Medicine and Health Sciences Commons^™

Enhancing Scholarly Productivity Among Physical Therapy Faculty Through Professional Networks, Betsy J. Becker, Gilbert Willett, Victoria Kennel

Posters and Presentations: Physical Therapy

Purpose

Let's build a talented workforce of physical therapy educators with diverse ideas who collaborate on projects and discover new knowledge! Faculty are the educational leaders in physical therapy. With growing demands on workload and time, it is essential to attract talent to academia and provide a supportive team to navigate the path toward a successful career. Scholarly productivity accreditation requirements are challenging, especially for new faculty with primary teaching responsibilities or those without an academic doctoral degree. Evidence suggests that network connections can improve faculty performance, innovation and retention. This study arose from concerns in recent years related to …

Who's In The Inner Circle? Exploring Network Connections Among Health Professions Faculty For Career Advancement, Maureen Becker, Elsie Wordekemper, Betsy J. Becker

Posters and Presentations: Physical Therapy

Purpose/Hypothesis

The purpose of this study is to explore the meaning of network connections in new or early career health professional faculty. Knowing this information can foster targeted faculty development strategies to build, leverage and maintain connections for advancement with scholarly activity. Faculty shortages currently exist amongst the medical and healthcare professions compounded by an aging U.S. population, increasing the demand for health care services.1 Each year, new faculty are hired, following carefully executed and costly searches. Much time, energy and finances are invested into "human" resources, not limited to, but including; salary, benefits and start up packages. All of …

Macromolecular Prodrug For The Treatment Of Ulcerative Colitis, Yuanyuan Sun

Theses & Dissertations

Ulcerative colitis is a chronic inflammatory bowel disease affecting the colon. More than 1 million Americans are affected, with the annual economic burden up to 14.9 billion in the United States. By far, ulcerative colitis still lacks the cure and the current treatment strategies are limited due to severe side effects and in-sufficient efficacy. The tofacitinib (Xeljanz) is the only approved oral medication by for adults with moderately-to-severely-active ulcerative colitis. But the related side effects and serious infections still have to be resolved. In the previous study in our lab, the researchers have successfully developed and characterized multiple hy-drophilic prodrug …

The Effectiveness Of Registered Dietitians In Diabetes Case Management, Meghan C. Mclarney

Theses & Dissertations

OBJECTIVE: The objective of this paper is to investigate the effectiveness of diabetes education provided by registered dietitians (RD) in a diabetes case management (DCMs) model, compared to diabetes education provided by RDs in the usual care model (UCM) at an outpatient endocrinology clinic in Omaha, Nebraska. This study hypothesizes that education by RD DCMs will be equal or more efficacious in regards to primary outcomes of A1C and BMI and secondarily, lipid results and adherence (total encounters) when compared to outcomes of UC.

METHODS: This is a cross sectional retrospective review of patients with diabetes (n=946), receiving traditional RD …

Synthesis And Characterization Of Long-Acting Rilpivirine Prodrugs, James R. Hilaire

Theses & Dissertations

Antiretroviral therapy (ART) requires lifelong daily dosing to suppress viral replication, restore or maintain immune function and improve quality of life. As an alternative, long-acting (LA) antiretrovirals (ARVs) aim to deliver therapeutic drug concentrations over an extended period, ultimately requiring monthly or even more extended dosing intervals. Specifically, the success of recent clinical trials examining LA cabotegravir and rilpivirine (CAB and RPV LA) highlight the advent of these novel HIV-1 therapeutics. Further optimization of LA dosage forms are required and rests upon improving dosing frequency, injection volumes and tissue distribution to viral compartments. To this end, we report the synthesis …

Perception Of Bone Mineral Loss On Cone-Beam Computed Tomography (Cbct) & Digital Periapical (Pa) Film: An Ex-Vivo Comparison, David P. Hamm

Theses & Dissertations

Using micro computed tomography (micro-CT) as a reference standard, the purpose of this investigation was to evaluate the influences of bone mineral loss and radiographic contrast in digital periapical (PA) film and cone-beam computed tomography (CBCT). Seven dog and human mandibles were sectioned, followed by modification via cortical bone drilling to create 248 lesions and/or trabecular bone acid demineralization to create 96 coronal slice pairs. Pretreatment and post-treatment radiographs (PA, CBCT, and/or micro-CT) were taken for lesion rating/perception in addition to two-dimensional (area) and three-dimensional (volumetric) measurements of 50 drilling lesions and 20 coronal slice pairs. 4-7% bone mineral loss …

Impediments To The Historical Development Of The Clinical Pap Test In The United States: Their Relevance In Optimizing Cervical Cancer Screening In The State Of Qatar, Nikolaos Chantziantoniou

Theses & Dissertations

Three hundred surveys listing 31 questions were distributed amongst women and men at Sidra Medicine, Doha, State of Qatar, to assess knowledge and perceptions of: Cervical cancer (CxCa); preventive Pap test screening; Human Papilloma Virus (HPV) vaccination; and, need for population-based screening. Survey questions captured categorical statistical data through four categories: (1) Socio-demographic; (2) Healthcare Services; (3) Health Literacy; and, (4) Self-efficacy and Perceptions. Hypothesis 1: 12 survey questions pertaining to CxCa and Pap testing revealed 8 statistically-significant dependencies; notably, 70% of respondents were aware of CxCa; however, 31.8% were unaware that CxCa may be curable; 33.7% were unaware …

Delineating Phenotypes Of Rare Disease, Lois J. Starr

Theses & Dissertations

Not available.

Health Literacy Changes In A Technology-Enhanced Diabetes Prevention Program, Cody Goessl

Theses & Dissertations

Background: In 2001, the Diabetes Prevention Program was published evaluating the efficacy of a pharmaceutical intervention, Metformin, and a behavioral lifestyle intervention (LI) to reduce incidence of Type 2 diabetes mellitus. The LI was observed to reduce the incidence of the disease by 58% relative to 31% in the medication treatment. Amongst technology based LIs, little has been done to address different health literacy populations.

Objectives: This dissertation evaluated how teach-back and teach-to-goal can influence the uptake of information obtained in each health education lesson, behaviors and its influence on engagement and weight loss.

Methods: Four hundred forty-two participants …

Maternal Cognitions And The Origins Of Early Sensorimotor Based Play In Infants Born Preterm, Sandra L. Willett

Theses & Dissertations

Maternal cognitions are beliefs, perceptions, and expectations that guide parenting practices. For at-risk infants born prematurely, these maternal constructs may influence the caregiving environment and opportunities for motor experience. The impact of maternal cognitions on motor development in infants born preterm is not well-documented. This three-part dissertation systematically explores: 1) the nature and extent of existing evidence supporting the link between maternal cognitions and motor development of infants born preterm, 2) if maternal perception of infant vulnerability as measured by an adapted Vulnerable Baby Scale (VBS) can be validly and reliably quantified in mothers of infants born preterm and near …

Planning And Implementation Of Physical Therapy Services In An Athletic Training Pro-Bono Clinic: An Administrative Case Report, Tessa Wells, Scott Unruh

Posters and Presentations: Physical Therapy

Background & Purpose

Athletic Training and Physical Therapy students have overlapping, yet unique aspects of clinical competencies and scopes of practice, offering rich potential for interprofessional partnership. University of Nebraska Medical Center (UNMC) Doctor or Physical Therapy Education expanded its program to the University of Nebraska-Kearney (UNK) campus, which boasts a Division II athletic training (AT) program. To create meaningful IPE experiences for both programs (1,2), campus leaders from the UNMC College of Allied Health Professions and UNK sought to create an interprofessional clinic by adding PT care to an existing AT-led pro-bono clinic serving the University intramural recreation community. …

Association Of Copy Number Variations With Chronic Hepatitis B In Chinese Population, Fang Niu

Capstone Experience: Master of Public Health

With one third of the Hepatitis B virus (HBV) infection population of the world, chronic Hepatitis B (CHB) has become a top burden in China. CHB is a lifelong infection with HBV which can cause serious health problems, like cirrhosis, liver cancer or even death. HBV infection is known to result in various clinical conditions, including asymptomatic HBV carriers to chronic hepatitis and primary hepatocellular carcinoma. Several studies have shown that host genetic susceptibility could be an important factor that determines these various outcomes of HBV infection. Many Single Nucleotide Polymorphisms (SNPs) and Copy Number Variations (CNVs) have been associated …

Comorbidity Profile Of Head And Neck Cancer Patients With And Without Depression, Michaela Frenzel

Capstone Experience: Master of Public Health

This population-based retrospective study used SEER-Medicare data from 2002-2010 to assess depression, comorbidity, and substance use in the elderly head and neck cancer population. Out of 3,533 head and neck cancer patients, 10.6% had depression diagnoses two years prior to cancer diagnosis, 8.9% were newly diagnosed with depression within one year after cancer diagnosis, and 44.5% of those with preexisting depression had an additional depression diagnosis within one year following cancer diagnosis. Comorbid conditions (p<0.0001) and substance use (p=0.0017) showed associations with depression prior to cancer diagnosis yet, no significant associations with incidence of depression in this head and neck cancer population. This study affirms the need for continual depression screenings in head and neck cancer patients and suggests the need for increased research into the burden of comorbid conditions and substance use within the head and neck cancer population.

The Lived Experience Of Psychological Occupational Stress In Early Childhood Education, Brooke Fletcher

Capstone Experience: Master of Public Health

Early childhood education (ECE) programs have been recognized by the Institute of Medicine and the Administration for Children and Families as excellent interventions to alleviate the long-term negative effects of poverty in the United States, but the quality of intervention provided and outcomes for the target population are adversely hindered by high occupational stress burdens for ECE teachers. According to Sheridan, Edwards, Marvin, and Knoche, the models used to address this concern are not empirically supported for specific applicability to ECE nonprofit settings. There is a need for deeper understanding of the lived experiences of ECE teachers, including the psychological …

Evaluation Of Family Inc.'S Home Visitation Program, Brooke A. Linnenbrink

Capstone Experience: Master of Public Health

FAMILY, Inc. is a nonprofit that provides public health and family support services to women, children, and families in Pottawattamie and Mills counties. It's home visitation program provides health education information to families in the communities that are expecting a child or have a child less than five years of age. This project looked at FAMILY, Inc.’s database regarding the health of children enrolled in their home visitation program and use that information to help develop health education tools as they prepare to expand their programming to include Early Head Start (EHS). Currently FAMILY uses the Parents as Teachers curriculum, …

Explore Barriers Associated With Not Testing For Hiv Among Men Who Have Sex With Men In Dodoma, City, Tanzania, Maria M. Mushi

Capstone Experience: Master of Public Health

Goal

The goal of the project is to explore barriers associated with not testing for HIV among men who have sex with men (MSM) in Dodoma City, Tanzania.

Objectives

In order to achieve the goal of exploring barriers associated with not testing for HIV among MSM, I will plan and conduct the study, analyze the data, and prepare the final research report.

Methods

A qualitative descriptive study will be conducted in Dodoma City, Tanzania. A total of 10 MSM 19 years of age and above will be purposefully selected by 3 peer educators to be part of the study. I …

Following The Growth Of Sarah's Baby: An Ipe Activity For Medical Nutrition & Diagnostic Sonography Students, Tanya M. Custer, Megan Timmerman, Cynthia M. Schmidt, Teresa L. Hartman, Harlan Sayles, Kathryn Wampler, Lea Lambing, Kim Michael

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Objectives: Interprofessional education (IPE) involves collaborative learning among students from different professions. While acceptance of these types of activities is increasing, there are opportunities to expand the number of health care professions involved in IPE. The purpose of this study was to explore student perceptions and outcomes after participation in a Diagnostic Medical Sonography (DMS) and Medical Nutrition Education (MNE) interprofessional education activity centered around a clinical case study on fetal growth. Subjects & Methods: The IPE activity was administered to four student cohorts from academic years to 2015-2016 to 2018-2019. Participants included 66 students (n=39 DMS and n=27 MNE). …

Improving Internal Reliability Of A Trauma-Informed Care Program Evaluation Instrument, Ashley A. Raposo-Hadley

Capstone Experience: Master of Public Health

The project has analyzed the recent changes to the trauma-informed care (TIC) curriculum evaluation instrument by assessing the changes in Cronbach’s Alpha scores and effect significance. Data was collected from pre-training and post-training surveys completed at the time of delivery of the TIC curriculum training. Participants included hospital staff and medical or nursing students at Nebraska Medicine, University of Nebraska Medicine Center, and Health Creighton University Medical Center. The three research questions are (1) Did the item edits change item subgroupings? (2) Did the item edits increase instrument reliability? (3) Did the item edits impact statistical significance? 3 subscales, working …

Access To Care And Melanoma Incidence And Mortality In Nebraska, Natalia Trinidad

Capstone Experience: Master of Public Health

The purpose of this study is to determine incidence and mortality of melanoma across all counties in Nebraska in the context of access to primary care providers and dermatologists. Crude and age-adjusted incidence rates of melanoma from 2001-2016 by county were calculated for the following year intervals: 2001-2005, 2006-2010, 2011-2016. Variables for melanoma cases were obtained from the Nebraska Cancer Registry and included the case’s zip code at diagnosis, race, ethnicity, sex, age at diagnosis, year, cancer site, vital status, stage of disease, and the ICD-O code for the cancer type. Crude and age-adjusted mortality rates were calculated for the …

Interoperable Knowledge Modeling In Emergency Care: Application Of The Hl7 Emergency Care Domain Analysis Model, James C. Mcclay, Laura Heermann Langford

Posters and Presentations: Emergency Medicine

The Emergency Care System (ECS) in the United States provides intermittent unscheduled care to an increasing number of patients annually. Every ECS patient encounter generates data in a myriad of unlinked systems at regional emergency services and hospitals. Often, their prior health records are not available in a timely manner, fragmented, or not found. To address availability and interoperability data relevant to emergency care, the Health Level Seven (HL7) Emergency Care Workgroup seeks to ensure evolving health data interoperability standards incorporate ECS considerations. Foundational to that effort is a comprehensive model of Emergency Care information. This emergency care domain analysis …

Developing Interactive Curricular Elements With Teams Of Faculty, Staff And Students, Betsy J. Becker, Sara Bills, Robert H. Fuchs, Kellie Gossman, Tessa Wells, Peggy Moore

Posters and Presentations: Physical Therapy

Students are continually searching for new resources to augment their learning. Online resources have become highly favored, especially by the millennial age group, for convenience, self-paced content, and versatility across learning styles. It has been reported that e-learning platforms are as effective as traditional face-to-face instruction, but may be best utilized when used as an adjunctive resource for teaching psychomotor skills.1,2 In a study about student confidence, results showed an increase in self-efficacy following the use of online learning materials.3 Blended learning, the next generation of web-based education, mixes advances in technology with creative faculty to fuse effective delivery methods …

Multi-Campus Dpt Programmatic Development In A Public University: Leadership Considerations, Betsy J. Becker, Teresa Cochran, Joseph Norman, Kyle Meyer

Posters and Presentations: Physical Therapy

Background/Purpose: Institutional pressure for expanded revenue streams, coupled with workforce development needs to insure patient access of health resources both drive programmatic expansion of healthcare education programs across multiple campus sites. Such expansion is predicated on deliberate planning and resource acquisition for effective course delivery and successful programmatic outcomes. The University of Nebraska Medical Center’s College of Allied Health Professions opened a second campus site in 2016, located 185 miles from the main campus and the urban corridor of the state. The Doctor of Physical Therapy (DPT) program (and four additional allied health professions) modified traditional course delivery to create …

Monocyte Anti-Inflammatory Activity Is Dictated By Metabolic Status During Staphylococcus Aureus Biofilm Infection, Kelsey J. Yamada

Theses & Dissertations

Staphylococcus aureus biofilms represent a significant cause of morbidity and economic burden and are often associated with nosocomial infections, including medically implanted devices. In particular, prosthetic joint infections (PJIs) are a growing concern due to the continued increase in orthopedic procedures. Staphylococcal species cause >50% of all PJIs, while S. aureus represents the most invasive and associated with the most morbidity. S. aureus-associated biofilm infections are recalcitrant to antibiotic therapy, due to both the acquisition of genetic elements and metabolic dormancy. Furthermore, S. aureus biofilm infections remain chronic because they cannot be cleared by the immune system. Recent studies …

God, I Hope This Part Of My Life Is Over: A Focused Ethnography Of A Correctional Youth Facility’S Therapeutic Climate, Eric Meyer

Theses & Dissertations

Although all prisons have the same goal of isolating offenders from society, the precise strategies used vary from one jurisdiction to the next. Some prisons use means of punishment to gain inmate compliance. Other prisons concentrate their limited resources on rehabilitation. Contained within the following pages are details of a focused ethnography that was completed in a state correctional youth facility that housed males between the ages of 15 and 21 years, all of whom were convicted of violent crimes. This study had the objective of exploring the climate of therapy in this correctional youth facility where rehabilitative programs were …

Common Areas For Improvement From After Action Reports (Aars) Generated After Exercises Or Actual Disasters, As Reported By A National Sample Of U.S. Hospitals, Abdoulaye Abdoulaziz

Theses & Dissertations

Many hospitals conduct exercises every year, and they conclude the process with an After-Action Report and Improvement Plan. Therefore, there are thousands of AAR/IP’s across the country with limited opportunity to compare them or to learn from them collectively. Our project has gathered Improvement Plans (IP’s) and conducted a qualitative analysis which determined whether the “lessons learned” can be categorized into common themes.

Development Of Macromolecular Prodrug Conjugates For The Treatment Of Inflammatory Diseases, Gang Zhao

Theses & Dissertations

Inflammation is the complex biological response to the stimuli triggered by various factors like pathogens, damaged cells, or irritants. Constant uncontrolled acute inflammation may become chronic conditions, leading to significant tissue damage, contributing to a series of chronic inflammatory diseases. Our lab has been working on the different types of inflammatory diseases and has developed multiple macromolecular prodrug conjugates for the better therapeutic efficacy and reduced toxicity. The general approach we have taken is to incorporate small molecules containing monomers into water-soluble and biocompatible polymers, such as N-(2-Hydroxypropyl) methacrylamide (HPMA) copolymers. The superior and the sustained efficacy of those macromolecular …

Relationship Between Binge Eating Disorder And Circadian Chronotype, Leon B. Jons

Theses & Dissertations

Binge eating disorder (BED) is a common condition in the general population and is more common in individuals with obesity. The later timing of food intake has been associated with an increase incidence of obesity. The purpose of this study was to evaluate the relationship between circadian chronotype and BED in a population of individuals with obesity. The sample consists of a retrospective review of 170 subjects presenting to an obesity medicine clinic who had been clinically evaluated for BED and chronotype.

No significant correlation was found between BED and a late chronotype in this population. In a secondary analysis …

Polymeric Chloroquine: Modifying An Old Drug To Make It A Little Sweeter, Richard Sleightholm

Theses & Dissertations

Hydroxyethyl starch (HES) is a clinically used polysaccharide colloidal plasma volume expander. The goal of this study was to synthesize HES modified with hydroxychloroquine (HCQ) as a novel polymeric drug with the ability to inhibit the invasive character of pancreatic cancer (PC) cells. HES was conjugated with HCQ using a simple carbonyldiimidazole coupling to prepare Chloroquine-modified HES (CQ-HES). CQ-HES with various degrees of HCQ substitution were synthesized and characterized. In vitro studies showed CQ-HES to have a similar toxicity profile as HCQ. Confocal microscopy revealed the propensity of CQ-HES to localize to lysosomes, and mechanistic studies confirmed the ability of …

Development Of Approaches Of Tumor Trapping Enhanced Bb2r-Targeted Radiopharmaceuticals For Prostate Cancer, Wenting Zhang

Theses & Dissertations

The Gastrin-Releasing Peptide Receptor (BB2r) has been intensively investigated as a cancer target over the years. Numerous diagnostic and therapeutic BB2r-targeted agents have been developed for various solid tumors, including prostate cancers, due to the high expression level of BB2r on neoplastic relative to normal tissues. The development of those targeted agents have mainly utilized the modified c-terminal of bombesin(BBN), a peptide that has nanomolar binding affinity to human BB2r. However, a major issue that hinders the clinical translational potential of low-molecular weight, receptor-targted agents, is their short residence time at tumor tissues due to the intrinsically high diffusion and …

Barriers And Facilitating Factors To The Integration Of The First Uk-Trained Physician Associates Onto Secondary Care Services In The British National Health Service, Tamara S. Ritsema

Theses & Dissertations

Introduction: The Physician Associate (PA) profession was brought from the United States (where it is called the "Physician Assistant" profession) to the United Kingdom (UK) approximately 15 years ago. Universities have begun to train PAs and these graduates are now starting work in the British National Health Service (NHS) in both primary and secondary care. The number of PAs graduating from PA programs and beginning to work in secondary care will increase substantially over the next few years. No research has been conducted on barriers and facilitators to the integration of a UK-trained PA onto a secondary service.

Methods: A …