Medicine and Health Sciences Commons^™

The Public Health Lens: An Introduction To Population-Based Care In Athletic Training, Jenna L. Allocco

Capstone Experience: Master of Public Health

Historically, the athletic training profession has been focused on the individual; however, potential exists to drive large-scale prevention efforts in the athletic community with a population-based, public health approach. Relationship between the two professions has been acknowledged in in previous literature to do with educational competencies and opportunities for research, as well as in policy development involving sudden cardiac death, sport-related concussion and osteoarthritis prevention. Incorporating public health concepts such as the ecological model, health literacy, health behavior and evidence-based program planning and evaluation may improve athletic training health outcomes and prove beneficial to each respective discipline.

Hearing Conservation In A Meat Processing Facility, Abolore Muinat Idris

Capstone Experience: Master of Public Health

Introduction: The aim of this study was to evaluate personal noise exposures at a meat processing facility, and educate employees on the proper use of hearing protectors.

Materials and Methods: We collected full-shift personal dosimetry on thirty-six production floor employees, one quality control employee, and four maintenance employees. These were compared to the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) criteria. We also collected point source noise measurement at eight workstations from precook. We administered a questionnaire to assess production floor employees’ hearing loss perception and non-occupational source of noise exposure. …

An Evaluation Of Implementing Trauma-Informed Care Training In Healthcare Settings, Amanda Kis

Capstone Experience: Master of Public Health

Background: Trauma-informed care (TIC) has recently become a popular topic in medical science. Many patients’ health conditions have been diagnosed and treated purely as medical issues, yet emerging research indicates that trauma is sometimes the source of many physical and mental conditions. Implementing TIC education in healthcare systems may lead to preventing the onset of symptomology related to undiagnosed, chronic trauma experience.

Objectives: The primary goal of this Capstone project was to implement TIC training developed by Trauma Matters Omaha Coalition and assess preliminary evidence for changes in participants’ confidence, clinical knowledge, professional knowledge, self-awareness, and assumptions and biases regarding …

Factors Associated With Participant Attrition In A Longitudinal, Survey-Based Rheumatic Disease Databank, Kathryn A. Grafel

Capstone Experience: Master of Public Health

Introduction: Participant attrition is a problem common to many longitudinal studies, and when it occurs nonrandomly, it can impact the study’s validity and generalizability. Identifying factors associated with attrition can help to detect bias and aid in developing targeted interventions to reduce attrition. Methods: Logistic regression and Cox proportional hazards regression models were constructed separately for patients with rheumatoid arthritis, systemic lupus erythematosus, and other rheumatic diseases who participated in the FORWARD study between 1998 and 2018. Results: Patient characteristics associated with attrition included male sex, younger age, non-White race, and less education, each of which was identified in multiple …

Trends In Childhood Elevated Blood Lead Levels In Nebraska, 2013 – 2017, Ellana Haakenstad

Capstone Experience: Master of Public Health

This project explored the exposure to lead among children in Nebraska. Using the Nebraska Department of Health and Human Services’ Blood Lead Level database, trends were investigated in screening; demographics; incidence; and prevalence of elevated blood lead levels, statewide and by census tract. The study further explored the geography of lead exposure and elevated blood lead level cases with maps. Based on these results, policy recommendations were made to the Nebraska Department of Health and Human Services’ Childhood Lead Poisoning Prevention Program, particularly about areas of Nebraska with high risk of lead incidence and exposure risk where testing should be …

Nutritional Factors Associated With Thyroid Cancer And Nodules Using The Integrated Cancer Repository For Cancer Research (Icare2), Dong Liu

Capstone Experience: Master of Public Health

Introduction: The incidence of thyroid cancer in the United States has rising on average 3.1% each year over the last 10 years. Much of this increase is attributed to increased detection using ultrasound. Dietary habits can be an important modifiable risk factors for different types of cancer, but the association between dietary factors and thyroid cancer has not been well studied. The goals of this capstone were to: 1) review the literature for the association between dietary factors and thyroid cancer, 2) describe demographic and behavioral characteristics of patients with thyroid nodules and cancer in a hospital-based registry, and 3) …

Effect Of N-Nitrosoatrazine On Embryogenesis In Avian Embryos, Nur Firyal Roslan, Moses New-Aaron, Martha Rhoades, Kent Eskridge

Posters and Presentations: College of Public Health

Preliminary studies suggest that the nitrosamine N-nitrosoatrazine (NNAT) is teratogenic and mutagenic. We hypothesized that the embryos exposed to NNAT would have higher mortality and lower growth rate compared to unexposed embryos. In this study, we evaluated growth and mortality in chick embryos after exposure to NNAT dissolved in dimethyl sulfoxide (DMSO). The study was divided into three experiments depending treatment design. First, the effect of DMSO on embryo growth and survival was tested. Second, we compared growth and survival between embryos treated with DMSO, 50:50 DMSO:water and NNAT at 0.245 µmol/l. Finally, we compared growth and survival between …

Birth Outcomes And Water: A Multidisciplinary Study, Moses New-Aaron, Jane L. Meza, Patrick J. Shea, Martha Rhoades

Posters and Presentations: College of Public Health

Evidence that agrichemicals are associated with the incidence of birth defects is inconsistent. We examined whether nitrate and nitrosatable agrichemicals present in well water are associated with birth defect rates in Nebraska counties. Birth defect data from the Nebraska Department of Health and Human Services, 2005-2014, were merged with well data obtained from the Quality-Assessed Agrichemical Contaminant Database for Nebraska Ground Water (1977-2014). Nebraska counties with higher rates of birth defects had a greater prevalence of agrichemicals in well water. Of the 33 contaminants sampled from different well types, nitrate and atrazine were of interest. Birth defect rates were negatively …

Emotional Exhaustion, Depersonalization, And Feelings Of Decreased Personal Accomplishment Oh My: What Message Are We Sending To Our Students?, Nikki Sleddens, Betsy J. Becker

Posters and Presentations: Physical Therapy

PURPOSE:

The purpose of this presentation is to address the issue of burnout amongst PTs through the lens that addressing this issue in our profession may very well be the first step in building resilience in the academic and clinical environments.

METHODS AND/OR DESCRIPTION:

Physical therapy student well-being is a priority for academic institutions. Yet, are we, as academic and clinical faculty, who are responsible for promoting student well-being, “well” ourselves? Could burnout of our academic and clinical faculty impact our student’s wellness? Burnout is a syndrome described as emotional exhaustion, depersonalization, and feelings of decreased personal accomplishment. All effects …

Evaluation Of A Competency-Based Health Policy Training Program, Jim P. Stimpson, Kathleen Brandert, Brandon Grimm, Fernando A. Wilson

Reports: Center for Health Policy

An academic and practice partnership was formed to create and implement a competency-based training program for local health departments in health policy. We evaluated if the training program improved the policy knowledge and competency of participants.

Participants exhibited significant increases for self-assessed policy competency, including substantial improvements in “Critique the feasibility and expected outcomes of potential policy options”, “Identify and assess the strengths and motivations of key stakeholders and potential resistors”, and “Recommend a specific policy change”.

The policy competency instrument developed in this report could be used to measure policy knowledge and competency in future training implementations.

Evaluation Of A Competency-Based Health Policy Training Program, Jim P. Stimpson, Kathleen Brandert, Brandon Grimm, Fernando A. Wilson

Reports: Center for Health Policy

No abstract provided.

Economic Implications Of Tobacco Use For The State Of Nebraska Government, Fernando A. Wilson, Nizar K. Wehbi, Ali S. Khan

Reports: Center for Health Policy

We examine smoking-related expenditures for the state Medicaid program and for lost productivity among state government employees. The predicted number of new diagnoses of smoking-related illnesses among government employees ranged from 109 cases of kidney disease to 856 cases of arthritis and related diseases. We estimate over 6,000 lost workdays due to sick leave among currently smoking vs. non-smoking employees. Smoking-related illness is estimated to increase state budgetary expenditures on Medicaid by approximately $114.9 million annually.

A Translational Evaluation Of Potential Iatrogenic Effects Of Single And Combined Contingencies During Functional Analyses Of Target Responses, Billie Retzlaff

Theses & Dissertations

The interview informed synthesized contingency analysis (IISCA) is controversial, with some extolling its benefits relative to traditional functional analysis (FA; e.g., efficiency; Slaton, Hanley, & Raftery, 2017) and others focusing on its shortcomings (e.g., false-positive outcomes; Fisher, Greer, Romani, Zangrillo, & Owen, 2016). One limitation of prior comparisons is investigators could not ascertain with surety the true function(s) of the participants’ problem behavior for use as the criterion variable. In Chapter 1, we developed a translational study to circumvent this limitation by training a specific function for a surrogate destructive behavior prior to conducting an FA and synthesized contingency analysis …

Properties Of Synaptic Transmission From Rods And Cones In The Outer Plexiform Layer Of The Vertebrate Retina, Xiangyi Wen

Theses & Dissertations

Photoreceptors are the first neurons in the visual system. They transduce changes in light intensity into graded changes in membrane potential that are then transformed into chemical signals by regulating the release of glutamate-filled synaptic vesicles. Rod and cone photoreceptors release glutamate continuously in darkness and release slows in light. To help track rapid changes in light intensity, photoreceptors are capable of both rapid exocytosis and rapid endocytosis of synaptic vesicles.

Endocytosis is needed for recycling synaptic vesicles but also appears to be important for removing proteins and lipids from active zones to restore release site function after prior vesicle …

Development Of Novel Therapies For The Treatment Of Inflammatory Bowel Disease, Shrey Kanvinde

Theses & Dissertations

Inflammatory bowel disease (IBD) is a chronic and remittent inflammation of the gastrointestinal tract (GIT). Despite extensive research efforts, there is no cure nor a well-defined pathogenesis for IBD. Loss of epithelial barrier function, increased colonic immune cell infiltration and upregulation of pro-inflammatory cytokines are the hallmarks of IBD. Despite treatments like painkillers, aminosalicylates, steroids, and biologics, almost 70% patients require surgery at least once in their life time. The main limitation with most of the current treatments is they are either absorbed systemically or administered systemically resulting in adverse side effects. As a result, there is a huge unmet …

An Evaluation Of The Use Of A Clinical Research Data Warehouse And I2b2 Infrastructure To Facilitate Replication Of Research, Bret Gardner

Theses & Dissertations

Replication of clinical research is requisite for forming effective clinical decisions and guidelines. While rerunning a clinical trial may be unethical and prohibitively expensive, the adoption of EHRs and the infrastructure for distributed research networks provide access to clinical data for observational and retrospective studies. Herein I demonstrate a means of using these tools to validate existing results and extend the findings to novel populations. I describe the process of evaluating published risk models as well as local data and infrastructure to assess the replicability of the study. I use an example of a risk model unable to be replicated …

Polymeric Nanocarriers Delivering Anticancer Agents For The Treatment Of Chemoresistant Prostate Cancer And Lung Metastatic Melanoma, Ruinan Yang

Theses & Dissertations

The aims of this thesis is to first develop novel combination chemotherapies of two anticancer agents and their appropriate drug delivery platforms to treat chemoresistant prostate cancer, and second develop a polymeric conjugate of a biodegradable polymer and novel tubulin destabilizer to treat lung metastatic melanoma.

In Chapter 1, a general introduction of polymeric nanocarriers including polymeric micelles and polymer drug conjugates for cancer therapy was given. In Chapter 2, we described a combination therapy of paclitaxel (PTX) polymer conjugate and cyclopamine (CYP) polymer conjugate, which had the potential to treat chemoresistant prostate cancer. We first synthesized mPEG-b-PCC-g-PTX-g-DC (P-PTX) …

A Multi-Level Assessment Of Healthcare Facilities Readiness, Willingness, And Ability To Adopt And Sustain Telehealth Services, Jamie Larson

Theses & Dissertations

Telehealth technologies are becoming more pervasive throughout the healthcare system as a way to provide services to patients that would otherwise have difficulty with access. Currently, little is known about the current state of telehealth use within clinics and hospital in the US. Most studies evaluating telehealth programs are feasibility or small patient outcome studies from one location. Utilizing a hybrid framework combining the levels of complex socio-technical systems with the theory of ready, willing and able. The theory of ready, willing, and able is founded on the basis that these three preconditions need to be met for a change …

Examining The Relationships Between School Engagement, Physical Activity, And Attention-Deficit Hyperactivity Disorder In Children Using The Ecological Model, Minh Nguyen

Theses & Dissertations

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with onset usually occurring in childhood and adolescence. During these developmental stages, social interactions and external environments can have significant impact on children’s growth and development. Few studies previously used a theoretical model to examine the effects of social and external environments on ADHD. The goal of this dissertation is to apply an ecological perspective to examine the roles of school and community in the development of childhood ADHD through school engagement and physical activity. Three studies were implemented to carry out this goal. Study 1 examined the associations of neighborhood, school, and …

Determining The Adoption And Implementation Of Nutrition Policies At Food Pantries Across The United States, Meagan Helmick

Theses & Dissertations

Food insecurity occurs when there is a lack of access to enough food to live an active, healthy life. Current efforts to address food insecurity include developing and implementing policies, programs, and practices at the federal, state, and local levels. Specifically, local efforts target decreasing food insecurity through emergency food networks including food banks and food pantries. Over the last several years, many food banks and food pantries have worked to improve the nutritional quality of the foods they offer. However, food pantries are smaller and less formal organizations than food banks. Thus, they have limited resources to develop and …

Health Professional Treatment Practices For Pediatric Sickle Cell Disease In Nigeria, Natalie Wichelt

Capstone Experience: Master of Public Health

Abstract

Sickle cell disease (SCD) is caused by a genetic defect that results in abnormal hemoglobin genes that can cause devastating health effects like chronic hemolytic anemia and vaso-occlusive crises. Additionally, sickle cell disease can cause defects in the immune system, leaving those with the disease highly susceptible to a variety of different infections. In the pediatric population specifically, the complications of sickle cell disease contribute significantly to the under-five mortality rate of Nigeria. In response to the Millennium Development Goals 4, 5 and 6, as well as with growing national concern over the challenges faced by sickle cell disease …

Perspectives, Challenges, And Oral Cancer Screening Practices Of Primary Care Providers At Nebraska Medicine, Nishitha Ponnamaneni

Capstone Experience: Master of Public Health

Background

High mortality and morbidity associated with oropharyngeal cancer (OPC) are due to delayed diagnosis. Early detection of OPC is possible by incorporating oral cancer screening (OCS) in the annual screening examination protocol of primary care providers (PCPs). The study was aimed to understand the perspectives and barriers of PCPs in screening their patients for OPC.

Objectives

1) To understand challenges PCPs’ face in performing OCS, 2) To determine the factors that influence PCPs’ decision to complete OCS, and 3) To determine if PCPs who received education on OCS are more likely to perform the screening compared to PCPs who …

Equity Of Care Analysis At Chi Health Hospitals And Clinics In The Omaha Metro Area., Lindsey Cork

Capstone Experience: Master of Public Health

The goal of the project is to identify if health disparities exist between patient groups based on race, ethnicity, language, payer type, and location of residence who received healthcare services from CHI Health system in the Omaha Metro area during January 2017 – March 2018. The health outcomes of interest are HPV vaccination rates, diabetes control rates, breast cancer screening rates, colorectal cancer screening rates, and 30-day hospital readmissions. Patient data from six Omaha area clinics and five hospitals was analyze in this study.

Among the six CHI Health clinics in this study, Lakeside had the highest rates of A1c …

Collaboration Between University Centers For Excellence In Developmental Disabilities (Ucedds) And Independent Living Networks, Sarah Swanson

Capstone Experience: Master of Public Health

In every state and U.S. Territory, there is a University Center for Developmental Disabilities (UCEDD), which is part of the state Developmental Disabilities network and an Independent Living (IL) Network, composed of Centers for Independent Living and Statewide Independent Living Councils. Each of these receive federal funding (and frequently state funding) to support people with disabilities and their families. However, each has different federal funding sources, different origins within federal legislation and different requirements. Through discussions with IL and UCEDD leadership it is clear that there are collaborations between the two, yet this is not widely recognized. This research proposal …

Protecting And Serving Yourself: The Mental Health Of Police Officers In Kaukauna, Wisconsin, Caina Weiner

Capstone Experience: Master of Public Health

The service learning hours performed at the Kaukauna Police Department served as a valuable learning experience to better understand an organization that is involved in public health. Although some may view this as non-traditional, the police department is quite involved in the community’s health. They work closely with public health officials and are also involved in certain public health programs, such as drug and alcohol programs. The health of a police officer must also be considered as a public health topic. A police officer is part of a vulnerable population of individuals that are “first responders.” These individuals are at …

Title X Family Planning Secondary Data Analysis Needs Assessment, Laura Triplett

Capstone Experience: Master of Public Health

The goal of the Title X Needs Assessment is to ‘Provide individuals the information and means to exercise personal choice in determining the number and spacing of their children', prevent unintended pregnancies, and reduce the number of abortions.’ Objectives include but are not limited to family involvement, abstinence and safer sex practice, intimate partner violence, human trafficking, contraceptive services, pregnancy testing and counseling, achieving pregnancy, basic infertility services, preconception health, STI/STD testing and treatment and HIV testing, Well Women/Men Exams; screening for breast cancer, cervical cancer, and testicular cancer in males. Sexual health education and reproductive life planning will be …

A Characterization Of The Medical-Legal Partnership (Mlp) Of Nebraska Medicine, Jordan Pieper

Capstone Experience: Master of Public Health

This research study was completed at Legal Aid of Nebraska’s Health, Education, and Law Project through the partnership it has formed working with Nebraska Medicine and Iowa Legal Aid. Traditionally, health and disease have always been viewed exclusively as "healthcare" issues. But with healthcare consistently growing towards holistic approaches to help patients, we now know there are deeper, structural conditions of society that can act as strong driving forces of a person's poor daily living conditions that can negatively impact health. The importance of a Medical-Legal Partnership is that it considers a patient's social determinants of health (SDHs). The goal …

Evaluating And Increasing Lead Poisoning Prevention Awareness In The Refugee Population Of Douglas County, Ne, Kara Albright

Capstone Experience: Master of Public Health

Background: Lead poisoning is a major public health concern. It accounted for twelve percent of the global burden for intellectual disabilities, and two and a half percent of the global burden for heart disease and stroke, as well as nearly 500,000 deaths in 2015 (World Health Organization, 2018). While everyone is at risk of lead exposure, refugee and immigrant children are at an increased risk because they have increased access and use of products from outside the United States that have been shown to contain lead (Moser, R., and Brownback, S., 2012; and New York State Department of Health, …

Open Book Testing In Health Science Education: Student Perceptions And Outcomes In Ultrasound Physics, Kim Michael, Tanya M. Custer

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Objectives: The purpose of this study was to investigate the use of open book exams (OBE) in the education of imaging students and to assess the beliefs and perceptions of the students in regard to the use of open book testing.

Subjects & Methods: Study participants included twenty-seven sonography students enrolled in an academic health sciences center. OBE was implemented in two ultrasound physics courses. Data was collected through focus groups & exam outcomes. Creswell’s procedure for data analysis & representation was followed.

Results: Overall outcomes showed no statistically significant difference between exam grades for the different cohorts with the …

Electrophysiological Biomarkers Of Chemotherapy-Related Cognitive Impairment In Hematological Malignancy Patients, David E. Anderson

Theses & Dissertations

Multiple cancer populations frequently report cognitive impairment following treatment with chemotherapy agents (“chemo-brain”). Impaired neuropsychological performance is commonly reported in cognitive domains of attention and executive function. Understanding neural mechanisms underlying cognitive impairments is essential to developing prevention and rehabilitation strategies. Brain imaging studies frequently show chemotherapy-related impairments within the attentional control network, which is comprised of a constellation of cortical regions that govern reportedly impaired cognitive functions. In the current dissertation research, I developed a novel electrophysiology battery aimed at recording near-instantaneous neural activity within the attentional control network during cognitive task performance. Cancer patients diagnosed with hematological malignancy …