Digital Commons Network^™

Transitioning To Adolescent And Young Adult Or Adult Cancer Survivorship Care: A Systematic Review Of Contemporary Guidelines And Trials, Darren Haywood, Hammersley, Ursula Sansom-Daly, Jordana Mcloone, Evan Dauer, Helen Wilding, Nicolas H. Hart, Thomas Walwyn

Research outputs 2022 to 2026

Background: Health service transitions of child, adolescent, and young adult cancer survivors between paediatric and adult cancer care services are pervasively fragmented, resulting in poor coordination, reduced satisfaction, and adverse outcomes for cancer survivors and significant others (e.g., caregivers and family members). Numerous trials and clinical guidelines have been developed to support care transitions, but their convergence, divergence, and methodological quality remain unclear. To advance clinical practice and quality research about care transitions, a synthesis of trials and guidelines on child, adolescent, and young adult care transition across age-appropriate cancer services is required to inform future research, practice, guideline, and …

A Clinical Study Examining The Effects Of Dietary Nitrate On Urinary N-Nitrosamines, Catherine P. Bondonno, Michaela L. Sundqvist, Sujata Shinde, Kevin Croft, Jonathan M. Hodgson, Mattias Carlström, Eddie Weitzberg, Jon O. Lundberg

Research outputs 2022 to 2026

BackgroundInorganic nitrate from dietary sources has raised health concerns due to its possible conversion into carcinogenic N-nitrosamines, leading to strict regulations on nitrate concentrations in food and drinking water.ObjectivesIn this study, which was a part of a larger randomized controlled trial, we evaluated urinary excretion of N-nitrosamines in response to daily dietary nitrate intake over a 5-wk period using 2 different forms of nitrate administration.MethodsA total of 231 participants with mild hypertension were randomly assigned into 3 groups. Group 1 (n = 78) consumed vegetables low in nitrate along with a placebo capsule (300 mg potassium chloride). Group 2 (n …

Digital Decoding Of The Multidimensional Pain Experience In People Living With Dementia, Kreshnik Hoti, Ipsit V. Vahia, Paola Chivers, Jeffery David Hughes

Research outputs 2022 to 2026

Background: Understanding how pain manifests in people living with dementia can facilitate pain management but evidence from large real-world studies is limited. Through digitally compiled large number of pain assessments, we explore how behavioural indicators manifest across all widely used domains of pain assessment. Methods: This is a population based observational study with data from aged care homes across Australia, New Zealand and the United Kingdom. Pain assessments were conducted over a period of 5.3 years in 89 230 residents living with advanced dementia. The primary outcome was to determine pain indicator occurrence across pain levels and explore their predictive …

Diacylglycerol Kinase Eta As A Novel Target In Nras Mutant Melanoma, Haley P. Wilson, Casey D. Stefanski, Signe Caksa, Glenn L. Mersky, Scott D. Varney, Jelan I. Haj, Dan A. Erkes, Timothy J. Purwin, Vivian Chua, Andrew E. Aplin

Research outputs 2022 to 2026

NRAS mutations occur in 10%–30% of cutaneous melanomas and are associated with high tumor mutational burden. Mutant NRAS signaling drives aberrant cell growth and proliferation, in part, through activation of the RAF–MEK-ERK1/2 kinase pathway; however, targeted therapies to this pathway have limited effectiveness in patients with NRAS mutant melanoma. The role of other targetable signaling pathways in NRAS mutant melanoma is poorly characterized. Here, we demonstrated that one isoform of diacylglycerol kinase, diacylglycerol kinase eta (DGKη), a lipid signaling regulator, was highly expressed in NRAS mutant melanoma patient samples. Knockdown of DGKH in NRAS mutant melanoma cell lines resulted in …

Neuromuscular Performance Changes In Response To The Australian Special Forces Selection Course, Angela Uphill, Kristina L. Kendall, Stuart Guppy, Michael Vacher, Simon Parker, Hannah Brown, Brendan Ashmore, Travis Zomer, G. Gregory Haff

Research outputs 2022 to 2026

Introduction: Strenuous military activities, such as Special Forces (SF) selection courses, are known to involve high physical loads in the presence of food and sleep deprivation, which can have detrimental impacts on physical performance. Understanding the magnitude of performance deficit and the time required for recovery associated with these events, is important for injury prevention and maintaining operational readiness. The purpose of this study was to investigate the changes in physical performance in response to the Australian SF Selection Course (SF-SC) and to monitor recovery throughout 8 weeks following the course. Materials and Methods: Ninety-three healthy male participants (age: 28 …

Clinical Pathway For Rhogam Administration In The Emergency Department, Lauren Kyzar, Amy Bigham

Appalachian Student Healthcare Research Review

Background: Clinical pathways in emergency departments (ED) are designed to standardize patient care and reduce variability in clinical practice. In a rural hospital setting, the ED management of RhoGAM administration in pregnant patients with vaginal bleeding varied by provider with no standard of care achieved. This approach raised concerns about potential patient safety issues.

Methods: In response, the local emergency department medical director, in conjunction with local perinatal providers developed a clinical pathway to standardize care and optimize RhoGAM administration. The clinical pathway was implemented to the local ED providers over a three-month period. Retrospective chart review for Type and …

Inequity In Education Through The Lens Of Social Studies Curriculum Using Studies Weekly, Emma Roy

Honors Theses

This study examines the representation of the Civil Rights Movement within the Studies Weekly elementary social studies curriculum and evaluates its alignment with culturally relevant pedagogy, critical race theory, and civic education frameworks. Through a qualitative content analysis of twelve assessment questions and accompanying lesson materials, the findings reveal consistent patterns of oversimplification, limited historical nuance, and an overreliance on factual recall. Key themes including systemic racism, collective activist, and diverse historical perspectives are minimized or omitted altogether. These omissions contribute to what scholars identify as curriculum bias, where dominant narratives are privileged while marginalized voices are unheard. The results …

Podcasting As A Marketing And Communication Modality: Exploring Its Impact On Potential New Members’ Satisfaction, Attitudes, And Decision-Making In Utc Sorority Recruitment, Britain Meyers

Honors Theses

This study explores podcasting as a marketing and communication modality within the context of sorority recruitment, specifically examining its impact on Potential New Members’ (PNMs) preparedness, satisfaction, attitudes, and decision-making. Centered around Scrappy’s Sorority Scoop, a four-episode podcast created by the University of Tennessee at Chattanooga 2025-2026 Panhellenic Council, this research investigates how podcast engagement influences the recruitment experience. Using qualitative interviews with eight participants who both joined a Panhellenic chapter and listened to the full podcast series prior to recruitment, the study identifies key themes related to the podcast’s effectiveness. Findings indicate that podcasting enhances PNMs’ understanding of the …

Belonging, Governance, And The Future Of The Nation: Rethinking Citizenship In Tribal Nation Communities, Meadow Carroll

Honors Theses

Tribal citizenship is often framed as a question of identity or legal status, but it functions more fundamentally as a structure of governance that determines who participates in political life and whether nations can sustain themselves over time. This study compares the citizenship frameworks of the Cheyenne and Arapaho Tribes and the Cherokee Nation to examine how different enrollment criteria shape political participation, demographic continuity, and institutional capacity. Drawing on tribal constitutions, enrollment materials, governance records, and voter participation data, the analysis demonstrates that citizenship systems produce measurable differences in how tribal governments function in practice. Systems based on fixed …

The Effect Of Chronic Aerobic Exercise On Working Memory: A Study On Young Adults, Alexandria J. Morris

Honors Theses

Physical activity is essential for optimal health. Cognitive function is a major part of that, and can be evaluated through working memory (WM). This thesis examines the impact of physical activity on WM in young adult college students. It reviews existing research on exercise and WM, highlights gaps in the literature focused on this demographic, and explores the importance of chronic and moderate to high-intensity exercise to WM. There is existing research that examines the correlation of WM and physical activity for both acute and chronic exercise, as well as for children, adults, and older adults. Acute aerobic exercise shows …

Post-Dobbs: Observed Maternal And Infant Health Outcomes, Erin P. Yenawine

Honors Theses

This research investigates how the variance in abortion legislation and access across the United States has impacted infant and maternal health. This builds upon previous research identifying a relationship between abortion policy and quantity of births, (Myers et al., 2025; Bell et al., 2025) abortion policy and infant and maternal health pre-Dobbs (Gardner, 2024), and an emerging body examining the health outcomes post-Dobbs for mothers and infants (Gemmill et al., 2025; Gressler & Lewis, 2025). Scholars indicate that primary contributors to increases in infant mortality may be the continuation of pregnancies with congenital abnormalities and compounded barriers of access to …

“Who Are We?”: Exploring Adolescent Identity And Community Through Collaborative Mural Art, Rachel E. Stacy

Honors Theses

This thesis explores how participation in a high school mural club influences students’ sense of personal identity and community. By creating and leading a mural club, I guided students in designing and painting murals around their school and extending this work into the local community, all focused on how students defined themselves within the context of the school’s motto: “A Star is Rising”. I used qualitative methods including surveys, observational notes, artist statements, and visual documentation to examine and analyze how students experienced identity and collaboration throughout the process. The findings show that the creation of these murals provided students …

Creative Nonfiction Essays, Colby S. Langley

Honors Theses

To write about the present with any authority requires a keen eye for the past. To write from our lives into meaningful creative nonfiction requires a firm understanding that experience is the composite of life experience blending into the current moment. The writing is then drawn irreversibly towards emotion: indulgent and oppressive. The extremity of emotion dictates the difficulty of transcribing the experience onto the page, and violence is a source of both extreme emotion and experience. It is important to note that I am primarily considering personal violence for this essay, while societal and institutional violence have their own …

A Narrative Of The Plague Doctor And How Its Historical Context Translates To The Modern View Of The Plague Doctor, Callie P. Johnston

Honors Theses

The Plague Doctor was once a historical figure who practiced medicine primarily on those infected with the bubonic plague. The plague doctor, as a historical figure and physician, has been transformed in modern culture and media. Originally perceived as a harbinger of both hope and death, the Plague Doctor has undergone a historical transformation from a masked physician to a more stylized character that appears in modern media, digital art, toys, costumes, video games, and popular culture. This thesis examines the evolution of the Plague Doctor from its historical role as a plague physician to its current iconography as a …

Evaluating The Effects Of Urbanization On Meiofauna Biodiversity In Chattanooga’S Lentic Ecosystems Through Gis Applications, Keyle M. Bryant

Honors Theses

Urbanization is a leading driver of biodiversity loss in freshwater ecosystems, yet its effects on meiofauna—microscopic invertebrates that serve as key bioindicators of ecosystem health—remain poorly understood in lentic environments. This study evaluated the effects of urbanization on meiofaunal biodiversity in ten lentic waterbodies across Hamilton County, Chattanooga, Tennessee, by integrating environmental DNA (eDNA) metabarcoding, in-situ abiotic measurements, and Geographic Information Systems (GIS)-based land use analysis. Water samples were collected between January and April 2023 and processed using 18S rRNA amplicon sequencing to assess biodiversity as richness (amplicon sequence variants or ASVs, phylogenetic diversity or PD, and community composition). Land …

How Do Community Gardens Contribute To A Thriving National Park City: A Case Study Of Chattanooga, Tennessee, Ansley B. Barry

Honors Theses

On April 3, 2025, Chattanooga, Tennessee became the first National Park City (NPC) in North America. With a long, industrial history, Chattanooga has made quite the pivot from being widely renowned for its low air quality and particulate pollution to being recognized as the Best Outdoor City in the US by Outdoor magazine. The goals emphasized by the National Park City campaign are creating a city-wide common interest of community-led sustainability efforts. While the initiative highlights many important initiatives to make the city more sustainable and resilient, community gardens are noticeably left out of the conversation. This paper argues that …

Dissociation, Anxiety, And The Vestibular System: Understanding The Impacts Of Anxiety, Panic, And Dissociation On The Vestibular System, Julian Achata

Honors Theses

Previous research indicates that vestibular dysfunction is associated with symptoms of anxiety, panic, and dissociation. The present study will investigate anxiety, panic, and dissociation symptoms and identify the connections between reported symptom severity and vestibular functionality. This study will focus on three different hypotheses: 1) higher levels of dissociation will correlate with increased vestibular disruption; 2) higher levels of anxiety will correlate with increased vestibular disruption; 3) higher levels of panic will correlate with increased vestibular disruption. Six virtually administered self-report measurements were used to identify the variables: Beck Anxiety Inventory (BAI), Depersonalization Derealization Inventory (DDI), Dissociation Experiences Scale-II (DES-II), …

Red, White, And Broke: A Call For Accountability In Government, Mary A. Scott

Honors Theses

This study examines the scale of waste, fraud, and abuse in U.S. federal spending. The purpose of this research is to clarify how fiscal management in the federal government is intended to operate versus how it actually functions. Using a combination of conceptual analysis, existing literature, case-based evidence, and data analysis, findings suggest that the persistence of oversight failures arises from weak implementation, limited enforcement authority of oversight bodies, and an emphasis on recovery rather than prevention practices. This study contributes to the broader discussion of public finance by providing an accessible framework to understand why the foundational federal principle …

Environmental Awareness And Community Sentiments In A Superfund Site: A Study Of South Chattanooga, Mia Dial

Honors Theses

The concept of environmental injustice refers to the disproportionate exposure of marginalized communities to environmental hazards, often resulting from the placement of industrial sites, waste facilities, or other environmentally harmful infrastructure in areas with limited political and economic power. Alton Park, a historically underserved neighborhood in Chattanooga, Tennessee, faces elevated environmental risks due to its proximity to the South Chattanooga Lead Superfund Site and legacy industrial contamination. This study used semi-structured individual interviews to assess community awareness, perceptions, and behaviors related to environmental hazards in Alton Park. Residents generally reported some awareness of the Superfund site, though knowledge was often …

Resilience By Living With The Land And Community: A Case Study Of A Local Food Forest, Olivia Beck

Honors Theses

Imagine a public space where food, leisure, outdoor activity, and community engagement occur in one place, all in an urban forest ecosystem. For many, this is a hopeful vision of the future, and that is exactly what the idea of an urban food forest provides. In agroecology, a food forest or forest garden consists of planting diverse edible plants and mimicking the patterns of natural ecosystems. The intricate planning and design ensure the forest is self-sustaining, much like a natural forest, making it very resilient once established. However, they face many challenges and take time to grow and develop to …

Preliminary Vascular Plant Checklist Of The City Of Chattanooga, Matthew J. Scott

Honors Theses

The City of Chattanooga, Tennessee was designated as a National Park City in April 2025 by the National Park City Foundation. Yet, there has not been a comprehensive vascular flora compiled for the city, though there have been extensive collections and observations made of the plant biodiversity in the area from the late 1800s onward. The goal of this project was to examine both the existing herbarium collections and public observation records from iNaturalist to compile a preliminary vascular plant checklist for Chattanooga, and to include conservation and ecological data for the species currently documented to provide a holistic review …

Growing Change: A Gis Spatial Analysis To Plan Urban Gardens In Chattanooga, Carson A. Chalk

Honors Theses

Food insecurity and limited access to fresh nutritious food in Chattanooga is a prevalent issue, primarily among lower socioeconomic households, and can put strain on overall well-being. This study aimed to identify suitable vacant parcels in Chattanooga where urban gardens could be developed using a GIS-based spatial analysis. Spatial data involving vacant parcels, slope, zoning, and proximity to grocery stores was cross referenced with socioeconomic data focused on poverty rates, vehicle ownership, and mean household income to identify the most suitable sites in areas of greatest need. Sites identified as suitable through GIS were then visited to verify their suitability. …

A Meta-Analysis Of Endometrial Cancer Metabolites As Potential Non-Invasive Biomarkers, Makenna K. Johnson

Honors Theses

Endometrial Cancer (EC) is the most prevalent gynecological cancer in the United States and causes tens of thousands of deaths. Despite its massive negative impact in developed countries, there currently is no reliable screening tool used to diagnose women. Due to this urgent need for minimally invasive and precise techniques to diagnose this malignancy, the metabolomics field has been at the forefront of current research. An untargeted mass-spectrometry approach is used by many researchers to form an initial hypothesis as to which metabolites are key in identifying EC cases. However, there are sometimes inconsistencies between studies. A meta-analysis approach examines …

Glass Vault - A Novella, Christopher M. Young

Honors Theses

This book focuses on several themes, but the core topics I wanted to discuss were family, mental health, and grief. One of the initial premises I wanted to pursue was the creation of a perfect storm in which all enjoyment came at the cost of a painful reality. Amber is a woman who has gone through several devastating events, struggling to accept the reality she finds herself in. By virtue of the incredibly unlikely scenario of finding and falling in love with a rich man, she already has a difficult time believing that the things around her are real sometimes. …

Exploring The Alignment Between Medical School Outcomes With Residency Competencies: A Modified Delphi Study, Sally A. Santen, Luan Lawson, Jose A. Negrete Manriquez, Marjorie Westerveld, Laurah Turner, Anita Wilson, Phd, Yoon Soo Park, Eric S. Holmboe, Michael S. Ryan, Medical School Outcomes Milestone Study Group

JeffMD Academic Affairs

PURPOSE: Facilitation of competency-based medical education adoption would benefit from alignment between medical school (undergraduate medical education [UME]) and residency (graduate medical education [GME]) assessments. This study explores the strength of an a priori alignment of medical school assessments with residency competency domains to guide programmatic assessment and research.

METHOD: In fall 2023, the authors (US faculty with UME and GME expertise) used a 2-phase Delphi consensus approach (9 participants in phase 1 and 16 in phase 2) to independently map medical school assessments to the Accreditation Council for Graduate Medical Education competency domains (0, no association; 1, some or …

Domain-Specific Concussion Knowledge And Reporting In United States Major League Rugby Players, Julie Stamm, Katherine Hunzinger, Owen Sheehy, Christine Baugh

Department of Exercise Science Faculty Papers

Previous research indicates high concussion knowledge is not associated with better concussion reporting, with research examining the relationship between reporting and global concussion knowledge. Concussion knowledge has not yet been investigated in United States Major League Rugby (MLR) players. This study evaluated domain-specific concussion knowledge, concussion history, and reporting behaviors among active MLR players. In a cross-sectional design, 207 MLR athletes (age 26.6 ± 3.4 years) completed a survey assessing concussion history, knowledge, and nondisclosure reasons. While in the MLR, 24% reported an undisclosed concussion, with nondisclosure reasons related to a lack of concussion knowledge, a desire to continue playing, …

The Law Of Healthcare Administration, 11th Ed., Sallie Sanford, J. Stuart Showalter

Books

The Law of Healthcare Administration, 11th Edition,aims to provide future healthcare leaders with the most accurate, engaging, and practical guide to this complex area of law. Its extensively revised 15 chapters include coverage of the American legal system, medical malpractice law, tax exempt standards, fraud and abuse investigations, abortion regulation, healthcare initiatives undertaken by the second Trump administration, and more.  Its new case law examples involve not only hospitals and physicians but also other institutional providers (such as community health centers and nursing homes) and individual allied health professionals (such as pharmacists and nurse practitioners).

The 5i’S Framework Of Creative Self-Leadership, Maggie Cubbler

Creativity and Change Leadership Graduate Student Master's Projects

The purpose of this Master of Science in Creativity and Change Leadership project is to establish a framework for Creative Self-Leadership (CSL) development. Viewed through a gendered lens, the framework addresses how women's intrapersonal processes—the 5I's of introspection, interoception, intuition, imagination, and intrinsic motivation—are often compromised by sustained environmental and systemic pressure, and proposes practices designed to restore and strengthen these internal guides.

By recalibrating these intrapersonal processes toward accurate self-knowledge, CSL employs the science of creativity to lead women in their own quest for change, agency, and resilience while remaining cognizant of the dynamic between her and her environment.

Techno-Imagination: Elevating Creativity Through Xr And Ai, Christopher Spitzer

Creativity and Change Leadership Graduate Student Master's Projects

Techno-Imagination: Elevating Creativity Through XR and AI explores the history of creativity and computing technology, supported by research and academic literature, and looks at the possibilities of a convergence between the two. In parallel, a brief biographical story of the author shares how a passion for creativity emerged, along with a growing interest in science and technology—specifically extended reality—which ultimately came together in the creation of this master’s project. The project also highlights how the Creative Problem Solving (CPS) process was used alongside AI bots and twenty research-based creative thinking skills in developing the business model canvas. Finally, the outcome …

Systemic Barriers To Educational And Employment Attainment Among Individuals With Substance Use Disorders, Mollie B. Mccann Poblocki

Creativity and Change Leadership Graduate Student Master's Projects

Substance use disorders (SUDs) and opioid use disorder (OUD) represent one of the most pressing yet poorly understood public health crises in the United States. Despite decades of clinical intervention, recovery outcomes remain deeply unequal, not because individuals lack motivation, but because the structural systems surrounding them are fundamentally broken. This project explored that reality through a comprehensive literature review examining how systemic barriers across educational systems, labor markets, poverty dynamics, and healthcare infrastructure shape vulnerability, treatment access, and recovery outcomes for individuals with SUDs. Major findings revealed a consistent socioeconomic gradient of harm: individuals with lower educational attainment, unstable …