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At least 199 records · Page 11Linked to original sources
PubMed2002

Teaching the quality improvement process to junior medical students: the Nebraska experience.

To teach the continuous quality improvement (CQI) process to junior medical students at the University of Nebraska during their rural family medicine preceptorship, we designed and implemented a population health project in 1998. This project requires students to select a problem affecting a population in their preceptor's practice, analyze that problem, and suggest a solution or remediation using CQI principles. Support for the students during their project includes Web-based examples and readings. Results of this project have included national presentations and changes in several preceptors' practice patterns. This project has been well accepted by preceptors and students.

Curriculum↗
PubMed1992

Liver transplantation at the University of Nebraska Medical Center from 1985 to 1992.

Based on our 7 and one-half-year experience with liver transplantation at the University of Nebraska Medical Center: 1. Success and growth of the program has been, in part, the result of close interaction and support of the various specialists involved. 2. We have demonstrated that outstanding patient and graft survival rates can be obtained with cyclosporine/prednisone immunosuppression. 3. Few, if any, technical contraindications exist to liver transplantation. 4. Surgical advances have allowed allografts to be salvaged which would otherwise require replacement. 5. Routine donor-liver biopsy prior to implantation has reduced the rate of primary nonfunction. 6. New strategies to improve survival for patients with hepatitis-B-related liver disease and hepatic malignancies undergoing liver transplantation need to be developed. 7. The management of patients with fulminant hepatic failure is evolving and now includes innovative approaches such as the use of ECLS and auxiliary transplants.

Academic Medical Centers↗
PubMed1992

Merging the departments of psychiatry of a private and state university: the Nebraska experience.

Medical colleges throughout the nation are being pressured to decrease the costs of medical education. In some of our smaller cities, the duplication of faculty expertise and costly technological resources at distinct but neighboring campuses has led to training costs far beyond what can be comfortably supported by either the institutions or their students. While the trend toward collaboration or mergers between identical medical departments on adjacent campuses is gaining ground, the methods required to achieve success in these ventures remain relatively uncharted. This paper provides an overview of the creation of successful merger between the departments of Psychiatry of Creighton University School of Medicine and the University of Nebraska College of Medicine. The development of the merger from conception to completion, along with the lessons learned along the way, are offered in the hope that other medical departments may benefit.

Academic Medical Centers↗
PubMed1992

The Nebraska Medicaid Drug Utilization Review Program.

There are reports in the literature which address the effects of DUR on morbidity and cost containment in a non-acute setting. Most of the information, however, is under acute care circumstances. Some of the studies performed under these situations have shown added benefits in terms of patient care. This article attempts to document similar changes in morbidity and cost containment in a relatively ambulatory Medicaid population. It must be remembered that the Medicaid population in Nebraska is composed of some patients who are institutionalized in a variety of settings. In 1989, the Medicaid population had an average age close to 65. Forty-three percent of these patients resided in a nursing home and may have either received hospitalization as a result of a Drug Therapy Problem or incurred added expenses while maintaining residency in a long-term care environment. The cost savings noted here do not reflect other factors such as the effects of age, race, gender, residential status, diet, smoking, exercise, disease prior to Medicaid enrollment, etc. This estimate does not take into account the effects of increased ingredient or administrative costs. Any increases in claims amount over time would tend to boost cost savings while increases in administrative expenses would tend to blunt this effect. If an adjustment was made for age, gender and other factors, cost-savings could be affected. Additionally, the DUR program does not include any drug effects which could be attributable to changes in other prescribed medications secondary to the original inquiry.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost Control↗
PubMed2004

Outbreak of histoplasmosis among industrial plant workers--Nebraska, 2004.

In February 2004, the Nebraska Health and Human Services System (NHHSS) notified CDC about an outbreak of histoplasmosis among workers at a local agricultural processing plant (plant A). Three workers at the plant had acute, febrile, respiratory illness; two had serologic evidence of histoplasmosis. NHHSS and CDC conducted an investigation to determine the source of transmission and the extent of the outbreak. This report summarizes the findings of that investigation, which confirmed occupationally acquired histoplasmosis. Additional measures might be necessary to minimize risk for histoplasmosis among persons who work in the agricultural industry in areas where it is endemic.

Agriculture↗
PubMed2006

Varicella outbreak among vaccinated children--Nebraska, 2004.

On November 19, 2004, a school nurse notified the Nebraska Health and Human Services System (NHHSS) of a varicella outbreak in an elementary school (grades kindergarten through 7). In collaboration with local health department officials and CDC, NHHSS initiated a retrospective cohort study to determine the magnitude of the outbreak, assess vaccine coverage and effectiveness, and compare disease severity among vaccinated and unvaccinated students. This report summarizes the investigation and considers the suitability of school settings for case-based surveillance. The findings highlighted the importance of improving varicella vaccination coverage and implementing varicella vaccination school-entry requirements.

Chickenpox↗
PubMed1991

Congenital syphilis in Nebraska: a case report.

In the United States, the incidence of acquired syphilis has increased thirty four percent in the last decade with young, black, urban dwelling, drug dependent females representing the highest risk group. Concomitantly, congenital syphilis has increased causing spontaneous abortions, stillbirths, and neonatal morbidity and longterm neurologic sequela. Because physicians are no longer familiar with the disease, it is estimated that only twenty-five percent of neonatal syphilis is diagnosed during the first year of life. This report describes the first reported case of congenital syphilis in Nebraska. Our patient demonstrates the typical clinical findings of lethargy, extremity swelling and the pseudoparalysis of Parot, while laboratory evaluation showed anemia, abnormal hepatic enzymes, hypoproteinemia, and confirmatory positive neonatal VDRL and FTA-ABS. The plain film radiographic survey illustrated the characteristic findings of periostitis, metaphyseal banding and cortical erosion. By relying upon the relatively inexpensive and easy to obtain radiographic long bone survey a prompt diagnosis can be made and immediate treatment instituted while awaiting confirmatory serology. We must reacquaint ourselves with the increasing incidence of acquired and congenital syphilis. This will enable us to make a timely and cost-effective diagnosis of cogenital syphilis and prevent its devastating complications.

Arm↗
PubMed1991

Salsuginus yutanensis n. sp. (Monogenea: Ancyrocephalidae) from Fundulus sciadicus in Clear Creek of eastern Nebraska.

Salsuginus yutanensis n. sp. (Monogenea: Ancyrocephalidae) is described from the gills of the plains topminnow, Fundulus sciadicus Cope, from Clear Creek in eastern Nebraska. Salsuginus yutanensis is distinguished from previously described species by having a shorter accessory piece and different hamulus proportions, especially in the relative lengths of deep and superficial roots. In addition, the angles between deep and superficial roots distinguish S. yutanensis from several congeners.

Animals↗
PubMed1991

A report of maternal deaths in Nebraska for the years 1987, 1988 and 1989.

The article briefly presents the background and findings of Maternal Mortality reviews in Nebraska. Twenty-five years of these reviews, 1963 through 1987, are summarized in two tables. The maternal mortality rates and a list of the leading causes of maternal deaths are presented. Brief summaries of the fourteen maternal deaths which occurred in the past three years 1987, 1988 and 1989 are presented. The importance of continuing this review process is stressed and the State Health Department is encouraged to include maternal mortality reports in their annual Vital Statistic Report.

Adolescent↗
PubMed1991

Nebraska dental professional's procedures and opinions related to infectious diseases.

Based on the findings of this study, the following specific strategic recommendations are offered: 1. Offer continuing education courses throughout the state at reasonable fees. The courses should emphasize recognition of AIDS related lesions and infectious diseases, aseptic techniques/infectious disease control, AIDS, Hepatitis B, and infections/antibiotics. In addition, continuing education courses in the area of medical history taking methods should be offered to teach methods of inquiring about sexual and drug-use histories. 2. Establish a state resource center for information regarding infectious diseases. This could, perhaps, be a cooperative venture with the Department of Health, the Nebraska Dental Association, and the College of Dentistry. There is a need to gather, interpret and disseminate periodic updates on infectious disease research. This venture should also focus on developing literature for practitioners with consistent information about infection control regulations and guidelines. 3. Either through continuing education courses or through the information resource center, provide instruction on realistic assessment of the risk of infectious disease transmission in dentistry. 4. Develop a public relations campaign to educate the public about infection control policies in dentistry, what is being done to protect the public. 5. A research effort should be undertaken to determine the discrepancy between self-reported infection control practices and observed infection control practices. This could be accomplished through patient and dentist surveys, interviews, and/or observations. 6. Establish a confidential HIV blood screening program for health care providers.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Haptoglobin phenotyping from older bloodstains by enzyme immunoassay and haptoglobin phenotypes within a Nebraska Caucasian population.

Enzyme immunoassay and Western blotting (electrophoretic) techniques were used to determine haptoglobin (HP) phenotypes from older bloodstains. Serum was collected from liquid blood and the HP phenotypes were determined. Bloodstains were prepared from these specimens and stored at various temperatures for several months. The stains were extracted and applied to gradient polyacrylamide gels. The Western blotting technique was used to achieve the transfer of HP bands from the gels to the nitrocellulose membranes. Enzyme immunoassay with goat anti-HP antiserum and rabbit anti-goat immunoglobulin peroxidase were used to identify the HP bands from the extracted samples. Enzyme immunoassay was found to be clearly more sensitive than o-dianisidine or o-tolidine in detecting HP bands from diluted serum samples. The haptoglobin frequency in a Caucasian population in Nebraska was calculated. The frequencies of Phenotypes 1, 2-1, and 2 were found to be 15.8, 48.4, and 35.8%, respectively.

Blood Preservation↗
PubMed1990

[Lucid alternating epileptic psychosis. Identification of neuropsychological deficit using the Luria-Nebraska neuropsychological battery].

The Luria-Nebraska neuropsychological battery (LNNB) was applied to 15 epileptic patients with clear consciousness episodic alternating psychoses. 73% of patients showed psycho-organic impairment. Epileptic patients with combinations of focal and generalized seizures had greater mental impairment (87%) compared to those who presented only focal seizures. Rythm, memory and intellectual processes were affected most. The right parieto-occipital and left frontal zones were the areas showing greater involvement. These results show a close relationship between neuropsychological impairment and the presence of clear consciousness episodic alternating epileptic psychoses.

Adolescent↗
PubMed1989

Access to health information services in Nebraska.

The McGoogan Library of Medicine serves as Nebraska's vital link to health-related information. According to Norman Cousins, "The library is not a shrine for the worship of books. It is not a temple where literary incense must be burned or where one's devotion to the bound book is expressed in ritual. A library, to modify the famous metaphor of Socrates, should be the delivery room for the birth of ideas--a place where history comes to life."

Academic Medical Centers↗
PubMed1989

Genetic structure of Mennonite populations of Kansas and Nebraska.

We describe the gene frequency distributions for 29 different blood group, serum, and erythrocytic proteins for three Mennonite communities from Kansas and Nebraska and compare their gene frequencies with those of Amish, Hutterite, and Mennonite populations using the topological method of Harpending and Jenkins (1973). Subdivision of these communities into congregations reveals that the "fission-fusion'h model best characterizes the relationship between the genetic patterns and historical events. These Mennonite populations, although reproductively isolated at the turn of this century, are presently entering the mainstream of US rural culture.

Blood Grouping and Crossmatching↗
PubMed1989

Trace element concentrations in perinatal beef calves from west central Nebraska.

Trace element analyses were performed on 144 livers from perinatal calves submitted to the Veterinary Science Laboratory, North Platte, NE. All calves originated from herds in west-central Nebraska and ranged in age from 8 months of gestation up to 6-week-old neonates. Calves were divided into 5 categories based on objectives gross examination and ocular fluid evaluation: abomasal ulcers, abomasal tympany, diarrhea, stillborn and excessive nitrate exposure. Excessive zinc concentrations were found in 4 of the 5 categories. Only in the abomasal ulcer category could a correlation be found; this category routinely was found to have deficient to low normal liver copper concentrations and highest liver molybdenum concentrations. Both excesses and deficiencies of selenium and iron occurred in all categories.

Abomasum↗
PubMed1987

Mosquito surveillance employing New Jersey light traps on Indian reservations in Iowa, Nebraska and South Dakota in 1984 and 1985.

A mosquito surveillance program was established in 1983 on Indian reservations in Iowa, Nebraska and South Dakota. Standard New Jersey light traps were operated on 12 reservations throughout the summer seasons in 1984 and 1985. Rainfall levels in general were higher than normal at all sites in 1984 but were lower than normal at most sites in 1985. Aedes vexans was the most abundant species collected on all reservations and Culex tarsalis second in abundance. Man-biting collections of mosquitoes near Brookings in 1984 reached 35 mosquitoes/5 minutes in early July and were largely composed of Ae. vexans, Ae. dorsalis and Ae. nigromaculis while numbers of Cx. tarsalis and An. quadrimaculatus were minor. During the same period in 1985, man biting collections averaged less than 5/5 minutes.

Aedes↗
PubMed1986

Occurrence and seasonal incidence of mosquitoes on Indian reservations in Iowa, Nebraska and South Dakota during 1983.

A mosquito surveillance program designed to prevent future human cases of Western equine encephalitis or Saint Louis encephalitis was established in 1983 on Indian reservations under the jurisdiction of the Aberdeen Area Indian Health Service in Iowa, Nebraska and South Dakota. Standard New Jersey light traps were operated on all reservations throughout the summer season while CDC miniature and encephalitis virus surveillance traps were employed for shorter periods of time on 4 reservations. Aedes vexans was the most abundant species except on the Pine Ridge, Rosebud, Winnebago and Yankton Sioux reservations in which Culex tarsalis predominated and for the Sac-n-Fox where Aedes trivittatus occurred with the greatest frequency.

Animals↗
PubMed1988

Diversity of the parasite assemblage of Fundulus zebrinus in the Platte River of Nebraska.

Changes in the values of the Shannon H' diversity index as determined for individual hosts (infraassemblage diversity), host samples (sample assemblage diversity), and for species density are reported for an assemblage of 7 parasites in Fundulus zebrinus in the Platte River in Nebraska for a 5-yr period. The parasites were: Myxosoma funduli (gill), Trichodina sp. (gill), Gyrodactylus bulbacanthus (gill), Salsuginus sp. (gill), Gyrodactylus stableri (body surface), and Neascus sp. (= Posthodiplostomum; eyes and body cavity). In addition, relative abundance and equitability are given for each of the study years. Mean infraassemblage diversity, sample assemblage diversity, species density, and equitability were all significantly negatively correlated with river streamflow (measured in cubic feet per second) of the year prior to the sample, but were independent of the concurrent year's streamflow. Over the long term, M. funduli and Trichodina sp. were the most, and G. bulbacanthus was the least, abundant. Species pair prevalence and relative density correlations showed few long-term patterns of co-occurrence or microallopatry. The strongest association was between M. funduli and the Neascus sp. and was attributed to similarities in ecological requirements of intermediate hosts.

Animals↗