Medicine and Health Sciences Commons^™

Temporal And Geospatial Trends Of Pediatric Cancer Incidence In Nebraska Over A 24-Year Period, Evi A. Farazi, Shinobu Watanabe-Galloway, L. Westman, B. Rettig, P. Hunt, R. Cammack, John W. Sparks, Don W. Coulter

Journal Articles: Epidemiology

BACKGROUND: Data from the Surveillance, Epidemiology, and End Results (SEER) revealed that the incidence of pediatric cancer in Nebraska exceeded the national average during 2009-2013. Further investigation could help understand these patterns.

METHODS: This retrospective cohort study investigated pediatric cancer (0-19 years old) age adjusted incidence rates (AAR) in Nebraska using the Nebraska Cancer Registry. SEER AARs were also calculated as a proxy for pediatric cancer incidence in the United States (1990-2013) and compared to the Nebraska data. Geographic Information System (GIS) mapping was also used to display the spatial distribution of cancer in Nebraska at the county level. Finally, …

An Epidemiological Study Of Pediatric Sports And Recreational Injuries Reporting To The Emergency Room In Grand Forks, Nd, Carly Bertsch, Lucas Dolan

Physical Therapy Scholarly Projects

PROBLEM: The purpose of this research study is to evaluate the emergency room records from Altru Health System in Grand Forks, ND from 2011-2015 to find trends in pediatric injuries from the ages of 0-19. The justification for the study is to provide Grand Forks with information about the frequency and distribution of pediatric sports and recreational injuries. No injury surveillance system has been implemented to monitor youth injuries, but his study is a continuation of a previous 10-year study and the combining of the two time frames would result in a 15-year compilation of data. By using descriptive data …

The Development Of Azd7624 For Prevention Of Exacerbations In Copd: A Randomized Controlled Trial, Naimish R. Patel, Danen M. Cunoosamy, Malin Fagerås, Ziad Taib, Sara Asimus, Tove Hegelund-Myrbäck, Sofia Lundin, Katerina Pardali, Nisha Kurian, Eva Ersdal, Cecilia Kristensson, Katarina Korsback, Robert Palmér, Mary N. Brown, Steven Greenaway, Leonard Siew, Graham W. Clarke, Stephen I. Rennard, Barry J. Make, Robert A. Wise, Paul Jansson

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: p38 mitogen-activated protein kinase (MAPK) plays a central role in the regulation and activation of pro-inflammatory mediators. COPD patients have increased levels of activated p38 MAPK, which correlate with increased lung function impairment, alveolar wall inflammation, and COPD exacerbations.

OBJECTIVES: These studies aimed to assess the effect of p38 inhibition with AZD7624 in healthy volunteers and patients with COPD. The principal hypothesis was that decreasing lung inflammation via inhibition of p38α would reduce exacerbations and improve quality of life for COPD patients at high risk for acute exacerbations.

METHODS: The p38 isoform most relevant to lung inflammation was assessed …

Socioeconomic Status And Cigarette Expenditure Among Us Households: Results From 2010 To 2015 Consumer Expenditure Survey, Mohammad Siahpush, Evi A. Farazi, Shannon I. Maloney, Danae Dinkel, Minh N. Nguyen, Gopal K. Singh

Journal Articles: Epidemiology

OBJECTIVES: To examine (1) the association between household socioeconomic status (SES) and whether a household spends money on cigarettes and (2) socioeconomic variations in proportion of total household expenditure spent on cigarettes among smoking households.

METHODS: We pooled data from six consecutive years, 2010-2015, of the Consumer Expenditure Interview Survey. The interviews involved a structured questionnaire about household income, demographics and expenditures including expenditure on cigarettes. Households that reported cigarette expenditure in the previous 3 months were distinguished as smoking households. SES indicators were household poverty status, education and occupation of the head of household. Logistic regression was used to …

Common Diagnoses Among Refugee Populations: Linked Results With Statewide Hospital Discharge Database, Kerui Xu, Shinobu Watanabe-Galloway, Ming Qu, Brandon Grimm, Jungyoon Kim

Journal Articles: Epidemiology

BACKGROUND: According to the U.S. State Department's Refugee Processing Center and the U.S. Census Bureau, in the fiscal year 2016, among all states in the United States, Nebraska resettled the highest number of refugees per capita.

OBJECTIVES: The objectives of this study were to determine the most common reasons for refugees utilizing hospital services in Nebraska between January 2011 and September 2015, and to examine whether refugee patients had increased risks for adverse health conditions compared to non-refugee patients.

METHODS: Statewide linkage was performed between Nebraska Medicaid Program's immigration data, and 2011-2015 Nebraska hospital discharge data inpatient and outpatient files. …

Depression, Thanu Abraham

Senior Honors Theses and Projects

Depression is one of the most prevalent mental health disorders in the United States. Anyone can be diagnosed with depression at any point in life. The objective of this paper is to explore depression within special populations. This paper will be sectioned into five different chapters. Chapter I will discuss what depression is. Chapter II will examine depression in adolescents. Chapter III will explore postpartum depression. Chapter IV will discuss geriatric depression. Chapter V will explore the relationship between depression and cardiovascular disease. Each section will contain extensive research within its topic. Although depression drastically impacts one's life, only half …

Evaluation Of The N-O-T Program For Smoking Cessation Among High School Students, Whitney Jaye Erickson

Walden Dissertations and Doctoral Studies

Adolescents and young adults use more tobacco than all other adults, yet the percentage of this younger population eventually quitting the use of tobacco is lower. There is little evidence-based research to support adolescent smoking cessation programs. Using social learning theory (SLT) and the stages of change model, the purpose of this project was to evaluate the effectiveness of the Not-On-Tobacco (N-O-T) program, an evidence-based adolescent smoking cessation program, in reducing or preventing the number of cigarettes smoked by high school boarding students and to evaluate how best to individualize the program for this high school going forward. The DNP …

Provider Adherence To Recommendations For Hpv Vaccination In A Family Practice And Pediatric Clinic, Kara Saling

DNP Projects

Background: The HPV vaccination has consistently had lower adherence rates than the goal set by Healthy People 2020. The Advisory Committee on Immunizations Practices (ACIP) now recommends that children (both male and female) 11 to 12 years of age should start to receive the HPV vaccine before exposure to the virus. However, even with the change in the new guidelines, the HPV vaccine administration rates still trail other adolescent vaccinations.

Purpose: The purpose of this project is to identify pediatric and family practice provider adherence to ACIP/CDC recommendations on HPV vaccinations in a Southeastern United States health system in …

The S.P.I.R.I.T. Program: Spirituality Promotion Interdependence Resiliency Inclusive Therapy, Alycia Heisler, Brianna Safranski

Occupational Therapy Capstones

Purpose: Native American children and adolescents are some of the most underserved people in the United States (Warzak, Dogan, & Godfrey, 2011). Common mental health problems this population typically experiences are depression, suicidal thoughts or ideation, traumatic experiences, substance use, and results of historical trauma (Brockie, Dana-Sarco, Wallen, Wilcox, & Campbell, 2015). They have the highest rates of these mental health problems, more than any other ethnic group (Evans-Campbell, Walters, Pearson, & Campbell, 2012). There is a need for preventative programs to be implemented with elementary school-aged Native American children and adolescents (Ohl, Mitchell, Cassidy, & Fox, 2008; Stigler, …

An Occupational Therapy Perspective Of A School-Based Suicide Prevention Program With A Peer-Mentorship Emphasis, Maddie Bjornstad, Karyssa Kimery

Occupational Therapy Capstones

Suicide is one of the leading causes of death in adolescents today (Pisani et al., 2012; Katz et al., 2013). Zalsman et al. (2016), reported the recognition of suicide prevention as a public health priority has helped to encourage research, detection, treatment, and management of individuals at risk for suicide, however the implementation of proven, evidence-based, and cost-effective strategies are the duty of public health policy makers and healthcare providers. Occupational therapists are trained to help individuals determine what occupations are meaningful and completed in order to feel a sense of self-efficacy, therefore occupational therapy can play a critical role …

Occupational Deprivation In Adolescents From Low-Income And Food Insecure Homes: A Screening Tool And After School Program, Claire Eidenschink

Occupational Therapy Capstones

Adolescents who experience food insecurity are exposed to an increased risk of health disparities related to cognitive, psychosocial, and physical functioning (Cook & Frank, 2007). Each of these domains of functioning impacts occupational performance in all roles that an adolescent assumes. Of note, the role of a student is drastically impacted. Therefore, a program to address strategies for meeting basic needs within a familiar setting, such as a school, is relevant and necessary for this population. Such a program would offer an opportunity to close the gap in disparities and increase health outcomes of adolescents who experience food insecurity as …

Wayne County Board Of Education Adaptation Of Love Notes Curriculum For Adolescent Pregnancy Prevention, Allison Shea Merritt

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

West Virginia has the 8^th highest rate of adolescent pregnancy in the United States and the rate in Wayne County is significantly higher. Adolescent pregnancies cause negative health outcomes for both the baby and the mother. Adolescent mothers are at an increased risk of anemia, preeclampsia, and preterm labor and babies born to adolescent mothers are more likely to have a low birth weight and to have cognitive impairment. To address this burden, the school board has decided to use the ADAPT-ITT framework on the evidence-based Love Notes adolescent pregnancy prevention curriculum to adapt it to be more culturally …

Brachial Artery Vasculitis And Associated Stenosis Presenting As Elbow Pain In A 16-Year-Old Soccer Player: A Case Report, Eric R. Reynolds, Andrew D. Ashbaugh, James P. Toldi, Deana M. Mercer, Mark Langsfeld, Christopher A. Mcgrew

UNM Orthopaedic Research Journal

Chronic vascular occlusion in the upper extremity can result from repetitive trauma, atherosclerosis, proximal embolic events, hypercoagulable states, and systemic diseases such as collagen vascular disease and vasculitis. Considerable functional impairment can result from these maladies; however, sometimes the condition develops slowly with minimal effect on the patient. We describe a 16-year-old soccer player with slow-progressing elbow pain and loss of range in motion caused by brachial artery vasculitis and resultant brachial arterial stenosis. Although vascular insults and lesions rarely cause chronic vascular occlusion, physicians should consider this possibility in patients with localized pain or atrophy, especially if the condition …

Practice Survey: Adherence Monitoring And Intervention In Pediatric Gastroenterology And Hepatology., Michele H. Maddux, Shawna Ricks, Julie A. Bass, James F. Daniel, Ellen Carpenter, Kimberely Radford

Manuscripts, Articles, Book Chapters and Other Papers

Purpose: Despite significant medication nonadherence rates among youth with pediatric gastroenterology and hepatology disorders, little is known about current adherence practices in pediatric gastroenterology care. This study summarizes current practices surrounding adherence monitoring and intervention in pediatric gastrointestinal (GI) and hepatologic care in the USA.

Participants and methods: One hundred and fifty-four pediatric GI providers completed an online survey designed to examine current practices surrounding adherence monitoring and intervention, specific strategies used to monitor and treat poor adherence, and the barriers currently experienced in relation to adherence monitoring and intervention.

Results: Practices varied greatly in terms of when and how …

Current Approaches And New Developments In The Pharmacological Management Of Tourette Syndrome., Julio Quezada, Keith A. Coffman

Manuscripts, Articles, Book Chapters and Other Papers

Tourette syndrome (TS) is a neurodevelopmental disorder of unknown etiology characterized by spontaneous, involuntary movements and vocalizations called tics. Once thought to be rare, TS affects 0.3-1% of the population. Tics can cause physical discomfort, emotional distress, social difficulties, and can interfere with education and desired activities. The pharmacologic treatment of TS is particularly challenging, as currently the genetics, neurophysiology, and neuropathology of this disorder are still largely unknown. However, clinical experience gained from treating TS has helped us better understand its pathogenesis and, as a result, derive treatment options. The strongest data exist for the antipsychotic agents, both typical …

A Vocational Training Program For High School Students With Disabilities On An Alternative Track To Graduation, Natalie Jennings, Michael Lehnerz

Occupational Therapy Capstones

Problem: According to the Bureau of Labor Statistics (2017), in 2016 the employment rate for persons with a disability was 17.9 percent compared to 65.3 percent for persons without a disability. The discrepancy between the employment rates can partially be contributed to a lack of high school readiness preparation as evidenced by Evert Cimera, Gonda, and Vaschak (2015) who found that the referral rates of transition-aged youth decreased from 62.3 percent in 2004 to 50.0 percent to 2013.

Purpose: The purpose of this scholarly project is to minimize the gap during the transition from high school to vocational …

Occupational Therapy Practice Trends For Occupations Impacted By Puberty In Children With Asd, Sydney Larson, Kelsey Hemberger

Occupational Therapy Capstones

Introduction: Adolescents face physical, social, cognitive, and emotional changes during the developmental stage of puberty. Pubertal changes can be difficult for neurotypical adolescents to cope with, but especially for individuals with autism spectrum disorder (ASD). Specifically, adolescents with ASD experience challenges with adapting to physical and emotional changes, managing new hygiene routines, abiding to social norms, and inappropriate sexual behaviors (Beddows & Brooks, 2016; Cridland, Caputi, Jones, & Magee, 2015; Cridland, Jones, Caputi, & Magee, 2014). While occupational therapy plays a role in helping adolescents with ASD, a lack of occupational therapy literature on this topic leads to unknown …

Promoting Successful Community Re-Integration For Incarcerated Juveniles: The Role Of Occupational Therapy To Enhance Quality Of Life, Madison Gerszewski, Bailey Odegaard

Occupational Therapy Capstones

The purpose of this scholarly project is to present a manual for occupational therapists working with juvenile delinquents in their transition into the community following incarceration. The intended outcome of the project is for juvenile delinquents to be independent, successful members of the community.

A literature review pertaining to juvenile delinquents was conducted and addressed recidivism, risk factors, and unmet needs. At this time, there are no practice guidelines in the United States that capture occupational therapy’s scope of practice when working with adolescents who have been involved in the criminal justice system.

A manual was developed in order to …

An Examination Of Primary Care Providers’ Assessment And Plan Of Care For Children And Adolescents Who Are Overweight Or Obese, Kevin Pinto

DNP Projects

Background: Childhood and adolescent obesity rates have more than tripled since the 1970s. Currently in the United States, one in five children is obese (6-19 years of age). It is important to identify children and adolescents who are overweight or obese because early intervention may help to reduce the long-term implications of obesity. The purpose of this project was to examine how often pediatric primary care providers diagnosed overweight or obesity and created a plan of care for children 6-17 years of age who were overweight or obese. Facilitators and barriers to diagnosing and creating a plan of care were …

Evaluation Of The Crafft Substance Use Screening Tool In Primary Care, Leanne Coleman

DNP Projects

PURPOSE: The purpose of this research study was to evaluate the use of the CRAFFT tool within a pediatric primary care setting. The specific objective was to assess the frequency of documentation of substance use screening, counseling, and/or intervention before and after the implementation of the CRAFFT tool.

METHOD: The practice site chose to implement an evidence based adolescent substance use screening tool (CRAFFT Tool) to improve practice. This practice improvement project utilized a descriptive design with a review of electronic medical records before and after a substance use screening tool was implemented. Two hundred medical records were reviewed, 100 …

Sexual Risk Behaviors Of African American Adolescent Females: The Role Of Cognitive And Religious Factors, Safiya George Dalmida, Natasha Aduloju-Ajijola, Dora L. Clayton-Jones, Tami Thomas, Ricardo J. Erazo Toscano, Rashunda Lewis, Terri Fleming, Shirley Taylor, Macie Lunyong

College of Nursing Faculty Research and Publications

Introduction: African American (AA) high school-age girls are more likely to have had sex before age 13 years and have higher rates of all sexually transmitted infections. Cognition and religion/spirituality are associated with adolescent sexuality, therefore, the purpose of this study was to identify cognitive and religious substrates of AA girls’ risky sexual behaviors. Method: A descriptive study was conducted with 65 AA girls aged 15 to 20 years using computerized questionnaires and cognitive function tasks. Results: Average age was 17.8 ± 1.9 years and average sexual initiation age was 15.5 ± 2.6 years. Overall, 57.6% reported a history of …

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 …

Adolescent Medicine Trials Network For Hiv/Aids Interventions Data Harmonization: Rationale And Development Of Guidelines, Micah Mccumber, Demetria Cain, Sara Legrand, Kenneth H. Mayer, Debra A. Murphy, Matthew A. Psioda, Arlene C. Seña, Tyrel J. Starks, Michael Hudgens

Publications and Research

Background: The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) research program aims to defeat the rising HIV epidemic among adolescents and young adults in the United States.

Objective: This study aims to optimize cross-study analyses and comparisons of standardized measures (variables) collected in the ATN. Methods: Guidelines were developed for harmonizing measures to be collected across ATN studies.

Results: Eight domains were identified for harmonization—Demographics and Socioeconomic Characteristics, Sexual Behavior and Risk, Substance Use and Abuse, HIV-Positive Cascade, HIV-Negative Cascade, Mental Health, Social Support and Isolation, and Pre-exposure Prophylaxis Cascade.

Conclusions: The collection of selected key measures in a …

Pilot Study: Knowledge And Attitudes Regarding Sport-Related Concussion In A Rural Interscholastic Sport Sample, Austin Westland

Electronic Theses and Dissertations

Context: Evidence supports education initiatives to improve knowledge of sport-related concussion (SRC) in active children and adolescents, as well as improve attitudes towards reporting concussion events to a supervising adult with the ultimate goal of early diagnosis and management. Most evidence focuses on urban and suburban children’s SRC knowledge and attitudes; however, little is known regarding knowledge and attitudes of children participating in sport in rural environments. Understanding current knowledge and attitudes of rural children can inform future education and health behavior strategies that encourage early reporting. Objective: Two objectives guided this study. First, obtain and analyze pilot data regarding …

The Who.I.Am Study : Identity Formation And Motor Competence In Adolescents, Amanda Timler

Theses

Our sense of identity is an emergent concept that develops over the lifespan in response to many factors, however the adolescent phase is the most critical. During adolescence, some factors that influence identity are level of parent and peer support, environmental stresses and the ability to form personal interests and goals. These factors influence the health of one’s identity in both positive and negative ways, which may differ between males and females. Therefore, identity health refers to an individual’s capacity to develop a positive sense of self and to integrate their self within a number of valuable social settings. One …

Neuropeptide Y Cells Regulate Anxiety Behavior, Katelynn Corder

All ETDs from UAB

Dysregulation of the GABAergic system has long been implicated in anxiety disorders. Classic anxiolytic drugs, such as benzodiazepines, increase GABAergic transmission by modulating GABA¬A receptors, relieving anxiety symptoms. However, these treatments are not always effective and are often accompanied by negative side effects. Glutamate decarboxylase (GAD) is the enzyme responsible for producing GABA. Recent studies have shown that when the isoform GAD67 is reduced in specific brain regions or GABAergic subtypes, differential anxiety effects were found. These studies suggest that targeting specific GABAergic cell subtypes may provide a more effective treatment for anxiety disorders. Neuropeptide Y (NPY) is an abundant …

Predictors Of Binge Drinking In High School Youths In Montgomery County, Maryland, Lum M. Fube

Walden Dissertations and Doctoral Studies

Underage drinking is a major problem in the United States, leading to increased morbidity and mortality. About 43,000 deaths a year result from binge drinking in youths at a cost of $24 billion in 2010 to the U.S. economy. The purpose of this quantitative dissertation was to examine the predictors of binge drinking in high school youths in a highly racial diverse community of Montgomery County, Maryland. The social ecological model was the theoretical framework used for this study due to the presence of both personal and contextual factors that influence behavior. Using binary logistic regression to analyze data from …

Independent And Interactive Associations Of Negative Affect, Restraint, And Impulsivity In Relation To Binge Eating Among Women, Tyler B. Mason, Kathryn E. Smith, Jason M. Lavender, Robin J. Lewis

Psychology Faculty Publications

There is growing recognition that impulsivity may serve as an underlying risk factor for binge eating. In addition, the association of impulsivity with binge eating may be moderated by other affective and cognitive risk factors. This study examined independent and interactive associations of negative affect, dietary restraint, and facets of impulsivity with binge eating. A diverse sample of 566 undergraduate women completed online questionnaires of study variables. Results revealed a three-way interaction of negative affect, dietary restraint, and attentional impulsivity in relation to binge eating. Women who were high on each of these three variables reported the greatest levels of …

Sexual Coercion, Drinking To Cope Motives, And Alcohol-Related Consequences Among Self-Identified Bisexual Women, Michelle L. Kelly, Sarah J. Ehlke, Robin J. Lewis, Abby L. Braitman, Wendy Bostwick, Kristin E. Heron, Cathy Lau-Barraco

Psychology Faculty Publications

Background: Given higher sexual victimization and greater alcohol use among bisexual women, a critical public health challenge is to understand within-group variation that may heighten or explain these associations in bisexual women. Objectives: The present study tested a moderated-mediation model in which sexual coercion was hypothesized to be associated with alcohol-related consequences via drinking to cope motives in self-identified bisexual women who reported at least occasional binge drinking. Negative affect was hypothesized to moderate the sexual coercion-drinking to cope motives association. Methods: Participants were a community sample of 107 self-identified bisexual women (age M = 20.97, SD = 2.11) who …

Vitamin E Status Is Inversely Associated With Risk Of Incident Tuberculosis Disease Among Household Contacts, Omowunmi Aibana, Molly F Franke, Chuan-Chin Huang, Jerome T Galea, Roger Calderon, Zibiao Zhang, Mercedes C Becerra, Emily R Smith, Carmen Contreras, Rosa Yataco, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Few studies have previously assessed how pre-existing vitamin E status is associated with risk of tuberculosis (TB) disease progression.

OBJECTIVE: We evaluated the association between baseline plasma concentrations of 3 vitamin E isomers (α-tocopherol, γ-tocopherol, and δ-tocopherol) and TB disease risk.

METHODS: We conducted a case-control study nested within a longitudinal cohort of household contacts (HHCs) of pulmonary TB cases in Lima, Peru. We defined cases as HHCs who developed active TB disease ≥15 d after the diagnosis of the index patient, and we matched each case to 4 control cases who did not develop active TB based on …