Medicine and Health Sciences Commons^™

A Landscape Analysis Of Rapid Evidence Curation During The 2022 Sudan Virus Disease Outbreak In Uganda, Jemimah J. Wachap

Capstone Experience: Master of Public Health

Uganda's 2022 Sudan Virus Disease (SVD) outbreak emphasized the need for rapid and effective evidence curation in public health emergencies. This analysis examines evidence curation practices during the SVD response, identifying challenges and assessing the timeliness and effectiveness of strategies in low-resource settings. While global responses to previous outbreaks, like COVID-19, have advanced evidence synthesis, the SVD outbreak revealed infrastructure and data integration gaps. The study aims to map the evidence curation landscape, focusing on models and tools, such as data-sharing platforms, mobile Polymerase Chain Reaction (PCR) labs, and Integrated Management Systems (IMS). It will also address gaps in surveillance, …

Evaluating The Nebraska Medical Center's Repatriation Of Inter-Hospital Transfers, Natalie Crump

Capstone Experience: Master of Public Health

Background: Bed capacity challenges at large academic medical centers delay the transfer of rural patients, negatively impacting their safety and quality of care. Repatriating inter-hospital transfer (IHT) patients to referral facilities upon completing specialized care can improve tertiary hospital bed capacity and community hospital financial sustainability.

Objectives: This project aims to identify the barriers and facilitators to successful IHT repatriation and the process and outcome variables influenced by the Nebraska Medical Center’s reverse transfer program.

Study Design: A retrospective observational cohort study was conducted to identify barriers and facilitators of NM’s IHT repatriation program.

Methods: Descriptive and comparative analyses of …

A Research Report: What Are The Challenges That Refugee Women Experience When Seeking Healthcare Related To Pregnancy In The United States?, Manuela Krieger-Adi

Capstone Experience: Master of Public Health

Background

Refugees in the United States, including African refugee women, face many challenges in seeking healthcare after moving to the United States to resettle. It is urgent and essential to look into some of the health challenges the refugee community faces here in Omaha, Nebraska, that prevent them from seeking healthcare, especially when pregnant. This Capstone research project aims to focus on African refugee women, specifically in Omaha, Nebraska, and the challenges they face seeking healthcare related to pregnancy.

Methods

This research report involved five in-depth interviews conducted over Zoom. The target population was refugee mothers who had given …

Assessing The Association Between Total Cholesterol And Hospitalized Myocardial Infarction In Women Ages 32-70: An Analysis Of The Framingham Heart Study, Jolene L. Stapleton Duree

Capstone Experience: Master of Public Health

Objective

Heart disease is the leading cause of death in women that may go undiagnosed due to unexpected symptoms. The purpose of this analysis was to assess the effect of total cholesterol on the odds of hospitalized myocardial infarction (MI).

Methods

This analysis used a sample of 2,445 women from the Framingham Heart Study, an observational prospective cohort study. The exposure was total cholesterol, and the outcome was hospitalized MI. Logistic regression was used to estimate crude and adjusted odds ratios (OR). The adjusted models controlled for age, blood pressure, and diabetes. Effect modification by diabetes status was evaluated in …

Histomorphology Of Sharp-Force Trauma On Partially Cremated Remains, Horaceena Findley

Student Theses

Identifying sharp-force trauma in thermally altered human remains presents a significant challenge in forensic investigations, particularly in arson-related deaths where traditional autopsy techniques may be limited. This study explores the efficacy of histological methods in detecting sharp-force trauma on partially cremated remains using pig ribs (Sus scrofa) as a human analog. Simulated tool marks from a knife, screwdriver, and flathead screwdriver were inflicted at varying angles (60° and 90°) and subsequently exposed to high temperatures in an open fire setting. Histological analyses, including Hematoxylin and Eosin Y (H&E) and Gomori’s Prussian Blue staining, were employed to assess tissue structure and …

The Lived Experience Of New Graduate Nurses Implementing Evidence-Based Practice In A Clinical Setting, Kimberly A. Mcfarland

Electronic Theses and Dissertations

The purpose of this qualitative interpretive phenomenological analysis study was to explore the perceptions and lived experiences of new graduate nurses (NGNs) as they implemented evidence-based practice (EBP) in clinical settings. This study addressed the problem that NGNs often lack the skills and confidence to effectively apply EBP, despite its critical role in improving patient outcomes. The research aimed to provide insight into the challenges, support systems, and strategies that influence EBP integration during the transition from student to practicing nurse. The study utilized the interpretive phenomenological analysis methodology to analyze data collected through semistructured interviews conducted via the Teams …

In Vitro And In Vivo Evaluation Of The Effect Of A Commercial-Dried Enterococcus Faecium Fermentation Product As Quorum Sensing Inhibitors Of Salmonella Enterica Typhimurium, Ileana Loeza

Graduate Theses and Dissertations

The purpose of the present research was to evaluate Enterococcus faecium fermentation peptides (EFP) for antibacterial activity, inhibition of biofilm formation, and anti-quorum sensing properties against Salmonella Typhimurium (ST) in in vitro trials and individual body weight and ST organ colonization in therapeutic and prophylactic models in broiler chickens. Ninety-six day-of-hatch Cobb 500 broiler chickens were randomized and assigned to one of four treatments: NC) Negative Control, no EFP treatment and no ST challenge; NC+EFP) Negative Control, EFP treatment and no ST; PC) Positive Control, no EFP treatment and ST challenge, and PC+EFP) EFP treated and ST challenged. Independent trials …

A Stakeholder-Informed Conceptual Framework For Evaluating Genomics In Precision Oncology, Julie A. Wiedower

All Dissertations

This dissertation explores the value of genomic testing in precision oncology with an emphasis on how US payers conceptualize and prioritize elements of value. This research aims to address gaps in understanding payer perspectives and proposes a stakeholder-informed framework for evaluating genomic testing in oncology. To achieve this aim, the presented research investigates payer perspectives, value-based cancer care priorities, and the conceptual understanding of the value of a genetic diagnosis to establish a framework for value with the payer audience in mind. Chapter 1 outlines relevant background information relating to the genomic revolution and challenges in translating genomic testing technologies …

Biophysical Studies Of Nucleic Acid - Small Molecule Recognition, Andrea Conner

All Dissertations

The presented work is a collection of studies performed to examine small molecule recognition of nucleic acids. Recognition of nucleic acids was examined using two types of small molecules: aminoglycosides and Hoechst dyes. Chapter One focuses on established experimental techniques (i.e. absorbance, isothermal titration calorimetry, flow cytometry, cell microscopy, etc.) in small molecule recognition of nucleic acids. The emphasis of studies in the group has been on two focus areas. (i) Thermodynamic characterization of mixed A-form and B-form DNA or RNA conformation with aminoglycosides, particularly neomycin-class. (ii) Characterization of new Hoechst-morpholine (HT-MO) derivatives’ interactions with nucleic acids.

Focus area (i) …

The Genomic Landscape And Prognostic Impact Of Kras, Stk11, And Smarca4 Mutations And Co-Mutations On Survival Outcomes In Non-Small Cell Lung Cancer, Peter Manolakos

All Dissertations

Non-small lung cancer (NSCLC) accounts for 85% of lung cancer cases, and Kirsten rat sarcoma viral oncogene homolog (KRAS), Serine/Threonine Kinase 11 (STK11), and SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member 4 (SMARCA4) mutations and co-mutations have been increasingly recognized for their potential prognostic significance. However, clear knowledge gaps remain regarding which treatments should be selected for patients who present clinically with KRAS/STK11 or KRAS/SMARCA4 co-mutations, as outlined in Chapter 1. Despite significant clinical development advancements in immunotherapy and targeted therapy, a deeper understanding of the influence of these genomic …

Am I Woke Enough To Serve In Healthcare: A Secondary Analysis Of Pre-Health Students’ Personal And Professional Growth By Engaging In Cultural Competency Assessments, Harolynn Williams

All Dissertations

Healthcare providers must be equipped to serve an increasingly diverse population, yet cultural competence remains underemphasized in undergraduate pre-health education. This study explored how embedded cultural competency training influences undergraduate pre-health students’ perceptions of personal and professional growth. Using a qualitative descriptive design, the research incorporated intercultural assessments, the Intercultural Development Inventory (IDI), and the Global Competence Certificate (GCC), along with qualitative reflections from students enrolled in three versions of a cultural competence course: a year-long course, a semester-long course, and a short-term study abroad immersion six-week course. Findings revealed that students demonstrated measurable growth in cultural awareness, knowledge, communication, …

A Neuroimmune Circuit Mediates Chemo Brain Pathology, Daniel Ahmadi

McKelvey School of Engineering Graduate Student Theses & Dissertations

Chemotherapeutic agents, while effective in targeting malignant tumors, often reduce the patients’ quality of life by inducing fatigue, pain, and motivational deficits. These symptoms are collectively referred to as “chemo brain.” The mechanisms underlying these adverse effects, and specifically whether fatigue and motivational impairments share a common etiology, remain poorly understood. The neural–immune substrates of these symptoms remain obscure, in part because standard preclinical regimens either bypass key systemic signals or introduce local toxicity confounds. Here, I establish and validate a three‑day, low‑dose intravenous cisplatin protocol that avoids peritoneal inflammation and severe renal injury yet produces robust, reversible fatigue and …

Adolescent Developmental Domains: Examining Risk And Protective Factors In Loneliness, Archer Ward

Boise State University Theses and Dissertations

Adolescent mental health is on the decline and questions have been raised as to what might be contributing. The experience of chronic loneliness has been linked to increased risk of developing anxiety, depression, and suicidal behaviors in both adulthood and adolescence. However, little research has been conducted on the relationship between known risk and protective factors and loneliness in adolescence. The objective of this secondary data analysis is to examine the patterns of association between risk and protective factors in key developmental domains on loneliness. A total of 7,696 adolescent (M age = 14.6, 51% male) responses were collected during …

The Effects Of Daily Beef Consumption On Sleep, Mood, And Wellbeing In Postmenopausal Women, Caroline M. Coughlin

Biological Sciences Undergraduate Honors Theses

Menopause is often accompanied by changes in sleep, mood, and overall well-being, partly due to hormonal shifts and loss of muscle mass. Protein intake, especially from nutrient-rich sources like beef, may help address these changes, but research in postmenopausal women remains limited. This study explored how daily beef consumption, as part of a higher-protein diet, affected sleep quality, mood, and well-being over eight weeks. Ten active postmenopausal women were randomly assigned to either a control group (meeting standard protein recommendations) or a treatment group consuming twice that amount, including one serving of lean beef per day. Sleep was measured using …

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 …

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 …

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, …

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 …

The Association Between Economic Outcomes And Abortion: A Scoping Review, Larisa Nicole Stephenson

Capstone Experience: Master of Public Health

Background: Abortion access is not just an issue of autonomy, but an economic issue as well. Evidence of the intersectionality of abortion health care and economics has endured due to the financial cascading effects a denial of an abortion, or the inability to access an abortion, has on one’s personal, professional, and economic upward mobility. A change in recent policies impacting access to abortion warrants an updated synthesis examining the relationships between economic outcomes and abortion access for people of reproductive age in the United States (U.S.).

Aim: This scoping review summarizes evidence pertaining to the association …

Transgender And Gender-Diverse Health Care Access And Availability Of Care According To Resident Leaders In The Mahoning County, Ohio, Robin A. Perry

Capstone Experience: Master of Public Health

BACKGROUND: Transgender and gender diverse health is significantly under attack in the United States and there is a continued need to further research to identify ways to increase their access to both inclusive care as well as gender affirming care. The purpose of this study was to explore barriers and supportive factors that professionals and community leaders perceive surrounding the availability and accessibility of inclusive and gender affirming care for transgender and gender diverse people in Mahoning County, Ohio.

METHODS: Key informant interviews were conducted with professionals and community leaders who could be considered “facilitators” helping transgender and gender diverse …

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 …

Active Shooter And Radiological Contamination Full-Scale Exercise, Elise M. Lowe

Capstone Experience: Master of Public Health

Planning and conducting exercises in rural settings highlights the unique features and challenges of emergency preparedness in rural America. Exercise designers must employ creative solutions to plan for player/controller contingencies, limited resources, and patient management across large geographical areas. This paper outlines the process by which a full-scale mass casualty exercise was conducted in a small Wyoming town. It analyzes some of the major problems encountered in rural exercise development and the solutions employed. The focus is on the success and failures of the exercise design based on direct observation/participation, hotwash forms, the after-action review, and direct feedback from participants. …

Kansas City Health Department – Childhood Lead Poisoning Prevention Program – Quality Improvement, Hanh Pham

Capstone Experience: Master of Public Health

This capstone manuscript evaluates the Kansas City Health Department's Childhood Lead Poisoning Prevention Program’s effectiveness. Through comprehensive data analysis of grant utilization, return-on-interest (ROI) and participant satisfaction evaluation, the project will provide actionable recommendations for improving sustainable long-term outcomes in lead poisoning prevention.

Improving Oral Hygiene Practices In A Long-Term Care Setting For Individuals With Advanced Dementia: A Quality Improvement Initiative, Rachel L. Mcinerney

Capstone Experience: Master of Public Health

This quality improvement project utilized the Plan-Do-Study-Act framework to enhance oral hygiene practices in a long-term care setting for individuals with advanced dementia. Advanced dementia often leads to significant oral health challenges due to the individuals’ inability to communicate needs or independently manage oral care. Poor oral hygiene results in pain, systemic infections, and reduced quality of life. The project aimed to identify and address barriers to effective oral care delivery by focusing on organizational factors such as leadership, training, and caregiver support. This capstone paper provides insights into the quality improvement initiative’s aims, background, and methodology, while emphasizing its …

Integrated Primary Care And Mental Health In Rural Communities: A Comprehensive Literature Review To Understand Barriers, Zinab Alaskar

Capstone Experience: Master of Public Health

This comprehensive literature review capstone project identifies structural barriers to integrating primary care and mental health services in rural areas. It examined reliable literature and validated research articles to determine challenges and barriers to the adoption and expansion of integrating primary care and mental health services in rural communities. The hypothesis of this work is that the issues of workforce shortages, financial constraints, technological limitations, and stigma in a society limits the development and viability of integrated healthcare models. These structural limitations must be addressed to address issues related to access to health care, costs and patient well-being. As it …

Unbridled Healing: Identifying The Barriers Of Equine-Assisted Therapy, Sally A. Hamm

Human Development and Family Sciences Undergraduate Honors Theses

Despite the documented benefits of equine-assisted therapy (EAT) for mental health conditions, this complementary approach remains underutilized. This qualitative study investigated barriers preventing wider EAT implementation by examining challenges faced by clients, facilities, and volunteers. Data collected through open-ended surveys from 33 participants and the researcher's autoethnographic observations revealed eight common barriers: Accessibility (48 mentions), Money (43), Time (30), Awareness (23), Physical Factors (13), Relationships (13), Risk (13), and Weather (7). Clients identified financial constraints as their primary barrier, particularly insurance limitations. Facilitators struggled most with accessibility challenges, including lack of resources, trained staff, suitable horses, and appropriate facilities. Volunteers …

Parental Expectations On Pediatric Care For Children, Brenan Cash

Human Development and Family Sciences Undergraduate Honors Theses

Childhood pediatrics is a major factor for a full and healthy childhood for all children from adolescence to adulthood. However, the physical health aspect has been the main focus through most primary care clinics and hardly focuses on the mental health side. Mental health issues which involve anxiety, depression, and post-traumatic stress are more prominent than they have ever been, as up to 30% of children have experienced mental health issues such as posttraumatic stress disorder, especially in recent pandemic years (Meherali et al., 2021). This study employed a non-experimental, quantitative analysis utilizing online close-ended survey questions. The type of …

Effects Of Nsaids On Bone Healing Time In Orthopedic Patients, Alayne Brekke

Physician Assistant Scholarly Project Papers

Use of NSAIDs in adults recovering from orthopedic injury or surgery has been found to be largely inconclusive when it comes to determining significance in delay of bone healing. The purpose of this review is to determine whether use of NSAIDs is detrimental to bone healing after orthopedic injury or surgery. A literature review was performed using electronic databases PubMed and SportsDiscus from May to July of 2024. There were fifteen studies that met final inclusion criteria. Research overwhelmingly acknowledged that selective COX-2 inhibitors are not recommended in a post injury or post operative state. However, when it comes to …

Efficacy Of Menstrual Cycle Awareness In The Identification Of Premenstrual Dysphoric Disorder, Rachel Brothers

Physician Assistant Scholarly Project Papers

Premenstrual Dysphoric Disorder (PMDD) is characterized by identifiable psychological and physical symptoms that are present in the week before menses and is estimated to affect 3-8% of women of reproductive age globally. The identification of women who meet criteria for PMDD is important both clinically, to provide proper support and treatment, and for advancing research by identifying appropriate study participants. This literature review aims to investigate the efficacy of current and prospective tools to screen for symptoms of PMDD by comparing a common depression screening tool, the PHQ-9, to tools that enhance menstrual cycle awareness. A literature review was conducted …

Efficacy Of Low-Dose Naltrexone Compared To Gabapentinoids In Fibromyalgia, Dillon Boen

Physician Assistant Scholarly Project Papers

Fibromyalgia is a chronic pain disorder and often a diagnosis of exclusion characterized by widespread non-specific pain, fatigue, and cognitive dysfunction. Despite fibromyalgia’s significant prevalence, optimal clinical management remains uncertain because of its uncertain pathophysiology. This literature review evaluates the efficacy, safety, and tolerability of low-dose naltrexone (LDN) compared to gabapentinoids, including gabapentin and pregabalin, in the management of fibromyalgia symptoms. A literature review of studies published between 2005 and 2024 was conducted using PubMed's electronic search base. Specific keywords included LDN, low-dose-naltrexone, fibromyalgia, pregabalin, and gabapentin. Specific criteria were set to include all clinical trials and randomized controlled trials …