Digital Commons Network^™

Job Embeddedess Of Nurses Working In South Central Appalachia’S North Carolina Counties, Susan L. Adams Mrs.

Electronic Theses and Dissertations

Nurses working in the North Carolina counties of South Central Appalachia (NC-SCA) are a unique subset of nursing professionals. A continued nursing shortage is projected in this area while staffing has improved in other areas of SCA. The purpose of this research was to ascertain the level of job embeddedness of nurses working in NC-SCA in order to offer guidance regarding retention of nurses working in this area. Actively working licensed practical nurses, registered nurses, and advanced practice nurses (nurse practitioners, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists) from 29 North Carolina counties included in South …

Prescription Drug Abuse And Provider-Patient Communication: A Qualitative Analysis Of The Perspectives Of Prescribers And Patients, Stephanie M. Mathis

Electronic Theses and Dissertations

Prescription drug abuse is a public health problem of epidemic proportions in the United States. Provider-patient communication underpins many initiatives aimed at preventing and reducing the public health burden of prescription drug abuse. The characteristics of and factors contributing to this interpersonal process, however, have not been fully explored.

The purpose of this research was to examine: 1) the overall problem of prescription drug abuse and provider-patient communication about prescription drug abuse from the patient perspective; and 2) provider-patient communication about prescription drug abuse from the prescriber perspective. In 2014-2015, semi-structured interviews were conducted with 20 patients from primary care …

The Effects Of A Supermarket Tour On Improvement Of Nutrition Knowledge And Eating Behavior, Elizabeth Hall

Electronic Theses and Dissertations

The purpose of this study was to determine if participation in a supermarket tour improves nutrition knowledge and eating behavior in adult participants. Participants were recruited in communities surrounding Food City stores, a local supermarket. Prior to completing a standardized tour, participants completed a survey to assess nutrition knowledge and eating behavior. This survey was given to participants again three months later. A program evaluation was given one time at the end of the tour. Data analysis revealed no significant findings, other than the behavior-based question: “How many meals or snacks on most days included vegetables”. Vegetable consumption appeared to …

Design And Validation Of A Scale For Preschoolers: Measuring Nutrition Knowledge, Beliefs, And Behaviors, Michelle E. Johnson

Electronic Theses and Dissertations

The literature indicates a lack of validated scales to measure nutrition knowledge, attitudes and behaviors in preschool-aged children. Reliable and valid assessment tools are critical in the development of nutritional interventions for young children; careful design, including psychometric evaluation of reliability and validity, is the best approach to scale development. Best practice points to an efficient, yet comprehensive look at the constructs of knowledge, attitudes, and behaviors. This multi-phase study included 298 preschool children ages 2-6 years (151 girls, 147 boys; mean age 3.936). A 45-item scale was created, with 4 subscales to measure the nutrition knowledge, attitudes, and behaviors …

Approachability Of Nursing Clinical Instructors: Psychometric Assessment Of A Scale Development, Angela Collier

Electronic Theses and Dissertations

Approachability of nursing clinical instructors is largely unknown and misunderstood, yet critical for millennial students which currently comprise 82% of nursing students (National League for Nursing, 2014). Nursing education consists of both a didactic and a clinical component. Clinical education is dynamic and allows the student an experiential learning opportunity. Therefore, clinical nursing educators are vitally important. Approachability has been identified in many studies as a leading characteristic of an effective instructor. Although the importance of approachability of the instructor is established, currently no scale exists to measure this concept. The purpose of this study was to examine the validity …

Metabolic Regulation Of Myocardial Adaptation To Exercise., Andrew Alan Gibb

Electronic Theses and Dissertations

While the benefits of exercise affect several organs, a significant adaptive response occurs within the heart. Exercise promotes cardiac growth, increases angiogenesis, and enhances cardiac function and these adaptations are associated with a cardioprotective phenotype. Additionally, extensive evidence shows that exercise dynamically regulates myocardial metabolism. This can be attributed to both changes in hormonal stimulation, increases in bioenergetic demand, and the bioavailability of circulating substrates. However, it is unclear whether these changes in metabolism contribute to physiologic cardiac growth. We reason that exercise-induced changes in metabolism are required to balance the catabolic and anabolic reactions needed for growth. Specifically, we …

Social-Ecological Factors Affecting Patient Shield Use Among Radiologic And Computed Tomography Technologists, Megan Housenick-Lee

Electronic Theses and Dissertations

Medical radiation is estimated to contribute to over 200,000 deaths annually. Recent increases in the use of radiation-producing medical imaging examinations have led to increasing cumulative radiation dose to the general public. Multiple measures have been taken to address this alarming trend, including physician education, technologist education on dose reduction, and equipment-facilitated dose reduction techniques. Shield use can reduce the primary beam by up to 95%. Medical imaging technologists are the primary individuals responsible for applying shielding during an examination. Currently, literature shows that technologists are not shielding individuals as often as they should.

After pilot testing, medical imaging technologists …

Effect Of Total Body Iron On Metabolic Dysfunction Among U.S. Females In The Nhanes 2003-2010, Aged 12-49., Joseph Michael Carhart

Electronic Theses and Dissertations

Experimental and epidemiological studies have reported positive associations between iron parameters and metabolic dysfunction including: Type 2 diabetes mellitus (T2DM) (1-6), metabolic syndrome (7-15), non-alcoholic fatty liver disease (NAFLD) (16-22) and insulin resistance (23,24) with a number of studies showing that reductions in total body iron via dietary modification (e.g., reducing red meat intake) or phlebotomy lead to increases in insulin sensitivity (25), decreases in insulin resistance (26), and reductions in the prevalence of complications associated with T2DM (5, 27), metabolic syndrome (28) and NAFLD (22, 29). Moreover, the risk associated with these outcomes and total body iron differ between …

Pcb-Associated Steatohepatitis And The Role Of Nuclear Receptors., Heather Brooke Clair

Electronic Theses and Dissertations

Metabolic diseases, including fatty liver disease, hyperglycemia, and obesity, result when body systems responsible for managing allostasis (dynamic homeostasis across systems) are pressured beyond their collective compensatory reserve. Nutritional excess contributes to this state, the capacity of which is limited by genetic variation, and failure of one system will gradually lead to pathological overload in the others. Agents which act directly on the communication machinery linking these connected systems can also change the point at which allostatic load becomes allostatic overload. Environmental exposure to polychlorinated biphenyls (PCBs), a class of persistent organic pollutant, is associated with a specific form of …

Self-Management As A Mediator Of The Relationship Between Social Support And Health Outcomes Of African American Adults With Type 2 Diabetes., Tariq N. Al-Dwaikat

Electronic Theses and Dissertations

Type 2 diabetes (T2D) is often associated with serious complications. African American adults have higher rates of diabetes-related complications than other ethnicities. Diabetes self-management reduces the risk of developing biological and psychological symptoms. Social support promotes positive behavior change and self-management that leads to improved biobehavioral and psychosocial outcomes. Few studies explored the relationship between social support dimensions and self-management behaviors, diabetes biomarkers, and psychosocial outcomes of African American adults with T2D. The purpose of this dissertation was to examine the relationships of various dimensions of social support with self-management behaviors and diabetes biomarkers and psychosocial outcomes of African American …

Nurse Perspectives On The Work Impacts Of Decentralized Nursing Unit Design, Susan Mcdevitt

Electronic Theses and Dissertations

This study investigated nurse perspectives on the work impacts of a decentralized inpatient unit model. The study involved two rural acute-care hospitals in rural Nebraska that moved from a centralized to a decentralized inpatient unit design. The researcher conducted focus group discussions with staff and nursing management at both facilities with a total of 28 participants. In addition, the participants completed a 12-item questionnaire using a five-point Likert scale for responding. Focus group discussion and questionnaire were designed to investigate the areas of quality of care, communication, documentation, stress and wellbeing, and transition. Data gathered revealed that on all survey …

Outcomes Of An Integrated Approach To Speed And Strength Training With An Elite-Level Sprinter, Eric D. Magrum

Electronic Theses and Dissertations

The purpose of this study was to observe changes in sprint velocity, ground contact time, and peak force demonstrated by a competitive sprinter following an integrated approach to speed development and strength training. As part of an ongoing monitoring procedure the participant completed 20m sprint testing through an optical measurement system and isometric-strength testing before and after each phase of training. Sprint velocity, ground contact time and peak force were analysed using Tau-U, smallest worthwhile and percent change statistics. Results indicate sprinting velocity statistically improved while changes in peak force were practically significant and ground contact time remained trivial throughout …

Evaluating Effective Communication Methods: Improving Internal Communication, Amber L. Suthers

Electronic Theses and Dissertations

Relaying information from a Chief Communications Officer (CIO), or centralized communications departments to hospital employees is not always efficient or effective. Employees may not be informed of important changes to department protocols or hospital policies. The purpose of the study was to determine the most efficient and effective forms of internal communications in the hospital setting.

A total of 83 surveys were mailed to communication officers working in Tennessee hospitals in and east of Nashville. Sixteen communication officers responded. This low response rate may be attributed to poor designation of communication responsibilities and an abdication of responsibilities to an off …

Effects Of Acute Sepsis On Renal Structure And Sympathetic Innervation In Mice, Tuqa Alkhateeb

Electronic Theses and Dissertations

Sympathetic nerves are important for renal physiology and sepsis pathophysiology. A recent study showed sprouting of sympathetic nerves in spleen of septic mice. This study was done to test if renal sprouting of sympathetic nerves also happens and to investigate renal morphology in septic mice. Cecal ligation and puncture (CLP) was used to induce sepsis and kidneys were removed for evaluation. Bowman’s space was diminished with cortical bubble cells present suggestive of acute renal pathology, however, renal function was unchanged. Acute sepsis did not affect either renal sympathetic innervation or non-neuronal cholinergic cells. Mouse kidneys had more epinephrine (EPI) than …

Attending To Systemic Racism : Advancing Public Health's Approach To Youth Violence Prevention., Billie Faith Castle

Electronic Theses and Dissertations

This dissertation examines how the field of public health addresses the impact of systemic racism on health and how that informs public health’s approach to youth violence prevention. Beginning with an overview of youth violence, it breaks down the concepts of race and racism and how they are addressed within the science. It also reviews concepts that contribute to risk and protective factors of youth violence. The dissertation is written from a Critical Race Theory approach, argues that the social environment contributes to why youth violence is pervasive in certain neighborhoods, and promotes action from a macro-level approach. Seven chapters …

Exploring A Multifactorial, Clinical Model Of Thought Disorder : Application Of A Dimensional, Transdiagnostic Approach., Mara Ann Hart

Electronic Theses and Dissertations

Background: Bleuler saw thought disorder as the core defining feature of psychotic phenomena, reflective of the “splitting of the psychic functions” that occurred when, in the process of thinking, one’s ideas and feelings disconnect, becoming fragmented and competing functions. Unfortunately, interest in thought disorder as the conceptual core of psychosis was lost with rise of the modern DSM system, paralleling the shift towards a more simplistic, categorical way of defining psychiatric disorders. Aims: This study examined thought disorder from a dimensional perspective, with the aim of disentangling qualitative heterogeneity and diverse sources of influence. Analyses were based on …

Mirna Expression Changes In Arsenic-Induced Skin Cancer In Vitro And In Vivo., Laila Al-Eryani

Electronic Theses and Dissertations

Arsenic is a naturally prevalent metalloid. Chronic arsenic ingestion through drinking water causes skin cancer. Arsenic-induced cancer mechanisms are not well defined. Epigenetic changes, including microRNA expression changes, might be playing a role. This dissertation investigates the impact of miRNA expression changes in arsenic-induced skin cancer. MiRNA expression was measure and compared using 3 different techniques, RTq-PCR, hybridization arrays and RNA-sequencing. MiRNAs differential expression in skin lesions was phenotype- and stage-related. Immortalized human keratinocytes (HaCaT) were transformed by chronic low arsenite exposure serving as a model for arsenic-induced skin carcinogenesis. Early changes in miRNAs and target mRNAs contribute to arsenic-induced …

Cumulative Trauma, Emotion Reactivity And Salivary Cytokine Response Following Acute Stress Among Healthy Women., Yvette Z. Szabo

Electronic Theses and Dissertations

This study furthers understanding of how trauma exposure may be connected to the development and maintenance of poor health by focusing on cytokines, tightly regulated proteins of the immune system. Cytokine responses to acute stress have been associated with the onset of poorer mental health in physically healthy women. The present study examined how two factors recently associated with cytokine reactivity –cumulative trauma and emotion reactivity– are associated with salivary cytokine reactivity among healthy women. Seventy-one women, screened to be physically and mentally healthy, completed a laboratory acute stress paradigm and self-report measures of state emotion and trauma exposure. Participants …

Coal Ash Exposure And Asthma In Children., Jack Anthony Pfeiffer

Electronic Theses and Dissertations

This study examined the association between exposure to coal ash in the home among children aged 6-14 and asthma. Data was collected using personal modular impactors, lift tape samples, toe/finger nail samples, questionnaires, and peak flow meters. Laboratory methods used to analyze the samples included gravimetric analysis, scanning electron microscopy (SEM) / energy dispersive x-ray (EDX), and proton-induced x-ray emission (PIXE). Statistical methods used to analyze the data included the Chi Square Test of Independence, logistic regression, the Hosmer-Lemeshow Goodness of Fit test, Fisher’s Exact Test, and the Anderson-Darling Normality Test. Sample size was small, making statistical significance in calculated …

Basic Vision Research With Clinical Applications And Science Education Assessments, Andrew Wilson

Electronic Theses and Dissertations

Visual Acuity (VA) examinations are one of the most commonly conducted medical assessment throughout the world. Recent advances in computer technology allows for new forms of visual assessment to be conducted. In Part I of this thesis I demonstrate the capability of an automated computer program named VISION to assess human visual acuities. Different color combinations of an object against a background emitted from a computer screen are used to examine a variety of human color vision acuities. Results indicated a large difference in acuity scores between human subjects tested with these different color combinations. A single human subject exhibits …

The Effect Of Anxiety And Depression On College Students’ Academic Performance: Exploring Social Support As A Moderator, Katherine H. Bisson

Electronic Theses and Dissertations

The purpose of this study is to explore how social support is related to the overall well-being of college students. Literature suggests social support buffers a negative effect of distress on academic performance. This study attempts to provide practical information for a program called Student Opportunities, Advocacy, and Resources (SOAR) at Abilene Christian University (ACU), which assists students and connects them to resources available to support their path to success. A multiple linear regression was conducted to examine the association between anxiety, depression, social support, and academic performance using a sample of 93 students enrolled in this program in Fall …

Inhibition Of Chemotherapeutic-Induced Apoptosis In Esophageal Squamous Cancer Cells By The Keystone Periodontal Pathogen, Porphyromonas Gingivalis., Atul Kumar Agrawal

Electronic Theses and Dissertations

Recent evidence has shown that P. gingivalis, a Gram-negative, anaerobic oral bacterium, is negatively associated with the presence and outcome of esophageal squamous cell carcinoma (ESCC). While potential underlying mechanisms are yet to be established, P. gingivalis infection is known to inhibit apoptosis in gingival epithelial cells. Therefore, we hypothesized that P. gingivalis may also inhibit of the induction of apoptosis in human ESCC cells exposed to the commonly employed anti-ESCC chemotherapeutic agent, cisplatin. The capacity of P. gingivalis, at variant multiplicities of infection, to suppress cisplatin-induced necrosis and apoptosis in EC9706 ESCC cells was established by lactate …

Reducing Tobacco-Related Health Disparities : Exploring The Barriers And Facilitators To Smoking Cessation Among Individuals Experiencing Homelessness., Bernadette Guzman Antoon

Electronic Theses and Dissertations

Although the prevalence of smoking has declined in the U.S., vulnerable populations continue to suffer from tobacco-related health disparities. An estimated 68.0-80.0% of homeless adults are current cigarette smokers compared to 15.1% in the general population. The large gap in smoking rates suggests that current tobacco cessation programs designed to reduce smoking have little impact among individuals experiencing homelessness. The purpose of this study was to explore the barriers and facilitators to smoking cessation among the homeless. The second aim of this study was to explore if the barriers and facilitators to tobacco cessation differed among male smokers experiencing homelessness …

Technical And Physical Match Demands Of A Ncaa Division I Soccer Goalkeeper, Joanne Spalding

Electronic Theses and Dissertations

The purpose of this study was to provide a better understanding of the goalkeeper position in order to prepare goalkeepers for competition. The objectives of this study were to characterize the technical and physical demands of an NCAA Division I collegiate goalkeeper over three seasons and examine trends from season to season. Count and frequency for each definition were analyzed. Results show that although the goalkeeper’s technical demands were characterized by engaging in play without action and being in the goal area, the gradually increased use of the feet over three season’s hints on the importance of skills performed with …

Prevalence Of Communication Disorders In Children With Neonatal Abstinence Syndrome On School Speech-Language Pathology Caseloads: A National Survey, Brittany V. Ratliff

Electronic Theses and Dissertations

There is concern about the recently increasing number of infants born with Neonatal Abstinence Syndrome (NAS), yet little is known about its long-term neurodevelopmental effects. School-based speech-language pathologists (SLPs) are in a unique position to comment on potential long-term consequences of NAS because their caseloads include children with a variety of communication disorders and comorbidities. School-based SLPs across the United States (N = 258) responded to a survey about the presence of children with NAS on their caseloads and their perceptions of the children’s communication disorders and comorbidities. Results revealed that children with NAS currently are being treated by …

Correlates Of Human Papillomavirus (Hpv) Vaccine Acceptance In Appalachian Tennessee, Oluwatosin Ariyo

Electronic Theses and Dissertations

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the U.S., where one HPV-related cancer is diagnosed every 20 minutes. The most common HPV-related cancer is cervical cancer, with an estimated incidence of 12,000 cases annually, a third of which lead to death. Cervical cancer disparately affects women of ethnic minority groups and geographically isolated regions, such as Appalachia. Tennessee ranks third highest in cervical cancer incidence in the country. Many cases of cervical cancer could be prevented through vaccination against HPV, however, vaccination rates for females in Tennessee are among the lowest in the country. This mixed-methods …

An Investigation Of The Relationship Between Child, Family, And Community Factors And Early Childhood Oral Health And The Utilization Of Dental Health Services, Nicole Holt

Electronic Theses and Dissertations

Background / Objective: Children under the age of 5 years bear a disproportionate burden of oral disease. The aim of this study is to investigate how child, family, and community determinants impact dental care utilization, and parental report of child’s oral health. Methods: Data for this study came from the 2011/2012 National Survey of Children’s Health for children aged 1 to 5 years old. Dependent variables evaluated were if the child had an oral health problem, been to a dentist in the past year, and parents description of the child’s teeth. Independent variables were selected from child, family, and community …

Difference In Quality Of Life Between Group And Individual Exercise In A Faith-Based Sample, Everett Jackson Amburn

Electronic Theses and Dissertations

There is limited data on the quality of life of individuals who exercise in a group versus individuals who exercise alone. The purpose of this study was to determine if there is a difference in the quality life between adults who attend an exercise class and those who exercise alone. Using the WHOQOL-BREF, 27 adult females were surveyed in Central California at two Church of Latter Day Saints locations. Ten females were enrolled in a group exercise class while 17 were individual exercisers. The data was analyzed using a t-test for independent samples to determine if there is a …

Assessment Of Social, Dietary And Biochemical Correlates Of Cardiometabolic Risk In Pre-Adolescent Hispanic Children, Abraham Basil Alhassan

Electronic Theses and Dissertations

Obesity, elevated blood pressure and dyslipidemia are highly prevalent in Hispanic children. Compared to their non-Hispanic White peers, Hispanic children experience higher prevalence of obesity and hypertension. The Hispanic population in Tennessee has been growing, with about a tenth of newborn babies being Hispanic. This study aimed to: 1. Examine the influence of sociodemographic factors on Hispanic children’s cardiometabolic risk; 2. Assess the relationship between food group intake and cardiometabolic risk in Hispanic children; and 3. Evaluate the efficacy of non-traditional biomarkers for detecting cardiometabolic risk in Hispanic children. Data for the study came from a larger cross-sectional pilot study …

The Impact Of Teach-Back As A Patient Education Tool In Women With Inadequate Maternal Health Literacy Seeking Immunizations For Their Children, Barbara Jared

Electronic Theses and Dissertations

Health literacy is recognized as a contributor to health outcomes and maternal health literacy is important to the health and wellbeing of children and families. Of particular interest are mothers seeking immunization services for their children. The complexity of the recommended immunization schedule and the care management of children receiving immunizations have the potential to create negative health outcomes in the low health literate population. Assessment of maternal health literacy and provision of effective patient education adapted to the health literacy level of the individual is important for information transfer. The Teach-Back provides an opportunity to both assess understanding and …