Medicine and Health Sciences Commons^™

Establishing An Active Reproductive Health Center And A Sliding Fee Scale At Bellevue Health Clinic, Gbadero Yerokun

Capstone Experience: Master of Public Health

Abstract

Goal

To collect preliminary data that will be used by Bellevue Health Clinic leadership to make decisions about expanding upon reproductive health services, and creating a sliding fee scale for services provided.

Objectives

To describe aspects of the scope of reproductive health care services provided by Title X-funded clinics in Lincoln, Omaha, Fremont, Grand Island, Tecumseh, Hastings, Gering, Norfolk and North Platte (14 total). The project will also compare and contrast existing sliding scale fees provided at these sites and provide subjective answers from key informants of how Title X funding and a sliding fee scale impact the population. …

Multilevel Worksite Wellness Intervention To Improve Individual Behaviors And The Worksite Environment, Mariah Morgan

Capstone Experience: Master of Public Health

Due to increasing obesity rates, public health approaches must focus on improving healthy behaviors and reducing the risk of obesity-related health problems (“Nebraska State Nutrition Profile,” 2012; “State of Obesity,” 2016). Worksites offer opportunities to stimulate behavior change through environmental supports and provide natural structures for social support; therefore, worksites are ideal locations for teaching and implementing health promotion programs (Beresford et al., 2001; Salinardi et al., 2013; Sorensen et al., 1996; Touger-Decker et al., 2008). The Social Ecological Model (SEM), which illustrates that various factors are intertwined at multiple levels to influence behaviors, has been shown to produce significant …

Youth Focus Groups: Design And Analysis Plan For The Bears Project, M. Renee Beacom Claborn

Capstone Experience: Master of Public Health

This capstone project produced a qualitative research design and analysis plan for youth focus groups as part of a Quality Improvement project at OneWorld Community Health Center (OWCHC) School-Based Health Center (SBHC) located at Bryan High School (BHS) in a program called BEARS. The intended use of this project is to serve as a reference guide for BEARS program planners to utilize as part of the data collection and analysis processes. The purpose for collecting qualitative data for this project is three-fold. 1. To explore adolescents’ perspectives of risk behaviors and associated health determinants common to their age group 2. …

Assessment Of Ems Workforce In Nebraska With Future Strategies, Matt Holt

Capstone Experience: Master of Public Health

Well-trained and fully staffed Emergency Medical Services (EMS) play a key role in improving the health of the surrounding community through rapid response, on scene care, and transportation to an appropriate facility. EMS is an integral part of the community, vital to limiting the severity of injuries, preventing morbidity, and improving the health of their populations. In order to ensure Emergency Medical Services in Nebraska are able to meet the needs of their populations and continue providing high-level care, an assessment of the State’s EMS workforce was conducted. By completing a workforce assessment, we gained a better understanding of the …

Examination Of Collaborative Efforts Of Central District To Achieve Success Of The Community Health Improvement Plan, Liene Topko

Capstone Experience: Master of Public Health

This was a quality improvement project that helped Central District Health Department (CDHD) work more closely with their community partners to identify the activities and programs that are currently in place to address priority health needs that were included in the 2016 Comprehensive Community Health Needs Assessment (CHNA). The purpose of this project is to identify the specific activities and programs that are being implemented by the health department and community partners in relation to the priority needs. These activities and programs were identified by conducting a survey of the major community partners. The findings from the survey helped to …

Primary Care Provider’S Perspectives Of Integrating Public Health Into The Prevention And Management Of Type Ii Diabetes Mellitus In Rural Nebraska, Emma Frost-Briley

Capstone Experience: Master of Public Health

Through the 2011 Community Health Needs Assessment, the Four Corners Health Department has identified type II diabetes mellitus as one of the communities top concerns within their communities. The goals of this project were: to develop a survey to assess the state of current practices of primary care providers on type II diabetes mellitus in the health department district, to identify primary care providers views on prevention, treatment, and management of type II diabetes mellitus in the health department district, and to examine primary care providers and local health department’s views on how primary care and public health can be …

The Use Of Electronic Health Records Data For Public Health: A Snapshot Of Current Practices In Nebraska’S Local Health Departments, Kushal Karan

Capstone Experience: Master of Public Health

Background: Public health issues are constantly changing and require local health departments (LHDs) to continually evolve in their approaches to address these issues. Advancements in health information technology (HIT), such as electronic health records (EHRs), play an important role in the collection of data that can be used to improve population health.

Objective: The purpose of this project was to assess the current use of electronic health records data by Nebraska’s local health departments and identify the data or tools they are using to address the health needs of the populations they serve.

Methods: In this study, a Mixed-Methods approach …

Employee Wellness At Private Clinic In Omaha, Ne: Social Marketing And Health Communications Perspective, Olivia Chambers

Capstone Experience: Master of Public Health

Midwest Gastrointestinal Associates (MGI) is a private clinic in Omaha, Nebraska that reached out to the College of Public Health for assistance in the clinic’s employee wellness program. An MPH student with a background in health and wellness provided MGI with a health promotion intervention to increase employee participation rates. A change was made to the wellness program in 2017 away from monthly health challenges and points—to small gifts distributed to all employees to increase engagement and morale. An initial program evaluation was performed to understand employee understanding and needs. Discovered was the need for an outlet employees could turn …

The Exploration Of Historical, Cultural, And Healthcare Utilization Factors When Clinically Treating Refugee Patients: Healthcare Providers’ View, Kandy Do

Capstone Experience: Master of Public Health

The objective of this project is to explore historical, cultural, and healthcare utilization factors that are significant to healthcare providers in their practice to clinically treat refugee patients holistically and equitably. Semi-structured interviews supported by a pre-interview questionnaire were conducted with 14 healthcare providers, who have experience in working with refugee patients. Purposive and snowball sampling method was used to recruit 14 healthcare providers. Thematic analysis was used to analyze qualitative data. Descriptive analysis was performed on the pre-interview questionnaire results. To our knowledge, there is limited research exploring historical, cultural, and healthcare utilization factors that are relevant for providing …

Epidemiologic And Spatial Differences In Colorectal, Lung, Breast, And Prostate Cancer Mortality-To-Incidence Ratios Between Blacks And Whites In Louisiana, Anas Almatrafi

Capstone Experience: Master of Public Health

Mortality and Incidence rates are widely used as indicators of health disparities among different racial groups. The current study used the mortality-to-incidence ratio (MIR) to provide a better population-based indicator of survival that can be used as an alternative and more accurate measure of the fatality based on incidence. This study intended to calculate and map MIRs for colorectal, lung and bronchus, breast and prostate cancers in Louisiana by race (Blacks vs Whites), sex, age groups, and geography. Age-adjusted mortality and incidence rates were calculated using the latest data release of the Surveillance, Epidemiology, and End Results (SEER) Program (1973-2014). …

Predictors Of Compliance And Predictive Values Of The Breast Cancer Screening Program Of The Oman Cancer Association (2009-2016), Sultan Al Balushi

Capstone Experience: Master of Public Health

Background: Most breast cancers in Oman are diagnosed at advanced stages and therefore early detection is important. The Oman Cancer Association (OCA) initiated a mobile mammography program in 2009 but no studies have evaluated the impact of the program. This study aimed to estimate the proportion of OCA-screened women who had repeated mammography (compliance) and the associated predictors. The sensitivity and specificity of the program were also evaluated.

Methods: Data for 13,079 women screened in the mammography clinic of OCA from 2009-2016 and medical records of all breast cancer patients seen at Royal and Sultan Qaboos University hospitals during the …

Evaluation Of Adult Mental Health First Aid: Findings From 2015-2017 Post-Course Surveys, Gina Schwieger

Capstone Experience: Master of Public Health

Abstract

Introduction: Lack of knowledge about mental health, lack of access to mental health care, and stigma create substantial barriers to the overall United States adult population from seeking or helping individuals with behavioral health issues. This study evaluated Adult Mental Health First Aid (MHFA) courses, an evidence-based program for increasing mental health knowledge, decreasing stigma, and increasing the community’s confidence in helping and frequency of referring people in need.

Methods: This retrospective evaluation of 2015-2017 Adult MHFA courses, utilizes qualitative and quantitative data from post-course surveys completed by course participants. Quantitative data was measured using a five-point Likert Scale. …

The Development Of A School Lunch Observation Measure To Assess School District Lunch Menu Implementation, Mariam Taiwo

Capstone Experience: Master of Public Health

Background: The most recent estimate of the prevalence of child and adolescent obesity in the United States is 17% (Ogden, Carroll, Lawman, & et, 2016). Based on evidence that the availability of healthy food at schools can significantly impact the nutrition behaviors of children, the Healthy and Hunger Free-Kids Act sets policy for the United States Department of Agriculture (USDA), which includes the National School Lunch Program (NSLP) and the School Breakfast Program (SBP) (USDA, 2017a). School food authorities (SFAs) are responsible for administering school feeding programs (Byker, Pinard, Yaroch, & Serrano, 2013). In other words, local school authorities (school …

Survey Of Indoor Air Quality In Residences Of Wic Participants In Lincoln, Nebraska, Eun Hee Kwon

Capstone Experience: Master of Public Health

Since 1992, Women, Infants, and Children at the Lincoln Lancaster County Health Department has provided supplemental food benefits, nutrition information, breastfeeding support, immunization referrals, and dental services to support low-income families and their children. However, statewide, the retention rate has been dropping since 2009, and if this continues, it can result in adverse health outcomes. As part of the Service Learning activities, this study aims to evaluate current services on clients’ experiences and improve their satisfaction by conducting the WIC participant-centered services survey. This cost-effective intervention program has been working successfully, however it does not provide the information of environmental …

Awareness And Attitudes Of The Latino Community In Omaha On Colorectal Cancer And Screening, Roger Gonzales

Capstone Experience: Master of Public Health

No abstract

Factors Associated With Fatalities In Production Agriculture, Moses New-Aaron, Jessica Semin, Risto Rautiainen, Murray Madsen

Posters and Presentations: College of Public Health

Background: Studying the work environment and demographics of agricultural workers involved in fatal incidents can provide valuable information on the cause of fatalities and lead to better prevention measures.

Objectives: To determine populations at risk of fatalities and the determinants of fatalities in production agriculture.

Method: Agricultural injury and fatality data were obtained from Press clippings and Google alerts covering seven Midwest States (SD, ND, MN, IA, NE, KS and MO). Google Alerts were collected based on key words including: “farm accident”, “farm incident”, “farm death”, “ranch accident”, ”ranch incident”, “ranch death”, “ATV farm death”, “ATV ranch death”, “livestock death”, …

Transforming Physical Therapy Education Through The Use Of Social Network Analysis, Betsy J. Becker, Sara E. Bills

Posters and Presentations: Physical Therapy

PURPOSE

Social Network Analysis (SNA) is a quantitative method to study the patterning and effect of relationships and how individual connections form into social structures that influence outcomes of the group. The purpose of this study is to explain the underpinnings of SNA and its application to PT education for student success and faculty development. This study is innovative and will be beneficial to the profession because there is currently no published literature exploring how PT education is influenced by social structures.

METHODS/DESCRIPTION

The aims of this study are to describe SNA and outline its potential to transform PT education. …

Frequently Identified Gaps In Antibiotic Stewardship Programs In Critical Access Hospitals, Philip Chung, Regina Nailon, Kate Tyner, Sue Beach, Scott Bergman, Margaret Drake, Teresa Fitzgerald, Elizabeth Lyden, Mark Rupp, Michelle Schwedhelm, Maureen Tierney-Brenran, Trevor Van Schooneveld, Muhammad Salman Ashraf

Posters and Presentations: Nebraska ASAP

Background: Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) is a CDC funded project. ICAP team works in collaboration with NE Department of Health and Human Services (NEDHHS) to assess and improve infection prevention and control programs (IPCP) in various health care settings including resource limited settings like critical access hospitals (CAH). Little is known about the existing gaps in antimicrobial stewardship programs (ASP) of CAH. Hence, we decided to study the current level of ASP activities and factors associated with these activities in CAH.

Methods: NE ICAP conducted on-site surveys in 36 CAH from October 2015 to February …

Direct Antioxidant Properties Of Methotrexate: Inhibition Of Malondialdehyde-Acetaldehyde-Protein Adduct Formation And Superoxide Scavenging., Matthew C. Zimmerman, Dahn L. Clemens, Michael J. Duryee, Cleofes Sarmiento, Andrew Chiou, Carlos D. Hunter, Jun Tian, Lynell W. Klassen, James R. O'Dell, Geoffrey M. Thiele, Ted R. Mikuls, Daniel R. Anderson

Journal Articles: Cellular & Integrative Physiology

Methotrexate (MTX) is an immunosuppressant commonly used for the treatment of autoimmune diseases. Recent observations have shown that patients treated with MTX also exhibit a reduced risk for the development of cardiovascular disease (CVD). Although MTX reduces systemic inflammation and tissue damage, the mechanisms by which MTX exerts these beneficial effects are not entirely known. We have previously demonstrated that protein adducts formed by the interaction of malondialdehyde (MDA) and acetaldehyde (AA), known as MAA-protein adducts, are present in diseased tissues of individuals with rheumatoid arthritis (RA) or CVD. In previously reported studies, MAA-adducts were shown to be highly immunogenic, …

The Interprofessional Academy Of Educators: Inclusive, Collaborative, Innovative, Tanya M. Custer, Kim Michael

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Issue to be addressed: To elevate the educational mission of the institution, UNMC established the Interprofessional Academy of Educators in 2016. Designed by educators for educators, this interprofessional community strives to improve health professions education by encouraging curricular innovation, supporting educational scholarship & offering mentorship for early career and seasoned educators.

Method: The inaugural class included a unique blend of medical scholars from 8 Colleges, 2 Institutes, Academic Affairs, IT Services, and Library Sciences. Members span a 500-mile wide campus. Eight SIGs foster interprofessional collaboration & scholarship. An academically diverse leadership team of five oversees the Academy.

Comparison Of Agricultural Injury And Fatality Characteristics Obtained From Media Monitoring Versus Official Statistics, Moses New-Aaron, Jessica Semin, Risto Rautiainen, Murray Madsen

Posters and Presentations: College of Public Health

Objective of project:

1. Compare the characteristics of fatal injuries reported by CFOI and CS-CASH media monitoring

2. Analyze the agreement between CFOI reported injuries and CS-CASH media monitoring fatal injuries

Planning/Research Method:

Background:

The Bureau of Labor Statistics, Census of Fatal Occupational Injuries (CFOI) provides statistics on occupational fatalities, but information on individual cases is not reported. The Central States Center for Agricultural Safety and Health (CS-CASH) tracks media reports of agricultural injury and fatality cases to augment CFOI data.

Methods:

Data was obtained from variety of sources. The primary data source was "Google Alerts" and other sources includes …

Development Of C5ar-Targeted Nanoparticles For Delivery Of Vaccines, Shailendra Bharadwaj Tallapaka Venkata Sesha

Theses & Dissertations

Since the early attempts of Benjamin Jesty at inducing immunity against smallpox and the pioneering work of Edward Jenner, vaccination has been, and continues to remain, the principal method of protection from diseases. However, most of the successful vaccines have been against pathogens that do not have major mechanisms to evade the immune system. So far, many life-threatening diseases like hepatitis C, HIV infection, malaria etc., have been resistant to existing vaccination strategies. Thus, there is an urgent need to develop new vaccination strategies that can generate long-lived protective immunity against such pathogens.

The purpose of this thesis is to …

Nutrition Status In Hospitalized Patients With Copd On Non-Invasive Ventilation, Sara M. Kvien Jensen

Theses & Dissertations

Background: Nutrition is an important aspect of critically ill hospitalized patient care but the lack of consistent nutritional guidelines for sub-critically ill patients with Chronic Obstructive Pulmonary Disease (COPD) requiring non-invasive positive pressure ventilation (NPPV) may be putting vulnerable patients at risk. Hand grip strength measurements are an emerging metric for nutritional status.

Objective: The objective of this study is to determine if hospitalized patients with COPD on NPPV show a difference in handgrip strength as a marker of nutritional status than those hospitalized patients with COPD not requiring NPPV.

Methods: This was a prospective observational study …

Development Of Cxcr4 Inhibitors For Topical Treatment Of Psoriasis, Suthida Boonsith

Theses & Dissertations

Psoriasis is a chronic inflammatory skin disease that is often associated with systemic comorbidities and impaired skin barrier function. There are several treatment options including topical treatment with immunosuppressants, phototherapy, and systemic therapies using small molecules and biological agents. However, none of them can be regarded as a perfect solution due to their toxicity during chronic use. Recently, the CXCR4/SDF-1 axis was found to play an important role in the pathogenesis of psoriasis. AMD3100, a small molecule CXCR4 antagonist can selectively bind to CXCR4 and inhibit skin inflammation, reduce angiogenesis and infiltration of inflammatory cells. Unfortunately, AMD3100 can only be …

Bedtime Fading With Response Cost For Treatment Of Sleep Disturbances In Children With Autism Spectrum Disorder, Sela Ann Sanberg

Theses & Dissertations

As many as 82% of children with Autism Spectrum Disorders (ASD) experience numerous chronic sleep-related problems and at a much higher frequency and severity than their typically developing peers. Behavioral treatments are considered best practice and first-line treatment to address sleep problems. These treatments tend to address one specific sleep-related behavior at a time. Bedtime Fading with Response Cost (BFRC) is a promising intervention that targets a multitude of sleep problems concurrently and has yet to be replicated by more than one investigative team in the home setting with children on the autism spectrum. This study evaluated the effectiveness of …

Hospital Based Emergency Department Visits With Dental Conditions: Outcomes And Policy Implications In The States Of California, Nebraska And New York, Sankeerth Rampa

Theses & Dissertations

The purpose of this dissertation was to present state-level estimates of hospital-based emergency department (ED) visits with dental conditions across all ages in the states of California, Nebraska, and New York. Also, this dissertation examined the outcomes and impact of changes in Medicaid policies on the utilization of ED with dental problems. State Emergency Department Databases (California, Nebraska, and New York), a component of the Healthcare Cost and Utilization Project (HCUP) was used for this dissertation. Dental conditions were identified by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. High-risk groups visiting EDs with dental conditions were …

Structural Violence And Gender-Based Violence In The United States, Sarbinaz Z. Bekmuratova

Theses & Dissertations

Three components of the dissertation project examined the relationship between three different constructs of structural violence and women’s experience of different violence types in their lifetime in the United States. The violence types examined in the study included psychological aggression, coercive control and entrapment, physical violence, stalking, sexual violence, and rape. 2010 National Intimate Partner Violence and Sexual Violence Survey with the final sample size of 9,827 was used for all three portions of the study to analyze the association of structural violence with six types of violence. Additional datasets used were Institute for Women’s Policy Research’s Status of Women …

Redirection Of The Immune Response To Staphylococcus Aureus Biofilm Infection, Anna G. Staudacher

Theses & Dissertations

Staphylococcus aureus (S. aureus) is a leading cause of community- and healthcare-associated infections and has a propensity to form biofilms. Biofilm infections are recalcitrant to host immune-mediated clearance as well as antibiotics, making them exceptionally difficult to eradicate. The biofilm environment has been shown to skew the host immune response towards an anti-inflammatory phenotype, characterized by alternatively activated macrophages, recruitment of myeloid-derived suppressor cells (MDSCs), and minimal neutrophil and T cell infiltrates. Our laboratory has attempted to redirect the host immune response towards one that would favor bacterial clearance by employing strategies to augment pro-inflammatory mechanisms. One such …

Patient-Centered Medical Home Adoption In School-Based Health Centers, Abbey Gregg

Theses & Dissertations

The patient-centered medical home (PCMH) is promoted as a primary care delivery design that can improve health care quality and patient outcomes while controlling health care costs. To achieve PCMH recognition, primary care providers must implement practice-level changes in order to deliver care that is comprehensive, coordinated, accessible, high quality, and whole-person oriented. This practice transformation requires advanced use of health information technology, staff investment in quality improvement and care coordination, and significant investments of both financial and human resources to support these activities. As a safety-net provider, school-based health centers (SBHCs) serve vulnerable children that typically experience barriers to …

Understanding The Chondrogenic Potential Of Articular Chondrocytes, Krishna Sarma

Theses & Dissertations

Articular cartilage is a smooth, visco-elastic, aneural, avascular tissue made of water, an exquisitely organized framework of proteoglycans, glycosaminoglycans, and collagen fibrils and articular chondrocytes. It’s beautiful organization and composition provide it with the flexibility and strength to cover, protect and lubricate the ends of long bones in a diarthrodial joint. Cartilage homeostasis relies on articular chondrocytes to translate the mechanical forces of daily activity into efficient remodeling of the extracellular matrix. Age, joint injury, or other insulting factors can progressively incapacitate articular chondrocytes, resulting in cartilage lesions that devolve to degenerative joint disease. Therefore, the central idea explored in …