Interprofessional Education Annual Report: 2019-2020

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Outcomes of a Novel Approach to Transcatheter and Hybrid Pulmonary Valve Replacement for Congenital Heart Disease in a Single Center

Purpose: This dissertation was designed to build my expertise in working with large datasets and to apply that knowledge to congenital heart disease patient problems. Relationships in a large dataset were examined using a nursing theory approach to identify relationships that would benefit from further research as a preliminary skill-building step. Outcomes from transcatheter (TC) and hybrid pulmonary valve replacement (PVR) versus surgical PVR were explored in the literature and finally in a study to begin to provide information to help health care providers tailor education and recommendations to patients/families selecting a treatment strategy for pulmonary regurgitation and/or stenosis. Design: A quasi-meta-analysis (Manuscript I) was undertaken to compare outcomes from TC and surgical PVR using the Wilson and Cleary (1995) conceptual model of health-related quality of life (HRQOL). In Manuscript II the Omaha System was used to analyze data from an existing leg ulcer database (no appropriate congenital heart disease database was available) to increase my skills at handling large databases and applying nursing theory to identify relationships that would benefit from further research. Visualization techniques (heat maps) were then used to examine new relationships among the variables. Models were developed to test the relationships between variables in predicting adherence to leg ulcer treatment and predicting leg ulcer development. Gaps identified in the literature from Manuscript I and the skills learned from the Manuscript II project were then used to design a single-center study to examine TC (n=32) and hybrid (n=15) PVR outcomes (procedural, mid-term, heart remodeling/function, arrhythmia, symptom, functional, and HRQOL as well as cost outcomes) (Manuscript III). The results were compared to the surgical literature and TC and surgical meta-analysis outcomes. Findings: Gaps identified in the quasi-meta-analysis (Manuscript I) were that hybrid PVR outcomes were limited to procedural outcomes. There were limited symptom and HRQOL outcomes for both TC and hybrid PVR. There were few reports of diastolic heart function for either TC or surgical PVR. The study (Manuscript III) showed hybrid PVR had similar heart remodeling outcomes as TC. There were no changes in heart function, arrhythmias, or exercise capacity for TC or hybrid PVR; this was similar to surgical PVR outcomes. Dyspnea and exercise intolerance decreased. Functional class improved but was only significant in the TC group which compares to surgical PVR. Length of stay was significantly shorter for TC and hybrid PVR than surgical PVR but costs were higher. Manuscript II demonstrated that the Omaha System was useful in aligning nursing theory and terminology to identify patterns between psychosocial characteristics and leg ulcers that could be investigated further. These skills in extracting and categorizing variables were used in designing the study reported in Manuscript II. Conclusions: The findings from Manuscripts I and III should help health care providers to begin to educate patients/families about the best PVR treatment options given individual patient anatomy, physiology, and preferences. Manuscript II demonstrated that the Omaha System was useful with large datasets to link theory and data to identify potential new hypotheses to test. This theory could be used to identify possible hypotheses to test with congenital heart disease databases

Relationship between life change events and communication apprehension

This research investigates relationships between communication apprehension (CA) and life change events, using college students at a Midwestern university. Instruments used were the Personal Report o f Communication Apprehension-24 (PRCA- 24) which measured CA, both overall and in four subareas, and a modified version of the Adolescent Life Change Event Questionnaire (ALCEQ), which records life change events during formative years and past year before being questioned. No significant relationships were found between the overall scores of the two instruments in this study, although demographic information showed that the younger college students reported more public speaking apprehension than the older groups. Also, females reported a higher level of apprehension in the PRCA subarea o f apprehension in meetings. Subjects were divided according to national norm quartile splits on PRCA overall and subscale scores. Analyses of occurrence of individual life change events in the five examined life time frames among these groupings revealed 41 significant differences. Many of these differences indicate experiencing certain life change events is related to CA levels. However, the major finding of this study was that the group highest in public speaking CA had a stronger history of family-related stability during the formative years, such as less occurrence of starting a new school, moving, and making new friends. They also reported less hassling with parents, and higher occurrence of being grounded

Internal Funding Newsletter, Academic Year 2013-2014

This newsletter features: a letter from Scott Snyder, Associate Vice Chancellor and Chief Research Officer, Office of Research and Creative Activity; 2013-2014 Internal Funding Awardees: Faculty Awards; 2013-2014 Award for Distinguished Research or Creative Activity: Roni Reiter-Palmon, Psychology; 2013-2014 Internal Funding Awardees: Student Awards; UNO Students Premiere First Feature Film; and Internal Funding Opportunities and Summary

Internal Funding Newsletter, Academic Year 2013-2014

This newsletter features: a letter from Scott Snyder, Associate Vice Chancellor and Chief Research Officer, Office of Research and Creative Activity; 2013-2014 Internal Funding Awardees: Faculty Awards; 2013-2014 Award for Distinguished Research or Creative Activity: Roni Reiter-Palmon, Psychology; 2013-2014 Internal Funding Awardees: Student Awards; UNO Students Premiere First Feature Film; and Internal Funding Opportunities and Summary

Air pollutant index calendar-based graphics for visualizing trends profiling and analysis

Detection of air quality abnormality is important as an early warning system for air quality control and management. The information can raise citizens’ awareness towards current air quality status. By using time series plot, the data pattern can be identified but not able to exactly determine the abnormality due to overcrowded plot. Therefore, visualization data profiling was presented in this study by using seven years Malaysia daily air pollutant index to improve the detection. Result shown, the developed approach can simply identify the poor air quality across the month and year. Malaysia air quality was good and consistent between November and May. However, upward trend existed between June and October due to the forest fire happened in Sumatra. This visualization approach improved air pollution detection profiling and it is useful for related agencies to guide the control actions to be taken. This approach can be applied to any countries and data set to give more competent information

Bringing Business Intelligence to Health Information Technology Curriculum

Business intelligence (BI) and healthcare analytics are the emerging technologies that provide analytical capability to help healthcare industry improve service quality, reduce cost, and manage risks. However, such component on analytical healthcare data processing is largely missed from current healthcare information technology (HIT) or health informatics (HI) curricula. In this paper, we took an initial step to fill this gap. We investigated the current HIT educational programs, BI industry, and healthcare BI job listings, and students’ perceptions of BI and how BI could be incorporated into HIT programs. The student survey results showed strong interests from students in a HIT course containing BI components or a BI course specialized in the healthcare context. Based on the student survey and investigation of BI industry and job market, as well as HIT educational programs, we developed a general curriculum framework and exemplar implementation strategies to demonstrate how BI can be incorporated into an HI or HIT program. To the best of our knowledge, this research is the first of its kind. Our approach of integrating information from students, the HIT industry and other HIT programs can also be used as a model for general HIT curriculum development and improvement

Evaluation of the University of Nebraska Medical Center’s 4Ms Geriatric Training Program at Nebraska Medicine Midtown

In 2015, the Health Resources and Services Administration (HRSA) created the Geriatrics Workforce Enhancement Program (GWEP) to address geriatric workforce challenges and improve the health outcomes of older adults. The GWEP redefines care delivery through a movement for age-friendly healthcare guided by evidence-based practices that align with the 4Ms: What Matters, Medication, Mentation, and Mobility. The 4Ms identify the key issues that should drive the decision-making and care for every older adult. 4Ms training sessions were conducted at the Nebraska Medicine Midtown Clinic and evaluated through a cross-sectional survey administered to both residents (trainees) and attendings (trainers). Data was collected and analyzed using REDCap and SPSS to explore the relationship between training satisfaction and comfortability to improve future training sessions. Results indicated that overall satisfaction (OS) with the training sessions significantly affected feeling comfortable (FC) managing the 4Ms geriatric concepts. Recommendations for training modifications and future research include focusing more on Mentation, applying the information learned to educate caregivers and staff, modifying the 4Ms teaching model, and implementing pocket cards for concept reinforcement

2017 Minnesota Undergraduate Scholars Posters at St. Paul Abstract Booklet

Abstract booklet from the fourth Minnesota Undergraduate Scholars Posters at St. Paul event. The multi-disciplinary poster presentation was held on March 2, 2017 from 11:00 AM to 1:00 PM at the State Capitol rotunda. Participating campuses included: Bemidji State University, Metropolitan State University, Minneapolis Community and Technical College, Minnesota State University, Mankato, Minnesota State University, Moorhead, Rochester Community and Technical College, Southwest Minnesota State University, St. Cloud State University, and Winona State University

Evaluation of the University of Nebraska Medical Center’s 4Ms Geriatric Training Program at Nebraska Medicine Midtown

In 2015, the Health Resources and Services Administration (HRSA) created the Geriatrics Workforce Enhancement Program (GWEP) to address geriatric workforce challenges and improve the health outcomes of older adults. The GWEP redefines care delivery through a movement for age-friendly healthcare guided by evidence-based practices that align with the 4Ms: What Matters, Medication, Mentation, and Mobility. The 4Ms identify the key issues that should drive the decision-making and care for every older adult. 4Ms training sessions were conducted at the Nebraska Medicine Midtown Clinic and evaluated through a cross-sectional survey administered to both residents (trainees) and attendings (trainers). Data was collected and analyzed using REDCap and SPSS to explore the relationship between training satisfaction and comfortability to improve future training sessions. Results indicated that overall satisfaction (OS) with the training sessions significantly affected feeling comfortable (FC) managing the 4Ms geriatric concepts. Recommendations for training modifications and future research include focusing more on Mentation, applying the information learned to educate caregivers and staff, modifying the 4Ms teaching model, and implementing pocket cards for concept reinforcement