Digital Commons Network^™

The Implications, Magnitude, And Development Of Traumatic Brain Injury For Individuals Undergoing Treatment For Opioid Use Disorder, Hannah G. Mitchell

Electronic Theses and Dissertations

There is an established bidirectional relation between substance use and traumatic brain injuries (TBIs). Despite the high rate of prescribing opioids for pain management following a TBI and the epidemic of opioid use disorder (OUD) in the United States, scarce research has specifically analyzed the association between TBI and OUD. In a series of three interrelated manuscripts, the present study will first examine the prevalence and features of TBIs among persons seeking treatment for OUD. Next, the present study will evaluate the association between TBI and indicators of risky health behaviors and OUD severity, including the risk of overdose and …

A Comparison Of Student Academic Variables In Mixed Teaching Methods And Traditionally Taught Biology Courses At Participating Community Colleges In Tennessee, Elesha Goodfriend

Electronic Theses and Dissertations

The primary purpose of this study was to compare academic variables from students participating in mixed teaching methods/course revitalization biology courses to those in traditional courses at two community colleges in Tennessee. A two-group comparison design using archived data was used, which evaluated differences in final grades, exam scores, and homework completion as indicators of the academic success between an urban institution and a rural college. A power analysis was performed using G*Power software to provide the needed sample size, indicating a size of 176. There were 227 students in the active teaching lecture classrooms, and 198 students in the …

Landslide Susceptibility And Tree Ring Eccentricity Analysis Along Unstable Slopes Of The New River Watershed, Anderson And Morgan Counties, Tn, Megan Palmer

Electronic Theses and Dissertations

Landslides are mass movements that affect infrastructure across East Tennessee, causing problems for the Tennessee Department of Transportation (TDOT). An assessment of conditions and locations of unstable slopes can aid TDOT in infrastructure management. Landslide susceptibility was evaluated for Anderson and Morgan counties, TN, off State Route 116 in the New River watershed. Susceptibility maps used a landslide inventory and six factors: elevation, slope, geology, distance from stream, rainfall, and curvature, input in forest-based classification and logistic regression models. Additionally, affected trees along these unstable slopes in Anderson and Morgan counties were cored to analyze mass movement impacts on tree …

Cost Saving And Resource Limited Public Health Interventions In Southeast Asia, Amanda Blackwelder

Electronic Theses and Dissertations

Background: Public health interventions are any activity with the objective of improving human health such as preventing or curing disease, reducing the severity or duration of a disease, or assisting in regaining function after a disease or injury. These interventions are known to be impactful; however, those living with the highest burden of disease such as individuals in low- and middle-income countries have limited money and resources to successfully implement these interventions. Southeast Asian countries are among some of the middle-income countries effected by the lack of affordable interventions. The aims of this study were to assess cost saving and …

In A State Of Becoming, Benjamin Conley

Electronic Theses and Dissertations

The artist discusses his Master of Fine Arts exhibition titled, In a State of Becoming. The exhibition was on view at the Tipton Gallery in downtown Johnson City, TN from February 26 March 8, 2024. In a State of Becoming showcased three large scale paintings, five multimedia prints, two sculptural installations, and a video projection installation. Conley's thesis research and current artistic practice revolve around the interfaces, connections, and relationships of humans and animals. Conley explicitly uses language like "animal" to describe "non-human animals" in his work's context. The exhibited works focused primarily on how the artist and/or the viewer …

Using Graphic Novels To Improve Reading Comprehension In Students With Autism Spectrum Disorder, Rachel Denney

Electronic Theses and Dissertations

Upper elementary and middle school students can be less than engaged due to the lack of pictures in texts. Making the reading transition from picture books to complex text literature is challenging for students. Graphic novels could be a resource to improve student engagement and comprehension and support students in that transition. Students with ASD can face additional challenges with reading comprehension and instruction during school. Currently graphic novels are not used commonly for students and the goal of the research is to investigate if these types of books can be a support for students, reading comprehension and engagement. The …

Psychiatric Mental Health Nurse Practitioner Perceptions Of How Providing Patient Care During The Covid-19 Pandemic Affected Their Own Mental Health, Linda Cabage

Electronic Theses and Dissertations

Public health concerns were prominent during the COVID-19 pandemic, particularly regarding rising cases of anxiety and depression among adults. U.S. healthcare providers were especially affected by the unrelenting demands on their time and service. Psychiatric Mental Health Nurse Practitioners (PMHNPs) provided patient care during the pandemic to meet the increasing need for mental health services as people began experiencing mood disturbances such as anxiety, depression, and grief. The purpose of this qualitative study was to explore the perceived effect of the COVID-19 pandemic on the mental health of PMHNPs. A qualitative design using the interpretive description method allows researchers to …

The Lived Experience Of Nurses In Caring For Patients With Covid-19, Jessica Barre

Electronic Theses and Dissertations

Limited research exists about the experiences of nurses’ caring for patients during the COVID-19 pandemic post hoc. To understand nurses’ realities of caring for patients with COVID-19, I aimed to understand the lived experience of nurses caring for patients with COVID-19 in the United States. A qualitative design with a hermeneutic phenomenological methodology was used. Sixteen participants were recruited via purposive sampling, augmented with snowball sampling. Data were collected through unstructured interviews and were analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Nurses’ experiences of caring for patients with COVID-19 in the U.S. were consolidated into four themes: “a living …

Influence Of Medication Assisted Treatment Weaning On Neonatal Abstinence Syndrome And Outcomes Among Infants Born To Women With Opioid Use Disorder, Rakesh Adelli

Electronic Theses and Dissertations

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome exhibited by infants born to mothers with opioid use disorder (OUD). The American College of Obstetricians and Gynecologists and other professional societies endorse opioid agonist pharmacotherapy (MATs) as the optimal treatment for OUD during pregnancy. This study focuses on impact of weaning of MAT drugs on the incidence of NAS and neonatal birth outcomes among babies born to women with opioid exposure.

The study population included eighty-six pregnant women with OUD, divided in to weaning and non-weaning groups based on their choice to wean the MATs during pregnancy. Univariate analysis was …

Dialogic Reading As An Intervention For Developing Reading Comprehension Skills In Early-Literacy School-Age Children With Disabilities, Kristi Burnette

Electronic Theses and Dissertations

The purpose of this study was to investigate the effects of dialogic reading as an intervention on participant ability to answer “wh” comprehension questions correctly and independently. Previous research conducted on dialogic reading was primarily conducted with young individuals with autism spectrum disorder, leaving a gap in the research with older age participants. Participants of this study included four students in upper elementary grades 4-6, ages 8-12 who have been identified to have a known deficit in reading comprehension, a cognitive disability, or autism spectrum disorder (ASD) in an attempt to further extend the research on dialogic reading as an …

Gentleman Death In Silk And Lace: Death And The Maiden In Vampire Literature And Film, Emily Wilson

Electronic Theses and Dissertations

This thesis contains an examination in the psychosocial significance of Hans Baldung Grien’s “Death and the Maiden” art motif, created during the Renaissance period following the Black Death, and its resurgence in the vampire fiction genre of both literature and film. I investigate the motif in Bram Stoker’s Dracula (1897) and Anne Rice’s Interview with the Vampire (1976) as well as their film adaptations by Francis Ford Coppola (1992) and Neil Jordan (1994), respectively. By examining the presence of the motif in art, literature, and film, I found that the common threads across all investigated works were the dominant social …

Using Cultural Contextual Story-Based Lessons To Teach Emergent Literacy Skills, Elizabeth Smith

Electronic Theses and Dissertations

The purpose of this study was to investigate and determine the effectiveness of teaching an English Language Learner (ELL) teacher to use a task analysis comprising story-based lessons with cultural contextual literature to promote emergent literacy skills for a middle school-aged Hispanic ELL student with an intellectual disability (ID). Using a single-case multiple probes across skill sets design, one student with an ID and an ELL teacher participated in this study. The student was taught by the ELL teacher using story-based lessons with cultural contextual literature to promote emergent literacy skills. Results indicated a functional relation between story-based lessons with …

The Perspectives And Experiences Of Arabic Mothers About Families’ Home And School Engagement, Fatimah Ahmed Rubayyi

Electronic Theses and Dissertations

Due to the rise in the rank of Arabic students in schools in the United States (U.S.), this qualitative study was designed to investigate the perspective of Arabic mothers in the U.S. regarding their experiences of involvement with their children’s schools. The approach includes a convenience sample of eight Arabic mothers. Through virtual focus groups, individual interviews, and concept maps the eight Arabic mothers shared their experiences and perceptions of what their children's primary schools and early childhood education programs are doing to involve them. Additionally, the study explored participants' recommendations for schools regarding family involvement for other Arabic families …

The Impact Of Biblical Women's Stories On Entrepreneurial Identity Formation:A Phenomenological Study Of Kenyan Women Entrepreneurs In The Diaspora, Lydia Githinji

Electronic Theses and Dissertations

This phenomenological study examines how biblical narratives and stories of strong female role models shape the entrepreneurial identity of Kenyan and Kenyan-American women. Ten female entrepreneurs were interviewed to understand these influences on their development. Themes emerged around mentorship, leadership, resilience, communication, networking, and legacy. Participants interpreted biblical tales through an entrepreneurial lens, resonating with the experiences and qualities of figures like Lydia, Deborah, Ruth, Esther, and the Proverbs 31 woman. Two key differences arose: those with closer African ties referenced the Bible more, and some cited male rather than female mentors. To address diverse perspectives, recommendations include balancing biblical …

Navigating New Frontiers: A Narrative Of Cte Administrators Leading Rural Innovation, Claire Bass

Electronic Theses and Dissertations

Public school districts play a pivotal role in the well-being of rural communities. To help mitigate the impact of labor market trends, societal shifts, and the skilled labor shortage, rural schools are in the initial stages of expanding innovative career pathways. As such, career and technical education (CTE) administrators serve their rural communities by facilitating robust career pathways to support local labor markets. Due to a skilled labor shortage, a declining labor force participation rate, and a rapidly evolving labor market, there is a lack of qualified and certified personnel to fill industry jobs (Davis et al., 2022). School districts …

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Psychological Mediation Of Minority Stress And Health: Exploration Of Risk Factors In Lgbq College Students, Kyndal Grammer

Electronic Theses and Dissertations

Decades of research have documented pervasive physical and mental health disparities among individuals holding a marginalized identity, including those who identify as lesbian, gay, bisexual, or queer (LGBQ). Heterosexism in the forms of harassment, rejection, and discrimination likely increases minority stress, which is theorized to contribute to documented health disparities. One group that may be particularly vulnerable to effects of heterosexist discrimination, harassment, and rejection is LGBQ college students, especially those who identify as first-generation and were raised in rural environments. The current study aimed to evaluate relationships between LGBQ discrimination, depression, and physical health outcomes at the bivariate level, …

Exploring Knowledge And Perceptions Of Nursing Students: A Quantitative Study On Sexual Assault And Sex Trafficking Awareness, Isabella Marino

Electronic Theses and Dissertations

This study aims to explore nursing students' knowledge and perceptions of identifying and treating victims of sexual assault and sex trafficking. Survey data was collected from second to fifth semester nursing students in Eastern Tennessee. The study aims to identify students' perceptions of medical personnel's ability to identify and treat sexual assault and sex trafficking victims, examine whether adherence to myths affects knowledge and confidence levels, determine students' confidence in identifying and treating victims, and evaluate whether demographic characteristics affect identification and treatment. Results will help improve our approach towards these issues.

Electrochemiluminescence Using Pencil Graphite Electrodes And Screen-Printed Carbon Electrodes Interfaced With A Simple Imaging System, Sandra Ehigiator

Electronic Theses and Dissertations

Electrochemiluminescence (ECL) is a phenomenon whereby electrochemical reactions generate a product that is capable of emitting light. ECL’s high sensitivity, selectivity, extremely low background, and relatively simple instrumentation make it particularly well-suited for chemical sensing and biosensing strategies. Here we report a simple ECL imaging system based on a camera interfaced with a zoom lens to compare pencil graphite electrode (PGE) and screen-printed carbon electrode (SPCE) arrays as ECL platforms. With this system, ECL signals generated from tris(2,2′- bipyridine)ruthenium(II) chloride hexahydrate ([Ru(bpy)3]2+) using co-reactant tri-n-propylamine (TPA) were linear with respect to [Ru(bpy)3]2+ concentrations from 9 to 450 μM. Detection limits …

A Phenomenological Study Of The Experiences Of Undergraduate Students Who Participated In The Ronald E. Mcnair Postbaccalaureate Achievement Program, Alexandria C. Craft

Electronic Theses and Dissertations

The purpose of this qualitative study was to explore the lived experiences of former McNair Program participants at a regional postsecondary institution in northeast Tennessee. More specifically, the study examined how past participants of a McNair Program perceived their program experiences related to their post-undergraduate educational endeavors and career pursuits. Although research has been conducted on McNair Programs, no research has been conducted on the lived experiences of individuals who participated in a McNair Program in northeast Tennessee within the last two decades, and little to no research has been conducted to identify the program components that former participants believe …

An Assessment Of The Current State Of Nursing Homes In The United States, Southern Region, And Tennessee, Nicole Galler

Electronic Theses and Dissertations

Introduction: Nursing homes throughout the U.S. have faced unprecedented challenges in recent years because of staffing shortages, and under-investment, especially since the COVID-19 pandemic. To gain insight into the current state of nursing homes, this study examined nursing home characteristics, quality, and accessibility from a national, regional and state perspective.

Methods: This cross-sectional study used secondary data from the Centers for Medicare and Medicaid Services, American Community Survey, Medicare Beneficiary, and the Tennessee Department of Health. Nursing home characteristics and quality were assessed through bivariate and multivariate regression in the U.S. Assessment of HHS Region 4 nursing home characteristics and …

Preliminary Evidence For The Validity And Reliability Of A Modified Adverse Childhood Experiences (Aces) Scale: The Variability In Aces Scale, Mary Jo Hedrick

Electronic Theses and Dissertations

Adverse Childhood Experiences (ACEs) research has proliferated in the last twenty years with significant research demonstrating the detrimental effects of early childhood adversity. While many measures purport to measure ACEs, very few capture the intensity of ACEs while still calculating the traditional “ACEs tally.” Thus, it is the goal of this dissertation to collect evidence for an expanded ACES measure. The Variability in Adverse Childhood Experiences Scale (VACE) measure builds upon the original ACEs and captures interval level data. Two survey-based studies were conducted in which convergent and criterion related validity and test-retest reliability evidence were collected. In …

A Bright Point In A Dull Day: A Qualitative Exploration Of Middle School Students’ Perceptions Of Music Ensemble Participation, Kailee Amburgey

Electronic Theses and Dissertations

Music participation, specifically in an ensemble setting, is known to promote learning and social skills and to contribute to a well-rounded overall education. With this in mind, this qualitative, constructivist grounded theory study explored the impacts that participating in chorus, band, or orchestra has on students’ overall experience in middle school, with a focus on joy and identity development. The researcher interviewed fifteen students about their personal experiences and feelings about their lives as middle schoolers and musicians. The findings, shared in six theoretical concepts tied to the research question, reveal important facets of these students’ experiences that shed light …

The Role Of The Speech-Language Pathologist With Survivors Of Traumatic Brain Injury From Intimate Partner Violence And Providers’ Knowledge Of This Role, Nicolle Mcadams

Electronic Theses and Dissertations

Intimate partner violence occurs globally at alarming rates. Many experience adverse health impacts such as traumatic brain injury. Healthcare providers do not know the role of the speech-language pathologist, or the rehabilitation needs of survivors.

Aims: This scoping review aims to identify speech-language pathology services for survivors of intimate partner violence with a resulting traumatic brain injury, and knowledge of healthcare providers on the rehabilitation needs of this population. A search was completed in May to October 2023, resulting in a total of 13 articles reviewed.

Main contributions: Speech-language pathologists lack knowledge to provide services to intimate partner violence survivors …

The Greater Implications Of Self-Perceptions Of Aging Among Younger Adults: Results From The Socially Nutritious Volunteer Training Program, Ashlyn Cobble

Electronic Theses and Dissertations

The rapidly growing rate of the older adult population has created a need to better understand younger adults’ self-perceptions of aging and current trends of ageism. The purpose of this secondary data analysis research project was to determine changes, if any, in participants’ self-perception of aging after the Socially Nutritious facilitator or nutrition ambassador volunteer training, which aims to develop knowledge and skills related to aging trends, older adult nutrition, preventing ageism, and communication and educational considerations when working with older adults. Findings indicate that participants with more frequent interactions with older adults had a more positive perception of their …

Healthcare Providers’ Screening And Counseling For Tobacco Use Among Youth In The United States: Prevalence, Practices, And Providers’ Perspectives, Adeola Omolade Ayo

Electronic Theses and Dissertations

Youth tobacco use is a public health concern in the United States (U.S.) with about 2.8 million middle and high school youth reporting current tobacco use in 2023. Healthcare providers (HCPs) can play a crucial role in addressing youth tobacco use through screening and counseling, yet rates of these interventions are suboptimal. Tennessee has a high prevalence of youth tobacco use and not much is known about these interventions in Northeast Tennessee. This study has several objectives: 1) conduct a scoping review of available evidence on screening and counseling for youth tobacco use and identify related gaps; 2) assess youth …

Exploring The Correlates And Predictors Of Covid-19 Vaccine Hesitancy And Uptake Among People Living With Hiv/Aids In Tennessee, Charles Olomofe

Electronic Theses and Dissertations

Background

The administration of the COVID-19 vaccines has met with resistance and hesitance from different population groups including people living with HIV/AIDS (PLWHA). It is concerning to know that PLWHAs are showing a higher rate of COVID-19 vaccine hesitancy than the general population. The objective of this study is to synthesize the literature and determine the correlates and predictors of COVID-19 vaccine hesitancy among PLWHA using primary and secondary data.

Methods

A scoping review was conducted to identify and summarize studies on COVID-19 vaccine hesitancy among PLWHA using the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) Extension for …

An Environmental Struggle: Nature’S Role In The Poetry Of Seamus Heaney And Robert Frost, Jake Lawson

Electronic Theses and Dissertations

Both New England’s Robert Frost and Northern Ireland’s Seamus Heaney are considered major poets of the 20^th century. Both poets present speakers who rely upon rural settings to explore troublesome feelings and difficult experiences. Their speakers project their human experience onto nature, but because nature is indifferent, they cannot find solutions for their personal discomfort and uncertainties. By examining the writers in this order—Ralph Waldo Emerson, Mary Oliver, Seamus Heaney, and Robert Frost—a spectrum concerning the poet and their relationship to nature emerges. By considering John Ruskin’s pathetic fallacy, we will see a movement from irrationality in transcendental depictions, …

Design And Validation Of A Test For Teachers: Measuring Knowledge Of Trauma, Jennifer B. Bilbrey

Electronic Theses and Dissertations

Research and interest in trauma-informed pedagogy have grown substantially. Trauma-informed pedagogy includes knowledge of trauma symptoms, associated behaviors, and environmental and instructional trauma-informed strategies. Various scales measure attitudes and experiences with trauma-informed practices; however, the literature suggests a lack of validated tests measuring teachers' knowledge of trauma. Reliable and valid tests measuring knowledge are critical when determining the professional development needs of both pre-service and in-service teachers. This multi-phase study aimed to fulfill this need by creating the Teachers’ Knowledge of Trauma (TKOT) test. With the guidance of literature and qualitative data from eight early childhood professional peers, a 50-item …

Exploring Spatiotemporal Patterns In Hazardous Hydrologic Events: Assessment, Communication, And Mitigation Through Geospatial Technologies, Emmanuel Afriyie

Electronic Theses and Dissertations

Tennessee has a long history of meteorological hazards that have caused property damage and loss of life. Given climate change and variability, it is imperative to look at trends to ascertain changes spatiotemporally. Space-time cubes, a novel geographic tool, were used to analyze historical heavy precipitation (1-, 2-, and 5-year returns), floods, and flash flood data in Tennessee counties to assess the trends, identify emerging hotspots/cold spots and display changes over space and time. For all return periods, trends analysis revealed that heavy precipitation events are increasing in several counties across the state, with middle Tennessee identified as a hotspot. …