Medicine and Health Sciences Commons^™

Investigating The Association Of Total Cholesterol Level And Odds Of Angina In Women Over 40: A Cohort Study Using Data From The Framingham Heart Study, Katelyn Mitchell

Capstone Experience: Master of Public Health

Objective To investigate the association between total cholesterol level and the odds of experiencing angina in women over the age of 40.

Methods This retrospective cohort study was conducted using a subset of the cohort from the Framingham Heart Study to create a multivariable logistic regression model for analysis. Out of the 4,434 participants in the Framingham cohort, 2,148 participants were women over the age of 40 and included in this study.

Results Of the participants who experienced angina (n=308) in this study, 62% had high cholesterol at the baseline. After controlling for age, women with high cholesterol had 2.03 …

Knowledge, Attitudes, And Behaviors Regarding Water Quality, Nitrate Contamination, And Related Health Issues Among Nebraska Healthcare Professionals, Jessenia Hincapie

Capstone Experience: Master of Public Health

Background: Nitrate contamination in drinking water is a public health concern, particularly in agricultural regions. Healthcare professionals often address water quality issues but may lack sufficient knowledge regarding the health effects of nitrate contamination. This study evaluates whether Nebraska healthcare professionals' knowledge and attitudes about nitrate contamination predict their behaviors in addressing this issue.

Methods: A survey was administered to healthcare professionals across Nebraska to assess their knowledge, attitudes, and behaviors regarding nitrate contamination in drinking water. A total of 462 respondents participated. Generalized linear regression analysis was employed to assess the impact of knowledge and attitudes regarding nitrate contamination …

The Ethics Of Vulnerability In Health Care, Hannah Dieterle

Electronic Theses and Dissertations

This dissertation seeks to address vulnerability within clinical healthcare settings. Currently, clinical vulnerability is underrecognized and insufficiently researched which leads to the perpetuation of negative health outcomes for vulnerable populations. Specifically, there is a lack of a consistent and universal definition of vulnerability which has built a shaky foundation on which to discuss vulnerability. This dissertation begins to address these issues and increase awareness on clinical vulnerability due to some populations experiencing the devastating effects of vulnerability at a higher and disproportionate rate when compared to other populations. There is a clear need for increased attention from ethicists and medical …

Preventing Depression In Grandparents Raising Grandchildren: An Educational Video Series, Sabrina Casares

Student Capstone Papers

This paper presents a doctoral capstone project that created and implemented a self-help occupation-based educational video series to prevent and manage depression among grandparent caregivers. It consists of a literature review regarding the impact of depression on grandparent caregivers, the population’s barriers and statistics relating to the correlation of developing depression as a grandparent caregiver. It includes the process to create the video series including review of the literature and the development process. Texas Grandparents Raising Grandchildren (TXGRG) is a non-profit organization dedicated to providing resources and support to empower and advocate for grandparent caregivers. Problem: There is a lack …

Comparison Of The Effect Of Heavy Pulls Vs Light Powers On A Subsequent Clean In Trained Athletes, Luke Devirgiliis

Electronic Theses and Dissertations

The sport of weightlifting has been competed since the first modern Olympiad. Competition in weightlifting consists of 3 attempts the snatch and clean and jerk declared by the athlete and their coach prior to the starting of the lift. While waiting for the athlete’s lift, waiting periods can change and warm up attempts may need to be adjusted. Often, coaches prescribe either a complete “light power” or partial “heavy pull” repetition of the competed movement during a long wait. Previous literature indicates that a heavier stimulus may cause a “post-activation potentiation”, or “post-activation performance enhancement” effect on the subsequent lift. …

Self-Rated Interprofessionalism Between Allied Health Professionals, Courtney Andrews

Electronic Theses and Dissertations

Preventable deaths due to medical errors are a significant cause of death in the United States. Decreased communication and collaboration has been cited as a potential reason for these preventable medical errors. Interprofessional practice (IPP) is a service delivery method where medical professionals from different disciplines intentionally work together in order to provide collaborated and collective care for patients. Interprofessional education (IPE) training programs are becoming more common in healthcare education, and have been cited as one way to improve IPP among healthcare providers. However, gaps exist in the literature regarding how to best structure and implement these programs so …

Understanding The Rising Use Of Fentanyl And The Impact Social Media Plays, Richard Omar Lopez

Electronic Theses, Projects, and Dissertations

This study examines how social media platforms like Reddit can be utilized to compare the discourse around fentanyl and recreational drug use. A dataset of 2549 personal experience posts were collected on fentanyl and other recreational drug use. Where the methodology included targeted queries, text processing, and natural language process (NLP) techniques such as sentiment analysis and topic modeling. Results indicate that fentanyl related discourse on Reddit was more likely to carry a cautious or neutral sentient, emphasizing its health risks or addiction. Contrasting the more positive sentiment recreational drugs carry, especially marijuana. Finding that Reddit plays a vital role …

Discrimination, Sexual Orientation, And Alcohol Amongst Latine, Brian Juarez

Electronic Theses, Projects, and Dissertations

Existing research acknowledges the influence of discrimination on alcohol use, this study emphasizes the equally significant role of sexual orientation on alcohol use. Associations between these factors and alcohol consumption demonstrate the necessity for ongoing research to analyze their intricate relationships and subsequent health outcomes. This study highlights the crucial need for an in-depth exploration of discrimination as well as marginalized identities as contributing factors in alcohol consumption.

Using a quantitative approach to assess secondary data gathered from the National Alcohol Surveys (NAS), this paper underscores the importance of a comprehensive and timely approach to research the multifaceted impact of …

Comparative Assessment Of Machine Learning And Deep Learning Models For Drug Effectiveness Using Sentiment Analysis, Blessing Ogechukwu Nwogu

Electronic Theses, Projects, and Dissertations

In recent years, the proliferation of online patient-generated drug reviews has created a valuable resource for assessing drug effectiveness and patient satisfaction, with sentiment analysis emerging as a powerful tool for extracting insights from this unstructured data.

This culminating research project conducted a comparative analysis of traditional Machine Learning (ML) and Deep Learning (DL) models for assessing drug effectiveness using sentiment analysis of participant reviews. The research aimed to evaluate the performance of Support Vector Machine (SVM), XGBoost, Random Forest, Long Short-Term Memory (LSTM), and Bidirectional Encoder Representations from Transformers (BERT) models in this context. This culminating research project addressed …

Service Provider Perceptions Of Systems Serving Individuals Experiencing Homelessness: A Needs Assessment And Strategic Plan In Johnson City, Tn, Opal Frye-Clark

Electronic Theses and Dissertations

This Integrated Learning Experience (ILE) investigates service providers' perceptions of Johnson City, Tennessee's homelessness services, aiming to inform a city-wide strategic plan for reduction. Employing a mixed-methods approach, the study gathered qualitative data through in-depth interviews with service providers in 2022 and quantitative data via a 2024 survey. The research focused on those directly involved in serving or significantly influencing the lives of individuals experiencing homelessness (IEH). Three key aims guided the investigation: (1) To analyze provider perspectives to identify community assets, opportunities, barriers, and unmet needs, informing a comprehensive needs assessment; (2) To refine these findings through SWOT analysis …

Ecological And Pathological Applications Of The Heat Shock Response, Taylor Rae Stanley

Theses and Dissertations

The heat shock response (HSR) is a cytoprotective stress response pathway that regulates cellular proteostasis. The HSR is an evolutionarily conserved pathway that is essential for normal cellular functioning. Here, we explore the broad ecological and pathological impacts of the HSR. In an ecological context, we perform gene level analysis of the transcriptomes of two closely related sunfish. We found that the more invasive bluegill sunfish has gene expansions in two HSR gene families, the HSP70 family and the HSP90 family compared to the redear sunfish. These gene expansions were also observed in several other teleost fish species and were …

Investigation Of Reproductive Inhibition During Chronic Heat Stress In C. Elegans, Macy Makenna Nielander

Theses and Dissertations

Nearly all organisms experience heterogeneity in environmental conditions that can negatively impact fitness. A common adaptive strategy to reduce the impact of this stress is called facultative diapause, where development and reproduction are temporarily arrested to promote survival. Facultative diapause is characterized by three major criteria, the arrest must be (i) induced by an unfavorable environmental condition, (ii) reversible, and (iii) driven by genetically regulated mechanisms. The aim of this thesis was to determine whether chronic heat-induced inhibition of egg laying in Caenorhabditis elegans represents a novel form of facultative diapause. It was found that the inhibition of egg-laying is …

Impact Of Educational Sessions On Compassion Fatigue Among Home Healthcare Nurses: An Evidence-Based Practice Project, Adebimpe Blessing Ogunsefunmi

Doctor of Nursing Practice Projects

Background: Nurses are compassionate professionals who provide critical care, often at the expense of their own well-being. As the healthcare system faces rapid changes due to an aging population, nursing shortages, and the impact of COVID-19, compassion fatigue has become increasingly common. Despite its prevalence, few healthcare institutions address this issue. Objective: The objective of this DNP project was to evaluate whether weekly educational sessions enhanced perceptions of a positive quality of life, which typically declines with increased compassion fatigue, as measured by the Professional Quality of Life (ProQOL) scale. PICOT Question: Do weekly educational sessions on compassion fatigue …

Smooth Muscle Cell Stress Response: Essential In Atherosclerotic Pathogenesis, Pujun Guan

Dissertations and Theses (Open Access)

Atherosclerosis remains the leading cause of death worldwide. Recent research using lineage tracing and single-cell RNA sequencing unveiled a previously undescribed and prominent role of smooth muscle cells (SMCs) in atherosclerotic plaque formation. SMCs undergo complex phenotypic modulation characterized by de-differentiation of SMCs and heterogeneously increased expression of markers for macrophages, fibroblasts, chondrocytes, and mesenchymal stem cells as plaques form. Cultured SMCs exposed to exogenous cholesterol mimic many of the phenotypic changes associated with plaque formation, and our lab determined this SMC modulation is driven by cholesterol entering the endoplasmic reticulum (ER) and triggering ER stress and PERK signaling. Further, …

Implementation Of A New Graduate Registered Nurse Mentorship Program: A Quality Improvement Project, Cindy N. Ruisi

Nursing Doctoral

Transitioning from student to a registered nurse is a critical period for new graduates, often marked by challenges affecting confidence and job satisfaction. Mentorship programs have been identified as an effective intervention to support new nurses during this transition. The Academy of Medical-Surgical Nurses (AMSN) offers a structured mentoring program that can be leveraged to enhance the confidence level and job satisfaction of new graduate registered nurses.

This quality improvement project aims to implement a new graduate registered nurse mentorship program at a > 400-bed community hospital. This program will incorporate components of the established Academy of Medical-Surgical Nurses mentoring program, …

General Sport Skills Performance Following The Combined Use Of Accentuated Eccentric Loading And Cluster Sets During A Strength-Endurance Training Phase, David Nelson

Electronic Theses and Dissertations

The purpose of this study aimed to evaluate the efficacy of resistance training with accentuated eccentric loading (AEL) and cluster sets (CS) versus traditional resistance training (TRAD) on general sports skills and power performance in recreationally trained individuals. Seventeen subjects (11 males, 6 females; mean age 23.2 ± 4.1 years; body mass 81.3 ± 22.2 kg; height 172.1 ± 10.0 cm; relative 1 RM back squat 1.5 ± 0.3) were randomly assigned to AEL (n = 9) or TRAD (n = 8) groups. After an initial familiarization and baseline testing, both groups underwent a four-week strength-endurance training regimen. The AEL …

Advocating For The Role Of An Occupational Therapy Assistant In The Mental Health Field, Aleah Snell

Honors Theses

As a student in the WMU OTA Bachelor's of Science program, I completed a baccalaureate project. I chose to advocate for the role of occupational therapy in traditional mental health settings. I chose this topic as I have had several close loved ones struggle with mental health, and I wanted to push my learning of occupational therapy's role in this setting further. Upon choosing my topic, I learned although occupational therapy initially started in mental health aiding veterans returning from war, only 2-3% of OT practitioners work in a mental health setting today. I wanted to understand this decline, and …

Obstructive Sleep Apnea And Obesity: How Weight Loss Improves Sleep Apnea Severity And Quality Of Life - An Integrative Review, Hannah Wilson, Neda Akbarshahi

Master's Projects

Introduction: With the growing prevalence of OSA due to the obesity epidemic, there is an urgent need to update treatment regimens. While CPAP continues to be the gold standard of OSA care, challenges with adherence and limited access to effective weight management strategies often impede care. The complex bidirectional relationship between obesity and OSA highlights the importance of addressing weight management in this patient population to help mitigate cardiometabolic risks. Personalized weight loss therapies should be integrated into standard OSA treatment regimens to reduce OSA severity, reduce comorbid conditions, and improve quality of life.

Aim: The objective of this integrative …

Characterizing Treatment Patterns And Associated Outcomes For Medicare Beneficiaries With Proximal Humerus Fractures, Sydney Lindros

All Dissertations

Proximal humerus fractures (PHF) are a common injury affecting older adults, though clinical decision making for these fractures remains challenging for physicians. Over the past two decades, clinical decision making has evolved with the emergence of new evidence like the ProFHER trial and the dissemination of reverse total shoulder arthroplasty (RTSA). There is a need to characterize the effects of these changes across geographic areas and evaluate the impact of differences in surgical procedure utilization rates on patient outcomes. Therefore, the goal of this dissertation was to gain a better understanding of the utilization patterns and outcomes associated with different …

A Replication Study — Suicidal Thoughts And Behaviors Among High School Students — Youth Risk Behavior Survey, United States, 2021, Mallory Hays

Capstone Experience: Master of Public Health

Suicidal thoughts and behaviors among adolescents are critical public health concerns in the United States, with suicide being the third leading cause of death among high school-aged youths (14-18 years). This study replicates and extends the findings of the 2021 Youth Risk Behavior Survey (YRBS) conducted by Gaylor et al., which analyzed data from 13,677 students in 2019 and 17,232 students in 2021. The original study revealed alarming increases in suicidal ideation and behaviors, particularly among female students, and highlighted disparities across demographic groups. Using raw YRBS datasets, this replication involved a pure replication of the original findings, followed by …

Promoting Adolescent Mental And Physical Health: Initiatives Focused On Connecting Public Health And Social Services To The Health Sector In Nebraska, Theresa Nguyen

Capstone Experience: Master of Public Health

This capstone focuses on the second recommendation of improving access to comprehensive, coordinated health services from the National Academies of Sciences, Engineering, and Medicine report The Promise of Adolescence: Realizing Opportunity for All Youth (2019). This proposal uses secondary data from the research project, Moving Evidence-Based Recommendations to Practice to Strengthen the Health Care System in Nebraska. Key stakeholders (n=28) were interviewed from the health care, public health, social services, and policy sectors. Each subject was asked to participate in a semi-structured interview by a trained interviewer. The interview was 1 hour long and conducted via phone call or Zoom. …

The Association Between Systolic Blood Pressure And Coronary Heart Disease In The Framingham Heart Study: A Long-Term Prospective Cohort Study, Alexandrea M. Welch

Capstone Experience: Master of Public Health

Coronary heart disease (CHD) is a leading cause of morbidity and mortality worldwide, with systolic blood pressure (SBP) as a critical risk factor. This study utilized data from the Framingham Heart Study to assess the association between SBP and CHD among participants. Univariate, bivariate, and multivariable logistic regression was used to explore this association as well as the association with other key covariates. We found a significant positive association between elevated SBP and the risk of CHD (adjusted OR: 1.69, 95% CI: 1.41-2.01, p < 0.0001). Age, sex, current blood pressure medication use, and body mass index (BMI) were significantly associated with CHD. Our findings support the need for blood pressure management to prevent cardiac events and reduce CHD burden.

Closing Gaps To Address Lifespan Health: Considerations For Developing A Preconception Healthcare Training For Community Health Workers, Jaclyn R. Vancamp

Capstone Experience: Master of Public Health

Community health workers (CHWs) are frontline public health workers who are embedded in their own communities and as linkages to care, decreasing health disparities for underserved individuals. The goal of this capstone project was to identify Michigan CHWs' knowledge gaps in the area of preconception healthcare. Through administering a training needs assessment to a sample of community health workers, the goal was to characterize knowledge gaps and make recommendations about what type of training would be most useful to them. The results of this needs assessment showed that the general state of self-reported knowledge about preconcept health among Michigan community …

Dietary And Physical Activity Behaviors In 2021 And Changes From 2019 To 2021 Among High School Students: A Replication Study, Jamila Nasir

Capstone Experience: Master of Public Health

Shannon L. Michael et al. conducted the study “Dietary and Physical Activity Behaviors in 2021 and Changes from 2019 to 2021 Among High School Students” to compare the prevalences of specific dietary and exercise behaviors among high-school students between 2019 and 2021, in order to examine how the COVID-19 pandemic affected these behaviors and to identify disparities in these effects.

This replication of the study focuses on exercise behaviors. The study data, drawn from the CDC’s YRBS in 2019 and 2021, had been selected using a three-stage cluster sampling method in which the clusters in the third stage were selected …

Association Between Cigarette Smoking And Angina Pectoris Among Middle-Aged Adults: Findings From The Framingham Cohort Study, Lauren M. Hron

Capstone Experience: Master of Public Health

Objectives: This study investigates the relationship between current cigarette smoking at baseline and the occurrence of angina pectoris during follow-up among middle-aged adults (30-70 years), adjusting for age, sex, BMI, diabetes status, education, and number of cigarettes smoked per day.

Methods: Using the Framingham Heart Study cohort (N=4,434), logistic regression analyses were performed. A backward selection approach identified confounders and explored effect modification.

Results: Angina prevalence was 16.4%, with higher odds observed in males, older individuals, and those with obesity or diabetes. Smoking status showed a non-significant association with angina in multivariable models (aOR:0.86, 95% CI: 0.73-1.01). However, age and …

Cybersecurity Vulnerabilities And Considerations In U.S. Healthcare Facilities: A Scoping Review, Rebecca J. Campbell

Capstone Experience: Master of Public Health

Robust cybersecurity measures are essential for business continuity of U.S. healthcare institutions which is to maintain care standards for all patients. Hackers seek to disrupt healthcare delivery for financial and political means, to disrupt services in retaliation, or simply for malicious intent (Wasserman & Wasserman, 2022). The COVID-19 pandemic further accelerated innovation and digitization in healthcare, including wearable and implanted medical devices, telehealth care delivery options, artificial intelligence, and cloud-based data management (Kioskli, Fotis, & Mouratidis, 2021). This progress in innovation continues today but also brings new vulnerabilities and challenges to stay ahead of cybersecurity threats.

Given that cyberattacks have …

Understanding And Mitigating The Potential Effects Of Postpartum Depression On Fathers And Male Support Persons, Rachel Norton-Turk

Capstone Experience: Master of Public Health

Background. During the postpartum period, best practices dictate that medical professionals screen new mothers or birthing persons for anxiety and depression and direct them to the appropriate resources and services they may need. This qualitative study explored the steps being taken to identify depression and anxiety concerns in male support partners during the postpartum period and to understand what resources are being brought to their attention if depression and anxiety are identified. Methods. A convenience sample of male support persons participated in semi-structured, one-on-one interviews either in-person or over Zoom between September and October 2024. Interviews were recorded, transcribed, …

A Cohort Study Examining The Risk Of Smoking On The Likelihood Of Developing Angina Among Women Under Age 65, Sarah Ward

Capstone Experience: Master of Public Health

Objective:

To determine if current smoking status is a risk factor for angina among women under the age of 65.

Methods:

A subset of participants from the Framingham Heart Studywere used to complete a cohort study. The analyses evaluated population means and characteristics, followed by bivariate and multivariable logistic regression, to determine the association of smoking and other key factors with angina.

Results:

Smoking status had a significant association to angina(OR 0.67, 95% CI: 0.52, 0.86, p-value= 0.0015). Age as a categorical variable had a significant relationship with angina (OR 0.97, 95% CI: 0.617, 1.520, p-value=

Conclusions:

Smoking had a …

Beryllium Work Area And Tank Waste, Angelica Zarate

Capstone Experience: Master of Public Health

My capstone was conducted at the Hanford site in Richland, Washington. It was once a location that produced weapons-grade plutonium, but now its mission is to clean up the radioactive waste that was left behind. My project focused on beryllium and how much is present in the 56 million gallons of waste that needs to be disposed of. I evaluated the OSHA regulations for beryllium work areas, medical surveillance, and beryllium exposure's environmental and health implications. The purpose was to determine if the concentrations present meet the requirements to continue to be considered a beryllium work area.

Comparative Study Of Coronary Heart Disease Incidence In Smokers Vs. Non Smokers: A Longitudinal Cohort Analysis From The Framingham Heart Study, Mona Melvin Periera

Capstone Experience: Master of Public Health

Objective: To evaluate the association between smoking and coronary heart disease (CHD) incidence while adjusting for potential confounding factors, including age, education level, systolic blood pressure, BMI, serum cholesterol, and diabetes, using data from the Framingham Heart Study.

Methods: A cohort of 4,434 participants aged 32–70 years, free of CHD at baseline, was analyzed. Smoking status (current vs. non-current smokers) was the primary exposure, and CHD incidence was the outcome. Adjustments were made for confounders using multivariable logistic regression models. Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

Results: CHD was diagnosed in 27.96% of …