Public Health Commons^™

Risk For Cardiovascular Diseases In Prostate Cancer Patients Treated With Androgen Deprivation: A Population-Based Cohort Study, Lei Jiang

Public Health Theses

Background: Previous studies evaluating the risk of cardiovascular diseases (CVD) in prostate cancer patients receiving androgen deprivation treatment (ADT) often did not distinguish different types of ADT.

Methods: We conducted a large, retrospective cohort study using the linked Surveillance, Epidemiology and End Results - Medicare database, including patients with primary localized prostate cancer diagnosed in 2007--2013 and followed through the end of 2014. Time dependent multivariable Cox proportional hazards models with death as the competing risk were used to evaluate the association between ADT (overall, and two subtypes: gonadotropin-releasing hormone [GnRH] agonists and oral antiandrogens) and incidence of CVD. …

Temporal And Intensity Relationships Between Physical Activity And Drunkorexia Behaviors Among First-Year College Students, Robert E. Booker Jr

Graduate Theses/Dissertations

The purpose of this research was to examine the temporal element of physical activity (PA) in relation to drunkorexia occurrences and how PA intensities predict severity of drunkorexia behaviors. No research, to our knowledge, has explored if students are proactively or reactively engaging in PA to reduce the effects of calories consumed from alcohol nor if there exists a dose relationship among PA intensities (sedentary, moderate, vigorous) and severity of drunkorexia behaviors. A convenience sample of first-year college students living in residence halls was selected to participate in the current study. Participants completed an online survey including The Drunkorexia Motives …

Infections Not Fought: Antibiotic Resistance In Underserved Communities, Derek Lillestolen

Senior Honors Theses

In 1928, the profound effects of penicillin were discovered and antibiotic treatments became extremely popular. Broad-spectrum antibiotics, like tetracyclines, have been since branded as cure-all prescriptions and used profusely in the Western World and abroad. Due to ignorance of specific biochemical mechanisms and the misuse of antibiotics these drugs inadvertently allowed the rise in prevalence of antibiotic resistant strains of certain bacteria as the century progressed. Now, the specific genetic causes and mechanisms of antibiotic resistance are being understood, but the fight against antimicrobial resistance is far from over. In the United States, thousands of fatalities are caused annually by …

Developing Certification Exam Questions: More Deliberate Than You May Think, Cheryl (Cheri) L. Marcham, Treasa M. Turnbeaugh, Susan Gould, Joel T. Nader

Publications

For more than 40 years, the multiple-choice examination has been the standardized assessment tool used in the certification process of OSH professionals (Wright, Turnbeaugh, Weldon, et al., 2015). The use of a multiple-choice exam to award a credential, however, has been criticized by many OSH professionals. This may be primarily due to a perception that relates to their previous academic experience with multiple-choice exams and a misunderstanding of the science behind the development of such exams.

The use of standardized tests clearly ensures a consistent and rapid method of scoring, but the use of such tests is legally defensible only …

Identification Of Tissue And Circulating Biomarkers For Premalignant And Malignant Lesions, Shu-Hong Lin

Dissertations and Theses (Open Access)

Recent advancement in technologies including next-generation sequencing and production-scale throughput qPCR have revolutionized the identification of biomarkers in the epidemiology field. In response to the vast amount of data generated from high-throughput technologies, novel inventions in the computer sciences fields have been applied to analyze these data. The current study demonstrates the application of such technologies in a variety of scenarios.

I first described how targeted and whole-exome sequencing were used to identify somatic mutations which marked the differences between colorectal adenomas and adenocarcinomas. A statistical test based on the unique clustering pattern of tumor suppressor genes and oncogenes was …

Hiv-Related Knowledge, Attitudes, And Behaviors In Two Low Resource Settings, Candice Lynn Collins

Electronic Theses and Dissertations

Two Human Immunodeficiency Virus (HIV) outbreaks occurred almost simultaneously in the United States (US) (2014-2015) and in Cambodia (2015). Information is lacking on HIV-related knowledge, stigmatizing attitudes, and high-risk behaviors (KAB) among the general population, which may affect the transmission of HIV and lead to outbreaks. The current study aimed to: 1) assess KAB among the general population in a high-risk county in the US, 2) analyze KAB among the general population of Cambodia, and 3) compare KAB across samples from a high-risk county in Northeast Tennessee and a province in Cambodia. Tennessee data were collected in 2017 and Cambodian …

Exploration Of Rape Myths Among Former Military Professionals, Gabrielle Caldara

Electronic Theses and Dissertations

Sexual violence is sometimes considered a taboo topic for discussion, but it gained widespread attention in the media in late 2017 due to the social movements addressing the sexual assault of women. However, sexual violence perpetrated against men lacks publicity in America, and highlights a similar situation in the Armed Forces. A discussion of sexually violent acts committed against men is sometimes impeded by cultural norms. This discrepancy associated with civilian and military communities inspired this exploratory study.

A convenience sample of 520 former American military professionals completed an anonymous online survey to describe their attitudes and beliefs regarding rape …

Context, Delivery, And Providers’ Perspectives Of Family Life Education In Tn, Usa, Ruby Yadav

Electronic Theses and Dissertations

In 2015, TN had the 9^th highest teen birth rate in the United States. School-based sex education programs have shown promise in curbing teen pregnancy rates. In TN public schools, sex education could be taught by teachers of subjects like biology, health education, or invited guests from ministries, or national or local nonprofit agencies. The content, rigor, and approach of sex education taught by these diverse groups of providers remains unknown. This pilot study tested a survey questionnaire and methodology, while providing information on the providers’ sex education practices and perspectives.

We adapted validated measures from past sex education …

Survey Of Hydration Knowledge And Behavior In Youth Mountain Bike Teams, Natasha Brand

Graduate Theses and Dissertations

Many youth sports organizations recognize the importance of educating on hydration practices and awareness, although according to recent research current hydration education is not correlating to effective practices. PURPOSE: The purpose of this study was to assess and describe the hydration knowledge and behavior of student-athletes participating in competitive junior high and high school mountain bike teams, in order to substantiate further research. METHODS: A total of 133 male and female participants, ranging from 11-18 years were surveyed on their hydration knowledge and behavior. All participants were apparently healthy and were active members of a National Interscholastic Cycling Association (NICA) …

Pornography As A Public Health Issue: Promoting Violence And Exploitation Of Children, Youth, And Adults, Elisabeth Taylor

Dignity: A Journal of Analysis of Exploitation and Violence

The pornography industry is expanding exponentially as a result of ongoing technological advances. The ability to stream videos over the internet and the ubiquity of the smart phone have meant that pornography producers are able to use algorithms to target potential consumers, to cultivate new sexual tastes and to deliver content to a more diverse audience over mobile devices. The advent of virtual reality pornography with interactive sex toys and sex robots imbued with artificial intelligence promises to unleash a further step-change in the extent to which pornography influences ‘real-world’ sexual culture. The critical analysis of pornography undertaken over decades …

Understanding The New Blood Pressure Guidelines, Susan H. Davide, Anty Lam

Publications and Research

Oral health professionals who are well versed in the new guidelines will be best prepared to handle the implications on patient care.

Transvaginal Cervical Length Surveillance Frequency And The Management Of Spontaneous Preterm Delivery In Twin Gestations, Ashley Janssen

Capstone Experience: Master of Public Health

Strategies to prevent preterm birth in multifetal gestation remain a high-priority in the United States. In women with a history of spontaneous preterm birth (sPTB) and singleton gestation, transvaginal cervical length (TVCL) surveillance and subsequent treatment is associated with a reduction in spontaneous preterm birth, however, there is limited data on the role of TVCL surveillance in twin gestation. The goal of this study is to determine if an association exists between TVCL and spontaneous preterm birth in twin gestations. Additionally, our research will assess whether TVCL surveillance impacts the timing of antenatal corticosteroids (ACS), magnesium sulfate administration, and maternal …

Massage Therapy Intervention For Pediatric Palliative Care Patients And Their Families, Taelyr Weekly

Capstone Experience: Master of Public Health

This study examined the feasibility and acceptability of a massage therapy intervention for pediatric palliative care patients and their adult caregivers to reduce their symptom impact at an urban pediatric hospital in Omaha, NE. Potential symptoms to be impacted by massage included stress for caregivers and pain, nausea, dyspnea, and anxiety for children. One hundred and thirty five massages were delivered to patients and caregivers in the PICU, NICU, and the inpatient hospital floor during the course of this non-randomized, pre-post study. Validated instruments were used to collect objective data from patients and caregivers, while observations were used to record …

A Strategic Approach To Employee Retention At Nebraska Families Collaborative, Rachel Walters

Capstone Experience: Master of Public Health

Nebraska Families Collaborative (NFC) is a nonprofit organization that supports children and families who are at risk, in eastern Nebraska. They offer a variety of services with the goal of moving children toward safety, permanency and well-being. Organizations such as NFC rely heavily on the commitment of the employees to carry out their mission, as do many other non-profit social service agencies across the country. The overall goal of the project was to identify reasons for high turnover and to identify potential solutions to reduce turnover and increase retention in the workplace at NFC. The main objectives were to analyze …

Quality Improvement: Assessing The Gaps In Education And Training Among Staff At Health, Education, And Law Project Hospital Sites In Nebraska, Michael Sauter

Capstone Experience: Master of Public Health

This research study was completed at Legal Aid of Nebraska’s Health, Education, and Law Project. The goal of this quality improvement study was to enhance the effectiveness of future Health, Education, and Law Project (HELP) training sessions for staff members of HELP sites in Nebraska. Through the use of an online survey tool, we received staff members’ input on the current training program, assessed their knowledge on relevant topics, and gave respondents an opportunity to include any appropriate suggestions. By means of this study, we were able to conclude that although staff members seemed to appreciate the training sessions overall, …

Macra Legislation (Medicare Access And Chip Reauthorization Act) And The Quality Provider Payment Program: Policy Analysis And Educational Program Evaluation, Katie Joseph-Johnson

Capstone Experience: Master of Public Health

ABSTRACT

Goal: The goal of this Service Learning/Capstone Experience is to provide an in-depth policy analysis and interpretation of the 2018 proposed changes in the Quality Payment Plan (QPP) as part of the 2015 MACRA legislation for the purpose of developing organizational training material.

Objectives: The key objectives of this project are 1) to complete a policy review of the current and proposed Quality Payment Program legislation from the Centers for Medicare and Medicaid Services (CMS), including June 2017 proposed updates and the November 2017 final rule updates; 2) to gain physician and hospital administrator’s perspective on realized …

Examining The Benefits And Client Satisfaction Of The Open Arms Of Minnesota Meal Service Program, Carlie Rhinehart

Capstone Experience: Master of Public Health

Chronic disease can leave individuals incapable of caring for themselves, leading to a low quality of life. Public health researchers have proven how crucial medically tailored meals are to those fighting such chronic diseases. Open Arms is a local nonprofit that started in 1986. They make and deliver meals, free of charge, to people with life-threatening illnesses.

The goal of this study is to examine the benefits of the meal services provided by Open Arms of Minnesota to clients who are chronically ill. To learn about the benefits, analysis was conducted on the client satisfaction survey data collected. The anonymous …

Hipaa Compliant Patient-Provider Communication: Student-Clinician Perceptions, Rachel Wenzl

Capstone Experience: Master of Public Health

Purpose: To evaluate the service learning clinical training facility’s HIPAA training by assessing student-clinician knowledge of the clinic’s HIPAA Compliance Plan and the impact of its training on student-clinician perceptions toward HIPAA-compliant patient-provider communication (PPC). For example, do student-clinicians feel it is important to be HIPAA-compliant and are they confident in discussing health-related activities and programs with patients or caregivers? The purpose of this project is not, at this time, to measure student-clinician intention to perform the behavior.

Methods: This project employed a mixed-methods, non-experimental cross-sectional study design using a retrospective post-test survey and group interview. The survey …

Mental Health Provider Perceptions On The Implementation Of Behavioral Health Interventions To Increase Access To Mental Health Care Services In Rural Nebraska, Grant Brueggemann

Capstone Experience: Master of Public Health

Abstract

Rural Nebraska communities are influenced by socioeconomic conditions and lack health care resources which contributes to the prevalence of mental health. As such, there is a need to implement effective intervention programs and evaluate current programs to reduce morbidity and mortality associated with mental health.

Goals: To assess the perceptions of mental health practitioners regarding public health programs and support services. This project also intends to gauge the effectiveness and viability of specific programs as potential solutions for increasing access and use of rural mental health care services. Furthermore, this project aims to inquire perceptions about the role …

Winnebago County Dryhootch Outreach Program, Greg Brittnacher

Capstone Experience: Master of Public Health

Abstract

Winnebago County Veterans Dryhootch Outreach Program

Aims: The Dryhootch Outreach Program focused on increasing behavioral activation through social interaction in a population of military veterans with Post Traumatic Stress Disorder (PTSD). The goals of the intervention were to reduce the prevalence of anxiety, depression, and PTSD symptoms. Additionally, the project aims to assist veterans to develop and maintain healthy relationships, assimilate with the “civilian” community, and effectively contribute to society.

Methods: Twenty-seven veterans with PTSD attended the twelve-week Dryhootch Outreach program provided by the Winnebago County Veterans Service office and partnering organizations. A pre-post interventional study format was utilized …

Identifying The Newly Insurable Medicaid Coverage Gap Population Under The Affordable Care Act: Who They Are And Where They Live, Samuel L. Woodruff

Capstone Experience: Master of Public Health

The goal of this Capstone Project is to better define and geographically locate the potential distribution of individuals who fall within the current Medicaid Coverage Gap and those populations who would be eligible for Medicaid under the expansion of Medicaid within the state of Nebraska. Using data from multiple United States Census Bureau sources, along with available data from the Health Resources and Services Administration (HRSA), this project looks to also locate populations of these individuals that may live within established Medically Underserved Areas (MUA's) or Health Professional Shortage Areas (HPSA's) within the state. American Community Survey 5-year Public Use …

Piloting An Observation Tool For The Garden To Table Program To Assess Education Of Underserved Youth In Omaha, Nebraska, Anthony Gargano

Capstone Experience: Master of Public Health

The Big Garden is a private 501-c3 organization, which utilizes multiple programs to grow healthy food, healthy kids, and healthy communities. The “Garden to Table” program helps students learn how to grow vegetables and herbs in their school garden as well as how to properly harvest, cook, and preserve these crops through various methods. This program specifically highlights STEAM education through plant science and organic gardening techniques, nutrition, and healthy lifestyles. In 2017, the “Garden to Table” program was taught after school at 5 middle schools in Omaha Public Schools: Marrs, McMillan, Monroe, Lewis and Clark, and King Science Center. …

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 …