Digital Commons Network^™

Becoming The Best Mom Or The Best Doctor? Gender Inequality And Medical Students’ Specialty Choice, Casey L. Lawson

Electronic Theses and Dissertations

In anticipation of an expected national shortage of primary care physicians, 24 medical students from the East Tennessee State University Quillen College of Medicine were selected through a snowball sample and participated in in-depth interviews. A major aim of the study was to explore the social and economic factors influencing students’ specialty choice and career interests. Students’ perceptions of “rural” environments, student debt, professional obligations, specialties, and preceptorship experiences were analyzed. Students’ gender heavily influenced their feelings about choosing a medical specialty, as did their stereotypes of physicians in particular medical fields. The thesis concludes with recommendations for challenging negative …

Barriers To Membership In The American Dental Hygienists’ Association In The State Of Georgia, Brandy Henderson

Electronic Theses and Dissertations

Professional associations must have a significant level of membership to be effective. Georgia membership is increasingly low; therefore, ADHA cannot represent dental hygienists’ interests. This study determined factors that caused dental hygienists to continue to forgo membership in the ADHA. Several theoretical views of professional membership were considered. The sample was acquired from an unbiased systematic sampling of 50% (3,270) of registered dental hygienists and a convenience sampling of ADHA nonmembers at 2 continuing education seminars in Georgia. Data collection procedures included an electronic cover letter, consent form, and survey via Survey Monkey or hard copies for seminars. Three hundred …

An Evaluation Of The Quality Assurance Plan At East Tennessee State University’S Dental Hygiene Program, Jennifer E. Fielden

Electronic Theses and Dissertations

Quality assurance in healthcare is fundamental in ensuring the achievement of desired outcomes for patients. In 2011 a quality assurance plan was created at the East Tennessee State University (ETSU) dental hygiene program in order to meet accreditation standards. The purpose of this study was to evaluate this plan in order to determine its effectiveness in improving the quality of patient care indicators. One hundred fifty patient charts were selected and audited. Deficiencies were counted in the categories of assessment, treatment, documentation, referral, caries management, perio management, patient education, and follow-up. Research findings were varied; however, external variables with the …

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …

Health Service Utilization And Stigma Among Hiv-Positive Men-Who-Have-Sex-With Men (Msm) In Rural Appalachia, Roger L. Blackwell Jr

Electronic Theses and Dissertations

ABSTRACT

Health Service Utilization and Stigma among

HIV-Positive Men-Who-Have-Sex-With-Men (MSM) in Rural Appalachia

by

Roger Lee Blackwell

The world has now entered the third decade of the AIDS epidemic. Men-who-have-sex-with-men continue to be disproportionately affected by HIV/AIDS. The United States still struggles in its response to this ongoing crisis in many areas: disease prevention, treatment, and HIV related stigma, prejudice and discrimination. Much of the information reported on MSM living with HIV has come from urban population centers, but only a few studies have focused on HIV positive MSM living in rural areas. Therefore, the overall aim of this dissertation …

Effects Of High Fidelity Simulation On Knowledge Acquisition, Self-Confidence, And Satisfaction With Baccalaureate Nursing Students Using The Solomon-Four Research Design, Rachel M. Hall

Electronic Theses and Dissertations

High Fidelity Simulation is a teaching strategy that is becoming well-entrenched in the world of nursing education and is rapidly expanding due to the challenges and demands of the health care environment. The problem addressed in this study is the conflicting research results regarding the effectiveness of HFS for students’ knowledge acquisition after participating in simulation exercises. Specifically this researcher determined the effects of a formatted simulation scenario on knowledge acquisition among nursing students and the students’ satisfaction and selfconfidence with the simulation learning activity. Kolb’s Experiential Learning Theory (1984) provided the framework for this study.

This study used a …

Patient Preference And Compliance Between Hawley Retainers And Vacuum-Formed Retainers Following Orthodontic Treatment., Justin Wild

Electronic Theses and Dissertations

Introduction: The traditional Hawley retainer has been replaced in many orthodontic offices by vacuum-formed retainers (VFRs). There has yet to be a study that investigates preferences and reasons for noncompliance between Hawley and vacuum-formed retainers by allowing each to be worn within the same patient. Specific Aim: To determine differences in compliance and reasons for noncompliance between Hawley and VFRs. Hypothesis: There will be increased compliance with VFRs due to better esthetics, speech, and comfort. Methods: In consecutive months but in a different order, two treatment groups received a set of Hawleys and VFRs following comprehensive treatment. All patients were …

Relationship Between A Measure Of Social And Emotional Development And Early Communication Development In Young Children With Cleft Palate, Jenna L. Pugh

Electronic Theses and Dissertations

This study was an examination of responses to a standardized assessment of social-emotional behaviors and correlation with speech and language development in young children with cleft palate and/or lip. Twenty-eight participants aged 14-35 months with nonsyndromic cleft palate and or lip were included in this study. The Infant-Toddler Social and Emotional Assessment (ITSEA) was used to identify emerging social and emotional behaviors. Descriptive analysis of ITSEA results was completed. Pearson correlation coefficient and effect size estimates were calculated between ITSEA domain raw scores and measures of speech and language development. A small proportion of participants (14%) showed ITSEA scores beyond …

The Relationship Of Stress Levels To Wellness Practices Among U.S. Radiologic Technology Program Directors, Jesse D. Pennington

Electronic Theses and Dissertations

The purpose of this modified replication study is to examine the relationship between the stress levels and the wellness practices of U.S. radiologic technology program directors and to determine if correlations exist between wellness practices and stress levels of the group. Additionally, relaxation activities and the feelings, characteristics, and symptoms associated with stress were considered. The design of the study was ex post facto correlational. The population of the study was U.S. radiologic technology program directors working in JRCERT accredited programs. The electronic instrument was distributed to 635 program directors through e-mail, with 424 (66.7%) usable returns. Significant associations were …

Influential Variables On The Timing Of Help-Seeking Behavior In Lung Cancer Patients., Lisa Carter-Harris

Electronic Theses and Dissertations

Lung cancer kills more people than any other cancer worldwide primarily because it is often diagnosed at an advanced stage. One factor that can influence advanced stage lung cancer diagnosis is delayed help-seeking behavior in individuals with symptoms suggestive of lung cancer. Delayed help-seeking behavior has been investigated in acute cardiovascular events and breast cancer, but there is little evidence on specific factors that influence the timing of help-seeking behavior in lung cancer patients. The purpose of this study was to explore the influence of healthcare system distrust, lung cancer stigma, and smoking status on the timing of help-seeking behavior …

Examining Stage At Diagnosis And Survival In Three Cancers With Definitive Screening Guidelines For Average-Risk Adults: The Role Of Marital Status, David J. Blackley

Electronic Theses and Dissertations

Each year there are more than 350 000 new cases and nearly 100 000 deaths attributed to colorectal, female breast, and cervical cancer in the United States. Screening tests can reduce morbidity and mortality associated with these cancers. Patient marital status has been associated with health outcomes, but no study has focused on the relationship of marriage with disease stage and survival for the 3 cancers with established screening guidance. It is critical to identify special populations that may be at risk for poor cancer outcomes.

The objective of this study was to examine the relationship of marital status with …

Preventing Skin Cancer In Adolescent Girls Through Intervention With Their Mothers, Mary K. Baker

Electronic Theses and Dissertations

Indoor tanning (IT) before the age of 35 increases one’s risk for melanoma by 75%, and epidemiological data show a 6.1% annual increase in the incidence of melanomas in white women younger than age 44 in the US. Population-based studies reveal that 15% of adolescents and 8% to 14% of their primary caregivers have engaged in IT in the past year.

The compelling case for IT being a significant risk factor for melanoma, together with the high rates of IT in teen girls and their mothers, provided a strong rationale for conducting an antitanning intervention directed at mother-daughter dyads. This …

Comparison Of Obesity Bias, Attitudes, And Beliefs Among Undergraduate Dietetic Students, Dietetic Interns, And Practicing Registered Dietitians, Sarah E. Welborn

Electronic Theses and Dissertations

The obesity epidemic in the United States is increasing, and health concerns are also on the rise as they are directly related to obesity. Even though the majority of Americans are overweight or obese, prejudice and weight bias continue to be prevalent and socially accepted in a culture that tolerates discrimination towards these individuals. Health care providers, including registered dietitians, are not exempt from instigating bias towards obese patients causing a decrease in the level of care that they receive. The main purpose of this study was to compare attitudes, beliefs, and bias concerning obesity among undergraduate dietetic students, dietetic …

Building A Foundation For Interprofessional-Education (Ipe) Between Dietetic Students And Dental Hygiene Students At East Tennessee State University (Etsu), Monique Richard

Electronic Theses and Dissertations

Nutrition education is an integral part of dental education as well as a variety of other healthcare professions¹, but interprofessional education (IPE) between the fields of dietetics and dental hygiene is limited. The purpose of this pilot study was to define areas of opportunity to establish a foundation for the implementation of complimentary curriculum between the dietetics and dental hygiene programs at ETSU. A 76-question survey was developed and administered to dietetic interns (n=26), dental hygiene students (n=49), dietetic faculty (n=23), and dental hygiene faculty (n=19) at ETSU and Baylor College of Dentistry at Texas A&M Health Science …

Practice Characteristics Of Graduates Of East Tennessee State University Quillen College Of Medicine: Factors Related To Career Choices In Primary Care, Ivy A. Click

Electronic Theses and Dissertations

The nation is facing a physician shortage, specifically in relation to primary care and in rural underserved areas. The most basic function of a medical school is to educate physicians to care for the national population. The purpose of this study was to examine the physician practicing characteristics of the graduates of East Tennessee State University Quillen College of Medicine including factors that influence graduates’ specialty choices and practice locations, especially those related to primary care. Secondary data for this study were collected from the college’s student database system and the American Medical Association Physician Masterfile. The study population included …

Cardiovascular Disease Among Diabetic Women With Bilateral Oophorectomy., Duke Appiah

Electronic Theses and Dissertations

Cardiovascular Disease (CVD) is the leading cause of death in women and the risk is increased threefold in diabetics. In postmenopausal diabetics, the ovary responds to hyperinsulinemia by increasing secretion of testosterone precursors which increases the risk of CVD. Data from the National Health and Nutrition Examination Survey (1988-2010) and the Study of Osteoporotic Fractures were used to test the hypothesis that a history of bilateral oophorectomy -surgical removal of both ovaries-would decrease the risk of CVD among postmenopausal diabetic women due to reduced androgen levels. Logistic regression, discrete time logit model, B-Spline regression and Cox proportional hazards models were …

Ncaa Division I Head Coaches' Experiences With Eating Disorders And Disordered Eating In Female Athletes: A Qualitative Analysis, Caitlyn Pecinovsky

Electronic Theses and Dissertations

In today's sport, NCAA Division I female athletes are under a constant pressure to reach an elite level of perfection in athletic performance, frequently adhering to the assumption that there is an inverse relationship between body size and performance level (Petrie & Sherman, 2007). Additionally, coaches have unrealistic expectations about weight and body image, which adds pressure on athletes to conform to certain weight or image driven standards. Perceptions that coaches hold about eating disorders and disordered eating present a set of risk factors that may increase the likelihood of female athletes developing maladaptive eating patterns (Scoffier, Maiano, & d'Arripe-Longueville, …

Nutrition Literacy And Demographic Variables As Predictors Of Adolescent Weight Status In A Florida County, Leslee D'Amato-Kubiet

Electronic Theses and Dissertations

In recent years, childhood obesity has increased to epidemic proportions across the United States (U.S.) in parallel with adult obesity, which often reflects poor dietary choices and bad nutritional habits. Nutrition literacy, which encompasses the constructs of nutrition knowledge and skills, is considered a basic tool for good dietary habits and health promotion undertakings; however, its more definitive relationship to adolescent children’s weight status is unknown. Most childrens’ weight status studies have focused solely on behavioral aspects of adolescent food intake, taking into consideration parental influence, peer pressure, and societal expectations. Studies evaluating the measurement of nutrition literacy with regard …

The Effects Of 6-Weeks Of Resistance Training On The Neuromuscular Fatigue Threshold In Older Adults, Nadia Emerson

Electronic Theses and Dissertations

Age-related deficits in muscle mass, strength, and function place an increased burden of work on existing skeletal muscle and may lead to early onset of neuromuscular fatigue (NMF) during activities of daily living. Resistance exercise (RE) is the proven method for improving neuromuscular function in healthy older adults. PURPOSE: To investigate the effects of 6 weeks of RE on the NMF threshold as well as strength and functional performance in older adults. METHODS: Twenty-four older adults were randomly assigned to 6 weeks of RE (EXE; n = 12; age 72 ± 6.3 y; BMI 28.4 kg/m2 ) or control (CONT; …

The Case For Extending Patent Terms For Drugs That Treat Rare Diseases, Joanna Louise Thompson

Electronic Theses and Dissertations

This paper seeks to determine if extended patent terms can positively effect the production of drugs that treat rare diseases. It reviews the structure of the modern pharmaceutical company and considers the regulatory history that lead to this structure. The paper applies historically significant economic research in the field of patents and considers patent alternatives to establish the best method for incentivizing the development of these drugs. The paper finds that while there are numerous pitfalls and issues with the patent method, there are no viable alternatives. It also concludes that extending patent terms for drugs that treat rare diseases …

Adolescent Substance Abuse Treatment: Does Family Systems Therapy Improve Family Functioning And Decrease Drug Use?, Darin J. Wallis

Electronic Theses and Dissertations

Family systems therapy is a way of working with individuals, couples, families, or a group of people that emphasizes relationships and a person's/family's greater "system" as important factors in establishing change and health (Haley, 1976; Minuchin, 1974). Treating adolescent substance abuse with family systems therapy has been demonstrated in the literature as being an effective method of intervention (Coatsworth, Santisteban, McBride, & Szapocznik, 2001; Kumfer & Alvarado, 2003; Leichtling, Gabriel, Lewis & Vander Ley, 2006; Liddle, 2002; Liddle et al., 2001; Rowe & Liddle, 2003), as the various ecological and epidemiological factors associated with adolescent substance abuse can be addressed …

Mental Health Outcomes Of First Generation College Students: Is Generational Status Associated With Increased Risk For Depression And Anxiety?, James L. Pease

Electronic Theses and Dissertations

The purpose of this study was to investigate whether there were differences in mental health outcomes between first generation college students and non-first generation college students. The sample (n = 6,449) consisted of undergraduate students, aged 18-22, in bachelor's degree programs, and was drawn from 15 colleges and universities throughout the United States. Acculturative stress was used as a theoretical framework for why first generation college students (pioneers) may screen higher in prevalence and severity of mental health outcomes. The particular mental health outcomes examined in this study were the prevalence and severity of depression and anxiety. The results …

Mental Health Literacy Of Latina Women In The United States For Their School-Aged Children, Annarheen S. Pineda

Electronic Theses and Dissertations

Despite known mental health (MH) disparities faced by Latino children relative to children from other minority groups of similar socioeconomic status (SES), little is known about how Latina mothers make MH decisions for their children. The present study examined links between Latina mothers' mental health literacy (MHL), including the recognition of and response to child psychiatric symptoms, and maternal acculturation factors as well as interpersonal violence (IPV) related symptomatology. Participants were 80 Latina mothers from Denver, Colorado and Modesto, California with at least one child between the ages of 8-12 years. Mothers were presented vignettes depicting child internalizing and externalizing …

The Effects Of Whole Body Vibration On Muscle Recovery And Performance, Nicole Dabbs

Electronic Theses and Dissertations

Facilitating muscle recovery in trained individuals is essential, as it allows for a quicker return to activity without reduction in performance. Many proposed modalities have been studied but have not shown consistent effectiveness. A relatively new modality, whole-body vibration (WBV) has been shown to increase strength and power outcomes and recently has been shown to decrease perceived pain associated with muscle soreness. Therefore, the purpose of this study is to examine the effects of WBV following exercise induced muscle damage over a period of 72 hours in recreationally trained females. Participants were randomly selected into either the control group or …

A Neurophysiological Examination Of Stress Control In Martial Artists, Jack Pemment

Electronic Theses and Dissertations

The philosophies behind many martial arts often claim that by practicing martial arts individuals can gain better control over stress. We tested this idea by using controlled physical stressors to elicit an acute stress response from martial artists (n=15) and non-martial artists (n=18). To measure the extent of the stress response, we looked at changes in heart rate, respiratory sinus arrhythmia, and galvanic skin level. These three measures explore both parasympathetic and sympathetic responses, and changes in these variables continue to be explored in studies of stress and reactive aggression. In addition to our physical stressors we also exposed individuals …

Community Pharmacists' Attitudes Toward An Expanded Class Of Nonprescription Drugs, Ruchitbhai Mukesh Shah

Electronic Theses and Dissertations

Objectives: there has been considerable discussion about creating a third class of drugs which would not require a prescription, but require a pharmacist's consultation upon purchase. Very recently the Food and Drug Administration (FDA) held a hearing which repositioned a third class as an expanded nonprescription drug class termed as the "new paradigm" using certain innovative technologies. The specific objectives of this study were to: 1) measure community pharmacists' attitudes toward an expanded nonprescription drug class under the FDA’s proposed "new paradigm"; 2) determine if attitudes of community pharmacists toward an expanded nonprescription drug class under the FDA’s proposed "new …

Using A Community-Based Participatory Research Approach To Address Individual And Community Health In Charleston, Ms. The Initial Step: A Formative Needs Assessment, Catherine Dane Woodyard

Electronic Theses and Dissertations

The purpose of this formative study was to use a Community-Based Participatory Research (CBPR) approach to conduct a comprehensive health needs assessment (CHNA) in Charleston, Mississippi (MS) to determine perceived needs of the community and identify priority health issues. A second purpose was to provide methodological and scholarly contributions to the existing literature regarding CBPR and CHNAs. The target population was residents living in Charleston, MS (N=2,193). Eighty-five residents participated in the study. This was a five-part study including: (1) Key informant interviews (n=11), (2) Focus groups (n=8), (3) Assessment of the built environment, (4) Assessment of the nutrition environment, …

Early And Intermediate Hospital-To-Home Transition Outcomes Of Older Adults Diagnosed With Diabetes, Jacqueline Lamanna

Electronic Theses and Dissertations

Over 5 million older adults with diabetes are hospitalized each year. Though typically not the index condition that leads to hospitalization, diabetes control often decompensates during the course of an admission and necessitates changes in home self-management plans. The specific transitional care needs of older adults with diabetes have been largely unstudied. Transition theory provided the guiding framework for this research and proposes that each transition is a complex process created by the continuous interaction of personal, community, and societal-level conditions that facilitate or inhibit the health of a transition. Hospitalization has been described as a series of three successive, …

Physiological Muscle Qualitative Changes In Response To Resistance Training In Older Adults, Tyler Scanlon

Electronic Theses and Dissertations

Muscle function is determined by structure and morphology at the architectural level. In response to resistance training, older adults have demonstrated that the neuromuscular system has a substantial adaptability, which may compensate for muscle size and quality and lead to improved functional capacities and higher quality of life. PURPOSE: The purpose of this study was to examine the effect of six weeks of progressive resistance exercise on muscle morphology and architecture in healthy older adults. METHODS: Twenty- five healthy men and women were randomly assigned to either six weeks of progressive resistance training (RT) (n=13; age = 71.08 ± 6.75, …

Impact Of Time-Varying And Time-Invariant Measures Of Adherence To Secondary Prevention Therapies Post-Acute Myocardial Infarction: An Application Of Marginal Structural Models (Msms), Tasneem Taher Lokhandwala

Electronic Theses and Dissertations

The purpose of the study was to explore the relationship between patient adherence to secondary prevention therapies post an initial episode of acute myocardial infarction (AMI) and subsequent risk of cardiovascular events by using time-invariant and time-varying measures of adherence. The effectiveness of both measures in predicting a (i) recurrent AMI, and (ii) mortality using various mathematical models and statistical techniques was compared. Time dependent confounding was accounted for by using marginal structural models (MSMs). A longitudinal cohort observational study design was employed using the retrospective Medicare 5% random national sample claims data from January 1st, 2006 to December 31st, …