Medicine and Health Sciences Commons^™

Health Program Quality Evaluation To Identify Program Improvement Opportunities, Sheila V. Phillips

Capstone Experience: Master of Public Health

Abstract

Objective: to identify Health Program improvement opportunities including reducing risk of unplanned visits.

Background: Health Program is a program in a Midwest community assisting persons with diabetes and Medicaid to help patients better self-manage their diabetes and connect with community resources. Communities are challenged with helping a growing number of persons with diabetes with multiple chronic conditions, medications, and increased use of unplanned visits. Information was needed to understand unmet needs of this population associated with unplanned visits to develop program improvements.

Methods: In a quality evaluation of a single center, a model of baseline prognostic factors associated with …

Assessing Quality Of Life And Mental Health Differences Among Young Adult Informal Caregivers And Non-Caregivers In Nebraska, Emily L. Frankel

Capstone Experience: Master of Public Health

The goal of this project is to identify differences in quality of life and mental health between younger informal caregivers and non-caregivers, ages 19-40, in Nebraska. To address this goal, a demographic and health assessment battery was disseminated to eligible participants (N=60), comprised of informal caregivers (N=30) and age-, education-, and gender-matched non-caregivers (N=30). The health assessment included reliable and validated questionnaires, including the RAND SF-36, EuroQol 5D, Kessler Psychological Distress Scale, and the General Health Questionnaire. By discovering relationships between quality of life and mental health with the length of time providing care, programming and intervention recommendations can be …

Effects Of Perioperative Hyperglycemia In Patients With Diabetes Compared To Patients Without Diabetes: A Retrospective Study Of Treatment And Outcomes, Matthew Anderson

Capstone Experience: Master of Public Health

The main goal of this project was to examine the differences in perioperative hyperglycemia treatment received by patients with a diagnosis of diabetes mellitus (DM) and patients without a diagnosis of diabetes (NDM); and how these treatment differences can affect the length of hospital stay. Studies have revealed that, when comparing DM and NDM patients with the same degree of perioperative hyperglycemia, NDM patients suffer worse outcomes. It has been suggested in previous research that this may be because NDM patients receive treatment that does not measure up to the standard of care treatment that DM patients receive. In this …

Assessing The Workforce Of The Southwest Nebraska Public Health Department For The Development Of A Workforce Development Plan, Arnel Ramos

Capstone Experience: Master of Public Health

The purpose of this project was to assess the capacity and needs of the Southwest Nebraska Public Health Department (SWNPHD) workforce and to develop a workforce development plan that would meet the accreditation standards of the Public Health Accreditation Board (PHAB). An assessment survey was developed online through the Survey Monkey website using competency skills based on the guidelines established by the Council on Linkages Between Academia and Public Health Practice. The selected competency skills were reviewed and approved for relevance by the SWNPHD leadership and the University of Nebraska Medical Center, College of Public Health, Office of Public Health …

Implementation Of A Survey To Reduce Urine Pregnancy Tests Prior To Gynecology Procedures In Primary Care, Rachel Morgan Budihas

Capstone Experience: Master of Public Health

Excluding pregnancy in individuals prior to initiating contraception is important. The Pregnancy Reasonably Excluded Guide (PREG) uses twelve questions related to a patient’s reproductive history to effectively rule out pregnancy without administering a urine pregnancy screen, saving the patient both time and money. The PREG survey was given at Mayo Clinic in Rochester, MN, from 2015 to 2018 to all patients receiving an Intrauterine Device or Subdermal Implant.

This study examined data from the 2018 collection year to determine if urine screening requests by providers were reduced from the pre-PREG data. It also determined whether urine tests were requested disproportionally …

Do Molecular Subtypes Of Breast Cancer Affect Outcomes Following Hypofractionation Or Conventional Fractionation Radiation Therapy?, Richard Sleightholm

Capstone Experience: Master of Public Health

Introduction

Molecular subtypes of breast cancer (BC) are well-established prognostic markers in early-stage BC patients. The addition of radiation therapy (RT) to breast-conserving surgery has improved outcomes in this patient population, with conventional fractionation (CF) and hypofractionation (HF) regimens displaying comparable morbidity and mortality. However, most studies have not taken into account molecular subtype. Thus, it is still unknown if outcomes are similar between CF and HF for each molecular subtype. Herein, the effects of molecular subtype on the efficacy of CF and HF radiotherapy regimens for early-stage BC patients receiving adjuvant RT was investigated.

Methods

A retrospective review of …

Great Plains Behavioral Risk Factor Surveillance System Project, Florence G. Duran

Capstone Experience: Master of Public Health

Background: Great Plains American Indians/Alaska Natives (AI/ANs) experience higher mortality rates than Non-Hispanic Whites from the same region. The National Behavioral Risk Factors Surveillance System (BRFSS) survey can have limitations of the estimates the health risks behaviors and services from one Tribal community to another. Goals and Objectives: The goal of this project is to address the lack of Tribal specific data among AI/ANs in the Great Plains region (ND, SD, NE, IA) by using Great Plains Tribal BRFSS data that captured information for three tribes in the Great Plains region. Tribal specific data will allow tribes to access, …

Creation Of Evaluation Tools For Workforce Development Opportunities Within A Local Health Department, Nancy Ann Esch

Capstone Experience: Master of Public Health

Improving the skills and competencies of the Central District Health Department’s (CDHD) workforce is essential in assuring the public’s health. However, to develop the desired skills and competencies of the workforce requires effective training programs. CDHD provides professional development funds to all staff to attend workforce development opportunities that can be used on specific training relevant to their position. Approved trainings at CDHD, however, are not evaluated for effectiveness. This capstone project aimed to develop evaluation tools to help determine the effectiveness of training programs at the CDHD. Kirkpatrick’s Four Levels of Training Evaluation (2016) was used to help build …

The Association Between Neurocognitive Impairment And Health-Related Quality Of Life Among People Living With Human Immunodeficiency Virus (Hiv)., Philip S. Amara

Capstone Experience: Master of Public Health

Background: Despite the use of combination antiretroviral therapy, HIV associated neurocognitive impairment (NCI) persists in HIV seropositive persons, albeit in milder forms than before therapy was available. Nevertheless, the relationship between NCI and health-related quality of life (HRQoL) is not well known.

Method: Baseline data from the CHARTER study was used to investigate the association between NCI and HRQoL. Factor analysis was employed to summarize the 35-item Medical Outcome Survey questionnaire into physical and mental HRQoL scores. General linear models were employed to investigate the association between NCI, as measured by global deficit scores (GDS), and HRQoL, and to control …

Mindful Meditation Practice For Imaging Professionals, Tanya M. Custer, Kim Michael

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Although a career in medical imaging is very fulfilling and rewarding, research shows that health care professionals are becoming more prone to burnout. The healthcare environment can be face-paced, stressful and demanding. Burnout syndrome results from emotional exhaustion that causes depersonalization and decreased professional accomplishment.1-3 Burnout can have a negative impact not only on the individual, but the environment as well. Decreased patient satisfaction and increased errors are both associated with burnout in the healthcare setting.2

Mindfulness can be defined as the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of …

Improving Antimicrobial Stewardship Programs In Small Community Hospitals Through An Assessment And Feedback Model, Philip Chung, Kate Tyner, Scott Bergman, Terry Micheels, Mark Rupp, Michelle Schwedhelm, Maureen Tierney, Muhammad Salman Ashraf, Trevor Van Schooneveld

Posters and Presentations: Nebraska ASAP

Small community hospitals often lack expertise and resources for antimicrobial stewardship program implementation. Using an assessment-and-feedback model, Nebraska ASAP performed onsite assessment of antimicrobial stewardship efforts in 5 small community hospitals and provided facility specific feedback on implementation/augmentation of antimicrobial stewardship program. As a result of this model, participating small community hospitals were able to increase the number of antimicrobial stewardship core elements implemented while reducing antibiotic use and incidence of CDI.

Assessment Of Trends In Population-Based Health Indicators In The Great Plain States, Jessica Pahwa, Shinobu Watanabe-Galloway

Posters and Presentations: College of Public Health

Purpose/Objective: The objective of this study is to analyze the geographic trends and to highlight the importance of social and geographic based health disparities using population health indicators and Health determinants among the great plains states (Nebraska, North Dakota and South Dakota).

Methods/efforts: Online databases (CDC, BRFSS, America’s Health Rankings, SAMHSA, County health rankings etc) were accessed to collect data population-based data for the great plains states. The incident rates of 10 health indicators and health determinants were chosen and studied. After tabulating the data in excel, the analysis was made through plotting graphs in SAS. Line graphs depicting the …

Income Generating Contracts At Non-University Clinics, Kelly Gonzales

Posters and Presentations: College of Nursing

No abstract provided.

Traditional And Innovative Approaches To Faculty Practice: Income Generating Contracts At Non-University Clinics, Kelly Gonzales

Posters and Presentations: College of Nursing

No abstract provided.

Where Are We Now? Practice-Level Utilization Of Nurse Practitioners In Comparison With State-Level Regulations, Jana Zwilling, Kathryn Fiandt

Posters and Presentations: College of Nursing

Background. Full practice authority for NPs is optimal for high-quality, cost-effective healthcare. However, a complete picture of utilization after states have adopted full practice authority needs to be determined. Objective. To review the evidence regarding practice-level utilization (PLU) of Nurse Practitioners (NP) PLU in comparison to state-level regulations (SLR). Data Sources. Studies published in English and based on US populations were identified through PubMed, CINAHL, and SCOPUS (January 1, 1989 - December 31, 2018), and bibliographies of retrieved articles. Of the 419 articles identified with these limits, 19 (5%) met all inclusion and exclusion criteria. Conclusions. Four categories …

Asking Before Accessing, Jennifer Baumert, Carly Hornig

Posters and Presentations: State of the Art Nursing Conference

No abstract provided.

Embracing Technology As The Extension Of Nursing Practice To Enhance The Patient Experience, Liz Raabe, Brandon Fleharty

Posters and Presentations: State of the Art Nursing Conference

No abstract provided.

Meaningful Measurement Of Diversity Initiative Outcomes, Cheryl Thompson

Posters and Presentations: State of the Art Nursing Conference

Diversification of students graduating from Nebraska colleges and schools of nursing is essential to providing a diverse healthcare workforce. Diversity related strategic plans typically include goals expressed using terms such as “increase”, “improve”, or “enhance” the diversity of their applicant pools or graduates. Less common is the practice of providing specific quantitative goals for setting or measuring progress towards expressed goals. This session will demonstrate a method for evaluating current diversity of students or graduates, setting concrete, measurable goals or benchmarks, and evaluating the outcome of diversity initiatives. Participants will take home a detailed tool for determining if recruitment, admission, …

Analytic Appraoch To Determining Causes Of Graduate Student Attrition, Cheryl Thompson

Posters and Presentations: State of the Art Nursing Conference

Student data is collected for a variety of uses from application to graduation. Data is most often collected and stored in a fashion that supports single student data retrieval or mass processing of data, for uses such as preparation for graduation. Because of this, retrieving data for use in analytic reports and for problem solving across cohorts of students is often more difficult. Student services staff may have difficulty explaining to technology staff the nuances required to meet their data needs, particularly when multiple individual queries are needed to reach an answer. One such example is identifying the circumstances leading …

Ovalbumin-Sensitized Mice Have Altered Airway Inflammation To Agriculture Organic Dust, Kristi J. Warren, John D. Dickinson, Amy J. Nelson, Todd A. Wyatt, Debra J. Romberger, Jill A. Poole

Journal Articles: Internal Medicine

Agriculture exposures are associated with reducing the risk of allergy and asthma in early life; yet, repeated exposures later in life are associated with chronic bronchitis and obstructive pulmonary diseases. The objective of this study was to investigate the airway inflammatory response to organic dust extract (ODE) in mice with established ovalbumin (OVA)-induced experimental asthma. C57BL/6 mice were either OVA sensitized/aerosol-exposed or saline (Sal) sensitized/aerosol-challenged. Both groups were then subsequently challenged once with intranasal saline or swine confinement ODE to obtain 4 treatment groups of Sal-Sal, Sal-ODE, OVA-Sal, and OVA-ODE. Airway hyper-responsiveness (AHR) to methacholine, bronchiolar lavage fluid, lung tissues, …

Optimization Of Faculty Practice Revenue: Lessons Learned From The Past Four Years, Kelly Gonzales, Amelia P. Stoltman, Kate Fiandt

Posters and Presentations: College of Nursing

No abstract provided.

Optimization Of Faculty Practice Revenue: Lessons Learned From The Past Four Years, Kelly Gonzales, Amelia Stoltman

Posters and Presentations: College of Nursing

No abstract provided.

Creating And Administering A Faculty Practice Fund, Kelly Gonzales, Amelia P. Stoltman

Posters and Presentations: College of Nursing

No abstract provided.

Scientific Landscape Of Dental Literature In 2018, Jafar Kolahi, David G. Dunning, Edward F. Rossomando

Journal Articles: College of Dentistry

In the information age, human medical knowledge continues to grow exponentially, leading us to what could be best described as a knowledge tsunami. In 1950, medical knowledge doubled approximately every 50 years, by 1980, it doubled every 7 years, and by 2010, to a mere 3.5 years. Even more startling, in 2020 human medical knowledge will double in a stunning 73 days.^[1],[2] Nowadays dental professionals face unprecedented information overload and must somehow manage it. Text mining, network visualization, and big data management techniques will help us to analyze and summarize exponentially growing knowledge in field of dentistry. In …

Anti-Human Interleukin(Il)-4 Clone 8d4-8 Cross-Reacts With Myosin-9 Associated With Apoptotic Cells And Should Not Be Used For Flow Cytometry Applications Querying Il-4 Expression, Robert Z. Harms, Kiana Borengasser, Vikas Kumar, Nora Sarvetnick

Journal Articles: Surgery

Interleukin(IL)-4 is produced by T cells and other leukocytes and is a critical mediator of monocyte and B cell responses. During routine flow cytometry panel validation for the investigation of intracellular cytokines, we observed unique IL-4 expression patterns associated with the widely available monoclonal antibody 8D4-8. Namely, IL-4 (8D4-8) expression was observed in the absence of cellular activation and enhanced following staurosporine exposure. Mass spectrometry analysis of immunoprecipitates from peripheral blood lymphocytes (PBL) revealed that 8D4-8 cross-reacts with the ubiquitous cytoskeletal protein myosin-9. We confirmed these results by western blotting immunoprecipitates, using immunofluorescence among staurosporine-treated Caco-2 cells, and by surface-labeling …

Ca2+ Sensor Synaptotagmin-1 Mediates Exocytosis In Mammalian Photoreceptors, Justin J. Grassmeyer, Asia L. Cahill, Cassandra L. Hays, Cody Barta, Rolen M. Quadros, Channabasavaiah B. Gurumurthy, Wallace B. Thoreson

Journal Articles: Pharmacology & Experimental Neuroscience

To encode light-dependent changes in membrane potential, rod and cone photoreceptors utilize synaptic ribbons to sustain continuous exocytosis while making rapid, fine adjustments to release rate. Release kinetics are shaped by vesicle delivery down ribbons and by properties of exocytotic Ca²⁺ sensors. We tested the role for synaptotagmin-1 (Syt1) in photoreceptor exocytosis by using novel mouse lines in which Syt1 was conditionally removed from rods or cones. Photoreceptors lacking Syt1 exhibited marked reductions in exocytosis as measured by electroretinography and single-cell recordings. Syt1 mediated all evoked release in cones, whereas rods appeared capable of some slow Syt1-independent release. Spontaneous …

Redox Biology In Physiology And Disease, Matthew C. Zimmerman, Adam J. Case

Journal Articles: Cellular & Integrative Physiology

No abstract provided.

Redox-Sensitive Calcium/Calmodulin-Dependent Protein Kinase Iiα In Angiotensin Ii Intra-Neuronal Signaling And Hypertension, Urmi Basu, Adam J. Case, Jinxu Liu, Jun Tian, Yulong Li, Matthew C. Zimmerman

Journal Articles: Cellular & Integrative Physiology

Dysregulation of brain angiotensin II (AngII) signaling results in modulation of neuronal ion channel activity, an increase in neuronal firing, enhanced sympathoexcitation, and subsequently elevated blood pressure. Studies over the past two decades have shown that these AngII responses are mediated, in part, by reactive oxygen species (ROS). However, the redox-sensitive target(s) that are directly acted upon by these ROS to execute the AngII pathophysiological responses in neurons remain unclear. Calcium/calmodulin-dependent protein kinase II (CaMKII) is an AngII-activated intra-neuronal signaling protein, which has been suggested to be redox sensitive as overexpressing the antioxidant enzyme superoxide dismutase attenuates AngII-induced activation of …

Identification Of Extracellular Dna-Binding Proteins In The Biofilm Matrix., Jeffrey S. Kavanaugh, Caralyn E. Flack, Jessica Lister, Erica B. Ricker, Carolyn B. Ibberson, Christian Jenul, Derek E. Moormeier, Elizabeth A. Delmain, Kenneth W. Bayles, Alexander R. Horswill

Journal Articles: Pathology and Microbiology

We developed a new approach that couples Southwestern blotting and mass spectrometry to discover proteins that bind extracellular DNA (eDNA) in bacterial biofilms. Using Staphylococcus aureus as a model pathogen, we identified proteins with known DNA-binding activity and uncovered a series of lipoproteins with previously unrecognized DNA-binding activity. We demonstrated that expression of these lipoproteins results in an eDNA-dependent biofilm enhancement. Additionally, we found that while deletion of lipoproteins had a minimal impact on biofilm accumulation, these lipoprotein mutations increased biofilm porosity, suggesting that lipoproteins and their associated interactions contribute to biofilm structure. For one of the lipoproteins, SaeP, we …

Central Glucagon-Like Peptide-1 Receptor Signaling Via Brainstem Catecholamine Neurons Counteracts Hypertension In Spontaneously Hypertensive Rats, Kenichi Katsurada, Masanori Nakata, Toshinobu Saito, Boyang Zhang, Yuko Maejima, Shyam Sundar Nandi, Neeru M. Sharma, Kaushik K. Patel, Kazuomi Kario, Toshihiko Yada

Journal Articles: Cellular & Integrative Physiology

Glucagon-like peptide-1 receptor (GLP-1R) agonists, widely used to treat type 2 diabetes, reduce blood pressure (BP) in hypertensive patients. Whether this action involves central mechanisms is unknown. We here report that repeated lateral ventricular (LV) injection of GLP-1R agonist, liraglutide, once daily for 15 days counteracted the development of hypertension in spontaneously hypertensive rats (SHR). In parallel, it suppressed urinary norepinephrine excretion, and induced c-Fos expressions in the area postrema (AP) and nucleus tractus solitarius (NTS) of brainstem including the NTS neurons immunoreactive to dopamine beta-hydroxylase (DBH). Acute administration of liraglutide into fourth ventricle, the area with easy access to …