Public Health Commons^™

Association Between Appendicular Skeletal Muscle Index And Leukocyte Telomere Length In Adults: A Study From National Health And Nutrition Examination Survey (Nhanes) 1999-2002, Lingzhi Chen, Nitin Shivappa Mbbs, Mph, Ph.D., Xiuxun Dong, Jinjing Ming

Faculty Publications

Background

A higher body mass index (BMI) is associated with shorter telomeres. The loss of muscle mass with aging is associated with adverse outcomes. The appendicular skeletal muscle index (ASMI) is currently used to quantify muscle mass.

Objective

We investigated the association of the ASMI with leukocyte telomere length in adult Americans.

Methods

This cross-sectional study used the National Health and Nutrition Examination Survey (NHANES) 1999–2002 dataset. Body composition was measured by dual-energy X-ray absorptiometry. Low muscle mass was defined using sex-specific thresholds of the appendicular skeletal muscle mass index (ASMI). The telomere-to-single-copy gene ratio (T/S ratio) was converted to …

Healthcare Workers' And Students' Current Knowledge And Perceptions Of Medical Marijuana Laws, Cole Isaac Stomp

Graduate Theses/Dissertations

As states across the United States enact Medical Marijuana Laws (MMLs), it is important to understand the implications of these policies and what effect they may have on the current healthcare industry. There is a lack of medical marijuana (MM) access due to novel policy and discrepancy of state legislature between those legalizing MM use versus current federal law. As of November, 2018, the state of Missouri has adopted MM policy, yet the perceptions, attitudes, and knowledge of MM and MMLs for current and future healthcare workers remains unknown. Therefore, the purpose of this study was to survey local healthcare …

Polycystic Ovarian Syndrome And Insulin Resistance: An Evaluation Of Treatment Modalities And Complication Prevention, Sarah Mann

Senior Honors Theses

Polycystic ovarian syndrome (PCOS) is a reproductive and endocrine disorder in women of childbearing age. This disorder includes multiple clinical manifestations, namely insulin resistance (IR) and infertility related to hormonal imbalances and anovulation. Despite being a common condition, its etiology and treatment modalities remain poorly defined. Without proper understanding and management of the condition, women may suffer numerous complications besides infertility such as diabetes mellitus type II (DMII), endometrial cancer, and cardiovascular disease. Therefore, further research is critical. This integrative review will create a comprehensive understanding of PCOS' pathophysiology, potential complications, treatment methods, and nursing considerations to promote the health …

Equitable Distribution Of Covid-19 Vaccines: Can Data Visualization And Optimization Help?, Zhennan Wang

Honors College Theses

Coronavirus disease (Covid-19) is known as an infectious disease that has a bigger impact on urban areas with high-density populations. In New York City, however, there are huge differences in the impacts of Covid-19 at the neighborhood level. In addition, there is a negative correlation between the Covid Case Rate and the Vaccination Rate, and areas that are affected the most have poor socio-economic conditions. To better address the equitable distribution of Covid-19 vaccines, I collected social and economic data from Community Health Profiles as well as Covid-19 data from NYC Health. Using this data I created visualizations in Tableau …

Social Environment Changes During Covid-19 Quarantine, Aileen Jimenez

Honors Theses

The purpose of this research project is to understand perceptions of the psychological, behavioral, and social impacts of COVID-19. Students at the University of Mississippi were invited to participate in an online questionnaire administered through Qualtrics. The questionnaire was composed of questions concerning health behaviors, including questions from the Depression, Anxiety and Stress Scale-21, Perceived Vulnerability to Disease Scale, Fear of Coronavirus-19 Scale, and the World Health Organization’s COVID-19 Snapshot Monitoring study. 274 students participated in the study. Overall, the results of this study suggested moderate distress across the sample, differences in sleep, exercise, and alcohol consumption during quarantine conditions, …

Evaluating Insurance Approval Rates Of Exome Sequencing And Its Effect On Minority Patients' Access To Genetic Care, Katlyn Frane

Dissertations and Theses (Open Access)

Exome sequencing (ES) is often a standard step in the genetic testing process for patients with rare or complex disease. Despite clinical implementation of ES, insurance companies (payers) continue to deny this test. We investigated if the payer barrier is influenced by payer type, and if other demographic or clinical information correlated to ES approval and obtainment. To do this, a retrospective chart and clinical database review was completed on patients seen at a tertiary care center and community-based clinic. Patient demographics, clinical indications, and testing recommendations and outcomes were used to assess ES approval and obtainment. We found that …

Risk And Clinical Risk Factors Associated With Late Lower Cranial Neuropathy In Long-Term Oropharyngeal Squamous Cell Carcinoma Survivors, Puja Aggarwal, Ryan P Goepfert, Adam S Garden, Naveen Garg, Jhankruti S Zaveri, Xianglin L Du, Michael D Swartz, Stephen Y Lai, C David Fuller, Renata Ferrarotto, Erich M Sturgis, Linda B Piller, Katherine A Hutcheson

Faculty, Staff and Student Publications

IMPORTANCE: Lower cranial neuropathy (LCNP) is a rare, but permanent, late effect of radiotherapy and other cancer therapies. Lower cranial neuropathy is associated with excess cancer-related symptoms and worse swallowing-related quality of life. Few studies have investigated risk and clinical factors associated with late LCNP among patients with long-term survival of oropharyngeal squamous cell carcinoma (OPSCC survivors).

OBJECTIVE: to estimate the cumulative incidence of and identify clinical factors associated with late LCNP among long-term OPSCC survivors.

DESIGN, SETTING, AND PARTICIPANTS: This single-institution cohort study included disease-free adult OPSCC survivors who completed curative treatment from January 1, 2000, to December 31, …

Media Framing, Moral Panic And Covid-19: A Comparative Analysis Of China, South Korea, And The Us., Deena Devore, Sinyong Choi, Yudu Li, Hong Lu

Criminal Justice Faculty Publications

COVID-19 is perhaps the single most impactful event defining 2020 globally. Drawing on theory on media typology involving freedom and responsibility, media framing and moral panic theories, this paper examines media coverage on COVID-19 in three countries, China, South Korea and the United States. Data were obtained from six news outlets, Xinhua News, South China Morning Post, Chosun, Hankyoreh, CNN and Breitbart, two from each of the three countries. More than 1,000 COVID-19 related reports, spanning six days (the last day of January to June, 2020) were selected and coded based on common priming themes such as tone, the othering, …

Covid-19 Student Mental Health Check Ii, Dianna Blankenship, Irma S. Jones

Criminal Justice Faculty Publications

The year 2020 will forever be known as the year of the COVID-19 pandemic which has affected the entire population in one way or another. What began in January 2020 still has the world population firmly in its grip a year later. The students’ responses, in their own words, to changes in living, daily `routines, and health fears can be seen in the following paper. In this article, the responses of students in several undergraduate classes at a Hispanic serving institution in south Texas were collected and synthesized. The 155 responses were divided into seven frequently observed and repeated themes: …

Investigating The Association Between Adolescent Polysubstance Use, Crime, And Violence In The United States, Christian Nwabueze

Electronic Theses and Dissertations

The lifetime prevalence of alcohol in the United States is 8% and lifetime prevalence of illicit drug use is about 2-3%. Substance use is common among adolescents and polysubstance use is becoming a public health threat.

The prevalence of adolescent physical dating violence was 8.2%, the prevalence of adolescent sexual violence was also 8.2% while the prevalence of dual adolescent physical and sexual violence was 2.6%. Compared to those who used only single substances, adolescents who did not use any substance were 60% less likely (OR = 0.42, 95% CI = 0.24 – 0.74) to experience physical dating violence, 50% …

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

Capstone Experience: Master of Public Health

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

Capstone Experience: Master of Public Health

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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 …

Mental Health Of Individuals Within Incarceration: A Systematic Literature Review, Steven I. Valladares

Capstone Experience: Master of Public Health

Mental Health Illness is on the rise in the United States. About 90% of incarcerated individuals have at least one mental health condition. The current federal and state incarceration systems do not seem to be well-equipped to transition an incarcerated individual to the civilian life. This is so because the incarceration system focuses too much on the punishment rather than rehabilitation. This framework could be deemed unsafe and dangerous to the civilian world once a prisoner gets released, due to incarcerated individuals not receiving adequate mental health treatment. This literature review highlights the flaws of the current incarceration system mental …

The Effect Of Fiber And Omega-6:Omega-3 Fatty Acid Ratio On Asthma And Asthma-Related Symptoms In An Adult U.S. Population, Korie As Nelson

Capstone Experience: Master of Public Health

Asthma is one of the most common diseases in the world affecting more than 10% of adults in many westernized countries and 339 million globally. Studies have shown a positive association between increased dietary fiber and improvement in asthma-related inflammation. Omega-3 fatty acids have also been shown to help mitigate inflammation in general. No identified studies have looked at the synergistic effect of omega-3 and omega-6 fatty acids alone and as a ratio with fiber on asthma, lung function, and respiratory morbidities. A positive association could mean that dietary interventions of fiber and fatty acids could significantly improve asthma and …

Efficacy Of Vaccine Candidates Against Zika Infection And Congenital Zika Syndrome: A Systematic Review And Meta-Analysis, Hannah Lund

Capstone Experience: Master of Public Health

There have been previous reviews looking into the efficacy of vaccine candidates against Zika infection in non-humans primates, but there hasn’t been a review looking into the efficacy against Congenital Zika Syndrome (CZS).The aim of this project was to systematically review literature on efficacy of vaccine candidates against Zika infection and CZS. A protocol was developed following PRISMA guidelines. English articles published since 2015 were included. Clinical trials (CCTs) that compared the efficacy of four Zika virus vaccine candidates' (PIV, DNA, mRNA, and Adenovirus) against zika infection and CZS in human and non-human primate models were included. Grey literature and …

Impact Of Dietary Fiber And Omega6/3 Intake On Copd Outcomes In U.S. Adults, Jacey Hain

Capstone Experience: Master of Public Health

COPD is the 4^th leading cause of death in the United States and is the leading cause of hospitalizations in adults.¹Although there is no cure for COPD, symptoms can be managed to increase the quality of life of those affected by the disease. Dietary omega-3 and -6 as well as fiber intakes have been noted as mitigating the burden of disease through their anti-inflammatory properties. We set out to look at the synergistic effect of both omega-3,-6, -6:-3 ratio and fiber on COPD, lung function and respiratory morbidities. We used data from the National Heath and Nutritional …

Predicting Suboptimal Care In Insured Nebraskans With Known And Suspected Chronic Conditions., Avery Wallace

Capstone Experience: Master of Public Health

Health insurance companies have a goal of improving population health for their members (people who the company insures). As a health insurance company, [Company] has ample data on the health of its members that can be utilized to improve the health, and by extension lives of the people they insure. Although [Company] does not deliver care, they communicate with their members and physicians to identify ways to improve the health of the member. Of specific interest are members with known chronic conditions who are receiving suboptimal care, as well as members who have undiagnosed chronic conditions. Two chronic conditions were …

Outpatient Visits At A Geriatric Psychiatry Clinic During The Covid-19 Pandemic, Thomas D. Bainter

Capstone Experience: Master of Public Health

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic led to a significant rise in the use of telehealth for healthcare delivery. The University of Nebraska Medical Center (UNMC) outpatient psychiatry clinic began using telehealth for nearly all patient visits shortly after the pandemic began. This project was intended to evaluate the effects of this change on patient visits with the geriatric psychiatry department at UNMC. For the months of April-August 2020 and April-August 2019, when in-person visits were still the norm, the following were compared: (1) no show and cancel frequency; (2) patient visit duration; (3) frequency of patient phone calls …

Workforce Assessment: Measuring The Impacts Of Covid-19 On The Maternal And Child Health Workforce, Ashleigh M. Sutphen

Capstone Experience: Master of Public Health

Workforce assessments provide an opportunity to assess, evaluate, and identify the needs of a particular workforce. The use of workforce assessments in the field of maternal and child health (MCH) has been an ongoing and a strongly supported effort by the Health Resources & Services Administration: Maternal and Child Health Bureau (MCHB). The maternal and child health workforce is responsible for providing essential public health services to some of the most vulnerable populations such as mothers, children, and people living with disabilities. Thus, the continuation of providing these essential public health services is critical – even in the midst of …

Conducting A Swot Analysis And Assessing Clinic Roles To Improve Integrated Healthcare, Jessica S. Hicks

Capstone Experience: Master of Public Health

Currently, those with a mental illness are less likely to receive primary care services and are more likely to die sooner than those without a mental illness. Combating this health disparity, integrated healthcare is a holistic approach that treats both mental and physical health. The cooperation and partnership of multiple health disciplines is a whole-person method that improves a patient’s overall wellbeing. Community Alliance is an organization in Omaha, Nebraska that offers integrated health care services through its clinic to community members. With multiple areas of care, roles and responsibilities can become easily obscured creating confusion and mistakes in the …

The Migration Of Carbapenem-Resistant Acinetobacter Baumannii From The Battlefields Of Iraq And Afghanistan To The Healthcare Facilities Of The Veterans Health Administration, Jeffery Rogers

Capstone Experience: Master of Public Health

Multidrug-resistant organisms (MDRO) pose a great threat to health across the globe. That threat is also felt in the Veterans Health Administration (VHA). Wounded warriors returning home from the battlefields of Iraq and Afghanistan may have brought with them MDROs, such as the bacterium Acinetobacter baumannii, as they have transitioned from military service into the VHA facilities. This study investigates the interconnectedness of military service in the Department of Defense (DoD) and a lifetime of care at VHA through a longitudinal tracking of a linked cohort of combat veterans with battlefield injuries and subsequent MDR infections of A. baumannii. …

Nebraska Public Guardianship Of Unbefriended Patients: A Preliminary Review Of Health Outcomes And Cost Savings, Emily N. Berzonsky

Capstone Experience: Master of Public Health

Unbefriended patients often experience an extended length of stay in the hospital while their medical providers await legal appointment of a public guardian to make their medical decisions. The medically unnecessary days the unbefriended patient spends in the hospital equates to high costs for the hospital, but more importantly, negative health outcomes for the patient. The purpose of this study is to provide literature and data to support recommendations for possible changes in Nebraska’s public guardianship appointment process. A literature review seeks to answer: (1) What is the median hospital length of stay for an unbefriended patient without a guardian …

The Epidemiology Of Clostridioides Difficile In Nebraska - A Descriptive Study Between 2018-2020, Storm Keffer

Capstone Experience: Master of Public Health

Objectives: Clostridioides difficile (C. diff) is a common but challenging infection both financially and medically. Due to these difficulties, Clostridioides difficile infection (CDI) caused by C. diff is a mandatory reportable disease in Nebraska and as such has been a priority disease targeted by various disease control practices across many hospitals. All CDI laboratory results are reported electronically through the Nebraska Electronic Disease Surveillance System (NEDSS). However, capturing and conceptualizing the true burden of CDIs in Nebraska has not been adequately accomplished since monitoring of CDIs began. The objective of this study is to examine the trends of …

Impact Of Proton Pump Inhibitor Use On Effectiveness Of Immune Checkpoint Inhibitors In Advanced Cancer Patients, Ken Chen

Capstone Experience: Master of Public Health

Background: Gut microbiome plays a critical role in modulating therapeutic effect of immune checkpoint inhibitors (ICIs). Proton pump inhibitors (PPIs) may affect the gut microbiome by altering gut pH.

Objective: To evaluate if concurrent use of PPI 0-30 days before or after initiation of ICIs (nivolumab or pembrolizumab) is associated with poorer overall survival (OS) and progression-free survival (PFS) for patients with stage IV non-small cell lung cancer (NSCLC), melanoma, renal cell carcinoma, transitional cell carcinoma or head and neck squamous cell carcinoma compared with no PPI use.

Methods: This was a single-center retrospective cohort study of advanced cancer patients …

The Spatial-Temporal Model Of Covid-19 Tests, Cases, And Deaths In The State Of Nebraska, Makayla Schissel

Capstone Experience: Master of Public Health

The goal of this project was to illustrate the spread of COVID-19 tests, cases, and deaths within the state of Nebraska and identify non-random clusters using a spatial-temporal model. This project is pertinent and innovative, as few spatial-temporal models in the United States revolving around COVID-19 offer information at the county, let alone, the state level. De-identified data was extracted from the State of Nebraska’s Department of Health and Human Services COVID-19 dashboard, transformed and prepared for analysis using SAS coding language. Clusters were identified though SaTScan software using a space-time permutation model. The model identified 5 different clusters related …

Factors Affecting The Mortality Rate Of Older Patients With Covid-19 In Nebraska: A Retrospective Cohort Study, Erin Johnson

Capstone Experience: Master of Public Health

The pandemic spread of COVID-19 is a continued global health emergency. The objectives of this paper were to examine Factors affecting the mortality rate of older patients with COVID-19 in Nebraska. A longitudinal analysis of data gathered from the Nebraska Electronic Disease Surveillance System (NEDSS) was performed. Included were 322 individuals who tested positive for COVID-19 in the month of October 2020. The Kaplan-Meier method was used to estimate the time to death of individuals over the age of 65 after a positive COVID-19 diagnosis and the probability of survival to any given time point. The effect of multiple risk …

A Deeper Look: The Impacts Of Covid-19 Among Latinos In Omaha, Diana Molina

Capstone Experience: Master of Public Health

The COVID-19 pandemic has manifested worldwide distress, affecting the lives of all population groups. Racial disparities are evident as minority populations are being disproportionately affected by the impacts of COVID-19. Data indicate that the Latino population may experience more severe cases of COVID-19 and have a higher mortality rate. However, little is known about the effects that the pandemic is having on day-to-day life. Thus, the purpose of this study is to investigate COVID-19's impact on life aspects including employment situation, finances, mental health, and experiences of discrimination among the Omaha Latino community. A survey collected data from 311 participants …

Health Belief Model Implications For Cervical Cancer Screening Among Refugee Women In Omaha, Nebraska, Na-Omi Hassane Dan Karami

Capstone Experience: Master of Public Health

Literature gap

According to the World Health Organization (2020), cervical cancer is among the top four most common cancers in women. However, refugee women are the least screened for cervical cancer. There is limited research examining the uptake of cervical cancer screenings among refugee women using the health belief model. Little is known about barriers and facilitators associated with the uptake of cervical cancer screening among refugee women in Nebraska.

Objectives:

The purpose of the study is to assess the health behavior of refugee women in Omaha towards cervical cancer screening via the health belief model and to determine the …

Ethnic And Racial Disparities In Covid-19 Infections In The United States, Seraphina Negash

Senior Honors Projects

No abstract provided.