Medicine and Health Sciences Commons^™

Municipal Drinking Water Quality: Environmental Health And Safety Perceptions In Phoenix, Arizona, Chelsey Weaver

Capstone Experience: Master of Public Health

The goals of the Service Learning/Capstone Experience (SL/CE) project included identifying current perceptions regarding lead in municipal drinking water and related environmental health and safety concerns in the Sunnyslope community of Phoenix, Arizona; evaluating and improving the current outreach program in order to effectively target drinking water perceptions; and identifying strengths and weaknesses in the City of Phoenix Water Services Department (WSD) and Environmental Services Division (ESD) that contribute to negative public perceptions of municipally supplied drinking water. Objectives used to meet the stated goals included developing and distributing a survey to measure perceptions of the above issues through a …

The Incidence Rate, Types, And External Causes Of Traumatic Brain Injuries In Parkinson’S Disease Patients In Nebraska 2008-2014, Maher Alsaadi

Capstone Experience: Master of Public Health

Background: Parkinson’s disease (PD) patients are at higher risk of traumatic brain injury (TBI) due to disease characteristics like tremor, bradykinesia, and impaired balance. Most of the studies that have been done in the United States to investigate the incident rate and causes of TBI among PD patients have mainly focused on falls, while none of these studies have thoroughly addressed all causes of TBI among the PD population or have used a population-based database. Our study aims to investigate the incidence rate, types, and external causes of TBI stratified by age of PD diagnosis using a population-based database from …

An Assessment Of Nontuberculous Mycobacteria In Nebraska, Molly Hoffman

Capstone Experience: Master of Public Health

Background. Nontuberculous mycobacteria (NTM) are an important cause of morbidity and mortality in the U.S., yet not much is known about the prevalence and risk factors. It is thought to be increasing and most commonly found in women and older adults. The objectives of this project were to estimate the burden of NTM in Nebraska and to describe the patterns of NTM infection including location, species, specimen source, and patient demographic characteristics.

Methods. The National Electronic Disease Surveillance System was searched for all NTM infections reported from 2012-2017. Cases were classified as either pulmonary or nonpulmonary and available information was …

Assessment Of Caffeine And Sugar Sweetened Beverage Consumption Among Adult Pregnant Women In An Urban Medical Center In Nebraska, Shilpa Karanjit

Capstone Experience: Master of Public Health

Abstract

Background: Unhealthy non-alcoholic drinks for pregnant women include beverages with high caffeine and added sugar. High caffeine intake during pregnancy has been reported to be linked with adverse pregnancy outcomes such as miscarriages and stillbirth. In addition, high sugar-sweetened-beverages (SSBs) intake increases the risk of maternal obesity that is associated with many serious health problems in both mother and the fetus such as gestational diabetes, hypertension, congenital anomalies, macrosomia, childhood obesity and cardiac diseases. Maternal obesity also increases the cost of prenatal and postnatal healthcare by increasing the need of surgical and anesthetic care for mother and intensive care …

Needs Assessment And Management In Geriatric Patients Of A Federally Qualified Health Center, Nora Kovar

Capstone Experience: Master of Public Health

The purpose of this project was to identify opportunities for quality improvement in the care of geriatric patients at OneWorld Community Health Centers (OneWorld) by applying the principles of Community Oriented Primary Care (COPC) in the implementation of the Medicare Annual Wellness Visit (AWV).

Specific objectives were to better understand factors affecting geriatric health risk assessment and management (including implementation of the Medicare AWV) in federally qualified health centers (FQHCs) and to utilize data from pilot visits to better understand patient health needs in one FQHC, with emphasis on fall risk, cognitive loss, activities of daily living, and compliance with …

Symptom Clusters And Quality Of Life Trajectories In Breast Cancer Patients Before And After Chemotherapy, Gaurav Kumar

Capstone Experience: Master of Public Health

Context. Breast cancer patients experience multiple concurrent symptoms before and after chemotherapy (CTX). Physical and psychological symptoms may persist after treatment and reduce the quality of life (QOL) of survivors.

Objectives. Identify differences in prevalence and severity of symptoms at three times within 1- year of starting CTX; and identify symptom cluster and QOL trajectories over these times in breast cancer patients.

Methods. Symptoms were identified in breast cancer patients (N=219) before the start of CTX (baseline), 30 days after the last CTX, and 1-year after the first CTX. Hospital Anxiety and Depression Scale and Symptom Experience Scale …

Occupational Health Challenges In Research, Anthony Blake

Capstone Experience: Master of Public Health

ABSTRACT

Introduction: Employees working in universities and hospitals are faced with common and unique health and safety challenges. Usually, the campus Department of Health and Safety is tasked with reducing employee exposure through risk assessments. Purpose: In this study, we present a unique risk assessment case study related to a research project undertaken by the campus Department of Health and Safety (DHES). This project also describes the activities done by DHES to improve campus safety. We hypothesized that carbon monoxide, particulate matter, formaldehyde, and VOCs emitted from burning wood chips in a closed laboratory space will exceed …

Matters Of Trust: Examination Of The Patient-Provider Relationship In Cancer Care, Krista A. Brown

Capstone Experience: Master of Public Health

Background: The intangible concept of trust is critical in the patient-provider relationship. Cancer patients may experience positive and negative impacts of trust in this relationship to a higher degree due to the inherently serious nature of their disease and the level of dependence upon treatment providers.

Objective: The goal of this study was to compare colorectal cancer patients’ levels of trust in their primary care physician and oncologist, along with examining trust differences associated with demographics and other characteristics.

Methods: Colorectal cancer patients (n=158) treated at Nebraska Medicine and consented into the Integrated Cancer Repository for Cancer Research IRB …

Hearing Conservation Program On A Campus: Worker Noise Exposure Assessment And Training, Tika Nepal

Capstone Experience: Master of Public Health

Abstract

Introduction: Campus workers are exposed to loud noise from boilers, chillers, generators, snow blowers, leaf blowers, helicopters, utility vehicles, laboratory animals etc. No studies have looked at characterizing noise exposures among campus workers to see who needed to be enrolled in the Hearing Conservation Program (HCP).

Goal: The goal of this study was to determine which employees needed to be enrolled in a HCP.

Methods: This was a cross sectional study conducted among campus workers. We identified utility plant workers, comparative medicine workers, landscaping crew, security officers and facility staff who used utility vehicles as employees potentially exposed to …

Student Moves: A Mixed Methods Cross- Sectional Study Of Elementary School- Based Physical Education In Omaha Public Schools, Ashley Carroll

Capstone Experience: Master of Public Health

Childhood obesity is one of the leading pediatric health problems and a major concern among Omaha metro parents (Professional Research Consultants, 2015). While there are many inter-related factors that contribute to the development of obesity, physical inactivity is a prominent risk factor. Targeting physical activity in health promotion is desirable for its feasibility and effectiveness in balancing energy consumption and expenditure (Hill, 2012). The Student Moves research project sought to inform school district and community strategies for promoting youth physical activity by assessing current physical education practices among a random sample of third- grade students in Omaha Public Schools. Variables …

Development Of A Provider Referral Network For The National Diabetes Prevention Program In Northeast Nebraska, Carling Adams

Capstone Experience: Master of Public Health

Diabetes continues to be a significant health problem for Americans, including Nebraskans. The National Diabetes Prevention Program has designed a course for individuals with prediabetes to implement lifestyle changes and reduce their risk for developing diabetes. Although Elkhorn Logan Valley Public Health Department (ELVPHD) has offered this course for a few years, they have struggled to enroll enough participants for CDC recognition. The purpose of this project was to work with ELVPHD to develop a provider referral network for the National Diabetes Prevention Program (DPP) courses offered by the health department. In establishing this network, the goal was to increase …

Bezoar: Imaging Findings & Case Study Of A Rare Pathology, Tanya M. Custer, Kim Michael

Posters and Presentations: Medical Imaging & Therapeutic Sciences

A bezoar is a hard, indigestible mass of material that forms within the alimentary canal, most commonly the stomach.1 Bezoars are classified according to composition. The most common type of bezoar is a phytobezoar composed of indigestible food fibers that occur in fruits & vegetables, including celery, pumpkin, prunes, raisins, & sunflower-seed shells. Other common types of bezoars include trichobezoars, composed of hair, & pharmacobezoars, made of undissolved medications.

A number of risk factors have been associated with bezoar development. Patients who have undergone gastric surgery, such as partial gastrectomy, are at an increased risk of developing a bezoar due …

Effect Of Nitrosamine (Nnat) On Embryogenesis: Evidence From A Study Using Avian Embryos Exposed To Nnat, Moses New-Aaron, Martha Rhoades, Jane L. Meza, Jeffrey Wallman

Posters and Presentations: College of Public Health

Background

Birth defects are a known cause of infant death in the United States with higher rates in the Midwest perhaps due to higher use of agrichemicals for farm activities. Nitrate and atrazine are two of the most prevalent agrichemicals contaminating drinking water supplies. When ingested together, in the acidic environment of the human stomach, they can react to form a nitrosamine, NNAT. Many nitrosamines are known to be mutagenic, carcinogenic and teratogenic.

Significance

Preliminary studies have suggested that NNAT is a teratogen and mutagen. Several other agrichemical compounds have been detected in Nebraska groundwater wells that have the potential …

A Systematic Review Of Universal, Teacher-Led Interventions Targeting Anxiety In U.S. Schools, Sonja F. Tutsch, Patrick Fowler, Gaurav Kumar, Adam Weaver, Brian Mckevitt, Denise Britigan, Christian I.J. Minter, Lorena Baccaglini

Posters and Presentations: College of Public Health

Implications of anxiety symptomatology experienced among children and adolescents in the US constitute a major public health crisis, calling for promising universal mental health interventions in K-12 schools. Schools represent an ideal setting for the implementation of population based, public health interventions, as children and adolescents spend a significant proportion of time in school. Discussions within the scientific community document several advantages to utilization of universal, Tier1 interventions. However, the efficacy of universal, school-based anxiety interventions in the US are not consistently documented. The purpose of this study is to systematically review the literature to identify the efficacy of universal …

Cervical Cancer Screening Among Patients Receiving Arvs In A Resource-Limited Environment, Moses New-Aaron, Jane L. Meza, Martha Goedert, Stephen Kibusi, Samwel Sumba, Caroline Damien, Siraj Shabani, James Charles

Posters and Presentations: College of Public Health

Significance

Cervical cancer is the most common cancer worldwide with increased risk among women living with HIV in a resource limited environment. Hence the need to determine factors affecting awareness, prior uptake of cervical cancer screening and willingness to screen among patients receiving Antiretroviral (ARV) drugs.

Data analysis

The data was collected by administered questionnaires to patients presenting for monthly ARV refills in a HIV clinic in Dodoma, Tanzania. A total of 421 women in the clinic with an average monthly income of 39 (USD) were interviewed. A total of 306 (73%) were aware of cervical cancer. Among those who …

The Status Of The Healthcare Workforce In The State Of Nebraska, Fernando A. Wilson, Nizar K. Wehbi, Jamie Larson, Kavita Mosalpuria, Ethan Chen, Marlene Deras

Reports: Center for Health Policy

No abstract provided.

The Impact On Youth Smoking Of Increasing The Cigarette Tax In Nebraska: An Update For 2018, Fernando A. Wilson, Nizar K. Wehbi, Jamie Larson, Li-Wu Chen

Reports: Center for Health Policy

No abstract provided.

Sooty Mangabey Genome Sequence Provides Insight Into Aids Resistance In A Natural Siv Host, David Palesch, Steven E. Bosinger, Gregory K. Tharp, Thomas H. Vanderford, Mirko Paiardini, Ann Chahroudi, Zachary P. Johnson, Frank Kirchhoff, Beatrice H. Hahn, Robert B. Norgren, Nirav B. Patel, Donald L. Sodora, Reem A. Dawoud, Caro-Beth Stewart, Sara M. Seepo, R. Alan Harris, Yue Liu, Muthuswamy Raveendran, Yi Han, Adam English, Gregg W.C. Thomas, Matthew W. Hahn, Lenore Pipes, Christopher E. Mason, Donna M. Muzny, Richard A. Gibbs, Daniel Sauter, Kim Worley, Jeffrey Rogers, Guido Silvestri

Journal Articles: Genetics, Cell Biology & Anatomy

In contrast to infections with human immunodeficiency virus (HIV) in humans and simian immunodeficiency virus (SIV) in macaques, SIV infection of a natural host, sooty mangabeys (Cercocebus atys), is non-pathogenic despite high viraemia. Here we sequenced and assembled the genome of a captive sooty mangabey. We conducted genome-wide comparative analyses of transcript assemblies from C. atys and AIDS-susceptible species, such as humans and macaques, to identify candidates for host genetic factors that influence susceptibility. We identified several immune-related genes in the genome of C. atys that show substantial sequence divergence from macaques or humans. One of these sequence divergences, a …

Microscale Gene Expression Analysis Of Tumor-Associated Macrophages, Kuldeep S. Attri, Kamiya Mehla, Surendra K. Shukla, Pankaj K. Singh

Journal Articles: Eppley Institute

Macrophages, apart from being the key effector cells of the innate immune system, also play critical roles during the development and progression of various complex diseases, including cancer. Tumor-associated macrophages, infiltrate tumors during different stages of cancer progression to regulate motility, invasion, and intravasation to metastatic sites. Macrophages can exist in different polarization states associated with unique function in tumors. Since tumor-associated macrophages constitute a very small proportion of tumor cells, analysis of gene expression pattern using normal extraction buffer-based methods remains a challenging task. Therefore, it is imperative to develop low-throughput strategies to investigate transcriptional regulations from a small …

Virtual Mentorship Network To Address The Rural Shortage Of Mental Health Providers, Heidi Keeler, Tara Sjuts, Kosuke Niitsu, Shinobu Watanabe-Galloway, Paul Force-Emery Mackie, Howard Liu

Journal Articles: Epidemiology

INTRODUCTION: The process of identifying effective responses to the challenges of placing and retaining a rural behavioral health workforce remains elusive. The Virtual Mentorship Network was developed to test the feasibility of using distance technology to connect rural students interested in mental health careers with mentors.

METHODS: In Year 1, college and high school students were virtually mentored using a near-peer approach both live and asynchronously as a cohort over 7 months. In Year 2, college students only were virtually intensely mentored live over 1 month. High school students were asynchronously provided with informational videos produced by mentors. Program benefits …

Sympatho-Excitatory Response To Pulmonary Chemosensitive Spinal Afferent Activation In Anesthetized, Vagotomized Rats, Julia A. Shanks, Zhiqiu Xia, Steven J. Lisco, George J. Rozanski, Harold D. Schultz, Irving H. Zucker, Han-Jun Wang

Journal Articles: Cellular & Integrative Physiology

The sensory innervation of the lung is well known to be innervated by nerve fibers of both vagal and sympathetic origin. Although the vagal afferent innervation of the lung has been well characterized, less is known about physiological effects mediated by spinal sympathetic afferent fibers. We hypothesized that activation of sympathetic spinal afferent nerve fibers of the lung would result in an excitatory pressor reflex, similar to that previously characterized in the heart. In this study, we evaluated changes in renal sympathetic nerve activity (RSNA) and hemodynamics in response to activation of TRPV1-sensitive pulmonary spinal sensory fibers by agonist application …

Identifying Bias In The Transition From Associate To Dental Practice Owner, David G. Dunning

Journal Articles: College of Dentistry

No abstract provided.

Precise And Efficient Nucleotide Substitution Near Genomic Nick Via Noncanonical Homology-Directed Repair, Kazuhiro Nakajima, Yue Zhou, Akiko Tomita, Yoshihiro Hirade, Channabasavaiah B. Gurumurthy, Shinichiro Nakada

Journal Articles: Munroe-Meyer Institute

CRISPR/Cas9, which generates DNA double-strand breaks (DSBs) at target loci, is a powerful tool for editing genomes when codelivered with a donor DNA template. However, DSBs, which are the most deleterious type of DNA damage, often result in unintended nucleotide insertions/deletions (indels) via mutagenic nonhomologous end joining. We developed a strategy for precise gene editing that does not generate DSBs. We show that a combination of single nicks in the target gene and donor plasmid (SNGD) using Cas9D10A nickase promotes efficient nucleotide substitution by gene editing. Nicking the target gene alone did not facilitate efficient gene editing. However, an additional …

Organic Barn Dust Inhibits Surfactant Protein D Production Through Protein Kinase-C Alpha Dependent Increase Of Gpr116, David Schneberger, Jane M. Devasure, Shelley A. Kirychuk, Todd A. Wyatt

Journal Articles: Environmental, Agricultural & Occupational Health

Prolonged exposure to organic barn dusts can lead to chronic inflammation and a broad range of lung problems over time, mediated by innate immune mechanisms. The immune surfactant or collectin surfactant protein D (SP-D) is a crucial multifunctional innate immune receptor. Little work to date has examined the effect of such collectins in response to organic dusts. We provide evidence here that agricultural organic dusts can inhibit mRNA and protein expression of SP-D in a human alveolar epithelial cell line, and an in vivo mouse model. This inhibition was not a result of lipopolysaccharide (LPS) or peptidoglycans, the two most …

Clinical Features Of Guillain-Barré Syndrome With Vs Without Zika Virus Infection, Puerto Rico, 2016, Emilio Dirlikov, Chelsea G. Major, Nicole A. Medina, Roberta Lugo-Robles, Desiree Matos, Jorge L. Muñoz-Jordan, Candimar Colon-Sanchez, Myriam Garcia, Marangely Olivero-Segarra, Graciela Malave, Gloria M. Rodríguez-Vega, Dana L. Thomas, Stephen H. Waterman, James J. Sejvar, Carlos A. Luciano, Tyler M. Sharp, Brenda Rivera-García

Journal Articles: Epidemiology

Importance: The pathophysiologic mechanisms of Guillain-Barré syndrome (GBS) associated with Zika virus (ZIKV) infection may be indicated by differences in clinical features.

Objective: To identify specific clinical features of GBS associated with ZIKV infection.

Design, Setting, and Participants: During the ZIKV epidemic in Puerto Rico, prospective and retrospective strategies were used to identify patients with GBS who had neurologic illness onset in 2016 and were hospitalized at all 57 nonspecialized hospitals and 2 rehabilitation centers in Puerto Rico. Guillain-Barré syndrome diagnosis was confirmed via medical record review using the Brighton Collaboration criteria. Specimens (serum, urine, cerebrospinal fluid, and saliva) from …

Evidence-Based Guidelines For Supportive Care Of Patients With Ebola Virus Disease, François Lamontagne, Robert A. Fowler, Neill K. Adhikari, Srinivas Murthy, David Brett-Major, Michael Jacobs, Timothy M. Uyeki, Constanza Vallenas, Susan L. Norris, William A. Fischer, Thomas E. Fletcher, Adam C. Levine, Paul Reed, Daniel G. Bausch, Sandy Gove, Andrew Hall, Susan Shepherd, Reed A. Siemieniuk, Marie-Claude Lamah, Rashida Kamara, Phiona Nakyeyune, Moses J. Soka, Ama Edwin, Afeez A. Hazzan, Shevin T. Jacob, Mubarak Mustafa Elkarsany, Takuya Adachi, Lynda Benhadj, Christophe Clément, Ian Crozier, Armando Garcia, Steven J. Hoffman, Gordon H. Guyatt

Journal Articles: Epidemiology

The 2013-16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive …

Short Term Dynamics Of The Sputum Microbiome Among Copd Patients., Rohita Sinha, Lisa A. Weissenburger-Moser, Jennifer L. Clarke, Lynette M. Smith, Art J. Heires, Debra J. Romberger, Tricia D. Levan

Journal Articles: Internal Medicine

Chronic obstructive pulmonary disease (COPD) is an inflammatory disorder characterized by incompletely reversible airflow obstruction. The complexity of the lung microbial community in COPD patients has been highlighted in recent years. Evidence suggests that transplantation, medications, age, and disease severity influence microbial community membership. However, the dynamics of the lung microbiome in stable COPD patients remain poorly understood. In this study, we completed a longitudinal 16S ribosomal RNA survey of the lung microbiome on replicate sputum samples collected from 4 former smokers with COPD (Stage 2) within a 2-day time period. Samples from each individual over the two-day period were …

Imaging-Based Clusters In Current Smokers Of The Copd Cohort Associate With Clinical Characteristics: The Subpopulations And Intermediate Outcome Measures In Copd Study (Spiromics), Babak Haghighi, Sanghun Choi, Jiwoong Choi, Eric A. Hoffman, Alejandro P. Comellas, John D. Newell, R. Graham Barr, Eugene Bleecker, Christopher B. Cooper, David Couper, Mei Lan Han, Nadia N. Hansel, Richard E. Kanner, Ella A. Kazerooni, Eric A.C. Kleerup, Fernando J. Martinez, Wanda O'Neal, Stephen I. Rennard, Prescott G. Woodruff, Ching-Long Lin

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Classification of COPD is usually based on the severity of airflow, which may not sensitively differentiate subpopulations. Using a multiscale imaging-based cluster analysis (MICA), we aim to identify subpopulations for current smokers with COPD.

METHODS: Among the SPIROMICS subjects, we analyzed computed tomography images at total lung capacity (TLC) and residual volume (RV) of 284 current smokers. Functional variables were derived from registration of TLC and RV images, e.g. functional small airways disease (fSAD%). Structural variables were assessed at TLC images, e.g. emphysema and airway wall thickness and diameter. We employed an unsupervised method for clustering.

RESULTS: Four clusters …

Use Of A 4-Week Up-Titration Regimen Of Roflumilast In Patients With Severe Copd, Henrik Watz, Nitin Bagul, Klaus F. Rabe, Stephen I. Rennard, Vijay Kt Alagappan, Jonas Román, Axel Facius, Peter Ma Calverley

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: The oral selective phosphodiesterase-4 inhibitor roflumilast (ROF) reduces exacerbations in patients with severe COPD. Adverse events (AEs) can cause early ROF discontinuation. Alternative dosing strategies may help patients continue their therapy.

METHODS: In this multicenter, double-blind trial, 1,321 patients with severe COPD were randomized 1:1:1 to 4 weeks' treatment with ROF 250 µg once daily (OD), 500 µg every other day (EOD), or 500 µg OD, each followed by ROF 500 µg OD for 8 weeks, plus standard therapy. The primary end point was the percentage of patients prematurely discontinuing study treatment.

RESULTS: Patients in the 250 µg OD/500 …

Oligomerization Of Bacterially Expressed H1n1 Recombinant Hemagglutinin Contributes To Protection Against Viral Challenge, Tess E. Kuenstling, Anthony R. Sambol, Steven H. Hinrichs, Marilynn A. Larson

Journal Articles: Pathology and Microbiology

Vaccination is the most effective intervention to prevent influenza and control the spread of the virus. Alternatives are needed to the traditional egg-based vaccine strategy for a more rapid response to new outbreaks. Two different hemagglutinin (HA) fragments (rHA1_1-326 and rHA1_53-269) derived from influenza A virus subtype H1N1 were expressed in Escherichia coli and characterized by immunoblot, gel filtration, hemagglutination, and competitive binding assays. rHA1_1-326 included neutralizing epitopes and the trimerization domain, whereas rHA1_53-269 included only the head of HA with the neutralizing epitopes. Mice were immunized with rHA1_1-326 or rHA1_53-269, and …