Digital Commons Network^™

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 …

Telehealth Acceptance And Medical Mistrust Among The Elderly Of Rural Appalachia: A Correlational Study Using The Medical Mistrust Index And Technology Acceptance Model, Victoria Hood-Wells

Electronic Theses and Dissertations

Adults aged 65 years and above have grown substantially over with past decade. However, the chance of developing multiple comorbidities only increases with age. Because elderly residents of rural Appalachia often encounter barriers to healthcare, rural nurses, providers, and policy makers must overcome physical and structural barriers, but also gain a more in-depth understanding of the personal and cultural attitudes impacting the use of new and innovative forms of healthcare delivery. With a slow and variable uptake of telehealth adoption in rural Appalachia, and in the presence of well-documented medical mistrust, this study was designed to better understand the degree …

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 …

Pathology And Osteological Observations Of Early Pliocene Rhinoceros, Teleoceras Aepysoma (Perissodactyla, Rhinocerotidae) From Gray Fossil Site, Tennessee, Thomas Scaife

Electronic Theses and Dissertations

Rhinoceroses were an important part of North America’s Paleogene and Neogene ecosystems, with Teleoceras aepysoma being one of the last representatives of this family. Specimens of T. aepysoma from the Gray Fossil Site (GFS) possess distinct/peculiar pathologies: including a pair of fused ribs and ankylosed phalanges. A qualitative description of the pathologies in the GFS T. aepysoma, including new material, was conducted to accurately identify pathologies and make interpretations about the life history of the GFS rhinos. Analysis suggests that rheumatoid arthritis is common in the lower limb bones of GFS rhinos. Additionally, the rib and toe pathologies are more …

Perinatal Buprenorphine Effects On Offspring Growth, Opioid Withdrawal, And Brain Morphology In Rats, Parker Barnes

Electronic Theses and Dissertations

Opioid use disorder (OUD) impacts 5.6 million people in the US. Buprenorphine (BUP) is a commonly prescribed opioid medication used to treat OUD, including in pregnant women. However, opioid use during pregnancy is associated with poorer infant outcomes including reduced fetal growth, neurodevelopmental deficits, and neonatal opioid withdrawal syndrome (NOWS). Recent clinical data suggests that providing mothers with a lower dose of BUP may result in fewer negative outcomes in infants. Here, a preclinical rodent model of low-dose perinatal BUP exposure was used to study offspring health outcomes in the neonate, juvenile, and adolescent offspring. Dams were given clinically relevant …

Seeds In The City: Impacts Of Urbanization On Avian Seed Dispersal Networks In The Southern Appalachians, Jody Horton

Electronic Theses and Dissertations

Urbanization is an intensive form of habitat disturbance associated with detrimental effects on biodiversity. However, few studies have investigated its effects on the number, identity and structure of species interactions while considering seasonal fluctuations in communities. Avian seed dispersal is a vital ecosystem service, and the interplay of urbanization and seasonality may impact seed dispersal in ways not predicted by either factor alone. In this study, we evaluate the effects of urbanization and season on avian seed dispersal networks in the southern Appalachians. We found that the number and richness of interactions was unaffected, but the identity of interacting bird …

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 …

Detection And Classification Of Diabetic Retinopathy Using Deep Learning Models, Aishat Olatunji

Electronic Theses and Dissertations

Healthcare analytics leverages extensive patient data for data-driven decision-making, enhancing patient care and results. Diabetic Retinopathy (DR), a complication of diabetes, stems from damage to the retina’s blood vessels. It can affect both type 1 and type 2 diabetes patients. Ophthalmologists employ retinal images for accurate DR diagnosis and severity assessment. Early detection is crucial for preserving vision and minimizing risks. In this context, we utilized a Kaggle dataset containing patient retinal images, employing Python’s versatile tools. Our research focuses on DR detection using deep learning techniques. We used a publicly available dataset to apply our proposed neural network and …

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 …

Comparative Analysis Of Surrogate Models For The Dissolution Of Spent Nuclear Fuel, Dayo Awe

Electronic Theses and Dissertations

This thesis presents a comparative analysis of surrogate models for the dissolution of spent nuclear fuel, with a focus on the use of deep learning techniques. The study explores the accuracy and efficiency of different machine learning methods in predicting the dissolution behavior of nuclear waste, and compares them to traditional modeling approaches. The results show that deep learning models can achieve high accuracy in predicting the dissolution rate, while also being computationally efficient. The study also discusses the potential applications of surrogate modeling in the field of nuclear waste management, including the optimization of waste disposal strategies and the …

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 …

Inhibition Of Pro-Inflammatory Lipid Mediators By Yersinia Pestis., Amanda Brady

Electronic Theses and Dissertations

Yersinia pestis causes the human disease known as plague. A key manifestation of plague is a delayed inflammatory response. Because this delay in inflammation is required for virulence, I was interested in defining the molecular mechanisms used by Y. pestis to evade immune recognition. Eicosanoids are produced early during infection and necessary to initiate a rapid inflammatory response. Despite the importance of these lipids in mediating inflammation, the role of eicosanoids during plague has not been previously investigated. Using an intranasal mouse model infection, I determined the kinetics of eicosanoid synthesis during pneumonic plague. I further demonstrated that LTB_{4 …}

Adding Texture Through Historical Research: Using Dramaturgy To Aid In The Creation Of Elizabeth (Bess) Borney., Nyazia Brittany Martin

Electronic Theses and Dissertations

This thesis follows my work with the production The Old Settler by John Henry Redwood. This document explores my process as an actor, and how I decided to capitalize on an opportunity to study Dramaturgy and apply what I learned to my actors' process. In the pages of this thesis I present the pieces of my process, including my vocal and movement work based in Laban and Alexander Technique. I give personal examples of how my dive into dramaturgical work positively affected how I crafted the role of Elizabeth (Bess) Borney. I also detail the transition out of my work …

Educator Perceptions Of Blended Teacher Professional Development: A Case Study Of A Vertically Aligned Virtual Professional Learning Community., Aslean White

Electronic Theses and Dissertations

This case study describes the design and enactment of a job-embedded, blended learning professional development plan for teachers to facilitate the collaborative inquiry of a vertically aligned virtual professional learning community. The study is of relevance because it seeks to implement recommendations from recent research on online teacher professional development (Barnett, 2020; Lockee, 2020; Powell & Bodur, 2019) using a framework for support structures designed to engage learners in blended and online learning environments (Philipsen et al., 2019). This qualitative multi-case study examined individual teacher cases using a within-case analysis to create teachers’ profiles to illuminate contextual traits and elucidate …

Providing Safe Spaces: An Examination Of Trio Sss Students’ Personal And Academic Self-Efficacy During Covid-19., Matthew Mcclendon

Electronic Theses and Dissertations

This qualitative study aimed to examine the impact of the TRIO SSS Program in increasing the academic preparedness, graduation rates, and personal development of first-generation college students. Specifically, the study examined how TRIO SSS affected students’ self-efficacy through academic performance and personal development during the COVID-19 pandemic. The theoretical lens for this study was the Social Cognitive Career Theory (SCCT) in which Lent et al. (1994) presented the SCCT as a particularly appropriate framework for those in the early stages of exploring and preparing for careers. A case study methodology, specifically an intrinsic case study, was utilized to investigate the …

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, …

Symptom Clusters In Individuals Seeking Treatment For Gambling Disorder, Blaine Stiglets

Electronic Theses and Dissertations

The fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) presents the criteria for Gambling Disorder (GD) as a unidimensional construct where each additional symptom corresponds to increased severity. Many individuals experience addiction symptoms in specific symptom clusters, with membership to one profile of symptoms or other better-representing disorder severity than raw symptom counts. This study explored whether similarly informative symptom clusters exist among adults seeking treatment for gambling harms. The sample included 444 adults (Mage= 44.95) who completed an assessment of DSM criteria for GD at intake. Through a latent class analysis of GD criteria, three …

Do Emotion Dysregulation And Internalized Shame Mediate The Relationship Between Borderline Personality Disorder Symptomology And Criminal Involvement?, Madison Smith

Electronic Theses and Dissertations

Borderline personality disorder (BPD) is a severe and debilitating mental disorder that is over-represented within the criminal legal system (CLS), with 15-29.5% of individuals in the CLS meeting criteria. However, little research has examined mechanisms leading to criminal involvement within this population. Potential mechanisms include positive/negative emotion dysregulation and internalized shame, which (aside from positive emotion dysregulation) have been linked to criminal involvement in other populations. Research has yet to examine these constructs as mechanisms explaining criminal involvement among individuals with BPD. This study examined positive/negative emotion dysregulation and internalized shame as mechanisms of the relationship between BPD and criminal …

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 …

Reclamation: The Towns Of The Virginia Coalfields, Craig Owens

Electronic Theses and Dissertations

The photographer discusses his work in Reclamation: The Towns of the Virginia Coalfields, a Master of Fine Arts thesis exhibit held at the Tipton Gallery from February 12th through February 23, 2024. The exhibition focuses on coal towns located in the southwestern part of Virginia. The exhibition consists of 20 framed, archival inkjet prints. Each framed work is 36” x 24” and is representative of the artist’s exploration of the towns. A catalog of the exhibit is included at the end of this thesis.

Owens examines formal and conceptual artistic influences, both historical and contemporary. Historic and contemporary photographic …

An Examination Of Early Childhood Leadership In Public Elementary Schools: A Mixed Methods Study, Wesam Alshahrani

Electronic Theses and Dissertations

As state-funded Pre-K programs in elementary schools continue to grow, elementary principals are increasingly responsible for supporting, supervising, and leading these programs. Therefore, examining elementary principals' early childhood leadership competencies and the factors influencing them may help understand and improve their experiences as early childhood education (ECE) leaders. This explanatory sequential mixed methods study examined the ECE leadership of Tennessee public elementary school principals in two phases.

In the quantitative phase, statewide surveys were used to collect data from 67 principals. The survey comprised 51 items assessing nine ECE leadership competencies, synthesized from statements of leading ECE and elementary education …