Medicine and Health Sciences Commons^™

A Descriptive Analysis And Assessment Of Predictive Factors For Participation In A Clinical Trial As Front-Line Therapy For Patients Enrolled In The Nebraska Lymphoma Study Group Registry, Jonathan L. Tefft

Capstone Experience: Master of Public Health

Background: Clinical trial participation, especially among cancer clinical trials in adult populations, continues to be low despite the large number of clinical trials available across the U.S. Estimates for clinical trial participation are as low as 5% in some adult cancer populations, however in some lymphoma populations this figure may be as high as 13.9%. This figure can be confusing, given that as much as 70% of Americans are estimated to be willing to participate in a clinical trial. Previous research shows that as much as 95% of surveyed respondents who said they had previously participated in a clinical trial …

Association Of Adverse Birth Outcomes With Maternal Exposure To Nitrate In Private Well Drinking Water: An Action Plan For Prevention, Jessyka R. Johnson

Capstone Experience: Master of Public Health

Abstract

Goal: The goal of the capstone project is to collect information required to develop an action plan focusing on minimizing exposure to nitrate in pregnant women, which, if implemented, can either prevent or reduce adverse health outcomes associated with nitrate exposure in utero.

Objective: The capstone project objective is to gain a better understanding of what programs to prevent exposure to nitrate from private well drinking water in pregnant women are already in place throughout the United States; to identify any areas of improvement in these programs; and to utilize this information to create a unique action plan in …

Characterization Of Cancer Incidence In Chronic Kidney Disease Patients: A Single Center Study, 2008 – 2018, Jagadeesh Puvvula

Capstone Experience: Master of Public Health

Background: Chronic kidney disease (CKD) is an established risk factor for cardiovascular disease, but the significance of lower Glomerular filtration rate on incidence and mortality from cancer is uncertain. There is evidence that cancer risk and cancer mortality may be increased in individuals with End Stage Renal Disease (ESRD) requiring dialysis or after renal transplantation but whether less severe kidney disease is associated with cancer remains poorly understood.

Some studies indicate that these associations do appear to be organ specific. It has been reported that reduced renal function is associated with an increased risk of cancers of the kidney and …

Burden And Risk Factors Associated With Hcv Infection Among People Living With Hiv Infection In Nebraska: Population-Based Cross-Sectional Study From 1997 To 2017, Issaka Kabore

Capstone Experience: Master of Public Health

Background: Previous studies have shown high prevalence of HCV infection among people living with HIV infection. Coinfected people are at risk of developing liver diseases resulting an increase rate of mortality. Several risk factors for HIV/HCV coinfection have previously been identified with injecting drug users (IDU) as the common route of exposure.

Methods: This was cross -sectional study using HIV and HCV registries maintained by Nebraska Department of Health and Human Services (NE DHHS) from1997 to 2017. A descriptive analysis was used to characterize the sample. Chi-squared test and Fisher exact test were selected to compare the different groups. …

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

Capstone Experience: Master of Public Health

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

Hearing Conservation In A Meat Processing Facility, Abolore Muinat Idris

Capstone Experience: Master of Public Health

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

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

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

Capstone Experience: Master of Public Health

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

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

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

Capstone Experience: Master of Public Health

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

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

Capstone Experience: Master of Public Health

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

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

Capstone Experience: Master of Public Health

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

Ethical Cannabis Lawyering In California, Francis J. Mootz Iii

St. Mary's Journal on Legal Malpractice & Ethics

Cannabis has a long history in the United States. Originally, doctors and pharmacists used cannabis for a variety of purposes. After the Mexican Revolution led to widespread migration from Mexico to the United States, many Americans responded by associating this influx of foreigners with the use of cannabis, and thereby racializing and stigmatizing the drug. After the collapse of prohibition, the federal government repurposed its enormous enforcement bureaucracy to address the perceived problem of cannabis, despite the opposition of the American Medical Association to this new prohibition. Ultimately, both the states and the federal government classified cannabis as a dangerous …

When Parents Have Misunderstandings About The Risks And Benefits Of Palliative Surgery., Berklee Robins, Adam Booser, John Lantos

Manuscripts, Articles, Book Chapters and Other Papers

When a child needs surgery, both the surgeon and the anesthesiologist must obtain informed consent from the parents. In theory, each specialist obtains permission for their respective portion of the procedure, with the anesthesiologist only obtaining informed consent for the administration of anesthesia and management in the operating room and recovery room. However, he or she may occasionally realize that the parents have misunderstandings about what the surgery and perioperative course entail. In such cases, he or she must decide whether their role is only to discuss the issues related to anesthesia care or whether he or she should also …

Child Abuse, Incarceration, And Decisions About Life-Sustaining Treatment., Paul C. Mann, Elliott Mark Weiss, Rebecca R. Seltzer, Rachel A B Dodge, Renee D. Boss, John Lantos

Manuscripts, Articles, Book Chapters and Other Papers

Most critical care interventions for children occur in the framework of a supportive environment with loving parents that are present at the bedside to help to guide medical interventions through shared decision-making. What happens, however, if the parents are precluded from being at the bedside because of legal entanglements? How should clinical decisions progress in those cases? In this Ethics Rounds, we present the case of an infant with severe hypoxic-ischemic encephalopathy at birth whose mother was incarcerated shortly after delivery. We explore clinical and legal challenges that the medical team faces in determining best interests for the infant in …

Evaluation Of The Hiv Infant Tracking System (Hitsystem) To Optimise Quality And Efficiency Of Early Infant Diagnosis: A Cluster-Randomised Trial In Kenya., Sarah Finocchario-Kessler, Brad Gautney, Anlin Cheng, Catherine Wexler, May Maloba, Niaman Nazir, Samoel Khamadi, Raphael Lwembe, Melinda Brown, Thomas A. Odeny, Jacinda K. Dariotis, Matthew Sandbulte, Natabhona Mabachi, Kathy Goggin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The HIV Infant Tracking System (HITSystem) is a web-based intervention linking providers of early infant diagnosis, laboratory technicians, and mothers and infants to improve outcomes for HIV-exposed infants. We aimed to evaluate the efficacy of the HITSystem on key outcomes of early infant diagnosis.

METHODS: We did a cluster-randomised trial at six hospitals in Kenya, which were matched on geographic region, resource level, and volume of patients (high, medium, and low). We randomly allocated hospitals within a matched pair to either the HITSystem (intervention; n=3) or standard of care (control; n=3). A random number generator was used to assign …

Genetic Predisposition To Necrotizing Enterocolitis In Premature Infants: Current Knowledge, Challenges, And Future Directions., Alain Cuna, Lovya George, Venkatesh Sampath

Manuscripts, Articles, Book Chapters and Other Papers

The role of genetics in the pathogenesis of necrotizing enterocolitis (NEC) was initially informed by epidemiological data indicating differences in prevalence among different ethnic groups as well as concordance in twins. These early observations, together with major advances in genomic research, paved the way for studies that begin to reveal the contribution of genetics to NEC. Using the candidate gene or pathway approach, several potential pathogenic variants for NEC in premature infants have already been identified. More recently, genome-wide association studies and exome-sequencing based studies for NEC have been reported. These advances, however, are tempered by the lack of adequately …

Hdl-C As Most Predictive Variable Of Visceral Adipose Tissue In Young Military Personnel Of The National Guard, Sofia Rae Sanchez Porush

Master's Theses

Twenty-two young men and women of the 49^thMilitary Police Brigade of the California National Guard were participants of our nutrition education and health assessment program. The California National Guard has expressed concern of unsatisfactory physical and nutritional status of their personnel related to a nutrition knowledge deficit as evidenced by preliminary data of insufficient dietary intake and poor nutrition knowledge assessment scores. Our program was designed to implement a nutrition intervention including education and evaluate its effectiveness in reducing Metabolic Syndrome (MetS) risk factors, improving body composition, and providing educational lessons intended to alter lifestyle. Baseline data was …

Epilepsy, Identity, And The Experience Of The Body, Stephanie Kılınç, Carol Campbell, Alison Guy, Anna Van Wersch

All Works

© 2018 Elsevier Inc. Living with a chronic condition can challenge a person's identity, yet there is a paucity of research exploring this experience for people with epilepsy and particularly for those diagnosed in adulthood. Consequently, through an interpretative phenomenological approach, the current study aimed to explore what the experience of adult-onset epilepsy meant for a person's identity. Thirty-nine people with adult-onset epilepsy from across the UK took part in up to two semi-structured interviews. A modified form of interpretative phenomenological analysis was conducted and identified three themes: 1) disarming the impact of seizures considered strategies used to control seizure …

Detecting Significant Genotype–Phenotype Association Rules In Bipolar Disorder: Market Research Meets Complex Genetics, René Breuer, Manuel Mattheisen, Josef Frank, Bertram Krumm, Ney Alliey Rodriguez

School of Medicine Publications

Background: Disentangling the etiology of common, complex diseases is a major challenge in genetic research. For bipolar disorder (BD), several genome-wide association studies (GWAS) have been performed. Similar to other complex disorders, major breakthroughs in explaining the high heritability of BD through GWAS have remained elusive. To overcome this dilemma, genetic research into BD, has embraced a variety of strategies such as the formation of large consortia to increase sample size and sequencing approaches. Here we advocate a complementary approach making use of already existing GWAS data: a novel data mining procedure to identify yet undetected genotype–phenotype relationships. We adapted …

Clabsi Rangers: A Team Approach To Extinguishing Clabsi, Alisa Bowman, Christine Bartlett, Sarah Gattis, Staci Hartmann, Eddie Lesage, Heidi Mosher, Joya Picket, Sarah Potts

Books, Presentations, Posters, Etc.

Purpose: Decrease incidence of Central line Associated Bloodstream Infection (CLABSI) in the ICU/IMCU at Swedish Medical Center by August 31^st 2018, with the overall goal of zero CLABSI stemming from the ICU’s.

Synthesis of Evidence: A review of CLABSI costs, the problem as a whole, and products that help decrease CLABSI was completed. Swedish’s current CLABSI state was discussed and ways to improve existing practices investigated. Ideas to engage and educate patients, family and staff in order to bolster infection prevention practices was reviewed.

Change in practice: Based on the evidence and our protocols we began reviewing patient charts …

250 Miles Apart, Saving Lives Together: Stop Sepsis, Ann C. Eells, Christiana Paul, Caroline Williams, Robert Fitting, Mauren Disbot, Bradley Shroeder, Jenifer Rofkahr, Amy Samolis

Books, Presentations, Posters, Etc.

No abstract provided.

Compassion Fatigue Among Mental Healthcare Providers And The Impact On Overall Wellbeing, Ruchi Patel

Doctoral Dissertations

Compassion, a virtue of the helping profession, can be jeopardized by a provider’s continuous exposure to the trauma experiences of others. The impact of burnout, secondary stress and compassion fatigue on a mental healthcare provider’s work and personal life has been increasingly studied due to negative ramifications on our community healers. The present study used a cross-sectional design to survey mental healthcare providers across specialty and discipline in efforts to gain a better understanding of the relationship between a provider’s degree of compassion fatigue and specific demographic variables, physical health and their spirituality. One hundred and thirty-seven participants across the …

Microbiota Metabolic Product Deoxycholic Acid Prevents Campylobacter Jejuni Chicken Colonization Through Modulating Ceca Anaerobes, Bilal Ali Alrubaye

Graduate Theses and Dissertations

Campylobacter jejuni is a prevalent infectious enteritis mainly foodborne from chickens. Despite of reducing C. jejuni food contamination dramatically decreases campylobacteriosis, few effective approaches are available for the bacterial reduction in chickens. The aim of this study was to use microbial metabolic product deoxycholic acid (DCA) to reduce C. jejuni chicken colonization. Broiler chicks were fed 0 or 1.5 g/kg DCA, lithocholic acid (LCA), or urodeoxycholic acid (UDCA) in diets or orally gavaged with cholic acid (CA, 1.5g/kg body weight). Birds were also transplanted with DCA modulated anaerobes (DCA-Anearo) or aerobes (DCA-Aero). Birds were infected with 109 CFU/bird human clinical …

The Impact Of Coaches' Character On Youth Basketball Players, Natasha Hill

Graduate Theses and Dissertations

If utilized effectively, recreation and sports can serve as major tools for developing youth, improving the educational environment, and increasing the number of productive adults that are healthier physically and mentally to positively impact society. Most research targeting recreation and sports developing youth has the perspective primarily of parents and youth. Evaluating the character strengths of coaches and youth athletes who actively participate in team basketball is vital.

An exploration of the value of basketball and character strengths of (n = 64) youth athletes, between the ages of 12 to 16 years, and the impact of their involvement with coaches …

Traumatic Complications Of Inpatient Massage Therapy: Case Report And Literature Review, Ishna Sharma, D'Andrea Joseph, Orlando Kirton

Abington Jefferson Health Papers

No abstract provided.

Review Of The Cardiovascular Toxicity Of Amitriptyline Treatment For Canine Neuropathic Pain, Saikaew Sutayatram, Kumpanart Soontornvipart, Piyasiri Glangosol

The Thai Journal of Veterinary Medicine

Nowadays, the lifespan of pets has been increased by improvements in veterinary practice but age-related disorders are also increasing. Several nervous system attenuations are well-known to be the result of aging and/or pathological lesions. In many cases, neuropathic pain (NP) can develop and cause a significant impact on the clinical outcome and quality of life. With the difficulty in identification of the specific cause of NP, most NP management is planned according to clinical manifestations and recommended trial therapy. The drug of choice for trial therapy seems to be amitriptyline, a tricyclic antidepressant with multiple effects on neurotransmitter receptors and …

Anti-Proliferative And Total Erk1/2 Inhibitory Effects Of Plant Flavonols On Human Cervical Cancer (Hela) Cells, Sookruetai Boonmasawai, Ladawan Sariya, Arpron Leesombun, Kridsada Chaichoun, Jarupha Taowan, Orathai Thongjuy

The Thai Journal of Veterinary Medicine

Kaempferol, myricetin and quercetin are abundant flavonols in edible fruit and vegetables. Much previous data has shown the beneficial effects of these flavonols in cancer treatments. Thus, the cytotoxic effects on rhesus monkey kidney epithelial cells (LLC-MK2) and the anti-proliferative effects on human cervical cancer (HeLa) cells through total ERK protein expression of kaempferol, myricetin and quercetin have been investigated. The cytotoxic assay at 24h revealed the high safety of three flavonols on LLC-MK2 cells. Kaempferol (1-1000 µM) did not have any significant effect on the viability of these normal epithelial cells. The cytotoxicity of myricetin and quercetin was 5 …

High Infection Rate Of Zika Virus In Mosquitoes Collected From An Area Of Active Zika Virus Transmission In Eastern Thailand, Apiwat Tawatsin, Atchara Phumee, Usavadee Thavara, Patcharawan Sirisopa, Wanapa Ritthison, Kitsanaphong Thammakosol, Proawpilart Intayot, Yutthana Joyjinda, Supaporn Wacharapluesadee, Thiravat Hemachudha, Padet Siriyasatien

The Thai Journal of Veterinary Medicine

Zika virus (ZIKV), chikungunya virus (CHIKV) and dengue virus (DENV) are emerging and re-emerging arboviral diseases. These viruses are transmitted to humans through the bites of Aedes mosquitoes. Recently, ZIKV infection has been described as an emerging disease in Thailand and many countries, especially in tropical and subtropical areas. Specific drugs and vaccines against these infections are unavailable; therefore, effective disease control relies on vector control measures only. To understand the transmission cycle of these viruses and mosquito vectors, this study is designed to investigate the natural infection of ZIKV, CHIKV and DENV in field-caught mosquitoes by molecular techniques. Adults …

Small Dosages Of Alpha1 Adrenoceptor Antagonist On Goat Semen Quality And Seminal Fluid Volume, Sakdichod Kimsakulvech, Sookruetai Boonmasawai, Dulyatud Gronsang, Chowalit Nakthong, Yupaporn Lanamtiang

The Thai Journal of Veterinary Medicine

The frozen goat semen process must wash seminal fluid from goat semen. A small dosage of alpha1 adrenoceptor antagonist or tamsulosin may reduce seminal fluid in goat. A latin square 4x4 was applied to twelve male goats to receive either normal saline (NSS), tamsulosin 3, 6 and 9 µg/kg intramuscular injection at one-week intervals. Semen collection by artificial vagina and libido scoring was performed within one-hour post injection. Semen quality and seminal fluid were evaluated after semen collection The results showed that none of the libido scores in the groups was different. Anejaculations occurred in 1 (8.3%), 3 (25%) and …

Computed Tomographic Contrast Enhancement And Tumor Angiogenesis In Canine Oral Tumors, Urapa Klansnoh, Wijit Banlunara, Nan Choisunirachon

The Thai Journal of Veterinary Medicine

The potential value of bolus tracking contrast enhanced computed tomography (CT) in the diagnosis of oral tumors in dogs was investigated by examining the relationship between contrast-enhanced CT image density and microvascularization. Among 20 dogs with oral tumors, aged 8 – 17 years, weight 3.6 – 40.0 kg, 13 dogs were suffering with melanoma (MM), 4 with squamous cell carcinoma (SCC), and 3 with fibrosarcoma. Based on contrast-enhanced CT scan, the time lag from the injection of contrast medium into the right cephalic vein until the contrast medium returned to the mid-cervical external jugular vein at the level of the …

The Potential Use Of Phytoestrogen Containing The Herb, Pueraria Mirifica, For Bone Healing In Osteoporotic Monkeys, Donlaporn Kittivanichkul, Nan Choisunirachon, Kumpanart Soontornvipart, Suchinda Malaivijitnond

The Thai Journal of Veterinary Medicine

Within the last decade, the positive effects of Pueraria mirifica on osteoporosis have been established in rats and monkeys. However, the effect of P. mirifica on bone healing has not been elucidated. In this study, post-menopausal osteoporotic monkeys were subjected to an iliac crest biopsy, divided into two groups (5 animals/group), and fed daily with standard monkey diet alone (PMP0 group) or mixed with 1,000 mg/kg body weight of P. mirifica powder (PMP1000 group) for 16 months. The progression of the bone healing was continuously assessed by X-ray radiography, and three individuals from each group were selected for a computed …