Medicine and Health Sciences Commons^™

Hosptial Preparedness For An Internal Mass Casualty Event, Jason Farr

Electronic Theses and Dissertations

The purpose of this study was to determine hospital preparedness for an internal mass casualty/active shooter event at Tennessee hospitals. Data were collected during May of 2019 by surveying the CEOs of the 86 acute care hospitals in Tennessee. The survey solicited responses about training, preparedness, and internal evaluation of procedures. CEOs of 28 (32.5%) of Tennessee’s acute care hospitals responded to the survey. Just over half (53.6%) of those responding indicated that they believed their facility was prepared or well prepared for an active shooter event. The mean responses of CEOs who had experienced an active shooter event were …

Design And Development Of A Comprehensive And Interactive Diabetic Parameter Monitoring System - Betictrack, Nusrat Chowdhury

Electronic Theses and Dissertations

A novel, interactive Android app has been developed that monitors the health of type 2 diabetic patients in real-time, providing patients and their physicians with real-time feedback on all relevant parameters of diabetes. The app includes modules for recording carbohydrate intake and blood glucose; for reminding patients about the need to take medications on schedule; and for tracking physical activity, using movement data via Bluetooth from a pair of wearable insole devices. Two machine learning models were developed to detect seven physical activities: sitting, standing, walking, running, stair ascent, stair descent and use of elliptical trainers. The SVM and decision …

Structure Elucidation Of A Pyrrolobenzodiazepine Alkaloid And A Biologically Active Polyketide Produced By Rhodococcus Sp. Mtm3w5.2 Via Two-Dimensional Nmr Spectroscopy, Garrett Johnson

Electronic Theses and Dissertations

As the battle against ever-increasing drug resistence bacteria rages on, novel and sometimes more complex natural products can be used to combat this. In this study, two-dimensional NMR techniques were utilized to collect a complete spectral data set for two natural products. The first structure, a synthesized Pyrrolobenzodiazepine alkaloid natural product was confirmed through these methods. The second, a strain of Rhodococcus, MTM3W5.2, produces a novel antibacterial molecule in broth cultures and the active compound was fractionated using a Sephedex LH-20 column. Chromatographic purification yielded a pure sample at 58.90 minutes, RT.58. HRMS data deduced an exact mass of …

Automatic Exposure Control During Computed Tomography Scans Of The Head: Effects On Dose And Image Quality, Stephen D. Osborne

Electronic Theses and Dissertations

Automatic exposure control (AEC) is effective at reducing potentially harmful radiation doses without sacrificing image quality for many types of computed tomography (CT) scans. However, there is a need for more information regarding the use of AEC for CT head scans. This study was conducted at Johnson County Community Hospital in Mountain City, TN. Preexisting adult CT head scans (n)60 were randomly selected to form 2 stratified samples, (n)30 each. One sample used a standard protocol, and the other used a protocol with a mA-modulated AEC system, Siemens CARE Dose 4D. Causal-comparative analyses were conducted, and …

An Exploratory Study Of Duty-Related Stress Among Conservation Officers, Logan Ledford

Electronic Theses and Dissertations

Research relating to police stress has typically focused on officers working in urban areas, neglecting their rural counterparts. This is especially true of conservation officers, who are tasked with enforcing laws in state parks and other recreational areas. To date, only a handful of studies have sought to better understand their experiences and perceptions. The current study seeks to further our understanding of conservation officer stress in three unique ways: (1) via applying McCreary and Thompson’s (2006) operational police stress scale (PSQ-Op) to the population, (2) determining whether officer characteristics (e.g., age, education, length of service) affect perceived stress, and …

The Effects Of Branched Chained Amino Acid Supplementation On Acute Markers Of Fatigue And Performance, Joseph Walters

Electronic Theses and Dissertations

The purposes of this dissertation were to investigate the acute effects of branched-chain amino acids on psychological, physiological, and subsequent performance changes following high volume resistance training. The rationale for this study design was based on abrupt or contiguous training/ competitions that specific athletes encounter in a competitive season. This study design also sought to fill some gaps in the scientific literature concerning the efficacy of BCAAs for subjective fatigue in a resistance training paradigm. To address the purposes of this dissertation, a one-week study was conducted on resistance trained males, in which half of the subjects were randomly selected …

Neonatal Intensive Care Unit Speech-Language Pathologists’ Perceptions Of Infants With Neonatal Abstinence Syndrome, Lauren Fabrize

Electronic Theses and Dissertations

Objective: The purpose of this study was to determine the characteristics, assessment, and treatment of infants with Neonatal Abstinence Syndrome (NAS) as perceived by Speech-Language Pathologists (SLP) and whether it differed from those of other Neonatal Intensive Care Unit populations.

Methods: A secure web-based questionnaire with 62 questions collected information on NAS, caseloads, treatment environment, and demographics. Twenty-six respondents initiated the survey; 42% completed most or all questions. Response analyses included descriptive and nonparametric inferential statistics.

Results: Infants with NAS were on the caseloads of 73% of respondents. The majority (79%) only saw infants with NAS and feeding problems. Primary …

Heat Waves And Heat-Related Mortality In East Tennessee, Taiwo Adesoba

Electronic Theses and Dissertations

Heat waves represent a public health challenge that requires multiple responses and warnings to protect vulnerable populations. Although studies have reported an increasing trend of heat wave occurrence in many areas of the world, no clear trend exists in East Tennessee. Using data from Parameter-elevated Relationships on Independent Slope Models (PRISM), CDC WONDER and the United States Census Bureau, the relationship between mortality rates and year was estimated during heat wave events between 1999 and 2010. Five heat wave definitions were tested. Overall, 2007 and 2010 stand out as the years with the highest number of heat wave days in …

Assessing Heat-Related Mortality And Morbidity Risks In Rural Populations And Sub-Populations, Emmanuel A. Odame

Electronic Theses and Dissertations

Heat stress is an environmental and occupational hazard exacerbated by climate change. Rural populations and sub-populations continue to experience disproportionate risks of heat-related impacts due to their low adaptive capacities in terms of infrastructure, information and other resources which are critical in dealing with heat. The study goals were to determine heat-related mortality risks in rural populations globally, explore the contribution of the outdoor work environment and other factors in association with occupational heat-related illnesses (HRI), and assess the risk of heat stress among crop workers using the Wet Bulb Globe Temperature (WBGT). Published peer-reviewed scientific literature on heat-related mortality …

The Influence Of Chronic Branched-Chain Amino Acid Supplementation On Measures Of Central And Peripheral Fatigue In Training Athletes, Tara K. Whiton

Electronic Theses and Dissertations

Branched-chain amino acid (BCAA) supplementation may improve recovery from competitive endurance training by reducing symptoms of central and peripheral fatigue. The purpose of this dissertation was to provide evidence for the use of BCAAs as a training nutrition strategy in order to improve recovery from training and further drive adaptive processes to training by increasing readiness to train. Collegiate distance runners undergoing intense competitive endurance training were monitored for symptoms of muscular soreness and psychological stress through a rated soreness chart and the Daily Analysis of Life Demands for Athletes Survey (DALDA) while taking either a BCAA supplement or a …

Effects Of Neuromuscular Fatigue Resulting From Repeat Sprint Exercise Among Trained Cyclists On Measures Of Strength And Power Performance, Robert B. Blaisdell

Electronic Theses and Dissertations

The purpose of this dissertation is to better understand the role of repeated-sprint ability (RSA) and resulting fatigue in cyclists; how it relates to measures of aerobic power and strength and power performance indices- due to the nature of cycling competitions and the necessity of RSA for success.

The first part of this dissertation attempted to elucidate the relationship between RSA and aerobic power and strength/ power measures in competitive cyclists. The purpose was to potentially illustrate the importance of the inclusion of strength and power training in the training regimen of cyclists. The findings showed several statistically significant relationships …

Exploring The Role Of Social Capital In The Implementation Of Fruit And Vegetable Incentive Programs: A Case Study Of The Appalachian Farmacy Program, Kiriinya Mwirigi

Electronic Theses and Dissertations

The study was conducted to explore the role of social capital in the implementation of Fruit and Vegetable Incentive Programs (FVIP) through a case study of the Appalachian Farmacy (AF) program and to fill a gap in literature on social capital utility in the implementation and evaluation of FVIPs. The study was guided by a conceptual model adopted from Berkman et al. (2000) to identify the mechanisms through which social networks can impact health. A qualitative content analysis was conducted retrospectively on secondary data from the evaluation of AF program to identify social capital attributes. In addition, the study conducted …

The Salivary Alpha-Amylase Response To Resistance Training, Asher Flynn

Electronic Theses and Dissertations

The purposes of this dissertation were to investigate the response of salivary alpha-amylase to a single resistance training session and to a week-long resistance training over-reaching protocol. The major findings of this dissertation are as follows:

Study 1 – A single resistance training session consisting of 5 sets of 10 repetitions of squat and bench press at 95 percent of repetition maximum creates a statistically significant increase in salivary alpha-amylase concentrations.

Study 2 – Two resistance training sessions consisting of 5 sets of 10 repetitions of squat and bench press at 95 percent of repetition maximum within 5 days does …

Changes In Psychological, Morphological, And Performance Characteristics In Preparation For A National Weightlifting Competition, Donald Marsh

Electronic Theses and Dissertations

The primary aim of this study was to examine the time course of change in muscle morphology and vertical jump performance in weightlifters preparing for a national competition. The secondary aim of this study is to examine how perceived recovery and stress state corresponds with alterations in training load leading up to competition. Eleven Olympic Training Site weightlifters completed a 4-week peaking phase for a national competition. Body mass, stress and recovery psychometric measures, and unloaded/loaded (20kg) squat jump height (SJH) were measured weekly and at the competition site. Vastus lateralis cross-sectional area (CSA), muscle thickness (MT) and pennation angle …

Barbell Trajectory And Kinematics During Two International Weightlifting Championships, Aaron J. Cunanan

Electronic Theses and Dissertations

Several methods have been used in the scientific literature to study the weightlifting pull. Broadly, these methods are used to measure kinematic or kinetic variables exhibited by the lifter, the barbell, or the lifter-barbell system. However, there is an apparent disconnect between weightlifting research and coaching practice that may reduce the perceived benefits of technique analysis among coaches and present some challenges for coaches who seek to incorporate technique analysis into their coaching practice. Differences and trends in the technique of competitive weightlifting performances are apparent from the available literature. However, there are also gaps in the literature due to …

Exploring The Match Demands Of Division I Women’S Collegiate Soccer, Robert W. Sausaman

Electronic Theses and Dissertations

The purpose of this dissertation is to shed light on the physical demands of women’s soccer at the NCAA division I college level. Though research does exists describing the physical demands of women’s soccer, the vast majority seeks to explain the physical demands association with the professional and international level. This dissertation sought to: 1) examine the physical demands of NCAA division I women’s soccer and 2) observe changes in physical demands of two NCAA division I women’s soccer players over a four-year career using a case study approach.

Study 1 examined the physical demands of twenty-three athlete from a …

Contemporary Nursing In Rural Appalachia: A Hermeneutic Study, Evelyn Brewer

Electronic Theses and Dissertations

Nurses make up a significant source of direct care for individuals, families, and communities. The problematic distribution of nurses and the potential to lose practicing nurses emphasizes the importance of retention and support of nursing professionals, especially in rural locations. One of the best ways to discover what is important to nurses is to ask and listen to the replies.

The focus for this dissertation is the lived experience of registered nurses in a six-county area in three adjoining states in rural South Central Appalachia. The purpose of this study is to interpret and understand the lived experience of contemporary …

Impact Of Adverse Childhood Experiences On Mental Health Outcomes And Related Prescription Practices In A Psychiatric Inpatient Sample, Carrie Lemay

Electronic Theses and Dissertations

A definitive association between adverse childhood experiences (ACEs) and negative physical and mental health outcomes has been established. There is evidence that individuals in forensic psychiatric facilities are disproportionately exposed to ACEs, which may impact severity, prognosis, and age of onset of psychiatric symptoms, including behavioral concerns of institutional aggression, self-harm behaviors, and suicide attempts. Such psychiatric and behavioral concerns are often managed through multiple psychotropic prescriptions, leading to psychotropic polypharmacy. This study evaluated the relationship between ACEs, mental health and behavioral concerns, and psychotropic polypharmacy through analysis of archival data from a forensic inpatient psychiatric facility. A total of …

The Influence Of Strength In Load-Velocity Relationships In The Back Squat, Thaddeus Light

Electronic Theses and Dissertations

Load-velocity relationships may vary between people of different strength levels and across different loads. The purpose of this dissertation was to investigate how external loads influence the velocity characteristics of the back squat exercise, and the influence of strength on these variables. Healthy male students with a history of resistance training completed repetitions at specified intensities of their estimated one-repetition maximum (1RM) until they reached 1RM. Back squat 3D motion analysis was captured using four Vicon T010 cameras (Vicon Motion Systems Ltd.; Oxford, UK) and Vicon Nexus 1.8.5 software. Data were transported into R custom coding statistical analysis software (version …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

Assessment Of Magnetic Resonance Imaging Safety: Allied Health Professional Clinical Competence, Tiffany Houser

Electronic Theses and Dissertations

Magnetic resonance imaging is a major advancement in the diagnostic imaging field. Most patients can tolerate an MRI however, there are some who are unable to complete a lengthy scan while lying completely still without sedatives or anesthesia. Non-MRI healthcare providers are trained to use equipment that is “unsafe” in the MRI suite due to the strong magnetic field. Staff who are not fully knowledgeable and trained in MRI safety measures can endanger staff and patients.

The purpose of this study was to determine the knowledge level of non-MRI healthcare providers regarding safety risks associated with MRI and to determine …

The Effects Of Two Novel Anti-Inflammatory Compounds On Prepulse Inhibition And Neural Microglia Cell Activation In A Rodent Model Of Schizophrenia, Heath W. Shelton

Electronic Theses and Dissertations

Recent studies have shown elevated neuroinflammation in a large subset of individuals diagnosed with schizophrenia. A pro-inflammatory cytokine, tumor necrosis factor-alpha (TNFα), has been directly linked to this neuroinflammation. This study examined the effects of two TNFα modulators (PD2024 and PD340) produced by our collaborators at P2D Bioscience, Inc., to alleviate auditory sensorimotor gating deficits and reduce microglial cell activation present in the polyinosinic:polycytidylic (Poly I:C) rodent model of schizophrenia. Auditory sensorimotor gating was assessed using prepulse inhibition and microglial activation was examined and quantified using immunohistochemistry and confocal microscopy, respectively. Both PD2024 and PD340 alleviated auditory sensorimotor gating deficits …

The Prevalence And Context Of Adult Female Overweight And Obesity In Sub-Saharan Africa, Ifeoma Ozodiegwu

Electronic Theses and Dissertations

Adult women bear a disproportionate burden of overweight and obesity in Sub-Saharan Africa (SSA). Precise information to understand disease distribution and assess determinants is lacking. Therefore, this dissertation aimed to: (i) analyze the prevalence of adult female overweight and obesity combined in lower-level administrative units; (ii) analyze the effect modification of educational attainment and age on the association between household wealth and adult female overweight and obesity; (iii) synthesize qualitative research evidence to describe contextual factors contributing to female overweight and obesity at different life stages. Bayesian and logistic regression models were constructed with Demographic and Health Survey (DHS) data …

Effect Of Prebiotic, Probiotic, And Enzyme Supplementation On Gut Fermentation, Markers Of Inflammation And Immune Response In Individuals With Gi Symptoms, Kaitlyn Webb

Electronic Theses and Dissertations

Current practices support the use of probiotic and prebiotic supplementation to improve chronic gastrointestinal distress (GID). The aim of this study was to determine the tolerance and benefits of GlutenShield (GS), a prebiotic, probiotic, and enzyme supplement, on adults with GID. Subjects (n=20) took either GS or the placebo for 30 days and completed a pre-treatment FFQ as well as a pre- and post-treatment GID questionnaire, blood draw, and stool sample. Participants consumed more total and saturated fat, and less fiber and whole grains compared to the recommended intake. A significant reduction in IgG2 was observed in the GS group …

Role Of Atm In T Cell Dysfunction During Chronic Viral Infections, Juan Zhao

Electronic Theses and Dissertations

Hepatitis C virus (HCV) or human immunodeficiency virus (HIV) infection leads to a phenomenon of inflammaging, in which chronic infection or inflammation induces an immune aged phenotype with T cell dysfunction. Thus, HCV or HIV infection has been deemed as a model to study the mechanisms of T cell infammaging and viral persistence in humans. In this dissertation, T cell homeostasis, DNA damage and repair machineries were investigated in patients with chronic HCV or HIV infection at risk for inflammaging. We found a significant depletion in CD4 T cells, which was correlated with their apoptosis in chronically HCV/HIVinfected patients, compared …

When Process Becomes Processing: Managing Instructor Response To Student Disclosure Of Trauma In The Composition Classroom, Kelci Barton

Electronic Theses and Dissertations

In first-year composition courses, there are three aspects of teaching that are researched well so far: disclosure of trauma in student writing, instructor feedback, and emotional labor. The disclosure of trauma is almost completely unavoidable in first-year composition. We encounter an issue with instructor feedback; how do we provide feedback to student writing, like grammar and mechanics, when the student has disclosed trauma in the writing? Additionally, we can build off this with emotional labor, which already occurs consistently in teaching but is heightened in this instance. When providing feedback to a student who has disclosed trauma, this can be …

Phase Specific Changes In Rate Of Force Development And Muscle Morphology Throughout A Block Periodized Training Cycle In Weightlifters, Dylan Guidetti Suarez

Electronic Theses and Dissertations

The purpose of this study was to investigate the kinetic and morphological adaptations that occur during distinct phases of a block periodized training cycle in weightlifters. Monitoring data from nine experienced collegiate weightlifters was examined retrospectively. Isometric mid-thigh pull and ultrasonography results from pre and post three specific training phases within a macrocycle leading up to a competition were compared. Changes in isometric rate of force development and vastus lateralis cross-sectional area reflected the expected adaptations of each training phase.