Public Health Commons^™

Body Appreciation, Gender, Motivation, And Competitive Success In Competition Climbing, Marissa Frost

All Theses

The focus of this study was to examine the relation between the constructs of body appreciation, gender, motivation, and competitive success in competition climbers. To gather data for this study, a Qualtrics survey was created and distributed amongst the competition climbing community through USA Climbing’s Facebook page and member email list. Data was then collected from competition climbers between the ages of thirteen and sixty over 45 days in the winter of 2017. A total of 236 competition climbers participated in the survey and 202 of those responses were used in this study. Body appreciation in this study was analyzed …

Advanced Epidemiologic Methods To Estimate Disparities In Peripheral Artery Disease In South Carolina By Geographic Location, Payor Status, And Socio-Demographics, Brian A. Witrick

All Dissertations

Peripheral artery disease (PAD) is a progressive circulatory disorder of the lower extremities that occurs when atherosclerotic plaques obstruct arteries carrying blood from the heart to the legs. PAD is associated with reduced quality of life and increased risk of poor outcomes, particularly among disadvantaged groups. There is a need to better understand disparities experienced by disadvantaged groups. Thus, the purpose of this doctoral research was to explore the association of geographic, economic, and socio-demographic factors with PAD. South Carolina is an ideal location to investigate disparities of PAD due to the risk profile of South Carolina residents and the …

The Effects Of Alcohol Intoxication And Threats To Masculinity On Engagement In Sexual Aggression: Results From A Web-Based Survey Design And Alcohol Administration Study, Tiffany Lynn Marcantonio

Graduate Theses and Dissertations

Background: Research examining the combined effects of men’s alcohol consumption and perceptions of their masculinity as precarious (e.g., viewing masculinity as easily threatened) on sexual aggression (SA) is lacking. The goal of this dissertation study was to assess if alcohol consumption and precarious masculinity are related to men’s SA via a web-administered survey (Study 1) and an in-person alcohol administration experiment (Study 2).

Methodology: In Study 1, two samples of young adult men (aged 18-30) were collected, 1) a community sample of 492 men and 2) a college sample of 478 men, to complete a 20-minute survey; participants answered questions …

The Complexities Of Guilt, Shame, Stigma, And Substance Use Among A Sample Of United States Substance Using Adults, Nicole A. Doyle

Graduate Theses and Dissertations

Background: Guilt, shame, stigma, substance use (problematic/nonproblematic), and help-seeking intention, are complex interrelated constructs that have not been collectively examined in community substance using adults, with mere pieces of each construct previously studied in various populations. Guilt pertains to an action (i.e., I did something bad) whereas shame pertains to the person (i.e., I am bad). Guilt has been shown to function adaptively by prompting individuals to repair transgressive behavior where shame has been shown to function maladaptively by prompting individuals to withdraw and compound the global negative feelings of the self. Stigma of substance use is pervasive and leads …

Exploring Higher Weight Women's Experiences Of Provider Weight Stigma, Meredith W. Moore

Graduate Theses and Dissertations

The purpose of this phenomenological study is to explore the phenomena of weight stigma as experienced by higher weight women in mental health treatment who also engage in restrictive eating behaviors. Women in larger bodies who are emotionally or behaviorally restrictive in their eating behaviors face a unique set of challenges and barriers. These include challenges due the disordered eating behaviors themselves, along with barriers related to weight stigma perpetuated by the mental health providers treating them (Harrop, 2019). Distinct hurdles to proper treatment including delay of diagnosis, longer duration of symptoms, and increased distress related to eating and body …

Six Feet Apart: Relational Turbulence Theory And Coping With Covid-19 Within Long-Distance Relationships, Mia Waymack

Graduate Theses and Dissertations

Among research that currently exists, no studies thus far combine elements of COVID-19, long-distance relationships, and Relational Turbulence Theory to explain how each of these elements impacts the others, if at all. Previous research does exist on each of these elements individually, although research regarding the long-term effects of COVID-19 on relationships is minimal considering the pandemic is ongoing. Long-distance relationships have been studied using Relational Turbulence Theory in previous studies within military relationships but have not been studied in connection with either COVID-19 or among college students. This study was conducted by way of qualitative, one-on-one interviews to determine …

Machine Learning Automated Detection Of Large Vessel Occlusion From Mobile Stroke Unit Computed Tomography Angiography, Alexandra L Czap, Mersedeh Bahr-Hosseini, Noopur Singh, Jose-Miguel Yamal, May Nour, Stephanie Parker, Youngran Kim, Lucas Restrepo, Rania Abdelkhaleq, Sergio Salazar-Marioni, Kenny Phan, Ritvij Bowry, Suja S Rajan, James C Grotta, Jeffrey L Saver, Luca Giancardo, Sunil A Sheth

Faculty, Staff and Student Publications

BACKGROUND: Prehospital automated large vessel occlusion (LVO) detection in Mobile Stroke Units (MSUs) could accelerate identification and treatment of patients with LVO acute ischemic stroke. Here, we evaluate the performance of a machine learning (ML) model on CT angiograms (CTAs) obtained from 2 MSUs to detect LVO.

METHODS: Patients evaluated on MSUs in Houston and Los Angeles with out-of-hospital CTAs were identified. Anterior circulation LVO was defined as an occlusion of the intracranial internal carotid artery, middle cerebral artery (M1 or M2), or anterior cerebral artery vessels and determined by an expert human reader. A ML model to detect LVO …

Early Detection Of Atypical Motor And Neurobehavior Of Infants At Risk Secondary To Opioid Exposure: A Prospective Study, Kara Boynewicz

Electronic Theses and Dissertations

Prenatal opioid exposure has been studied in relation to infants' medical outcomes. However, large gaps exist in the literature supporting early identification of atypical neurobehavior and motor development of infants with prenatal opioid exposure. The purpose of the study was to investigate whether prenatal opioid exposure has a negative influence on a newborn infant’s neurobehavior and motor development to aid in the early identification of potential delays. Using a prospective quasi experimental design, infants motor development using the Test of Infant Motor Performance (TIMP) and neurobehavior using the NICU Neonatal Network Scale (NNNS) was assessed on 58 infants in a …

Manual Therapy For Patients With Radiation-Associated Trismus After Head And Neck Cancer, Holly Mcmillan, Carly E A Barbon, Richard Cardoso, Abigail Sedory, Sheila Buoy, Christine Porsche, Kiara Savage, Lauren Mayo, Katherine A Hutcheson

Faculty, Staff and Student Publications

IMPORTANCE: Trismus is highly prevalent in head and neck cancer (HNC) survivorship. Current standards for trismus treatment include various stretch-based exercise protocols as a primary and single treatment modality with limited evidence regarding the role of manual therapy (MT) for this indication.

OBJECTIVE: To assess the effect size and associations of response to MT to increase oral opening in the setting of radiation-associated trismus.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective case series was conducted at the University of Texas MD Anderson Cancer Center between 2016 and March 2020 (before COVID-19 interruption) and included 49 disease-free survivors of HNC who were …

Misinformation And Vaccine Hesitancy Determinants: The Significance Of Framed Public Health Messaging, Alexandra I. Todd

Capstone Experience: Master of Public Health

In 2020, the SARS-CoV-2 (COVID19) outbreak effectively disrupted worldwide operation for months, leading to tremendous economic loss and adverse health outcomes. While countries grappled to control the virus and scientists worked around the clock to deliver a vaccine in record time, a pubic health communication crisis emerged. The spread of false and misleading information, also known as misinformation, has proved to be a barrier in the fight against COVID19 and its vaccination effort. Many factors including the rise of social media, distrust of government, polarization of news sources, and fragmented media have created an environment susceptible to misinformation. Utilized correctly, …

Financial Analysis Of New Medicare And Medicaid Guidelines, Reimbursement Rates, And Increased Enrollment On Four Nebraska Clinics, Jamilah J. Abdul-Hakim

Capstone Experience: Master of Public Health

Government health insurance plans such as Medicaid and Medicare were created with the intention of providing elderly, low-income, or disabled citizens with affordable and quality health insurance through government-contracted providers (Baicker et al., 2013). Medicare is a government health insurance program that provides healthcare to United States citizens 65 years and older, regardless of their income or past medical history. Medicaid was implemented as an assistance program to provide health insurance for low-income Americans and their families. Medicaid is administered by each state independently, which creates variation in reimbursement rates, services, and structure. (Grabowski, 2007).

Providers accepting Medicare and Medicaid …

A Survey And Analysis Of Educational Materials Addressing The Health Consequences Of Drinking Nitrate Contaminated Water In Medical Clinics Located In The Most At-Risk Areas Of Nebraska: Are Healthcare Providers Equipped To Protect And Educate Their Patients?, Laura Nagengast

Capstone Experience: Master of Public Health

Background: Eighty five percent of Nebraskans rely heavily on groundwater sources, including private wells, as their primary source of drinking water. Nitrate is one of the most common chemicals found in private well water. Numerous studies demonstrated the serious human health consequences from prolonged nitrate exposure. Therefore, due to the potential health risks, this project aimed to identify and evaluate the existing knowledge and awareness among healthcare providers as well as the educational materials in medical clinics in Nebraska related to health effects of drinking nitrate contaminated water.

Methods: An 8 multiple choice question survey was developed using Microsoft Forms. …

Evaluating First Responder Personal Preparedness In Douglas County, Nebraska's Volunteer Fire And Emergency Medicine Service, Kylie Johnson

Capstone Experience: Master of Public Health

In disaster response, it is essential for first responders to focus on their disaster role. Lack of personal preparedness at home could hinder a responder’s ability to focus their attention on their response role (13). Personal conflict, such as that caused between family duties and response duties, in a disaster can be mitigated through several means. One mitigation tactic is preparedness education and support offered by the responder’s organization. While the importance of responder personal preparedness cannot be understated, there is a lack of baseline data on the topic related to Nebraska responders.

To assess the state of first responder …

Assessing Meat Processing Workers’ Attitudes And Concerns Regarding Covid-19 Vaccination, Karen Schmeits

Capstone Experience: Master of Public Health

The COVID-19 pandemic has impacted industries across the globe. Specifically, for meat processing (meatpacking) facilities, the pandemic has changed the way facilities operate, how the workers perform tasks, and how workers perceive their health. The development of an FDA approved COVID-19 vaccine brought hope to meat processing employers and workers. However, little research has been conducted to know how meat processing workers feel about vaccines generally and how they perceive the COVID-19 vaccine. The purpose of this cross-sectional study was to investigate preventive vaccine determinants and attitudes and concerns specifically regarding the COVID-19 vaccine. Surveys were conducted with 128 meat …

Weight Gain Trajectory Over Five Years For Adult Primary Care Patients In Nebraska, Elizabeth M. Morris

Capstone Experience: Master of Public Health

INTRODUCTION: The continued rise in the prevalence of adult obesity in the United States is a public health concern. Several studies have identified the increasing rates of obesity, its impacts, and the factors leading to obesity. Some researchers have made obesity prevalence projections at the national and state levels. This study aims to fill the critical gap in real-time weight data trends among primary care adult patients in Nebraska. The main goal of this study is to determine and analyze the weight trajectory of adults in Nebraska over the past five years and determine if the trends vary among age …

Assessing Facilitators And Barriers To Enrolling In Cardiac Rehab, Michaela R. Geiser

Capstone Experience: Master of Public Health

Abstract: Heart disease has been a leading cause of death since the early 1900s (Heron & Anderson, 2016). Americans are at higher risk for heart disease if they have high blood pressure, high cholesterol, are overweight, inactive, and smoke, among other risk factors (CDC, 2019). If a person already has heart disease or has had a cardiac intervention (such as a stent), they may be referred to a local cardiac rehab program. Bryan Health in Lincoln, NE, currently offers two methods of delivering cardiac rehab: in-person or home-based. Research has not yet been done to assess enrollment facilitators and barriers …

The Perception Of Technology On Continuous Health And Environmental Monitoring For Professional Drivers, Troy Suwondo

Capstone Experience: Master of Public Health

Due to the sedentary nature of professional truck driving (among other high-risk behaviors and hazardous exposures) many suffer from acute and chronic health conditions. There are many potential hazards in the professional driving profession. Many of these hazards come from those that transport hazardous materials. Figuring out what health and environmental indicators are important to measure can be a way to minimize hazards. Continuous health monitoring technology may be an option to detect disease and alert professional drivers when vital signs indicate impending health crises. Before this can be implemented, it will be important to evaluate the perception of wearable …

Systematic Literature Review: Culturally Appropriate Approach To Advance Care Planning For Ponca Tribe Elders, Priscila Soto Prado

Capstone Experience: Master of Public Health

Advance Care Planning is understudied in Native American and Alaskan Natives communities. There is a strong need for further research on culturally adapting advance care planning (ACP) for indigenous communities. Specifically, for the Ponca Tribe, culturally adapting the ACP used would ideally increase the acceptance of ACP in that community. This systematic literature resulted in identifying four themes other tribes have utilized to culturally adapt their ACP, advance directive, palliative and/or end-of-life processes in an effort to increase completion rates. The four themes were involving the elders with the adaptation process, increasing education efforts and awareness of ACP and ADs, …

A Quantitative Job Satisfaction Comparison Between Certified Nursing Assistants (Cnas) Providing Care In Patients’ Homes Versus In Long-Term Care (Ltc) Facilities In The Omaha Metropolitan Area, Rusheena Shah

Capstone Experience: Master of Public Health

This capstone project looks at overall job satisfaction comparison between two groups of Certified Nursing Assistants (CNAs) – CNAs who provide home care in patients’ homes and CNAs who provide care in Long-term Care (LTC) facilities in the Omaha Metropolitan Area. In this quantitative study, a survey was sent to CNAs who provide home care to patients and CNAs who provide patient care at different nursing home facilities in the Omaha area. Prior research has indicated that even though CNAs perform similar job duties irrespective of the work environment; they experience varying degrees of job satisfaction which could be attributed …

Effect Of Climate Variability On Lyme Disease Cases In The United States – A Retrospective Study, Larissa Mark

Capstone Experience: Master of Public Health

Vector-borne illnesses are a growing serious global public health threat. According to the CDC, Lyme disease (LD) is the most common vector-borne disease in the United States. It is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of an infected black-legged tick. Since the discovery, LD has increased in both incidence and geographical distribution. Vector life cycles and disease transmission are highly sensitive to abiotic conditions; as such, it is expected that climate change will alter the geographic distribution and magnitude of vector-borne illnesses. Certain facets of climate change like precipitation patterns, greater climate …

Randomizer Utilizing R Shiny, Cali R. Savage

Capstone Experience: Master of Public Health

Currently, many published animal experiments fail to include concise information regarding randomization (Festing, 2014). By not including randomization efforts in published research, the ability for one to accurately reproduce a study’s results is greatly diminished. This can be seen in randomization efforts that may be difficult to reproduce, such as poor randomization techniques and lack of documentation. Therefore, the creation of the Randomizer utilizing software R to create a user-friendly program that can enable University of Nebraska Medical Center (UNMC) researchers, among others, to create randomization schemes for research involving mice, other animal, or human subjects, and enhance documentation and …

Developing A Curriculum To Combat Loneliness As A Public Health Concern In Businesses, Sophia Yelkin

Capstone Experience: Master of Public Health

Loneliness has been considered a public health epidemic affecting people across the world. Elderly populations have historically been considered most at risk for loneliness, but it is becoming evident that loneliness is not so selective. Younger generations show more signs and symptoms of loneliness than older generations. This often overlooked condition is attributable to decreased mental and physical health and can weaken performance in the workplace.

This capstone project creates a concise curriculum addressing loneliness for dissemination in the workplace, ensuring appropriate health literacy for the priority population. Understanding the pervasive nature of loneliness, identifying symptoms, and methods to counteract …

Local Public Health Legal Landscape Report, Christina Hitz

Capstone Experience: Master of Public Health

This report provides a framework for understanding and examining local public health authority and implications of proposed legislative changes, specifically whether a shift is occurring in public health authority from the executive to the legislative branch. It compares the public health governance and legal infrastructure of states making a shift in 2021 relative to Nebraska’s current and proposed public health infrastructure and provides a synopsis of the legal context for and the scope of local public health authority currently in Nebraska. Three resources were used to create two tables to compare both states with legislative changes in 2021 indicating a …

A Comprehensive Literature Review Of Recruitment And Retention Strategies For Primary Care Providers In Rural Communities, Christian Folken

Capstone Experience: Master of Public Health

Workforce trends within the United States indicate a growing crisis in the availability and distribution of primary care providers. Rural communities have been disproportionately affected by the lack of primary care providers. The gap in available primary care services in rural areas severely affects the population health outcomes of these communities. There is a critical need for rural healthcare systems to effectively understand and implement recruitment and retention strategies of primary care providers to meet the needs of their patients and community. The goal of this paper is to provide a centralized resource of evidence-based strategies regarding the recruitment and …

Exploring Factors Related To Cancer Recurrence In Nebraska, Zenghan Tong

Capstone Experience: Master of Public Health

Currently, the studies of cancer burden are focused on the incidence, mortality, and survival of cancer. Due to the early detection and advancement of therapies, more patients can live much longer after a cancer diagnosis. Health care providers and patients want to know more about cancer recurrence, which can significantly impact cancer survivors’ quality of life. At this moment, the cancer recurrence studies are clinically based on specific treatments of particular cancers and are usually limited to small and selected populations. This study utilized the population-based cancer registry data between 1996-2015 to examine the cancer recurrence status in Nebraska. The …

Respiratory Syncytial Virus (Rsv) Laboratory Surveillance And Mortality In Nebraska, 2016 – 2021, Derek Bumgardner

Capstone Experience: Master of Public Health

Respiratory syncytial virus (RSV) is a common respiratory virus affecting children and adults. The United States RSV peak season occurs regularly between October to May, but in April 2021, an unexpected United States interseason RSV epidemic ensued. RSV laboratory testing has changed in the United States due to increased use of nucleic acid amplification testing (NAAT) rather than antigen-based testing, affecting how RSV seasonal epidemics are determined. Nebraska linked RSV laboratory and death certificate data (2016-2021) were used to calculate crude, specific and adjusted RSV case and mortality rates by age, sex, race, and ethnicity. A Cochran – Armitage test …

A Walk In Two Worlds: An Indigenous Health Research Mentorship Model Developed From The Experiences Of Mentors And Mentees In A Cancer Research Education Program Aimed At Increasing Representation Of American Indians/Alaska Natives In Cancer Research And Healthcare Professions, Kiana Borengasser, Aislinn C. Rookwood, Joyce C. Solheim, Maurice Godfrey, Karen Taraszka Hastings, Keyonna King, Hannah Robbins, Mariah Abney, Rudy Smith Jr., Liliana Tamayo, Regina Emily Robbins

Capstone Experience: Master of Public Health

The National Cancer Institute promotes workforce development programs that aim to increase representation of American Indian/Alaska Natives in health science and research careers. One such program, Youth Enjoy Science at the University of Nebraska Medical Center, has employed American Indian/Alaska Native youth in mentored cancer research internships from 2017 to 2022. The primary purpose of this study was to examine mentor and mentee experiences of participation in Youth Enjoy Science research education internships to learn from their stories. We conducted semi-structured interviews with current and former Youth Enjoy Science mentees (n=8) and mentors (n=8). We analyzed and collectively re-storied the …

The Epidemiology Of Extended Spectrum Beta-Lactamase-Producing Enterobacterales In Nebraska, 2018 – 2021, Axel A. Vazquez Deida

Capstone Experience: Master of Public Health

Background: Extended spectrum beta-lactamase (ESBL)-producing Enterobacterales are considered a serious public health threat by the United States Centers for Disease Control and Prevention. However, surveillance of ESBL-producing Enterobacterales is currently limited to select states and the epidemiology of these antibiotic-resistant bacteria in Nebraska is still not well understood.

Objective: To describe the incidence of ESBL-producing Enterobacterales across local health department (LHD)-jurisdictions as well as at the state-level over time and assess population-specific factors associated with infection or colonization with these pathogens in Nebraska.

Methods: A retrospective, cross-sectional analysis of public health surveillance data reported to the Nebraska Department of …

Atrazine Levels In Rural Nebraska Counties And Parkinson's Disease, Muhammad Zahid

Capstone Experience: Master of Public Health

Parkinson's disease (PD) is a multifactorial disorder, connecting both genetic susceptibility and environmental risk factors. Several epidemiological and experimental studies support the evidence that pesticides exposure is positively associated with enhancing neurodegenerative diseases. The high amount of atrazine used in Nebraska and increased PD cases led us to evaluate the association between the long-lived water-soluble pesticide atrazine and PD in Nebraska counties. A person's exposure to atrazine may come from inhalation, dermal absorption, and ingestion. Three types of atrazine data covering 1992 to 2017 were used for this study: applied atrazine, atrazine in surface water, and atrazine in groundwater. In …

A Systematic Literature Review Of The Use Of Technology As An Emergency Preparedness Tool To Control And Contain The Covid-19 Pandemic, Alyssa Spartz

Capstone Experience: Master of Public Health

Various tools and strategies have been utilized in response to the COVID-19 pandemic. In addition to preexisting measures, novel mechanisms and methods have also been developed since the COVID-19 pandemic began to address several different needs worldwide. Technology, for example, has served as a unique and multifunctional tool to aid with controlling and containing the pandemic. While studies and reviews have been conducted to analyze specific types of technology, such as digital applications, a gap in the literature currently exists that fails to comprehensively understand and compare how multiple types of technology were implemented to address the COVID-19 pandemic. This …