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PubMed1998

Comparison of the Nebraska collar, a new prototype cervical immobilization collar, with three standard models.

OBJECTIVES: To determine whether a novel immobilization collar called the Nebraska collar would restrict motion of the cervical spine better than three traditional designs: the Philadelphia collar, the sterno occipital mandibular immobilizer (S.O.M.I.), and the Lehrman-Minerva cervical orthosis. DESIGN: Cervical spine radiographs and a compass were used to assess motion allowed by four separate cervical collars placed on volunteers. SETTING: University-affiliated level one trauma center. PATIENTS/PARTICIPANTS: Fourteen paid volunteers (six females and eight males) between the ages of twenty and thirty-five years (mean twenty-five years) were recruited. MAIN OUTCOME MEASUREMENTS: The maximum amount of flexion, extension, and lateral bending permitted by each collar was assessed by cervical radiographs taken of the volunteers while wearing each of the four collars. Maximum rotation was measured with a compass positioned on the top of the head of the volunteers and oriented in the horizontal plane. RESULTS: The Nebraska collar restricted rotation (p < 0.0001) and lateral bending (p < 0.0001) significantly more than did the other three orthoses. In total maximum extension from occiput to C7, the Nebraska collar was found to be more restrictive than the Philadelphia collar (p < 0.05) and the S.O.M.I. (p < 0.05). In total maximum flexion, there was no statistically significant difference among the four collars. When the total maximum flexion-to-extension motion was measured, both the Nebraska and Lehrman-Minerva cervical collars were found to be more restrictive than the Philadelphia collar (p < 0.05). CONCLUSION: The new Nebraska collar provides stabilization that is significantly more rigid than the other models tested, with no difference in patient comfort.

Adult↗
PubMed1990

Environmental epidemiology of non-Hodgkin's lymphoma in eastern Nebraska.

The incidence of non-Hodgkin's lymphoma (NHL) is increased in many counties in eastern Nebraska. Histologic analysis has revealed a twofold increase in the clinically aggressive, diffuse large cell subtype of NHL. To investigate the possible association between NHL and agricultural exposures, a population-based case-control study was conducted in eastern Nebraska in 1985. Telephone interviews were conducted with 201 men having histologically confirmed NHL and 725 controls. Among men, the use of the herbicide 2,4-D was associated with a 50% increased risk of NHL (OR 1.5, 95% CI 0.9, 2.4). Personal exposure to 2,4-D more than 20 days per year increased the risk threefold (OR 3.3, 95% CI 0.5, 22.1). Several classes of insecticides were also associated with increased risk: organophosphates (OR 1.9, 95% CI 1.1, 3.1), carbamates (OR 1.8, 95% CI 1.0, 3.2), and chlorinated hydrocarbons (OR 1.4, 95% CI 0.8, 2.3). As a result of intense agrichemical use, extensive contamination of shallow groundwater by nitrate and atrazine has also occurred in eastern Nebraska. A twofold increased incidence of NHL is present in counties with greater than 20% of the wells contaminated by nitrate (greater than 10 ppm) and in counties with intense fertilizer use. These findings suggest that NHL in eastern Nebraska may be related to the use of pesticides and nitrogen fertilizers.

Adult↗
PubMed1998

Surveillance for arthropod-borne viral activity in Nebraska, 1994-1995.

A 2-yr arbovirus surveillance program was established in Nebraska following the midwest flood of 1993. CDC light traps were used to collect mosquitoes at 11 localities throughout Nebraska. In 1994, we collected 685,582 mosquitoes, and we tested 1,359 pools of Culex mosquitoes for arbovirus infection, with St. Louis encephalitis virus isolated from 2 pools collected in Scotts Bluff County in western Nebraska. In 1995, 1,163,741 mosquitoes were collected and 2,788 pools tested, with 36 positive for western equine encephalomyelitis (WEE) virus. Thirty of the WEE-positive pools were collected in Scotts Bluff County, 4 pools from the city of Norfolk and 2 from the city of Grand Island. All viruses were isolated from Culex tarsalis Coquillett. The highest minimum infection rate of 3.81 per 1,000 mosquitoes was observed in Scotts Bluff County on 13 September 1995. The seasonal minimum infection rate for WEE was 0.52 in Scotts Bluff County. No human or horse disease attributed to arboviral infection was reported in Nebraska during 1994 and 1995.

Animals↗
PubMed1987

Comparison of the Luria-Nebraska Neuropsychological Battery-Children's Revision and the WISC-R with learning disabled children.

This investigation concerned the relationship between the Luria-Nebraska Neuropsychological Battery--Children's Revision and the WISC--R for a sample of 32 children identified as learning disabled. The children's mean age was 9 yr., 11 mo.; they were identified as learning disabled on the basis of ability (WISC--R)/achievement discrepancy test scores. The sample was of low average intellectual ability according to the WISC--R and the Luria-Nebraska T-scores. Intercorrelations between scores on the WISC--R and Luria-Nebraska lists were generally nonsignificant, with the exception of language and arithmetic measures on each test. Also, 84% or 27 of the present sample of 32 were correctly identified as learning disabled using a criterion of three or more Luria-Nebraska subscale scores greater than one SD above the mean.

Child↗
PubMedDate not supplied

Psychiatric nursing education in Nebraska: 1989-1990.

The academic and clinical content of psychiatric nursing curricula in the registered nurse basic educational programs in Nebraska for academic year 1989-1990 was explored by the Nebraska Sub-group of the Nursing Curriculum and Training Task Force of the National Alliance for the Mentally Ill. The review includes literature regarding the history, development, and future trends of psychiatric nursing; factors affecting nursing student attitudes toward psychiatric patients; basic content included in psychiatric and psychosocial nursing curricula; and concepts essential in working with the seriously, persistently mentally ill. Contrary to current trends in the United States, all Nebraska schools of nursing have a generic psychiatric nursing course taught by clinical specialists in psychiatric-mental health nursing. Hands-on clinical time spent with patients with psychiatric diagnoses as well as those with psychosocial needs varies from 84 to 200 hr per semester. Not all students are exposed to patients with severe and persistent mental illness. Fewer than 5% of Nebraska graduates choose psychiatric nursing as their area of practice. The authors express grave concern for the future of psychiatric nursing education. Implications for curriculum revision and replication studies are suggested.

Attitude of Health Personnel↗
PubMed1994

The need for health care reform in Nebraska.

This paper has identified some of the major health care problems in Nebraska. Although Nebraska does not face as many serious challenges as some other states, there is clearly a need for reform. For example, the health of our population is generally good, but many serious gaps exist, particularly for minority population groups. Per capita health care costs in Nebraska are only slightly below the national average, and out-of pocket costs for the average Nebraska family rank among the highest in the nation. In addition, Medicaid costs are exploding and create serious challenges to balancing the state's budget. Nearly 140,000 Nebraskans lack health insurance coverage and at least 90,000 others are underinsured. Many insurance policies limit or deny coverage to individuals with pre-existing medical conditions, deny coverage to individuals employed in certain occupations, and limit coverage for preventive services. "Cost shifting" continues to become more widespread, which significantly increases the number of small businesses that drop or reduce health insurance coverage for their employees. Finally, rural areas face some unique challenges related to their ability and capacity to provide services. There is a serious shortage of primary care physicians, mid-level practitioners, and many other allied health professionals. As a result, individuals, including a large elderly population, must travel long distances to obtain care. Many rural hospitals are under severe financial stress and some will close during the next five years. There appears to be an adequate supply of nursing home beds in rural areas, but many communities lack adequate in-home services.

Female↗
PubMed1983

Peabody Picture Vocabulary Test-Revised and luria-Nebraska Neuropsychological Battery for Children: intercorrelations for normal youngsters.

The relationship between scores on the PPVT-R and Luria-Nebraska Neuropsychological Battery for Children was examined utilizing 86 normal children, including 55 females and 31 males from middle-class families. Correlation coefficients were computed between the standard scores obtained on the PPVT-R and the T scores from the summary scales on the Luria-Nebraska. Significant relationships were predicted between the PPVT-R and the Receptive scale on the Luria-Nebraska. Significant but small correlations were found between the PPVT-R and this scale as well as the Intelligence, Visual, Arithmetic, Memory scales on the Luria-Nebraska.

Adolescent↗
PubMed1983

Aging and performance on the Luria-Nebraska neuropsychological battery.

The Luria-Nebraska Battery has been shown to be a valid measure of neuropsychological functioning in younger adults; however, little validity research with the elderly has been reported. Seventy-eight healthy elderly adults (mean age = 72.2 years) were tested with the Luria-Nebraska Battery and 92% of the profiles were found to be within normal limits. Significant age-related effects were also found on the Luria-Nebraska Battery. Similarly, the healthy elderly were divided into two age groups, young-old (60-74) and old-old (75+). Only the expressive speech and writing scales showed significant differences, and these were in the opposite direction one might expect, in that the old-old group performed significantly better. Additionally, the performance of 100 elderly brain damaged patients (mean age = 68 years) was examined and 86% of the profiles indicated the presence of brain damage. Overall, this study suggests that the Luria-Nebraska Battery may be a useful measure of neuropsychological functioning in elderly groups.

Aged↗
PubMed2001

The Interdisciplinary Generalist Project at the University of Nebraska Medical Center.

The Interdisciplinary Generalist Curriculum (IGC) Project at the University of Nebraska College of Medicine (Nebraska) had three goals: (1) to increase first- and second-year students' exposure to primary care practice in the community; (2) to develop specific educational programs introducing these students to the principles and practices of primary care medicine; and (3) to establish a generalist coordinating council to provide leadership and to nurture generalist educational initiatives in the College of MEDICINE: Students at Nebraska were already required to spend three half-days a semester in a longitudinal clinical experience (LCE) and to complete a three-week primary care block experience in the summer between the first and second years. IGC Project funds were used increase the number of required LCE visits to five a semester and to develop curricular enhancements that would maximize the educational potential of community-based clinical experiences for first- and second-year students. Curricular elements developed included a focus on faculty development for preceptors and development of the Primary Care Introduction to Medicine Curriculum, an eight-week, interdisciplinary module scheduled late in the first year to help prepare students for intensive summer rotations. Other developments were the implementation of a pediatric physical examination experience for first-year students and the implementation of instruction in community-oriented primary care in the second year. Lessons learned are related to: (1) the value and power of early clinical experiences; and (2) the enhancing effect of a holistic, longitudinal view of the curriculum on the planning of early clinical experiences.

Curriculum↗
PubMed1999

Developing an evaluation plan for school health programs in Nebraska.

This article describes a unique plan for comprehensive evaluation of school health programs. With property tax caps threatening Nebraska's school health programs, the Nebraska Dept. of Health and Human Services initiated an evaluation plan to answer the question, "What is the value of school health?" The plan used the "Targeting Outcomes of Program" (TOP) framework to measure impact indicators of a comprehensive school health program. To customize the plan for Nebraska schools, community input was sought from stakeholders identified from a small rural school district. Following a series of focus group meetings, the final evaluation plan was developed and implemented as a statewide evaluation of comprehensive school health services. The resulting plan addressed several deficiencies previously identified in the literature by including community input, attention to multiple roles, and measurable outcomes documenting effectiveness, or value.

Community Participation↗
PubMed2006

The role of rural health clinics in hospitalization due to ambulatory care sensitive conditions: a study in Nebraska.

CONTEXT: Hospitalization due to ambulatory care sensitive conditions (ACSCs) is often used as an indicator for measuring access to primary care. Rural health clinics (RHCs) provide basic primary care services for rural residents in health professional shortage areas (HPSAs). The relationship between RHCs and ACSCs is unclear. PURPOSE: The purpose of this study was to examine the relationship between the presence of RHCs in rural HPSAs and the likelihood of having an acute or chronic ACSC as the reason for hospitalization. METHODS: Nebraska hospital discharge data (1999-2001) and the 2003 Area Resource File were used in this analysis. A multilevel logistic regression analysis was used to examine the relationship between the presence of RHCs in rural HPSAs and the likelihood of having an ACSC as the reason for hospitalization, after controlling for individual characteristics and county-level contextual factors stratified by 3 age groups. The eligibility for logistic regression was limited to patients from 28 rural Nebraska counties designated as HPSAs in 2001. Patients with commercial payers were excluded from the study. FINDINGS: Elderly patients residing in rural Nebraska HPSAs with at least one RHC were significantly less likely to have a hospitalization due to chronic ACSCs. CONCLUSIONS: The presence of RHC is a significant factor associated with fewer hospitalizations for chronic ACSCs among the rural elderly residing in HPSAs.

Adult↗
PubMed2005

Prevalence of agglutinating antibodies to Toxoplasma gondii in adult and fetal mule deer (Odocoileus hemionus) from Nebraska.

Toxoplasma gondii is an apicomplexan parasite of mammals and birds. Herbivores acquire postnatal infection by ingesting oocysts from contaminated food or water. Toxoplasma gondii infection is common in white-tailed deer, Odocoileus virginianus, but little is known about the prevalence of infection in mule deer, O. hemionus. We examined sera from 89 mule deer from Nebraska for agglutinating antibodies to T. gondii using the modified direct agglutination test (MAT) with formalin-fixed tachyzoites as antigen. Thirty-one (35%) of the samples were positive at dilutions of > or = 1:25. Samples were examined from 29 fetuses from these mule deer and none were positive in the MAT. Sera from 14 white-tailed deer from Nebraska were also examined and 6 (43%) were positive for T. gondii. Samples were examined from 5 fetuses from these white-tailed deer and none was positive in the MAT. Our results in both deer species from Nebraska are similar to studies conducted in white-tailed deer from other regions of the United States. Our findings indicate that mule deer are frequently infected with T. gondii and that mule-deer meat may be a source of human infection.

Agglutination Tests↗
PubMed1999

Effectiveness of student assistance programs in Nebraska schools.

BACKGROUND: This study investigated whether Nebraska schools with Student Assistance Programs (SAP) are associated with reduced adolescent alcohol use and a higher level of academic achievement than students from schools without a SAP. METHODS: In 1992, the Toward a Drug Free Nebraska (TDFN) survey was administered to 3,454 students in grades seven to twelve at eighty-three Nebraska schools. A second survey, the TDFN "team activity report" collected from each school's team, the presence of a SAP (n = 34 schools) or absence of a SAP (n = 49 schools). Student responses for alcohol use and academic achievements were linked with the presence of a SAP through use of a school identification number on both surveys. RESULTS: Students from schools with a SAP reported a lower use of alcohol in the last thirty days, compared with students from schools without a SAP program (p < 0.05), and they also reported a significant difference in academic achievement (p < 0.05). CONCLUSIONS: While this study used post hoc analysis of data, the results suggest lower alcohol use and higher academic achievement among students from SAP schools. Given SAPs' popularity, these trends suggest that further research should be conducted to demonstrate the effectiveness of student assistance programs.

Adolescent↗
PubMed1998

A preliminary study of immunologic and hematologic profiles of peripheral blood from Nebraska farmers who apply pesticides to their fields.

OBJECTIVE: Laboratory studies have documented a wide range of pesticide-induced changes in the hematopoietic and lymphoreticular systems. Some of these are expressed as altered serum values, blood cell counts, and leucocyte functions. The goal of the present study was to determine whether these alterations were evident in peripheral blood of Nebraska farmers who applied pesticides to their fields. METHODS: An invitation to participate was mailed to 100 residents (70 farmers; 30 controls) of Butler County, Nebraska. All respondents (51 farmers and 21 controls) were enrolled and surveyed by written questionnaire for health status and pesticide use. Our analysis included 45 farmers and 18 controls. The farmers were divided into a high (n = 23) and a low (n = 22) pesticide use group. Statistical correlations of ten blood values with both pesticide use and age were evaluated, since pesticide use correlated with age. RESULTS: Four of the ten blood values correlated with pesticide use and age (Spearman Rho). In a multiple regression model, pesticide use (not age) proved to be a predictor of red blood cell count and hematocrit. In the same model, pesticide use was not a predictor of mean red cell volume or candida antigen-induced T-lymphocyte proliferation. Serum complement activity did not correlate with pesticide use among the farmers (n = 45) but was significantly reduced (ANOVA) in the high pesticide use group, compared to controls. CONCLUSIONS: A preliminary study of blood values in a small cohort of Nebraska farmers found no pesticide-associated effects on 1) leucocyte count, 2) antigen- and mitogen-stimulated T-cell proliferation, 3) mitogen-stimulated B-cell proliferation, and 4) concentrations of serum IgG and IgM. The study found small but statistically significant pesticide-associated effects on red blood cells and serum complement.

Adult↗
PubMed1975

Prevalence and potential vectors of Haemoproteus in Nebraska mouring doves.

Three hundred and nine mourning doves (Zenaida macroura) from Lancaster County, Nebraska, were examined for species of Haemoproteus. Older doves possessed higher Haemoproteus prevalences than younger doves. Mean total prevalence for each dove age group was as follows: adults, 61% H. sacharovi and 83% H. maccallumi; immatures, 35% H. sacharovi and 42% H. maccallumi; and nestlings, 31% H. sacharovi and 16% H. maccallumi. Yearly prevalences were less variable in mature doves than in immature and nestling doves. No correlation between nestling and parent Haemoproteus infections were observed, but nestmates in 10 or 18 nests harbored equivalent infections. Stilbometopa podopostyla and Microlynchia pusilla (Hippoboscidae) were collected from Nebraska doves. Hippoboscidae were collected from doves of all ages from April to August. Dove baited fly traps yielded Culex tarsalis and C. pipiens in Nebraska and Culicoides haematopotus, C. crepuscularis, and Simulium aureaum in Ames, Iowa.

Animals↗
PubMed1999

Seasonal incidence and geographical variation of Nebraska mosquitoes, 1994-95.

A mosquito survey was conducted in Nebraska during 1994-95. Mosquitoes were collected by CO2-baited CDC light traps at 11 localities throughout Nebraska. Total mosquitoes collected was 685,581 per trap (mean = 790) and 1,163,741 per trap (mean = 1,372) during 1994 and 1995, respectively. Twenty-seven mosquito species representing 8 genera were collected. The most abundant mosquitoes collected statewide were Aedes vexans at 74% of the 2-year total, Culex tarsalis at 11%; Aedes trivittatus, 5%; Aedes melanimon, 1.5%; and Aedes triseriatus, 1%. The floodwater mosquitoes were more prevalent in eastern Nebraska while standing-water mosquitoes, especially Culex tarsalis, were more prevalent in the west.

Animals↗
PubMed2001

New Nebraska mosquito distribution records.

Larval collections in Nebraska during 2000 established 2 new state distribution records for Ochlerotatus epactius and Anopheles perplexens and confirmed the presence of Culiseta melanura, bringing the total number of mosquito species reported from Nebraska to 50. Fifteen new county records for 10 species are noted, including the 1st report of Aedes albopictus from Lancaster County, marking its westernmost collection in Nebraska to date.

Aedes↗
PubMed2004

Teaching the basics of clinical pharmaceutical care: innovative pharmacy workshops at the University of Wisconsin and the University of Nebraska.

BACKGROUND: Safe and effective prescription writing, using drug formularies, and managing pharmaceutical care are skills medical students need to acquire. Spurred by the Undergraduate Medical Education for the 21st Century (UME-21) grants, the University of Wisconsin and the University of Nebraska independently developed educational workshops to address these competencies. METHODS: The University of Wisconsin's workshop is presented to medical students at the start of their third year. They receive information from pharmacists on medication errors, prescription writing, and drug formularies. A "learners guide" summary is discussed by a physician, which brings into focus the clinical application of the didactic session. A small-group session follows with hands-on experience in writing prescriptions and using formularies for three patient case scenarios. The workshop at the University of Nebraska consists of three sessions during the third-year internal medicine clerkship. In the first session, pharmacists discuss formularies, the Pharmacy and Therapeutics (PT) committee, and the preparation of a drug monograph. During the second session, students develop an evidence-based drug monograph on a product or herbal. In the final session, the class functions as a mock PT committee, and after listening to the drug monographs, determines whether the product should be added to the formulary. We evaluated students' satisfaction with the workshops using Likert scales and assessed students' ability to correctly fill out a prescription form. RESULTS: Both workshops were well received. The mean rating at University of Wisconsin was 1.7 on a scale of 1 (satisfied) to 7 (dissatisfied), and at University of Nebraska it was 3.8 with 5 (outstanding) to 1 (unacceptable). At the University of Wisconsin, on a year-end skills assessment involving 148 students, 100% of the students properly filled out a prescription. Ninety-four percent received an excellent grade, 6% a pass, and no marginal or failing grades were given out. CONCLUSIONS: The workshop on pharmaceutical prescribing was rated favorably by students. After participating in the workshop, students acquired skills in prescription writing.

Clinical Clerkship↗