Public Health Commons^™

A Comprehensive Literature Review Of Recruitment And Retention Strategies For Primary Care Providers In Rural Communities, Christian Folken

Capstone Experience: Master of Public Health

Workforce trends within the United States indicate a growing crisis in the availability and distribution of primary care providers. Rural communities have been disproportionately affected by the lack of primary care providers. The gap in available primary care services in rural areas severely affects the population health outcomes of these communities. There is a critical need for rural healthcare systems to effectively understand and implement recruitment and retention strategies of primary care providers to meet the needs of their patients and community. The goal of this paper is to provide a centralized resource of evidence-based strategies regarding the recruitment and …

Exploring Factors Related To Cancer Recurrence In Nebraska, Zenghan Tong

Capstone Experience: Master of Public Health

Currently, the studies of cancer burden are focused on the incidence, mortality, and survival of cancer. Due to the early detection and advancement of therapies, more patients can live much longer after a cancer diagnosis. Health care providers and patients want to know more about cancer recurrence, which can significantly impact cancer survivors’ quality of life. At this moment, the cancer recurrence studies are clinically based on specific treatments of particular cancers and are usually limited to small and selected populations. This study utilized the population-based cancer registry data between 1996-2015 to examine the cancer recurrence status in Nebraska. The …

Respiratory Syncytial Virus (Rsv) Laboratory Surveillance And Mortality In Nebraska, 2016 – 2021, Derek Bumgardner

Capstone Experience: Master of Public Health

Respiratory syncytial virus (RSV) is a common respiratory virus affecting children and adults. The United States RSV peak season occurs regularly between October to May, but in April 2021, an unexpected United States interseason RSV epidemic ensued. RSV laboratory testing has changed in the United States due to increased use of nucleic acid amplification testing (NAAT) rather than antigen-based testing, affecting how RSV seasonal epidemics are determined. Nebraska linked RSV laboratory and death certificate data (2016-2021) were used to calculate crude, specific and adjusted RSV case and mortality rates by age, sex, race, and ethnicity. A Cochran – Armitage test …

A Walk In Two Worlds: An Indigenous Health Research Mentorship Model Developed From The Experiences Of Mentors And Mentees In A Cancer Research Education Program Aimed At Increasing Representation Of American Indians/Alaska Natives In Cancer Research And Healthcare Professions, Kiana Borengasser, Aislinn C. Rookwood, Joyce C. Solheim, Maurice Godfrey, Karen Taraszka Hastings, Keyonna King, Hannah Robbins, Mariah Abney, Rudy Smith Jr., Liliana Tamayo, Regina Emily Robbins

Capstone Experience: Master of Public Health

The National Cancer Institute promotes workforce development programs that aim to increase representation of American Indian/Alaska Natives in health science and research careers. One such program, Youth Enjoy Science at the University of Nebraska Medical Center, has employed American Indian/Alaska Native youth in mentored cancer research internships from 2017 to 2022. The primary purpose of this study was to examine mentor and mentee experiences of participation in Youth Enjoy Science research education internships to learn from their stories. We conducted semi-structured interviews with current and former Youth Enjoy Science mentees (n=8) and mentors (n=8). We analyzed and collectively re-storied the …

The Epidemiology Of Extended Spectrum Beta-Lactamase-Producing Enterobacterales In Nebraska, 2018 – 2021, Axel A. Vazquez Deida

Capstone Experience: Master of Public Health

Background: Extended spectrum beta-lactamase (ESBL)-producing Enterobacterales are considered a serious public health threat by the United States Centers for Disease Control and Prevention. However, surveillance of ESBL-producing Enterobacterales is currently limited to select states and the epidemiology of these antibiotic-resistant bacteria in Nebraska is still not well understood.

Objective: To describe the incidence of ESBL-producing Enterobacterales across local health department (LHD)-jurisdictions as well as at the state-level over time and assess population-specific factors associated with infection or colonization with these pathogens in Nebraska.

Methods: A retrospective, cross-sectional analysis of public health surveillance data reported to the Nebraska Department of …

Atrazine Levels In Rural Nebraska Counties And Parkinson's Disease, Muhammad Zahid

Capstone Experience: Master of Public Health

Parkinson's disease (PD) is a multifactorial disorder, connecting both genetic susceptibility and environmental risk factors. Several epidemiological and experimental studies support the evidence that pesticides exposure is positively associated with enhancing neurodegenerative diseases. The high amount of atrazine used in Nebraska and increased PD cases led us to evaluate the association between the long-lived water-soluble pesticide atrazine and PD in Nebraska counties. A person's exposure to atrazine may come from inhalation, dermal absorption, and ingestion. Three types of atrazine data covering 1992 to 2017 were used for this study: applied atrazine, atrazine in surface water, and atrazine in groundwater. In …

A Systematic Literature Review Of The Use Of Technology As An Emergency Preparedness Tool To Control And Contain The Covid-19 Pandemic, Alyssa Spartz

Capstone Experience: Master of Public Health

Various tools and strategies have been utilized in response to the COVID-19 pandemic. In addition to preexisting measures, novel mechanisms and methods have also been developed since the COVID-19 pandemic began to address several different needs worldwide. Technology, for example, has served as a unique and multifunctional tool to aid with controlling and containing the pandemic. While studies and reviews have been conducted to analyze specific types of technology, such as digital applications, a gap in the literature currently exists that fails to comprehensively understand and compare how multiple types of technology were implemented to address the COVID-19 pandemic. This …

Testicular Torsion Education: Improving Awareness Among Boys And Their Caregivers Regarding The Urgency Of Evaluating Scrotal Pain, Abby Taylor

Capstone Experience: Master of Public Health

Introduction: Testicular torsion is a urologic emergency that requires prompt medical evaluation and surgical intervention. The length of time from onset of the torsion to evaluation in the emergency department is often delayed due to lack of knowledge of the urgency of the situation amongst boys and their caregivers. We hypothesize that an animated educational video will increase awareness of the condition and prompt urgent evaluation in the emergency department.

Methods: A 5-minute animated educational video was created following a boy, Danny, as he develops testicular torsion. Four population groups: boys, parents, school nurses, and pediatricians, completed group-specific pre- and …

Utilizing Re-Aim To Assess Adolescent Weight Loss Interventions: A Systematic Review, Jordan Mccullough

Capstone Experience: Master of Public Health

Adolescent overweight/obesity is an ongoing concern for public health professionals. One out of every five adolescents are overweight, and one out of every three is at risk. Adolescent overweight/obesity is associated with a higher chance of overweight/obesity, premature death, and disability in adulthood. A 2018 systematic review by Moores et al. compared the effectiveness of community-based treatment programs for adolescents (13-17 years) who are overweight and obese by comparing pre-program to post-program changes in weight-related measurements and health-behavior changes. While looking at the effectiveness of a program provides valuable information, other elements (i.e., representativeness of participants, implementation measures such as …

Helping Our Heroes: An Evaluation Of Mental Health And Organizational Policies Surrounding Suicide Prevention And Postvention Strategies For Nebraska First Responders, Maria S. Mickles

Capstone Experience: Master of Public Health

Suicide is ranked as one of the leading causes of death in the United States. Over 40,000 individuals die by suicide each year (Stanley, Hom, & Joiner, 2016; Vigil et al, 2021), and, in 2020, it was ranked in the top 9 causes of death for all ages (10-64), and second for those 10-14 and 25-34 years of age (Centers for Disease Control and Prevention, 2022). These statistics disproportionately reflect first responders (i.e., firefighters, dispatchers, law enforcement, EMS, paramedics, etc.), as they die by suicide more than the general public (National EMS Management Association, 2016). Within their line of work …

Rural And Agricultural Natural Disaster Stress And Recovery Study: Identifying Experiences And Community Preferences, Kristin K. Gaffney

Capstone Experience: Master of Public Health

Objective: The Rural Natural Disaster Stress and Recovery study surveyed flood and tornado affected residents (N=159 for analysis) in Arkansas and Nebraska, U.S., to address three hypotheses: 1) agricultural producers have different stress and recovery experiences compared to non-agricultural counterparts, 2) rural residents prefer community resources over external resources for disaster stress relief, and 3) communities can provide effective emotional health supports after disaster.

Methods: Demographics, exposure, stress, and recovery measures, and a resource use and effect inventory were analyzed in SAS with Chi-square tests, t-tests, Wilcoxon tests, and multiple linear regression modeling to identify differences between agricultural and non-agricultural …

Evaluation Of The University Of Nebraska Medical Center’S 4ms Geriatric Training Program At Nebraska Medicine Midtown, Holly M. Sesker

Capstone Experience: Master of Public Health

In 2015, the Health Resources and Services Administration (HRSA) created the Geriatrics Workforce Enhancement Program (GWEP) to address geriatric workforce challenges and improve the health outcomes of older adults. The GWEP redefines care delivery through a movement for age-friendly healthcare guided by evidence-based practices that align with the 4Ms: What Matters, Medication, Mentation, and Mobility. The 4Ms identify the key issues that should drive the decision-making and care for every older adult. 4Ms training sessions were conducted at the Nebraska Medicine Midtown Clinic and evaluated through a cross-sectional survey administered to both residents (trainees) and attendings (trainers). Data was collected …

Housing To Health: A Literature Review Analyzing Housing Pathways And Policy Initiatives, Evan P. Lesser

Capstone Experience: Master of Public Health

Housing is a vital aspect of an individual’s ability to enjoy a healthy lifestyle. It is so integral that the United Nations has stated that housing is a human right and extends beyond just basic shelter where housing should provide a certain level of structural integrity of the infrastructure, security, affordability, and access to surrounding resources. Existing research studying the relationship between housing and health outcomes suggest those with poor housing exhibit higher levels of chronic conditions such as asthma, heart disease, and diabetes, and higher chances of accidents within the home. The goal of this literature review, which has …

The Effect Of Post-Traumatic Stress Disorder On First Responders Following A Disaster: A Literature Review, Briar Butner

Capstone Experience: Master of Public Health

First responders work in a high-stress environment that can potentially produce traumatic situations. This includes aiding in the recovery and response efforts of critical events such as a disaster. A significant risk factor for developing post-traumatic stress disorder symptoms is people who have been through a disaster (National Institute of Mental Health, 2019). This literature review aims to search for evidence on PTSD in first responders following a disaster, identify the factors associated with the development of PTSD, and make recommendations on best practices to reduce or mitigate the incidences of PTSD. The search was conducted in three academic databases: …

The Use Of A Mobile Application And Text Messaging Platform To Improve Adherence To Medications In Solid Organ Transplant Patients, Lindsay M. Bruce

Capstone Experience: Master of Public Health

Poor adherence to medication regimens is responsible for 30-70% of all medication-related hospital admission in the United States and can be calculated to cost approximately $100 billion per year (Burra et al., 2011). The purpose of this pre-post cohort analysis is to measure the impact of using a mobile phone application and text messaging service on the medication possession ratio (MPR), a measure of adherence, among solid organ transplant patients who fill at Nebraska Medicine Outpatient Pharmacy. These interventions make it more convenient for patients to request refills, for pharmacy staff to send push notifications, and automatic refill and/or pickup …

Assessing Nutritional Health Knowledge In Sharing Clinic Patients With Diabetes, Minden Huntrods

Capstone Experience: Master of Public Health

Effective diabetes prevention and management relies on nutritional behaviors, thus a basic level of health knowledge is important for patients with diabetes and their caregivers in their quest to acquire acute glycemic control and minimize negative health outcomes (Ley et al., 2014). The purpose of this study was to assess the nutrition-related health knowledge of patients living with diabetes who are seen at the UNMC Sharing Clinic by use of a verbal questionnaire. This nutritional health knowledge assessment was a quantitative, prospective, survey-based study utilizing descriptive statistics. Approximately 86% of patients were proficient in food group and nutritious foods knowledge …

Interrogating Race And Place-Based Inequities In Hiv And Covid-19, Rohan Khazanchi

EMET Projects

Over the last four years, I have developed a research focus examining the intersections of race, place, and health. My M.D. Honors Thesis reflects a snapshot of these efforts. In this collection of brief research reports, I leverage area-based measures to investigate structural inequities in three contexts: the HIV epidemic in our hyperlocal community, the early stages of the COVID-19 pandemic, and clinical trials for novel COVID-19 therapeutics. I apply novel social epidemiologic tools to measure and explore disparate outcomes. And, in reflecting upon my findings, I discuss concrete implications for clinicians, researchers, and policymakers alike.

Chapter 1: Neighborhood-Level Deprivation …

Impact Of The Covid-19 Pandemic On The Malaria Control Program At The Epidemic Treatment Center Of Regional Hospital Of Kindia, Guinea, Mohamed Keita

Capstone Experience: Master of Public Health

The impact of infectious disease outbreaks and pandemics on the health systems could be alarming especially when there is an overlap in clinical manifestations of two infectious conditions. Despite the remarkable progress in reducing the burden of malaria in Africa since 2000, the COVID-19 pandemic has impacted the malaria control program. This paper describes the impact of the COVID- 19 pandemic on the health service delivery in Guinea and its consequences on malaria control programs before and during the COVID 19 pandemic. This paper aims to assess the impact of the COVID 19 pandemic on the malaria control program between …

Comparative Transmissibility Of Sars-Cov-2 Variants Delta And Alpha In New England, Usa, Rebecca Earnest, Rockib Uddin, Nicholas Matluk, Nicholas Renzette, Katherine J. Siddle, Christine Loreth, Gordon Adams, Christopher H. Tomkins-Tinch, Mary E. Petrone, Jessica E. Rothman, Mallery I. Breban, Robert Tobias Koch, Kendall Billig, Joseph R. Fauver, Chantal B.F. Vogels, Sarah Turbett, Kaya Bilguvar, Bony De Kumar, Marie L. Landry, David R. Peaper, Kevin Kelly, Greg Omerza, Heather Grieser, Sim Meak, John Martha, Hannah H. Dewey, Susan Kales, Daniel Berenzy, Kristin Carpenter-Azevedo, Ewa King, Richard C. Huard, Sandra C. Smole, Catherine M. Brown, Timelia Fink, Andrew S. Lang, Glen R. Gallagher, Pardis C. Sabeti, Stacey Gabriel, Bronwyn L. Macinnis, New England Variant Investigation Team, Ryan Tewhey, Mark D. Adams, Daniel J. Park, Jacob E. Lemieux, Nathan D. Grubaugh

Journal Articles: Epidemiology

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant quickly rose to dominance in mid-2021, displacing other variants, including Alpha. Studies using data from the United Kingdom and India estimated that Delta was 40-80% more transmissible than Alpha, allowing Delta to become the globally dominant variant. However, it was unclear if the ostensible difference in relative transmissibility was due mostly to innate properties of Delta's infectiousness or differences in the study populations. To investigate, we formed a partnership with SARS-CoV-2 genomic surveillance programs from all six New England US states. By comparing logistic growth rates, we found that Delta …

Lineage Abundance Estimation For Sars-Cov-2 In Wastewater Using Transcriptome Quantification Techniques, Jasmijn A. Baaijens, Alessandro Zulli, Isabel M. Ott, Ioanna Nika, Mart J. Van Der Lugt, Mary E. Petrone, Tara Alpert, Joseph R. Fauver, Chaney C. Kalinich, Chantal B. F. Vogels, Mallery I. Breban, Claire Duvallet, Kyle A. Mcelroy, Newsha Ghaeli, Maxim Imakaev, Malaika F. Mckenzie-Bennett, Keith Robison, Alex Plocik, Rebecca Schilling, Martha Pierson, Rebecca Littlefield, Michelle L. Spencer, Birgitte B. Simen, Yale Sars-Cov-2 Genomic Surveillance Initiative, William P. Hanage, Nathan D. Grubaugh, Jordan Peccia, Michael Baym

Journal Articles: Epidemiology

Effectively monitoring the spread of SARS-CoV-2 mutants is essential to efforts to counter the ongoing pandemic. Predicting lineage abundance from wastewater, however, is technically challenging. We show that by sequencing SARS-CoV-2 RNA in wastewater and applying algorithms initially used for transcriptome quantification, we can estimate lineage abundance in wastewater samples. We find high variability in signal among individual samples, but the overall trends match those observed from sequencing clinical samples. Thus, while clinical sequencing remains a more sensitive technique for population surveillance, wastewater sequencing can be used to monitor trends in mutant prevalence in situations where clinical sequencing is unavailable.

Zip8-Mediated Intestinal Dysbiosis Impairs Pulmonary Host Defense Against Bacterial Pneumonia, Derrick R. Samuelson, Deandra R. Smith, Kelly C. Cunningham, Todd A. Wyatt, Sannette C. Hall, Daryl J. Murry, Yashpal S. Chhonker, Daren L. Knoell

Journal Articles: Environmental, Agricultural & Occupational Health

Pneumococcal pneumonia is a leading cause of morbidity and mortality worldwide. An increased susceptibility is due, in part, to compromised immune function. Zinc is required for proper immune function, and an insufficient dietary intake increases the risk of pneumonia. Our group was the first to reveal that the Zn transporter, ZIP8, is required for host defense. Furthermore, the gut microbiota that is essential for lung immunity is adversely impacted by a commonly occurring defective ZIP8 allele in humans. Taken together, we hypothesized that loss of the ZIP8 function would lead to intestinal dysbiosis and impaired host defense against pneumonia. To …

Sars-Cov-2 Dysregulates Neutrophil Degranulation And Reduces Lymphocyte Counts, Abenaya Muralidharan, Todd A. Wyatt, St. Patrick Reid

Journal Articles: Environmental, Agricultural & Occupational Health

SARS-CoV-2, the virus that causes COVID-19, has given rise to one of the largest pandemics, affecting millions worldwide. High neutrophil-to-lymphocyte ratios have been identified as an important correlate to poor recovery rates in severe COVID-19 patients. However, the mechanisms underlying this clinical outcome and the reasons for its correlation to poor prognosis are unclear. Furthermore, the mechanisms involved in healthy neutrophils acquiring a SARS-CoV-2-mediated detrimental role are yet to be fully understood. In this study, we isolated circulating neutrophils from healthy donors for treatment with supernates from infected epithelial cells and direct infection with SARS-CoV-2 in vitro. Infected epithelial cells …

Aldehyde Trapping By Adx-102 Is Protective Against Cigarette Smoke And Alcohol Mediated Lung Cell Injury, Carmen A. Ochoa, Claire Nissen, Deanna Mosley, Christopher Bauer, Destiny Jordan, Kristina L. Bailey, Todd A. Wyatt

Journal Articles: Environmental, Agricultural & Occupational Health

Most individuals diagnosed with alcohol use disorders smoke cigarettes. Large concentrations of malondialdehyde and acetaldehyde are found in lungs co-exposed to cigarette smoke and alcohol. Aldehydes directly injure lungs and form aldehyde protein adducts, impacting epithelial functions. Recently, 2-(3-Amino-6-chloroquinolin-2-yl)propan-2-ol (ADX-102) was developed as an aldehyde-trapping drug. We hypothesized that aldehyde-trapping compounds are protective against lung injury derived from cigarette smoke and alcohol co-exposure. To test this hypothesis, we pretreated mouse ciliated tracheal epithelial cells with 0–100 µM of ADX-102 followed by co-exposure to 5% cigarette smoke extract and 50 mM of ethanol. Pretreatment with ADX-102 dose-dependently protected against smoke and …

Surface Modification Of Biodegradable Microparticles With The Novel Host-Derived Immunostimulant Cpdi-02 Significantly Increases Short-Term And Long-Term Mucosal And Systemic Antibodies Against Encapsulated Protein Antigen In Young Naïve Mice After Respiratory Immunization, Jacob E. Parriott, Jason P. Stewart, D. David Smith, Stephen M. Curran, Christopher D. Bauer, Todd A. Wyatt, Joy A. Phillips, Elizabeth Lyden, Geoffrey M. Thiele, Joseph A. Vetro Phd

Journal Articles: Environmental, Agricultural & Occupational Health

Generating long-lived mucosal and systemic antibodies through respiratory immunization with protective antigens encapsulated in nanoscale biodegradable particles could potentially decrease or eliminate the incidence of many infectious diseases, but requires the incorporation of a suitable mucosal immunostimulant. We previously found that respiratory immunization with a model protein antigen (LPS-free OVA) encapsulated in PLGA 50:50 nanoparticles (~380 nm diameter) surface-modified with complement peptide-derived immunostimulant 02 (CPDI-02; formerly EP67) through 2 kDa PEG linkers increases mucosal and systemic OVA-specific memory T-cells with long-lived surface phenotypes in young, naïve female C57BL/6 mice. Here, we determined if respiratory immunization with LPS-free OVA encapsulated in …

Post-Endotoxin Exposure-Induced Lung Inflammation And Resolution Consequences Beneficially Impacted By Lung-Delivered Il-10 Therapy, Jill A. Poole, Rohit Gaurav, Aaron Schwab, Amy J. Nelson, Angela Gleason, Debra J. Romberger, Todd A. Wyatt

Journal Articles: Environmental, Agricultural & Occupational Health

Although lung diseases typically result from long-term exposures, even a robust, one-time exposure can result in long-lasting consequences. Endotoxin is a ubiquitous environmental/occupational inflammatory agent often used to model airway inflammation. Using a murine model, the return to lung homeostasis following high dose inhalant lipopolysaccharide (LPS, 10-100 μg) exposure were delineated over 2 weeks. LPS-induced rapid weight loss, release of proinflammatory mediators, and inflammatory cell influx with prolonged persistence of activated macrophages CD11c⁺CD11b⁺ and recruited/transitioning CD11c^intCD11b⁺ monocyte-macrophages out to 2 weeks. Next, lung-delivered recombinant (r) interleukin (IL)-10 was intratracheally administered for 3 doses initiated …

Quantifying The Impact Of Immune History And Variant On Sars-Cov-2 Viral Kinetics And Infection Rebound: A Retrospective Cohort Study, James A. Hay, Stephen M. Kissler, Joseph R. Fauver, Christina Mack, Caroline G. Tai, Radhika M. Samant, Sarah Connolly, Deverick J. Anderson, Gaurav Khullar, Matthew Mackay, Miral Patel, Shannan Kelly, April Manhertz, Isaac Eiter, Daisy Salgado, Tim Baker, Ben Howard, Joel T. Dudley, Christopher E. Mason, Manoj Nair, Yaoxing Huang, John Difiori, David D. Ho, Nathan D. Grubaugh, Yonatan H. Grad

Journal Articles: Epidemiology

BACKGROUND: The combined impact of immunity and SARS-CoV-2 variants on viral kinetics during infections has been unclear.

METHODS: We characterized 1,280 infections from the National Basketball Association occupational health cohort identified between June 2020 and January 2022 using serial RT-qPCR testing. Logistic regression and semi-mechanistic viral RNA kinetics models were used to quantify the effect of age, variant, symptom status, infection history, vaccination status and antibody titer to the founder SARS-CoV-2 strain on the duration of potential infectiousness and overall viral kinetics. The frequency of viral rebounds was quantified under multiple cycle threshold (Ct) value-based definitions.

RESULTS: Among individuals detected …

Exposure To Toxicants Associated With Use And Transitions Between Cigarettes, E-Cigarettes, And No Tobacco, Hongying Dai, Neal L. Benowitz, Chandran Achutan, Evi A. Farazi, Abraham Degarege, Ali S. Khan

Journal Articles: Epidemiology

Importance: Transitions between e-cigarettes and cigarettes are common among tobacco users, but empirical evidence on the health outcomes of switching tobacco products is scarce.

Objectives: To examine changes in urinary biomarkers between baseline and 1-year follow-up among adult tobacco users switching between e-cigarettes and cigarettes.

Design, Setting, and Participants: This cohort study used data from wave 1 (baseline, September 2013 to December 2014) and wave 2 (1-year follow-up, October 2014 to October 2015) of the Population Assessment of Tobacco and Health Study. A subset of the probability sample of US adults who voluntarily provided biospecimens at 2 waves was analyzed. …

Access, Socioeconomic Environment, And Death From Covid-19 In Nebraska, He Bai, Michelle M. Schwedhelm, John-Martin Lowe, Rachel Lookadoo, Daniel R. Anderson, Abigail Lowe, James V. Lawler, M. Jana Broadhurst, David Brett-Major

Journal Articles: Epidemiology

Our study assesses whether factors related to healthcare access in the first year of the pandemic affect mortality and length of stay (LOS). Our cohort study examined hospitalized patients at Nebraska Medicine between April and October 2020 who were tested for SARS-CoV-2 and had a charted sepsis related diagnostic code. Multivariate logistic was used to analyze the odds of mortality and linear regression was used to calculate the parameter estimates of LOS associated with COVID-19 status, age, gender, race/ethnicity, median household income, admission month, and residential distance from definitive care. Among 475 admissions, the odds of mortality is greater among …

Disparities In Awareness Of And Willingness To Participate In Cancer Clinical Trials Between African American And White Cancer Survivors, Gaurav Kumar, Jungyoon Kim, Paraskevi A. Farazi, Hongmei Wang, Dejun Su

Journal Articles: Epidemiology

BACKGROUND: Cancer clinical trials (CCTs) are essential for cancer care, yet the evidence is scarce when it comes to racial disparities in CCT participation among cancer survivors in the Midwest. This study aimed to 1) assess disparities in the awareness of and willingness to participate in CCTs between African American and White cancer survivors; and 2) compare perceptions about CCTs between the two racial groups.

METHODS: The study was based on cross-sectional data from the survey "Minority Patient Participation in Cancer Clinical Trials" that collected information from 147 Black and White cancer survivors from Nebraska between 2015 and 2016. Chi-square …

Fielding Vaccines-Challenges And Opportunities In Outbreaks, Complex Emergencies, And Mass Gatherings, Laura J. Fischer, Robert C. Rains, Sherry M. Brett-Major, Mikiko Senga, Debra Holden, David Brett-Major

Journal Articles: Epidemiology

With the recent COVID-19 pandemic, the importance of vaccine development, distribution, and uptake has come to the forefront of the public eye. Effectively fielding vaccines during an emergency-whether that emergency is a result of an infectious disease or not-requires an understanding of usual vaccine-related processes; the impact of outbreak, complex emergencies, mass gatherings, and other events on patients, communities, and health systems; and ways in which diverse resources can be applied to successfully achieve needed vaccine uptake. In this review, both the emergency setting and briefly vaccine product design are discussed in these contexts in order to provide a concise …