Digital Commons Network^™

Effects Of Non-Face-To-Face Chronic Care Management On Service Utilization And Outcomes Among Us Medicare Beneficiaries With Diabetes, Dongzhe Hong, Charles Stoecker, Yixue Shao, Elizabeth Nauman, Vivian Fonseca, Gang Hu, Alessandra N. Bazzano, Edmond K. Kabagambe, Lizheng Shi

Population and Public Health Science Faculty Publications

Background: Type 2 diabetes mellitus (T2DM) results in heavy economic and disease burdens in Louisiana. The Centers for Medicare and Medicaid Services has reimbursed non-face-to-face chronic care management (NFFCCM) for patients with two or more chronic conditions since 2015. Objective: To assess the impacts of NFFCCM on healthcare utilization and health outcomes. Design, Setting, and Participants: This retrospective cohort study included Medicare fee-for-service beneficiaries with T2DM and at least one additional chronic disease between 2014 and 2018. Exposures: At least one record of NFFCCM Current Procedural Terminology codes. Main Measures: The health outcomes in the study included major adverse cardiovascular …

The Risk Management Of Covid-19: Lessons From Financial Economics And Financial Risk Management, Don M. Chance

Faculty Publications

The United States had one of the worst outcomes in the management of COVID-19 risk, with a death rate in the 94th percentile of all countries. Setting aside the obvious politicized nature of COVID-19 public health recommendations and mandates, we argue that best practices in financial risk management provide parallels that could have served as valuable guidance. We demonstrate here that considerable signals were missed that would have required very little effort and would have been consistent with sound risk management. We also identify examples of misleading information such as that COVID-19 was particularly hard on the elderly. The data …

Advanced Visualization In Minimally Invasive Spine Surgery: The Ergonomics, Economics, And Evolution Of Camera-Based Tubes And Retractors, Advith Sarikonda, Ahilan Sivaganesan, Sheeraz Qureshi

SKMC Student Presentations and Publications

BACKGROUND: Tubular spine surgery has emerged as a hallmark of minimally invasive spine (MIS) procedures. In recent years, thanks to technological advances, tubular dilators and retractors have been integrated with digital cameras to allow for ergonomic, high-definition visualization of the surgical field.

OBJECTIVE: To detail the evolution, ergonomics, economics, and outcomes of camera-based tubular spine surgery, spanning the origins of MIS tubular techniques to the current use of operative microscopes and tube-mounted digital cameras (TMDCs).

METHODS: This is a narrative review of studies examining the evolution of tubular spine surgery as well as its most recent advances, with a particular …

Enhancing Fan Engagement In Medium-Sized University Athletics: A Case Study Of The University Of Tennessee At Chattanooga, Colin Thompson

Honors Theses

The purpose of this study is to explore how medium-sized universities, specifically the University of Tennessee at Chattanooga (UTC), can mimic the successful fan engagement strategies of other universities to build a sustainable and engaged fan base. This study analyzes previous research into the factors that contribute to fan engagement, including the segmentation of attendees into fans or spectators, and compares financial records of selected peer institutions. Peer institutions were contacted in an effort to gain insights from their marketing departments. A randomized survey of the current student population was conducted to analyze what factors motivate athletic event attendance. The …

Reviving Historic Buildings - Adaptive Reuse Of The Jazzy Building, Mazze Stokes

Honors Theses

In the face of rapid urbanization and modernization, the significance of historic preservation and adaptive reuse has gained prominence as a sustainable approach to development. There is an intricate relationship between historic preservation and adaptive reuse, delving into the principles, challenges, and benefits inherent in this practice as they apply to the Jazzy Building on 619/621 Market Street in Downtown Chattanooga Tennessee. A mixed-use approach for the Jazzy Building is optimal, as it addresses the pressing need for expanded housing amidst Chattanooga's population growth, capitalizes on its potential as a tourist attraction, and aligns with the city's strong environmentalist ethos.

Peer Mentorship’S Effect On Nursing Students’ Perceived Stress, Collaboration, And Overall Well-Being, Brooklyn Loxtercamp

DNP Projects

Peer mentorship has proven benefits for undergraduate nursing students, such as improving a sense of belonging and teamwork, improving relationships, helping foster student-directed learning, improving leadership skills, and providing another layer of support for students (Andersen & Watkins, 2018). Because of these notable benefits, this project aimed to extend the work of these researchers to create a sustainable peer mentorship program at one Midwestern nursing program to decrease perceived levels of stress, increase collaboration, and improve students’ overall well-being. Participants (n=58) were recruited from the undergraduate nursing program and consent was obtained. The intervention included a month-by-month toolkit for mentors …

Supporting Nursing Care Transition For Late Preterm Infants From Nicu To The Level 1 Nursery, Megan R. Deans

DNP Projects

Late preterm births are increasing each year due to increasing rates of IVF, multiple births, and advancing maternal age (Visruthan et al., 2015). This group has been traditionally cared for in the NICU, but facilities may consider transitioning this care to the level 1 nursery due to the relative physiologic stability of this population (Visruthan et al., 2015). The transition, without appropriate planning, creates a potential for inconsistencies in caring for the diverse needs of 35.0-35.6 week late preterm infants (LPIs), including variations in education provided to parents and care of the LPI (Visruthan et al., 2015). This project aimed …

Perspectives Of Speech-Language Pathologists On Strategies And Skills To Support Parental Involvement In Language Stimulation And Co-Viewing, Jeanelle Canelo

Education Doctoral

The purpose of this qualitative phenomenological study was to guide the role of parents in language stimulation and parental co-viewing as it relates to linguistic development and adult-child facilitated screen use in toddlers. The study explored New York State licensed and certified speech language pathologist’s (SLPs) perceptions of a healthy balance of screen time (ST), playtime, and parent-child interaction. Objectives included understanding the impact of ST on communication skills and exploring how adult–child engagement influences language development outcomes in children under age 5. The methodology involved one-on-one interviews via Zoom with the SLPs, using semi-structured questions. Data was collected, transcribed, …

Constructive Memory And Conscious Experience, Daniel L. Schacter, Preston P. Thakral

Psychology: Faculty Publications

Episodic memory relies on constructive processes that support simulating novel future events by flexibly recombining elements of past experiences, and that can also give rise to memory errors. In recent studies, we have developed methods to characterize the cognitive and neural processes that support conscious experiences linked to this process of episodic recombination, both when people simulate novel future events and commit recombination-related memory errors. In this Per-spective, we summarize recent studies that illustrate these phe-nomena, and discuss broader implications for characterizing the basis of conscious experiences associated with constructive memory from a cognitive neuroscience perspective.

A Constructivist Grounded Theory Exploration Of Intergenerational Trauma Among Lgbtq+ Bipoc Individuals, Satveer Kler

Dissertations

Many scholars have argued that existing conceptualizations of trauma such as the Diagnostic and Statistical Manual of Mental Disorders (5th Ed.; DSM-5) conceptualization are inapplicable for individuals of marginalized communities. Individuals of marginalized communities may experience historical trauma, racial trauma, identity-related trauma, or collective trauma. Moreover, the effects of these forms of trauma may persist throughout different generations via biological transmission (e.g., epigenetics) or via interpersonal transmission (e.g., emotion socialization, cultural socialization, attachment, communication styles, behavioral socialization). The generational effects of these forms of trauma are referred to as intergenerational trauma. There has been a paucity of empirical explorations of …

Individual Differences In Perceptions Of Organizational Career Culture: A Fit Theory Perspective, Diogo Alberto Seixas

Dissertations

Attracting and retaining talent has been one of the most critical elements for business success. As organizations have different cultures within themselves, the organizational career culture communicates the organizational beliefs and practices valued for career success through organizational signals about career priorities. Using a scenario-based study, we explore individual preferences regarding four career cultures built on two dimensions of career signals: assimilation versus differentiation and intrinsic versus extrinsic rewards. We choose group beliefs, desirability of control, competitiveness, and protean career orientation as important traits because they clearly relate to the career signals and fit nicely in the organization’s career cultures. …

Carceral Degrees: Successful Postsecondary Educational Pathways For Students Impacted By The Criminal Justice System In Maine, Mara Sanchez Phd

Muskie School Capstones and Dissertations

The benefits of postsecondary degrees are striking for populations who have experienced incarceration, yet little is understood about how this population succeeds with educational attainment upon release from incarceration. This qualitative collective case study examined to what extent and how six formerly incarcerated individuals who started educational programming while incarcerated successfully persisted with postsecondary degrees after being released back into Maine communities. This study found that participants related education to self-care or treatment, described their own education journeys as different, or taking a different path, and felt motivated to persist with education despite external expectations, which one participant labeled “transformational …

Personalized Treatment Recommendations For Diabetes Patients, Charles Harrison

All Theses

In modern healthcare, the convergence of data-driven methodologies and decision making frameworks has become imperative for enhancing patient-care, operational efficiency, and resource allocation. This thesis explores the synergistic integration of two powerful paradigms: machine learning (ML) and Markov decision processes (MDPs), to address key challenges in healthcare management. Chapter 2 showcases the integration of ML techniques for predicting laboratory results using Electronic Medical Records (EMR) data. By harnessing the information embedded within EMRs, ML models offer predictive insights into patient outcomes, facilitating early detection of health risks and enabling personalized interventions. Various ML algorithms suitable for handling EMR data are …

Engineering The Properties Of Magnesium Aluminate Spinel Through Solid State Solutions, Robin Conner

All Theses

Magnesium aluminate spinel solid state solutions were prepared via the coprecipitation method and calcined in air at 900 °C for 2 h. The manipulation of magnesium aluminate spinel’s microstructure through the formation of solid state solutions with zinc and gadolinium substituting for magnesium was investigated. X-ray diffraction (XRD) and attenuated total reflectance Fourier transform infrared spectroscopy (ATR FTIR) confirmed the formation of a single cubic crystalline phase. The luminescence properties were investigated by radioluminescence (RL) under X-ray excitation and thermoluminescence (TL) measurements. In the case of zinc, all concentrations of the solid state solutions showed similar luminescence with bands at …

Regulation Of Serpina1 Mrna Expression By Environmental Conditions In Hepatocyte Cells, Fnu Jiamutai

All Theses

The SERPINA1 gene encodes the critical protease inhibitor α-1-antitrypsin (A1AT). A1AT represses neutrophil elastase activity to protect lung tissue from inflammatory damage. A deficiency in α-1-antitrypsin can lead to chronic obstructive pulmonary disease (COPD). Pathogenic genetic variants in SERPINA1 are also associated with A1AT protein misfolding and liver cirrhosis. The regulatory mechanisms of SERPINA1 expression are not well understood, but previous studies suggest that alternative polyadenylation in the 3' untranslated region (3'UTR) affects A1AT protein expression. In this study, we used the liver cancer cell line HepG2 to determine how environmental conditions influence SERPINA1 mRNA expression and post-transcriptional regulation. We …

Employing Single-Nucleus Rna-Seq To Uncover Genetic Factors Of Alzheimer Disease, Logan Brase

Arts & Sciences Graduate Student Theses and Dissertations

Alzheimer’s disease (AD) stands as a daunting global health challenge, affecting millions of individuals worldwide. This burden will only intensify with an aging global population. Despite significant advances in understanding AD, further exploration is needed to enhance the development of treatments and therapeutics. Particularly, I am interested in identifying the molecular pathways involved and the cell types mediating the etiology of AD. This work underscores the ability of single nucleus RNA-seq to investigate these pathways at the cell-type level and mitigate many of the hurdles limiting the successful development of treatments for AD, including genetic heterogeneity and translation of discoveries …

Evaluating Hmgb1 As A Biomarker For Metabolic Dysregulation And Progression Of Diabetes In A Mexican American Cohort, Peter Elvin, Walid Fakhouri, Craig Hanis, Cláudia Cristina Biguetti

School of Podiatric Medicine - Student Research

Aim/Hypothesis: This study focuses on HMGB1 to evaluate its association with the development and progression of diabetes within a Mexican American cohort of non-diabetic (ND), pre-diabetic (Pre-D), and diabetic (D) individuals.

Methods: Data from a cohort of 40 individuals, standardized by age (61.76±11.77), BMI (32.52±7.02), and sex (58% male, 42% female) was analyzed. We assessed several immunological markers utilizing ELISA assays from buffy coats. After excluding out of range samples, the remaining 20 individuals displayed statistical significance in HMGB1. Pearson's correlation coefficient examined the relationship between HMGB1 levels and glycemic changes (HOMA-IR, HOMA-B, HOMA-IS², and HbA1c). Statistical significance …

An Exploration Of The Lived Experiences And Decision-Making Processes Of Alternative Education Teachers Using An Interpretive Phenomenological Analysis, Ashley Irene Zehner

Electronic Theses and Dissertations

Students with behavioral challenges and mental health concerns have unique academic, behavioral, and emotional needs. Due to high student to teacher ratio and lack of mental health and behavioral resources, some students may not have their needs met in a public school general education setting. An option that can be a better solution for these students due to lower student to teacher ratio, mental health resources, and behavioral support is schooling in alternative schools. This study explored the daily routines and the decision-making process of alternative educators as they work to meet the multifaceted needs of their students. Using an …

Manipulation Of Cellular Proliferating Cell Nuclear Antigen (Pcna) During Herpes Simplex Virus Type 1 Infection, Jessica Packard, Jill A. Dembowski

Electronic Theses and Dissertations

Herpes simplex virus type 1 (HSV-1) is a double stranded DNA virus that replicates within the nucleus of host cells. Using accelerated native isolation of proteins on nascent DNA (aniPOND), cellular proteins were found to associate with HSV-1 replication forks. One host factor of interest is proliferating cell nuclear antigen (PCNA), the DNA sliding clamp that tethers DNA polymerases and DNA damage response proteins to replicating cellular DNA. Although HSV-1 encodes its own DNA polymerase processivity factor (UL42), PCNA plays a key role in HSV-1 infection. We used commercially available PCNA inhibitors and short hairpin RNAs (shRNA) to investigate how …

Structure-Function Relationships In Neurodegenerative And Infectious Diseases: Biophysical Characterization Of Rna Secondary Structures By Computational Techniques, Kendy Guarinoni

Electronic Theses and Dissertations

The research described in this dissertation focuses on the investigation of the structure and dynamics of regions of RNA implicated in two diseases: COVID-19 and amyotrophic lateral sclerosis/frontotemporal dementia (ALS/FTD). Both studies sought to create experimentally corroborated models that were used to characterize the structure and dynamics of the C9orf72 repeat expansion and the s2m region in coronaviruses, respectively and provided the foundation for future work. In our work involving the s2m region of SARS-CoV-2, the virus responsible for COVID-19, we determined that the homology modeling approach commonly used to derive atomistic structures when no coordinates are available yields a …

Environmental Factors (Rurality, Distribution Of Prescribers, And Altitude) Of People Who Died By Suicide In Montana, 2013- 2022, Anne N. Brown

Electronic Theses and Dissertations

Introduction: Suicide is increasingly prevalent in rural areas across the United States, especially in the western Rocky Mountain states. The connection between suicide and rural residency is not well understood, nor is the relationship between the distribution of prescribers, altitude, and suicide. Purpose: This retrospective quantitative study aimed to describe the characteristics of individuals who died by suicide in Montana and investigate the associations among rurality, distribution of prescribers, altitude, and suicide rate. Methods: Montana suicide mortality data for 2013-22 was used to describe individual characteristics. A second dataset was created for each Zip Code Tabulation Area (ZCTA) level in …

Cortical And Subjective Measures Of Individual Noise Tolerance Predict Hearing Outcomes With Varying Noise Reduction Strength, Subong Kim, Susan Arzac, Natalie Dokic, Jenn Donnelly, Nicole Genser, Kristen Nortwich, Alexis Rooney

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Noise reduction (NR) algorithms are employed in nearly all commercially available hearing aids to attenuate background noise. However, NR processing also involves undesirable speech distortions, leading to variability in hearing outcomes among individuals with different noise tolerance. Leveraging 30 participants with normal hearing engaged in speech-in-noise tasks, the present study examined whether the cortical measure of neural signal-to-noise ratio (SNR)—the amplitude ratio of auditory evoked responses to target speech onset and noise onset—could predict individual variability in NR outcomes with varying strength, thus serving as a reliable indicator of individual noise tolerance. In addition, we also measured subjective ratings of …

Developing Educational Resources For Clinicians And Caregivers To Increase Use Of Aquatic-Based Therapy In Occupational Therapy, Katherine Childrey

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Background: Aquatic therapy (AT) is a specialized intervention using the medium of water with therapeutic intent toward rehabilitation of specific physical and functional goals (Güeita-Rodríguez et al., 2019). AT benefits include increased joint mobility and muscle flexibility, improved head and neck control, increased attention and eye contact, improved tolerance of physical contact, and sensorimotor integration in the pediatric population (Kucher et al., 2015; Vonder Hulls et al., 2006). Physical therapists and occupational therapists (PT, OT) integrate AT into treatment plans supplemental to traditional practice. Occupational therapists facilitate performance patterns and directly influence children’s occupations of play, leisure, and social participation …

Identifying Genes Linked To Variation In Metabolic And Whole Plant Phenotypes Using Data From Genome Resequencing, Transcriptomics, And Metabolic Profiling Of A Field-Grown Maize Diversity Panel, Ramesh Kanna Mathivanan

Department of Agronomy and Horticulture: Dissertations, Theses, and Student Research

Maize metabolism is highly complex and influenced by genetic variation, yet the specific genes contributing to this variation and their links to non-metabolic traits remain less understood. To address this knowledge gap, we identified genes involved in maize metabolic variation and linked them to non-metabolic traits. We utilized a quadruplicate dataset of whole genome resequencing, transcriptomic, metabolic, and whole plant phenotype data from a single common field experiment of 660 diverse maize inbred lines. Leaf samples were collected shortly before flowering and analyzed using GC-MS for 26 metabolites. A Resampling Model Inclusion Probability Genome-Wide Association Study (RMIPGWAS) of approximately 2.6 …

U.S. District Court Issues Judgment To Hiv+ Plaintiffs Challenging U.S. Military Regulations Against Enlistment Of Asymptomatic Hiv+ Individuals, Arthur S. Leonard

Other Publications

No abstract provided.

Impact Of Pre-Harvest Fungicide Application On The Storage Performance Of Tomato Fruits, Zhifu Lan, Jing Huang, Komivi S. Akutse, Yongwen Lin

All Peer-Reviewed Publications

To examine the impact of pre-harvest fungicide applications on the postharvest storage performance of tomato fruits, we measured the lycopene content, hardness, soluble solids content, rotting rate, and weight loss rate of the fruits, as well as conducted a sensory assessment. Protective and systematic fungicides were sprayed on tomatoes 20 days before harvest in order to prevent rotting and weight loss during storage. Our findings showed that, the fungicide-treated tomatoes had a significantly lower rotting rate of 16.00% and a weight loss rate of 3.96%. However the control group experienced 65.33% rotting rate and 6.90% weight loss rate on 12th …

The Limits Of Immigrant Resilience, Huyen Pham, Natalie C. Cook, Ernesto Amaral, Raymond Robertson, Suojin Wang

Faculty Scholarship

Economists have identified important adaptations that immigrant workers have made to weather economic crises. During times of economic contraction, immigrant workers have moved across industries or geographical locations, downshifted to part-time work, and accepted lower wages to stay employed. Evidence from the Great Recession (2007–2009) shows the benefits of that economic resilience: immigrant workers were more likely than native-born workers to remain continuously employed, to have shorter periods of unemployment when they lost their jobs, and to regain jobs more quickly in the recovery period. Of course, these adaptations had significant personal costs for immigrant workers and their families, but …

Why Mlp Legal Care Should Be Financed As Health Care, William M. Sage, Keegan D. Warren

Faculty Scholarship

Medical-legal partnership (MLP) integrates the unique expertise of lawyers into collaborative clinical environments. MLP teams meet the needs of individual patients while also detecting structural problems at the root of health inequities and advancing solutions at the institutional, community, and system levels. Yet MLPs today operate in limited settings and survive on scant budgets. Expanding their impact requires secure funding. Financing MLPs as health care can do the following: (1) help address inequity at the point of care; (2) enable expert diagnosis and treatment of nonmedical drivers of health; (3) enhance team-based practice in health care organizations; (4) offer another …

Unraveling Wetland Ecology: The Effect Of Abiotic Heterogeneity And Habitat Size On Wetland Plant Diversity In The Piedmont, Gregory T. Gilmore

All Theses

Ecosystems around the world are seeing an unprecedented decline in biodiversity. However, to better prevent this decline we cannot only understand the drivers of biodiversity loss, but also the factors that support diversity. Traditional ecological hypotheses such as the Habitat Heterogeneity Hypothesis (HHH) and the Theory of Island Biogeography (TIB) have provided frameworks for understanding biodiversity drivers. However, recent research suggests a more nuanced relationship between heterogeneity, habitat size, and diversity than previously thought. This study looks to bridge existing research gaps by examining the ecologically and conservational important habitat of wetlands. Specifically, the study focuses on the plant diversity …

Silence In Stem? The Impact Of Experienced Social Identity Threats On Women, Madison Brumbaugh

All Theses

Despite making up a similar proportion of the workforce, women are grossly underrepresented in STEM occupations compared to men (65% vs. 35%). Prior research suggests that women’s underrepresentation in STEM results in negative consequences, such as increased psychological burnout and decreased work engagement (Hall et al., 2015; Hall et al., 2018), through the mechanism of social identity threat. Academics have yet to explore how experiencing social identity threat impacts silence behaviors for underrepresented women in STEM. Building off social identity theory and prior research on social identity threat, the current study sought to compare women working in STEM occupations who …