Medicine and Health Sciences Commons^™

Barriers In Hypertension Management Among Culturally Diverse Patients In An Urban Urgent Care Setting, Navpreet Kaur

Doctoral Projects

Hypertension is the leading cause of deaths related to cardiovascular disease conditions. A vast number of patients are not taking their medications as prescribed by the physicians. This non-adherence to hypertensive treatment plans results in increased numbers of cases of unstable blood pressure. Medication adherence will help to manage the controllable cardiovascular diseases and will automatically decrease the incidences of emergent cases in hospitals and urgent care clinics. It will further decrease the costs of diagnostic evaluations used during the emergent visits. This decreased patient load in the emergency rooms will improve quality patient care. The study timeframe of data …

Understanding The Skills Necessary For Advanced Practice Nurses In Oncology To Deliver Bad News To Patients With Cancer: The Results Of A Delphi Analysis, Matthew Michael Burke

Doctoral Projects

Overcoming the dichotomy of providing bad news in a compassionate, empathetic manner that strengthens dialogue and enhances a caring environment is the ultimate challenge advanced practice nurses (APN) face in oncology. This study aims to understand the skills necessary for APNs in oncology to deliver bad news to patients with cancer.

Using a Delphi analysis, an established method of developing a consensus, a novel, patient-centered survey tool has been developed designed to extract as much information as possible about the present issue from an expert panel. Oncology APNs were recruited via Facebook. The survey tool was administered using a web-based …

Comparing Two Surgical Outcomes: Minithoracotomy Or Full Sternotomy In Coronary Artery Bypass Grafting Surgery, Shirin Badrkhani

Doctoral Projects

Cardiovascular diseases and heart-related conditions can be life-threatening; however, some cardiovascular conditions can be managed with open heart surgery. Coronary artery bypass grafting (CABG) is the most common type of heart surgery performed on adults. There are two different surgical procedures to correct cardiac defects: mini-thoracotomy and full sternotomy. Mini thoracotomy approach has been shown to reduce complications, such as pneumonia, excessive blood loss, and infection in mitral valve repair surgeries. However, little research has been done to compare these two surgical approaches performed for patients undergoing coronary artery bypass grafting (CABG).

Specifically, there is inadequate data to compare these …

Human Papillomavirus Vaccine Program, Magdalena Ruiz

Doctoral Projects

Pediatric primary care focuses on maintaining patients’ health, preventing diseases, and assessing children’s developmental milestones. Vaccine administration and disease prevention are key components of a well-child exam for pediatric patients; however, vaccine refusal is an important complication of pediatric patient care. Of particular interest to this researcher is the HPV vaccine which was approved by the Federal Drug Administration and is currently recommended by the Centers for Disease Control and Prevention (2016) for both males and females, beginning at 11 or 12 years of age through age 26 years. The HPV vaccine protects against diseases and cancers caused by the …

Exploring Ways To Improve Healthcare Access For The Homeless Population In Merced County, Stella Nwasoka Adesokan

Doctoral Projects

Homelessness is a societal dilemma that affects people in the United States and around the globe. Homelessness relates to poor health conditions that affect the living conditions of individuals (Institute for Urban Initiatives, 2018). Chronic and acute illnesses are rampant in this group, most of these illnesses are treatable but accessing healthcare poses a challenge for this vulnerable population. Homeless persons are often unable to access healthcare due to fear and denial of ill health, difficulty in communicating health needs, and low self-esteem (Lamb & Joels, 2014).

In the study, questionnaires were administered to 25 homeless individuals through random sampling. …

Barriers In Health Care In Hmong Men And Women With Cardiac Diseases, Ying Thao

Doctoral Projects

Lauver’s theory of care seeking behaviors is applied to identify perceived barriers to accessing healthcare in Hmong men and women that may influence care seeking behaviors. The purpose of this study is to identify barriers in accessing health care among Hmong men and women ages 50 to 80 with cardiovascular heart disease (CHD) and risk factors for CHD (e.g., diabetes, hyperlipidemia, and hypertension). A quantitative descriptive analysis was used to look at demographic characteristics while a multiple regression analysis was used to statistically compare correlations between barriers to care, risk factors for CHD, sex, and access to health care. The …

A Retrospective Chart Review Pilot Study Of Fall Prevention Through A New And Innovative Care Model, Lydia Smith

Doctoral Projects

According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury-related mortality in the geriatric population, and they are the most common cause of brain injury and hip fracture. The prevalence for falls is 30% in patients over 65 in the United States who experience a fall annually, and the prevalence in dementia patients can be up to 80% annually; the consequences of falls can include injury, reduction in mobility, depression and decreased socialization with peers (CDC, 2015). The purpose of this retrospective chart review pilot study is to examine the number of falls …

Pilot Study: Program Evaluation Of Peanut Oral Immunotherapy In A Private Clinic, Kinga Olson

Doctoral Projects

The privilege of providing a therapy perceived by patients and families as “life changing” has seasoned physicians describing food oral immunotherapy (OIT) as one of “the most impactful and rewarding thing that they have done in medicine” (Wasserman, Jones, & Windom, 2018). OIT is a medical treatment that allows the immune system to become desensitized to a food to which it may otherwise be allergic. This is not a cure for food allergies but a way to decrease the incidence of anaphylaxis due to accidental ingestion. Living with food allergies can be distressing due to the daily fear of exposures. …

Pilot Study Of A Breastfeeding Support Training Program Designed Particularly For Infants With Common Congenital Anomalies And Defects, Gretchen Nelson Ezaki

Doctoral Projects

The American Academy of Pediatrics (American Academy of Pediatrics [AAP], 2018), the World Health Organization (World Health Organization [WHO)], 2018), and The March of Dimes (March of Dimes, 2016) recommend exclusive breastfeeding for the first six months of life. In 2014, 79% of women in the United States began breastfeeding their infants, but only 40.7% and 18.8% continued breastfeeding exclusively at three and six months respectively (Centers for Disease Control and Prevention, 2017). This doctoral project promotes breastfeeding by creating and testing simple teaching algorithms for training registered nurses to support breastfeeding, including for infants with trisomy 21, congenital heart …

Promoting Self-Efficacy Among Head And Neck Cancer Patients, Lily Lam

Doctoral Projects

Current survivorship visits at the Stanford head and neck oncology program are not standardized to address ongoing post-treatment sequelae. The objectives of this study help to address whether current non-standardized visits actually help to empower patients to self-manage their chronic diagnosis of head and neck cancer by measuring their self-efficacy levels before and after their post-treatment survivorship visit.

Given the convenience sampling method, 17 patients were enrolled in this quasi-experimental pilot study. Demographic information was collected for each patient: gender, ethnicity, smoker status, and age. Head and neck cancer patients would first be surveyed before and after their follow up …

The Effects Of Two Novel Anti-Inflammatory Compounds On Prepulse Inhibition And Neural Microglia Cell Activation In A Rodent Model Of Schizophrenia, Heath W. Shelton

Electronic Theses and Dissertations

Recent studies have shown elevated neuroinflammation in a large subset of individuals diagnosed with schizophrenia. A pro-inflammatory cytokine, tumor necrosis factor-alpha (TNFα), has been directly linked to this neuroinflammation. This study examined the effects of two TNFα modulators (PD2024 and PD340) produced by our collaborators at P2D Bioscience, Inc., to alleviate auditory sensorimotor gating deficits and reduce microglial cell activation present in the polyinosinic:polycytidylic (Poly I:C) rodent model of schizophrenia. Auditory sensorimotor gating was assessed using prepulse inhibition and microglial activation was examined and quantified using immunohistochemistry and confocal microscopy, respectively. Both PD2024 and PD340 alleviated auditory sensorimotor gating deficits …

Conversations Matter: Initiating A Serious Illness Conversation, Matthew J Gonzales, Suzanne Engelder

Books, Presentations, Posters, Etc.

No abstract provided.

What's New In Ovarian Cancer, Jessica L. Kozuki

Books, Presentations, Posters, Etc.

No abstract provided.

Cologuard: Stool Dna Testing For Colorectal Cancer Screening, Grace Hwang

Books, Presentations, Posters, Etc.

No abstract provided.

Comparative Effectiveness Of Intensity Modulated Radiation Therapy To 3-Dimensional Conformal Radiation In Locally Advanced Lung Cancer: Pathological And Clinical Outcomes., Sarit Appel, Jair Bar, Alon Ben-Nun, Marina Perelman, Dror Alezra, Damien Urban, Maoz Ben-Ayun, Nir Honig, Efrat Ofek, Tamar Katzman, Amir Onn, Sumit Chatterji, Sergey Dubinski, Lev Tsvang, Shira Felder, Judith Kraitman, Ory Haisraely, Tatiana Rabin Alezra, Sivan Lieberman, Edith M. Marom, Nir Golan, David Simansky, Zvi Symon, Yaacov Richard Lawrence

Department of Radiation Oncology Faculty Papers

OBJECTIVE: Intensity-modulated radiotherapy (IMRT) has better normal-tissue sparing compared with 3-dimensional conformal radiation (3DCRT). We sought to assess the impact of radiation technique on pathological and clinical outcomes in locally advanced non-small cell lung cancer (LANSCLC) treated with a trimodality strategy.

METHODS: Retrospective review of LANSCLC patients treated from August 2012 to August 2018 at Sheba Medical Center, Israel. The trimodality strategy consisted of concomitant chemoradiation to 60 Gray (Gy) followed by completion surgery. The planning target volume (PTV) was defined by co-registered PET/CT. Here we compare the pathological regression, surgical margin status, local control rates (LC), disease free (DFS) …

Formative Evaluation Of An Online Access To Justice Triage And Intake System, Jessica A. Wiens

Capstone Experience: Master of Public Health

The objective of this project is to evaluate the usability of Legal Aid of Nebraska’s LawHelp Nebraska online intake and triage system. A mixed-methods approach consisting of observations, semi-structured interviews, and validated survey were used with 14 participants as they interacted with the system. A convenience sample was used through recruitment of clients at Legal Aid of Nebraska’s Omaha office during legal assistance walk-in hours. To analyze the qualitative data from the semi-structured interviews and retrospective observation forms, researchers used thematic analysis. For quantitative data collected through a survey, researchers used descriptive analysis and validated scoring. The project and results …

Evaluation Of A Community Health Worker Intervention On Rates Of Measles, Mumps And Rubella Immunization In A Somali Population In Lexington, Nebraska, Melanie Menning

Capstone Experience: Master of Public Health

Measles is a highly contagious viral disease. It remains an important cause of death among young children globally, despite the availability of a safe and effective vaccine.

There have been increasing outbreaks of measles to waning immunization. This study sought to evaluate rates of Measles, Mumps and Rubella (MMR) immunization in a Somali population living in Lexington, Nebraska and to evaluate a community health worker intervention to improve immunization rates. NESIIS data for Lexington Regional Health Center (LRHC) was queried to assess MMR trends for all clinic patients between 15 and 72 months both before and after implementation of the …

Rates Of Sudden Unexpected Infant Death And Potential Risk Factors For Unsafe Sleep Behaviors In Douglas County, Nebraska From 2008 To 2017, Balkissa Ouattara

Capstone Experience: Master of Public Health

Abstract unavailable.

Impact Of Continuing Education In Reducing Perceived Challenges To Treating Patients Co-Prescribed Opioids And Benzodiazepines Among Midwest Clinicians, Kyle Stirewalt

Capstone Experience: Master of Public Health

Goal

The goal of this Capstone project was to provide meaningful Continuing Education (CE) to clinicians in the Midwest to reduce perceived challenges to safely treating patients co-prescribed opioid analgesics and benzodiazepines

Objectives

Using continuing education, increase clinician knowledge of effective alternative non-opioid and non-benzodiazepine therapies for chronic conditions while increasing clinician comfort in tapering patients off opioid analgesics and benzodiazepines

Methods

A one-hour CE presentation was prepared with the assistance of the Nebraska Department of Health and Human Services (NeDHHS) and broadcast to clinicians in the Midwest through a live webinar in coordination with the Great Plains Quality Innovation …

Neighborhood Variability In Obesity In Children In Omaha, Nebraska, Ann Essay

Capstone Experience: Master of Public Health

BACKGROUND: The prevalence of childhood obesity is a serious public health concern in the United States. Although several individual-level factors have been found to be associated with obesity in children, neighborhood environmental and social factors likely play an important role. The main goal of this study was to describe the prevalence of child obesity in Omaha, Nebraska by various demographic subgroups, determine if obesity prevalence varies by neighborhood operationalized as zip code, and examine the association between neighborhood-level child obesity prevalence and neighborhood-level socioeconomic status. It was hypothesized that child obesity prevalence varies by demographic subgroup and by zip code …

Assessment Of Hearing Exposures And Personal Protective Equipment Use In Agricultural Workers, Kelsie M. Musil

Capstone Experience: Master of Public Health

Agriculture continues to rank as one of the most hazardous industries in the United States. This is in part due to the high number of hazardous exposures that farmers face, including respiratory and hearing exposures. The danger to workers can be reduced by properly wearing personal protective equipment (PPE). However, it has been shown that agricultural workers wear PPE at a low rate, in part due to inconvenience and poor accessibility of the equipment. There is little knowledge currently about how PPE are stored, maintained, and if they are used in a correct manner in specific exposure conditions by the …

Training For Evidence-Based Youth Physical Activity Leader Practices, A. Jake Larose

Capstone Experience: Master of Public Health

Purpose: From a social ecological viewpoint, the way in which individuals interact with their surrounding environment, has a direct effect on their actions. One approach to modify behavior change is to strive to change the environment, thus driving behavior change. Participating in physical activity (PA) is a behavior to be targeted, due to its numerous health benefits. A population to consider targeting for increasing PA is children, as creating PA habits in childhood has been shown to track into adulthood . Change at a population level should begin by focusing efforts on the environments in which children are spending their …

The Correlates Of The Maternal Fetal Attachment In The Democratic Republic Of The Congo, Orphee L. Tamba

Capstone Experience: Master of Public Health

Maternal-fetal attachment is defined as the relationship of affection that exists between the pregnant woman and her fetus during pregnancy. It increases throughout the pregnancy and predicts not only the attachment style between the mother and the child but also the chances of optimal socioemotional development during infancy. The Maternal Antenatal Attachment Scale measures the Maternal-Fetal Attachment (MFA). Several versions of this scale have been adapted in various parts of the world. However, to date no study has been conducted on the validation of this scale in sub-Saharan Africa and the identification of factors associated with the MFA. This cross-sectional …

Pilot Evaluation Of Oneworld's Education Sessions On Sexually Transmitted Infections For Adolescents And Young Adults In The South Omaha Community, Mariela Bahena

Capstone Experience: Master of Public Health

Background. Rates for sexually transmitted infections (STIs) in Douglas County, specifically gonorrhea and chlamydia, are among the highest in the nation. Adolescents and young adults between the ages of 15 and 24 are one of the most at-risk groups for acquiring either STI. Though not fatal itself, gonorrhea and chlamydia can lead to serious complications and physical discomfort in both males and females. Evidence-based and age-appropriate sexual health education has been proven to reduce the risk of STIs. Studies have shown that comprehensive education programs with a focus beyond abstinence are effective in promoting safe sex practices.

Aim. This project …

Domestic Violence Shelters For Survivors- A Needs Assessment, Tanushree Ojha

Capstone Experience: Master of Public Health

Background: Domestic violence (DV) is a serious public health issue in the United States, and globally. It includes physical violence, sexual violence, threats, emotional abuse, stalking, and psychological aggression (including coercive acts) by a current or former intimate partner. It is a serious, preventable public health problem that affects millions of Americans (CDC, 2017b). There is an alarming number of domestic violence cases encountered each year. Globally, 1 in 3 women has experienced some domestic violence in their lifetime. Globally, as many as 38% of women are murdered by an intimate male partner because of violence against an intimate female …

Initiation Of A Roundtable Meeting To Determine Safety Hazards And Provide Education To Range Bison Herd Workers, Lucia Finocchiaro

Capstone Experience: Master of Public Health

This capstone project serves as an important piece of greater project studying bison handling. Bison production is both a growing and dangerous industry. As a new enterprise in many parts of the country and on tribal lands, significant numbers of untrained employees may be hired. This project undertakes methods to better understand the risks associated with bison handling and to thereby improve handling procedures and increase safety. Herd managers (from tribal and non-tribal sites), researchers, safety experts, and stakeholders were brought together for a roundtable meeting in Omaha. This meeting was designed to provide stakeholders a forum to discuss common …

Examining The Prevalence Of Urban American Indians With Uncontrolled Diabetes In Nebraska., Nasreen Wahab Maiwandi

Capstone Experience: Master of Public Health

Diabetes is a major public health problem in American Indian Alaska Native (AI/AN) population which contributes to an increased number of morbidity and mortality.

Diabetes was largely unknown in AI/AN communities before the World War II but soon after the WWII Indian Health Service (IHS) providers began reporting diabetes among this population. (McLaughlin, 2010). A group of researchers in 1963 identified the first type II diabetes epidemic in Pima Indiana community of Arizona among AI/AN population. (Shultz, LO, et al, 2006). Soon, cases of diabetes in AI/AN more than doubled in prevalence rate compared to the general U.S. population, resulting …

A Living Experience Of Feeling Listened To: A Parsesciencing Inquiry, Teodora Duarte-Quilao

Dissertations, Theses, and Capstone Projects

Listening is the phenomenon of interest and feeling listened to is considered the universal humanuniverse living experience. The aim of this investigation is to contribute new knowings and understanding to the universal humanuniverse living experience of feeling listened to. The purposes of the investigation are: (a) to discover the discerning extant moment of the universal humanuniverse living experience of feeling listened to, (b) to expand the human becoming paradigm, and (c) enhance the disciplinary knowledge of Parsesciencing (Parse, 2016) and disciplinary knowledge in general. People in all areas of life experience being disregarded and not listened to. The significance is …

Across Curriculums: A Need For Audiology Instruction For Teachers Of The Deaf And Hard Of Hearing, Jenna M. Morishita

Dissertations, Theses, and Capstone Projects

Objective: The purpose of this project is to gain insight into the requirements of teacher education programs with regard to instruction in audiology for teachers of the deaf and hard of hearing. Though individual teacher preparation programs have vast differences as they pertain to philosophy and methodology, graduates of each of these programs seek to work with children with hearing loss and therefore should have more than a basic understanding of audiology.

Method: The websites and course catalogs (when available) were reviewed for the 48 graduate programs listed on DeafEd.net. Data was collected on courses with the term “audiology” in …

Body Dissatisfaction And Weight Bias In Children, Megan Janette Jensen

Undergraduate Honors Capstone Projects

This article reviews the rate of body dissatisfaction and weight bias among young children. It was initially hypothesized that body-image begins much earlier than adolescence, where most interventions take place. Out of fifty articles read on the subject, forty-five peer reviewed articles were included in this review. The findings of these articles were synthesized for a comprehensive review on the topic. Results suggested that weight bias begins around three years of age, while body dissatisfaction begins around age five for girls, and seven for boys. Rates of body dissatisfaction among children were similar to the rate among adolescents, averaging out …