Public Health Commons^™

Nebraska Wic Client Survey & Study Of Preterm Birth, Caleb Unekwu Adejoh

Capstone Experience: Master of Public Health

Background: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program provides supplemental foods, health care referrals, and nutrition education to low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children. Preterm birth remains the second leading cause of infant mortality following birth defects but there is a dearth of research on characteristics of WIC clients who are at risk of preterm birth. Objectives: The objective of the service learning was to design paper and online client satisfaction survey forms in English and Spanish for use by the Nebraska WIC program. The objective of …

Municipal Drinking Water Quality: Environmental Health And Safety Perceptions In Phoenix, Arizona, Chelsey Weaver

Capstone Experience: Master of Public Health

The goals of the Service Learning/Capstone Experience (SL/CE) project included identifying current perceptions regarding lead in municipal drinking water and related environmental health and safety concerns in the Sunnyslope community of Phoenix, Arizona; evaluating and improving the current outreach program in order to effectively target drinking water perceptions; and identifying strengths and weaknesses in the City of Phoenix Water Services Department (WSD) and Environmental Services Division (ESD) that contribute to negative public perceptions of municipally supplied drinking water. Objectives used to meet the stated goals included developing and distributing a survey to measure perceptions of the above issues through a …

The Incidence Rate, Types, And External Causes Of Traumatic Brain Injuries In Parkinson’S Disease Patients In Nebraska 2008-2014, Maher Alsaadi

Capstone Experience: Master of Public Health

Background: Parkinson’s disease (PD) patients are at higher risk of traumatic brain injury (TBI) due to disease characteristics like tremor, bradykinesia, and impaired balance. Most of the studies that have been done in the United States to investigate the incident rate and causes of TBI among PD patients have mainly focused on falls, while none of these studies have thoroughly addressed all causes of TBI among the PD population or have used a population-based database. Our study aims to investigate the incidence rate, types, and external causes of TBI stratified by age of PD diagnosis using a population-based database from …

An Assessment Of Nontuberculous Mycobacteria In Nebraska, Molly Hoffman

Capstone Experience: Master of Public Health

Background. Nontuberculous mycobacteria (NTM) are an important cause of morbidity and mortality in the U.S., yet not much is known about the prevalence and risk factors. It is thought to be increasing and most commonly found in women and older adults. The objectives of this project were to estimate the burden of NTM in Nebraska and to describe the patterns of NTM infection including location, species, specimen source, and patient demographic characteristics.

Methods. The National Electronic Disease Surveillance System was searched for all NTM infections reported from 2012-2017. Cases were classified as either pulmonary or nonpulmonary and available information was …

Assessment Of Caffeine And Sugar Sweetened Beverage Consumption Among Adult Pregnant Women In An Urban Medical Center In Nebraska, Shilpa Karanjit

Capstone Experience: Master of Public Health

Abstract

Background: Unhealthy non-alcoholic drinks for pregnant women include beverages with high caffeine and added sugar. High caffeine intake during pregnancy has been reported to be linked with adverse pregnancy outcomes such as miscarriages and stillbirth. In addition, high sugar-sweetened-beverages (SSBs) intake increases the risk of maternal obesity that is associated with many serious health problems in both mother and the fetus such as gestational diabetes, hypertension, congenital anomalies, macrosomia, childhood obesity and cardiac diseases. Maternal obesity also increases the cost of prenatal and postnatal healthcare by increasing the need of surgical and anesthetic care for mother and intensive care …

Needs Assessment And Management In Geriatric Patients Of A Federally Qualified Health Center, Nora Kovar

Capstone Experience: Master of Public Health

The purpose of this project was to identify opportunities for quality improvement in the care of geriatric patients at OneWorld Community Health Centers (OneWorld) by applying the principles of Community Oriented Primary Care (COPC) in the implementation of the Medicare Annual Wellness Visit (AWV).

Specific objectives were to better understand factors affecting geriatric health risk assessment and management (including implementation of the Medicare AWV) in federally qualified health centers (FQHCs) and to utilize data from pilot visits to better understand patient health needs in one FQHC, with emphasis on fall risk, cognitive loss, activities of daily living, and compliance with …

Symptom Clusters And Quality Of Life Trajectories In Breast Cancer Patients Before And After Chemotherapy, Gaurav Kumar

Capstone Experience: Master of Public Health

Context. Breast cancer patients experience multiple concurrent symptoms before and after chemotherapy (CTX). Physical and psychological symptoms may persist after treatment and reduce the quality of life (QOL) of survivors.

Objectives. Identify differences in prevalence and severity of symptoms at three times within 1- year of starting CTX; and identify symptom cluster and QOL trajectories over these times in breast cancer patients.

Methods. Symptoms were identified in breast cancer patients (N=219) before the start of CTX (baseline), 30 days after the last CTX, and 1-year after the first CTX. Hospital Anxiety and Depression Scale and Symptom Experience Scale …

Occupational Health Challenges In Research, Anthony Blake

Capstone Experience: Master of Public Health

ABSTRACT

Introduction: Employees working in universities and hospitals are faced with common and unique health and safety challenges. Usually, the campus Department of Health and Safety is tasked with reducing employee exposure through risk assessments. Purpose: In this study, we present a unique risk assessment case study related to a research project undertaken by the campus Department of Health and Safety (DHES). This project also describes the activities done by DHES to improve campus safety. We hypothesized that carbon monoxide, particulate matter, formaldehyde, and VOCs emitted from burning wood chips in a closed laboratory space will exceed …

Matters Of Trust: Examination Of The Patient-Provider Relationship In Cancer Care, Krista A. Brown

Capstone Experience: Master of Public Health

Background: The intangible concept of trust is critical in the patient-provider relationship. Cancer patients may experience positive and negative impacts of trust in this relationship to a higher degree due to the inherently serious nature of their disease and the level of dependence upon treatment providers.

Objective: The goal of this study was to compare colorectal cancer patients’ levels of trust in their primary care physician and oncologist, along with examining trust differences associated with demographics and other characteristics.

Methods: Colorectal cancer patients (n=158) treated at Nebraska Medicine and consented into the Integrated Cancer Repository for Cancer Research IRB …

Hearing Conservation Program On A Campus: Worker Noise Exposure Assessment And Training, Tika Nepal

Capstone Experience: Master of Public Health

Abstract

Introduction: Campus workers are exposed to loud noise from boilers, chillers, generators, snow blowers, leaf blowers, helicopters, utility vehicles, laboratory animals etc. No studies have looked at characterizing noise exposures among campus workers to see who needed to be enrolled in the Hearing Conservation Program (HCP).

Goal: The goal of this study was to determine which employees needed to be enrolled in a HCP.

Methods: This was a cross sectional study conducted among campus workers. We identified utility plant workers, comparative medicine workers, landscaping crew, security officers and facility staff who used utility vehicles as employees potentially exposed to …

Student Moves: A Mixed Methods Cross- Sectional Study Of Elementary School- Based Physical Education In Omaha Public Schools, Ashley Carroll

Capstone Experience: Master of Public Health

Childhood obesity is one of the leading pediatric health problems and a major concern among Omaha metro parents (Professional Research Consultants, 2015). While there are many inter-related factors that contribute to the development of obesity, physical inactivity is a prominent risk factor. Targeting physical activity in health promotion is desirable for its feasibility and effectiveness in balancing energy consumption and expenditure (Hill, 2012). The Student Moves research project sought to inform school district and community strategies for promoting youth physical activity by assessing current physical education practices among a random sample of third- grade students in Omaha Public Schools. Variables …

Development Of A Provider Referral Network For The National Diabetes Prevention Program In Northeast Nebraska, Carling Adams

Capstone Experience: Master of Public Health

Diabetes continues to be a significant health problem for Americans, including Nebraskans. The National Diabetes Prevention Program has designed a course for individuals with prediabetes to implement lifestyle changes and reduce their risk for developing diabetes. Although Elkhorn Logan Valley Public Health Department (ELVPHD) has offered this course for a few years, they have struggled to enroll enough participants for CDC recognition. The purpose of this project was to work with ELVPHD to develop a provider referral network for the National Diabetes Prevention Program (DPP) courses offered by the health department. In establishing this network, the goal was to increase …

Effect Of Nitrosamine (Nnat) On Embryogenesis: Evidence From A Study Using Avian Embryos Exposed To Nnat, Moses New-Aaron, Martha Rhoades, Jane L. Meza, Jeffrey Wallman

Posters and Presentations: College of Public Health

Background

Birth defects are a known cause of infant death in the United States with higher rates in the Midwest perhaps due to higher use of agrichemicals for farm activities. Nitrate and atrazine are two of the most prevalent agrichemicals contaminating drinking water supplies. When ingested together, in the acidic environment of the human stomach, they can react to form a nitrosamine, NNAT. Many nitrosamines are known to be mutagenic, carcinogenic and teratogenic.

Significance

Preliminary studies have suggested that NNAT is a teratogen and mutagen. Several other agrichemical compounds have been detected in Nebraska groundwater wells that have the potential …

A Systematic Review Of Universal, Teacher-Led Interventions Targeting Anxiety In U.S. Schools, Sonja F. Tutsch, Patrick Fowler, Gaurav Kumar, Adam Weaver, Brian Mckevitt, Denise Britigan, Christian I.J. Minter, Lorena Baccaglini

Posters and Presentations: College of Public Health

Implications of anxiety symptomatology experienced among children and adolescents in the US constitute a major public health crisis, calling for promising universal mental health interventions in K-12 schools. Schools represent an ideal setting for the implementation of population based, public health interventions, as children and adolescents spend a significant proportion of time in school. Discussions within the scientific community document several advantages to utilization of universal, Tier1 interventions. However, the efficacy of universal, school-based anxiety interventions in the US are not consistently documented. The purpose of this study is to systematically review the literature to identify the efficacy of universal …

Cervical Cancer Screening Among Patients Receiving Arvs In A Resource-Limited Environment, Moses New-Aaron, Jane L. Meza, Martha Goedert, Stephen Kibusi, Samwel Sumba, Caroline Damien, Siraj Shabani, James Charles

Posters and Presentations: College of Public Health

Significance

Cervical cancer is the most common cancer worldwide with increased risk among women living with HIV in a resource limited environment. Hence the need to determine factors affecting awareness, prior uptake of cervical cancer screening and willingness to screen among patients receiving Antiretroviral (ARV) drugs.

Data analysis

The data was collected by administered questionnaires to patients presenting for monthly ARV refills in a HIV clinic in Dodoma, Tanzania. A total of 421 women in the clinic with an average monthly income of 39 (USD) were interviewed. A total of 306 (73%) were aware of cervical cancer. Among those who …

The Status Of The Healthcare Workforce In The State Of Nebraska, Fernando A. Wilson, Nizar K. Wehbi, Jamie Larson, Kavita Mosalpuria, Ethan Chen, Marlene Deras

Reports: Center for Health Policy

No abstract provided.

The Impact On Youth Smoking Of Increasing The Cigarette Tax In Nebraska: An Update For 2018, Fernando A. Wilson, Nizar K. Wehbi, Jamie Larson, Li-Wu Chen

Reports: Center for Health Policy

No abstract provided.

Virtual Mentorship Network To Address The Rural Shortage Of Mental Health Providers, Heidi Keeler, Tara Sjuts, Kosuke Niitsu, Shinobu Watanabe-Galloway, Paul Force-Emery Mackie, Howard Liu

Journal Articles: Epidemiology

INTRODUCTION: The process of identifying effective responses to the challenges of placing and retaining a rural behavioral health workforce remains elusive. The Virtual Mentorship Network was developed to test the feasibility of using distance technology to connect rural students interested in mental health careers with mentors.

METHODS: In Year 1, college and high school students were virtually mentored using a near-peer approach both live and asynchronously as a cohort over 7 months. In Year 2, college students only were virtually intensely mentored live over 1 month. High school students were asynchronously provided with informational videos produced by mentors. Program benefits …

Organic Barn Dust Inhibits Surfactant Protein D Production Through Protein Kinase-C Alpha Dependent Increase Of Gpr116, David Schneberger, Jane M. Devasure, Shelley A. Kirychuk, Todd A. Wyatt

Journal Articles: Environmental, Agricultural & Occupational Health

Prolonged exposure to organic barn dusts can lead to chronic inflammation and a broad range of lung problems over time, mediated by innate immune mechanisms. The immune surfactant or collectin surfactant protein D (SP-D) is a crucial multifunctional innate immune receptor. Little work to date has examined the effect of such collectins in response to organic dusts. We provide evidence here that agricultural organic dusts can inhibit mRNA and protein expression of SP-D in a human alveolar epithelial cell line, and an in vivo mouse model. This inhibition was not a result of lipopolysaccharide (LPS) or peptidoglycans, the two most …

Clinical Features Of Guillain-Barré Syndrome With Vs Without Zika Virus Infection, Puerto Rico, 2016, Emilio Dirlikov, Chelsea G. Major, Nicole A. Medina, Roberta Lugo-Robles, Desiree Matos, Jorge L. Muñoz-Jordan, Candimar Colon-Sanchez, Myriam Garcia, Marangely Olivero-Segarra, Graciela Malave, Gloria M. Rodríguez-Vega, Dana L. Thomas, Stephen H. Waterman, James J. Sejvar, Carlos A. Luciano, Tyler M. Sharp, Brenda Rivera-García

Journal Articles: Epidemiology

Importance: The pathophysiologic mechanisms of Guillain-Barré syndrome (GBS) associated with Zika virus (ZIKV) infection may be indicated by differences in clinical features.

Objective: To identify specific clinical features of GBS associated with ZIKV infection.

Design, Setting, and Participants: During the ZIKV epidemic in Puerto Rico, prospective and retrospective strategies were used to identify patients with GBS who had neurologic illness onset in 2016 and were hospitalized at all 57 nonspecialized hospitals and 2 rehabilitation centers in Puerto Rico. Guillain-Barré syndrome diagnosis was confirmed via medical record review using the Brighton Collaboration criteria. Specimens (serum, urine, cerebrospinal fluid, and saliva) from …

Evidence-Based Guidelines For Supportive Care Of Patients With Ebola Virus Disease, François Lamontagne, Robert A. Fowler, Neill K. Adhikari, Srinivas Murthy, David Brett-Major, Michael Jacobs, Timothy M. Uyeki, Constanza Vallenas, Susan L. Norris, William A. Fischer, Thomas E. Fletcher, Adam C. Levine, Paul Reed, Daniel G. Bausch, Sandy Gove, Andrew Hall, Susan Shepherd, Reed A. Siemieniuk, Marie-Claude Lamah, Rashida Kamara, Phiona Nakyeyune, Moses J. Soka, Ama Edwin, Afeez A. Hazzan, Shevin T. Jacob, Mubarak Mustafa Elkarsany, Takuya Adachi, Lynda Benhadj, Christophe Clément, Ian Crozier, Armando Garcia, Steven J. Hoffman, Gordon H. Guyatt

Journal Articles: Epidemiology

The 2013-16 Ebola virus disease outbreak in west Africa was associated with unprecedented challenges in the provision of care to patients with Ebola virus disease, including absence of pre-existing isolation and treatment facilities, patients' reluctance to present for medical care, and limitations in the provision of supportive medical care. Case fatality rates in west Africa were initially greater than 70%, but decreased with improvements in supportive care. To inform optimal care in a future outbreak of Ebola virus disease, we employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to develop evidence-based guidelines for the delivery of supportive …

Variation In Competence For Zikv Transmission By Aedes Aegypti And Aedes Albopictus In Mexico, Selene M. Garcia-Luna, James Weger-Lucarelli, Claudia Rückert, Reyes A. Murrieta, Michael C. Young, Alex D. Byas, Joseph R. Fauver, Rushika Perera, Adriana E. Flores-Suarez, Gustavo Ponce-Garcia, Americo D. Rodriguez, Gregory D. Ebel, William C. Black

Journal Articles: Epidemiology

BACKGROUND: ZIKV is a new addition to the arboviruses circulating in the New World, with more than 1 million cases since its introduction in 2015. A growing number of studies have reported vector competence (VC) of Aedes mosquitoes from several areas of the world for ZIKV transmission. Some studies have used New World mosquitoes from disparate regions and concluded that these have a variable but relatively low competence for the Asian lineage of ZIKV.

METHODOLOGY/PRINCIPAL FINDINGS: Ten Aedes aegypti (L) and three Ae. albopictus (Skuse) collections made in 2016 from throughout Mexico were analyzed for ZIKV (PRVABC59-Asian lineage) VC. Mexican …

Adherence And Perceived Barriers To Oral Antiviral Therapy For Chronic Hepatitis B, Kerui Xu, Li-Ming Liu, Evi A. Farazi, Hongmei Wang, Fedja A. Rochling, Shinobu Watanabe-Galloway, Jian-Jun Zhang

Journal Articles: Epidemiology

BACKGROUND: Globally, of the 248 million people chronically infected with the hepatitis B virus (HBV), 74 million reside in China. Five oral nucleot(s)ide analogs (NUCs) have been approved for the treatment of chronic hepatitis B (CHB) in China.

OBJECTIVES: The aims of this study were to determine rates of adherence to NUC therapy in patients with CHB, to identify the self-perceived barriers to adherence, and to examine the factors associated with adherence.

METHODS: Questionnaire-based interviews were administered among Chinese patients with CHB at hepatology clinics of a tertiary hospital in the city of Wuhan, China. Adults aged 18 years or …

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, …

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 …

Catching Chances: The Movement To Be On The Ground And Research Ready Before An Outbreak, David Brett-Major, James V. Lawler

Journal Articles: Epidemiology

After more than 28,000 Ebola virus disease cases and at least 11,000 deaths in West Africa during the 2014⁻2016 epidemic, the world remains without a licensed vaccine or therapeutic broadly available and demonstrated to alleviate suffering. This deficiency has been felt acutely in the two, short, following years with two Ebola virus outbreaks in the Democratic Republic of Congo (DRC), and a Marburg virus outbreak in Uganda. Despite billions of U.S. dollars invested in developing medical countermeasures for filoviruses in the antecedent decades, resulting in an array of preventative, diagnostic, and therapeutic products, none are available on commercial shelves. This …

Xenosurveillance Reflects Traditional Sampling Techniques For The Identification Of Human Pathogens: A Comparative Study In West Africa, Joseph R. Fauver, James Weger-Lucarelli, Lawrence S. Fakoli, Kpehe Bolay, Fatorma K. Bolay, Joseph W. Diclaro, Doug E. Brackney, Brian D. Foy, Mark D. Stenglein, Gregory D. Ebel

Journal Articles: Epidemiology

BACKGROUND: Novel surveillance strategies are needed to detect the rapid and continuous emergence of infectious disease agents. Ideally, new sampling strategies should be simple to implement, technologically uncomplicated, and applicable to areas where emergence events are known to occur. To this end, xenosurveillance is a technique that makes use of blood collected by hematophagous arthropods to monitor and identify vertebrate pathogens. Mosquitoes are largely ubiquitous animals that often exist in sizable populations. As well, many domestic or peridomestic species of mosquitoes will preferentially take blood-meals from humans, making them a unique and largely untapped reservoir to collect human blood.

METHODOLOGY/PRINCIPAL …

Coming Out Of "Retirement"-Predictors Of Driving Resumption Among Older Drivers, Kendra Ratnapradipa, Jing Wang, Marla Berg-Weger, Mario Schootman

Journal Articles: Epidemiology

Background and Objectives: Predictors and consequences of driving cessation in older adults have been studied extensively. This study sought to establish the extent to which former drivers resume driving and identify associated factors.

Research Design and Methods: Descriptive analysis of the 2011-2015 National Health and Aging Trends Study data (Round 1:

Results: Among drivers who stopped driving during the study, 17%-28% resumed driving. Age, vehicle ownership, stroke, hospitalization, memory, and perceived transportation barriers were associated with resumption in regression analysis. In multilevel analysis stratified by baseline driving status, poor word recall (OR = 0.62; 95% CI = 0.40, 0.95) and …

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. …

A Needs Assessment For Simulation-Based Training Of Emergency Medical Providers In Nebraska, Usa, Nizar K. Wehbi, Rajvi Wani, Yangyuna Yang, Fernando A. Wilson, Sharon J. Medcalf, Brian Monaghan, Jennifer Adams, Paul Paulman

Journal Articles: Epidemiology

Background: Training emergency medical services (EMS) workforce is challenging in rural and remote settings. Moreover, critical access hospitals (CAHs) struggle to ensure continuing medical education for their emergency department (ED) staff. This project collected information from EMS and ED providers across Nebraska to identify gaps in their skills, knowledge, and abilities and thus inform curriculum development for the mobile simulation-based training program.

Methods: The needs assessment used a three-step process: (1) four facilitated focus group sessions were conducted in distinct geographical locations across Nebraska to identify participants' perceived training gaps; (2) based on the findings from the focus group, a …