Medicine and Health Sciences Commons^™

Evaluating The Therapeutic Potential Of Geranylgeranyl Diphosphate Synthase Inhibitor, Ram2061, In Myeloma Bone Disease, Molly Muehlebach

Theses & Dissertations

Multiple myeloma (MM) is a hematological malignancy of the plasma cells which often results in lytic bone disease. Myeloma bone disease (MBD), characterized by diffuse osteopenia, bone lesions, or pathological fracture, results from MM mediated promotion of osteoclast resorption and dual inhibition of bone formation, drastically reducing bone strength and integrity. Development of MBD is known to significantly impact patient quality of life and increase risk of mortality. Considering that up to 80-95% of MM patients are expected to develop bone disease post-initial MM diagnosis, there is a significant need within this population for therapeutics which address both MM disease …

Keep Me Upright, Joscelyn C. Zimmerman, Kamrie L. Peterson

Doctor of Nursing Practice Projects: College of Nursing

Background: As our society ages, falls have emerged as a leading cause of accidental injury and death globally, significantly impacting older adults’ quality of life (Matchar et al., 2017; WHO, 2021). The consequences of falls are profound, encompassing physical injuries, psychological distress, and substantial healthcare costs. In the U.S., Medicare spends approximately $31.3 billion annually on fall-related care (Gettel et al., 2020). These statistics underscore the need for standardized fall prevention strategies in primary care.

Purpose: This Doctor of Nursing Practice (DNP) project aimed to implement a standardized systems-level process change for fall risk screening and education during Medicare Annual …

The Impact Of Public Health Authority On Emergency Response In State Health Departments, Jessica L. Baggett

Dissertations: Doctor of Public Health

Background

Public health authority plays a crucial role in enabling state health officials to implement emergency response measures such as isolation, quarantine, and vaccination campaigns. However, legislative changes following the COVID-19 pandemic have significantly curtailed these authorities in many states, raising concerns about the ability of public health officials to respond effectively to future health crises. The erosion of public health authority has highlighted gaps in the legal literacy of health officials and underscored the need for enhanced training in navigating political and legal challenges.

Purpose

The purpose of this study is to assess legal literacy among state health officials, …

Assessing Cervical Cancer Health Literacy Among Karen Women In The Omaha Area, Grace Berentson, Michaela Bartels, Monica Angeletti, Jennifer Liu

Posters and Presentations: Family Medicine

No abstract provided.

Evaluation Of A Joint Staffing Model With Clinical Pharmacy In An Outpatient Family Medicine Residency Clinic, Daniela Cortes Reyes, Jessica Witt, Melanie Menning, Anthony Donovan

Posters and Presentations: Family Medicine

No abstract provided.

Assessing And Addressing The Needs Of Socially Vulnerable Populations To Enhance Community Emergency Preparedness And Resilience: A Mixed Methods Study, Jennifer E. Harris

Dissertations: Doctor of Public Health

Background: A robust understanding of the needs of individuals and communities can help reduce the impact of a disaster, especially on those communities that already have associated health disparities. By strategically including these populations into mitigation, preparedness, response, and recovery planning, emergency management plans can be enhanced to be more inclusive and effective by identifying targeted resources during a crisis. Additionally, understanding and improving upon individual resiliency can potentially bolster a community’s resiliency level and reduce overall susceptibility to a disaster event, and expedite the recovery phase. Purpose: The purpose of this study is to assess the emergency …

Demographic Groups’ Use Of Agency Intimate Partner Violence (Ipv) Services: A Quality Improvement Project To Identify And Engage Local Underserved Populations, Mia Parker

Capstone Experience: Master of Public Health

This quality improvement project intended to identify populations of adult intimate partner violence (IPV) survivors in Spokane County, Washington, by race/ethnicity and sex who are underserved by a local victim service agency and provide action-oriented, evidence-informed recommendations that the agency may utilize to increase engagement with these local underserved populations. Methods used include secondary data analysis, timeline creation, literature review, and interpretation of quantitative and qualitative data analysis. This was a capstone project designed to demonstrate multiple public health competencies.

Ocular Surface Squamous Neoplasia (Ossn) Risk Factors In Lusaka, Zambia: The Role Of Hiv And Socioeconomic Status, Stepfanie N. Siyumbwa, Peter Julius, Tabitha Nkhata, Obvious N. Chilyabanyama, Abraham Mengist, Gleb Haynatzki, Charles Wood

Capstone Experience: Master of Public Health

Objective

To identify and evaluate potential risk factors for OSSN at the University Teaching Hospital (UTH) in Lusaka, Zambia.

Methods

Data from 475 patients were analyzed retrospectively, and it included 390 with OSSN and 85 with benign biopsies. Variables with significance values

Results

Several key predictors of OSSN were identified after controlling for confounders in the household cooks sub-population, these were, a lower household income (adjusted odds ratio [aOR] = 0.64, 95% CI: 0.46–0.90, p = .009), a Lab confirmed HIV-positive status (aOR = 3.56, 95% CI: 1.72–7.21, p = .001) and exposure to biomass smoke (aOR = 2.47, 95% …

Is Diabetes A Predictor Of A Diagnosis Of Hypertension In The Population Of 32- To 70-Year-Olds In A Cohort Study? A Multivariate Logistic Regression Analysis Of A Subset Of Data Obtained From The Framingham Study, Walter Marquez-Lavenant

Capstone Experience: Master of Public Health

Objective: Assess the independent role of diabetes on hypertension using logistic regression, while adjusting for covariates such as age, sex, BMI

Methods: A subset of data from the Framingham Cohort study, with 5,209 participants and collected across three periods from 1956 to 1968, was analyzed. The dataset includes laboratory, clinic, questionnaire, and event data from 4,434 individuals and was analyzed using SAS software for logistic regression.

Results:In the adjusted model, diabetes was not associated with hypertension (aOR:1.1, 95% CI:0.67-1.81, p=0.7). Females had 26% higher odds of hypertension than males (aOR=1.26, 95%CI:1.09-1.25, p=0.00). Participants aged 51 or older (aOR=2.86, 95%CI:2.37-2.47, …

Restoring Trust In Public Health: An Analysis Of The Lasting Implications Of The Covid-19 Pandemic Response On Community Trust In Public Health In Nebraska, Kerri Dittrich

Capstone Experience: Master of Public Health

Background and Significance

Public trust is essential for effective public health efforts. In Nebraska, as in many regions, the pandemic response exposed strengths and vulnerabilities in the public health system. Misinformation, political discourse, inconsistent messaging, and poor communication contributed to growing mistrust, threatening the long-term success of public health programs and initiatives. While national trends have been studied, Nebraska-specific research remains limited.

Methods

An original descriptive survey was designed and administered to public health professionals in Nebraska to assess their perceptions of public trust in the local public health system before and after the COVID-19 pandemic. The survey also explored …

The Role Of Responsive Feeding In Childhood Development And Clinical Implications: A Comprehensive Literature Review, Alexander Burbach

Capstone Experience: Master of Public Health

Responsive feeding refers to caregiver-infant feeding interactions that encourage healthy eating behaviors and support the child’s autonomy by responding to their hunger and satiety cues. Responsive feeding supports healthy early childhood development, influencing self-regulation in eating behaviors and long-term health outcomes, particularly in obesity prevention. A comprehensive literature review was conducted to examine the impact of responsive feeding practices on childhood development in the United States and its clinical implications. The objectives were to explore the role of parental feeding practices in shaping childhood eating behaviors, understand the relationship between responsive feeding and obesity, and determine literature daps. Articles for …

Severe Acute Malnutrtion Among Children Under Five In South Sudan, Rhoda Elia Iburu Kenyi

Capstone Experience: Master of Public Health

Severe acute malnutrition (SAM) is a life-threatening condition characterized by severe wasting. The World Health Organization defines SAM as a low weight-for-height Z-score (WHZ) less than -3 standard deviation (SD) from the median growth standard or the presence of edema of both feet and/or mid-upper arm circumference (MUAC) less than 115mm. SAM is a significant public health concern affecting children under five in developing countries, with South Sudan being one of the most severely affected regions. Persistent food insecurity, weak healthcare systems, and ongoing conflict contribute to the high SAM prevalence in the region, where political, religious, and social divisions, …

The Impact Of Stigma On Individuals Affected By Leprosy: A Pilot Study, Mardo Tarr

Capstone Experience: Master of Public Health

Background: Leprosy, while a treatable condition, continues to be associated with significant stigma, which adversely influences the physical, psychological, social, and economic well-being of affected individuals throughout their lives. The stigma linked to leprosy leads to social exclusion, mental health difficulties, and obstacles to accessing healthcare and employment opportunities (Brakel et al., 2019; Sermrittirong & Van Brakel, 2014). This research employs Life Course Theory to describe the long-term experiences of stigma, coping strategies, and social support individuals living with leprosy. By synthesizing findings from existing literature and conducting a qualitative interview, the study offers an in-depth understanding of how various …

An Exploration Of Substance Abuse By Healthcare Workers During The Covid-19 Pandemic: A Scoping Review, Andrew Hills

Capstone Experience: Master of Public Health

Objective

This scoping review aims to identify available literature and research on substance abuse by healthcare workers (HCWs) during the COVID-19 pandemic to examine whether the stress of their duties during the pandemic exacerbated existing issues of substance abuse.

Methods

A literature search using PubMed and Google Scholar using Harzing Publish or Perish identified 100 relevant professionally-authored, peer-reviewed, English-language academic articles published between 2015 and 2025 on substance abuse by HCWs. Exclusions were done via a review of the abstract and then from the full text, reducing the number of articles to three from those three articles which generated an …

Evaluating Surge Capacity In The Emergency Department: A Comprehensive Literature Review On Preparedness And Response Frameworks, Tanner J. Riscoe

Capstone Experience: Master of Public Health

Medical surge capacity in emergency departments is influenced by four critical factors: staff, stuff, space, and systems. Understanding these factors and the interplay between them is critical. Emergency departments are increasingly encountering issues with overcrowding, patient boarding, and medical surge events causing interruptions in care and depleting critical resources. Coordination of medical surge is challenging during normal operations but is intensified during times of crisis. This comprehensive literature review seeks to better understand the current state of the literature surrounding surge preparedness and response in emergency departments across the United States, identify gaps in the current literature, and ultimately recommend …

A Stakeholder Analysis For Engagement: A Pestle Framework For The Nebraska Coalition For Patient Safety, Kaleb Horton

Capstone Experience: Master of Public Health

The Nebraska Coalition for Patient Safety (NCPS) is a not-for-profit organization designed to collaborate with Nebraska’s hospitals and healthcare organizations to benefit patient safety. NCPS, as do all organizations, have varying types of stakeholders who are engaged at some level in the function of NCPS or the services of NCPS. Research across industries demonstrates the importance of stakeholder assessment and evaluation and it has been shown that collaborative efforts with stakeholders can improve outcomes (Newig et al., 2023). Acquiring input from those who are directly affected by the organization’s strategic planning can help determine and shape future direction. This capstone …

Feasibility Study Of Service Expansion To Non-American Indians At The Santee Health & Wellness Center, Phil D. Jaquith

Capstone Experience: Master of Public Health

Challenges with obtaining access to healthcare in rural communities continue to be a clear issue. There are both structural and economic issues that limit patient access to care. With geographic issues also affecting access, many patients in Nebraska must travel further and wait longer throughout most rural communities to receive needed care. Care services seem to be retracting vs expanding, and patients continue to seek options that are closer to home and more comprehensive in scope. It is vital for communities and health services organizations to assess all care options and services they can expand or currently have to attract …

Healthcare Emergency Management Salary Survey Analysis, Grace E. Thiel

Capstone Experience: Master of Public Health

The field of emergency preparedness is an often unknown and unrecognized aspect of healthcare, forming an integral component of patient and worker safety. While an important field, there is limited data focused on the field pertaining to salaries of workers, resources utilized and produced, and the typical working environment. The purpose of this project is to assess salary and other demographic markers of healthcare emergency preparedness professionals in the United States. The project will compare salary, full-time equivalent levels, preparedness program budgets, and other markers across the country. The data from this study will also be compared to previous survey …

A Comprehensive Literature Review Of Barriers And Facilitators To Alcohol Use Disorder Screening And Treatment, Lizette M. Orihuela

Capstone Experience: Master of Public Health

Background: Alcohol Use Disorder (AUD) remains a significant public health issue with extensive personal, societal, and economic impacts. Recent studies indicate that no amount of alcohol consumption is entirely safe, linking it directly to increased chronic disease risks, including cancer. Despite well-documented negative health outcomes, clear guidance on what constitutes AUD through diagnostic criteria provided by the DSM-5, AUD continues to be underdiagnosed and undertreated.

Objectives: This comprehensive literature review explores the key barriers and facilitators influencing AUD screening and treatment engagement.

Methods: A comprehensive literature review was conducted, gathering from various databases including, PubMed, PsycINFO, Scopus, Google Scholar, and …

Optimizing Case Management Manuals: A Ryan White Quality Improvement Project For Northwest Missouri, Megan Mcbane

Capstone Experience: Master of Public Health

The Ryan White HIV/AIDS Act, established in 1990, has played a critical role in providing essential services for individuals living with HIV, including medication access, adherence support, health coverage, housing, and transportation. In rural Missouri, particularly in the northwest region, HIV case management under the Ryan White program is guided by four separate manuals, creating inefficiencies and burdens for case managers. This paper presents a process evaluation plan utilizing the Plan-Do-Study-Act (PDSA) framework to address these challenges and improve service delivery. The aim of this quality improvement project is to enhance the efficiency and effectiveness of HIV case management in …

Cardiac Patient Care Coordination: A Comprehensive Literature Review On Outcomes, Payton Allen

Capstone Experience: Master of Public Health

Care coordination is a vital aspect of the U.S. primary care landscape. Care Coordination is the deliberate process of managing a patient across different provider settings and services and is a vital part of chronic patient care. Most primary care providers (PCPs) today have moved to adopt some form of patient-centered care that serves as the central hub for coordinating and managing a patient's complete healthcare journey. PCPs' access to specialist records and their familiarity with their patients' long-term disease courses uniquely position them as the prime coordinators of patient care. Care coordination is becoming increasingly important in cardiac care …

Utilizing The Health Belief Model To Design A Community-Based Program To Increase Cervical Cancer Screening Rates Among 21 To 25-Year-Olds In The Omaha Metro Area, Karli Baker

Capstone Experience: Master of Public Health

The 2021 Douglas County Community Health Needs Assessment found that cervical cancer screening rates have been on a downward trend since 2011. Previous studies on cervical cancer screening interventions have examined refugee populations, and current programs in Douglas County offer assistance to uninsured women, typically aged 40 and older. However, interventions have overlooked young women aged 21 to 25 in the Omaha metro area, who exhibit the lowest cervical cancer screening rates. We will use the PRECEDE-PROCEED Model as a framework to design an educational program for young women aged 21 to 25, guided by the theoretical underpinnings of the …

A Comprehensive Literature Review Of Barriers To Hormone Therapy Utilization: Strategies For Improving Menopause Management In Women Aged 40-60, Suhan Lee

Capstone Experience: Master of Public Health

Menopause is a natural transition marked by the cessation of ovarian activity, often accompanied by vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM), and psychological changes that significantly impact women’s quality of life. Hormone therapy (HT) has been the primary treatment for managing menopausal symptoms, particularly VMS, providing substantial relief when initiated within 10 years of menopause. Despite its effectiveness, HT usage has declined dramatically over the past two decades primarily due to barriers such as stigma, safety, misinformation, provider hesitancy, financial barriers, and cultural beliefs. This comprehensive literature review explores key factors influencing HT decision-making, including the media’s role …

Breaking Barriers To Smoking Cessation: Applying The Baby & Me - Tobacco Free Program To Improve Maternal And Child Health In Omaha, Nebraska, Madison Ravens

Capstone Experience: Master of Public Health

Smoking during pregnancy remains a pressing public health concern, contributing to adverse outcomes such as preterm birth, low birth weight, and developmental complications. In Nebraska, about 10% of pregnant women continue to smoke throughout pregnancy—above the national average, highlighting a critical gap in maternal health interventions. The Baby & Me – Tobacco Free (BMTF) program provides an evidence-based solution through structured counseling, carbon monoxide (CO) monitoring, and incentive-based rewards to support smoking cessation among pregnant women. This capstone project utilized the Getting to Outcomes framework to develop a detailed implementation plan to support Tobacco Free Nebraska (TFN) in launching the …

A Comparative Analysis Of Preventable Deaths And Healthcare Accessibility: The U.S. Healthcare System Vs. Canada, The United Kingdom, And Australia, Aleya K. Byrd

Capstone Experience: Master of Public Health

The United States continues to struggle to improve healthcare performance and patient outcomes in comparison with other developed nations. This study examines access to primary care services and preventable deaths by comparing the performance of the United States, Australia, Canada, and the United Kingdom. (Blumenthal et al., 2024). A comprehensive scoping literature review method was applied to examine the health systems of three countries' public health structures to better understand the factors that may influence the US health system performance in accessing primary care services and decreasing preventable deaths. Understanding the structures that lead to the outcomes can help provide …

Barriers To Medication-Assisted Treatment For Opioid Use Disorder In Prisons And Jails In The United States: A Comprehensive Literature Review, Amy C. Smith

Capstone Experience: Master of Public Health

Background: The American Society for Addiction Medicine guidelines state that all FDA-approved medication for opioid use disorder should be available for all patients (CDC, 2024). Medication-assisted treatments for opioid use disorders, also known as medication for opioid use disorder (MOUD), are treatments that help diminish the physical symptoms of addiction to opioids. Currently, there are three FDA-approved medications to treat opioid use disorder: buprenorphine, methadone, and naltrexone (FDA, 2024). Despite being at an increased risk for opioid misuse and overdose, incarcerated individuals in the U.S. often do not have access to MOUD. This comprehensive literature review aimed to determine the …

Surge Scramble: An Evaluation Of Combining The Medical Response And Surge Exercise With The Centers For Disease Control And Prevention’S Pan Flu Scramble, Rebecca L. Thompson

Capstone Experience: Master of Public Health

This report analyzes how Hospital Preparedness Program funding recipients in Nebraska adapted the Center for Disease Control’s Pan Flu Scramble format to meet Medical Response and Surge Exercise (MRSE) requirements in the 2023-2024 fiscal year. By combining the MRSE and Pan Flu Scramble, the recipients created an in-person functional exercise format for the six Nebraska health care coalitions to test their respective chemical plans and the Health Care Crisis Protocol for the State of Nebraska. The report explains the design and conduct of the exercises and provides a comprehensive evaluation of the exercise design and conduct. This report will outline …

State Case Count As An Indicator Of Successful Multistate Outbreak Investigation, Lorisa M. Pennell

Capstone Experience: Master of Public Health

Background/Objectives: Shiga-Toxin producing Escherichia coli (STEC) is a contaminant found in multiple food types and causes multistate outbreaks due to the industrialization of food production. In this report I examine the differences in outbreaks categorized by the regulating agency responsible in outbreak prevention and compare outbreak case counts when organized by positive outbreak investigation and response outcomes.

Methods: STEC Multistate outbreak data was obtained from the Center for Disease Control’s National Outbreak Reporting System (NORS) for outbreaks occurring from 2006-2023. Outbreaks were organized into those regulated by either the US Food and Drug Administration (FDA) or the US Department of …

Focus Group Study Of Racial Disparities And The Effects Of Parental Marijuana Use On Youth Marijuana Use, Avina K. Mahroke

Capstone Experience: Master of Public Health

Marijuana has become one of the most used drugs in the United States. There has been an increase in use among both adults and youth during the past several years. Public health interventions are needed to address marijuana use because of its detrimental effects on youth well-being. Research shows that marijuana can lead to problems with memory, learning, attention, and even depression among youth. Furthermore, marijuana exposure in-utero can lead to developmental issues and problems with other organs such as the lungs. Youth are influenced to start using drugs, like marijuana, for numerous reasons, and parents are one of those …

Investing In Embedded Practitioners: Lessons From The Region Vii Public Health Expansion Program, Julia Quigley

Capstone Experience: Master of Public Health

Public health systems in the United States face mounting challenges, including workforce shortages, skill gaps, and increasing demands on practitioners. These issues are particularly acute in rural and Tribal communities, where systemic barriers and health disparities persist. The Region VII Public Health Expansion Program (PHES) addresses these challenges by investing in practitioners already embedded in their communities. Through fully funded public health degree programs, the PHES aims to enhance workforce retention, strengthen skills, and support the delivery of essential public health services in Missouri, Iowa, Nebraska, and Kansas. This study evaluates the program's innovative approach, which departs from traditional recruitment …