Medicine and Health Sciences Commons^™

Rare Tumors: Opportunities And Challenges From The Children's Oncology Group Perspective., Kris Ann P. Schultz, Murali Chintagumpala, Jin Piao, Kenneth S. Chen, Rachana Shah, Robyn D. Gartrell, Emily Christison-Lagay, Farzana Pashnakar, Jesse L. Berry, Allison F. O'Neill, Lauren M. Vasta, Ashley Flynn, Sarah G. Mitchell, Brittani Kn Seynnaeve, Jeremy Rosenblum, Samara L. Potter, Junne Kamihara, Carlos Rodriguez-Galindo, Douglas S. Hawkins, Theodore W. Laetsch

Manuscripts, Articles, Book Chapters and Other Papers

While all childhood cancers are rare, tumors that are particularly infrequent or underrepresented within pediatrics are studied under the umbrella of the Children's Oncology Group Rare Tumor committee, divided into the Retinoblastoma and Infrequent Tumor subcommittees. The Infrequent Tumor subcommittee has traditionally included an emphasis on globally rare tumors such as adrenocortical carcinoma, nasopharyngeal carcinoma, or those tumors that are rare in young children, despite being common in adolescents and young adults, such as colorectal carcinoma, thyroid carcinoma, and melanoma. Pleuropulmonary blastoma, gonadal stromal tumors, pancreatic tumors including pancreatoblastoma, gastrointestinal stromal tumor, nonmelanoma skin cancers, neuroendocrine tumors, and desmoplastic small …

"My Gut Feeling Is…": An Ethnographic Study Exploring Interprofessional Communication About Children And Adolescents With Chronic Musculoskeletal Pain In Paediatric Rheumatology., Rebecca R. Lee, Janet E. Mcdonagh, Tim Rapley, Albert Farre, Mark Connelly, Tonya M. Palermo, Karine Toupin-April, Emily Wakefield, Sarah Peters, Lis Cordingley

Manuscripts, Articles, Book Chapters and Other Papers

Interprofessional communication about inflammatory and non-inflammatory musculoskeletal conditions is an important component of assessment and management in paediatric rheumatology. Chronic pain is a feature of some of these conditions which likely influences the extent and type of communication about pain. Research investigating interprofessional communication about paediatric pain is limited but has found that communication is inclusive of the biopsychosocial context of children/adolescents as well as their families. The aim of this ethnographic study was to explore interprofessional communication about children and adolescents with chronic musculoskeletal pain in paediatric rheumatology. We observed forty-five healthcare professionals recruited from 3 UK paediatric rheumatology …

Atrial Appendage Accessory Pathway Ablation: Tips For Recognition And Approach To Ablation, Nikola Dragisic, Emily R. Backes, Lindsey Malloy-Walton, Philip M. Chang

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Leukocyte Cell-Derived Chemotaxin 2 Correlates With Pediatric Non-Alcoholic Fatty Liver Disease., Diego Paine-Cabrera, Lisa Harvey, Dakota R. Robarts, Michele T. Pritchard, John Thyfault, Steven A. Weinman, Udayan Apte, Voytek Slowik

Manuscripts, Articles, Book Chapters and Other Papers

Non-alcoholic fatty liver disease (NAFLD), newly renamed metabolic dysfunction-associated liver disease (MASLD), is a leading cause of liver disease in children and adults. There is a paucity of data surrounding potential biomarkers and therapeutic targets, especially in pediatric NAFLD. Leukocyte cell-derived chemotaxin 2 (LECT2) is a chemokine associated with both liver disease and skeletal muscle insulin resistance. Our aim was to determine associations between LECT2 and common clinical findings of NAFLD in pediatric patients. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum LECT2 concentrations in children (aged 2-17 years) with and without NAFLD. LECT2 concentrations were then correlated to …

Sars-Cov-2 Epidemiology And Covid-19 Mrna Vaccine Effectiveness Among Infants And Children Aged 6 Months-4 Years - New Vaccine Surveillance Network, United States, July 2022-September 2023., Ayzsa Tannis, Janet A. Englund, Ariana Perez, Elizabeth J. Harker, Mary Allen Staat, Elizabeth P. Schlaudecker, Natasha B. Halasa, Laura S. Stewart, John V. Williams, Marian G. Michaels, Rangaraj Selvarangan, Jennifer E. Schuster, Leila C. Sahni, Julie A. Boom, Geoffrey A. Weinberg, Peter G. Szilagyi, Benjamin R. Clopper, Yingtao Zhou, Meredith L. Mcmorrow, Eileen J. Klein, Heidi L. Moline

Manuscripts, Articles, Book Chapters and Other Papers

SARS-CoV-2 infection in young children is often mild or asymptomatic; however, some children are at risk for severe disease. Data describing the protective effectiveness of COVID-19 mRNA vaccines against COVID-19-associated emergency department (ED) visits and hospitalization in this population are limited. Data from the New Vaccine Surveillance Network, a prospective population-based surveillance system, were used to estimate vaccine effectiveness using a test-negative, case-control design and describe the epidemiology of SARS-CoV-2 in infants and children aged 6 months-4 years during July 1, 2022-September 30, 2023. Among 7,434 children included, 5% received a positive SARS-CoV-2 test result, and 95% received a negative …

Clinical Trials In Cardiogenic Shock: Challenges And Solutions For The Future, Anju Bhardwaj, Sahoor Khan, Shashank Sinha, Preethi Pirlamarla, Rajiv Sankaranarayanan, Alexander Hajduczok, Holger Thiele, Navin Kapur

Division of Cardiology Faculty Papers

No abstract provided.

Patient, Provider, And Interpreter Perspectives On Interpreter Modality And Barriers To Interpreter Use In A Pediatric Inpatient Setting, Brooklyn Leitch

Capstone Experience: Master of Public Health

There are a growing number of patients and families in the United States who use a language other than English (LOE). Standard of care for best patient outcomes requires that these families receive professional interpretation for every encounter, preferably in the interpreter modality that they are most comfortable with and that provides the best communication. Unfortunately, they often do not receive this. Objectives of this research include learning how interpreter services are selected and used as well as which modality (in-person, video, or phone) is preferred by patients and families, providers, and interpreters. We aim to better understand the experiences …

Barriers And Facilitators To Enrollment For Free And Reduced Price Meals In The School Nutrition Program Among Lawrence Public School Families, Emily Brinkman

Capstone Experience: Master of Public Health

Many low-income families are facing nutrition insecurity, meaning they do not have consistent and equitable access to healthy, safe, affordable foods to meet needs for optimal health and well-being. The impact of nutrition insecurity is especially concerning for children as they are more likely to face adverse outcomes that can limit physical, intellectual, and emotional potential across the lifespan. The U.S. Department of Agriculture administers the School Nutrition Programs that can help improve access to nutritious foods. Eligible families can apply for their children to receive free or reduced-price school meals based on income level and household size. However, many …

Spotlight On Mental Health On A Healthcare Campus: An Assessment Of Psychological Trauma Awareness, Training, And Treatment In The University Of Nebraska Medical Center College Of Public Health Community, Jenny E. Mueller

Capstone Experience: Master of Public Health

Background: Psychological trauma has been recognized as a public health concern of epidemic proportions globally. Public health community awareness of and education in trauma is likely to be integral to preparing future public health professionals to work effectively and safely in the field. Currently, the extent of trauma awareness, training, and treatment on the University of Nebraska Medical Center College of Public Health (UNMC COPH) campus is not known.

Aims: The aims of this project are to investigate and assess the level of psychological trauma awareness, training, and treatment on the UNMC COPH campus; and to provide recommendations for actions …

Substance Use Patterns Among High School Students - A Replication Study Of The 2020 Youth Risk Behavior Survey, Haley Irons

Capstone Experience: Master of Public Health

The study selected for replication is “Prescription Opioid Misuse and Use of Alcohol and Other Substances Among High School Students” by Christopher Jones and colleagues published in the Morbidity and Mortality Weekly Report Supplement in August 2020. The original report used data from the Centers for Disease Control’s 2009-2019 Youth Risk Behavior Survey (YRBS), which is a cross-sectional survey administered every two years to a sample of public- and private-school students in 9th–12th grade in the United States. Researchers from the original report aimed to use the 2009-2019 YRBS data to examine substance use among high school students, characterize the …

From Vapor To Vice: Unraveling The Links Between Vaping And Traditional Substance Abuse Among Youth, Ayana Powell

Capstone Experience: Master of Public Health

ABSTRACT:

Objective: To evaluate whether vaping or using e-cigarettes is associated with the use of traditional substances, such as cigarettes, alcohol, and marijuana.

Methods: Using data from the Monitoring the Future surveys, a multivariable logistic regression model was performed, and prevalent odds ratio were calculated to evaluate the association between vaping and traditional substances.

Results: Vaping use among U.S. adolescents and teenagers was found to be an associated with use of traditional substances (cigarette use [OR]= 6.36 [CI]= 4.84, 8.38; alcohol use [OR]=5.80 [CI]= 5.28, 6.38; and marijuana use [OR]= 7.77 [CI]= 6.95, 8.70).

Conclusion: This study will assist …

Strategies To Encourage Recall And Prevent Relapse After Full Mouth Rehabilitation Under General Anesthesia In Children, Claire Koukol

Capstone Experience: Master of Public Health

Background: Dental caries are preventable. Dentists utilize many prevention strategies in the office and provide at-home education to families. However, once a child develops Early Childhood Caries (ECC), especially in more severe cases, they may need general anesthesia (GA) to complete treatment. While this is an effective way to achieve full mouth dental rehabilitation (FMDR), this burdens the healthcare systems and families and does not come without risk to the patient. Patients with high caries experience remain at high risk of caries relapse after FMDR under GA, sometimes necessitating additional FMDR under GA. While there has been a significant amount …

The Power Of An Effective Safety Culture, Justin B. Negley

Capstone Experience: Master of Public Health

Workplace injuries and illnesses have continued to decrease significantly through increased regulations, awareness, and technological advances. These enhancements are not enough to continue to drive these rates lower. A robust safety culture within an organization is required to truly affect change that will continue to diminish the occurrence of injuries and illnesses within the workplace. This project seeks to define the key aspects and elements that are fundamental to a culture of safety as a top priority amongst competing demands. The foundations of a robust safety culture were identified through a systematic literature review, a site comparison example of safety …

Exploring The Mental Health Experience Of Perinatal Military Spouses Based In Sigonella, Italy, Lyndsey Dannenberg

Capstone Experience: Master of Public Health

The perinatal period can have a profound impact on the mental health of women, their infants, and their families, especially when it comes to depression and anxiety disorders. This study aims to delve into the experiences of perinatal mental health among military spouses stationed overseas, on Naval Air Station Sigonella, Italy, and contribute to the limited research on active-duty military spouses and their perinatal mental health while stationed overseas. The research uses a qualitative phenomenological approach, seeking to provide valuable insights into the lived experiences of military spouses and their perinatal mental health. Risk factors associated with perinatal mental illness …

Nutrition Needs Assessment For A Produce Prescription Program In The Pediatric Dental Setting, Zachary Houser

Capstone Experience: Master of Public Health

More than half of young people in the U.S. aged 2-19 have a poor-quality diet, including low fruit and vegetable (FV) intake (Liu et al., 2020). Poor nutrition increases health risks, including chronic diseases such as dental caries and obesity, low-income households experience higher rates of poor nutrition and subsequent health burdens (AAPD, 2022b). Produce prescriptions (PPR) are a type of financial incentive program that can improve FV intake among low-income populations (Ridberg et al., 2019). PPR programs are often conducted in a primary medical setting (Little et al., 2022); however, no literature describes PPR programs conducted in a dental …

Environmental Exposure Effects To Humans And Trends Of Harmful Algal Blooms In Nebraska, Ericka Sanders

Capstone Experience: Master of Public Health

Harmful algae blooms (HAB) are becoming more of a human health concern. Humans are exposed to harmful algae blooms from freshwater bodies used for recreational activities. The presence of harmful algae blooms has been increasing across the United States. Aerosol, dermal, and ingestion routes of exposure are ways humans can develop an illness when around a HAB. Environmental exposure to humans above 8 ppb per liter of surface water can cause mild to severe symptoms and, in rare cases, may be fatal. Exposure can be acute or chronic. The Nebraska Department of Environment and Energy (NDEE) has implemented a monitoring …

Antibiotic Prescribing Patterns In The Emergency Department, Maddison Mcconnaughhay

Capstone Experience: Master of Public Health

Purpose: Antibiotic resistance is a major public health problem in the United States, resulting in significant morbidity and mortality (CDC, 2019). This study seeks to understand how antibiotic use for dental problems may contribute to antibiotic resistance and adverse drug reactions while only temporarily relieving the underlying oral health condition. Previous research suggests differences in prescribing patterns for pain management by provider type, but little is known about antibiotic prescribing patterns, especially for diverse groups of pediatric patients (Chua, et al., 2019). This study aims to characterize antibiotic prescribing patterns in a midwestern children's hospital emergency department for non-traumatic dental …

Body Mass Index And Acute And Chronic Work-Related Injuries; A Random Sample Analysis Of Occupational Health Clinic Records, Nicole M. Lundy

Capstone Experience: Master of Public Health

Workplace injuries are detrimental because they impact the productivity and wellbeing of workers. The ultimate goal is to minimize job-related injuries due to workplace exposure. This study examines the relationship between body mass index (BMI), age, gender, and injury patterns. Data was collected through a chart review of patients from an occupational medicine health clinic in Grand Rapids, Michigan from January 2022 through December 2022.

This was an exploratory study with no population sample control group. Variables investigated were body mass index, gender, age, and type of injury sustained. The injuries were classified by body part into head, back, lower …

Evaluating The Utility Of Hospital Full-Scale Exercises In Veteran Health Administration's Emergency Departments, Brian Barhorst

Capstone Experience: Master of Public Health

The Department of Veterans Affairs' (VA) Veterans Health Administration (VHA) serves nine million veterans annually. Preparing for and responding to emergencies locally and nationally remains one of its critical missions. While VA policy requires the Homeland Security Exercise and Evaluation Program (HSEEP) methodology to conduct national-level exercises, local medical facility exercises mandated by The Joint Commission do not hold the same requirement. This evaluation assesses the effectiveness of hospital-based exercises within the Veterans Health Administration in preparing VA Emergency Departments (EDs) and Urgent Care Centers (UCCs) for local disasters by querying ED/UCC Medical and Nursing Directors about their experiences with …

Nurse Initiated Standing Orders: A Process Improvement At An Emergency Department In Interior Alaska, Justin D. Melberg

Capstone Experience: Master of Public Health

Emergency Departments (EDs) are a valuable and limited public health resource. In addition to treating acute medical emergencies, EDs bridge the gaps in urgent care and primary care accessibility, operating twenty-four hours a day, seven days a week, providing care regardless of an individual’s ability to pay. EDs across the country operate at or above capacity regularly, and overcrowding is projected to increase due to decreased facilities and available inpatient beds. Innovative measures are necessary to increase patient throughput and decrease length of stay while maintaining quality care. Nurse initiated standing orders, also known as nurse driven protocols, standing orders, …

Geospatial Distribution Of Pharmacist Diabetes Management Within A Patient Centered Medical Home Model In Omaha, Nebraska, Anthony Donovan

Capstone Experience: Master of Public Health

Patients with uncontrolled diabetes, defined as a hemoglobin A1c value greater than 9%, are at an increased risk of diabetes progression. Primary care is often the first point of contact where patients with uncontrolled diabetes are identified and treated. Pharmacists are utilized in diabetes medication management of patients with uncontrolled diabetes as one component of primary care multidisciplinary models of care. This descriptive project describes the geospatial distribution of patients with uncontrolled diabetes from a single institution in the Omaha, Nebraska area who were exposed to pharmacists within a Patient Centered Medical Home (PCMH) model of care compared to those …

Evaluating Lack Of Access To Secondary Prevention-Based Healthcare Services Between Racial/Ethnic Groups In The United States: A Logistic Regression Analysis Using 2022 Brfss Cross-Sectional Data, Samuel Ortiz Severiano

Capstone Experience: Master of Public Health

Objective: To determine whether racial/ethnic minorities have reduced access to preventive healthcare services in the United States, with participation in routine checkups serving as the metric for access. Methods: Performing logistic regression analysis comparing the length of time since the last routine checkup between different racial/ethnic groups in the study population. Those who haven’t had a routine checkup in at least 12 months served as the comparison group. Results: Black populations were 66% less likely to not have access to preventive care compared to White populations, while Asian, American Indian/Alaskan Native, and Native Hawaiian/Pacific Islander populations were 8.5% more likely …

Associations Between Self-Reported Cognitive Decline And Chronic Diseases: A Cross-Sectional Analysis Of Behavioral Risk Factor Surveillance System (Brfss) 2022, Hailey Child

Capstone Experience: Master of Public Health

Objective: This study seeks to capture how self-reports measure cognitive decline. The association between chronic conditions and cognition with age consideration in individuals aged 45 and older is investigated.

Methods: Univariate analysis generates frequencies and weighted percentages of 2022 BRFSS data. Chi-square tests and polytomous regressions generate odds ratios for bivariate analyses. A weighted multiple logistic regression model stratified by age group analyzes self-reported cognitive decline.

Results: Respondents ages 45 to 54 with three or more chronic diseases have the highest odds (OR = 6.81; 95% CI = 4.42, 10.48) of cognitive decline. Respondents 75 and older …

The Relationship Between Self-Reported Mental Health And Body Mass Index Among Adults In The United States Using The 2021 Behavioral Risk Factor Surveillance System (Brfss), Madhur Pandey

Capstone Experience: Master of Public Health

Objective

This study investigated the link between frequent mental distress (FMD) and body mass index (BMI) in 2021 among U.S. adults, while considering sociodemographic and lifestyle factors.

Methods

Using 2021 Behavioral Risk Factor Surveillance System (BRFSS) data, we analyzed the association between BMI as the dependent variable and FMD as the independent variable, considering the sociodemographic factors and lifestyle variables. Logistic regression models were applied.

Results

In our sample, 30.7% had a normal BMI, while 69.3% were outside the normal range. Of these, 85.1% reported infrequent mental distress, whereas 14.9% reported FMD. Those with FMD were more likely to have …

Examining The Relationship Between Adverse Childhood Experiences And Covid-19 Vaccine Status Using 2022 Brfss Data: A Cross-Sectional Study, Cristhian A. Chau-Valdivia

Capstone Experience: Master of Public Health

Abstract:

Objective.To determine the association between adverse childhood experiences (ACEs) scores with COVID-19 vaccination outcomes before and after adjusting for demographic variables.

Methods. Data were from 2022 Behavioral Risk Factor Surveillance System (BRFSS) surveys regarding 13 categories of ACEs, COVID-19 vaccination, and demographic variables. Data was weight adjusted for survey respondent data. This complex design combined the core and optional modules. Participants who received at least one dose of the COVID-19 vaccine were categorized as vaccinated. The sample size is 12,514.

Results. Participants who were female (OR=1.35, 95% CI: [1.19,1.52]), greater than or equal to 65 years old (OR=4.76, 95% …

A Cross-Sectional Analysis Of Adverse Childhood Experience Exposure On Cancer Diagnosis Utilizing The 2022 Behavioral Risk Factor Surveillance Survey Data, Emma Zipperer

Capstone Experience: Master of Public Health

Objective: To determine the association between Adverse Childhood Experiences (ACEs) and cancer diagnosis based on ACE exposure levels.

Methods: We utilized data collected in the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey. The study population (n=54,148) was restricted to states that reported on the optional model of experiencing ACEs and those who responded about cancer diagnosis. A univariate analysis, bivariate analysis and a multivariate logistic regression were performed. Odds of cancer diagnosis among those with differing ACE exposure levels were calculated.

Results: High ACE exposure had 20% higher odds of cancer diagnosis when compared to low ACE exposure. White, …

Mental Health Perceptions Among Us Veterans And Non-Veterans: 2022 Behavioral Risk Factor Surveillance System, Nicole Frederickson

Capstone Experience: Master of Public Health

Objective. To determine the association between veteran status and perceived mental health in US adults.

Methods. 2022 Behavioral Risk Factor Surveillance System cross-sectional telephone survey data were used. Analyses were adjusted for confounding sociodemographic and health-related characteristics. Weighted multinomial logistic regression was used to determine the association between veteran status and reporting 0, 1-13, or 14+ poor mental health days.

Results. A total of 430,653 individuals were included in this analysis. Veteran status was associated with decreased odds of reporting 1-13 poor mental health days than nonveterans (OR=0.81; 95% CI 0.77, 0.86) but greater odds of reporting 14+ poor mental …

Adverse Childhood Experiences As Individual Predictors Of Subjective Cognitive Decline: Analyzing The 2022 Behavioral Risk Factor Surveillance System, Ruthie Schmitt

Capstone Experience: Master of Public Health

Objectives. This study explored the association of Adverse Childhood Experiences (ACEs) and Subjective Cognitive Decline (SCD). This study aimed to determine within the United States which ACEs have a stronger association with SCD after 45 years of age by analyzing all 13 ACEs individually with SCD.

Methods. Data were obtained from the 2022 BRFSS. An analytic sample of 42,509 adults over 45 years of age from seven states was analyzed using binary and multivariate logistic regression. The outcome variable investigated in this study was SCD, and the explanatory variables were 13 ACEs.

Results. Of the respondents, 10.4% reported experiencing SCD …

Associations Between Long Covid And Healthcare Access: A Cross-Sectional Analysis Of The Behavioral Risk Factor Surveillance System (Brfss) 2022, Tiffany Elliott

Capstone Experience: Master of Public Health

Objective. To evaluate the association of healthcare access with Long COVID and clinical and sociodemographic factors.

Methods. Data were from the CDC's 2022 Behavioral Risk Factor Surveillance System (BRFSS) surveys regarding four measures of healthcare access and Long COVID. There were 25,549 respondents who reported Long COVID and 95,830 respondents who did not report Long COIVD.

Results. 25,549 (22.0%) of respondents reported Long COVID. Significant associations were found in respondents with public health insurance and delayed medical care due to cost. Those with chronic health conditions were more likely to report Long COVID. Women, certain racial/ethnic groups, …

Association Between Frequent Mental Distress And Insurance Status Using The 2022 Brfss, Christina Clayson

Capstone Experience: Master of Public Health

Objectives

Determine if there is a direct relationship between frequent mental distress and health insurance coverage.

Methods

Data from the 2022 BRFSS was used to calculate adjusted percentages. Crude odds ratios for both mental distress and insurance coverage. Multivariate analysis calculated crude and adjusted odds ratios for frequent mental distress by insurance coverage with income as a covariate.

Results

Individuals reporting frequent mental distress had lower income, less education, and were younger. Individuals without health insurance were more likely to be younger, Hispanic, and not have graduated high school. There was no significant association between frequent mental distress and not …