Medicine and Health Sciences Commons^™

Renal Sympathetic Vasomotion Monitoring As A Novel Method For Intraprocedural Feedback For Renal Denervation, Peter Ricci Pellegrino Et Al, Alicia M. Schiller, Han-Jun Wang, Yiannis S. Chatzizisis, Irving H. Zucker

Graduate Medical Education Research Journal

No abstract provided.

Synthetic Resorbable Vs. Cellulose Bandage For Minor Hemorrhage In A Porcine Model, Ujwal R. Yanala, Sandra Noriega, Ruben Spretz, Jorge Ragusa, Luis Nunez, Gustavo Larsen, Mark Carlson

Graduate Medical Education Research Journal

No abstract provided.

A Comparative Analysis Of Survival And Funding Discrepancies In Cancers With High Mortality, Bradley R. Hall, Andrew Cannon, Pranita Atri, Christopher S. Wichman, Lynette M. Smith, Sushil Kumar, Surinder K. Batra, Hongmei Wang, Apart Kishor Ganti, Aaron R. Sasson, Chandrakanth Are

Graduate Medical Education Research Journal

No abstract provided.

The Effects Of Stiff Stent-Grafts On Segmental Aortic Stiffness And Left Ventricular Mass: A Pilot Swine Model Study, Paul Aylward, Alexey Kamenskiy, Jason Mactaggart

Graduate Medical Education Research Journal

No abstract provided.

A Performance Improvement Project In Antibiotic Administration For Open Fractures, Benjamin Ogden, Christopher Deans, Matthew Mormino, Michaela Mccarthy, Elizabeth Lyden, Justin Siebler

Graduate Medical Education Research Journal

No abstract provided.

Virtual Reality (Vr) To Improve The Experience Of The Mohs Patient: A Prospective Interventional Study, Shauna Higgins, Shera Feinstein, Makenzie Hawkins, Myles Cockburn, Ashley Wysong

Graduate Medical Education Research Journal

No abstract provided.

Sarcoidosis Of The Mandibular Condyle: A Rare Disease That Can Mimic Malignancy, Chad Sloan, Ben Lacrosse, Lei Yu, Alexander Braun, Scott Lauer, Timothy Donovan, John Baker, Jason Untrauer

Graduate Medical Education Research Journal

Sarcoidosis can involve any of the organs, however intraosseous involvement is rare and ranges from 5 to 15%, with lesions of the mandible being even rarer – currently with few known cases reported. Intraosseous lesions involving the mandible have been noted to be asymptomatic or associated with chronic jaw pain. Additionally, mandibular involvement can present as a lytic bone lesion mimicking osseous malignancy. Chronic polyarthritis is commonly associated with the progression of sarcoidosis and intraosseous involvement has been considered a late-stage sequelae. We report a case of biopsy-proven sarcoidosis within the mandibular condyle in an asymptomatic 56-year-old Caucasian female who …

A Case Of Parsonage-Turner Syndrome, Steven Embry, T. Jason Meredith

Graduate Medical Education Research Journal

Neuralgic Amyotrophy, also known as Parsonage-Turner Syndrome (PTS), is a clinically diagnosed and largely under-recognized inflammatory disorder which primarily affects the brachial plexus. Correct diagnosis is often delayed and the disease causes significant patient morbidity due to extreme pain, paresis, and often sensory abnormalities of the upper extremity. Although the pathophysiology is not completely understood, it is classically preceded by an identifiable inciting event and complete recovery may take months to years.

An Uncommon Adverse Effect Of A Common Drug-Dress Syndrome-Not Just Skin Deep!, Alamelu Udayappan

Graduate Medical Education Research Journal

Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome is a rare, life-threatening hypersensitivity reaction that causes skin exfoliation, hematological abnormalities, lymphadenopathy, and extensive internal organ involvement. Characterized by a long latency period, this unusual side effect of aromatic anti-epileptic drugs, as well as many common drugs cause a mortality rate of up to 10% if left untreated. In the absence of a well-established therapy, primary and secondary prevention have a key role in the management of DRESS Syndrome. Herewith presenting a case of an adolescent girl with rashes and systemic symptoms, the cause of which, on obtaining a detailed …

The Financial Burden Of The Urology Match: Room For Improvement, Jinfeng Jiang, Joshua S. Engelsgjerd, Chad A. Lagrange, Christopher M. Deibert

Graduate Medical Education Research Journal

Abstract

Introduction/ Background – The Urology match remains highly competitive, but there is limited published data on the costs of the application process for contemporary applicants. This study aims to determine the financial burden of the Urological match and the effect it has on applicants.

Methods/ Materials – All applicants to the University of Nebraska Medical Center (UNMC) Urology Residency in the 2019 Urology match were invited to complete an anonymous, IRB approved online survey containing 16 questions on interview travel and costs, financial aid, and debt burden.

Results – Thirty-nine out of 183 (21%) applicants responded to the survey. …

An Overview Of Neurology Residency Training In Epilepsy At The University Of Nebraska Medical Center, Daniel Crespo Artunduaga, Mohamed Taha, Arun Swaminathan

Graduate Medical Education Research Journal

Neurology residency offers a comprehensive training program over 4 years in management of various neurological disorders. Epilepsy represents a common condition managed by neurologists and forms a core curriculum in the training of neurology residents. We conducted an anonymous survey among the trainees at our neurology program to identify knowledge and treatment gaps and help us modify our training regimens to provide high impact and good quality training to our trainees. We conducted a 35-question survey to determine various aspects of our neurology residents’ training to identify and overcome shortfalls. Our program requirements are rigorous and match up with those …

Long Term Outcomes Of Surgical And Clinical Symptoms Following Minimally Invasive Heller Myotomy: A Retrospective Clinical Database Review, Laura E. Flores, Priscila Rodrigues Armijo, Bhavani Pokala, Sarah Samreen, Dmitry Oleynikov

Graduate Medical Education Research Journal

I

Introduction

Minimally invasive Heller myotomy rates have increased, but little evidence is available regarding long term clinical and surgical outcomes. Our aim was to evaluate long term symptom improvement and medication resolution for patients undergoing minimally invasive Heller myotomy.

Methods

A single-institution database was retrospectively reviewed for patients undergoing laparoscopic Heller myotomy (LHM) or robotic Heller myotomy (RHM) during 2007-2018. Patients with primary HM followed by a Dor fundoplication were included. Demographics and surgical data were analyzed. Esophageal symptoms, testing, and medication use were collected preoperatively (pre-op), at 6-month (6-mo), 12-month (12-mo), and long-term (LT; 12-mo+) follow-up. Analysis was …

Necrotizing Enterocolitis Following Gastroschisis Repair: An Update, Rachel K. Schlueter, Shahab F. Abdessalam, Stephen C. Raynor, Robert A. Cusick

Graduate Medical Education Research Journal

Purpose:

Necrotizing enterocolitis (NEC) is a known complication of gastroschisis with an incidence above the expected rate in the neonatal population. While many physicians today are aware of this association, the last publication to explore this association in detail and identify possible risk factors of NEC in gastroschisis patients was published over twenty years ago. From our large database of patients with gastroschisis managed by a single group of pediatric surgeons, we reviewed our experience and the recent literature to update what is known about gastroschisis and NEC.

Methods:

From 2001 to 2017, a gastroschisis registry was maintained. Data from …

Comprehensive Chronic Pain Treatment: Does Smoking Affect Outcomes?, Jamison Hofer, David Cates, Valerie K. Shostrom, Brendan Thelen, Kimberley Haynes-Henson

Graduate Medical Education Research Journal

Abstract

Objective: To determine whether smoking status effects pain and functional outcomes in a chronic pain program.

Methods: A retrospective cohort study of 178 patients treated at the Nebraska Medicine comprehensive Pain Management Program over a five year period was completed. Outcomes measures were the Visual Analog Scale Past Month Average Pain score (VAS-PMA), Multidimensional Pain Inventory pain and interference scales (MPI-P and MPI-I), and the Pain and Impairment Relationship Scale (PAIRS). Patients were categorized by smoking status into non-smoker or current smoker groups. Wilcoxon tests were used to compare the pre scores, post scores, and post-minus-pre scores between smoking …

Perceptions Of Safety And Support Among High School Football Players Utilizing A Helmet Impact Detection System, Chris Snyder, Kailey Snyder, Alyssa Irby, Danae Dinkel, Adam B. Rosen

Graduate Medical Education Research Journal

Background: Concussions are common in high school football athletes and can have short and long-term health impacts. New football helmets furnished with accelerometers to detect rate and location of impact have recently emerged. The use of these helmets offers the ability to rapidly and objectively assess concussions on the sideline. However, minimal research has explored athlete’s perceptions of the use of these helmets. Purpose: The purpose of this study was to determine high school football players’ perceptions of safety and support following a season of use of a Helmet Impact Detection System. Methods: 118 high school football players from a …

A Retrospective Study At Two Level One Trauma Centers On The Association Of Internal Injuries With Femoral Fractures, Ryan E. Miller, Catherine Olinger, Leonid Grossman, Dennis Chakkalakal, Karl Bergmann, Elizabeth Lyden, Justin Siebler

Graduate Medical Education Research Journal

Abstract: Injuries capable of fracturing the femur often involve concurrent internal organ damage. However, up to 25% of injuries are initially missed. Prior studies evaluating the association of femur fractures with internal injury included only automobile trauma, were skewed toward more severe injuries, and were broad database studies. To our knowledge, there are no studies of this kind that include bicycle, motorcycle, and motor vehicle-pedestrian trauma, excluding those deceased at the scene, and which included chart reviews. We hypothesized that in the trauma setting, the presence of a femur fracture would correlate with an increase in concomitant internal organ injuries. …

Orthopaedic In-Training Examination (Oite) Preparation And Study Habits Of Orthopaedic Residents: Revisited, Christopher F. Deans, Emmett J. Gannon, Joseph Morgan, Elizabeth Lyden, Matthew Mormino

Graduate Medical Education Research Journal

Introduction: The Orthopaedic In-Training Examination (OITE) is well-established as the cornerstone for educational evaluation of orthopaedic surgery residents. Great significance has been placed on the OITE, particularly as it has been found to correlate closely with successful completion of the American Board of Orthopaedic Surgery Part I Exam (ABOS I). Our study correlated different aspects of OITE study preparation, including resources and habits, with OITE performance.

Methods: An online survey was created to assess these different aspects and distributed to 163 programs across the United States for distribution to orthopedic residents in each program.

Results: Data analysis showed …

Age-Adjusted Incidence Rates And Time Trends Of Non-Hodgkin Lymphoma By Subtype, 2000-2015, Daitrang Le

Capstone Experience: Master of Public Health

Background: Non-Hodgkin lymphomas (NHL) are a group of diverse and complex cancers of the lymphocytes. More than 60 subtypes have been identified based on certain characteristics of the cancer cell. The objectives of this study were to: 1) determine NHL age-adjusted incidence rates from 2000 to 2015 in the U.S. by age, sex, and race/ethnicity; 2) to examine age-adjusted subtype-specific NHL incidence rates by age, sex, and race/ethnicity; 3) to determine if there was significant time trend in age-adjusted NHL incidence rate from 2000-2015 in the U.S by age, sex, and race/ethnicity.; 4) and to examine time trend in age-adjusted …

Association Between Gastroduodenal Ulcer And Age Of Diagnosis Of Head And Neck, Gastroduodenal And Pancreatic Cancer, Rukevwe Madusor

Capstone Experience: Master of Public Health

Background: Cancer is the second leading cause of death in the United States and remains a major public health problem worldwide. Epidemiological studies have demonstrated that insulin like growth factor-1 (IGF-1) is linked to ulcers and most cancers. Although studies have investigated the role of IGF1 in ulcer healing and cancer pathogenesis, the link between ulcer and cancer remains unclear. Hence, we assessed the relationship between ulcers and cancers.

Methods: This study consists of a sample of 180 cancer patients obtain by convenience sampling who were seen at Nebraska Medicine and were enrolled in the integrated cancer repository for cancer …

Assessment Of Particulate Matter Levels In Homes With Children, Ali Al Rabou

Capstone Experience: Master of Public Health

Children’s exposure to particulate matter (PM) is of great interest because it can cause adverse health effects, including asthma, and decreased lung function. The purpose of this study was to determine the levels of PM in low socio-economic status homes in Omaha, Nebraska. Between October 2018 and September 2019, we collected ambient air PM samples from 30 homes, of which 70% had at least one asthmatic child. Samples were collected at 2 feet and 4 feet to represent the breathing zones of toddlers and older children, respectively. We also asked the study participants questions related to indoor air quality (IAQ). …

Influence Of Health Habits On The Success Of The Community Response Program, Hannah Harrington

Capstone Experience: Master of Public Health

The goal of this project is to determine how specific health habits can affect success of the Community Response (CR) program. Community Response is a program that brings government, non-profit and faith-based organizations together in one community to share resources, identify challenges and create solutions with the goal of strengthening the protective factors that help families raise happy, healthy children (Lift Up Sarpy County, 2018). Health habits include habits centered around everyday life including protective factors such as maintaining support systems, financial stability, and other ways to strengthen families, eliminate risk, and keep children out of the child welfare system. …

The Association Between Melanoma And Exposure To Arsenic Among U.S. Adults Using The National Health And Nutrition Examination Survey (Nhanes) From 2003 To 2016, Ahmed Bedaiwi

Capstone Experience: Master of Public Health

Background: Melanoma is a deadly skin cancer at late stages, and its incidence has been increasing significantly over the last ten years in the United States. Chronic exposure to arsenic has been associated in many studies as a risk factor for non-melanoma skin cancer, notably squamous cell carcinoma. However, current knowledge is limited regarding melanoma and long-term arsenic exposure.

Methods: We conducted a cross-sectional study using the 2003-2016 cycles of the National Health and Nutrition Examination Survey (NHANES), to investigate the association between arsenic exposure and self-reported melanoma and non-melanoma skin cancer diagnoses. Univariate and multivariate logistic regressions were conducted. …

Evaluating Occupational Hazards And Personal Protective Equipment Use On Farms In Kyrgyzstan, Christopher Tougeron, Chandran Achutan, Kenesh Dzhusupov, Lorena Baccaglini

Capstone Experience: Master of Public Health

Objectives – The purpose of this study was to identify occupational hazards and personal protective equipment use on farms operating in Kyrgyzstan.

Methods – We recruited 20 farmers in Kyrgyzstan. They completed a questionnaire and responded to interview questions to determine their occupational hazards, personal protective equipment use, and work-related injuries. We measured noise levels using the National Institute for Occupational Safety and Health sound level meter application for Apple iOS.

Results – Most farmers reported knowing how and when to use personal protective equipment, however 95 percent had not received training on how to use them. Observation of farmers …

Organizational Culture Change In The United States Government And Its Application In State And Local Public Health Agencies: A Literature Review, Katherine Barrow

Capstone Experience: Master of Public Health

State and local health agencies play a critical role in the assessment and assurance of public health in the United States. Their authority to shape the structure and delivery of health services makes organizational culture change imperative for the improvement of government services and ultimately, the health of the public. A systematic literature review using SCOPUS, PsycINFO, Business Source, and Academic Search Premier was conducted to 1) analyze organizational culture change efforts in United States federal, state, and local government settings and 2) make recommendations on how to implement organizational culture change initiatives in state and local health agencies. Of …

Developing A Training Program For Omaha Metro Area Sexual Assault Nurse Examiners Caring For Individuals With Developmental Disabilities, Emily Blanchard

Capstone Experience: Master of Public Health

Individuals with developmental disabilities experience many barriers to healthcare and are at a substantially higher risk for sexual assault and trauma. There is a need for more inclusive and collaborative healthcare policies, practices, and education to guide healthcare providers during their encounters with individuals with developmental disabilities as patients, especially during forensic examinations following sexual assault and trauma. In the Omaha metro area, physical therapists at the Munroe-Meyer institute provide clinical services in a transdisciplinary program that refer victims of sexual violence to local health systems’ Sexual Health Nurse Examiners (SANEs).

There is an existing service gap for individuals with …

Using Syndromic Surveillance To Assess The Impact Of Environmental Factors On Asthma- And Copd- Related Ed Visits In Douglas County, Nebraska, Sandra Gonzalez-Ramirez, Anne Mardis O'Keefe, Tricia D. Levan, Lynette Smith

Capstone Experience: Master of Public Health

Background: Asthma and chronic obstructive pulmonary disease (COPD) are chronic diseases associated with health disparities in Douglas County, Nebraska and in the United States. Currently there is a lack of information describing the impact of environmental factors in Nebraska on the burden of emergency department (ED) visits or hospitalizations related to these chronic respiratory (CR) diseases. The aim of this study was to determine if there is an association between the numbers of seasonal viral respiratory (SVR)- related ED visits, outdoor air pollutants, aeroallergens, or meteorological factors on the number of CR- related ED visits in Douglas County, Nebraska.

Methods: …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience: Master of Public Health

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Trends Of Endometrial Cancer Among Adult Women In The United States, Fnu Kanishka

Capstone Experience: Master of Public Health

Background: Endometrial cancer also referred to as uterine corpus cancer is the fourth most common cancer diagnosed among US women. It is also one of the few cancers in the US that has an increasing incidence and mortality rate. This study examined the overall and race specific age-adjusted incidence rate as well as incidence-based mortality rate of endometrial cancer in the United States from 1975-2016.

Methods: Surveillance, Epidemiology, and End Results (SEER) 1975-2016 data were used. Overall and race specific age-adjusted incidence rate, incidence-based mortality rates and 95% confidence intervals were calculated Trend graphs were created, annual average percent change …

Evaluation Of Relationship Between Lead-Dust Loading, Lead-Dust Concentration, And Total Dust Loading Metrics Across Multiple Data Sets, Charles Bevington

Capstone Experience: Master of Public Health

Lead-dust monitoring studies report values as either lead-dust loadings µg/ft² or as lead-dust concentrations µg/g. It is rare for studies to report both metrics. When only lead-dust loading values are present, professionals require an approach to estimate lead-dust concentration values. A literature search identified five studies that contained raw data for both lead-dust loading and lead-dust concentration. An additional thirty-two studies had summary-statistics available for both lead-dust loading and lead-dust concentration. Studies with raw-data were used to develop an empirically-based loading to concentration statistical relationship. Raw data sets were critically evaluated to determine whether elimination or …

Cs-Cash Pilot Grant: Improving Agricultural Worker Health & Safety Awareness Through Multimodal, Case-Based Physician Assistant Education, Carey Wheelhouse, Mia Hyde, Annie Wildermuth, Wayne Mathews

Posters and Presentations: Physician Assistant

The University of Nebraska Medical Center Division of Physician Assistant Education intends to improve health outcomes of patients in Midwest agricultural communities through didactic, clinical, and case-based instruction of Physician Assistant (PA) students.

Aims

1. Increase PA student awareness of agricultural health and safety issues
2. Increase PA student medical knowledge on respiratory health, chemical exposure, and noise-induced hearing loss
3. Enhance PA student communication skills with agricultural patients
4. Increase patient health care access in agricultural environments

UNMC PA students will undergo learning specific to agricultural-related respiratory health issues, chemical exposures, and hearing loss, including preventative health education and communication with agricultural patient …