Medicine and Health Sciences Commons^™

The Balance Between Financial And Quality Performance In For-Profit Hospitals Versus Non-Profit Hospitals, Blake Seidner

CMC Senior Theses

Recent trends of financial distress for non-profit hospitals and the uptick in acquisition of these hospitals by for-profit entities indicate different focuses from the management of each type of hospital. Using data on hospital quality and basic financial measures, this study examines shift in the balance of financial and quality performance. The dataset focuses on private non-profit and for-profit hospitals with low bed counts, ranging from 50-200 total beds. Results indicate a positive relationship between for-profit status and basic financial performance measures, such as profitability, and a negative relationship with patient experience, cost reduction for the patient, and overall quality. …

The Effects Of Recreational Marijuana Legislation On The Opioid Epidemic In Washington State, Steven Dickerson

CMC Senior Theses

This paper analyzes the impact of the 2012 legalization of recreational marijuana in Washington State on opioid abuse. Using synthetic control methodology, this paper finds that the legislation prevented 638 overdose deaths and lead to over 3,600 individuals seeking treatment for opioid abuse disorders. Due to the large health, social, and economic impacts of the opioid epidemic, further research should be conducted into ways to reduce the number of opioid prescriptions, the number of opioid overdoses, and opioid abuse generally.

Mental Health In U.S. Prisons: How Our System Is Set Up For Failure, Katherine Daifotis

CMC Senior Theses

During the past 60 years, United States prisons have become one of the primary institutions caring for mentally ill individuals. Factors such as privatization of mental health care with a focus on profit-maximization, ineffective jail diversion programs, and unsuccessful mental health courts have contributed to prisons having an increased population of mentally ill inmates. In fact, about 20% of people who are currently incarcerated suffer from a major mental illness (Mason, 2007). Other elements outside of the justice system such as a lack of mental health awareness and a lack of resources have led to damaging interactions between the mentally …

A Link Between Gut Microbes & Depression: Microbial Activation Of The Human Kynurenine Pathway, Christina Cobb

CMC Senior Theses

Our gut microbiota is involved in human development, nutrition, and the pathogenesis of gut disorders, but has more recently been implicated as a possible mechanism in the pathophysiology of several brain disorders, including disorders of mood and affect, such as depression. Researchers have referred to this dynamic, bidirectional signaling pathway between the gut and the brain as the “gut-brain axis.” However, most research on this axis has been limited to rodent studies, and there has been little insight into the mechanism behind it. I propose that the kynurenine pathway, where tryptophan is converted to kynurenine, is a compelling mechanism mediating …

Homophobia In Registered Nurses, Matthew Berry

Honors Undergraduate Theses

Homophobia plays a significant role in the treatment of individuals who identify as lesbian, gay, bisexual, or transgender (LGBT). The purpose of this study is to explore the presence of these types of negative attitudes as they present themselves in the nursing workforce. 520 registered nurses were contacted via email to partake in a survey assessing homophobic attitudes and perceptions regarding nursing care of LGBT persons. A total of 27 registered nurses responded and the resulting data were analyzed using descriptive statistics. A majority of registered nurses were female (89.3%), greater than 40 years of age (75%), white (75%), heterosexual …

Evaluating Outcomes Of Education On Waste Management In The Hospital Setting, Taryn N. Schlather

Honors Undergraduate Theses

With advancements in healthcare, we continue to find new needs that must be addressed. Hospitals generate a substantial amount of medical waste, and proper disposal is important for patient and staff safety, environmental protection, and cost efficiency. A series of studies show there is a need for further education on hospital waste management policies. This thesis aims to evaluate education interventions to improve knowledge and healthcare waste disposal practices. This literature review was conducted using multiple databases, including MedLINE, CINAHL, GreenFILE, Google Scholar, EBSCOhost, and NCBI, to find qualifying research articles in the English language from 2005-2018. Key terms for …

The Effects Of Hormone Replacement Therapy (Hrt) On Surgically Postmenopausal Women: A Review Of The Literature, Leslie M. Hertweck

Honors Undergraduate Theses

The primary purpose of this research was to examine the effects of HRT in women with acute estrogen deficiency from surgically induced menopause. The secondary purpose was to evaluate how HRT improves symptoms of acute estrogen deficiency and quality of life (QOL) in women using hormone supplementation. Peer reviewed articles published from 2000 to 2017 that were written in the English language with a focus on the use of HRT in women with acute estrogen deficiency after surgical menopause were evaluated for relevance. Evidence suggests the primary reason for decreased use of HRT is the associated risks outweighing the benefits; …

Mental Health Interventions For Adolescent Cancer Patients, Kelsey A. Faherty

Honors Undergraduate Theses

Background: According to the National Cancer Institute (2017) approximately 15,270 individuals’ ages 0 to 19 years would be diagnosed with cancer in 2017. Although pediatric cancer survival rates continue to rise, there are high rates of anxiety, fear, and depression amongst this population. The purpose of this literature review was to explore mental health interventions for adolescent cancer patients.

Methodology: A total of 165 articles were found in a literature search. Databases used include: CINAHL Plus with Full Text, Cochrane Center Register of Controlled Trials, Cochrane Clinical Answers, MEDLINE, and PsycINFO. As results were further narrowed based on relevance and …

Appreciating The Golden Hour: A Comparative Interdisciplinary Study, Taylor Tachon

Honors Undergraduate Theses

Within the health care, many medical professionals know about the critical time restraints for provisions of care within their discipline, but do not know the term "The Golden Hour". The Golden Hour is a term indicating the universal time restraint found within every area of health care and more specifically, every area of nursing. The term and concept represented by it should be recognized to better the outcomes of our patients. Although the Golden Hour typically indicates a 60-minute period of time, various settings recognize shorter and longer periods during which specific actions must be taken to assure positive patient …

A Transcultural Perspective On Nonpharmacological Treatment Of Postpartum Depression: A Systematic Review, Amanda W. Leyva

Honors Undergraduate Theses

Despite PPD’s global extent, scarce research that addresses culturally competent alternative interventions exists. The purposes of this thesis were to 1) analyze the existing literature on non-pharmacological treatment of PPD in the US and across selected cultures; 2) determine the effectiveness of cross-cultural non-pharmaceutical therapy; and 3) examine and suggest ways health care providers can integrate non-pharmacologic interventions into PPD treatment in the US. The systematic electronic search comprised the databases Cumulative Index to Nursing and Allied Health Literature, Medline, PsycINFO and SAGE Research Methods. Searches were limited to English language, peer reviewed, and research articles between 2007 and 2017. …

Online Support Group For Chinese Women With Ovarian Or Cervical Cancer, Yuan Xing

Honors Undergraduate Theses

Women with gynecological (GYN) cancer experience a wide spectrum of physical, emotional and social effects after diagnosis and treatment of their cancer. The insufficient availability of local support groups, limited transportation for the rural Chinese population and a shortage of oncologists make it difficult to have face-to-face support groups for Chinese GYN cancer patients. However, the wide access of Internet has provided an opportunity for people to have online support groups. The purpose of this study was to observe and describe the types of support given to and by Chinese GYN cancer survivors in a QQ chat group. This was …

The Effects Of Emerging Technology On Healthcare And The Difficulties Of Integration, Skyler J. Pavlish-Carpenter

Honors Undergraduate Theses

Background: Disruptive technology describes technology that is significantly more advanced than previous iterations, such as: 3D printing, genetic manipulation, stem cell research, innovative surgical procedures, and computer-based charting software. These technologies often require extensive overhauls to implement into older systems and must overcome many difficult financial and societal complications before they can be widely used. In a field like healthcare that makes frequent advancements, these difficulties can mean that the technology will not be utilized to its full potential or implemented at all.

Objective: To determine the inhibiting factors that prevent disruptive technology from being implemented in conventional healthcare.

Methods: …

Exploring What It Is Like To Be An Undocumented Alien In Seek Of Healthcare, Eliany C. Torrez Pon

Honors Undergraduate Theses

Currently, there are about 11.8 million undocumented aliens in the United States who are not eligible for public insurance or any type of private coverage obtained through the American Health Care Act of 2017. This creates barriers to healthcare for this large population and has negative implications for the healthcare system. Despite the availability of clinics and low-cost healthcare, this group tends to underuse resources or seek healthcare for emergencies only which leads to increased cost totaling approximately $1.1 billion a year. The goal of this qualitative study is to better understand what it is like to be an undocumented …

Factors That Influence The Formation Of Peanut Allergies In Children, Christie Gleason

Honors Undergraduate Theses

Allergies have the potential to be a life-long debilitating fight, especially the severe reactions from allergies such as anaphylaxis. Peanut allergies tend to be both common and severe, and they happen to be found hiding in many food products. People can have allergic reactions to food products that were made in the same facility as peanut products, that is why it is so important to be aware of the products that are being consumed. The incidence of peanut allergies has increased in the last decade, which is why it is crucial to study these allergies. This thesis looks at when …

A Comparison Of The Quality Of Care And Cost Efficiency Between Anesthesia Providers, Daniel A. Carter

Honors Undergraduate Theses

The development of anesthesia has greatly contributed to the safety of surgeries, reduced the level of invasiveness of many procedures, and provided increased comfort for patients. The delivery of anesthetics has been primarily provided by one of two unique health care providers: a trained physician who has specialized in anesthesia, or an advanced practice nurse—the certified registered nurse anesthetist (CRNA). Both providers have a similar scope of practice, are nationally certified, and often work side-by-side. However, in recent years there has been some controversy between the two providers regarding autonomy, safety, and quality of services. The purpose of this study …

Pediatric Misscare Survey To Fill In The Gaps, Molly S. Baker

Honors Undergraduate Theses

Missed nursing care, according to Kalisch and Williams, is nursing care that is not completed to the highest quality of care, leading to an increase in hospital costs and poor patient outcomes. Missed nursing care can occur with any patient population; however, a survey by Kasich called the MISSCARE Survey has only been used in the adult and neonatal populations. Pediatric patients are a diverse and complex subset of the population, differing greatly from the adult and neonatal populations, thus identifying a need for a focused pediatric survey to effectively study missed nursing care in the pediatric setting. The purpose …

The Effects Of Recorded Maternal Sound On Preterm Neonates: A Systematic Literature Review, Angela Aloisantoni

Honors Undergraduate Theses

A fetus hears and responds to maternal sounds as early as 26 weeks' gestation. When born prematurely, a neonate may face health challenges due to overall organ immaturity and hospitalization in the Neonatal Intensive Care Unit, where developmentally important maternal sounds are replaced with routine hospital noise. A potential intervention that can provide meaningful auditory stimulation these neonates lack is implementation of maternal sound interventions. These interventions replicate the intrauterine auditory environment by playing recorded maternal speech and heart sounds in the incubator. A literature review was completed to identify effects on neurodevelopmental, nutritional, and physiological measurements this intervention may …

Implementation And Evaluation Of Guillain-Barré Syndrome Surveillance In Puerto Rico During The 2016 Zika Virus Epidemic, Chelsea G. Major, Emilio Dirlikov, Nicole A. Medina, Roberta Lugo-Robles, Desiree Matos, Jorge Muñoz-Jordán, Candimar Colón-Sánchez, Myriam García-Negrón, Marangely Olivero-Segarra, Graciela Malavé-González, Dana L. Thomas, Carlos A. Luciano, Stephen H. Waterman, James Sejvar, Tyler M. Sharp, Brenda Rivera-García

Journal Articles: Epidemiology

OBJECTIVE: Guillain-Barré syndrome (GBS) is an uncommon autoimmune disorder that follows infection or vaccination, and increased incidence has been reported during Zika virus (ZIKV) transmission. During the 2016 ZIKV epidemic, the Puerto Rico Department of Health (PRDH) implemented the Enhanced GBS Surveillance System (EGBSSS). Here, we describe EGBSSS implementation and evaluate completeness, validity, and timeliness.

METHODS: GBS cases were identified using passive surveillance and discharge diagnostic code for GBS. Completeness was evaluated by capture-recapture methods. Sensitivity and positive predictive value (PPV) for confirmed GBS cases were calculated for both case identification methods. Median time to completion of key time steps …

Schistosoma Mansoni And Other Intestinal Parasitic Infections In Schoolchildren And Vervet Monkeys In Lake Ziway Area, Ethiopia, Dejene Teklemariam, Mengistu Legesse, Abraham Degarege, Song Liang, Berhanu Erko

Journal Articles: Epidemiology

OBJECTIVE: To assess Schistosoma mansoni and other intestinal parasitic infections in schoolchildren and vervet monkeys (Chlorocebus aethiops) in Bochessa Village, Ziway, Ethiopia.

RESULTS: Fecal specimens from selected schoolchildren and droppings of the vervet monkeys were collected and microscopically examined for intestinal parasites using the Kato-Katz thick smear and formol-ether concentration techniques. The prevalences of S. mansoni, Trichuris trichiura, Ascaris lumbricoides, Enterobius vermicularis, hookworms, Hymenolepis nana and Taenia species among the children were 35.7, 26.9, 24.1, 2.1, 2.1, 1.07 and 2.1%, respectively (by Kato-Katz) and 39.3, 36.1, 35.6, 2.9, 10.0, 4.3, and 2.9%, respectively (by formol-ether concentration). Prevalence of S. mansoni …

An Objective Measure Of Sleep In Division I College Soccer Players Compared To The General College Population, Natalie Brown

College of Graduate Studies: Theses & Dissertations

Introduction: Sleep is necessary for proper recovery from daily life for both college athletes and students.

Purpose: To objectively evaluate the sleep quality of college athletes across gender, comparing them to a normal college student population.

Methods: A convenience sample of 104 subjects (19.39 ± 1.28 years), 42 Division college athletes and 62 comparison college students completed one week of data collection using the ActiGraph GT3X device. Wear time, sleep time, and wake time were recorded by each participant. Independent variables were athlete status and gender. Dependent variables were Total Sleep Time (TST), Wake After Sleep Onset (WASO), Latency, and …

Factors Associated With Iron-Folic Acid Supplement Use Among Pregnant Women In Karu, Nasarawa State, Nigeria - A Cross Sectional Study Using Theory Of Planned Behavior, Toyin O. Akomolafe

College of Graduate Studies: Theses & Dissertations

Introduction: Iron-folic acid supplementation is one of the key interventions provided during antenatal care (ANC) services to reduce iron deficiency, maternal anemia, low birthweight and other pregnancy-related complications responsible for maternal and neonatal mortality. However, use of iron-folic acid supplements and adherence with recommended dosage in Nigeria is low. The purpose of this cross-sectional study was to examine factors associated with iron-folic acid supplements use among pregnant women in Karu local government area (LGA), Nasarawa, Nigeria. Methods: Questionnaires were administered in face-to-face interviews with 64 pregnant women (18 – 49 years old) and 19 healthcare providers in selected …

Insights And Evidence Gaps In Girl-Centered Programming: A Systematic Review, Nicole Haberland, Katharine Mccarthy, Martha Brady

Poverty, Gender, and Youth

Increased attention to the needs of adolescent girls has led to a growing number of programs in low- and middle-income countries. Questions remain, however, about what aspects of program design are most effective. This hinders efforts to effectively allocate resources, scale up programs, and replicate results across settings. This review looks at how the number of program components, involvement of supporting actors who influence the lives of girls, supplemental “booster” activities, intervention exposure level, and community saturation level influenced outcomes for girls. While findings suggest the importance of multicomponent programs and longer program exposure, each area requires further rigorous research …

Delivering Impact For Adolescent Girls: Emerging Findings From Population Council Research, Population Council

Poverty, Gender, and Youth

Despite numerous global commitments to invest in improving the lives of adolescent girls, questions remain as to what package of interventions can deliver the best outcomes. This report synthesizes findings from nine recent Population Council impact evaluations, conducted around the world, which indicate that empowerment and asset-building interventions for adolescent girls can improve education, health, economic, social capital, gender-equitable attitude, and violence outcomes for girls. The report includes implications for programs and investment, and identifies open questions for further research and evaluation.

Perceptions Of Health Professionals In Ghana On The Role Of The Community In Chronic Disease Management, Jesuseme Omoruan

College of Graduate Studies: Theses & Dissertations

The prevalence of chronic disease has been on the rise in various developing countries. This study is an exploratory investigation of the perceptions of health professionals in Kumasi, Ghana on the role of the community in chronic disease management. Using the Chronic Care Model as a framework, the objective of the study was to examine the extent of community-healthcare system in chronic disease management and to explore the barriers to and facilitators of community involvement in chronic disease management. By exploring the availability of community resources that positively contribute to the management of these patients, the study fills an existing …

Factors Associated With Continuous Improvement By Local Boards Of Health, Tran Nguyen

College of Graduate Studies: Theses & Dissertations

Background: The continuous improvement as applied to a local board of health (LBoH) is one of the six governance functions and focuses on activities that target LBoH’s self-improvement and improvement of local health department (LHD) it governs.

Purpose: The purpose of this study was to determine the engagement level of LBoHs in continuous improvement efforts and to identify factors associated with this function. The goal was to provide insights that will inspire LBoHs to improve their continuous improvement governance function for better practices, and in turn, enhance the performance of local health departments (LHDs) for which the LBoHs serve as …

A Neglected Problem In Burnout Research, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Although we share with Eckleberry-Hunt et al. (2018) some of their criticisms regarding the problematic conceptualization of burnout, we are perplexed by the authors’ silence regarding burnout–depression overlap, which is arguably the most troubling problem attached to the burnout construct. The extensive research suggests that burnout reflects a combination of depressive responses. The emotional exhaustion component of burnout involves fatigue and depressed mood, two diagnostic criteria for depressive disorders. Maslach et al. (2001) wrote that there is “a predominance of dysphoric symptoms” in burnout. Depersonalization symptoms are commonly found in depressed individuals. Diminished personal accomplishment reflects well-known depressive manifestations of …

Program And Proceedings: Nebraska Academy Of Sciences 1880–2018, 138th Anniversary Year, One Hundred-Twenty-Eighth Annual Meeting

Nebraska Academy of Sciences: Programs and Proceedings

Program

Aeronautics and Space Science

Collegiate Academy: Biology

Biological and Medical Sciences

Chemistry and Physics>/p>

Collegiate Academy: Chemistry and Physics

Learn to Print 3-D Models for Your Classroom Workshop

Aeronautics and Space Science Poster Session

Maiben Memorial Lecture: Thomas Clemente

Anthropology

Applied Science and Technology

Earth Science

Environmental Sciences

Teaching of Science and Mathematics

Friend of Science Award: Mary Kalen Romjue and Michael Sibbernsen

Spatiotemporal Variations In Coexisting Multiple Causes Of Death And The Associated Factors, Emmanuel Oluwatobi Salawu

Walden Dissertations and Doctoral Studies

The study and practice of epidemiology and public health benefit from the use of mortality statistics, such as mortality rates, which are frequently used as key health indicators. Furthermore, multiple causes of death (MCOD) data offer important information that could not possibly be gathered from other mortality data. This study aimed to describe the interrelationships between various causes of death in the United States in order to improve the understanding of the coexistence of MCOD and thereby improve public health and enhance longevity. The social support theory was used as a framework, and multivariate linear regression analyses were conducted to …

Elements Of Expatriate Adjustment In Host Country Organizations, Denise Suzanne Schickel

Walden Dissertations and Doctoral Studies

Globalization and international business increasingly require the services of skilled expatriates in overseas offices. Over the past 50 years, numerous studies have focused on various factors affecting expatriate adjustment, primarily through quantitative research, reaching no conclusions on what factors in cross-cultural training would guarantee expatriate success. Expatriate failure has high personal and organizational costs. The purpose of this study was to use the qualitative methodology of narrative inquiry to investigate the adjustment, transition, and repatriation experience as a holistic process. Two theoretical constructions, Bandura's social learning theory, applied to the learning process in an international assignment, and social identity theory, …

A Phenomenological Investigation Of Adult Daughters Of Childhood Paternal Abandonment, Mary Spencer

Walden Dissertations and Doctoral Studies

A father's abandonment of his minor daughter can leave an indelible impression on her psyche -- one that can forever affect her intimate romantic relationships. The purpose of this qualitative phenomenological study was to explore where women who were abandoned by their fathers prior to the age of 18 are today as adults in terms of their intimate romantic relationships and how they develop and engage in these relationships. The research questions examined how a daughter being abandoned by her father prior to the age of 18 relates to where she is today in her adult intimate romantic relationships and …