare undergraduate nurses for transition into clinical practice upon graduation. Simulation has been a valuable tool to provide experiential learning and promote clinical decision-making. The next iteration of improving clinical simulation as an experiential learning modality for nursing students is Immersive Virtual Reality (IVR): a realistic, immersive simulation in a 3-dimensional environment that is experienced by body movements and hand controllers. IVR can incorporate …

Back Cover Vol 4 Issue 1

Graduate Medical Education Research Journal

No abstract provided.

Painful Foot Lesions: A Case Report, Trevor Lockard

Graduate Medical Education Research Journal

No abstract provided.

Prisma Mri And Meg Leading To A Successful Frontal Lesionectomy In A Medically Refractory Epilepsy Patient, Erin Dennis

Graduate Medical Education Research Journal

No abstract provided.