Public Health Commons^™

Advanced Preparation Makes Research In Emergencies And Isolation Care Possible: The Case Of Novel Coronavirus Disease (Covid-19), David Brett-Major, Elizabeth R. Schnaubelt, Hannah M. Creager, Abigail Lowe, Theodore J. Cieslak, Jacob M. Dahlke, Daniel W. Johnson, Paul D. Fey, Keith F. Hansen, Angela L. Hewlett, Bruce G. Gordon, Andre C. Kalil, Ali S. Khan, Mark G. Kortepeter, Christopher J. Kratochvil, Luann Larson, Deborah A. Levy, James Linder, Sharon J. Medcalf, Mark E. Rupp, Michelle M. Schwedhelm, James N. Sullivan Md, Angela M. Vasa, Michael C. Wadman, Rachel E. Lookadoo, John-Martin J. Lowe, James V. Lawler, M. Jana Broadhurst

Journal Articles: Epidemiology

The optimal time to initiate research on emergencies is before they occur. However, timely initiation of high-quality research may launch during an emergency under the right conditions. These include an appropriate context, clarity in scientific aims, preexisting resources, strong operational and research structures that are facile, and good governance. Here, Nebraskan rapid research efforts early during the 2020 coronavirus disease pandemic, while participating in the first use of U.S. federal quarantine in 50 years, are described from these aspects, as the global experience with this severe emerging infection grew apace. The experience has lessons in purpose, structure, function, and performance …

Diagnostic Accuracy Of Chest Computed Tomography Scans For Suspected Patients With Covid-19: Receiver Operating Characteristic Curve Analysis, Lianpin Wu, Qike Jin, Jie Chen, Jiawei He, David Brett-Major, Jianghu James Dong

Journal Articles: Epidemiology

BACKGROUND: Computed tomography (CT) scans are increasingly available in clinical care globally. They enable a rapid and detailed assessment of tissue and organ involvement in disease processes that are relevant to diagnosis and management, particularly in the context of the COVID-19 pandemic.

OBJECTIVE: The aim of this paper is to identify differences in the CT scan findings of patients who were COVID-19 positive (confirmed via nucleic acid testing) to patients who were confirmed COVID-19 negative.

METHODS: A retrospective cohort study was proposed to compare patient clinical characteristics and CT scan findings in suspected COVID-19 cases. A multivariable logistic model with …

The Impact Of Body Mass Index And Sociodemographic Factors On Moderate-To-Vigorous Physical Activity And Sedentary Behaviors Of Women With Young Children: A Cross-Sectional Examination, Danae M. Dinkel, Nicholas Hein, Kailey Snyder, Mohammad Siahpush, Shannon I. Maloney, Lynette M. Smith, Evi A. Farazi, Corrine K. Hanson

Journal Articles: Epidemiology

OBJECTIVES: Moderate-to-vigorous physical activity provides multiple benefits to women after childbirth. To achieve these benefits, the recommendation that adults obtain, 150 min of moderate-to-vigorous physical activity per week and reduce sedentary behaviors, also applies to women in the post-partum phase of the life span. However, research examining the moderate-to-vigorous physical activity and sedentary behaviors of women with young children (0-2 years) is limited. A greater understanding of these behaviors from a nationally representative sample is needed. Therefore, the primary objective of this study was to determine the levels of moderate-to-vigorous physical activity and sedentary behaviors of a nationally representative sample …

The Covid-19 Response In Nebraska: How Students Answered The Call, Sabrine Chengane, Anlan Cheney, Sierra Garth, Sharon J. Medcalf

Journal Articles: Epidemiology

The Student Response Team at the University of Nebraska Medical Center answered the statewide call to assist local health departments during the coronavirus disease 2019 (COVID-19) pandemic. As a voluntary student-led effort, the SRT assisted health departments to conduct contact tracing, monitor social media, and educate the public. Their experience demonstrates how students can increase the public health surge capacity of local health departments while gaining applied experience during public health emergencies. This call-to-action commentary proposes that SRTs should be formed, trained, and deployed through academic institutions across the nation and the globe, during and beyond the current pandemic.

Colorectal Cancer Screening Uptake: Differences Between Rural And Urban Privately-Insured Population, Mesnad Alyabsi, Jane L. Meza, K. M. Monirul Islam, Amr Soliman, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

Earlier studies investigated rural-urban colorectal cancer (CRC) screening disparities among older adults or used surveys. The objective was to compare screening uptake between rural and urban individuals 50-64 years of age using private health insurance. Data were analyzed from 58,774 Blue Cross Blue Shield of Nebraska beneficiaries. Logistic regression was used to assess the association between rural-urban and CRC screening use. Results indicate that rural individuals were 56% more likely to use the Fecal Occult Blood Test (FOBT) compared with urban residents, but rural females were 68% less likely to use FOBT. Individuals with few Primary Care Physician (PCP) visits …

Innovative Framework For Academic And Public Health Departments' Partnership On Preparing Future Practitioners- Preliminary Data, Michele Kekeh, Muge Akpinar-Elci, Myngoc Nguyen, Nancy Welch

Community & Environmental Health Faculty Publications

This article presents a model to respond to current public health challenges and transform knowledge into preventive strategies. It also presents an innovative way for academic institutes and public health departments to focus on public health workforce development. Academic institutes partnership with public health departments have started fostering service-learning opportunities to engage students in public health with an emphasis on the specific public health outcomes. However, the benefit of service–learning projects on the health departments and the populations served is largely unknown. Recently, these service-learning opportunities are becoming less sustainable due to the inability of preceptors to provide the necessary …

Anemia And It's Associated Factors Among Adolescents In Kuwait, Lemia Shaban, Abdullah Al-Taiar, Abdur Rahman, Reem Al-Sabah, Olusegun Mojiminiyi

Community & Environmental Health Faculty Publications

We estimated the prevalence of anemia among school children and investigated factors associated with this problem in Kuwait. A cross-sectional study was conducted on 1415 adolescents randomly selected from middle schools in Kuwait. Hemoglobin, iron, ferritin, folate and vitamin B-12, in addition to many other laboratory indicators, were measured in a venous blood sample. Data on risk factors for anemia were collected from parents and adolescents. Multiple logistic regression was used to investigate factors associated with anemia. The prevalence of anemia was 8.06% (95% CI: 6.69-9.60%), which was significantly higher among females compared to males (10.96% vs. 5.04%; p < 0.001). Mean (SD) Hb level was 133.7 (9.89) g/L and 130.00 (10.48) g/L among males and females, respectively (p < 0.001). The prevalence of mild, moderate and severe anemia was 5.94%, 1.91% and 0.21%, respectively. Gender, age, iron concentration and ferritin were associated with anemia in multivariable analysis. These data indicate that anemia among school children in Kuwait is of mild public health significance. Further reduction in anemia in school girls should focus on correcting iron deficiency. Surveillance systems for anemia may consider using a cut-off point that is specific for the method of blood sampling and the method of Hb measurement.

Risk Factors For Workplace Encounters With Weapons By Hospital Employees, James Blando, Chalsie Paul, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

Objective:The specific aim of this study was to determine which risk factors were associated with frequent weapons confiscation in a healthcare facility. This study investigated the hypothesis that hospital-related factors impact the frequency of weapons confiscation.

Study design:Cross-sectional.

Methods:A cross-sectional survey was administered on-line to hospital security directors and assessed the associations of organizational factors with the frequency of weapons confiscation.

Results:It was found that hospitals with metal detectors were more than 5 times as likely to frequently confiscate weapons, suggesting this intervention is effective. It was also found that hospitals with psychiatric units were more likely to have frequent …

An Analysis Of Inclusion Resources, As A Pathway To Retention Of Minority Students In The Medical Profession, Beverly K. Andre

PCOM Capstone Projects

What is Diversity? Retention? Often, these terms are used interchangeably without true understanding of their individual meanings. Diversity is offering a variety or having multiple ethnicities amongst a cohort in proportions seen within society. However, retention refers to the continuous possession or maintenance of the variation seen in said cohort. With regards to medical institutions, it seems that there is no separation. Many medical institutions seek to be diverse and create a picture of multiethnic cohorts but regrettably, effective retention techniques aren’t always adopted to make these visions a reality. The damage caused by the lack of adequate retention techniques …

A Systematic Review Of The Of Factors Contributing To Sustained Homelessness And Those Influencing The Deterioration Of Homeless Health And Healthcare, Mojisola Delano

PCOM Capstone Projects

Homelessness is a perpetual problem occurring in society. With a lack of competency of either government institutions or private establishments to provide the required intervention to provide shelter and aid for the existing homeless population or to prevent further homelessness; the next best objective would be to keep this population healthy, by employing hygiene interventions. However, there is a serve lack in hygiene interventions as well. A few US cities and many counties abroad have begun to research and implement strategies for sanitary intervention in homeless hygiene in hopes that if they are unable to “cure” homelessness, then they can …

Defining Current Gaps In Quality Measures For Cancer Immunotherapy: Consensus Report From The Society For Immunotherapy Of Cancer (Sitc) 2019 Quality Summit, Sara Pai, David Blaisdell, Rachel Brodie, Robert G. Carlson, Heidi Finnes, Michele Galioto, Roxanne E. Jensen, Tom Valuck, Antonia R. Sepulveda, Howard L. Kaufman

Population and Public Health Sciences Faculty Publications

Background Quality measures are important because they can help improve and standardize the delivery of cancer care among healthcare providers and across tumor types. In an environment characterized by a rapidly shifting immunotherapeutic landscape and lack of associated long-term outcome data, defining quality measures for cancer immunotherapy is a high priority yet fraught with many challenges. Methods Thus, the Society for Immunotherapy of Cancer convened a multistakeholder expert panel to, first, identify the current gaps in measures of quality cancer care delivery as it relates to immunotherapy and to, second, advance priority concepts surrounding quality measures that could be developed …

The Va Mission Act Of 2018: A Potential Game Changer For Rural Gme Expansion And Veteran Health Care, Anne Victoria Neale, Phil Lupo, Marjorie A. Bowman, Dean A. Seehusen

Population and Public Health Sciences Faculty Publications

The Veterans Healthcare Administration (VHA) is the largest health care delivery system in the United States. It includes 172 medical centers (VAMCs), with over 1,100 Community Based Outpatient Centers (CBOCs) and various other sites of care. In addition to training physicians to care for veterans and active duty service members, the VHA is also directed to assist in supplying health care personnel to the nation.Through its Office of Academic Affiliations (OAA), VHA develops partnerships with Accreditation Council for Graduate Medical Education (ACGME)/American Osteopathic Association (AOA) accredited residency program sponsoring institutions. These collaborations include 144 out of 152 allopathic medical schools …

Individual Ems Disposition In The Prehospital Setting To Predict Future Opioid Overdose And Mortality, Lillie Valliere

Global Public Health | Senior Theses

Introduction

There have been over 400,000 deaths related to prescription opioids in the US since 1999, with the highest prevalence among individuals aged 45-54 years old. However, adults between the ages of 18 and 34 have the highest prevalence of misuse of prescription opioids. With accidental overdoses as a leading cause of death, Marin County is just one community that is heavily impacted by this ongoing epidemic. Statistics related to non-fatal and fatal opioid overdoses are difficult to accurately count due to the differing ways counties may categorize cause of death, diagnoses, and other contributing factors. However, looking at 911 …

Effects Of Latinx Parental English Proficiency On Stress, Maria Alvarez Pineda

Global Public Health | Senior Theses

Background

In the United States, patients who have Limited English Proficiency (LEP) report having more problems communicating with their children’s doctor which leads to these children having worse health care access than those who have parents with a High English Proficiency (HEP). Parents with LEP also experience discrimination in this setting which can lead to increased psychological distress. The goal of this study was to determine if the level of English Proficiency is associated to stress levels and discrimination among Latinx parents when they take their chidlren to the doctor.

Methods

Participants consisted of 22 Latinx parents (86.4% Mexican and …

Boundaries And Infomediaries: A Qualitative Study Of The Information Practices Of Community Health Workers, Robert M. Shapiro Ii

Theses and Dissertations--Communication

Despite successful efforts to treat and manage diseases, public health officials have recently begun a campaign to refocus efforts toward initiatives to alleviate the pressures that are often referred to as social determinants of health. In eastern Kentucky, and in other geographical regions labeled as health professional shortage areas or medically underserved areas, issues stemming from social determinants are compounded with health care systems that are often lacking the human resources to meet basic medical needs. One strategy has been to utilize volunteers and paraprofessionals such as community health workers to lessen the burden on the primary care and hospital …

Occupational Opioid Surveillance And Intervention Evaluation: A Mixed Methods Collaborative Project Among Southeast First Responders, Robin Thompson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction: This capstone assessed and addressed the issue of occupational opioid exposure among first responders working in the southeastern United States from 2017-2019. The first study aimed to assess the emerging issue of occupational opioid exposure as well as current knowledge and training practices among first responders of the following southeastern states: Kentucky, Georgia, Mississippi, and Virginia. The second study aimed to address this emerging issue through formative research followed by evaluation of the impact of an educational video and associated knowledge gained with a group of Kentucky-based first responders.

Methods: The analysis drew from three primary datasets: (1) self-reported …

Analysis Of Genetic Structure And Pathogen Dynamics Of Ixodes Scapularis In Southwestern Virginia, Leemu Jackson

Undergraduate Honors Theses

Ixodes scapularis, or the blacklegged tick, is the primary vector of Borrelia burgdorferi. This pathogen is the causative agent of Lyme disease, the most common vector-transmitted disease in the United States. Although I. scapularis is distributed throughout the eastern U.S., Lyme disease is only considered endemic in the northeastern region of the country. Prior to 2007, Lyme disease was uncommon in Virginia, but since then cases of Lyme disease have increased dramatically with a hotspot forming in the Roanoke-Blacksburg area. The purpose of the current study was to determine whether B. burgdorferi prevalence and the genetic structure of I. …

The Caregiver Advise Record And Enable (Care) Act And Compassion Fatigue In The United States, Karen Marie Johnson

Walden Dissertations and Doctoral Studies

The transition from hospital to home can be complicated, leaving family caregivers in stressful situations that they may not know how to handle. The burden that is placed on these individuals has led researchers to focus on the public health implications of caregiving in hopes of identifying at-risk caregivers. This quantitative analysis identified what relationships exist between caregiver compassion fatigue among family caregivers and training or education received per the Caregiver Advise Record and Enable (CARE) Act and if education influences readmission rates. A purposive sample of 385 family caregivers participated in this study. The Care Transitions Measure (CTM-15), the …

Neonatal Jaundice And Developmental Impairment Among Infants In Kilifi, Kenya, Dorcas N. Magai, Michael Mwaniki, Amina Abubakar, Shebe Mohammed, Anne L. Gordon, Raphael Kalu, Paul Mwangi, Hans M. Koot, Charles R. Newton

Institute for Human Development, East Africa

Background: Neonatal jaundice (NNJ) is common in sub‐Saharan Africa (SSA), and it is associated with sepsis. Despite the high incidence, little has been documented about developmental impairments associated with NNJ in SSA. In particular, it is not clear if sepsis is associated with greater impairment following NNJ.

Methods: We followed up 169 participants aged 12 months (57 cases and 112 controls) within the Kilifi Health Demographic Surveillance System. The diagnosis of NNJ was based on clinical laboratory measurement of total serum bilirubin on admission, whereas the developmental outcomes were assessed using the Developmental Milestones Checklist and Kilifi Development …

The Relationship Between Social Media Engagement And Psychological Well-Being In College Students At The University Of New Hampshire, Emily G. D'Antonio

Honors Theses and Capstones

Social media use has increased substantially in recent years, and for the college-aged population, social media is often the leading method of communication. Research indicates this reliance on digital connection could have a negative impact on the health of young adults (Bagroy et al., 2017). The college years are a time of personal growth and defining actions, yet can also be burdened by mental health issues related to stress, anxiety, and depression (Hunt & Eisenberg, 2010). Acknowledging these trends, the current study explores how college students’ specific frequency and intentionality while interacting on social media relates to their psychological well-being. …

The Cholera Crisis In Yemen: Case Studies On Vulnerability And Resilience In Sana'a, Al Hudaydah, And Ma'areb, Noor Albannein A. Al-Saad

Honors Theses and Capstones

The largest recorded cholera epidemic in history is happening right now in Yemen, a country which has reported over 2 million cases of cholera as of 2020. Yemen has a history of endemic cholera, but prolonged conflict in the country has led to deteriorating conditions that have triggered massive outbreaks of the disease. The purpose of this study is to investigate the direct and indirect causes of the cholera epidemic in Yemen by proposing factors that may confer vulnerability and resilience in Yemeni governorates. Case studies were constructed for three governorates: Sana’a and the inner municipality of Amanat Al Asimah; …

Knowledge And Behavioural Interventions To Reduce Human Health Risk From Private Groundwater Systems: A Global Review And Pooled Analysis Based On Development Status, S. Mooney, C. P. Mcdowell, J. O'Dwyer, P. D. Hynds

Articles

Groundwater contamination constitutes a significant health risk for private well users residing in rural areas. As the responsibility to safeguard rural private domestic groundwater typically rests with non-expert homeowners, interventions promoting risk mitigation and awareness represent the most viable means of preventing supply contamination. However, no global review or pooled analyses of these interventions has been undertaken to date. The current study sought to identify and quantify the performance of private well interventions from 1990 to 2018 via a global systematised review and pooled analysis. The PICO (Population-Intervention-Comparison-Outcome) approach was employed for literature identification. Relevant studies were statistically analysed across …

Dustbowl Waters: Doctrinal And Legislative Solutions To Save The Ogallala Aquifer Before Both Time And Water Run Out, Warigia M. Bowman

Articles, Chapters in Books and Other Contributions to Scholarly Works

Eighty-three years after the Dust Bowl, residents of America’s High Plains face a dire threat: their primary aquifer faces depletion, and entire sections of the country are set to run out of groundwater by the end of the century or sooner. The Ogallala Aquifer provides a significant amount of America’s agricultural irrigation water and is a primary source of drinking water for Colorado, Kansas, Nebraska, New Mexico, Oklahoma, South Dakota, Texas, and Wyoming. This Article argues that policymakers should slow the Aquifer’s depletion rate by implementing changes to irrigation technology, crop choice, consumer behavior, legal doctrine, and legislation. This Article …

Tetanus Immunity Among Adults In The Democratic Republic Of The Congo, Sue K. Gerber

Walden Dissertations and Doctoral Studies

Although tetanus is not a contagious disease, it can be deadly for people who are exposed and do

not have protective immunity against tetanus, which can be acquired only through vaccination.

Most studies on adult tetanus protective immunity are from high-income countries; limited

studies occur in Africa, and none has been reported from the Democratic Republic of the Congo

(DRC). This study sought to determine protective immunity against tetanus among adults in

DRC in relation to their age, sex, place of residence, and for women, antenatal care. The primary

purpose of this observational cross-sectional study using a nested serosurvey within …

Development Of A Clinical-Academic-Community Collaboration To Improve Health Literacy, Daniela B. Friedman Ph.D., Michelle A. Arent, Brooks Yelton Ma, Lmsw, Mayank Sakhuja, Venice E. Haynes, Samuel Noblet, Heather M. Brandt Ph.D., Ches, William D. Isenhower, Abraham Wandersman, Diana Zona, Cyndi New, Delores Fedrick, Jonathan Scaccia, Larisa Bruner

Faculty Publications

Limited health literacy is associated with poor patient health outcomes and increased hospitalization rates. Patient-provider communication plays an important role in patient health literacy and the understanding of medical terminology. This study demonstrates how a collaboration between clinical, academic, and community partners was instrumental in the design and implementation of a clinic readiness assessment and a clinic-based pilot intervention to encourage patient-provider communication and improve patient health literacy. A state hospital association, academic research team, and community adult literacy center director collaborated to develop a 60-item clinic readiness assessment and an evidence-informed pilot intervention. The clinic readiness assessment captured clinics’ …

Meat Intake And Prostate Cancer In African American Men, Uchenna Njoku

Walden Dissertations and Doctoral Studies

African American men have more prostate cancer and are more than twice as likely to die of the disease as Caucasian men, and the reasons for this racial disparity have not been clarified. Identifying lifestyle and dietary risk factors of prostate cancer is an important public health issue. Studies on the association between meat intake and prostate cancer risk have produced inconsistent results. The purpose of this cross-sectional quantitative study was to determine whether there is an association between total meat intake and total prostate cancer risk among African American men when controlling for age, income, educational level, physical activity, …

Behavioral, Demographic, And Clinical Determinants Of Hiv Serostatus In Zambian Women, Debebe Masresha Gebreyohannes

Walden Dissertations and Doctoral Studies

The rate of human immunodeficiency virus (HIV) infection shows a diminishing trend at the global level while it shows increasing in intensity of mortality, morbidity, and burden in Sub-Saharan Africa. The intertwined behavioral, demographic, and clinical determinants fueled the incidence of infections in Zambian women. The purpose of this study was to determine the association between demographic, behavioral, and clinical determinants with HIV serostatus in Zambian women. With the conceptual framework of the World Health Organization’s Commission for Social Determinants of Health (CSDH) and quantitative method of MANOVA, this study examined Zambian Demographic Health Survey data for Zambian women of …

Impact Of Education On Hiv Testing Among African American Women In The United States, Florence Matimbah Mbangowah

Walden Dissertations and Doctoral Studies

Improved and increased human immunodeficiency virus (HIV) testing among African American women in the United States could facilitate early detection of the virus. The purpose of this cross-sectional quantitative study was to determine if there was a significant association between HIV testing participation and education level (i.e., high school, college, post-college level) based on access to healthcare after accounting for insurance, income, employment, marital status, English language proficiency, and vision quality. The integrated theory of health behavior change, the theoretical framework used for this research, proposes that changes in health behavior can be improved by various factors such as fostering …

Sociopolitical Determinants Of Parental Acceptance Of Childhood Vaccination In Abuja, Nigeria, Lawrence Madu Ohammah

Walden Dissertations and Doctoral Studies

Despite the efficacy of vaccines, some parents still reject vaccination of their children, resulting in low vaccination coverage, a greater burden of vaccine-preventable diseases, and high infant mortality. The purpose of this study was to investigate the sociopolitical determinants of vaccination status among children, aged 0-24 months, and identify the factors that drive vaccine hesitancy. The social ecological model served as the theoretical framework. The study research design was a quantitative cross-sectional survey. An interviewer-administered questionnaire was used to collect primary data from parents and caregivers in 384 randomly selected households from 48 settlements in the Abuja Municipal Area Council. …

Hiv Positive African American Women’S Lived Experiences And Clinical Outcomes, Christie Olejemeh

Walden Dissertations and Doctoral Studies

African American (AA) women are disproportionately affected by HIV/AIDS. The infection rate for AA women continues to increase, and literature lacks information specifically on education for AA women regarding viral suppression at diagnosis. The purpose of the study was to understand the lived experiences of AA women living with HIV in the District of Columbia, particularly how they acquired knowledge of viral suppression. To understand their experiences with antiretroviral medications, viral suppression, discrimination, and stigma, this qualitative study applied a hermeneutic phenomenological approach. The theories of resilience and empowerment were applied. Ten HIV positive AA women living in the District …