Public Health Commons^™

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 …

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 …

Impact Of Local Covid-19 Policies On The Homeless Population: Case Study In Two Montana Counties, Franchesca D. Talbot

Capstone Experience: Master of Public Health

COVID-19 has had a significant impact on people experiencing homelessness in Montana. In each Montana County, local policies in addition to individual shelter policies determine the requirements for homeless shelters in relation to capacity, distancing, and other public health measures designed to prevent the spread of COVID-19. The policies often differ from county to county, which often lead to different outcomes across the state. This case study analyzed data from multiple sources on the number of COVID-19 cases and deaths among the homeless populations in Missoula and Lewis and Clark Counties in Montana and linked them to the effectiveness of …

Cadmium And Chromium Evaluation Of Offutt Air Force Base Aircraft Maintenance Bay, Nickolas Lamal

Capstone Experience: Master of Public Health

The 55th Aircraft Maintenance Squadron is based out of Offutt Air Force Base (AFB). The organization has requested testing of Air Ground Equipment (AGE) maintenance operations for heavy metals, specifically cadmium and chromium while evaluating one break area for the harmful compounds. It is hypothesized that heavy metals may be in excessive limits and could potentially harm staff and their families as take-home toxins. If left uninvestigated and evaluated, excessive exposure to heavy metals could cause injury or illness within the unit’s ranks, decreasing unit effectiveness and efficiency. Sampling methods include preliminary assessments of break area and adjacent glass bead …

Predictors Of Poor Glycemic Control In Diabetic Clients With Mental Health Illness, Community Alliance, Omaha, Nebraska, Rachelle Flick

Capstone Experience: Master of Public Health

People with severe mental illness tend to die 10-25 years earlier than the general population (WHO). Main contributors to these premature deaths include comorbidities such as hypertension, cardiovascular disease, and diabetes. Diabetes prevalence in mentally ill people is 2 times higher than the general population (WHO). The World Health Organization is taking action to improve the health of people with severe mental illness. These efforts include creating protocols of prevention, identification, assessment, and treatment for mentally ill people, as well as improving access to general health services through the integration of physical and mental health services. Community Alliance, located in …

A Literature Review Of Paid Sick Leave And Disparate Populations In The United States During The Covid Pandemic, Jessica Davies

Capstone Experience: Master of Public Health

The COVID pandemic is providing many public health and health policy learning opportunities to identify disparities among women, minorities, and underserved/distressed populations and inform subsequent policy-level strategies. It is recommended people stay home when they are sick; yet, not all people have access to paid sick leave. Individuals are left with the unfortunate decision to lose pay or go to work when they are ill. This is disconcerting in any given year with the annual flu illness and other communicable diseases; however, especially concerning during the COVID pandemic given the high virus transmissibility. Paid sick leave is not universally accessible …

Developing And Piloting An E-Learning Module On Respiratory Protection, Emily Girard

Capstone Experience: Master of Public Health

Respiratory diseases are one of the most common causes of occupational illnesses in the United States. Many occupations use personal protective equipment (PPE) in the form of respirators to protect against respiratory hazards when other control methods are not effective. However, some workers may not have had adequate training on their use. An e-learning module was developed to provide information about respirators and their use in agriculture. The interactions of matching, sorting, and review questions require the user to be an active participant with the goal of reinforcing the information. It was hypothesized the average summative assessment score would increase …

Evaluating Nebraska Ems Providers' Ability And Willingness To Respond To Bioterrorism Emergencies, Ryan Houser

Capstone Experience: Master of Public Health

Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack, and identify factors that predict preparedness and willingness among Nebraska Emergency Medical Service providers, who are key to resilience in the face of an attack. The survey was available for one month in 2021 during which 190 EMS providers responded to the survey. The subjects included Registered Nurses, doctors, EMTs, and paramedics. Only 10% of the respondents are both …

Gender Disparity In Obesity And Lifestyle Characteristics Among Adults In Mississippi, Jalysa M. Edwards

Capstone Experience: Master of Public Health

Obesity is a primary public health concern and is associated with several chronic health diseases that can have dire consequences. According to the World Health Organization (WHO), there were about 1.9 billion overweight adults aged 18 years and above and at least 650 million adults were obese worldwide in 2016. Adults living in Mississippi are of particular concern, due to the high obesity rate which has continued to increase over the past 25 years. Mississippi’s obesity rate is 37.3%, which is one of the highest rates of adult obesity in the United. While obesity increases the risk of disease outcomes, …

Occupational Injuries Associated With Workplace Violence In An Academic Medical Center, Rebecca J. Bonacci

Capstone Experience: Master of Public Health

Violence is a major source of workplace injury in the medical profession. Peer reviewed literature is lacking for workers that have injuries through violence from clients who have intellectual disabilities. Literature for hospital security is also lacking. In this study of workplace violence, we compared injuries among the occupational groups at an academic medical center from 2017-2020. We hypothesized that violence will be similar across the years. Occupational injury and illness data was obtained from an academic medical center. The number of violence cases was divided by the total number of injury cases and reported as a percentage. We found …

Factors Contributing To Trust Of Occupational Healthcare Services In Meatpacking Plants, Gabriella Ochoa

Capstone Experience: Master of Public Health

Meatpacking refers to the slaughtering of livestock and processing and packaging it into meat and other byproducts. Meatpacking is a large industry employing thousands of workers from various racial and socioeconomic backgrounds in Nebraska. These workers have experienced disparities in accessing occupational health services such as language barriers, fear of job loss, or deportation due to immigration status if these services were used. The purpose of this study was to investigate how trust in occupational health services varied among employees at a meatpacking plant in Nebraska by demographic characteristics, particularly by ethnicity, gender, and English language proficiency.

Derivation And Validation Of A General Predictive Model For Long Term Risks For Mortality And Invasive Cardiovascular Interventions In Congenital Heart Disease, David A. Danford

Capstone Experience: Master of Public Health

Introduction. Accurate assessment of prognosis is a key driver of clinical decision making in congenital heart disease (CHD), but is complicated because CHD represents such a diverse collection of conditions. The aim of this investigation is to derive, validate, and calibrate multivariable predictive models for time to surgical or catheter-mediated intervention (INT) in CHD and for time to death in CHD. Methods. 4108 unique subjects were prospectively and consecutively enrolled, and randomized to derivation and validation cohorts. Total follow up was 26,578 patient-years, with 102 deaths and 868 INTs. Accelerated failure time multivariable predictive models for the outcomes, based on …

Population-Level Prevalence Of Depression And Summary Statistics Of Women With At Least A Year Post-Final Menstruation With And Without Hysterectomy, Happiness Kingi

Capstone Experience: Master of Public Health

Background: Depression is associated with estrogen hormonal changes. There are few comparisons studies on the population-level prevalence of depression in women at least a year post final menstruation with and without hysterectomy.

Objectives: 1) To determine the population-level prevalence of depression in women with at least a year post final menstruation with and without hysterectomy and 2) to calculate the summary statistics of women with at least a year post final menstruation with and without hysterectomy

Methods: A population-based cross-sectional design was used. Respondents were female participants of the U.S. National Health and Nutrition Examination Survey (NHANES) …

Re-Aim Evaluation Of Workplace Weight Management Interventions: A Systematic Review, Adrienne Gothard

Capstone Experience: Master of Public Health

Overweight/Obesity is a major public health concern that affects nearly a third of the world’s population. In addition to personal health effects such as cardiovascular disease, cancer, and diabetes, obesity can take a toll on an employer’s bottom line, specifically healthcare costs and absenteeism. Many employers promote intervention programs targeted at lifestyle and behavioral factors to improve workforce health. A 2016 systematic review by Weerasekara et al. compared several of these intervention programs based on the effectiveness of the program, measured in participant’s weight changes from baseline to post-intervention. While this information can be valuable to employers who are interested …

Association Of New And/Or Progressive Multiple Organ Dysfunction Syndrome With Mortality And New Morbidity Among Children Encountering Septic Shock, Rachel L. Waworuntu

Capstone Experience: Master of Public Health

Despite reductions in sepsis mortality, there remains a substantial morbidity burden among children who survive sepsis. Furthermore, the majority develop multiple organ ‘group has historically been analyzed as a single cohort. Using the Life After Pediatric Sepsis Evaluation (LAPSE) investigation database, we studied the association of new and progressive multiple organ dysfunction syndrome (NPMODS) with morbidity and mortality among children with septic shock. We hypothesized that NPMODS represents a distinct phenotype based on evolving organ dysfunction. There was evidence of an association but it did not reach the 0.05 level of significance. We also hypothesized and confirmed that children with …

The Impact Of Obesity On Covid-19 Outcomes In A High-Risk, Majority Hispanic Community Sample, Maxwell A. Lawlor

Capstone Experience: Master of Public Health

The novel coronavirus disease 2019 (COVID-19) pandemic has caused over 33.7 million cases and 605,000 deaths in the United States¹. Factors associated with increased odds for hospitalization, death, and other poor outcomes include age, comorbid conditions like cardiovascular disease and lung disease, and obesity. COVID-19 has also disproportionately affected Hispanic communities across the United States and in Omaha. Potential explanations for this disparity include social determinants of health, particularly occupational factors, structural challenges to access healthcare services, and increased medical comorbidities including obesity. In this retrospective cohort study, we used patient data from April to May 2020 (N=1,000) …

How The Covid-19 Pandemic May Have Impacted Hospital Acquired Infection Rates, Mackenzie Lecy-Schoenherr

Capstone Experience: Master of Public Health

Background: Hospital Acquired Infections (HAIs) are preventable; however, they continue to occur. Many HAI’s can be prevented by adhering to the Centers for Disease Control and Prevention (CDC) Healthcare Infection Control Guidelines. In late 2019 a novel virus, known as SARS-CoV-2, or COVID-19, emerged and spread across the globe. CDC recommended additional infection prevention and control practices during the COVID-19 pandemic, in addition to standard practices. This study will compare HAI rates before and during the COVID-19 pandemic as well as between COVID and non-COVID units.

Methods: HAI data collected pre-COVID-19 and during COVID-19 will be compared to determine …

Barriers Associated With Mental Health Services For People With Refugee Background In Douglas County, Mustapha Barry

Capstone Experience: Master of Public Health

INTRODUCTION: The United States of America has been one of the leading countries where refugees from all over the world seek safety and security under the refugee resettlement program. Research suggests that refugees underutilize mental health services throughout the United States, despite the higher rates of mental health issues among refugees.

OBJECTIVE: This study explored barriers, support services, and factors associated with mental health services utilization among people with refugee backgrounds in Douglas County, Nebraska.

METHODS: Data from 30 participants were collected through a telephone survey and analyzed to determine participant’s level of mental health services utilization, barriers to mental …

Evaluating A Community-Based Breastfeeding Support Organization In Nebraska, Katelyn Elaine Goodroe

Capstone Experience: Master of Public Health

Specific Aims: The aims of this evaluation plan are to investigate the role of the Nebraska nonprofit organization, MilkWorks, in promoting breastfeeding and family support programming and to identify future internal and external growth opportunities through an assessment of the organizational practices using stakeholder perspectives and marketing structure to better promote infant and parental health.

Significance: As a best practice, evaluation of MilkWorks is critical to providing proper services for promoting infant development and parental health in urban and rural Nebraska communities.

Background: MilkWorks was founded in Lincoln, Nebraska, by mothers with the intention of promoting breastfeeding by offering support …

Case Study Of Nursing Home Residents: The Association Between Carbapenemase-Producing Enterobacteriaceae (Cpe) And Covid-19, Jordan Ranta

Capstone Experience: Master of Public Health

None

Influenza Surveillance: Comparative Analysis Of Influenza Cases Data In Nebraska, Anna Carpenter

Capstone Experience: Master of Public Health

.

Alteration Of Perceptions Of Safety Before And After Fit Testing Among College Of Dentistry Students, Tanner H. Clark

Capstone Experience: Master of Public Health

The COVID-19 pandemic has changed how hospitals and healthcare academic programs operate. This change has restricted services provided as well as educational opportunities for those training to be in healthcare. Further, personal protective equipment (PPE) has been required to help protect workers potentially having contact with patients who may have COVID-19. Dentistry workers are at particularly high risk due to repeated and continuous aerosol generating procedures. Healthcare students have traditionally been restricted to areas with minimal risk during clinical experiences; however, with the exposure occurring ubiquitously, avoiding the risk is nearly impossible. There is no uniform inclusion of students in …