University of Nebraska Medical Center
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Evaluating Knowledge of Emergency Procedures for Top Hazards Among Hospital Staff
No full textHospitals serve as frontline responders during public health emergencies, but the effectiveness of their response relies heavily on staff awareness and engagement with emergency preparedness training. This capstone project assesses hospital staff’s baseline knowledge of procedures for responding to the top emergency hazards. These hazards were selected based on Nebraska Medicine’s biannual Hazard Vulnerability Analysis (HVA), which identifies fire, severe weather events, and winter storms as high-priority risks requiring consistent staff readiness. Despite the existence of emergency procedures and training materials, literature reveals limited data on staff knowledge of these procedures across different hazards. This study, conducted at a large academic hospital, includes two key components: (1) a review of current institutional training materials and (2) an anonymous survey of clinical staff. The survey will include multiple-choice and scenario-based questions to assess staff knowledge of specific procedures for each hazard. Results will identify strengths and gaps in staff procedural knowledge across hazards, informing evidence-based recommendations to strengthen institutional preparedness. The project applies to core public health competencies related to data collection, analysis, and organizational preparedness, and fulfills emergency preparedness concentration competencies by examining health data and assessing the effectiveness of current training programs. Ultimately, this research supports efforts to build a more resilient healthcare workforce prepared to respond effectively in times of crisis
The Road to Regulation: A Literature Review of the Influences on the Updated Silica Standards
No full textSilica is a hazardous compound that poses a risk to human health resulting from dust creating activities across various industries. Several agencies, including OSHA (Occupational Health and Safety Administration) and MSHA (Mine Safety and Health Administration) have adopted regulatory oversight of silica exposure in the workplace. As more research has been conducted on silica exposure, the health effects are becoming better described, which has led to the creation and updating of exposure regulations to protect worker health. The objective of this literature study is to review the data presented to the Department of Labor and discuss how the factors that influenced the passage of the new silica standard. The specific aims of this review are to examine the rationale for OSHA’s interpretation of the presented data for regulatory changes, identify the factors that affected the passage of the new standard, and discuss the changes in the rulemaking process for regulation change
MUC16 and COL7A1 in ECM Remodeling in Lung Adenocarcinoma Metastasis
No full textLung adenocarcinoma (LUAD) remains one of the deadliest cancers globally, mainly due to its aggressive metastatic potential. Emerging evidence implicates extracellular matrix (ECM) remodeling as a critical driver of tumor progression. In this study, we investigate the cooperative roles of the MUC16 and COL7A1 genes, which are frequently overexpressed in LUAD, in ECM remodeling, stiffness, and metastatic progression.
It was hypothesized that the overexpression of MUC16 and COL7A1 increases ECM stiffness, thereby triggering integrin-mediated signaling cascades that support tumor cell invasion and dissemination. Transcriptomic analysis of LUAD patient datasets revealed a significant co-upregulation of MUC16 and COL7A1 in metastatic tumors. Functional assays in 3D ECM-mimetic cultures demonstrated that co-expression leads to increased collagen deposition and matrix crosslinking, resulting in a stiffer ECM microenvironment.
Furthermore, this hypothesized remodeling enhances integrin β1 activation and downstream FAK/Src signaling, promoting cytoskeletal rearrangements and migratory phenotypes. In vivo models confirmed that dual overexpression accelerates metastatic burden compared to single-gene overexpression or controls. These findings suggest that MUC16 and COL7A1 act synergistically to remodel the ECM in LUAD, creating a mechanically favorable niche for tumor spread. Targeting this axis may offer novel therapeutic opportunities to hinder metastasis and improve patient outcomes
The Effectiveness of Interventions in Reducing Sexually Transmitted Infections Among African American Adolescents: A Comprehensive Literature Review
No full textIn the United States, an estimated 20 million new sexually transmitted infections occur annually, with half of the cases occurring in adolescents. The infection rate among African American adolescents is four times higher than that among white adolescents. Although many types of interventions exist, few are specifically designed for African American adolescents. In conducting this comprehensive literature review and synthesis, I examined the effectiveness of existing interventions in creating behavioral change among African American adolescents by applying the health belief model to interpret and organize the findings. The databases PubMed, Embase, and Google Scholar were searched on October 1, 2025. Studies were screened for inclusion based on the following criteria: published between January 2015 and September 2025, involving a population aged 15-24 years, and consisting of a majority of African American individuals. Findings suggest that interventions incorporating demonstrations of proper ways to use contraception, strategies for effective partner communication, and support for self-efficacy among African American adolescents can promote meaningful behavioral change. This review indicates that future research and interventions should incorporate culturally specific aspects for African American adolescents to improve the effectiveness in creating behavioral change and, in turn, reducing the prevalence of sexually transmitted infections.
Keywords: Adolescents, African American, Sexually Transmitted Infections, Intervention
Reducing Sleep-Related Infant Deaths in Douglas County
No full textDouglas County, including the city of Omaha, covers 339.6 square miles along the border of the Missouri River in Nebraska with a population of 517,110 (https://www.douglascounty-ne.gov/) and is one of seven large urban counties in the state. There are approximately 8,000 infants born in Douglas County annually (Nebraska Vital Statistics Birth Dashboard). The Douglas County Health Department (DCHD), established in 1854, is one of the oldest county health departments in the state and manages multiple public health projects annually. In 2024-2025, a renewed focus for DCHD has been its infant mortality rate (IMR). In 2024, 44 infant mortalities occurred in Douglas County based on death certificates filed in Vital Statistics that year (Douglas County Health Department, 2025). Based on 8,039 births occurring in Douglas County in 2024 that gives a provisional infant mortality rate of 5.5 per 1,000 live births (Nebraska Vital Statistics Birth Dashboard, 2025). From 1999-2002 the IMR was as high as 7.74 per 1,000 live births (CDC Wonder Database, 2025). From 2003 to 2006 the IMR improved, but the rate for Black infants remained much higher at 13.8 compared to non-Hispanic whites at 4.9 per 1,000 live births (Figure 1) (Douglas County Health Department, 2025). Local collaborative efforts were put in place during this time that improved both the overall IMR and especially the IMR for Black infants. Unfortunately, a clear and consistent racial disparity in IMR has remained and appears to be widening since 2015
Quantifying the Public Health Impact of Lyme Disease in Minnesota: A Simulation Analysis of Reported and Unreported Cases
No full textBackground: Lyme disease, the most common vector-borne disease in Minnesota, is estimated to be underreported by a factor of 10. Delayed diagnosis and misdiagnosis may lead to health complications and increased personal and societal costs. Environmental factors can help to predict high disease years, allowing for early intervention to decrease disease burden. Objective: To estimate the health and cost burdens of Lyme disease and the extent to which they could be diminished by public health intervention when high-incidence Lyme disease years are forecasted. Methods: We used 5 two-dimensional Monte Carlo simulations to estimate (1) average annual expected burden of Lyme disease, (2 and 3) average burden in low- and high-incidence years, and (4 and 5) the expected burden saved with public health educational interventions preceding high-incidence years. We employed cases reported to the Minnesota Department of Health adjusted for estimates of underreporting found in the literature. Results: Among an average of 8436 Lyme disease cases annually, 6074 of them were unidentified. High-incidence years saw over 3700 more cases than low-incidence years, with incremental costs to patients and society exceeding 1.9 million in societal costs. Discussion: The simulations presented revealed substantial health and cost burden from Lyme disease, including hidden impacts from undiagnosed and unreported cases. Burden varied widely between high- and low-incidence years, highlighting the need to prioritize prevention when peak years are predicted. While we estimated the effects of individual prevention measures, real-world interventions often combine strategies, potentially producing a greater, multiplicative impact, suggesting our estimates may be conservative. Conclusions: Simulation modeling demonstrates Lyme disease’s significant impact on individuals and society. Annual forecasting-triggered public health interventions could reduce cost and disease burden, and these findings may help justify the cost of prevention efforts in policy decision-making
Ocular Surface Squamous Neoplasia (OSSN) Risk Factors in Lusaka, Zambia: The Role of HIV and Socioeconomic Status
Get PDFObjective
To identify and evaluate potential risk factors for OSSN at the University Teaching Hospital (UTH) in Lusaka, Zambia.
Methods
Data from 475 patients were analyzed retrospectively, and it included 390 with OSSN and 85 with benign biopsies. Variables with significance values
Results
Several key predictors of OSSN were identified after controlling for confounders in the household cooks sub-population, these were, a lower household income (adjusted odds ratio [aOR] = 0.64, 95% CI: 0.46–0.90, p = .009), a Lab confirmed HIV-positive status (aOR = 3.56, 95% CI: 1.72–7.21, p = .001) and exposure to biomass smoke (aOR = 2.47, 95% CI: 1.05–5.84, p = .039).
Conclusion
Lower household income and HIV-positive status were identified as significant risk factors, underscoring the need for targeted public health interventions. Logistic regression models outperformed regularized methods in predicting OSSN risk. We recommend improved healthcare access, HIV screening, and environmental protection measures could significantly reduce OSSN incidence in at-risk populations
Body Composition in Preterm Infants: Current Insights and Emerging Perspectives
Get PDFIn recent years, significant advancements in respiratory and nutritional care have markedly improved the survival rates of preterm infants and enhanced long-term health outcomes. Despite these improvements, emerging research highlights the lasting impacts of early growth patterns on an individual\u27s health trajectory. Adults born prematurely face a higher incidence of health issues related to their early birth. The American Academy of Pediatrics recommends that preterm infants should achieve growth rates similar to those of fetuses, with clinicians emphasizing nutrition delivery to help these infants reach their expected weight for gestational age. However, this approach often results in altered body composition, characterized by increased fat mass and decreased fat-free mass compared to full-term infants. Air displacement plethysmography stands out as a highly reliable method for measuring preterm body composition, while DEXA scans, despite their reliability, tend to overestimate body fat. Other methods include bioelectric impedance, isotope dilution, MRI, ultrasound, and skinfold thickness, each with its own strengths and limitations. In this paper, we aim to raise awareness among neonatal clinicians about the importance of achieving acceptable neonatal body composition. We discuss the pros and cons of different body composition measurement methods, the impact of nutrition and other factors on body composition in preterm infants, long-term follow-up data, and the potential use of body composition data to tailor nutritional interventions in NICU and post-discharge settings. This comprehensive approach is designed to optimize health outcomes for preterm newborns by focusing on their body composition from an early stage
A Comprehensive Review on Utilizing Human Brain Organoids to Study Neuroinflammation in Neurological Disorders
Get PDFMost current information about neurological disorders and diseases is derived from direct patient and animal studies. However, patient studies in many cases do not allow replication of the early stages of the disease and, therefore, offer limited opportunities to understand disease progression. On the other hand, although the use of animal models allows us to study the mechanisms of the disease, they present significant limitations in developing drugs for humans. Recently, 3D-cultured in vitro models derived from human pluripotent stem cells have surfaced as a promising system. They offer the potential to connect findings from patient studies with those from animal models. In this comprehensive review, we discuss their application in modeling neurodevelopmental conditions such as Down Syndrome or Autism, neurodegenerative diseases such as Alzheimer\u27s or Parkinson\u27s, and viral diseases like Zika virus or HIV. Furthermore, we will discuss the different models used to study prenatal exposure to drugs of abuse, as well as the limitations and challenges that must be met to transform the landscape of research on human brain disorders
Psychological Safety and Clinical Reasoning in Athletic Training and Physical Therapy Clinical Education: A Nationwide Survey of Student Perception
Get PDFPsychological safety contributes to effective learning environments in healthcare, where clinical experiences foster the development of clinical reasoning skills needed for accurate patient care decisions. Inadequate clinical reasoning skills may lead to misdiagnosis and inappropriate patient care decisions, resulting in poor outcomes and unnecessary costs. This study examines the effect of psychological safety on clinical reasoning within athletic training and physical therapy clinical experiences. A quantitative, cross-sectional survey assessed perceptions of psychological safety and clinical reasoning among Doctor of Physical Therapy and Master of Athletic Training students and recent graduates. Survey measures indicated good reliability (a = .83 and .85). Data were analyzed with descriptive statistics, Pearson’s correlation, and linear regression. Analysis of 338 responses, equally distributed between professions, revealed a statistically significant, weak positive correlation (r = .27, p \u3c .001) between psychological safety and clinical reasoning. Stratification by profession and student status showed weak to moderate correlations. Linear regression demonstrated up to 10% of the variance in clinical reasoning scores was explainable by psychological safety scores. This study underscores the impact of individuals’ perceptions of psychological safety and clinical reasoning, emphasizing the importance of facilitating psychological safety within clinical experiences