Medicine and Health Sciences Commons^™

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 …

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 …

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 …

Retention Strategies For Medical Technologists: Addressing The Shortages And Vacancies In The Clinical Laboratory, Kathy S. Small

Electronic Theses and Dissertations

It is important to have well-trained and qualified laboratory professionals. Seventy percent of patient care is based on decisions made from laboratory results, yet there is a growing shortage of medical technologists. Although some baby boomers are delaying retirement, worsening of the shortage crisis is inevitable. Retention of medical technologists has become more important than recruitment. The purpose of this study was to identify and evaluate innovative retention strategies used by clinical laboratory managers throughout the United States.

A significant finding of this study was the lack of qualified medical technologists entering the ranks of laboratory managers. This study identified …

Anxiety In Children With Williams Syndrome : Association With Negative Reactivity, Self-Regulation, And Sensory Modulation., Nicole A. Crawford-Zelli

Electronic Theses and Dissertations

Williams syndrome (WS) is a neurodevelopmental disorder caused by a submicroscopic deletion of approximately 25 genes on chromosome 7q11.23 (Hillier et al., 2003). This genotype is associated with a characteristic set of phenotypic features including mild to moderate intellectual disability, a distinctive cognitive profile, facial dysmorphology, common personality traits, cardiovascular problems, and connective tissue disorders (Morris, 2010). In addition, behavioral difficulties such as anxiety symptoms (e.g., Leyfer, Woodruff-Borden, & Mervis, 2009), negative reactivity (e.g., Davies, Udwin, & Howlin, 1998), problems with self-regulation (e.g., Woodruff-Borden, Kistler, Henderson, Crawford, & Mervis, 2010), and sensory modulation difficulties (e.g., John & Mervis, 2010) are …

Characterization Of The Functional Role And Therapeutic Potential Of Microrna Mir-125a In Acute Myeloid Leukemia, Melanie Lorraine Ufkin

Electronic Theses and Dissertations

Acute myeloid leukemia (AML) is a heterogeneous disease marked by a highly variable clinical course and response to therapy. The average age of individuals diagnosed with AML is approximately 69 years old. Due to age of the patient and how quickly the disease progresses, many are unable to receive therapy, leading to death between 4 and 12 weeks after diagnosis. More effective and less cytotoxic treatments are crucial for those diagnosed with AML. Therefore my work has been focused on understanding genetic pathways altered within AML to develop new-targeted therapies. Specifically, I have been studying microRNAs (miR), which regulate proteins …

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 …

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 …

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 …

Cyclin E Induction And Oncolytic Replication Of E1b-Deleted Adenoviruses., Pei-Hsin Cheng

Electronic Theses and Dissertations

Virus-mediated oncolysis has been considered as a new and promising cancer therapeutic approach. Although adenoviruses (Ads) with deletion of E1b55K preferentially replicate in cancer cells and have been used in numerous cancer treatments, the selective replication mechanism of this kind of virus still remains controversial. The lack of a well-established studies focusing on possible mechanisms enabling tumor selectivity of oncolytic Ads has hindered the further development of virotherapies and limits their clinical applications. Therefore, uncovering the molecular basis behind the tumor-killing phenomena will fill critical gaps in our understanding of the oncolytic adenovirology. Previously our laboratory has demonstrated that Ad …

Screening The Safety Net, Babette L. Southard Mrs

Electronic Theses and Dissertations

Safety net clinics across the country struggle with a lack of resources to tackle the needs presented. Screening programs set up for children and elderly have proven to be effective in triaging need, prioritizing care, and maximizing resources. These programs do not currently exist for working uninsured adults. Research was initiated to answer the question: Does the screening process improve patient care for the community clinic? During a 6-week pilot study a licensed dental hygienist performed 30 screenings in the community clinic setting. Findings were recorded and coded according to patient’s level of need identified. Pre- and posttest data for …

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 …

Regulating Rsma Expression In Pseudomonas Aeruginosa, Sean D. Stacey

Electronic Theses and Dissertations

Pseudomonas aeruginosa, a Gram-negative bacillus, commonly infects immunocompromised individuals and uses a variety of virulence factors to persist in these hosts. The posttranscriptional regulator, RsmA, plays a role in the expression of many virulence factors in P. aeruginosa. RsmA up regulates virulence factors used in colonizing hosts. However, regulation of rsmA is not well elucidated. Transposon mutagenesis was performed on P. aeruginosa containing a transcriptional rsmA-lacZ fusion to answer this question. Mutants were screened via β-galactosidase assay and transposon insertions identified via arbitrary PCR. A probable MFS transporter, we named mtpX, was one significant transposon mutant identified. …

Systemic Leptin Modulates The Expression Of E-Cadherin, Β-Catenin In The Ovary Of Dietary-Induced Obese Infertile Rats, Olufunke A. Sokan

Electronic Theses and Dissertations

One of the numerous complications of obesity is infertility. Leptin has been shown to reverse infertility; however, exact mechanism is poorly understood. Recent evidence indicates Ecadherin/ β-catenin complex, which is a structural constituent of adherens junction, is expressed in the rat ovary during folliculogenesis. We hypothesized that systemic leptin modulates the expression of E-cadherin and β-catenin in dietary-induced obese infertile rats to reverse infertility. Female Sprague-Dawley rats were fed either regular chow diet (RCD) (n=6) or high fat diet (HFD) (n=14). Oestrus cycles were monitored daily until their cycles became irregular. 100 ug/ml of leptin was given intraperitoneally to HFD-fed …

Exercise Participation During Weight Loss On A High Protein – Low Carbohydrate Diet Plan In Females Aged 15-25 Years, Margaret Mobley-Meulman

Electronic Theses and Dissertations

Weight gain due to poor diet and lack of exercise is responsible for over 300,000 deaths each year (U.S. Department of Health and Human Services, 2010). Obese adults have an increased risk for serious health conditions including high blood pressure and cholesterol, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and certain cancers (National Cancer Institute, 2012). Participation in exercise can help control weight, strengthen muscles and bones, and reduce the incidence of cardiac events, stroke, hypertension, type 2 diabetes, colon and breast cancers, osteoporotic fractures, gallbladder disease, obesity, depression, anxiety, and delay mortality …

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 …

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 …

The Involvement Of Beta-Catenin In The Inflammatory Response Leading To Autoimmune Diabetes Development., Arin Lee Zirnheld

Electronic Theses and Dissertations

We identified and characterized a novel defect in β-catenin expression in bone marrow derived dendritic cells (BMDC) from NOD mice, a model for human Type I diabetes. This protein is expressed at high levels throughout the lifespan of the mouse and correlates with increased pro-inflammatory cytokine production by the BMDC and IFNγ induction by T cells cocultured with the BMDC. These defects, including a similar pattern of pro-inflammatory cytokine production, are also observed in human monocytederived DC from diabetic patients. After exploring several potential mechanisms involved in the accumulation of β-catenin in NOD BMDC, we found that β-catenin is phosphorylated …

Unpacking The Temperament Weight Relationship: The Mediating Role Of Food Preferences, Sarah A. Berry

Electronic Theses and Dissertations

The current study examined the mediating role of possible food preferences on the temperamentweight relationship among 18-month-old toddlers. Parents of 37 typically developing toddlers completed the Early Childhood Behavior Questionnaire (ECBQ). During a lab visit toddlers’ weight and recumbent length were measured and recorded. Toddlers also completed a sequential touching task to examine their ability to categorize a healthy group of foods and an unhealthy group of foods. The only temperament measure found to associate with both child weight status and food categorization was inhibitory control. Toddlers’ food categorization was not found to mediate the relationship between inhibitory control and …

Bioengineering The Expression Of Active Recombinant Human Cathepsin G, Enteropeptidase, Neutrophil Elastase, And C-Reactive Protein In Yeast, Eliot T. Smith

Electronic Theses and Dissertations

The yeasts Pichia pastoris and Kluyveromyces lactis were used to express several recombinant human proteins for further biochemical characterization. Two substitution variants of recombinant human enteropeptidase light chain (rhEPL) were engineered to modify the extended substrate specificity of this serine protease. Both were secreted as active enzymes in excess of 1.7 mg/L in P. pastoris fermentation broth. The substitution variant rhEPL R96Q showed significantly reduced specificities for the preferred substrate sequences DDDDK and DDDDR; however, the rhEPL Y174R variant displayed improved specificities for these substrate sequences relative to all other reported variants of this enzyme. The neutrophil serine proteases human …

Efficacy Of Partial Rom Squat In Maximal Strength Training, Caleb Bazyler

Electronic Theses and Dissertations

Eighteen well trained males (1RM Squat: 150.57 ± 26.79 kg) were assigned to two groups: full ROM training (control) and full ROM with partial ROM training (CP) for the seven-week training intervention. There was a significant time effect (p

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 …

Genetic Imbalances In Endometriosis Detected By Oligonucleotide-Array Based Comparative Genomic Hybridization, Natalie Burke

Electronic Theses and Dissertations

Endometriosis is one of the most common gynecological diseases as it is thought to affect up to 15% of the female population. Characterized by the growth and proliferation of endometrial tissue outside of the uterine cavity, it is a complex condition with varying degrees of severity and can affect multiple regions of the body with symptoms ranging from a total lack of symptoms to debilitating pain and infertility. The most accepted theory of how endometriosis initiates is that of retrograde menstruation; however, approximately 90% of women with unobstructed fallopian tubes are thought to have some menstrual debris in the peritoneal …

Role Of Ethanol As A Cofactor In Haart Induced Hepatic Steatosis And Injury., Hridgandh Donde

Electronic Theses and Dissertations

Highly Active Antiretroviral Therapy (HAART) has led to a significant increase in the life expectancy of HIV patients; however, there are significant side effects including lipodystrophy and hepatotoxicity. Alcohol abuse is highly prevalent in HIV infected individuals and hence may be a significant negative cofactor in HAART induced hepatotoxicity. The present study examines the mechanisms underlying HAART and alcohol induced hepatotoxicity. The effects of HAART drugs (azidothymidine, and Indinavir sulphate) in combination with alcohol were examined in in vivo animal model. Alcohol and HAART drug interactions and hepatotoxicity were also assessed in-vivo using an animal model of chronic alcohol feeding. …

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 …

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 …

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 …

A Mathematical Model For Antibiotic Resistance In A Hospital Setting With A Varying Population, Edward H. Snyder

Electronic Theses and Dissertations

Antibiotic-resistant bacteria(ARB) is causing increased health risk and cost to society. Mathematical models have been developed to study the transmission of resistant bacteria and the efficacy of preventive measures to slow its spread within a hospital setting. The majority of these models have assumed a constant total hospital population with the admission and discharge rates being equal throughout the duration. But a typical hospital population varies from day to day and season to season. In this thesis, we apply variable admission and discharge daily rates to existing deterministic and stochastic models which examine the transmission of single and dual resistant …

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 …

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 …