Resilience Of Interdependent Transportation And Healthcare Systems: A Simulation-Driven Framework Incorporating Social Equity And Facility Optimization, S. Yasaman Ahmadi

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The overarching goal of this dissertation is to develop an integrated, simulation-driven framework to assess and enhance the resilience of interdependent transportation and healthcare systems before, during, and after natural hazards. By examining how spatial disruptions, social vulnerability, operational constraints, and infrastructure interdependencies affect access to and functionality of hospitals, this research offers a multifaceted evaluation of system performance under stress. This dissertation examines the impact of natural hazards, particularly floods, on the interdependent transportation and healthcare systems. The proposed approach combines and advances GIS-based network analysis, graph-theoretical modeling, and discrete-event simulation to evaluate system performance under different scenarios. The …

Egg White Hydrolysate In Hypertension: A Mechanistic Investigation Of Gut Microbiota Dependent And Independent Pathways, Emerson David Nolasco

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Cardiovascular diseases are one of the leading causes of mortality worldwide in which hypertension is a risk factor. Present pharmacological interventions require long-term adherence to the therapy and are often associated with undesirable side effects. Moreover, treatments have overlooked the role of the microbiome in the development of hypertension. Egg white hydrolysate (EWH) has exhibited antihypertensive properties with potential to be used as a natural alternative for the prevention and management of hypertension. However, EWH peptide’s effect on the gut microbiome remains yet to be elucidated. Studies have described that a portion of the ingested protein can remain undigested as …

“Self-Compassion Has To Be The Heartbeat Of How I Move Through Life”: A Mixed Methods Study Of Family Caregiver Emotional Well-Being, Sarah O. Rasby

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Often referred to as “hidden patients,” family caregivers endure numerous physical, emotional, psychological, and social hardships due to the demands of caregiving, which often results in their own needs going unmet. With the projected 61.3 million of the baby boomer generation entering the long-term care phase by 2029 along with a mass shortage of professional caregivers post-pandemic, more and more family members are expected to fill in for the role of care without sufficient access to support services (Pollard & Scommegna, 2014; Smith & Chang, 2016). An exploratory, mixed-methods study using a three-group intervention design was utilized to investigate the …

Experiences Of Disclosure Among Transgender And Gender Diverse Sexual Assault Survivors, Merle E. Huff Ii

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Around half of TGD people have experienced sexual assault victimization (Abern et al., 2023; Clements-Nolle et al., 2006; James et al., 2016; Martin et al., 2022; Risser et al., 2005; Stotzer, 2009), which leads to higher rates of depression and PTSD (Grant et al., 2011; Grocott et al., 2023; Fernández-Rouco et al., 2017; Hawkey et al., 2021; Matsuzaka & Koch, 2019; Parr, 2020; Ussher et al., 2020). Disclosure of victimization may be important among TGD survivors. The current study was guided by minority stress theory (Meyer, 2003) and the gender minority stress and resiliency model (Testa et al., 2015) to …

Quality Improvement Project Advancing Success In Nursing Education: An Evidence-Based Approach To Remediation, Jessica Wilson

Doctor of Nursing Practice Projects

Nursing education requires intense academic work, which creates specific obstacles for learner achievement. The improvement of academic results in BSN 346 and similar high-stakes courses remains essential for maintaining learner retention, graduation success, and practice readiness. This quality improvement project assessed how evidence-based remediation with structured implementation compared to traditional voluntary remediation methods. The research investigated whether faculty-led evidence-based remediation meetings would enhance BSN 346 learner success through concept map score assessment. A retrospective pre-/post-intervention study analyzed concept map performance between two learner groups from Spring 2025, who received standard remediation, and Summer 2025, who received structured remediation. The researchers …

Integrating Sensory Strategies In The Classroom Setting: A Field Guide, Abigail Walcott

Occupational Therapy Doctorate Capstone Posters

During my 14-week capstone project, I worked alongside St. John Vianney Catholic School, an early education and K-8 school to develop a program to target identified needs of students related to sensory challenges and emotional regulation skills to improve participation in school-based occupations. My primary ACOTE focus area was program development, and I worked to assess classroom needs and develop a program that could be implemented in the traditional classroom setting. My goals for this capstone project were to observe and discuss with my site mentor to assess classroom needs, to research and to create an evidence-backed program guide for …

Bridging Theory To Practice: An Evidence-Based Training Program For Implementing Animal-Assisted Therapy In Appalachian Clinical Settings, Lauren Kessler

Occupational Therapy Doctorate Capstone Posters

No abstract provided.

The Use Of Sensory Interventions For Stress Management In College Students, Cassidy Cain

Occupational Therapy Doctorate Capstone Posters

For my doctoral capstone, I partnered with the Student Success Center (SSC) at Eastern Kentucky University and the director of the SSC, Dr. Ashley Sweat, to explore the connections between commonly used occupational therapy sensory intervention techniques and stress management for college students. The focus of my project is education and program development for the Student Success Center. In my literature review, I identified stress as one of the largest contributors to students not returning to college. The Student Success Center provides services for students who are already at a high risk of not continuing their college education. Based on …

Promoting Social-Emotional Learning In Pre-K Students, Hailey Dawn Turner

Occupational Therapy Doctorate Capstone Posters

During my doctoral capstone and applied leadership experience, I partnered with Eastern Scholar House, a child development center at Eastern Kentucky University serving children ages 0–5. The primary ACOTE focus area was education, with an emphasis on educating Pre-K teachers and parents on social-emotional learning (SEL) and strategies to support its development in both the classroom and home settings. Project goals included gaining hands-on experience with SEL, understanding its impact on well-being, collaborating with an interprofessional team, and providing educators with practical SEL resources. A literature review and needs assessment highlighted the benefits of SEL in improving behavior, academics, and …

Ability At Bat: Adaptive Sports For Individuals With Disabilities, Jamison B. Watson

Occupational Therapy Doctorate Capstone Posters

No abstract provided.

Anxiety During Perimenopause: A Narrative Qualitative Study Of The Women’S Lived Experiences, Kayla Mcelhany

Dissertations and Theses (Open Access)

Abstract

Objectives: Perimenopause has been associated with increased anxiety symptoms. However, data is lacking regarding the experiences of women with perimenopausal anxiety and the contributing factors to worsening anxiety symptoms. We explored the experiences of women with self-reported new onset or worsening of anxiety symptoms during perimenopause to better understand contributing factors.

Study design: Twenty women participated in one-on-one interviews to explore experiences of perimenopausal anxiety in the context of their daily lives and perimenopausal physical changes. Inductive thematic analysis was used to develop codes and themes from the transcribed interview data. Analysis was done using MAXQDA software.

Main …

Indigenous Gut Health, Tasha Vivier Morin

Indigenous Health Student Publications

Indigenous gut health is a critical but often overlooked determinant of overall well-being. Gut health encompasses digestion, nutrient absorption, immune function, and the balance of the microbiome. Indigenous communities face unique challenges related to geography, food access, and the legacy of colonization, all of which affect dietary diversity and microbiome health. Drawing from the Health Belief Model, this project proposes a culturally responsive, education-based intervention to increase awareness of fiber-rich diets and their role in preventing chronic disease. The intervention aims to address upstream factors such as food access and health literacy, particularly among Indigenous families. Traditional diets once supported …

Association Of Epigenetic Aging With Plasma Cbiomarkers Of Amyloid, Tau, Neurodegeneration, And Neuroinflammation In Hispanic/Latino Adults, Myriam Fornage, Wassim Tarraf, Martha L Daviglus, Charles Decarli, Kevin A Gonzalez, Carmen R Isasi, Sayaka Kuwayama, Melissa Lamar, Bonnie E Levin, Humberto Parada, Alberto R Ramos, Tatjana Rundek, Bharat Thyagarajan, Hector M González

The Brown Foundation: Institute of Molecular Medicine

Background: Blood-based biomarkers hold significant promise for the early detection and diagnosis of Alzheimer's disease (AD) and other dementias. Age-related changes in blood levels of AD biomarkers are well-documented but poorly understood. Epigenetic clocks are mathematical models based on DNA methylation patterns that reflect various aspects of the multidimensional aging process. We investigated the associations of epigenetic aging with five blood-based AD biomarkers in 2656 Hispanic/Latino adults (mean age 62.5 years; 65% females) from the Hispanic Community Health Study/Study of Latinos. We used multivariable linear regression models to estimate the associations of acceleration in each of five epigenetic clocks with …

Antithrombotic Strategies And Outcomes In Neonates And Infants With Cardiac Shunts: A Systematic Review And Meta-Analysis., Amy L. Kiskaddon, Neil A. Goldenberg, Marisol Betensky, Joshua W. Branstetter, Dina Ashour, Pamela Williams, Arabela C. Stock, Michael Silvey, Therese M. Giglia, Nhue L. Do, Cardiac Disease Thrombosis And Hemostasis Working Party Of The Isth Ssc Subcommittee On Pediatric And Neonatal Thrombosis And Hemostasis

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Cardiac shunt thrombosis in neonates and infants remains a concern for shunt failure and mortality. The optimal strategy for thromboprophylaxis remains unknown.

OBJECTIVES: This systematic review aims to characterize antithrombotic strategies and outcomes in neonates and infants with a cardiac shunt.

METHODS: MEDLINE, Embase, and Cochrane CENTRAL were searched from inception through July 2024 for studies reporting shunt thrombosis prevalence among infants who received a cardiac shunt. We estimated the pooled prevalence of shunt thrombosis using random-effects meta-analysis. In the subgroup analysis, we evaluated the effects of shunt type and antithrombotic strategies on shunt thrombosis prevalence.

RESULTS: A total …

American College Of Rheumatology Guidance Statements For Addressing Mental Health Concerns In Youth With Pediatric Rheumatologic Diseases., Natoshia R. Cunningham, Ashley N. Danguecan, Samantha L. Ely, Yaa Amponsah, Alaina Davis, Suzanne Edison, Julia G. Harris, Jordan T. Jones, Alana Goldstein-Leever, Alison Manning, Anne Mchugh, Crystal Mui, Ekemini Ogbu, Nikki Reitz, Martha Rodriguez, Natalie Rosenwasser, Alyse Tankanow, Erin Treemarcki, Katherine Winner, Tamar B. Rubinstein, Andrea M. Knight, Carra Mental Health Workgroup

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: Pediatric rheumatologic diseases (PRDs) are characterized by high rates of anxiety and depression known to impact health-related outcomes. We present guidance statements to assess and manage mental health concerns for youth with PRDs in pediatric rheumatology practice.

METHODS: Development of the guidance statements was initiated in 2019 and concluded in November 2023. It included (1) the formation of a task force (including pediatric rheumatologists, pediatric behavioral health providers, patients, and parents) led by two licensed pediatric psychologists and two board-certified pediatric rheumatologists, (2) iterative drafting of statements and rating of evidence based on the Oxford Centre for Evidence-Based Medicine …

Biomechanical Analysis Of 3d Correction And Bone-Screw Forces As A Function Of Rod Insertion Sequence And Orientation Relative To The Sagittal Plane In Adolescent Idiopathic Scoliosis Instrumentation., Camille Pillot, Xiaoyu Wang, Alexandria Mallinos, Todd Ritzman, Lorena Floccari, Richard M. Schwend, Carl-Eric Aubin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: In adolescent idiopathic scoliosis instrumentation, rods are typically aligned with the sagittal plane during the initial translation maneuver. Surgeons often empirically orient the rod slightly opposite to the scoliotic curve, but the optimal orientation and insertion sequence, as well as their influence on 3D correction and forces, remain unclear. This study investigates the biomechanical influence of these rod parameters on scoliosis correction.

METHODS: Patient-specific multi-body biomechanical models were developed for 30 adolescent idiopathic scoliosis patients (11 hypo-, 12 normo-, 7 hyper-kyphotic thoracic curves) to simulate posterior instrumentation with a primary segmental translation correction maneuver. Rod insertion was tested in …

Indoor Air Quality Conditions And Respiratory Virus Detections In Elementary Schools—Kansas City, Missouri, February–March 2023, Olivia M. Almendares, Jasmine D. Ruffin, Luke Gard, Rangaraj Selvarangan, Anjana Sasidharan, Dithi Banerjee, Nibha Sagar, Amanda Hayes, Sydnie Petty, Brian R. Lee, Chris T. Young, Janelle Potter, Shannon Tilsworth, Jennifer Goldman, Jennifer E. Schuster, Hannah L. Kirking

Manuscripts, Articles, Book Chapters and Other Papers

Background/Objectives: Respiratory viruses circulate year-round and can spread indoors via inhalation of airborne particles. Effective ventilation and filtration may reduce transmission, particularly in school settings where children and staff spend significant time. This study examines the impact of indoor air quality (IAQ) and ventilation in schools on respiratory virus detection.

Methods: During February 27 to March 30, 2023, we assessed the relationship between IAQ and respiratory viruses in two Kansas City, Missouri, elementary schools by collecting bioaerosol samples, student and staff nasal swabs, and monitoring IAQ across 10 rooms (six classrooms, two common spaces, and two nurses’ offices). We calculated …

Intention To Take Pre-Exposure Prophylaxis (Prep) As An Hiv Preventive Medication: An Application Of The Health Belief Model And Theory Planned Behavior, Besuthu Nakekelwa Nkambule

Graduate Theses and Dissertations

South Africa (SA) has 7.7 million citizens (12.6% of its 2023 population) living with human immunodeficiency virus (HIV). The use of pre-exposure prophylaxis (PrEP) as an antiretroviral medication for HIV-negative individuals is a promising HIV prevention strategy in SA that can help the attainment of an HIV free generation. PrEP offers greater than 90% protection against HIV acquisition. Despite SA’s efforts in increasing PrEP coverage for its citizens, primarily to those at substantial risk, its adoption remains relatively low. Structural barriers related to access, costs, lack of awareness, and, more recently, US funding cuts exacerbate the challenges of PrEP’s potential …

Work Impairment And Financial Outcomes Among Adults With Vs Without Long Covid, Michael Gottlieb, Ji Chen, Huihui Yu, Michelle Santangelo, Erica S. Spatz, Nicole L. Gentile, Rachel E. Geyer, Caitlin Malicki, Kristyn Gatling, Kelli N. O'Laughlin, Kari A. Stephens, Joann G. Elmore, Lauren E. Wisk, Michelle L'Hommedieu, Robert Rodriguez, Juan Carlos C. Montoy, Ralph C. Wang, Kristin L. Rising, Efrat Kean, Jonathan W. Dyal, Mandy J. Hill, Arjun K. Venkatesh, Robert A. Weinstein

Department of Emergency Medicine Faculty Papers

IMPORTANCE: While much of the focus on long COVID (LC; defined as developing new, persistent symptoms lasting 3 months or longer after SARS-CoV-2 infection) has been on health status and quality of life, the impact on individual work productivity and financial distress are less well established.

OBJECTIVES: To assess differences in work and financial outcomes among individuals with current, resolved, and no LC up to 3 years after initial infection.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, multisite, longitudinal cohort study enrolled adult participants (age ≥18 years) with at least 1 reported SARS-CoV-2 infection from December 7, 2020, to August 29, …

Reconstruction Of A Pelvic Nonunion Secondary To Metastatic Breast Cancer And Palliative Radiation., Ronald Peirish, Landon Reading, Cesar Cereijo

Surgery Articles

Pathologic pelvic nonunions are uncommon, although they remain a difficult problem and require meticulous surgical planning and execution for desired outcomes. In this paper, we discuss a patient who sustained a pathologic pelvic insufficiency fracture secondary to radiation therapy for metastatic breast cancer, who subsequently developed a symptomatic nonunion that required surgical intervention secondary to debilitating pain and inability to ambulate. We also discuss the classification of insufficiency fractures of the pelvis to guide treatment, in addition to complications associated with surgical intervention. A 51-year-old female with a 12-year history of metastatic breast cancer. She presented to an outside facility …

How Was Rehab? A Follow-Up To A Randomized Effectiveness Control Trial Of A Brief Acceptance And Commitment Therapy Protocol For Inpatient Detoxification Patients, Alexander J. Twohy

Dissertations

Residential treatment for Substance Use Disorders (SUD) is a common treatment modality. However, the literature is sparse on modifiable predictors that affect change during the residential treatment stay. Acceptance and Commitment Therapy (ACT) has been shown to be an effective treatment for SUDs. Weststrate et al. (2023), in a randomized controlled effectiveness trial, compared ACT plus medication management to medication management during detoxification. The addition of ACT increased consumer satisfaction and ACT skills use, while decreasing psychological inflexibility and reducing withdrawal symptoms.

This study explored whether the brief ACT intervention had impacts during participants' subsequent residential stay. Forty out of …

Diagnostic Accuracy Of The Stopbang Questionnaire Against Polysomnography For The Screening Of Obstructive Sleep Apnea In A Tertiary Hospital In Kenya., Sandra Obaje Maseno

Master of Medicine in Internal Medicine

BACKGROUND: Obstructive sleep apnea is a syndrome of upper airway and neuromuscular dysfunction during sleep that subsequently causes interruption of normal breathing. Polysomnography is the reference test for the diagnosis of obstructive sleep apnea. Obstructive sleep apnea can be categorised as mild, moderate or severe based on an apnea-hypopnea index (AHI) on polysomnography. The recommended treatment using Continuous Positive Airway Pressure lowers morbidity and mortality rates. The STOPBANG questionnaire has been used as a screening tool for obstructive sleep apnea due to its easy and concise approach. However, even with the increasing prevalence of obstructive sleep apnea and its risk …

Perception And Experiences With Telemedicine Among Caregivers Of Children Requiring Outpatient Chronic Care, Maureen Wambui Kigara

Master of Medicine in Paediatrics and Child Health

Introduction Telemedicine is an expanding healthcare modality with potential to enhance access to paediatric specialist care, reduce healthcare costs, and minimize school and work disruptions. However, little is known about caregiver perceptions and experiences with telemedicine in low- and middle-income countries, especially in the context of chronic paediatric care.

Objectives This study explored how caregivers of children with chronic health conditions perceive and experience telemedicine, and what factors influence its adoption. The findings aim to inform the design of patient-centered paediatric telemedicine services.

Methodology A cross-sectional qualitative study was conducted at the Paediatric Specialist Clinics of Aga Khan University Hospital. …

Dominican Republic Medical Mission Trip 2025, Julianna Wolff, Carla Kosorog

HLTHS 1800 Global Healthcare Initiatives: Dominican Republic 2025 Documents

This medical mission trip was located within the Dominican Republic in the

La Ciénaga area.

- The predominant language spoken is Dominican Spanish. However, many

students learn a combination of French and English throughout their

schooling.

- As explained throughout this presentation, access to healthcare ranges

from minimal to none within this region of the Dominican Republic.

Reducing Suicide Ideation Through Healthcare Provider Training In The Use Of The Columbia Suicide Severity Rating Scale (C-Ssrs) In A Rural Community Mental Health Clinic, Lashunda R. Lewis

Doctoral Projects

This doctoral project aimed to address the inconsistent and inadequate assessment of suicide risk by healthcare professionals in a Rural Community Clinic. Staff members do not comprehensively understand the Columbia-Suicide Severity Rating Scale and vary in how they screen patients before the intervention. When we looked at the baseline, we found that only 45% of charts contained suicide risk screening, and C-SSRS was used in only 5% of cases. Some of the main obstacles reported were not properly training staff and keeping patients from sharing their thoughts on this subject.

The main objective of the doctoral project was to test …

Titer-First Vaccination Protocol In An Employee Health Clinic, Obehi Dickson

Doctor of Nursing Practice Final Project Abstract

Purpose:

The purpose of this project was to evaluate the clinical and financial outcomes of implementing a titer-first vaccination protocol for new employees at an Employee Health Clinic. This project sought to improve cost-effectiveness and reduce unnecessary vaccinations.

Background:

This project was conducted at a large healthcare organization in Houston, Texas, to address the cost burden of traditional vaccination protocols. Pre-vaccination serologic testing helps identify existing immunity, reducing unnecessary vaccinations and overall clinic costs.

Methodology:

The titer-first vaccination protocol includes serologic testing for measles, mumps, rubella (MMR), varicella, and hepatitis B, followed by vaccine administration for those without immunity. Data …

Dean's Research Newsletter, August 2025, Neil W. Schluger

SOM Dean's Research Newsletter

No abstract provided.

Simulating The Blood Transfusion System In Kenya: Modelling Methods And Exploratory Analyses, Yiqi Tian, Bo Zeng, Jana Macleod, Gatwiri Murithi, Cindy Makanga, Hillary Barmasai, Linda Barnes, Rahul Bidanda, Tecla Chelagat, Carolyne Njoki

Anaesthesiology, East Africa

The process of collecting blood from donors and making it available for transfusion requires a complex series of operations involving multiple actors and different resources at each step. Ensuring hospitals receive adequate and safe blood for transfusion is a common challenge across low- and middle-income countries, but is rarely addressed from a system level. This paper presents the first use of discrete event simulation to study the blood system in Kenya and to explore the effect of variations and perturbations at different steps of the system on meeting blood demand at patient level. A process map of the Kenyan blood …

2024 Eacts/Eactaic Guidelines On Patient Blood Management In Adult Cardiac Surgery In Collaboration With Ebcp, Filip Casselman, Marcus Lance, Aamer Ahmed, Alice Ascari, Juan Blanco-Morillo, Daniel Bolliger, Maroua Eid, Gabor Erdoes, Renard Haumann, Anders Jeppsson

Anaesthesiology, East Africa

No abstract provided.

Prevalence And Risk Factors Of Cerebral Microhemorrhages And Superficial Siderosis In Cognitively Unimpaired Older Adults: Analysis From The Chariot-Pro Substudy, Sujin Kang, Dimitra Kafetsouli, Jamie Ford, Janice Wong, Luc Bracoud, Joyce Suhy, Parthenia Giannakopoulou, Chinedu Momoh, Tom Russ, Craig Ritchie

Brain and Mind Institute

Introduction: Cerebral microhemorrhages (CMHs) and superficial siderosis (SS) are relatively common side effects of anti-amyloid immunotherapies, termed amyloid-related imaging abnormalities (ARIA-H). They are also observed in treatment-naïve older adults. This study explored relationships with modifiable and non-modifiable risk factors.

Methods: This cross-sectional study included 1414 cognitively unimpaired, treatment-naïve individuals aged 60 to 85 years from the Cognitive Health in Ageing Register: Investigational, Observational and Trial Studies in Dementia Research (CHARIOT): Prospective Readiness cOhort (PRO) SubStudy. Relationships between CMHs/SS and cardiovascular risk factors, amyloid beta (Aβ) load, apolipoprotein E (APOE) ε4 status, educational attainment, and white matter hyperintensities were …