Public Health Commons^™

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

Capstone Experience: Master of Public Health

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

Assessing Quality Of Life And Mental Health Differences Among Young Adult Informal Caregivers And Non-Caregivers In Nebraska, Emily L. Frankel

Capstone Experience: Master of Public Health

The goal of this project is to identify differences in quality of life and mental health between younger informal caregivers and non-caregivers, ages 19-40, in Nebraska. To address this goal, a demographic and health assessment battery was disseminated to eligible participants (N=60), comprised of informal caregivers (N=30) and age-, education-, and gender-matched non-caregivers (N=30). The health assessment included reliable and validated questionnaires, including the RAND SF-36, EuroQol 5D, Kessler Psychological Distress Scale, and the General Health Questionnaire. By discovering relationships between quality of life and mental health with the length of time providing care, programming and intervention recommendations can be …

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

Capstone Experience: Master of Public Health

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

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

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

Capstone Experience: Master of Public Health

Abstract unavailable.

Assessing The Workforce Of The Southwest Nebraska Public Health Department For The Development Of A Workforce Development Plan, Arnel Ramos

Capstone Experience: Master of Public Health

The purpose of this project was to assess the capacity and needs of the Southwest Nebraska Public Health Department (SWNPHD) workforce and to develop a workforce development plan that would meet the accreditation standards of the Public Health Accreditation Board (PHAB). An assessment survey was developed online through the Survey Monkey website using competency skills based on the guidelines established by the Council on Linkages Between Academia and Public Health Practice. The selected competency skills were reviewed and approved for relevance by the SWNPHD leadership and the University of Nebraska Medical Center, College of Public Health, Office of Public Health …

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

Capstone Experience: Master of Public Health

Goal

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

Objectives

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

Methods

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

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

Capstone Experience: Master of Public Health

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

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

Capstone Experience: Master of Public Health

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

Implementation Of A Survey To Reduce Urine Pregnancy Tests Prior To Gynecology Procedures In Primary Care, Rachel Morgan Budihas

Capstone Experience: Master of Public Health

Excluding pregnancy in individuals prior to initiating contraception is important. The Pregnancy Reasonably Excluded Guide (PREG) uses twelve questions related to a patient’s reproductive history to effectively rule out pregnancy without administering a urine pregnancy screen, saving the patient both time and money. The PREG survey was given at Mayo Clinic in Rochester, MN, from 2015 to 2018 to all patients receiving an Intrauterine Device or Subdermal Implant.

This study examined data from the 2018 collection year to determine if urine screening requests by providers were reduced from the pre-PREG data. It also determined whether urine tests were requested disproportionally …

Effects Of Perioperative Hyperglycemia In Patients With Diabetes Compared To Patients Without Diabetes: A Retrospective Study Of Treatment And Outcomes, Matthew Anderson

Capstone Experience: Master of Public Health

The main goal of this project was to examine the differences in perioperative hyperglycemia treatment received by patients with a diagnosis of diabetes mellitus (DM) and patients without a diagnosis of diabetes (NDM); and how these treatment differences can affect the length of hospital stay. Studies have revealed that, when comparing DM and NDM patients with the same degree of perioperative hyperglycemia, NDM patients suffer worse outcomes. It has been suggested in previous research that this may be because NDM patients receive treatment that does not measure up to the standard of care treatment that DM patients receive. In this …

Do Molecular Subtypes Of Breast Cancer Affect Outcomes Following Hypofractionation Or Conventional Fractionation Radiation Therapy?, Richard Sleightholm

Capstone Experience: Master of Public Health

Introduction

Molecular subtypes of breast cancer (BC) are well-established prognostic markers in early-stage BC patients. The addition of radiation therapy (RT) to breast-conserving surgery has improved outcomes in this patient population, with conventional fractionation (CF) and hypofractionation (HF) regimens displaying comparable morbidity and mortality. However, most studies have not taken into account molecular subtype. Thus, it is still unknown if outcomes are similar between CF and HF for each molecular subtype. Herein, the effects of molecular subtype on the efficacy of CF and HF radiotherapy regimens for early-stage BC patients receiving adjuvant RT was investigated.

Methods

A retrospective review of …

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

Capstone Experience: Master of Public Health

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

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

Capstone Experience: Master of Public Health

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

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

Capstone Experience: Master of Public Health

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

Aim. This project …

Great Plains Behavioral Risk Factor Surveillance System Project, Florence G. Duran

Capstone Experience: Master of Public Health

Background: Great Plains American Indians/Alaska Natives (AI/ANs) experience higher mortality rates than Non-Hispanic Whites from the same region. The National Behavioral Risk Factors Surveillance System (BRFSS) survey can have limitations of the estimates the health risks behaviors and services from one Tribal community to another. Goals and Objectives: The goal of this project is to address the lack of Tribal specific data among AI/ANs in the Great Plains region (ND, SD, NE, IA) by using Great Plains Tribal BRFSS data that captured information for three tribes in the Great Plains region. Tribal specific data will allow tribes to access, …

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

Capstone Experience: Master of Public Health

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

Creation Of Evaluation Tools For Workforce Development Opportunities Within A Local Health Department, Nancy Ann Esch

Capstone Experience: Master of Public Health

Improving the skills and competencies of the Central District Health Department’s (CDHD) workforce is essential in assuring the public’s health. However, to develop the desired skills and competencies of the workforce requires effective training programs. CDHD provides professional development funds to all staff to attend workforce development opportunities that can be used on specific training relevant to their position. Approved trainings at CDHD, however, are not evaluated for effectiveness. This capstone project aimed to develop evaluation tools to help determine the effectiveness of training programs at the CDHD. Kirkpatrick’s Four Levels of Training Evaluation (2016) was used to help build …

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

Capstone Experience: Master of Public Health

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

The Association Between Neurocognitive Impairment And Health-Related Quality Of Life Among People Living With Human Immunodeficiency Virus (Hiv)., Philip S. Amara

Capstone Experience: Master of Public Health

Background: Despite the use of combination antiretroviral therapy, HIV associated neurocognitive impairment (NCI) persists in HIV seropositive persons, albeit in milder forms than before therapy was available. Nevertheless, the relationship between NCI and health-related quality of life (HRQoL) is not well known.

Method: Baseline data from the CHARTER study was used to investigate the association between NCI and HRQoL. Factor analysis was employed to summarize the 35-item Medical Outcome Survey questionnaire into physical and mental HRQoL scores. General linear models were employed to investigate the association between NCI, as measured by global deficit scores (GDS), and HRQoL, and to control …

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

Capstone Experience: Master of Public Health

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

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

Improving Antimicrobial Stewardship Programs In Small Community Hospitals Through An Assessment And Feedback Model, Philip Chung, Kate Tyner, Scott Bergman, Terry Micheels, Mark Rupp, Michelle Schwedhelm, Maureen Tierney, Muhammad Salman Ashraf, Trevor Van Schooneveld

Posters and Presentations: Nebraska ASAP

Small community hospitals often lack expertise and resources for antimicrobial stewardship program implementation. Using an assessment-and-feedback model, Nebraska ASAP performed onsite assessment of antimicrobial stewardship efforts in 5 small community hospitals and provided facility specific feedback on implementation/augmentation of antimicrobial stewardship program. As a result of this model, participating small community hospitals were able to increase the number of antimicrobial stewardship core elements implemented while reducing antibiotic use and incidence of CDI.

Assessment Of Trends In Population-Based Health Indicators In The Great Plain States, Jessica Pahwa, Shinobu Watanabe-Galloway

Posters and Presentations: College of Public Health

Purpose/Objective: The objective of this study is to analyze the geographic trends and to highlight the importance of social and geographic based health disparities using population health indicators and Health determinants among the great plains states (Nebraska, North Dakota and South Dakota).

Methods/efforts: Online databases (CDC, BRFSS, America’s Health Rankings, SAMHSA, County health rankings etc) were accessed to collect data population-based data for the great plains states. The incident rates of 10 health indicators and health determinants were chosen and studied. After tabulating the data in excel, the analysis was made through plotting graphs in SAS. Line graphs depicting the …

Ovalbumin-Sensitized Mice Have Altered Airway Inflammation To Agriculture Organic Dust, Kristi J. Warren, John D. Dickinson, Amy J. Nelson, Todd A. Wyatt, Debra J. Romberger, Jill A. Poole

Journal Articles: Environmental, Agricultural & Occupational Health

Agriculture exposures are associated with reducing the risk of allergy and asthma in early life; yet, repeated exposures later in life are associated with chronic bronchitis and obstructive pulmonary diseases. The objective of this study was to investigate the airway inflammatory response to organic dust extract (ODE) in mice with established ovalbumin (OVA)-induced experimental asthma. C57BL/6 mice were either OVA sensitized/aerosol-exposed or saline (Sal) sensitized/aerosol-challenged. Both groups were then subsequently challenged once with intranasal saline or swine confinement ODE to obtain 4 treatment groups of Sal-Sal, Sal-ODE, OVA-Sal, and OVA-ODE. Airway hyper-responsiveness (AHR) to methacholine, bronchiolar lavage fluid, lung tissues, …

Consequences Of Pathogen Lists: Why Some Diseases May Continue To Plague Us, David Brett-Major, Trina Racine, Gary P. Kobinger

Journal Articles: Epidemiology

The current strategy used by many funding agencies for determining how money is spent on research to help prevent infectious disease outbreaks is based on pathogen-specific priority lists. Listing disease threats provides focus for business and research planning conducive to specific goals of developing a drug, or a vaccine, or other particular product. But, this singular type of focus has consequences. This perspective explores the consequences of lists, and describes how parallel programming independent of disease lists that address what we need to do to prevent and mitigate emerging disease risks may provide benefits out of reach of a singular …

Effect Of Abo Blood Group On Asymptomatic, Uncomplicated And Placental Plasmodium Falciparum Infection: Systematic Review And Meta-Analysis, Abraham Degarege, Merhawi T. Gebrezgi, Consuelo M. Beck-Sague, Mats Wahlgren, Luiz Carlos De Mattos, Purnima Madhivanan

Journal Articles: Epidemiology

BACKGROUND: Malaria clinical outcomes vary by erythrocyte characteristics, including ABO blood group, but the effect of ABO blood group on asymptomatic, uncomplicated and placental Plasmodium falciparum (P. falciparum) infection remains unclear. We explored effects of ABO blood group on asymptomatic, uncomplicated and placental falciparum infection in the published literature.

METHODS: A systematic review and meta-analysis was performed using the preferred reporting items for systematic reviews and meta-analyses guidelines. Articles in Pubmed, Embase, Web of Science, CINAHL and Cochrane Library published before February 04, 2017 were searched without restriction. Studies were included if they reported P. falciparum infection incidence or prevalence, …

The Impact Of Travel Time On Colorectal Cancer Stage At Diagnosis In A Privately Insured Population, Mesnad Alyabsi, Mary Charlton, Jane L. Meza, K. M. Monirul Islam, Amr Soliman, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

BACKGROUND: Rural residents are less likely to receive screening for colorectal cancer (CRC) than urban residents. However, the mechanisms underlying this disparity, especially among people aged 50-64 years old with private health insurance, are not well understood. We examined the impact of travel time on stage at CRC diagnosis.

METHODS: This retrospective cohort study used data from the Blue Cross and Blue Shield of Nebraska. Members of this private insurance company aged 50-64 years, diagnosed with CRC during the period 2012-2016, and continuously enrolled in the insurance plan for at least 6 months prior to CRC diagnosis, were selected for …

Vaccination Coverage And Awareness Of Hepatitis B Virus Among Healthcare Students At A University In Cyprus, Zoe Roupa, Maria Noula, Evi A. Farazi, Antonis Stylianides, Christos Papaneophytou

Journal Articles: Epidemiology

Introduction: The risk for healthcare students to get infected by transmitting infectious viruses, including hepatitis B virus (HBV), in a hospital setting is extremely high through exposure to blood and/or body secretions.

Aim: The aim of this work was to evaluate both the vaccination history of healthcare students at a University in Cyprus and their serologic immunity against HBV. In addition, we assessed their knowledge and behaviors towards the transmission and prevention of hepatitis B (HB).

Results: Total amount of 168 students participated in this study and more than 50% of them provided complete documentation of vaccination history against HBV. …

Awareness Of Human Papilloma Virus And Cervical Cancer Prevention Among Cypriot Female Healthcare Workers, Andria Christodoulou, Jirayr Ajzajian, Dejun Su, Hongmei Wang, Zoe Roupa, Evi A. Farazi

Journal Articles: Epidemiology

Background: Cervical cancer incidence varies around the world with the highest rates in Eastern Africa and the lowest rates in Western Asia. In Cyprus, a small Mediterranean island, cervical cancer incidence was 6.4 per 100,000 in 2013. HPV is an established risk factor for cervical cancer with HPV-16 and HPV-18 being the most common carcinogenic strains. Cervical cancer is preventable through primary (HPV vaccination) and secondary (Pap and HPV tests) prevention. These prevention methods should be promoted, however, in order to design a cancer prevention programme and the awareness and characteristics of populations should be investigated so that prevention programmes …

Next-Generation Sequencing Of Hiv-1 Single Genome Amplicons, Gustavo H. Kijak, Eric Sanders-Buell, Phuc Pham, Elizabeth A. Harbolick, Celina Oropeza, Anne Marie O'Sullivan, Meera Bose, Charmagne G. Beckett, Mark Milazzo, Merlin L. Robb, Sheila A. Peel, Paul T. Scott, Nelson L. Michael, Adam W. Armstrong, Jerome H. Kim, David Brett-Major, Sodsai Tovanabutra

Journal Articles: Epidemiology

The analysis of HIV-1 sequences has helped understand the viral molecular epidemiology, monitor the development of antiretroviral drug resistance, and design candidate vaccines. The introduction of single genome amplification (SGA) has been a major advancement in the field, allowing for the characterization of multiple sequences per patient while preserving linkage among polymorphisms in the same viral genome copy. Sequencing of SGA amplicons is performed by capillary Sanger sequencing, which presents low throughput, requires a high amount of template, and is highly sensitive to template/primer mismatching. In order to meet the increasing demand for HIV-1 SGA amplicon sequencing, we have developed …

Using "Outbreak Science" To Strengthen The Use Of Models During Epidemics., Caitlin Rivers, Jean-Paul Chretien, Steven Riley, Julie A. Pavlin, Alexandra Woodward, David Brett-Major, Irina Maljkovic Berry, Lindsay Morton, Richard G. Jarman, Matthew Biggerstaff, Michael A. Johansson, Nicholas G. Reich, Diane Meyer, Michael R. Snyder, Simon Pollett

Journal Articles: Epidemiology

Infectious disease modeling has played a prominent role in recent outbreaks, yet integrating these analyses into public health decision-making has been challenging. We recommend establishing ‘outbreak science’ as an inter-disciplinary field to improve applied epidemic modeling.